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Archive for the ‘Preventative Medicine’ Category

Worcester researchers study link between microbiome and Alzheimer’s disease – WCVB Boston

Tuesday, October 13th, 2020

Researchers in Worcester are taking a closer look at Alzheimer's disease by studying the bacteria in the gut."Our main theory on this is that your gut microbiome influences your systemic immune profile which then affects your brain immune profile," said Dr. John Haran, associate professor of emergency medicine and microbiology and physiological systems at UMass Medical School and clinical director of the UMass Center for Microbiome Research.His team was just awarded a $3.3 million grant from the National Institute on Aging to explore how the gut microbiome can affect cognitive functioning.Haran said the microbiome is a complex organ made up of billions of cells and 70% of the immune system lies there.Last year, his team reported people diagnosed with Alzheimer's dementia share certain gut microbiomes that fuel inflammation. Now, they will study know what else that could mean."If the inflammation is being driven from the microbiome, there's two things that could happen. One it could be preventative, to not have the inflammation happens in the first place. Second, if that inflammation is kind of cured or quieted down, the immune system would have time to then to recover back," Haran said.The center is actively recruiting seniors living in the Worcester area, both with an Alzheimer's diagnosis and those without. To inquire about participating in the study, you can call 508-925-0348 or email umass.emresearch@gmail.com .

Researchers in Worcester are taking a closer look at Alzheimer's disease by studying the bacteria in the gut.

"Our main theory on this is that your gut microbiome influences your systemic immune profile which then affects your brain immune profile," said Dr. John Haran, associate professor of emergency medicine and microbiology and physiological systems at UMass Medical School and clinical director of the UMass Center for Microbiome Research.

His team was just awarded a $3.3 million grant from the National Institute on Aging to explore how the gut microbiome can affect cognitive functioning.

Haran said the microbiome is a complex organ made up of billions of cells and 70% of the immune system lies there.

Last year, his team reported people diagnosed with Alzheimer's dementia share certain gut microbiomes that fuel inflammation. Now, they will study know what else that could mean.

"If the inflammation is being driven from the microbiome, there's two things that could happen. One it could be preventative, to not have the inflammation happens in the first place. Second, if that inflammation is kind of cured or quieted down, the immune system would have time to then to recover back," Haran said.

The center is actively recruiting seniors living in the Worcester area, both with an Alzheimer's diagnosis and those without.

To inquire about participating in the study, you can call 508-925-0348 or email umass.emresearch@gmail.com .

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Worcester researchers study link between microbiome and Alzheimer's disease - WCVB Boston

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Susquehanna Wellness Clinic to Serve Primary Care Needs of the Area – GANT News

Thursday, October 8th, 2020

The Susquehanna Wellness Clinic, a primary care office located in Frenchville, is opening its doors in November of 2020 to begin serving adult patients health and wellness needs.

The clinic is focused on holistic, person-centered approaches to care, aiming to build trusting relationships and provide the personalized care to each individual.

Dr. Baltazar Corcino, M.D. and Jamie Bush, CRNP will be staffing the clinic, and will be supported by a comprehensive team of medical professionals. Both individuals have a long-standing history of providing quality and meaningful care in the Clearfield community.

Corcino has a proud history of caring for the residents of Clearfield County, and is excited to continue this work in the clinic. Hes worked in internal medicine in emergency room, private practice and hospital settings.

Bush, a board-certified nurse practitioner, specializes in family medicine and has additional experience in ICU and ER settings as well as urgent care and neurosurgery settings.

The clinic will serve a variety of needs for adult patients 18 and older. These services include adult medicine, geriatric care, preventative medicine, immunizations, annual wellness visits, health care screenings, laboratory testing, chronic care management and interdisciplinary team planning.

Additionally, the clinic will provide transportation when necessary to seniors 60 and older to clinic appointments, conduct in-home visits to patients physically unable to come into the clinic and Telehealth services to connect virtually when coming in for an appointment isnt an option.

The clinic will be hosting an open house to the public on Oct. 21, from 3 p.m. 5 p.m. The event will include facility tours, meet and greet with staff and light refreshments.

The clinic will officially open its doors on Monday, Nov. 2, 2020 to begin serving patients. Hours of service are Monday Friday, from 8:30 a.m. 3:30 p.m., by appointment.

If you have any questions about the clinic or are interested in becoming a patient, please call 814-765-2695 or e-mail info@susqwell.com. Dont forget to follow the clinic on Facebook for announcements and upcoming events.

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All the president’s medicine: How doctors are treating Donald Trump – ABC News

Thursday, October 8th, 2020

The leader of the free world is now fighting his own battle with a virus that's laid global siege. A concoction of some experimental treatments is helping him do it.

On Monday evening, after spending three nights undergoing treatment for COVID-19 at Walter Reed National Military Medical Center, President Donald Trump returned home to the White House.

Standing on the balcony, Trump removed his mask and gave a double thumbs up to the crowd.

Minutes later, in a produced video released via tweet, Trump claimed his victory over the virus.

"I didn't feel so good," Trump said to camera. "Two days ago I felt great, like better than I have in a long time... better than 20 years ago."

"Now I'm better -- and maybe I'm immune! I don't know. But don't let it dominate your lives. Get out there. Be careful. We have the best medicines in the world, and they're all happened, very shortly, and they're all getting approved."

Trump has been recovering under close watch from a team of physicians administering world-class care and special access to therapeutics. Monday, his personal physician, Dr. Sean Conley, told reporters Trump "has continued to improve" over the past 24 hours, having "met or exceeded all standard hospital discharge criteria."

There is not enough evidence to confirm when, or if, some level of immunity to COVID-19 occurs, and how long it might last. Experts say right now, the president is likely still contagious. The Centers for Disease Control and Prevention says COVID-19 patients should stay isolated for at least 10 days after the start of their symptoms or after receiving a positive test. Trump's doctors said Monday he "may not entirely be out of the woods yet," but they are using what they have called a "multi-pronged approach" in his treatment, which will continue as he recuperates at home.

Trump's diagnosis early Friday morning plunged a nation already in chaos into further crisis, uncertainty and fear for his well-being of urgent concern amid a pandemic that has now claimed the lives of more than 210,000 Americans.

Over the weekend, Trump assured the public he was feeling "much better" since being given a sundry mix of medication, some of it experimental, which he called "miracles coming down from God."

A car with US President Trump drives past supporters in a motorcade outside of Walter Reed Medical Center in Bethesda, Maryland on October 4, 2020.

The full picture of what treatments Trump has received thus far is still evolving, as still-outstanding questions in the public interest are met with more fulsome, forthright detail. Monday, his medical team told reporters they continue to treat him with the intravenous antiviral Remdisivir, and have continued with the steroid Dexamethasone.

Of the combination of medicines and supplements now being deployed to help him recoup, many are not yet definitively known to beat the novel coronavirus, but are thought to help mediate the virus' symptoms and severity in the body. There is, as of now, no drug "approved" by the FDA for COVID-19 treatment, though some have been given emergency authorization.

Some experts have raised questions about the uniquely robust drug regimen now being administered to the president. Dr. Lew Kaplan, president of the Society of Critical Care Medicine and a surgeon at the University of Pennsylvania, said these types of "non-standard processes" can " invite error." This exact combination of medications has not been tested together yet in large-scale studies.

NIH treatment panel guidelines member Dr. Mitchell Levy assured that there is no "miracle" drug yet available.

"If you look at our guidelines, we just don't think there's enough evidence to recommend one way or the other," Levy, chief of pulmonary critical care at Warren Alpert Medical School of Brown University, told ABC News. "So little is proven. It's like the Wild West, and he's the president of the United States, and so you feel like: 'I want to do anything I can to prevent the disease from progressing.' That often drives us to do things outside of the normal standard. And that is never a good idea. There's a standard of care for a reason. With COVID-19, part of the problem is, we're never really sure what the standard of care is."

Other experts are more optimistic

"All of these treatments shift the odds in your favor," Dr. William Schaffner, professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center, told ABC News. "None of them is a magic wand that suddenly makes you feel better," he added, explaining that Trump's treatment plan was made respecting the parameters of available science.

The president's doctors have said he is taking at least eight medicines and supplements. The timeline of Trump's illness remains murky; however, here's what we know about what the president is taking -- and when he started taking it.

Remdesivir

Before Trump was to check out of Walter Reed and head back to the White House Monday evening, his physicians told reporters they planned to administer the fourth dose of the antiviral drug Remdesivir. He has been receiving Remdesivir intravenous infusions since Friday, within 24 hours of revealing his diagnosis. Initially developed for Ebola treatment, it has solid evidence supporting its use in COVID-19 patients, according to the National Institutes of Health, and based on that promising potential, the FDA has issued emergency authorization for its use. Typically given to patients with severe infection, it works by hindering the virus' replication in the body.

Once Trump settles back at the residence, his doctors say, they've made arrangements for the fifth and final dose of his treatment course, Tuesday evening.

In this undated image from video provided by Regeneron Pharmaceuticals on Friday, Oct. 2, 2020, vials are inspected at the company's facilities in New York state, for efforts on an experimental coronavirus antibody drug. Antibodies are proteins the body makes when an infection occurs; they attach to a virus and help the immune system eliminate it.

Regeneron monoclonal antibody "cocktail"

Trump is taking a cocktail of two synthetic, pharmaceutical versions of what occurs naturally in the body to fight off infection. A mix of monoclonal antibodies, this one made by biotech company Regeneron, is thought to be promising, though still in its experimental phase. Late last month, Regeneron published positive, yet preliminary data for its cocktail treatment showing it improved symptoms in patients without severe disease.

While it is not yet FDA-authorized, Trump has been granted access to it under "compassionate use," enabling him to get it outside of a clinical trial. A Regeneron spokesperson confirmed to ABC News that Trump's medical staff reached out to them for permission to use their monoclonal cocktail, and it was cleared with the FDA.

Dexamethasone

Trump's personal physician told reporters Monday afternoon that they continue to treat the president with the steroid Dexamethasone, in response to temporary drops in his oxygen levels.

A corticosteroid used for its anti-inflammatory effects, Dexamethasone has solid evidence supporting its use in COVID-19 patients, according to the National Institutes of Health. In severe cases it's thought steroids can fight the haywire inflammation caused by the virus; however in milder cases, one trial found "no benefit (and the possibility of harm) among patients who did not require oxygen."

When pressed by reporters Monday afternoon, Conley, Trump's personal physician admitted that the president had, in fact, been given supplemental oxygen twice since falling ill. Previously, Conley had said he was not sure if Trump had received it a second time, and would have to check with the nursing staff.

Regarding those two times Trump received supplemental oxygen, Conley said, "it wasn't required."

Schaffner told ABC News that though the press and public have not seen the president's chest X-rays or CAT scans, prescribing the steroid is "a borderline indication within the physicians' prerogative."

Whatever was on those CAT scans, Schaffner said, along with his oxygen levels, seems "undoubtedly what targeted physicians' decision to add dexamethasone," in hopes that it would moderate his immune system response's "collateral damage."

Famotidine

Famotidine, more commonly known by its brand-name Pepcid, is an FDA-approved for heartburn, not COVID-19. Some early, observational studies showed improved survival amongst hospitalized COVID-19 patients. Still, experts caution that observational studies are no substitute for high-quality, randomized trials designed to demonstrate a treatment's true effectiveness. A trial for an intravenous infusion of famotidine is still ongoing.

Zinc

This is not the first time Trump has said he is taking Zinc. In mid-May, Trump told reporters he had been taking both Zinc and Hydroxychloroquine as a "preventative" measure. On Friday, as his doctors listed off the treatments he would now receive for his infection, Zinc again appeared on the list. As an over-the-counter supplement, Zinc is subject to less regulatory oversight. Its virus-fighting properties have shown mixed results in prior studies. Schaffner described Zinc, along with Vitamin D, as "adjunctive therapies, the benefits of which are not known."

"There is some data that Zinc is helpful if you have the common cold," he said. "But not COVID."

Vitamin D

Trump's doctor announced the president is also taking a vitamin D supplement. Studies show an association between vitamin D deficiency and a greater risk of and dying from COVID-19. However, most people get enough vitamin D from their diet. At this point, studies have not demonstrated that taking a vitamin D supplement can help fend off COVID-19 related illness, although there is an ongoing, randomized trial that may offer clarity.

Melatonin

Melatonin is a naturally-occurring hormone with antioxidant, anti-inflammatory properties also helping regulate circadian rhythms. Some researchers have suggested that the supplement might help compliment other COVID-19 treatments. At this point, research showing that this supplement helps COVID-19 patients is limited, but there is at least one small, randomized study ongoing in the U.S.

Aspirin

Available over the counter, aspirin have been taken internationally as concomitant treatment for COVID-19 -- in response to the strange prevalence of clotting and pulmonary embolism doctors have seen crop up in some patients. Aspirin may also help reduce low grade fevers. Saturday, the president's medical team said he no longer had a fever, after less than a day's time. On Monday afternoon, his medical team told reporters Trump "has not been on any fever reducing medications for over 72 hours," but declined to elaborate.

For people for people who don't have increased cardiovascular risks or COVID-19, daily aspirin use is no longer recommended as a way to reduce the risk of heart attacks, because the risks are now believed to outweigh the benefits.

Before taking any medication, people should always check with their doctor, as every patient's situation is different.

This report was featured in the Monday, Oct. 5, 2020, episode of "Start Here," ABC News' daily news podcast.

"Start Here" offers a straightforward look at the day's top stories in 20 minutes. Listen for free every weekday on Apple Podcasts, Google Podcasts, Spotify, the ABC News app or wherever you get your podcasts.

ABC News' Eric Strauss and Ben Gittleson contributed to this report.

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All the president's medicine: How doctors are treating Donald Trump - ABC News

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ARH webinar on preventative healthcare set for October 5 – Times Tribune of Corbin

Thursday, October 8th, 2020

Lexington Appalachian Regional Healthcare (ARH) invites adults across Central Appalachia to participate in a webinar on Preventative Healthcare and How it Saves Lives.

Participants will learn what screenings and immunizations they should have at every age, how living a healthy lifestyle can change your health outcomes andthe importance of maintaining healthcare appointments during a pandemic.

Speakers Dr. Elizabeth Nelson and Dr. Paula Jones will discuss adult preventative screenings by age and gender, beginning at age 18; the importance of regular health check-ups; the importance of a healthy lifestyle; immunizations you should have; COVID safety precautions at hospitals and clinics and the ease of telemedicine.

Elizabeth Thompson Nelson, MD, FHM, practices at Beckley ARH Hospital in Beckley, Wva. Dr. Nelson is board certified in internal medicine, providing care for adults. She diagnoses and treats chronic illness, promotes health and disease prevention and is dedicated to excellence in patient care. Dr. Nelson completed her residency and internship in internal medicine at Georgetown University Hospital in Washington, DC, and her doctor of medicine degree at the Howard University College of Medicine, Washington, DC.

Paula Jones, DO, practices at ARH Medical and Specialty Associates in Harold, Ky. Dr. Jones treats adults and children over 13 years of age, diagnosing and treating both acute and chronic illnesses. She provides routine health screenings and counseling on lifestyle changes in an effort to prevent illnesses before they develop. Dr. Jones completed her doctor of osteopathy from Kentucky College of Osteopathic Medicine in Pikeville, Ky. and is a board-certified Osteopathic Family Physician.

Adults who would like to participate in this webinar can register for the event at the following link: https://zoom.us/webinar/register/WN_vgycht7fQ_uZKOEgKIewTQ

We are making critical coverage of the coronavirus available for free. Please consider subscribing so we can continue to bring you the latest news and information on this developing story.

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An apple a day? Four GPs on the top health advice they give and follow – The Guardian

Thursday, October 8th, 2020

GPs tend to talk too much. We give a lot of advice, admits Dr Arash Ahmadi from Brisbanes Racecourse Village Family Practice.

Thats because education is one of the biggest parts of a general practitioners job, Ahmadi explains. A lot of the work they do is around preventative medicine, which means encouraging patients to adopt the lifestyle modifications that will keep them healthy.

So what are the golden rules GPs live by and advise others to follow? To find out, we asked four doctors for the medical advice they think we could all benefit from.

I recommend to everybody to stay away from processed food as much as they can, and to eat as fresh as possible, says Dr Ahmadi.

That means avoiding frozen or pre-prepared foods anything thats ready-made and just needs to be heated up as well as things like sausages.

One of the main issues with processed food is the materials they add to the food to keep it fresh or fresh-looking or fresh-tasting colours, flavours, chemicals, Ahmadi says. He explains that those additives can cause liver damage and high cholesterol.

He advises patients to delete your UberEats app, try to cook as much as you can and look at the nutritional panels on the back of foods in the supermarket. We dont have to be perfect, he says, but weve got to try.

And as for whether Ahmadi follows this advice himself? Absolutely. Nutrition is one of my passions in life.

Something I live by and truly believe in is to do some exercise first thing in the morning, says Dr James Stewart from Southside Medical Practice on the Sunshine Coast. He says the current health guidelines recommend exercising five times a week, for 30-40 minutes per session.

And thats at moderate intensity, Stewart says. So the way I explain that to my patients is that if youre going for a walk, you want to not quite be able to finish your sentences because youre that puffed. Going for a walk where youre comfortable the whole way is good but not great.

He says regular exercise will help with weight control, reduce your cardiovascular risk and do good things for your brain.

The main benefits from exercise, I feel, is to do with mental health. You get a good release of endorphins and serotonin when you exercise and that leads to an improved mood and sense of wellbeing. So if you exercise in the morning, youve got a nice buzz that sets you up for the day.

One piece of advice I tell a lot of patients who are above 65 and at risk of cardiovascular disease is that an aspirin a day keeps the doctor away, says Dr Hany Eldebeiky from Seymour Medical Clinic.

Eldebeiky says a daily aspirin can help to prevent heart attacks and strokes, something that over-65s are at increased risk of. A lot of factors contribute to that, like high cholesterol and high blood pressure, Eldebeiky explains. So when we take an aspirin, this thins the blood a little bit, which improves the blood pressure and prevents clotting or blood coagulation.

He is keen to stress, though, that every individual is different and that it is very important that you consult with your own GP before taking aspirin, or any medication as there are risks as well as benefits. This advice wouldnt apply to a patient with a history of ulcers, or someone at risk of stomach bleeding, for instance, and there are many other people for whom the medication may not be suitable.

But a daily aspirin has worked for him: Im not 65, but I take an aspirin a day and because Im high risk my dad had his first [heart] attack in his 40s, Eldebeiky says. Since I started taking aspirin, I havent had anginal or chest pain again.

Dr Kelly-Anne Garnier, from QV Medical on Elizabeth Street in Melbourne, believes she couldnt live without meditation and mindfulness. Its well known to modulate or reduce the impact of stress, she says. Its something that is evidence-based and effective.

Garnier says that stress is considered to be inflammatory, which can put us at risk of a whole cohort of physical and mental ailments.

All sorts of inflammatory conditions would be worse with stress: skin diseases, auto-immune diseases. Even things like the risk of heart attack and stroke increase with stress, she says. The other impact of stress is sleep disturbance, and we know sleep disturbance is bad for us for all sorts of reasons. And an increased stress level puts us at risk of anxiety, depression and burnout.

As for how to get started with meditation? It is as simple as breathing, becoming aware of ones breath and trying to step outside of oneself and observe oneself, she says. But also, importantly, doing this in a non-judgemental fashion. And thats what takes a little bit of practice the non-judgement. But there really is no right or wrong way [to do it].

This article was amended on 7 October 2020 to stress that individuals must consult with their own general practitioner before taking aspirin.

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An apple a day? Four GPs on the top health advice they give and follow - The Guardian

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Trump doctor Conley degree from Philadelphia College of Osteopathic Medicine: What it means – On top of Philly news – Billy Penn

Thursday, October 8th, 2020

Love Philly? Sign up for the free Billy Penn email newsletter to get everything you need to know about Philadelphia, every day.

The doctor whos been treating President Donald Trump for the coronavirus has roots in Philadelphia. Its where he trained in medicine.

Dr. Sean Conley, the 40-year-old whos been at the forefront of national health updates lately, has been the presidents physician for two years. He grew up in Doylestown, and graduated from Central Bucks High School East in 1998. His medical degree comes from the Philadelphia College of Osteopathic Medicine.

The Philly higher ed institution is not your average medical school. Turns out Conley doesnt actually have an MD degree.

Instead, hes a DO a doctor of osteopathic medicine. With that certification, Conley can do everything a regular doctor can do, like prescribe medicine and perform surgery in all 50 states.

The training is different in that it takes a more holistic look at the body than traditional medicine. It emphasizes primary care, and practices that encourage the body to heal itself rather than the immediate prescription of medicine or use of surgery to correct problems.

At first, the practice was highly controversial. During the first decade of PCOMs existence, it wasnt even legal in Pennsylvania. Over the next two centuries, debates over osteopathy continued, with traditional physicians critiquing its more controversial practices like the in the late 1800s idea to shake a child to cure scarlet fever.

In recent years, the stigma has mostly dissolved as the training and practice have themselves become more legit. Now, earning a DO degree requires the same training as an MD, plus extra coursework.

Conleys Philly alma mater is considered a pioneer in the field, and helped see it through to the modern day.

The first person to bring osteopathic medicine to Philadelphia was a woman named Clara Martin. In 1899, the city directory listed her as an osteopath, working from an office on 67th Street near the Cobbs Creek Parkway, just south of Mount Moriah Cemetery.

That same year, two physicians named Snyder and Pressly founded what would become PCOM, then called the Philadelphia College and Infirmary of Osteopathy.

Philly was experiencing a general boom in medical institutions right then, notes a published history of the school called To Secure Merit, by Carol Benenson Perloff. Episcopal Hospital, German Hospital (now Lankenau), Jewish Hospital (now Einstein Medical Center) and Presbyterian Hospital were all founded between 1849 and 1882.

PCOM first opened at 12th and Market, filling two rooms inside a 13-story office tower. Within a year, it outgrew that space and relocated to the Witherspoon building at Juniper and Walnut.

Enrollment kept growing. Many students were people inspired by seeing osteopathic doctors step in after traditional medicine had failed.

Alum Arthur Flack, who graduated in 1906, said he got interested when he saw osteopathic medicine helped cure cases of typhoid fever amid an epidemic in his hometown of Butler, Pa.

When I first became a studentmy marvel was as to the intense devotion manifested by the small group of physicians headed by you, Flack said in 1925, according to Perloffs book. Without such sincere devotion, Osteopathy today would be only a memory in Pennsylvania.

Thing is, osteopathy wasnt even legally recognized when PCOM first opened its doors.

The first attempt to legalize it in Pennsylvania passed through the state legislature in 1905, but was vetoed by then-Governor Pennypacker. It wasnt until 1909 that a Governor Stuart signed the bill to allow osteopathic doctors to apply for state licensure, 10 years after the Philadelphia college was first founded.

Licensing made the practice more popular, and PCOM continued to outgrow its facilities. The school moved to Spring Garden Street, then to 33rd and Arch, and eventually to North Broad Street.

Some drama: Before the legalization of osteopathy, the college had raised about $3,000. But the founders continued not to pay faculty with actual money for their teaching they compensated them only with stock in the school.

In 1904, faculty started demanding payment. The founders refused, and there was a theatrical back-and-forth in which the schools deans threatened to resign unless the two founders resigned. Shockingly, both founders did resign, and a board of trustees was established that still exists today.

By 1910, PCOM was considered a pioneer when it became one of the first to adapt to new statewide legalization requirements, and create a four-year program, which it maintains to this day.

After those gazillion relocations and expansions, PCOM landed at its current campus on City Avenue at the Bala Cynwyd border.

The school currently has almost 2,000 students, across areas of study like clinical psychology, biomedical sciences and forensic medicine. Like osteopathic medicine schools nationwide, its really tough to get in. In 2019, nearly 7k students applied for just 441 spots in the program.

Dr. Conley, Trumps doctor, has a degree that takes four years to complete. The first two are spent learning basic and clinical sciences, and the second two doing hands-on work in teaching hospitals.

While enrolled, the Bucks County native likely got plenty of Philly experience, since students spend four months working in city neighborhoods at PCOMs Community Healthcare Centers.

After their four years, some students declare a specialty and spend more time in school. PCOM reports that a majority of its grads end up in family medicine, general internal medicine, OB/GYN or pediatrics.

In general, osteopathic medicine has grown in popularity in recent years seen as a more hands-on version of health care. DOs work to understand how all parts of the body are connected, and take a major focus on preventative and primary care.

An osteopathic medicine student in New York told the New York Times in 2014 she became interested in the practice after a standard MD said shed need surgery to correct her chronic ear infections but then she went to a DO, who corrected the problem by stretching her neck, she said.

The infection happened because of fluid in the ear, said the student, Gabrielle Rozenberg, and the manipulations opened up the ear canal.

The practice has become widespread enough that PCOM has opened two more campuses, both in Georgia. According to the American Association of Colleges of Osteopathic Medicine, about 25% of all medical students today are training at an osteopathic school.

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When Will Concerts Return? Experts Weigh In. – HuffPost

Thursday, October 8th, 2020

During the COVID-19 pandemic, weve taken restaurant dining outside, replaced international travel with national park road trips and put work meetings that still probably shouldve been emails on Zoom.

But one experience that seems almost impossible to imagine in our new reality is the traditional live music show. While virtual concerts can provide great joy and entertainment, fans have lamented that they dont capture the true feeling of an IRL show.

But when will we get the real deal again? HuffPost asked health experts to share their thoughts on the concert experience in time of coronavirus and their predictions for the future of live music.

Concerts are particularly risky in this pandemic.

While weve figured out relatively safe ways to bring back pre-pandemic activities like restaurant dining, concerts pose many more challenges in the coronavirus era.

Concerts bring together some of the highest-risk behaviors for COVID-19 transmission, said Brian Labus, a professor at the University of Nevada, Las Vegas School of Public Health. We have large groups of people standing in close contact for an extended period of time while singing and cheering. Plus they would need to keep removing their masks to smoke or drink a beer. If we try to change these things, we would really change the entire concert experience.

The social aspect of traditional live music concerts makes it difficult to transition to a scenario where concertgoers are asked to enjoy the music in a socially distanced setting.

- Dr. Kristin Dean, board-certified physician and medical director at Doctor on Demand

As large gatherings, traditional concerts are by nature potential superspreader events. The lack of personal space and constant flow of respiratory droplets as people sing or speak loudly to each other make most music shows a prime location for virus transmission.

Enjoying live music with friends has begun to feel like a remnant of a better time as the impacts of a global pandemic continue to change the way we interact with the world, said Dr. Kristin Dean, a board-certified physician and medical director at the telemedicine service Doctor on Demand. The social aspect of traditional live music concerts makes it difficult to transition to a scenario where concertgoers are asked to enjoy the music in a socially distanced setting.

She noted that attempts to hold live shows with (and without) social distancing, masks and additional precautions have sparked controversy and led to questions around how to move forward while remaining safe.

In August, German researchers conducted an experiment that aimed to answer those questions. To study the spread of the novel coronavirus in a concert setting, they outfitted about 1,500 people with tracking devices and fluorescent hand sanitizer. Participants then attended three simulations of a concert one as if there were no pandemic, one with moderate restrictions and one with more strict safety measures.

While the results have not yet been published, the study has already faced criticism for the risks involved in the experiment and questions about its accuracy given participants were not permitted to drink. Still, the findings could offer helpful insights into the possibilities for live music going forward.

Sean Gallup via Getty Images

Well need to have the virus under control first.

The experts who spoke to HuffPost were in agreement that the virus must be much more under control before we can bring back the concert experience. Most pointed to the need for a very low level of coronavirus transmission in communities, which is best reached through a widely deployed vaccine.

For concerts to be as safe as possible, youd need to have herd immunity established, said Dr. Kim Kilby, a family and preventative medicine physician and senior leader at MVP Health Care. To achieve this, experts have suggested that 75% of the population must either have received the vaccine or survived the infection.

The U.S. is nowhere near the point of herd immunity, and to try to reach that level without a vaccine could cost millions of lives, overwhelm hospitals, further harm the economy and lead to a number of long-term health challenges for those who survive severe cases.

There are multiple vaccine candidates that look promising, but the CDC has said they wont be widely available until mid-2021. Thus, many artists and venues have already moved their concerts to dates next summer, and they may have to push them again as the year unfolds.

No large gatherings such as concerts should be held at least till the middle or end of next year, said Jagdish Khubchandani, a professor of public health at New Mexico State University. Concerts are not essential, and people should find alternate ways of entertainment ... The pandemic wont last forever, but the more we engage in events like concerts, there will be prolonged recovery from the pandemic.

A vaccine will be a big help, but not the total solution.

It is difficult to anticipate when or even if we will return to the traditional live concert setting that we were accustomed to prior to the COVID-19 pandemic, said Dean. Vaccinations, immunity and decreased spread of the virus may result in a safer environment to consider returning to concertgoing as we knew it, but it is too early to tell.

Even if we reach the herd immunity threshold in the next year or so, traditional concerts may still pose a risk to many, as the virus will not simply disappear. As a result, venues will likely need to take precautions to protect concertgoers health, and some music fans may still be hesitant to attend a big show.

It would be a better situation if we had vaccines, but realistically we may have to have a hybrid of recommendations, said Dr. Jake Deutsch, a physician and founder of Cure Urgent Care. He emphasized the need for venue safety measures and rapid testing in addition to greater immunity.

Testing being readily available, accurate, cost-effective, and providing rapid results can also facilitate the return of traditional concerts, noted Dr. Sachin Nagrani, a physician and medical director for the telemedicine and house call provider Heal.

Outdoor concerts will resume before indoor shows.

Outdoor events will return sooner given the lower risk of transmission of the virus when outdoors due to easier ability to distance, naturally high ventilation and sunlight sanitizing outdoor surfaces, said Nagrani.

Indeed, concert organizers have already been testing out new outdoor music experiences amid the pandemic. In August, English artist Sam Fender performed for 2,500 fans at the Virgin Money Unity Arena the U.K.s first socially distanced music venue.

Ian Forsyth via Getty Images

The setup featured spaced-out private platforms, food and drink delivery and strict distancing rules. Six weeks after the venue opened, however, new COVID-19 restrictions to address rising case counts forced it to shut down.

Although outdoor concerts may be a good first step in the return of live music events, changing seasons and everyday weather conditions can be limiting. Keeping people spaced apart is also not necessarily easier outside.

A Hamptons fundraiser concert featuring the Chainsmokers came under fire in July after photos and videos from the event showed egregious social distancing violations.

Masks will be part of the equation for a while.

While the prospect of an effective COVID-19 vaccine looks promising, health experts have made it clear that it wont completely shield everyone from the disease. Therefore, face masks will still be an important part of our lives, especially in high-risk situations like large public gatherings.

People need to understand that even as the vaccine is rolled out, we will need to continue to wear masks and physically distance to prevent spread of coronavirus, said Krutika Kuppalli, an infectious diseases physician and vice chair of the IDSA Global Health Committee.

Mask-wearing will be part of the concert experience of the future, at least for little while, as will other important restrictions, Dean noted.

The same safety measures we recommend for reducing the spread of COVID-19 apply to live music shows, including social distancing, wearing a mask, frequent hand-washing, disinfecting communal surfaces prior to use and remaining home while you are sick or if you have had a known exposure to COVID-19 within the past 14 days, she said.

Expect more checkpoints.

Just as weve seen restaurants do temperature checks before allowing patrons to dine, music venues will likely implement similar measures as concertgoers arrive at shows.

While those checks will not be the only safety installments into the concert experience, we can reasonably expect that temperature checks, questionaries and other protections might be built into concerts in the future, said Kilby.

Concert organizers will have to monitor the spread of the virus in the community and surrounding areas where attendees may travel from. As rapid testing becomes more widely available, venues could also require proof of a negative result.

The reduced capacity will make it difficult, or even impossible, for the bands and promoters to break even.

- Labus

Point-of-care testing to get done in the moment when they arrive would be a game-changer, noted Deutsch.

If there are going to be more checkpoints, however, he believes venues need to rethink the ways they funnel attendees into the space to allow for social distancing. Touchless technological solutions and sanitizer stations at entry and exit points are obvious additions as well.

Organizers will need to reduce crowding.

As in-person concerts resume, organizers will likely have to limit the number of attendees to allow for social distancing. Still, Labus noted, thats not enough to prevent crowding.

Its not just about reduced capacity, we have to reduce the density of the crowds as well, he said. Even if you only allow 10% of the venues capacity, those people will all crowd near the stage unless you have assigned seating that keeps them apart. That means having small crowds spread out in large venues, which would drastically change the concert experience.

Venues with built-in seating may be at an advantage, but other spaces can of course add chairs or other mechanisms to ensure proper spacing.

I do think that outdoor venues will return before indoor ones, Kuppalli said. I would also think smaller venues would be more likely, and places with assigned seating like the Hollywood Bowl would be preferential this way you can have people appropriately distance and wear masks.

Kevin Mazur via Getty Images

Artists and venues will continue to face challenges.

Its no secret the concert industry is struggling in 2020, and a vaccine or gradual resumption of live shows will not cover the financial losses wrought by the pandemic.

The reduced capacity will make it difficult, or even impossible, for the bands and promoters to break even, said Labus. Given the logistical challenges of mounting national tours, I would expect to see smaller acts in smaller venues before we see the return of large arena shows.

In a recent survey of about 1,350 live industry professionals, more than 72% expressed concern about their companys ability to survive COVID-19. A similar number said they do not believe the government has given proper consideration to the plight of the sports and live entertainment industry as compared to other impacted industries such as airlines, hotels, restaurants/retail.

Its important for music fans to support their favorite artists and venues as they navigate this new reality, whether that means donating to relief funds, buying tickets to virtual events or spreading awareness.

There are options to enjoy concerts right now, such as online or drive-in performances, said Nagrani. I highly encourage supporting your favorite artists and venues via the available options given our current constraints.

Virtual concerts and viewings of pre-recorded shows have their own entertainment value, but as Kilby noted, its not quite the same as the powerful live experience.

We can expect that the concert experience will be different going forward, and innovative artists are already trying new ways of engaging fans, she said. Throughout the pandemic, drive-in concerts have gained in popularity as an alternative to traditional concerts, but they are not accessible everywhere. They also dont allow for the same experience or sound quality that a traditional in-person concert would have.

While theres a lot of uncertainty surrounding the concert experience in the age of COVID-19, one thing we know for sure is that its going to take some time for the industry to recover.

As Khubchandani emphasized, We have to be patient.

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Women In Longevity Medicine And The Rise Of The Longevity Physician – Forbes

Thursday, October 8th, 2020

Dr. Evelyne Bischof speaking at the 2020 China-Israel Summit on Longevity Medicine

Over the past decade, we witnessed unprecedented advances in the field of biogerontology, and the massive convergence of biotechnology, information technology, AI, and medicine. And now we are witnessing the birth of a new field of longevity medicine, which integrates the latest advances in many of these fields of science and technology. My definition longevity medicine is advanced personalized preventative medicine powered by deep biomarkers of aging and longevity.

And, like in the field of AI for drug discovery, women are at the forefront of this revolution and there were precedents when we had to look for a male physician to make a conference panel more diverse.

One of the physician-scientists who stands out in this area is Dr. Evelyne Yehudit Bischof. I first got a note with a request for more information on one of our research papers from Dr. Bischof on December 30th, 2019 while in Shanghai. A request I almost ignored due to the heavy workload but accidentally I looked at her profile which was highly unusual. In brief, Evelyne is a German medical doctor with an MD from Max Planck Institute for Molecular Biology and Genetics, who interned at Columbia University, and Harvard MGH and Beth Israel Medical Deaconess, attending physician at University Hospital Basel in Switzerland, and associate professor at Shanghai University of Medicine and Health Sciences. She fluently spoke six languages including German, Russian, and Mandarin Chinese, which was quite impressive. The second time we met was at Human Longevity Inc, in San Diego when she was interviewing with one of the most influential entrepreneurs and investors in longevity biotechnology, Dr. Wei-Wu He to join HLI as a longevity physician.

Dr. Evelyne Yehudit Bischof

The longevity industry is rapidly emerging and longevity clinics are being set up in various parts of the world. So I decided to ask Eva a few questions to elucidate this new and emerging industry.

Alex: Eva, we know each other for almost a year and you do not fail to impress with your academic publications, public lectures, and clinical work. You are as close to the longevity physician as it can possibly get. Can you tell us a bit more about yourself and about the work that you are doing on the clinical side and on the research side?

Dr. Evelyne Bischof: Thank you, Alex it is an honor to be so generously introduced by a true innovator, scientist and entrepreneur, as well as a longevity KOL and allow me to revert the compliment. I am a rather globally oriented internal medicine specialist, with training and work experience in Germany, USA, Switzerland and China. For almost a decade now, I have been splitting my time between Shanghai and Basel, creating a path that allowed me to conclude my residency and fellowship, develop translational and clinical research niches and collaborators, as well as to engage actively in academic medical education. While my clinical work was mostly based in a university clinic in Basel in internal, intensive and onco-hematologic medicine wards, my scientific pursuits and academic teaching were mostly based in Shanghai, where I went along the track from a junior lecturer to an associate professor in 2016. My research focused primarily, but not exclusively, on oncology and being an internist at core on geroncology and precision medicine in general internal medicine. Geroncology is a crucial field that investigates the very much interlinked pathways of aging and tumorigenesis, leading to the epidemiological observation that age is the number one risk factor to develop cancer for all.

Both Switzerland and China are innovative hubs with strong medical and bioscientific profile, which allowed me to learn from some of the finest experts worldwide. The frequent travels and splitting my life between continents were not always easy, but - coming from a simple background of non-academic farmer and handcraft family Alongside - I will be forever grateful for all the great people I met and worked with, the abundant cultural nuances and differences I was able to learn and appreciate, the stimulating and constructive exchange and so much more in soft and hard skills, on professional and personal level. with the emergence of AI-based solutions in the clinic and with the rise of longevity medicine, my passion and efforts are now focused on these domains, while I continue my clinical practice in the university hospitals, academic lecturing at two medical schools (currently in Shanghai - due to COVID-19-related travel restrictions) and research/public speaking (globally - thanks to COVID-19-related shift to virtual communication).

Alex: Can you tell us about your perspective on the emerging field of longevity medicine starting from your own definition of the field?

Dr. Evelyne Bischof: With pleasure! My personal definition of longevity medicine is clear: it is precision medicine driven by deep aging biomarkers. Surely, the definition is succinct, but extremely deep. Precision medicine is per se an enormously complex and dynamic field, driven by multimodally mined data and their constant re-evaluation, reannotation and reiteration to provide qualitative and quantitative using AI-algorithm outputs applicable for clinical practice. Longevity medicine is a to say the next generation of precision medicine that evaluates the patient within the reference range for the patients ideal age (usually 20-30) and is looking for ways to reduce the gap between the current parameters and the parameters of maximum physical performance for the ideal age. Deep aging clocks as quantifiable, trackable and accurate biomarkers of aging and an indispensable component of longevity medicine. Without being able to actually measure the biological age and its changes due to interventions, longevity medicine cannot be performed. I strongly believe that this field of medicine will revolutionize healthcare and change the mindset of all the doctors, the policy makers, the stakeholders and above all: the patients. Allow me to add that I consider each of us as a patient we all suffer from aging! I also believe that citing Peter Diamandis in the future, if a physician wont be using A.I. in guiding diagnosis and therapy, it'll be a malpractice". This said, I would love to add that we need more passionate physicians in longevity and this can only be achieved with an appropriate educational setting, which will be inaugurated this month by Deep Longevity and collaborators.

Alex: What do you see as the most promising developments in the field of longevity medicine that can truly push the needle and add a few decades if not more to the healthy youthful life of the individual?

Dr. Evelyne Bischof: Besides of deep aging clocks and AgeMetrics, which I truly without cronyism embrace and would encourage all physicians to implement in their daily practice, I see a big potential in gene therapies, in (natural and designed) gerolytics and senolytics, as well as supplements that will show safe efficacy in combating senescence from the molecular to system level. Studies on AKG, rapamycin and metformin are already fueling this hope. Of course, all interventions will require a prior comprehensive precision health assessment and continuous monitoring. For the latter, the wearables and applications will certainly bring us even faster to an extension of a healthy and productive lifespan.

I am encouraged by the fact that there are two major developments, perpetuated by the racing speed of longevity medicine and geroscience. Number one: doctors are shifting from putting a patient on meds to putting a patient on a personalized longevity protocol that becomes a natural, integral, rewarding part of their lives. Number two: society is realizing that it is not important how old one is, but how one shows his/her own age. Remembering this allows one to make sure he or she does not become a slave of the myths about the elderly, but also to be mindful that even at an early chronological age, one might actually experience silent accelerating aging due to modifiable risk factors or pathomechanisms.

Alex: Without promoting Human Longevity Inc or Health Nucleus 100+, can you tell us what an average person with an average income can do to increase their performance and longevity?

Dr. Evelyne Bischof speaking at the 2020 China-Israel Summit on Longevity Medicine

Dr. Evelyne Bischof: This is a very valid question in fact, when it comes to reasonably boosting performance and creating a good base for longevity, one does not necessarily be wealthy. The components of the magic mixture are the well-known pillars of preventative and functional medicine: exercise, nutrition, supplements, moderation. However, longevity physicians are now able to customize the right proportions of each for a specific person, minding the biovariability, comorbidities, chronological age, but also lifestyle and preferences. In an extreme generalization, I would suggest caloric restriction via intermittent fasting to an overall healthy person, with at least an A-Z vitamin and mineral supplement, 15-30min workout at least 3 times a week, moderation in substance use to the minimum, but with permissible enjoyment, if needed (alcohol and cigarettes), a minimum of 6 hours of sleep without interruption, circadian rhythm (regular times) of sleep and food intake, no meals at night (at least 4 hours before night rest) and very importantly cognitive activities (books, foreign languages, crosswords), preferably rewarding ones so that the psychological wellbeing area is also covered. Everyone is able to use stairs as their gym, to not to eat before sleep, to choose water over other drinks, to laugh aloud to oneself and to learn text parts by heart (because decelerating psychological aging and cognitive decline are crucial aspects of healthy longevity). I recall I was always reading the ingredients and how to use? texts on tubes during shower, so as not to waste the time. My first sentence in Russian was actually the instruction of how to use a shampoo.

Dr. Evelyne Bischof speaking at a conference on aging and longevity

Alex: And if someone has nearly unlimited access to capital, what should they do?

Dr. Evelyne Bischof: I believe, as in any other business or property of this particular population, the individuals should seek good investments and insurance in relation to their health and the health of their significant surrounding (family, friends, workers etc.). The investment should involve as precise diagnostics as possible, that harnesses all cutting edge and untapped potential of the human genome, deep quantitative phenotyping, complete -omics and -ioms (e.g. microbiome, epigenomics, metabolomics, proteomics etc.), advanced imaging with radiogenomic algorithms etc. As it is a dynamic field, constantly evolving and implementing new features and/or better ways of interpretation, such diagnostic comprehensive checkups (or part of them) should be repeated regularly. The insurance part does not relate to a contracted policy, but to a complex entity of lifestyle recommendations and interventions lead by an entrusted longevity physician (basically a physician that can list and pronounce the aforementioned terms), who understands and permanently advances in the field, being able to combine human and artificial intelligence and customize an individual approach of prevention and (if needed) therapy for a specific patient. In addition, the leading physician needs to comprehend and implement the personal challenges and preferences of the patient, such as mostly disturbed wake-sleep rhythm, irregular and unhealthy social meals, acute and chronic stress exposure, irritability or fatigue etc., to create a program that will be realistic, allow the patient to remain compliant and engaged based on his/her educated informed decisions. Simply said: knowing 150 GB of a patients data, a physician of trust should be a good lead towards identification, mitigation and elimination of actionable diseases (years and decades ahead) and risk factors that curb the quantity and quality of life.

Alex: I know maybe 3-4 people like you in the world, who have an MD, are actively engaged in biomedical research, and work with some of the high-profile clients who are spoiled with the most cutting-edge medical care provided by the top medical institutions. And all of them are women. Why do we see such gender imbalance in the field?

Dr. Evelyne Bischof in the clinic

Dr. Evelyne Bischof: Again thank you very much for this encouraging statement, this time speaking on behalf of women in medicine, academia and STEM. As you know, one of my side areas of interest is the study of biological sex differences in various diseases, predominantly cancer, and ultimately also on the sex (biological) and gender (socio-cultural) variables influencing pathomechanisms, diagnostic and therapeutic decisions, resulting differing toxicities, follow up strategies and outcomes (recovery, chronification etc.). It was natural to engage in debates and develop curiosity about the gender distribution in academia in general. Recently, with an ad hoc group of collaborators from Europe, USA and China, we demonstrated in a Lancet Oncology paper that female representation at the podium, meaning as keynote speakers and scientific committees at the largest oncological conferences in China. Our data showed that China is much more inclusive, without an intensive active promotion or directives towards gender quotas. As you know, I am a big fan of this country, but this quantitative study once again showed how impressive this country is and perhaps we found one of the contributing factors for the nations booming leading role in biotech and medicine.

Overall however, there are indeed significant differences in various fields, as well as an overall underrepresentation of females in leadership and podium roles. I am happy to see that in longevity science and medicine, we have dedicated females that can unfold their passions and translate them into viable solutions that do impact the public and individual health. As always, the reasons are multifold, but perhaps the most important one is that in longevity, driven women are emerging in an inclusive environment that embraces non-discriminating and non-stigmatized diversion. In different words: the longevity field seems to embrace inclusion at the same (ultrarapid) pace as STEM and medicine are evolving. The sex and gender differences clearly allow to generate creativity and innovation it is a mutually perpetuating process. Last but not least, it is thanks to committed male mentors and collaborators that actually value D&I (diversity and inclusion) intuitively or knowingly (based on evidence that diverse teams outperform the less diverse one by over 35%). Most male KOLs in longevity, like yourself, promote and underline the importance of D&I. On a final note myself, personally, I have always remained at the unconscious side when facing a person I work with. Accountability, motivation and fairness have proven to be non-gender related in my experience as I have faced many challenges being a (previously young) female, permanent foreigner and on top of that blond. The typical situation at a round dinner table in China with 12 male professors usually ended up with us all laughing at my gambei with water being the only discrepancy from the norm.

Dr. Evelyne Bischof speaking at the 2020 China-Israel Summit on Longevity Medicine

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White House Outbreak Exposes Contact Tracing-Shaped Hole In US COVID Response – TPM

Thursday, October 8th, 2020

In the days after it became clear that the White House had suffered a COVID-19 outbreak, many who had been in the building or interacted with the President wondered aloud: why hadnt they heard from contact tracers?

But though the idea of a legion of agents armed with the know-how to trace and detect an outbreak may be comforting, its one of a series of misconceptions that surround the idea of contact tracing in the U.S.

Though the concept has been successfully implemented in countries around the world and in a few locations here, the U.S. as a whole lags far behind where it needs to be in order to have contact tracing function as an effective tool to mitigate and control the pandemic.

Beyond the lack of infrastructure, personnel, and funding for the local public health departments that conduct contact tracing, the approach also faces a conceptual problem due to the massive amount of virus that continue to spread across the country.

Theres just too much viral load for contact tracing to be effective right now, Gary Slutkin, a former WHO epidemiologist who fought disease in Africa, told TPM.

Whats left is a bleak but revealing picture: a key tool needed to bring the pandemic to an end is missing.

Contact tracing operates on a simple principle: if you can identify who an infected person has been in close contact with, you can get ahead of COVID-19 by quarantining those exposed to the virus.

The approach is an essential component of any pandemic mitigation and prevention strategy, allowing public health officials to catch and halt transmission chains as they occur.

But its a huge ask. A report from the Association of State and Territorial Health Officials estimated that nearly 330,000 contact tracers would be needed nationwide, assuming a ratio of one contact tracer per one thousand citizens.

And contact tracing is most suited for the beginning and ends of the epidemic curve,Josh Michaud, associate director for global health policy at the Kaiser Family Foundation, told TPM times whencases are few enough that individual outbreaks can be tracked down and potential cases contained.Thats not the situation the U.S. finds itself in today, with only somewhat-mitigated spread.

In places where you have a city or a county or something where theres just widespread transmission, too many cases to count, in that kind of situation you dont see contact tracing having much of an impact, Michaud said.

Coupled with the overwhelming rate of new cases in the U.S., slow testing turnaround times and lack of resources for the local public health departments that actually trace contacts drastically reduce the effectiveness of an already sparsely used program.

If results are being delayed 7-10 days, contact tracing almost is worthless because you cant identify people quickly before theyve already spread the virus, Michaud noted.

Public health departments around the country are already equipped to handle the function in limited ways due to past experience with tuberculosis and HIV/AIDS, Dr. William Schaffner, a professor of preventative medicine at Vanderbilt University Medical School, told TPM.

Its traditionally done at the local level, by the city or county health departments, and it takes some training, he added. It depends on gaining the trust of the person whom youre interviewing for the case.

We havent had a lot of resources, Schaffner added.

Congress appropriated $25 billion for COVID-19 testing and contact tracing in March as part of the CARES Act.

But since then, no new federal dollars have been earmarked for the task.

Experts told TPM that in an ideal scenario, COVID-19 transmission would be reduced to a level where contact tracing would be effective: individual outbreaks could be caught and stopped by local public health departments.

If you think of the population as being infected in a more circumscribed way the White House, for example contact tracing there can be very, very helpful, Schaffner added. You can button things up in that particular population. But if you think of our population at large, regardless of what were doing with contact tracing, it has a much less notable effect.

And though some areas like New York City have managed to stand up groups of contact tracers to try to identify and halt new outbreaks as they occur, many areas with underfunded health departments have had trouble finding the money and time to track down the contacts of people infected with COVID-19.

Several proposals would see billions of dollars go towards local public health departments, allowing them to hire scores of contact tracers that would be able to meet the level the country needs to keep virus transmission at a level far lower than it is today.

ASTHO and Johns Hopkins released an estimate saying that 100,000 contact tracers was the minimum needed nationally to rapidly identify, contain, support, and re-testindividuals who are infected and have been exposed.

The Biden campaign has latched onto that number, committing to establishing a U.S. Public Health Job Corps that would be composed of at least 100,000 people to work on public health issues around COVID-19, including contact tracing. Biden has also said that he would establish a U.S. Public Health Service Reserve Corps that would deploy around the country to train local health departments to detect and respond to COVID-19 outbreaks.

Other questions around massive budgetary losses in local government linger. Public health departments are already constrained by a steep drop in tax revenue, making it difficult to add more services.

The HEROES Act, House Democrats bill aimed at addressing the pandemic, includes a $75 billion appropriation for testing and contact tracing which would go part of the way towards addressing this.

But, Michaud argued, to have avoided outbreaks in the fall and coming winter, the country should have made these investments months ago.

The time to invest was yesterday, he said. We needed to make sure to have those in place for what could be a surge in cases going forward as the weather gets colder.

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The Dangers Of Chocolate And Xylitol Toxicity In Dogs And Cats – Severna Park Voice

Thursday, October 8th, 2020

By Dr. Monica Capella l Associate Veterinarian, VCA Calvert Veterinary Center

With the fall weather comes the beautiful parts of the season carving pumpkins, apple pies, the changing of the leaves and the excitement of Halloween. With the hocus pocus, spooky ghosts and holiday fun also comes one of my favorite parts of all the candy! Its no surprise that our furry friends also find these sweet treats appealing, but for them, there are real dangers hiding behind the shiny wrappers.

Chocolate toxicity is a common problem we see this time of year in veterinary medicine, and we are going to go through what signs to look for in your pets, some tips and tricks for minimizing exposure for your pets, and helpful resources for owners to contact in the event of ingestion. At the end of this article, we will also highlight some major points about xylitol toxicity.

There is a significant variation in how your dog may respond to chocolate toxicity relative to other dogs. Smaller dogs and pre-existing conditions like liver, kidney, heart and neurologic disease may make your dog more susceptible to chocolate toxicity. Mild to moderate signs we look for in dogs are vomiting, increased urination, diarrhea and restlessness. Additional warning signs can include agitation, hyperactivity, ataxia (stumbling gait), increased heart rate, breathing faster, high temperature and high blood pressure. Severe toxicity may cause tremors, seizures, severe abnormal heart rhythms, coma and death, which is why identifying exposure and being as informed as possible is critical when contacting an animal poison control center.

Tips And Tricks For Owners

Helpful Links/Resources For Owners

https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4952115

https://veterinarypartner.vin.com/default.aspx?pid=19239&id=6107960

Xylawhat? Xylitol!

Xylitol is a sugar substitute compound that has become more popular in todays market and is found in products like sugarless gum, toothpaste and certain brands of peanut butter. Your dogs normal response to sugar intake is the same as in the human body ingestion of sugar leads to release of insulin to help move that sugar into the tissues to be used for energy. The problem with Xylitol is that we can see an increased release of insulin (three to seven times greater) in dogs, leading to severely low blood sugar. Signs can include vomiting, tremors, incoordination, collapse, and seizures within 30 minutes 12 hours of ingestion. Unfortunately, Xylitol ingestion in dogs can be a two-part problem as the liver becomes affected, leading to acute liver failure, bleeding and clotting problems. If you suspect your dog has ingested Xylitol, contact your veterinarian and poison control center immediately to learn the next steps and have your pet evaluated.

Helpful Links/Resources For Owners

In regards to chocolate and Xylitol toxicity for your pets, the best medicine is preventative medicine. Staying informed and limiting your pets risk of ingestion will help make this fall season safe and enjoyable for everyone in the family, including your canine and feline companions. The veterinarians and staff at VCA Calvert Center thank you for your time and dedication to the care of your pets, and they are available by phone or email if you have additional questions or concerns. We wish everyone a season of safe and happy memories during these times!

The veterinarians of VCA Calvert Veterinary Center have over 35 years of combined experience helping pets stay healthy and happy. For more information about how to care for your exotic pet, call today for an appointment at 410-360-PAWS or schedule online at http://www.vcahospitals.com/calvert. VCA Calvert Veterinary Center is conveniently located at 4100 Mountain Road and has been proudly serving the Pasadena community for over 16 years.

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Can you be LGBTQ+ and Christian? – The Scribe

Thursday, October 8th, 2020

BrandonFlanery

bflanery@uccs.edu

Can you be LGBTQ+ and Christian?

Thisquestion is critical, as itstheprimary reason why U.S. Americans are leaving evangelical churches.

According to Public Religion Research, 70 percent of millennials are alienatedbychurchesjudgments towards LGBTQ+individuals, and with good reason.

According to the Trevor Project, LGB youth are almost five times as likely to have attempted suicide compared to heterosexual youth, and according to the American Journal of Preventative Medicine, religious LGBTQ+ youth are significantlymore likelythan their non-religious peers to attempt suicide.

We cant afford to not have an informed opinion on this. There are literally human lives at stake, andunless youre burying yourself underground (literally or symbolically),you willcome into contact withLGBTQ+peopleat some point in your life.Were statistically everywhere. Shoot, you might even have one as a kid. What are you going to do then?

With all that in mind, my hope is that I can help you start the journey with this article.

First off, why me? Well, because Im Christian, gay, was raised in the church, worked in ministry,Ileft ministry and Christianity because of the pain I endured. But Icame back, researched and prayed through my position on being gay and Christian, and Im now buildingbelievr, an app that exists tohelp LGBTQ+ Christians find belongingandconnection in love.

I dont say that to toot my own horn. Its to help build some ethos as quickly as possible(after all, Im already breaking the character limit; my editor is going to kill me).

So,forsakeof brevity,Im going to point you to two amazing resources that will elaborate far more succinctly that I ever willbe able toin a short article. TheReformation Project and Beloved Ariseare two organizations that havecatalogued resources like books and videos by scholars to show you that it is okay to be queer and Christian.

Readingany of the books they recommend is a great start. In summary, they will all tell youthe same thing: the condemnationofLGBTQ+ peopleiswrong, andany verse thatalludesto the condemnation of LGBTQ+ peopleismissing context and has been mistranslated over the centuries.In fact, most of the verses about homosexuality inthe Biblewere translated as pedophilia all the way upuntilthe 1950s.

But Ill let the experts speakonthis,because theyll do a far better job. What I want to do in this article isa little more meta. I want tobring into question what it means to be a Christian and how that affects those whoare LGBTQ+.

When growing up,I was told insensately, Christianity isnt a religion; its a relationship. Heres the problem: I would hear it from the most religious people. Heres the other problem: even though itsa hypocriticalclich, theyre right.

Religion says, Heres what you do to please God Heres what you do to get to Heaven Heres what you do to be a good (insert religiousnoun)

Its all about whatthe humandoes in relation to the deity in question.

Thats not what Jesus came to do; He didnt come to create a new way of getting to God.

The reason Christianity (in its purest form) isactually differentthan all other religionsis that humanity had been trying to get to God for millennia, and we werent able. Were not able.Instead, God said, Im coming to them, and Im making all this right.

The word gospelliterally translates to good news. If were talking about another way to get to God, thats not good news. None of us can make it, regardless of what the magic formulais.Thats thepointof the Bible hundreds of humanstooka good shot at getting to God,and none of them did.So,God had to come to us.

Christianity is truly just about trust.Its not about what I do to get to God, including my sexuality.Its about knowing humanity has done a shit job of being perfect. We keep fucking it up. We were never enough. But Jesus was enough, andtrustingin His love, in His goodness,leads us to loving Him and loving others. Thats the work of Christianity.

I want to pointtotwo places in the Bible to make a point here.

The first one is Genesis 1-3 (you know, the verses that make it so that Christians dont believe in evolution). In this story Adam and Eve ate from theTree of theKnowledge of Good and Evil (religion), and it cursed them and all of humanity. If we continue to live out of this tree of religion, were going to keep cursing humanity. Just look at historyanyone heard of the Crusades? Or the wars in Ireland? Or whats currently happening inKashmir?

Instead, were called to life in the Tree of Life, which is living in connection to Jesus (relationship),who is the embodiment of Love.

Which brings me to my next story in Acts 15.

In short, heres what happened:non-Jews, or Gentiles,were becoming Christians;Jewish Christianswere complaining they werent obeying the law; everyone was confused on what to do. Were these Christians who wouldnt obey the law actually saved?

Heres the crazy part, and not a ton of Christians talk about this.

In response to this unrest, the 12 disciples of Jesuscame together at the Council of Jerusalem andprayed. After which, they decided thatGentileChristiansshouldfollow threerules.

What? Can humans just change the rules? They can if theres a higher rule that is helping them navigate the world. A new commandment I give you:Love one another. As I have loved you, so must you love one another(John 13:34).

Jesus came to fulfill the law, to fulfill religion,because we couldnt make it to God. After He took care of it all, He says, Go love.

The reason the 12 disciples of Jesus gave instructions (not laws)to theseGentileChristianswas not becauseJesus got it wrong.They were fulfillingHis new instruction; they wereteachingthe firstChristians tolovepeople in a new context that was foreign to them.

And thats what Christians are called todo to love God and people inourcurrent context. Andaccording to that context,wevalue women,we valueegalitarianism,we value racial justice, we value equity,andwe value ourLGBTQ+brothers and sisters because they are worthy of love.

The culture to which the Bible was written used sodomy as a way of degrading conquered nations, of using power to abuse those who were powerless. It wasnt abouta sharedlove. That wasnt their context. But that is our context now, and Christians can fulfill the words of Christ,loving our neighborsby believing and trusting that their LGBTQ+ brothers and sisters and non-binary siblingsareloved in the eyes of God,andthatHis sacrifice through Jesus was more than enoughfor us all.

Regardless of gay or straight, cis or trans, none of us could make it and all of us believed God was cruel. The message of Christ is that He was able and that He is love, if we believe.

Who then is the one who condemns? No one. Christ Jesus who died more than that, who was raised to lifeis at the right hand of God and is also interceding for us. Who shall separate us from the love of Christ? I am convinced that neither death nor life, neither angels nor demons, neither the present nor the future, nor any powers, neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord(Romans 8:34-39).

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The role of precision medicine in the pandemic response – VatorNews

Thursday, October 8th, 2020

Investments into precision medicine companies is rising, but how much has it helped?

What healthcare will look like when the COVID pandemic is over is tough to say right now. What new technologies will emerge from this? What new data sets are created and how they are shared? Will healthcare shift to being more preventative? That will likely take years to sort out.

One interesting thing to look out for will be if we see a rise in precision health. This is healthcare that is tailored to each individual person, using their genes to figure out what treatments will work best for them. In a pandemic like COVID, knowing how to treat each person, and what drugs they will react best to, could have saved countless lives.

Precision health, however, didn't see the same type of rise in adoption as a space like telehealth, which a recent reportspeculated would encompass over 20 percent of all patient visits this year,representing $29.3 billion of medical services. Perhaps the difference is that telehealth services have been around for a long time, even if nobody was really using them before they were forced to; precision heath, on the other hand, is a relatively new space. The Human Genome Project was only completed in 2003, after all.

Still, the pandemic does seem to have increased investor interest in the space, which perhaps shows that they are betting on it to take on a bigger role if we were to go through another similar pandemic (knock on wood!).

In 2018, there was $565 million invested in 17 deals into startups using artificial intelligence to improve precision medicine.

In Q2 of this year, there was $5.1 billion invested in the healthtech space, representing 22 percent of all VC dollars invested during the quarter. Of that, $2.6 billion came from Series A investments into biopharma companies, compared to $2.3 billion in all of 2017.As such, valuations for these companies have increased by at least two-fold since the start of 2019.

There are also digital therapeutics, which compromises precision medicine. Thesetherapeutics interventions are driven by software programs that use data to prevent, manage, or treat disorderand diseases. Investments in this category have grown an average of 40 percent year-over-year for each of the the last seven years; it reached $1 billion in 2018.

Another subset of precision medicine ispredictive analytics, which uses data to predict what will happen to each patient, and to personalize their care based on those outcomes. This is a market that is expected to reach $7.8 billion by 2025.

Some of the biggest precision medicine companies include 23andMe, which has raised $786.1 million; Tempus, which has raised $620 million; Helix, which has raised $353 million; and PathAI, which has raised $90.2 million.

2020 investments into precision medicine

The largest deal so far this year into a precision medicine company is Grail, which focuses on understanding the human genome to provide medical breakthroughs in oncology. The company announced a $390 million Series D financing round in may from new investors including Public Sector Pension Investment Board and Canada Pension Plan Investment Board, as well as two undisclosed investors, along with existing backers including Illumina. This brought its total funding tomore than $1.9 billion.

Other precision medicine companies that have raised funding this year include:

Be sure tocheck out theHealthcare in Politicsevent tomorrow(register forhere!)where multiple panels of experts, policy makers and lawmakers who will be on hand to discuss topics related to healthcare policy and decision making, including the role of precision medicine in the pandemic response.

(Image source: hdfgroup.org)

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Will a Face Mask Protect Against Both The Flu And COVID-19? Here’s What Doctors Say – Women’s Health

Thursday, October 8th, 2020

Sure, people wear face masks these days mostly to help prevent the spread of COVID-19. But now experts say there might be an added benefit of wearing your mask when out in public: It could lower your odds of contracting the flu.

Like COVID-19, the flu is a virus thats mainly spread through infected respiratory droplets. Wearing a mask will likely decrease transmission of the flu as well, says Richard Watkins, MD, an infectious-disease physician in Akron, Ohio, and a professor of internal medicine at Northeast Ohio Medical University.

Rajeev Fernando, MD, an infectious-disease expert in Southampton, N.Y., expects that the 2020-21 flu season will actually be milder than usual because of coronavirus-prevention methods, including widespread mask wearing. Its the same concept as preventing the spread of COVID-19, he says. Masks can help prevent respiratory droplets from spreading.

That being said, you should still plan on getting a flu shot and practicing other flu prevention methods this year. Here's what you need to know about protecting yourself from the fluvia face masks and other measuresthis year.

FWIW: The Centers for Disease Control and Prevention (CDC) does not currently list wearing a face mask in its main recommendations for preventing the spread of the flu. Instead, the CDC recommends avoiding close contact with people who are sick, covering your coughs and sneezes, washing your hands well with soap and water, avoiding touching your eyes, nose, and mouth, and cleaning and disinfecting objects that could be contaminated with the viruses that cause the flu.

However, the CDC does point people to everyday preventative measures for stopping the spread of COVID-19 as part of its tips for preventing the spread of the flu. And among those measures is advice to wear a face mask whenever you go out.

Medical staff wear surgical masks when treating flu patients, Fernando says, and a cloth face mask can likely offer at least some level of protection. And if someone who has the flu wears a mask and the people around them also wear a mask, the odds of the infected person making others sick drops dramatically, Fernando says.

The CDC specifically says that getting vaccinated against the flu this season is more important than ever and lists these as important reasons to get your shot:

At this point, I would recommend as many preventive measures that we know are successful, Fernando says. Theres really no reason not to get your flu shot. We will have a weaker flu season if everyone does that.

This content is imported from {embed-name}. You may be able to find the same content in another format, or you may be able to find more information, at their web site.

And, if you continue to practice known ways of preventing the spread of COVID-19, like wearing your mask, avoiding crowds as much as possible, social distancing, and washing your hands regularly, your odds of contracting the fluand COVID-19should plummet, Watkins says.

Sounds like a win-win.

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California Wildfires Have Burned 4 Million Acres And The Season Isn’t Over Yet (KPBS Midday Edition Segments) – KPBS

Thursday, October 8th, 2020

"The 4 million mark is unfathomable. It boggles the mind, and it takes your breath away," a spokesperson for Cal Fire said.

Speaker 1: 00:00 California's disastrous wildfire season is now one for the record books. Roughly 4 million acres have burned that is far and away. The largest area destroyed in one season in modern California history. Climate change has been named as the major culprit in the state's bigger, hotter, faster moving wildfires in recent years, but a new report finds another and potentially manageable cause of these tremendous fires. That is where California is building new homes and the fire safety measures required in that construction. Joining me is reporter Elizabeth wile co author of an investigative report on wildfire and California housing policy published by pro Publica and Elizabeth. Welcome to the program. Thank you so much. Attention has been given to climate change as the crucial element in our devastating wildfires and rightly so, but what role does back country development play in sparking those fires?

Speaker 2: 01:02 Well, it plays a very large role. Um, climate change, of course, underlies this, all our heating planet and weather patterns are making it worse, but where humans live in our environment makes a tremendous difference in both where wildfires start, how many homes and lives are lost in those fires, how difficult those fires are to fight once they do start and how possible it is to manage the landscape well in a sort of preventative medicine way before fires started all.

Speaker 1: 01:38 And in your article, there's this figure that 95% of wildfires are caused by humans.

Speaker 2: 01:44 Yes. So the landscape does need to burn. California is a Mediterranean landscape and fire is a natural part of that landscape, but yes, 95% of fires are sparked by human. Someone drives down the road, a spark flies from something, somebody start to barbecue. As we all know, PG and E has started an awful lot of fires in the state. So the ignitions almost always are human caused. So when you have more humans living in an environment, the more likely it is that fires will start.

Speaker 1: 02:21 What's driving the development of homes in the back country or the wild land, urban interface area as it's

Speaker 2: 02:29 Yes, it's a mouthful. The wild land, urban interface. Well, the California has a housing crisis, as we all know. So the state desperately needs housing housing in a lot of coastal urban centers is extremely expensive. So people for financial reasons often move further and further away from those cities, uh, into areas that are now known as the wifi, the wild land, urban interface, and of those areas are often beautiful and people like living there. So there are many reasons people are getting pushed outward, but housing policy is a very large part of it.

Speaker 1: 03:09 When housing developments are planned, is there any state requirement that the wildfire risk needs to be assessed?

Speaker 2: 03:16 No, there are many different requirements and different municipalities, but this week Newsome vetoed a bill that for the first time would have made wildfire risks are part of what's known as the housing allocation process. It's very detailed in arcane and that part is not important. But as of now, wildfire is not whilst our risk is not considered in warehousing needs to be developed in California.

Speaker 1: 03:44 And the experts you spoke with said that it's really necessary to have a requirement at the state level about that. What is their reason?

Speaker 2: 03:53 Well, most, most housing decisions are made on the local level and therefore are very influenced by local politics. So for better or worse, a lot of more affluent suburbs and cities are very resistant to housing. There are a lot of underpinnings to this, but people will say traffic is already bad and their schools are already underfunded and their public transportation already. Isn't good enough. And many other reasons that often housing is resisted. So that becomes part of the issue at the local level, that if you leave it up to the locals and they don't want housing, it won't get built. But if there's state oversight sort of looking at the big picture in California and what needs to happen, we might move in the right direction more quickly now. Okay.

Speaker 1: 04:42 In your report, you say that it would not be possible to stop people from living in these remote areas, 11 million people in the state live in the wild land, urban interface, but are there ways to make the houses safer?

Speaker 2: 04:56 Yes. There are many ways to make the houses safer. And I, and I highly recommend to listeners if they live in a fire prone area to just, you know, look it up. But the first and most important thing to do is make sure you have a good roof, that you have a roof that is flame resistant, most houses burn, because embers blow in the wind and land on somebody's roof. And the house burns down as fire people often like to say, houses don't burn up. They burn down. So that's the first thing. And then people will find that they should clear vegetation out from around their houses. So if an Ember flies, the house is less likely to burn. There are a lot of fairly simple things that homeowners can do to make their own home safer. And a lot of experts believe that the community level of organization is really the most important thing relative to keeping our neighborhood safe. That if one house burns, the next is more likely to burn, but if your neighborhood can get together and everybody make your homes, fire safe together, you'll really put yourself at far less risk.

Speaker 1: 06:06 I have been speaking with pro public, a reporter, Elizabeth Weil and Elizabeth. Thank you so much for speaking with us. Thank you.

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Donald Trump Promises Seniors The Same Care He Got, For Free, Admits He Was "Very Sick" As Election Looms – HillReporter.com

Thursday, October 8th, 2020

Donald Trump has often been criticized for failing to follow through on promises. His latest promise, in a video clip posted to his Twitter feed, is that older Americans in an age range to be particularly vulnerable to COVID-19 will have the same medical treatment he received, at no cost. With reports that Joe Biden crossed the critical 270 elector vote mark, Trump described himself as capable of handling the crisis, and his opponent as unable to do so.

In the clip, Trump offers no plan for how he will provide this, doesnt say whether the treatment will be accessible to all Americans or just senior citizens, and doesnt address whether any other medical care, including preventative care, would be provided. Instead, he admits he was very sick when he went into the hospital Friday (a sharp contrast with the previous statements insisting it was merely a precaution), and that the medications provided, including experimental treatments that are not yet publicly available, worked for him so quickly that he could have left the next day. Then he promises that hell make the same available to my favorite people in the world seniors, for free.

To my favorite people in the world seniors. Im a senior. I know you dont know that. Nobody knows that, the president begins. We have medicines right now I call them a cure, he says. I went into the hospital a week ago. I was very sick. He says that after taking the medications made available to him through Walter Reeds top-tier medical team, he could have walked out the next day. Sooner.

He promises these treatments will be available immediately, and takes credit.

To seniors, he says, They like to say youre vulnerable. Youre not vulnerable. Youre the least vulnerable. But for this one thing, you are vulnerable. And so am I. But I want you to get the same care that I gotYoure gonna get the same medicine, youre gonna get it free. No charge! And were gonna get it to you soonWere gonna take care of our seniors, all free. He does not offer any specifics about when immediately might be, or what kind of plan hes proposing to make the treatments available.

Trump then transitions into bashing his opponent in the 2020 election.

The president was checked into Walter Reed last Friday, assuring the public it was just a precaution. Since then, information released about his diagnosis, timeline, and treatment has included contradictions, and the White House has refused to state when Trumps last negative COVID-19 test was. Though he is still within the 10-day quarantine period, the president has been releasing videos, maskless, apparently filmed outside the White House. Its not clear whether he is still on the steroid treatment he began receiving while in the hospital.

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A Face Mask Might Help Protect You Against The Flu This Year – Yahoo Lifestyle

Thursday, October 8th, 2020

From Women's Health

Face masks might help protect against the flu in addition to novel coronavirus.

The CDC doesn't officially recommend face masks for flu prevention, but does point to other "everyday preventative measures."

Doctors reiterate that masks can prevent respiratory droplets from spreading, including for both the flu and COVID-19.

Sure, people wear face masks these days mostly to help prevent the spread of COVID-19. But now experts say there might be an added benefit of wearing your mask when out in public: It could lower your odds of contracting the flu.

Like COVID-19, the flu is a virus thats mainly spread through infected respiratory droplets. Wearing a mask will likely decrease transmission of the flu as well, says Richard Watkins, MD, an infectious-disease physician in Akron, Ohio, and a professor of internal medicine at Northeast Ohio Medical University.

Rajeev Fernando, MD, an infectious-disease expert in Southampton, N.Y., expects that the 2020-21 flu season will actually be milder than usual because of coronavirus-prevention methods, including widespread mask wearing. Its the same concept as preventing the spread of COVID-19, he says. Masks can help prevent respiratory droplets from spreading.

That being said, you should still plan on getting a flu shot and practicing other flu prevention methods this year. Here's what you need to know about protecting yourself from the fluvia face masks and other measuresthis year.

FWIW: The Centers for Disease Control and Prevention (CDC) does not currently list wearing a face mask in its main recommendations for preventing the spread of the flu. Instead, the CDC recommends avoiding close contact with people who are sick, covering your coughs and sneezes, washing your hands well with soap and water, avoiding touching your eyes, nose, and mouth, and cleaning and disinfecting objects that could be contaminated with the viruses that cause the flu.

Story continues

However, the CDC does point people to everyday preventative measures for stopping the spread of COVID-19 as part of its tips for preventing the spread of the flu. And among those measures is advice to wear a face mask whenever you go out.

Medical staff wear surgical masks when treating flu patients, Fernando says, and a cloth face mask can likely offer at least some level of protection. And if someone who has the flu wears a mask and the people around them also wear a mask, the odds of the infected person making others sick drops dramatically, Fernando says.

The CDC specifically says that getting vaccinated against the flu this season is more important than ever and lists these as important reasons to get your shot:

It can reduce your risk of catching the flu, and of being hospitalized or dying from the flu if you do happen to contract it.

Getting a flu vaccine can save healthcare resources for the care of people who have COVID-19.

At this point, I would recommend as many preventive measures that we know are successful, Fernando says. Theres really no reason not to get your flu shot. We will have a weaker flu season if everyone does that.

And, if you continue to practice known ways of preventing the spread of COVID-19, like wearing your mask, avoiding crowds as much as possible, social distancing, and washing your hands regularly, your odds of contracting the fluand COVID-19should plummet, Watkins says.

Sounds like a win-win.

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California Will Keep Burning. But Housing Policy Is Making It Worse. – ProPublica

Thursday, October 8th, 2020

ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up to receive our biggest stories as soon as theyre published.

Monday morning, Sept. 28, California woke up sweaty, devastated, even shocked to find the state burning again. But if were honest, and to our great shame, no one was surprised. Wed seen this horror movie in this town. Three years ago, wildfire killed 25 people in Sonoma County. Now the Glass Fire was there, again, burning toward Santa Rosa. At 12:30 a.m., a string of seniors stood in line, many in pajamas, waiting to board an evacuation bus from their retirement home. A tiny woman with a roller bag stooped over her walker. A man in a red shirt leaned on his red cane. A woman in a purple robe and magenta slippers sat in her wheelchair, a white teddy bear in her lap. They disembarked at the Santa Rosa Veterans Memorial Auditorium. But then at 2:48 a.m., before the slumped crowd, a young man climbed on a folding chair and announced: The fire was moving too fast toward them. Time to move again.

Farther east, the Butte County sheriff issued an evacuation warning for the entire town of Paradise. The Camp Fire killed 85 people in Paradise less than two years ago. Many survivors, including the former mayor, spent the night trying and failing to sleep in one of Paradises 434 newly rebuilt homes.

It is all too close, too soon: the propane tanks exploding, the safety-vest orange sky. By daylight, that sky rained chunks of ash, like dead moths. Many Californians would have felt less triggered by locusts.

California, as we all now know, is going to burn.

The ecosystem here depends on fire to stay healthy. OK, fine.

We suppressed that fire for a hundred-plus years, and now were living with a deathly backlog of kindling. Not fine, but thats going to take decades to fix.

The climate crisis has warmed and dried that tinder, leading to five of the six largest fires in California history just this year. Not fine at all, but the time frame of remedying this uhh lets just put that to the side.

Which leaves us with the one thing we could be doing to keep wildfire from destroying homes and lives: get a whole lot smarter about where and how we build.

Housing is the megafire-sized climate issue that lawmakers in California keep failing to adequately address even though when asked directly how important housing is to California climate policy, Kate Gordon, Gov. Gavin Newsoms senior climate policy adviser, told me, Oh, its HUGE. Yet it remains intractable.

Adam Millard-Ball, a professor who studies urban planning and environmental economics at the University of California, Santa Cruz, told me, Its absolutely the weak link in the states climate policy. Affluent urban areas and suburban areas have been incredibly successful at pulling up the drawbridge, as Millard-Ball put it, blocking new housing and pushing Californians to live in evermore remote communities, often in whats known as the wildland urban interface. (WUI, the shorthand for this area where humans meet nature, is pronounced woooeeee.) It kicks off a pernicious cycle. Once there, people drive more, increasing emissions. And thanks to emissions globally, those areas are burning more than ever before. In August, Millard-Ball himself recently had to evacuate his home because of the CZU August Lighting Fire Complex.

So with that as a backdrop. ... he said. Californias housing dysfunction has been thrown into really tragic, stark relief for the last couple of months.

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California leads the country on most climate issues; its showpiece is green transportation. Just last week, amid this latest round of fires, Newsom promised to phase out new gas-only cars by 2035. But when it comes to addressing the root causes why people have to drive in the first place. ... Millard-Ball trailed off. Not much happens. Or not much good.

On Wednesday night, Newsom vetoed a bill that would have nudged Californians to stop putting new housing in high fire-risk zones. The piece of legislation had overcome a yearlong delay, appeased initial detractors including the development lobby and passed the legislature by wide margins before flaming out at the eleventh hour on the governors desk.

It was, as original sponsor Sen. Hannah-Beth Jackson, a Democrat from Santa Barbara, acknowledged when the California Senate Housing Committee began debating it in April 2019, not exactly the sexiest stuff in the world. But it had two important goals: One, to identify existing structures highly vulnerable to burning in wildfire and make plans to retrofit them. (This was not politically complicated, as the measure did not even include funding.) Two, to ease pressure to develop in the parts of California with the highest wildfire risk. To date, no legislation related to wildfires or any other climate-related hazard impacts Californias arcane housing allocation system. (That system tells each region how much housing its required to build over a stretch of five or eight years.) But once wildfire risk is codified as a valid reason not to build, whats next? Extreme heat? Nick Cammarota, with the California Building Industry Association, articulated that viewpoint when he called the bill a housing killer.

We dont want to have gentrification. We dont want to have seismic risk. We dont want to have sea level rise or wetlands, or ag land preservation or floods, or toxics. Or you name it, he continued. The entire state is covered with imperfect places to build.

Yet dealing with WUI development, according to fire pros like former California State Fire Marshal Kate Dargan, is the most urgent fire question in the state.

Newsom did sign legislation to improve emergency response and preparedness efforts. But his veto of what was a pretty modest bill felt inauspicious to climate policy wonks who pay attention to such things. At this moment, it is extremely disappointing to hear that @GavinNewsom decided not to sign #sb182, Michael Wara, director of the Climate and Energy Policy Program at Stanford University, tweeted at 10:31 p.m. on Wednesday. The housing crisis enormously complicates decisions not to build anywhere. But solutions to Californias housing production needs are not now nor will they in future be in the WUI. A half-hour later he tweeted again, appalled by Newsoms refusal to back away from sprawl that must ultimately be defended from wildfire at enormous cost in treasure, and hopefully not in blood.

What will it take to create change? If we cant do it now, with the impetuses of the housing crisis and the wildfire. Millard-Ball said. Then he trailed off. It would be incredibly sad to sit back and do nothing.

This is the basic WUI problem: Houses are essentially big piles of fuel. Houses in the WUI also mean people in the WUI, and people ignite over 95% of California wildfires. Houses further increase risk to lives and structures by making it difficult for land managers to do prescribed burns. Once wildfires grow large, houses increase risks for firefighters. Houses in the WUI cost a fortune to defend.

Max Moritz, a wildfire specialist at University of California Cooperative Extension at the Bren School in Santa Barbara, began focusing intently on the WUI problem six years ago. Hed been creating fire probability maps under different climate change scenarios, and his data on fuel included plants that could burn, but not buildings. He found that nearly a quarter of the increased risk that appeared to be due to climate change was in fact due to development. So in 2016, Moritz worked with a team of scientists to co-write a paper laying out why we need to include land use in the wildfire models. (I can send it to you if you want it. Its great bedtime reading.) Then Moritz pivoted to synthesizing the research on fire in the WUI. His goal was to lay out the facts for policymakers. Then maybe this stuff could get codified, he said. Because yeah, why isnt it? Why isnt it regulated?

After the 2009 Black Saturday fires in Australia that killed 173 people and destroyed 2,133 homes, the federal government launched a commission that found (among many other things) planning and building controls are crucial factors affecting safety. The Australians then instituted swift, sweeping changes. Among them: including bushfire risk in planning new development and making ember risk part of building codes. Yet, over the past seven years, wildfires in California have killed 193 people and destroyed nearly 50,000 structures, and the state has done comparatively little to fix the problem. We have these tragic, huge events. We have Black Saturday after Black Saturday and almost no movement on these things, Moritz said.

Hed hoped the research he and others had done on where and how we build in the face of climate change would spur bolder action. Man, youve got the chance here to establish your legacy, as a progressive leader, tackling a tough problem, he said, as if talking to Newsom shortly before the governor vetoed the bill. But hey, land use urban planning thats political. Thats tough, right? Yeah. We need some guts.

To protect a single home from wildfire in the WUI, this is your basic checklist. Defensible space. (No combustibles close to your home for sure in the first 5 feet. Newsom did sign a separate law on Tuesday mandating this for high fire severity zones.) Class A fireproof roof. Dual-paned windows. Remove flammables from under deck. Metal gutter covers. A mesh covering all vents.

But protecting a single home in the WUI is (with only some exaggeration) like being the only one in your family who wears a mask. Safety is inherently a community project, and fire experts, as a rule, freak out about their neighbors houses and yards. One has nightmares about wood shingle siding that ignites and flies off like an airfoil spreading fires. Another about mulch that lets embers smolder until a wind whips them into open flames that creep right up to peoples house walls. A third told me about ponderosa pines killed by bark beetles but not yet cut down. Have you ever had a real Christmas tree and burned it in February? he asked. They go off like napalm.

For Wara, of Stanfords Climate and Energy Policy Program, the zombies are the 20-foot-tall juniper bushes that line his neighbors house. Its a herd immunity thing, right? he said. Once your neighbors house catches fire and starts throwing embers, yours is probably next. I dont think people get that.

In the early 1970s, the National Commission on Fire Prevention and Control tackled the problem of indoor fire. This culminated in the America Burning report, which in turn led to the creation of the U.S. Fire Administration and an over 50% drop in indoor fires since 1980. But theres no such equivalent effort for wildfires. To help fix this, for the past two years, Alexander Maranghides, a fire protection engineer with the National Institute of Standards and Technology, or NIST, has been co-leading a detailed reconstruction of the Camp Fire that destroyed Paradise. (NIST plans to release its first of three 400-page reports this fall.) The outside fire problem is technically somewhere between one and two orders of magnitude more complex than the interior fire problem, Maranghides said. Those fires involve topography, weather, fuel conditions, fire-fighting response, on and on. Just defining the fire dynamics of embers alone is a huge task. The intention of this science is not to keep people from living in the WUI at all, which almost nobody thinks is feasible. The intention is to make the public and policymakers WUI literate and provide science and tools that could lead to the creation of cost-effective solutions, so we dont keep repeating the same tragic, expensive mistakes.

Wara pointed out that people are rebuilding in Coffey Park, a neighborhood in Santa Rosa that was nearly destroyed in 2017. And theyre doing all these things that are so avoidable. Like wood fences connecting the homes. Its like a vertical, combustible ember catcher! You just dont need to do that.

Heres the political problem: 11 million people, over a quarter of all Califorians, live in the WUI. We are not going to kick them out.

At the same time, the state is in a housing crisis, and Newsom staked his career on fixing it. In his inaugural address, in January 2019, he announced a Marshall Plan for housing and promised to build 3.5 million new affordable units by 2025. You could hear the tension between that promise and watching his state burn down in his veto Wednesday night. Wildfire resilience must become a more consistent part of land use and development decisions, he wrote. However, it must be done while meeting our housing needs.

Right now, the states climate priorities are skewed. California has focused on solar and wind and electric vehicles the sort of technology solution side of climate, she said. We havent focused as much on land use, Gordon, the Newsom adviser, admitted. This is an oversight, and the administration knows it, even refuses at times to act that way. As a state, were the one who pays for the disaster mitigation, right? Gordon said. Its just not sustainable. I mean, our entire budget will become about disaster response if we dont get ahead of this thing.

Without action at the state level, its hard to see how California achieves good climate housing policy. Local governments have a lot of power. Too much power, Millard-Ball, the UC Santa Cruz professor, argues. Cities can effectively ignore the climate crisis when theyre making certain decisions, he said. Like most cities in California have developed climate action plans, which are great in terms of things promoting waste reduction and street trees and energy efficiency. But they have said almost nothing about creating more walkable, transit-oriented places to live.

The situation is becoming dire. Insurers, losing a fortune in the WUI, are rapidly dropping homeowner policies. The hemorrhage of non-renewals grew so acute that Californias insurance commissioner essentially instituted a circuit-breaker halt and declared a one-year moratorium. But that may not be enough help for residents to afford to stay. As Mariposa County Supervisor Kevin Cann told me, You go on the FAIR Plan the California insurance policy of last resort and you realize, Holy smokes! I used to pay $1,200 a year and now Im going to pay $5,000. Thats a second mortgage.

The hard truth is: this is as it should be. WUI housing, with its true costs factored in, is not the bargain real estate agents refer to when they say, Drive until you qualify. Last year, the National Bureau of Economic Research, or NBER, published a paper detailing how taxpayers are subsidizing people living in high fire risk zones. How? Firefighting is expensive California may spend a billion dollars this year. A large percentage of that will go to defending private homes. This firefighting benefit is not negligible: NBER calculated it can exceed 20% of a propertys value. The very fact that firefighting is publicly funded decreases the incentive for WUI residents to fireproof their properties. Distorting the housing market further and creating moral hazard: Because much of firefighting budgets comes out of federal disaster funds, publicly funded fire response decreases the incentive for a city or state hello, California to create and enforce wildland building codes.

This pattern, according to NBER, will grow more pronounced with climate change.

The state would also save money if it took a preventative medicine approach and shifted more funds into fire prevention. Every dollar invested in risk mitigation typically saves six in disaster costs. Dargan, the former state fire marshal, who was a firefighter for 30 years and has a son working as a first responder right now, believes the state makes a mistake by not viewing fire prevention and suppression as the same thing. Mitigation and response just happen at different times on the continuum of solutions, she said. We have the worlds best response system in California. And that system works beautifully until a megafire erupts. Then that system fails. At that point, no matter how well theyre trained or how hard they work, firefighters are unable to focus on firefighting. All they can do is get people out ahead of time and even then were beginning to fail at greater numbers. We need a better plan. For taxpayers. For WUI residents, like those seniors evacuated from their homes after midnight in Santa Rosa on Monday and then evacuated from the evacuation center around 3 am. For people, including her son, on the front line.

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California Will Keep Burning. But Housing Policy Is Making It Worse. - ProPublica

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Chris Christie still hospitalized with COVID-19: Heres the type of treatments doctors say he may be getting – NJ.com

Thursday, October 8th, 2020

Former Gov. Chris Christie has spent five days in the hospital being treated for the coronavirus with little word on how hes doing.

Christie is one of several people who spent time with President Donald Trumps inner circle who tested positive for COVID-19 over the last week. The former New Jersey governor was admitted into Morristown Medical Center on Saturday as a precaution because of his history with asthma.

At the time, Christie said he had mild symptoms. Since then, he and his doctors have been publicly silent about his treatment and condition. A source with knowledge of the governors case said only that he is in good spirits and is getting good care.

Its unclear if Christie, 58, is still in the hospital because his condition has gotten worse or if hes being held as a precaution. In addition to asthma, Christie has weight issues, two conditions that may put him at higher risk for complications from the virus. He also is the former governor.

Obviously, VIPs get VIP treatment, said Lewis Nelson, an emergency physician and chair of emergency medicine at the Rutgers New Jersey Medical School in Newark.

Nelson hasnt treated Christie and doesnt know the details of his case. But he said being a VIP can be a blessing and a curse in a hospital. A high-profile patient can get top notch care and speedy access to doctors and drugs other patients might not get, as President Donald Trump did during his hospitalization for COVID-19.

But they can also be held in the hospital longer than necessary.

They do tend to get over-managed and over-tested, Nelson said.

Christie is likely receiving some of the same treatments as other coronavirus patients who were ill enough to have to be admitted to a hospital. Heres what a COVID-19 patient might experience in the hospital, according to Nelson and Anne K. Sutherland, a pulmonologist who runs the intensive care unit at University Hospital in Newark:

Evaluation: Though Christie tweeted "I checked myself into Morristown Medical Center, most people dont get to just show up at the hospital when they test positive for COVID-19 and get a room like its a hotel, doctors said.

Coronavirus patients would likely be examined by a doctor who would check for fever, breathing difficulties and a low blood oxygen level, Nelson said. If the blood oxygen reading is 94% or below, the patient would likely be given oxygen and admitted to the hospital because that may be a sign they are headed for a crisis.

Patients with high risk factors, including being overweight, having diabetes or asthma, a heart condition or a chronic health condition, would be more likely to be hospitalized, Nelson said.

Access to drugs: While in the early days of the virus doctors were unsure what, if any, drugs to use to treat COVID-19, most hospitalized patients are now given remdesivir, an antiviral. The drug was first developed to treat Ebola but has become a go-to drug for hospitalized coronavirus patients in recent months.

There is not definitive proof remdesivir works, but there is also no proof it does any harm, Nelson said. So, many doctors are using it to treat COVID-19 patients, especially those who are older, overweight or have other high-risk factors.

We tend to use remdesivir fairly liberally in these people, Nelson said.

Patients may also be treated with anti-inflamatory drugs and steroids, like the dexamethasone steroid Trump was given in the hospital. Again, doctors say there are no studies proving they work. But doctors have found them effective in many patients.

In New Jersey hospitals, some COVID-19 patients may also be asked to participate in one of several clinical trials testing the effectiveness of other new drugs and treatments.

It remains unclear whether many treatments, including the Regeneron monoclonal antibody cocktail Trump was given, are working. But many doctors and patients are willing to experiment, Nelson said.

We dont know the best answer. Thats the problem, Nelson said.

Asthma concerns: Asthma is considered one of the conditions that might raise a patients risk for having a severe case of COVID-19. But asthma sufferers, like Christie, probably would not receive any special drugs or monitoring.

They would not be treated any differently, said Sutherland, a pulmonologist and associate professor at the Rutgers New Jersey Medical School.

The preliminary data has shown that having asthma doesnt increase the severity of the coronavirus or increase a patients risk of death, Sutherland said. But more extensive studies are needed. For now, doctors keep a close eye on asthma patients.

An isolated room, with the possibility of visitors: New Jersey hospitals no longer have the crush of COVID-19 patients that did in the early months of the pandemic. These days, patients will likely have their own rooms in an isolated part of the hospital in units reserved for coronavirus patients, the doctors said.

Were able to sequester people, Nelson said.

Patients who are not on ventilators are usually able to eat meals, if they feel well enough, and walk around their rooms. They are not usually permitted to walk the halls or go to other areas of the hospital.

Hospitals have lifted their bans on visitors to COVID-19 patients, so some patients are able to see their families from a safe distance.

Constant monitoring: Coronavirus patients will be hooked up to multiple monitors and have a steady stream of nurses and doctors checking on them, Sutherland said.

They will likely have a pulse oximeter checking their oxygen levels continuously and a heart monitor to check for cardiac complications. They will have their blood pressure monitored every one to four hours, along with their respirator rate.

Doctors will also be monitor patients and give them preventative drugs for blot clots in the legs and lungs, a dangerous complication found in some COVID-19 patients, Sutherland said.

Those with breathing difficulties might need supplemental oxygen or a high-flow nasal oxygen machine, a devise that looks similar to a sleep mask used by people with sleep apnea, Sutherland said. As a last resort, patients will be put on a ventilator to keep them breathing if the virus attacks their lungs.

Watching the timeline: Patients who are able to breathe on their own should not expect a long stay in hospital unless they have other complications, the doctors said.

If youre not on a ventilator ... you are usually going to be gone from the hospital in a few days, Nelson said.

Doctors who have treated many coronavirus patients say theyve spotted a pattern in people who develop severe cases. The turning point for many is between five and eight days after they get sick.

Thats when they would take a turn for the worse, Sutherland said.

Most people who make it past the 10-day mark without severe symptoms dont get any sicker, she added. But every case is different and there are no guarantees.

Thank you for relying on us to provide the journalism you can trust. Please consider supporting NJ.com with a subscription.

Kelly Heyboer may be reached at kheyboer@njadvancemedia.com.

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Chris Christie still hospitalized with COVID-19: Heres the type of treatments doctors say he may be getting - NJ.com

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Prevention Efforts Prove Critical With Heightened Risk Of Legionella In School Water Systems – ACHR NEWS

Monday, September 28th, 2020

Prevention Efforts Prove Critical With Heightened Risk Of Legionella In School Water Systems | 2020-09-28 | ACHR News This website requires certain cookies to work and uses other cookies to help you have the best experience. By visiting this website, certain cookies have already been set, which you may delete and block. By closing this message or continuing to use our site, you agree to the use of cookies. Visit our updated privacy and cookie policy to learn more. This Website Uses CookiesBy closing this message or continuing to use our site, you agree to our cookie policy. Learn MoreThis website requires certain cookies to work and uses other cookies to help you have the best experience. By visiting this website, certain cookies have already been set, which you may delete and block. By closing this message or continuing to use our site, you agree to the use of cookies. Visit our updated privacy and cookie policy to learn more.

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Advances in the treatment of stroke | Columnists | rocketminer.com – Daily Rocket Miner

Monday, September 28th, 2020

Weakness on one side of the body, slurred speech, facial drooping, inability to find or understand words; these are symptoms of a stroke which are typically sudden in onset. The symptoms can be subtle, or they can be severe. Regardless, rapid diagnosis and treatment is the key to recovery.

Not long ago, not much could have been done for someone as they were having a stroke. Often, we could only wait and see how the patient recovered with rehabilitation. For years, prevention was the only tool we had to combat initial and recurring strokes. Preventative measures such as blood pressure control, aspirin or other blood thinners, cholesterol control, and of course, a healthy diet and exercise remain especially important today. Thankfully, we now have a few more options.

Clot-busting medications have been a great advancement in the treatment of strokes since the mid-1990s. If administered soon enough, sometimes these clot-busting medications can work to break up a clot that is blocking blood flow in an area of the brain thus restoring circulation. This can help to preserve or at least minimize the area of the brain that would be permanently damaged.

There are risks to these meds, such as bleeding, but the chance of improving the outcome usually justifies their use. To minimize risks, the clot-busting medication must be initiated within three to four- and one-half hours following the onset of symptoms. Physicians also consider other criteria before treating with clot-busting meds, including the patients medical history, blood test results, and they must rule out a hemorrhagic stroke using CT imaging of the brain. A hemorrhagic stroke is when damage is done by a ruptured blood vessel rather than from blockage.

More recently, technological developments have changed the emergent care offered for very severe strokes. It is now possible to manually restore blood flow to the brain using minimally invasive surgery. A surgeon inserts a system of catheters and wires into an artery in the arm or groin, advances this system up through the neck and into the brain. Then, at the location of the blood vessel blockage, the blood clot is removed and the circulation to the affected area is restored.

Highly specialized, this new procedure seems almost miraculous. It has been referred to as the Lazarus procedure as it literally brings people back to life and sometimes immediate improvement is noted as soon as during the procedure.

The keys are recognition and time. Know the signs and get help quickly. Think of the acronym FAST: Face drooping? Arm weakness? Speech difficulty? Time to call 9-1-1.

Andrew Ellsworth, M.D. is part of The Prairie Doc team of physicians and currently practices family medicine in Brookings, South Dakota. For more information, visit http://www.prairiedoc.org.

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Advances in the treatment of stroke | Columnists | rocketminer.com - Daily Rocket Miner

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