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A Japanese supercomputer has taken the top prize in a renowned global speed competition for the first time since 2011, beating out the Chinese and American competitors that usually win. Fugaku, as the supercomputer is called, clocked in a score of 415.53 petaflops on the biannual Top500 List.

To put that into context, a system capable of one-petaflop speed can perform one quadrillion "floating point operations," or computer arithmetic calculations. To keep up with a one-petaflop supercomputer, you'd have to perform one calculation every second for 31,688,765 years, according to Indiana University. Multiply that by 415.53 petaflops, and that's one calculation every second for about 13.2 billion years. Phew.

This marks the first time an Advanced Reduced instruction set computing Machine (ARM) supercomputer has taken the lead slot on the Top500 List. Usually, ARM processorswhich require fewer transistors, are cheaper, use less power, and create less heatare relegated to the world of mobile devices like smartphones, tablets, or laptops, making Fugaku's win particularly compelling.

"For Arm, this achievement showcases the power efficiency, performance and scalability of our compute platform, which spans from smartphones to the worlds fastest supercomputer," Rene Haas, president of Arm's IP Products Group, said in a prepared statement. Arm Holdings is the Softbank-owned semiconductor company that first introduced ARM chips.

Fugaku beat out its nearest competitor, Summitan IBM-developed supercomputer that lives at Oak Ridge National Laboratory in Tennesseeby 266.93 petaflops. That supercomputer previously topped the Top500 List in the last round of competition, back in November, when it ranked in at 148.6 petaflops.

The latest ranking included four supercomputers from the U.S., two from Italy, two from China, one from Japan, and one from Switzerland.

Fugaku is installed at the RIKEN Center for Computational Science in Kobe, Japan. The original idea came about back in 2014, and the supercomputer won't even be fully operational until April 2021.

At RIKEN, around 3,000 researchers use the machine for drug discovery; personalized and preventative medicine; natural disaster simulations; and studies into the fundamental laws of the universe. And on an experimental basis, researchers are even using Fugaku for COVID-19 research into diagnostics, therapeutics, and simulations showing the spread of the virus.

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"Fugaku was developed based on the idea of achieving high performance on a variety of applications of great public interest...and we are very happy that it has shown itself to be outstanding on all the major supercomputer benchmarks," Satoshi Matsuoka, director of the RIKEN Center, said in the statement. "I hope that the leading-edge IT developed for it will contribute to major advances on difficult social challenges such as COVID-19."

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Meet Fugaku, the New Fastest Computer in the World - Popular Mechanics

On the same Monday in June, two studies emerged challenging most of what everyone thinks we know about the battle against the deadly pandemic SARS-CoV-2 coronavirus, and both suggest a fundamental frailty in the way humans think:

We are prejudiced by a desire to believe in human dominion over nature.

That fundamental belief, the studies suggest, might have prejudiced conclusions that non-pharmaceutical efforts to contain the pandemic have been successful even though the evidence doesnt appear to support that conclusion.

After modeling real-world data from 40 countries, professor Harald Walach from the Poznan University of Medical Sciences in Poland and German health consultant Stefan Hockertz concluded that little of what has been done to battle the disease to date has proven truly effective and some actions might have made things worse.

Interestingly, none of the variables that code for the preparedness of the medical system, for health status or other population parameters were predictive (of lower death rates), they wrote. Of the public health variables, only border closure had the potential of preventing cases and none were predictors for preventing deaths. School closures, likely as a proxy for social distancing, was associated with increased deaths.

The pandemic seems to run its autonomous course and only border closure has the potential to prevent cases. None of them contributes to preventing deaths.

The study was published on the preprint server MedRxiv and has not been peer-reviewed. The authors appeared to concede that, but they werent pulling any punches.

It is interesting to observe that closure of schools emerges as a strong positive predictor for the number of deaths, i.e. school closures are associated with more deaths, they wrote. This could be an indicator for strong social distancing rules in a country which might be counterproductive in preventing deaths, as social distance for very ill and presumably also very old patients, might enhance anxiety and stress and could then become a nocebo.

It could also reflect the fact that countries which saw a rising tendency of deaths closed schools as an emergency measure, and hence school closure is an indicator of fear in a country. But considering the prevention of deaths, none of the public health measures studied are associated with the prevention of deaths.

Conceding that their work contradict(s) new modeling data using time series models that report clear evidence for the effectiveness of non-pharmaceutical interventions, they took direct aim at those findings.

The major shortfall of these models is that they ignore the most likely reason why we find the data we find: immunity in the population and neglecting the strength ofnatural immunity, they write. Thus, a new reliability study of such models shows that they are crucially dependent on assumptions, parameters assumed and the time point at which they capture data. If the wrong assumption about a potential resistance against an infection in a population is made, the results are far off from true values.

Walach and Hockertz are not alone in this thinking. Another study new on the MedRxiv server Monday also concluded that while actions taken to slow the spread of the disease appear to have reduced demand for space in intensive-care units none of the proposed mitigation strategies reduces the predicted total number of deaths below 200,000. Surprisingly, some interventions such as school closures were predicted to increase the projected total number of deaths.

A team of researchers from the University of Edinburgh reached those conclusions after investigating the United Kingdoms response to the pandemic as guided by the advice of the countrys Imperial College against the subsequent trajectory of the disease.

Like Walach and Hockertz, the Edinburgh group led by Professor Ken Rice, an astrophysicist who specializes in modeling, concluded that closing schools actually increased the number of deaths, but the Edinburgh scientists didnt stop there.

We confirm that adding school and university closures to case isolation, household quarantine, and social distancing of those over 70 would lead to more deaths when compared to the equivalent scenario without school and university closures, they write. Similarly, adding general social distancing to a case isolation and household quarantine scenario was also projected to increase the total number of deaths.

Though this conclusion might at first appear counter-intuitive, the logic is sound. As with all viruses, SARS-CoV-2 needs new hosts to infect in order keep spreading. The fewer people it is capable of infecting, the harder it for the disease to travel through a population.

Thus if a large number of young people are infected and subsequently develop antibodies to ward off future infections, the virus has an increasingly harder time finding hosts and the spread of the disease slows.

The qualitative explanation for this is that within all mitigation scenarios in the model, the epidemic ends with herd immunity with a large fraction of the population infected, the Edinburgh researchers wrote. Strategies which minimize deaths involve having theinfected fraction primarily in the low-risk younger age groups. These strategies are different from those aimed at reducing the ICU burden.

Younger people for reasons still not fully clear have far better odds of beating SARS-CoV-2 than old people. Some do get very sick from COVID-19 the disease caused by the coronavirus but overall death rates are relatively low.

The U.S. Centers for Disease Control (CDC) currently estimates a COVID-19 case fatality rate of 0.05 percent for those age 49 and under. It rises to 0.2 percent for those age 49 to 64 and climbs to a deadly 1.3 percent for those 65 and older.

When the data is further broken down, it lays things out even more clearly. The CDC charts a COVID-19 death rate that starts at 3.5 deaths per 100,000 for those aged 5 to 17 and climbs steadily to 535.2 deaths per 100,000 for those age 85 and older.

The chart reflects that those 50 to 64 years old are dying at a rate almost five times greater than those age 18 to 29, and by age 65, the death rate for the 65-and-older group is approaching 10 times that of those under 30.

For comparison sake as to the death rates for younger ages, U.S. drug deaths for those age 18 to 34 (the closest available cohort to the 18 to 29 group for COVID) are 30.9 per 100,000.

A 2009, peer-reviewed meta-analysis of studies of the common flu published in the journal Epidemiology reported that most estimates for that disease fell in the range of 5 to 50 deaths per 100,000, but as with COVID-19 rose monotonically with age, from approximately one death per 100,000 symptomatic cases in children to approximately 1,000 deaths per 100,000 symptomatic cases in the elderly, although with substantial variation in the estimates within each age group.

Other than trying to protect the most vulnerable while growing herd immunity among the less vulnerable, both studies suggest there is not a whole lot that humans can do to change the course of the COVID-19 at this time.

The image that emerges from the data and the attempt to understand their relationship through modeling is that of a largely autonomous development, Walach and Hockertz write. It affects mainly the elderly. Smoking is somewhat protective and border closures is associated with a lower number of cases. But other measures closing of schools and lockdown of whole countries do not contribute to a reduced number of cases or deaths.

The data does indicate, they add, that if suspected cases are tracked and traced fast enough as in Taiwan and Hong Kong containment is possible.(but) once infectionsare in the vulnerable segments of a population, like in hospitals or homes for the elderly,political actions like school closures or country lockdowns do not prevent deaths.

If anything, social distancing seems to be harmful. What might be useful but cannot be seen in our coarse-grained data are special protective measures geared to protect these vulnerable populations, such as protective masks for personnel and visitors in hospitals and old peoples homes, or the wearing of face masks in places with bad ventilation and close proximity of people.

They admit its nice to believe the existing public health measures work, but argue the data just doesnt support that conclusion.

We have pointed out that the peak of the cases had been reached in Wuhan already on January 26th, only three days after the city lockdown, they write. This was surely too short to be an effect of public health measures as cases manifest with a delay of at least five and rather more days. And a careful analysis shows that, if one uses realistic retrodiction (back-tracking of time) of cases, then effects of public health measures cannot be seen.

The Edinburgh study gives more credit to the interventions but concludes that when they are relaxed which must inevitably be done since governments cant hold people in lockdown forever anything that has been gained by the lock down is lost and maybe worse.

The consequence of some interventions, they warn, is that they suppress the first wave so that a second wave, occurring after the interventions have lifted, then leads to a total number of deaths that exceeds the total for the equivalent scenario without this additional intervention.

Both studies argue for protecting the elderly and others most vulnerable while growing herd immunity among younger citizens. If they are right, the U.S. might now be accidentally engaged in this practice given the Black Lives Matter protests that have drawn together large numbers of primarily young demonstrators.

As of this time, there have been no reports of deadly disease outbreaks tied to those protests, but there is no way of knowing how many people might have been infected who are asymptomatic and presymptomatic and destined to show up infections counts in the days ahead.

The Swedes, who have taken a beating for a more liberal response to dealing with the pandemic, generally followed the model suggested in the studies, but did a terrible job of protecting the elderly.

An estimated 90 percent of the 5,100 dead in Sweden are over 70 years old and three-quarters were in nursing homes or receiving home care, according to a report from Barrons magazine.

Swedish national epidemiologist Anders Tegnell described it as a weakness of the nations elderly care.

The Swedish death rate of 507 per 100,0000, according to the Worldometer COVID-19 tracker, is far higher than that of its Scandanavian neighbors, but less than that of Italy (573/100,000) and Spain (606/100,000) two countries that engaged in onerous lockdowns.

Swedens rate is less than a third that of New York (1,607/100,000) and near a third of that of New Jersey (1,467/100,000). A number of studies have flagged population density as a possible contributing factor there, but the latest studies point to age being a bigger issue.

Since being elderly is a risk factor for many diseases, and eventually death, and cannot be changed, political actions in future pandemics would likely need to focus on protecting these members of society first, Walach and Hockertz written. Apparently, closing schools and locking down countries is not the right method to preventdeaths.

The study is sure to be controversial.

Back in March, Dr. David Katz a specialist in preventative medicine and public health, and the founding director of Yale Universitys Yale-Griffin Prevention Research Center wrote an op-ed for the New York Times (NYT) suggesting that idea.

Not long after, Katz appeared on CNN where NYT Science and Health writer Donald McNeil called the op-end an extremely dangerous way of thinking and demanded the doctor take that paper back and apologize for it because I think it provided a scientific underpinning for (President) Donald Trump to say things like the cure is worse than the disease.

McNeil called for a lengthy lockdown to save lives, arguing were not going to be able to think about our 401Ks or take retirement at the time we want to. Were going to have to think about getting enough calories, for perhaps the next year until a vaccine is here.

McNeil seemed wholly unaware of economic realities. And a year-long down lockdown seems even more unrealistic now and then.

After a lockdown of only a couple months, the country has been split by the biggest protests since the Vietnam War as Americans, largely the young, demand racial justice, a noble goal no one is quite sure how to achieve in a society that has become only more tribal in the past decade.

Katz, meanwhile, is sticking to his original suggestion for dealing with SARS-CoV-2. He is continuing to call for a risk-based response to the disease.

Currently there is no guidance for what comes after flattening the curve,' he writes. It delays but does not prevent a spike in hospital need and mortality, unless maintained until a vaccine is available.

Everybody back to the world now means a high, unacceptable rate of severe infection and death among those at elevated risk.

Hunker in a bunker until theres a vaccine ignores the potentially massive adverse health effects of social determinants of health as lives, livelihoods, goods, services, and supply chains are disrupted and degraded.

He has been criticized as putting economics ahead of health, but the two new studies would suggest the equation is not that simple.

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Tagged as: #SARS-CoV-2, age gap, assumptions, CDC, COVID-19, deaths, elderly, fear, flatten the curve, flu, german, herd immunity, homes, hospitals, human dominion, Imperial College, intensive care, Katz, lock down, low-risk, medRxiv, models, more deaths, non-pharmaceutical efforts, pandemic, Poland, prejudice, school closures, shortfalls, social distancing, Sweden, United Kingdom, younger

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Against the tide - craigmedred.news

CHICAGO, June 18, 2020 /PRNewswire/ -- With the COVID-19 pandemic interrupting non-urgent medical care, physicians are concerned that important gains in preventing colorectal cancer could be lost and their patients could miss out on life-saving preventive care or treatment.

Colorectal cancer is the second-leading cause of cancer death, yet it is highly preventable and treatable with screening and early diagnosis, said Laura J. Zimmermann, MD, MS, medical director of Rush's Prevention Center and assistant professor of Preventive Medicine and Internal Medicine at Rush Medical College.

"If it's caught early, it has a really high cure rate, but if by delaying we find something later, it may be harder to treat," she said.

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While Rush is starting to perform screening colonoscopies again, colorectal surgeon Dana Hayden, MD, MPH, associate professor and chief of the Division of Colon and Rectal Surgery at Rush Medical College, worries that the delay in care will linger and patients who had taken the important step of scheduling a colonoscopy may put off rescheduling and others who are due to be screened won't.

"We really don't know how long the delay could last," Hayden said. "Patients may be focused on more urgent matters than preventative care and may also be nervous about coming to the hospital while the pandemic continues."

That would reverse a positive, lifesaving trend:

The rate of people over age 50 who are up to date on colorectal cancer screening has improved greatly in the past several years, from 38% in 2000 to 66% in 2018, according to the American Cancer Society.

"As the rate of screening has increased in these age groups (over 55 years old), the incidence of colorectal cancer has decreased," Hayden said. And the mortality rate has declined as well.

Delayed screening means people will miss the opportunity to prevent or treat the disease early. That leads to a greater incidence of cancer, which is diagnosed at later stages with more severe symptoms and higher mortality, she said.

While it is impossible to know how much screening will be missed because of the pandemic, a look at the number of new colorectal cancer cases projected for 2020 in the U.S., two months with little or no screening theoretically could postpone diagnosis of cancer in 24,650 patients, among those some 9,860 cancers that may be at an advanced stage already.

Link:
Covid-related delays In colorectal cancer screening jeopardizes preventive care, early treatment - DOTmed HealthCare Business News

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For many residents of the Okanagan, the fatalities caused by illicit drug use may seem a distant problem with little to no impact on your life. However, everyone has a role to play in preventing overdoses.

BC has recorded the highest number of fatal overdoses in a single month, with deaths overtaking those due to COVID-19 in the whole year. During May, 170 individuals lost their lives due to illicit drug overdoses, where COVID-19 has caused 167 deaths in the entirety of 2020.

Of these overdose deaths, 82% involved fentanyl. Fentanyl is a strong opioid painkiller, 100 times stronger than morphine. It is often mixed with heroin or crack cocaine to enhance the effects, not always with the users knowledge.

Despite an initial reduction in overdose related deaths in 2019, fatalities have surged since the start of the pandemic. This is in part due to regular supply chains being cut off, and users having limited access to overdose prevention sites or drug checking services.

Interestingly, there were no deaths at supervised consumption or drug overdose prevention sites across B.C. in May, when these figures were released.

So what can you do?

There are several steps you can take to have a positive impact on the community in Kelowna, in terms of reducing harm caused by illicit drug use.

If you see someone in the street that looks like they could be having an overdose, stop and check theyre OK. If you feel uncomfortable doing this, call RCMP for a wellness check or 911 for an ambulance.

The signs of an overdose include not breathing or breathing very slowly, blue tinged lips or fingertips, an unusual gargling or snoring sound, or that the individual cant be woken and doesnt respond to pain.

If you see someone that could be overdosing, shake the person, shout at them and try to get a response to pain (squeeze their shoulder tightly in your hand). If theres no response, call 911 immediately.

Turn the individual on their side to prevent them from choking, and stay with them until help arrives.

To provide even more help, carrying and understanding how to use a naloxone kit is the best way to prevent deaths from overdose. The kits are free, and available from most pharmacies without a prescription. Carrying a kit in your car is a hugely important step in helping to save someones life; even if you dont feel comfortable using it, someone else at the scene may be able to.

Aside from saving someones life from the immediate effects of an overdose, there are other ways you can help in the bigger picture.

If you know someone that actively uses, support them in seeking help. Connecting with someone in the grips of addiction can be tough, but your support is vital in empowering them to get treatment and stay clean. Offer to accompany them to appointments, and ask them how you can help. Even alcohol addiction can lead to overdosing, so reach out now to anyone you know that is struggling.

Help to reduce the stigma around illicit drug use and overdosing by talking openly with your kids, teenagers and adult children about drug use. Discuss the reasons people use drugs, as well as the risks involved, to help reduce the likelihood of harm and encourage healthy behaviours.

The Okanagan has many supportive housing facilities and centres with drug overdose prevention sites or drug checking facilities. Although you may feel uncomfortable with one of these centres being in your neighbourhood, engage with the staff and residents at the centre to fully understand what it means to be tackling addiction, and how overdose prevention sites are helping. Many centres run community engagement days to help build bridges in the neighbourhood; even if you dont approve, educating yourself is key to understanding the reasons behind these facilities.

Overdoses are common, but they are also preventable. Empower yourself and your family to reduce stigma, help others and ultimately save lives.

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What to do if someone ODs - Health and Happiness - Castanet.net

Every Married to Medicine cast member is a millionaire but does the newest addition really have a net worth of $500 million? Maybe at least she compared herself to someone with that fortune.

Buffie Purselleis married to a physician but has created her own empire as a personal finance and tax expert. She shared on CNBC in 2017 she built her net worth through a number of businesses shes created. She admits to working up to 12 hours a day and only sleeps a total of 40 hours per week.

Known as Buffie the Tax Heiress Purselle said, Im going to quote Beyonce when she said that she thinks she might be the black Bill Gates. I think I just might be the black, curvy, fabulous Marcus Lemonis-in-the-making. Marcus Lemonis has a net worth of $500 million. Shes undoubtedly a resourceful and powerful entrepreneur. However, other resources put Purselles net worth closer to $1 million.

Toya Bush-Harris and Dr. Heavenly Kimes both have a reported net worth of $4 million each. Kimes runs a successful dental practice in Atlanta who specializes in cosmetic dentistry. She often shares success stories on Instagram and patient transformation photos. Replacing missing teeth can restore your smile to optimal health, function and appearance. Dental implants are a great option for restoring your smile because the implants are designed to look, function and feel just like your natural teeth, and with proper care, they can last a lifetime, she recently shared along with a video.

RELATED: This Is How Much the Stars of Married to Medicine Make in Real Life

Bush-Harris is married to a physician and is a published author. She released the childrens book, SleepyHead Please Go To Bed!Bush-Harris created a tremendous social media following using the hashtag, #MommyChronicles.

Also worth $4 million is Mariah Huq who is a Married to Medicine creator and producer. Huq is married to Dr. Aydin Huq and she often entertains at her lavish home on the series.

Married to Medicine top docs all have a net worth ranging from $3.5 to $3 million. Dr. Simone Whitmore has a net worth of $3.5 million as one of the most sought after OB/GYNs in the Atlanta area. Whitmore is a mother of two and has been with husband Cecil for 23 years. Viewers witnessed the couple experiencing rocky moments throughout the series.

Dr. Jacqueline Walters has a net worth of $3 million is also a highly respected OB/GYN in Atlanta. Walters is a published author and a two-time breast cancer survivor. She also openly discussed her infertility on the series.

RELATED: After Hesitating To Start a Family With Her Ex-Husband, Married To Medicine Star Quad Webb Has Adopted a Daughter

Also, with a net worth of $3 million is Dr. Contessa Metcalfe. Metcalfe focuses her practice on preventative medicine and became friends with Dr. Britten Cole while in the Navy. Metcalfe became the crossover cast member between Married to Medicine and Married to Medicine Los Angeles.

Quad Webb is a millionaire in her own right. With a reported net worth of $1.5 million, Webb was a medical sales representative when she first joined the series. But now owns Picture Perfect Pup, a specialty brand designed for dogs. She was originally married to Dr. Gregory Lunceford but the couple has since divorced. Webb recently adopted a baby.

Continued here:
Does a 'Married to Medicine' Cast Member Have a Net Worth of $500 Million? - Showbiz Cheat Sheet

Jeff Williams, chief operating officer of Apple Inc., speaks during an Apple event at the Steve Jobs Theater at Apple Park on September 12, 2018 in Cupertino, California.

Justin Sullivan | Getty Images News | Getty Images

Apple has grand ambitions to move into the health care field. The company's CEO Tim Cook once referred to health as the company's "greatest contribution to mankind."

In the last five years or so, the company has built up a big internal team staffed with doctors, health coaches, and engineers. It has developed health-focused software and hardware, and even started medical clinics for its own employees.

But with a concrete strategy and a biomedical breakthrough, such as non-invasive blood pressure or blood sugar monitoring, it could do a lot more. Ahead of its World Wide Developer Conference (WWDC) next week, here's what people in the health and technology sector think of Apple's influence and achievements so far -- and where it needs to go next.

Apple has a slew of products and services in health care.

Its primary product is the Apple Watch, and health is both a major use case and selling point. Its smartwatch device offers activity tracking, heart rate monitoring, an electrocardiogram to detect irregularities with the heart's rhythm, fall detection alerts, integrations with third-party health apps, and more.

The Apple Watch has other benefits, but overall, "the greatest use case for Apple Watch still remains health," said Ben Bajarin, an analystwith Creative Strategies specializing in consumer technology.

Henrik Berggren, founder of a diabetes-focused virtual medical clinic called Steady Health, said the Apple Watch is most helpful when it comes to tracking exercise and incorporating data from existing blood-sugar tracking devices. Many of Steady Health's patients already have Apple Watches or iPhones, and the group will look at that data in addition to their blood glucose levels and eating habits. "That exercise part they're doing quite well today," he says.

Beyond the Watch, vice president of technology Kevin Lynch is working to let customers bring medical information, including lab results and medical history, to their iPhones. That software, known as Apple Health Records, is continuing to make strides, but is still held back by the fact that consumers have to remember which doctors and hospitals they've been to in recent years and log into those systems separately.

The company has also developed software kits for third-party developers to build health applications. Among the most widely used is ResearchKit, which helps academics recruit people to their clinical trials via mobile devices.

Internally, Apple's California-based employees can use a health-care system known asAC Wellness. The company doesn't speak about it much and hasn't said whether it plans to expand those clinics to consumers more broadly. For now, it likely functions as a way for the health teams to learn about the practice of delivering medicine - and not just building tech.

During the Covid-19 pandemic, Apple teamed up with Google to release contact tracing technology for mobile phones, which public health researchers can use to build apps to track exposure to the virus. The company has seen the most traction for that in Europe and Asia.

Doctors have mixed feelings about the role of consumer health devices, including Apple's.

While some are bullish on their potential, others say that it's highly cumbersome for them to analyze this patient-generated information, and they don't currently get paid for the extra work. Many are simply refusing to look at data from wearable devices.

When John Koetsier, a technology consultant and writer, tried to share his Apple Watch data with a doctor, he was essentially told to keep it to himself. Koetsier had been tracking his food intake, weight and exercise on his own. But his doctor said that he had too many information sources already, and was feeling overwhelmed.

There are also questions about the accuracy of wearable devices when tracking health data.

"I trust Apple's step tracking, but heart rate I'm more concerned about," said Dr. Josh Emdur, a telemedicine doctor with SteadyMD. Emdur said he once admitted a patient into the hospital a few years ago because of an Apple Watch result, but it turned out to be a false alarm. He acknowledges that the data seems to have improved since then, and he's now using Apple Watches as a heart health screening tool. But he'll still recommend a medical device, like a Zio cardiac monitor, as a followup.

"To make the use- generated data actionable from devices like the Apple Watch, it needs to integrate better with electronic health record dashboard so a care team can see trends and it all comes in in a structured way," he said.

New York-based cardiologist Dr. Jeffrey Wessler says the Apple Watch offers more benefits than harms. "It really was a catalyst for the industry because it was the first time a consumer device began to infiltrate the clinical environment in a high volume way," said Wessler, who runs preventative heart health clinics called Heartbeat. "

But he notes that it can be frustrating patients come in with a concerning Apple Watch reading but no risk factors. In that case, there might not be a clear treatment pathway, and they're simply sent back home and told to come in if they develop symptoms.

"That's taking visits and time away from people who really need us," said Wessler.

Apple could make money in health by using it as a way to market and sell more of its devices. But there are much bigger opportunities in the $3.5 trillion health care sector.

The company has already announced partnerships with insurers, like Aetna, where users can "earn off" the cost of a device by engaging in healthy behaviors. It's also talking to some private Medicare plans about subsidizing the cost of the device for seniors.

Imagine if the company could somehow build a body of clinical evidence to get into the business of taking on risk for a population. If it can truly prove that it could improve the quality of care and bring down costs, that would be a huge opportunity. That vision would take many years to achieve, but it would certainly meet Cook's goal of having a major impact on health care.

Another game-changer would be if Apple can introduce more sophisticated sensors, including non-invasive glucose or blood sugar monitoring or a blood-pressure monitor. At that point, its device could reach a much bigger market -- 6 in 10 Americans - with one or more chronic diseases, as well as prevention. More than 1 in 3 Americans, for instance, are at high risk for type 2 diabetes.

"If they came out with a blood sugar or blood pressure monitor that was non-invasive and continuous, it would be a complete game changer," said Berggren. "That's what we dream about for the watch."

"I think there's a lot of opportunity for Apple still in the space," said Bajarin. "For me, it's really hinges on preventative health (as) that really expands the potential of the Apple Watch."

Other experts suggested the following areas where Apple should go next:

Better sleep tracking: "I'd love to see more in that direction," said Dr. CalvinWu, an endocrinologist with Steady Health. "They're just scratching the surface on sleep."

Telemedicine: Wessler, the cardiologist, believes that there needs to be an intermediary layer that helps triage patients. Instead of rushing to the emergency room or to a specialist, Apple could direct patients to an online visit and even offer its own video-based online medicine service.

More women's health focus: Several of the doctors wanted to see more thorough tracking for menstruation, fertility, and reproductive health.

More interoperability and integration with other medical devices: Apple already has close relationships with companies like Dexcom in the diabetes space, but the doctors agreed that it would be helpful to expand on that.

More validated clinical trialswould give Emdur, the telemedicine doctor, more confidence about the medical features in its products, including arrhythmia detection. Apple has done some trials, but it could double down.

Food logging: Helping people track the nutritional content of their food is another opportunity. Imagine snapping a picture of the food and algorithms figure out what's in the food. "It's a really hard problem but if anyone could solve it, that would probably be Apple," said Berggren.

More focus on seniors: The company has a fall-detection feature and many of its heart health features are useful to seniors, but it could do more to make its devices more accessible to older groups.

Apple Pay integrations: Apple could use its expertise in payments to help people navigate their health care bills.

More health features in Airpods: For Bajarin from Creative Strategies, that's an obvious move. It's easier to measure some vitals from the ear, which could make it a powerful health-focused wearable.

What's on your Apple Health wishlist? Let us know at @CNBCTech.

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Apple still has a lot of room to grow in the $3.5 trillion health care sector - CNBC

DURHAM, N.C. -- Speculation that a vaccine for COVID-19 might be widely available by the end of this year is overly optimistic, three Duke experts said Wednesday.

While there may be substantial scientific progress by the end of 2020, there will still be significant manufacturing hurdles to clear before a vaccine is available to most people, the experts said during a briefing for media.

Below are excerpts from the briefing:

David Ridley, health economist

Dr. Fauci is quite optimistic. I think optimism is good. I think optimism has a really important role. We need people within these companies being optimistic. If everyone sits back and talks gloom and doom nothings ever going to get done. So I respect that optimism.

But will you and I get vaccinated this year? No way. Its possible a vaccine will be approved this year. But not at scale. We wont have a lot of doses of this.

We might have some people vaccinated this year. But the average person wont be vaccinated this year.

Thomas Denny, chief operating officer, Duke Human Vaccine Institute

If youre going into a tough game, you need a coach thats getting the team revved up. We may have some good science by the end of the year and think we have some leading candidates. But manufacturing them to have it all administered, thats a tall order to be ready by the beginning of 2021.

Ooi Eng Eong, deputy director, Emerging Infectious Diseases Programme, Duke-NUS Medical School in Singapore

Once we get to the efficacy phase and ask the question of whether this vaccine will work to prevent infection, that depends on how common the infection is at that time. If the situation still goes on as it is, we shouldnt have any problem testing efficacy."

But if for whatever reason the prevalence of the disease goes down, it will take us a much longer time to assess efficacy.

Were not going to get rid of the coronavirus in a hurry. Its going to stay with us. Even if we can vaccinate people, protect them from infection the question is how long will immunity last?

If we think about using vaccines in stages, potentially we could get one, possibly at the soonest to me, about this time next year. Anything sooner than that is extremely optimistic. Others have said we could get it by the end of this year. Im an optimistic person, but Im not that optimistic.

David Ridley

Were preparing to manufacture at scale. Fortunately, some of these vaccine makers are already manufacturing now. Sanofi said theyre going to be able to make 100 million doses this year and a billion doses next year. Thats really unprecedented. Usually youd wait to see if your vaccine is having some success. If you think theres a 1-in-8 chance that youre going to get on the market, and youre already spending tens of millions, hundreds of millions of dollars, thats kind of crazy. But thats the crazy world we live in and I salute them for it.

Usually it takes years to manufacture. You want to be sure you got a good vaccine before you begin making it at scale. Typically this is going to take four or five years. Maybe now we can do it in one or two years. Part of this is going to depend on the appetite of these manufacturers to start building something now that they probably will never use.

My guess is this will take longer than people will assume because there will be a little bit of foot-dragging. If you drag your feet a little bit longer and make sure its a good vaccine, that its going to work before you make the huge investments in manufacturing, you can save a lot of money.

Thomas Denny

The duration of immunity post-vaccination is a major scientific issue were trying to understand. Were also trying to understand right now whats the duration of immunity after natural infection. That will help us probably understand how well or how well not vaccines will work for us.

One of the approaches were taking at the vaccine institute, were also exploring the potential development of a pan-coronavirus vaccine.

If we can develop a vaccine that would cover protection to all types of coronaviruses that may be a threat to us we think that would be a big benefit. Thats a longer-term goal for ours. Its 18 months to two years out. I dont think there are many playing in that space currently. Most are looking at the short-term COVID-19 pathogen and trying to get a rapid vaccine developed for that one.

Ridley

Its very common for the second product, a later product to be better than the first. Lipitor was fifth to market for cholesterol drugs and was arguably better than the previous four.

Its reasonable to expect that later entrants will be better. Assuming the virus is still with us and still a threat, Id expect other companies to continue product development.

Ooi Eng Eong

Obviously theres pressure. Theres pressure from the demand from the public for a solution so they can go back to some level of normality in their lives. Theres pressure from colleagues in the hospitals saying we need to deal with this.

Theres also competition from other groups working on vaccines. I think competition is good. It forces us to think harder to come up with better, more innovative ways of doing things. There is pressure but I think at some level of pressure is good to really push the boundaries.

Ridley

We need a lot of materials in this process. Some are very simple. Gowns and masks are pretty simple things. Swabs for diagnostics are pretty simple things. Rubber stoppers, medical glass sound pretty simple. But we really have a high standard for those because anytime we have something coming into contact with the vaccine thats going to go straight into your blood stream, we have a really high standard for sterility.

Sterile water always seems to be in shortage. Water should be easy to make. But it has to be sterile because its going straight into the bloodstream. We cant underestimate the importance of all these products along the line.

We might be a little concerned about hoarding. Theres cost to scaling up PPE. Theres cost to scaling up medical glass and rubber stoppers. Someone might hoard those. One of the vaccine manufacturers, one of the hospitals might try to grab those materials. Theres all sorts of parts in this process and if one of them breaks down, it slows the process of getting the vaccine to people."

Ridley

None of the major vaccine manufacturers will charge ridiculous prices. Theyre in this game to try to do good, to try to impress their employees, to try to impress their shareholders. Theyre not going to do that by charging ridiculous prices.

Ooi Eng Eong

Were testing (our vaccine) as a preventative vaccine. But is an intriguing possibility. Our fight against the virus relies on the body to recognize first of all its infected with the virus. It triggers a series of processes. So it is entirely possibly theoretically that because were using an RNA vaccine, the vaccine will trigger the processes that will allow the (body) to fight an RNA pathogen.

Weve only had this virus for seven months now. Theres a lot we dont know about this virus.

Think about it like a thief breaking into your house. If this person is very skilled at overcoming your alarm, they will be able to break into your house. If you have another system that can activate the alarm while the break-in is in process, you would actually trap the thief. So it is something that is possible.

Denny

Those with underlying medical conditions, and first-line responders. Hospital workers, theyre the highest priority. If we cant keep those folks going, were in trouble.

Faculty participants

Thomas N. DennyThomas Dennyis chief operating officer of the Duke Human Vaccine Institute, a professor of medicine and an affiliate member of the Duke Global Health Institute. His administrative oversight includes a research portfolio of more than $400 million. Denny has served on numerous committees for the NIH over the last two decades.thomas.denny@duke.edu

Ooi Eng EongOoi Eng Eongis a professor of medicine and deputy director of the Emerging Infectious Diseases Programme at Duke-NUS Medical School in Singapore. He also co-directs the Viral Research and Experimental Medicine Centre at the SingHealth Duke-NUS Academic Medical Centre (ViREMiCS), which studies therapies and vaccines against viral infections.engeong.ooi@duke-nus.edu.sg

David RidleyDavid Ridleyis a professor of the practice at Dukes Fuqua School of Business, where he is faculty director of the Health Sector Management program.He was lead author of the paper proposing a review program to encourage development of drugs for neglected diseases that became U.S. law in 2007.david.ridley@duke.edu

---Duke experts on a variety of other topics related the coronavirus pandemic can be found here.

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COVID-19 Vaccine in 2020 Highly Unlikely, Experts Caution - Duke Today

Where have all the patients gone? Thats what doctors in our West Virginia University hospitals began asking as the coronavirus pandemic spread.

We were prepared for a rise in COVID-19 patients, but we didnt expect the sharp decline we saw in everyday cases. Our emergency department visits fell by half in early April, a time when we would normally see growth as flu season overlaps with an increase in trauma as the weather improves. Inpatient stays fell by nearly two-thirds during the same time period.

Did the population of a state that ranks in the bottom of most health indicators suddenly get better? Did their lung disease, heart disease and vascular disease improve?

In the emergency room, we heard the reason: I thought I could wait this out, patients told us.

Delaying treatment for acute and chronic conditions comes at a cost, both human and financial.

In hospitals across the U.S. andEurope, people fearing contracting COVID-19 have been choosing not to seek the emergency treatment they need. One survey conducted in April found thatnearly a third of U.S. adults had delayed medical careor avoided seeking care because they were concerned about getting COVID-19.

The numbers reported by hospitals seem to bear that out. U.S. emergency room trips for heart attacks fell 24% in the 10 weeks after the government declared a national emergency, according todata released June 22by the Centers for Disease Control and Prevention. Visits for strokes were down 20%, and visits for hyperglycemia, or uncontrolled high blood sugar, were down 10%.Childrens vaccinations also dropped offsignificantly, according to CDC data, raising new concerns after last yearsmeasles outbreak.

This has certainly been our experience as physicians and faculty at the West Virginia University School of Medicine. The patients we saw in the emergency room this spring were a lot sicker, and the proportion of emergency room patients who needed hospitalization increased.

Delaying treatment for acute and chronic conditions comes at a cost, both human and financial.

A patient with appendicitis who gets treatment early will usually undergo laparoscopic surgery, using small incisions and a camera, and can go home two days later. If the same patient waits too long, however, and a pocket of infection known as an abscess forms, that means more complex surgery. We will have to insert a tube for several days to drain the abscess, and the patient will be hospitalized longer, in addition to going on antibiotics. In the worst case, the appendix could burst and lead to diffuse peritonitis and sepsis, a medical emergency with severe abdominal pain and low blood pressure.

Similarly, if a diabetic with a foot infection that is early in the stages of cellulitis, a painful localized skin infection, waits a week to two longer than usual, theres a greater chance the infection has reached the bone, becoming an osteomyelitis that could require amputation.

The ultimate cost for delaying treatment can be loss of life.Data from the CDCshows the U.S. had66,000 more deaths than expectedfrom January through the end of April, with only about half of those linked to COVID-19. In April and May, the U.S. saw about13% more non-COVID-19 deathsthan would have been expected.

In some cases, clinics have tried to balance the risks. For example, many clinics delayed preventative care such as cancer screenings because of the risk of COVID-19. One U.S. study foundan abrupt drop in preventative cancer screeningsof between 86% and 94% through April. Treatments for cancer patients continued, but with hospitals takingextra precautionsto protect patients while their immune systems are compromised.

COVID-19 is not going away anytime soon, nor will heart attacks, strokes or appendicitis.

If you feel you need to see your doctor, go. If you feel you need to go to the emergency department, call 911. Its better than the pain and costs that can come with delay.

COVID-19 is not going away anytime soon, nor will heart attacks, strokes or appendicitis.

Your experiences during hospital visits going forward will definitely be different for a while. People arriving for hospital care that doesnt require staying overnight should expect some kind of screening process to make sure that they are not ill with COVID-19. The health care system will encourage social distancing at check-ins, as well as in the waiting rooms, and everyone will be wearing face masks.

While these unprecedented times have upended our care processes, they also offer patients and health care systems new opportunities.

When we talk to our patients, many of them appreciate the opportunity for virtual visits, especially those at highest risk for complications from COVID-19 infection. The ability to establish virtual urgent care as well as offer many clinical services through virtual visits is here to stay.

The past few weeks have seen very significant changes at all points of patient entry into a hospital or clinic. However, clinical medicines fundamental principle ofprimum non nocere, first do no harm, prevails, and we remain committed to making sure that patients who need care get it on time and do not have to delay their visits or ignore their symptoms.

Arif R. Sarwari, Physician, associate professor of infectious diseases, chair of Department of Medicine, West Virginia University and Christopher Goode, Emergency medicine physician, chair of Emergency Medicine, West Virginia University. This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Fearing coronavirus, patients delayed hospital visits, putting health and lives at risk - Considerable

"The current setting we're in is certainly quite triggering for people who have migraines. People are worried and they're getting more migraine headaches," said Dr. Rachel Colman, director of the Low-Pressure Headache Program at the Icahn School of Medicine at Mount Sinai in New York.

In addition, "many of us have our work-home boundaries blurred right now," said Dr. Merle Diamond, president and managing director of Chicago's Diamond Headache Clinic.

"We're working from home, and oftentimes that makes it harder to have an on-switch and an off-switch," she said. The change in work can be triggering because "migrainers have very sensitized nervous systems that don't like change."

Nor are we getting up and moving, stretching, hydrating or sleeping as we should, which can all be significant triggers, Diamond said. She's the daughter of Dr. Seymour Diamond, who was renowned for shattering common medical assumptions that migraines were psychosomatic, a sign of depression or just an excuse to avoid chores or work.

Is my headache Covid-19?

Of course, in today's reality, the first thing that pops into any headache sufferer's head is: Do I have Covid-19?

Longtime "migrainers" may know the difference, but what if you're a newbie to the world of head pain? From what is known right now, Diamond said, a headache brought on by Covid-19 presents much differently than a migraine.

"You may have fever, you may have persistent coughing and all of those things can predict a headache," said Diamond, who is a National Headache Foundation board member.

"However, the headache of Covid-19 is described as a really tight, sort of squeezing sensation, and typically worsens with coughing and fever," she said.

That sensation happens as our immune system rallys in response to the virus, releasing chemicals called cytokines. Cytokines produce inflammation, which is perceived as pain by the cerebral cortex of the brain.

But a migraine presents much differently, Diamond said, with a throbbing pain that is moderate to severe, and can be accompanied with a sensitivity to light and noise and vomiting.

"The best way to describe a migraine is that it is a sick headache," Diamond said. "Patients describe it as their brain is too big for their skull.

"Then there's the migraine hangover. For a lot of patients the pain part of their headache might last eight hours, 12 hours, 14 hours, but after the headache is gone, they have cognitive clouding," Diamond added.

"They're lethargic, they're irritable, they may still continue to have light sensitivity or nausea. The whole process for some migraines can take several days," she said.

While migraine, tension and cluster headaches are the most common forms, there are hundreds of different subtypes of headaches.

Categories include abdominal, hormonal, caffeine, hypertension, post-traumatic and rebound headaches; allergy, sinus, medication, cough, sex or exercise-induced headaches; as well as headaches defined by symptoms, such as stabbing, thunderclap, ice-pick or exploding head syndrome.

Two severe and dangerous types of headaches are caused by meningitis, where the membranes that cover the brain and spinal cord become swollen or inflamed, and encephalitis, an inflammation of the brain that is caused by viral infection, with neck stiffness and fever.

In Covid-19 cases, the most severe and dangerous headaches seem to be in people who are extremely sick with Covid-19, said Colman, who is a member of the National Headache Foundation Health Care Professionals Leadership Council.

"There's been some really bad headache disorders with Covid-19," Colman said. "it's too early to know for sure, but it does seem like the very ill patients that have very sick lungs and are really struggling in ICU tend to be the ones that are getting the more serious complex neurological complications."

What to do?

Anyone who is suffering from constant or debilitating headaches or migraines should reach out to a headache specialist for help, experts say. Most are seeing patients via telemedicine, and will work with you to get to the root of the problem.

"I'm trying to troubleshoot some of the issues that are happening during isolation," Colman said. "Is it the fact that they're not sleeping, they're not leaving work at work, they're not exercising anymore?

"Or is it the fact that they're very stressed out with worry about financial and personal and family obligations? So trying to kind of find the root cause for why the worsening is to try and work on it," she said.

There are also preventative things you can do to keep headaches at bay.

"Make sure you have good hydration at the place that you're sitting and drink a certain amount every hour," Diamond said. "It's also important to get up, breathe and stretch at least once an hour."

Meditation and relaxation exercises are extremely helpful, as is biofeedback, she suggested.

"I think that's really helpful and it doesn't take a lot of time. You can do it in five to 10 minutes and it just kinda resets, which is what we want to do," Diamond said. "Then making sure you're not skipping meals, and that you're not overworking. You have to have an off to your day if you can."

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Covid-19 or migraine? Here's how to tell and what to do about it - CNN

Health

REXBURG, Idaho (KIFI/KIDK) - Maintaining a healthy body is important for both genders but also taking the time to bring awareness to common health issues that are more common in one encourages early detection and treatment, according to family physician at Seasons Family Medicine, Dr. Michael Packer.

"The essence of preventative medicine is that catching something early and dealing with it almost always means less pain, less trouble, less procedures than catching it later," Dr. Packer said.

There are key things Dr. Packer suggests everyone should be doing to stay healthy, "The foundational thing is active lifestyle and healthy diet."

As men get older, Dr. Packer says there are common health issues they should be actively preventing.

"Age by age, there are different things that we ought to be following when you hit your 40s and 50s we need to be doing some cancer screening like screening for prostate cancer, screening for colon cancer. The biggest risk for men is cardiovascular disease and so making sure that cholesterol is well controlled making sure they don't have diabetes, making sure their blood pressure is controlled."

According to a study done by the CDC, most preventative care visits are made by women versus men. Dr. Packer tells us this is especially concerning during the COVID-19 pandemic when many people have put off their medical care.

"A healthier person, if they get the disease is a lot better than somebody who has a lot of other health issues," Dr. Packer said.

Many doctors in the area are offering telehealth visits for those who don't feel comfortable coming in.

Idaho / Idaho Falls / Local News / News / Top Stories / Videos

Link:
Men's Health Month: What preventative care men should be taking - Local News 8 - LocalNews8.com

Following previous articles in Open Access Government where we discussed the treatment of cancer, pain, psoriasis, rheumatoid arthritis and epilepsy, this final piece focuses on the use of cannabinoids to treat COVID-19.

The coronavirus disease 2019 (COVID-19) is an infectious disease caused by SARS-CoV-2, a novel coronavirus that was first identified in Wuhan, China, in December 2019 (Smith & Mackenzie, 2020). Since then, COVID-19 has spread globally, resulting in an ongoing pandemic. In the UK alone, there were over 275,000 confirmed cases of the disease, resulting in more than 39,000 deaths as of 2nd June 2020. Worldwide, 6.37 million confirmed cases and over 377,000 deaths were reported.

COVID-19 is part of a large family of coronaviruses. Some are relatively harmless, causing only common cold-like symptoms, while others can be more severe, causing diseases such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) (World Health Organization (WHO), 2020). Following the SARS outbreak in 2002, and MERS in 2012, COVID-19 is the third significant coronavirus outbreak in the last two decades.

Coronaviruses can be transmitted through both direct (droplet and human-to-human transmission) and by indirect contact (airborne contagion and contaminating objects). The most common symptoms associated with COVID-19 include a fever, cough, shortness of breath, fatigue and loss of smell or taste (CDC, 2020). More severe symptoms, which have been associated with adults with the disease, include pneumonia, acute respiratory distress syndrome (ARDS), sepsis and septic shock (Rothan & Byrareddy, 2020) (Huang, Wang, Ren, & Zhao, 2020).

The outcome and severity of COVID-19 are associated with excess production of proinflammatory cytokines, known as a cytokine storm (Ye, Wang, & Mao, 2020). In some patients, this leads to acute respiratory distress syndrome (ARDS), and multiple organ failure (Zaim, Ching, Sankaranarayanan, & Harky, 2020). Effectively, suppressing the cytokine storm is a crucial step in preventing the deterioration of patients with COVID-19 infection, and in saving patients lives.

Cannabidiol (CBD) has the potential to attenuate the pro-inflammatory response and cytokine storm that is observed in COVID-19 patients.

CBD is a phytocannabinoid derived from the Cannabis sativa. CBD has analgesic, anti-inflammatory, antineoplastic and chemo-preventative properties (W. A, 2008), but no psychoactive activity. CBD has been shown to be effective in reducing inflammation in an animal model of acute lung disease, where CBD reduced the production of pro-inflammatory cytokines in the bronchoalveolar lavage (BAL) fluid in the lungs (Ribeiro, et al., 2015). Suppressing the release of pro-inflammatory cytokines have the potential to be used as a therapeutic treatment for patients with COVID-19.

CBD has multiple mechanisms of action, some of which have been explored when investigating the effects of CBD on lung disease, including models of ARDS, sepsis and acute lung injury. The nuclear factor NF-kB pathway is involved in proinflammatory signalling, where NF-kB activation is widely implicated in inflammatory diseases. NF-KB is a mediator of pro-inflammatory gene induction and modulates the release of pro-inflammatory cytokines (Lawrence, 2009).

The p38 mitogen-activated protein kinase (MAPK) is an intracellular protein that can initiate inflammation (Kumar, Boehm, & Lee, 2003). The activated form of p38-MAPK (phosphorylated p38-MAPK), is upregulated in response to inflammatory and stress stimuli and plays a central role in the production of pro-inflammatory cytokines (Shieven, 2005). Blocking MAPK-p38 signalling reduces activation of pro-inflammatory cytokines and phosphorylation of p38-MAPK. CBD inhibits phosphorylated p38-MAPK, which leads to decreased production of NKkB and AP-1 (both inflammatory transcription factors) resulting in reduced inflammation (Silva, et al., 2019).

MicroRNA (miRNA) are small non-coding RNA that regulate a wide range of genes. Alternations in their expression are associated with immune responses, inflammatory signalling pathways and pathogenesis of lung diseases, such as ARDS and acute lung disease. Mi-146a is a negative regulator of inflammation, leading to the reduction of NF-KB transcriptional activity. However, mi-146a has shown to be upregulated during immune activation through increased NF-KB activity (Taganov, Boldin, Chang, & Baltimore, 2006). In one study, CBD reduced the activity of NF-KB signalling, which downregulated mi-146a expression (Kozela, et al., 2010) and decreased the release of pro-inflammatory cytokines (IL-6 and IL-1) (Juknat, Gao, Coppola, Vogel, & Kozela, 2019). This provides evidence that CBD has anti-inflammatory effects that are mediated via the NF-KB signalling pathway.

CBD also acts as an antagonist for the G-coupled protein receptor, GRP55 (Ryberg E, et al., 2007). GPR55 signalling can modulate certain pro-inflammatory cytokines The role of GPR55 on the immune response was investigated in an animal model of sepsis. The inhibition of GPR55 using CBD-related antagonists decreased the release of pro-inflammatory cytokines and reduced inflammation (Ahou, Yang, & Lehmann, 2018). GPR55 inhibition may, therefore, be a novel target for attenuating hyper-inflammation in sepsis and a potential target to treat COVID-19.

There is one ongoing clinical trial investigating the effects of CBD on COVID-19. The study, currently in proof-of-concept (POC) stage, is investigating the use of CBD in combination with steroids in a small cohort of 10 COVID-19 patients at Rabin Medical Center, Israel (Stero Biotechs, Ltd, 2020).

Within the last 20 years, we have seen three deadly coronaviruses and can expect to see more in the future. Suppressing release of pro-inflammatory cytokines by CBD provides a potentially new therapeutic approach in the treatment of COVID-19. There is limited research into CBD and COVID-19 during this current pandemic, however, there is evidence that demonstrates that CBD can reduce the cytokine storm observed in the severe symptoms of the virus. The limited research to date shows that the use of CBD to treat ARDS caused by COVID-19 and other diseases and infectious agents is a promising avenue that warrants further investigation.

References

Ahou, J., Yang, H., & Lehmann, C. (2018). Inhibition of GPR 55 improves dysregulated immune response in experimental sepsis. . 1-9.

CDC. (2020, April 28). Coronavirus Disease 2019. Retrieved May 28, 2020, from Centers for Disease Control and Prevention: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

Huang, C., Wang, L., Ren, L., & Zhao, H. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. 395(10223), 497-506.

Juknat, A., Gao, F., Coppola, G., Vogel, Z., & Kozela, E. (2019). miRNA expression profiles and molecular networks in resting and LPS-activated BV-2 microgliaEffect of cannabinoids. 14(2).

Kozela, E., Pietr, M., Juknat, A., Rimmerman, N., Levy, R., & Vogel, Z. (2010). Cannabinoids 9-tetrahydrocannabinol and cannabidiol differentially inhibit the lipopolysaccharide-activated NF-B and interferon-/STAT proinflammatory pathways in BV-2 microglial cells. 285(3), 1616-26.

Kumar, S., Boehm, J., & Lee, J. (2003). p38 MAP kinases: key signalling molecules as therapeutic targets for inflammatory diseases. 2(9), 716-26.

Lawrence, T. (2009). The Nuclear Factor NF-B Pathway in Inflammation. 1(6).

Ribeiro, A., Almeida, V. I., Costola-de-Souza, C., Ferraz-de-Paula, V., Pinheiro, M. L., Vitoretti, L. B., . . . Palermo-Neto, J. (2015). Cannabidiol improves lung function and inflammation in mice submitted to LPS-induced acute lung injury. 37(1), 35-41.

Rothan, H., & Byrareddy, S. (2020). The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. 109.

Ryberg E, L. N., Leonova, J., Elebring, T., Nilsson, K., Drmota, T., & Greasley, P. (2007). The orphan receptor GPR55 is a novel cannabinoid receptor. Br J Pharmacol, 152(7), 1092-101.

Shieven, G. (2005). The biology of p38 kinase: a central role in inflammation. 5(10), 921-928.

Silva, R. L., Silveira, G. T., Wanderlei, C. W., Cecilio, N. T., Maganin, A., Franchin, M., . . . Cunha, T. M. (2019). DMH-CBD, a cannabidiol analog with reduced cytotoxicity, inhibits TNF production by targeting NF-kB activity dependent on A2A receptor. 368, 63-71.

Smith, D., & Mackenzie, J. (2020). COVID-19: a novel zoonotic disease caused by a coronavirus from China: what we know and what we dont.

Stero Biotechs, Ltd. (2020). Stero Biotechs Announce an IP Protected Clinical Trial for COVID-19 Patients Using a CBD-Steroid Treatment. Retrieved from prnewswire: https://www.prnewswire.com/news-releases/stero-biotechs-announce-an-ip-protected-clinical-trial-for-covid-19-patients-using-a-cbd-steroid-treatment-301043465.html

Taganov, K., Boldin, M., Chang, K., & Baltimore, D. (2006). NF-kappaB-dependant induction of microRNA miR-146, an inhibitor to signalling proteins of innate immune responses. 103(33), 12481-6.

World Health Organisation (WHO). (2020, January 14). WHO Statement regarding cluster of pneumonia cases in Wuhan, China 2020. Retrieved May 29, 2020, from https://www.who.int/china/news/detail/09-01-2020-who-statement-regarding-cluster-of-pneumonia-cases-in-wuhan-china

Ye, Q., Wang, B., & Mao, J. (2020). The Pathogenesis and Treatment of the `Cytokine Storm in COVID-19. 80(6), 607-613.

Zaim, S., Ching, J., Sankaranarayanan, V., & Harky, A. (2020). COVID-19 and Multi-Organ Response. 100618.

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Cannabinoids in medicine part 5: Treating COVID-19 - Open Access Government

Are your allergies particularly bad this season?

I thought this would be a great and timely issue to bring back my Healthy Actions column, a monthly chat with a local medical expert. I had to pause the columns during the height of coronavirus coverage.

My expert is Dr. Matthew Mivsek, a family medicine doctor with Unity Health Networks Hudson office.

Also check out an accompanying video with Mivsek, where we answer some reader questions.

Q: Typically, when is allergy season?

A: Tree pollination is early spring, grass pollination is late spring and summer and ragweed is late summer and early fall.

Q: Is this season worse and why?

A: Yes, there are quite a few patients coming into the office and calling the office with allergy symptoms, more so than usual this year. The likely reason is the unseasonal weather early in the year, both with warmer-than-usual temperatures early on and an unexpected snowstorm in May. The amount of precipitation has increased pollination and overall pollen counts.

The fluctuations of the temperatures led to both tree and grass pollens starting to come at the same time, which has really sent a lot of individuals allergies into overdrive.

A useful app to track the potential to aggravate allergy symptoms when spending time outside and the overall pollen counts is Weather.com. It will show breakdowns of tree pollen, grass pollen and ragweed pollen. If you know which type of pollen you are most allergic to, you can try to avoid days when the specific counts are higher.

Q: Some people say this is the worst season ever and others say theyre doing OK or had some mild issues a few weeks ago. Why?

A: What everyone is allergic to is different. Ive had people saying the same thing. It does vary from year to year and unless you know exactly what youre allergic to, its hard to say.

Q: Could stay-at-home orders keeping us inside have helped with allergies?

A: Thats a reasonable theory. Generally, staying inside in air conditioning or with the windows closed helps with allergies.

Q: Does the wind or rain affect allergies?

A: Wind can definitely make allergies worse by circulating pollen in the air. Ive heard that rain can make things worse. It may not be that day, but a few days later with the humidity. Sometimes also when the raindrops fall, theyre throwing pollen in the air.

Q: How can I tell if this is allergies, a cold, the flu or COVID-19?

A: The most important symptoms to be aware of regarding COVID-19 are fever (over 100.4 degrees Fahrenheit), cough and shortness of breath.

Allergies typically present with runny nose or nasal congestion, itchy, watery eyes and scratchy throat, predominantly. A cough is usually caused by post-nasal drainage in the setting of allergies that are not controlled.

A cold/flu/coronavirus symptom presentation can be similar, so I can understand the concern regarding this matter. A major difference between allergies and cold, flu, coronavirus is the presence of a fever.

Q: So what over-the-counter relief is there?

A: There are several options. In the category of oral antihistamines or pills, the least potent are Claritin (generic name loratadine) and Allegra (fexofenadine), moderately potent are Zyrtec (cetirizine) and Xyzal (levocetirizine) and most potent is Benadryl (diphenhydramine), but Benedryl, that does make you pretty tired and make it difficult to function throughout the day.

For nasal sprays, there are steroid nasal sprays such as Flonase, Nasacort and Rhinocort that are going to be most effective; antihistamine nasal sprays such as Astelin and saline nasal sprays such as Simply Saline and Ocean mist.

Be sure to use the nasal spray properly. Lean slightly forward and point the spray in your nose toward the outer corner of your eye. Lightly sniff. If you sniff too much and can taste the spray, it wasnt used correctly and has gone down your throat instead of into your sinuses.

For eyedrops, there are antihistamine ones, such as Zaditor, Pataday, Naphcon and Alaway.

Q: Is it preference to take a pill versus nasal spray?

A: Yes, rather than use an oral medication that goes throughout the body and can have potential side effects, if you want to directly treat the problem, you can use a nasal spray.

Q: Is it better to do something preventive and take allergy medications before the season starts instead of waiting for an attack?

A: There certainly is benefit to practicing preventive medicine in all aspects of medication, and preventative measures to alleviate allergy symptoms is no different. If you know that your allergy symptoms are the worst in the spring, beginning to take an oral antihistamine toward the end of winter can help to alleviate symptoms moving through peak allergy seasons.

Q: Is it safe to layer other medications on during a flare-up?

A: Yes, its OK to layer treatments. Taking an oral antihistamine can be paired with any nasal spray and eyedrops. You want to be careful about the decongestant part, or "D" portion of a pill, especially for someone with high blood pressure because it can elevate blood pressure. Those with high blood pressure should take Coricidin HBP.

Q: When should I call or ask a doctor for a prescription instead of trying over-the-counter remedies?

A: If youve maxed out therapies over the counter or youre uncomfortable with what youre layering, call for an appointment or telehealth appointment. You can also ask the pharmacist at the store.

Q: What about shots?

A: Thats usually done by an allergist through a referral. Before allergy shots or immunotherapy, they would do a prick test to find out which allergen is causing the response.

Q: Can wearing a mask help?

A: A mask certainly wont hurt to protect against allergens and can help with airborne pollen, just like viruses. Cloth masks are going to be the least effective, followed by surgical masks and health-grade N-95 masks. We havent necessarily used masks for treatment of allergies, but they can help, especially for those who may want to wear masks when theyre mowing the grass or doing yard work.

Beacon Journal consumer columnist and medical reporter Betty Lin-Fisher can be reached at 330-996-3724 or blinfisher@thebeaconjournal.com. Follow her @blinfisherABJ on Twitter or http://www.facebook.com/BettyLinFisherABJ and see all her stories at http://www.beaconjournal.com/topics/linfisher

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Healthy Actions: Heres relief if your allergies are flaring up - Akron Beacon Journal

Dr. Emily Lange has been an OB-GYN physician for eight years. She is currently in her fifth year at Methodist Physicians Clinic Womens Services, at Methodist Jennie Edmundson Hospital.

Lange and her husband, Arnie, have been married for eight years and have four children Anthony (6), Lucia (5), Isaac (3) and Claudia (1).

In her free time, Dr. Lange enjoys spending time outdoors with her children, meeting with her book club and participating in a womens Bible study fellowship group.

Lange also belongs to Global Partners in Hope a nonprofit organization that aims to address the tangible needs of people in communities across the globe by providing health care, clean water, sustainable energy, leadership courses and many other services.

As a physician, Lange feels very privileged that coming to work each day allows her to provide quality services to her patients.

Sometimes you see great outcomes in a finite time span such handing a healthy baby to a healthy mom, other times it is more subtle and long term such as providing education during a well woman exam about vaccines and helping individuals navigate their own healthcare goals, Lange said. I approach medicine as a partnership between me and my patients, their success is my reward.

Our Womens Center provides full spectrum gynecologic and obstetrical care. I enjoy working with women at all stages of their lives.

Much of clinic time is spent providing preventative care and education to address specific questions women have. This allows a relationship with patients to develop that is very rewarding as

I walk through many life changing events with them.

Lange continued: I love delivering babies and seeing families grow. I love the community at Jennie Edmundson. I have the best co-workers in clinic and the best nurses in the hospital.

I have delivered 3 of my children at Jennie and have been very impressed with the care from a patient standpoint as well.

We are excited to be expanding the scope of womens services to Council Bluffs and western Iowa meeting your health care needs closer to home.

Stay up to date on Jennie Edmundsons womens services renovation projects by going online to http://www.jehfoundation.org.

More:
June 17 Face of the Day: Dr. Emily Lange - The Daily Nonpareil

08:45 14/06/2020 Gabi Zietsman

Volunteering isnt just good for the soul it can also increase your lifespan.

A study by the University of Michigans Institute for Social Research published in the American Journal of Preventative Medicine analysed data from comprehensive US research involving adults over the age of 50 to see if theres any correlation between volunteering and physical health, health behaviours and psychosocial wellbeing.

READ: Even a little activity keeps ageing brains from shrinking

They chose 34 indicators that signify what it means to age well how it affects things like life satisfaction, optimism, physical activity, depression and chronic conditions.

With over 12 000 participants over the span of four years, they found that those who volunteered for more than 100 hours a year about 2 hours a week had a 44% reduced mortality risk, a 17% reduced risk of mobility issues and 12% increased physical activity.

'A means to stay young'

The volunteering heroes were also less hopeless, had more of a purpose in life and felt less lonely. They were also 29% less likely not to be in regular contact with their friends.

However, the study did not find volunteering to have any impact on chronic diseases like cancer, diabetes and arthritis, certain behaviours like drinking and smoking, and other indicators like depression and connection with family.

ALSO SEE: Worried about ageing? Scientists discover 4 distinct ageing patterns

This contradicts earlier studies, although the researchers noted that it could be due to the studys missing "cause of death" statistics of participants.

Previous studies on health and volunteering also tended to be limited in sample size and skewed towards younger subjects.

It concludes that volunteering could prevent a decline in quality in life as we get older, help the psyche and make us more resilient to stress factors.

The art of helping in our communities is also something that physicians could potentially prescribe to older patients who are willing and able as a means to "stay young".

However, during the Covid-19 pandemic, those that fall in the high-risk age category need to be careful with activities outside their homes including helping their fellow humans.

Image credit: Getty Images

Excerpt from:
Another benefit of volunteer work? Science says it can help you live longer - Health24

Dale Okorodudu, MD founder of DiverseMedicine Inc. and the Black Men In White Coats Video Series addresses healthcare disparities in this new pandemic world

Dale Okorodudu

Dale Okorodudu, MD, the founder of DiverseMedicine Inc. and the Black Men In White Coats is driven by a desire to educate our community on the short and long term impact of neglecting our health and what that does to the solo and the community at large.

Astrophysicist, cosmologist, planetary scientist, author, and science communicator, Neil deGrasse Tyson said Not only are we in the Universe, but the Universe is also in us. I dont know of any deeper spiritual feeling than what that brings upon me.

In the May 14th issue of the Los Angeles Times in an article entitled Some creators of color fear coronavirus will be a major setback in TVs diversity push, written by staff writer Greg Braxton, creators such as ABCs black-ish Kenya Barris, Gloria Calderon Kellett, co-creator and showrunner of Netflixs One Day at a Time, and John Ridley, creator of ABCs American Crime and an Oscar winner for 12 Years a Slave, expressed their concerns for the long term impact of the pandemic on people of color in the entertainment industry. Here are the facts, the virus is particularly lethal for Black and Latino segments of the population. This situationhas prompted heightened concerns among some of TVs top talents about their creative and personal futures.

When I shared this link with Dale Okorodudu, MD, via email his response was Wow. Thats the exact reason were pushing to get this done now. Perhaps some doors will open up and we can get our message out.

Doctor Okorodudu understands the uncomfortable reality about the virus and how its been particularly lethal for the African-American and Latino population. Data across the board is calculating that those of us under 50 are dying of the coronavirus at significantly greater rates than other groups, including whites.

In New York, we are at twice the rate according to preliminary data released on the date of filing. This alarming news isnt new for Dr. Okorodudu. The facts are helping to drive his initiative harder.

But Dr. Dale Okorodudu knew all of this and as the founder of DiverseMedicine Inc. and the Black Men In White Coats Video Series knowing whats ahead is one of the key reasons that hes passionate about health. Our health in particular.

Dr. Okorodudu was raised in League City, Texas (just outside of Houston), and completed both his undergraduate and medical training at the University of Missouri. He relocated to Durham, North Carolina where he completed his Internal Medicine residency training at Duke University Medical Center.

After training, Dr. Okorodudu returned to Texas and completed his Pulmonary & Critical Care Fellowship at UT Southwestern Medical Center. His clinical practice is at the Dallas VA Medical Center. Dr. Okorodudu has a passion for addressing healthcare disparities which he has done via promoting diversity in the medical workforce. Outside of medicine, he enjoys spending time with his wife, 3 children, and church family.

A white coat is a symbol and not just a garment to Dr. Okorodudu; it carries weight, especially when its on the shoulders of a black man. As a pulmonary and critical care physician, who specializes in treating lung ailments, Dr. Okorodudu has been smashing societys stereotype of what a doctor looks like ever since he started as an undergrad and continues to move forward with renewed vigor.

Here is what Dale Okorodudu, MD founder of DiverseMedicine Inc. and the Black Men In White Coats Video Series and the author of the new childrens book series called Doc to Dochad to share about why we need more Black men in the medical field.

LOS ANGELES SENTINEL: Dr. Dale Okorodudu why did you start Black Men in White Coats (BMIWC)?

DALE OKORODUDU, MD: It is an organization that I built to foster diversity in medicine through mentorship and motivation. It is my mission.

LAS: But why? Is there a shortage of Black men in the medical profession?

DO: Yes, there is. There is only around 2 percent of medical school applicants in the United States are Black men and the number of Black males applying to medical school is declining despite rising rates in other fields of study.

LAS: Why do you think this is happening?

DO: The biggest thing is the lack of role models. A lack of mentors in the field, individuals that look like them. We have a lot of young Black men who have so much potential but they dont see people like them in the medical field. You gravitate toward whats like you and whats around you.

LAS: So its safe to say thats one of the inspirations behind creating and running Black Men In White Coats Video series and books, as well?

DO: Exactly. In exposing young black children to the idea that they could be doctors, leading by example, is paramount. Black young men need to see themselves as the men in white coats and know the coat would fit.

LAS: I am feeling you, Doctor. See it. Believe it. Become it.

DO: Exactly.

LAS: Youve written a childrens book series called Doc to Doc, why?

DO: My goal in doing this is to provide exposure to the medical field to kids of all ages and all backgrounds. Kids learn in different ways. There are all kinds of ways to reach them. Some kids watch a lot of television. Others listen to music. My older son listens to music now. Some of them love books. For those kids that do the love the books [I thought] if I can give them little kids that look like them [Black kids] that want to do things in medicine that might catch their eye.

LAS: Well it caught mine and it caught others, so bravo Doctor.

DO: Thank you. And for those that dont love the books, if I give them something that looks like them that is colorful and fun, they might begin loving and reading books. I wanted to make them fun books. I have two little kids, two little Black boys, and a little Black daughter.

LAS: I love it. Three kids. Gosh. They must keep you on your toes.

DO: (laughing) They do and they are the inspiration for the Doc to Doc series. My kids like it so I knew other kids would like [the books] it.

LAS: Genius. You have built-in marketing and focus group right inside your home. Hey, an idea just popped into my head. Have you ever thought of pitching this as an animated series for one of the streaming platforms?

DO: I would love to. Its a goal.

LAS: What are you working on right now?

DO: We are working on making a feature-length documentary on Black Men In White Coats.

LAS: Thats amazing news?

DO: Thank you. The goal is to pitch this to one of the streaming platforms.

LAS: Its so important to get your message out. You have the expertise and purpose. Now lets push into the pandemic. Thoughts?

DO: I have a lot of thoughts. I will begin with whats happening in the African-American communities and thats one of the reasons that I wrote the Doc to Doc children book series. I just put out a book in the series that concentrates on viruses.

LAS: Smart.

DO: Well, my wife suggested it because of everything thats going on right now so the kids understand whats going on. It helps to make sense of whats happening. Talking about why you should wear a mask. Why you should wash your hands. My kids are asking me about it and now its in the book as part of the growing Doc to Doc children book series. This is for kids and also informative for the parents.

LAS: Is there another part of this as well?

DO: There is and I keep going back to this. Its very important. I want to make health care fun for people. To make health care less intimidating for people. No one wants to be told that they are sick. No one wants those crazy medical bills. A lot of people fear the health care system.

LAS: And for good reason. But why are you so passionate to make us feel comfortable?

DO: Thats a great question. If more people become knowledgeable then we can move into preventive care so things wont get us bad on the back in.

LAS: So. Things. Dont Get. Us. Bad. On. The. Back. In. Got it. Amen.

DO: Right now, one of the books that I want to write is Doc to Doc on diabetes.

LAS: Dr. Dale, please write that book. Its needed for sure.

DO: This disease is impacting us and I want our community to engage with the health care community about conditions that impact us. I want the kids to understand so they begin living a different kind of lifestyle so they wont get diabetes or get caught up in the same health problems that their parents are caught up in. We must get them at an early age.

LAS: Dale Okorodudu, MD founder of DiverseMedicine Inc. and the Black Men In White Coats Video Series you are doing Gods work. Can you share some information about the feature-length documentary series on Black Men In White Coats?

DO: Weve completed the project and now in post-production. Its about the lack of Black men in medicine. A year ago we did a Kickstarter campaign (https://www.kickstarter.com/projects/drdale/black-men-in-white-coats-the-film). When we started the campaign a lot of people tried to discourage me because with Kickstarter if you dont raise all of the money you dont get a dime. My goal was 100,000 (one hundred thousand) and a lot of people, a lot, thought I was crazy. We raised it. That was validation that people want this. People understand what we are talking about. People understand the struggle. Only about 2 percent of U.S. physicians are Black and the number of Black male applicants to medical school has not been growing. We need to convince more Black boys to pursue careers in the field. In the feature length documentary, we dive into why Black men are not in the medical profession and the implications. I get too excited about this new project. Now people are talking about the pandemic and how Black and Brown people are dying at higher rates than Whites. People in my field we understand why. Like its like duh.

LAS: So this pandemic impact on people of color isnt new information for those in the medical community?

DO: No. Weve been talking about his for years. Thats just one of the reasons that we need diversity in medicine. These things come to light when other people become infected by it. We need to concentrate on preventative medicine. We need to focus on the front end.

This interview has been edited for length and clarity.

Dale@DiverseMedicine.com http://www.DiverseMedicine.com Click Below to Check Out My Amazon Bestselling Books! https://doctordalemd.com/product/how-to-raise-a-doctor-book-bundle-50/

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Dale Okorodudu, MD founder of DiverseMedicine Inc. and the Black Men In White Coats Video Series addresses healthcare disparities in this new pandemic...

NEW BRUNSWICK, NJA Highland Park psychologist, age 66, died by falling from a New Brunswick parking deck on the morning of Sunday, June 7.

Her death is the ninth suicide involving one of New Brunswicks parking decks in six years, and the second to take place this year.

Reliable sources told New Brunswick Today that another similar tragedy has occurred since June 7, the second in one week. Police have not yet responded to a request for information about the incident.

New Brunswick Today reported on the eighth death in March and detailed steps that the New Brunswick Parking Authority (NBPA) could take to prevent further deaths.

Although NBPA officials previously informed New Brunswick Todays editor of potential plans to implement physical preventative barriers on one of their parking decks, those plans to prevent suicides have been put on the back burner due to the pandemic, according to the NBPAs executive director, Mitchell Karon.

The NBPA recently installed gates on some elevator doors at the topmost floors and stairwells of parking decks in response to the most recent suicides.

David Minchello, general legal counsel for the NBPA, confirmed during the April 27 NBPA Board of Commissioners meeting that he received a copy of New Brunswick Todays previous article on the issue of New Brunswicks suicides and has distributed copies to the board.

Acknowledging the seriousness of this mental health crisis, the NBPA considers the safety of our patrons in our facilities a priority, Harry S. Delgado, Director of Operations and Security for NBPA, wrote in an email to NBT reporters.

We are committed to mitigation, Delgado continued.

We have safety measures in place such as physical tours of all our twelve facilities by our Parking Services Department, the use of video analytics and other technologies coordinated to help deter these types of incidents.

While NBTs reporter investigated a parking deck facility, three security personnel approached her with compassionate concern during her time there. They eventually asked her to leave despite learning that she is a reporter. One worker explained to her that, given the recent deaths, they are being especially diligent and mindful when they notice any questionable behavior.

Kathleen Cohen, a fellow of Sports Medicine with Rutgers Robert Wood Johnson Medical School, witnessed the aftermath of the victims fall.

I was just walking when I heard what I thought was a car accident, Cohen said.

At first, I ran towards her to try to help and see what I could do but then I realized that there was nothing that I could do or that anyone could do.

Having that all happen in real time meant that I had no time to prepare myself. There was no way to protect myself from that while I was trying to understand what happened.

Police officers who responded to the incident were really compassionate, according to Cohen.

They werent judgmental.

Cohen and other witnesses were shocked and saddened by the death; officers and other witnesses, similarly to Cohen, wished they had been able to help the victim prior to her fall.

She was a block away from a very good hospital emergency room, Cohen said.

They wouldve been able to help her immediately.

Nobody saw her before she jumped or going up the floors. No one could have talked her out of that.

I dont feel responsible, but there is part of me that thinks What if I had seen her sooner? Cohen asks.

Two years prior, Susan Higgins worked as an ER nurse at New Brunswicks Robert Wood Johnson (RWJ) Hospital, where the stressors in her life snowballed and drove her into a state of despair.

I was already in a place of hopelessness, feeling that nothing mattered, and that everything in my life was pointless, Susan said.

It was a busy day. I had my patient load, but I couldnt concentrate even though I tried to stay focused.

As I was getting more depressed, I was already thinking of ways to kill myself if I really would. For whatever reason, I already felt that using the parking deck would have been the easiest thing.

Higgins admits there were several warning signs in her emotional state and behavior that she couldnt see before she reached the dark place of considering the end to her own life.

It wasnt that one or two things happened, Higgins said.

There were months, even years, of accumulated stress in work and my life.

I felt like no matter what I did, it didnt matter or how hard I worked didnt matter.

Though clinical depression is a relatively common mental illness, part of its complexity is due to its wide range of etiologies.

In Higginss case, she explained that factors in her personal life, the pervasive punitive culture in healthcare professions, and biological imbalances influenced her depression.

Theres an attitude in healthcare, especially in emergency medicine, where they say, you need to deal with this. If you cant handle it alone, youre weak. Youre not cut out for this. You cant do this anymore,' Higgins said.

Cohen also said there is a stigma among the barriers preventing healthcare workers from coming forward about their personal struggles with mental illness.

In the medical field, it is almost adaptive to see doctors and nurses as invincible, Cohen said.

They are expected to give everything they have to their profession and their patients and work overtime. Then its discouraged for them to say, Im struggling, or to disclose a psychiatric illness, even when they need support.

Particularly in health care, you need support and you cant do these things alone, Higgins said.

When you have a punitive system, where people get in trouble for mistakes, people are going to hide their mistakes. That snowballs into a culture without growth or learning and with fear The ones who suffer are the patients and healthcare workers.

A spokesperson for RWJUH has not responded to questions sent by a NBT reporter about what mental health services are available to their staff.

Alongside the strife in her work life, her clinical depression actively fought to perpetuate harmful, self-blaming perspectives.

Depression thrives in isolation, Higgins said.

The depression lies to you. It tries to convince you that youre the cause of all the problems.

Calling victims of suicide selfish misses the point.

People who die by suicide think the people who love them would be better off if theyre gone.

Susan Higgins, however, did not die that day.

She remembers January 26, 2018, as the day her life changed for the better.

Thats the day I finally reached out for help, Higgins said.

Instead of ending her life, she stopped the physicians assistant of her primary doctor, who was also working at RWJ that day.

You have to help me, She told him. I need help.

The physicians assistant connected Higgins with her primary care doctor, who reacted compassionately and responsibly by admitting her to another hospitals ER for emergency treatment.

My primary doctor saved my life that day, Higgins said.

Although getting help for her mental health was not a straightforward process, Higgins treatment has helped her build a reliable support system with a multitude of coping tools such as one-on-one counseling, group therapy, medications like antidepressants, guided meditation and more.

Therapy is kind of like an oil change, Higgins explains.

Even when I have a great support system, its still helpful for me to go back when I feel that I need it and touch base with a professional.

A good therapist does more than listen.

A therapist is going to be there to help you differentiate between what is constructive and what is helpful and what beliefs may be harmful to you.

Higgins has found medication to be especially helpful, although she was resistant at first to taking antidepressants.

I didnt want to go on antidepressants for a long time, she said. I assumed that I just needed therapy.

But when I got to a point where things were actually pretty good in my life, I still felt really depressed.

I had to try different medications and it isnt as simple as going on a pill. Sometimes you need to make changes.

Despite her complicated journey to recovery, her treatment has enabled her to better cope with challenges in her life.

The last few months managing an ER in NYC have been very stressful, but I havent been depressed, Higgins said. I certainly havent been to a point of considering killing myself.

Im happy that I got help.

Both Higgins and Cohen compared mental illnesses like depression to chronic physical illnesses like diabetes that need ongoing treatment and help.

If someone is diabetic, and they start to recognize their symptoms of low blood sugar, they know what to do. They know what steps to take to get their blood sugar back up. Then they check their blood sugar and go from there, Higgins said.

You dont have to wait until youre in a diabetic shock to get help.

Depression is a disease, and part of treatment is recognizing when you need help and taking those steps before its too late.

I dont distinguish between physical disease and mental disease as much as others tend to, because I understand that it is a physical problem, Cohen said.

In order to prevent suicides at their parking facilities, the NBPA has taken some steps in the past, as previously reported by New Brunswick Today.

Previously implemented plans include perimeter alarms on one of their eight parking decks and signage that raises awareness for the New Jersey Hopeline.

However, there is little evidence to suggest that perimeter alarms are effective as a method of suicide prevention.

Signage for suicide hotlines also do not tend to work as effective means of suicide prevention on their own.

Individuals who intend to die by suicide often do not bring their phones with them. Elizabeth Johnsen, a victim of suicide who died after falling from a New Brunswick parking deck on June 5, 2014, did not bring her phone with her.

Theres really not good evidence that signs matter all that much, Kim Kane, a suicide prevention specialist who worked to improve parking facilities in Boise, Idaho, said in a previous NBT interview.

To think you can talk someone out of suicidality with the help signs may be overly optimistic, Kathleen Cohen said.

Maybe [the reliance on signs] misunderstands the actual nature of the suicidal condition.

If somebody is suffering that much that they think that the only answer is suicide, you cant always expect them to be able to ask for help in that moment like making a phone call.

Its harder to reach that person when theyve already made up their mind, Susan Higgins said.

Barriers, while being the most expensive and intrusive method of preventing suicide, are also the only method proven to prevent deaths.

Once you put barriers up, suicides typically go to zero, Kane explained.

Means restriction is actually one of the very few things we know that actually reduces suicide rates.

Means restriction is known to be effective, Cohen said.If you can, why would you not?

Although Cohen doubts that the NBPA holds meetings to discuss their moral duty to the public, they do have fiscal and liability concerns which should make the suicides on their parking facilities a major concern.

It is both morally and financially impractical for them to allow this to continue, Cohen said.

Why dont they add fencing where you literally cant fall from the building or the parking deck? Higgins asks of the NBPA.

How much could a chain link fence cost?

If you prevent the means, you give that person a second chance, Cohen said.

When asked about plans for physical barriers, Security Director Delgado explained that NBPA has restricted pedestrian access to many areas in our facilities to authorized personnel only by installing scissor gates and other physical barriers.

Those barriers have been installed on some of the elevator entrances of the topmost floors and the stairwells of their parking facilities.

Structural modifications to our facilities are currently being considered, Delgado said.

Delgado recognizes the issue as a mental health crisis exasperated by a public health crisis.

The NBPA is committed to do anything it can in [their] efforts to mitigate these tragic incidents, Delgado said.

If someone exhibits any warning signs of suicide, they should not be left alone.

They should be taken to any medical facility for emergency treatment.

Warning signs to watch out for:

Steps you can take to help:

I know that its really hard to help yourself, but its not shameful to get help. Higgins said. Its not weakness. It does not mean that you arent able to cope with something.

It is the same as if you have a broken leg or a chronic medical illness. Sometimes you need outside help, and it is OK to ask for help.

Kristin is a graduate of Rutgers University and a reporter with New Brunswick Today

Mohsin is a third-year Rutgers student whose passion for local activism, artistic expression, and organizational leadership is only matched by his desire to bring intriguing, relevant stories to the New Brunswick community.

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2 More Deaths at NBPA Decks After Suicide Issue on Back Burner Due to the Pandemic - New Brunswick Today

Partisanship in American politics has weaponized the face mask while people continue to fall sick and die of the coronavirus.

But a growing body of research shows that wearing face coverings in public can limit the spread of the highly contagious disease, which has infected more than 2 million people in the United States and killed 115,251 as of Saturday, based on data from Johns Hopkins University.

A review and meta-analysis funded by the World Health Organization and published in The Lancet, a peer-reviewed medical journal, examined data from 172 studies from 16 countries and six continents.

Without a mask, the risk of transmitting COVID-19 is 17.4%. With an N95 respirator or face mask, that number drops to 3.1%.

"Our findings continued to support the ideas not only that masks in general are associated with a large reduction in risk of infection from SARS-CoV-2, SARS-CoV, and MERS-CoV but also that N95 or similar respirators might be associated with a larger degree of protection from viral infection than disposable medical masks or reusable multilayer (1216-layer) cotton masks," the review's authors wrote.

Similarly, maintaining between three and six feet of distance from others reduces the infection rate from 12.8% to 2.6%.

"The main benefit of physical distancing measures is to prevent onward transmission and, thereby, reduce the adverse outcomes of SARS-CoV-2 infection. Hence, the results of our current review support the implementation of a policy of physical distancing of at least 1 [meter] and, if feasible, 2 [meters] or more," according to the review.

Medical experts believe that the coronavirus typically spreads via droplets from a patient's coughs, speech, or sneezes. It's also possible fora person to never show symptoms and yet transmit the diseaseto others they come in contact with.

Some people wear masks, with others don't, in Huntington Beach, California, on April 25, 2020. Apu Gomes/AFP/Getty Images

So eye protection hasn't been a standard recommendation like regular hand-washing. But the Lancet review found that wearing goggles or a faceshield brings the transmission rate down from 16% to 5.5%.

"The use of a mask alone is insufficient to provide an adequate level of protection or source control, and other personal and community level measures should also be adopted to suppress transmission of respiratory viruses," the WHO said. "Whether or not masks are used, compliance with hand hygiene, physical distancing and other infection prevention and control (IPC) measures are critical to prevent human-to-human transmission of COVID-19."

President Donald Trump's actions, however, continue to fly in the face of these findings. He refuses to wear masks in public and went so far as to poke fun at Democratic presidential nominee Joe Biden for wearing one.

Meanwhile, a study conducted by the US Navy's Bureau of Medicine and the Centers for Disease Control and Prevention found that preventative measures also lowered the infection rate among sailors on board the USS Theodore Roosevelt.

The Navy reported that out of a crew of about 4,800 sailors, 1,273 tested positive for the virus and 382 sailors participated in the study.

The results indicated that sailors who did not wear masks experienced an 80.8% infection rate, while those who used face coverings had a 55.8% infection rate. People who did not follow social distancing guidelines fell sick at a rate of 70% versus 54.7% for those who stayed around six feet away from others.

Also, sailors who used common areas reported an infection rate of 67.5% and those who avoided those spaces saw a 53.8% infection rate.

The Navy also reported that 18.5% of those who came down with the coronavirus were asymptomatic so they did not fall sick at all, but were still contagious while still others had mild symptoms.

"This study shows young, healthy adults with COVID-19 might have mild, atypical, or no symptoms; therefore, symptom-based surveillance might not detect all infections. Use of face coverings and other preventive measures could mitigate transmission in similar settings," the Navy said in a statement, according to the San Diego-Union Tribune.

These findings were echoed by a British study, led by scientists at Cambridge and Greenwich universities, which concluded that lockdowns alone cannot prevent surges in coronavirus cases and deaths.

"Our analyses support the immediate and universal adoption of face masks by the public," Richard Stutt, who co-led the study at Cambridge, Reuters reported.

Stutt added that masks, social distancing, and other containment measures could be "an acceptable way of managing the pandemic and re-opening economic activity" as companies race to develop a vaccine against COVID-19.

The spread of the coronavirus disease (COVID-19), in Fayetteville Nick Oxford/Reuters

This study appeared in a scientific journal called Proceedings of the Royal Society A, with authors writing that "when facemasks are used by the public all the time (not just from when symptoms first appear), the effective reproduction number, [R value], can be decreased below 1, leading to the mitigation of epidemic spread."

The R value indicates how contagious an infectious disease is.An R value above 1 can trigger exponential growth of a virus, per Reuters. In the case of the coronavirus, studies so far suggest that on average patients infect 2 1/2 other people.

So, the study says, "face mask use by the public could significantly reduce the rate of COVID-19 spread, prevent further disease waves and allow less stringent lock-down regimes. The effect is greatest when 100% of the public wear face masks."

A study that was published by the nonprofit Institute of Labor Economics (IZA) investigated the German city of Jena and arrived at similar conclusions about the efficacy of face masks.

"After face masks were introduced on 6 April 2020, the number of new infections fell almost to zero," the authors wrote, adding that the face coverings were most helpful in curbing the infection rate among people who were above 60 years old.

"We believe that the reduction in the growth rates of infections by 40% to 60% is our best estimate of the effects of face masks . . . We should also stress that 40 to 60% might still be a lower bound," they added.

The study went on to say that masks could have made a more significant impact if they had been used earlier and more widely. It wasn't until April 20 and April 29 that all German federal states made it compulsory to wear face coverings.

"The daily growth rates in the number of infections when face masks were introduced was around 2 to 3%," the study's authors wrote. "These are very low growth rates compared to the early days of the epidemic in Germany, where daily growth rates also lay above 50%. One might therefore conjecture that the effects might have been even greater if masks had been introduced earlier. "

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Dr. Jennifer Rubin, D.M.D.

BOULDER, Colo. (PRWEB) June 17, 2020

Boulder Smile Design is proud to welcome Dr. Jennifer Rubin, D.M.D. to its practice. Dr. Rubin is a board-certified pediatric dentist, allowing the practice to expand services and provide comprehensive care for its growing number of patients.

Dr. Rubin is an exceptional addition to our team, said Jesse Friedman, D.M.D., owner of Boulder Smile Design. She is an extremely skilled dentist and has a huge heart, both of which make her an amazing pediatric and special needs dentist."

Since she was a little girl, Dr. Rubin always knew she wanted to be a dentist for kids. Dr. Rubin attended Boston University, where she received a Bachelor of Science in Psychology, a Master's in Biomedical Sciences, and finally her dental degree from the Boston University Henry M. Goldman School of Dental Medicine. She graduated with magna cum laude honors. She followed that with a hospital-based General Practice Residency at New York Presbyterian-Weill Cornell Hospital in New York City and then completed her residency in pediatric dentistry at Mount Sinai Hospital in New York City as well. In addition to her range of dental service expertise, Dr. Rubin is an active member in the Boulder dental community, volunteering with a number of local organizations and regularly visiting local schools and daycare centers to educate children. She is a member of the American Dental Association, the Colorado Dental Association, and the Metro Denver Dental Society. She is board certified from the American Board of Pediatric Dentistry and also maintains an active membership with the American Academy of Pediatric Dentistry. She takes continuing education classes every chance she gets and stays up-to-date on the latest in pediatric and special needs care.

I wanted to join Boulder Smile Design because I knew that the levels of care matched my own rigorous standards, said Dr. Rubin. They have always provided exceptional dentistry in Boulder. I absolutely love taking care of children, and I treat for each one like my own.

Boulder Smile Design has provided high-end dental care for families in the area for nearly 50 years, with just over 10 in its current location. All dentists in the office work to understand individual patient dental needs and use state-of-the-art materials and equipment to achieve these goals. Services are comprehensive and range from ongoing preventative care to emergency dentistry services. Patients of all ages count on the dental cleaning and checkup services to prevent cavities, avoid gum disease, and boost overall health. The office uses absolutely no amalgam or mercury fillings; resin composite (white fillings) and sealant services provide further proactive and restorative dental care to ensure the ongoing health of each tooth and patient. Advanced restorative and prosthodontic services, such as crowns, bridges, porcelain veneers, and dental implants are also available to provide natural-looking improvements for stained, chipped, decayed, damaged, or broken teeth. The dentists stay up-to-date with a variety of continuing education, including sleep medicine, sleep apnea, and sleep-disordered breathing; craniofacial growth, cosmetic dentistry, laser technology, orthodontics, and complex rehabilitative care. The dentists employ a range of digital technology, including 3-D oral scanners, ultra-low-radiation digital x-rays, and the newest and most advanced equipment for diagnosing and treating disease.

The dentists at Boulder Smile Design take their role and engagement in the community seriously. Each dentist has donated considerable pro bono dental work for a range of non-profit organizations including Give Kids a Smile, the Dental Lifeline Network, and the Colorado Mission of Mercy. The professionals in the practice understand the important role dental health and esthetics play in both overall wellness and confidence in life.

We have a responsibility for our patients and our city, Dr. Friedman said. We view every day as an opportunity to give our very best to patients and the community overall. Every single person should have the opportunity to receive phenomenal care in a comfortable, relaxing, stress-free environment.

Boulder Smile Design is open Mondays, Tuesdays, and Thursdays from 7-5; Wednesdays from 7-3; and select Fridays and Saturdays. Call to ask about your dental insurance. It is located at 3000 Center Green Drive, Suite 215, Boulder, CO 80301. Learn more about Boulder Smile Design at http://www.bouldergeneraldentist.com or call for an appointment (303) 442-6142.

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Boulder Smile Design Expands Their Team With Addition of New Pediatric Dentist, Dr. Jennifer Rubin, DMD - PR Web

The outbreak of COVID-19 has not only pushed economies into recession but also brought forth the fragility of healthcare systems in general. Migrating to digital mode has since been a major move across the healthcare sector. Increased digitalisation is expected to help service providers create a robust and critical infrastructure focused on patients safety and quality care. The future of digital healthcare appears promising as patients would be more comfortable using digital services for complex and sensitive medical conditions. However, a major downside of going digital is the imminent threat of attacks lingering in the cyberspace. Considering that the healthcare sector is critical infrastructure, patient information and medical reports available online would be a gold trove that could be exploited for various malicious purposes.

Digital healthcare refers to the integration of medical knowledge with information technology (IT) applications (apps) to help improve medical care and supervision of patients. This means that a smartphone can be used to determine patients medical condition by monitoring patients vital data (pulse, blood pressure and oxygen saturation) including body temperature and movement patterns. It can also be used to determine if the patient has taken the prescribed medication.

Digital technologies enable need-oriented solutions and the provision of preventative, clinical and rehabilitative services. Deploying advanced technologies like digital health, big data, artificial intelligence (AI), augmented reality (AR) and virtual reality (VR), wearables and internet of things (IoT), 3D printing technology and so on would impact different forms of treatment, care concepts, and image of the medical profession and role of patients. In terms of IT strategy, many of these areas relate to opportunities for the formulation of hospital processes subject to the concept of hospital 4.0. New diagnostic and therapeutic approaches are developed with the support of IT management in the context of precision medicine approach and digital therapeutics that powers personalised predictive care.

Todays telehealth technology is empowering patients in the remotest locations of the world to access quality healthcare and receive life-saving diagnoses. Telemedicine allows access to quality healthcare at any time thereby levelling the playing field geographically and financially. Additionally, it has been observed that using AI and deep learning, body scans have been shown to analyse CAT scans up to 150 times faster than human radiologists, detecting acute neurological events in just 1.2 seconds.With several medical-grade sensors including optical, temperature, electrodermal, accelerometer and barometer being incorporated within wearables, these devices can be comfortably worn on the arm for several days and have higher-than-average patient satisfaction and adherence rates. The data from these wearables can be used in effective ways like monitoring health and providing preventative care. For instance, Hong Kong has been putting electronic wristbands on arriving passengers to enforce the coronavirus quarantine.The wristbands are connected to a smartphone app to make sure that people stay at home and break the chain of further spread of the virus.

There has been a slew of technologies deployed to check the spread of COVID-19 like contact tracing apps, electronic fences, robots, and infrared (IR) thermal screening. These technologies that aid round-the-clock remote monitoring and analytics are providing clinicians with decision support for early identification of any physiological alterations that could indicate deterioration, and facilitating early interventions for better outcomes.It has been predicted that by 2025 most of the hospitals worldwide would move to the digital platform, thereby increasing the market size of the healthcare sector from US$ 16.92 billion in 2017 to about US$ 58.78 billion by 2025.However, there is an evident downside to these healthcare innovations. These new devices open-up more entry points of cyberattacks and challenges for those in charge of online security and patient data protection.

The healthcare sector has been the prime target of online attacks threatening day-to-day work and compromising confidential patient data. The critical infrastructure systems in hospitals are particularly threatened by ransomware, besides different types of malware and distributed denial of service (DDoS) attacks, which can be locked up by malicious actors and unlocked only following payment of ransom.

Security researchers in Israel have been able to create malwares capable of adding tumours into CAT and MRI scans and misleading doctors into misdiagnosing high-profile patients.Another reason for increased attacks is the availability of enormous patient data that is worth a lot of money. Nefarious actors sell the data to counterfeiters who then produce genuine-looking insurance claims. Tampering of health and personal data like medical history, allergies, and medications can have dire consequences.

Medical devices are designed for one-point tasks like monitoring of heart rates or dispensing drugs. They are not designed with security in mind. Although the devices themselves may not store the patient data that attackers pursue, they can be used as launching grounds to attack a server that holds valuable information, or facilitates access to other networks, or let hackers install expensive ransomware on servers. In a worst-case scenario, medical equipment can completely be overridden by attackers, limiting hospitals from providing vital life-saving treatment to patients.

Since 2009, medical data theft has occurred either by stealing laptops or hard drives or identifying and stealing passwords. However, in recent years, myriad cyberattacks have compromised millions of medical records and patients personal information. For instance, in 2018, the MGM Hospital in Vashi, Mumbai fell victim to a cyberattack that locked the hospital data and demanded a ransom in bitcoins.Similar incidents of WannaCry, Petya and NotPetya ransomware attacking the healthcare sector have been reported from many countries, notably the 2017 attack on the United Kingdoms National Health Service (NHS) where more than 70,000 devices like laptops, desktops and medical machinery were infected with attackers demanding ransom in cryptocurrency to decrypt the encrypted data of the hospitals.

In the backdrop of COVID-19, many healthcare organisations have seen an increase in cyber exploitation. According to a report, the cyberattacks in the healthcare sector increased by 150 per cent during January-February 2020 as criminals sought to take advantage of the system vulnerabilities during the crisis.Scams by grey-marketers for personal protective equipment (PPE) have also seen a steady rise as healthcare professionals remain short of critical supplies.

On March 13, 2020, one of the Czech Republics biggest testing laboratories, Brno University Hospital, was hit by a cyberattack. As a result, the hospital had to postpone urgent surgical interventions and transfer patients with acute conditions to a different hospital while shutting down their entire IT network.Similarly, the website of Champaign-Urbana Public Health District in the United States was attacked by new ransomware called NetWalker.Victims received a ransom demand for the encryption key to regaining access to their data. This ransomware camouflaged itself within essential Windows functions to evade anti-virus detection. Health district employees became aware of the ransomware attack on March 10 when they lost access to the medical files. The Federal Bureau of Investigation (FBI) thereafter issued a warning about Kwampirs (a backdoor Trojan that grants remote computer access to the attackers) malware targeting supply chains including the healthcare industry.

Microsoft has also been warning healthcare organisations to watch out for sophisticated ransomware attacks that could target them through their virtual private networks (VPNs) and other network devices. In particular, Microsoft warned about ransomware campaign called REvil (also known as Sodinokibi), which actively exploits gateway and VPN vulnerabilities to gain a foothold in the target organisations.After successful exploitation, attackers steal credentials, elevate their privileges and move laterally across compromised networks, installing ransomware or other malware payloads.

India has not been very far behind in riding the digital wave. In 2017, the union cabinet approved the formulation of National Health Policy, under which a National e-Health Authority (NeHA) is to be setup.Such a policy would evolve and expand health information networks across the continuum of care, such as e-Health, m-Health, and cloud technology and IoT in healthcare delivery. Major IT initiatives include India Fights Dengue mobile app which provides interactive information on the identification of symptoms and links users to the nearest hospitals and blood banks. TheSwasth Bharat(Healthy India) app provides information on healthy lifestyle, disease conditions and their symptoms, treatment options, and first aid and public health alerts.Through theKilkarimobile app initiative, audio messages about pregnancy as well as childbirth and child care are directly sent to the families and parents. A mobile-based audio training course has been developed for expanding the knowledge base of the rural voluntary health workforce. Other m-Health applications include National Health Portal, Online Registration System, E-Rakt Kosh, ANM Online (ANMOL), telemedicine projects (in remote and inaccessible areas), Tobacco Cessation Programme and leveraging mobile phones for reaching out to the tuberculosis patients.

The Ministry of Health and Family Welfare introduced a draft bill on Digital Information Security in Healthcare Act (DISHA) in March 2018.One key purpose of the proposed bill is to secure and create reliable storage of healthcare data. It will help constitute a health information exchange, as deemed eligible by the Act, and maintain the digital healthcare data of individual patients. The central government plans to incorporate a database to store information of patients and other health system components at the district and national-levels (National Health Information Network) which is expected to be implemented by 2020 and 2025, respectively.A key suggestion is to link Aadhaar to the health information network so that the patient identification works seamlessly. It also includes the participation of the private sector in developing a common network to help in accessing information by both public and private healthcare providers.

With the allocation of funds in the 2019 union budget for theAyushman Bharat Yojana,developing the healthcare sector is a top priority. Meanwhile, to ensure better coverage for the healthcare initiative, the Ministry of Health has issued a critical document for public consultation to completely digitalise the healthcare data, and create a national digital health network called National Digital Health Blueprint.This would help deliver value-added services to the concerned users with a consent-based flow of citizens health record.

India is committed to financially support all the digital initiatives and looks for multi-stakeholder engagement and private-public partnerships to scale up these initiatives. Even under the current crisis, the government has rolled out apps such asAarogya Setuto help citizens identify the risk of contracting COVID-19 andAYUSH Sanjivanito spread awareness about traditional Ayurvedic medicines.

Going digital is the most effective way to protect the first line of healthcare workers especially in the case of highly communicable viruses like COVID-19 while increasing the efficiency of health services. However, cybersecurity cannot be an afterthought in the healthcare sector. Medical specialists often use old and outdated software/hardware with minimum security features, staff lacks the necessary security know-how to implement updates and patches promptly, and many medical devices lack security software altogether. Human error opens a hole in systems as most breaches are triggered by employee mistakes or unauthorised disclosures. Experts note that hospitals often do not know what systems run on the devices they use. Many of these devices are black boxes to hospitals as there is a general lack of awareness, besides the usual lack of resources. Without a multi-layered protective cyber ecosystem, the medical staff may not even know when they are under attack.

India is at the cusp of digital transformation. However, with digital threats becoming trickier, a more holistic approach towards cybersecurity would be needed to facilitate the creation of a vibrant digital healthcare environment. If going digital is necessary for the country to be on par with the digital world, then building a resilient and trusted cyber ecosystem is also a necessity.

Research Analyst at Manohar Parrikar Institute for Defence Studies and Analyses.

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Digital healthcare and rising cyber concerns - TheDispatch

The coronavirus is pushing telemedicine to the forefront of healthcare, but not all ETFs are adequately levered to this theme. The Principal Healthcare Innovators Index ETF (Nasdaq: BTEC), does however, feature some telemedicine exposure.

BTECtracks the Nasdaq U.S. Healthcare Innovators Index, which is designed to provide exposure to early-stage small-capitalization healthcare companies. These are primarily biotechnology and life science, which have the potential to create cures for cancer, develop new medical technologies, or spearhead other medical advances.

High-flying Teledoc Health (NASDAQ: TDOC) is a top 10 holding in BTEC and another example of the ETFs leverage to themes emerging from the coronavirus.

BTEC, which turns four years old in August, seeks to tap into the increasing demand for healthcare solutions as demographic trends have driven healthcare spending to more than double in the last 20 years, according to Principal.

With telemedicine still in its nascent stages, theres ample runway for growth and that could underscore the already compelling long-term thesis for BTEC.

With Americans wary of hospitals and clinics as potential vectors of infectious disease, more are starting to appreciate telemedicine and communicating with their health-care providers online, according to CNBC.

Since the coronavirus outbreak, health care technology has come to the fore with various innovations to combat the virus. This can only help fuel health care technology exchange-traded funds (ETFs) moving forward from preventative medicine to treatment.

Disruptive technology is not relegated to certain sectors as it will permeate into all industries in some form or fashion. For example, augmented reality is technology comprised of digital images superimposed over the real world, and its use is primed to drive industry growthindustries like real estate and manufacturing are already putting the technology to use in a variety of ways.

Importantly, BTEC is a passive fund with an active index structure, one that removes large-cap and less liquid companies as well as those with inconsistent or negative earnings trends. Conversely, BTEC focuses on research and development-focused firms that have the potential to deliver legitimate disruption.

Online healthcare services and telemedicine will continue to become more prevalent and essential. We see the potential for continued greater use of digital technologies to benefit patients and result in fewer visits to the clinic, said Jefferies strategist Simon Powell in a recent note to clients.

For more on multi-factor strategies, visit our Multi-Factor Channel.

The opinions and forecasts expressed herein are solely those of Tom Lydon, and may not actually come to pass. Information on this site should not be used or construed as an offer to sell, a solicitation of an offer to buy, or a recommendation for any product.

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Telemedicine Is One Contributor to This Healthcare ETF's Compelling Story - ETF Trends