StemCell Therapy

Objectives:Osteoarticular infections are infrequent in pediatric patients, although their incidence seems to be increasing. They usually affect children younger than 5 years and tend to localize in the lower limbs. Because of their nonspecific symptoms, especially at onset, a timely diagnosis is difficult to achieve, with the subsequent risk of a delay in treatment. We hereby report the management of osteoarticular infections in our pediatric emergency department.

Methods:This is a retrospective descriptive study of patients diagnosed with osteoarticular upper limb infection in the pediatric emergency department of a tertiary hospital from January 2011 to December 2016.

Results:From an initial global sample of 170 patients diagnosed with osteomyelitis or septic arthritis at any location at the pediatric emergency department, 32 children (18.82%) with upper limb involvement were included in the study. Of them, 22 were male and the mean age at diagnosis was 14.5 months (interquartile range, 2-106). Eighteen patients (56%) were diagnosed with septic arthritis, and 14 (44%) had a diagnosis of osteomyelitis.The most frequent symptom was pain (50%). More than one third of patients (11) had received a different diagnosis in a previous hospital visit. A traumatic etiology was suspected in 7 cases (21%).Regarding acute phase reactants, the mean value for C-reactive protein was 21.3 mg/L, and erythrocyte sedimentation rate was elevated in 27 cases (84%). In 28 patients, blood cultures were obtained, 24 of which came back negative. All children received antibiotic treatment and achieved a full recovery.

Conclusions:One third of patients were misdiagnosed at the first consultation, which stresses the importance of a high clinical suspicion to avoid delays in diagnosis and treatment of osteoarticular infections. This study also shows a lower mean age of children with upper limb infection as compared with those with lower limb infection. All patients recovered fully with oral antibiotics.

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Characteristics of Upper Limb Osteoarticular Infections at the Emergency Department of a Tertiary University Hospital in Spain - DocWire News

BOTHELL, Wash. & KENILWORTH, N.J.--(BUSINESS WIRE)--Sep 14, 2020--

Seattle Genetics, Inc. (Nasdaq: SGEN) and Merck (NYSE: MRK), known as MSD outside the United States and Canada, today announced two new strategic oncology collaborations.

This press release features multimedia. View the full release here: https://www.businesswire.com/news/home/20200914005237/en/

The companies will globally develop and commercialize Seattle Genetics ladiratuzumab vedotin, an investigational antibody-drug conjugate (ADC) targeting LIV-1, which is currently in phase 2 clinical trials for breast cancer and other solid tumors. The collaboration will pursue a broad joint development program evaluating ladiratuzumab vedotin as monotherapy and in combination with Mercks anti-PD-1 therapy KEYTRUDA (pembrolizumab) in triple-negative breast cancer, hormone receptor-positive breast cancer and other LIV-1-expressing solid tumors. Under the terms of the agreement, Seattle Genetics will receive a $600 million upfront payment and Merck will make a $1.0 billion equity investment in 5.0 million shares of Seattle Genetics common stock at a price of $200 per share. In addition, Seattle Genetics is eligible for progress-dependent milestone payments of up to $2.6 billion.

Separately, Seattle Genetics has granted Merck an exclusive license to commercialize TUKYSA (tucatinib), a small molecule tyrosine kinase inhibitor, for the treatment of HER2-positive cancers, in Asia, the Middle East and Latin America and other regions outside of the U.S., Canada and Europe. Seattle Genetics will receive $125 million from Merck as an upfront payment and is eligible for progress-dependent milestones of up to $65 million.

Collaborating with Merck on ladiratuzumab vedotin will allow us to accelerate and broaden its development program in breast cancer and other solid tumors, including in combination with Mercks KEYTRUDA, while also positioning us to leverage our U.S. and European commercial operations, said Clay Siegall, Ph.D., President and Chief Executive Officer of Seattle Genetics. The strategic collaboration for TUKYSA will help us reach more patients globally and benefit from the established commercial strength of one of the worlds premier pharmaceutical companies.

These two strategic collaborations will enable us to further diversify Mercks broad oncology portfolio and pipeline, and to continue our efforts to extend and improve the lives of as many patients with cancer as possible, said Dr. Roger M. Perlmutter, President, Merck Research Laboratories. We look forward to working with the team at Seattle Genetics to advance the clinical program for ladiratuzumab vedotin, which has shown compelling signals of efficacy in early studies, and to bring TUKYSA to even more patients with cancer around the world.

Ladiratuzumab Vedotin CollaborationDetails

Under the terms of the agreement, Seattle Genetics and Merck will collaborate and equally share costs on the global development of ladiratuzumab vedotin and other LIV-1-targeting ADCs. The companies have agreed to jointly develop and share future costs and profits for ladiratuzumab vedotin on a 50:50 basis worldwide. Merck will pay Seattle Genetics $600 million upfront and make a $1.0 billion equity investment in 5.0 million shares of Seattle Genetics common stock at a price of $200 per share. In addition, Seattle Genetics will be eligible to receive up to $2.6 billion in milestone payments, including $850 million in development milestones and $1.75 billion in sales milestones.

The companies will jointly develop and commercialize ladiratuzumab vedotin and equally share profits worldwide. The companies will co-commercialize in the U.S. and Europe. Seattle Genetics will be responsible for marketing applications for approval in the U.S. and Canada, and will record sales in the U.S., Canada and Europe. Merck will be responsible for marketing applications for approval in Europe and in countries outside the U.S. and Canada, and will record sales in countries outside the U.S., Europe and Canada. Including the upfront payment, equity investment proceeds and potential milestone payments, Seattle Genetics is eligible to receive up to $4.2 billion.

The closing of the equity investment is contingent on completion of review under the Hart-Scott-Rodino Antitrust Improvements Act of 1976 (HSR Act).

TUKYSA Collaboration Details

Under the terms of the agreement, Merck has been granted exclusive rights to commercialize TUKYSA in Asia, the Middle East and Latin America and other regions outside of the U.S., Canada and Europe. Seattle Genetics retains commercial rights and will record sales in the U.S., Canada and Europe. Merck will be responsible for marketing applications for approval in its territory, supported by the positive results from the HER2CLIMB clinical trial.

Merck will also co-fund a portion of the TUKYSA global development plan, which encompasses several ongoing and planned trials across HER2-positive cancers, including breast, colorectal, gastric and other cancers set forth in a global product development plan. Seattle Genetics will continue to lead ongoing TUKYSA global development planning and operational execution. Merck will solely fund and conduct country-specific clinical trials necessary to support anticipated regulatory applications in its territory.

Seattle Genetics will receive from Merck $125 million as an upfront payment and is eligible to receive progress-dependent milestones of up to $65 million. Seattle Genetics will also receive $85 million in prepaid research and development payments to be applied to Mercks global development funding obligations. In addition, Seattle Genetics would receive tiered royalties on sales of TUKYSA in Mercks territory.

The financial impact of these collaborations is not included in Seattle Genetics 2020 guidance.

Seattle Genetics Conference Call Details

Seattle Genetics management will host a conference call to discuss these collaborations today at 6:00 a.m. Pacific Time (PT); 9:00 a.m. Eastern Time (ET). The event will be simultaneously webcast and available for replay from the Seattle Genetics website at http://www.seattlegenetics.com, under the Investors section. Investors may also participate in the conference call by calling 844-763-8274 (domestic) or +1 412-717-9224 (international). The conference ID is 10147850.

About Ladiratuzumab Vedotin

Ladiratuzumab vedotin is a novel investigational ADC targeted to LIV-1. Most metastatic breast cancers express LIV-1, which also has been detected in several other cancers, including lung, head and neck, esophageal and gastric. Ladiratuzumab vedotin utilizes Seattle Genetics proprietary ADC technology and consists of a LIV-1-targeted monoclonal antibody linked to a potent microtubule-disrupting agent, monomethyl auristatin E (MMAE) by a protease-cleavable linker. This novel ADC is designed to bind to LIV-1 on cancer cells and release the cell-killing agent into target cells upon internalization. Ladiratuzumab vedotin may also cause antitumor activity through other mechanisms, including activation of an immune response by induction of immunogenic cell death.

About TUKYSA (tucatinib)

TUKYSA is an oral, small molecule tyrosine kinase inhibitor (TKI) of HER2, a protein that contributes to cancer cell growth. TUKYSA in combination with trastuzumab and capecitabine was approved by the U.S. Food and Drug Administration (FDA) in April 2020 for adult patients with advanced unresectable or metastatic HER2-positive breast cancer, including patients with brain metastases, who have received one or more prior anti-HER2-based regimens in the metastatic setting. In addition, TUKYSA received approval in Canada, Singapore, Australia and Switzerland under the Project Orbis initiative of the FDA Oncology Center of Excellence that provides a framework for concurrent submission and review of oncology products among international partners. A marketing application is under review in the European Union.

TUKYSA is being evaluated in several ongoing clinical trials and additional studies are planned. Current trials include the following:

For additional information, visit http://www.clinicaltrials.gov.

TUKYSA Important Safety Information

Warnings and Precautions

If diarrhea occurs, administer antidiarrheal treatment as clinically indicated. Perform diagnostic tests as clinically indicated to exclude other causes of diarrhea. Based on the severity of the diarrhea, interrupt dose, then dose reduce or permanently discontinue TUKYSA.

Monitor ALT, AST, and bilirubin prior to starting TUKYSA, every 3 weeks during treatment, and as clinically indicated. Based on the severity of hepatoxicity, interrupt dose, then dose reduce or permanently discontinue TUKYSA.

Adverse Reactions

Serious adverse reactions occurred in 26% of patients who received TUKYSA. Serious adverse reactions in 2% of patients who received TUKYSA were diarrhea (4%), vomiting (2.5%), nausea (2%), abdominal pain (2%), and seizure (2%). Fatal adverse reactions occurred in 2% of patients who received TUKYSA including sudden death, sepsis, dehydration, and cardiogenic shock.

Adverse reactions led to treatment discontinuation in 6% of patients who received TUKYSA; those occurring in 1% of patients were hepatotoxicity (1.5%) and diarrhea (1%). Adverse reactions led to dose reduction in 21% of patients who received TUKYSA; those occurring in 2% of patients were hepatotoxicity (8%) and diarrhea (6%).

The most common adverse reactions in patients who received TUKYSA (20%) were diarrhea, palmar-plantar erythrodysesthesia, nausea, fatigue, hepatotoxicity, vomiting, stomatitis, decreased appetite, abdominal pain, headache, anemia, and rash.

Lab Abnormalities

In HER2CLIMB, Grade 3 laboratory abnormalities reported in 5% of patients who received TUKYSA were: decreased phosphate, increased ALT, decreased potassium, and increased AST. The mean increase in serum creatinine was 32% within the first 21 days of treatment with TUKYSA. The serum creatinine increases persisted throughout treatment and were reversible upon treatment completion. Consider alternative markers of renal function if persistent elevations in serum creatinine are observed.

Drug Interactions

Use in Specific Populations

For more information, please see the full Prescribing Information for TUKYSA here.

About KEYTRUDA (pembrolizumab) Injection, 100 mg

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

Merck has the industrys largest immuno-oncology clinical research program. There are currently more than 1,200 trials studying KEYTRUDA across a wide variety of cancers and treatment settings. The KEYTRUDA clinical program seeks to understand the role of KEYTRUDA across cancers and the factors that may predict a patient's likelihood of benefitting from treatment with KEYTRUDA, including exploring several different biomarkers.

Selected KEYTRUDA (pembrolizumab) Indications

Melanoma

KEYTRUDA is indicated for the treatment of patients with unresectable or metastatic melanoma.

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

Non-Small Cell Lung Cancer

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

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

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

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

Small Cell Lung Cancer

KEYTRUDA is indicated for the treatment of patients with metastatic small cell lung cancer (SCLC) with disease progression on or after platinum-based chemotherapy and at least 1 other prior line of therapy. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials.

Head and Neck Squamous Cell Cancer

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

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

KEYTRUDA, as a single agent, is indicated for the treatment of patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) with disease progression on or after platinum-containing chemotherapy.

Classical Hodgkin Lymphoma

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

Primary Mediastinal Large B-Cell Lymphoma

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

Urothelial Carcinoma

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

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

KEYTRUDA is indicated for the treatment of patients with Bacillus Calmette-Guerin (BCG)-unresponsive, high-risk, non-muscle invasive bladder cancer (NMIBC) with carcinoma in situ (CIS) with or without papillary tumors who are ineligible for or have elected not to undergo cystectomy.

Microsatellite Instability-High or Mismatch Repair Deficient Cancer

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

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

Microsatellite Instability-High or Mismatch Repair Deficient Colorectal Cancer

KEYTRUDA is indicated for the first-line treatment of patients with unresectable or metastatic MSI-H or dMMR colorectal cancer (CRC).

Gastric Cancer

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

Esophageal Cancer

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

Cervical Cancer

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

Hepatocellular Carcinoma

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

Merkel Cell Carcinoma

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

Renal Cell Carcinoma

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

Tumor Mutational Burden-High

KEYTRUDA is indicated for the treatment of adult and pediatric patients with unresectable or metastatic tumor mutational burden-high (TMB-H) [10 mutations/megabase (mut/Mb)] solid tumors, as determined by an FDA-approved test, that have progressed following prior treatment and who have no satisfactory alternative treatment options. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials. The safety and effectiveness of KEYTRUDA in pediatric patients with TMB-H central nervous system cancers have not been established.

Cutaneous Squamous Cell Carcinoma

KEYTRUDA is indicated for the treatment of patients with recurrent or metastatic cutaneous squamous cell carcinoma (cSCC) that is not curable by surgery or radiation.

Selected Important Safety Information for KEYTRUDA

Immune-Mediated Pneumonitis

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

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

Immune-Mediated Colitis

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

Immune-Mediated Hepatitis (KEYTRUDA) and Hepatotoxicity (KEYTRUDA in Combination With Axitinib)

Immune-Mediated Hepatitis

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

Hepatotoxicity in Combination With Axitinib

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

Immune-Mediated Endocrinopathies

KEYTRUDA can cause adrenal insufficiency (primary and secondary), hypophysitis, thyroid disorders, and type 1 diabetes mellitus. Adrenal insufficiency occurred in 0.8% (22/2799) of patients, including Grade 2 (0.3%), 3 (0.3%), and 4 (<0.1%). Hypophysitis occurred in 0.6% (17/2799) of patients, including Grade 2 (0.2%), 3 (0.3%), and 4 (<0.1%). Hypothyroidism occurred in 8.5% (237/2799) of patients, including Grade 2 (6.2%) and 3 (0.1%). The incidence of new or worsening hypothyroidism was higher in 1185 patients with HNSCC (16%) receiving KEYTRUDA, as a single agent or in combination with platinum and FU, including Grade 3 (0.3%) hypothyroidism. Hyperthyroidism occurred in 3.4% (96/2799) of patients, including Grade 2 (0.8%) and 3 (0.1%), and thyroiditis occurred in 0.6% (16/2799) of patients, including Grade 2 (0.3%). Type 1 diabetes mellitus, including diabetic ketoacidosis, occurred in 0.2% (6/2799) of patients.

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

Immune-Mediated Nephritis and Renal Dysfunction

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

Original post:
Seattle Genetics and Merck Announce Two Strategic Oncology Collaborations - The Baytown Sun

Written by Ralph Alex Arakal | Bengaluru | Updated: September 14, 2020 8:12:24 amAhmed and his family after the successful bone marrow transplant (Express photo)

A three-year-old girl from Iraq became a lifesaver for her 18-year-old brother after she donated her bone marrow for a successful transplantation that took place in Bengaluru.

Ahmed had undergone splenectomy in his native country and was referred to Manipal Hospitals in Bengaluru since only optimal treatment is available in Iraq. According to doctors at the hospital, the teenager was also suffering from symptomatic anemia (needing frequent blood transfusions) and jaundice.

Dr Mallikarjun Kalashetty, consultant Haematology, Haemato-Oncology & Bone Marrow Transplantation at Manipal Hospitals, said Ahmed required an allogeneic bone marrow transplantation.

The best donors for such patients are the human leukocyte antigen (HLA)-matched siblings who are normal or with a minor form of haemoglobinopathy (a hereditary condition involving an abnormality in the structure of haemoglobin) or thalassaemia (a blood disorder involving lower-than-normal amounts of an oxygen-carrying protein), Dr Kalashetty explained.

However, things were not easy for the medical team at the hospital considering the age of the donor the patients three-year-old younger sister and the obvious language barrier. Transfusion experts at the hospital soon realised the process was challenging as they required the processing of 8-10 litres of blood from the donor aged three, weighing 18 kilograms, who had only a blood volume of about 1.3 litres.

Considering her age, the donor had to be sedated to elicit co-operation during apheresis (extracting blood and separating components) in multiple sittings and preserve the stem cells through cryopreservation. To counter the low volume of blood going into the apheresis machine, we filled the dead spaces with compatible RBC, and to reduce the fluid overload, we determined and monitored the volume of the fluid going into the body of the child, Dr C Shivaram, consultant transfusion medicine said.

However, the allogeneic bone marrow transplantation was successful and Ahmed has now recovered from the sickle-cell disease. He did have few complications after transplantation like mucositis, febrile neutropenia, and viral reactivation, which were successfully managed, Dr Kalashetty said.

Ahmeds quality of life has improved significantly and his parents are overjoyed to see their son doing so well after suffering from the illness for several years. The satisfaction of seeing the joy on the faces of the patient and his family is unmatched, he said.

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Three-year-old bone marrow donor, Bengaluru doctors give Iraqi boy a new lease of life - The Indian Express

I discussed the case of Donor 9623 with Dov Fox, a professor of health law at the University of San Diego. Fox covered the lawsuits in his book, Birth Rights and Wrongs, and he has spent the past year diving even deeper into the case of Donor 9623interviewing parents who were deceived, children coming to terms with their genetic inheritance, and eventually the donor himself for a new Audible podcast.

Read: IVF mix-ups have broken the definition of parenthood

Fox and I have spoken before about the ways embryo mix-ups and other examples of reproductive technology gone awry confound the law and the very notion of parenthood. Tens of thousands of babies are born with the help of reproductive technology every year in the U.S., yet fertility clinics and sperm banks remain surprisingly unregulated. Mistakes, when they happen, have deeply existential consequences. Before the podcasts release last week, we talked again about Donor 9623 and how courts try to make sense of the uncomfortable idea of wrongful birth, a term that he argues makes no sense.

This interview has been edited for length and clarity.

Sarah Zhang: In your book, you covered several cases where reproductive technology gone wrong poses these really hard questions: white parents who were inseminated with the wrong donor sperm and ended up with a Black child, parents who had aborted based on an incorrect fetal diagnosis, a surrogate who didnt want to relinquish the child. What specifically drew you to this case of Donor 9623 so much that you wanted to do a whole podcast about it?

Dov Fox: I thought this case was really gray. It wasnt that there was just an obvious loophole in the legal framework or the law hadnt caught up to the advances in technology. It raised really deep, hard, fundamental questions about human existence, with an eye to the future of gene editing and embryo screeningwhat it means to be a parent and what is reasonable for would-be parents to expect. Thats an uncomfortable place for judges and for lawmakers.

This was one of the very largest and most international sperm banks that shipped to tens of thousands of parents in dozens of countries all over the world. This is an especially popular donor for more than a decade. And there were so many parts of his history that were concealed or misrepresentedhis health and his criminal record and his educational background.

Zhang: You say this is an uncomfortable place for judges and lawmakers, and while wrongful-birth lawsuits get a lot of attention, they havent been very successful in court in the U.S. Why is that?

Fox: A lot of courts that say no to wrongful-birth claims say its about protecting the individual children. And theres intuitive appeal to this idea. God, how awful would it sound to the child to learn that their life, their existence, is wrongfulthat their parents didnt want them, dont want them, wanted a different kid instead, dont love them. Thats not what parents intend, but that doesnt necessarily mean that it doesnt express that, whether to their kids or to other groups who have the very condition that their kids have.

More:
One Sperm Donor. 36 Children. A Mess of Lawsuits. - The Atlantic

In late November 2019, authorities in Peru found two jaguar cubs in a house in Chanchamayo, in the countrys central Amazonian region. The cubs were so young that they still had part of the umbilical cord attached; their mother was nowhere to be found. Legal proceedings were opened against the alleged poachers, and although the cubs were taken to a specialized zoo, they died within a few weeks. Separation from the forest and their mother can be fatal for jaguar cubs.

The cubs were among 86 seizures associated with the species by Peruvian authorities between 2015 and 2020. In addition to live animals, authorities have recovered fangs, skins, skulls and other body parts, according to the National Forest and Wildlife Service (SERFOR). Studies by SERFOR and the Wildlife Conservation Society (WCS) indicate that the nine jaguar-related items seized in 2019 represent less than 10% of what can be found in some illegal markets around the country.

The seizures effectively amount to the tip of the iceberg when it comes to the illicit trade in parts and live specimens of jaguars in Peru, which is home to the second-largest population of the big cat in South America, behind only Brazil. The total wild population of the species is about 163,000, according to 2018 estimates by the Venezuelan Institute for Scientific Research (IVIC) and the big cat conservation NGO Panthera.

In this investigative series, Mongabay Latam starts out with a regional snapshot of the plight of the jaguar. We interview more than 10 scientists to look at the threats and strategies to conserve this species in six countries: Bolivia, Ecuador, Guyana, Peru, Suriname and Venezuela.

163,098 The estimated jaguar population in South America is around 1.95 jaguars per 100 square kilometers an average disaggregated by South American country: Brazil / Peru / Colombia / Bolivia / Venezuela / Guyana / Suriname / Ecuador / French Guyana / Paraguay / Argentina

A four-month study by WCS and SERFOR in Peru shows that the illegal trade in jaguar parts is more common than previously thought. During visits to 21 locations in Iquitos, the capital of the Amazonian region of Loreto, researchers found 96 jaguar parts for sale in markets, handicraft shops, piers and even hotels. Jaguar fangs and claws were found embedded in necklaces and bracelets, while skins were hung up on show along public highways, almost like paintings or carpets.

Their investigation also covered two other cities in the Peruvian Amazon Pucallpa (in the Ucayali region) and Puerto Maldonado (in Madre de Dios) as well as Puno in the Andes. In total, they found 102 jaguar parts for sale publicly: 45% of these comprised skins, 37% fangs, 14% claws, and the remaining 4% were jaguar fat and skulls. Three-quarters of these parts were incorporated into handicrafts. The price of fangs, depending on the buyer, ranged from 30 to 1,000 soles ($9 to $280).

We have normalized animal trafficking; in Latin America we are used to seeing these kinds of scenes, says Liliana Juregui, an expert in environmental justice at the IUCN NL. Her organization has coordinated investigations in Bolivia and Suriname, countries where the first evidence of the rise of international trafficking of jaguar parts to Asia was uncovered seven years ago.

Despite the seriousness of the problem, data for seizures of jaguar parts in these countries have not been recently updated. In Bolivia, cases stopped being counted in early 2019, as attention focused on environmental emergencies such as massive forest fires, as well as the political upheaval that led to a change of government, according to ngela Nez, a biologist specializing in jaguars who researches trafficking as part of Proyecto Operacin Jaguar (Operation Jaguar Project) in Bolivia.

Since 2014, we have seized around 700 fangs, including a seizure in China [of fangs] that originated from Bolivia, Nez says, emphasizing the need to continue monitoring this environmental crime. According to the Bolivian Ministry of Environment and Water, there have been more than 20 legal actions taken related to the illegal trafficking of fangs, with five of the cases resulting in criminal sentences.

Research conducted by the IUCN NL also found that the demand for jaguar parts in Bolivia began in 2013 and was advertised through radio stations and posters distributed in rural areas. Between 2014 and 2016, the trafficking problem was underway in earnest, with 300 jaguar parts found in 16 postal packages, 14 of them sent by Chinese citizens working in Bolivia.

The facts that link the trafficking of jaguar parts to Asia, particularly China, are sensitive, considering that the most affected countries, such as Bolivia and Suriname, have sought to diplomatically resolve the problem by establishing alliances with the Chinese community within their territories.

But if there is one thing scientists in the six countries agree on, its the link between jaguar trafficking and the presence of companies engaged in Chinese-backed infrastructure projects in areas of high biodiversity, such as the Amazon. A study published in early June by the journal Conservation Biology examined the relationships between trafficking of wild cats and Chinese investments in South and Central America.

Among the main findings were that trafficking has been increasing and that the Chinese citizens involved in illegal activities dont belong to the Asian communities already established in these countries, but are instead workers who travel to the Amazon to work on the megaprojects such as new dams and roads. Chinese companies have invested heavily in developing countries, first in Africa and then in South America, says Guyanese geographer Anthony Cummings, who also investigates the trafficking of jaguar parts in his country. While we are not trying to stigmatize, it is important to be aware of the connection.

In Suriname, for example, the IUCN has found evidence of trafficking since 2003, when a former forest service employee there was contacted by the owner of a Chinese supermarket in the capital, Paramaribo, who was looking for jaguar fangs and claws. Esteban Payn, regional director of Pantheras northern South America program, says that due to the significant decline of tigers in Asia, demand for big cat parts used in traditional medicine seems to have been filled by parts from other big cats. Its suspected that this may be one of the reasons why trafficking of jaguar parts is growing in Latin American countries.

Large-scale illegal mining and logging have been observed in Surinames Brownsberg Nature Park. An estimated 40,000 people live within and around these mining camps, though only 18,000 people are formally registered. Links between this activity and wildlife trafficking are being investigated.

According to the IUCNs Juregui, this is an important hypothesis. We believe that there are links to illegal logging and its trade, or to gold routes. Trafficking routes are cross-border and take advantage of their porosity, she says, referring to how criminal groups use the same routes to traffic gold, timber and wildlife.

Although the trafficking of jaguar parts is the obvious threat, there are other clear dangers for the continents top predator. Cummings mentions two in Guyana: conflict between jaguars and ranchers or farmers, and with gold miners in the Guyanese jungle, as both groups kill the animals in retaliation for attacking their livestock, crops or pets.

Despite the cries for help from Latin American countries, it has not been possible [to vary their level of protection], says Rodrigo Medelln, a scientist at the Latin American Alliance for Jaguar Conservation. Even the leopard has been categorized as at risk of extinction, despite having a larger area of occupancy than the jaguar, he says of the big cat species found in Africa and Asia.

See related: Is Chinese investment driving a sharp increase in jaguar poaching?In Venezuela, Mara Fernanda Puerto, founder of Proyecto Sebraba, an NGO that studies jaguars, says there are no official numbers for seizures, and that jaguars are at constant threat from the use of their parts in Sanera, a popular belief system in some parts of the country, which has even attracted parishioners with political power. We have reports of local consumption of these animals, and that there is a risk of reporting when a jaguar or ocelot has been seized. Once it has been done, within a few hours [the report] disappears, Puerto says.

In her investigation into the threats to jaguars, she has encountered a prisoner incarcerated in southern Lake Maracaibo with a jaguar skin hanging in their cell as a symbol of power. It is on display there, despite it being a crime.

In other countries, such as Ecuador, where no significant evidence of trafficking of jaguar parts has been found, alerts continue to be triggered due to the strong pressure of deforestation and habitat loss. Galo Zapata-Ros, scientific director of WCS in Ecuador, says that in the countrys Amazon region, there has been a 30% loss of habitat.

In the Choc area, 90% has been deforested now due to the advancement of livestock and agriculture, such as the cultivation of African [oil] palm, he says. This area is an important jaguar corridor between Ecuador and Colombia. The growth of such monocultures near protected natural areas is also occurring in Peru and Brazil, where these areas play a crucial role in big cat conservation.

To protect a species, its important to understand it. This applies to the jaguar populations in each of the six countries in questions, where investigations began in 2013 after the first evidence of a rise in trafficking of jaguar parts in Bolivia appeared.

Key data on jaguars in South America. In this region there are 23 populations and 60 jaguar conservation units (JCUs). Sources: Jaguar populations: Antonio de la Torre, Jos F. Gonzlez-Maya, Heliot Zarza, Gerardo Ceballos and Rodrigo Medelln, 2018. Average number in jaguar conservation units: Data Basin/Panthera, 2010.

On the IUCN Red List, the jaguars conservation status is categorized as being near threatened, an assessment that many in the scientific community say doesnt reflect their concerns. As with many other species, the lack of information is a factor in whether the jaguar should be placed under one of the threatened categories: vulnerable, endangered, or critically endangered. Vania Tejeda, biodiversity officer for WWF in Peru, says its difficult to raise the alarm about the dangers faced by jaguars without investigations to demonstrate that they exist. It is difficult to push policies when there is no supporting scientific information, she says.

Recent findings, such as a 60% reduction in the species original habitat across South America, indicate that the threat is significant. Some range countries, aware of this problem, have begun to invest in the research necessary to categorize these species conservation status within their territory. For instance, the libros rojos de la fauna silvestre (wildlife red books) of Bolivia, Venezuela and Ecuador the national equivalents of the IUCN Red List assess the jaguar populations in the Amazon as being vulnerable, and the population inhabiting the Ecuadoran coast as critically endangered. In Peru, the species is listed as near threatened, but scientists led by Jos Luis Mena, director of the WCS Species Initiative in Peru, want to bring together studies carried out in recent years to improve their level of protection.

For scientists such as Rodrigo Medelln and Antonio de la Torre from the Latin American Alliance for Jaguar Conservation, there is already sufficient evidence to recategorize the jaguars conservation status at the continental level. De la Torre says that only by raising the status to vulnerable moving it from near threatened into a threatened category will it be possible to increase resources for its conservation, in turn drawing public and political attention to its care. The call for attention of an international organization may be heard more than that of local biologists and conservationists, he says.

However, there is one more step that must be taken along with the categorization, and for which more studies are also needed: the protection of habitats.

See related: A jaguar nicknamed Short-Tail is the first known to cross between Belize and Guatemala

In Peru, says Jos Luis Mena, five jaguar conservation units, or JCUs, have been identified in recent years. These are spaces that should be protected by law as important jaguar habitats, but have not been recognized as such by the state.

We must identify which are the priority areas for this conservation, as [jaguars live] in protected areas, Mena says. There is also an analysis of which spaces these corridors should support.

Peruvian scientists have begun to collect information in the northern jungles of Loreto and the southern ones of Madre de Dios. But the countrys central forests and the Ucayali region still need to be covered, Mena says. In these latter locations, in particular, cases of trafficking of jaguar parts have been detected, with six of the 11 seizures recorded between 2019 and 2020 occurring in these areas.

The lack of data in Bolivia is also evident, with many questions still unanswered: Where are the jaguars? How many are there? What spaces should be protected? According to Nez from Proyecto Operacin Jaguar, studies have focused mainly on two protected areas: Madidi and Kaa-Iya national parks in the Gran Chaco region. Outside the protected areas, where the jaguar is most at risk, not many studies are carried out on the species, she says.

Even in protected spaces such as Tariqua National Flora and Fauna Reserve, where jaguars move freely, there is no clear idea of how many there are, Nez says. The need for information becomes more urgent against the increase in oil and gold extraction and hydroelectric activities within the parks and reserves. Operation Jaguar, an IUCN NL project carried out in Bolivia, Guyana and Suriname, aims to conserve the big cats by identifying the most vulnerable areas to focus on.

Across South America, jaguar populations face very similar dangers, with little difference between the various range countries. Ecuador also has to contend with a lack of information, and has started updating its national jaguar conservation plan to identify existing research and determine who will be involved in new studies.

Jessica Pacheco, from WWF Ecuadors forest and freshwater program, says theres already information on the jaguar population in Cuyabeno Fauna Production Reserve, but not, for example, on the population that moves through the Achuar Indigenous territory along the border with Peru. Pacheco is especially interested in studying the latter area since, she says, It is not a national protected area but has still maintained high levels of wildlife conservation.

To this list of areas to explore, Galo Zapata-Ros of WCS adds the Andean foothills and the corridors that connect them to the Ecuadoran Amazon. We know very little about what happens in these areas and there are records of the jaguar above 2,000 meters [6,600 feet], he says, adding that WCS will start a project in these places in 2021. Zapata-Ros says cross-border corridors, such as those that link Yasun and Cuyabeno with La Paya Natural National Park in Colombia or with Geppi National Park in Peru, should not be forgotten. Jaguar conservation must have a transboundary approach, he says.

In Venezuela, to reaffirm the importance of the connection between jaguar populations, Proyecto Sebrabas Mara Puerto uses satellite imagery to identify routes that can link Sierra de Perij Park with Cinagas de Juan Manuel. Esteban Payn of Panthera says that to complete the puzzle, it would be ideal to revive the proposal for a park that would link Colombia and Venezuela, in the area of Sierra del Perij, where jaguars are known to move through.

But Puertos enthusiasm is tempered by the reality of the political situation in Venezuela. The corridor that links to Colombia should be protected, but there has already been a rejection of this proposal by the Ministry of Environment of Venezuela, she says, adding that theres no national plan for jaguar conservation in her country.

For 12 years, Puerto has concentrated her work in Cinagas de Juan Manuel National Park, south of Lake Maracaibo in Zulia state, where she estimates there are up to 3.37 jaguars per 100 square kilometers. This is an important number considering that the jaguar population density for the whole of Venezuela is an estimated 1.97 per 100 km2 with around 11,500 of the big cats in the grasslands alone according to a study by Wlodzimierz Jedrzejewski and other scientists from IVIC and Panthera.

Further research on jaguars in Venezuela may include the region of Los Llanos and the state of Amazonas. In Guyana and Suriname, research has focused primarily on threats to jaguar populations. According to Jedrzejewskis study, there are an estimated 11,500 jaguars in both countries, though there arent enough studies yet to confirm this.

Further research on jaguars in Venezuela may include the region of Los Llanos and the state of Amazonas. In Guyana and Suriname, research has focused primarily on threats to jaguar populations. According to Jedrzejewskis study, there are an estimated 11,500 jaguars in both countries, though there arent enough studies yet to confirm this.

In Guyana, biologist and geographer Cummings has been studying jaguars in his native country since 2014. He says the Guyanese government, represented by the Management and Conservation of Wildlife Commission, is currently interested in systematizing the data generated by studies, such as one hed been conducting on the animals situation in four Indigenous communities a few months ago through camera traps and drones. However, this study has been halted due to the quarantine, though there are hopes for it to be resumed before the end of the year.

At the end of 2018, 14 of the 18 countries that are home to jaguars joined forces to launch the Jaguar 2030 Plan, a road map for the conservation of the animal and the 30 landscapes it inhabits. This plan highlights priority areas to ensure the survival of the species, such as the JCUs, corridors that link territories both inside and outside the countries, and, above all, the importance of protecting natural areas that are part of their habitat.

Protected natural areas are those that will prevent human-made threats, says Vania Tejeda from WWF Peru. She adds that a recent WWF study of protected areas in Peru, Ecuador and Colombia has verified the effectiveness of such areas in keeping jaguar populations stable and ensuring the forests are healthy.

There are examples throughout South America: in Bolivia, Rob Wallace, a scientist who has studied jaguars for more than 20 years, highlights the Tambopata-Madidi transboundary landscape that encompasses natural areas in Peru (Tambopata National Reserve and Bahuaja-Sonene National Park) and Bolivia (Madidi National Park and Piln Lajas Biosphere Reserve).

Since the beginning of 2000, together with colleagues Guido Ayala and Mara Viscarra, Wallace has carried out research using camera traps that revealed a density of 0.5 jaguars per 100 km2 in 2001. By 2008 the density was up to 2, and by 2014 between 5 and 6. Since then, however, hunters have put severe pressure on the species. In 2019, the scientists carried out new monitoring that will more reliably depict the big cats current situation.

Wallace highlights the importance of joint work between countries and uses South Americas jaguar subpopulation map as evidence. According to research carried out in 2018 by Antonio de la Torre and other scientists from the Latin American Alliance for Jaguar Conservation, 26 of the 34 subpopulations are located in cross-border areas. This was also one of the main reasons outlined in the Convention on the Conservation of Migratory Species of Wild Animals (CMS) for the jaguar to be included in Appendices I and II. This would oblige each country to boost conservation efforts for the species and work with other range countries on cross-border protection.

Positive and negative factors are converging in the fight for the survival of this feline, says Rodrigo Medelln from the Latin American Alliance for Jaguar Conservation. Although the pressures of trafficking and habitat loss are evident, he notes that international conservation strategies, such as the Jaguar 2030 Plan, along with growing interest in expanding studies and taking actions to protect jaguars, have increased under the IUCN and global wildlife trade treaty CITES. Medelln says each country must also commit to start concerted actions in the next five years.

One of these actions is the Jaguar Corridor, a Panthera initiative that forms part of the Jaguar 2030 Plan and seeks to preserve genetic continuity between the JCUs through key cross-border sections. The area it covers spans 6 million km2, about three times the size of Mexico. As Pantheras Payn says, The Jaguar Corridor should act as a layer to generate better sustainable decisions for South Americas development. This means understanding where to build a road and where to permit areas for agriculture.

WWF Ecuadors Pacheco says countries should consider the sociocultural situations of the communities near the areas where jaguars are found as part of their conservation strategies. In updating the national conservation plan, we are taking this link with the communities into account. The process must be observed holistically, while also considering the educational side and exchange of information, she says.

Sometimes it can be difficult to sell the concept of conservation to local populations, even with animals as charismatic as the jaguar. But for Guyanese scientist Cummings, its necessary to start with everyday situations. If we know that having water is directly linked to the presence of jaguars in the forests, we might see it differently: that the environments health is directly connected to my health, that when an animal is wiped out, it has implications for my quality of life.

Banner image credit: Kipu Visual.This story was first reported by Mongabays Latam team and published here on our Latam site on June 17, 2020.

Read more Mongabay stories about jaguars here and big cats in general, including lions and tigers, here.

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Poaching pressure mounts on jaguars, the Americas' iconic big cat - Mongabay.com

Gray mold on cannabis plants is a sign of a fungal disease called Botrytis blight. It appears as a thick blanket of webs on the plants and causes severe damage to the buds during growth and even after harvest.

In most cannabis plants, gray mold starts growing on the inside of a bud before appearing on the outside. One of the preventative measures that cultivators can take early on is to protect the buds from moisture. Using tents or greenhouse to cover plants can help to attain this.

Other than this, there are a number of other techniques that can help to stop the infection from damaging the plants. Here is a complete guide to prevent and control the infection.

Typically, gray mold causes a discoloration of plant buds and a lot of moisture retention in the leaves. This causes lesions to appear on the plant, advancing into a rot in later stages. The final stage that follows after this is the appearance of the mycelium, or gray mold in the affected plant.

According to experts, if an infection appears to be gray on the outside, it is most probably gray mold. For confirmation, examining a microbial infection under a microscope can provide solid answers.

The good news for cannabis cultivators is that although gray mold is a fairly common fungal disease, it is not aggressive. It does not harm any healthy plant tissue to progress further. In fact, the disease enters the plant through pruning cuts, damages caused by insects or dying tissues of spent leaves.

As mentioned earlier, Botrytis blight does not damage healthy tissue. It enters plants through wounds created by insects. Therefore, one of the first steps to ensure protection from gray mold is to inhibit insects and diseases from attacking the plants.

Like most fungal infections, Botrytis blight flourishes in humid and dark conditions. Just 12 hours of wetness and 90% humidity levels can set the infection in motion.

This is one of the major reasons of mature plants getting infected. The dense leaf and flower growth in mature plants inhibits ventilation, creating ideal conditions for the sporadic growth of the infection.

Opening up plants for more sunlight absorption can discourage the spread of the fungal infection in plants.

Using water management techniques like drip irrigation and proper drainage can be helpful in controlling this problem. Experts also suggest the use of a couple of humidity meters in cultivation facilities for maximum control.

In addition, small tips like watering the plants early in the morning and maximizing time between watering can ensure moisture control in the plants.

End users of cannabis usually consume the plant through inhalation or smoking. This is why using commercial fungicides on the crops for treatment is highly discouraged.

One of the primary ingredients for treating fungal infections is Myclobutanil. A number of studies have found that it turns into Cyanide gas while smoking, posing serious threat to the health of the end user.

Using organic fungicides is an alternate option for crop growers. Using potassium bicarbonate, bacillus amyloliquefaciens and Tetra Crop Control can help to stop the spread of infection if it is spotted early enough.

It is noteworthy that some cannabis strains are naturally mold resistant. Being inhabitants of wet and humid climates, these strains naturally have naturally developed resistance to the infection.

To curb the spread of gray mold, there are a number of techniques that can be applied by growers of cannabis plants.

Removing moldy buds and sterilizing the plants can inhibit the growth of gray mold on other parts.

Sterilizing equipment used in pruning damaged plant parts will ensure infection containment. Proper disposal of damaged parts after solarization will also ensure that the pathogens have been completely destroyed.

Botrytis has a tendency to feed on dying leaves. Therefore, removing any possible habitat can assure the infection does not thrive.

Plucking fan leaves off the plant can also be a possible step towards maintaining ventilation and humidity in its surroundings.

For assuring the best possible mold free harvest, it is important to consider the environment of the drying rooms of the harvested crops.

More often than not, buds are put in drying rooms that are humid or have a polluted airspace. In other cases, storing them while they were not completely dry starts the development of the mold.

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Nebraska Medical Bill initiative blocked from entering the November ballots - Cannabis Health Insider

South African Caster Semenya won the 800-meterrun at the Rio Olympics in 2016.

But a rulingfromthe Swiss Supreme Court on Tuesday means Semenya won't get to defend her title at next year's Olympics unless she takes medication to lower her testosterone levels.

Semenya, a two-time Olympic champion,has a genetic condition known as hyperandrogenism that elevates the level of male sex hormones in her body. A new rule institutedin 2018 by World Athletics, an international governing body, disqualifies her from competing internationally because of that condition. Semenya has been fighting that rule since it was passed, and with Tuesday's decision, she lost her second appeal.

Semenya's longtime attorney, Gregory Nott,has said theymay challenge the judgment in Swiss and European courts. He joinedThe World's host Marco Wermanfrom Johannesburg.

Related:So what if some female Olympians have high testosterone?

Gregory Nott: Look, we were very disappointed, naturally, to get the ruling that we have. However, the past has shown us that 7% of CAS [Court of Arbitration in Sports] rulings have been overturned by the [Swiss] Supreme Court. And so the odds were stacked against us. Yes, we were disappointed. Were we completely flabbergasted? No.

I mean, at the end of the day, this is the dignity of Caster. And would a judgment like that be found against a male runner? Would it be found against, let's say, a European runner? Would we find ourselves in the same position?

She's very positive. She spoke this is her quote: The doors are closed, but not locked. And so, she sees an opportunity, whether it be legal means alternatively, track means, athletic means of still fighting back, still making her presence felt among competitors.

Well, very simply put, it was seen as an advantage.

So, that particular ruling was to negate or try to create fairness within the complete section of runners under a women's race. And for that reason, a particular level a cutoff, as it were, [was established]. Anyone above that level had to have hormonal or surgical interventions to ensure that their testosterone levels were dropped.

Now, one would argue, did [Michael] Phelps have to have his feet cut off because he had bigger feet than the other swimmers?

[Caster] was born as a woman. And she has she competed as such.

Well, partly. And a large part of the appeal was the human dignity and human rights of Caster, and the effects of these regulations upon her dignity, upon her self-image and a whole variety of other human rights issues as well.

Never. She won't do it, period. That's ... never... you'll never find her do it.

She's absolutely strong-willed, and there's absolutely no way that she will take any medicine or hormonal interventions at all, physically.

She testified as much and she said as much publicly. So you won't find her doing that. No.

I see the will of Caster. I see her indomitable spirit. I see her as a person, as a human being. And I think that really strikes a chord. It resonates, and I identify with her in so many ways. I see the love of our country for her.

You know, the one thing I really hate are bullies and I've always hated them since I was a young schoolboy. So, I can't stand it, and I don't like the lean on her. Quite frankly, I've seen the lean on her since I first represented her 10 years ago, and that really riles me up. And you know, I was involved in activist law many years ago, decades ago. And its within my very being. And Caster, for me, resonates.

And she's not only a client, but a family friend, and part of the family. So, for me, I'm very passionate about her. I love the way she holds herself and carries herself. And if you knew South Africa, and where she came from, and the fight that she's actually had to do and take, [that] would be an extraordinary story that she has told. And it deserves telling, because there's such an example for others and not only others in South Africa, but others who want the opportunity and the rest of the world. You want to see justice done at the end of the day and you want to see fair play. So, there is a sense of being robbed.

This interview has been edited and condensed for clarity.

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'There is a sense of being robbed': Olympian Caster Semenya loses appeal on testosterone rule - The World

I wish to counter many politicians claims that the government seeks to take over our health care system. The specious claims ignore the huge beneficial role government has played, and plays, in improving human health. Our collective good health and longevity derives from a hundred years of federally funded research in public health, human physiology, genetics, surgery, pharmacology, immunology, microbiology, virology and engineering.

Biomedical research at universities, medical schools, hospitals and research laboratories is substantially supported by the government. Few realize that the largest share of funds for training physicians and for postgraduate physician training come directly or indirectly from the government.

Millions of Americans receive health care through Medicare, Medicaid, veterans hospitals, Indian Health Service, Public Health Service, the Uniformed Services (Department of Defense) and others. The government subsidizes health care insurance premiums for thousands of United States civil servants. Without government support, our present health care system would implode. In their polemics, some politicians call this government support socialism or socialized medicine. I call it informed self-interest by a government concerned with the well-being of its citizens.

I practiced government medicine for over 40 years as a United States Air Force pediatrician, biomedical researcher, teacher and administrator. I witnessed massive growth in medical knowledge, the introduction of incredible new technologies and evolution of new medical skills. Hundreds of new drugs, biologics, surgical techniques, vaccines, enhanced genetic knowledge and approaches to improving mental health have revolutionized modern medicine, allowing more accurate diagnosis, real-time health monitoring, and temporary replacement of hearts, lungs and kidneys. Americans now survive cancer more often than ever before.

These new technologies and tools are only possible because the citizens of this country invested in the acquisition of knowledge, tools and services the research enterprise produced. Yet, the United States fails to equitably distribute these advances to all citizens. Health care is rationed based on ability to pay. We often spend large sums to treat patients with complex and life-threatening conditions while basic preventive care is unavailable to many families and children. Unnumbered citizens and families are bankrupted annually by catastrophic illness.

I believe the United States must redress modern health care inequities. There is much debate about how this might be done. It seems to me the fairest solution is a countrywide insurance program, or programs, to provide access to care, education, public health and protection from catastrophic illness for every person and family in the land.

This is not government takeover. It is the responsibility of government to provide life, liberty and the pursuit of happiness for all Americans, not only those who can pay. I urge all to consider voting with an eye to making our wealth of health care resources accessible to all citizens of our great country.

Val G. Hemming is the 2015 recipient of the distinguished alumni award from the University of Utah College of Medicine. He is the emeritus dean of the F. Edward Hbert School of Medicine at the Uniformed Services University of the Health Sciences in Bethesda, Md.

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Guest opinion: Why accessible health care is not government takeover - Deseret News

There are basically two types of cattle in the world today. One includes the European and British breeds that descended from the original wild cattle (Bos taurus) of those regions. The other includes the more heat-tolerant animals of the tropics (the hump-backed droopy-eared Zebu cattle, Bos indicus) that include the cattle of India, Asia and Africa). Almost all cattle breeds in the U.S. today are of British and European descent, but many ranchers in the South and Southwest prefer cattle with some Zebu breeding because they are more suited to that environment.

The American Brahman was developed from several strains of cattle imported from India between 1854 and 1926, and from imported Zebu cattle from Brazil. Since then, several American breeds and composites have been created using Brahman bloodlines, including Santa Gertrudis, Brangus, Beefmaster, etc.

Dr. Jan Bonsma of South Africa was a famous cattle geneticist and student of breed efficiency, selecting cattle for the most functional traits. He was involved in the development of two new breeds, the Bonsmara and the Beefmaster. He developed the Bonsmara by crossing native Afrikaner cattle (Zebu) with Hereford and Shorthorn to develop a hardier animal than the British breeds, with better beef quality and fertility than the Zebu. Today the Bonsmara breed he created is the most numerous breed in South Africa and these cattle have been imported to other countries around the world including the U.S.

Bonsmas concept of functional efficiency in cattle was that we need to adapt the cattle to their environment, and not the other way around. He was an advisor to Tom Lasater, who created Beefmaster cattle in the U.S. Bonsmas principles of functional efficiency and Lasaters six essentials of Beefmaster breeding created a type of cattle that can adapt to harsh environments and efficiently convert grass to a well-muscled meat carcass.

Beefmaster cattle were the first American composite breed (combination of three or more breeds). In the early 1930s, Lasater developed this blend of breeds in southern Texas. Beefmasters are a composite made up of roughly one-half Bos Taurus genetics using Hereford and Shorthorn, and one-half Bos Indicus genetics (Brahman).

The American Brahman was created earlier by using Nelore cattle from Brazil (a Zebu type that came originally from India), the Gir (a dairy breed from India) and the Guzerat--a breed developed in Brazil from the Kankrej cattle imported into Brazil from India between 1875 and 1964. The Guzerat was very instrumental in creation of the American Brahman.

The blend of British breeds with zebu type cattle (providing more heat tolerance and insect resistance) to create the Beefmaster was of great benefit to cattle raisers in Texas and other southern regions of North America. In 1937, Lasater closed his herd and no outside genetics have been introduced into the breed since that time. In

1954, the Beefmaster breed was recognized by the USDA as an American breed. Currently, Beefmaster Breeders United is the fifth-largest breed registry in the U.S. Over the last 70 years, intense selection for economically important traits has resulted in a homozygous beef breed that has the growth potential of a hybrid.

Lasater selected cattle on what he called the six essentials of disposition, fertility, weight, conformation, milk production, and hardiness. Todays Beefmaster breeders also select for calving ease, fast early growth, moderate frame, easy fleshing ability and longevity. Adhering to Lasaters six essentials make these additional goals easier and faster to accomplish.

Beefmaster cattle have strong maternal traits as well as excellent growth and carcass traits. They are well known for their ability to handle heat and drought, with more insect resistance than most British and European breeds. They tend to be moderate in size, and generally light red to dark red in color, although some have white mottling on their faces and underline. The blend of Zebu and Bos taurus creates the most hybrid vigor of any cattle cross because these types are so unrelated. The blend has created super cows.

See more here:
Development of heat-resistant cattle in the U.S. - Post Register

UWMadisons Athletic Training program is transitioning to the masters degree level due to changing national accreditation standards and an anticipated growth in demand for athletic trainers in the coming years.

The new Master of Science in Athletic Training (MSAT) program which was approved by the UW Systems Board of Regents in April is now accepting applications and will enroll its first cohort in the summer of 2021.

Athletic trainers are multi-skilled health care professionals who collaborate with physicians as part of a health care team to provide preventative services, emergency care, clinical diagnosis, therapeutic intervention, and rehabilitation of injuries and medical conditions. Athletic trainers provide this health care in a variety of settings for people involved in all levels of physical activity.

If you enjoy sports and physical activity, solving problems, caring for patients, and working with people then a career in athletic training might be for you, says UWMadisons Andrew Winterstein, who directs the universitys Athletic Training program, which is housed in the School of Educations Department of Kinesiology.

Athletic trainers do everything from creating injury prevention programs at high schools, to providing health care to intercollegiate or professional sports teams. Others help workers safely perform on a factory assembly line, or treat patients of all ages and skill levels in a clinical rehabilitation setting.

Athletic trainers are the health care professionals who use their skills where no two days or job settings are alike, says Winterstein, a distinguished clinical professor with the Department of Kinesiology.

The new MSAT program is replacing the current Athletic Training program offered at the bachelors degree level. Athletic training programs across the country are making the transition following a decision from the Commission on Accreditation of Athletic Training Education (CAATE), the Board of Certification (BOC), and National Athletic Trainers Association. By the fall of 2022, athletic training programs nationally will no longer be enrolling students at the undergraduate level. However, students currently enrolled in athletic training programs and current athletic trainers will not need to earn a masters degree to satisfy this new standard.

The U.S. Bureau of Labor Statistics projects that employment of athletic trainers will grow 19 percent from 2018 to 2028, which is much faster than the average for all occupations. Demand for athletic trainers is expected to increase as people become more aware of the long-term effects of sports-related injuries, and as a growing middle-aged and older population remains active.

UWMadisons new MSAT program takes 24 months to complete, beginning with a summer session, and includes capstone clinical preceptorships in local environments and locations around the country. The curriculum, which includes 58 credits, is front-loaded in year one (summer, fall, and spring semesters), with a heavy didactic schedule and limited clinical experiences. The second year (summer, fall, and spring semesters) then stresses immersive clinical field placements supported by innovative courses that include both face-to-face and online formats.

The program at UWMadison gives students the unique opportunity of working with elite Big Ten Conference athletes competing at the highest level of intercollegiate sports. Clinical education is guided by a talented collection of athletic training professionals dedicated to preparing students in the program for their future.

Something new and exciting in the MSAT program is that we will be offering more immersive clinical experiences for the students at a variety of locations around the country and in our own Big Ten settings, says Shari Clark, the programs clinical education coordinator. These intensive experiences will provide authentic clinical learning experiences to prepare students for a range of patient care.

As a comprehensive university, UW-Madison also offers countless collaborative interprofessional education, research, and care opportunities where MSAT students can learn from physicians with the UW School of Medicine and Public Health in the classroom, operating room, and athletic health care setting. Additional opportunities exist alongside other health science students studying to become physical therapists, occupational therapists, and physician assistants.

Im very excited about the opportunities that the new MSAT program will bring to our students, says David Bell, an associate professor with the Department of Kinesiology and the director of the Wisconsin Injury in Sport Laboratory. I believe that students will be able to add to their clinical experience by participating in research that will directly benefit their patients.

Winterstein notes that the changing nature of health care and an increased emphasis on inter-professional practice will make the masters level of education very important to the professions future.

The new UWMadison program is accredited by the Commission on Accreditation of Athletic Training Education and students are eligible to sit for the national Board of Certification exam after successful completion of the MSAT program.

Our Athletic Training program is already a well-respected member of the health sciences community on campus and fully contributes to the research, instructional, and outreach missions of UWMadison, says Winterstein. The transition from the bachelors to the masters degree level will allow for greater collaboration as an interprofessional partner with existing health sciences programs.

For more information visit the MSAT programs website.

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UWMadison launching Master of Science in Athletic Training program - School of Education - University of Wisconsin-Madison

With upwards of 1 million licensed doctors in the United States, there have never been more caretakers to help you maintain perfect health. But nearly all patients would agree that finding the right Doc can be tricky. Yes, most doctors wear a white coat or a pair of scrubs, and can be found in hospitals or steely offices but the truth is that doctors are vastly different from one another, and most have an expertise in one particular area of medicine. There are hundreds of documented medical specialities and related certifications that physicians can pursue in their career, and there is often a special doctor for each affliction or illness, no matter how complex or rare that condition may be.

Where does one start when faced with a specific health issue? First step: It's a good idea to establish care with a primary care doctor, so that you have someone to oversee your healthcare treatment. They'll work with other doctors when the time comes, too: "Your primary care provider is an important first stop when receiving care, and they can help you to determine when you may need to see a specialist," says Craig Hersh, M.D., a board certified family medicine physician and the Chief Medical Officer for Empire BlueCross BlueShield.

"Think of your primary care provider as the front door to the healthcare system, who can also help you navigate and work with the specialist who best matches your needs," Dr. Hersh tells Good Housekeeping.

Sometimes, though, you might need direct access to a specialist say, if you've moved recently and don't have a primary care provider just yet. With the help of Dr. Hersh, we'll explore the most common types of doctors you'll likely turn to for help in your lifetime each of these 26 specialists can help address unique health concerns, and may finally get you the treatment you've been searching for.

This article generalizes the roles and descriptions of common doctors and specialists: It isn't intended to be a complete list, nor is it reflective of laws, statutes, regulations, license issues, or Medical Practice Acts by state. It is meant to be educational in nature and isn't a substitute for actual medical or treatment advice from a licensed professional. Remember: Always call 911 if you are experiencing a life-threatening emergency.

Primary care providers | Internist | Pediatrician | Geriatric specialists | Gynecologist, OB/GYN | Dermatologist | Allergist | Cardiologist | Endocrinologist | Gastroenterologist | Geneticist | Hematologist | Neurologist | Otolaryngologist | Pulmonologist | Nephrologist | Infectious disease specialists | Osteopath | Radiologists | Urologist | Plastic surgeons

Also known as a family physician, a primary care provider is in charge of handling your routine healthcare appointments, including annual physicals and vaccinations over time. Primary care doctors should always be your first call if you have a health concern that isn't an emergency, as they can help treat everything from the common cold to a physical injury. More often than not, they'll attempt to alleviate any symptoms you are experiencing; they may also refer you to another doctor or specialist.

A primary care provider can treat symptoms associated with conditions like:

These doctors work similarly to a primary care provider, in that they can see a patient routinely over their lifetime; unlike their counterparts, however, they usually have a background in internal medicine and spend their time in hospitals. Internists don't usually treat children or preteens, but care for anyone else from young adults to elderly patients, especially those who need help in diagnosing or managing chronic conditions or diseases. They may specialize in certain areas as well, like gastroenterology.

Pediatricians handle scheduled care and check-ins for infants, toddlers, younger children, adolescents, preteens, and most teenagers. They function like a primary care provider, designed for children specifically, but also keep kids' vaccinations up to date and do important screenings as they get older. Pediatricians are also a good point of contact to discuss any particular health concerns or questions about your child's physical or mental development.

Some elderly individuals may transition from a primary care doctor to what's know in the healthcare space as a geriatric specialist. Geriatricians take over primary care of people who are aging, and can help manage conditions that particularly impact the elderly, everything from severe arthritic pain to diabetes and dementia. These docs are on the other end of the family medicine spectrum from pediatricians!

Gynecologists, of course, handle preventative care for women in reproductive health, menopause, and hormone issues and you know that an obstetrician specifically looks after pregnant women and delivers their babies. An ob/gyn office (combining the two specialties) is also be a place where cervical cancer is tested and diagnosed, and where breast exams are performed.

Nearly everyone knows that dermatologists have the best information about routine skincare but they're also the specialist in charge of treating more serious skin issues, hair loss, or nail irregularities. Rashes or severe acne, rosacea or psoriasis, and skin cancer are treated; these specialists examine symptoms, help you manage them as best as possible, and provide a longterm treatment plan if possible.

These physicians are specially trained to determine if someone has an allergy, and they may also be referred to as an immunologist. If you're wondering if you have an allergy, an allergist is the doctor to see. In addition to diagnosing and managing allergies, these specialists may also help manage asthma, certain lung conditions, and immunodeficiency disorders. An allergist can give patients with allergies injections to help manage their allergies in the long run.

These physicians are in charge of taking care of your heart, but they'll most likely step in for direct care if you have high blood pressure, or experience heart failure or irregular heartbeats. Cardiologists often use physical stress tests and electrocardiography to diagnose, treat, and prevent other issues. You'll also have to be under their care after a heart attack, as your primary doctor may need screening done for future heart conditions.

These physicians look after your eyes, both medically and surgically, which is different from a optometrist, who is responsible for eye tests and corrective lenses as well as prescribing medication for some diseases. Opticians solely help you with the fit of your glasses and contacts overall.Ophthalmologists will also be needed if you develop a serious eye impairment, like glaucoma and cataracts as you age.

For those dealing with diabetes or a thyroid issue, an endocrinologist will help you pinpoint the source of trouble or help you troubleshoot longterm solutions. These specialists assess and treat internal glands that produce hormones and other bodily functions.

Digestive issues? If they're not clearing up whether it's diarrhea, bloating, acid reflux, or excessive flatulence it's time to ask for a gastroenterologist's help. Gastroenterologists who are licensed physicians, unlike gastrologists treat anything related to your digestive system (including bad breath!), and for longterm treatment, they help you control issues like irritable bowel syndrome or Crohn's disease. They may also screen you for issues later in life, like a colon cancer screening such as a colonoscopy.

Out of all doctors on this list, this may be one of the few that often require a referral; these doctors specifically look at whether a health issue has been inherited at birth, or if your genes are causing (or will cause) an issue in the future. They'll often help patients understand how genetic conditions could be passed along to a child preemptively, or they'll help to treat hereditary conditions that turn up.

If you're suffering an iron deficiency, or more serious conditions like anemia or hemophilia (inability to clot), a hematologist will step in to assess issues in your blood. They can be instrumental in preventing and treating cancers of the blood, such as leukemia.

Ah, the good brain doctor. But did you know that neurologists are also in charge of managing symptoms related to the nervous system, or anything that relates to your spine? Most often, neurologists tend to patients who have survived a stroke, or battle serious conditions like Parkinson's disease, multiple sclerosis (MS), and numbness or nerve pain caused by neuropathy. You may also seek them out for migraines and severe headaches that aren't going away.

These specialized surgeons also take care of your head and neck, but they focus on sinus, hearing, and throat disorders, among other issues. They are more commonly referred to as ENTs because they take care of your "ear, nose, and throat" primarily. You may visit an ENT for sinus issues, allergies and their side effects, as well as swallowing and hearing issues.

Ouch! You'll be heading to a podiatrist if you have foot, ankle, or lower leg pain or issues that can't be addressed by your primary care provider. While a visit to the podiatrist is often because someone has physically injured muscles, joints, or bones in their feet, these foot docs can also manage side effects from chronic conditions like diabetes.

Often mentioned in the same breath as a immunologist, these specialists are in charge of mitigating any pain or health concerns in your lungs and the entire respiratory system. You'll be referred to them for asthma often, but pulmonologists also diagnose and treat conditions like chronic obstructive pulmonary disease (COPD), emphysema, and lung cancer.

Believe it or not, this doctor is just focused on a singular organ in your body: The kidney. They are often called in for longterm treatment for serious chronic kidney diseases, of which there are many: They may also set up dialysis for those experiencing kidney failure.

These doctors may be known as virologists, or epidemiologists, but more routinely they're called infectious disease physicians. These targeted specialists treat ailments that are caused by viral bacteria or viruses themselves, including conditions like HIV/AIDS, tuberculosis, and malaria.

A referral to an oncologist might be terrifying for some, especially if they have yet to yield a positive result for any kind of cancer, but oncologists are often first examining your body, blood, or tissue samples beforehand. They may treat a benign tumor, which isn't cancerous by nature, but these specialist are still required. Oncologists are the point people for anyone who is living with cancer, and they'll draft treatment options, plus additional care when you reach remission.

These doctors are different from what's known as a naturopath, or a natural doctor. Osteopaths, titled as D.O.s in the field, receive similar training to a traditional M.D. but a greater emphasis is placed on treating a person for holistic health using elements of alternative medicine. Particularly, they often focus on relieving physical pain and tension in your body, especially in muscles and in joints.

These specialized care providers only see you for a short amount of time, and mainly for one thing only: Tests. Radiologists use imaging of all kinds to make an official diagnosis after another doctor or your primary care provider orders a test. The radiologist will make a detailed report to send back to your primary doctor or the specialist who ordered the test. Their testing services most commonly include:

Another highly targeted care provider, a urologist will treat pain and conditions related to the urinary tract (including bladders and urethra) for both men and women. They may troubleshoot issues like incontinence or help you pass a kidney stone; for men, they also deal with reproductive concerns.

A visit to a plastic surgeon's office isn't always for "craniofacial" adjustments. A bulk of a plastic surgeon's doesn't have to do with cosmetic procedures: They take care of the physical reconstruction of the body, and can help to repair your skin after a serious injury or burn, for example.

A special note on the following healthcare providers: They all address aspects of mental health in one way or another, with differences based on patients' needs. Each of them have different academic qualifications of various degrees, and they work in vastly different settings as well. "Only one type can prescribe medication and treat other medical conditions," Dr. Hersh explains.

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26 Different Types of Doctors - The Most Common Types of Doctors and Specialists - GoodHousekeeping.com

Throughout antiquity, from the Mediterranean to Egypt and todays Middle East, people believed that misfortune, including accidents, diseases, and sometimes even death, were caused by external forces.

Be they gods or other types of supernatural forces (such as a daimon), people regardless of faith sought magical means of protection against them.

While medicine and science were not absent in antiquity, they competed with entrenched systems of magic and the widespread recourse to it. People consulted professional magicians and also practised their own forms of folk magic.

Read more: Spells, charms, erotic dolls: love magic in the ancient Mediterranean

Possibly derived from the Latin word amoliri, meaning to drive away or to avert, amulets were believed to possess inherent magical qualities. These qualities could be naturally intrinsic (such as the properties of a particular stone) or imbued artificially with the assistance of a spell.

Not surprisingly the use of amulets was an integral part of life. From jewellery and embellishments on buildings, to papyri inscribed with spells, and even garden ornaments, they were deemed effective forms of protection.

Amulets have been around for thousands of years. Amber pendants from Denmarks Mesolithic age (10,000-8,000 BC) seem to have been worn as a form of generic protection.

Jewellery and ornaments referencing the figure of the scarab beetle were also popular all-purpose amulets in Egypt, dating from the beginning of the Middle Kingdom (2000 BC).

Read more: Michelle Obama's necklace and the power of political jewellery from suffragettes to a secretary of state

Two of the most common symbols of protection are the eye and the phallus. One or both amulet designs appear in many contexts, providing protection of the body (in the form of jewellery), a building (as plaques on exterior walls), a tomb (as an inscribed motif), and even a babys crib (as a mobile or crib ornament).

In Greece and the Middle East, for example, the evil eye has a history stretching back thousands of years. Today the image adorns the streets, buildings and even trees of villages.

The magic behind the evil eye is based on the belief that malevolence can be directed towards an individual through a nasty glare. Accordingly, a fake eye, or evil eye, absorbs the malicious intention in place of the targets eye.

The phallus was a form of magical protection in ancient Greece and Rome. The Greek sculpture known as a herm in English functioned as apotropaic magic (used to fend off evil). Such artefacts, featuring a head and torso atop a pediment often in the shape of a phallus and, if not, definitely featuring a phallus were used as boundary markers to keep trespassers out.

The implicit threat is that of rape; come near a space that is not your own, and you may suffer the consequences. This threat was intended to be interpreted metaphorically; namely, a violation of anothers property would entail some form of punishment from the supernatural realm.

The phallus amulet was also popular in ancient Italian magic. In Pompeii, archaeologists have uncovered wind chimes called tintinnabulum (meaning little bell). These were hung in gardens and took the form of a phallus adorned with bells.

This phallic shape, often morphing into bawdy forms, presented the same warning as the herm statues in Greece. However, the comic shapes in combination with the tinkling of bells also revealed a belief in the protective power of sound. Laughing was believed to ward off evil forces, as was the sound of chimes.

One scholarly view of magic is that it functions as the last recourse for the desperate or dispossessed. In this sense, it presents as a hopeful action, interpreted by some modern commentators as a form of psychological release from stress or a sense of powerlessness.

In the context of magical thinking, amulets may be dismissed by critical thinkers of all persuasions, but they remain in use throughout the world.

Often combined with science and common sense, but not always, amulets have made a resurgence during the COVID-19 pandemic. The amulets are equally as diverse, coming in all shapes and sizes, and promoted by politicians, religious leaders and social influencers.

A traditional form of adornment and protection in Javanese culture, now popular with tourists, burnt root bracelets, known as akar bahar, have been sold by community shamans. Indonesias Agriculture Minister Syahrul Yasin Limpo, meanwhile, has promoted an aromatherapy necklace containing a eucalyptus potion touted as a preventative against COVID (useless in terms of science but perhaps less dangerous than hydroxychloroquine).

This necklace prompts the question: where does alternative medicine end and magic begin? It is not a new question, since there has been an intersection between magical lore and medical knowledge for thousands of years.

Read more: A murky cauldron modern witchcraft and the spell on Trump

In Babylon, circa 2000-1600 BC, a condition known as kurrum disease (identified as a ringworm, symptoms of which include facial pustules), was responded to by both magicians and doctors. And in one text there is a healer who appears to perform the role of magician and doctor simultaneously.

Other ancient cultures also practised medical magic through amulets. In Greece, magicians prescribed amulets to heal the wandering womb, a condition whereby the womb was believed to dislodge and travel throughout a womans body, thus causing hysteria.

These amulets could take the form of jewellery on which a spell was inscribed. Amulets were also used to prevent pregnancy, as evidenced in a recipe written in Greek from around the second century BC, which instructed women to: take a bean with a bug inside it and fasten it to yourself as an amulet.

In a contemporary religious context, written amulets replace spells with prayers. In Thailand, for example, Phisutthi Rattanaphon, an Abbot at Wat Theraplai Temple in Suphan Buri, has issued people with orange paper inscribed with protective words and pictures.

Designed to ward off COVID-19, the papers represent the crossover between magic and religion; a paradigm as entrenched as the blurring of magic and medicine in numerous historical and cultural contexts. Thankfully, face masks and hand sanitiser are also available at the temple.

Originally posted here:
Scarabs, phalluses, evil eyes how ancient amulets tried to ward off disease - The Conversation AU

Photo illustration by Slate. Photos by Samuel Corum/Getty Images, John Moore/Getty Images, and Justin Tallis/AFP via Getty Images.

This is part of Six Months In, a Slate series reflecting on half a year of coronavirus lockdown in America.

Since January, the coronavirus pandemic has killed more than 190,000 Americans, and it has left an especially brutal impact on Black people and people of color. The racist systems that keep many communities of color in a state of perpetual disadvantagefrom housing to education to, yes, medicinehave made them uniquely vulnerable to this plague. Ive been writing about COVID-19s decimation of Black communities since the pandemic reached the U.S., and Ive been speaking with fellow journalists and health professionals for my series Conversations on Moving Forward to get a sense of why Black people have been disproportionately dying of COVID, and what we can do about it. For the latest installment, marking about six months since the pandemic became real for Americans, I spoke with Dr. Uch Blackstock, founder and CEO of Advancing Health Equity and an emergency medical physician, about how the coronavirus pandemic intersects with racism, and what needs to change to ensure this wont happen at the same scale again. Our conversation has been edited and condensed for clarity.

Julia Craven: You left academic medicine to come back into direct patient care.

Uch Blackstock: Im a second-generation physician, which is something I need to mention because only about 2.6 percent of physicians are Black women.* My mother was the original Dr. Blackstock. All the work that I do, especially around health equity, is in her memory.

I left academic medicine because I wanted to do health equity work. I wanted to explicitly address racism in health care. As you may know, sometimes these organizations, even health care orgs, are not always the most hospitable to Black faculty and students and trainees. And I couldnt really work in the authentic way that I wanted to. So I left and started my own organization to work with health institutions regarding racism in medicine and racial health inequities.

I spoke with you earlier this year about the pandemic and how it was going to have a really hard effect on Black communities and other communities of color. Give us an overview of what we have seen so far.

Its been horrible. When we look at the COVID-19 mortality rates, Black Americans have died at the highest rates. The virus has been allowed to essentially run throughout our communities because of lack of any federal leadership around the pandemic.

What does this say about the way racism works in our country, particularly how it intersects with our medical and public health systems?

For a long timeand this is true for myself and other clinicians I knowweve always thought about health as being just related to the care thats available. If you have access to health care, then youre healthy, right? But I think what this moment has brought into clarity is the fact that we know structural racism is a key driving force of the social determinants of health. If you have jobs that are putting you on the front lines, youre going to be exposed to the coronavirus. If you are living in overcrowded housing, which is more likely to occur in our communities because of lack of affordable housing and lack of opportunities for homeownership, then youre going to be in environments where youre more likely to be infected. Even thinking about who is using public transportation and who is less likely to be able to afford a car, were looking at our communities.

What systemic racism has done is limit the opportunities Black Americans have, to the effect that its placed us in a situation where we are most vulnerable to this virus. Add onto that the fact that our communities carry the highest burden of chronic diseasewhich, again, is a result of racism, lack of access to care, lack of quality care, lack of investment in our communities, lack of opportunities for finding healthy food options in our neighborhoods. All of what were seeing right now just shows how deeply embedded racism is in this country, in every aspect of the lives that we lead.

What happens when you compound that with the stress everyones feeling?

We also know that the chronic stress of living in areas where there has been this disinvestment, that increases your stress response, increases cortisol levels, influences gene expression. Some of the high rates of diabetes and autoimmune diseases that we see among Black Americans are due to this idea of epigenetics: the fact that the stress of racism can change which genes are turned on and off. All of those factors combined have left Black communities essentially sick.

Why is an anti-racist framework important in medicine, whether it be structurally or in your interpersonal interactions?

We actually have been having a discussion among physicians about whether social justice and systemic racism are things we should learn within our education and training. How can you adequately care for your patient on an interpersonal level, and how can institutions adequately and equitably care for communities, if we dont understand the broader structural forces that are influencing peoples health? If there are underlying socioeconomic factors like poverty, inequality, lack of education, whatever I do is not going to make a difference, right? Thats why I think this is a call to action for health care institutions to be thoughtful and more transformative in thinking about how are we educating and training anyone interacting with patients. How do we give them a framework for understanding what especially Black patients and communities have gone through in this country for centuries?

That has my gears turning about how Black medical schools, historically Black medical schools, have closed. If they were still here, how do you think this would have abated the difference that were seeing with the coronavirus?

In the early 1900s, there was an educational specialist named [Abraham] Flexner who was commissioned by the Carnegie Mellon Foundation and the American Medical Association to look at medical education. He came up with these rigorous medical standards that didnt necessarily correlate with better education or training, but did lead to the closing of a number of the majority of Black medical schools. A study showed that between 20,000 and 30,000 physicians, mostly Black physicians, would have been trained or in the workforce if those schools had remained open.

Another study came out last week on infant mortality. The Black babies who were more likely to be cared for by Black physicians at birth, their infant mortality rate was significantly lesser compared with the Black babies cared for by white doctors. We know that having more Black physicians is not going to end health care inequities, but it is one significant factor to addressing them. When we talk about reparations and talk about what needs to be done now, to have Black medical schools where we are focusing on educating Black health care professionals would be key.

I think about how vital it is to have Black doctors in place, because I know from my own experience, if it werent for Black doctors

I had a patient, a young Black woman, who came in and said, I want to make sure youre Black because I want to make sure that I feel listened to. And I said, Yes, I am here. I will listen to you. I realized that its so important for patients to feel seen, heard, and valued by the person caring for you.

I also think that, being a patient, thats the most vulnerable you can be as a human being, to put your care, your health, into the hands of this complete stranger. And we have a lot of data and literature that shows that most clinicians, regardless of their race, have a preference for white patients over Black patients. Weve seen that manifest in terms of who gets pain medication and who doesnt. Weve seen that implicated as a factor in the Black maternal mortality crisis. We see it with infant mortality data. We have to think about training a workforce that is competent in providing care to Black patients. Part of that is having more Black physicians, but part of it is training other health care professionals who may not be Black in taking care of Black patientswhich is crazy, but that just shows you how deeply embedded racism is, right?

Another thing I wanted to get into is the mental health effects of the pandemic on communities of color. I saw a study from the CDC saying that there is an increased rate of respondents saying they were suffering from depression and anxiety and having suicidal ideation. And that increase was higher among people of color. When we start talking about a community that already has limited access to mental health care options, what are we looking at here?

That shows how racism is not just affecting physical health, right? Black people have to deal with our fellow Black citizens being killed by the police. Thats the stress of everyday racism. Our communities have suffered the more significant economic losses, in terms of small businesses, in terms of jobs. All of those factors are making this crisis even more of a crisis for us in particular. Add that onto the fact that in our communities, were under- and uninsured and dont have access to mental health professionals. I think were going to see this second wave of mental health issues. Were thinking of physical issues in terms of the virus, but also thinking about the long-term effects of what this will do in terms of the mental health of our communities.

Any local and state efforts that are going to address racial health inequities, its not just going to be about increasing testing availability, its not going to just be about making sure that the health care institutions in our communities are more well resourced, but its going to be about making sure people have housing and financial assistance and that they have access to mental health services. Its going to have to be a multipronged approach.

Its frustrating that people dont have access to these very basic needs.

Thats why, however horrible and depressing this moment is, I also think its a moment to think about transformative structural change and about how, just from a health care perspective, we can provide better care to people. Im all for universal health coverage, single-payer. Thats something weve seen across the world: Countries have done better when people have health insurance. But we need to also be thinking about how our health care institutions function and ensure theyre engaged with the communities theyre serving, that theyre working with community-based organizations on the ground who already have trusted leaders in the community. How can we liaise with these organizations to make sure the COVID patients were discharging have somewhere to stay, have financial assistance, have health insurance? These are ways that health care institutions can start thinking a little bit more progressively and competently about how you care for patients in these communities. It needs to be what we call structurally competent care.

There was a piece about pulse oximeters and how they dont give accurate reads on melanated skin. I was wondering if thats something people should be concerned about, considering that pulse oximeters and blood oxygen levels play such a big role in coronavirus treatment.

Absolutely. I saw that piece and obviously was very disturbed by it, but it made sense to me that that would happen, because often we are not enrolled in clinical trials or in testing of medical devices, right? There is that whole other issue with recruiting usyou have bias in and bias out. So I would say to be extra vigilant if youre having any symptoms. I tell my patients to come back even if its just to get your oxygen checked, because we can also do other testing for you to see how youre doing. What we see with the pulse ox is that this is also a way that technology itself can be embedded with bias that could be harmful to our patients.

I wanted to ask you about the election and the coronavirus. One narrative weve seen popping up is that an administration change could dramatically shift the response that were seeing.

Im trying to be realistic because the fact is we had racial health inequities during prior administrations. We had the killing of Black Americans during prior administrations. So I dont know if were going to see radical enough change on that level. I do think that if we have a change in administration, there will be improved testing availability, an emphasis on preventative measures, and more effective leadership, hopefully. But I think its going to take a while for us to see any real improvement.

What about sending kids back to school? For Black and Latino Americans, for people who have essential jobs, this is a big issue, and day care is very expensive.

The fact is, schools have essentially become a safety net for our children. Im in NYC, which has 1.1 million children in the public school system, including my own children, and most of them are Black and Latino. The kids dont just go to school for education but for health care: We have hundreds of clinics in schools. They go for special education services.

Our children not being in school is going to have profound effects, worse than educational gaps. But we also know that our communities are also the ones that have been most disproportionately affected by the coronavirus, and the schools may not have the resources to bring people back safely. So, its almost a false choice, right? I think for many families, it will be deeply personal depending on what their priorities and needs are.

I remember seeing early on how a lot of folks were concerned about kids being able to eat, because school is often the only place some kids can get food. I know that in D.C., at least a couple of the schools said, Kids can come here and get their food. Its been interesting to see how our social systems have shifted to meet this moment, because some of them werent meeting the moment before. Same with evictions: It was very clear, once the pandemic kicked in, that we dont have to evict people.

Yeah, I think this is opportunity for us to think about transformational change in all aspects of how we do things. So, as I mentioned, even with how we take care of patientsthinking about it as beyond the interpersonal and more structural. So even though this is an unprecedented time, and theres been a significant amount of human suffering, this is an opportunity for us to move forward in thinking about how can we create structural and sustainable change that will help support our communities.

Watch the full conversation here:

Correction, Sept. 14, 2020: Uch Blackstock originally misstated that 2.6 percent of Black women are doctors. That percentage of physicians are Black women. Her quote has been edited.

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Why Black Americans are dying of the coronavirus at such disturbing rates. - Slate

Posted Sep 13, 2020, 5:26 pm

Michael WentzelSpecial to TucsonSentinel.com

As the COVID-19 pandemic has progressed, we have seen an alarming amount of disinformation spread online, including by our elected officials. Take the conspiracy video "Plandemic," which alleges that the coronavirus was created in a lab and intentionally spread to generate profit.

The video went viral and has been viewed more than eight million times. In comparison, informational videos from the scientists at the Centers for Disease Prevention and Control and World Health Organization typically get no more than a few thousand views.

"Plandemic" is just one of many sources of disinformation that offer inaccurate advice to protecting oneself from COVID-19.

Conspiracy videos recommend everything from drinking water every 15 minutes and avoiding ice cream to drinking silver and consuming a lot of garlic.

Doctors find themselves powerless to help patients who dismiss the severity of the virus and listen to conspiracists over the advice of medical professionals.

Some patients are going as far as ingesting disinfectants because they have heard it will treat the virus; according to the American Journal of Tropical Medicine and Hygiene, more than 800 patients have died after consuming highly concentrated alcohol in ill-guided attempts to treat the prevent or treat the virus.

A company that calls itself "Genesis II Church of Health and Healing" even proclaimed its "Miracle Mineral Supplement," which contains industrial bleach that can cause kidney, respiratory, or liver failure if ingested, could treat and prevent COVID-19.

The FDA had to hurriedly warn the public about the risks of consuming the product.

As if we don't have enough to deal with, our elected officials routinely ignore science too.

Less than two weeks before the virus put the entire country into lockdown, President Donald Trump still insisted that COVID-19 was a hoax, but even once he realized it clearly was not, he still did not take it seriously.

Despite advice from our public health leaders to practice social distancing and wear masks to prevent the spread of the virus, Trump and Vice President Mike Pence refuse to wear masks in public. Pence leads the White House's coronavirus task force, yet he toured the Mayo Clinic without a mask on April 28 (that same day, the U.S. reached one million COVID-19 cases). Meanwhile, Trump encouraged Americans to take hydroxychloroquine to prevent COVID-19 without reputable evidence that the drug was effective. The FDA then rushed to give emergency authorization of the drug, only to revoke it a few months later after research concluded it is not an effective treatment or preventative measure against COVID-19.

Amid lies and conspiracy theories, our light at the end of the tunnel is scientific innovation.

Thanks to a round-the-clock collaboration between the public and private sectors, there are several COVID-19 vaccines and treatments in development. One, for example, blocks the novel coronavirus from binding to human cells and reproducing; by stopping the virus from connecting with human cells, the drug prevents it from multiplying and attacking the body.

There are more than 100 different vaccines at various stages of development, and researchers are using different avenues such as gene therapy, DNA, and antibodies from survivors to develop an effective vaccine.

U.S. health care innovation has saved millions of lives.

HIV is now a manageable disease, no longer a death sentence. Thanks to developments in early-detection mammogram technology, female breast cancer cases dropped by 40 percent in 2016. We now have a drug that can treat over 90 percent of Hepatitis C patients, whereas older drugs took nearly a year to become effective and even then only worked on 50 percent of patients.

History teaches us that our best bet is to support the researchers working to develop treatments and vaccines for COVID-19.

We owe it to the frontline essential workersour grocery store workers, healthcare workers, sanitation services, public transit operators, and so many morerisking their lives every day to do better in this pandemic.

We need to ignore disinformation, whether it comes from the Internet or the White House, and instead follow the advice of our public health professionals. Supporting and investing in their research and innovation will get us through this crisis.

Michael Wentzel, M.D., was a nurse for 16 years with experiences ranging from trauma and intensive care to flight nursing and nursing hospital supervisor, both military and civilian, before going to medical school.

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Ignore disinformation & rely on science to get through COVID-19 pandemic | Guest opinion - TucsonSentinel.com

Dr. Bens Grams likes to say he does things a little differently. The Little Falls based chiropractor assesses the entire body to determine not only the source of someones pain, but the cause of that pain. Then he works to treat the body with various therapies, not just by correcting a misalignment, but focusing on long-term treatments as well as preventative care.

Our goal here has always been to provide our community with non-drug, non-surgical options for pain relief, Grams said.

To help with his goal, Grams recently acquired an Erchonia laser, an FDA approved non-invasive method to help treat chronic and acute pain.

Erchonia is a cold laser, meaning it doesnt heat the tissue. The special light targets the bodys cells to encourage healing.

Its pretty incredible. To understand how it works you have to understand how cells heal. So we have these little power factories inside the cells called mitochondria. So mitochondria produces energy, ATP, in the cell and then the cell uses that to perform its basic function. One of its most fundamental functions is to repair itself under injury or damage, Grams said.

The energy components of a cell can burn out and are not able to provide the energy needed to heal cells, he said. The laser essentially jump-starts the cell into working more efficiently, and the body takes the healing process from there.

If the cells cant heal, the tissue cant heal. If the tissue cant heal, the person cant heal, Grams said.

In just two months since offering laser treatments, Grams has had dozens of patients try the Erchonia, and with some great results.

The treatment takes anywhere from five to 10 minutes, and the patient shouldnt feel anything but some possible tingling. Some patients may need one or two sessions while others may need a couple dozen, Grams said. It all depends on the condition.

When youre in practice that long, you get used to how things heal, but some of our tougher cases are healing faster than you ever could have hoped, Grams said. People are kind of excited about new technology that helps their body.

The laser treatment can help with issues from pain related to a recently sprained ankle to chronic pain from older issues. Conditions such as tendinitis, bursitis, sciatica, rotator cuff injuries and even digestive issues can be corrected with the Erchonia, Grams said.

You can treat just about any muscle or joint in the body with it. Whats also exciting is it also has healing effects in body systems as well. It not only affects the musculoskeletal system but it affects the organs by helping cells communicate better with each other, Grams said.

Dr. Ben Grams introduced the Erchonia laser at his practice in Little Falls to help his patients with pain conditions. He even uses the laser to treat his wrist pain from years of wear as a chiropractor.

When a patient comes in, Grams works to find not only the source of the pain, but the cause of the problem. Erchonia is a double laser allowing both areas of the body to be treated. Sometimes, he said, lower back pain can be due to a hip problem, even if the patient doesnt feel pain in the hip, both areas need to be addressed to truly treat the pain and its cause.

Many patients use the laser treatment in conjunction with other rehabilitative therapies. Since not all conditions can be treated with the laser, Grams offers a multitude of similarly non-invasive, drug free options, including adjustments, muscle therapy, corrective movement therapy, therapeutic ultrasound and more.

The chiropractor has various certificates for several techniques, including working in pediatric and perinatal areas. Grams used these methods on his wife and new baby during and after the pregnancy. His daughter was aligned within a few minutes of being born, which can help with colicky babies.

I think its so important for kids to be checked regularly as far as alignment and making sure the joints are holding property alignment. It can help them the rest of their life, he said.

Grams passion for natural methods of pain treatment and prevention ignited when he was in college and his grandmother was being treated at the Mayo Clinic in Rochester.

She was in the hospital having some tests and she suffered a perforated ulcer, the lining of your stomach wears thin and the acid contents basically spills in the guts. Its incredibly painful and its life threatening, Grams said.

Luckily, his grandmother made it through her surgery and her life was saved. But Grams wondered why such a thing would happen in the first place. The surgeons answer led Grams to where he is today.

He nonchalantly said, Well, its likely due to her daily use of Ibuprofen for pain relief. And it just hit me like a lightning bolt, Grams said. There were these things that were supposed to be helping her, but were actually hurting her. At that moment I decided I was going to help people be pain free and healthy, but I was going to do it without prescribing medications or doing any surgeries.

After shadowing some of what Grams said were the most intelligent and holistic thinking chiropractors hes met, Grams curated his focus as a chiropractor focusing on the entire body, beyond perming adjustments. Now Grams is in his ninth year at his Chiro Plus Rehab clinic in Little Falls.

The doctor even wrote a book, The Solution to Back and Neck Pain, which was a top seller on Amazon.com in the chiropractic, chronic pain, and alternative medicine sections.

The book was read worldwide and, to Grams astonishment, encouraged a man to fly from Beijing, China to seek his treatment, twice.

We do things different than the average chiro, Grams said. Were happy to just adjust someone if they just want to get cracked and go on their way. But, if people are wanting to change and really get after the underlying cause of the problem, I think were set up pretty well to accomplish that.

For more information on Grams practice visit http://www.chiroplusrehab.com or call (320) 632-9224.

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LF chiropractor offers non-invasive cold laser treatment for pain, focused on holistic therapies - ECM Publishers

ARLINGTON, Va. (PRWEB) September 14, 2020

Kalorama Information recently released its report on the 80+ billion dollar in vitro diagnostic market. Among other information and intense market segmentation in the 1,800+ page report was the following:

What does that mean? Less than one might think. Theres still opportunity in this industry. The remainder of the market is held by 100s of companies; some, of which, specialize in specific test segments and others serve their local markets. IVD remains dynamic. There are constant innovations. This report documents these innovations in each segment market chapter. The IVD industry is a high R&D spend industry, and there is routine interest from venture capital firms in diagnostic products

More information can be found in The Worldwide Market for In Vitro Diagnostic Tests, 13th Edition: https://kaloramainformation.com/product/the-worldwide-market-for-in-vitro-diagnostics-13th-edition/

About Kalorama Information:Kalorama Information, part of Science and Medicine Group, is the leading publisher of market research in healthcare areas, including in vitro diagnostics (IVD), biotechnology, healthcare, medical devices, and pharmaceuticals. Science and Medicine Group supports companies seeking to commercialize the rapidly changing marketplace at the intersection of science, medicine, and technology. Comprised of industry-leading brands, Science and Medicine Group serves analytical instrument, life science, imaging, and clinical diagnostic companies by helping them create strategies and products to win markets and provide platforms to digitally engage their markets through a variety of innovative solutions. Kalorama Information produces 30 reports a year. The firm offers a Knowledge Center, which provides access to all published reports.

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The 80-Billion Dollar IVD Market: Five Fast Facts from New Report - PR Web

Although few called it polio at the time, an increasing number of Canadians had started to become aware of a mysterious cluster of cases of infantile paralysis in the fall of 1910.

In early September of that year, the Toronto Star reported that medical authorities attributed a recent local spate of infantile paralysis in young children to injuries. It had nothing to do, they said, with the cases reported in various places across the line in the United States, or in Hamilton, where a little girl had died of polio in August.

By December, it was no longer possible to deny it was part of a larger problem. Macleans (then called the Busy Mans Magazine) reported that there were ten little children suffering from infantile paralysis at a ward in the Hospital for Sick Children and connected it to outbreaks across Canada and around the world. Polio was hard to pin down, though, since its progression was wildly unpredictable.

With polio, no two cases were the same, explains Christopher J. Rutty, a professional medical/public historian and adjunct professor at the University of Torontos Dalla Lana School of Public Health. That epidemic was actually one of the closest parallels to COVID, especially in terms of the variability of impacts, from very mild to very severe.

Polios worldwide death toll was in the millions. In Canada, tens of thousands recovered but were left with some form of disability. Some developed flu-like symptoms after they were exposed to the polio virus and recovered relatively swiftly and easily. Some never developed symptoms at all; others started showing symptoms up to three weeks after exposure.

Just like with COVID-19, there was a sub-clinical factor to it, where people have it without realizing theyre affected, which helps it spread quite effectively, says Rutty. By the time you had paralytic cases in the area it had pretty well spread everywhere. So it took a long time to really get a handle on it, but its not really till the late 40s or early 50s that we started understanding the epidemiology.

For over four decades, between the earliest clusters of modern polio in the early 20th century and the Salk vaccine in the mid-1950s, people lived often terrified in its shadow. And there was no shortage of misinformation about transmission, prevention and cures, according to Gareth Williams, professor of medicine at the University of Bristol and author of Paralysed With Fear: The Story of Polio.

These ranged from the sensible to the bizarre, from barring children from theatres and pools to a panic over house pets that saw 70,000 cats and 8,000 dogs turfed from their homes and euthanized, despite public health departments reassurances that the pets were all right. All manner of homeopathic cures and tonics hit the market, as well as warnings that seafood, dairy or certain fruits and vegetable were to blame.

Several researchers prescribed big doses of vitamin C and one nutritionist, Benjamin Sandler, zeroed in on sugar and high-carb diets as the culprit in his book Diet Prevents Polio a theory pretty similar to the ones that back the new crop of corona-diets touted by various contemporary pundits in the COVID era.

Cutting back on sugar and/or upping vitamin C is one thing, but other tactics were more detrimental. In Texas, where many associated polio with houseflies, DDT was liberally sprayed in rivers, city streets and even on people. In Canada, one particularly popular preventative in the mid-1930s was a picric acid-alum nasal spray that was devised by Simon Flexner, director of the Rockefeller Institute for Medical Research in New York. He thought polio entered the brain through the nose (it didnt), so the thing to do was to blast it with acid while it was still in the nose.

Flexner was basically king of American medical research in the 1920s and 1930s and, on the basis of not very good experiments, he decided that the polio virus got in through the nose, says Williams. So the whole thing about picric acid is that this is a nasty, nasty toxin. Even before they worked out just how carcinogenic it was, you could tell organic chemists because their fingers were often stained yellow with picric acid.

However awful and useless picric acid may have been, it was arguably better than some of the supposed cures, especially the red-hot poker cure and brain washout therapy. The first is as its name suggests, a procedure wherein paralyzed children were branded with a fire iron immediately above the vertebrae affected in the hopes that the inflammation would suck the virus out of the spinal cord through the skin. The brain washout saw a mild saline solution injected into an afflicted child with hopes the virus would pour out through a spinal tap inserted into their back.

You might ask yourself why on earth they did that, but the answer is that there was nothing else at all, says Williams. And the terrible thing about polio is that it was a disease that dropped out of a clear summer nights sky and lifted off kids that had been playing perfectly happily the day before. So youve got to put yourself in the place of parents who were desperate to do anything.

The good news is that science has come a long way since then. We know way more about viruses than we did circa 1910 to 1955, which makes it pretty unlikely that were 40-something years away from a vaccine. Even so, both our experts warn that no safe vaccine is likely to be widely available until early next year.

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Still, a year isnt the same as four decades. So we should be able to muster up some patience and resist the call of cures such as potentially toxic oleander or Miracle Mineral Supplement: a drinkable industrial bleach. Also and this is key to disregard the misinformation when we finally do get a safe vaccine.

Any vaccine is only going to work if people take it, says Williams. And you can already go online and find people rehearsing arguments for a vaccine that doesnt exist yet. So thats another area that I think people are going to have to watch very carefully.

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How polio was the COVID-19 of its era, right down to the misinformation and bogus cures - TheSpec.com

The move part of a broader agreement with the Boston Teachers Union on reopening schools that was announced Thursday comes as the city has been grappling with wide variations in coronavirus cases among its neighborhoods. Of particular concern is East Boston, which has the highest weekly positivity rate, 8.7 percent.

If East Boston were its own school system, state guidelines would strongly recommend keeping classrooms closed because its positivity rate is so high. However, Bostons overall weekly positivity rate is 1.7 percent, according to the most recent city data, enabling the districts classrooms to reopen.

Boston will begin online classes citywide on Sept. 21 and then gradually bring students back into classrooms in waves, starting in October with the highest-need students, including those with profound disabilities and those who do not know English.

Mayor Martin J. Walsh announced the union agreement as part of his routine briefings on the citys virus efforts. He highlighted the provision about the routine COVID-19 testing of union employees and other measures in the agreement such as additional training for educators on how to teach remotely and the ability to bring their own children to school if they cant secure child care.

The focus of this framework is ensuring the safety of everyone in our schools, Walsh said.

Jessica Tang, president of the Boston Teachers Union, described the testing program as a good first step, but said she would like to see more wide-scale testing of staff. She noted educators report to their schools from across the city and the region while students also criss-cross the city to get to their schools many relying on public transit creating ripe conditions for a widespread outbreak.

If we are focusing efforts on places with highest risk of infection, hopefully it will help prevent or limit spread, Tang said.

She said she would like the district to administer rapid testing for educators exhibiting symptoms to determine whether they have been infected or are instead suffering from the flu, allergies, or something else. Tang said the move would decrease potentially unnecessary quarantines that would keep teachers away from their students.

Boston appears to be one of just a handful of districts in the state that is planning to test teachers.

Cambridges school committee made routine testing for teachers a condition of reopening school buildings for students next month. The city is finalizing plans with the Cambridge-based Broad Institute to offer a testing program for all staff who will work in school buildings, said Lyndsay P. Brown, chief strategy officer for Cambridge Public Schools. The plan will not have to be approved by the school committee, said Brown.

Wellesley and Hanover plan to test staff before they enter schools, according to union agreements with the districts. Wellesley will also provide free testing once a week for staff for preventative monitoring. Watertown, Everett, Revere, and Lexington are also planning to offer at least some testing to school staff, according to the Massachusetts Teachers Association.

Debate over whether to routinely test educators has been unfolding over the summer as districts prepare to reopen schools. It intensified after Governor Charlie Baker announced plans to dispatch mobile COVID-19 testing units to schools experiencing potential clusters of cases. Teachers unions criticized the move as too reactive as they pressed for wide-scale free testing of teachers and students as a preventative measure.

The Massachusetts Department of Elementary and Secondary Education, however, has not issued any guidelines on routine testing, while the Centers for Disease Control and Prevention doesnt recommend universal testing for asymptomatic school employees and students.

In its guidance, the CDC said it is not known if testing in school settings provides any additional reduction in person-to-person transmission of the virus beyond what would be expected with implementation of other infection preventive measures, such as social distancing, mask wearing, hand washing, and enhanced cleaning procedures.

The guidance also says universal testing could present some challenges, including whether all students, parents, and staff would be receptive to the idea.

But Joshua Barocas, an infectious disease physician at Boston Medical Center and a faculty member at Boston University School of Medicine, said there can be value in doing sample testing if it is part of a broader COVID-19 prevention plan. He compared it to the kind of surveillance and population testing occurring in nursing homes, shelters, and other congregate settings, which aim to test between 20 to 40 percent of people every two or four weeks.

It can be effective at recognizing an outbreak early, said Barocas, but it also can lead to the need for further investigation and testing. Im hopeful if someone sees a possible signal of an outbreak . . . that they would increase testing to determine if its actually a signal or just noise.

He said going with a sampling of 5 percent of union members each week is a good starting point and from there the district could assess whether its large enough to be effective in either spotting potential outbreaks or instilling confidence among educators, students, and parents that they will be safe.

At 5 percent, the testing program is a potentially ambitious effort for the BPS, and could mean testing up to approximately 375 educators a week or 1,500 over the course of a month, according to Globe calculations. The Boston Teachers Union has about 7,500 active members, including nurses, classroom aides, and guidance counselors across 125 buildings.

But not all union members would be eligible for testing. The agreement limits testing to only those who report to school buildings with students inside. Members can only be tested every 14 days. Results would be available within 24 to 48 hours.

The district will provide weekly public reports on incidents of infection by school, according to the agreement.

Many details of the testing program are still being worked out with the Boston Public Health Commission, a school spokesman said Thursday night. The school system also had no estimated cost for the program and did not say where the money would come from to cover the testing.

Thomas Scott, executive director for the Massachusetts Association of School Superintendents, said he has mixed feelings about routine testing, especially the cost and the possibility of false positives for employees with no symptoms.

Having regular testing probably has some value," he said, but he added, "I dont know if it will make a difference for districts in preventing transmissions.

Beth Kontos, president of the American Federation of Teachers Massachusetts, which Boston teachers belong to, said she views the BPS COVID-19 testing as a win for public health. But she wishes the state would create a routine testing program for all districts instead of just providing emergency testing.

Its a shame we have to wait for people to get sick until we do the right thing, she said.

Felicia Gans and Naomi Martin of the Globe staff contributed to this report.

James Vaznis can be reached at james.vaznis@globe.com. Follow him on Twitter @globevaznis. Bianca Vzquez Toness can be reached at bianca.toness@globe.com. Follow her on Twitter at @biancavtoness.

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Boston to randomly test teachers and other educators weekly for COVID-19 - The Boston Globe

In nearly 40 years of the HIV epidemic, only two people have likely been cured of the virus. Both scenarios resulted from stem cell transplants needed to fight blood cancers such as leukemia. Inspired by these two cases, a team of scientists is studying a multipronged way to potentially control HIV without medication. It involves two different genetic alterations of immune cells and with a safer method of stem cell transplants, also referred to as bone marrow transplants, a procedure that is generally toxic and dangerous.

The research is being funded by a five-year $14.6 million grant from the National Institutes of Health. The scientists coleading the preclinical studies are Paula Cannon, PhD, a distinguished professor of molecular microbiology and immunology at the Keck School of Medicine of the University of Southern California, and Hans-Peter Kiem, MD, PhD, who directs the stem cell and gene therapy program at the Fred Hutchinson Cancer Research Center, also known as Fred Hutch. According to a Keck School of Medicine press release, the two other main partners are David Scadden, MD, a bone marrow transplant specialist and professor at Harvard University and the Harvard Stem Cell Institute, and the biotechnology company Magenta Therapeutics.

In the HIV cure scenariosinvolving the so-called Berlin and London patientsboth men received stem cell transplants from donors with a natural genetic mutation that made them resistant to HIV. Specifically, their genes resulted in immune cells that lack CCR5 receptors on their surface (HIV latches onto these receptors to infect cells). Unfortunately, this method isnt viable for the nearly 38 million people worldwide living with HIV. Not only is it expensive, toxic and riskyit involves wiping out the patients immune system and replacing it with the new immune cellsbut it also requires matched donors who are CCR5 negative. According to the press release, about 1% of the population have this mutation.

With funding from this new grant, researchers hope to overcome these challenges in several ways. First, Cannon has already developed a gene-editing method to remove the CCR5 receptors from a patients own stem cells. She now hopes to further genetically engineer stem cells so they release antibodies that block HIV.

Our engineered cells will be good neighbors, Cannon said in the press release. They secrete these protective molecules so that other cells, even if they arent engineered to be CCR5 negative, have some chance of being protected.

Fred Hutchs Kiem will use CAR-T therapya new method of genetically modifying immune cells that is emerging out of cancer researchwith the goal of creating T cells that attack HIV-infected cells.

In addition, other scientists involved in the federal grant aim to develop less toxic methods of bone marrow transplantationfor example, by reducing the amount of chemotherapy required and speeding up the process of creating the new immune system.

The research finding could translate to other illnesses, such as cancer, sickle cell anemia and autoimmune disorders.

A home run would be that we completely cure people of HIV, Cannon said. What Id be fine with is the idea that somebody no longer needs to take anti-HIV drugs every day because their immune system is keeping the virus under control so that it no longer causes health problems and, importantly, they cant transmit it to anybody else.

For the latest on the cure cases, see Famed London Man Probably Cured of HIV from earlier this year. And in related news, see $14M Federal Grant to Research CAR-T Gene Therapy to Cure HIV.

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$14.6M Grant to Explore a Therapy to Control HIV Without Meds - POZ

When Takeda unveiled its translational cell therapy engine early last year, the Japanese pharma made it clear the crew, under Novartis vet Stefan Wildt, is going all the way: clinical expertise, bioengineering chops, world-class collaborations, plus chemistry, manufacturing and control.

The final piece of the puzzle has now fallen in place, with the opening of a 24,000 square-foot cell therapy manufacturing facility at its R&D headquarters in Boston.

In that early space, having it situated in proximity to our teams is quite powerful, Chris Arendt, head of the oncology therapeutic area unit, told Endpoints News. When you think about it, the process defines very much the medicine and the cell therapy space

Designed to produce clinical-grade material from discovery through pivotal Phase IIb trials, the site will support five ongoing pacts. They include pluripotent stem cell work with Kyoto University Nobel laureate Shinya Yamanaka, gamma delta T cell research with Adrian Hayday and his biotech, armored CAR-Ts with Koji Tamada at Noile-Immune Biotech, next-gen CARs with Memorial Sloan Ketterings Michel Sadelain, and finally CAR-NK with Katy Rezvani at MD Anderson.

With three programs now in the clinic, Takeda is now picking two more to test in humans in 2021, Arendt said. While each research partnership has taken on its own bespoke approach to manufacturing up to now, the new facility will provide a central spot to lock down the process development as close to the final product as possible.

At the forefront are TAK-007, an allogeneic CD19-targeted CAR-NK being tested in Phase I/II for relapsed or refractory non-Hodgkins lymphoma; TAK-940, 19(T2)28z1xx CAR-T cells featuring a next-gen signaling domain from MSK; and TAK-102, a cytokine and chemokine armored CAR-T directed at GPC3-expressing previously treated solid tumors. The latter two are in first-in-human trials.

Having a dedicated facility scales the operations up so that the team can simultaneously advance multiple programs, he added.

Before the Covid-19 pandemic sucked out all the oxygen in the room, the booming cell therapy markets demand for physical infrastructure captured considerable attention. Gileads Kite constructed its own viral vector manufacturing center in order to leave no stone unturned. Contract manufacturers like Catalent were snapping up space, and even Deerfield got into the game with a splashy, $1.1 billion entrance.

The way hes built the team now grown to well over 150 scientists the learnings from any one program can be quickly applied to the whole portfolio, Wildt noted.

We wanted to place the engine team at that sweet spot between late-stage discovery and rapidly putting forward innovative ideas and concepts into clinical translation, he said. It was just a concept a few years ago. And now we can partner with hospitals and patients and really see hopefully we can be successful on their behalf.

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Takeda opens cell therapy manufacturing facility tucked right in its Boston R&D hub - Endpoints News