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Dr. Linda McKibben, Former FDA Pediatric Medical Officer, Division of Vaccines and Related Products, Joins NDA Partners – Yahoo Finance

February 10th, 2020 8:41 am

NDA Partners Chairman Carl Peck, MD, announced today that Dr. Linda McKibben, a former Pediatric Medical Officer/Clinical Reviewer in the Division of Vaccines and Related Products at the FDA Center for Biologics Evaluation and Research, has joined the firm as an Expert Consultant.

ROCHELLE, Va., Jan. 29, 2020 /PRNewswire-PRWeb/ --NDA Partners Chairman Carl Peck, MD, announced today that Dr. Linda McKibben, a former Pediatric Medical Officer/Clinical Reviewer in the Division of Vaccines and Related Products at the FDA Center for Biologics Evaluation and Research (CBER), has joined the firm as an Expert Consultant. Dr. McKibben's expertise includes pediatric therapies, pediatric trials, preventative medicine, public health, health policy, and clinical regulatory strategy.

Prior to joining the FDA, Dr. McKibben served in multiple roles at the US Centers for Disease Control and Prevention as Senior Advisor for Health Services Research at the National Center for Infectious Diseases (NCID), Senior Medical Officer in the Office of HealthCare Partnerships (OHP), and Medical Epidemiologist at the National Center for Prevention of Injuries (NCIPC). She has also served as a Senior Policy Analyst/Medical Director of Altarum Institute (Alexandria, Virginia), and Vice President of Health Policy at The Lewin Group (Falls Church, Virginia).

Most recently, she served as a Clinical Trials Medical Consultant for Ripple Effect Communications, where she supported the Deputy Director of Extramural Research at NIH's National Institute for Child Health and Human Development, and as a Medical Consultant in the Integrated Product Development Division of PAREXEL Consulting.

According to Dr. Carl Peck, "Dr. McKibben's first-hand knowledge and experience in pediatric therapies, pediatric trials, preventative medicine, and clinical regulatory strategy, both at the FDA and in the Industry, make her an excellent addition to our team of Expert Consultants. We are very pleased to welcome her to NDA Partners."

Dr. McKibben earned her medical degree from the Medical College of Georgia, Doctor of Public Health degree in Health Policy from the University of Michigan, Master of Public Health degree from Harvard University, School of Public Health, and bachelor's degree in microbiology/pre-medicine from the University of Georgia. She is a fellow of the American Academy of Pediatrics and board certified in preventative medicine.

About NDA Partners NDA Partners is a life sciences management consulting and contract development organization (CDO) focused on providing product development and regulatory services to the pharmaceutical, biotechnology, and medical device industries worldwide. The highly experienced Principals and Expert Consultants in NDA Partners include three former FDA Center Directors; the former Chief Executive Officer and Chief Science Officer at the United States Pharmacopeial Convention (USP); an international team of more than 100 former pharmaceutical industry and regulatory agency senior executives; and an extensive roster of highly proficient experts in specialized areas including nonclinical development, toxicology, pharmacokinetics, CMC, medical device design control and quality systems, clinical development, regulatory submissions, and development program management. Services include product development and regulatory strategy, expert consulting, high-impact project teams, and contract management of client product development programs.

Contact Earle Martin, Chief Executive Officer Office: 540-738-2550 MartinEarle@ndapartners.com

SOURCE NDA Partners LLC

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Dr. Linda McKibben, Former FDA Pediatric Medical Officer, Division of Vaccines and Related Products, Joins NDA Partners - Yahoo Finance

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Prairie Doc Perspectives – Your guide for prevention and wellness – The Capital Journal

February 10th, 2020 8:41 am

Primary care doctors do a lot of different things. We diagnose illnesses from the trivial, to the catastrophic. We treat maladies both chronic and acute. We confront, and we console.

Of course, these are common roles in medicine, filled by many different providers. One role the primary care physician is more uniquely suited to fill, however, and one of my personal favorites, is that of guide. Im talking specifically about the art of prevention, of maintaining wellness over the long term, and reducing the risk of diseases that might make it harder to do what you need to do, what you want to do, what you love to do.

Prevention is truly underutilized. We are a lot better at looking for a problem, and a pill or a procedure to fix it, than we are at fixing what might lead to a problem in the first place. In fairness, human beings are inclined to wait for the crisis to hit before we believe it is really and truly ahead. Changing habits is hard and eating takeout pizza while watching must-see TV is a lot less work than hitting the gym and making a salad.

On the other hand, some parts of prevention are easy. Its easy to get a flu shot, or a shingles shot. Its easy to get a mammogram, or a colonoscopy. Its easy to get blood drawn, and get checked for diabetes or hepatitis C.

Of course, its only easy to do these things if you are aware of the benefits of doing so. This is the value of the annual checkup. From birth, to your last birthday, wellness visits have an important role.

For infants and children, we monitor growth and development. For adults, we screen for diseases, and give advice on reducing risk factors that might lead to disease. Even the oldest of our old can benefit from simple tests for things such as hearing and memory. At every age, we think about safety: is that infant sleeping on her back? Is that teen wearing his seatbelt? Is that adult drinking and driving? Is that elderly person at risk for falls? Has that patient received their flu shot?

Under the Affordable Care Act, most insurance programs cover prevention visits with no copay. This even includes Medicare. Everyone can benefit from these opportunities to focus on staying well, rather than treating problems.

Prevention is an important part of being a primary care doctor, and an important reason to HAVE a primary care doctor. So, take your preventative action today, make a call and set up an appointment, just for that checkup.

Deb Johnston, M.D. is a contributing Prairie Doc author who has practiced family medicine for more than 20 years.

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The Crazy Coronavirus ‘Cures’ on the Chinese Web Include Trump’s Secret ‘Super-Drug’ – The Daily Beast

February 10th, 2020 8:41 am

NANJING, ChinaChinas rulers are now calling the coronavirus epidemic a major test of Chinas system and capacity for governance and Communist Party leader Xi Jinping is warning against any lack of boldness fighting it. But infections are rampant, the death toll is still mounting, and the country is increasingly isolated by a world community afraid this could become a pandemic. With no vaccine, hospitals overcrowded, and a dearth of solid information about how to treat the flu-like disease, what are Chinas 1.4 billion people (or the rest of us) supposed to do?

The answers have come on the internet: stay away from your pet dog, gargle salt water, fumigate with vinegar, take a potion made from flowers, and smoke a lot.

Yes, fake news has gone viral in the fight against the virus, which youd expect. But the picture is complicated by the Chinese medias advocacy of traditional Chinese medicine, and some half-baked reporting that credits U.S. President Donald Trump with possession of a "super drug" hell be willing to share real soon.

Chinese citizens hungry for any kind of protection against the disease have been posting and re-posting dubious reports about miracle cures and alternative medicine on the main Chinese social networks: the microblog Weibo and the chat app Weixin.

In a country where many hundreds of millions of people are currently holed up inside, on break from work, and thirsty for any new information about the deadly virus, such bad reporting and fake news that goes viral can provoke some frenzied side effects.

After Peoples Daily published an article claiming that scientists researching the novel coronavirus found shuanghuanglian oil, a traditional Chinese medicine concocted from three flowers, was effective treating it, believers in the efficacy of traditional medicine, or TCM, flocked to drug stores and bought up all of it they could find.

Sales and hype were such that the stock price of one producer, Fushen Pharmaceutical Co., soared by 120 percent on the Hong Kong stock exchanges as markets opened February 3. For a brief few minutes, founder and chairman and majority stakeholder Cao Changcheng was a billionaire, richer on paper than Huawei CEO Ren Zhengfei, until the speculative rush died down and the price fell back to its opening level. Even so, at 8 Hong Kong dollars a share it's worth twice what it was two weeks ago.

Combining multiple bullshit ideas, one Chinese blogger wrote, Its a disease carried by canines and spread to nearby dogs, dog-to-dog, then dog-to-human.

And while shuanghuanglian, which includes Japanese honeysuckle, Chinese skullcap, and forsythia suspensa and comes in tablet form as well as oil, might not be as dangerous to its users as drinking bleach (a cure recommended by QAnon conspiracy theorists in the United States) or consuming the dung and urine of cows, recommended by a swami in India, the injectable form can cause anaphylactic shock if administered to pregnant women or young children.

Although many Chinese publications claim that shuanghuanglian has been shown to be effective against influenza, respiratory illnesses, and a variety of ailments, they did have to report that there is no evidence to suggest it does anything against coronavirus.

Young Chinese laugh at the drama over shuanghuanglian. The Chinese characters used look and sound similar to the characters for double egg yolk lotus seed paste moon cake (shuanghuang lianrong yuebing), prompting the joke that after shuanghuanglian is sold out, people should buy moon cake. Consumption of all manner of TCM products is largely concentrated among their elders. When it is used, it is mostly as a preventative measure in addition to, not instead of, modern medicine. But various herbal products are hardly the only less-than-scientific solutions being offered.

Many viral messages advise people to swish diluted salt water around in their mouth before and after leaving the house as a means to kill the virus. This advice sometimes is attributed falsely to Dr. Zhong Nanshan, who discovered SARS in 2003. While salt water mouthwashes are sometimes used as a home remedy for sore throats or colds, they would do nothing against coronavirus, as multiple Chinese websites have noted.

Other false rumors about the virus claim it is spread by dogs, or that hanging clothes outside can disinfect them.

Combining multiple bullshit ideas, one Chinese blogger wrote, Its a disease carried by canines and spread to nearby dogs, dog-to-dog, then dog-to-human. Dogs do not get sick, but humans get sick. After humans get sick, they spread it to dogs, and the cycle continues. So, people must stay away from dogs. Families who raise dogs must keep their dogs inside the house, and you cannot play with your dog. Before going out, spray alcohol on your head and clothes. When you return home, wipe your hands, cell phone, and belongings with alcohol. Hang your coat on the open-air balcony to air it out, and gargle diluted salt water.

Young Chinese laugh at the drama over shuanghuanglian.

Some of the methods of prevention have to be jokes. One post claimed that smoking prevents all varieties of coronavirus because the oil from smoke coats ones lungs at a nanometer level, preventing coronavirus from striking the lungs cells, almost like your lungs are wearing a nanometer mask at the cellular level.

One piece of outright fake news was debunked by official national-level tabloid Global Times Monday afternoon. The false news, shared by a large number of Weibo users on February 2, asserted that there was an American super drug that could cure diseases caused by coronavirus and that President Donald Trump was going to fast-track its proliferation to China.

But the story is a little more complicated than smoking and puppy hoaxes.

Real highly effective drug has come out. It has gone through Americas process for effective medicines. Trump called on Americas Centers for Disease Prevention and Control to publicly release the formulation. I hope our researchers dont continue to be obsessed with huoxiang zhengqi/hyssop oral oil for vital energy [another Chinese medicine] and shuanghuanglian, and instead quickly try this medicine, one variation said.

The storyline shares much in common with pro-Trump posts swimming around right-wing corners of the American blogosphere. Theres a simple answer being hidden from the public, and perhaps an exaggeration of somevacuousstatement Trumputteredwithout thinking, aboutwhich conspiracy theorists will fill in the blanks.

What Trump did say in an interview with CNBC on January 22 was that, We have it totally under control. Its one person coming in from China, and we have it under control. Its going to be fine. We do have a plan, and we think its going to be handled very well.

Trump never said anything about America having any kind of secret or fast-track drug. The drug in question, remdesivir, has not been proven effective yet. It was previously tested as a treatment for Ebola in the Congo and performed worse than competitors, but its manufacturers say it has been useful against SARS and MERS, which also are coronaviruses.

The origin of the Chinese fake news apparently can be traced back to a post on January 29 by the Chinese website Science Net. That piece summarized Jon Cohens article in Science, published on January 27, about potential existing drug combinations that might work against coronavirus, before adding its own exaggerations and rhetorical flourishesthe super drug moniker.

In reality, Cohens article notes the apparent effectiveness of remdesivir in a study of mice, and cites a microbiologist agreeing that it is the most promising drug, while emphasizing that it is unproven and not available in China.

Gilead, the California-based maker of remdesivir, has issued a statement that the company is in active discussions with researchers and clinicians in the United States and China regarding the ongoing Wuhan coronavirus outbreak and the potential use of remdesivir as an investigational treatment. Whether or not remdesivir ultimately is made available, and whether it proves effective, does not hinge on Trump or the CDC, but on the New York Stock Exchange on Monday, Gilead shares shot up 5 percent.

Cohen, who has three decades of experience as a writer for Science and whose writing on coronavirus has been increasingly cited on Weibo, said by email, I hear from people all over the world, every day, including people from China. Many have questions I cannot answer. Some are pushing their own theories. Some want me to play doctor and want medical advice, which I cannot give. Some are just worried and want accurate information.

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Roby: Preventative actions to take during flu season – Yellowhammer News

February 10th, 2020 8:41 am

The University of Alabama at Birmingham (UAB) is already considered a national leader in precision medicine. Now, the university has proposed a project that could transform the Birmingham metropolitan area and the entire state for generations to come. The only catch? A final portion of funding from the State of Alabama is needed to make the project a reality.

First, some background.

Precision medicine focuses on individual patients to understand how their lifestyles, behavior, environment and genetics interact to affect their health. More importantly, precision medicine allows a systematic approach to integrate these key factors into the prevention, diagnosis and treatment of disease all tailored to each and every individual patient.

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Essentially, what UAB does in its world-class precision medicine practice in partnership with top-notch Alabama entities like HudsonAlpha and Southern Research is: (1) sequence a patients whole genome or a specific tumors genome; (2) then evaluate that sequence for a mutation(s); (3) use a massive and continually growing database to determine what effect any given mutation has on a patient; (4) cross-reference that mutation with all known compounds or drugs to (5) determine a treatment plan for the patients condition.

This process cures rare diseases on a regular basis. The story of UABs own Matt Might, considered a preeminent international leader in the field, epitomizes what precision medicine is all about.

Between May 2016 and April 2019, UABs precision medicine practice successfullydeveloped research plans for 90 patients who were each previously believed to have an undiscoverable rare disease. Additional patients were also referred directly to an appropriate program or specialist through UABs precision medicine process.

Moreover, UAB (through the Alabama Genomic Health Initiative) has repurposed approximately 10 existing medications for treating new disorders through the precision medicine practice. Examples are as simple as over-the-counter medications like Prevacid that UAB has discovered can be repurposed to treat a rare disease.

Simply put, the results have been staggering just in the first few years of UABs precision medicine focus.

However, this could be merely the beginning a prelude to historic things to come.

To really establish itself as the unequivocal global leader in genomic medicine and data sciences, UAB is committed to renovating and outfitting a state-of-the-art genomics facility.

The university has already secured a generous $10 million donation from Lee Styslinger III and the Altec-Styslinger Foundation. As such, UAB plans to name the building the Altec-Styslinger Genomic Medicine and Data Research Building.

UAB has further secured $8 million in federal funding.

Yet, to get the facility done, another $50 million is needed. UAB is asking the state for this amount through anAlabama Public School and College Authority bond issue. Governor Kay Ivey chairs the authority.

The university also plans to pursue local government funding from both the City of Birmingham and Jefferson County.

The University of Alabama System, in which UAB is one of three campuses, argues that the payoff on the requested $50 million in funding for the state would be unquestionably worth it in multiple ways.

First, the most tangible way is the estimated economic benefits of the project.

With this facility in place, UAB would recruit 50 researchers and an additional 300 support staff, meaning 350 high to very high paying jobs would be created. The university would spend $75-100 million recruiting this top talent over the next seven or eight years. UAB projects those researchers, when collaborating with the intuitions existing Hugh Kaul Precision Medicine Institute and Alabama Genomic Health Initiative, can generate $75-85 million in new funding.

Ultimately, leaders within the UA System believe that Birmingham would be set to become the Silicon Valley of Biomedicine with the facility operational.

Each rare disease discovered or treatment plan formed could, in itself, become a large spin-off healthcare startup company based in the Magic City. This has already happened once in the first few years of the precision medicine practice in the form of a leukemia drug screening service that identifies the best possible treatment for each individual leukemia patient.

At a meeting of the UA Systems board of trustees Friday at UAB, UA System Chancellor Finis St. John said that the UAB genomics facility could have a transformational impact on the Yellowhammer State similar to the likes of NASA and Redstone Arsenal, Mercedes-Benz and the Port of Mobile. He called the project a once in a lifetime opportunity.

St. John said this is an opportunity to improve the lives of our citizens in a way which may never occur again.

Watch his powerful remarks:

St. Johns urgency was echoed by each trustee on Friday. Board members made passionate pleas for the state to support this unprecedented effort.

It should also be noted that it is not just officials associated with UAB or the UA System leading the charge on this project.

Every member of the Jefferson County state legislative delegation (who essentially never unanimously agree on anything) has signed a letter of support for the project, calling for the facility to be funded.

Senators wrote in their respective joint letter in 2019, stating, The economic impact of this project cannot be overstated.

This letter was authored by Senate Rules Committee Chairman Jabo Waggoner (R-Vestavia) and signed by Senate Majority Leader Greg Reed (R-Jasper), State Sen. Rodger Smitherman (D-Birmingham), State Sen. Linda Coleman-Madison (D-Birmingham), State Sen. Shay Shelnutt (R-Trussville), State Sen. Dan Roberts (R-Mountain Brook) and State Sen. Priscilla Dunn (D-Bessemer). House members signed onto a separate letter echoing similar sentiments, and U.S. Senator Richard Shelby (R-AL) backs the project and helped secure the federal funding component.

Here is a snippet from the state senators letter:

Waggoner and Smitherman attended the board of trustees meeting on Friday to emphasize their staunch support for the project.

The State can provide this support (the requested funding), and the State should provide this support because nothing that the State could do [with the funding] would be more important to the future of this state, St. John said.This is not a project to benefit UAB. Its not a project to even benefit the University of Alabama System. It is a project for the future of the citizens of Alabama.

Because, while the economic impact of the project could be unparalleled, there is a bigger factor in play, the greatest of them all: peoples lives.

Ivey has said that every life is a sacred gift from God.

UABs genomics facility would undoubtedly save countless lives and improve the quality of others. That return on investment is quite simply priceless.

Sean Ross is the editor of Yellowhammer News. You can follow him on Twitter @sean_yhn

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Common medication may lower risk of broken heart during bereavement – News – The University of Sydney

February 10th, 2020 8:41 am

Professor Geoffrey Tofler

Bereavement following the death of a loved one is one of the most stressful experiences to which almost every human is exposed, said Professor Tofler, Professor of Preventative Cardiology at the University of SydneysFaculty of Medicine and Health, and Senior Staff Cardiologist at Royal North Shore Hospital.

Our study isthe first clinical trial to examine how the cardiac risk factors could be mitigated during early bereavement.

The research team from the University of Sydney, Royal North Shore Hospital and the Kolling Institute enrolled 85 spouses or parents in the study within two weeks of losing their family member.

Forty-two participants received low daily doses of a beta blocker and aspirin for six weeks, while 43 were given placebos. Heart rate and blood pressure were carefully monitored, and blood tests assessed blood clotting changes.

The main finding was that the active medication, used in a low dose once a day, successfully reduced spikes in blood pressure and heart rate, as well as demonstrating some positive change in blood clotting tendency, said Professor Tofler.

The investigators also carefully monitored the grief reaction of participants.

We were reassured that the medication had no adverse effect on the psychological responses, and indeed lessened symptoms of anxiety and depression, said Professor Tofler.

Encouragingly, and to our surprise, reduced levels of anxiety and blood pressure persisted even after stopping the six weeks of daily beta blocker and aspirin.

Co-investigator Associate ProfessorTom Buckleysaid the study builds on the teams novel work in this area with their earlier studies among the first to identify the physiological correlates of bereavement.

While beta blockers and aspirin have been commonly used long term to reduce cardiovascular risk, they have not previously been used in this way as a short-term preventative therapy during bereavement, said Associate Professor Buckley of the University of Sydney Susan Wakil School of Nursing and Midwifery.

The authors acknowledge that larger long-term studies are needed to identify who would benefit most however the findings provide encouragement for health care professionals to consider this preventative strategy among individuals that they consider to be at high risk associated with early bereavement.

Our finding on the potentially protective benefit of this treatment is also a good reminder for clinicians to consider the well-being of the bereaved, said Associate Professor Buckley.

Future studies are needed to assess if these medications could be used for other short periods of severe emotional stress such as after natural disasters or mass bereavement where currently there are no guidelines to inform clinicians.

Co-investigator Dr.Holly Prigerson, Co-Director of the Center for Research on End-of-Life Care at Weill Cornell Medicine in New York, said, This is an important study because it shows ways to improve the physical and mental health of at-risk bereaved people. It is a preventive intervention that is potentially practice-changing, using inexpensive, commonly available medicines.

People experiencing cardiac symptoms should discuss their condition with a health care professional before taking medication as incorrect use could be harmful.

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Lunch and Spa thermal pools circuit for just 20 euros at the Archena Balneario – Murcia Today

February 10th, 2020 8:41 am

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The thermal baths complex of the Balneario of Archena has been in use since the time of the Roman occupation of this part of the Iberian Peninsula in the third century BC and offers a full range of thermal spa leisure options including thermal baths, thermal spa circuit, health and beauty treatments as well as a hotel and restaurant complex which is open throughout the year.

At the heart of the Balneario is the water which emanates from a natural spring at a temperature of 52.5 degrees Celsius and with a high mineral content which makes it particularly beneficial for treating sore joints and also facilitates the natural repair processes of the skin.

The Spa Centre itself offers extensive facilities, with an innovative indoor-outdoor thermal circuit experience complemented by a wide range of medical, beauty and relaxation treatments, attracting both visitors on courses of therapy (principally related to respiratory conditions, articulatory problems and stress) and those looking for a period of relaxation and pampering.

In addition, the thermal bath complex in Archena, it has to be said, is one of the most attractive places in the Region of Murcia, set as it is in the lush greenery which thrives on the banks of the River Segura at the southern end of the Ricote Valley.

Treatment, massage, saunas and recreational areasThere are three main areas at the Balneario de Archena offering therapeutic, beauty and relaxation treatments and recreational activities.

1. The Balnea thermal spa circuit (circuito Termal Balnea). This is a comprehensive and extensive spa circuit in which bathers pass through a wide range of different elements both inside and outside of the spa complex.

The Balnea Thermal Spa Circuit includes various saunas at different temperatures and levels of humidity, one of which is heated purely by the water of the spring while others use a variety of techniques. In addition there is a cross-current pool of minero-medicinal water with a temperature of 30 to 31C, a lemon pool (with fresh lemons floating in water at a temperature of 34 degrees), a flotation pool providing conditions similar to the Dead Sea, a cold water pool at 20 degrees, an igloo at approximately 2C, contrast showers, corridors containing alternating jets of warm and cool water, warm hammocks and infrareds.

The facilities also include onsite eateries in the Termalium area at the La Piscina snack bar and the Restaurante del Agua.

In addition, a wide range of beauty and health treatments (including facials, massages etc) are offered in the Centro de Esttica The beauty treatments include facial cleansing, oxygen Termalium (cleansing and hydration), Termalium Caviar (exfoliation and relaxation massage), cell refreshment anti-aging therapy, cleansing and collagen veil, hydration, face and scalp massages, beauty body massages, chocolate massage, chakra stone massage, psychosomatic Ayurveda, cellulite draining massage, peeling massage, lymphatic body drainage, foot reflexology, slimming and firming treatment and a vitamin C citrus bath.

The beauty centre is open:

Monday to Saturday from 10:00 to 14:00 and 16:00 to 20:00Sunday from 10:00 to 14:00 and 15:00 to 19:00. (see feed below for full information)

PricingA complete 2-hour circuit of the facilities in the Balnea spa area of the Balneario de Archena is priced at 25 euros during the week and 35 euros at weekends for those who are not staying at the hotels in the complex: guests at the Hotel Termas, Hotel Levante and Hotel Len receive a 5-euro discount.Open: 7 days a week from 11:00 to 21:00Age limit: 14. Minors aged 14-18 must be accompanied by an adult.

2. SPA Thermal swimming poolsThe swimming pools of the Balneario de Archena are filled using the waters of the thermal spa and provide year-round fun and relaxation for adults and children both indoors and outdoors.

For youngsters there is an additional special pool with slides, and also an area which generates a current around a small circuit, which is particular popular! For the grown-ups, meanwhile, there are two main pools, one indoors in the lush green setting of the Balneario and the other under cover, and a series of Jacuzzis and jet showers.

Full-day tickets here are priced at between 10 euros and 22 euros for adults depending on the time of year, with discounts for children (7 euros to 12 euros) and for evening-only sessions. Whole-day visits are recommended, allowing a chance to eat at the bar or the Restuarante del Agua.

Under-18s must be accompanied by an adult.

The swimming pools are open between November and March from 10.00 to 21.00, from March to June and from 1st September to 31st October between 10.00 and 22.00, and in July and August from 10.00 until midnight.

Full pricing is as follows:November until March open from 10:00 to 21:00Weekdays: adults 10, evening-only admission 7 (from 18:00), children 7.Weekends and public holidays: adults 17, evening-only admission 13 (from 18:00), children 11.March until October, plus 2nd to 10th December and the Christmas period: March to June and from 1st September to 31st October between 10.00 and 22.00, and in July and August from 10.00 until midnight.

Weekdays: adults 14, evening-only admission 8 (from 19:00), children 8.Weekends and public holidays: adults 22, evening-only admission 15 (from 19:00), children 12.

NB: During July and August the night-time reduced price period begins at 21:00 with the facilities closing at midnight

3. The thermal baths on the underground floors of the Hotel TermasIn this area of the Balneario a wide range of thermal treatments is available.

Most of the properties of thermal therapy lend themselves to both therapeutic and preventative medicine, particularly in the fields of respiratory and articulatory problems (painful joints) as well as countering stress, and the results achieved at the thermal baths in Archena are extremely positive, providing an improvement in quality of life for patients by reducing pain, improving mobility and lessening the dependence on pharmaceuticals.

The facilities on the second basement level of the Hotel Termas have been awarded the seal of quality by the Spanish tourist authorities, and a fully qualified medical team is present to oversee treatments and to prescribe them.

See feed below for full range of treatments available, ranging from 14 and 45 euros. See feed below for full details of how to book, price lists and treatment descriptions.

Therapeutic treatments

Treatments are prescribed by the onsite medical team, which includes three specialists in hydrology who perform an exhaustive initial check on all customers staying in the hotels and monitor their progress minutely. The treatments available in the spa underneath the Hotel Termas include the following:

Archena massage: the flagship treatment at the Balneario consists of a massage using thermal mud which is then showered off with water from the thermal spring. This is particularly effective at reducing muscle spasms and tension.

Thermal mud: a clay poultice containing thermal water is applied to the joints at a temperature of 45C. Beneficial for rheumatic diseases, painful musculo-skeletal conditions and the effects of trauma.

Termarchena: a small thermal circuit consisting of a steam room, a thermal water pool at 37C, a corridor with contrast showers (hot and cold) and two cabins providing 5-7 minutes of manual friction with mud and ice on the back.

For respiratory conditions there are also facilities for steam from the thermal spa to be breathed in directly, and a host of other therapeutic and physiotherapeutic options are provided.

All of the above are located in the Roman baths under the Hotel Termas, but the Balneario complex also includes numerous other treatments, all using the spring water, in the Balnea thermal circuit.

Hotel accommodation

Hotel Thermas (4-star)

Hotel Levante (4-star)

Hotel Len (3-star)

(Click for more information about the hotels or see feed below)

Practical details

What to take with you

Visitors to the Balneario de Archena are reminded to take with them a dressing-gown (white is preferred), at least one bathing costume, flip flops or similar, a bathing cap and a towel. For hotel guests the dressing-gown is included, and they can also be hired at the Balneario at a small extra cost.

Food, refreshments, souvenirs

Apart from the hotel dining-room restaurants in the Termas ( la carte) and the Len (buffet) there are also various other opportunities to grab a bite to eat or drink, including the chiringuito at the swimming pools, the cafeteria in the Casino (with its beautiful shady terrace), and a snack-bar. Another option is the Restaurante Del Agua, next to the swimming pools, and in summer the Bar Azul on the river bank offers live entertainment every Friday evening.

There is an onsite souvenir shop which also sells the most indispensable items for visitors: bathing caps, flip-flops, dressing gowns and swimwear!

How to get to the Balneario de Archena

Heading north from the city of Murcia on the A-30 motorway towards Madrid, take the exit at kilometre 121, where Archena is clearly signposted on the MU-554 road. Once approaching the town follow the signs for Balneario de Archena: these take visitors on a rather roundabout route, encircling the whole town before entering from the other side, so to speak, but trust the signs they do work!

The only sign which might be easy to miss is just about the last one, when the route appears to be taking visitors back out of town towards Villanueva del Ro Segura and Ulea. This is a right turn just after a Repsol petrol station: be on the lookout!

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Kim Kardashian West Is Raising Her Kids on a Plant-Based Diet – LIVEKINDLY

February 10th, 2020 8:41 am

Kim Kardashian West isnt eating meat anymore. And neither are her kids. For the most part, anyway.

According to a recent Twitter post, the Keeping Up With the Kardashians stay says her kids, Psalm, 8 months, Chicago, 2, Saint, 4, are all joining her in the plant-based diet with the exception of North, 6, who still eats fish.

Kardashian West announced last year that she was eating plant-based in a bid to help reduce her lifelong battle with psoriasis and psoriatic arthritis.

Before the arthritis hit, I spent about four months doing everything naturalevery ointment, cream, serum, and foam you can possibly imagine and everything from the dermatologist, she wrote in a blog post on her sister Kourtneys Poosh website. I even tried an herbal tea that tasted like tar. I tried celery juice for eight weeks. Then Id do celery juice mixed with the tea. I would do that twice a day. I was just exhausted by everything. I changed my diet to plant-based (which I still follow).

She said that she works to reduce stress and take time for herself so that she is centered. And diet still plays a role: I live a healthy life and try to eat as plant-based as possible and drink sea moss smoothies, she wrote.

The reality star also recently shared the contents of her refrigerator. The photos revealed a number of Beyond Meat products and lots of produce.

Kardashian West isnt the only parent raising kids on a plant-based diet. A growing number of schools are offering students meatless meals, too.

In New York, the citys public schools are all offering Meatless Monday menus. The Los Angeles school district has also been expanding its vegan lunch offerings.

Filmmaker James Camerons wife Suzy Amis Cameron runs the MUSE School in Los Angeles County. It only serves students vegan meals and was the inspiration behind Amis Camerons One Meal a Day program and book. According to Amis Cameron, going vegan just one meal a day for a year saves up to 200,000 gallons of water and reduces as much gas equal to a road trip from LA to New York.

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Kim Kardashian West Is Raising Her Kids on a Plant-Based Diet

Description

Kim Kardashian West and Kanye West are following the trend of raising kids on a plant-based diet for their health and the climate.

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Jill Ettinger

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LIVEKINDLY

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At the heart of our own history: Cardiology sees changes in North Platte and beyond – North Platte Telegraph

February 10th, 2020 8:41 am

Before 2011, if you had chest pain and went to what was then Great Plains Regional Medical Center, theyd run non-invasive tests, like an echocardiogram.

If you showed signs of a heart attack, youd probably be given a medication that dissolves blood clots and then flown to a larger hospital. That medication, called a thrombolytic, can restore blood flow to the heart in most people. But time is muscle, and if flow isnt completely restored, there can still be muscle loss.

Maybe you wouldnt even go to Great Plains for medical help, as was noted in a Sept. 1987 Telegraph article: Although the hospital has equipment and qualified doctors to provide heart tests, heart patients often leave North Platte.

There are a fair number who leave town because we dont have a cardiologist, (hospital president Cindy) Bradley said.

The hospital had a cardiac rehabilitation lab for people after they have a heart attack, but little to do to prevent or treat one.

In a county with one of the highest death rates due to cardiovascular disease in the state, the hospitals board decided in 2004 that something needed to be done to establish cardiovascular care in Lincoln County.

It began with a diagnostic catheterization lab: A place where tests can be done to determine if intervention is needed.

Patients who didnt have an active heart attack would be given a general cardiology work-up, which generally included an electrocardiogram measuring the electrical activity of the heartbeat and maybe a diagnostic catheterization passing a thin, flexible tube through the vessels in the heart to see how well the organ is functioning. Patients with a heart attack would be transferred to another hospital with treatment options.

Ivan Mitchell

As you can see, we had a lot of good diagnostic tools, but no intervention tools, said Ivan Mitchell, chief operating officer of Great Plains Health. With time being muscle for your heart, it took a lot longer to do treatment.

Cardiologys roots run deep

Humans have realized the importance of the pulse and the heart since ancient times: An unknown Egyptian physician describes the heart as the center of a system of vessels and seems to identify arterial fibrillation, a condition where the heart fails to beat with enough force to pump blood and that can cause cardiac arrest, according to a 1995 paper by Dr. James Willerson and Rebecca Teaff.

In the fourth century B.C., the philosopher Aristotle thought that the heart was the seat of intelligence, whereas the brain merely existed to cool blood.

In the second century A.D., the prominent physician Galen cited the liver as the source of veins, and said the heart was simply an organ blood passed through.

It wasnt until 1628 that the heart came back into the spotlight as the organ responsible for circulation. At that time, English physician William Harvey published his key work, in which he proposed that the heart pumps blood around the body with a single system of arteries and veins. The book included experiments and evidence backing that up, though others in the field were slow to accept his idea.

It took until the 20th century for physicians to link chest pain and hardening of the arteries with heart attacks, according to Dr. Rachael Hajar in her 2017 article on the history of coronary artery disease.

Getting blood pumping in the Great Plains

In 2011, the GPH board decided to move toward an interventional program they wanted to treat people right then and there if they came into the hospital with a heart attack.

They hired on a doctor, and added an interventional cath lab and clinic space. They added another doctor.

And then something happened.

What was really interesting was that we started to see the mortality rate decrease when that happened, Mitchell said, because if someone has an active heart attack, (the cardiology team) could do an intervention essentially right away.

The program couldnt seem to stop growing a second cath lab had to be added in 2018, and more doctors were hired.

Since 2016, weve had about 300% growth, Mitchell said. Weve really become a regional presence and referral center for our cardiology program.

The lab is a really, extremely busy cath lab, with 11 procedures alone taking place on the day Mitchell was interviewed.

The interventions include implantable medical devices, like the implantable cardiovascular defibrillator a battery-powered device that keeps track of heart rate and pacemakers, which help the heart beat in a regular rhythm. Even after the patient leaves the hospital with an implantable device, theyll still receive support from what Mitchell calls the Device Clinic.

If you have a pacemaker in and your heart throws a rhythm thats concerning, it will actually alert our Device Clinic, which will then alert the physicians, he said. Having that (clinic) here has been a great thing.

With all of the procedures available at GPH, some may be surprised to learn that the hospital doesnt have a cardiothoracic surgeon on site.

The data out there suggest that the programs without cardiothoracic surgery in hospitals have just as good of outcomes as programs that do have cardiothoracic surgery, Mitchell said. So what weve done is if someone comes in and their blockage is so severe that they need open heart surgery, we actually have a couple of tools that are used (until they can be transferred).

One of those options is a balloon pump, which is a balloon attached to a catheter. The doctor inserts it into the artery inside your upper leg and guides it to the aorta, or main artery, where the balloon inflates when the heart relaxes and deflates when it contracts. This allows the heart to pump more blood to the body using less energy, according to Johns Hopkins Medicine.

The other option is a device called an Impella, a mini heart pump that goes in like the balloon pump and works by drawing blood out of the heart and pumping it into the aorta, according to the Federal Drug Administrations page on recently approved medical devices.

(Acute interventions) really save lives, without any question, said Dr. Azariah Kirubakaran, an interventional cardiologist at GPH.

Until 1961, heart attack patients who made it to a hospital were simply placed in beds located throughout the hospital, far away from nurses stations, often with lethal results the risk of dying in a hospital from myocardial infarction was around 30%, according to Nabel and Braunwald.

Following that, cardiac care units where heart attack patients were closely monitored were implemented in general hospitals.

Balloon angioplasty and insertion of bare-metal stents were implemented soon after.

The first artery-to-artery anastomosis, known today as a cardiac bypass graft surgery, was performed in 1968 by Dr. George Green of Saint Lukes Hospital in New York. This surgery has become the absolute gold standard for bypasses, said Ludovic Melly and Gianluca Torregrossa in a 2018 article on the history of artery bypass grafting.

Cardiologists began to open blocked coronary arteries using streptokinase, a thrombolytic, in 1976.

In 1988, it was found that aspirin further reduced deaths in patients who had suffered heart attacks when used in conjunction with a thrombolytic.

These leaps and bounds in treatment are so recent that Kirubakaran can recall what he calls the dark ages during the early days of his own career.

I have personally seen people just die like flies, basically, back in the 80s, when they had heart attacks, Kirubakaran said. Compared to that, its a night and day difference. Even though I cant say that nobody dies of a heart attack thats not true the risk has been tremendously reduced with all the technologies we have, and its getting better every year.

For as many patients who have sought treatment, GPH is also trying to make sure some patients dont get to that point.

Dr. Azariah Kirabakaran

(Prevention) is a lot more attractive than trying to fix something once its happened for a variety of reasons: One, it doesnt put patients at risk at the time of the expression of the disease, Kirubakaran said. Secondly, its a lot less expensive to do so. And now there are ways of prevention that can be applied to large populations and it can be helpful to do so.

The Heart Institute at GPH has started offering a discounted cardiac screening to help patients determine their risks.

There are a lot of people who theyve caught those heart issues early on because of (the screenings), Mitchell said.

One of the components of that screening is calcium scoring, which measures the build-up of calcium in arteries. The greater the amount of calcified plaque, the higher the risk of heart disease.

But one of the most mundane things is also one of the best ways to catch heart problems early.

The most basic thing is to get your physical: Check your bloodwork, check your blood pressure, all that good stuff, Mitchell said. Ensuring that youre established with your primary care provider is also important because they can track your health over time and identify any worrying trends.

In spite of all of the treatment, diagnostic and preventative measures, Kirubakaran and Mitchell still feel that the program has more room to grow.

Kirubakaran hopes the program will be able to move toward doing more than just treating blockages with catheters.

We can replace some other valves at least with catheter-based techniques, which are a lot less invasive. It can be tolerated even by people who are very, very frail. Even seven or eight years ago, that was something unimaginable, but now its almost routine, Kirubakaran said.

Another thing that Kirubakaran hopes to see is cardiac MRI, which would allow them to see the heart in greater detail.

Studies show that the MRI is probably a lot more acurate of a stress test than any other test we can run. he said.

Mitchell also spoke on the possibility of eventually bringing an electrophysiologist to GPH, someone who would deal with electrical impulses in the heart and would be able to burn or scar heart tissue causing irregular heartbeats, a procedure known as an ablation. Much like in a house, one person cant necessarily fix everything.

Your interventional cardiologist is like a plumber theyre making sure the pipes are working and that the blood is pumping through your system, Mitchell said. An electrophysiologist is considered the electrician, and theyre making sure the rhythm is proper.

Technological advances are changing the ways cardiovascular disease is approached.

Kirubakaran described a medication being developed that would lower bad cholesterol by 40% to 45% with a single shot once a year.

A lot of people are already looking at it in terms of preventing large populations of people (from further developing heart disease), Kirubakaran said. It turns out that the longer your blood vessels are exposed to bad cholesterol, the higher the liklihood of developing a blockage. Being able to reduce the amount of bad cholesterol would therefore reduce the risk.

The Human Genome Project, where researchers sequenced and mapped all of the genes in Homo sapiens, was completed in 2003 and gave more insight into genetic components of diseases. Kirubakaran discussed the implications this research has in treatment of cardiovascular disorders.

Now there are a lot of things we know about atrial fibrillation, congestive heart failure, coronary artery disease, cardiomyopathy these all have some genetic background to them. How much genetics has a role to play and how much environment has a role to play, those are variable depending on an individual patient, Kirubakaran said. But now we are having more and more success figuring out how much genetics is playing a role, which can lead to better therapies that target the genes causing the diseases.

Kirubakaran is looking to a future without heart attacks.

Once theres a heart attack, its a messy thing. Theres no easy, clear-cut solution, Kirubakaran said. So if my patients never get to that point, Ill be really happy.

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Top 5 Recent Advances In Israeli Cancer Research And Treatment | Health News – NoCamels – Israeli Innovation News

February 10th, 2020 8:41 am

To mark World Cancer Day, an international day to raise awareness of the disease, NoCamels is highlighting some recent medical developments in Israeli cancer research, treatment, and care all from 2019-2020.

Why does cancer therapy help some patients and not others? That is a question Israeli Professor Yuval Shaked of the Technion Israel Institute of Technology in Haifa has been trying to answer with his latest medical research. Shaked recently published a study in Nature Reviews Cancer, a monthly review journal covering the field of oncology, that delved into how understanding and predicting individual host responses to cancer therapy can significantly improve care.

The initial cancer treatment phase can be often successful, but many patients are affected by the development of resistance, characterized by tumor relapse and/or spread, the Technion said in a statement.

The majority of studies devoted to investigating the basis of resistance have focused on tumor-related changes that contribute to therapy resistance and tumor aggressiveness, Shaked wrote. But over the past decade, the diverse roles of various host cells in promoting therapy resistance have become better understood. The current understanding is that cancer therapy can induce local and systemic responses in the patients body, and these actually support the resurgence of cancer and its progression.

Current modern immunotherapy has revolutionized cancer care, Shaked said in a Technion statement. However, despite considerable advances in cancer treatment, most patients do not respond to therapy at all or from a particular stage. Without the ability to predict the effectiveness of treatment, many suffer from disease recurrence or spread, which sometimes erupts with even greater violence.

Over the years, many have investigated and are still investigating the effect of therapy on the tumor itself, but few have analyzed the effect of the therapy on the patient, he pointed out.

This shift in focus can produce better care and help advance personalized and precision medicine, he indicated.

We are not saying that existing treatments are not good, he emphasized in the statement. They just arent suitable for everyone. Each treatment triggers a host response, and when this response exceeds the therapy effect, we receive ineffective treatment. For the therapy to be effective at the specific host level, it is important to predict the same counter-response and try to block it. This is how we will gain much more effective therapy.

Shaked is the head of the Technion Integrated Cancer Center and the chief scientific advisor of OncoHost a company he founded that uses response profiling to improve personalized cancer therapy.

OncoHost recently opened a new state-of-the-art laboratory in Binyamina for this very research and has already begun clinical trials in Israel. The company is in talks to start trials in Europe and the US, Shaked said,

It was recently awarded a $1 million grant as part of the Binational Industrial Research and Development (BIRD) Foundation to advance its research.

For immunotherapy, one of the most important effective approaches today in the field of cancer, only some 20-30 percent of patients today respond. Through blood testing, we can predict the outcome of patients treated with immunotherapy and continue such treatment only in patients in whom treatment is expected to be effective, he said.

Based on the present study, in the future, we may offer combined therapies to increase the effectiveness of treatment or allow patients who are currently unresponsive to immunotherapy drugs to respond to them. This is a huge revolution that we must advance not only in research but also in the commercialization of research into actual therapies. Only then can we contribute to saving lives, he added.

Israels Alpha Tau Medical, an Israeli medical technology company that developed breakthrough radiation cancer therapy, announced late last year that initial results of a preclinical trial have proved very promising.

Alpha Tau Medical was founded in 2016 to focus on R&D and commercialization of its breakthrough cancer treatment, Alpha DaRT (Dffusng Alpha-emtters Radaton Therapy). The technology, initially developed in 2003 by Professors Itzhak Kelson and Yona Keisari at Tel Aviv University, delivers high-precision alpha radiation that is released when radioactive substances decay inside the tumor, killing cancer cells while sparing the surrounding healthy tissue.

The first clinical trial of the treatment was conducted in Israel and Italy starting in 2018. The trial was designed to establish the safety, feasibility, and efficacy of the companys Alpha DaRT technology for patients with squamous cell carcinoma of the skin and head and neck area.

The results, published in the International Journal of Radiation Oncology, Biology, and Physics, showed nearly 78.6 percent of 28 patients received a complete tumor response rate. That means the patients all responded to the alpha radiation treatment in some way.

Overall, these impressive outcomes serve as an excellent basis for future trials in other tumor types, said the principal investigator of the trial Prof. Aron Popovtzer, MD, from Rabin Medical Center in Israel. The Italian arm of the trial was led by Dr. Salvatore Roberto Bellia from the IRST (Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori).

Future clinical trials will also investigate Alpha DaRT in other oncology indications, as a monotherapy or in combination with various systemic therapies.

Late last year, Israeli scientists said a new study they conducted showed that a small molecule called PJ34 triggered the self-destruction of human pancreatic cancer cells in mice.

According to the research,publishedin the peer-reviewed open-access biomedical journal Oncotarget, the administration of the molecule reduced the number of cancer cells in developed tumors by up to 90 percent in 30 days.

The study was led by Professor Malka Cohen-Armon and her team at Tel Aviv Universitys Sackler Faculty of Medicine, in collaboration with Dr. Talia Golan and her team at the Cancer Research Center at Sheba Medical Center, and conducted with transplantations of human pancreatic cancer cells into immunocompromised mice, or xenografts.

Professor Cohen-Armon indicated that the mechanism, tested in parallel studies, acted efficiently in additional types of cancer, eradicating a variety of resistant cancer cells (breast, lung, brain, and ovarian cancer) including types resistant to current therapies.

PJ34 is being tested in pre-clinical trials according to FDA regulations before clinical trials on larger animals and then humans begin, Tel Aviv University said in a statement at the time.

Dr. Golan is a lead researcher at the Pancreas Cancer Olaparib Ongoing (POLO) Clinical Trial at the Sheba Medical Center.

This past summer, NoCamels reported on Dr. Golans work on a drug regimen that proved promising for some pancreatic cancer patients, specifically those with advanced stages of the disease as well as a BRCA 1 or 2 germline mutation.

BRCA1 & 2 are tumor suppressor genes, meaning that those with the deleterious mutation have a higher lifetime risk of developing cancer. The gene is predominantly linked to breast and ovarian cancer, but several studies name pancreatic cancer as the third most common cancer associated with these mutations.

Among patients with pancreatic cancer, onlyfour to seven percent have this gene variation, so Dr. Golans clinical trial team looked for participants from across the world.

Dr. Golan tested the effectiveness of a drug regimen that featured a PARP inhibitor called Lynparza, the trade name for the biological agent olaparib.The drug blocks the production of Poly ADP-ribose Polymerase (PARP), a protein that repairs DNA in tumor cells.

Her study, published in the New England Journal of Medicine, explained: PARP inhibitors cause an accumulation of DNA damage and tumor-cell death. The PARP inhibitor olaparib has been shown to have clinical efficacy in patients with a germline BRCA mutation and ovarian or breast cancer.

The results of the Phase III randomized, double-blind study with a placebo control group showed that, in essence, the drug treatment regimen stalls the progression of the disease. Of the 3,315 patients who underwent screening, 154 fit the study criteria to be assigned to trial intervention, thus 92 received the treatment and 62 received the placebo.

The median progression-free survival was significantly longer in the olaparib group than in the placebo group (7.4 months vs. 3.8 months), the study detailed.

Israeli and British scientists published a new study in October that showed that a simple blood test that relies on a DNA repair score proved effective for lung cancer screening.

The study was led by Professor Zvi Livneh and Dr. Tamar Paz-Elizur, both members of the Weizmann Institute Department of Biomolecular Sciences, alongside Professor Sir Bruce Ponder of the University of Cambridge and Professor Robert Rintoul from Royal Papworth Hospital and Cambridge.

Titled DNA-Repair Biomarker for Lung Cancer Risk and its Correlation with Airway Cells Gene Expression and published in the peer-reviewed journal the National Cancer Institute-Cancer Spectrum (JNCI-CS), the scientists study found that patients DNA repair scores a summation of the activity of three DNA repair enzymes (OGG1, MPG and APE1) through which cells are known to respond to genetic damage can significantly improve current lung cancer risk prediction, assisting prevention and early detection.

The study involved 150 British patients with non-small-cell lung cancer and a control group of 143 healthy volunteers. The scientists calculated each participants DNA repair score based on blood activity levels of three enzymes known to respond to DNA damage, the Weizmann Institutesaidin a statement.

They found that the DNA repair score of those with lung cancer was lower than the control group across the board, establishing this enzymatic activity as a robust biomarker for lung cancer risk independent of smoking.

The results, the Weizmann Institute said, validated a previous studypublished in 2014by Professor Livneh that examined DNA repair scores in an Israeli population, showing that the new approach could potentially be implemented to promote more effective lung cancer screening worldwide.

Reliance on age and smoking status as the two main risk factors isnt enough, as preventative screening in this selected population misses most lung tumors, the Israeli and British scientists wrote in their paper. Moreover, individuals who are not obvious candidates for screening remain unaware of the danger they may face leading to delayed treatment and poorer prognosis, they went on.

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Molecular Diagnostics Industry Report, 2020 to 2026 – Analysis by Product, Technology, Application, End-user and Region – PRNewswire

February 8th, 2020 9:51 pm

DUBLIN, Feb. 7, 2020 /PRNewswire/ -- The "Molecular Diagnostics Global Market - Forecast to 2026" report has been added to ResearchAndMarkets.com's offering.

The global molecular diagnostics global market is estimated to reach $18,668.9 million by 2026 growing at a high single-digit CAGR from 2019 to 2026.

Among the overall molecular diagnostic market is increasing prevalence of different types of cancers, infectious diseases, genetic disorders and other diseases, increasing awareness in personalized medicine and companion diagnostics and also growth in the point of care testing and sequencing-based tests and other molecular techniques.

Molecular diagnostics plays a pivotal role in the evaluation of the disease and for the effective response for specific therapy. However, the complex regulations for the approval of molecular diagnostic tests, availability of competing/alternative technologies, high cost of the tests, and also a shortage of technical experts are some of the restrains for the growth of the molecular diagnostics market.

Segment Highlights

The molecular diagnostics global market is segmented based on product, technology, application and end-users.

The product market is further categorized into instruments, consumables and software and services. As per research estimations, the consumable global market commanded the largest revenue in 2019 and is projected to grow at double-digit CAGR from 2019 to 2026.

The molecular diagnostics global market by technology is divided into PCR, microarray and microfluidics, isothermal nucleic acid amplification tests, in-situ hybridization, NGS and other technologies. PCR accounted for the largest revenue in 2019 and is expected to grow at a double-digit CAGR from 2019 to 2026 due to low cost and is a common and indispensable technique used for diagnosis when compared to other instruments such as NGS and also due to technological advancements in PCR and their subtypes such as digital droplet PCR with precise and highly sensible results.

The molecular diagnostics by application market is classified into infectious diseases, oncology, genetic testing, transplantation, blood screening and other diseases such as metabolic disorders and diseases associated with the central nervous system. The largest revenue was contributed by infectious diseases segment in 2019 and this market is expected to grow at a high single-digit CAGR from 2019 to 2026 due to high incidence of bacterial and viral infections.

Infectious diseases are further segmented into bacterial, viral and other diseases. The viral diseases commanded the largest revenue in 2019 and the market is expected to grow at a strong double-digit CAGR from 2019 to 2026. Viral diseases are further segmented into HIV, hepatitis, HPV, influenza and other viral infections. Among these, HIV accounted for the largest revenue in 2019 and is expected to grow at a double-digit CAGR from 2019 to 2026.

The bacterial diseases are sub-segmented into sexually transmitted diseases (STD) caused by bacteria, hospital acquired infections, tuberculosis and other diseases such as sepsis, pneumonia and meningitis, etc. Sexually transmitted disease accounted for the largest revenue in 2019 and is expected to grow at high single-digit CAGR from 2019 to 2026. The growth is attributed to the increased awareness about the molecular based kits available for the diagnoses of STDs and also increases in the prevalence.

Under genetic testing segment the market is segmented into NIPT, cystic fibrosis and other genetic testing, among them NIPT commanded the largest revenue in 2019 and is expected to grow at a double digit CAGR from 2019 to 2026 as NIPT provides a safer alternative to invasive tests and it analyzes fetal cell-free DNA (cfDNA) from the mother's circulation, making early detection of genetic disorders such as Down syndrome and other chromosomal aberrations easier.

Based on the type of cancer, the oncology market is segmented into lung, breast, colorectal, prostate, ovarian, melanoma, ovarian and other cancers. The largest revenue under oncology was accounted for by colorectal cancer with the revenue in 2019 and breast cancer is expected to grow at double-digit CAGR from 2019 to 2026.

Based on the cancer care, the oncology segment is subdivided into early screening, companion diagnostics, prognosis and recurrence. Early screening contributed for the largest revenue in 2019 and companion diagnostics is expected to grow at double-digit CAGR from 2019 to 2026. Further, the transplantation market is segmented into kidney, heart and other transplantation such as lung and pancreatic transplantation. Among them, kidney transplantation commanded the largest revenue in 2019.

Molecular diagnostics end-users market is segmented into hospitals, clinical/centralized laboratories, academics and research and other end users. Clinical/centralized laboratories accounted for the largest revenue due to the rapid adoption of technology and economies of scale in testing a large number of samples collected from affiliated hospitals.

Geographical wise, North America region commanded the largest revenue in 2019 and is expected to grow at a mid-single-digit CAGR from 2019 to 2026 owing to the high demand for early detection, treatment selection and prevention of diseases with advanced technology due to diseases associated with the lifestyle. However, the Asia-pacific region is expected to grow at an early teen CAGR from 2019 to 2026 attributing to increasing awareness of the molecular based test for the better outcome.

Competitive Landscape

The molecular diagnostics global market is a competitive market and all the existing players in this market are involved in developing new and advanced molecular based techniques for diagnosis to maintain their market shares and also acquiring companies for product expansion.

Some of the key players in molecular diagnostics global market are Abbott Laboratories (U.S.), F.Hoffmann-LA Roche AG (Switzerland), BioMerieux (France), Qiagen (Netherlands) Exact Sciences (U.S.), Grifols (Spain), Danaher Corporation (U.S.), Hologic, Inc. (U.S.), and Myriad Genetics, Inc. (U.S.)

Key Topics Covered

1 Executive Summary

2 Introduction

3 Market Analysis3.1 Introduction3.2 Market Segmentation3.3 Factors Influencing Market3.3.1 Drivers and Opportunity3.3.1.1 Increasing Incidence of Infectious Diseases3.3.1.2 Rising Incidence of Cancer and Non-Infectious Diseases3.3.1.3 Technological Advancements3.3.1.4 Favorable Reimbursements3.3.1.5 Investment by Major Players3.3.2 Restraints and Threats3.3.2.1 Lack of Skilled Professionals3.3.2.2 High Cost of Molecular Diagnostics Products3.3.2.3 Lack of Standardization of the Molecular Diagnostics Test3.3.2.4 Stringent and Time-Consuming Regulatory Issues3.3.2.5 Lack of Reproducibility and Repeatability3.3.2.6 Biochemical and Alternative Tests3.4 Market Share Analysis3.4.1 Molecular Diagnostics Global Market Share Analysis3.4.2 Molecular Diagnostics In Infectious Diseases Market Share3.5 Regulatory Affairs3.5.1 U.S.3.5.2 Europe3.5.3 China3.5.4 India3.5.5 Japan3.5.6 Australia3.5.7 South Korea3.6 Reimbursement Scenario3.7 Clinical Trials3.7.1 Ctdna Clinical Trials3.7.2 Cfdna Clinical Trials3.7.3 Circulating Tumor Cells3.7.4 Companion Diagnostics3.8 Latest and Upcoming Products3.9 Porter's Five Force Analysis3.10 Funding Scenario

4 Market Sizing4.1 U.S.Cancer Care Market Sizing Information4.1.1 Oncology Testing4.1.1.1 Early Screening4.1.1.2 Companion Diagnostics4.1.1.3 Prognosis Monitoring4.1.1.4 Recurrence Monitoring4.1.2 Non-Invasive Prenatal Screening (NIPT)4.1.3 Transplantation Diagnostics

5 Molecular Diagnostics Global Market, by Products5.1 Introduction5.2 Instruments5.3 Consumables5.4 Software and Services

6 Molecular Diagnostics Global Market by Technology6.1 Introduction6.2 PCR6.3 Microfluidics and Microarray6.4 Isothermal Nucleic Acid Amplification Technology (INAAT)6.5 In-Situ Hybridization6.6 Next Generation Sequencing (NGS)6.7 Others

7 Molecular Diagnostics Global Market, by Application7.1 Introduction7.2 Infectious Diseases7.2.1 Bacterial Diseases7.2.1.1 Sexually Transmitted Diseases7.2.1.2 Hospital Acquired Infections7.2.1.3 Tuberculosis7.2.1.4 Others7.2.2 Viral Diseases7.2.2.1 Hiv7.2.2.2 Hepatitis7.2.2.3 Influenza7.2.2.4 Human Papiloma Virus (HPV)7.2.2.5 Other Viral Diseases7.2.3 Other Infectious Diseases7.3 Genetic Testing7.3.1 Non-Invasive Prenatal Testing (NIPT)7.3.2 Cystic Fibrosis7.3.3 Other Genetic Diseases7.4 Oncology Testing7.4.1 Cancer Types7.4.1.1 Introduction7.4.1.2 Lung Cancer7.4.1.3 Breast Cancer7.4.1.4 Colorectal Cancer7.4.1.5 Prostate Cancer7.4.1.6 Melanoma7.4.1.7 Ovarian Cancer7.4.1.8 Others7.4.2 Cancer Care7.4.2.1 Introduction7.4.2.2 Early Screening7.4.2.3 Companion Diagnostics7.4.2.4 Prognosis Monitoring7.4.2.5 Recurrence Monitoring7.5 Transplantation7.5.1 Kidney Transplantation7.5.2 Heart Transplantation7.5.3 Other Transplantation7.6 Blood Screening7.7 Other Diseases

8 Molecular Diagnostics Global Market, by End Users8.1 Introduction8.2 Hospitals8.3 Clinical/Centralized Laboratories8.4 Academic and Research8.5 Others

9 Molecular Diagnostics Global Market, by Region9.1 Introduction9.2 North America9.2.1 U.S.9.2.2 Rest of North America9.3 Europe9.3.1 France9.3.2 Germany9.3.3 Italy9.3.4 Rest of Europe9.4 Asia-Pacific Region9.4.1 China9.4.2 India9.4.3 Japan9.4.4 Rest of Asia-Pacific9.5 Rest of the World9.5.1 Brazil9.5.2 Rest of Latin America9.5.3 Middle East and Others

10 Competitive Landscape10.1 Introduction10.2 Approvals10.3 Collaborations10.4 Acquisitions10.5 New Product Launches10.6 Others

11 Major Companies11.1 Abbott Laboratories11.1.1 Overview11.1.2 Financials11.1.3 Product Portfolio11.1.4 Key Developments11.1.5 Business Strategy11.1.6 SWOT Analysis11.2 Becton, Dickinson and Company11.3 BioMerieux11.4 Danaher Corporation11.5 Exact Sciences Corporation11.6 Grifols, S.A.11.7 Hologic, Inc.11.8 Myriad Genetics, Inc.11.9 Qiagen N.V.11.10 F. Hoffmann-La Roche Ltd.

Companies Mentioned

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Origins and insights into the historic Judean date palm based on genetic analysis of germinated ancient seeds and morphometric studies – Science…

February 8th, 2020 9:50 pm

INTRODUCTION

The date palm (Phoenix dactylifera), a dioecious species in the Arecaceae (formerly Palmae) family has a historical distribution stretching from Mauritania in the west to the Indus Valley in the east (1). A major fruit crop in hot and arid regions of North Africa and the Middle East and one of the earliest domesticated tree crops, archaeobotanical records suggest that the earliest exploitation and consumption of dates is from the Arabian Neolithic some 7000 years before the present (yr B.P.) (1). Evidence of cultivation in Mesopotamia and Upper Arabian Gulf approximately 6700 to 6000 yr B.P. support these centers as the ancient origin of date palm domestication in this region, with a later establishment of oasis agriculture in North Africa (1, 2).

The current date palm germplasm is constituted by two highly differentiated gene pools: an eastern population, consisting of cultivars extending from the Middle East and Arabian Peninsula to northwest India and Pakistan and a western population covering North Africa and sub-Saharan Africa (3, 4). Introgressive hybridization by a wild relative in North African date palms has been proposed as a source of this differentiation (2).

Date palms in the southern Levant (modern-day Israel, Palestine, and Jordan), situated between eastern and western domestication areas, have historically played an important economic role in the region and were also of symbolic and religious significance (5). The Kingdom of Judah (Judea) that arose in the southern part of the historic Land of Israel in the 11th century BCE was particularly renowned for the quality and quantity of its dates. These so-called Judean dates grown in plantations around Jericho and the Dead Sea were recognized by classical writers for their large size, sweet taste, extended storage, and medicinal properties (5). While evidence suggests that Judean date culture continued during the Byzantine and Arab periods (4th to 11th century CE), further waves of conquest proved so destructive that by the 19th century, no traces of these historic plantations remained (5).

In 2008, we reported the germination of a 1900-year-old date seed (6) recovered from the historical site of Masada overlooking the Dead Sea. In the current study, six additional ancient date seeds from archaeological sites in the Judean desert were germinated, bringing to seven the number of ancient genotypes genetically analyzed using molecular markers. In addition, morphometric analysis was used to compare the size and shape of ungerminated ancient date seeds with modern varieties and wild dates.

This study, which confirms the long-term survival of date palm seeds, provides a unique opportunity to rediscover the origins of a historic date palm population that existed in Judea 2000 years ago. The characteristics of the Judean date palm may shed light on aspects of ancient cultivation that contributed to the quality of its fruit and is thus of potential relevance to the agronomic improvement of modern dates.

Of the hundreds of ancient date seeds and other botanical material recovered from excavations carried out in the Judean desert between 1963 and 1991 (7, 8) (fig. S1), 32 well-preserved date seeds from the archaeological sites of Masada, Qumran, Wadi Makukh, and Wadi Kelt were planted in a quarantine site at Kibbutz Ketura (table S1). Of these, six ancient seeds germinated and were further identified by the following monikers: Masada: Adam; Qumran: Jonah, Uriel, Boaz, and Judith; and Wadi Makukh: Hannah (Figs. 1 and 2).

(A) Adam, (B) Jonah, (C) Uriel, (D) Boaz, (E) Judith, (F) Hannah, and (G) HU37A11, an unplanted ancient date seed from Qumran (Cave FQ37) used as a control. Scale bars, 0.5 cm (A, no bar size as unmeasured before planting). Photo credit: Guy Eisner.

Ages in months at time of photograph (A to C) Adam (110 months), Jonah (63 months), and Uriel (54 months). (D to F) Boaz (54 months), Judith (47 months), and Hannah (88 months). Photo credit: Guy Eisner.

On visual inspection, no specific observation linked the ability of these seeds to germinate compared with those that failed to germinate. Before planting, the ancient date seeds had been weighted, and their length was measured, with the exception of those seeds from Masada, (including Adam, the germinated seed), which unfortunately were not measured (table S1). No statistically significant differences were found between germinated and ungerminated seeds in either weight {1.67 0.55 and 1.61 0.29 g, respectively [Students t test (t) = 0.348, degree of freedom (df) = 24, P = 0.731]} or length [27.60 3.7 and 26.8 3.7 mm, respectively (t = 0.455, df = 24, P = 0.653)].

Radiocarbon ages are shown (Fig. 3 and table S2) for ancient date seeds germinated in the current study and also for the date seed (seed 3/Methuselah) germinated in our previous work (6). These ages were obtained from seed shell fragments found clinging to the rootlets of germinated seedlings during their transfer into larger pots (3 to 17 months of age). The values were recalculated to take into account contamination by modern carbon incorporated during seedling growth previously shown to reduce measured radiocarbon age by approximately 250 to 300 years, equivalent to 2 to 3% modern carbon (table S2) (6). On the basis of these calculations, Methuselah germinated in our previous study (6) and Hannah and Adam in the current study are the oldest samples (first to fourth centuries BCE), Uriel and Jonah are the youngest (first to second centuries CE), and Judith and Boaz are intermediate (mid-second century BCE to mid-first century CE) (Fig. 3).

Eighteen ancient date seeds that failed to germinate were recovered from the potting soil and compared with modern seeds derived from 57 current date palms of which 48 are cultivated varieties and 9 are wild individuals (9, 10). Ancient seeds were significantly larger in terms of both length and width (length, 27.62 3.96 mm; width, 10.38 0.71 mm) than both current cultivar (length, 20.60 4.70 mm; width, 8.33 1.02 mm) and wild date palm seeds (length, 16.69 3.39 mm; width, 7.08 0.46 mm) (Fig. 4). Ancient seeds were, on average, 27.69% wider (t = 11.923, df = 18.391, P = 2.157 1010) and 38.37% longer than the combined current samples (wild and cultivated) (t = 7.422, df = 17.952, P = 3.564 107).

Length (millimeters) (left) and width (millimeters) (right) of ancient date seeds that failed to germinate (n = 18), 9 current wild individuals (n = 180), and 48 cultivated P. dactylifera varieties (n = 928). Letters a, b, and c above boxes indicate Tukeys groups derived from HSD.test function and R package agricolae.

When only compared to the cultivars, the ancient date seeds were still larger: 24.55% wider (t = 11.923, df = 18.391, P = 2.157 1010) and 34.06% longer (t = 7.422, df = 17.952, P = 3.564 107). However, the contrast in seed size is even more marked when comparing ancient seeds and current wild date palms: The Judean date palm seeds were, on average, 39.55% wider (t = 19.185, df = 18.471, P = 5.943 1014) and 65.48% longer than current wild samples (t = 11.311, df = 19.574, P = 2.472 1010) (tables S3 and S4).

Analysis of seed shape diversity in current and ancient date seeds using principal components analysis (PCA) (dudi.pca function) performed on seed outlines confirmed visual observation that modern cultivated seeds were more diverse in size than ancient ones but did not differentiate between the two groups [multivariate analysis of variance (MANOVA), P > 0.05]. Ancient seeds displayed an elongated shape similar to current cultivated samples (fig. S2).

The sex of the six germinated ancient date seedlings in the current study identified using three sex-linked simple sequence repeats (SSR) (11) were as follows: Judith and Hannah are female genotypes and Uriel, Jonah, Boaz, Adam, and Methuselah (seed 3) from the previous study (6) are male genotypes. Through microsatellite genotyping, three levels of genetic inheritance were investigated to highlight geographic origins (Fig. 5, A and B): (i) inheritance transmitted by both parents to progeny, obtained by microsatellite markers showing western and eastern patterns of the ancient seeds genomes (4), as presented in structure analysis and pie charts (Fig. 5A); (ii) inheritance transmitted from mother to progeny through the chloroplast genome, reflecting maternal lineage origin by reporting chloroplastic minisatellite eastern or western alleles (Fig. 5B, arrow) (12); and (iii) inheritance transmitted from father to son through the Y chromosome, reflecting paternal lineage origin by reporting male specific sex-linked eastern or western alleles (Fig. 5B, arrow) (11).

(A) Structure analysis results are shown for modern and ancient western (green) and eastern (orange) genotype contributions. Pie charts highlight eastern (orange) and western (green) ancient seeds nuclear genomes contributions. (B) Ancient seeds maternal and paternal lineages origin. Arrows represent clonally transmitted parental information, with maternal (chloroplastic) and paternal (Y chromosome) from western (green) and eastern (orange) origins.

Structure analysis revealed that distribution of the germinated ancient date seeds was within previously described eastern and western date palm gene pools (Fig. 5A). Methuselah, Hannah, and Adam are the most eastern genotypes, although they also show ancient western contributions requiring numerous generations and highlighting ancient crosses. Boaz and Judith are the most admixed, with almost equal eastern and western contributions reflecting more recent crossings. Jonah and Uriel are the most western genotypes with the most western parental lineages (Fig. 5B).

To shed light on genetic diversity of the ancient dates, basic population genetic parameters were estimated and compared to modern reference collections (tables S5 and S6). The ancient genotypes showed an allelic richness value (Ar) (i.e., the number of alleles) of 3.59, a relatively high diversity for such a small sample size (seven genotypes) compared to values of other countries sampled (table S6). Genetic relationships between the ancient date and current varieties (Fig. 6 and table S7) show Methuselah and Adam close to eastern modern varieties Fardh4 and Khalass, respectively, assigned to current Arabian Gulf varieties; Hannah and Judith related to modern Iraqi varieties Khastawi and Khyara, respectively; and Uriel, Boaz, and Jonah, the most western genotypes, related to modern Moroccan varieties, Mahalbit, Jihel, and Medjool, respectively.

Modern varieties from United Arab Emirates (light orange), Iraq (red), Tunisia (blue), Morocco (light green), Egypt (dark green), and ancient genotypes (purple).

In the current study, six ancient date seeds, in addition to the seedling obtained in our previous study (6), were germinated. All the seeds were approximately 2000 years old and had been previously recovered from archaeological sites in the Judean desert, a rain shadow desert of ca. 1500 km2 located between the maquis-covered Judean Hills and the Dead Sea (fig. S1).

Little is known about the mechanisms determining seed longevity; however, it has been related to the ability to remain in a dry quiescent state (13). In the current study, low precipitation and very low humidity around the Dead Sea could have contributed to the longevity of the ancient date seeds, which may be an adaptation of date palms to extreme desert conditions fostering seed dispersion. Their remarkable durability, however, may also be connected to other extreme environmental conditions in this area; at 415 m below mean sea level, the Dead Sea and its surroundings have the thickest atmosphere on Earth, leading to a unique radiation regime and a complex haze layer associated with the chemical composition of the Dead Sea water (14). However, since no visible evidence in the current study was linked to seed germination and, accordingly, to their long term survival, further investigations are needed to understand the basis of date palm seed longevity.

Among the worlds oldest cultivated fruit trees, P. dactylifera is the emblematic of oasis agriculture and highly symbolic in Muslim, Christian, and Jewish religions (5). Closely connected to the history of human migrations, the first cultivated varieties of P. dactylifera are thought to have originated around Mesopotamia and the Upper Arabian Gulf some 6700 to 6000 yr B.P. (1, 2, 10). In Judea, an ancient geopolitical region that arose during the 11th century BCE in the southern part of the historic Land of Israel, and situated at the cross roads of Africa, Asia, and Europe, the origins of date palm cultivation are unknown. However, from historical records, a thriving Judean date culture was present around Jericho, the Dead Sea, and Jordan Valley from the fifth century BCE onward, benefitting from an optimal oasis agriculture environment of freshwater sources and subtropical climate (5).

Described by classical writers including Theophrastus, Herodotus, Galen, Strabo, Pliny the Elder, and Josephus, these valuable plantations produced dates attributed with various qualities including large size, nutritional and medicinal benefits, sweetness, and a long storage life, enabling them to be exported throughout the Roman Empire (5, 15, 16). Several types of Judean dates are also described in antiquity including the exceptionally large Nicolai variety measuring up to 11 cm (5, 15, 16).

In the current study, ancient seeds were significantly longer and wider than both modern date varieties and wild date palms. Previous research has established that both fruits and seeds are larger in domesticated fruit crops compared with their wild ancestors (17), suggesting that the ancient seeds were of cultivated origin (9, 18), most likely originating from the regions date plantations. Furthermore, an increase in seed size has been linked allometrically to an increase in fruit size (19), corroborating the historical descriptions of the large fruits grown in this region.

Genotypes of the germinated ancient date seedlings cover a large part of present-day date palm distribution area, findings that reflect the variety, richness, and probable influences of the historic Judean date groves. Microsatellite genotyping shows a relatively high diversity, with eastern and western gene pool contributions, allelic richness, and genetic proximity to current varieties cultivated in the Arabian Peninsula, Iraq, and North Africa. Although the sample size is small, a predominance of eastern female lineages (six of seven) indicates that eastern female varieties grown from local germplasm were probably clonally propagated from offshoots to maintain desirable fruit qualities. Male lineages, mainly western (four of five), suggest that genetically different or foreign males were used for pollination. This assumption is supported by first century texts, indicating that substantial knowledge existed in ancient Judea 2000 years ago regarding the most suitable males for pollination of female date palms (20).

Our results reinforce the historical narrative that a highly sophisticated domestication culture existed in ancient Judea. Local farmers with an interest in maintaining genetic diversity in their date plantations and anthropogenic pressures leading to selection on fruit dimension and other desirable traits used cross-breeding with foreign (genetically different) males to develop a rich collection of varieties.

These findings suggest that Judean date culture was influenced by a variety of migratory, economic, and cultural exchanges that took place in this area over several millennia.

In Israel, the oldest remains of P. dactylifera are wood specimens 19,000 yr B.P. from Ohalo II site on the Sea of Galilee (21). Recovery of carbonized date seeds from Chalcolithic and Early Bronze Age sites (4500 to 2900 BCE) in the Judean desert, Jordan Valley, and Jericho (22, 23) and early Iron Age sites in Israel (12th to 11th century BCE) (24) suggest that human exploitation and consumption of dates occurred at this time. However, it is unclear whether these samples, which are relatively few in number and of very small size (22, 25, 26), are derived from ancient wild populations, as suggested by morphometric studies of modern wild date populations (18) or represent an early stage of the domestication process.

In the current study, although the sample size is too small to claim a trend, on a gradient from east to west genetic contributions, the older the germinated seeds are on radiocarbon dating (Fig. 3), the more eastern is the nuclear genome (Fig. 5, A and B ). In this respect, Methuselah, Adam, and Hannah (first to fourth centuries BCE) have a predominantly eastern nuclear genome and eastern maternal lineage, their relationship to modern varieties from the Arabian Gulf and Iraq suggesting that they belong to the same eastern genetic background.

The P. dactylifera cultivated by the inhabitants of Judea at that time therefore appears to be from the eastern gene pool, possibly growing locally and related to oasis populations, of which relict populations were recently found in Oman (9).

Elite female cultivars may also have been introduced to ancient Israel from these regions, consistent with a pattern of human intervention and possibly active acquisition of date palm varieties. Established trade links are documented with Arabia and the Persian Gulf from at least the 12th century BCE (27). Babylonian date palm cultivation in southern Mesopotamia (most of modern Iraq), originating some 6000 yr B.P. (1, 2), used deportees from ancient Judea following its conquest in the sixth century BCE (28). After the collapse of the Neo-Babylonian Empire, returning exiles may have brought this specialized knowledge and selected cultivars back to Judea; a date variety Taali cultivated in both Judea and Babylon is mentioned in the Talmud (29).

Western genetic admixtures in the germinated seedlings and their proximity to current cultivated date varieties from Morocco also suggest that ancient Judean date palms were the result of germplasm exchanges with this area and of multiple crosses. Introgression of eastern genomes into western ones are common, detected in varieties from Algeria, Morocco, Mauritania, and particularly east-west junction areas like Egypt (1, 2, 4, 30). In the latter, eastern contributions from the Persian Gulf, detected in ancient Egypt date seeds from 1400 BCE to 800 CE, reveal a chronological pattern of change in agrobiodiversity and the possible emergence of a western form in the Roman period (10).

Introgression of date palm western genomes into eastern ones, however, is far lower (1, 2, 4, 12), their presence in the current study reflecting west to east exchanges.

The origins of these exchanges are unclear; however, archaeological evidence indicates that North Africa, Near East, and Mediterranean cultures were clearly linked during the Neolithic in the southern Levant (approximately 11,700 to 7300 B.P.) and were associated in Jericho with the earliest origins of food production and fundamental changes in human subsistence strategies (31).

Phoenicia, a maritime trading nation occupying the coastal areas of modern northern Israel, Lebanon, and Syria (1500 to 300 BCE), was also historically associated with cultivation and trade of date palms (32). We can speculate that later west to east germplasm exchanges to this region may have been associated with domesticated varieties originating in Phoenician City States in North African (e.g., Carthage in present-day Tunisia) (32), where oasis agriculture appeared relatively late in the archaeological record (3).

The most western genotypes in the current study (Uriel and Jonah) are also the youngest seeds (mid-first to mid-second CE), coinciding with established trade routes linking this region to North Africa and supporting evidence for date consumption in the latter 2000 years ago (2, 3). This period coincides with Judeas well-documented wars against Rome (66 to 73 CE and 132 to 136 CE) and deportation and displacement of its population (16). The ancient seeds in the current study were found in the Judean desert, historically a place of refuge due to its steep cliffs and inaccessible caves (16, 23). The loss of political autonomy and the final collapse of Judea have been postulated as causing major disruption to labor intensive practices associated with date cultivation (33). Elite cultivars no longer conserved by vegetative propagation (offshoots) were gradually replaced by seedling date palms producing fruits displaying considerable variation within the progeny. Although P. dactylifera can live for more than 100 years (33) and date groves in this region are thought to have persisted for several more centuries, they were already rare by the 11th century and had been entirely replaced by seedling populations or feral, wild trees producing only low-quality fruit (5, 33), by the 19th century.

The current study sheds light on the origins of the Judean date palm, suggesting that its cultivation, benefitting from genetically distinct eastern and western populations, arose from local or introduced eastern varieties, which only later were crossed with western varieties. These findings are consistent with Judeas location between east-west date palm diversification areas, ancient centers of date palm cultivation, and the impact of human dispersal routes at this crossroads of continents.

Given its exceptional storage potentialities, the date palm is a remarkable model for seed longevity research. Investigations on the molecular mechanisms involved in long-term protection in the dried state have important implications on plant adaptation to changing environments and for biodiversity conservation and seed banking. As new information on specific gene-associated traits (e.g., fruit color and texture) (3) is found, we hope to reconstruct the phenotypes of this historic date palm, identify genomic regions associated with selection pressures over recent evolutionary history, and study the properties of dates produced by using ancient male seedlings to pollinate ancient females. In doing so, we will more fully understand the genetics and physiology of the ancient Judean date palm once cultivated in this region.

The objectives of this study and its design were as follows:

1) The origin and selection of ancient date seeds derived from archaeological sites in the Judean desert.

2) The germination of ancient date seeds in a quarantine site following a preparatory process.

3) Radiocarbon dating and recalculation of calendar ages of germinated ancient date seeds based on seed shell fragments and selected controls.

4) Seed morphometric studies: Comparing ungerminated ancient date seeds with seeds from modern date varieties and wild date palms.

5) Microsatellite analysis of seven germinated date seedlings.

(statistical methods are included in the respective sections)

The ancient date seeds in the current study were obtained from botanical material recovered from archaeological excavations and surveys carried out at the following sites in the Judean desert between 1963 and 1991 and stored at room temperature since their discovery (fig. S1).

1) Masada: An ancient fortress/palace complex built by King Herod the Great (37 to 4 BCE) at the southern end of the Dead Sea on the site of an earlier Hasmonean fortification (141 to 37 BCE) (7). The site, built on a plateau approximately 400 m above the Dead Sea, was first excavated by the late Y. Yadin (Institute of Archaeology, Hebrew University, Jerusalem, Israel) from 1963 to 1965 (7). Bioarchaeological material found at this time included large numbers of date seeds buried under rubble close to the remains of an area identified as a food storage site.

2) Qumran: An archaeological site situated at the northern end of the Dead Sea including an ancient settlement dating from the second century BCE destroyed in 68 CE and a number of caves located in the surrounding cliffs and marl terrace associated with the 1947 discovery of the Dead Sea Scrolls. Later excavations and surveys of caves in this area, carried out from 1986 to 1989, by J. Patrich and B. Arubas (The Institute of Archaeology, The Hebrew University, Jerusalem, Israel) (8) included the following: Qumran Cave 13: artifacts found included potsherds from period 1b Qumran (until 31 BCE), numerous date stones and dried dates in a pit, and a pottery juglet dated to approximately 67 to 79 CE containing an unknown viscid substance and wrapped in palm fibers (used as a control in radiocarbon analysis in the current study) (see below); and Qumran Cave FQ37: containing a number of date stones and first to second CE century artifacts from the late Second Temple period (60 to 70 CE) and Roman period.

3) Wadi Makukh: A winter water channel in the Judean desert surrounded by high cliffs and containing a number of caves, which were surveyed from 1986 to 1989 (above). Date seeds found in caves 1, 3, 6, and 24 in this area were included in the current study; Cave 1 was found to include a Chalcolithic burial site (fifth millennium B.P.) containing human skeletons as well as Roman period artifacts but with signs of considerable disturbance by grave robbers (8).

4) Wadi Kelt: A winter water channel running from Jerusalem to the Dead Sea containing a number of caves (8). Date seeds from Masada were provided to S.S. by M. Kislev (Faculty of Life Sciences, Bar Ilan University), initially in 2005 (6) and again in 2007 (germinated in the current study), following permission by the late E. Netzer (Department of Archaeology, Hebrew University of Jerusalem). Date seeds from Qumran, Wadi Makukh, and Wadi Kelt were provided to S.S. by J. Patrich in 2009.

Out of a collection of many hundreds of ancient date seeds, a total of 34 were selected for the current study based on the specimens appearing visually to be intact whole seeds, in good condition, and without holes. They included Masada (8 seeds), Qumran (18 seeds), Wadi Makukh (7 seeds), and Wadi Kelt (1 seed). Ancient date seeds selected above were identified by code numbers and photographed, and measurements of weight and length were made before planting (with the exception of Masada seeds, which unfortunately were not measured) (table S1). One date seed, from the Qumran excavations (HU 37 A11), was selected as a control and left unplanted (table S1).

The remaining 33 seeds were subjected to a preparatory process to increase the likelihood of seed germination using the following established methods to sprout delicate germplasm (34): seeds were initially soaked in water for 24 hours and in gibberellic acid (5.19 mM) (OrthoGrow, USA) for 6 hours to encourage embryonic growth. This was followed by Hormoril T8 solution (5 g/liter) (Asia-Riesel, Israel) for 6 hours to encourage rooting and KF-20 organic fertilizer (10 ml/liter) (VGI, Israel) for 12 hours. All solutions were maintained at 35C.

Following the above procedure, one seed was found to be damaged and not planted. The remaining 32 seeds were separately potted in fresh sterile potting soil, 1 cm below the surface, and placed in a locked quarantine site at the Arava Institute of Environmental Sciences, Kibbutz Ketura, located in the southern Israel. Eight weeks after germination and periodically afterward, KF-20 (10 ml/liter) and iron chelate (10 g/liter) were added to the seedlings. Irrigation used desalinated water, as our previous study on germinating the first ancient date seed (6) indicated that using the regions highly mineralized water produced tip burn (darkening and drying of leaves).

Radiocarbon ages in the current study were obtained for the following bioarchaeological material: (i) fragments of seed shell coat found clinging to the rootlets of six germinated ancient date seeds when these seedlings were transferred into larger pots, (ii) an unplanted ancient date seed from cave 37 Qumran (HU37 A11) (used as a control), and (iii) part of an ancient palm frond surrounding an oil juglet found in Qumran Cave 13 (used as a control). Radiocarbon ages of seed shell fragments from the germinated seedlings were recalculated to take into account modern carbon incorporated during seedling growth (6).

1) Methodology: Nonorganic carbon (carbonates) were removed from all samples with 10% HCl under reduced pressure followed by repeated washes in deionized water until neutral (pH 7). Organic acids formed during the rotting process were removed with 10% NaOH followed by repeated washes (as above). To prevent absorption of atmospheric CO2, all samples were placed again in 10% HCl and then washed in deionized water until neutral. To remove chemicals used in the germination process, a 7-mm-long shell fragment from the germinated date seed weighing 80 mg was cut into six cubes of 8 mm3 and subjected to an additional series of four boil washes. All samples were heated in an evacuated sealed quartz tube with CuO as an oxygen source. The resulting CO2 was mixed with hydrogen in the ratio 2.5:1 and catalytically reduced over cobalt powder at 550C to elemental carbon (graphite). This mixture was pressed into a target and the 14C:12C ratio (for radiocarbon age) measured by accelerator mass spectrometry at the Institute for Particle Physics of the Swiss Federal Institute of Technology Zurich (ETHZ).

2) Calendar age: Calendar age was obtained using the OxCal 4.3 calibration program based on the latest IntCal 13 calibration curve (35). Calibrated calendar ages can be found with a probability of 68.3% in the 1-range and with a probability of 95.4% in the 2-range (table S2). The probability distribution P of individual ages is given for each sigma range. The 14C activity is reported as pMC (percentage of modern carbon) and corresponds to the ratio of the activity of the sample to the corrected activity of the oxalic acid standard, which has an age of 0 yr B.P.

3) Calculation of correction for pMC: The effect of contamination by modern carbon incorporated during seedling growth previously shown in our first germination of an ancient date seed to reduce measured age by 250 to 300 years (equivalent to 2 to 3% pMC) (6) was calculated using the following three groups based on the source of the ancient seeds in both the current and previous studies:

(i) Masada: Adam (current study), Methuselah (seed 3), and seed 1 [both from previous study (6) in which seed 1 was used as a control].

(ii) Qumran Cave 13: Judith and an ancient palm frond (used as a control)

(iii) Qumran Cave 37: Boaz, Jonah, Uriel, and seed HU37A11 (used as a control)

The germinated ancient seed Hannah from Wadi Makhukh was not assigned to a group due to the absence of a suitable control and considerable disruption to the site.

Using as age-controls the ancient palm frond (Qumran Cave 13), seed HU37A11 (Qumran Cave 37) from the current study and seed 1 (Masada) from the previous study (6), we assumed that a positive pMC difference between the germinated seeds and control sample could be attributed to modern carbon that was absorbed during germination. Ages of the germinated seeds were therefore recalculated (assuming that the measurement error remains unchanged) by adjusting the measured age to the control sample. For Hannah since no control exists, an average deviation (derived from the other samples) was taken into account.

Comparison of ancient date seeds that failed to germinate with modern date seeds. This was performed on the following groups:

1) Modern date seed (P. dactylifera) samples (n = 56): Being either from cultivated varieties (n = 47) or uncultivated and possibly wild individuals (n = 9) (9). Seeds from these sources (total n = 1108) were used as a current referential for seed morphometric analysis. The cultivated modern samples originated from 11 countries spanning date palm distribution from Spain to North Africa to the Middle-East. The candidate wild date palms originated from Oman and have been hypothesized as wild date palms based on seed shape, seed size (18), and genetic studies based on microsatellite and whole-genome resequencing data (9).

2) Ancient date seeds (n = 18): Of 26 ancient date seeds obtained from Qumran, Wadi Makukh, and Wadi Kelt archaeological sites (described above) that had been planted in the quarantine site, 21 failed to germinate and were retrieved from the potting soil. Of these, three were discarded as they had fragmented and were in poor condition. The remaining 18 retrieved ancient date seeds together with modern reference seeds (described above) were rephotographed on dorsal and lateral sides, and measurements of length and width were remade (table S3) [Neither current or previous (6) ancient date seeds from Masada that failed to germinate were used in the morphometric study as these seeds were not retrieved from the potting soil].

The following statistical analyses were performed using R software (36).

1) Size analysis of modern seeds: The length and width of a total of 1108 seeds obtained from 47 current cultivated varieties (928 seeds) and 9 current wild individuals (180 seeds) were measured using ImageJ (37) following the protocol previously established by Gros-Balthazard et al. (18). The thickness was not measured since it is highly correlated with width (18).

2) Comparison of seed size between current and ancient samples: Measurements for current varieties were compared with those measured for the ancient date seeds using boxplots and Students and Tukeys tests (table S4).

3) Analysis of seed shape diversity in current and ancient date seeds: PCA (dudi.pca function) was performed on seed outlines assessed by Fourier coefficients, a morphometric method applied to outline analysis.

DNA preparation. DNA of six ancient date seedlings from the current study and one (Methuselah) from the previous study (6) was analyzed. A set of 19 SSR was used for genotyping as described by Zehdi-Azouzi et al. (4). Gender was determined using date palm sex-linked microsatellite markers (11). Maternal lineages were traced back using the plastid intergenic spacer psbZ-trnf minisatellite (12, 38). Paternal lineages were studied through Y haplotypes using the three sex-linked SSRs (mPdIRDP80, mPdIRDP50, and mPdIRDP52) (11).

Total cellular DNA was extracted from lyophilized leaves using the TissueLyser and the DNeasy Plant Mini Kit (QIAGEN SA, Courtaboeuf, France) according to the manufacturers instructions. After purification, DNA concentrations were determined using a GeneQuant spectrometer (Amersham Pharmacia Biotech, France). The quality was checked by agarose minigel electrophoresis. The resulting DNA solutions were stored at 20C.

Amplification and genotyping. Polymerase chain reactions were performed in an Eppendorf (AG, Hamburg, Germany) thermocycler. Reaction was performed in 20 l and contained 10 ng of genomic DNA, 10 reaction buffer, 2 mM MgCl2, 200 M deoxynucleotide triphosphates, 0.5 U polymerase, and 0.4 pmol of the forward primer labeled with a 5M13 tail, 2 pmol of the reverse primer, and 2 pmol of the fluorochrome-marked M13 tail and MilliQ water. A touchdown polymerase chain reaction (PCR) was carried out with following parameters: denaturation for 2 min at 94C, followed by six cycles of 94C for 45 s, 60C for 1 min, and 72C for 1 min; then 30 cycles of 94C for 45 s, 55C for 1 min, and 72C for 1.5 min; then 10 cycles of 94C for 45 min, 53C for 1 min, 72C for 1.5 min; and a final elongation step at 72C for 10 min. PCR products were analyzed using an ABI 3130XL Genetic Analyzer (Applied Biosystems, Foster City, CA, USA). Allele size scoring was performed with GeneMapper software v3.7 (Applied Biosystems).

Genetic analyses. The ancient genotypes were compared to a reference matrix (90 genotypes) containing genotyping data on current date palm varieties covering the two genetic pools defined by Zehdi-Azouzi et al. (4) and including 35 samples from the eastern pool and 55 samples from the western pool (table S5). The number of alleles per group (NA), the number of alleles with a frequency higher than 5% (NA,P), and the observed (Ho), the expected (He) heterozygosities, and the fixation index values (FIS) were estimated using the GenAlEx 6.5 program (table S6). The allelic richness of each group was also calculated via the divBasic function implemented in the R package diversity (table S6) (39).

The hierarchical classifications were generated using PHYLIP package by calculating Cavalli-Sforza and Edwards distances (40) between ancient genotypes and current varieties (table S7). The obtained distance was used to construct the dendrogram using the neighbor-joining algorithm (41). The tree was drawn using DARwin software (42).

The membership probabilities of the ancient genotypes were identified by using a model-based clustering algorithm implemented in the computer program STRUCTURE v.2.3.4 (43). This algorithm identifies clusters (K) with different allele frequencies and assigns portions of individual genotypes to these clusters. It assumes the Hardy-Weinberg equilibrium and linkage equilibrium within clusters. The STRUCTURE algorithm was run without previous information on the geographic origin of the accessions using a model with admixture and correlated allele frequencies with 10 independent replicate runs for each K value (K value ranging from 1 to 6). For each run, we used a burn period of 10,000 iterations followed by 1 million iterations. The optimal number of clusters was assigned by using the run with the maximum likelihood validated with an ad hoc quantity based on the second-order rate of change in the log probability of data between different K values (fig. S3).The optimal alignment of the independent iterations was obtained by CLUMPP v.1.1 implemented in the Pophelper software v.1.0.10 (44); Pophelper v.1.0.10 (44) was also used to plot the results for the optimal K.

Acknowledgments: We thank J. Patrich and the late E. Netzer for making available ancient date seeds from Judean desert excavations; R. Krueger (USDA-ARS, USA) for providing some current date palm varieties; and S. Zehdi (Faculty of Sciences, University of Tunis El Manar, Tunisia), A. Lemansour (UAEU, DPDRUD, United Arab Emirates), M. A. Elhoumaizi (Sciences Faculty, Morocco), and C. Newton for allowing the use of genotyping data on current date palm varieties in the reference matrix. M. Collin is acknowledged for the help in the figure preparation and T. Bdolah Abraham for the help in statistics. O. Fragman-Sapir is acknowledged for identification of ancient date seeds and C. Yeres and A. Rifkin for information on Midrashic and Talmudic Jewish source material. Funding: The study was supported by donations to NMRC from The Charles Wolfson Charitable Trust (UK), G. Gartner and the Louise Gartner Philanthropic Fund (USA), and the Morris Family Foundation (UK). Author contributions: S.S. initiated, designed, and coordinated the study, procured ancient date samples, researched historical and archaeological information and integrated it with scientific findings, and wrote the paper. E.C. and N.C. performed genetic analyses on germinated seedlings. E.S. germinated ancient date seeds. M.E. performed radiocarbon analysis. M.G.-B., S.I., and J.-F.T. performed morphometric analysis. F.A. supervised genetic analyses and with E.C., M.G.-B., and M.E. helped write the manuscript. Competing interests: The authors declare that they have no competing interests. Data and materials availability: All data needed to evaluate the conclusions in the paper are present in the paper and/or the Supplementary Materials. Additional data related to this paper may be requested from the authors.

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Origins and insights into the historic Judean date palm based on genetic analysis of germinated ancient seeds and morphometric studies - Science...

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The Future Is Faster Than You Think Book Review: How To Learn About Exponential Technologies And Develop A Positive Mindset – Forbes

February 8th, 2020 9:50 pm

Future is Faster Than You Think (FFTYT)

(Book: The Future Is Faster Than You Think)

When it comes to exponential technologies there are few people in the world more informed than Dr. Peter H. Diamandis, earning degrees in molecular genetics and aerospace engineering from MIT and a Harvard-trained medical doctor who co-founded, XPRIZE, BOLD Capital Partners, and more than two-dozen companies operating at the leading edge of technology & longevity. He also runs Abundance 360 (A360), a tightly-curated, by-application-only community of 360 technology executives where he teaches exponential entrepreneurship and invites the most outstanding leading technology executives to share the latest advances in the fields of AI, computing, energy, transportation, retail, gaming, healthcare, and longevity. The Abundance 360 members & the high profile XPRIZE board that Diamandis has cultivated take an active part in this community, tackle new challenges with XPRIZE, go on trips to the most tightly-controlled labs, centers for disease & aging as well as obtain courtside access to the latest technologies that most arent even aware of yet. Why does Diamandis spend so much time with those in his community? Diamandis is here to inspire, guide and transform the way these executives think in order to get the motivation, energy to create their massively transformative purpose in life and become moonshot thinkers. In fact, I was invited to give a talk at Abundance 360 and present the work to a group of about 360 people who you usually see on the covers of technology magazines. I had a chance to hear about the employee longevity programs at the Beijing Genomics Institute, new approaches to developing blockbuster promotional videos at Riot Games and got KDA Popstars on my playlist (since then they got over 300 million views on Youtube), and even learned a few new things in artificial intelligence.

To make this knowledge available to a broader audience, approximately every five years Diamandis publishes a book. These books quickly make it to the bookshelves of technology luminaries and business leaders and become New York Times bestsellers. And if you liked his two other New York Times bestsellers, Abundance and Bold, you will certainly be wowd by The Future is Faster Than You Think. But for those who hear about these books for the first time, I recommend getting the entire trilogy and starting from Abundance. Every one of these books starts with a very simple but non-obvious realization - the world is substantially better than you think. Every one of us living in developed countries has a higher standard of living and more entertainment options than the Queen of England twenty years ago thanks to technology. The world is more peaceful, more connected, never been more at the ready to take on new challenges, and fix the problems that we complain about today. And it is getting better every year. The global poverty rate is on the decline, alternative and sustainable sources now supply a substantial amount of our energy, there are major advances in oncology as well as medicine, and more and more bright minds are joining the productive longevity revolution.

However, humans have evolved to perceive the negative bias much stronger than the positive happening around us and tend to focus on short-term goals. For millennia, humans needed to quickly react to immediate threats, and our bodies and minds evolved accordingly. The modern media is using this evolutionary trait at large feeding us a constant stream of dramatic current events in the battle for our attention. If there are 100 pieces of news and only 1 of them is negative, the news-driven society that we live in tends to pay most attention to and focus on the negative. And since almost every news agency has access to almost the same information at the exact same millisecond, they compete for the most dramatic interpretation of the negative at hand. Like Abundance and Bold, The Future Is Faster Than You Think explains how to go around this short-term reactionary behavior and focus on the positive.

Similar to Abundance and Bold, The Future Is Faster Than You Think covers a very large number of advances in major areas of our lives that cannot and should not be ignored; however, the central topic of the book is artificial intelligence, which glues all of these sections together. It also covers the limitations and dangers of AI and other technologies but still keeps a positive outlook on the entire field.

Another unique feature of The Future Is Faster Than You Think is the way the information is presented. The presentation of a technology trend or discovery usually starts with some background and problem definition, a brief description of how the technology works, provides one or two examples of the real-world application of this technology and then follows with a thought experiment on how and where this technology can be used in the future. Some of these thought experiments become thought-provoking asking the reader to imagine the convergence of several of these technologies and the implications on the different industries and our daily lives. In other words, this book teaches you to imagine, invent, and disrupt.

In my opinion, whether you work for a cutting-edge AI, automotive, or coal mining company, this is one book every CEO, CIO, CTO, and head of innovation, investor, or entrepreneur needs to read and have on their bookshelf. I am buying a few copies to give out to the employees, friends, and partners.

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‘The Goop Lab’ Exploration Of Shrooms And Self Pleasure Is Wild – The Federalist

February 8th, 2020 9:50 pm

Gwyneth Paltrows latest entry into the Goop franchise is her new Netflix series, The Goop Lab. The six episodes deal with a range of wellness issues: psychedelics, cold therapy, orgasms, nutrition for longevity, energy healing, and psychics. In the opening credits, Paltrow notes that her goal in traversing this path is the optimization of self like were here one time, one life. Living the examined life is one thing, but crying while undergoing energy healing is quite another.

Wellness is like this odd religion, wherein the affluent compensate for their lack of physical exertion, where we can be deemed good for eating right, where reducing stress and balancing our work/life engenders us with virtue. Following wellness dictates can become overwhelming, such in the case of orthorexia, an obsession with health. Living longer, eating healthier, connecting more with nature and with our bodies, eradicating or reducing the impact of disease through holistic healing all have the kind of associated values that used to come with organized, God-centric religion.

Goop employees were the guinea pigs trying out all the treatments over the six-episode mini-season. People from accounting and IT were on these journeys, too, not just the creatives in the open office plan. These adventures are like the ultimate corporate off-sites.

The first episode follows Goopers to Jamaica for a psilocybin experience. The active ingredient in magic mushrooms, psilocybin can cause hallucinations and changes in how the body feels. Shrooms can be eaten plain, but shroom tea is far more palatable.

My first thought was how awful it would be to embark on a psychedelic trip with my co-workers. But my second was that after hippies spent decades lolling about in the gutter wearing tie-dye and goofy grins, hallucinogenics are going mainstream.

In micro doses or in a full-on therapeutic trip, psychedelics have hit the wellness set. The circumstances and ethos surrounding these wacky drugs are way different than when I was dabbling my own neurons in a psilocybin bath. Now its got a purity. People fly first-class to beautiful locations to be guided by Ph.D.-level shamans who run foundations for the furtherance of psychedelic research.

For those who havent tried shrooms, I can attest to the fact that they take about an hour to kick in and have an earthy flavor. If youre in a group of 10 friends who all want to get as high as you do, watch for elbows as you all storm the dish of mushrooms and try to stuff as many into your mouth as possible.

This was not the Goop experience. Goop staffers had people to hold them while they cried and released their past trauma. We had firecrackers, large canisters of gasoline, and a penchant for flame. Goopers got some healing on their journey, but we probably had more fun.

The deep dive into the inner mind was followed by an episode where Goopers dove into the freezing water of Lake Tahoe in winter. Cold therapy promises healing, and Goop shows testimonials from people who swear by daily cold immersion.

When I was recently on a wellness and mindfulness adventure in Arizona, I met a semi-psychic astrologer who swore by cold showers. Hed gone so far as to shut off the gas in his home so hed be forced into the cold immersion regimen. In contrast, the Goopers, post-swim, sat around a fire, glasses of red wine and bottles of imported beer in their hands, expressing gratitude to the Dutch guy who led the excursion, to the lake maybe, and to fulfillment.

Cold therapy is about taking down the body temperature to activate some of the bodys dormant systems. Thats what so much of the current wellness trends are about: the benefits of denying ourselves comfort to find healing in deprivation. Wellness practitioners are contemporary ascetics. Through suffering, fasting, and flagellation, we find enlightenment, live longer, and master our desires.

A feeling of rectitude accompanies this that once we challenge ourselves, our skin, and our minds, we have achieved something worthwhile. Its like a prayer to the ether, to the world itself. Discovering what the body can do when released from its comfort zone is a big part of the wellness explored in Goop. Such is the case with the episode on womens orgasms.

Paltrow and Goop Chief Content Officer Elise Loehnen spoke with womens orgasm specialist Betty Dodson. While Goop staffers didnt participate in one of Dodsons everyone gets naked workshops in part because, as Loehnen suggests, it would be an HR crisis Loehnen and Paltrow get a detailed account of how these orgasm workshops go down. Basically, everyone gets off.

Its a little disconcerting to hear orgasms and womens pleasure discussed so clinically by 90-year-old Dodson, Paltrow, Loehnen, and CEO of the Betty Dodson Foundation Carlin Ross. The episode was almost like a real-life Our Bodies, Ourselves, although not the new one, the old one my step-mom gave me back in the late 80s. Wellness in this context is knowing how your body works, learning what gives you pleasure, and figuring out how to ask for it without being ashamed.

Women undergo surgery for labiaplasties up by 45 percent over 2015-16 to achieve the perfect vulva appearance, but according to Dodson, lots of women never even hold the mirror up to nature to have a look for themselves. Dodson combats the shame and what Paltrow calls the deep resistance we have to our own genitalia by teaching women to orgasm and to run the f-ck.

One notable moment in this episode occurs when Ross masturbates to orgasm to show how its done. Viewers hear real orgasm sounds, not performative receiving as in porn. Seeing and hearing this in a realistic way, from a woman who is confident and comfortable with her body, is something of a disconnect. Seeing Ross know how to pleasure herself without any weirdness, embarrassment, or shame is a bit revolutionary. Shame is a killer of pleasure, says Dodson.

The episode on energy healing was another stand-out. But in this case, its hard to see how energy massage makes any sense. The practitioners of energy healing work with the energy around your body, whatever that means.

Those who partake in the experience have left in tears, and Paltrow swears by her sessions, as does everyone on Goops staff who tries it. With eyes closed, those on the massage table seem to feel the placement of the energy healers hands and behave as though they are affected by the not-touch. Its frankly a little hard to believe.

I had one random reiki healing session when I was hanging out with a friend who was studying it, and I had an asthma attack. We went onto the balcony in the New York winter, and he ran his hands along the outline of my body, his hands several inches away. The attack stopped, but I dont actually count that as proof of anything.

My wellness experiences are limited to spa retreats gifted to me by exceedingly generous family members. In November, I was at Miraval in Arizona, and I lost count of the number of times I was chastised for communing with my iPhone instead of with the desert air and sky. For the record, I communed with them too, and I have the pictures to prove it.

It was here that I had a full-body, blindfolded, Thai underwater massage that brought me to tears and made me seriously reflect on my control issues. I had an Ayurvedic experience that gave me visions that I was living my life behind glass, and everything beautiful was on the other side. I also met a fellow wellness patron who was friendly and open until finding out I wrote for The Federalist.

In the opening credit sequence, Paltrow says that when she founded Goop in 2008, she thought her calling was something else other than making out with Matt Damon on screen or whatever. Now Goop is a full-fledged lifestyle brand offering health, wellness, self-image overhauls, and merch. The Goop site features articles, clothes, products, beauty and nutrition tips, books, and all kinds of other ways to spend vast sums of money on self-care.

The Goop Lab is very much an advertisement for the lifestyle the brand promotes. While it offers every conceivable kind of object or service to attain the goal of wellness, the one thing is does not provide is meaning. Theres a feeling in the content that morality is inherent in being destressed, living longer, looking younger, and feeling stronger. Good health and wellness, however, are not moral successes. They are flukes of money, time, and genetics.

Paltrows impulse to encourage people to be their best selves is certainly sound, but its missing a component meaning: a reason to do the right thing regardless of whether it will make us feel better. These enhancements and treatments are all about extending pleasure, in one form or another, yet the path to enlightenment rarely comes with affirmations, a feeling of self-satisfaction, or a glass of wine at the end.

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Anemia: Causes, symptoms and treatment – Livescience.com

February 8th, 2020 9:49 pm

Anemia also known as iron-poor blood is a condition that develops when either the blood doesn't have enough red blood cells or the concentration of hemoglobin in red blood cells is very low. Hemoglobin is the iron-containing protein in red blood cells that carries oxygen from the lungs to the rest of the body. When there are fewer red blood cells than normal or low levels of hemoglobin, the body doesn't get enough oxygen-rich blood for healthy functioning, which is what causes the symptoms of anemia.

Anemia is the most common blood disorder in the United States, affecting nearly 3 million Americans, according to the Centers for Disease Control and Prevention (CDC).

The term anemia is a broad one that represents several hundred different conditions some of them mild and treatable, others that are quite serious, said Dr. Nancy Berliner, chief of hematology at Brigham and Women's Hospital in Boston. There are three reasons that people are anemic, Berliner said: Either their body can't make enough red blood cells, something is destroying the red blood cells faster than their body can make news ones or blood loss (from menstrual periods, colon polyps or a stomach ulcer, for example) is greater than blood cell production.

There are more than 400 different types of anemia, according to the Pacific Heart, Lung & Blood Institute. Here are a few of the more common and better understood types:

Iron-deficiency anemia: The most common form of anemia is caused by low-iron levels in the body. Humans need iron to make hemoglobin, and most of that iron comes from dietary sources. Iron-deficiency anemia can result from a poor diet or from blood loss through menstruation, surgery or internal bleeding.

Pregnancy also increases the body's need for iron because more blood is needed to supply oxygen to the developing fetus, which may quickly drain the body's available iron stores, leading to a deficit. Problems absorbing iron from food because of Crohn's disease or celiac disease can also result in anemia.

Vitamin deficiency anemia: Besides iron, the body also needs two different B-vitamins folate and B12 to make enough red blood cells. Not consuming enough B12 or folate in the diet or an inability to absorb enough of these vitamins can lead to deficient red blood cell production.

Sickle cell anemia or sickle cell disease (SDC): This inherited disease causes red blood cells to become crescent-shaped rather than round. Abnormally shaped red cells can break apart easily and clog small blood vessels, resulting in a shortage of red blood cells and episodes of pain, according to the Mayo Clinic. People become chronically anemic because the sickle-shaped red cells are not pliable and can't get through blood vessels to deliver oxygen, Berliner said.

SDC occurs most often in people from parts of the world where malaria is or was common, according to the CDC; the sickle cell trait may provide protection against severe forms of malaria. In the U.S., SDC affects an estimated 100,000 Americans.

Thalassemia: Thalassemia is an inherited blood disorder that results in lower-than-normal levels of hemoglobin. This type of anemia is caused by genetic mutations in one or more of the genes that control the production of hemoglobin, according to the National Heart, Lung & Blood Institute (NHLBI).

Aplastic anemia: Aplastic anemia is a rare, life-threatening condition that develops when bone marrow stops making enough new blood cells, including red cells, white cells and platelets.

Aplastic anemia may be caused by radiation and chemotherapy treatments, which can damage stem cells in bone marrow that produce blood cells. Some medications, exposure to toxic chemicals like pesticides, viral infections and autoimmune disorders can also affect bone marrow and slow blood cell production.

Hemolytic anemias: This disorder causes red blood cells to be destroyed faster than bone marrow can replace them. Hemolytic anemias may be caused by infections, leaky heart valves, autoimmune disorders or inherited abnormalities in red blood cells, according to the American Society of Hematology.

Anemia of inflammation: Also called anemia of chronic disease, anemia of inflammation commonly occurs in people with chronic conditions that cause inflammation. This includes people with infections, rheumatoid arthritis, inflammatory bowel disease, chronic kidney disease, HIV/AIDS and certain cancers, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

When a person has a disease or infection that causes inflammation, the immune system responds in a way that changes how the body works, resulting in anemia. For example, inflammation suppresses the availability of iron, so the body may not use and store the mineral normally for healthy red blood cell production, Berliner said. Inflammation may also stop the kidneys from producing a hormone that promotes red blood cell production.

The risk for anemia is higher in people with a poor diet, intestinal disorders, chronic diseases and infections. Women who are menstruating or pregnant are also prone to the disorder.

The risk of anemia increases with age, and about 10% to 12% of people over 65 are anemic, Berliner said. But the condition is not a normal part of aging, so the cause should be investigated when it's diagnosed, she said. Older adults may develop anemia from chronic diseases, such as cancer, or iron-deficiency anemia from abnormal bleeding.

According to NHLBI, the following types of people have an increased risk of developing anemia:

Mild forms of anemia may not cause any symptoms. When signs and symptoms of anemia do occur, they may include the following, according to the NHLBI:

The first test used to diagnose anemia is a complete blood count, which measures different parts and features of the blood: It shows the number and average size of red blood cells, as well as the amount of hemoglobin. A lower-than-normal red blood cell count or low levels of hemoglobin indicate anemia is present.

If more testing is needed to determine the type of anemia, a blood sample can be examined under a microscope to check for abnormalities in the size and shape of the red cells, white cells and platelets.

Related: This man's taste buds disappeared because of a blood condition

The treatment of anemia depends on the specific type of anemia, Berliner said, and anemias caused by nutritional deficiencies respond well to changes in diet. People with iron-deficiency anemia may need to take supplemental iron for several months or longer to replenish blood levels of the mineral. Some people, especially pregnant women, may find it hard to take iron because it causes side effects, such as an upset stomach or constipation, Berliner said.

For vitamin-deficiency anemias, treatment with B12 or folate from supplements (or a B12 shot) and foods, can improve levels of these nutrients in the blood, Berliner said.

Serious problems, such as aplastic anemia, which involves bone marrow failure, may be treated with medications and blood transfusions. Severe forms of thalassemia might need frequent blood transfusions.

Treatment for sickle cell anemia may include pain medications, blood transfusions or a bone marrow transplant.

Additional resources:

This article is for informational purposes only, and is not meant to offer medical advice.

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Cannabis and integrative medicine in Canada – Health Europa

February 8th, 2020 9:48 pm

Dr Dani Gordon is a double board-certified medical doctor, working with integrative medicine, as well as wellness expert and leading expert in clinical cannabis/cannabinoid medicine after treating 2500+ patients in Canada in a referral complex chronic disease practice where she specialised in neurological disorders, chronic pain and mental health conditions.

She speaks internationally on cannabinoid medicine and in mid-2018 moved to London to train the UKs first cannabis medicine specialist physicians, developing a leading online cannabis medicine physician training programme, helping to set up the UKs first cannabis medicine clinics and become a founding member of the UK Medical Cannabis Clinicians Society (MCCS), delivering the MCCS guidelines to 10 Downing Street.

Gordon is an American Board Specialist in Integrative Medicine, the newest American sub-specialty of mainstream medicine, focussed on the intersection of conventional and natural evidence-based medicine and therapeutics and she has studied herbal medicine and meditation extensively throughout India and south east Asia with traditional teachers, mind-body medicine at Harvard, neurofeedback brain training and EEG brain imaging techniques with leaders in the field in North America.

Here, she speaks to Health Europa Quarterly about her extensive background in cannabis medicine, patient experience, and the representation of women in the rapidly evolving industry.

I am medical doctor and Im trained in both integrative medicine, which is natural evidence-based medicine and a recognised speciality. I am also trained in family medicine in Canada, and I specialise specifically in herbal medicine, cannabinoid medicine as part of my integrative medicine practice.

I have been practising integrative medicine for the last decade in Canada and that is mostly what I do in my clinical practice. Around four years ago, I started experimenting with medical cannabis and I have been running a complex chronic disease clinic with a focus on medical cannabis for the last four years in Canada; at this point I have treated thousands of patients using medical cannabis and CBD.

I have also trained medical students, physicians and allied health care providers on how to use cannabis medicine. I am a writer, and I speak worldwide on cannabis medicine and other natural evidence-based medicine topics and integrative medicine. Last year I relocated back to the UK where Im also a citizen to get involved on this side of the pond.

Since that time, Ive been involved in quite a few major projects here, I advise on some of the high profile child epilepsy cases, and Im the vice chair of the Medical Cannabis Clinicians Society. I advise companies and I have overseen training the first group of UK specialist doctors in cannabis medicine along with overseeing the curriculum for the Academy of Medical Cannabis, which is the main body established to educate physicians and researchers on medical cannabis.

Integrative medicine is a subspecialty which started out in the States. I already had my postdoctoral fellowship and you already need to be a doctor to take the fellowship programme. Its a two-year fellowship which I completed in 2012 in the US, and the reason I decided to do it is because I was practising as a holistic medical doctor in Canada. I was already a conventionally trained medical doctor with the qualifications I had, but I wanted to add to my practice natural things such as herbal medicine, mindfulness-based stress reduction techniques and mind- body techniques for the benefit of my chronic disease patients.

I went to the states and completed this training in 2012, because there was no postdoctoral level training in natural medicine and I really wanted to have the most bona fide qualification. Since 2012, it has now become a fully recognised speciality in medicine in the US. Initially I wasnt interested in integrative medicine when I started my practice in 2009 as a family doctor helping people with chronic disease was my main interest. I realised that just using pharmaceutical drugs alone for complex chronic diseases, were not really cutting the mustard so to speak. It just wasnt really working very well for a lot of my patients with anxiety, stress related disorders, mental health conditions, fibromyalgia, chronic fatigue syndrome, chronic pain and sleeping problems. Pharmaceutical drugs were just not helping enough on their own.

I became interested in cannabis specifically in 2015. At that time, I had been practising with herbal medicines and conventional drugs for almost half a decade. A lot of my patients started to tell me about their experiences with using cannabis therapeutically because I practised herbal medicine as well as the conventional kind.

I was really interested in the things they were doing, for example some of my patients were juicing cannabis in its raw form and saying that it didnt make them feel high. They explained that it was really a health supplement that their parents generation had been using it in West coast Canada where a lot of people grow cannabis on their land. That got me really interested in why they were juicing it and not getting high and what was what was happening with this plant; as a herbalist I became very intrigued.

I also had a few patients who were at the end of their life with terrible cancers and they told me how they were taking homemade cannabis tinctures to help reduce their morphine needs so that they could be more aware and alert. It allowed them to manage their pain, experience better quality of life and spend more time with their families in their final days.

I started to investigate it from there to find out how I could introduce it into my practice, so people wouldnt need to experiment with it alone and in isolation. I sought out additional training in cannabis medicine, and just found a few mentors but back in 2015, there really wasnt that much awareness. I started opening my door to cannabis medicine being included in my practice through the Health Canada legal system and I just started learning hand in hand with my patients. I was reading all the latest research and working with the plant just as I did with all my other herbal medicine practise. I started to see all these incredible changes in my patients so that really spurred me on to continue.

When I first started out in cannabis medicine, I was actually quite sceptical because I had a lot of ingrained training from medical school that cannabis was an addictive drug that it was going to make people lazy, hurt their brains and make them more tired.

What I found was the patients who were in orphan disease categories with conditions such as fibromyalgia, chronic fatigue syndrome, chronic anxiety and chronic depression, chronic pain were improving when nothing else we had tried previously was really effective. When I started to study the endocannabinoid system, which is the cannabis system we have in our own bodies It made sense because essentially the cannabis plant regulates our own cannabis system which is involved in processes such as regulating our mood and pain signals.

We [doctors and researchers specialising in cannabis medicine] think that a deficient endocannabinoid system also known as Endocannabinoid Deficiency Syndrome theory may play a role in all of these overlapping symptom clusters that are very, very difficult to treat. Conditions such as irritable bowel syndrome, fibromyalgia, chronic daily headaches, chronic migraine, chronic depression and anxiety all these issues sometimes improve using traditional drugs, but it usually doesnt provide a good solution with few side effects.

What I started to do with cannabis is adding in different forms of cannabis medicines primarily the low THC and high CBD strains of the plant and then selecting different strains of the plant more specifically. I found with my background as a herbalist I was able to really personalise the therapy.

With many of my patients who suffered from chronic mental health conditions, I really wanted to get them practising something called Mindfulness Based Stress Reduction (MBSR) which I went to Harvard to study alongside some of the top researchers in the world. I really believe in it; however, it is not a quick fix. Unfortunately, people with chronic pain and chronic mental health conditions are often so poorly that they cant summon the mental effort to keep the practise going long enough for it to start working.

Once I got them onto cannabis, even the low THC cannabis which did not make them feel high, I started to get them to use it before their mindfulness or meditation practise. I found that they started to do more mindfulness and from there they started to exercise more because they werent fatigued. Many patients started to lose weight and become more social; it was kind of a snowball effect that allowed them to do a lot of other things. It allowed them to engage with a lot of non-drug therapies such as CBT that they couldnt engage with before because they were too ill.

I think its been enormously important to the patient experience and I have to say that it has reinvigorated my love of medicine in many ways. It is the kind of medicine that is very well tolerated by most people and helps them with their quality of life so greatly, even though it doesnt cure their condition.

We dont know that cannabis cant cure things and maybe one day we can figure that out, but for now its about quality of life. It has changed my patients lives in ways I could never imagine. Nobody Ive ever prescribed an antidepressant to has ever said to me this has changed my life, but daily and weekly in my practice, I get letters from patients and verbal testimonials that starting them on cannabis has saved their marriage, or completely changed the relationship they have with their children because they can engage with their family life again.

I have seen patients who were so debilitated by very advanced arthritis that they couldnt work or play music anymore and they are able to go back to those things. I had one patient who surprised me with a concert; he hadnt played in 10 years and he was very depressed because his hands were so painful.

I have seen ranchers who live out in the middle of the countryside in Alberta who couldnt get on their horse anymore to round up their cattle and when I did a follow up consultation via a video app, they took me with them on a ranch ride for the first time in five years. It had been five years since theyd been on the horse.

Ive treated young adults with epilepsy who had been told that they would never be independent and that they were going to be in a care home for the rest of their lives, and seen them be able to go to a part time job and get an animal to keep them company these things were not possible before. It changes the whole familys lives not just the person with epilepsy. As far as a single thing I can give someone, although its not a cure it has been the single most powerful tool that I have found so far since going from a Western medicine doctor to a herbal medicine doctor.

One of the things that I get very excited about is changing the perception of cannabis because I think the old perception of cannabis was this kind of stoner culture. On the recreational side of cannabis, which is very different to the medical side. Its not a very wholesome image.

The images that were portrayed of women were often women in bikinis smoking cannabis which are not necessarily positive images of women in general and definitely not the image of cannabis the medicine as I practise it. I feel very lucky to be involved in kind of seeing the transformation of the image of the plant because a hundred years ago, it was a perfectly respectable botanical medicine and its coming full circle back to that.

I feel that women have played a large role in that to be honest, and really introducing a balanced movement into the modern era. It isnt just me, there is Hannahs Deacon, Alfies mother and Charlie Caldwell these are the women who have had kids with epilepsy and have had to fight for access to the treatment. Carly Barton is a good friend of mine and a patient advocate. I have needed and developed a network of women and through social media many of them have become my friends. I think it has been a powerful tool for connecting and empowering women.

One thing that you do find when you enter the business side of the cannabis world is a lot of the people may have come from a traditionally male dominated industry. Often, when I go to give a talk, I will be one of the only women there, but I do feel that is already changing. It is certainly the case that as with many male dominated, corporate professions, women are generally underrepresented which is something needs to be taken seriously; we might potentially have to work harder than men.

Dr Dani GordonIntegrative Medicine Specialistdrdanigordon.com

Please note, this article appeared in issue 11 ofHealth Europa Quarterly, which is available to read now.

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Vibroacoustic Therapy Shows Brain and Sleep Quality Benefits in Clinical Trial for Insomnia – Sleep Review

February 8th, 2020 9:48 pm

Many people find it easier to sleep in a car or a train because of the vibration and noise that helps rock them to sleep. But a more specific approach for using a vibratory and auditory stimulation program helps improve brain function and sleep amount and quality in patients with insomnia, according to a study published in the journal Sleep Disorders.

Using fMRI scans, the study found improvements in the functional connectivity in the brain as well as in measured amount of minutes slept and self-reported sleep quality. The areas of the brain that were affected were a combination of areas that are involved in sleep itself as well as areas that have improved function as the result of having better sleep. Such an approach might be particularly useful for people with insomnia by helping them to improve their amount and quality of sleep. The study was performed by the Department of Integrative Medicine and Nutritional Sciences, as well as the Departments of Neurology and Radiology, at Thomas Jefferson University.

Approaches that use a combination of vibratory and auditory stimulation have the goal of matching the brains natural rhythms and help improve the amount and quality of sleep. Another goal is to help improve the brain areas affected by a lack of sleep. The current study found changes in areas of the brain associated with both auditory and vibratory sensation. In addition, areas such as the thalamus and prefrontal cortex, which are critical for memory and cognition, were also affected. The current study tested this by tracking changes in functional connectivity using resting state fMRI.

This study is essential for understanding how vibratory and auditory stimulation can improve sleep amount and sleep quality in insomnia patients, says senior author on the paper Daniel Monti, MD, chairman of the Department of Integrative Medicine and Nutritional Sciences and Director of the Marcus Institute of Integrative Health at Thomas Jefferson University, in a release. The study shows how the intervention has a direct effect on vibratory and auditory processing areas of the brain, as well as on important cognitive areas that are impaired when people dont get enough sleep,

This study evaluated 30 patients with insomnia symptoms who continued their current treatments and were placed into two groupsthe first group received the auditory and vibratory stimulation for approximately one month; and the second group, the control patients, received only their standard-of-care treatment for insomnia for the same time period. Those patients in the active group were given an auditory stimulation program, lasting approximately 60 minutes that they used each night as they went to sleep. In addition, they came into the Marcus Institute of Integrative Health twice a week to receive a combination of vibratory and auditory stimulation for 24 minutes using a specially designed chair that merges the two stimuli. This combination of the vibration and auditory stimulation during the day, coupled with the auditory stimulation during sleep, is supposed to help the brain enter the sleep state more effectively.

Patients underwent brain scanning using resting state fMRI to measure functional connectivity that evaluates how different parts of the brain interact with each other at the start of the study and after a month. Changes in brain connectivity reveal how the brain rewires itself when people are sleeping better. Some of the changes are related to the effects of the therapy itselfthe impact of vibration on sensory areas of the brain and some are related to the effects of improved sleep. This fMRI scan was used to determine the changes in brain function associated with auditory and vibratory stimulation in patients with insomnia. Patients also were evaluated clinically using several different measures of sleep quality and quality of life.

Compared to controls, the patients receiving the auditory and vibratory stimulation had significant changes in functional connectivity in the sensory and auditory receptive areas of the brainshowing how the stimulation seemed to be having its effect. In addition, areas involved in higher cognitive and executive functions, such as the thalamus and prefrontal cortex, were significantly affectedshowing that improved sleep improves your brains function.

This is an exciting study that shows how vibration and sound stimulation affect the brain and improve sleep in patients with insomnia and could have important implications for better managing patients with sleep problems, says corresponding author and neuro-imaging expert Andrew Newberg, MD, professor and director of research at the Department of Integrative Medicine and Nutritional Sciences. The investigators hope that this research will open up new avenues of treatment for insomnia patients.

There are no conflicts of interest. The study was funded by a gift from the Marcus Foundation.

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"Depression Naps" Are a ThingBut Here’s What You Should Be Doing Instead – Yahoo Lifestyle

February 8th, 2020 9:48 pm

Anyone who has spent time on Twitter lately has likely read about #depressionnaps. People usually take these naps to escape emotions, surrender to depression, and temporarily avoid anything negative in your lifeand while the connotations are serious in theory, Twitter users have quickly escalated depression naps to meme status.

According to Daniel Amen, MD, a psychiatrist and best-selling author, depression is a common problem among women especially. He says that "20% of teen girls meet the clinical criteria for depression and 23% of women [are] taking antidepressant medication." Admittedly, it is tempting to escape our problemsbut is it the right thing to do?

If you have ever taken a depression nap, you are probably familiar with that crushing realization upon waking that your problems are still there. Depression naps can even make the problem worse. Jessica Renz, Psy.D., co-founder and licensed clinical psychologist at MindWell NYC, says that depression naps aren't the answer. They prevent you from actively participating in your life. "These naps feed the cycle of shame, blame, negative self-talk, and inaction that are major symptoms of depression," she says. Plus, they can throw off your sleep/wake cycle and makesleeping harder at night.

Here are seven healthier things you can do instead of heading for the covers when depression strikes.

It's no wonder that many experts recommend pets for seniors and have therapy pets visiting children's hospitals. Pets are healing. Studies have shown that just petting a live animal reduces anxietyany animal. Plus, animals like dogs need walkinghey, anything that will get you out the door and in the fresh air, right? If you're unable to own a pet, volunteering at your local shelter is a good way to get animal time without a long-term commitment.

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Grateful people are happier people. Renz suggests that you spend three minutes a day writing down at least three to five things you are grateful for. Of course, if you think of more than five things you're grateful for, don't stop there. The more, the better. Starting off (or ending) your day with gratitude will give you the framework for a better day.

Sunlight has been proven to help with seasonal affective disorder (SAD). Elizabeth Trattner, an acupuncture physician and doctor of integrative medicine, says that sunlight boosts the production of hormones that help depression and creates endorphins that make you feel better.Wearing sunscreen is still a good idea though and will protect your tender skin against sun damage.

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Tackling a big issue or dilemmamay make you want to head straight for bed, but breaking your task into smaller parts and taking one item at a time makes your goal look and feel more attainable. Plus, if youre feeling unmotivated and depressed about what you have to do, Renz says that rewarding yourself after checking off a task can be a magic bullet in breaking apart the cycle of depression.

Serving another personor even reaching out to a loved one takes the focus off you for a minute. It is easy to get absorbed in our own problems, but helping someone else with theirs can put things in perspective and give you a much-needed break from your own. Renz suggests that you stay focused on the other person in that interaction as much as possible.

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Since the early 1900s, researchers have been interested in the connection between exercise and depression. Exercise is very effective in treating its symptoms. Researchers have concluded that what matters is how often you exercise, not how hard you exercise. Trattner, an integrative medicine doctor, says that the Chinese have been prescribing exercise for their patients for centuries as a way to move chi and make a patient feel better. She says that even a light walk will help.

If you'resleeping at night but still sleepy during the day, you might have a problem other than depression. Amen suggests that you should be checked for thyroid problems or exposure to toxins such as mold. Additionally, obstructive sleep apnea (OSA) is a serious medical condition that can cause sleepiness, depression, and can even result in death. It's estimated that 22 million Americans have OSA. A physical may help you uncover the cause of your sleepiness and what should be done to treat it.

"The bottom line is that we need to do the opposite of what depression tells us to do. Get out, get moving, and get rewarded," says Renz. It may be funny on Twitter, but frequent depression naps can be a sign that things aren't right in your life. And that's no joke.

Next up: Is It Bad to Sleep on Your Stomach? We Asked a Doctor

This post has been updated by Sarah Yang.

This article originally appeared on The Thirty

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The (over) promise of the mindfulness revolution – San Francisco Chronicle

February 8th, 2020 9:48 pm

The phones screen turns a serene blue, and Calm, the leading mindfulness application, opens. At the very center, without capitalization or punctuation, small and faint, are the words take a deep breath.

That gives way to a menu. What brings you to Calm?

The app offers options to reduce anxiety, develop gratitude, build self esteem, even increase happiness.

The next screen offers a seven-day free trial. Once the trial has ended, the annual rate is $69.99, a small price for happiness.

Somewhere around 2010, according to experts and Google search data, the practice of mindfulness began an upward swing. In less than a decade, it has become the fastest-growing health trend in the United States, according to the federal Centers for Disease Control and Prevention. Mindfulness rules the online app store. The San Francisco-based Calm is valued at $1 billion, and its competitor Headspace at $350 million. (The industry as a whole has been estimated to be worth as much as $4 billion.) Meditation retreats are en vogue. Corporations offer access to mindfulness in the same way they do for gyms. Even the military uses mindfulness breathing techniques to boost soldiers performance.

But as with any Next Big Thing, there are reasons to be cautious. Some say this rush into mindfulness has outpaced the science and stripped it of its cultural context. All of this threatens to turn a tool for well-being, for situating oneself in the current moment, into a tool for standard American commercialism.

Around the same time mindfulness began its upward trajectory, Ronald Purser, a management professor at San Francisco State University, started to feel the familiar weight of doubt. Hed been doing a fair amount of corporate management training and consulting redesigning the workplace to work better, at least in theory, for everybody. I became somewhat disillusioned and disenchanted, he says. Even when we were making progress, trying to redesign work so employees would have more autonomy and decision-making, the management sort of pulled the plug on some of those experiments.

It was around this time, too, that Chade-Meng Tan, a software engineer at Google, gained notoriety for integrating mindfulness into Googles corporate culture through a series of in-house mindfulness seminars. In 2012, Tan turned those courses into a blockbuster book, Search Inside Yourself: The Unexpected Path to Achieving Success, Happiness (and World Peace), and Purser found himself attending Tans very first public offering.

I became very disappointed by what I saw, just in terms of what the program was and how superficial it was, Purser says. I just saw this as part of the interest in behavioral science techniques as a way of yoking the interest or subjectivity of employees to corporate goals.

A year later, Purser published an essay with the Huffington Post. It was titled Beyond McMindfulness. Mindfulness meditation, he wrote, was making its way into schools, corporations, prisons, and government agencies including the U.S. military. Purser, a student of mindfulness for 40 years, wasnt knocking the practice but was wary of its growing reputation as a universal panacea for resolving almost every area of daily concern. Last year, Purser expanded on the essay and published a book titled McMindfulness: How Mindfulness Became the New Capitalist Spirituality.

Early on in his book, he writes this: I do not question the value of adapting mindfulness for therapeutic use, nor do I deny that it can help people. What bothers me is how its promoters want things both ways: one minute, mindfulness is science, since thats what sells; the next, it stands for everything in Buddhism, since thats what makes it sound deep.

The issues Purser called out eight years ago have only grown with time. Rhetoric, he says, still outpaces results. The practice becomes increasingly decontextualized, meme-ified and gamified. Mindfulness becomes a cure for more and more our happiness, our anxiety, our pain, even world peace.

Its worth pausing a moment to define or at least try to define mindfulness.

At its very core, its deepest and truest roots, mindfulness is a Buddhist meditation technique. There are hundreds, probably thousands of different meditative techniques. This is only one of them, says Mushim Ikeda, a Buddhist meditation teacher. Traditionally, in the Buddhist scriptures, it is said that what we call mindfulness meditation was one of 40 different techniques that the historical Buddha, the one we call the Buddha, talked about. So it wasnt even his one and only meditation technique according to those scriptures.

She knows those scriptures well. Ikeda, who primarily teaches at the East Bay Meditation Center, describes herself as a socially engaged teacher a social justice activist, author, and diversity and inclusion facilitator.

She describes mindfulness meditation as a secular term in Buddhism, one thats also called insight meditation. This is a sort of awareness, she says, that is different from the awareness that we might call everyday awareness the sort we need to drive a car, or maintain a conversation, or use an ATM. She and others describe mindful awareness as spacious and nonjudgmental. Ikeda says, Its been said mindfulness only sees. It does not judge.

The most common technique involves closing the eyes and focusing on the breath and only the breath, moving other thoughts, and the thoughts that come with those thoughts, away and out.

Mindfulness as a secular, western therapeutic intervention did not begin in Silicon Valley. Rather, youd have to go back to 1979 and a man named Jon Kabat-Zinn and the founding of the Stress Reduction Clinic at the University of Massachusetts Medical School. Kabat-Zinn has studied the effects of what he dubbed mindfulness-based stress reduction (MBSR for short), on everything from brain function to skin disease.

Still, its hard to ignore Silicon Valleys latest role in spreading and expanding mindfulness in the pursuit of a different tech culture value, peak performance. There is Search Inside Yourself, the book that coincided with the movements growth spurt. There are Twitter co-founder Jack Dorseys much-publicized meditation retreats. (Black Mirror, the dystopian science fiction show, seemed to parody both him and the now-ubiquitous apps.) Recently, there was the dopamine fast, a pseudo-scientific dopamine reset by way of doing nothing. (One originator said he drew directly from Buddhist Vipassana meditation when he crafted the fast.)

The voices are soothing and smooth soft, but not quite a whisper. The cadence and diction perfect, gently pulling you along. Birds chatter in the background. Waves move gently to meet a beach. Or maybe a brook babbles as it pushes over and under and between river rocks.

Breathing in ... I am calm.

Breathing out ... I am at peace.

A chime rings, a signal that this 90-second meditation to calm anger has ended. Calm offers its congratulations.

The danger in this rapid evolution is that it threatens to turn a very old practice into a fad that overpromises and underdelivers.

Helen Weng has practiced Buddhist meditation for more than two decades. I was reading a lot of books about psychology because I was unhappy because high school is horrible, she says. And her father, who, along with her mother, had immigrated to the United States from Taiwan, could offer her books about Buddhist philosophy. The two came together. The Dalai Lamas teachings offered her an opportunity to cultivate her own well-being. I dont like the word happiness anymore, but you can use mental exercises to become more aware of your feeling states and your thoughts.

Now Weng works as a clinical psychologist with the psychiatry department at UCSF and a neuroscientist with the Osher Center for Integrative Medicine and the Neuroscape Center, both at UCSF as well. Her scientific work uses magnetic resonance imaging to measure the amount of oxygen in the blood that flows to the brain as people meditate. Essentially, she can track whether the meditator is actually focused on their breath or if their attention has wandered. And in her clinical work, she offers meditation as one of many possible therapeutic interventions.

Still, she calls the recent spread of mindfulness very freaky.

Im very proud that practices from eastern cultures and religions generate so much interest, she says. At the same time, mindfulness and its results are super hard to study. So much so that I just thought I was a bad scientist for a long time. Whats more, she says, meditation isnt always the right sort of behavioral therapy.

Im very disturbed by these messages that meditation basically cures everything or its good for everyone or theres universally very good positive effects. The effects are really moderate and subtle. Its not any better than any other kind of psychotherapy, she says. Part of it is cultural appropriation where its this magical, mystical thing that then people can say does all these things, and I think were still in the height of that and its going to take some time for things to settle down.

Medical students, she says, inevitably ask her how much time they have to commit to mindfulness to make it work. There are studies that show clear benefits to mindfulness. Weng points to one that indicated 30 minutes a day of compassion meditation for two weeks increased altruistic giving to strangers and brain responses to pictures of people suffering.

But the key here is consistency. What happens if you work out for 30 minutes just once? she asks. It benefits you a little bit. Thats good. But if you just do it once, its not going to have a long-term effect.

After the chime and the congratulations, the waves keep moving in and out, and a quote appears onscreen. Insanity is doing the same thing over and over again expecting different results. (A quote sometimes attributed to Albert Einstein, but probably more correctly attributed to Narcotics Anonymous.) And in that moment, Calm reminds you that you really should turn on push notifications, in order to fully experience Calm. Decline and itll ask one more time about its mindfulness reminders.

Are you sure? Its hard to set aside time for yourself in our busy world without a little help.

Farrah Fawcett and Lee Majors are jogging. Theyre tan, of course. Their shorts are short. Her blond hair is fanned out, so are his brown curls. She has a broad, blindingly white smile and a red handkerchief tied around her neck. His jacket is zipped down almost to his navel; his chest is hairy. And right beside them, a headline: Farrah & Lee & Everybodys Doing It: Stars Join The Jogging Craze.

This is the cover of the July 4, 1977, issue of People magazine. Alex Will, the chief strategy officer for Calm, the industry-leading mindfulness meditation app, likes to reference this cover when he talks about mindfulness. (Theres even a copy of the issue at the office.) To understand the future of mindfulness, just look to the past.

Mindfulness is becoming mainstream, Will says. People are starting to understand that taking care of the mind is just as important as taking care of the body. Meditation and mindfulness is one way to do that.

In some respects, Calm isnt doing anything that hasnt already been done. Before smartphones, one could buy a meditation CD, slip it into a home stereo and start counting breaths. The app just makes it more portable and more accessible than ever before. I think one of the reasons Ive been so successful is that it is a very low bar for someone to try and get into, Will says. There are short, two-minute long meditations, narrations to help with sleep, even a beginners guide to mindfulness. Similarly, if you want to go deeper, we have a 30-minute master class where you can learn how to break bad habits.

All of the content, Will says, is vetted by mindfulness instructors, and, now that the app is available in more than 100 countries, the programming is also run by people to make sure translations work. This is very nuanced, he says. Language really matters. The Calm app has also been part of various clinical studies in an attempt to back up the applications rhetoric.

Mindfulness, by the way, has already had its magazine-cover moment. Not quite 37 years after the jogging craze, Time magazine featured the Mindfulness Revolution on its Feb. 3, 2014, issue. A blond, fair-skinned model stands straight, hands at her sides, eyes closed, face slightly upward. And the headline: The science of finding focus in a stressed-out multitasking culture.

Mindfulness began to trend in large part because corporations embraced the practice as a way to help employees relieve stress. This is one of the cruxes of Pursers concerns that mindfulness is just a way to wring more productivity from employees, a sleight of hand that shifts the onus from the company to the worker.

In 2012, the year Chade-Meng Tan published Search Inside Yourself, the idea of offering mindfulness courses to employees still felt novel. The New York Times featured Tan and the course hed developed for Google employees a course that involved meditation, Tibetan brass bowls, stream-of-consciousness journaling and lots of emotional openness. Even then the course was framed as a way to help employees deal with their intense workplace no mention of toning down the intensity.

Eight years later, mindfulness courses are the rule, not the exception. Apple, Nike, HBO and Target have all offered some form of mindfulness training to employees. Aetna, the insurance provider, decided to offer mindfulness and other stress-relief activities (including dog petting) after an internal study found that the most stressed-out employees spent $1,500 more a year on health care. And if a company cant bring a trained expert on board, well, they can always give employees memberships to Calm or Headspace.

The Buddha taught that almost everything comes and goes, says Muslim Ikeda, the East Bay Meditation Center instructor. Its called impermanence or change. And health trends famously come and go. Its a product of our capitalist system.

One year, its a certain kind of berry thats going to cure everything. Another year, its mindfulness meditation thats going to cure everything. Five years from now, heaven only knows, itll be something else. Burnt toast who knows?

Ikeda offers a path forward, a path separate from capitalism, a path that encourages students to cultivate a practice in which they care for themselves so that they may, in turn, care for their communities. Its an approach based in social justice and altruism. And yet, she isnt dogmatic.

Mindfulness, Ikeda says, does not judge.

A person might use mindfulness to lower their blood pressure or achieve peak performance. A corporation might use mindfulness to paper over an inherently unjust and healthy system. All this, she says, is like using a Swiss Army knife for just one thing. Its not what the tool was intended to do, and its not all it can do.

Mindfulness is always mindful awareness of something, Ikeda says. Who knows what a given individual is going to do with it? Or what it will do for them?

An individual might, for instance, become mindfully aware of a broken system.

Ryan Kost is a San Francisco Chronicle staff writer. Email: rkost@sfchronicle.com. Twitter: @RyanKost

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Continuing to work while going through cancer treatment? These tips can help – telegraphherald.com

February 8th, 2020 9:48 pm

The diagnosis of cancer can turn your life upside down in a matter of minutes.

It is a life-altering experience that can be a cause for a lot of stress on the individual who received the diagnosis, as well as family members and caretakers. There are many things to think about when the diagnosis is made, including whether or not youll need to continue working throughout your treatment.

Holistic therapies can aid in the reduction of stress and ease the side effects of treatment if having to work while going through cancer.

Having cancer does not necessarily mean that you will have to stop working. Most likely you will need time off for appointments, treatments or extra rest. You might decide to work as much as possible or take a leave of absence and return when you feel up to it. Or you might have to continue to work for financial reasons and/or health insurance benefits.

One benefit of working while going through cancer is that going to work can help you feel more normal.

If you decide to continue working, it could take some adjusting. Your body might respond differently to normal activities when you have cancer or are going through treatment. You might feel tired, more stressed, have pain or difficulty thinking or remembering things.

Something to consider during this trying time are the benefits of integrative health. Integrative health is the unity of conventional and holistic medicine. It is a healing-oriented model that considers the whole person body, mind, spirit and lifestyle. It uses all appropriate therapies, both conventional and alternative, and focuses on the needs, values and well-being of the person.

Here are some holistic measures to help reduce stress and side effects of treatment:

Conserve energy. Take short breaks as needed throughout your workday to keep your energy up.

Be mindful of your innermost desires and acclimate optimism into your daily thoughts. Take time for yourself to reflect, soul search and nourish the soul. A positive mental attitude during this trying time can help heal the body and reduce stress.

Consider meditation practices. Meditation clears space in your head. Apps such as Insight Timer and Headspace are great places to start.

Use reminder lists and alarms to remember your meetings or tasks. Write a list of tasks that need to be completed for the day. A daily planner, Post-it Notes or use of a smartphone might be helpful tools. Set alarms to help remind you of the tasks that need to be accomplished.

Be open and honest about your situation. Talk with your manager about any concerns. Share your feelings and concerns with your family members and health care team.

Fuel your body with good nutrition. This will help to provide optimal energy throughout the day. A dietitian with experience in oncology nutrition can help you develop a plan.

Consider using essential oils. Aromatherapy can help ease anxiety, pain and nausea symptoms. A clinical aromatherapist can help guide you on which essential oils would be beneficial.

It is important to know your rights. Side effects of cancer treatment are considered disabilities under the American Disabilities Act. Your employer must provide reasonable accommodations according to the American Society of Clinical Oncology. These can include:

Giving you breaks to take medication, see a doctor or rest.

Having you do a job that fits your new hours or abilities better.

Giving you access to counseling through an employee assistance program.

Please remember, you are not in this alone. We live in a wonderful community where people care and want to help in any way they can. Seek out services offered by the community. There are many support groups and valuable resources available to help you and your loved ones through this healing journey.

Jessica Kennedy, BSN, RN, CHC, CMSRN, Jessica is a nurse at MercyOne Dubuque Medical Center.

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UK expert calls for integration of medicine to combat cancer – The New Indian Express

February 8th, 2020 9:48 pm

By Express News Service

KOCHI: Time for integration has come and it is not because allopathic medicines fail in treatment but rather it is the demand of the people and patients worldwide, said Dr Michael Dixon, Chair-College of Medicine and Integrated Health, UK, and Visiting Professor, University of Westminster and University College London, while inaugurating the two-day International Conference on Integrative Oncology 2020 (ICIO 2020) at Le Meridien, here on Saturday. The conference is being organised by the Global Homeopathy Foundation (GHF).

Dr Dixon called upon integration of various medical streams while combating diseases. He pointed out that anti-microbial resistance, over-prescription of opiates (drugs derived from opium) and over-prescription of conventional medicines have compounded the situation. Enormous issues persist back in United Kingdom (UK), National Health Services (NHS) England banned herbal and homoeopathic medicines while Royal College of General Practitioners asked general practitioners not to offer Homoeopathy and National Institute for Clinical Excellence changed guidelines on palliative care and back pain, said Dr Dixon.

However, he said the good news is that at last AYUSH has arrived in UK with College of Medicine and Integrated Health taking the lead and it is also forming an Integrated Medical Alliance apart from organising a yoga conference. Integration of medical systems is of paramount importance in oncology for prevention, treatment, treating side-effects of conventional medicine and preventing recurrence, he said.Those who addressed the inaugural function included Dr Jayesh Sanghavi, vice- chairman GHF, Dr T K Harindranath, president, Indian Homoeopathic Medical Association, Dr Piyush Joshi, secretary general, Homoeopathic Medical Association of India, Dr Eswaradas, chairman, GHF, Dr Issac Mathai, Soukya Holistic Clinic, Dr Velavan, Radiation Oncologist, Erode Cancer Centre, Dr Sandeep Roy, chairman, organising committee ICIO 2020, Dr Madhavan Nambiar IAS (retd), Patron GHF and Dr Sreevals G Menon, Managing Trustee, GHF.

Over a thousand delegates from 30 countries apart from India are attending the event. Around 25 key scientific papers are being presented at the summit. ICIO 2020 is held in association with Central Health & FW Ministry, AYUSH/TCAM Ministry, all AYUSH/TCAM research councils and the governments of Kerala and Maharashtra, and National AYUSH Mission.

PRESENTATIONSDr Vinu Krishnan, member, sub-committee on cancer, Central Council for Research in Homoeopathy, New Delhi, presented a paper on Analysis and observations of stage 3 and 4 lung cancers using homoeopathic interventions while Dr K M Madhu, superintendent, Kottakkal Arya Vaidya Sala Ayurvedic Hospital and Research Centre, Kochi, presented a paper Integrative oncology-an ayurvedic approach. Dr Bindu John Pulparambil, RMO, Government Homoeo Hospital, Thiruvananthapuram, presented a paper on palliative care while Dr Ravi Doctor, associate professor with Virar Homoeopathic Medical College, Mumbai, dealt on clinical assessment of homoeopathy and its role in survival in third and fourth stage cancers. Dr Surendran Veeraiah of Cancer Institute (WIA) presented a paper on psychosocial care in oncology.

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