StemCell Therapy

The 2010s were the decade in which we were reminded that science is just a method, like the rhythm method. And just like the rhythm method, it can be more or less rigorously applied, sabotaged, overrated, underrated and ignored. If you dont treat it with respect, you may not get the optimal result, but thats not the methods fault.

That may be where the similarities end, because when its done well, science is very effective, and this decade furnished its fair share of breakthroughs to make us gasp. Physicists detected phenomena that were predicted decades ago gravitational waves, the Higgs boson particle indicating that they have been on broadly the right track in their understanding of how the universe works. Astronomers added awe-inspiring detail. Nasa probes found towering ice mountains on Pluto and organic chemistry the stuff of life on Mars and a moon of Saturn. And who could forget the exoplanets those planets orbiting distant stars? Thousands of them were discovered in just the past 10 years. No wonder science fiction is booming.

Biologists didnt slack either. They honed an immunological defence mechanism found in bacteria, Crispr-Cas9, into a powerful gene-editing tool that works in plants and animals including humans. They added several new ancestors to the human family tree and discovered ghostly traces of others as yet unseen and unnamed. And very old DNA started giving up its secrets, after researchers succeeded in extracting it from ancient bodily remains and sequencing it. This threw open a huge window on our species past, revealing that every person alive today is the product of multiple migrations and that relations between different waves of migration have always been complicated. Neanderthals and modern humans probably clobbered each other, for example, but they also interbred.

But this was also the decade in which science was commandeered by all kinds of people with political, social and economic axes to grind. Ancient DNA researchers understood early on the potential for their discoveries to be politicised the science of human origins always has been but they still werent able to fully control the message. Thus we learned about white supremacists engaging in sinister milk-chugging parties in America, supposedly designed to smoke out people of non-European heritage who cant digest lactose, and baseless claims made by some Hindu nationalists that the speakers of the original Indo-European language hailed from the Indian subcontinent. Ancient DNA researchers themselves were accused of engaging in an undignified bone rush, and disrespecting indigenous remains.

Dissing the dead is one thing, dissing the living quite another. The world was shocked when, in 2018, the Chinese biophysicist He Jiankui announced he had used Crispr to edit the genomes of twin girls the first humans born with edited DNA they can pass on. Ethical concerns were raised over whos entitled to know what about private health records as genetic testing becomes mainstream, and over the prohibitive pricing of gene therapies after the first of these was approved in 2012 then taken off the market.

We welcomed the boon of artificial intelligence the fruit of massively increased computing power, cheap memory, advances in data management and new maths and statistics and fretted over its potential negative impact on us.

The first vaccine against Ebola was approved. In the Democratic Republic of the Congo, where Ebola continues to rage, health workers are battling not only the disease, but also hesitation about getting vaccinated. This is now a global problem, and though the reasons for it are complicated and vary according to who is hesitating in the UK and US Andrew Wakefield has a lot to answer for. He abused the scientific method in a previous decade, when he made false claims about a link between the MMR vaccine and autism. Fear of vaccines has come home to roost most visibly, in the form of a global resurgence of measles. Its not all down to him, though. Weve been so well served by vaccines that relatively few people alive today remember what life was like before them how, for example, people wept with joy when Jonas Salks polio vaccine was announced in 1955.

We heard a lot in this decade about how trust in experts has waned, but its difficult to know how much of that perception is real and how much of it comes down to minority opinions bellowed through the sousaphone of social media. In 2019, the US-based organisation Scholars at Risk reported that attacks on higher education communities had more than doubled globally over the previous three years ranging from restrictions on academic expression to wrongful imprisonment and even violence. On the other hand, surveys suggest that trust in scientists is quite stable over the long term, and science funding has been slowly increasing in the worlds richest countries.

Taken together, perhaps what these indicators reflect is that, like the rhythm method, the scientific method is one we should be glad to have in our armoury, but that both have the potential to wreak havoc in the context of a toxic relationship.

Laura Spinney is a science journalist based in Paris. Her latest book is Pale Rider: The Spanish Flu of 1918 and How it Changed the World

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Science made astonishing progress. It was also hijacked by those with an axe to grind - The Guardian

This article, written byMichael Mackley, Dalhousie University, originally appeared on The Conversation and is republished here with permission:

Youve likely heard about direct-to-consumer DNA testing kits. In the past few years, at-home genetic testing has been featured in the lyrics of chart-topping songs, and has helped police solve decades-old cold cases, including identifying the Golden State Killer in California.

Even if you dont find a DNA testing kit under your own Christmas tree, theres a good chance someone you know will.

Whether youre motivated to learn about your health or where your ancestors came from, it is important to understand how these tests work before you spit in the tube.

While exciting, there are things that these genetic testing kits cannot tell users and important personal implications that consumers should consider.

Health, traits and ancestry kits

My main area of research is around clinical genome sequencing, where we look through all of a persons DNA to help diagnose diseases. With a PhD in genetics, I often get questions from friends and family about which direct-to-consumer genetic test they should buy, or requests to discuss results. Most questions are about two types of products: ancestry and health kits.

The most popular ancestry kit is from AncestryDNA. These kits are aimed at giving users insight into where their ancestors might be from. They can also connect users with family members who have used the service and have opted into having their information shared. Another option is Living DNA, which has a smaller dataset but provides more precise information on the U.K. and Ireland.

The most popular health kit is from 23andMe. Depending on the users preference, results include information on predispositions for diseases such as diabetes and Alzheimers, as well as on the likelihood of having certain traits such as hair colour and taste. This company also offers ancestry analysis, as well as ancestry and trait-only kits that dont provide health information. The kit offered by the newer MyHeritage DNA also provides a combined ancestry and health option.

There are other kits out there claiming to evaluate everything from athletic potential to relationship compatibility. But gift-buyers beware: for most of these, in contrast to those above, the evidence is seriously lacking.

How these tests work

For all of these tests, customers receive a kit in the mail. The kits contain instructions for collecting a saliva sample, which you mail back to the company for analysis.

During this analysis, these popular tests do not look at the entire genome. Instead, they employ single nucleotide polymorphism (SNP) genotyping. As humans we all share 99.9 per cent of our DNA. SNPs are essentially what is left: all of the points at which we can differ from our neighbour, making us unique. SNP genotyping looks at a subset of these sites to survey the users genome.

These SNPs are then compared to reference datasets of individuals with known conditions or ancestry. Most results are based on the SNPs shared with a given group. For example, if your results say that you are 42 per cent Southeast Asian, its because 42 per cent of your SNPs were most likely to have come from a group in the reference dataset labelled Southeast Asian. The same goes for traits and health conditions.

How they differ from clinical tests

Direct-to-consumer genetic tests are not a substitute for clinical assessment. The methods used differ dramatically from what is done to diagnose genetic diseases.

In a clinical setting, when suspicion of a genetic condition is high, entire genes are often analyzed. These are genes where we understand how changes in the DNA cause cellular changes that can cause the disease. Furthermore, clinical assessment includes genetic counselling that is often key to understanding results.

In contrast, findings from direct-to-consumer genetic tests are often just statistical links; there is commonly no direct disease-causing effect from the SNPs.

Users may interpret a result as positive, when the risk increase is only minimal, or entirely false. These tests can also give false reassurance because they do not sequence genes in their entirety and can miss potentially harmful variants.

Before you spit in a tube, stop and think

These tests are exciting: they introduce new audiences to genetics and get people thinking about their health. Theyre also helping to build vast genetic databases from which medical research will be conducted.

But for individual users, there are important caveats to consider. Recent reports have questioned the accuracy of these tests: identical twins can receive different results. Furthermore, a lack of diversity in the reference data has caused particular concern regarding accuracy of results for ethnic minorities.

There are also concerns about the way these tests emphasize racial categories that science considers to be social constructs and biologically meaningless.

A recent paper in the British Medical Journal suggests four helpful questions for users to consider. First, users should ask themselves why they want the test. If it is to answer a medical question, then they should speak with their doctor. Users should also think about how they might feel when they receive results containing information they would rather not know.

Users should also consider issues around security and privacy. It is important to read the fine print of the service youre using, and determine whether youre comfortable sharing personal information, now and in the future.

In Canada, policies around genetics have not always kept up with the science. At present, direct-to-consumer genetic testing is unregulated. And, although Canadians have legislative protections against genetic discrimination, those laws are being challenged in the courts, and could change.

Finally, it may also be worth discussing DNA testing with relatives. We share half of our genome with our immediate family members, and smaller fractions with more distant relatives. Genetic results not only affect us, but our family.

Bottom line: Its all for fun

Some users may feel they learn more about themselves. For others, results may bring people closer together not a bad outcome for the holiday season.

At the end of the day, these genetic testing kits are for entertainment: they should not be used to assess health risk in any meaningful way.

If you have any questions related to your health or a genetic disease, discuss these with your family doctor or a suitable health-care professional.

Michael Mackley, Junior Fellow, MacEachen Institute for Public Policy and Governance; Medical Student, Dalhousie University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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DNA tests might be a fun holiday gift, but beware of the hype - HalifaxToday.ca

Based on the results of the pivotal HER2CLIMB Trial (NCT02614794) presented at the 42nd San Antonio Breast Cancer Symposium (SABCS) held in San Antonio, Texas, December 10 14, 2019, and data published in the New England Journal of Medicine (NEJM), Seattle Genetics confirmed that the company completed the submission of a New Drug Application (NDA) to the U.S. Food and Drug Administration (FDA) for tucatinib.

Tucatinib is an investigational, oral, small molecule tyrosine kinase inhibitor (TKI). Tyrosine kinases are enzymes that are a part of many cell functions, including cell signaling, growth, and division. But in some cases they may be too active or found at high levels in some types of cancer cells. In that case, blocking them may help keep cancer cells from growing.

Tucatinib is highly selective for HER2.

HER2-positive breast cancerPatients with HER2-positive breast cancer have tumors with high levels human epidermal growth factor receptor 2 (HER2), a protein which promotes the aggressive spread of cancer cells.

According to the American Cancer Society, in the United Stated, an estimated 271,270 new cases of invasive breast cancer were diagnosed in in 2019.[1] In addition, based on the available data, between 15% and 20% of all diagnosed breast cancer cases worldwide are HER2-positive.[2]

Historically, HER2-positive breast cancer tends to be more aggressive and more likely to recur than HER2-negative breast cancer.[2][3][4]

In patients with metastatic breast cancer, the most common site of first metastasis is in bone, followed by lung, brain, and liver.[5][6] In about 50% of metastatic HER2-positive breast cancer cases, patients develop brain metastases over time. [2][7]

Although there have been many advances in the treatment of metastatic HER2-positive breast cancer, there is still a significant unmet medical need for new therapies that can impact metastatic disease, especially brain metastases. There are currently no approved therapies demonstrating progression-free survival or overall survival benefit for the treatment of patients with HER2-positive metastatic breast cancer after progression following treatment with trastuzumab emtanzine.[8][9][10]

Combination therapyIn their NDA, Seattle Generics requested the FDA to approve tucatinib in combination with capecitabine (Xeloda; Genentech/Roche) and trastuzumab (Herceptin; Genentech/Roche) for treatment of patients with locally advanced unresectable or metastatic HER2-positive breast cancer, including patients with brain metastases, who have received at least three prior HER2-directed agents separately or in combination, in the neoadjuvant, adjuvant or metastatic setting.

This setting is the same setting for which the investigational drug was recently granted Breakthrough Therapy designation by the FDA and included patients with brain metastases, who have been treated with trastuzumab, pertuzumab (Perjeta; Genentech/Roche), and trastuzumab emtanzine (Kadcyla; Genentech/Roche).

HER2CLIMB TrialThe HER2CLIMB study is a multinational randomized (2:1), double-blind, placebo-controlled, active comparator, pivotal clinical trial included data from 612 enrolled patients.

The trial results published in the NEJM, presented at the SABCS by Rashmi K. Murthy, M.D., assistant professor of Breast Medical Oncology, demonstrated that tucatinib significantly improved progression free survival (PFS) and overall survival (OS) in patients with advanced HER2-positive breast cancer, with and without brain metastasis.

The trial met its primary endpoint of the study demonstrated that the treatment combination reduced the risk of death by 46% compared with trastuzumab and capecitabine alone. The trial also met its secondary endpoints at interim analysis, demonstrating prolonged OS, reduced the risk of death by 34% and extended PFS by 52% among patients with brain metastasis.

Furthermore, with 41%, the overall response rate was higher in the tucatinib group compared with 23% in the standard of care treatment.

This is a uniquely designed trial in that it allowed patients to enroll if they had untreated, treated stable or previously treated, but progressive brain metastasis, Murthy noted.

Brain metastasizes are common in up to half of patients during the disease course, but there are limited systemic treatment options because most available agents have difficulty crossing the blood brain barrier, she added.

Well toleratedThe study results demonstrated that the triplet combination of tucatinib + capecitabine + trastuzumab was generally well tolerated with no unexpected toxicities. In the tucatinib arm the investigators observed diarrhea, hand-foot syndrome, nausea, fatigue, and vomiting, all mostly low grade, as the reported adverse events. Furthermore, there was a low drug discontinuation rate of 5.7% in the triplet arm compared with 3% in the control arm.

This trial verified that tucatinib is both a safe and effective treatment, Murthy explained during the SABCS.

These results are realy unprecedented for late line therapy in locally advanced, metastatic, breast cancer. This is a major treatment advance for patients who have significant unmet medical need. I believe that tucatinib in combination with trastuzumab and capecitabine could be the new standard of care for patients pretreated with multiple anti-HER2 agents including patients with brain metastasis, Murthy said.

Todays submission marks another important milestone for Seattle Genetics and tucatinib, and a potential advance for patients with either locally advanced or metastatic HER2-positive breast cancer, including those with and without brain metastases, said Roger Dansey, MD, Chief Medical Officer at Seattle Genetics.

We look forward to working with the FDA on the review of this application, he concluded.

Clinical trialsTucatinib, Trastuzumab, and Capecitabine for the Treatment of HER2+ LMD NCT03501979A Study of Tucatinib vs. Placebo in Combination With Ado-trastuzumab Emtansine (T-DM1) for Patients With Advanced or Metastatic HER2+ Breast Cancer NCT03975647A Study of Tucatinib vs. Placebo in Combination With Capecitabine & Trastuzumab in Patients With Advanced HER2+ Breast Cancer (HER2CLIMB) NCT02614794

References[1] American Cancer Society, Cancer Facts and Figures 2018-2019.[2] Loibl S, Gianni L (2017). HER2-positive breast cancer. The Lancet 389(10087): 2415-29.[3] Slamon D, Clark G, Wong S, et al. (1987). Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science 235(4785): 177-82.American Cancer Society (ACS) (2018). Breast cancer HER2 status. Last accessed: December 20, 2018.[4] Kennecke H, Yerushalmi R, Woods R, et al. (2010). Metastatic Behavior of Breast Cancer Subtypes. Journal of Clinical Oncology 28(20): 3271-7.[5] Berman AT, Thukral AD, Hwang W-T, et al. (2013). Incidence and Patterns of Distant Metastases for Patients With Early-Stage Breast Cancer After Breast Conservation Treatment. Clinical Breast Cancer 13(2): 88-94.[6] Duchnowska R, Loibl S, Jassem J (2018). Tyrosine kinase inhibitors for brain metastases in HER2-positive breast cancer. Cancer Treatment Reviews 67: 71-7.[7] Verma S, Miles D, Gianni L, et al. (2012). Trastuzumab Emtansine for HER2-Positive Advanced Breast Cancer. New England Journal of Medicine 367(19): 1783-91.[8] Geyer CE, Forster J, Lindquist D, et al. (2006). Lapatinib plus Capecitabine for HER2-Positive Advanced Breast Cancer. New England Journal of Medicine 355(26): 2733-43.[9] Blackwell KL, Burstein HJ, Storniolo AM, et al. (2012). Overall Survival Benefit With Lapatinib in Combination With Trastuzumab for Patients With Human Epidermal Growth Factor Receptor 2Positive Metastatic Breast Cancer: Final Results From the EGF104900 Study. Journal of Clinical Oncology 30(21): 2585-92.

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Seattle Genetics Submits New Drug Application to the US FDA for Tucatinib - OncoZine

TORONTO Marcus Smart had a simple word to express how things have been as hes dealt with a serious eye infection the last few weeks:

Hell.

The Celtic guard missed his seventh straight game Christmas Day, but hes appreciative that he wont be losing the gift of eyesight. That frightening possibility existed for a time during this process, and Smart and his doctors are still being cautious.

Just really, really painful and really not knowing, Smart said of his condition during these recent weeks. I thought I was going to go blind for a while. The doctors said it was the worst case of viral conjunctivitis that theyve seen, so basically I was a guinea pig to see how to handle this if it ever happens again with anybody else.

But it was the worst pain that Ive been through in a very long time, and I dont wish it on anybody. But Im here. The eyes feel better. Im still trying to adjust to some lights, light sensitivity. But everything, the contagious part is gone. They cleared me. They said from here on everything should be OK. I still have to see them kind of on a daily basis. They say its so my cornea doesnt get white spotted behind it and mess up my eyesight. So its definitely a process. Its an annoying process, but Im just blessed to be able to come back and get through this.

Smart went through a workout here and was set to go through another session when the Celtics get back to Boston later in the day. He is hoping to play in Saturdays game at the Garden against these same Raptors, but nothing can be certain.

Especially considering the scare that he might suffer some form of blindness.

The way it was going, they were so worried about it affecting my cornea and my vision, so it was a little scary, Smart said before the holiday game. At first we thought it was an allergic reaction, because I broke out in hives like the day before my eyes started having allergic reaction. But we caught it so early that the same symptoms came off, and then about three days later it transferred from my left eye to my right eye, and thats when we ruled out that an allergic reaction was the cause. They said it was a virus called the (adenovirus), and it was caused by having a cold already and being sick, so it makes sense because right before that, those two days after the Denver game, Dec. 6th, the 7th and 8th, I came down with an allergic reaction and a really bad cold.

The Celtics actually sent me home, because I was feeling really bad, and it just kind of broke my immune system down and opened it up for everything else. Everything else in my body went haywire. It was just some unfortunate events that happened, but on the good side, I got to rest and heal up the injuries that I had and just let my body do what it does.

But, Smart noted, it was difficult going through these last weeks.

It was painful, it was burning, it was really hard. I couldnt see, he said. I had outdoor sunglasses everywhere I went. Even in the darkI was wearing sunglasses. It was that bad. Just every morning I would wake up (and) just having this sticky discharge coming out of my eyes that was sealing my eyes shut. It was really just gross. It got so bad that my eyes, my eye lids started forming these mucus membranes, and they literally had to go in and pry the mucus membranes out. I actually have a picture that I showed the guys. It was prettygross. I was bleeding tears every time they did it for like a day. They did that for about four days straight.

The first day was probably the worst, just because it built up so much that it started to scab under my eyelids, and they had to open the scab and then pull it out. It felt like they were putting needles in my eyes. They were using the tweezers and vice grips to hold my eyes and actually get into my eyelids, both the bottom and top. So it was definitely some pain, and I never want to go through it again and, like I said, I never want anybody else to go through it.

Smart remains under care to prevent further issues or any type of relapse.

Every day they were checking my corneas, theyre checking my eyesight and just making sure that my corneas werent being affected by it, he said. I have to go back pretty much every day for a while now just to monitor it. Because they say that even though Im healthy and everything is cleared up, my corneas could still be affected and get like white spots behind it and really affect my vision, so theyre trying to make sure that doesnt happen. Theyve got me on these special eye drops that I have to take four times a day. Im on two different sets of eye drops. I was on three, so thats I guess progress. But definitely yes, its scary, and Im glad that it hasnt (come back), and I hope it doesnt.

As for his readiness to play, Smart put himself at about 80%. I was able to get the last two days, workouts in and just was really getting my body back to playing shape and adjust and making sure Ive got my strength back and my conditioning and wind back. If it was up to me, obviously I would try to play (Wednesday). But just with everything happening, being more cautious than ever, and just giving myself and my body extra time to recuperate and get back into shape.

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Marcus Smart had to deal with a blindness scare from eye infection - Boston Herald

CORALVILLE, Iowa, Dec. 23, 2019 /PRNewswire/ --The nation's leading association that fights against diabetes released a new set of clinical standards that for the first time include the use of autonomous artificial intelligence (AI).

The American Diabetes Association (ADA)'s 2020 Standards of Medical Care in Diabetesstates that, "AI systems that detect more than mild diabetic retinopathy and diabetic macular edema authorized for use by the FDA represent an alternative to traditional screening approaches."

To date, IDx-DR is the first and only FDA-authorizedautonomous AI diagnostic system for the detection of diabetic retinopathy and macular edema. It is currently in use at a number of large health systems that each serve tens of thousands of people with diabetes and have struggled to implement diabetic retinopathy eye exams at scale for their large diabetes population.

"The ADA's inclusion of our technology in its Standards of Care marks a significant move toward mainstream adoption of autonomous AI in clinical care," said Michael Abramoff, MD, PhD, Founder and Executive Chairman at IDx. "Our early customers are visionary leaders who foresaw that autonomous AI would one day become a standard of care for diabetic retinopathy screening, and taking that leap is paying off for them. Already, health systems that are using IDx-DR have experienced significant improvements in accessibility, efficiency and compliance rates, unleashing massive potential for cost savings and improved patient outcomes."

The Standards of Care were published last week in Diabetes Care, the highest-ranked, peer-reviewed journal in the field of diabetes treatment and prevention. Physicians, healthcare systems, health insurers and quality of care organizations look to the ADA's Standards of Care for consensus and evidence-based best practices to improve health outcomes for people with diabetes.

About IDx-DRIDx-DR is an FDA-authorized AI-based diagnostic system designed for use at the front lines of care to detect diabetic retinopathy and macular edema, common complications of diabetes and leading causes of blindness. IDx-DR is cleared by the FDA to make an assessment without the need for a clinician to interpret the image or results, making it usable by health care providers who may not normally be involved in eye care.

The exam typically takes 5-10 minutes. Operators use a robotic fundus camera to take pictures of the patient's retinas the back part of the eye, which are then analyzed by the autonomous AI's algorithms for signs of diabetic retinopathy. An immediate diagnostic report is produced at the point of care, allowing the physician to discuss the results with the patient while they are still in the office.

About IDxIDxis a leading AI diagnostics company on a mission to transform the quality, accessibility, and affordability of healthcare. Founded in 2010 by a team of world-renowned clinician scientists, the company is focused on developing clinically-aligned autonomous algorithms that detect disease in medical images. By enabling diagnostic assessment in primary care settings, IDx aims to increase patient access to high-quality, affordable disease detection.

The company's first product, IDx-DR, is an FDA-cleared AI-based diagnostic system that detects diabetic retinopathy and macular edema. IDx is developing additional AI-based diagnostic systems for the detection of macular degeneration, glaucoma, stroke risk and ear infection.

IDx2300 Oakdale BlvdCoralville, IA 52241Phone: 319-248-5620www.eyediagnosis.net

IDx Contact:Laura ShoemkerDirector of Marketing Communications1-319-248-5620lshoemaker@eyediagnosis.net

SOURCE IDx

http://www.eyediagnosis.net

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2020 ADA Standards of Care just arrived and now includes AI to prevent blindness - PRNewswire

In case you weren't aware, the annular solar eclipse took place on December 26, 2019.

People from around the world were able to witness the phenomenon which some have dubbed the "ring of fire" and "ring of light".

The third solar eclipse for the year was also the most dangerous. Watching the close to four-hour long eclipse without any protection for the eyes can lead to total blindness.

But that didn't stop many experiencing the eclipse for themselves with some purchasing solar eclipse glasses while others using clever cost effective methods.

However, these 31 blind individuals were given an experience of a lifetime. They got to "listen" to the annular solar eclipse - a first in Malaysia.

They were members of the Penang Branch of the Society for the Blind Malaysia and St Nicholas Home.

Tech Dome Penang Chief Executive Officer Khong Yoon Loong, who spoke to Malay Mail Online, said LightSound 2.0, a device capable of converting sun light into high-pitch sound, was used to give the blind individuals an unforgettable experience.

The sound will slowly change and go down to a lower pitch as the eclipse happens so the blind can hear the difference in the sounds, he explained.

At the start of the phenomenon, 11.15 am, the LightSound 2.0 began transmitting high pitched sound into the room which the individuals were in.

The sound gradually changed to a low pitch as the eclipse progressed before peaking again.

The LightSound 2.0 was brought from the University of Harvard. Apart from the Tech Dome Penang, it was also placed in Tanjung Piai in Johor and in Serian, Sarawak, to record the annular solar eclipse.

The sounds recorded from all three locations would be compiled to form a unique melody.

For Johari Saad who is blind, "listening" to the annular solar eclipse was a surreal experience.

"It felt as though the space above was singing," the 48-year-old said to Berita Harian.

Johari was not blind when the phenomenon previously occurred on August 28, 1998.

"That time I was still a kid with good vision. This program takes me back to my childhood and I'm extremely thankful to the people who made the LightSound 2.0. I understand the phenomenon better through it."

Meanwhile, S Bumah Devi said she was thrilled when she could tell the difference of frequency when the eclipse happened.

"This is the first time I'm listening to the sound of sun light absorbed to be turned into sound. Exciting stuff," the 48-year-old said.

The next annular solar eclipse will take place on May 21 in 2031. Mark your calendars!

Cover image supplied by Kaveenesh Sagar / Tech Dome Penang.

Link:
These blind Malaysians experienced the annular solar eclipse through their ears. Wait, how? - Mashable SE Asia

Its that time of year again when we celebrate the New Year with friends and loved ones. But did you know it can be risky for eyes? Sparkling apple cider and champagne glasses will be flowing, but this is the time to review how to keep your eyes, and those of your friends and family, safe from trauma.

Did you say 50 miles per hour?

Yes, when released from the bottle, corks travel more than twice as fast as your car in a school zone! In fact, corks can travel so fast that they can shatter glass. Imagine what can happen to your eye at that speed.

The initial impact to the eye can cause injuries that can range from a severe scratch on the cornea all the way up to a laceration of the eye itself. These injuries usually require surgery, but still can lead to blindness or loss of the eye. But also keep in mind that consequences of the injury can be delayed, often by many decades. One example is delayed-onset glaucoma which leads to painless vision loss and blindness over time.

Article continues below...

So, what steps can you take to protect yourself and others?

We are glad you asked. Whether you toast with sparkling cider or champagne, remember the bottle corks are under pressure and if the proper precautions are not taken, the cork could fly off and injure your eye.

Here are some simple steps you can follow to keep all those eyes safe on New Years Eve. Follow these steps to keep your evening a fun one:

A toast to a happy and safe New Years for your family and friends and remember the joy your eyes bring to the celebration!

Wyoming Ophthalmological Society

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This New Years Eve Dont Shoot Your Eye Out! - Oil City News

The American Diabetes Association (ADA) released a new set of clinical standards that for the first time include the use of autonomous artificial intelligence (AI).

The ADAs2020 Standards of Medical Care in Diabetesstates that AI systems that detect more than mild diabetic retinopathy and diabetic macular edema authorized for use by the FDA represent an alternative to traditional screening approaches.

To date, IDx-DR is the first and onlyFDA-authorizedautonomous AI diagnostic system for the detection of diabetic retinopathy and macular edema.

It is currently in use at a number of large health systems that each serves tens of thousands of people with diabetes and has struggled to implement diabetic retinopathy eye exams at scale for their large diabetes population.

The ADAs inclusion of our technology in its Standards of Care marks a significant move toward mainstream adoption of autonomous AI in clinical care, said Dr. Michael Abramoff, founder, and executive chairman at IDx. Our early customers are visionary leaders who foresaw that autonomous AI would one day become a standard of care for diabetic retinopathy screening, and taking that leap is paying off for them.

The Standards of Care were published last week inDiabetes Care, the highest-ranked, peer-reviewed journal in the field of diabetes treatment and prevention. Physicians, healthcare systems, health insurers and quality of care organizations look to the ADAs Standards of Care for consensus and evidence-based best practices to improve health outcomes for people with diabetes.

The Standards of Care published last week inDiabetes Care can be accessed here.

IDx-DR is an FDA-authorized AI-based diagnostic system designed for use at the front lines of care to detect diabetic retinopathy and macular edema, common complications of diabetes and leading causes of blindness.

The exam typically takes 5-10 minutes. Operators use a robotic fundus camera to take pictures of the patients retinas the back part of the eye, which are then analyzed by the autonomous AIs algorithms for signs of diabetic retinopathy.

An immediate diagnostic report is produced at the point of care, allowing the physician to discuss the results with the patient while they are still in the office.

See the rest here:
New 2020 ADA Standards of Care Points to AI to Prevent Blindness - dLife.com

This has been a great year for the overall stock market and a banner year for a handful of drugmakers that don't even have a product to sell yet.

These three biotech stocks entered 2019 ready to provide market-thumping returns, and they delivered. Let's look at what made them the industry's top stocks this year to see if they can do it again in 2020 and beyond.

Data source: Yahoo! Finance.

Unnecessary blood vessel growth in the retina is the leading cause of progressive blindness in older adults, and injections of vascular endothelial growth factor (VEGF) inhibitors to halt that growth is a huge business. Sales of the leading VEGF inhibitor, Eylea from Regeneron (NASDAQ:REGN) reached a whopping $5.5 billion during the first nine months of 2019 but could face fierce competition soon from Kodiak Sciences' lead candidate, KSI-301, in a few short years.

With Eylea, patients need to receive injections every other month, and there's usually a few days between doses where patients aren't protected. Shares of Kodiak Sciences soared this year thanks to surprisingly good results from a VEGF inhibitor called KSI-301, which show it remains at therapeutic concentrations for more than twice as long as Eylea.

Kodiak recently secured $225 million in financing from one of the most successful biotech-focused funds on the planet, Baker Brothers, in return for a 4.5% royalty on KSI-301's potential sales. The company will use the funds to run pivotal studies that could lead to Food and Drug Administration (FDA) approval in 2022 of KSI-301 for the treatment of retinal vein occlusion. Also in 2022, the company expects to submit applications that could expand KSI-301's purview to age-related macular degeneration, diabetic macular edema, and diabetic retinopathy.

Image source: Getty Images.

Patients with myelofibrosis produce so many unnecessary blood cells that their bone marrow becomes permanently damaged. Blood cell overproduction also causes the spleen to swell, along with a variety of other symptoms.

There's just one myelofibrosis treatment at the moment, Jakafi from Incyte (NASDAQ:INCY). Jakafi's a kinase inhibitor that reduces blood cell proliferation for the vast majority of myelofibrosis patients, but its benefits tend to drop off after a few years. Constellation Pharmaceuticals stock soared this year after an interim analysis of an ongoing study with its lead candidate, CPI-0601, which produced some compelling evidence of efficacy for patients who had stopped responding to Jakafi.

Constellation's lead candidate is a potential first-in-class BET inhibitor thatreduced spleen volume for 94% of patients and reduced total symptom scores for 93% of patients. Among a subset of 13 patients who relied on frequent blood transfusions going into the study, four became transfusion independent.

Constellation will begin a placebo-controlled pivotal trial in 2020 with CPI-0601 plus Jakafi. Sales of Incyte's drug are expected to reach $1.7 billion in 2019, and CPI-0601 sales could peak at more than $1 billion annually if it continues to produce results in line with those we've already seen.

Image source: Getty Images.

Neurology's come a long way in recent years, but the brain is so complex that we still don't understand the root cause of most mental health issues. One thing we're sure of is that certain drugs tend to amplify each other's effects when combined.

Instead of relying on trial and error to come up with a new depression drug, Axsome Therapeutics is taking advantage of a well-known interaction between bupropion, a decades-old antidepressant, and dextromethorphan, the main ingredient in over-the-counter cough syrup.

There wasn't a lot of enthusiasm for AXS-05 at the beginning of 2019, but one clinical trial victory after another has sent the stock higher. Around 16 million Americans experience a bout of major depressive disorder each year, but available treatments don't get the job done for a majority of them. If AXS-05 earns a widely expected approval to treat this enormous population, the stock could keep on rising in 2020 and beyond.

Now that the market caps of these three drugmakers have reached 10 figures, another year like 2019 isn't likely. For example, if Axsome were to repeat its 2019 performance, it would end 2020 worth about as much asAmgen.

Another year of market-beating gains, though, is well within the realm of possibility for all three of these biotech stocks. Although nobody's ever gone broke by taking profits following huge run-ups, it's probably a good idea to hang on to shares of these stocks for the long run.

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3 Biotech Stocks That Crushed It in 2019 - The Motley Fool

Prevent Blindness provides free resources to the public for Januarys National Glaucoma Awareness Month

CHICAGO (PRWEB) December 26, 2019

According to estimates from the Prevent Blindness report, Future of Vision: Forecasting the Prevalence and Costs of Vision Problems, more than 3.2 million Americans ages 40 and over have glaucoma in the year 2020. The number is expected to increase as the population ages. Glaucoma, often referred to as the The Sneak Thief of Sight, is a leading cause of vision loss that damages the optic nerve. Although symptoms may not be noticeable at first, glaucoma slowly diminishes peripheral vision (side vision), making activities such as driving increasingly difficult.

January is National Glaucoma Awareness Month and Prevent Blindness, the nations oldest volunteer eye health and safety nonprofit organization, seeks to educate the public on the disease, including risk factors, types of glaucoma, treatment options and more. Prevent Blindness offers a dedicated web page providing patients and their caregivers with free information at https://www.preventblindness.org/glaucoma or its online resource, Living Well with Low Vision at https://lowvision.preventblindness.org.

More women than men have glaucoma. Risk factors for glaucoma also include:

The American Academy of Ophthalmology (AAO) also states that those with diabetes, migraines, high blood pressure, poor blood circulation or other health problems affecting the whole body are at increased risk of glaucoma.

The year 2020 is an ideal reminder for all of us to make the resolution today to save our vision for tomorrow, said Jeff Todd, president and CEO of Prevent Blindness. By detecting vision problems and treating them early, including those from glaucoma, we can help to avoid significant vision impairment.

The AAOs EyeCare America program provides eye care at no out-of-pocket cost to medically underserved seniors age 65 and older, and glaucoma exams to those at increased risk. For more information, visit https://www.aao.org/eyecare-america.

Allergan is supporting the efforts of Prevent Blindness in its public outreach efforts to protect vision from glaucoma. Allergan is a leading global pharmaceutical company with a more than 70-year heritage in eye care has launched over125 eye care products and invested billions of dollars in treatments for the most prevalent eye conditions including glaucoma, ocular surface disease, and retinal diseases such as diabetic macular edema and retinal vein occlusion. Recently, Allergan launched the My Glaucoma campaign which is designed to help people understand the burden of living with glaucoma and empower those with the disease and their caregivers to feel comfortable speaking with their doctor about a treatment regimen that fits their lifestyle. For more information, visit http://www.MyGlaucoma.com.

For more information on glaucoma, or other financial assistance programs, including Medicare coverage, please call Prevent Blindness at (800) 331-2020 or visit https://www.preventblindness.org/glaucoma.

About Prevent Blindness Founded in 1908, Prevent Blindness is the nation's leading volunteer eye health and safety organization dedicated to fighting blindness and saving sight. Focused on promoting a continuum of vision care, Prevent Blindness touches the lives of millions of people each year through public and professional education, advocacy, certified vision screening and training, community and patient service programs and research. These services are made possible through the generous support of the American public. Together with a network of affiliates, Prevent Blindness is committed to eliminating preventable blindness in America. For more information, or to make a contribution to the sight-saving fund, call 1-800-331-2020. Or, visit us on the Web at preventblindness.org or facebook.com/preventblindness.

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Glaucoma, The Sneak Thief of Sight, Continues to Affect Vision of Millions of Americans - PR Web

In the future, when people try to imagine what it was like to live in our time, there will be lots of artifacts to sift through: TV shows, YouTube videos, selfies on Instagram, as well as the traditional things, like newspapers and news reports.

But movies will have a special place.

A few things make movies a particularly good measure of what was happening and what people were thinking at a particular time. First, theyre meant to be watched by large groups, and so theyre intended to please almost everyone. This means that if a movie endorses an idea in strong terms, you can assume that either that idea was widely held or, at the very least, reasonable people thought that idea was widely held. Almost nobody makes a movie with the intention of offending the audience.

Second, movies are not spontaneous. They are meticulously composed fantasies, created to please viewers at a particular time, and as such they consciously and unconsciously capture the aspirations, assumptions and values of their day. They give the facts of the era the cars people drove, the phones people used but also capture the hopes and expectations, the ideas that people had about themselves.

So, we are now 20 years into the 21st century, a fifth of the way through. Today, were looking at 20 movies that people in the distant future can look at if they want a crash course on what Americans were thinking, feeling and experiencing in the first two decades of the 21st century.Each one captures an idea or a moment or a style that helped tell the story of their time, and ours.

Following 9/11, the national trauma that began our current era, movies suddenly began telling stories of civic collapse. Sometimes it was an invasion, sometimes zombies woke up, but the idea that ran through all these films is that civilization, something we thought was built on rock, was quite fragile and could actually go away. Blindness, in which a huge swath of the public suddenly lose their eyesight, was a mystical yet brutal treatment of this idea, a real plunge into the abyss.

Honorable Mention: A more popular version of this concept (from a post-apocalypse standpoint) can be found in Mad Max: Fury Road (2015).

Written by and starring Oakland natives Daveed Diggs and Rafael Casal, this film told an affecting personal story about friendship, while dramatizing a number of current social issues, such as the strains of gentrification and the tension between the police and the black community.

This is very much a personal story, but because director Richard Linklater filmed Boyhood over the course of 12 years, it captures, as no film ever has, the incidentals of life over a long span of time the toys and the computers that people used, the haircuts that were popular, how people carried themselves and how families interacted.

By taking two straight archetypes and making them gay, this Ang Lee film about a rodeo cowboy and ranch hands secret relationship made pop cultures most powerful case for gay marriage, at a time when most Americans were against it.

Honorable Mention: Gus Van Sants Milk (2008), about the assassinated gay rights leader, presented the gay rights movement as a great American movement in the tradition of Martin Luther King and civil rights.

It was just another exciting, well-made Roland Emmerich action movie, except as the climate crisis has worsened, its images of superstorms, frozen oceans and mass migrations have stayed in mind. Essentially, it presents the climate version of the civic chaos film. We thought we could take the weather for granted. It turns out, we couldnt.

Jacob Aaron Estes wrote and directed this story of a mild-mannered obstetrician (Tobey Maguire) whose life begins to derail. A shrewd moral document, the movie steers the audience into taking the doctors side, while subtly revealing that every one of his problems is due to moral laxity. The film is, in essence, an indictment (and a record) of modern morality, which means that most of the audience watching never even figures out that the Maguire character is a bad person.

Starring Renee Zellweger and Ewan McGregor, this satire of early 1960s sex comedies was also a commentary on the fluidity of romantic and sexual mores in general, so that, in the end, when the movie contorts itself to please a modern audience, it both records the 2003 notions of right and wrong and slyly shows that these ideas will someday also seem outdated.

A running and increasing anxiety of the 21st century has been the notion that computers could take the place of people, or begin to dominate human life. This low-key film starring Oscar Isaac and Alicia Vikander, playing an android with impressive intelligence, made the most frightening and persuasive case for how that might happen.

A British and American counterterrorism team sits in a boardroom trying to figure out when to strike a cabal of suicide-vest-wearing terrorists, in this powerful film about awful choices in modern warfare. It contains the already classic curtain line from Alan Rickman, as a British general: Never tell a soldier that he does not know the cost of war.

Until this decade, the Civil War was always presented as a noble dispute between two equally worthy sides. This film presented the Confederacy as a political and social evil, which was stamped out in one Mississippi county, under the leadership of a Confederate deserter named Newton Knight. Theres a goosebumps moment when Gugu Mbatha-Raw looks at the baby she has had with Knight, trying to decide whether hes black or white. Finally, Mbatha-Raw says, Youre just a brand-new thing, arent you?

Honorable Mention: Quentin Tarantino got the ball rolling by presenting slavery as an unmitigated evil in Django Unchained (2012), and director Steve McQueen followed with the Oscar-winning 12 Years a Slave.

The spiritual sickness of modern life the loneliness, the longing, the problems of connection, the distorted and mournful eroticism was captured beautifully in this film, starring Emily Blunt and written by Erin Cressida Wilson.

Honorable Mention: Chloe (2010), a film in the same vein, also written by Wilson. And Watchmen (2009).

Steven Soderbergh made the first and best film about the Great Recession, with porn star Sasha Grey as a high-priced call girl who finds herself slipping. Its about someone finding out shes not as special as she thought she was, which is the bitter lesson for everyone in a recession.

Honorable Mention: The Wolf of Wall Street.

A vacation movie set in New Orleans during the Essence Music Festival that depicts adult female friendship and modern-day sexual mores in real ways, while demonstrating what was hilarious in 2017.

Honorable Mention: Mike and Dave Need Wedding Dates (2016).

Justin Long and Drew Barrymore meet and fall in love, but theyre separated geographically by their careers in a film that captured the anxieties of young Americans trying to enter the job market during the recession.

Joaquin Phoenix fell in love with a Siri-like computer operating system in Spike Jonzes tale of the near future, in which the human personality becomes distorted by technology.

Honorable Mention: Robin Williams starred in The Final Cut (2004), which imagines a future in which everything people see and hear is recorded by a computer chip in their brains, thus transforming human interaction for the worse.

A lot of movies are making oblique commentaries about President Trumps administration, but this Ike Barinholtz comedy directly addressed the alienation, the bitter discord and the darkest fears that this presidency has introduced into modern American life.

There have been a number of 9/11 movies, but no film captured the aftermath of that tragedy the sick feeling we all carried with us better than this masterpiece from Spike Lee.

Honorable Mention: United 93 (2006), Paul Greengrass film about the hijacked flight that crashed in Pennsylvania.

This Brady Corbet film attempted and succeeded in telling the moral history of the 21st century, through the story of a high school girl who survives a school shooting and becomes a pop star.

This celebration of the female principle, through the avatar of a superhero, made in anticipation of our first female president, became a focal point of aspiration and a statement of value when the election didnt go as planned.

Honorable Mention: Black Panther, which positioned Oakland as a focal point in a Marvel superhero film.

With Vin Diesel at the center, this aggressively directed Rob Cohen movie introduced a new kind of action film and a new kind of 21st- entury cool, which had something to do with tattoos and shaved heads. And what was all this cool fighting going up against? Terrorists, of course, intent on making the world unlivable.

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20 movies that tell the story of our century (so far) - San Francisco Chronicle

Renowned ophthalmologist and president and founder of the Eye Foundation of America Dr. V.K. Raju has been chosen to serve as the keynote speaker at a Jan. 1 100th anniversary event at the Rotary Club of Kolkata.

Born in Rajahmundry, Andhra Pradesh, Raju earned his medical degree from Andhra University and completed an ophthalmology residency and fellowship at the Royal Eye Group of Hospitals in London.

The Indian American physician is board certified in ophthalmology, and is a Fellow of the Royal College of Surgeons and the American College of Surgeons.

He moved to the United States in 1976 and has since resided in Morgantown, West

Virginia, where he is currently a clinical professor of ophthalmology at West Virginia University, runs practices at Regional Eye,and is the

founder and medical director of the nonprofit Eye Foundation of American.

Raju is also thedirector of the International Ocular Surface Society, director of the Ocular Surface Research and Education Foundation, MBBS at Andhra University in India, and the chairman of the Goutami Eye Institute in Rajahmundry.

Serving as the keynote of the upcoming centenary event isnt the first great honor bestowed on Raju.

He has also received numerous awards, including the AMA Foundation Nathan Davis Excellence in Medicine International Award; four-time awardee by The American Academy of Ophthalmology; Martin Luther King Jr. Achievement Award from WVU; Distinguished Community Service Award from the American Association of Physicians from India; Pride of the Pride Award from Lions International District 29 Vaidya Ratna; Lifetime Achievement Award from the American Association of Ophthalmologists of Indian Origin; and the Lifetime Achievement Award from the WV State Medical Association.

Raju also was among the class of 2017 inductees into the University of Toledo Global Medical Missions Hall of Fame, thePresidents Lifetime Achievement Award from President Barack Obama, and the Lifetime Achievement Award from the North America Telegu Society.

The Rotary is a very near and dear partner to the Eye Foundation of America's heart. The Rotary has done amazing things on a local, national and global scale- most notably the work to end polio. The Eye Foundation of America works to back Rotary causes as well, especially those that work towards public health and disease prevention, Raju explained in an interview with India-West.

The 100-year history of this club is a monumental occasion, with Raju speaking on the work of the Eye Foundation as well as the collaborative project the EFA and the Kolkata Rotary Club are embarking on: The Retinopathy of Prematurity.

The project has been growing steadily in India for some time now. The Eye Foundation of America will be gifting a Ret-Cam during the celebration. With this device, ophthalmologists in Kolkata will be able to more efficiently and accurately screen more premature babies for the disease, allowing the possibility for vision saving laser treatments or surgery as needed. Without the screening, many premature babies would be blind for life.

This speaking event will be a great chance to further the joint mission of saving lives and improving health, Raju told India-West.

During a trip to India in 1977, the physician was approached with a request to use his ophthalmology experience to examine a local farmer with an eye problem. He realized just how much his home country needed eye care services, especially for under-served and under-privilegedareas.

He began returning to Andhra Pradesh every few months to conduct eye camps in rural locations where he and a team of medical professionals trained in eye care would perform vision screenings, check for glasses, provide medications, and recommend surgery, he explained.

As the eye camps grew in size and frequency, Raju realized the need for a more established care center to provide surgeries free of charge. The first eye hospital was constructed and ophthalmologists were hired full time to provide care, he added.

In 1982, the EFA was originally founded as the West Virginia Ophthalmology Foundation Inc. In 1990, the name was changed to the West Virginia Eye Foundation, Inc. The final name change happened in 1992 under the advice of a friend, who recommended a name that would encompass the wider spread of the foundation. The Eye Foundation of America has been so-called since 1992, Raju told India-West.

The mission of EFA is to prevent blindness by going where the need is greatestoften rural and remote areas of developing countries where there is no medical care or where the cost of the care is prohibitive.

Our primary goal is to eliminate avoidable childhood blindness. Although the Eye Foundation of America serves people of all ages, we have a special place in our hearts for children because it is they who have the most to lose, he said.

Visually impaired or blind children grow up without the same advantages as sighted children. Unable to read and write, they often cannot support themselves as adults and may become dependent on their families and /or communities, Raju added.

Raju continued to note that premature babies are also a focus, as they can suffer from Retinopathy of Prematurity, a retinal condition unique to premature babies as a result of receiving too much oxygen.

With help from our donors and volunteers worldwide, we have been able to screen over 200,000 premature babies and perform treatments on hundreds of babies that are affected by this disease, he said.

In addition to preventing childhood blindness, the EFA plans to touch the lives of 100,000 people in India as a part of its ongoing efforts to eliminate avoidable blindness due to diabetes and diabetic retinopathy a condition that often leads to blindness if left untreated.

In addition to these primary focus points, the EFA also contributes to Vitamin A supplements and education efforts, he said.

To date, the Eye Foundation of America has performed over 3 million vision screenings. Over 650,000 sight-saving surgeries have been performed at no cost, the foundation notes.

Hundreds of thousands of pairs of glasses have been provided, often the simplest form of vision care, but one which makes a huge impact to each person. The EFA also coordinates education for medical professionals, including grand rounds teaching sessions, fellowship programs for residents, and additional specialty training for ophthalmologists, it said.

In the coming years, Raju said that the Eye Foundation of America will continue to provide care to those that need it poverty stricken, rural and under-privileged people around the world.

We will continue to collaborate with groups that need our resources while growing our own footprint. In the immediate future, the Eye Foundation of America is thrilled to announce the imminent construction of another eye hospital in Rajahmundry, he told India-West. We have outgrown our current space at Goutami Eye Institute and we will be moving into a five-floor facility with wings devoted specifically to ocular oncology, pediatric ophthalmology, and retinopathy of prematurity.

The current Goutami Eye Institute will serve as a vision therapy and occupational rehabilitation center to help those individuals effected by vision-threatening diseases or blindness regain their independence and learn new skills, Raju said.

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Eye Foundation of America's Indian American Founder VK Raju to Speak at Rotary Club of Kolkata, Announce Project on Treating Preemie Eye Disease -...

By "Sunday Morning" contributing videographer Judy Lehmberg.

The caption on this past week's "Sunday Morning" Moment of Nature indicates the bighorn sheep were filmed near Gardiner, Montana. They were, but more specifically in Gardner Canyon. (That isn't a misspelling; the town is named Gardiner, but the nearby river is the Gardner River in Gardner Canyon; I have no idea why no one has adjusted the spelling of one or the other so they match.) The canyon is just inside the north entrance of Yellowstone National Park and just south of the town of Gardiner. The high cliffs of this steep canyon are some of the best places in the park to see bighorns, although that wasn't always the case.

Two hundred years ago there were at least several million bighorns in the western U.S., so many that the Shoshoni (sometimes referred to as the Sheepeaters) relied upon them as their primary food source. By 1900, after what Ernest Thompson Seton referred to as "the epoch of relentless destruction by the skin hunters," their numbers were reduced to a few thousand in the entire United States. Once the U.S. Army began protecting Yellowstone and its animals, their numbers began to rise, and by 1912 Seton reported a Yellowstone bighorn population of at least 200.

That number has fluctuated over the last 100-plus years with a high of close to 500. Most of that fluctuation has been due to disease. Bighorns are susceptible to conjunctivitis caused by Chlamydia which results in their cornea becoming keratinized and opaque, resulting in blindness. The disease itself doesn't kill them, but the blindness makes it difficult to both find food and navigate the cliffy areas they call home. An outbreak of conjunctivitis in 1981-82 reduced the Gardner Canyon bighorn population by 60%. Mature males were hit especially hard as the outbreak happened during the winter when they were in rut, presumably because that's when they devote more time to fighting and mating than looking for food. The sheep also suffered a decline when pneumonia broke out in 2015. However, they appear to have bounced back since then. Although the source of either disease has never been proven, it is known that domestic sheep carry both and can be found north of Yellowstone where some bighorns live. Domestic sheep-borne disease, reduction of habitat and ranching have all contributed to their decline nationwide.

Bighorns, like other sheep, have horns rather than antlers. The difference is antlers are new bone which grows every year and are shed in the spring. Horns are composed of an inner core of bone covered by a keratinized sheath, neither of which is ever shed, and continue to grow throughout a male's lifetime. The female's horns are smaller and only grow during the first few years of life. The age of a bighorn male can be determined by the deeper grooves in their horn. The grooves form during the November-to-December rut when males are more concerned with mating than eating. If the horn tips are broken or worn and the area between their nose and eyes is scarred, that is another indication of age.

The male's skull is about twice as thick as a female's to provide some protection while they butt heads during the rut. If they hit each other straight on, the horns can take the brunt of the collision. Even so, it is amazing how hard they can hit each other. Testosterone can be a scary chemical sometimes.

One of the most surprising encounters we've had with bighorns was several years ago in the early spring just before lambing season. We found a group of bighorns on a cliff near the confluence of the Lamar River and Soda Butte Creek, and stopped to film them.

What happened next can be seen in the video below:

If you visit Yellowstone and would like to see bighorn sheep, there are several areas you should look. The cliffy areas around the confluence of the Lamar River and Soda Butte Creek, the area near the confluence of the Lamar River and the Yellowstone River, both in the Lamar Valley, as well as during a hike up Mount Washburn and (probably the most reliable area) Gardner Canyon. Because the canyon is so high and steep, it is worth pulling off the road and carefully scoping the east side, especially in the late spring when the females are lambing. After the lambs get a few weeks old, it isn't unusual to see them form groups that run along the cliff side seemingly for the pure joy of being alive.

Judy Lehmberg is a former college biology teacher who now shoots nature videos.

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To watch extended "Sunday Morning" Nature videos click here!

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Nature up close: Domestic sheep-borne disease, reduction of habitat and ranching have all contributed to their decline nationwide, but bighorn sheep...

Homonyms spawn countless puns and some of the most amusing turns of phrase in modern culture. Think of Baloo the bear singing Bare Necessities in the Disney version of Jungle Book.

Now though, the New Year presents an opportunity to consider a homonym as a motivating message. Just as the number 20/20 is the measure of optimal vision, the year 2020 can be about setting an intention for keeping clear sighted about what climate change means now and in the future, and how best to respond. One of my Sea Grant colleagues in Alaska said recently that residents there dont have to be convinced of the reality of climate change, because melting permafrost, flooding coastal villages and altered fisheries there are everyday realities. They are readily engaging in projects to adapt. Neither can we in Connecticut afford the luxury of willful blindness.

Already coastal roads from Greenwich to Stonington are experiencing sunny day flooding at high tides, storm drains are overwhelmed with frequent heavy rains, and warming waters in Long Island Sound are reordering the marine ecosystem. This March, municipal officials from around the state will gather for the seventh climate adaptation workshop co-sponsored by Connecticut Sea Grant in as many years. This time, the topic requested by previous attendees will be shoreline retreat. Its a highly sensitive but necessary conversation for the many cities and towns with shoreline neighborhoods increasingly vulnerable to rising seas and intensifying storms. Figuring out if, where and how to structure fair and orderly buy-out programs is one of the many daunting challenges thats better to face now than after the next natural disaster.

Managing shoreline retreat is just one of the many climate change conundrums involving the intersection of the coastal economy with the environment. Decades of fossil fuel emissions are changing the chemistry of the atmosphere, the ocean and the land, setting off a cascade of impacts moving with momentum that cant be stopped immediately, and not ever without confronting the truth. One of those truths is accepting what we dont know, and working to understand it.

Thats the case with the acidification of our coastal areas. Its the more complicated cousin of the better known phenomenon of ocean acidification turning offshore waters into hostile environments for coral reef survival, among other effects. But the changes there are following a more predicable path. Not so in coastal areas like the Long Island Sound estuary. Variable inputs of freshwater from rivers, nutrients and pollution from land and warming temperatures are combining with increasing carbon dioxide levels to change local water chemistry in erratic ways that threaten coastal economies. In some areas elsewhere in the North Atlantic region, commercial shellfish farmers are adding buffering agents to the seawater in their hatcheries where young shellfish are grown. Without it, the larvae cant develop their shells properly.

But the exact combinations of mechanisms causing this to happen in one area and not in another as little as 10 miles away remains unknown. Nor can we predict where it will happen next. Connecticut Sea Grant, working with the New England Coastal Acidification Network, has been working to further the science and will be communicating findings to industry, policymakers and the public in 2020, a continuation of work begun in 2018.

But working on the hard problems of climate change isnt just for the scientists and their colleagues in groups like Sea Grant. Consider the words of the Rev. Margaret Bullitt-Jonas, who shared the panel with Connecticut Sea Grants Juliana Barrett and others at a forum last October titled, Reality, Hope and Action in an Age of Climate Change at St. James Episcopal Church in New London. In her recent book of Advent readings, she writes, However we participate in healing creation, all of us are needed. Everyone has a part to play.

Consider, too, the words of the wonderful writer Wendell Berry. In an essay about a sustainably managed Pennsylvania forest as metaphor for the kind of reordering needed in our collective and individual relationships with our home planet, he writes: To say that the good care of the forest, as of all the worlds places, depends upon love is, sure enough, to define a difficulty. But not an impossibility. The impossibility is that humans would ever take good care of anything that they dont love. And we can take courage from the knowledge that millions of Americans once loved their vegetable gardens, cared well for them, and kept them dependably productive and that a good many still do.

With love, clear vision and resolve to play our part, 2020 can be a better year for us and the Earth.

Judy Benson is the communications coordinator at Connecticut Sea Grant, a partnership of the University of Connecticut and the National Oceanic and Atmospheric Association that is one of 34 Sea Grant programs nationwide. She can be reached at: judy.benson@uconn.edu.

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Having 20/20 vision about climate change in 2020 - News from southeastern Connecticut - theday.com

Now is the time of year when we typically take inventory of our lives and set new goals. Relationships, finances, careers and health are all important aspects that impact our overall wellbeing. For this New Year, consider making your health a top priority.

According to the recent Americas Health Rankings Annual Report, the nations obesity rate continues to rise, with one in three adults now experiencing obesity. In Arizona, 29.5 percent of adults are obese. This alarming statistic may have serious health consequences such as diabetes which now impacts approximately 30 million adults and is the No. 1 cause of kidney failure, lower-limb amputations, and adult blindness, according to the Centers for Disease Control and Prevention.

There are many factors that play a role in your health, but one that you can control is making a commitment to start living a healthier lifestyle. Sure, there will be some bumps during your wellbeing journey, but your goal can be achievable and you deserve to reap the benefits.

Consider some helpful tips for achieving a healthier you in 2020.

Regular exercise may help you live longer and may reduce your risks for a host of diseases. Try to aim for at least 2.5 hours of moderate aerobic activity a week, but if thats too challenging then start off with 15 minutes here and 15 minutes there. Every little bit counts. To be successful, your fitness program should become a part of your daily life.

Also, check with your health plan and employer to see if they offer wellness incentives. For example, UnitedHealthcares Gym Check-In program enables participating employers to provide employees and their spouses the opportunity to each earn hundreds of dollars a year for visiting a fitness facility 12 days or more per month.

Sure, its easier said than done, but good nutrition is a vital part of a healthier lifestyle. Experts say the healthiest diets are rich in fruits and vegetables, because these foods are full of healthful nutrients and fiber. Here are three simple tips to eating healthier: Go for more fruits and veggies; choose less meat and fat; and keep an eye on the size of your food portions. Just saying no, to the buffet can do wonders.

If youre feeling stressed, its important to unwind and relax by doing something you enjoy. Maybe its watching a movie, reading a book, or volunteering to give you time to recharge. Also, make time to connect with others. Maybe thats friends, family, a faith group or a hobby club. Its important that you dont isolate yourself after a stressful event. Remember, if you cannot get a handle on your stress, talk to your doctor. She or he may recommend a counselor who could help you find other ways to help reduce or manage the unhealthy stress in your life.

Take time today to make an appointment with your doctor for your annual wellness visit and be sure to ask about preventive services such as health screenings and vaccines. Check with your health plan as many preventive services have no additional cost, as long they are delivered by care providers in your plans network. Your doctor will help you create a treatment plan to help manage any chronic conditions, such as asthma, diabetes and high blood pressure.

Ann Marie OBrien, R.N., is the national director of health strategies for UnitedHealthcare.

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Tips to help achieve a healthier you in 2020 - AZ Big Media

LAHORE: Pakistan stands at the 12th spot in the global ranking for cataract surgical rate (CSR) and tops the Muslim world with a ratio of 5,203 per million population per year.

Released by the National Committee for Eye Health (NCEH) -- under the Ministry of National Health Services, Regulations and Coordination, the report, titled Cataract Surgical Mapping Pakistan-2019, was prepared under the supervision of Prof Asad Aslam Khan, the coordinator for National Programme for Prevention and Control of Blindness. The report has been declared a landmark achievement for Pakistan in meeting the targets set by the World Health Organisation (WHO).

Cataract remains the leading cause of blindness worldwide, accounting for nearly half (47.8 per cent or 17.7 million) of the cases. The treatment is surgical, a highly cost-effective intervention.

The report, a copy of which is available with Dawn, mentions significant statistics regarding Pakistans record cataract surgeries in the last two decades. The surgeries were conducted through public-private partnership between the federal/provincial health department and international and national non-governmental organisations (NGOs) following WHO guidelines.

The current report on mapping of cataract surgical services indicates that Pakistan has exceeded its targets for 2020 that were projected in 2002, the report reads.

The NCEH carried out a comprehensive survey all over the country to compile the report and found that over 1.1 million cataract surgeries were reported in 2018. The data indicates that Pakistan achieved CSR of 5,253 (with Azad Jammu and Kashmir included) and 5,307 (minus AJK).

There is an overall preponderance of cataract surgeries in females (male to female ratio is 0.95), the report further states.

The data indicated the proportion of cataract surgeries by service provider nationally barring AJK with the government sector contributing to 15.9pc of the surgeries, forces 1.8pc, NGOs 39.9pc, and the private sector 42.4pc.

In order to achieve a CSR of over 7,500 by 2030, at least 1.84 million surgeries must be performed annually. If there is no change in the current annual cataract surgical output, the CSR will drop to 4,628 by 2030, the report stated. At least 58,000 to 60,000 more cataract surgeries will need to be performed every year than the rate of each previous year to achieve the 7,500 target.

Prof Asad Aslam Khan, also chief executive officer of the Mayo Hospital, said that during the last two decades the NCEH upgraded eye units of 27 teaching, 120 district headquarters and 100 tehsil headquarters hospitals. More than 800 optometrists, 50 orthoptist, 51 investigative oculist, 1,200 ophthalmic technician, 34 vitreoretinal specialist, 24 paediatric ophthalmologist, 92 community ophthalmologist and more than 100 ophthalmic nurses have been produced in the country, he claimed.

He said the first report on mapping of cataract surgical services was compiled in 2002, which determined the national, provincial and district CSRs, and it had noted that Pakistan had a national CSR of 2,254.

He said the Universal Eye Health a Global Action Plan 2014-2019 had been launched by the WHO following a resolution passed by the World Health Assembly in 2013. This global action plan identified cataract surgical rate as one of the three global monitoring indicators.

In the last 20 years, there has been an incremental change in the distribution of eye care services in Pakistan, especially with development in and investment by the public sector, a mushroom growth in the non-government sector and a massive increase in the private sector.

We now approach the end of Vision 2020 The Right to Sight next year in 2020 and straddle the Sustainable Development Goals era with about 10 years left to go by 2030, said Dr Khan.

For future planning, he said, it was vitally important to obtain updated data about the changing trends of CSR at the national, provincial and district levels in Pakistan. As a result of all the achievements of the NCEH, Pakistan is now among the top 12 countries with highest CSR, he added.

Published in Dawn, December 25th, 2019

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Pakistan ranks 12th globally in conducting cataract surgeries - DAWN.com

Its only been 10 years, but in that time the world has been transformed. Social media has gone from angel of democracy to demon. Climate change has become something we can see with our own eyes. All over the world, established orders have been overturned.

In Israel, new technologies like auto-tech, fintech, AI and food-tech have emerged to dominate Israels high-tech scene, while Israels food scene has come of age as you can tell by the high number of accolades to Israeli restaurants rolling in. Israeli TV has also won its fair share of praise, spurring an unexpected new area of export.

In this decade, Israel lost one of its most internationally popular leaders, Shimon Peres; but women the world over got two strong new role models Israeli actor Gal Gadot, who stormed the world with her portrayal of Wonder Woman, and Netta, who swept Eurovision with her bubbly empowerment song, Toy.

Weve looked back through our archives to discover your favorite stories. Its an extraordinary journey that charts the emergence of Israels aid industry, the move toward veganism and alternative meats, and the growth of tourism to Israel from just 1.9 million tourists to Israel in 2010, to 4m. in 2019.

Some of the technologies we wrote about went on to huge success, some pivoted, and some notably Shai Agassis Better Place went out with an almighty bang.

Take a look through the decades and remember some of the highlights of every year.

2010

An IDF doctor tends to a patient at the field hospital in Haiti, January 23, 2010. Photo courtesy Israel Ministry of Foreign Affairs

One of the decades most iconic gadgets, Amazons Kindle e-reader, was largely developed in the heart of Israels high-tech center in Herzliya.

In June 2010, a professor from Bar Ilan University announced that he was developing a male contraceptive pill. His hope was that it would be out on the market within five years. While the idea created huge interest, the product ultimately never came to fruition.

Israel gained worldwide praise for the speed and efficiency with which it offered aid to Haiti in the wake of a catastrophic 7.0 magnitude earthquake that killed around 160,000 people. The field hospital set up by the Israel Defense Forces was one of the most advanced hospitals in Haiti. Five years later, Israel was still in Haiti helping rebuild the community. Haiti was the first time that the world really sat up and noticed Israeli humanitarian aid.

A breakthrough from Hadassahs Human Embryonic Stem Cell Research Center was poised to enable cultivating embryonic stem cells for treatments for disorders such as Parkinsons disease, diabetes and age-related macular degeneration. This later formed the basis for CellCure Neurosciences, currently developing OpRegen for treating dry AMD.

2011

The beaches of Tel Aviv. Photo by Shutterstock

Our top story of 2011 was on Vaxil Bio Therapeutics, which was developing a vaccine that could activate the bodys natural immune system to seek and destroy cancer cells. Since then, the company has completed a Phase I/II clinical trial in multiple myeloma patients, and is advancing toward clinical studies in additional solid tumor indications.

Yokneam-based Neuronix developed an electromagnetic stimulation system for treating moderate Alzheimers disease, allowing patients to regain faded cognitive skills. Though approved for use in Europe, Australia and Israel, in 2019 an FDA advisory panel decided that the benefits of the system did not outweigh the risks to patient health.

In June, we published a list of the 10 best beaches in Israel. Nine years later, the story continues to be one of our most popular, which for a country with as much beautiful coastline as Israels, isnt that surprising.

In May, we launched the first of a series of articles on hiking in Israel. The top 10 hikes in Israel was first, followed by water hikes, desert hikes, hikes in Jerusalem, and hikes in the Dead Sea.

2012

Tal-Yas trays catch every drop of dew. Photo: courtesy

To celebrate Israels 64th birthday, ISRAEL21c described 64 blue-and-white innovations with the potential to transform and enrich lives across the planet.

The US developer of skyTran chose Israel as the perfect place to pilot the software-guided personal transport pods that glide on a cushion of air. While the Tel Aviv project has yet to get off the ground, additional Israeli cities including Netanya and Eilat have since signed development deals with skyTran to upgrade public transportation.

This story about groundbreaking agricultural innovations from drip irrigation to drought-proof seeds proved so popular, and so important, that we updated it in 2019.

An amazing invention that turns pet droppings into harmless, odorless powder within seconds has developed into game-changing applications for human waste-management in the United Statesand Brazil.

2013

Pomegranate juice on sale at the Carmel Market. Photo by Anna Wachspress

The outright winner for story of the yearin 2013 though we could never completely understand why was our piece on 10 great reasons to love the pomegranate. Pomegranate, anyone?

In 2013, we began a new series on things to do for free in various cities around Israel. Our first story was an immediate hit and continues to be popular. We updated it earlier this year.

To celebrate Israels 65th birthday, we took a look at some of the incredible ways Israel is helping to look after our planet. Its still an impressive list.

When we reported on CartiHeal in 2013, the novel Israeli implant which provides a scaffold for the body to regenerate joint-protecting cartilage was already regarded as a major potential advance. It also featured in the top stories of 2016. Find out more below.

2014

The Iron Dome proved the unexpected hero of the 2014 war with Gaza. Photo by Shutterstock

From the Babysense baby breathing monitor to the Skysaver emergency evacuation device, this list compiled 18 potentially lifesaving technologies developed in Israel.

In 2014, the Iron Dome defense system emerged as the undisputed savior in Israel during the summer conflict with Gaza. Born out of necessity and Israeli chutzpah, the Iron Dome intercepts rockets, artillery and mortars headed for population centers. Sneak preview: Some of the prototype components were taken from a toy car.

Most of these unusual places to lay your head that we featured in this story including a yurt and a converted bus are still in business and popular with visitors looking for a different hospitality experience.

Medical devices and pharmaceuticals are a risky business and not all make it to market. But many of the exciting products anticipated in 2014 went on to successful clinical trials, such as Premia Spines TOPS alternative solution to spinal fusion surgery and CartiHeals implant for treating cartilage lesions in arthritic and non-arthritic joints.

2015

Is clean meat on the way? Photo by Shutterstock

This story exploded on the Internet, going viral within a day. It featured the work of nonprofit Modern Agriculture Foundation, which launched the worlds first feasibility study to determine how to create commercial tissue-engineered chicken breast. We featured the organization again in 2017, and it is still hard at work collaborating with academics and commercial companies to create a clean meat alternative.

We asked photographers across Israel to help us out with this gorgeous compilation of photographs to celebrate Israels 67th birthday.

3. 12 impossible ideas that Israelis turned into reality

Tell an Israeli that their idea is preposterous, and youve just given that inventor a reason to see it through. We loved this article, which highlights not only Israeli innovation, but the Israeli can-do attitude that takes an impossible idea irrigating crops in the desert, or a missile defense shield for an entire country and turns them into reality.

4. Israeli school builds cool classroom for ADHD teens

Our readers loved this story on a new classroom built at the Darca High School inKiryat Malachi, developed specially for children with attention and learning disorders. The room featured bouncy chairs made from yoga balls, walled off cubicles, desks on wheels, and a touch of the outdoor.

5. How well do you know Israel? The quiz

We knew it was going to be a tough one, but we were still surprised when virtually no-one managed to get a full 25 out of 25 questions right. You can still try this quiz. Will you get it right? Dont say you havent been warned!

2016

CartiHeal is advancing its implant for cartilage regeneration. Image by Natalia Budianska Shutterstock.com

1. Syrian refugee creates website to thank Israelis

A Sunni Muslim originally from the city of Homs created Thank You Am Israel, a website dedicated to the Israeli and Jewish organizations and people helping Syrian refugees.

2. 9 of the best Israeli snacks

The rising global popularity of Israeli cuisine isnt limited to gourmet fare. Here we tempted your taste buds with Israels most iconic snack foods, such as Bamba and Krembo, getting attention from bloggers and noshers around the world.

3. 9 of the most beautiful sukkot in Israel

Our readers loved seeing photos of the gorgeous booths created for dining during the Sukkot holiday in the fall, from Jerusalems Waldorf Astoria, to kibbutzim in the north and south, to the Samaritan communities of Mount Gerizim and Holon.

4. My Name is Israel

Our downloadable, printable 15-slide exhibition shares the stories of Israeli aid in the wake of international disasters and Israelis helping refugees even citizens of enemy nations and sharing their expertise and knowledge worldwide. This DIY exhibition, still available on our home page, was displayed in creative ways in several countries.

5. Cartilage regeneration on the way for knees, osteoarthritis

CartiHeal, mentioned already in 2013,caused quite a stir among readers for its groundbreaking Agili-C implant to treat cartilage and osteochondral defects in traumatic and osteoarthritic joints. Agili-C has now been implanted in over 500 clinical study patients with knee, ankle, and great toe cartilage lesions in Europe and Israel; clinical studies have begun in 15 US sites.

2017

Israeli actor Gal Gadot as Wonder Woman. Photo: courtesy

When Hurricane Harvey barreled into Texas in August, Israeli NGO, IsraAID rushed to help. The story touched a chord and was shared on Facebook alone more than 260,000 times.

2. 14 things you didnt know about Gal Gadot

2017 was most definitely Gal Gadots year. In fact, so were 2018 and 2019, and 2020 could turn out to be just as successful for this Israeli actor. But it was in 2017 that Gadot first stormed the world with her role as Wonder Woman. Find out how Beyonc helped her get the part.

3. 25 brilliant tech companies to watch in 2017

In January, we asked high-tech experts which companies to watch for in the coming year. They identified many hot growth areas including augmented reality, auto-tech, fintech, clean-tech, drones and digital health. And many of the companies they mentioned have indeed gone on to significant things.

4. 69 fabulous reasons we love Israel

For Independence Day, we put together a slideshow of photographs showing some of the many reasons we love Israel.

5. Test your glucose levels without drawing blood

Integrity Applications developed a glucose monitoring device that allows diabetics and pre-diabetics to track blood sugar levels without the need to prick a finger. The device is now on sale in several locations around the world.

2018

Koolulam mass singalong at the Tower of David Museum, June 2018. Photo by Ricky Rachman

1. 800 Jews, Christians, Muslims sing One Love in Jerusalem

You just cant watch this video without getting goosebumps. Israel social singing sensation Koolulam gathered Jews, Christians and Muslims at the Tower of David Museum in a vocal show of unity coinciding with the Muslim holiday of Eid al-Fitr.

2. Israeli scientists develop implanted organs that wont be rejected

Its the stuff of sci-fi, only its real: Israeli researchers invented the first fully personalized tissue implant, engineered from a small fatty tissue biopsy from the patient. This will make it possible to engineer any kind of tissue implant for any part of the body, without danger of rejection.

3. One drug could treat Alzheimers, MS, Crohns and more

Hebrew University-Hadassah Medical School Prof. David Naor is developing a single drug that could effectively treat incurable inflammatory diseases such as Crohns disease, ulcerative colitis, rheumatoid arthritis and multiple sclerosis as well as neurodegenerative maladies such as Alzheimers disease.

4. 8 of the most anticipated hotels opening in 2018

Youre always on the lookout for exciting new places to stay in Israel, and this list really whet your appetite. Now you can book rooms at (most of) these fabulous hotels in Tel Aviv-Jaffa, the Galilee and the Negev, aside from two that still havent opened.

5. Rescuers turn to Israeli tech to save trapped boys

Maxtech Networks communications technology helped divers free 12 boys and their coach trapped for 11 days in a flooded Thai cave.

2019

REEs prototype vehicle chassis. Photo by Yuval Chen

It is testament to just how successful and admired Israeli TV shows have become worldwide, that our most popular story of the year was about the best Israeli TV. While many Israeli shows have been remade, streaming services have opened up the original Israeli versions to viewers all over the world to great acclaim. Last week, the New York Times named Hatufim (Prisoners of War) the finest international TV show of the decade, and Fauda came in at number eight.

2. Buy fresh unsold food from restaurants

The new SpareEat app that lets restaurants and markets offer surplus food at the end of the day at a huge discount appealed to readers two-fold firstly they get to eat great Israeli restaurant food at a discount, and secondly it reduces food waste. Its a win-win!

3. An Israeli startup is totally reinventing how cars are built

The inventors thought investors would laugh at them when they came up with the revolutionary idea of a flat modular platform, a bit like a skateboard, that houses all the cars major components, but instead they loved it. We wrote about Ree in September. The following month, the company unveiled its flat-chassis technology inside Hino Motors new FlatFormer design.

4. Could immunotherapy treatment from Israel cure cancer?

In January we ran a story on Jerusalem startup Immunovative Therapies, which is developing an immunotherapy that could potentially cure cancer. No surprises why this was popular. The company has conducted dozens of clinical trials, but its still a very long road ahead. Worth watching in future years.

5. 13 reasons you should eat like an Israeli

Large breakfasts, salad with every meal, copious amounts of vegetables and olive oil, a reliance on the Mediterranean diet its no surprise that Israel was #1 on a new ranking of countries with the lowest rate of diet-related deaths worldwide, and #10 on the 2019 Bloomberg Healthiest Country Index. In our article we took a look at the reasons why.

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The top 45 stories of the decade - ISRAEL21c

JK McKnight, Opinion contributor Published 7:03 a.m. ET Dec. 26, 2019

Life is what happens to you while you're busy making other plans John Lennon

Last summer I left the music industry the land of perpetual planning after a 20-year climb. Over the course of the last year, Ive had the opportunity to look around and see what escaped me previously.

When I drive around our city, I notice more and more concrete, less and less tree canopy. More honking,less patience. More frustration, less fulfillment. It wasnt long ago that we didnt have smart phones, online retail, delivery servicesand other modern conveniences advertised to simplify our lives yet we feel like we have less time than ever before.

What were missing is balance.

In 1980, there was a little-known independent film produced by Francis Ford Coppola titled Koyaanisqatsi.The title is derived from the Hopi tribeand means "life out of balance."The documentary has no words. It shows images of natural landscapes and elemental forces that over time transition to chaotic scenes of modern civilization and technology. Set in fast-paced, consumer-driven Los Angeles, the images move slowly against an orchestral backdrop to achieve maximum dramatic effect. Simple frame by simple frame.

The film reveals humanity growing further and further apart from its native environment. The message is simple: Balance is everything. From the moment of conception, our bodies must maintain the right balance of fluids, gases, nutrients and temperature to grow, surviveand thrive.

Today our lives are out of balance.

Too much time in cars, cubiclesand conference rooms, not enough time in nature. Too much screen time, not enough human time. The largest study of adult development in history (Grant Study, Harvard University) determined that relationships not genetics are the No. 1factor in determining happiness and longevity.

We are social beings whohave depended on one another throughout civilization to survive. We think weve evolved so much from our primitive ancestors. We have not.

You may like: 37 years after Mother Teresa came to Appalachia, her nuns return to help the poor

A life out of balance impacts everything we do, and Im convinced it is responsible for most societal ills. The solution is balance in three core sectors:

We need to get outside the concrete and spend more time outside. A 2017 UK study found 75% of children spend more time indoors than prison inmates. Immersing yourself, family and friends in nature and connecting deeply with them is the antidote we all need. I hear that families dont family anymore. Its true. Husbands and wives need to do a better job of putting their phones (and work) away, especially around children. We all need to talk less, listen more. As they say, no one knows everything, but everyone knows something. Go to great places with great friends, take your relationships off social media and into the real world. Forge real connections. Be vulnerable. Stop preaching, start doing.

Check this out: Here are the 12 highest-rated Louisville restaurants our critic reviewed in 2019

Find your purpose and passion. Work nourishes noble minds, but your work should be meaningful and worth doing for more than money and status. You are not a machine. You are a human being, capable of incredible things. Dream beyond your surroundings. Anything is possible with a plan, setting achievable goals with clear ends coupled with the will and determination to succeed. So consider cutting yourself loose from a job that brings no joy or fulfillment, or a boss that doesnt inspire and uses fear to motivate, and pursue what truly moves you. Work should be rewarding and have a positive impact on your family and community.

More: Courier Journal photographer travels to Belgium looking for the ghost of his father

Embracing community helps us live longer, be happier and more fulfilled, and happiness is the byproduct of fulfillment. We live in a global economy, and what happens on the other side of the planet impacts our daily lives.

Ive found service provides fulfillment that money, status or accomplishment cant possibly reach, a sense of wholeness that connects me to people and places all around the world. One of my most powerful life experiences came in 2015, when I visited the Guayaki Foundation a remote Argentina reserve my Foundation co-sponsors with Patagonia. It was there I met a man, Evaristo Borges, who was our guide through the week.

He was warm and welcoming, and while he couldnt speak a lick of English, I immediately connected to his energy, determination, pride and purpose. I didnt know it until the end of our trip, but his livelihood was made possible by our foundation, and the way he embraced that opportunity said everything I needed. A commitment to service helps mold a high-character person who leaves an enduring, inspiring, positive legacy. Isnt that what we all want?

I challenge us all to think about our daily routine differently, growing together to have greater life, work, community balance in the 2020s.

JK McKnight isthe founder of Louisville'sForecastle Festival, Forecastle Foundation and the Man of the Land: The Art of Impact. Reach him atjk@jkmcknight.com and manoftheland.org.

Read or Share this story: https://www.courier-journal.com/story/opinion/2019/12/26/work-life-balance-rethink-your-daily-routine-these-three-areas/4194977002/

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Our lives are out of balance. Here are 3 ways we can straighten ourselves out - Courier Journal

Clock on white plate with fork and knife, intermittent fasting, meal plan, weight loss concept on ... [+] blue table

With the holidays upon us and everyone focused on watching their waistline, its a natural to think about the ideal diet to prevent weight gain and maybe even promote weight a little loss.

Lets face it, its really difficult to go on a diet. Diets are faced with a high risk of failure with the bulk of them failing, ending with eventual weight gain above and beyond where you started.

The concept of caloric restriction which has been explored as a way to improve longevity has been shown to be successful in animal models (mice), offering an enticing possibility to humans. But implementing this into your daily lifestyle may be problematic and may not be realistic in the long run.

Another more intriguing approach that has been gaining popularity in the past decade is intermittent fasting (IF), a form of time-restricted eating.

In a nutshell, its a way to extend the window of time during the day in which you dont eat. Instead of eating from the time you awaken, the goal is to delay the onset of eating, thereby extending your fasting period that naturally occurs when you sleep.

IF involves only eating for a defined period of time in a 24-hour period. For example, it may involve eating for an 8-hour period during the dayas opposed to grazing on food all day longand fasting for the remaining 16 hours. (During the fast, you are permitted to drink water, have black coffee, or tea.)

For example, instead of eating from 7 am when you awaken, you would begin eating at 11 am or noon until 7 or 8 pm. When you do eat, the goal is to eat moderately, although you are permitted to eat the foods that you would normally eat.

Variations on this theme include the 5:2 approach (eating normally 5 days a week and approximately 500-600 calories 2 days week), or alternate day fasting (ADF).

With IF becoming more popular, its important that physicians and other healthcare professionals be aware of the principles and science behind the diet in order to have a rational discussion with their patients.

In an article published today in the New England Journal of Medicine, Mark Mattson, PhD, a neuroscientist at Johns Hopkins School of Medicine, explains the nuances behind the approach to IF, along with why he adopted this approach to eating more than 20 years ago.

Mattsons personal reasons for adopting intermittent fasting began well before he embarked research into the topic itself. It actually began about 35-40 years ago as a method he could use to reduce symptoms related to acid reflux which he found were worse if he ate breakfast and then rode his bike to work in the research lab.

I started doing it way back in graduate school at the University of Iowa in the early 80s, he explained. So I quit eating breakfast and found that I didnt get the refluxand I havent eaten breakfast since then!

Little did he realize that this was at the beginning of a pursuit of a concept that would shape his research, and have broad implications for disease management, metabolism as well as weight loss.

Health Benefits of Intermittent Fasting

While certain subgroups of patients, including those with diabetes and pre-diabetes may benefit from adopting this approach to eating (by lowering HB A1C levels), its value and principles certainly extends to other subgroups including those with cardiovascular disease, neurologic ailments (multiple sclerosis, Alzheimers and Parkinsons disease) and patients with cancer.

While IF may facilitate weight loss by reduced caloric intake, its more important benefits include improved glucose regulation via lower insulin levels, reduced blood pressure and lower resting heart rate, all indicators of improved health.

There may also be a reduction in weight-related medical conditions such as elevated cholesterol, and non-alcoholic fatty liver disease (NAFLD), offered Dr. Minisha Sood, an endocrinologist at Lenox Hill Hospital, in New York City.

Importantly, intermittent fasting or alignment of eating with our natural circadian rhythms may positively impact the gut microbiome which could improve overall metabolism and health,she explained.

Metabolic Switching

The concept by which this is facilitated is known as metabolic switching, which according to Mattson, is a healthy homeostatic mechanism that evolved in Homo Sapiens over thousands of years during periods when food was scarce. This involves switching by our bodys cells from using glucose during the fed state to free fatty acids (FFA) and ketone bodies during periods of starvation. This switch, which is metabolically advantageous, actually serves to reduce inflammation by utilizing adaptive pathways in our cellular machinery.

As Mattson explains, glucose is the normal fuel our bodies rely on during the fed state. When we eat, excess glucose beyondimmediate caloric expenditures is stored as a compound known as glycogen in the liver for quick burst of energy, but excess as fats (triglycerides). Triglycerides or fat is broken down to compounds known as free fatty acids (FFA) along with glycerol. Further metabolism of FFA by the body produces compounds known as ketone bodies which are used by the brain, heart and other organs during periods when glucose is not immediately available.

Clearly IF is not for everyone, with lifestyle, age, medical history, work hours (shifts) and personal preference being key factors that may influence the ability to adhere to this lifestyle and approach to eating, as Mattson explains. There may also be sex differences and genetics that ultimately influence individual success with IF.

Time restricted eating or intermittent fasting may be actually easier to stick with than daily calorie restriction or daily calorie control, explained Sood. When studied head-to-head, intermittent fasting and daily calorie restriction are both equally effective for weight loss so its really a matter of finding an approach which works with ones lifestyle and which can be followed consistently.

In regard to potential downsides of IF, Sood explained that some people may experience increased hunger toward the end of the fasting period each daythe hunger response may wane over time and people adjust. If they do not feel an improvement in hunger levels or they experience headache or fatigue while fasting they may want to consider a shorter fast or an alternative approach to weight loss.

Health coaches and fitness professionals also have seen encouraging results in terms of improved stamina and muscle strengthening after integrating IF into workouts and training sessions for clients.

Ive seen clients drop 1-2 lbs per week, making no changes to their diet at the startonly changing the time that they eat, said Nicole Winhoffer, a fitness artist, and creator of the NW Method in New York City. Their brains functioned better, they performed better, and were able to execute 30% more in their workouts.

Elite athletes have also embraced this concept, according to Mattson. Its clear that British athletes have excelled in the Tour de France in the last 5-7 years, he offered. The potential reason? The use of keto esther, a supplement which Mattson points out has surged in popularity among elite British cyclists in recent years. The World Anti-Doping Agency (WADA), he explained, has cleared this compound since it is naturally derived. The results have been rather impressive to say the least.

Intermittent Fasting to Treat Chronic Disease

Buy there are several areas where Mattson believes that IF may have positive benefits including cancer and neurologic diseases such as multiple sclerosis (MS) Parkinsons, and Alzheimers disease .

He points out various studies where improvement in tumor burden may be seen. His rationale for this approach is based on the premise that cancer cells can only use glucose to proliferate. With IF, with only ketone bodies available, the cells are unable to survive and the tumor burden is reduced.

Research also supports the numerous beneficial metabolic effects of IF related to neurologic function, including positive effects on verbal and working memory and cognition seen in older adults. The benefits further extend to disease states such as MS where ongoing trials hope to show improved function based on preliminary results seen thus far.

Mattsons article is an important contribution to our understanding of metabolism.It demonstrates that beyond choosing healthy diets and avoiding high sugar/high fat and processed food, the amount of time between meals can provide significant benefits as well, offers Benjamin Hirsh, M.D., Director, Preventive Cardiology, Northwell Health's Sandra Atlas Bass Heart Hospital, Manhasset, New York.

Physician and public health guidance on how to implement healthy lifestyle choices overall will yield much greater benefits overall to individuals hoping to improve their health and the population at large, he explained. However, for the individual who wants to try a diet where the pattern is as much about fasting as it is about food intake choices, there is now a dietary pattern that they can pursue.

However, this also must be done under the guidance of a physician very knowledgeable about this science, and the diet must be followed very strictly, which will be difficult to do outside the context of a clinical trial, he added.

Breakfast As The Least Likely Meal

Mattson sums his thoughts about IF up by stating that from an evolutionary perspective, breakfast is the least likely meal, a reflection of his thoughts that embrace cellular adaptations and metabolic switching as products of evolution of human physiology. Mattson explains that we never awoke to a ready-made breakfast over ten thousand years ago, prior to the agricultural revolution.

Instead, humans had to forage or find food, or make a kill. It involved work and time with the natural process of fasting already part of our existence before we could ever eat.

He also envisions how this approach could one day be adopted as part of an approach or treatment for obesity, to help jumpstart the process with inpatient stay, ideally reimbursed by insurance companies or other third party payers. Since we already treat alcohol use disorder and opiate abuse in this manner, why not obesity? The concept is compelling to say the least.

Read more here:
Can Intermittent Fasting Help You Lose Weight And Improve Your Health? - Forbes

On the night, it didnt seem too alarmist or over the top to think his entire career was in jeopardy. It was the angle at which Zlatan Ibrahimovics leg bent, the way his entire body seemed to vibrate when he hit the deck and the crowds sense of foreboding as this big, powerful man stayed down. Everyone knew the likely diagnosis: ruptured knee ligaments, and that it was the injury every footballer feared the most, especially one who was 18 years into his career.

As it turned out, more fool us for underestimating the man wearing Manchester Uniteds No 9 shirt on that April evening at Old Trafford in 2017.

Ibrahimovic was not the kind of guy, we ought to have remembered, who would be defeated by a career-threatening injury. He was the kind of guywho wouldnail the rehab, attempt a flying bicycle kick in the first minute of his comeback match and have the surgeons in Pittsburgh wanting to use him for medical research.

He would go on to score 53...

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Daniel Taylor: With Zlatan and Ronaldo still united at the top of the game, it's 'what if' for Rooney ahead of... - The Athletic