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Rheumatoid Arthritis Treatment Market Industry Analysis, Trend and Growth, 2017-2027 – Info Street Wire

December 27th, 2019 10:49 am

Study on the Rheumatoid Arthritis Treatment Market

The comprehensive report published by Future Market Insights (FMI) offers an in-depth intelligence related to the various factors that are likely to impact the demand, revenue generation, and sales of the Rheumatoid Arthritis Treatment Market. In addition, the report singles out the different parameters that are expected to influence the overall dynamics of the Rheumatoid Arthritis Treatment Market during the forecast period 2017-2027.

As per the findings of the presented study, the Rheumatoid Arthritis Treatment Market is poised to surpass the value of ~US$ XX by the end of 2029 growing at a CAGR of ~XX% over the assessment period 2017-2027. The report includes a thorough analysis of the upstream raw materials, supply-demand ratio of the Rheumatoid Arthritis Treatment in different regions, import-export trends and more to provide readers a fair understanding of the global market scenario.

ThisPress Release will help you to understand the Volume, growth with Impacting Trends. Click HERE To get SAMPLE PDF (Including Full TOC, Table & Figures) at https://www.futuremarketinsights.co/reports/sample/REP-GB-3119

The presented study addresses the following queries related to the Rheumatoid Arthritis Treatment Market:

The presented market report dives deep into understanding the business strategies adopted by leading market players in the global Rheumatoid Arthritis Treatment Market. Further, the SWOT analysis for leading market players is enclosed in the report along with the revenue share, pricing analysis, and product overview of each company.

The extensive study on the Rheumatoid Arthritis Treatment Market pinpoints the different factors that are likely to influence the prospects of the Rheumatoid Arthritis Treatment Market in each region.

Decisive Information Enclosed in the report:

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key players and products offered

Potential and niche segments, geographical regions exhibiting promising growth

A neutral perspective on market performance

Must-have information for market players to sustain and enhance their market footprint

NOTE All statements of fact, opinion, or analysis expressed in reports are those of the respective analysts. They do not necessarily reflect formal positions or views of Future Market Insights.

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Goldman’s 8 Highest-Conviction Health Care Stocks to Buy – Yahoo Finance

December 27th, 2019 10:49 am

Goldman Sachs is bullish on these health care stocks.

Last U.S. presidential election season, health care stocks didn't perform very well. Political headline risk related to drug pricing and "Medicare for All" could weigh on health care valuations again in 2020. Fortunately for investors, the Goldman Sachs analyst team says there are still plenty of opportunities for long-term investors to buy health care stocks heading into an election year. Goldman says valuations are reasonable, aggressive policy changes are unlikely, innovation and product development are booming and there is consolidation potential in the sector as well. Here are Goldman's eight high-conviction health care stock ideas for 2020.

Amgen (ticker: AMGN)

Amgen is a global biopharmaceutical company that markets drugs for oncology and inflammation. Analyst Terence Flynn says Amgen will likely outperform consensus revenue and earnings per share estimates in 2020 and 2021. After winning a patent battle against arthritis drug Enbrel in August and acquiring plaque psoriasis and psoriatic arthritis drug Otezla shortly thereafter, Flynn says Amgen is on track to grow revenue by between 4% and 8% annually over the next four years. Data on Tezepelumab and AMG 510 may also be near-term catalysts. Goldman has a "buy" rating and $279 price target for AMGN stock.

BioMarin Pharmaceutical (BMRN)

BioMarin is a biopharma company focused on the treatment of serious rare and ultra-rare diseases. Analyst Salveen Richter says BioMarin has a diversified portfolio of treatments that is positioned to deliver more than 20% revenue growth in 2020. Richter estimates BioMarin's seven core commercial products will generate a combined $1.7 billion in fiscal 2019 revenue and peak at more than $6 billion in combined revenue in 2030. Richter estimates peak sales for BioMarin's gene therapy treatment for hemophilia A at $1.3 billion. Goldman has a "buy" rating and $157 price target for BMRN stock.

Incyte Corp. (INCY)

Incyte is a biotech company focused on hematology, oncology and inflammation. Richter says Incyte's lead drug Jakafi is on track for $2.9 billion in peak 2028 sales. In addition, he says Incyte has a strong development pipeline of 21 drugs, with eight already in pivotal-stage clinical trials. Phase III Gravitas-301 data for itacitinib in steroid nave acute graft-versus-host disease should be a near-term catalyst. Richter is anticipating updates from the company's dermatology franchise in the first half of 2020. Goldman has a "buy" rating and $122 price target for INCY stock.

Iqvia Holdings (IQV)

Iqvia is a global advanced analytics, technology and life sciences research company. Analyst Robert Jones says Iqvia is a large-cap growth stock, and its research segment should be particularly strong in 2020. Jones says the market isn't fully appreciating Iqvia's technology segment, which is producing healthy organic revenue growth due to solid demand for real-world evidence. Jones says the election cycle could drive RWE demand in 2020, differentiating Iqvia from other health care stocks that have negative headline risk. Goldman has a "buy" rating and $191 price target for IQV stock.

UnitedHealth Group (UNH)

UnitedHealth is one of the largest global managed care organizations. Analyst Stephen Tanal says United's commercial, Medicare Advantage and Medicaid businesses are all attractive, and its Optum acquisition gives the company access to a unique collection of data and services. Goldman is projecting more than $19 billion in operating cash flow in 2020, with only about $2.3 billion needed for capital expenditures and share buybacks. Tanal says 2020 guidance is conservative, and UnitedHealth is well-positioned for at least 13% annual EPS growth. Goldman has a "buy" rating and $330 price target for UNH stock.

Vertex Pharmaceuticals (VRTX)

Vertex is a biopharma company focused on developing treatments for cystic fibrosis. Vertex is also developing a pipeline of therapies for pain, sickle cell disease, kidney disease and other conditions. Vertex shares gained 25% in the past three months, and Richter says Vertex is on track for impressive EPS growth in the coming years due to its multiple pipeline drivers. Goldman has a "buy" rating and $285 price target for VRTX stock.

Story continues

Dentsply Sirona (XRAY)

Dentsply Sirona is one of the largest manufacturers of dental office solutions, including consumables and high-end equipment. Analyst Nathan Rich says Dentsply Sirona's new Primescan intraoral scanner should benefit from long-term demand and be a major contributor to 2020 revenue growth. In the longer-term Primescan upgrade programs could drive additional revenue upside. In addition, new product launches and the company's One DS loyalty program could be bullish catalysts. Rich says the company's restructuring efforts appear to be ahead of schedule, suggesting potential margin growth opportunities ahead. Goldman has a "buy" rating and $66 price target for XRAY stock.

Zoetis (ZTS)

Zoetis is the global leader in animal health medicines and vaccines. Rich says Simparica Trio could be the world's first $1 billion animal health drug and has the potential to add as much as 30 percent to Zoetis EPS. Favorable pricing and product mix should contribute to cash flow growth and boost margins as well. Finally, Rich says the company's expansion to diagnostics and new pain drugs may be long-term growth opportunities as well. Pet care has also historically been relatively recession-proof, potentially limiting downside risk. Goldman has a "buy" rating and $148 price target for ZTS stock.

Goldman Sachs' top health care stocks for 2020:

-- Amgen (AMGN)

-- BioMarin Pharmaceutical (BMRN)

-- Incyte Corp. (INCY)

-- Iqvia Holdings (IQV)

-- UnitedHealth Group (UNH)

-- Vertex Pharmaceuticals (VRTX)

-- Dentsply Sirona (XRAY)

-- Zoetis (ZTS)

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Drugs for Rheumatoid Arthritis Market 2019 Global Share, Trend, Segmentation and Forecast to 2025 – Market Research Sheets

December 27th, 2019 10:49 am

Global Drugs for Rheumatoid Arthritis Market research report gives a comprehensive outlook of the markets 2019-2025 and offers an in-depth summary of the current market status, historic, and expected way forward for the Drugs for Rheumatoid Arthritis Market. Additionally, to this, the report provides data on the restraints negatively impacting the markets growth. The report includes valuable information to assist new entrants, as well as established players, to understand the prevailing trends in the Market.

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Key Objectives of Drugs for Rheumatoid Arthritis Market Report: Study of the annual revenues and market developments of the major players that supply Drugs for Rheumatoid Arthritis Analysis of the demand for Drugs for Rheumatoid Arthritis by component Assessment of future trends and growth of architecture in the Drugs for Rheumatoid Arthritis Market Assessment of the Drugs for Rheumatoid Arthritis Market with respect to the type of application Study of the market trends in various regions and countries, by component, of the Drugs for Rheumatoid Arthritis Market Study of contracts and developments related to the Drugs for Rheumatoid Arthritis Market by key players across different regions Finalization of overall market sizes by triangulating the supply-side data, which includes product developments, supply chain, and annual revenues of companies supplying Drugs for Rheumatoid Arthritis across the globe

Major Players included in this report are as follows AbbVie IncHoffman-La Roche AGAmgen IncPfizer IncBristol-Myers Squibb CoJohnson & JohnsonUCB Biosciences IncMitsubishi Tanabe Pharma CorpBiogen IncMerck & CoMarket Segment by Product TypePharmaceuticalsBiopharmaceuticals

Drugs for Rheumatoid Arthritis Market can be segmented into Product Types as PrescriptionOTC

Drugs for Rheumatoid Arthritis Market can be segmented into Applications as HospitalClinicsOther

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Drugs for Rheumatoid Arthritis Market: Regional analysis includes:Asia-Pacific (Vietnam, China, Malaysia, Japan, Philippines, Korea, Thailand, India, Indonesia, and Australia)Europe (Turkey, Germany, Russia UK, Italy, France, etc.)North America (United States, Mexico, and Canada.)South America (Brazil etc.)The Middle East and Africa (GCC Countries and Egypt.)

Target Audience: Drugs for Rheumatoid Arthritis Equipment Manufacturers Traders, Importers, and Exporters Raw Material Suppliers and Distributors Research and Consulting Firms Government and Research Organizations Associations and Industry Bodies

Stakeholders, marketing executives and business owners planning to refer a market research report can use this study to design their offerings and understand how competitors attract their potential customers and manage their supply and distribution channels. When tracking the trends researchers have made a conscious effort to analyse and interpret the consumer behaviour. Besides, the research helps product owners to understand the changes in culture, target market as well as brands so they can draw the attention of the potential customers more effectively.

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Report structure:In the recently published report, DataIntelo.com has provided a unique insight into the Drugs for Rheumatoid Arthritis Industry over the forecasted period. The report has covered the significant aspects which are contributing to the growth of the global Drugs for Rheumatoid Arthritis Market. The primary objective of this report is to highlight the various key market dynamics listed as drivers, trends, and restraints.

These market dynamics have the potential to impact the global Drugs for Rheumatoid Arthritis Market. This report has provided the detailed information to the audience about the way Drugs for Rheumatoid Arthritis industry has been heading since past few months and how it is going to take a shape in the years to come.

DataIntelo has offered a comprehensive analysis of the Drugs for Rheumatoid Arthritis industry. The report has provided crucial information about the elements that are impacting and driving the sales of the Drugs for Rheumatoid Arthritis Market. The section of competitive landscape keeps utmost importance in the reports published by DataIntelo. Competitive landscape section consists of key market players functioning in the worldwide industry of Drugs for Rheumatoid Arthritis.

The report has also analysed the changing trends in the industry. Several macroeconomic factors such as Gross domestic product (GDP) and the increasing inflation rate is expected to affect directly or indirectly in the development of the Drugs for Rheumatoid Arthritis Market.

Table of Contents1 Industry Overview of Drugs for Rheumatoid Arthritis2 Manufacturing Cost Structure Analysis3 Development and Manufacturing Plants Analysis of Drugs for Rheumatoid Arthritis4 Key Figures of Major Manufacturers5 Drugs for Rheumatoid Arthritis Regional Market Analysis6 Drugs for Rheumatoid Arthritis Segment Market Analysis (by Type)7 Drugs for Rheumatoid Arthritis Segment Market Analysis (by Application)8 Drugs for Rheumatoid Arthritis Major Manufacturers Analysis9 Development Trend of Analysis of Drugs for Rheumatoid Arthritis Market10 Marketing Channel11 Market Dynamics12 Conclusion13 Appendix

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Global Septic Arthritis Treatment Market Growth (Status and Outlook) 2019-2024 | Exclusive Report by Magnifier Research – Market Research Sheets

December 27th, 2019 10:49 am

Global Septic Arthritis Treatment Market 2019 by Company, Regions, Type and Application, Forecast to 2024offers an orderly representation of the market that proposes a positive growth rate in the upcoming years. The report contains the combinations, methods, summarized study, and data gathered from various sources. The research experts have studied the historical data and provided an idea of the direction this market will take in the forthcoming years. The report involves key insights pertaining to industry deliverables, particularly market trends, market share, market competitors and recognized players, market size, current valuation, and revenue estimations for the forecast period from 2019 to 2024. The research study is reliable, wide-ranging, and the result of strong analytical research on theSeptic Arthritis Treatmentmarket.

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The report investigates evaluates theSeptic Arthritis Treatmentmarket on the basis of market segments and geographical areas and current market trends. Various factors such as development, rapidly increasing demand, economic stability are directly and indirectly fuelling growth in the market are also covered in the report. An assessment of the technical barriers, other issues, as well as market restraints is determined. Key market competitors who majorly hold the market shares in terms of demand, supply, and income through their products, services, and after deal processes are studied and their comprehensive abstract has been provided in the report.

The report encloses a precise evaluation of theSeptic Arthritis Treatmentmarket, including growth rate, current scenario, and volume inflation prospects, on the basis of Porters Five Forces analysis. It provides reliable and authentic projections regarding the market. The report has thoroughly studied the market report on the basis of R&D developments, distribution channels, industrial penetration, manufacturing processes, and revenue.

Lupin Pharmaceuticals (US), F. Hoffmann-La Roche Ltd (Swtizerland), AbbVie Inc (US), Amgen Inc (US), Bristol-Myers Squibb Company (US), Johnson & Johnson (US), Pfizer (US),

The global version of this report with a geographical classification such as:

North America (United States, Canada and Mexico), Europe (Germany, France, UK, Russia and Italy), Asia-Pacific (China, Japan, Korea, India and Southeast Asia), South America (Brazil, Argentina, Colombia), Middle East and Africa (Saudi Arabia, UAE, Egypt, Nigeria and South Africa)

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Moreover, manufacturing base distribution, production area, and product type, concentration rate mergers & acquisitions, expansion are provided in the report. The report further has included a new project SWOT analysis, investment feasibility analysis, investment return analysis, and development trend analysis. It also delivers vital information referring to the industrys concentration ratio.

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Auranofin Market Status And Forecast 2027, By Players, Types And Applications – Market Research Sheets

December 27th, 2019 10:49 am

Auranofin is a gold-containing salt with chemical formula and name C20H34AuO9PS and Gold, 2,3,4,6 tetraacetate respectively. It is used for treatingarthritis and is classified as an antirheumatic agent by World Health Organization and is also called disease-modifying antirheumatic drug (DMARD). Antirheumatic drugs are the ones that are used in the treatment of rheumatism. Auranofin is known by different names in different countries. Auranofin improves arthritis symptoms like painful, tender and swollen joints and morning stiffness. Also, it is said to decrease the pain by reducing inflammation and it slows down or stops the immune system from attacking the joints and Auranofin acts by inhibiting DNA synthesis. Auranofin should be considered only when other non-steroidal anti-inflammatory drugs and appropriate steroids are ineffective in controlling the symptoms of rheumatoid arthritis.

The use of Auranofin is increasing as the number of people having arthritis is increasing. This can driveauranofin marketas it is effective and is reported to exhibit less serious side effects as compared to other drugs that are used for treating arthritis.

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Increasing Demand for Auranofin Owing to Rising Arthritis Demographics

According to CDC reports, arthritis is still a serious health crisis in the U.S. and it is a global epidemic as well. Recent estimates showed that nearly 91 million Americans might have arthritis (37%), including one- third of those aged bwtween18 to 64 plus 300,000 children approximately. The underlying reasons for the increasing population with arthritis are obesity, lack of physical activity, Vitamin D deficiency and others. Also, Arthritis is rising in Europe, Latin America and in Middle East Africa and reasons being sedentary lifestyle and in some cases, heredity. The growing population with arthritis is anticipated to fuel the Auranofin market as it is less severe than the other drugs that serve the same purpose.

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The Auranofin market is rising because of the growing arthritis population and it is expected to grow in the coming years. The key players of Auranofin include Ferro Pfanstiehl Laboratories, Inc.,Prometheus laboratories inc, JOHNSON MATTHEY INC, Lek Pharmaceuticals d.d, Medichem SA and Company Overview ofLonza Group Ltd and others. Apart from them, more industrialists and manufacturers are showing a keen interest in the Auranofin as the demand for the auranofin, due to the rising population with arthritis is growing and is expected to escalate until and unless people dont practice healthy lifestyle and engage themselves in physical activities.

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‘Your Songs Will Live On. You Will Be Missed.’ Rick Charette Leaves The Stage – Maine Public

December 27th, 2019 10:49 am

Beloved Maine childrens singer Rick Charette and his Bubblegum Band played their 29th annual holiday concert at St. Josephs College earlier this month. It was a sold-out show, standing room only. As always, the price of admission was a new, unwrapped toy for a child in need.

Its likely to be Charettes final public performance ever.

Health challenges are forcing the 72-year-old author of Alligator in the Elevator and I Love Mud off the stage. But he doesnt want to make a big deal of it.

Id like to have people thinking of the music when they think of me, rather than my physical condition, Charette said. Thats why Im downplaying it.

He hinted at his retirement back in 2018, and while Charette is reluctant to talk about specifics, he said a combination of arthritis, a nagging shoulder injury and a touch of Parkinsons disease are making it difficult to perform his energetic shows. Charette would rather stop while hes still at the top of his game, rather than fizzle out and fade away.

I knew I should have said something about it being the last one, but I just couldnt bring myself to do it, Charette said. It would have been just too sad.

For now, hes telling people who want to book him to call back in the spring, when he might feel better. Charettte knows thats not likely, though.

Im ever hopeful but still accepting that, at some point, some things are the way they are, he said.

In the meantime, Charette can look back on an exceptional 35-year career of writing, singing and making children happy.

Charette grew up in Westbrook. When he graduated from Cheverus High School in 1965, music was already a big part of his life.

Pete Seeger was my hero in terms of what he could do to have the whole audience in the palm of his hand, singing along, Charette said over a cup of coffee at his kitchen table in Windham.

He also admired Bob Dylans songwriting.

While earning a degree in English at the University of Southern Maine, Charette found moderate local success as a folksinger, wielding an acoustic guitar, dulcimers and the occasional banjo. He played the bar and coffeehouse circuit and opened for better-known acts such as Tom Rush.

He wasnt always happy, though.

Playing for adults, I was a nervous wreck, Charette said. It was painful. Then, I played a little bit for kids, and it was a whole different vibe. I seemed to relax and be comfortable.

He knew hed found his niche.

Singing with kids meant he did not have to play in smoky bars anymore where the music was secondary to drinking and gabbing. Kids didnt yell requests for Neil Young all night, either.

I liked the hours a lot better, Charette said.

Bubble Gum was the first childrens song he wrote. Kids immediately latched on to its gentle, bouncing cadence and quirky lyrics: I dont like frog legs cause they smell like feet. You can take away the liver. Give me something sweet Bubble gum, bubble gum. Lots of fun with my bubble gum.

By 1983, Charette had recorded an albums worth of original material. He also scored a distribution deal with Activity Records.

When the record came out, it gave me credibility as a performer for kids, he said.

The company passed on his second batch of songs in 1985. They thought Charettes tunes werent educational enough. They wanted more colors and numbers.

At that juncture, Charette and Roy Clark, his piano player and arranger, hatched a plan. They both mortgaged their homes and started their own company, Pine Point Records. Their first release was the album Alligator in the Elevator.

That went on to sell several hundred thousand copies, Clark said.

Charettes best-known song, I Love Mud, appeared on that record.

All I have to do is sing, Mud, mud, I love mud, and everyone finishes the rest of the chorus, Charette said. And its usually the grown-ups singing loudest.

Clark said its Charettes ability to listen to kids, to take their interests seriously, that makes him a good songwriter. Instead of deciding what a child should be singing, he finds out what kids want to sing about.

Thats special. Thats unique, Clark said.

All told, Pine Point Records released 11 albums by Charette. The latest came in 2016.

With a hit childrens record, Charette was soon playing concerts and teaching school songwriting workshops across the country. Many of Charettes his best-loved songs include hand motions or sign language to help keep wee ones engaged. Skunk, bear and alligator puppets also played prominent roles in his performances.

Its beautiful pandemonium, said bassist Mike Burd of Industry. Burds played in the Bubblegum Band for about three years. Rick is a totally humble, gentle, self-effacing, completely transparent, honest guy. The kids fall all over him and follow him all around. The parents do the same thing and, in many cases, the parents parents did the same thing. He has this multigenerational audience. Everybody knows all the words to every song.

Charette has always shied away from politics or broad moralizing in his songs, focusing instead on warmth, fun and singability.

I just want it to be a happy time for them, he said. I think it makes a difference for kids, later in life just knowing someone cares for them giving them that time to play.

Its been a good life for Charette. Hes a happily married father of three and grandfather of two. Hes a longtime resident of Windham, living in an immaculate condo with access to Sebago Lake. Recently, however, hes started to feel his age.

My 60s were good, Charette said. But it seems like when I hit 70, I hit a wall.

Thats when he had a bicycle accident. Charette broke his collarbone and a few ribs, going down hard on a hidden curb.

The bones healed, but his shoulder has never been the same, making it hard to play the guitar. Charette also has arthritis and Parkinsons disease which hes opening up about for the first time.

Ive been reluctant to put that out there in public, he said. Its just the beginning stages and sometimes, when people know something like that about you, they start treating you differently.

He doesnt want that. Charettes early symptoms are manifesting mostly in tight muscles. They make it hard to move around. His feet often feel leaden, immobile.

I wouldnt want to present that onstage. You want kids dancing around, he said. In my mind, in my head, Im still right there. But physically, its just too difficult.

Looking ahead, Charette dreams of hiking when the weather gets nice again. He also imagines days when he might feel well enough to volunteer singing with children, stuck in the hospital. Hes still thinking up songs, too. Charette recently wrote one about Windham and gave it to a local schoolteacher.

Some days are better than others, and when they are, I try to make the most of them, Charette said.

He thinks about his musical legacy, pondering what its meant to himself and the thousands of children hes sung songs with.

Thats something Ive wondered, Charette said. Will this just be time that was taken up? Will they really remember any of it?

As news of his retirement spreads, hes getting his answer.

Cards, letters and Facebook messages are starting to pour in. People tell him about the impact his music had on their lives and now on their childrens lives.

He performed at my school all the time. I had Ricks records on my Christmas list in the 80s when I was a kid, said Heather Hilton, who grew up in Limington. Last year his downloads were on my sons wish list.

Hilton said her 5-year-old son especially likes Charettes epic song Where Do My Sneakers Go at Night? Hiltons mother, an elementary school teacher, still plays Charettes songs in her classroom and said her pre-K students still love them.

One card Charette received this month reads: From my birthday party in kindergarten, to Baxters first concert, youve made us smile throughout the years. Thank you for your wonderful gift of music. Your songs will live on. You will be missed.

It came with a smiling family portrait and was signed, Allyson, Baxter and Tristan.

After his final concert, one little girl waited in line to meet Charette. When it was her turn, she handed him a crinkled drawing of a snowman. It was signed, in pencil, From Athena.

I dont think its sunk in, yet, Charette said, looking at the drawing and the card. Sometimes, I beat myself up. I wish I could do more. Then, I have to remind myself to feel good about the things Ive already done.

Clark thinks Charettes music will be around long after both of them are gone. He points out that I Love Mud and Alligator in the Elevator are so familiar in the kid world, that many people mistake them for traditional folk songs in the public domain.

That seems to suit Charette just fine.

If I had to sum up the whole thing, Im just so gratified that Ive had this run, this experience, Charette said. Its always been the words and the music and the kids.

This story appears through a media sharing agreement with Bangor Daily News.

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9 Symptoms of Type 1 & Type 2 Diabetes: Complications …

December 27th, 2019 10:47 am

What are the chronic complications of diabetes?

These diabetes complications are related to blood vessel diseases and are generally classified into small vessel disease, such as those involving the eyes, kidneys and nerves (microvascular disease), and large vessel disease involving the heart and blood vessels (macrovascular disease). Diabetes accelerates hardening of the arteries (atherosclerosis) of the larger blood vessels, leading to coronary heart disease (angina or heart attack), strokes, and pain in the lower extremities because of lack of blood supply (claudication).

The major eye complication of diabetes is called diabetic retinopathy. Diabetic retinopathy occurs in patients who have had diabetes for at least five years. Diseased small blood vessels in the back of the eye cause the leakage of protein and blood in the retina. Disease in these blood vessels also causes the formation of small aneurysms (microaneurysms), and new but brittle blood vessels (neovascularization). Spontaneous bleeding from the new and brittle blood vessels can lead to retinal scarring and retinal detachment, thus impairing vision.

To treat diabetic retinopathy, a laser is used to destroy and prevent the recurrence of the development of these small aneurysms and brittle blood vessels. Approximately 50% of patients with diabetes will develop some degree of diabetic retinopathy after 10 years of diabetes, and 80% retinopathy after 15 years of the disease. Poor control of blood sugar and blood pressure further aggravates eye disease in diabetes.

Cataracts and glaucoma are also more common among diabetics. It is also important to note that since the lens of the eye lets water through, if blood sugar concentrations vary a lot, the lens of the eye will shrink and swell with fluid accordingly. As a result, blurry vision is very common in poorly controlled diabetes. Patients are usually discouraged from getting a new eyeglass prescription until their blood sugar is controlled. This allows for a more accurate assessment of what kind of glasses prescription is required.

Kidney damage from diabetes is called diabetic nephropathy. The onset of kidney disease and its progression is extremely variable. Initially, diseased small blood vessels in the kidneys cause the leakage of protein in the urine. Later on, the kidneys lose their ability to cleanse and filter blood. The accumulation of toxic waste products in the blood leads to the need for dialysis. Dialysis involves using a machine that serves the function of the kidney by filtering and cleaning the blood. In patients who do not want to undergo chronic dialysis, kidney transplantation can be considered.

The progression of nephropathy in patients can be significantly slowed by controlling high blood pressure, and by aggressively treating high blood sugar levels. Angiotensin converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor blockers (ARBs) used in treating high blood pressure may also benefit kidney disease in patients with diabetes.

Nerve damage from diabetes is called diabetic neuropathy and is also caused by disease of small blood vessels. In essence, the blood flow to the nerves is limited, leaving the nerves without blood flow, and they get damaged or die as a result (a term known as ischemia). Symptoms of diabetic nerve damage include numbness, burning, and aching of the feet and lower extremities. When the nerve disease causes a complete loss of sensation in the feet, patients may not be aware of injuries to the feet, and fail to properly protect them. Shoes or other protection should be worn as much as possible. Seemingly minor skin injuries should be attended to promptly to avoid serious infections. Because of poor blood circulation, diabetic foot injuries may not heal. Sometimes, minor foot injuries can lead to serious infection, ulcers, and even gangrene, necessitating surgical amputation of toes, feet, and other infected parts.

Diabetic nerve damage can affect the nerves that are important for penile erection, causing erectile dysfunction (ED, impotence). Erectile dysfunction can also be caused by poor blood flow to the penis from diabetic blood vessel disease.

Diabetic neuropathy can also affect nerves to the stomach and intestines, causing nausea, weight loss, diarrhea, and other symptoms of gastroparesis (delayed emptying of food contents from the stomach into the intestines, due to ineffective contraction of the stomach muscles).

The pain of diabetic nerve damage may respond to traditional treatments with certain medications such as gabapentin (Neurontin), phenytoin (Dilantin), and carbamazepine (Tegretol) that are traditionally used in the treatment of seizure disorders. Amitriptyline (Elavil, Endep) and desipramine (Norpraminine) are medications that are traditionally used for depression. While many of these medications are not indicated specifically for the treatment of diabetes related nerve pain, they are used by physicians commonly.

The pain of diabetic nerve damage may also improve with better blood sugar control, though unfortunately blood glucose control and the course of neuropathy do not always go hand in hand. Newer medications for nerve pain include Pregabalin (Lyrica) and duloxetine (Cymbalta).

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Diabetes tips 2020 for a fit and healthy life – TheHealthSite

December 27th, 2019 10:47 am

Diabetes is a condition where your body either does not produce enough insulin or it is unable to use the insulin that it produces effectively. Insulin is a hormone that regulate your blood sugar levels. Uncontrolled diabetes can lead to many chronic health problems that can, at times, be fatal. The World Health Organisation says that diabetes can be treated, and its consequences avoided or delayed with diet, physical activity, medication and regular screening and treatment for complications.

Here, we reveal the best diabetes tips to follow in 2020. With our tips, you can save your self from a lot of adverse complications and live a long and healthy life.

If you are overweight, try to come down to your ideal body weight. Maintaining your body weight will help you to keep your blood sugar levels under control. If you think it will help, consult a nutritionist or your doctor. Hey will be able to guide you on the right path.

Add a lot of fruits and vegetables to your diet. Have fibre rich foods and avoid processed and sugary foods. Eat whole grains and legumes. Keep away from alcohol and stop smoking. All this will boost your overall health and also help you to keep your diabetes in check.

This test will help you know your average blood sugar level for the past 2 to 3 months. This will go a long way in helping you to formulate a plan to check your sugar levels. Seek an appointment with your doctor and get this test done. You should ideally do this twice a year. It will help you know if you are on the right track.

Heart diseases is a common complication of diabetes. And, blood pressure has a direct impact on heart diseases. So, it is essential to keep blood pressure levels under control. Go for regular check -ups and take prescribed medications for blood pressure.

This will improve overall fitness and health. It will help you lose weight and control cholesterol and blood pressure. Try to squeeze in at least 30 minutes of exercise e very day. Anything that increases heart rate will help.

Published : December 27, 2019 2:16 pm | Updated:December 27, 2019 2:30 pm

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Could the Way You Make Your Coffee Impact Your Health? – Bicycling

December 27th, 2019 10:47 am

When you think about your preride prep, chances are, the coffee is just as important as the gels or energy bars you stash in your pockets. Which is good, because the health benefits of coffee, including a decreased risk of certain cancers, dementia, and stroke, are widely known. And while there is evidence that a cup of joe can also protect against the development of type 2 diabetes, new research out of Sweden found that the way you make your coffee might play a bigger role in the diseases prevention than previously thought.

In the study, published in the Journal of Internal Medicine, researchers looked at data from 421 participants in the Vsterbotten Intervention Program (1991 to 2005) who, after about seven years, developed type 2 diabetes and compared them to 421 participants who stayed healthy.

They looked at specific biomarkers in the participants blood samples (that were frozen from the Vsterbotten Intervention Program) and found that those who drank two to three cups of filtered coffee a day were 60 percent less likely to develop type 2 diabetes than those who drank only one cup of filtered coffee a day. However, drinking unfiltered coffeeboiled, K-cups, or French press, for examplehad no effect on type 2 diabetes risk.

So whats the deal? While researchers dont know for sure, the compounds in coffee that are known to elevate your blood lipid and homocysteine (an amino acid) levelswhich could lead to type 2 diabetesget captured in the filter paper and dont actually make it into the coffee you end up drinking, according to Rikard Landberg, Ph.D., study coauthor and head of the Division of Food and Nutrition Science at Chalmers University of Technology.

While this may seem alarming, Landbergs takeaway is still a positive one: Coffee isnt detrimental to your overall health. Intake of two to three cups per day could make a significant contribution to a healthy lifestyle for prevention of type 2 diabetes, he told Bicycling.

[Find 52 weeks of tips and motivation, with space to fill in your mileage and favorite routes, with the Bicycling Training Journal.]

While this specific study found that filtered coffee may be best for prevention, coffee, in general, contains chromium, which helps your body utilize insulin (a hormone that regulates your blood sugar).

So if you have a family history of diabetes or simply want to reduce your chances of developing it later in life, go ahead and sip a cup for a jolt of caffeine in the morning as well as an afternoon pick-me-up. Itll do more than just wake you up.

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Dexcom Partners With Tandem Diabetes Care on Insulin Pump in Parts of Europe – dLife.com

December 27th, 2019 10:47 am

DexCom, Inc. has partnered with Tandem Diabetes Care in the UK,Sweden,Italy, andSpainto distribute the Dexcom G6 CGM System integrated with the Tandem Diabetes Care t:slim X2 insulin pump for people with diabetes.

Tandems t:slim X2 insulin pump with Basal-IQ technology uses Dexcom G6 CGM readings to predict glucose levels 30 minutes ahead and suspend insulin delivery when glucose is predicted to go low.

Insulin delivery resumes as soon as sensor glucose values begin to rise. The use of the integrated system reduced the time spent below 3.9 mmol/L (70 mg/dL) by 31 percent compared to the use of a CGM-integrated pump without automated insulin suspension1.

Combining the Dexcom G6 with Tandems t:slim X2 insulin pump will meaningfully improve diabetes management. Not only does the system eliminate the need for fingersticks, but it also helps patients reduce the frequency and duration of low-glucose events, saidErik Bjorkman, Dexcoms General Manager for EMEA.

Also, with the Dexcom G6 app, users can share their glucose information with up to five people. Whether you are a parent of a child with diabetes or an adult, the Dexcom G6 lets you seamlessly keep track of glucose levels and enables the users care team to remotely monitor their loved ones for extra peace of mind.

The t:slim X2 insulin pump with Basal-IQ technology, combined with the Dexcom G6, presents a meaningful advancement in the automated insulin delivery category, offering people with diabetes a simple-to-use system that predicts and helps prevent lows with zero fingersticks, saidBrian Hansen, executive vice president and chief commercial officer for Tandem Diabetes Care.

Some of the Dexcom G6 features include:

The CE Marking confirms that the G6 system meets the Essential Requirements of the Medical Device Directive MDD 93/42/EEC as amended by 2007/47/EC.

The powerful and ground-breaking new system is also the first CGM system to receive the US Food and Drug Administrations (FDA) De Novo classification.

With this new classification, the Dexcom G6 CGM system is indicated for use as both a stand-alone CGM and for integration into automated insulin dosing (AID) systems.

For more information on Dexcom G6, visitwww.dexcom.com/global.

Source:

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Excess Fat That Spills From the Liver into the Pancreas May Cause Type 2 Diabetes – Interesting Engineering

December 27th, 2019 10:47 am

Diabetes is a troublesome disorder that can cause havoc on the body. According to the International Diabetes Federation, approximately463 million adultswere living with diabetes in 2019 and by 2045 this number is set to rise to700million.

Furthermore, theproportion ofpeople with type 2 diabetes is increasingin most countries. Now, a new study has found that "fat over-spills from the liver into the pancreas" may be what is responsible for triggering type 2 diabetes.

RELATED:WEIGHT TRAINING CAN CONTROL DIABETES IN OBESE PEOPLE

The research followeda group of people who had type 2 diabetes but had lost weight and successfully reversed the condition.The researchers uncovered that type 2 diabetes is caused as a response to too much fat in the body.

We saw that when a person accumulates too much fat, which should be stored under the skin, then it has to go elsewhere in the body. The amount that can be stored under the skin varies from person to person, indicating a personal fat threshold above which fat can cause mischief," said in a statementProfessor Roy Taylor, from theNewcastle University Institute of Translational and Clinical Research,

When fat cannot be safely stored under the skin, it is then stored inside the liver and over-spills to the rest of the body including the pancreas. This clogs up the pancreas, switching off the genes which direct how insulin should effectively be produced, and this causes Type 2 diabetes.

The study brings good news for type 2 diabetes sufferers as it indicates that the condition is reversible. In fact,previous Newcastle studies that found that type 2 diabetes can be reversed led to the large DiRECT trial.

This trial found that weight loss techniques combined with a low-calorie diet resulted in a remission of type 2 diabetes.

This means we can now see type 2 diabetes as a simple condition where the individual has accumulated more fat than they can cope with," said Taylor.

Importantly this means that through diet and persistence, patients are able to lose the fat and potentially reverse their diabetes. The sooner this is done after diagnosis, the more likely it is that remission can be achieved.

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What Every Person With Diabetes Should Know About Insulin Resistance – Yahoo Lifestyle

December 27th, 2019 10:47 am

Ive been on a real insulin-resistance kick lately. Its imperative that all people with diabetes understand the causes of insulin resistance and thus the importance of reducing it with a healthy diet and active lifestyle.

Causes of insulin resistance are multi-factorial. First: obesity, specifically abdominal obesity. This is primarily due to a high circulation of free fatty acids and unwanted fat deposits in the muscles and liver (enlarged adipose tissues at max capacity). This process causes chronic inflammation, resulting in a decrease in protective metabolic regulators and an increase in inflammatory mediators. These mediators have been directly associated with increased insulin levels (or insulin requirements). This inflammatory process can also occur high fat diets.

Lipoatrophy, the partial or complete loss of adipose tissue, and lipodystrophy, unwanted fat deposits in the muscles or liver (fatty liver), have also been associated with insulin resistance. The reason for this is unclear, but it is hypothesized that this condition results in a decrease in insulin receptor expression and insulin signaling. People with PCOS are also prone to higher levels of insulin resistance as a result of their associated generalized lipodystrophy. Acanthosis nigricans (Google it) is a common skin condition observed with lipodystrophy and is often seen in insulin resistant PWD.

Related: The 'Taboo' Type 1 Diabetes Medication: What to Know About GLP-1 Therapy

Research also shows a correlation between chronic stress and insulin resistance thanks to the hormone cortisol. In acute stress, cortisol stimulates production of glucose by the liver, designed to be immediately utilized in a fight-or-flight response. Chronic stress, however, is directly correlated with increased insulin requirements (endogenous or exogenous), a disruption of insulin signaling, and impaired overall insulin-mediated glucose uptake.

Menstruation tends to have a negative effect on insulin resistance, particularly just after ovulation. There is little research, but this phenomenon is thought to be due to the progesterone spike that happens during the luteal phase. Hopefully, there will be more research on this topic in the near future (insert empowering feminist comment here).

These are a few of the many contributors to insulin resistance. I havent even scratched the surface so I will likely do another post shortly. I just wanted to get some food for thought out to you all. Those of you who have been following me closely know that I have been attempting to decrease my insulin resistance with a low-fat, plant-based, whole-food diet. I have been on the diet for about a week thus far and have really been enjoying it! I have seen a reduction in my prandial insulin requirements, yet I have been eating more than I was when on my previous standard diet. Also, Ive really been enjoying fruits, something I used to stay away from!

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6 Ways to Pull Yourself Out of Diabetes Burnout

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Limited eating times could be new way to fight obesity, diabetes – Sumter Item

December 27th, 2019 10:47 am

By Satchin Panda University of California San Diego Pam Taub University of California San Diego

People with obesity, high blood sugar, high blood pressure or high cholesterol are often advised to eat less and move more, but our new research suggests there is now another simple tool to fight off these diseases: restricting your eating time to a daily 10-hour window.

Studies done in mice and fruit flies suggest that limiting when animals eat to a daily window of 10 hours can prevent, or even reverse, metabolic diseases that affect millions in the U.S.

We are scientists - a cell biologist and a cardiologist - and are exploring the effects of the timing of nutrition on health. Results from flies and mice led us and others to test the idea of time-restricted eating in healthy people. Studies lasting more than a year showed that TRE was safe among healthy individuals. Next, we tested time-restricted eating (TRE) in patients with conditions known collectively as metabolic syndrome. We were curious to see if this approach, which had a profound impact on obese and diabetic lab rats, can help millions of patients who suffer from early signs of diabetes, high blood pressure and unhealthy blood cholesterol.

A leap from prevention to treatment

It's not easy to count calories or figure out how much fat, carbohydrates and protein are in every meal. That's why using TRE provides a new strategy for fighting obesity and metabolic diseases that affect millions worldwide. Several studies had suggested that TRE is a lifestyle choice that healthy people can adopt and that can reduce their risk for future metabolic diseases.

However, TRE is rarely tested on people already diagnosed with metabolic diseases. Furthermore, the vast majority of patients with metabolic diseases are often on medication, and it was not clear whether it was safe for these patients to go through daily fasting of more than 12 hours - as many experiments require - or whether TRE will offer any benefits in addition to those from their medications.

In a unique collaboration between our basic science and clinical science laboratories, we tested whether restricting eating to a 10-hour window improved the health of people with metabolic syndrome who were also taking medications that lower blood pressure and cholesterol to manage their disease.

We recruited patients from UC San Diego clinics who met at least three out of five criteria for metabolic syndrome: obesity, high blood sugar, high blood pressure, high level of bad cholesterol and low level of good cholesterol. The patients used a research app called myCircadianClock, developed in our lab, to log every calorie they consumed for two weeks. This helped us to find patients who were more likely to spread their eating out over the span of 14 hours or more and might benefit from 10-hour TRE.

We monitored their physical activity and sleep using a watch worn on the wrist. As some patients with bad blood glucose control may experience low blood glucose at night, we also placed a continuous glucose monitor on their arm to measure blood glucose every few minutes for two weeks.

Nineteen patients qualified for the study. Most of them had already tried standard lifestyle interventions of reducing calories and doing more physical activity. As part of this study, the only change they had to follow was to self-select a window of 10 hours that best suited their work-family life to eat and drink all of their calories, say from 9 a.m. to 7 p.m. Drinking water and taking medications outside this window were allowed. For the next 12 weeks, they used the myCircadianClock app, and for the last two weeks of the study they also had the continuous glucose monitor and activity monitor.

Timing is the medicine

After 12 weeks, the volunteers returned to the clinic for a thorough medical examination and blood tests. We compared their final results with those from their initial visit. The results, which we published in Cell Metabolism, were pleasantly surprising. We found most of them lost a modest amount of body weight, particularly fat from their abdominal region. Those who had high blood glucose levels when fasting also reduced these blood sugar levels. Similarly, most patients further reduced their blood pressure and LDL cholesterol. All of these benefits happened without any change in physical activity.

Reducing the time window of eating also had several inadvertent benefits. On average, patients reduced their daily caloric intake by a modest 8%. However, statistical analyses did not find strong association between calorie reduction and health improvement. Similar benefits of TRE on blood pressure and blood glucose control were also found among healthy adults who did not change caloric intake.

Nearly two-thirds of patients also reported restful sleep at night and less hunger at bedtime - similar to what was reported in other TRE studies on relatively healthier cohorts. While restricting all eating to just a six-hour window was hard for participants and caused several adverse effects, patients reported they could easily adapt to eating within a 10-hour span. Although it was not necessary after completion of the study, nearly 70% of our patients continued with the TRE for at least a year. As their health improved, many of them reported having reduced their medication or stopped some medication.

Despite the success of this study, time-restricted eating is not currently a standard recommendation from doctors to their patients who have metabolic syndrome. This study was a small feasibility study; more rigorous randomized control trials and multiple location trials are necessary next steps. Toward that goal, we have started a larger study on metabolic syndrome patients.

Although we did not see any of our patients go through dangerously low levels of glucose during overnight fasting, it is important that time-restricted eating be practiced under medical supervision. As TRE can improve metabolic regulation, it is also necessary that a physician pays close attention to the health of the patient and adjusts medications accordingly.

We are cautiously hopeful that time-restricted eating can be a simple, yet powerful approach to treating people with metabolic diseases.

The Conversation is an independent and nonprofit source of news, analysis and commentary from academic experts.

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ESPN reporter Edward Aschoff diagnosed with pneumonia and HLH before he died – WPVI-TV

December 27th, 2019 10:47 am

When ESPN reporter Edward Aschoff died, he had been diagnosed with multifocal pneumonia and a rare disease known as HLH, his fiance tweeted.

Aschoff was first admitted to the hospital and diagnosed with pneumonia in many parts of his lungs but was brought back to the emergency room when antibiotic treatment failed and he got worse, Katy Berteau said.

HLH, hemophagocytic lymphohistiocytosis, is a rare disease that affects the immune system.

She did not provide any further details about the manner of Aschoff's death, which occurred on his 34th birthday.

Other people, including Aschoff himself, expressed surprise about the seriousness of the illness in a young man in apparently good health.

"Anyone ever had multifocal (bilateral) pneumonia in their early 30s as some who never gets sick and has a very good immune system? Asking for two friends ... my lungs," he tweeted on December 5.

More questions have come up about his second diagnosis, HLH. It is unclear if Aschoff had HLH or pneumonia first, if one came from the other, and exactly how he died so quickly.

Here is what we know about the diseases Aschoff's had:

Pneumonia is when air sacs in the lungs fill with fluid or pus. It can be caused by a virus, bacteria or a fungus, causing a fever and respiratory problems.

It can occur in one or both lungs, and multifocal means the pneumonia occurs in multiple places.

Thousands of people die around the world each year of pneumonia, but most healthy people can fight it off, especially with antibiotics and antiviral medications. The people most at risk are the young, elderly, frail or immune-compromised.

What is HLH?

HLH is a rare disease that affects the immune system, making certain white blood cells attack other blood cells and enlarging the spleen and liver, according to Johns Hopkins Medicine.

It can be inherited or acquired, Johns Hopkins said. About a quarter of cases are passed down through families, and the rest come from infections, a weakened immune system and cancer.

Is it dangerous?

There is treatment for HLH, and acquired forms may clear when properly treated, Johns Hopkins said. If familial HLH goes untreated, it is usually fatal.

Treatments include chemotherapy, immunotherapy, steroids, antibiotic drugs and antiviral drugs. Stem cell transplants can cure HLH in most cases if drug treatments don't work, Johns Hopkins said.

There is no way to prevent HLH, the medical center said.

The-CNN-Wire& 2019 Cable News Network, Inc., a WarnerMedia Company. All rights reserved.

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Sickle cell patient is pain free after geneediting trial altered her DNA – The Times

December 27th, 2019 10:47 am

Sickle cell disease is a genetic condition in which red blood cells, which should be circular, adopt a crescent shape and are sticky and rigidALAMY

The first patients to receive gene-editing treatments for inherited blood diseases will enter the new year free of agonising symptoms.

The experiments suggest that altering DNA could treat sickle cell disease (SCD) and beta thalassemia, conditions both caused by faulty genes that hamper the bloods ability to carry oxygen.

The companies behind the trials said that a patient in the US with SCD had been well since July. A thalassemia patient in Germany had been free of symptoms for nine months. Previously she had 16 blood transfusions a year.

British patients could be offered similar experimental therapies next year. The treatment for both conditions involved a high-precision gene-editing tool called Crispr-Cas9. It was used to alter the DNA of some of the cells of Victoria

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Updates in the Management of Multiple Myeloma – Pharmacy Times

December 27th, 2019 10:47 am

Kirollos S. Hanna, PharmD, BCPS, BCOP

The National Comprehensive Cancer Network MM panel prefers triplet therapy over doublet as the standard of care for all patients because of improved response rates, depth of response, and rates of progression-free survival (PFS) or overall survival.3 The combination of a proteasome inhibitor (PI), an immunomodulatory drug (IMiD), and a corticosteroid remains the cornerstone of frontline treatment for patients, regardless of eligibility for autologous stem cell transplant (ASCT). As an example, the bortezomib/lenalidomide/dexamethasone regimen is a preferred category 1 recommendation for transplant-eligible and -ineligible patients.3

Many agents administered as frontline therapy for patients with MM are used in the relapsed/refractory setting. Choice of therapy is influenced by what was used in the frontline setting, patient comorbidities and organ function, response assessment from prior treatment, tolerability of prior therapy, and time to relapse. Despite numerous treatment combinations, the primary goals of therapy for all patients with MM are disease control, improved quality of life, and prolonged survival. MM remains incurable to date. This article reviews select novel treatments that have recently expanded the therapeutic landscape for patients with MM and highlights others in the pipeline.

Daratumumab as Frontline Treatment for MMDaratumumab (Darzalex), an anti-CD38 monoclonal antibody, was initially approved on November 16, 2015, for the treatment of patients with relapsed/refractory MM.4 The FDA recently approved 2 daratumumab combination regimens as frontline treatment for patients with MM.

The MAIA trial (NCT02252172), an open-label, randomized (1:1), active-controlled phase 3 study, compared daratumumab 16 mg/kg, in combination with lenalidomide (Revlimid), and low-dose dexamethasone (DRd) with lenalidomide and low-dose dexamethasone (Rd) in patients with newly diagnosed MM who were ineligible for ASCT.5 A total of 737 patients were randomized, 368 to the DRd arm and 369 to the Rd arm. MAIA demonstrated an improvement in PFS in the DRd arm compared with the Rd arm. The median PFS had not been reached in the DRd arm and was 31.9 months in the Rd arm (HR, 0.56; 95% CI, 0.43-0.73; P <.0001), representing a 44% reduction in the risk of disease progression or death in patients treated with DRd. In responders, the median time to response was 1.05 months (range, 0.2-12.1) in the DRd group and 1.05 months (range, 0.3-15.3) in the Rd group. The median duration of response had not been reached in the DRd group and was 34.7 months (95% CI, 30.8not estimable [NE]) in the Rd group. In patients with newly diagnosed MM who received DRd, the most frequent (20%) adverse ef fects (AEs) were infusion reactions, diarrhea, constipation, nausea, peripheral edema, fatigue, back pain, asthenia, pyrexia, upper respiratory tract infection, bronchitis, pneumonia, decreased appetite, muscle spasms, peripheral sensory neuropathy, dyspnea, and cough.

The CASSIOPEIA trial (NCT02541383), an open-label, randomized, active-controlled phase 3 study, compared induction and consolidation treatment withbortezomib, thalidomide, and dexamethasone (DVTd) with treatment with bortezomib, thalidomide, and dexamethasone (VTd) in patients with newly diagnosed MM who were eligible for ASCT.6 A total of 1085 patients were randomized, 543 to the DVTd arm and 542 to the VTd arm. CASSIOPEIA demonstrated an improvement in PFS in the DVTd arm compared with the VTd arm. At a median follow-up of 18.8 months, the median PFS had not been reached in either arm. Treatment with DVTd resulted in a reduction in the risk of progression or death by 53% compared with VTd alone (HR, 0.47; 95% CI, 0.33-0.67; P <.0001). In patients with newly diagnosed MM who received DVTd, the most frequent (20%) AEs were infusion reactions, periph eral sensory neuropathy, constipation, asthenia, nausea, peripheral edema, neutropenia, thrombocytopenia, pyrexia, and paresthesia. AEs that occurred with 5% frequency in the DVTd arm were infusion reactions, nausea, neutropenia, thrombocytopenia, lymphopenia, and cough. No significant differences were observed in the number or type of serious AEs between the 2 treatment arms.

Selinexor for Relapsed/Refractory MMSelinexor (Xpovio) offers a novel mechanism of action as a first-in-class selective inhibitor of nuclear export 1 (XPO1).7 XPO1 inhibition leads to accumulation of tumor suppressor proteins in the nucleus; reductions in several oncoproteins, such as cMyc and cyclin D1; cell cycle arrest; and apoptosis of cancer cells. Selinexor in combination with dexamethasone is indicated for adult patients with relapsed/refractory MM who have received at least 4 prior therapies and whose disease is refractory to at least 2 PIs, at least 2 IMiDs, and an anti-CD38 monoclonal antibody.4

Investigators evaluated the efficacy of selinexor plus dexamethasone in the STORM trial (NCT02336815), a multicenter, singlearm, openlabel study.7,8 In STORM part 2, 122 patients were treated with selinexor 80 mg in combination with dexamethasone 20 mg on days 1 and 3 of every week. The overall response rate (ORR) was 25.3% (95% CI, 16.4-36.0), with 1 stringent complete response, no complete responses, 4 very good partial responses, and 16 partial responses. The median time to first response was 4 weeks (range, 1-10).

The median duration of response was 3.8 months (95% CI, 2.3-NE). Common AEs reported in at least 20% of patients included thrombocytopenia, fatigue, nausea, anemia, decreased appetite, decreased weight, diarrhea, vomiting, hyponatremia, neutropenia, leukopenia, constipation, dyspnea, and upper respiratory tract infection.

It is important to note the first dose reduction is administered as 100 mg once weekly, followed by 80 mg and 60 mg once weekly for subsequent reductions.7 Patients should receive antiemetic therapy prior to doses of selinexor.

Ongoing Clinical TrialsInvestigators continue to evaluate novel drug mechanisms and therapeutic combinations, aiming to optimize treatment outcomes and safety for patients throughout all stages of disease. B-cell maturation antigen (BCMA) targeting has demonstrated efficacy in treating MM.9 Anti-BCMA chimeric antigen receptor T-cell therapies, such as idecabtagene vicleucel, received FDA breakthrough therapy designation for treating relapsed/refractory MM based on data from the phase 1 CRB-401 trial. Antibody-drug conjugates such as belantamab mafodotin have demonstrated an ORR of 60% with a median duration of response >1 year, based on findings from the phase I DREAMM-1 trial.10

The treatment landscape of MM is extremely bright, with novel agents and combinations in various clinical trial phases. Importantly, clinicians should remain up-to-date on novel therapies to provide optimal and safe therapeutic options for patients in all phases of treatment.

REFERENCES

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From the image of a black hole to ‘artificial embryos’, 2019 was the year of many firsts in science – Economic Times

December 27th, 2019 10:47 am

NEW DELHI: An image of the black hole, the stuff of science fiction down the decades, was at the centre of a year that saw science breaching new frontiers with exciting firsts such as the development of a quantum computer that can outperform its classical counterparts and artificial embryos.

Cutting edge innovations in research and technology celebrated science and forwarded humankind's understanding of complex realities of the universe. The year will also be remembered as the year of testing biological and ethical limits in the laboratory, helping researchers find new avenues in the treatment of critical diseases.

In April, the International Event Horizon Telescope collaboration, consisting of a global network of radio telescopes, unveiled the first actual image of a black hole, a place in space where gravity pulls so much that even light cannot escape.

To produce the image, the researchers combined data from a network of radio telescopes to take simultaneous readings from around the world.

Science magazine named the image of the supermassive black hole situated at the centre of the Messier 87 galaxy, 54 million light years away, as the 2019 Breakthrough of the Year.

The imaging of the black hole is a fantastic revelation that is simultaneously a validation and a celebration of science, Ayan Banerjee, from the Indian Institute of Science Education and Research (IISER) in Kolkata, told PTI.

Although it does not uncover something that we did not know earlier, it does convert science fiction into science -- which is crucial for the acceptance of science in the daily lives of human beings, and the generation of future scientists, Banerjee said.

In a year that marked the 50th anniversary of the Apollo Moon landings, lunar exploration was high on the agendas of space agencies.

In January, China's Chang'e-4 probe became the first spacecraft to land safely on the far side of the Moon. Its rover Yutu-2 continues to roll across the dusty soils of Von Karman crater on the lunar body.

Other attempts to explore the Earth's natural satellite were not so successful.

To produce the image, the researchers combined data from a network of radio telescopes to take simultaneous readings from around the world. In April, an Israeli-led effort to put the first private spacecraft on the Moon's surface ended in a crash landing. The same fate was met by India's ambitious Chandrayaan-2 Vikram lander in September.

The ongoing Mars missions returned a host of results. In April, NASA announced that its robotic Mars InSight lander had recorded a marsquake for the first time ever.

The marsquake' is the first recorded trembling that appears to have come from inside the planet, as opposed to being caused by the forces above the surface, such as wind.

There were many firsts in the micro world of laboratories too.

US researchers restored cellular function in 32 pig brains that had been dead for hours, opening up a new avenue in treating brain disease -- and shaking our definition of brain death to its core.

Announced in April in the journal Nature, the researchers at the Yale University School of Medicine devised a system roughly analogous to a dialysis machine, called BrainEx, that restores circulation and oxygen flow to a dead brain.

In another out-of-body experiment, scientists grew monkey embryos in a dish for nearly three weeks -- longer than primate embryos have ever been grown in the laboratory before.

The advance raised ethical concerns of whether lab-grown human embryos should be allowed to develop beyond 14 days, a restriction imposed in most countries.

In September, researchers at the University of Michigan in the US provided a possible circumvention of the 14-day limit by using human stem cells to make artificial embryos' that mimic the early development of a real human embryo.

Our stem cell structures that mimic embryos can help fill critical gaps in knowledge about early human development, and that could lead to a lot of good, Jianping Fu, an associate professor at Michigan, who led the study, said in a statement.

In October, Google took a quantum leap in computer science. Using its state-of-the-art quantum computer, called Sycamore, the tech giant claimed "quantum supremacy" over the most powerful supercomputers in the world by solving a problem considered virtually impossible for normal machines.

The quantum computer completed the complex computation in 200 seconds. That same calculation would take even the most powerful supercomputer approximately 10,000 years to finish, according to researchers from the University of California, Santa Barbara, who published their results in the journal Nature.

A fantastic discovery has been that of Google's 53 qubit quantum computer ('quantum supremacy), Banerjee said.

And for the first time in July, an artificial intelligence (AI) bot beat human champions at multiplayer poker.

The AI programme developed by Carnegie Mellon University in the US in collaboration with Facebook AI defeated leading professionals in six-player no-limit Texas hold'em poker, the world's most popular form of poker.

The AI, called Pluribus, defeated poker professional Darren Elias, who holds the record for most World Poker Tour titles, and Chris Ferguson, winner of six World Series of Poker events.

In August, researchers from Oxford University and IBM Research made the first-ever ring-shaped molecule of pure carbon in the lab by using an atomic-force microscope to manipulate individual molecules.

Carbon can be arranged in a number of configurations. For example when each of its atoms is bonded to three other carbon atoms, it's relatively soft graphite.

A ring of carbon atoms, where each atom is bonded to just two others, and nothing else has eluded scientists for 50 years. Their best attempts have resulted in a gaseous carbon ring that quickly dissipated.

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From the image of a black hole to 'artificial embryos', 2019 was the year of many firsts in science - Economic Times

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Association Between Change in Circulating Progenitor Cells During Exercise Stress and Risk of Adverse Cardiovascular Events in Patients With Coronary…

December 27th, 2019 10:46 am

1. A decrease in circulating progenitor cells during exercise stress-testing in patients with stable coronary artery disease is associated with worse outcomes than the presence of myocardial ischemia.

Evidence Rating Level:2 (Good)

Risk stratification for stable coronary artery disease (CAD) typically involves the measurement of stress-induced myocardial ischemia, often using single-photon emission computed tomography (SPECT) myocardial perfusion imaging. However, given the cost and radiation exposure associated with this technique, efforts are being focused towards the identification of surrogate biomarkers. Recent evidence suggests that levels of circulating progenitor cells (CPCs) and resident stem cells may be decreased in patients with myocardial ischemia, however, the impact on adverse cardiovascular events is unknown. In this prospective cohort study, 454 patients with stable CAD were studied to investigate the association between the change in CPC counts during stress testing and the risk of adverse cardiovascular events, specifically, cardiovascular death and myocardial infarction (MI). CPCs were enumerated with flow cytometry as CD34+mononuclear cells, with additional evaluation of subsets co-expressing the chemokine receptor 4 (CXCR4+), at rest and 45 minutes after stress testing. Stress-induced myocardial ischemia was measured with SPECT myocardial perfusion imaging at rest and 30 to 60 minutes after stress testing. At baseline, 76% of patients were men, and 31.3% had stress-induced ischemia by SPECT. Researchers found that those with stress-induced ischemia had a decrease in circulating CD34+/CXCR4+cells (median decrease 20.2%, IQR -45.3 to 5.5, p<0.001), whereas those without stress-induced ischemia experienced a cell count increase (median increase 3.2%, IQR -20.6 to 35.1, p<0.001). After adjusting for demographic variables and comorbidities, every unit increase in the ischemic defect was found to be associated with a 13% decrease in CD34+cell counts after exercise stress. During a median follow-up of 3 years, 5.2% of patients experienced adverse events (12 cardiovascular deaths, 12 MIs). Stress-induced ischemia was significantly associated with adverse events after adjustment for covariates (HR 2.79, 95% CI 1.55 to 5.03). Furthermore, each 50% decrease in the CD34+/CXCR4+count after stress testing, was found to be significantly associated with adverse outcomes, even after adjusting for presence of ischemia (HR 1.84, 95% CI 1.34 to 3; HR 2.59, 95% CI 1.15 to 5.32, respectively). In summary, this study suggests that a decreased CPC count during and after exercise is an even stronger predictor of adverse outcomes in patients with stable CAD than stress-induced myocardial ischemia. Thus, further research on the prognostic implications of increasing CPC mobilization are warranted.

Click to read the study in JAMA Cardiology

Image: PD

20192 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from2 Minute Medicine, Inc. Inquire about licensinghere. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

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Intermittent fasting could improve longevity – The Hill

December 27th, 2019 10:45 am

A new study poses that eating during a 6- to 8-hour window and fasting for the remaining 16 to 18 hours can increase longevity and help support weight loss.

Titled Effects of Intermittent Fasting on Health, Aging, and Disease, the study was authored by Mark Mattson and Rafael de Cabo. It states that eating in a 6-hour period and then abstaining from food for the remainder of the day can catalyze a metabolic switch in the body that makes cells switch from glucose-based energy to ketone-based energy. In this process, the cells convert fat to energy.

Some benefits of the diet are supposedly increasing stress resistance, longevity, decreasing the risk for diseases like cancer and obesity, aiding weight loss efforts, and having more energy overall.

There are some pitfalls to intermittent fasting, however; aside from it being a very difficult diet to maintain (approximately 38 percent give it up), some individuals with particularly low blood sugar, such as people with diabetes, may not be suited to restricting their calories and limiting their daily meals.

Additionally, people with cardiovascular conditions may suffer from the disturbance in the bodys electrolytes.

Aside from preexisting conditions, intermittent fasting can be helpful. Matteson is quoted saying Patients should be advised that feeling hungry and irritable is common initially and usually passes after two weeks to a month as the body and brain become accustomed to the new habit."

While studies have been relatively small, they showcase a success rate; another report authored in 2018 found that people with type 2 diabetes were able to reduce their insulin intake after practicing intermittent fasting. The report did note, however, that the trial was medically supervised.

Speaking to CNN, Dr. Abhinav Diwan, an associate professor at Washington University in St. Louis, cautioned individuals who are ready to try intermittent fasting.

People do not want to put themselves at risk by fasting without consulting a doctor."

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Intermittent fasting could improve longevity - The Hill

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Governments And Employers Need To Get Real About Longevity – Forbes

December 27th, 2019 10:45 am

By Carol Hymowitz, Next Avenue Contributor

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As lifespans lengthen around the world, men and women are: delaying when they marry and have children; returning to school as adults to gain skills and working beyond traditional retirement age. In countries as dissimilar as Japan and Morocco, theyre marrying five to 10 years later on average than their parents did.In the United Kingdom, more women are having babies in their 40s than before turning 20. And in the U.S., most employees 50 and older say they want to keep working after turning 65.

Now, governments and businesses need to catch up to individuals efforts adapting to longevity. The policymakers and employers have to revise their work, education, health care and other policies once designed for much shorter, different lives.

That was the consensus of economists, physicians, executives, educators and others from almost every continent who met at the Rockefeller Bellagio Center in Italy this fall to begin charting a global longevity agenda. The conference, organized by the Stanford Center on Longevity and The Longevity Forum with support from the Rockefeller Foundation and Prudential Assurance Singapore, was the first major interdisciplinary global convening on longevity. (You can read more about it on the Stanford Center on Longevity site.)

If we live a hundred-year life using the same norms that worked for sixty or seventy years, its unlikely to be a good long life, said Andrew Scott, an economics professor at University of London, co-organizer of the conference and co-author of The 100-Year Life. And while theres much that individuals need to do to adjust, they wont be able to seize the advantages of longer lives without policy changes from governments, corporations and other institutions.

The conference participants discussed numerous, varied issues, such as:

While many countries have begun addressing longevity, the most comprehensive planning is occurring in Singapore. In that country, the average life expectancy is 85 among the highest in the world and about 24% of the labor force is 55 or older, up from 14% in 2008.

Also on Forbes:

But Singapore isnt focusing on building nursing homes. Instead, the island city-nation is investing $3 billion to support lifelong learning and employability, health and wellness, financial literacy and multi-generational housing, among other initiatives.

Singapores only resource is human capital, and our population is aging faster than in any other country. We realized we had to address this to survive, John Eu-Li Wong, professor in medical sciences and senior vice president, National University of Singapore, told participants at the Bellagio conference.

The countrys longevity agenda was also discussed at a November conference in Singapore, also supported by the Rockefeller Foundation and Prudential Assurance Singapore.

To sustain economic growth, Singapore over the next decade is raising its retirement age from 62 to 65 and requiring employers to reemploy men and women who want to work until at least 70.The government there also gives businesses a 3 percent credit to offset wages of employees over 50 and makes grants to companies so they can modify jobs for older workers.

In addition, wellness programs in all communities include regular screenings for chronic diseases, and activities such as Tai Chi and dance lessons. National Silver Academy, a network of colleges and community-based organizations, offers post-secondary education to older people, who can take courses in technology, business, literature and other subjects, and who often share classrooms with youth. A SkillsFuture program teaches Singaporeans of all ages necessary skills for future jobs, and a MoneySense program teaches young and old alike how to manage money and invest.

Singapores small size (population: just 5.8 million) and a lack of U.S.-style partisan politics battles make it easier to implement a nationwide longevity plan. But its effort to harness the advantages of being an aging society is a model for other countries, said Laura Carstensen, executive director of the Stanford Center on Longevity and co-leader of the Bellagio conference.

Instead of focusing on frail old age, Singapore is trying to support people all the way through their long lives," Carstensen noted. "Its changing the narrative from aging is a burden to longevity is an opportunity.

Developing nations are beginning to launch age-friendly programs while continuing to grapple with problems like providing clean water and building adequate roads.

In Bangladesh, where average life expectancy has risen to about 73 from 48 in 1960, a strong network of non-governmental organizations (NGOs) is taking the lead in addressing aging and longevity.

For example, Dhaka-based BRAC (formerly called the Bangladesh Rehabilitation Assistance Committee), the worlds largest NGO, is funding research and treatment of hypertension, diabetes and other noncommunicable diseases.BRAC also offers microloans to adults seeking to start small businesses. Such efforts are enabling Bangladeshi to live longer and more prosperous lives.

Wealthier, developed countries looking at longevity often have an array of uncoordinated programs to help residents stay productive and healthy longer.Some have been launched by governments; others by nonprofits or private companies.

In the United Kingdom, The Pension Advisory Service (TPAS) and insurer Aviva are experimenting with programs to help middle-aged people evaluate their jobs, finances and health, as well as their plans for later in life.In 2018, TPAS targeted a small group of self-employed workers, aged 35 to 50, with one-to-one phone conversations. There are now plans to make this midlife checkup an online program.

Just like when you take your car to the garage, UK Pensions Minister Guy Opperman said when launching the program, this service will highlight where improvements might be made to ensure everything is running smoothly.Aviva initially enrolled about 100 employees in workshops; it will offer the programs to all UK employees 45 and older.

Many European countries, including Denmark and Finland, now offer digital literacy training to adults. The goal: ensuring that older as well as younger people arent excluded from an increasingly digitized world.

In Ireland, where just 17% of those aged 65 to 74 have at least basic digital literacy skills, according to a 2017 Eurostat survey, the government has funded several nonprofits to provide 10 hours of free computer instruction to anyone who has never used the Internet. Its targeted for people over 45 and those who live in rural areas, are disabled or unemployed.

In the U.S., the federal government and most employers are not yet doing much to address longevity. Yet, as Kerry Hannon wrote on MarketWatch, Americans 65 to 74 and age 75 and older are expected to have faster annual rates of labor force growth than others. And just 77% of workers surveyed by the Transamerica Retirement Study said their employer is supportive of working past 65.

But U.S.-based nonprofits like Encore.org are tapping the potential of longer lives and intergenerational connections to help solve social problems.And ones such as iRelaunch and PathForward help midlifers re-enter the workplace after absences or layoffs.

Most people, whether they live in San Francisco or Singapore, when asked about their aspirations for living until 100, say I hope I dont outlive my money, orI hope I dont get dementia, said Carstensen.Its time to overcome those anxieties by envisioning, and sharing, all the ways we can use our extra time to improve the quality of our lives.

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Governments And Employers Need To Get Real About Longevity - Forbes

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