Archive for October, 2019

Scientists now know that genetics, although important, are not everything and what people are exposed to in the environment matters a great deal for predicting disease risks and overall health. There is reason to believe its especially vital for pregnant women and babies, so much so that its driving a new emerging field of study known as exposome research,or the investigation of human exposures as they relate to health. New data indicates that children may be at risk for everything from early puberty, male infertility, high blood pressure, certain cancers, autoimmune diseases, and even autism, depending on what they come into contact with in the womb.

There is probably a genetic component to autism, but its pretty clear that autism happens somewhere during fetal development at some critical time, says Dr. Michael Snyder, a medical doctor and geneticist. Understanding what the pregnant mom is exposed to and how that might lead to autism is a big deal and the answer is not really known. A lot of stuff is happening and its really important to know what moms are being exposed to. Prenatal exposures are very under-studied and very important to study.

The good news is that recent advances have made studying environmental exposures more possible than ever before. The challenge is, they have a lot of work to catch up on.Snyder, who also teaches and runs the Snyder Lab at Stanford University, is currently working with his colleagues to catalog as many relevant chemical and biological compounds in order to figure out exactly what it means for parents and their developing children. Here, he sharedwhat we know about how the environment, how it can hurt babies, and how much more there is left to be learned.

Its probably safe to say the field of exposome research is not well understood by the general public. What can you tell me about how this research works and how the data is developing?

Exposures can fall into different types. There are biological exposures, like allergens and things like that, and there are chemical exposures, called particulates. Were just starting to classify them, but we havent broken down the composition so much. Whats special about our work is that were trying to understand it in more detail what were exposed to, and on an individual level. Most research before would just put a device in a neighborhood to see the exposures as a whole, but what were doing is trying to tell the difference between my exposure and yours.

Do you have any examples?

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One of the most obvious examples of this is smoking. We tell pregnant women not to smoke because of the clear chemical carcinogens that are going to be dangerous to the fetus. Clearly, most pregnant women dont smoke but theyre obviously exposed to lots of other things and I dont think we know what all those things are.

And youre seeing growing public interest in this research. Why?

People are realizing that autism is on the rise and its not just a matter of increased diagnosis anymore. Its reasonable to think that environmental exposures might contribute to that.People are starting to care about chemical exposure in the environment now because were learning it affects their kids, but also they are making the connections between things like polluted rivers and cancer. Data on people getting cancer living near toxic dumps is really quite clear. That awareness helps.

What else are you finding in the research that parents should know about.

What we and others are finding is that plastics are everywhere, certain carcinogens are everywhere, VEET which is found in bug sprays is everywhere. Having said that, their concentrations range from one place to another. Weve been able to show that location is probably the number one factor, but seasons are also a factor, especially when it comes to biological exposures, but to some extent chemicals as well.

Your exposure is pretty dynamic, meaning when you go from one place to the next there are very different exposures, some are chemical, some are more fungal. Some areas are loaded with more pesticides than others. If we can understand this better, we can reduce some of the exposures in bad areas.

What about plastics? Is the growing concern about the impact of plastics on our health warranted?

Most of us grew up during a time when plastic was everywhere and just assumed to be inert, meaning it didnt move. But clearly there is stuff that leaks out of plastics, and its only been realized more recently that that stuff is getting into what we eat. That is a recent phenomenon compared to even a few years ago because now we can measure it. From our work, it was very eye-opening to see that plastics were in nearly every sample we looked at. I certainly didnt expect that and it does raise concerns.

People hypothesize, but dont conclusively know, that girls are going through puberty earlier. Its been suggested that a lot of the stuff out there looks like estrogen related compounds that could be influencing that. A lot of these things are very similar to plastics.

What scientific advances have made it more possible to measure exposures?

Advances in DNA and RNA sequencing have helped us better identify the biological compounds its getting cheaper and easier to do that. After wearing a device for two years, I was exposed to over 2,000 different strains and we can pick that up and quantify all that now. Same goes for chemical compounds. Mass optometry is getting more and more sensitive and our ability to detect and identify these chemicals has gone up. Those technologies have been very powerful in finding whos been exposed to what.

Exposome research is getting a lot more attention in Europe and international communities. Why is the U.S. seemingly falling behind?

The European Union is rolling out a big initiative of environmental exposures. Theyre just awarding grants now, but we havent seen, anything like that in the United States. China is very concerned about it as well. I think part of it is just how funding has gone for this. Most of the funding in the U.S. comes from the NIEHS, The National Institute of Environmental Health Sciences, and thats a very small institute compared to the overall National Institutes of Health. Most of the funding for biomedical research comes from NIH, but it doesnt fund environment research, because that is funded by NIEHS, and that is much smaller. Its just the way the funding is set up in the U.S.

So how long will it take for the research to catch up with the environment? How many years off are we from knowing how exposures affect people, especially developing babies?

In fairness were still just cataloging this and our work is incomplete. Step one is to identify all these things and then step two is that were doing most of these studies with mice, which is helpful, but we need to start doing them with humans and were still a few years away.

Estimating an exact number of years is tricky because that can change, but I do think it will take a long time, at least several years, to get everything cataloged. Then to test their effects is going to take many more years, so it will take some time. Maybe a decade, but there will certainly be things we learn between now and the next ten years. There will just more to learn after ten years. If we knew the answers, it wouldnt be science. Regionally, most of this will take 10 years or more, but I sure hope we can catalog everything in the next few years, and then once you know what youre exposed to, you can determine its effects.

Based on what we currently know what are the safest places and seasons for pregnant women?

We dont know much about seasons. Where we live in the Bay Area, we know that pine and eucalyptus peak in the late spring, early summer. So people with severe allergies may have a problem. But we know that there are other fungi that come in the fall, and if youre allergic to that, it wont be a good time for you. People in the northeast may avoid some of this in colder temperatures in the winter because they stay inside. Then there was a time when we heated homes with kerosene, and that wasnt good for our health either. But we dont know what this means for pregnancy.

Assuming its the same for fetuses everywhere, living near highways in cities, there are clearly a lot more particulates in the air, and that is generally perceived as bad. Toxic dump sites are not good either, and anywhere there is excessive amounts of pollution would be a place to avoid. But the reality is that most people dont have a choice where they live. They cant go buy a new house somewhere and theyre stuck where theyre stuck.

Its very nuanced and I dont think we know the effects all of these exposures have on peoples health. For all we know there is a major health hazard going around and no one is doing anything about it. It is all very concerning to me.

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Want to Know About Your Baby and Fetus Health? Know Your Exposome - Fatherly

There are any number of ways to quantify the astonishing things that Jos Altuve has wrought as a 66-inch-tall ballplayer wielding a 33-inch-long bat.

Statisticians can testify that Altuve has hit 11 postseason home runs a record for Major League Baseball second baseman including three in the just-completed American League Division Series.

High-speed cameras can document that Altuves Thursday night home run, the final blow in the Astros 6-1 victory over the Tampa Bay Rays that wrapped up the hard-fought, best-of-five series, traveled 405 feet and left his bat at 103.6 mph with a launch angle of 26 degrees.

Biomechanics analysts can postulate that Altuves success derives from a relatively high strength to body mass ratio, fast-twitch muscular interaction and exceptional ability to translate energy through adjacent body parts.

But it takes the words of a witness such as Justin Verlander, armed only with his two good eyes and an appreciation of the skills required to play big-league baseball, to provide an adequate summary of what these elements represent to anyone playing with or against Altuve.

The stamp of an incredible ballplayer is when you know immediately, after playing with them a week or two, how special they are, Verlander said before the Astros open the American League Championship Series against the Yankees on Saturday at Minute Maid Park.

Altuve beats you in every facet of the game, he added. He beats you with his legs. He beats you with his arm. He beats you with his contact. He can hit the long ball. He has range at second base that is unbelievable. He does everything extremely well, and when you put it all together and add in that clutch gene that he has, it makes Jos Altuve.

Astros fans have marveled at Altuve for a decade, through his arrival in 2011 with teams that lost at least 100 games three years in a row through the ballclubs rebuild with three straight 100-win seasons, the 2017 World Series title and Altuves selection with Texans defensive lineman J.J. Watt as Sports Illustrateds 2017 Sportspersons of the Year.

However, his recent power surge, with a career-high 31 home runs in MLBs year of the long ball, plus three more in the Division Series, has focused new attention on the astonishing things that Altuve can perpetrate upon an incoming baseball.

Truth be told, those who study baseball, strength training and biomechanics say that Altuve, with 11 homers in 165 postseason plate appearances, succeeds because of the same elements that powered Babe Ruth, who at 6 feet, 2 inches tall and 215 pounds had 15 homers in 167 World Series plate appearances.

Its our expectations, they say, that are befuddled by Altuves excellence.

He has signals that go to his brain to his arms quicker than other people, and he can react to them, Astros general manager Jeff Luhnow said. He sees things like no one else sees things. It involves eyes, the way people are wired and their physical abilities.

Hes one of the elite athletes of the world. I dont think we can explain why Michael Jordan did what he did or what LeBron James does or what any elite athlete does. They just have the ability to do it.

Altuves relatively small size has long been the subject of some humor. Witness the website howmanyaltuves.com, where users can calculate distances in units paired to Altuves height (which the website says is 5 feet, 5 inches); 100 yards, for example, is 55.38 Altuves.

Height, however, is not a liability in baseball to the degree that it is in other team sports. Wee Willie Keeler, Rabbit Maranville, Phil Rizzuto, Joe Sewell and Hack Wilson all were selected to the National Baseball Hall of Fame despite standing 5-foot-6 or shorter, and Wilson in 1930 hit 56 home runs with an MLB record 191 RBIs.

Dr. Glenn Fleisig, research director for the American Sports Medicine Institute in Birmingham, Ala., said one of baseballs singular virtues is that players of any stature can excel given certain other attributes.

Biomechanics is a fancy word for technique, which is the proper sequence of different motions. When do you rotate your hips? How much do you rotate them? When do you twist your trunk? When do you extend your elbow? he said. The guys who succeed can consistently fire body parts at the right time with the right amount of flexibility and power.

You have to have the right combination. Its not genetics, its not conditioning, its not training. Its everything. You have to have all three. You cant have just two. And proper mechanics is the same for the big guys and the little guys.

Matthew Mahar, director of the School of Exercise and Nutritional Sciences at San Diego State University, said Wilson may be the Hall of Famer who most resembles Altuve in terms of body composition.

My visual analysis suggests that they both used relatively large bats and were able to generate great bat speed, which would lead to the force needed to hit the long ball, Mahar said. They both appear to use enormously strong lower bodies to generate bat speed.

Duane Knudson, a professor at Texas State University in San Marcos who is president of the International Society of Biomechanics in Sports, said certain physical forces favor a player of Altuves size.

The larger person has more body mass to fling around to swing a bat, Knudson said. Think about Arnold Schwarzenegger having to twist his trunk to hit a baseball. Now think about Simone Biles and the amount of strength that she has relative to her body mass.

Strength researchers talk about relative strength. I would imagine that Jos Altuve has a very high strength to body mass ratio, and hes able to make the most of his stature.

Astros shortstop Carlos Correa may lack up-to-date knowledge of biometric analysis, but, like Verlander, he knows what he sees when it comes to Altuves relative strength.

Pound for pound, he is the strongest guy in the clubhouse. He is a strong human being, Correa said. Hes fast. His legs are strong. He can squat more than anybody in the weight room. He can do maybe 20 pullups in a row, and nobody else can do that in here.

His power is insane, and he can transfer it to the ball. Call it what you want, but the man is good.

In 2011, when Altuve made his Astros debut, a story on the website FanGraphs.com said that based on his height and the attributes he displayed during his early career, he most resembled those of Bip Roberts, who at 5-foot-7 played 12 years in the big leagues and was a career .294 hitter with 30 home runs and an on-base percentage of .358 with 264 stolen bases and an on-base plus slugging percentage of .737.

Through nine seasons, however, Altuve has 128 homers with a .315 batting average, 254 steals, a .364 on-base percentage and an OPS of .827.

In other words, hes trending less toward Bip Roberts and more toward Joe Morgan, who began his career in Houston and made the Hall of Fame despite a modest 5-foot-7 stature.

Morgan said during a recent trip to Houston that he believes Altuve is the best player in the game.

I love Altuve. What is there not to love? Morgan said. He hits as many home runs as the guys theyre saying are better than him, he drives in runs, he scores runs. He can do anything, and what makes him special is that hes shorter than me.

To say that he has exceeded expectations, said his former minor league manager Rodney Linares, now a coach with the Rays, is a modest assessment.

I never thought he would hit more than 15 or 20 homers a year, Linares said. He deserves a lot of credit. He works more than anybody. He has the short limbs and quick hands, and if he can get to a ball, he can do something with it.

Altuve acknowledges that he has changed his game over the last few years to emphasize power.

Now, Im just looking to drive the ball, Altuve said earlier this year. Using that little adjustment has impacted my game big-time.

Still, the subject of homers makes him cringe.

I dont like talking about homers, he said earlier this week. Yes, I ended up with a lot of homers, and it makes me happy because youre helping your team.

I think as you get older you become, maybe, a little bit smarter. You know what theyve been doing to you the last couple of years. You know what youve got to go to look for. Last year theyve thrown me a certain pitch, and I was taking it. Now, I start swinging, so I think thats why maybe Im hitting some homers.

Biometrics has made more advances in the art of pitching than hitting, since the pitcher initiates the action and therefore has fewer variables to deal with than the batter receiving the pitch. The sum of a player such as Altuve, however, clearly is greater than the parts.

A body is a linked mechanical system, said Knudson, the Texas State professor. We transfer energy between body segments, and some of that force is hard to track because force is three-dimensional. If you apply it in the wrong direction, it can be counterproductive.

Hitting a baseball may be one of the most difficult things to do in sports. Its a complex, three-dimensional movement. Trying to understand it may be one of the most important questions in biomechanics. But the science is accelerating, and eventually well get there.

david.barron@chron.com

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Jose Altuves hitting is art, but its science, too - Houston Chronicle

FORT LAUDERDALE, Fla., Oct. 11, 2019 /PRNewswire/ -- Today, the first ever "Community Health Heroes" were announced by Life Extension and Reader's Digest. "Community Health Heroes" is a companion program to Reader's Digest's search for 2019's "Nicest Places in America." The three organizations and individuals chosen this year exemplify what it means to live a healthy life and give back to those in their community. This year's "Community Health Heroes" honorees are Camp Sweeney in Gainesville, Texas, People's Health Clinic in Salt Lake City, Utah and Mariano "Nano" Corona from Okeechobee, Fla.

"We are thrilled to be able to announce our three 'Community Health Heroes' honorees," said Dr. Michael Smith, Life Extension education director. "Each one of these organizations and individuals highlight the best in our country and our local communities. In addition, each honoree exemplifies Life Extension's core values of providing a human connection in all that we do and our passion for excellence."

The 10 finalists for "Community Health Heroes" were selected from the more than 1,000 submissions received this year for Reader's Digest "Nicest Places in America" program. Of those, the three that had the most powerful health impact on the most people were selected as the "Community Health Heroes" honorees. "Community Health Heroes" also features an online hub of custom content filled with inspiring true stories and advice about people living healthier and happier lives, part of Life Extension's sponsorship of "Nicest Places in America."

As a health organization, Life Extension knows first-hand how customers' personal lives have improved through the knowledge and services provided by Life Extension. These three stories of people helping others in need resonated deeply with the judges.

Camp Sweeney is a camp for children with diabetes in Gainesville, Texas. Camp Sweeney opened in 1950 and since then has helped 30,000 children from over 10 different countries and 40 states to make diabetes education a top priority. What began as a camp for children with type 1 diabetes has become the largest camp of its type in the world making it a dream destination for children with the condition.

The People's Health Clinic in Salt Lake City, Utah, was created in 1999 when a Catholic priest, a physician and a local businessman decided to hold a health fair out of a rented van in a parking lot. More than 700 people showed up and it was then they knew something more must be done for the underinsured of their community. Today, the clinic provides primary care, pediatrics, women's health services (free pap smears and mammograms included), prenatal care, chronic illness treatment and even vision, dental and mental health services, all for free.

The final "Community Health Heroes" honoree is Mariano "Nano" Corona of Okeechobee, Fla. Nano Corona is the founder of the "Ride for the Fight," a fundraising effort to make certain that no local family facing a cancer diagnosis has financial needs that go unmet. "Ride for the Fight" is a rodeo competition in which the proceeds pay for anything someone with cancer might need: groceries, copays for medication, gas money to get to chemotherapy treatments, or school clothes for the children whose parents are sick. Corona was inspired to create "Ride for the Fight" after he had a brush with cancer himself in 2010.

In addition to announcing the "Community Health Heroes," Reader's Digest today named Columbiana, Ohio, as the 2019 "Nicest Place in America". This year's nationwide search received more than 1,000 submissions of stories of places across America where people are kind and civility is winning. From these submissions, Reader's Digest editors and a panel of judges selected the 50 "Nicest Places in America"one for each state. After a nationwide vote, Reader's Digest editors and the panel of judges selected Columbiana, Ohio, as the "Nicest Place in America."

If you would like to learn more about the inspiring stories of each "Community Health Heroes" honoree visit https:/www.rd.com/communityhealthheroes.

About Life ExtensionFort Lauderdale, Fla.-based Life Extension is the health solutions expert that is translating scientific research into everyday insights for people wanting to live their healthiest lives. For nearly 40 years, Life Extension has pursued innovative advances in health, conducting rigorous clinical trials and setting some of the most demanding standards in the industry to offer a full range of quality nutritional vitamins and supplements and blood-testing services. Life Extension's Wellness Specialists provide personalized counsel to help customers choose the right products for optimal health, nutrition and personal care. To learn more, visit LifeExtension.com.

AboutReader's DigestReader's Digest, a Trusted Media Brands, Inc. brand, simplifies and enriches consumers' lives by discovering and expertly selecting the most interesting ideas, stories, experiences and products in health, home, family, food, finance and humor. Reader's Digest is available online at RD.com; in print; via digital download on iPad, mobile apps and tablets; and can be accessed via its social media channels:Facebook,Twitter, Instagram, YouTube, and Pinterest.

About Trusted Media Brands, Inc.Trusted Media Brands, Inc. comprises a network of engaged, active readers who genuinely connect with its blend of uplifting and enduring expertly-curated family, food, health, home improvement, finance and humor content digitally, via magazines and books, social media, and events and experiences. Founded in 1922 by DeWitt Wallace as Reader's Digest Association, one of the first user-generated content publishers, Trusted Media Brands, is headquartered in New York City. For more information, visit TMBI.com.

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Life Extension and Reader's Digest Unveil the First-Ever "Community Health Heroes" Honorees - PRNewswire

Key point: The Next-Generation Air Dominance program has moved to the prototype stage.

The Navy is currently analyzing air frames, targeting systems, AI-enabled sensors, new weapons and engine technologies to engineer a new 6th-Generation fighter to fly alongside the F-35 and ultimately replace the F/A-18.

The Navy program, called Next-Generation Air Dominance, has moved beyond a purely conceptual phase and begun the exploration of prototype systems and airframes as it pursues a new, carrier-launched 6th-Gen fighter to emerge in 2030 and beyond, service officials explained.

Some important areas of consideration include derivative and developmental air vehicle designs, advanced engines, propulsion, weapons, mission systems, electronic warfare and other emerging technologies, Navy spokeswoman Lt. Lauren Chatmas told Warrior earlier this year.

A formal Analysis of Alternatives, expected to complete this year, is weighing the advantages of leveraging nearer-term existing technologies such as new variants or upgrades to cutting edge weapons, sensors and stealth configurations - or allowing more time for leap-ahead developmental systems to emerge.

The current analysis follows a now-completed Initial Capabilities Document detailing some of the sought-after requirements for the new aircraft, or family of aircraft, Chatmas explained.

Anticipated decisions about a 6th-Gen fighter balance themselves upon the as-of-yet unknown maturity of various promising new weapons and technologies nearing a threshold of operational possibility.

For instance, some now-in-development next-gen stealth technologies, including new radar-evading configurations, coating materials and advanced thermal-signature reduction are fast-approaching levels of combat readiness. Yet, absent a clear timeframe when, for example, new stealth or AI enabled sensors can ensure overmatch for decades to come, Navy developers are thinking it may make sense to push the current art-of-the-possible to the maximum extent. (To Read Warrior Maven's Report on Air Force 6th-Gen Prototyping - CLICK HERE)

This challenge, explored by a Naval Postgraduate School essay called The 6th-Generation Quandry, poses the question as to whether it might be equally if not more effective to postpone formal 6th-generation development until truly breakthrough advances emerge, while pursuing advanced variants of current, yet upgradable platforms in the interim.

The 2016 paper, from the Naval Postgraduate School Acquisition Research Program, cites a handful of current systems showing significant long-term promise. The paper sites new models of the F-35 optimized for air combat, the emerging B-21, drone-launching C-130 mother ships and weapons truck arsenal planes are positioned to optimize current technological progress.

These systems, including a B-52-like arsenal plane, unmanned fighter jets, AI-empowered sensors and new weapons with unprecedented range are designed to accommodate new iterations of AI, processing speeds, software upgrades and other incremental improvements.

According to this logic, there simply might not be enough of a margin of difference in performance between the best upgraded platforms of today - and something entirely new which could be built in the next 10 years or so.

Could these upgradable systems, fortified by new-iterations of stealth technology now being woven into the B-21, themselves be sufficient to propel naval aviation superiority for decades? This would alleviate the risk and expense of pursuing something truly breakthrough in the near term, potentially freeing up funding and resources to explore paradigm-changing air-fighter technologies for the long term.

Furthermore, current sensors, avionics and weapons systems are increasingly AI-reliant, a circumstance which makes it easier to greatly improve performance by integrating new algorithms, analytics or processing speed. In effect, all of this raises the question as to whether an entirely new airframe is truly needed to achieve overmatch in coming decades? By 2030?

These questions seem to be informing the current Navy rationale, which is to look at both new airframes as well as adaptations of the best of whats available. The latter option brings its own advantages, because various industry developers are already building prototypes of 6th-Gen fighters with newly designed, stealthier airframes. Looking at applications of AI, miniaturized long-range sensors, targeting technology and drones operating with ever-increasing levels of autonomy - some contend that perhaps some of the most essential ingredients of long-term transformational technologies are, in effect, already here. This would be the basis upon which a nearer-term aircraft, drawing from some off-the-shelf-items, would be pursued.

Some of these decisions are also expected to be impacted by the success with which the Navy is able to keep extending the combat service life of the F/A-18. The Navys F/A-18 Service Life Extension Program has already extended the aircrafts initial plans to fly 6,000 flight hours to 8,000 hours through a series of upgrades. Now, looking at the airframes and the state of cutting-edge avionics, the service is hoping to push its fleet of F/A-18s to 10,000 hours.

Navy officials tell Warrior these upgrades are significant and, in many cases, can bring the F/A-18 combat performance well into the future. Some of the adjustments start with the airframes themselves; Service Life Assessment Programs look to possibly replace the center barrel of the airframe and analyze the fatigue of the Nacelle (engine coating or skin), service officials say.

The F/A-18 upgrades also add new navigation technology, digital memory devices, mission computers, helmet-mounted cueing systems, Electronically Scanned Array Radar and an advanced targeting sensor called Infrared Search and Track, As a passive sensor, IRST enables better targeting while not emitting a signal, making it vulnerable to enemy electronic warfare attacks.

All Paths Point to 6th-Gen AI

There is widespread consensus that applications of AI appear to provide the framework for the most defining expected technological progress. In fact, a 2017 paper from a 16-nation NATO conglomerate of analysts, called the Joint Air Power Competence Center, raises questions about when, and how, AI may outpace the human ability to keep up. The essay, titled Air Warfare Communication in a Networked Environment, quotes Air Force Acquisition Executive William Roper from his previous role directing the Pentagons Strategic Capabilities Office, saying AI is progressing beyond the human ability to interface with it.

For instance, smart sensors able to gather, analyze and organize vast volumes of combat information in milliseconds, using AI-fortified algorithms, are now being built into airframes themselves to combine new sensing technology without increasing an aircrafts radar signature. The absence of an external antenna, pod or structured array of some kind removes otherwise more radar-detectable structures from an airframe.

Smart sensors and smart antenna arrays with adaptive properties would be embedded into the structure of an aircraft, an essay from Jain Universitys International Institute for Aerospace Engineering states. ( Sensor Technology and Futuristic Of Fighter Aircraft, Jain Univ).

At the same time, while massive increases in sensor ranges, data-sharing and long-range connectivity will continue to bring as-of-yet unprecedented advantages to warfare operations, there are also challenges which emerge as combat becomes more networked. Referring to this phenomenon as creating clusters of embedded ISR, the Joint Air Power Competence Center paper warns of security risks and what it calls hyper-connectivity.

New much-longer range sensors and weapons, incorporating emerging iterations of AI, are expected to make warfare more disaggregated, and much less of a linear force on force type of engagement. Such a phenomenon, driven by new technology, underscores warfare reliance upon sensors and information networks. All of this, naturally, requires the expansive "embedded ISR" discussed by the paper. Network reliant warfare is of course potentially much more effective in improving targeting and reducing sensor-to-shooter time over long distances, yet it brings a significant need to organize and optimize the vast, yet crucial, flow of information.

Not everybody in the network needs to see and hear everything. There needs to be a hierarchy, and a backup architecture for degraded network operations, the paper writes.

These types of challenges, wherein vast amounts of ISR data needs to be aggregated, analyzed and organized, are precisely what AI and high-speed processing can address. Using advanced algorithms and real-time analytics, computing power can instantly identify and disseminate key moments or items of combat relevance, thereby establishing priorities and massively quickening the human decision cycle.

AI-informed combat decisions, enabled by accelerated real-time analytics, allow human decision makers to draw upon otherwise inaccessible pools of data. Algorithms can integrate new information, instantly compare it against vast amounts of stored data, and come to informed conclusions without requiring human intervention. Often referred to as easing the "cognitive burden," AI and iterations of man-machine interface, can perform time-consuming or otherwise impossible information-analysis tasks, all while a human functions as ultimate decision-maker in a command and control role. While AI is quickly advancing toward being able to discern and organize seemingly subjective information, there are many decision-making abilities and problem solving faculties regarded as unique to human cognition.

Osborn previously served at the Pentagon as a Highly Qualified Expert with the Office of the Assistant Secretary of the Army - Acquisition, Logistics& Technology. Osborn has also worked as an anchor and on-air military specialist at National TV networks. He has a Masters in Comparative Literature from Columbia University. This first appeared earlier in the year.

Image: Reuters.

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Will The Navy's 6th Generation Fighter Jet Be The End Of the U.S. F-35 and F-22? - The National Interest Online

One of Chaskas most noticeable landmarks has had the wind knocked out of it.

A turbine, located near Pioneer Ridge Middle School and just off of Highway 212, has been shut down and bladeless since Sept. 10 for refurbishment, according to a Minnesota Municipal Power Agency (MMPA) official. The repair of the blades is part of a refurbishment and life extension project.

It is scheduled to be fixed over the next couple months and will regain its gusto in November, according to City Administrator Matt Podhradsky.

The turbine is connected to Chaskas local distribution system and produces up to 160 kilowatts of energy per hour from the wind.

The agency owns and maintains it, and each city has their own turbine that exists within their city, Podhradsky said. There are 11 other cities in the MMPA.

Last year, the agency started providing energy to Elk River, which is the only city that still needs a wind turbine built, Podhradsky added.

The turbine in Chaska has been in operation for almost a decade and now needs to be refurbished as part of its maintenance cycle, according to an email from Krystal Knutson, a senior associate at MMPA. The project includes replacing the hydraulic hoses and pumps, replacement of all control systems, and cleaning and painting of the turbine tower.

The 10 other turbines in the other member cities are also down for routine maintenance, according to Podhradsky.

Turbines have a six-month maintenance schedule and the one in Chaska works during the winter. However, it is turned off occasionally because of ice buildup or if it is below approximately -4 degrees, according to Knutson.

The wind turbine was built near Pioneer Ridge so students could learn about wind power. It is located near a trail for residents to check it out. An informational sign explains how wind is converted to energy.

Additionally, MMPA (Chaskas wholesale electric provider) sponsors an energy education program that buses fourth-graders from member communities to MMPAs Faribault Energy Park power plant every May. At the plant, students rotate through three stations that provide educational information about energy efficiency, renewable energy (including visiting an on-site wind turbine), and power generation and distribution, according to Knutsons email. Students from both Clover Ridge Elementary and St. Johns School in Chaska participated in the program this year.

The maintenance cost of the turbine is covered by MMPA, according to Knutson. When asked what the price of the maintenance would be, Knutson wrote in an email, MMPA does not want to provide to this information.

The cost would not be directly billed back to the city, Podhradsky said, adding that it is supported by rates paid by residents in the member communities.

MMPA also has 24 turbines in Blooming Prairie and 39 in Sauk Centre.

The 80-foot turbine was one of 11 shipped to Minnesota from California, for $300,000 each in 2009.

In 2009, parts for the wind turbine were delivered to Chaska and after delays from the cold winter, it was up and operational the next year.

Initially, energy from the wind turbine was spotty. The turbine had to be repaired three times in 2010. Once because it was creating loud noises, and again almost four months later after a malfunctioning brake at the Faribault site triggered the shutdown of all MMPA turbines.

Last year, MMPA installed solar panels near Clover Ridge Elementary as part of its Hometown Solar Energy program.

The idea was to put the panels near a school so teachers could tie it back to their science curriculum, Podhradsky said.

The purpose of the grant program is to provide an educational asset to our member communities and to help teach local youth first-hand how sunlight is converted into electricity, as well as the unique characteristics of solar power, according to MMPAs website.

Currently, 11 of the 12 member communities have solar panel installations.

MMPA is mandated to have a quarter of its electric utilities supported by renewable energy by 2025. Currently, the agency is on track at about 21-22%, Podhradsky said.

More here:
No spin here: Wind turbine going through refurbishment - SW News Media

Sorry, we cant help you, said the Apple store Genius. My AirPods were dying. After just 15 minutes of use, the wireless headphones I use daily chirp a sad little battery-depleted alert. I came to Apple to get them repaired.

The employee said there were lots of people like me, with $159 AirPods purchased in 2016 and 2017 that now cant hold a charge. But even though Apple promises battery service, the store had no way to fix my AirPods. It didnt even have a way to test them.

Cupertino, we have a problem: AirPods are comfortable and convenient headphones that have attracted tens of millions of customers. But each one of those white sticks contains a rechargeable battery marching toward an untimely death in as little as two years. Apples plan to deal with that reality is just to sell us new ear buds. When your AirPods day comes, the only option is to ask Apple for discounted replacements but youll need to know its code word to even get that.

Not long ago, headphones were among the most universal, long-lasting electronics. We shouldnt let Apple turn them into expensive, disposable electronics. Its hurting our wallets and the environment.

Apple doesnt dispute that the lithium-ion batteries inside AirPods wear out. All rechargeable batteries have a limited life span and may eventually need to be serviced or recycled, Apple says on its website. Replacing batteries is very common on phones and laptops. In 2018, Apple stores got deluged when the company offered to replace the batteries in older iPhones for $29.

But with AirPods, Apple offers far less help. First, theres no way to determine the health of the batteries in the ear buds or their charging case. Apple wont even share guidelines on their life expectancy. AirPods are built to be long-lasting, said Apple spokeswoman Lori Lodes, without specifics. Mine went for 34 months; others have reported they die as soon as 18 months.

When your AirPod batteries finally go, even Apples employees are confused about your options. Across three separate support encounters in the store and online, they told me I had to buy a replacement pair for $138, nearly the price of a whole new set. But I remembered Apple had once told me it would service depleted batteries for $49. I reported that, along with my recommendation to buy AirPods. So what gives?

After weeks of back-and-forth with Apple and refusing to take no for an answer at the store I finally got answers:

If your AirPods are less than a year old and the battery is not performing up to the promised five hours of listening time, an Apple store will replace them at no cost.

Apple recently began selling its AppleCare+ warranty for $29, which covers the battery, too. But this extended warranty lasts only two years which wouldnt have been long enough to save my AirPods.

If your AirPods are out of warranty, Apple will replace them for $49 per stick so in reality, $98 total. A replacement for the charging case, which doesnt wear out as quickly, is also $49. The key phrase to say is battery service. (Apple is providing additional training to customer service representatives on that point, but if you still have trouble, show them this link or this column.)

A $98 battery fix is still mighty expensive. Apple will replace the battery on an iPhone for as little as $49. An Apple Watch battery costs just $79. What makes AirPods so different? Because Apples battery service for AirPods is code for throwing it away. Apple isnt repairing AirPods its just replacing the ear buds and recycling your old ones.

To understand why, I performed an autopsy on a dearly departed pair. Inside, I found the design of AirPods makes them inevitably obsolete.

What could be so hard about replacing the battery in an AirPod? I dont ordinarily go CSI on gadgets, so I sought advice from some folks who do.

Kyle Wiens, the CEO of repair website iFixit, offers instructions on how to disassemble electronics and sells replacement parts. The first time Wiens tried to get inside an AirPod, he cut himself and bled all over it. Another time, the battery combusted in a poof of smoke on his team.

AirPods were never meant to be opened, Wiens warned me.

But I wanted to see for myself. With Wiens watching, I began the operation with the silver cap at the end of the AirPod stick. You might think it unscrews to let you get inside. No such luck. Its glued in there, and I couldnt yank it out even after carefully heating the AirPod to loosen the glue. That meant I had to cut in and to save my fingers, Wiens loaned me a special vibrating knife that slices plastic.

Inside the AirPod, I found so much glue I couldnt even tug out the now-exposed end of the battery with tweezers. So I cut very carefully along the edges of the AirPod stick, to crack open a section like the top of a coconut. There, at last, was the battery, about as thick as a large spaghetti noodle.

I had avoided spilling blood, but after all the cutting I still had a problem: My AirPod was now a Humpty Dumpty in so many pieces Id never be able to reassemble it again. Wiens said hed tried this five times, across both the first- and second-generation AirPods, and awarded AirPods a repairability score of zero out of 10. There is no way we can feasibly understand taking the battery out without completely destroying the AirPod, he said.

I asked Apple whether that was true. It didnt answer.

The cause of death on my AirPods was clear: bad product design.

Earlier this year, the website Vice called AirPods a tragedy of disposable wealth. I see them as a symptom of Apples preoccupation with thin products. Its the tech-world version of fashions fixation on skinny models, where Apple sets the trend and other manufacturers feel pressure to follow.

Excessive thinness isnt healthy for gadgets, either. Apples desire to shave a few millimeters off designs has resulted in MacBook keyboards that fail, iPads that catch fire at recycling centers and now millions of AirPods that will probably end up in the trash.

Sealing up electronics with glue instead of screws and latches can help make devices lighter and more resistant to moisture and dust. But great ear buds even ones tiny enough to sit in your ears dont have to be impenetrable. iFixit found a way to pop open Samsungs $129 Galaxy Buds, so replacement batteries can slip in kind of like on a watch. Samsung doesnt officially offer this repair option, but iFixit sells a pair of replacement batteries for $29.

Apples disposable AirPod design is expensive for us. But its doing permanent damage to our environment. Thats not how Apple talks about it, though.

Apples products are designed with the environment in mind, said Lodes, the Apple spokeswoman. Everything from the materials we select to the way we approach recycling is meant to leave the world better than we found it.

How exactly are AirPods designed with the environment in mind? Because you can bring them to Apple to be recycled. We work closely with our recyclers to ensure AirPods are properly recycled and provide support to recyclers outside of our supply chain as well, said Lodes.

Thats like saying your daily paper coffee cup habit is good for the environment because you always put it in the recycling bin. AirPods may actually be worse than that: Theyre so small, theres isnt much material that can be recycled from them. Significant energy, water and materials go just into the process of making AirPods.

The golden rule for helping the earth is to produce less new stuff. Electronics companies can do that by making their products last as long as possible through repair and reuse which are all but impossible with AirPods.

In the Greenpeace 2017 Guide to Greener Electronics, Apple got a B- grade overall because of its commitments to using renewable energy and efforts to create a closed-loop supply chain. But the environmental group gave Apple a D in the category of product life extension, because it has consistently made it more difficult for customers to repair their devices, replace their batteries, or upgrade the devices so that they continue to stay in use.

Apple isnt the only tech company guilty of pushing consumption over repair. New $130 headphones from Amazon called Echo Buds contain batteries that cant be repaired, the company told me. (Amazon CEO Jeff Bezos owns The Washington Post.) Microsoft says it would also replace an entire unit when the battery fails on its $249 Surface Earbuds.

Before this trend continues, lets agree on a common-sense rule suggested by Wiens: The life span of an expensive, resource-intensive gadget shouldnt be limited to the life span of one consumable component. You wouldnt buy an electric toothbrush where you couldnt replace the brush. Or a car with glued-on tires.

Apple kept fundamentally the same design for AirPods between its first- and second-generation of the headphones, which debuted in March. Now, the Apple rumor mill has lit up with hints of forthcoming third-generation AirPods in pre-release code for iOS 13.2.

Lets hope this time around, AirPods really are designed with the environment in mind. Not to mention our wallets.

Tens of millions of people own AirPods, Apples most successful new product in years. But each one of those white buds contains a rechargeable battery marching toward an untimely death in as little as two years. (REF:pacecornsilkj / The Washington Post)

The rest is here:
Everyones AirPods will die. Weve got the trick to replacing them. - The Seattle Times

In many industries, theres usually one or two companies that become nearly synonymous with their particular market. One of the most obvious examples is Coca Cola (KO). Think about it: We still refer to a soda as a coke, even though the soft drink manufacturer allegedly abandoned using cocaine in its formulation long ago. In emerging technologies like artificial intelligence, its more difficult to pinpoint a clear leader in many cases. Nvidia (NVDA) is still the obvious choice for AI chips. After that, there are very few household names that represent anything close to a pure play in AI technology. However, one name has emerged in the last few years that has become the face of AI drug discovery: Insilico Medicine.

Regular readers will certainly recognize the startup as a key player in the longevity industry. Weve profiled the company on several lists here and here related to drug discovery, as part of our ongoing coverage of life extension science. September was a particularly good month for the Rockville, Maryland startup. At the beginning of the month, it published a paper in Nature Biotechnology that detailed its efforts to design and validate a drug candidate for treating fibrosis and other diseases in just 46 days, shaving off months if not years from the discovery process, not to mention saving millions of dollars. A week later, the five-year-old startup completed a $37 million Series B, bringing its total disclosed funding to $51.3 million.

Insilico Medicine co-founder and CEO Alex Zhavoronkov

We recently caught up with Insilico Medicine co-founder and CEO Alex Zhavoronkov, who is on a crusade to prove that automation will be a big part of the future of healthcare. We talked about the companys recent achievement in accelerating the drug discovery process; its open challenge to big pharma; Insilicos numerous partnerships and joint ventures; the difficulties in getting funding for longevity therapy research and development; and the AI hype surrounding healthcare in general.

We wont spend too much time dissecting Insilicos latest achievement, as thats already gotten plenty of press. You can find a good deep dive into the paper and its significance by Margaretta Colangelo, a managing partner at Deep Knowledge Ventures, which made some of the first investments in the company about five years ago. It wasnt just the fact that Insilico Medicines new AI platform, called Generative Tensorial Reinforcement Learning (GENTRL), accomplished the feat of designing and validating a drug in such a short timeframe. It was also the first time anyone had combined two AI techniques known as generative adversarial networks (GANs) and generative reinforcement learning for drug discovery. Both Colangelo and Zhavoronkov refer to the achievement as pharmas AlphaGo moment, referring to Google DeepMinds defeat of a professional Go player.

Insilico Medicines AI platform, called Generative Tensorial Reinforcement Learning (GENTRL), combines two AI techniques known as generative adversarial networks and generative reinforcement learning for drug discovery. Credit: Insilico Medicine

Zhavoronkov first presented the paper at a conference in Basal, Switzerland, hometown to two of big pharmas biggest players Roche and Novartis. The choice of venue was obviously intentional, as Insilico has actively sought the spotlight since it was founded in 2014 in order to prove the value of AI to improve human health and quality of life. In 2015, for example, a group of Zhavoronkovsstudents and colleagues founded, Youth Laboratories, listing him as an adviser. It was a machine vision company that focused on aging and skin health which made headlines in 2016 for hosting an online beauty contest, Beauty.AI, that was judged solely by machines and attracted a bit of controversy for picking mostlyfair-skinned people. That led to yet another project, Diversity.AI, an effort to use machine learning to make sure we all have an equal opportunity to be spied on marketed to. Last year, the company was named to CB Insights prestigious AI 100 list.

But back to Insilicos primary focus: defeating age-related disease. Zhavoronkov believes his companys AI platform has advanced to the point where it could automate drug pipeline development from end to end and produce a marketable drug within 24 months or less with the right kind of backing. So while its efforts have focused on pre-clinical activities like identifying drug targets and developing therapeutic molecules around those specific disease targets, Insilicos AI also boasts predictive powers.

Insilico Medicine applies artificial intelligence throughout the drug development pipeline. Credit: Insilico Medicine

We also work with some of our pharma partners on predicting clinical trial outcomes; we also analyze clinical trials data, said Zhavoronkov, who is looking to partner with a major pharmaceutical company on an XPRIZE-type challenge where Insilico races against the clock to develop the first drug fully developed using artificial intelligence and one that targets a rare disease. If no contenders emerge, Zhavoronkov said he still believes it will be possible to develop a viable drug using AI within four or five years.

He noted that investment banks are also interested in Insilicos AI predictive analytics around clinical outcomes. The reason for the attention is obvious: If investors can leverage a tool that can better predict the chance of success or failure of a particular drug, that would surely influence how much money if any they are willing to put into a particular project or company. Weve noted previously that venture capitalists are increasingly turning toward AI to guide their investments into the hottest startups.

While Insilico awaits to see what big pharma company will emerge to take up its challenge, it has plenty of other partnerships and ventures to juggle. In fact, the company just announced today a new collaboration worth up to $200 million with one of Chinas biggest pharmaceutical companies, Jiangsu Chia Tai Fenghai Pharmaceutical Co. The goal of the collaboration is to accelerate drug discovery for triple-negative breast cancer using artificial intelligence.

We actually started making those kind of advanced partnerships where we would plan to take products into [clinical trials] only recently, Zhavoronkov said, for about the last year or so.

He noted that his company has about 16 ongoing collaborations, including several with one of the key players in the longevity industry Juvenescence. One of the more advanced joint ventures with Juvenescence is with a company called Generait Pharmaceuticals that is targeting senescent cells, which are cells that have stopped dividing but continue to secrete inflammatory molecules that damage nearby cells and tissues, leading to disease and an earlier death. Generait has already identified several disease targets but Zhavoronkov could not go into details at this time.

A sampling of some of the deals and partnerships brokered by Insilico Medicine. Credit: Insilico Medicine

Another joint venture between Juvenescence and Insilico, which also includes the nonprofit Buck Institute for Research on Aging, is Napa Therapeutics. Insilico has already done its part and Napa is now working on several potential drug molecules that could help boost the levels of an oxidized compound called nicotinamide adenine dinucleotide (NAD+), which is involved in getting the power plant of the cell called the mitochondria revved up again. So far, the molecules look very good, Zhavoronkov said.

Many [partnerships] are with smaller companies, you know, where we do get less money up front, but we do get the data, he noted. We need their pre-clinical data so we can train [our algorithms].

While Zhavoronkov is obviously pleased to have just pocketed $37 million from investors like Chinese AI tech giant Baidu and a pharmaceutical firm like Eli Lilly and Company, he feels that respect for the longevity industry is still lacking. For example, few of Insilicos major investors backed the company because they are specifically interested in life extension science, according to Zhavoronkov.

They invested not because of longevity. I actually need to divest of some of my longevity-focused programs, he explained. They invested because of the generative chemistry. It works; they know it works. Thats a major disruption. So thats why they invested. They didnt consider longevity; longevity is not being perceived as credible in financial circles yet.

Legitimacy is also difficult to build when there is so much hype around artificial intelligence.

There are lots and lots of scientific charlatans very often re-positioning very old technology as AI, he said. Suddenly, every statistician within big pharma became an AI scientist.

In terms of direct competitors, Zhavoronkov noted that he deeply respects the work being done by San Francisco-based Atomwise, but the technology from others is mostly smoke and mirrors. Thats why Insilico is focused on publishing its work in peer-reviewed journals in order to back up its claims. The company has published about 60 papers in the last five years.

Thats because Zhavoronkov believes that there is nothing more important than longevity, whether youre talking about the big-picture economics of healthcare or living more productive, healthier years in the twilight of life.

The goal is to create the longevity economy, he said. So, in the next couple years, as we ingest a little bit more data and develop more advanced algorithms, we will be able to go after more complex problems.

If the longevity industry does live up to its lofty goals of becoming the biggest industry in human history, Insilico Medicine will likely play a major role in that success. Even if we dont all end up living as old as Moses, the potential to cure some of humanitys most debilitating diseases is too good to ignore. And, right now, no one is ignoring Insilico Medicine.

We thinkthis AI-powered weight loss app could be a multi-billion dollar business - not because it's backed by the world's most sophisticated investors- but because it works. If you want to lose weight and keep it off for good, check out Noom. People who use Noom lose weight and keep it off for good.

Read more:
Insilico Medicine Becomes the Face of AI Drug Discovery - Nanalyze

AirPod batteries are sealed inside, so you need to cut in to access them. CREDIT: Washington Post photo by James Pace-Cornsilk

"Sorry, we can't help you," said the Apple store Genius. My AirPods were dying. After just 15 minutes of use, the wireless headphones I use daily chirp a sad little battery-depleted alert. I came to Apple to get them repaired.

The employee said there were lots of people like me, with $159 AirPods purchased in 2016 and 2017 that now can't hold a charge. But even though Apple promises "battery service," the store had no way to fix my AirPods. It didn't even have a way to test them.

Cupertino, we have a problem: AirPods are comfortable and convenient headphones that have attracted tens of millions of customers. But each one of those white sticks contains a rechargeable battery marching toward an untimely death in as little as two years. Apple's plan to deal with that reality is just to sell us new ear buds. When your AirPods' day comes, the only option is to ask Apple for discounted replacements - but you'll need to know its code word to even get that.

Not long ago, headphones were among the most universal, long-lasting electronics. We shouldn't let Apple turn them into expensive, disposable electronics. It's hurting our wallets - and the environment.

Apple doesn't dispute that the lithium-ion batteries inside AirPods wear out. "All rechargeable batteries have a limited life span and may eventually need to be serviced or recycled," Apple says on its website. Replacing batteries is very common on phones and laptops. In 2018, Apple stores got deluged when the company offered to replace the batteries in older iPhones for $29.

But with AirPods, Apple offers far less help. First, there's no way to determine the health of the batteries in the ear buds or their charging case. Apple won't even share guidelines on their life expectancy. "AirPods are built to be long-lasting," said Apple spokeswoman Lori Lodes, without specifics. Mine went for 34 months; others have reported they die as soon as 18 months.

When your AirPod batteries finally go, even Apple's employees are confused about your options. Across three separate support encounters in the store and online, they told me I had to buy a replacement pair for $138, nearly the price of a whole new set. But I remembered Apple had once told me it would service depleted batteries for $49. I reported that in The Post, along with my recommendation to buy AirPods. So what gives?

(c) 2019, The Washington Post Geoffrey A. Fowler

Washington Post tech columnist Geoffrey A. Fowler takes apart an airport in an attempt to understand the batteries. CREDIT: Washington Post photo by James Pace-Cornsilk

After weeks of back-and-forth with Apple - and refusing to take no for an answer at the store - I finally got answers:

- If your AirPods are less than a year old and the battery is not performing up to the promised five hours of listening time, an Apple store will replace them at no cost.

- Apple recently began selling its AppleCare+ warranty for $29, which covers the battery, too. But this extended warranty lasts only two years - which wouldn't have been long enough to save my AirPods.

- If your AirPods are out of warranty, Apple will replace them for $49 per stick - so in reality, $98 total. A replacement for the charging case, which doesn't wear out as quickly, is also $49. The key phrase to say is "battery service." (Apple is providing additional training to customer service representatives on that point, but if you still have trouble, show them this link - or this column.)

A $98 battery fix is still mighty expensive. Apple will replace the battery on an iPhone for as little as $49. An Apple Watch battery costs just $79. What makes AirPods so different? Because Apple's "battery service" for AirPods is code for "throwing it away." Apple isn't repairing AirPods - it's just replacing the ear buds and recycling your old ones.

To understand why, I performed an autopsy on a dearly departed pair. Inside, I found the design of AirPods makes them inevitably obsolete.

What could be so hard about replacing the battery in an AirPod? I don't ordinarily go CSI on gadgets, so I sought advice from some folks who do.

Kyle Wiens, the CEO of repair website iFixit, offers instructions on how to disassemble electronics and sells replacement parts. The first time Wiens tried to get inside an AirPod, he cut himself and bled all over it. Another time, the battery combusted in a poof of smoke on his team.

AirPods were never meant to be opened, Wiens warned me.

But I wanted to see for myself. With Wiens watching, I began the operation with the silver cap at the end of the AirPod stick. You might think it unscrews to let you get inside. No such luck. It's glued in there, and I couldn't yank it out even after carefully heating the AirPod to loosen the glue. That meant I had to cut in - and to save my fingers, Wiens loaned me a special vibrating knife that slices plastic.

Inside the AirPod, I found so much glue I couldn't even tug out the now-exposed end of the battery with tweezers. So I cut very carefully along the edges of the AirPod stick, to crack open a section like the top of a coconut. There, at last, was the battery, about as thick as a large spaghetti noodle.

I had avoided spilling blood, but after all the cutting I still had a problem: My AirPod was now a Humpty Dumpty in so many pieces I'd never be able to reassemble it again. Wiens said he'd tried this five times, across both the first- and second-generation AirPods, and awarded AirPods a repairability score of zero out of 10. "There is no way we can feasibly understand taking the battery out without completely destroying the AirPod," he said.

I asked Apple whether that was true. It didn't answer.

The cause of death on my AirPods was clear: bad product design.

Earlier this year, the website Vice called AirPods a "tragedy" of disposable wealth. I see them as a symptom of Apple's preoccupation with thin products. It's the tech-world version of fashion's fixation on skinny models, where Apple sets the trend and other manufacturers feel pressure to follow.

Excessive thinness isn't healthy for gadgets, either. Apple's desire to shave a few millimeters off designs has resulted in MacBook keyboards that fail, iPads that catch fire at recycling centers and now millions of AirPods that will probably end up in the trash.

Sealing up electronics with glue instead of screws and latches can help make devices lighter and more resistant to moisture and dust. But great ear buds - even ones tiny enough to sit in your ears - don't have to be impenetrable. iFixit found a way to pop open Samsung's $129 Galaxy Buds, so replacement batteries can slip in kind of like on a watch. Samsung doesn't officially offer this repair option, but iFixit sells a pair of replacement batteries for $29.

Apple's disposable AirPod design is expensive for us. But it's doing permanent damage to our environment. That's not how Apple talks about it, though.

"Apple's products are designed with the environment in mind," said Lodes, the Apple spokeswoman. "Everything from the materials we select to the way we approach recycling is meant to leave the world better than we found it."

How exactly are AirPods designed with the environment in mind? Because you can bring them to Apple to be recycled. "We work closely with our recyclers to ensure AirPods are properly recycled and provide support to recyclers outside of our supply chain as well," said Lodes.

That's like saying your daily paper coffee cup habit is good for the environment because you always put it in the recycling bin. AirPods may actually be worse than that: They're so small, there's isn't much material that can be recycled from them. Significant energy, water and materials go just into the process of making AirPods.

The golden rule for helping the earth is to produce less new stuff. Electronics companies can do that by making their products last as long as possible through repair and reuse - which are all but impossible with AirPods.

In the Greenpeace 2017 Guide to Greener Electronics, Apple got a "B-" grade overall because of its commitments to using renewable energy and efforts to create a closed-loop supply chain. But the environmental group gave Apple a "D" in the category of product life extension, because it has "consistently made it more difficult for customers to repair their devices, replace their batteries, or upgrade the devices so that they continue to stay in use."

Apple isn't the only tech company guilty of pushing consumption over repair. New $130 headphones from Amazon called Echo Buds contain batteries that can't be repaired, the company told me. (Amazon CEO Jeff Bezos owns The Washington Post.) Microsoft says it would also replace an entire unit when the battery fails on its $249 Surface Earbuds.

Before this trend continues, let's agree on a common-sense rule suggested by Wiens: The life span of an expensive, resource-intensive gadget shouldn't be limited to the life span of one consumable component. You wouldn't buy an electric toothbrush where you couldn't replace the brush. Or a car with glued-on tires.

Apple kept fundamentally the same design for AirPods between its first- and second-generation of the headphones, which debuted in March. Now, the Apple rumor mill has lit up with hints of forthcoming third-generation AirPods in pre-release code for iOS 13.2.

Lets hope this time around, AirPods really are designed with the environment in mind. Not to mention our wallets.

Follow this link:
Everyone's AirPods will eventually die. We've got the trick to replacing them - cleveland.com

NEW DELHI: Be it smartphones, notebooks or electric cars, lithium-ion batteries have revolutionized our world, laying the foundation for a wireless, fossil fuel-free society, the Royal Swedish Academy of Sciences said on Wednesday while awarding the 2019 Nobel prize in Chemistry to John Goodenough, Stanley Whittingham and Akira Yoshino.

The Li-ion technology is currently the best performing technology for energy storage based on batteries. Li-ion batteries are used in small electronics (smartphones, laptops etc) and are also the best options for electric cars.

In the 1970s as the world stared at oil crisis, Whittingham from Binghamton University in the US, American professor and solid-state physicist Goodenough (currently at the University of Texas at Austin) and Japanese chemist Yoshino advanced the development in the field through the 1980s.

Since Lithium is the lightest metal, using lithium ions made batteries lighter.

The lithium-ion batteries were launched commercially by Sony and Asahi Kasei Corporation in 1991.

Today, the race is on among the stakeholders to find a battery that can let users enjoy time on their devices without worrying about the charge.

Researchers from the University of Alberta recently developed a new battery technology that could provide 10 times more charge capacity compared to the lithium-ion power packs.

This battery technology utilizes silicon nanoparticles as an electrode for the lithium-ion batteries. Silicon is abundant, and the substance only costs around a third of the price of high-purity graphite, which sells for more than $10,000 per metric ton.

Going forward, smartphones will sport graphene batteries that charge swiftly, and will mark a quantum leap from the fast charging technologies and the current default of lithium-ion batteries.

When it comes to electric cars, Elon Musk-run Tesla has achieved great deal of efficacy in this field and is now aiming to create a lithium-ion battery that can run a car or an electric truck for over 16 lakh kms.

Current Tesla cars can achieve about 8 lakh kms out of their batteries before they face any serious problem.

A new research paper from Dalhousie University in Nova Scotia, Canada has claimed the Jeff Dahn-led team is close to creating a lithium-ion battery that can run a car for over 1 million (over 16 lakh) miles.

For more than a decade, Tesla engineers have been obsessed with making the world's most efficient electric vehicles.

As a result, Tesla vehicles already travel farther on a single charge than any other production EV on the market.

Model S and Model X cars can achieve nearly 600 kms and 525 kms per charge on a 100 kWh battery pack.

Tesla's choice of cylindrical cells sets it apart from other EV players. The company also uses a liquid-cooled thermal management system to manage battery temperatures whereas other automakers take a more economical air-cooling approach.

By adjusting the temperature of the battery pack, Tesla is able to ensure that cells are operating in their most efficient and optimal states, thereby maximizing battery longevity as well as performance.

It has been argued that lithium will be one of the main objects of geopolitical competition in a world running on renewable energy and dependent on batteries.

Current research areas for lithium-ion batteries include life extension, energy density, safety, cost reduction and charging speed, among others.

Research has also been under way in the area of non-flammable electrolytes as a pathway to increased safety based on the flammability and volatility of the organic solvents used in the typical electrolyte.

See the rest here:
From phones to Tesla cars, lithium-ion batteries come of age - Economic Times

"The Aesthetic Medicine Congress", in collaboration with the British College of Aesthetic Medicine, takes place at the Hotel Palace from October 11 to 13. Top international and local experts will present trends in aesthetic medicine, rejuvenation and facial and body shaping for around 400 announced participants.

In addition to presenting the latest technology and research results, there will also be live demonstrations, interactive panels and lectures on topics ranging from aesthetic medicine to medical tourism.

The Second Congress of Aesthetic Medicine in Dubrovnik, under the high auspices of the President of the Republic of Croatia, Kolinda Grabar-Kitarovic, will be opened by Tourism Minister Gari Cappelli.

Apart from Croatia and the region, participants from Congress come from Britain, Ireland, Italy, Germany, Netherlands, Belgium, Switzerland, France, Greece, USA, Mexico, India, UAE

The famous names of aesthetic medicine are coming to the congrees, such as Raj Kanodia, Tapan Patel, Matt Stefanelli, Bob Khanna, Herve Raspaldo, Tracy Mountford, Tom van Eijk, Iman Nurlin, Dimitris Sykianakis, Ravi Jain and David Ecclestone. The local experts and lecturers are Sinisa Glumicic, Mario Zambelli, Nikola Milojevic, Davor Mijatovic, Zoran Zgaljardic, Tomica Bagatin, Zeljana Bolanca, Aleksandar Milenovic, Mladen Dudukovic and others.

TAMC 2019 is an international aesthetic congress that offers an interactive, evidence-based, multidisciplinary program and provides a platform to encourage the exchange of ideas and experiences, educate, initiate intense discussions, and expand opportunities for new contacts.

TAMC 2019 covers all aspects of aesthetic medicine, and this year's highlights include: anti-aging and face shaping dermal fillers, skin rejuvenation treatments including stem cell and blood plasma treatments, aesthetic gynecology, life extension (gerontology), body shaping and fat reduction, Botulinum toxin type A basic and advanced techniques, complication management, anatomy, cosmetic surgery, cosmetic dentistry, patient communication, business building and marketing, as well as medical tourism.

Link:
The Aesthetic Medicine Congress to bring trends in plastic surgery to Dubrovnik - The Dubrovnik Times

Kristin Hull is Founder, CEO, and CIO of Nia Impact Capita

If you look 208 years into the futureaccording to the worlds top economistsyoull see a far more healthy, secure, and productive world fueled by gender equality. Though its not very encouraging to those of us living in a culture of entrenched bias, we owe it to future generations to move toward fairness and inclusiveness anyway. The fact is, harnessing the talent we need to compete in the 21st and 22nd century means elevating women and girls today. International Day of The Girl (Friday, October 11th) is a reminder that we need to play the long game. We all have to do our part to accelerate progress for our girls, their girls, and their girls even if the benefits of a more fair and open society will not be our own to enjoy.

These trailblazing female CEOs are humble about their formative years, frank about the daunting challenges they encountered, and relentlessly encouraging.

We need girls to believe that they belong at the table, says Diana Kapp, that they deserve to make money and have power. Kapps new book, Girls Who Run the World: 31 CEOs Who Mean Business, tells the origin stories of female leaders who are disrupting an array of industries from construction to personal genetics, biotech to green energy. Consider that the unstoppable Jessica Matthews of Uncharted Power, Tina Sharkey of Brandless, Kara Goldin of Hint, and Anne Wojcicki of 23andMe were all once just ordinary girls who set out on stratospheric climbs with no guides, no manuals, and no maps. Like a World Book Encyclopedia of feminine role models, Kapp's trailblazing CEOs are humble about their formative years, frank about the daunting challenges they encountered, and relentlessly encouraging.

After tracking these womens trajectories from childhood dreamers to game-changing leaders, Kapp noticed they all shared a similar characteristic. These women have cajones, she says. They embrace imperfection and experimentation, are determined to figure things out on their own, and are willing to move forward without knowing many of the answers.

Female CEOs featured in Girls Who Run The World by Diana Kapp

The book connects the reader to the girl inside each of these innovators, granting a friendly and intimate access meant to inspire and ignite the ambitions of young women. Each story illustrates how passion and conviction for new ideas drive purpose, why a tough skin is critical, how to withstand the inevitable doubters, and how to be nimble and pivot when necessary. Most important is the willingness to "fail and flail" because inevitably, things go wrong, often. The message for the next generation is that these girls did it, and you can too. And that even in the face of failure, its still worth it to strike out boldly on your own.

In the spirit of International Day of The Girl, lets send our girls a message of inspiration and support. Attitudes are only going to change when this generation, the next generation, and every generation of girls after refuse to believe they deserve anything less.So what would you say to yourself as a young girl? and share your message with girls everywhere tomorrow, October 11th.

Here's a gallery of women CEOs who have plenty of great ideas for young women.

See the original post:
Notes To Myself As A Girl: Female CEOs Tell Girls What They Need To Hear Most - Forbes

The trypanosomatid parasite Crithidia mellificae infects managed honeybees, but could it also affect wild bees? A recent article investigates.

Cara Macfarlane 11 Oct 2019

Source: Strobl et al, 2019

Several regions of the world have reported adecline in wild bee species. A contributing factor may be pathogen spillover from managed honeybees, and a variety of pathogens so far exclusively linked to honeybees have been detected in several wild bee species.

However, the detection of a pathogen does not necessarily mean the infection is spreading per se. Pathogens may behave differently within a novel host, where a species may not serve as a suitable host or the parasite does not replicate. Disease progression and symptom intensity can also differ both between and within species.

Several factors influence host susceptibility to pathogens and infection, such as life history traits (e.g. reproductive strategies and sociality), environmental traits, nutrition and the genetics of the host and pathogen. For example, greater infection resistance is typically observed in hosts with genetic heterozygosity and in social groups with higher genetic diversity. The haploid susceptibility hypothesis predicts in Hymenoptera the haploid males from unfertilized eggs should have higher susceptibility (compared to diploid females) as they lack heterozygosity.

Trypanosomatids are unicellular eukaryotic flagellate parasites, and some species colonize the hindgut of bees. They damage intestinal cells through formation of hemidesmosomes, and these lesions can reduce host health at the individual and colony level. In bumblebees, parasite cells multiply after oral ingestion and are transmitted to novel bumblebee hosts via fecal-oral transmission.

The trypanosomatid parasite Crithidia mellificae infects honeybees. While little is known about the effects of infection, there are positive correlations between C. mellificae infection levels and honeybee colony winter mortality. Two common solitary bee species, Osmia cornuta and Osmia bicornis have also recently been suggested as novel hosts of C. mellificae.

In a recent paper, Strobl and colleagues tested whether this parasite could infect a solitary bee by challenging male and female O. cornuta with C. mellificae. The authors also employed honeybee workers as positive controls to assess infection parameters in a known host. Bee body mass, survival and pathogen infection levels were evaluated as measures of susceptibility.

O. cornuta were randomly allocated to treatment (exposed to C. mellificae cells) or uninfected controls, and the males and females separated (control: n = 2 cages, C. mellificae exposure: n = 4 cages). Honeybee workers were randomly allocated to eight cages (control: n = 3, C. mellificae exposure: n = 5), and all cages were maintained for 19 days.

Each cage was provided with a C. mellificae-infected sucrose solution or with sucrose (controls). Survival was recorded every 24 hours and dead individuals were removed. Bees were investigated for living C. mellificae cells before inoculation with C. mellificae (day 0) and on days 6, 10, 15 and 19 post inoculation (p.i.). Bees were individually weighed to assess body mass and anesthetized with CO2, before quantifying C. mellificae cells. DNA sampled on day 0, 15 and 19 was analyzed by PCR and parasite loads were quantified by qPCR.

C. mellificae cell counts on specific days preinfection and p.i. (A) In honeybees (A. mellifera), C. mellificae cell counts significantly increased over time p.i. (B) In O. cornuta females (), C. mellificae cell counts did not significantly change over time p.i. (C) C. mellificae cell counts did not significantly change in O. cornuta males ().

In all groups of bees, body mass did not significantly change over time p.i. (all P> 0.05) or differ between control and C. mellificaeexposed individuals.

After 19 days p.i., 75.5% of the 83 control honeybees and 63.2% of the 128 C. mellificae-exposed honeybees were alive, with significantly reduced survival in parasite-exposed individuals. Of the 80 honeybees sampled for C. mellificae counting, 32.5% of the bees were infected. Parasite cell counts increased 6.6 fold in infected honeybees between days 6 and 19 p.i. and significantly reduced survival.

C. mellificae exposure did not significantly affect survival of O. cornuta females. Of the 25 control O. cornuta females 80.7% survived compared to 68.1% of the 56 C. mellificae-exposed females. However, male O. cornuta had the lowest survival of all bee groups. After 19 days p.i., 39% of the 43 controls and none of the 81 C. mellificae-exposed male bees were alive. Of the 41 O. cornuta females sampled over the entire p.i period, 68.3% showed C. mellificae cells, whereas 90% of the 30 males sampled showed parasite cell counts.

In O. cornuta bees, C. mellificae numbers increased 23.6 fold within cages but did not significantly change between days 6 and 19 p.i. in individual females or males. In both female and male O. cornuta, the proportion of infected individuals increased over time p.i.

A significant positive correlation between C. mellificae cell counts and C. mellificae genomic equivalent copies per bee was also observed in all groups of bees.

Proportion of infected individuals on specific days p.i. The proportion of infected honey bee (A. mellifera) workers, O. cornuta females () and O. cornuta males () are shown on days 6, 10, 15 and 19 p.i.

Strobl and colleagues demonstrate that the solitary wild bee O. cornuta can host the honeybee parasite C. mellificae, and that males are more susceptible. The proportion of infected hosts also increased in O. cornuta cages with feces, but not in honeybee cages without feces. This indicates a fecal-oral transmission route for C. mellificae, as with Crithidia species infecting bumblebees.

The reduced survival of infected honeybee workers provides some causal evidence for the correlation between overwintering colony mortality and C. mellificae infection levels. With evidence of a negative effect on managed honeybee species and male wild solitary bee species, field studies are required to evaluate spillover potential from managed to wild bees and vice versa.

Read the original here:
Trypanosomatid parasites in bees... taking a walk on the wild side? - BugBitten - BMC Blogs Network

In light of the announcement of the 2019 Nobel Laureates, we highlighted 3 of the 50 Cornell faculty and alumni, past and present, who have been awarded Nobel Prizes in Physics, Chemistry and Physiology and Medicine.

Hoffmann

Prof. Roald Hoffmann, chemistry, is the Frank H. T. Rhodes Professor of Humane Letters, Emeritus and has been part of the Cornell faculty since 1965. Hoffmann has researched a variety of sub-fields within chemistry, including organic chemistry, inorganic chemistry and solid state chemistry.

Hoffmann shared the Nobel Prize with Kenichi Fukui in 1981 for their theories, developed independently, concerning the course of chemical reactions. However, Hoffmann relatedmixed feelings regarding the Nobel Prize: pleasure at the recognition, but alsosadness that his colleague R.B. Woodward did not live to receive it with him. He also described the jealousy of peers and the pressure of being watched in the future.

If everyone around you asks you what are going to do next, you begin to think about that and that inhibits creativity, Hoffman said.

However, winning the Nobel Prize didnt change his focus on research and teaching, including teaching undergraduates.

I remained a scientist and I remained teaching Introduction to Chemistry, though I havent done it for 10 years now because Im retired, Hoffman said.

Hoffmann has also been heavily involved in the humanities throughout his life, writing plays, books and poetry. Hoffmann has always believed strongly in the importance of communicating science to the public, saying that scientists should take every opportunity to speak to the general public.

When asked what advice he had for students interested in a future in research, Hoffmann suggested getting research experience in college.

The research experience allows you to move from very large classes [] to the research group and the research group meetings which are usually smaller and which are more of a scientific family, Hoffman said.

Varmus

While many scientists began their careers with a deep passion for science, Dr. Varmus story was more complex. Varmus went through high school hating science.

[I] grew up in pleasant circumstances on Long Island where my major interests in life were tennis and fiction, not science. Science teachers were pretty appalling, Varmus said in a lecture on May 2nd.

While Varmus started as a physician, his career changed course because of his work as a commissioned officer in the Public Health Service of the NIH.

That experience at NIH, my first serious exposure to laboratory life and at the advanced age of 28, determined the course of my career, Varmus wrote in an email to The Sun.

After Dr. Varmus won the 1989 Nobel Prize for his research partnership with J. Michael Bishop studying oncogenesis [becoming cancerous] in retroviruses, Varmus pursued leadership opportunities in addition to research.

I took advantage of my new public platform to get engaged in the leadership of institutions that I admire, hoping to make changes that I thought were important, Varmus said.

Despite his numerous leadership positions, including seven years as the director of the NIH, 10 years as President of Memorial Sloan Kettering and five years as the director of the National Cancer Institute, Varmus continued his research.

Varmus is now the Lewis Thomas University Professor of Medicine at Weill Cornell Medical School, and is studying the molecular mechanisms of oncogenesis.

McClintock

Barbara McClintock M.S. 25, PhD 27, was a pioneering researcher in cytogenetics, the study of the structure of DNA within a cell nucleus. Her discoveries transformed the field of genetics, and while she passed away in 1992, her memory lives on.

McClintock studied the chromosome structure inside maize cells, and discovered what were later called jumping genes, or components that moved between chromosomes. Decades passed before her work was recognized, because her research did not align with conventional wisdom in science before the discovery of DNA.

Previously, people thought that each chromosome is a unique structure/entity, containing its own genetic materials, Prof. Jun Kelly Liu, molecular biology and genetics, wrote in an email. This is also the reason why it took people many years to accept the mobile genetic element concept that she proposed.

After other scientists confirmed her theories, McClintock won the 1983 Nobel Prize in Physiology and Medicine for the discovery that she made many decades earlier, making her the only Cornell-affiliated woman to date to win a Nobel Prize in science. While a she was a Cornell alumna, McClintock did not become a Cornell faculty member because the university refused to hire a female professor.

Liu reflected on the mixed Cornells mixed legacy related to McClintock in an email with the Sun: Its really inspiring to have a woman scientist win the Nobel Prize. She didnt get hired as a professor at Cornell even with all her groundbreaking work, all because she was a woman.

While other women have since won the Nobel prize in physiology and medicine, chemistry and physics, women remain underrepresented among science laureates. Liu has some suggestions for addressing this concern.

We need more women to be in faculty positions so that they can serve as role models to students who are considering a career in the sciences, Liu said.

Anil Oza 22 contributed to reporting in this article.

Excerpt from:
A Look at Past Cornell-Affiliated Nobel Prize Laureates: How their Legacy will Inspire Generations of Scientists to Come - Cornell University The...

Express News Service

BENGALURU:Breast cancer is the most common form of cancer in Indian women and accounts for 27 per cent of all cancers in women. About 1 in 28 women are likely to develop breast cancer during their lifetime. In the urban areas the incidence is 1 in 22 as compared to the rural areas where 1 in 60 women develop breast cancer. The incidence begins to rise in the early thirties and peaks at the age of 50 64 years.CausesThe exact cause of breast cancer is not known. However, several factors affect our risk of developing breast cancer. The chances of developing the disease depends on a combination of our genes and bodies, lifestyle, life choices and the environment. Being a woman and age are the two biggest risk factors.The other risk factors aren Early puberty: Women who started their periods at an early age have a slightly increased risk of breast cancer. The earlier you began your periods, the higher your risk, but this effect is small and gradual. The increase in risk is probably because of the longer exposure to the female hormone estrogen.

nLate menopause: Women who go through themenopause later than average have a slightly increased risk of breast cancer. The later you go through menopause, the higher your risk, but this effect is small and gradual. The increase in risk of breast cancer seen in women who have a late menopause is probably because these women are exposed to the female hormone oestrogen for longer than women who go through the menopause earlier.

n Genetics: In a small number of women, breast cancer runs in the family. Of allwomen who develop breast cancer, up to 15% has asignificant family history of the disease and about one in 20 has inherited a fault in a gene linked to breast cancer. Women who have inherited faults in known breast cancer genes such as BRCA1 or BRCA2 are atincreased risk of developing breast cancer.

n High breast density: The amount of tissue compared to fat in your breasts is known as breast density. Having high breast density (a low proportion of fat) is one of the biggest risk factors for breast cancer. The density of your breasts tends to gradually fall over time, but because age is also a risk factor for breast cancer, this does not mean that your risk of breastcancer reduces as your breasts change. In fact, your risk of breast cancerincreases as you get older.n Ethnicity: A white woman is more likely to develop breast cancer than a black, Asian, Chinese or mixed-race woman. Ashkenazi Jews and Icelandic women have a higher risk of carrying inherited faults in breast cancer genes, such as BRCA1 or BRCA2, which are known to increase the risk of developing breast cancer.Life choices, lifestyle and environment: Factors that increase the risk of breastn cancer are: Weight gain, lack of exercise, alcohol, hormone replacement therapy, the combined oral contraceptive pill, ionizing radiation, radiotherapy, stress and possibly shift work.Pregnancy and breastfeeding reduce the risk. Age and number of pregnanciesaffect the risk. The earlier the pregnancies and the more the number of pregnancies, the lesser is the risk of cancer. Breastfeeding slightly reduces your risk of breast cancer and the longer you breastfeed, the more your risk of breast cancer is reduced. Breastfeeding may reduce breast cancer risk by altering the balance of hormones in the body and by delaying the return of your periods.

How do I reduce the risks?Unfortunately, there is nothing that you can do to change most of the above risk factors. Lifestyle modifications should as detailed above should be made.But all women should be breast aware this means knowing what is normal for you so that you are aware as soon as something changes. The sooner you notice a change the better, because if cancer is found early, treatment is more likely to be successful. Get into the habit of looking at and feeling your breasts from time to time. This will help you to notice any change if it occurs.

What is Breast Self-Awareness?Breast self-examination (BSE) and clinical breast examination are inexpensive and noninvasive procedures for the regular examination of breasts. Evidence supporting the effectiveness of these 2 screening methods is controversial.Even with appropriate training, breast self-examination has not been found to reduce breast cancer mortality. In fact, most of the expert groups now recommend breast self-awareness instead of BSE. Breast self-awareness is a womans attunement to the normal appearance and feel of her breasts, so that she can seek medical advice if she notices any changes such as pain, a mass, new onset nipple discharge, or redness.

The author is the director, senior obstetrician and gynaecologist - Fortis La Femme Hospital, Richmond Road, Bengaluru.

See more here:
One in 28 women develops breast cancer - The New Indian Express

As with fertility testing, the type of infertility treatment you receive will depend on your unique health and medical history. If youre a woman with a blocked fallopian tube, for instance, you may need surgery to remove the blockage or to repair damage before trying other fertility treatments. If youre a man who isnt producing sperm, its possible you have a blockage as well, and your doctor might recommend a procedure that retrieves viable sperm directly from the testes, or a surgery that removes the blockage.

If youre a woman under 35, treatment will likely start conservatively, said Dr. Choi. For example, your doctor may prescribe oral drugs such as clomid or letrozole, which increase the odds of pregnancy by boosting the number of eggs you release during ovulation. This approach is also common for women with certain hormonal conditions such as polycystic ovary syndrome, in which ovulation doesnt occur regularly.

Your doctor might instruct you to combine oral drugs with sex at home; or to time taking them with ovulation or with an in-office procedure called an intrauterine insemination (IUI), in which a clinician prepares a sperm sample then inserts it directly into the uterus to increase the odds of conception.

[More on intrauterine insemination.]

Women who are over 35 may also start conservatively with oral drugs or IUI, but if those measures dont work after a couple of tries, or if its clear from your medical history that they arent likely to work, Dr. Choi typically recommends moving more quickly to more aggressive treatments, such as in vitro fertilization (I.V.F.). Here, the idea is to fertilize the egg outside of the body and then put the resulting embryo back in. (To read more about I.V.F., see our guide on it here.)

Fertility treatments will also vary for people who are single, in same-sex relationships or transgender. If youre a woman whos single or in a same-sex relationship, for example, you may try IUI or I.V.F. with sperm from a donor, depending on your age and your fertility status. Women in same-sex partnerships will also need to decide which partner should carry the baby, which will depend on preference, age and health. (It is also possible for one partner to harvest eggs and the other to carry the embryo, a process sometimes called reciprocal I.V.F., shared maternity or co-maternity.)

Men who are single or in same-sex partnerships will need a surrogate to carry the embryo, whether she uses IUI, I.V.F. or some other means of conception. Men in these circumstances may also need an egg donor.

If youre transgender, your fertility treatment will depend on your individual history regarding sex reassignment surgeries, hormone treatments and so on. For example, if youve already had sex reassignment surgery, you may need donor sperm or eggs, unless you froze your own beforehand. If you only had hormone treatments, you may be able to reverse this process temporarily through new hormone treatments (under the guidance of a physician), in order to produce viable sperm or eggs.

Continue reading here:
Your Guide to Fertility and Getting Pregnant - NYT Parenting

When did you first hear about the hunger disease study that was conducted in the Warsaw Ghetto?

I visited Poland as part of a delegation from Ichilov Hospital [in Tel Aviv]. Given the composition of the group, our guide, Yaki Gantz, included medical information in his tours. One day, when we were near the Warsaw Childrens Hospital, he told us about the hunger that had existed in the ghetto during World War II. And then he mentioned, in passing, that because the hunger was so acute, a group of Jewish physicians there decided to carry out a study of its effects.

The situation in the Warsaw Ghetto was singular. There is testimony of a meeting of senior Gestapo personnel and Nazi physicians Eichmann was also in attendance at which it was decided to liquidate the ghetto by means of starvation. According to their calculations, low-calorie food rationing would wipe it out in nine months.

They calculated a daily ration, just as we dietitians do.

It was racially derived rationing: Germans received more than 2,000 calories; Jews, less than 200.

There was a clear hierarchy [in the occupied countries]. First the Germans, then the Ukrainians, whose ration was about 1,000 calories; the Poles with 600; and the Jews, at the bottom, with 180 calories. As a dietitian, I must say that this is an incomprehensible number 180 calories a day means one slice of bread, one potato and soup, which was mostly water. I doubt that a portion of soup like that contained more than 10 calories. Thats nothing. My head started to spin.

I said to my colleague, dietitian Dror Ben Noah: Do you understand 180 calories? He too was shocked. I asked whether he had ever heard of the hunger disease study that had been conducted in the ghetto. He said he hadnt. Google turned up only a few results, referring to the fact that the study had indeed been carried out. The material itself the data, the findings simply doesnt exist on the web. We realized that we had to do something.

Well talk about the fate of the manuscript that documented the study shortly, but lets first consider the story itself. The plan to starve the ghettos residents didnt cause its liquidation, but it definitely took a toll. The bodies lying in the street, which we know all too well from photographs, were those of victims of starvation.

Its a lethal combination hunger and disease. The starvation plan mainly took the lives of the most vulnerable: the elderly, children, mothers of small children. Its also important to emphasize that the ration of 180 calories was provided in return for payment, and most people could not afford it, of course.

But in practice the ghetto inmates managed to obtain additional food, through smuggling, the black market and public kitchens.

The public kitchens of the Joint [the Joint Distribution Committee] gave out soup and that truly was one of the most amazing and moving things I learned on my trip, in connection with the research study. They declared that from their point of view, the distribution of the soup made it possible to give children in the ghetto an educational experience involving courtesy and cooperation.

The brutal hunger gave rise to horrors, undoubtedly. There was cannibalism. There was violence, people murdered and stole to get food. And yet, on the other hand, a bowl of watery soup could engender values. A social network. Support. You need to see the photographs of the orderly line where everyone is waiting patiently. Of the children sitting at sparkling-clean tables. Those who were fortunate in the ghetto existed on 800 calories a day, but that average consumption also gradually decreased, as time passed and resources dwindled.

Seeking validity

In February 1942, a group of Jewish physicians in the ghetto, led by Dr. Israel Milezkowski, decided to conduct an extensive study of the physiology and pathology of hunger there.

Milezkowski thought in practical terms. He wanted to understand how hunger disease could be cured. It was another physician, Dr. Julian Fliederbaum, who saw the potential of such a study, who created the whole research platform. He wrote that this was a singular opportunity to study hunger and that he wanted to do so with the best tools at his disposal, so that the results would have incontrovertible scientific validity.

An impressive research structure was indeed created. The study was divided into several sections, each led by an expert in a particular field. The topics researched included blood circulation, clinical aspects of starvation in children, bone marrow and more.

To begin with, the scale of the research project was immense. More than 100 participants, which is a huge study. By comparison, in clinical studies we conduct today, in a metabolic laboratory, having 10 subjects is considered a dazzling success. The ghetto study was carried out at the highest standards.

How could the researchers know that the subjects medical condition was due to hunger and not to a combination of that and other diseases?

The subjects were hospitalized in separate rooms that were strictly off-limits, to avoid infection. They were given medical tests and the results were recorded on the wall. Like a medical chart. The tests they administered were solely for research purposes, irrespective of the subjects medical condition.

Its sad and horrible, and its very hard for me to say this, but they also performed autopsies to ascertain that this was in fact the cause of death. Anyone who was found to have been suffering from a different disease was omitted from the study. The most difficult part was to collect the various findings from all sections of the research. The researchers spent the nights in the cemeterys [ritual] purification structure, collecting, summarizing, performing autopsies and writing up the findings as in a scientific article.

Jews were prohibited from engaging in scientific work. If theyd been caught, they all would have been executed.

The Judenrat [Jewish Council, established by order of the Germans] authorized the research. Its members understood the importance of the study, and also allocated resources to it. Money was needed to smuggle in equipment blood-test kits, for example. Most of the smugglers were women, because if the authorities caught a male smuggler they could check to see if he was circumcised and know immediately that he was a Jew. Imagine youre sending a female smuggler to get hold of some piece of medical equipment. She has no idea what it even is. What to ask for. So they draw her a detailed picture. As a professional, I can only admire their thinking.

For example, the researchers wanted to understand what happens to the energy usage of a person who loses weight. Thats a question that occupies the experts in our field even today. We measure it with special equipment and calculators, but they simply calculated it using a pen and paper. The subjects underwent a test for tuberculosis, as the physicians realized that they could draw inferences from this about the immune system. They examined the acidity of the digestive system, hormone levels. What was even known about hormones in the 1940s? Look, at that point in history, the finest medical minds of Central Europe were concentrated in the Warsaw Ghetto. All of them were Jews. It was absolutely a scientific hothouse horrifying and frightening, but a hothouse. They even did glucose-tolerance tests.

What I wonder is where they got sugar.

They used 75 grams of sugar per subject. Sugar was priceless in such a situation. One cannot imagine how much it was worth.

Act of defiance

Is it even imaginable how the researchers themselves stood up to it? After all, they were hungry themselves.

They were hungry. Picture it: a physician studying the disease he is himself is suffering from and from which he will also likely die. We know the stories about physicians who fell ill with diseases and tried to come up with medication to treat them; some of them succeeded. That is not the case here. They werent doing the research in order to save themselves. They did the research in the clear knowledge that they would suffer the identical fate: There were physicians who took part in the project, and died of hunger.

And the study ended with the Grossaktion the deportation and mass murder of the Jews in the ghetto during the summer of 1942.

The researchers final meeting was apparently held in August 1942, during that Aktion. Dr. Milezkowski informed the group that this would be the last one and announced that the findings had been hidden in the cemetery. Some of the physicians who had taken part in the study were also deported in the Aktion. As far as is known, a week after that meeting most of them were no longer alive.

Of those who led the study, only one survived. The manuscript was successfully smuggled out of the ghetto. Milezkowski himself apparently committed suicide. He wrote an introduction to the study, which is jolting: I hold my pen in my hand and death stares into my room.

Yes. He understood this was the end. He understood that if the study would survive and be published, it would perpetuate the memory of all the participants. He writes explicitly that this project is their response to the murderers, adding, I shall not wholly die. This is a story of unbelievable heroism. The way they functioned, under those conditions. The self-surrender, the transcendence. I cant understand where they found the inner fortitude to do all that.

The study gave them meaning.

What is more precious than meaning? The study is their act of defiance, the doctors revolt. We should note the courage of Prof. [Witold] Orlovski, the Polish colleague who safeguarded the manuscript. After the war, Dr. Emil Apfelbaum, the only one of the leaders of the study who survived, retrieved the text from Orlovski and passed it on to the Joint Distribution Committee. Because the JDC was then headquartered in France, the manuscript was translated into French and published in France. I dont know how many copies were printed probably only dozens.

In 1979, an English-language version was published in book form under the editorship of Dr. Myron Winick, an American expert on nutrition, under the title Hunger Disease: Studies by the Jewish Physicians in the Warsaw Ghetto. At the moment, the fate of the original manuscript is unknown.

True. No one knows where it is. By the way, even the Joint didnt know it had this material. I contacted the organizations historian and didnt let up, until one day she called and said, We have it. They produced the Polish and French versions, in 1946. The materials are in their archives.

Are copies of the English edition still available?

They exist but are rare. I found a few copies on Amazon and eBay. I bought them, because I think that every copy should be salvaged and preserved. The thing is that, because of our interest, and because we bought a few copies, we drove the price up. The first copy I bought cost $5. Now theyre going for $1,000. We are raising money to buy all the extant copies.

Lets talk about the studys relevance for our time. When you declare that you want to save it, the goal is not to place it in a museum. You want to make this body of knowledge available. From your perspective, its a textbook.

This study is super-relevant in terms of all the issues were dealing with today in the field of nutrition. People dont realize it, but most of our work in hospitals focuses on malnutrition thats generated by disease. Because we live in a society of abundance, we find it hard to understand that hunger exists. But such research is relevant also, lets say, when it comes to the metabolic or biochemical situation of people with advanced cancer a situation in which, even if there is plenty of food available, the body simply consumes itself. That condition is described in an unprecedented way in the study.

We understand today that a phenomenon like edema stems from hunger. But it wasnt yet known at the time the ghetto study was conducted. That study examined, proved and effectively diagnosed a disease that is today called the hunger disease. A disease that has various symptoms, and if treated at the relevant stage, if there is timely intervention can be cured with food.

That is an important point in itself that there is a point of no return, after which it becomes impossible to save a starving person by means of feeding. Can you describe the stages [development] of hunger disease?

The first stage is a decline in the reserves of fat. The second stage is an accelerated aging of all the body tissues. The final stage, which is relevant for our time, is called cachexia a sometimes irreversible decline in the mass of body fat and muscle; in children, it also affects the bones. At this stage, in cancer sufferers, for example, in order to help the patient, its necessary to treat the source of the cachexia. The tumor itself. The patient is fed, of course, but only if treatment of the cancer is successful will he be able to begin to recover.

The internal organs also respond to hunger with a process of shrinkage and nonfunctioning.

Autopsies performed during the study revealed a small liver, an enlarged spleen and a weakened heart muscle.

Winick writes that the physicians most important conclusion was that the rehabilitation process from hunger disease must be gradual. If the medics of the Allied liberation forces had known that, possibly many lives could have been saved. Many survivors died after liberation, simply because they ate.

That is a truly appalling story. Do you know what they were given? Condensed milk. The people who liberated them thought the survivors needed to be given something that would be both imperishable and rich in calories. But condensed milk is actually pure fat. Their body couldnt handle it. One of our fellow dietitians, Shulamit, second-generation [to Holocaust survivors], told us that when the Allies arrived in the camp where her father was, and distributed food, her father said: Take care of the others, I can wait. And thats how he was saved. If hed fallen on the food like all the others, he would have died on the spot.

When a person suffering from anorexia-induced cachexia comes to see me, we feed them very carefully. Ten calories per kilo of body weight, for example. At the same time, we start to correct the deficiencies in micronutrients, because that is what kills them. We add phosphorus, magnesium, vitamins. Without that treatment, all youre doing is bombarding the patient with calories, and the body just collapses. Only after we see a correction in those values can the caloric value be increased. Death resulting from food intake is a phenomenon we also have see among children in Africa, because of the good intentions of aid organizations, which simply didnt know what to do.

Generally speaking, its more difficult to assist undernourished children, because they need food in order to develop and not just in order to survive. When they dont receive food, the heart, the liver and the brain dont develop. It can be clearly seen that the process of collapse, which in adults lasted months, took weeks in children.

Unique point in history

I wonder if among the subjects in the ghetto there were those who were not in a terminal state, and who could possibly have been helped, but whose fate was sealed for the sake of the research.

I dont know. The findings show that they arrived in different stages of hunger. I find it hard to believe that any of them was in truly initial stages. Were talking about women who weighed 28 kilos [62 pounds]; elderly people who weighed 34 kilos. That is not a good situation. Its important to understand: They were given food in the ghetto hospital. Meager food, but still food. They were treated well. They were given painkillers. Their eye infections were treated. But it was impossible to save them.

Palliative care.

Yes. Their [suffering] was relieved as much as possible. And additionally, they were subjected to testing. The physicians carried out some of the tests on themselves, to set a reference point. Its all detailed here in the study. Systematically. With graphs they drew. Its simply out of the question that we dont have this material.

Overall, and for obvious reasons, there are very few studies about hunger. The best known of them is the Minnesota Starvation Experiment of 1944-45, which is controversial in itself.

That study was conducted on [draft-age young men]. What sort of malnutrition regime was imposed on them in the project? To consume 1,800 calories a day instead of 3,000 or 4,000. What would have happened if theyd had to subsist on the rationing that existed in the ghetto? God help us. Beyond that, the researchers didnt reach the achievements of the hunger study in Warsaw. The latters findings on how hunger affects the eyes, for example, is unparalleled.

The only way to arrive at such findings is through atrocities. Ethically and practically, there is no way to conduct a study of this kind. It could only have occurred at that point in history.

The doctors in the Warsaw Ghetto could also perform an autopsy to see exactly how hunger affected organs, but that was not an option in the Minnesota experiment. Its a wild historical drama: That horror is the greatness of the ghetto study; its the total opposite of the appalling studies the Nazis carried out in the Holocaust.

We havent spoken about the psychological effect of hunger.

At first there is whats known as hunger madness. People become violent. People are ready to do anything. Anything in order to eat and get food. Cannibalism can occur. Killing. Theft. The Minnesota study dwelt on this stage, because they wanted to understand the behavior of POWs; the study describes how they had to restrain the subjects with force because they were willing to do anything to get food. They wanted to eat everything, including non-foods. After the madness comes a stage of apathy. Youre hungry but you dont want to eat. Food is no longer of interest. The subjects in the ghetto study were already in that phase. They were apathetic.

That connection, between the studys historical importance and its scientific relevance, is rare.

Its findings are relevant. The method and the planning are relevant. Even the equipment they used is relevant. You know, I came back from Warsaw obsessed. My children cant take me any more. They tell me Im driving everyone crazy. I told the story of the research project to people I met in the supermarket. I just wanted to shout it out to the world. A month ago, I got back from another trip to Poland, this time to a conference in Krakow. It was unbelievable: The lectures revolved around the questions and the findings of the study. The knowledge theyre so proud of in 2019 it all already existed but no one knows about it. Its a scientific legacy of the first order.

The physicians in the ghetto had to decide either to despair of the situation and give up, or to tell themselves: I am a doctor and this is my way to fight back. They have not received sufficient scientific appreciation, certainly not enough for their greatness of spirit. Breakthrough studies like this one, studies that are milestones, are quoted and made use of for years upon years. This study remained in the dark. Today I can find through Google an article that appeared 30 years ago in the Lancet and order it. There is no access to the [text of the original] hunger disease study. Only those with a physical copy of the book can make use of it.

You and your colleagues have a plan.

Absolutely. First, we have to get hold of all the copies of the English-language edition that still exist and distribute them in relevant places: universities, laboratories, nutrition units in hospitals. The second thing I want to do is to get the book retranslated, from the Polish original. I dont know Polish, but even the superficial comparison I made shows that there are sections missing in the English and French versions. For example, the Polish version has the initials of all the names of the subjects. There are names of doctors who took part in the study and were omitted, and thus not perpetuated. I imagine that other things are also missing.

The aspiration is to translate the whole book anew and make it accessible, digitally, in libraries, in other sources. For people to work with it, study it, quote from it. And, of course, in the end we also want to have a Hebrew version, with notations and commentaries relevant for our time from expert physicians. On all these fronts we are moving ahead slowly but surely. It will all happen. We are goal-motivated. We will not give up.

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The secret starvation study conducted by Jewish doctors at Warsaw Ghetto - Haaretz

SAN RAMON, Calif., Oct. 11, 2019 /PRNewswire/ -- Surprising results in a new national survey find that consumers rarely trust popular celebrity endorsements for weight loss programs. In fact, according to the survey, conducted by LeanMD, Inc., nearly 60% of adults say medical professionals are their go-to-source for weight loss information. Although the weight loss industry paid out multi-million dollar sums to celebrities for their endorsements last year, including the Kardashians, Oprah Winfrey, Rob Lowe, Marie Osmond and Dan Marino, the survey uncovered the fact that less than 2% of consumers are inclined to take their advice.

Less surprisingly, the survey found that men and women across all age, regional and economic demographics, have attempted to lose weight. Over one third of respondents have lost between ten and 25 pounds in their lifetime.

LeanMD, Inc. is a medically supported weight loss program that features a mobile app and offers patients a way to lose weight safely and effectively. Additional findings from their survey of 1,022 adults age 18 to 65 from across the US include:

"Although the weight loss industry pours incredible amounts of money into celebrity endorsements, we were not surprised to find most adults prefer to get their medical advice from a medical professional," said Dr. Mark Musco, co-founder, CEO & Chief Medical Officer of LeanMD. "When we look at a patient, we see the entire person, including their lab results, medical history, body composition analysis, and more. As medical providers, we have access to all the tools needed to maximize patients' metabolism and help them reach optimum health levels. For example, we can check hormone levels, thyroid function and other key metrics; and we can prescribe medications to help the patient manage hunger safely."

Dr. Musco adds that losing weight can be risky especially if the patient has known (or unknown) health conditions and it is important to have weight loss and vital signs monitored consistently, to ensure weight loss is accomplished safely.

About LeanMD, Inc.LeanMD is a medically supported weight loss program that features a mobile app and offers patients a way to lose weight safely and effectively. Today, LeanMD has locations throughout California, Colorado, Hawaii, Indiana, Louisiana, Texas and Oregon, with new markets scheduled to launch. Learn more at http://www.leanmd.com.

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National Survey Debunks Celebrity Endorsements with Nearly 60% of Adults Claiming Medical Professionals are their Go-To Source for Weight Loss Info -...

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Keeping the weight in check is a never-ending process. Even if someone gets set into a routine that becomes second nature, it is still basically work. Working to make sure the weight stays at the ideal level. But sometimes those people with a set routine start to see a weight gain. Slowly but surely the weight can inch up the scale.

What could possibly be causing this weight gain? There are plenty of reasons for this but the main reason that affects most people is a decrease in metabolism. As people grow older, their metabolism drops. Its just a fact of life. But sometimes it drops too steeply at too young an age. It can cause problems like weight gain or muscle mass decrease or trouble sleeping.

Trying to figure out if it is actually the metabolism levels that are causing these problems can be as simple as going to the doctor. But who really wants to go to the doctor? Nobody. Not because making sure the body is in top shape is a bad thing. Its because the entire process of going to the doctor is just a nightmare. Waiting forever and, even with insurance, spending too much money on what will end up being a 5-minute meeting with a doctor. Its mind-numbing.

Luckily, there is a way to get some health facts without having to go to the doctor. Cutting out at the middle man can only be a good thing. Over at EverlyWell, there are tons of options for take-home tests to get levels on all sorts of things. Testosterone levels or cholesterol levels can be checked from home with ease. And fittingly, EverlyWell also has a Take Home Metabolism Test.

The Take-Home Metabolism Test is really simple to use. Just order the test and it will be delivered pretty quickly to the home. Once it has arrived, enter the barcode on the box into the EverlyWell site. Then it is time to just give a little prick on the finger to extract a little bit of blood, then deposit some saliva into the prepackaged vials that come in the box. Pack them up and send them back to EverlyWell. From there, a board-certified physician will check the levels and send the results in on the EverlyWell platform.

What the doctor is going to look at is the levels of three key hormones. What the test will check out is cortisol, free testosterone, and thyroid-stimulating hormone levels. From there, the doctor will be able to figure out if the metabolism is not working at the highest functionality. And it is simple as can be. The Take-Home Metabolism Test is a lot simpler than having to get up and go to the doctor.

Being able to check out the metabolism levels at home with the Take-Home Metabolism Test is really the definition of convenient. There is nothing too difficult here. And from the comfort of home, each man can figure out what needs to be done with these results. There are plenty of ways to work around a metabolism deficiency. But they cant be utilized without the knowledge this test can provide. Get it now to get back on the right path.

Get It: Pick up the Take-Home Metabolism Test ($89) at EverlyWell.

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Jordan Teitelbaum is a successful guy. Also, busy. At 32, the father of two is finishing an endoscopic sinus surgery fellowship (he specializes in removing brain tumors through the nose), looking for a job, paying the mortgage on his new house, and trying to be present in the life of the woman he married three years ago while attempting, in the spare moments he doesnt really have, to look ahead.

Im only partially into my thirties, I can see that this will be the most demanding decade yet, he laughs. Im trying to set up the rest of my life, not just for myself, but for my little family.

Teitelbaum doesnt sleep much. And hes far from alone. Doctors or not hell, parents or not American thirtysomethings tend to struggle with the stress of their third decade after the comedown from their mid-twenties before stabilizing in their forties, lightening up in their fifties, and peaking again in their sixties. (Research shows that happiness peaks at the age of 23 and 69, hold the jokes.) The ennui takes many thirtysomethings by surprise they tend to be, after all, more secure and stable professionally, personally and financially than twentysomethings but maybe it shouldnt. In 1968, ur-developmental psychologist Erik Erikson posited that there are eight stages of psychosocial development and that the sixth stage, Intimacy vs. Isolation, occurs between the ages of 18 and 40. This stage is characterized by significant emotional conflict in close relationships. If the stage is completed, people move on to have healthy, secure, and committed relationships. If not, they struggle to move on with their lives and face a heightened risk of loneliness and depression in the long term. In other words, thirtysomethings like Teitelbaum are playing a high stakes game.

No wonder theyre so stressed.

Regardless of lifestyle, personal well-being, as measured by Gross Domestic Product in aggregate, tends to bottom out in peoples thirties. Why? Because as thirtysomethings shed the impractical expectations they carried through their twenties, age, economic realities, and social changes deliver a combination punch that, emotionally speaking, puts many on their ass. And, yes, its worse for parents. Theres reason to believe that the early parenthood drives down well-being scores significantly. As rewarding as parenthood may be in the long-term, the short term is hard as hell.

Before we hit our thirties its acceptable to make mistakes both professionally and romantically. But as we get older, failure may feel more significant and lead to some loneliness and isolation, Karen Rosen, a psychotherapist and clinical social worker, explains. Combine this with the strain of sustaining a household and you have some adults who are really tapped out. Its a time of pretty strained resources.

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There are plenty of economic factors that exacerbate thirtysomethings economic concerns. Financial experts recently estimated that the age of 31 is the most expensive year of peoples lives on average, costing people about $61,000. This is a consequence of a combination of big bills, such as weddings, buying a house, having a baby, and paying for a honeymoon, on top of everyday expenses, but does not include retirement savings or money to support a family in the long-term that will cost extra. That means that, with the average salary hovering just over $44,000 among full-time employees, plenty of people spend their third decade going into debt. This is more the case now than historically because of the outsized effect of the Great Recession on Millennials. Americans born between 1981 and 1996 have fallen short of every generation of young adults born after the Great Depression, amassing less wealth than their parents and grandparents higher levels of education. Men and women in their thirties are marrying at the lowest rates on record, and the U.S. birth rate is similarly the lowest it has been in 32 years.

Though the job market has recovered since cratering in 2008, Millennials remain behind when it comes to earning, wages adjusted seemingly forever down after entering a job market at cut-rate salaries, and thats on top of decades of wage stagnation. It doesnt help that student debt has exploded. The average debt after graduation is about currently $30,000, nearly double what it was in the 1990s.

What can people in their thirties do other than white knuckle it through the toughest time of their lives?

The not-so-great good news for Millennials is that many owe less because they have fewer assets. In 2016, homeownership rates fell to 36 percent among people under 30, compared to nearly half of Baby Boomers who owned homes at the same age. This has inevitably driven down home ownership rates overall to the lowest in half a century, 63 percent, compared to nearly 70 percent in 2005, when the subprime lending bubble was about to burst. The problem is not that Millennials are unmotivated or unaware of their generational shortcomings. Research out of Stanford found that most people over 25 actually want to get married by the age of 27, buy a home by 28, and start at family by their 29th birthdays. But since the ability to accomplish these goals has decreased with every generation, those between the ages of 25 and 34 want them the most. But thanks to the rise of the gig economy and false promises of hustle culture, they are the least set up to achieve them.

And heres the thing: Thirtysomethings would be feeling the burn even if none of those things was true. Why? Because thirtysomethings are in a high resource demand part of their lives. They are, on average, supporting a kid, making car payments, and trying to invest or investing in real estate. They are also incurring the costs of working (commuting isnt free) while also spending on activities designed to help them maintain social connections that seem increasingly tenuous. If weddings make peoples twenties expensive, everything makes peoples thirties expensive. This is a lesson people tend to learn in the fifties, when they report being about five to six percent happier than those in their thirties in no small part because theyve made it to lower demand, higher resource point in their lives.

Theres a reason why grandparents often seem so much happier than new parents. They have money.

They also have kids. That might sound odd, but theres a difference between having young children and having grown kids. Research suggests that having grown kids increases well-being profoundly and that having young children does not. Individuals who invest the struggle that is their thirties into having children, like Teitelbaum, generally experience higher levels of happiness in their fifties, whereas those who do not either flatline or become worse off.

A recent study of over 55,000 people 50 and older demonstrated this, along with other work published in 2011 and 1994. Parents are not invariably happy, but they become happier once children achieve economic independence and move out. This is presumably because grown kids provide social and emotional support and keep their parents engaged in a way that infants can not and do not, forcing their parents to look for meaningful connection elsewhere.

And that search, as many can attest, becomes hard after the party-hardy twenties come to an end. A study of over three million men and women found that the number of friendships they had started to decline in their mid-twenties, dropped off dramatically throughout their thirties, and did not begin to rebound again until their mid-forties, when their kids were older and more self-sufficient. The problem? Thirtysomethings just dont have the bandwidth to maintain many close relationships and lose touch with the outside world as a result. And this takes a massive toll. Friendship has been found to lower blood pressure and BMI, increased longevity, improved psychological health, and increase individuals ability to cope with rejection. For thirtysomethings, this is particularly dangerous. Consider Maslows hierarchy of needs. Its called a hierarchy for a reason: If people cannot elevate themselves to a point where they feel a sense of belonging, they will not be able to elevate themselves further and get a sense of self-esteem. This makes the inevitable diaspora of the thirties friends moving for work, love, and to have children profoundly destabilizing on a personal level.

Our basic needs such as food, sleep, shelter, and safety are the staples of our well-being. Lack in any of this can, in the long run, have detrimental effects on our health, Dr. Lina Velikova, a physician and sleep expert. When those needs are not met, it is that much harder for people to experience deeper feelings of fulfillment.

Its also worth dwelling on that second need for a moment because sleep and sleep related issues define, in many senses, the experience of living through ones thirties.

Sleep starts to naturally decline in sleep that starts at the age of thirty, exacerbating mental and emotional strain. Deep sleep specifically, also known as delta sleep, which supports memory and learning as well as facilitates hormone production, declines by some 50 percent by the time people enter their thirties. A massive review of literature published in 2017 found that this may be a result of aging brains fail to recognize signals of tiredness or exhaustion. The result is usually a combination of insomnia and sleepiness, the haze of early middle age. Parents, who lose an average 109 minutes of sleep every night for the first year of their childrens lives, struggle more.

People who sleep less than the recommended seven-hour minimum produce more stress hormones like cortisol, experience more inflammation, and are at a higher risk for certain types of cancers. Sleep deprivation can also lead to sexual dysfunction. Because thirtysomethings are often unaware of a biological transition taking place, they may misdiagnose symptoms of sleeplessness as signs of true sexual dysfunction, mood disorders, or even burnout.

Long story short, because of tiredness and feelings of abandonment, thirtysomethings focus bad energy on themselves. And all that self-reflection can exacerbate the problems.

In America, psychoanalysis really took off because it spoke to consumerism, it spoke to privileging the individual over the collective or community, and spoke to the inward, almost egotistically if overdone self-reflection, psychotherapist Michael Aaron explains.

The American wellness industry, broadcasting messages about hustling, seizing the day, getting perfect skin, meditating, and eating the right CBD vitamins, offers, at best, half-measures.

The problem is that individualism rarely makes anyone feel better. An overwhelming amount of evidence suggests that, for better or worse, immediate resources and environment move the needle the most when it comes to overall well-being. Immediate resources, thanks to increased spending, and environment, thanks to social shifts, are the two places that thirtysomethings tend to feel like theyre losing ground. Does therapy solve that? Only if therapy promotes social behaviors and only if it helps dad and mom find time to see friends. Pre-modern man didnt have these problems.

Aaron cites French sociologist mile Durkheims seminal 1897 work, Suicide, in which Durkheim demonstrates a strong link between industrialization and suicide rates. He concludes that capitalism makes it harder for individuals to meet their basic needs while maintaining close interpersonal relationships.

People were feeling atomized, and less of a sense of community, and feeling more alone and isolated. In losing their sense of community, they were more likely to experience depression that could lead to suicide, Aaron explains. Durkheims point is that we cannot minimize the role of the broader society in the way it affects people.

The American wellness industry, broadcasting messages about hustling, seizing the day, getting perfect skin, meditating, and eating the right CBD vitamins, offers, at best, half-measures. Rather than being empowered to solve problems by thinking socially, Americans are pushed towards consumer solutions. It is remarkable how many of those solutions are sold at considerable cost to people in their thirties.

So what can people in their thirties do other than white knuckle it through the toughest time of their lives? Making more of an effort to address basic social and emotional needs is obvious, but may not be practical for everyone. Time is short (especially for parents). But sleeping more, participating in active financial planning, and asking for help are all good ideas. And, as with all things, expectations are key and, research proves, strongly correlated with happiness and well-being. Thirtysomethings who expect to be crushing it, likely wont. Those who understand that they may have to sacrifice short-term well-being for long-term stability, on the other hand, will likely make it through unscathed.

Every day is a marathon, but I am happy precisely because I have two great kids, a talented and takes-care-of-most-things wife who is the dopest mom, and I am doing well in my career, says Teitelbaum. He pauses for a second to consider his success. Drained is a good word for it, he adds.

Teitelbaum claims he is happy. And thats critical. Happiness and well-being are different. While happiness is considered a temporary state or feeling, well-being is a more permanent stasis based on health, happiness, welfare, and prosperity. If well-being is the meal, then happiness is the butter. The good news is that happiness is not off the table for people in their thirties, especially parents of young children, and represents one area where they can gain traction. It may be a few years before you can get a full nights sleep, workout, eat right, or hang out with your buddies regularly, but it is possible to be content and proud of the hard work getting done.

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The application provides an instant and fast responding source for its users. Applications are of different types that inspire people and to use for specific reasons. Almost every app has unique and special attention and attraction to specific communities for some purpose.

Applications can be of different topics and can represent different ideas that attract the communities and engage them for specific tasks. The use and the requirements depend upon its features and the demands for which people ask for immediate response. Innovators and creative planners always inspire from the massive range of ideas and never lose their energies and requirements for which they wait for. From education to entertainment, almost every type of mobile apps are available for the peoples interests and to facilitate them at the maximum level. Almost every idea requires special consultancy, need and value for its users. People can make sure what they need and what type of plans can facilitate them to relax to worries and to enjoy the online convenient access to solve their issues.

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Get latest information about medical testsalong with complete prescription and timing; TSH Thyroid Stimulating Hormone,Blood Sugar/Glucose Fasting, Ultrasound Whole Abdomen, CBC Haemogram, E.C.G.,X-Ray Chest PA View, Lipid Profile, Thyroid Profile, Search more testsinformation and awareness can be got from this recommended app. Different typesof appointments with doctors can be made with the help of this quick respondingapp. Find the online list of Top Hospitals in different regions and do youronline consultation to find a doctor. Book doctorappointments with Cardiologist, Oncologist, Nephrologist, Neurologist,Orthopedist, Obstetrician & Gynecologist, Dermatologist, General Physician,Search more specializations with 50% off offer by getting online access. Thereare numerous other inspiring feature ideas which are helping the interestedcommunities to solve their interests relevant issues and to facilitate themaccording to their satisfaction level.

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Latest Application Ideas for Online Consultancy and Other Activities - iLounge

Some women think that if they are not overweight, there is no need to do exercise or work out. However, it is a common mistake. Exercise is very important as it provides various health benefits besides weight loss.

Did you know exercise releases endorphins, which are feel-good chemicals? If you know the benefits of working out, you will stay motivated to do it regularly. We have compiled a list of benefits of regularly working out so that you can get out of your bed and get going.

What are the risks of not exercising?

A sedentary type of lifestyle can increase the risk of health problems such as cardiovascular disease, type 2 diabetes, cancer, or osteoporosis. It can also lead to premature death from all causes such as complications of being overweight and obesity.

In many parts of the world, the number of overweight and obese people is increasing rapidly. Overweight and obesity are two of the major health issues caused due to not working out, while there are many more than these two. Therefore, it is advised that you take time out of your busy schedule to work out and see the benefits yourself. Here are a few of those benefits:

1. Prevents muscle loss

Over time, our bodies are not able to build muscles efficiently. Also, our muscles break down more quickly as compared to when we are young. If we make the workout a part of our regular schedule, we can not only maintain our muscle mass but can also increase it.

As a woman, if you work out regularly, you can keep your metabolism high. This will give you the strength and endurance to complete your everyday tasks. You can also prevent falls, which can be a life-changing experience for some of the adults.

2. Exercise improves sleep

Sleep is important to look and feel good because your body does the repair work during sleep. You get to replenish vital nutrients and vitamins during sleep. A growth hormone is secreted during sleep that helps to rebuild skin and hair, which is why it is called beauty sleep!

As per a survey, it was discovered that women find it more difficult to sleep or stay asleep as compared to men. This tendency may get even more troublesome during motherhood, monthly hormonal changes, or at the time of menopause. However, regular exercise can help improve sleep.

3. It increases your energy levels

A regular workout can help you increase your energy levels. Apart from being an energy booster for healthy people, it is a good solution for those suffering from various medical conditions. As per a study, regular exercise helped reduce the feelings of fatigue, which had complained about persistent fatigue.

You can combat chronic fatigue syndrome (CFS) and other serious illnesses through regular workout. It has also proven to increase the energy levels in people suffering from diseases such as HIV/AIDS, cancer, multiple sclerosis, etc.

If you want, you can also include supplements in your diet to get a better physique and higher energy levels. Body Iron Inside Out is an awesome website to check out the reviews of other users and see how they are benefited by taking particular supplements.

4. Reduces PMS symptoms and menstrual cramps

Some women find it difficult to deal with Premenstrual syndrome (PMS) and menstrual cramps. However, studies suggest that regular exercise or workout is an effective way to reduce PMS symptoms and menstrual cramps.

Apart from reducing PMS symptoms, it is also effective for dealing with mental issues such as stress and irritability, which are very common among women. Working out during your menstrual periods has proven to improve your mood and reduce menstrual pain.

5. It helps you control your diabetes

Along with taking the right kind of diet to lower blood sugar levels, working out regularly is a great add-on. It increases your insulin sensitivity so that your cells can use the available insulin to take up glucose in a much efficient way.

An increase in insulin sensitivity can help delay your need for medication or let you use smaller doses than before. We all know exercise helps in reducing weight, which will, in turn, help you get your diabetes under control.

6. Weight Management

One of the most common and known benefits of workout is weight management. Working out regularly helps increase your caloric expenditure, which in turn will help you lose weight or maintain your ideal weight.

Regular exercise can help enhance your metabolic rate, which can make weight management a much simpler affair for you. It will also keep the obesity-related and heart-related diseases away from you.

Bottom Line

Regular workout offers many benefits that can enhance and improve nearly all aspects of your physical and mental health. It increases the production of hormones that are responsible for making you happier and help you sleep better.

Your skin will glow, you will lose weight, the risk of acquiring chronic diseases decreases, and your sex life improves tremendously. It helps improve sexual desire, function as well as performance in both men and women. You must do regular workout, whether it is aerobic or a combination of aerobic and resistance training, to get a healthier life.

However, you must consult a physician before starting any kind of workout so that you do it properly, especially if you have some pre-existing health issues.

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6 Benefits of Workouts for Women - Don't Just Look Healthy, Be Healthy - Siliconindia.com

MONTREAL - Quebec will now cover the cost of a breakthrough immunocellular cancer treatment for young patients with acute lymphoblastic leukemia, and adults with non-Hodgkin's lymphoma, who meet the criteria.

"The therapeutic value was demonstrated," said Health Minister Danielle McCann on Tuesday, adding, "this kind of immunotherapy treatment is the way of the future, and we are at the forefront."

The health care investment represents $35-million annually for the province.

CAR-T cell therapy was approved by Health Canada last year for the two life-threatening cancers, when standard first line treatments are ineffective, or when patients have suffered relapses. However, up until now, access to the treatment has been limited to patients who are part of studies.

Now that the therapy is on RAMQ's list, it's estimated about 60 adults and ten children will benefit annually in Quebec.

"It's exciting, because we actually empower the patient's own immune system to target and attack and destroy this cancer,' says Dr. Isabelle Fleury, a hematologist-oncologist at Maisonneuve Rosemont Hospital, one of two centres in Quebec where the treatment is offered.Its also where pivotal immunotherapy research was conducted, which helped lead to the therapys regulatory approval.

Six-year-old St-Jean-sur-Richelieu resident Olivia Labelle was treated with CAR-T two months ago at Ste-Justine Hospital, the second centre accredited to administer the therapy. "She did really great, and her leukemia is in remission," according to her pediatric hematologist-oncologist, Dr. Henrique Bittencourt, who calls the treatment "revolutionary."

Dr, Bittencourt cautions that CAR-T, an immunotherapy and gene therapy combined, is not always the answer. Some pediatric patients relapse, but Bittencourt says 50 per cent of patients are still in remission about three-and-a-half years later.

As young Olivia zoomed around a Ste-Justine hallway, only pausing to hang upside-down on a sofa next to her doctor, it was difficult to imagine how sick she'd been only months earlier. "It's reassuring," her mother Anabelle Soucy-Cote sighs. "We've learned to appreciate the good moments."

After two rounds of chemotherapy failed, 64 year old Richard Vallieres became eligible for CAR-T therapy to help him recover from non-Hodgkin's lymphoma. Dr. Fleury was there with him in his Maisonneuve-Rosemont Hospital room as he received his re-engineered immune cells on Tuesday. "Of those (adult patients) who respond to CAR-T, 70 per cent are still in remission two years later, so it's a giant step," Fleury says.

CAR-T stands for chimeric antigen reception T-cell therapy.

In simple terms, this is how the personalized treatment works:

Currently, the patient's cells have to be sent to the United States to be modified. There are plans to develop a similar type of cell transformation laboratory at Maisonneuve Rosemont.

Minister McCann told CTV other provinces are in the process of analyzing whether they will follow Quebec's lead. Two hospitals in Ontario are developing treatment centres of their own.

In the meantime, "Quebec will also be able to provide care for people who are coming from other provinces in Canada," the health minister explained.

See more here:
Quebec to cover revolutionary cancer treatment for types of leukemia and non-Hodgkins lymphoma - CTV News

Dr. John Geyman has been retired from medical practice for over twenty years now. But during that time, he has written more than twenty books as an emeritus faculty at the University of Washington.

Most of the books focus on the dysfunction of our medical industrial complex from the privatization of Medicare to Obamacare and Trumpcare and how we can replace it with pure single payer Medicare for all.

Lets go to some of the outliers first. You wrote a book called Flight is a Lifetime Passion.

I grew up in Santa Barbara during the war, Geyman told Corporate Crime Reporter in an interview last week. We were close to a Marine air base. I would look up and see B-17s or Wildcats fly over. I was always looking at the sky. I followed that closely as a teenager.

I wanted to fly in the Navy when I graduated from Princeton, but I flunked my eye test. Even though my eyes were better than 20/20, I had too much astigmatism. And if you are trying to land on a carrier with astigmatism, it doesnt work out well.

I didnt get to fly then, but I learned to fly during medical school and have flown regularly since those early years. Now I am a united flying octogenarian or UFO where I fly cancer patients regularly to the mainland from our island for chemo and radiation therapy.

It has always been a passion. And Ive had a number of airplanes, all small ones, some open air. Ive flown them across the country, including a biplane across from Texas to here in Washington. Flying has been an avocation for me. And Ive written several books on flying.

You wrote a book titled Souls on a Walk: An Enduring Walk Unbroken by Alzheimers.

Thats about my wife of 56 years Gene (Eugenia). She died of Alzheimers about eight years ago. She had a sixteen year course of Alzheimers. As is often the case in the early part, the signs are subtle. But I took care of her at home the whole way, except for the last four days in the hospital. I wrote about that and shared that experience and the whole problem of taking care of Alzheimers patients. She was an artist and painted a beautiful painting, even in the last few months. That book is a sharing of what it was like.

Do you have any insights into the causes of Alzheimers?

No. And there is still no cure on the horizon. There have been different theories as to the cause, but no one has nailed it down. The biggest risk is just growing older.

Most of your books deal with the healthcare system broadly. Your early books were The Modern Family Doctor and Changing Medical Practice (1971) and Family Practice: Foundation of Changing Healthcare (1980).

The first book where you deep dive on policy is Healthcare in America: Can Our Ailing System Be Healed? (2002).

I was trying to look at the whole system for the first time. I looked at the major trends decreasing access and increasing costs, specialization, increased technology. I looked at the politics, rationing in our free market society, lessons from other countries.

Then comes The Corporate Transformation of Healthcare: Can the Public Interest be Served (2005). Falling Through the Safety Net: Americans without Health Insurance (2005). Shredding the Social Contract: The Privatization of Medicare (2006).

Since then, Medicare has been privatized to a far greater degree. Medicare has effectively been corrupted. Now when you say Medicare for All, you are saying bring in a corrupted Medicare for All?

There always has been a pressure to privatize because there is a belief that the private sector is more efficient than the government sector. Thats fallacious. Traditional Medicare started in 1965 as a public single payer program for people over 65. But private insurers have always been pushing. And they say they can do it better. And they got government policy makers to go along.

The government has bailed out private insurers along the way with many billions of dollars in overpayments. It has been collusion with the federal government based on a theory that private is better. But it isnt. There is a huge amount of fraud in both Medicare and Medicaid. In Medicaid overpayments are endemic in more than 30 states, often involving unnecessary or duplicative payments to providers.

Is there any indication that a single payer system will be any better at deterring fraud than a multi-payer system?

Billing would be very much simplified. There would be negotiated fees with physicians, with other healthcare professionals that would be reasonable, fair and consistent. There would be negotiated global annual budgets with hospitals, nursing homes and other facilities. Right now, we have an electronic medical record which has become rapidly a billing instrument.

There are all kinds of daily profiteering on that. Two thirds of physicians are now employed by big hospital systems or in some cases insurance companies. The pressure on physicians is to upcode or say that you did more in that office visit than you actually did. The electronic record is a big part of the inflation in healthcare costs right now.

That would be reined in by simplifying the whole billing system under single payer.

You wrote a book in 2008 titled The Corrosion of Medicine: Can the Profession Reclaim Its Moral Legacy? Like the general population, doctors are split on the question of single payer.

There is a lot of distrust throughout our population of government and of Congress. One reason for the distrust is the privatization. There is also a lot of denial about the extent of the problem.

The polls show that 84 percent of Democrats support Medicare for All and even 52 percent of Republicans support Medicare for All.

But there are some polls asking if you were forced to give up your employer based insurance, would you still be in favor of Medicare for All? And those polls come out different.

The employer based system is being hyped by the coalition against Medicare for All. But its a very fragile system. Something like 40 million people lose their jobs or leave their jobs every year. And they lose their health insurance. The average person now has twelve different jobs before they get to be 50 years old. Its a very unstable system right now. And we would be much better off with a well run Medicare for All.

Under Medicare for All, 95 percent of Americans will pay less than they do now for health care and insurance. Its a no brainer if you look at the whole system.

In 2008, you came out with Do Not Resuscitate: Why the Health Insurance Industry is Dying and How We Must Replace It.

You say that we must replace it with a government run single payer. But its not just privatization that is undermining Medicare. Its also rampant government bureaucratization.

This is true. Its poor health policy. Its government at its worst bailing out the private insurance industry. That isnt to say that Medicare for All, well done, as it is in almost all advanced countries in the world western Europe, Canada, New Zealand, Australia, Scandinavia. There are solid approaches for determining fair fees, bulk purchasing of drugs and medical supplies lots of savings though decreased administrative costs.

The overhead of private insurers is 18 to 20 percent. Traditional Medicare is 2.5 percent in this country right now.

In 1995, Taiwan solved their health care problems with a solid Medicare for All system. I was in practice in Mount Shasta in 1965 when Medicare and Medicaid came in. It was seamless. A patient would come in and show me their card. And the question was how can I help you? Not whats your insurance, as is the first question today when you go to the doctor.

In 2015 you wrote a book titled How Obamacare is Unsustainable: Why We Need a Single Payer Solution for all Americans. You were not a fan of Obamacare.

I wasnt. The politics hijacked it. Now, nine years into Obamacare, it has failed to contain costs or improve quality of care. The Obamacare insurers limit patient choice and access through restrictive and changing networks. Often even a doctor in a network doesnt know he or she has been changed. And patients often find out after the fact. Premiums have gone up by profiteering private insurers. That continues. More than 27 million are not insured. And 84 million Americans are underinsured. Deductibles keep going up. Deductibles as high as $10,000 a year are in effect. Middle aged Americans are much more likely to die of heart disease than they were in 2010. Obamacare has failed to improve access and contain costs because the private insurers have such a big role in the system. And there is quite a bit of fraud out there.

You say the vast majority of Americans support single payer. If that is the case, why dont we have it?

There is a huge amount of disinformation and rhetoric in the debate over how we should proceed. And much of it is carefully used to discredit Medicare for All.

Dr. Don McCanne does the quote of the day for Physicians for a National Health Program. Here is how he frames the situation:

Im much more worried about our friends than our enemies. A decade ago our friends kicked us out of the negotiations and brought us Obamacare. By now we could have had everyone covered at a cost we could afford, but instead we have tens of millions of uninsured and underinsured who are losing their choices in health care while our national health care expenditures increase at twice the rate of inflation, all the while perpetuating suffering, hardship, and premature death.

[For the complete q/a format Interview with John Geyman see 33 Corporate Crime Reporter 38(13), Monday October 7, 2019, print edition only.]

Link:
John Geyman on the Failure of Obamacare the Medical Industrial Complex and the Single Payer Solution - Corporate Crime Reporter

What are the symptoms?

Metastatic disease symptoms are tricky because they vary depending on where the cancer cells have spread, Henry says. Some symptoms might be caused by side effects of medication or they might be an indication of depression. Its important to explore the cause.

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I always encourage a patient with a history of breast cancer to call us if she has a new symptom, especially if it sticks around longer than expected, she says.

These are some common symptoms of metastatic breast cancer by site:

Symptoms of bone metastases:

Symptoms of brain metastases:

Symptoms of liver metastases:

Symptoms of lung metastases:

What are the treatments?

Patients with metastatic disease are primarily treated with systemic therapies drugs that work throughout the body. These include chemotherapy, targeted drugs and hormonal therapy. Surgery or radiation may be used to slow the growth or reduce the size of tumors.

Identifying optimal treatment depends on the specific type of breast cancer, specifically the hormone receptor status and the HER2 status of the cancer.

There are many different types of breast cancer. Oncologists will conduct extensive testing of tumors, with sequencing, and look at specific findings to understand what the cancer might respond to best, Henry explains.

For example, patients with hormone receptor positive cancers are typically first treated with anti-hormone treatments such as an aromatase inhibitor or fulvestrant, often in conjunction with other targeted drugs. Those with HER2-positive cancer will receive Herceptin or other treatments directed against HER2 as part of treatment. In addition, women with a BRCA gene mutation may receive a PARP inhibitor as part of their treatment.

More and more treatments are being developed and approved, so we have many more options for treatment now than we did just five to 10 years ago, Henry says.

Do men get metastatic breast cancer?

Yes. But only about 1%-2% of all breast cancers occur in men, so the disease is not very common in men overall. But when it does occur in men, it can spread and become metastatic, Henry says.

What is the prognosis?

While there is no cure for metastatic breast cancer, there are treatments that slow the cancer, extending the patients life while also improving the quality of life, Henry says. Many patients now live 10 years or more after a metastatic diagnosis.

We are seeing improvements in how long people are living. The new types of medicines that are being approved treat the cancer and help with other symptoms. People are not only living longer, but they are also feeling better longer for the most part, which is very encouraging.

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How do clinical trials fit into the equation?

I think clinical trials in general are very important, because almost every drug we have in practice right now, we learned about through a clinical trial, Henry says.

The Rogel Cancer Center always tries to have clinical trials available for all patients, no matter the stage.

Ask your oncologist about the opportunity to participate in clinical trials, even if it hasn't been mentioned to you, Henry says. It's one way to get access to new exciting drugs, which may be beneficial.

What if a patient sees the term metastatic on an online pathology report before seeing the oncologist? Does that mean they have stage 4?

Because we have electronic medical records now, and everyone has fairly early access to documents like pathology reports, it can cause a lot of anxiety and be very confusing to a patient, Henry says. Sometimes a pathology report may say metastatic to lymph node. But that may not mean it is stage 4. It may simply mean the cancer has spread to an adjacent lymph node. Henry emphasizes that patients should talk to their doctor to understand their diagnosis.

What hope do you give patients with metastatic breast cancer?

We have seen quite a number of medications approved in the last few years. And we know that there are more medications being reviewed by the FDA for consideration of approval in the next few years, Henry says. Its an exciting time in oncology to have all these new treatments being developed.

I always stress to patients that I want to do everything I can to help them live as long as they can, while still maintaining quality of life, allowing them to do the things they want to do. We do our best to make sure that we adjust treatment schedules to allow people to attend graduations or family reunions, or a trip they want to be able to take, explains Henry.

We want to help them look forward.

Continue reading here:
Metastatic Breast Cancer: What You Should Know - University of Michigan Health System News

Stem cell therapy, which All Blacks prop Owen Franks used to help fix a damaged shoulder, is raising hopes of a whole range of medical breakthroughs.

But there's a way to go before the medical establishment is convinced.

In late 2017, US Food and Drug Administration (FDA) Commissioner ScottGottliebhad this to say:"We're at the beginning of a paradigm change in medicine with the promise of being able to facilitate regeneration of parts of the human body, where cells and tissues can be engineered to grow healthy, functional organs to replace diseased ones; new genes can be introduced into the body to combat disease; and adult stem cells can generate replacements for cells that are lost to injury or disease."

REGEN CELLULAR

Dr Hassan Mubark takes blood from All Blacks prop Owen Franks.

Yet, as an indication of how far there is still to go, the FDA has also warnedpeople in the USagainst "unscrupulous providers" offering stem cell products that were unapproved and unproven.

READ MORE:*Rugby World Cup 2019: All Black Owen Franks thrown a stem cell lifeline*Owen Franks hits back at critics following omission from Rugby World Cup squad*Stem cell therapy for All Black Israel Dagg as he hits comeback trail with Crusaders*Experimental stem cell treatment shows results for Waikato woman with MSA Cerebella*Stem cell clinics accused of taking advantage of patients*Reported stem cell treatment could give hope to Michael Schumacher

"Researchers hope stem cells will one day be effective in the treatment of many medical conditions and diseases," it said, thenadded: "Stem cells have been called everything from cure-alls to miracle treatments. But don't believe the hype."

Looking at just the area of deteriorating joints, it's easy to see how stem cell therapies, if they deliver on the promise,could make life much better for many people with osteoarthritis who are in pain and have restricted movement.

Last week, Otago University researchers predictedthe number of knee replacement surgeries needed for osteoarthritis would increase from around 5000 a year in 2013 to abut9000 in 2038.

AP

Former Formula One champion Michael Schumacher received devastating head injuries in a ski accident six years ago. Last month it was reported he has undergone stem cell treatment in Paris.

Osteoarthritis is the area where ReGen Cellular,the clinic where Franks had the therapy, has done most of its work in the past two to three years, although ithas recently expanded its services to include a range of diagnosed auto-immune conditions, among them rheumatoid arthritis, multiple sclerosis, and type 1 diabetes.

ReGensaid 55 per cent of its patients were aged over 60, 35 per cent were 40-60 and 10 per cent were sports-based.

Theclinic usesPure Expanded Stem Cell (PESC) therapy, which involves taking 40 grams - about a teaspoon - of fat from around a patient's stomach. Mesenchymal stem cells (MSCs)in that sample are then multiplied in the clinic's Queenstown laboratory for about eight weeks. At the end of that process 100 million to 200 million cells have been produced.

Otago University

Otago University, Christchurch regenerative medicine research team have invented a bio-ink - a gel-like substance mixed with human stem cells - to be used with a bio-printer to make human body parts. Video shows the printer using bio-ink to make a body part.

For the treatment of osteoarthritis, between 50m and 100m stem cells are injected into larger joints, with 25m to 50m into smaller joints. ReGen said the therapy provided immediate pain reduction and increased mobility. MRI scans showed cartilage could and did regenerate.

ReGendescribedMSCs as the cells that "wake up damaged or lazy cells". Slightly more technically, Nature.com said MSCs wereadult stem cells present in multiple tissues, including the umbilical cord, bone marrow and fat.MSCscan self-renew by dividing and can differentiate into multiple tissues including bone, cartilage, muscle and fat cells, and connective tissue.

ReGen director of patient care Marcelle Noble said the clinic believed its treatments, if offered early enough, would save the public health system hundreds of millions of dollars through lessened replacement surgeries, and would save ACC millions of dollars in lengthy rehabilitation programmes.

The treatment for two knees was half the price of one knee replacement surgery within the public health system, she said. ReGen advertises osteoarthritis treatment for a single joint at $12,500 and for two joints at $15,000.

GETTY IMAGES

Former All Black Israel Dagg had stem cell therapy for an injured knee, but in the end had to give the game away because of the injury.

So far mainstream funding hadnot been offered for the therapy, Noble said. But the clinic had a "big breakthrough" earlier this year when two insurers in New Zealand accepted patients'PESC therapy claims. In July, ACC accepted consultation by ReGen's chief medical officer Dr Hassan Mubark.

ReGen only had data for the past five years on the success of its therapy, but the fact patients were returning to have other areas of their body treated was an indication of how people feltthe therapy was improving their quality of life, Noble said.

Globally, "massive" R&D spending was going into stem cell research. More therapies would become available and stem cell treatment would become "commonplace".

At any one time ReGen had 50-75 patients' cells growing in its incubators, Noble said. Of the patients treated, 40 per cent hadailments in therknees, 30 per cent in their hips, 20 per cent in their shoulders. The final 10 per cent were for sports and other issues, including problems with tendons, muscles, cartilage tears, fingers, elbows, ankles and hands.

SUPPLIED

Dr Ron Lopert undergoing part of the PESC treatment.

The first patient to undertake ReGen's PESC therapy was retired GP Dr Ron Lopert, who lives in Tauranga.

For five to 10 years, he had beengetting aches and pains in his hips after playing sport, and the problem was becoming more noticeable, he said. In 2013 he had an x-ray that showed he had moderate to severe osteoarthritis in both hips,more severein his right hip.

He stopped playing all sports and started researching different forms of treatment. Ideally, he wanted to be able to get some of his own cartilage back and reverse the osteoarthritis. It seemedPESCshould do that.

In 2015, aged 61, he had the therapy, with stem cells being injected into each hip joint.Within weeks henoticed an improvement in the range of motion and a decrease in pain, Lopert said.Some of that was just the anti-inflammatory component of stem cell injection, but he thought he also received a longer term benefit from cartilage regeneration.

SUPPLIED

Dr Lopert on his recent travels. He says he has much less hip pain.

He put the success of the procedure at75 per centin terms of symptoms and function, and100 per cent when it came to avoiding invasive surgery."I opted for a much more natural treatment where my own tissue is regenerating, instead of a metal prosthesis," Lopert said.

He was not sure all the improvement came from the stem cell treatment. As well as avoiding overuse of the joints, which meant he hadn't returned to playing sport, he had also switched to an anti-inflammatory diet.

His left hip continued to have hardly any symptomsbut he had started noticing the "odd twinge now and then" in his right hip.

"The vast majority of days it's fine provided I'm just walking and doing ordinary things. On the odd occasion I might carry something heavy, then I would notice it the next day and it (right hip) would stay painfulintermittentlyfor the next couple of days," Lopert said.

Sean Gallup

In this picture from February, German Chancellor Angela Merkel looks through a microscope at brain organoids grown from stem cells.

Some of his stem cells had been retained after the treatment, and he was booked in for a follow-up injection for his right hip at the end of October.

He expected the therapy would become a "go to" treatment, and would become an early intervention for osteoarthritis. But more independent research was needed to confirm the success of the treatment. "The evidence is slowly building up but there needs to be more before the Government will accept it," Lopert said.

In his case, he thought there had been cartilage regeneration in his hips, but that was based on his symptoms. "It would have been nice had I had MRI scans before and after the injection for objective evidence," he said.

From the perspective of the medical establishment, the New Zealand Orthopaedic Association said it supported a position statement on stem cell therapy produced by the Royal Australian College of Surgeons.

That paper, approved in mid-2018,noted stem cell therapy was a "rapidly advancing" area, but many proposed stem cell therapies were experimental and not yet proven. It did not support surgeons administering stem cell therapy outside of an ethically approved registered clinical trial.

"Whilst there may be scope for innovative treatment in the future, currently, the clinical effectiveness and safety of stem cell therapies remain scientifically unproven," RACS said.

In this country, an ACC spokesperson said ACC did not have an official position on stem cell therapy for the treatment of injuries. An internationally standardised evidence-based healthcare approach was used to help ACC decide how it covered injuries and funded treatments.

Dr HassanMubark, ReGen's chief medical officer, was a healthcare provider contracted to ACC in the specialty of rheumatology, and ACC had funded consultation fees with Mubark, the spokesperson said. Those consultations were for diagnostic and treatment planning purposes and did not need prior approval from ACC.

ACC had to consider legislative criteria when deciding whether to fund any particular treatment. There would be many reasons why ACC might decide to fund a client to see a rheumatologist for an opinion on the diagnosis and possible management of their condition. That would not commit ACC to funding any proposed treatment but would provide the client and ACC with information to help decision-making.

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Stem cell therapy helped Owen Franks but there's still plenty to prove - Stuff.co.nz