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Archive for the ‘Hormone Physician’ Category

Glycemic Monitoring and Management in Advanced Chronic Kidney Disease. – Physician’s Weekly

Glucose and insulin metabolism in patients with diabetes are profoundly altered by advanced chronic kidney disease. Risk of hypoglycemia is increased by failure of kidney gluconeogenesis, impaired insulin clearance by the kidney, defective insulin degradation due to uremia, increased erythrocyte glucose uptake during hemodialysis, impaired counter-regulatory hormone responses (cortisol, growth hormone), nutritional deprivation and variability of exposure to oral anti-hyperglycemic agents and exogenous insulin. Patients with end stage kidney disease frequently experience wide glycemic excursions, with common occurrences of both hypoglycemia and hyperglycemia. Assessment of glycemia by glycated hemoglobin (HbA1c) is hampered by a variety of CKD-associated conditions that can bias the measure either to the low or high range. Alternative glycemic biomarkers, such as glycated albumin or fructosamine, are even less reliable than HbA1c. Therefore, HbA1c remains the preferred glycemic biomarker despite its limitations. Based upon observational data for associations with mortality and risks of hypoglycemia with intensive glycemic control regimens in advanced CKD, a HbA1c range of 7-8% appears to be most favorable. Emerging data on the use of continuous glucose monitoring in this population brings promise for more precise monitoring and treatment adjustments to permit fine-tuning of glycemic management in patients with diabetes and advanced CKD. Endocrine Society 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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Glycemic Monitoring and Management in Advanced Chronic Kidney Disease. - Physician's Weekly

Your menstrual pattern could be a sign of infertility – Times of India

Are you aware your irregular menstrual pattern or cycle that tends to include missing periods can be a sign of infertility? This may suggest that a woman may not be ovulating on a regular basis as she should be. Irregular ovulation can happen due to many problems such as polycystic ovary syndrome (PCOS), obesity, being underweight, or having thyroid issues. Here, we explain to you why an irregular menstrual pattern can lead to infertility. Read on to know more about thisThe menstrual cycle can be described as the monthly series of changes that a womans body undergoes in order to prepare her for conceiving (the possibility of getting pregnant). The process of ovulation takes place when ones ovary releases an egg. Moreover, at the same time, ones hormonal changes also prepare the uterus in order to conceive and get pregnant. So, if the ovulation takes place and the egg is not fertilized, the lining of the uterus sheds via the vagina and this is termed as a menstrual period.Know what is a normal cycle?Did you know? Menstrual flow tends to occur every 21 to 35 days and may last up to 7 days. Also remember that during the first few years when the menstruation starts, ones cycle can be long. Yes, you heard it right. You will also be surprised to know that the menstrual cycles tend to become short and regular, as you age. But, if your menstrual cycle is irregular, the flow is heavy and you encounter any problems while menstruating then it can be worrisome.

This is how your periods can be causing infertility

Missing period for the wrong reason: Consult your doctor, if you are trying to get pregnant and you have missed your period owing to the wrong reason. Missing period for a long time can indicate an underlying condition that can be bothersome. (PCOS), obesity, and having thyroid issues can be culprits. This can also put you at risk of infertility.

Abnormal blood flow: Are your periods heavy or light? Then, this can become a growing matter of concern and a grave problem that needs to be solved before the conception. As, this can be an obstacle in conceiving.

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Your menstrual pattern could be a sign of infertility - Times of India

Men’s Cycles (They Have Them Too, You Know) – Ms. Magazine

Editors note: In honor of Menstrual Equity Day (May 28), Ms. is republishing this classic piece from its first issue in 1972. The original piece (below) was written by Dr. Estelle Ramey; the introductionwritten by Rameys granddaughter, Jessica Stender, Ms. contributor and feminist lawyeris a modern revisit of topics explored by Ramey in 72.

The cry that anatomy is destiny has held women back for centuries. Inherent in this claim is the idea that womens hormones render them unfit for positions of leadership.

In 1970, Dr. Edgar BermanVice President Humphreys physician and a member of the Democratic Partys Committee on National Prioritiesdismissed U.S. Representative Patsy Minks assertion that a woman could be president, by referencing womens raging storms of monthly hormonal imbalances.

The woman who subsequently held him to account was Dr. Estelle Rameymy grandmother.

In a letter published in the Washington Star, she observed that as an endocrinologist (specializing in the study of hormones), she was startled to learn that ovarian hormones are toxic to brain cells. This led to a highly publicized debate between the two, hosted by the National Womens Press Club, (women were barred at that time from membership in the National Press Club)a confrontation that ultimately nurtured a broader public awareness of the scientific invalidity of such arguments.

In Mens Cycles (They Have Them Too You Know)published in the first issue of Ms. Magazine in 1972 and republished hereDr. Ramey exposed the inherent sexism of statements like Dr. Bermans. She explained that hormonal variations affect all human beings, and that, although far less acknowledged, men also experience monthly hormonal cycles which cause changes in mood, energy and overall well-being.

She emphasized that the broader failure to accept this reality not only prevents an understanding of how these cycles affect mens physical and mental health, but also perpetuates the myth of womens inferiority owing to their inherent biological difference from men.

As Dr. Ramey pointed out, What is human and the same about the males and females classified as Homo Sapiens is much greater than the differences.

While progress has unquestionably been made in societys views of female capabilities, women continue to be denigrated and denied positions of power on the pretext of physiological inferiority. One need look no further than the current occupant of the White House, who crudely suggested that reporter Megyn Kelly had been on her period after she questioned him during a presidential debate, and who repeatedly makes demeaning comments about womens appearance, proper role, and emotional strengthreferring, for example, to Hillary Clinton as unstable, unbalanced and unhinged.

As noted by Dr. Ramey, a broader societal recognition of the inherent similarities between the sexes, will require a rejection of the mythology of male biological stabilityan imperative which has not yet become a reality, perhaps because logic has little to do with the impulse to enshrine and justify a power structure.

Male supremacy rests on the belief that women are defective men, since they are periodic and lack the rod of divinity.

Sooner or later at every cocktail party polemic on the subject of women, someone (usually male) plays the trump card.

You have to admit, says the accuser, all sweet reason and paternalism, that women are biologically different from men.

This is the cue for cries of Vive la diffrence, or other examples of sexual wit, and the argument for social justice being made by the defendant (usually female) tends to get drowned out in the innuendo and laughter.

As an endocrinologist, I found out long ago that men and women are different. But I also found that what is human and the same about the males and females classified as Homo sapiens is much greater than the differences. I think we are all beginning to understand that differentwhen applied to females, or to males of other raceshas been exaggerated and oddly interpreted in order to come out synonymous with inferior.

In fact, the accusations and laughter so common in living room debates are almost gestures of religious faith: forms of worshipping the great Freudian tenet, Anatomy Is Destiny.

As a rational justification of sex discrimination becomes harder and harder to find, much less sustain, the need for the religious masculine supremacy becomes greater and more intense. The newest wave of pseudo-biology and pseudo-anthropology to hit the publishing business, a wave typified by Lionel Tiger and his belief that human females should behave in the same way baboon females do, is a self-protective upsurge of this popular religion.

In practice, the religion rests on the belief that women are defective men. They are structurally lacking, since they lack the rod of divinity.

(Of course, Mother Goddesses have been worshipped for precisely the reverse reasonthat they have wombs, and men do notbut logic has little to do with the impulse to enshrine and justify a power structure.)

Furthermore, females lack the consistent and calm behavior of males, because women suffer from a form of periodic lunacy imposed by their lunar sex hormone rhythms. Men, according to this theory, are the natural leaders, being endowed with a biological stability that rivals that of the rocks.

To be fair, the recurrent drama of menstrual bleeding must have been unnerving to primitive peoples. In man, the shedding of blood is always associated with injury, disease or death. Only the female half of humanity was seen to have the magical ability to bleed profusely and still rise phoenix-like each month from the gore.

But now that human knowledge has exceeded the invention of elaborate myths to explain the events most obvious in nature, we should be willing to accept and to study the less obvious evidence of cycles, both monthly and daily, that affect all living thingsmen as well as women, plants as well as animals.

Because men do have monthly cycles. The evidence of them may be less dramatic, but the monthly changes are no less real.

In Denmark, for instance, a careful, sixteen-year study was conducted in which male urine was tested for the fluctuating amounts of male sex hormones it contained. The result: A pronounced 30-day rhythm was revealed through the ebb and flow of hormones.

Other studies have tested mood changes in men. More than 40 years ago, for instance, the late Dr. Rex Hersey believed that male factory workers were incorrectly thought to be stable and unchanging in their daily capabilities. For a year, he observed both management and workers, concentrating on a group of men who seemed particularly well-adjusted and at ease in their jobs.

Through a combination of four-times-a-day interviews with the workers, regular physical examinations, and a supplementary set of interviews with their families, he arrived at charts for each individual, showing that emotions varied predictably within the rhythm of 24 hours, and within the larger rhythm of a near-monthly cycle of four to six weeks.

Low periods were characterized by apathy, indifference or a tendency to magnify minor problems out of all proportion. High periods were often marked by a feeling of well-being, energy, a lower body weight and a decreased need for sleep.

Each man tended to deny that he was more or less irritable, more or less amiable, at different points in his cyclebut standardized psychological tests established clearly that he responded very differently to the same life stresses at different times of his cycle. This denial by men of a cyclicity traditionally accepted by women may be an important factor: a two-edged sword for both men and women.

Female acceptance of, and even obsession with, the monthly cycle may unnecessarily accentuate its effects. Women actively engaged in ego-satisfying work, for instance, report far less discomfort or emotional disarray during their biological ups and downs than women who are bored or relegated to stultifying jobs.

Even the statistical information derived by science is reported in a culturally-influenced way. Monthly discomforts are rightly regarded as normal in women, because 60 percent of all women report them.

But the obvious conversethat 40 percent of all women report no cycle symptomsis emphasized much less. And 40 percent is a lot of women.

It is forever being pointed out, too, that women have a higher incidence of car accidents and suicides during their periods. However, it is rarely added that the percentage of women who have accidents or commit suicide is still much lower than the percentage of men.

Men, on the other hand, also respond to cycles in a way that is a function of their culturally-acquired self-image. They deny it.

This reluctance to deal with their biological bondage has probably played down mens monthly symptoms compared to womens, since the human brain is extraordinarily powerful and suggestible. But it has also postponed the study of male cycles by a largely male scientific community, and therefore postponed the practical utilization of biological rhythms in the treatment of disease or in protection against disease both mental and physical. (Resistance to disease may be different at different points in the cycle, for instance, yet this possibility is rarely considered in treatment. Japanese researchers have discovered psychoses that occur in teenagers and adult men in near-monthly cycles.)

Study of mens cycles might even have the socially and commercially useful result of reducing the accident rate.

The directors of the Omi Railway Company of Japan, for instance, are pragmatic students of human behavior and have therefore decided to accept the fact that men have lunar cycles of mood and efficiency. This company operates a private transport system of more than 700 buses and taxis in dense traffic areas of Kyoto and Osaka.

Because their operations were plagued with high losses due to accidents, the Omi efficiency experts began in 1969 to make studies of each man and his lunar cycles and to adjust routes and schedules to coincide with the appropriate time of the month for each worker. They report a one-third drop in Omis accident rate in the past two years, despite the fact that during the same period traffic increased. The benefit to the companyand to the menhas been substantial.

Menopause in men has been studied somewhat more than the effects of their monthly cycles, but not enough.

For women, the menopause is an abrupt end to an obvious cyclicity, and it is made more traumatic by various cultural factors: Older women are often regarded as having less social value than older men, and womens main role as mother is likely to run out about the time of menopause, as children become independent and leave home.

For men, menopause appears to be less traumatic, being largely a social and psychological response to a generalized fear of aging and death. They are likely to be at the height of their careers at this crucial time, in great contrast to most women. (Among women, those with continuing ego-satisfying work suffer menopausal symptoms much less.)

But it is also true that there is a gradual decrease in the secretion of testosterone, the male hormone, from youth to old age. In some men, the downslope of sex hormone production is steeper than in others. Very little attention has been given to this part of the male life cycle, perhaps again because meneven men of sciencehave assumed their freedom from cycles. (One wonders sometimes if they prefer not to know.)

But a great deal more research into the male menopause needs to be done if men are to be relieved medically from some of its symptoms, and to suffer less from the personal implications of trying to deny biological facts.

So there are, for all living things, lunar cycles, as well as the longer life cycles of childhood, puberty, adulthood and senescence. But another kind of cyclethe daily or circadian onehas often been either ignored or taken for granted by both men and women.

The data just beginning to come out of hospitals and laboratories are rather startling. They show men and women to be in a constant 24-hour rhythmic flux of hormones, moods, strengths and weaknesses. We sleep and wake, our body temperature rises and falls with our hormones (sex hormones included), and this causes a rise and fall of efficiency and libido.

These circadian rhythms are remarkably fixed in time and are difficult to alter by changes in lifestyle. They are also age-linked: The young child has more erratic timing of biological events, and the older person shows signs of disorganization in daily timing. In healthy maturity, however, the adult human changes with clock-like regularity during each day, just as he or she does during each month, or each of lifes seasons.

The hormonal cycles that have been most studied are the periodic changes in the adrenal hormones (cortisone, for example), which are called the stress hormones. These vital substances are secreted in largest amounts about the time of waking in the morning, and in the smallest amounts after midnight. Their physiological effects, however, are not felt until several hours after the highs and lows are seen in blood levels of the hormones.

A similar pattern has been reported for the secretion of male and female sex hormones in the course of each day. Testosterone levels are found to be highest in early morning and lowest after midnight. The maximum functional effects seem to be reached several hours after the actual secretion of the hormones. They induce subtle changes in mood and behavior, but men are seldom aware of them. Many psychological tests have shown, however, that daily mood variability is a real and recurrent background to emotional response.

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In medicine, relatively little attention is being paid to the significance of these cyclic changes in hormones. Yet there is evidence to show that the timing of the administration of a drug is critical in determining its effects, whether toxic or curative.

When a certain dose of amphetamines was given to rats at the daily peak of their body temperature cycle, for instance, it killed 77.6 percent of them. The same dose, given to litter mates of these animals at the lowest point in their daily activity cycle, killed only 6 percent.

Yet we continue to prescribe and use buckshot capsules that release drugs at the same rate continuously into the blood stream with no regard to changes of sensitivity. Overdoses are probably errors in timing, as frequently as errors in dosage. If a person imposes a powerful stimulus on the brain when it is already at peak excitability for that 24-hour cycle, he or she can cause death with the same dose of the drug taken with impunity on another day, at another point in the excitability rhythm.

Cancer cells also seem to be affected by the circadian rhythms. They may be at their highest point of metabolic activity and cell division when normal cells in the same organ are at a low point. This has many implications for therapy, whether with anti-cancer chemicals or with X-rays. It may eventually be possible to time the treatment so that the cancer cells are at the peak of their sensitivity to the destructive agents while the normal cells are most resistant to them. Smaller doses of these toxic agents would thus be more curative, and the unpleasant side effects could be minimized.

Some clinicians and researchers are beginning to suggest that certain kinds of cancers may result from the consequences of altered internal clocks. Cancer cells have abnormal rhythms and are outside the temporal discipline found in healthy tissue. Some people are more sensitive than others to an alteration in their fundamental cyclicity.

Given these two facts, investigators propose that inheritance of susceptibility to cancer may be related to a propensity for mis-timing, and that a persons speed of readjustment to time shifts could be an indicator of vulnerability to illnesses of mis-timing. Such individuals, they point out, should probably avoid irregular work-rest schedules and jobs involving rotating shifts. Its still very much in the theoretical stage, but these concepts may turn out to be vital to the preventive medicine of the future.

Emotional problems may also be exaggerated in individuals who frequently alter their cyclicity. (But remember, individual tolerance of such changes varies. Ideally, those least suited to such jobs could be pre-selected out.) Workers who often change from night to day shifts have been found to be the most vulnerable to emotional and physical disorders.

Next come those workers who remain in the night shift: They are more likely than day workers to have ulcers or nervous disorders. And most healthy are those who work regularly and during the day.

Even the traveler who flies overnight to Tokyo or Peking has significantly deranged his or her circadian rhythms, and cerebral activity is likely to suffer. In addition, individuals vary greatly in their ability to restore normal cycles, sleep-wake patterns and performance.

Some of mens most cherished tests of stamina have to do with the ability to function well without sleep, but these tests of manhood may be doing us all in. Interns, for instance, are traditionally put through round-the-clock work schedules during much of their internship, as if this were part of the training of a real doctor, like the puberty tests of primitive tribes. In fact, a recent study in the New England Journal of Medicine indicated that chronic sleep deprivation impaired the interns performance sharply, no matter how much of a man the male or female intern might be.

Sleep-deprived interns, said the study, felt increased sadness and decreased vigor, egotism and social affection. In addition, numerous psychopathologic symptoms developed

Internal clocks arent reset easily. Even after ten hours sleep for each intern, the previous sleep-deprivation resulted in decrements on a vigilance task. The article concludes that only a small amount of sleep loss can be sustained before emotional and intellectual function deteriorates.

It seems hard for men to admit they are not the masters of nature. During World War II, Dr. Nathaniel Kleitman of the University of Chicago was asked by the Navy to study the sleep patterns of seamen working the traditional four-hour shifts of naval duty. Dr. Kleitman measured body temperature cycles and correlated these changes with efficiency of performance in the four-hour cycle. It turned out to be a terrible physiological way to run a Navy, with enormous cost in efficiency of response.

Dr. Kleitman wrote an eloquent scientific report on his findings. The Navy thanked him courteously and has continued the traditional four-hour work cycle to this day.

Given this and a myriad of other evidences of male resistance, it is perhaps optimistic to expect our male-run hierarchies to take lessons from women, or even from the Japanese, when it comes to the less admissible problem of monthly cycles. Such a departure from the mythology of male biological stability might produce in men the same kind of psychological wrench that Copernicus inflicted on them when his theories revealed that man is not, in fact, the center of the universe.

But menand womenshould take heart. What separates us from baboons and other animals, even if Lionel Tiger would rather not admit it, is our very different kind of cerebral cortex.

We are Homo sapiens: the thinking ones. We share with other living creatures a captivity to time, but human beings, we alone have the extraordinary plasticity of behavior that results from the unique powers of our cerebral cortex. In other words, our minds can control our behavior to a degree unknown in any other animal. Perhaps we would all be better off if we recognized both the cycles that control humans, male and female, and the intellectual powers that can mitigate their effects.

Thomas Jefferson had periodic migraine headaches all his life. Abraham Lincoln had periodic depressions. The potential women leaders of this country have cycles, as all living things have to varying degrees, but women do not have the encouragement to mitigate and work around their cycles. Womens chains have been forged by men, not by anatomy.

We should all be informed of the various forces that influence us. As Dylan Thomas wrote,

Time held me green and dying

Though I sang in my chains like the

sea.

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Men's Cycles (They Have Them Too, You Know) - Ms. Magazine

What To Expect From Your Period After Taking The Morning After Pill – BabyGaga

The morning-after pill is a type of emergency contraceptive that women use to prevent pregnancy.

The morning-after pill is a type of emergency contraceptive that women use to prevent pregnancy. Often, it used as a plan B after the user suspects that their usual birth control method may have failed. Also, women who have had unprotected intercourse can use the morning after pill just to reduce their chances of having gotten pregnant.

This type of contraceptive is not designed to be used as a primary method of birth control. Instead, it is intended as a backup.

The morning-after pills contain progestin, the same hormone found in oral contraceptives, known as levonorgestrel. However, the hormone levels found in the morning-after pill are usually higher. The higher doses of levonorgestrel often affect the normal pattern of the menstrual cycle.

RELATED:Pregnant Women Offered A Scam Treatment That Supposedly Reverses Morning After Pill

Morning-after pills are designed to stop conception after having unprotected intercourse. The hormones in the pills work by delaying ovulation. If the egg was already released before intercourse, the pill works by stopping fertilization from taking place.

In the process of doing this, the length of your normal period can be affected. It is not unusual for you to see a change in your normal menstrual cycle after taking the morning-after pill. Some women do not have any irregularities though.

After taking the morning after pill, your next period can be:

You should not get alarmed if you notice spotting between periods. These changes normally last for one cycle. You should soon resume to your normal cycle. If you notice that you have not had your period after a week, take a pregnancy test just to be sure.

As mentioned earlier, morning-after pills should never be used as primary birth controls. They should only be taken during emergencies. The more you take, the more you are likely to experience irregular menstrual cycles. In a year, if you find yourself using too many morning-after pills, it is advisable to talk to your physician to recommend other birth control methods that are more effective.

Is it true that morning-after pills can cause a miscarriage? The truth is that morning-after pills should never be used as an abortion pill. Also, they are not designed to cause miscarriages. However, if you experience a heavy blood flow containing large clots after taking this medication, you should visit your doctor as soon as possible.

If you are a parent, using morning-after pills is safe for you and your baby. Apart from affecting your normal menstrual cycle as discussed above, the levonorgestrel hormone is known to decrease milk production. This is only for a brief moment and it does not harm the breastfeeding baby.

Studies have shown that no brand of morning-after pills is 100 percent effective. No contraception is either. The only way you can be sure that a morning-after pill has worked is to wait until you get your next period. As mentioned earlier, one of the effects can be delayed periods. So, it is very important that you remain calm during this period. Keep yourself busy with other activities to take your mind off ofthe results.

It is advisable to learn about your menstrual cycle. There is more to it than just when and how long you get your periods. Having this information can help you spot signs when you are due and when you are late.

The number one question most women ask after they test positive after a pregnancy test is will the baby be ok? It is very important that you visit your doctor if the test result is positive. Your doctor will insist on doing more tests just to confirm the results. This is because there have been cases of false-positive results. Once your doctor has confirmed your results, the two of you can discuss your options. He or she will help you decide what is best for you.

Note that morning-after pills affect each woman differently. The way it affects you and your body could be different from the next woman. However, if you experience any long-term side effects or changes that seem to be ongoing, make a point to see your physician as soon as possible.

NEXT:Study Reveals The Birth Control Pills Can Impact A Woman's Oxytocin Levels

Sources:healthline.com,mymorningafter.co.uk,mayoclinic.org

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What To Expect From Your Period After Taking The Morning After Pill - BabyGaga

The real impact of not having been touched in months – Mashable SE Asia

What makes the coronavirus pandemic unlike any other collective tragedy is that we can't commiserate together.

Post-layoff drinks at a dive bar near the office; embracing someone you haven't seen in months; pats on the back these are seemingly small comforts that have morphed into luxuries in the past few months.

While there are many things I miss about the Before, these touches of comfort are high on the list. As we round the corner into another month of social distancing I find myself thinking about touch constantly. One look at dating apps or porn sites and I know I'm not alone in that.

The phrase "touch starved" might once have sounded dramatic, evoking Victorian-era courting where couples couldn't even bear witness to each other's ankles. In a time where I haven't high-fived let alone hugged someone in months, though, it doesn't sound overdramatic at all.

While there's limited research on "touch starvation" itself, according to Dr. Natasha Bhuyan, MD, a practicing family physician in Phoenix, Arizona, there's emerging touch research that emphasizes its positive impact. "Physical touch activates brain neurotransmitters that can lift our mood, reduce stress, and even improve sleep quality," she said.

Dr. Lori Whatley, clinical psychologist and author of Connected and Engaged, reaffirmed those benefits. "As humans we are wired for connection, and connection also means touch," she said. "Touch with other humans is at the foundation of connection and an essential part of our being and forming healthy relationships."

Unfortunately, many are currently going without any physical connection for months on end. A lack of touch intensifies feelings of isolation, said Dr. Mitchell Hicks, core faculty in Walden University's PhD in Clinical Psychology program. When we can't touch anyone it leaves the impression that we lack that connection we're wired for, that we're truly alone.

"For many, touch from a loved and trusted person increases their visceral sense of connection and soothes them," said Hicks. "No amount of videoconferencing can really make up for that."

It's not just that touch gives the impression of connection, either. Touch actually has an impact on the brain. Humans deprived of connection experience a decrease in oxytocin a hormone known to increase positive feelings and a simultaneous increase in the stress hormone cortisol, explained Dr. Alexis Parcells, MD. High levels of cortisol can lead to a slew of physical and mental health problems, such as increased blood pressure.

"People suffering with touch deprivation report high rates of depression, anxiety, and insomnia," said Parcells.

"People suffering with touch deprivation report high rates of depression, anxiety, and insomnia."

Despite the consequences of lack of touch, there is good news. You can do something to help and I don't mean stopping social distancing. (Do not stop social distancing.) The benefit of touch has to do with moving the skin, said Dr. Tiffany Field, founder and director of the Touch Research Institute said in an interview with To the Best of Our Knowledge. Moving the skin stimulates the brain. This means that exercise, such as yoga or dance, can produce some of the benefits we see from touch.

Furthermore, it's okay to go months without touch if you're taking care of your mental health in other ways, according to Bhuyan. While there's no "real" substitute for human touch, there are activities you can do to give the same benefits.

While exercise can give you some of the physical benefits, it doesn't do much when it comes to creating that connection with your loved ones. Bhuyan suggests exercising with a friend over video while it seems silly, it can actually be beneficial. "The mutual body movement can create a powerful connection," said Bhuyan. "Its also important to invest in your own self-care and mindfulness."

Parcells suggested any virtual meetup, not just working out. While it's not the same as meeting in person, it still has a positive impact. Parcells said, "Research has shown that a virtual connection is about 80% as effective in increasing the release of oxytocin as seeing that same person face-to-face."

Whatley reiterated, "When we connect personally with others via FaceTime we can release oxytocin and lower stress." This is exactly the opposite of what occurs when we lack touch.

Another suggestion of Parcells has already been heeded by people across the United States: adopting a pet. "Time and time again," said Pacells, "Studies have shown pets to be therapeutic during a stressful time." Not only do they provide comfort, but they're a tactile substitute for human interaction.

As monks have demonstrated over millennia, we won't die from not having been touched in a while. There's no direct substitute from human touch, but through exercise and speaking to our loved ones even virtually we can maintain some of these benefits. Maybe we don't have to be touch starved; maybe we just need a little nosh.

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The real impact of not having been touched in months - Mashable SE Asia

Coronavirus Advisory: The role of medical laboratory science in a COVID-19 world – Greater Baton Rouge Business Report

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Since the World Health Organization (WHO) declared the novel coronavirus a pandemic on March 11, 2020, the words COVID-19 testing have become a fundamental part of every U.S. citizens vocabulary. Each day, news sources report the number of new coronavirus cases, the number of new deaths and total deaths, as well as the number of coronavirus tests performed. These testing results have shaped the very foundation of U.S. society by providing data to the White House Coronavirus Task Force and state leaders. This data is used to make pivotal decisions about public health and the nations economy. Such decisions have resulted in life versus death outcomes for loved ones and have had a vital impact on our personal finances.

Because COVID-19 is a respiratory disease, it can only be diagnosed through the collection of a nasal swab. We have all seen images of healthcare workers collecting nasal swabs, but have you ever wondered what type of healthcare professional is actually performing the tests on those swabs? Within the laboratory are unseen medical laboratory scientists who carefully analyze a variety of biological specimen types using specialized skills and sophisticated instrumentation. Information from the analysis of clinical specimens can provide data critical for patient diagnosis, treatment, prognosis, or disease prevention. The medical laboratory scientist (MLS) works as an integral member of the healthcare team and touches the lives of every patient.

The term COVID-19 testing has been used in the media to encompass a variety of components, which may require some clarification. Testing may be used to refer to the drive-thru testing sites, which are strictly nasal swab collection sites, or it may refer to the actual laboratory tests. Lab tests include both the genetic test used to detect the viral particles and the antibody test used to detect antibodies formed to the virus. Medical laboratory scientists perform both of these tests.

At the forefront of the pandemic, genetic testing was not available in hospital labs. However, hospital labs worked quickly to acquire the necessary equipment and reagents. Performance of COVID-19 testing by an MLS within these labs is especially vital because it provides emergency room physicians with rapid testing results for patients with suspect respiratory symptoms. If test results are positive for COVID-19, patients are placed in COVID-19 designated rooms to receive specialized care. This process not only provides the most rapid and ideal treatment for the patient, but also protects family members, other hospitalized patients, and healthcare workers from the infection.

We have all heard the news reports about the challenges the lab faces when acquiring the necessary testing reagents. The unavailable or delayed testing in the case of coronavirus could be the loss of human lives. Without hospital-based lab testing results, direct patient care providers are handicapped. In addition, unnecessary waste of personal protective equipment (PPE) and other critical resources is likely to occur because symptomatic patients may require interim isolation if their COVID status is unknown.

Antibody testing is performed on blood collected after a patient recovers from coronavirus infection. Positive results indicate that the patient has had a past infection with COVID-19. Convalescent plasma is a blood product collected from recovered patients. It is being used to treat hospitalized patients suffering from current COVID-19 infections, although the exact clinical impacts of such treatments are still uncertain. Medical laboratory scientists and the laboratory team within the blood bank department collect, test, manage and issue such convalescent plasma. Thus, not only are medical laboratory scientists among the most essential healthcare workers in the diagnosis of COVID-19, but they also play critical roles in providing blood products used in the treatment of patients with COVID-19.

Because the results obtained from COVID-19 testing govern the nations current and future health until a vaccine can be developed, the field of medical laboratory science has become the cornerstone of healthcare during the COVID-19 crisis. Though medical laboratory scientists typically do not have face-to-face contact with patients, they are the unsung heroes performing these crucial tests that guide patient care decisions each day. Almost all patients, whether hospitalized, ill, or just in for an annual checkup, require laboratory testing. Some routine tests performed by an MLS include:

Blood cell counts Blood typing and donor testing Chemistry panels and hormone levels Therapeutic drug monitoring and drugs of abuse detection Hepatitis and HIV testing Bacterial cultures and viral testing Urine evaluations

It is difficult to imagine how modern medicine could function without the quick availability of reliable results from the MLS profession.

In this time of uncertainty, many people may be considering alternate career options. Medical laboratory science is one consideration but is a career unknown to most people. What type of person might choose a career in MLS?

The type of personal characteristics that lead to success in MLS include:

Sharp critical thinking and problem-solving Meticulous attention to detail Effective intrapersonal communication skills

Critical thinking and problem-solving are essential, especially in the evaluation of abnormal patient results, which may require additional verification, advanced follow-up testing, or manual assessments. Because the production of accurate, quality results is at the forefront of laboratory testing, following complex procedures with great attention to detail is a necessity for medical laboratory professionals. In addition, the MLS must be able to communicate about testing protocols and critical patient results with colleagues and members of the multidisciplinary healthcare team such as nurses and physicians accurately.

According to the U.S. Bureau of Labor Statistics, employment of medical laboratory scientists is expected to increase 11 percent over the next decade, much faster than the average for all occupations. A greater need to diagnose medical conditions through lab testing is projected due to the growing number of patients within the aging population. Although the most common employment site for medical laboratory scientists is the hospital lab, opportunities expand far beyond the hospital to include public health labs, physician offices, industrial/research labs, biotechnology labs, and crime labs. In the wake of the COVID pandemic, healthcare employment opportunities will continue to be abundant.

While the long-term repercussions of COVID-19 are mostly unknown, one thing remains certain: MLS professionals will always play a crucial behind-the-scenes role in American healthcare even after this crisis has passed.

Are you interested in making a difference in the lives of our future healthcare heroes? Please visitfranu.edu/giving to learn ways of how you can make an impact.

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Coronavirus Advisory: The role of medical laboratory science in a COVID-19 world - Greater Baton Rouge Business Report

Melatonin: Is it safe, does it work and other FAQs – CNET

Can melatonin make you as sleepy as this pup?

Sleep: We all want more. Most of us are in perpetual sleep debt, accruing lost hours every time we hit the hay. Waking up puffy-eyed and groggy is not ideal, yet many people accept it as their normal. The occasional late night at work or weekend of partying doesn't help our quest for more shut-eye.

If only there was a supplement that promised to improve your sleep cycle so you could bounce out of bed bright-eyed and bushy-tailed every morning.

Our Health & Wellness newsletter puts the best products, updates and advice in your inbox.

Melatonin, per various marketing claims, pill bottles and social media hype, could be that supplement. Is it really that easy, though? Can you just pop a sleep supplement before bed and quickly enter dreamland -- and stay there till sunrise?

If you're itching to grab a bottle of melatonin gummies next time you're at your local drugstore, first read up on the potential benefits and risks, plus how to supplement melatonin smartly and avoid dangerous drug interactions.

Read more: Collagen supplements promise smooth skin, but you should eat these foods instead

What is melatonin?

Melatonin is a hormone that animals, including humans, produce to regulate circadian rhythms. Melatonin may have some other functions, but its role in sleep-wake cycles is the most extensively studied and understood.

Read more: Caffeine: How bad is it really?

Now playing: Watch this: 9 sleep myths, busted by a sleep doctor

7:07

How does melatonin work?

Your body naturally produces melatonin in response to darkness and reduces production of melatonin in response to light. It's referred to as the "sleep hormone" because it essentially tells your body when to sleep and when to wake up.

Everyone has a circadian rhythm or "internal clock" that runs on a 24-hour cycle and is affected by your body's production of melatonin.

How it works: A certain area of your brain -- specifically thesuprachiasmatic nucleusin the hypothalamus -- controls this body clock, and it's primarily influenced by light and environment.

Your SCN processes that information and signals your body to produce melatonin accordingly. Various tissues in your body produce melatonin, but the main source is the pineal gland, a small gland inside your brain.

Melatonin production can be suppressed by constant exposure to light, which is primarily where all of the advice about shutting down screens an hour before bed comes from: Feeding your eyes bright light up until the point you shut your eyes can result in a wacky melatonin-production schedule, thus a messed up sleep schedule.

Melatonin supplementation is supposed to aid your body's natural production of melatonin -- if done correctly, this theoretically can help regulate your circadian rhythm and result in better sleep. While potentially beneficial if used properly, supplemental melatonin can be detrimental or, at best, useless, if not used with care.

Read more: Vitamin D is crucial for immune health -- make sure you're getting enough

Melatonin benefits

The obvious benefit is that melatonin can help you sleep more and sleep better, if used correctly (more on that later). However, melatonin can do much more than boost just one night of sleep -- it can also help you reset your circadian rhythm and result in a firmly established, healthy sleep cycle. You don't need a doctor to tell you that a healthy sleep cycle can help you be more alert, motivated and productive.

Basically, the benefits of melatonin mirror those of getting more sleep, and they can extend much further into your life than you may initially think. Sleep is the foundation of human function: Without it, we are at risk for an array of emotional and physical health problems, not to mention things like auto accidents and other dangerous mistakes.

Melatonin can also benefit people who have secondary sleep disorders, or a sleep disorder that's a symptom of a different condition or circumstance. This includes people whose jobs require shift work, poor sleep caused by jet lag and sleep-wake disorders in people who are blind.

Read more: Vitamin C: Why you need it and how to get enough of it

Melatonin risks and side effects

All supplements come with risks -- melatonin is no different.

Short-term side effects of melatonin are generally mild, but can still be frustrating or inconvenient. Side effects reported in clinical trials related to melatonin include:

Other than those listed, melatonin doesn't appear to induce any serious conditions, although some health organizations and practitioners worry that supplementing melatonin may mess with your body's natural production of the hormone. There's no evidence to currently support the idea that people build a tolerance to melatonin, though.

Certain people should use caution with melatonin to avoid any potential complications, including people who are pregnant or breastfeeding, people who are on dialysis treatment, people who have liver problems and people with autoimmune conditions.

Read more: Zinc and coronavirus: The supplement may help reduce severity of symptoms, but it's no cure

Is melatonin safe?

Melatonin is generally considered safe for short-term use, although some health agencies express concern about product quality and efficacy, as well as labels with misinformation. Here's the lowdown from some of the biggest health agencies:

As for the stance of the Food and Drug Administration on melatonin, there isn't really one. In the US, melatonin is classified as a dietary supplement, which means it is less strictly regulated than food ingredients or medications. The FDA has sent warning letters in the past to food and beverage companies who make questionable claims about melatonin in their products.

Melatonin is probably one of the most studied supplements currently available to consumers. Evidence in individual scientific studies sways both ways, but meta-analyses generally come to the same conclusion: Melatonin is generally safe and well-tolerated, even in the absence of sleep improvements.

Does melatonin actually work?

The scientific evidence on melatonin points in both directions: Many studies say it works, many say it doesn't. This could be because melatonin affects everyone differently (as do all supplements), so to find out if melatonin works for you, you'd have to try it yourself.

For argument's sake, here are some recent peer-reviewed studies on the efficacy of melatonin:

If you do decide to take melatonin, consider discussing potential benefits and risks with your doctor first, as well as proper dosing and timing guidelines, which are outlined below.

There are also many research studies on the efficacy of melatonin as it pertains to specific conditions, such as melatonin for sleep following a traumatic brain injury, melatonin for Parkinson's disease and melatonin for ADHD. If you have a health condition you think may benefit from melatonin, perusing studies can help you learn more, although you should definitely check with your doctor, too.

Is melatonin addictive?

There's no evidence that melatonin as a substance is addictive. No studies have reported that melatonin can cause people to build a dependence on or tolerance of the hormone, and it isn't known to cause symptoms of withdrawal.

What you may become "addicted" to, though, is the feeling of improved sleep. Once you know what it feels like to fall asleep quickly, stay asleep through the night and wake up energetic, it's tough to go back to the exact opposite. This may make it hard for you to fall asleep without the help of melatonin.

Even though melatonin isn't known to be addictive, if you have a history of addiction to any substance, it may be a good idea to discuss melatonin with your doctor before trying it.

Best time to take melatonin

Studies support taking melatonin between 30 minutes and two hours before bedtime. The range exists because everyone absorbs medications at different rates and your own body's melatonin production can affect how quickly supplemental melatonin works.

The most important thing is to avoid taking melatonin too late at night -- like way after your bedtime -- lest your sleep cycle get shifted and you have to drag yourself out of a cycle of late nights.

How much melatonin should you take?

There's no exact dosage of melatonin that everyone should take, as it can vary based on factors such as gender, age, health conditions, body size and more. According to the NIH, no effective dosing has been established, and dosing in studies has ranged from 0.1 up to 10 milligrams.

The National Sleep Foundation recommends a dose of 0.2 milligrams to 5 milligrams for adults, although it's not clear where that determination came from. If you plan to take melatonin, try starting with the smallest possible dose and working your way up to a dose that helps you fall asleep but doesn't cause any side effects.

Keep in mind that the FDA doesn't regulate melatonin, so what you see on the product label may not be what you get.

Can you take melatonin every night?

There's no evidence that warrants advising against taking melatonin every day, but keep in mind that the majority of clinical trials to date have only tested short-term use of melatonin (three months or less), and that more research is needed to determine if it's safe to take melatonin every day for a long time.

Should you take melatonin for insomnia?

If you have or think you have insomnia, you should chat with your doctor about melatonin as a potential treatment. Some major health agencies advise against using melatonin to treat insomnia and instead advocate for cognitive behavioral therapy or another drug-free intervention.

Your doctor may want you to try lifestyle modifications first, such as increasing your daily exercise, changing your eating habits or reducing alcohol consumption. Your provider will also want to rule out other conditions that can coexist with insomnia, such as anxiety or depression. Sometimes, when drug-free interventions don't suffice, prescription medication is needed to treat insomnia.

Can you take melatonin with...?

Before you take melatonin, check with your doctor if you have any existing health conditions. According to drugs.com, which is powered in part by theAmerican Society of Health-System Pharmacists, Harvard Health and Mayo Clinic, you should take caution -- and ask your doctor if you can take melatonin -- if you have any of the following health conditions:

You should also check with your doctor about melatonin drug interactions if you're currently on any other medications, including other sedatives.

Remember, when taking any dietary supplement, use it wisely.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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Melatonin: Is it safe, does it work and other FAQs - CNET

Menopause: How to prepare your body for it – Times of India

Menopause is a natural phase of a womans life and is marked by the complete cessation of periods for one whole year. The average age at which Indian women undergo menopause is approximately 46 years. The main physiological change is that the ovaries stop producing the female reproductive hormone- estrogen.The years prior to menopause are called pre-menopause and they involve many changes such as irregular periods, vasomotor symptoms such as hot flashes(feeling hot suddenly for a few seconds to minutes especially in the face), cold sweats(i.e., sweating for no reason), mood disturbances including irritability, emotional lability and bouts of anger and crying etc. Other changes include urogenital symptoms such as urinary leakage, urgency and vaginal dryness and irritation; skin changes such as thinning, dryness, itching etc and loss and thinning of scalp hair. These symptoms can be variable in presentation and severity. About 80% women experience symptoms like hot flashes, which is the most common symptom.The health risks revolve around the effects of lack of estrogen such as bone loss leading to osteoporosis and associated fragility fractures, heart disease such as atherosclerosis, myocardial infarction, dementia, psychological disorders, certain cancers like breast, colon cancer etc.Being well-informed is the first step towards self-care. It is important that women in their premenopausal years undergo certain baseline tests to determine if there are any underlying diseases. Common disorders that may be pre-existing or new-onset are anaemia, hypocalcemia, vitamin D deficiency, osteoporosis, diabetes mellitus, hypertension and hypothyroidism, hypercholesterolemia and depression and anxiety. Also a baseline cancer screening is important and involves tests like Pap smear for cervical cancer, clinical breast examination and mammography and an ultrasound scan of the abdomen and pelvis.Lifestyle modification forms the fundamental preventive strategy at this age. Consistent moderate exercises such as weight bearing exercises, strength and balance exercises, yoga asanas and surya namaskar, regular walking or jogging go a long way in maintaining physical and emotional health. Nutrition at this stage is also important and should aim to get enough calcium, iron and other micronutrients along with soya based protein which is rich in phytoestrogens (plant based estrogen). Calcium supplements and vitamin D supplementation may be required to prevent weakening of bones. About one fifth of menopausal women may have severe symptoms for which various medications may need to be initiated. Menopausal hormone therapy can be given in selected individuals after a thorough evaluation, and helps alleviate symptoms substantially. Although, fertility rates drop substantially in perimenopause, women must use effective contraception until menopause is complete i.e., a year has passed since the last period.Regular follow up with physician, gynaecologist, urologist, psychiatrist, orthopaedician, ophthalmologist etc is vital to maintain health over the long term. Annual or more frequent health checks would help in identifying diseases earlier.Being fit at forty, strong at sixty and independent at eighty should be the motto for us women.May 25th 2020By Dr. Aruna Muralidhar, senior consultant obstetrician and gynaecologist, Fortis La Femme, Richmond Town, Bengaluru

Disclaimer: The views and opinions expressed by the doctors are their independent professional judgment and we do not take any responsibility for the accuracy of their views. This should not be considered as a substitute for physician's advice. Please consult your treating physician for more details.

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Menopause: How to prepare your body for it - Times of India

For cancer treatment and more, genetic-based precision medicine holds a lot of promise – Connecticut Magazine

A month following surgery for thyroid cancer, a Hartford Hospital patients tumor grew to 10 inches. The case was presented to the hospitals tumor board, which involved 30 doctors from different specialties.

The gene mutation found to be controlling the patients tumor growth was already well-established as a driver of melanoma, the deadliest form of skin cancer, says Dr. Sope Olugbile, medical oncologist at Hartford HealthCare.Chemotherapy wouldnt work fast enough against the aggressive tumor. Tumor board members recommended a targeted therapy already treating patients with melanoma. Without that genetic information, we wouldnt have been able to come up with that therapy, he says. The treatment saved the patients life, so far. Our goal is to use more of the genetic information to drive the treatment of cancer patients.

This type of personalized care, known as precision medicine and its subset, genomic medicine, has been offered for years at world-renowned cancer-treatment hospitals such as Memorial Sloan Kettering Cancer Center in New York, Dana-Farber Cancer Institute in Boston and University of Texas MD Anderson Cancer Center in Houston. Its now the standard of care in Connecticuts Hartford HealthCare Cancer Institute, UConn Health Center in Farmington, Connecticut Childrens Medical Center in Hartford and Smilow Cancer Center at Yale New Haven Health.Cancer therapy has become precision therapy, says Dr. Roy Herbst, professor of medicinal oncology and pharmacology, and chief of medical oncology at Yale Cancer Center and Smilow Cancer Hospital.

Dr. Roy Herbst, of Yale Cancer Center and Smilow Cancer Hospital, says that precision care is often used in cancer treatment these days.

While its most commonly used with cancer patients, precision medicine is also making inroads into other areas of health care including the treatment of some cardiac patients. Its also being studied and used on a limited basis to treat those with rare diseases. In the U.S., newborns are screened with a blood test for hearing loss and heart defects. If detected and treated early, this can prevent death and disability in some cases. For some doctors and researchers, precision medicine holds the promise of effective targeted diseases and chronic conditions, and, even more revolutionary, the chance to prevent illness before it arises. The race is on to gather as much data as possible in order to increase understanding of the connection between genes and overall health; here in Connecticut, Yales Center for Genetic Health last fall launched its Generations project to collect DNA from 100,000 volunteers (see sidebar below).

Precision medicine involves the study of human genes, called the genome. The human genome contains 23 pairs of chromosomes within all human cells, and each chromosome contains hundreds to thousands of genes. Using high-level computing and mathematics, genomics researchers analyze massive amounts of DNA-sequence data to find variations or mutations that affect health, disease or response to drugs, according to an online description by The Jackson Laboratory for Genomic Medicine in Farmington.

Researchers can sequence an entire tumor to look for markers or abnormalities that can be treated with a targeted medication that attacks that mutation, unlike traditional chemotherapy that kills healthy cells along with cancer cells, says Herbst, also associate director for translational science at the Yale School of Medicine.

These days, when Yales precision medicine tumor board meets weekly, they dont focus on where the tumor began, he says. They look at what errors occurred in the DNA of the tumor, because once they know whats driving the tumor, they can treat it.For example, lung cancer is the most common cancer in the world. When a nonsmoker gets lung cancer, doctors sequence the tumors DNA to see if it contains one of eight genes known to mutate.

Each cancer cell has about 18,000 to 20,000 genes, and there are some cancers where just one of those genes is directing the growth of the cancer, Olugbile says. We call that the driver gene. The other 17,999 are just following the lead of that driver gene, he says. That means if we tag just that one gene with the medication then we can actually shut down the growth of the entire cancer.

Traditional chemotherapy can only be given for 4-6 months because of the side effects, while targeted oral medications have very few side effects and patients remain on them for an average of two years, Olugbile says.

In the past five years, genetic testing has become standard of care for some cancers specifically colon, lung and melanoma because those types of cancers tend to have genetic mutations that have been known to respond to therapy, says Sara Patterson, manager of clinical analytics and curation at Jackson Labs, which works with UConn and Yale researchers.But targeted therapy is not a cure-all, and researchers are still a long way from using precision medicine to treat all cancer patients. Even if cancers have the same genomic change and mutation, theres no guarantee they will all respond to the same therapy, she says.Overall, precision medicine is only effective at stopping the spread of cancer in an average of 20 percent of cancer patients treated, Olugbile says, with variations by cancer. Sometimes the cancer returns because the tumor changes to resist the therapy, Patterson adds.

As doctors and researchers do more genomic sequencing, the data pool will grow and so will knowledge of what medications work most effectively against various tumor types.The more information we gather, the better well know how to treat specific patients, Patterson says.

Reimbursement from insurance companies can be a challenge. If precision treatment for a particular type of cancer hasnt been approved by the insurance industry, its difficult to get reimbursed for genomic testing, says Sue Mockus, director of product innovation and strategic commercialization at Jackson Labs.Its a catch-22. Even though a patient with pancreatic cancer could benefit from a targeted therapy, unless that patient is part of a clinical trial that would pay for the genomic testing, the patient would have to pay out of pocket, the annual cost of which can run into the hundreds of thousands of dollars. If you do have a mutation identified and your physician wants to give you the medication off label, you have to fight with the insurance company, Mockus says.

Experts have suggested a value-based approach to precision medicine, reports the International Journal of Public Health. This means policy decisions about reimbursement and investment in research and development will factor in how long patients lives are prolonged and the quality of those lives, the Journal reports.

Oncologists also offer cancer patients immunotherapy, another form of personalized medicine, Patterson says. Theyre using diagnostic tests on tumors, independent of genomic sequencing, to determine if their tumor profiles make them a good immunotherapy candidate. Immunotherapy is approved for multiple tumor types, as long as they have certain markers, she says.

Former President Jimmy Carter became cancer free after receiving radiation and immunotherapy to treat the melanoma that had spread to his brain and liver. While immunotherapy can cure cancer for some, its only effective about 20 percent of the time, Olugbile says. It varies a bit by cancer, with some cancers having a higher success rate, he adds.

Through a collaboration with Memorial Sloan Kettering, Hartford HealthCares Advanced Disease Clinic was scheduled to open this spring to give patients even more options, he says. If targeted therapies and immunotherapies dont work or are not a match for patients, doctors will look for suitable clinical trials that offer potential treatments, Olugbile says.Our goal is to create awareness on two fronts, one is among the doctors. Yes, we are available to help if patients have gone through standard of care who didnt respond, he says. Its also an option for patients who want to be treated with precision medicine closer to home. The goal is to make it available so they dont have to go to New York or Boston, he says. Its right here in Hartford and hopefully at other cancer centers over time.

From Yale, Herbst leads a clinical trial through the National Cancer Institute where he and his team are trying to match the right patient to the right drug.Every tumor is getting sequenced. Thats accelerating the field. The sequencing techniques have gotten cheaper and faster, so we can analyze them at the point of care, Herbst says. This is why clinical trials are so important. Whats a clinical trial today is standard of care tomorrow.

In a study published in the journal Science Translational Medicine, a multi-institutional research team including a Connecticut doctor developed an advanced method to analyze existing data from thousands of clinical trials, comparing which genes FDA-approved drugs work against to the genes active in pediatric brain tumor patients. This sped up the lengthy process of developing cancer drugs.

Dr. Ching Lau, head of the oncology-hematology division at Connecticut Childrens Medical Center and the pediatric oncology-hematology department at UConn School of Medicine, is accessing the World Community Grid, an IBM-funded program that allows researchers worldwide to perform tens of thousands of virtual experiments. Instead of screening thousands and thousands of compounds to try to find a potential drug, we found we could use genomics data already available and do a more systems-approach analysis to figure out the predominant pathways driving the tumor cells, Lau, professor at The Jackson Laboratory, says in an email. Then we asked if there were any existing FDA-approved drugs that could potentially modulate those pathways.

The researchers identified eight drugs that could potentially fight medulloblastoma (MB) tumors, the most common malignant brain tumor in children. One of the drugs showed an increased survival rate in mice with MB tumors, and a clinical trial is being pursued.

Personalized medicineand heart disease

Precision medicines applications have expanded beyond cancer care. At first, much heart disease research relied on a genetic analysis of whether someone was predisposed to a disease. Thanks to a growing database of patient information that is shared worldwide, researchers can mine huge data sets with hundreds of thousands of cases for patterns and abnormalities that lead to discoveries, says Beth Taylor, associate professor of kinesiology at UConn and director of exercise physiology research in cardiology at Hartford Hospital. Researchers and clinicians know that about half the people who have heart attacks dont have the typical risk factors such as high blood pressure, obesity and diabetes. To determine why physically active people with healthy diets have heart attacks, researchers are using precision medicine to comb through large studies to find small predictors, Taylor says. Often the influence of any one factor is hard to detect unless you have a big sample size, she says.

The National Institutes of Health requires grant recipients to share their data to a national registry so that researchers have access to big data, she says. (Personal information such as date of birth, name and address are removed from files used for research studies.)

When we first began to really measure genetic variations, it was believed that was going to be the big hope in treatment, Taylor says. But genes are complex and environmental factors modify genetics for multiple generations.

For the first time ever, weve got wide-scale computing ability to analyze huge data points. This can better allow us to predict disease progression and optimize treatment, she says. Many of us would say that this concept of big data is as or more important than genetic risk. Genetic risks are not the whole picture.

For the first time ever, weve got wide-scale computing ability to analyze huge data points. This can better allow us to predict disease progression and optimize treatment.

Progress with diabetes

Precision medicine is not widely used in the treatment ofdiabetesin the U.S., except when it comes to a rare form of diabetes called neonatal diabetes mellitus. While type 1 and type 2 diabetes are controlled by two or more genesand additional genetic factors,neonatal diabetes mellitus involves a single gene and develops in babies under 6 months old.

Through genetic testing of babies with elevated blood sugar levels,researchers learnedthat about half the patients have gene mutations that respond well to a pill used to treat type 2 diabetes and they dont need to be on insulin for the rest of their lives like type 1 diabetics, says Karel Erion,director of research stewardship and communications for the American Diabetes Association.

When infants show signs of type 1 diabetes at Yale New Haven Childrens Hospital or Connecticut Childrens Medical Center, they are automatically tested for neonatal diabetes, hospital doctors say.

An example of precision medicine as a predictor of disease is the TrialNet database, which uses genetic testing to determine whether the relatives of those with type 1 diabetes have two or more of the five diabetes-related autoantibodies (proteins produced by the immune system directed against the persons own proteins) linked to increased risk of developing type 1 diabetes. Type 1 diabetics must take insulin for the rest of their lives to survive, and theres no known way to prevent the autoimmune disease. Type 1 diabetes, formerly called juvenile diabetes, typically strikes children and adolescents, causing the pancreas to stop producing insulin, a hormone needed to process sugar, or glucose, from food. Type 2 diabetes was formerly known as adult-onset diabetes, but the disorder is being seen in more children, thought to be the result of a rise in childhood obesity. Screening identifies the early stages of the disease years before any symptoms appear, according to the TrialNet website.

In a study published in the New England Journal of Medicine, researchers from the TrialNet Study Group, led by Yale Universitys Dr. Kevan Herold, found that an experimental medication delayed the onset of type 1 diabetes in high-risk participants by two years compared to the control group. The disease was diagnosed in 43 percent of the participants who received the medication, teplizumab, and 72 percent of those who received the placebo.

Alzheimers disease and dementia

Only 1 to 3 percent of the 5 million people living with Alzheimers disease have a genetic mutation that leads to whats called genetic or familial Alzheimers. But one in three older adults will eventually develop some form of dementia, says Rebecca Edelmayer, the Alzheimers Association director of scientific engagement.

Like other diseases that strike large segments of the population, researchers rely on big data to learn about Alzheimers and which genes play a role in who gets it.Researchers have learned that there are several risk factors that contribute to dementia, she says. Specifically, the presence of heart disease, high blood pressure, diabetes, social and cognitive isolation, poor nutrition and the level of education, can contribute to cognitive decline, she says.

Scientists from around the world share research data and draw from data in the Global Alzheimers Association Interactive Network, she says.The field has made some dramatic advances in understanding of how genetics play a role and how other underlying diseases play a role, Edelmayer says. We need to give doctors evidence-based recommendations.

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For cancer treatment and more, genetic-based precision medicine holds a lot of promise - Connecticut Magazine

The real impact of not having been touched in months – Mashable

What makes the coronavirus pandemic unlike any other collective tragedy is that we can't commiserate together.

Post-layoff drinks at a dive bar near the office; embracing someone you haven't seen in months; pats on the back these are seemingly small comforts that have morphed into luxuries in the past few months.

While there are many things I miss about the Before, these touches of comfort are high on the list. As we round the corner into another month of social distancing I find myself thinking about touch constantly. One look at dating apps or porn sites and I know I'm not alone in that.

The phrase "touch starved" might once have sounded dramatic, evoking Victorian-era courting where couples couldn't even bear witness to each other's ankles. In a time where I haven't high-fived let alone hugged someone in months, though, it doesn't sound overdramatic at all.

While there's limited research on "touch starvation" itself, according to Dr. Natasha Bhuyan, MD, a practicing family physician in Phoenix, Arizona, there's emerging touch research that emphasizes its positive impact. "Physical touch activates brain neurotransmitters that can lift our mood, reduce stress, and even improve sleep quality," she said.

Dr. Lori Whatley, clinical psychologist and author of Connected and Engaged, reaffirmed those benefits. "As humans we are wired for connection, and connection also means touch," she said. "Touch with other humans is at the foundation of connection and an essential part of our being and forming healthy relationships."

Unfortunately, many are currently going without any physical connection for months on end. A lack of touch intensifies feelings of isolation, said Dr. Mitchell Hicks, core faculty in Walden University's PhD in Clinical Psychology program. When we can't touch anyone it leaves the impression that we lack that connection we're wired for, that we're truly alone.

"For many, touch from a loved and trusted person increases their visceral sense of connection and soothes them," said Hicks. "No amount of videoconferencing can really make up for that."

It's not just that touch gives the impression of connection, either. Touch actually has an impact on the brain. Humans deprived of connection experience a decrease in oxytocin a hormone known to increase positive feelings and a simultaneous increase in the stress hormone cortisol, explained Dr. Alexis Parcells, MD. High levels of cortisol can lead to a slew of physical and mental health problems, such as increased blood pressure.

"People suffering with touch deprivation report high rates of depression, anxiety, and insomnia," said Parcells.

"People suffering with touch deprivation report high rates of depression, anxiety, and insomnia."

Despite the consequences of lack of touch, there is good news. You can do something to help and I don't mean stopping social distancing. (Do not stop social distancing.) The benefit of touch has to do with moving the skin, said Dr. Tiffany Field, founder and director of the Touch Research Institute said in an interview with To the Best of Our Knowledge. Moving the skin stimulates the brain. This means that exercise, such as yoga or dance, can produce some of the benefits we see from touch.

Furthermore, it's okay to go months without touch if you're taking care of your mental health in other ways, according to Bhuyan. While there's no "real" substitute for human touch, there are activities you can do to give the same benefits.

While exercise can give you some of the physical benefits, it doesn't do much when it comes to creating that connection with your loved ones. Bhuyan suggests exercising with a friend over video while it seems silly, it can actually be beneficial. "The mutual body movement can create a powerful connection," said Bhuyan. "Its also important to invest in your own self-care and mindfulness."

Parcells suggested any virtual meetup, not just working out. While it's not the same as meeting in person, it still has a positive impact. Parcells said, "Research has shown that a virtual connection is about 80% as effective in increasing the release of oxytocin as seeing that same person face-to-face."

Whatley reiterated, "When we connect personally with others via FaceTime we can release oxytocin and lower stress." This is exactly the opposite of what occurs when we lack touch.

Another suggestion of Parcells has already been heeded by people across the United States: adopting a pet. "Time and time again," said Pacells, "Studies have shown pets to be therapeutic during a stressful time." Not only do they provide comfort, but they're a tactile substitute for human interaction.

As monks have demonstrated over millennia, we won't die from not having been touched in a while. There's no direct substitute from human touch, but through exercise and speaking to our loved ones even virtually we can maintain some of these benefits. Maybe we don't have to be touch starved; maybe we just need a little nosh.

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The real impact of not having been touched in months - Mashable

Does PCOS affect your ability to conceive? – The Indian Express

Updated: May 26, 2020 7:57:00 pm

By Dr Shweta Goswami

In the past few decades, Polycystic ovary syndrome (PCOS) has emerged as one of the leading and most talked about health issues among women who are in their reproductive phase i.e. in the age group of 16 to 40 years. Speaking of the statistics, the problem affects 1 out of 10 women globally. If we talk about India alone, PCOS has a prevalence of nearly 20 per cent with one in five women being affected by it.

It is advisable that with the current lockdown, it is important to manage your PCOD or PCOS symptoms. PCOS is a problem triggered by elevated levels of the androgen hormones in a female body. Since androgen is mainly a male hormone that plays a vital role in the development of traits like facial and body hair growth, PCOS is likely to induce the same traits in women. Some of the common symptoms that indicate PCOS include:

*Irregular menstrual cycles with a gap of more than 35 to 40 days between two consecutive periods.*Acne-breakout on the face, chest and back.*Excessive hair loss and dandruff.*Dark patches in areas around the neck, groin and under the breasts.*Persistent mood swings and anxiety.*Unhealthy weight gain.

Read| How to get pregnant: A gynaecologists guide to boosting your fertility

To understand how PCOS affects your ability to conceive, it is very important to first understand these two terms fertility and ovulation. Fertility refers to the capability to reproduce i.e. to conceive a child naturally, whereas ovulation is a part of the mensuration cycle marked by the monthly release of an ovum (female gamete) from the ovaries. Regular and healthy ovulation is extremely important for female fertility.

Since PCOS interferes with the normal mensuration cycle, it is likely to disrupt the process of ovulation and negatively impact fertility. This happens because the ovaries are not able to release the ovum and even if they do, elevated levels of hormones like testosterone and estrogen affect the egg quality; thereby increasing the chances of infertility, miscarriage and stillbirth. PCOS can also prevent the uterine lining from developing properly, thereby hindering the implantation of the matured egg.

Read| How to calculate your pregnancy in weeks and months

This is a question that concerns almost every woman who has been detected with PCOS as it is one of the leading causes of female infertility. The problem can be easily tackled by adapting to healthy lifestyle modifications and simple medication.

So, the answer to this question is yes, it is possible to conceive a child even after being detected with PCOS, provided you opt for the treatment and stick to a healthy lifestyle.

Read| The challenges for fertility treatment in India

Here are a few tips that can help you to manage PCOS effectively during this current lockdown:

Keep your weight under check- The bond between obesity and PCOS is inseparable. Approximately 40 to 80 per cent of women suffering from PCOS are either obese or overweight. The reason behind this is that women with PCOS have an increased resistance to insulin owing to which they gain weight very easily and find it quite difficult to get rid of the same. Studies have shown that even 10 per cent weight loss can significantly improve ovulation and fertility. Here is what you need to do:

Whatever goes inside our body has a direct impact on our health. It is very important to have a balanced and healthy diet, making sure that you are not missing out on any important nutrients. You can easily get a personalized diet plan from a dietician which consists of all the haves and have nots. Diet management is very important. Since junk food is not easily available due to the lockdown use this as an opportunity to lose weight by shunning high-calorie foods and going for oats, dalia, and poha.

Take your medication on time- For women who find it rather difficult to lose weight naturally, certain medication may be prescribed for assisting in weight loss by decreasing insulin resistance. However, the medication alone will not be effective if you do not resort to healthy lifestyle changes.

Indulge in physical activities- A sedentary lifestyle promotes obesity. At least 150 minutes of exercise per week is required to keep your weight under check. You can join a gym or perform simple mat exercises at home depending upon your convenience.

Stress management A happy life is key to a healthy life. Excessive stress and strain can have a very negative impact on your reproductive health by releasing stress hormones as well as triggering problems like stress-eating which eventually lead to obesity.Maintain a balance between your work and personal life.

Here are some other tips to keep in mind:

*Indulge in activities that you love to do*Focus on self-love*Get enough sleep*Exercise regularly*Go out with family and friends

The mainstay of treatment in PCOS, after lifestyle modification is ovulation induction and follicular monitoring, to correct the problem of egg development. Your physician will be able to guide you on the treatment module depending upon the level of PCOD in your body. This is helpful for patients to understand their ovulation cycles before opting for other treatment options like IVF. It is important to note that in certain rare cases women might still find it difficult to conceive after the treatment. Such women can opt for assisted reproduction methods like IVF (In Vitro Fertilisation). The procedure is carried out by inducing artificial fertilization of male and female gametes using a combination of medicines, therapies and surgical procedures.

(The author is associate Director, fertility, Cloudnine Group of Hospitals, Noida.)

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Does PCOS affect your ability to conceive? - The Indian Express

Stress caused by Covid-19 makes us doubly vulnerable: What the average person can do about it – Economic Times

By Deepak Chopra, Rudolph E Tanzi, Michelle Williams, Ryan Castle, William C Bushell, Kimberly Brouwer and Paul J Mills

The Covid-19 pandemic has brought with it a second pandemic, not of disease but of stress. We all feel stress as added pressure. This pressure registers psychologically as worry and anxiety, while the body responds with stress hormones. The overall stress response is designed to be a short-term reaction. When stress persists, however, it enters into the mix of threats posed by Covid-19.

So what can the average person do to reduce the threat?

We advocate meditation, yoga, and deep regular breathing (Pranayama), which are practices available to anyone. They can be easily done at home, with the intention of returning to a relaxed, balanced state. Paying attention to stress is always advisable, but doubly so during this crisis. There is a specific connection that wed like to explain.

First, a little background. Although Covid-19 is very easily transmitted from person to person, the risk of being hospitalised or dying primarily affects people who are already at risk because of old age, infirmity, or chronic diseases such as cancer, diabetes, autoimmune illness, obesity, and heart disease. All of these chronic illnesses are associated with measurable low grade inflammation in the body.

The chronic low-grade inflammation that develops with advanced age has become known as inflammaging. Most people with chronic illness unknowingly have low grade inflammation. Recent research points to a second finding: These same disorders are often accompanied by persistent low grade anxiety and depression.

In a crisis like the current pandemic, anxiety and depression also begin to affect healthy people due to stress. It has become increasingly evident that low level inflammation and chronic stress lie at the heart of many disorders that take years or even decades to develop before symptoms appear that can be treated by a physician.

Against this background, which pertains to countless people in modern society, there is increased danger when acute illness strikes. In addition to the elderly and chronically ill, Covid-19 is causing acute respiratory illness and stroke sometimes leading to death in seemingly otherwise healthy younger people. The transition from SARS-CoV-2 infection to being diagnosed with Covid-19 is typically accompanied by a so-called cytokine storm. Cytokines are proteins that are major drivers of inflammation, and their rapid increase, or storm is one of the bodys immune responses to acute threat.

In addition, studies have connected pro-inflammatory cytokines to the stress response; they regulate well-known stress hormones such as ACTH and cortisol. Three major systems are involved: the immune system, central nervous system and endocrine hormone system.

In the face of these connections, we are coming forward to suggest that complementary practices deep breathing, yoga and meditation can play an important role during this pandemic. These practices have been confirmed by hundreds of scientific studies to bring down over-activity of the autonomic nervous system, calm the mind from anxiety, reduce the stress response, regularise heartbeat, and lower blood pressure. Together, all of these diverse benefits are associated with reducing the invisible presence of chronic low-grade inflammation, especially if added to good sleep, exercise and proper diet.

We dont fully understand how the immune response, linked to stress and inflammation, can turn lethal. As a response to cuts, wounds, invading pathogens, and other threats, prior to antibody formation, the body first responds with inflammation as a normal yet crucial healing function. But it has long been known that inflammation is paradoxical. Acute inflammation can overreact, harming or even killing the patient. (Instances of strokes and heart attacks among young Covid-19 patients might be linked to micro-cytokine storms in the brain and heart.)

The threat from low-grade chronic inflammation was not discovered until recently but seems to be widespread. It is unaccompanied by swelling, burning and redness of the skin that marks acute inflammation and therefore goes undetected by the patient or physician.

Preventing and addressing chronic low-grade inflammation and its significant adverse consequences are urgent issues, even more urgent during a pandemic. There seems to be every reason to make the public aware how deep breathing, meditation, yoga and other healthy lifestyle practices can help during this crisis and long afterwards.

DISCLAIMER : Views expressed above are the author's own.

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Stress caused by Covid-19 makes us doubly vulnerable: What the average person can do about it - Economic Times

Celebs who don’t want you to know they’re going bald – Nicki Swift

Even though male balding is almost as inevitable as gravity, celebrities simply do not like to speak on the IP behind their dramatic hair restoration innovations. What is verifiable, however, is when Elon Musk sold PayPal in 2002 the cash transaction website that made him a billionaire he was indeed abalding man. More present day, however, he is quite the opposite. That requires some kind of scientific explanation, and with a $38.2 billion fortune,the SpaceX and Tesla founder could surely afford a consultation.

"I mean, he had a class three to a class four (out of seven) hair loss pattern and he now shows no evidence, at least in the front, of any hair loss," New York hair transplant specialist, Dr. Jefferey Epstein, told Page Six in 2018, further describing the odds that Musk went under the knife as "highly, highly likely." Epstein added that Musk may have had at least two procedures, running him between $20,000 and $30,000 a sum the engineering mogul likely located between the seats in one of his electric cars.

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Celebs who don't want you to know they're going bald - Nicki Swift

4 common causes of night sweats and when to be concerned – Insider – INSIDER

Ever wake up in the middle of the night dripping in sweat, like you just ran a marathon? Then you're one of many people who have experienced night sweats, or sleep hyperhidrosis.

Night sweats aren't related to your environment, like if your room is too hot. Rather, they're usually caused by hormonal fluctuations in the body or are a side effect of medication.

Either way, they can have a big impact on your sleep. Night sweats often wake you up, and you may have to change your clothes or sheets in order to comfortably fall back asleep.

Here's what you need to know about the common causes of night sweats and when to see a doctor.

Night sweats are often linked to the hormonal fluctuations during menopause and perimenopause.

More than 80% of women in perimenopause and menopause experience hot flashes or sudden, intense feelings of warmth. When these happen at night, they can cause night sweats.

Menopause occurs 12 months after a woman has her last menstrual period, usually between the ages of 45 and 55. Perimenopause occurs in the 7 to 14 years before menopause.

Specifically, the drop in the hormone estrogen, which occurs during perimenopause, is linked to night sweats because it affects the body's temperature regulation.

"Women experience more night sweats related to hormonal changes during perimenopause and menopause," says Soma Mandal, MD, board-certified internist at Summit Medical Group, in Berkeley Heights, New Jersey.

Night sweats during menopause aren't cause for concern, but they can be uncomfortable.

If you're experiencing night sweats during menopause, talk to your doctors about treating the symptoms with medications that help replace estrogen.

Hormonal disorders can make it difficult for your body to regulate its normal temperature, which can cause night sweats.

Body temperature is regulated by the hypothalamus, an area in the brain that produces hormones. When your hormones are out of balance, it sometimes means that the hypothalamus isn't able to regulate temperature correctly.

Hormonal disorders that can affect body temperature and cause night sweats include:

If you experience other symptoms of a hormonal imbalance, such as weight changes or headaches, talk with your doctor about these symptoms.

If you're sick with a viral or bacterial infection, your body raises its internal temperature to fight off the infection, which is what causes fever.

This increase in body temperature can lead to sweating and night sweats are a common symptom associated with fevers.

"Various infections such as HIV, tuberculosis, and infectious mononucleosis can cause night sweats," Mandal says. "These conditions can produce chemicals called cytokines which combat infection. Cytokines can induce fever and night sweats."

If you experience a fever in addition to night sweats, you may want to check in with your doctor about what type of infection you have.

Certain medications can cause night sweats, including antidepressants for depression or anxiety.

A 2018 study found that up to 14% of people on Selective Serotonin Reuptake Inhibitors (SSRIs) the most common form of antidepressants experience excessive sweating and night sweats.

The study authors concluded that these medications likely affect the areas of the brain that produce hormones, which help control temperature and sweating.

Other medications that may cause night sweats include:

If your medications are causing night sweats, you can try sleeping in lighter clothes or keeping the room cooler. If night sweats continue to interrupt your sleep, you should talk to your doctor about your concerns.

According to Mandal, night sweats by themselves aren't always a cause for concern.

That's especially true if they're happening for a common reason like if you're going through menopause or taking SSRIs. However, if you're experiencing other symptoms as well, your night sweats could indicate a bigger problem.

"If they are accompanied by fever, weight loss, general malaise, or change in appetite, then it's time to get checked out by your primary care physician," Mandal says.

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4 common causes of night sweats and when to be concerned - Insider - INSIDER

My Breast Reconstruction Surgery Was Delayed Because Of COVID-19 – Women’s Health

The surgery was scheduled for March 20. I had already had pretty in-depth discussions with nurses from the surgery and anesthesia departments about all of the preoperative details. But on March 18, I got a call from the physicians assistant who works with my surgeon, and I knew what she was going to say as soon as I heard her voice: Surgery on my reconstructed breast had been canceled due to COVID-19.

Since then, Ive had a unilateral mastectomy, five months of chemotherapy, 28 radiation treatments, and four years of hormone blockers. Ive had no evidence of disease since my mastectomy on June 19, 2015.

Ive also had three different types of breast reconstruction. First, in March 2016, I had reconstruction with a breast implant and a breast reduction on my left breast to match its size. But the implant never really settled well. It was very highit didn't look very natural next to my other breast. And it was very tightthe muscles in my chest felt like they were seizing up or cramping a lot, and it was even uncomfortable to lay on my stomach to go to sleep.

So then, in May 2019, I had something called DIEP flap reconstruction, which is when they basically take your belly, disconnect it from its blood supply, and reconnect it to the chest as new breast tissue. (During that surgery, we learned that the implant had actually ruptured a little bit.)

Almost all DIEP flap surgeries are successful, but mine wasnt. About two weeks after the surgery, I met with my surgeon, and as soon as he saw the tissue, his face fell. The tissue was dead. So a week or two after that, I had to basically have another mastectomy to get the new tissue removed.

Finally, I had whats known as TUG flap reconstruction in November 2019. It involved a third surgeon and using the inner portion of my left thigh. It worked! The only issue is that the breast is really small because its from my inner thigh, so it's basically like an A cup, compared to my native breast, which is now like a D. (Before, I had double Ds. I had a great rack, I'm not gonna lie.)

So I'm pretty lopsided now. Im expecting to still have one or two more fat transfers, probably from my stomach, to my reconstructed breast, and then probably another reduction on my native breast so that they can match in size.

Since my TUG flap, my surgeon took a job out of the country, but we had this little window where he was going to be back to do some surgeries and I was going to be on spring break from both my teaching job and being a PhD student.

At the time, the pandemic was starting to ramp up in Iowa, where I live. The university I teach for had just closed for the rest of the semester. In fact, I was really debating internally with myself: Is it moral for me to get the surgery at this point and take up protective personal equipment (PPE) and resources? Is it safe for the staff there? Is it safe for me? So I was a little relieved when they made the call for me.

After that, I didnt hear from the hospital until mid-May (of course, theyve had bigger issues to deal with), when the physicians assistant called to tell me that my next surgery will take place on June 5.

She assured me that the hospital has enough PPE and is well prepared. My husband will have to drop me off and pick me up without entering the hospital, and the thought of waiting for surgery alone is daunting, to say the least. Ill also have to drive two hours one-way to Iowa City for a COVID-19 throat swab test the day before my surgery because the test has to be done within the University of Iowa Hospitals and Clinics system. Its inconvenient, but I'm happy to do it and keep my medical team safe.

But Im feeling a little disappointed in a selfish way that I have had to wait longer to have my breast reconstructed. Im just really ready to have my body put back together. One of the worst parts of this surgery being delayed is that we're not just holding on one surgery; theres going to be a series of surgeries and recoveries that follow. So its frustrating to not know what the timeline is going to look like and to not have an idea of what my body is going to look or feel like months or even a year from now.

I have to be on hormone blockers for five years before I can pause them to try to have kids because I had estrogen receptor (ER)-positive and progesterone receptor (PR)-positive breast cancer, which means the cancer cells grow in response to estrogen and progesterone. So when I finish those up in 2021 and my husband and I are 35, I want to get the ball rolling with IVF as soon as I can.

The goal was to have the reconstructions complete by this summer. Then I could have until the end of next year to just exist in my body without having it be something that needs to be fixed or manipulated or changed, have a short amount of time to travel, to swim, to work out normallybecause rumor has it pregnancy is kind of hard.

While the fat transfers are a quicker recovery, the reduction on my native breast is a longer ordeal, and I'm trying not to miss any more of my job or sacrifice working on my PhD. I dont think it will be possible to squeeze in multiple fat transfers and a reduction on my native breast in the next few months, which means the next big chunks of time I have arent until this coming winter break and next summer, or maybe spring break next year. As a result, Ill probably have to either push back IVF or go straight from the surgery into trying to be pregnant.

Plus, experts are predicting a second wave of outbreaks, so really any concept of a timeframe I had is out the window. I think I'm just going to have to undergo my future procedures based on the surgeon's availability, breaks in the school year, and the waves of this pandemic.

Before cancer, you've got all the options in the world open to you, and then cancer goes, Nope, youve got a limited set of choices. And to have that reduced even furtheron one hand, I'm used to it; on the other hand, its getting really old. Im just tired of having cancer and these surgeries dictate the pattern of my life.

But then you get through that terror of treatment, and you start to see the light at the end of the tunnel. You go, Oh, wait, my appearance does matter to me. Im still a young woman, and I still want to be able to wear a sports bra that supports me. I want to be able to buy a wedding dress that I look nice in.

As you start to get back to your normal life, you start to remember those priorities. Reconstruction seems like its just a cosmetic thing, like it's not a big deal. But it changes your mental health, it changes your outlook, and it changes in the way your muscles move and the balance of weight across your chest.

I joke a lot about cancerthats how I copeand so I get why people say that. And yes, technically, the Womens Health and Cancer Rights Act of 1998 says insurance must also cover expenses related to the reconstruction of a breast after a mastectomy. But I would much rather not have gone through cancer than get a free boob job. Its not an equal tradeoffand I have paid so, so dearly, both literally and figuratively, in many other ways.

Reconstruction is a way of feeling normal again and not having this reminder every time I take a shower, every time I dress, every time I buy new clothes, of what Ive been throughand all the work that still has to be done.

Reconstruction is a way of trying to put the trauma of the past five years behind me. And then, even if Im not perfectly happy with my body, I could say, Okay, this is it. I know what I've got to work with, and I could start to embrace it. I could move forward. Right now, its more like being stuck in limbo.

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My Breast Reconstruction Surgery Was Delayed Because Of COVID-19 - Women's Health

On the Basis of Gender – The Viking Magazine

Left foot forward. Right foot forward. While that may well be the mantra playing in 18-year-old Caster Semenyas head as she flies furiously down the length of the track towards the finish line, the spectators watching her would be lucky to be able to distinguish between her feet as she runs. Her high speed reduces her muscular figure clad in a South-African-colored uniform to a blur of green and yellow as she finishes almost a full second before her closest opponent at the World Championships in the 800 meter race.

Semenya didnt just win her event she dominated it.

But later that fateful night in 2009, instead of being celebrated for the young phenom that she had trained arduously to become, Semenya came under fire for potentially having an unfair advantage as the public began to question her biological sex. The intrusive testing and inquisitions that followed affected Semenyas ability to compete, but she did her best to hold her head high and carry on as people picked apart her prowess. Semenyas case was just one of many that deals with the complicated role of gender in sports, a topic that becomes increasingly relevant as athletic science improves and athletes of all genders become faster and stronger than ever before.

When people think of sports, their mind often divides mens sports and womens sports into two separate entities, with the athletes within them as strictly binary. Sports have been categorized this way throughout history with the intention of ensuring that competition that ensues will be fair. But how do we define fair, and will this rigid separation continue to be the norm in the future?

In some sports, such as distance swimming, the average percent difference between men and womens times is a slim 5.5%, according to a 2010 study in The Journal of Sports Science and Medicine. In other sports, such as weightlifting, this difference is more significant at 36.8% according to the same source. Because each sport is unique in the physical challenge it presents to athletes, the same standards for legislation and rules regarding gender and fairness cannot be applied universally.

Recently, there has been an increase in discussion surrounding transgender athletes competing in the gender category that best matches their gender identity. While some push back against trans inclusion in situations such as the Idaho bill passed in March that enforces genital and hormonal testing of athletes, others fight for equality in sport. Harvard graduate Schuyler Bailar a trans swimmer who was accepted onto the mens team and found great success and joy in living life as his most authentic self is one of the athletes leading the fight for gender inclusivity in sports. The role that gender plays in sports is already complexthe way gender and sports will interact in the future is even more so.

Despite a social movement towards increased transgender inclusion and a general heightened understanding of what it means to be transgender, many major sports leagues, such as USA Powerlifting, have chosen to keep their original policies in place. In a statement of the organizations transgender participation policy, the USA Powerlifting league cited both the physical advantage of males and a ban on the androgens often used to transition from female to male as reasons for their stance.

While the term discrimination is used to catch the attention of the public, it is most often misused, the statement read. We are a sports organization with rules and policies. They apply to everyone to provide a level playing field.

While some question whether the USA Powerlifting policies are discriminatory against transgender athletes, the organization said it is fair in a sport largely based on physical strength and compared gender discrimination to policies surrounding age restrictions.

This bill attempts to solve a problem that does not exist while slamming the door shut for transgender student athletes to fully participate in their school communities.

Kathy Griesmeyer

At the high school level, some athletes have protested transgender participation in the gender category of their choice. Recently, at a high school in Connecticut, the families of female track runners filed a lawsuit against the participation of transgender athletes in womens sports, arguing that their female children competing against runners with male anatomy could hinder their personal chances of earning track titles and scholarships.

Those who share the same opinion as those parents have formed conservative groups and are supported by legislators throughout the states that are looking to ban participation of transgender athletes in both mens and womens sports. For example, the Idaho state Senate recently passed Republican-sponsored bill 24-11. If signed, this bill would prohibit both trans and intersex girls from competing in the girls heats of high school and college sports.

If a female athletes sex is questioned by a coach, parent, or administration of the other team, the future of that athletes participation depends on if their biological sex is confirmed by a signed physicians statement that shall indicate the students sex based solely on: The students internal and external reproductive anatomy; the students normal endogenously produced levels of testosterone; an analysis of the studentsgenetic makeup, according to the bill.

This bill fails to acknowledge that the inclusion and acceptance of transgender people and their identity is extremely important to their well being, both physically and mentally. By reducing someone to their biological sex characteristics, one is blatantly disregarding their internal identity.

Additionally, this bill only targets female athletes, requiring them to go the extra step if their sex status is questioned in order to play their sport, while their male counterparts do not have to endure this same burden. This suggests that, should a woman have success in an athletic event, her success may be attributed to genetic alterations rather than talent.

Kathy Griesmyer, a policy director with the American Civil Liberties Union of Idaho, is disappointed with this bill, citing that it is intentionally transphobic and that it makes things more difficult for athletes that already face many social hurdles simply for fulfilling their true sense of identity.

This bill attempts to solve a problem that does not exist while slamming the door shut for transgender student athletes to fully participate in their school communities, Griesmyer said in a statement in response to the bill. Idaho has not seen any issues with trans girls competing in the girls sports. This unconstitutional and mean-spirited bill prevents trans girls from finding community and self-esteem in sports, and will certainly result in litigation to defend the civil rights of Idahos transgender community.

In addition to being transphobic, this bill is an invasion of the athletes privacy and puts power in the hands of coaches or parents who may use it to place their competitors at a harsh disadvantage.

In a similar proposition, legislation announced in January could prevent transgender women in Arizona from participating in athletics teams based on their gender identity, requiring some females athletes to provide a doctors note stating their biological sex in order for them to compete in their sport.

However, this rule only applies to womens sport and not to male counterpart sports. The vast majority of the arguments surrounding barring transitioned athletes center solely on male-to-female athletes. Those critics cite the biological differences between men and women that, they claim, could lead to significant competitive advantages for male athletes. Most of these changes take place during puberty: a biological male undergoing puberty will see a host of changes due to their significantly elevated testosterone levels compared with biological females. According to a study comparing female to male testosterone, an adult male will have seven to eight times the natural testosterone coursing through a womans body on average.

This testosterone is accompanied by scores of physiological changes, among them larger muscles, denser bones and a higher proportion of lean body massits these traits that lead to the bigger, faster, stronger notion surrounding male athletes.

While transitioning to female often involves the use of testosterone suppressants and estrogen, most in favor of barring trans athletes argue that these measures dont reverse the increased bone density, superior musculature, and other characteristics of male puberty.

So despite the fact that female-to-male athletes who choose to undergo hormone therapy treatment will also have elevated testosterone levels, this isnt seen as a threat: the vast majority of benefits will be derived from a biological male puberty, not from an addition of testosterone to a body thats undergone female puberty.

But, of course, thats not always the case. A 2016 Washington Post article examining the trans advantage cites that after a year of hormone therapy, female trans distance runners completely lose their speed advantage over cisgender women. Similarly, individuals like Nancy Barto, an Arizona state representative, recognize that regardless of whether a male-to-female athlete will have a greater advantage in sports than a female-to-male athlete, legislature that targets women specifically cis or otherwise puts up barriers to prevent their participation. This type of legislature in sport is counterproductive, introducing yet another in a long line of historical roadblocks for female athletes.

When this is allowed, it discourages female participation in athletics and, worse, it can result in women and girls being denied crucial educational and financial opportunities, Barto said in an interview with NBC News.

The recent passage of such legislation such as the bill signed by Idahos governor on March 30 raises questions about what, exactly, constitutes someone as being transgender. Legislators such as Representative Barbara Ehardt, a sponsor of the bill passed in Idaho, have said that genital exams and genetic and hormone testing could easily determine an athletes sex. However, in reality, sex testing may not be that simple, as it is difficult to come up with metrics to objectively distinguish between different sexes.

Some of the sex testing methods that Ehardt cited may even produce contradictory results. At the 1966 European Track and Field Championships in Budapest, Polish sprinter Ewa Kobukowska passed a genital exam and qualified as female. The following year, Kobukowska failed a chromosomal test, and was barred from participating in the European Cup womens track and field competition in Kiev. An analysis later found that she had a set of XXY chromosomes.

A similar issue arises when it comes to hormone testing. The International Association of Athletics Federation, which sets testosterone limits for women in racing events ranging from the 400-meter to one-mile race, bans athletes who produce abnormally-high levels of testosterone from participating in womens sports.

In 2011, the IAAF set the limit for womens testosterone levels at 10 nanomoles per liter of blood, widely considered the lower end of the typical testosterone level among males. This limit barred Dutee Chand, an Indian sprinter who naturally produces high levels of testosterone, from competition. Chand later won an appeal against her ban; the court agreed with Chand that there was no scientific evidence linking high testosterone levels to better athletic performance. The IAAF commissioned a study in 2017 and justified with data that was highly scrutinized lowered the limit to five nanomoles per liter seven years later, a change that was meant to ensure a level playing field for athletes, IAAF President Sebastian Coe said. Critics argued that the data was flawed, and urged the IAAF to retract the study, which was published in the British Journal of Sports Medicine.

However, the IAAF stood firmly behind its study and said it would not retract the paper. Our evidence and data show that testosterone, either naturally produced or artificially inserted into the body, provides significant performance advantages in female athletes, Coe said. The press release goes on to state that most females have testosterone levels of between 0.12 to 1.79 nanomoles per liter, and that no females testosterone level would exceed the IAAFs new limit unless they had disorders of sex development or a tumor.

An example of a female athlete with higher than usual levels of testosterone is track champion Caster Semenya of South Africa. She began running seriously at age 12, and by the time she became an adult, she was competing in the Olympics. Due to her incredible success and ability, suspicion arose regarding Semenyas biological sex and levels of testosterone. She soon found herself the target of an extremely intrusive media investigation and was eventually barred from competing; after an investigation discovered that she was born with XY chromosomes, Semenyas genetic makeup was ruled an unfair advantage over her competition.

On August 19, 2009, Semenya won the 800-meter event in the World Championship by a landslide, but following this impressive feat came a seemingly never ending public investigation into her biological sex and sex characteristics.

Along with stripping Semenya of any type of celebration or praise for her accomplishments, the public reduced her feats to her gender. The scrutiny Semenya endured is disproportionate to her situation, as she is seconds off the world record and is relatively competitive with other female athletes, disproving the idea that she has an unfair advantage she is simply talented at what she does.

Typically, it is women who endure accusations of this nature. Michael Phelpss abnormally long wingspan is never labeled as an unfair advantage; it is simply a tool that makes him successful. Most professional basketball players are extremely tall compared to the general population, making them genetic oddities, and this is never labeled as an unfair advantage. Yao Ming, for instance, is a staggering 76 tall, a height thats inspired countless conspiracy theories about whether the star was bred in a lab rather than born to his 63 mother and 67 father. Tinfoil hats aside, Mings height enabled him to tower over even his fellow NBA competitors. Ming is nearly a full foot taller than the average NBA player, who stands at 67, and nearly two feet taller than the average American male, who stands at 59, which gives him a clear competitive advantage based on his genetics. And instead of protesting Usain Bolt, society hails him as the fastest man in the world, despite his body being described as built for speed due to his abnormal proportions. In a BBC News article, former Great Britain sprinter Craig Pickering said, Bolt is a genetic freak because being 65 tall means he shouldnt be able to do what he does at the speed he does given the length of his legs.

Along with stripping Semenya of any type of celebration or praise for her accomplishments, the public reduced her to her gender.

The main goal of most professional athletes is to be the best they can, so why was Semenya punished for her gift? The examples listed above are few compared to the gifted male athletes celebrated for the genetic gifts that enable them to compete leaps and bounds ahead of most athletes. And the countless examples seem to point to one central notion: men who are good at what they do are not held to the same unreasonable standards or stigma as their female counterparts.

Although Semenyas case has gained notoriety, she is not the first female athlete to face restrictions from her sport when her performances were deemed, essentially, too good to be true. Maria Jos Martnez-Patio, an internationally-recognized hurdler turned college professor, has a history that eerily parallels that of Semenya, so much so that Martnez-Patio calls herself the Semenya of the 1980s, according to a profile with the United Kingdoms Times. Martnez-Patio faced little scrutiny or public attention initially; at 22, she was given a certificate of femininity after passing a sex test the title is often awarded after enduring humiliating and intrusive tests such as gynecological exams, MRIs, and ultrasounds enabling her to advance to the quarter finals of the 100-meter hurdles at the world championships in Helsinki.

But in 1985, her troubles began.

At the World University Games, a new test karyotype analysis that examined her chromosomes directly found that she had an XY 46th chromosome, the chromosomal pattern typical of a biological male. Martnez-Patios story was more complex than her chromosomes she has androgen insensitivity syndrome which means her body doesnt respond to testosterone in a typical fashion, so any advantage she was perceived to have was likely naturally negated but the storm of public backlash that poured down on her was indifferent to that fact. After her test, Martnez-Patio was ruled ineligible to participate in femaleathletics, and even encouraged to fake an injury to leave quietly. She suddenly found herself barred from the sport shed played and loved all her life and newly privy to information regarding her sex that would leave anyones head spinning if not reconsidering what theyd thought was the truth about their gender their entire life. If the sudden onslaught that had struck Martnez-Patio wasnt already enough, the humiliation and shame of being pushed to lie, to leave gracefully not to make a scene was the final straw. Despite her initial compliance with the injury scheme, Martnez-Patio chose to fight back. In 1986, despite the public media skewering shed endured, she entered the Spanish national championships 60-meter hurdles event. She was told she had two options: withdraw from the event discreetly, or face public condemnation. She chose the latter. After competing and winning, she was stripped of her scholarship and athletic residency, and faced consequences in her private life that were far more hurtful than any Spanish press article.

In The Times article, Martnez-Patio describes how she suffered after the test. I lost my boyfriend because all the media said I was a man, Martnez-Patio said. On many occasions, I thought the best thing was to die because I could not stand so much suffering and injustice. I had to leave my residence in a high-performance center in Madrid within 24 hours. I was on the street. The most complicated thing is having to publicly demonstrate your status as a woman before the whole world. You feel as if everyone is talking about the amount of woman that you are. And this stigma accompanies you for the rest of your life.

Similarly to Martnez-Patios situation, when she was told to cease competing until her chromosomal test results were returned, the International Amateur Athletic Federation, or IAAF, requested Semenya to refrain from competing until there was a definitive conclusion from sex verification tests. As this all occurred, Semenya, her family and her team upheld the statement that she was biologically female and had identified as a woman since birth, regardless of her abnormal hormone levels.

However, this type of testing is not as accurate or conclusive as many hoped it would be. According to many studies and Dr. Gerald Conway, an endocrinologist who worked on the study of Semenyas hormones, while it is true that higher-than-usual levels of testosterone can give an individual an advantage in sport, this is not always the case.

There is an advantage to exposure to testosterone, which is why people use testosterone as an anabolic steroid, Conway said. There are natural conditions, where women normally have more testosterone in circulation, and they would have a biological advantage in many sports arenas.

But the quantitative level of testosterone in ones blood isnt the end all be all, as some women do not react to having high levels of the hormone because their bodies simply dont recognize it.

Katrina Karkazis, a cultural anthropologist and research fellow at Yale, co-authored the book Testosterone: An Unauthorised Biography with Rebecca Jordan-Young, a sociomedical scientist. In it, Karkazis and Jordan-Young critique and dismantle the previously believed effects testosterone has on the body.

In an interview with The Guardian, Karkazis discussed misconceptions about the actual impact testosterone can have on an athlete.

Testosterone is a very dynamic hormone, Karkazis said. Its actually responsive to social cues and situations. For example, if a coach gives you positive feedback, that can raise your testosterone level Where we run into trouble is trying to make comparisons across individuals based on testosterone levels. Sometimes its individuals with lower testosterone who do better. So its not as simple as saying more testosterone equals better performance.

Schuyler Bailar made history as the first openly transgender swimmer in the NCAA. As a member of the graduating class of 2019 from Harvard, the Virginia native took a gap year after high school during which he came out as transgender. After becoming a star swimmer in high school, Bailar had been recruited to swim for the womens team at Harvard, although after coming out he was unsure if he would be able to swim on the mens team once his education at Harvard began.

In an interview on the Ellen Show, Bailar said that while he has not been as competitive in mens heats in comparison to the dominance he showed when racing against women, he doesnt mind. Bailar admits that while he is no longer placing first, he is holding his own in races, defying people who support barring trans athletes from existing as themselves.

Im not winning anything, but I think Im not awful, Bailar said with a smile on his face. I keep up with my teammates and I keep up with the people around me, but Im not winning anything like I used to and thats definitely humbling.

While some people may argue that trans athletes fight to change which gender category they compete in for an advantage or other external reasons, Bailar is simply living life in a way that feels true to himself and because the sport is important to him. Along with being a swimmer, Bailar has become a public speaker, and aims to raise awareness about transgender youth in sports.

It [not winning] has helped me develop something I was working on before, which was learning to love swimming just for swimming, and I think that theres a lot of other kinds of glory in that, Bailar said.

I was just ecstatic and it was as much glory as I wouldve gotten in first place. Probably more, because I was myself.

Schuyler Bailar

Bailar has found that having the support of his team and improving on his own personal times can be just as exciting and rewarding as a medal.

In my last meet, I got sixteenth place, which obviously is not first place, Bailar said with a laugh. But the whole team was on the side of the deck and they jumped up and were screaming for me because I dropped a lot of time from my best, so I did really well relative to myself, and I was just ecstatic and it was as much glory as I wouldve gotten in first place. Probably more, because I was myself.

Elizabeth Edwards, an 18-year-old senior at the Urban School of San Francisco and a transgender woman, believes legislation which requires sex testing doesnt work and unfairly discriminates against transgender women like herself.

The requirement of gender reassignment surgery is ridiculous, especially considering the absurdly strict medical standards currently held in the US to qualify trans people to undergo them, Edwards said. Also, sex verification standards leads without fail to unfair standards of gender expression normativity that bear down on cis people, and result in cis people being disqualified on bases of uniquely high/low chemical levels that result from normal variance in such factors across the cisgender population.

A study conducted by researchers from the Department of Molecular and Cell Biology and Biochemistry at Brown University found that as many as 2% of the population have traits which deviate from the ideal male or female, including hormone levels and the structure of the internal genital duct systems and external genitalia. This seems to suggest that sex testing would not necessarily be as straightforward as critics suggest.

According to Edwards, at the professional level, the highest reasonable requirement should be proof that an athlete has undergone hormone reduction therapy for 18 months.

By that point, trans and cis people are chemically identical, and such quote-unquote biological dis/advantages such as bone density will have fallen to the wayside, Edwards said.

While research on this subject has hardly reached a consensus, a meta-analysis of eight research articles conducted by researchers from the Nottingham Centre for Gender Dysphoria and Loughborough University concluded that there is no evidence that hormones such as testosterone give transgender female athletes an advantage.

The analysis also reviewed 31 sport policies from various national and international competitions and found that rules restricting participation from transgender athletes discourage transgender athletes from participating in sports.

Within competitive sport, the athletic advantage transgender athletes are perceived to have appears to have been overinterpreted by many sport organisations around the world, which has had a negative effect on the experiences of this population, the analysis reads.

The researchers also write that sports organizations need to improve their policies to be more inclusive.

Given the established mental and physical health benefits of engaging in physical activity and sport, the barriers transgender people experience are a significant limitation to the promotion of healthy behaviours in transgender individuals, the analysis reads.

Kay Svenson, a Paly alum and recent graduate of Wellesley college, is a trans activist and believes that trans people, like all people, have the right to be treated in accordance with their gender identity, and this includes sports.

Sex-based discrimination is prohibited under Title IX, and that amendment is not up to the free interpretation of the (potentially transphobic) governing bodies of the state or local school district, Svenson said. We need to work harder to ensure that differences in birth anatomy do not shape our definition of athletic fairness.

Svenson believes that it is important that transgender people have the means and support to pursue their personal athletic careers, free of judgment.

Trans athletes have just as much of a right as cis athletes do to compete in the gender category that they identify with, Svenson said.

While there is no explicitly correct answer or proposed set of regulations surrounding the role of gender identity in sports today, if athletes and fans alike continue to ask hard questions respectfully and work towards giving everyone the opportunities to enjoy sports, compete as themselves, and make sure matches remains competitive, it will be a victory for everyone. Nonetheless, as gender identity and societal views surrounding the gender spectrum become more well understood and all-encompassing, the issues described will only become more complex. Its time to have conversations about this topic now so were ready for the more complex questions later.

Read more from the original source:
On the Basis of Gender - The Viking Magazine

Fighting the COVID Blues: Advice from Business Research – Harvard Business School Working Knowledge

Life was hard enough for the one-third of Americans who had wrestled with anxiety prior to the COVID-19 pandemic.

Now, the disease that has killed almost 100,00 in the United States, left millions unemployed, and socially distanced many people from friends and family is causing fear, isolation, and financial distressa mentally toxic combination for many.

In fact, almost half of adults in the United States, 45 percent, say that worry and stress related to the coronavirus and the resulting economic downturn are hurting their mental health, according to a study by the Kaiser Family Foundation.

We asked Harvard Business School experts who study well-being to share strategies for coping with this unsettling period to prevent the coronavirus blues from taking a huge toll, both personally and professionally.

You're not going to be a good [business] leader unless you know how to lead yourself, says Arthur C. Brooks, Arthur C. Patterson Faculty Fellow. You're not going to be a good entrepreneur unless you see that your life is your enterprise; your life is your startup.

Heres what Brooks and four other HBS experts recommend:

Focus on the here and now. In a matter of weeks, as the coronavirus rapidly began taking an increasing number of lives and livelihoods, people suddenly felt as if their future became murkier.

When uncertainty and disappointment morph into fear, people often try to gather information that might help them reduce their risksincluding spending hours reading or watching the news.

Rather than ruminating on the virus and replaying possible future outcomes in our minds, its best to let go of the notion that anyone can completely control the COVID-19 fallout and instead focus on today, say Brooks and Leonard A. Schlesinger, the Baker Foundation Professor.

This is such an impermanent state of affairs that we just have to do as best we can, Brooks says.

Make time for introspection. The coronavirus represents a historic inflection point that is likely to forever change us, as did the assassination of President John F. Kennedy and the terrorist attacks on September 11, 2001.

Brooks suggests using this period as an opportunity to take stock of your own life. Does your work reflect your values? Have you let some important relationships languish? Did you give up on a dream too soon?

One of the things that I feel is really important is that people not waste this moment, Brooks says. When something causes you to become introspective, that should be a moment and opportunity for intense personal growth.

Indeed, when we focus our energy on our strengths, we feel more authenticand that increases resilience and happiness, improves relationships, and reduces stress, according to research by Francesca Gino, the Tandon Family Professor of Business Administration. If we take time to reflect on what were good at and enjoy, we may discover that all the meetings we used to hold in the office sucked up too much time or that a trip to the childrens museum wasnt the key to bringing the family joy.

Rather than fighting for ways to get back to our usual routine or even just waiting for this crisis to end, a better approach is to embrace this time, Gino says. We might find new routines and activities that we appreciate more.

Tap into your inner spark of curiosity. Curiosity is critical to learning, innovation, and even higher levels of life satisfaction, so getting inquisitive could help us now. Preliminary results of a study Gino conducted during the coronavirus crisis shows that people with a heightened sense of curiosity feel less stress and approach their days thinking about what they might learn during this strange period, rather than feeling paralyzed by their changed circumstances.

To pique your own curiosity, consider setting regular learning goals, whether its figuring out a challenging piece of software, trying a new recipe, or searching for answers to the deep questions children ask because theyre naturally more curious, given that curiosity peaks at ages four and five.

When my child asks, Why is the sky blue? I turn it around and say, Why do you think its blue? How can we find the answer? Maybe before the pandemic we had places to go and we felt we didnt have a few extra minutes to look for the answers to those questions, says Gino, who has four children. Now we have an opportunity to do just that. Even learning something small can give you pleasure and a sense of accomplishment.

And if the house gets a little messy during a curiosity quest, thats OK. Gino recalls her two-year-old exclaiming it was snowing while scattering salt from an open jar all over the floor, or her young children running around the kitchen, flinging open cabinets, and putting colanders on their heads as hats.

I used to ask them to stop but, at some point, I realized I was contributing negatively to my own curiosity and theirs, she says. Usually, the chaos or mess is not as big or loud as I envisioned it would get. And the joy that comes out of the little mess is significantly higher than the small amount of cleaning you have to do afterward.

Schedule each day. Many parents are caring for their children and guiding their remote learning while trying to do their own jobsand feeling like theyre failing on all fronts. Eventually, thoughts about unfinished work tasks encroach on relaxation time, making people feel as though theyre always working.

Youre trying to stuff too much into a little sack and it keeps tearing open, Brooks says.

He recommends people schedule everything they need or want to do, whether its finishing a presentation or talking a walk. Sticking to the schedule will help restore some work-life balance and reduce cognitive load, freeing up mental bandwidth to efficiently process all the tasks people need to accomplish.

Focus on important projects. When people get stressed, they often look to accomplish tasks that are unimportant but feel urgent in the moment. So they spend their days feeling like theyre putting out small fires everywhere by answering emails and crossing relatively menial obligations off the to-do list.

To relieve time stress, people would benefit by setting aside blocks of time every day or even just once a week to work on the important heavy-lifting projects they put off but that weigh them downwhether personal or work-related, says Assistant Professor of Business Administration Ashley Whillans. If colleagues try to schedule meetings during that time, say no, and turn off alerts so youre not getting pinged with messages while trying to focus. Protect that time at all costs, Whillans says. It will help you feel more in control.

Its also OK to request more time to get work projects done if necessary, since studies show managers are generally willing to extend deadlines when employees ask. Its taking us longer to accomplish tasks right now, so we should ask for the time we reasonably need to get things done, Whillans says.

Gracefully bow out of extraneous activities. Many employers are trying to help their employees unwind by scheduling virtual coffee breaks, lunch gatherings, and happy hours with coworkers. But Whillans says companies should be careful about adding too many obligations to peoples already-full plates, even if their intention is to relieve stress through social interactions. And, if youre on the receiving end of these invitations and can tactfully decline, do it.

Adding more things to peoples schedules is not the way to go. All the video calls are especially exhausting, Whillans says.

Take time off, if you can. The demands of work havent slowed for many. And even in the best of times, people who report greater time scarcitythose who feel overwhelmed by having too much to do with not enough time to do everythingare more anxious and less satisfied with their lives, according to research by Whillans and Michael I. Norton, the Harold M. Brierley Professor of Business Administration.

Workers who are able to take time off and recharge during this disconcerting period will be more engaged when they return.

People often dont take the vacation time they have coming to them, and many are feeling even more hesitant to ask for time off right now. But they are also feeling really burned out, Whillans says. We have all had to do a lot of adapting in a short time, and we dont know when this is going to end. All the things we cant control are emotionally taxing, so, now more than ever, we need to take the personal time we have accumulated.

On days we do work, we should build in mini-mental health breaks to take a walk or enjoy coffee with a family member or friend, virtually or in person. Just taking 10 minutes to slow down can be helpful for our mental health, rather than being constantly in motion, Norton says.

Put your family first. People who stake their self-worth on financial success spend less time with family and feel lonelier as a result, Whillans recent research shows. We need to remember to set work aside and make time to connect in meaningful ways with family and friends, says Whillans, whose partners stressful work as an emergency room physician is a daily reminder to set her priorities straight.

I am really walking the talk in terms of my research right now, she says. The weight of whats going on underscores what really matters. We should be mindful about how we spend our timeand spending time together is much more precious than an abstract paper or phone call I dont need to take. Life is inherently unpredictable and uncontrollable, but what we say yes to are things we can control.

Naturally, emotions may flare when people are confined together. If you want your relationships to outlast the pandemic, resist the urge to express frustration through contempt, whether its a dismissive eye-roll or a sarcastic jab, Brooks says. Research by relationship scholar John M. Gottman found that couples who expressed contempt were more likely to divorce.

Hug it out. Schlesinger and Brooks recommend a simple strategy for relieving tension among friends and families who are quarantining together: Hug each other regularly for 20 seconds. This is the amount of time it takes to boost levels of oxytocinthe so-called love hormonein the brain to peak levels.

If youre lucky enough to have the physical presence of other folks in your house, grab one of them and hug them, Schlesinger says. And if youre social distancing alone, use videoconferencing tools to reach out to family and friends, so that you can look at each other as you talk, since eye contact also lifts oxytocin levels.

Connecting on social media, however, doesnt offer the same benefits. While use of social platforms has increased during the pandemic, with Facebook traffic rising by 50 percent in some countries, people dont get a boost of oxytocin from these interactions. Seeing random photos of happy families or political memes may even have the opposite effect and sap those good feelings. Outside of professional networking, its best to limit social browsing time to 30 minutes a day, Brooks and Schlesinger advise.

Lean on rituals. Continuing with longtime rituals, like making a partners coffee every morning or reading two storybooks to children before bed, can help couples and families bond and provide comfort at a time when so many other aspects of our lives have changed, Norton says.

With little kids, we dont mix up the bedtime ritual. We do the same thing in the same order because we know this is really important to them, Norton says. We think as grownups we dont need rituals anymore, but thats not the case. They help us calm our nerves.

Now people are adapting old ritualsby holding virtual Sunday dinners or gathering for church onlineand inventing new ones by going for walks on the same route every day or designating certain nights to playing games.

Preliminary data from a new study by Norton and HBS doctoral candidate Ximena Garcia-Rada shows more than half of parents have introduced new rituals since the crisis startedand many say they help their families cope. Even rituals that may seem annoying or kids complain about and ask why they have to do them are centering for families, Norton says. People need the familiar things that bond them even more during this crisis.

Rituals can also help employees working from home add boundaries around their workday. When people typically arrive home from work, they often have a corner or a mudroom where they drop their stuff, Norton says. Now many people have work all over the place. He advises storing laptops and work-related materials in a certain spot to mark the end of the workday.

Perhaps most tragically, social distancing has halted many in-person communal grieving rituals like wakes and funerals, adding to the sorrow of people mourning loved ones. Yet, even if the typical ceremonies arent practical right now, people can benefit from creating their own private, idiosyncratic rituals. One woman who lost a spouse years ago told Norton, I washed his car every week as he used to do.

Theres no ancient text to say you should wash someones car, Norton says. But, by doing something personally relevant and symbolic, she felt better.

Share your money and time with others. Material purchases are less satisfying than buying experiences like taking a trip or attending a show, Nortons research shows. Even though vacations and restaurant outings may not be in the cards right now, we can still spend money in ways that foster shared experiences with loved ones.

For example, buying a ping-pong table, TV, or online movie subscription for the family to enjoy together might make you happier than purchasing a phone to use by yourself, he says.

Also, the research shows spending money on other people makes us happier than spending it on ourselves. Many are doing just that, donating a portion of their stimulus checks to food banks or to friends who are out of work. Some are helping others in non-financial ways, including recovered coronavirus patients donating plasma to help the sick.

During this crisis, you see people doing incredibly altruistic, kind, giving things, such as people getting food and medicine to the elderly neighbors theyve never met before, Norton says. When you give generously to others, it makes you happier than when you focus only on yourself.

Expressing gratitude also acts as a powerful source of well-being, increasing dopamine levels and boosting productivity, says Gino. Ive gotten into the habit of calling or writing a note to people I havent talked to in a while to express gratitude for something they have done, she says. Showing someone else appreciation makes us feel good.

While life might have seemed simpler and more predictable prior to the coronavirus invading our world, thats probably an illusion. A cluttered home will probably still be messy when the virus abates.

Don't romanticize what life was before the coronavirus, Schlesinger says. Your house wasnt perfect.

When Schlesinger checks in with his grown children, he reminds them that the COVID-19 pandemic will end. Eventually, people will return to work, whether at their old jobs or new positions. Children will go back to school and catch up on missed lessons. The economy will stabilize.

And then, Brooks says, we'll look back on this and say, Hey, remember when we were all home together?

Dina Gerdeman is senior writer at Harvard Business School Working Knowledge, and Danielle Kost is senior editor.

[Image: jeffbergen]

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Fighting the COVID Blues: Advice from Business Research - Harvard Business School Working Knowledge

Hormone Replacement Therapy Market Size Worth $39.6 Billion By 2027: Grand View Research, Inc. – P&T Community

SAN FRANCISCO, May 19, 2020 /PRNewswire/ -- The global hormone replacement therapy marketsize is expected to reach USD 39.6 billion by 2027, expanding at a CAGR of 7.7%, according to a new report by Grand View Research, Inc. A significant rise in the incidence rate of hormonal disorders in the newborns, adults, and elderly and populations is driving the market. The Prader-Willi syndrome (PWS) affects one in every 15,000 newborns, thereby boosting the demand for the therapy.

Key suggestions from the report:

Read 100 page research report with ToC on "Hormone Replacement Therapy Market Size, Share & Trends Analysis Report By Product (Estrogen, Human Growth), By Route Of Administration (Oral, Parenteral), By Type Of Disease, By Region, And Segment Forecasts, 2020 - 2027" at: https://www.grandviewresearch.com/industry-analysis/hormone-replacement-therapy-market

Estrogen replacement hormone therapy helps in reducing the vaginal indications of menopause, such as dryness, burning, itching, and pain during intercourse. Estrogen is available in the forms of pill, gel, skin patch, cream or spray form. It is highly successful for treating problematic menopausal night sweats and hot flashes. Around 45% of women between the ages of 40 to 60 years of age were reported taking counseling sessions from a physician regarding the advantages and disadvantages of using hormone replacement therapy (HRT) after menopause.

Growing awareness about menopausal signs and the treatment options is growing the HRT market. Owing to the significant development for ERT, there has been an initiation of very safe treatment options for the patients situated in various geographies of the world. For example, augmentation of innovative drug delivery systems like transdermal estrogen patches and vaginal estrogen drugs.

Grand View Research has segmented the global hormone replacement therapy market based on product, route of administration, type of disease, and region:

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About Grand View Research

Grand View Research, U.S.-based market research and consulting company, provides syndicated as well as customized research reports and consulting services. Registered in California and headquartered in San Francisco, the company comprises over 425 analysts and consultants, adding more than 1200 market research reports to its vast database each year. These reports offer in-depth analysis on 46 industries across 25 major countries worldwide. With the help of an interactive market intelligence platform, Grand View Research helps Fortune 500 companies and renowned academic institutes understand the global and regional business environment and gauge the opportunities that lie ahead.

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Hormone Replacement Therapy Market Size Worth $39.6 Billion By 2027: Grand View Research, Inc. - P&T Community

Edited Transcript of ONTX earnings conference call or presentation 14-May-20 8:30pm GMT – Yahoo Finance

Newtown May 18, 2020 (Thomson StreetEvents) -- Edited Transcript of Onconova Therapeutics Inc earnings conference call or presentation Thursday, May 14, 2020 at 8:30:00pm GMT

* Abraham N. Oler

Onconova Therapeutics, Inc. - Senior VP of Corporate Development & General Counsel

Onconova Therapeutics, Inc. - CFO

Onconova Therapeutics, Inc. - Chief Medical Officer and Senior VP of Research & Development

* Steven M. Fruchtman

Onconova Therapeutics, Inc. - CEO, President & Director

Laidlaw & Company (UK) Ltd., Research Division - MD of Healthcare Research & Senior Biotechnology Analyst

H.C. Wainwright & Co, LLC, Research Division - MD of Equity Research & Senior Healthcare Analyst

Ladies and gentlemen, thank you for standby, and welcome to the Onconova Therapeutics First Quarter 2020 Earnings and Corporate Conference Call. (Operator Instructions) As a reminder, this conference call is being recorded.

I would now like to turn the conference over to your host, Mr. Avi Oler, Senior Vice President, Corporate Development and General Counsel. Thank you, sir. Please go ahead.

Abraham N. Oler, Onconova Therapeutics, Inc. - Senior VP of Corporate Development & General Counsel [2]

Thank you, operator. Good afternoon and welcome to Onconova's First Quarter 2020 Corporate Update and Financial Results Conference Call. Earlier this afternoon, we issued a press release outlining our financial results and business progress during the quarter. If you have not seen this press release, it is available on the Investor Relations page of our website at http://www.onconova.com.

On today's call, Dr. Steve Fruchtman, President and CEO, will discuss the company's recent highlights and anticipated clinical and business milestones. After Steve completes his opening remarks, Mark Guerin, our Chief Financial Officer, will review first quarter financial results. Following Mark's report, we will move to the Q&A portion of the call, which will be joined by Dr. Rick Woodman, our Chief Medical Officer. Lastly, Steve will come back with some final comments and a review of our upcoming milestones.

Before we begin, I remind everyone that statements made today during this conference call will include forward-looking statements under the safe harbor provisions of the Private Securities Litigation Reform Act of 1995, which involve risks and uncertainties that can cause actual results to differ materially. Forward-looking statements speak only as of the date they are made as the underlying facts and circumstances may change. Except as required by law, Onconova disclaims any obligation to update these forward-looking statements to reflect future information, events or circumstances. Please see the forward-looking statements disclaimer in the press release issued this afternoon and the risk factors in the company's current and future filings with the SEC.

With that, it is my pleasure to now turn the call over to Steve.

Thank you, Avi. Good afternoon, everyone, and thank you for joining today's call. First, our hearts go out to the many individuals and families impacted by the devastating COVID-19 pandemic. The world has truly changed, and we hope that brilliant scientists from around the world can bring new therapies and preventions to this devastating plague.

Onconova demonstrated significant progress during the first quarter of 2020, highlighted by the completion of enrollment of our pivotal Phase III INSPIRE trial in higher-risk myelodysplastic syndromes. We are fortunate to have achieved full enrollment prior to the profound impact of the worldwide COVID-19 pandemic, which has forced disruptions to research studies at many hospitals and cancer centers across our globe.

With enrollment now completed, Onconova's pivotal Phase III INSPIRE trial is advancing to the next pivotal catalyst. Based on historical survival trends in the INSPIRE trial, we continue to anticipate reporting top line survival data in the second half of 2020. And we expect to present the results of the INSPIRE trial at a major medical meeting later this year. With INSPIRE enrollment now complete, we are preparing for when we reach 288 survival events before analyzing and releasing top line survival data.

To shorten time lines for our anticipated NDA submission to the FDA, we have already begun NDA work prior to data readout. We are working with regulatory consultancy experts on our NDA document for the U.S. FDA as well as on the MAA document for the EMA to be in position to expedite our health authority applications when data becomes available.

We are also advancing our plans to be ready for commercialization. And to develop internal Onconova expertise, we have nominated a commercial expert, Ms. Terri Shoemaker, to our Board, who was instrumental in the commercialization of azacitidine, the most frequently prescribed pharmaceutical agent in higher-risk MDS.

As you recall, INSPIRE is an open-label, randomized, controlled, international study designed to determine the efficacy, safety and tolerability of single-agent intravenous rigosertib in the treatment of patients with second-line, high-risk MDS. Patients in this study are less than 82 years of age and have progressed on, relapsed or failed to respond to previous treatment with the standard of care hypomethylating agent therapy. The study randomized patients to receive either intravenous rigosertib with best support of care or the physician's choice of therapy with best support of care.

The primary end point of this study is overall survival of all randomized patients in the intent-to-treat population. There is also a second opportunity for an FDA approval, which is the sequential analysis of the overall survival of the very high-risk subgroup as defined by the revised International Prognostic Scoring System. Should rigosertib prolong survival in the INSPIRE trial in a statistically significant manner, we believe rigosertib could be the first new treatment for higher-risk MDS in more than 15 years.

Today, we disclosed that at the European Hematologic Association's upcoming virtual congress, Onconova and our collaborators at MD Anderson Cancer Center and the centers participating on the INSPIRE trial have an accepted presentation. The presentation, which was just posted to the European Hematology Association's website, detail the impact of the RAS pathway mutations on patients failing azacitidine and is entitled, Mutations in RAS Pathway Genes Correlates with Type of Failure to Azacitidine: Genomic Analysis at Randomization onto the INSPIRE Trial.

As you know, advances in the understanding of genomics have revolutionized cancer care. Participants on the INSPIRE trial received deep genomic sequencing of their blood or bone marrow at randomization and at multiple time points in their treatment during the study. The genomic data from the INSPIRE trial identifies the most common mutations in high-risk MDS following azacitidine failure, including those of the RAS pathway that may be targeted by rigosertib. We believe this data presentation will further advance the learnings about MDS, the important role of genomics and the possible place of rigosertib treatment for MDS and other RAS-driven cancers.

We have made important progress with our additional pipeline programs as well. In addition to the INSPIRE trial, we are advancing plans for a pivotal Phase II/III combination trial of oral rigosertib and azacitidine in adult patients with HMA-naive, higher-risk MDS. We received feedback from the FDA in 2019 and are preparing a Phase II/III protocol for submission based on their guidance. We anticipate meeting with the FDA in the third quarter of this year after submitting a Type C meeting request to consult with FDA. We anticipate this new registration trial will begin later this year following the FDA feedback and following the survival pivotal data readout from our INSPIRE study.

We have also received notification that the Phase I trial, which forms the basis for this new pivotal trial with oral rigosertib combined with azacitidine in HMA-naive, high-risk MDS patients, has been accepted for publication in Leukemia Research and anticipate its publication in the upcoming months.

In addition to studying rigosertib in MDS, we are primed for additional rigosertib development progress, including the to be initiated Phase I/IIa study of rigosertib plus nivolumab in Stage 4 KRAS-mutated lung adenocarcinomas following the reopening of clinical cancer research programs post the COVID-mandated stoppage as well as additional planned indications for rigosertib in other KRAS-mutated cancers and our pipeline programs. The study in KRAS-mutated lung adenocarcinoma will be an investigator-sponsored trial, and we anticipate the first patient will be enrolled following the mitigation of the burden of the COVID pandemic that has been placed on our academic medical centers.

While checkpoint inhibitors represent a significant advancement in the standard of care in treating lung cancer and have achieved blockbuster status many times over, tremendous unmet medical need continues to exist following disease progression. In our view, this makes our novel combination approach with rigosertib a very attractive option to pursue in lung cancer and potentially beyond.

And beyond rigosertib, ON123300 is our investigational first-in-class dual inhibitor of CDK4/6 and ARK5. We believe ON123300 has the potential to treat numerous cancers, including refractory metastatic breast cancer, with CDK4/6 inhibitors already commercially available. For those who are not familiar with this field, CDK inhibitors have emerged as promising compounds targeting very large cancer indications such as hormone receptor-positive metastatic breast cancer. Due to its unique targeting of ARK5 as well as CDK4 and 6, we believe ON123300 has the potential to overcome many of the existing agents' limitations, making it potentially suitable for certain cancers that may not be responsive to the current generation of commercially available CDK4/6 inhibitors. If successful, we believe ON123300 could address this very large market opportunity.

We maintain global rights of ON123300 outside of China. Our partner in China for this compound is HanX Biopharmaceuticals, who funded the Chinese IND-enabling studies. The Chinese IND was approved in January of 2020 by the Chinese health authority. We anticipate a Phase I study may begin in China in the second half of 2020. We also intend for the Chinese IND-enabling studies to comply with our FDA standards. To the U.S. and the rest of the world outside of China, our manufacturer for ON123300 is now qualified. We plan to file a U.S. IND in the fourth quarter of 2020 after obtaining the required manufacturing data.

With regard to business development. During the first quarter, we reacquired rigosertib rights in Greater China. As a result, Onconova controls the rights for rigosertib in the U.S., Europe and China, which are among the largest pharmaceutical markets in the world. Last year, we announced plans to launch an early access program with Inceptua Medicines Group. We anticipate launching this program in select countries in the second half of this year. We expect to continue to evaluate opportunities as we progress from one milestone to the next milestone.

As a reminder, our upcoming Annual General Meeting of Stockholders is coming up on May 27. I encourage stockholders to vote at our upcoming Annual General Meeting. Our proxy materials are available on our website. I am very excited that Onconova's Board of Directors has nominated life science industry veteran, Terri Shoemaker, to join the Board at this time. As mentioned, Terri has highly relevant experience in the MDS space. Terri was a key executive in the launch of azacitidine in MDS and will be a very valuable addition to our Board of Directors. We believe her experience in developing and managing commercial organizations in the life science industry will be instrumental in our efforts moving forward as we prepare for potential commercialization of rigosertib.

And now I'd like to turn the call over to Mark Guerin, our Chief Financial Officer, for a discussion of our financial results for first quarter 2020. Mark?

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Mark Patrick Guerin, Onconova Therapeutics, Inc. - CFO [4]

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Thanks, Steve, and good afternoon, everyone. Cash and cash equivalents as of March 31, 2020, totaled $31 million compared to $22.7 million as of December 31, 2019. As previously noted, common stock warrant exercises since our financing transaction in November 2019 have added $10.6 million of cash to our balance sheet. Also, of the almost 29 million stock warrants outstanding as of March 31, 2020, over 80% of them were in-the-money as of May 13. Based on our current projections, we expect that our cash and cash equivalents will be sufficient to fund our ongoing trials and operations into the third quarter of 2021.

Our net loss was $5.1 million for the quarter ended March 31, 2020, compared to $7.6 million for the comparable period in 2019. Research and development expenses were $3.4 million for the quarter ended March 31, 2020, and $4.1 million for the comparable period in 2019. General and administrative expenses were $1.8 million for the quarter ended March 31, 2020, and $3.2 million for the comparable period in 2019.

This completes my financial review. I'll now turn the call back to Steve.

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Steven M. Fruchtman, Onconova Therapeutics, Inc. - CEO, President & Director [5]

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Thank you so much, Mark. With that, we'd like to open the call for questions. After the Q&A, I'll finish with some final closing remarks. Operator, please open the call to Q&A session, and thank you.

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Questions and Answers

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Operator [1]

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(Operator Instructions) Our first question comes from the line of Joe Pantginis with H.C. Wainwright.

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Joseph Pantginis, H.C. Wainwright & Co, LLC, Research Division - MD of Equity Research & Senior Healthcare Analyst [2]

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Glad you're all doing well. So I have 3 questions, 2 of which, I think, are pretty much logistical. The first one is with regard to INSPIRE, it's great that you enrolled everyone right now and things are progressing and the time lines are still on track. So I was just curious, as part of your -- I guess, call it, your statistical assumptions now with COVID, is there a potential for any loss to follow up for any of these patients that you might not hear about some of these events? Or is it not a concern?

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Steven M. Fruchtman, Onconova Therapeutics, Inc. - CEO, President & Director [3]

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I'll ask Rick to take that question, and thank you, Joe.

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Richard Charles Woodman, Onconova Therapeutics, Inc. - Chief Medical Officer and Senior VP of Research & Development [4]

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Yes, Joe. Thank you. The main challenge with the COVID pandemic for our global study has been monitoring of the sites. Fortunately, the number of patients in which we are not able to confirm survival events is extremely small. And we anticipate that continuing in part due to the efforts of our CRO and the clinical research assistance in the field and the team in Onconova as well as some good luck. And I think that we anticipate for the remainder of the collection of survival events that we will be able to continue doing that monitoring. But it is a challenge, and the monitors and the team have -- had to develop unique ways in which to interact with the sites because of the pandemic.

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Joseph Pantginis, H.C. Wainwright & Co, LLC, Research Division - MD of Equity Research & Senior Healthcare Analyst [5]

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Got it, Rick. And then my second logistical question, if you will. I know we discussed this in the past, but sometime has elapsed, and I just want to make sure if your thinking is still the same with regard to the communication strategy around putting out the data for INSPIRE. So since you're looking to present them at a major medical meeting in the second half, I'll just say presumably ASH, would you look to then have one of those typical top line press releases to say, okay, it hit, and we'll give the further data at an upcoming conference? Or not hit as...

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Steven M. Fruchtman, Onconova Therapeutics, Inc. - CEO, President & Director [6]

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Avi, why don't -- I'll ask Avi to take that one, if I may. Go ahead, Avi.

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Abraham N. Oler, Onconova Therapeutics, Inc. - Senior VP of Corporate Development & General Counsel [7]

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Sure. Sure thing. In terms of communication, Joe, thanks for the question, but you're exactly right that we would anticipate announcing the data when it is ready at a top line level and presenting full data at an upcoming major medical meeting such as ASH or another major medical meeting.

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Joseph Pantginis, H.C. Wainwright & Co, LLC, Research Division - MD of Equity Research & Senior Healthcare Analyst [8]

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Got it. And then my question is -- or my third and last question. With regard to the upcoming Type C meeting, obviously, you've already had a lot of productive discussions with the FDA around the study design. So I guess I would ask it 2 ways. What's your wish list of what you want to get out of there? And what are the key outstanding things that you need to get solidified?

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Steven M. Fruchtman, Onconova Therapeutics, Inc. - CEO, President & Director [9]

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Rick?

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Richard Charles Woodman, Onconova Therapeutics, Inc. - Chief Medical Officer and Senior VP of Research & Development [10]

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Yes, Joe. So I think the first part to your question is that we want to get agreement from the FDA on a novel, unique, adaptive design, a combination of a Phase II/III. And this adaptive design we presented at ASH and some of the unique features. We feel this design is particularly advantageous for us in a variety of ways as well as the medical community and the health authorities. And I think it is the additional challenge that we have is developing, particularly, as we indicated in the abstract at ASH, a very rigorous and robust interim analysis that allows us to move forward into the Phase III part of the study.

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Operator [11]

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Your next question comes from the line of Naureen Quibria with Maxim Group.

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Naureen Quibria, Maxim Group, LLC - Senior Equity Research Associate [12]

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So first, I guess, starting first with INSPIRE. Can you remind us or are you able to disclose what the current event rate is right now? And is there an average number of events that you're seeing per month? Are you able to discuss that in any detail?

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Steven M. Fruchtman, Onconova Therapeutics, Inc. - CEO, President & Director [13]

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I think I'll try my hand at that, and thank you very much. We did reveal, I believe mid-March, that we have over 85% of our survival events that we require of the 288. And the reality is it's quite variable. We do monitor by month every -- the survival events that we see, it is variable. But based on what we are observing, we anticipate reaching pivotal data the second half of 2020. So before the end of the year. It's harder -- it's very hard to make a more accurate prediction than that.

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Naureen Quibria, Maxim Group, LLC - Senior Equity Research Associate [14]

Original post:
Edited Transcript of ONTX earnings conference call or presentation 14-May-20 8:30pm GMT - Yahoo Finance

People who grew up at high elevation may be less susceptible to COVID-19, according to study – Vail Daily News

People who grew up at high elevations might be less susceptible to the novel coronavirus, according to arecent study of the virus impactin high altitude communities.

The study, which was published by the Respiratory Physiology and Neurobiology journal, compared case data for the virus among communities in Bolivia, Tibet and Ecuador and found that cities and towns in higher elevations have reported fewer COVID-19 cases.

According to BoliviasMinistry of Health websiteLa Paz, Bolivia, has reported 328 cases of the virus and Santa Cruz, Bolivia has reported 2,300 cases as of Friday. La Paz sits 11,943 feet above sea level with a population of 2.7 million people. Santa Cruz is 1,365 feet above sea level with a population of 1.6 million people. For some context, Breckenridge is 9,600 feet above sea level.

This is data that strongly suggests that high altitude is protective, said Dr. Gustavo Zubieta-Calleja, director of the High Altitude Pulmonary and Pathology Institute in La Paz and one of the researchers on the study.

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When the virus attacks a persons lungs it causes hypoxia, a term used for oxygen deficiency in the body. Zubieta-Calleja said its similar to taking a person from sea level and putting them at the peak of Mount Everest. People who live at high altitude develop a tolerance to hypoxia and this may help them fight the virus, he said.

To take the theory even further, Zubieta-Calleja suggests a potential treatment for the virus could be to increase a persons red blood cell count at the early stages of the disease to simulate the biology of people who already live at high altitude.

You have to increase the red blood cells for people in order to survive the acute phase, the critical, phase of COVID, he said.

Zubieta-Calleja said a doctor would have to inject the hormone erythropoietin into a persons blood, which would stimulate the production of red blood cells.

That way your red blood cells increase and when things get more severe, then you have a reserve of red blood cells, he said.

However, some doctors are skeptical of studies like this one, because there is still so much researchers dont know about the virus.

Dr. Erik Swenson, a pulmonologist from the University of Washington, said the study shouldnt change how people live their lives in the pandemic.

It could be true, but they dont have the information to really tease out whether this is hypoxia that is living at these altitudes or is it a whole host of other factors that are relevant to those populations, he said.

Swenson suggested the ability to widely test COVID patients in these areas varies and other factors such as low pollution, healthier lifestyles and the dispersion of molecules at high altitude might contribute to the low number of cases in high altitude areas.

One of Zubieta-Callejas previous articles suggests that ultraviolet light can act as a natural disinfectant, which might be a possible reason for why less people have the virus in high altitude areas as well.

Researchers also arent sure how long a person would have to live at high altitude in order to develop the tolerance to hypoxia required to prevent COVID.

Summit County physician Dr. Christine Ebert-Santos said people living at high altitude shouldnt use this information as a reason to stop following protocols that prevent the spread of the disease.

Because of all the other factors involved in this infection, we really cant change anything that were doing, she said. We still have to be just as cautious about the contagious virus (and) the presence of a person who could spread the virus.

Ebert-Santos also said that people come from all over in Summit County and tolerance to hypoxia varies from person to person.

Even though we could say these are potential mitigating factors of COVID infection, we cannot promise any individual that they have more protection or they would have a less severe course, she said.

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People who grew up at high elevation may be less susceptible to COVID-19, according to study - Vail Daily News

9 foods that promote relaxation to help you keep calm – CNET

Chowhound

If you're experiencing nervousness, racing thoughts, difficulty getting to sleep or even panic during thecoronavirus pandemic, you're not alone. This is astressful time. It's only natural that we'd feel a little amped and uneasy.

If you're having trouble relaxing, avoidingsugarandcaffeineis a must. These ingredients can further stress our bodies and set us up for anxiety. On the flip side, there are foods that can help support our nervous system, increase our resiliency to stress, and even make us feel calm right after we eat them.

As we move through this crazy time, let's lean on these nine foods that promote relaxation.

A fermented drink that falls somewhere betweenyogurtand milk,kefiris a great addition to your social distancing routine. It can be made from dairy milk ornut milkand contains high amounts of beneficial bacteria, which support a healthy gut microbiome. At first glance, our gut health might seem unrelated to our nervous systems, but it's actually quite the opposite. Studies have shown not only thatstress can alter the microbiomein undesirable ways, but thatanxiety could actually be alleviatedby regulating gut bacteria.

You can drink kefir plain or use it as a creamy base for recipes like in thischilled avocado, cucumber and kefirsoup recipe by Julie Smolyansky.

Fatty fish such assalmonare full of omega-3 fatty acids, which have proven to be extremely beneficial for calming the nervous system. In fact, a systematic review of 19 clinical trials -- published inJAMA Open Network--showed that improvements in anxiety symptoms were associated with omega-3 fatty acid treatment. Try thismaple mustard grilled salmon recipefrom Christine Gallary and add salmon to the menu a few times a week.

Read more:The best places to buy fresh seafood online

Tart cherriescontain high levels of various phytochemicals, including melatonin. You've probably heard of melatonin before; it's known as the "sleep hormone" because our bodies release it in the evening to help us get to sleep. Well,studies have shownthat consuming tart cherry juice increases melatonin levels and can improve sleep quality and duration. If you're having trouble winding down at night, tart cherries might be the perfect food to lean on.

Read more:Other foods that can help you sleep

Have you ever wondered whycucumber wateris so popular? It could be because the smell ofcucumbershas natural stress-relieving properties. And it's not only the smell, either. This low-sugar fruit also contains B vitamins, which help support our central nervous system. In fact,studieshave shown that a B complex vitamin can improve anxiety symptoms compared to placebo.

Plenty of studies have found interesting links between vitamin C and mood. In fact, one study on 42 high school students showed thatvitamin C actually lowered anxiety levels. Citrus fruits -- which includelemons,limes, oranges and grapefruit -- are one of the best ways to get vitamin C in your diet. Here'show to segment citrusfor easy, mess-free eating.

You might not think of Vegemite as a health food, buta study, published in 2018, showed that people who consume yeast-based spreads -- such asMarmite, Vegemite, Promite and Aussiemite -- have lower levels of anxiety and stress. According to the researchers, the B vitamin content in these spreads is likely to thank for their anxiety-reducing powers. To start using Vegemite, try spreading it thinly on one side of agrilled cheese sandwich. It adds a bitter, salty flavor that you may just learn to love.

Onionsare one of the best sources ofprebiotic fiber, which helps to feed healthy gut bacteria. As we now know, a balanced microbiome is essential for optimal mental health. Other sources of prebiotic fiber include leeks,bananas,garlicandapples. Try adding raw onions to salads or whips of thisEasy Caramelized Onions recipefrom Aida Mollenkamp.

Pumpkin seedsare one of the best sources of magnesium, which is often referred to as the "relaxation" mineral and is one of the topstress-relieving nutrients. Many of us are deficient in magnesium, as processed foods are virtually devoid of it. But luckily, pumpkin seeds provide more than 150 mg of magnesium per cup, which is almost 50% of your daily recommended intake. Try thishomemade pumpkin seed milk recipe, from the book Magnesium Everyday Secrets.

Lucky you: Research published in theJournal of Proteome Researchfound that eating about 1 and a half ounces ofdark chocolateper day can actually lead to lower levels of cortisol, which is one of our primary stress hormones. For extra relaxation benefits, dark chocolate also contains significant levels of magnesium. Just make sure you opt for dark chocolate and if you're not sure what to buy, these are thebest dark chocolate barsout there.

Focusing on these foods can help promote relaxation, peaceful sleep, and a sense of calm despite what's going on outside. Luckily, most of these foods are also affordable, delicious and can be prepared in any number of creative ways.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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9 foods that promote relaxation to help you keep calm - CNET

MLB’S Testing Plan Is Thorough, But Does It Pass The Doolittle Test? – Deadspin

Sean Doolittle has a lot to say about MLBs plans to return to action, but how do his concerns align with the leagues?Illustration: Eric Barrow (Getty)

While there are certainly many miles of financial sparring between MLB owners and players to get through before the league can return to play, issues rooted in the players concerns over safety. While a good portion, if not all, being the players anger over the owners reneging on a deal they made in March to pay prorated salaries is simply the owners acting like jagoffs, the players have contended that the owners financial risk is matched or exceeded by the players physical one. Today The Athletics Ken Rosenthal and Evan Dreilich got hold of the 67-page memo that outlines how MLB will handle the physical risk and testing to get the season under way.

It covers most everything you would think, while not going into detail about some other things you would hope for. At least not yet. Sean Doolittle outlined what his concerns were a week ago, and it seems a pretty fair checklist for what MLB is proposing to get players back into uniform. To wit:

What Rosenthal and Dreilich have outlined does not address what MLB will do about long-term effects or ailments due to anyone contracting COVID-19. That of course is something that MLB can address when it comes up, as someone is likely going to test positive. But it would also do the players faith some good to have some sort of plan now for long-term care and effects. Theres enough mistrust as is. And no, certainly infertility and hormone ratios arent addressed either, and you can bet a fair amount of players want to ask but are afraid to. Its a major question, as even a mild case could cause a players career to be in severe jeopardy if those long term lung-scarring conditions occur.

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This is addressed. At least the spring training portion protocol calls for multiple locker rooms, and as many facilities outside as possible. With stadiums remaining empty there are certainly more options than before to be repurposed for this. You could easily envision even stadium concourses that will have no need to house fans used for this. In addition theres a pretty stiff regiment of cleaning and disinfecting for each clubhouse. Spring training, at least to start, will be staggered as to how many players there are at once.

A curious aspect is that for spring training, if teams are going to use their home stadiums and not Florida or Arizona bases, they are encouraged to find minor league or college stadiums to spread out players. But that also means another facility that has to be regularly cleaned and sanitized, as well as testing for additional staff who have to man that venue. This one feels like its probably not going into the final agreement.

This is the meat of what Rosenthal and Dreilich have reported. Players will be tested multiple times per week, and will have an intake screening for spring training wherever that takes place. Players will be tested upon arriving at spring training, and then isolate while awaiting results. The idea here is to start spring training with a clean slate as it were, and to separate anyone who tests positive from jump street. Of course, false positives and negatives will make that nearly an impossibility, but thats the nature of the beast here.

Players will have temperature and symptom checks twice daily at the facilities, as well as be expected to conduct daily temperature tests at home. Any abnormality there will result in rapid-result testing for that individual.

Another concern of many players is the well-being of their families, and thats addressed in that the testing sites for players at their ballparks will be available to players families and area health care workers and first responders. Nothing is mentioned about what happens if a family member of a player tests positive, but one would have to think that a player would have to be quarantined, along with anyone he came into contact with. Of course, that could be a good chunk of or even the entire team.

As far as the amount of testing, spreading it out to the ballpark sites at least pushes it into the neighborhood of doable. A rough estimate of players, coaches, clubhouse staff, stadium staff is about 100 per team. A couple of tests per week for everyone still would be about 800-1,000 per month, which shouldnt deprive cities of tests to people who really need them.

There doesnt seem to be much mention of these folks, which seems to leave it up to the airlines or hotels or bus companies they work for to make sure they get tested. MLB will have to address what kind of assurances are going in both directions for this to work.

MLBs outline here is pretty strict, in that anyone even with a raised temperature wont be allowed on site and will remotely receive treatment from the team physician. The team physician will also direct anyone else who needs to be tested and isolated, as well. Perhaps the size of the roster is meant to address this, but its not a hard leap to envision a team having to keep eight or 10 players in quarantine for two weeks of the season with just one positive test or even one suspicion of infection with a raised temp. And Doolittle is right, and its not addressed yet, is what everyone is going to feel if just one player or team employee becomes dangerously ill. Not just for fear of the virus spreading, but MLB having to answer the question as to why it thought a baseball season was worth having if it meant possibly killing even one person.

Doolittles other concerns about players with compromised immune systems or long-standing conditions, as well as family members such as his own wife, basically are addressed in the rigorous and thorough testing and monitoring outlined here. The hope is that all of it will quickly weed out those that have the virus and keep them from the players and staff that are in more danger than most. But obviously, no system is perfect.

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MLB'S Testing Plan Is Thorough, But Does It Pass The Doolittle Test? - Deadspin

Why your sleep and wake cycles affect your mood – Harvard Health Blog – Harvard Health

Its no accident that most people tend to sleep at night and are awake during the day. Our sleep-wake cycle is determined by our circadian rhythm, the bodys internal clock. Like old-time clocks, this internal clock needs to be reset every day, and is adjusted by first exposure to light in the morning.

Our circadian rhythms are controlled by multiple genes and are responsible for a variety of important functions, including daily fluctuations in wakefulness, body temperature, metabolism, digestion, and hunger. Circadian rhythm also controls memory consolidation (the formation of long-term memories occurs during sleep); the timing of hormone secretion (for example, the hormones controlling body growth work mostly at night); and body healing.

While the circadian sleep phase typically occurs at night, there are a range of times during which the sleep phase can occur, with some people programmed to sleep from early evening to early morning (known as morning larks), while others stay up late and sleep late (known as night owls). In addition to determining the timing of their sleep, a persons circadian tendency can also affect their choice of emotional coping skills, such as assertiveness or rationalization, and their predisposition to psychological disorders.

An irregular circadian rhythm can have a negative effect on a persons ability to sleep and function properly, and can result in a number of health problems, including mood disorders such as depression, anxiety, bipolar disorder, and seasonal affective disorder.

A recent study suggested that the night-owl type might have a greater predisposition to psychological disturbances. The authors found that the different circadian types were likely to have different coping styles to emotional stressors, and the ones adopted by the morning larks seemed to result in better outcomes and fewer psychological problems. This was a correlational study, so the reason for adopting different styles wasnt explained, but this study emphasizes the great impact circadian rhythms have on health and functioning.

Most of the evidence on the relationship between mood problems and circadian rhythm comes from studies of shift workers, whose sleep periods are out of sync with their circadian rhythm. Multiple studies show an increased prevalence of depression in night-shift workers. One meta-analysis showed that night-shift workers are 40% more likely to develop depression than daytime workers. Conversely, circadian rhythm disturbances are common in people with depression, who often have changes in the pattern of their sleep, their hormone rhythms, and body temperature rhythms.

Symptoms of depression may also have a circadian rhythm, as some people experience more severe symptoms in the morning. The severity of a persons depression correlates with the degree of misalignment of the circadian and sleep cycles.

Many successful treatments of depression, including bright light therapy, wake therapy, and interpersonal and social rhythm therapy, also directly affect circadian rhythms. (For the impact of circadian rhythm on the occurrence and treatment of depression related to bipolar disorder, please see this blog post on light therapy for bipolar disorder.)

Misalignment of the circadian rhythm may also provoke anxiety. Shift work results in a sleep disorder when your nighttime work shifts affect your ability to fall asleep and stay asleep, causing you to have excessive sleepiness during the day that in turn results in distress and affects your ability to function normally. Nurses with shift work disorder have increased anxiety scores on questionnaires. In a study on jet lag, in which travel changes the time of the external environment so that it is no longer synchronized with the internal clock and disrupts sleep, travelers had elevated anxiety and depression scores.

In seasonal affective disorder, people feel down and depressed in the winter months. Researchers believe this is due to changes in circadian rhythms as a result of seasonal changes in the length of daylight. People with seasonal affective disorder feel better using artificial morning light to realign their circadian rhythm with their sleep-wake cycle.

There is no way to change your circadian type since it is genetically determined, though there is some natural change that occurs during your lifespan. For example, our circadian sleep phase tends to shift later during adolescence (more owls) and advances earlier as we age (more like the lark).

If you find that your circadian sleep phase is out of sync with your desired schedule, you can either shift your social life to match your circadian rhythm, or try to shift your circadian rhythm to match your social life. It may be easier to try to shift your work and social life to your circadian rhythm: an example would be a person who has a delayed circadian rhythm and likes to sleep late and wake up late switching from a job with a 7 AM start time to a job which allows him or her to start working later around 10 AM. The other option would be talking to a sleep physician and doing ongoing work to try to shift your circadian rhythm to match your work and social life to an earlier wakeup time.

In general, the best way to improve your mood is to get a good nights sleep by matching your circadian rhythm to your sleep-wake cycle. Exposure to light in the morning helps synchronize the clock. Exposure to bright light at night, including bright artificial lights and screen time on laptops, tablets, and phones, can cause disruption in circadian rhythm and may contribute to worsening mood and negative consequences for health.

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Why your sleep and wake cycles affect your mood - Harvard Health Blog - Harvard Health

Blood clots are a silent threat | News, Sports, Jobs – Lock Haven Express

KARLA ANDERSON

Stay-at-home orders during this pandemic, have led to many long hours sitting in front of a computer at an unfamiliar desk or your kitchen table as you work from home or homeschool your kids. Then, you retreat to the couch to hide from the news only to binge-watch an entire Netflix series without getting up from your seat. A sedentary lifestyle isnt healthy, and it could put you at increased risk for developing a blood clot such as a deep vein thrombosis (DVT).

WHAT IS A DVT?

A blood clot is a clump of blood that has changed from a liquid to a gel-like or semisolid state. Clotting is a necessary process that can prevent you from losing too much blood in certain instances, such as when youre injured or cut. When a clot forms inside one of your veins, it wont always dissolve on its own. This can be a very dangerous and even life-threatening situation.

A blood clot in a large vein, usually in your leg, is called a deep vein thrombosis. A DVT can partly or completely block the flow of blood through the vein (causing swelling of the area below) and can move or break off and travel to the lungs. When the clot moves to the lungs its known as a pulmonary embolism and can cause death. A pulmonary embolism requires immediate medical attention.

When you sit for a long period of time, the blood flow to your legs slows down, and when your legs are still and hanging down, blood tends to pool in the muscular beds of the calf. These factors can make it easier for a clot to form and increase your risk for DVT.

SYMPTOMS OF A BLOOD CLOT

Many people that form a DVT never notice any symptoms. Symptoms include:

Swelling of your leg or arm

Pain or tenderness not caused by an injury

Skin that is warm to the touch, with swelling or pain

Redness of the skin, with swelling or pain

As mentioned, individuals with a DVT are at an increased risk for a pulmonary embolism. If you have difficulty breathing, chest pain that worsens with a deep breath, cough blood, or a faster than normal or irregular heartbeat, seek immediate attention.

PREVENTING BLOOD CLOTS

The good news is that blood clots can be prevented and treated if you understand your risk factors and get treatment quickly. Risk factors include:

Advanced age

Birth control methods that contain estrogen or hormone therapy

Cancer and cancer treatments

Chronic diseases such as heart and lung conditions, or diabetes

Family history of blood clots

Hospitalization for illness or surgery

Obesity

Severe trauma, such as a car accident

Smoking

Sitting too long, especially with legs crossed or confined to bed/wheelchair

Your physician will decide what treatment is best for you based on factors such as age, overall health, medical history, extent of the condition and symptoms. Treatment may include any of the following:

Medications such as blood thinners or clot-dissolving medications

Vena cava filter inserted to catch clots, usually only recommended for patients unable to take medication and blood thinners

Simple lifestyle modifications can help reduce your risk. Some simple tips to keep your blood flowing include:

Take short walk breaks as often as you can. Try taking a phone call on the go or using a headset so you can move freely around the home.

Try chair exercises. Simple leg raises, ankle flexing, and calf raises are low-impact ways to keep blood circulating.

Make time for play. When your work is done, include time to get active. Go for bike ride, walk with your family, or even play hide-and-seek with your kids in the yard its all about movement.

Its important that you understand how your lifestyle plays a role in your health. Talk with your doctor about your risk for blood clots and what you can do to prevent them.

Karla Anderson, MD, is a vascular surgeon with UPMC. She sees patients at the Heart & Vascular Institute, 740 High St., Suite 3001, Williamsport. For more information on blood clots and vascular health, visit UPMCSusquehanna.org/Vascular.

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Nutritionists Say These Are the Best Gummy Vitamins – Yahoo Lifestyle

Taking vitaminsseemed much more exciting when we were children. From the Flintstones brand to fruity liquids to gummies, getting your nutrients was much more of a treat than a task. Cut to two decades later, and vitamins are way less alluring. The good news is that gummies aren't just for kids anymorein fact, adult gummies have been on shelves for a long time, and their increasing popularity has encouraged more brands to jump on the bandwagon, making vitamins an enjoyable part of our day once again. Below, we interviewed a few top nutritionists and wellness experts and asked them to share the best gummy vitamins.

Take a look at what they had to say below.

Vitafusion Women's Supercharged Multi ($10)

"Vitafusion's SimplySupercharged Multivitamin is a good one," says Alissa Rumsey, MS, RD, founder of Alissa Rumsey Nutrition and Wellness. "You only need to take two gummies a day, and it only has three grams of sugar. It also has the simplest ingredients in the vitamin as well as having a good amount of vitamin D and B. Vitamin D is especially good for the winter months and for people who do not get a lot of sun on a daily basis."

Nature Made Vitamin C ($18)

"I prefer Nature Made gummy vitamins," says Lisa Moskovitz, RD, CDN. "They are USP verified, which means they are tested and meet specific requirements set out by the United States Pharmacopeia."

Olly Flawless Complexion ($14)

The Olly brand utilizes the research and savvy of naturopathic physician Taryn Forrelli, ND, who says that theseskin-geared gummies "deliver purifying antioxidants and minerals to support cell detox, hormone health, and proper metabolism, plus a concentrated botanical blend of spearmint, Aronia berry, and dandelion."

Hum Nutrition Hair Sweet Hair ($25)

Sarah Greenfield, RD, loves theseHum gummies because of their proven ingredients. "Some key nutrients include biotin, or B7, which helps the body break down proteins needed for hair growth," she explains. "One study found women experiencing hair loss had a biotin deficiency and adding biotin supplements helped increase hair growth. Zinc plays a role in immune function and also helps maintain the health of hair follicles, leading to the growth of healthier hair.Fo-ti, a Chinese herb is included to help decrease graying by increasing melanin (hair pigment) production."

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Nordic Naturals Omega-3 Gummy Fish ($30)

WhileAmy Shapiro MS, RD, CDN, advocates forgummy vitaminsprimarily for children or adults who have trouble swallowing pills, she's a fan of theNordic Naturals brand for gummies, especially its omega-3 blend. It's ideal for those with picky palates or vegetarians (eggs and fish like salmon, herring, and mackerel are high in omega-3).

Rainblow Light Rainbow Light Sunny Gummies ($27)

Shapiro is also a fan of the brand Rainbow Light and recommends its gummy varieties. They're totally natural with no artificial flavors, colors, or preservatives.

MyKind Organics Women's Multi Organic Fruit + Vitamin Chews ($25)

"I generally stay away from recommending gummies to clients as nutritional supplementation because many brands are actually packed with artificial ingredients and loads of sugars. However,Garden of Life brand makes the cleanest organic and non-GMO gummies on the market! Not to mention, it makes a variety for men, women, and kids that are loaded with necessary vitamins and minerals. Well done, Garden of Life!" says Dana Kofsky of Wellness Styled.

SmartyPants Adult Complete Daily Gummy Vitamins ($21)

"I absolutely adore SmartyPants gummy vitamins!The brand isorganic, sustainable, taste amazing and are family-owned.It makes it oh so easy to live sustainably by using post-recycled materials inits bottles in an effort to do itspart in protecting our planet. It is so important to trust in a brand and know that you are helping the planet along the way. SmartyPants has truly been an amazing part of me and my kids' daily routine for years," says Lo Roxburgh, author and wellness expert also known as the Body Whisperer.

Gem Daily Vitamin Subscription (one month) ($39)

Shauna Faulisi, a holistic nutritionist and founder of Soul Wellness Method in Los Angeles, doesn't recommend gummy vitamins as a first step to a healthy diet, preferring her clients to get vitamins and minerals through vegetables, clean fats, and proteins, and taking specific supplements based on their individualized needs. But she understands there may be limitations: "I know that it's not always possible to purchase and get on a regiment with many different supplements to take based on schedule, access to fresh foods, and monetary resourcesand I think one should embrace whatever added wellness regimen they can bring into their life, large or small, and feel proud about it!" she says. "My go-to recommendation for gummy vitamins are GemThe brand uses dates as a binder and sweetener, along with fiber and omega-filled chia seeds to bind.Gemhasa variety of vitamins and minerals as well as the adaptogen ashwagandha to help ease stress. It also hasone of my favorite anti-aging ingredients, the powerful antioxidant, astaxanthin. Gem is an incredibly well-thought-out daily supplement that uses only the purest, whole food ingredients to get the job done."

Next up: No Lie: These Vitamins Will Make Your Hair, Skin, and Nails Flawless

This post was updated by Sarah Yang.

This article originally appeared on The Thirty

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