Archive for the ‘Hormone Physician’ Category

Jamie Prock, RN-BSN, is an OB Nurse currently practicing within the Indian Health Service.

One of the biggest topics I encounter surrounding labor and delivery is induction of labor. I sit and listen to the process be explained, but I consistently admit patients for induction that remain confused or simply have unrealistic expectations of this process. I am going to break it down for you.

First things first, just like no child you have will be exactly likethe other; no pregnancy will go the same either. Induction and delivery are no exception to this rule. If you have had children previously, I do suspect that you have some knowledge of this process, but please understand that medicine and recommendations are constantly evolving. The process will likely not be the same twice. That being said, let us dive into what exactly induction of labor means.

Induction of labor is simply a process designed to push your body into labor. Labor is achieved in a variety of ways and using different mechanisms. During the natural process, the cervix begins to efface, or thin out, and start to dilate, or open. This process is preparing to allow the baby to travel through the birth canal and be delivered. With an induction, your physician or midwife, and your labor nurseprovide medications to assist in this process.

Depending on where your body is in the process will determine how your induction begins, continues, and progresses. If your body has done some of the work on its own, it is possible that you just need the body to begin having adequate contractions. If it has not, cervical ripening is the starting point. Cervical ripening is a term that refers to the process of effacing. As the cervix effaces, it will also begin to open. This is generally accomplished either mechanically or with medication.

Cervical ripening drugs include cervadil, or dinoprostone. This vaginal insert stays in place for 12 hours. Cytotec is a medication that can be taken orally or placed vaginally during this process. Of note, Cytotec is also given rectally in the case of post-partum hemorrhage. Mechanical means of ripening are a cooks catheter, also known as a Foley bulb. This is inserted into the cervix, designed to mechanically cause dilation and effacement. It will usually come out on its own when the cervix is dilated to four or more. These are the most common forms of cervical ripening.

After ripening has been achieved, Pitocin is usually started. Pitocin is a synthetic hormone designed to mimic the natural hormone, oxytocin, which is produced by the body. Pitocin is started at a low rate and gradually increased until adequate labor is achieved. The purpose of this drug is simply to cause contractions. The contractions will continue to push the baby down and open the cervix until dilation is complete and you are ready to push.

RELATED:10 Things To Know About Getting Induced For Labor

As you can see, induction of labor is a process. Natural labor is also a process. Both processes can take some time and do not happen quickly. This is one of the most common misconceptions of induction. For the record, there is no magic pill to make you instantly have a baby. This process could be quick, as in hours, or it could take a few days. A long induction does not mean it is not working, simply taking longer. Make sure you are ready, have realistic expectations, and ask questions when you are having an induction.

How To Cope With Pregnancy While Also Going Through A Divorce

Jamie Prock, RN-BSN, is an OB Nurse currently practicing within the Indian Health Service. During her career, she has worked at various locations throughout the Oklahoma and Arkansas region. She obtained her A.A.S. in Nursing from Bacone College in Muskogee, OK. Then went on to receive her B.S.N. from Oklahoma Wesleyan College in Bartlesville, OK. Prior to her education in the Nursing Profession, she attended the University of Arkansas with a Journalism major. After giving birth to her first son, she decided she wanted to be a labor and delivery nurse. Mrs. Prock also teaches nursing students part time at Rogers State University. She is a Fetal Monitoring Instructor for AWHONN. She continues to work on her Masters in Nursing while working full time. She is married to Russell, and together they have six children with a grandchild on the way. In her spare time, she enjoys spending time with her family, listening to music, journaling, and cooking.

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What Does Induction Of Labor Mean? | BabyGaga - BabyGaga

Body stiffness is frequent when waking up within the morning. But taking it evenly could be overwhelming. There could be main causes behind the frequent ache within the joints, Swati Sharma is telling

If I bear in mind the time earlier this yr, I used to look at my grandmother's agility. In the morning, I and I needed to rise up as nicely. If the mom ever complained of backache, she used to get taunted, she has develop into older than us.

->When I used to be of mom's age, I too began complaining of backache or joint ache like her. The stiffness and joint ache of the physique is not seen by taking a look at age. In the morning it takes about fifteen minutes to maintain the toes down from the mattress after opening the eyes. Sometimes the shoulders are stiff, generally the heels are moaning in ache. The knee turns and the knee begins to reply. In the span of twenty years, the tempo of each life and illnesses has develop into very quick. These stiffness and ache occurring within the morning inform some story, you additionally hear:

These are the indicators of illnessesMorning stiffness in joints is a direct indication that youve began having bone issues. How critical the issue is is a matter of investigation. Anoop Agarwal, an orthopedic physician, says that if the stiffness happens in lots of joints, a person might develop systemic inflammatory illness. The poisonous substances current within the blood concurrently have an effect on many joints. These sorts of illnesses are often susceptible to a number of sorts of arthritis resembling rheumatoid arthritis, seronegative arthritis. This downside is discovered extra in ladies than males.

Males are usually extra prone to have ankylosing spondylitis. There is stiffness within the muscle mass of the waist, neck or again. Plantar fasciitis causes ache on account of swelling within the ankles, particularly within the morning. This sort of ache will get higher after waking up within the morning. Uric acid additionally has an necessary position in the issue of stiffness and joint ache that happens after waking up within the morning. Many sorts of issues happen even when uric acid will increase within the physique. Joint ache is one in all them. If uric acid doesnt come out of the physique, then it begins gathering within the type of crystals within the joints.

Catering and way of life is accountableOur meals and way of life are quickly altering like a gadget's specialty. Due to this, the issues occurring on the age of 60 have began to happen on the age of 40. Outside meals has develop into part of our way of life. Our behavior of solely giving significance to services has distracted our consideration from well being. Dr. Anoop says that the meals that involves the door, we have no idea. Apart from this, on account of haste and style, weve adopted junk meals a lot that the physique doesnt get sufficient diet. Regular consumption of such meals will increase the quantity of poisons within the blood. It is critical to grasp right here that the dietary supplements discovered within the drug shops can not compensate for the pure diet from the meals gadgets. Apart from this, the wasteful way of life can also be liable for this stiffness within the physique. Due to the ever growing busyness, our relationship with train and nature is sort of damaged. Staying indoors, not getting sufficient daylight and ineffective timetable for sleep are additionally liable for bone and muscle issues.

Some steps in the direction of therapy'The downside is handled by controlling its causes. Whether its hormone modifications or diet, its worthwhile to take note of your meals. You should determine that the physique will get all types of vitamins in enough amount. Many occasions weight-reduction plan to handle the determine additionally reduces diet. To drop some pounds, its higher to have a balanced food plan and train repeatedly.'Lack of calcium within the physique can also be liable for joint ache. To overcome this deficiency, you may take calcium and vitamin-D dietary supplements with the recommendation of a health care provider. Try to take vitamin-D naturally. Vitamin-D works to hold calcium within the physique to the bones. Due to deficiency of vitamin-D, calcium is wasted contained in the physique. For this, each morning spend 20 minutes in daylight in 50 % open physique. No matter how busy the life-style is, dont forget to take a 30-minute stroll. Blood circulation is sweet by taking a stroll and the toxins dont accumulate within the physique. 'Do not take the stiffness within the physique evenly within the morning. Seek medical recommendation earlier than it turns into a major problem. Use the information with fomentation and oil therapeutic massage as per the recommendation of the physician.

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These causes could also be behind the frequent joint ache - Sahiwal Tv

Arizona Republican lawmakers are pushing a bill to effectively ban transgender girls from interscholastic sports.

A coalition of over 150 businesses is opposing a bill currently being considered by the Arizona state House of Representatives that would impose invasive medical exams on transgender girls who want to play sports.

One Community, a coalition of LGBTQ-friendly Arizona businesses and individuals, announced on Wednesday that the Arizona Diamondbacks, the Arizona Lodging & Tourism Association, the Arizona School Boards Association, and TechNet had all signed on to a letter in opposition to the bill, along with law firms, restaurants, media companies, resorts, and a yoga studio.

They are all concerned that the bill, H.B. 2706, authored by Republican state Rep. Nancy Barto and co-sponsored by 22 of her GOP colleagues, would effectively prevent transgender girls from participating with interscholastic or intramural girls teams.

If a kid's gender were ever disputed, the bill would require a kid who's gender was disputed to provide a signed physician's statement that "indicates the student's sex based solely on all" of three factors: their "internal and external reproductive anatomy," a measurement of their "endogenously produced levels of testosterone," and an "analysis" of their genetic makeup.

The bill, which stipulates that "athletic teams or sports designated for females, women, or girls may not be open to students of the male sex," would block a student from participating who couldn't provide a physician's statement meeting the strict criteria.

Barto named the bill the "Save Women's Sports Act." A national anti-trans group has been pushing similar bills in other states.

"Science is what it is," Barto told a local newspaper earlier this month. "The difference between males and females is obvious."

But one parent disputed this during a legislative hearing earlier this month. She noted that many trans kids who transition before puberty, including her own daughter, do not produce the male hormones that could provide an athletic advantage and others take hormone-suppressing drugs.

"Gender is far more complex than our genitals," she told the lawmakers.

The ACLU of Arizona opposes the bill and warned on Monday: "AZ's #HB2706 would subject girl athletes to invasive examinations such as: -a physical exam of the childs genitals, -a blood test, -and genetic testing".

"Girls should not be subjected to ANY of these over-the-top invasive medical exams in order for them to play sports," the ACLU said.

Still, the House Rules Committee voted on Wednesday to send the bill to the full House.

Republicans hold a majority in both chambers of the Arizona Legislature, and because Gov. Doug Ducey (R) has a history of opposing LGBTQ rights, it could well become law.

But Arizona businesses have reason to worry about the bill's impact if it does beyond how much it would harm student athletes.

In 2014, the GOP-controlled legislature passed S.B. 1062, a bill which would have allowed businesses to discriminate against LGBTQ people as long as they cited religious beliefs. Amid threats of an economic boycott of Arizona, then-Gov. Jan Brewer, a Republican, vetoed the bill.

Since that time, boycotts of other states over their new anti-LGBTQ laws have caused significant economic impact. After North Carolina passed its infamous "bathroom bill" in 2016, the state lost tens of millions of dollars in business. One 2017 analysis before that law's partial repeal predicted more than $3.76 billion in lost business for North Carolina over a dozen years.

Published with permission of The American Independent Foundation.

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New GOP bill would require invasive medical exams of trans kids who want to play sports - The American Independent

JACKSONVILLE, Fla. A few years have passed since Deidra Radel was a young woman proudly wearing her Navy uniform. As a mom and wife, her life was going great.

Then-- in her early 40s -- she found herself stuck with the awful symptoms of menopause. Hot flashes. Night sweats. Draining fatigue. Radel went to a doctor in South Florida and was given a type of Hormone Replacement Therapy (HRT), which went under her skin.

"It was terrible! I looked like a teenage boy," she said. She actually took selfies of all the acne that hit her to document the bad results of the HRT.

"I wanted to cry," she says.

Turns out she got an incorrect mix of hormones in her HRT, but the experience was so bad Radel figured she would just deal with her symptoms and never try HRT again.

Radel

Then she heard about an internal medicine physician at Mayo Clinic Jacksonville, Dr. Jackie Thielen. She came to Jacksonville from Mayo Rochester as an expert on women's health issues. Radel had a long meeting with Thielen, and she wound up taking a customized treatment of HRT.

Does she have any symptoms at all now? Hot flashes? Fatigue? Horrible night sweats?

"No. No. No!" Radel said. She's back to full steam with her family. In fact, she agreed to share her story to encourage other women to talk with their doctors and not just suffer from menopause.

Radel

The message to all women? In Thielen's words: "Women do not have to suffer in silence."

Here are some facts about menopause from Thielen:

When a woman goes 12 consecutive months with no periods

"But really menopause can occur between ages 40 and 58," Thielen said. "A woman can experience symptoms leading up to the actual menopause for years."

Thielen points to current research that says some women need estrogen or some form of HRT early on after menopause to cut down their risk of medical troubles.

Thielen says a study, which hit the news in 2002, made women and some doctors frightened of HRT. She says the bad rap continues. "We're trying to change that," Thielen said.

Some women may need to avoid HRT. Those may include particular forms of breast cancer. Women with a certain history of blood clots may need to steer clear as well but even in those cases there could be safe ways to take HRT.

For example, Dr. Thielen says anti-depressants are showing solid results in stopping hot flashes. It doesn't mean you're depressed. "It's all about brain chemistry," Dr. Thielen says.

A Woman's Health Specialty Center will open this spring at Mayo Clinic in Florida. It will provide a team approach for the evaluation, diagnosis and treatment of women's unique needs. Those include:

For more information on menopause click hereand here.

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Hot flashes: How this veteran won the battle against menopause - FirstCoastNews.com WTLV-WJXX

for The month of march is Endometriosis Awareness Month. The world is to draw attention to the relatively unknown, yet common disease areas. 200 million women around the world suffer it, and in the united kingdom, the disease is common. The disease is in the taboesfeer, " says physician and researcher Esther van Barneveld, and that is if they want to stop it. Six questions about endometriosis.

"Endometriosis is a chronic disease. Tissue on the lining of your womb, it is in areas outside the uterus (womb). It is usually found in the peritoneum or the organs in the abdomen. It is also found in the vagina, a scar from an emergency c-section. It is a tissue that grows, it creates chronic inflammation, and that gives you different problems."

"this can range from no symptoms to, in extreme abdominal pain, particularly during menstruation. If the endometriosis on the bowel wall, it may also have problems to give. Or, in the bladder, for example, blaasklachten. Some women have pain during intercourse. Women with endometriosis may be less fertile. This can be the result of growths, and adhesions of the fallopian tubes, and ovaries."

"Worldwide, approximately one in ten women suffers from endometriosis. In the Netherlands, it is estimated that around 400,000 are women. Endometriosis is as common as diabetes and rheumatoid arthritis. However, you can hear most of the time, something about it. As the impact is huge and can be. The quality of life for women with endometriosis is often significantly lower than in women who don't have it."

"Women have to think for yourself is the pain in the menstrual period should. Also, general practitioners and specialists to prescribe for the symptoms are often at a 'normal' menstrual pain. In some cases women are frightened, as aansteller to be seen, and they dare not complain to get out. The diagnosis is, on average, only every eight years. That is why it is important to keep the veil on for endometriosis, to stop it."

"to be The most effective treatment for endometriosis is hormone therapy, that is, the menstrual period is suppressed, such as the oral contraceptive pill, or have a hormoonspiraaltje. It does, however, mean that women have during this treatment can not become pregnant. In addition, the hormonal treatments that often have side-effects.

"Women who do not have the hormones capable of, or willing to use, and are most dependent on pain killers. An exploratory surgery in which endometriosis is removed, is sometimes a possibility, but the symptoms are often not clear. Up to 75% of the patients after surgery symptoms to keep. How can this be, it is still not clear. There is a research need."

"all Kinds of organizations, including the national Endometriosis Foundation, which is committed to the endometriosis is known to do. There is also research being done; for example, we are in the Centre of excellence for Endometriosis in Maastricht, responsible for the development of a patintenapp. That can help you with the research, and, at a later stage in the process of monitoring the disease and evaluating the treatment. The app measures the action in real time, taking into account the factors that may have an impact on pain, such as diet, sleep, and stress."

"with The knowledge we can apply it in the treatment. This leads to faster and improve the quality of care that the person is focused, and thus more. We can also test whether a new treatment is effective, or yoga or any other therapy, for example, can help."

now, Of Barneveld, is a physician-researcher at the Centre for Endometriosis of the Maastricht university medical centre (UMC+) and GROW School for Oncology and Developmental Biology.

Link:
Pain due to disease in endometriosis: Women think that they are hiring' - Celeb's Net

From Family Features

Michele Adams is quick to say, I dont want to throw anyone under the bus, but it took her being hit by a car for her thyroid disease to finally be diagnosed.

Adams has always been an active person, but for a few years, she had felt tired and had a constant tightness in her throat. She was diagnosed with post-nasal drip but did not feel relief after a year of treatment.

I thought this exhaustion, hoarse voice and lump in my throat were just my new normal, Adams said. Id accepted it, and I shouldnt have.

During this time, Adams went on a bike ride in northeastern New Jersey something she still does frequently. However, on this day, Adams was struck by a car as she was biking.

The incident resulted in an MRI scan. Adams was not seriously injured, but doctors noticed something unexpected. The scan revealed nodules in her lower neck, which suggested thyroid disease.

I now realize I had symptoms of a thyroid condition for years, Adams said. Id had it up to here with not feeling like myself. Once I had the MRI results, I knew to seek out a thyroid expert, and I found an endocrinologist.

Thyroid disease is more common than diabetes and heart disease, but more than half of Americans with thyroid disease are unaware, according to the American Association of Clinical Endocrinologists (AACE). This lack of awareness can endanger a persons health and well-being.

The thyroid is a butterfly-shaped gland located low in the front of the neck below the Adams apple. It produces thyroid hormones that influence almost every cell, tissue and organ in the human body.

Common signs of thyroid diseases include:

Cheryl Rosenfeld, D.O., is a thyroid expert and AACE member. Rosenfeld is also the physician who treated Adams thyroid disease.

If the thyroid does not function correctly, it can affect every possible aspect of a persons life, Rosenfeld said. Remember that thyroid conditions can cause changes in mental health, including depression. Ive also spoken to patients whove experienced an inability to concentrate, which seriously affected their performance at work.

Several disorders can arise if the thyroid produces too much hormone (hyperthyroidism) or not enough (hypothyroidism).

Other thyroid diseases include:

Undiagnosed thyroid issues can also place a person at increased risk for heart disease, osteoporosis, infertility and other serious conditions.

Once I was placed on treatment for Hashimotos and hypothyroidism, my life changed completely, Adams said. My throat is no longer sore, and Im able to go out with my family or spend time at the gym without feeling completely drained of energy.

The first step to ensure your thyroid gland functions properly is to speak with a health care provider about your symptoms and whether a thyroid test is needed.

Anendocrinologistis aspecially trained doctor who is qualified to diagnose and treat hormone-related diseases and conditions, including thyroid cancer and all other diseases related to the thyroidgland.

Visitthyroidawareness.comto learn more about thyroid health.

SOURCE:American Association of Clinical Endocrinologists

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It Impacts Weight, Sleep and Mental Health... - The Apopka Voice

A similar but much larger case series (also authored by the medical advisor to Abortion Pill Rescue and medical director of Culture of Life Family Health Care) reports that it was approved by an institutional review board. It still remains deeply flawed, according to experts. This series, published in Issues in Law & Medicine in 2018, looked at data from 754 pregnant people who called an unspecified hotline between June 24, 2012, to June 21, 2016, and explained that they had taken mifepristone but not misoprostol and were interested in continuing their pregnancies. Just over 200 potential participants were excluded for various reasons, like deciding to continue with the abortion or a lack of follow-up. Out of the 547 participants included in the analysis who received progesterone, 257 gave birth, but again, that doesnt translate into scientific proof that abortion reversal works. There was no consistency in terms of where or how the patients received progesterone, how far along they were in the pregnancy, or whether or not they had an ultrasound before the reversal to confirm if there even was still a viable embryo present.

Trying to base medical protocols and legislation on this kind of fundamentally flimsy research goes against both science and the moral responsibilities of health care providers.

Elizabeth Nash, senior state issues manager at the Guttmacher Institute, says that abortion reversal laws are such an example of overreach that reproductive advocates were surprised to see more states propose bills after Arizonas got shot down in 2016.

On top of creating a policy based on incomplete evidence, these laws get into a very important question on informed consent, Nash tells SELF, explaining that no ethical physician would move forward with an abortion unless they were absolutely sure of their patients choice.

I cant emphasize strongly enough that when people enter an abortion facility, the only thing on the providers mind is whether this decision and process is what a woman clearly wants, Lisa Harris, M.D., Ph.D., a professor of obstetrics-gynecology and medical ethics at Michigan Medical at the University of Michigan in Ann Arbor and coauthor on the abortion regret systematic review mentioned earlier, tells SELF. It was already an ethical breach to offer [abortion reversal] care, and now its even more so because there are legitimate safety concerns. If someone in my community offered this, I would say it is outside the bounds of whats considered efficacious and safe.

Bonnie Steinbock, Ph.D., a professor emerita of medical ethics at Albany/State University of New York, agrees, telling SELF, I dont think [theres] any justification for offering something, much less mandating that doctors [provide it], when they simply dont know what the safety of the thing theyre offering is.

Drs. Harris and Grossman have concerns regarding how these laws might influence patients decisions if they incorrectly believe abortion reversal is actually possible.

It could mislead some women into thinking they dont have to be 100% sure of their decision because they could just change their mind after taking the pill, Dr. Grossman says. He compared these laws to recent bills attempting to require physicians to re-implant ectopic pregnancies, which he and Dr. Creinin say is biologically impossible.

Both types of legislation mandate medical treatment that is completely unproven and potentially dangerous, Dr. Grossman says. Thats the new fact of the anti-abortion movement, and thats very concerning. I cannot think of another example where, essentially, legislators are making up a treatment or basing it on the poorest quality evidence. Its only related to abortion where we allow that to take place.

The question now is how lawmakers will react to new worries about the risks of trying to reverse an abortion.

I really hope that the well-being of people seeking abortion is first and foremost in the hearts and minds of legislators, and that with this new evidence, they might reconsider the requirement, Dr. Harris says. If legislators are unwilling to consider that, its going to be increasingly hard for me to imagine that laws like that come at all from compassion for people seeking abortion care.

Related:

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No, Its Not Medically Possible to Reverse Abortions - Self

Dr. John Haygarth knew that there was something suspicious about Perkinss Metallic Tractors. Hed heard all the theories about the newly patented medical deviceabout the way flesh reacted to metal, about noxious electrical fluids being expelled from the body. Hed heard that people plagued by rheumatism, pleurisy, and toothache swore the instrument offered them miraculous relief. Even George Washington was said to own a set. But Haygarth, a physician who had pioneered a method of preventing smallpox, sensed a sham. He set out to find the evidence.

The year was 1799, and the Perkins tractors were already an international phenomenon. The device consisted of a pair of metallic rodsrounded on one end and tapering, at the other, to a point. Its inventor, Elisha Perkins, insisted that gently stroking each tractor over the affected area in alternation would draw off the electricity and provide relief. Thousands of sets were sold, for twenty-five dollars each. People were even said to have auctioned off their horses just to get hold of a pair. And, in an era when your alternatives might be bloodletting, leeches, and purging, you could see the appeal.

Haygarth had a pair of dummy tractors created, carved carefully from wood and painted to resemble the originals. They were to be used on five unsuspecting patients at Bath General Hospital, in England, each suffering from chronic rheumatism. Using the lightest of touches, the fakes were drawn over the affected areas, with remarkable results. Four of the five patients declared that their pain was relieved. One reported a tingling sensation that lasted for two hours. Another regained the ability to walk.

The following day, Haygarth repeated his test using the true metallic tractors, with the same results. Other physicians soon followed his lead, using increasingly elaborate fakes of their own: nails, pencils, even old tobacco pipes in place of the tractors. Each brought the truth more clearly into focus: the tractors were no better than make-believe.

This humble experiment wasnt the only one of its kind. By the start of the nineteenth century, experimentation had already driven two centuries of significant changes in science. The Royal Society of London, the scientific academy of which Haygarth was an elected fellow, began insisting that all claims needed to be verified and reproduced before they could be accepted as scientific fact. A shakeup was under way. Astronomy had split off from astrology. Chemistry had become disentangled from alchemy. The motto of the society neatly encapsulated the new spirit of inquiry: Nullius in Verba. Translation: Take nobodys word for it.

Physics, chemistry, and medicine have had their revolution. But now, driven by experimentation, a further transformation is in the air. Thats the argument of The Power of Experiments (M.I.T.), by Michael Luca and MaxH. Bazerman, both professors at the Harvard Business School. When it comes to driving our decisions in a world of data, they say, the age of experiments is only beginning.

In fact, if youve recently used Facebook, browsed Netflix, or run a Google search, you have almost certainly participated in an experiment of some kind. Google alone ran fifteen thousand of them in 2018, involving countless unsuspecting Internet users. We dont want high-level executives discussing whether a blue background or a yellow background will lead to more ad clicks, Hal Varian, Googles chief economist, tells the authors. Why debate this point, since we can simply run an experiment to find out?

Luca and Bazerman focus on a new breed of large-scale social experiments, the power of which has already been demonstrated in the public sector. As they note, governments have used experiments to find better ways to get their citizens to pay taxes on time, say, or to donate organs after death. N.G.O.s have successfully deployed experiments in developing countries to test the effects of everything from tampons to textbooks. The impact of a simple experiment can be dramatic, particularly in monetary terms.

A few years ago, if you searched for eBay on Google, the top two results would take you directly to the auction sites home page. The second one was produced organically by the Google algorithm; the first was an advertisement, paid for by eBay and meant to pop up whenever its name appeared as a keyword in someones search.

Steve Tadelis, a professor of economics at the University of California, Berkeley, was spending a year at eBay at the time, and was suspicious about the value of placing such ads. Wouldnt people get to eBay anyway if they were searching for it, without the sponsored results? But, as Luca and Bazerman recount, eBays marketing group defended the millions of dollars spent on the ads each year, noting that many people who clicked on them ended up buying things on eBay.

An experiment was in order. By turning Google ads on and off, Tadelis and his research team tracked the traffic coming to their site and discovered thatas Tadelis had suspectedmuch of the money eBay had been shelling out was wasted. The marketing team had an exaggerated notion of how valuable those ads were: without the sponsored result, searchers would simply click on the free organic links instead. The company could (and did) save itself millions.

Theres an important point in all of this: instead of going by our possibly unreliable intuition, we can, in a range of cases, know for sure whether an intervention has an effect by running a trial and collecting the evidence. Its a step that Esther Duflo, who shared a Nobel Prize in Economics for her work using experiments to study how global poverty can be alleviated, makes a particularly strong case for. Without gathering and analyzing the evidence, she has said, we are not any better than the medieval doctors and their leeches.

The most reliable way to test an intervention is by using a type of experiment known as a randomized controlled trial (R.C.T.). You randomly assign subjects to groups and then treat each group differently. One group will receive the intervention, while another, the control group, will not. Control here is key. The aim is to make the groups as similar as possible, to constrain as many variables as you can manage, because if the only thing allowed to change freely is the intervention itself you can study its true effect. In the tech world, the intervention might simply be a different Web-page layout or a new pricing plan. Here, the usual term is A/B testing, but the objective is the same: to create some basis for comparison.

Such studies tell you whether something works, though not why. Haygarths experiment wasnt a randomized trial by modern standards, but he nonetheless proved the power of experimenting: by directly comparing the experiences of patients on the day they got treated with the tractors with their experiences on the day they were treated with the fakes, he could show that the tractors were duds. The second set of observations served as a kind of control group.

Without a properly randomized control group, there is no real way to measure whether something is working. Take the case of the Scared Straight program, developed in the United States to discourage at-risk kids from choosing a life of crime. The theory seemed sound. By taking young offenders on organized visits to prison and allowing them to meet murderers and armed robbers, theyd see the terrifying consequences of breaking the law, and be less likely to do so themselves in the future.

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Big Tech Is Testing You - The New Yorker

When asked to picture someone having a heart attack, many people would imagine a man clutching his chest in sudden pain and dropping to the ground. However, this scenario isnt always accurate. In women, heart attack symptoms are often more subtle.

Women and men differ when it comes to heart health. Its important for women to understand our unique symptoms and cardiovascular concerns, so we can recognize when were at risk and take steps to protect our health.

In the United States, cardiovascular disease is the leading cause of death for women, causing one in three deaths each year more than all cancers combined. While chest pain is the most common symptom of a heart attack, its often not very severe in women.

In fact, sometimes it may not even be the most noticeable symptom. Women are more likely to experience pain in other areas, such as the neck, jaw, shoulder, arm, upper back or abdomen.

In addition, women frequently experience other symptoms, including shortness of breath, nausea or vomiting, sweating, lightheadedness, unusual fatigue, indigestion or palpitations. Women also tend to experience symptoms more often at rest, or when asleep, compared to men.

Also, certain heart conditions are exclusive to women. One of those conditions is peripartum cardiomyopathy, which is weakening of the heart muscle during pregnancy or shortly after delivery.

Women and men share many of the same risk factors for heart disease, including high cholesterol, high blood pressure, diabetes, smoking, family history of heart disease and obesity.

However, there are risk factors that affect women specifically. These include postmenopausal state, hormone replacement therapy as well as pregnancy complications like preeclampsia or gestational diabetes. Also, inflammatory disorders like lupus and rheumatoid arthritis can impact womens cardiovascular risk.

The good news is we have more treatment options now than a decade ago, from heart disease prevention and management to surgical cardiac procedures.

Two recent developments were working with at Tower Health Medical Group are the MitraClip, a percutaneous procedure to treat leaky mitral valve, and the Watchman procedure, which helps prevent stroke in patients with atrial fibrillation who cannot take blood thinning medications.

We can reduce the risk of heart disease by living a healthy lifestyle. Its important to quit smoking, exercise regularly, eat a healthy diet, manage your stress, limit alcohol intake and take medications as prescribed.

In addition, know your numbers: blood pressure, cholesterol level, blood glucose level and weight. Work with your doctor to understand whats too high or too low and how to keep them within normal range.

When it comes to heart health, time matters. Taking preventive steps now and catching problems early will help. Make sure you schedule an annual wellness visit with your physician. This is the most important step in cardiovascular screening.

During the visit, your physician can review your individual risk factors of heart disease, check weight and blood pressure and discuss screening blood tests. Women with increased cardiac risk may require additional testing or referral to cardiologist.

Be proactive and take control of your health. Not only will it help your heart, but itll boost your overall well-being.

Agnieszka Mochon, M.D., practices cardiology with Tower Health Medical Group.

More:
Boosting women's heart health takes more than wearing red - Reading Eagle

Spring is around the corner, and with it comes the start of Daylight Saving Time.

DST is one of the oddest times of the year. It begins the second Sunday in March at 2 a.m., so this year on Sunday, March 8 the clocks will be turned ahead one hour. It ends Nov. 1 when we fall back an hour and return to Standard Time.

Some people find it difficult to adapt to DST because by moving the clocks back or ahead we gain or lose an hour of sleep. It also means work schedules and other events change their time.

It might seem inconsequential at first, but DST messes with your body clock and it can take about one week for the body to adjust to new schedules and times for sleeping, eating and other activities, according to the Centers for Disease Control and Prevention.

The reason for this is a disruption in the circadian rhythm. Also known as your sleep/wake cycle, the circadian rhythm is a 24-hour internal clock that cycles between sleepiness and alertness at regular intervals.

Basically the circadian rhythm communicates to the brain when we should sleep and when we should be awake, says Dr. Alison Lima, a board certified family medicine physician at WellSpan Family Medicine.

With daylight saving, suddenly the hourly schedule is different so it throws people off, Lima says.

Light is the main environmental cue. Light suppresses the secretion of the sleep-inducing hormone melatonin. So it is important to expose yourself to the light during the waking hours as much as possible and on the contrary, do not expose yourself to bright light when it is dark outside.

Until your body adjusts to the new times and brighter evenings, you might have trouble falling asleep, staying asleep, or waking up at the right times.

Does the time change affect everyone the same way?

No. People adjust differently. For children, however, it could be more challenging because bedtime is now different, Lima says.

Gradually adjust your childs nap and sleep times by 10 to 15 minutes each day before the time change so the shift is more gradual for them. Following a regular routine from dinnertime to bedtime will help your child slow things down and be ready to snuggle up.

People who sleep seven or less hours per day can have consequences that are more serious because sleep disruptions can affect cognitive performance. Studies link the lack of sleep at the start of DST to car accidents, workplace injuries, suicide, and depression among other things.

A group of U.S. researchers conducted a study and determined that the risk of a heart attack increased 24 percent the Monday after switching over to daylight saving time. However, the risk diminished over the remainder of the week. By contrast, it dropped 21 percent on the Tuesday after the fall time change.

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One way to help your body adjust is to gradually change the times for sleep, eating, and activity, Lima says. Start shifting your normal routine a little bit, maybe a week or two before DST starts, to ease the transition into the new schedule.

Lima doesnt recommend taking a nap in the middle of the day if you feel tired after the switch to DST because its going to decrease your ability to sleep at night.

Work through the new schedule. Stick through it and you will be able to fall asleep when you should, Lima says. And avoid doing things that close to bedtime.

The more you pay attention to your body and identify feelings of alertness or drowsiness, the better you ll feel.

Here are some tips to a smoother transition to DST:

Avoid naps. If you have to take a short nap during the day, take it early and for no longer than 20 minutes.

Don't stay up later than usual. Go to bed at your usual time to avoid messing with your internal clock. Set your bedside alarm or smartphone as you usually would and fight the urge to stay up late.

Practice good sleep hygiene. Take advantage of this moment to perform a sleep reset. Don't look at screens before bed and if you do, make sure to use blue light blocking glasses in order to avoid straining your eyes. Keep your bedroom at a temperature conducive for soothing you into a deep sleep.

Skip caffeine. As the week progresses, you may become sleepy at unusual times. Let sleep kick in naturally and avoid caffeinated beverages after lunchtime. Opt for decaf instead.

Stick to a routine with kids. You shouldn't expect the first week after the time change to go off without a hitch, but sticking to your usual schedule may be the best course of action. Some children who are more sensitive to schedule shifts may require a more extended adjustment period. However, things should be back to normal within two weeks.

Pay attention to your pets. An hour change may not seem like a lot to you, but it may confuse your pets. Keep the adjustment in mind when planning feeding times and outdoor bathroom visits. If you're on a schedule, know that it may take a few weeks before your pets get settled into a new routine.

Bring snacks to work. Your stomach isn't keeping track of the clock; it may grumble outside of your designated lunch break. Bring a few extra snacks along just in case.

Be especially vigilant while driving to protect yourself since others around you may be sleepier and at risk for making an error that can cause a vehicle crash.

Here is the original post:
Does daylight-saving time mess with your internal clock? Here are tips to manage the time change - LancasterOnline

From Bicycling

While there is no cure for Alzheimers disease, more evidence is surfacing that shows your lifestyle and diet may be able to help ward it off. A recent study published in Neurology found that what you eat is not only good for your body, but also beneficial for your brain. Eating leafy greens, veggies, and berries daily plus drinking tea can help reduce your risk of dementia by 48 percent.

The study looked at the eating habits of 921 people in the Rush Memory and Aging Project who complete annual neurologic evaluations and dietary assessments that include reporting the frequency they ate 144 foods over the previous year.

The results showed that those who had a high intake of flavanols, an antioxidant that helps reduce inflammation, were 48 percent less likely to later develop dementia than the people in the lowest intake group. Thats likely because the anti-inflammatory properties of flavanols can prevent over-activation of inflammatory cells, helping to reduce cellular damage.

When this cellular damage occurs in the brain, is thought to be one of the potential causes of Alzheimers and vascular-type dementia, Thomas Holland, M.D., a physician scientist at Rush University Medical Center in the Rush Institute for Healthy Aging, told Runners World. In total, researchers found that over 30 fruits, vegetables, and beverages contribute to the beneficial flavanols that can ward off dementia. Though not an exhaustive list, certain foods contributed to high intake of flavanols in the self-reported diets of the participants.

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

These results show the types foods we are consuming do matter, Holland said. And, though important, it is not just the nutrients in the foods we eat that contribute to our health. Its also the bioactives (chemicals, such as antioxidants, in foods that affect our bodies) contained in them.

Eat your fruits and vegetables, particularly dark leafy greens, and drink some tea every now and again, Holland said. A healthy diet that contains various fruits and vegetables is critical for continued health, especially brain health and is a strong component of a healthy lifestyle.

The bottom line: Adding one serving of dark leafy greens a day, one cup of raw veggies, one serving of other veggies a day, a handful of berries at least five times a week, and a cup of tea (preferably without sugar) can help lower your risk of dementia. A healthy diet combined with exercisewhich has also been shown to help delay cognitive declineenough sleep, and other brain-stimulating activities, such as reading, will help boost your brain health.

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More Evidence That Antioxidant-Rich Foods Can Boost Your Brain Health - Yahoo Lifestyle

Boulder Feb 26, 2020 (Thomson StreetEvents) -- Edited Transcript of Clovis Oncology Inc earnings conference call or presentation Monday, February 24, 2020 at 9:30:00pm GMT

Clovis Oncology, Inc. - VP of IR

* Daniel W. Muehl

Clovis Oncology, Inc. - Executive VP & CFO

* Patrick J. Mahaffy

Clovis Oncology, Inc. - Co-Founder, CEO, President & Executive Director

SVB Leerink LLC, Research Division - MD of Targeted Oncology & Senior Research Analyst

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

* Kennen B. MacKay

RBC Capital Markets, Research Division - MD & Co-Head of US Biotechnology Research

Ladies and gentlemen, thank you for standing by and welcome to the Clovis Oncology Fourth Quarter and Full Year 2019 Conference Call. (Operator Instructions)

I would now like to hand the conference over to your speaker today, Anna Sussman, VP of Investor Relations. Thank you. Please go ahead.

Anna Sussman, Clovis Oncology, Inc. - VP of IR [2]

Thank you, Mike. Good afternoon, everyone, and welcome to the Clovis Oncology fourth quarter and fiscal year 2019 conference call. Thank you for joining us. You have likely seen this afternoon's news release. If not, it's available on our website at clovisoncology.com. As a reminder, this conference call is being recorded and webcast. Remarks may be accessed live on our website during the call and will be available in our archive for the next several weeks.

Today's agenda includes the following: Patrick Mahaffy, our President and CEO, will discuss the key components and highlights of today's corporate update; and Dan Muehl, Clovis' Chief Financial Officer, will cover the quarter and year's financial results in greater detail. Pat will make a few closing remarks, and then we'll open the call for Q&A, during which time Lindsey Rolfe, our Chief Medical Officer, will also be available to answer questions.

Before we begin, please note that during today's conference call, we may make forward-looking statements within the meaning of the federal securities laws, including statements concerning our financial outlook and expected business plans. All these statements are subject to risks and uncertainties that could cause actual results to differ materially from those described in the forward-looking statements. Please refer to our recent filings with the SEC for a full review of the risks and uncertainties associated with our business. Forward-looking statements speak only as of the date on which they are made, and Clovis undertakes no obligation to update or revise any forward-looking statements.

Now I'll turn the call over to Pat Mahaffy.

Patrick J. Mahaffy, Clovis Oncology, Inc. - Co-Founder, CEO, President & Executive Director [3]

Thanks, Anna. Welcome, everybody. We appreciate your time today. I'll begin with a commercial update for Rubraca. I'm pleased to report that our global net revenue for the fourth quarter of 2019 was $39.3 million, up 5% sequentially from Q3 2019 and up 30% over Q4 2018. This sequential quarter growth was driven primarily by increased revenue in Germany and launches in England and Italy during the fourth quarter.

For the full year 2019, global net revenue was $143 million, up 50% from 2018. The year-over-year growth for the quarter and the year was driven largely by growth in U.S. sales, including overall growth in total volume and better management of the patient assistance program, offset to some extent by higher gross to net adjustments.

We've seen stepwise growth over the last several quarters, including the 12% increase in U.S. sales from Q2 2019 to Q3 2019 and are pleased that we have maintained this higher level of sales in Q4 2019.

Our key near-term objectives remain the same. Grow U.S. ovarian cancer revenues by increasing market share in, and overall adoption of the maintenance treatment indication in the recurrent ovarian cancer setting; increase European revenues through Rubraca ovarian cancer launches in England, Italy, France and Spain, along with driving continued revenue growth in Germany. I should note that the adoption of maintenance treatment in ovarian cancer in Europe is similar to that of the U.S., and we and our competitors are making considerable efforts to overcome observation or watch and wait as the standard approach to treating recurrent ovarian cancer; and hopefully, on or before our PDUFA date of May 15, begin to grow revenue through with the addition of the potential new indication in the U.S. for the treatment of BRCA1/2 mutant recurrent, metastatic, castrate-resistant prostate cancer or mCRPC. And that brings us to our most near-term development and regulatory program in this setting.

In November 2019, we submitted our planned supplemental new drug application, or sNDA, for Rubraca as a monotherapy treatment of adult patients with BRCA1/2 mutant-recurrent, metastatic CRPC. The filing was based on data from the TRITON2 clinical program in advanced prostate cancer. In January 2020, we announced that the FDA accepted our sNDA for Rubraca and granted priority review status to the application with the PDUFA date of May 15, 2020. We're actively preparing for Rubraca launch in prostate cancer in the U.S., which we will commence upon receipt of FDA approval.

We think that Rubraca represents an important hormone-free and chemotherapy-free option for our targeted population of men in the U.S. who have metastatic CRPC, approximately 12% of whom have a mutation of BRCA. We've been encouraged by our interactions with both the medical community and to a lesser extent, the urology community about the potential of Rubraca to address the unmet medical need in recurrent CRPC. We are actively engaged in launch preparations, including sales force training, and we will be ready to launch on approval, which we expect to occur on or before May 15.

Now I'll briefly discuss the latest updates to our clinical pipeline for Rubraca. During the fourth quarter, we initiated the LODESTAR study, our Phase II pan-tumor study to evaluate Rubraca in homologous recombination repair genes across tumor types. The study will evaluate Rubraca in patients with recurrent solid tumors associated with the deleterious homologous recombination repair or HRR gene mutations. Based on our interactions with FDA, the study may be registration-enabling for a targeted gene and tumor-agnostic label, if data from the trial support an accelerated approval.

Next, I'd like to briefly highlight our combination studies with BMS for both Rubraca and lucitanib, and then I'll discuss our newest compound, FAP-2286. We remain enthusiastic about our ongoing clinical collaboration with Bristol-Myers Squibb. I'll take a moment to review certain of our combination studies for both Rubraca and lucitanib with nivolumab. I'll begin with the Rubraca combination. FRACTION-GC is a BMS-sponsored, multi-arm Phase II study evaluating the combinations of each of Opdivo and Yervoy with Rubraca as well as Opdivo, Yervoy and Rubraca in combination for the treatment of advanced gastric cancer. This is the first sponsored study to explore this triplet combination and it is now enrolling patients into the safety lead-in portion of the study.

The Clovis sponsored Phase III ATHENA trial in first-line maintenance for advanced ovarian cancer continues to enroll well, and we anticipate completing enrollment in this 1,000 patient study in the second quarter of 2020. With ATHENA, we believe we are uniquely positioned to evaluate Rubraca in terms of 2 outcomes: as monotherapy versus placebo in the first-line maintenance setting in the HRD population, inclusive of BRCA and in the all-comers or intent-to-treat population as well as any potential advantage of the combination of Rubraca and Opdivo in the same patient populations. ATHENA is the first frontline switch maintenance study designed to show both PARP monotherapy and PARP/PD-1 combination therapy in one study design.

I'll take a moment to review the analysis plan for ATHENA. First, expected in the second half of 2021, we will see the results of Rubraca monotherapy versus placebo in all study populations and then probably a year or more later, we will see the results of Rubraca plus Opdivo versus Rubraca in all study populations. In each of these analyses, we will first evaluate outcomes in the HRD population, including BRCA, and then step down to the entire intent-to-treat population.

To wrap up Rubraca and move to lucitanib, I'll note that SEASTAR, our Clovis-sponsored Phase Ib/II study that includes multiple single-arm Rubraca combination studies, including the combination of Rubraca with lucitanib in ovarian cancer, is currently enrolling the dose-finding Phase Ib portion of the study. Lucitanib, of course, is our investigational inhibitor tyrosine kinases including vascular endothelial growth factor receptors 1 through 3, platelet-derived growth factor receptors alpha and beta and fibroblast growth factor receptors 1 through 3.

As we have discussed on prior calls, there are very encouraging data in studies of a drug similar to lucitanib, which inhibits the same 3 pathways when combined with the PD-1 inhibitor. This provides us a compelling clinical rationale for the development of lucitanib in combination with the PD-1. We believe the combination of lucitanib with the PD-1 targeting monoclonal antibody represents a large potential opportunity in multiple solid tumor types.

Angiogenesis has been shown to be immunosuppressive within the tumor microenvironment, dampening antitumor immune responses. Preclinical data demonstrates that the anti-tumor activity of the PD-1 inhibitor is enhanced through the inhibition of angiogenesis by lucitanib, which targets 3 relevant proangiogenic pathways as well as simultaneously targeting tumor cell proliferation and anti-VEGFR therapy resistance driven by PDGF and FGF receptors.

In February 2019, we announced the expansion of our clinical collaboration with Bristol-Myers Squibb to include planned combinations of Opdivo with lucitanib. The Clovis-sponsored LIO-1 study is a Phase Ib/II study evaluating lucitanib in combination with Opdivo. LIO-1 is now enrolling patients with gynecological and other solid tumors. We hope to have preliminary data from this study as well as the Rubraca/lucitanib combination study at medical meetings in 2020.

In addition, the BMS-sponsored CHECKMATE 79X study is a Phase I/II study evaluating multiple combinations with Opdivo, including an arm in combination with lucitanib in patients with second-line non-small cell lung cancer. This study is expected to initiate in early 2020.

Now let me describe the newest addition to the Clovis pipeline, our peptide-targeted radiopharmaceutical therapy program and our lead compound FAP-2286. In September 2019, we announced a global licensing and collaboration agreement with 3B Pharmaceuticals, with initial focus on the peptide-targeted radionuclide therapy and imaging agent targeting fibroblast activation protein alpha, commonly referred to as FAP. FAP is highly expressed in cancer associated fibroblasts, which are found in the majority of cancer types, potentially making it a suitable target across a wide array of solid tumors. It is highly expressed in many epithelial cancers, including more than 90% of breast, lung, colorectal and pancreatic carcinomas. Clovis will conduct global clinical trials and has obtained U.S. and global rights, excluding Europe where 3BP retains rights. We are planning to submit the IND for FAP-2286 in the second half of this year.

In addition, we and 3BP are collaborating on a discovery program directed at 3 additional targets for radionuclide therapy, to which we have global rights. [We've regarded] this program for many reasons, including, of course, the opportunity to be a leader in the emerging field of targeted radiotherapy for treatment for solid tumors. In this case, we also have the opportunity to be the first to clinically develop an FAP-targeted radionuclide, and we are also enthusiastic about the targets that are the subject of our discovery collaboration.

In addition, while our initial development focus is on monotherapy, there is an evident biological rationale to combine targeted radionuclide therapy with cancer therapies, including anti-PD-1 agents as well as with Rubraca. And we intend to explore these combinations first preclinically and potentially clinically as well.

Now some of you may be familiar with the history of PSMA-targeted radionuclides, in particular, lutetium PSMA-617, which was used extensively under named patient use in Germany and certain other countries prior to the initiation of any formal clinical development programs. While we do not anticipate such extensive named patient use like that, which occurred for lutetium PSMA-617, we have had expressions of interest for named patient use from German physicians.

To this end in December 2019, Professor Dr. Richard Baum presented his initial independent clinical experience with FAP-2286 in the first named patient use of the compound in the imaging and treatment settings at the International Centers for Precision Oncology Foundation Symposium in Germany. Professor Dr. Baum's early results in patients with advanced solid tumors, including breast, pancreatic, colorectal and ovarian cancers, showed the following: images of 10 patients imaged with PET/CT with Gallium 68, FAP-2286 were completely consistent with standard of care FDG-PET/CT scans in the same patients. In patients treated with lutetium FAP-2286, there were encouraging tumor accumulation and retention and a reported lack of significant adverse effects was demonstrated within the first 2 months after the first dose.

As a reminder, named patient programs are not clinical trials and the treating physician independently makes all decisions including dose and assessment of efficacy and safety. We found this reported experience encouraging, and our focus remains on initiating a broad clinical development program for our FAP-targeted compound. We currently plan to submit an IND application for FAP-2286 in the second half of 2020, followed by a Phase I study to determine the dose and tolerability of the FAP-targeting therapeutic agent with expansion cohorts planned in multiple tumor types as part of the global development program.

Thus far, in radiotherapeutic development, physicians have used an imaging agent, mostly Gallium 68, to identify patients with the appropriate level of tumor target, which in our case would be FAP. We are exploring opportunities to generate imaging data for FAP-2286, potentially even before our IND is submitted. Not only would this information will be useful to gain additional experience with FAP-2286 and better understand the characteristics of FAP expression in multiple tumor types, but further it would allow us to collaborate with academic institutions eager to explore the potential of FAP as an imaging and treatment target.

And with that, I'll turn the call over to Dan to discuss fourth quarter and fiscal year 2019 financial results.

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Daniel W. Muehl, Clovis Oncology, Inc. - Executive VP & CFO [4]

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Thanks, Pat, and hello, everyone. We reported net product revenue for Rubraca of $39.3 million for Q4 2019, which included U.S. net product revenue of $36.1 million and ex U.S. net product revenue of $3.2 million compared to the net product revenue reported in Q4 2018 of $30.4 million all of which was in the U.S. This represents a 5% increase over Q3 2019 and a 30% increase year-over-year. U.S. net product revenues was $36.1 million for the fourth quarter, in line with the $36.5 million reported in Q3 and up 19% from the $30.4 million recorded in Q4 2018.

The supply of free drug distributed to eligible patients in the U.S. through the Rubraca patient assistance program for Q4 2019 was 18% of the overall commercial supply compared to 20% in Q3 2019. This represented $8 million in commercial value for Q4 2019 compared to $9 million in Q3 2019 and $10.4 million in Q4 2018. Ex U.S., net product revenue was $3.2 million for the fourth quarter, which represents a $2.1 million increase from the previous quarter, driven primarily by increased revenue in Germany and launches in England and Italy during the fourth quarter.

Net product revenue for 2019 was $143 million, which included $137.2 million and $5.8 million in U.S. and ex U.S. product revenues, respectively. This compares to $95.4 million in net product revenues in 2018, all from the U.S. This represents an increase of 50% year-over-year.

U.S. net product revenue was $137.2 million in 2019, up 44% from the $95.4 million reported in 2018. This was largely driven by growth in total volume and better management of the patient assistance program, offset to some extent by higher gross to net adjustments. The supply of free drug distributed to eligible patients in the U.S. through the Rubraca patient assistance program in 2019 was 20% of the overall commercial supply compared to 26% in 2018. This represented $34.8 million in commercial value for 2019 compared to $33.4 million in 2018.

Gross to net adjustments totaled 17.4% in Q4 2019 and 15% for the full year 2019 compared to 10.1% in Q4 2018 and 10.4% for the full year 2018. The increase in gross to net adjustments reflects an increase in the U.S. and the impact of growing European sales. We expect gross to net adjustments to be in the mid-teens in 2020, pending the revenue mix between U.S. and Europe.

Turning now to a discussion of cash. As of December 31, we had $296.7 million in cash, cash equivalents and available for sale securities. In August 2019, Clovis repurchased $190.3 million aggregate principal amount of its 2.5% convertible senior notes due 2021. Approximately $97.2 million aggregate principal amount of these notes remain outstanding.

In January 2020, Clovis repurchased $123.4 million aggregate principal amount of its 4.5% convertible senior notes due 2024 that were initially issued in August 2019. This transaction will save $28 million in cash on interest payments under the notes issued in 2019, and approximately $148 million aggregate principal amount of these notes remain outstanding. Additionally, the company has $300 million in aggregate principal amount outstanding of its 1.25% convertible senior notes due 2025.

And as of December 31, we had drawn approximately $35 million under the TPG ATHENA clinical trial financing and had up to $140 million available to draw under the agreement to fund expenses of the ATHENA trial through Q3 2022.

Based on the company's anticipated revenue, spending, available financing sources and existing cash, cash equivalents and available for sale securities, we believe we have sufficient cash, cash equivalents and available-for-sale securities to fund our operating plan into the second half of 2021. This does not include any cash repayment that may be required to pay off unless we refinance, the remaining $97.2 million aggregate principal amount of the 2.5% convertible notes due 2021 at their maturity in September of 2021.

Net cash used in operating activities was $70.1 million for Q4 2019 and $323.6 million for the fiscal year 2019 compared with $82.7 million for Q4 2018 and $366 million for the comparable periods in 2018. In addition, borrowings under the TPG ATHENA financing provided $13.8 million in cash in Q4 2019, reducing net cash utilized in operating activities to $56.3 million during the quarter. Net cash used in operating activities for Q4 2019 included an upfront payment of $9.4 million to 3B Pharmaceuticals related to the in-licensing of FAP-2286.

Net cash used in operating activities was $127.1 million for the second half of 2019 and $196.5 million for the first half of 2019, a reduction of $69.4 million or 35%. In addition, borrowings under the TPG ATHENA financing provided $8.6 million in the first half and $26 million in the second half of 2019, reducing net cash utilized in operating activities by $86.8 million or 46% from the first half to the second half of 2019.

We reported a net loss for Q4 of 2019 of $99.5 million or $1.81 per share and $400.4 million or a net loss of $7.43 per share for fiscal year 2019. In 2018, the net loss for the fourth quarter was $99.3 million or $1.88 per share and $368 million or a net loss of $7.07 per share for the full year. Net loss for Q4 and fiscal year 2019 included share-based compensation expense of $12.6 million and $54.3 million compared to $11.4 million and $49.1 million for the comparable periods in 2018.

Research and development expenses totaled $72.5 million for Q4 2019 and $283.1 million for the full year 2019 compared to $71.2 million and $231.3 million for the comparable periods in 2018. The increase for the full year is primarily due to higher research and development costs for Rubraca clinical trials.

Selling, general and administrative expenses totaled $45.2 million for Q4 2019 and $182.8 million for the full year 2019 compared to $49.1 million and $175.8 million for the comparable periods in 2018. Selling, general and administrative expenses increased for the full year due to commercialization activities for Rubraca including increased costs associated with building out the European commercial infrastructure.

Now I'll turn the call back to Pat.

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Patrick J. Mahaffy, Clovis Oncology, Inc. - Co-Founder, CEO, President & Executive Director [5]

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Thanks, Dan. Happy birthday. We are pleased with our progress in the fourth quarter and in 2019 in total. We demonstrated strong sales growth in 2019 with Rubraca in the second-line ovarian cancer maintenance setting. In the U.S., we remain focused on growing our share of the ovarian cancer PARP inhibitor market as well as expanding second-line maintenance PARP adoption overall. In Europe, Rubraca is now reimbursed in Germany, England, Italy, France and Spain, and during the course of 2019, we launched in Germany, England and Italy. Rubraca launched earlier this month in France and will launch shortly in Spain.

In addition to our sales progress, we also showed a significant reduction in our net cash utilized in operations, which was 60 -- or excuse me, $86.8 million or 46% lower in the second half of 2019 and in the first half of 2019, reflecting reductions in product supply costs, milestone payments, disciplined with head count additions, clinical trial management and the benefits of the TPG ATHENA financing. We submitted the supplemental NDA for Rubraca in BRCA1/2 mutant recurrent metastatic CRPC in mid-November. And we're pleased that the FDA granted priority review designation for the application and a PDUFA date of May 15, 2020. This provides the potential for a U.S. launch in a second tumor type in May of this year.

We remain enthusiastic about the potential for lucitanib with 2 Clovis-sponsored combination studies now open for enrollment: one with Rubraca in advanced ovarian cancer as part of SEASTAR as well as one in combination with Opdivo in advanced gynecological cancers and other solid tumors. We hope to have initial data from these trials at medical meetings in 2020.

And finally, we look forward to submitting the IND for FAP-2286 in the second half of 2020, and we're enthusiastic about the opportunity to develop this compound specifically and potentially up to 3 additional radionuclide therapies in this emerging field. We believe with this program, we have the opportunity to become a leader in the development of this important new treatment modality for multiple solid tumor types.

And with that, I'd be happy to answer any questions you may have.

================================================================================

Questions and Answers

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Operator [1]

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(Operator Instructions) Your first question comes from Kevin MacKay (sic) [Kennen MacKay] from RBC Capital.

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Kennen B. MacKay, RBC Capital Markets, Research Division - MD & Co-Head of US Biotechnology Research [2]

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Maybe if you could talk a little bit more about some of the Rubraca dynamics in the U.S. market? It seems like maybe there was a slight volume decline after backing up the gross to net and free drug impact, but would love if you could maybe help contextualize that market and again, the dynamics going on there a little bit more.

And then a follow-up on lucitanib. We saw some very impressive VEGF plus checkpoint data in prostate cancer from the COSMIC trial at ASCO GU. I was wondering if -- how you were thinking about targeting prostate center with lucitanib if there are any plans there with the thinking that maybe it would just be a far and less competitive field than the more validated RCC space?

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Patrick J. Mahaffy, Clovis Oncology, Inc. - Co-Founder, CEO, President & Executive Director [3]

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Yes. So first dynamic in the market, we actually did see a volume increase in Q4, it was modest, but we did see a volume increase. We were affected by the higher gross to net, which reflects some contracting, we, as other companies have done in the space. The thing I'll also point to is that while we don't have a good perfect data set from olaparib. It does appear that sales, for instance, for ZEJULA were also flat to down in Q4 compared to Q3. It could just be a dynamic of the quarter.

I also think it's important to note, as I said in my prepared remarks, we saw a 13% increase in Q3 compared to Q2, and we maintained that increase in Q4. And I think that it's important as you look back at our reported sales that our growth hasn't really occurred on a linear quarterly basis. What we've seen is $32 million and $32 million and then jumped to $36 million, and now we're $36 million, and hopefully, we'll see another jump beginning in some quarter in 2020.

So I think that we had held our own in this market. We still need with our competitors to do everything we can to grow adoption of second-line maintenance, so that we can really not only take more share, but benefit from kind of a rising tide lifting all boats, a better adoption, and so that will remain a focus of ours in 2020.

As to the data for a VEGF inhibitor plus a PD-L1 that were presented at ASCO GU, obviously, we've paid attention to that, too. We think it's worth further exploration for us potentially with the PD-1, potentially if that was of interest to Bristol, but we -- it's early days to figure out what the next step for us would be. But we, like you, were impressed with the data and see an evident opportunity for the combination of the VEGFs for a pan-angiogenesis compound like lucitanib with a PD-1.

One thing you said, Kennen, I just want to address, as you said, rather than go into the very crowded RCC space, that has not been our priority. Our priority have been these kind of [ecological] cancers and some other solid tumor indications where we have precedent data for Keytruda with pembro, but it is not a subject of our study activities now to pursue RCC.

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Operator [4]

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Your next question comes from Michael Schmidt from Guggenheim.

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Michael Werner Schmidt, Guggenheim Securities, LLC, Research Division - Senior Analyst & Senior MD [5]

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I had a couple around prostate cancer. First of all, congrats on the PDUFA date, the acceptance and then the PDUFA date, obviously. Just wondering how you think about the competitive dynamics in BRCA-positive prostate cancer longer term with other companies, obviously, having started additional trials in earlier lines of therapy in mCRPC. And just wondering how you think about maybe the initial market dynamics and longer term the potential for Rubraca in prostate cancer?

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Patrick J. Mahaffy, Clovis Oncology, Inc. - Co-Founder, CEO, President & Executive Director [6]

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Yes. So we think for now and for a reasonable future, the PARP inhibitor approvals will be limited to us and to olaparib. Each of the other competitors running a single-arm study are reasonably behind based on the enrollment rates that they showed mostly recently at ASCO GU, which was only a couple of weeks ago. So that's pretty up-to-date data. So we -- like anybody, we'd love to be alone, but we're confident that we have a good chance of being first or tied for first based on AZ's announcement of their timing, and obviously, ahead of any other competitors. So 2 is better than 3, which is what we base in ovarian right now.

With regard to earlier line opportunities in prostate, the exploration being done by some others has recently started studies combining their PARP inhibitors with, for instance, abiraterone or enzalutamide. We will start a combination study with enzalutamide before the end of this year in collaboration with a number of investigators, we're already effectively signed up for this. So I think that in the event there is an opportunity to combine a PARP inhibitor with an enzalutamide or an abiraterone or one of the next gen products, we will be competitive in that space in a reasonably similar time frame to the other trials that are seeking the same indication.

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Edited Transcript of CLVS earnings conference call or presentation 24-Feb-20 9:30pm GMT - Yahoo Finance

This article originally appeared on VICE US.

In plain white text atop a blue-to-pink gradient, Solace greets new users with a dictionary definition of its name: comfort or consolation in a time of distress or sadness. Its a fitting name for an app that aims to give trans people more information about various aspects of transitiona one-stop resource for people who know they are trans, but dont know how to be trans.

After entering some basic informationtheir name, their pronouns, and their location by statethe user is presented with some common transition goals, as Solace terms them. These include all of the major transition milestones like beginning hormone replacement therapy and updating the name and gender marker on ones passport, as well as seemingly mundane (but surprisingly difficult) tasks like buying the right bra.

The goal, according to Solace co-founder Robbi Katherine Anthony, is to help users make their transitions as easy as possiblesomething she wished she could be able to say about her own.

Transition is beautiful, but its also incredibly hard, Anthony told VICE.

Born in New Mexico, the 27-year-old software developer now lives in Spokane, Washington. She came up with the idea and designs Solace with fellow developer Patrick McHugh, and turned to Crowdbotics, a software company in Berkeley, to build out the app. As Solaces only full-time employees, Anthony and McHugh run an extraordinarily lean operation, bouncing between Anthonys home, her 1998 blue Honda CR-V, and whatever coworking space they might be working in on a given day. Its fly or die every single day here, said Anthony. But shes committed to making something that she hopes makes transition a little less confusing, a tool she would have appreciated if it had existed all those years ago.

My transition has been rough, she told VICE. But Ill be damned if I dont do everything in my power to help others avoid that.

Solace co-founders Patrick McHugh (L) and Robbi Katherine Anthony (R). Photo courtesy of Robbi Katherine Anthony.

Anthony said that one of the biggest hurdles she faced in the early stages of her transition was finding out how to transition in the first place. She blamed a lot of this inaccessibility on gatekeeping, a term that, in a trans context, often refers to the many ways in which a health care professional can refuse gender-affirming care to a trans patientsay, a doctor who wont prescribe hormones, or surgeon who wont operate on a woman he doesnt find attractive or cis-passing enough for his standards. Anthony told VICE that she experienced this kind of medical gatekeeping firsthand, but she also used the term to describe her experiences with other trans people.

Certain people in the community become gatekeepers of information, Anthony said. Transition is a model of oral tradition, but if you have to meet people in order to transition, that inherently limits transition to people who can access that network. Some people physically cannot do that or dont want to. That information is also highly anecdotal, which she said is a problem because it ignores how one persons circumstances are not analogous to another persons.

Solace disrupts that model, she continued. If the process could be reduced from finding the right gatekeepers to having a compendium that allows you to proceed on your own terms, I think it would be healthier.

I asked Anthony if creating Solace, an app designed to circumvent community gatekeepers, might turn her into the very trans community gatekeeper she set out to circumvent.

Thats a really fair question, Anthony said. Gatekeeping, in its most nefarious forms, requires folks to do some interaction in order to get information. Whether its being approved by a moderator to join a group, seeking out a time or space or venue based on terms dictated by someone else, or being forced to curry favor with someone for them to share informationthats gatekeeping in my book.

Solace, which launched in December 2019, is quite unlike any of the other trans-specific apps available through Apples App Store. Searching for trans or transgender on my iPhone turns up an endless scroll of dating apps for cis men trying to meet trans women and crossdressers with nearly illegibile, knockoff brand names like Tinded, Sinder, and Transdr. Theyre mostly godawful, Anthony said. Fetishizing trans people... transsexual dating dot this, and stuff. There are a few practical options that actually seem to have been designed with a trans user in mind, like audio recording apps to practice voice modification, crowdsourced safe restroom finders, and a selfie-driven transition tracker. But nothing is quite as comprehensive as Solace, which contains more than 180,000 words of text, according to Anthonys estimate.

The app gives users the ability to curate a custom checklist of transition tasks, which are divided into three categories: legal (updating your birth certificate, what you can do about workplace discrimination); lifestyle (coming out to your family, connecting with other trans people); and medical (facial feminization surgery, laser hair removal, family planning). Every item is comprehensive, containing lots of actionable information about the task at hand. The coming out to family entry, for example, includes both tips on what to do (write a coming out letter to each and every family member, ask to be called by your name and pronouns, be ready to explain what transgender means) along with general advice (make sure you are sober when you come out, be prepared to lose your housing or financial support).

Many of the resources are tailored to the users gender identity and location, as non-discrimination laws and the legal hoops one has to hop through in order to change the name and gender marker on their state-issued documents vary by state. For example, the page for updating your birth certificate in Arizona correctly notes that youll need an affidavit, a certified copy of a court order, a photo copy of a valid government-issued ID, a signed letter from your physician verifying that youve undergone a sex change operation, and a small fee. The page for Washington is significantly shorter, as the Evergreen State doesnt require surgery or a fee.

Solace is free to download and the creators have no intention of selling user data to third parties. We will never charge a penny, Anthony said. Were currently donor supported. We tap into foundation support, sometimes as grants. Were structured as a nonprofit. This community faces a disproportionate amount of poverty, so putting a paywall on this thing felt counterintuitive to what we were trying to do. And data-mining, she paused. Our stomachs turn at the thought of it.

Anthony declined to share how many people have downloaded Solace since launch, though she said she and McHugh are currently halfway to reaching their 2020 user goal. The app has had a number of updates since its December launch, like the addition of more detailed information regarding Medicaid coverage for trans care in different parts of the country. Anthony said that she also plans to integrate a news aggregator with articles about a variety of trans topics, implement dynamic pronouns within the apps copyto match the pronouns the user enters, and launch a mode for parents and guardians of trans kids.

Listening to Anthony talk, I couldnt help but think about how different my experience with transitioning has been. Its not that I havent had to seek out other trans people to find out who they see for laser hair removal or whether progesterones really worth the hype; Ive had to do all of those things. The difference is that I view them as positives rather than negatives. Ive found a lot of value in talking to other trans people about their experiences and sifting through their anecdotal experiences to figure out what might be right for me. Im deeply grateful for all the friendships Ive made and communities Ive joined after putting myself in uncomfortable, new social situations. I asked Anthony if she was concerned that an app like Solace might lead trans people away from their local communities. Its a byproduct were aware of, she said, but I wouldnt say that its a goal of ours.

Our entire ethos is about providing this community with agency, and part of agency is allowing people to access information on their own terms, she said.

Solace might not be of that much use to me, an extrovert in a major city whos already in community with other trans people (and my questions at this point of my transition are more existential than they are practicalless about how do I do this or how do I do that, and more about what do I do now). But it could be useful to people who dont know any trans people, or live in a part of the country with no visible local community, and might be particularly helpful for early transitioners or trans people who havent come out yet and are still trying to figure out where to begin.

Regardless of who makes use of Solaces many comprehensive resources, Anthony was clear about one thing: she doesnt want anyone to rely on the app forever. The ultimate sign of Solaces success is that the user deletes the app because they dont need it anymore, she said.

Follow Harron Walker on Twitter .

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Want to Transition? There's an App for That - VICE UK

Minneapolis native Aliya Feroe recalls the flustered OB-GYN who referred her to another physician after learning she identified as queer. For Rhi Ledgerwood, who was designated female at birth, identifies as trans and doesnt have sex with men, it was a doctor advising about condoms and pregnancy prevention. For Tim Keyes, who came out as gay at age 17, its when doctors automatically assumed he sleeps with women.

Ask any LGBTQ patient about awkward doctor visits and chances are theyll have a story to tell.

When being heterosexual is presumed even in doctors offices, those who identify otherwise can feel marginalized and less likely to seek medical care, contributing to health problems that include high rates of depression, suicidal behavior, alcohol and drug use and inadequate health screenings, LGBTQ advocates say.

Now, moves are afoot to remedy that. The American Medical Association vowed in November to push for a federal ban on gay conversion therapy. Medical schools are beefing up education on LBGTQ health issues. And some schools are making a major push to recruit LGBTQ medical students, backed by research showing that patients often get better care when treated by doctors more like them.

Feroe, Keyes and Ledgerwood all pursuing medical careers are part of the trend.

LGBTQ physicians deserve an equal standing in the medical community and LGBTQ patients deserve the same quality of care awarded to anyone else, said Feroe, a third-year Harvard medical student.

Increasing LGBTQ enrollment and training in LGBTQ health issues in medical schools can help achieve those goals, advocates say.

Exact numbers of LGBTQ medical students and doctors are unknown. In 2018, the AMA added sexual orientation and gender identity as an option for members to include in demographic profiles the group compiles. Of the 15,000 doctors and students who have volunteered that information so far, about 4% identify as LGBTQ. Thats similar to Gallup estimates for the general U.S. population, although LGBTQ advocates believe the numbers are higher and rising as more people are willing to out themselves.

This past fall, Harvards entering class of medical students was 15% LGBTQ, a milestone that is no accident.

The Association of American Medical Colleges primary application used by U.S. schools began offering prospective students the option of specifying gender identity and preferred pronouns in 2018. Harvards school-specific application allows applicants to identify as lesbian, gay, bisexual, transgender or queer. A response is not required, but the option sends a message that youre wanted, said Jessica Halem, the medical schools LGBTQ outreach director.

We know that doctors need to look like and be a part of the communities they serve, Halem said.

We have gay Muslim students. Lesbians from China. Students who are survivors of conversion therapy, she said. "They are now out and very proud gay people and they are healing those wounds."

Feroe had intended to present herself as straight in medical school, fearing doing otherwise would be off-putting for patients and make her feel like an anomaly among her peers.

But Harvard has an active LGBTQ student group on campus, faculty members who ask students if they prefer being called her, him or they, and coursework addressing LGBTQ medical care. Halem said that includes what screening tests are needed for women who have sex with transgender men, the hormone treatments to prescribe for transgender patients, and what it means when someone identifies as pansexual.

Feroe said she was blown away during a recent surgery rotation at one of Harvards affiliated hospitals, where a few patients were accompanied by same-sex partners. The doctors she was training with smoothly asked about peoples lives and were completely comfortable when learning patients were queer, she said, important steps toward offering non-judgmental patient-centered care.

A 2017-18 Association of American Medical Colleges report found that while most schools include some LGBTQ coursework, half reported three or fewer lectures, group discussions or other learning activities.

And a study of medical residents published last March found a widespread lack of knowledge on LGBTQ health issues. Dr. Carl Streed, the lead author and an associate professor at Boston Universitys medical school, is among advocates pushing for a standardized, mandatory LGBTQ curriculum to fill the gaps.

Streed said a harrowing doctors visit nearly 15 years ago when he had symptoms of a cold and swollen lymph nodes motivated him to pursue a medical career.

When I explained I was a gay man, the physician became very brusque, suggested HIV testing, left the room and never came back, recalled Streed, who was an undergraduate at the time.

Testing elsewhere showed Streed did not have HIV, but no one suggested tests for illnesses more common among college students, including mononucleosis, and he never received a diagnosis.

Physicians personal beliefs should not determine the quality of care and compassion that is delivered to patients, he said.

Rhi Ledgerwood entered the University of Louisville medical school in 2014, the year it became the pilot site for coursework and training in LGBTQ health issues based on guidelines from the Association of American Medical Colleges.

At Louisville, LGBTQ health care topics are woven into the curriculum in classes that explore issues such as gender-affirming hormone therapy, taught along with more traditional coursework.

Ledgerwood, now a medical resident in pediatrics, remembers feedback from classmates who felt it didnt apply to them or their future practices. It went against their beliefs and they didnt feel like they should be wasting their time on this subject.

They were politely told the curriculum was here to stay, and Louisville now serves as a model for other medical schools.

When Tim Keyes enrolled in Stanford Universitys medical school in 2015, he was surprised to learn he was one of only two gay students in the first-year class who were out.

Because were here in the California Bay area, I was expecting the community to be a little bit different, Keyes said.

LGBT health issues were crammed into one elective class that attracted relatively few students, but now a broader focus is part of the mandatory curriculum.

Two years ago, Keyes was among six students at four universities who created the Medical Student Pride Alliance. The group has 31 chapters on U.S. campuses and works to promote recruitment of LGBTQ students in medical schools, more enlightened coursework and improvements in LGBTQ medical care.

A lecture he heard at Stanford in which a professor mentioned that nearly 1 in 2 teens under age 18 who identify as transgender will attempt suicide shows why the groups work is so important, Keyes said.

The professor went on to note that studies have shown the risk becomes much closer to zero, Keyes recalled, if a physician simply counsels them and offers affirmative care.

Read this article:
Harvard med student from Minneapolis part of push to improve LGBTQ care - Minneapolis Star Tribune

Because fasting may negatively affect a woman's hormones, there are related concerns about fertility. Some medical experts think that a woman's body may see fasting as a danger of impending starvation. As a result of this, they think the body inhibits ovulation since there wouldn't be enough nutrients to sustain a growing fetus.

However, there are other doctors, like Felice Gersh, M.D., who have opposing views. Gersh says, "Based on what we know now, my prediction is that short periods of fasting will actually enhance fertility."

So, who's right? Once again, the science isn't totally clearand most of the research has been done on animal models, instead of humans.

In one study, researchers looked at how three months of intermittent fasting affected female rats. They found that the rats not only lost 19% of their body weight, but they also had significant changes in their reproductive hormones. LH and kisspeptin levels went down, while estradiol levels went up.

However, another review looked at intermittent fasting in women with polycystic ovary syndrome, or PCOSa condition with infertility as one of its hallmark symptoms. The researchers hypothesized that intermittent fasting could actually improve fertility in women with PCOS by reducing levels of glucose, insulin, IGF-1, and IGFBP1.

According to the report, women with PCOS tend to have increased expression of IGF-1 and IGFBP1, two hormones that affect insulin production. When insulin levels get high, it triggers the body to make more androgen hormones, like testosterone, which makes it harder to get pregnant. On the other hand, when insulin levels go down, it can improve ovarian function.

Another study added on to this, concluding that short-term calorie restriction could actually increase LH levels in women with PCOS while simultaneously decreasing glucose, insulin, leptin, and testosterone.

Read more here:
Is Intermittent Fasting Safe For Women? All Your Questions Answered - mindbodygreen.com

The Utah Legislature has passed a resolution regarding high school start times that, while not binding, nonetheless brings the childhood development issue into the spotlight in school districts around the state including in Park City, where local school officials have spent significant time in recent years grappling with the topic.

Rep. Suzanne Harrison, D-Draper, introduced the legislation. As a physician and a mother of teenagers herself, she said the issue of sleep-deprived children is near and dear to her.

Anyone who has teens knows it is difficult to wake them up early in the morning, she said. But they arent lazy they are in a unique developmental period. They are undergoing a host of biological changes, including brain development and sleep changes.

Chief among those changes as they pertain to sleep is the bodys release of melatonin, the hormone that helps regulate a persons sleep cycle. In the average adult, melatonin starts kicking in around 9 p.m. For the average teenager, health experts say, the body doesnt release melatonin until 11 p.m. As a result, only one in 10 teens are getting the recommended nine hours of sleep.

And this is putting them at risk for serious mental health, physical health and academic risks, Harrison said.

Harrisons resolution, H.C.R. 3, encourages Utah school districts and charter schools to consider the possible benefits and consequences of a later start to the school day for high schools. After winning support in the House earlier this month, the resolution was approved in the Senate Friday, sending it to the governors desk.

The resolution is nonbinding it encourages districts to explore the change but doesnt mandate it. That, Harrison said, is by design. For one thing, she said, addressing sleep deprivation in teenagers requires a holistic approach. It isnt just the schools that need to adjust.

There are many things parents, families, communities and school districts can do to help our kids get more sleep, she said. Looking at school start times is one thing that studies have shown can help kids get more sleep and is an important public policy discussion to have.

For another, Harrison recognizes that a statewide mandated school start time is unworkable. Different communities have different needs. The emphasis, she said, is on local solutions.

Im hoping this resolution will encourage conversations at the local school district and community level to educate families about sleep science and have a local discussion about how to help our kids be as healthy and academically successful as possible, she said. This is not a mandate. Im asking for conversations and innovative ideas for helping our kids.

Harrison said she is looking forward to discussing the issue as a parent in her own community and seeing what works there.

I would love to see some reasonable shifts in start times where feasible, she said. I also hope this will spur innovative ideas and solutions. There is not a one-size-fits-all solution for this.

Harrison said in her research she has already seen some school districts make interesting changes to their schedules to allow their students to get more sleep.

Some school districts are offering options for first period to allow more students to sleep in, she said. Other districts have shifted the timing of core classes versus electives or PE classes to accommodate later school start times so student athletes miss electives or PE rather than core classes the few times a semester when they need to leave for competitions or games.

Other districts have found opportunities for improving efficiencies in transportation schedules or routes to help address transportation challenges in shifting times. The bright people in our communities and districts may come up with other ideas, but we wont discover them unless more communities have the conversation about sleep science and high school start times.

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State resolution puts school start times, once considered in Park City, in the spotlight - The Park Record

Try: Fatty fish such as trout, sardines, and herring

How much? Have one four- to six-ounce serving two or three times a week. Or consult your doctor about taking fish-oil supplements.

Eating fatty fish, which are high in long-chain omega-3 fatty acids, may lower the body's production of prostaglandins, hormone-like chemicals that can induce inflammation and pain, causing migraines. (ICYMI, there is a difference between headaches and migraines.)

"We found that adolescents who took 1.25 grams of fish oil daily for two months experienced fewer headaches, which were less severe and didn't last as long," explains Zeev Harel, M.D., a researcher who has studied the topic of foods that help migraines and the director of Pediatrics and Adolescent Medicine at Community Health Services in Hartford, Connecticut.

Avoid: Processed meats, artificial sweeteners, red wine, chocolate, hard cheeses, and citrus. Research shows that 20 percent of migraine sufferers are sensitive to one or more of these foods.

See original here:
Best Foods That Help Migraines, Stress, and Beyond - Shape Magazine

BOISE, Idaho After two days of emotional testimony on H.B. 500 -- or the trans student athletes bill sponsored by Rep. Barbara Ehardt, R-Idaho Falls, and Sen. Mary Souza, R-Coeur dAlene -- the decision was finally made: the bill will head to the floor with a "do pass" recommendation. While Democratic members opposed, Idahos House State Affairs Committee voted on party lines today to advance it.

"I really appreciate the process. This has all been about preserving opportunities for girls and women in sports, and it's important. The state has an invested interest in doing this. I feel that we've done the right thing," said Ehardt, after the voice vote.

Democratic Assistant Minority Leader John McCrostie recently called the proposed legislation an effort to try to take the humanity of trans people.

Cricket Yager, who identifies as non-binary, says they attended Thursday morning's hearing to show support for the opposition. They say they feel the decision is "difficult to grapple with."

"I think the bill itself was pretty outrageous and it's oppressive. We have, like, centuries of violence against transgender people, and just queer people in general. My reaction is just kind of hopeless," said Yager.

H.B. 500 would ban transgender girls from playing on cisgender girls' high school and college sports teams. It would also subject them to physical examinations by a physician that would be used to determine gender. Rep. Elaine Smith, D-Pocatello, asked Ehardt if students would be subject to pelvic examinations; Ehardt said the process would glean information from non-invasive blood and urine samples.

"The invasive examinations that young athletes would be subjected to if this bill passes are barbaric and cruel, and violate an individual's privacy, said Mistie Tolman, Idaho State Director of Planned Parenthood Votes Northwest and Hawaii. Trans athletes are complex athletes whose determination, will, and dedication to their sport should be celebrated, not shunned."

As we previously reported, reps from the office of the Idaho High School Activities Association (IHSSA) say they have a pre-existing policy on trans athletes in high school sports, which came to them from the National Federation of High Schools. That policy requires trans women athletes who wish to participate on girls' teams to receive hormone therapy for a year, under a doctor's care. After completing 12 months of hormones, trans women are allowed to play alongside the gender they identify with.

If Ehardt's bill is passed, it could create some pretty big complications for state colleges and universities in Idaho that are members of the NCAA. The NCAA also requires its members to allow transgender athletes to participate in sports that align with their gender identity.

Transgender men may do so immediately, but similar to the National Federation of High Schools, the law for trans women in the NCAA is that they must undergo testosterone suppression therapy for a year before competing.

As 6 On Your Side previously reported, another Republican lawmaker, Rep. Christy Zito, R-Hammett, introduced a bill this session that would ban doctors from even providing hormone treatments to people under 18, so 6 On Your Side will keep you updated on that -- as well as on Ehardt's bill.

Read this article:
Trans student-athletes bill heads to floor with 'do pass' recommendation - 6 On Your Side

In plain white text atop a blue-to-pink gradient, Solace greets new users with a dictionary definition of its name: comfort or consolation in a time of distress or sadness. Its a fitting name for an app that aims to give trans people more information about various aspects of transitiona one-stop resource for people who know they are trans, but dont know how to be trans.

After entering some basic informationtheir name, their pronouns, and their location by statethe user is presented with some common transition goals, as Solace terms them. These include all of the major transition milestones like beginning hormone replacement therapy and updating the name and gender marker on ones passport, as well as seemingly mundane (but surprisingly difficult) tasks like buying the right bra.

The goal, according to Solace co-founder Robbi Katherine Anthony, is to help users make their transitions as easy as possiblesomething she wished she could be able to say about her own.

Transition is beautiful, but its also incredibly hard, Anthony told VICE.

Born in New Mexico, the 27-year-old software developer now lives in Spokane, Washington. She came up with the idea and designs Solace with fellow developer Patrick McHugh, and turned to Crowdbotics, a software company in Berkeley, to build out the app. As Solaces only full-time employees, Anthony and McHugh run an extraordinarily lean operation, bouncing between Anthonys home, her 1998 blue Honda CR-V, and whatever coworking space they might be working in on a given day. Its fly or die every single day here, said Anthony. But shes committed to making something that she hopes makes transition a little less confusing, a tool she would have appreciated if it had existed all those years ago.

My transition has been rough, she told VICE. But Ill be damned if I dont do everything in my power to help others avoid that.

Solace co-founders Patrick McHugh (L) and Robbi Katherine Anthony (R). Photo courtesy of Robbi Katherine Anthony.

Anthony said that one of the biggest hurdles she faced in the early stages of her transition was finding out how to transition in the first place. She blamed a lot of this inaccessibility on gatekeeping, a term that, in a trans context, often refers to the many ways in which a health care professional can refuse gender-affirming care to a trans patientsay, a doctor who wont prescribe hormones, or surgeon who wont operate on a woman he doesnt find attractive or cis-passing enough for his standards. Anthony told VICE that she experienced this kind of medical gatekeeping firsthand, but she also used the term to describe her experiences with other trans people.

Certain people in the community become gatekeepers of information, Anthony said. Transition is a model of oral tradition, but if you have to meet people in order to transition, that inherently limits transition to people who can access that network. Some people physically cannot do that or dont want to. That information is also highly anecdotal, which she said is a problem because it ignores how one persons circumstances are not analogous to another persons.

Solace disrupts that model, she continued. If the process could be reduced from finding the right gatekeepers to having a compendium that allows you to proceed on your own terms, I think it would be healthier.

I asked Anthony if creating Solace, an app designed to circumvent community gatekeepers, might turn her into the very trans community gatekeeper she set out to circumvent.

Thats a really fair question, Anthony said. Gatekeeping, in its most nefarious forms, requires folks to do some interaction in order to get information. Whether its being approved by a moderator to join a group, seeking out a time or space or venue based on terms dictated by someone else, or being forced to curry favor with someone for them to share informationthats gatekeeping in my book.

Solace, which launched in December 2019, is quite unlike any of the other trans-specific apps available through Apples App Store. Searching for trans or transgender on my iPhone turns up an endless scroll of dating apps for cis men trying to meet trans women and crossdressers with nearly illegibile, knockoff brand names like Tinded, Sinder, and Transdr. Theyre mostly godawful, Anthony said. Fetishizing trans people... transsexual dating dot this, and stuff. There are a few practical options that actually seem to have been designed with a trans user in mind, like audio recording apps to practice voice modification, crowdsourced safe restroom finders, and a selfie-driven transition tracker. But nothing is quite as comprehensive as Solace, which contains more than 180,000 words of text, according to Anthonys estimate.

The app gives users the ability to curate a custom checklist of transition tasks, which are divided into three categories: legal (updating your birth certificate, what you can do about workplace discrimination); lifestyle (coming out to your family, connecting with other trans people); and medical (facial feminization surgery, laser hair removal, family planning). Every item is comprehensive, containing lots of actionable information about the task at hand. The coming out to family entry, for example, includes both tips on what to do (write a coming out letter to each and every family member, ask to be called by your name and pronouns, be ready to explain what transgender means) along with general advice (make sure you are sober when you come out, be prepared to lose your housing or financial support).

Many of the resources are tailored to the users gender identity and location, as non-discrimination laws and the legal hoops one has to hop through in order to change the name and gender marker on their state-issued documents vary by state. For example, the page for updating your birth certificate in Arizona correctly notes that youll need an affidavit, a certified copy of a court order, a photo copy of a valid government-issued ID, a signed letter from your physician verifying that youve undergone a sex change operation, and a small fee. The page for Washington is significantly shorter, as the Evergreen State doesnt require surgery or a fee.

Solace is free to download and the creators have no intention of selling user data to third parties. We will never charge a penny, Anthony said. Were currently donor supported. We tap into foundation support, sometimes as grants. Were structured as a nonprofit. This community faces a disproportionate amount of poverty, so putting a paywall on this thing felt counterintuitive to what we were trying to do. And data-mining, she paused. Our stomachs turn at the thought of it.

Anthony declined to share how many people have downloaded Solace since launch, though she said she and McHugh are currently halfway to reaching their 2020 user goal. The app has had a number of updates since its December launch, like the addition of more detailed information regarding Medicaid coverage for trans care in different parts of the country. Anthony said that she also plans to integrate a news aggregator with articles about a variety of trans topics, implement dynamic pronouns within the apps copyto match the pronouns the user enters, and launch a mode for parents and guardians of trans kids.

Listening to Anthony talk, I couldnt help but think about how different my experience with transitioning has been. Its not that I havent had to seek out other trans people to find out who they see for laser hair removal or whether progesterones really worth the hype; Ive had to do all of those things. The difference is that I view them as positives rather than negatives. Ive found a lot of value in talking to other trans people about their experiences and sifting through their anecdotal experiences to figure out what might be right for me. Im deeply grateful for all the friendships Ive made and communities Ive joined after putting myself in uncomfortable, new social situations. I asked Anthony if she was concerned that an app like Solace might lead trans people away from their local communities. Its a byproduct were aware of, she said, but I wouldnt say that its a goal of ours.

Our entire ethos is about providing this community with agency, and part of agency is allowing people to access information on their own terms, she said.

Solace might not be of that much use to me, an extrovert in a major city whos already in community with other trans people (and my questions at this point of my transition are more existential than they are practicalless about how do I do this or how do I do that, and more about what do I do now). But it could be useful to people who dont know any trans people, or live in a part of the country with no visible local community, and might be particularly helpful for early transitioners or trans people who havent come out yet and are still trying to figure out where to begin.

Regardless of who makes use of Solaces many comprehensive resources, Anthony was clear about one thing: she doesnt want anyone to rely on the app forever. The ultimate sign of Solaces success is that the user deletes the app because they dont need it anymore, she said.

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More:
Want to Transition? There's an App for That - VICE

When most people clean up their diets to lose weight or boost their overall health, one of the first things they're told to cut out is alcohol. After all, no amount of alcohol is particularly "good" for you, per an August 2018 analysis in The Lancet and it's certainly not low in calories, no matter which type you're sipping.

Meditation is one way to relax without alcohol.

Credit: Westend61/Westend61/GettyImages

But for many, a glass of wine or a cold beer at the end of a long workday is a go-to way to de-stress and unwind. And that's nothing to sneeze at, because lowering your stress levels can be key for weight loss, too.

While a casual drink may seem harmless, there's often a biological component at play that keeps alcohol at the top of the list of favorite de-stressors, Roger Adams, PhD, personal trainer, doctor of nutrition and owner of eatrightfitness, tells LIVESTRONG.com.

"At its basic level, alcohol of any kind is a depressant, meaning it slows down the activity and processes of the brain and central nervous system," Adams says. "If used only occasionally for stress relief, alcohol is likely to be quite effective in the short-term. However, we tend to need to consume more over time to get the same de-stressed feeling, so consumption is likely to increase."

This increased alcohol consumption over time can cause myriad health problems, including mood and behavior disruptions, high blood pressure, stroke, liver disease and even cancer, according to the National Institute on Alcohol Abuse and Alcoholism.

Many of us may find it difficult to relax without alcohol, but there are compelling health benefits to limiting your intake.

Credit: BrianAJackson/iStock/GettyImages

On the other hand, stress is also a major health issue. One March 2018 study in the journal Psychological Science found that even stress that is seen as small and insignificant can lead to health problems including heart disease, anxiety and depression, chronic pain and more.

Another November 2018 study in Neurology discovered that a high-stress lifestyle could lead to memory loss and brain shrinkage before the age of 50.

And, like alcohol, stress doesn't help your waistline either. Those who suffer from long-term stress are more likely to be obese, according to a study published February 2017 in the journal Obesity. The main culprit is cortisol, a stress-induced hormone that can encourage your body to hold onto fat.

In short: If both stress and drinking are bad for you, the healthiest lifestyle is one that includes less of both.

Luckily, there are plenty of stress-relieving solutions that can help you whittle your waistline and boost your health. Here, experts share their science-backed alternatives to drinking that can still help relieve stress.

Exposure to nature has a lot o benefits, including a better mental state of wellbeing as you leave all the noise of life behind, Adams says.

This was shown in an April 2019 study published in Frontiers in Psychology, which examined two biomarkers of stress when exposed to nature: salivary cortisol, a measure of the amount of stress hormone in the saliva, and alpha-amylase, digestive enzymes. They found that both stress biomarkers dropped in people when they were exposed to nature.

So instead of happy hour after work, suggest taking a walk or throwing a frisbee in the park with your pals, or simply take a walk through the trees after dinner instead of parking yourself on the sofa with a cold one.

Did you know that keeping a food diary is one of the most effective ways to manage your weight? Download the MyPlate app to easily track calories, stay focused and achieve your goals!

Meditation can be a powerful stress-reliever, according to a systematic review and meta-analysis published March 2014 in JAMA Internal Medicine. After reviewing 47 trials, the researchers concluded that mindfulness meditation can improve levels of anxiety, depression and pain as well.

Another study, published July 2019 in Scientific Reports, found that it takes as little as 40 days of meditating to change your brain waves enough to improve stress.

"Progressive relaxation meditation involves a guided experience where you relax each part of your body, as well as calm the inner chatter that often feeds stress and worry and keeps us too stimulated for sleep," Roseann Capanna-Hodge, PsyD, psychologist and certified integrative medicine mental health provider, tells LIVESTRONG.com.

One of the best parts about meditating is that it's easy to do anywhere all you need is a safe and quiet place to sit, reflect and calm your mind. If you're looking for a little guidance, consider downloading one of the many meditation apps out there, such as InsightTimer or Calm.

Practice yoga as a healthy alternative to alcohol for stress relief.

Credit: fizkes/iStock/GettyImages

Like meditation, yoga is a good alternative to drinking that can provide boundless benefits for the body and mind, particularly when it comes to reducing levels of stress, anxiety and depression, per a February 2018 study in the International Journal of Preventive Medicine.

"By performing yoga moves and breathing properly, you can promote your mental health through the relief of stress," Jamie Bacharach, medical acupuncturist and yoga practitioner, tells LIVESTRONG.com. "Due to its use of meditation-like posing and deliberate breathing, yoga has the ability to increase your own body awareness, relax the mind and give you a sharper focus, all of which contribute to optimized mental health."

Being mindful of one's surroundings and using visualization to reduce stress has become an increasingly popular technique. Though it sounds quite similar, visualization is different than mindfulness or meditation.

"Visualization involves actually visualizing what you want and honing in on one's authentic purpose to create goals around it," explains Dr. Capanna-Hodge. "It's a powerful way to not only get clarity on your goals but to help manifest them."

To incorporate visualization into your day-to-day, Dr. Capanna-Hodge suggests taking a few minutes to sit in a quiet place and visualize what you want to accomplish and pair it with action around those goals that move them to positive outcomes.

"Whether you have a goal to better manage stress or address a specific issue, intent-oriented visualization is a great way to create positive momentum by getting to the core of the issue and its resolution," she says.

"The lasting effects throughout the day of a short workout can provide the calming effect that you may be looking for in that after-work cocktail."

It might sound simple and it is but getting your heart rate up is one of the best ways to reduce the effects of stress.

When you exercise, your body amps up its production of the "feel-good" hormone known as endorphins, while stress does the complete opposite, explains Joseph De Santo, MD, board-certified physician and addiction specialist for the BioCorRx Recovery Program.

Indeed, in responses gathered for the American Psychological Association's Stress in America 2019 survey, a whopping 53 percent of adults reported that they feel good about themselves after exercising, and 30 percent reported feeling less stressed.

"No matter what you are doing, if you are moving, oxygen is getting to the brain more efficiently and endorphins are being released," Dr. De Santo says. "The lasting effects throughout the day of a short workout can provide the calming effect that you may be looking for in that after-work cocktail."

Using essential oils is one way to relax without alcohol.

Credit: JGI/Tom Grill/Tetra images/GettyImages

Essential oils not only smell nice, but they can have a beneficial effect on both your brain and body.

Lavender oil in particular, has been shown to help alleviate symptoms of anxiety, according to one July 2017 study published in The Mental Health Clinician.

"When essential oil molecules enter the nose or mouth, they pass to the lungs and eventually the brain and other parts of the body, stimulating the olfactory system, which is the part of the brain connected to smell," Dr Capanna-Hodge explains. "As the molecules reach the brain, they affect several regions, including the limbic system, which is linked to the emotions, our memory and attentional systems, as well as our hormone and immune systems, and can lower cortisol and stress levels."

She recommends using an infuser to disperse essential oils around your home or workplace to keep your stress levels low and your body relaxed.

This nutrient has numerous health benefits, including enhancing bone health and reducing one's risk for diabetes, heart disease and anxiety. It also has impressive stress-relieving perks, as shown in a May 2017 study published in Nutrients, which found magnesium supplementation to be beneficial in relieving anxiety as well as stress.

"By supplementing with magnesium, you not only calm the nervous system, you help your body combat stress and give it what it needs to work at an optimal level," says Dr. Capanna-Hodge.

You can take a magnesium supplement, but you can also score the nutrient in certain foods, particularly spinach, almonds, avocado, tofu and dark chocolate.

Keep in mind the recommended daily intakes for magnesium, according to the National Institutes of Health:

Most Americans (1 in 3) are not getting their fair share of shut-eye and it's having a negative affect on their health and overall wellbeing, according to the Centers for Disease Control and Prevention.

What's more: Oftentimes stress is the cause of inability to sleep well. A National Sleep Foundation poll found that 43 percent of young and middle-aged adults report difficulty sleeping at night as a result of stress at least once a month.

"Getting to bed and getting enough sleep for four to five REM cycles (typically six hours minimum) can provide your brain the healing time that allows it the chance to re-organize and refresh, so you don't carry stress over from the previous day," Dr. De Santo says.

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Alternatives to Drinking: How to Relax Without Alcohol - LIVESTRONG.COM

Just a word or two: Welcome to Friday, dear readers, as we wrap up another busy workweek and look forward to another well-earned weekend.

Its Feb. 21 out there, and before we begin, please speak up today is International Mother Language Day, the U.N.s multicultural salute to linguistic diversity.

For the bun of it: Sticky situation.

Going to extremes: Today is also National Grain-Free Day (a big one for the low-carb set) and National Sticky Buns Day (not so much).

And give a deserving someone a hug on National Caregivers Day, always the third Friday in February, honoring healthcare professionals who deliver long-term and hospice care.

Stop, thief: Today is also the 162nd anniversary of the worlds first electric burglar alarm, installed in Boston on Feb. 21, 1858.

Dental record: Dentist Lucy Hobbs became the first woman to obtain a DDS degree from an American university on this date in 1866.

Hobbs was required to attend only one semester at the Ohio College of Dental Surgery, thanks to credit earned during years of private practice (after initially being rejected by the college because she was a woman).

Lab work: The first U.S. institutional medical laboratory, the Hoagland Laboratory, opened in Brooklyn on this date in 1887.

Physician and founder Cornelius Hoagland sunk $150,000 of his own money, including $100,000 for construction and a $50,000 endowment, into what was also Americas first bacteriological lab.

Fizz, fizz:: Oh, what a relief it is.

Plop, plop: Alka-Seltzer, the all-purpose rumbly tummy treatment, made its commercial debut on Feb. 21, 1931.

Doubling down: And they wouldnt make their game-changing announcement for another week or so, but according to the story, controversial scientist James Watson and his longtime lab partner, Francis Crick, discovered DNAs double-helix structure on this date in 1953.

Bowl of cherries: Syndicated newspaper columnist and beloved American humorist Erma Bombeck (1927-1996) who also authored more than a dozen books, including several bestsellers would be 93 years old today.

Nina Simone: The high priestess of soul.

Also born on Feb. 21 were colorful English chemist John Mercer (1791-1866), who invented the mercerization process for textiles and was a color-photography pioneer; French fashion icon Hubert de Givenchy (1927-2018); jazz and R&B great (and civil rights crusader) Nina Simone (1933-2003); and Star Wars actor Anthony Daniels (born 1946), the only actor to appear in all nine of the Skywalker Saga films, as fussy droid C-3PO.

Going up: And take a bow, William McDonough the American architect, environmental engineer and pioneer of the upcycling movement (which takes mere recycling to the next level) turns 69 today.

Wish these and all the other Feb. 21 innovators a happy birthday at editor@innovateli.com. Well take the presents story tips and calendar items, all shapes and sizes, please and thank you.

From our sponsor: Headquartered in New York for more than 20 years, Webair delivers agile and reliable Cloud and managed-infrastructure solutions leveraging its highly secure, enterprise-grade network of data centers in New York, Los Angeles, Montreal, Amsterdam and the Asia-Pacific. Its services can be delivered securely via direct network to customers existing infrastructure, enabling them to consume SLA-backed solutions with ease, efficiency and agility as if they were on-premise. With an emphasis on reliability and high-touch customer service, Webair is a true technology partner to enterprises and SMBs including healthcare, financial, legal firms, IT, eCommerce, SaaS and VoIP providers.

BUT FIRST, THIS

Sports model: Another week, another new vertical for supply-chain authentication specialist Applied DNA Sciences.

Just days after announcing DNA strand-producing spinoff company LineaRX would expand an existing collaboration with Italian partner Takis Biotech to take the fight to the dreaded 2019-nCoV coronavirus, the Stony Brook-based biotech is making its first-ever foray into the dietary supplements market with a new, multiyear deal that applies the DNA-based CertainT authentication solution to products containing Nitrosigine, a leading sports supplement produced by Westchester-based Nutrition21.

Nitrosigine (a bonded arginine-silicate, for those keeping score) has earned FDA New Dietary Ingredient status and is currently incorporated into some 250 consumer products. That places a premium on traceability and authenticity, according to Nutrition 21 VP Bill Levi, and led the manufacturer straight to Applied DNA. The scientific evidence provided by [the] CertainT platform will support these principles with verification of product compliance through the supply chain, Levi said Wednesday.

Running start: A leg up for minority- and women-owned business enterprises.

MWBE, start your engines: Albanys 2020 Regional MWBE Opportunities Expo Series, designed to encourage minority- and women-owned startups across the state, will get rolling next month with an all-day event on Long Island.

Sponsored by the Empire State Development Corps Division of Minority and Womens Business Development and supported by other state agencies and local partners, the expo series will feature panel discussions, MWBE certification workshops, details on the states MWBE Business Builder Boot Camp, access to regional Small Business Development Centers, expert government-contract procurement tips and other advice designed to help women and minorities start their own businesses, and succeed.

The series is scheduled to kick off March 20 at Farmingdale State College, with other expos scheduled throughout the year at Binghamton University, the University at Buffalo and Mohawk Valley Community College. More details on next months Farmingdale State expo right here.

TOP OF THE SITE

Incentivized: Theyre feeling motivated at the Suffolk County IDA, which is busily fortifying county employment on an incentives-package hot streak.

Hail to the chief: One of the hardest workers in all of Long Island innovation explains why the COO is usually an organizations most vital cog.

Easy does it: Love this newsletter? Us, too. Help us help you by sharing this one with your fellow innovators and urge them to subscribe for free, already. Its not hard.

ICYMI

The state approves new Long Island-based cardiac labs; the nation approves new Long Island-based craft-beer awards.

BEST OF THE WEST (AND SOMETIMES NORTH/SOUTH)

Innovate LIs inbox overrunneth with inspirational innovations from all North American corners. This weeks brightest out-of-towners:

From Wisconsin: Fitchburg-based biotech JangoBio leaps forward with sustainable stem-cell based therapies promising complete hormone restoration.

From Texas: Houston-based William P. Hobby Airport hastens international arrivals and departures with face-recognition biometric tech.

From Georgia: Atlanta-based IoT developer Digital Matter earns critical Verizon certifications with battery-powered global asset-tracking devices.

ON THE MOVE

Kaitlin Friedman

+ Kaitlin Friedman has joined Woodbury-based SterlingRisk Insurance as alternative market leader in the SterlingRisk Programs Department. She previously served as an account executive for HUB International in Woodbury.

+ ERASE Racism has announced two new hires: Nadia Jean-Franois, formerly a middle school teacher in Florida, is now the education equity coordinator, and Steve Glassroth, formerly an attorney in Alabama and Georgia, is now director of Housing Policy & Initiatives.

+ Jeremy Musella has joined Uniondale-based Forchelli Deegan Terrana as an associate in the Corporate/Mergers & Acquisitions and Veterinary practice groups. He previously served as an associate at Garden City-based Cullen and Dykman.

+ Mark Nuccio has been elected treasurer of the Walt Whitman Birthplace Association in Huntington Station. He is the founder and partner of Bethpage-based Design Edge Group.

+ Sean Miller has been elected treasurer of the Literacy Nassau Board of Directors in Wantagh. He is the store manager for TD Bank in Floral Park.

+ Islandia-based Lewis Johs Avallone Aviles has announced the promotion of two new partners: Amy Bedell, formerly senior counsel, and Annemarie Jones, formerly an associate.

BELOW THE FOLD

Breathe normally: There are better ways to deal with 2019-nCoV.

Healthy start: Successful startups must first learn these 10 valuable lessons.

Sick days: How companies around the globe are coping with the coronavirus.

Feeling better: How Big Tech is changing hospital operations (for the better).

Curing what ails you: The healthcare sector is just one of the cutting-edge industries tapping into the HIPAA- and HITECH-compliant IT services provided by Webair, one of the amazing firms that support Innovate LI. Check them out.

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No. 477: In which the Suffolk IDA incentivizes and the double helix debuts plus, sticky buns for all! - Innovate Long Island

February 18, 2020 (American Thinker) To describe Canada as a totalitarian state-in-progress sounds like a gross and indeed absurd exaggeration. Yet many premonitory signs are present. In the words of political philosopher William Gairdner, author ofThe Book of Absolutes,The Great Divide, andThe Trouble with Canada, Canada has just crossed the red line between soft-socialism and soft-totalitarianism.

Gairdner has assembled a virtual mountain ofevidencefor his claim:Bill C-25seeking to impose diversity on all corporations; financial penalties against organizations that do not comply with government programs; a teeming brigade of government surveillance inspectors that is, spies: wage spies, speech spies, feminist spies, pay equity spies, Human Rights spies; paralegal bodies known as Human Rights Tribunals with the power to levy crippling fines, bankrupt families, and shut down businesses, impose prison time for contempt of court, and compel conformity via re-education.

The list goes on. Bill C-16 prohibits discrimination on the basis of gender identity and gender expression, which sounds unexceptionable except for the obvious fact that discrimination is in the eye of the offended beholder and the government enforcer. The bill effectively mandates that citizens address others by their preferred pronouns and transgender fantasies or else! Its zir, ze, zem, or zeir, or youre done for. Its Emily, not Brian, or your jobs in peril. TheOntario Human Rights Codestipulates that refusing to refer to a trans person by their chosen name and a personal pronoun that matches their gender identity ... will likely be discrimination in social areas like employment, housing, education, and so on. As Queens University law professor Bruce Pardy writes, human rights have become a weapon to normalize social justice values and delegitimize competing beliefs. There are other laws on the books, bills such asC-59, C-75, andC-76, that reduce and even criminalize freedom of expression, infringe on privacy rights, compromise due process, and render government transparency a thing of the past.

The assault against normalcy, common sense, civil rights, and charter freedoms gives no indication of relenting. Bill S-202, an act to amend the Criminal Code now before Parliament, would outlaw what the government misleadingly calls Conversion Therapy that is, by criminalizing parents, lawyers, physicians, and church leaders who object tostate-compelled hormone-drugging and genital mutilation procedures, the bill would effectively prevent minor children undergoing forced transgender operations, surgical and hormonal, from receiving the help they need. This whole agenda to sterilize and mutilate children, write the editors ofAction4Canada, is pure evil and in violation of ... the Charter of Rights and Freedoms, the Universal Declaration of Human Rights, The International Covenant on Civil and Political Rights,as well as a physicians ethicalcommitment promising to First, do no harm.

In an article for the National Post, columnistRex Murphy, one of that rare breed of truth-telling Canadian journalists, writes: This government, or the agencies of this government, are establishing a pattern of misusing the authority of the law. Among other instances of official malfeasance, Murphy skewers the Liberal governments fraudulent case against Rebel News founderEzra Levantfor publishing and promoting a book critical of Prime Minister Justin Trudeau,The Librano$, during the October 2019 election without registering the book with a government agency. Can anybody name any other book, ever, Murphy asks, which has been the subject of an investigation by the Commissioner of Canada elections? ... WillPEN Canada, defender of authors and journalists, take up the banner for Mr. Levant? Rhetorical questions, obviously.

As of this writing, new developments have come to the fore. Not satisfied with relying on the misapplication of electoral law or conducting dodgy prosecutorial attacks on individuals whom the party wishes to intimidate, silence, or arrest, Trudeaus Liberals are considering a motion requiring all news contentcreators to procure agovernment licensefor approved content, thus controlling public access to information. These are autocrats that Canada has empowered, writes spokesman forCanadians for Language FairnessGordon Miller (personal communication). Now we will pay the price.

Not content with such despotic measures, the CRTC (Canadian Radio-Television and Telecommunications Commission)proposesto identify news sites that are accurate, trusted, and reliable with the intent to enhance the diversity of voices. Truth be told, there are precious few accurate, trusted, and reliable news sites in Canada. As in the U.S., they are almost all parabellum outfits, taking dead aim at honest reporting. Moreover, we know that emphasizing diversity of voices is equivalent to the imposition of the grievance-driven identity-group and social justice model on public broadcasting while constraining factual reporting and bridling the dissemination of genuine news. It is, in effect, tantamount to a government monopoly on information, which, as Conservative shadow minister for industry and economic developmentMichele Rempel Garnerrightly warns, puts us in league with countries that control the media.

That the warning comes from a Conservative M.P. who, like the majority of her colleagues, has embraced many of the Liberals woke policies and progressivist attitudes shows how far gone we are. Indeed, the contagion has spread throughout the House. All of Canadas political parties signed on to Bill C-76, which received royal assent in December 2018 and imposes further restrictions on third-party speech during extended election periods. This is to be expected. Every political party steers to the Left, including, as noted, the Conservatives, who are essentially Liberal Lite. Trudeau is simply the most visible embodiment and effective bellwether of the political virus infecting the country.

The treatment ofOmar Khadris another case in point. A Canadian citizen and youngest son of an Al-Qaeda terrorist family who was detained at Guantanamo Bay for violations of the laws of war in Afghanistan, including killing American combat medic Christopher Speer, Khadr was repatriated to Canada and awarded a $10.5-million compensationsettlementby Trudeau. Although the issue is clouded and precise information is difficult to find, it appears likely that he remains on a no-fly list. No matter: Khadr recently flew first class to keynote a panel discussion at Dalhousie University in Nova Scotia.

The beleaguered Levantconfronted himwith a series of questions was he aware of a no-fly list? Did he donate a portion of his cash windfall to the widow of Dr. Speer? (Levant did not mention that Khadr haspurchaseda strip mall in Edmonton for a substantial portion of his payout.) Khadr is regarded as a Canadian hero who suffered at the hands of the dastardly Americans, while Levant is nothing but a gadfly, so it was no surprise to see Levant grilled by four policemen and unceremoniously escorted from the airport. They got the wrong guy, as the expression has it, but thats how things happen in a nascent police state.

Canadiancombat veteran Jeremy MacKenzie,who attended the event or tried to was livid with righteous fury, recalling his buddies who gave their lives in Afghanistan fighting the Taliban and the likes of the extended Khadr family. Responding toTrudeaus excusein reference to military veterans pensions that veterans are asking for more than the federal government can afford, MacKenzie fumes that, that notwithstanding, we will make Omar Khadr, the Taliban terrorist, a multi-millionaire. Canada, he proclaims, is not the country that I signed up to fight for and it is certainly not the country that those men and women died for. Like Levant, he was escorted from the premises an analogy for the dwindling remnant of patriotic Canadians being escorted from their country.

These are developments that should not be dismissed as mere desultory details. They add up. As Gairdner points out, soft totalitarianism is a considerable way from hard totalitarianism. But it all starts somewhere, and this week, the road got shorter. There is a sort of politicalMartini curveat work as Canada races to keep up with the Leftist conformity of the modern international elite. Regrettably, Canada has no Donald Trump or Viktor Orbn or Boris Johnson on the current political horizon. Nor is there a term limit on the office of prime minister, which suggests that a socialist troll and ideological jamoke like Justin Trudeau may be in power for years to come. The one party that promised a return to social, political, and fiscal sanity, Maxime Berniers The Peoples Party of Canada, was deep-sixed by the media and wiped out at the polls. That tells us all we need to know.

To say it cant happen here the title of Sinclair Lewiss 1935 novel, though he targeted the wrong constituency is an expression of overweening confidence and lack of historical awareness. One does not have to think back to the demise of the Weimar Republic in Germany. A mere glance at the European Unions unelected, bureaucratic authoritarianism, or a recognition of what the Democrat Party is demonstrably planning for the United States, should awaken us to the danger. To be awakened, we might remark, is the opposite of being woke. Canada stands as a vivid illustration of what would be in store for the U.S. under a Democrat administration.

It can happen here, and it is happening right now, right here, in Canada.

David Solways latest book isNotes from a Derelict Culture, Black House Publishing, 2019, London. A CD of his original songs,Partial to Cain, appeared in 2019.

Published with permission from the American Thinker.

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Canada is sinking into totalitarianism. The evidence is overwhelming - Lifesite

Hormones are chemical messengers that signal cells throughout the body and coordinate vital functions.

Over time, hormone levels can fluctuate, which disrupts balance and leads to undesirable symptoms like hot flashes, mood changes, and decreased libido.

If you are experiencing hormonal imbalance symptoms, bioidentical hormone replacement therapy may be right for you.

However, before starting this course of treatment, youll likely have a number of questions, including: What are bioidentical hormones? How does bioidentical hormone therapy work? How can I find the best hormone doctor near me?

Heres what patients need to know about BHRT, and what they can expect should they decide to undergo this procedure.

Bioidentical hormones are compounded hormones that are molecularly-similar to the hormones that naturally-occur in the body.

Derived of natural plant sources, bioidentical hormones are inserted under the skin in a simple in office-procedure. Once implanted, they are able to replicate the bodys natural hormone levels.

Individuals who are experiencing symptoms related to hormonal-imbalance, including hot flashes, night sweats, mood swings, low libido, and weight gain, should consider bioidentical hormone replacement therapy.

To start this process, patients may research the procedure online and attempt to locate the best hormone doctor near me.

At an in-person consultation, their provider will evaluate their symptoms and overall health and determine if BHRT can help restore hormonal balance, alleviate symptoms, and offer disease prevention.

During a BHRT procedure, bioidentical hormone pellets, which are smaller than a grain of rice, are inserted in fatty tissue under the skin.

They are then able to consistently release small physiologic doses of hormones into the bloodstream.

A key advantage of BHRT is that it achieves sustained hormone levels throughout the day and avoids fluctuations and undesirable effects. Patients can enjoy BHRT benefits for a period of three-to-five months.

If you are considering BHRT and looking for the best hormone doctor near me, call our office today to schedule a consultation with board-certified gynecologist Dr. Melinda Hall.

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Best Hormone Doctor Near Me - The Menopause Center

Stock image, St. George News

CONTRIBUTED CONTENT Do you take thyroid hormone medication for your thyroid problems but still suffer from fatigue, weight gain, hair loss, constipation, depression, cold hands and feet or other symptoms? Has your doctor told you your lab tests are normal and there isnt anything more to do?

If so, you may respond well to functional medicine for low thyroid problems.

Hypothyroidism, or low thyroid function, affects millions of Americans, most of them women. Its common for people with thyroid problems to go undiagnosed for years. Those who are diagnosed still experience low thyroid symptoms and a gradual worsening of their symptoms despite taking medication. This is because they are not getting the autoimmune disease treatment they need.

Approximately90%of hypothyroidism cases in the United States are caused by Hashimotos, an autoimmune disease that attacks and destroys the thyroid gland. If you have hypothyroidism symptoms, its likely you have autoimmune Hashimotos.

While you still may need thyroid medications in order to function, these meds will not address the underlying autoimmune condition damaging your thyroid gland.This is why its important to seek out Hashimotos disease treatment from a physician trained in functional medicine.

For starters, its not sufficient to only run a blood test for TSH, as most clinics do. Instead, you need to test for TPO and TGB antibodies. If either of these is positive this means you need Hashimotos thyroiditis help.

At the RedRiver Health and Wellness Center, our functional medicine wellness team willhelp you restore balance to your immune system so it stops attacking the thyroid gland.

This is a customized approach that takes into consideration each persons unique triggers for Hashimotos hypothyroidism symptoms. There are numerous approaches to treatment.

Going on a gluten-free diet

Numerous studies show a strong link between Hashimotos hypothyroidism and gluten, the protein found in wheat, barley, rye, spelt and other wheat-like grains. Whats more, studies also show that people who are gluten-intolerant are more prone to Hashimotos. Gluten also cross-reacts with the thyroid gland.

This means that if you are gluten-intolerant and have Hashimotos, your immune system mistakes portions of your thyroid as gluten and attacks it whenever you eat gluten.

The AIP diet for Hashimotos

For some people, going gluten-free works great and improves their thyroid problems. For many others, its not enough and they require spending some time on the autoimmune Paleo or AIP diet. This is an anti-inflammatory diet that eliminates common inflammatory foods, such as dairy, eggs, soy and grains.

After a period of time on the diet, you then introduce foods you eliminated one at a time every three days to monitor for symptoms. Its important to eat a diverse array of plenty of vegetables while on the AIP diet for Hashimotos so you dont risk developing more food sensitivities due to loss of oral tolerance.

Address a leaky gut

A common Hashimotos disease treatment is to address a leaky gut, or intestinal permeability. Its common for leaky gut to play a role in autoimmune diseases such as Hashimotos thyroid problems. Leaky gut happens when the small intestine becomes inflamed and damaged, allowing undigested foods, bacteria and other foreign invaders into the bloodstream. Once in the bloodstream, these pathogens trigger inflammation and autoimmunity in other places in the body.

Balance blood sugar

Balancing blood sugar is an important autoimmune disease management strategy. Many people do not realize how unstable their blood sugar is it is either chronically too low or too high. This is because the normal American diet is typically too high in sugars and processed carbohydrates, such as breads, pastas, pastries and desserts.

Blood sugar imbalances trigger inflammation and hormonal imbalances that make it difficult to effectively manage an autoimmune condition such as Hashimotos hypothyroidism. Blood sugar imbalances also cause unpleasant symptoms such as energy crashes, fatigue, excess belly fat, premenstrual syndrome and other hormone problems, mood swings and sleep issues.

These are just a few of the basics of autoimmune disease treatment for conditions such as Hashimotos hypothyroidism. Its important to manage your autoimmune condition to lower your risk of developing other autoimmune diseases, such as pernicious anemia, rheumatoid arthritis, vitiligo or Type I diabetes.

To learn more about Hashimotos and other factors that can cause hypothyroidism, read my book The Truth About Low Thyroidorcontact one of our functional medicine wellness centers for more information.

If you do not already have a functional medicine provider, call RedRiver Health and Wellness Center St. George at 435-767-9355or emailRedRiverSG@redriverhealthandwellness.com.

Written by JOSH REDD, RedRiver Health and Wellness Center.

S P O N S O R E D C O N T E N T

About RedRiver Health and Wellness Center

One of the main goals at RedRiver Health and Wellness Center is to work with patients to improve their health, well-being and quality of life. The RedRiver Health and Wellness Center team is passionate about helping ailing patients achieve optimal health, and we truly care about the success of each and every patient.

RedRiver chiropractic physicians are great advocates for prescribing physicians and endocrinologists. In fact, many of our patients see their prescribing physicians more frequently while under our care than they would otherwise. Our goal is not to replace our patients primary care physicians and specialists but to complement their care by providing patients with nutrition, diet, lifestyle and educational support and strategies.

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Are your thyroid symptoms a sign you need treatment for Hashimoto's disease? Functional medicine may help - St George News

Many instances in on a regular basis life, we dont understand concerning the coming illness and that illness takes a type of type because of which harmful penalties need to be suffered. One such drawback is leg burning. Lack of vitamin B, folic acid or calcium within the physique is the primary reason behind burning sensation within the toes. The drawback of burning within the toes could be because of many causes, today were going to share with you about a few of these causes, so whats the delay, tell us about it.

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Burning on the toes could be gentle, sharp and extreme. Often this irritation is because of nervous system dysfunction or dysfunction. Or vitamin B12 deficiency can improve Vitamin B12 performs an necessary position in lots of capabilities of our physique together with nervous system. Due to lack of which this drawback arises.

Additionally, neuropathy illness will also be a reason behind burning of the toes, as neuropathy has an impact on all nerves. Therefore it may well primarily have an effect on all organs and methods. In this, burning, ache and prickling within the toes are felt in a really delicate method. Burning within the toes will also be brought on by hypertension. Blood circulation can also be troublesome because of hypertension. Due to this, theres a change within the colour of the pores and skin, pulsate of the toes and a lower within the temperature of the arms, because of which the toes really feel burning.

It has been discovered that these individuals who have kidney issues are additionally present in these folks, even when theres a kidney illness, its attainable to burn the toes. Diabetes is the main reason behind burning sensation within the toes. These folks dont require any additional testing to diagnose the illness. And the physician instantly controls it. Or the decrease ranges of thyroid hormone additionally trigger burning sensation within the toes.

Therefore, dont ignore the issue of burning sensation within the toes, who ought to get therapy instantly and forestall the issue. This drawback could be handled higher provided that this drawback is much less, so deal with your well being and observe medical recommendation with therapy.

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If you're additionally troubled by the issue of burning toes, then this therapy - Sahiwal Tv