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Biosecurity, boars and benchmarking in Pig Progress 9 – Pig Progress

The latest edition of Pig Progress is available for reading digitally. The latest copy zooms in on health issues as well as breeding and genetics.

To start with the last theme breeding and genetics Pig Progress was fortunate enough to take a little look into DanBreds new boar manual. The Danish breeding company publishes a step-wise manual with many chapters how to deal with its male animals.

Pig Progress had a sneak preview and chose the chapter as to how to train the boars. Dummies, stroking, boards, feeding many tips and tricks are discussed by DanBreds Trine Lund Pedersen on pages 6-7.

On the verge of health and breeding issues is Hendrix Genetics pig division, i.e. Hypor. This company has been very prominent in South Korea and sees this country confronted with African Swine Fever (ASF) in recent months. Boerderij reporter Judith Waninge and Pig Progress editor Vincent ter Beek learned about the BioHypor system a well thought-through biosecurity approach which should keep farms free from ASF. Pages 16-17

Hugues (Hugo) Six, general manager East and South-East Asia for Hendrix Genetics. Photo: Vincent ter Beek

And whilst we were in Asia, we also took a look into the situation in the Philippines. Dr Steven McOrist has an insight view as to what has been going on there in recent months and shares his experiences on pages 12-14.

Photo: Dr Steven McOrist

Also in this months farm visit, health issues were never far off. With the help of German syringe manufacturer Henke-Sass, Wolf, Pig Progress was allowed to visit Albesa Ramadera, an innovative model farm near Lleida, Spain. The farm aims to combine animal welfare, precision farming and a good health status. Throw all these philosophies in the blender and the result is a fascinating visit on pages20-23.

Laia Calder Puig (left) and Cristina Sanmartn Ruz vaccinating a piglet against PCV2. Note the yellow light in the vaccination device. Photo: Vincent ter Beek

More on-site visits in this edition as we also took a look at a feed production site of the Brazilian cooperative Lar. This is one of the larger agro-industrial cooperatives in Brazil. As African Swine Fever in Asia is likely to offer great export opportunities, the cooperative is keen to keep its business clean and free from any potential pathogenic hazards. Pages 8-10

The Lar feed mill in Santa Helena, PR, Brazil. Photos: Vincent ter Beek

Pig Progress has been truly on the move over the last few months as colleagues Rosie Burgin and Vincent ter Beek also paid a visit to Qingdao, China, mid-September, to take a look at the 2 large international trade shows that were held simultaneously there. VIV Qingdao took place in western Qingdao, whereas EuroTier China was organised 50km down the road in this huge city. The shows were held in a time when ASF has rampaged the Chinese swine industry. How did the virus affect the shows? Let us take you back to VIV Qingdao (pages 28-29) and EuroTier China (pages 30-31).

The Cosmopolitan Exposition centre in Qingdao welcomed over 20,000 visitors during the 3-day event. Photo: Vincent ter Beek

A trade show is always a good time to launch new products. Challenge Animal Health introduced various new types of antibiotics at EuroTier China.

Pig Progress also took a look at the Animal AgTech Summit, held 1-2 October in Amsterdam, the Netherlands. This relatively new concept aims to get companies in the international animal agribusiness together to discuss applications and innovations with regard to precision farming. Various interesting new companies were present and explained their case we highlight 5 of them on pages 26-27.

One of the ways precision farming can benefit pig producers is through the possibility of benchmarking. After all, being able to monitor and measure all kinds of developments inside pig farms, also allows farmers to compare performance with others. In Canada, financial benchmarking has become popular, as correspondent Treena Hein explains on pages 24-25.

Benchmarking starts with knowing exactly what is going on inside the pig houses. Photo: Bert Jansen

Columnist John Gadd continues where he left off in October with his series on immunity, and discusses now which type of stressors exist for pigs and what can be done about them (page 15). Then, Dr Monique Pairis-Garcia discusses the different types of animal welfare definitions and delves into the value of knowing what an animal experiences (page 34).

To view these articles online or other issues of the magazine just click on our digital magazine section and then on issue nr 9. Registration is free.

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Biosecurity, boars and benchmarking in Pig Progress 9 - Pig Progress

Recommendation and review posted by Bethany Smith

2 the Outdoors: Saving a species – WGRZ.com

BUFFALO, N.Y. The role of zoos has taken on critical importance in both preservation and conservation of increasingly threatened species such as the rhinoceros.

The Buffalo Zoo has been very active in working with rhinos. Its two adult rhinos, Tashi and George, are helping to increase the global population of greater-one horned rhinos. Tashi, a 23 year old female, recently gave birth to a male calf named Mohan. The zoo tried to breed George and Tashi, but it didn't take, so they had to resort to artificial insemination.

RELATED: It's a boy! Baby rhino born at the Buffalo Zoo

It's a complex process guided by the American Species Survival Plan, which was developed in 1981 by the American Association of Zoos and Aquariums. The SSP program was created to help ensure the survival of selected species in zoos and aquariums, most of which are threatened or endangered in the wild.

"We look at the genetics of each individual animal, and then match them best who matches best with who to know where to send them with, who to breed them with, how many offspring can they have, are they over represented, are they under represented," said Buffalo Zoo Assistant Curator Joe Hauser. "So there's a lot of factors to the genetic portion, and where the animals go."

Hauser says that Tashi has given birth four times, two naturally and two artificially. Young Mohan's birth went off smoothly, as anxious zoo keepers watched from a distance.

"We stayed out of the barn when she is giving birth, we wanted to make sure she's paying attention to giving birth, and not trying to disturb that," he said. "So we watched her on the camera and your heart's pounding the whole time, and fortunately with Mohan, he hit the ground and was kicking right away."

In a few years, Mohan will hopefully father more rhinos. And though unsuccessful in breeding with Tashi this time, George is just entering his prime breeding years. His genes will also contribute to the overall success of his species.

"George is actually the third most genetically valuable male in North America, so he's very valuable," Hauser said.

The Buffalo Zoo has also helped Rhinos in Indonesia, raising $14,000 over the summer for the organization.

International Rhino Foundation

The zoo's efforts to help these ancient mammals doesn't stop with breeding. Over the summer Hauser and the zoo raised $14,000 to donate to the Sumatran Rhino Rescue, an Indonesian organization dedicated to saving the Sumatran rhino, the most critically endangered large mammal on earth. There are less than eighty left in existence.

"The government of Indonesia along with International Rhino Foundation and other NGO's they recently developed the Sumatran Rhino Rescue, which is a plan to be able to capture the remaining Sumatran Rhinos that are out in the wild, bring them into human care, put them in managed breeding situations, increase their numbers, and then re-release them back out into the wild," Hauser said.

There are less than 80 Sumatran Rhinos left in the wild. The Sumatran Rhino Rescue is working to preserve them.

International Rhino Foundation

It will take the entire global community to ensure the future of the rhino, and the zoo is rightfully proud of its contribution to the cause.

"And I hope that we can pass that along to our zoo guests, and the zoo community, and the Western New York community, and all across the United States, we can do this, and you can take a lot of pride in knowing you played a part in saving a species," Hauser said.

To help support the Buffalo Zoo's efforts, click here.

To learn more about Sumatran Rhino Rescue, click here.

RELATED: 2 the Outdoors: Banding geese on top of the world

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2 the Outdoors: Saving a species - WGRZ.com

Recommendation and review posted by Bethany Smith

Fertility startup Mojo wants to take the trial and error out of IVF – TechCrunch

Fertility tech startup Mojo is coming out of stealth to announce a 1.7 million (~$1.8M) seed round of funding led by Nordic seed fund Inventure. Also participating are Doberman and Privilege Ventures (an investor in Ava), plus a number of angel investors including Josefin Landgard (founder and ex-CEO of Kry) and Hampus Jakobsson (venture partner at BlueYard, BA in Clue & Kind.app).

Mojos mission, says co-founder and CEO Mohamed Taha, is to make access to fertility treatment more affordable and accessible by using AI and robotics technology to assist in sperm and egg quality analysis, selection and fertilization to reduce costs for clinics. Only by reducing clinics costs will the price fall for couples, he suggests.

What the AI does in our technology stack from now until our roadmap is completed, product wise, is to look at sperm, look at eggs, look at data and ensure that the woman or the couple get precise treatment or the precise embryo that yields healthy baby, he tells TechCrunch. The role of robotics is to ensure that the manipulations/procedures are done precisely and at reduced time compared to nowadays, and also accurately.

The idea for the business came to Taha after he was misdiagnosed with a kidney condition while still a student. His doctor suggested freezing his sperm as a precaution against deterioration in case he wanted to father a child in the future, so he started having regular sperm tests. I was super annoyed with one particular fact, he says of this. Every time I do a sperm test I get a different result.

After speaking to doctors the consensus view of male fertility he heard was I shouldnt care about my fertility worst case scenario all that they need from me is one sperm. He was told it would be his future partner who would be put on IVF to take the treatment for me. Doctors also told him there was little research into male fertility, and therefore into sperm quality such as which sperm might yield a healthy baby or could result in a miscarriage. And after learning about what IVF entailed, Taha says it struck him as a tough deal for the woman.

Its completely blackbox, he says of male fertility. I also learned that in terms of IVF or ART [assisted reproductive technologies] everything, pretty much, is done manually. And everything, pretty much, also is done at random you select a random sperm, they fertilize it with a random egg. Hopefully the technician whos doing it manually knows his or her job. And in the end theres going to be an embryo that will be implanted.

He says he was also struck by the fact the trial and error process only works 25% of the time in high end laboratories, yet can prospective parents between 40,000-100,000 for each round of treatment. This is where the idea of the company came from, he adds. Mojos expectation for their technology is that it will be able to increase IVF success rates to 75% by 2030.

The team started work in 2016 as a weekend project during their PhDs. Taha initially trained as an electrical engineer before going on to do a PhD in nanotechnology, investigating new and affordable materials for use as biosensors. It was the microscopes and robotic arms that he and his co-founder Daniel Thomas, were using in the labs to examine nanoparticles and select specific particles for insertion into other media that led them to think why not adapt this type of technology for use in fertility clinics as an alternative to purely manual selection and fertilization.

The other two co-founders are Fanny Chesa and Tobias Boecker.

We just completely automate everything to ensure that the procedure is done faster, better and at the same time more reliably, Taha says of the concept for Mojo. No randomness. Understand the good from the bad.

That at least is the theory. To be clear, they dont yet have their proposition robustly proved out nor productized at this stage. Their intended first product, called Mojo Pro, is still pending certification as a medical device in the EU, for example. But the plan, should everything go to plan, is to get it to market next fall, starting in the UK.

This product, a combination of microscopy hardware and AI software, will be sold to fertility clinics (under a subscription model) to offer an analysis service consisting of a sperm count and quality check as a first service for couples to determine whether or not the man has a fertility problem.

Initially, Mojos computer vision analysis system is focused on sperm counts, automating what Taha says is currently a manual process, as well as assessing some basic quality signals such as the speed and morphology of the sperm. For example, a sperm with two heads or two tails would be an easy initial judgement call to weed out as bad, he suggests.

The first product is to look at the sperm and say if this man experiences infertility or not. So we have a smart microscopy built custom in-house. And this is where the element of the robotics comes in, he explains. At the same time we put on it an AI that looks at a moving sperm sample. Then, through looking at this, the system on Mojo Pro will tell us what is the sperm count, what is the sperm mobility (how fast they move) and what is the predominant shape of the sperm.

The second part is the selection of the sperm [i.e. if the sample is needed for IVF]. Now we ensure that good sperm is being selected. This microscopy will look at the same and visually will guide the embryologist to pick the good sperm thats highlighted around, for example, by a green box. Good sperm have green boxes around them, bad sperm have red boxes around them so they can pick up through their current techniques the sperm that are highlighted green.

Based on internal testing of Mojo Pro the system has achieved 97% of the accuracy of a manual sperm count so far, per Taha, who says further optimization is planned.

Though he admits theres no standardization of sperm counts in the fertility industry which means such comparative metrics offer limited utility, given the lack of robust benchmarks.

The way we are going with this is were really choosing the best of the best practitioners and we are just comparing our work against them for now, is the claim. (Mojos lab partner for developing the product is TDL.)

We will try to introduce new standards for ourselves, he adds.

The current research focus is: What are the visuals to make sure the sperm is good or bad; how to actually measure the sperm sample, the sperm count; in terms of morphology how we can incorporate a protocol that can be the gold standard of computer vision or AI looking at sperm?

The wider goal for the business is to understand much more about the role that individual sperm and eggs play in yielding a healthy (or otherwise) embryo and baby.

Taha says the teams ultimate goal is automating the fertilization process, again with the help of applied AI and robotics (and likely also incorporating genetic testing to screen for diseases).

He points out that in many markets couples are choosing to conceive later in life. The big vision, therefore, is to develop new assisted reproductive technologies that can support older couples to conceive healthy babies.

Generally speaking we leave our fertility to chance which is sex So theres a little bit of randomness in the process. This doesnt necessarily mean its bad its how the body functions. But when you hit later ages, 30 or 40, we face biological deficiencies which means the quality of the eggs are not good any more, the quality of the sperm might not be good any more, if fertilization happens with old gametes you are not sure there is a healthy baby. So we need technology to play a role here.

Imagine a couple at the age of 40 who want to conceive a baby ten, twelve years from now. What happens if this couple have the possibility of the sperm of the man to be shipped somewhere, the egg of the woman to be shipped somewhere and they get fertilized using high end technology, and they get informed once the embryo is ready to be implanted. This is where we believe the consumer game will be in the future, he says.

We envisage ourselves going from just working with clinics in the coming ten years making our AI and our robotics really flawless at manipulation, and then we are envisaging of having as consumer-facing way where we ensure people have healthy babies. Not necessarily this will be a clinic but it will be somehow where fertilization will happen in our facilities.

Im not speaking about super humans or designer babies, he adds. Im speaking about ensuring at a later stage of the conception journey to have a healthy baby. And this is where we see ART can actually be the way to procreate at later stages in order to ensure that the baby is healthy then there should be new technologies that just give you a healthy baby and not mess up with your body.

Of course this is pure concept right now. And Taha concedes that Mojo doesnt even have data to determine good sperm from bad beyond some basic signifiers.

But once samples start flowing via customers of the first product they expect to be able to start gathering data (with permission) to support further research into the role played by individual sperm and eggs in reproduction looking at the whole journey from sperm and egg selection through to embryo and baby.

Though getting permission for all elements of the research they hope to do may be one potential barrier.

Once the first module is in the market we will be collecting data, he says. And this data that well be collecting will go and be associated with the live births or the treatment outcome. And with that well understand more and more what is a good sperm, what is a bad sperm.

But we need to start from somewhere. And this somewhere right now what were relying on is the knowledge that good practitioners have in the field.

Taha says he and his co-founders actively started building the company in January 2018, taking in some angel investment, along with government grants from France and the EUs Horizon 2020 research pot.

Theyve been building the startup out of Lyon, France but the commercial team will shortly be moving to the UK ahead of launching Mojo Pro.

In the short term the hope is to attract clinics to adopt the Mojo Pro subscription service as a way for them to serve more customers, while potentially helping couples reduce the number of IVF cycles they have to go. Longer term the bet is that changing lifestyles will only see demand for data-fuelled technology-assisted reproduction grow.

Now we help streamline laboratory processes in order to help the 180M people who have fertility problems have access to fertility at an affordable price and reliable manner but also we have an eye on the future what happens when genetic testing [plays] an important role in the procreation and people will opt for this, he adds.

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Fertility startup Mojo wants to take the trial and error out of IVF - TechCrunch

Recommendation and review posted by Bethany Smith

Breaking Down The Invitae Short (Podcast Transcript) – Seeking Alpha

Editors' Note: This is the transcript of the podcast we published last week on Invitae (NYSE:NVTA). We hope you enjoy.

Daniel Shvartsman: Welcome to the Razor's Edge. I'm Daniel Shvartsman. I'm joined by Seeking Alpha author Akram's Razor on this show. Each episode we take an investing idea or theme that Akram has been looking at for his personal investing as well as the Seeking Alpha marketplace service he runs, also called The Razor's Edge. We look at the ideas themselves, stress test them, try to figure out where they might go right or wrong, talk about what's been going on, and talk about the research and analysis that led to this take.

The idea to share some current investing ideas here into consideration, but also get the ins and outs of deep fundamental market research today. This week's topic has a lot behind it. The ticker symbol is NVTA. The stock is Invitae. Akram released a short case on the company on Seeking Alpha on October 11th, that went long in terms of breaking down why the genetic testing company was more like a WeWork than an Amazon. In other words, the company has had prodigious revenue growth, but it's come at a cost of increasingly negative cash flows and limited competitive advantage, in Akram's view. Was a thoroughly researched short case and as is often the case it's attracted a lot of attention, both positive and negative.

On today's Razor's Edge, we're going to talk about what brought Akram to this case, what investors are missing, and some of the reactions since he went public on Invitae. We're also joined by a colleague of Akram's, James who can add some insight on this topic based on research he's done on the stock as well.

Before we begin a quick disclaimer and disclosure; The Razor's Edge is a podcast on Seeking Alpha's The Investing Edge channel. The views discussed belong to either Akram, James in this case, or me respectively, and nothing on this podcast should be taken as investment advice. We'll disclose any positions in any stocks discussed at the end of the podcast, though upfront I can say I have no positions in any of the stocks we plan to discuss, Akram is short Invitae and long Myriad Genetics, and James is short, Invitae. We're recording this on the morning of November 4th.

Listen to or subscribe to The Investing Edge on these podcast platforms:

All right, guys. Good morning. Welcome.

Akram Razor: Good morning.

James: Good morning. Thanks.

DS: So let's just go really basic, why Invitae? What brought -- why does your radar get on this stock? Where did they come up?

AR: That's definitely an interesting part of the story. I guess the starting point was, there was people shorting Myriad. So I follow the Southern Investigative Reporter. And they've done a couple short pieces on that. And I kind of have taken a look at it briefly, which caused me to take a brief look at Invitae, and that was probably like, May or June. And then Ilumina missed big time on earnings, and I've traded Ilumina several times of the year. I've never traded any of these other stocks in terms of that. But it kind of got me interested in the space. And I guess what kind of, I mean, like, I think I had pinged James on it a couple times being like this is like this is worth looking into, but like neither of us had really gotten that excited about it.

And then there was a report that came out by a short seller, recommending the stock is an amazing long idea, which I read, because I know the short seller and his work. Once I read that, I was like, I need to look at this company a little closer. And then just the typical process, like pulling up their filings, seeing exactly what's going on financially, and I was just like, wow, this is just an incinerator. What are they doing? Why is -- like, what's the business model?

And that brought me to, there's an author on Seeking Alpha who had published a lot on this over the years, capital markets, laboratories and read their work, and they made these Amazon compares where, obviously, that's where you get a little bit of a heightened radar, when a laboratory diagnostic company is being compared to Amazon, which I mean, I don't know also if you know -- and I had like a brief experience with Theranos in 2000 it was say like, early 2014, like back when it was like -- I was picking on the Decacorns then, my favorite, like when I used to write my market commentary and I'd have a little bit of fun with it.

At the time, the two I was having fun with were Zenefits and Theranos. But I mean in Theranos' case, like I was just curious as far as what like -- I mean, it was a private company, $10 billion, obviously a lot of hype. I was like, wow, do I short Quest and LabCorp, right? I mean, I can't make -- I can't invest in Theranos. But if this company is so revolutionary like it, there's this pretty simple thesis out there in the public markets where I mean, if they're going to stick a lab in a box, I should go short Quest Diagnostics and LabCorp.

And I have, on the medical side, an extensive network of friends and family. So I ended up doing just one call with someone who'd been at Quest and in the laboratory diagnostic space, pretty senior for about 20 years. And like, I mean, it was like a 30 minute conversation. I felt stupid by the time it was over. It was just like, he's like, are you an idiot, you can't stick a Lab-in-a-Box. It was like -- it was literally like that, after like being very polite for a little while. So that type of stuff kind of intrigued me. And Theranos ended up being Theranos. I never really did much more with it after that. And then Wall Street Journal came after it, and it became this cautionary tale. I don't know if James -- did you follow Theranos very closely, I don't even know if we really discussed that?

J: No, I had heard from some VC friends who were very skeptical of it all the way through. But I wasn't that close to the name myself.

AR: Yeah, I mean, neither of us I would say, I would characterize myself as close to it. But I mean, I did take the time to literally be like, hey, do I short these stocks because of Theranos, right? It was like an investment idea at the time.

So yeah, I mean, I guess that's what started it, right. I mean, like Theranos had this -- and then the message was just kind of just like affordable blood testing for all, a social cause being compared more to, like technology differentiating companies and I mean, Elizabeth Holmes like to associate herself when she talked about things, when she compared herself to the Google Founders and Facebook and like, I mean, if you saw the documentaries like here we were at, in Brazil, and this is where we -- who was sitting there, and the Google guys, and the Amazon and Facebook, and we are the stars of the show, right?

And if you look at Invitae, I mean, like on the surface, it's like there's a social enterprise element to it, right? Where it's just like, we have a mission, and this mission is to make genetic testing affordable for all. I mean, like, they don't care, they don't describe themselves as like a laboratory diagnostics company, right?

DS: Well, they --

AR: That was a genetic information company. Go ahead.

DS: Yeah. I mean, if you look, I have got their 10-K open, their last one and it's -- our goal is to aggregate a majority of the world's genetic information into a comprehensive network that enables sharing of data among network participants to improve healthcare and clinical outcomes. So it's this.

AR: Yeah, so what does that mean?

DS: Right. You know, it is this very -- it is very big mission, right. It is very big.

AR: Yeah, I mean, James, obviously has some views on this. Like, I mean, what do you think of that part?

J: Well, I think that really comes down to the crux of the investment case here, which is, just because something sounds good as a sound bite doesn't mean that it actually makes sense in business. And so the idea of accumulating the world's genetic information, you would argue, seems like if you could do that would allow you to capture rents on that database. But there are very real issues with that. Namely the company has said that they won't do that. And then when they're pressed about how -- whether or not they will do that, they kind of seem to give non answers what I can tell.

So that's one of the questions right that that I think would be very helpful for the company to lay out there, very specifically, which is, if we gather all this data up, and specifically what data is being gathered? Are they -- is that data, they've also released to a common database, like they say they have been doing, is there additional data that they're not releasing?

AR: Well, I mean, the data that they're sharing with the common database is the variant of unknown significance data, right? So I mean, that's what they're contributing to Clinvar. We don't really know. But like, I mean, I'll be honest, like if I was to go in and have hereditary cancer test, I would have never thought once about, like, who the lab doing the test is or ask the oncologist anything, but like literally now knowing this business, I mean like, make sure you're not using Invitae, because I have no clue what they're going to do with that data.

Like my DNA is a product for them to figure out somewhere down the road just to do something with it, I mean, it's so -- like James just said, it's very bizarrely unclear, which is decidedly convenient when you're running a business model like this.

DS: So step back for a second. So the thesis -- the company's thesis is that they're providing genetic tests. And then they're aggregating that, they provide it at -- arguments are they providing it for below the cost that they actually have to pay to their providers to actually deliver the test but low cost testing that they can then -- if we're going to use the Silicon Valley jargon, that they get the flywheel of more genetic data and improve, they get a lot of volume, and eventually, that's both going to give them scale to lower the costs, but then also they're aggregating this huge genetic database, which as you kind of point out, Akram, they're going to have to do something with to make it reasonable, which raises concerns in of itself. But the idea is that eventually they'll get scale from offering at cost that will allow them to become a profitable business, I think. That's how I understood the company's take and the company's argument.

AR: I mean, like James just said the company hasn't explained that. So if you look at this company's history, this isn't like a startup, number one, right. So this company was founded in 2009. They've been at this for a decade, okay. Initially, they were kind of rare disease focused, right?

Like where they're deriving the revenue, if they were to actually describe themselves accurately, they would be like, we do hereditary cancer testing far cheaper than Myriad, right? And I mean, like, I think that's an important thing to look at this. I mean, there are sources of revenue, which is generally speaking what has attracted people to the stock, it's not science, right. It's not like you've developed a test or you're like Foundation Medicine and you've got this companion diagnostic clinical trials and you are about to do something where you're going to earn a high margin, because you've developed something nobody else has. That's typically, what people get excited about in science and biotechnology, right?

You get rewarded for R&D, okay. These guys have approached the market that Myriad discovered the BRCA mutation in 1994, okay. That's like what the indication of hereditary cancer right? I understand cancer, 90% of it is not hereditary. So you're looking -- when you talk hereditary, there's a less than 10% chance that it's something hereditary. That's helpful from a clinical standpoint, as far as your treatment for cancer diagnosis, whether it's early or late stage or whatnot.

So this company came into this space in the sense that Myriad had a monopoly on this gene, right? They started doing their first BRCA testing lab kit was like 1996. They had the patent on that gene till 2013 when the Supreme Court struck it down, right. So these guys entered this space, essentially, from that standpoint as a competitor against Myriad. And once that space kind of opened up in hereditary cancer testing, I mean like, well, you can't patent these genes, right? Which is great for competition, but what's the flip side of it?

If I make a major discovery on gene X correlates to disease Y, right? And I can't patent it and I'm running like a test that kind of identifies that historically, kind of tough to build a very profitable business around it. So when we go back to like what you were saying about like this whole genetic information and whatnot, the most interesting thing about this business is look at the rest of the landscape. Nobody's selling the story, like Myriad's still the revenue leader in hereditary cancer testing.

The other space the company is in deriving revenue from is reproductive health, carrier screening, non-invasive prenatal screens. And that's the most crowded market ever. It's got Ilumina and Sequenom, which is owned by LabCorp, like pretty much, they control the IP there. And then there's like a half a dozen other competitors owned by large companies.

So like, in hereditary cancer, you've got Myriad. And then you kind of have this like at a huge, huge, huge discount to Myriad prices, Invitae, right? I mean, like now they're running what, $99 tests, okay? So you look at it and you can sit here we can just, like figuring out what they want to do data wise and the fact that it's Vegas kind of important. It's also important in the context of -- well, there's a whole industry here, right? I mean, this is at least what -- we got some heat when we cautioned this like, some of this has attracted obviously a lot of retail investors by using the Amazon compare. And, in the initial thesis it was like a cautionary mention at the end, like that the laboratory diagnostic space doesn't need another Theranos.

And at least in Theranos' case, what they were selling to investors was we're building a better mousetrap essentially, right? Like we've got -- we've engineered something that's going to change the way we are able to do testing. And that's not the story here. The story here, I mean, if you go back to the founder in 2016, there's a couple of interviews with him. And he literally says like, we're providing the same test that everyone else is providing, we're just making them more affordable. That was that's their initial story, right.

So I mean, you do kind of run into something like that, which is where, like some people may think it like, you know, oh, it's very, self-serving or opportunistic to compare this to WeWork. It is, exactly like WeWork from a business standpoint. Like you can't get around that fact. And I think the Amazon like -- and this is not like some guy writing a really bullish Seeking Alpha article and using hyperbole, the management sticks to compares. I mean, they -- literally they have a slide in their investor deck, what we can learn from Amazon, and they make statements like our competitors -- what did they say, James, is like the competitors margin is our opportunity or

J: Yeah, something that effect. Yeah, you've heard a lot of ground there, Akram. I think the important aspect of what you've said and the commonality among all those points is that the management team has made some very high level statements about the promise of this industry and the promise of their company. And they could really answer a lot of these questions if they wanted to, right? They could say, okay, here is our revenue breakdown from cancer or nips [ph], kind of other panels, which don't have necessarily the clinical efficacy.

Or they could say, here's our -- here's what we're getting from the various cost cutting or network effects or economies of scale that we promised. And here's how this is going to develop, but they don't they just say, trust us, it's all going to work out. And the way that it's not [ph] going to work out is that it worked out for Amazon. So it's there's not much transparency, there's a lot of just kind of big picture verbiage I would say.

AR: Yeah. I mean, 100% and like, I mean, you get the Amazon story, Daniel, right. I mean, if you look at it, people like, if you look, well, come on, Amazon was losing money. No, Amazon was improving operating cash flow from literally from day one. I mean, people forget, like, you make money selling DVDs and books online, particularly if you don't pay your suppliers for 100 days, right? I mean, like, where was Amazon after a decade? It was already a behemoth, right?

So when you look at it, Amazon had someone else, i.e., their suppliers funding their growth. It's free, cheap capital. This company went and IPOed in 2015, at $16 a share, had like 25 million shares outstanding. They're at 100 now, four years later, right? I mean, it's like, they keep going back to the well. So if you're an investor and you're looking at it from a return on investment on money, you're giving them. I mean, you have a serious problem. And if you look at it, and you say, hey, I'm going to compare myself to Amazon. Well, Amazon had a cost structure that attacked this cost structure of brick and mortar, okay?

They benefited from so many things. We didn't have sales taxes, if you were paying on Amazon as a consumer. They benefited from the fact that they went into markets with huge existing volume already, books and DVDs. They didn't have to convince people to buy X, Y and Z. They were already huge volume markets. I mean, I'm sorry, but like hereditary cancer testing. It's not something people get excited about to go online or buy as a gift for a friend.

I mean, like, we get the DTC space, and even that has already slowed down drastically, and that's Ancestry. And if Ancestry slowed down at like 30 million tests, right, like, you really think people are going to be super excited as individual consumers to be like, I really need to figure out whether I have a history of cancer right now. I mean

J: Well, and more importantly, more importantly, I think there's a healthy amount of skepticism in the medical community whether or not these tests are useful, right? Like the issue with any test is, if you find something, an indicator of a disease. Does that help you catch the disease? Does it help you catch it earlier than existing testing or physical exams, or other ways of seeing the diseases there? And then can you do anything about it?

So, I think one of the issues here is even if you were to send your saliva [ph] sample out, and you came back with saying indication that you might have liver cancer potentially. A, you wouldn't know, if that were real, because it's really just a correlation at this point. There's not enough data. B, even if you knew, it was real, there's really not much to do except worry about it. And so you have a lot of additional burdens on the patient and the healthcare system in terms of emotional and financial burdens, without any clear benefit.

And so I think within -- as I'm saying, within breast cancer, that there is a clear benefit in terms of efficacy and outcomes. But for the rest of the space, it's really not clear. And that's why, if you look at the treatment protocols for most of the commercial payers, they don't pay for all these tests, because the research doesn't demonstrate that they should.

DS: So one of the things I'm -- as we're throwing around these comparisons. I'm thinking about the -- there's a notion in Silicon Valley and sort of abroad, the market, the idea of tech, tech as a category is becoming less and less meaningful, because companies are adopting online models or tech models to different verticals. And what I think about with Theranos and Invitae, specifically, healthcare is a very complicated sector, both in terms of the way payers work and we can get into Medicare in a little bit, but the way the payment system works.

And I'm not talking even about what might or might not happen in the future with changes to insurance. But just -- that's, I think, always been fairly -- you have to really work through it. And the articles for example, there's looking at the different reimbursement codes and that sort of thing. Like, it's more than you have to do to figure out, well, are they going to buy this software tool or not?

And then also, Theranos is a problem, because they were actually -- there were issues of fraud around people, things that were supposed to help people's health. And so I guess I'm just kind of, I guess, I wanted to hear a little bit more about like, because -- a lot of the response.

AR: Well, I mean, look -- let's, I mean, if you think about Theranos, where really was the fraud. The fraud like, I mean, if you read the indictment, what she's really on the hook for the biggest time is misleading investors, okay. I mean, that's the biggest part.

Yes, correct, like at the end, there was issues with the lab testing and they were getting inaccurate results because by the time she did that deal with Walgreens, and clearly they were at a point where they were desperate for showing meaningful revenue, because they need to raise more cash, right? Because they still haven't made the Edison work, right? They're trying to engineer a problem. They're working on it.

She didn't set out to commit fraud, right? She set out to build -- to stick a Lab-in-a-Box, right? But she had bigger aspirations. She wanted to take -- that she wanted to aggregate your data. She wanted to stick it in this cloud called Yoda, right? I mean, if you look today, you still have people who defend -- I mean, what's his name?

DS: Yeah.

AR: Tim Draper has really defended her. And what does he defend her on the point, and his point is that look, she had this vision to give you a movie of your health, i.e. like look, I get my blood work once a month, and that goes into a cloud, right? And my physician can track it. And I'm building a historical picture of a trend, by having more real time information on my blood work, cholesterol, everything right? So that creates preventative medicine in their view, right? Like your ability to have an earlier and more accurate versus a snapshot, right?

So he's like, look, she had that and was great and I genuinely have discussed this with James. I believe if she had IPOed this company and the company had started out as like, hey, she's got this Edison and this finger stick. It would have been just like binary tech play, right? She either makes it or she doesn't. And people would have debated that and thought that out there would been the believers. And then there would have been the skeptics, but she would have had plenty of time, as she gauged how that was working, okay?

To find something that generates revenue, which investors are willing to pay for, like with her inflated market cap on the Edison optimism, where she could just do regular lab testing like Quest and like LabCorp, but she would obviously do it at a lower price, right? But she would sell you the story that I'm going to stick this in the cloud, and you're going to pay a subscription fee, right? And that subscription fee to that cloud, Yoda, where all your information is and your general practitioner can access it and whatnot, that's the business. That's where I make money.

Of course, what's the problem with that business? And that business is -- well, I mean, that you're going to be like, well, you're losing a lot of money per test, doing your tests at a lower price than Quest and LabCorp or whatever to provide this back end service, why can't they do that, right? I mean, like, that becomes the same thing because you're going to need the same infrastructure. That's where she ran into issues. She's collecting data and she doesn't have the lab infrastructure to do it at the scale that these guys are doing.

If she'd been like these DTC companies, 23AndMe ancestry, she could have actually struck a deal, which is like, I'll be the cloud and I'll outsource the testing to them. And I will take a loss on the tests, because my investors are going to subsidize it, right? I mean, there was -- there would have been many Ways, but of course, she was also trying to kill their businesses. So it didn't work, right, with her engineering. but like, I mean, the bottom-line is, is if you look at it, like, it's something where you had a potential business model in that sense, where we would be asking the same questions that you'd ask about in detail, right? Like what are you doing that's different?

If you look at them today, Quest and LabCorp, they've entered into direct-to-consumer testing. I can go online and order my own tests and schedule the appointment and go pick them up, right? I'd like it's really, like, it's something where I don't even need to go through my medical practitioner if I want to get tested. And I don't know, to the degree I mean, I've discussed this with other people in the medical community on the testing side and I'm just, why isn't there a VIP service like, if I'm an extremely wealthy individual, where they come to my house, do the work, store in a cloud. And there's access to my blood work, on let's say -- but we don't have to do a monthly but let's say every three months, right?

These -- I mean like these are obviously options. So when you look at something like that and you see what went wrong with this company, her biggest mistake was being private. It's like -- because with her turtlenecks and Steve Jobs and Stanford dropout, I mean, the benefit of doubt, she would have gotten, if you look at the benefit of doubt, for example, that this company, Invitae has gotten. I mean, their CEO says one thing, and then he does the other three months later and nobody has cared like, at all. No one's asking questions. I mean, I don't know if you -- have you watched the CNBC, the Invitae interview with him on CNBC, Daniel?

DS: No. No, I haven't pulled that up.

AR: If you watch that, you would not understand what the company does. It's like we are the company the key opinion leaders turn to and this -- like, he does not say I'm a laboratory diagnostics genetic testing company, who derives primarily its revenue from doing these types of tests. And we're doing them at a significant discount to a competitor, who has had a monopoly in the space for ages. And we're using that to generate volume and we're hoping to parlay that into other sectors. And this is like -- this is our business model. Because to be -- to tell you the truth, if you look at this closely, I don't think they figured it out. They are trying to figure it out as they go along and that's part of the problem here.

DS: Isn't -- you said, if Theranos that they could have arguably sold tests below costs, but then put the -- like, isn't that essentially what the Invitae has? They haven't maybe laid out that vision but they're essentially selling below cost to get into -- like they could build that into the cloud sort of approach like?

AR: Okay. No, let's not make that mistake, okay? I'm saying that Theranos, if they wanted to, okay, and wanted to pivot for a story to sell, that sells well, when you're dressed like Steve Jobs, and you dropped out of Stanford, and you're a unique character and you're -- you've got a Board that has these people on it. And you've convinced Tim Draper and Larry Ellison to invest in you and whatnot, right? When you've dressed something like that, and you've ticked all those boxes, okay, you could just be like, hey, I'm going to do the same blood work everyone else is doing, I'm going to do it cheaper. So come to me. And how I'm going to make money off of it down the road, is I'm going to store that data, and it's going to give you a real time picture.

Now if you were to compare this on genetic information, my DNA isn't constantly changing, right? So if I'm doing -- if my focus is hereditary screening, i.e., what's been passed on to me, and what does that indicate?

What is the usefulness of that sitting there, right? Number one. And number two, in her case, it would be like, well, you still need to build the lab infrastructure to do the tests. You're going to have to do huge volume. So any business that -- like I mean, if you listen to the CEO, he literally sits on conference calls. And he's like, we hope to do half a million tests this year and reach a million people next year, and on our way to billions across the world. Well, what kind of infrastructure, you need Amazon infrastructure for that, right? I mean, how many geneticists do you need, genetic counselors? The industry doesn't even have the employees. I mean, we were discussing this, like, how big is that industry James.

J: It's well smaller than then I thought it was. I think it's in the thousands of genetic counselors. I forget it, 10,000 or 15,000.

AR: So you're going to need lab technicians, genetic counselors, you're going to need the physical footprint. You're going to need logistics. I mean have you looked -- like part of the thing that like -- we found kind of interesting is just look at Quest Diagnostics. I mean, there was a $100 price target slapped on this thing. That's the market cap of Quest, okay? They have 3,500 trucks like 26 planes, 6,000 patient access points, right? They have infrastructure to test everybody.

The internet bull on this stock, he's been close to management. He's done a lot of write ups on it. One of his write ups was just recently, and I read it and he's like, I visited the company and the CEO told me that they're actually paying for the trucks to go to FedEx, to pick up the samples and bring them back instead of waiting for FedEx to bring them to the lab. And he's like, I've never seen a company who cares about the customer so much. And I am like -- I mean, sorry, logistics are part of his business. Collecting the samples and the turnaround time and what the infrastructure you need to do it, right?

Like that's not something of like, hey, I really care about my customer. It's something you have to do and unfortunately, Quest and LabCorp are sitting there with huge economies of scale and scope and infrastructure and the same machines available to them, and the lab technicians and the geneticists and everything to flip this switch on, and they're not flipping it on. Why?

DS: Right.

AR: It doesn't make money, because the volume isn't significant enough and the cost isn't at that point. So when this company talks about driving down costs, no, they're not driving down costs. Everyone else has a lower cost per test already established, because they have higher volumes in the space, right? If you look at it Myriad's cost per sample is in the $140, $150 range. If you look across all these other labs, who are doing the stuff and the testing on the reproductive health they're all far lower, right?

So this is a last person in the space coming and trying to get to the volume, trying to get to the economies of scale and trying to drive it down, right? But they still are subject to the same cost infrastructure limits. It's not amazon.com. They haven't eliminated the blockbuster employees sitting, that when they're competing against in DVDs like a Netflix or an Amazon or whatnot, they haven't eliminated the huge physical retail footprint that a Barnes & Noble needed, right? Like, they still have the same limitations, from a cost standpoint. They're relying on Ilumina machines, consumables, Agilent, Read [ph] everybody -- like it's the vials from, what's the company that sells the vials?

J: OraSure

AR: OraSure, right, like you're buying the same stuff from the same people. So it's when you look at it from that standpoint, like if they were to sell you a story about data or whatever, it's like, well, everybody else can sell us a story about data. Why are they selling it to us?

J: It's an interesting dynamic here, because when there was the rebuttal by this bullish commentator/endorsed analyst of the company, there was a comment that, hey, it's not just the raw data, it's not just the genetic information that is useful, because genetic information in and of itself doesn't tell you enough about the disease. And I think that's a partial indictment of the whole process. But more importantly, what the analyst said is, what the company does is they take that information and they combine it with a patient's medical record. That includes all of their scans, their CTs, their MRIs, all their historical blood tests, all their physical exams, and then it takes that data. And if you get enough of that data, then you can start running effectively very large statistical relationships and figure out, okay, which genetic mutations might be associated with which diseases.

The problem with that is, as far as we know, that's not what's happening. And yet the company, again, they've kind of endorsed this, this guy is an analyst of record, the company hasn't come out and said that. But that's not what's happening. Because if it is what is happening, I think they're serious privacy concerns. So I think it's very different, if you as patients and [indiscernible] into 23AndMe, you might sign a paper, some paperwork somewhere, but if they're actually signing away the rights to all their medical records. Again, I don't believe they are, but again, this is what would need to happen in order for this data to be proprietary and useful. Then I would imagine the consumers are not aware of that.

And so you kind of have this catch 22, if you're getting the data, whatever, this guy refers to it as the golden data, whatever it is, if you're getting that data, such that it's useful, you're probably in violation of some privacy laws, whether or not you are in terms of you're covered legally, I think just patients don't understand that's what's happening. And if you're not getting that data, then there's a very real question as to what exactly is the use of just this genetic information without putting it into -- in context without kind of correlating it to these other disease markers?

And again, this is a question that could -- that's very answerable by the company as far as we know, has decided not to answer.

J: I mean, look, there's also two elements of that, right. If you remember also, in his rebuttal, he pointed out to a subscription model, right ,where he was even saying that this should be looked at from a dollar-based retention standpoint like a SaaS company. So I mean, again, if he's saying this, it's something that well was spoon fed to him, okay? And that's part of the element here, when you're dealing with something like this, and you look at that, it's like, all right, so like, I go in, I do a test for cancer, but you know, a BRCA screen. And you're saying -- are you essentially saying that, in year one, you generated revenue off of the actual testing, but then in year two, and year three, supposedly, my DNA is something that just sits there, and they can find ways to make money off of, by farming it for some sort of data that they can sell to pharma.

And it's tenuous at best to even understand how that model would work, because if you look at the rest of the industry, you just have to assume, they're all idiots. I mean, how many tests has Myriad done? I mean, look, when you go back to this thesis, Daniel, one of the most important things here is, when I put this on, this company was bigger than Myriad, literally in enterprise value, it was bigger than a company with $850 million in revenue, 20 years of testing. They've done 6 million tests through some -- to that effect I think it is at this point.

They have a database that they've made a trade secret since 2004, as far as variant data. They have four times the employees of Invitae. I mean, if you were to look at this company from there -- one notable institutional bull in the space, like this bull doesn't own any Myriad, okay. And they have a genetic spawn, and they did like kind of throw like a little bit of a shade at this thesis when it came out. And I mean, I can imagine they got a lot of questions because they own a lot of the stock and they were like, these are the companies leading in AI.

And then they like -- they listed Invitae like two other names. And then they put in their tweet, which was almost essentially directed, not my gen [ph], which I mean, for someone like me, I just -- I didn't even really spend much time getting into the AI nonsense. But if you look at Myriad how many people with machine learning backgrounds and data scientists do they employ, plenty.

You could just go on LinkedIn, look at it, and draw your conclusion. But they're not out running around saying, hey, we got AI, we're doing stuff. We're literally running machine learning models on your DNA. We're figuring out better ways, a secret sauce. Like who would advertise that? If you actually have made the data a trade secret, and you refuse to share it and they've gotten a lot of heat for it, literally the whole industry had to band together to contribute data freely to Clinvar, because Myriad won't share, because they're like, hey, fine, you took away our patent, but who cares about that. Our ability to interpret this is better than everybody else at this juncture.

So again, you look at it, at something like that, and you're just like, well, there's companies who've been doing this for decades. And you're just supposed to assume that like data science is completely irrelevant to them. But the company that acquired an AI startup in July, by September is a leader in this space. I mean what, you know.

DS: Solet me -- so there are a few directions to go here. But let's quickly touch on Myriad. It's -- you're using it as a payer here, as I think you mentioned, it's -- short sellers have kind of had their eyes on it. Somebody like Southern Investigative Reporting Foundation has reported about it. Why are you comfortable with that as the other side of this trade given the fact that they've also come under fire?

AR: I mean, I don't know James, you want to tackle this? I'm obviously a lot more bullish on Myriad then most people. I would say, like, I can't really get my head around the short thesis, and I can't get my head around the short thesis in a relative context. I mean, if you've looked at the space there are some companies with some pretty crazy valuations. Myriad is not a hard business to understand. They have a cash cow in hereditary cancer. They've used that to diversify into companion diagnostics, into carrier screening, now into these pharmaco-genetic tests, psychotropic like for depression, which is a very controversial area.

A lot of a lot of volatility around Myriad lately, let's say the last six months, has been tied to this gene site division, and the way the FDA wants to treat these tests, where I get a DNA test that like tells me, I'm more tolerant for Zoloft over Prozac. And no science has shown any clinical efficacy yet, and it's a controversial area, because there's obviously some doctors, and they've been doing -- they've been running clinical studies to try to get this approved. And they missed the primary endpoints on it. But there's also an argument that in depression, which is like opioids, a national crisis, essentially speaking, and it's not going to get better, that there's nothing, and something is better than nothing. I mean, two-thirds of antidepressants are prescribed by general practitioners. Not -- you're not talking about the psychiatry side here. These are not experts on these drugs or on mental health.

And the argument is that maybe you give them something that starts this out with a little bit more direction, however little incremental it is. Now when the stock got hammered in the summer, on its last earnings, was because they said the FDA is pushing back on them on the labeling. And then recently, there was another genetic psychotropic-related test company where the FDA allowed them to resume sending the test information, but to the doctors. So the patient just gets this, like here's what your genetics say, but nothing about the drugs. But the doctor actually gets the drug indications. And then that doctor can see that and that doctor can use that as part -- like as a helpful part of his treatment.

But again, you go back to -- they haven't been able to show scientifically and it's hotly debated. I mean, there was just recently something in -- two Harvard doctors had published something in one of the big journals on mental health, same thing with oncology, like outside of BRCA, like there was a recent paper basically like these other genes are like no better than a placebo.

So this is part of the problem in the space but I mean, I haven't -- I don't have the numbers in front of me. I mean, James do you remember off the top of your head, but I mean, I think it's like $850 million in revenue and like $150 million in EBITDA, something like that against a company with -- that did what, like $144 million in revenue last year and lost what $100 million.

J: Yeah, but larger now.

DS: Yeah, $850 million, trailing 12 months revenue, looks like EBITDA of over $100 million at least.

AR: Yeah. So like, you can look at that, I mean, and this is something when you look at stocks, I mean I was long, some Pinterest against the Snapchat short. And I thought about closing it before earnings. And the reason I thought about closing it is that you know, Snap is $16 billion and Pinterest is 15 billion and Twitter after its 35% decline is 18.2 billion AV. Yeah, Twitter's growing slower than the other two. But it's like three to four times the revenue base. And you got to kind of adjust for that, when you get to that point.

And you're like, this is a company that is in the advertising space, and it's doing -- it's going to do whatever issues its got, it's going to do 3.5 times what this is going to do and their enterprise values are a hair apart. So when you -- like this wasn't -- this is a case where if you would look at an Invitae, you'd be like, this has got to be like a quarter a fifth of the size of like, even if you are a believer and you're willing to buy into the speculation of a Myriad.

And then the other problem you have with it is that they're interrelated. All the revenue growth that is coming for Invitae is coming because Myriad hasn't come down in pricing. They've been fighting this price decline, because they've had the luxury to fight it as the leader in the space and they're extracting a premium for their testing, because they -- like there's a compelling argument, at least from their end, that based on the data we have in the history, our tests can more accurately predict what you have, as far as a likelihood of a hereditary cancer and indication reliably.

And it's ironic, and we were discussing this when we were working on this, like this company throw shade at who -- I mean, they throw shade at the DTC companies. Like they literally just gave a scientific presentation at this Houston Cancer Conference with Genetics or whatever, just like two weeks ago, where they were like, here's 23andMe's tests, okay, and this is what's wrong with it. Like 23AndMe gives you a BRCA test, that only is designed to detect three variants. Basically, if you're not an Ashkenazi Jew, it's useless.

But it's literally a report that is bundled in with the ancestry, with the health with the 50, 60, 70 reports, you get for $100 okay. It's not like you're going into buy this or you're going to your doctor and you're like, okay, I had breast cancer, I'm worried about a potential recurrence. Let's see family history. Do I need to get a mastectomy early because I have this mutation and that's a good preventative measure, et cetera, et cetera. They're not looking at 23AndMe. Like, it's -- you're competing in the clinical grade medical diagnostics market. But here's this company attacking the DTC companies who are not really their competitors.

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Cleveland Clinic doctor leads effort to reduce health disparities among black men – freshwatercleveland

The health of black men worries Dr. Charles Modlin. The numbers are clear. Theyre many times more likely to contract various serious illnesses than other Americans. So the Cleveland Clinic urologist is doing something about it.

In 2003, he launched the Minority Mens Health Fair in Cleveland. Now he is bringing the Clinics 20-plus institutes together under an umbrella organization to address the glaring health disparities in a comprehensive way.

Dr. Charles Modlin launched the Minority Mens Health Fair in Cleveland in 2003 to help eliminate health disparities among black men.Theres a lot of helplessness and hopelessness that minority men feel, Modlin says. They may think that whatever happens to them, society doesnt really care. Through this health fair and other activities, I think weve shown that we do care, they do matter to their families, their community and society.

The annual health fair was a good start, he says. The first disease we wanted to target was prostate cancer, which was twice as common in African-American men as white men and where the death rate was twice as high, Modlin says. A lot of it is delayed presentation. We know that if we can diagnose prostate cancer in the early stages, then we can cure black men at the same rate as white men.

Now Modlin, an African-American kidney transplant surgeon who has completed more than 500 transplants at the Clinic in the past 20 years, is stitching together the Clinics new Multicultural Health Center of Excellence. It will help the Clinics diverse institutes develop their own programs and approaches to address the health disparities, building on the success of the health fair, as well as the Minority Mens Health Center, which Modlin also helped launch in 2003.

What were doing basically is getting ready to take this to the next level, amplify it and spread it across the entire Cleveland Clinic, he says.

Dr. Charles Modlin talks with a patient at the Minority Mens Health Center at the Cleveland Clinic.Many doctors are unaware of health disparities and how to address them, says Modlin, who is the only black transplant surgeon in the Clinics history. A lot of times, poor communication may lead to poor patient compliance and follow-up, he says. A patient may think a caregiver doesnt care about them or is not listening to them. At the same time, patients also need to be more health literate.

Several new programs already have been launched under the Multicultural Health Center of Excellence. One is the Clinics Minority Stroke Program, which is housed under the Cerebrovascular Center in the Neurological Institute. Its goal is to increase stroke awareness among minority groups in order to lower stroke rates and improve stroke outcomes, according to its website.

Another example is the Clinics Center for Multicultural Cardiovascular Care, which is housed under the Arnold Miller Family Heart and Vascular Institute. It aims to research and understand the nature of heart and vascular diseases that are unique to special groups, identify appropriate testing for high risk populations, provide access to treatment, and understand how treatments differ among races and cultures.

The list of other new Clinic programs under the umbrella is long. They include the Neurological Institute's Minority Stroke Center; the Glickman Urological & Kidney Institute Minority Kidney & Hypertension Center; the Orthopedic & Rheumatologic Institute Minority Center; and the Respiratory Institute Minority Lung Health Center.

The Clinics marketing department is working internally on creating standardized individual webpages for each of these "center" programs before going live externally.

The Minority Men's Health Fair in 2018.The launch of this new initiative shows that the Clinic is committed to reducing health disparities, Modlin says. The directive is for us to try to take care of patients even when theyre not in front of us in an exam room. One example is that its now built into physicians schedule every week that they have time to stop and manage patients. There may be patients that we know are not coming back, patients who missed lab draws or didnt get that X-ray we ordered, and we proactively call them and remind them that they missed their appointment and ask, Whats going on, what can we do to help you?

Another mission of the Center for Multicultural Health Excellence will be to champion diversity in the field. Having more minority doctors is important because it can improve minority patient outcomes, says Modlin, who is one of only an exceedingly small number of African-American transplant doctors in the U.S.

The new center will also conduct more research into the causes behind minority health disparities, with the aim of identifying genetic variants that cause varying responses in disease and health. For example, the newly launched African-American Male Biobank houses a growing collection of blood and urine samples, accompanied by a database of donor demographics, including age, medical history and family history. The biobank, which is one of the only African-American biobanks in the nation, is approved by the Cleveland Clinic Institutional Review Board.

Efforts to reduce health disparities across the U.S. are beginning to see results, but much more work is needed, Modlin says. Since physicians have been taking a proactive approach to screening for prostate cancer, we have actually seen a lessening of some of the gaps, he says, citing one example.

Yet he has seen firsthand how efforts to reduce health disparities can make a difference. I cant tell you how many times people say, I never would have come in without this doctor, or how many times weve saved peoples lives at the health fair, he says.

The Clinics Minority Mens Health Fair, which takes place annually in April, has expanded to four Northeast Ohio locations and has reached more than 35,000 people with free early prevention screenings.

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Cleveland Clinic doctor leads effort to reduce health disparities among black men - freshwatercleveland

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Everything Will Wade said ahead of LSU-UMBC – 247Sports

On Marlon Taylors health Hes going to be out a while; its going to be another few weeks. We are going to go back and look at something in the foot. He still has some issues in his foot that we need to get addressed so I think the earliest he will be back is in two to three weeks. I think our goal would be to have him back by the East Tennessee State game. I think that would be a realistic goal for him to come back in the middle of December but if not then right after Christmas. We are going to be without him for an extended period. We will shut him down and recalibrate on a few things.

On Trendon Watfords performance Trendon (Watford) is off to a really good start. Every time you get a five-star kid, everyone says this and this. You look at how he stacks up against the other guys in the country and he is way out performing the other guys that are supposed to be in his class. I think he is playing extremely well, obviously we need to clean up some of the stuff at the free throw line and some of the turnovers. I think a lot of it is him playing in tighter spaces. He is playing like I said, with the adjustment of the speed, so it takes some time. (VCU) is as tough as environment as we have played in.

"You put a freshman out there at VCU, it is not easy, it is not high school. I think he has adjusted well and there are certainly some other ways we can help him get the ball closer to the basket a little easier without him having to dribble it eight times to get down there which increases the margin for error. It is part of the reason we started him at the three the other night.

"It puts our biggest lineup out there and Charles (Manning) is so smart he sees thing really well coming off the bench. It helps him get in the flow of the game, I thought he played better in that role. Theres some mismatches we can take advantage of at the three that we sometimes cant take advantage of when he is playing at the post spot. I think he is off to a very good start. He is going to continue to get better and continue to move forward.

On the players in the recruiting class Jalen (Cook) has such a good personality. He committed to us first. Hes got a great pride about LSU, hes got a great pride about Louisiana and representing the state and representing the boot. Hes been to the Under Armour camp, he was at NBA Top 100 camp. It is the same 150 players that go to all the same stuff together.

"Whether its USA Basketball, the camps, the top 100, its the same 100-125 guys that go to everything together so they develop relationships and get to know each other. (Jalen) Cook has a good personality, so people like to be around him. Certainly, having Bradley (Ezewiro) there at Oak Hill didnt hurt anything. Bradley is someone who is aggressive. Hes aggressive on the court, hes aggressive how he goes and gets rebounds. That is really his nature.

We have to sign a big class. We have three signed and we have to sign another three or four before its all done. We have some work ahead of us and we need to add some big guys. We need to add a wing that can help us replace what Marlon (Taylor) brings us. We need to add another ball handler, but we have some good irons in the fire. All those guys certainly know each other and are very close. Any time you get a high-level player like Cameron (Thomas), (Jalen) Cook and Bradley (Ezewiro), other guys want to play with those guys.

On other teams focusing on playing LSU We probably snuck around on some folks last year. I dont think people just circle LSU on their schedule for basketball. I think certainly there are other programs in our league that get that. I think if you ask the average SEC fan who won the regular season SEC title last year, they probably wouldnt know.

"That stuff moves on as time does. I think you develop a target more as you go through the season and you pile up wins. I think at the end of the year we had a target on our back when we were winning and we were a threat to win the SEC. It is our job to regain the target. You have to embrace it, if you have it, you have to embrace it. You can run from it or you can run to it and you better run to it. We have to get to the point where we have that.

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Scientists Cracked the Case of Why Octopuses of the Same Species Can Look Totally Different – SciTechDaily

A warty-skinned octopus living about 9,000 feet below the surface of the ocean. Credit: (c) ROV Jason

Deep beneath the oceans surface, surprisingly cute warty pink octopuses creep along the seafloor. But not all these octopuses look alike. While we humans love a good Is your skin oily, dry, or combination? quiz, members of one octopus species take variations in skin texture to a whole new level. Some have outrageous warts, while others appear nearly smooth-skinned. Scientists werent sure if these octopuses were even members of the same species, and they didnt know how to explain the differences in the animals looks. But in a new study, scientists cracked the case: the deeper in the ocean the octopuses live, the bumpier their skin and the smaller their bodies. DNA revealed even though the octopuses looked different, they were the same species.

If I had only two of these animals that looked very different, I would say, Well, theyre different species, for sure. But variation inside animal species can sometimes fool you, says Janet Voight, associate curator of zoology at the Field Museum and the lead author of the paper in the Bulletin of Marine Science. Thats why we need to look at multiple specimens of species to see, does that first reaction based on two specimens make sense?

An octopus with comparatively smooth skin, living 5,000 feet below the oceans surface. Credit: Ocean Networks Canada/ CSSF-ROPOS

To figure out if the smooth and warty octopuses were the same species, the scientists examined 50 specimens that were classified as Graneledone pacificathe Pacific warty octopus. Plunging deep into the ocean in ALVIN, a human-occupied submersible vehicle, Voight collected some of the octopuses from the Northeast Pacific Ocean. The team also studied specimens loaned from the University of Miami Marine Laboratory and the California Academy of Sciences. They looked at specimens from up and down the Pacific, from as far north as Washington State to as far south as Monterey, California, and from depths ranging from 3,660 feet to more than 9,000 feet below the oceans surface.

The researchers counted the number of warts in a line across each octopuss back and its head and the number of suckers on their arms. They found that the octopuses from deeper in the ocean looked different from their shallower counterparts. The deep-sea specimens were smaller, with fewer arm suckers, and, most noticeably, bumpier skin than those from shallower depths. The thing is, there werent two distinct groups; the animals appearances changed according to how deep they live. Comparing the octopuses DNA sequences revealed only minor differences, supporting the idea that they were all the same species, despite looking so different.

A deep-sea octopus with very warty skin. Credit: (c) Field Museum, John Weinstein

Sometimes when animals look different from each other, scientists can be tempted to jump the gun and declare them separate speciesespecially in the deep sea, where very little is known about animal life and scientists often dont have many specimens to compare. But looking different doesnt necessarily mean that animals are members of different species; take Chihuahuas and Great Danes, which are both the same species of Canis lupus familiaris. Dogs different appearances are due to selective breeding by humans, but in the case of the warty octopuses in this study, their different appearances seem to result from environmental influences, because their appearance changes depending on where the octopuses are from.

Scientists arent sure why the variations in skin texture occur with depth. But they do have a hunch about the size difference.

Voight thinks that these octopuses usually eat creatures from the sediment on the ocean floor, passing food from sucker to sucker and then crushing their prey like popcorn. Theres less food as you get deeper in the ocean. So these animals have to work harder to find food to eat. And that means at the end of their lives, theyll be smaller than animals who have more food. If youre a female whos going to lay eggs at the end of your life, maybe your eggs will be smaller, says Voight. Smaller eggs mean smaller hatchlings.

Support for this hypothesis comes from the number of suckers on the males arm that transfers sperm packets to females.Earlier research by Voight found that male hatchlings have a fully formed arm with all its suckers in place. The researchers documented that the number of suckers on this arm was way smaller in males from greater depth, and Voight hypothesizes it relates to egg size.

The octopus hatchlings in shallower water, only 3,660 feet, are bigger. Their eggs had more yolk. As the embryos grew, they developed farther inside the egg than the ones from 9,000 feet, who were developing in smaller eggs. They had less energy to fuel their growth before they left the egg, so they made fewer suckers, says Voight. Seeing these physical manifestations of octopuses food limitation provides a hint of how they might fare as climate change progresses and the octopuses food supply fluctuates.

Voight notes that this study, which shows that different-looking octopuses can still be the same genetic species, could help researchers down the line trying to identify life forms in the deep sea. Remotely operated vehicles (ROVs) collect video footage of the ocean floor, and it can be used to estimate the number of species presentif we know what they look like. Thats why, Voight says, its so important to examine specimens in person and use characteristics you cant see on video to identify species boundaries.

Theres still just so much we dont know about the deep sea. We need to be able to understand the information thats becoming available from ROV footage. And we can only do it by knowing what the animals look like.

Reference: A depth cline in deep-sea octopods (Cephalopoda: Graneledone) in the northeast Pacific Ocean by Janet R Voight, Jessica A Kurth, Richard E Strauss, Jan M Strugnell and A Louise Allcock, 7 October 2019, Bulletin of Marine Science.DOI: 10.5343/bms.2019.0039

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Penguin Computing to deliver Magma Supercomputer, one of the First Intel Xeon Platinum 9200 Series Processor-based Servers for AI and HPC -…

FREMONT, Calif., Nov. 18, 2019 (GLOBE NEWSWIRE) -- Penguin Computing, Inc., a leader in high-performance computing (HPC), artificial intelligence (AI), and enterprise data center solutions and services, today announced that it, along with partners Intel and CoolIT, will deliver the Magma Supercomputer to Lawrence Livermore National Laboratory. The Magma system was procured through the Commodity Technology Systems (CTS-1) contract with the National Nuclear Security Administration (NNSA) and is one of the first deployments of Intel Xeon Platinum 9200 series processors with support from CoolIT Systems complete direct liquid cooling and Omni-Path interconnect.

Magma is based on Relion XE2142eAP compute servers. Magmas 752 compute nodes are each configured with dual Xeon Platinum 9242 processors, with a theoretical peak of over 7 TFLOPs and 293TB of system memory calculating an RPeak of 5.313 PFLOPS. CoolIT Systems provides the complete direct liquid cooling solution for Magma through a blind-mate coldplate loop design which captures +85% of the server heat through CPU, DIMM and VR coldplates, allowing the servers to operate at maximum efficiency. The CoolIT subfloor piping, in-rack manifolds and row-based CHx750 CDUs deliver the required heat exchanging capability and coolant flow to support all racks.

Funded through NNSAs Advanced Simulation & Computing (ASC) program, Magma will support NNSAs Life Extension Program and efforts critical to ensuring the safety, security and reliability of the nations nuclear weapons in the absence of underground testing.

The convergence of HPC and AI is here today. We are excited to deliver Magma, an HPC system that is enhanced by artificial intelligence technology, said William Wu, Vice President of Hardware Products at Penguin Computing. We are seeing artificial intelligence permeate every industry and, specifically in HPC, we can now deliver a converged platform that allows AI to accelerate HPC modeling for our data scientist customers.

We continue designing new, leading edge solutions with our partners for the DOE NNSAs CTS-1 contract. Magma is another example of a great shared effort resulting in an HPC cluster designed and built to meet new demanding workloads. We anticipate this system to qualify for the November 2019 Top500 HPC list, said Ken Gudenrath, DOE Director at Penguin Computing.

Penguin Computing is committed to Expanding the world's vision of what is possible! The Magma cluster brings a new level of synergy amongst our clients, partners and Penguin Computing. One of our primary goals with Magma is to bring new mission technologies and capabilities to Livermore National Labs and its user communities, said Sid Mair, President of Penguin Computing.

Magma is a major leap forward in HPC and AI convergence that could only be achieved with trusted engineering collaboration between Lawrence Livermore National Lab, Penguin Computing, and Intel, said Phil Harris, VP and GM of Intels Datacenter Solutions Group. With up to 96 cores per node, massive memory bandwidth, and integrated AI acceleration with Intel DL Boost technology, the Intel Xeon Platinum 9200 processor will provide a powerful foundation for Lawrence Livermore National Lab to enhance its ability to achieve its mission goals.

The Commodity Technology System efforts at NNSA represent a very cost-effective way to manage our workload at each of our three laboratories, said Mark Anderson, Director for NNSAs Office of Advanced Simulation and Computing and Institutional Research and Development Programs. In this model, commodity-based systems take on the bulk of day-to-day computing, leaving the larger advanced technology capability systems available for only the most demanding problems across the Tri-Lab community. This is just an example of the sophisticated approach NNSA is taking to manage demanding workloads in the most efficient manner for the country.

Magma represents a timely addition to our CTS machines in order to address the significant surge in demand coming from NNSAs major Life Extension Program, said Michel McCoy, LLNLs Advanced Simulation & Computing program director. It is essential to have available a supply chain that can respond essentially instantly, delivering state-of-the-art technology in just a few months to meet pressing national security needs. We look forward to moving this system into production as fast as possible.

Under the CTS-1 contract, Penguin Computing has delivered more than 22 petaflops of computing capability to support the ASC program at the NNSA Tri-Labs of Lawrence Livermore, Los Alamos and Sandia national laboratories.

For more information about the Relion XE2142eAP server and Intel Xeon Platinum 9200 processors, or to speak with a Penguin Computing representative, please visit us at http://www.penguincomputing.com.

About Penguin ComputingFor 20 years, the Penguin Computing team of artificial intelligence (AI), engineering, and computer science experts has reimagined how startups, Fortune 500, government, and academic organizations solve complex technology challenges and achieve their organizational goals. Penguin Computing is focused on open platforms, including Open Compute Project (OCP) systems. We specialize in innovative on-premise high-performance computing (HPC), bare metal HPC in the cloud, AI, and storage technologies coupled with leading-edge design, implementation, hosting, and managed services including sys-admin and storage-as-a-service, and highly rated customer support. More information at http://www.penguincomputing.com.

About CoolITCoolIT Systems, Inc. is the world leader in energy efficient liquid cooling technology for the Data Center, Server and Desktop markets. CoolIT's Rack DLC platform is a modular, rack-based, advanced cooling solution that allows for dramatic increases in rack densities, component performance, and power efficiencies. The technology can be deployed with any server and in any rack making it a truly flexible solution. For more information about CoolIT Systems and its technology, visitwww.coolitsystems.com.

About Lawrence Livermore National LaboratoryFounded in 1952, Lawrence Livermore National Laboratory provides solutions to our nations most important national security challenges through innovative science, engineering and technology. Lawrence Livermore National Laboratory is managed by Lawrence Livermore National Security, LLC for the U.S. Department of Energy's National Nuclear Security Administration.

Penguin Computing and Relion are registered trademarks of Penguin Computing, Inc. Intel and Xeon are registered trademarks of Intel Corporation or its subsidiaries in the U.S. and/or other countries. Penguin Computing is a subsidiary of SMART Global Holdings Inc., (NASDAQ: SGH).

Penguin Computing Media ContactKarbo CommunicationsSian Blevinspenguin@karbocom.com

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Savannah wins third Mutamba mining concession in Mozambique – Mining Technology

Exploration and development firm Savannah Resources has conditionally secured third mining concession (9228C) for the Mutamba project in Mozambique.

The mining concession 9228C was awarded by Mozambiques Minister of Mineral Resources and Energy for the Mutamba Heavy Mineral Sands project.

The award represents a significant achievement for Savannah which operates a joint venture with Rio Tinto.

It has a term of 25 years, which is valid until 3 September 2044, with a possibility of 25 additional years towards mine-life extension.

The mining concession covers an area of 11,807ha and is contiguous with 9735C and 9229C concessions, which were secured by Savannah in September.

These permits cover ground in Inharrime and Jangamo districts in southern Mozambique.

The Mutamba project is in close proximity to the North/South EN1 highway and the port of Inhambane.

It also benefits from a high-quality established transport infrastructure, a daily air service to Inhambane, and grid power.

Mutamba has an Indicated and Inferred Mineral Resource of 4.4Bt at 3.9% total heavy minerals and constitutes one of the largest remaining mineral sands deposits in the world that is yet to be developed.

Savannah CEO David Archer said: The conditional award of the third Mining Concession to Mutamba Minerals Sands SA completes the tenement set of the Mutamba Project in Jangamo/Inharrime and represents a significant achievement for Savannah in its joint venture with Rio Tinto.

To finalise the process, the normal administrative payments and processes need to be completed; these are currently underway for all three licences.

We are completing the administrative conditions in a chronological manner following which all three licences will be fully formalised in due course, which, when completed, will continue to consolidate our position in the Mozambican mining industry.

Once these three Concessions are formalised, they will enable the joint venture with Rio Tinto to progress the Pre-feasibility study (PFS) towards completion.

The companys interest in the heavy mineral sands project will rise from 20% to 35%, upon completion of the PFS.

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Global Soy Extracts Market Research: Key Companies Profile with Sales, Revenue, Price and Competitive Situation Analysis – Industry Ping

Soy extracts are medicinal as well as nutritional ingredients derived from soya beans. Soy Extracts contain isoflavons that exhibit phytoestrogen properties and it is ideal for treating medical conditions involving extreme estrogen hormone imbalance. A research study has found out that soy extracts inhibits the growth of estrogen independent breast cancer tumors better than genistein. Soy Extracts find applications in treatments for cancer prevention, high cholesterol levels in body, menopausal symptoms, osteoporosis, and some other medical conditions. Due its properties that help in protection of skin and antiageing process, soy extracts find applications in various cosmetic and skincare products. Moreover, they find applications in protein supplements, functional foods & beverages and other pharmaceutical products. The increasing awareness about the health benefits of soy extracts products among public is expected aid the growth of soy extracts market globally.

Access Report Details at: https://www.themarketreports.com/report/global-soy-extracts-market-by-manufacturers-regions-type-and-application-forecast

Market share of global Soy Extracts industry is dominate by companies like Alpro, Archer Daniels Midland Company, Beiersdorf Australia Limited, Hebei Bonherb, Natrol Llc, Novaforme, Layn, Life Extension, 3w Botanical Extract, Xian Changyue Phytochemistry, Whitewave Services Inc and others which are profiled in this report as well in terms of Sales, Price, Revenue, Gross Margin and Market Share (2018-2019).

There are 15 Chapters to deeply display the global Soy Extracts market.

Chapter 1, to describe Soy Extracts Introduction, product scope, market overview, market opportunities, market risk, market driving force;

Chapter 2, to analyze the top manufacturers of Soy Extracts, with sales, revenue, and price of Soy Extracts, in 2017 and 2019;

Chapter 3, to display the competitive situation among the top manufacturers, with sales, revenue and market share in 2017 and 2019;

Chapter 4, to show the global market by regions, with sales, revenue and market share of Soy Extracts, for each region, from 2013 to 2019;

Chapter 5, 6, 7, 8 and 9, to analyze the key regions, with sales, revenue and market share by key countries in these regions;

Chapter 10 and 11, to show the market by type and application, with sales market share and growth rate by type, application, from 2013 to 2019;

Chapter 12, Soy Extracts market forecast, by regions, type and application, with sales and revenue, from 2019 to 2024;

Chapter 13, 14 and 15, to describe Soy Extracts sales channel, distributors, traders, dealers, Research Findings and Conclusion, appendix and data source

Purchase this premium research report at: https://www.themarketreports.com/report/buy-now/1496967

Market Segment by Regions, regional analysis covers:

Market Segment by Type, covers:

Market Segment by Applications, can be divided into

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Global Soy Extracts Market Research: Key Companies Profile with Sales, Revenue, Price and Competitive Situation Analysis - Industry Ping

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Mother suing NHS trust after doctors failed to reveal Huntington’s disease risk – inews

NewsHealthWoman alleges that St George's in London owed her a duty of care to tell her of her father's diagnosis given staff knew she was pregnant

Monday, 18th November 2019, 7:57 pm

A woman is suing a NHS trust for not revealing her father had been diagnosed with Huntington's disease before she had her own child.

The woman, known as ABC, learned by accident that her father carried the gene for the degenerative, incurable brain disorder four months after her daughter was born. She was tested and found she had inherited the Huntington's gene, which means she will eventually develop the disease. Her daughter has not been tested, but has a 50:50 chance of inheriting it.

The woman alleges that St George's NHS Trust, London, owed her a duty of care to tell her of her father's diagnosis, given that doctors there knew she was pregnant. ABC says that had she known about her father's condition she would have had a genetic test and would have had an abortion, rather than allowing her daughter to run the risk of inheriting the disease or having to look after a seriously ill parent.

At the time, ABC and her father were undergoing family therapy organised by the NHS, so she argues that there was an obligation to protect her psychological or physical well-being. The NHS said the case raised competing duty of care and duty of confidentiality issues.

Secret of father's illness

If ABC wins the case, it would trigger a major shift in the rules governing patient confidentiality, and raise questions over the potential duty of care owed to family members following genetic testing.

In 2007, ABCs father shot and killed her mother. He was convicted of manslaughter on the grounds of diminished responsibility and detained under the Mental Health Act. It was suspected that he might be suffering from Huntingtons.

About 8,500 people in the UK have Huntington's disease and a further 25,000 will develop it when they are older. It is a rare inherited disorder which progressively destroys brain cells. Huntington's generally affects people in their prime - in their 30s and 40s - and patients die about 10 to 20 years after symptoms start. Some patients describe it as having Parkinson's, Alzheimer's and motor neurone disease rolled into one.

When his diagnosis was confirmed in 2009 by doctors at the trust, ABC's father told medics he did not want his daughter informed. She had told him she was pregnant and he told doctors he feared she might kill herself or have an abortion.

This case was first argued at the High Court in 2015 when a judge ruled that a full hearing should not go ahead. The judgement said there was "no reasonably arguable duty of care" owed to ABC. But in 2017, the Court of Appeal reversed that decision and said the case should go to trial. Experts say disclosure of personal information, without the consent of a patient, may be justified to prevent exposing others to a risk of death or serious harm.

'Duty of confidentiality'

Emily Jackson, a law professor at the London School of Economics, said: "If a patient doesn't want her doctor to tell her children about her terminal diagnosis, for example, or her HIV status, then it goes without saying that the doctor should respect the patient's confidence.

"The complicating factor with a genetic diagnosis is that it isn't just information about the individual patient, but it also reveals that his or her relatives are at risk. In such circumstances, and where the relative could act upon that information, should the doctor's duty be extended to the patient's close family members?"

A spokesperson for St George's Healthcare NHS Trust said: "This case raises complex and sensitive issues in respect of the competing interests between the duty of care and the duty of confidentiality. It will be for the court to adjudicate on those issues during the trial."

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Longtime Lung Cancer Thrivers – Curetoday.com

Three survivors describe what life looks like seven and 15 years out from diagnosis.

Happily, the answer to both questions turned out to be yes. Two weeks after receiving his diagnosis in September, Pantelas had a lobectomy to treat what was believed to be stage 1b disease. However, the surgery revealed a more dire diagnosis: stage 3b with stage 4 lymph node involvement. Pantelas then received radiation every day for 12 weeks and chemotherapy. His oncologist, Dr. Philip Stella, who provides care at Saint Joseph Mercy Health System in Michigan, worked the infusion schedule around the birth of Pantelas daughter that November. Pantelas and his wife named their baby Stella in honor of his doctor.Pantelas has been in remission since completing treatment in April 2006, and Stella now has two younger sisters. This life is not what I expected when I got my diagnosis, Pantelas says. I am grateful for every day with my family.

Still, the going hasnt been easy. Pantelas had to leave his job in information technology when lingering treatment side effects such as sinus infections, bronchitis, pneumonia and a weakened immune system left him ill and fatigued.

No longer able to work, the self-professed workaholic threw himself into volunteerism. Pantelas sits on several institutional review boards for lung cancer research and clinical trials. In September, he traveled to Kenya as a representative of A Fresh Chapter, a nonprofit organization founded by a breast cancer survivor that facilitates volunteer and leadership experiences to empower people affected by cancer. My goal is to learn how the medical community views and treats cancer in Kenya and to see how we can help pediatric cancer patients get the best care, Pantelas says.

Between the volunteer work and caring for his family as a stay-at-home dad, Pantelas has developed a new perspective. I got my lung cancer diagnosis a month after Peter Jennings (a national television news correspondent) died from the disease, he says. I would sit in waiting rooms staring at his pictures on TV and magazines and wonder if his fate was going to be mine.

In 2020, Pantelas will turn 67 the age his dad was when he died. I never would have thought that I would still be here 15 years after getting a lung cancer diagnosis, he says.

TREATMENT BREAKTHROUGHS ADVANCE LIFEAlthough lung cancer remains the leading cause of cancer deaths worldwide, advancements in treatments are helping people like Pantelas live longer and healthier than ever before. Thanks to the advent of genomic tumor testing, weve seen dramatic changes in precision medicineand targeted treatments for non-small cell lung cancer (NSCLC), which is the most common form of lung cancer, says registered nurse Rebecca Lehto, who holds a doctorate in nursing with a neuro-behavior concentration and is a cancer nursing researcher and an associate professor at Michigan State University in East Lansing.

Historically, treatment for advanced lung cancer included chemotherapy and radiation or, more often, a combination of these therapies. Chemotherapy, in particular, was viewed as a one-type-fits-all regimen, with everyone following the same protocol and receiving the same care. Today, people who receive a diagnosis of advanced NSCLC usually first undergo genomic or molecular testing to check for changes or mutations in tumors called oncogenes. Several somatic gene mutations, such as ALK, EGFR and KRAS, are commonly associated with the development of NSCLC and can likely be treated with a targeted therapy drug.

Armed with this information, doctors can tailor a treatment plan that is proven to be most effective against a patients specific mutation. When I started in this field nearly 20 years ago, people with advanced lung cancer were living six to 12 months after diagnosis. Survival rates today are significantly improved, says Dr. Alice Shaw, who holds a doctorate in genetics and is director of thoracic oncology at Massachusetts General Hospital in Boston.

She urges patients to ask her about survival rates instead of searching the internet. Lung cancer is a very complex disease with different types and causes. Most of the statistics online today are outdated and dont apply to a persons unique circumstances, she says. With the incredible progress taking place these days, its almost impossible for anyone to accurately estimate prognosis. I certainly wouldnt put stock in statistical data found online.

FIGHTING FOR LIFE AND A FAMILYNewlywed Emily Bennett Taylor took great pains to avoid online information when she received a stage 4 lung cancer diagnosis in 2012. I was 28 and still in great shape from my years as a college athlete, says the Long Beach, California, resident. Taylor decided to stay positive and have the upper hand against cancer. In her view, dire statistics based on other peoples circumstances would serve no purpose in her very personal fight.While Taylor and her husband, Miles, awaited results of genomic tumor testing, the couple began discussing their future. I had always wanted children, and I didnt want cancer to take my family away from me, Taylor says. Before beginning cancer treatments, she took the first step of in vitro fertilization: having her eggs harvested, fertilized and stored. Taylor hung images of the frozen embryos in the couples home as a reminder that happy times would follow the dark days.

Unfortunately, genomic profiling of Taylors tumors didnt show any known genetic mutations for lung cancer. Without these markers, Taylor wasnt a candidate for the latest targeted therapies that are helping to extend the lives of people with advanced lung cancer. Chemotherapy was her only option, but even after six months of treatment followed by maintenance therapy, the odds of the cancer returning remained too high for comfort. My doctor felt my best chances at having the life I wanted parenting with my husband as we watched our kids grow up was to try something radical like surgically removing the entire lung, Taylor says.

She and her family turned to the GO2 Foundation for Lung Cancer, a nonprofit patient advocacy organization for survivors and their loved ones. The foundation helped Taylor locate a surgeon willing to do an operation that isnt typically done on people with metastatic lung cancer. On February 8, 2013, Dr. Raja Flores, a thoracic surgeon at Mount Sinai in New York City, surgically removed Taylors diseased right lung, the linings of her chest cavity and lung, lymph nodes, a section of her diaphragm and the membrane surrounding her heart. The intensive surgery was followed by 28 rounds of high-dose chest radiation.

After Taylor had done all she could to fight the disease, the couple waited through two years of clean scans before pursuing their dream of parenthood. Scanxiety is definitely very real and difficult to manage, Taylor says. We learned early on to schedule the scans first thing in the morning on a Monday. That way, results often are available by the afternoon. Taylor says meditation visualizing herself healthy and happy spending time with her family helps her cope with scanxiety and the lingering fear of a cancer recurrence.

Through the help of a surrogate, the couple welcomed twin daughters, Hope and Maggie, into the world in April 2016. Hope was a word often used during her treatment, and Taylor was also treated at City of Hope Medical Center. Maggie was named after Taylors great grandmother. Mothering twin babies has been challenging for Taylor, who fatigues easily and requires a lot of rest. When youre used to being active and independent, its hard to admit that you need help doing even routine things like grocery shopping, Taylor says. But once I accepted my new normal and let people in to help, life became more manageable and enjoyable.

When Taylor isnt busy changing diapers and thwarting tantrums, she speaks at GO2 Foundation events and replies to emails from young people facing a similar diagnosis. People find her through her blog, Emily Kicks Cancer. We originally created that site as a way to keep everyone informed about how I was doing with treatments, Taylor says. Now its a way to offer hope to others. When I was diagnosed, there werent a lot of positive stories about people surviving this type of cancer. I want to change that and inspire others to seek out the best medical care so they can fulfill their life dreams.

MAINTAINING HOPEIn 2012, Susan Warmerdam was 47 when she learned she had stage 4 lung cancer. She was relieved when tumor testing showed EGFR and KRAS mutations: That meant her doctors could try new treatments that hadnt been available to her father, who died of complications of the disease in 1999, 10 months after receiving a diagnosis.

Warmerdam began taking Tarceva (erlotinib), an oral targeted therapy drug. At the time, Tarceva was considered experimental as a first-line treatment for lung cancer; it was approved in 2013 by the Food and Drug Administration for patients with advanced NSCLC who had an EGFR mutation. Warmerdam was still in treatment. She also participated in a clinical trial for another drug that researchers hoped would slow or prevent resistance to Tarceva. Atfirst, I was reluctant to join a clinical trial I didnt want to feel like an experiment, says Warmerdam, who lives in Chicago. But then I realized that if other people hadnt participated in the trial for Tarceva, the treatment wouldnt have been available to me. Plus, you never know when the next new drug will be the miracle cure.

For Warmerdam, Tarceva turned out to be her miracle drug. My doctors said I had a stellar and unforeseen response to the drug, she recalls. The tumors shrank so much that she was able to have surgery in 2013 to remove the lymph nodes and adrenal glands where the cancerhad spread. When testing showed no evidence of cancer in the removed tissue, she had a third surgery, a lobectomy, to remove part of her right lung in January 2014. Once again, that tissue showed no evidence of disease. Warmerdam has been off treatments and cancer free ever since.

When I was diagnosed, doctors told me the cancer was inoperable and incurable. I was given a less than 2% chance of living another five years, Warmerdam says. Here I am seven years later, loving life. Had I taken some peoples advice to quit work and check things off my bucket list, I would be broke today healthy, but broke.

Warmerdam credits a large network of family, friends and colleagues for supporting and guiding her through the most difficult time in her life: I immediately reached out to people who could help. I asked a nutritionist friend to revamp my diet. I asked a friend whos a plumber to install water filters throughout my home.

Throughout her treatments, Warmerdam continued to work at a financial investment firm to keep normalcy in her life. She formed a hope-and-healing cancer group at her church. Over the years, with the help of her network, she has raised more than $370,000 for the American Lung Associations lung cancer research efforts.

When people come to me for advice, I tell them I am proof that a lung cancer diagnosis is not a death sentence. Stay positive and hopeful because the next drug you need may be right around the corner, Warmerdam says. But you have to educate yourself so that you can be your own best advocate.

Original post:
Longtime Lung Cancer Thrivers - Curetoday.com

Recommendation and review posted by Bethany Smith

Hip osteoarthritis: 6 ways to treat it – Medical News Today

Osteoarthritis, sometimes called "wear and tear" arthritis, is a common degenerative condition. Doctors can treat osteoarthritis with medication and surgery. People can also manage their symptoms with different exercises and stretches.

Osteoarthritis is the most widespread form of arthritis. The Arthritis Foundation estimate that in excess of 30 million people in the United States have osteoarthritis.

Although osteoarthritis can occur in any joint, it commonly affects the weight-bearing joints, such as the knees and hips.

Read on to find out more about osteoarthritis of the hip. We discuss what causes the condition, how doctors diagnose it, and the different ways to treat it.

Treatments for osteoarthritis focus on reducing pain and improving mobility. Effective ways to treat osteoarthritis include the following:

Pain management is essential for people living with hip osteoarthritis. People can treat mild to moderate pain with over-the-counter pain relievers, such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs).

People who have moderate to severe osteoarthritis may experience more intense pain. In such cases, prescription pain relief may be necessary.

Some people may require medications to help slow the progression of arthritis or reduce some of the symptoms. Examples of such drugs include:

Corticosteroids

Corticosteroids control inflammation by mimicking the effects of cortisol, a hormone that regulates the immune system.

People can take oral corticosteroid tablets. Doctors can also inject corticosteroids directly into the hip joint. However, corticosteroid injections offer only temporary pain relief. People will require additional injections going forward.

Hyaluronic acid injections

Another potential treatment for osteoarthritis is an injection of hyaluronic acid into the hip joint or another joint that osteoarthritis is affecting.

In 2019, the Food and Drug Administration (FDA) approved a hyaluronic acid injection for treating osteoarthritis of the knee.

Although some doctors have used the injection to treat osteoarthritis of the hip, the FDA has not yet approved it for this use.

Hyaluronic acid injections do not affect everyone in the same way. Some people do not experience any pain relief after receiving the injection. However, approximately 30% of people stay pain free for up to two years, according to the Arthritis Foundation.

Physical therapists are trained healthcare professionals who specialize in diagnosing and treating conditions that limit mobility. People with hip osteoarthritis may benefit from physical therapy sessions.

During the initial session, the therapist will assess the person's physical condition and any specific mobility problems they have. They will then devise a set of tailored exercises to help improve mobility.

The therapist teaches people how to perform each exercise so that they can safely continue their treatment at home. They may also recommend additional treatment options, such as braces, walkers, or hot and cold therapy.

Some people experience severe hip pain or stiffness that significantly affects their quality of life. These people may benefit from surgery.

There are two main surgical options for hip osteoarthritis:

Hip resurfacing

This procedure involves trimming or shaving away damaged bone on the femoral head. The femoral head is the upper end of the thigh bone, which sits inside the hip socket.

After removing the damaged bone, the surgeon covers the femoral head with metal. The surgeon also fits a metal cup inside the hip socket.

Total hip replacement

During this procedure, a surgeon replaces the entire hip joint, including the femoral head and the socket. In their place, the surgeon fits artificial components made of metal, plastic, or ceramic.

Each surgical option carries benefits and risks. A doctor will guide people through the available options before deciding on the best treatment to pursue.

Stem cells are cells that have the potential to develop into a range of different cell types. Researchers are currently looking into whether stem cell therapies could help to replace and regenerate damaged tissues within the human body.

Mesenchymal stem cells are stem cells that can develop into bone and cartilage, among other types of tissue. According to a 2018 review, mesenchymal stem cells could help to repair damaged cartilage and reduce inflammation in knee osteoarthritis.

However, stem cell therapy is not yet ready for use in clinical settings. Advances in gene editing techniques may help overcome many of the limitations currently facing stem cell therapy.

Exercises that may help manage symptoms of hip osteoarthritis include:

Stretching every day can also help to improve flexibility and relieve joint stiffness and pain. Consider the following stretches:

Sitting hip flexion

Sit-stand

Hip opener

Forward fold

People can also perform this stretch from a seated position:

Cartilage is a rubber-like tissue that covers the ends of the bones in the joints. Here, it acts as a cushion that prevents the end of one bone from rubbing against the end of an adjoining one. It also provides lubrication that allows the joint to move easily and painlessly.

In osteoarthritis, the cartilage inside the joints wears away, causing two or more bones to rub together. This process results in joint inflammation, swelling, and pain.

The risk of osteoarthritis increases with age. As people grow older, the cartilage cushions between their joints slowly deteriorate. The symptoms of discomfort and pain tend to worsen as the cartilage continues to break down.

To diagnose hip osteoarthritis, a doctor will take a person's medical history and carry out a physical examination of the joints. The doctor may also order the following diagnostic tests:

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Hip osteoarthritis: 6 ways to treat it - Medical News Today

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Ocugen Stock Is Nothing More than a Risky Trade on Even-riskier Biotech – Investorplace.com

For those looking to knock one out of the park, the biotechnology sector frequently provides the catalysts you need. Case in point is Ocugen (NASDAQ:OCGN), a gene therapies provider that specializes in rare eye diseases. Previously a privately held company, OCGN entered into a reverse merger with Histogenics. Essentially, Histogenics shares, HSGX, has become Ocugen stock.

Source: Shutterstock

Under the terms of the deal, Histogenics shareholders collectively hold about 10% of the new, combined company, which will include only Ocugens lean team. Since OCGN stock has been struggling in the markets due to a clinical failure of Histogenics flagship NeoCart therapy a regenerative therapy for treating knee cartilages the reverse merger made sense for Histogenics.

But for Ocugen, the benefits, at least from a scientific perspective was unintuitive. Both companies are involved in cell therapies, but thats where the similarities end. Primarily, Histogenics focused on orthopedics, while Ocugen focuseed on rare eye diseases. You dont have to be a medical doctor to recognize that the human eye is more complex than your foot.

Nevertheless, the appeal for contrarian investors is the vast historical disparity in the Ocugen stock price. A year-and-a-half ago, OCGN stock was firmly trading in three-digit territory. Now, you can get an equity share for well under a buck. Afew years back, the OCGN stock price was above $500. Therefore, a return to $100 isnt that unreasonable, strictly under this context.

At the same time, this price swing emphasizes how incredibly quick fortunes can evaporate. After all, some poor soul bought Ocugen stock as it approached $700 following its initial public offering.

Its this latter sentiment you should focus on if youre considering gambling on OCGN.

One of the main reasons why small biotech firms are so volatile is because they have their eggs in one basket. Typically, theyll have either a single or very few viable therapies. If they pass clinical trials, their shares can soar. Or, they become a buyout target by a big pharmaceutical company.

If they dont, these smaller players usually dont have the resources to stay afloat. Thats the biggest risk hanging over OCGN stock.

If you look at the underlying companys financials, youll see that it doesnt generate any revenues. As a result, theyre relying on grants, cash holdings or equity dilution to keep from drowning. None of these factors are viable for Ocugen stock. Investors are not comfortable with the drug pipeline performance, nor does OCGN have gobs of cash.

As far as using the capital markets, Im not sure how low Ocugen stock can go.

Because of its stretched financials, Ocugen really needs to have high-probability therapies. However, because of the companys focus on rare eye diseases, this places them in a quandary. Usually, rare diseases are incredibly difficult to address. More importantly from an investment perspective, the scale just isnt there.

That may sound cold to those who suffer from these rare conditions. But the reality is, if a biotech firm produces a treatment for rare diseases, it will launch into a limited market. Thus, that firm has no choice but to ramp up prices.

In prior years, biotech firms could get away with this business practice. But with healthcare costs becoming red-hot issue for the 2020 election, the incentive to drive up prices evaporated. So, even if Ocugen did roll out a groundbreaking therapy, they would do so at a very sensitive time.

As someone who takes a more speculative approach to investing, Im not against others following suit. But theres a difference between gambling and being stupid with your money.

I have a tough time appreciating any bull case for OCGN stock. Clearly, the Histogenics portion of the reverse merger hasnt added substantively to Ocugens narrative. From a technical standpoint, share prices dropping below a buck is a serious red flag. Thats especially so for shares that once traded for several Benjamins.

As of this writing, Josh Enomoto did not hold a position in any of the aforementioned securities.

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Ocugen Stock Is Nothing More than a Risky Trade on Even-riskier Biotech - Investorplace.com

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U.S. stem cell clinic offering unapproved therapies brings direct-to-consumer marketing to Ottawa – Ottawa Citizen

Just a few months after Health Canada began cracking down on private clinics offering unapproved stem cell therapies, at least one U.S. clinic has moved in to fill the vacuum with direct marketing to Canadian consumers.

The clinic from Burlington, Vermont, even offers shuttle buses to transport people from Ottawa to the clinic four hours away for treatment it suggests will end joint pain, among other things. Lunch and dinner are free, but each injection costs $6,880. Two for $10,880.

The treatments, using umbilical cord-derived mesenchymal stem cells, are not approved in either Canada or the United States. Health Canada warns that Canadians who travel abroad for stem cell treatments may put themselves at risk.

While stem cells, which were discovered at the University of Toronto in 1961 by James Till and Ernest McCulloch, promise to revolutionize many treatments and could offer breakthroughs for diseases, almost all are still considered experimental and have yet to be proven safe or effective. Clinical trials on numerous potential stem cell therapies are under way, including in Ottawa.

While research progresses, private stem cell clinics have popped up around the world making promises for treatments not yet proven safe or effective.

A 2018 study by Leigh Turner of the University of Minnesota Center for Bioethics found 43 clinics offering stem cell treatments in Canada and 750 in the U.S. Earlier this year, Health Canada sent Canadian clinics, including some in Ottawa, cease-and-desist letters.

Clinics in Vermont, near the Canadian border, appear to have ramped up marketing to Canadians since then. One clinic has been holding back-to-back seminars. Another says it stopped marketing in Canada after receiving a warning from Health Canada.

There have been cases of harm as a result of treatments, including two women who had permanent damage to their sight after stem cells were injected into their eyes at a Florida clinic. Other patients have been infected with unsterilized equipment and others have developed tumours at the site of stem cell injections.

A common harm, critics say, is exploitation.

Dr. Michael Rudnicki is director of the regenerative medicine program and Sprott Centre for Stem Cell Research at the Ottawa Hospital Research Institute, says of stem cell therapy claims: If it sounds too good to be true, it probably is too good to be true.jpg

Health officials say the clinics are misusing the promise of stem cell therapy to exploit vulnerable patients.

These patients are in pain and they are suffering and they are looking for help and they are being exploited, said Dr. Michael Rudnicki, director of the regenerative medicine program and Sprott Centre for Stem Cell Research at the Ottawa Hospital Research Institute.

If it sounds too good to be true, it probably is too good to be true.

At a recent seminar at a west-end Ottawa hotel meeting room, Roseanna Ammendolea of the Vermont Center for Regenerative Medicine told a packed room that her clinic and others like it had successfully treated people for pain related to arthritis, neuropathy and other ailments that affected joints using mesenchymal stem cells from umbilical cords. The stem cells, she claimed, are both effective and safe, saying there had been no issues with cell rejection.

We will not give injections if we feel that this injection will not be beneficial to our patients. This is why we are so successful.

Participants, including some who walked with canes and others who talked about being in pain and having mobility issues, were shown videos of people described as Canadian clients who claimed the treatments worked. One man said it was probably the best money I have spent in my life as far as my health. Another said she would do it again in a heartbeat and was able to do things she hadnt been able to do earlier.

They were also shown a slide showing long wait times for hip and knee replacements in Ontario, We are not a priority, she said. Where does that leave us? Participants werent told exactly how the stem cells were supposed to work, but claimed they had successfully improved pain and mobility issues in clients.

What the seminar goers werent told is that, even in the U.S., the treatment is not covered by health insurance because it remains unproven.

The U.S. Federal Drug Administration has issued a warning to consumers not to use cell therapies that are unapproved or unproven.

Stem cells have been called everything from cure-alls to miracle treatments. But dont believe the hype. Some unscrupulous providers offer stem cell products that are both unapproved and unproven. So beware of potentially dangerous procedures and confirm whats really being offered before you consider anytreatment, the FDA said in a statement.

The only stem-cell-based products that are FDA-approved for use in the United States are blood-forming stem cells derived from cord blood for limited use in patients with disorders affecting the body system that is involved in the production of blood. Bone marrow is also used for these treatments, but is generally not regulated by the FDA for that use.

Health Canada has granted market authorization for a stem cell therapy to treat graft-versus-host disease and two cell-based gene therapies to treat certain cancers. Most cell therapies are still experimental.

I totally understand the skepticism of it, Doug Argento, who works at the Vermont Center for Regenerative Medicine, said in a telephone interview, but the fact is that things that are approved now and medically paid for were seen as renegade 20 or 30 years ago.

The treatment employs technology developed by Neil Riordan, founder, chairman and chief science officer of the Stem Cell Institute in Panama, using human umbilical cord tissue-derived mesenchymal stem cells. There are 41 such clinics across the U.S. Riordan also played a role in the development of a nutritional product called Stem-Kine, which producers claim without scientific backing increases the number of stem cells circulating in a persons body.

The stem cells injected in the clinic, Argento said, are from umbilical cord tissue as a result of caesarean births to reduce risk of infection.

Rudnicki, of The Ottawa Hospital Research Institute, says there is no evidence that these sorts of cells are regenerative at all. It would not pass muster in Canada.

The public has to understand that there are people out to remove them from their money.

Rudnicki says he regularly receives inquiries from people desperate to get stem cell treatments. He says he tries to connect them with clinical trials that they might be able to participate in.

Rudnicki noted there were multiple clinical trials in Canada, including treatments of autoimmune diseases, trials involving treatment for Type 1 diabetes and others.

But the use of these inappropriate cell types for treating arthritis and joints and so on is certainly not approved by Health Canada and would not be allowed in Canada under the regulations.

There is some evidence that injections of some stem cell products might have a temporary positive impact on inflammation, he said, but it will not be regenerative and will not restore function to joints. They are being sold a bill of goods.

Leigh Turner of the University of Minnesota Center for Bioethics, meanwhile, says the explosion in clinics offering unproven stem cell therapies in the U.S. is a marketplace that traffics in misrepresentation. It is easy to see how people are taken advantage of and scammed.

It is also difficult to find out about physical harms being done to patients.

There are no safety studies. We dont have good data. But we do know there have been some serious harms.

Stem cell therapies have the potential to become standard treatment in some areas, but they are not there yet, Turner said.

Businesses are tapping into genuine human suffering, desperation and also hope.

Turner also noted there was an excellent chance that the vials of liquid being injected into patients did not actually contain stem cells.

Dr. Jonathan Fenton of another stem cell clinic in Burlington, the Vermont Regenerative Medicine, said he had complained about the new clinic, the Vermont Center for Regenerative Medicine, which has a similar name and employs hard-sell tactics, he said.

His clinic takes bone marrow from patients hips and injects it. The procedure is done the same day. He says he regularly sees Canadian patients for bone marrow aspiration therapy and platelet-rich plasma treatments, using their own blood. The treatments, he says, speed healing and are allowed in the U.S. The use of bone marrow aspiration is neither proven nor allowed in Canada.

Fenton, who is secretary-treasurer of the American Academy of Orthopedic Medicine, acknowledged many people offering stem cell treatments are not doing it to the highest ethical standards.

He has filed complaints with state officials over clinics selling unsafe or fraudulent treatments. I have asked the state and federal judiciary to close down this clinic for committing fraud.

He said his platelet and bone marrow treatments were covered by a major Vermont health insurer because they saw the cost of benefits were going down and patients were requiring fewer surgeries.

He said he was told by Health Canada that he could not market in Canada. Representatives of the Vermont Center for Regenerative Medicine, meanwhile, said they had discussions with Health Canada about what they could and could not say when marketing in Canada before holding seminars in Ottawa and Halifax.

We have looked at the information provided and have not identified any immediate non-compliance with advertising regulations pertaining to Canadian health products, a Health Canada spokesperson said, adding that the agency was continuing to assess.

Back at a west-end Ottawa hotel, some participants in the seminar, including a retired pharmacist, said they were considering getting the treatments. But its expensive.

Another participant said he was skeptical. They seemed very sketchy when I went online.

epayne@postmedia.com

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U.S. stem cell clinic offering unapproved therapies brings direct-to-consumer marketing to Ottawa - Ottawa Citizen

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These Scientists May Have Found a Cure for ‘Bubble Boy’ Disease – Smithsonian

On the morning of April 25, 2018, in Fort Wayne, Indiana, Omarion Jordan came into the world ten-fingers-and-toes perfect. His mother, Kristin Simpson, brought her dark-haired newborn home to a mostly empty apartment in Kendallville, about 30 miles to the north. Shed just moved in and hadnt had time to decorate. Her son, however, had everything he needed: a nursery full of toys, a crib, a bassinet and a blue octopus blanket.

Still, within his first couple of months, he was plagued by three different infections that required intravenous treatments. Doctors thought he had eczema and cradle cap. They said he was allergic to his mothers milk and told her to stop breastfeeding. Then, not long after he received a round of standard infant vaccinations, his scalp was bleeding and covered with green goop, recalled the first-time mother, who was then in her late teens. She took him to the hospital emergency room, where, again, caregivers seemed puzzled by the babys bizarre symptoms, which didnt make any sense until physicians, finally, ordered the right blood test.

What they learned was that Omarion was born with a rare genetic disorder called X-linked severe combined immunodeficiency (SCID), better known as the bubble boy disease. Caused by a mutated gene on the X chromosome, and almost always limited to males, a baby born with X-linked SCID, or SCID-X1, lacks a working immune system (hence the unusual reaction to vaccination). The bubble boy name is a reference to David Vetter, a Texas child born with SCID-X1 in 1971, who lived in a plastic bubble and ventured out in a NASA-designed suit. He died at 12, but his highly publicized life inspired a 1976 TV movie starring John Travolta.

Today, technological advances in hospitals provide a kind of bubble, protecting SCID-X1 patients with controlled circulation of filtered air. Such safeguards are necessary because a patient exposed to even the most innocuous germs can acquire infections that turn deadly. As soon as Omarion tested positive for the disorder, an ambulance carried him to Cincinnati Childrens Hospital in nearby Ohio and placed him in isolation, where he remained for the next few months. I had no idea what would happen to him, his mother recalled.

Approximately one in 40,000 to 100,000 infants is born with SCID, according to the Centers for Disease Control and Prevention. Only about 20 to 50 new cases of the SCID-X1 mutationwhich accounts for about half of all SCID casesappear in the United States each year. For years, the best treatments for SCID-X1 have been bone marrow or blood stem cell transplantations from a matched sibling donor. But fewer than 20 percent of patients have had this option. And Omarion, an only child, was not among them.

As it happened, medical scientists at St. Jude Childrens Research Hospital in Memphis, Tennessee, were then developing a bold new procedure. The strategy: introduce a normal copy of the faulty gene, designated IL2RG, into a patients own stem cells, which then go on to produce the immune system components needed to fight infection. Simpson enrolled Omarion in the clinical study and Cincinnati Childrens Hospital arranged a private jet to transport her and her son to the research hospital, where they stayed for five months.

St. Jude wasnt the first to try gene therapy for SCID-X1. Nearly 20 years ago, researchers in France reported successfully reconditioning immune systems in SCID-X1 patients using a particular virus to deliver the correct gene to cells. But when a quarter of the patients in that study developed leukemia, because the modified virus also disrupted the functioning of normal genes, the study was halted and scientists interested in gene therapy for the disorder hit the brakes.

At St. Jude, experts led by the late Brian Sorrentino, a hematologist and gene therapy researcher, set out to engineer a virus delivery vehicle that wouldnt have side effects. They started with a modified HIV vector emptied of the virus and its original contents, and filled it with a normal copy of the IL2RG gene. They engineered this vector to include insulators to prevent the vector from disturbing other genes once it integrated into the human genome. The goal was to insert the gene into stem cells that had come from the patients own bone marrow, and those cells would then go on to produce working immune system cells. It was crucial for the viral vector to not deliver the gene to other kinds of cellsand thats what the researchers observed. After gene therapy, for example, brain cells do not have a correct copy of the gene, explained Stephen Gottschalk, who chairs St. Judes Department of Bone Marrow Transplantation and Cellular Therapy.

In the experimental treatment, infants received their re-engineered stem cells just 12 days after some of their bone marrow was obtained. They went through a two-day, low-dose course of chemotherapy, which made room for the engineered cells to grow. Within four months, some of the babies were able to fight infections on their own. All eight of the initial research subjects left the hospital with a healthy immune system. The remarkably positive results made news headlines after being published this past April in the New England Journal of Medicine. Experimental gene therapy frees bubble boy babies from life of isolation, the journal Nature trumpeted.

So far, the children who participated in that study are thriving, and so are several other babies who received the treatmentincluding Omarion. As a physician and a mom, I couldnt ask for anything better, said Ewelina Mamcarz, lead author of the journal article and first-time mother to a toddler nearly the same age as Omarion. The children in the study are now playing outside and attending day care, reaching milestones just like my daughter, Mamcarz says. Theyre no different. Mamcarz, who is from Poland, came to the United States to train as a pediatric hematologist-oncologist and joined St. Jude six years ago.

Other medical centers are pursuing the treatment. The University of California, San Francisco Benioff Childrens Hospital is currently treating infant patients, and Seattle Childrens Hospital is poised to do the same. Moreover, the National Institutes of Health has seen success in applying the gene therapy to older patients, ages 3 to 37. Those participants had previously received bone marrow transplants from partially matched donors, but theyd been living with complications.

In the highly technical world of medicine today, it takes teamwork to achieve a breakthrough, and as many as 150 peoplephysicians, nurses, regulators, researchers, transplant coordinators and othersplayed a role in this one.

Sorrentino died in November 2018, but hed lived long enough to celebrate the trial results. In the early 90s, we thought gene therapy would revolutionize medicine, but it was kind of too early, said Gottschalk, who began his career in Germany. Now, nearly 30 years later, we understand the technology better, and its really starting to have a great impact. We can now develop very precise medicine, with very limited side effects. Gottschalk, who arrived at St. Jude a month before Sorrentinos diagnosis, now oversees the hospitals SCID-X1 research. Its very, very gratifying to be involved, he said.

For now the SCID-X1 gene therapy remains experimental. But with additional trials and continued monitoring of patients, St. Jude hopes that the therapy will earn Food and Drug Administration approval as a treatment within five years.

Simpson, for her part, is already convinced that the therapy can work wonders: Her son doesnt live in a bubble or, for that matter, in a hospital. He can play barefoot in the dirt with other kids, whatever he wants, because his immune system is normal like any other kid, she said. I wish there were better words than thank you.

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These Scientists May Have Found a Cure for 'Bubble Boy' Disease - Smithsonian

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CNST Stock Is Particularly Risky After Its Recent Run – Investorplace.com

In my view, few investment sectors are as frustrating as the pharmaceutical industry. One moment, you could be riding high on bullish momentum. The next, you could be staring at unfathomable losses. For stakeholders of Constellation Pharmaceuticals (NASDAQ:CNST), though, theyre enjoying the positive end of this dynamic. Year to date, CNST stock is up a blistering 846%.

Source: Shutterstock

Most of these bonkers gains came within the last two months. Since the beginning of October, Constellation Pharmaceuticals stock has jumped nearly 400%. And in this month alone, CNST is up over 68%. Seemingly, this company has no downside, inspiring others to jump aboard this extreme momentum name. Should you follow suit?

Unlike other speculative gambles, a fundamental case exists for the massive skyrocketing of CNST stock. Among the underlying companys therapies is an experimental drug called CPI-0610, a treatment for myelofibrosis. According to pharma giant Celgenes (NASDAQ:CELG) website, myelofibrosis is a rare blood cancer. Only 5,000 people in the U.S. are diagnosed with the illness each year.

Further, myelofibrosis starts in the stem cells of the bone marrow, leading to the production of faulty blood cells. Prior efforts in treating this illness have not produced substantive results. However, Constellations CPI-0610 has performed exceptionally well in a phase II study; hence, the massive surge in Constellation Pharmaceuticals stock.

In fact, all four patients that participated in the study responded positively to the drug. Because of the positive data that came from the clinical trial, Constellation will expand the study to include more patients. This, of course, suggests supreme confidence in the CPI-0610 therapy, and that could ultimately represent a paradigm-shifting breakthrough.

Still, I think you should consider the long road ahead before jumping aboard CNST stock.

By their very nature, rare diseases are difficult to address. And among this class of debilitating conditions, myelofibrosis is particularly nasty. According to Dr. Ruben Mesa, myelofibrosis is a variable disease. This means that medical doctors must apply custom-tailored treatments for different patients.

Thus, while Constellation may have won the initial round in its Phase II study, the real work is coming ahead. With many more test subjects, the chances that CPI-0610 could be considered ineffective or even adverse jump significantly.

In other words, the enthusiasm were seeing now with CNST stock could quickly go the other way.

Theres also the little matter of the economics and politics of addressing myelofibrosis. As you might imagine, combating rare diseases without financial incentives wouldnt make much economic sense. But the Orphan Drug Act, passed in 1983, encouraged pharmaceuticals to address rare diseases through various incentive programs.

Unfortunately, like anything involving government action, good intentions gave way to hellish results. Pharmaceuticals gamed the system the Orphan Drug Act created, pocketing massive profits for rare-disease therapies. Since the patients had no recourse in this monopolized environment, they (and their insurance companies) foot the bill.

Underlining the current bullish thesis for CNST stock is the idea that Constellation will become the only viable myelofibrosis player. Celgene is trying but is coming up short. Essentially, Constellation can charge what they want for their drug if theyre successful.

But even if they are successful and thats a huge if the political environment for price-gouging pharmaceuticals is extremely unfavorable.

No matter how great a scientific achievement Constellation has made, diving into Constellation Pharmaceuticals stock seems risky. With shares gaining 400% in the past month and a half, most of the good news is surely baked in.

Of course, we could hear even better results once the company expands its myelofibrosis study. But that too is a risky perspective.

For those who are not familiar with the pharmaceutical industry, I highly recommend reading Dr. Mario Beauregards book Brain Wars. Among the many topics that Dr. Beauregard covers, a central motif is the mysteries of the mind. Compelling evidence indicates that our mental state can generate healing.

But a flipside to this concept is that an alarming number of pharmaceuticals fail the placebo test; that is, many if not most drugs are no more effective than patients belief in their efficacy.

Soon, well see how good CPI-0610 really is. For those that cant handle extreme price swings, you should stay away from Constellation Pharmaceuticals stock.

As of this writing, Josh Enomoto did not hold a position in any of the aforementioned securities.

Originally posted here:
CNST Stock Is Particularly Risky After Its Recent Run - Investorplace.com

Recommendation and review posted by Bethany Smith

Do you hate vegetables? It could be in your DNA – WTSP.com

ST. PETERSBURG, Fla. Vegetarians and vegans this one may be for the meat-eaters.

It's for the people who simply cant stomach the thought of chowing down on some fresh and healthy vegetables.

It turns out thats a preference that may run a lot deeper than casual dislike. According to the results of a new study, our genetic code has a powerful influence over how we perceive bitter flavors.

And guess what green vegetables fall into the bitter category on a flavor chart?

Well a lot of them.

This weekend, scientists are presenting their not-so-tasty findings at the American Heart Associations Scientific Sessions in Philadelphia. Researchers took DNA samples from 175 people more than 70 percent female with an average age of 52 and asked them to fill out a food frequency questionnaire. They found that people with a very specific genetic makeup ate the least amount of vegetables.

Your genetics affect the way you taste, and taste is an important factor in food choice, said Dr. Jennifer L. Smith. Shes a postdoctoral fellow in cardiovascular science at the University of Kentucky School of Medicine and she wrote the study.

Jennifer L. Smith, Ph.D., R.N.

American Heart Association

Smith explains that every person inherits two copies of a taste gene called TAS2R38.

People with two copies of the AVI variant are not sensitive to bitter tastes from certain chemicals.

People with one AVI and one PAV variant think those same chemicals taste bitter.

People with two PAVs are hypersensitive to them and the flavor is exceptionally bitter.

Were talking a ruin-your-day level of bitter when they tasted the test compound, said Smith.

While this may be a great excuse at a dinner party or over the holidays, there is one important side note. People who find broccoli and Brussels sprouts to be completely untouchable may also be turned off by coffee, chocolate and beer.

Thats rough.

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UNC Biology Researcher Honored With National Women in Science Fellowship – INDY Week

Christine Roden, a postdoctoral researcher at UNC-Chapel Hill, wasone of five women honored this month for the work in STEM fields by L'Oral USA,as part of the cosmetics companys For Women in Science Fellowship program.

L'Oralrecognized the 2019 fellows at a November 7awards ceremony hosted by CBS Evening Newsanchor Norah O'Donnell at the Carnegie Institution for Science in Washington, D.C.

Now in its sixteenth year, the fellowship program, which includes a $60,000 cash award, is administered by the American Association for the Advancement of Science. The program has recognized eighty female postdocstudents with over $4 million since 2003, according to a news release on Tuesday.

Roden is a thirty-two-year-old RNA biologist and Pennsylvania native. She earned a Ph.D.in genetics at Yale University and an undergraduate degree in biology from the University of Pittsburgh.

The fellowship will enable her to spend time learning new techniques for RNA profiling. She can also use the funding to hire an undergraduate to assist her with experiments and data collection.

Her research in RNA biology at the University of North Carolina, Chapel Hill seeks to understand how disrupted RNA structures can result in diseases like ALS or cancer, with the potential to improve treatments for these types of diseases, a L'Oral USA spokeswoman, told the INDY in an email.

The press releasesays the programs funding and support for women scientists comes at a critical time in their careers.

The For Women in Science Fellowship program is rooted in LOrals core belief that the world needs science and science needs women because women in science have the power to change the world, the release states. Although the number of women in science is increasing, there remains a leaky pipeline,with significant career drop-off happening during the years between postdoc and tenure track. In addition to grant funding, fellows receive mentorship, media training, career coaching, and recognition.

The fellowship candidates were evaluated based on their intellectual merit, research potential, scientific excellence, and commitment to supporting women and girls in science. The fellowship winners are required to serveas role models for younger generations, according to the release.

Roden and the four other fellowship recipientsare being honored for their important research across a wide range of fields, from neuroscience to paleoceanography.

Women interested in applying for the fellowship can learn more here.

Contact staff writer Thomasi McDonald at tmcdonald@indyweek.com.

Support independent local journalism.Join the INDY Press Clubto help us keep fearless watchdog reporting and essential arts and culture coverage viable in the Triangle.

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UNC Biology Researcher Honored With National Women in Science Fellowship - INDY Week

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Scientists reveal why we feel so tired in the morning – Yahoo Lifestyle

If youre the type of person who snoozes your alarm every morning or cant function before (or even after) yourmorning coffee, there might be a genetic reason for that.

New research by DNA testing company,23andMe, has discovered that genetic programming plays a part in our wake up time.

The research studied over 1,500 British people to determine that 7.55am was the UKs average genetic wake up time.

This means that the average Brit willwake upnaturally just before 8am each day.

READ MORE: Drinking tea or coffee has no impact on sleep, according to study

Many people set their alarms for much earlier than that, hence our feelings of tiredness and lack of productivity.

Interrupting your bodys circadian rhythm (which is the official term for our body clock) can leave us feeling out of sorts at the beginning of the day.

If you dont feel tired first thing, it doesnt mean youre immune to these feelings. Many people have tiredness slumps at different points in the day.

READ MORE: Parents can buy children anti-nightmare mist

TheNHShas found that one in five of us get unusually tired and have suggested some good ways to wake yourself up when the slump sets in.

Exerciseis cited as one of the key ways to bolster your energy reserve. Aside from the psychological benefits of exercise, it alsolowers your risk of early death by 30%.

Cutting down oncaffeineis another recommended way to beat the tiredness. As a nation of tea drinkers, we are all at risk of being over-stimulated by the affects of caffeine. Switching to decaffeinated tea and coffee could make all the difference.

Getting into a routine of having daytime naps may also interrupt your bodys circadian rhythm. If you go to sleep every time you feel a bout of tiredness, you may struggle to get to sleep at night, so says the NHS.

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Scientists reveal why we feel so tired in the morning - Yahoo Lifestyle

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Introducing the Targeted Anticancer Therapies and Precision Medicine in Cancer Collection – PLoS Blogs

While the rate of death from cancer has been declining since the 1990s, an estimated 9.6 million people died from cancer in 2018, making it the second-leading cause of death worldwide [1]. According to the NCI Cancer Trends Progress Report, in the United States, the incidence and death rates of some cancer types have also been increasing. Together, these facts indicate that despite tremendous recent progress, the research community unfortunately still has a long list of tasks to complete to end global suffering from cancer.

The clinical management of cancer has long been rooted in morphological and histopathological analyses for diagnosis, and the triad of surgery, chemotherapy, and radiation for treatment. However, we are quickly moving towards a pervasive reliance on high resolution, high throughput, molecular marker-based diagnostic as well as precision-targeted therapeutic modalities. The progressive development of the paradigm that defined molecular drivers of cancer has exposed therapeutic vulnerabilities; for example, the BCR-ABL1 gene fusion in chronic myeloid leukemia, KIT mutations in gastrointestinal stromal tumors, ERBB2 amplification in a subset of breast cancers, or EGFR mutations and ALK/ ROS/ RET gene fusions in lung cancers to name a few. Fueled by advances in high-throughput sequencing, it is increasingly practical (and arguably affordable) to systematically pursue Targeted Anticancer Therapies and Precision Medicine in Cancer.

PLOS ONE, together with PLOS Computational Biology, launched a Call for Papers earlier this year to increase understanding of this clinically important area. The scope of this call encompassed four areas: identification and classification of driver genes and somatic alterations; target and drug discovery; mechanisms of drug resistance; and early detection and screening.

Today, we are very happy to announce the launch of the resulting Collection. Featuring an initial set of nearly two dozen papers, with more to be added as they are published, these articles represent diverse facets of ongoing efforts in this area, where general knowledge of cancers serves to inform individual patients care, and at the same time particulars from individual cancer cases contribute to improved resolution of our general knowledge pool.

Somatic aberrations that are critical to the development, growth and progression of cancer are defined as drivers that are typically accompanied by large numbers of incidental aberrations referred to as passengers, acquired in the tumors due to the general chromosomal instability characteristic of advanced cancers. Distinguishing driver aberrations from passengers in individual tumors represents an active area of research that involves development of smarter analytical algorithms, as well as definitive functional characterization of candidate aberrations.

Emilie A. Chapeau et al. developed a conditional inducible transgenic JAK2V617F mouse model that recapitulates aspects of human myeloproliferative neoplasms, including splenomegaly, erythroid expansion and hyperproliferation of bone marrow, with some intriguing differences seen between male and female mice. Importantly, the disease phenotype was reversible when transgene expression was switched off. This work underscores the key role for JAK2V617F in the initiation and maintenance of myeloproliferative neoplasms, and suggests that inhibitors specific to this JAK2 mutation might be efficacious in this disease [2].

Using targeted exon sequencing and array comparative genomic hybridization (CGH), Gayle Pageau Pouliot et al. identified monoallelic mutations in Fanconi-BRCA pathway genes in samples collected from children with T cell acute lymphoblastic leukemia (T-ALL). These mutations appeared to arise in early stages of tumorigenesis, suggesting a potential role for Fanconi-BRCA pathway insufficiency in the initiation of T-ALL. Although PARP inhibitors did not affect viability of isolated T-ALL cells with monoallelic Fanconi-BRCA mutations, these cells were hypersensitive to UV irradiation in vitro or ATR inhibition in vivo, suggesting that ATR inhibitors might have therapeutic value in T-ALL [3].

Three papers in this Collection examine links between genetic alterations and prognosis. Sumadi Lukman Anwar et al. report that LINE-1 hypomethylation in human hepatocellular carcinoma samples correlates with malignant transformation, decreased overall survival and increased tumor size [4]. Investigating HER2-positive breast cancer specimens, Arsalan Amirfallah et al. found that high levels of vacuole membrane protein 1 (VMP1) could potentially contribute to cancer progression and might be a marker of poor prognosis [5]. Finally, in their systematic review and meta-analysis, Chia Ching Lee et al. identified low discordance rates in EGFR mutations between primary lung tumors and distant metastases, although they note some differences depending on metastatic site. Notably, discordance rates appear to be higher in bone metastases compared to central nervous system or lung metastases [6]. These studies provide much-needed leads for the potential development of new diagnostic tests or targeted therapies.

Precision therapy of cancers is premised on the identification of tumor-specific driver aberrations that are necessary for tumor growth and survival. These aberrations represent potential therapeutic targets. While matching therapeutics have been developed for some of the tumor-specific targets, particularly many oncogenic kinases, a large number of defined driver aberrations remain in search of effective therapies. Drug discovery efforts to match defined targets represent a vigorous area of ongoing research with implications for survival and quality of lives of cancer patients worldwide. The development of drugs to treat cancers driven by transcription factors, chromatin modifiers, and epigenetic modulators has proved particularly challenging. On the other hand, recent development of novel immunotherapeutic approaches has spurred research to identify potential targets and matching drug discovery efforts.

This Collection highlights several interesting new strategies to identify potential lead compounds for cancer treatment. Thomas W. Miller et al. describe the development of a biochemical quantitative high-throughput screen for small molecules that disrupt the interaction between CD47 and SIRP. Preclinical studies have shown that disrupting this interaction may provide a new approach for cancer immunotherapy. Small molecular inhibitors that specifically target the interaction between CD47 and SIRP are potentially advantageous over biologics that target CD47, because they might have less on target toxicologic issues and greater tissue penetrance [7].

Work from Gabrielle Choonoo, Aurora S. Blucher et al. examines the feasibility of repurposing existing cancer drugs for new indications. The authors compiled information about somatic mutations and copy-number alterations in over 500 cases of head and neck squamous cell carcinoma (HNSCC) and mapped these data to potential drugs listed in the Cancer Targetome [8]. This approach uncovered pathways that are routinely dysregulated in HNSCC and for which potential anti-cancer therapies are already available, as well as those for which no therapies exist. The work opens new therapeutic avenues in the treatment of this disease and also illuminates which pathways could be prioritized for the development of therapies [9].

Another important approach in extending the clinical utility of existing anti-cancer drugs is to determine whether they are effective in other settings. Indeed, Kirti Kandhwal Chahal et al. have demonstrated that the multi-tyrosine kinase inhibitor nilotinib, which is approved for use in chronic myeloid leukemia, binds the Smoothened receptor and inhibits Hedgehog pathway signaling. Nilotinib decreased viability of hedgehog-dependent medulloblastoma cell lines in vitro and in patient-derived xenografts in vivo, suggesting that nilotinib might be an effective therapy in Hedgehog-dependent cancer [10]. (Check out the authors preprint of this article on bioRxiv.) Darcy Welch, Elliot Kahen et al. took a different approach to identify new tricks for old drugs. By testing two-drug combinations of five established (doxorubicin, cyclophosphamide, vincristine, etoposide, irinotecan) and two experimental chemotherapeutics (the lysine-specific demethylase 1 (LSD1) inhibitor SP2509 and the HDAC inhibitor romidepsin), they found that combining SP2509 with topoisomerase inhibitors or romidepsin synergistically decreased the viability of Ewing sarcoma cell lines in vitro [11].

Two papers in this collection describe potential new therapeutic approaches in cancer. Vagisha Ravi et al. developed a liposome-based delivery mechanism for a small interfering RNA targeting ferritin heavy chain 1 (FTH1) and showed that this increased radiosensitivity and decreased viability in a subpopulation of glioma initiating cells (GICs) [12]. Yongli Li et al. identified 2-pyridinealdehyde hydrazone dithiocarbamate S-propionate podophyllotoxin ester, a podophyllotoxin derivative that inhibits matrix metalloproteinases and Topoisomerase II. Treatment with this compound decreased the migration and invasion of human liver cancer cell lines in vitro, as well as growth of HepG2-derived tumors in mouse xenografts [13].

The success of precision cancer therapy targeting defined somatic aberrations is hampered by an almost inevitable, eventual treatment failure due to the emergence of drug resistance. Resistance often involves new mutations in the therapeutic target itself, or it may result due to activation of alternative pathways. Identification and therapeutic targeting of drug resistant clones represents an ongoing research problem with important practical implications for the clinical management of cancer.

Afatinib is a pan-human epidermal growth factor receptor (HER) inhibitor under investigation as a potential therapeutic option for people with gastric cancer; however, preclinical studies have found that some gastric cancer cell lines are resistant to afatinib treatment. Karolin Ebert et al. identify a potential mechanism behind this lack of response, demonstrating that siRNA-mediated knockdown of the receptor tyrosine kinase MET increases afatinib sensitivity of a gastric cancer cell line containing a MET amplification. As upregulation of MET has been linked to resistance to anti-HER therapies in other cancers, these findings support a role for MET in afatinib resistance in gastric cancer and suggest that combined afatinib and anti-MET therapy might be clinically beneficial for gastric cancer patients [14].

Identifying mechanisms to circumvent drug resistance is critically important to improve response and extend survival, but it is equally important to identify individuals who could be at risk of not responding to anti-cancer therapeutics. Lucas Maahs, Bertha E. Sanchez et al. report progress towards this end, showing that high expression of class III -tubulin in metastatic castration-resistant prostate cancer (CRPC) correlated with decreased overall survival and worse response rate (as measured by changes in prostate-specific antigen (PSA) levels) in CRPC patients who received docetaxel therapy. The development of a biomarker indicating potential treatment resistance to docetaxel could help develop treatment plans with the best chance of success [15].

The converse approach identifying biomarkers that correlate with drug sensitivity could help distinguish subsets of patients who would benefit most from a certain anti-cancer therapy. Kevin Shee et al. mined publicly available datasets to identify genes whose expression correlate with sensitivity and response to chemotherapeutics and found that expression of Schlafen Family Member 11 (SLFN11) correlates with better response to a variety of DNA-damaging chemotherapeutics in several types of solid tumors [16]. Separately, Jason C. Poole et al. validated the use of the Target Selector ctDNA assay, a technology developed by their group that allows the specific amplification of very low frequency mutant alleles in circulating tumor DNA (ctDNA). Testing for EGFR, BRAF and KRAS mutations yielded a very high, >99% analytical sensitivity and specificity with the capability of single mutant copy detection, indicating that accurate molecular disease management over time is possible with this minimally invasive method [17].

Work from Georgios Kaissis, Sebastian Ziegelmayer, Fabian Lohfe et al. uses a machine learning algorithm to differentiate subtypes of pancreatic ductal adenocarcinoma based on 1,606 different radiomic features. Intriguingly, the subtypes identified in their analysis correlated with response to chemotherapeutic regimens and overall survival [18]. An imaging approach taken by Seo Young Kang et al. demonstrates the potential power of fluorodeoxyglucose (FDG) PET/CT scans in determining the response of people with metastatic differentiated thyroid cancer to radioactive iodine treatment [19].

Since cancer growth and development accrues progressive accumulation of somatic aberrations, early detection holds the promise of more effective interventions. Similarly, screening of at risk demographics has been found effective in preventing or better managing cancer care, as exemplified by the significant reduction in cases of cervical cancer after the introduction of the Pap smear as well as human papillomavirus (HPV) testing.

Biomarker development is also critically important for the early detection of cancer and metastatic disease; moreover, biomarkers are being identified that can provide insight into patient prognosis. Several papers in this Collection report interesting findings in the area of biomarker development. A report from Lingyun Xu et al. describes a magneto-nanosensor-based multiplex assay that measures circulating levels of PSA and four proteins associated with prostate cancer. This approach segregates people with prostate cancer from those with benign prostate hyperplasia with high sensitivity and specificity [20].

Two articles provide new insight into markers of disease progression and survival. Vidya Balagopal et al. report the development of a 22-gene hybrid-capture next generation sequencing panel to identify measurable residual disease in patients with acute myeloid leukemia (AML). In their retrospective study, the panel was effective at detecting evidence for residual disease. Importantly, it correctly identified patients who had never relapsed in that no evidence of residual disease was detected in any of these respective samples. Once validated, this approach could potentially be useful in monitoring patients with AML to ensure that recurrence or relapse is identified as soon as possible [21]. Separately, Yoon-Sim Yap et al. use a label-free microfluidic platform to capture circulating tumor cells (CTCs) from people with breast cancer and show that absolute numbers of CTCs predict progression-free survival with higher levels of CTCs correlating with a worse prognosis [22].

Finally, Lucia Suzuki et al. report findings into a potential role for the intestinal stem cell marker olfactomedin 4 (OLFM4) as a biomarker for metastasis in esophageal adenocarcinoma. The authors found that OLFM4 expression was not significantly associated with disease-free or overall survival; however, low OLFM4 expression was detected in poorly differentiated early and advanced-stage esophageal adenocarcinoma and was an independent prognostic variable for lymph node metastasis [23].

This collection of studies encompassing the range of research topics under the banner of targeted anticancer therapies highlights the diversity, complexity and inter-disciplinary nature of research efforts actively contributing to our collective knowledge base with the hope to positively impact the lives of all cancer patients.

We would like to thank all Academic Editors and reviewers for their expert evaluation of the articles in this Collection as well as the authors for their contributions to this field. Special thanks to Senior Editor, Team Manager Emily Chenette for her invaluable help and guidance in publishing this Collection.

Andrew Cherniack

Andrew Cherniack is a group leader in the Cancer Program at the Broad Institute of MIT and Harvard and in the Department of Medical Oncology at the Dana Farber Cancer Institute. He led the Broad Institutes effort to analyze somatic DNA copy number alterations for The Cancer Genome Atlas (TCGA) and is now co-principal investigator of the Broad Institutes copy number Genome Data Analysis Center for the National Cancer Institutes Genomic Data Analysis Network (GDAN). He also leads the oncoming effort to identify new cancer therapeutic targets for the partnership with Bayer. Prior to joining the Broad Institute in 2010, Dr. Cherniack worked in both academia and industry, with a 9-year tenure at the Abbott Bioresearch Center following a similar time period in the Program in Molecular Medicine at UMass Medical School, where he was a postdoctoral researcher and a research assistant professor. Dr. Cherniack holds a Ph.D. in molecular genetics from Ohio State University and a B.A. in biology from the University of Pennsylvania.

Anette Duensing

Anette Duensing is an Assistant Professor of Pathology at the University of Pittsburgh School of Medicine and a Member of the Cancer Therapeutics Program at the University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center. Dr. Duensings research focuses on bone and soft tissue sarcomas with the goal of identifying novel therapeutic approaches that target the underlying molecular biology of these malignancies. Her special interest and expertise are in gastrointestinal stromal tumors (GISTs), a sarcoma characterized by mutations in the KIT or PDGFRA receptor tyrosine kinases and the first solid tumor entity that was successfully treated with small molecule kinase inhibitors. Dr. Duensing holds an M.D. degree from the University of Hannover School of Medicine, Germany, and was a research scholar of the Dr. Mildred Scheel Stiftung fr Krebsforschung (German Cancer Aid/Deutsche Krebshilfe) at Brigham and Womens Hospital, Harvard Medical School. She is the recipient of an AACR Scholar-in-Training Award (AACR-AstraZeneca), a Young Investigator Award from The Liddy Shriver Sarcoma Initiative, a UPCI Junior Scholar Award, a Jeroen Pit Science Award, a Research Award from the GIST Group Switzerland and was named Hillman Fellow for Innovative Cancer Research. Dr. Duensing is co-founder and leader of the Pittsburgh Sarcoma Research Collaborative (PSaRC), a highly translational, interdisciplinary sarcoma research program. She is also affiliated with the Department of Urology at the University of Heidelberg, Germany. Dr. Duensing is an Academic Editor for PLOS ONE and author of nearly 70 original articles, reviews and book chapters.

Steven G. Gray

Steven Gray graduated from Trinity College Dublin in 1992. He joined the laboratory of Tomas J. Ekstrm at the Karolinska Institute (Sweden) in 1996 and received his PhD in 2000. He moved to the Van Andel Research Institute in Michigan, USA where he continued his studies on the therapeutic potential of histone deacetylase inhibitors in the treatment of cancer. He also spent time as a visiting fellow at Harvard Medical School, Boston working on epigenetic therapies for neurodegenerative disease. Returning to Europe, Dr. Gray spent some time at the German Cancer Research Centre (DKFZ Heidelberg), and subsequently moved to Copenhagen to work for Novo Nordisk as part of the research team of Prof Pierre De Meyts at the Hagedorn Research Institute working on epigenetic mechanisms underpinning diabetes pathogenesis. Dr. Gray is currently a senior clinical scientist at St Jamess Hospital at the Thoracic Oncology Research Group at St. Jamess Hospital. He holds adjunct positions at both Trinity College Dublin (senior clinical lecturer with the Dept. of Clinical Medicine), and at Technical University Dublin (adjunct senior lecturer, School of Biology DIT). Dr. Gray has published over 100 peer-reviewed articles, 15 book chapters and has edited 1 book. Research in Dr Grays laboratory focuses on Receptor Tyrosine Kinases as potential therapeutic targets for the treatment of mesothelioma; epigenetic mechanisms underpinning drug resistance in lung cancer; targeting epigenetic readers, writers and erasers for the treatment of mesothelioma and thoracic malignancy; circulating tumour cells; and non-coding RNA repertoires in mesothelioma and thoracic malignancy.

Sunil Krishnan

Sunil Krishnan is the Director of the Center for Radiation Oncology Research and the John E. and Dorothy J. Harris Professor of Gastrointestinal Cancer in the department of Radiation Oncology at MD Anderson Cancer Center. He received his medical degree from Christian Medical College, Vellore, India and completed a radiation oncology residency at Mayo Clinic, Rochester, Minnesota. In the clinic, he treats patients with hepatobiliary, pancreatic and rectal tumors with radiation therapy. His laboratory has developed new strategies and tools to define the roles and mechanisms of radiation sensitization with gold nanoparticles, chemotherapeutics, biologics and botanicals. Dr. Krishnan serves as the co-chair of the gastrointestinal scientific program committee of ASTRO, co-chair of the gastrointestinal translational research program of RTOG, consultant to the IAEA for rectal and liver cancers, chair of the NCI pancreatic cancer radiotherapy working group, and Fellow of the American College of Physicians. He has co-authored over 200 peer-reviewed scientific publications, co-authored 17 book chapters, and co-edited 3 books.

Chandan Kumar-Sinha

Chandan Kumar-Sinha is a Research Associate Scientist in the Department of Pathology at the University of Michigan. He obtained Masters in Biotechnology from Madurai Kamraj University, and PhD in Plant Molecular Biology from Indian Institute of Science. He completed a Postdoctoral Fellowship at the Department of Pathology, University of Michigan, where he worked on genomic profiling of cancers. Thereafter, he joined the Advanced Center for Treatment, Research and Education in Cancer in India as a faculty member. After establishing a cancer genomics group there, he moved back to the University of Michigan to pursue translational cancer research. Dr. Kumar-Sinhas current research involves integrative clinical sequencing using high-throughput genome and transcriptome analyses to inform precision oncology. He has authored over 50 peer-reviewed publications, two book chapters, and is named co-inventor on a patent on prostate cancer biomarkers.

Gayle E. Woloschak

Gayle Woloschak is Professor of Radiation Oncology, Radiology, and Cell and Molecular Biology in the Feinberg School of Medicine, Northwestern University. Dr. Woloschak received her Ph.D. in Medical Sciences from the University of Toledo (Medical College of Ohio). She did her postdoctoral training at the Mayo Clinic, and then moved to Argonne National Laboratory until 2001. Her scientific interests are predominantly in the areas of molecular biology, radiation biology, and nanotechnology studies, and she has authored over 200 papers. She is a member of the National Council on Radiation Protection, the International Commission on Radiation Protection and numerous other committees and also serves on the US delegation to the United National Scientific Committee on the Effects of Atomic Radiation.

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Introducing the Targeted Anticancer Therapies and Precision Medicine in Cancer Collection - PLoS Blogs

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Growth of Autologous Stem Cell And Non Stem Cell Based Therapies Market projected to amplify during 2026 – Crypto News Byte

Autologous stem cell and non-stem cell based therapiesinvolve an individuals cell to be cultured and then re-introduced to the donors body. These therapies do not use foreign organism cells and are therefore free from HLA incompatibility, disease transmission, and immune reactions.Increasing demand for the new therapies in the field of regenerative medicine is directly facilitating the growth of autologous stem cell and non-stem cell based therapies market. Furthermore, since the risk to transplantation surgeries is significantly reduced in these therapies, they are increasingly being preferred for treatment of bone marrow diseases, aplastic anemia, multiple myeloma, non-Hodgkins lymphoma, Hodgkins lymphoma, Parkinsons disease, thalassemia, and diabetes.

Moreover, rising incidents of cancer, diabetes and cardiovascular diseases along with growing geriatric population is another factor attributed for its high growth. However, side-effects of autologous stem cell and non-stem cell based therapies such as nausea, infection, hair loss, vomiting, diarrhea, etc. are expected to affect the market to an extent. High cost is another factor that can act as challenge to autologous stem cell and non-stem cell based therapies market. In spite of this, less risk post transplantation surgeries and favorable tax reimbursement policies are anticipated to reduce the impact of these limitation during the forecast period.Autologous stem cell and non-stem cell based therapies market can be segmented on the basis of application, end-user, and region.

In terms of application, the autologous stem cell and non-stem cell based therapies market can be segmented into blood pressure (BP) monitoring devices, intracranial pressure (ICP) monitoring devices, and pulmonary pressure monitoring devices.

In terms of end-user, the market can be segmented into ambulatory surgical center and hospitals. By region, the market can be segmented into North America, Europe, Asia Pacific, Middle East and Africa and South America. Amongst all, Asia Pacific is anticipated to be the most attractive market owing to favorable reimbursement policies in the region.The players operating in autologous stem cell and non-stem cell based therapies market are limited. They are consistently involved in research and development activities for product development to keep up with the growing competition, thereby aiding the growth of autologous stem cell and non-stem cell based therapies market across the world.

The major players operating in autologous stem cell and non-stem cell based therapies market are Regennex, Antria(Cro), Bioheart, Orgenesis Inc., Virxys corporation , Dendreon Corporation, Tigenix, Georgia Health Sciences University, Neostem Inc, Genesis Biopharma, Brainstorm Cell Therapeutics, Tengion Inc., Fibrocell Science Inc., Opexa Therapeutics Inc, Regeneus Ltd, and Cytori Inc., among others.

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Growth of Autologous Stem Cell And Non Stem Cell Based Therapies Market projected to amplify during 2026 - Crypto News Byte

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Navy Beginning Tech Study to Extend Trident Nuclear Missile Into the 2080s – USNI News

An unarmed Trident II D5 missile launches from the Ohio-class ballistic missile submarine USS Rhode Island (SSBN-740) off the coast of Cape Canaveral, Fla. on May 9, 2019. US Navy Photo

ARLINGTON, Va. The Navys Strategic Systems Program this fiscal year will begin looking at what new technologies it will need to develop to sustain and modernize its nuclear weapons so they can operate on the Columbia-class ballistic missile submarines through the 2080s.

After the Trident D5 missiles underwent an original life extension effort (D5 LE), the office determined they would undergo a D5 LE2 effort that would insert new technologies where possible, find new ways to replace old parts that can no longer be manufactured, and otherwise keep the missiles reliable as a strategic deterrent for more than six more decades.

We are starting this year for the first time in our budget we have a line in [Fiscal Year 2020], and the real crux to that is looking at all of those new technologies that we need to go think about on how were going to take what we have today, how were going to modernize it and how were going to get it to last the entire life of the Columbia, which is we all know about 2084, SSP Director Vice Adm. Johnny Wolfe said last week at the Naval Submarine Leagues annual symposium.

Wolfe said the original life extension effort has gone well, with five flight tests in the last year showing the missiles can still fly the tracks theyre supposed to. In fact, three motors involved in a test that were about three decades old performed like new during the test, he said.

However, this first life extension effort wont get the missiles through the end of the Columbia SSBNs life.

For example, Wolfe said, the Navy decided about six years ago to end production on the post-boost control system, and unique materials are used in that system. With industry knowledge now lost, the Navy needs to develop a new post boost control system with new materials, based on what industry can provide today.

The way we did it then were not going to be able to exactly do it in the future, he said, and SSP needs to build in a learning ramp for industry as they reconstitute this capability.

With this second life extension effort, the plan is, if you look at some of the critical technologies weve got today, and Ill just talk about rocket motors: I would tell you, were the only people right now that use a 1.1 propellant and we have to do that because of volume constraints that weve got. Theres no need to change that, and as we talk about how were going to do this, we are going to continue on producing those rocket motors because, quite frankly, if you look from a reliability perspective, that is the biggest contributor and I would tell you theres nothing better than what weve got in the submarine force today with those motors. So were not going to change that. Were going to continue with that, the vice admiral said.What we are going to start to do is start to look at what are those technologies and I talked about post-boost control, things like nose bearings things we know we wont be able to produce anymore.

The government is currently operating under a continuing resolution that does not allow new programs to start. The current CR expires next week and it remains to be seen what funding mechanism Congress will be able to pass, and therefore how it will affect SSPs ability to get started on this early work on the Trident D5 LE2.

Additionally, Wolfe said SSP has been involved in modernizing the legacy Ohio-class SSBNs and using those modernization and upgrade efforts as risk-reduction measures for the Columbia class.

For example, the Ohio class used an Electrostatically-Supported Gyro Navigator (ESGN) as the inertial navigator for the Trident D5 missile. Wolfe said that, in his modernization portfolio, the biggest program right now is making sure we get the next strategic navigator on the Ohio, which is a risk-mitigator for Columbia because, as we make this change from ESGNs to fiber optics, theres a lot of learning weve got there.

He added that several modernization efforts on shipboard systems such as the fire control system are taking place, and that their installation on the Ohio SSBNs will ease the fleets transition to Columbia as sailors on the new subs will already know how to operate and maintain these systems.

Its not just modernizing the triad; its making sure that we can sustain what we have today until we get to all those modernization programs, he said of the importance of these Ohio upgrade efforts.

Related

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Navy Beginning Tech Study to Extend Trident Nuclear Missile Into the 2080s - USNI News

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Soup-To-Nuts Podcast: What might the 2020 dietary guidelines for the first 1,000 days include? – FoodNavigator-USA.com

Until now, the Dietary Guidelines for Americans has provided dietary advice for people 2 years and older, prompting caregivers and healthcare practitioners to turn to a disparate set of resources to figure out the best diet for pregnant women, infants and young children. These include famous books, such as What to Expect When Youre Expecting, and guidelines from various organizations, such as the American Heart Association and the American Academy of Pediatrics.

And while these are influential and well-researched recommendations, by bringing this group under the purview of the broader Dietary Guidelines for Americans, the US government will for the first time take ownership of them a move that will provide a consistency that so far has been lacking.

The move also is a double-edged sword for the CPG industry. Some hope that including this group in the broader Dietary Guidelines for Americans will protect them undue corporate influence, while others see potential opportunities for innovative manufacturers creating solutions to help Americans meet the recommendations.

While we wont know for sure what the guidelines will include until the recommendations are released and vetted, this episode of FoodNavigator-USAs Soup-To-Nuts podcast explores some of the themes, suggestions and questions that dietitians and industry players would like to see addressed and how these issues might impact CPG manufacturers.

[Editors Note: Never miss another episode of FoodNavigator-USAs Soup-To-Nuts Podcast subscribe to us on iTunes.]

Even though the Dietary Guidelines for Americans are designed with health care professionals in mind and, therefore, are not very consumer-friendly, Amy Kimerlain, a registered dietitian who specializes in childrens nutrition and a spokeswoman for the Academy of Nutrition and Dietetics, explained at the Food & Nutrition Conference & Expo in Philadelphia last month that the inclusion of recommendations for the first 1,000 days of life is a critical first step to improving the lives of women and children in the US.

The dietary guidelines allow for general recommendations for healthy Americans across the population, and so now with the introduction of looking at the first 1,000 days, were obviously going to pay closer attention to now not only infants and toddlers, but also prenatally as well, Kimerlain said. She added, these guidelines ultimately will allow for people to look and reflect to see what changes they may need to make in order to improve their health over the long run.

With that in mind, Kimerlain said she hopes the recommendations look not only at the nutrients that are critical to a childs development, but also on what and how much pregnant women need to consume to keep themselves healthy. This includes advice around how many extra calories do women actually need when eating for two, guidance on how much weight they should expect to gain and remain healthy and how diet can help manage potential complications.

Drilling deeper into what the guidelines might include for expecting women, Kristi King who is also a spokeswoman for the Academy of Nutrition and Dietetics and the senior pediatric dietitian at Texas Childrens Hospital in Houston, says she hopes the guidelines will include specific recommendations about choline intake.

She explained that choline is a underrated nutrient, that were just now starting to figure out that within that first 1,000 days is so incredibly important for infants and brain development.

She added that this could be an opportunity for supplement manufacturers as well as select food marketers.

An early mover on this from the supplement side is Life Extension, which is a Fort Lauderdale, Fla., based company that launched at FNCE its Prenatal Advantage multivitamin. Like most other prenatal supplements, Life Extensions Prenatal Advantage includes folic acid and DHA, which have long been recognized as essential for developing infants. But it also is one of the few prenatal supplements that includes choline.

On the food side, one of the best sources of choline are eggs, one of which provides 25% of the recommended daily value.

Mickey Rubin, the executive director of the American Egg Boards Egg Nutrition Center explained the importance of the eggs in providing choline as well as more generally supporting maternal and infant health.

Despite the importance of choline to developing infants, he noted only about 25% of expecting mothers are familiar with it, compared to 90% who know about folic acid. In addition, little more than half of health professionals currently are aware of choline.

Beyond choline, Rubin says the high amount of lutein in eggs also can help support developing infants cognitive development by increasing their macular pigment which has been linked to cognition.

Fiber is another necessary nutrient for expecting mothers, infants and young children that King says she wants the upcoming dietary guidelines to highlight. Not only does she say she wants to see stronger recommendations around how much should be consumed, but also guidance clarifying how best to get it including, of course, fresh fruits and vegetables, but also canned and frozen produce as well.

Related to fiber and gut health, King says she would also like to see in the recommendations advice around probiotics, including if they are appropriate for children and expecting women and if so which ones and how much.

Scientifically-based guidance in the dietary guideline recommendations around breastfeeding versus the use of formula also likely will have a significant impact on the CPG industry, predicts King.

Like many dietitians, King advocates that breastfeeding is best, but also acknowledges it is not always an option. In those cases, she says, she would like to see the dietary guidelines recommend the use of FDA approved formula, which is held to a higher safety and nutrition standard than many others from around of the world.

In addition to addressing infant formula, King predicts, the recommendations will tackle toddler milks, for which there is not the same nutritional standard as infant formula but about which much confusion and controversy swirl.

Beverages more broadly also will likely be a hot button topic in the recommendations, with experts predicting the dietary guidelines will call for significantly reduced consumption of sugary drinks, potentially including juice. It likely also will expand or include recent guidelines to restrict drinks for children under five to breast milk, water and dairy milk with only occasional consumption of 100% fruit juice if whole fruit is not an option.

These likely are only a small sample of the issues that will be addressed in the guidance. While the upcoming guidance likely wont make everyone happy or be perfect, as Kimerlain notes, it is a first step.

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Soup-To-Nuts Podcast: What might the 2020 dietary guidelines for the first 1,000 days include? - FoodNavigator-USA.com

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Boeing Focused on Maxs Safe Return to Service – Aviation International News

While emphasizing safety, innovation, and partnerships at the Dubai Airshow, Boeings senior leaders said the company is focused on returningthe 737 Max to service and supporting customers and supplier partners affected by the airplanes grounding, while they also expressed empathy for those most affected by the two fatal crashes of the aircraft.

Our thoughts remain with families and victims, and we continue to support them economically and emotionally, said Stan Deal, president and CEO, Boeing Commerical Airplanes, at a briefing yesterday. All employees at Boeing have them in their thoughts, and we will use these tragedies to refocus on safety, quality, and integrity.

Leanne Caret, president and CEO of Boeing Defense, Space & Security, and Ted Colbert, president and CEO of Boeing Global Services, voiced similar sentiments.

Turning to other programs, Deal said the in-development 777X will fly in early 2020, and we plan to deliver the airplane in the early 2021 timeframe, slightly later than originally hoped. Meanwhile, the company has a backlog of more than 5,500 commercial aircraft, and with global demand forecast for more than 44,000 airliners over the next 20 years at an estimated value of $16 trillion, the fundamentals remain in place for strong growth, Deal said.

Caret notedBoeing projects $2.5 trillion in defense and space market opportunities over the next decade and is continuing to see demand from the U.S. and partners around the world, with a significant portion coming from the Middle East. Caret cited the KC-46 Pegasus aerial refueling tanker, the new T-7 jet trainer, and the CH-47F Chinook and AH-64 Apache military helicopters as ideally suited to Middle East customers.

Boeing is also the prime contractor for the International Space Station, and Caret congratulated the UAE Space Agency and astronaut Hazzaa Al Mansoorion his recent mission to the space station.

With less than 20 percent of the worlds military aircraft fleet slated for replacement over the next decade, Boeing also sees substantial demand for upgrades, maintenance, and service life extension programs, creating large opportunities for its Global Services division.

"The strength of Boeing is our unrivaled ability to deliver lifecycle value for our customers," Colbert said.

Boeing estimates global demand for $225 billion in commercial and government services over the next decade, with the Middle East ranking fourth in global aftermarket growth behind the U.S., Europe, and Asia-Pacific.

Colbert said that Boeing maintains two parts hubs in Dubai that stock some 1.7 million parts to support customers. With big data analytics expected to play a growing role in predictive maintenance and other aftermarket services, Boeing has been operating a digital analytics hub in the UAE since 2007, although its been used primarily for flight planning services through its Jeppesen division.

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Boeing Focused on Maxs Safe Return to Service - Aviation International News

Recommendation and review posted by Bethany Smith


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