For Fast Companys Shape of Tomorrow series, were asking business leaders to share their inside perspective on how the COVID-19 era is transforming their industries. Heres whats been lostand what could be gainedin the new world order.

James Merlino,chief clinical transformation officer of the Cleveland Clinic

The old saying in crisis is never let the opportunity go to waste. Weve learned a couple things. One is that this has reemphasized the importance of safety. Were doing thermal screening for healthcare providers. Were testing any patient whos coming in for any surgery or ambulatory care. If theyre COVID-positive, well delay their procedure unless its an emergency.

The second thing is were seeing technology innovations, such as virtual rounding done on an iPad and virtual [visits]. Before COVID hit, we were doing 3,000 virtual visits a month. In March, we did 60,000. Then there are small things, such as putting IV pumps and ventilators outside the door in our COVID ICU.

We have to learn how to live with COVID. Some hospitals may suffer. But I want to believe that this is going to make us deliver care more efficiently. Weve been talking about social determinants and chronic health for a long time, but this is our opportunity to step in. COVID-19 preys on the elderly, on the socially disadvantaged. Going forward, we have to manage COVID-19 with more consistent care.

Nancy Lublin, CEO of Crisis Text Line, a nonprofit organization that provides free mental health texting services

If you were feeling things before, if you were struggling before, if you had an addiction or an eating disorder or anxiety or depression or a bad relationship, those things just became a lot harder. And even if you were perfect before, you are not perfect now.

53% of our texters before COVID were under the age of 17, and now the biggest age group were seeing is 18 to 34. Their lives have just been turned upside down. They were adulting, and now theyre home with their parents. Or theyre quarantined with roommates whom they didnt really know that well, or sheltering alone, and thats really hard. Or they have little children. Dating has been disrupted for the 18-to-34 age groupfor everybody.

When COVID first hit America, we saw a massive influx in anxiety. They were using words like freaked out, panic, and it was mostly about symptoms. That shifted into what we consider the second wave of feeling: the impact of the quarantines. Weve seen a 78% increase in domestic violence, a 44% increase in sexual abuse. Weve seen a huge increase in financial stress, people worried about homelessness, or thinking about financial ruin.

Mental health and well-being should be part of our education. One of the most important things is how to communicate with people, how to disagree with people, how to have productive relationships. And yet we dont learn any of this. Instead we learn calculuswhich I still havent used.

Christos Christou, international president of Doctors Without Borders

Because of COVID, it is now extremely challenging to move our resources and our people to those places that need them. Were not allowed to fly from Canada or Europe to Yemen, Tanzania, etc. And we are not allowed to export any material, because of nationalism, a very selfish approach by states, which are fighting against each other for supplies. They want to show that they can protect [their citizens]. They will ban any exportation of PPE and, in the event we get a new vaccine, they will make sure that they can stockpile it.

There are multiple crises within the COVID crisis. TB patients are not allowed to access any hospitals at the moment, and they need treatments every day. HIV patients, the same. We have war traumas. Some of the facilities have been repurposed, so its not easy for us to run surgeries. Malaria kills millions of people. We have the treatments, but [theyve] been affected a little bit because of all these debates about the chloroquine. We [also] have a rapid test for malaria. [But] the company that is producing this test has decided now that theres much more profit by repurposing it into a rapid test for COVID.

We have to rethink health systems. Its obvious that only public health systems and national health systems are going to provide the solution.

Im afraid for those places we cannot access. In Northwest Syria, [after] Idlib was bombed [in February], people were in desperate need of food, accommodation, and health services. All of a sudden, with COVID, everyone forgot about this situation. But this doesnt mean that their problems evaporated. Yemen is another place. In the past few days we have confirmed that theres a local transmission of COVID, and theres zero capacity. Im not talking about ventilators or ICU beds. They dont even have the test, the diagnostic. This is one of my nightmares.

[Source images: Videvo; _Aine_/iStock]The other one is related to those places where people live in high-density settlements. Im talking about communities like Coxs Bazar in Bangladesh, the Greek Islands, the favelas in Brazil, the [refugee] camps in Kenya. Anything related to good hygiene or stay-at-home policies in these place is just a luxury. [Its] not an option.

We have to rethink health systems. Its obvious that only public health systems and national health systems are going to provide the solution. If we leave it to the free market, their rules are different: Their driver is profit making. They have every right to do so, but you cannot ask for vaccines or therapeutics and diagnostics from those people. In this [pandemic], we should not allow anyone to profit from the solution.

Dr. Gianrico Farrugia,CEO of Mayo Clinic

COVID has enabled us to create virtual health as a new normal. Not only in terms of remote monitoring and acute medical care, but also for advanced care at home. For example, electrocardiograms can be done on a smartwatch to diagnose heart failure or to measure potassium.

As a nation, we have been promising and not delivering on telehealth now for several years, and that has had to do with licensure, regulation, billing, but also just healthcares reluctance to change. With those barriers removed, weve been able to move from maybe 400 to 35,000 virtual visits a week.

Some of the regulations that have been relaxed need to become permanentand in a way that can be enforced so patient safety does not suffer. We [shouldnt] go back to where we were, because we would have lost a huge opportunitythis tiny silver lining in the pandemic, which is the digital revolution of healthcare.

Yonatan Adiri,CEO of Healthy.io, a company that uses cellphone cameras to create clinical grade at-home tests for urinary tract infections and kidney disease

I dont buy that this has been the watershed moment for healthcare. The forces of status quo are very strong. Physicians can now practice across state lines; Medicare will reimburse remote patients sessions at the same price as in-person. People thought these things would take a decade to happen. We now have to work to keep this the new normal. All it takes is one company making false claims that creates a safety or efficacy issue and the whole thing will be rolled back.

If this had happened 10 years ago, it would have been a million-and-counting dead, and not 300,000 dead.

If this had happened 10 years agowithout computation, without DNA sequencing, without cloud, without bandwidth, without high-resolution selfie camerasit would have been a million-and-counting dead, and not 300,000 dead.

Andrew Diamond,chief medical officer at primary care company One Medical, which offers outdoor testing sites for COVID-19

We need a strategy to test enormous numbers of people, almost on a surveillance-like basis. And if you cant do that, then you need an alternative, like really robust contact tracing. I could see by the fall or maybe mid-winter that we could have technology where you couldat the door of your office building or apartment building or mass transit station or airport airline terminalspit into a disposable cup at a machine that gives you a readout in a matter of minutes.We also need to double down on taking care of hypertension, diabetes, and obesity. Some of the people who are most vulnerable to the worst effects of the infection are people with those conditions. Thats our bread and butter in primary care, but thats also how were actually going to contain the damage from COVID-19, as it lives with us for months and years to come.

Peter Diamandis,founder of the XPrize Foundation and several companies in the health space, including Cellularity, Human Longevity, and Covaxx

People feel abandoned by the healthcare system. They feel its dangerous to go to hospitals because theyre overloaded. There is a significant opportunity for new startups and for Apple, Google, and Amazon to step in and deliver much more efficient turnkey data-driven services.

The government should be pouring capital into research, but its going to be entrepreneurial companies that are in your home already that are delivering and collecting the data [that will] make you the CEO of your own health. How do you partner with AI to really understand whats going on and what your options are? I dont think health systems can innovate sufficiently [on their own].

Richard Park,cofounder of CityMD and CEO of Rendr Care

Whats going on now is this huge, bubbling, socioeconomic friction between the haves and the have-nots. COVID-19 is a real reflection of that, especially in New York. If you look at CityMD and its hot spots, its [where you find] the vulnerable populations.

I was born here in the States, but to immigrant parents, who migrated here in the late 60s. They were grateful to be second-class citizens here in the greatest country on the planet. That humility, that you are always in debt to the greater society . . . was an underlying theme at home.

Theres going to be more and more pressure to be efficient on healthcare, and so the baseline standards will get more and more meager.

[My family] would open stores and close stores and [have] terrible financial troubles. Not unlike so many other New Yorkers today, especially now with COVID. We had borrowed money from so many people to pay rent. It accentuated a tremendous amount of shame and guilt. I would, as a kid, walk around, knowing, That person lent us $5,000. That person lent us $10,000, over the years. I couldnt even look them in the eye. The beautiful part of it was, as a community, they lent us money and they knew they were never getting it back. And I finally actually paid back everybody. Some of that debt was more than 35 years old. People were never expecting it.

[Source images: Videvo; _Aine_/iStock]At CityMD, the other founders are immigrants, and they understood this. We made a decision early on not to separate Medicaid [patients] from [those with] commercial [insurance plans]. People said, You cant mix the two populations. The Wall Street banker will not sit next to the Medicaid person. Maybe that was true in the past, but we said, Were not going to do that. Now we know, it absolutely does work together.

Concierge medicine is wrong. I consider that wrong. Its not how I want to roll. I dont want to participate in that. [But] as the economy has difficulty, as Medicaid enrollment swells, revenue decreases at the state level. Its a bad mix: more enrollment, less revenue for it. This puts pressure on everybody. In the same way, employers have this impossible 5% year-over-year [increase in] healthcare costs. Its not sustainable. Theres going to be more and more pressure on healthcare to be efficient, and so the baseline standards will get more and more meager. Thats why the [concierge medical services] will arise. There are people who can afford it.

More from Fast Companys Shape of Tomorrow series:

Excerpt from:

Here's how COVID-19 is reshaping medicine, according to experts - Fast Company

Pandemic or not, Leigh Reynolds will be at the hospital doing what she loves keeping others safe in her own hometown. Shes the acute care services clinical manager at Sovah HealthMartinsville, which has treated patients who have fallen ill from the coronavirus.

We often think of medical care as a series of treatments and medications, but good care is about more than addressing physical conditions it is about connecting with patients in ways that help them embrace their recovery, she said. The best nurses know that forming a strong relationship with their patients is an integral part of succeeding as a nurse, and how we interact with our patients influences their recovery.

In January, most Americans hadnt even heard of the novel coronavirus. In February, 2019-nCoV seemed like a bit of a nuisance in the United States, but not much of a threat. In March, COVID-19 struck hard, causing national shutdowns of schools, nonessential businesses and even elective medical procedures.

When the virus hit Virginia on March 7, hospitals prepared to handle a surge of infected patients. Now, the daily case count appears to be on the mend and local hospitals never stretched beyond capacity. The case count in the Martinsville and Henry County area isnt as high as it is in other portions of the state. And the staff at Sovah HealthMartinsville say they are prepared to handle whatever may come.

Jackie Wilkerson, Chief Nursing Officer, confirmed that the hospital has treated patients who tested positive for COVID-19.

The hospital put extra precautions in place to lessen the spread of the virus and also treat it as effectively as possible.

Treating infectious diseases is not new to our hospital and the guidelines for protecting patients, staff and visitors are comprehensive and evidence based. Out of an abundance of caution, we are taking several additional precautions, Wilkerson said. For example, increased sanitation and hand washing, implementing a no-visitor policy, all patients and staff are being screened appropriately and temperature checks are taken upon entry, all persons entering the facility must wear a mask throughout the entire building and a designated COVID-19 unit to treat positive patients as well as suspected positives.

There are certain practices and precautions that are unique to treating COVID-19 patients.

Some extra precautions would be increased personal protective equipment [PPE] usage, such as a respirator and face shield, along with increased sanitation and using a separate room to put on and take off necessary personal protective equipment, said Ashley Williams, director of acute care services.

Taking an abundance of precaution to keep the infection rate as low as possible, the no-visitor policy can make a hospital stay rather lonely for patients. To boost patient morale, the role of nurses and others on the medical team had to become even more pronounced. In addition to completing their normal rounds, nurses at Sovah HealthMartinsville also serve as temporary family members to each hospital patient, especially those in isolation.

The care needed for a COVID-19 patient is more intense and involves more detail, Williams said, referring to how the disease attacks the respiratory system. The other challenge is isolation. Not being able to allow visitors is a tremendous physical and emotional challenge for the caregivers because we see the toll it takes on our patients. We, as caregivers, are stepping up and taking care of these patients as if they were our own family.

As essential workers, the hospital staff of doctors, nurses, nursing assistants, respiratory therapists, housekeepers, dietary staff and others are not staying at home during the pandemic.

Instead, they report to work so that they can care for others potentially infected with the virus.

Being able to keep our community members in their hometown and care for them close by gives me every reason to come to work because that is what I would want for myself or my own family, Reynolds said. Our patients become our family, and to see them recover is truly life changing.

When a patient does recover, whether its from COVID-19 or another ailment, theres nothing like the feeling medical professionals get from knowing that they helped when a patient does recover.

We cheer and pray for our patients just like we do our own family, Reynolds said. Seeing them recover and being able to go home healthy and happy is a feeling like no other. We do it for them, not for us.

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It takes more than medicine to fight the coronavirus - Martinsville Bulletin

The crisis of coronavirus disease 2019, also known as COVID-19, presents a set of unprecedented circumstances to the health care community. The disease has a particular impact on patients with cancer and their oncology care teams who are trying to maintain the right balance between the use of immunosuppressive treatment and risk of cancer progression. Wenhua Liang, PhD, and colleagues analyzed the risk for severe COVID-19 in patients with cancer.1 They reported that patients with cancer might have a higher risk of COVID-19 than individuals without cancer. They emphasized that patients with malignancy had poorer outcomes from COVID-19, providing a timely reminder to physicians that more intensive attention should be paid to patients with cancer to prioritize treatment versus risk of death and adverse outcomes. Patients who underwent chemotherapy or surgery in the past month had a numerically higher risk (3 of 4 patients [75%]) of clinically severe events than did those not undergoing chemotherapy or surgery, observed by logistic regression (odds ratio, 5.34; 95% CI, 1.80-16.18; P = .0026) after adjusting for other risk factors, including age, smoking history, and other comorbidities.

The authors of this study have proposed 3 major strategies for treating patients with cancer in the COVID-19 crisis. The first approach is an intentional postponing of adjuvant chemotherapy or elective surgery for stable cancer in endemic areas. Second, stronger personal protection provisions should be made for patients with cancer or cancer survivors. Third, more intensive surveillance or treatment should be considered when patients with cancer are infected with COVID-19, especially in older individuals or those with other comorbidities.

Oncologists and institutions caring for these patients face the continued challenges of administering treatment while simultaneously reducing the risk of complications in the event they end up contracting COVID-19. Stopping chemotherapy may be an option for patients in complete remission on maintenance therapy. In those patients, we may be able to switch chemotherapy from intravenous to oral therapies. This change would decrease the frequency of clinic visits. A chemotherapy break may be an option when feasible. Delays or modifying adjuvant treatment may be balanced with the risk of recurrence. The prophylactic growth factors and antibiotics in high-risk chemotherapy regimens is of paramount importance. When the absolute benefit of adjuvant chemotherapy may be quite small, and if non-immunosuppressive options are available (eg, hormonal therapy in estrogen receptorpositive early-stage breast cancer), risk of COVID-19 infection may be considered as an additional factor in weighing the patients available treatment options.

Providers caring for patients with cancer undergoing cytotoxic chemotherapy need to consider changing their treatment plan when feasible to reduce the risk of life-threatening complications as well as reducing the frequency of their clinic visits. Targeted therapies are approved for a number of aggressive cancers from nonsmall cell lung cancer, stage IV melanoma, to acute myeloid and lymphoid leukemia. These therapeutic options offer an opportunity to consider treatment of patients with the likelihood of a better response while at the same time increasing dose density and intensity without raising the toxicity profile.

Precision medicineguided targeted therapies as well as immunotherapy may have a special role in identifying patients who may need cancer treatment. Most targeted agents are orally administered. The toxicity and adverse event profiles of many orally administered targeted therapies is significantly different from chemotherapy. A much higher complication rate from cytotoxic chemotherapy places patients with cancer at a much higher risk of complications from COVID-19 infection. Rigorous biomarker testing and appropriate therapeutic choice should be considered in this patient population, especially in the face of a global pandemic.

Assessing Cancer by Treatment Priority Determination: Top, Intermediate, and Low Priority

Instead of an arbitrary approach, a system to determine the priority for consultation and treatment of patients with cancer may provide a consistent approach for all patients and providers (TABLE).2 It is also important to avoid, as much as possible, having different levels of care. We recommend following an assessment for patients with cancer and treatment priority determination that would assist cancer clinics and decision makers in the management of these patients. Given the dynamic situation, it is likely that this will vary from day to day, and daily accommodation reassessment may be required. The patient priority assessment and classification would allow flexibility determined by the local circumstances and available resources. The local or regional circumstances and the availability of resources may influence a cancer clinics ability to follow the criteria.

This virus was previously referred to as novel betacoronavirus severe acute respiratory syndrome virus coronavirus 2 (SARS-CoV-2).3 What started in early December 2019 with 3 patients diagnosed with unexplained pneumonia in the Wuhan province of China has led to a global pandemic. At the time this article was written, more than 3 million cases have been reported and 207,973 deaths across Europe, the Americas, Western Pacific, Eastern Mediterranean, Southeast Asia, and Africa are attributed to the disease.4 The United States alone has 1,005,147 cases and 57,505 deaths.5

In March 2020, the World Health Organization declared COVID-19, caused by SARS-CoV-2, a public health emergency of international magnitude and a global pandemic.6 According to the World Health Organization, the definition of pandemic is a worldwide spread of a new disease for which most people do not have immunity.

A sudden surge in the cases of COVID-19 due to the pandemic, along with efforts to contain it, has led to multiple challenges that no country has experienced in the last several decades. The global pandemic from COVID-19 poses a unique set of challenges not only for patients with cancer who need their treatment, but also for caregivers, oncologists, and the overall care team. It is recognized that there is a need to treat patients with cancer during a pandemic, due to their immunocompromised state from the nature of their disease or type of treatment they are receiving. Further, it is of paramount importance that the oncology care team develop and evolve a systemic approach that prioritizes patients, disease, and types of treatment. So far, the efforts of organizations and individual oncologists are being rapidly outpaced by the increasing number of patients with COVID-19. It is likely that this will be a dynamic situation that will vary each day.

Deaths from COVID-19 have been caused by multiple organ dysfunction. This observation might be attributable to the widespread distribution of angiotensin-converting enzyme 2the functional receptor for SARS-CoV-2in multiple organs.7,8 Patients with cancer are more susceptible to infection than individuals without cancer because of their malignancy and anticancer treatments, such as chemotherapy.9 These patients might be at increased risk of COVID-19 and have a poorer prognosis.

Rapid growth in the number of patients with COVID-19 symptoms has led to capacity pressures to the health care system on a local, regional, and national level. Cancer clinics and hospital inpatient and outpatient areas have started experiencing capacity challenges. Patients with cancer are faced with difficult decisions and anxieties related to the risks of treatment versus exposure and increased risk of contracting COVID-19. It is expected that the COVID-19 global pandemic will hit in 1 or more waves. At the peak of the COVID-19 wave, a significant portion of hospital or clinic staff will be ill or unavailable to work (eg, due to school closures, family obligations, fear, disease, illness, etc.

COVID-19 has left an indelible mark on the history of the world. Although the death toll world wide approaches 140,000, it is only through humanitys collective ingenuity and compassion to care for one another will we weather this pandemic. We are making daily progress and we applaud all health care workers who find themselves on the frontlines against this disease.

References:

1. Liang W, Guan W, Chen R, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21(3):335-337. doi:10.1016/S1470-2045(20)30096-6

2. Dietz JR, Moran MS, Isakoff SJ, et al. Recommendations for prioritization, treatment, and triage of breast cancer patients during the COVID-19 pandemic. the COVID-19 pandemic breast cancer consortium [published online ahead of print, 2020 Apr 24]. Breast Cancer Res Treat. 2020;1-11. doi:10.1007/s10549-020-05644-z

3. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-513. doi:10.1016/S01406736(20)30211-7.

4. Coronavirus disease (COVID-19) pandemic. Coronavirus disease (COVID-19) outbreak situation. World Health Organization website. Updated March 31, 2020. Accessed March 31, 2020. bit.ly/2QZvZlg.

5. Coronavirus Disease 2019 (COVID-19). Cases in U.S. Centers for Disease Control and Prevention website. Updated March 31, 2020. Accessed March 31, 2020. https://bit.ly/2vKBtc6.

6. WHO Director-Generals opening remarks at the media briefing on COVID-19 - 11 March 2020. World Health Organization website. Published March 11, 2020. Accessed March 31, 2020. https://bit.ly/3al0yJE.

7. Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-273. doi: 10.1038/s41586-020-2012-7

8. Hamming I, Timens W, Bulthuis ML, Lely AT, Navis G, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004;203(2):631-637. doi: 10.1002/path.1570

9. Kamboj M, Sepkowitz KA. Nosocomial infections in patients with cancer. Lancet Oncol. 2009;10(6):589-597. doi: 10.1016/S1470-2045(09)70069-5

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COVID-19 Presents an Opportunity for Precision Medicine to Play Expanded Role in Care - Targeted Oncology

1. Amongst the five examined classes of antihypertensive medications (ACE Inhibitors, ARBs, beta blockers, calcium-channel blockers, and thiazide diuretics), none were associated with a substantial increase in likelihood of COVID-19.

Evidence Rating: 2 (Good)

Infection of host cells by SARS-CoV-2 is mediated via an interaction with membrane-bound angiotensin-converting enzyme (ACE) 2, and as such, it has been suggested that treatment with ACE inhibitors or angiotensin-receptor blockers (ARBs) may be associated with an increased risk of developing COVID-19. Antihypertensive medications such as calcium channel blockers, which do not interact with the renin-angiotensin-aldosterone system (RAAS), have been suggested as potential beneficial alternatives in affected patients. As hypertension affects nearly half of the adult American population, any potential interactions between antihypertensive medications and COVID-19 must be meaningfully sorted out, especially when considering ACE inhibitors are often prescribed as first line pharmacologic treatment for the condition. In this retrospective cohort study, data from a large health care network in New York City was used to determine whether antihypertensive medications were associated with any difference in risk of developing COVID-19. The study included 12,594 patients, 5894 (46.8%) who had confirmed COVID-19, of which 1002 patients had severe illness as indicated by ICU admission, mechanical ventilation requirements, or death. A total of 4357 (34.6%) patients from the dataset had hypertension, of which 2573 (59.1%) were COVID-19 positive. Using propensity-score matched analyses, an absolute difference of at least 10 percentage points in the likelihood of a positive test with at least 97.5% certainty was ruled out for ACE inhibitors, ARBs, beta-blockers, calcium-channel blockers, and thiazide diuretics. Likewise, there was no substantial difference in risk of developing severe disease among patients taking any of the antihypertensive medications. Overall, evidence from the study suggests that there are no direct adverse effects associated with ACE inhibitors, ARBs, or any of the other examined antihypertensive medications in the context of increasing risk of developing COVID-19.

Click to read the study in NEJM

Image: PD

2020 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

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Antihypertensive medications and risk of COVID-19 - 2 Minute Medicine

By Medicine Hat News Opinion on May 23, 2020.

Curling legend Pat Ryan was a game changer in every sense.

Id watched him as a kid and was still in journalism school in 2007 when I had the opportunity to sit down with him at The Continental Cup in Medicine Hat.

The interview was one of my first, so it stuck with me, and when I saw he was the subject of an episode on a Netflix series called The Losers, I skipped right to his and sat down to watch.

The title is misleading, as Ryan was anything but a loser. Except in 1985, when a string of errors and his opponent making the greatest shot in the sports history cost Ryans Alberta rink the Brier, our Canadian championship.

Whats more, Ryans team missed several easy hits to lose to Al Hackner, a shot-making master from the Thunder Bay region whose finesse for the game was unmatched at the time. Ryan was so distraught that he almost quit the sport.

Almost.

As many Albertans will remember fondly, Ryan stayed with the game and soon formed a team that would include Randy Ferbey, now one of the biggest names the sport has ever had. Ruling with an iron fist, Ryan shaped his new team into the nations best through a strategy no team before had ever used.

Hit everything.

They throw a guard? Hit it out of there. They throw one in the house? Smash it into oblivion. No matter what the other team threw, Ryan aggressively attacked it with 44-pound granite torpedoes as if he were captaining a submarine.

It worked to perfection and no one had an answer for it. Ryans Alberta rink won back-to-back Brier championships using this strategy, going on to World Championship silver in 1988 and gold in 1989.

There was only one problem Outside his own rink and his Albertan supporters, everyone either hated playing him or despised watching him. Ryans strategy was annoying and it was boring without rocks in play throughout an end, his team had become so awful to watch that in the 1989 Brier final, they had to win while the crowd chanted, Booooring! Booooring! over and over.

None of it sat well with the sports governing bodies, both in Canada and internationally, and not long after Ryan was booed at the Brier, they literally changed the rules of the sport to stop it. Hit everything? Nope, not anymore.

Alls well that ended well in the world of curling, of course, as not only did the games excitement level dramatically improve, but Ryan even went on to win again under the new rules, this time skipping a rink out of B.C.

So, the question is, why is a political columnist telling a 35-year-old curling story? If you havent already picked it up yourself, as I watched this 37-minute Netflix episode I couldnt help but see glaring similarities to Premier Jason Kenney and his United Conservative team.

Kenneys strategy is exactly like Ryans was no matter what anyone does, hit it with an aggressive attack. There is no finesse to Kenneys game.

In fact, he despises finesse. Finesse means playing nice. Finesse means working with other peoples rocks in play. Finesse means dirty words like social licence. To Kenney, finesse is a losers game. As far as Kenney is concerned, Albertans dont play nice Albertans hit everything.

Since long before the UCP even won the election, Kenney has promised to make the world bow to Albertas needs. According to Kenney, we must force our enemies to submit, and we will fly out of the hack to deliver stones at a blistering pace until they do.

Kenney has delivered hits in every direction foreign radicals, environmentalists, the green left, B.C., Quebec, Texas, Saudi Arabia, Russia, Norway, Moodys, David Suzuki, George Soros, whoever is controlling Greta Thunberg while shes supposed to be in school, the Medicine Hat News, Justin Trudeau, Rachel Notley and he never runs out of rocks.

Most recently he took aim at China over COVID-19, and decided Gerald Butts and Barack Obama are now behind our oil woes. And lo and behold, just like with Ryans curling strategy, people outside Alberta have grown bored of it, and his so-called opponents have only become irritated by it.

Outside his fans in Alberta, Kenney is just not very well liked, and we didnt need the Chinese consulate to put him in his place last week to see it. But, no matter how many similarities I can draw between Jason Kenney and Pat Ryan, there is still one major difference.

Pat Ryan was winning.

Jason Kenney, and therefore Alberta as a whole, is getting his butt whipped. Even if every opponent he has targeted was actually working to defeat Alberta somehow (spoiler alert: they arent) his hit-everything strategy is an utter failure, and hes far too slow to learn that he does not control the sport.

Ryan at least brought home some hardware before curling snuffed out his strategy. Whats Kenney brought home so far? Jobs? Investment? Nope, not even a shiny trophy we can admire. All we have is the reverberating chants of the world growing bored of him.

The fans hate us. Our opponents wont play with us. And our premier is too stubborn to realize theyve already changed the game.

Scott Schmidt is the layout editor for the Medicine Hat News. Contact him at sschmidt@medicinehatnews.com or follow him on Twitter at @shmitzysays. Scotts opinions are his own and do not necessarily reflect those of the News editorial board.

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Laying It Out: Throwin' stones and coming up empty - Medicine Hat News

As the worldwide COVID-19 pandemic continues to deliver both health and economic blows, hopes are pinned on medical researchers identifying drugs and vaccines needed to stop the viruss spread, heal those who are sick and ease concerns about returning to a semblance of normal. But the process of developing new medicines is a long one, and at best new vaccines can take more than a year.

Go to the web site to view the video.

Video by Farrin Abbott

The Innovative Medicines Accelerator builds on and expands existing programs and adds new resources to help Stanford investigators turn their good ideas into effective drugs for people.

Into this landscape enters the newly created Innovative Medicines Accelerator (IMA), which was envisioned to overcome obstacles in developing medicines. The IMA arose as part of Stanfords Long-Range Vision long before COVID-19 found a foothold in humans, and was designed to aid in medicines for everything from deadly diseases like cancer to rare disorders overlooked by most pharmaceutical companies. But in this time of need, its programs are focused entirely on helping researchers test their ideas about potential medicines for COVID-19.

Our programs were envisioned before our new priority came along, and thats the COVID-19 pandemic, said Chaitan Khosla, Baker Family co-Director ofStanford ChEM-H who is also leading the IMA. The scale of what Stanford researchers have accomplished in the past two and a half months is unprecedented. Where we are today might not have been so powerful if not for the efforts of people associated with the IMA.

A valley of death lies between a good idea in the lab and a drug that can be tested in humans. (Image credit: Farrin Abbott)

The IMAs programs aid scientists in traversing the so-called valley of death that chasm between a good idea in the lab and the first test of a new drug in humans. This valley, created by a lack of funding and drug development expertise on the academic side and by concerns about financial risk on the industry side, isnt entirely unnavigable. Many ideas cross the divide each year, but the difficulty adds to the time and cost of developing new medicines.

Stanford faculty who have successfully developed vaccines and drug prototypes were aided by a network of expertise and programs centered in the School of Medicine and in the interdisciplinary life sciences institutes like Stanford ChEM-H, Stanford Bio-X and the Wu Tsai Neurosciences Institute. The IMA builds on and expands those resources so more can benefit, while also filling in gaps that have waylaid some projects. These added programs include funding promising early-stage research, adding technical capabilities and expertise and assisting with studies in human tissues to help ensure good ideas discovered in mice will be effective in people.

The Innovative Medicines Accelerator builds on and expands resources already available at Stanford to create a bridge across the valley of death. (Image credit: Farrin Abbott)

The concept of building on existing resources was immediately helpful in responding to COVID-19, particularly the Stanford ChEM-H Knowledge Centers, which are facilities run by staff with deep drug development experience and who provide expertise along with the technical resources.

If ChEM-H didnt exist, the first thing the IMA would have to do in order to be successful is create it, said Carolyn Bertozzi, Baker Family co-director of ChEM-H, andAnne T. and Robert M. Bass Professor in theSchool of Humanities and Sciences.

For example, Peter Kim, professor of biochemistry, is making use of the ChEM-H Macromolecular Structure Knowledge Center to learn how human antibodies bind SARS-CoV-2, the virus that causes COVID-19, as part of work to develop a vaccine. Jeffrey Glenn, professor of medicine, is one of several researchers developing drug prototypes against various types of viruses, including SARS-CoV-2, with assistance from the ChEM-H Medicinal Chemistry Knowledge Center.

As the IMA considers research funding for COVID-19 projects, it is augmenting these knowledge centers in anticipation of increased need, and adding new ones that fill additional gaps like allowing investigators to screen a high volume of molecules as potential drugs known as high-throughput screening.

In addition to networking existing facilities, the IMA is expanding space in the Keck Science Building where researchers can safely handle deadly, airborne pathogens, called a biosafety level 3 (BSL3) facility. Researchers including Catherine Blish, associate professor of medicine, are already carrying out experiments in the smaller space to test existing drugs against SARS-CoV-2 in infected cells, and studying the virus biology to identify new drug candidates. When it is complete, the expanded space will provide access to more investigators developing COVID-19 medicines and could also aid in addressing possible future pandemics or known airborne pathogens like tuberculosis.

As part of the Long-Range Vision, which emphasizes partnership to accelerate impact, IMA will also form alliances with biotechnology and pharmaceutical companies, governments and nongovernmental organizations to exchange knowledge and expertise. These would resemble an existing relationship between Takeda Pharmaceutical Company and Stanford ChEM-H called the Stanford Alliance for Innovative Medicines, in which Takeda provides access to drug development expertise, not generally available in academia, to help potential medicines reach patients more quickly.

In addition to easing the path to drug prototypes, the IMA overcomes another hurdle in developing effective medicines the fact that many great ideas originate with lab animals like mice or flies but fail when they reach human trials. Khosla calls this a second valley of death.

If theres one thing weve learned from clinical trials its that mice arent humans, said Khosla, who is also the Wells H. Rauser and Harold M. Petiprin Professor in the School of Engineering and professor of chemical engineering and of chemistry.

The challenge has been that investigators used to working with laboratory animals often dont have the resources or regulatory expertise to access human subjects or tissues. To overcome that problem, IMA will provide funding and expertise and also assist with collecting and storing tissues. (These experiments will have the added benefit of producing new discoveries about human biology.)

Many drugs arent effective in humans because they come from ideas developed in laboratory animals like mice, flies and worms. (Image credit: Farrin Abbott)

That approach which they call Experimental Human Biology is already being applied toward COVID-19 at the IMA-supported COVID Clinical and Translational Research Unit (CTRU). Here, researchers are gathering blood samples from people with or without COVID-19 and from people participating in trials of existing drugs to see if they are effective against COVID-19. Those samples can help researchers understand how the human immune system responds to an experimental drug, and they are being banked for possible future experiments as investigators have new ideas for medicines or vaccines.

Stanford also has expertise in creating mini organs including brains, and lung and intestinal tissue in laboratory dishes. These organoids can be used to test ideas in cells representing human biology. Some COVID-19 work takes advantage of such labs-in-a-petri-dish in the form of clusters of cells that mimic the human immune system. Looking beyond the current crisis, Stanford also has banks of stem cells derived from people with different disease backgrounds that can be grown into a range of tissue types.

These programs, which are ramping up now to address COVID-19, will ultimately benefit a range of diseases in need of new medicines or even help prepare for a future pandemic.

The metrics of success for the IMA are based on impact, said Khosla. That doesnt have to be just in terms of reducing the time or cost of developing a drug. What if you could powerfully benefit the health of one kid with an extremely rare disease? Thats a pretty big impact.

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The Innovative Medicines Accelerator turns its focus on COVID-19 | Stanford News - Stanford University News

Third in a series on the self-sufficiency of Appalachian culture.

Until World War II, many a mountain woman doctored herself and her family with what she had, and while the idea of home-grown medicine may conjure images of hot tea and honey by a fireside, some of the old country cures were almost as tough as the illnesses themselves.

During my early years in Haywood County, Marvin and Elizabeth Green of Fines Creek became two of my favorite people to visit. They were warm and welcoming, and willing to share remarkable memories.

Their recollections of early life in Haywood County were full of home remedies, some of them almost incredible. Another historic treasure, the late Dr. Stuart Roberson, Haywood County physician from 1930 until retirement in 1985, backed up their stories with memories of his own.

More than a century ago, when people got sick in Cruso, or Fines Creek, it might take a day to summon a doctor, another day for him to arrive. Families had to make or contrive their own cures, using a little bit of store-bought goods and a whole lot of what nature provided.

Youd get sick here, there might be some old country doctor to help, but there was no hospital until you got to Asheville, no automobiles, Marvin Green told me. He was born in 1901. I was nine or 10 years old before I saw my first car.

We did a little bit of everything, his wife, Elizabeth, added. I reckon it helped some; we thought it did, anyhow.

Groundhog grease, onions and catnip

Following are some of the homemade treatments the Greens recalled from their childhood, including some that are not for the faint of heart.

Elizabeths brother struggled with croup. His mother made him swallow groundhog grease. Elizabeth said it would break up the congestion in his system, though she was grateful she never had to try the cure firsthand; the smell was bad enough.

Another treatment for croup, the Marvins said, was a poultice made of onions fried in grease. The poultice went on the chest, but the patient was also expected to drink the onion juice. Ive used many a mustard plaster and onion poultice on the chest, Dr. Roberson agreed.

Tea from the bark of the red alder tree treated babies with jaundice. Other tree barks were also used for treatments. Elizabeth Green treated herself for kidney infections many times with a tea made of peach tree bark.

Mothers treated fever with the herb boneset.

Catnip tea was used to help babies sleep.

Mountain people also believed ginger root could treat the measles. Marvin Green was working in Detroit, Michigan, when he came down with the measles in 1922. Visitors from home had him make a ginger root tea, which he declared kept him out of the hospital.

Elizabeths mother would take cornmeal and salt and make a dough, which she put on her head to treat headaches.

Blackberry juice helped diarrhea and stomach troubles, Elizabeth told me. Dr. Roberson agreed that the juice was good medicine.

A mix of honey and alum was gargled to treat a sore throat.

I remember one thing, I thought it was horrible, that my mother did one time, Elizabeth Green said. My half-brother, he used to have what we called the quinsy they call it tonsillitis now. He had swelling up in his throat til he couldnt breathe or swallow. The doctor wasnt doing much good, and my mother says, Well, Im going to do the old remedy; Ive got to do something.

Her mother took hog manure and made a poultice, which she put on the young mans throat, to break the congestion and swelling.

It was a terrible thing to do, but she said he was going to die if she didnt get something done.

Elizabeth said the swelling went down within minutes.

Dr. Roberson recalled patients telling him of sheep droppings added to tea to draw out the measles.

Until World War II, he said, he would make home visits to mothers in labor and would often find an axe under the bed, pointed side up, to cut the pain.

Camphor and confiscated moonshine

Living on Bald Mountain in Buncombe County, my paternal grandmother relied on laxatives, including Dr. Pearces Pleasant Pellets, Black Draught, epsom salts and castor oil. She treated scrapes and abrasions with camphor. As my father wrote, the camphor, Im sure, was a good disinfectant since it was pure moonshine whiskey with camphor shavings added.

At that time you could go to the sheriffs office in Asheville and get a jar of confiscated whiskey free if you wanted it for medicine. The rule was that you had to take a block of camphor and shave it into the jar there at the office. If you knew the sheriff, the rule was usually waived on your word that you were using it for medicine.

Band Aids were unknown, so usually a cut or stubbed toe was tied up with a piece of old sheet and sewing thread and doused in camphor.

Local author Louise Nelson, who grew up in Crabtree and Big Branch during the 1920s and 1930s, lists a number of home remedies in her book Country Folklore, including the groundhog oil for croup. Among her familys treatments:

Use chimney soot in the wound for blooding.

For a cold in the chest, use a poultice of camphor and turpentine. (They used an onion and turpentine poultice for croup.)

For sore throat, gargle with salt and vinegar water.

Make a candy from Jerusalem Oak to get rid of worms.

For bee stings, cover with wet snuff.

For poison ivy, use buttermilk, vinegar and salt.

A number of home remedies are also mentioned in Heritage of Healing, the history of Haywood County medicine. Bark from the poplar tree, brewed into a tea, was used for digestive problems, as were teas made of bayberry or the outer bark of the hemlock tree.

Tea from holly leaves was used to reduce fever. Sassafras was a common herbal medicine, used for stomach trouble, skin problems, dropsy, gout and a poor appetite. It was mixed with honey to treat influenza.

Many early settlers herbal remedies were used or adapted from the Cherokee, whose medicine men used more than 600 different plants in their practices.

Sources for this story include: Families practiced their own medicine with groundhog grease, teas and herbs, The Mountaineer, April 15, 1988; Country Folklore 1920s and 1930s and thats the way it was, by Louise Nelson; Heritage of Healing: A Medical History of Haywood County by Nina L. Anderson and William L. Anderson, published by the Waynesville Historical Society and Bald Mountain and Beyond by Stuart A. Nanney

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Many home remedies were good medicine if you could survive the cure - The Mountaineer

ZUG, Switzerland and CAMBRIDGE, Mass. and BOSTON, May 11, 2020 (GLOBE NEWSWIRE) -- CRISPR Therapeutics (Nasdaq: CRSP) and Vertex Pharmaceuticals Incorporated (Nasdaq: VRTX) today announced that the U.S. Food and Drug Administration (FDA) granted Regenerative Medicine Advanced Therapy (RMAT) designation to CTX001, an investigational, autologous, gene-edited hematopoietic stem cell therapy, for the treatment of severe sickle cell disease (SCD) and transfusion-dependent beta thalassemia (TDT).

RMAT designation is another important regulatory milestone for CTX001 and underscores the transformative potential of a CRISPR-based therapy for patients with severe hemoglobinopathies, said Samarth Kulkarni, Ph.D., Chief Executive Officer of CRISPR Therapeutics. We expect to share additional clinical data on CTX001 in medical and scientific forums this year as we continue to work closely with global regulatory agencies to expedite the clinical development of CTX001.

The first clinical data announced for CTX001 late last year represented a key advancement in our efforts to bring CRISPR-based therapies to people with beta thalassemia and sickle cell disease and demonstrate the curative potential of this therapy, said Bastiano Sanna, Ph.D., Executive Vice President and Chief of Cell and Genetic Therapies at Vertex. We are encouraged by these recent regulatory designations from the FDA and EMA, which speak to the potential impact this therapy could have for patients.

Established under the 21st Century Cures Act, RMAT designation is a dedicated program designed to expedite the drug development and review processes for promising pipeline products, including genetic therapies. A regenerative medicine therapy is eligible for RMAT designation if it is intended to treat, modify, reverse or cure a serious or life-threatening disease or condition, and preliminary clinical evidence indicates that the drug or therapy has the potential to address unmet medical needs for such disease or condition. Similar to Breakthrough Therapy designation, RMAT designation provides the benefits of intensive FDA guidance on efficient drug development, including the ability for early interactions with FDA to discuss surrogate or intermediate endpoints, potential ways to support accelerated approval and satisfy post-approval requirements, potential priority review of the biologics license application (BLA) and other opportunities to expedite development and review.

In addition to RMAT designation, CTX001 has received Orphan Drug Designation from the U.S. FDA for TDT and from the European Commission for TDT and SCD. CTX001 also has Fast Track Designation from the U.S. FDA for both TDT and SCD.

About CTX001CTX001 is an investigational ex vivo CRISPR gene-edited therapy that is being evaluated for patients suffering from TDT or severe SCD in which a patients hematopoietic stem cells are engineered to produce high levels of fetal hemoglobin (HbF; hemoglobin F) in red blood cells. HbF is a form of the oxygen-carrying hemoglobin that is naturally present at birth and is then replaced by the adult form of hemoglobin. The elevation of HbF by CTX001 has the potential to alleviate transfusion requirements for TDT patients and painful and debilitating sickle crises for SCD patients. CTX001 is the most advanced gene-editing approach in development for beta thalassemia and SCD.

CTX001 is being developed under a co-development and co-commercialization agreement between CRISPR Therapeutics and Vertex.

About the CRISPR-Vertex CollaborationCRISPR Therapeutics and Vertex entered into a strategic research collaboration in 2015 focused on the use of CRISPR/Cas9 to discover and develop potential new treatments aimed at the underlying genetic causes of human disease. CTX001 represents the first treatment to emerge from the joint research program. CRISPR Therapeutics and Vertex will jointly develop and commercialize CTX001 and equally share all research and development costs and profits worldwide.

About CRISPR TherapeuticsCRISPR Therapeutics is a leading gene editing company focused on developing transformative gene-based medicines for serious diseases using its proprietary CRISPR/Cas9 platform. CRISPR/Cas9 is a revolutionary gene editing technology that allows for precise, directed changes to genomic DNA. CRISPR Therapeutics has established a portfolio of therapeutic programs across a broad range of disease areas including hemoglobinopathies, oncology, regenerative medicine and rare diseases. To accelerate and expand its efforts, CRISPR Therapeutics has established strategic partnerships with leading companies including Bayer, Vertex Pharmaceuticals and ViaCyte, Inc. CRISPR Therapeutics AG is headquartered in Zug, Switzerland, with its wholly-owned U.S. subsidiary, CRISPR Therapeutics, Inc., and R&D operations based in Cambridge, Massachusetts, and business offices in San Francisco, California and London, United Kingdom. For more information, please visit http://www.crisprtx.com.

CRISPR Forward-Looking StatementThis press release may contain a number of forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, as amended, including statements regarding CRISPR Therapeutics expectations about any or all of the following: (i) the status of clinical trials (including, without limitation, the expected timing of data releases) and discussions with regulatory authorities related to product candidates under development by CRISPR Therapeutics and its collaborators, including expectations regarding the benefits of RMAT designation; (ii) the expected benefits of CRISPR Therapeutics collaborations; and (iii) the therapeutic value, development, and commercial potential of CRISPR/Cas9 gene editing technologies and therapies. Without limiting the foregoing, the words believes, anticipates, plans, expects and similar expressions are intended to identify forward-looking statements. You are cautioned that forward-looking statements are inherently uncertain. Although CRISPR Therapeutics believes that such statements are based on reasonable assumptions within the bounds of its knowledge of its business and operations, forward-looking statements are neither promises nor guarantees and they are necessarily subject to a high degree of uncertainty and risk. Actual performance and results may differ materially from those projected or suggested in the forward-looking statements due to various risks and uncertainties. These risks and uncertainties include, among others: the potential impacts due to the coronavirus pandemic, such as the timing and progress of clinical trials; the potential for initial and preliminary data from any clinical trial and initial data from a limited number of patients (as is the case with CTX001 at this time) not to be indicative of final trial results; the potential that CTX001 clinical trial results may not be favorable; that future competitive or other market factors may adversely affect the commercial potential for CTX001; uncertainties regarding the intellectual property protection for CRISPR Therapeutics technology and intellectual property belonging to third parties, and the outcome of proceedings (such as an interference, an opposition or a similar proceeding) involving all or any portion of such intellectual property; and those risks and uncertainties described under the heading "Risk Factors" in CRISPR Therapeutics most recent annual report on Form 10-K, and in any other subsequent filings made by CRISPR Therapeutics with the U.S. Securities and Exchange Commission, which are available on the SEC's website at http://www.sec.gov. Existing and prospective investors are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date they are made. CRISPR Therapeutics disclaims any obligation or undertaking to update or revise any forward-looking statements contained in this press release, other than to the extent required by law.

About VertexVertex is a global biotechnology company that invests in scientific innovation to create transformative medicines for people with serious diseases. The company has multiple approved medicines that treat the underlying cause of cystic fibrosis (CF) a rare, life-threatening genetic disease and has several ongoing clinical and research programs in CF. Beyond CF, Vertex has a robust pipeline of investigational small molecule medicines in other serious diseases where it has deep insight into causal human biology, including pain, alpha-1 antitrypsin deficiency and APOL1-mediated kidney diseases. In addition, Vertex has a rapidly expanding pipeline of genetic and cell therapies for diseases such as sickle cell disease, beta thalassemia, Duchenne muscular dystrophy and type 1 diabetes mellitus.

Founded in 1989 in Cambridge, Mass., Vertex's global headquarters is now located in Boston's Innovation District and its international headquarters is in London, UK. Additionally, the company has research and development sites and commercial offices in North America, Europe, Australia and Latin America. Vertex is consistently recognized as one of the industry's top places to work, including 10 consecutive years on Science magazine's Top Employers list and top five on the 2019 Best Employers for Diversity list by Forbes. For company updates and to learn more about Vertex's history of innovation, visit http://www.vrtx.com or follow us on Facebook, Twitter, LinkedIn, YouTube and Instagram.

Vertex Special Note Regarding Forward-Looking StatementsThis press release contains forward-looking statements as defined in the Private Securities Litigation Reform Act of 1995, including, without limitation, the information provided regarding the status of, and expectations with respect to, the CTX001 clinical development program and related global regulatory approvals, and expectations regarding the RMAT designation. While Vertex believes the forward-looking statements contained in this press release are accurate, these forward-looking statements represent the company's beliefs only as of the date of this press release and there are a number of factors that could cause actual events or results to differ materially from those indicated by such forward-looking statements. Those risks and uncertainties include, among other things, that the development of CTX001 may not proceed or support registration due to safety, efficacy or other reasons, and other risks listed under Risk Factors in Vertex's annual report and quarterly reports filed with the Securities and Exchange Commission and available through the company's website at http://www.vrtx.com. Vertex disclaims any obligation to update the information contained in this press release as new information becomes available.

(VRTX-GEN)

CRISPR Therapeutics Investor Contact:Susan Kim, +1 617-307-7503susan.kim@crisprtx.com

CRISPR Therapeutics Media Contact:Rachel EidesWCG on behalf of CRISPR+1 617-337-4167 reides@wcgworld.com

Vertex Pharmaceuticals IncorporatedInvestors:Michael Partridge, +1 617-341-6108orZach Barber, +1 617-341-6470orBrenda Eustace, +1 617-341-6187

Media:mediainfo@vrtx.com orU.S.: +1 617-341-6992orHeather Nichols: +1 617-961-0534orInternational: +44 20 3204 5275

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CRISPR Therapeutics and Vertex Pharmaceuticals Announce FDA Regenerative Medicine Advanced Therapy (RMAT) Designation Granted to CTX001 for the...

Tribune News ServiceNew Delhi, May 11

Former prime minister Manmohan Singh is stable but under observation for a fever, hospital sources said on Monday, a day after he was admitted to AIIMS New Delhi.

Singh developed the fever as a reaction to a new medication and was being investigated further, said sources.They said the ex-PM was admitted to cardiothoracic unit of the hospital and was undergoing tests and medical observation to rule out other causes of the fever.

He is under the care of a team of doctors.

Hospital sources said, Dr Manmohan Singh was admitted for observation and investigation after he developed a febrile reaction to a new medication. He is being investigated to rule out other causes of fever and is being provided care as needed. He is stable and under the care of a team of doctors at the Cardiothoracic Centre of AIIMS.

Singh was taken to AIIMS Cardiac Care Unit on Sunday night and doctors said they were observing his condition. He was later shifted to a private room and remains under observation.

Earlier, in 2009, he had undergone a coronary artery bypass surgery by a team of surgeons led by cardiothoracic surgeon Ramakant Panda at AIIMS.

Singh is a senior leader of the opposition Congress and currently represents Rajasthan in the Upper House of Parliament. He was the Prime Minister between 2004 and 2014.

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Manmohan Singh stable, had developed reaction to new medicine: AIIMS sources - The Tribune India

Even after the pandemic is over, telehealth practices will probably continue.

The way our pets receive veterinary care changed dramatically two months ago. One day we were in the exam room with them; the next, we were all driving to the clinic, calling from our cars to announce our arrival, and staying in them while masked vet techs came and took pets inside for exams. Intercoms at clinic entrances enable germ-free communication with the front desk. Telehealth is trending.

High-tech accommodations that veterinarians and pet owners have made to deal with the COVID-19 virus will likely remain in the future. Phone calls, video and social media may all play a role in the way pets receive care and the way we witness it.

For instance, if you can't go in with your pet, can you still see the exam and communicate with the veterinarian?

"Absolutely," said Peter Weinstein, a veterinarian and executive director of the Southern California Veterinary Medical Association. Once the pet is in the exam room, he said, it's easy to initiate a Zoom, Skype or FaceTime call with the client so they can see what's going on.

Veterinarian Julie Reck, who practices in South Carolina, foresees using video and social media more frequently to let owners see what's going on if a pet has to "go to the back" for a procedure or is recovering from surgery.

"We do a lot on our social media for our veterinary page," she said. "We get video content of our patients all the time, whether that's while we're in the exam room or if they're in the back treatment area. If we're going to change that dynamic and separate the pet parent and the pet, we need to up the ante with that a little bit."

Anxious about letting your pet go into the veterinary clinic without you? It's not surprising that he might be weirded out by that masked and gowned technician and veterinarian. Separating pets and their people isn't ideal, but veterinary staff can ease pet anxiety by using low-stress or Fear-Free handling techniques, food rewards, stress relievers such as pheromone diffusers or soft music, and nonskid surfaces on exam tables to help them remain calm and comfortable.

Remote health care, or telehealth, may become more common for what were once routine in-clinic visits. Beyond a pandemic situation, it can benefit people who are sick but have a pet who needs to be seen or who don't have access to transportation. It's also useful in remote areas where specialist care or even general practice care isn't available.

Maybe your dog has a lump on his chin. If you have an already-established doctor-patient relationship, you can take a photo of the lump and email or text it to your veterinarian for advice on whether it can wait, or if needs to be treated immediately.

In some instances, you may not need an already-established relationship for your pet to receive treatment. Last month, the Food and Drug Administration temporarily relaxed some requirements regarding physical examinations to make it easier for veterinarians to prescribe drugs in certain situations without directly examining the pet. State veterinary medical association requirements may still be in effect in some areas, though.

Whenever the pandemic is over, lingering fear will likely affect the way veterinary medicine is delivered. We may see hybrid models combining traditional delivery of veterinary medicine with new drive-up, drop-off or telehealth services.

Weinstein counsels patience to pet owners and veterinarians who are navigating new territory and are concerned about their own health as well as that of their families and pets.

"If we can all respect one another's needs, we'll all come out of this just fine," he said.

Pet Connection is produced by a team of pet-care experts headed by veterinarian Marty Becker and journalist Kim Campbell Thornton of Vetstreet.com. Joining them is dog trainer and behavior consultant Mikkel Becker.

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Veterinary medicine changing in wake of COVID-19: Pet Connection - GoErie.com

]]> Except for hard metals like stainless steel, gold and titanium, most synthetic materials in the body create a very significant scarring response. Credit: INSERM

The power of needlework should never be underestimated. Where would we be without the textile industry providing natural and synthetic fibres to thousands of sectors across the globe? In addition to clothing our bodies, textiles are used to help heal them, from wound dressings to sutures and meshes. Some scientists are now going further, using weaving and knitting techniques to create medical fabrics from biological materials such as human cells.

Nicolas LHeureux, director of research at INSERM, the French National Institute of Health and Medical Research is exploring exactly this. He works on repairing damaged blood vessels with biological textiles grown in the laboratory.

Synthetic materials are recognised as not being a normal part of the body, LHeureux explains. Except for hard metals like stainless steel, gold and titanium, most create a very significant scarring response.

He likens it to a splinter. The body recognises the material as foreign and reacts to it by trying to push it out. If its not able to eject it, scar tissue will form and inflammation will be triggered. This can lead to redness, pain, swelling and scarring.

Some parts of the body are better at dealing with scarring than others. Sometimes a scar can actually be helpful, providing mechanical support to the structure. But in a blood vessel, a scarring response could recreate the same blockage surgeons were aiming to fix in the first place. Grafting and stenting can result in restenosis (where the treated vessel closes off again) over time due to this scarring behaviour.

A scarring response will create a lot of tissue that will clog the inner part of your tube. Then your blood will not flow well anymore, LHeureux says.

Synthetic grafts work best for large vessels such as the aorta, which is roughly two centimetres in diameter. If there is a little bit of scarring from the graft, the blood will likely still be able to flow normally. But for smaller blood vessels, rejection of synthetic materials can create a real problem.

LHeureux and his team are developing grafts that wont produce that rejection response. What is more likely to be accepted is a material the body is already familiar with. Researchers cultivate human cells in the laboratory (originally extracted from a skin biopsy), where various chemicals are used to influence them to form sheets of collagen. These sheets are then cut into thin threads of yarn-like material.

The material we collect in sheets is the extracellular matrix outside the cell. Thats what we get the cells to overproduce in the lab, LHeureux reveals. This is the material that they lay down in the right conditions at the bottom of the plastic containers where we grow the cells.

Because the makeup of collagen doesnt vary from person to person, it is hoped that each patient wouldnt need vessels produced from their own cells.

Once the yarn is ready, its time to get sewing. By weaving, braiding or knitting, the team can form tubes of collagen to replace the synthetic structures that are traditionally used in cardiovascular surgery.

We tend to use weaving because it makes a really nice tight wall which is really important if youre making a blood vessel, says LHeureux.

This is weaving as youve never seen it before, but it still requires a loom. The custom-made device has to be tiny so vessels of five millimetres in diameter can be produced. Its made out of stainless steel and plastic so it can be cleaned easily. And it is circular in shape to produce tubes from the collagen yarn.

How well these grafts will be tolerated by the body still needs to be tested though. The next step of the research is to see how the vessels perform in animals. Using genetically modified rodent models that dont reject human tissue, the team will be able to see if the biological textiles adapt well to the body environment.

But one problem with rats and mice is the small size of their blood vessels. So, the researchers are also working on producing similar medical textiles using sheep cells. Once animal model results prove promising, itll be time to think about transplanting the grafts into humans.

The sheep is about the same size as a human in terms of the blood vessels, so well be able to try surgeries that we would do in humans with vessels that would be the same size and using all the same instruments. So, its much more representative, LHeureux explains.

There are other research groups working on similar projects.The University of Minnesota Medical School recently grew human-derived blood vessels in a pig. While US company Humacyte is also trying to produce extracellular matrices for vascular and non-vascular applications. In the future, LHeureux hopes to collaborate with groups like these to find the best way of producing biological textiles at scale.

When we bring this material that is completely logical, completely human and integrates well inside the body to patients, well have a solution that weve never had before in medicine.

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Spin me a yarn: the future of medical textiles and regenerative medicine - Medical Device Network

Department:Department of Internal Medicine, Hematology and OncologyFaculty of MedicineDeadline:11 Jun 2020Start date:upon agreement

Director of the University Hospital Brno and Dean of the Faculty of Medicine of Masaryk University announces aselection procedure for the position aDepartment Head for:

Department of Internal Medicine, Hematology and Oncology

The Department of Internal Medicine, Hematology and Oncology is amedical, educational and research institution of the University Hospital Brno and the Medical Faculty. It provides comprehensive care for adult patients in the specialized fields of hematology, oncology and internal medicine.

The candidate for the position of aDepartment Head must be arespected expert in the field of hematology or oncology or internal medicine, with experience of working in agiven field and with expertise in pre-graduate and postgraduate education.

The Head of the department will be responsible for the management of the clinic, undergraduate medical education, doctoral studies, publishing and coordination of research conducted at the clinic. The Candidate for Department Head will present his/her idea of fulfilling the above during the selection process.

Requirements for adeclared position:

We offer:

Applications together with

should be sent to the HR department of the Faculty of Medicine, through e-Application (see below). For more information contact Ing. Ivana Jankov at 54949 5730 or e-mailjanackova@med.muni.cz

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Department Head for Department of Internal Medicine, Hematology and Oncology job with MASARYK UNIVERSITY | 206366 - Times Higher Education (THE)

LARAMIE, Wyo. (Press Release) -- Public interest to utilize the Medicine Bow National Forest and Thunder Basin National Grassland in Wyoming is currently high, and as is seasonally typical, recreation and access opportunities vary widely.

The Forest and Grassland are open for dispersed use. Common public questions revolve around camping opportunities. Dispersed options are currently very limited, and broadly, visitors will find limited access for roads and trails, which is typical for this time of year due to seasonally closed roads, lingering snowpack and wet, muddy conditions.

Most developed recreation sites are not typically open this time of year due to accessibility.

Recreation opportunities will increase as spring transitions to summer and roads/trails become more accessible. This typically is weather-dependent and includes dispersed camping.

Be aware that black bears are on the move and hungry. Visit the Wyoming Game and Fish Bear Wise webpage for more information about camping in bear country: https://wgfd.wyo.gov/Regional-Offices/Laramie-Region/Laramie-Region-News/Be-Bear-Wise-in-black-bear-habitat

Area-specific updatesThunder Basin NG: The Grassland is currently free of snow and accessible for use. Caution should be used following a rain event or new snow melt as many of the gravel and dirt roads can become slick or impassable. The Weston Hills Recreation Area has been experiencing unusually high use during the last month. Expect the main parking area to be crowded or full. Additional parking is available on the north side of Forest Road 1246 or nearby on BLM lands. All motorized trails are limited to vehicles 50 or less.

Laramie Peak area: Most areas are accessible except for Friend Park and the Laramie Peak Trailhead. Campfires have been reported in this area. Please remember that fire restrictions are in place and campfires are not currently allowed.

Pole Mountain area: All roads are still under a seasonal closure but are being evaluated frequently and will be opened as quickly as conditions allow.

Sierra Madre & Snowy Ranges: Access is very limited. Please use sites only where resource damage will not occur. Most popular or regularly used dispersed camping areas are still inaccessible. Some lower elevation areas along the North Platte River are accessible, such as the Routt Access.

All our offices are serving the public remotely and are available by phone. Check with your local Ranger District office for site-specific information.Forest Supervisors Office (Laramie), (307) 745-2300Brush Creek-Hayden Ranger District (Saratoga), (307) 326-5258Douglas Ranger District (Douglas), (307) 358-4690Laramie Ranger District (Laramie), (307) 745-2300

Additional recreation and access information may be found on this website, https://www.fs.usda.gov/goto/mbrtb/covid_19, or you can follow the Medicine Bow-Routt National Forests and Thunder Basin National Grassland on Twitter, @FS_MBRTB.

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Recreation and access opportunities vary widely on Medicine Bow National Forest and Thunder Basin National Grassland - wyomingnewsnow.tv

By Carol Ryan

Seeking comfort while sheltering at home, shoppers are reaching for Hershey Bars rather than gluten-free energy balls. That is bad news for challenger brands, whose healthy snacks were taking market share from global food companies until very recently.

Discussing their latest quarterly results, executives at Nestl, Kraft Heinz and Procter & Gamble all said consumers are returning to old-fashioned brands that had previously fallen out of favor. The Hershey Company noted that its confectionery products gained 3 percentage points of market share over the past month or so. As consumers hoard nonperishable food, goods such as processed cheese and canned soup that had been losing out to healthier alternatives are recording their strongest sales in years.

It isn't yet clear if the trend will stick, but the shift is significant. Challenger brands have been taking market share from global food manufacturers for several years. In January and February this year, insurgent brands -- defined as those that are growing more than 10 times faster than their category -- captured 35% of the year-over-year growth in the consumer industry, according to consulting firm Bain & Company. In March and April, their share of growth shrank to 5%.

Lack of scale is now a disadvantage. Supermarkets have reduced the range of products they offer to ensure everyday essentials are available. That plays to the strengths of global manufacturers like Nestl and P&G who can deliver orders in bulk. In the short term at least, small brands are being elbowed off the shelves.

The asset-light business model favored by insurgent brands also has downsides. As they use third-party manufacturers rather than owning factories, these companies struggle to increase capacity when there is a big spike in demand. They are also competing with deep-pocketed rivals for constrained logistics services. Third-party transport costs have increased by 20% in certain markets.

Even if the distribution squeeze is temporary, startups may not have the cash to survive for long. Funding for these kinds of businesses is drying up. Worldwide, the number of venture capital investments in consumer brands fell 26% in the first quarter of 2020 compared with the same period of last year, PitchBook data shows. Even before the crisis, investors had moved on to other hot sectors such as health care and software. Last year, venture capitalists handed over 54% less cash to consumer brands than in 2018, according to data tracked by Goldman Sachs.

Of course, entrepreneurs are nothing if not nimble and can focus on selling their goods online. The problem for food brands in particular is that over 90% of sales still happen in bricks-and-mortar stores in most markets. Challengers with a well-established online sales channel may fare better in the current reversal.

Meanwhile, big food brands have an unlikely opportunity to regain some of the ground they lost in recent years. They might even buy up struggling rivals on the cheap.

Write to Carol Ryan at carol.ryan@wsj.com

(END) Dow Jones Newswires

May 11, 2020 06:36 ET (10:36 GMT)

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Disruptive Food Brands Get a Taste of Their Own Medicine Heard on the Street - Morningstar.com

Mande Holford, an associate professor in chemistry at Hunter Collegein New York City who studies how venoms can be used to discover drugs for pain and cancer, says it goes deeper than just finding new drugs: venoms also offer the opportunity to answer big questions about evolution.

This is a chance to achieve not just Moon shots, but Jupiter shots: how can we figure out how venom evolved and use this for the benefit of humanity? she asks.

Scientists are now diving into the biological wealth of animal peptides to tackle a new threat: the novel coronavirus. Zachary Crook, lead protein scientist in the Jim Olson Lab at the Fred Hutchinson Cancer Research Center, has started looking through databases of peptides from a range of animals in a search for peptides that could either bind to the spike protein on the surface of the virus, or to the ACE-2 receptor on human cells which the virus attaches to, in order to prevent it from exerting its effects. Our eventual goal is a drug administered by a puff from an inhaler or nebuliser which can halt the infection in its tracks, says Crook.

Despite the many applications of animal peptides, however, time to find new solutions may be running out. Thanks to the biodiversity crisis, every year thousands of species go extinct, often before weve even discovered them or had the chance to sequence their genome.

The scientific evidence is pretty solid that we will hit an inflection point where it will be hard to recover this trend, and we will lose a lot of species the next 10 years are important for us to bin that curve and try to restore, protect, and learn from the biodiversity we have on this planet, says Holford.

Now, as always, nature can provide us both with cures as well as scourges and there are perhaps few examples of this more potent than animal toxins.

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The life-saving medicines inspired by animals - BBC News

In these trying times, laughter is needed to alleviate our stress and prevent us from going stir crazy while stuck in our homes.

This esteemed newspaper, throughout the 1890s, provided this laughter to its readers in the form of social satire. Fans of The New Yorkers Borowitz Report will appreciate the particular turn-of-phrase and wit of the Aitkin Ages editor C.C. Kellys the Town Tramp. If you want even more satire, investigate the articles written by It, a man by the name of Gawthmey.

The dictionary defines satire as the use of humor, irony, exaggeration, or ridicule to expose and criticize the stupidity or vices of people, particularly in the context of contemporary politics and other topical issues. In the case of Tramp, his favorite targets seem to be Democrats, the town band, and the foibles of his friends.

In his Jan. 2, 1892 column, titled a picker-up of unconsidered trifles, Tramp wishes his readers a happy new year.

Happy New Year, good people, one and all. The Tramp hopes it may be a prosperous one to you, and that you may all turn over a new leaf and amend your ways of last year, the which he doubts not, you being human like himself might do with profit. He trusts all of you may keep the customary good resolutions for a day or two longer than usual, which will be a step in the right direction anyhow; and advises the making of few of the same ...

This seems a rather polite way to say behave better to his troublemaking readers. However, in reading through the Tramp articles, a favorite stood out.

In this favorite, Tramp takes on oleomargarine, a detestable product. He compares it to castor oil, with the scent of dead mens bones and all uncleanliness. He pleads with Hon. Kittel to ban the stuff, saying we have plenty enough cows for good butter, and if he slay this dragon which is injecting the means of madness in the very veins of life the farmers will rise up and call him blessed and reelect him sure.

Now, while this author has never tried oleo, as someone in the history field mention of it has come up. Many recall recipes it was used in or use of it from their childhoods. Never has it been described quite so strongly. One wonders was it really as awful as the Tramp proclaims? Perhaps it is time to break out these old recipes and try the stuff?

The author has provided samples of the Tramps other work for your enjoyment here. Brighten up your stay-at-home with a dash of biting humor. If you are a fan of Stephen Colbert and The Colbert Report, or The Daily Show with Trevor Noah, you will no doubt appreciate the Tramps style.

Remember, this too shall pass, and we will once again be with our neighbors and friends, once again visit museums and attend school. We at the Aitkin County Historical Society miss our visitors and members, our volunteers and student groups. We are looking forward to opening our doors to you once more.

If you have questions about Aitkin County history, visit http://www.aitkincohs.org or email Administrator Heidi Gould at achs@ait

kincohs.org.

I close this article with a quote in the Tramps writing, a quote by Jack Bunsby. It reads: Avast then, keep a bright lookout. Ahead, and good luck to you.

Good luck to us all, and we await the day we can once again be together in groups larger than 10 and closer than six feet apart.

Heidi Gould is the adminisrator of the Atkin County Historical Society.

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Laughter is the best medicine | Other Opinions | messagemedia.co - Aitkin Independent Age

By: Lifestyle Desk | Updated: May 9, 2020 5:47:40 pm Keep your blood pressure under control during the pandemic. (Source: getty images)

Early studies surveying people with the novel coronavirus disease found that up to 30 per cent of them had hypertension, according to a report by The Lancet. So, how are hypertension and the risk of coronavirus related?

High blood pressure in itself does not cause an increased susceptibility to coronavirus. But from what we have seen so far, about one-fourth to half of the COVID-19 patients who had to be admitted had high blood pressure, among other ailments, Dr Nishith Chandra, cardiology, director-interventional cardiology, Fortis Escorts Heart Institute, told indianexpress.com.

He said, It has been seen that a lot of patients of COVID-19 are asymptomatic or show minor symptoms, and get better. A person with high blood pressure or other heart diseases, who is exposed to the virus, however, is more likely to require hospitalisation or even ventilation, as opposed to infected patients without blood pressure.

Read| How to stay calm during the coronavirus pandemic

Any comorbidity or existing medical condition like diabetes or heart disease may result in a more severe impact of the virus on the body due to a weaker immune system. Those who have high blood pressure and are already on medication may have compromised immunity. Again, elderly people with coronary heart disease or high blood pressure are more susceptible to the virus.

That said, people with high blood pressure should not be paranoid. Hypertension is a very common condition, with nearly 30-40 per cent of the adult population in India suffering from it. The good news is hypertension can be easily controlled. One should ideally strictly control blood pressure during the pandemic, the doctor advised. Here are some ways to do it.

1. Adhere to a good lifestyle; follow a healthy diet and keep yourself physically active by exercising.

2. Avoid excess salt in your food.

3. Eat fruits and vegetables that are rich in potassium like spinach, broccoli, apricots, raisins and dates.

4. Drink three to four litres of water daily to remain hydrated.

5. Limit the consumption of alcohol and caffeine to keep your blood pressure levels in check.

6. If you are unable to control blood pressure, consult your doctor without delay.

Read| Coronavirus and the elderly: All you need to know

A study published in The New England Journal of Medicine stated that blood pressure medicines do not put you at more risk of contracting the virus. Besides, on March 17, 2020, the American Heart Association, Heart Failure Society of America and the American College of Cardiology issued a joint statement to confirm that one should not stop taking the prescribed medicines for blood pressure. These medications dont increase your risk of contracting COVID-19. They are vital to maintaining your blood pressure levels to reduce your risk of heart attack, stroke and worsening heart disease, the guidelines read.

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COVID-19: What people with high blood pressure must know, from diet to medicine - The Indian Express

In the past week Ive been involved in three different medical appointments, one for my wife and two for myself. Those encounters portend fundamental changes all of us are going to experience moving forward.

Call us when you get to the parking lot, my dentists receptionist told me during a call Wednesday, in advance of a Thursday morning visit. When I did, she instructed me to enter the building.

A hygienist wearing a face mask and rubber gloves met me in the waiting room, holding a form on which there were eight questions she proceeded to ask.

The first was: Do you have a fever, or have you felt hot or feverish recently (14-21 days)?

She also asked if Id had a cough, or flu-like symptoms or shortness of breath. Down near the bottom was this one: Have you traveled in the past 14 days to any regions affected by COVID-19?

More or less, thats like asking if Id traveled anywhere, because the virus has struck just about everywhere, save the Mojave Desert and certain counties in Montana and Wyoming that have far more cows than people.

All the personnel in that dental office wore gloves and masks. And absent from the waiting room were any magazines whatsoever; in the past there were at least 25. The same was true at Vistar Eye Center on Jefferson Street, which I visited Thursday afternoon for a previously scheduled ophthalmologist appointment.

Two feet inside Vistars lobby, an attendant took my temperature as soon as I walked in. She stood behind a clear plastic shield with a cut-out that allowed her to extend her gloved hand, which held a small, no-touch electronic thermometer.

In Dr. Frank Cotters ophthalmology suite, everybody wore masks and gloves (which they changed after washing their hands in between each patient). Each treatment room was disinfected after a patient left it. Disinfecting wipes and lotions were strategically placed in the office, too.

Many of the chairs in Vistars waiting rooms were overturned to prevent patients sitting too closely together. Upright chairs were set apart at 6-foot distances.

Last weekend, Donna tripped and fell on a sidewalk along Grandin Road and injured her left arm. So I drove her to VelocityCare, the Carilion Clinic-owned urgent care center on Electric Road in the Tanglewood area. There, she answered the screening questions from the passenger seat of our SUV before they would let her in the door. (As it turned out, her arm was fractured.)

And those are the minor changes in medical treatment that youre likely to experience soon if you havent already. Its going to be that way for months into the foreseeable future, at the least.

For many appointments, you may not visit your physician at all. Instead, youre likely to wind up talking to them on the phone, or over a digital video link via broadband internet.

It is a whole new world, said Kim Roe, Carilion Clinics vice-president for family and community medicine. (She also oversees VelocityCare.)

Dr. Steve Morgan, a family practice physician and Carilions chief medical information officer, said prior to the pandemic, the health care provider had taken small steps toward telemedicine, mostly in psychiatry.

We were providing around 100 video visits per day, Morgan said. Now, were providing 600 to 700 video visits a day, across a variety of specialties, he said. Previous to the pandemic, Carilion expected it would be two years before they reached that volume of telemedicine visits.

We didnt anticipate it happening over 40 days, Morgan added.

Even primary care, which only a few months ago was nearly all person to person, is now often iPad to iPad or doctor and patient talking on the phone.

A friend of mine, Jeff Krasnow, experienced this firsthand during a recent annual physical with a non-Carilion doctor.

It was predominantly telemedicine, he told me.

What about the blood draw? I asked.

Krasnow said a couple of days before the video consultation with the doctor, he drove to his physicians office parking lot. There, a phlebotomist drew blood from his arm as he stuck it out his drivers-side window.

The pandemic has caused a physical shakeup in health care thats forced practitioners to differentiate between what needs to be brought into the office and what can be done on a digital platform, Roe told me.

Our patients have also seen the benefits of it, Morgan said. Many patients will see it as, this is a more convenient way to interact with [health care] providers.

Of course, telemedicine cant substitute for in- person doctor visits in every case. No doctor can yet put a broken limb in a cast via an iPad or smartphone. For that reason, Donna has an in-person appointment with an orthopedic surgeon Monday.

Roe said Carilion is also sensitive to the fact that not everyone owns technology that will allow video doctor visits. And even when patients do, they may not possess the technological savvy to make it happen.

Besides that, broadband isnt necessarily available in all rural areas Carilions geographic reach extends to Galax and Tazewell County.

And many patients, Roe noted, buy cellphone minutes in blocks. On any given day, they might not have enough phone minutes for a telephonic visit.

So office visits arent going away completely. But those patients can expect to see far fewer waiting-room magazines and far more masks and latex gloves, and to be screened for COVID-19 before they get in the door.

I think its important for your readers to know that, if they feel like they need services, theres a safe place for us to provide care to them, Roe said.

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CASEY: The brave new world of post-pandemic medicine - Roanoke Times

University Medical Center Hamburg-Eppendorf, Hamburg, Germany (D.W., J.S., M.L., S.S., C.E., A.H., F.H., H.M., I.K., A.S.S., C.B., G.D., A.N., D.F., S.P., S.S., C.B., M.M.A., M.A., K.P., S.K.)

Asklepios Hospital Barmbek, Hamburg, Germany (H.B., A.S.)

Bethesda Hospital Bergedorf, Hamburg, Germany (H.B.)

Agaplesion Diakonie Hospital, Hamburg, Germany (A.D.)

Amalie Sieveking Hospital, Hamburg, Germany (H.P.)

Asklepios Hospital Saint Georg, Hamburg, Germany (S.S.)

Financial Support: Institutional Funds of University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Disclosures: Dr. Nierhaus reports grants and personal fees from CytoSorbents Europe and personal fees from Thermo Fisher Scientific and Biotest outside the submitted work. Dr. Frings reports personal fees from Xenios outside the submitted work. Dr. Bokemeyer reports personal fees from Sanofi-Aventis, Merck KgaA, Bristol-Myers Squibb, Merck Sharp & Dohme, Lilly ImClone, Bayer, GSO Contract Research, AOK Rheinland/Hamburg, and Novartis outside the submitted work. Dr. Kluge reports grants from Ambu, E.T. View, Fisher & Paykel, Pfizer, and Xenios and personal fees from Amomed, ArjoHuntleigh, Astellas, Astra, Basilea, Bard, Bayer, Baxter, Biotest, CSL Behring, CytoSorbents, Fresenius, Gilead, MSD, Orion, Pfizer, Philips, Sedana, Sorin, Xenios, and Zoll outside the submitted work. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at http://www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-2003.

Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Eliseo Guallar, MD, MPH, DrPH, Deputy Editor, Statistics, reports that he has no financial relationships or interests to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Christina C. Wee, MD, MPH, Deputy Editor, reports employment with Beth Israel Deaconess Medical Center. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Yu-Xiao Yang, MD, MSCE, Deputy Editor, reports that he has no financial relationships or interest to disclose.

Reproducible Research Statement: Study protocol: Available with approval through written agreement with Dr. Wichmann (e-mail, d.wichmann@uke.de). Statistical code: Available from Dr. Kluge (e-mail, s.kluge@uke.de). Data set: Not available.

Corresponding Author: Dominic Wichmann, MD, Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany; e-mail, d.wichmann@uke.de.

Current Author Addresses: Drs. Wichmann, Burdelski, de Heer, Nierhaus, Frings, and Kluge: Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.

Drs. Sperhake, Edler, Heinemann, Heinrich, Mushumba, Kniep, Schrder, and Pschel: Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.

Drs. Ltgehetmann, Pfefferle, and Aepfelbacher: Institute of Medical Microbiology Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.

Dr. Steurer: Department of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.

Dr. Becker: Department of Pulmonology and Internal Intensive Care, Asklepios Hospital Barmbek, Rbenkamp 220, 22307 Hamburg, Germany.

Dr. Bredereke-Wiedling: Emergency Department, Bethesda Hospital Bergedorf, Glindersweg 80, 21029 Hamburg, Germany.

Dr. de Weerth: Department of Internal Medicine, Agaplesion Diakonie Hospital, Hohe Weide 17, 20259 Hamburg, Germany.

Dr. Paschen: Department of Anesthesiology and Intensive Care, Amalie Sieveking Hospital, Haselkamp 33, 22359 Hamburg, Germany.

Dr. Sheikhzadeh-Eggers: Emergency Department, Asklepios Hospital Saint Georg, Lohmhlenstrasse 5, 20099 Hamburg, Germany.

Dr. Stang: Department of Oncology, Asklepios Hospital Barmbek, Rbenkamp 220, 22307 Hamburg, Germany.

Drs. Schmiedel and Addo: Sections of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.

Dr. Bokemeyer: Department of Hematology and Oncology, Section of Pneumology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.

Author Contributions: Conception and design: D. Wichmann, J.P. Sperhake, F. Heinrich, S. Kluge.

Analysis and interpretation of the data: D. Wichmann, J.P. Sperhake, M. Ltgehetmann, S. Steurer, F. Heinrich, H. Mushumba, I. Kniep, A.S. Schrder, A. de Weerth, C. Bokemeyer, M.M. Addo, M. Aepfelbacher, S. Kluge.

Drafting of the article: D. Wichmann, J.P. Sperhake, M. Ltgehetmann, I. Kniep, S. Kluge.

Critical revision for important intellectual content: D. Wichmann, J.P. Sperhake, I. Kniep, C. Burdelski, G. de Heer, A. Nierhaus, A. de Weerth, A. Stang, S. Schmiedel, M.M. Addo, M. Aepfelbacher, S. Kluge.

Final approval of the article: D. Wichmann, J.P. Sperhake, M. Ltgehetmann, S. Steurer, C. Edler, A. Heinemann, F. Heinrich, H. Mushumba, I. Kniep, A.S. Schrder, C. Burdelski, G. de Heer, A. Nierhaus, D. Frings, S. Pfefferle, H. Becker, H. Bredereke-Wiedling, A. de Weerth, H. Paschen, S. Sheikhzadeh-Eggers, A. Stang, S. Schmiedel, C. Bokemeyer, M.M. Addo, M. Aepfelbacher, K. Pschel, S. Kluge.

Provision of study materials or patients: D. Wichmann, A. Heinemann, F. Heinrich, H. Mushumba, C. Burdelski, G. de Heer, A. deWeerth, S. Sheikhzadeh-Eggers, C. Bokemeyer, M.M. Addo, K. Pschel.

Statistical expertise: S. Kluge.

Obtaining of funding: M. Aepfelbacher.

Administrative, technical, or logistic support: D. Wichmann, J.P. Sperhake, S. Steurer, C. Edler, A. Heinemann, F. Heinrich, A.S. Schrder, C. Burdelski, M.M. Addo, S. Kluge.

Collection and assembly of data: D. Wichmann, J.P. Sperhake, M. Ltgehetmann, S. Steurer, C. Edler, F. Heinrich, H. Mushumba, I. Kniep, A.S. Schrder, G. de Heer, A. Nierhaus, D. Frings, S. Pfefferle, H. Becker, H. Bredereke-Wiedling, A. de Weerth, H.R. Paschen, A. Stang, S. Schmiedel, K. Pschel, S. Kluge.

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Autopsy Findings and Venous Thromboembolism in Patients With COVID-19 - Annals of Internal Medicine

Written by Chahat Rana | Chandigarh | Published: May 10, 2020 2:35:18 am According to Mittal, the Sector 46 hospital is the only private Ayurveda hospital amidst the total 18 selected by the Central Council of Research in Ayurvedic Sciences under the Ministry of AYUSH to conduct these trials. (Representational)

Trials of an Ayurveda medicine, AYUSH 64, on Covid-19 patients is set to begin at Shri Dhanwantri Ayurvedic College in Sector 46 of Chandigarh. The trial will be conducted only on asymptomatic patients or those with mild symptoms, 30 of whom have already been shifted to the college and hospital.

At least 20 more such patients are scheduled to be shifted to the college and hospital within the next few days. The hospital has a total capacity to house seventy such patients.

We already have 30 patients with us who have agreed for the trials. They will receive allopathic treatment, but we will also give them the Ayurvedic medicine AYUSH 64 and collate data on the efficacy of the medicine, which will be then given to the ICMR, says Dr Naresh Mittal, General Secretary of the college management committee.

According to Mittal, the Sector 46 hospital is the only private Ayurveda hospital amidst the total 18 selected by the Central Council of Research in Ayurvedic Sciences under the Ministry of AYUSH to conduct these trials.

The AYUSH ministry had announced Thursday that it will begin clinical research studies along with the Council of Scientific and Industrial research (CSIR) by conducting trials of four approved Ayurvedic medicines- Ashwagandha, Yashtimadhu, Guduchi Peepli and AYUSH 64. These studies will be done as joint initiative between the Ministry of AYUSH, Ministry of Health, Ministry of Science and Technology with the aid of CSIR and ICMR.

Earlier, the health secretary for Chandigarh had announced a sudden change of plans in which Covid-19 patients with mild symptoms or asymptomatic patients will be shifted to the Ayurveda hospital in Sector 46.

Apart from Ayurveda staff, one doctor from GMCH-32 will be attached to the hospital for allopathic care.

Once the capacity of the hospital is reached, asymptomatic patients or those with mild Covid-19 symptoms will be shifted to the Sood Dharamshala in Chandigarh.

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Ayurveda medicine trial to begin on asymptomatic Covid-19 patients in Chandigarh - The Indian Express