Month: July 2019

Study highlights inadequate effort of health care insurers to combat opioid epidemic

first_imgJun 22 2018Health care insurers including Medicare, Medicaid and major private insurers have not done enough to combat the opioid epidemic, suggests a study led by researchers at Johns Hopkins Bloomberg School of Public Health.The Bloomberg School researchers examined major insurers’ 2017 coverage policies for drugs to treat chronic lower-back pain, and concluded that these policies missed important opportunities to steer patients towards safer and more effective treatments than prescription opioids.”Our findings suggest that both public and private insurers, at least unwittingly, have contributed importantly to the epidemic,” says study senior author G. Caleb Alexander, MD, MS, associate professor in the Bloomberg School’s Department of Epidemiology and co-director of the Johns Hopkins Center for Drug Safety and Effectiveness.The study, which will be published online on Friday, June 22, in the journal JAMA Network Open, provides one of the most comprehensive looks ever at insurers’ pain coverage policies, and comes as the opioid epidemic continues to ravage communities across the country. The U.S. Department of Health and Human Services (HHS) has estimated that in 2016, the most recent year for which complete data are available, over 42,249 Americans died from opioid overdoses, the most of any year on record. More than 2.1 million Americans had an opioid use disorder (addiction) in 2016, with economic costs from the epidemic estimated to be as high as $504 billion dollars.Alexander and colleagues, with funding and technical assistance from the Office of the Assistant Secretary for Planning and Evaluation (ASPE) (DHHS), the National Institutes of Health and the Centers for Disease Control and Prevention (CDC), analyzed the coverage policies of 15 Medicaid plans, 15 Medicare Advantage plans and 20 commercial insurers in 2017. The team focused on common plan types within 16 states that together comprise about one-half of the U.S. population. Many of the states examined have been hit especially hard by the epidemic.In addition to analyzing plan details, the researchers also conducted in-depth interviews with over 43 senior health care executives that administered representative plans. The investigators focused on 62 prescription drugs used to treat chronic lower back pain, one of the most common types of chronic, non-cancer pain for which prescription opioids have been overused. Their analysis included 30 prescription opioids and 32 other drugs including non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants and topical analgesics.The analysis revealed that many insurers failed to apply evidence-based “utilization management” rules to discourage opioid overuse and encourage safer and more effective alternatives. What’s more, many of the utilization management rules in place were applied as often to non-opioids as opioids.”Opioids are just one tool in the pain management tool box, and unfortunately, many of the plans that we examined didn’t have well-developed policies in place to limit their overuse,” Alexander says.There are three types of common “utilization management”–quantity limits, step therapy and prior authorization.Related StoriesStudy reveals link between inflammatory diet and colorectal cancer riskLiving with advanced breast cancerNew research links “broken heart syndrome” to cancerWhile “quantity limits”–which restrict the number of pills that can be dispensed–were commonly used for opioids, they were generally for a 30-day supply, rather than a shorter supply as is recommended in the CDC Guideline for Prescribing Opioids for Chronic Pain. This is important since the duration of early prescriptions for opioids is associated with the likelihood that a patient will convert to chronic use. Since the study was initiated, several major insurers have begun implementing more stringent quantity limits on first prescriptions.”Step therapy”–which requires that treatment start with a less risky drug such as an NSAID, an over-the counter, anti-inflammatory and pain medication, and allows a riskier opioid only if the first drug fails to work–is another strategy to reduce inappropriate opioid use. But the researchers found that the plans they studied rarely required step therapy for opioids. Among the Medicaid plans, for example, a median of only 9 percent of covered opioids required step therapy. For commercial plans, the median figure was just 4 percent. Among the Medicare plans there were virtually no step therapy requirements for opioids.Similarly, the practice of “prior authorization,” in which the prescriber must contact the insurer for pre-approval before writing a prescription the insurer will cover, was applied to only a minority of covered opioids. Although, here too, some insurers have begun implementing policies such as requiring prior authorization for individuals with chronic, non-cancer pain, initiating treatment with extended release/long-acting (ER/LA) opioids.The researchers found too that both public and commercial plans tended to make covered opioids available relatively cheaply to patients. The median commercial plan, for example, placed 74 percent of opioid painkillers in Tier 1, the lowest cost category, and the median commercial co-pay for Tier 1 opioids was just $10 for a month’s supply.”To their credit, while every health plan we examined was actively trying to combat the epidemic, their focus was generally on utilization management and identifying high-volume prescribers and patients, rather than on comprehensive strategies to improve the treatment of chronic pain,” Alexander says. On the whole, these coverage policies “help explain why the opioid epidemic has taken root,” he adds.In 2016, the CDC issued recommendations for stricter limits on opioid prescribing, noting among other things that “Non-opioid therapy is preferred for chronic pain outside of active cancer, palliative, and end-of-life care.” These guidelines, as well as soaring rates of injuries and deaths from opioids, continue to shape changes in clinical practice.”Insurers can either be part of the problem, or part of the solution,” says Alexander. “The good news is that an increasing number of health plans are recognizing their contribution to the epidemic and developing new policies to address it. The bad news is that we have a very long way to go.”Source: https://www.jhsph.edu/news/news-releases/2018/health-insurance-plans-may-be-fueling-opioid-epidemic.htmllast_img read more

Scientists discover new way to predict healthy individuals at risk of developing

first_imgJul 10 2018An international team of leukemia scientists has discovered how to predict healthy individuals at risk of developing acute myeloid leukemia (AML), an aggressive and often deadly blood cancer.The findings, published today in Nature, illuminate the ‘black box of leukemia’ and answer the question of where, when and how the disease begins, says co-principal investigator Dr. John Dick, Senior Scientist at Princess Margaret Cancer Centre, University Health Network.”We have been able to identify people in the general population who have traces of mutations in their blood that represent the first steps in how normal blood cells begin on a pathway of becoming increasingly abnormal and puts them at risk of progressing to AML. We can find these traces up to 10 years before AML actually develops,” says Dr. Dick. “This long time window gives us the first opportunity to think about how to prevent AML.”Dr. Dick is also a Professor, Department of Molecular Genetics, University of Toronto, holds the Canada Research Chair in Stem Cell Biology, and is Co-Leader of the Acute Leukemia Translational Research Initiative at the Ontario Institute for Cancer Research.Study author Dr. Sagi Abelson, a post-doctoral fellow in the Dick lab, says: “AML is a devastating disease diagnosed too late, with a 90 per cent mortality rate after the age of 65. Our findings show it is possible to identify individuals in the general population who are at high risk of developing AML through a genetic test on a blood sample.”The ultimate goal is to identify these individuals and study how we can target the mutated blood cells long before the disease actually begins.”The study builds on Dr. Dick’s 2014 discovery that a pre-leukemic stem cell could be found lurking amongst all the leukemia cells that are present in the blood sample taken when a person is first diagnosed with AML. The pre-leukemic stem cell still functions normally but it has taken the first step in generating pathway of cells that became more and more abnormal resulting in AML (Nature, February 12, 2014), and continues his quest to trace every step in the evolution of AML, starting with blood cells from healthy people.Related StoriesHealthy lifestyle lowers dementia risk despite genetic predispositionMolecular switches may control lifespan and healthspan separately, genetic discovery suggestsStudy: Treatment of psychosis can be targeted to specific genetic mutation”Our 2014 study predicted that people with early mutations in their blood stem cells, long before the disease appears and makes them sick, should be able to be detected within the general population by testing a blood sample for the presence of the mutation.” says Dr. Dick.Co-principal investigator Dr. Liran Shlush, a former fellow in the Dick lab, and now Senior Scientist at the Weizmann Institute in Israel, led the approach to use data from a large European population health and lifestyle study that tracked 550,000 people over 20 years to determine correlations to cancer.The leukemia team extracted the data from more than 100 participants who developed AML six to 10 years after joining the study, plus the data from an age-matched cohort of more than 400 who did not develop the disease.Dr. Dick says: “We wanted to know if there was any difference between these two groups in the genetics of their ‘normal’ blood samples taken at enrollment. To find out, we developed a gene sequencing tool that captured the most common genes that get altered in AML and sequenced all the 500 blood samples.”The answer was “Yes”. The seeds of the blood system started picking up mutations years before an individual was diagnosed with AML, a finding that enabled the team to predict accurately who had been at risk of disease progression.Furthermore, the team used advanced computational technology to assay the information obtained from routinely collected blood tests taken over 15 years in Israel and housed in a massive database of 3.4 million electronic health records.The study has deepened our understanding of the distinction between AML and a common feature of aging called ARCH–age-related clonal hematopoiesis–whereby blood stem cells acquire mutations and become a little more proliferative. For the vast majority of people this is just a completely benign feature of aging.”Every AML patient has ARCH but not everyone with ARCH gets AML,” explains Dr. Dick. Source:https://www.uhn.ca/corporate/News/PressReleases/Pages/Leukemia_researchers_discover_genetic_screening_tool_to_predict_healthy_people_at_risk_for_developing_AML.aspxlast_img read more

Scientists identify pathways that reveal insights into mechanism of lung cancer etiology

first_img Source:https://www.dartmouth-hitchcock.org/ Aug 17 2018Lung cancer is the leading cause of preventable cancer death. A disease of complex origin, lung cancer is usually considered to result from effects of smoking and from multiple genetic variants. One of these genetic components, a chromosome named 15q25.1, has been previously identified as a leading influencer of susceptibility to lung cancer, smoking behavior, and nicotine addiction. However, no previous study has investigated the mechanisms of this lead agent, or documented the susceptibility pathways that allow this chromosome to modify development of disease.A research team led by Xuemie Ji, MD, PhD, Research Associate in Department of Biomedical Data Science at Dartmouth’s Geisel School of Medicine, helped solve this central problem. The team identified two main pathways involving the mechanism by which the chromosome 15q25.1 locus influences lung cancer risk. The first pathway is an interaction pathway in the nervous system that is implicated in nicotine dependence. The other pathway can control key components in many biological processes, such as transport of nutrients and ions, and the human immune system.Related StoriesBacteria in the birth canal linked to lower risk of ovarian cancerAdding immunotherapy after initial treatment improves survival in metastatic NSCLC patientsNew protein target for deadly ovarian cancerThe results have been newly published in Nature Communications. “Our findings in pathways uncover insights into the mechanism of lung cancer etiology and development, which will potentially shorten the interval between increasing biological knowledge and translation to patient care,” says Ji. “Blocking genes downstream or in parallel pathways might provide a strategy to treat such cancer.”The study used two independent cohorts of 42,901 individuals with a genome-wide set of genetic variants, as well as an expression dataset with lung tissue from 409 lung cancer patients to validate findings. Two different methods were used to analyze data, and confirm that the findings are reliable and can be repeated with different methods. “To our knowledge, this is the first study to explore the pathogenic pathways related to the mechanisms of chromosome 15q25.1 and the first to use a novel analysis approach to analyze data and to validate the findings,” says Ji. “The ability to block the damaging genetic variants downstream or in parallel pathways might improve lung cancer prognosis and survival, and therefore provide alternative strategies to treat such cancer.”The team is working to identify more mechanisms contributing to the increased risk of lung cancer. They aim to provide more explanation for the large unexplainable division of lung cancer occurrences.last_img read more

Star statistician Hans Rosling takes on Ebola

first_imgMONROVIA—Hans Rosling is a global health celebrity, a former head of the Division of Global Health at the Karolinska Institute in Stockholm whose riveting lectures have made him a star of TED talks, and a fixture of the World Economic Forum in Davos, Switzerland. But since 20 October, he has occupied room 319 of Liberia’s Ministry of Health & Social Welfare, a large yellow building not far from the Atlantic Ocean. Working alongside the country’s head of Ebola surveillance, Luke Bawo, he is helping the ministry make sense of the largest Ebola outbreak ever recorded.Rosling has come without any affiliation, which he says helps him stay independent. “He just walked into the office and introduced himself,” Bawo says.He feels bad about not coming earlier. Ebola arrived in Liberia from Guinea in March, then spread south to Monrovia, where it exploded in August. Hospitals were closed and Ebola treatment units were overwhelmed. “I thought the Ebola outbreak could be stopped locally,” Rosling says. “I just wasn’t smart enough.” (He also felt he was too old to work in a treatment unit.) Click to view the privacy policy. Required fields are indicated by an asterisk (*) Country * Afghanistan Aland Islands Albania Algeria Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia, Plurinational State of Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, the Democratic Republic of the Cook Islands Costa Rica Cote d’Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People’s Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People’s Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, the former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Martinique Mauritania Mauritius Mayotte Mexico Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Norway Oman Pakistan Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Qatar Reunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela, Bolivarian Republic of Vietnam Virgin Islands, British Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Emailcenter_img Sign up for our daily newsletter Get more great content like this delivered right to you! Country When he saw the epidemic curve go up in Sierra Leone and down in Liberia in October, he was skeptical, and he decided to find out firsthand what was happening. He canceled his lectures and contacted the Liberian government. “I’m not a virologist and I’m not a clinician, but I have considerable experience investigating messy epidemics in poor parts of Africa,” he says.A quarter-century ago, he faced a threat that seemed even more terrifying than Ebola. In August 1981, Rosling was working as a district medical officer in northern Mozambique when he sat in front of a line of 30 women and children whose legs had become paralyzed over the past month. “I had this big neurology book, and their disease did not exist in that book,” Rosling says. A South African submarine had been spotted in a nearby bay a few weeks earlier. “It was fully possible that it was biological warfare.”When he came home that evening, he told his wife to take their kids and drive them to a safer place a few hours away. He didn’t sleep the next 48 hours. “When you face a disease that may be infectious, 98% of your intellectual capacity becomes blocked. You become so scared, thinking you will die, thinking you may be crippled, thinking about your children.” It took 2 weeks before it became clear the affliction wasn’t contagious. (Now called konzo, it’s caused at least in part by toxic compounds in cassava roots.) A group of Italian nuns helped Rosling overcome his fears. “I don’t think I could have done this without them,” he says.The experience left Rosling with a cool approach to health crises and a keen sense of what it takes to fight a disease in one of the poorest parts of the world. Soon after he arrived in Monrovia, he became convinced that the Liberian decline is real, driven in large part by changes in behavior that reduce the risk of infection. Liberia now reports only some 10 new cases a day. That’s good news, but it also presents big new challenges. While Ebola was the main cause of death, safe burials were essential. Now that new infections are less common, people could in principle resume traditional funeral practices, which include contact with the body, for deaths not due to Ebola. But spreading that message could cause people to drop their guard with Ebola victims, too, leading to new infections. “Any decision will have many complicated consequences,” Rosling says.Rosling learned that lesson, too, in the konzo outbreak. Because he was initially unable to rule out an infectious disease, the Mozambican government set up a roadblock to stop the disease from spreading. A group of people took a boat along the coast to evade the blockade, and it sank. “I have stood there and seen the bodies of 18 women and children who drowned because of that roadblock,” he says. “That stays with you. Eighteen bodies of people you killed.”After he arrived in Monrovia, Rosling started by doing simple things, such as proofreading the ministry’s epidemiological reports, which he says nobody had time for. He changed an important detail in the updates: Rather than listing “0 cases” for counties that had not reported any numbers—which could be misleading—he left them blank. Next, he tackled the problem behind the missing data. Some health care workers couldn’t afford to call in their reports, because they were paying the phone charges themselves; Rosling set up a small fund to pay for scratch cards that gave them airtime.One of Hans Rosling’s recent “Factpods” on YouTube discussed the spread of Ebola in West Africa.Now, he’s focusing on how to get the number of new cases down to zero. That means finding every single case, tracing that patient’s contacts, and isolating all of those who show symptoms—a huge challenge in a country where many villages are hours away from a road, Ebola symptoms like diarrhea and fever are common, and the fear of the deadly virus drives some contacts to skip town and seek out a traditional healer. “We have to make a meticulously perfect system work in a country where such a system cannot exist,” he says. “This is the biggest intellectual challenge I have participated in in my life.”On a whiteboard in his office, Rosling has drawn a complicated flow chart to show how the information about patients and their contacts moves through the system. Data are lost at several steps. Some people die on the way to the hospital; others give different ages or names at different points. Rosling’s aim is to know how many of the newly discovered Ebola patients are already on one of the contact lists. But so far he has been struggling even to find out what county every patient is from.Others on the front lines welcome Rosling’s help. Kevin De Cock, who leads the U.S. Centers for Disease Control and Prevention (CDC) field team in Liberia, calls him “an eminent epidemiologist with immense African experience. He provides strong technical and intellectual input.” Bawo says he admires Rosling’s commitment but worries that he’s overstretching himself. “He is welcome to stay, but I make it my business that he takes one day off a week,” Bawo says. “Every Sunday I don’t call him, he does not call me, and I do not want him to send me an e-mail.”Rosling says he’s tired of the portrayal of Africa as a continent of incompetence, superstition, and rampant corruption. “I am astonished how good people are that I work with here, how dedicated, how serious,” he says. When The New York Times reported that governmental infighting was hampering the Ebola response, Rosling tweeted: “Don McNeil misrepresents Liberia’s EBOLA-response to win the MOST INCORRECT ARTICLE ABOUT EBOLA AWARD.” His self-assurance and impatience with opinions he disagrees with can grate on others. “I find him quite irritating,” says one Western colleague. “Mostly because he turns out to be right about most things.”Rosling is critical of Western nations’ response to the crisis. Whereas experts from elsewhere in Africa have come as colleagues and stayed for long periods of time, for instance, agencies like CDC replace their staff every few weeks, which Rosling says hampers continuity. (CDC is like Cuba, Rosling says: “Amazing people, bad system.”) The U.S. military won’t transport patients or even blood samples in their helicopters, he adds: “Welcome to the continent of less superstition.”Rosling eventually wrote his Ph.D. thesis about the konzo outbreak, helped set up the Swedish chapter of Doctors Without Borders, and became a professor of global health at the Karolinska Institute, where he retired in 2012. His talks still garner “obscene fees,” he says—some $600,000 annually—which he uses to finance the Gapminder Foundation, a nonprofit he set up to bring development statistics to a broad audience. His talks have been viewed by millions, 200,000 people follow him on Twitter, and he has rich and powerful fans. “Mark Zuckerberg called me yesterday,” he says at one point, to ask how his money could help fight Ebola.Rosling’s 2006 TED talk debunked myths about the developing world.In his talks, which feature dazzling graphics, Rosling is fond of emphasizing that most people’s view of the world is wrong. He often asks how many children get the standard childhood vaccinations—20%, 50%, or 80%? Most people answer 20%, but it’s 80%. “The problem is that the education systems in North America and Europe and the media have not conveyed a fact-based view of the world.”Similarly, many people lump everything from Turkey to Somalia together as the developing world, blurring the differences between middle-income countries and those dominated by extreme poverty. He likes to say that 1.5 billion people have a light bulb and a washing machine, 4 billion have only the light bulb, and about 1.5 billion have neither. The populations of Liberia, Guinea, and Sierra Leone mostly fall into the last category, he says. “And that is one reason we can have such a huge Ebola outbreak here.”Eradicating extreme poverty should be a top priority, says Rosling, who has been critical of programs that focus on a single disease, such as the multibillion-dollar initiative to eradicate polio. That has put him at odds with Bruce Aylward of the World Health Organization (WHO), who heads the campaign. Now, Aylward is also in charge of WHO’s Ebola response, but in this case, there’s no disagreement: “Ebola is different,” Rosling says, adding that Aylward gave him important guidance. Aylward praises Rosling as “great added value.”                Although he does not come into contact with Ebola patients, Rosling had one moment when his fear of infectious diseases returned. One night in his Monrovia hotel, he developed diarrhea. He skipped dinner and locked himself up in his room. “I had to plan. Should I tell my family? Should I not?” he says. He decided to take his temperature every 2 hours and monitor himself for additional symptoms. “But I did finish my report before I went to bed.” He felt fine the next morning, and he’s not planning to return to Sweden anytime soon. “I canceled Christmas with the family,” he says. “But I hope to be home for Midsummer’s Eve.”*The Ebola Files: Given the current Ebola outbreak, unprecedented in terms of number of people killed and rapid geographic spread, Science and Science Translational Medicine have made a collection of research and news articles on the viral disease freely available to researchers and the general public.last_img read more

RNA world inches closer to explaining origins of life

first_imgThe molecular dance that led to the origin of life billions of years ago remains one of the deepest mysteries in modern science. Though the exact choreography is forever lost to time, scientists now say they may have identified one of the key steps. Chemists in Germany today report a plausible way in which basic chemicals available on early Earth may have given rise to compounds called purines—chemicals that are a key ingredient of DNA, RNA, and energy metabolism in all cells.The new work is “very pretty chemistry,” says Gerald Joyce, a chemist at the Scripps Research Institute in San Diego, California, who specializes in the chemistry that may have given rise to life.Joyce and others have long suggested that one of the key early events in this process was the formation of RNA—a long chainlike molecule that conveys genetic information and speeds up other chemical reactions. Both of those functions were necessary for life to evolve. But sorting out how RNA itself may have arisen—and led to an “RNA world”—has been a struggle. 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Required fields are indicated by an asterisk (*) Emailcenter_img Sign up for our daily newsletter Get more great content like this delivered right to you! Country RNA is made up of four different chemical building blocks: adenine (A), guanine (G), cytosine (C), and uracil (U). Seven years ago, researchers led by the U.K. chemist John Sutherland showed a plausible series of steps by which chemical reactions on early Earth could have synthesized cytosine and uracil, also known as pyrimidines. But this route hasn’t been shown to give rise to adenine or guanine, RNA’s purine building blocks. Others partially succeeded in the purine quest. In 1972, the U.K. chemist Leslie Orgel and colleagues suggested one possible route for purine formation on early Earth. But it never seemed all that plausible, says Thomas Carell, a chemist at Ludwig Maximilian University of Munich in Germany. That’s in part because the process produced only tiny amounts of the purines so vital for life.“People have been looking for synthetic routes to making purines for 40 years,” Carell says.Carell and colleagues stumbled on a new lead several years ago, when they were studying how DNA is damaged. DNA is very similar to RNA, except that uracil is replaced with thymine. They were studying how a molecule called formamidopyrimidine (FaPy) reacts with DNA, and found it also readily reacts to form purines. So they decided to look into whether early Earth conditions could have given rise to FaPys, and thus purines.The first step was easy. It requires only hydrogen, cyanide, and water. Hydrogen cyanide, a simple molecule containing only three atoms—hydrogen, nitrogen, and carbon—is widely believed to have been abundant on early Earth. It readily reacts in water—also thought to be plentiful at the time—to form one of a class of molecules called aminopyrimidines, which contain several chemical groups called amines. Normally, these amines react indiscriminately to form a wide mix of different compounds. That’s a bad thing in this case, Carell explains, because most of those products wouldn’t be purines.Carell needed to find a way to stop all but one critical amine from reacting. “Initially I thought this would never work,” Carell says. But the solution, he says, was far simpler than he expected. When Carell’s team spiked their solution with just a bit of an acid—also widely considered abundant on early Earth—a reaction caused an extra proton from the acid to attach to the aminopyrimidine. That extra proton killed the reactivity of all but one of the amine groups on the molecule. And much to Carell’s delight, the lone amine that stayed reactive was precisely the one that reacts to form a purine.That’s not all. Further lab results presented today in Science show that the reactive amine on the aminopyrimidine readily bonds with either formic acid or formamide. Last year, the Rosetta space probe detected both of those chemicals on a comet, so scientists think they also probably rained down on early Earth. Once the bonds have formed, products of those reactions then eagerly react with sugars to create large quantities of purines. “It’s like a domino cascade,” Carell says.Mic drop? Not so fast, says Steven Benner, a chemist and origin of life expert at the Foundation for Applied Molecular Evolution in Alachua, Florida. Benner agrees that the newly suggested purine synthesis is a “major step forward” for the field. But even if it’s correct, he says, the chemical conditions that gave rise to the purines still don’t match those that Sutherland’s group suggests may have led to the pyrimidines. So just how As, Gs, Cs, and Us would have ended up together isn’t yet clear. And even if all the RNA bases were in the same place at the same time, it’s still not obvious what drove the bases to link up to form full-fledged RNAs, Benner says.We’re here, so it must have happened somehow. But RNA-world researchers still need to line up a few more dominoes before one of the greatest mysteries of life will be truly solved.last_img read more

Inside the global campaign to get rid of rabies

first_imgInside the global campaign to get rid of rabies Zipline Taking aim at a global scourge The World Health Organization and other groups have announced the goal of eliminating rabies as a public health problem. The key to fighting it: vaccinating dogs. © Felix Lankester During a campaign in Siaya County in Kenya, vets vaccinated 15,000 dogs against rabies in 10 days. In theory, nobody should die from rabies. It’s one of the few viral diseases where administering a vaccine after exposure can still save your life. Developing countries try to provide enough doses to hospitals and clinics. Unfortunately, supplies often run out. People who can’t afford to buy the jabs from private pharmacies, or don’t get them in time, are doomed. Untreated rabies is the deadliest of all diseases, fatal almost without exception. Sign up for our daily newsletter Get more great content like this delivered right to you! Country (Graphic) V. Altounian/Science; (Data) M. C. Schneider et al., Cadernos de Saude Publica, Rio de Janeiro, 23 (9): 2049–2063, Set, 2007; Philosophical Transactions of the Royal Society B 2013 368, 20120143 (24 June 2013) Email By Erik StokstadJan. 19, 2017 , 9:00 AM Katie Hampson, veterinary epidemiologist, University of Glasgow A campaign pays off Some developing countries have succeeded in eliminating rabies. Others have made great progress. As Sri Lanka ramped up dog vaccinations, for example, human deaths declined. The country has also spent heavily on postexposure vaccines, further cutting deaths. Sarah Cleaveland (left) came to Serengeti National Park in Tanzania to study rabies in wildlife. Concerned about human deaths, she now advocates for rabies elimination in dogs. ‹› On its way out Countries in Latin America and the Caribbean have made steady progress toward eliminating canine rabies. With help from the Pan American Health Organization, they jointly purchase and share vaccines, use standardized surveillance, and coordinate vaccination along borders. A cat brought in a bag to a vaccination campaign in Kenya. Cats, too, can transmit rabies to humans. That’s why the global plan calls for cheaper and faster treatment for people. But its long-term bet is on vaccinating domestic dogs, which pose the biggest threat to people in the developing world. “It’s the only way you’re going to eliminate the problem,” says Louise Taylor, scientific director of the Global Alliance for Rabies Control, an advocacy group based in Manhattan, Kansas. To rid a canine population of the virus, vets aim to immunize at least 70% of dogs for several years. After that, a lower coverage level suffices to keep outbreaks at bay. In Mugumu, a dusty town on the northwestern side of the park, researchers are trying to quantify the benefits of dog vaccination. Ahmed Lugalo, a veterinary epidemiologist affiliated with Sokoine University of Agriculture in Morogoro, Tanzania, follows up on dog bites and rabies cases recorded in logbooks from clinics and hospitals. He also has a network of dozens of paraveterinary assistants in surrounding villages who keep an ear out for reports of rabid dogs, conduct interviews, and, when possible, take brain samples of dogs suspected to have died of rabies. The effort, directed by veterinary epidemiologist Katie Hampson of the University of Glasgow and funded by the Wellcome Trust, provides data that allow researchers to create and test models of rabies transmission and the effects of vaccination.On a recent afternoon, Lugalo and a paravet drive to the outskirts of Mugumu to interview Ghati Muhingira about a serious dog bite. Her children play nearby, as scrawny chickens peck in the dirt yard. A breeze rustles corn fields. This past August, Muhingira’s oldest daughter, Asha, was bitten on her leg by a dog as she walked to school. Gazing vacantly into the distance, Muhingira says that after she saw the deep wound, she called a motorbike taxi and rushed 7-year-old Asha to the hospital. The staff only gave her a tetanus injection, because the dog’s owner said it had been protected against rabies.In early October, Asha told her mother that her healed leg was aching. Two days later, when she became feverish and had trouble swallowing, her mother took her to the hospital. It was rabies. The owner of the dog had lied about its vaccination. A few hours before she died, Asha, delirious, thought she saw her school teacher and called out: “I’m healed. I want to go home.”Later in the day, Lugalo says that such stories take an emotional toll—he recently became a father himself. During the interview, however, he’s all business. He asks how much Muhingira spent on the hospital visit. Then he asks about the dog. It had bitten another child, Muhingira says. Lugalo advises her to get her own dog immunized, and the team leaves to interview the mother of the other victim. Not taking any chances, she had already gotten her daughter vaccinated. The dog owner, who lived next door, boarded up his house after the police started an investigation. “He has run away, like his mad dog,” says Lugalo’s co-worker Matthias Magoto, shaking his head. Country * Afghanistan Aland Islands Albania Algeria Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia, Plurinational State of Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, the Democratic Republic of the Cook Islands Costa Rica Cote d’Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People’s Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People’s Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, the former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Martinique Mauritania Mauritius Mayotte Mexico Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Norway Oman Pakistan Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Qatar Reunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela, Bolivarian Republic of Vietnam Virgin Islands, British Wallis and Futuna Western Sahara Yemen Zambia Zimbabwecenter_img J. You/Science; (Data) Public Health Veterinary Services, Sri Lanka Ministry of Health © Natalia Jidovanu © Natalia Jidovanu This strategy has stopped rabies as a killer in developed nations. Elsewhere, the challenges are enormous, and nowhere bigger than in sub-Saharan Africa. Poor countries can hardly pay for millions of dogs to be vaccinated, and their governments often have trouble organizing vaccination campaigns across vast rural areas—even if they have the political will. Big donors, for their part, prefer to work on diseases with a higher death toll or believe that reaching enough dogs is too complicated.In fact, dog campaigns are relatively straightforward, but they often face obstacles. The veterinary teams that typically run them don’t work together with public health authorities and tend to prioritize cattle and other valuable livestock, which usually die of other diseases. “In Africa, what’s a dog? It’s worth nothing,” says Jens Fissenebert, who runs Mbwa Wa Africa, an animal welfare charity near Arusha, Tanzania. “The connection with saving human lives is not there.”Now, in pilot projects underway in Tanzania, Kenya, and a few other African countries, scientists are testing strategies for reaching and vaccinating dogs more efficiently. They are also collecting data to pin down the toll of rabies, demonstrate the connection between dog vaccination and human health in poorer countries, and quantify the economic benefits of national campaigns.Although the 2030 target seems improbable, if not impossible, proponents point to a few successful efforts—including the brief defeat of dog rabies in N’Djamena, the capital of dirt-poor Chad—to show that the disease can be beaten back even in Africa. “It’s not going to be fast, easy, or inexpensive,” says Charles Rupprecht, a rabies expert and consultant near Atlanta. “But it can be done.”THE RABIES VIRUS IS A MARVEL of biological ingenuity, cruelly manipulating its host’s behavior to further its own reproduction. After a dog becomes infected, usually through a bite by another dog, the virus travels to the brain and renders the animal hyper-aggressive and excitable, with a hoarse howl. The virus also spreads to the salivary glands, which start producing saliva laden with billions of viral copies. By interfering with the pharyngeal nerves, the virus makes it hard for the dog to swallow, leading to more saliva and increased chances of transmission.The disease is similarly gruesome in humans. In what’s known as paralytic rabies, about one in five patients slips into a coma and dies of respiratory and heart failure. Furious rabies is even worse, with symptoms including fear of water—even to drink—spasms, terror, and aggression. Human-to-human transmission of rabies is believed to be extremely rare, and has only been documented from a few organ or cornea transplants. Only 15 people are known to have survived rabies, and almost all had been at least partially immunized.Louis Pasteur developed the first rabies vaccine, made from the dried spinal cords of infected rabbits, and famously used it to save the life of a 9-year-old Parisian boy in 1885. Today’s versions are produced from virus grown in cultures of human cells, then chemically sterilized; they are more effective, far less painful, and have fewer side effects. Three to five jabs over several weeks will prevent the virus from reaching the brain if given quickly enough. A dose of rabies antibodies is also recommended for people not previously inoculated.Dog vaccines were first developed in the 1920s. Still, it took decades to eliminate rabid dogs as a public health threat in Europe, Japan, and elsewhere. Now, Latin America is on the verge of replicating the success (see timeline, below), following a concerted and coordinated campaign that reaches 40 million to 50 million dogs each year. Delivery of postexposure rabies vaccines to remote clinics can be delayed by bad roads, especially in the rainy season. In October 2016, Rwanda’s Ministry of Health began an experiment with drones to transport vaccines and supplies of rare blood types. Delivery of postexposure rabies vaccines to remote clinics can be delayed by bad roads, especially in the rainy season. In October 2016, Rwanda’s Ministry of Health began an experiment with drones to transport vaccines and supplies of rare blood types. Rabies can never be wiped off the face of the planet, as smallpox was, because so many mammal species harbor it. These reservoirs pose a continuing, albeit minor risk for humans: In the United States, one or two people still die each year after being bitten by rabies-infected bats. In Eastern Europe, rabid foxes are a concern.As with other neglected diseases, it is difficult to know the exact human toll. Asia currently suffers the highest number of deaths, an estimated 35,000. Africa has fewer, but the individual risk of dying of rabies is particularly high in sub-Saharan countries (see map, p. 241) because of the many unvaccinated dogs—they’re widely used for guarding livestock and homes—and underfunded health systems.”DANGER! DANGER! RABIES KILLS” says the poster on the mud-brick building. A makeshift clinic has been unloaded from a battered Land Rover in Ligamba, a small village in the Mara region here, to offer free shots for dogs. In the shade of a tree, Imam Mzimbiri wields a hypodermic needle. He tells a middle-aged man to grasp the neck of his large dog. The man digs his sandals into the sand, but the dog leaps away and nearly breaks his rope leash. Mzimbiri, a veterinarian with the Serengeti Health Initiative run by the Lincoln Park Zoo in Chicago, Illinois, casually walks off and then circles back behind the dog. He darts in and jabs the needle into its thigh. “This one was hard to handle,” he says.Mostly, the animals cooperate. Over several hours, the team vaccinates 145 dogs. Traveling to all the villages within 10 kilometers of Serengeti National Park, Mzimbiri and his team notch up 45,000 dogs a year. They also vaccinate the occasional cat; although cats are uncommon pets in Africa and not a reservoir of the virus, they can transmit rabies to people.The work has helped make this part of Tanzania an exemplar of progress in the fight against rabies. The campaign started out of concern for endangered African wild dogs (Lycaon pictus), which had died out in Serengeti National Park from rabies. In 2002, the U.S. National Science Foundation provided $1.5 million for a study of carnivore disease ecology in the park. As part of the work, veterinary epidemiologist Sarah Cleaveland of the University of Glasgow in the United Kingdom and colleagues started vaccinating dogs around the borders, hoping to keep rabies from spreading to other wildlife in the Serengeti.Cleaveland quickly became equally concerned about rabies’s impact on people. “As soon as you start studying rabies in wildlife, you’re confronted by the human tragedy,” she says. Fortunately, the dog campaign helped bring down human cases and alleviated other hardships. Villagers bitten by a rabid dog can spend 25% of their annual income on inoculations, which cost an average of $60 for a full five shots. (Most people get three.) And rabid dogs can infect cattle, driving annual livestock losses across Africa that cost some $280 million a year. Zipline A cat brought in a bag to a vaccination campaign in Kenya. Cats, too, can transmit rabies to humans. Click to view the privacy policy. Required fields are indicated by an asterisk (*) (Graphic) J. You/Science; (Data) K. Hampson et al., PLOS Neglected Tropical Diseases 9 (16 APRIL 2015) ©PLOS One © Natalia Jidovanu Africa’s rabies researchers see things that policymakers will never see. They are able to give a voice that otherwise won’t be heard. Vaccination events are often held at primary schools or during holidays to boost the turnout of children and their puppies. On a Sunday evening last July, Flora Gichonge was walking with her friends to church near the village of Gesarya, Tanzania. Suddenly, they were attacked by something hellish: A rabid dog, foaming at the mouth, charged out of the dense bushes lining the dirt road. “We tried to run away, in fear,” the 25-year-old recalls. But she tripped and fell. The dog lunged and bit her in the backside before her friends drove it away by throwing stones.After Gichonge limped home, a relative urged her to travel the 16 kilometers to the nearest hospital to get immunized against rabies. Her husband, a businessman, had the $40 to buy three doses of the life-saving vaccine from a pharmacy. A few days later, she was back at work, gathering and selling nuts. She knows she was lucky, although now she’s afraid of strange dogs.Many others are less fortunate. An estimated 59,000 people die from rabies worldwide each year, almost all infected by dogs. Malaria, HIV, and tuberculosis take much higher tolls. But the horrible suffering caused by rabies—some patients have convulsions and become aggressive, just like rabid dogs—and the fact that many victims are children led the World Health Organization (WHO) and other groups in 2015 to announce a goal to eliminate rabies deaths worldwide by 2030. © Natalia Jidovanu IT’S PAINSTAKING WORK like this that helps clarify the true burden of rabies. Cleaveland has developed a now widely used method to estimate the death toll, using the numbers of bites by dogs thought to be rabid, as well as records of postexposure vaccine use. The best estimate for the current toll in Africa, 21,000 deaths, comes from a 2015 paper by Hampson and colleagues; it’s 100 times higher than official figures.The initial numbers from the Serengeti were enough to turn Cleaveland into an advocate for better control of rabies and, ultimately, its elimination. She helped WHO win what became $12 million from the Bill & Melinda Gates Foundation for pilot projects in Tanzania, South Africa’s KwaZulu Natal province, and the Philippines.Starting in 2010, government workers began to vaccinate 150,000 dogs across Tanzania’s southeast, covering about 18% of the country, and on the island of Pemba in the north. Health and veterinary workers used text message questionnaires to report dog bites and use of human vaccine, which led to better, faster, and cheaper surveillance, researchers reported in PLOS Medicine last April. By the third year, 65% of dogs in the target villages had been vaccinated, on average. The coverage was lower in remote villages.The effort halved the number of reported dog bites overall, and rabies appears to be almost gone from about a third of the 28 districts in the program. For 2 years the dog population on Pemba was free of the virus. Unfortunately, this past August, an infected dog brought in from the mainland caused a small outbreak. “It was really disappointing,” Hampson says.The main lesson of the pilot: Eliminating rabies in Tanzania, although feasible, may be a logistical challenge, and surprisingly expensive. An audit by Rupprecht and colleagues found that costs ranged from $7.30 to $11.27 per dog, much more than the $1 to $1.50 they had expected. Higher startup costs, such as vehicles and other equipment, contributed, but the bulk of the bill was due to per diem payments that Tanzania charged WHO for the services of government vets.The government is now drawing up a strategy to expand the scheme to the entire country. Tanzania will have to do the job without support from the Gates Foundation, however, which funded only pilot projects, hoping that governments and other donors would then take over. The test of Tanzania’s resolve will come in September, when the next vaccination round is due to start.A FEW OTHER CAMPAIGNS have emboldened rabies fighters in sub-Saharan Africa. A team led by Jakob Zinsstag, a veterinary epidemiologist at the Swiss Tropical and Public Health Institute in Basel, eliminated canine-transmitted rabies for 2 years in N’Djamena, although one rabid dog was detected in 2014, apparently an invader from the countryside. KwaZulu-Natal has seen success at a bigger scale. In 2007, rabies cases in dogs and humans were at their highest recorded levels; they have declined dramatically thanks to vaccination efforts supported by another Gates Foundation–funded program. Kenya is the latest country to get on board, with growing political support. It released a national strategy for rabies elimination in 2014 and has started two pilot projects.Even national success won’t be enough in the long run, says Thumbi Mwangi, a veterinary epidemiologist at Washington State University (WSU) in Pullman and an adviser to Kenya’s Zoonotic Disease Unit. “The day we have fully eliminated rabies in Kenya, we will start to get incursions” from neighboring countries, he says. Ultimately, Africa will need to develop the kind of regional cooperation that has worked well in Latin America.For Africa as a whole, rabies elimination would cost between $800 million to $1.55 billion, says François-Xavier Meslin, a former director of neglected tropical diseases at WHO in Geneva, Switzerland. The price could come down, however. In 2012, the World Organisation for Animal Health started a “virtual” dog vaccine bank, which lowers prices by allowing buyers to purchase collectively. Another potential saver emerged just 2 months ago. Until now, the dog vaccine has always had to be kept below 8°C—impossible in far-flung villages without electricity. In November 2016, scientists reported that the vaccine works just as well if it has been kept for 3 months at 30°C or for 6 months at 25°C, potentially enabling remote communities to keep vaccines on hand and immunize their dogs by themselves. “It could be transformative,” says WSU’s Felix Lankester, director of the Serengeti Health Initiative, who led the study.There may even be a way to free up millions of dollars for dog vaccinations. GAVI, the Vaccine Alliance, will consider rabies when it reviews its $1.6 billion investment strategy in 2018. GAVI does not pay for animal vaccines, yet it would save many lives by providing human postexposure vaccines to developing countries, advocates say; governments could then use some of their health budget for dog vaccines instead. Some experts worry, however, that the availability of more human vaccine could actually lower the pressure to eliminate rabies in dogs and thus perpetuate the problem.Slow-moving governments and hesitant donors have left some advocates frustrated. “I just have this anger bubbling up about why we think it is OK to let this go on,” Cleaveland says. But Hampson is hopeful that the stories collected in the field—including those of Asha’s death and Flora’s survival—will ultimately make a difference. Africa’s rabies researchers, she says, “see things that policymakers will never see. They are able to give a voice that otherwise won’t be heard.”last_img read more

Lawmakers move closer to funding Trumps border wall worrying biologists trying to

first_img Email UA/USFWS/Flickr (Public domain) Lawmakers move closer to funding Trump’s border wall, worrying biologists trying to save endangered species An automated camera captured this male jaguar in Arizona’s Santa Rita Mountains in 2015. The House of Representatives yesterday approved a spending bill that includes $1.6 billion to start building the “contiguous and impassable wall” along the U.S. border with Mexico that President Donald Trump made a centerpiece promise of his campaign for the White House. The wall funding is expected to encounter stiff resistance from Democrats in the Senate, who have vowed to block the project. But the House’s move is worrying some researchers who are closely following the funding battle: conservation biologists who are concerned a wall could further complicate efforts to save species that routinely move between the two nations.“[As conservation researchers,] we see beyond borders. The way we see conservation does not stop at a political border just because our interests stop there,” says Sergio Avila, a conservation scientist at the Arizona-Sonora Desert Museum in Tucson.One of those species is the jaguar (Panthera onca), a species sometimes described as a “reluctant warrior” for its powerful jaws but shyness around humans. The jaguar once ranged as far north as the Grand Canyon in Arizona and as far south as Argentina. These days, however, jaguars occupy 60% of that historic range, and are mostly absent from the United States, where the cat is classified as endangered under the U.S. Endangered Species Act (ESA). Efforts to restore U.S. populations had been mired in a multidecade struggle to develop a workable strategy. But last year that effort reached a landmark of sorts: the release of a 508-page draft recovery plan developed by a multinational team of experts. It lays out a 50-year roadmap for rebuilding jaguar populations that could cost some $600 million to fully implement. Even under the most optimistic scenarios, the plan faces formidable obstacles. It is still at least a year away from being finalized, and it is not a legally binding document—so it will be up to Congress and the Secretary of the Interior to request and provide the needed funding.Wall uncertaintyNow, Trump’s proposed wall is presenting another challenge to the jaguar’s future. Biologists say the barrier could block paths the cats have historically used to move across the border, and could be key to allowing it to recolonize in the United States.Jaguar enthusiasts note that, ironically, the battle over the wall comes just as U.S. researchers have had one of their best years for jaguar sightings in a long time. Three different animals were spotted in the United States in 2016, including one cat never seen before. It was photographed in the Dos Cabezas Mountains, 96 kilometers north of the U.S.–Mexico border. That’s the farthest north of Mexico a jaguar has been seen in decades, the Arizona Republic reported. “That’s a pretty big deal,” says Howard Quigley, executive director of the jaguar program at Panthera, a group based in New York City with researchers spread across the continent, who co-led the science team that helped write the jaguar recovery plan.There is still no clear plan for what Trump’s wall might look like, or exactly where along the border it would be built. More than 1050 kilometers of fencing already exist along the 3201-kilometer frontier between the two nations, according to the Department of Homeland Security (DHS). And earlier this year, designers submitted more than 200 possible configurations for filling the gaps,  including plans for solid concrete barriers dozens of meters high as well as more permeable structures, in response to a DHS request. (Trump has suggested it could be a clear barrier adorned with solar panels, which would produce electricity that could be sold to help pay for the wall’s construction.)Normally, such a massive federal construction project would have to go through environmental reviews that can take years. The U.S. Fish and Wildlife Service, for example, would have to weigh in on how the wall might affect any species listed under the ESA, such as the jaguar. But earlier this year, Interior Secretary Ryan Zinke suggested the White House might invoke a provision of a 2005 immigration law that could allow federal officials to sidestep those reviews. Such moves would likely draw lawsuits from environmental groups and others.Recovering the “reluctant warrior”All of the jaguars seen in the United States—about one every 3 years—are believed to have originated from a population located about 210 kilometers south of the border. That’s why one major focus of the draft recovery plan is maintaining “connectivity” between the two nations, by protecting cross-border corridors that connect Arizona, New Mexico, and the Mexican states of Sonora and Chihuahua. In particular, biologists want to enable Mexican jaguars to use some of the 309,263 hectares of land in the Southwestern United States that biologists have identified as “critical habitat.”Maintaining such an expansive range is especially crucial for the jaguar, biologists say, because unlike other large carnivores that occur over large landscapes, jaguars do not have genetically distinct subpopulations. That means “whether you take the DNA of a jaguar from northern Argentina or from northern Mexico, they are essentially genetically the same,” Quigley says. The best way to maintain a diverse, healthy population is to allow cats from various regions to intermingle, enabling genes to flow throughout the population.Biologists warn that when species lose large swaths of habitat and get cut off from other populations, they face the devastating health effects associated with inbreeding.  Compared to their South American relatives, jaguars living in Mexico have the lowest genetic diversity of the species, Quigley and colleagues concluded in a 2016 study appearing in PLOS ONE.“Eventually, they’re so unhealthy that they can’t survive and they’re their own worst enemy,” says Melanie Culver, a conservation geneticist at the University of Arizona in Tucson who worked on the recovery plan.Fences and walls complicate that intermingling, notes the recovery plan, which received “well over 200 emailed comments and a handful of written letters” during a public comment period, according to the Arizona Daily Star. And biologists fear a border wall—if ever funded by Congress and built—could entirely block the cat from the northern United States end of its historic range.But any wall is unlikely to prevent humans from moving across the border, say wall critics. To underline that point, some cite a quote from Janet Napolitano, a former governor of Arizona and Secretary of Homeland Security under President Barack Obama: “Show me a 50-foot wall and I’ll show you a 51-foot ladder,” Napolitano said in 2005.“Humans will always be able to get across—they’ll find a way,” Culver says. “But the wildlife eventually will lose their ability. They can’t go out and buy a ladder.”The Congressional battle over funding the wall is likely to continue for months, or even years.Rachael Lallensack is an intern with Nature in Washington, D.C. She reported and wrote this story while an intern at Science.center_img Click to view the privacy policy. Required fields are indicated by an asterisk (*) Country * Afghanistan Aland Islands Albania Algeria Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia, Plurinational State of Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, the Democratic Republic of the Cook Islands Costa Rica Cote d’Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People’s Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People’s Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, the former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Martinique Mauritania Mauritius Mayotte Mexico Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Norway Oman Pakistan Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Qatar Reunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela, Bolivarian Republic of Vietnam Virgin Islands, British Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe By Rachael LallensackJul. 28, 2017 , 11:30 AM Sign up for our daily newsletter Get more great content like this delivered right to you! 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Plants outweigh all other life on Earth

first_img 0.02 Humans Archaea Livestock Measured in terms of carbon content (to factor out variable components like water), all life on Earth weighs about 550 gigatons. Of that, plants make up 450 gigatons of carbon (GT C), followed by bacteria at 70 GT C and fungi at 12 GT C, scientists report today in the Proceedings of the National Academy of Sciences. Animals comprise a mere 2 GT C, of which half are arthropods—including insects, spiders, and crustaceans. And although humans weigh in at just 0.06 GT C—on par with krill and termites—our impact on biomass since the beginning of civilization has been huge, scientists say. Humans and their cattle, pigs, and other livestock outweigh wild mammals by more than 20-fold; similarly, domesticated fowl surpass all other birds. Humans have also had an impact on plant biomass, which has been cut in half in the past 10,000 years.To figure out the biomass of each creature, quantitative biologists spent 3 years combing the scientific literature. But their ultimate goal wasn’t to figure out how much life weighs—it was to discover the most abundant protein on the planet. They’re still working on that question (subsurface microbes presented them with a particular challenge), but they hope to answer it within the coming year. Wild 0.002 0.06 2 Cnidarians 450 GT C 0.2 Animals 0.2 Protists 70 8 Plants outweigh all other life on Earth mammals Plants pack more heft than any other kingdom of life on the planet, making up 80% of all the carbon stored in living creatures. That’s just one surprise in a comprehensive new survey of Earth’s biomass, which finds that groups with the greatest number of species—such as arthropods—aren’t necessarily the heaviest. Kingdoms of life N. Desai/Science Plants Nematodes 1 GT C Animals 0.007 0.7 Fish Viruses 0.1 Wild birds Michael Hanson/Aurora Photos Annelids Molluscs By Elizabeth PennisiMay. 21, 2018 , 3:25 PM 12 4 Arthropods 0.2 Bacteria Fungi 0.1last_img read more

NCI Director Norman Sharpless named acting FDA chief

first_img NCI Director Norman Sharpless named acting FDA chief Ned Sharpless Email Click to view the privacy policy. Required fields are indicated by an asterisk (*) By Jocelyn KaiserMar. 12, 2019 , 2:45 PM Country * Afghanistan Aland Islands Albania Algeria Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia, Plurinational State of Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, the Democratic Republic of the Cook Islands Costa Rica Cote d’Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People’s Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People’s Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, the former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Martinique Mauritania Mauritius Mayotte Mexico Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Norway Oman Pakistan Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Qatar Reunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela, Bolivarian Republic of Vietnam Virgin Islands, British Wallis and Futuna Western Sahara Yemen Zambia Zimbabwecenter_img Sharpless has bolstered support for NCI-funded clinical trials and freed up funds for research grants by trimming the internal NCI budget. He introduced a new policy to support promising young investigators by adding 2 years to their initial 5-year research grants. A champion of big data, Sharpless had just begun to shape a plan to spend $50 million in 2020 in part to share data on pediatric cancer patients as part of a 10-year childhood cancer initiative proposed by President Donald Trump. Although he does not have an industry background, he has started two biotech companies.The highly regarded Gottlieb reportedly recommended Sharpless as his replacement. He tweeted today: “I’m delighted by the announcement from @SecAzar that @NCIDirector will serve as acting commissioner of #FDA. Ned is a friend to FDA, a great public health champion, a dedicated physician, and will be warmly welcomed into his new role. FDA will benefit greatly from his leadership.”NCI Deputy Director Douglas Lowy, who served a stint as acting NCI director from April 2015 to October 2017, will again step in as acting NCI director. Norman Sharpless, director of the National Cancer Institute (NCI) in Bethesda, Maryland, will become acting administrator of the U.S. Food and Drug Administration (FDA) in Silver Spring, Maryland, after current FDA chief Scott Gottlieb steps down in early April.The announcement came this morning from Health and Human Services Secretary Alex Azar at a U.S. House of Representatives hearing. “Dr. Sharpless’ deep scientific background and expertise will make him a strong leader for FDA,” Azar said in a statement. “There will be no let-up in the agency’s focus, from ongoing efforts on drug approvals and combating the opioid crisis to modernizing food safety and addressing the rapid rise in youth use of e-cigarettes.”Gottlieb’s resignation to spend more time with his young family in Connecticut rattled markets and FDA watchers when it was announced last week. That uncertainty is at least temporarily eased by the acting appointment of Sharpless, a physician-scientist and former director of the University of North Carolina’s cancer center in Chapel Hill who has drawn praise as NCI director since October 2017. Sign up for our daily newsletter Get more great content like this delivered right to you! Country Daniel Sone/National Cancer Institute last_img read more

11 Prince Tributes

first_img 5. The Cast Of ‘The Color Purple’ Goes In A Tribute to Prince from the cast of The Color Purple | THE COLOR PURPLE on Broadway https://t.co/JLo5QINHYx pic.twitter.com/s9ilzeXiJu— TheTrendz (@thetrendz101) January 9, 2017 9. Bruno Mars Rocks Out At The Grammys The @dwdrums played during @BrunoMars 59th #GRAMMYs @prince tribute is on display! Enter to win a signed replica: https://t.co/vAO1puCTko pic.twitter.com/fV7OhtHEq1— GRAMMY Museum (@GRAMMYMuseum) March 8, 2017 2. Madonna Tried It Source:false Who better to end the 2016 BET Awards and honor her lost friend than the uber talented Sheila E? In an eight-minute set, she danced and drummed her way through a medley of Prince songs. She had the audience partying like it was 1999! Source:false Many people wanted to show their love for Prince once news of his passing hit, even branded products — from Cheerios to Hamburger Helper. While some tributes were a nice touch, others were just plain corny. If you’re going to show love, at least put some thought into it. 3. Cheesy Brand Tributes We are saddened today at the news of Prince’s passing. His music meant so much to so many. pic.twitter.com/qMpnSO5zIq— TiVo (@TiVo) April 21, 2016 1. Dan Phillips Learns That Prince Lyrics Don’t Belong In A Sportscast. Watch The Prince Tribute That Got Newscaster Dan Phillips Fired (VIDEO) https://t.co/QWdi3moApj #PrinceRIP pic.twitter.com/8fHrKptigh— Rickey (@rickey) April 30, 2016 8. The Time Gives Dance Moves For Days In the end…this is who i really wanted to see.. @theoriginal7ven @TheMorrisDay SLAYED!!!! #GRAMMYs pic.twitter.com/LdbLbr5uZ7— Melbourneapolis (@Melbourneapolis) February 14, 2017 Source:false Bruno Mars is solidifying his spot as one of the best entertainers of the past decade. He proved his talents at the 59th Annual Grammy Awards by covering Prince’s 1984 hit “Let’s Go Crazy.” Geared in a sparkly purple jacket, Bruno gave us the coordinated dance moves we love and an unsuspected shred of the guitar. Bruno killed it. 6. Erykah Badu Gives A Sultry Rendition Of “The Ballad of Dorothy Parker” Bet Awards Watch Prince Tribute With The Roots, Erykah Badu, … : https://t.co/rCjyYt5FQu .. pic.twitter.com/KfrnjW0wlL— Jasmine James (@jasminejames342) October 14, 2016 Source:false This is the song Madonna TRIED to sag. Luckily with Maxwell, the 2016 BET Awards booked the right chops to deliver a Prince-written classic. It was stripped down, sincere, and most important, soulful. Take notes, Madge. 10. Sheila E. Brings Down The House In An Epic Finale Sheila E. Gives EPIC Prince Tribute at BET Awards https://t.co/1d4E2A2IUk pic.twitter.com/vAK6n8SOWg— Trending Report™ (@TrendingReport) June 28, 2016 7. Maxwell Gives A Smooth Take On Nothing ‘Compares 2 U’ Watch Maxwell Sing in the Rain and Honor Prince at the BET #HIPHOP #NEWHIPHOP #LAVALORDZ https://t.co/ObH8zwpLi3 pic.twitter.com/o081Nid1Vd— LAVALORDZ (@LAVALORDZ) July 1, 2016 4. Jennifer Hudson Overpowers A Classic Jennifer Hudson Brings Down The House With Prince Tribute At BET Awards https://t.co/wOLeUDFAR8 pic.twitter.com/ONsCbrPPHD— SpiritualNurse Sandy (@SpiritualNurse) June 28, 2016 Source:false The Morris Day-led band opened up the Prince 2017 Grammy tributes with a bang! Everyone had “Jungle Love” as Day led folks in shimmying, shaking, and checking their hairdo in the mirror. Such a heartwarming tribute from a band who owes much of their success to The Purple One. Source:false When news broke that Madonna was going to pay tribute to Prince at the Billboard Music Awards, many folks were not here for it. Even a Change.org petition was started to get her replaced. However, the awards show supported their decision and Madonna gave a horrendous performance of Prince’s “Nothing Compares 2 U.” She even dragged poor Stevie Wonder into her mess of a performance to perform “Purple Rain.” Source:false Badu put folks in a sexy mood at the 2016 BET Awards when she covered a standout track from Prince’s ‘Sign o’ the Times’ album. Backed by The Roots, the soul diva had the audience chanting along to the song. Source:false One sports anchor thought it would be cute if he combined Prince lyrics with recent sports highlights. Dan Phillips of WZTV Fox-17 started a story with, “Dearly beloved, we are gathered here today to get though this thing called life. An electric word, life, but I’m here to tell you there’s something else – the NHL playoffs.” He was fired from his position soon after. People across social media are celebrating the life of Prince today, which is his 61st birthday. In addition, his new album “Originals,” which is 15 tracks by the Purple One that were originally records Sheila E., Apollonia 6, The Bangles and  Sinéad O’Connor. The album is exclusively available on Tidal and everywhere else on June 21.JAY-Z said in a press release about the new material, “Prince led the way, for artistic freedom, for ownership. He’s one of the bravest people I can think of in the industry. He trusted us, not just me, but TIDAL, to continue his fight. Trying to help further that legacy through his music is an honor we couldn’t pass up as an organization dedicated to empowering artists. This gives his true fans that peek behind the curtain.”SEE ALSO: Some No Name, Pitchy R&B Singer Disrespected Keith Sweat And Gets Demolished On TwitterAs we all know, when Prince passed away on April 21, 2016 many people tried to honor the icon with a tribute. Some rocked and some failed.Check it out below:11 Prince Tributes From ‘F*cking Awful’ To ‘OMG, I’m Crying!’ was originally published on globalgrind.com Source:false The actors of the hit Broadway musical ‘The Color Purple’ were one of the first to pay tribute to the deceased icon when they belted out “Purple Rain” after a show. With J-Hud and Cynthia Erivo singing together, the performance went viral. Source:false Jennifer Hudson kicks off our many 2016 BET Awards tributes and she didn’t disappoint when it came to Prince. Hudson’s powerful pipes soared in Prince’s “Purple Rain.”last_img read more

Justin Fairfax Wants Name Cleared With An Investigation

first_imgIt was a risky move that could backfire depending on investigators’ findings.Fairfax endorsed a criminal investigation back in April but according to CNN he formally made the request via his lawyers, to the district attorneys’ offices in Suffolk County, Massachusetts, and Durham County, North Carolina. SUBSCRIBE Democratic Leadership Of Virginia Surrounded In Controversy After Racists Photos And Sexual Assault Allegations Surface Virginia’s lieutenant governor Justin Fairfax is fighting back against the sexual assault investigations against him. Despite his accusers not requesting a criminal investigation into their claims and never pressing charges, Fairfax and his team are asking for a criminal investigation as he maintains his innocence.See Also: Justin Fairfax’s Staffers Have Reportedly Resigned Justin Fairfax , Meredith Watson , Vanessa Tyson “An objective and thorough investigation of that allegation should be conducted, and the results reported to the public,” the letter read in part. “Just as no serious crime should go unprosecuted; no innocent person should have his reputation tarnished by a false accusation.”He also would like to testify under oath and wants his accusers to do the same.In January, Meredith Watson publicly accused Fairfax of raping her when they were in college together nearly two decades ago. She alleged the incident took play while they were students at Duke University in 2000, according to a report from the Washington Post. Watson’s claim came less than a week after Vanessa Tyson said Fairfax forced her to give him oral sex during the summer of 2004.Watson also claimed former NBA player and Fox Sports analyst Corey Maggette, who played at Duke for one year from 1998 to 1999, raped her, too.At that time, Watson’s lawyer told the Post that her client only wants Fairfax to resign. That echoed the sentiments of Tyson, who said she only went public after she saw Fairfax was on the verge of being elevated to governor when it was discovered that Virginia Gov. Ralph Northam has racist images on his medical school yearbook page.Fairfax denied both Tyson’s and Watson’s claims. Maggette has also denied Watson’s accusations.There were calls to impeach Fairfax by Virginia House Democrats, those calls ended by February.According to a CBS local affiliate in Virginia, Virginia House Democrats said in a statement today, “Ms. Watson & Dr. Tyson are courageous in coming forward to tell their stories. We respect all survivors and believe they should be fully heard. The allegations they have made against Lt. Gov. Fairfax are criminal in nature and we are treating them with the seriousness they deserve.”center_img Del. Patrick Hope (D-Arlington) was the first to call for Fairfax’s impeachment on Feb. 8. But two days later he said, “There has been an enormous amount of sincere and thoughtful feedback which has led to additional conversations that need to take place before anything is filed. We owe it to all parties involved — especially the victims — to make sure that we have thought through every option the General Assembly has. That’s what these conversations are for — so we can build more consensus on a path forward.”CBS also reports, “After a draft of the articles circulated among lawmakers, members of the Virginia Legislative Black Caucus said the move was too extreme, without providing Fairfax enough time to defend himself.”In April, Fairfax passed a lie detector test by Jeremiah Hanafin who also administered a polygraph test last year to Christine Blasey Ford who accused Supreme Court Justice Brett Kavanaugh of sexual assault.SEE ALSO:How Is Ralph Northam Still Governor Of Virginia?Black Lawmakers Could Lead Virginia Past Blackface, Sex Scandals #IBelieveVanessa: Justin’s Fairfax Accuser, Vanessa Tyson, Getting Tons Of Support On Twitter Entertainment, News and Lifestyle for Black America. News told by us for us. Black America’s #1 News Source: Our News. Our Voice. Thanks for signing up! Get ready for Exclusive content, Interviews,and Breaking news delivered direct to your inbox. Get ready for Exclusive content, Interviews,and Breaking news delivered direct to your inbox.last_img read more

ScarJo Whitesplains Any Role Comments After Backlash

first_img The Common Good Forum & American Spirit Awards 2019 Jamaican Republican Who Is Running Against AOC Supported Her A Year Ago Twitter Destroys Mia Love For Defending Trump’s Racist ‘Go Back’ Tweets No one:No one in the world:No one in the universe: Scarlett Johansson: pic.twitter.com/cPNMiZj2s3— Chris ︽✵︽ (@ChrisScavenger) July 14, 2019 It’s long been evident that Hollywood has a major diversity problem. And with the film industry’s history steeped in racism, it definitely does not help when white actors continue to feel entitled to play roles meant for Black people as well as other people of color.On Sunday, actress Scarlett Johnansson came under fire for comments she made during a recent interview with As If Magazine about being “allowed to play” any role.“You know, as an actor I should be allowed to play any person, or any tree, or any animal because that is my job and the requirements of my job,” Johansson said. “I feel like it’s a trend in my business and it needs to happen for various social reasons, yet there are times it does get uncomfortable when it affects the art because I feel art should be free of restrictions.” And as Johansson continues to believe she should be able to play anyone, Black actors continue to struggle for opportunities in film that are all too often given to white people.SEE ALSO:State Department Releases Statement On A$AP Rocky Being Jailed In Sweden R. Kelly Alleged Sex Slaves Post A Video From The Singer’s Condo In Trump Tower Morehouse Students Take To Social Media And Claim Sexual Harassment Complaints Were Ignored AddThis Sharing ButtonsShare to FacebookFacebookFacebookShare to TwitterTwitterTwitterShare to MoreAddThisMoreShare to EmailEmailEmail Johansson tried to walk back her comments claiming media outlets edited them for “clickbait.” Then she went on to pretty much say the same thing again:“An interview that was recently published has been edited for click bait and is widely taken out of context,” Johansson said in a statement. “The question I was answering in my conversation with the contemporary artist, David Salle, was about the confrontation between political correctness and art. I personally feel that, in an ideal world, any actor should be able to play anybody and Art, in all forms, should be immune to political correctness.”While one of the main issues that came to light following her comments was the lack of representation of transgender actors in film, there is also the lingering topic of Black representation, as well.And though Johansson went on to claim that she does support and fight for diversity, if white actors, who are usually preferred over Black and brown actors, can play anyone, how is that diverse?Over the years, many white actors and actresses have played Black people in movies, such as Angelina Jolie, who played a real-life Black woman in “A Mighty Heart;” Joseph Fiennes, who played Michael Jackson in “Elizabeth, Michael and Marlon;” and Jeanne Elizabeth Crain, who played a mixed-race Black woman in “Pinky.”Johansson’s logic could also be applied to the too-many-to-count incidents where actors like Judy Garland, Fred Astaire, Bing Crosby, Robert Downey Jr. and more have donned blackface in films that continued to perpetuate stereotypes of Black people. In 2018, Johansson faced backlash from the LGBTQ community for agreeing to play a transgender man in the movie “Rub & Tug.” She went on to reluctantly remove herself from the role. One year earlier in 2017, she faced another controversy for playing an Asian character in the movie “Ghost In The Shell.”Many people called the actress out for her comments on social media: Blackface , Scarlett Johansson , White actors playing Black characters Scarlett Johansson: I can play anything I want. Actors can play anything they want.White cis men: yeah!Female POC: I am Bond, J…White cis men: not like that— Delaney King (@delaneykingrox) July 15, 2019 Scarlett Johansson preparing for her upcoming roles: pic.twitter.com/YFUK7T1R1f— hannah lee (@hannahleewrites) July 14, 2019 More By Megan Sims White Tears! Former Meteorologist Files Lawsuit Claiming He Was Fired Because Of Diversitylast_img read more

The Dogman of Michigan A Legend with More Sightings than Bigfoot

first_imgFor a rural man like Ray Greenway, creepy eyes twinkling in the darkness was nothing to be worried about. He lived in the area of Manistee, Michigan, a place containing its fair share of critters. One particular night in 1986 however, he had a brush with nature he didn’t expect. He spotted a pair of twinkling eyes, but something was wrong. They were high in the air, not where you’d expect the gaze of a four-legged creature to be.To Ray’s surprise, the thing, whatever it was, made a break for him and then jumped clear across the road never to be seen again. He may have glimpsed a bit of fur but, as an article for Ranker puts it, one thing that’ll always stay with him is those “yellow eyes.” In the same piece Ray recalls “that I saw both eyes, as if it was looking at me, the whole time. That, along with the leaping ability, is what I will never forget.”Manistee, Michigan Photo by Decumanus CC BY-SA 3.0What did he witness that unusual night? The answer could lie in one of Michigan’s enduring local legends: the Dogman. Ranker remarks that “There have been far more sightings than Bigfoot, who is practically the poster-creature for cryptozoology.”Thought to be half-man, half-dog, Dogman is known for his ability to walk on two legs. If you ever came face to face with him, you’d soon know about it. The head has been compared to a ferocious hound, and there’s another type that resembles a sasquatch. Like the sasquatch, Dogman is in the category ‘cryptid,’ meaning legendary and elusive beast.Sasquatch is another type of ‘crytpid’The first recorded instance of humans encountering the Dogman was back in 1887, where a couple of lumberjacks got more than they bargained for among the trees of Wexford County. Not that they didn’t survive to tell the tale. Despite its fearsome reputation, accounts of Dogman attacks have yet to be substantiated in the mainstream media.Dedicated website Dogman Encounters states the truth is being kept under wraps. “Most eyewitnesses who possess that kind of evidence don’t want it released to the public. Amazing videos, pictures, and vocals of Dogmen have all been shared with me. Impressive Dogman evidence most definitely DOES exist.”A coyote is caught on camera during the night.Dogman Encounters also believe the beast dates back to Ancient Egypt, and that “Dogman encounters have been reported on every continent, except Antarctica.”The monstrous myth appeared to disappear into the fabric of Michigan folklore until 1987, oddly enough the year after Ray Greenway’s experience. A specially-composed song, simply titled The Legend, was broadcast on local radio. The composition’s atmospheric evoking of historical brushes with the toothsome terror led to a steady stream of calls from listeners.Penning the ditty was DJ Steve Cook. Bizarrely he claimed not to know about the Michigan Dogman, though his efforts struck such a chord with the population that it seems unlikely this was a coincidence.Cook has explored the idea of the Dogman having deep supernatural connections. Interviewed for a 2012 Huffington Post article he reveals that he once “spoke with an elder from the Ottawa-Chippewa tribe in the 1980s who believed dogmen were members of a shapeshifting skinwalker tribe who became stuck somewhere between their human and animal forms.”In 2007 the Dogman made an out-of-focus-appearance in a supposed home movie called The Gable Film. This was an eerie sequence that would put the Blair Witch to shame. The blurry footage depicts something crawling through the forest, followed by an attack where a gaping maw is in fleeting yet frightening evidence.Sadly for conspiracy buffs The Gable Film turned out to be a fake, with a certain Steve Cook revealed as one of the individuals involved in the shenanigans.Read another story from us: Did Michael Rockefeller Meet His End at the Hands of a Native Tribe?Movie stardom of a limited sort arrived in 2012 with Dogman, directed by Richard Brauer and starring Larry Joe Campbell. Set in the creature’s Midwest habitat, it was successful enough to spawn a sequel, Dogman 2: The Wrath of the Litter, a couple of years later.Whether chilling the bones of local children through folk tales, entertaining listeners via song or tempting viewers from the DVD shelf, the Dogman is one breed that won’t run out of legs.last_img read more

Air Canada and GlobalMedic help Dominica prepare for hurricane season

first_imgShareTweetSharePinDelsol with Rahul Singh of Global Medic and Jeff Edwards of Air CanadaDominica’s Trade & Investment Commissioner, Frances Delsol and Consuls General from Grenada, St Vincent and the Grenadines  joined with over thirty (30) volunteers from GlobalMedic, Air Canada workers, Community group members from Dominica & Grenada at the Air Canada’s Brampton location to pack hurricane relief supplies as the 2019 Atlantic hurricane season is set to begin on June 1.“It is important that we get these relief supplies into the islands early and before the hurricane season get into full gear”, said Jeff Edwards, General Manager, Cargo Network Control, Air Canada. “We have an interest in not only flying people to the islands, we also have a responsibly to assist these islands we serve especially in times of disaster. We have employees in the island and we are like family so we have a keen interest in making sure we can assist with hurricane preparednessGlobalMedic and Air Canada have been working together since 2016 to assist Caribbean countries with hurricane relief supplies.GlobalMedic is responsible for getting the supplies through donations and sponsorship and Air Canada is responsible for shipping the relief supplies to the islands to which they operate.Rahul Singh, Executive Director at GlobalMedic for twenty-one (21) years is excited about these early preparations for the 2019 hurricane season. GlobalMedic has performed relief operations in Grenada and Dominica in the past after the islands were hit by Hurricanes Ivan and Maria in 2004 and 2017 respectively.“GlobalMedic could not have done this work without donors like Proctor and Gamble, our volunteers and our partner Air Canada. We will make available over 4000 kits to be shared among the islands. Dominica is slated to recieve 500 kits. Each kit costs approximately US$120 and will be donated free of cost to the countries. This kit is essentially a hygiene kit that is ideally suitable for a family of five. It contains a water purification kit, toothpaste, soap and toothbrushes. From experience we know that we have to protect health and well-being of families if displaced by a disaster: We will also be working on preparing an Emergency Food and Disaster Kit as well”, said Singh.Volunteers preparing kits Trade Commissioner Delsol, who joined the assembly line to assist with packing the supplies, expressed his gratitude to Air Canada and GlobalMedic.  She said “The Government and people of Dominica are extremely grateful for the hurricane kits. We understand the need for preparedness, while we hope this hurricane season will prove to be uneventful.  We are taking a more pro-active stance with regards to disaster response and we hope our early preparedness will bring a sense of comfort to our folks in Dominica.Ms. Delsol also mentioned the imminent launch of the Dominica Disaster Preparedness Group (SAFE-D) which she heads, that will address preparation and response for Dominica from Canada in the event of future natural disasters.GlobalMedic is the operational arm of the David Mc Antony Gibson Foundation (DMGF). We operate as a registered Canadian charity, and our mandate is to save lives by providing short-term, rapid response in the wake of disasters and crisis, both at home and abroadThe key word is rapid, as you might expect from an agency that was founded by paramedics. GlobalMedic is often the first team, and many times the only one, to get critical interventions to people in life-threatening situations following a disaster. This is what we are known for in the world of humanitarian disaster response.GlobalMedic achieves this through our well-developed Emergency Programs and our internationally deployable Rapid Response Team (RRT).Visit: www.globalMedic.caAir Canada is Canada’s largest domestic and international airline serving more than 200 airports on six continents.  Canada’s flag carrier is among the 20 largest airlines in the world and serves more than 48 million customers each year.Visit: www.aircanada.caTrade Commisioner with Sam Elfassy, VP Air Canada Safetylast_img read more

Winslow High School hires new principal

first_imgApril 2, 2019 Winslow High School hires new principal By L. Parsons         The Winslow Unified School District Governing Board held a special meeting last week to approve the hiring of Dr. William James Donner as the principal of Winslow High School. Donner, mostSubscribe or log in to read the rest of this content. Bottom Adlast_img

British minister to visit Iran on Sunday for talks on tensions

first_imgBy Reuters |London | Published: June 22, 2019 3:40:06 pm Advertising Top News us iran tension, iran us relations, britain, andrew murrison, us news, iran news, uk news Andrew Murrison will visit Iran on Sunday. (Twitter/@AWMurrison)Britain’s Middle East minister Andrew Murrison will visit Iran on Sunday for “frank and constructive” talks, Britain said, as tensions between Tehran and Washington rise after the downing of an unmanned U.S. drone. After Masood Azhar blacklisting, more isolation for Pakistan Virat Kohli won’t have a say in choosing new coach Karnataka trust vote today: Speaker’s call on resignations, says SC, but gives rebel MLAs a shield “At this time of increased regional tensions and at a crucial period for the future of the nuclear deal, this visit is an opportunity for further open, frank and constructive engagement with the government of Iran,” the Foreign Office said in a statement.Murrison will call for urgent de-escalation in the region and raise concerns about “Iran’s regional conduct and its threat to cease complying with the nuclear deal to which the UK remains fully committed.” Post Comment(s)last_img read more

More Indians becoming obese number of undernourished in India decline UN report

first_imgBy PTI |United Nations | Published: July 16, 2019 9:55:17 pm Post Comment(s) UN chief saddened by loss of life, destruction due to heavy rains in India, South East Asia The real cure “We must foster pro-poor and inclusive structural transformation focusing on people and placing communities at the centre to reduce economic vulnerabilities and set ourselves on track to ending hunger, food insecurity and all forms of malnutrition,” the UN report said.It noted that poverty rates have declined between 3 per cent and 6 per cent per year in El Salvador, Ghana, India, Tunisia and Uganda.“China and India have enjoyed significant economic growth in recent years. Between 1990 and 2017, the two countries had an average GDP per capita growth rate of 8.6 per cent and 4.5 per cent, respectively. However, the effects of growth within each country have been different,” it said.The report noted that an increase in the GDP per capita in both countries has been accompanied by poverty reduction. China’s poverty rate declined from 88 per cent in 1981 to 0.7 in 2015. Advertising More Explained Advertising Advertising Related News Best Of Express In comparison, India’s poverty reduction “seems relatively more modest” – moving from 48.9 per cent in 1987 to 21.2 per cent in 2011, it said.“The unique growth patterns and inequality levels in each country may help explain the differences observed in the countries in terms of poverty and food security and nutrition trends,”“The pattern of economic growth in China, especially in the 1980s, shows that the primary sector, where most of the poor derive their livelihoods, was one of the most dynamic sectors behind the GDP growth. On the other hand, in India the rate of growth has been higher in the industrial and services sectors than in agriculture,” it said.The report said that the impacts of economic slowdowns on food security and nutrition are demonstrated in Haiti, Nepal and the Niger.Amid a global financial crisis coupled with high food prices, households’ food security, as measured by dietary diversity, reduced by 5 per cent in Nepal, 8 per cent in the Niger, and 23 per cent in Haiti due to increased food prices.In the Indian Himalayas, economic slowdown coupled with natural resource depletion and climate change negatively impacted on food production and employment opportunities. This resulted in increased threats to food security due to lower purchasing power, it added.The report also took note of the Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS), introduced by India in 2005, the largest public works programme in the world.“Unlike the previous cases, the MGNREGS was not designed to address employment problems arising from an economic downturn or to rebuild infrastructure damaged by a natural disaster.Building on the experience of the state of Maharashtra, the MGNREGS instead guarantees up to 100 days of unskilled manual work on public projects during the lean seasons, at the statutory minimum wage, to all rural households. “In this way, the programme helps rural households to stabilise their earnings and to smooth their consumption all along the year,” it said. NRC deadline approaching, families stranded in Assam floods stay home The number of children (under 5 years of age) who are overweight stood at 2.9 million in 2018.In percentage terms, the prevalence of undernourishment in the total population in India was 22.2 per cent in 2004-06 and 14.5 per cent in 2016-18. Prevalence of wasting in children (under 5 years of age) was 20.8 per cent in 2018, while the Prevalence of obesity in the adult population was three per cent in 2012, increasing to 3.8 per cent in 2016The report said that globally, hunger is increasing in many countries where economic growth is lagging, particularly in middle-income countries and those that rely heavily on international primary commodity trade.The annual UN report also found that income inequality is rising in many of the countries where hunger is on the rise, making it even more difficult for the poor, vulnerable or marginalised to cope with economic slowdowns and downturns. Karnataka: Supreme Court to rule today, says Speaker’s powers need relook Explained: Kulbhushan Jadhav case file In undecided Congress, first open call for Priyanka: She should be party chief The report titled the State of Food Security and Nutrition in the World 2019 was issued Monday by United Nations’ Food and AgricultureOrganization (FAO), the International Fund for Agricultural Development (IFAD), the UN Children’s Fund (UNICEF), the World Food Programme (WFP) and the World Health Organization (WHO).The report said that an estimated 820 million people across the world did not have enough to eat in 2018, up from 811 million in the previous year, which is the third year of increase in a row, underscoring the immense challenge of achieving the Sustainable Development Goal of Zero Hunger by 2030.In India, the number of undernourished people declined from 253.9 million in 2004-06 to 194.4 million in 2016-18. However, the number of adults (18 years and older) who are obese grew from 24.1 million in 2012 to 32.8 million in 2016. India, obesity in India, obesity in children, unhealthy eating, undernourished, United nation, FAO, IFAD, UNICEF, WEP, WHO, Indian Express news. In India, the number of undernourished people declined from 253.9 million in 2004-06 to 194.4 million in 2016-18. However, the number of adults (18 years and older) who are obese grew from 24.1 million in 2012 to 32.8 million in 2016. (Representative Image)More Indians are becoming obese while the number of undernourished people in the country has declined, according to a report by the UN that said that globally over 820 million people are suffering from hunger. UN rights council to investigate killings in Philippine drug war last_img read more

Flash flood govt prepared Nitish Kumar in Bihar Assembly

first_img Bihar: Unable to enforce liquor law, 41 police officers shunted out Explained: The Hague rules on Kulbhushan Jadhav today Heavy rain in Nepal leads to flood in several Bihar districts Best Of Express Nitish kumar, Bihar news, flash floods, Bihar flash floods, Bihar flash floods death toll, india news, indian express Water gushes over a railway track in Madhubani on Tuesday. (PTI)DEATH toll in the Bihar floods on Tuesday reached 30 with five girls drowning in a pond in Sheohar district. However, the disaster management department has pegged the toll at 25 as it has not included the incident of drowning as a flood-related death in official figures. NRC deadline approaching, families stranded in Assam floods stay home Karnataka: Supreme Court to rule today, says Speaker’s powers need relook Advertising Advertisingcenter_img While 11 people have died in Sitamarhi, nine deaths have been reported from Araria so far. A total of 25,71,600 people from 555 panchayats in 78 blocks are affected by the floods.The Disaster Management Department’s Principal Secretary, Pratyaya Amrit, said, “We are running 676 community kitchens and 125 motorboats are engaged in relief and rescue operations with 25 NDRF and SDRF teams being on the job.”Madhubani, Sitamarhi, Sheohar, East and West Champaran, Supaul, Darbhanga, Muzaffarpur, Katihar, Purnea, Kishanganj and Araria have been affected by the floods, the Chief Minister said.For the past three or four days, the Terai region of Nepal has been lashed by rainfall ranging between 280 and 300 mm, which was many times higher than the 50 mm which is considered normal for the area during this time of the year, and as a result, several rivers in Bihar like Kosi, Bagmati and Mahananda have been in spate, he said. Twelve districts are affected by the floods with Sitamarhi, Madhubani and Araria being the worst-hit.Speaking in the Assembly, Bihar Chief Minister Nitish Kumar called it a “flash flood” caused by incessant rainfall in Nepal. “Generally, there are floods in Bihar in August. But it is flash flood, similar to the one in 2017. We are fully prepared to deal with it. Relief and rescue operations are on. We have arranged 199 relief camps for displaced people.”Kumar also said the government had apprehensions about drought in several districts due to inadequate rainfall. More than 1 lakh people have been evacuated, he said. Have taken all possible steps to prevent spread of AES: Bihar to Supreme Court Related News By Express News Service |Patna | Published: July 17, 2019 4:21:05 am The Chief Minister, who has conducted aerial surveys of the affected areas in the past few days, said top officials of village development and road construction departments have been asked to personally take stock of the damage caused so that rebuilding programmes are initiated once the situation is normal.“All flood-affected districts have been allocated sufficient funds. It is being ensured that dependents of those who have lost their lives get ex-gratia within 24 hours of the deaths. It has been a standing principle of our government that those affected by calamities have the first claim to the governments coffers. Funds will not come in the way of rescue, relief and rehabilitation,” Kumar said. Post Comment(s)last_img read more

Uttar Pradesh 50 students injured after hightension wire falls into school

first_imgBy PTI |Balrampur | Published: July 15, 2019 5:36:35 pm Advertising Advertising The students are stated to be out of danger, officials said.When the wire fell into the school, the students were at a distance but water had collected in the compound after rainfall due to which they came in contact with electricity, District Magistrate Karun Karunesh said.Fifty students sustained injuries and they were shifted to nearby hospitals, he said. Post Comment(s) Haryana schools to get power from domestic feeders center_img Related News Bangalore’s ‘electric shock’ death toll rises by the day, even as BESCOM talks of awareness Two employees of the Power Department were suspended and a departmental inquiry ordered against the junior engineer concernedThe district magistrate said the basic education officer and Power Department’s executive engineer were issued directions to conduct a survey of schools and remove any such wires passing over them. uttar pradesh, uttar pradesh electricity, up rain, high tension wire, students injured, up school student injured, indian express Water had collected in the compound after rainfall due to which the students came in contact with the electricity.About 50 students were injured Monday when a high-tension wire fell into a primary school in Naya Nagar Vishnupur area here, police said.last_img read more

Highquality hospitals provide lower cost care for 82 of diagnoses analysis reveals

first_img Source:https://www.unitedhealthgroup.com/newsroom/2018/2018-10-03-hospitals-lower-cost-care.html Reviewed by Kate Anderton, B.Sc. (Editor)Oct 3 2018High-quality hospitals deliver lower-cost care for 82% of diagnoses, according to a new analysis that Advisory Board released today on variations in care that do not improve care costs or patient outcomes.The data from Advisory Board’s analysis of 468 hospitals indicate a typical facility could save up to $29 million annually by delivering care in line with cost benchmarks for high-quality hospitals. “Achieving a realistic chunk of this savings opportunity, however, will require most health systems to rethink how they prioritize, set and embed care standards,” said Steven Berkow, Executive Director, Research at Advisory Board, an Optum, Inc. business.Clinical leaders have long sought to improve care quality by reducing unwarranted care variation. Health system CEOs and CFOs are now counting on this clinical strategy to help bend the healthcare cost curve as well. System savings goals from care variation reduction (CVR) increasingly range from $50 to $150 million. In the latest Annual Health Care CEO Survey, C-level health system executives told Advisory Board that their No. 1 concern for 2018 is preparing the enterprise for sustainable cost control and No. 2 is innovative approaches to expense reduction. According to Mr. Berkow, “CVR is one of the few avenues for generating the level of savings needed to withstand downward pressures on hospital revenues without negatively impacting care, and hopefully improving it.”Safely Bending the Healthcare Cost CurveMany health systems have sought evidence that the potential savings from CVR can be large enough to help bend the healthcare cost curve—and achievable without compromising care quality and outcomes. At their request, Advisory Board analyzed recent cost and quality data from more than 20 million deidentified patients across 468 hospitals. The resulting research shows that meaningful CVR is both attainable and more effective than traditional cost-cutting.”Our high-performer benchmark is based on high-quality care, not low cost,” explained Veena Lanka, MD, Senior Director, Research at Advisory Board. More specifically, Advisory Board defined a separate top-quality cohort using four well-established patient outcome indicators, like complication rate, and found that these high-quality hospitals typically delivered lower-cost care for comparable patients.A typical hospital spends up to 30% more to deliver care with comparable or lower-quality outcomes than the top-performing cohort. Dr. Lanka underscored that “Eliminating this cost gap entirely is not realistic due to underlying clinical, demographic, and operational differences between organizations that are difficult to fully control for within study design.” But multimillion dollar savings are achievable by reducing unwarranted variation. “Closing just a quarter of the cost gap for less than 10% of the conditions we analyzed could net over $4 million in annual savings for a typical hospital and over $40 million for 10-hospital system—without compromising quality.”Related StoriesTAU’s new Translational Medical Research Center acquires MILabs’ VECTor PET/SPECT/CTAMSBIO offers new, best-in-class CAR-T cell range for research and immunotherapyApplication of machine learning methods to healthcare outcomes researchMethodist Le Bonheur Healthcare’s CVR Journey”Embarking on a journey to reduce care variation can be challenging, but our success is due to dedicated teams of physicians, nurses and administrators, all working toward the common goal of improving every life touched at Methodist Le Bonheur Healthcare,” said Arthur Townsend IV, MD, MBA, Chief Clinical Transformation Officer for Methodist Le Bonheur Healthcare.Methodist Le Bonheur Healthcare (MLH) is an integrated, not-for-profit healthcare delivery system based in Memphis, Tennessee serving the greater metropolitan area including portions of eastern Arkansas and northern Mississippi.Methodist began its CVR journey in 2014, supported by data and analytics tools from Advisory Board Technology, which is now part of Optum. The initial projects addressed unwarranted variation in utilization of laboratory tests, and packed red blood cell transfusions. These initiatives exceeded expectations for success, and in March 2017 the scope was expanded to address clinical conditions.Clinical Consensus Groups (CCGs) including subject matter experts, physicians, nurses, and administrative champions were formed to develop care standards. The first two CCGs addressed variation in care and clinical documentation for stroke and sepsis. Both projects resulted in care standardization that greatly benefitted patients. By Q2 2018, they yielded more than $800,000 in cost savings and revenue in a quarter for the Methodist Le Bonheur Healthcare system.”We see care variation initiative as the next frontier in improving overall quality and significant cost reduction across the system through physician leadership,” said Michael Ugwueke, president for Methodist Le Bonheur Healthcare.The next project Methodist is undertaking started in August. It addresses variation in treatment of atrial fibrillation.The Advisory Board’s data set for this analysis includes cost and quality data spanning April 2014 to March 2017 for a national cohort of 468 individual hospitals. The sample set includes more than 20 million deidentified patients (from discharge data) across 13 service lines and 983 diagnosis subgroups. High performers were determined solely by care quality indicators, specifically patient mortality rate, complication rate, readmission rate, and length of stay.last_img read more