Nebraska Medicine to close burn center, send patients to St. Elizabeth – Lincoln Journal Star

CHI Health and Nebraska Medicine announced a new collaboration Thursday that will make St. Elizabeth the only burn care center in the state.

Nebraska Medicine said it will close its inpatient burn unit on Sept. 4. It will continue to care for burn patients in trauma situations and on an outpatient basis, but all patients needing inpatient burn care will be sent to CHI Health St. Elizabeth.

St. Elizabeth is one of 66 burn centers in the U.S. verified by the American College of Surgeons and the American Burn Association. The unit has 16 beds and serves an average of 500 burn patients from a six-state area each year. Nebraska Medicine treats about 100 burn patients a year.

This decision was made after much careful research and discussion, Nebraska Medicine Chief Medical Officer Harris Frankel said in a news release. "As we transition away from inpatient burn treatment, residents of the Omaha metro can be assured that our emergency and trauma response for burn patients will be as strong as ever, as will our outpatient clinic care. Well work closely with the staff at St. Elizabeth to make sure burn patients receive the right care in the right center.

The two hospital systems said the move shows they are working together to eliminate the duplication of this highly specialized service. Consolidating inpatient care to one burn unit lowers the overall cost of care for patients and employers, while still ensuring patients have access to high-quality care.

The team of highly skilled and specially trained physicians, nurses and therapists welcome the opportunity to care for more burn patients. Cary Ward, CHI Health chief medical officer said in the release. This collaboration is a perfect illustration of how health systems are working together to reduce costs and improve quality of care through specialization.

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Nebraska Medicine to close burn center, send patients to St. Elizabeth - Lincoln Journal Star

Researchers Used Tiny Autonomous Vehicles to Deliver Medicine to the Stomach of Mice – Futurism

In BriefMicromotors the width of a single strand of human hair havebeen used to administer antibiotics to the stomach of micesuffering from a bacterial infection. Micromotor Medic

Researchers usedautonomous vehicles known as micromotors to cure bacterial infections in the stomachs of mice. Micromotors are only the width of a single human hair, which allows themto negotiate the labyrinthine confines of the human body, and administer precise treatment.

In this study, micromotors were used to provide mice with a dose of antibiotics every day for five days. This regimen was found to be more effective than the standard method of administering the medicine.

Micromotors are arelatively new technology, but theyre coming along in leaps and bounds. Earlier this year, researchers in Germany developed a method of combining the vehicles with sperm cells to help combat tumors.

This particular implementation of micromotors is comprised of a spherical magnesium core thats coated with specialized layers that perform various different functions,, like protecting the vehicle, carrying the treatment, and giving it the ability to stick the walls of the stomach.

However, its the core thats the really clever part it propels the micromotor along, but it does so in a way that helps the medicine have the desired effect.

The micromotors are able to move around the stomach thanks to the propulsion provided by the magnesium as it reacts with gastric acid. This reaction actually reduces the level of acidity in the stomach for a short amount of time.

This amounts to more than complementary antacid; antibiotics and protein-based drugs can be rendered useless by the gastric acid in the stomach. As such, its essential that the acidity level be dropped before they are released from the micromotor to do their job. This particular layer of the vehicle responds to the acidity around it, and it will only administer the medicine when it detects safe conditions for it to do so.Click to View Full Infographic

The acidity level of the stomach is said to return to its normal state within 24 hours. The micromotors themselves are largely biodegradable, so when finished, they simply dissolve within the stomach without leaving anything harmful behind.

There is still a long way to go, but we are on a fantastic voyage, said Dr. Joseph Wang, professor at the University of California San Diego and the lead researcher on the project, alongside fellow professor Dr. Liangfang Zhang. Following the success of these tests, the research team plans to engage in a larger study with animals but the long-term goal is to investigate whether the same technique can be used safely on a human subject.

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Researchers Used Tiny Autonomous Vehicles to Deliver Medicine to the Stomach of Mice - Futurism

BGSU, Liberty schedule home-and-home football series – Hustle Belt (blog)

The Bowling Green Falcons adds a third date to their 2020 out-of-conference schedule and their first 2023 date with the addition of the Liberty Flames.

The dates were announced as part of a schedule reveal released by Liberty University Wednesday afternoon. Bowling Green has yet to release an official confirmation, but does list the games on its future schedules page and Twitter feed.

According to Liberty Universitys release, BGSU will host Liberty in 2020, and then make a return trip to Lynchburg, Virginia in 2023.

BGSU has one more spot to fill for the 2020 season, as the Falcons currently have Ohio State and Illinois on the schedule. The Falcons will have to flesh out their 2023 schedules, as Liberty is their only current opponent scheduled.

The scheduling is interesting for a number of reasons. Liberty football is currently a member of the FCS Big South Conference and are in the midst of transitioning to full FBS membership, where it will be a post-season eligbile independent starting in 2019.

The Flames first season at the FBS level will be in 2018, although they are ineligbile to go to the postseason, as per transtional requirements.

LIberty football is also coached by Turner Gill, who came to prominence at MAC member Buffalo before flaming out at Kansas.

The Flames have done a masterful job thus far in its FBS scheduling, with expected home-and-homes scheduled with Duke, Wake Forest, Virginia Tech, BYU, Syracuse, UMass and Old Dominion. Bowling Green will be Libertys second add from the MAC, with Buffalo already on the schedule for 2019 and 2023.

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BGSU, Liberty schedule home-and-home football series - Hustle Belt (blog)

Liberty Bridge and Inbound Liberty Tunnel closures scheduled for August 18-21 – WTAE Pittsburgh

PITTSBURGH

PennDOT District 11 is announcing the closure of the Liberty Bridge and the inbound Liberty Tunnel in the City of Pittsburgh, Allegheny County, will occur Friday night, August 18 through Monday morning, August 21 weather permitting.

The Liberty Bridge in both directions and the inbound (northbound) Liberty Tunnel will close to traffic from 8 p.m. Friday night continuously through 5 a.m. Monday morning. Crews will conduct latex overlay operations on the Liberty Bridge. Concrete patching work will occur in the inbound Liberty Tunnel.

The outbound Liberty Tunnel and PJ McArdle Roadway will remain open the entire weekend. All other traffic will be detoured during the closure.

Posted Detours

Inbound Liberty Tunnel

Outbound Liberty Bridge from Downtown Pittsburgh

Outbound Liberty Bridge from Westbound Route 885 (Boulevard of the Allies)

Outbound Liberty Bridge from Route 380 (Bigelow Boulevard)

Outbound Liberty Bridge from I-279 Parkway North

The $80.08 million Liberty Bridge Rehabilitation Project includes deck replacement and ramp reconstruction, structural steel repairs, painting of the entire structure, concrete repairs, signage improvements and installation of a new alternating overhead lane control system. The project will continue into 2018. The Joseph B. Fay Company is the prime contractor.

The inbound Liberty Tunnel closure is part of the $30.27 million final phase of tunnel rehabilitation work which includes roadway pavement rehabilitation, the addition of safety and control systems, air monitoring upgrades, a fire suppression system and CCTV installation. Additionally, extensive renovation of the fan house including replacing eight fan units, replacing all electrical equipment, concrete repairs, roof and drainage repairs, and retaining wall erection.

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Liberty Bridge and Inbound Liberty Tunnel closures scheduled for August 18-21 - WTAE Pittsburgh

Liberty Apple Orchard set to open – The Edwardsville Intelligencer

Photo: For The Intelligencer

The trees at Liberty Apple Orchard, just outside of Edwardsville.

The trees at Liberty Apple Orchard, just outside of Edwardsville.

Liberty Apple Orchard set to open

Liberty Apple Orchard, a U-Pick orchard located just east of Edwardsville, will be opening for its fifth season Aug. 21 at 3 p.m.

Throughout the apple season, the orchard offers 13 varieties of apples and provides a unique family-fun, educational opportunity with its replica one-room schoolhouse on site.

New this season, the orchard will be offering additional products from local farmers as well as be expanding its hours.

Steve Miller, who cares for the orchard with his wife Lugene, was looking forward to the orchards season opening on Aug. 21, which occurs just after the solar eclipse. In response to suggestions from our guests, we have expanded our hours and will offer additional products from local farmers, Steve Miller said.

Liberty Apple Orchard will be open for U-pick guests from 10 a.m. to 5 p.m. Saturdays, 1 p.m. to 4:30 p.m. Sundays and after school from 3 p.m. to 5 p.m. Tuesdays through Fridays. On Labor Day, Sept. 4, the orchard will be open from 1 p.m. to 5 p.m.

In addition, beginning this year, Liberty Apple Orchard will offer apple butter and honey from local producers as well as cider in early September and pumpkins in late September from local farmers.

Sweet Gala and Jonathan apples will be the first varieties ready for picking. Then by early September, McIntosh, Blondee, Empire, and Cortland apples will be available, followed by Liberty and Fuji varieties. In October, Braeburn, Enterprise, Candycrisp, Gold Rush, and Granny Smith will be available for picking.

Getting through the growing season and on to the apple picking season takes much TLC every year. The orchard employed nine EHS and Metro-East (Lutheran) High School students this past winter to assist with pruning. The work commenced in December and continued until early February, Steve Miller explained.

The Feb. 28 hail storm damaged some of the apple trees as hail of up to two inches pelted the orchard. On March 15 - the dreaded Ides of March - temperatures fell to 16 degrees and, based on earlier university studies, we thought that we would lose many varieties for this season, especially the Braeburn and Granny Smith buds that were well developed. To the surprise of the University of Illinois Extension staff, the trees survived quite well through the cold spell, Steve Miller noted.

Liberty Apple Orchard is located at 8308 Kuhn Station Road in Edwardsville in a rural setting yet not far from Glen Carbon, Troy and Highland. From the Meyer YMCA in Edwardsville, go east on Goshen Road approximately 2 miles, turn right on Staunton Road, cross the bike trail, and turn left on Kuhn Station Road. Liberty Orchard is down the road about one-fourth of a mile on the right.

When turning down the Liberty Orchard drive, the Liberty schoolhouse immediately comes into view. Liberty School consists of a store with fresh picked apples and childrens books, apple cooking books, and apple-inspired greeting cards. The interior design of Liberty School picks up motifs from schools of 100 years ago, including a chalkboard around the ceiling, presidential photos, books and an original, refinished schoolhouse desk.

The orchard with its apple picking and schoolhouse provides a unique, family-fun experience. The orchard is well mowed, easily accessible from our drive and ideal for photos of your family," Lugene Miller pointed out.

The Millers objectives are to provide high quality local fresh fruit, an educational experience for children and families, and community participation and outreach.

As part of this goal, the orchard offers opportunities for class or groups to call and schedule field trips to pick apples and learn about growing an apple orchard, fundraisers for youth groups, mission groups, or schools, and a source of healthy snacks for fall festival/Halloween celebrations.

Just as in the past four years, Liberty Apple Orchard will continue to serve local food banks in Madison County communities as part of its community outreach. In 2016, the orchard delivered over 12,000 pounds of apples to 12 regional food banks. Food banks typically have canned and boxed processed food available, but little if any fresh fruit, Steve Miller pointed out. We are especially thankful for the many volunteers who picked thousands of pounds of apples at Liberty Apple Orchard in 2016 to serve children and families at regional food banks.

Many church and civic groups volunteered including St. Boniface eighth graders, Trinity Lutheran Church, Girl Scout Troop 559, EHS Student Council, EHS EPIC, Urban Harvest, Immanuel United Methodist Church, Mt. Joy Church and many others, he added. The apples were delivered from September through December and include most of the 13 varieties grown on the orchard.

Also in its 2016 community outreach, Liberty Apple Orchard hosted a fund raiser for the St. Vincent de Paul Society. This organization, supported by St. Boniface, St. Marys and St. Cecilia Church, provides rent and utilities assistance to those in need in the Edwardsville school district.

While many enjoy visiting the orchard for its local U-Pick opportunity, Liberty Apple Orchard's produce is also available at the Land of Goshen Farmer's Market in Edwardsville on Saturday mornings and some local grocery stores.

For further information on the ripening schedule and times and dates for special events, follow Liberty Apple Orchard on Facebook or visit its website at http://www.libertyappleorchard.com. Call (618) 659-9217 for other questions or to schedule a group field trip.

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Liberty Apple Orchard set to open - The Edwardsville Intelligencer

Benedictine, Liberty Co., Jenkins and Savannah High construct programs for long-term success – Savannah Morning News

One team has has established itself as one of the top programs in the state, while another has shown it can compete consistently at the highest level. Two other teams had breakthrough seasons last year, and are looking to build on them.

Benedictine, Liberty County, Jenkins and Savannah High caught the imagination of high school football fans across the Coastal Empire last year and the teams cant wait to get their seasons started.

In his seventh year at the helm at Benedictine, Danny Britt is looking to follow up on a perfect season as the Cadets rolled through Class 2A beating Fitzgerald handily in the title game for the GHSA state championship and finishing 15-0.

The title run came two years after Britt led the Cadets to their first football crown, also in Class 2A in 2014 when they beat Greater Atlanta Christian in the championship game.

Britt (66-14 through six seasons at BC) is stressing that this season has nothing to do with last years success.

Trying to do the same thing we did last season, going undefeated, is virtually impossible, Britt said. But we never come into a season setting a certain number of wins or a championship as a goal. We have more internal goals like how we run practice every day, and who is going to become our leaders. That way we can always be successful and improve every day.

Britt said that his goal when he started at Benedictine was to build a program rather than a team.

In essence that was the big picture of what I wanted to accomplish when I got here, Britt said. I wanted the freshmen who entered BC to grow as a player and a person in their four years here. I wanted something that was year-round and consistent so we could develop and grow.

With a senior class featuring quarterback Nick Iannone, running backs Terrick Smalls and Travis Blackshear and free safety Jonah Griffin, the Cadets are stacked and ready to make another playoff run.

Libertys legacy

Liberty County has been on the way up the last few years under Kirk Warner, who enters his 16th year leading the Panthers. Last season, Liberty County advanced to the Class 3A quarterfinals, losing to Greater Atlanta Christian in triple overtime to end the year. The Panthers have posted a 19-6 record in the last two years and developed stars such as Raekwon McMillan, who went on to Ohio State and is now a rookie with the Miami Dolphins, and Richard LeCounte, now a freshman at Warners alma mater of Georgia.

The No. 1 key to our success is that we have been blessed with some excellent players, but I think another factor has been our coaching staff, Warner said. We have had a lot of stability there and not much turnover. I think our staff does a great job keeping our kids on track in school with their academics as well as working well with them on the field. Its twofold, we have the talent and we have the coaches to push the players to be the best they can be.

The talent train keeps rolling into Hinesville at the Liberty County Station. Defensive tackle Tramel Walthour looks to carry on the tradition McMillan and LeCounte created of top national recruits. DE Traveon Freeman and DB Josh Washington will also be standouts along with running back/receiver Kris Coleman.

Jenkins and Savannah gave public school fans something to cheer about last year on the football field in addition to the basketball court, where the city schools have traditionally excelled. And both schools have new coaches this year.

Back at Jenkins

Jason Cameron, 31, takes over at Jenkins. The New Jersey native was the offensive coordinator for the Warriors for five seasons before stepping away last year. Hes back after veteran coach Tim Adams took an assistant coaching job at Effingham County, leading a team that includes some top-notch talent including wide receiver Tyrone Scott, quarterback Javonte Middleton and linebacker Kareem Bailey.

It was s a great experience working with coach Adams and Ive played for and worked with a number of excellent coaches, Cameron said. Im going to take some of the things I have learned from them and add in my own style and mesh it together.

Were coming into the season with high expectations, but were setting our goals on a day-to-day basis. We want to win each day in the weight room, each rep in practice and move on from there.

Last year, the Warriors edged Savannah High 21-20 and won their first region crown since 1966. They went on to beat Dougherty County in the first round for the first postseason win in school history.

Milestones for SHS

Savannah High had a similar breakthrough last year under coach Tony Welch. The Blue Jackets went 9-3, making the playoffs for the first time since 1993 and winning a postseason game for the first time since 1969.

Welch left after three seasons to take the same post at his alma mater, Claxton. David Roberson, 31, a former assistant at Lithia Springs and player at Savannah State, is now in charge.

Roberson has a strong group of returning athletes including Region 3-3A player of the year Malik Nesbitt and quarterback Dezmond Brinson, who recently received a scholarship offer from Cornell. The Blue Jackets picked up a big-time player in Fred Nunn, a linebacker/fullback who transferred from Benedictine.

We have a lot of guys coming back, so were not going to try to reinvent the wheel, Roberson said. Were going to try to accentuate on the positive things we did last year. We worked on some deficiencies that we had. But these kids have been in this system for three years. They are comfortable with it. Were going to introduce a few new formations, but were also going to stick with the things that we did well.

The big date on the Savannah High schedule is Oct. 20, when the Blue Jackets face Jenkins at Memorial Stadium in a rematch of last years classic. They also will host Claxton and coach Welch on Sept. 1 at Memorial.

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Benedictine, Liberty Co., Jenkins and Savannah High construct programs for long-term success - Savannah Morning News

A Libertarian and Progressive Agree: This Reform Is Needed to Fix Elections – IVN News

It kind of sounds like an odd pairing at first, no? A self-described neo-libertarian and a progressive Democratjoin forces. Yet what they are advocating for is something most people will agree on: We need fairer elections.

Manu Koenig the neo-libertarian and Faisal Fazilat the progressive Democrat are two locals of Santa Cruz, California, who want their city to adopt ranked choice voting. It is reform that theysay has been endorsed byformer President Barack Obama, Sen. John McCain, and Sen. Bernie Sanders, among others.

Its an issue that both sides of the political spectrum can agree onbecause, in the end, every side wants fair elections. Everyone wants it to be democratic, says Fazilat. (Good Times, August 16, 2017)

How does ranked choice voting work? Here is a video that explains it and why advocates support it:

Here are a few things supporters say ranked choice voting can do:

Ranked choice voting would encourage candidates to actually talk about the issues that voters care about. This kind of system favors grassroots campaigns where candidates are going door-to-door. Theyre talking with as many people as they can, saysFaisal Fazilat.

Read more about Manu Koenig and Faisal Fazilat and their grassroots effort to adopt ranked choice voting in Santa Cruz, California here.

Ranked choice voting is currently used in 11 cities, will be used in Memphis starting in 2019, and is the law of the land in Maine for statewide and non-presidential federal elections. Voters in Santa Fe, New Mexico, approved ranked choice voting in 2008, but the city council has yet to implementits use in city elections.

Photo Credit: Steve Heap / shutterstock.com

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A Libertarian and Progressive Agree: This Reform Is Needed to Fix Elections - IVN News

Tropical Storm Harvey Begins to Drench the Windward Islands; Tropical Storm Conditions Expected to Arrive Early Friday – The Weather Channel

Story Highlights

Harvey will bring rain and gusty winds to the Windward Islands.

Then, it will track across the Caribbean Sea into next week.

Harvey is not a threat to the United States.

Two other areas of disturbed weather are being monitored for development in the Atlantic Basin.

Tropical Storm Harvey is beginning to bring rain to theWindward Islands, and may posea threat early next week in parts of Central America's Caribbean coast.

Tropical storm warnings have been issued for parts of the Windward Islands, including Martinique, St. Lucia, Barbadosand St. Vincent and the Grenadines. Warnings are issued when tropical storm conditions are expected within 36 hours. A tropical storm watch is in effect for Dominica, where those conditions are possible within that timeframe.

(MORE: Hurricane Central)

Tropical storm conditions, with winds of 39 mph or greater, are expected to first reach the Lesser Antilles within the warning areaearly Friday, making outside preparations difficult or dangerous. Tropical storm conditions are possible in the watch area on Friday.

Thunderstorm activity over the storm has not changed much since a Thursday afternoon hurricane hunter flight found winds of 40 mph. Another mission is scheduled into Harvey on Friday morning to see if anything has changed in the storm.

Harvey will bring2 to 4 inches of rain across the Windward Islands from Martinique southward to Grenada, which could trigger life-threatening flash flooding and mudslides in mountainous terrain.

After that, the system will then track westward through the rest of the Caribbean Sea, and will likelypose a threat to parts of Central America and/or Mexico's Yucatan Peninsula early next week.

It's not clear how strong thistropical storm will become through its Caribbean trek, due to potential interaction with dry conditions and sinking air. Interests throughout the Caribbean should monitor the progress of Harvey through early next week.

At this time, Tropical Storm Harvey is not a threat to the United States.

Invest 92L continues tofesterafew hundred miles to the east of Harvey.

This invest has shown signs of strengthening through late day Thursday, and could become a tropical depression on Friday or over the weekend.

A fresh surge of such dry air, known as theSaharan Air Layer (SAL),is pushing toward 92L right now.This dry air may mix in with the disturbance, preventing thunderstorms from persisting and clustering.

Furthermore, if 92L tracks farther north, as expected, wind shear the change in wind direction with height is strongerto the north of the Leeward Islands, according to an analysis from the University of Wisconsin.

This hostile wind shearthat typically rips apart tropical disturbances and weaker tropical cyclones may inhibit 92L from developing significantly, if it gains enough latitude north of the Leeward Islands this weekend.

A hurricane hunter mission has beententatively scheduled for Saturday afternoonto determine if Invest 92L has organized and strengthened enough to be classified as atropical depression or tropical storm.

It's worth noting that even if 92L doesn't develop into a tropical cyclone the next few days, this disturbance will likely continue migrating through the Bahamas, then into the Gulf of Mexico next week and will be monitored for any potential later development.

Finally,a tropical wave emerged off the west African coast Wednesday, well east of Harvey and 92L, kicking offits journey across the eastern Atlantic Ocean.

This latest wave may develop by the weekendbut won't near the longitude of the Lesser Antilles until early next week.

(MORE: Tropical Cyclone During the Eclipse?)

What form that system takes tropical wave, depression, storm or hurricane and where it exactly tracks remain unknown at this time, though the majority of forecast guidance suggests this system will track north of the Leeward Islands.

(MORE: Why Tropical Waves are Important During Hurricane Season)

We are in the climatological peak of the hurricane season, so each tropical wave or area of low pressure in the Atlantic Basin must be watched closely for development. As the image to the right shows, named storms can form in about every part of the Atlantic Basin this time of year.

As an example, thedisturbance that formed into Gertto thenortheast of the Bahamas lastweekend was tracked for nearly 10 days before it finally developed. That tropical wave also originated over Africa.

That said, not all tropical waves orlow-pressure systems that emerge from Africa become tropical depressions or tropical storms, but they are all monitored closely, particularly when atmospheric conditions are ripe for them to spin up.

(MORE: Where Every U.S. Landfalling Hurricane Began Its Journey)

Now is a good time to make sure you have a plan in case of a hurricane strike. The Federal Alliance for Safe Homes has an excellent website to help you make your plan.

Check back with weather.com for updates in the days ahead on these latest systems and the rest of hurricane season.

(MORE: NOAA Predicts Active Rest of the Hurricane Season)

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Tropical Storm Harvey Begins to Drench the Windward Islands; Tropical Storm Conditions Expected to Arrive Early Friday - The Weather Channel

Weymouth neighbors transform traffic islands into memorials – The Patriot Ledger

Century Road has three traffic islands, all maintained by the neighbors that live there.

WEYMOUTH Century Road, a quiet dead-end street, is distinguished by three traffic islands, each 40 feet long and 10 feet wide that were originally maintained by the town.

That was until Joe Saccardo, a retired State Police trooper living in the neighborhood, and his wife, Mary Ann, began to look after the one directly in front of their home 15 years ago.

He transformed the island, then mostly just grass, into a memorial for his son, Mark Saccardo. Mark Saccardo, a Boston College graduate, died in a car accident in 1997 at 23.

I wanted to do something in memory of my son, said Saccardo, who has lived in the neighborhood for 43 years.

Mark Saccardos island bears a plaque reading This island is maintained in memory of Mark Duke Saccardo. He earned the nickname Duke because of his love for the show Dukes of Hazzard. The island is dotted with small trees, surrounded with purple flowers. Under the shade of the tree is a small stone bench.

Before long, Saccardo said, other neighbors joined in. The second island is maintained by the Proud Century Road neighbors and friends and not in memory of anyone specific.

The third island is maintained by Century Road resident Ginny Flynn. The island is dedicated in memory of her husband, Frank. Frank Flynn, of Weymouth, was a 28-year veteran of the Boston Fire Department. Flynn died in 2014 after a battle with lung cancer.

Joe Saccardo was surprised other residents began to maintain the islands with him.

I think its great that people responded after I did, said Joe Saccardo. It brings together the neighborhood. We may be the only street with islands maintained by residents in Weymouth.

Zane Razzaq may be reached at zrazzaq@ledger.com.

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Weymouth neighbors transform traffic islands into memorials - The Patriot Ledger

Bids for low-number Cape and Islands license plates reach almost $13000 – The Boston Globe

How much would you pay for the license plate of your dreams?

For low-number Cape and Islands plates, people are bidding as high as $12,760, as of Thursday afternoon.

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The plates up for auction, numbered one through 999, are part of the IC series and have never before been issued.

If you want a number thats special to you, or if you think having a single digit on your license plate will make your beat-up car look classier, act fast, because bidding for the plates ends Friday at 5 p.m.

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Bids on single and double-digit numbers are in the thousands, but if your lucky number happens to be in the triple digits, you could be sporting it on your license plate for less than $200.

The auction is in celebration of the 20th anniversary of the release of the specialty Cape and Islands license plates, said Wendy Northcross, chief executive of the Cape Cod Chamber of Commerce.

Northcross said the Cape and Islands plate is especially popular because of its design, which features Easthams Nauset Lighthouse.

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Although seemingly simple, its the states most popular specialty plate, with more than 42,000 on the road since they were introduced in 1996.

Some people tell us, Oh, we just love the lighthouse, Northcross said.

Jay Coburn, the executive director of the Cape Cod Community Development Partnership, attributed the popularity of the plates to vacationers affinity for the Cape.

Half of the second homes in the Commonwealth of Massachusetts are on Cape Cod, so we have a huge population of part-timers here ... and its a really important part of their lives, he said.

Whether you want the plate to show your love for the Cape or to spruce up your ride, the money you bid will be used for good.

All the proceeds go to economic development or tourist promotion on the Cape and Islands, Northcross said.

Proceeds will fund upkeep of visitor centers, business counseling services, loans to small businesses, and affordable housing projects.

The winner of each plate will be notified automatically as soon as bidding closes Friday.

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Bids for low-number Cape and Islands license plates reach almost $13000 - The Boston Globe

Dutch engineers test floating islands with hopes to house communities threatened by rising seas – Fox News

As sea levels around the world continue to rise, countries continue to explore new and innovative techniques to protect infrastructure and coastal communities.

In the Netherlands, a team of engineers is currently exploring the possibility of what life might be like if people lived and worked at sea.

Researchers from Maritime Research Institute Netherlands (Marin) recently tested out a floating mega island which is made of 87 large floating triangles and can reach as large as 5 km (3 miles). The island was put through a simulation where it withstood waves with a height of 50 feet (15 meters).

(Photo/Marin)

The floating islands could be a future housing solution in locations such as the Netherlands and parts of the southeastern United States coast, which are at risk from rising seas.

As sea level rises, cities become overcrowded and more activities are carried out at sea, raising the dikes and reclaiming land from the seas are perhaps no longer an effective solution," said Olaf Waals, project manager and the concept developer for Marin. An innovative alternative that fits with the Dutch maritime tradition is floating ports and cities.

A recent study from University of Florida researchers said that sea-level rise is accelerating in parts of the southeastern U.S.

The study, published in Geophysical Research Letters, said sea levels rose dramatically between Cape Hatteras, North Carolina, and Miami from 2011 to 2015, and during that time, the rise was six times more than the global average sea rise attributed to climate change.

The reason for the accelerated rise, or "hot spot," is being attributed to a "one-two punch from naturally occurring climate variations," specifically El Nio and the North Atlantic Oscillation.

In a statement, Arnoldo Valle-Levinson, lead author of the study and professor of civil and coastal engineering sciences, described the future for some southeastern U.S. cities as Venice-like.

We need to understand that the ocean is coming, Valle-Levinson said.

In a recent interview with Nola.com, Waals said cities such as New Orleans may need space where they could develop or put homes as sea levels rise.

Waals said their first test was to see how the 26-foot-wide model behaves in wind, waves and currents, and it "did well because the island flexes with the waves."

"The first row of triangles bend with the waves but also reflect the energy of the waves," Waals said. "It would be feasible to actually absorb a lot of the wave energy."

Testing was conducted in Marin's offshore model basin, a large pool where ocean waves, winds and currents can be simulated.

The project has been underway for about a year, and in that time, the research team developed the triangular shaped islands and planned how they wanted to connect them, Erik-Jan De Ridder a senior project manager for Marin told AccuWeather in an email.

Possible uses include providing working space for cultivating food, such as fish; loading and transporting cargo in areas where there is little infrastructure; and storing, generating and maintaining sustainable energy, like solar power.

(Photo/Marin)

Some of the benefits of the islands include the ability to be easily extended by connecting additional islands, as well as easily remove islands.

Drawbacks include potential ecological problems like how the islands could block sunlight from reaching aquatic plants. There will also be considerable economical and technical challenges as well as government regulations to overcome before these islands could become a reality, according to De Ridder.

Many questions remain including how strong the islands need to be to withstand winds and currents, how traffic and transportation would be organized and what effect the motion of the island could have on the people who would live and work there.

Marin will next look to conduct testing in intermediate-sized bodies of water where there is some type of shelter, like a bay. Eventually, the group will aim to move large structures offshore.

De Ridder said it's difficult to say how soon it will be before housing is possible since they are in the early stages of development, but in 10 years it might be possible to have several houses in a sheltered area.

People will have to get used to the idea that you can live on a floating island, De Ridder said.

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Dutch engineers test floating islands with hopes to house communities threatened by rising seas - Fox News

The Untimely Death Of A Marshall Islands Visionary – Honolulu Civil Beat

After a short, sudden illness that ended with cardiac arrest in a Taipei Hospital, the Republic of the Marshall Islands second highest ranking official, Minister in Assistance Mattlan Zackhras, died on Aug. 8 at the age of 47.

In a statement, Marshall Islands President Hilda Heine praised Minister Matt (as he was known) for work(ing) tirelessly, at home and abroad, on behalf of the Marshallese people and the Islands that he deeply loved.

Foreign Minister John Silk would assume Zackhras duties, Heine said.

Zackhras, a native of Namdrik Atoll, served in RMIs parliament, called the Nitijela, from 2004 until his death and, as Minister in Assistance, the Marshall Islands equivalent of vice president. Pre-dating his career in politics and continuing throughout it, Zackhras was well-known as a leader in promoting sustainable development projects like copra and coconut oil production and pearl farming on Namdrik.

In 2015, Zackhras helped secure more than $375,000 from the U.S. to support black lip pearl oyster farming as a way to bolster economic opportunity in the face of climate change according to Tom Armbruster, U.S. ambassador to the Marshall Islands (2012-2016). Armbruster said the project demonstrated the resilience of the Marshallese people as well as Zackhras own initiative and positive outlook.

He was always a welcoming and warm public servant who put the Marshall Islands and its people first, Armbruster wrote in an email, describing Zackhras death as a real loss.

Marshall Islands Minister in Assistance Zackhras Mattian, center, died earlier this month. Colleagues call his unexpected passing a great loss.

Hilary Hosia

Although Marshall Islands culture, language and legendary seafaring navigational prowess are millennia-old, the Republic of the Marshall Islands wasnt established as a self-governing nation until 1979 after centuries of colonization by Spain, Germany, Japan, and finally the United States.

Between 1946 and 1958, the U.S. conducted 67 nuclear weapons tests in the northern Marshall Islands resulting in radiation contamination, widespread deaths and illness, forced displacement and a severe disruption of culture and society.

In recent years, this relatively young United Nations member (RMI joined the U.N. in 1991) has become a prominent example of how low-lying island nations are being impacted by coastal inundation, coral bleaching, prolonged drought and other climate change-related threats.

In the face of these challenges, Zackhras proved himself to be an effective local and national leader and a tireless advocate for his country and other large ocean states on the international stage.

Andrew Jacobs, the European Unions ambassador for the Pacific, described Zackhras as a true warrior for climate action, saying that his advocacy carried influence around the world in the mould of former (RMI) Minister Tony deBrum. Jacobs called Zackhras death a great loss.

Writing from the RMI capital of Majuro, Jack Niedenthal, general secretary of the Marshall Islands Red Cross Society, called Zackhras a go to senator who always made time to help people and someone who enjoyed celebrating great ideas without seeking to take credit.

Mattlan was simply a genuinely nice person, Niedenthal said.

Mark Stege, outgoing director of the Marshall Islands Conservation Society, explained that as a leader in Parliament, Zackhras elevated his colleagues consciousness about the importance in conservation in the Pacific. Stege said Zackhras was instrumental in building a model of community-driven coastal resources management.

His continued hard work and quiet leadership championing conservation during these times will bear fruit for the Marshallese people for many decades to come, said Stege.

Tamara Greenstone Alefaio of the Micronesia Conservation Trust worked with Zackhras on many initiatives for more than a dozen years praised him as a humble leader who listened with intent and spoke with clarity to advance climate action and advocate for his country. Continuing his work, she said, is the best way to honor his legacy.

In an age of political strongmen, when loud voices, bullies and sabre rattlers get the most headlines, Minister Mattlan Zackhras was the polar opposite. Soft-spoken, down-to-earth, genuinely warm and forthcoming, I had the chance to interview him while on a reporting trip to Majuro in May 2016.

While President Heine was overseas and Minister Matt was acting-president, he still made time to meet with me in his office for nearly an hour. Now, as then, his thoughts on climate change, migration, the nuclear legacy and working for his nations first female president are worth revisiting.

Below are are excerpts from our interview. Comments have been edited for clarity and length.

Jon Letman: I want to ask you about migration. As I understand it, the number of Marshallese living outside of the Marshall Islands is now maybe between 30 percent to 40 percent of the overall population. How does your administration see migration? Is it something you want to stop or slow or does it have benefits?

Minister Matt: I think any government in any country would like to see their people remain where they are. In the second set of (Compact of Free Association) negotiations, I would say that we really fought hard to convince the U.S. side that without the proper support to build the right type of medical facilities and education system that we needed and support along the way that would require, you would always see whether it will increase or decrease people utilizing this so-called safety valve within the Compact agreements.

The provision that allows us to travel (without a visa to the U.S.) its a privilege. I think thats what we try to tell our people: be constructive or be part of the communities constructively and not become a burden. Unfortunately you have some people that just fall through the crack and go out without even proper training. We want to focus on these trade area trainings, when some of our people go out they can be helpful and be part of the community rather than be a so-called burden that we hear a lot.

Is your administration doing something to create conditions so that people are less likely to want to migrate or less likely to feel the need to and what are the focus areas?

This administration wants to create more jobs. Thats why people just leave looking for work. Others may view it differently but right now were facing a brain drain in our country because the most capable and smart people are going out. I dont blame them but at the same time we try to instill a sense of responsibility and (patriotism) towards their country because no matter where they are they will always come back and have to pay their share to the country. Again, you dont want all your capable people going out and a way to stop it is to raise the standard of living. Its becoming harder and harder to find jobs here in the Marshall Islands. Thats why they go out.

Minister Matt, as he was known, worked with Namdrik technician Apii McLeod in 2012 on a project to develop oyster cultivation and harvesting. Theyre holding bags of black lip oyster pearls.

Giff Johnson

We also talked about Kwajalein Atoll, home to the U.S. Armys Ronald Reagan Ballistic Missile Defense Test Site, and how it affects Marshallese living near the base.

Weve always viewed ourselves as a major contributor to world peace. Not only because of Kwajalein military base and the ongoing missile testing there but starting back from the nuclear legacy when the strongest atomic bomb was dropped here as a test site. So I think while the U.S. may find Kwajalein of strategic importance, I think it should be a two-way street. The benefit that we get out of (it) is the assistance that comes through the rental of the facility the lease(through 2066) towards our landowners and rightly so.

In terms of the work force and the small economy there, I see some contribution where most of the workers in terms of the labor force, the majority of it is Marshallese and we have very capable people in the park plants and doing basic stuff. But I would just like to see more training to become more responsible to key areas. We see the value in Kwajalein and the military base but it should be both ways.

You know, theyre benefiting just by testing billion and million dollars worth of military equipment on a daily basis or whenever they do their testing. I know the amount of money spent on this and how important it is for the U.S. but I dont think it should be at the expense of the local people.

We discussed the right of strategic denial which gives the U.S. exclusive military control over more than half a million square miles of land, air and water in the Pacific, including the RMI. I asked Minister Matt if he thought the Marshall Islands would be under threat without the U.S. base at Kwajalein.

The concern now is that there is just so much influence of China in the region. So much so that theyre just next door in FSM (the Federated States of Micronesia) because FSM recognizes China the Marshall Islands dont. Diplomatically, we recognize Taiwan. But threat I dont really see it, but again its these big brothers trying to dominate the region. When you combine all three Micronesian nations Palau, FSM and Marshalls, thats a big body of water and its one of the most lucrative bodies when it comes to fishing. Today theyre not really looking at land its the ocean, because were ocean states.

I know this is a complicated question, but are nuclear issues resolved?

To us it will never be resolved until the U.S. discloses everything because most of what we dont know is still classified. And just recently they were declassified because we worked with the Clinton administration when he was in office and he allowed some of it to be declassified and we found some information like Project 4.1 where we werent aware of it when we negotiated the first Compact. You cannot just wash your hands off of an issue that is still impacting the Marshallese people until today. You have a big dome on Enewetak (atoll) thats leaking and youre just not doing anything about it.

Runit dome? Is it leaking?

Runit dome yeah.

Has there been an adequate response by the U.S.?

Well, theyre saying its not contaminated. After the testing they just brought in all of the materials and shielded it with a large cement dome over it and just say, okay, problem solved.

What do you think Americans today should understand about these nuclear issues?

I think thats the very unfortunate part of our story, is that we dont have access to the major networks like CNN. We can be captured a little here and there whenever theres an article about climate and we link up the nuclear issue with that just to raise the profile again and remind people. But if it was the U.S. and it was the sheer thought of the extent and strength of a nuclear device being tested in their soil that would have been a major issue.

Take Nevada, for example, and try to compare. I think the only difference is that it was done in a different country. And for those who probably dont really understand, I think its on us today, a lot of the youngsters today need to keep the momentum going because most of our leaders that were living back then are dying or theyve already gone, but they were brave. I live until the day that we will see the full disclosure of all the documents.

Is that central to disclosure?

Theres no closure until theres full disclosure to this nuclear (issue). Im glad that its being discussed now at the World Humanitarian Summit, the issue of loss and damage. Well, it has to do with the climate change but again, looking at it from humanitys side. Thats something that we really need to revisit and keep telling the story to anyone and everyone that wants to open their ears and understand.

Last question, real quick President Heine, I believe shes your boss.

Yes.

She is the first female president of an independent Pacific Island nation, the first female president of the Marshall Islands. What is the significance of this?

Shes also the first female president in the Pacific region. I think were just proud of her accomplishments. Theres no question that a woman would have been president, it was just a matter of when. Its a very timely appointment because, were seeing others coming into play. And I dont know about the U.S. but I know for sure about Taiwan. (President Heine) is in Taiwan now for the inauguration of (Taiwans first female president Tsai Ing-wen), she took three of our lady mayors with her so its mostly a womans delegation led by the president.Others were very excited when I attended recent meetings in Guam. They were saying, Oh, it would have been us! Palau, they were also saying it should be us.

While some may say that we are not there yet, I think shes proven so many people wrong and I think she will keep on surprising people. Shes a tough lady and very consistent, no doubt about her education background and how smart she is because shes probably the smartest person in the parliament today but I think she made history and its a positive one for the Marshall Islands.

End note: Three months after interviewing Minister Matt in Majuro, I met him for a second time by chance at the East-West Center in Honolulu at a meeting of Pacific Island nation leaders. When I saw Minister Matt, I called him over and reminded him of our previous meeting. He quickly smiled and took my hand and, as before, was approachable, genuine, and full of warmth.

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The Untimely Death Of A Marshall Islands Visionary - Honolulu Civil Beat

Cancer Genetics Expert Katherine L. Nathanson, MD, Named Deputy Director of Abramson Cancer Center – Newswise (press release)

Newswise PHILADELPHIA Katherine L. Nathanson, MD, an internationally recognized expert in the field of cancer genetics, has been named deputy director of the Abramson Cancer Center of the University of Pennsylvania. Nathanson is a professor of Translational Medicine and Human Genetics in the Perelman School of Medicine, and the associate director for Population Sciences in the Abramson Cancer Center, co-leader of the Cancer Control Program, and Chief Oncogenomics Physician. She also serves as director of Genetics for the Basser Center for BRCA. She will begin her new role as deputy director immediately.

Dr. Nathanson is a distinguished physician-scientist and has long been a valued colleague and member of the cancer center, said Robert Vonderheide, MD, DPhil, the director of the ACC. Her clinical and research portfolio incorporates an impressive array of diseases. She has played a critical role in many of the ACCs most recent advancements and is well known as an international expert in somatic and germline cancer genetics. I am delighted she has accepted this new leadership role.

As Deputy Director, Nathanson will oversee multiple aspects of the cancer centers scientific and clinical missions, including strategic planning, program development and evaluation, faculty recruitment, leadership appointments, and resource allocation.

Im honored to take on this new leadership role to advance the mission of the Abramson Cancer Center: to reduce the burden of cancer throughout the region, the nation, and the world by extending our integrated program of laboratory, clinical and population-based research, Nathanson said.

Nathanson received her bachelors degree from Haverford College and her MD from the University of Pennsylvania. She completed residencies in Internal Medicine at Beth Israel Hospital in Boston, as well as in Clinical genetics at the Childrens Hospital of Philadelphia and at Penn. She joined the Penn faculty in 2001, and since then, she has published more than 250 peer-reviewed articles in top journals, such as Nature, JAMA, Cancer Cell, and The New England Journal of Medicine. She has an extensive record of national service for multiple organizations including the American College of Medical Genetics and Genomics, where she serves as the Cancer Genetics editor for Genetics in Medicine, and the American Association for Cancer Research. Nathanson is also the chair of the Cancer Genetics study section for the National Institutes of Health and is an elected member of the American Society of Clinical Investigation and the American Association of Physicians.

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Penn Medicineis one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of theRaymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and theUniversity of Pennsylvania Health System, which together form a $6.7 billion enterprise.

The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 20 years, according toU.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $392 million awarded in the 2016 fiscal year.

The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center -- which are recognized as one of the nation's top "Honor Roll" hospitals byU.S. News & World Report-- Chester County Hospital; Lancaster General Health; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2016, Penn Medicine provided $393 million to benefit our community.

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Cancer Genetics Expert Katherine L. Nathanson, MD, Named Deputy Director of Abramson Cancer Center - Newswise (press release)

Idaho dairy industry elevates worker safety, training – Capital Press

Idahos dairy industry is taking a unique and proactive approach to improving worker safety with a statewide on-farm training program.

Carol Ryan Dumas/Capital Press

David Douphrate, assistant professor of epidemiology, human genetics and environmental sciences at the University of Texas, answers questions during a panel on a new worker training program for Idahos dairy industry during the Idaho Milk Processors Association annual conference, while Robert Hagevoort, extension dairy specialist at New Mexico State University, looks on.

SUN VALLEY, Idaho Training a largely inexperienced, non-English-speaking workforce on Idahos dairies for the ultimate goal of worker safety has become a priority for both dairymen and the processors they supply.

Unfortunately, it took a fatality on a dairy to bring it to the table, Rick Naerebout, director of operations for the Idaho Dairymens Association, said during the Idaho Milk Processors Association annual conference last week.

That tragedy occurred in February 2016, when worker Ruperto Vazquez-Carrera, 37, drowned in a waste pond after mistakenly driving a feed truck into the pond in pre-dawn hours under flooded conditions.

IDFA quickly responded to prevent future tragedies by engaging with experts in worker safety and training to figure out how to get our arms around the issue of comprehensive training, Naerabout said.

We realized we have an opportunity to do more than check a box on safety and be proactive instead of reactive, he said.

The worker training and safety program has been in development for more than a year, and IDFA has hired a full-time worker training and safety specialist to lead it. The program rolled out this week, starting at dairies owned by IDA board members.

Processors are collaborating in the program and sharing in the cost, said Daragh Maccabee, senior vice president of procurement and dairy economics for Glanbia Nutritionals.

Processors met with IDA in April 2016 to discuss a path forward, wanting to participate in a meaningful way, he said.

While there are already good practices in place, the event which drew the attention of OSHA, the United Farm Workers of American and the media highlighted a need for more structure. The primary objective of the program is to provide a safe work environment, he said.

People safety is our No.1 priority, and Glanbia wants to support the producer community in a real way, he said.

As an industry, we need to be able to show to the world we are responsible, he said.

IDFA contracted worker safety and training experts David Douphrate, assistant professor of epidemiology, human genetics and environmental sciences at the University of Texas, and Robert Hagevoort, extension dairy specialist with New Mexico State University to develop a program.

Hagevoort said the U.S. dairy industry is experiencing growing pains, with the number of operations decreasing and herd size increasing, driven by economies of scale. It is also moving to automation, with a need for high-skilled workers.

Employment on dairies is not based on skill but on willingness, resulting in a lot of foreign workers unfamiliar with large animals. And its a population challenged by reading comprehension and retention, he said.

Training has to be consistent, repetitive and comprehensive and include both classroom and live training with animals. In addition to the what, the why of safety issues and animal handling must be explained, he said.

Idahos consortium can be beneficial in developing and evaluating training materials and training the trainer to train employees, he said.

Douphrate agreed, saying the focus needs to be on safety leadership and management.

You cant be everywhere on the farm, you have to delegate and need to equip supervisors, he said.

They need to be able to effectively train workers and evaluate whether that training is being retained and workers are applying what they learned, he said.

We want a proactive approach to address injuries and fatalities before they happen, he said.

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Genetic Variance is Key to Individual Immune Response – Genetic Engineering & Biotechnology News

Ever wonder why your friend, co-worker, or partner doesnt get as sick as you, even though they caught the same bug you did? Maybe they made some Faustian bargain that affords them greater protection to infections, or perhaps they are part of some top-secret government experiment that injects them with an array of antigens isolated from an alien race living in Area 51. While both theories are potential explanations, it seems likely that differences in response to infection lie in something a bit more scientificlike genetics. Now, a collaborative team of investigators from the University of Bonn, Germany, and the New York Genome Center has just published findings that map several genetic variants that affect how much gene expression changes in response to an immune stimulus.

Results from the new studypublished in Nature Communications in an article entitled Genetic Regulatory Effects Modified by Immune Activation Contribute to Autoimmune Disease Associationsoffer novel insights into the genetic contribution to varying immune responses among individuals and its consequences on immune-mediated diseases.

Our defense mechanisms against microbial pathogens rely on white blood cells that are specialized to detect infection," explained co-senior study investigator Veit Hornung, Ph.D., chair of immunobiochemistry at the Ludwig-Maxmilians-Universitt in Munich. Upon encounter of microbes, these cells trigger cellular defense programs via activating and repressing the expression of hundreds of genes.

We wanted to understand how genetic differences between individuals affect this cellular response to infection," added co-senior study investigator Johannes Schumacher, Ph.D., a research scientist at the Institute of Human Genetics within the University of Bonn.

The human immune system plays a central role in autoimmune and inflammatory diseases, cancer, metabolism, and aging. The researchers discovered hundreds of genes where the response to immune stimulus depended on the genetic variants carried by the individual.

"These genes include many of the well-known genes of the human immune system, demonstrating that genetic variation has an important role in how the human immune system works," noted lead study investigator Sarah Kim-Hellmuth, Ph.D., a postdoctoral researcher at the New York Genome Center. "While earlier studies have mapped some of these effects, this study is particularly comprehensive, with three stimuli and two-time points analyzed."

In the current study, the research team captured genetic variants whose effects on gene regulation were different depending on the different infectious state of the cells. These included four associations to diseases such as cholesterol level and celiac disease. Moreover, the researchers discovered a trend of genetic risk for autoimmune diseases such as lupus and celiac disease to be enriched for gene regulatory effects modified by the immune state.

"Here, we isolate monocytes from 134 genotyped individuals, stimulate these cells with three defined microbe-associated molecular patterns (LPS, MDP, and 5-ppp-dsRNA) [lipopolysaccharide, muramyl dipeptide, and 5' triphosphate double-stranded RNA], and profile the transcriptomes at three-time points, the authors wrote. Mapping expression quantitative trait loci (eQTL), we identify 417 response eQTLs (reQTLs) with varying effects between conditions. We characterize the dynamics of genetic regulation on early and late immune response and observe an enrichment of reQTLs in distal cis-regulatory elements. In addition, reQTLs are enriched for recent positive selection with an evolutionary trend towards enhanced immune response. Finally, we uncover reQTL effects in multiple GWAS [genome-wide association study] loci and showed a stronger enrichment for response than constant eQTLs in GWAS signals of several autoimmune diseases.

Co-senior author Tuuli Lappalainen, Ph.D., assistant professor at Columbia University and core member of the New York Genome Center added that this data supports a paradigm where genetic disease risk is sometimes driven not by genetic variants causing constant cellular dysregulation, but by causing a failure to respond properly to environmental conditions such as infection."

Using the collected monocyte samples, the researchers treated the cells with three components that mimic infection with bacteria or a virus. They then analyzed how cells from different individuals respond to infection by measuring gene expression both during the early and late immune response. Integrating the gene expression profiles with genome-wide genetic data of each individual, they were able to map how genetic variants affect gene expression, and how this genetic effect changes with the immune stimulus.

Findings from this new study provide a highly robust and comprehensive dataset of innate immune responses and show wide variation among individuals exposed to diverse pathogens over multiple time points. The investigators identified population differences in immune response and demonstrated that immune response modifies genetic associations to disease. The research sheds light on the genomic elements underlying response to environmental stimuli and the dynamics and evolution of immune response.

"It's been known for a long time that most diseases have both genetic and environmental risk factors, concluded Dr. Lappalainen. But it's actually more complicated than that because genes and environment interact. As demonstrated in our study, a genetic risk factor may manifest only in certain environments. We are still in early stages of understanding the interplay of genetics and environment, but our results indicate that this is a key component of human biology and disease. The molecular approach that we took in our study can be a particularly powerful way for researchers to delve deeper into this question."

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Genetic Variance is Key to Individual Immune Response - Genetic Engineering & Biotechnology News

The healthcare debate we’re not having – The Hill (blog)

Theheadlinesfrom Capitol Hill give the impression that Congress is debating the future of U.S. healthcare. Thats somewhat misleading. The debate is about health insurance, not healthcare.

It is an important distinction. Insurance is a ticket to enter the healthcare system. Healthcare is what the system delivers. To be sure, if Congress rolls back insurance coverage, it will prevent millions of Americans from gaining timely access to healthcare. That is abad outcome in itself and worthy of the attention its getting.

Nonetheless, a real debate over healthcare would begin with an accurate diagnosis of our ailing system. We have theworlds most expensive healthcare, and despite the superior quality of American providers, science and technology ourlife expectancyandinfant mortality ratesare the middle of the pack among developed nations.

The cost, quality and patient experience of care varies widely among doctors and hospitals. Despite billions of dollars of investments in information technology, medical records still dont follow patients across providers, and we lack the real-time data insights that fuel quality improvement in other industries. Finally, our healthcare system emphasizes treating people when they are sick not keeping them well.

Federal policy on its own cannot improve the sectors leadership, culture, cost or quality. Those of us who provide care must step up and accept accountability for the results we deliver. But the federal government can help us chart a course toward more patient-focused, coordinated and cost-efficient care by giving us the right incentives, setting consistent rules and removing the roadblocks.

Thats why a new debate should begin with the topic that is currently missing from the headlines: payment.

We pay for most healthcare services today one by one, a system called fee-for-service. The more services a doctor or hospital delivers, the more they get paid. Sicker patients earn them (us) higher payments and drive each healthcare team member to concentrate on the services they alone deliver, not the patient as a whole person. As a result, we care for people in a fragmented, inefficient and costly fashion.

Conversely, if we were to pay providers based on the quality and cost of care they provide, they would more likely focus on keeping people well, managing patient illnesses and preventing costly interventions that send people to the hospital. This is known popularly as value-based care. It may be a poor choice of phrases, conjuring up K-marts blue-light special instead of Tiffanys light blue box, but the point is the right one: payment should reward the value of services not the volume. Value-based payment holds providers accountable for the quality of their care, and puts their payments at risk if they dont deliver.

The federal government can play a decisive role in moving the ball forward. Medicare alone accounts for20 percent of all healthcare spending. Under both Democratic and Republican administrations, Medicare has begun to embrace value-based payments.

But instead of accelerating this trend, the Trump administration has proposed slowing it down, albeit to avoid overwhelming small physician practices. If we stay on this course, it will penalize early adopters like Prevea Health and many of my fellow American Medical Group Association members, which have invested millions reengineering systems to provide value-based care. The administration should be helping lead the way, not putting on the brakes.

We also lack timely access to Medicare and commercial payer claims data about the very patients we serve. Data is the lifeblood of quality improvement, and without it, we lack the feedback we need to improve patients health outcomes. Congress can fix this by requiring both federal and commercial payers to provide access to this data.

But data is also a double-edged sword. Currently, Prevea is required to submit data to numerous payers in different formats. And we are not alone shouldering this incredible burden on financial and workforce resources that could be spent on patient care.

One study reported inHealth Affairsfound that physicians in four common specialties spend, on average, 785 hours per physician and $15.4 billion annually dealing with the reporting of quality measures. Congress should require federal and commercial payers to standardize the data submission and reporting processes.

In the depths of the Great Depression, FDR said, The country demands bold, persistent experimentation. It is common sense to take a method and try it: If it fails, admit it frankly and try another. But above all, try something.

Bold, persistent experimentation is what we, as healthcare leaders, need to be asking of Congress. We know the healthcare system we have isnt serving our best interests. The debate we should be having in Washington and throughout our country is about creating a system that will.

AshokRai, M.D., is president and CEO of Prevea Health and the incoming chairman of American Medical Group Association,an Alexandria, Va.-based association representing multispecialty medical groups and integrated systems of care.

The views expressed by contributors are their own and are not the views of The Hill.

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The healthcare debate we're not having - The Hill (blog)

All of these health-care plans are so 20th century – Washington Post

By Todd G. Buchholz By Todd G. Buchholz August 17 at 7:25 PM

Parrots can learn economics, claimed Victorian economist Alfred Marshall. Just teach the parrot to squawk supply and demand. So if a parrot can learn, why cant the U.S. government?

House and Senate GOP health-care plans, like Obamacare itself, have squawked loudly about subsidizing demand but said little about the supply of doctors, nurses and drugs. That is economic malpractice.

It is also so 20th-century. In an era of Amazon, Uber and Airbnb, the non-health-care economy is getting a shock treatment of new supply that is boosting accessibility while restraining prices. Health care needs a supply-side shock, too, and government can help.

Health care is not entirely immune to supply-side pressures. When Lasik eye surgery appeared in 1999, thousands of eye surgeons jumped into the act and prices fell by about 25 percent in 10 years. Shortly after the Food and Drug Administration approved Botox for furrowed brows in 2002, dermatologists, nurses and spas jumped in, keeping prices from rising. The government does not subsidize these cosmetic procedures.

We are seeing other hints of supply-side improvements in medicine. In California, Heal.com will send a doctor to your house for $99. Does it work? In San Diego, Heal.com receives a 4.5 score on Yelp. Nearby hospitals receive a 3.0.

Now, of course, the hospital handles many more dire cases than a drive-up doctor making house calls. But note this: Many hospital patients are labeled LWOT (left without treatment). These are cases in which sick or injured patients feel so frustrated with waiting times that they drive off. In one California hospital, more than 20 percent of emergency-room patients are LWOT.

An aging population is pushing up demand, and without more supply, prices will catapult higher. Doctors are aging, too: More than 30 percent are 60 or older. Forecasts project a physician shortage ranging from 46,000 to 90,000 by 2025, especially among specialists.

Already, one quarter of the federal budget goes to Medicare and Medicaid. Taxpayers will find themselves frustrated with packed waiting rooms and higher taxes. So what can Washington do to help spark a supply-side shock in health care? Here are four important steps:

First, we need new medical schools. The United States accredited no new medical schools from 1986 through 2004. Recently, in response to the looming shortage of doctors, a number of new schools have been announced, for example, at the University of Nevada, Seton Hall and Washington State. Yet new schools face formidable licensing costs and delays from federal, state and local boards, which can deny accreditation for serious reasons such as unhygienic equipment as well as nonmedical worries such as the dimensions of parking garage spaces. Government agencies can work together to fast-track approval processes.

Second, state governments should give greater authority to nurse practitioners and physician assistants to open their own practices and encourage walk-in clinics, such as CVSs Minute Clinic and Walmarts Care Clinic. Research shows that, compared with doctors offices, such clinics deliver cheaper and equivalent care for patients who presented symptoms of ear infections, sore throats and urinary tract infections.

Third, the Food and Drug Administration should pursue reciprocity for drug approval with other advanced countries. Under current law, if a drug is approved by the European Medicines Agency, Americans cannot buy it unless the FDA slogs through its own long, expensive protocol. And theres precedent: In 2013, a potentially lethal meningitis outbreak spread through Princeton Universitys dorms. Princeton begged the government to allow it to buy a common vaccine made by Novartis in Switzerland. The bureaucrats eventually relented. Why cant the FDA permit reciprocity with other advanced countries for other cases?

Finally, legal reform could also save patients money. Fear of lawsuits cuts the effective supply of health-care services in two ways: First, malpractice insurance payments encourage early retirement. Second, fear prods practicing doctors to order unnecessary procedures, leaving fewer resources for those who need treatment. More than 80 percent of physicians say that they prescribe tests for fear they will be sued if they do not. The American Board of Internal Medicine has specified 45 tests that are often prescribed without merit, from annual electrocardiograms to imaging for temporary lower back pain.

Americans need more doctors, more nurses and more prudent care.Trying to solve health-care problems by focusing just on demand is like trying to cut rope with only the bottom blade of a scissors. Youll likely struggle to get the results you desire, and you might even hurt yourself.

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All of these health-care plans are so 20th century - Washington Post

Doctors warm to single-payer health care – Salon

Single-payer health care is still a controversial idea in the U.S., but a majority of physicians are moving to support it, a new survey finds.

Fifty-six percent of doctors registered either strong support or were somewhat supportive of a single-payer health system, according to the survey by Merritt Hawkins, a physician recruitment firm. In its 2008 survey, opinions ran the opposite way 58 percent opposed single-payer. Whats changed?

Red tape, doctors tell Merritt Hawkins. Phillip Miller, the firms vice president of communications, said that in the thousands of conversations its employees have with doctors each year, physicians often say they are tired of dealing with billing and paperwork, which takes time away from patients.

Physicians long for the relative clarity and simplicity of single-payer. In their minds, it would create less distractions, taking care of patients not reimbursement, Miller said.

In a single-payer system, a public entity, such as the government, would pay all the medical bills for a certain population, rather than insurance companies doing that work.

A long-term trend away from physicians owning their practices may be another reason that single-payer is winning some over. Last year was the first in which fewer than half of practicing physicians owned their practice 47.1 percent according to the American Medical Associations surveys in 2012, 2014 and 2016. Many doctors are today employed by hospitals or health care institutions, rather than working for themselves in traditional solo or small-group private practices. Those doctors might be less invested in who pays the invoices, Miller said.

Theres also a growing sense of inevitability, Miller said, as more doctors assume single-payer is on the horizon.

I would say there is a sense of frustration, a sense of maybe resignation that were moving in that direction, lets go there and get it over with, he said.

Merritt Hawkins emailed its survey Aug. 3 and received responses from 1,003 doctors. The margin of sampling error is plus or minus 3.1 percentage points.

The Affordable Care Act established the principle that everyone deserves health coverage, said Shawn Martin, senior vice president for advocacy at the American Academy of Family Physicians. Inside the medical profession, the conversation has changed to how best to provide universal coverage, he said.

Thats the debate were moving into, thats why youre seeing a renewed interest in single-payer, Martin said.

Dr. Steven Schroeder, who chaired a national commission in 2013 that studied how physicians are paid, said the attitude of medical students is also shifting.

Schroeder has taught medicine at the University of California-San Francisco Medical Center since 1971 and has noticed students increasing support for a single-payer system, an attitude they likely carry into their professional careers.

Most of the medical students here dont understand why the rest of the country doesnt support it, said Schroeder.

The Merritt Hawkins findings follow two similar surveys this year.

In February, a LinkedIn survey of 500 doctors found that 48 percent supported a Medicare for all type of system, and 32 percent opposed the idea.

The second, released by the Chicago Medical Society in June, reported that 56 percent of doctors in that area picked single-payer as the best care to the greatest number of people. More than 1,000 doctors were surveyed.

Since June 2016, more than 2,500 doctors have endorsed a proposal published in the American Journal of Public Health calling for a single-payer to replace the Affordable Care Act. The plan was drafted by the Physicians for a National Health Program (PNHP), which says it represents 21,600 doctors, medical students and health professionals who support single-payer.

Clare Fauke, a communications specialist for the organization, said the group added 1,065 members in the past year and membership is now the highest since PNHP began in 1987.

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Doctors warm to single-payer health care - Salon

Trump administration agrees to continue healthcare subsidy for now – Los Angeles Times

The Trump administration, faced with increasing pressure from Republican members of Congress, backed away from causing an immediate crisis in healthcare marketplaces and agreed Wednesday to continue making payments to insurance companies that are widely viewed as critical to keeping the industry stable.

President Trump and his top aides have flirted for months with cutting off the money, known as cost-sharing reduction payments, which help subsidize insurance co-payments and deductibles for low-income and moderate-income Americans. Doing so would be one step toward causing the Affordable Care Act to implode as Trump has sometimes put it.

The decision to make this months payment, due next week, signaled that the administration has decided against immediately precipitating a collapse, potentially giving Congress time to pass a bipartisan package of fixes to some of the laws problems.

Leading Republican members of Congress have pressed the administration to keep making the payments, fearing that any move to cut them off would cause chaos in insurance markets. Trump has said voters would blame Democrats for any problems with the markets, but few Republican elected officials share that view.

The pressure to continue the payments increased Tuesday when the Congressional Budget Office reported that cutting off the payments would actually increase federal spending. Ending them would cause insurance premiums to rise sharply and thereby increase the cost of other government subsidies, the budget office said.

A White House official confirmed Wednesday that the administration had decided to make this months payment, which will total about $600 million. The question of whether to make future payments remains under review.

The announcement drew praise from Sen. Lamar Alexander (R-Tenn.), the head of the Senate committee that handles healthcare legislation.

The decision to continue the subsidies helps 18 million Americans who dont get insurance from the government or on the job, Alexander said in a statement.

When Congress returns from its recess in September, lawmakers should quickly pass legislation that would continue the payments through next year, Alexander said.

The continuation should be linked to changes in the current law to give states more flexibility on the kinds of insurance policies that consumers can buy, he added.

But some conservative lawmakers and organizations were quick to voice their displeasure, calling the payments a bailout of insurance companies.

That opposition illustrated the difficulty Alexander and like-minded lawmakers will face in trying to round up Republican support for legislation to stabilize a healthcare law the party has long wanted to repeal.

And if Congress does not quickly settle the issue, the continued month-to-month uncertainty about the payments is likely to cause insurers to hike premiums.

Already, industry executives have publicly blamed the uncertainty for higher premiums for next year. Insurers are coming up on deadlines next month for setting their premiums for next years open enrollment period.

The part of the healthcare law at issue greatly lowers the cost of insurance for millions of low- and middle-income consumers by requiring insurers to hold down deductibles and co-payments.

That requirement can save thousands of dollars for families with big medical bills who can qualify for the cost reductions if their incomes are below about 2 times the federal poverty level.

The requirement to hold down co-payments and deductibles, however, costs insurance companies a lot of money. To make them whole, the government reimburses them with the monthly payments.

Since early this year, the administration has refused to commit to continue sending the checks.

In late July, after Republicans failed in their effort to repeal the healthcare law, Trump said that he wanted to let Obamacare implode. An abrupt cutoff of the cost-reduction payments would be among the quickest ways to make that happen.

The cost-sharing reductions have long been a controversial part of the healthcare law.

Republican lawmakers went to court in 2014 to challenge the payments, saying Congress had never appropriated money for them. A federal district judge in Washington agreed last year. The Obama administration appealed, and the ruling has been on hold ever since.

At one point, Trump administration officials talked of dropping the appeal as a way to kill the payments. That option faded this month after Democratic state attorneys general won the right to intervene in the case, which would allow them to keep the appeal alive if Trump pulled out.

Although many of Trumps advisors oppose the payments, the budget office report Tuesday put them in a difficult position.

The report from the nonpartisan budget office said that cutting off the payments would have paradoxical effect of increasing federal spending.

Thats so because insurers would still be required to hold down deductibles and co-payments for low- and moderate-income consumers. To avoid losing money, some insurers would pull out of the marketplaces. Most, however, would raise premiums, the budget office projected.

The premiums for the medium-cost silver plans on the exchanges, which are the most popular plans among consumers, would go up by about 20% to 25% over the next couple of years if the cost-sharing payments ended, the budget office said.

The cost of those higher premiums would land primarily on taxpayers, not on individual consumers. Thats because nearly 80% of people receiving coverage on the marketplaces also receive a second kind of government assistance to help pay monthly premiums. As overall premiums rise, so will the cost of those other government subsidies.

The net result would be to increase the federal deficit by almost $200 billion over the next 10 years, the budget office said.

If the subsidy payments were ended, insurers pulling out of the market would leave about 5% of the population in counties with no marketplace insurer, the budget office also projected.

david.lauter@latimes.com

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Trump administration agrees to continue healthcare subsidy for now - Los Angeles Times

Health care still an employee priority as businesses eye uncertain future – Pittsburgh Post-Gazette


Pittsburgh Post-Gazette
Health care still an employee priority as businesses eye uncertain future
Pittsburgh Post-Gazette
Health care remains a primary concern for most employees in the job search process, though some companies say that age impacts how important of a consideration those benefits are. At Leroy Metz's Downtown law firm Metz Lewis Brodman Must O'Keefe, ...

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Health care still an employee priority as businesses eye uncertain future - Pittsburgh Post-Gazette