Episode 71: The advancements and innovations in veterinary medicine – DVM 360

In this episode of The Vet Blast Podcast, Dr Adam Christman is joined by Brendan Lynch, VP of digital strategy and client experience at VCA Animal Hospitals, who discloses not only why innovation matters but also how technology can advance the profession to new heights.

According to Brendan Lynch, VP of digital strategy and client experience at Veterinary Center of America Inc. (VCA) Animal Hospitals, the pandemic brought increased patient demands and higher client expectations with simultaneous veterinary staff shortages, empathy fatigue, and burnout across teams. Ergo, now more than ever innovative change is essential for veterinary professionals to stay healthy and to maintain a prosperous profession.

I believe that its time to evolve, adapt and find new and better ways to do things that help our veterinary teams, our clients, and their pets, he told Adam Christman, DVM, MBA, in this episode of The Vet Blast Podcast.

Lynch then described the efforts VCA has made to adapt practice operations during the pandemic and beyond, including how this has benefited clients and veterinary staff alike.

One of the things that I think was exciting that [VCA] leaned into a lotis our digital abilities to improve access to care, increase convenience, and streamline the operational workflows," Lynch said. "We saw close to 50,000 clients use our telehealth services with 165% increase from before the pandemic and then we had sent and received over 11 million text messages between our hospital teams and clients and this was just in 2020 alone.

Weve been seeing this adoption continue to accelerate going into 2021 which has been a great opportunity to help us streamline the experience for our clients and associatesThis year to date, weve conducted or completed close to 2 million mobile payments transactions," he added.

Listen to the full podcast below for more on the strides VCA has been making in veterinary practice innovation.

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Episode 71: The advancements and innovations in veterinary medicine - DVM 360

UChicago Medicine performs record-breaking heart transplants on Thanksgiving – WGN-TV

CHICAGO Lifesaving work doesnt stop on the holidays.

This Thanksgiving, doctors at the University of Chicago Medicine performed record-breaking work.

Some patients and their families are incredibly thankful this Thanksgiving after the transplant team saved not one but two lives today.

The University of Chicago Medicine transplant team keeps beating even on Thanksgiving Day.

We had two patients who probably would not have lived past another 24-48 hours, and we gave them potentially decades more of life, said Dr. Val Jeevanandam, Director of Heart and Vascular Center at UChicago Medicine. So we gave them a lot more Thanksgivings in the future.

This Thanksgiving, the team surpassed previous years, bringing the total number of heart transplants in 2021 to 55.

We think that we have broken the record for number of transplants done in Illinois in a calendar year, and it was all done at Thanksgiving, Jeevanandam said.

It was a gratifying day for both those whose lives were saved and those doing the saving.

There was about 10 people who were part of this team to get the transplants done, and I think were all thankful for the fact that were part of a program that was able to help people and be able to save lives on Thanksgiving Day, Jeevanandam said.

Thanksgiving dinner plans had to be postponed for some because of the intensive surgeries. But, this lifesaving team at UChicago Medicine was able to make it home to finish off the holiday.

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Yale researchers unlock secrets through study of long-term effects of COVID-19 – Yale Daily News

Yale researchers expand their work on long COVID in conjunction with Survivor Corps to study how vaccinations are affecting long COVID symptoms.

Yash Roy 11:45 pm, Nov 28, 2021

Contributing Reporter

Jessai Flores

Researchers at the Yale School of Medicine are currently engaged in a year-long study to investigate the long-term effects of COVID-19, colloquially termed long COVID.

Symptoms of long COVID include fatigue, shortness of breath, difficulty concentrating, sleep disorders, fevers, anxiety and depression, all of which can persist for months after initially contracting and recovering from COVID-19. In recent months, professors and community members at the School of Medicine have turned their focus towards the condition, according to professor of medicine Harlan Krumholz. A study currently underway aims to track the long-term implications of COVID-19 vaccines on previously infected individuals who continue to suffer from long COVID.

What were trying to do is bring together the best of clinical and epidemiologic science with basic biological science and to then make some kinds of conclusions about what it is that people are experiencing [with long COVID], Krumholz said. What are the factors that seem to be associated with better or worse trajectories? And what are the underlying biological factors that seem to be underlying some of these syndromes [with long COVID]?

Krumholz explained that Yale researchers started their inquiry into long COVID with research conducted in February by Albert Ko, professor of epidemiology at the Yale School of Public Health. Ko started to develop large scale studies of healthcare workers, and collect both blood and information about [them] from the outset. The aim of this study was to determine the long-term effects of COVID-19.

For the study, Yale researchers turned to Akiko Iwasaki, professor of immunobiology and molecular, cellular and developmental biology and of epidemiology at the School of Medicine, and also partnered with Survivor Corps, the largest COVID-19 survivor organization in the United States.

[Our] goal is to try to understand the disease pathogenesis behind long COVID, Iwasaki said. And the tool that were using is to really leverage the changes in the immune responses that occur after vaccination. [Vaccinations] are therapy or intervention where people have reported significant changes in their symptoms. The vaccines themselves arent going to be a cure for the long COVID, but its a means for us to learn about how the vaccine might improve somebodys symptoms. And so we can emulate that better with a more appropriate therapy.

The study has tested five different hypotheses on why long COVID exists, according to Iwasaki. Among them is the viral reservoir hypothesis, in which infectious particles or remnants of the virus persist in the bodies of people afflicted with long COVID. The second is that autoimmune diseases are triggered by COVID-19. The third centers around microbiomes and the balance of good and bad bacteria in the body. The fourth stems from unrepaired tissue damage, and the fifth focuses on the reactivation of previous viruses, like herpes. While there are five distinct hypotheses, Iwasaki explained that the underlying reasons for long COVID might be a combination of these.

According to Diana Berrent, founder of Survivor Corps, she and Iwasaki began to work together to study long COVID in people who had been vaccinated after connecting over social media.

It started off as a Twitter conversation, Berrent explained. The study was eventually launched in the spring and was completed over the summer as a longitudinal study [a study that observes variables over a long period of time]. So, this is an example of citizens and scientists working together to make science go at little warp speed.

According to Iwasaki, the partnership with Survivor Corps helped facilitate enrollment in the study, since at the time of her February conversation with Berrent the organization already had about 100,000 members who had been infected with COVID-19.

The first stage of the vaccination study concluded this summer. Due to recent impositions of vaccine mandates throughout the U.S., the researchers are expanding upon their existing research by increasing the number of individuals in the study and watching their symptoms through the end of next May.

According to Daisy Massey 19, clinical research affiliate at the medical school, the research focuses on the patterns of how vaccinations are changing immune systems and affecting long COVID.

By looking in such detail at the immune system during these immune assays [a procedure that records a response to a given stimulation], the goal is to look for patterns continuously in the people we study and eventually hopefully being able to test hypotheses that we developed together, Massey told the News. The stage were at right now is weve had the first wave of people go through. But with the vaccine mandate, were actually coming up with more people who are planning now to get vaccinated so we are starting to come together and do analyses now.

According to Krumholz, the studies larger implications are the development strategies that have the power to unlock a lot of secrets about whats causing these problems [with long COVID].

Survivor Corps was founded in 2021 to bring COVID-19 survivors together.

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Sport and Physical Activity Research and Teaching Network – Faculty of Medicine and Health – News – The University of Sydney

The Sport and Physical Activity Research and TeAching Network (SPARTAN) aims to facilitate high-impact interdisciplinary research that addresses physical activity and public health, promotes population health, advances knowledge and expertise in athletic performance and identifies novel strategies in injury prevention and management.

The Faculty of Medicine and Health (FMH) is proud to include world-leading experts in physical activity and elite sport research. SPARTAN brings together the global expertise of FMH members in Public Health, Sport Science and Medicine and key strategic collaborator Sydney University Sports and Fitness (SUFS) to explore the facilitators of human health, performance, and best practice in injury prevention and management.

We aim for our research, education and collaborations to contribute to better health outcomes for people in the community from vulnerable groups at risk of physical inactivity, through to competitive athletes at every level including juniors, Masters and retired athletes.

SPARTAN will offically launch on Wednesday December 2021, 12.30 - 1.30pm. Register here to join this event. Network membership will be opened at this time.

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Sport and Physical Activity Research and Teaching Network - Faculty of Medicine and Health - News - The University of Sydney

Health Care Professions merit badge debuts, replacing the Medicine merit badge – Scouting Magazine

The badge design will not change.

Within the vast and vital universe of health care, there are pharmacists and phlebotomists, optometrists and orthotists, sonographers and speech therapists to name just a half-dozen of the many specialists who keep us healthy and happy.

In fact, these professionals work in a field so vast that simply calling it all Medicine doesnt quite cut it.

Thats why this month, the Boy Scouts of America is introducing the Health Care Professions merit badge, a STEM-focused, career-oriented badge designed to introduce young people to the roles that health care professionals play in the delivery of health care.

The badge will replace the Medicine merit badge and will feature a new merit badge pamphlet and new requirements, available here. The design of the merit badge emblem will not change.

When the Medicine merit badge was first introduced in 1991, it was primarily developed to focus on the doctor side of human health care delivery, says Lisa Balbes, advancement lead of the Scouts BSA Committee. As the fields of human medicine expanded through specialization, support services and technology, it became apparent that Scouts were interested in learning about other areas of human health care and medical support.

Trying to develop an individual merit badge for each health care specialization would see the number of available merit badges more than double.

Instead, theBSA has decided to create a single merit badge that will encompass a wide variety of health care careers, Balbes says.

The Health Care Professions merit badge is highly customizable, meaning Scouts can select which health care professions to investigate further.

Does your Scout have an aunt who is an audiologist or a neighbor who is a nurse anesthetist? They can choose those professions to examine in greater depth.

The badge requirements present Scouts with four groups of health care professions. Within each group, Scouts get to choose three that interest them most. They must describe the role those professionals play and research what educational and licensing requirements those professionals must meet.

The groups are:

Group 1:

Group 2:

Group 3:

Group 4:

For requirement 5, Scouts must choose one of the 33 professions listed above and arrange to visit that professional at their workplace. After that meeting, the Scout must discuss the visit with their counselor.

Thats a great way for a Scout to get an up-close view of the important, challenging, well-paying field of health care.

Scouts who have begun work on the Medicine merit badge may continue working on it until they are finished or turn 18.

After Dec. 31, 2021, Scouts may not begin working on the Medicine merit badge and should instead work on the Health Care Professions badge.

Hard-copy editions of the Health Care Professions merit badge pamphlet should be available in mid-November.

Much more goes into a movie than cinematography. Thats why, in 2013, the BSA replaced the Cinematography merit badge with the Moviemaking merit badge.

Computers still play a critical role in our society, but they exist in a larger world of digital technology. Thats why, in 2014, the BSA replaced the Computers merit badge with the Digital Technology merit badge.

Notice the trend? The requirements within the BSAs138 merit badgesarent chiseled in stone. Theyre regularly adjusted in response to the real world.

That might mean smaller tweaks, like the 2016 addition of snowshoeing to the Snow Sports merit badge. Or it might mean major overhauls, like when Cooking became Eagle-required in 2014.

The National Merit Badge Subcommittee reviews all merit badges every two years, Balbes says. We want to ensure they are current and relevant to the needs of todays Scouts.

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Ultrashort-pulse lasers kill bacterial superbugs, spores Washington University School of Medicine in St. Louis – Washington University School of…

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Technique likely safe for human cells; has potential for sterilizing wounds, blood products

Researchers at Washington University School of Medicine in St. Louis have found that multidrug-resistant bacteria and bacterial spores can be killed by ultrashort-pulse lasers. The findings could lead to new ways to sterilize wounds and blood products without damaging human cells.

Life-threatening bacteria are becoming ever more resistant to antibiotics, making the search for alternatives to antibiotics an increasingly urgent challenge. For certain applications, one alternative may be a special type of laser.

Researchers at Washington University School of Medicine in St. Louis have found that lasers that emit ultrashort pulses of light can kill multidrug-resistant bacteria and hardy bacterial spores. The findings, available online in the Journal of Biophotonics, open up the possibility of using such lasers to destroy bacteria that are hard to kill by other means. The researchers previously have shown that such lasers dont damage human cells, making it possible to envision using the lasers to sterilize wounds or disinfect blood products.

The ultrashort-pulse laser technology uniquely inactivates pathogens while preserving human proteins and cells, said first author Shaw-Wei (David) Tsen, MD, PhD, an instructor of radiology at Washington Universitys Mallinckrodt Institute of Radiology (MIR). Imagine if, prior to closing a surgical wound, we could scan a laser beam across the site and further reduce the chances of infection. I can see this technology being used soon to disinfect biological products in vitro, and even to treat bloodstream infections in the future by putting patients on dialysis and passing the blood through a laser treatment device.

Tsen and senior author Samuel Achilefu, PhD, the Michel M. Ter-Pogossian Professor of Radiology and director of MIRs Biophotonics Research Center, have been exploring the germicidal properties of ultrashort-pulse lasers for years. They have shown that such lasers can inactivate viruses and ordinary bacteria without harming human cells. In the new study, conducted in collaboration with Shelley Haydel, PhD, a professor of microbiology at Arizona State University, they extended their exploration to antibiotic-resistant bacteria and bacterial spores.

The researchers trained their lasers on multidrug-resistant Staphylococcus aureus (MRSA), which causes infections of the skin, lungs and other organs, and extended spectrum beta-lactamase-producing Escherichia coli (E. coli), which cause urinary tract infections, diarrhea and wound infections. Apart from their shared ability to make people miserable, MRSA and E. coli are very different types of bacteria, representing two distant branches of the bacterial kingdom. The researchers also looked at spores of the bacterium Bacillus cereus, which causes food poisoning and food spoilage. Bacillus spores can withstand boiling and cooking.

In all cases, the lasers killed more than 99.9% of the target organisms, reducing their numbers by more than 1,000 times.

Viruses and bacteria contain densely packed protein structures that can be excited by an ultrashort-pulse laser. The laser kills by causing these protein structures to vibrate until some of their molecular bonds break. The broken ends quickly reattach to whatever they can find, which in many cases is not what they had been attached to before. The result is a mess of incorrect linkages inside and between proteins, and that mess causes normal protein function in microorganisms to grind to a halt.

We previously published a paper in which we showed that the laser power matters, Tsen said. At a certain laser power, were inactivating viruses. As you increase the power, you start inactivating bacteria. But it takes even higher power than that, and were talking orders of magnitude, to start killing human cells. So there is a therapeutic window where we can tune the laser parameters such that we can kill pathogens without affecting the human cells.

Heat, radiation and chemicals such as bleach are effective at sterilizing objects, but most are too damaging to be used on people or biological products. By inactivating all kinds of bacteria and viruses without damaging cells, ultrashort-pulse lasers could provide a new approach to making blood products and other biological products safer.

Anything derived from human or animal sources could be contaminated with pathogens, Tsen said. We screen all blood products before transfusing them to patients. The problem is that we have to know what were screening for. If a new blood-borne virus emerges, like HIV did in the 70s and 80s, it could get into the blood supply before we know it. Ultrashort-pulse lasers could be a way to make sure that our blood supply is clear of pathogens both known and unknown.

Tsen SWD, Popovich J, Hodges M, Haydel SE, Tsen KT, Sudlow G, Mueller EA, Levin PA, Achilefu S. Inactivation of multidrug-resistant bacteria and bacterial spores and generation of high-potency bacterial vaccines using ultrashort pulsed lasers. Journal of Biophotonics. Nov. 21, 2021. DOI: 10.1002/jbio.202100207

This research was supported by the National Institute of Biomedical Imaging and Bioengineering of the National Institutes of Health (NIH), grant number 3R01EB021048-04S1; and by Arizona State University investigator incentive funding.

SDT and KT hold patents on System and method for inactivating microorganisms with a femtosecond laser (publication no. US20080299636 A1).

Washington University School of Medicines 1,700 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Childrens hospitals. The School of Medicine is a leader in medical research, teaching and patient care, consistently ranking among the top medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Childrens hospitals, the School of Medicine is linked to BJC HealthCare.

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Baylor College of Medicine: Tips for staying safe and healthy this Thanksgiving as the pandemic continues – Community Impact Newspaper

A health expert with Baylor College of Medicine provides advice to stay safe and healthy while celebrating Thanksgiving with family. (Karolina Grabowska/Pexels)

One of the things thats better this year is that we have vaccines and the advantage of knowledge, said Isabel Valdez, physician assistant and assistant professor of general internal medicine at Baylor, in a Nov. 22 news release. We have learned a lot in the last year about how COVID-19 behaves and what it looks like. We also have more access to testing so that if we have symptoms we can get tested right away, even at home. Above all, we have vaccines. We have learned a lot and have come a long way.

Here are some health and safety tips as families across the country gather with their loved ones.

Gathering with family and friends

For the fully vaccinated, it is safe to gather around other vaccinated individuals since there is a lower chance of catching COVID-19 and spreading the infection to others, Valdez said. Despite this, it is still important to watch for symptoms and get tested symptoms become present, Valdez added.

Last year, the fear was that if you had symptoms you needed to stay home, Valdez said in the news release. You couldnt get tested as easily and we didnt have vaccines widely available, so we were telling people to cancel their plans. This year, assuming you are vaccinated, we are saying to put your plans on hold while you get your test results.

Valdez said it is important to be cautious around those who are immunocompromised and children who have not received their full vaccine doses. Also, outdoor seating is still recommended, if possible, and gatherings should be small and held with just family members, she said.

For those who are vaccinated and displaying symptoms, Valdez recommends social distancing and wearing a maskeven if the test is negativeto lessen the risk of passing other viruses such as the common cold or the flu.

Serving food

In 2020, serving food buffet-style was not recommended. This year, it is considered safe if everyone is vaccinated and incorporates a few hygiene rules, including keeping hand sanitizer and soap nearby, keeping food covered, ensuring there are utensils for every dish, and washing hands before and after preparing a dish, Valdez said.

For those who want to be extra cautious, you can wear your mask and sanitize your hands well before going up to the buffet table, regardless of vaccine status, she said.

Travel

Whether by car or by airplane, extra precautions are needed for travelers, Valdez said in the news release.

Flyers should keep their distance from others, or stick close together with their family or people they know while keeping hand sanitizer on hand and always wear their mask, Valdez said.

Even if you are vaccinated, its not a bad idea to stay cautious at the airport by wearing your mask and having hand sanitizer with you while walking around crowded places and touching things, Valdez said in the news release. If everyone in your family is vaccinated you can cluster together, because we dont know who all are vaccinated while at the airport. Be cognizant of spacing and [wear a] mask anytime you are going to be surrounded by the masses.

Finally, drivers should keep hand sanitizer in their car for when they stop at gas stations or rest stops, and wear their masks if they go indoors.

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Baylor College of Medicine: Tips for staying safe and healthy this Thanksgiving as the pandemic continues - Community Impact Newspaper

Microbiologists have cracked the case of Shedd Aquariums missing medicines – Ars Technica

Enlarge / The Shedd Aquarium in Chicago partnered with microbiologists at Northwestern University to find out why chloroquine kept disappearing from the water in the quarantine habitat.

Founded in 1930, Chicago's Shedd Aquarium is not just a popular tourist attraction. Its staff also aids in worldwide conservation efforts and conducts essential research on animal health and behavior, nutrition, genetics, aquatic filtration, and molecular and microbial ecology. Over the last four years, those staffers have been puzzled by the mysterious disappearance of an antiparasitic drug routinely added to the water in the aquarium's quarantine habitat. Now, with the help of microbiologists at Northwestern University, they've cracked the case. The culprits: some 21 members of a family of microbes who were munching regularly on the medicine in the water, according to a recent paper published in the journal Science of the Total Environment.

The aquarium's Center for Conservation and Research includes an Animal Care and Science Division, with a state-of-the-art animal hospital for monitoring the health of all the animals in the exhibits and treating them as necessary. (If you want to know how to give an electric eel an MRI, the center's team has you covered.)

Since 2015, the center has been working on a special research project investigating aquarium microbiomes. Among other topics, the project involves studying microbial communities in aquarium bio-filters. Such closed aquatic systems can quickly become toxic, thanks to ammonia waste from the fish, and certain microbial communities can help keep those levels in check. But other microbes are less beneficial, as evidenced by the Case of the Missing Chloroquine.

Whenever the Shedd Aquarium acquires new animals, the creatures are first placed in the quarantine habitat to prevent them introducing any outside pathogens into the aquarium's carefully controlled environment. Part of that process involves administrating chloroquine phosphate, usually by adding it to the habitat's water. Staffers regularly monitor the chloroquine concentrations, which is how they noticed that those concentrations were usually much lower than expectedoften too low to serve as an effective antiparasitic.

Enter co-author Erica M. Hartmann and her fellow microbial detectives from Northwestern University. They took samples of the quarantine habitat's water, as well as swab samples from the walls and pipes of the habitat. They brought the samples back to their lab for extensive analysis. All told, they counted some 754 different microbes that called the habitat home, and the team quickly surmised that the chloroquine thief was among them.

"There are microbes in the water, obviously, but there also are microbes that stick to the sides of surfaces," said Hartmann. "If you have ever had an aquarium at home, you probably noticed grime growing on the sides. People sometimes add snails or algae-eating fish to help clean the sides. So, we wanted to study whatever was in the water and whatever was stuck to the sides of the surfaces."

Next, the researchers had to winnow down the suspects. First, they took cultures of each microbe and gave each only chloroquine as food. Alas, those results didn't narrow the field that much. But a critical clue emerged from their chemical analysis of the leftover chloroquine: it was missing all the nitrogen.

"Carbon, nitrogen, oxygen and phosphorous are basic necessities that everything needs in order to live," said Hartmann. "In this case, it looks like the microbes were using the medicine as a source of nitrogen. When we examined how the medicine was degraded, we found that the piece of the molecule containing the nitrogen was gone. It would be the equivalent to eating only the pickles out of a cheeseburger and leaving the rest behind."

Eventually, Hartmann et al. were able to identify 21 potential perpetrators who flourished in the habitat's pipes, some of which do not appear to have been previously studied. It's still unclear which of those are scarfing up all the nitrogen in the chloroquine, but at least the aquarium now knows the issue lies in the pipes. Unfortunately, simply regularly flushing those pipes probably won't fix the problem, since the microbes cling tenaciously to the sides. According to Hartmann, the habitat pipes will need to be scrubbed or possibly replaced altogether. Switching between freshwater and seawater could also help keep microbial populations in check in the future.

"Overall, our results expand the body of knowledge surrounding aquarium microbiomes and veterinary drug degradation, revealing how microbial ecology and chemistry can be integrated into future management of saltwater circulating enclosures," the authors concluded. "Furthermore, these findings might illuminate phenomena occurring in other nitrogen-limited environments when nitrogen-containing anthropogenic chemicals are added."

DOI: Science of the Total Environment, 2021. 10.1016/j.scitotenv.2021.150532 (About DOIs).

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World is put on high alert over the Omicron coronavirus variant – WXOW.com

Dutch health authorities are investigating whether 61 people traveling from South Africa who tested positive for Covid-19 on Friday were infected with the new and potentially more transmissible coronavirus variant known as Omicron.

The World Health Organization (WHO) said late on Friday that early evidence suggest the Omicron variant, first identified in South Africa, could pose an increased risk of reinfection and said that some of the mutations detected on the variant were concerning.

The variant has so far been found in Botswana, Hong Kong and Belgium. The European Centre for Disease Prevention and Control said Friday there was a "high to very high" risk the new variant would spread in Europe.

GGD Kennemerland, the municipal health service responsible for the Amsterdam Schiphol airport, said the positive test results would be examined as soon as possible. Those who tested positive were sent into isolation at a nearby hotel, the Dutch authorities added.

The discovery of the new variant has sparked fears around the world. A number of countries have imposed travel bans and the global markets plunged.

But while WHO designated the Omicron a "variant of concern" on Friday, it stressed that more research is needed to determine whether the variant is more contagious, whether it causes more severe disease, and whether it could evade vaccines.

"This variant has a large number of mutations and some of these mutations have some worrying characteristics," Maria Van Kerkhove, WHO's technical lead for Covid-19, said in a statement on Friday.

"Right now there are many studies that are underway ... so far there's little information but those studies are underway so we need researchers to have the time to carry those out and WHO will inform the public and our partners and our member states as soon as we have more information," she added.

Lawrence Young, a virologist and a professor of molecular oncology at Warwick Medical School in the United Kingdom, said the Omicron variant was "very worrying."

"It is the most heavily mutated version of the virus we have seen to date. This variant carries some changes we've seen previously in other variants but never all together in one virus. It also has novel mutations," Young said in a statement.

The variant has a high number of mutations, about 50 overall. Crucially, South African genomic scientists said Thursday more than 30 of the mutations were found in the spike protein -- the structure the virus uses to get into the cells they attack.

The discovery of the variant sparked a fresh round of travel restrictions across the world, with many countries shutting their borders to travelers from several southern African countries.

The United States, the European Union, the United Kingdom, Australia, Japan, Russia, Brazil, Saudi Arabia, Israel, Egypt, the Philippines, Thailand and a number of other countries already announced or proposed bans on flights from the region.

Most, including the US, have restricted travel from South Africa, Botswana, Zimbabwe, Namibia, Lesotho, Eswatini, Mozambique and Malawi.

The South African government has taken an issue with the travel bans, pointing out in a statement that the Africa Centres for Disease Control and Prevention "strongly discourages" travel bans for people originating from countries that have reported the variant.

"Over the duration of this pandemic, we have observed that imposing bans on travelers from countries where a new variant is reported has not yielded a meaningful outcome," the statement said.

Scientists have praised South African health authorities for their quick reaction to a Covid-19 outbreak in the country's Gauteng province, which led to the discovery of the new variant.

When cases in the province started to rise at a higher rate than elsewhere, health experts focused on sequencing samples from those who tested positive, which allowed them to quickly identify the B.1.1.529 variant.

Peacock said the South African health ministry and its scientists "are to be applauded in their response, their science, and in sounding the alarm to the world."

She added the development shows how important it is to have excellent sequencing capabilities and to share expertise with others. That message was reinforced by WHO, which has on Friday called on countries to enhance their surveillance and sequencing efforts to better understand coronavirus variants.

But Dr. Richard Lessells, an infectious diseases specialist at the University of KwaZulu-Natal in Durban said South Africa was being "punished" for its transparency and ability to pick up the variant quickly and flag the issue to the international health authorities.

"What I found disgusting and really distressing ... was not just the travel ban being implemented by the UK and Europe but that that was the only reaction or the strongest reaction. There was no word of support that they're going to offer to African countries to help us control the pandemic," he told CNN.

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& 2021 Cable News Network, Inc., a WarnerMedia Company. All rights reserved.

CNN's Martin Goillandeau, David McKenzie, Ghazi Balkiz, Laura Smith-Spark, Sharon Braithwaite, Antonia Mortensen, Tim Lister and Lauren Lau contributed reporting.

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Internal medicine: a career path that leads to much more – The Star Online

WHAT kind of doctor do you want to be?

If you want to be a medical professional who thrives on providing your patients with comprehensive care to optimise their wellbeing, then you should consider a career in internal medicine.

Internal medicine is a combination of clinical diagnostics on a broad range of complex and common conditions, with a personalised and compassionate approach to medicine.

A doctor of internal medicine called internists specialises in managing diseases of internal organs such as the heart, kidneys, liver and lungs, while also serving as a primary care physician for adult patients.

The subspecialties within internal medicine include cardiology, gastroenterology, pulmonary or

critical care, infectious disease, haematology or oncology and nephrology.

Versatile and in-demand

Internists are trained to provide complete patient care.

As such, they can work in a number of different contexts, whether as primary care physicians, hospitalists or a combination of both, because they treat such a wide range of illnesses.

Some operate in a group or private practice, while others work in clinics, hospitals or medical offices.

Subsequently, internal medicine is often considered to be the gateway to a wide range of subspecialities.

Internists may opt to continue as general physicians or undergo additional training to specialise in a subspeciality.

Whichever path you choose, your services will be highly demanded, as it is projected that Malaysia will require an additional 28,000 specialists by 2030 to meet the demands of our growing and ageing population.

If you relish being a significant contributor to medical research, internal medicine may be a good fit for you too. This discipline places high value on research and internists are important in applying fundamental science information to clinical treatment, as well as in basic science discoveries.

Those who are team players will also benefit from being an internist. It is believed that most internists, including those in training programmes, will operate in teams in the future, with many leading the teams rather than practising independently.

Nurses, pharmacists, social workers, other professionals and other medical experts will make up the rest of the team, which is organised around the characteristics of the people or communities being treated.

To learn more, you can attend Newcastle University Medicine Malaysias ongoing masterclasses for medical students and healthcare professionals, which are held under its Forward NUMed banner.

The latest masterclass, titled Internal Medicine as a Speciality The Fast Track Way!, features notable speakers including International Medical University Malaysia professor of internal medicine Prof Datuk Dr Kew Siang Tong, Health Ministry medical development division deputy director Hirman Ismail, College of Physicians Malaysia president Prof Dr GR Letchuman Ramanathan, Malaysia Advanced Acute Internal Medicine and Ultrasound Society Datuk Seri Dr Paras Doshi, as well as NUMed honorary professor and consultant physician Edmund Ong.

The masterclass will be held this Saturday (Nov 27), from 9am to 12.30pm. Those interested can register at http://forwardnumed.newcastle.edu.my/

For the latest updates on upcoming webinars or masterclasses, visit the Forward NUMed: Charting New Paths to the Next Normal Facebook page or email admissions@newcastle.edu.my. You may also contact 07-555 3800 or WhatsApp 011-1231 5411 / 012-7849456.

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Internal medicine: a career path that leads to much more - The Star Online

How long Covid reveals western medicine’s weaknesses – The Independent

As I walked her up the flight of stairs to my clinic room, Victoria* barely engaged with my small talk. I glanced back at her. Above her mask, she looked strained, miserable, and I saw that her reticence was because she was ready to burst into tears. I thought one more question might have tipped her over the edge, so we continued in silence until we reached the sanctuary of the outpatient room.

The tears were not long in coming. She told me that early in the pandemic, before Covid testing was widely available, shed had what was assumed to be a mild case of the illness. Her doctor advised her to stay at home, which was the standard advice to everyone at that early stage of the pandemic. For the next few days, she lay in bed. A week passed, then two, and then steadily the weeks turned to months.

I had long Covid before it had a name, she told me. Yet even after it had a name, even after she had been assessed, X-rayed, had an MRI and countless blood tests, she was little better off. And even once people started talking about it, the name long Covid offered no clues about how this illness was to be treated, how long it might last, or what the future would now hold for those with it. And so at each clinic appointment Good news! Your lung function tests are completely normal! Victoria began to feel more adrift. If they couldnt find anything wrong with her, how was this ever going to be fixed?

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How long Covid reveals western medicine's weaknesses - The Independent

Vice-Chancellor’s Excellence Awards 2021 – Medicine, Nursing and Health Sciences – Monash University

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25 November 2021

Congratulations to all of our staff who were honoured at the recent Vice-Chancellors Excellence Awards 2021.

The annual awards acknowledge those who contribute above and beyond the requirements of their roles, and foster cross-University collaboration to achieve positive outcomes for our staff and students. For the first time this year, the awards expanded to include the Universitys staff both in Australia and overseas.

Full list of Faculty award recipients include:

The Vice-Chancellors Excellence Awards for Occupational Health & Safety (OH&S) recognise staff who have made an outstanding contribution by implementing innovative and exciting ideas in OH&S at Monash.

Multidisciplinary Collaboration:

Laboratory Services Team

The Vice-Chancellor's Excellence Awards for Diversity and Inclusion recognise staff (individuals and teams) who have made an outstanding contribution to supporting diversity and fostering inclusion at Monash and beyond.

This award has a particular focus on recognising staff who support workplace wellbeing and resilience. The awards recognised the contributions of professional staff who excelled, going above and beyond the requirements of their roles to demonstrate significant and sustained achievement.

Medicine Course Md Professional Staff Team

See the full list of University recipients.

About Monash University

Monash University is Australias largest university with more than 80,000 students. In the 60 years since its foundation, it has developed a reputation for world-leading high-impact research, quality teaching, and inspiring innovation.

With four campuses in Australia and a presence in Malaysia, China, India, Indonesia and Italy, it is one of the most internationalised Australian universities.

As a leading international medical research university with the largest medical faculty in Australia and integration with leading Australian teaching hospitals, we consistently rank in the top 50 universities worldwide for clinical, pre-clinical and health sciences.

For more news, visit Medicine, Nursing and Health Sciences or Monash University.

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Alberta Environment comments on rare wildlife sighting in Medicine Hat area – CHAT News Today

So I drove right by him and then I did a bit of a double take and my mind clicked in a little bit.. I was able to turn around for him to cross the road and get a few pictures of him, Borl added.

There have been only five official grey wolf sightings in the Medicine Hat area in just over 20 years, according to Joel Nicholson, Senior Wildlife Biologist with Alberta Environment and Parks.

He says the wolf hasnt caused a disruption and theyve taken no action against it.

Borl also caught images this year of some swift foxes in the Medicine Hat area, and while more common than the grey wolf, the foxes are on the endangered species list.

Borl believes the foxes and wolves are becoming more common in Alberta due to a more inclusive approach to wildlife by the public, which he applauds, saying they too belong in our province.

But he also notes he grew up on a farm and says he understands the concerns of rural landowners.

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Alberta Environment comments on rare wildlife sighting in Medicine Hat area - CHAT News Today

Auerbach: Michigan flipped the script to give Ohio State a taste of its own season-spoiling medicine – The Athletic

ANN ARBOR, Mich. Everyone calls this place the Big House, but everybody whos been for a game knows its almost never all that loud here. Its crowded, sure 110,000 of your closest friends (and some enemies) but the noise mostly evaporates from the bowled bleacher seats into the air.

Not on this day. Not against these Buckeyes. Not with so much history and so much failure riding on it all. It got loud, and it stayed loud.

By the time the Michigan players jumped and hugged and celebrated as the students poured over the wall to meet them midfield, Michigan Stadium pulsed at a decibel level previously unreached. Aidan Hutchinson, who cemented his place in Wolverines history on a day he sacked Ohio State quarterback C.J. Stroud three times, said hed never heard it this loud before.

But then again, Saturday was a day for firsts. Jim Harbaugh got his first win over Ohio State, a 42-27 victory that punched Michigans first-ever ticket to the Big Ten championship game. And perhaps the strangest twist of all was the manner in which the Wolverines beat the Buckeyes for the first time in nine tries.

It was domination, Harbaugh said.

Michigan flipped the script. It beat Ohio State the way it has so often been beaten during the Harbaugh era: by dominating both lines of scrimmage, with help from the nations best pass rusher (or two) and a rushing attack that picked up chunks at will. The Wolverines did not press. They did not commit dumb penalties. The game did not get away from them.

Michigan averaged 7.2 yards per carry to Ohio States 2.1.

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Auerbach: Michigan flipped the script to give Ohio State a taste of its own season-spoiling medicine - The Athletic

More colleges face bankruptcy even as top schools experience record wealth – CNBC

The University of Maryland

The Washington Post | The Washington Post | Getty Images

Across the country, colleges are in crisis.

Fewer students went back to school again this year, dragging undergraduate enrollment down another 3.5% from last year, according to a reportfrom the National Student Clearinghouse Research Center.

Combined with last autumn's declines, the number of undergraduate students in college is now down 7.8% compared to two years ago the largest two-year enrollment drop in the last 50 years, the report found.

There is, however, a wide disparity among schools, with less selective institutions and those serving low- and middle-income students seeing the biggest drop in enrollments.

Community college enrollment experienced the steepest declines, now down 15% since 2019, while highly selective colleges notched enrollment gains up 3.1% to return to pre-pandemic levels.

The consequences of fewer students and less tuition revenue could be severe, according to Sam Pollack, a partner and senior member of NEPC's Endowments and Foundations practice.

In fact, 62% of higher education leaders said that is the biggest challenge they now face, according to a recent NEPC survey.

More from Personal Finance:Less than half of high schoolers want to go to a four-year collegeHere are the colleges with the best return on investmentHow to maximize your college financial aid

Already, a number of small schools have had to shut down entirely.

Recently, Bloomfield College in New Jersey, which was founded in 1868,said it may be forced to close after the current academic year.

"Bloomfield College has been struggling with a decade-long decline in enrollment," Bloomfield's President Marcheta Evans said in a letter to the community. "The resulting financial challenges have only been exacerbated by the pandemic.

"And, Bloomfield is not alone," she added. Judson College in Alabama,Becker Collegein Massachusetts andConcordia College New Yorkalso plan to close, among others.

Meanwhile, the country's most elite institutions are faring better than ever and have the financial cushion to prove it.

This year, a small group of universities, including many in the Ivy League, experienced a record-breaking increase in applications and net revenue gains.

These schools also reported record-breaking gains for their endowments largely due to investments in private equity or venture capital, according to Pollack. Some endowments grew more than 50%.

As a result, universities such as Harvard, Yale, Stanford and Princeton are able to expand their financial aid offerings, lowering the cost and increasing the appeal to even more students nationwide.

"They are often made to be the villains, but the vast majority of these institutions are working very hard to deploy those funds to the benefit of students," Pollack said.

In fact, the top schools for financial aidare all private and their very generous aid packages can make them surprisingly affordable, despite the eye-popping sticker prices.

"If the highly selective schools are able to subsidize that cost, it makes it even more compelling and that has broad implications for the higher education landscape," Pollack said.

At Yale, for example, tuition and fees plus books, room and board averaged$77,750 this year, according to data from The Princeton Review, but the average need-based scholarship award or free money was just over $59,000 bringing the total out-of-pocket cost down to roughly $22,000.

"That hefty sticker cost might be intimidating, but find out the average cost that students and parents are actually paying," said Robert Franek, The Princeton Review's editor-in-chief.

"It could end up being less expensive than your local public college."

But without the same resources, less competitive schools are in danger of losing even more students, widening the divide, Pollack said.

Like what is happening to the nation as a whole, "there is increasing bifurcation between the haves and have nots and that appears to be true in higher education."

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More colleges face bankruptcy even as top schools experience record wealth - CNBC

Katie Price swerves final bankruptcy hearing AGAIN as court date is pushed back to February 2022… – The Sun

KATIE Price has swerved her final bankruptcy hearing AGAIN as the court date has been pushed back to February 2022, The Sun can reveal.

The 43-year-old star was due to return to court before the end of the year to update trustees on paying back her debts - but the hearing has now been rescheduled.

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A source told us: "Katie was due in court next month but now the court date has been moved to Feb 2022 - which is disappointing for a lot of creditors."

The former glamour model was declared bankrupt in November 2019, and in August we revealed that she faces prison if she misses her next hearing.

After the 2019 ruling, Katie was supposed to pay off 12,000 a month to her creditors after taking out an individual voluntary arrangement (IVA) - but failed to do so.

The next hearing is to review her attempts to pay back her hefty debts to creditors two years after going bust.

Katie owes a staggering 3.2 million to her creditors, but is unlikely to pay it all back.

The mother-of-five saw her once lucrative 45million media empire fall apart after the downfall of her third marriage to Kieran Hayler and the collapse of her businesses.

Exclusive

And earlier this year, Katie was hit with a repossession order for her 1.35million home after she failed to repay a debt of more than 500,000 on the property dubbed the Mucky Mansion.

She faces losing the house if she cannot stump up the cash to pay off her debtors before a repossession hearing.

A Land Registry search for the property reveals owner Katie owes money to both Kensington Mortgage Company and solicitor Archerfield Partners LLP.

It has been a difficult few months for Katie, who was admitted to rehab in September after pleading guilty to drink-driving while disqualified.

She was spared an immediate jail term despite flipping her BMW after a booze and drugs bender.

But she could still face jail when sentenced on December 15.

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Katie Price swerves final bankruptcy hearing AGAIN as court date is pushed back to February 2022... - The Sun

Man who sought to conceal interest in 5m Dalkey property has bankruptcy extended – The Irish Times

The High Court has extended a businessmans bankruptcy to last a total of 13 years after finding he had endeavoured to conceal his interest in a 5.5 million Dalkey property.

Godfrey Lalor, who once owned a property on Sorrento Road, Dalkey, Co Dublin, was adjudicated bankrupt in June 2016. A year later the official assignee to the bankrupts property filed a motion seeking to extend the bankruptcy on grounds of non-cooperation and failure to disclose assets.

In a recent judgement, Mr Justice Richard Humphreys extended Mr Lalors bankruptcy to June 2029. The normal term of bankruptcy is for one year, but this can be extended in cases of non-cooperation or non-disclosure of assets, he noted.

Mr Justice Humphreys said he believes to be justified the official assignees characterisation of Mr Lalors approach to the situation as catch me if you can. The judge also endorsed as correct, the official assignees assertion that it is essential for the integrity of the bankruptcy process that a bankrupts obligation to cooperate fully and disclose everything in relation to assets is strictly enforced.

The judge noted that Mr Lalor had sought to conceal his interest in the Monte Rosa property on Sorrento Road to prevent it being realised for the benefit of his creditors. Further, some of the evidence given by Mr Lalor under cross-examination was misleading, while he also had failed to co-operate with the courts previous July 2021 conclusion, Mr Justice Humphreys said.

The judge also found that Mr Lalors assertions of lack of control over relevant corporate assets and accounts were lacking in credibility in all of the circumstances.

Mr Justice Humphreys said that near total non-cooperation would presumably warrant a near maximum bankruptcy period, and these circumstances come into the top bracket of the full 15-year period. However, the judge said he had regard to any limited elements of information arguably supplied by Mr Lalor, as well as any arguably relevant circumstances, in setting the term at 13 years. Mr Justice Humphreys was finalising a 2019 decision made by Ms Justice Teresa Pilkington to extend in principle the bankruptcy term.

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Man who sought to conceal interest in 5m Dalkey property has bankruptcy extended - The Irish Times

Boy Scouts will lobby on bill to curb tactics used in bankruptcy proceedings – Politico

With Daniel Lippman

PROGRAMMING NOTE: Well be off for Thanksgiving this Thursday and Friday but back to our normal schedule on Monday, Nov. 29.

BOY SCOUTS WILL LOBBY ON BANKRUPTCY BILL: The Boy Scouts of America has hired former Alabama Democratic Rep. Bud Cramer and Jefferies Murray of 535 Group to lobby on bankruptcy reform legislation aimed at curtailing a settlement practice that would release troop sponsors, including tens of thousands of churches and civic groups; local councils; and the national Boy Scouts organization from liability for sexual abuse claims lodged against the organization.

The House Judiciary Committee approved the Nondebtor Release Prohibition Act this month. The bill targets what Democrats describe as a loophole in bankruptcy code that helped the Sackler family, the people and institutions that enabled Larry Nassar, and others like them escape accountability for wrongdoing through bankruptcy proceedings.

The bill would restrict the use of third-party, or nondebtor, releases in bankruptcy proceedings, unless express consent is given by the creditors. The practice, which has split federal courts, shields affiliates, officers or other stakeholders who may be accused of wrongdoing but who have not filed for bankruptcy protections themselves in exchange for settlement payments and, in the Boy Scouts case, signing over some insurance rights. The tactic has been used in the bankruptcy settlements of several high profile cases in recent years, including those of opioid maker Purdue Pharma, USA Gymnastics and church dioceses.

The bill would also place restrictions on bankruptcy courts ability to pause lawsuits against third parties while a repayment plan is negotiated, and allow courts to dismiss Chapter 11 bankruptcy reorganization cases if a debtor was formed during a divisional merger that took place in the last decade. Critics of the bill, which was approved on party lines, argue the legislation could disrupt bankruptcy proceedings in favor of lengthy litigation that may result in less of a recovery or no resolution at all, while empowering small numbers of holdout creditors.

The Boy Scouts of America (BSA) engaged 535 Group to help explain our proposed Plan of Reorganization to lawmakers and demonstrate how the current structure is the best path forward for Scouting and for survivors, with this Plan poised to establish the largest sexual abuse compensation fund in the history of the United States, a spokesperson told PI, adding that the organization has spent nearly two years working through a financial restructuring to come to a resolution that will equitably compensate survivors of past abuse and ensure that Scoutings mission continues. The Associated Press reported this fall that ballots to approve the Boy Scouts reorganization plan and proposed $1.6 billion trust fund are being sent to the more than 82,000 men who say they were molested as scouts.

Good afternoon and welcome to PI. Ill be off for Thanksgiving tomorrow and Friday, but PI will be back in your inboxes on Monday. Until then keep sending those tips, and I hope you have a restful holiday: [emailprotected]. And be sure to follow me on Twitter: @caitlinoprysko.

PANDEMIC PREPAREDNESS GROUP LOBBIES UP: Guarding Against Pandemics, an advocacy group pushing for more investment in preparing for the next pandemic, is ramping up its lobbying operation as it pushes to hike the amount of funding included in Democrats reconciliation bill or through other avenues.

According to disclosures filed this week, Varun Krovi, a former House Democratic aide and former lobbyist at Invariant, registered as an in-house lobbyist for the group in September. The group hired a team of more than a dozen lobbyists at Ogilvy Government Relations a month later, according to another disclosure filing. The group, which is funded in-part by crypto billionaire and Biden donor Sam Bankman-Fried, previously hired Van Scoyoc Associates in August.

Guarding Against Pandemics has fought for Democrats to provide $30 billion for pandemic preparedness in their reconciliation bill, a number initially sought by President Joe Biden this spring. He later decreased that figure to $15 billion, and the sum included in the version passed by the House last week was slashed even further, to $3 billion, according to figures from the Kaiser Family Foundation. Another $16.2 billion would go toward building out public health infrastructure.

In response to earlier reports that pandemic preparedness funding might be gutted as Democrats sought to reduce the price tag of the bill, Guarding Against Pandemics called the suggestion unthinkable. The group has also applauded pandemic preparedness provisions in legislation introduced by Reps. Diana DeGette (D-Colo.) and Fred Upton (R-Mich.) last week, though that bill faces steep odds in a narrowly divided Congress.

DOING IT FOR THE GRAM: Adam Mosseri, the head of Instagram, has agreed for the first time to testify before Congress, as bipartisan anger mounts over harms to young people from the app, The New York Times Ryan Mac and Cecilia Kang report. Mosseri is expected to appear before a Senate panel during the week of Dec. 6 as part of a series of hearings on protecting children online, said Senator Richard Blumenthal, who will lead the hearing.

Mr. Mosseris appearance follows hearings this year with Antigone Davis, the global head of safety for Meta, the parent company of Instagram and Facebook, and with Frances Haugen, a former employee turned whistle-blower. Ms. Haugens revelations about the social networking company, particularly those about Facebook and Instagrams research into its effects on some teenagers and young girls, have spurred criticism, inquiries from politicians and investigations from regulators.

Blumenthal said he would question Mr. Mosseri about how Instagrams algorithms can send children into dangerous rabbit holes and would seek a commitment from Mr. Mosseri to make Instagrams ranking and recommendation decisions transparent to the public and to experts who can study how the app amplifies harmful content.

ANOTHER SETBACK FOR ISRAELI SPYWARE FIRM: Apple sued the NSO Group, the Israeli surveillance company, in federal court on Tuesday, another setback for the beleaguered firm and the unregulated spyware industry, The New York Times Nicole Perlroth reports. The lawsuit is the second of its kind Facebook sued NSO in 2019 for targeting its WhatsApp users and another consequential move by a private company to curb invasive spyware by governments and the companies that provide their spy tools.

Apple, for the first time, seeks to hold NSO accountable for what it says was the surveillance and targeting of Apple users. Apple also wants to permanently prevent NSO from using any Apple software, services or devices, a move that could render the companys Pegasus spyware product worthless, given that its core business is to give government clients full access to a targets iPhone or Android smartphone.

Apple is also asking for unspecified damages for the time and cost to deal with what the company argues is NSOs abuse of its products. Apple said it would donate the proceeds from those damages to organizations that exposed spyware.

Jenelle Krishnamoorthy has been promoted to be vice president for global public policy and international affairs at Merck. She most recently was the company's associate vice president for global policy for communications and population health.

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535 Group, LLC: Boy Scouts Of AmericaBallard Spahr LLP: Grail, LLCCdb Projx LLC: Clemson UniversityCornerstone Government Affairs, Inc.: The Pew Charitable TrustsGuarding Against Pandemics, Inc.: Guarding Against Pandemics, Inc.Washington & Madison, LLC: American Hellenic Institute

Big Fire Law & Policy Group, LLP: Ndn CollectiveFirst Strategic: Sda Inc.Maryland & District Of Columbia Credit Union Association: Maryland & District Of Columbia Credit Union Association

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TfL crisis latest: entire Tube line may have to close and bankruptcy notice issued – Evening Standard

C

losing an entire Tube line is among the options that Transport for London may have to consider as a result of its financial crisis, it has been revealed.

TfL finance chief Simon Kilonback said the failure to secure Government cash for long-term repairs and upgrades would have a disastrous impact on the capitals transport network.

Mr Kilonback told the TfL finance committee on Wednesday that TfL could be forced into the full closure of a line or part of a line or smaller reductions across the whole [Underground] network.

He did not name the line most likely to be closed but the Bakerloo and Jubilee lines are reportedly at risk.

The Metropolitan and Hammersmith & City lines could also be options due to lower passenger numbers and overlapping rail or Tube services.

DLR and London Overground services are also at risk, Heidi Alexander, the deputy mayor for transport, told the committee.

A blue sky future is unlikely for TfL

Mr Kilonback said there was a risk that TfL would have to issue a section 114 notice - effectively declaring itself bankrupt and handing responsibility for services back to the Government.

This would mean it would only commit to providing services required by law, such as school buses, taxi licensing, certain road repairs and the Woolwich ferry.

It would also be likely that TfL would seek to run only services where it made a profit, he suggested.

A video of the TfL meeting can be viewed here:

Mayor Sadiq Khan has requested an urgent meeting with Transport Secretary Grant Shapps, but has yet to receive a reply.

TfL commissioner Andy Byford told the TfL finance committee there was less than three weeks to save TfL and the London recovery.

He said: I never thought I would say this but getting the Elizabeth line across the line seems a darn sight easier than trying to sort this one out.

TfL commissioner Andy Byford: Funding crisis is even worse than Crossrail

Mr Byford has written to the permanent secretary at the Department for Transport requesting the start of negotiations. He said he was desperate to avoid what happened in the last bail-out, when agreement was only reached with 11 minutes to go before the deal expired.

Passengers are also likely to face a bumper fares hike from the New Year. TfLs plans expect a rise of the RPI rate of interest plus one per cent.

This is likely to mean an extra five per cent on fares, though Mr Khan has the final decision.

TfL ticketing chief Shashi Verma said: This is the city with the highest public transport fares in the world to start off with.

Mr Kilonback said: I think we unfortunately face the situation we first faced back in May 2020, where we are going to have to consider what is required under statute, and say that under S114 of the local Government Finance Act we cannot see a way to balance the budget.

That requires us to commute all expenditure other than that which is required for statutory purposes, which are very limited in terms of the transport services we operate, and to continue to run things that contribute to getting out of the problem and to stop anything which makes the problem worse.

Whereas in the past, certainly the Tube and some of our rail services were covering their operating costs. That isnt the case today. This is not a threat. Its the reality of the statutory position we are in, given the lack of certainty over funding.

A TfL spokeswoman, asked whether Londons fares were the highest in the world, said: In London, 72 per cent of the operating costs of running the TfL network are covered completely by fares and another 14 per cent by other commercial revenues.

Other cities cover a much larger proportion of their costs from government subsidies or dedicated taxes.

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TfL crisis latest: entire Tube line may have to close and bankruptcy notice issued - Evening Standard

What happened to Love Actually cast Daniel Craig romance, bankruptcy, tragic death and rant over s*** &… – The Sun

WITH a love triangle, an affair and doomed romances - who could have predicted Love Actually would become such an iconic Christmas film?

But the festive flick unites Brits around the country and millions of us gather around our TV screens to watch it every year.

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It's been 18 years since Love Actually was released and many have eagerly followed the careers of the actors who starred in it.

They include Thomas Brodie-Sangster - the child star who at 13 years old played lovestruck drummer boy Sam.

Fans were shocked when it was revealed that he's now 31 and reportedly dating Elon Musk's ex-wife, whom he divorced twice, Talulah Riley.

The pair co-star in Danny Boyle's upcoming Sex Pistols drama Pistol, where he plays popstar Malcolm McLaren and she takes on Vivienne Westwood.

Since Love Actually came out in 2003, Thomas has starred in everything from the Maze Runner series to Game Of Thrones and The Queen's Gambit - but what happened to his co-stars?

Here, we look at the fates of those behind one of Britain's all-time favourite Christmas flicks.

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Olivia stole the show when she sang Mariah Carey's All I Want for Christmas is You at just 11 years old.

Now the American actress is 29, living in LA, and you may have followed her on The X Factor: Celebrity, where she ended up coming 12th in 2019.

Olivia has also been part of the cast behind the animated series Adventure Time on Cartoon network, where she voices Marceline the Vampire Queen.

She has also worked on Disney's Phineas and Ferb, where she voices Vanessa Doofenshmirtz.

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German actress Heike Makatsch became one of the biggest villains of Christmas when her character Mia flirted with her married boss, Harry, played by the late Alan Rickman, in the movie.

One of the most emotional scenes saw Harry buy Mia a gold necklace, which his wife, Karen, played by Emma Thompson, thought was for her.

After flirty Mia, Heike played Leisel's mother in the movie version of The Book Thief in 2013.

Heike, 50, has had a string of high-profile romances. She previously dated James Bond star Daniel Craig and was married to actor Max Martin Schrder for 10 years.

She's in a relationship with actor Trystan Ptter and lives in Berlin.

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Lulu played Emma Thompson's daughter in Love Actually and famously dressed up as a lobster for her school nativity.

She was 12 years old when she appeared in the beloved Christmas flick but in recent years branded it "cheesy and sexist".

Speaking on the Almost Famous podcast,Lulu said: "I think it's a s**t film. I think it's aged badly. All the women in it are sort of passive objects."

The 30-year-old, who's now a comedian, was described as unrecognisable by fans of the 2003 film.

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In Love Actually, he was Kiera Knightley's doting husband Peter and was unknowingly caught in the middle of a love triangle.

While their marriage stayed intact, his best friend Mark, played by Andrew Lincoln, made a questionable attempt to seduce Kiera's character.

Since the 2010 film, Chiwetel took a role in Doctor Strange, starred as Scar in The Lion King remake and was the lead role of Solomon Northup in 12 Years A Slave.

The latter landed him Best Actor nominations at the Golden Globes, The Oscars and a winning nomination at the BAFTAS.

One of the most memorable scenes from the film sees Andrew's character Mark express his love to Juliet via some cardboard signs outside her house.

Whilst she ran out and kissed him, the pair don't get together and Juliet stays married to his best friend.

Since his tragic storyline in Love Actually, Andrew's career has boomed, starring in AMC series The Walking Dead as sheriff deputy Rick Grimes.

While he didnt get his fairytale ending in Love Actually, he did in real life.

In June 2006, three years after the heartwarming film was released, he married Gael Anderson. They have two children, Matilda, 14, and Arthur, 11.

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Joanna, who played the character 'Just Judy', was one half of the loveably awkward duo that stood in for sex scenes in a porn film, alongside Martin Freeman.

After Love Actually, she went on to appear in everything from Midsomer Murders to Nativity 2: Danger In The Manger and Doctor Who.

But she's best-known for starring as Stacey Shipman in the hit BBC sitcom Gavin & Stacey, which ran from 2007 until 2010. A Christmas special was released in 2019.

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Former EastEnders star Martine was memorable in Love Actually as the cheerful Downing Street staff member who swore at Hugh Grant's Prime Minister but ended up winning his heart.

Martine has since proved her talents off the screen on the stage, winning an Olivier for her role as Eliza in My Fair Lady in the West End.

While she endeared herself to millions as Natalie, sadly Martines career after Love Actually hasn't been as easy.

The 45-year-old has struggled to land big parts in any major show or film and has only had a few small parts in TV shows.

Shes made appearances on Celebrity Gogglebox and more recently The Masked Singer UK, but she hasnt had anything as high profile as Love Actually.

Martine has also been a panellist on Loose Women, alongside the likes of Katie Price, Andrea McLean, Nadia Swahala and Ruth Langsford.

She has been married to singer Jack McManus since 2012 and has a six-year-old son, Rafferty.

But she hasn't had an easy time of it, having to file for bankruptcy in 2013, and openly struggling with her health, suffering from Chronic Fatigue Syndrome and Fibromyalgia.

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In Love Actually she broke hearts while playing workaholic Sarah, who aside from her busy schedule had to take care of her mentally ill brother.

An outburst from her sibling prematurely ended a saucy moment of passion between Laura's character and ripped actor Rodrigo Santoro.

Since then, she spent a year on the US comedy Frasier, starred in American Dad! and has acted in dark drama Ozark since 2017.

Despite not sharing any scenes together, Laura and Liam Neeson are close friends in real life and he even walked her down the aisle for her wedding in May 2009.

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Brazillian actor Rodrigo Santoro's romance with Sarah, played by Laura Linney, sadly came to nothing in the film - but since then he has played a number of big parts.

He was unrecognisable after shaving off his hair to play 'god' Xerxes in the 2006 action flick 300 and also starred as Paulo in Lost.

Recently, Rodrigo played Westworld's 'most wanted' bandit Hector Escaton and he starred in Boundless, a drama about two men who sailed around the world 500 years ago.

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Lucia played Colin Firth's housekeeper turned love interest, Aurelia, in Love Actually.

Towards the end of the film, he won her heart in a hilariously bumbling scene where the writer tried and often misspoke Portuguese.

Since then Lucia has starred in a number of TV series and films back in Portugal.

January played Jeannie, one of the attractive American girls that sex-obsessed Colin (Kris Marshall) bumps into in Wisconsin.

She was the ringleader of the group of girls who fell for his English accent and charms.

A few years later in 2007, she was cast as Betty Draper in Mad Men, which ran until 2015 and is regarded as one of the best television dramas ever made.

The role saw January nominated for two Golden Globe Awards for Best Actress in Television Series Drama and a Primetime Emmy Award for Outstanding Lead Actress in a Drama Series.

Alan was already an acting legend when he starred in Love Actually alongside Emma Thompson and Hugh Grant.

He had already taken on the iconic role of Severus Snape in the Harry Potter franchise, and had previously starred in Die Hard, Robin Hood: Prince of Thieves and Sense and Sensibility.

Alan played the character of Harry, a successful director of a design agency, who cheats on his wife Karen with his young, pretty secretary Mia.

Alan couldn't have been more different from his on-screen loverat character in real life, happily married to former Labour Party councillor Rima Horton after meeting in their late teens.

Tragically, Alan passed away from pancreatic cancer in 2016 at the age of 69, having won a Bafta, Emmy, a Golden Globe and a SAG during a glittering career.

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What happened to Love Actually cast Daniel Craig romance, bankruptcy, tragic death and rant over s*** &... - The Sun