The Daily Biotech Pulse: Positive Adcom Verdict For Merck, Homology Medicine Slips On Mixed Gene Therapy Efficacy Data – Yahoo Finance

Here's a roundup of top developments in the biotech space over the last 24 hours.

Scaling The Peaks

(Biotech stocks hitting 52-week highs on Dec. 17)

Down In The Dumps

(Biotech stocks hitting 52-week lows on Dec. 17)

Stocks In Focus Homology Medicines Reports Mixed Efficacy Data For Gene Therapy To Treat Phenylketonuria

Homology Medicines Inc (NASDAQ: FIXX) announced initial Phase 1/2 data from the pheNIX trial that evaluated its HMI-102 gene therapy in patients with phenylketonuria, with safety data from the Cohort 1 consisting of two patients administered low dose and Cohort 2 consisting one patient administered mid dose, showing that HMI-102 was well tolerated.

The efficacy data was mixed, with the Cohort 1 patients not showing a reduction in phenylalanine through Week 10 and 12. But the patient dosed in Cohort 2 showed a reduction in phenylalanine of 35% and 48% from baseline at Weeks 1 and Week 4, respectively.

The stock fell 21.84% to $17 in after-hours trading.

FTC Files Compliant To Block Illumina's Deal To Buy PacBio

The FTC saidit has authorized an action to block Illumina, Inc.'s (NASDAQ: ILMN) $1.2 billion buy of Pacific Biosciences of California (NASDAQ: PACB). In an administrative complaint, the agency alleged that "Illumina is seeking to unlawfully maintain its monopoly in the U.S. market for next-generation DNA sequencing systems by extinguishing PacBio as a nascent competitive threat."

The administrative trial is set to begin Aug. 18, 2020.

Pacific Biosciences shares declined 7.85% to $4.93 in after-hours trading.

See Also: After Amarin Snags Vascepa Label Expansion, Analyst Says Biopharma An Attractive M&A Target

Merck Keytruda Gets Thumbs Up From Adcom For Bladder Cancer

Merck & Co., Inc. (NYSE: MRK) said the Oncologic Drugs Advisory Committee of the FDA voted 9 to 4 in favor of recommending the company's Keytruda for the treatment of certain patients with high-risk, non-muscle invasive bladder cancer.

The company expects a PDUFA action date of January2020, based on priority review.

Rigel Chief Commercial Officer Quits

Rigel Pharmaceuticals, Inc. (NASDAQ: RIGL) said its chief commercial officer Eldon Mayer has resigned, effective Dec. 23, to pursue an opportunity with an emerging company. The company said it has begun a search for a replacement, and until a new person assumes office, the commercial leadership team will directly report to CEO Raul Rodriguez.

Offerings

Neoluekin priced its previously announced underwritten public offering of 8.925 million shares of its common stock at $8.40 per share. The company expects to generate gross proceeds of about $75 million from the offering. The offering is expected to close on or about Dec. 20.

On The Radar Adcom Meeting

FDA's Oncologic Drugs Advisory Committee will discuss Oncologic Drugs Advisory Committee Epizyme Inc's (NASDAQ: EPZM) NDA for tazemetostat tablets for treating patients with metastatic or locally advanced epithelioid sarcoma not eligible for curative surgery. The briefing document released Monday showed that the FDA, though commending the company for exploring tazemetostat as a potential therapy for epithelioid sarcoma in a biologically rational way, expressed concerns about insufficient evidence to conclude that the investigational drug confers benefits in patients.

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The Daily Biotech Pulse: Positive Adcom Verdict For Merck, Homology Medicine Slips On Mixed Gene Therapy Efficacy Data - Yahoo Finance

Class of 2019: From Military to Medicine, Grad Discovers His Life’s Duty – University of Texas at Dallas

Text size: students

Dec. 19, 2019

Editors Note: Every Comet follows a distinct path to UTDallas, and members of the Class of 2019 are no exception. A few soon-to-be fall graduates shared their thoughts about their journeys as they get ready to tackle new challenges after commencement.

Timothy Culbertson, 24, of Plano said he was drawn to UT Dallas specifically because of the healthcare studies program in the School of Interdisciplinary Studies. A transfer student and a U.S. Navy reservist, he found the courses offered at UTDallas both rigorous and a perfect fit for his interest in medicine.

My brother also came here [to UT Dallas], and I knew it was going to be challenging, Culbertson said. So I came prepared to study.

He found a second home on campus through the UTDallas Military and Veteran Center (MVC), where he worked as a Peer Advisor for Veteran Education (PAVE). His passion for serving in the military, he said, had a tremendous impact on his chosen career field medicine.

After graduation, Culbertson will begin his studies at The University of Texas Health Science Center at Houstons McGovern Medical School next fall. His primary goal is to serve veterans.

Culbertson will also soon celebrate another milestone before heading to medical school hes getting married in June.

What will you miss most about UTD?

The MVC. Ive made good friends, and probably my best times and best memories at UTDallas were hanging out there.

Would you rather have to retake a final exam or be Temoc for a day?

It depends on the final exam. If its one Im prepared for, I love the post-exam feeling. But if Im less prepared? Id rather be Temoc for a day.

What is a fun fact about you?

Ive never pulled an all-nighter while at UTD I always got at least four hours of sleep.

What are the best ways to survive a Monday?

Chick-fil-A Chick-n-Minis.

Whats the most Instagrammable spot on campus?

I dont have an Instagram, but if I did, it would be the main mall by the fountains.

Whats the first thing youll do to celebrate your graduation?

Im probably going to spend time with family and eat a nice, juicy steak.

What accomplishment/project are you most proud of from your time at UTD?

I would say mentoring both through PLTL (Peer-Led Team Learning) and PAVE. I had a lot of good mentoring when I first started here, and it was nice to pay it forward and give back to the UT Dallas community.

UT Dallas alumni make their mark wherever they go. How will you make yours?

After medical school, I really want to work with veterans, provide humanitarian aid overseas, serve my country and serve those who have served it as well.

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ATEC Graduate Relishes Quest in Video Game Design

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Economics Grad Demonstrates High Degree of Diligence

Media Contact: Katherine Morales, 972-883-4321,[emailprotected]or the Office of Media Relations, UT Dallas, (972) 883-2155, [emailprotected]

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Class of 2019: From Military to Medicine, Grad Discovers His Life's Duty - University of Texas at Dallas

signs Andrews Institute as official sports medicine provider – University of West Florida Newsroom – UWF Newsroom

Andrews Institute currently serves as the official medical partner, providing UWF athletics with team physicians. UWF and Andrews Institute signed a contract in which Andrews Institute will continue serving in this role and expand the partnership as the official sports medicine provider of UWF athletics for health care, orthopedic and sports medicine. Andrews Institute is the exclusive Official Medical Partner and Official Sports Medicine Provider of University Athletics Department for medical services including, but not limited to athletics, athletic training, physical therapy, orthopedic and sports medicine.

We are excited to expand our great relationship with the University of West Florida, said Dr. David Joyner, Andrews Institute executive director and senior vice president. What the University of West Florida stands for is truly astounding. We see this partnership as our world-class team taking care of another world-class team.

Andrews Institute will provide certified athletic trainers and athletic-training services for the 400 UWF student-athletes under the medical direction of team physicians Dr. Roger Ostrander and Dr. Joshua Hackel. Andrews Institute will also grant UWF athletes access to a full-time sports medicine physical therapist at Baptist Medical Park Nine Mile on University Parkway.

Two great organizations are joining to forge a transformative partnership that provides the highest quality care for our student-athletes, said Dave Scott, UWF athletics director. We are grateful for Andrews Institutes support and thrilled to have this world-class organization right in our own backyard.

UWF fields 15 athletic teams. The rich UWF athletics tradition includes nine national championshipsin five sports, 102 conference titles, 15 GSC womens all-sports trophies, eight GSC mens all-sports trophies and the GSC overall all-sports trophies every year since its inception in 2013-2014. The UWF football team will play Minnesota State at 2 p.m. on Saturday, Dec. 21, in McKinney, Texas, for the NCAA Division II national championship. This marks the second national title appearance for program in only its fourth year of existence.

Andrews Institute provides certified athletic trainers and team physicians to all 23 public high schools in a four county area, Chipola College, Pensacola Christian College and Pensacola Christian Academy.

For more information about the University of West Florida Department of Intercollegiate Athletics, visit http://www.goargos.com.

For more information about Andrews Institute for Orthopaedics & Sports Medicine, visit http://www.andrewsinstitute.com.

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signs Andrews Institute as official sports medicine provider - University of West Florida Newsroom - UWF Newsroom

School of Medicine Faculty Member Dr. Andrea Meyer Stinson to Serve as Partner on $200K Grant to Develop Trauma Informed Community in Middle Georgia -…

MACON Andrea S. Meyer Stinson, Ph.D., associate director of the Master of Family Therapy Program and associate professor of psychiatry and behavioral sciences/pediatrics in Mercer University School of Medicine, will serve as a partner and consultant on a two-year, $200,000 grant from the Pittulloch Foundation, in partnership with Resilient Georgia, to integrate trauma awareness into the Central Georgia community.

The Pittulloch Foundation and Resilient Georgia have offered grants to four cities and the surrounding counties to provide a regional emphasis on trauma informed awareness, Adverse Childhood Experiences (ACEs) and child sexual abuse prevention training as a basis to transform systems and procedures crossing both public and private sectors.

The Resilient Middle Georgia grant will be managed by the Community Partnership, a Bibb County collaborative that has been dedicated to making an impact in the lives of children and families for more than 20 years.

Dr. Meyer Stinson, who is a board member for Resilient Georgia, will serve as a partner on the Resilient Middle Georgia Project, alongside Jill Vanderhoek, executive director of Community Partnership in Bibb County, and the Community Foundation of Central Georgia. The project will focus on building awareness and a common language around trauma, adversity, ACEs and resilience in Bibb and other Middle Georgia counties.

Traumatic experiences often create long-lasting effects, and creating more opportunities in our area to inform providers of those effects will allow them to better serve the community, said Vanderhoek. We are grateful to the Pittulloch Foundation for providing this grant to help Middle Georgia and to Resilient Georgia and the Community Foundation for their support.

The primary aim of the grant is to bring together multiple stakeholders, including education, health care, social services, mental health providers, law enforcement, juvenile justice, families and community champions, to align conversations and build awareness and trainings that will better support children and families coping with adversity and trauma.

Adversity and challenges occur in all families, however some children and youth experience an accumulation of severe stressors that can impair their development and functioning, Dr. Meyer Stinson said. By bringing together our community to talk about and recognize trauma and ACEs as an important public health concern, we can move towards a common understanding and language about ways to help reduce the potential impact of these experiences.

Dr. Meyer Stinson will serve as a consultant for the grant and liaison between the School of Medicine and Resilient Middle Georgia. She will help in developing community-wide awareness events, coordinating renowned speakers, analyzing and reporting data, as well as planning education and training opportunities for School of Medicine students, faculty, staff and physician preceptors.

In order for individuals to thrive physically and mentally, it is essential to address both the family and the community in which they live, especially for rural and underserved areas, said Jean Sumner, M.D., dean of Mercer University School of Medicine. Dr. Meyer Stinsons involvement in this project will support our mission of working with rural and underserved individuals, while also building a network of well-trained and trauma informed healthcare providers for the broader region.

About Mercer University School of Medicine (Macon, Savannah and Columbus)

Mercer Universitys School of Medicine was established in 1982 to educate physicians and health professionals to meet the primary care and health care needs of rural and medically underserved areas of Georgia. Today, more than 60 percent of graduates currently practice in the state of Georgia, and of those, more than 80 percent are practicing in rural or medically underserved areas of Georgia. Mercer medical students benefit from a problem-based medical education program that provides early patient care experiences. Such an academic environment fosters the early development of clinical problem-solving and instills in each student an awareness of the place of the basic medical sciences in medical practice. The School opened a full four-year campus in Savannah in 2008 at Memorial University Medical Center. In 2012, the School began offering clinical education for third- and fourth-year medical students in Columbus. Following their second year, students participate in core clinical clerkships at the Schools primary teaching hospitals: Medical Center, Navicent Health in Macon; Memorial University Medical Center in Savannah; and The Medical Center and St. Francis Hospital in Columbus. The School also offers masters degrees in family therapy, preclinical sciences and biomedical sciences and a Ph.D. in rural health sciences.

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School of Medicine Faculty Member Dr. Andrea Meyer Stinson to Serve as Partner on $200K Grant to Develop Trauma Informed Community in Middle Georgia -...

Novartis embraces the digital world to reimagine medicine for patients – SiliconANGLE News

In a highly regulated space such as the pharmaceutical industry, the process of digital transformation has been slower than in other sectors. However, the Swiss pharmaceutical giant Novartis AG has been focused on changing this narrative in recent years as it embraced digital and data.

We are trying to reimagine medicine through user data and technology, said Loic Giraud (pictured, center), business analytics COE head at Novartis. Were trying to optimize the backbone of our day-to-day processes. Through the cloud we can make use of data to innovate, operate and engage.

Giraud spoke with Rebecca Knight (@knightrm), host of theCUBE, SiliconANGLE Medias mobile livestreaming studio, during the Accenture Executive Summit at the AWS re:Invent event in Las Vegas. He was joined by Fang Deng (pictured, right), big data and advanced analytics program lead at Novartis, and Vikas Sindwani (pictured, left), principal director of applied intelligence at Accenture. They discussed how Novartis is reimagining new products for patients using digital technologies and a growing industry acceptance of the cloud. (* Disclosure below.)

Novartis has developed a new platform Nerve Live which is designed to leverage the firms massive data pool. Faster and more thorough analysis of data, using artificial intelligence and machine learning, will help the company research and develop new drug therapies.

Were trying to reimagine our products for the patient, Deng said. Our objective is to leverage new technologies, concentrate on data in the cloud, and build a new platform for Novartis users.

The pharmaceutical company is also embracing the cloud. Earlier this month, Novartis announced that it would work with Amazon Web Services Inc. to overhaul its manufacturing and business operations.

Companies like healthcare, media, metals and mining were behind the curve in cloud-adoption rates because of their respective concerns around compliance and security of data, Sindwani explained. That trend is slowly shifting as companies are becoming more open. Theyve seen how the public cloud has matured.

Watch the complete video interview below, and be sure to check out more of SiliconANGLEs and theCUBEs coverage of the Accenture Executive Summit during the AWS re:Invent event. (* Disclosure: Accenture LLP sponsored this segment of theCUBE. Neither Accenture nor other sponsors have editorial control over content on theCUBE or SiliconANGLE.)

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Novartis embraces the digital world to reimagine medicine for patients - SiliconANGLE News

Manchester bids to grow genomics and precision medicine hub with Citylabs 4.0 – EPM Magazine

Manchesters health innovation campus, Citylabs, is set for further expansion following high as it continues to grow its presence as an international hub for genomics and precision medicine.

Manchester Science Partnerships (MSP) and Manchester University NHS Foundation Trust (MFT) havesubmitted plans to develop Citylabs 4.0, a new 35 million development which will grow the existing Citylabs campus by 125,000 sq ft.

The Joint Venture partnership between MSP and MFT, the UK's largest NHS provider Trust, is the first of its kind, with the first phase - Citylabs 1.0 - already home to diagnostics, medtech, digital health and genomics businesses who are driving the future of medicine and healthcare.

Rowena Burns, chair, Manchester Science Partnerships, said: Weve seen huge developments and significant growth in the life sciences and digital technology sectors over the last five years, with pioneering solutions being created to tackle some of our most pressing health challenges. Were keen to harness the opportunities created by the growth in these sectors and our plans for Citylabs 4.0 speak to this ambition.

At Citylabs we have created a dynamic ecosystem, a place where companies and researchers work side by side, benefiting from being co-located on Europe's largest clinical academic campus."

Subject to planning approval by Manchester City Council, Citylabs 4.0 will be built at the south of the MFT Oxford Road campus, adjacent to Citylabs 2.0 & 3.0, and provide seven floors of office and lab space where brilliant research will be translated into new healthcare diagnostics and treatments which can then be quickly adopted into Manchesters health system.

Businesses at Citylabs have access to clinical and academic collaborators located on the campus, and a programme of business support including advice on funding sources, new markets, and professional services. Theyre also surrounded by hospitals and the UKs largest student population at the University of Manchester and Manchester Metropolitan University.

This campus extension follows the 60 million expansion underway to create Citylabs 2.0 and 3.0. Citylabs 2.0 is due for completion in late 2020 and will be home to diagnostics company Qiagen, who will base their European Hub for Diagnostics Development at the campus. Citylabs 3.0will begin construction following the completion of Citylabs 2.0.

Professor Neil Hanley, MFTs director of research and innovation, adde: We are all rightly proud that the Citylabs approach has brought together NHS, academic and commercial sectors, completely in line with the UK GovernmentsLife Sciences Industrial Strategywhich made this a national priority.

That we are now driving on with further buildings speaks volumes about our ambition for growth in research and innovation that benefits patient care and the regional economy. I look forward to plans for Citylabs 4.0 being realised.

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Manchester bids to grow genomics and precision medicine hub with Citylabs 4.0 - EPM Magazine

New veterinary medicine research projects take on foot-and-mouth disease and ASF – Fence Post

MANHATTAN, Kan. High-priority diseases in cattle and swine will be tackled by three researchers in the Kansas State University College of Veterinary Medicine with grants totaling nearly $1 million from the U.S. Department of Agricultures Agricultural Research Service.

Jrgen Richt, Regents distinguished professor and director of the Center of Excellence for Emerging and Zoonotic Animal Diseases, received a $150,000 USDA ARS grant for Evaluation of Novel Foot-and-Mouth Disease Virus Vaccine Candidates with Broad Breadth of Protection Phase II.

With a $176,900 grant, Mike Sanderson, professor of epidemiology and associate director of the Center for Outcomes Research and Epidemiology, is leading the project Simulation Modeling of Foot-and-Mouth Disease Outbreaks in Livestock in the U.S.

Actions Supporting the Development of an African Swine Fever Virus Live Attenuated DIVA Vaccine is under the direction of Jishu Shi, professor of vaccine immunology, with a $640,720 grant.

Both Sandersons and Richts projects focus on foot-and-mouth disease, which affects livestock production in many regions of the world, including much of Asia and Africa.

Foot-and-mouth disease is a high-priority transboundary disease that would severely impair livestock health and production if introduced to the U.S., Sanderson said. The goal of this research is to model outbreak and control scenarios in the U.S. to improve preparedness and identify optimal disease response strategies to mitigate the impacts of a potential foot-and-mouth disease outbreak.

Because the foot-and-mouth disease virus is antigenically diverse, Richt said vaccines must be matched to target certain viral isolates to be effective.

The objective of this research project is to support the development of novel foot-and-mouth disease virus vaccine candidates and determine their immunogenicity in its natural host, Richt said. It will also help generate new knowledge on next-generation vaccines for this virus, with broader activity that will ultimately help to prevent and control foot-and-mouth disease.

Shis research is centered on the development of control strategies against African swine fever virus, a threatening swine disease that has become a major issue in China and other Asian countries.

The collaboration with USDA ARS is a valuable partnership for us in African swine fever vaccine research and highlights the importance of the K-State Biosecurity Research Institute as a key facility for K-State researchers working on high-consequence animal diseases, Shi said. It will strengthen our capability in research that will be related to the National Bio and Agro-defense Facility, or NBAF, and provide new impetus for our long-standing partnership with USDA ARS research scientists.

The Biosecurity Research Institute, known as BRI, is a biosafety-level 3 and biosafety-level 3 agriculture research facility that allows for the study of high-consequence pathogens affecting plants, animals and food products, including zoonotic pathogens that infect humans. NBAF will be the nations foremost animal disease research facility and is being built by the U.S. Department of Homeland Security adjacent to K-States Manhattan campus.

The two objectives of Shis project are the development of accompanying differentiation of infected from vaccinated animals, or DIVA, tests for the African swine fever virus live attenuated DIVA candidate developed by the ARS, and the development of a stable cell line supporting the replication of those vaccine candidates.

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New veterinary medicine research projects take on foot-and-mouth disease and ASF - Fence Post

Water companies would be best advised to swallow their medicine – The Guardian

In a parallel political universe, Ofwats pricing framework for the English and Welsh water companies for the next five years would have been redundant before it was announced on Monday. Incoming Labour ministers would instead be inspecting their soon-to-be nationalised assets.

None of that will now happen, so the key issue in a still-privatised world is different. Will any of the companies that have bleated behind the scenes about a politicised regulatory process dare to allege unreasonable harshness on the part of Ofwat? Will any appeal to the Competition and Markets Authority (CMA)?

Well have to wait eight weeks the permitted period for an appeal to find out, but the likely suspects would be well advised to swallow their medicine.

First, Ofwats review is pitched as the toughest ever, but so it had to be. Shareholders since privatisation in 1989 have enjoyed a dividend bonanza so this was always going to be a moment to lean in the opposite direction. Thats not evidence of politicisation; its just a recognition that regulation has been too lax. Ofwats new demands will strike most bill-payers as reasonable: lower returns on capital; a reduction in bills by 50 on average, ignoring inflation, over the next five years; and a 16% cut in leaks.

Second, Ofwat has given some ground between its draft and final calculations. Companies, in aggregate, will be allowed about 1.5bn of extra expenditure to meet performance targets. The concession is not huge in the context of a 51bn spending programme, but its a softening.

Third, the new regime will only look tough to the laggards, judged by efficiency. Note how the share price of Severn Trent, one of three companies that got top-of-the-class fast track status during Ofwats review, is within pennies of its all-time high. Its shareholders see little to frighten them.

Fourth, an appeal to the CMA is not a one-way bet. The competition regulator is allowed to conclude that Ofwat should have been harder. That thought ought to concentrate minds in the boardrooms of the four companies Anglian, Northumbrian, Thames and Yorkshire that are thought most likely to appeal. Its time for them to accept that, in a privatised but regulated system, owners have to take a hit sometimes.

Its hard to keep up with transport firm FirstGroups view of its best strategy. Back in May, the future emphasis for the group was going to be First Student and First Transit, its two North American bus contractors, since they had the greatest potential to generate sustainable value and growth over time.

Now both operations may be sold. Whats prompted the U-turn? One can point to the arrival of David Martin as chairman in August but, since he seemed to endorse the May vision only last month, the latest development looks to be a lobbying triumph for activist investor Coast Capital, aided these days by fellow investor Robert Tchenguiz. The duo demanded a sale of all US assets, not just the Greyhound coaching business, a few weeks ago; now they may get it.

A UK-only future would be a mighty come-down for FirstGroup, which can currently call itself one of the worlds largest transport companies with 100,000 employees. Indeed, even within the UK, the future of the bus division is unclear, as FirstGroup is exploring what form of separation is possible while meeting pension obligations.

If the buses were also to exit along with the US assets, all that would be left would be the UK rail business, from which FirstGroup seemed to be contemplating an orderly retreat only a year ago. Then it won the West Coast Partnership franchise and all is now apparently right with rail.

One can view this strategic soul-searching as an exercise in rationalisation, the polite term for a break-up. Its hard, though, to escape the feeling that theres a simpler alternative to uncertain deal-making: just run the businesses better.

Mike Ashley has been banging on about his elevation strategy for years and now he has something to show for it: a share price that elevated by 31% in a day. Context is everything, however. The improvement to 472p merely took the shares back to where they stood at the start of 2016, which is roughly when Ashley adopted his other obsession diversification.

House of Fraser, the main product of that ambition, clearly isnt getting worse, which was why the shares jumped on Monday. But the eventual returns from the HoF deal remain a mystery. Ashley runs a tighter ship than the old management (no surprise there) but the long-term investment demands in the department store business are anyones guess.

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Water companies would be best advised to swallow their medicine - The Guardian

Sangamo Highlights Advancements in Genomic Medicine Pipeline and Expanded R&D and Manufacturing Capabilities at R&D Day – Business Wire

BRISBANE, Calif.--(BUSINESS WIRE)--Sangamo Therapeutics, Inc. (Nasdaq: SGMO), a genomic medicine company, is hosting an R&D Day today beginning at 8am Eastern Time. During the event, Sangamo executives and scientists plan to provide updates across the Companys clinical and preclinical pipeline, as well as an overview of manufacturing capabilities to support clinical and commercial supply. A live webcast link will be available on the Events and Presentations page of the Sangamo website

The talent, R&D capabilities, manufacturing expertise, and operations infrastructure we have brought to Sangamo have enabled us to advance a genomic medicine pipeline that spans multiple therapeutic areas and now also extends into late-stage development, said Sandy Macrae, CEO of Sangamo. As we make progress in clinical development, we gain insights into the use of our technology and are applying those insights as we advance new programs, such as the gene therapy for PKU and the genome regulation candidates for CNS diseases we are announcing today.

Macrae continued: We will continue to pursue a dual approach of retaining certain programs for our proprietary pipeline while also establishing pharmaceutical partnerships to gain access to therapeutic area expertise and financial, operational, and commercial resources. Strategic collaborations will be a particularly important consideration as we advance programs for diseases affecting large patient populations.

R&D Day updates on clinical and preclinical pipeline programs:

Gene therapy product candidates for hemophilia A, Fabry disease, and PKU

SB-525 is a gene therapy product candidate for hemophilia A being developed by Sangamo and Pfizer under a global development and commercialization collaboration agreement. The transfer of the SB-525 IND to Pfizer is substantially completed. Pfizer is advancing SB-525 into a Phase 3 registrational study in 2020 and has recently begun enrolling patients into a Phase 3 lead-in study.

At R&D Day, Sangamo executives are presenting data from the SB-525 program which were recently announced at the American Society of Hematology (ASH) annual meeting.

The cassette engineering, AAV engineering and manufacturing expertise which Sangamo used in the development of SB-525 are also being applied to the ST-920 Fabry disease program, which is being evaluated in a Phase 1/2 clinical trial, as well as to the newly announced ST-101 gene therapy program for PKU, which is being evaluated in preclinical studies with a planned IND submission in 2021.

Engineered ex vivo cell therapy candidates for beta thalassemia, kidney transplantation, and preclinical research in multiple sclerosis (MS)

Sangamo is providing an overview of the Companys diversified cell therapy pipeline this morning. Cell therapy incorporates Sangamos experience and core strengths, including cell culture and engineering, gene editing, and AAV manufacturing. At R&D Day, Sangamo scientists today are reviewing the early data presented this month at ASH from the ST-400 beta thalassemia ex vivo gene-edited cell therapy program, which is being developed in partnership with Sanofi.

Sangamo is also providing updates on the companys CAR-TREG clinical and preclinical programs. CAR-TREGS are regulatory T cells equipped with a chimeric antigen receptor. Sangamo is the pioneer in CAR-TREGS, which may have the potential to treat inflammatory and autoimmune diseases. TX200 is being evaluated in the STEADFAST study, the first ever clinical trial evaluating a CAR-TREG cell therapy. Tx200 is being developed for the prevention of immune-mediated organ rejection in patients who have received a kidney transplant, a significant unmet medical need. Results from this trial will provide data on safety and proof of mechanism, building a critical understanding of CAR-TREGS in patients, and may provide a gateway to autoimmune indications such as Crohns disease and multiple sclerosis (MS). Sangamo is also presenting preclinical murine data demonstrating that CAR-TREGS accumulate and proliferate in the CNS and reduce a marker of MS.

In vivo genome editing optimization

Clinical data presented earlier this year provided evidence that Sangamo had successfully edited the genome of patients with mucopolysaccharidosis type II (MPS II) but also suggested that the zinc finger nuclease in vivo gene editing reagents were under-dosed using first-generation technology. Sangamo has identified potential improvements that may enhance the potency of in vivo genome editing, including increasing total AAV vector dose, co-packaging both ZFNs in one AAV vector, and engineering second-generation AAVs, ZFNs, and donor transgenes.

Genome regulation pipeline candidates targeting neurodegenerative diseases including Alzheimers and Parkinsons

Sangamo scientists today are presenting data demonstrating that the companys engineered zinc finger protein transcription factors (ZFP-TFs) specifically and powerfully repress key genes involved in brain diseases including Alzheimers, Parkinsons, Huntingtons, ALS, and Prion diseases. Sangamo is advancing its first two genome regulation programs toward clinical development:

Sangamo scientists are also presenting data demonstrating progress in the development of new AAV serotypes for use in CNS diseases.

Manufacturing capabilities and strategy

Sangamo is nearing completion of its buildout of a GMP manufacturing facility at the new Company headquarters in Brisbane, CA. This facility is expected to become operational in 2020 and to provide clinical and commercial scale manufacturing capacity for cell and gene therapy programs. The Company has also initiated the buildout of a cell therapy manufacturing facility in Valbonne, France. Sangamos manufacturing strategy includes in-house capabilities as well as the use of contract manufacturing organizations, including a long-established relationship with Thermo Fisher Scientific for clinical and large-scale commercial AAV manufacturing capacity.

R&D Day webcast

A live webcast of the R&D Day, including audio and slides, will be available on the Events and Presentations page of the Sangamo website today at 8am Eastern Time. A replay of the event will be archived on the website.

About Sangamo Therapeutics

Sangamo Therapeutics is committed to translating ground-breaking science into genomic medicines with the potential to transform patients lives using gene therapy, ex vivo gene-edited cell therapy, and in vivo genome editing and gene regulation. For more information about Sangamo, visit http://www.sangamo.com.

Sangamo Forward Looking Statements

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Sangamo Highlights Advancements in Genomic Medicine Pipeline and Expanded R&D and Manufacturing Capabilities at R&D Day - Business Wire

One in six GPs could quit medicine within a year, GMC report finds – GP online

The GMCs State of medical education and practice 2019 (SoMEP) report shows that 18% of GPs were considering leaving medicine entirely in 2020.

Nearly a quarter of GPs polled by the regulator 'gave responses that suggested they were at high risk of burnout' - and nearly one in 10 had taken a 'leave of absence due to stress' within the past 12 months. Around one in six GPs said they were unable to cope 'every day'.

GPs were significantly more likely to be dissatisfied than doctors as a whole - with 45% of GPs dissatisfied compared with 30% of all doctors.Increasing workload, long hours, difficulty dealing with patient expectation and bureaucracy were among key factors cited by GPs.

The report, which gathered responses from 1,079 GPs, found a growing shift towards part-time working in general practice; a trend theGMC said reflected deliberate choices by GPs to manage their wellbeing and protect against burnout.

A total of69% of full-time GPs said they were likely to reduce the amount of time they worked in clinical practice next year, and 36% of GPs had done so in 2019. Nearly half (45%) of GPs said they were already contracted to work less than full-time (LTFT).

The GMC highlighted an increasing number of doctors in GP training which grew by 6% in 2019, but warned it may not directly translate into reduced pressure on GP services because of the continuing trend towards LTFT working.

The regulator called for legislative change to allow a more streamlined process for registering overseas-trained doctors and innovative models of education to attract more doctors to general practice.

The GMC found that GPs working LTFT were more likely to be satisfied at work (6% higher) and less likely to be planning to leave the profession compared with full-time colleagues. Meanwhile, the analysis showed doctors who paused before starting their specialty training were, on average, at lower risk of burnout.

GMC chief executive Charlie Massey said: The challenge our health services are facing is no secret. We need more flexible training and career options if high levels of patient care and safety are to be sustained.

Doctors say they are no longer prepared to stick with the traditional career paths to meet that demand. We are seeing what looks like a permanent shift in the way newer doctors plan their careers.

That doctors are making choices for a better work-life balance and career development is a new reality which health services cannot ignore. Establishing a sustainable workforce and encouraging supply, particularly of expert generalists who can spread the burden in primary care, is vital.

RCGP chair Professor Martin Marshall said: It's not surprising to see more GPs reducing or planning to reduce the number of clinical hours they work. They shouldnt be criticised for this - its this flexibility in working patterns that general practice offers that makes the job sustainable, so that GPs and our teams can continue to deliver safe care to a million patients a day across the country.

Working "full-time" in general practice is simply not doable for many, and this is causing GPs to burn out, or leave the profession earlier than they planned to because they feel they cannot guarantee safe standards of care for their patients. It makes sense that GPs are making choices about their career to safeguard against this.'

BMA chair Dr Chaand Nagpaul said: 'Exhausted and burnt out doctors, overwhelmed by demand, are struggling to provide the level of care that patients deserve. This is affecting quality and safety of the care thats being delivered. Its clear that the impact of the state of the NHS is being felt across the whole profession from juniors beginning their careers, to experienced hospital doctors and GPs.

'The government and employers need to do more to retain the existing workforce. This means recognising the flexible working patterns that doctors are increasingly opting for, and as the BMA has consistently called for, a learning rather than a blame culture in the health service.'

GPonline reported last month that the full-time equivalent (FTE) fully-qualified GP workforce fell by 340 over the year to September 2019.

GP practices delivered a record 30.8m appointments in October 2019 - by far the highest figure recorded in a single month since NHS Digital began collecting data 18 months ago.

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One in six GPs could quit medicine within a year, GMC report finds - GP online

Medicine or Myth? The Dubious Benefits of Placenta-Eating – Undark Magazine

When Brooke Brumfield wasnt battling morning sickness, she craved nachos. Like many first-time expectant mothers, she was nervous and excited about her pregnancy. She had just bought a house with her husband, a wildland firefighter who had enrolled in paramedic school to transition to firefighting closer to home. Everything was going according to plan until 20 weeks into Brumfields pregnancy, when she lost her job at a financial technology startup and, with it, her salary and three months paid maternity leave. After building a new business to support her family, she had clients, but childcare was limited, and her husbands schedule was always shifting. By the time her baby arrived, everything was beyond overwhelming, Brumfield says. I pretty much felt like a truck hit me.

Brumfield had heard stories from friends and family about a way to minimize the stress and emotional fallout of the postpartum period: consuming her placenta, the vascular organ that nourishes and protects the fetus during pregnancy and is expelled from the body after birth. The women swore by the results. They said their milk supply improved and their energy spiked. The lows caused by plummeting hormone levels didnt feel as crushing, they explained.

Brumfield enlisted her doula who, for a fee, would steam, dehydrate, and pulverize her placenta, pouring the fine powder into small capsules. She swallowed her placenta pills for about six weeks after delivering her daughter. She said they helped her feel more even, less angry and emotional. When her milk supply dipped, she says, I re-upped my intake and [the problem] was solved.

Social scientists and medical researchers call the practice of consuming ones own placenta placentophagy. Once confined to obscure corners of alternative medicine and the countercultures crunchier communities, it has been picked up by celebrities (Kourtney and Kim Kardashian, January Jones, Mayim Bialik, Alicia Silverstone, Chrissy Teigen) and adopted by the wider public.

Although there are no official estimates of how many women ingest their placenta after delivery, the internet is increasingly crowded with placenta service providers preparers of pills, smoothies, and salves to support new mothers in the slog to recovery. But the purported benefits are disputed. Depending on whom you ask, placenta-eating is either medicine or a potentially dangerous practice based on myth. How did this practice go mainstream, despite a lack of reported scientific or clinical benefits? The answer may say much more about the world new mothers live in than it does about the placenta.

In any doctors office or primary care setting, a provider treating a patient will often mention new research that supports a recommended treatment. A pregnant woman diagnosed with preeclampsia, for example, might learn from her health care provider that low-dose aspirin has been shown in recent studies to reduce serious maternal or fetal complications. But the basis for placentophagy, a practice that lies beyond the boundaries of biomedicine, is a 16th-century text.

Li Shizhens Compendium of Materia Medica, or Bencao gangmu, first published in 1596, is a Chinese pharmacopoeia and the most celebrated book in the Chinese tradition of pharmacognosy, or the study of medicinal plants. It appears on the websites of placenta service providers and in the pages of the standard references for practitioners of traditional Chinese medicine (TCM), a millennia-old medical system with a growing global reach.

The basis for placentophagy, a practice that lies beyond the boundaries of biomedicine, is a 16th-century text.

A physician and herbalist, Li drew on his empirical experiences treating patients but also on anecdotes, poetry, and oral histories. His encyclopedia of the natural world is a textual cabinet of natural curiosities, according to historian Carla Nappis The Monkey and the Inkpot, a study of Lis life and work. Containing nearly 1,900 substances, from ginseng and peppercorn to dragons bone and turtle sperm, Lis book describes dried human placenta as a drug that invigorated people, and was used to treat impotence and infertility, among other conditions. For advocates of placentophagy, this book serves as ethnomedical proof of the long-standing history of the practice and by extension, its efficacy and safety.

But like many claims to age-old provenance, the origins of placentophagy as a postpartum treatment are disputed. Sabine Wilms, an author and translator of more than a dozen books on Chinese medicine, scrutinized classical Chinese texts on gynecology and childbirth and told me theres no written evidence at all of a woman consuming her own placenta after birth as a mainstream traditional practice in China, even if formulas containing dried human placenta were prescribed for other conditions, as described in Lis book.

Beyond Lis 400-year-old encyclopedia, evidence of postpartum placenta-eating is nearly impossible to find in the historical record. Womens voices are notoriously difficult to unearth from the archives, and even in the 19th century, the details of childbirth and what happened to the placenta went largely unreported. But when two University of Nevada, Las Vegas anthropologists pored over ethnographic data from 179 societies, they discovered a conspicuous absence of cultural traditions associated with maternal placentophagy.

The earliest modern recorded evidence of placentophagy appears in a June 1972 issue of Rolling Stone. I pushed the placenta into a pot, wrote an anonymous author, responding to the magazines call asking readers to share stories from their personal lives. It was magnificent purple and red and turquoise. Describing her steamed placenta as wonderfully replenishing and delicious, she recounted eating and sharing it with friends after delivering her son.

Evidence of postpartum placenta-eating is nearly impossible to find in the historical record.

Raven Lang, who is credited with reviving the oldest known and most commonly used recipe for postpartum placenta preparation, witnessed placentophagy while helping women as a homebirth midwife and TCM practitioner in California in the early 1970s. These women lived off the land, she explained, and might have drawn inspiration from livestock and other animals in their midst.

It wasnt long before placentophagy made its way beyond Californias hippie enclaves. In 1984, Mary Field, a certified midwife and registered nurse in the U.K., recounted eating her placenta, an unmentionable experience, to ward off postpartum depression after the birth of her second child. I remain secretive, Field wrote, for the practice verges on that other taboo cannibalism as it is human flesh and a part of your own body. She recalled choking down her own placenta. I could not bear to chew or taste it.

The rise of encapsulation technology, developed for the food industry and picked up by placenta service providers in the early aughts, put an end to visceral experiences like Fields. No longer must women process their own placenta or subject themselves to its purported offal-like flavor. Tidy, pre-portioned placenta pills resembling vitamins can be prepared by anyone with access to a dehydrator, basic supplies, and online training videos.

The boom in placentophagy highlights a longstanding puzzle for researchers. Almost every non-human mammal consumes its placenta after delivery, for reasons that remain unclear to scientists. Why did humans become the exception to this nearly universal mammalian rule? For Daniel Benyshek, an anthropologist and co-author of the UNLV study that found no evidence of placentophagy being practiced anywhere in the world, the human exception raises a red flag: It suggests the reasons that humans have eschewed placentophagy arent just cultural or symbolic, but adaptive that theres something dangerous about it, or at least there has been in our evolutionary history.

Scientific data on the potential benefits and risks of placentophagy is scarce, but a few small studies suggest that any nutrients contained in cooked or encapsulated placental tissue are unlikely to be absorbed into the bloodstream at concentrations large enough to produce significant health effects. Whether and in what quantity reproductive hormones such as estrogen survive placental processing has been little studied, but ingesting them after birth could have negative effects on milk production and may also increase the risk of blood clots.

Almost every non-human mammal consumes its placenta after delivery, for reasons that remain unclear to scientists.

Yet placental encapsulation services which remain unregulated in the U.S. have found a receptive audience of American consumers. (The food safety agency of the European Union declared the placenta a novel food in 2015, effectively shuttering the encapsulation business on the continent.) Mostly small and women-owned, placenta service businesses position themselves as an alternative to a highly medicalized, bureaucratized birthing process that has often neglected the needs of women. Postpartum checkups focus narrowly on pelvic examinations and contraceptive education. One survey of U.S. mothers found that one in three respondents who received a postpartum checkup felt that their health concerns were not addressed. In contrast, placenta service providers speak the language of empowerment.

That language can resonate with new mothers like Brumfield, who face overwhelming pressures to care for a newborn, nurse on demand, manage a household, and return to work amid anxieties about postpartum depression, dwindling energy, and inadequate milk supply.

In some ways, placenta consumption is motivated by a desire to perform good mothering, wrote scholars from Denmark and the United States in a paper on the emergence of the placenta economy. It reflects the idea of maternity as a neoliberal project, in which new mothers are responsible for their own individual well-being as well as that of their babies, they added.

Meanwhile, rates of postpartum depression keep climbing, maternity leave policies are stingy, and child care costs are often prohibitive. Its easy to see why many women would be eager to seek help, real or perceived, wherever they can find it.

Daniela Blei is a historian, writer, and book editor based in San Francisco.

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Medicine or Myth? The Dubious Benefits of Placenta-Eating - Undark Magazine

Share the Art of Medicine by Embracing the Role of Mentor – AAFP News

How can medical students in 2019 learn all there is to know in medicine in four (or even five) years of school?

When I was in medical school and residency training more than 30 years ago, there were 400 to 450 FDA-approved medications (including OTC products). Only about 150 of those were applicable to my patients. I learned them all, their possible side effects and contraindications. Since then, the number of FDA-approved drugs has tripled,(www.raps.org) making it impossible to keep up. Now I have to rely on my subspecialty consultants to know the medications specific to their limited scope of practice, which I am exposed to less often.

Similarly, technology has led to more treatments and procedures -- microsurgeries, laser surgeries, robot-assisted surgeries and more -- that may benefit patients. Again, recently I have found consultants recommending therapies with which I am not familiar.

Simply put, the explosion of knowledge in medicine has made staying current challenging. Throw in the evolution of electronic health records, and medical students have more cognitive knowledge to master to become physicians than I or my peers ever did.

But many of us older folks benefited from an excellent education in the doctor-patient relationship and other arts that are crucial in all fields of medical care, not just in primary care. Although even long ago, medical school was no walk in the park, there was time between scientific knowledge acquisition activities to learn this art: how to cultivate an effective and caring doctor-patient relationship and how to use other modalities along with that medical knowledge base to serve patients.

It's no wonder that a current medical student might be drawn to a limited-scope specialty rather than the broad, comprehensive, evolving field that is family medicine. But as family doctors, we know how important it is for every doctor to practice the art as well as the science of our work to be successful in our healing field.

Despite recent advances in the curriculum by some medical schools, students spend much of their first two years focused on core science classes before starting clinical rotations in their third year. By the start of year four, most have made important decisions about their career path, yet many still have their family medicine/primary care rotation ahead of them. It leaves me wondering how -- and when -- students will learn the art of building relationships with patients. And if they don't have adequate exposure to this vital skill, which is at the heart of primary care, what are the odds that they will choose a broad-spectrum specialty like family medicine?

Medical schools should be actively resisting medical practice becoming a lost art. We must know how to care, listen and give our time. Relying on evidence-based medicine alone is no substitute for these skills. Students need to see the power of connecting with patients so that they can see what a rewarding and meaningful specialty family medicine can be for them.

The AAFP and seven other family medicine organizations have undertaken the 25 by 2030 project that aims to achieve 25% of U.S. medical students matching into family medicine by 2030. This is a big reach -- one that is vital to strive toward not just for our specialty, but for our country's health care.

Key to success in this goal is having high school and premed students exposed to the joy of a career in medicine, and medical students exposed early to what we do in our clinics that augments the scientific knowledge they are acquiring and transforms an excellent scientific physician into an excellent clinical doctor.

I wrote in this blog a few years ago that I had started precepting first- and second-year medical students again in my clinic after taking a break from it. What I rediscovered is that working with students is rewarding, and they do not slow me down or present an obstacle to an effective patient visit. More significantly, students are eager to acquire the noncognitive patient-physician relationship-building techniques that I model and teach them in my office. I've had students drive more than an hour to spend time with me in my clinic.

Students have told me that, even on busy days when there isn't much time for answering questions, they can learn a lot just by observing. Although there is so much to learn in medicine, they see the connection I make with patients. After more than 30 years in practice, I can read the expressions on my patient's faces and gauge how they react to my words.

The students I teach, as well as those I am exposed to in my AAFP travels, are eager to learn this aspect of doctoring. I recently gave up some of my clinic teaching to take on co-teaching small group sessions at the medical school. I am struck by the extensive check-off lists of competencies that each student must demonstrate. I empathize with my full-time faculty colleagues who have so much cognitive knowledge to teach (and check off on lists of achievements), and it has helped me understand how they struggle to include relationship-building education.

This early exposure requires schools to carve out time in the first year, and even the first semester, for students to learn the art of doctoring. It also requires us veteran physicians to accept students into our offices to watch us deliver health care and to practice that art as time allows.If you aren't already connected to students, contact a medical school department of family medicine in your area, and embrace the role of mentor.

Alan Schwartzstein, M.D., is the speaker of the AAFP Congress of Delegates.

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Share the Art of Medicine by Embracing the Role of Mentor - AAFP News

The Guardian view on alternative medicines: handle with care – The Guardian

Human health is complicated, and while the history of medicine is often represented as a triumphant march from darkness into light, for many people it doesnt feel like that. Partly this is because we take so much for granted. Its hard to imagine a time when infection and childbirth were serious threats to life. But its also true that as life expectancy has extended and lifestyles have changed, new illnesses and conditions have taken the place of old ones. Dementia, obesity and anxiety disorders are among them.

Sometimes a visit to the doctor doesnt make us, or our loved ones, feel better. There is nothing wrong with looking beyond conventional medicine for activities or remedies that may help. But people should understand that such alternatives are not tested in the same way as the drugs or exercises prescribed by doctors. While manufacturers, practitioners and users of treatments including herbs and osteopathy may make claims about their effectiveness, the public should treat such claims with healthy scepticism: try something by all means, but do not mistake heartfelt testimonies or lengthy appointments for evidence-based medicine.

There has long been a minority of members of the public who opted out of orthodoxy in medicine as in other areas of life. Until recently this was generally viewed as a personal choice that needed to be challenged only in extraordinary circumstances (for example if life-saving treatment was denied to a child). That this tradition of tolerance is now being questioned is largely due to recent falls in the take-up of childhood vaccinations. Last month Simon Stevens, the chief executive of NHS England, went public with serious concerns about homeopathy, and a decision to renew the accreditation of the Society of Homeopaths is being challenged after it was discovered that some members promoted a nonexistent cure for autism.

The situation is not unique to the UK, with the internet providing conduits for anti-vaxx and other myths that did not previously exist. This week Europes leading doctors issued a warning about unproven Chinese medicines, and the World Health Organizations recent decision to grant them recognition.

Regulation is important, as these doctors point out. Policymakers must be alert to the risks posed by unscrupulous or incompetent operators to vulnerable, unwell people, as well as the danger to the general public of anti-vaxxers. There is also a more general cause for concern if the market for alternative medicine is growing because people are choosing magic over science. Rationality matters in principle. But it need not crowd out curiosity or open-mindedness. Placebo effects are well documented, as is the human need for attention. Unconventional ideas and methods can help people, as long as they understand the difference between what is tested, and proven to be effective, and what is neither.

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The Guardian view on alternative medicines: handle with care - The Guardian

What is Osteopathic Medicine and OMT? – CapeGazette.com

You may have seen DO at the end of a physicians name but not known the meaning behind this degree. It stands for doctor of osteopathic medicine, and these doctors are trained in modern medicine as well as holistic medicine based on the philosophy that the body is an integrated whole. They receive special instruction in the musculoskeletal system and osteopathic manipulative therapy (OMT), a hands-on approach to diagnosing and treating patients. Bayhealth Primary Care PhysicianVincent Lobo, DO, DACFP, who has been performing OMT in his practice for over 40 years, discusses its uses and benefits.

The premise behind osteopathic or holistic medicine is that the mind, spirit, and structure and function of the body are interdependent. Essentially, if your body is structurally healthy, it heals itself. Pain or other problemsoccur when there are somatic dysfunctions of different levels of the spine, said Dr. Lobo. Somatic dysfunction is defined as a restriction in the bodys framework. This may originate in the skeletal system or fascia, the bodys connective tissue, and may alter the circulatory, lymphatic or nervous system.

If theres a lesion in the back or the spine is out of alignment, for example, the nerves that connect from that area to the internal organs send abnormal nerve impulses that will, in turn, affect those organs, he said. The opposite can also occur when a disorder of an internal organ manifests as a spine problem, such as an inflamed gall bladder causing back pain.

Osteopathic physicians aim to restore the normal mechanics in the body. In an osteopathic structural exam, I typically examine for posture, spinal motion, joint restriction, tissue spasms, spinal curvature, leg lengths, and conditions of the feet, said Dr. Lobo. With OMT, gentle pressure is applied or manual manipulations are done on the muscles, joints or nerves that are the source of the dysfunction. This can improve posture, relieve pressure and reduce pain.

Dr. Lobo said that some of the more common ailments for which he performs OMT are chest wall pain, tension headaches, thoracic pain, sinus problems, neck and low back pain, temporomandibular joint dysfunction (TMJ), and some abdominal pain. There are a variety of OMT techniques, and these are dependent upon the specific problem and a patients age. Two types are muscle energy techniques, involving muscle stretching and contractions, and myofascial release which is like a soft tissue massage.

A critical element of osteopathic medicine is preventative medicine and education, said Dr. Lobo. This includes encouraging patients to maintain healthy diet and physical activity, and teaching them what they can do on their own to help with their medical issues, such as using correct form when lifting, wearing orthotics in shoes, or doing certain exercises.

All DOs have the knowledge, but not all DOs perform OMT, Dr. Lobo said. Its another modality of treatment but like anything else, including physical therapy or acupuncture, nothing is 100%. I think its good for people to know that Bayhealth has this resource through some of its doctors.

To learn more about osteopathic physicians and those who use OMT in their practice, visitBayhealth.org/Find-A-Doctoror call 1-866-BAY-DOCS (229-3627).

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What is Osteopathic Medicine and OMT? - CapeGazette.com

Women in medicine more likely to experience ‘microaggressions’ than men. Here’s what you can do about it. – The Daily Briefing

Female medical faculty members find "microaggressions"indirect, fleeting comments that are "rooted" in "unconscious bias" against a marginalized groupcommon in the workplace, while male faculty say they seldom occur, according to a study published last week in Academic Medicine, the study's lead author VJ Periyakoil, writes for the New York Times' "Well."

Periyakoil is an associate professor at Stanford University School of Medicine.

A few years ago, Periyakoil started the Stanford Project Respect to study communication in health care and "foster mutually respectful interactions between health professionals and their patients."

For the project, Periyakoil and her colleagues hired professional actors to reenact 34 different microagression scenarios as well as controlor "nontoxic"versions of the scenarios. The interactions were recorded and turned into 68 videos that medical faculty at four medical schools across the country viewed in random order. The faculty members were then asked to rate each scenario on the frequency in which they occurred in real life.

The sample group consisted of 124 people, 79 of whom were women and 45 of whom were men.

The results, published last week in Academic Medicine, showed female faculty were more likely than male faculty to say the microaggression scenarios were common in the workplace.

The female faculty members reported that workplace microaggressions were frequent overall. On the other hand, male faculty from the same workplaces said microaggressions were uncommon.

The researchers as part of the project also collected stories of microaggressions from health care workers across the country. One female surgeon recalled being interviewed by a panel of men, which she called a "manel," and being asked how she would, "be able to effectively communicate in the operating room as a woman."

Another said that when she asked her boss about being promoted to a different position, he responded, "Well, I'm just deciding, you know, if I'd like to give you an engagement ring or not. You have to convince me."

In one situation that Periyakoil calls particularly "appalling," a lecturer selected a female student to be a model for his ultrasound skills demonstration and called a certain angle of the instrument probe a "money-shot."

Based on her research, Periyakoil offers suggestions about how medical faculty can confront microaggressions and create a better climate for female faculty and students.

In the moment, calling out microagressions can be "daunting," Periyakoil writes, but at a closer look, "we see that microaggressions are rooted in our unconscious biases that are fed by the gender and racial tensions that seethe under the surface and bubble up when we least expect them."

As a result, the first step to changing the culture is acknowledging the problem, Periyakoil writes.

"If you are the perpetrator and you catch yourself in the act, apologize immediately and sincerely for your misstep. If you are the recipient, speak up respectfully and promptly in the moment," she writes.

Bystanders can also play a critical role in mitigating the culture by calling out microaggressions and supporting victims of the comments.

For example, during a gynecology seminar, a professor asked a female student if she could tell how much estrogen she has inside of her body when she's ovulating. The "mortified" female student sat in silence, but then a male classmate stepped in.

"Professor, I've never, um, ovulated before, but I think I can take this question," he said (Periyakoil, New York Times, 10/31; Vyjeyanthi et al., Academic Medicine, 10/29).

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Women in medicine more likely to experience 'microaggressions' than men. Here's what you can do about it. - The Daily Briefing

WVU Rockefeller Neuroscience Institute first in US to use deep brain stimulation to fight opioid addiction – WVU Medicine

Posted on 11/5/2019

MORGANTOWN, W.VA. -- The West Virginia University Rockefeller Neuroscience Institute and WVU Medicine, today (Nov. 5) announced the launch of a first-in-the-U.S. clinical trial using deep brain stimulation for patients suffering from treatment-resistant opioid use disorder.

Funded through a grant from the National Institute on Drug Abuse, the clinical trial is led by principal investigatorAli Rezai, M.D., executive chair of the RNI, and a multidisciplinary team of neurosurgical, psychiatric, neuroscience, and other experts.

The team successfully implanted a Medtronic DBS device in the addiction and reward center of the brain. The trials first participant is a 33-year-old man, who has struggled with substance use disorder, specifically excessive opioid and benzodiazepine use, for more than a decade with multiple overdoses and relapses.

West Virginia has the highest age-adjusted rate of drug overdose deaths involving opioids. In 2017, drug overdose deaths involving opioids in West Virginia occurred at a rate of 49.6 deaths per 100,000 persons, according to NIDA.

Our team at the RNI is working hard to find solutions to help those affected by addiction, Dr. Rezai said. Addiction is a brain disease involving the reward centers in the brain, and we need to explore new technologies, such as the use of DBS, to help those severely impacted by opioid use disorder.

The first phase of this clinical trial involves four participants. To qualify, patients will have failed standards of care across multiple levels of WVU Medicines comprehensive inpatient, residential, and outpatient treatment programs that include medication, as well as psychological and social recovery efforts.

Despite our best efforts using current, evidence-based treatment modalities, there exist a number of patients who simply dont respond. Some of these patients remain at very high risk for ongoing catastrophic health problems and even death. DBS could prove to be a valuable tool in our fight to keep people alive and well, James Berry, D.O., interim chair of the WVU Department of Behavioral Medicine and Psychiatry and director of Addiction Services at RNI, said.

DBS, or brain pacemaker surgery, involves implantation of tiny electrodes into specific brain areas to regulate the structures involved in addiction and behavioral self-control. This study will also investigate the mechanism of the addiction in the brain. The U.S. Food and Drug Administration has approved DBS for treating patients with Parkinsons disease, essential tremor, dystonia, epilepsy, and obsessive-compulsive disorder. The RNI team routinely uses DBS to treat patients with these disorders.

About the Rockefeller Neuroscience Institute

We are improving lives by pioneering advances in brain health. With the latest technologies, an ecosystem of partners, and a truly integrated approach, we are making tangible progress in our goal to combat public health challenges ranging from addiction to Alzheimers, benefiting people in West Virginia, neighboring states, and beyond. Learn more about the RNIs first-in-the-world clinical trials and the top caliber experts joining us in our mission.

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WVU Rockefeller Neuroscience Institute first in US to use deep brain stimulation to fight opioid addiction - WVU Medicine

How to Close the Gender Pay Gap in US Medicine – Harvard Business Review

Executive Summary

Indefensible differences in salary between women and men persist in medicine, with female primary care and specialist doctors earning 25% and 36% less, respectively, than their male counterparts. These differences are especially egregious given that female physicians actually outperform male physicians in some areas. Its hard to imagine by what calculus a health care organization would pay women less than men for their better outcomes. The solutions to this unacceptable state including transparency around salary data, focused coaching and sponsorship, and equitable promotions.

Despite increased attention to gender disparities in the workplace, indefensible differences in salary between women and men persist in medicine. One national study of academic physicians in 24 public medical schools found that female physicians make about 10% less than their male counterparts at all academic ranks, even after adjusting for specialty, hours worked, and other variables. Medscapes 2019Physician Compensation Report finds even greater disparities, with full-time male primary care and specialist doctors earning 25% and 33% more, respectively, than their female counterparts.

These differences are especially notable and disappointing given that female physicians actually outperform male physicians in some areas; one study of 1.5 million Medicare hospitalizations found that female doctors patients had significantly lower mortality and fewer rehospitalizations. Its hard to imagine by what calculus a health care organization would pay women less than men for their better outcomes.

The solutions for closing this gap are complex, but achievable. Drawing on existing research, lessons from other fields, and our own experience as researchers and leaders committed to gender equity, we believe that organizations should pursue three approaches to address the problem.

Enhance Salary Data

Lack of accurate salary data creates a major barrier both to leaders seeking to address inequities and to female physicians as they negotiate. Pay audits and increased transparency could help. Organizations outside of medicine have effectively used audits to reveal pay discrepancies and enhance pay equity. For example, after a 2015 analysis of more than 17,000 salaries at Salesforce, the company found that 6% of the employees (about equally split between men and women) required a salary adjustment, including, CEO Marc Benioff told CNN, quite a few women who were paid less than men.

To create the most useful audits in healthcare it will be essential to assure that they capture total compensation. Many physicians, particularly those practicing in academic settings, receive compensation from both clinical and non-clinical activities. Evidence from outside of medicine suggests that women are more likely to volunteer or be volunteered for non-promotable work, and, within medicine, women perceive that they are more likely to be given uncompensated work (such as unpaid committee or teaching positions and office-improvement projects) alongside clinical care. Comparing compensation for clinical activities alone would not capture these differences which contribute to lower overall salaries for amount worked.

In addition, auditing should take into consideration the demands that female physicians patients make relative to those made of male physicians. There is evidence that female physicians have more female patients, and more patients with psychosocial complexity, than their male counterparts do. Patients in both groups often require longer visits and more management time outside the office. Further, research shows that patients tend to seek a different (and more time-consuming) kind of care from female doctors, often talking and disclosing more and expecting more empathic listening. Accurate auditing will need to account for patient complexity in addition to number of patients seen or the number of patients a physician has on their panel to accurately assess clinical load.

Providing salary transparency is a more controversial approach to promoting equal pay that has been explored in other industries. Public universities such as the University of California system have made compensation data publicly available for many years. In Canada, public disclosure of faculty salaries above a certain threshold reduced the gender pay gap. Some private entities have joined the trend as well. At the software startup Buffer, publicly publishing pay data did not eliminate gender-based salary discrepancies. However, it did push the company to identify and address potential sources of inequity, such as subjectivity in assessing experience and readiness for promotion. While there isnt a case of a health system that has published salary data and demonstrated the subsequent effects, experiences from other industries suggest this approach is worth discussing. We acknowledge that there are certainly many potential negative effects of pay transparency on organizational dynamics, and any transparency initiative should be rolled out with caution. A medical institution considering transparency would need to ensure careful auditing of data ahead of publication, and to have well thought out plans for addressing potential conflicts among staff, as well as between staff and management, that might emerge.

Data from the Harvard Kennedy School shows that women negotiate for lower compensation than men do in the absence of clear industry standards but negotiate for equal salaries when standard salary information was available, suggesting the value of creating environments in which information about compensation is shared across gender lines.

Engage Allies in Coaching and Sponsorship

Much of coaching and peer support for women physicians has focused on same-gender mentorship and peer groups. While these provide female physicians with role models similar to themselves and create comfortable spaces for reflection, given evidence that men are more likely to get explicit information about paths to advancement in management or to receive mentorship or sponsorship at all, they should be engaged as allies in systematic ways. Men can serve as sponsors who recommend women for new opportunities or as coaches who share a different perspective on salary negotiation or insight about the opportunities being presented to male mentees. Studies in other industries show that male sponsorship is crucial to closing the gender pay gap, and theres every reason to think it could have a similar impact in health care. Mixed-gender peer coaching groups can provide similar opportunities for sharing salary or tactical data.

While the most natural source for recruiting an institutions mentors and coaches is from within, there may be value to engaging diverse external coaches as well. At Brigham and Womens Hospital, we have started providing female faculty with access to external coaches in the areas of leadership, network development, time management, and technology use, in addition to more traditional peer support and individual coaching.

We acknowledge that in the MeToo era some men have shied away from mentoring or coaching women altogether, which is a loss for all involved. Its up to health care organizations to encourage mixed-gender mentorship, provide the training and guidelines needed to do it well, and outline clear consequences for inappropriate behavior or abuse of the relationship.

Facilitate Equitable Promotion

Much of the pay disparity in in academic medical centers is driven by academic rank differences, making facilitation of equitable promotion a priority. A small proportion of full medical professors across the U.S. are female, despite increased representation of female physicians on faculty and among medical school graduates (in 2017, for the first time, women outnumbered men entering U.S. medical schools).

These data suggest that new approaches are needed to ensure promotion of women in academic medicine. These may include: 1) revamping promotion guidelines to create tracks that reward activities aside from grant-funded research, such as teaching, that are often not rewarded in traditional promotions but are central to academic medicine; 2) requiring that female physicians be included on all search and promotion committees; 3) ensuring that open leadership positions are widely publicized rather than privately directed to a select group of candidates; 4) providing grants to support womens career advancement, including family travel grants that facilitate womens attendance at conferences with children and childcare providers; and 5) providing one-on-one external coaching to help female physicians create career roadmaps, tailor their CV for promotions, and identify what they need to accomplish in order to be ready for the next step in promotions.

While no institution yet serves as a clear beacon in matters of promotion equity, several have instituted programs that may help narrow the recognition and promotion gap. For example, Dana Farber Cancer Institute in Boston names its most accomplished clinicians as Senior Institute Physicians, ensuring that those excelling in clinical care are recognized for their efforts. Many institutions, among them UCLA and Duke, have several promotion tracks for faculty to ascend, including ones that focus on clinical care rather than research.

The initiatives we propose are just a start in solving a complex and persistent problem, and the data on what approaches will be most successful. Its high time that health care aggressively engage in and rigorously evaluate efforts to close the unproductive and unjustifiable pay gap in medicine.

Editors note:Because of an editing error, we have corrected the statement in the first paragraph that full-time female primary care and specialist doctors make 25% and 33% less than their male counterparts to read that full-time male primary care and specialist doctors make 25% and 33% more, respectively, than their female counterparts.

Link:

How to Close the Gender Pay Gap in US Medicine - Harvard Business Review

Five Things You May Not Know about Naturopathic Medicine – Patch.com

Naturopathic medicine blends age-old healing traditions with scientific research and modern medicine. Naturopathic doctors (NDs) view symptoms as the body's way of communicating an underlying imbalance and looks at treating the root cause of illness versus just the symptoms. The ultimate goal being to treat the whole person.

Naturopathic medicine treats everything from common health concerns such as high blood pressure or cholesterol, joint and muscle pain, allergies, headaches, to more complex issues like irritable bowel syndrome or other digestive issues. Today, it is becoming even more mainstream with the current sociocultural movement towards preventive health care, stopping disease before it starts, or before it becomes devastating. This whole-person approach can also help patients find new ways for dealing with stress or fatigue, fostering a new way of approaching and dealing with everyday stressors.

If you've never considered naturopathic medicine, here are a few things you might want to know.

1. Naturopathic medicine can complement your primary care.

The best part about a naturopathic physician is that they can work alongside your primary care doctor. In fact, some health systems and physicians even provide naturopathic care with traditional medical care. Physicians who complete the required training can administer naturopathic care in the same office and during the same appointment as your regular checkups.

2. Naturopathic physicians must be accredited.

State-licensed NDs graduate from accredited naturopathic medical programs and pass a national board exam. There are six such programs at seven campuses in North America.

3. Some of our most common ailments can benefit from naturopathic medicine.

Many conditions you may have experienced both acute and chronic could benefit from naturopathic approaches, particularly if you're interested in alternatives to prescription drugs or certain over-the-counter medicines. In naturopathy, a practitioner may suggest herbal remedies, vitamin therapies, dietary changes, and other interventions before resorting to pharmacology. However, NDs will never dismiss the need for certain pharmaceutical drugs, if the patient's issue requires that level of intervention.

4. Naturopathy is more than herbs.

Naturopathic medicine takes a holistic approach to care using non-invasive therapies and techniques that promote the body's own self-healing and regulation of biological processes. Some of these approaches include herbs or plant-based medicines, but not all.

Establishing a healthy diet, supplementing with vitamins, regular exercise and stress-reduction techniques from yoga to mindfulness practices are other important components of a naturopathic treatment plan. The good news is, an ND can help you develop a plan that works for you and helps you overcome your health issues, while having a lasting impact on your overall wellbeing.

5. Visits may be covered by your insurance.

The demand for naturopathic medicine is growing. We see NDs at traditional health systems, as well as systems developing an entire new service line dedicated to this care. It is also becoming more common to be covered by your insurance.

In fact, Humana will introduce naturopathic medicine benefits on Medicare Advantage plans in select counties in Washington for the 2020 plan year. The Medicare Advantage and Prescription Drug Plan Annual Election Period (AEP) starts Oct. 15 and goes through Dec. 7. To find a plan that meets your health care needs visit Humana.com/Medicare or contact Humana to set up an appointment with a licensed insurance agent.

If you are looking to integrate naturopathic medicine into your care plan, the first step is to select a health plan that includes the benefit and the next is to talk to your primary care physician. If they are not eligible to practice naturopathy themselves, they can connect you to someone who can.

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Five Things You May Not Know about Naturopathic Medicine - Patch.com

Medicine disposal kiosks collect nearly two tons in first year of operation – Kitsap Sun

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Estefanny Carrera a dental receptionist at Peninsula Community Health Services with the medicine disposal box in the lobby.(Photo: Larry Steagall / Kitsap Sun)

In their first year of operation, Kitsap's medicine drop-offkioskssaw a ton of action... literally.

Kitsaps MED-Project collected more than 3,800 pounds of medicine last year,according to the programs first annual report. And public health officials expect that number will only increase as more people learn about the free service.

After the Kitsap Public Health District overhauled a medicine take-back program a few years ago,the program has gradually expanded to 13 kiosks, as well as amail-in site, at pharmacies, health care clinics and law enforcement offices across Kitsap County.

Its kind of been a slow rollout across the country with more and more partners coming out and convenientlocations across the county, said Kitsap Public Health District spokesman Tad Sooter.

MED-Project, a contractor hired by drug manufacturers, began operating in March 2018. That came after the Kitsap Public Health Board voted in 2016 to require drug manufacturers to install and handle medicine disposal kiosksfollowing similar ordinances passed in King and Snohomish counties.

The Kitsap County Sheriff's Officepreviously offered medicine disposals at several locations, but the health district had said the program was inadequate. Many residents were looking for more convenient access.

I think that this program, in contrast to some of the historical programs, has a little more enthusiasm, said Bryan McKinnon,with the public health districts Solid and Hazardous Waste program. People are really happy to have options.

The new program hasmore drop-off locations, but the sheriff's medicine disposal system does not have data to track usage trends, said Jan Brower, Solid and Hazardous Waste manager.

Still, Brower expects to see a rise in the number of medicine drop-offs in the coming years. Were hoping as the program matures, and we do more education and outreach, even more people will participate in the program, she said.

Erica Liebelt, executive and medical director of the Washington Poison Center, says secure medicine drop-off programs like the one in Kitsap help preventaccidental poisoning and drug abuse and curtailenvironmental pollution.

Medications left in the household increase the risk that people who shouldn't be taking them would use them in the wrong fashion, she said. The bottom line is we dont want unused medications lying around the house with the vulnerability of people who shouldnt be getting them.

In Washington, poisonings from pain medications were the most frequent calls to the Washington Poison Center last year. Studies have found that about 70 percent of those who abuse prescription medicine obtain the drugs from friends or family, according to the Washington State Department of Health.

Having unused medicine lying around the house can be especially dangerous for young children, Liebelt said.

In 2015, there were nearly 500 calls to the Washington Poison Center regarding accidental medication poisoning of children 6 and younger in Kitsap County, according to the public health district.

Kitsap is among six counties in Washington state with the medicine drop-off service. But next year, Washington will implement a statewide medicine disposal program funded by drug manufacturers, which is expected to start between spring and late fall of 2020.

Brower, of the Kitsap Public Health District, hopes the statewide program will continue to spread awareness.

Moving forward we really want to focus on getting the information out there so everyone knows what to do with expired or unused medication, she said.

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Medicine disposal kiosks collect nearly two tons in first year of operation - Kitsap Sun

Sheriff’s Office adds Operation Medicine Cabinet drop-off site in Wixom – The Oakland Press

A new, 24/7 drop-off site for unused or outdated prescription medicine opened in Wixom this week.

A ribbon-cutting for the newest Operation Medicine Cabinet Prescription Drug Collection Program drug drop-off location in Oakland County was held on Thursday at the Wixom Police Department.

The program allows individuals a safe place to drop off their outdated or unused prescription drugs. A drop-box is located in the lobbies of law enforcement agencies across the county for residents to access all day, every day.

A ribbon-cutting for the newest Operation Medicine Cabinet Prescription Drug Collection Program drug drop-off location in Oakland County was held on Thursday, Nov. 7, 2019, t the Wixom Police Department,49045 Pontiac Trail, just east of Wixom Road.

Police Chief Ron Moore joined with Oakland County Sheriff Michael Bouchard, Julie Brenner, Alliance for Healthy Communities Coalition executive director, and members of Wixom TEAM for the event.

The Wixom Police Department is at 49045 Pontiac Trail, just east of Wixom Road.

A list of Oakland Countys drop-off collection sites is at:https://www.oakgov.com/sheriff/Community%20Services/domestic/Pages/Ope ration-Medicine-Cabinet.aspx.

The program's partner law enforcement agencies include:

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Sheriff's Office adds Operation Medicine Cabinet drop-off site in Wixom - The Oakland Press