Nobel Assembly member, Randall Johnson (R), speaks to announce the winners of the 2019 Nobel Prize in Physiology or Medicine (L-R) Gregg Semenza of the US, Peter Ratcliffe of Britain and William Kaelin of the US, seen on a screen during a press

Dr. William G. Kaelin, Jr., Sir Peter J. Ratcliffe, and Dr. Gregg L. Semenza now have an extra line to add to their resumes or LinkedIn profiles. The Nobel Assembly announced on Monday that these three physician-scientists have been awarded the 2019 Nobel Prize in Physiology or Medicine for helping find ways that your body can sense and adapt to different levels of oxygen:

Winning this Prize will bring each of them a third of a 9 million Swedish kronor or $907,000 cash prize and an amazing retort to anyone else who may brag too much at a cocktail party. Of course, the Nobel Prize isnt their first accomplishment but instead serves as a tribute to three careers that have brought discoveries that may lead to new treatments for anemia and cancer.

Kaelin is currently a Professor at Harvard Medical School and the Dana-Farber Cancer Institute. Born in 1957, he eventually got his M.D. from Duke University, Durham, and trained in internal medicine and oncology at Johns Hopkins University and the Dana-Farber Cancer Institute.

Ratcliffe wasnt a Sir yet when he was born in 1954. After studying medicine at Cambridge University and completing nephrology training at Oxford, he subsequently became the Nuffield Professor of Clinical Medicine at Oxford and the Director of Clinical Research at the Francis Crick Institute in London, Director for Target Discovery Institute at Oxford, a Member of the Ludwig Institute for Cancer Research, and knighted.

Semenza is a Professor of Medicine at Johns Hopkins University and Director of the Vascular Research Program at the Johns Hopkins Institute for Cell Engineering. He was born in 1956, obtained both an MD and a PhD from the University of Pennsylvania and completed residency training in pediatrics at Duke University and a post-doc at Johns Hopkins University.

To understand the importance of their discoveries, its important to understand the how your body needs complex ways to regulate oxygen levels. As you first learn when you try to put a sock over your head (dont try this, by the way), oxygen is pretty fundamental to everything that you do. Without it, the trillions and trillions of cells in your body couldnt survive and function. Each cell uses oxygen to help break down nutrients into energy. Thus, no oxygen, no energy. No energy, no cells, and no you. And no Instagramming and texting.

The trouble is oxygen, like macaroni and cheese and anything else good in life, isnt always present at the levels that you and all your cells would like. Oxygen levels can fluctuate in the air that you breathe and in different parts of your body. The ability of each of your cells to get oxygen can depend heavily on location, location, location, as the old real estate saying goes.

Think of your body as a large and complex metropolitan area with many different neighborhoods. Red blood cells are like little Ubers picking up oxygen at your lungs and then carrying the molecules of oxygen along your blood vessels, which serve as roads to different parts of your body. Just as the roads are different in different parts of the Boston area, the density and networks of blood vessels vary throughout your body. Thus, not every part of your body will always get the same amount of blood and oxygen. These differences can be exacerbated when your blood circulation in general decreases, such as when you are lying on the coach after eating way too much macaroni and cheese, or blood flow in a particular part of your body gets interrupted, such as when you are bleeding or have a blood clot.

Therefore, like a well-run city, your body needs ways of sensing whats going on in each of the neighborhoods and adjusting oxygen levels accordingly. One way of adjusting your bodys oxygen supply in general is by changing your breathing rate. The carotid arteries are the major blood vessels in your neck and the ones that often spurt blood in slasher horror movies. These arteries include structures called carotid bodies that can check the oxygen levels in the passing blood. If oxygen levels are too low, the carotid bodies sends signals through nerves to increase your breathing rate. If the oxygen levels are too high, the carotid bodies will signal to slow your breathing. While this may help the overall amount of oxygen getting into your lungs and blood circulation, it alone cant monitor and adjust the oxygen thats getting to more local levels throughout your body.

Another thing that regulates oxygen levels is EPO, which is pronounced like Emo but with a p instead of an m. EPO is short for erythropoietin, a hormone that can stimulate your body to produce more red blood cells and thus have more Ubers to deliver oxygen. When EPO levels rise, erythropoiesis, a fancy name for red blood cell production, increases. However, before the work of Semenza, Ratcliffe, and Kaelin and their respective teams, it wasnt clear exactly how oxygen levels were able to affect EPO levels.

Here is Dr. Gregg L. Semenza M.D., Ph.D at a press conference at Johns Hopkins Hospital after learning that he had won the Nobel Prize for Medicine. (Photo by John Strohsacker/Getty Images)

In the 1990s, both Semenzas and Ratcliffes teams found that all types of body tissues have the ability to sense oxygen levels, not just the kidney cells that produce EPO. Semenzas team found DNA sequences near the genes that code for EPO and continued to search for ways that the EPO gene is regulated. A HIF, HIF hooray moment came when they found a protein complex, which they named HIF for hypoxia-inducible factor. Hypoxia is a medical term for low oxygen. Thus, when George Costanza said on an episode of Seinfeld, oxygen, I need oxygen, he could have said, I have hypoxia, instead. Thus, hypoxia-induced means something that will be stimulated by low oxygen levels. The team eventually realized that this protein complex actually consists of two different proteins that can bind DNA, which they named HIF-1 and ARNT.

Experiments showed that when oxygen levels are high, cells have very low levels of HIF-1 because the HIF-1 thats produced gets rapidly degraded. However, when oxygen levels dip low, HIF-1, in the words of the Supremes, keeps on hanging on and doesnt degrade as quickly. Therefore, there is more HIF-1 around to stimulate the EPO genes to produce more EPO.

The difference seemed to be ubiquitin. Ubiqutin can bind to HIF-1 and mark it to go bye bye, which is what host of the game show The Weakest Link says to contestants before they must exit. In this way, ubiquitin serves as a label to say, please get rid of this.

But it still wasnt yet clear how lower oxygen levels could keep ubiquitin from binding to HIF-1. This is when Kaelins team entered the mix. They had been studying something seemingly unrelated, von Hippel-Lindaus disease, which is often abbreviated VHL disease. This is a condition that is inherited and includes mutations in the VHL gene. They observed that normally the VHL gene codes for proteins that seem to prevent certain cancers from developing. In VHL disease, mutations prevent this gene from working properly, allowing a number of different cancers to emerge.

William G Kaelin Jr., MD, speaks at the Dana Farber Cancer Institute on October 7, 2019 in Boston, Massachusetts. (Photo by Scott Eisen/Getty Images)

Here is an example of how starting on one path doesnt necessarily lead you to where you thought you would go and how the most interesting things in life can be unexpected. Kaelins team eventually realized that such cells with mutations in the VHL gene also expressed abnormally high levels of hypoxia-regulated genes, which made them wonder whether VHL played a role in regulating the response to low oxygen levels. This wasnt totally surprising since cancer cells also need oxygen to survive, and such cells cant always get the same access to blood and oxygen when they sit deep in the middle of tumors.

Indeed, additional work showed that the VHL genes produce proteins that then help connect ubiquitin to HIF-1 and thus label HIF-1 for destruction. In essence, VHL is like a warehouse inventory manager using ubiquitin as a label for get rid of this. But the scientists were still left with the question, how do oxygen levels influence whether VHL labels HIF-1 with ubiquitin?

The mystery step turned out to be prolyl hydroxylation. What-yl what-xylation? This is a process by which enzymes (calledprolyl hydroxylases) add hydroxyl groups to two parts of the HIF-1 protein. A hydroxyl group is a combination of an oxygen atom (designated by O) and hydrogen atom (designated by H) and symbolized by -OH. This process is necessary for the HIF-1 protein to be labeled and destroyed. Think of it as OH, lets get rid of this. When oxygen levels are lower, many HIF-1 proteins may not get this OH thus preventing the VHL-ubiquitin labeling process from occurring. The work of Kaelin, Semenz, and their teams thus found the final piece of the puzzle and said OH, thats how it works.

You can see how prolyl hydroxylases could play major roles in the treatment of anemia (which occurs when your red blood cell counts are low) and various cancers with their ability to ultimately regulate red blood cell production and oxygen delivery. Again, cancer cells need oxygen to survive. Starve them of oxygen and you may have a way of killing them.

It didnt seem like this trio of investigators started their independent scientific careers with the intent of all of this happening. While science needs some direction, you cant just go into a lab and start mixing things together, the best science often emerges from exploration and being curious and open to different possibilities. Semenza, Ratcliffe, and Kaelin clearly had the minds and abilities to do such science but they also had the time and resources to do so. Like body tissues do for varying oxygen levels, science and scientists need to have the ability and opportunity to adapt to what they may find. This may not occur as often these days when research funding is more limited and people and institutions are pushing for immediate returns on work. For the eventual benefit of humankind, scientists need to be able to say, OH, lets try this, and then find OH, what do we have here?

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The 2019 Nobel Prize In Medicine: Here Is What Won The Award - Forbes

INDIANAPOLIS, Oct. 11, 2019 /PRNewswire/ -- Eli Lilly and Company (NYSE: LLY) announced today that the U.S. Food and Drug Administration (FDA) has approved REYVOW (lasmiditan) an oral medication for the acute treatment of migraine, with or without aura, in adults. REYVOW has a unique mechanism of action and is the first and only FDA-approved medicine in a new class of acute treatment for migraine (serotonin (5-HT)1F receptor agonists).

"Millions of people with migraine face an ongoing battle with the unresolved pain and symptoms of a migraine attack. There is a substantial unmet need for new acute treatments for migraine, like REYVOW, which is why we are proud of today's approval and Lilly's continuing contribution to the migraine community," said Gudarz Davar, M.D., vice president, neurology development, Lilly Bio-Medicines. "New expectations have been set in migraine care; pain freedom is now the treatment goal for people living with migraine and those who treat them. At Lilly, we are pioneering innovative medicines to provide new options for patients with migraine."

As with other medicines with central nervous system (CNS) activity, the FDA required abuse potential studies for REYVOW. Abuse potential refers to the likelihood that abuse will occur with a particular drug product or substance with CNS activity. Consistent with the FDA's guidance, Lilly conducted a human abuse potential assessment; as part of that assessment, therapeutic doses of REYVOW were associated with less drug liking when compared to alprazolam, but more than placebo. The recommended controlled substance classification for REYVOW is currently under review by the Drug Enforcement Administration (DEA) and is expected within 90 days of today's FDA approval, after which REYVOW will be available to patients in retail pharmacies.

"As a physician who specializes in the treatment of migraine and headache disorders, I commonly treat patients who are looking for acute treatment options that offer the chance for pain freedom during migraine attacks. This approval is especially significant because migraine pain is so often severe and incapacitating," said Jan Brandes, M.D., MS, FAAN, assistant clinical professor, Department of Neurology, Vanderbilt University. "With new science comes new hope. Considering up to 40% of people with migraine do not get adequate responses from their initial acute treatment prescription, having a new and novel option like REYVOW is an important development for physicians and the patients we treat.1,2,3,4"

The New Drug Application (NDA) for REYVOW included data from two Phase 3 single-attack studies (SAMURAI and SPARTAN), which evaluated the safety and efficacy of REYVOW for the acute treatment of migraine in adults. Both studies met the efficacy endpoints of pain freedom and freedom from most bothersome symptom (MBS; patient selected from nausea, sensitivity to light, or sensitivity to sound) at two hours following administration of REYVOW in comparison to placebo. Treatment emergent adverse events were generally mild to moderate and the most frequent included dizziness, fatigue, paresthesia (tingling or numbing sensation on the skin), sedation (sleepiness or drowsiness), nausea and/or vomiting and muscle weakness. See additional Important Safety Information below.

The REYVOW Phase 3 development program, including the open-label GLADIATOR study, involved more than 4,000 patients and the treatment of more than 20,000 migraine attacks.

"For over 25 years, Lilly has been committed to helping people affected by disabling headache disorders, investigating more than a dozen different compounds," said Patrik Jonsson, senior vice president and president, Lilly Bio-Medicines. "The approval of REYVOW is an exciting development for patients and physicians seeking the potential for pain freedom when a migraine attack happens."

About REYVOW (lasmiditan)

REYVOW is a new oral treatment that binds to 5-HT1F receptors with high affinity and is approved by the FDA for the acute treatment of migraine, with or without aura, in adults. Its therapeutic effects are presumably mediated by agonist effects at this receptor; however, the precise mechanism is unknown. REYVOW is not indicated for preventive treatment of migraine. Once available, REYVOW can be prescribed to patients in oral doses of 50 mg, 100 mg, and 200 mg as needed.

IMPORTANT SAFETY INFORMATION FOR REYVOW

Warnings and Precautions

Driving Impairment

REYVOW may cause significant driving impairment. In a driving study, administration of single 50 mg, 100 mg, or 200 mg doses of REYVOW significantly impaired subjects' ability to drive. Additionally, more sleepiness was reported at 8 hours compared to placebo. Advise patients not to engage in potentially hazardous activities requiring complete mental alertness, such as driving a motor vehicle or operating machinery, for at least 8 hours after each dose of REYVOW. Patients who cannot follow this advice should not take REYVOW. Prescribers and patients should be aware that patients may not be able to assess their own driving competence and the degree of impairment caused by REYVOW.

Central Nervous System Depression

REYVOW may cause central nervous system (CNS) depression, including dizziness and sedation. Because of the potential for REYVOW to cause sedation, other cognitive and/or neuropsychiatric adverse reactions, and driving impairment, REYVOW should be used with caution if used in combination with alcohol or other CNS depressants. Patients should be warned against driving and other activities requiring complete mental alertness for at least 8 hours after REYVOW is taken.

Serotonin Syndrome

In clinical trials, reactions consistent with serotonin syndrome were reported in patients treated with REYVOW who were not taking any other drugs associated with serotonin syndrome. Serotonin syndrome may also occur with REYVOW during coadministration with serotonergic drugs [e.g., selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and monoamine oxidase (MAO) inhibitors]. Serotonin syndrome symptoms may include mental status changes (e.g., agitation, hallucinations, coma), autonomic instability (e.g., tachycardia, labile blood pressure, hyperthermia), neuromuscular signs (e.g., hyperreflexia, incoordination), and/or gastrointestinal signs and symptoms (e.g., nausea, vomiting, diarrhea). The onset of symptoms usually occurs within minutes to hours of receiving a new or a greater dose of a serotonergic medication. Discontinue REYVOW if serotonin syndrome is suspected.

Medication Overuse Headache

Overuse of acute migraine drugs (e.g., ergotamines, triptans, opioids, or a combination of drugs for 10 or more days per month) may lead to exacerbation of headache (i.e., medication overuse headache). Medication overuse headache may present as migraine-like daily headaches or as a marked increase in frequency of migraine attacks. Detoxification of patients including withdrawal of the overused drugs and treatment of withdrawal symptoms (which often includes a transient worsening of headache) may be necessary.

Adverse Reactions

The most common adverse reactions associated with REYVOW (> 2% and greater than placebo in clinical studies) were dizziness, fatigue, paresthesia, sedation, nausea and/or vomiting, and muscle weakness.

Drug Abuse and Dependence

REYVOW contains lasmiditan (Controlled substance schedule to be determined after review by the Drug Enforcement Administration.)

Abuse

In a human abuse potential study in recreational poly-drug users (n=58), single oral therapeutic doses (100 mg and 200 mg) and a supratherapeutic dose (400 mg) of REYVOW were compared to alprazolam (2 mg) (C-IV) and placebo. With all doses of REYVOW, subjects reported statistically significantly higher "drug liking" scores than placebo, indicating that REYVOW has abuse potential. Subjects who received REYVOW reported statistically significantly lower "drug liking" scores than alprazolam. Euphoric mood occurred to a similar extent with REYVOW 200 mg, REYVOW 400 mg, and alprazolam 2 mg (43-49%). A feeling of relaxation was noted in more subjects on alprazolam (22.6%) than with any dose of REYVOW (7-11%). Phase 2 and 3 studies indicate that, at therapeutic doses, REYVOW produced adverse events of euphoria and hallucinations to a greater extent than placebo. However, these events occur at a low frequency (about 1% of patients). Evaluate patients for risk of drug abuse and observe them for signs of lasmiditan misuse or abuse.

Dependence

Physical withdrawal was not observed in healthy subjects following abrupt cessation after 7 daily doses of lasmiditan 200 mg or 400 mg.

Full Prescribing Information and Medication Guide.

LM HCP ISI 11OCT2019

About Migraine

Migraine is a neurologic disease characterized by recurrent episodes of severe headache accompanied by other symptoms including nausea, sensitivity to light and sensitivity to sound.5,6 More than 30 million American adults have migraine, with three times more women affected by migraine compared to men.7 According to the Medical Expenditures Panel Survey, total annual healthcare costs associated with migraine are estimated to be as high as $56 billion annually in the United States, yet it remains under-recognized and under-treated.8

About Lilly's Commitment to Headache DisordersFor over 25 years, Lilly has been committed to helping people affected by headache disorders, investigating more than a dozen different compounds for the treatment of migraine and cluster headache. These research programs have accelerated our understanding of these diseases and furthered the advancement of treatments for headache disorders including REYVOW, approved by the FDA for the acute treatment of migraine, with or without aura, in adults. Our goal is to apply our combined clinical, academic and professional experience to build a research portfolio that delivers comprehensive solutions and addresses the needs of people affected by these disabling neurologic diseases.

About Eli Lilly and CompanyLilly is a global health care leader that unites caring with discovery to create medicines that make life better for people around the world. We were founded more than a century ago by a man committed to creating high-quality medicines that meet real needs, and today we remain true to that mission in all our work. Across the globe, Lilly employees work to discover and bring life-changing medicines to those who need them, improve the understanding and management of disease, and give back to communities through philanthropy and volunteerism. To learn more about Lilly, please visit us at lilly.com and lilly.com/newsroom. P-LLY

This press release contains forward-looking statements (as that term is defined in the Private Securities Litigation Reform Act of 1995) about REYVOW (lasmiditan) as an acute treatment for patients with migraine and reflects Lilly's current belief. However, as with any pharmaceutical product, there are substantial risks and uncertainties in the process of development and commercialization. These forward-looking statements are based on the company's current plans, objectives, estimates, expectations and intentions and inherently involve significant risks and uncertainties. Commercialization and the timing of events could differ materially from those anticipated in such forward-looking statements as a result of these risks and uncertainties, which include, without limitation, risks and uncertainties associated with: the company's ability to effectively commercialize REYVOW in the U.S.; delays or problems in the supply or manufacture of REYVOW; obtaining and maintaining appropriate pricing and reimbursement for REYVOW; complying with applicable U.S. regulatory requirements; any delays in, or the outcome of, scheduling by the U.S. Drug Enforcement Administration (DEA) for REYVOW; and other risks and uncertainties affecting the company. For further discussion of these and other risks and uncertainties, see Lilly's most recent Form 10-K and Form 10-Q filings with the United States Securities and Exchange Commission. Except as required by law, Lilly undertakes no duty to update forward-looking statements to reflect events after the date of this release.

2019 Lilly USA, LLC 2019. All rights reserved

________________________

SOURCE Eli Lilly and Company

https://www.lilly.com

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Lilly's REYVOW (lasmiditan), The First and Only Medicine in a New Class of Acute Treatment for Migraine, Receives FDA Approval - PRNewswire

WASHINGTON, Oct. 11, 2019 /PRNewswire/ -- AACC, a global scientific and medical professional organization dedicated to better health through laboratory medicine, is pleased to announce a publishing partnership with Oxford University Press for its peer-reviewed journals, Clinical Chemistry and The Journal of Applied Laboratory Medicine. Both journals will join Oxford University Press's world-class science portfolio starting in January 2020. The partnership will increase researchers' and healthcare practitioners' access worldwide to the important science published in the journals.

Laboratory medicine is essential to high-quality patient carewithout it, patients might receive the wrong diagnosis, inappropriate treatment, or no treatment at all if an illness isn't accurately detected. As the most trusted and authoritative journal in laboratory medicine, Clinical Chemistry is committed to driving progress in the field by highlighting innovative research at the forefront of clinical testing. The Journal of Applied Laboratory Medicine, in turn, focuses on advancing the practice of lab medicine by showcasing findings that lab professionals can easily put into action. Together, these journals cover the gamut of timely healthcare subjects, from new tests that could help combat the opioid epidemic to gender-based disparities in medicine.

"With Clinical Chemistry and The Journal of Applied Laboratory Medicine, AACC strives to provide lab professionals and related fields with the vital information they need to solve challenging patient health problems," said AACC CEO Janet B. Kreizman. "We are excited to partner with Oxford University Press's experienced publishing team to expand the reach of this crucial research and applied laboratory medicine information."

About AACCDedicated to achieving better health through laboratory medicine, AACC brings together more than 50,000 clinical laboratory professionals, physicians, research scientists, and business leaders from around the world focused on clinical chemistry, molecular diagnostics, mass spectrometry, translational medicine, lab management, and other areas of progressing laboratory science. Since 1948, AACC has worked to advance the common interests of the field, providing programs that advance scientific collaboration, knowledge, expertise, and innovation. For more information, visit http://www.aacc.org.

Clinical Chemistry (clinchem.org) is the leading international journal of laboratory medicine, featuring nearly 400 peer-reviewed studies every year that help patients get accurate diagnoses and essential care. This vital research is advancing areas of healthcare ranging from genetic testing and drug monitoring to pediatrics and appropriate test utilization.

Launched by AACC in 2016, The Journal of Applied Laboratory Medicine (jalm.org) is an international, peer-reviewed publication showcasing the applied research in clinical laboratory science that is driving innovation forward in healthcare.

Christine DeLongAACCSenior Manager, Communications & PR(p) 202.835.8722cdelong@aacc.org

Molly PolenAACCSenior Director, Communications & PR(p) 202.420.7612(c) 703.598.0472mpolen@aacc.org

SOURCE AACC

https://www.aacc.org

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AACC's Journals, Clinical Chemistry and The Journal of Applied Laboratory Medicine, to Be Published through Oxford University Press - PRNewswire

What is your coming out story?

Its a little anticlimactic, actually, because I had figured out who I was quite early. In high school and college, I had amazing friends and social networks and was pretty much out to everybody except my immediate family. I had a hang-up about telling my family. I chalked it up to there being a lot going on with my family, my grandmother being sick, and of course not wanting to disappoint my family. I internally felt that my family didnt need another stressor at the moment. Early in my training, thats when I came out to them officially. I had been dating my now husband for several months, and knowing it was a solid committed relationship, I felt it was time to be completely out and share my joy with my family. It was a much later coming out than I had wanted, but I did it when it felt right and authentic to me.

How did you feel after?

I felt great. There were some rough moments, of course, but it made me realize I wish I had done it earlier. Even my parents said they wished I hadnt waited or delayed any of it, because they would have loved and supported me, and shared in my joy, and coming into my own. They did understand its an individual process and a step you take in your own time.

I think, looking back, would I do it differently? Absolutely. Am I upset with how it played out? No. I just think we all have hang-ups about certain things, seeking approval and wanting to be the person we think others have envisioned. Coming out is really an individual experience and timed when one sees fit. It wasnt that I was completely inhibited or wasnt able to experience life, but just not openly with everyone. When I came out, my mom even joked, Can I still dance at your wedding? Yes, I answered with happy tears, and happily, that happened in 2016 when I married my husband, Neil.

Did you ever need a professional coming out?

I didnt, really. I was always out at work because I was comfortable with myself. I never had to say to somebody else, Im gay, but at times it was slightly uncomfortable. I remember one situation at the hospital where a faculty member made a comment about my clothing and how I almost looked straight, as I was wearing jeans just before leaving for vacation. I knew deep down she meant no harm by this comment, as we have a great relationship, but I was completely embarrassed. It was one of the only times I felt like I had a public outing in the workplace, or ever, for that matter.

I just laughed it off in that moment and everyone probably realized how awkward that was for her, too. But I made a decision that I had to stand up for myself. Either I was going tosit with this frustration, and let someone make comments about me like that, or I was going to be honest with her and explain how this had affected me. However, I was a trainee, and it was uncomfortable to have to speak up to a senior mentor and discuss such a personal situation with her. However, with the encouragement of friends, I did it. The essence of the conversation was that her words and actions outed me and reflected stereotypes that are inappropriate. I explained that coming out and sharing that information with those around me is 100% my decision. She was absolutely apologetic, owned it, regretted saying it, and never meant to hurt me that way.

In general, being gay has never been an issue for me at work. In fact, it is not solely what defines me. People are generally very supportive of me as a person, and I know I am lucky. I am always unapologetically myself no matter what.

You met someone at work?

When I was a fellowliterally the first week of trainingI walked into rounds and saw someone who intrigued me. I said to a nurse practitioner, Who is that? It turned outhe was our clinical pharmacist at the time. After a year of friendship and getting to know each other, we started dating at the end of my first year of training. We have now been together for eight-and-a-half years, and married for over three years. Meeting him and having such an amazing, supportive husband is the best thing that has ever happened to me.

Our journey together is an amazing story because hes Indian, and culturally being gay and Indian, it was really a struggle for him and his family. My family is Jewish, and though supportive, Neil and I werent sure how our same-sex multicultural relationship would be embraced. Our wedding was proof that people come around. Both sides were incredibly well represented and openly shared in our joy. Even his great grandmother was dancing and smiling ear to ear on the dance floor. We wrote our ceremony combining elements of both cultures and embracing a central theme that love is love. Many family members came up to us and commented on how much love was in the room and they could feel how much we loved each other. That night, we broke cultural barriers and we broke stereotypes, able to demonstrate it doesnt matter whether youre a man and woman, man and man, or woman and woman. When you love somebody and you are your authentic self, life happens and its beautiful.

How do you think your LGBT perspective contributes to your work?

I think it gives me a unique perspective in caring for adolescent patients and those coming of age. People have asked me how to approach or help patients who have expressed concerns about coming out. I think each of our personal experiences shapes how we approach and appreciate patient concerns in a unique way, where youre able to give some of yourself and your background to the clinical encounter. I have often thought, if my pediatrician asked me about sex or sexuality, perhaps it would have normalized my feelings, and I wouldnt have waited so long to come out to my family. To that end, I am committed to discussing this with patients to help them know they have a safe space to talk about anything they want. Even patients I have treated for cancer or have had a bone marrow transplant years priorknow they can call me or email me anytime. I make myself available to them knowing that one day, a struggling teenager will reach out and it may make a difference in their life to have someone who understands.

Its also been nice to take care of patients who are the children of parents in same-sex families. As my husband and I are embarking on the family-building process, its easy to relate to families in similar situations. An unspoken compassion and understanding the difficulties and challenges of creating a family in the LGBTQ community help form a bond between us. Sadly, our world does not always accept families where there are same-sex parents.

I also enjoy being a part of medical education and mentoring trainees, fellows, residents, and students. Im on the Outlist, and people can and have contacted me. Also, as part of the PENN LGBTQ People in Medicine program, I mentor two medical students longitudinally; one now a fourth-year and another a third-year. Together, we have developed an on-campus family where we meet to chat about all things from research and career planning, to how they are doing as people facing LGBTQ challenges in academia. I feel proud to be a small part of their medical school journey, and again, wish I had this when I was a medical student. Its awesome to be part of a community at Penn which promotes diversity and discussions around it. I think Penn Medicine has done a lot of work to really support the LGBTQ community and I am excited to play a small role in helping students along the way.

Youve had people reach out to you from the Outlist?

I have. Ive had several people reach out to me, and one who wanted to shadow me clinically. It is a really great service, and I encourage more students and members of the Penn community will join the list and take advantage of its potential.

Anything youd like to add?

When youre able to embrace your true self, love yourself, and live confidently as your authentic self, navigating life is easier. Though this sounds both trite and hard to do, you truly will thrive on the other side. Do I think there might be people who take issue with who I am? I am sure there are. But do I let it upset me or get in my way? No. I am myself with every single person; I dont change who I am or how I act with anybody. And I think being that way has allowed me to succeed and advance in my career.

Originally posted here:

A Q&A with Penn Medicine's Jason Freedman for National Coming Out Day - Penn: Office of University Communications

Fighting for acceptance and access to medicine in India as a transgender HIV-positive person - Asia-Pacific - RFI

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Fighting for acceptance and access to medicine in India as a transgender HIV-positive person - RFI English

The practice of pimping (also known as toxic quizzing") and the use of the word in medical education is being called into question. In an article recently published in BMC Medical Education, the authors are asking the medical community to stop using this degrading word and for the end of this practice.

Caroline King, Kelsey Priest & David Chen 11 Oct 2019

skynesher / Getty Images / iStock

It is the first month of medical school, and you hear the word pimping in an unfamiliar context: medical education. You learn that pimping, also known as toxic quizzing, happens when a junior trainee is asked a series of obscure or intentionally unanswerable questions, usually publicly, by a more senior physician. You may adopt pimping into your vocabulary, which is already rapidly expanding with medical terminology. Or you may not be able to shake the colloquial connotations of pimping a form of sex-trafficking and you may silently disengage when classmates and professors casually use the term. Or you may begin to question the culture of your profession, which has retained qualities of exclusion for women, non-binary individuals, and people of color throughout its evolution.

We are adding our voices alongside medical educators and learners who are calling into question the use of the word, and the practice of pimping in medical education.

() seeing the very good has helped us to recognize the very bad.

To be clear, we do not fear hard work. We are not afraid to meet the limits of our own knowledge, or the exciting challenges of learning the science and art of medicine. We wouldnt be here if we did. Instead, we have each had the privilege of experiencing effective clinical teaching. When a senior physician maps out how to localize a neurologic lesion, or stays an hour after clinic to teach us how to read EKGs and chest x-rays, or shows us how to properly hold an otoscope. We have each reaped the benefits of these learning moments. These are the opportunities in which physicians, our teachers, seek to understand how much we know so they can show us what is beyond. We have experienced the good, and seeing the very good has helped us to recognize the very bad.

The word pimping, as described in our commentary, was popularized in a satirical 1989 JAMA article. At that time, women comprised less than 20% of medical faculty positions and around 30% of medical student graduates. The word to describe the practice of toxic quizzing was born from a system that not only excluded people of color and non-male identified persons, but trampled on the practices of traditional woman-identified healers. The result is a training system the perpetuates the abuse of power hierarchies. A symptom of this system is the normalized culture of using words that some (and certainly not all) would describe as locker room talk, including pimping.

It is time to rethink the practice of pimping, and the elimination of the use of the word will naturally follow.

We have arrived, after centuries long-struggle, to a moment of reckoning in the face of the #MeToo movement. We are questioning not only what language we use as leaders, but also what toxic behaviors exist within society, and in places of learning. We must work to stop harms that persist, particularly in spaces where hierarchies are the foundation of systems. It is time to rethink the practice of pimping, and the elimination of the use of the word will naturally follow.

Can medicine, and particularly medical education, make this change? It can, it should, and it must to meet the evolving demands and needs of a contemporary physician workforce. We see this work, this evolution, related to the ongoing discourse on licensing exams, rethinking resident work hour limits, questioning the harms of medical honor societies, and calling out the lack of patient consent in medical training. When practice changes, the labels used to describe the practice will follow. When toxic quizzing is eliminated, the term pimping in medicine will become irrelevant, because these behaviors will cease to exist.

skynesher / Getty Images / iStock

The use of the word, and practice of pimping within medicine is not devoid of cultural and contextual meaning. Pimping occurs in a training system in which up to 50% of women medical students experience gender harassment from faculty and staff, and a society in which 1 in 4 undergraduate women are sexually assaulted by the time they graduate. For now, the use of the term pimping serves as a label for a behavior that is culturally ingrained within the medical education system. In addition to asking the medical community to stop using this degrading word, we are also calling for the end of this practice.

Support Services

In the United States, Title IX of the Education Amendments of 1972 (Title IX) and the Clery Act are federal laws that require educational programs to address and remedy any known sex and gender discrimination, including sexual assault and harassment on campus. All institutions that accept federal financial support are required to stop discrimination, prevent the recurrence of the behavior and mitigate its effects. Contact the Title IX Coordinator at your institution for more information about your rights and resources.

Some institutions have non-reporting, private resources on campus, such as privileged or confidential advocate programs (resources will vary by institution and state). If you need help navigating issues related to sexual assault or harassment, the National Sexual Assault Telephone Hotline is a free, 24/7 resource: 1-800-656-HOPE (4673).

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Why Pimping, the Practice, and the WordShould Be Eradicated from Medicine - BMC Series blog - BMC Blogs Network

Research News

The UB Biorepository has the capacity to collect, process, store and distribute millions of biological specimens that are maintained at a constant -81 degrees Celsius. Photo: Douglas Levere

By ELLEN GOLDBAUM

Published October 11, 2019

UB has officially launched the UB Biorepository, a critical new facility in the Clinical and Translational Research Center that will be a powerful resource regionally and throughout the state in driving biomedical innovation in academia and industry.

From molecular profiling of samples to integration with clinical data about patients, the facility has the capacity to collect, process, store and distribute millions of biological specimens that will allow UB and its research and industry partners to harness the discoveries that ultimately benefit patients. The UB Biorepository strengthens the ability of researchers in academia and industry to advance precision medicine by developing new drugs and diagnostic tools targeted to specific disorders and even individual patients.

The biorepository is important to UB for many reasons: to foster broad academic and industry collaboration, to create a valuable resource not just for UB researchers, but for partners at institutions across New York State, and to make UB pre-competitive for significant federal funding opportunities, says Venu Govindaraju, vice president for research and economic development.

Adds Michael E. Cain, vice president for health sciences and dean of the Jacobs School of Medicine and Biomedical Sciences at UB: The extensive use of biological materials is absolutely critical today in the fields of biomedical science, precision medicine and clinical science. The biorepository is already playing a significant role in increasing UBs research enterprise and serving as a hub for collaboration.

The UB Biorepository program is designed to advance discovery and innovation in health care.

Part of BIG

Funded by UB and New York State, the UB Biorepository is a critical part of the Buffalo Institute for Genomics and Data Analytics (BIG), which connects life sciences companies to technical expertise and high-tech facilities at UB. BIG is supported by Gov. Andrew M. Cuomos economic development efforts in Buffalo, and is one of the key initiatives helping to build the regions innovation economy by leveraging its life sciences assets to drive economic growth.

According to Andrew Brooks, chief operating officer and director of technology development at RUCDR Infinite Biologics at Rutgers University and a consultant to the UB Biorepository, a centralized biorepository is an essential ingredient today in advancing biomedical research and collaborations.

While in the past the emphasis was on the safe storage and preservation of biospecimens, the explosion of big data in biomedicine has created major new opportunities for innovation based on the far more detailed information now available about each biospeciman. The UB Biorepository provides comprehensive annotation of biospecimens, through which the functions and locations of genes and coding regions in a genome are identified, as well as big data integration.

Rich resource

With each individual sample potentially providing as many as hundreds of thousands of annotations, or datapoints, whether youre studying the genome, the proteome or the the microbiome, the biospecimens in the biorepository are an incredibly rich resource, says John E. Tomaszewski, SUNY Distinguished Professor and the Peter A. Nickerson Chair of Pathology and Anatomical Sciences in the Jacobs School.

While the facility operates 24/7 with multiple backup systems, maintaining specimens at a constant minus 81 degrees Celsius and conducting blood fractionation (separating out specific components) and pathology services, as well as nucleic acid extraction, the staff at the biorepository and those who use it are keenly aware that patients are at the center of everything they do.

Every biospecimen represents a patient, says Norma J. Nowak, executive director of UBs New York State Center of Excellence in Bioinformatics and Life Sciences, and faculty leader with Tomaszewski of the biorepository. Nowak, whose research directly contributed to the mapping of the human genome, has seen precision medicine evolve over the decades.

As part of the human genome program, there was a perception that once we sequenced that first genome, we would have the answers to solving human disease, she says. Now we know that individuals genomes are different and that those differences, at the molecular level, result in how individuals respond to therapeutics and which diseases they may be at risk for.

She describes the UB Biorepository as comprehensive and disease agnostic, meaning that it will cover every kind of disease; it also includes biospecimens that are part of population health studies and may not be associated with any disease at the time of collection, which will contribute meaningful information about exposures and epidemiological or environmental health questions.

Targeting diseases in Western New York

In particular, Nowak explains, having a biorepository in Western New York allows local researchers in both academia and industry to target diseases that have a high incidence in Western New York, such as multiple sclerosis (MS). For example, she notes that biospecimens gathered by Bianca Weinstock-Guttman, professor of neurology in the Jacobs School and a physician with UBMD Neurology, are housed in the biorepository and will help researchers address fundamental questions about who is at risk for MS and why.

Nowak adds that the biorepository will become an especially valuable resource since it will eventually reflect the ethnic and international diversity of Buffalo and Western New York. The biorepository will capture that diversity, she says.

And companies are taking notice. Circuit Clinical, which partners with BIG, develops software products that are driving enrollment in clinical trials. It was among the first to take advantage of the UB Biorepository.

The UB Biorepository is a key asset in positioning UB and Western New York at the heart of precision medicine research opportunities both academic and commercial in the years ahead, says Irfan Khan, founder and CEO of Circuit Clinical. This facility will enable biomedical companies to enlist UB and Circuit with strong confidence that any biostorage needs for their clinical projects are well within UBs state-of-the-art capabilities.

The UB Biorepository program is obtaining College of American Pathologist accreditation, and it implements Good Laboratory Practice and is Good Clinical Practice certified. It manages biosamples suitable for use in any downstream applications with academic, pharmaceutical and biotechnology partners.

More information about the UB Biorepository is available online.

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UB's biorepository brings power of precision medicine to Western New York - UB Now: News and views for UB faculty and staff - University at Buffalo...

Three scientists were awarded the Nobel Prize in Physiology of Medicine for their discovery of the mechanism of how cells regulate oxygen: William G. Kaelin, MD, an oncologist who is the professor of medicine at Harvard Medical School and the Dana-Farber Cancer Institute; Gregg Semenza, MD, PHD, a scientist at Johns Hopkins; and Peter Ratcliffe, FRS, FMedSci, of the Francis Crick Institute in London.

The key breakthroughs were made through an oncological look into a rare hereditary cancer type, according to the Nobel Assembly at Karolinska Institute.

The Nobel Committee cited that Semenza and Ratcliffe were focused on the rise of the levels of the hormone erythropoietin (EPO) in response to hypoxia (low oxygen levels) in the 1990s. Both Semenza and Ratcliffe were studying the genes controlling EPO in mice and thereby elucidating the hypoxia-inducible factor, or HIF.

Kaelin, a cancer researcher, was instead studying an inherited syndrome called von Hippel-Lindaus disease, or VHL. Its a rare inherited affliction which dramatically increases the likelihood of some tumors. The mutated gene in VHL was eventually shown by Kaelin to show that it controlled the response to hypoxia and was thus integral in HIF.Kaelinshowed that one form of the protein, HIF-2, is critical in the development of some kidney cancers, and how HIF-1 is hijacked by triple-negative breast cancers, according to a statement by the Dana-Farber Cancer Institute.

The consequent identification of proline hydroxylases of the 3 scientists working independently of one another fully determined how oxygen uptake is regulated, the Nobel officials explained.

Through the combined work of these 3 laureates it was thus demonstrated that the response by gene expression to changes in oxygen is directly coupled to oxygen levels in the animal cell, allowing immediate cellular responses to occur to oxygenation through the action of the HIF transcription factor, the Nobel Committee stated.

The 3 scientists were named winners of the Lasker Award for Medical Science in 2016.

The impact to cancer includes possible inhibitors to the HIF pathway including one found by Kaelin and his colleagues to block the EPAS1 function, thereby slowing tumor growth, as per a 2016 study published inNature.

Kaelin said in a phone interview with a Nobel interviewer that some of the key breakthroughs were made because they were trying to understand the entire oxygen pathway.

The clinical features of patients who had mutations in the VHL gene were a curious constellation of findings but one way to unify them was that there was some abnormality in the way the tumors they were developing were sending and responding to oxygen, Kaelin recalled. We thought if we could understand that, we could understand more globally how cells and tissues sense and respond to changes in oxygen.

I, like my co-awardees, Im trained as a physician, he added, in the early-morning call. We understood very well the important of oxygen in so many human disease Now that we understand the pathway we have opportunities for pharmacological intervention in diseases such as cancer.

The work was made possible, Kaelin added, because the scientists were trying at first to just understand the biology and they were not focused solely on clinical applicability.

There are no shortcuts, as far as Im concerned, the oncologist said.

Originally posted here:

Nobel Prize in Medicine Awarded to Three For Oxygen Regulation Linked to Cancers - Cancer Network

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There has been a lot of hype about the digital transformation of healthcare. Some commentators are beginning to say the field is growing too fast and others say it has already peaked. Sure, there have been many promises but now the initial exuberance is being tempered as people focused on responsible progress and real payment models come into the picture, setting the stage to help address healthcares many problems.

The good news is that industry leaders are working slow and sure to build the field of digital medicine. The goal is to harness the power of technology to transform healthcare and secure the business model. Groups such as the Digital Medicine Society (DiMe) and Digital Therapeutics Alliance (DTA) are helping ensures this new field is evidence-based with effective and safe treatments. The DiMe scientific advisory board had its first meeting a couple of weeks ago (I am a board member) and committed to develop ethically sound Good Digital Practice types of guidelines.

Industry meetings are now focused on reimbursement and partnerships, not just cool shiny digital apps. The Digital Therapeutics (DTx) East conference was held on the Harvard Medical School campus. Attendance nearly doubled since the previous year and focus was on reimbursement, IPOs, partnerships and payors. The conference theme was integration of digital therapies into the healthcare system, which is code of course, for How are we going to pay for this stuff? Earlier themes centered on promoting science and excitement grew around positive clinical studies, which caught the attention of venture investors. But the field needed to mature and show that early speculators can get returns on their invested capital.

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Venture investors are beginning to see returns from public markets. Over $34 Billion in private funding has gone into digital applications in healthcare in the last decade, peaking with $9.5 Billion last year. This summer we saw a handful of high-value initial public offerings (IPOs), which means that financing risk is being transferred from venture insiders to public markets, who usually demand profits and have a low tolerance for promises. With Livongo, CatalystHealth and several others, there is a portfolio of publicly traded digital health companies that are collectively worth around $20 Billion. Some of these companies are experiencing over 2X annual revenue growth, which suggests payers are also voting with their pocketbooks. Public investor money helps validate the digital healthcare business model.

Conditions are ripe for a digital medicine inflection point. We all know that healthcare in America is extremely inefficient and provides poor accessibility. There are hundreds of millions who suffer from multiple chronic conditions or behavioral health issues including substance abuse. The sheer volume of need overwhelms the few thousand healthcare professionals who serve such populations. The average doctor visit is just 12 minutes and most people see their physicians only 2-3 times per year.Digital disease management such as Voluntis diabetes and oncology platforms make a difference because they leverage doctors and nurses time. The key to success is patient engagement that also improves adherence. For example, Proteus Digital Health has demonstrated success in difficult hypertension patients that were considered refractory to regular drug therapy.

Good digital practice guidelines will establish the trust that patients and doctors need to embrace technology-based solutions. The DiMe scientific advisory board has membership from the National Institutes of Health (NIH), Food and Drug Administration (FDA) as well as some of the pioneers who developed early digital healthcare platforms. It takes a village for a new field to responsibly develop and professional societies are helping take on the challenge to create recommendations and a virtual library of evidence-based health information. DiMe has hundreds of members from across industry, academia and 24 different countries. They are working collaboratively to establish good digital practice guidelines to help set the standards for this new industry.

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The FDA is creating a regulatory atmosphere to help promote advances. Even government regulators are helping. Recently the FDA issued a statement on new steps to advance digital health policies that encourage innovation and enable efficient and modern regulatory oversight. This includes a draft of practices for artificial intelligence (AI) and machine learning (ML) based software as a medical device.

It is exciting to witness the birth of a promising new industry. As digital medicine matures we should have reason to believe that sometimes good things can develop when different groups collaborate to help sort out the mess that is healthcare.

Read more:

Digital Medicine Movement Is Growing Up And Thats A Good Thing - Forbes

Charles Martin II, Guest Columnist Published 5:00 a.m. CT Oct. 10, 2019

I want to change this unjust and immoral law that prohibits people from choosing an all-natural,God-given plantto treat their illnesses and alleviate their suffering.

I agree with our good Governor that prayer and fasting are wonderful means of grace and powerful tools for one's spiritual discipline. I believe in the power of prayer. I also believe in science and feel that we get God's best for people when we take advantage of both prayer and science.

I have been a pastor here in Tennessee for 30 years and I have witnessed my share of pain and suffering in people's lives during that time. I am also a medical cannabis advocate and believe wholeheartedly in the medicinal properties of this God-given plant. The problem is cannabis is illegal at the Federal level as well as here in Tennessee and this presents a moral dilemma for me as a Pastor. Let me explain.

Lawsprovide for us the opportunityto live in peace and harmony with our neighbors. However, laws that oppress or infringe on the natural human rightsand freedomsof people are unjust laws. "How does one determine whether a law is just or unjust? A just law is a man made code that squares with the moral law or the law of God. An unjust law is a human law that is not rooted in eternal law and natural law." - Dr. Martin Luther King, Jr.

This difference betweenjust andunjust laws brings me to the heart of my dilemma: How can I as a law-abidingcitizen-a member of the Clergy in covenant with God to care for all God's people-obey an immoral law? Specifically, how can Isupport a law that is clearly not rooted in natural law- a law that demands that I stand idly by and watch a human beingsuffer in pain when I have the mental faculties, physicalaccess and themeans to help alleviate human suffering.

(Photo: Getty Images)

I do not wish to break the law. I want to change this unjust and immoral law that prohibits people from choosing an all-natural,God-given plantto treat their illnesses and alleviate their suffering. To incarcerate and make an otherwise law-abiding citizen into a criminal for choosing to usecannabis as medicine to alleviate their suffering is absolutely unconscionable to me.

Why iscannabis socontroversial?I have tobe honest here, for the better part of my life I believedmuch of the stigma, stereotypes and propaganda associated with cannabis.

Hear more Tennessee Voices: Get the weekly opinion newsletter for insightful and thought provoking columns.

As a Southern, Bible-belt-raised-boy the use of cannabis, or as we called it, "dope," was a symbol of rebellion and asign of laziness. Why didI believe such things?It was theculture of my community.

This ideologywas passed on to meby the people with whom I lived and loved.We valued family, community, country, and hard work.We wereno fans of Communists, draft-dodgers, long hair, or the hippie counterculture- and marijuana was a symbol of all of those things. During the 60s, 70s, and 80sall of the politicians, preachers and news media were saying the same thing: "Hippies smoke dope. Hippies are Communists. Communists are bad. Dope is bad."

Tennesseans need a solid medical cannabis program for the sick and suffering, and I have read that Governor Lee does not support medical cannabis. On this day of prayer and fasting, I will be praying for God to soften Governor Lee's heart and open his eyes to the truth: Cannabis is medicine.

With love and justice,

Reverend Charles Martin II is pastor of Erin United Methodist Church in Erin, Tennessee.

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My prayer is that Tennessee will embrace cannabis as a medicine for the sick | Opinion - Tennessean

ATLANTA - Cobb County prosecutors say an unlicensed doctor who performed cosmetic procedures on women is on trial for racketeering and the unlawful practice of medicine.

He is a man our FOX 5 I-Team knows well. It was more than ten years ago that our I-Team first reported on the legal problems of then Dr. Nathaniel Johnson.

Johnson pleaded guilty to Medicaid fraud and lost his license to practice medicine. Cobb prosecutors say after serving time Johnson began practicing medicine again.

Senior I-Team reporter Dale Russell was in court as the case unfolded.

I saw all those awards on the wall, I'm thinking I found the doctor of my dreams, testified patient Monique Broscious.

The man Monique Broscious consulted with, prayed with, and she says performed a cosmetic procedure on her was not a licensed doctor.

"I'm thinking I found the doctor of my dreams."

He told me he had been doing this for years, pointed out other things that he could do to my body to make it body. So, I didn't have a reason not to think he wasn't a doctor, testified Broscious.

It is not the first time the I-Team has reported on Nathaniel Johnson's troubles in a courtroom.

Eleven years ago, the FOX 5 I-Team investigation found Dr. Johnson allowed this man, Jeff Romeus, to pose as a licensed doctor in Dr. Johnson's gynecology practice. Romeus was a Guyana medical school graduate, but not a licensed doctor.

Following our report, the state prosecuted Dr. Johnson and he pled guilty to Medicaid fraud, conspiracy to defraud the state, and aiding the unlicensed practice of medicine in 2014. He was ordered to repay taxpayers $300,000 in restitution and surrender his medical license.

Johnson served six months behind bars and was out on probation, running his Hello Beautiful Cosmetic Surgery center in Smyrna when Monique Broscious found him in 2016. And so did Cobb County Police

Johnson and two employees are now in court facing 90 counts of theft by deception, racketeering, and the unlawful practice of medicine.

His conceit was he thought the rules didn't apply to him, said prosecutor Jason Marbutt in court.

In his opening statement, prosecutor Jason Marbutt told the jury that Johnson opened a cosmetic surgery clinic and performed procedures on patients. Marbutt argued Shannon Williams posed as a nurse, and she and Dr. Peter Ulbrich worked side by side with Johnson knowing Johnson was no longer a licensed doctor.

This is a criminal case. The proceedings shouldn't have happened at all, said Marbutt.

This case is about the road to redemption, countered Johnsons attorney Dwight Thomas.

Thomas told the jury everything Johnson did was appropriate and permissible and that Johnson was just an office administrator.

But, Monique Broscious testified Johnson was in the operating room during her procedure.

Dr. Johnson was on one side; Dr. Ulrich was on the other side, testified Broscious.

Under cross-examination, Thomas got her to admit she signed paperwork before that procedure saying Dr. Peter Ulbrich would be her physician.

Still, she dug in her heels and insisted Nathaniel Johnson lied to her about being a doctor.

Every day I remember exactly what happened to me. Every day I remember exactly who I spoke to, how they introduced themselves and who took my money. Every day, testified Broscious.

Prosecutor Jason Marbutt told the jury there are 45 victims in the case, but not all of them will testify. The trial is expected to last into next week.

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Nathaniel Johnson on trial for theft, racketeering, and practicing medicine without a license - FOX 5 Atlanta

We often talk about genetics as if its set in stone. She just has good genes or He was born with it are common phrases.

However, over the past decade, biochemists and geneticists have discovered that your genetic expression changes over time. Based on environmental factors, certain genes may be strongly expressive while others are dormant.

In fact, a 2016 study of human longevity found that only 25% of health outcomes are attributable to genetics. The other 75% of outcomes are attributable to environmental factors. Among those environmental factors, diet and nutrition play a major role.

An entire branch of scientific research has now exploded around nutrigenomics, the study of the interaction between nutrition and genetics. Scientists now understand that genes set the baseline for how your body can function, but nutrition modifies the extent to which each gene is expressed.

As more data comes in about the types and quality of food that improve health outcomes, high-tech farmers are also entering the nutrigenomics conversation. Using precision agriculture, they hope to produce food thats targeted to deliver a nutrient-rich, genetically beneficial diet.

Implications Of Nutrigenomics

Researchers have found that theres no such thing as a perfect diet. Dietary recommendations are not one-size-fits-all. Each individual needs different nutritional choices for optimal health and gene expression. In addition, each person is different in the extent to which their genes and health are impacted by their diet.

Geneticists and nutritionists are working together to study the dietary levers that most impact genetic expression. If theyre successful, it may be possible to prevent and treat disease through individualized nutrition tailored to your genetic profile. Indeed, you may walk into a doctors office and leave with a dietary prescription customized to your DNA.

In the near future, instead of diagnosing and treating diseases caused by genome or epigenome damage, health care practitioners may be trained to diagnose and nutritionally prevent or even reverse genomic damage and aberrant gene expression, reports Michael Fenech, a research scientist at CSIRO Genome Health and Nutrigenomics Laboratory.

The initial results of nutrigenomics studies are promising. A healthy, personalized diet has the potential to prevent, mitigate, or even cure certain chronic diseases. Nutrigenomics has shown promise in preventing obesity, cancer and diabetes.

If Food Is Medicine, Food Quality Matters

Nutrient abundance or deficiency is the driving factor behind nutrigenomics. Foods that have grown in poor conditions have a lower nutritional density. In turn, eating low-quality foods can have a significant impact on human gene expression. In order to take advantage of the findings of nutrigenomics, consumers need access to high-quality, nutrient-dense foods.

Similar to human health, plant health is impacted by the combination of genes and nutrient intake. Healthy soil, correctly applied fertilization techniques, and other forms of environmental management lead to healthy crops.

However, applying these custom growing techniques at a large scale is a major challenge. Agriculture technology (AgTech) will play a big role in allowing farmers to precisely manage the growing conditions and nutrient delivery for their crops. In turn, this precision farming will make crops more nutritious and targeted for nutrigenomics-driven diets.

Making Food Thats Better For Us

Plant health relies on nutrient uptake from the soil. In order to ensure plants receive the nutrients they need, farmers need to precisely apply additives where theyre needed. With in-ground sensors, advanced mapping of crop quality across a field, and other technologies, farmers can target their applications of water and nutrients to match plant needs. The days of broadly applying generic fertilizer to entire fields are coming to an end.

Farmers play an integral role in providing access to diverse, nutritious food, explains Remi Schmaltz, CEO of Decisive Farming. Nutrient deficiency in plants and the soil can contribute to the deficiencies found in humans. The opportunity exists to address these deficiencies through precision nutrition delivered by the agriculture sector.

Additionally, CRISPR and other technologies allow us to experiment with the genetic makeup of plants, increasing nutrition and flavor, both pluses for consumers. In recent years, genetic modification has produced disease-resistant bananas, more flavorful tomatoes, lower gluten wheat, non-browning mushrooms and sustainable rice. While there has been a lot of skepticism over genetically-modified crops, multiple studies have shown that GMOs are safe for consumption and can even improve plant health and nutrition.

Using Biochemistry And Big Data To Create Better Food And Healthier People

Nutrigenomics will completely change how we think about health and disease prevention. Indeed, personalized diet recommendations that are tailored to your genes could be a new form of medicine for chronic illnesses.

Nevertheless, a key part of making nutrigenomics effective is having access to high-quality, nutrient-dense foods. AgTech is using the internet of things, AI, precision farming and gene editing to make nutrient-dense food more readily available. The benefits to public health from these efforts could change the way we think about medicine, longevity and what it means to be healthy.

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Food As Medicine: What Biochemistry And Genetics Are Teaching Us About How To Eat Right - Forbes

There is still quite a lot of chatter about cloud these days and it doesn't seem to be showing any signs of slowing down or getting less complex

"Whats your multi-cloud strategy?"

How about hybrid cloud? Whats your plan?

How about your on-premise hybrid multi-layer hyper-converged cloud?

The variations are dizzying. So weve decided to keep our move to cloud technology a little simpler to start. While were finding our way slowly but steadily with targeted projects, we are learning what works well and how best to get there through these experiences.

This approach takes planning at a strategic level in determining clouds place in the overall technology portfolio as well as orchestrating among multiple technical teams in pursuing targeted initiatives. Significant time is also needed to implement and assess results and progress made.

We began with moving email to the cloud not an earth-shattering endeavor but its a start, and email maintains a significant production workload. There is a mounting track record for email migrations to cloud and at this point its most likely considered low hanging fruit for most organizations.

Currently were also in the midst of moving our analytics platforms to cloud. Thats a little more complex than email. So were migrating in phases and iterating as we go along. A few positives weve experienced so far in migrating to cloud:

That said, we are still determining the long-term cost of moving all of our analytics workloads to cloud. We just dont know enough yet to have that answer. I hear a fair amount of negative comments about the cost of cloud and how its more expensive than on-premise.

But I havent really seen any long term side-by-side comparisons to validate those remarks and wonder if thats really true or just the experience of some that havent properly managed their cloud infrastructure and usage. Heck, your cable bill is a great example of how an unmanaged service can get out of control.

Were modeling our experiences each time we move a workload and use that knowledge to develop a profile that helps us plan for the next opportunity. We are also now facing the tough work of developing migration plans for all of our existing analytics infrastructure. This is not a trivial task for sure and well learn along the way.

My advice for anyone that seems to be in a fog about the cloud is to keep in mind that its really not a new whiz-bang just-invented technology. At its core, it is an updated version of traditional economy of scale CPU and storage sharing thats been around for decades, with a variety of new bells and whistles for sure.

Proper planning, oversight and management go a long way - just like these elements have always been the key underpinnings of successful technology pilot, rollout and maintenance.

My ultimate recommendation is to use these cornerstone approaches for cloud migration just the way you would any other technology project. And lastly, dont bite off more than you can chew. This will help you avoid the pitfalls that have always been in play with Information Technology.

Excerpt from:

Penn Medicine's experience moving to cloud: Don't bite off more than you can chew - Healthcare IT News

The first Adaptive Design Workshop for Preclinical, Clinical Veterinary, and Translational Human Studies at Colorado State Universitys brand-new Translational Medicine Institute (TMI) is set for Friday, Nov. 8.

Adaptive designs have been used by major pharmaceutical and device companies to improve the efficiency and ethical balance of randomized clinical trials.

Dr. Heather Pidcoke, the CSUs first chief medical research officer and associate director of research at the TMI met up with us to discuss adaptive clinical design and give some insight into everything that it entails.

Adaptive clinical design is essentially designing a clinical trial in a way that allows continual modifications to major pieces and components of the trials as data is collected.

These changes do not undermine the validity or the integrity of the trials, but rather help create a positive allocation of resources and speed up the potential for scientific findings.

Heather Pidcoke: Some of the biggest advantages are shorter trial times, improved likelihood of scientifically relevant trial outcomes, reduced use of resources, and limited allocation of inferior trials.

With adaptive design, the waste of money, time, and materials is minimized through the constant changing and rearranging of the trial. When a hypothesis seems to be ineffective, researchers have the flexibility to restructure the trial to different dosage amounts or different populations instead of being stuck in an inconclusive trial.

HP: Sample size, dosage, termination of inferior treatments, lengthening and/or shortening of trial times, and the creation of more focused populations are some of the most common trial modifications in adaptive design.

Modifications like these help investigators manage the scope of their research as the results of the trials begin to be uncovered.

HP: Yes, The US Food and Drug Administration and European Medicines Agency have both released extensive resources and guidelines that properly explain the adaptive design process. It is necessary to read through these documents before engaging in any sort of adaptive design trials.

HP: It is very important to have a sound plan for your trial before it has begun. Unplanned modifications can weaken the validity of the study and may not allow for the study to support the application of a future product.

Be prepared and have a variety of scenarios planned out to make sure that your research is valid and that your actions are in accordance with the USDA and EMA guidelines.

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CSU to host first Adaptive Design Workshop at newly constructed Translational Medicine Institute - Source

Highpoint Health is excited to have a full-time presence in Switzerland County.

(Vevay, Ind.) - Highpoint Health Physical Therapy & Sports Medicine is now open in Vevay. Located at 1035 W. Main Street, Suite 2, the facility offers a comprehensive array of preventive and rehabilitative services for all ages and activity levels including children, high-level athletes and geriatric patients.

Individuals are seen for back, neck, shoulder, hip, knee and ankle pain, as well as for repetitive stress injuries, arthritis, work conditioning, post-operative joint replacements, post-operative orthopedic injuries, sports related injuries, balance disorders, fall prevention, industrial rehabilitation, neurological rehabilitation, wound care, lymphedema management and dysfunction of the upper and lower extremities.

The new facility also offers gait analysis, ultrasound, electrical stimulation, neuromuscular, re-education, traction, biofeedback, aerobic training, plyometrics, hands-on manual therapy, compression garment fitting, work conditioning, balance training, neuro-developmental treatment (NDT), Graston soft tissue mobilization, proprioceptive neuromuscular facilitation (PNF), functional assistance, dry needling, and strength training exercises to ensure that patients receive the most appropriate form of care for their injury or condition.

Our physical therapy and sports medicine team is excited about having a full time presence in Switzerland County, noted Ed Brush, MSPT/ATC, Director of Highpoint Health Rehabilitation Services. While our office in Vevay is new, our staff has long cared for patients in the area through our work with Switzerland County High School and Highpoint Health Home Health & Hospice. With our new facility, we are looking forward to welcoming patients from throughout the region including those from Ohio, Jefferson, Ripley, Gallatin and Carroll Counties.

Hours for the new Vevay facility are Mondays, Wednesdays and Fridays from 8:00 a.m. to 6:30 p.m., and Tuesdays and Thursdays from 8:00 a.m. to 1:00 p.m. To learn more about Highpoint Health Physical Therapy & Sports Medicine - Vevay, or to schedule an appointment, please call 812/427-0293. A public open house is planned for later this year.

Read more:

Highpoint Health Opens New Therapy, Sports Medicine Location In Vevay - Eagle 99.3 FM WSCH

On August 11, Jheison Giraldo 21, a third-year student in the Renaissance School of Medicine, delivered the student address to incoming students at the School of Medicines White Coat Ceremony. Giraldo, who immigrated to the United States from Colombia and is the first member of his family to graduate from college, spoke about his experience at Stony Brook and his advice for the Class of 2023.

What a privilege it is giving the student address today. It was exactly two years ago when I sat somewhere over there. I was so nervous that day that I barely remembered anything at all. Only a couple of things really stood out to me.

I remember being way too worried about tripping on my way up to the stage and aiming my arms correctly so that when they put on my white coat it would go on smoothly. You know, you have to look good up here.

Then, I remember taking steps across this stage, and when i turned to put on my white coat I heard my family cheer. I completely forgot about my arms and looked at my mom and brother.

I walked over to pick my new stethoscope, and I turned around and looked back, because right behind me was my wife.

I remember when we stood on this stage together, our families cheering THAT moment became one of my most cherished memories. I realized that this would be the beginning of an adventure for both of us, and what an adventure it has been.

I have watched a lot of movies and read a lot of books where the main character goes on an adventure, and they get one special item. Today, you start your adventure and you get one very special item. Its the white coat.

I dont know if they told you, but the white coat youre receiving has got magic. It will allow you to sleep the least amount youve ever slept before. Your focus will become 10 times as sharp. Your brain will be able to absorb more information than you have ever been able to hold, and your fingers will type as fast as the Flash when you are writing notes.

I am obviously joking, but the white coat gives you superpowers. It opens doors for research opportunities, and community outreach programs that would be impossible to get while you were pre-med. People actually listen to medical students.

The biggest power it has is with patients. Ive had patients tell me things they have never told their closest family members.

One patient told me about their suicide attempts. At the end of the conversation, they told me I was the first person they ever told that to.

Just last week, I saw a patient be strong for his family. He told them that he was going to be okay, and he was confident. Then, the family left and he broke down in tears. He told me about all of his fears; he told me he was afraid to die.

For some reason, the patients know that you will listen. They know that you are there to help them, that you will behave in a way that benefits them and upholds their values, and most importantly, that you are trustworthy. That is a superpower.

This is something that has been built by the people who have come before you. They have built an image of empathy, compassion, professionalism and altruism.

These are just a few of the qualities that make a good physician. When you put on that white coat, that is what it represents. It is important to think about that, when you are in the library, in the classroom, and in the hospital. You represent those who have come before you.

The power that Ive been talking about is in every thread of your white coat. Every physician adds another thread, and whether positive or negative, they shape the way that patients and communities see us.

It is a power that we all build together. In four years time, you will also add your thread to the white coat.

Now, I know it seems like a lot of responsibility and this is your first week but the next four years will prepare you for the future.

When those patients shared those things with me, all I could think was, Im just a medical student; why are you telling me these things? even though I knew I was prepared to handle those situations.

In all honesty, I have to say that we all have a little of that impostor syndrome, that feeling that we are not good enough or that we dont belong. You may think at some point after a hard week that someone made a mistake, they sent the acceptance to the wrong person. I joke with my wife about this. I say to her, Hey, they havent caught on to us yet. Even standing here today, Im asking, Why me?

My first thought is that I always say, Yes, so they knew I would show up. My second is that I can give you some perspective about success.

Im the first person in my family to graduate college. Im a Colombian immigrant that came from a family of farmers, raised by my mother who is a house cleaner and a brother who, instead of pursuing school himself, helped me in every way that he could.

I know firsthand how many barriers there are just to graduate college. I was one of the Student National Medical Association presidents. My knowledge of these barriers allowed me to teach those in our community who might face these same barriers how to overcome them.

I was part of a group of very committed medical students and faculty who brought hundreds of underserved students to this medical school, all in hopes that we can inspire them and help them get over these barriers.

Last year was the first year that one of our very own HOPE program graduates matriculated to medical school, and guess where they went? Thats right: they came here to the Renaissance School of Medicine.

I could go on about me, but my point is not to pay attention to what I have achieved but to pay attention to my first reaction. After I received this prestigious honor, I thought, Am I good enough? Despite all my success, its the question that I asked myself before every major achievement that I have had.

In this field, there will always be those moments of doubt. You will feel that you dont belong, or that you may not be good enough to reach your goals. Im here to tell you that its all a lie.

Hopefully, my perspective will help you in those moments of doubt, because if I can do this, so can you!

Fear of failure is what keeps us from achieving our highest potential, and this room is filled with potential. So, as you start your adventure/career, I have some pearls of wisdom that will help you along the way. Its seven things that have really helped me get through these last couple of years.

Now, I want you all to open your eyes and look around, see all these new faces around you.

These are the people who will be with you for the next four years. Its here in medical school that you will form lifelong bonds and friendships.

I want you to look at the faculty and alumni who are here to guide and support you as you grow into physicians, and I want you to look back at all of your family and friends who have helped you get you where you are today. This is the exercise that always helps me, because I know that I am not alone.

You have hundreds of people that you can rely on. We are a big family here, and its my pleasure to officially welcome you all to the Renaissance School of Medicine family.

Congratulations, Class of 2023.

Go here to see the original:

Renaissance School of Medicine Student on the Magic of the White Coat - Stony Brook News

McMaster University, Hamilton, Ontario, Canada (D.Z., J.B., K.C., K.M., B.S., Y.L., G.H.G.)

Dalhousie University, Halifax, Nova Scotia, Canada (B.C.J.)

Jagiellonian University Medical College, Krakw, Poland (M.M.B.)

Iberoamerican Cochrane Centre Barcelona, Biomedical Research Institute San Pau (IIB Sant Pau), Barcelona, Spain (C.V., M.R., P.A.)

University of British Columbia, Vancouver, British Columbia, Canada (D.S.)

University of Toronto, Toronto, Ontario, Canada (A.A.)

Clinica Las Americas, Medellin, Colombia (A.M.Z.)

Chosun University, Gwangju, Republic of Korea (M.A.H.)

Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands (R.W.V.)

Institute of Science and Technology, Universidade Estadual Paulista, So Jos dos Campos, So Paulo, Brazil (R.E.)

Acknowledgment: The authors thank Thomasin Adams-Webber (Hospital for Sick Children) for her help designing our search strategy.

Disclosures: Dr. El Dib received a So Paulo Research Foundation (FAPESP) (2018/11205-6) scholarship and funding from the National Council for Scientific and Technological Development (CNPq) (CNPq 310953/2015-4) and the Faculty of Medicine, Dalhousie University. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at http://www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-0622.

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

Reproducible Research Statement:Study protocol: Available at PROSPERO (CRD42017074074). Statistical code and data set: Available from Dr. Johnston (e-mail, bjohnston@dal.ca).

Corresponding Author: Bradley C. Johnston, PhD, Department of Community Health and Epidemiology, Dalhousie University, Centre for Clinical Research, Room 404, 5790 University Avenue, Halifax, Nova Scotia B3H 1V7, Canada; e-mail, bjohnston@dal.ca.

Current Author Addresses: Ms. Zeraatkar, Ms. Bartoszko, nad Drs. Sadeghirad and Guyatt: Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada.

Dr. Johnston: Department of Community Health and Epidemiology, Dalhousie University, Centre for Clinical Research, Room 404, 5790 University Avenue, Halifax, Nova Scotia, B3H 1V7, Canada.

Dr. Cheung: 114 Loganberry Crescent, Toronto, Ontario M2H 3H1, Canada.

Dr. Bala: Jagiellonian University Medical College, 7 Kopernika Street, 31-034 Krakw, Poland.

Ms. Valli and Drs. Rabassa and Alonso-Coello: Iberoamerican Cochrane Centre, Instituto de Investigacin Biomdica de Sant Pau (IIB Sant Pau-CIBERESP), Carrer de Sant Antoni Maria Claret 167, Barcelona 08025, Spain.

Dr. Sit: University of British Columbia, 107-1165 West 13th Avenue, Vancouver, British Columbia V6H 1N4, Canada.

Mr. Milio: 592 Regal Place, Waterloo, Ontario N2V 2G3, Canada.

Dr. Agarwal: Department of Medicine, University of Toronto, Suite RFE 3-805, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada.

Mr. Lee: 30 White Lodge Crescent, Richmond Hill, Ontario L4C 9A1, Canada.

Ms. Zea: Clinica Las Americas, Diagonal 75B N. 2A-80/140, Medellin, Colombia.

Dr. Han: Department of Preventive Medicine, College of Medicine, Chosun University, 309 Philmun-daero, Dong-gu, Gwangju 61452, Korea.

Dr. Vernooij: Department of Research, Netherlands Comprehensive Cancer Organisation, Godebaldkwartier 419, Utrecht 3511 DT, the Netherlands.

Dr. El Dib: Institute of Science and Technology, So Jos dos Campos, Avenida Engenheiro Francisco Jos Longo, 777, Jardim So Dimas, So Paulo 12245-000, Brazil.

Author Contributions: Conception and design: D. Zeraatkar, B.C. Johnston, M.M. Bala, P. Alonso-Coello, G.H. Guyatt, R. El Dib.

Analysis and interpretation of the data: D. Zeraatkar, B.C. Johnston, M.M. Bala, M. Rabassa, D. Sit, M.A. Han, P. Alonso-Coello, G.H. Guyatt, R. El Dib.

Drafting of the article: B.C. Johnston, R. El Dib.

Critical revision of the article for important intellectual content: D. Zeraatkar, B.C. Johnston, M.M. Bala, D. Sit, B. Sadeghirad, A.M. Zea, Y. Lee, M.A. Han, R.W.M. Vernooij, P. Alonso-Coello, G.H. Guyatt, R. El Dib.

Final approval of the article: D. Zeraatkar, B.C. Johnston, J. Bartoszko, K. Cheung, M.M. Bala, C. Valli, M. Rabassa, D. Sit, K. Milio, B. Sadeghirad, A. Agarwal, A.M. Zea, Y. Lee, M.A. Han, R.W.M. Vernooij, P. Alonso-Coello, G.H. Guyatt, R. El Dib.

Provision of study materials or patients: B.C. Johnston, R. El Dib.

Administrative, technical, or logistic support: D. Zeraatkar, B.C. Johnston, R. El Dib.

Collection and assembly of data: D. Zeraatkar, B.C. Johnston, J. Bartoszko, K. Cheung, M.M. Bala, C. Valli, M. Rabassa, D. Sit, K. Milio, B. Sadeghirad, A. Agarwal, A.M. Zea, Y. Lee, M. Han, R.W.M. Vernooij, R. El Dib.

Read more:

Red Meat Intake and Cardiometabolic and Cancer Outcomes - Annals of Internal Medicine

The cast members of Married to Medicine aren't just friends; they're practically family. So when Quad Webb and Dr. Gregory Lunceford decided to get divorced last season, it naturally had an impact on the group.

But did the end of this marriage mean the end of Dr. Gregory's friendships with the group? Dr. Jackie Walters confirmed that her husband, Curtis Berry, and Dr. Heavenly Kimes' husband, Dr. Damon Kimes, still have a relationship with Dr. Gregory today during the ladies' appearance on Watch What Happens Live with Andy Cohen Sunday night (clip above).

Dr. Jackie and Dr. Heavenly also noted that they're cool with that. "It doesn't matter to me," Dr. Heavenly said.

The Married to Medicine OBGYN provided some more insight into Curtis' friendship with Dr. Gregory during an interview with The Daily Dish on Monday, September 30 in New York City, sharing that they bonded over their love of golf in the past, so they still keep in touch. "It is absolutely not difficult to have my husband be friends with Greg because we don't talk about the two," Dr. Jackie said.

Dr. Heavenly echoed that sentiment during a separate interview with The Daily Dish on Monday. "Damon and Greg actually refer patients back-and-forth, so they're friends and they have a professional relationship. So yeah, he does speak to Greg once in a while," she said. "I've never had really a relationship with any of the men, so no, it makes no difference to me. I think Damon has friends with the men, and I kind of stay separate with the women."

Mariah Huq also told The Daily Dish during an interview earlier this month that she and her husband,Dr. Aydin Huq, don't keep in touch with Dr. Gregory at all these days. "But if I see him, I would speak [to him], hug him," she said. "I have no problems with him at all."

Quad shared in September 2018that she had filed for divorce from Dr. Gregory. The Daily Dish confirmed in August that the couple's divorce is finalized.

Watch Quad open up about her divorce this season ofMarried to Medicine, below.

Preview

Was Quad Webb "Pinned to the Cross" by the Ladies During Her Divorce?

See the original post here:

Does the Married to Medicine Cast Keep in Touch with Quad Webb's Ex-Husband? - Bravo

The digital press release with multimedia content can be accessed here:

Basel, and Redmond, October 1, 2019 Novartis today announced an important step in reimagining medicine by founding the Novartis AI innovation lab and by selecting Microsoft as its strategic AI and data-science partner for this effort. The new lab aims to bolster Novartis AI capabilities from research through commercialization and help accelerate the discovery and development of transformative medicines for patients worldwide.

As part of the strategic collaboration announced, Novartis and Microsoft have committed to a multi-year research and development effort. This strategic alliance will focus on two core objectives:1) AI Empowerment. The lab will aim to bring the power of AI to the desktop of every Novartis associate. By bringing together vast amounts of Novartis datasets with Microsofts advanced AI solutions, the lab will aim to create new AI models and applications that can augment our associates capabilities to take on the next wave of challenges in medicine.2) AI Exploration. The lab will use the power of AI to tackle some of the hardest computational challenges within life sciences, starting with generative chemistry, image segmentation & analysis for smart and personalized delivery of therapies and optimization of cell and gene therapies at scale.

Microsoft and Novartis will also collaborate to develop and apply next-generation AI platforms and processes that support future programs across these two focus areas. The overall investment will include project funding, subject-matter experts, technology, and tools.

Vas Narasimhan, CEO of Novartis, said, As Novartis continues evolving into a focused medicines company powered by advanced therapy platforms and data science, alliances like this will help us deliver on our purpose to reimagine medicine to improve and extend patients lives. Pairing our deep knowledge of human biology and medicine with Microsofts leading expertise in AI could transform the way we discover and develop medicines for the world.

Microsoft CEO, Satya Nadella, added, Our strategic alliance will combine Novartis' life sciences expertise with the power of Azure and Microsoft AI. Together, we aim to address some of the biggest challenges facing the life sciences industry today and bring AI capabilities to every Novartis employee so they can unlock new insights as they work to discover new medicines and reduce patient costs.

Novartis Data & Digital Novartis is focusing itself as a leading medicines company powered by advanced therapies and data science. Going big on data and digital is a key strategic pillar that helps Novartis realize that ambition. Data science and digital technologies allow the company to reimagine how to innovate in R&D, engage with patients and customers, and increase operational efficiencies. Novartis focuses its efforts around four strategic digital priority areas:1) Scaling 12 digital lighthouse projects: Build a strong foundation and jumpstart our digital transformation2) Make Novartis digital: sharing, learning and talent acquisition3) Becoming the #1 partner in the tech ecosystem: bridge Novartis with external expertise4) Bolder moves: lead through future disruptive healthcare scenarios with large-scale partnerships

DisclaimerThis press release contains forward-looking statements within the meaning of the United States Private Securities Litigation Reform Act of 1995 that can generally be identified by words such as to transform, multiyear, commitment, to found, aims, vision, potential, can, will, plan, expect, anticipate, committed, or similar terms, or regarding the development or adoption of potentially transformational technologies and business models and the collaboration with Microsoft; or by express or implied discussions regarding potential marketing approvals, new indications or labeling for the healthcare products described in this press release, or regarding potential future revenues from collaboration with Microsoft or such products. You should not place undue reliance on these statements. Such forward-looking statements are based on our current beliefs and expectations regarding future events, and are subject to significant known and unknown risks and uncertainties. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those set forth in the forward-looking statements. There can be no guarantee that the collaboration with Microsoft will achieve any or all of its intended goals or objectives, or in any particular time frame. Neither can there be any guarantee that any healthcare products described in this press release will be submitted or approved for sale or for any additional indications or labeling in any market, or at any particular time. Nor can there be any guarantee that the collaboration with Microsoft or such products will be commercially successful in the future. In particular, our expectations regarding the collaboration with Microsoft and such products could be affected by, among other things, uncertainties involved in the development or adoption of potentially transformational technologies and business models; the uncertainties inherent in research and development of new healthcare products, including clinical trial results and additional analysis of existing clinical data; regulatory actions or delays or government regulation generally, including potential regulatory actions or delays with respect to the collaboration with Microsoft; global trends toward health care cost containment, including government, payor and general public pricing and reimbursement pressures and requirements for increased pricing transparency; our ability to obtain or maintain proprietary intellectual property protection; the particular prescribing preferences of physicians and patients; general political, economic and trade conditions; safety, quality or manufacturing issues; potential or actual data security and data privacy breaches, or disruptions of our information technology systems, and other risks and factors referred to in Novartis AGs current Form 20-F on file with the US Securities and Exchange Commission. Novartis is providing the information in this press release as of this date and does not undertake any obligation to update any forward-looking statements contained in this press release as a result of new information, future events or otherwise.

About NovartisNovartis is reimagining medicine to improve and extend peoples lives. As a leading global medicines company, we use innovative science and digital technologies to create transformative treatments in areas of great medical need. In our quest to find new medicines, we consistently rank among the worlds top companies investing in research and development. Novartis products reach more than 750 million people globally and we are finding innovative ways to expand access to our latest treatments. About 108 000 people of more than 140 nationalities work at Novartis around the world. Find out more at http://www.novartis.com.

Novartis is on Twitter. Sign up to follow @Novartis at http://twitter.com/novartisnewsFor Novartis multimedia content, please visit http://www.novartis.com/news/media-libraryFor questions about the site or required registration, please contact media.relations@novartis.com

About MicrosoftMicrosoft (Nasdaq MSFT @microsoft) enables digital transformation for the era of an intelligent cloud and an intelligent edge. Its mission is to empower every person and every organization on the planet to achieve more.

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Novartis Media RelationsE-mail: media.relations@novartis.com

Novartis Investor RelationsCentral investor relations line: +41 61 324 7944E-mail: investor.relations@novartis.com

See more here:

Novartis and Microsoft announce collaboration to transform medicine with artificial intelligence - GlobeNewswire

Ms. Caudill and I then went to a conference room to discuss music therapy with my husband, Don, and our friend Alexandra, who has engaged in music ministry. Music must be an especially effective form of therapy, Don supposed, because it directly expresses and creates emotions. Alexandra agreed. Singing in a choir for and with people impaired by dementia, she has witnessed elderly men and women who could not remember their own names recalling verbatim the words of beloved hymns.

Music lights up neurons between the right and left hemispheres of the brain, Ms. Caudill said. It can also aid in neuroplasticity, helping the brain form new connections. A stress reliever, music is used to recover speech, improve walking and assist in the retrieval of memories. Popular and classical melodies can be infinitely modified to meet various backgrounds and tastes.

[Read more about the use of music for mental health.]

Sometimes depressed patients are encouraged to compose new lyrics to a favorite song that can then convey their reactions to their condition. Ms. Caudill recorded a lymphoma patient singing her version of Shawn Mendess In My Blood and upon discharge gave her an MP3 of her new anthem: Sometimes I feel I should give up, but I cant. It isnt in my blood.

Others strum the reverie harp with Ms. Caudill or hum while she accompanies on guitar. She has drummed with relatives awaiting a family members medical decisions. One man asked for help choosing music for his own memorial; Ms. Caudill calls this legacy work and adds that it also involves facilitating life review, reminiscing and aiding in the clarification of values and beliefs through discussions of song lyrics.

In Oliver Sackss Musicophilia: Tales of Music and the Brain, the renowned neurologist drew on the enormous and rapidly growing body of work on the neural underpinnings of musical perception and imagery that started to evolve in the 1980s. It seeks to explain why those with brain injuries, epilepsy, Alzheimers, Parkinsons, autism and strokes may respond powerfully and specifically to music (and, sometimes, to little else). With these misfortunes, as with cancer, rhythms and harmonies can deliver Proustian mnemonics, giving patients access to lost words and worlds. Or they can simply provide the solace of auditory pleasure when few other delights can be experienced or recalled.

Professionals like Ms. Caudill meet the spiritual, psychological or aesthetic needs of the afflicted by producing sounds testifying to the fact that beauty continues to exist in the world. Witnessing people in circumstances that have conspired to warp their sensory faculties and to reduce them to passivity, music therapists offer patients perhaps the only activity conceivable that of listening as a pathway to becoming sensate and thus incontestably attuned to the animating realization of still being alive and responsive.

Music has worked for me as a fail-safe sedative. During a fraught 17-day stay in the hospital because of post-surgical infections 10 years ago, Beethovens Cavatina furnished the only moments during which I was released from suffering. Don had brought me the CD, along with a portable disk player.

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When Music Is the Best Medicine - The New York Times