Cook Islands ratings affirmed at 'B+/B'

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Standard & Poor's Ratings Services affirmed its 'B+/B' issuer credit ratings on the Cook Islands. The outlook is stable. The Transfer & Convertibility assessment remains 'AAA'.

"The ratings affirmation Islands reflects the Cook Islands' moderate average income level and modest government debt burden," Standard & Poor's credit analyst Craig Michaels said. "However, vulnerabilities associated with the country's weak policymaking culture and institutional settings constrain the ratings. Despite recent improvements, we believe the government can further strengthen institutional checks and balances in order to safeguard its past gains in fiscal consolidation."

In addition, the Cook Islands economy is vulnerable to the impact of cyclones and changing tourism preferences on its major revenue earner, the tourism industry. Further moderating the ratings are the country's lack of monetary policy flexibility and data deficiencies that constrain our analysis of the Cook Islands' external position.

We project Cook Islands' real per capita GDP growth to average 3.6% over 2014 to 2016, partly reflecting further expected declines in its population. Emigration is high in the Cook Islands, averaging 1.5% of the population annually during the past 17 years. Although the Cook Islands' integration with the Australian and especially New Zealand labor markets gives the Cook Islands a valuable alternative for its citizens, it does constrain prospects for the economy to diversify into higher value-added areas. However, we expect moderate further increases in tourist arrivals to support economic growth, with tourism remaining the primary economic activity in the Cook Islands. Income is high compared to that of peers, with GDP per capita estimated at US$21,000 in the year ended June 30, 2012.

In our base-case scenario, we project general government debt will rise by an average 3.3% of GDP annually over 2014 to 2016, with net debt expected to average 22% of GDP over the same period. General government interest expenditure to revenues is estimated to be a low 1.0% on average between fiscal years 2014 and 2016, reflecting the concessional and long-term nature of current borrowings. The Cook Islands' increasing debt is mainly because of water and sanitation investment, although ongoing shortfalls in infrastructure and basic services will continue to limit fiscal flexibility. And while government debt remains low, a large portion of this debt is exposed to foreign currency movements.

We equalize the local currency rating with the foreign currency rating, reflecting the Cook Islands' absence of both monetary policy flexibility and a domestic capital market, and its use of the New Zealand dollar. The transfer and convertibility assessment for the Cook Islands is 'AAA', which also reflects its use of the New Zealand dollar.

Mr. Michaels added: "The stable outlook balances the Cook Islands' sound economic growth prospects and low level of government debt, against the challenges it faces in overcoming weak political and institutional settings and infrastructure shortcomings."

We would lower the ratings if a weakening in global economic conditions reduces tourism sector receipts and, in turn, worsens the government's finances. A weakened commitment to uphold past fiscal gains through high operating spending, resulting in its debt burden rising by significantly more than we currently expect, could also bring pressure on the ratings.

Improvements in the sovereign creditworthiness could come with sustained gains in policymaking stability and effectiveness, evidenced by the reduction of sizable data deficiencies, and progress in increasing economic opportunities for residents.

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Cook Islands ratings affirmed at 'B+/B'

CHOP Researcher Co-Leads Study Finding Genes that Affect Blood Pressure

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Newswise Philadelphia, Feb. 20, 2014 A large international study analyzing genes in tens of thousands of individuals has discovered 11 new genetic signals associated with blood pressure levels. Ten of those signals are in or very near genes encoding proteins that appear to be likely targets for drugs already in existence or in development.

The fact that most of these new gene signals are druggable targets offers the possibility of expedited pharmaceutical development of therapeutics for high blood pressure, a serious risk factor for cardiovascular diseases, said geneticist Brendan J. Keating, D. Phil., of The Center for Applied Genomics at The Childrens Hospital of Philadelphia, co-senior author of the study. Some of the protein targets already are targets of existing drugs for other diseases, while others are the focus of drugs currently in early-phase clinical trials or under preclinical development.

Keating collaborated with two other senior co-authors, Folkert W. Asselbergs, M.D., Ph.D., of University Medical Center Utrecht, the Netherlands, and Patricia B. Munroe, Ph.D., of Queen Mary University, London, U.K. The study appears online today in the American Journal of Human Genetics. Study co-authors were from the U.S., the U.K., the Netherlands, Canada, Germany, Sweden and Ireland.

High blood pressure, or hypertension, a chronic medical condition, is a well-known risk factor for heart disease, stroke, peripheral artery disease and chronic kidney disease. It is a complex condition, affected by many different genes. Because not all patients respond well to current blood pressure medications and other treatments, and other patients require combinations of three or more drugs, there is a substantial unmet need for improved medicines.

In the current study, the researchers performed a discovery analysis of DNA from more than 87,000 individuals of European ancestry. They then assessed their initial findings in a replication test, using an independent set of another 68,000 individuals.

The study team confirmed 27 previously discovered gene signals associated with blood pressure, and discovered 11 novel genetic signals. When the researchers used pharmacological databases to analyze potential targets in the discovered genetic regions, they found that gene products associated with 10 of the genes were predicted to be targets for small-molecule drugs. Two genes, KCNJ11 and NQO1, in fact, are already currently targeted by existing approved drugs. If clinicians can reposition existing drugs to treat some patients with hypertension, this will save significant time in drug development, as they wont be starting development from scratch, said Keating.

Keating added that other gene signals discovered in the study are associated with candidate drugs currently under development within pharmaceutical companies, and it may be possible that they can be repositioned as blood pressure therapeutics.

He stressed that even with possible repositioning, much research remains to be done to determine which drug candidates are effective against hypertension, possibly in personalized treatments based on patients genetic makeup. Keating added that the list of genes affecting blood pressure will likely grow as research continues.

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CHOP Researcher Co-Leads Study Finding Genes that Affect Blood Pressure

Using Supercomputers To Speed Up Genome Analysis

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February 20, 2014

Image Caption: Beagle, a Cray XE6 supercomputer at Argonne National Laboratory, supports computation, simulation and data analysis for the biomedical research community. Credit: Argonne National Laboratory

Lee Rannals for redOrbit.com Your Universe Online

Researchers writing in the journal Bioinformatics say that genome analysis can be radically accelerated.

Over the years, the cost of sequencing an entire human genome has dropped, but analyzing three billion base pairs of genetic information from a single genome can take months. A team from the University of Chicago is reporting that one of the worlds fastest supercomputers is able to analyze 240 full genomes in about two days.

This is a resource that can change patient management and, over time, add depth to our understanding of the genetic causes of risk and disease, study author Elizabeth McNally, the A. J. Carlson Professor of Medicine and Human Genetics and director of the Cardiovascular Genetics clinic at the University of Chicago Medicine, said in a statement.

Megan Puckelwartz, a graduate student in McNallys laboratory and the studys first author, said the Beagle supercomputer based at Argonne National Laboratory is able to process many genomes simultaneously rather than one at a time.

It converts whole genome sequencing, which has primarily been used as a research tool, into something that is immediately valuable for patient care, Puckelwartz said in a statement.

Scientists have been working on exome sequencing, which focuses on just two percent or less of the genome that codes for proteins. About 86 percent of disease-causing mutations are located in this coding region, but still about 15 percent of significant mutations come from the other coding regions.

Researchers used raw sequencing data from 61 human genomes and analyzed the data on Beagle. They used publicly available software packages and a quarter of the computers total capacity, finding that a supercomputer environment helped with accuracy and speed.

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Health-Care Tips Every Boomer Needs to Know

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With 11,000 baby boomers becoming eligible for Medicare every day, according to government projections, the number of people who can afford to access doctors and hospitals is rising significantly, adding more pressure to an already-strained health-care system.

For some 65 year olds, Medicare is their only insurance source; for others it will improve and supplement their access and coverage.

Patient advocate Ruth Fenner Barash says new and improved health care coverage is always a good thing, but warns that the U.S. health-care system is not always the benevolent safety net many people believe it to be, especially for people dealing with problems associated with aging.

"Patients and their loved ones cannot blindly turn themselves over to this massive, technology based system and trust that it will care or take care of them," says Barash, who wrote For Better or Worse: Lurching from Crisis to Crisis in Americas Medical Morass (http://forbetterorworsebook.com).

Her book chronicles the long medical journey her husband, Philip, endured with her as his advocate. On the tail, she discovered mismanagement and excess, useless interventions and a sometimes complete disregard for pain even when there was no hope of healing.

"I learned a great deal from our experience, and I want others to benefit from what Ive learned," she says.

Barash offers the following tips for boomers and their loved ones, to deal with medical problems:

Tip No.1: Avoid the Emergency Room if You Can

Barash says her experience proved emergency rooms were developed with the idea that few people would use them; most people would see their physician. But as health-care costs rose, ERs became a primary-care facility for the uninsured or those looking to pay for services out of pocket.

She points out that ERs were not created for patients to spend a lot of time in, presumably, they would be seen quickly and be either admitted to the hospital or treated and released.

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Health-Care Tips Every Boomer Needs to Know

Study: New health program shows promise

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A health care effort focused on preventive medicine and a team approach to treatment is showing promise improving care and reducing costs, state officials say.

The Health Care Homes initiative has increased patient access to clinics, particularly for people of color, while improving quality and coordination of care, according to a state study released Thursday.

Health Care Homes is not home health care. The idea is to change the way clinics provide care from a traditional, illness-based model, to one that strives to improve the health of patients with chronic conditions and disabilities.

Clinics can receive extra payments for their efforts. At the same time, the program is intended to reduce health care spending enough to cover its own costs.

In the first three years of the program, Minnesota has certified 322 primary care clinics as health care homes. That's about 43 percent of eligible family practice clinics in the state.

Besides lowering costs, Health Care Homes clinics outpaced other clinics on quality metrics such as asthma care and colorectal cancer screening, officials said.

"What you're seeing here is that the care is better for those individuals who are enrolled in a health care home," said Doug Wholey, who led the University of Minnesota team that evaluated Health Care Homes for the Legislature.

"Health Care Homes had higher overall quality of care for diabetes care, vascular care, asthma care and colorectal cancer screening," Wholey told reporters. Clinics that were certified as Health Care Homes scored better than non-certified clinics on a number of quality measures, he added.

The rate of appropriate asthma care was approximately 20 percent higher among Health Care Homes clinics than it was for uncertified clinics. Screening for colorectal cancer was 8 percent higher in Health Care Homes. And blood vessel care scored 4 to 8 percent higher. The results were all statistically significant.

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Self Regional Healthcare, Clemson, Genetic Center create national genetics research hub

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21-Feb-2014

Contact: Peter Hull phull@clemson.edu 843-209-8341 Clemson University

GREENWOOD, S.C. A new partnership will establish formal collaboration among genetic researchers and Clemson University faculty at the Greenwood Genetic Center and Self Regional Healthcare, expanding an already successful working relationship.

Self Regional Healthcare will support the Clemson University Center for Human Genetics with a gift of $5.6 million over three years. The gift consists of an initial contribution of $2 million for the center's facilities and a subsequent contribution of $3.6 million to support research in genetics and human diagnostics at the facility located on the Greenwood Genetic Center campus.

"Today's announcement will create a new pipeline for genetic research," said John Pillman, chairman of the Self Regional board of trustees. "The collaboration of these three partners will ultimately connect genetic therapeutics research to patients."

Jim Pfeiffer, president and chief executive officer of Self Regional, said the partnership will accelerate the rate of innovation in genetic medicine. "This is what I like to call a win-win-win scenario," said Pfeiffer.

Steve Skinner, director of the Greenwood Genetic Center, said such collaborations are crucial to turning research advances into clinically available therapies for patients, not only in Greenwood and across South Carolina, but globally.

"This collaboration is a major step forward for patients as we combine the resources and strengths of each institution: Self's commitment to patient care, Clemson's expertise in basic scientific research and our experience with genetic disorders and treatment," Skinner said.

Self Regional and the Genetic Center have had an affiliation agreement since 1975 with the Genetic Center's clinical faculty serving as the Department of Medical Genetics for Self Regional.

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3D Printing and Additive Manufacturing

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21-Feb-2014

Contact: Sophie Mohin smohin@liebertpub.com 914-740-2100 x2254 Mary Ann Liebert, Inc./Genetic Engineering News

New Rochelle, NY, February 20, 2014A new era of manufacturing is upon us. Recent developments in 3D printing and additive manufacturing technologies are set to usher in the next generation of industrial competitiveness. To address the rapid advances and potential of this groundbreaking new technology, Mary Ann Liebert, Inc., publishers has released an exclusive preview issue of our new peer-reviewed journal 3D Printing and Additive Manufacturing (3DP).

Editor-in-Chief Dr. Hod Lipson, Director of Cornell University's Creative Machines Lab at the Sibley School of Mechanical and Aerospace Engineering, and his expert Editorial Board invite you to view this exclusive preview issue. The Journal will explore emerging challenges and opportunities in additive manufacturing, ranging from new developments of processes and materials, to novel applications in new areas, such as health, medicine, and bio-printing.

To maximize the global impact of this important forum, the articles will be translated into Mandarin Chinese and appear alongside the English version.

"This powerful new journal provides a much-needed multidisciplinary forum on the rapidly evolving technologies of 3D printing engineering and additive manufacturing on a global scale," says Dr. Lipson. "3DP provides a much-needed professional forum for professionals interested in 3D printing across diverse fields, to work towards establishing the next industrial revolution. This journal provides biologists, engineers, materials specialists, and computer scientists a common meeting place."

3DP also addresses the important questions surrounding this powerful and growing field, including issues in policy and law, intellectual property, data standards, safety and liability, environmental impact, social, economic, and humanitarian implications, and emerging business models at the industrial and consumer scales.

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Contact: Sophie Mohin, Mary Ann Liebert, Inc., (914) 740-2100, smohin@liebertpub.com

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3D Printing and Additive Manufacturing

Researcher Finds Gene Therapy a Promising Tool for Cardiac Regeneration

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Newswise WASHINGTON (Feb. 20, 2014) After a heart attack, there is often permanent damage to a portion of the heart. This happens, in part, because cardiac muscle cells are terminally differentiated and cannot proliferate after blood flow is blocked off to the heart. This partial healing can be attributed to heart disease being one of the leading causes of death. What if the cells could be stimulated to divide and the heart could be induced to repair itself? This was the question posed by George Washington University (GW) researcher Scott Shapiro, M.D., Ph.D., and his co-authors, who found that cardiac regeneration may be a possibility with gene therapy.

The research, published yesterday in Science Translational Medicine, found that gene therapy can elicit a regenerative response in pig hearts. Shapiro and his research team first looked to small animals such as the zebrafish, which are able to regenerate heart tissue after a heart attack. This animal has a key protein at play, Cyclin A2 (Ccna2).

After seeing the effects of CCna2 in small animals, we began looking at the effects of the gene in larger animals, such as pigs, said Shapiro, assistant professor of medicine at the GW School of Medicine and Health Sciences. We delivered Ccna2 directly into the heart and found that pigs not only had improved cardiac function, but also found evidence of cellular regeneration.

Ccna2 is a prenatal gene normally turned off in humans after birth. Shapiro believes using gene therapy as a tool for cardiac regeneration, optimized for humans, could lead to a viable treatment option for patients who suffer from myocardial infarction, or heart attack.

The study, titled Cyclin A2 Induces Cardiac Regeneration After Myocardial Infarction Through Cytokinesis of Adult Cardiomyocytes, is available at http://stm.sciencemag.org/content/6/224/224ra27.short.

Additional authors of the study include researchers from the Cardiovascular Institute at the Mount Sinai School of Medicine, the Centro Nacional de Investigaciones Cardiovasculares at the Hospital Universitario La Paz, and the Division of Cardiology at the Albert Einstein College of Medicine.

Media: To interview Dr. Shapiro about this study, please contact Lisa Anderson at lisama2@gwu.edu or 202-994-3121.

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Researcher Finds Gene Therapy a Promising Tool for Cardiac Regeneration

GW researcher finds gene therapy a promising tool for cardiac regeneration

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PUBLIC RELEASE DATE:

20-Feb-2014

Contact: Lisa Anderson lisama2@gwu.edu 202-994-3121 George Washington University

WASHINGTON (Feb. 20, 2014) After a heart attack, there is often permanent damage to a portion of the heart. This happens, in part, because cardiac muscle cells are terminally differentiated and cannot proliferate after blood flow is blocked off to the heart. This partial healing can be attributed to heart disease being one of the leading causes of death. What if the cells could be stimulated to divide and the heart could be induced to repair itself? This was the question posed by George Washington University (GW) researcher Scott Shapiro, M.D., Ph.D., and his co-authors, who found that cardiac regeneration may be a possibility with gene therapy.

The research, published yesterday in Science Translational Medicine, found that gene therapy can elicit a regenerative response in pig hearts. Shapiro and his research team first looked to small animals such as the zebrafish, which are able to regenerate heart tissue after a heart attack. This animal has a key protein at play, Cyclin A2 (Ccna2).

"After seeing the effects of CCna2 in small animals, we began looking at the effects of the gene in larger animals, such as pigs," said Shapiro, assistant professor of medicine at the GW School of Medicine and Health Sciences. "We delivered Ccna2 directly into the heart and found that pigs not only had improved cardiac function, but also found evidence of cellular regeneration."

Ccna2 is a prenatal gene normally turned off in humans after birth. Shapiro believes using gene therapy as a tool for cardiac regeneration, optimized for humans, could lead to a viable treatment option for patients who suffer from myocardial infarction, or heart attack.

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The study, titled "Cyclin A2 Induces Cardiac Regeneration After Myocardial Infarction Through Cytokinesis of Adult Cardiomyocytes," is available at http://stm.sciencemag.org/content/6/224/224ra27.short.

Additional authors of the study include researchers from the Cardiovascular Institute at the Mount Sinai School of Medicine, the Centro Nacional de Investigaciones Cardiovasculares at the Hospital Universitario La Paz, and the Division of Cardiology at the Albert Einstein College of Medicine.

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GW researcher finds gene therapy a promising tool for cardiac regeneration