Forza Horizon 5s amazing intro shows why its a huge hit on Game Pass – Polygon

I dont normally care about cars. But then Im whipping down a desert highway in the middle of a sandstorm guided by magical glowing arrows into the warm embrace of Hermes himself. Suddenly, I care a lot about cars.

Such is the power of Forza Horizon 5s intro. Like a street performer doing something so wild you cant help but stop, stare, and drool, the first 10 minutes of Playground Games open-world racing title require your attention. Its not enough that the intro drops you out of a plane and onto the smoldering slopes of an active volcano. It drops you four times, in four different cars, into four vastly different Mexican biomes, all while the soundtrack thumps and bumps and barely lets up long enough for you to catch your breath before the next sequence begins.

The raw euphoria it conveys is so impressive that its easy to miss how fantastic of a tutorial it all is. In the same time it takes other games to wax poetic about Ayn Rand, or convince Vaas to stop talking, Forza Horizon 5 has already shown you:

Whats more, it does all of this without actually saying all that much. Theres a button prompt for the Rewind ability (possibly because I had smashed into a palm tree after my eyes rolled back into my head), and it tells you how to change your perspective (the first-person cameras are not welcome in my household), but by and large, Forza Horizon 5 understands that youre mainly just here to haul ass. For a solid eight out of 10 minutes, my pedal was smooching the floor. By the time I crossed the finish line and stumbled, dazed, into the meat of the game, with its cavalcade of activities, checklists, and challenges, I was hooked. Nay, I was obsessed. I needed more cars with which to see more of this world as soon as possible.

One day after Forza Horizon 5s official release, Xbox boss Phil Spencer announced that more than 4.5 million players had already played the game across Windows PC, Xbox consoles, and cloud gaming. It was also the largest launch day for an Xbox Game Studios title, and reached three times the number of peak concurrent players as Forza Horizon 4s launch.

That last figure doesnt surprise me. Forza Horizon 5 launched on Xbox Game Pass, after all, a service with 18 million subscribers as of January, and a reported 23 million in April. Its hard to imagine any of those players booting up, downloading this game, and not sticking around to see those first 10 minutes through to the end. Its also not hard to imagine them being hooked like I was, and drawn into the absolute waterfall of cars to unlock.

Im speculating wildly here, but it feels as if Playground Games designed this intro specifically for Game Pass subscribers a player base that would be coming across Forza Horizon 5 much like we used to come across rental games at the supermarket. The intro is ecstatic and momentous, its energy contagious. And as soon as its over, Playground Games beckons to the rest of its sweeping landscape, replete with tropical storms, Aztec ruins, and shiny cars, all but daring you to go play another game.

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Forza Horizon 5s amazing intro shows why its a huge hit on Game Pass - Polygon

Celeb Shelf: Instead of scrolling through my phone I read a book, shares actor-turned-author Jugal Hansraj – Free Press Journal

Jugal Hansraj wears many hats hes an actor, writer and a National Award-winning film director. Jugal made inroads into the audiences hearts as a child artiste in the movie Masoom and then went on to star as the lead in movies like Papa Kahte Hain and the multi-starrer, Mohabbatein. He also took the directors chair for the animated film, Roadside Romeo and the Priyanka Chopra-starrer Pyaar Impossible.

Jugal made his debut as an author in 2017 with a childrens book, Cross Connection The Big Circus Adventure. Now, he is back with another childrens book, The Coward and the Sword. Speaking about what inspired him to pen the book, Jugal says, A journey I started over three years ago after the birth of my son has finally come to fruition. My novel The Coward and the Sword is truly a labour of love for me. The inspiration came to me from a Buddhist quote by the 13th century Japanese reformer, Nichiren Daishonin A sword is useless in the hands of a coward. A story started to form in my head and I started writing. To have the opportunity to be able to share my work with the world makes me feel so fortunate. I hope (if anything) I can inspire others through this book to find the courage within their own hearts. Here the author, who has entertained many with his writings, gives a glimpse of his reading habits. Excerpts:

Whats your writing process? Where do you draw inspiration from?

My writing process is not a complicated one: I first visualise my story as if it is unfolding on the big screen and based on that I start making notes. I then develop it from there.

When did you get into reading? School or college? Or later?

I got into reading way back when I was in school. I loved spending time in my school library, so much that I eventually became a student librarian.

Which are your favourite books? How have they made an impact on you?

There are too many... In fiction, theres The Fountainhead by Ayn Rand and in non-fiction, I would pick A Short History of Nearly Everything by Bill Bryson. The former taught me about the difference between ego and pride. The latter was truly educational and informative... It gave me a deeper understanding of our planet and us people got to where we are today.

Favourite authors and why do you like them?

Too many to mention but to name a few: PG Wodehouse, Bill Bryson, Ayn Rand; Anthony Bourdain, Agatha Christie, Arthur Conan Doyle, JRR Tolkien JK Rowling. William Dalrymple, Ruskin Bond, RK Narayan and many more!

Favourite genre and books you enjoyed reading from the genre?

I love reading fantasy, and travelogues by authors like Pico Iyer, Bill Bryson and J Maarten Troost.

You have a busy schedule, how do you take out time for reading?

When Im busy and have a bit of downtime, instead of scrolling through my phone I read a book.

How many books do you read in a month?

After fatherhood, its a lot less about one in six weeks, nowadays.

From where do you get book recommendations?

Friends, Kindle recommendations and from articles.

Do you prefer an ebook or a physical book? Why?

I prefer physical books... The feel and smell of the pages of a book are just wonderful. But I must confess, I read more ebooks nowadays just so I can save some space at home.

Whats on your currently reading shelf?

I just finished reading We Were the Lucky Ones by Georgia Hunter. Next in the line are The New Human Revolution by Daisaku Ikeda; The Map of Knowledge by Violet Moller, and Autumn Light by Pico Iyer.

Any special bookish memory you would like to share?

Laughing aloud heartily while reading books by PG Wodehouse and attracting stares from people who thought I was crazy!

Book adaptations (films/theatre/TV) you have watched and loved. Why?

I loved the movie adaptations of The Lord of the Rings and The Hobbit by JRR Tolkein, and the Noble House mini-series based on the book of the same name by James Clavell.

A book you want to see being made into a film?

My book, The Coward and the Sword

Classic (one or more) you havent read but claimed to have read?

(Laughs) I havent claimed to have read books that I havent read yet, but this sounds like a good idea!

Have you ever saved money to buy a book?

As a kid, I used to borrow books from the library, so I didnt have to save up.

Book/ books you would recommend to our readers?

There are many, but the must-reads are books by Bill Bryson... They are educative, informative and yet entertaining and funny. I wish my school textbooks would have been as interesting and fun as Brysons books!

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Celeb Shelf: Instead of scrolling through my phone I read a book, shares actor-turned-author Jugal Hansraj - Free Press Journal

Community clay tennis court in Minneapolis changing the game for local players – KARE11.com

MINNEAPOLIS Clay Tennis courts have long been a staple in professional tennis and private clubs.

"I tell you what, its like a dream come true, says Charles Wood, President of the Board of Minneapolis Community Clay Courts.

"They did a fantastic job in organizing," says clay court enthusiast Tom Haeg.

Now, players in the Twin Cities can enjoy their own clay tennis experience for free at the Minneapolis community clay courts in the Waveland Triangle Park in Minneapolis finished last month.

"'At the beginning it didnt seem like it was going to happen," says Wood. "But you just keep trying, you do different things. You just keep talking to people

It worked. And the project had no shortage of support. From private donors, to companies employee match programs and the USTA.

"Its so gratifying," says Wood. "You cant do it all by yourself. And when people step up and say, thats a great idea how can I help, it sort of gives you the idea that you can keep going.

The courts are more than just a cool attraction. They are easier on players joints, and they have an environmental effect as well. The surface reduces runoff.

"Its a permeable surface. So there is not this runoff. The city becomes nothing but runoff, and so this just absorbs into the clay," says Wood.

Absorbed into the clay, as the court has been absorbed into the hearts of those who use it.

"We all take care of it," says Wood. "And that gives the community investment into the court itself."

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Community clay tennis court in Minneapolis changing the game for local players - KARE11.com

Robert Kramer Obituary (1936 – 2021) – Diamondhead, MS – The Sun Herald – Legacy.com

Robert "Bob" Kramer, Sr. January 5, 1936 - November 10, 2021 Diamondhead, Mississippi - Robert "Bob" Kramer, Sr., age 85, a resident of Diamondhead, passed away Wednesday, November 10, 2021, in Gulfport. He was preceded in death by his parents, John, and Margaret Kramer; his sons, Richard Kramer and James Kramer; his brother, Kenneth Richard Kramer; and his grandson, Jeffery Kramer. Bob is survived by his wife of 29 years, Barbara Burks Kramer; his son, Robert W. (Dawn) Kramer, Jr.; his stepdaughters, Stacey (Philip) Sunseri, and Suzette Hyde; his grandchildren, Zachary Kramer, Amber Kramer, Jana Heinrichs, Rydder Kramer, Madison Kramer, Ethan Kramer; his step grandchildren, Rachel Sunseri, Helen Hyde; his great-grandchildren, Vanessa Kramer, William Heinrechs; and his step great-grandchildren, Dean Savoie, Scarlette Stroud. Bob was raised in Honolulu, Hawaii and moved to the mainland at 18 yrs old. He served in the U.S.A.F. at Hamilton Air Force Base in California. Bob was a machinist, when he retired from Los Angeles Water and Power in 1993, he then moved to Diamondhead and built his retirement home. Bob was proud of his "shop" where he did all of his woodworking. Private services will be held at a later date. Riemann Family Funeral Home, 141 Hwy 90, Waveland is serving the family.

Published by The Sun Herald on Nov. 14, 2021.

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Robert Kramer Obituary (1936 - 2021) - Diamondhead, MS - The Sun Herald - Legacy.com

Why Modern Medicine Struggles With Treating Chronic Pain – The New York Times

Rosss answer is to look for a middle ground between research science and more creative options, and to remember that modern medicine is both marvelous and still often wrong. He writes:

What we need, Im convinced, are more people and institutions that sustain a position somewhere in between. We need a worldview that recognizes that our establishment fails in all kinds of ways, that theres a wider range of experiences than what fits within the current academic-bureaucratic lines and yet at the same time still accepts the core achievements of modern science.

In practical terms, he offers several pieces of advice, including: Impatience is your friend. If your doctor struggles to help you, youll need to help yourself. Trust your own experience of your body. Experiment, experiment, experiment. (He wrote a column last year laying these out, with a focus on long Covid patients.)

After reading Rosss book and talking with him about it, I was reminded of how often modern medicine is both a vital part of treatment and an incomplete one. For many people, the path to a healthier, better life involves not only a doctors treatment but also some combination of physical therapy, dietary changes, exercise, massage, acupuncture, podiatry and more.

In the future, its even possible that medical science will come to understand why some of those measures worked better than a doctors approach. Medicine is a changing discipline, and it always will be.

In the conclusion of Deep Places, Ross ends on a note of optimism:

I am writing this story in part for those chronically suffering, more numerous than the healthy ever realize to give them hope that their condition can be changed even if it cant be eliminated, that they might be able to save their own lives even if they feel abandoned by their doctors, that they might, like me, be able to get, not fully well yet, but better, genuinely better.

Related: My colleagues in the Well section examine recent changes in how people understand and treat chronic pain. The latest science shows that there are many powerful tools available to patients to take control of the pain in their lives and perhaps begin anew, Erik Vance writes in the introduction.

The package includes articles on the new science of pain; cognitive behavioral therapy (or C.B.T.); the role of exercise; and how one patient built her own care team.

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Why Modern Medicine Struggles With Treating Chronic Pain - The New York Times

Regenerative Medicine Market to reach US$ 25,959.5 Mn by end of 2028, Says Coherent Market Insights – PRNewswire

SEATTLE, Nov. 12, 2021 /PRNewswire/ --The global regenerative medicine market is estimated to account for25,959.5Mn in terms of value by the end of 2028.

The field of regenerative medicine encompasses three areas that researchers from all around the world have been investigating: stem cell therapies, adult stem cell therapies, and gene therapy.Regenerative medicine seeks to treat illness by using the body's own ability to make new tissue, organ, or even cells. This field is the subject of regenerative medicine research all over the world. While the field of regenerative medicine continues to grow, there has been a lot of interest from the pharmaceutical and biotech industries with the hopes of finding treatments for age-related illnesses such as Alzheimer's and Parkinson's disease. However, the field of stem cell therapies is relatively new with researchers discovering and testing ways of producing new stem cells from adult cells in the human body. These stem cells are then injected into the patient in hopes that the new cells will grow and multiply and thus cure the patient of an illness or disease. Stem cell therapies has been successful in many cases, but scientists continue to research and test more effective methods. Another area that regenerative medicine looks into is the development of new and effective organs for transplant. Scientists and doctors have been trying for years to develop organs that can replace ones that are damaged or destroyed in certain accidents or diseases.

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Market Drivers:

Growing initiatives by key players to launch various regenerative medicine therapies is driving growth of the regenerative medicine market. For instance, in May 2021, The SingHealth Duke-NUS Academic Medical Centre (AMC) has announced the launch of a research institute and disease center that will advance regenerative medicine and introduce cellular therapies to improve patient care.

The increasing focus of key players on R &D of gene and stem cell therapy is again fostering growth of the market. For instance, in October 2021, VectorBuilder Inc. and Landau Biotechnology Co., have entered into a strategic partnership to establish the first primate gene therapy R&D center. The center will build advanced vector screening and optimization platforms to provide unique CRO services to the rapidly growing gene and cell therapy industry.

Market Opportunities:

Growing incidence of bone and joint disorders and orthopedic surgeries around the globe is expected to offer lucrative growth opportunities to the regenerative medicine market. According to Joint-surgeon.com, more than 24,000 orthopedic patients are treated per year. More than 2400 surgical procedures are performed per year. More than 250 international patients are treated per year.

Increasing development and launch of various novel innovative regenerative medicines products is expected to serve potential growth opportunities. For instance, in January 2021, Essent Biologics, a nonprofit biotechnology company, announced its launch to provide human-derived biomaterials and 3D biology data to the regenerative medicine research community.

Market Trends:

Growing number of public-private partnerships and agreements among key players is a major trend observed in the market. For instance, in February 2018, The National Institute of Standards and Technology (NIST) and the Standards Coordinating Body for Gene, Cell and Regenerative Medicines and Cell-based Drug Discovery (SCB) have partnered for the development of standards for accelerating R&D and clinical translation of regenerative medicine and advanced therapies.

The increasing focus of key players to invest in the field of regenerative medicine is expected to stimulate growth of the market. For instance, in September 2021, PTC Therapeutics announced that it will provide initial funding of $60 million to the Spinal Muscular Atrophy (SMA) Foundation to discover and develop regenerative medicines for neuromuscular diseases to help restore patients lost function.

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Competitive Landscape:

Major players engaged in the global regenerative medicine (Bone and Joint) market include Anika Therapeutics, Inc, Baxter International, Inc., Arthrex, Inc., CONMED Corporation, Medtronic, Plc, Smith & Nephew plc, Johnson & Johnson, Stryker Corporation, Aziyo Biologics, Zimmer Holdings, Inc., and Ortho Regenerative Technologies Inc etc.

Market segmentation:

Global Regenerative Medicine (Bone and Joint) Market, By Technology:

Global Regenerative Medicine (Bone and Joint) Market, By Application:

By Geography:

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Regenerative Medicine Market to reach US$ 25,959.5 Mn by end of 2028, Says Coherent Market Insights - PRNewswire

Researchers Laud First Prospective Evidence of Functional Precision Medicine Benefit – Precision Oncology News

NEW YORK Since a group of Austrian researchers published results in Cancer Discovery a few weeks ago showing that a functional precision medicine approach improved patients' survival, discussions have rippled through the field about the study's implications for personalized cancer medicine and how, logistically, researchers in other health systems might replicate the work.

The EXALT-1 prospective trial, short for Extended Analysis for Leukemia/Lymphoma Treatment, demonstrated that testing patients' samples for drug response ex-vivo and then treating them accordingly could improve survival for those with blood cancers, such as acute myeloid leukemia, acute lymphoblastic leukemia, and B-cell and T-cell non-Hodgkin lymphomas.

The trial design, in theory, was not all that different from a genomically matched umbrella trial such as NCI-MATCH, I-PREDICT, or the lung cancer-specific National Lung Matrix Trial. Consenting patients received genomic testing, followed by individualized treatment based on the results. In EXALT-1, however, therapy selection didn't rely on genomic sequencing results, but rather on information gleaned from directly treating patients' samples with a series of drugs ex vivo.

If live tumor samples representing a model of tumors inside patients' bodies shrink when exposed to a drug ex vivo, the idea goes, there may be a decent rationale for treating the patient with the same drug.

"Functional precision medicine assays represent a shortcut that bypasses a large proportion of the mechanistic understanding," explained PhilippStaber, who led the EXALT-1 trial and is a physician scientist and directs the lymphoma program at the University of Vienna. "These assays directly screen for functional compounds [and] provide a direct, quick, and individual drug selection for a specific cancer sample."

In other words, with functional testing, it isn't essential to understand the exact biological reason why a patient's cancer is responding to a drug; seeing the patients' cancer cells respond is enough to inform therapy decisions.

EXALT-1 enrolled 143 patients with relapsed or refractory blood cancers after a median of three prior lines of treatment. Investigators ran these patients' fresh samples biopsies, bone marrow aspirations, or peripheral blood samples through an ex vivo functional precision medicine assay to determine if their cancer cells showed responses to 139 drugs. A molecular tumor board involving pharmacists, hematologist oncologists, biologists, pathologists, and specialists from laboratory medicine reviewed the functional testing results and generated treatment recommendations for each patient.

Of 56 advanced blood cancer patients who received recommended treatments, 54 percent experienced a meaningful benefit from the approach, which the researchers defined as significantly longer progression-free survival times than prior treatments. The median progression-free survival ratio calculated as the time patients spent on matched treatment without progression divided by their time without progression on prior treatment was 3.4. "This indicates that their individual progression-free survival on [functional precision medicine]-guided treatment more than tripled when compared to their most recent individualized response time," Staber and colleagues wrote in the Cancer Discovery paper.

After a year receiving matched therapies, moreover, 23 percent of patients still hadn't experienced disease progression, whereas the same had been true of just five percent of these patients on their previous treatments.

In theNational Lung Matrix Trial, for comparison, in 15 out of 19 cohorts in that molecularly matched study there were either zero or single-digit response rates.

"Compared to other precision medicine trials, this is quite remarkable," Staber said in a web-based discussion with members of the Society for Functional Precision Medicine this week, highlighting the durable responses that he and his colleagues observed in EXALT-1.

Pharmacoscopy approach

The functional ex vivo testing approach, dubbed "pharmacoscopy," was used to screen patients' samples for drug responses. After staining the cancer cells and suspending them in wells containing different drugs, the test uses single-cell imaging via immunofluorescence paired with automated microscopy and machine-learning analysis to see which drugs led to cytotoxicity and reduced the fraction of cancer cells in the sample material.

The technologies in the ex vivo assay aren't particularly novel and are "used in many academic centers worldwide," Staber said. But they aren't routinely used to personalize treatment decisions for patients in an n-of-1 fashion because the approach hasn't demonstrated feasibility or survival benefit in prospective studies.

That may soon change. "This [Cancer Discovery] paper will become a classic because it is one of the first, if not the first, to be published to actually do this prospectively with the intent of demonstrating patient benefit," said Anthony Letai of the Dana-Farber Cancer Institute and president of the Society for Functional Precision Medicine, during a discussion of the EXALT-1 results. "All of us, myself included, have to publish more of this, but I think this is a superb start."

After EXALT-1, Staber and his team are now conducting a highly anticipated randomized study dubbed EXALT-2, in which 150 patients with aggressive hematologic cancers are randomized to three cohorts, and matched to treatment via comprehensive genomic profiling with Foundation Medicine's FoundationOneHeme or using the ex vivo functional assay approach, or given physician's choice of treatment. Researchers will compare patients' progression-free survival times across these cohorts.

Advantages, challenges

Proponents of the functional precision medicine approach believe it could get around the limited benefit seen with genomically matched precision oncology, and a number of groups are working on validating this.

"Genomics are important and have been helping us to deepen our molecular understanding of disease mechanisms, [but] the translation of these insights into effective treatments remains challenging," Staber said. While targeting driver mutations with available drugs can provide significant benefit among certain populations, the approach to date hasn't benefitted the majority of cancer patients. A low proportion of patients ultimately match to a therapy arm in precision medicine umbrella trials after genomic sequencing.

For example, published data from the NCI MATCH trial last year showed that just 12 percent of approximately 5,500 sequenced cancer patients received treatment based on molecular tumor markers.

In theory, because the utility of functional testing doesn't rely on a patient having an established molecular biomarker, the number of patients matched with a drug via ex vivo response testing could be much higher, if not universal.

Seeing the commercial opportunity in this approach, several functional precision medicine firms have sprung up in recent years hoping to validate these tests and market them as superior to genomically informed precision medicine. The testing approach used in the EXALT-1 trial, for example, sparked a spinout company from the Austrian Academy of Sciences, dubbed Allcyte, which was then acquired by Exscientia this past June.

Massachusetts Institute of Technology spinout Traverais another player in the space that aims to commercialize a broadly predictive biomarker that measures cell mass to predict drug efficacy.

"In theory, we should be able to run this assay for every drug, and in practice, we're finding out that that's exactly right," Clifford Reid, CEO of Travera, recently said about the approach. Reid, who spent much of his career in the commercial genomics space and was formerly CEO of sequencing technology firm Complete Genomics, moved to Travera when he realized the limits of genomically matched treatment approaches and is now an active member of the Society for Functional Precision Medicine.

Other firms are seizing the approach in new ways. SEngine, for example, is working on commercializing its high-throughput drug screening PARIS test as a diagnostic tool using patient-derived three-dimensional organoids. Notable Labs, meanwhile, uses functional precision medicine assays to in-license and repurpose failed targeted drugs for functional biomarker-defined patient populations.

All these firms see tremendous potential in guiding cancer treatment with functional assays be it in the place of genomic sequencing or via a combination of both approaches. Several of these firms have validated their tests in large-scale studies to the extent that they have shown their tests can predict drug responses with high sensitivity. Some of the firms have even prospectively validated the predictive capabilities of their approaches.

But showing that the drugs predicted to work by these functional assays are actually allowing patients to live longer will be key to the future success of this approach. And toward that end, there are still logistical hurdles to overcome.

"The Holy Grail for functional precision medicine approaches would be to really personalize treatment, to get to an N-of-1 therapy, and this is structurally quite challenging," Staber said.

First, researchers and commercial firms running these validation studies must have access to the hundreds of drugs they will test on patients' tissue or blood samples.

In Vienna, Austria, where EXALT-1 took place, this is not a major challenge, Staber explained, since the pharmaceutical companies offered two-month supplies of their drugs for free, and then, the insurance companies covered the off-label treatments for benefitting patients. This type of coverage-with-evidence schema is not common across health systems around the globe.

"This may be [possible] due to our insurance system in here in Austria," Staber acknowledged. "Maybe we are living on a cloud."

Additionally, in a discussion following his presentation to the Society for Functional Precision Medicine, several US-based researchers raised concerns about CLIA certification for the functional laboratory tests or needing an investigational device exemption from the US Food and Drug Administration to perform a clinical trial. The documentation and regulatory processes involved can be a challenge for studying new approaches like this.

Finally, the requirement that patient samples remain fresh and "living" during the functional testing procedure to maintain strong correlation with patients' drug responses places logistical challenges on functional precision medicine on the whole. While next-generation sequencing of formalin-fixed paraffin-embedded tissue samples can be done over the course of several weeks, fresh tissue needs to be tested shortly after biopsy.

The approach, wrote Staber and colleagues in Cancer Discovery, is "based on the collection of viable cells, the procurement of which requires an intimate interplay between different hospital departments, such as surgery, pathology, and laboratory."

Because Staber, as well as the firm Exscientia, envision a future in which a central lab can run patient samples and generate treatment recommendations on a commercial scale, the hope is that "real-time biopsy becomes common for personalized approaches [and] this hurdle can be expected to vanish gradually."

In the EXALT-1 trial, Staber said, the turnaround time from biopsy to treatment recommendation was five days, but "in well-optimizedsettings, [the approach in EXALT-1] or similar functional approaches can offer reports between 36 and 96 hours post sampling." However, turnaround times may be more of an issue outside of Austria, on a global scale.

Beyond the logistical barriers of obtaining the drugs, certifying tests, and transporting fresh samples, there is pervasive belief across much of the field, based on earlier failed studies using a limited roster of drugs and older technologies, that functional testing doesn't work. Researchers and commercial firms will need to contend with this.

"Too often, if you try to broach the topic of functional precision medicine, you often get a very uninformed response to the effect of, 'Well, we tried that and it doesn't work,'" Letai said in a discussion of the EXALT-1 study implications. "[But that was] 20-to-30 years ago when there was nothing but cisplatin and there were these chemo sensitivity in vitro assays that didn't work well enough for clinical use and guess what? Everything has gotten better since then. Let's give it another try."

See the article here:

Researchers Laud First Prospective Evidence of Functional Precision Medicine Benefit - Precision Oncology News

What it’s like in anesthesiology and pain medicine: Shadowing Dr. Gulur – American Medical Association

As a medical student, do you ever wonder what it's like to specialize in anesthesiology and pain medicine? Meet Padma Gulur, MD (@doctorgulur), an anesthesiology and pain medicine specialist and a featured physician in the AMA'sShadow Me Specialty Series, which offers advice directly from physicians about life in their specialties. Check out her insights to help determine whether a career in anesthesiology and pain medicine might be a good fit for you.

The AMA's Specialty Guide simplifies medical students' specialty selection process by highlighting major specialties, detailing training information and providing access to related association information. It is produced by FREIDA, the AMA Residency & Fellowship Database.

Learn more with the AMA about themedical specialties of anesthesiology and pain medicine.

"Shadowing" Dr. Gulur

Specialties: Anesthesiology and pain medicine.

Practice setting: Hospital in Durham, North Carolina.

Employment type:Employed by a hospital.

Years in practice:15.

A typical day and week in my practice: I work both on an inpatient pain service and in an outpatient, clinic-based practice.

On the inpatient service, I usually arrive at the hospital around 7:30 a.m. to get sign-out and coordinate assignments. The team then disperses to round on patients and we meet up again for table rounds around 11 a.m. We do follow-up rounds on patient and new consults after the table rounds in the afternoon.

Procedures are done as needed throughout the day. Around 2 p.m. every afternoon, we conduct a brief teaching session for the team on a topic of their choice from a set curriculum or impromptu topics related to patient care issues that may have arisen during the week.

The day ends when the work is done, usually by 5 p.m. but at times quite a bit later. If the patients are more complicated or the census on the service is high, it can also mean more notes to write at the end of the day. When covering inpatient, we cover one week at a time with home call overnight.

On the outpatient clinic, we have scheduled patients in four-hour blocks starting at 8 a.m., breaking for lunch around noon for an hour. It is not uncommon for patient visits in the morning to run into the lunch hour or for afternoon visits to run into the evening. Many times we also use the lunch hour to make insurance peer-review calls or call-backs to pharmacies and patients.

Most evenings I try to get back home in time to have dinner with my family, saving notes for after dinner if the workday has been particularly busy.

I spend about one-third of my time in this role as a clinician caring for patients on an inpatient pain service or outpatient clinic practice. The other two thirds of my time is spent equally between administrative and research activities. Administratively, I spend time focusing on a variety of issues as the health systems director for pain management strategy and opioid surveillance. I am also the executive vice chair for the department, and in this role I manage our performance and operations. These roles routinely extend into after-hours and weekend work.

As a researcher, I conduct clinical research in optimal pain management modalities and prevention science. Writing grants and papers is often an after-hours activity.

The most challenging and rewarding aspects of anesthesiology and pain medicine: Patients suffering from chronic pain can be very debilitated, and this impacts their social relationships, including with their doctors or other health professionals. To achieve a reasonable quality of life, a true biopsychosocial approach must be implemented, which can take some time to show results. This is the most challenging part.

The most rewarding aspect is when these patients start to benefit from a multimodal approach. The improvement in their quality of life is a true joy to see.

How life inanesthesiology and pain medicine has been affected by the global pandemic: As a population at risk, patients suffering from chronic pain have particularly been affected by the pandemic. Their critical social support structures have been impacted, as well as their ability to stay active, both of which have worsened their psychosocial well-being and impaired their progress.

Telehealth has been a blessing in helping these patients continue to access their physicians and other social support structures.

The long-term impact the pandemic will have onanesthesiology and pain medicine: The more regular use of telehealth to improve access and compliance will play a major role in the coming years.

How my lifestyle matches, or differs from, what I had envisioned: Training in anesthesiology is simply phenomenal. The breadth of learning and the terrific balance of cerebral and hands-on skill sets prepare you to take care of patients with varying disease states and across all age groups.

The year in the pain fellowship is probably one of the best years of training, as you gain skills and friends for a lifetime. Both training programs provide adequate work-life balance.

Skills every physician in training should have for anesthesiology and pain medicine but wont be tested for on the board exam: Compassion and empathy. Chronic pain is a disease state that, for the most part, is not externally visible and yet can be extremely debilitating. These patients depend more heavily than most on the therapeutic relationship with their providers to feel better.

One question physicians in training should ask themselves before pursuing anesthesiology and pain medicine: The three key elements for physicians professional satisfaction are:

Challenges to providing high quality care in pain medicine can often be external. For example, there is often lack of coverage for complementary, alternative and nonpharmacological options that may benefit these patients. In addition, the regulatory and documentation requirements are, at times, substantial. Will the joys of helping this population in need compensate for the practice challenges you may face?

Books every medical student interested in anesthesiology and pain medicine should be reading:

The online resource students interested in anesthesiology and pain medicine should follow: The website for our teams Pain Relief & Opioid Mitigation Innovation Science Lab highlights relevant research.

Quick insights I would give students who are considering anesthesiology and pain medicine: Live your best life! Your wellness directly impacts your ability to do your best for your patients. Wellness should not depend on your environmentit should be a personal focus, irrespective of your environment.

Mantra or song to describe life in anesthesiology and pain medicine: Everything Is AWESOME!!! from "The Lego Movie," by Tegan and Sara featuring The Lonely Islandespecially these lyrics:

Everything is awesome / Everything is cool when you're part of a team / Everything is awesome when you're living out a dream / Everything is better when we stick together.

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What it's like in anesthesiology and pain medicine: Shadowing Dr. Gulur - American Medical Association

The Wind River Reservation received good medicine by the delivery of 50 bison in October – Wyoming Public Media

A semi-truck delivered 47 bison last month. Originally, 50 were to be delivered but three were injured in the load up. 27 animals went to the Eastern Shoshone tribe and 20 to the Northern Arapaho.

Tribal Buffalo Program Manager and Eastern Shoshone member Jason Baldes helped facilitate the delivery onto his tribe's land. After a tribal elder offered a prayer, Jason spoke to the attendees. Around 50 people bundled up against the cool morning air stood in anticipation.

"I want to thank the National Wildlife Federation for allowing this work to continue through partnership," Jason says to the crowd I also want to thank the Intertribal Buffalo Council who arranged for the distribution of our surplus conservation buffalo to tribes. These animals came from a long trip, 14 hours on the road, so I don't want to waste any more time. The buffalo speak for themselves."

Right after he was done speaking, Jason and the truck driver open the door of the truck but it took some time for the animals to exit the truck.

"They do what they want," said Jason as we waited near the semi.

After the bison were released, they ran into the pasture and tribal members stood in awe of the new herd.

"It goes right to my heart. As soon as I got close, I blessed myself because It's a blessing they've come back to the reservation and our people need to bring our culture back" said Eastern Shoshone member Caroline Mills.

She wasn't alone in her recognition of the importance of the day. Former Eastern Shoshone Councilman Wes Martel was in attendance and said he made a connection with the bison.

"It's a real powerful feeling. While they were still in the truck, I got to go up and touch one. I put my hand on him. And my heart was in him and his heart was in me."

After the bison ran out to meet the rest of their new herd, I found Jason Baldes and asked him about the importance of the bison on the Wind River Reservation

He said, "Shoshone people, we are buffalo people. Gweechoon Deka, the buffalo eaters. But we haven't been able to eat them for 130 years. They're also very important as a keystone species, they're ecologically very important on the landscape. And so, the federal government, settlers, colonizers removed the buffalo as a means to subjugate us as Native people to reservations."

Bison used to be a big part of the Eastern Shoshone culture and traditions. After they were nearly eradicated, we lost some of those traditions.

"It's about revitalization. It's about healing, bringing this animal back to our communities because this was the commissary for our grandmas and grandpas, food, clothing, shelter. But it's also central to our cultural, ceremonial, spiritual belief systems. And so for the future of our people, our young ones. We have to have a foundation in buffalo again" Jason said.

The bison help the Earth by aerating the soil with their hooves. They help bring back plants by planting native seeds. Now, the bison are going to bring back so much more.

"It's about healing land, changing our land-use policies, focusing on cultural revitalization, language preservation, ensuring our young people are grounded in this buffalo so that in the future we have the ability to exercise sovereignty, self-determination. And this is about food sovereignty too, so you know, getting this animal back into our diets is very important for our health. And so the hope is that we can continue to grow our buffalo herds, manage them as wildlife as the creator intended."

The bison are unique in that they aren't interbred with cattle like a lot of bison seen across the American West these days. These are descendants of wild bison near us.

"These are considered conservation buffalo. They have reputable genetics. These animals come from Wind Cave which descended from Yellowstone."

We watched the new bison join up with the herd we've been growing over the last five years.

"The Shoshone Tribe, we have over 60 animals now, the Arapaho will have over thirty," said Jason.

As an enrolled Eastern Shoshone member, I am blessed to be in the presence of so many beautiful animals. I wish my grandmother could see this. I agree with Wes Martel when he told me, "It's really gratifying to see buffalo. Welcome home."

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The Wind River Reservation received good medicine by the delivery of 50 bison in October - Wyoming Public Media

Medicines Wellness Conundrum – The New Yorker

Michelle didnt yank Tobys socks off from the toes. She rolled them down from the calf, using both hands, pausing to cradle each newly bare foot. She gently ran her hands up and down Tobys exposed shins. She touched one of Tobys wrists to feel her pulse, and pressed the tips of her thumbs between Tobys eyes and at her ankles for a few seconds at a time. Sometimes, she held a hand an inch or so above Tobys skin, then moved it through the air, as though dusting an invisible shelf.

A soft cap warmed Tobys nearly hairless head; the waxen pallor of chemotherapy hung on her face. She was in the middle of a yearlong course of treatment for early-stage breast cancer, at New York-Presbyterian/Columbia Hospital, in Manhattan. A few months earlier, Toby, who lives in New Jersey, had undergone a double mastectomy and begun chemotherapy. When the chemo made her nauseated, and the nausea medication only made her feel worse, she began meeting weekly with Michelle Bombacie, who manages the Integrative Therapies Program at Columbia University Irving Medical Center, for a mixture of acupuncture, acupressure, light-touch massage, and Reiki.

Wellness is an umbrella term. It can be used to cover forms of traditional Chinese medicine, such as acupressure and acupuncture; aspects of the Indian tradition Ayurveda; and more recent inventions like Reiki, which involves pressure-free caressing and non-touch hand movements. It can also encompass nutritional counselling, herbal supplements, exercise, homeopathy, massage, reflexology, yoga, touch therapy, art therapy, music therapy, aromatherapy, light therapy, and more. The wellness movement is one of the defining characteristics of health care in this era, Timothy Caulfield, a University of Alberta professor focussed on health and science policy, told me. By some estimates, the wellness industry, loosely defined, is worth over four trillion dollars.

Wellness is often presented as an alternative to the modern medical system, and is pursued in spas or other dedicated spaces. But, in recent years, hospitals have begun embracing it, too. By one estimate, around four hundred American hospitals and cancer centers now host a wellness facility of some kind; most offer services aimed at stress reduction and relaxation, but many also promise to help patients improve their energy levels, strengthen their immune systems, and reduce chemotherapy-induced fatigue and nausea. A few provide fringe services, such as apitherapy (which uses bee products, such as honey or venom), or promise to adjust patients life force. Cancer patients are particularly drawn to whats known as complementary care: up to ninety per cent use some service that falls under the aegis of wellness. At some of the countrys top health-care institutions, patients can receive chemotherapy in one wing of the hospital and, in another, avail themselves of aromatherapy, light-touch massage, and Reikiinterventions that are not supported by large, modern studies and that are rarely covered by insurance.

The commingling of medicine and wellness has been alarming for some physicians. Weve become witch doctors, Steven Novella, a neurologist at the Yale School of Medicine, told the medical Web site STAT, in 2017. Patients at such centers are being snookered, Novella argued, and hospitals commit an ethical error in offering services in wellness centers that they would eschew on their medical floors. (Novella is the founder of Science-Based Medicine, a Web site dedicated to debunking alternative therapies.) Many physicians find Reiki particularly unnerving: practitioners of the technique, which was invented in Japan in the early twentieth century, move their hands on or over the body, ostensibly to shift the flow of energy within it. In 2014, in an article in Slate, the science journalist Brian Palmer reviewed the literature on Reiki and found no evidence that it workedit was, he wrote, beneath the dignity of a great cancer center to offer it.

On the other hand, some doctors support the provision of wellness interventionseven those not backed up by rigorous studiesas long as they do no harm and dont replace medical care. And many patients feel that such interventions help them. After Toby started seeing Michelle Bombacie, her nausea disappeared, and she became energetic enough to care for two puppies. I know something changed within me, she told me. Although Toby didnt have strong views about how Reiki works, she described the experience with Bombacie as critical to the success of her treatment. It gave me the tools to work on my mental health and spiritual health, and to shift my focus from being out of control and kind of helpless to having more trust in myself and my doctors, she said. Kim Turk, the lead massage therapist at Duke Integrative Medicine, told me that she considers Reiki practitioners to be facilitators who support peoples own healing.

Patient satisfaction matters to hospitalsMedicare penalizes them for low satisfaction ratings. Massages and yoga may make patients happier and keep them coming back. Hospitals are banking on the fact that treating you in a more humane way will make you want to stay as a customer, Thomas DAunno, a New York University professor whose focus includes health-care management, said. And yet medicine, if it is to function, depends on trust. Hospitals are supposed to be bastions of evidence-based care; wellness treatments dont meet that standard. Can the best of wellness be brought into the hospital without compromising the integrity on which health care depends?

The term wellness, as we use it today, dates roughly to 1961, when Halbert L. Dunn, an eminent biostatistician and former head of the National Office of Vital Statistics, published the book High-Level Wellness. Dunn took his cue from the constitution of the World Health Organization, ratified in 1948, which redefined health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Wellness, he wrote, was about functioning better over timehaving an ever-expanding tomorrow. This inspirational idea found a broad audience. In the nineteen-seventies, so-called wellness centers began offering fee-for-service therapies; in the following decades, corporate wellness programs subsidized gym memberships and meditation classes.

The new concept dovetailed with an ongoing medical story. American doctoring in the nineteenth century, as the medical historian Norman Gevitz has written, was characterized by poorly trained practitioners employing harsh therapies to combat disease entities they understood insufficiently. As a result, osteopathy, homeopathy, and chiropractic techniques attracted educated, conventionally trained physicians who were frustrated with treatments that didnt seem to work. Mainstream doctors readily embraced what wed now call alternative therapies until 1910, when the Carnegie Foundation asked Abraham Flexner, an education reformer from Louisville, Kentucky, to report on the state of medical schools in the U.S. and Canada. Flexner evaluated a hundred and fifty-five medical schools according to the standards of the German medical system, which emphasized rigorous research; in his report, he warned of rampant charlatanism and quackery, and called for an end to treatments that werent evidence-based. Many medical schools closed soon after the report was published.

The Flexner Report ushered in the modern era of American medicine, in which interventions are based on reliable evidence. But Flexners disregard for bedside manner and other intangibles had an unexpected consequence. The professions infatuation with the hyper-rational world of German medicine created an excellence in science that was not balanced by a comparable excellence in clinical caring, Thomas Duffy, a professor at the Yale School of Medicine, wrote, in a centennial history of the report. Physicians, Duffy argued, began to distance themselves from patients. It fell to nurses to provide the empathy that doctoring no longer facilitated, by comforting, massaging, listening, and expressing compassion.

Advances in technology further chilled the clinic. Medicine had long been synonymous with the laying on of handswith diagnosis by feel and the use of healing touch. Patients, the medical historian Jacalyn Duffin told me, were essentially the authorities on whether they were sick; it was up to physicians to isolate the cause. The invention of the stethoscope, in 1816, shifted the balance. You werent sick unless the doctor found something, Duffin said. By the end of the twentieth century, diagnostic devicesX-ray machines, MRI scanners, and ultrasoundshad made diagnosis increasingly objective while allowing doctors to conduct mostly touch-free exams. Abraham Verghese, an infectious-disease physician at the Stanford University School of Medicine, has written that, for doctors today, the patient in the bed can seem almost as an icon for the real patient whos in the computer.

These days, moreover, medical practice is focussed on efficiency. In surveys, most doctors say that they spend between nine and twenty-four minutes with each patient per visit. (This may be an overestimate.) One study has found that physicians listen to their patients for an average of eleven seconds before interrupting. There is a gap between what we want from health care and what we get. Wellness stands ready to fill it.

Lila Margulies, a high-school friend of mine, was diagnosed with lung cancer, in March, 2017. Forty-three years old and a nonsmoker, she underwent surgery, chemotherapy, and radiation before the cancer spread to her bones. She had already been interested in wellnesstaking herbal supplements, visiting an acupuncturistand the cancer deepened her interest in alternative approaches. Alongside her treatment, Lila adopted a diet that she believed would stop her cancer from growing, increased her supplement intake, and began working with an energy healer. Her friends contributed to a GoFundMe campaign so that she could afford the expensive healing sessions.

Lila was open with her oncologist about her extra-medical pursuits. She met regularly with her energy healer at his home, in Mahopac, New York, for sessions that combined conversationhe spoke with her about her fear of leaving her young children behindwith a cross-cultural mix of touch therapies. All of it came back to energy and how energy moves in the body and between people, Lila told me. Her cancer was stable for several years; last fall, she learned that it had begun spreading again. She continues to feel that her sessions with her healer were beneficial. It was so tangible, she said. It made a huge difference.

Research has explained some of the physical mechanisms that underlie our enjoyment of light touch. In the late nineteen-thirties, a Swedish neurophysiologist named Yngve Zotterman discovered nerve fibres in cats that respond to slow, gentle touch. In the nineteen-nineties, another neurophysiologist from Sweden, ke Vallbo, working with other researchers, found that the same fibres existed in people. The nerves, known as C-tactile afferents, or CT fibres, prompt not only a physical sensation but also pleasant emotions. Gentle strokingat one to ten centimetres per second, with a hand or a body-temperature objectreleases opiates, along with other chemicals that make us feel good. These relaxing effects originate in the manipulation of the skin. Theres a specific receptor and a specific pathway, Frauke Musial, a professor at the government-funded National Research Center in Complementary and Alternative Medicine, at the Arctic University of Norway, told me. Without touch, we never experience the feelings that touch causes.

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Medicines Wellness Conundrum - The New Yorker

News Features Brevard’s Most Authoritative Health & Medicine Information – Space Coast Daily – SpaceCoastDaily.com

Your Trusted Source for Brevard County News, Sports, Weather and & InformationCLICK HERE TO SEE THE Nov. 15, 2021 EDITION

BREVARD COUNTY, FLORIDA Space Coast Daily, Brevards leading local news and information source, is proud to present its newest member of the SCD family of outstanding multimedia products.

Featuring some of the best and long-standing journalists and multimedia producers in our community, Space Coast Daily has established itself as the most trusted and most-read locally produced news and information source in Brevard County.

With the launch of Space Coast Dailys direct-mail newspaper, Brevardians can count on us to deliver unbiased news and information that is important to them, with emphasis on public safety, health and wellness, education, government, entertainment and local sports delivered in print and right into your mailbox, said Space Coast Daily President and Publisher Tom Palermo.

Our multimedia venues now include SpaceCoastDaily.com, the areas most-read locally-produced news website; Space Coast Daily Facebook page, which features among the largest and most engaged audience of any local venue of its kind; our direct mail SPACE COAST DAILY NEWS newspaper and Space Coast Daily magazine, Brevard Countys most-read local magazine.

Via Space Coast Daily TV, SCD is the leading local producer of video news and information, including broadcast from both the field and from the Space Coast DailyFriday Night Locker Room Erdman Cadillac Studios on Merritt Island.

High Value, Quantifiable Results

As pioneers using the web and social media, Space Coast Daily reaches hundreds of thousands of people each month via video content produced and distributed on those venues.

In addition, the Space Coast Dailys popular E-mail News Blast reaches a large engaged audience that has signed up to receive Brevards best and most trusted news and information headlines right into their inboxes.

Space Coast Daily has developed the unique processes and multimedia venues to generate high-value exposure for Brevard businesses in a quantifiable way by producing and presenting highly engaging and interactive multimedia content including live video via our very robust multimedia channels, said Space Coast Daily Partner Giles Malone.

Our successful and trackable strategy is based on high-quality content marketing that is then distributed to the areas largest and most engaged audience. We have been working very successfully with all types of businesses and organizations for four decades, and can effectively increase your qualified prospects, and boost your ranking online with our unique content-rich multimedia approach, said Malone.

For almost 40 years, the principals of Space Coast Daily have been successfully assisting businesses to grow and prosper.

Now more than ever with the COVID-19 challenges, we are very aware that our marketing and advertising clients are looking for high value and quantifiable results from their marketing investment, said Palermo.

Call today to reserve your ad space in Brevard Countys most exciting newspaper.

For more information, email Contact@SpaceCoastDaily.com or call 321-615-8111

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Predictive Medicine with IoT Wearables – IoT For All

IoT wearables are helping to transition reactive medicine to predictive medicine, especially for those with chronic illnesses. Patients with chronic diseases are five times more likely than others to end up in the emergency room than those without chronic diseases. The hospitalization rates for patients with chronic disease are significantly higher because most patients are not able to proactively manage their condition so they must remember every single step of their care plan.

Proactively managing a patients chronic condition is crucial for both patients and healthcare providers alike. Doctors need real-time patient data to detect when something is abnormal and intervene early. Additionally, real-time data helps patients feel more in control of their health and prompts them to alter their behavior to lead a healthier lifestyle.

IoT wearable devices are the latest wave of innovation in the medical device industry. When regular medical devices are connected to the cloud, they can collect essential real-time data that could be life-saving. More importantly, designing an IoT medical device that is also comfortable for patients to wear is invaluable to improve health outcomes and intervene early. Below are the five primary benefits of wearable IoT devices in healthcare:

In surgery specifically, surgeons can receive patient data in real-time while maintaining sterility and increasing efficiency and comfort. There are also wearable IoT devices that can assist surgeons during surgery. For example, Pixee, a France- based medical device company, completed the first total knee replacement surgery using artificial reality (AR) navigation eyeglasses called Vuzix M400 AR Smart Glasses. Surgeons can use these glasses to navigate throughout the surgery while seeing augmented reality information displayed in their field of view.

With wearable IoT devices, you can also monitor the condition of patients pre and post-operations. Many post-op patients are at risk of complications such as sepsis, stroke, or shortness of breath. Wearables can be used to continuously monitor their condition, which lowers the risk of post-op complications and can speed up recovery.

Arguably, the most vital benefit of IoT-enabled wearable devices is the ability to provide patients and healthcare providers with all the information they need to detect abnormalities early. Having this kind of visibility into the relevant aspects of an individuals health profile gives doctors the information they need to make informed decisions and patients the autonomy to make necessary lifestyle changes. For example, wearable respiratory monitor sensors can send alerts to a patients smartphone about abnormalities in their breathing pattern, heart rate, and temperature. These notifications provide early detection of lung function deterioration and enable medical professionals to provide early treatment to prevent lung failure.

With wearable digital technology, patients can be more active in their care and better understand how their behaviors can impact their health in real-time. For example, Welt created a smart IoT belt that prevents patients from falling by predicting risk factors from abnormal gait patterns. By measuring gait patterns such as speed and symmetry of walking, the belt notifies the users through an app about potential fall risks. This prompts users to change their walking patterns to avoid falling. Similarly, there are different types of smartwatches that track your steps, water intake, heartbeat, and calories lost. These are all tools to help take ownership of your health.

According to a recent P&S Intelligence report, the market for wearable technology is expected to surpass $65 billion by 2030. The growing market appeal of wearable devices will impact decisions made by both healthcare providers and payers alike. Insurers view wearables as keys to lowering medical costs while boosting patient satisfaction. With constant real-time monitoring of a patients healthcare status, patients require fewer healthcare visits.

Wearables also allow patients to self-diagnose where possible, which drives down healthcare costs. With the rapid development of machine learning algorithms, wearables will continue to become less intrusive to patients, while still providing deep insights to health care providers. Fewer trips to the hospital mean wearable technology will provide an eyes-on-hands-off approach to healthcare, producing better patient outcomes while lowering costs.

Three of the most common chronic conditions primary care physicians (PCPs) usually treat are diabetes, heart disease, and asthma. Below are examples of IoT wearables that are being developed to better monitor chronic conditions.

Eversense created the first FDA-approved continued glucose monitoring sensor, which is implanted right under the skin to track glucose levels. When the sensor detects glucose levels are abnormal, the transmitter placed on top of the implanted sensor vibrates and sends notifications to the users mobile app via Bluetooth. With this technology, diabetic patients can constantly monitor their glucose levels without the hassle of pricking themselves and checking glucose levels manually.

Patients with irregular heartbeat, either a dangerously fast heartbeat (tachycardia), or an abnormal heartbeat (arrhythmia), may utilize wearable defibrillators or implantable defibrillators. Zoll LifeVest is a wearable life vest that monitors a patients heartbeat and sends shock treatments to restore the heart to a normal rate.

Approximately 25 million Americans have asthma, which is about 1 in 13 Americans. There are intelligent asthma wearable devices that can predict the onset of an asthma attack before the patient even experiences symptoms.

Clearly, the future of medicine is predictive, not reactive. With IoT wearable technology providers and patients can proactively monitor conditions in real-time, which means it will never be too late to provide care to patients.

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Predictive Medicine with IoT Wearables - IoT For All

PEER certification awarded to College of Medicine and Hershey Medical Center – Penn State News

HERSHEY, Pa. Penn State Universitys College of Medicine and the Milton S. Hershey Medical Center were recently awarded a platinum-level Performance Excellence in Electricity Renewal (PEER) certification from GBCI.

PEER is the worlds first certification program that evaluates the resiliency, reliability and sustainability of participating organizations power systems. The program evaluates the power systems across six categories: reliability and resiliency of power systems; their energy efficiency and environmental impact; the operation, management and safety of these systems; grid services; innovation and exemplary service; and regional priority of the energy systems.

Since 2010, Hershey Medical Center has been working towards creating a more sustainable power system by implementing an Energy Conservation Program. Through this, the Medical Center has been able to reduce its energy consumption by 20%. This led to monetary savings and a carbon output reduction.Not only does the increased reliability and sustainability help the environment, but it also increases healthcare resiliency, or the persistence of high-quality healthcare.

As a healthcare provider, Hershey is unable to stop operations in the event of a power outage. In order to continue providing lifesaving medical care, it is critical that they have uninterrupted access to a fully functional power grid, equipped with backup systems in the event of power failures. To evaluate its energy infrastructure and performance, the Hershey Medical Center pursued PEER certification.

The PEER Certification process forced us to step back from the day-to-day tasks of operating and maintaining the campus infrastructure to support the Milton S. Hershey Medical Center mission, and holistically consider the campus as a microgrid and the future of renewable energy and sustainability possibilities, said Kevin Kanoff, campus energy engineer.

The achievement of the platinum PEER certification from GBCI is the highest possible award an important honor and signifier of their commitment to energy efficiency and reliability. Out of 110 available points, Hershey Medical Center earned 85. One infrastructure project that helped to achieve these ratings isthe Combined Heat and Power unit which supplies 75% of Hershey Medical Centers energy requirement. The Hershey Medical Center also met the goals of supplying an alternative power supply for 100% of all project loads and updating and optimizing HVAC and lighting systems to be more efficient.

The PEER Certification process provided us with the means to further evaluate our environmental performance through established metrics, identify areas where we have excelled and more importantly where there are opportunities for improvement as we strive to be a leader in environmental practices within the health care industry, said Mark Heisey, facilities compliance program manager and Campus Sustainability Council Environmental Subcommittee co-chair.

With these projects, Hershey Medical Center was able to increase fuel efficiency use from 51% to 75%, mitigate around 55,000 MWh of electrical supply and distribution losses, and reduce the centers electricity production related carbon emissions by 10%.

Improvements such as theseprovide greater potentialto reduce the impact of the center on the environment, and in addition, to have a positive impact on the communitys health and well-being. With reduced carbon emissions,localhealth effects related to pollution and warminghave the opportunity for reduction as well. In addition, it helps to increase the reliability of the medical center, with improvements to the power grids capability to withstand an increase in storms and extreme weather events related to climate change. Reduced costsare also likelyto improve the quality-of-care patients receive, as money saved could be spent making further improvements.

We are committed to a holistic framework that addresses the efficiency and effectiveness of our electrical system. said Marvin W. Smith, CHFM assistant vice president, facilities, Penn State College of Medicine, Penn State Health Milton S. Hershey Medical Center, Through PEER certification, we demonstrate dedication to reliability, resiliency and the environment.

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PEER certification awarded to College of Medicine and Hershey Medical Center - Penn State News

Dr. Harris Berman, HMO pioneer and former Tufts University School of Medicine dean, dies at 83 – The Boston Globe

Dr. Berman, who finished his career as what he cheerfully described as the oldest medical school dean in the United States, died in Tufts Medical Center on Oct. 30 of congestive heart failure. He was 83 and lived in Brookline.

A cofounder in 1971 of the Matthew Thornton Health Plan not-for-profit HMO in New Hampshire, Dr. Berman became chief executive of Tufts Health Plan in 1986, guiding it while its membership grew from 60,000 to 1 million.

Then at 65, he joined the Tufts University School of Medicine faculty, initially chairing the department of public health and community medicine, then serving as dean of public health and professional degree programs.

Dr. Berman was named interim dean of the medical school in 2009. When the interim title was dropped two years later, he became at 73 the oldest medical school dean in the nation, as far as anyone could tell. He retired in 2019.

He came in and did something thats, unfortunately, quite rare in a university. He spent a lot of time listening to other people, said Lawrence Bacow, who was president of Tufts when Dr. Berman was interim dean, and is now president of Harvard University.

Harris never felt the need to be the smartest person in the room, although he often was, Bacow said at Dr. Bermans funeral service. And whenever he spoke, people realized that he was the wisest. And in an academic setting, wisdom is often a much scarcer resource than intellect.

Part of Dr. Bermans wisdom was rooted in his Peace Corps experience, and that illuminating conversation with a young bureaucrat.

The revelation that another country spent its limited financial resources for health care on prevention was a whole new way of thinking for me, he said in a 2011 interview with a Tufts publication when he was named dean of the School of Medicine.

Ive never forgotten that guy, Dr. Berman said. He certainly affected my thinking and my future. He was absolutely right. Even in this country, where we have lots of money and lots of resources, we still dont have enough, and we should spend more than we do on public health and prevention. India got me interested in population medicine, in the whole question of how you prevent illness.

And that, he added, eventually led me to get involved with starting HMOs. How do you take care of a population? How do you take the budget you have and do the most that you can for people in your care? How do you keep them healthy, and prevent illness? That experience in India was formative for me.

With Dr. James Squires, he launched Matthew Thornton in New Hampshire, where they both were from, and the HMO grew to about 50,000 members.

Then he switched to leading Tufts Health Plan, taking a very businesslike path for someone who had trained as a physician.

My dad was a businessman, and I had heard business talk at the dinner table all my life, Dr. Berman said. Business came naturally to me.

The older of two siblings, Harris Alan Berman was born in Concord, N.H., on May 30, 1938.

His father, Frederick Berman, ran a wholesale plumbing and heating supply business. His mother, Marion Rubin Berman, who was known as Mitzi, was a pianist. A New England Conservatory graduate at age 19, she performed, accompanied, and taught lessons and encouraged her sons lifelong love of and involvement with music.

At Concord High School, the student newspaper dubbed him Busy Bee Berman because of his leadership in so many activities. Harris then went to Harvard, from which he graduated in 1960 with a bachelors degree.

In New York City, where he graduated in 1964 from the Columbia University College of Physicians and Surgeons, Dr. Berman began dating Ruth E. Nemzoff, and they married in 1964.

They had met several years earlier when Ruth was a counselor at a summer camp his sister attended. Later, friends in New York fixed them up on a date.

I think what drew us together was that on our first date we talked about going into the Peace Corps, said Ruth, who has a doctorate in administration, social policy, and planning, and taught for many years at what is now Bentley University. She also has written books about parenting and family relations.

We both were very much attracted to the notion of service and adventure, she said, and that was a theme throughout our lives.

They had four children: Kim of Bethesda, Md., Seth of Cambridge, Rebecca of San Francisco, and Sarabeth of Washington, D.C.

While working with those whose careers he encouraged, Dr. Berman was really good at seeing the big picture. He used to say, Its not a crisis. Its a problem that needs to be solved, " said Rebecca, a physician who followed her father into academia and directs the internal medicine residency program at the University of California, San Francisco.

Beyond being an amazing dad, she said, he also was really a coach and a mentor to me when I started this job.

From middle age onward, Dr. Berman faced a series of health challenges: a heart attack, bypass surgery, kidney cancer, a pacemaker.

He was really a walking testament to miracles of modern medicine, Sarabeth said at his funeral.

As he attended milestone family events, what became clear to me is that he was marking time by the landmarks in my life that he never expected to see, she said. That idea defined my relationship to him and really how he lived. He made the time. He marked the moments. Its not so much that he treated every day like his last day. Its more that he lived purposely and with gratitude.

A service has been held for Dr. Berman, who in addition to his wife and children leaves his sister, Phyllis of Sudbury, and 11 grandchildren.

Dr. Berman was sort of a quiet person who really knew what was right, and what he wanted to accomplish, and set out to do that in a way that was never flashy, Seth said in an interview.

At the funeral, Seth recalled that when he was a boy, his father returned home to share the story of an HMO chief executive who had sold his company and made hundreds of millions of dollars. I asked my father, Arent you jealous? Anyone who knows my father and is older than 14 could probably guess his answer: Why would I be jealous? That is not what I set out to do. This typifies one of my fathers greatest strengths.

Though he achieved great success, Dr. Berman didnt compare his life to others and always took the time to enjoy the view from wherever he was and whatever path he was on, Seth said. When I think of my father, I think of a man who was truly content.

Bryan Marquard can be reached at bryan.marquard@globe.com.

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Dr. Harris Berman, HMO pioneer and former Tufts University School of Medicine dean, dies at 83 - The Boston Globe

Medicine must stop using race and ethnicity to interpret test results – New Scientist

By Layal Liverpool and Jennifer Tsai

Roberto Cigna

SHOULD your race or ethnicity influence the prescription you get from your doctor? Both are still used in medicine to interpret test results and guide treatment decisions, but the evidence is questionable and the approach can cause serious harm.

Medical guidelines in the US, UK and elsewhere often recommend the use of algorithms that contain adjustments for a persons race or ethnicity, from tools used to assess bone fracture risk to devices containing embedded racial or ethnic adjustments for measuring lung function. The latter can be partly traced back to the suggestion by US slaveholder Samuel Cartwright in the 1800s that Black people had naturally low lung capacity and so were healthier when enslaved.

These algorithms are finally coming under significant scrutiny. Recently, the US National Kidney Foundation and the American Society of Nephrology formally established a consensus against the use of race adjustment in kidney function equations. A similar race-based kidney test adjustment was also removed from UK medical guidance set by the National Institute for Health and Care Excellence (NICE). These decisions came in response to growing concerns that the race adjustment was contributing to underdiagnosis and undertreatment of kidney disease among Black people.

Yet race-based decisions are still permeating other parts of medicine with little evidence to support them. NICE, for example, has declined to review its guidance on high blood pressure treatment that recommends different drugs for Black people compared with everyone else. The guidance currently says that doctors should prescribe drugs called ACE-inhibitors to people under the age of 55 with high blood pressure unless they are of black African or African-Caribbean family origin, in which case they should receive different drugs.

Dipesh Gopal, a general practitioner who is also at Queen Mary University of London, and his colleagues have written to NICE twice over the past year requesting an urgent review of this guidance, but it declined in both cases, responding that evidence suggests there are clinically meaningful differences in the effectiveness of treatments for individuals in these family origin subgroups.

But Gopal and others dispute this evidence, particularly given that race and ethnicity are poorly defined social constructs with no biological basis. Indeed, according to the data, peoples treatment responses quite literally arent black and white.

In response to Gopal and his colleagues, and to the content of this article, NICE said that there is not a clear-cut biological and genetic homogeneity amongst all Black and White people and that the guideline does not account for people with mixed heritage. But it said performing the relevant tests on everyone wasnt possible due to the expense, and the additional time.

Using race or ethnicity as an indicator of biology in this way is lazy and imprecise. NICE and other health organisations globally should start systematic reviews of race-based recommendations across their guidelines immediately. A doctors glancing assumption about a persons race or ethnicity doesnt offer meaningful biological information that can guide medical decisions. They arent biological variables and cant be used as a proxy for genetic make-up.

This doesnt mean medicine should become colour blind. Racism clearly drives health inequities in many countries and this must be addressed. But perpetuating harmful and unscientific ideas about biological differences between races in medical guidance isnt the solution.

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Medicine must stop using race and ethnicity to interpret test results - New Scientist

Temple works to increase the number of Black men in medicine – Temple University News

Black male physicians at Temple gathered in the Lewis Katz School of Medicines Medical Education and Research Building on Nov. 5 for the third annual Evening for Black in Men Medicine: an event celebrating the achievements of and offering mentorship opportunities for Black premedical and medical students as they make their way into the medical field.

The evening was part of the Office of Health Equity, Diversity and Inclusions efforts to recruit, support, retain and advance high-quality medical students from backgrounds that are historically underrepresented in medicine, as well as to specifically address the ongoing shortage of Black men in medicine.

Black male medical students accounted for just 3.1% of the national medical student body in 1978. By 2019, the figure had declined to 2.9%. And the number of Black male matriculants to medical schools for more than 40 years has not surpassed the numbers in 1978.

According to a 2015 report by the Association of American Medical Colleges, there were 542 Black male matriculants in medical school in 1978. That was reduced to 515 in 2014.

Participants at An Evening for Black Men in Medicine. (Photography by Joseph V. Labolito)

The participants in attendance represented a range of Black male doctors from the Katz School of Medicine, Temple University Health System and the Greater Philadelphia region. Alongside them were pre-med students identified through Temples Pre-professional Health Studies Office, primarily from Temple and other local area colleges and universities, plus Temple medical students.

Abiona Berkeley, the interim senior associate dean of diversity, equity, and Inclusion at the Katz School of Medicine, and Amy Goldberg, the schools interim dean, were the first two speakers at the event.

Steuart Wright, a Black medical student at Temple, introduced Temple President Jason Wingard as a guest speaker.

During President Wingards speech, he asked the group questions like, What is the responsibility of Black men in medicine? and, Why do we need to increase the number of Black men in medicine?

The reason why were having this interactive dialogue is first to listen, to better understand what the communitys needs are and what the physicians or the aspiring physicians needs are,'' he said. You have to use the resources available to you. Build relationships. Secure resources, financial and intellectual, and identify stakeholders of all kinds, then put it all into practice and dont be afraid to take risks.

We have a commitment and a responsibility to the community, added President Wingard.

Wingard noted that there have been financial barriers for Black men trying to pursue a path in the medical field, as well as not having the background or the necessary resources.

One of the participants in the room asked President Wingard what he will do to help forge a tighter connection between the university and the community to make it easier for Black physicians to serve the community.

I'm going to listen, execute fearlessly, leverage our resources, raise money and apply it to the places in need. We want this room to be full of Black men in medicine, said President Wingard. We want Philadelphia and Temple University to be the leaders in dialogue around this topic.

Also speaking at the event was Provost Gregory N. Mandel, who said one of Temples primary goals is to provide education that is affordable and accessible to a diverse student body.

Many people face not having a parent who was in the health profession, so they may not know the steps to take. We are thinking about how to get information out in order to provide a support system with both a diverse and inclusive environment where everyone can participate, said Mandel.

Deric C. Savior served as the keynote speaker at the Evening for Black Men in Medicine event. (Photography by Joseph V. Labolito)

Deric C. Savior, head of the medical oncology section in Fox Chase Cancer Center at Temple University Hospital and an associate professor in the Department of Hematology/Oncology, also spoke with the group.

Savior specializes in treating lung, head and neck cancers and has earned recognition from Best Doctors in America and Medical Oncology and Hematology in 20152016 and 20192020 and Top Doctors, Medical Oncology and Philadelphia magazine in 20182021.

Savior added to his list of accomplishments by receiving the 2021 Black Men in Medicine Award at Temple.

Following the presentations, the participants gathered for conversation and networking over dinner in the Medical Education and Research Building.

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Temple works to increase the number of Black men in medicine - Temple University News

How to uncover your purpose and thrive in veterinary medicine – DVM 360

In a recent interview with dvm360, Dr Mia Cary revealed pointers on how veterinary professionals can lead successful career paths, starting with formulating a purpose.

At the Atlantic Coast Veterinary Conference (ACVC), Mia Cary, DVM, compiled a list of her top 3 ways that can help veterinary professionals become successful within their career, plus highlights a few resources professionals can utilize to get started.

View the video below for the entire discussion. The following is a partial transcript:

Mia Cary, DVM: When I launched my own business, I spent a lot of time thinking about what matters most to me, and I created a personal purpose statement that also became my professional purpose statement. [My purpose statement] is simply activating others to thrive, and that allows me [to decide] what to say yes to, and what to say no to. So, I think knowing your purpose is extremely important.

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How to uncover your purpose and thrive in veterinary medicine - DVM 360

Scipher Medicine to Present at the Jeffries London Healthcare Conference – Business Wire

WALTHAM, Mass.--(BUSINESS WIRE)--Scipher Medicine, a precision immunology company matching patients with their most effective therapies, today announced that Alif Saleh, Chief Executive Officer, and John Strumbos, Chief Financial Officer, will participate in the Jeffries London Healthcare Conference, November 16-19.

Scipher Medicine will present from London at 10 a.m. GMT on Tuesday, November 16, and management will be available for in-person and virtual investor meetings during the conference. A live webcast of the conference presentation will be available here.

About Scipher Medicine

Scipher Medicine, a precision immunology company matching patients with their most effective therapies, believes that patients deserve simple answers to treatment options based on scientifically backed data. Using spectra, our proprietary network medicine platform, and artificial intelligence, we commercialize blood tests revealing a persons unique molecular disease signature and match it to the most effective therapy, ensuring optimal treatment from day one. The patient molecular data generated from our tests further supports the discovery and development of novel and more effective therapeutics. We partner with leading payers, providers, and pharmaceutical companies to bring precision medicine to autoimmune diseases. Visit http://www.sciphermedicine.com and follow Scipher Medicine on Twitter, Facebook, and LinkedIn.

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Scipher Medicine to Present at the Jeffries London Healthcare Conference - Business Wire

Disc Medicine Announces Oral Presentation on Bitopertin at the 63rd American Society of Hematology Annual Meeting – PRNewswire

CAMBRIDGE, Mass., Nov. 11, 2021 /PRNewswire/ --Disc Medicine, a clinical-stage biopharmaceutical company focused on the discovery and development of novel treatments for patients suffering from serious hematologic diseases, today announced that the company and its collaborators at Boston Children's Hospital have been selected to give an oral presentation at the upcoming 63rd American Society of Hematology (ASH) Annual Meeting and Exposition, which will be held in Atlanta, GA on December 11-14, 2021.Disc will present data from studies of bitopertin, the company's orally available glycine transporter 1 (GlyT1), in preclinical models of Erythropoietic Protoporphyria (EPP) and X-Linked Protoporphyria (XLP).

Details of the presentation are as follows:

Abstract Number:760

Title:Proof of Mechanism Studies with Bitopertin, a Selective Glycine Transporter 1 Inhibitor Under Development for the Treatment of Erythropoietic Protoporphyria (EPP) and X-Linked Protoporphyria (XLPP)

Date / Time:Monday, December 13, 2021: 5:15 PMSession:102. Iron Homeostasis and Biology: Disorders of Iron and Heme and Novel treatments Presenter:Paul Schmidt

Full abstract currently available through the ASH conference website: https://ash.confex.com/ash/2021/webprogram/Paper150441.html

About Bitopertin

Bitopertin is designed to be an oral, potent, and selective inhibitor of GlyT1, a key membrane transporter required to supply developing red blood cells with sufficient glycine to support erythropoiesis. Glycine is an essential component of heme and by limiting glycine uptake in newly forming red blood cells, bitopertin is designed to modulate heme biosynthesis to potentially treat a range of hematologic disorders associated with the biosynthesis of heme and hemoglobin. Bitopertin has been evaluated in a comprehensive clinical program focused on certain neurological disorders conducted by Roche in over 4,000 individuals, which demonstrated the activity of bitopertin as a GlyT1 inhibitor and suppressor of heme biosynthesis. In preclinical studies in human and animal models of erythropoietic protoporphyria (EPP) and X-linked protoporphyria (XLP), bitopertin was shown to significantly decrease PPIX, a toxic intermediate of heme synthesis that is the underlying cause of the disease. Disc Medicine is planning to develop bitopertin as a potential treatment for patients with EPP and XLP as well as a range of other hematologic diseases. Bitopertin is an experimental agent and is not approved for use as a therapy in any jurisdiction worldwide.

About Disc Medicine

Disc Medicine is a clinical-stage biopharmaceutical company that is dedicated to transforming the lives of patients with hematologic disorders. We are building a portfolio of innovative, first-in-class therapeutic candidates that affect fundamental pathways of red blood cell biology. Disc Medicine is committed to developing treatments that empower and bring hope to the many patients who suffer from hematologic disease. For more information, please visit http://www.discmedicine.com.

SOURCE Disc Medicine

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Disc Medicine Announces Oral Presentation on Bitopertin at the 63rd American Society of Hematology Annual Meeting - PRNewswire

‘Laughter the best medicine to move away from COVID’ – SooToday

Comedian Pete Zedlacher performs in Sault Ste. Marie on November 27 at Soo Blaster

If anyone needs a laugh right now, its everyone.

With Covid quarantines and lockdowns behind us for now, stand-up comic Pete Zedlacher has been back on stage and is noticing that laughter really is the best medicine.

Im getting so many compliments after the shows with people saying I didnt realize how much I missed other human beings in an experience watching a comedian perform and sharing the laughter, he said.

It really reminds us that we are all part of this big tribe and being separated from each other has been very trying.

Zedlacher will be performing in Sault Ste. Marie on Nov. 27 at Soo Blaster.

Born and raised in Wawa, Zedlacher has fond memories of driving into the Sault as a boy, seeing the bright lights of the city and the water tower.

Sault Ste. Marie was a big city to me. It was exciting when I got to the Sault, he said.

Soon as I saw the water tower coming in and then the stop lights. Oh my God it was exciting. And then youd go to the Station Mall and ride the escalators at Sears. It was all very exciting.

But, seriously, folks, Zedlacher, who now lives in Calgary, says getting back to live shows couldnt come soon enough.

Just as many saw their workplaces move online, so did Zedlacher, and hes had about one Zoom call too many.

I did some Zoom shows where you perform stand-up comedy into your laptop and people tune in from their living rooms, and it sounds just as fun as Ive described, he said.

People are not apt to laugh while theyre staring into their laptop. When you put a wi-fi signal and two screens in front of it, its very removed."

Inspired by comedians like David Letterman and television shows like Saturday Night Live, there is one true comic that stands out as having influenced Zedlachers decision to become a comedian Fozzie Bear.

I was a very little boy, and I was watching The Muppet Show and Fozzie Bear said he was a comedian and I turned to my mom and said, What does that mean hes a comedian? and my mom told me thats his job, thats what he does, he makes people laugh, and she said I sat there for a couple of seconds and nodded and said, Yup, Im going to be a comedian.

Fast forward 30 years to a Just For Laughs comedy festival that brought it all full circle for Zedlacher.

The Muppets are hosting the gala and I had to follow Fozzie Bear. Im in the wings and Im watching Fozzie Bear warm up the audience before I hit the stage, he said.

Zedlacher has won many awards including a Canadian Comedy Award for Best Male Standup and a Sirius XM Top Comic Award. He has had multiple Canadian Comedy Award nominations and two Gemini nominations.

Besides stand-up comedy, Zedlacher also has many credits in television writing and acting. Highlights include The Ron James Show, The Hour With George Stroumboulopoulos, The Jon Dore Television Show, and CBC Radios The Debaters.

Zedlacher also appeared on a few episodes of Degrassi: The Next Generation, playing a cop alongside Aubrey Graham, aka Drake.

Zedlacher jokes about that time, saying he encouraged Drake to pursue his musical dreams after the then-actor said he wanted to try his hand at rap and hip hop.

I told him he should do it. And he said yeah? And I said yeah, youve got a real shot at it and he looked at me and said thanks, man, and I said, cool, and you know, two years later hes Drake. Hes like the biggest recording artist in Canadian history and he still has not thanked me.

Zedlacher is looking forward to his show in the Sault in a few weeks and hopes many will get out of the house and share in the laughter.

I cant stress enough how important that is for us as human beings to share in moments like that, he said.

Theres nothing like being in a comedy audience and theres that loud laugher off to your left who makes you laugh even harder, and just the energy in the room between the performer and the audience. Its a magical experience that cant be matched on Netflix or CBC Radio, you know, its got to be seen live.

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'Laughter the best medicine to move away from COVID' - SooToday