Letter to the editor: Progress on Turtle Creek – TribLIVE

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The article Murrysville library program will focus on Turtle Creeks history, recovery (June 25, TribLIVE) stated that in the early 1970s, members of the Turtle Creek Watershed Association began working with the University of Pittsburgh and the state to make the stream more hospitable for aquatic life. An earlier Trib article noted that one of the worst mine drainages is into Brush Creek, which flows into Turtle Creek, in Irwin.

I live downstream from Irwin, and I have had a large turtle (1 foot across) come into my yard from Brush Creek to eat the fish in my pond several times. The turtle was orange from the creek. Also I have had great blue herons, mallard ducks and Canada geese come into my yard from the creek. So the association must be making some headway.

Brush Creek is doing well, but a problem with Turtle Creek is that the Army Corps of Engineers built steep cement sides for flooding stabilization, which doesnt help wildlife but helps to prevent peoples homes from being flooded.

Susan Stiles

North Huntingdon

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Letter to the editor: Progress on Turtle Creek - TribLIVE

Purdue Deal Comes Amid Progress on Opioid Litigation. What to Expect Next. – Barron’s

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A major development on Thursday in the bankruptcy of the maker of the painkiller OxyContin is one more sign of progress in the long-stalled efforts to resolve the litigation over the opioid crisis.

Attorneys general for a handful of states, including New York, ended their opposition to Purdue Pharmas bankruptcy plan, clearing the way for a $4.5 billion settlement.

The progress comes many years into the effort by state and local governments to hold makers, distributors, and sellers of prescription opioids responsible for the opioid crisis, which killed nearly 500,000 people between 1999 and 2019, according to the Centers for Disease Control and Prevention.

In a cover story in the fall of 2019, Barrons reported that the enormously complex litigation, involving thousands of plaintiffs and a diverse range of defendants, was entering a critical phase.

The Covid-19 pandemic, however, derailed progress, as court dates were canceled and trials postponed.

The CEO of one of the many defendants in the sprawling litigation, Teva Pharmaceutical Industries (ticker: TEVA), told Barrons in May 2020 that the postponement of a key trial in New York had pushed off the finalization of a settlement deal.

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Unfortunately in these cases it seems like the lawyers dont really get the final things done until you have some time pressure, and that probably means we wont see a final settlement until we get close to a new, rescheduled New York trial, Teva CEO Kre Schultz said at the time.

That New York trial, the first opioid trial to be held before a jury, has finally started. Opening statements began in late June. There are also trials ongoing in state court in California and in federal court in West Virginia.

Whats more, Johnson & Johnson (JNJ) in late June reached a $230 million settlement with New York state in late June, in advance of the start of the trial. The company said at the time that the settlement wasnt an admission of liability or wrongdoing.

Movement on this trial may advance completion of a final settlement with the plaintiffs, UBS analyst Kevin Caliendo wrote at the time. JNJ has now set a bar here, potentially catalyzing other defendants to reach settlements and failure to do so will not bode well for sentiment.

Those additional settlements have not yet come. Even if they do, theres still a theres a long way to go. The so-called multidistrict litigationa massive proceeding in federal court in Cleveland that brings together thousands of separate casesis working toward a number of trials, including one set to begin in October.

The litigation has been a long-term overhang for shares of some of the defendants. This year, shares of some of the generic drugmakers that are defendants in the cases have fallen, including Teva, which is down 3.7%, and Endo International (ENDP), which is down 46%.

Shares of drug distributors are doing better this year, with AmerisourceBergen (ABC) up 18% and Cardinal Health (CAH) up 6.6%, while the S&P 500 is up 16%.

Write to Josh Nathan-Kazis at josh.nathan-kazis@barrons.com

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Purdue Deal Comes Amid Progress on Opioid Litigation. What to Expect Next. - Barron's

Gene therapy for sickle cell disease: progress and competition – BioPharma Dive

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Editor's note: BioPharma Dive, as part of our gene therapy coverage, is taking a closer look at inherited diseases for which researchers are developing genetic medicines. We aim to give a brief overview of the pipeline and lay out what could come next for such drugs. This, on sickle cell disease, is our latest.

Sickle cell disease is one of the world's most common inherited blood disorders, though that isn't reflected in the number of treatments for it. Three new drugs hit the market between 2017 and 2019. But before those additions, nearly two decades had passed since the Food and Drug Administration last approved a sickle cell medicine.

Now, a handful of companies are looking to not just treat the disease, but potentially cure it. Their goal, broadly, is to fix the mutations that cause sickle cell through the use of cutting-edge gene editing technologies. One of these treatments has already advanced to the final stage of human testing, and is expected to be submitted for approval late next year or early in 2023.

A one-time, possibly curative treatment would be momentous, as the median life expectancy for someone living with sickle cell is estimated to be between 45 to 55 years in the U.S. The disease also causes strokes, organ damage and episodes of severe pain known as vaso-occlusive crises. Genetic medicines developed by Bluebird bio and by CRISPR Therapeutics and Vertex Pharmaceuticals have shown promising signs that they can mostly eliminate vaso-occlusive crises, although further testing is needed to better understand if they have limitations or if their effects might wear off over time.

Such treatments raise tough questions, though. Gene-based treatments are very expensive and fairly difficult to make, which presents a major problem in sickle cell given that many people with the disease live in lower-income countries. Drug developers like Novartis say they're tailoring their work to address some of these issues, but it's unclear how well they'll be able to remedy long-standing problems of access and equity.

Sickle cell is caused by mutations in the gene that creates hemoglobin, the protein on red blood cells responsible for carrying oxygen.

Patients therefore experience the disease differently depending on their genetic make-up. Those with two copies of the mutated gene have more serious symptoms, like anemia, which happens because sickled red blood cells die much sooner than their healthy counterparts.

Sickled cells are also hard, sticky and misshapen, so they pose the threat of clumping together and causing a stroke.

In more severe cases, the symptoms require patients to get blood transfusions. There are also a few medications available specifically for complications of the disease, in particular the painful episodes that happen when sickled cells clog a blood vessel. The FDA approved a drug called hydroxyurea in the late 1990s for adults experiencing these vaso-occlusive crises. Then it approved another, an oral powder, in 2017.

In 2019, the FDA cleared two more medicines for market: Novartis' Adakveo, which helps reduce the frequency of vaso-occlusive crises, and Global Blood Therapeutics' Oxbryta, which is meant to inhibit red blood cells from sickling and breaking down. Novartis and Global Blood set the monthly list prices for their drugs between $7,000 and $10,400.

Additionally, a cure for sickle cell exists in the form of bone marrow transplants, though the treatments can cause life-threatening side effects and even death.

As with other diseases, genetic medicines for sickle cell are being positioned as long-lasting and, potentially, curative treatments.

If the therapies now showing promise continue to prove effective over time, they could eliminate the long-term symptoms of sickle cell, allowing patients to go without blood transfusions. Lessening or removing the need for blood transfusions would both lower the cost of care as well as avoid the related buildup of iron in the blood, which can require separate treatment.

Gene-based treatments could also prevent vaso-occlusive crises a main reason for hospitalization among sickle cell patients, who sometimes need strong painkillers like opioids.

Some clinical studies of sickle cell gene therapies are enrolling children. However, should any therapy come to market, older children or adults would likely be the first recipients, given the risks and uncertainties.

A handful of companies have ushered genetic medicines for sickle cell into clinical trials, with the majority still in earlier stages. The farthest along is Bluebird's LentiGlobin, which is designed to deliver an engineered version of the gene that codes for hemoglobin.

SOURCE: Companies, clinicaltrials.gov

To make LentiGlobin, Bluebird takes a patient's stem cells, uses special viruses to outfit them with the corrected gene and then reinfuses them.

This is different from the gene-editing approach favored by several other main developers. At least two sets of partners CRISPR and Vertex, and Novartis and Intellia Therapeutics are using the Nobel Prize-winning CRISPR-cas9 technology to get stem cells to produce high levels of what's known as fetal hemoglobin. Fetal hemoglobin is a form of the vital protein, but it stops being produced roughly six months after a person is born. Gene editing, in theory, keeps the switch for this protein on, helping remedy the main problems associated with sickle cell.

Genetic medicines have already shown promise treating sickle cell. A small study of Bluebird's found that, after treatment, hemoglobin levels were close to what's considered normal, and almost no patients experienced vaso-occlusive crises or acute chest syndrome, another symptom of the disease.

CRISPR and Vertex gave a similarly positive update on their program last month. The companies' said that the small group of sickle cell patients given their therapy, named CTX001, had yet to experience vaso-occlusive crises following treatment. Data also suggest their therapy can have a long-lasting effect.

The breakthroughs didn't come without setbacks, however. Bluebird's LentiGlobin program has faced multiple delays tied to manufacturing and safety concerns. In February, the company halted two of its sickle cell studies after one participant developed leukemia and another appeared to have a disease of the bone marrow. Bluebird has since conducted an investigation and determined its therapy was "very unlikely" to be related to the cancer case.

In April, Bluebird said the bone marrow diagnosis had been revised to a condition known as transfusion-dependent anemia.

Bluebird was allowed to resume its sickle cell studies in June. Prior to the study halt, the company had said it planned to ask for approval in late 2022, although that may now be delayed.

Sticking to that timeline would put Bluebird well ahead of rival therapies, according to an analysis by the investment bank Raymond James. The next closest is CRISPR and Vertex's treatment, which Raymond James analysts think could be submitted for approval in two to three years. Testing, after a slower start, is now moving quickly, however.

Behind that, genetic medicines from Aruvant Sciences and partners Sanofi and Sangamo Therapeutics are on track to be filed in three to five years, according to Raymond James.

In the meantime, there are many uncertainties to contend with. Researchers are still trying to understand whether genetic medicine will work for all sickle cell patients, or whether it'll live up to its potential as a lifelong fix for the disease.

Even if these treatments do reach the market, they'll likely still face challenges. For example, therapies currently in development use toxic conditioning regimens to prepare patients' bodies for cell reinfusion, and that may restrict who's able or willing to receive them.

In a recent note, analysts at Stifel wrote that they see the toxic regimens as "limiting the commercial opportunity" for the kinds of treatments being developed by Bluebird, Vertex and CRISPR. "We of course view these events in the context of profound efficacy," the analysts wrote, "but even so, we don't expect the risk/benefit of these agents to resonate with younger, more mild patients."

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Gene therapy for sickle cell disease: progress and competition - BioPharma Dive

The Facts on Pattern-or-Practice Investigations – Center For American Progress – Center For American Progress

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This fact sheet will be periodically updated to account for new policy developments. It was last updated on July 8, 2021. Click here to view other fact sheets in this series.

On April 21, 2021, one day after a Minneapolis jury convicted former police officer Derek Chauvin for the murder of George Floyd, U.S. Attorney General Merrick Garland announced that the U.S. Department of Justice (DOJ) had opened an investigation into the city of Minneapolis and the Minneapolis Police Department (MPD). The civil probe will assess whether the MPD engages in a pattern or practice of unconstitutional or unlawful policing, marking the first pattern-or-practice investigation under the Biden administration. Less than a week later, Garland announced a second investigation, this time into the Louisville/Jefferson County metro government and the Louisville Metro Police Department, whose police officers shot and killed Breonna Taylor in her apartment while executing a no-knock search warrant.

As the DOJ under the Biden administration ramps up its use of pattern-or-practice investigations, here is what you need to know about this vital tool for bringing about police reform and accountability.

In 1994, in the aftermath of an independent commissions finding that linked the beating of Rodney King to institutional failure within the Los Angeles Police Department, Congress authorized the attorney general to investigate law enforcement agencies for a pattern or practice of conductthat deprives persons of rights, privileges, or immunities secured or protected by the Constitution or laws of the United States. These investigations, commonly referred to as pattern-or-practice investigations, focus on widespread or systemic misconductas opposed to isolated or sporadic instances of wrongdoingwhich might include routine uses of excessive force; repeated stops, searches, or arrests that are unreasonable; and discrimination based on race, ethnicity, national origin, religion, disability, or sex. As such, pattern-or-practice investigations differ from criminal civil rights prosecutions of individual law enforcement officers by the DOJ, which focus on specific instances of police misconduct.

The Civil Rights Division of the DOJ first identifies potential subjects for investigation by examining publicly available information, allegations brought by witnesses and complainants, and its own research on common or developing issues in law enforcement nationwide. If the division decides to open a probe, the Special Litigation Section immediately engages a variety of stakeholders in the jurisdiction, including community members and victims of police misconduct, officers at all levels of rank, police unions and affinity groups, and local government leaders. And while no investigation is the same, almost all involve reviewing written policies and systems for accountability, observing officer training and activities, and analyzing data of relevant incidents.

At the end of the probe, the division issues its findings in a public report or letter. If the law enforcement agency is found to have engaged in a pattern of unconstitutional or unlawful policing, the division can negotiate a reform package with the police department to remedy the systemic failures identified during the investigation. A federal court signs off on the legally binding agreement, called a consent decree, and often appoints an independent monitoring team to oversee the implementation of the mandated reforms. Alternatively, the DOJ can offer reform recommendations that are not legally binding in a technical assistance letter or negotiate a memorandum of agreementa court-enforceable contract that is similar to a consent decree but does not require ongoing oversight. If an agreement cannot be reached, the division may look to compel the reforms through civil litigation.

Building on this federal model, a number of states have statutorily empowered their state attorneys general to conduct their own pattern-or-practice investigations. In 2000, California became the first to do so, prompting then-state Attorney General Bill Lockyer to secure a consent decree with the Riverside Police Department a year later. In the wake of national protests against police violence in 2020, Colorado, Virginia, and Nevada passed similar legislation aimed at combating systemic police misconduct. With this newfound authority, Colorado Attorney General Phil Weiser opened a pattern-or-practice investigation into the Aurora Police Department following the death of Elijah McClain. Similarly, Virginia Attorney General Mark Herring announced that he was investigating patterns or practices of misconduct within the Windsor Police Department after its officers pepper sprayed a Black U.S. Army medic in uniform while holding him at gunpoint during a traffic stop.

Critics of pattern-or-practice investigations have arguedthat the resulting police reform agreements tie the hands of police officers and therefore undermine public safety. But research suggests the opposite to be true. For example, a study from the Harvard Kennedy School found that Los Angeles experienced lower crime rates and a higher quality of enforcement activity after its police department implemented a consent decree.

While some opponents point to data showing crime spikes in certain jurisdictions immediately after they entered into reform agreements, such increases have been temporary and diminished over time. In fact, the Center for American Progress found that in all 10 analyzed jurisdictions that fulfilled a reform agreement, violent crime rates declined in the years thereafter. Moreover, research from the University of Pennsylvania found that the use of consent decreeswhen accompanied by court-appointed monitoringwas linked to a 29 percent reduction in officer-related fatalities.

Kenny Lo is a former research associate for Criminal Justice Reform at the Center for American Progress.

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The Facts on Pattern-or-Practice Investigations - Center For American Progress - Center For American Progress

Commissioners get updated on progress of comprehensive plans – Norfolk Daily News

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MADISON Input is continuing to be gathered to update the comprehensive plans of Madison and Pierce counties.

Earlier this week, the Madison County Board of Commissioners was given an update on the process from Lowell Schroeder, who represented Five Rule Rural Planning, which has been hired to oversee and lead the updates.

The Kearney-based company had done planning work in Pierce County in recent years and was selected to update the plan after proposals were sought.

Cities and counties are urged to update their comprehensive plans at least once every 20 years. A USDA Rural Development grant is paying for a significant part of the updates.

Schroeder, a community planner with Five Rule Rural Planning, said a website had been developed at http://www.riseourregion.com where people can get updates. The current work includes interviews with people.

Really what the project (consists of) is gathering information and hard data and getting public input and pulling all the information together for the county to meet the requirements to update the county comprehensive plan, Schroeder said.

Schroeder, who formerly worked for the Northeast Nebraska Economic Development District, said the comprehensive plan would provide useful information on which the planning commission can base its decisions, among other things.

Commissioner Ron Schmidt said one of his concerns would be that as cities and towns grown, their territorial jurisdiction grows. With Norfolk, for example, it extends 2 miles from the city limits. With towns, the limit is 1 mile.

Schmidt said the concern is that sometimes there can be feedlots or other intense agricultural uses established. But as the city grows, there is pressure to allow competing residential or other uses located next to the agricultural uses.

Schroeder said that is a concern, and there will be opportunities for public discussion with the updates. It also will include a public hearing before the Madison County Board of Commissioners for final approval.

Along with both Pierce and Madison counties, the communities in the counties are also updating their plans if they havent done so recently.

ECAP, or the Entrepreneurial Community Activation Process, is run by the University of Nebraska and will be conducting a strategic planning process for the communities.

Schroeder said part of the update includes updating the conditions of the bridges in the county. Schroeder said he would contact Dick Johnson, county roads superintendent, to start compiling that information for Madison County.

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Commissioners get updated on progress of comprehensive plans - Norfolk Daily News

Research Updates: Making Progress on an ‘Antibiotic Nightmare’ – UPJ Athletics

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Mycobacterium abscessus is among the deadliest bacteria in the world, earning the nickname antibiotic nightmare among clinicians. With millions of cases of antibiotic-resistant infections each year in the U.S. alone, developing alternate therapies is ever more important to keeping the clinicians toolbox full.

A new paper from biologist Graham Hatfull,published today in Nature Medicine, advances the science behind bacteriophage therapy to help treat antibiotic resistant lung infections.While the case described in the paper did not result in a cure for the patient, it was an example of how researchers can learn from all circumstances to advance knowledge that will improve treatment for others.

Its not just M. abscessus infections: Graham Hatfulls team is also investigating whether phages could help people with tuberculosis, which is becoming increasingly resistant to antibiotics and which kills more than 1.5 million people each year worldwide. Ina March 2021 paper, Hatfulls group proposed a five-phage cocktail that was effective in killing a broad spectrum of Mycobacterium tuberculosis strains.

This case study certainly provides key insights into how best to use bacteriophages therapeutically, said Hatfull, who is the Eberly Family Professor of Biotechnology and HHMI Professor at Pitt.

Hatfulls lab has identified and sequenced the genes of thousands of phagesbacteria-killing virusesto see which can integrate with bacterial DNA and interrupt its expression, effectively stopping infection. In 2019,he proved this kind of treatment can really work.

A British teenager with cystic fibrosis was ravaged by an infection of M. abscessus. While researching experimental treatment options, her mother learned about Hatfulls lab and contacted him about giving phage treatment a try. The cocktail of intravenous and topical phages slowed the infection and saved her life.

Based on this success, Hatfull and his team earned international acclaim. When he presented the teens case at a 2019 seminar, it caught the attention of a pulmonologist at Johns Hopkins University, Keira A. Cohen, who had been caring for a man with a lung infection of M. abscessus. Could phages help this patient, too?

The new paper describes him as an older man with lung diseases stemming from two infections, M. abscessus and Mycobacterium avium complex. He wasnt responding well to traditional multidrug therapy, and he was also having side effects from his prolonged use of antibiotics including hearing loss, balance problems and weight loss. His infection and quality of life were so bad that he was referred to palliative care.

Hoping for a dramatic turn, Cohen sent a sample of her patients mycobacterial species to theHatfull Lab. It turned out that the mans M. abscessus strain was susceptible to the same three phages used in the London patient. After getting approval from their local institutions and compassionate use permission from the Food and Drug Administration, they gave the treatment a shot.

Unlike the antibiotics, the patient didnt have negative reactions to the therapy, which was delivered intravenously. However, he also didnt have a sustained reaction like the London patient. During treatment, his bacterial levels dropped, but on prolonged phage administration, they rebounded. His immune system had waged a strong response against the phages.

The researchers posit that the key lies in the immune reaction. The London patient had had a double-lung transplant and was on immunosuppressing drugs at the time of her phage therapy. Its possible, they theorize, that those drugs prevented or delayed her immune systems response to the phages, which gave them time to neutralize the infection.

Even though the phage therapy didnt provide lasting relief to this second patient, it still marks an important push forward in scientists search for treatments for drug-resistant lung infections.

First, they suspect that an aerosolized delivery, similar to an asthma inhaler, might be a good alternative to an injection to target disease in these types of patients. Cohen, whos co-author on the new paper, is currently trying that approach on the elderly patient. Second, the authors suggest that using the phages sequentially rather than altogether, could help to stay one step ahead of the immune system.Lastly, future trials could potentially employ immunosuppressing drugs to confirm whether that indeed is the factor that helped the London patients therapy succeed.

This story was written by Robyn K. Coggins, managing editor of Pittwire.

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Research Updates: Making Progress on an 'Antibiotic Nightmare' - UPJ Athletics

Disappointment with P11 in Austria a sign of Williams’ progress, says team boss Capito – Formula 1 RSS UK

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George Russell came agonisingly close to scoring his first point for Williams in the Austrian Grand Prix, and while the teams CEO Jost Capito was disappointed, he said that disappointment showed just how far the squad have come.

Williams havent scored a point since Germany 2019 37 Grands Prix ago but Russells finish of 11th from eighth on the grid brought them mighty close last weekend in Austria, and the Briton has been on a run of stellar races including P12 in France, and a 10th-place qualification next time in Styria that unfortunately led to a DNF.

READ MORE: Alonso says fight for P10 was like a title battle but admits he was a bit sad to snatch P10 from Russell

The teams CEO Capito said that the fact that everybody is disappointed that Williams only scored 11th and not better in Austria was a good omen.

Im very disappointed and Im very happy that everybody is disappointed because four weeks ago everybody would have triumphed for 11th place, he explained. Twelfth place in France was fantastic and now being disappointed with 11th shows the fire of the team and the enthusiasm the team has now, that they want more; they are not happy with a result that doesnt deliver points.

2021 Austrian Grand Prix: Russell and Alonso battle in Spielberg

Asked whether Russells P11 in Austria was better than his P12 in France, Capito replied saying that both were a fine achievement but more importantly, they served as an emblem of the teams rapid improvement.

READ MORE: They want to win New Williams management are not messing around says Russell

France was fantastic race for him and this was a fantastic race for him, as was last week [Styria]. I think if we would have, as I said before the triple header, what we would achieve in these three races, everybody would have said youre completely crazy never ever.

Now we are even disappointed with these results and I think this shows the way we are taking with the team, he reiterated.

George Russell: 'Keeping a guy like Fernando behind was nigh on impossible'

With Russells home Grand Prix at Silverstone up next, Capito backed him for another solid result depending on the weather.

READ MORE: Carlos Reutemann an enigmatic genius remembered

Its very dependent on the weather conditions. I think everybody knows by now our car is very tricky in windy conditions and Silverstone is known [to be] very windy! he said.

I think if its very windy we might struggle; if its not that windy then we might have a chance to be somewhere close to where we were here, said Capito.

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Disappointment with P11 in Austria a sign of Williams' progress, says team boss Capito - Formula 1 RSS UK

Quintana Roo has made considerable reactivation progress with 90 percent of projects resuming says governor – Riviera Maya News

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Cancun, Q.R. The government of Quintana Roo says with the reactivation of tourism in the face of the pandemic, the state has made considerable progress. Governor Carlos Joaquin says that 90 percent of the projects that were postponed due to the pandemic, have restarted.

There are currently 5,000 hotel rooms being built, he reports, in addition to shopping malls. According to state government information, the companies that have reactivated construction include AM Resorts, Grupo Posadas, Grupo Lomas and Grupo Tafer, with its Garza Blanca properties.

Joaquin says some of those projects will be completed by the end of this year, while others are anticipated to be finished in early 2022.

The governor reported that 122,000 jobs were lost last year, which represented 25 percent of all jobs in the state, however, they are expected to be recovered in July.

The governor also highlighted the reactivation in air connectivity, which he stresses, is nearing pre-pandemic figures with 518 daily operations, close to the 600 before covid. Tourism officials for the state are anticipating an 80 percent recovery for the upcoming summer months. He points out that the state is expecting around 2.8 million tourists, which for the same time in 2019, was 3.5 million.

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Quintana Roo has made considerable reactivation progress with 90 percent of projects resuming says governor - Riviera Maya News

Little progress seen in Texas refinery lockout talks – Reuters

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United Steelworkers (USW) union members picket outside Exxon Mobil's oil refinery amid a contract dispute in Beaumont, Texas, U.S., May 1, 2021. Exxon locked out the plant's about 650 union-represented employees citing fears of a strike. REUTERS/Erwin Seba/File Photo

HOUSTON, July 6 (Reuters) - Exxon Mobil (XOM.N) and United Steelworkers (USW) said little progress was made in talks on Tuesday between company and union negotiators to end a nine-week lockout of 650 workers at a Beaumont, Texas refinery and lube oil plant.

Exxon made counter offers to proposals offered by USW Local 12-243, which represents workers at the 369,024 barrel-per-day (bpd) refinery and adjoining lube oil plant, said Hoot Landry, USW International representative.

"They made five counters, one was moving in the right direction," Landry said.

Exxon spokesperson Sarah Nordin confirmed the meeting.

"The company's bargaining team met with the union today," Nordin said. "After discussion, both sides remain far apart. The company's current offer remains available for a vote by the membership."

Exxon locked out the workers on May 1, citing the risk of a strike.

The USW has said the companys last proposal requires its members to give up long-standing seniority and would create a separate contract for workers in the lube oil plant from that for workers in the refinery.

Exxon has said the proposal would give it flexibility to be profitable in low-margin environments.

Reporting by Erwin Seba; Editing by Stephen Coates

Our Standards: The Thomson Reuters Trust Principles.

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Little progress seen in Texas refinery lockout talks - Reuters

Hundreds of unsheltered homeless living in downtown Austin the progress on Prop B – KXAN.com

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AUSTIN (KXAN) The Austin Police Department, Austin Fire Department and Austin-Travis County EMS met with public safety commissioners on Tuesday afternoon to discuss the implementation and enforcement of Proposition B, the homeless camping ban.

APD Lieutenant Lee Davis, who oversees homeless community outreach, shared some data points: Since Prop B passed, there have been 114 people who have been connected to services during the education and outreach phase. As of July 1, 382 warnings have been delivered to those experiencing homelessness and there has been a 21% reduction of tents on city streets.

The big question that remains, Lt. Davis said, is where officers will direct people when citations are issued beginning July 11, the day Phase 3 is scheduled to begin.

If we are going to ask folks to leave, we ought to have a place to take them, Lt. Davis said.

Davis spoke to the complexity of establishing and enforcing a coordinated and consistent procedure that yields progress and also treats people humanely. He said APDs emphasis will continue to be on connecting people to services and resources. He also asked for patience and help from the community during the process.

APD cannot be the tip of the spear, but rather a link in the chain. And so we are going to be a wheel within a wheel. And our goal is to bring in as many folks who want to be a part of this as possible, Lt. Davis said.

Bill Brice, the Vice President of the Downtown Austin Alliance, was also invited to speak at the public safety commission meeting. The DAA did not have a direct role in implementing Prop B, but has paid close attention to daily operations on behalf of its clients who live and work downtown.

Brice said the DAA has begun sending ambassadors out on the streets once a month to count the amount of unsheltered homeless people living within the public improvement district, which encompasses most of the downtown sector. As of June 17, Brice said there were 808 unsheltered homeless individuals living on the street, in cars or in tents.

Brice expressed disappointment at the slow progress, which he says is driving people away from visiting Austin.

The reinstatement of the aggressive solicitation laws also went into effect as did the ordinance against sitting and lying in the public rights of way, we see little enforcement of those ordinances happening right now, Brice said. These are significant problems that are turning away visitors, that are concerning tenants, residents, people that are occupying office space and other buildings downtown.

Brice echoed Lt. Davis sentiment, saying the community needs to come to an agreement of finding a suitable place to send people once the next phase of the ordinance goes into effect.

Phase 3 of the ordinance begins July 11 and continues until Aug. 7. Austin Police have the power to issue citations to anyone not following the law. A 72-hour notice will be issued before an encampment clean up begins. During clean up, anyone still on the premises may be cited or arrested.

If we dont want people living unsheltered under bridges, in parks, in woods, greenspaces, high fire dangers, flood risk areas, then we have to say yes to have appropriate facilities for them to be, Brice said.

APD is still working on a diversionary program that will connect people to services before an arrest or citation occurs to keep from taking them to community court or jail.

Reach KXANs Education Reporter Alex Caprariello by emailatalexc@kxan.comor by phone at512-703-5365, or find him onTwitterandFacebook.

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Hundreds of unsheltered homeless living in downtown Austin the progress on Prop B - KXAN.com

Ken Paxton Named "Enemy of Progress" by DC Watchdog Group – Dallas Observer

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A government watchdog group Thursday named Texas Attorney General Ken Paxton an "enemy of progress," citing his role in challenging the outcome of the 2020 presidential election, anti-immigration efforts and ties to the oil and gas industry.

The D.C.-based organization Accountable.USnamed Paxton a top target of its Enemies of Progress campaign, which aims to hold conservative attorneys general across the country accountable for preventing progress on some of the countrys toughest challenges, according to a press release.

The campaign highlights Paxtons role as an architect of conservatives failed effort to overturn the results of the 2020 U.S. presidential election and his numerous lawsuits challenging the Biden administrations changes to federal immigration laws. Paxton has launched these challenges as he awaits trial for criminal securities fraud charges from 2015.

Instead of fighting for their best interests, Attorney General Paxton is spending Texans taxpayer dollars on frivolous lawsuits against the Biden administration on behalf of his special interest donors, said Kyle Herrig, president of Accountable.US.

Paxton should consider focusing on his own legal troubles and get out of the Biden administrations way rather than spending taxpayer-funded resources obstructing much-needed relief for millions of Texas families, Herrig said.

Paxtons office did not respond to requests for comment.

"Paxton should consider focusing on his own legal troubles ... " - Kyle Herrig, Accountable.US

An Accountable.US report issued alongside the campaign announcement lists Paxton as first amongst a list of 13 attorneys general who have consistently acted on behalf of the industries and wealthy contributors backing their political aspirations.

The report highlights Paxtons ties to the Republican Attorneys General Association (RAGA), a conservative group whose affiliatedRule of Law Defense Fund helped organize the Jan. 6 U.S. Capitol protest. RAGA donated nearly $740,000 to Paxtons 2018 reelection campaign the second most of any individual donations to his campaign, according to the report.

The campaign comes as Paxton grapples with the latest developments in his legal disputes.

Last month, the State Bar of Texas launched an investigation into Paxtons efforts to overturn the election to determine if his actions violated its professional misconduct rules.

Around a month after Donald Trumps defeat in the 2020 election, Paxton filed a lawsuit with the U.S. Supreme Court, alleging unconstitutional changes to voting rules in key battleground states clinched the election for President Joe Biden. The court dismissed the suit three days later.

In a June appearance on Steve Bannons podcast, Paxton bragged that he used his office to secure victory for Trump in Texas during the 2020 election.

His office successfully blocked Harris County from sending applications for mail-in ballots to all registered voters, a move he said clinched Texas for Trump. We would've been one of those battleground states that were counting votes in Harris County for three days and Donald Trump would've lost the election," Paxton said.

If found guilty of professional misconduct, Paxton could be disbarred and suspended.

Some two weeks after the State Bar announced its investigation, whistleblowers in a separate ongoing lawsuit against Paxton accused him in court filings of deliberately misconstruing their testimony in an attempt to get the case dismissed. Their accusation is the latest development in a case filed in February by four of Paxtons aides, who allege Paxton used his office to aid an allies business interests.

Meanwhile, Paxton is still awaiting a trial following 2015 felony fraud charges. Paxton is accused of persuading investors to buy stock in a technology firm without disclosing his financial interests in the firm.

Paxtons legal issues cloud his campaign for reelection in 2022 and have served as attack material for Land Commissioner George P. Bush, who announced his campaign for attorney general last month.

Keep the Dallas Observer Free... Since we started the Dallas Observer, it has been defined as the free, independent voice of Dallas, and we would like to keep it that way. Offering our readers free access to incisive coverage of local news, food and culture. Producing stories on everything from political scandals to the hottest new bands, with gutsy reporting, stylish writing, and staffers who've won everything from the Society of Professional Journalists' Sigma Delta Chi feature-writing award to the Casey Medal for Meritorious Journalism. But with local journalism's existence under siege and advertising revenue setbacks having a larger impact, it is important now more than ever for us to rally support behind funding our local journalism. You can help by participating in our "I Support" membership program, allowing us to keep covering Dallas with no paywalls.

Michael Murney is a reporting fellow at the Dallas Observer and a graduate of Northwestern Universitys Medill School of Journalism. His reporting has appeared in Chicagos South Side Weekly and the Chicago Reader.

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Ken Paxton Named "Enemy of Progress" by DC Watchdog Group - Dallas Observer

These Countries Are Making Progress on the 4-Day Working Week – Tatler Singapore

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The world's largest pilot project trialling the four-day week has proved successful in Iceland but what about other countries?

Iceland has just completed the world's largest pilot project trialing the four-day week, involving more than 2,000 workers. This experiment has proved successful, and has reignited the debate surrounding a measure that has long been advocated as a way of increasing employee wellbeing and productivity. But what's the state of affairs in other countries?

Working less, but better, by switching to a four-day week. The idea may not be new, but it has been in the news again in recent days, with all eyes on Iceland. This northern country has just unveiled the results of a large pilot study conducted between 2015 and 2019 among 1 per cent of the Icelandic population. The idea was to propose a reduction in working hoursto 35-36 hours a weekwhile keeping the same salary.

This program was set up by the British and Icelandic think tanks Autonomy and the Association for Sustainability and Democracy (Alda), and involved 2,500 people living in Iceland and working in the public sector (schools, hospitals, social services, etc).

Four years later, the experiment has proved largely successful, with the researchers who conducted the study reporting an increased rate of productivity and wellbeing among most of the workers who took part. The trial even had beneficial effects for the wider population. According to the two think tanks behind the study, 86 per cent of Iceland's working population was able to benefit from new agreements signed between 2019 and 2021, allowing for more flexible working and a reduction in hours.

Related: 9 Work-Friendly Cafes With Wifi in Singapore

In light of these more-than-satisfactory results from the world's largest trial of the four-day week, there is every reason to be tempted. The idea has been discussed and debated for several decades. But how far have other countries gone to implement it?

While some companies around the world have been operating a four-day week for some time, no country has yet made it a general practice at the national level. However, the pandemic seems to have changed the situation. The idea came back to the forefront in Germany in 2020, for example, when several companies adopted a four-day week to avoid layoffs during the pandemic.

Spain, on the other hand, is following in Iceland's footsteps, and will launch a similar pilot project this fall, on the initiative of the left-wing party, Mas Pais. Although it is still in its early stages, it is already known that the project could involve 3,000 to 6,000 Spanish workers over a period of three years, and some 50 million in funding. About 200 companies are expected to participate, and an evaluation of productivity and employee wellbeing is scheduled to be carried out after one year.

The idea is also gaining traction in the United Kingdom. In 2020, various parties in the country (including the opposition Labour Party) signed a motion calling on the government to set up a commission to study the proposal.

Related: Work From Home Tips: 7 Productivity Mistakes to Avoid

As for France, the four-day week is far from widespread, although a law passed in 1996 allows companies to implement it. On the political scene, it is again on the left that the idea is advocated, notably by the MEP Pierre Larrouturou, founder of the Nouvelle Donne party and author of a 1999 book on the subject (Pour la semaine de quatre jourspublished by ditions La Dcouverte).

However, several companies in France have been operating a four-day week for some time. These include Welcome To The Jungle (Paris), Yprema (Ile-de-France) and Love Radius (PACA) and, more recently, the IT group LDLC (Auvergne-Rhne-Alpes).

Related: 7 Stylish Co-Working Spaces in Singapore

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These Countries Are Making Progress on the 4-Day Working Week - Tatler Singapore

Local business thrives at Philipsburg Fest, cruise-in – Clearfield Progress

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PHILIPSBURG Eric Bordas, organizer for the recent cruise-in here, has already set his sights on an event for next year.

The cruise-in drew in a crowd as part of Philipsburg Fest on Saturday. Folks of all ages wandered the street, taking pictures of cars or visiting local businesses.

The turnout was overwhelming, said Bordas. Well do it again next year.

The date may fall in June in the future, Bordas noted.

Philipsburg Fest was a response to the cancellation of Philipsburg Heritage Days. Events, such as the cruise-in, gave residents and visitors something to do.

People were just so tired of not doing something that they were so happy to have something to do, said Clairissa Bordas, Erics wife.

Young car enthusiasts enjoyed the spread of vehicles. Collin Foster, 10, collected footage throughout the event with plans to create a video on YouTube. He has always had a love of cars.

When asked about his favorite car, Foster responded, Thats a hard choice. I have a little too many. I like classics, and I like newer vehicles.

Fire companies, including Chester Hill, Reliance and Hope, were at the cruise-in.

Just out here, enjoying the weather and supporting the event, Hope Fire Co. Assistant Chief Justin Butterworth said.

The fire company had a UTV at the event. The vehicle is primarily for fighting wildfires and rescuing victims in difficult to reach locations, according to Butterworth. The company also sold pre-sale tickets for their chicken barbecue set for July 31, Butterworth noted.

Local businesses benefited from the cruise-in.

Today was great, said Brandi McGarvey, owner of Thieves Market. Lots of foot traffic.

Thieves Market rented out upstairs space at $20 a table for vendors during the day, McGarvey noted. The business typically hosts vendors during special events.

During Philipsburg Heritage Days, Thieves Market closes. The cruise-in, which allowed businesses to stay open and have easy in-and-out foot traffic, helped bring in customers, McGarvey stated.

This event was hands down way more successful than Heritage Days, said McGarvey.

The public feedback throughout the event was positive.

I heard great things from all people, McGarvey stated. All customers that came through said great things about this event.

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Local business thrives at Philipsburg Fest, cruise-in - Clearfield Progress

Book Review: The History of Animal-Based Medicine in China – Undark Magazine

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Liz P.Y. Chee vividly remembers the first time she visited a bear farm. It was 2009, and Chee, who was working for a Singapore-based animal welfare group, flew to Laos to tour a Chinese-owned facility. The animals Chee saw were hardly recognizable as bears, she later wrote, because they had rubbed most of their fur off against the bars of the cages and had grown very long toenails through disuse of their feet.

As at countless other bear farms across China and Southeast Asia, the bears there were being held for their bile. Bear bile which is either milked through a catheter permanently inserted into the animals gall bladders or extracted by stabbing large needles into the animals abdomens is popularly prescribed across the region to treat a host of ailments, including, most recently, Covid-19. It is also marketed as an all-around health tonic. Although there is a growing animal welfare and anti-bear farming movement in China, the industry remains powerful.

BOOK REVIEW Maos Bestiary: Medicinal Animals and Modern China, by Liz P. Y. Chee (Duke University Press Books, 288 pages).

Seeing the suffering bears made Chee wonder about the cultural and historical forces that brought the animals there a question that propelled her to conduct exhaustive research on animal medicalization in China. In Maos Bestiary: Medicinal Animals and Modern China, she details her findings, many of which are distilled from sources never before published in English. Chee, who is now a research fellow and lecturer at the National University of Singapore, also found that, until now, even scholars in China have dedicated scant attention to the history of animal-based medicine, despite the controversy associated with the topic today.

If Chinese medicine retains an Achilles heel in the present century, it is the widespread perception that it is contributing to a holocaust among wild creatures, Chee writes, and in so doing supporting a global criminal enterprise of animal poaching and trafficking. Moreover, she adds, such medicines are often condemned as being as ineffective as they are unethical, even by some Chinese physicians. Many of these products are medically useless at best, Chee writes, and in some cases, actually harmful.

Defenders of animal-based Chinese medicine often point to the practices 2,000-plus year history. In Maos Bestiary, however, Chee shows that the roots establishing the use of most animals as ingredients in medicine are not as deeply planted in Chinas culture as many believe. Instead, the industry as it exists now was purposefully developed, expanded, and promoted over the last century. Today, it is more closely linked to politics and profit than to ancient culture and tradition. This revelation has important implications for both species conservation and for public health, Chee argues, because it leaves room for possibilities of choice and change.

Chee focuses on the evolution of animal-based medicine throughout the tumultuous period of modern Chinas formation, from the 1950s through the 1980s. These decades encompassed the early years of the Peoples Republic of China, Maos Great Leap Forward and Cultural Revolution and, finally, Deng Xiaopings reforms.

While animal-derived medicines do have a long history in China, Chee found that their use in the past was nowhere near the startlingly abundant level they are at today. Around 400 animals were cited in the 16th century Compendium of Materia Medica, for example, whereas more than 2,300 are listed today in pharmacopeias.

Many newly medicalized species exist only on distant continents, such as jaguars in South and Central America. Nor is Chinas use of animals in traditional medicine solely based on Chinese innovation, Chee found; ideas, approaches, and technologies from the Soviet Union, North Korea, Japan, and the Western world all heavily influenced the industrys development. So while animal-based products may still hold the aura of tradition, Chee writes, in fact, most are the products of a profit-driven expansion.

Animal-based medicines are often condemned as being as ineffective as they are unethical, even by some Chinese physicians.

Efforts to abolish traditional medicine and replace it with a science-based approach, primarily inspired by Japan, began in the 1920s and continued through the early days of a Communist government that was racing to build an industrialized economy. While researchers acknowledged that some especially efficacious Chinese herbs were worth investigating to find their active ingredients, animal-based remedies were initially undervalued and underdeveloped by the new regime as it worked to build up its pharmaceutical sector, Chee writes.

Traditional doctors pushed back on the attempt to phase out their industry, however, and argued that the synergistic effects of the plant, animal, and mineral ingredients of their practice were too complex to be nailed down in a lab. To appease both groups, the state-owned drug-making sector decided that doctors trained in Chinese and Western medicine should learn from each other, scientizing Chinese medicine and seeking new innovations from tradition.

To learn from the Soviet Union was also a popular phrase in China at this time. Following the example set by the USSR, China was especially interested in creating its own pharmaceuticals from local ingredients to become self-sufficient. Soviet interest in animal-based folk medicine and the USSRs own practice of farming deer for medicinal ingredients soon provided modern and scientific sanction for the Chinese fascination with faunal drugs, Chee writes.

During the Great Leap Forwards period of rapid industrialization, animals as well as plants were swept up in this nationwide project, Chee continues. China expanded its export of high-end medicinal products like deer antler, rhino horn, and tiger bone, especially to Chinese expatriates. To meet steep quotas, authorities promoted the creation of laboratory farms for scaling up production. Entrepreneurs at these farms were also encouraged to find more uses for existing animal parts, and to engineer additional uses for new parts and species.

Once a medicinal animal was farmed, there was pressure or incentive to justify the use of all of its parts, regardless of previous traditions that had often been quite selective as to which part should actually be taken as medicine, and for what purpose, Chee writes. Medicine farms popped up for a host of additional species, including geckos, ground beetles, scorpions, snakes, and seahorses.

Chee shows that the roots establishing the use of most animals as ingredients in medicine are not as deeply planted in Chinas culture as many believe.

Wildlife farming also began being presented as something benefiting conservation because it allegedly spared wild animals from being hunted. In fact, it usually had the opposite effect by stimulating the market and relying on hunters to replenish farm stocks, Chee notes. While she does not delve deeply into the impact this has had on animal populations within and outside China, many sources today argue that demand for traditional medicine all but emptied the countrys forests of tigers, pangolins, and other highly sought after species.

During the purges and upheavals of the Cultural Revolution, the export of luxury medicines such as rhino horn were scaled up to generate much-needed revenue. Back home, however, a stark lack of medical care and supplies inspired an emphasis on miracle cures derived from cheaper, more common animals.

Chicken blood therapy the direct injection of chicken blood (from live chickens) into human bodies was representative of this time, Chee writes. The doctor who founded the treatment claimed chicken blood therapy could cure more than 100 conditions, and it was heavily promoted throughout the country, becoming emblematic of economical grassroots innovations and the very expression of red medicine, Chee writes.

This practice started to be phased out in 1968 when news surfaced of people dying after being injected with chicken blood. But similar remedies soon took its place, including ones that used goose or duck blood, lizard eggs, or toad heads. These new remedies were marketed as magic-like cures for serious and otherwise untreatable conditions, including cancer an attribute that has become standard in the marketing of many animal-based drugs today, Chee writes.

After Deng came to power in 1978, wildlife farming and animal-based medicine became even more popular as part of the official policy to enrich farmers, Chee continues. The government-supported bear bile industry which was originally inspired by facilities in North Korea and continues to flourish today was one major result of this period, as was the proliferation of tiger farms.

Policy shifts also had significant ramifications for the regulation of Chinese medicine, and its impact on consumers and the environment. The forestry ministry was given decision-making power over wild medicinal animals, Chee writes, and would essentially manage Chinas forests as extraction sites. Meanwhile, the health ministry only had full regulatory control of patented drugs, so companies selling animal-based medicines could bypass health or efficacy regulations and make extravagant, unchallenged claims about their products curative value.

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Chinese medicine has become globalized over the last three decades, and animal-based products have continued to play a central, if increasingly problematic, role, Chee writes. The industry is assailed in the international media for its role in driving species declines, and clashes regularly occur within China between proponents of animal-based medicines and those who value wildlife and conservation. Many middle-class Chinese, both on the mainland and in the diaspora, and within Chinese medicine itself, have been on the front lines in the battle to save endangered species from poaching and consumption, Chee points out.

Maos Bestiary went to press in the midst of the Covid-19 pandemic, and Chee writes in the introduction that the likely link between Covid-19s emergence and wild animals fundamentally changes the debate by making wildlife use a global public health issue.

Yet despite the undeniable threats posed by zoonotic diseases, animal-based traditional medicine remains an immensely profitable, and thus politically influential force in China, she continues. As evidence, Chinese authorities not only did not ban animal-based medicine during the pandemic, but actually promoted remedies containing bear bile for treating Covid-19.

As for shaping the industrys future to mitigate the dangers for both wildlife and humans, Chee looks not to officials but to Chinese consumers, who can choose to boycott animal-based medicines. There is a large and growing animal welfare movement in China, so this could be more than just a pipe dream. Whether they will reinvent the pharmacology of Chinese medicine as a practice less reliant on animals, endangered or otherwise, she concludes, remains a vital question.

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Book Review: The History of Animal-Based Medicine in China - Undark Magazine

Dr. Simone Reveals an Off-Camera Moment with Dr. Jackie That Helps Get to "The Core" of Their Issues – Bravo

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Married to Medicine reunions always have a way of making our jaws drop, and the Season 7 sit-down was no exception. Dr. Simone Whitmore and Dr. Jackie Walters surprised everyone when they revealed that the events of the season, including the drama with Buffie Purselle and its aftermath, had put a major strain on their relationship.

But, as also tends to be the case at Married to Medicine reunions, the group rallied around the pair and brought them back together. Dr. Simone and Dr. Jackie hugged and shared their commitment to getting their friendship back on track.

Fast forward to the beginning of Season 8, and the OBGYNs were still not in a good place. But after some time passed, Dr. Simone and Dr. Jackie did eventually find their way back to one another, and an emotional conversation appeared to ease the tension between the two. This time, the reconciliation seemed to stick.

During Part 2 of the Married to Medicine Season 8 reunion, which aired on July 11, Dr. Simone gave an update on where she and Dr. Jackie stand today. "Well, we are in a much better place, and we talk, we study together still," Dr. Simone explained. "And, you know, the fact is I don't harbor any ill feelings about Jackie. I love Jackie. I will always love Jackie."

When it came to why she and Dr. Simone didn't follow through on their promise to repair their relationship after the Season 7 reunion, Dr. Jackie said, "Life got in the way. And when you don't work on a relationship and I think this is for everybody it falls apart."

Dr. Simone then explained why she didn't invite Dr. Jackie to son Michael's graduation party this season, which took place before they had made up. "I just, we were awkward," Dr. Simone said. "It was a close gathering with close friends, family. I didn't want anything to be awkward."

Host Andy Cohen pointed out that Dr. Simone had invited Anila Sajja to the event, whom she had only recently met. "That's where I got super offended is when Anila got invited," Dr. Jackie said, to which Dr. Simone replied, "But she was the only person there, the only person there that was not part of my close circle."

Dr. Simone also addressed Quad Webb's comments on Watch What Happens Live with Andy Cohenearlier this season in which she questioned if her reconciliation with Dr. Jackie was genuine. "First of all, you used the word 'fake,' as if we made up strictly for TV. It's not something I would do," Dr. Simone said. "And so I came to Jackie from a genuine place when I spoke to her. But we have some difficult topics that we need to tackle."

"You don't just get back to normal overnight with a hug," Dr. Simone added. "At least I don't."

Dr. Jackie shared that she felt like Dr. Simone hasn't had her back the way she has for Toya Bush-Harris. "What I said to Simone is I noticed she has developed the ability to ride for Toya no matter what. And no disrespect to Toya. Toya can say 'achoo' and Simone has an explanation for it," Dr. Jackie said. "What I had hoped for Simone last year is when I was being crucified by the situations that I was in with the people who aren't here today, that Simone would've ridden for me like that."

Dr. Simone said that she felt like she had been there for Dr. Jackie after that explosive dinner during the trip to Mexico last season. "I came to you in Mexico I'm not gonna play this game with you with no f--king camera around to say you responded at dinner in a way that is not you. I need for you to fix it," she recalled. "I came to your hotel room, no microphone, no camera, and said that s--t last night doesn't represent you. I said it to you."

But Dr. Jackie said that she didn't feel the support from Dr. Simone in that moment. "And did I not explain to you why I reacted? I said, 'Simone, that wasn't the place. It was your dinner.' And never did you go back to the group and say, 'That ain't who Jackie is,'" Dr. Jackie shared. "Petty as it is, I did take offense to that, and that is part of why we haven't healed is we have not been able to deal with the hard stuff."

Dr. Simone admitted, "I should have said it out loud."

The real root of Dr. Simone and Dr. Jackie's issues was now starting to become clearer, according to Andy. "It sounds like we're getting to the core of when this all went left," he said. "You're not getting what you need from each other in terms of the other backing you up and defending you."

Of course, Dr. Simone's conflict with Dr. Heavenly Kimes has also been connected to all of this. When it comes to the current status of her friendship with Dr. Simone, Dr. Heavenly said at the reunion, "I don't speak to Simone. Simone doesn't speak to me."

Andy went on to ask Dr. Simone if she felt like she and Dr. Heavenly could once again have thatclose bond they shared while the OBGYN was going through her marital issues. "Let me say that I would love to be back in that place with Heavenly, but it's difficult for me as a sensitive person to read and hear about all the bulls--t and sensitive stuff she says about me on the regular," Dr. Simone said, later specifying that she has heard Dr. Heavenly, who is a dentist, make negative comments about her teeth. "That, I don't want those kind of friends."

Dr. Simone noted that she thinks she could be friends with Dr. Jackie while she's still close to Dr. Heavenly "once Heavenly and I are back in a better place." "I've been trying. I've called you over and over again, Simone. You know I have," Dr. Heavenly said in response (clip above). "You have not put up any effort."

Dr. Simone admitted that it's been challenging for her to be able to move forward with Dr. Heavenly. "I had a close relationship with Heavenly, and Jackie knows it. But when I fall down and out with people, I fall hard," she said. "It's hard to let go of stuff."

However, Dr. Simone does want to get her friendship with Dr. Heavenly back on track and even described herplans to do so once they all get back home to Atlanta. "What I told Heavenly is I missed her birthday party and told her I couldn't come. And I am going to celebrate her birthday when we get back to Atlanta, and I get past some personal things," Dr. Simone shared, adding that she would also like Dr. Jackie to be there.

The Married to Medicine Season 8 reunion continues with Part 3 on Sunday, July 18 at a special time of 10:15/9:15c.Want more Married to Medicine? Catch up on the Bravo app.

The Daily Dish is your source for all things Bravo, from behind-the-scenes scoop to breaking news, exclusive interviews, photos, original videos, and, oh, so much more. Subscribe to The Daily Dish podcast, join our Facebook group, and follow us on Instagramfor the latest news hot off the presses. Sign up to become a Bravo Insider and be the first to get exclusive extras.

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Dr. Simone Reveals an Off-Camera Moment with Dr. Jackie That Helps Get to "The Core" of Their Issues - Bravo

Therapy dog bringing a different type of medicine to BRG patients – WBRZ

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BATON ROUGE - A service dog is bringing comfort and relief to those recovering at Baton Rouge General.

Fin and his owner Frank walk around the hospital seeing nurses and patients, especially Jimmy Santangelo.

When Jimmy was diagnosed with acute lymphoblastic leukemia he and his wife were not sure how to cope until the four-legged expert came in.

"Frank walked in and then her eyes lit up. She got a whole different attitude a whole different personality," Jimmy said.

"That was kinda a turning point for me, you know just being able to let it all out, in a good way, a good positive way that I didn't feel like was going to upset him. I was just laughing and crying at the time," said Jimmy's wife, Mickey Santangelo.

From there the relationship flourished. Every time Jimmy comes back to Baton Rouge General for chemo treatment Fin and Frank make a visit.

"I know every time I come up here, they'll make it a point to just sit with us and we just get to love on him," Mickey said.

"We got pets and dogs at home, it gives me the sense that I'm at home," Jimmy said.

For Frank, he says that's exactly their goal: to provide stress-relieving medicine to hospital patients and staff every day.

"I just feel blessed that we are a part of it and we're just doing what God wants us to do," Frank said

Dr. Fin and Frank will keep providing that joy as long as they are allowed to. Frank and Fin visit multiple hospitals across the area and also serve at Healing Place Church.

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Therapy dog bringing a different type of medicine to BRG patients - WBRZ

Alternative medicine: Definition, examples, benefits, and risks – Medical News Today

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The term alternative medicine encompasses a wide range of medical practices and systems from cultures around the world. In countries such as the United States, people use it to describe practices that are outside mainstream medicine.

The term alternative medicine is subjective. While doctors in one part of the world might regard a practice as mainstream, doctors elsewhere might view the same practice as alternative.

This article discusses what alternative medicine is, different types of alternative medicine, and whether it is better than conventional medicine.

The term alternative medicine describes any form of medicine or healing that does not fall into conventional medical practice.

In the U.S. it refers to forms of medicine that are not widely accepted or practiced by medical doctors, particularly those that do not have as much scientific evidence to support them as more mainstream methods.

Some types of alternative medicine have been around for hundreds and even thousands of years. Others are quite new. Sometimes, something that begins as an alternative treatment can become part of mainstream medicine due to strong evidence that it works and has no safety risks.

Many people use terms such as alternative medicine, integrative medicine, and complementary medicine interchangeably. However, each term describes something different:

Some people group complementary and alternative medicine together under the acronym CAM. There are many types of CAM. The National Institutes of Health (NIH) group them into five broad categories.

Mind-body therapies focus on the relationship between the mind and body to help treat or manage a condition. Some examples include:

Meditation is an ancient practice that is prominent in religions such as Hinduism and Buddhism. Today, there are many forms of meditation people can try; some are religious in nature, and some not.

Many studies have verified that meditation has health benefits. It can lower blood pressure and stress levels. Research suggests it may also reduce the symptoms of:

Learn more about the types of meditation.

Biofeedback involves the use of machines that measure unconscious or involuntary bodily processes, such as heart rate or muscle contractions. The device then converts the information into audio, visual, or tactile signals. A therapist then helps someone learn to control these signals.

Biofeedback can help people learn to relax painful muscles, alter their mental state, and more. Its most common uses include management of neuromuscular disorders, chronic pain, anxiety, and incontinence.

Hypnosis involves someone going into a deep state of relaxation and focusing on suggestions a clinician makes while the person is in a hypnotic state. The aim is for the suggestions to help change a persons mental state, resulting in health benefits.

According to the American Psychological Association (APA), most clinicians agree hypnosis has benefits for:

Similar to meditation, yoga is a mind-body exercise that originates in spiritual practices. It involves moving through sequences of poses and stretches while also focusing on breathing. Many people around the world practice yoga to promote mental and physical well-being.

Some research suggests yoga may help:

Most studies on yogas benefits have been with small numbers of people, so more research is still needed.

Tai chi is a martial art that originated in China. It involves a series of postures or slow movements combined with controlled breathing. Some research suggests tai chi may help:

Biologically based therapies use substances such as plants and foods to improve health or treat conditions. Some examples include:

Some CAM and integrative practitioners use nutritional supplements, such as vitamins, minerals, or other beneficial compounds, to treat or manage conditions.

This includes the use of plants or plant compounds for medical benefits. There are many examples of plants that people use to treat symptoms or conditions. Popular examples include:

Dietary approaches to medicine involve using food itself to treat certain conditions. This may mean eating foods with specific medicinal properties, following diets that contain certain nutrients, or avoiding some foods altogether.

These therapies aim to help people by manipulating invisible energy fields. According to some medical systems and practices, the energy around the body can influence health. By addressing disturbances or blockages in energy, practitioners believe it is possible to treat certain conditions.

Some examples of biofield therapies include:

This involves a practitioner running their hands over or gently touching someones body to control or restore their flow of energy.

Reiki originally comes from Japan. During reiki treatments, practitioners try to control energy in the body by using their hands. This may involve placing them on someone, just above them, or even working at a distance from a person. The aim is to free blocked energy and improve the bodys natural healing abilities.

Body-based therapies involve a therapist physically moving one or more parts of a persons body for therapeutic benefits. Common examples include:

During massage, a practitioner uses their fingers, hands, or tools to knead, rub, or press the bodys soft tissue. It is an ancient therapy, and people have practiced it in most cultures throughout history. There are many types of massage, each of which involves different techniques, rhythms, and areas of the body.

Reflexology involves pressing or manipulating pressure points in the hands or feet. The idea behind it is that a practitioner can target and help other parts of the body. It can also promote relaxation.

This therapy manipulates someones muscles, tissues, or bones to help the body heal from musculoskeletal conditions or help someone cope with a condition that may be causing pain.

Whole medicine systems refer to sets of beliefs and practices that work together. These systems have typically evolved over hundreds of years. Some of the most well-known methods include:

TCM is a complex system based on a belief in two opposite forces: yin and yang. For the body and mind to be in good health, practitioners believe that yin and yang must be in balance. TCM practitioners use a combination of herbal, mind-body, and physical therapies to achieve this.

TCM is over 2,000 years old and is where practices such as acupuncture and tai chi have their origins.

Ayurveda is a holistic health system that developed in India thousands of years ago. Ayurvedic practitioners believe that everyone is made up of five elements: air, fire, water, earth, and ether (or space). The way these elements combine dictates how the body works.

Homeopathy comes from Germany and is around 200 years old. It focuses on two theories: that like cures like and that the lower the dose is of something, the more effective it is.

There is little evidence that homeopathy works for any condition. Additionally, some substances homeopathy uses are toxic, such as white arsenic and deadly nightshade.

Naturopathy is a system that includes a mixture of traditional and alternative approaches to medicine. It focuses on using natural and noninvasive ingredients and techniques, such as herbs, exercise therapy, dietary changes, and massage, among many others.

In some U.S. states, naturopathic doctors can also prescribe pharmaceutical medications, but this varies based on location.

Many people debate whether conventional medicine is better than alternative medicine. When comparing them, it is important to consider the following:

One of the main benefits of standard medical care is that it undergoes rigorous research. Through clinical trials and studies, scientists can determine whether certain techniques, medicines, and courses of treatment are effective and safe.

Many scientists use these methods to study alternative medicine, too. However, the data is not always as abundant or reliable. Some types of alternative medicine, such as homeopathy, have very little scientific evidence to support them.

There are exceptions to this. Some types of alternative therapy have been well-researched by scientists, so doctors can safely recommend them to patients. Examples of this include yoga and meditation, as well as acupuncture. The American College of Physicians recommends acupuncture as a first-line treatment for lower back pain.

Some people believe that alternative medicine is better than conventional medicine because it often focuses on natural substances, which some believe to be safer, gentler, or more suitable for the human body than manufactured medicines.

However, as with conventional medicines, natural medicines can also cause side effects, drug interactions, and poisoning at the wrong dosages. Some natural products can also contain harmful substances not listed on the label. For example, some Ayurvedic products contain naturally occurring toxins, such as mercury or lead.

Even when natural products are safe, it can be more difficult for companies to ensure they have consistent levels of potency and purity. Third-party testing can reduce this problem, but not all companies use it.

For some, conventional medicine is more difficult to access than the alternative treatments available within their communities. In comparison to the U.S. healthcare system, alternative medicine may be:

These are important factors and can make alternative medicine more appealing. People who have had negative experiences of healthcare may also prefer to seek alternative options.

Alternative medicine refers to medical practices that are not mainstream. In the U.S., people use this term to refer to a wide range of therapies and medical systems, from Ayurveda to reflexology.

Whatever form of treatment a person chooses, it is always important to consider the evidence that supports it, potential risks and side effects, and whether the practitioner is fully qualified. Where possible, always speak with a medical doctor before trying alternative treatments, as they can have risks.

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Alternative medicine: Definition, examples, benefits, and risks - Medical News Today

Combining Gamification, Cash Incentive Increases Veterans’ Exercise – pennmedicine.org

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PHILADELPHIA We know that turning goals into a game can increase peoples physical activity. We also know that financial incentives can be effective, especially when theyre framed in a way where people lose money if they dont reach their goals. But a new Perelman School of Medicine at the University of Pennsylvania study adds to evidence that combining the two can result in significant gains.

Researchers affiliated with Penn Medicines Center for Health Care Innovation showed that a group of veterans who were overweight or obese and receiving care from a Philadelphia hospital were able to increase their daily step counts by more than 1,200, on average, when their personalized goals were paired with a game in which they received support from a buddy, all while they stood to potentially lose reward money if they didnt hit their targets.

The research, believed to be the first of its kind among veterans, was published in JAMA Network Open.

What our study begins to show is that the combination of varying approaches can be effective, but we need to learn more about the duration and ability to sustain an effect over longer-periods of time, said the studys lead author, Anish Agarwal, MD, a clinical innovation manager in the Penn Medicine Center for Digital Health and an assistant professor of Emergency Medicine.

Often, companies create programs to encourage healthier behavior among employees. These programs typically involve step counts measured by some form of pedometer and daily or weekly goals, but leave it at that. Agarwal believes that its important to study how different framings of goals and the accomplishment of them is important to improving them and actually helping people improve their behaviors.

The world of mobile and digital health has created an environment where rolling these programs out is easier and more interactive, Agarwal said. Time will certainly tell in how these incentives can be used to in equitable and sustainable ways.

For this study, Agarwal and his fellow researchers including senior author Mitesh Patel, MD, an associate professor of Medicine recruited 180 participants. They were randomly assigned to one of three different, equal groups. Everyone, including those in the control group, received an electronic, wearable device to track steps and selected a personalized goal. But two of the groups utilized a behavioral science concept called gamification, in which their goals were tied to a game in which they achieved points and levels for hitting their step goals. The progress of these participants was shared weekly via email with a buddy the participant had designated who could review them and encourage them.

One of those groups, though, had money riding on their goals. In total, they stood to make $120 if they hit their goals each week for the studys 12-week intervention period. Every week that they didnt achieve their goals, the participants lost $10 from the total theyd be issued at the end of the study.

It was this group, the researchers found, who made the largest strides during the intervention period. Compared to the control group, they significantly increased their steps by an average of 1,224. The other gamified group did increase their steps above the control group, but it was only by 433, which was not significant.

Loss aversion is a very powerful motivator, Patel said. Most programs deliver rewards after the goal is achieved, but this clinical trial, similar to previous ones, shows that offering financial upfront and letting participants know they can be an effective strategy.

After the 12-week intervention period ended, the researchers continued to observe participants step counts when the games were turned off. In the eight weeks following, neither group sustained their progress compared to those who were not part of the games. The group with financial incentives did still have an average 564 step increase in their daily totals, but the non-incentive group actually decreased their daily steps by an average of 160.

Agarwal said that more research is needed to determine exactly why they got the results they did when research has supported gamification both with and without financial incentives. Their main focus is to increase the intervention time, and, ultimately, achieve longer term changes.

Next steps for us are to begin to design and test approaches which help sustain the effect beyond the intervention period, Agarwal said. One could imagine varying financial amounts at risk, duration of the intervention, and a strong social incentive. In this study the social incentive was passive, a weekly email to a social support person, but we could imagine more social connection or competition to test for individuals or groups.

This study was funded by a Career Development Award from the Department of Veterans Affairs Health Services and Research Department (HX-001922-01).

Other authors include Kimberly Waddell, Dylan Small, Chalanda Evans, Tory Harrington, Rachel Djaraher, and Ai Leen Oon.

Penn Medicineis one of the worlds leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of theRaymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nations first medical school) and theUniversity of Pennsylvania Health System, which together form a $8.9 billion enterprise.

The Perelman School of Medicine has been ranked among the top medical schools in the United States for more than 20 years, according toU.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $496 million awarded in the 2020 fiscal year.

The University of Pennsylvania Health Systems patient care facilities include: the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Centerwhich are recognized as one of the nations top Honor Roll hospitals byU.S. News & World ReportChester County Hospital; Lancaster General Health; Penn Medicine Princeton Health; and Pennsylvania Hospital, the nations first hospital, founded in 1751. Additional facilities and enterprises include Good Shepherd Penn Partners, Penn Medicine at Home, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.

Penn Medicine is powered by a talented and dedicated workforce of more than 44,000 people. The organization also has alliances with top community health systems across both Southeastern Pennsylvania and Southern New Jersey, creating more options for patients no matter where they live.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2020, Penn Medicine provided more than $563 million to benefit our community.

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Combining Gamification, Cash Incentive Increases Veterans' Exercise - pennmedicine.org

New Clinical Study Investigates Using Integrated Diagnostics to Enable Precision Medicine for Liver Cancer Patients – Business Wire

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OXFORD, England--(BUSINESS WIRE)--Perspectum is pleased to announce that a new prospective, observational, cohort study called Precision medicine for liver tumours with quantitative magnetic resonance imaging and whole genome sequencing (Precision1, NCT04597710) is underway. Participants with primary or secondary liver cancer will be recruited from Hampshire Hospitals NHS Foundation Trust in Basingstoke. Perspectum will also partner with experts in clinical applications of genomic sequencing in patients with cancer from the University of Oxford.

In the study, Perspectums Hepatica imaging technology will be integrated with clinically actionable whole genome sequencing biomarkers and digital pathology results to disrupt the cancer care pathway.

The Hepatica report provides hepatobiliary surgeons with quantitative metrics that can be employed to evaluate a participants overall liver health prior to surgery. Based on these quantitative liver tissue characteristics, the surgeons will assess whether to modify their participants existing surgical plan (Mole et al., 2020, Sethi et al., 2021). Once the participants liver cancer is surgically removed, Perspectum will collect and prepare the tumour tissue for whole genome sequencing (WGS) and analyse the data using the bioinformatics pipeline developed by University of Oxford.

Mr Myrddin Rees OBE, consultant hepatobiliary surgeon at Hampshire Hospitals NHS Foundation Trust, says, We are delighted to be part of this innovative study. Knowing the wellbeing of the liver is crucial to enable us to plan liver surgery. Linking that to the genomic make-up of the tumours is likely to guide us to accurately predict which patients will benefit from surgery and how much liver tissue could be removed safely in each patient.

University of Oxfords Dr Sarah Gooding says, Precision1 will investigate how AI may support clinical decision making, by integrating and scoring complex genetic, digital pathology and imaging data, in the management of liver metastases. This is a tremendously exciting blueprint for improving clinical decision making in the big data age. Mr Rees adds, This could represent another key step towards personalised care for patients with both primary and secondary cancer in the liver.

This study is funded as part of the Innovate UK/UKRI Data to Early Diagnosis and Precision Medicine Challenge (project number 50234).

About Perspectum

Perspectum, a global medical technology company with offices in the U.K., the U.S. and Singapore, delivers leading digital technologies that help clinicians provide better care for patients with chronic metabolic diseases, multi-organ pathologies and cancer. With a strong focus on precision medicine using advanced imaging and genetics, our vision is to empower patients and clinicians through quantitative assessments of health enabling early detection, diagnosis and targeted treatment. With a diverse team of physicians, biomedical scientists, engineers and technologists, Perspectum offers a way to manage complex health problems at scale.

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New Clinical Study Investigates Using Integrated Diagnostics to Enable Precision Medicine for Liver Cancer Patients - Business Wire

Residents and Faculty Honored During McLeod Family Medicine Residency Graduation – McLeod Health

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McLEOD REGIONAL MEDICAL CENTER 8 JULY 2021

A graduation for the 39th McLeod Family Medicine Residency Program was held on June 25. The Class of 2021 included Dr Caitlin Basnight, Dr. Aria Behrouzi, Dr. Eric Hart, Dr. James Johnson, Dr. Narjah Martin, Dr. Brice Morey, Dr. Yorke Reynolds and Dr. Brandon Washington.

This class represents the 39th class to graduate from our program, said Dr. Gerard Jebaily, McLeod Family Medicine Residency Program Director. At 60 percent, we have the highest retention rate of Residents who have remained in South Carolina to practice, the highest rate in the state. We are very proud of our program and its graduates.

During the graduation ceremony, Dr. Eric Hart was presented with the 2021 Society of Teachers of Family Medicine Residents Teacher Award for exemplifying skills and interests in teaching. The recipient of this award, chosen by program faculty, excels in precepting medical students, community and peer teaching, patient education, and presentations given at regional family medicine meetings. Dr. Hart will join the McLeod Medical Staff as a Hospitalist at McLeod Regional Medical Center starting in August.

Dr. Richard R. Howell was also named the 2021 recipient of the Halford Award for Leadership in Humane Education by South Carolina AHEC and McLeod Health. The award was presented to Dr. Howell by Dr. Jebaily and Dr. Allan Macdonald, Associate Program Director. Since 1984, Dr. Howell has been an integral part of the Family Medicine Residency Program at McLeod Regional Medical Center serving as the Director of Geriatric Education. Recently, Dr. Howell was named Program Director for the McLeod Family Medicine Rural Residency Program. The Halford Award is presented to a Family Medicine Residency Training Program Faculty Member in recognition of outstanding leadership in providing humane education. The award is named for Dr. James Halford, who was the founding director of the AnMed Health Family Medicine Residency Program. Award winners demonstrate a caring attitude and respect for patients, residents and students; value human dignity; demonstrate a passion and joy for teaching, learning and working with others and participating in community service activities.

Additionally, Dr. Susan Robins was honored with the Faculty of the Year award. Dr. Robins serves as the Site Director for the McLeod Family Medicine Rural Residency Program in Cheraw and cares for patients at McLeod Primary Care Cheraw. Chief Resident Dr. James Johnson presented the award to Dr. Robins. Since my classes arrival three years ago, Dr. Robins has always cared deeply for each individual residents education as well as their personal well-being. She is a shining example of why our residency program is so very fortunate to have the faculty that we do to help guide us to becoming the best possible doctors that we can be, said Dr. Johnson.

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Residents and Faculty Honored During McLeod Family Medicine Residency Graduation - McLeod Health