A small space rock led to a big discovery an X-ray-belching black hole – NBCNews.com

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The black hole appeared as a bright speck, a glowing spot against a cosmic backdrop, but one that easily could have been missed altogether especially because astronomers weren't even looking for it.

Students from the Massachusetts Institute of Technology and Harvard University and scientists associated with NASA's OSIRIS-REx mission an expedition to robotically retrieve a sample from a near-Earth asteroid were conducting routine observations when they unexpectedly spotted the distant black hole belching out X-rays, the agency announced Friday.

What they had stumbled upon was special; it is the first time that such an X-ray outburst has been glimpsed from interplanetary space, according to NASA.

The cosmic phenomenon was captured by the Regolith X-Ray Imaging Spectrometer (REXIS), a shoebox-size instrument aboard the OSIRIS-REx spacecraft, which is in orbit around the asteroid Bennu. The spectrometer, which is jointly operated by scientists and students at the two schools, is designed to measure the X-rays Bennu emits as it absorbs solar radiation.

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The fortuitous observation provides a nice confidence boost for those involved with the student experiment.

"Detecting this X-ray burst is a proud moment for the REXIS team," Madeline Lambert, an MIT graduate student who designed the instrument's command sequences that revealed the black hole, said in a statement. "It means our instrument is performing as expected and to the level required of NASA science instruments."

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The "flaring" black hole was spotted Nov. 11, appearing as a luminous object just off the asteroid's edge.

X-ray outbursts can occur when a black hole pulls in matter from a star in its vicinity, according to NASA. As stellar debris interacts with the disk of material that surrounds a black hole, intense bursts of energy can be unleashed. But these types of eruptions can be observed from space, because Earth's atmosphere protects the planet from X-rays and other forms of high-energy radiation.

The black hole's outburst was separately confirmed by two telescopes installed at the International Space Station in low-Earth orbit.

The surprise detection is a valuable example of how many scientific discoveries can happen in unanticipated ways, said Richard Binzel, a professor of planetary sciences at MIT who is one of the scientists working with the REXIS instrument.

"We set out to train students how to build and operate space instruments," he said in a statement. "It turns out, the greatest lesson is to always be open to discovering the unexpected."

The OSIRIS-REx mission's robotic probe, which reached Bennu in December 2018, is scheduled to return to Earth in 2023.

Bennu is thought to be a relic from the early days of the solar system. The diamond-shaped space rock measures about one-third of a mile at its equator and orbits at an average distance of about 100 million miles from the sun.

According to NASA, the mission could help astronomers understand how planets and other cosmic objects formed in the solar system, and it could help researchers study near-Earth asteroids that pose a threat to the planet.

Denise Chow is a reporter for NBC News Science focused on the environment and space.

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Cygnus mission extended for tests of communications payload – SpaceNews

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DENVER A Cygnus cargo spacecraft that was scheduled to reenter in late February will instead remain in orbit for another month so a payload on the spacecraft can perform additional tests.

The Northrop Grumman NG-12 Cygnus spacecraft, called S.S. Alan Bean by the company, was unberthed from the International Space Station Jan. 31 after spending nearly four months attached to the station. The Cygnus deployed several smallsats after moving away from the station, and at the time the company said the spacecraft would end its mission with a destructive reentry at the end of February.

However, there was no notice of the spacecrafts reentry by early March, and the Space Track database of objects in orbit, maintained by the Defense Department, showed March 4 that the spacecraft remained in orbit.

In a March 4 statement to SpaceNews, Northrop Grumman said a customer with a payload on the Cygnus sought extra time in orbit, a request that required Northrop Grumman to seek an extension of a Federal Communications Commission license for spacecraft communications.

The extension of our license by the FCC allows Northrop Grumman to extend our NG-12 mission beyond our original completion date, enabling us to offer increased operational flexibility for our customers, Frank DeMauro, vice president and general manager of Tactical Space at Northrop Grumman, said in the statement. The NG-12 spacecraft remains in excellent health as we carry out a few more weeks of in-orbit operations.

Northrop Grumman didnt disclose the customer, but its request to amend the FCC license for the mission stated that it was for a payload from Lynk, a Virginia-based company working on technology for satellites to enable direct communications with mobile phones. The company, previously known as Ubiquilink, raised $12 million in a seed funding round in July 2019.

Charles Miller, chief executive of Lynk, said March 4 that the extension will allow for additional tests, which have been going well.

Lynk is producing great results from the space testing our third cell tower in space in many different countries around the world, he said. We asked Northrop Grumman to extend the Cygnus 12 mission because we wanted to get in more testing time on the payload and testing accomplished in additional countries.

Miller added that NASA graciously agreed to the Cygnus mission extension, and that both Northrop and SEOPS, the company that handed integration of the Lynk payload on the Cygnus, have bent over backwards to support testing of the payload.

Northrop demonstrated on the NG-11 Cygnus mission the ability for the spacecraft to remain in orbit for an extended period after departing the ISS. That spacecraft stayed in orbit for four months after leaving the station in August 2019. It successfully completed a series of tests, including showing that Northrop could operate two Cygnus spacecraft successfully once the NG-12 Cygnus launched in November 2019.

The NG-12 Cygnus mission will be extended through April 2, according the request, which the FCC approved March 3.

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Cygnus mission extended for tests of communications payload - SpaceNews

Japan’s Space Dream? Cleaning Up the Mess. – The Diplomat

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At last years G-20 Summit in Osaka, the government announced measures to promote Japans name in space innovation. Japan has leapt at the opportunity to commercialize technology in the new experimental market of space garbage removal.

Even as humans struggle to clean up the environmental mess on Earth, there is growing space pollution hurtling around Earth. Earths orbit is increasingly crowded by inactive and defunct spacecraft and satellite parts, ranging from the size of a bus to nuts and bolts and specks of paint.

When pieces of debris collide, it sparks a chain reaction where fragments continue to collide with each other, breaking up into smaller and smaller pieces. The magnitude of man-made space debris is staggering. NASA is currently tracking 500,000 pieces between 1 and 10 centimeters in diameter. But the latest figures show there are 900,000 pieces debris ranging from 1 cm and 10 cm and 128 million fragments between one millimeter and one cm. There are also 5,000 satellites orbiting Earth, of which only 3,000 are active.

Competition in the satellite industry is heating up as tech companies such as SpaceX, Amazon, and OneWeb race to provide global internet coverage through the mass launch of satellites. But as space junk continues to clog orbit, the growing satellite industry faces an unpredictable future unless a solution can be found to remove abandoned space clutter.

Space pollution poses the risk of accidents, which could damage active satellites as well as the International Space Station. Space collisions in orbit also put human life and infrastructure on Earth at risk.

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Japan hopes to cement itself as a space power and has developed a national space agenda showcasing three Japan-based private aerospace ventures. One of the selected space ventures is Astroscale, which specializes in space debris removal.

Japans Aerospace Exploration Agency (JAXA) has partnered with Astroscale to pull off the worlds first debris removal mission. JAXAs Commercial Removal of Debris Demonstration (CRD2) project is made up of two stages aiming to collect a large fuselage originally from a Japanese rocket. The first stage will launch an experimental satellite in 2022 to collect data and inspect the fuselage.

Astroscales portfolio also consists of the ELSA-d mission self-described as the worlds first commercial orbital debris removal. The two-part 180 kilogram chaser satellite and 16 kg target satellite feature a magnetic docking mechanism and will stimulate a series of separation and capture maneuvers. Astroscale aims to test launch a demonstration on a Soyuz mission in the first half of 2020, aiming for commercialization by fiscal year 2025.

Astroscale, which was founded by a former Finance Ministry bureaucrat Mitsunobu Okada, has raised $102 million dollars, with a portion of funding coming from the Japanese government-backed Innovation Network Corporation Japan (INCJ). Astroscale was also awarded a $4.5 million dollar grant from the Tokyo Metropolitan Government to set the roadmap for commercializing space debris removal.

The concept of environmental sustainability has expanded to the realm of outer space, with the international community forging an approach to orbital sustainability. In February, Japan and the UN signed a joint statement pledging to raise awareness on space debris and to share research on removing space debris with the international community. Japans UN Ambassador Kimihiro Ishikane said its the first time Japan will participate in a formal treaty concerning space trash, which has become a big problem. He added, Japan will leverage its long history with space trash and looks forward to cooperating.

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Japan's Space Dream? Cleaning Up the Mess. - The Diplomat

Lumberton students’ project will go to outer space on rocket, allow astronauts to test concrete material in space – 12newsnow.com KBMT-KJAC

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LUMBERTON, Texas Two Lumberton High School students are set to make their mark on space travel with an experiment to test how concrete works in outer space.

Dr. Nick Brake at Lamar University helped the Lucas Mason and Austin Havard research and develop the idea. Brake is an associate professor of civil engineering.

"What we want to do is see if this ultra-high performance material, it works very well down here, can also work up there as well for the purpose of colonization or building structures in space," Dr. Nick Brake said.

Mason and Havard are participating in the Student Spaceflight Experiments Program, and the pair of young scientists beat out 375 middle school and high school students to be chosen.

"I honestly wasn't expecting it so it was a nice surprise," Mason said.

The teens are in eleventh grade. They'll see the science experiment loaded onto a rocket ship and sent to the International Space Station. Astronauts will replicate their earthly experiments in space.

Their science experiment is one of 34 from around the world that will be loaded onto the rocket ship.

"It was a great, great feeling," Havard said. "It is sort of strange because we've learned all the times, we've learned about all the different trips up there and knowing we had a part of it."

The rocket will launch in October 2020.

"It has been very, enlightening to see the process behind all this stuff. I didn't know how things like this worked before hand so I learned a lot," Mason said.

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Lumberton students' project will go to outer space on rocket, allow astronauts to test concrete material in space - 12newsnow.com KBMT-KJAC

‘Best Dish in the Galaxy?’: Eastside High Culinary Students Await Word From NASA – WUFT

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George Smith has been cooking since he was 5 years old. So when his teacher at Eastside High School in Gainesville introduced a competition to create a dish for NASA, he was all for it.

Youre getting a chance to send food to space, Smith, 18, said. Who wouldnt want to do that?

Taste. Appearance. Aroma. Texture. Those were the key judgment factors at a regional contest of the NASA HUNCH Culinary Challenge for high school students held recently at Eastside.

Smith and three other students from the Institute of Culinary Arts at Eastside competed against teams from the International Studies Preparatory Academy (ISPA) in Coral Gables and Nature Coast Technical High School in Brooksville, near Tampa.

The prize is one of 10 spots in a national competition at NASAs Johnson Space Center Food Lab in Houston in April. NASA will process the food from the winning team and then send it up to the International Space Station, orbiting 248 miles above Earth, for astronauts to enjoy.

Last May, Phoebus High School of Hampton, Virginia, won the national competition with their organic harvest hash with butternut squash entre.

Greetings from the International Space Station, a group of seven astronauts wrote in a thank you note to the Phoebus team. They eat the hash on Christmas day as part of a big brunch.

We loved it, they wrote. We were all speculating as to which herbs gave it the unique flavor and then found the ingredient list. Thank you and best wishes from orbit.

This years competition theme is ethnic dish. The Eastside students also including senior Connor Mayer, 18, and juniors Alani Cromwell, 17, and Cirius Brown, 16 initially chose the idea of Tacos in Space. However, that idea didnt last long.

After the research phase, we realized that wouldnt work, so were doing quesadillas in space, said Pam Bedford, the schools culinary arts teacher and the teams mentor. It doesnt have the nice ring that tacos in space did, but its what were working with.

For the record, Mayer said, the team discovered that tacos would break apart in space, while quesadillas are glued together with cheese.

The teams quesadillas consist of Mexican-based pork carnitas with refried beans, salsa verde and guacamole. Mayer said the sauce was not traditional: He condensed the sauce by heating it on the stovetop to make it thicker. That should keep the quesadilla from floating away in space.

The students from Nature Coast juniors Christian Delarosa, Collin Leonard and Angie Ortiz offered a couscous dish with onions, bacon, carrots and broccolini. The ISPA students freshmen Ana Paula, Dairon Hernandez and Victoria Vasquez, and sophomore Hector Pomar crafted their Big Boy Spinach, with potatoes, spinach, garlic, tomatoes and avocado oil.

The students from ISPA were the only participants who are not a part of a culinary program.

Were the only crazy ones here, said Marisol Restrepo, a biology teacher at the school.

The judges didnt reveal their final scores at the regional competition, but they expressed their confidence in all of the students dishes.

Theres no winner today, but I dont know how the rest of the contestants will be able to beat you guys, said one of them, Darin Nine, director of culinary instruction at the Department of Culinary Arts and Hospitality at Marion Technical College in Ocala.

Jacqui Bressinger, director of strategic partnerships for the American Culinary Federation, helped organize the contest.

We hope that one of the Florida teams will have the best dish in the galaxy, Bressinger said.

The judges scoresheets have been sent to NASA, where officials there were expected by this week to pick the 10 best dishes from high schools across the country. Bedford said she and the Eastside students have been trying to stay positive while waiting patiently for the results.

Make no mistake, though, thats not easy, the teacher said.

Thinking youre waiting for bad news will drive you crazy, so theyre choosing to wait for the good news, she said.

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When Voyager 2 Calls Home, Earth Soon Wont Be Able to Answer – The New York Times

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Voyager 2 has been traveling through space for 43 years, and is now 13 billion miles from Earth. But every so often, something goes wrong.

At the end of January, for instance, the robotic probe executed a routine somersault to beam scientific data back to Earth when an error triggered a shutdown of some of its functions.

Everybody was extremely worried about recovering the spacecraft, said Suzanne Dodd, who is the Voyager project manager at NASAs Jet Propulsion Laboratory in Pasadena, Calif.

The missions managers on our planet know what to do when such a fault occurs. Although it takes about a day and a half to talk to Voyager 2 at its current distance, they sent commands to restore its normal operations.

But starting on Monday for the next 11 months, they wont be able to get word to the spry spacecraft in case something again goes wrong (although the probe can still stream data back to Earth). Upgrades and repairs are prompting NASA to take offline a key piece of space age equipment used to beam messages all around the solar system.

The downtime is necessary because of a flood of new missions to Mars scheduled to leave Earth this summer. But the temporary shutdown also highlights that the Deep Space Network, essential infrastructure relied upon by NASA and other space agencies, is aging and in need of expensive upgrades.

On any given day, NASA communicates with an armada of spacecraft in deep space. These long distance calls require the most powerful radio antennas in the world. Luckily NASA has its own switchboard, the Deep Space Network or DSN.

The DSN is one of space explorations most valuable assets. It comprises one station in the United States in Goldstone, Calif. and two overseas in Canberra, Australia and Madrid. It has been in operation nonstop for 57 years, and without it, spacecraft that traveled beyond the moon couldnt communicate with Earth. It is used not only by NASA, but also the European Space Agency and the space programs of Japan, India and soon even the United Arab Emirates.

This summer, four missions are scheduled to launch to Mars. When the spacecrafts arrive at the red planet next year, three of them will need additional bandwidth to speak to Earth (China will use its own dishes for its Mars mission).

Each station on Earth is outfitted with three 34-meter antennas and one 70-meter antenna. They switch back and forth depending on where a spacecraft is in relation to our planet, and you can see which spacecraft are talking to Earth in real time by visiting NASAs DSN Now website.

Because of Voyager 2s trajectory relative to Earth, it can talk to only one station and one antenna in the network: Canberras 70 meter dish, also known as DSS 43. And that dish will need to be improved for the new Mars missions, prompting a shutdown and temporary dismantlement.

Frankly, theres never a good time to take down an asset and never a good time to fix the potholes in the road, said Ms. Dodd, who is also director of the group that manages the Deep Space Network for NASA. But you know youre going to do the work at the airport, not during the Christmas rush. Youre going to do it when its less busy.

Because Voyager 2 is considered a geriatric spacecraft, losing contact with it for any length of time is risky. And for the next 11 months, Earths ability to communicate with the probe, now in whats considered interstellar space, will be limited.

There is risk in this business as there is in anything in spaceflight, said Glen Nagle, NASAs outreach and administration lead for the station in Australia. Its a major change and the longest downtime for the dish in the eighteen years Ive been here.

One of the biggest risks is keeping Voyager 2s communication antenna pointed at Earth. To do this, the probe fires its thrusters more than a dozen times a day to stay oriented. The missions managers have to trust that the automation on board will be executed relatively flawlessly for nearly a year.

Staying warm enough is another major concern. The Voyager team has been slowly shutting off instruments in order to use their heaters to keep the spacecrafts fuel lines at a balmy 32 degrees Fahrenheit.

Weve done the analysis to show that we can get through the downtime, with some margin for error, said Todd Barber, the propulsion engineer for the twin Voyager spacecraft. (Voyager 1 is able to communicate with other dishes.)

While the team wont be able to command Voyager 2, they will still be listening to the spacecraft. By combining the power of the other antennas in Canberra, they will be able to collect its scientific observations.

The Canberra site will still be getting data back from the spacecraft, Ms. Dodd said. The science data will still be coming down.

Being able to only listen could prompt some anxiety. While Voyager 2 will keep collecting and sending back science data, should something go wrong, members of the team will be powerless to help it, and will just have to watch with their hands tied.

Weve been planning on this for over a year, Ms. Dodd said. I think like any good planning, were prepared for it. And weve done our best, you know, weve done the best that we can.

And the operations to restore Voyager 2 during its recent troubles may highlight how much more life it could have in deepest space, Ms. Dodd said. Never before had all of the spacecrafts instruments been shut off in this manner. Much to the mission managers delight and surprise, they were all brought back to life.

They also came back on, which is actually pretty remarkable, she said.

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Students note the challenges of medical school debt and look toward tuition options – The Daily Tar Heel

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The costs of applying

Hernandez, who comes from a lower-middle class family, graduated from Duke University in 2016. Although he received a full-tuition scholarship for medical school, he said he still took out around $20,000 in loans to cover other living costs like housing, food and insurance.

Hernandez said he felt early on that he was part of a minority, both in terms of socioeconomic background and ethnicity. Most importantly, he said in many of his premed classes, he was surrounded by peers from legacy physician families.

And so what I think that does, is it sets up this disparity of people that know the plan to get into med school, like people that know you have to volunteer, you got to shadow, you gotta they know what boxes to check to get into med school, Hernandez said.

The Association of American Medical Colleges offers a Fee Assistance Program to help students address potential financial barriers in the application process. Hernandez said while fee assistance did lower the price of the MCAT and provide some study resources, he took out a $1,000 loan to pay for books.

He said as a student of lower socioeconomic status, these additional costs are constantly in the back of his mind.

It pervades every thought throughout med school of when you see that stethoscope and youre like, Damn, you know, thats a lot of money, those kinds of things, he said.

According to the Office of Financial Aid & Scholarships, the cost of attendance per year at UNC School of Medicine is $70,920 for in-state students and $98,314 for out-of-state students. The "cost of education", or COE, takes into account expenses for items like school supplies, transportation and room and board.

Like Hernandez, first-year UNC medical student Noelani Ho believes the financial burden of attending medical school begins in the application process. She co-authored an article on the issue, which was published in October in the New England Journal of Medicine. Ho said the cost of applying can be daunting, and acts as a barrier to increasing diversity in the profession.

Our argument there was like, it's great that we're starting this conversation about free tuition, we definitely think thats the direction we need to be going in and it's definitely helping the cause, Ho said. But we also need to address the fact that the pool of applicants that medical schools are picking to give this free tuition to, is in and of itself not as diverse as it needs to be, both in terms of race and socioeconomic status.

Addressing education debt

Admissions officers at 70 medical schools in the U.S. and Canada were surveyed in a separate Kaplan poll, in which only 4 percent of officers said they believed their institution would be able to offer free tuition in the next decade.

Jeff Koetje, Kaplan Test Preps director of pre-health programs, said moving toward tuition-free options involves a number of factors.

"What is within the realm of possibility for a school is going to depend on what is that mix of sources of funds that are currently available to the school to support its operations, and tuition is a pretty significant aspect of that, Koetje said. The elimination of tuition or the reduction in tuition coming into the school means that the school really needs to think about how is it going to make up that loss of that particular source of funds.

UNC School of Medicine currently offers a number of scholarships and financial aid to its students, although the majority of awards are loans. 78 percent of UNC medical school students received scholarships, according to 2017-2018 data from the Liaison Committee on Medical Education.

Beat Steiner, senior associate dean for medical student education, said UNC School of Medicine supports trying to find ways to reduce tuition burden for students.

I think it's important to note that were a state-sponsored school, right, so were a state medical school, Steiner said. And if it was the will of the citizens of North Carolina to go in the direction of tuition free, that would be just wonderful.

Steiner said two-thirds of UNCs cost of education is paid for by student tuition, while the remaining one-third is funded by state and donor support to the School of Medicine. He said one way the school tries to reach students of underrepresented backgrounds is by encouraging professional development in state high schools.

Obstacles for free tuition

Julie Byerley is the vice dean for academic affairs in the UNC School of Medicine. She said although she supports lowering students debt, she has also heard the argument that its unfair to single out education debt in medicine given the number of other valuable professions in the United States. But she also said one reason medical education may be more costly is because it happens in an apprenticeship sort of way, and is therefore expensive to carry out.

She also said increasing tuition-free options could lead to a potential devaluation of initiatives that incentivize students to go into needed areas of medicine, like the Kenan Primary Care Medical Scholars Program. The program offers financial support and opportunities to students pursuing careers in rural medicine and primary care.

Ariel Harris, a first-year in UNCs School of Medicine and first-generation college student, said when she was applying to UNC, the school placed a lot of emphasis on going into primary care.

Harris said she received a $20,000 scholarship for medical school, but like Hernandez, she had to take out loans to cover the other parts of the cost of education. Both Harris and Hernandez said despite the benefits of the fee assistance program, the costs of applying limited the schools they chose to apply to.

Ho said perhaps one way to level the playing field for prospective medical school students is for the Association of American Medical Colleges to place a cap on the number of schools students can apply to or for schools to encourage more virtual interviews to cut down on travel costs.

Harris said she hopes medical schools can be more transparent about costs, particularly at events like pre-health fairs for undergraduate students.

They talk about all the great things that come with their school, but then you see this really big price tag, and then people kind of shy away, Harris said.

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Students note the challenges of medical school debt and look toward tuition options - The Daily Tar Heel

University School of Medicine surpassed funding record with grants from NIH – University of Virginia The Cavalier Daily

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During 2019, the University School of Medicine met multiple milestones. The Federal Drug Association approved an artificial pancreas for Type I diabetics developed over the past decade at the University. Another team of researchers discovered the protein that allows the bacteria species Geobacter sulfurreducens to conduct electricity, which could have implications for biomedical device development.

While commonalities between these projects may not be immediately apparent, they all are similar in that they have the same major source of funding the National Institutes of Health, a federal agency that conducts and supports medical research. In the past year, NIH awarded the University a record amount of funding $146.3 million, a $25.4 million increase from fiscal year 2018.

David S. Wilkes, dean of the School of Medicine, attributed the Universitys growing number of approved grant proposals from NIH, as well as the more than $400 million the School of Medicine received overall this year, to a targeted approach to research that focuses on specific areas of study. Emphasizing depth over sheer breadth, Wilkes claimed, served the School of Medicine well in terms of finances and achievements.

We put plans in place to reinvigorate the research enterprise at the medical school, Wilkes said. That was in part through finding specific areas of research to invest in, investing in current faculty and also making strategic hires of additional faculty.

Faculty and staff implemented these new strategies at the School of Medicine nearly five years ago when they committed to promoting seven core biological and medical fields cancer, cardiovascular medicine, metabolic disorders, neurosciences, organ transplant, precision medicine and regenerative medicine. In each of these key disciplines, researchers conduct basic, clinical and translational studies to learn how the body functions and develop novel treatments and therapies.

Were hoping for discoveries that enhance the care of patients, the way healthcare is delivered or novel techniques for diagnosing disease and testing how medicines work, Wilkes said. Were hoping for a better understanding of biology as it relates to human conditions.

One of the beneficiaries of numerous NIH grants is Boris Kovatchev director of the University Center for Diabetes Technology and a pioneer on the artificial pancreas, a device thousands already rely on for life-sustaining insulin. When explaining why he has stayed at the University for 28 years, Kovatchev noted that the Universitys Center for Diabetes Technology is well-respected when it comes to diabetes technology development. He also expressed gratitude for several colleagues at the University including Marc Breton, Sue Brown, Mark DeBoer and Stacy Anderson for their expertise on Type I diabetes treatments and the funding from NIH they contribute to the program.

When I came to U.Va. a long time ago, U.Va. already had a very strong endocrinology and diabetes program, Kovatchev said. Now, the U.Va. Center for Diabetes Technology is probably number one in the world.

Initial funding for Type I diabetes research for Kovatchev started over 20 years ago, and for almost 12 years, NIH has continuously awarded Kovatchev and his team grants. In 2016, they received over $12 million for clinical trials of the artificial pancreas. Not only did this sum significantly surpass the average amount of NIH research project grants in fiscal year 2018 $535,239 but it is also the largest given by NIH for research on Type I diabetes.

NIH has special diabetes funding, and that has been a reliable source of funding for specific areas of research related to Type I diabetes, Kovatchev said. They have been our major source.

Similarly, contributions from NIH subsidize the work of Edward H. Egelman, professor of biochemistry and molecular genetics. Along with other scientists from Yale University and the University of California, Irvine, in 2019, Egelman discovered the structure that enables certain bacteria species to conduct electricity.

While it was commonly accepted that bacteria transported electrons via filamentous appendages that can cause infections, or pili, researchers found that distinct filaments encase molecules with metal and compose a nanowire to facilitate electron transfer. Egelman cited recent and past NIH grants as essential for this type of research, as well as for exploring novel topics that led him to unexpected conclusions.

I am very fortunate to have had sustained funding from the NIH for almost all of my career, and this has allowed my research to go off in unanticipated directions, Egelman said in an email to The Cavalier Daily. The point is that with fundamental or basic research we never quite know what the consequences will be but my NIH funding allowed me to pursue these studies that may have direct implications for everything from nanoelectronics to biomedical engineering.

NIH continues to support a variety of ongoing endeavors at the University. For example, researchers at the University and Virginia Tech recently accepted $3.4 million to develop a miniature model of a lymph node they hope will aid future studies of the organ. The integrated Translational Health Research Institute of Virginia, an initiative throughout the state to connect clinical researchers, disbursed $200,000 from NIH to four multi-institutional research projects several of which involve University faculty in its initial effort to sponsor combined biomedical and data-driven projects, such as the use of ultrasounds to help treat depression.

At the start of a new decade, the challenge for the School of Medicine, Wilkes said, is not necessarily if there will be adequate monetary resources for research, but rather if there will be adequate laboratory space. With a record year behind them, University researchers are looking forward now, as research expansion is likely on the horizon.

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University School of Medicine surpassed funding record with grants from NIH - University of Virginia The Cavalier Daily

Realizing the medical school dream, for himself and his family – Scope

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Jimmy Zheng was in the 10th grade whenhe decided to try to pay his own way through college and beyond.

His mother, who worked as a grocery store clerk, had recently fallen from a ladder, and was forced to give up her job after a hospital stay. Though his father continued to put in long hours for his online leather goods business, the return was modest -- not the dream they had hoped to achieve when they immigrated from China to California.

"I realized they were working really hard, but theywere not really succeeding in the way they thought they would, coming here toAmerica," Zheng told me. "That moment was really critical for me to realize,I'm actually going to need to do some work to lift up this family, movingforward."

Scholarships and multiple jobs helped Zheng pay for college; and after graduating, he took a consulting position to continue supporting himself. He dreamed of becoming a doctor, but thought he'd have to delay a few years because of the cost. Stanford Medicine worked with him to provide an option he could afford, and he's now in his second year of medical school.

"The financial aid made a difference in terms of the timeline of my trajectory and my career path," Zheng said. "To me, that's everything, because the earlier I can go into medicine, the earlier I can start living my dream and my passion -- and also support myself and my family."

His words resonated with me and my colleagues, as we worked on #WeAreStanfordMed, a series of videos exploring how financial assistance impacts Stanford Medicine students. We wanted to tell the stories of those who have benefitted from scholarships and programs that defray the costs of medical school.

Many fall into this category. During the past academic year, more than two-thirds of Stanford medical students received some form of financial aid, and the median debt for last year's graduating class -- just over $89,000 -- was significantly less than the national median of $200,000 reported by the Association of American Medical Colleges.

This is no coincidence: Stanford Medicine leaders have long worked to address the rising cost of medical education, including through an ongoing mission to reduce graduating debt. Last week, the school reached a milestone in that journey, announcing a $90 million program that will eliminate medical school debt for students with the most need.

Removing financial barriers can make a big difference for promising young physicians-in-training, as we learned from Zheng and the other students in our videos.

Zheng told us that his aid means he doesn't have to work side jobs, like he did in college, and he can focus on his studies and an array of related activities. In his first year of medical school, he worked on machine-learning research to automate detection and classification of certain diseases and conditions. He also was a student leader in a public health effort to get flu vaccines to underserved communities, and he mentored high school students interested in science and medicine.

Zheng said that his strong sense of service comes from his parents. Inspired by them and his volunteer work at a homeless clinic, he envisions a career in primary care, working with the medically underserved. The decision will be easier because he knows he'll have minimal debt from medical school, Zheng said.

"Something about working with people who have been overlooked by society, people who are struggling and don't have the resources to thrive -- that reminded me a lot of immigrant populations, of people I came from," Zheng told me, my colleague Margarita Gallardo and videographer Kevin German during filming.

Seeing him with his parents -- casually joking with them, draping his arms protectively around their shoulders -- touched our hearts. Learning his story -- and those of the four other students -- inspired us and made us feel proud to be part of an institution that is ensuring the next generation of physicians reflects the diversity of the communities they serve.

#WeAreStanfordMed is a video series spotlighting Stanford medical students and the impact of financial assistance on their education and aspirations.

Photo and video by Luceo

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Realizing the medical school dream, for himself and his family - Scope

Paying the Price – Harvard Medical School

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Caring for homeless patients presents a unique set of challenges, said Katherine Koh, a street psychiatrist for Boston Health Care for the Homeless Program (BHCHP) and a Harvard Medical School instructor in psychiatry at Massachusetts General Hospital.

For one thing, the population is afflicted by a high burden of psychiatric, medical and substance-related illnesses. But the nature of a life of homelessness can also make it difficult to access health care.

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Working with this population, I have witnessed myriad social factors that interfere with my patients receiving optimal health care, including competing and often superseding priorities of food, shelter and safety, said Koh.

With this in mind, Koh said, it is important to design adequate payment systems for provider organizations caring for this population to make sure that sufficient resources are available to provide high-quality care to patients, despite these barriers. The need is more pressing now than ever, as homeless populations are increasingly part of accountable care organizations (ACOs), which have to manage their health care needs under a budget.

Yet, researchers say, there have never been reliable comparisons of what homeless individuals spend or use on health care compared to a relevant control group.

Now, in what is believed to be the first paper of its kind, a team of researchers has found that the homeless and unstably housed patients cared for by the BHCHP spent2.5 times moreon health care than a disadvantaged group of Massachusetts Medicaid patients who were not homeless. BHCHP is one of the largest freestanding homeless health care programs in the U.S., serving about 11,000 people across 45 clinical sites in Boston.

The study, which appears in the February issue of Health Affairs, was led by Koh and other members of the Boston Health Care for the Homeless Program, including Melanie Racine, Jessie Gaeta, Barry Bock, and Mary Takach, as well as members of the Boston Medical Center Health System, including John Goldie and Daniel Martin, in collaboration with Zirui Song, assistant professor of health care policy in the Blavatnik Institute at HMS.

These findings could help inform the design of payment models to improve the value of health care spending among vulnerable populations, Song said.

Comparing data from 402 BHCHP patients who were continuously enrolled for 3 years to 18,638 similarly enrolled people insured by Massachusetts Medicaid (MassHealth) with no evidence of homelessness, the study found that observed spending for BHCHP patients was 2.5 times higher than Massachusetts Medicaid beneficiaries. BHCHP patients spent on average $18,764 per person per year on health care. Currently, the risk adjustment for people experiencing homelessness that ACOs receive from Massachusetts Medicaid is $550 person per year. This amounts to only about one-eighth of the adjusted difference in spending between the BHCHP and comparison Medicaid populations observed in the study, suggesting that the current risk adjustment is inadequate.

Outpatient care largely explained the difference in spending between the two populations. The difference was smaller after adjustment for the risk score, which suggested that homelessness or housing instability was meaningfully correlated with higher health care spending.

Several core principles have emerged that guide successful models of care for homeless patients, including the need to deliver direct care in shelters and on the streets, engagement and earning trust, the creation of multidisciplinary teams that integrate medical and psychiatric and addiction care, the inclusion of homeless persons in the design and implementation of care models, a recognition that street and shelter services are a part of mainstream specialty and hospital care, and the necessity of medical respite care for those no longer in need of expensive hospital care but who are much too ill to withstand living on the streets or in the shelters, said co-author James O'Connell, street physician and president of BHCHP.

This study creates the foundation for potential mechanisms for calculating risk for this costly and vulnerable population, said OConnell, who is also HMS assistant professor of medicine at Mass General.

Funded by the National Institutes of Health (NIH Directors Early Independence Award DP5-OD024564).

This story includes portions that were originally published as a news brief from the HMS Department of Health Care Policy.

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Paying the Price - Harvard Medical School

Arcturus Therapeutics and Duke-NUS Medical School Partner to Develop a Coronavirus (COVID-19) Vaccine using STARR TechnologyCollaboration seeks to…

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SAN DIEGO and SINGAPORE, March 04, 2020 (GLOBE NEWSWIRE) -- Arcturus Therapeutics, Inc. (the Company, NASDAQ: ARCT), a leading messenger RNA medicines company,and Duke-NUS Medical School (Duke-NUS), a research intensive, graduate entry medical school, today announced their partnership to develop a Coronavirus (COVID-19) vaccine for Singapore. The development of a COVID-19 vaccinewill be based on the Companys STARR technologyand will take advantage of a unique platform developed at Duke-NUS allowing rapid screening of vaccines for effectiveness and safety.

The STARR Technology platform combines self-replicating RNA with LUNAR, a leading nanoparticle non-viral delivery system, to produce proteins inside the human body. Due to superior immune response and sustained protein expression, Arcturus STARR Technology is expected to produce a vaccine response at much lower doses compared to traditional mRNA vaccines. This could lead to the ability to treat many more people with a single GMP-manufactured production batch, thereby greatly increasing efficiency and reducing time required to produce sufficient quantities of vaccine for large populations.

We have observed STARR technology in pre-clinical models to be effective at extraordinarily low doses -- greater than 30-fold more efficient than traditional mRNA. The Arcturus manufacturing process has been applied in multiple large GMP batches of highly pure RNA in our LUNAR-OTC program. If successful, Arcturus could develop a vaccine capable of vaccinating millions of people for a fraction of the cost of traditional mRNA vaccines, said Joseph Payne, President & CEO of Arcturus Therapeutics.

Duke-NUS has been on the front lines in the fight against COVID-19, developing the first serological tests for COVID-19 and was among the first groups to isolate and culture the virus. The partnership with Arcturus Therapeutics combines complementary strengths as we work together to fight this global outbreak, said Professor Thomas M. Coffman, Dean of Duke-NUS Medical School.

COVID-19 belongs to a family of coronaviruses that can cause serious respiratory disease. Arcturus plans to apply its STARR Technology toward the development of a vaccine to protect against COVID-19. The self-replicating RNA-based therapeutic vaccine triggers rapid and prolonged antigen expression within host cells resulting in protective immunity against infectious pathogens.

There is a tremendous urgency to develop an effective prevention for the current Coronavirus crisis. The Duke-NUS and Arcturus partnership could expedite a solution to this urgent need as we utilize STARR Technology to bring a vaccine candidate for clinical testing in the shortest time possible, said Professor Ooi Eng Eong, Deputy Director of the Emerging Infectious Diseases programme at Duke-NUS.

Arcturus Corporate Deck has been updated accordingly, and is available at ArcturusRx.com

For more information and potential collaboration opportunities regarding Arcturus Coronavirus vaccine, please contact Arcturus by email at Vax@ArcturusRx.com

About STARR TechnologyThe STARR technology platform combines self-replicating RNA with LUNAR, a leading nanoparticle delivery system, into a single solution to produce proteins inside the human body. The versatility of the STARR technology affords its ability upon delivery into the cell to generate a protective immune response or drive therapeutic protein expression to potentially prevent against or treat a variety of diseases. The self-replicating RNA-based therapeutic vaccine triggers rapid and prolonged antigen expression within host cells resulting in protective immunity against infectious pathogens. This combination of the LUNAR and STARR technologyTM is expected to provide lower dose requirements due to superior immune response, sustained protein expression compared to non-self-replicating RNA-based vaccines and potentially enable us to produce vaccines more quickly and simply.

About CoronavirusCoronaviruses are a family of viruses that can lead to respiratory illness, including Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). Coronaviruses are transmitted between animals and people and can evolve into strains not previously identified in humans. On January 7, 2020, a novel coronavirus (2019-nCoV) was identified as the cause of pneumonia cases in Wuhan City, Hubei Province of China, and additional cases have been found in a growing number of countries.

About Duke-NUS Medical SchoolDuke-NUS is Singapores flagship graduate entry medical school, established in 2005 with a strategic, government-led partnership between two world-class institutions: Duke University School of Medicine and the National University of Singapore (NUS). Through an innovative curriculum, students at Duke-NUS are nurtured to become multi-faceted Clinicians Plus poised to steer the healthcare and biomedical ecosystem in Singapore and beyond. A leader in ground-breaking research and translational innovation, Duke-NUS has gained international renown through its five signature research programmes and eight centres. The enduring impact of its discoveries is amplified by its successful Academic Medicine partnership with Singapore Health Services (SingHealth), Singapores largest healthcare group. This strategic alliance has spawned 15 Academic Clinical Programmes, which harness multi-disciplinary research and education to transform medicine and improve lives.For more information, please visit https://www.duke-nus.edu.sg/

AboutArcturus TherapeuticsFounded in 2013 and based in San Diego, California, Arcturus Therapeutics Holdings Inc. (Nasdaq: ARCT) is an RNA medicines company with enabling technologies LUNAR lipid-mediated delivery, Unlocked Nucleomonomer Analog (UNA) chemistry, STARR technology and mRNA drug substance along with drug product manufacturing. Arcturus diverse pipeline of RNA therapeutics includes programs to potentially treat Ornithine Transcarbamylase (OTC) Deficiency, Cystic Fibrosis, Coronavirus (COVID-19), Glycogen Storage Disease Type 3, Hepatitis B, and non-alcoholic steatohepatitis (NASH). Arcturus versatile RNA therapeutics platforms can be applied toward multiple types of nucleic acid medicines including messenger RNA, small interfering RNA, replicon RNA, antisense RNA, microRNA, DNA, and gene editing therapeutics. Arcturus technologies are covered by its extensive patent portfolio (182 patents and patent applications, issued in the U.S., Europe, Japan, China and other countries). Arcturus commitment to the development of novel RNA therapeutics has led to collaborations with Janssen Pharmaceuticals, Inc., part of the Janssen Pharmaceutical Companies of Johnson & Johnson, Ultragenyx Pharmaceutical, Inc., Takeda Pharmaceutical Company Limited, CureVac AG, Synthetic Genomics Inc., Duke-NUS, and the Cystic Fibrosis Foundation. For more information visit http://www.Arcturusrx.com

Forward Looking StatementsThis press release contains forward-looking statements that involve substantial risks and uncertainties for purposes of the safe harbor provided by the Private Securities Litigation Reform Act of 1995. Any statements, other than statements of historical fact included in this press release, including those regarding strategy, future operations, collaborations, the likelihood of success of the Companys Coronavirus (COVID-19) vaccine or other products, the status of preclinical and clinical development programs and the planned initiation of clinical trials are forward-looking statements. Arcturus may not actually achieve the plans, carry out the intentions or meet the expectations or projections disclosed in any forward-looking statements such as the foregoing and you should not place undue reliance on such forward-looking statements. Such statements are based on managements current expectations and involve risks and uncertainties, including those discussed under the heading Risk Factors in Arcturus Annual Report on Form 10-K for the fiscal year ended December 31, 2018, filed with the SEC on March 18, 2019 and in subsequent filings with, or submissions to, the SEC. Except as otherwise required by law, Arcturus disclaims any intention or obligation to update or revise any forward-looking statements, which speak only as of the date they were made, whether as a result of new information, future events or circumstances or otherwise.

ContactArcturus TherapeuticsNeda Safarzadeh(858) 900-2682IR@ArcturusRx.com

LifeSci Advisors LLCMichael Wood(646) 597-6983mwood@lifesciadvisors.com

Duke-NUS Medical School CommunicationsLekshmy Sreekumar, Ph.D.(+65) 6516-1138lekshmy_sreekumar@duke-nus.edu.sg

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Arcturus Therapeutics and Duke-NUS Medical School Partner to Develop a Coronavirus (COVID-19) Vaccine using STARR TechnologyCollaboration seeks to...

More than just a liberal arts university: How the Law School and Med School put USD on the map – The Volante

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The University of South Dakota is the only university in the state that has a law school and a medical school. Leah Dusterhoft | The Volante.

USD is the only university in South Dakota that offers both a medical school and a law school, but for University President Sheila Gestring, that distinction only increases the schools duties to South Dakota.

Gestring said the law and medical schools face a heightened level of obligation to help the state.

(That is) a special responsibility, because were educating the future doctors and lawyers that are going to practice here in the state of South Dakota, Gestring said.

The Med Schools new curriculum

Mary Nettleman, dean of USDs Sanford School of Medicine, said 80% of the med schools graduates plan to practice in South Dakota. One aspect of the medical school which has changed throughout Nettlemans eight years here, she said, is the curriculum.

The curriculum has been modernized, Nettleman said in an email interview with The Volante. There is a renewed emphasis on student wellness, a Certificate in Bioethics has been added, more experience with Native American culture has been added.

The curriculum also features more experiences and fewer lectures in the first few years for students. USDs medical school students have more clinical experience before graduation than most medical students, Nettleman said. Students also have proven to have high board scores and pass rates. She said the graduating class for this upcoming May earned 100% board pass rates on both required national boards.

The most recent results show that our average board score was better than 75% of medical schools in the country, Nettleman said.

Nettleman, who will retire this July, said serving as the dean of the medical school was a pleasure and privilege. In 2017, the medical school received the Spencer Foreman Award, which is the top award a medical school can receive, Nettleman said. Only one school is chosen each year.

One new project the school is starting to work on will emphasize the importance of kindness.

We are fortunate to have students and faculty who are inherently kind, Nettleman said. What we are trying to do is to make kindness a visible part of our culture and curriculum.

The Law School starts conversations

Neil Fulton, the Dean of USDs Law School, said the school plays an important role in serious discussions about a variety of issues.

When there are conversations about government, about justice in society, about who we are as a society, the law school really needs to be front and center in those conversations and I think our faculty, students and staff do that, Fulton said.

Last year, 49 students graduated from the law school, and 203 students are enrolled this year.

One thing law students, as well as faculty and staff need, Fulton said, is to adapt to changes in the law. Property laws, which pertain to what people are allowed to own, have changed over time, Fulton said.

In the course of (a property law) class, professors are going to talk about digital property and electronic issues in a way that they didnt (30 years ago), Fulton said. So, even though the classes stay the same, the law continues to evolve to meet societal changes.

The law school has also added newer courses emphasizing experiential learning and hands-on opportunities.

Fulton said the school has expanded its connection with the East River Legal Services, so students can get volunteer opportunities to represent real clients. Theyve also added a practicum course with the Sioux Falls Public Defenders Office, which gets students in courtrooms.

Our graduates are going to go out and be leaders in their communities and weve got graduates who are going out to almost every community in South Dakota and surrounding states in the region, Fulton said.

Both the Law School and Medical School, Fulton said, play an important role not only to USD, but to the state of South Dakota.

The Law School and the Med School and USD in general have a tremendous history of service to the state, Fulton said. Thats really important because a little bit about who were are defines a lot about who were going to be.

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More than just a liberal arts university: How the Law School and Med School put USD on the map - The Volante

Stopping the Second Hit – Harvard Medical School

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Acute myeloid leukemia, or AML, a blood cancer affecting adults and children, requires more than one genetic hit to develop.

As we age, many of us acquire a genetic mutation that enables certain blood cells to multiply faster than others, forming their own distinct population. This first hit, known asclonal hematopoiesisof indeterminate potential, or CHIP, isnt necessarily harmful.

But if a second hit comes that makes those cells malignant, its essentially a guarantee you will get leukemia in the not-too-distant future, saidScott Armstrong, the David G. Nathan Professor of Pediatrics at Harvard Medical School and president of theDana-Farber/Boston Childrens Cancer and Blood Disorders Center.

The result is a rapid buildup of immature, dysfunctional blood cells.

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In research recently published inScience, Armstrong and colleagues propose that interfering with this second hit, specifically by using a compound currently in preclinical studies in mice, could stop AML before it gets started.

The work suggests that screening people for the first hit, then watching for and treating the second hit, could prevent AML from developing.

The idea is that you would screen people and follow those who have clonal hematopoiesis and treat people who develop the second mutation, said Armstrong, who is senior author of the study.

Early intervention

The researchers worked with mice that had the first hit, a mutation in the geneDNMT3Athat is associated with CHIP.

When they introduced the second hit, a mutation in the geneNPM1, the mice went on to develop leukemia.

If these mice were treated early with a compound called VTP-50469, however, the premalignant blood cells stopped multiplying and leukemia never developed. There were no apparent toxic effects.

We eradicated the cells that would ultimately become leukemia cells, said Armstrong. This is one of the first times weve had a molecule thats effective and can act selectively on preleukemic cells rather than normal cells. We treated the mice for many weeks, and theyre just fine.

It remains to be seen whether the findings can be replicated in people.

Learning from infant leukemias

VTP-50469 came out of earlier research by Armstrong and colleagues on rare, high-risk infant leukemias known as MLL-rearranged leukemias.

The compound targets a complex of proteins that join together and turn on the genes driving the leukemia. VTP-50469 disrupts two proteins in this complex, Menin and MLL. The complex falls apart, so the leukemia genes turn off.

In the infant leukemia study, done in mice and leukemia cell lines, VTP-50469 treatment led to sharp decreases in the number of leukemia cells, and, in some animals, remission of the cancer. Normal blood cells were unharmed.

It turns out that more common adult leukemias are using these same mechanisms, said Armstrong.

A close cousin of VTP-50469 is now in clinical trials in adults with relapsed AML. Armstrong hopes to see a similar trial launched in children with AML this year.

A model for preventive care?

While screening everyone over a certain age for clonal hematopoiesis may not be practical yet, one could imagine screening people who are thought to be at heightened risk for AML, such as those who had chemotherapy previously or in whom problems in the circulatory system are suspected.

The same preventive care concept could apply to other cancers that involve multiple hits, Armstrong believes.

You need to know which mutations are important, and the order of the mutations, and you need to have a drug thats relatively nontoxic, since youre talking about a patient that, at that time, isnt sick, he said. If you have a molecule that targets one of the early mutations, thats really the holy grail: being able to intervene early in the cancer development process.

Hannah Uckelmann, HMS research fellow in pediatrics at Dana-Farber/Boston Childrens Cancer and Blood Disorders Center, is first author of the paper.

The study was supported by the National Institutes of Health (CA176745, CA204639, CA066996, CA206963, P30CA008748 and U54OD020355-04), Wicked Good Cause, Cookies for Kids Cancer, SFB/the German Research Foundation (DFG, UC77/1-1) and Cancer Research UK (C22324/A23015).

Adapted froma poston Discoveries, the Boston Children's research and clinical innovation blog.

Image: kieferpix/Getty Images

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Stopping the Second Hit - Harvard Medical School

Women Have Closed Med School Enrollment Gap; Others Remain – AAFP News

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In 2017, for the first time, the class of students entering U.S. medical schools was more than 50% female.

It wasn't a fluke.

In 2018 and 2019, women matriculants outnumbered men. Now, for the first time, women make up the majority of students in U.S. medical schools. According to the Association of American Medical Colleges' 2019 Fall Applicant, Matriculant and Enrollment Data Tables,(www.aamc.org) women accounted for 52.4% of medical school matriculants this academic year.

It's been a long time coming.

Women now make up about 35% of the U.S. physician workforce, compared to 5% in 1970. It wasn't until the 1970-71 academic year that women accounted for more than 10%(report.nih.gov) of a single U.S. medical school class. The incoming class of 1992-93 was the first to reach 40%, but it took more than two decades for women to finally break the 50% mark in 2017-18.

Yet women in medicine still have work to do to reach equity with their male colleagues. According to the AAMC report Diversity in Medicine: Facts and Figures 2019,(www.aamc.org) "medical school faculty continued to be predominantly white (63.9%) and male (58.6%)," and the same holds true for practicing physicians, where the majority are also white (56.2%) and male (64.1%).

According to AAMC 2019 faculty data, women held only 25.6% of full professorships(www.aamc.org) and 15.9% of clinical sciences permanent department chairs.(www.aamc.org)

Women also face a gap in payment. According to the 2019 Medscape Physician Compensation Report,(www.medscape.com) male subspecialty physicians earned an average of about 33% more than their women colleagues, down from a 36% gap a year earlier. However, the gender gap actually widened in primary care -- according to the Medscape survey -- from about 18% in 2018 to nearly 25% in 2019.

So why am I optimistic that things will change?

As the number of women in medicine continues to swell, so do our numbers in leadership. The presidents of some large national health organizations, including the AMA and the American Academy of Pediatrics, are women.

In family medicine, the presidents of the AAFP Foundation and the Association of Family Medicine Residency Directors are women, and there are many other women in our leadership pipeline. More than half of the AAFP's 55 constituent chapters have women presidents, and women chair three of the Academy's seven commissions.

In 2020-21, women -- including me -- will take on the president's role in six national family medicine organizations: the AAFP, AAFP Foundation, American College of Osteopathic Family Physicians, Association of Departments of Family Medicine, North American Primary Care Research Group and Society of Teachers of Family Medicine.

Many of the women with leadership roles in family medicine have benefited from attending the National Conference of Constituency Leaders, which is the AAFP's leadership development event for underrepresented constituencies: women physicians, minority physicians, new physicians, international medical graduate physicians and LGBT physicians. The annual event is scheduled for April 23-25 in Kansas City, Mo., in conjunction with the AAFP's Annual Chapter Leader Forum.

As I write this post, Black History Month is winding down, and I would be remiss if I did not mention that our health care workforce must grow not only to equally represent men and women but also to address racial disparities. Although the matriculation rate of African Americans to medical schools has marginally increased, we are not yet represented in medicine in proportion with our percentage in the general population. (And neither are Hispanics or Native Americans and Alaska Natives.)

It has been noted that more black men entered medical school in 1978 than in 2014,(www.aamc.org) and the low numbers persist. We must continue to work to inspire and mentor more women and minorities to seek leadership positions within our organizations and in the C-suite to ensure that our workforce reflects our overall population.

The AAFP has set an ambitious goal to ensure that by 2030, 25% of U.S. medical school seniors will select family medicine as their specialty. As we strive to reach that lofty mark, we need to continue to mentor our young black men and women to increase the diversity of our workforce to achieve true health equity.

Ada Stewart, M.D., is president-elect of the AAFP.

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CRISPR Used To Edit Genes Inside A Patient With A Rare Form Of Blindness : Shots – Health News – NPR

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Scientists at the Casey Eye Institute, in Portland, Ore., have have injected a harmless virus containing CRISPR gene-editing instructions inside the retinal cells of a patient with a rare form of genetic blindness. KTSDesign/Science Photo Library/Getty Images hide caption

Scientists at the Casey Eye Institute, in Portland, Ore., have have injected a harmless virus containing CRISPR gene-editing instructions inside the retinal cells of a patient with a rare form of genetic blindness.

For the first time, scientists have used the gene-editing technique CRISPR to try to edit a gene while the DNA is still inside a person's body.

The groundbreaking procedure involved injecting the microscopic gene-editing tool into the eye of a patient blinded by a rare genetic disorder, in hopes of enabling the volunteer to see. They hope to know within weeks whether the approach is working and, if so, to know within two or three months how much vision will be restored.

"We're really excited about this," says Dr. Eric Pierce, a professor of ophthalmology at Harvard Medical School and director of the Inherited Retinal Disorders Service at Massachusetts Eye and Ear. Pierce is leading a study that the procedure launched.

"We're helping open, potentially, an era of gene-editing for therapeutic use that could have impact in many aspects of medicine," Pierce tells NPR.

The CRISPR gene-editing technique has been revolutionizing scientific research by making it much easier to rewrite the genetic code. It's also raising high hopes of curing many diseases.

Before this step, doctors had only used CRISPR to try to treat a small number of patients who have cancer, or the rare blood disorders sickle cell anemia or beta-thalassemia. While some of the initial results have been promising, it's still too soon to know whether the strategy is working.

In those other cases, doctors removed cells from patients' bodies, edited genes in the cells with CRISPR in the lab and then infused the modified cells back into the volunteers' bodies to either attack their cancer or produce a protein their bodies are missing.

In this new experiment, doctors at the Casey Eye Institute in Portland, Ore., injected (into the eye of a patient who is nearly blind from a condition called Leber congenital amaurosis) microscopic droplets carrying a harmless virus that had been engineered to deliver the instructions to manufacture the CRISPR gene-editing machinery.

Beginning in infancy, the rare genetic condition progressively destroys light-sensing cells in the retina that are necessary for vision. Vision impairment with LCA varies widely, but most patients are legally blind and are only able to differentiate between light and dark or perhaps to detect movement.

"The majority of people affected by this disease have the most severe end of the spectrum, in terms of how poor their vision is," Pierce says. "They're functionally blind."

The goal is that once the virus carrying the CRISPR instructions has been infused into the eye, the gene-editing tool will slice out the genetic defect that caused the blindness. That would, the researchers hope, restore production of a crucial protein and prevent the death of cells in the retina, as well as revive other cells enabling patients to regain at least some vision.

"It's the first time the CRISPR gene-editing is used directly in a patient," Pierce says. "We're really optimistic that this has a good chance of being effective."

The study is being sponsored by Editas Medicine, of Cambridge, Mass., and Allergan, based in Dublin. It will eventually involve a total of 18 patients, including some as young as ages 3 to 17, who will receive three different doses.

"We're very excited about this. This is the first time we're doing editing inside the body," says Charles Albright, the chief scientific officer at Editas.

"We believe that the ability to edit inside the body is going to open entire new areas of medicine and lead to a whole new class of therapies for diseases that are not treatable any other way," Albright says.

Francis Collins, director of the National Institutes of Health, calls the advance "a significant moment."

"All of us dream that a time might be coming where we could apply this approach for thousands of diseases," Collins tells NPR. "This is the first time that's being tried in a human being. And it gives us hope that we could extend that to lots of other diseases if it works and if it's safe."

Pierce, Albright and others stressed that only one patient has been treated so far and that the study, still at a very early stage, is designed primarily to determine whether injecting the gene-editing tool directly into the eye is safe.

To that end, the researchers are starting with lowest dose and the oldest patients, who have already suffered extensive damage to their vision. And doctors are only treating one eye in each patient. All of those steps are being taken in case the treatment somehow backfires, causing more damage instead of being helpful.

"CRISPR has never been used directly inside a patient before," Pierce says. "We want to make sure we're doing it right."

Still, he says, if the underlying defect can be repaired in this patient and others with advanced damage, "we have the potential to restore vision to people who never had normal vision before. It would indeed be amazing."

The study involves a form of Leber congenital amaurosis known as Type 10, which is caused by a defect in the CEP290 gene.

If the approach appears to be safe and effective, the researchers will start treating younger patients.

"We believe children have the potential to have the most benefit from their therapy, because we know their visual pathways are still intact," Albright explains.

The procedure, which takes about an hour to perform, involves making tiny incisions that enable access to the back of the eye. That allows a surgeon to inject three droplets of fluid containing billions of copies of the virus that has been engineered to carry the CRISPR gene-editing instructions under the retina.

The idea is that once there, the CRISPR editing elements would snip out the mutation that causes a defect in CEP290. The hope is that this would be a one-time treatment that would correct vision for a lifetime.

If it works, the volunteers in the study might be able to have the procedure repeated on the other eye later.

"If we can do this safely, that opens the possibility to treat many other diseases where it's not possible to remove the cells from the body and do the treatment outside," Pierce says.

The list of such conditions might include some brain disorders, such Huntington's disease and inherited forms of dementia, as well as muscle diseases, such as muscular dystrophy and myotonic dystrophy, according to Pierce and Albright.

"Inherited retinal diseases are a good choice in terms of gene-based therapies," says Artur Cideciyan, a professor of ophthalmology at the University of Pennsylvania, given that the retina is easily accessible.

But Cideciyan cautions that other approaches for these conditions are also showing promise, and it remains unclear which will turn out to be the best.

"The gene-editing approach is hypothesized to be a 'forever fix,' " he says. "However, that's not known. And the data will have to be evaluated to see the durability of that. We'll have to see what happens."

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CRISPR Used To Edit Genes Inside A Patient With A Rare Form Of Blindness : Shots - Health News - NPR

WSU and Henry Ford Health System host World Congress Ultrasound in Medical Education – The South End

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The Wayne State University School of Medicine, in collaboration with the Henry Ford Health System, will host the 2020 World Congress Ultrasound in Medical Education in Detroit Sept. 17-20.

The congress will bring together the medical profession and those concerned about the quality of todays health care to share experiences, expertise and thoughts on how best to incorporate the power of ultrasound into education and clinical practice, and will feature the latest in innovative research in ultrasound education, including the use artificial intelligence to teach and assess learner competencies. There will be a number of oral and poster presentations from beginner to expert level to stimulate discussion across the spectrum. Medical students, mid-level practitioners, allied health professionals, residents and graduate students will have the opportunity to interact with national and international research experts.

Participants will learn from educational experts who have successfully implemented four-year longitudinal curricula to develop an understanding about what to teach, how to teach, assessment methods and where to seamlessly integrate ultrasound in line with Liaison Committee on Medical Education standards. Curriculum development and implementation will encompass all aspects of point-of-care ultrasound, from ultrasound applications in microgravity to undergraduate, graduate and global health applications. The congress will include opportunity to share an update on the new International Consensus Curriculum for undergraduate ultrasound integration.

Abstract submissions are now being accepted here.

Register for the event here.

Complete congress information is available here.

Plenary speakers will include:

Scott Dulchavsky, M.D., Ph.D., professor of Surgery, Molecular Biology and Genetics at the Wayne State University School of Medicine; the Roy D. McClure Chair of Surgery and surgeon-in-chief at Henry Ford Health System in Detroit, Michigan; and chief executive officer of The Innovation Institute at Henry Ford Hospital.

Richard Hoppmann, M.D., the Dorothea H. Krebs Endowed Chair of Ultrasound Education and professor of Medicine at the University of South Carolina School of Medicine.

Michael Blaivas, M.D., M.B.A., FACEP, FAIUM, affiliate professor of Medicine at the University of South Carolina School of Medicine.

Resa Lewiss, M.D., director of Point-of-Care Ultrasound at the University of Colorado School of Medicine.Chris Fox, M.D., chair of the Department of Emergency Medicine at the University of California, Irvine School of Medicine.

David Bahner, M.D., RDMS, professor of Emergency Medicine and Ultrasound Division chief at the Ohio State University College of Medicine.

Rachel Liu, B.A.O., M.B.B.C.H., FACEP, assistant professor of Emergency Medicine and director of Point-of-Care Ultrasound Education at the Yale University School of Medicine.

Vicki Noble, M.D., professor and vice chair of Emergency Medicine at the Case Western Reserve School of Medicine.

J. Antonio Bouffard, M.D., senior staff radiologist, Division of Musculoskeletal Images at Henry Ford Hospital in Detroit.

Julian Suszanski, M.D., Department of Emergency Medicine at Henry Ford Hospital in Detroit.

Sudhir Baliga, M.D., Department of Emergency Medicine at Henry Ford Hospital in Detroit.

Caroline Dowers, M.D., Department of Emergency Medicine at Henry Ford Hospital in Detroit.

Christopher Clark, M.D., Department of Emergency Medicine at Henry Ford Hospital in Detroit.

Arif Hussain, M.D., head of Cardiac Critical Care and Consultant Anesthesia at the King Abdul-Aziz Cardiac Center in Riyadh, Saudi Arabia.

Luca Neri, M.D., World Congress on Ultrasound in Medical Education.

Matthew Jackson, Ph.D., associate professor of Biochemistry, Microbiology and Immunology at the Wayne State University School of Medicine.

Erin Stratta, M.D., MEDOPs Point-of-Care Ultrasound Project coordinator/MSF International Doctors Without Borders.

Thomas Marshburn, M.D., NASA astronaut and Emergency Medicine physician, Statesville, N.C.

The agenda includes:

Sept. 17Pre-conference Ultrasound Session9 a.m.-3:30 p.m.: Ultrasound Boot Camp Ultrasound for Medical School Faculty5-7:30 p.m.: Welcome reception and registration: Marriot Hotel at the Detroit Renaissance Center

Sept. 187-8 a.m.: Continental breakfast and registration8-8:15 a.m.: Welcome and History of Motown Video and Conference Theme8:15-8:30 a.m.: WCUME 2020 Social Media Networking Information for Conference8:30-9 a.m.: Keynote address: Scott Dulchavsky M.D., Ph.D.9-9:30 a.m.: NASA presentation ADUM curriculum for training astronauts9:30-10 a.m.: Wayne State University Ultrasound Curriculum Update10-10:30 a.m.: Coffee break/exhibits/poster viewing10:30 a.m.-noon: Oral abstractsNoon-1 p.m.: Lunch/exhibits/poster viewing1-1:30 p.m. : Richard Hoppmann M.D., Use of Handheld Devices1:30-2 p.m.: Michael Blaivis M.D., Use of AI in Teaching US2-2:30 p.m.: Ultrasound Simulation: Latest Update in Curriculum Development/Implementation2-2:30 p.m.: Coffee break/exhibits/poster viewing2:30-3 p.m.: Ultrasound Education Pre-clerkship undergraduate curriculum3-3:30 p.m.: Ultrasound Education Pre-clerkship undergraduate curriculum3:30-4 p.m.: Ultrasound Education Undergraduate clerkship curriculum4-4:30 p.m.: Ultrasound Education Undergraduate clerkship curriculum2:30-3 p.m.: Hands-on Workshop Teaching Gross Anatomy3-3:30 p.m.: Hands-on Workshop Teaching Cardiac Physiology3:30-4 p.m.: Hands-on Workshop Abdominal Ultrasound4-4:30 p.m.: Hands-on Workshop Cardiovascular Ultrasound5:30-8:30 p.m.: (Optional) Visit of historic sites in Detroit, River Cruise Boat Ride, Detroit Institute of Arts

Sept. 197-8 a.m.: Continental breakfast and registration8 a.m.-8:45 a.m.: International Consensus Curriculum Update8:45-9:15 a.m.: Clinical Skills Curriculum Is This Where Undergraduate US Education Should Reside?9:15-10 a.m.: Panel Discussion: Schools With Successfully Integrated Four-Year Programs on Curriculum Implementation10-10:30 a.m.: Coffee break/exhibits/poster viewing10:30 a.m.-noon: Oral abstractsNoon-1 p.m.: Lunch/exhibits/poster viewing1-1:30 p.m. : Students Perspective1:30-2 p.m.: Deans Perspective2-2:30 p.m.: Educators Perspective2-2:30 p.m.: Coffee break/exhibits/poster viewing2:30-3 p.m.: Ultrasound Education - Ultrasound Simulation3-3:30 p.m.: Ultrasound Education Ultrasound Simulation3:30-4 p.m.: Ultrasound Education Ultrasound Innovation4-4:30 p.m.: Ultrasound Education Ultrasound Innovation2:30-3 p.m.: Hands-on Workshop Vascular Ultrasound3-3:30 p.m.: Hands-on Workshop Thoracic Ultrasound3:30-4 p.m.: Hands-on Workshop Procedural Applications4-4:30 p.m.: Hands-on Workshop Musculoskeletal UltrasoundNoon-4 p.m.: Student Ultrasound Competition (students only)4-5 p.m.: Student Ultrasound Final Round (Main Ballroom, open to all conference attendees) Medical Jeopardy and Lightning Round Crown Winners Ultrasound Cup with Trophy Award5:30-6:30 p.m.: Break (Exhibit Hall)7-10 p.m.: Group Dinner at the Roostertail

Sept. 207-8 a.m.: Continental breakfast8-8:30 a.m.: WINFOCUS Update8:30-9 a.m.: Canadian Ultrasound Experience9-9:30 a.m.: Ultrasound in Africa9:30-10 a.m.: Break10-10:30 a.m.: US Education International Ultrasound10:30-11 a.m.: US Education Global Ultrasound11-11:30 a.m.: US Education Global Ultrasound11:30 a.m.-noon: Announcement of oral and poster presentation winnersNoon: Closing remarks

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WSU and Henry Ford Health System host World Congress Ultrasound in Medical Education - The South End

Illuminating the Athletic Aorta – Harvard Medical School

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Its long been known that endurance athletes have larger hearts on average than the rest of the population and that cardiac enlargement is a healthy adaptation to exercise.

But what wasnt known until now was whether the aortathe main artery leaving the heart and supplying the body with oxygenated bloodfollowed suit, and if it did, whether that might pose problems as athletes aged.

Get more HMS news here

The prevailing wisdom is that the aorta is a relatively stable structure with minimal plasticity, said Aaron Baggish, associate professor of medicine at HMS and director of the Cardiovascular Performance Program at Massachusetts General Hospital. But this concept comes from studies done almost exclusively on young competitive athletes, typically under 25 years of age.

This prevailing wisdom ran counter to the observations of Timothy Churchill, HMS clinical fellow in medicine in the Cardiovascular Performance Program, who noticed that a surprisingly high number of masters athletes were coming in for evaluation of aortic enlargement. This rapidly growing population of men and women continue to train and compete into middle age and beyond.

Churchill proposed pinning down the actual prevalence of this characteristic. In 2018, Baggish, Churchill and their team undertook a cross-sectional study evaluating aortic size in 442 veteran endurance athletes aged 50 to 75 years who were taking part in athletic competitions across the United States.

Their findings are described in the journal JAMA Cardiology.

We set up study sitesat several large-scale rowing and running events that attract high-caliber masters athletes and did cardiac ultrasounds at the race venues, Churchill said.

They found that 20 to 25 percent of the athletes had aortas larger than the upper limit of clinical normality.

It was proof of concept for us because while wed been seeing it in the clinic for a long time, it had never been studied in an isolated fashion, Baggish said.

Open question

The question of whether this is a good or a bad thing remains open, according to the researchers. Dilated aortas in nonathletic populations put patients at increased risk for a leak or rupture, and acute events involving the aorta have mortality rates as high as 50 percent.

We want to know whether this enlargement means the same thing in an athlete as in a nonathlete, Churchill said.

The findings from the study are pushing us to do more science, said Baggish, who described two viable yet unresolved implications of their work. The first is that aortic enlargement among masters athletes is a benign adaptation and another feature of the so-called athletes heart, where big is good.

The alternative is that being a lifelong exerciser may cause dilation of the aorta with the sort of attendant risk seen in nonathletes, he said.

To find out, the team plans to turn this cross-sectional study into a longitudinal one, checking outcomes for the same cohort four to five years from their initial ultrasounds.

Were now halfway through that waiting period, so it wont be too long until we have a touchpoint, Baggish said. If we find that big aortas are a benign adaptation, doctors can be reassured when they see it and not put patients through unnecessary testing and surgery.

If we find that they really are an indicator of risk, then we have to think about screening people who fit this bill, he continued. So regardless of what the next step tells us, it has very important clinical implications. For now, our goal is to alert athletes and their doctors about this evolving story.

The study was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health, the National Football League Players Association and the American Heart Association. Conflict of interest disclosures can be found in the full text of the paper.

Adapted from a Mass General news release. Image: Getty Images.

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Illuminating the Athletic Aorta - Harvard Medical School

Jacobs School students ditch their white coats for chef’s coats – UB Now: News and views for UB faculty and staff – University at Buffalo Reporter

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Campus News

Medical students work in the Culinary Arts department kitchens of SUNY Erie Community College as part of the Introduction to Culinary Medicine pilot course. Photos: Meredith Forrest Kulwicki

By ELLEN GOLDBAUM

A new, interprofessional course being taught this month to UB medical students doesnt take place in a lab or a classroom. Instead, its happening in the Culinary Arts department kitchens of SUNY Erie Community College. And instead of white coats, the students wear chefs coats and toques.

Along with UB graduate student dietitians, theyre taking Introduction to Culinary Medicine, a pilot course in the Jacobs School of Medicine and Biomedical Sciences at UB thats helping them understand food and health in a new way.

They apply their lessons immediately, preparing meals every Wednesday afternoon in the kitchens of the Culinary Arts department at SUNY Eries City Campus. Theyre also learning about some of the things that prevent patients from eating healthfully.

Mealtime is a special time

The idea for the course came together as culinary medicine was emerging both nationally and locally. But faculty member Helen Cappuccino, clinical assistant professor of surgery in the Jacobs School, traces her interest in the food/health connection back to her childhood.

Being raised in an Italian family, so much of our family life was transacted around the table, says Cappuccino, who is also assistant professor of oncology in the breast surgery division at Roswell Park Comprehensive Cancer Center. Eating good foods that were flavorful and nourishing was always important, but it wasnt just about getting calories in. It was about the family bonding at the table, about moderation, about trying new things. Mealtime is a very special time for laughing, for loving and savoring at once.

As a breast cancer surgeon, Cappuccino keeps current with studies of how different foods might impact cancer. Her patients often bring it up.

A cancer diagnosis often shakes people to their foundation, she says. It makes them introspective and questioning of everything they did and thought they knew. Diet is no exception. I spend a lot of time talking to them about factors they can control, including diet, smoking cessation, physical activity, maintaining optimal body weight and alcohol.

In 2014, Cappuccino had the opportunity to attend a course at the Goldring School for Culinary Medicine at Tulane University. When she found out that SUNY Erie faculty members Kristin Goss, associate professor and chair of the Culinary Arts department, and Dorothy Johnston, assistant professor in the department, had attended the same course, they began to discuss how to bring culinary medicine to Buffalo.

All three knew each other as members of the Buffalo chapter of the Chanes des Rtisseurs, the local chapter of an international food and wine society.

Kristen Goss,associate professor and chair of the Culinary Arts department at SUNY Erie Community College, gives some guidance to a student as he shreds carrots.

Bringing culinary medicine to Buffalo

Through the same food and wine group, we connected and began our mission to bring a culinary medicine course to the Jacobs School, Cappuccino says.

SUNY Erie culinary arts faculty had begun developing a curriculum not just for their own students, but also to share with local medical and dietetics students. The goal is to eventually make this kind of curriculum available to local health care providers.

A cancer diagnosis and realization of what I could change personally and professionally started this initiative five years ago, Goss says. I shared an office with our department chair at the time, Dorothy Johnston, and honestly stated, I need to make our culinary nutrition class better and this is where I want to start.

With assistance from Johnston and Cappuccino, who has supported the SUNY Erie Culinary Arts program through her affiliation with the Chanes des Rtisseurs, Goss says they began to develop the course, with Nicole Klem, program director of the dietetic internship in UBs Department of Exercise and Nutrition Sciences, and Lisa Jane Jacobsen, associate dean for medical curriculum at the Jacobs School, spending countless hours coordinating between the institutions in order to make the course a reality.

This recent collaboration has been a tremendous gift, Goss says.

Chef instructor Kyle Haak watches as students chop vegetables.

Intensive elective

The Jacobs School pilot course is being offered as an intensive, month-long elective. Students do modules online about the science of food, why food is medicine, and then they go to SUNY Erie to learn about healthy recipes and the principles of food preparation, explains Jacobsen clinical associate professor of obstetrics and gynecology.

The curriculum involves a journal club, a standard aspect of many medical school courses where students meet to discuss the latest scientific papers in a particular field. They also practice what theyve learned on standardized patient volunteers, individuals trained to simulate real patients with specific conditions.

They learn to elicit nutrition histories and how to counsel patients on nutrition, Jacobsen says, adding that, as with much of the medical school curriculum, the course includes an emphasis on understanding the factors that prevent patients from living as healthfully as they might want to.

In the module on food insecurity, the students are given a very limited budget. They will be expected to take the bus to the supermarket, buy food for a family and come back to the kitchen to prepare it, she says. They need to learn about barriers to healthy eating, which could be financial, or transportation, a lack of knowledge. All these cultural influences could have an impact.

Jacobsen notes that physicians are often called upon to discuss nutrition with their patients, whether the patient is diabetic or pregnant or has hypertension or a common gastrointestinal complaint.

Culinary medicine and nutrition are subjects that most medical schools dont dedicate enough time to, Cappuccino says. Together with my medical, culinary and dietetics colleagues, we are committed to changing that.

Continued here:

Jacobs School students ditch their white coats for chef's coats - UB Now: News and views for UB faculty and staff - University at Buffalo Reporter

In Other News: UT med student starts fresh food delivery service to help those in need – KVUE.com

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AUSTIN, Texas Fresh fruits and vegetables are something a lot of us take for granted.

"Food insecurity" is the term used when someone doesn't have reliable access to nutritious and affordable food. Nationwide, it's a growing concern.

To combat food insecurity, a group in Austin is looking to help bridge the gap, one box at a time.

Every Sunday, Chesley Measom and others deliver boxes as a part of Good Apple. Measom told KVUE she's been working with Good Apple since November 2019.

Good Apple is an Austin-based grocery delivery service with the purpose of giving produce that would otherwise go to waste and get it into people's homes.

"Hi, Zoe. I got your weekly Good Apple delivery," Measom said.

"Thank you so much," Zoe Mantarakis said.

"Need help getting it inside or anything?" Measom asked.

"I'll be fine, thanks, I really appreciate it," Mantarakis said.

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But how do these boxes get into the hands of people like Mantarakis?

The team from Good Apple packs produce boxes every week at Johnson's Backyard Garden. Each pack contains items that otherwise would have gone in the compost pile for one reason or another.

"We are an Austin-based produce delivery company, on a mission to end food insecurity," said Zach Timmons, a Dell Medical Schoolstudent and the group's CEO and co-founder.

Timmons and others hand-pack and hand-deliver every box.

"So I think, I'm the CEO and co-founder of Good Apple, but I'm also a medical student and I think I take care of patients every day," Timmons said. "I have a complete third year to work on community projects, and so when I was forming the projects on that, food insecurity was something I was really passionate about working more on."

Subscribers can choose a weekly, bi-weekly or monthly schedule and the boxes are dropped on their doorstep.

Some of the boxes made go to the paying subscribers to the service. But othershave another destination.

"Using the profits from that paid service, as well as partnerships from other food pantries in the community, we're able to provide a free grocery delivery service to families facing food insecurity," Timmons said.

RELATED:

The majority of the people preparing the produce boxes are also Dell Medical students, like Timmons. Good Apple receives help from volunteers in the community, as well.

As for the free boxes, the company sends those to "impact clients."

"That could be family who doesn't have any access to food, but also a single mother with three kids working multiple jobs to make ends meet," Timmons added.

"You just never know anyone's story so it's important that help exists ... because people need it," Mantarakis said.

Mantarakis is a single mom with three kids, living on food stamps.

"But it's just not enough to feed the whole month," Mantarakis said. "Assistance is a really touchy subject. It's hard to be public about the assistance that you're receiving sometimes."

Good Apple allows Mantarakis to give her kids better meals with healthier options.

As for Timmons, the fresh food delivered might be just what the doctor ordered.

"As physicians and other health care providers, we're kinda uniquely positioned to identify these problems in our patients," Timmons said.

The "impact clients" are referred to Good Apple by local food pantries and a pediatricians office who screens their patients for food insecurity.

Good Apple's goal is to keep this business going even after they graduate from Dell Medical School.

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In Other News: UT med student starts fresh food delivery service to help those in need - KVUE.com

What’s the Difference Between Supplements, Vitamins, and Pharmaceuticals? – One Green Planet

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Supplements, multivitamins, and pharmaceutical products arent necessarily controlled stringently by the Food and Drug Administration (FDA), which means that those milligrams and gram dosages you see may not actually be verifiable. Plus, the fillers, preservatives, and artificial ingredients could potentially be dangerous.

So, what is a responsible consumer to do?

Gain some knowledge, perspective, and ample education on these products. By providing yourself with a foundation to use at will, youll also increase the probability of avoiding dangerous products and ensuring that what youre consuming is accurate, high-quality, and beneficial.

libellule789/Pixabay

When it comes to sussing out the difference between supplements, multivitamins, and pharmaceuticals, the best place to start is with the actual terminology. Not simply understanding the terms themselves, but the wording that generally goes along with each product. Its truly a complicated web of language, but once you know what to look for its really actually simple!

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The term dietary supplement is exactly what youd think a supplement to your diet that may increase a deficiency or add balance. Alright, if were going super technical, the actual definition ofdietary supplementis a product taken orally that contains one or more ingredients (such as vitamins or amino acids) that are intended to supplement ones diet and are not considered food.

Depending on the type of dietary supplement, they can help you get adequate amounts of essential nutrients if you dont eat a nutritious variety of foods, yet its important to note that supplements cant take the place of the variety of foods that are important to a healthy diet.

Hence that wholesupplementpart of the dietary supplement.

Yes, dietary supplements contain vitamins, but they can also contain minerals, herbs or other botanicals, amino acids, enzymes, and many other ingredients. Dietary supplements also come in a variety of forms, including tablets, capsules, gummies, and powders, as well as drinks and energy bars. Each form requires additional ingredients most gummies require gelatin and most tablets have artificial flavors.

Thatmany other ingredientspart tells you a lot about the fact that dietary supplements can have lots of things you may not necessarily want. This makes it even more important to review the ingredients label thoroughly.Yet, its important to know that dietary supplements are required to come with a supplement facts label which lists the active ingredients, the amount per serving (dose), as well as other ingredients, such as fillers, binders, and flavorings.

All the info is there, you just have to take the time to look!

JerzyGorecki/Pixabay

You may think the termmultivitaminis pretty self-explanatory, but, in reality, its actually not.

Multivitamins also referred to as MVM supplements, as they can be mineral-based contain a combination of vitamins and minerals, and sometimes other ingredients as well. You may also see these referred to as multisandmultiplesor simplyvitamins. Whats even more confusing? Multivitamins are actually a sort of subsection of dietary supplements, so youll also see them calledmultivitamin supplementsand shelved with other dietary supplements.

With that said, while dietary supplements can contain everything from garlic extract to turmeric extract to an herbal-vitamin-mineral-chemical concoction, a multivitamin or mineral supplement generally should stick just to that vitamins and minerals.

Its important to note that multivitamin manufacturers are the ones that choose which vitamins, minerals, and other ingredients, as well as their amounts, to include in their products. With that said, most companies choose to stick to government-mandated recommended amounts, yet not all. Be aware of high doses of certain vitamins which oftentimes come in packs of two or more pills to take each day as well as those that are marketed for special purposes, such as better performance or energy, weight control, or improved immunity, as these products usually contain herbal and other ingredients.

Read the label!

Make sure that the amounts in your multivitamin are close to either the Recommended Dietary Allowances (RDAs), Adequate Intakes (AIs), or the Daily Value (DV), which are government-regulated amounts that have been shown safe for human consumption.

Just because theres more, doesnt necessarily mean its better for you.

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Now we get to the big one pharmaceutical.

Per the Faculty of Pharmaceutical Medicine of the Royal Colleges of Physicians of the United Kingdom, you start looking at the termpharmaceuticalby definingpharmaceutical medicine,which is the medical scientific discipline concerned with the discovery, development, evaluation, registration, monitoring and medical aspects of marketing of medicines for the benefit of patients and the health of the community.

Simply put, its the art of selling pharmaceuticals.

Alright, what are pharmaceutical medications? These are chemicals that are designed to prevent, diagnose, treat, or cure a disorder in laymen terms, we simply call them medicines. Keep in mind, there are an immense number and [type] of pharmaceutical drugs, designed to aid almost every type of condition known to medical science.

Yet, returning to the Royal Colleges of Physicians, theres a lot more to a pharmaceutical med then the simple creation and distribution. Theres also clinical testing of medicines, translation of pharmaceutical drug research into new medicines, safety and well-being of research participants in clinical trials, and understanding the safety profile of medicines and their benefit-risk balance.

Its not simply up to you as a consumer, but your physician also has to obtain a thorough understanding of pharmacoeconomics, medical aspects of the marketing of medicines, business administration and the social impact of healthcare on patients and public health, in order to truly prescribe a medication to a patient.

Thats what pharmaceutical reps and pharmaceutical-sponsored conventions are designed around.

Plus, theres a whole onslaught of pharmaceutical physicians doctors that work in the pharmaceutical industry, yet maintain a position or relationship with medical colleges in primary and secondary health care and at universities.

Simply put, theres a lot of hands in the pot of a single pharmaceutical drug from the invention to testing to financing to marketing to selling.

tpsdave/Pixabay

Now that weve got the terminology down, its time to take a closer look at how our government regulates, guides, and advises upon each of these products. This may actually be the most important part of the pie! While the Food and Drug Administration (FDA) cant always guarantee 100 percent safety and efficacy of their systems, their involvement absolutely increases the consumers ability to trust in the quality and ingredients label of the product.

Clker-Free-Vector-Images/Pixabay

As multivitamins are actually a subcategory of dietary supplements, they both follow the same guidelines.

When it comes to dietary supplements, there are two sides to the coin: guidelines for the manufacturer and guidelines for the consumer.

For the manufacturer, there actually arent that many regulations.

The Food and Drug Administration regulates both finished dietary supplement products and dietary ingredients. With that said, they regulate dietary supplements under a different set of regulations than those covering conventional foods and drug products. This basically means that supplements dont suffer the same severe scrutiny that food and pharmaceutical drugs do.

First and foremost, while manufacturers and distributors of dietary supplements and dietary ingredients are prohibited from marketing products that are adulterated or misbranded. This means that the companies themselves are responsible for evaluating the safety and labeling of their products. Luckily, the companies must ensure they meet all the requirements of DSHEA [Dietary Supplement Health and Education Act of 1994] and FDA regulations and the FDA is tasked with taking action against any adulterated or misbranded dietary supplements product after it reaches the market, as long as they catch it.

When it comes to labeling, theres actually a guideline of almost any type of label out there including Liquid Dietary Supplements, Substances added to Foods and Beverages, Ephedrine Alkaloids, Nutrient Content Claims, to name just a few. There are also labeling guidelines when it comes to warning statements, new dietary ingredients, and substantiation for claims, to name just a few more.

For the consumer, theres LOTS of information to know about how these pills are regulated.

While there are a host of FDA guidelines almost too many to remember there are a few that stand out and should be noted. Here are a few:

Basically, a supplement company has full reign to create, promote, and begin selling their product without almost any interference by the FDA. With that said, once the supplement hits the market, dietary supplement firms must report to FDA any serious adverse events that are reported to them by consumers or health care professionals.

So, when it comes to dietary supplements and multivitamins, consumers are the guinea pigs. Thats why its so incredibly important to read the ingredients labels. Most of the regulations that these companies follow have to do with labeling.

nosheep/Pixabay

On the other hand, when it comes to pharmaceutical medications and drugs, there are too many regulations and guidelines for consumers to even consider.

This is a good thing!

Specifically, the FDA actually has a group designed to watch out for the safety of drugs, called the Consumer Watchdog for Safe and Effective Drugs (CDER). CDER was designed to evaluate new drugs before they can be sold by ensuring that drugs, both brand-name and generic, work correctly and that their health benefits outweigh their known risks.

When CDER uses the word drug, theyre actually referring to a wide range of products including prescription drugs, over-the-counter medications, generic drugs, and other drug-related products such as fluoride toothpastes, antiperspirants, dandruff shampoos, and sunscreens.

Of course, vitamins and dietary supplements can be sold without prior approval from the FDA and are regulated by the FDAs Center for Food Safety and Applied Nutrition, and dont fall under CDERs scrutiny.

Before a drug is allowed to be sold, it must pass over a variety of hurdles including an incredibly thorough drug development and review process. Per the Food and Drug Administration and CDER site, the process goes like this:

Drug companies seeking to sell a drug in the United States must first test it. The company then sends CDER the evidence from these tests to prove the drug is safe and effective for its intended use. A team of CDER physicians, statisticians, chemists, pharmacologists, and other scientists reviews the companys data and proposed labeling. If this independent and unbiased review establishes that a drugs health benefits outweigh its known risks, the drug is approved for sale.

With that said, its important to note that CDER doesnt actually test drugs itself, although it does conduct limited research in the areas of drug quality, safety, and effectiveness standards.

kzd/Pixabay

As you can see, all three products supplements, multivitamins, and pharmaceuticals have potential dangers to be aware of. Yet, ironically enough, those that are the most highly regulated were talking pharmaceuticals here are actually the most dangerous. This is not only due to the chemical content, but its also about the behind the scenes of these companies, the big money influences, and the possible dramatic damage that can be sustained.

While the government as enforced as strict safety guidelines via CDER as possible, theres a lot of backdoor wheeling and dealing that goes on when it comes to big money companies.

In an article by Science Magazine entitledHidden conflicts? Pharma payments to FDA advisers after drug approvals spark ethical concern,the process and potential ethical issues are laid out.

How does it work?

In order for the FDA to approve a drug, a meeting takes place to vote on the drug involving medical researchers, physicians, and patient advocates. During the meeting, the pharmaceutical company gives a presentation in which medical data and clinical trials are presented. The FDA takes painstaking precautions via a well-established system to identify possible conflicts of interest before such advisory panels meet, given that they either approve or deny a drug based upon these meeting outcomes.

Unfortunately, one example discovered a hole in their process.

When the drug Brilinta hit the market, all seemed great. This multi-billion dollar drug was meant to prevent heart attacks and strokes by limiting blood clotting and it was selling like gangbusters. Yet, the big companies behind the drug AstraZeneca and other firms began to splurge large quantities of money on four physicians that had been part of the advisory group. These payments were supposedly for travel and advice.These are called pay-later conflicts of interest, and they have gone largely unnoticed and entirely unpoliced.

Due to excellent reporting by Science Magazine journalists, they reviewed compensation records from drug companies to physicians who advised FDA on whether to approve 28 psychopharmacologic, arthritis, and cardiac or renal drugs between 2008 and 2014, and found widespread after-the-fact payments or research support to panel members.

This is just one example of many regarding how big pharma has influenced those that stand in their way over the years.

Of course, this doesnt mean we shouldnt be taking pharmaceutical medications. Some of us wouldnt survive without them. All it means is that a little bit of research and digging may be necessary on the consumers part in order to verify that the drug youre taking is a verifiably and ethically produced drug.

janjf93/Pixabay

As scary as it is, there are a handful of companies out there that have your best interest and health at heart. Yes, thats hard to imagine, but its true! Here are five of the most trusted brands of supplements and multivitamins that you can feel good about purchasing. Youll note that pharmaceuticals are not included on this list, as those are doctor prescribed. Just make sure you ask the right questions, talk with your doctor, and do the necessary research before beginning any pharmaceutical regimen.

Of course, its always important to speak with a medical professional before embarking on a new supplement regimen!

Garden of Life Vitamin D3/Amazon.com

If youve followed any of my articles then this one doesnt cause any surprise. Garden of Life is one of the most trusted brands of supplements and multivitamins available. They carry a host of incredibly hard to obtain government-regulated certifications including certified USDA organic, non-GMO verified, certified Vegan, certified Gluten-Free and NSF certified, Kosher certified via the Orthodox Unions Kosher Division and Star-K Kosher Certification, Green-e Energy certified, LEED Gold certified, and B-corp certified.

Garden of Life not only follows the FDA guidelines, but they also have self-proclaimed guidelines including creating products based on the natural ingredients in whole foods, keeping out chemicals and unhealthy ingredients, and achieving maximum traceability. Traceability refers to knowing where each and every ingredient in our product comes from and getting to know each and every source.

MaryRuths Organic Liquid Probiotics/Amazon.com

This is yet another one that pops up on vegan supplement lists almost every single time! MaryRuths Organics not only offers a huge variety of types of supplements, but they also focus on organic ingredients and vegan-friendly recipes. Run by Mary Ruth, a Certified Health Educator, Nutritional Consultant, and Culinary Chef, this company focuses on providing wholesome supplements for the entire family.They focus on products that are non-GMO, plant-based, vegan, with as few allergens as possible.

Deva Vegan Multivitamin and Mineral Supplement/Amazon.com

Deva is one of those super exclusive companies that make solely vegan supplements. These companies are few and far between as they need to go a step further in the process to find chemical-free vegan-friendly alternatives for their supplements. Yet, Deva goes even further with earth-friendly certifications including Labor Day, the Vegan Society, Co-op America, and America Forests certifications. Their mission is to deliver high-quality vegan/vegetarian vitamins and supplements with the best value to our customers, while focusing on both health and planet-conscious practices.

We also highly recommend downloading ourFood Monster App, which is available foriPhone, and can also be found onInstagramandFacebook. The app has more than 15,000 plant-based, allergy-friendly recipes, and subscribers gain access to new recipes every day. Check it out!

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Excerpt from:

What's the Difference Between Supplements, Vitamins, and Pharmaceuticals? - One Green Planet