Entrepreneurship at Scale: Data Drives Better Healthcare
From Apple to Amazon, technology companies have transformed consumer expectations for how services are provided and the level of personalization possible. Healthcare companies are taking notice ...
By: GE Software
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Entrepreneurship at Scale: Data Drives Better Healthcare - Video
One of the most common complaints I hear as a veterinarian is how difficult it is for many cat owners to get their cat to the veterinarian (or anywhere else outside of the home, for that matter.) The chief reason these owners have difficulty is because their cat does not like the carrier and is often hard to actually get into the carrier.
Being able to get your cat into and out of the carrier when needed is a necessity though. Cats need regular veterinary care and, in order to get to the veterinarian, a cat carrier is essential. Theres also the fact that, should an emergency occur that requires leaving your home quickly with your cat, being able to get your cat into the carrier quickly and easily without a struggle could mean the difference between life and death.
Fortunately, there are some good ways to help your cat become acclimated to the carrier and to essentially make your cats carrier a retreat for him while hes at home as well as making it a home away from home, a place where your cat feels safe and secure when out of your home. In other words, your cats carrier doesnt have to be (and shouldnt be) a scary thing for him.
The American Association of Feline Practitioners (AAFP) have kindly provided the following infographic that contains some great tips for helping your cat become acclimated to the carrier. Definitely worth a look!
It may take some time and patience but your cat can learn to love and enjoy his carrier. Once that happens, your life and your cats life will become much less complicated and stressful, especially when it comes time for that veterinary visit.
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WASHINGTON (AP) Insurers aren't required to encrypt consumers' data under a 1990s federal law that remains the foundation for health care privacy in the Internet age an omission that seems striking in light of the major cyberattack against Anthem.
Encryption uses mathematical formulas to scramble data, converting sensitive details coveted by intruders into gibberish. Anthem, the second-largest U.S. health insurer, has said the data stolen from a company database that stored information on 80 million people was not encrypted.
The main federal health privacy law the Health Insurance Portability and Accountability Act, or HIPAA encourages encryption, but doesn't require it.
The lack of a clear encryption standard undermines public confidence, some experts say, even as the government plows ahead to spread the use of computerized medical records and promote electronic information sharing among hospitals, doctors and insurers.
"We need a whole new look at HIPAA," said David Kibbe, CEO of DirectTrust, a nonprofit working to create a national framework for secure electronic exchange of personal health information.
"Any identifying information relevant to a patient ... should be encrypted," said Kibbe. It should make no difference, he says, whether that information is being transmitted on the Internet or sitting in a company database, as was the case with Anthem.
Late Friday, the Senate Health, Education, Labor and Pensions committee said it's planning to examine encryption requirements as part of a bipartisan review of health information security. "We will consider whether there are ways to strengthen current protections," said Jim Jeffries, spokesman for chairman Lamar Alexander, R-Tenn.
The agency charged with enforcing the privacy rules is a small unit of the federal Health and Human Services Department, called the Office for Civil Rights.
The office said in a statement Friday that it has yet to receive formal notification of the hack from Anthem, but nonetheless is treating the case as a privacy law matter. Although Anthem alerted mainline law enforcement agencies, the law allows 60 days for notifying HHS.
The statement from the privacy office said the kind of personal data stolen by the Anthem hackers is covered by HIPAA, even if it does not include medical information.
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Medical fraud could increase as hackers gain sensitive medical information on victims
With more health providers and insurers incorporating IT into clinical care, hackers are viewing the health care industry as their next target.
"Cybercriminals know that the health industry is moving into EHRs and there's more data to steal," said Ann Peterson, program director at the Medical Identity Fraud Alliance, an organization that works to reduce medical fraud.
Electronic health records, or EHRs, are increasingly being used by hospitals and doctors' offices to store information such as test results and treatment plans, along with data such as patient names, Social Security numbers and birth dates.
Health insurance companies also use EHRs and store other personal data, such as credit card details, making them attractive targets for hackers. This week, Anthem, one of the largest health insurers in the U.S., said sensitive information on possibly 80 million employees and customers had been exposed during a cyberattack. The information thieves made off with included patient names, Social Security numbers, birth dates and medical identification numbers.
The information can be pieced together and used to commit a variety of types of fraud, making it lucrative for hackers. Social Security numbers, for example, can be used to gain access to bank accounts, noted John Kindervag, a principal analyst at Forrester Research.
By targeting Anthem, hackers were able to access information that is commonly used to reset user names and passwords, said Ian Campbell, CEO of Nucleus Research. People are sometimes asked to enter their mother's maiden name when signing up for services, for example. Since this information is static, it can be combined with a person's email address to reset a person's email account.
"People should ask 'Will I have a problem 10 years from now because someone knows information that's not normally available?'" he said.
The health care industry is especially vulnerable compared to retailers and banks, which are more accustomed to cyberattacks, said Lynne Dunbrack, research vice president at IDC Health Insights.
"Cybercriminals tend to think of health care organizations as soft targets. Historically, they haven't invested much in IT, and security specifically," she said.
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In the presidentsbudgetreleased this week, the Obama administration proposed approximately $400 billion in health-care savings. While that sounds impressive, the number might actually be lessfor one proposal relies on a board that does not yet exist and that the administration has made no effort to establish.
As it has in previous years, the presidents 2016 budget proposal relies on savings achieved by strengthening the Independent Payment Advisory Boardthis time to the tune of more than $20 billion. Created as part of Obamacare, IPAB was intended to be a group of non-partisan experts, nominated by the president and confirmed by the Senate, who would make recommendations on slowing the growth of Medicare costs. The recommendations were to take effect automatically unless overruled by Congress.
Although the health-care law was enacted nearly five years ago, the administration has made no attempt to constitute IPAB:
* The president has not nominated members to the board for Senate confirmation;
* The president has signed appropriations legislation rescinding spending reserved for the board, most recently in Section 522 of last years cromnibus legislation;
* While secretary of health and human services, Kathleen Sebelius testified before Congressin 2011 that her agency would undertake a rule-making process to define rationing. Obamacare prohibits IPAB from rationing, but the term is not defined in statute. The administration, however, has not begun such a regulatory process.
When questioned on this issue, the administration has argued that the slowdown in Medicare spending makes the board unnecessary at the moment. Administration officials could also make the accurateif politically unpopularassertion that the Department of Health and Human Serviceshas the power to implement Medicare savings proposals unilaterally in the absence of a fully functioning board.
Nevertheless, the administration continues to rely on budgetary savings presumed to come from strengthen[ing] a board that President Obama has not moved to establish. That raises questions about its commitment to budgetary savingsand to IPAB itself.
Chris Jacobs is policy director ofAmerica Next, a conservative think tank. He is onTwitter:@chrisjacobshc
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* Anthem says breach may have affected 'tens of millions' of customers
Health care offers attractive growth opportunities for cybercriminals looking to steal reams of personal information, as the hacking of a database maintained by the second-largest U.S. health insurer proves.
The latest breach at health insurer Anthem Inc. follows a year in which more than 10 million people were affected by health care data breaches including hacking or accidents that exposed personal information, such as lost laptops according to a government database that tracks incidents affecting at least 500 people. The numbers, compiled by the Department of Health and Human Services, show that last year was the worst for health care hacking since 2011, when more than 11 million people were affected.
Anthem is the parent company for Amerigroup, which has more than 209,000 members enrolled in New Jersey, according to the state Department of Banking and Insurance. It is unclear whether they have been affected. The department is looking into the issue, a spokesman said. A spokeswoman for Amerigroup could not be reached for comment Thursday afternoon.
Health-care hacking is becoming more of a focus as retailers and other businesses have clamped down on security after massive breaches at companies like Target and Home Depot. That has made it more difficult in some cases for hackers to infiltrate their systems. As a result, they've turned their attention toward health care.
Experts say health-care companies can provide many entry points into their systems for crooks to steal data. And once criminals get that information, they can pull off far more extensive and lucrative schemes.
"If someone steals your credit card and home address, they might be able to buy something, but you can usually get that locked down quickly," said Tony Anscombe, a security expert with the cybersecurity firm AVG Technologies. "With medical records and a Social Security number, it's not so simple."
Anthem said late Wednesday that hackers broke into a database storing information on 80 million people in an attack the company discovered last week. The Blue Cross Blue Shield insurer said the hackers gained access to names, birth dates, email address, employment details, Social Security numbers, incomes and street addresses of people who are currently covered or have had coverage in the past.
The insurer, which covers more than 37 million people, said credit card information wasn't compromised, and it has yet to find any evidence that medical information was targeted. Anthem doesn't know how many people were affected by the attack, but a spokeswoman said that number was probably in the "tens of millions."
The impact could be far-reaching. The hackers may have simply been probing Anthem's defenses with plans to plant malware that steals information or to come back with a much larger attack, said Eran Barak, CEO of another cybersecurity firm, Hexadite.
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The medical genetics of Jews is the study, screening, and treatment of genetic disorders more common in particular Jewish populations than in the population as a whole.[1] The genetics of Ashkenazi Jews have been particularly well-studied, resulting in the discovery of many genetic disorders associated with this ethnic group. In contrast, the medical genetics of Sephardic Jews and Mizrahi Jews are more complicated, since they are more genetically diverse and consequently no genetic disorders are more common in these groups as a whole; instead, they tend to have the genetic diseases common in their various countries of origin.[1][2] Several organizations, such as Dor Yeshorim,[3] offer screening for Ashkenazi genetic diseases, and these screening programs have had a significant impact, in particular by reducing the number of cases of TaySachs disease.[4]
Different ethnic groups tend to suffer from different rates of hereditary diseases, with some being more common, and some less common. Hereditary diseases, particularly hemophilia, were recognized early in Jewish history, even being described in the Talmud.[5] However, the scientific study of hereditary disease in Jewish populations was initially hindered by scientific racism, which believed in racial supremacism.[6][7]
However, modern studies on the genetics of particular ethnic groups have the tightly defined purpose of avoiding the birth of children with genetic diseases, or identifying people at particular risk of developing a disease in the future.[6] Consequently, the Jewish community has been very supportive of modern genetic testing programs, although this unusually high degree of cooperation has raised concerns that it might lead to the false perception that Jews are more susceptible to genetic diseases than other groups of people.[5]
However, most populations contain hundreds of alleles that could potentially cause disease and most people are heterozygotes for one or two recessive alleles that would be lethal in a homozygote.[8] Although the overall frequency of disease-causing alleles does not vary much between populations, the practice of consanguineous marriage (marriage between second cousins or closer relatives) is common in some Jewish communities, which produces a small increase in the number of children with congenital defects.[9]
According to Daphna Birenbaum Carmeli at the University of Haifa, Jewish populations have been studied more thoroughly than most other human populations because:[10]
The result is a form of ascertainment bias. This has sometimes created an impression that Jews are more susceptible to genetic disease than other populations. Carmeli writes, "Jews are over-represented in human genetic literature, particularly in mutation-related contexts."[10] Another factor that may aid genetic research in this community is that Jewish culture results in excellent medical care, which is coupled to a strong interest in the community's history and demography.[11]
This set of advantages have led to Ashkenazi Jews in particular being used in many genetic studies, not just in the study of genetic diseases. For example, a series of publications on Ashkenazi centenarians established their longevity was strongly inherited and associated with lower rates of age-related diseases.[12] This "healthy aging" phenotype may be due to higher levels of telomerase in these individuals.[13]
The most detailed genetic analysis study of Ashkenazi was published in September 2014 by Shai Carmon and his team at Columbia University. The results of the detailed study show that today's 10 million Ashkenai Jews descend from a population only 350 individuals who lived about 600-800 years ago. That population derived from both Europe and the Middle East. [14]There is evidence that the population bottleneck may have allowed deleterious alleles to become more prevalent in the population due to genetic drift.[15] As a result, this group has been particularly intensively studied, so many mutations have been identified as common in Ashkenazis.[16] Of these diseases, many also occur in other Jewish groups and in non-Jewish populations, although the specific mutation which causes the disease may vary between populations. For example, two different mutations in the glucocerebrosidase gene causes Gaucher's disease in Ashkenazis, which is their most common genetic disease, but only one of these mutations is found in non-Jewish groups.[4] A few diseases are unique to this group; for example, familial dysautonomia is almost unknown in other populations.[4]
TaySachs disease, a fatal illness of children that causes mental deterioration prior to death, was historically more prevalent among Ashkenazi Jews,[18] although high levels of the disease are also found in some Pennsylvania Dutch, southern Louisiana Cajun, and eastern Quebec French Canadian populations.[19] Since the 1970s, however, proactive genetic testing has been quite effective in eliminating TaySachs from the Ashkenazi Jewish population.[20]
Gaucher's disease, in which lipids accumulate in inappropriate locations, occurs most frequently among Ashkenazi Jews;[21] the mutation is carried by roughly one in every 15 Ashkenazi Jews, compared to one in 100 of the general American population.[22] Gaucher's disease can cause brain damage and seizures, but these effects are not usually present in the form manifested among Ashkenazi Jews; while sufferers still bruise easily, and it can still potentially rupture the spleen, it generally has only a minor impact on life expectancy.
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Genetic disorder Classification and external resources MeSH D030342
A genetic disorder is an illness caused by one or more abnormalities in the genome, especially a condition that is present from birth (congenital). Most genetic disorders are quite rare and affect one person in every several thousands or millions.
Genetic disorders may or may not be heritable, i.e., passed down from the parents' genes. In non-heritable genetic disorders, defects may be caused by new mutations or changes to the DNA. In such cases, the defect will only be heritable if it occurs in the germ line. The same disease, such as some forms of cancer, may be caused by an inherited genetic condition in some people, by new mutations in other people, and mainly by environmental causes in still other people. Whether, when and to what extent a person with the genetic defect or abnormality will actually suffer from the disease is almost always affected by environmental factors and events in the person's development.
Some types of recessive gene disorders confer an advantage in certain environments when only one copy of the gene is present.[1]
A single gene disorder is the result of a single mutated gene. Over 4000 human diseases are caused by single gene defects.[4] Single gene disorders can be passed on to subsequent generations in several ways. Genomic imprinting and uniparental disomy, however, may affect inheritance patterns. The divisions between recessive and dominant types are not "hard and fast", although the divisions between autosomal and X-linked types are (since the latter types are distinguished purely based on the chromosomal location of the gene). For example, achondroplasia is typically considered a dominant disorder, but children with two genes for achondroplasia have a severe skeletal disorder of which achondroplasics could be viewed as carriers. Sickle-cell anemia is also considered a recessive condition, but heterozygous carriers have increased resistance to malaria in early childhood, which could be described as a related dominant condition.[5] When a couple where one partner or both are sufferers or carriers of a single gene disorder and wish to have a child, they can do so through in vitro fertilization, which means they can then have a preimplantation genetic diagnosis to check whether the embryo has the genetic disorder.[6]
Only one mutated copy of the gene will be necessary for a person to be affected by an autosomal dominant disorder. Each affected person usually has one affected parent.[7] The chance a child will inherit the mutated gene is 50%. Autosomal dominant conditions sometimes have reduced penetrance, which means although only one mutated copy is needed, not all individuals who inherit that mutation go on to develop the disease. Examples of this type of disorder are Huntington's disease,[8]neurofibromatosis type 1, neurofibromatosis type 2, Marfan syndrome, hereditary nonpolyposis colorectal cancer, and hereditary multiple exostoses,Tuberous sclerosis, Von Willebrand disease, acute intermittent porphyria which is a highly penetrant autosomal dominant disorder. Birth defects are also called congenital anomalies.
Two copies of the gene must be mutated for a person to be affected by an autosomal recessive disorder. An affected person usually has unaffected parents who each carry a single copy of the mutated gene (and are referred to as carriers). Two unaffected people who each carry one copy of the mutated gene have a 25% risk with each pregnancy of having a child affected by the disorder. Examples of this type of disorder are Albinism, Medium-chain acyl-CoA dehydrogenase deficiency, cystic fibrosis, sickle-cell disease, Tay-Sachs disease, Niemann-Pick disease, spinal muscular atrophy, and Roberts syndrome. Certain other phenotypes, such as wet versus dry earwax, are also determined in an autosomal recessive fashion.[9][10]
X-linked dominant disorders are caused by mutations in genes on the X chromosome. Only a few disorders have this inheritance pattern, with a prime example being X-linked hypophosphatemic rickets. Males and females are both affected in these disorders, with males typically being more severely affected than females. Some X-linked dominant conditions, such as Rett syndrome, incontinentia pigmenti type 2, and Aicardi syndrome, are usually fatal in males either in utero or shortly after birth, and are therefore predominantly seen in females. Exceptions to this finding are extremely rare cases in which boys with Klinefelter syndrome (47,XXY) also inherit an X-linked dominant condition and exhibit symptoms more similar to those of a female in terms of disease severity. The chance of passing on an X-linked dominant disorder differs between men and women. The sons of a man with an X-linked dominant disorder will all be unaffected (since they receive their father's Y chromosome), and his daughters will all inherit the condition. A woman with an X-linked dominant disorder has a 50% chance of having an affected fetus with each pregnancy, although it should be noted that in cases such as incontinentia pigmenti, only female offspring are generally viable. In addition, although these conditions do not alter fertility per se, individuals with Rett syndrome or Aicardi syndrome rarely reproduce.[citation needed]
X-linked recessive conditions are also caused by mutations in genes on the X chromosome. Males are more frequently affected than females, and the chance of passing on the disorder differs between men and women. The sons of a man with an X-linked recessive disorder will not be affected, and his daughters will carry one copy of the mutated gene. A woman who is a carrier of an X-linked recessive disorder (XRXr) has a 50% chance of having sons who are affected and a 50% chance of having daughters who carry one copy of the mutated gene and are therefore carriers. X-linked recessive conditions include the serious diseases hemophilia A, Duchenne muscular dystrophy, and Lesch-Nyhan syndrome, as well as common and less serious conditions such as male pattern baldness and red-green color blindness. X-linked recessive conditions can sometimes manifest in females due to skewed X-inactivation or monosomy X (Turner syndrome).
Y-linked disorders, also called holandric disorders, are caused by mutations on the Y chromosome. These conditions display may only be transmitted from the heterogametic sex (e.g. male humans) to offspring of the same sex. More simply, this means that Y-linked disorders in humans can only be passed from men to their sons; females can never be affected because they do not possess Y allosomes.
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Clinical Policy Bulletin: Genetic Testing
Aetna considers genetic testing medically necessary to establish a molecular diagnosis of an inheritable disease when all of the following are met:
The member displays clinical features, or is at direct risk of inheriting the mutation in question (pre-symptomatic); and
The result of the test will directly impact the treatment being delivered to the member; and
Achondroplasia (FGFR3) Albinism Alpha-1 antitrypsin deficiency (SERPINA1) Alpha thalassemia/Hb Bart hydrops fetalis syndrome/HbH disease** (HBA1/HBA2, alpha globin 1 and alpha globulin 2) Angelman syndrome (GABRA, SNRPN Beta thalassemia** (beta globin) Bloom syndrome (BLM) CADASIL (see below) Canavan disease (ASPA (aspartoacylase A)) Charcot-Marie Tooth disease (PMP-22) Classical lissencephaly Congenital adrenal hyperplasia/21 hydroxylase deficiency (CYP21A2)* Congenital amegakaryocytic thrombocytopenia Congenital central hypoventilation syndrome (PHOX2B) Congenital muscular dystrophy type 1C (MDC1C) (FKRP (Fukutin related protein)) Crouzon syndrome (FGFR2, FGFR3) Cystic fibrosis (CFTR) (see below) Dentatorubral-pallidoluysian atrophy Duchenne/Becker muscular dystrophy (dystrophin) Dysferlin myopathyEhlers-Danlos syndrome Emery-Dreifuss muscular dystrophy (EDMD1, 2, and 3) Fabry disease Factor V Leiden mutation (F5 (Factor V)) Factor XIII deficiency, congenital (F13 (Factor XIII beta globulin)) Familial adenomatous polyposis coli (APC) (see below) Familial dysautonomia (IKBKAP) Familial hypocalciuric hypercalcemia (see below)Familial Mediterranean fever (MEFV) Fanconi anemia (FANCC, FANCD) Facioscapulohumeral muscular dystrophy (FSHMD1A) Fragile X syndrome, FRAXA (FMR1) (see below) Friedreich's ataxia (FRDA (frataxin)) Galactosemia (GALT) Gaucher disease (GBA (acid beta glucosidase)) Gitelman's syndromeHemoglobin E thalassemia ** Hemoglobin S and/or C ** Hemophilia A/VWF (F8 ( Factor VIII)) Hemophilia B (F9 (Factor IX)) Hereditary amyloidosis (TTR variants) Hereditary deafness (GJB2 (Connexin-26, Connexin-32 )) Hereditary hemorrhagic telangiectasia (HHT) Hereditary hemochromatosis (HFE) (see below) Hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome (fumarate hydratase (FH) gene) Hereditary neuropathy with liability to pressure palsies (HNPP) Hereditary non-polyposis colorectal cancer (HNPCC) (MLH1, MSH2, MSH6. MSI) ( see below) Hereditary pancreatitis (PRSS1) (see below) Hereditary paraganglioma (SDHD, SDHB)
Hereditary polyposis coli (APC) Hereditary spastic paraplegia 3 (SPG3A) and 4 (SPG4, SPAST) Huntington's disease (HTT, HD(Huntington)) Hypochondroplasia (FGFR3) Hypertrophic cardiomyopathy (see below) Jackson-Weiss syndrome (FGFR2)Kallmann syndrome (FGFR1) Kennedy disease (SBMA) Leber hereditary optic neuropathy (LHON) Leigh Syndrome and NARP (neurogenic muscle weakness, ataxia, and retinitis pigmentosa) Long QT syndrome (see below) Limb girdle muscular dystrophy (LGMD1, LGMD2) (FKRP (Fukutin related protein)) Malignant hyperthermia (RYR1) Maple syrup urine disease (branched-chain keto acid dehydrogenase E1) Marfans syndrome (TGFBR1, TGFBR2) McArdle's diseaseMedium chain acyl coA dehydrogenase deficiency (ACADM) Medullary thyroid carcinoma MELAS (mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes) (MTTL1, tRNAleu) Mucolipidosis type IV (MCOLN1, mucolipin 1) Mucopolysaccharidoses type 1 (MPS-1) Muenke syndrome (FGFR3) Multiple endocrine neoplasia type 1 Muscle-Eye-Brain disease (POMGNT1) MYH-associated polyposis (MYH) (see below) Myoclonic epilepsy (MERRF) (MTTK (tRNAlys)) Myotonic dystrophy (DMPK, ZNF-9) Neimann-Pick disease, type A(SMPD1, sphingomyelin phosphodiesterase) Nephrotic syndrome, congenital (NPHS1, NPHS2) Neurofibromatosis type 1 (NF1, neurofibromin) Neurofibromatosis type 2 (Merlin) Neutropenia, congenital cyclic Phenylketonuria (PAH) Pfeiffer syndrome (FGFR1) Prader-Willi-Angelman syndrome (SNRPN, GABRA5, NIPA1, UBE3A, ANCR, GABRA ) Primary dystonia (TOR1A (DYT1)) Prothrombin (F2 (Factor II,20210G> A mutation)) Pyruvate kinase deficiency (PKD) Retinoblastoma (Rh) Rett syndrome (FOXG1, MECP2) Saethre-Chotzen syndrome (TWIST, FGFR2) SHOX-related short stature (see below) Smith-Lemli-Opitz syndrome Spinal muscular atrophy (SMN1, SMN2 ) Spinocerebellar ataxia (SCA types 1, 2, 3 (MJD), 6 (CACNA1A), 7, 8, 10, 17 and DRPLA) Tay-Sachs disease (HEXA (hexosaminidase A)) Thanatophoric dysplasia (FGFR3) Von Gierke disease (G6PC, Glycogen storage disease, Type 1a) Von Hippel-Lindau syndrome (VHL) Walker-Warburg syndrome (POMGNT1) 22q11 deletion syndromes (DCGR (CATCH-22))
* Medically necessary if results of the adrenocortical profile following cosyntropin stimulation test are equivocal or for purposes of genetic counseling.
** Electrophoresis is the appropriate initial laboratory test for individuals judged to be at-risk for a hemoglobin disorder.
In the absence of specific information regarding advances in the knowledge of mutation characteristics for a particular disorder, the current literature indicates that genetic tests for inherited disease need only be conducted once per lifetime of the member.
Note: Genetic testing of Aetna members is excluded from coverage under Aetna's benefit plans if the testing is performed primarily for the medical management of other family members who are not covered under an Aetna benefit plan. In these circumstances, the insurance carrier for the family members who are not covered by Aetna should be contacted regarding coverage of genetic testing. Occasionally, genetic testing of tissue samples from other family members who are not covered by Aetna may be required to provide the medical information necessary for the proper medical care of an Aetna member. Aetna covers genetic testing for heritable disorders in non-Aetna members when all of the following conditions are met:
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Newswise BETHESDA, Md., Feb. 5, 2015 /PRNewswire-USNewswire/ -- Carrier screening for inherited genetic disorders is an important part of preconception and prenatal care for the nearly 4 million women who give birth in the US annually. Carrier screening is meant to identify couples at risk for passing on such genetic conditions to their children. While there have been limitations to this approach in the past, new technology in genotyping and genetic sequencing allows for more efficient carrier screening of a greater number of conditions simultaneously.
In an important new statement, several of the nation's leading medical societies have collaborated to provide guidance on such advances and their use in reproductive medicine. The American College of Medical Genetics and Genomics (ACMG) along with the American College of Obstetricians and Gynecologists, the National Society of Genetic Counselors, the Society for Maternal-Fetal Medicine and Perinatal Quality Foundation have just released a new Joint Statement on "Expanded Carrier Screening in Reproductive Medicine - Points to Consider" published online ahead of print in Obstetrics & Gynecology ("the Green Journal") in Current Commentary at http://journals.lww.com/greenjournal/toc/publishahead.
Anthony R. Gregg, MD, FACOG, FACMG, vice-president, Clinical Genetics of the American College of Medical Genetics and Genomics and a co-author of the Joint Statement said, "This document is a sort of a blueprint of expanded carrier screening in clinical practice. It serves obstetric care providers by helping them navigate pretest information to share with patients and concepts applicable to posttest follow-up. Importantly, pitfalls surrounding expanded carrier screening are described. Readers will recognize that this document does not advocate for or against the universal implementation of expanded carrier screening. There is a paucity of scientifically sound information to guide professional organizations in taking a firm stance. For now currently available practice guidelines (summarized in the joint document) authored by ACMG and ACOG prevail and these represent a minimum screening standard. Professional organizations may, at a later time, determine whether and to what extent patients should be informed of expanded screening technology."
The five groups collaborated on the Joint Statement on Expanded Carrier Screening in order to provide education for clinicians and laboratories regarding the use of expanded genetic carrier screening in reproductive medicine. It states, "The current statement demonstrates an approach for health care providers and laboratories who wish to or who are currently offering expanded carrier screening to their patients."
While the new Joint Statement is not intended to replace existing practice guidelines and policy statements, it states that they "offer an opportunity for health care providers to better understand expanded carrier screening. Many more conditions, genes and variants are analyzed when expanded carrier screening is used compared with current screening approaches.... However, this approach introduces complexities that require special considerations."
ACMG President-Elect Gerald Feldman, MD, Ph.D., FACMG stated, "There are always advantages and disadvantages when a new technology is implemented, as is the case for expanded genetic testing. This document was written to provide a summary of the important points a physician should consider when discussing expanded carrier screening with his or her patient, because these tests offer testing for many more conditions than currently recommended by professional organizations. It is important that the patient fully understand and consent to such testing if they so choose. A referral to a genetics health care professional, such as a Board-certified clinical geneticist, should always be recommended when appropriate."
"Variation among people as to what they think justifies consideration when making reproductive decisions is varied and complicates generating a specific list of genes and variants that should be part of a test. Our goal for this document was to highlight the important aspects of genes and diseases that should be considered when developing expanded carrier screening panels, " said co-author Michael S. Watson, MS, Ph.D., FACMG, Executive Director of the American College of Medical Genetics and Genomics.
About the ACMG and ACMG Foundation Founded in 1991, the American College of Medical Genetics and Genomics (www.acmg.net) advances the practice of medical genetics and genomics by providing education, resources and a voice for more than 1750 biochemical, clinical, cytogenetic, medical and molecular geneticists, genetic counselors and other healthcare professionals, nearly 80% of whom are board certified in the medical genetics specialties. ACMG is the only nationally recognized medical organization dedicated to improving health through the practice of medical genetics and genomics. The College's mission includes the following goals: 1) to define and promote excellence in the practice of medical genetics and genomics and to facilitate the integration of new research discoveries into medical practice; 2) to provide medical genetics and genomics education to fellow professionals, other healthcare providers, and the public; 3) to improve access to medical genetics and genomics services and to promote their integration into all of medicine; and 4) to serve as advocates for providers of medical genetics and genomics services and their patients. Genetics in Medicine, published monthly, is the official ACMG peer-reviewed journal. ACMG's website (www.acmg.net) offers a variety of resources including Policy Statements, Practice Guidelines, Educational Resources, and a Find a Geneticist tool. The educational and public health programs of the American College of Medical Genetics are dependent upon charitable gifts from corporations, foundations, and individuals through the ACMG Foundation for Genetic and Genomic Medicine (www.acmgfoundation.org.)
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I would like to start this Topic with a discussion on the contents of the ancient Sumerian Tablets where genetic engineering experiments were done:
1. to create humans or human-like species (Neanderthals) through mixing human gene with the apeman's gene, and
2. to alter the features of humans.
Through this discussion, we can evaluate the possibilities of whether ancient genetic engineering experiments may have been responsible for some of the weird looking bones, which had been found and which are being considered as evidences of evolution.
But before I start a discussion on the contents of the Sumerian Tablets, I am going to explain a little about the contents of the ancient Sumerian Tablets here, so that the reader will understand why I am using the Sumerian Tablets in my discussion here. Then, I will connect the genetic engineering experiments, and other contents in the Sumerian Tablets, to the Neanderthals and Cro Magnons. Then, I will be discussing the following:
1. the possibilities of evolution of the apeman to the present day man
2. how the Replitians had paved the way for ET and evolution believers (just as they had paved the way for Buddha, Abraham, Christ, and Mohammad).
3. the possibilities of ancient genetic engineering experiments that may have created and / or aggravated the Rh negative blood situation (I will be connecting the Cro Magnons to this discussion relating to the Rh negative blood; and I will also be discussing the elongated skulls, giants etc).
I will be discussing the Sumerian Tablets later, in another Topic, so as to give explanations on the story in the Sumerian Tablet. So I am not going to explain, the contents of the Sumerian Tablets, to a great extent here.
You will be able to read the translations of the contents of the Sumerian Tablets (in videos), through the link:
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JSB Market Research: Gene Therapy Central Nervous System Insight
Gene Therapy Central Nervous System Insight: Pipeline Assessment, Technology Trend, and Competitive Landscape provides the information across the gene therap...
By: Kalyani Roy
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JSB Market Research: Gene Therapy Central Nervous System Insight - Video
To show your support of this position statement, please send an e-mail with your intent, and affiliation to danielle.bonadies@yale.edu
Below please find the full text on a Genetic Testing Lab Position Statement that pledges we, the ordering clinicians, will continue to make laboratory and testing choices based on what is in the best interest of our patients and will not be swayed by political, personal or financial gain.
This is also an opportune time for patient organizations, clinical organizations and insurers to show their support of laboratories that will fully share past, current and future data in open databases that serve research and patient care.
Please pass this on to your family, friends, colleagues, patients and contacts within your networks.
Genetic Testing Position Statement
Cancer Genetic Counseling Program Yale School of Medicine/Yale Cancer Center
New Haven, CT February 2014
With the emergence of new testing technologies and the 2013 Supreme Court decision banning gene patenting, the available cancer genetic testing options and the laboratories offering testing have expanded exponentially and are likely to continue to do so. As providers we have a responsibility to our patients to make the best decisions regarding which laboratory to use and which tests are most appropriate based on what is best for the patients. Our decisions will not be swayed by political, personal and/or financial gain.
2. Time: How long will the patient have to wait for his or her test results?
3. Cost: Will our patients insurance carrier cover this test at this laboratory?
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FDA Approves Genentechs Lucentis (Ranibizumab Injection) for Treatment of Diabetic Retinopathy in People with Diabetic Macular Edema
On November 14, 2014, a Genentech medicine received FDA approval for use in a specific type of platinum-resistant ovarian cancer.
On February 6, 2015, the FDA approved a Genentech Medicine for the treatment of diabetic retinopathy in people with diabetic macular edema (DME).
Presentations, Posters, and Papers galore. Check out our ACR 2014 newsroom to learn more about our commitment to rheumatology.
Genentech will present important new ophthalmic data at the 118th Annual Meeting of the American Academy of Ophthalmology (AAO) from October 18-21 in Chicago.
On October 15, 2014, the FDA approved a medicine for the treatment of idiopathic pulmonary fibrosis (IPF).
Read about Genentechs planned acquisition of Seragon.
With the recent acquisition of Seragon, Genentech is excited to add a new class of investigational medicines known as SERDs to our pipeline.
Genentech fully supports efforts to increase transparency around the partnership between the industry and healthcare professionals.
Medicine for people with chronic idiopathic urticaria (CIU), a form of chronic hives.
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One of the most popular dinner party conversation topics is the possibility that the United States will be joined or even surpassed as a superpower by another nation, such as China. China has some very smart people, a vast land area, and over four times the population of the US, so it should catch up easily, right? Let's assess the what makes a superpower, and what it would take for China to match the US on each pillar of superpowerdom.
A genuine superpower does not merely have military and political influence, but also must be at the top of the economic, scientific, and cultural pyramids. Thus, the Soviet Union was only a partial superpower, and the most recent genuine superpower before the United States was the British Empire.
To match the US by 2030, China would have to :
1) Have an economy near the size of the US economy. If the US grows by 3.5% a year for the next 25 years, it will be $30 trillion in 2006 dollars by then. Note that this is a modest assumption for the US, given the accelerating nature of economic growth, but also note that world GDP only grows about 4% a year, and this might at most be 5% a year by 2030. China, with an economy of $2.2 trillion in nominal (not PPP) terms, would have to grow at 12% a year for the next 25 years straight to achieve the same size, which is already faster than its current 9-10% rate, if even that can be sustained for so long (no country, let alone a large one, has grown at more than 8% over such a long period). In other words, the progress that the US economy would make from 1945 to 2030 (85 years) would have to be achieved by China in just the 25 years from 2005 to 2030. Even then, this is just the total GDP, not per capita GDP, which would still be merely a fourth of America's.
2) Create original consumer brands that are household names everywhere in the world (including in America), such as Coca-Cola, Nike, McDonalds, Citigroup, Xerox, Microsoft, or Google. Europe and Japan have created a few brands in a few select industries, but China currently has none. Observing how many American brand logos have populated billboards and sporting events in developing nations over just the last 15 years, one might argue that US dominance has even increased by this measure.
3) Have a military capable of waging wars anywhere in the globe (even if it does not actually wage any). Part of the opposition that anti-Americans have to the US wars in Afghanistan and Iraq is the envy arising from the US being the only country with the means to invade multiple medium-size countries in other continents and still sustain very few casualties. No other country currently is even near having the ability to project military power with such force and range. Mere nuclear weapons are no substitute for this. The inability of the rest of the world to do anything to halt genocide in Darfur is evidence of how such problems can only get addressed if and when America addresses them.
4) Have major universities that are household names, that many of the worlds top students aspire to attend. 17 of the world's top 20 universities are in the US. Until top students in Europe, India, and even the US are filling out an application for a Chinese university alongside those of Harvard, Stanford, MIT, or Cambridge, China is not going to match the US in the knowledge economy. This also represents the obstacles China has to overcome to successfully conduct impactful scientific research.
5) Attract the best and brightest to immigrate into China, where they can expect to live a good life in Chinese society. The US effectively receives a subsidy of $100 to $200 billion a year, as people educated at the expense of another nation immigrate here and promptly participate in the workforce. As smart as people within China are, unless they can attract non-Chinese talent that is otherwise going to the US, and even talented Americans, they will not have the same intellectual and psychological cross-pollination, and hence miss out on those economic benefits. The small matter of people not wanting to move into a country that is not a democracy also has to be resolved.
6) Become the nation that produces the new inventions and corporations that are adopted by the mass market into their daily lives. From the telephone and airplane over a century ago, America has been the engine of almost all technological progress. Despite the fears of innovation going overseas, the big new technologies and influential applications continue to emerge from companies headquartered in the United States. Just in the last two years, Google emerged as the next super-lucrative company (before eBay and Yahoo slightly earlier), and the American-dominated 'blogosphere' emerged as a powerful force of information and media.
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The Futurist: Why the US Will Still be the Only Superpower ...
Martin Ford Silicon Valley Entrepreneur,Futurist and Speaker Leading expert on the Robot Revolution, Artificial Intelligence, Job Automation, and the Impact of Accelerating Technology on Workplaces, the Economy and Society
Martin Ford is the founder of a Silicon Valley-based software development firm and the author of the books Rise of the Robots: Technology and the Threat of a Jobless Future and The Lights in the Tunnel: Automation, Accelerating Technology and the Economy of the Future. He has over 25 years experience in the fields of computer design and software development. He holds a computer engineering degree from the University of Michigan, Ann Arbor and a graduate business degree from the University of California, Los Angeles.
He has written for publications including Fortune, Forbes, The Atlantic, The Washington Post, Project Syndicate, The Huffington Post and The Fiscal Times. He has also appeared on numerous radio and television shows, including NPR and CNBC.Martin is a frequent keynote speaker on the subject of accelerating progress in robotics and artificial intelligenceand what these advances mean for the economy, job market and society of the future.
Martinis available to speak on the robotics revolution and the economic, political, business and job market impacts of advancing information technology. He can also offer unique insight into the implications of future technologies for specific businesses, industries and sectors of society.
For information, please use thiscontact page and select speaking inquiry in the form.
Selected recentspeaking events include:
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Impressionism (c.1870-1890)
CLAUDE MONET (1840-1926) 'Rouen Cathedral in Full Sunlight', 1893-94 (oil on canvas)
Impressionism is the name given to a colorful style of painting in France at the end of the 19th century. The Impressionists searched for a more exact analysis of the effects of color and light in nature. They sought to capture the atmosphere of a particular time of day or the effects of different weather conditions. They often worked outdoors and applied their paint in small brightly colored strokes which meant sacrificing much of the outline and detail of their subject. Impressionism abandoned the conventional idea that the shadow of an object was made up from its color with some brown or black added. Instead, the Impressionists enriched their colors with the idea that a shadow is broken up with dashes of its complementary color.
Among the most important Impressionist painters were Claude Monet, Pierre Auguste Renoir, Edgar Degas, Camille Pissarro, Alfred Sisley and Henri de Toulouse Lautrec.
VINCENT VAN GOGH (1853-90) 'Caf Terrace at Night', 1888 (oil on canvas)
Post Impressionism was not a particular style of painting. It was the collective title given to the works of a few independent artists at the end of the 19th century. The Post Impressionists rebelled against the limitations of Impressionism to develop a range of personal styles that influenced the development of art in the 20th century. The major artists associated with Post Impressionism were Paul Czanne, Paul Gauguin, Vincent Van Gogh and Georges Seurat.
Czanne was an important influence on Picasso and Braque in their development of Cubism. Van Gogh's vigorous and vibrant painting technique was one of the touchstones of both Fauvism and Expressionism, while Gauguin's symbolic color and Seurat's pointillist technique were an inspiration to 'Les Fauves'.
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Der Futurismus war eine aus Italien stammende avantgardistische Kunstbewegung, die aufgrund des breit gefcherten Spektrums den Anspruch erhob, eine neue Kultur zu begrnden.
Der Einfluss des Futurismus geht wesentlich auf seinen Grnder Filippo Tommaso Marinetti zurck und dessen erstes futuristisches Manifest von 1909. Die Bewegung endete mit dem Tod Marinettis im Jahre 1944.
Am 20. Februar 1909 publizierte der junge italienische Jurist und Dichter Filippo Tommaso Marinetti in der franzsischen Zeitung Le Figaro sein futuristisches Manifest und begrndete damit die futuristische Bewegung:
Trotz der hufigen Verwendung von Wir hat Marinetti das Manifest allein konzipiert (Pluralis Modestiae). Es spiegelt die berzeugungen und die Verfassung eines jungen Millionrssohnes wider, der mit siebzehn Jahren auf sich allein gestellt im Paris des Fin de Sicle Erfahrungen sammelte. Geprgt wurde er dabei von seinem literarischen Freundeskreis, zu dem vor allem Symbolisten wie Guillaume Apollinaire, Joris-Karl Huysmans und Stphane Mallarm gehrten, die sich, zur Gewalt bekennend, gegen die herrschende brgerliche Ordnung auflehnten. Mit ihnen stand Marinetti auch den Anarchisten wie Pierre-Joseph Proudhon, Michail Bakunin und vor allem Georges Sorel nicht fern und begrte die Attentate ihrer Aktivisten. Im Manifest findet man auch Gedankengut von Friedrich Nietzsche. Wie Nietzsches Zarathustra, streben Marinettis Helden ihre Ziele allein gegen eine feindliche Welt ohne Rcksicht auf ihr Umfeld gewaltttig an.
Neben der Ablehnung der (christlichen) Moral und der Abneigung Marinettis gegenber Frauen zeigt sich im Manifest das Fehlen jeglicher sozialer Bezge. Nach einem vollendeten Jura-Studium fasste er den Entschluss, nicht in die Fustapfen seines erfolgreichen Vaters zu treten, sondern eine neue Kulturrichtung ins Leben zu rufen.
Das Manifest war als provokativer Tabubruch konzipiert, der Jugend, Gewalt, Aggressivitt, Geschwindigkeit, Krieg und Rcksichtslosigkeit verherrlichte und den als Passatisten (Anhnger des Vergangenen) bezeichneten etablierten Kulturtrgern und deren Anhngern den Kampf ansagte. Die Zerstrung von Bibliotheken, Museen und Akademien als Hort des Passatismus (berlebte Anschauungen) sollte der neuen Kultur den Weg ebnen und Italien eine neue kulturelle Identitt verleihen. Dazu Giovanni Lista:[2]
Die italienischen Knstler waren stets von der Idee gelhmt, nur die Nachkommen eines nunmehr verschwundenen Ruhms zu sein. Gegen diese Zwangsvorstellung von der unerreichbaren Vergangenheit verkndete Marinetti, dass sich eine neue Welt ankndige, und dass Italien jetzt seinen jahrhundertealten Ruhm zu Grabe tragen und vom Gewicht seiner herrlichen Vergangenheit befreien msse.
Selbst dieses provokative Manifest wre im skandalgewohnten Paris wohl ber ein Tagesgesprch nicht hinausgekommen, htte nicht Marinetti das in Knstlerkreisen geweckte Interesse dazu gentzt, einen Kreis junger Knstler um sich zu scharen und zu konzertiertem Schaffen zu bewegen, was er durch finanzielle Zuwendungen zu frdern verstand.
Zum Grundritual des Futurismus gehrten die zahlreichen Manifeste, mit denen sich der Futurismus in seiner Gesamtheit und in seinen Teilbereichen prsentierte.
Was den Futurismus von anderen Kunstrichtungen deutlich unterschied und zu dessen Verbreitung entscheidend beitrug, war die Art der Prsentation. Marinettis Serate futuriste (Futuristische Abende), die er ab 1910 vor allem in norditalienischen Theaterslen veranstaltete, sollten primr provozieren.[3] Deshalb begannen solche Abende grundstzlich mit der verbalen Herabsetzung der jeweiligen Stadt und ihrer Brger. Anschlieend wurden Manifeste verlesen, futuristische Kunstwerke gezeigt, futuristische Musik gespielt sowie Ausschnitte aus futuristischer Theaterkunst geboten. Solche Abende waren aus der Sicht Marinettis nur dann erfolgreich, wenn es sptestens zu Ende der Veranstaltung zu einem Tumult mit Einschreiten der Sicherheitskrfte kam und das Medienecho entsprechend gro war.
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The News We Could Lose: New Threats to Journalism and Press Freedom (Part 1)
Diane Foley, mother of executed U.S. journalist James Foley, and Debra Tice, mother of missing freelance journalist Austin Tice, talked with Judy Woodruff, co-anchor and managing editor of...
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The News We Could Lose: New Threats to Journalism and Press Freedom (Part 1) - Video
Orlando Hyundai Payment Freedom!
By: Now Digital
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