Monthly Archives: September 2019

Researchers in Canada have developed a novel clinical tool that uses patients overall health status and the risk for intermittent shock events to predict 1- and 2-year mortality in cystic fibrosis (CF), according study results published in European Respiratory Journal.1

Although survival in patients with CF has improved steadily during the past 3 decades, CF remains a life-shortening illness with half of all deaths occurring before the age of 35 years.2 Thus, there is a great need for developing an accurate prediction model for mortality to identify patients who would benefit from expedited referral to a lung transplant program. The researchers sought to develop a clinical tool for predicting 1- and 2-year risk for death using Canadian CF Registry data from 1982 to 2015 and validating it using United Kingdom CF Registry data from 2007 to 2013.1

They found that the combined effect of CF chronic health status and CF intermittent shock risk provided a simple clinical scoring tool for assessing 1-year and 2-year risk for death in an individual person with CF. The Canadian-derived model validated well with the UK data and correctly identified 79% of deaths and 95% of survivors in a single year in the United Kingdom.

In addition, the receiver under the operating curve of the 2-year mortality model was significantly greater than the model that predicted survival based on forced expiratory volume in 1 second <30% predicted (0.95 vs 0.68, respectively; P <.001).

The prediction model has some limitations. For one, although the majority of the predictor variables were obtained in the previous 12 months for the 1-year model or in the 12-month interval 1 year before for the 2-year model, the annual measurements in the Canadian registry do not reflect acute deterioration in health status. The researchers noted that it would be helpful to use encounter-based records in the future. In addition, the study population includes observations over the course of 30 years, during which CF prognosis and treatment have changed considerably.

In conclusion, the mortality prediction models provide accurate risks of death over 1-and 2-year time horizons, the researchers stated.1 The calculated probability of death may provide physicians and patients with important information with which to access key clinical decisions, such as transplant discussion and referral when the risk of death in the next 2 years is considered high.

References

1. Stanojevic S, Sykes J, Stephenson AL, Aaron SD, Whitmore GA. Development and external validation of 1- and 2-year mortality prediction models in cystic fibrosis. Eur Respir J. 2019;54(3).

2. Cystic Fibrosis Canada. 2012 Annual Report: The Canadian Cystic Fibrosis Registry. Toronto, Cystic Fibrosis Canada. Available at http://www.cysticfibrosis.ca/de/action/download?downloads=16&file=dl_Registry+2012 +-+English+FINAL+FOR+WEB.pdf. Published February 2014.

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New Clinical Tool Predicts 1- and 2-Year Mortality in Cystic Fibrosis - Pulmonology Advisor

The Cystic Fibrosis Foundation(CFF) is giving Eloxx Pharmaceuticals up to $1.61 million to support its planned Phase 2 clinical trial program assessing the safety, tolerability, and chemical properties of ELX-02, Eloxxs lead investigational compound to treatcystic fibrosis (CF) caused by nonsense, or stop, mutations.

The program is set to include two open-label, dose escalation, Phase 2 trials. One, called EL-012, will enroll up to eight patients in the U.S.; the other, EL-004, will enroll up to 16 patients in Europe.

Both studies will focus on the effects of multiple doses of ELX-02 in patients with at least one G542X allele.

The G542X allele is an abnormal variant of the CFTR gene (the gene defective in CF patients) that is included in Class I, which comprises a group of nonsense mutations that insert a stop signal in the coding sequence of CFTR. Because of this premature stop signal, the production of the CFTR protein halts, leading to the production of a shorter, non-functional protein.

ELX-012 is an experimental treatment that targets ribosomes the small structures that are responsible for the production of proteins in cells to tell them to bypass the stop signal in the mutatedCFTR coding sequence. In this way, ELX-012 increases the amount of full-length CFTR protein that is being produced, potentially minimizing the effects of CF.

The financial support provided by the CFF will help to bring EL-012 in testing in patients. The U.S. study will take place at clinical sites that are part of CFFs Therapeutics Development Network, the largest global network of CF clinical trials.

The company anticipates that early trial data will be available before the end of the year.

We are very gratified by the CF Foundations support as we advance our development program for ELX-02 in cystic fibrosis. The CF Foundations funding will accelerate the program in the U.S., Robert E. Ward, chairman and chief executive officer of Eloxx Pharmaceuticals, said in a press release.

We are also pleased that Dr. Ahmet Uluer, director of the Adult Cystic Fibrosis Program at the Boston Childrens Hospital has agreed to be the lead investigator in the U.S., and we look forward to reporting top line data from this trial later this year, Ward added.

If Eloxxs clinical trial program succeeds, ELX-02 may become the first treatment option for CF patients carrying at least one nonsense mutation. This would fulfill one of the top priorities of CFF: identifying and implementing therapies that tackle the root cause of CF.

Despite extraordinary progress in helping people with CF live longer and healthier lives, there is still critical work to be done to help all people living with this disease, the CFF stated in a news release.

Joana holds a MSc in Biology and a MSc in Evolutionary and Developmental Biology from Universidade de Lisboa. She is currently finishing her PhD in Biomedicine and Clinical Research at Universidade de Lisboa. Her work has been focused on the impact of non-canonical Wnt signaling in the collective behavior of endothelial cells cells that made up the lining of blood vessels found in the umbilical cord of newborns.

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Patrcia holds her PhD in Medical Microbiology and Infectious Diseases from the Leiden University Medical Center in Leiden, The Netherlands. She has studied Applied Biology at Universidade do Minho and was a postdoctoral research fellow at Instituto de Medicina Molecular in Lisbon, Portugal. Her work has been focused on molecular genetic traits of infectious agents such as viruses and parasites.

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CF Foundation Awards Eloxx $1.61M to Support Trial in People with Nonsense Mutations - Cystic Fibrosis News Today

Adults with cystic fibrosis (CF) are less active than they should be, although they have comparable activity levels to people without the genetic disorder, according to a recent review.

The review also showed that there are not enough studies that objectively assess physical activity levels in CF. Therefore, more research in this area is warranted, the investigators said.

The study, Physical activity and associations with clinical outcome measures in adults with cystic fibrosis; a systematic review was published in the Journal of Cystic Fibrosis.

Physical activity is known to benefit all people, but CF patients gain even more from being physically active because exercise can slow down the decline in lung function. It also can help clear mucus from the lungs, among other benefits.

Experts recommend at least 150 minutes of moderate-to-vigorous physical activity each week, and walking a minimum of 10,000 steps per day for all individuals. In CF patients, doctors dont often assess their physical activity in a consistent way. Given that, very little is known about patients exercise habits.

Now, researchers atLiverpool John Moores University, in the U.K., sought to evaluate physical activity levels in CF adults. The goal was to compare their exercise habits with expert recommendations, and to those of people without the genetic disorder.

To do so, the investigators reviewed 18 studies. Scientific articles had to include measurement of physical activity and/or sedentary behavior using a tool validated for use in the general adult population and/or adults with CF, as well as quantification of baseline physical activity and/or sedentary behavior prior to any interventions.

In five out of eight studies in which such assessment was possible, adults with CF were found to not practice 150 minutes of moderate-to-vigorous physical activity each week, or walk 10,000 steps per day. Importantly, those without the disease also failed to meet expert recommendations, and did so approximately in the same proportion as CF patients.

In addition, scientists observed no differences between CF and healthy subjects physical activity levels in three out of five studies.

A total of 13 studies investigated the association between physical activity and other clinical outcome measures, including lung function, body mass index, exercise capacity, and exacerbation frequency. However, there was not enough evidence to backup a relationship between lung function, exercise capacity, and physical activity.

Only three studies used objective physical activity assessments, meaning participants used accelerometer-based systems to quantify their movement. In these studies, associations between physical activity and clinical variables were more evident, in comparison with studies that used self-reported physical activity.

Notably, the researchers said all of the studies analyzed were of low quality.

There is a requirement for high quality studies designed specifically to explore PA [physical activity] in adults with CF, ideally employing standardised PA [physical activity] assessment methods, the researchers said.

Overall, based on the results, the team concluded that physical activity in adults with CF is largely comparable to their non-CF peers, despite being insufficiently active to achieve PA recommendations.

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Physical Activity Levels in CF Should Be Objectively Researched, Review Says - Cystic Fibrosis News Today

A Chippewa Falls man will be sentenced Dec. 9 for stealing a pickup truck and driving it into another vehicle, injuring a man in Eau Claire.

Police said Byer W. Nevins was also intoxicated at the time of the incident.

Nevins, 23, 627 W. Central St., pleaded no contest recently in Eau Claire County Court to felony counts of hit and run causing great bodily harm and operating a motor vehicle without the owners consent.

Felony counts of first-degree recklessly endangering safety, second-offense drunken driving causing injury and knowingly operating while revoked, and four misdemeanor counts of bail jumping were dismissed but can be considered at sentencing.

Judge Michael Schumacher ordered a pre-sentence investigation by the state Department of Corrections.

Nevins could be sentenced to up to 13 years in prison.

According to the criminal complaint:

Nevins and a 14-year-old acquaintance went car shopping on Aug. 7 looking for unlocked cars with keys in them on Pomona Drive in the town of Washington. They found a Chevy Silverado with the keys inside, and Nevins drove to pick up a 16-year-old friend. The trio then went to Bloomer to switch license plates with another vehicle. Surveillance video from a Bloomer convenience store showed the three stopping to put gas into the truck.

With Nevins driving, the trio returned to Eau Claire and were involved in two hit-and-run incidents reported on the citys north side. One of those crashes injured a man in his early 70s, breaking his sternum and back when the Silverado rear-ended his Mercury Grand Marquis at about 7:50 a.m. on the North Crossing.

The truck sped away from the crash site, but witnesses then reported seeing it in the vicinity. They told police three people got out of the truck, wiped down the sides and threw a bottle of alcohol into bushes before running away.

Police apprehended Nevins and the teens shortly afterward. When police found Nevins, he was having trouble standing, smelled of alcohol and had bloodshot eyes. Officers took him to Mayo Clinic Health System in Eau Claire for medical clearance and a blood draw to determine his alcohol level.

The juveniles told police that Nevins had been driving the whole time.

Nevins had drunken driving convictions in 2016 and 2018 in Chippewa County, plus other pending cases that required that he not consume alcohol while out on bond. His driving privileges also had been revoked.

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CF man admits to hit-and-run with stolen vehicle - Leader-Telegram

The 17-year-old Cystic Fibrosis (CF) warrior from Bond Head, Madi Vanstone is back from her trek to China and says it was a fabulous trip.

Madi and her mother, Beth Vanstone, were originally supposed to travel to Machu Piccchu, Peru in May, but due to concerns over the altitudes and her condition, the trip was cancelled by CF Canada.

Instead of letting it get them down, the Vanstones decided to plan another trip, while continuing to raise funds for CF Canada. They teamed up with United Kingdom based organization, Charity Challenge to climb the Great Wall of China in September.

It was incredible! exclaimed Beth.

The toughest thing we have ever done, and especially for Madi living with Cystic Fibrosis, she said.

The mother-daughter team flew out on Sept. 5 and stayed for a total of 12 days.

For five days, they trekked for six to eight hours per day, travelling on a different part of the wall for about one and a half hours a day to a new spot.

Some of the wall was crumbling and untouched other spots were refurbed and there was a day we hiked a lot of the day beside the wall as it was in such poor repair. It was beautiful, it was tough and it was empowering, described Beth.

Madi says it was one of the toughest things she has ever done, but also one of the most rewarding.

In total, they were able to raise over $28,000 for CF Canada through fundraising for the trip.

Hopefully one day CF will stand for cure found, said Beth.

Madi says hopes one day there will be a cure for CF and all CF patients will be able to trek the Great Wall.

It is important for Canadians to know that treatments are available to improve the health of CF patients and that our government needs to work harder to ensure these medications get to the patients that need them, she said.

Madi has been on the drug Kalydeco since she was 12-years-old, which she says has helped her tremendously.

The drug is very expensive, and through her efforts of visiting Queens Park and speaking to former premier, Kathleen Wynne and former health minister, Deb Matthews, she was able to get the drug covered under OHIP.

With the new pharmacare proposal, the Vanstones are worried about access to orphan drugs like Kalydeco and continue to advocate and raise awareness about life saving medication for Canadian patients.

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Bond Head Cystic Fibrosis Warrior, Madi Vanstone back from her trek to the Great Wall of China - CollingwoodToday

Dividend paying stocks like CF Industries Holdings, Inc. (NYSE:CF) tend to be popular with investors, and for good reason some research suggests a significant amount of all stock market returns come from reinvested dividends. If you are hoping to live on your dividends, its important to be more stringent with your investments than the average punter. Regular readers know we like to apply the same approach to each dividend stock, and we hope youll find our analysis useful.

A 2.5% yield is nothing to get excited about, but investors probably think the long payment history suggests CF Industries Holdings has some staying power. The company also returned around 6.3% of its market capitalisation to shareholders in the form of stock buybacks over the past year. Some simple analysis can offer a lot of insights when buying a company for its dividend, and well go through this below.

Click the interactive chart for our full dividend analysis

Companies (usually) pay dividends out of their earnings. If a company is paying more than it earns, the dividend might have to be cut. Comparing dividend payments to a companys net profit after tax is a simple way of reality-checking whether a dividend is sustainable. CF Industries Holdings paid out 60% of its profit as dividends, over the trailing twelve month period. This is a healthy payout ratio, and while it does limit the amount of earnings that can be reinvested in the business, there is also some room to lift the payout ratio over time.

We also measure dividends paid against a companys levered free cash flow, to see if enough cash was generated to cover the dividend. CF Industries Holdingss cash payout ratio last year was 24%, which is quite low and suggests that the dividend was thoroughly covered by cash flow. Its encouraging to see that the dividend is covered by both profit and cash flow. This generally suggests the dividend is sustainable, as long as earnings dont drop precipitously.

As CF Industries Holdings has a meaningful amount of debt, we need to check its balance sheet to see if the company might have debt risks. A rough way to check this is with these two simple ratios: a) net debt divided by EBITDA (earnings before interest, tax, depreciation and amortisation), and b) net interest cover. Net debt to EBITDA measures total debt load relative to company earnings (lower = less debt), while net interest cover measures the ability to pay interest on the debt (higher = greater ability to pay interest costs). CF Industries Holdings has net debt of 2.13 times its EBITDA. Using debt can accelerate business growth, but also increases the risks.

We calculated its interest cover by measuring its earnings before interest and tax (EBIT), and dividing this by the companys net interest expense. With EBIT of 4.07 times its interest expense, CF Industries Holdingss interest cover is starting to look a bit thin.

Before buying a stock for its income, we want to see if the dividends have been stable in the past, and if the company has a track record of maintaining its dividend. For the purpose of this article, we only scrutinise the last decade of CF Industries Holdingss dividend payments. The dividend has been stable over the past 10 years, which is great. We think this could suggest some resilience to the business and its dividends. During the past ten-year period, the first annual payment was US$0.08 in 2009, compared to US$1.20 last year. Dividends per share have grown at approximately 31% per year over this time.

Its rare to find a company that has grown its dividends rapidly over ten years and not had any notable cuts, but CF Industries Holdings has done it, which we really like.

While dividend payments have been relatively reliable, it would also be nice if earnings per share (EPS) were growing, as this is essential to maintaining the dividends purchasing power over the long term. Over the past five years, it looks as though CF Industries Holdingss EPS have declined at around 17% a year. A sharp decline in earnings per share is not great from from a dividend perspective, as even conservative payout ratios can come under pressure if earnings fall far enough.

To summarise, shareholders should always check that CF Industries Holdingss dividends are affordable, that its dividend payments are relatively stable, and that it has decent prospects for growing its earnings and dividend. First, we think CF Industries Holdings has an acceptable payout ratio and its dividend is well covered by cashflow. Its not great to see earnings per share shrinking. The dividends have been relatively consistent, but we wonder for how much longer this will be true. In sum, we find it hard to get excited about CF Industries Holdings from a dividend perspective. Its not that we think its a bad business; just that there are other companies that perform better on these criteria.

Given that earnings are not growing, the dividend does not look nearly so attractive. Businesses can change though, and we think it would make sense to see what analysts are forecasting for the company.

Looking for more high-yielding dividend ideas? Try our curated list of dividend stocks with a yield above 3%.

We aim to bring you long-term focused research analysis driven by fundamental data. Note that our analysis may not factor in the latest price-sensitive company announcements or qualitative material.

If you spot an error that warrants correction, please contact the editor at editorial-team@simplywallst.com. This article by Simply Wall St is general in nature. It does not constitute a recommendation to buy or sell any stock, and does not take account of your objectives, or your financial situation. Simply Wall St has no position in the stocks mentioned. Thank you for reading.

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Would CF Industries Holdings, Inc. (NYSE:CF) Be Valuable To Income Investors? - Simply Wall St

Zooming in on shares of CF Industries Holdings, Inc. (NYSE:CF), we note that the average target price is presently $54.75. This is the consensus target based on projections provided by the covering analysts polled. Wall Street analysts have the ability to provide price target predictions for stocks that they cover. Price target estimates can be calculated using various methods. Many investors will track stock target prices, especially when analysts make changes to the projections. A good research report will generally give detailed reasoning for a specific target price estimate. Some investors may follow analyst targets very closely and use the information to complement their own stock research.

Trading the stock market can sometimes feel like a wild roller coaster ride. When stocks are soaring, investors may feel like they cant lose. When markets are sinking, investors may feel like there is nothing that they can do. Individual investors may have experienced both ends of the spectrum. Sometimes, an investor may secure some winning trades right out of the gate. This may cause the individual to become overconfident in their ability. Markets have the ability to shoot down overconfidence very quickly. On the other side, investors may only experience losses right off the bat and become highly discouraged. Figuring out how to manage winners and losers can big a big help to the investors psyche in the long-term. Frequently assessing which trades worked and examining why they worked may greatly assist the investor. The same can be said for trades that did not pan out.

Checking in on stock price activity for CF Industries Holdings, Inc. (NYSE:CF), we have recently seen shares trading near the $48.65 mark. Investors will often track the current stock price in relation to its 52-week high and low levels. The 52-week high is currently $56.06, and the 52-week low is presently $39.01. When the current stock price is trading close to either the 52-week high or 52-week low, investors may pay closer attention to see if there will be a breakthrough that level. Over the past 12 weeks, the stock has seen a change of 4.31%. Going back to the start of the calendar year, we can see that shares have moved 11.81%. Pulling the focus closer to the past 4 weeks, shares have seen a change of .81%. Over the past 5 trading days, the stock has moved -2.72%.

Taking a quick look at analyst opinions, we can see that the current average broker recommendation on shares of CF Industries Holdings, Inc. (NYSE:CF) is presently 2.11. Out of the covering analysts polled by Zacks Research, 4 have put a Strong Buy or Buy rating on the stock.

As earnings season comes into focus, investors will be closely tracking sell-side estimates. According to analysts polled by Zacks Research, the current quarter EPS consensus estimate is currently sitting at .34 for shares of CF Industries Holdings, Inc. (NYSE:CF). The number consists of estimates provided by 5 contributing analysts. For the last reporting period, the company posted a quarterly EPS of 1.28. The consensus estimate for last quarter before the earnings report was .81. Looking out further to the next quarter EPS estimate, the consensus is currently resting at .49. This consensus estimate includes 3 analysts taken into consideration by Zacks. Shifting the focus to the current fiscal year EPS estimate, the number is currently 1.48. Widening the gaze to the next fiscal year, we can see that the consensus EPS estimate is presently 2.29.

Active traders are typically striving to spot winning entry and exit points for trades. Following technical indicators may help traders gain some insight on how best to do this. There are plenty of indicators that have helped traders make winning trades. Because there are so many to choose from, beginning traders may want to start by focusing on a few different combinations to start with. Professional chartists may have ultra complex charts set up to spot perfect trade entries. Others may use one or two simple indicators to aide with setting up the trade. Keeping track of all the data may be a challenge at first, but there are many platforms out there that have made the process much simpler than ever before. Setting up a winning strategy may take some time and perseverance, but taking the time to acquire the proper knowledge may mean the difference between winning and losing trades in the future.

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Watching the Consensus Target Price on These Shares: CF Industries Holdings, Inc. (NYSE:CF) - Blackwell Bulletin