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Category Archives: Cf

Doctors Willing to Help Specialists in CF Infant Care, But… – Cystic Fibrosis News Today

Posted: July 29, 2021 at 9:00 pm

Most primary care providers (PCPs) in Ontario family physicians, pediatricians, and midwives voiced a willingness and confidence in providing some level of care to infants testing positive for cystic fibrosis (CF) in newborn screening programs, a Canadian survey reported.

A majority favored treating minor illnesses like infections over total care for infants with the disease, preferring to share duties with CF specialists.

However, hesitancy voiced by some in caring for babies identified as CF carriers people who will not develop the disease, but could pass it along to their own children due to uncertainty in their ability to reassure parents about their childs health, and in caring for infants whose CF screening was inconclusive concerned the studys researchers.

Education and care guidelines for children with CF or inconclusive CF diagnoses are needed, as they would enable PCPs to provide well-baby and minor illness care with more confidence, particularly in rural and remote areas, the scientists wrote.

The survey, Newborn screening for cystic fibrosis, was published in the journal Canadian Family Physician.

CF is an inherited disordercausedby mutationsin the CFTR gene, which leads to impaired chloride ion and water transport across cell membranes, resulting in abnormally thick mucus secretions, particularly in the lungs and digestive tract.

Newborn screening (NBS) programs can identify CF in early infancy, before the onset of clinical symptoms. Dried blood-spot samples are collected within days of birth and screened for elevated immunoreactive trypsinogen (IRT), a marker for CF.

A positive IRT result prompts a DNA analysis to identifyCFTR mutations. Two faulty copies of the gene, one from each parent, are needed to have CF. People with only one mutatedCFTR gene are considered CF carriers. A final diagnosis follows a sweat chloride test, which can be abnormal and signify CF, be inconclusive, or be normal and identify the child as a CF carrier.

Ongoing newborn screening programs are leading to more newborns being diagnosed with CF or as carriers, raising a need to understand the preferred roles played by primary healthcare providers in caring for these children.

Researchers at the University of Toronto surveyed PCPs to investigate their preferences and confidence in caring for children with confirmed CF, those with an inconclusive CF diagnosis, infants who are CF carriers, as well as with care management for CF families.

Questionnaires were sent to primary care providers in Ontario who were identified as having treated an infant with a positive screening result in the previous six months. Of note, midwife care in the province is limited to the first six weeks of life.

The questionnaire asked PCPs about their role in providing routine baby care, such as guidance in caring for CF infants, administering vaccines, assessing development and growth, and caring for minor illnesses, such as lung infections or diarrhea.

A total of 321 PCPs completed the survey: 208 family physicians, 68 pediatricians, and 45 midwives.

Results showed that 77% of PCPs would not on their own provide total routine baby care for those with a confirmed diagnosis, with most (68%) sharing care with CF specialists. More than half (54%) would provide total care for minor illnesses 54% of family physicians, 85% pediatricians, and 4% of midwives.

Slightly more confidence was indicated for newborns with an inconclusive CF diagnosis about half (49.5%) of responding PCPs favored providing total routine baby care to these children, while most (67%) would provide total care for minor illnesses.

Almost all (89%) PCPs would care for infants who were CF carriers, while 9% preferred to share baby care with a specialist and 2% to refer the case to a specialist. Most (84%) would provide total care for minor illnesses of CF carriers 97% of family physicians, 94% of pediatricians, and 9% of midwives.

Overall, pediatricians were more disposed to provide care independently for infants with confirmed CF or inconclusive diagnoses, while [midwifes] were less disposed to provide care independently for these children, the researchers wrote.

Sightly over half (54%) said they were extremely or very confident in reassuring parents of CF carriers about their childs health, and 59% said to be extremely or very confident in explaining CF carrier status for future family planning. About 25% knew how to order adult CF carrier tests, and 67% understood how to provide a referral for a CF diagnosis.

Given that these care providers were likely more familiar with CF than average PCPs, as they had recently had an infant in their practice with a positive NBS result for CF, findings here indicate a need for PCP education about the meaning of inconclusive and carrier results, the researchers wrote.

For CF carriers, PCPs were significantly more likely to provide total baby care if they were extremely or very confident in reassuring parents about their childs health. They were also more likely to treat minor illnesses if they were moderately confident in this area.

Midwives were the least likely to provide total care. The team noted, however, that midwives responses might reflect guidelines that limit their scope of practice to caring for babies without abnormalities or disorders.

No other predictors of care were identified.

This study found that most PCPs are willing to care for infants with a range of screen-positive CF [newborn screening] results in some capacity, the researchers concluded. However, providers lack of confidence to reassure about carrier status raises issues about its possible medicalization, prompting the need for specific PCP education about genetic disorders and the meaning of genetic test results, particularly carrier status.

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CF Industries Holdings, Inc. Declares Quarterly Dividend and Confirms Dates for First Half 2021 Results and Conference Call – Business Wire

Posted: at 9:00 pm

DEERFIELD, Ill.--(BUSINESS WIRE)--CF Industries Holdings, Inc. (NYSE: CF) today reported that its Board of Directors has declared a $0.30 per share dividend on its common stock. The dividend will be payable on August 31, 2021, to stockholders of record as of August 16, 2021.

Additionally, the Company confirmed that it will report its first half 2021 results after the market close on Monday, August 9, 2021. The company plans to host a conference call to discuss these results at 9:00 a.m. ET on Tuesday, August 10, 2021.

Investors can access the call by dialing 866-748-8653 or 678-825-8234. The passcode is 5624196. The conference call also will be available live on the Companys website at http://www.cfindustries.com. Participants also may pre-register for the webcast on the Companys website. Please log-in or dial-in at least 10 minutes prior to the start time to ensure a connection. A replay of the webcast will be available through the companys website at http://www.cfindustries.com.

About CF Industries Holdings, Inc.

At CF Industries, our mission is to provide clean energy to feed and fuel the world sustainably. With our employees focused on safe and reliable operations, environmental stewardship, and disciplined capital and corporate management, we are on a path to decarbonize our ammonia production network the worlds largest to enable green and blue hydrogen and nitrogen products for energy, fertilizer, emissions abatement and other industrial activities. Our nine manufacturing complexes in the United States, Canada, and the United Kingdom, an unparalleled storage, transportation and distribution network in North America, and logistics capabilities enabling a global reach underpin our strategy to leverage our unique capabilities to accelerate the worlds transition to clean energy. CF Industries routinely posts investor announcements and additional information on the companys website at http://www.cfindustries.com and encourages those interested in the company to check there frequently.

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[VIDEO] CF Sunrise Helping New Businesses With Programs & More – Discoverweyburn.com – DiscoverWeyburn.com

Posted: at 9:00 pm

For those interested in starting their first business all of the steps and tasks needed to accomplish their goals may seem too daunting.

This is where Community Futures Sunrise in Weyburn can step in to bridge the gap between struggling entrepreneurs and successful business owners.

"We've been busy over the last year developing programs for our small business community and also our municipal leaders who are in charge of our community governance," told Community Futures Sunrise General Manager, Verna O'Neill.

CF Sunrise has created a number of different initiatives to help connect these individuals with the information and resources that they need to be successful in the province.

One of those is their How to Start a Business in SK webinar that is open to the public and completely free to join.

"We run that webinar once per month and we'll walk you through all of the steps on how to start a business in southeast Saskatchewan successfully," O'Neill explained. "Then they will be connected with our office so that there are advisory and coaching services beyond that webinar for them to tap into."

She added that a lot of entrepreneurs have the same questions that they need to be answered and after many years of providing those answers and shifting with the everchanging circumstances of the economy CF Sunrise is a one stop shop for anyone that may be on the fence about creating that new business venture.

"In addition to our services for small businesses we also have some economic development services that we are implementing this fall to support our community leaders and local government," shared O'Neill. "So we have a number of workshops that we will be rolling out to help them retain the business community that we have in the Weyburn area or to attract new investment into our community. We have everything from basic economic development all the way to how you can retain and expand your business community. It's also a great opportunity to connect with other people that are interested in economic development within the southeast portion of our province."

With the current state of the world shifting to more of an online community of sharing and communicating Community Futures are helping new businesses to up their online presence and find new ways to attract customers in the current digital age that we live in.

One way that they are helping entrepreneurs with their online endeavors is with their Go Digital Sask program that is a free one-hour session for southeast business owners that is set to run for the next two years.

CF Sunrise has also been promoting southeast Saskatchewan residents to get out and experience all that the local communities have to offer with their Where Is It Wednesday Facebook contest that provides a chance to win a $20 gift card from a local business of your choice within the community of the week.

Another opportunity that they have created for potential business owners is their Destination Creation Program for tourism-based businesses and entrepreneurs interested in learning more.

Below you can listen to O'Neill explaining the specifics of this upcoming program in September and October.

To keep up with the latest at Community Futures Sunrise you can follow them on Facebook and Instagram or you can also visit their official website.

Below you can view a new video on Community Futures and what they have to offer that was shared on their social media pages.

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Philadelphia Union at Inter Miami CF odds, picks and prediction – USA TODAY Sportsbook Wire

Posted: July 25, 2021 at 3:27 pm

The Philadelphia Union (6 wins, 4 losses, 5 draws) travel south to take on Inter Miami CF (2-8-2) Sunday at DRV PNK Stadium in Fort Lauderdale, Fla. Kickoff is set for 7:30 p.m. ET. Below, we preview the Philadelphia Union vs. Inter Miami CF odds and lines, and make our best MLS bets, picks and predictions.

The Union come in struggling of late with a 1-2-2 record over their last five games. However, its excused as Philadelphia sent many players to represent their respective nations in the CONCACAF Gold Cup.

Philadelphia is down GK Andre Blake, F Cory Burke and D Alvas Powell, all of which have played an impactful role this season. Inter Miami CF sent just D Kelvin Leerdam.

Over the last five games, Miami has allowed 12 goals and scored just 1. Its been a brutal stretch for the Eastern Conferences last-place team.

Odds via BetMGM; accessUSA TODAY Sports betting oddsfor a full list. Lines last updated at 9:10 a.m. ET.

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Philadelphia Union 1, Inter Miami CF 0

BET on the UNION (+130) as the couple of pieces theyre down shouldnt impact them too much. Blake is the most important loss as hes their starting goalie.

GKJoe Bendik has served as a decent backup. This match will be more about Inter Miamis inability to defend. It has given up 22 goals through 12 matches and Miami has also lost five of six home games and doesnt take advantage of the home crowd.

Despite being down a couple players, Id still back Philadelphia.

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LEAN to the UNDER 2.5 (-125) as the best value on the total.

The Union will be without their second-leading scorer in Burke. They arent a score-heavy side as they have just 19 goals through 15 matches.

Philadelphias strength comes in its defending which should get a nice break as the only player on the opposing side to really worry about is F Gonzalo Higuan. Hes the only Inter Miami player with more than 1 goal on the season.

That said, the Under hit in three of the last six games for both sides. Its the better play but just for half a unit.

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Want some action in this one? Place an MLS bet with BetMGM today. For more sports betting picks and tips, visit SportsbookWire.com. Pleasegamble responsibly.

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Philadelphia Union at Inter Miami CF odds, picks and prediction - USA TODAY Sportsbook Wire

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Family Has Miracle On Their CF Journey The Okawville Times – The Okawville Times

Posted: at 3:27 pm

Ryan and Alicia Luechtefeld have had their share of ups and downs in their journey of raising two children with Cystic Fibrosis. Both Madison, 17, and Logan, 11 take daily treatments and medication for the inherited disorder that affects the lungs, digestion system, and other organs.

Their latest up is so high that it is off the radar.

Thanks to a new Trikafta medication Madison has been taking for 18 months, recent testing showed that her sodium chloride level was so low that she no longer has CF.

The Luechtefelds consider that nothing short of a miracle. Miracles do happen when you believe the fight can be won! said Alicia.

Logan started taking Trikafta three weeks ago when the drug was approved for 6-12 year olds. In just three days of taking Trikafta, Logans cough was almost completely eliminated, his mother said.

Read the full story in this weeks issue.

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Former CF Bank building turned over to Wellsville Community Foundation – Morning Journal News

Posted: at 3:27 pm

WELLSVILLE The Wellsville Community Foundation (WCF) took ownership of the former CF Bank office building on Main Street last month.

The building, which has not been in full use for a number of years, was given to the non-profit WCF by the bank. The foundation plans to determine the best charitable or non-profit use of the buildings and are soliciting ideas from the community. There will be several open houses held.

We are honored that CF Bank has entrusted us with this historic building, said WCF President Eddie Murphy. Each effort pursued or adopted will be done in the spirit of community advocacy and advancement.

There are seven current trustees of the WCF Attorney Nick Amato; Cressy Belden, a new resident to the area; County Municipal Court Judge Timothy McNicol; Murphy, a retired executive; Peter Russell, a former banker; Linda Weekley, a retired educator; and Robert G. Geno Williamson, a retired executive.

Mr. Tim ODell, CEO and the board of directors of CF Bank were extremely generous in their gift of this property, said Russell, who initiated the negotiations on behalf of the foundation. But thats not all. They also gave us an additional $5,000 to kick off our fundraising for necessary improvements to the property.

The WCF is welcoming donations. Membership starts at $100. Donations can be made through the website, http://www.wellsvillecommunityfoundation.org or through any board member. The WCF is a non-profit, IRS tax exempt organization, founded and incorporated in late 2020 and receiving 501c3 status in 2021. The mission of the organization is to contribute to charitable purposes, or conduct activities, for the common good, general welfare and civic benefits of the Wellsville community and its environs.

Besides the CF Bank building project, the WCF is eager to begin supporting the community through improvement projects with the first being the ongoing business district Clean Streets campaign, which is being led by member Cris McNicol.

Williamson points out nearly everyone on the board grew up in Wellsville.

Eddie (Murphy) went to L.A. and I went to Long Island, Williamson said, and we came back to the Ville. We all want to support the town any way we can, and raise some revenue to spur growth. I think we will be able to accomplish something; how many somethings? We will see.

Consumers Bank of Minerva is assuming ownership of the former CF Bank drive-through in Wellsville, along with the branch bank in Calcutta.

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WATCH: Odds and bets on New England Revolution vs. CF Montreal – USA TODAY Sportsbook Wire

Posted: at 3:27 pm

The New England Revolution look to extend their win streak Sunday against CF Montreal. Sitting at No. 1 in the Eastern Conference and No. 2 in MLS standings, the Revs are coming off a 5-0 rout of Inter Miami CF on the road Wednesday. CF Montreal is 6-4-4 and looks to bounce back after a 1-0 loss to NYCFC earlier in the week.

With both teams having played Wednesday, Sundays matchup will show who can outperform on short rest. Will New England continue to shine at home, or will Montreal pull off an upset on the road vs. the top team in the conference? Watch to find out each teams odds of coming away with a W. CheckBetMGMfor the most updated odds.

BetMGM Sportsbook is offering a RISK-FREE first bet up to $600 (paid in free bets). Promotion available in CO, IA, IN, MI, NJ, PA, TN, VA, WV and Washington D.C. New customer offer, terms and conditions apply. Place all of your legal, online sports bets at BetMGM Sportsbook. Bet now!

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Jesus Madrazo Elected to Board of Directors of CF Industries Holdings, Inc. – Business Wire

Posted: at 3:26 pm

DEERFIELD, Ill.--(BUSINESS WIRE)--CF Industries Holdings, Inc. (NYSE: CF) today announced that its Board of Directors has elected Jesus Madrazo, founder and chairman of Kompali Farms, as an independent director for the company. Prior to founding Kompali Farms, Mr. Madrazo served for more than two decades in diverse global leadership roles at Monsanto Company and, more recently, as executive vice president, public affairs and sustainability, for the Crop Science division of Bayer.

The election of Mr. Madrazo brings membership of the CF Industries Holdings, Inc. Board of Directors to twelve. He is expected to stand for re-election by stockholders at the companys 2022 Annual Meeting.

We are pleased to welcome Jesus to the CF Industries Board, said Stephen A. Furbacher, chairman of the board, CF Industries Holdings, Inc. With his strong leadership experience, a global perspective, a passion for sustainability, and a deep background in agriculture serving customers and as a farmer himself, Jesus will serve the Board and our management team greatly. We look forward to his contributions as we work together to create long-term value for our stockholders.

About Jesus MadrazoMr. Madrazo, 51, is the founder and chairman of Kompali Farms, a large wine venture in Mexico renowned for its innovation by uniting technology and sustainability to deliver value to consumers while minimizing environmental impact. Prior to Kompali Farms, he served as a member of the executive leadership team and as executive vice president, public affairs and sustainability, for the Crop Science division of Bayer. Prior to joining Bayer, Madrazo held the role of Vice President, Commercial and Global Supply Chain, at Monsanto, which he first joined in 1999.

Mr. Madrazo holds a legal degree from the Instituto Tecnolgico y de Estudios Superiores de Monterrey in Mexico and received post-legal degrees from Universidad Nacional Autnoma de Mxico (UNAM) and University of Arizona. He also holds an MBA from Cardiff Business School in the United Kingdom. He has been a member of multiple industry coalitions and non-governmental organization boards of directors around the world.

About CF Industries Holdings, Inc.At CF Industries, our mission is to provide clean energy to feed and fuel the world sustainably. With our employees focused on safe and reliable operations, environmental stewardship, and disciplined capital and corporate management, we are on a path to decarbonize our ammonia production network the worlds largest to enable green and blue hydrogen and nitrogen products for energy, fertilizer, emissions abatement and other industrial activities. Our nine manufacturing complexes in the United States, Canada, and the United Kingdom, an unparalleled storage, transportation and distribution network in North America, and logistics capabilities enabling a global reach underpin our strategy to leverage our unique capabilities to accelerate the worlds transition to clean energy. CF Industries routinely posts investor announcements and additional information on the companys website at http://www.cfindustries.com and encourages those interested in the company to check there frequently.

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Mental Health Screening Tools for CF Patients, Caregivers – ubmd.com

Posted: July 21, 2021 at 12:33 am

Jacobs School of Medicine and Biomedical Sciences researchers are finding mental health screenings to be an important component for cystic fibrosis (CF) patients and their caregivers.

CF is a genetic, progressive disease that causes persistent lung infections and impacts the most basic physical processes. While recent breakthroughs have significantly extended the lifespan of patients with CF, the disease presents patients and their caregivers with significant, lifelong daily challenges.

Disease Takes Mental Toll on Patients, Caregivers

The primary purpose of CF clinics is to treat the physical disease, but providers are well aware of the mental toll it takes on patients and caregivers.

It can be challenging for people with CF and their families to sustain daily therapies and to live with a life-limiting disease, saysDanielle M. Goetz, MD, clinical associate professor of pediatrics and director of the Cystic Fibrosis Center of Western New Yorkat UBMD Pediatrics and Oishei Childrens Hospital.Our team began to feel that mental health screening was an important part of care to look at.

The Jacobs School/Oishei team effort was led by Goetz and Carla A. Frederick, MD, associate professor of medicine, with guidance from Drucy S. Borowitz, MD, clinical professor emeritus of pediatrics, and Beth A. Smith, MD, professor of psychiatry and pediatrics.

Depression Linked With Worse Health Outcomes

In 2013, the Buffalo researchers began systematically using efficient tools for screening for anxiety and depression in patients and their caregivers, both of whom exhibit higher rates of these conditions than the general population.

The researchers also developed an algorithm to determine which type of treatment would be necessary.

The screening process has been shared with other centers and was piloted at a larger CF center at the Ann and Robert H. Lurie Childrens Hospital of Chicago.

These tools and the research it is based on are described in apaperpublished in May in the British Medical Journal Open Quality.

CF is a disease that affects the whole body, including the ability to breathe and digest food, explains Goetz, who is also a pediatric pulmonologist with UBMD Pediatrics. The burden of taking two-to-three hours per day to clear the airways of mucus and taking multiple medicines can be so difficult and cause feelings of isolation.

The disease also can cause diabetes and liver problems.

It is a lot to think about and address, says Goetz, adding that previous studies have shown that depression in CF patients is linked with worse health outcomes, including decreased lung function, lower body mass index and increased exacerbations and hospitalizations.

Restrictions Can Lead to Feelings of Isolation

Due to the grave risk of passing infections to each other, people with CF are also not supposed to gather, as depicted in the book and adapted Hollywood film Five Feet Apart, which tells the story of a romance between two teens with CF.

In reality, CF patients are advised to stay six feet apart from each other (even before the COVID-19 pandemic), a restriction that by itself can lead to feelings of isolation and depression.

At the same time, since most CF patients are diagnosed as young children, parents or caregivers of CF patients are intimately involved with their care.

Parenting is hard, and parenting a child who has multiple medical and perhaps social needs is challenging, Goetz says.It makes sense that depression and anxiety are more common in these parents and caregivers. Watching and helping their child go through multiple stressors is painful.

We support the parents and caregivers, oftentimes talking to them about how they are dealing with their child or loved ones illness and how we can help them to seek help when needed.

Questionnaires Used With Clinical Assessments

In 2013, the center began to assess all of its 180 pediatric and adult CF patients for depression. The center is now screening between 95 and 99 percent of patients and caregivers.

The first step was a simple screening questionnaire (the Patient Health Questionnaire-2, or PHQ-2), which asks about the degree to which the individual has experienced either depression or anhedonia (lack of pleasure in activities the patient used to find pleasurable).

A positive response to either question triggers a more detailed questionnaire (the Patient Health Questionnaire-9 or PHQ-9) or Generalized Anxiety Disorder-7 (GAD-7) questionnaire, which the center now uses as the initial screening tools.

With these questionnaires, along with clinical assessments, the center assesses patients as having mild, moderate, moderately severe or severe depression or anxiety.

Patients are then referred to mental health specialists or treated at the CF center by its own mental health coordinator. They receive follow-up assessments to determine effectiveness of treatment.

Suicide Ideation Included in Screening Process

The researchers reported a higher prevalence of both depression and anxiety in the CF center than has been reported in the literature.

They also found that 5 to 10 percent of patients and caregivers had thought about committing suicide. The researchers had made the decision to include suicidal ideation in the screening process, and all clinic staff were trained to assess for this.

We looked at it this way, Goetz says. If we choose not to screen for suicidal ideation, it just means we may be missing it, not that suicidal ideation is not occurring.It is a challenging thing to screen for, though, if you dont know what to do with a positive screen.

So, it is important for the whole team to understand how to do the screening and how to make an emergency plan with patients, she adds. Anyone on the team can learn, especially nurses and providers, but really anyone, in case there isnt a social worker or psychologist on the team.

The centers emergency plans are tailored to each patient and may involve development of a suicide risk management plan, namely, a safety net for the patient, or urgent or emergent referral to a mental health professional.

Goetz explains that the stepped process, beginning with the short questionnaire, allows for quick screening for all people with CF and their caregivers.

A provider can then hone in on what needs to be done for each patient, with a focus on those who need more interventions, she says.

It has been so meaningful to have a social worker and psychologist in our clinic who can help support the providers in providing the best mental health care or referrals for care, Goetz adds. I cant say enough good things about this integrative approach and the importance of mental health and its impact on physical health.

Essential Role in Quality Improvement Efforts

CF Care Center teams also include nutritionists, respiratory therapists, nurse coordinators and research coordinators, all of whom play essential roles in quality improvement efforts.

The toolkit and related resources have now been disseminated on an international listserv for CF mental health and medical providers.

The CF Center of WNY at UB and Oishei Childrens Hospital, a Cystic Fibrosis Foundation-accredited center that treats patients from eight counties, has been involved in the CFFoundations Quality Improvement Network.

Goetz notes that the mental health screening project demonstrates a key premise of the quality improvement effort.

We know now that people with CF should be involved with our projects from their inception, Goetz says. That is an excellent aim for all teams looking to improve clinical care: The people who know best how to improve the process for disease assessment and management are likely the people living with the disease.

Other Co-Authors Are From Jacobs School

Along with Goetz, Frederick, Borowitz and Smith, other Jacobs School co-authors are:

Adrienne Savant, MD, of the Ann and Robert H. Lurie Childrens Hospital of Chicago, is also a co-author.

The research was funded by Cystic Fibrosis Foundation Therapeutics, part of the Cystic Fibrosis Foundation.

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Preview: New England Revolution know not to overlook Inter Miami CF – Boston.com

Posted: at 12:33 am

New England RevolutionRevolution goalkeeper Brad Knighton earned a 1-0 shutout last Saturday in Atlanta.

By Matt Doherty, The Boston Globe

The Eastern Conference-leading Revolution enter Wednesday nights match against host Inter Miami CF (7:30, Ch. 38) with experience of what can happen when you start slowly against a last-place team.

Just two weeks ago, the Revolution hosted then-last-place Toronto FC and started flat, allowing three goals in the first 24 minutes of a 3-2 loss.

New England faces a similar situation against a reeling Inter Miami that has dropped five straight matches to fall behind Toronto for last in the East. The Revolution know they have to be focused from the opening kickoff.

There isnt an easy game in MLS, midfielder Matt Polster said Monday. You know that as a team, and we know if were not playing at our best, we could struggle to win games. So for us, we need to be focused from the first minute to the last minute to win this game. Miami is a good team. I think their record doesnt really show what theyre capable of, so we have to come out really strong and show what were about.

After allowing 11 goals in its last five matches, the Revolution (8-3-3) returned to form last Saturday, holding Atlanta to five shots on net in a 1-0 win. Atlanta fired coach Gabriel Heinze following the defeat.

Brad Knighton, who was making his second straight start in net for Matt Turner (Gold Cup), recorded his first clean sheet since Oct. 13, 2018, and appears to be gaining confidence.

The Revolution backline was also stellar, anchored by center backs Henry Kessler and Andrew Farrell, and right back Brandon Bye.

It was a big-time performance from us at Atlanta, said Bye. Coming away with the shutout and the win, obviously, is the most important thing. We look to build on this and to continue to be strong in the back and not give up goals. Thats our goal.

Inter Miami (2-7-2) will play for the first time since July 3 after its match last Saturday at the New York Red Bulls was postponed because of inclement weather. Miami has dealt with injuries to key attackers Gonzalo Higuain (fitness), Rodolfo Pizarro (hip), and Robbie Robinson (hamstring), but all three are slated to return for Wednesdays match.

Miami also signed three international players as reinforcements over the past few weeks, including Dutch goalkeeper Nick Marsman, who is expected to start.

Although Miami has scored a league-low nine goals and just one during its five-game skid, Revolution coach Bruce Arena is expecting a difficult match.

They are a team that needs 3 points, said Arena. They have good players. They brought in some new players that theyll be playing in the game, and we expect them to be a handful. We know some of the results havent gone their way as of late, so we expect to see a team that comes at us real hard and its going to be difficult game.

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