Inside, the 720S Coupe cabin is carried forward. Accessed by new frameless doors, which open in the typical – and eye-catching – McLaren dihedral fashion, there’s dual-zone climate control that automatically adjusts whether the RHT is up or down. An 8-inch touchscreen handles multimedia and infotainment, while bespoke controls switch between the different drive modes and trigger other features. The active rear spoiler rises automatically at higher speeds, for better downforce, and can flip up to act as an airbrake. Again, its positions are different depending on if the RHT is open or closed. The Spider also gets new 10-spoke lightweight forced alloy wheels – 19-inches at the front and 20-inches at the back – shod in Pirelli P ZERO rubber as standard. P ZERO CORSA tires are a no-cost option. Some things haven’t needed to change, of course, and prime among those is the engine. That’s McLaren’s mighty M840T 4.0-liter twin-turbo V8, pushing 710 horsepower and 568 lb-ft of torque to the rear wheels. There’s a 7-speed SSG transmission and electro-hydraulic steering. The suspension uses McLaren’s Proactive Chassis Control II hydraulic system, with Comfort, Sport, and Track modes. MORE McLaren 720S Coupe Review0-60 mph comes in 2.8 seconds, with 0-124 mph a mere 7.9 seconds. Top speed is 212 mph with the RHT up, or 202 mph with hit down. Carbon ceramic disc brakes are standard front and rear – 15.3-inches at the front, and 15-inches at the back – with 6-piston aluminum calipers for the front and 4-piston at the rear. Three trims – standard, Performance, and Luxury – will be offered, along with two new exterior colors, Belize Blue and Aztec Gold. The Supernova Silver color first offered on the McLaren 12C is also being resurrected for the 2019 720S Spider. In the US, pricing for the 720S Spider will kick off at $315,000 – compared to the roughly $285k for the Coupe – with McLaren saying deliveries should begin from March 2019. It’s available to order now. McLaren has pulled the wraps – and the roof – from its latest supercar, with the 2019 720S Spider promising both performance and an uninterrupted view of the sky. A second variation of the award-winning 720S Coupe, the new McLaren 720S Spider is also the second car in the British automaker’s Track25 business plan, which should see a whopping 18 new cars or derivatives by the end of 2025. Twice as quiet in operation as the 650S Spider roof, it’s also significantly quieter inside when it’s closed. Indeed, noise levels are said to be lower than in the old 650S Coupe. When the RHT is opened, meanwhile, the rear window lowers automatically to control airflow into the cabin. That rear window can be independently controlled, too, dropping down between buttresses that are an inch lower than those in the 650S Spider to also help reduce turbulence.Despite the clever new roof tech, the 720S Spider is only 108 pounds heavier than the 720S Coupe. McLaren says that, at 2,937 lbs in its lightest form, it undercuts its closest rival by almost 200 pounds.If you still want to see the sky, but don’t want to be exposed to the elements, there’s a trick there, too. Like the McLaren Speedtail, the 720S Spider has a clever electrochroamatic glass panel. Optional on the new convertible, it can switch between transparent and tinted electronically. It automatically tints when the car is stopped, to keep the cabin temperature low, but remembers the last setting when the 720S Spider is started up again. 2019 McLaren 720S Spider Gallery Story TimelineRocket scientist explains McLaren 720S science of speedMcLaren Special Operations outs bespoke Track Theme and Pacific Theme 720S Velocity carsMcLaren Special Operations creates a bespoke 720S all about that stealth The new convertible certainly starts from a good place. Like the 720S Coupe, it uses the automaker’s Monocage II-S carbon fiber core, with a bespoke carbon fiber body structure on top of that. Since that was all designed with a drop-top in mind from the outset, no extra stiffening or strengthening was required compared to the Coupe. What’s new, of course, is the Retractable Hard Top, or RHT. Gone is the central “spine” running from the top of the Coupe’s windshield to the rear, spanning the cabin. Instead, the 720S Spider gets a one-piece, carbon fiber roof panel that’s electrically rather than hydraulically driven. AdChoices广告Not only does it look good – hardly changing the silhouette of the car compared to the original – it’s also much faster than rival roofs. Indeed, it will raise or lower in 11 seconds, six seconds faster than the old 650S Spider could manage. It’ll also operate when the car itself is running at higher speeds, with the strong motors and light roof weight meaning it can be used at speeds up to 31mph.
The nationwide sweep involved arrests of doctors, nurses and other licensed medical professionals.Los Angeles Times: Feds Charge 91 Healthcare Providers With Billing FraudA federal healthcare strike force has charged 91 doctors, nurses and other licensed medical professionals in a nationwide sweep in connection with fraudulently billing the government nearly $430 million. Those charged included a group in Los Angeles that ferried patients for ambulance rides that were never medically necessary (Serrrano, 10/4).Reuters: Authorities Charge 91 In $430 Million Medicare FraudNinety-one people including doctors, nurses and other medical professionals were charged criminally in a new sweep of Medicare fraud involving seven U.S. cities and $430 million in alleged false billing, officials said on Thursday. It was the government’s second big raid in recent months after a similar effort in May alleged $452 million in fraud in Medicare, the U.S. health program for the elderly and disabled (Ingram and Morgan, 10/4).Bloomberg: U.S. Charges 91 Over Millions In False Medicare BillsU.S. authorities charged 91 people with Medicare fraud in a nationwide crackdown, alleging schemes involving $429.2 million in false billing, Attorney General Eric Holder said. Doctors, nurses and other medical professionals were among those who billed Medicare for unnecessary services and paid kickbacks to acquire patient information for fraudulent bills, Holder said today at a news conference in Washington (Mattingly, 10/4).CQ HealthBeat: Medicare Fraud Operation Results In Charges Against 91 In Seven CitiesAttorney General Eric H. Holder Jr. and Health and Human Services Secretary Kathleen Sebelius announced the nationwide operation at a Thursday afternoon news conference with law enforcement and HHS officials who participated in the strike force effort. … Together, those indictments charge more than $230 million in home health care fraud; more than $100 million in mental health care fraud; more than $49 million in ambulance transportation fraud; and millions more in other frauds (10/4).Politico Pro: DOJ Announces $430M In Medicare FraudThe Medicare Fraud Strike Force has arrested 91 people in seven cities for Medicare fraud schemes totaling approximately $430 million, Attorney General Eric Holder announced Thursday. “Over the last 24 hours, Medicare Fraud Strike Force operations in seven different cities have conducted one of the largest health care fraud takedowns on record,” Holder said. … He said defendants were charged in Miami, Los Angeles, Dallas, Houston, New York City, Chicago and Baton Rouge, La., for schemes including home health care, mental health care and ambulance fraud (Smith, 10/4).Houston Chronicle: FBI Arrests Historic Houston Hospital’s CEO, Son, 5 Others After 30 years as CEO of one of Houston’s most historic hospitals, Earnest Gibson III, along with his son and five others, was arrested on Thursday — part a national Medicare fraud sweep involving $430 million in bogus billings and 91 health care providers in seven states. If the allegations against the 68-year-old Gibson are true, that he and others at the hospital bilked the Medicare program of $158 million over a period of more than seven years, it could prove lethal for Riverside, once the primary hospital for the city’s black population. Gibson and his son Earnest Gibson IV, 35, were charged with 13 counts: conspiracy to commit health care fraud; conspiracy to defraud the United States and pay and receive health care kickbacks; one count of money laundering and ten counts of violating the anti-kickback statute (Langford, 10/4).CNN Money: Medicare Fraud Case: 91 Professionals ArrestedThe Justice Department announced criminal charges Thursday against 91 people who allegedly received about $430 million through wide-ranging Medicare fraud. … Among those arrested by the FBI Thursday was Ernest Gibson, the president of Riverside General Hospital in Houston, along with his son, who is also an employee of the hospital, and four others associated with the hospital. “We are going after people, whatever their positions, whatever their level,” said Holder (Isidore, 10/4).Medpage Today: Medicare: Feds Charge 91 In Fraud SweepIn Dallas, 14 individuals — including two doctors and two registered nurses — were charged for their alleged involvement in $103.3 million in false billings. In one case involving a home healthcare company, Joseph Megwa, MD, signed roughly 33,000 prescriptions for more than 2,000 beneficiaries from 2006 to 2011; many beneficiaries had primary care physicians who never certified home healthcare services for them. … In Brooklyn, 15 people, including one doctor, were charged in various fraud schemes costing Medicare $23.2 million, including paying cash for physical therapy that was never provided in some cases (Pittman, 10/4).Meanwhile, in other news -Reuters: FDA Cracks Down On Websites Selling Bad DrugsThe U.S. Food and Drug Administration said it has cracked down on thousands of online pharmacies for selling potentially unsafe, unapproved or fake medicines, including the erectile dysfunction drug Viagra and antiviral Tamiflu. The FDA, working with international regulatory and law enforcement agencies from about 100 countries, said on Thursday that it took action against more than 4,100 Internet pharmacies, bringing civil and criminal charges, removing offending websites and seizing drugs worldwide (Sherman and Berkrot, 10/4). This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. 91 Charged With $430 Million Medicare Billing Fraud
First Edition: February 15, 2013 This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. Today’s headlines include news about how the health law’s insurance exchanges are taking shape. Kaiser Health News: Capsules: Feds Increase Costs To High-Risk Pool Members; Valentine’s Day Surprise: Senate Democrats Blast Obamacare Implementation; As Hospital Challenges Rise, Their Bond Ratings FallNow on Kaiser Health News’ blog, Phil Galewitz reports on news related to federal high-risk pools: “The Obama administration has increased costs for about 38,000 people enrolled in high-risk insurance pools run under the federal health law to prevent the program from running out of money” (Galewitz, 2/14).In addition, he filed a report about some Senate Democrats’ criticism of certain elements of the health law: “Testifying before the powerful Senate Finance Committee, the administration’s top regulator on new health exchanges encountered criticism from several Democrats who helped push through the 2010 federal health overhaul — among them Chairman Max Baucus of Montana and Sens. Ron Wyden of Oregon, Bill Nelson of Florida and Maria Cantwell of Washington” (Galewitz, 2/14).Also on Capsules, Jay Hancock writes about hospital bond ratings: “Nonprofit hospitals don’t issue stock, so you can’t track their financial health by the ups and downs of share prices. But many sell bonds, and it’s fair to say that hospital bonds haven’t fared as well recently as the Dow Jones average. Last year set a record for hospital-bond downgrades, as debt levels rose and hospitals faced the uncertainty of business under the Affordable Care Act, debt-rater Moody’s said this week” (Hancock, 2/15). Check out what else is on the blog.The Associated Press/Washington Post: A Look At How Administration Says Automatic Budget Cuts Would Diminish Government ServicesThe sequester law exempts Social Security, Medicaid, food stamps and Medicare recipients’ benefits from cuts, but most programs are vulnerable. … The National Institutes of Health would lose $1.6 billion, trimming research on cancer, drying up money for hundreds of other research projects and eliminating up 20,000 private research positions nationwide. Health departments would give 424,000 fewer tests for the AIDS virus this year. More than 373,000 seriously ill people may not receive needed mental health services (2/15).USA Today: States Face Friday Deadline On Health Care ExchangesAs states work to decide by Friday whether they plan to create their own or partner with the federal government to run health exchanges, there has been one last-minute surprise and one skin-of-the teeth agreement (Kennedy, 2/15).The New York Times: Enrollments For Insurance Start Oct. 1, Official SaysAn Obama administration official told Congress on Thursday that the government would be ready to enroll millions of people in private health insurance plans this fall, but senators of both parties expressed doubts (Pear, 2/14).The Washington Post’s WonkBlog: Inside The Obama Administration’s Plan To Build 25 Insurance MarketsFor months now, it’s been one of the health care overhaul’s biggest unknowns: Will the federal government be ready to run two dozen state insurance marketplaces? On Thursday Gary Cohen, director of the Center for Consumer Information and Insurance Oversight gave the Senate Finance Committee the most comprehensive explanation to date of what the agency has achieved so far—and what remains to be done (Kliff, 2/14).The Associated Press/Washington Post: McDonnell To Feds: Virginia Will Use Federal Health Exchange But Retain Oversight On ProvidersGov. Bob McDonnell told the Obama administration Thursday that while Virginia will use a federally run health insurance exchange, the state intends to retain regulatory authority over insurance providers that do business with Virginians through the exchange. McDonnell’s Feb. 14 letter to Gary Cohen of the U.S. Department of Health and Human Services confirms his December position not to commit Virginia to establishing its own exchange that would be financed and operated by the state (2/14).The Washington Post’s The Fix: Bobby Jindal’s Make-Or-Break MomentBut since then Jindal has made some tough budget choices and has pushed some difficult education reforms. Perhaps most troubling for him right now is his decision to reject a federal Medicaid expansion – a decision the Voter/Consumer Research poll showed is unpopular with the state’s voters. Jindal has been out front among Republican governors in rejecting the Medicaid expansion, even as a growing number of GOP governors have decided to take part. In fact, Jindal wrote an op-ed in the Washington Post last month about why he decided to reject the expansion (Blake, 2/14).Politico: Gaps In Health Law Dental Coverage The health care law was supposed to go a long way toward getting more kids access to dental care. But as it stands now, the effort may fall short. Children’s dental coverage is considered an “essential health benefit” under the law. But the way it’s likely to be offered — through separate dental policies with no penalties for parents who don’t get them — has dentists and child health advocates worried (Cunningham, 2/15).Politico: Courts Split On Contraception, Cases Plow ForwardThe cases brought against the Obama administration’s employer contraception coverage rule are largely marching forward, despite the White House’s recent attempt at compromise, the American Civil Liberties Union noted in an update Thursday (Smith, 2/15).The Wall Street Journal’s Washington Wire: CDC Report Sheds Light On Contraception UseTwo statistics at the heart of the controversy over mandatory insurance coverage of contraception — that 99% of American women have used contraception, including 98% of Catholics — are getting fresh attention from the Centers for Disease Control and Prevention. The topline findings in a Valentine’s Day release from CDC back both of those claims, but with important caveats that are sometimes blurred in the debate (Radnofsky, 2/14).The New York Times: Uphill Road For Plan To Cut Government’s Drug CostsIn just a handful of words in his State of the Union address, President Obama renewed a proposal to lower the amount that the federal government pays for drugs taken by low-income seniors — a measure that supporters say would save the government more than $150 billion over the next decade. But it faces formidable opposition from Republicans, some Democrats and the powerful pharmaceutical industry, making passage unlikely (Thomas and Pear, 2/14).The Wall Street Journal: Numbers, Numbers And More NumbersUnder pressure to do more with less, insurers, pharmacy benefit managers and health-care providers are all pushing data analysis to new heights. Insurers have been crunching numbers for years to figure out which patients are most likely to generate high costs. Now other groups are gauging probabilities of relapses, and the likelihood of a patient’s not taking his or her medicine. Using models that draw on massive troves of medical and other data, some are also focusing on seemingly healthy individuals, trying to prevent problems before they occur (Tibken, 2/14).Los Angeles Times: Anthem Blue Cross Rolls Back Rate IncreaseIn response to pressure from California regulators, Anthem Blue Cross agreed to a slightly lower rate increase for about 630,000 individual policyholders that will save consumers an estimated $54 million. Anthem, a unit of Indianapolis insurance giant WellPoint Inc., had sought to raise rates an average of 18% beginning Feb. 1. California Insurance Commissioner Dave Jones said Thursday that the company had agreed to reduce the average increase to 14% after regulators reviewed Anthem’s rate filing (Terhune, 2/15).The New York Times: Cardinal Health Is Buying Large Medical Supplier For $2 BillionCardinal Health, the second-largest distributor of prescription drugs, announced on Thursday that it was buying a large medical supplier in a $2 billion deal aimed at expanding the business into the growing area of home health care (Thomas, 2/14).The Wall Street Journal: The Y Takes On DiabetesA new health program being rolled out at YMCAs across the country shows the potential for a community-based organization to deliver a nationwide health-care intervention. The Y’s target is diabetes. Research has shown that the program, which combines exercise, dieting and individual counseling, can have a big impact in reducing incidences of diabetes. Impressed by the research, insurers and employers are providing direct funding as the YMCA seeks to enroll participants in the program and induce them to reach weight-loss targets (Dooren, 2/14).USA Today: As Alzheimer’s Rate Soars, Concern Rises Over CostsPatients with Alzheimer’s and other forms of dementia will spend three times more on health care than patients with other types of illnesses, the association says. Medicare patients with Alzheimer’s and other dementias spent $43,847 on health care and long-term care services, compared to $13,879 spent by patients without those illnesses, the association said in a 2012 report. For government health care programs already facing economic strain, these estimates are daunting, researchers and advocates say (Lloyd, 2/14).Check out all of Kaiser Health News’ e-mail options including First Edition and Breaking News alerts on our Subscriptions page.
First Edition: March 26, 2013 Today’s headlines include reports about the challenges of long-term care planning and the startling rise in disability within the United States. Kaiser Health News: Temp Agencies See Opportunity In Health LawKaiser Health News staff writer Jay Hancock, working in collaboration with The Washington Post, reports: “The rush to implement the Affordable Care Act, which is generating billions for insurers, hospitals and technology vendors, also looks like a boon for staffing companies, whose share prices have soared. But some suggest that exceptions for temporary employees could leave holes in the health law’s expanded coverage” (Hancock, 3/26). Read the story.Kaiser Health News: Slow Progress On Efforts To Pay Docs, Hospitals For ‘Value,’ Not VolumeReporting for Kaiser Health News in collaboration with USA Today, Russ Mitchell writes: “For decades, reformers have sought to change how doctors and hospitals are paid to reward quality and efficiency – efforts that accelerated as a result of the health care overhaul. But surprisingly little progress has been made to date, a consortium of large employers reported today” (Mitchell, 3/26). Read the story.Kaiser Health News: Insuring Your Health: Large Companies Are Increasingly Offering Workers Only High Deductible Health PlansIn her latest Kaiser Health News consumer column, Michelle Andrews writes: “Historically, one of the perks of working at a big company has been generous health benefits with modest out-of-pocket costs. But increasingly, large companies are offering their employees only one option: a plan with a relatively high deductible linked to a savings account for medical expenses” (Andrews, 3/26). Read the column.The New York Times: Companies Get Strict On Health Of WorkersEmployers are increasingly trying to lower health care costs by using incentives to persuade workers to make better lifestyle choices, a new survey shows, but what remains less clear is whether a reward is better than a punishment — or whether the programs work at all (Thomas, 3/25).The Wall Street Journal: U.S. Moves To Dismiss Suit Against Michigan Blue CrossThe Justice Department on Monday moved to dismiss its long-running antitrust lawsuit against Blue Cross Blue Shield of Michigan. The department said that the state had resolved the agency’s concerns by enacting a law that bans certain deals between insurers and health-care providers. The department, however, said it was continuing to investigate the use of the deals in health-plan contracts elsewhere (Kendall, 3/25).The Washington Post’s WonkBlog: Here’s Obamacare’s Most Controversial RegulationThe Affordable Care Act changes the health care system in myriad ways — everything from allowing insurers to charge tobacco smokers higher premiums to guaranteeing free coverage of breast pumps. One provision, however, has engendered more controversy than any other: The requirement that contraceptives be covered without co-payment has drawn more than 147,000 public comments, according to an analysis from the Sunlight Foundation. These are the letters that companies, non-profits and private citizens send to the federal government, hoping to sway the regulatory process (Kliff, 3/25).NPR: Arkansas Medicaid Expansion Attracts Other States’ InterestSince the Supreme Court made the Medicaid expansion under the federal health law optional last year, states’ decisions have largely split along party lines. States run by Democrats have been opting in; states run by Republicans have mostly been saying no or holding back. But now Arkansas – at the suggestion of the federal government – has suggested a third option: Enroll those newly eligible for Medicaid in the same private insurance plans available to individuals and small businesses (Rovner, 3/26).The New York Times: Expense And Emotions In Preparing For Long-Term CareThe emotional impact of witnessing the decline of a family member or helping to care for one is often the reason people seek coverage for long-term care, people who work in the aging field say (Carrns, 3/25).NPR: Unfit for Work: The Startling Rise Of Disability In America (A four-part series)In the past three decades, the number of Americans who are on disability has skyrocketed. The rise has come even as medical advances have allowed many more people to remain on the job, and new laws have banned workplace discrimination against the disabled. Every month, 14 million people now get a disability check from the government (Joffe-Walt, 3/26).Los Angeles Times: Limiting Hospital Intern Shifts May Not Cut Errors, Studies FindIt’s been 15 years now, but Dr. Sanjay Desai remembers the brutal hours he worked as a young medical intern and how he struggled with fatigue while treating patients. “There were days we were easily working 36 hours straight and you couldn’t remember how you got home — if you got home,” Desai said. “It wasn’t safe.” Times have changed. Regulations now demand that teaching hospitals limit first-year trainees to 16-hour shifts. By reducing work hours, medical authorities reasoned, interns would get more sleep, suffer less fatigue and commit fewer mistakes (Morin, 3/25).The New York Times: Salesmen In The Surgical SuiteIt is not the first time patients have claimed they were harmed by Intuitive’s robotic surgical equipment, called the da Vinci Surgical System. But the Taylor case, set for trial in April, is unusual. Internal company e-mails, provided to The New York Times by lawyers for the Taylor estate, offer a glimpse into the aggressive tactics used to market high-tech medical devices and raise questions about the quality of training provided to doctors before they use new equipment on patients. Intuitive, based in Sunnyvale, Calif., declined to comment on the lawsuit but said studies showed that its robotic equipment results in better outcomes than conventional open surgery (Rabin, 3/25).The New York Times: U.S. Wants State To Pay After Audit Of Youth CareIn another critical assessment of New York’s multibillion-dollar Medicaid program, a federal audit says the state improperly claimed $27.5 million in reimbursements for services to mentally ill and emotionally disturbed children and teenagers (McKinley, 3/26).The Associated Press/Washington Post: Maryland House Passed Bill Further Implements Health Care ReformA measure to further implement federal health care reform in Maryland passed the House of Delegates on a 93-43 vote Monday with little debate. The measure creates a dedicated funding stream for the Maryland Health Benefit Exchange, which is a new insurance market that will offer residents a choice of private health plans. While the exchange is on track to be up and running by Jan. 1 with federal help in the first year, the state will begin paying roughly $24 million in fiscal year 2015. The money will come from an existing 2 percent tax on insurance plans that are state-regulated (3/25).The New York Times: Caregiver For Disabled People Sues New York StateThe employee, Jeffrey Monsour, has brought to light a number of questionable practices by the state, as varied as routinely falsifying fire drills and turning a blind eye toward abuse of those in the state’s system of care for people with developmental disabilities. He was one of the people interviewed and featured in a 2011 series of articles by The New York Times examining problems of abuse and corruption within the system (Hakim, 3/25). Check out all of Kaiser Health News’ e-mail options including First Edition and Breaking News alerts on our Subscriptions page. This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. House Republican leaders began a series of meetings last week to sell this idea to their rank-and-file members. Also in Capitol Hill news, cancer clinics argue that Congress should have addressed the cuts they took as a result of sequestration before turning to the spending reductions’ impact on air travel.The Washington Post: GOP Moves Away From Entitlements And Toward Tax Reform In Budget DealWith another fight over the national debt brewing this summer, congressional Republicans are de-emphasizing their demand for politically painful cuts to retirement programs and focusing on a more popular prize: a thorough rewrite of the U.S. tax code. Reining in spending on Social Security and Medicare remains an important policy goal for the GOP. But House leaders launched a series of meetings last week aimed at convincing rank-and-file lawmakers that tax reform is both wise policy and good politics and should be their top priority (Montgomery, 4/27).The Hill: Cancer Clinics: Our Cuts From Sequester Needed Earlier Remedy Than FAA’sCongress should have addressed deep cuts to cancer clinics before tackling airline delays caused by sequestration, people at several of those clinics said Friday. Both the House and Senate have now voted to restore funding that the Federal Aviation Administration lost through the automatic budget cuts known as “sequestration.” The bill is headed to President Obama’s desk (Baker, 4/28).A Friday hearing explored how Health Insurance Portability and Accountaiblity Act rules are being interpreted by providers – Medpage Today: HIPAA Being Misinterpreted, Congress ToldHealth care providers often misunderstand or over-interpret a 1996 health privacy law and as a result frequently do not share vital health information with family, caregivers, and others, lawmakers heard Friday. Some members of Congress have expressed concern that certain provisions of the Health Insurance Portability and Accountability Act — called HIPAA for short — have prevented providers from sharing information with loved ones and law enforcement that may have saved a patient’s life or the lives of others. The law restricts the sharing of information in most circumstances unless the patient grants permission (Pittman, 4/26)Also in the news, a bipartisan bill was introduced in the Senate last week regarding Food and Drug Administration oversight of compounding pharmacies – Reuters: Draft Bill Gives FDA Authority Over Some PharmaciesThe Food and Drug Administration would gain greater authority over pharmacies that compound sterile drugs and ship them across state lines under proposed legislation announced on Friday. The proposal from a bipartisan group of U.S. senators comes in the wake of a meningitis outbreak last fall that killed 53 people and sickened more than 700. The outbreak was linked to a tainted steroid distributed by the New England Compounding Center (Clarke, 4/26).The Hill: Senators Push Expanded Oversight Of Compound PharmaciesA bipartisan group of senators wants to give federal regulators greater oversight of compound pharmacies following bacterial contaminations nationwide that have killed at least 50 people and sickened hundreds more. Sens. Tom Harkin (D-Iowa), Lamar Alexander (R-Tenn.), Al Franken (D-Minn.) and Pat Roberts (R-Kan.) released a draft bill on Friday to make the blurry regulatory lines surrounding the pharmacies more clear (Wilson, 4/26). Some GOP Lawmakers Are Shifting Focus From Medicare To The Tax Code
This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. The lawmakers will likely meet this week to set principles for the changes, which could include allowing lower coverage: “copper” insurance plans.The Wall Street Journal: Democrats To Offer Fixes For Health LawSeveral centrist Senate Democrats, including some up for re-election this fall, are planning to push for changes to the Affordable Care Act — a move that has stirred debate within the party about whether making these fixes would keep the spotlight trained on the health law’s flaws. Democrats in Congress have vowed to keep — and improve — President Barack Obama’s health-care overhaul, but their recent efforts have been overshadowed by controversial White House tweaks and delays (Peterson, 3/26).Fox News: Democrats Said To Push For New Changes To ObamaCare Amid Midterm FearsSens. Mark Warner, D-Va.; Mark Begich, D-Alaska; Mary Landrieu, D-La.; Heidi Heitkamp, D-N.D.; Joe Manchin, D-W.Va.; and Sen. Angus King, I., Maine, will introduce proposals to improve the law, The Wall Street Journal reported. Begich and Warner have called for allowing “copper” plans on the government-run health exchanges. The new insurance plans would offer lower premiums and higher out-of-pocket costs than the “bronze,” “silver” and “gold” options currently offered (3/27).And Republicans also are aiming at the law –Politico: Kevin McCarthy Pitches Obamacare Changes to LobbyistsHouse Majority Whip Kevin McCarthy huddled Wednesday with roughly 40 K Streeters to rally their support for a bill that would change Obamacare’s definition of a work week. The bill would increase the definition of a full-time week from 30 hours to 4o hours, the current bar at which employers are required to provide health coverage for their workers (Palmer and Sherman, 3/26).CNN: Alabama Candidate Takes Aim At ObamacareA U.S. House candidate in Alabama is literally shooting down Obamacare. A video released by his campaign on Wednesday, shows Will Brooke using a variety of firearms to destroy a copy of the Affordable Care Act. The ad begins with Brooke seated on the bed of a truck next to a stack of paper that he says is a copy of the law championed by the President. The ad is titled “Let’s Do Some Damage” (Davidson, 3/26). Senate Democrats Ready Health Law Changes
This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. Brill, who has spent years investigating the healthcare industry and the creation of the Affordable Care Act, said Obamacare has made healthcare more accessible for Americans; but the overall cost of healthcare has not gone down as the president said would happen. (1/5) More public reporting on hospital quality could help to reduce hospital prices, results of a study suggest. The prices for two common cardiac procedures did not increase as quickly in states where the first public reporting on cardiac quality occurred when Medicare released it in 2007, researchers reported in the latest issue of Health Affairs. Prices for the same two procedures grew more quickly in states where cardiac quality data already was available. (Evans, 1/5) Modern Healthcare: Hospital Quality Reporting May Hold Down Prices Study: Hospital Quality Reporting May Help Control Prices Commercial health plans used hospital performance as leverage to negotiate prices, the study reported in Modern Healthcare found. Also in the news, author Steven Brill talks about how the health law has increased access to care but has yet to reduce costs. CBS News: “America’s Bitter Pill” Author Steven Brill On Obamacare
A recent nationwide survey revealed that 66 percent of automotive consumers would consider paying more for a vehicle with an alternative powertrain. more…The post Survey: Two out of three might pay more for alternative powertrain vehicle appeared first on Electrek. Source: Charge Forward
Source: Charge Forward Tesla has historically been having difficulties penetrating the German auto market, which is known for preferring German vehicles, but it looks like the Model 3 is helping Tesla pierce the market and shake establish automakers. more…The post Tesla is shaking up German automakers with Model 3 doing surprisingly well on their home turf appeared first on Electrek.
Source: Charge Forward While I enjoy riding around on $4,000 electric bicycles as much as the next guy, I know that such bikes have a more limited market. Budget-level electric bicycles in the sub-$1,000 range are a lot easier for us average Joes to justify.But sometimes it can be hard to find an e-bike that is cheap on price without being cheap on quality. After spending some good saddle time on the Roadster Ghost from Ride1Up though, I think I’ve found a great entry-level e-bike for those looking to save a few (or a pile of) bucks. more…Subscribe to Electrek on YouTube for exclusive videos and subscribe to the podcast.https://www.youtube.com/watch?v=2LVEtRE51hUThe post Review: Ride1Up Roadster Ghost electric bicycle is a great e-bike for under $1,000 appeared first on Electrek.
This recent law review article titled “Laxity at the Gates: The SEC’s Neglect to Enforce Control Person Liability” does not mention the Foreign Corrupt Practices Act, but it did get me thinking about control person liability in connection with SEC FCPA enforcement actions.As highlighted in this post, in the aftermath of a 2009 SEC individual FCPA enforcement action based on “control person” liability some predicted the start of a new trend. However, this “trend” never occurred.As previously highlighted in this 2009 post, the Nature’s Sunshine Products Inc. (NSP) SEC FCPA enforcement action included charges against Douglas Faggioli and Craig Huff. Specifically, the complaint alleged that Faggioli (President and Chief Executive Officer of NSP and a member of its board of directors who during the relevant time period was NSP’s Chief Operating Officer) and Huff (NSP’s former CFO) as “control persons” of NSP violated the FCPA’s books and records and internal control provisions.The SEC generally alleged that both Faggioli and Huff had “supervisory responsibilities” over NSP’s senior management and policies, yet as “control persons,” “failed to make and keep books, records, and accounts, which in reasonable detail, accurately and fairly reflected the transactions of NSP” and failed to devise and maintain an adequate system of internal accounting controls. Without admitting or denying the SEC’s allegations, Faggioli and Huff each agreed to pay a $25,000 civil penalty.As highlighted in this prior post, the enforcement action was believed to be the first FCPA enforcement action in which the SEC charged a corporate executive with an FCPA violation under a Section 20(a) “control person” theory of liability (even though, as noted in the prior post, the SEC had previously charged corporate executives under other indirect theories including aiding and abetting a company’s FCPA violations by invoking Section 20(e)).The “control person” theory of liability used the NSP / Faggioli / Huff enforcement action generated much attention and commentary.For instance, this law firm alert noted:“This kind of “control person” liability has been used before by the SEC — e.g., in the Tyco, WorldCom, and Enron cases — but has never been used before in an FCPA case. The SEC’s extension of this theory to the FCPA represents an expansion of potential liability for individual corporate officers.[…]Because the Nature’s Sunshine case was settled by the SEC through consent judgments with Faggioli and Huff, the agency’s arguments in favor of control person liability were not fully explained or litigated. Nonetheless, the SEC’s willingness to use control person liability could be a powerful enforcement tool to pursue senior executives or directors who could have known of bribery or could have stopped it from occurring had they exercised their influence within the company.”This law firm update stated:“On July 31, 2009, the Salt Lake City Regional Office of the U.S. Securities and Exchange Commission (“SEC”) opened what could become a new chapter in FCPA enforcement. […] [T]he case is notable because it appears to be the first time the SEC has held public company officials responsible for an FCPA-related books and records violation based solely upon their status as “control persons.”[…][T]he Nature’s Sunshine case appears to be the first time such supervisory accountability has figured in an FCPA case. The case also may mark a trend towards the expanded use of Section 20(a) liability by the SEC. […] Section 20(a) also can be a powerful tool in addressing the liability of a parent company for conduct at its subsidiaries. Still open for debate is the question whether Nature’s Sunshine is a singular case arising under exceptional circumstances, or a portent for expanded use of Section 20(a) liability in the FCPA context. In particular, if the SEC’s new FCPA enforcement unit were to apply Section 20(a) to substantive FCPA anti-bribary violations, the impact could be dramatic.”This lawyer-drafted article stated:“[Recently] there was much wailing and rending of garments among criminal defense and securities enforcement practitioners alike when, for the first time in the … history of the Foreign Corrupt Practices Act (FCPA), the Securities and Exchange Commission invoked §20(a) of the Securities Exchange Act of 1934 (Exchange Act) to impose FCPA liability on two corporate executives based solely on the allegation that they were “control persons” with supervisory authority over the company employees who had committed the primary FCPA violations.In “client alerts” and other missives to industry, practitioners correctly warned that the SEC appeared to be unleashing a new and less-exacting standard of FCPA liability, one that sidesteps entirely the scienter or “guilty knowledge” standards that Congress specifically wrote into the act and replaces them, instead, with notions of strict or “respondeat superior” liability for individual executives, board members and private equity investors who neither know of nor consciously avoid learning about FCPA violations occurring somewhere within the corporate chain of command. The case that set off this uproar was SEC v. Nature’s Sunshine Products Inc.[…]Within the charging language of the Nature’s Sunshine complaint … FCPA practitioners immediately spotted a harbinger of even more aggressive FCPA enforcement to come.[…]Nature’s Sunshine appears to mark the first time that the SEC has sought to hold corporate executives responsible for FCPA violations based solely on their status as “controlling persons” having supervisory authority over those who committed the primary FCPA violations.12 At a minimum, the Commission’s choice to marry §20(a) and the FCPA in such unprecedented fashion clearly signals a more aggressive enforcement posture against corporate executives and other individuals. In turn, the mere specter of potential “control person” FCPA liability for otherwise blameless corporate executives necessarily adds to companies’ already daunting task of monitoring and remediating potential FCPA liability risks. And, given that the overwhelming majority of FCPA investigations are settled short of litigation, the SEC’s apparent willingness to threaten such “control person” liability likely will drive the costs of FCPA settlements even higher.[…]Whether Nature’s Sunshine portends a new era of FCPA enforcement rife with actions against executives and other individuals who neither participated in, knew of, or even avoided learning about primary FCPA violations within their chain of command is unknown.”Nearly a decade after the NSP / Faggioli / Huff enforcement action what is known is that the “new trend” of “control person” FCPA individual enforcement actions that some hinted at never occurred.Since the 2009 NSP / Faggioli / Huff enforcement action, it is believed that the SEC has attempted to invoke this theory of liability only once. As highlighted in this 2012 post in the SEC complaint against Mark Jackson (former Noble Corporation CEO) and James Ruehlen (Director and Division Manager of Noble’s subsidiary in Nigeria) the SEC alleged, among other various cases of action, that during the violations, Jackson was Noble’s Chief Financial Officer, Chief Operating Officer, and ultimately President and Chief Executive Officer, and Chairman of the Board of Directors and that Jackson directly or indirectly controlled Noble, Defendant Ruehlen, and others, and therefore was liable as a control person under Section 20(a) of the Exchange Act for all of their violations.Unlike the vast majority of FCPA defendants (corporate and individual) charged in an SEC enforcement action, Jackson and Ruehlen mounted a defense and the case ended with a whimper on the eve of trial and without admitting or denying the SEC’s allegations, Jackson consented to a final judgment permanently restraining and enjoining him from violating the FCPA’s books and records provisions.Seeking to better understand the general lack of “control person” theories of liability in individual FCPA enforcement actions, I reached out to Neil Smith (K&L Gates and former senior counsel in the SEC’s Enforcement Division where he was also a member of the SEC’s FCPA Unit) and he stated:“In making enforcement charging decisions, the SEC will look at the full landscape of available charges that fit the provable conduct. If control person liability is the best charge that can be proven against an individual, then I think the SEC staff will recommend that charge to the Commission in FCPA and other cases. However, if a more substantive charge – whether it be a direct violation or a charge for causing or aiding and abetting an FCPA, books and records, or internal controls violation – is supported by the evidence, then control person liability may be redundant.” Save Money With FCPA Connect Keep it simple. Not all FCPA issues warrant a team of lawyers or other professional advisers. Achieve client and business objectives in a more efficient manner through FCPA Connect. Candid, Comprehensive, and Cost-Effective. Connect
Categories: Market Talk ASIA / AUSTRALIA:China responded to the UK’s criticism of its handling of Hong Kong by telling them that they should not interfere in “domestic affairs.” The UK’s Foreign Secretary tweeted full support for the Hong Kong citizens right for a peaceful protest. In addition, he told China that the way good relations are maintained is on the basis of mutual respect. The Chinese UK ambassador stated that these remarks have damaged their relations.The US says the recent “disturbing” missile tests contradict China’s promise not to use the South Chinese Sea as a militarized zone. The Pentagon stated that the recent tests were designed to intimidate other claimants to the disputed waters. The Chinese Government did pre-warn ships not to enter the test area.South Korea cut their global growth targets as they realize that demand has been hit by the US-Chinese trade war.The major Asian stock markets had a mixed day today. Shanghai decreased 28.68 points or -0.94% to 3,015.26, Kospi decreased 26.00 points or -1.23% to 2,096.02, ASX 200 increased32.30 points or 0.49% to 6,685.50, NIKKEI 225 decreased 116.11 points or -0.53% to 21,638.16, Hang Seng decreased 20.42 points or -0.07% to 28,855.14, and SENSEX increased 22.77 points or 0.06% to 39,839.25.The major Asian currency markets had a mixed day today. AUDUSD increased 0.0041 or 0.59% to 0.7035, NZDUSD increased 0.0033 or 0.50% to 0.6704, USDJPY decreased 0.0130 or 0.01% to 107.8670, and USDCNY decreased 0.0030 or 0.04% to 6.8838.Gold increased 0.01 USD/t oz. or 0.00% to 1,419.10 and silver decreased 0.0035 USD/t. oz or -0.02% to 15.3176.Some economic news:South Korea:CPI (YoY) (Jun) remain the same at 0.7%CPI (MoM) (Jun) decreased from 0.2% to -0.2%FX Reserves – USD (Jun) increased from 401.97B to 403.07BAustralia:AIG Services Index (Jun) decreased from 52.5 to 52.2Services PMI increased from 51.5 to 52.6Building Approvals (MoM) (May) increased from -4.7% to 0.7%Exports (MoM) (May) increased from 2% to 4%Imports (MoM) (May) decreased from 3% to 1%Private House Approvals (May) increased from -2.6% to -0.3%Trade Balance (May) increased from 4.871B to 5.745BNew Zealand:ANZ Commodity Price Index (MoM) decreased from 0.1% to -3.9%China:Caixin Services PMI (Jun) decreased from 52.7 to 52.0India:Nikkei Services PMI (Jun) decreased from 50.2 to 49.6M3 Money Supply remain the same at 10.1%Singapore:Manufacturing PMI (Jun) decreased from 49.9 to 49.6EUROPE / EMEA:Some are raising concerns at the lack of democracy when choosing the top officials at the EU. With a German, French, Belgian, and Spaniard being elected some feel as if only the elite European countries are being served. The first meeting of the EU parliament didn’t go so well when the Brexit Party and other anti-European parties turned their backs during a European anthem.A European satellite has recorded the month of June to be the hottest month “since records began.” June was 2 degrees hotter than normal, with some people claiming humans are responsible.Canada has refused to apply its European Union Trade deal to the UK if no Brexit agreement occurs. This means that a lot of work needs to be done, contrary to what has been told by politicians, if the UK crashes out without a deal in October.Switzerland and the EU are still in disagreement with regards to existing deals – with the EU adamant to shut down the “Swiss model.” Shares of Nestle, Novartis, and UBS will for now be traded on the SIX exchange in Zurich rather than in Frankfurt or London.The major European stock markets had a green day today. CAC 40 increased 42 points or 0.75% to 5,618.81, FTSE 100 increased 50.13 points or 0.66% to 7,609.3, and DAX increased 89.52 points or 0.71% to 12,616.24.The major European currency markets had a mixed day today. EURUSD decreased 0.0005 or 0.04% to 1.1278, GBPUSD decreased 0.0012 or 0.10% to 1.2579, and USDCHF increased 0.0008 or 0.08% to 0.9869 .Some economic news:Spain:Spanish Services PMI (Jun) increased from 52.8 to 53.6Italy:Italian Services PMI (Jun) increased from 50.0 to 50.5France:French Markit Composite PMI (Jun) decreased from 52.9 to 52.7French Services PMI (Jun) decreased from 53.1 to 52.9Germany:German Composite PMI (Jun) remain the same at 52.6German Services PMI (Jun) increased from 55.6 to 55.8Eurozone:Markit Composite PMI (Jun) increased from 52.1 to 52.2Services PMI (Jun) increased from 53.4 to 53.6UK:Services PMI (Jun) decreased from 51.0 to 50.2Norway:House Price Index (YoY) (Jun) increased from 1.80% to 2.60%U.S. / AMERICAS:The U.S. Department of Congress hit Vietnamese steel with a steep 400% tariff today. Vietnam is one of the countries allegedly benefitting from the U.S.-China trade war. Other Asian countries, such as Taiwan and South Korea, have used Vietnam’s position to their advantage by routing exports to Vietnam before sending them to the U.S. to bypass tariffs.This Wednesday, President Trump accused both China and Europe of “playing [a] big currency manipulation game and pumping money into their system in order to compete with USA.” The president suggested that the U.S. should “match” their games and insinuated that America has allowed other countries to take advantage of it for years.According to CNN’s latest poll, former Vice President Joe Biden remains in the lead as the top Democratic presidential candidate, but Kamala Harris came in at 17%, which is just shy of Biden’s 22% lead. Elizabeth Warren (15%) came in third, while Bernie Sanders (14%) came in fourth. All other potential candidates received 4% or less. CNN will host the next round of debates on July 30 and 31 in Detroit, Michigan.Canada is hosting a Ukraine Reform Conference (URC) this week in Toronto, Ontario. According to the URC website, the goal of the event is to “reinforce security, democratic accountability and prosperity for all of the people of Ukraine.” Canada has vowed to support Ukraine’s fight for sovereignty in the face of “Russian aggression.” PM Trudeau posted on Twitter: “Canadians stand with the Ukrainian people & will always defend Ukraine’s sovereignty. We are close friends & allies, and together we’re working to create more good, middle class jobs for people in both our countries.”Wall Street did not let the half-day impact its bullish momentum as the U.S. marketplace continued its upward trajectory. The S&P 500 hit a new record high yet again, closing at 2,995.82 after adding 22.81 points (+0.77%). The Dow also closed at a new record high after climbing 179.32 points (+0.67%) to 26,966.00. The Nasdaq advanced another 61.14 points (+0.75%) to close at 8,170.23. The Russell 2000 added 11.58 points (+0.74%), closing at 1,572.12.The U.S. markets will be closed tomorrow in honor of Independence Day.The Canadian markets performed well this Wednesday with the TSX Composite advancing 104. 91 points (+0.64%) to 16,576.20, and the TSX 60 gaining 7.01 points (+0.71%) to 992.46.Brazil’s Bovespa recovered from yesterday’s performance, adding 1,437.94 points (+1.43%) to close at 102,043.11.ENERGY:A recent report from the University of Cambridge suggests that Bitcoin’s energy consumption is more than that of the whole of Switzerland.China has raised import quotas even with falling refining margins. The US is considering allowing China to import oil from Iran. The US EIA also reported a draw of 5 million barrel, with WTI moving up closer to the 60 dollar range.The oil markets had a green day today. Crude Oil increased 1.05 USD/BBL or 1.87% to 57.4146, Brent increased 1.46 USD/BBL or 2.34% to 63.7150, Natural gas increased 0.051 USD/MMBtu or 2.28% to 2.2863, Gasoline increased 0.0495 USD/GAL or 2.65% to 1.9166, and Heating oil increased 0.0137 USD/GAL or 0.73% to 1.9028.Top commodity gainers: Cheese (7.16%), Milk (6.39%), Corn (4.53%), and Wheat (2.88%). Top commodity losers: Rubber (-2.61%), Oat (-2.37%), Lumber (-2.04%), and Cocoa (-1.56%).The above data was collected around 15:11 EST on Wednesday. BONDS:Japan -0.15%(-1bp), US 2’s 1.77% (+0bps), US 10’s 1.95%(-3bps), US 30’s 2.47%(-4bps), Bunds -0.39% (-2bp), France -0.10% (-4bp), Italy 1.58% (-27bp), Turkey 15.59% (-17bp), Greece 2.05% (-86bp), Portugal 0.30% (-7bp), Spain 0.21% (-8bp) and UK Gilts 0.70% (-3bp).German 5-Year Bobl Auction decreased from -0.560% to -0.660%US 4-Week Bill Auction increased from 2.145% to 2.210%US 8-Week Bill Auction increased from 2.120% to 2.155% « Market Talk – July 2, 2019 Market Talk – July 9, 2019 »
Source:https://meeting.nutrition.org/ Jun 11 2018Researchers have demonstrated that a program aimed at helping people modify lifestyle factors such as diet and exercise is as effective as medication at reducing blood pressure. Participants in the study saw their blood pressure drop 19 points, on average, after taking part in the Weimer Institute Newstart Lifestyle program for just 14 days. Other studies have shown that a blood pressure reduction of this magnitude can cut a person’s risk of heart disease or stroke in half.”By adapting selected lifestyle health principles, half of the people in our study achieved normal blood pressure within two weeks while avoiding the side effects and costs associated with blood pressure medications,” said research team leader M. Alfredo Mejia, associate professor at Andrews University. “The Newstart Lifestyle program works quickly, is inexpensive and uses a palatable diet that allows for moderate amounts of salt and healthy fats from nuts, olives, avocado and certain vegetable oils.”Related StoriesDon’t ignore diastolic blood pressure values, say researchersDon’t Miss the Blood-Brain Barrier Drug Delivery (B3DD) Summit this AugustNew ACC/AHA guidelines could improve detection of gestational hypertensionMejia will present results from this study at the American Society for Nutrition annual meeting, Nutrition 2018, held June 9-12, 2018 in Boston.The reduction in blood pressure accomplished by the program was equivalent to what can be achieved using three half-dose standard medications for blood pressure. In addition, 93 percent of the participants were able to either reduce the dose (24 percent) or eliminate their blood pressure medications (69 percent).People participating in the Newstart Lifestyle program follow a vegan diet, walk outside daily, drink substantial quantities of water, get adequate daily sleep and participate in optional spiritual activities. The program’s vegan diet consists of foods, such as legumes, whole grains, vegetables, fruits, nuts, seeds, olives, avocados, soymilk, almond milk and whole-grain breads.For the study, the researchers evaluated data from 117 people with high blood pressure who had participated in the Newstart Lifestyle program at the Weimer Institute for 14 days. At the end of the program, half of the participants achieved a systolic blood pressure below the recommended 120 mmHg. The program was effective at lowering blood pressure in varying types of individuals, including otherwise healthy men and women and people with diabetes or who were obese and those with high cholesterol levels.Next, the researchers plan to test the program in more people over a longer time period to better understand its long-term effects and biological basis. They also want to determine if the program can be used to improve other health problems, such as diabetes, cardiovascular disease and obesity.
Jun 18 2018Autopsy is often an overlooked source of medical insight which may be hindering advances in cardiovascular medicine, according to new research published in a special issue of the American Heart Association’s journal Circulation.”Autopsy is a source of discovery that informs the way we think about disease systemically,” said Jeffrey E. Saffitz, M.D., Ph.D., co-editor of the special issue and chair of the department of pathology at Beth Israel Deaconess Medical Center in Boston. “Atherosclerosis, hypertension, diabetes and metabolic syndrome – these are the diseases you study during an autopsy. These are the diseases that are killing hundreds of thousands of people and autopsy is important to help understand how these diseases develop and progress.”The special issue explores the role of autopsy in cardiovascular medicine through a series of original papers and commentaries. “If the papers and commentaries in this issue of Circulation are any indication, there is still much to be learned from autopsy,” Saffitz said.Saffitz, pathology content editor for Circulation, sets the theme by tracing the history of autopsy back to the 16th century at the University of Padua, where Andreas Vesalius used postmortem exams to place the heart at the center of the human body the way Copernicus put the Sun at the center of the solar system.Autopsy information provided the first image of the human coronary system 60 years ago when Monroe Schlesinger, a pathologist at Beth Israel Hospital in Boston, working with Hermann Blumgart, chief of medicine and the father of nuclear cardiology, were the first to image the human coronary system by x-ray of autopsy hearts injected with a lead-based agar medium. Their findings provided insight into the basic processes underlying chest pain and heart attack; identified collateral heart circulation; defined the anatomy of the disease heart and the vascular changes of congestive heart failure and cardiogenic shock.Yet, the autopsy rate has declined steadily for several reasons, chief among them is because hospitals are no longer required to maintain a threshold rate of autopsies for accreditation; the lack of reimbursement for autopsies; and advances in imaging technology, which is often viewed as a substitute for autopsy. As a result, today most autopsies are done by medical examiners who are seeking a cause of death, rather than answers about disease.In the Circulation special autopsy issue, three studies offer insight into how autopsy contributes to answers about the causes of sudden cardiac death, gathering information from implantable devices about time and cause of death as well as ways to improve heart function, and identifying the original cause of atherosclerosis – fatty deposits that can clog arteries and lead to heart attack and stroke).The first study suggests that molecular autopsy may provide answers regarding sudden unexplained death in the young and whether surviving family members are also at risk.Related StoriesStudy explores role of iron in over 900 diseasesWeightlifting is better for the heart than cardioTeam approach to care increases likelihood of surviving refractory cardiogenic shockMichael J. Ackerman, M.D., Ph.D., of the Mayo Clinic’s Windland Smith Rice Sudden Death Genomics Laboratory in Rochester, Minnesota, worked with an international team of scientists who studied sudden unexplained death in the young at a cellular level using a technique called whole exome molecular autopsy. The process was used on 25 cases that occurred in the Chicago area from January 2012 through December 2013. Twelve deaths were in blacks and 13 in whites.They identified 27 ultra-rare mutations in 16 of the 25 autopsies (64 percent). Nine of those unusual defects occurred in 12 blacks (75 percent) and seven in 13 whites (54 percent). Ackerman’s team concluded that 14 percent of the cases represented mutations that could have been detected by genetic testing, which suggests the need for genetic testing of surviving family members.Ackerman’s co-authors and disclosures are included in the manuscript. The study was funded by the Mayo Clinic Windland Smith Rice Comprehensive Sudden Cardiac Death Program.In the second study, Florian Blaschke, M.D., of the Charité – Universitaetsmedizin Berlin, Campus Virchow-Klinikum in Germany, and colleagues studied autopsy subjects with cardiac implantable electronic devices (CIEDs). These devices often store valuable downloadable information which is useful to determine cause, mechanism and time of death more precisely than autopsy alone.The researchers collected and analyzed data from 151 cardiac implanted electronic devices – 109 pacemakers, 35 defibrillators and seven implantable loop recorders – removed during 5,368 autopsies conducted from February 2012 to April 2017. Device and data analysis determined the time of death in 70 percent of these cases and clarified the cause of death in 60.8 percent. In addition, device analysis in an important tool to detect potential CIED-related safety issues.Blaschke’s co-authors and disclosures are included in the manuscript.In the last study, David Herrington, M.D., M.H.S., Wake Forest University School of Medicine in Winston-Salem, North Carolina, and colleagues took tissue samples harvested from 100 autopsies of young adults and used mass-spectrometry to identify early signs of “re-wiring” at a cellular level that appear to be the earliest sign of atherosclerosis.Tests of the tissue samples detected changes in a handful of mitochondrial proteins – considered the building blocks of tissue. Importantly all the changes occurred in protein networks believed to be markers for atherosclerosis.Herrington’s work, Shaffitz said, is representative of the role autopsy information can play in the American Heart Association’s One Brave Idea initiative, which is intended as a multipronged campaign to identify the root cause of heart disease and identify strategies to prevent it. Source:https://newsroom.heart.org/news/studying-heart-disease-after-death-can-help-the-living?preview=d22c
Source:https://moffitt.org/newsroom/press-release-archive/2018/new-study-views-cancer-treatment-as-a-game-to-find-strategies-that-improve-patient-outcomes/ Aug 10 2018Game theory can be utilized to identify potential flaws in current cancer treatment approaches and suggest new strategies to improve outcomes in patients with metastatic cancer, according to a new article published online today by JAMA Oncology. The study, which is authored by a mathematician, an evolutionary biologist and clinical physicians from Moffitt Cancer Center and Maastricht University, challenges the decades old standard of treatment for metastatic cancers in which drugs are typically administered continuously at the maximum-tolerated dose (MTD) until the tumor progresses.The study shows that, by viewing cancer therapy as a game between the treating physician and the cancer cells, continuous administration of the same drug or drugs at MTD fails to exploit critical advantages possessed by the physician. Instead, the authors encourage oncologists to develop flexible strategic treatment plans. By exploiting his/her knowledge of the cancer’s evolutionary dynamics, the oncologist can continuously adjust drugs and doses to delay or prevent cancer progression caused by the evolution of resistance. With each adjustment, the oncologist updates information on the cancer’s response.The Moffitt research team, led by Robert A. Gatenby, M.D., used mathematical modeling to investigate cancer treatment as a game played by the physician and cancer cells. In their study, the researchers demonstrate that the physician has two big advantages over his/her tumor opponents. First, the physician is rational while the cancer cells are not. This means that the physician, by understanding the principles of evolution, can plan ahead and anticipate the tumor cells’ response. Cancers, like all evolving organisms, can never anticipate the future and because of this are particularly vulnerable to changes in treatment by the physician. In addition, the physician has the advantage of always “playing” first – the cancer cells cannot begin to evolve resistance until the physician administers a therapy. This sequence of moves means that cancer treatment has a distinctive game theoretic form termed a “leader-follower” or “Stackelberg” game. Von Stackelberg was a German mathematician who extensively investigated the game dynamics in the mid-20th century. His work and that of several other game theorists have demonstrated that the leader in a Stackelberg gains a substantial advantage by using the first move to limit subsequent tumor responses. Furthermore, the leader can use fore-knowledge of the cancer to anticipate and steer its evolution and vulnerabilities.”Current treatments for metastatic cancers, by giving the same drug repeatedly at the maximum tolerated dose, can inadvertently increase the speed with which cancer cells can evolve effective counter measures and then regrow,” said Gatenby, co-director of Moffitt’s Center of Excellence in Evolutionary Therapy. “Today, therapy is usually changed only when the tumor progresses. By using this strategy the physician cedes control to the cancer. Although standard practice for decades, administering drugs at maximum-tolerated dose until progression is rarely the optimal game theoretic strategy for metastatic cancers.”Related StoriesNew protein target for deadly ovarian cancerCancer killing capability of lesser-known immune cells identifiedNew research links “broken heart syndrome” to cancer”The current maximum-tolerated dose approach will only be successful if the cancer cell population is made up of similar cells that are unable to adapt and evolve quickly,” said Joel Brown, Ph.D., an evolutionary biologist at Moffitt. “That is rarely what we see for cancers that have widely metastasized. We can and must anticipate, steer and exploit the cancer cells’ evolutionary responses to our therapies.”The study proposes changes in the standard treatment paradigms by encouraging physicians to better use their advantages as the sentient leader in their high-stakes game with the cancer. They can do this by continuously adjusting treatment and forcing the cancer cells to constantly change their response to unpredictable attacks from new drugs or combinations of drugs. The authors suggest that the physicians begin by precisely defining the goal of treatment. Is to cure the patient or is it to prolong life? This allows the physician to better balance the benefit of therapy against the potential toxicity and its effects on the patient’s quality of life. In a related suggestion, the authors suggest that the treating physician develops a strategy to deal with cancer cells that are resistant to therapy. If the goal is to cure, then resistant cells must be killed or prevented. If the goal is control, then physicians can use evolutionary principles to minimize the proliferation of resistant cells while limiting the toxicity of treatment. Finally, the physician, as the sentient player in the game, can continuously analyze the intratumoral evolutionary dynamics based on the tumor response during each treatment cycle. This information, often with the aid of a mathematical model, can provide information to improve the outcomes in subsequent cycles – a well-recognized approach in recursive games termed Bellman’s Principle.To operationalize their theoretical study, the research team suggests precision medicine for metastatic cancers. In addition to using molecular techniques to identify treatment targets, precision medicine should integrate strategies to deal with the evolution of resistance which almost invariably leads to failure of even highly successful targeted therapies. The health team should design an explicit Resistance Management Plan (RMP) for each patient – an approach commonly used in pest management. They also recommend that the physician analyzes the outcomes of every patient, similar to After Action Reports (AAR) used in the military and disaster response teams. By learning from each individual patient, personalized oncology can itself evolve and improve over time.While this approach is designed for incurable metastatic cancers, Katerina Stankova, Ph.D., a mathematician at Maastricht University and an expert on game theory, notes that the full dynamics of Stackelberg games have not yet been rigorously explored. “As we develop the mathematics in conjunction with cancer therapies, we expect that our analyses will uncover novel game-theoretic, evolutionary strategies that may increase the probability of curing even aggressive and heterogeneous cancers,” Stankova added.
Cuvier’s beaked whales (Ziphius cavirostris) just shattered their own deep-diving record—as well as that of elephant seals, which were the previous record-holders. The little-known species of beaked whales, cigar-shaped cetaceans with prominent snouts and which range from tropical to northern temperate seas, has long been considered one of the most extreme divers in the ocean, capable of reaching a depth of 1888 meters and staying below for 95 minutes. But a new study that tracked eight individuals off the coast of southern California via satellite tags, as in the photo above, shows they can do much more. (Male Cuvier’s beaked whales have tusks, and the scars on the back of the male in the photo are from fighting with other males.) One whale dove to 2992 meters below the surface, breaking the deep-dive record of a southern elephant seal that was tracked to 2388 meters. Another Cuvier’s beaked whale in the study remained below the surface for 2 hours and 17 minutes. Unlike elephant seals and deep-diving sperm whales, which remain at the surface for an extended period after their dives, the beaked whales headed back into the depths less than 2 minutes later, the scientists report online today in PLOS ONE. The beaked whales in the study made their deep dives about seven times a day, foraging for squid and fish; they spent more time at the surface at night. By better understanding this species’ diving behaviors, the scientists hope to solve an ongoing mystery: Why are Cuvier’s beaked whales particularly sensitive to military sonar operations? Sixty-nine percent of all recorded strandings of marine mammals that were associated with such operations involved this species. Yet these eight whales were tagged and followed on a U.S. Navy sonar training range, leading the scientists to suggest that Cuvier’s beaked whales in this area may have adapted to human noise—perhaps, in part, by becoming the most extreme of extreme divers.See more ScienceShots.
Not all sperm are created equal. Some swim like Michael Phelps and others swim like your 80-year-old grandmother. The difference, researchers have found, lies in their ability to compress their DNA. A sperm expressing less of a gene called protamine 2 relative to a gene called protamine 1 is able to more tightly wind up long strands of its genetic material in its nucleus, making its head sleeker—and more hydrodynamic. These differences have important consequences in the real world. Reporting in the current issue of the Proceedings of the Royal Society B, the team found that more promiscuous species of mice produce less protamine 2 relative to protamine 1 in their sperm, and thus more hydrodynamic sperm. The reason is that males of these species mate with females in quick succession, so males with the fastest sperm are more likely to sire pups. As a result, promiscuous species of mice are more likely to produce sperm that are champion swimmers.See more ScienceShots.
Source:false 5. Prince’s favorite meal was spaghetti and orange juice. 1. Today Would Have Been Prince’s 61st Birthday, We Are Honoring His Life Source:false 20. Prince’s dad once had a band called Prince Rogers Jazz Trio. 13. Despite his small stature, Prince was a remarkable basketball player. Source:Getty (Photo by Ebet Roberts/Redferns) 2. Prince wrote his first song at age 7. He titled it “Funk Machine.” Source:false Source:Getty (Photo by Rob Verhorst/Redferns) 16. In 2013, Prince performed at “Star Wars” director George Lucas’ wedding. 7. Michael Jackson’s “Bad” was supposed to be a duet with Prince. Source:false Source:false Source:false 11. Family and friends called Prince “Skipper” as a kid. 10. Fleetwood Mac’s Stevie Nicks was supposed to write “Purple Rain,” but couldn’t handle the pressure. 17. The movie “Purple Rain” cost $7 million to make and grossed over $69 million. Source:false 9. In 1980, when John Lennon was murdered, Prince was only a few blocks away. Today, Prince would have been 61 years old and, right on time, a new alum is being released called “Originals.” The 15-track album are songs written by the artists but were first released by others like Sheila E., Apollonia 6, The Bangles and Sinéad O’Connor. The album is exclusively available on Tidal and everywhere else on June 21.SEE ALSO: Some No Name, Pitchy R&B Singer Disrespected Keith Sweat And Gets Demolished On TwitterThe musical genius passed away on April 21, 2016 but he certainly has not left the world of pop culture. In September, Prince posthumously received a major honor from the University of Minnesota. The institution—which is based in his hometown—awarded him with an honorary degree for his contributions to the music industry and the city of Minneapolis.The university held a ceremony where they awarded him with a Doctor of Humane Letters degree. However, the school made the decision to give the “Purple Rain” singer an honorary degree long before he passed away. “Prince emulates everything a musician should be,” Michael Kim, director of the university’s School of Music, said in a statement according to CNN. “Society pressures young people to conform to certain standards, and Prince was anything but standardized. Be yourself, know who you are and good things are going to happen.”In addition, Prince clapped back from the grave after Trump had the audacity to his music at rallies. “The Prince Estate has never given permission to President Trump or The White House to use Prince’s songs and have requested that they cease all use immediately,” Prince’s estate said in a statement via Jeremiah Freed, also known as Dr. Funkenberry.While Prince was certainly a political artist, he often talked about race, poverty and faith in his music. He was not associated with a particular political party, and he was also open about never voting. In 2009, Prince told Tavis Smiley about President Barack Obama, “Well, I don’t vote. I’ve don’t have nothing to do with it. I’ve got no dog in that race.”He continued, “The reason why is that I’m one of the Jehovah’s Witnesses and we’ve never voted. That’s not to say I don’t think … President Obama is a very smart individual and he seems like he means well. Prophecy is what we all have to go by now.”That said, fun fact, in 1990, Prince gave $2,000 to Minnesota Sen. Rudy Boschwitz, who was a Republican.We are honoring the Purple One’s legacy with other surprising facts you may not have know.Happy Birthday, Prince: 20 Surprising Facts About The Purple One was originally published on globalgrind.com Source:false 4. Prince once sued Adobe Photoshop to prevent fans from altering his photos. Unfortunately, he lost. Source:false Source:false 21. Prince sent Janelle Monae a singing telegram asking for a copy of her “The Electric Lady” album. 8. Prince was a devout Jehovah’s Witness. Source:false Source:false 15. In 2012, Prince dissed Maroon 5 for covering “Kiss.” 3. As a child, Prince struggled with epilepsy 18. Prince scrapped his 1987 album “The Black Album” just days before its release. Source:false Source:false Source:false 6. The “Purple Rain” soundtrack spent 24 weeks at number one on Billboard. Source:false Source:false 14. Prince formed his first band when he was 13 years old. Source:false 12. In 1984, Prince not only had the number one movie in the country, but also the number one single & album. Source:false 19. Prince penned The Bangles’ “Manic Monday” and Chaka Khan’s “I Feel For U.”