Natural Grocers (NYSE: NGVC) reported Q2 EPS of $0.15, $0.03 better than the analyst estimate of $0.12. Revenue for the quarter came in at $215.9 million versus the consensus estimate of $210.72 million.
Highlights for Second Quarter Fiscal 2018 Compared to Second Quarter Fiscal 2017
Net sales increased 12.3% to $215.9 million;
Daily average comparable store sales increased 7.1%;
Net income increased 13.6% to $3.4 million with diluted earnings per share of $0.15;
EBITDA increased 1.7% to $13.1 million;
Opened three new stores, resulting in 7.4% store growth for the twelve month period ended March 31, 2018;
The Company is raising its fiscal 2018 outlook for daily average comparable stores sales growth to 3.5% to 4.5% and narrowing its fiscal 2018 diluted earnings per share outlook to $0.43 to $0.50; and
The Company\’s Board of Directors has authorized a two-year extension of the Company\’s $10 million share repurchase program.
Strokes can drastically change the mind and body. Symptoms may differ among individuals, but many experiences are common.
Strokes occur when a clot or burst artery prevents blood from getting to the brain. When brain cells do not receive enough blood, they can be damaged or die.
Different parts of the brain control different bodily functions, so a stroke can affect almost any part of the body.
While it is difficult to predict a stroke, a person can take steps to lower their risk. Read on, to learn how strokes feel and how to tell if someone is having one. We also describe the types of stroke and their outlooks.
What does a stroke feel like?
A headache is the only painful symptom of a stroke.
The list below includes classic signs of stroke. It is common to only experience some of the symptoms.
For example, a person experiencing numbness and difficulty balancing due to a stroke may not also have cognitive problems. This may put them off going to the hospital.
If someone experiences any of the following symptoms, they should seek medical aid as soon as possible:
Of these symptoms, only the headache is painful. Many people who have a stroke do not feel any pain.
If a person is unsure whether something is wrong, they may ignore the other symptoms. However, in cases of a stroke, fast action is essential. Be aware of all the symptoms, and be prepared to call an ambulance if they appear.
Anyone who may be having a stroke should not drive. Symptoms may rapidly become worse, and they could harm themselves or others in an accident.
In the following video, a scientist talks about what it felt like to have a stroke. She recognized the signs and witnessed the gradual disappearance of her speech, memory, and ability to move:
What to do
The Act FAST campaign aims to educate people so that they can recognize a stroke as soon as possible. This is because the longer a stroke is untreated, the more damage it can do. FAST is an acronym that stands for:
Facial drooping
Arm weakness
Speech difficulties
Time to call emergency services
If a person cannot lift both arms, smile with both sides of the mouth, or say a full sentence, it is essential to seek emergency care. Any of these symptoms can signal a stroke.
What are the effects of a stroke?
The effects of a stroke vary, depending on the affected area of the brain.
Another factor is how long it took to receive treatment. Any delay allows more brain cells to die or be damaged.
Some people only experience minor effects after a stroke, such as fatigue or difficulty with coordination. Others may need to relearn basic functions, such as walking and swallowing, and they will need ongoing support.
According to the Centers for Disease Control and Prevention, strokes are responsible for one in 20 deaths in the United States.
Strokes can affect many functions, including:
Vision
Approximately one-third of people who experience a stroke have problems seeing afterward. These can range from some blurring in one eye to total blindness.
While some visual function can improve after a stroke, a complete recovery is uncommon.
The following visual difficulties can also be caused by a stroke:
An individual may have a variety of these symptoms or only one. They can range in severity and may get better over time.
Emotional impact
A stroke can leave a person feeling shaken, confused, and scared. Strokes are life-changing events and may require a person to relearn basic functions or activities.
Everyone’s experience is different, but it is usually helpful to speak about a stroke and its emotional impact with friends, family, a therapist, or a support group.
It is crucial to speak with a professional if these feelings start to become overwhelming. A therapist can help a person to deal with the emotional impact of a stroke and make changes to reduce stress.
Types of stroke
There are three types of stroke.
Ischemic strokes, which are caused by clots that block blood flow
Hemorrhagic strokes, which occur when a blood vessel bursts
Ministrokes, or transient ischemic attacks, which are caused by temporary clots
What does a ministroke feel like?
Signs and symptoms of ministrokes are the same as those of other strokes, but they may pass more quickly.
A ministroke typically lasts between a few minutes and a few hours. Symptoms may pass so quickly that a person barely notices them. For example, a person may have difficulty speaking or moving for a few minutes before the function returns.
Anyone who suspects that they have had a ministroke should seek emergency care. They serve as a serious warning that a full stroke may occur.
What causes strokes?
Stress may increase the risk of having a stroke.
Ischemic strokes are caused by clots in blood vessels that block the flow of blood to the brain. Hemorrhagic strokes occur when a weakened blood vessel in the brain bursts.
It is not possible to foresee a stroke, but certain factors increase a person’s risk.
Unavoidable risk factors include:
Age. As arteries age, they harden and narrow, making it easier for them to become blocked.
Sex. Younger men are more at risk than younger women. However, after menopause, women are more likely than men to die of stroke.
Family history. If a close relative has had a stroke, a person is more likely to have one.
Personal history. If a person has already had a stroke, it increases their risk of another.
Avoiding the following can reduce the risk of having a stroke:
Every stroke has different effects, and the extent of damage varies widely from person to person. Stroke teams will assess the impact and monitor a person’s progress in the hospital and at home.
Recovery may be a long process, but many benefit from occupational therapy and other forms of support aimed at restoring a person’s independence.
Outlook
Having one stroke increases the likelihood of having another. However, a team of doctors can give a person advice on reducing their risk.
Talking about the effects of a stroke can help a person to process feelings of vulnerability and isolation. Stroke treatments are improving, and people are increasingly becoming educated.
Receiving immediate treatment can limit damage and result in fewer complications and an easier recovery.
Fasting for 24 hours can reverse the loss of stem cell function in the gut that accompanies aging, according to a study of mice.
Intestinal stem cells are crucial for tissue repair and regeneration, and their decline as we age means that it becomes harder to recover from gastrointestinal conditions and infections.
The researchers, who were led by a team from Massachusetts Institute of Technology (MIT) in Boston, discovered that fasting for 24 hours boosted regeneration of gut stem cells in younger and older mice.
They found that fasting exerted this effect by means of a metabolic switch that causes cells to break down fatty acids instead of carbohydrates such as glucose.
They also discovered a molecule that can activate the same switch — a finding that might lead to drugs that boost older people’s recovery from gastrointestinal infections or chemotherapy.
You can read a report on the study in a paper that is now published in the journal Cell Stem Cell.
‘Workhorses of the intestine’
Stem cells are immature cells that have remarkable properties. For instance, they can replicate almost indefinitely and develop into virtually any type of cell in the body, forming an essential source of new cells for growth and repair in many tissues.
In the gut, they maintain and repair tissue lining, which “renews itself” about every 5 days.
In reference to this, co-senior study author Ömer H. Yilmaz — an assistant professor of biology at MIT — describes intestinal stem cells as the “workhorses of the intestine.”
“[D]uring aging,” he notes, “intestinal stem [cell] function declines, which impairs the ability of the intestine to repair itself after damage.”
In their study paper, Yilmaz and his colleagues explain that diet is known to have a “profound effect” on the ability of tissue to regenerate itself.
Short-term fasting had a strong effect
There is also evidence that intermittent fasting can benefit health and age-related decline in tissue function.
This spurred the researchers to study how short-term fasting might impact tissue regeneration at the molecular level, particularly through its influence on stem cells.
They removed intestinal stem cells from young and aged mice that had fasted for 24 hours and cultured them in the laboratory.
They found that fasting had a very strong effect on the stem cells’ capacity for regeneration, spurring them to form “organoids,” rather like “mini-intestines.”
They saw this happen in cultured cells taken from both the young and the aged fasting mice.
Metabolic switch mediates effect of fasting
Additional investigation at the molecular level revealed that fasting made the stem cells switch from metabolizing carbohydrates, such as glucose, to metabolizing fatty acids.
The switch is in a pathway that is controlled by a group of molecules that regulate gene expression, called peroxisome proliferator-activated receptors (PPARs). PPARs control several pathways that trigger cells to break down fatty acids.
When the scientists turned off the metabolic switch, they found that fasting no longer boosted intestinal stem cell regeneration.
A final experiment showed that it was possible to “mimic” the effect of fasting on the switch with a molecule that behaves like a PPAR.
Help for people with damage to gut lining
This last finding suggests that it might be possible to activate intestinal tissue regeneration and repair without fasting, which many people find very difficult.
The researchers suggest that such a treatment might help individuals having chemotherapy, which, in many cases, damages the lining of the gut.
It might also help older people to recover more quickly from intestinal conditions and infections.
The researchers are also going to further explore the molecular mechanisms at work when the metabolic switch induces gut stem cells to increase their regenerative powers.
They also want to discover whether fasting has a similar effect on stem cells in other tissues.
The U.S. Food and Drug Administration on Friday approved Novartis AG’s combination therapy to treat an aggressive type of thyroid cancer.
The therapy, which uses Novartis’ Tafinlar and Mekinist, was approved to treat anaplastic thyroid cancer that cannot be removed surgically or has spread to other parts of the body, and has a type of abnormal gene known as BRAF V600E.
This is the first FDA-approved treatment for patients with this form of thyroid cancer and the third type of cancer with this specific gene mutation, the FDA said
The company has been expanding the use of this drug for other diseases as well. In combination, Tafinlar and Mekinist are approved for use to treat a type of lung cancer that has the BRAF V600E gene.
The FDA had last month approved the combination to treat a type of melanoma.
LifePoint Health continued to struggle with sluggish volumes and ballooning costs at the outset of 2018.
Admissions to the Brentwood, Tenn.-based hospital chains’ 71 campuses dropped 2.2% during the first quarter of 2018 compared with the same period a year earlier on a same-hospital basis, the company reported in its earnings release Friday.
LifePoint CEO Bill Carpenter told analysts and investors in a call Friday morning that the company continues to forecast flat volumes in 2018, but it is forging ahead with its goals of driving margin improvement across hospitals, managing costs in a tough volume environment and returning capital to shareholders.
LifePoint entered into definitive agreements during the first quarter to sell three of its Louisiana hospitals, a move Carpenter said will yield a little over $20 million. The hospitals generate about $100 million in annual revenue, but their earnings have been flat in recent years, he said.
Carpenter didn’t say whether the health system expects to divest additional facilities, but said LifePoint is always looking at opportunities.
“Let’s be clear: We don’t buy hospitals in order to turn around and sell them,” he said.
The company posted a net loss of $5.3 million in the first quarter of 2018, down from net income of $64 million during the same period in 2017. Revenue on a same-hospital basis fell 0.4%, to $1.6 billion in the first quarter of 2018 from the same period in 2017. Overall revenue fell 1.7% during that time, while expenses rose 4.7%.
LifePoint’s same-hospital supply costs as a percentage of revenue increased 16.6% during the first quarter of 2018. Mike Coggin, LifePoint’s chief financial officer, said that increase stemmed from growth in high acuity service lines, such as cardiology and pulmonology.
Inpatient surgeries fell 3% during the first quarter of 2018 compared to the same period in 2017. And emergency room visits dropped 4%. Coggin said that despite the drop in ER visits, the chain saw a better case mix, with fewer low acuity visits among Medicaid and self-pay patients.
LifePoint continued to battle high costs during the quarter, including elevated capital expenditures that will continue until 2020, Coggin said. LifePoint plans to spend $475 million in capital expenditures this year alone, a number that will decline next year.
“What that yields will probably be a flat level of cash flow,” he said, “almost a negligible amount of free cash flow for us in calendar 2018.”
Ambulatory healthcare services hiring continued to drive overall job growth in the healthcare sector in April, making up 70% of new hires last month.
Healthcare added 24,400 jobs in April, a slight improvement from the previous month’s gains, bringing the sector’s total new hires to 305,000 over the year, according to the U.S. Bureau of Labor Statistics’ newest jobs report released Friday.
The overall unemployment rate inched down to 3.9%, following six months at 4.1%. Total employment increased by 164,000 people.
Ambulatory healthcare added 17,000 jobs, up from 16,200 in March. Within that, physician’s offices saw the highest increase, at 7,100. Medical and diagnostic laboratories, by contrast, lost 700 jobs.
Hospitals added 8,000 jobs last month, down from 9,900 jobs in March.
The nursing and residential-care facilities sector lost 500 jobs in April, far fewer than the 3,700 the sector lost in March. Nursing-care facilities continue to drive those losses, shedding 2,700 jobs. Residential mental health, by contrast, gained 1,500 jobs. That’s in stark contrast to March, when residential mental health lost 4,100 jobs.
Within the social assistance sector, individual and family services gained 5,900 jobs, while vocational rehabilitation lost 1,300.
About 20 percent of Medicaid-insured children receive a psychiatric diagnosis by age 8 years, according to a study published online April 30 in JAMA Pediatrics.
Dinci Pennap, M.P.H., from the University of Maryland in Baltimore, and colleagues examined the longitudinal patterns of psychotropic medication use in association with diagnosis and duration of use in a Medicaid-insured birth cohort with data for 35,244 children followed for up to 96 months.
The researchers found that 19.7 percent of children in the birth cohort had received a psychiatric diagnosis by age 8 years; 57.7 percent of these diagnoses were behavioral. Compared with boys, girls were more likely to receive an incident psychiatric diagnosis of adjustment disorder (22.2 versus 14.5 percent) or anxiety disorder (7.1 versus 4.1 percent). By age 8 years, 10.2 percent of children in the cohort had received a psychotropic medication. Among medication users, 80.5, 16.4, and 4.3 percent, respectively, received monotherapy, received two medication classes concomitantly, and received three or more medication classes concomitantly for 60 days or more. Among medicated children, the annual median number of days of psychotropic medication use increased with age, reaching 210 days for children aged 7 years.
“Medicaid-insured children received substantial mental health services and had prolonged exposure to psychotropic medications in the early years of life,” the authors write. “These findings highlight the need for outcomes research in pediatric populations.”
