Walgreens, Alphabet's Wing partner on OTC drug delivery by drones

 Alphabet-owned Wing will deliver over-the-counter medicines and household essentials sold at Walgreens via drones, The Wall Street Journal reported April 7.

Starting April 7, Walgreens will stage drone deliveries from a store parking lot in the town of Little Elm, Texas. 

How it works:

• Customers can purchase drone-delivered products through Wing's app.
   
• Walgreens team members will then fulfill customer orders, using a tablet to summon the drone once orders are completed.
  
  
• The delivery items will be attached to lines dropped by hovering drones.
   
• The drone will then reel in the line and fly to deliver the product to the customer.
  
  
• Route planning and flight will be autonomous, but human pilots from Wing will oversee the operations.

Texas Health Resources, a network of nonprofit hospitals, also said it is in discussion to include Wing's drone delivery services for its first-aid kits and to ship medical supplies between facilities.

https://www.beckershospitalreview.com/innovation/walgreens-alphabet-s-wing-partner-on-otc-drug-delivery-by-drones.html

Under Government Health Care, The Doctor Won’t See You Now

 In less than three weeks, the federal public health emergency for COVID-19 is set to expire. Some experts worry that the end of the emergency could unleash a flood of pent-up demand for health care—and add more stress to a health system already stretched thin.

That’s because thousands of Americans—particularly seniors and those at higher risk of severe cases of COVID-19—postponed care during the pandemic. Many may look to reschedule their appointments when the public health emergency ends. The rush could yield long waits for routine care, the thinking goes.

This is a once-in-a-generation concern in the United States. But it’s a fact of life in the United Kingdom’s single-payer system.

Congressional Democrats are planning to renew their calls for importing single-payer health care stateside. The House Oversight Committee is holding a hearing on the idea March 29, and Sen. Bernie Sanders, I-Vt., has promised to reintroduce his Medicare for All bill soon.

The latest data from the United Kingdom’s National Health Service should stop them in their tracks. More than 6 million people across the Atlantic—a record high—are on waiting lists for routine care. Nearly 24,000 patients have been waiting more than two years for necessary hospital treatment.

Patients are stuck waiting no matter how serious their condition is. As of January, one-quarter of patients with suspected cancer cases were waiting over two weeks to see a specialist. Almost one-third of cancer patients are waiting more than two months to start treatment.

Wait times for mental health services are also soaring. One patient told The Huffington Post he considers himself “lucky” to have received mental health support after waiting one year. He had previously been on a wait list for 18 months—and ended up moving before he was able to get mental health care.

NHS officials say wait times will get worse before they get better. Delays in hospital treatment aren’t expected to ease for at least two years. Nearly 11 million people—roughly one in five Britons—could be in treatment queues by 2024.

Of course, the pandemic has contributed to the strain on the U.K. health system. But long waits have plagued the NHS—and all single-payer systems—long before COVID-19.

There were nearly 4.5 million people waiting for hospital treatment in September 2019, months before the United Kingdom confirmed its first COVID-19 case. In fact, the NHS has failed to hit wait targets for non-urgent care since February 2016. It hasn’t met key goals for timely cancer care since 2014.

Now, two years into the pandemic, wait times are so inexcusable that U.K. Health Secretary Sajid Javid is considering a new approach. He’s expected to announce a plan to get patients who have spent 18 months or more waiting for surgery out of NHS treatment queues—by paying for them to receive care through a private provider instead of a government one.

In other words, U.K. officials are admitting that their government-run system is incapable of providing patients with timely, quality care.

If only U.S. progressives pining for government-run health care would come to the same conclusion.

Since they don’t have enough votes to pass national single-payer legislation through Congress, Democrats are taking a piecemeal approach. President Biden made a government-run public health insurance option a centerpiece of his campaign. Three states have implemented public options within their borders. Sixteen more are considering similar plans. Some local governments even have their own public health insurance plans.

The results have been disastrous.

Consider the recent news out of my home state, California. Health officials just announced $55 million in fines against Los Angeles County’s government-run health plan for low-income residents. The punishment came after a state analysis found patients were waiting an average of 89 days to see a specialist at publicly funded health facilities—nearly six times as long as the state’s 15-day requirement.

That’s unacceptable. But any wait under 90 days would be a miracle in a single-payer system. If Democratic lawmakers get their way, U.S. patients could soon be hoping for such miracles—long past the end of the pandemic.

Sally C. Pipes is president, CEO, and the Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is “False Premise, False Promise: The Disastrous Reality of Medicare for All,” (Encounter Books 2020). 

https://www.pacificresearch.org/under-government-health-care-the-doctor-wont-see-you-now/

Cereal fiber but not fruit or vegetable fibers linked with lower inflammation

 Researchers at Columbia University Mailman School of Public Health and colleagues evaluated whether dietary fiber intake was associated with a decrease in inflammation in older adults and if fiber was inversely related to cardiovascular disease. The results showed that total fiber, and more specifically cereal fiber but not fruit or vegetable fiber, was consistently associated with lower inflammation and lower CVD incidence. Until now there had been limited data on the link between fiber and inflammation among older adults, who have higher levels of inflammation compared with younger adults. The study findings are published in JAMA Network Open.

The research includes data from a large and well-characterized prospective cohort of elderly individuals, with detailed data on dietary intake, inflammation, and incidence of CVD. The research confirmed previously observed associations between dietary fiber and CVD and extended those investigations to include the source of the fiber, the relationship of fiber with multiple inflammatory markers, and to test whether inflammation mediated the relationship between dietary fiber and CVD.

Of the 4125 adults enrolled in the Cardiovascular Health Study from 1989 to 1990 participants received a food frequency questionnaire that was administered to those without prevalent CVD at enrollment and then were followed up visits for development CVD (stroke, myocardial infarction, and atherosclerotic cardiovascular death) through June 2015. Blood samples were assessed for markers of inflammation.

"Higher intakes of dietary fiber is associated with lower CVD risk. A common hypothesis has been that higher fiber intakes reduce inflammation, subsequently leading to lower CVD risk" said Rupak Shivakoti, PhD, assistant professor of epidemiology at Columbia Mailman School. 'With findings from this study, we are now learning that one particular type of dietary fiber -- cereal fiber -- but not fruit or vegetable fiber was associated with lower inflammation. With findings from this study we now are learning that cereal fiber has the potential to reduce inflammation and will need to be tested in future interventional studies."

Although there are data to suggest that fiber in general might have anti-inflammatory effects by improving gut function, modifying diet and satiety (eg, reduced fat and total energy intake), and improving lipid and glucose profile metabolism, why cereal fiber but not vegetable or fruit fiber is associated with lower inflammation is not clear and warrants further investigation, noted Shivakoti. Further, he notes that it is not clear whether cereal fiber per se or other nutrients in foods rich in cereal fiber are driving the observed relationships.

"Additionally, we learned that inflammation had only a modest role in mediating the observed inverse association between cereal fiber and CVD," observed Shivakoti. "This suggests that factors other than inflammation may play a larger role in the cereal fiber-associated reduction in CVD and will need to be tested in future interventions of specific populations.

Co-authors are from Columbia University Mailman School of Public Health; University of Washington; Brigham and Women's Hospital; Harvard Medical School; Boston Veterans Healthcare; Larner College of Medicine at the University of Vermont; San Francisco Veterans Affairs Health Care System; University of California-San Francisco; Kaiser Permanente Washington Health Research Institute; New York Academy of Medicine; Beth Israel Deaconess Medical Center; and Harvard Chan School of Public Health,

The research was supported by the National Heart, Lung, and Blood Institute, the National Institute of Neurological Disorders and Stroke, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

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Story Source:

Materials provided by Columbia University's Mailman School of Public Health. Note: Content may be edited for style and length.

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Journal Reference:

1. Rupak Shivakoti, Mary L. Biggs, Luc Djoussé, Peter Jon Durda, Jorge R. Kizer, Bruce Psaty, Alex P. Reiner, Russell P. Tracy, David Siscovick, Kenneth J. Mukamal. Intake and Sources of Dietary Fiber, Inflammation, and Cardiovascular Disease in Older US Adults. JAMA Network Open, 2022; 5 (3): e225012 DOI: 10.1001/jamanetworkopen.2022.5012

https://www.sciencedaily.com/releases/2022/04/220406132428.htm

Potential target and compounds to slow development of Alzheimer's

 Researchers at LSU Health New Orleans Neuroscience Center of Excellence and Karolinska Institutet have discovered a potential biomarker for Alzheimer's disease diagnosis that may also serve as a therapeutic target. Examining cerebrospinal fluid samples from patients with cognitive impairment ranging from subjective impairment to a diagnosis of Alzheimer's disease, they found a shift in the profile of specialized lipid mediators from pro-resolving to pro-inflammatory. The results of the exploratory study are published in the Springer journal, Cellular and Molecular Neurobiology.

Specialized lipid mediators are bioactive compounds composed of polyunsaturated fatty acids like DHA and EPA. They are signaling molecules that regulate a wide range of cellular responses including cell growth and death, as well as infection and inflammation. Specialized lipid mediators have unique properties and roles in inflammation. Pro-inflammatory lipid mediators promote inflammation, and pro-resolving lipid mediators resolve inflammation.

It takes several years or more for Alzheimer's disease (AD) to develop into dementia, and neuroinflammation is a key early contributor. During that time, subjective cognitive impairment (SCI) and mild cognitive impairment (MCI) can be used as intermediary diagnoses of increasing severity. The population of this study consisted of 136 participants -- 53 with SCI, 43 with MCI and 40 with an Alzheimer's disease diagnosis. The researchers assessed 22 lipids in samples of the participants' cerebrospinal fluid (CSF), including pro-resolving lipid mediators, pro-inflammatory lipid mediators, prostaglandins, their fatty acid precursors and intermediate derivatives. Neuroprotection D1 (NPD1), discovered by the Bazan lab, is one the pro-resolving lipid mediators studied.

The research team found that levels of pro-resolving lipid mediators were correlated with severity of cognition impairment -the greater the severity, the lower the levels of the lipid mediators that resolve inflammation. They also found a relationship between cognition impairment severity and pro-inflammatory lipid mediators -- the greater the degree of cognition impairment, the higher the levels of the lipid mediators that promote inflammation.

"Based on these findings, we are expanding our work to brain cell-specific targets, besides neurons, astrocytes and microglia, as well as additional novel protective signals, which would allow us to explore slowing down AD onset," says Nicolas Bazan, MD, PhD, Boyd Professor and Director of LSU Health New Orleans Neuroscience Center of Excellence. "For this purpose, we have set up 10-x genomics to decipher not only the genes but also epigenomics engaged in early disease states. Since the CSF lipidome changes were closely correlated with detailed clinical and radiological AD patient status, we believe that the studied events are revealing novel essential mechanisms of brain health. A uniqueness of our approach is that we have discovered mechanisms and, more importantly, molecules that target those mechanisms and could became therapeutics."

Other members of the LSU Health New Orleans research team include Drs. Khanh V. Do, Bokkyoo Jun, and Marie-Audrey I. Kautzmann. Ceren Emre, who recently completed her PhD at the Karolinska Institutet, worked at LSU Health New Orleans Neuroscience Center of Excellence for eight months before the pandemic. Other researchers from the Karolinska Institutet include Drs. Erik Hjorth, Ying Wang, Makiko Ohshima, Maria Eriksdotter, and Senior Professor Marianne Schultzberg, Bazan's key collaborator.

Funding from the EENT Foundation of New Orleans, the Swedish Research Council, the Swedish Alzheimer's Foundation, Stockholm County Council and the China Scholarship Council supported the research.

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Story Source:

Materials provided by Louisiana State University Health Sciences Center. Note: Content may be edited for style and length.

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Journal Reference:

1. Khanh V. Do, Erik Hjorth, Ying Wang, Bokkyoo Jun, Marie-Audrey I. Kautzmann, Makiko Ohshima, Maria Eriksdotter, Marianne Schultzberg, Nicolas G. Bazan. Cerebrospinal Fluid Profile of Lipid Mediators in Alzheimer’s Disease. Cellular and Molecular Neurobiology, 2022; DOI: 10.1007/s10571-022-01216-5

https://www.sciencedaily.com/releases/2022/04/220406160603.htm

Exercise shown to release protein reducing bowel cancer risk

 Experts have identified for the first time exactly how exercise can lower your risk of getting bowel cancer and slow the growth of tumours.

Scientists at Newcastle University have shown that physical activity causes the cancer-fighting protein, interleukin-6 (IL-6), to be released into the bloodstream which helps repair the DNA of damaged cells.

The findings, published in the International Journal of Cancer, sheds new light on the importance of moderate activity in the fight against the life-threatening illness and could help develop treatments in the future.

Repairing DNA

Dr Sam Orange, Lecturer in Exercise Physiology at Newcastle University, said: "Previous scientific evidence suggests that more exercise is better for reducing bowel cancer risk as the more physical activity people do, the lower their chances of getting it. Our findings support this idea.

"When exercise is repeated multiple times each week over an extended period, cancer-fighting substances -- such as IL-6 -- released into the bloodstream have the opportunity to interact with abnormal cells, repairing their DNA and reducing growth into cancer."

In the small-scale study, which is a proof of principle, the team from Newcastle and York St John universities recruited 16 men aged 50-80, all of whom had lifestyle risk factors for bowel cancer, such as being overweight or obese and not physically active.

After providing an initial blood sample, the participants cycled on indoor bikes for a total of 30-minutes at a moderate intensity and a second blood sample was taken as soon as they finished pedalling.

As a control measure, on a separate day, scientists took further blood samples before and after the participants had rested. Tests were carried out to see if exercise altered the concentration of cancer-fighting proteins in the blood compared to resting samples and it was found that there was an increase in IL-6 protein.

Scientists added the blood samples to bowel cancer cells in a lab and monitored cell growth over 48 hours. They identified that blood samples collected straight after exercise slowed the growth of the cancer cells compared with those collected at rest.

Furthermore, as well as reducing cancer growth, the exercise blood samples reduced the extent of DNA damage, suggesting that physical activity can repair cells to create a genetically stable cell type.

Dr Orange said: "Our findings are really exciting because they reveal a newly identified mechanism underlying how physical activity reduces bowel cancer risk that is not dependent on weight loss.

"Understanding these mechanisms better could help develop more precise exercise guidelines for cancer prevention. It could also help develop drug treatments that mimic some of the health benefits of exercise.

"Physical activity of any type, and any duration, can improve health and reduce bowel cancer risk but more is always better. People who are sedentary should begin by moving more and look to build physical activity into their daily routines."

Dr Adam Odell, Senior Lecturer in Biosciences from York St John University, who was also involved in the study alongside Dr Alastair Jordan and Dr Owen Kavanagh, added: "Importantly, it is not just bowel cancer risk that can be reduced by leading a more active lifestyle. Clear links exist between higher exercise levels and a lower risk of developing other cancers, such as cancers of the breast and endometrium.

"By working out a mechanism through which regular physical activity is able to produce anti-cancer effects, our study provides further support for current national and global efforts to increase exercise participation."

Bowel cancer prevalence

Bowel cancer is the 4th most common cancer in the UK, accounting for 11% of all new cancer cases. There are around 42,900 people diagnosed in the UK every year, that's nearly 120 each day.

It is estimated that physical activity reduces the risk by approximately 20%. It can be done by going to the gym, playing sports or through active travel such as walking or biking to work, but also as part of household tasks or work like gardening or cleaning.

The team intend to carry out further research to identify exactly how exercise reduces DNA damage in early-stage cancers and to establish the most effective form of exercise for protecting against the disease.

Story Source:

Materials provided by Newcastle University. Note: Content may be edited for style and length.

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Journal Reference:

1. Samuel T. Orange, Alastair R. Jordan, Adam Odell, Owen Kavanagh, Kirsty M. Hicks, Tristan Eaglen, Stephen Todryk, John M. Saxton. Acute aerobic exercise‐conditioned serum reduces colon cancer cell proliferation in vitro through interleukin‐6‐induced regulation of DNA damage. International Journal of Cancer, 2022; DOI: 10.1002/ijc.33982

https://www.sciencedaily.com/releases/2022/04/220407101013.htm

Texas Governor Directs State To Bus Or Fly Illegal Immigrants To DC As Title 42 Ends

 by Isabel van Brugen via The Epoch Times (emphasis ours),

Texas Gov. Greg Abbott on Wednesday said that his government will provide charter buses or flights to transport illegal immigrants released from federal custody into its territory to Washington D.C.

The Republican made the remarks during a press briefing, saying that his state on the southern border has been “overwhelmed by hordes of illegal immigrants who are being dropped off by the Biden administration.”

“We are sending [the illegal immigrants] to the United States capital where the Biden administration will be able to more immediately address the needs of the people that they are allowing to come across our border,” Abbott told reporters.

The measure comes in response to the lifting of Title 42 by the Biden administration last week.

The public health provision is a Centers for Disease Control and Prevention (CDC) order that was invoked in March 2020 under President Donald Trump to minimize the spread of COVID-19 by ensuring that only essential travel occurred at U.S. borders.

It directed that illegal immigrants could be quickly expelled back into Mexico as a pandemic precaution, rather than be processed under Title 8 immigration law, which is a much more protracted process inside the United States.

As the Biden administration prepares to drop the measure on May 23, Border Patrol agents and local officials along the border are bracing for an even greater influx of illegal immigrants.

In a release that followed shortly after the governor’s press conference, Abbott’s office said only those who volunteer will be transported, and must show documentation that they have been processed by the Department of Homeland Security.

“The Biden Administration’s open-border policies have paved the way for dangerous cartels and deadly drugs to pour into the United States, and this crisis will only be made worse by ending Title 42 expulsions,” Abbott said.

“With the end of Title 42 expulsions looming next month, Texas will immediately begin taking unprecedented action to do what no state has done in American history to secure our border,” the governor added.

“The new strategies announced today and next week will further strengthen our already robust response to the Biden border disaster, and we will use any and all lawful powers to curtail the flow of drugs, human traffickers, illegal immigrants, weapons, and other contraband into Texas.”

Abbott also announced additional strategies being deployed immediately to “secure the border.”

A Border Patrol agent picks up four illegal aliens after Kinney County Sheriffs deputies arrested a U.S. citizen smuggler who was transporting them to San Antonio, in Kinney County, Texas, on Oct. 20, 2021. (Charlotte Cuthbertson/The Epoch Times)

DPS and the Texas Military Department (TMD) are preparing additional boat blockades, deploying razor-wire at low-water crossings and high-traffic areas, and installing container blockades to stem the flow of illegal crossings, Abbott’s office said.

The state may announce additional policies in the coming weeks to “respond to the expected surge in illegal immigration,” the governor’s office added.

Charlotte Cuthbertson contributed to this report.

https://www.zerohedge.com/political/texas-governor-directs-state-bus-or-fly-illegal-immigrants-dc-title-42-ends

Hospital Factors Drive Many Discharges Against Medical Advice

 Patients who leave a hospital against medical advice may be called "difficult" or "uncooperative." But a new study suggests that in many cases, that label is unfair.

The analysis found that in about 1 in 5 cases, shortcomings in the quality of care and other factors beyond patients' control explain why they leave the hospital before completing recommended treatment.

Dr Kushinga Bvute

Clinicians may be quick to blame patients for so-called discharges against medical advice (AMA), which comprise up to 2% of hospital admissions and are associated with an increased risk of mortality and readmission. But "we as providers are very much involved in the reasons why these patients left," Kushinga Bvute, MD, MPH, a second-year internal medicine resident at Florida Atlantic University, in Boca Raton, who led the new study, told Medscape Medical News. Bvute and her colleagues presented their findings April 6 at the Society of General Internal Medicine (SGIM) 2022 Annual Meeting, in Orlando, Florida.

Bvute and her colleagues reviewed the records of 548 AMA discharges — out of a total of 354,767 discharges — from Boca Raton Regional Hospital from January 2020 to January 2021. In 44% of cases, patients cited their own reasons for leaving. But in nearly 20% of AMA discharges, the researchers identified factors linked to treatment.

Hospital-related reasons patients cited for leaving AMA were general wait times (3.5%), provider wait times (2.6%), provider care (2.9%), the hospital environment (2.7%), wanting a private room (2%), and seeking medical care elsewhere (6.2%).

Patient-related factors were refusing treatment (27%), feeling better (3.5%), addiction problems (2.9%), financial complications (2.9%), and dependent care (2.4%). Ten (1.8%) eloped, according to the researchers.

Nearly 60% of patients who were discharged AMA were men, with a mean age of 56 years (standard deviation, 19.13). The average stay was 1.64 days.

In roughly one third of cases, there was no documented reason for the departure ― underscoring the need for better reporting, according to the researchers.

To address AMA discharges, hospitals "need to focus on factors they influence, such as high-quality patient care, the hospital environment, and provider-patient relationships," the researchers report.

New Procedures Needed

The hospital is working on procedures to ensure that reasons for AMA discharges are documented. The administration also is implementing preventive steps, such as communicating with patients about the risks of leaving and providing discharge plans to reduce the likelihood that a patient will return, Bvute told Medscape Medical News.

Bvute said the findings should encourage individual clinicians to "remove any stereotypes that sometimes come attached to having those three letters on your charts."

Data were collected during the COVID-19 pandemic, but Bvute does not believe that fear of coronavirus exposure drove many patients to leave the hospital prematurely.

The study is notable for approaching AMA discharges from a quality improvement perspective, David Alfandre, MD, MPH, a healthcare ethicist at the VA National Center for Ethics in Health Care in Washington, DC, told Medscape.

Alfandre, who was not involved in the study, said it reflects growing recognition that hospitals can take steps to reduce adverse outcomes associated with AMA discharges. "It's starting to shift the conversation to saying, this isn't just the patient's problem, but this is the healthcare provider's problem," he said.

Alfandre co-authored a 2021 analysis showing that hospital characteristics account for 7.3% of variation in the probability of a patient being discharged AMA. However, research is needed to identify effective interventions besides the established use of buprenorphine and naloxone for patients with opioid use disorder. "I think everybody recognizes the quality of communication is poor, but that doesn't really help us operationalize that to know what to do," he said.

Emily Holmes, MD, MPH, medical director of the Changing Health Outcomes Through Integrated Care Excellence Program at IU Health in Indianapolis, cautioned that data may be biased because defining AMA discharge can be subjective.

Reasons are not consistently documented and can be difficult to capture because they are often multifactorial, Holmes told Medscape. "For example, long wait times are more problematic when a patient is worried about finances and care for a child," she said.

But Holmes, who was not involved in the study, said it does encourage clinicians "to think about what we can do systematically to reduce AMA discharges."

Bvute, Alfandre, and Holmes reported no relevant financial relationships.

Society of General Internal Medicine (SGIM) 2022 Annual Meeting: Abstract PS1-29. Presented April 6, 2022.

https://www.medscape.com/viewarticle/971745