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Monday, April 3, 2023

Biden White House 'uninterested' in Nashville shooting victims

 Every day last week, after three children and three adults were murdered by a transgender shooter at a Christian school in Nashville on Monday, Joe Biden waxed lyrical about the “joy, strength, and absolute courage [of] transgender and nonbinary Americans.” 

Hard though it is to believe at a moment when discretion and sensitivity were needed, the president issued statements from the White House claiming “Transgender Americans shape our Nation’s soul.” 

On Friday, four days after the massacre at the Covenant Christian school, he issued a proclamation declaring March 31 as “Transgender Day of Visibility” and railed against “MAGA extremists [who] are advancing hundreds of hateful and extreme state laws that target transgender kids and their families … These attacks are un-American and must end.” 

The White House marked the occasion with a 3,464-word “fact sheet” suggesting that “conservative politicians” were driving “transgender youth” to consider suicide. 

Never fear, though, President Biden is “standing up for transgender kids and their families.” 

But who is standing up for Christian kids and their families? 

Must they now fear for their lives because of the hysterical lie, encouraged by the president, that their loving faith is bigoted and hateful toward transgender people? 

The Biden administration held events for “Transgender Day of Visibility” days after six people were killed a shooting at the Covenant School in Nashville.
The Biden administration held events for “Transgender Day of Visibility” days after six people were killed in a shooting at the Covenant School in Nashville.
Photo by SAUL LOEB/AFP via Getty Images

Ignoring tragedy 

Who is standing up for the victims of last week’s horror? 

Certainly not the media, which has decided that the real victims are the transgender community, in anticipation of some imaginary backlash from Christians. 

“Fear pervades Tennessee’s trans community amid focus on Nashville shooter’s gender identity” was a typical headline from NBC

The six victims of the shooting were killed by Audrey Hale — who identified as transgender.
The six victims of the shooting were killed by Audrey Hale, who identified as transgender.
Hale's manifesto on the shooting has yet to be released to the public.
Hale’s manifesto on the shooting has yet to be released to the public.
Linkedin/Audrey Hale

Corporate America sang from the same hymn book.

One day after the massacre of three little kids in Nashville, Amazon sent a message to “LGBTQIA+ employees and allies” expressing “support and solidarity during this period of apprehension and uncertainty.” 

Biden and his White House just kept pumping out their trans propaganda right into the weekend. 

They said not one word about Christians all week, despite the fact that the Nashville shooting appears to have been a hate crime targeted at a Christian school; we can’t yet definitely assert the motive because the killer’s so-called “manifesto” is being kept from us, unlike similar documents in other massacres. 

Even when the funerals began for the Nashville victims, the White House didn’t let up. 

On Friday, in the middle of Biden’s orgy of trans-pandering, the first of the Nashville victims was buried. Evelyn Dieckhaus, 9, was honored for her “unwavering faith in the goodness of others.” 

Mourners attending the funeral service for Nashville shooting victim Evelyn Dieckhaus at Woodmont Christian Church on March 31, 2023.
Mourners attending the funeral service for Nashville shooting victim Evelyn Dieckhaus at Woodmont Christian Church on March 31, 2023.
AP Photo/Wade Payne

“Evelyn made people feel known, seen, but never judged.” 

Mourners at Woodmont Christian Church in Nashville, a couple of miles from the Covenant School, wore pink and green “in tribute to Evelyn’s light and love of color,” as her family requested. 

The next day, the White House went ahead with a “White House Roundtable Affirming Transgender Kids.”

This was an opportunity for domestic policy adviser Susan Rice to use children as props in a cynical political stunt aimed at demonizing Republicans in red states who have passed laws to protect kids from sex hormones and experimental gender surgery. 

In doing so, the Republican legislatures and governors like Florida’s Ron DeSantis are in accord with the most up-to-date thinking in Europe.

Countries like Sweden, Finland, Belgium and England, hardly bastions of transphobia, have cracked down hard on the use of puberty blockers, cross-sex hormones and surgery for children, after finding that the interventions have done more harm than good and are not evidence-based. 

But the Biden administration wasn’t going to let such pesky concepts interfere with its virtue-signaling. 

On Saturday, while the White House roundtable kicked off, a different event was being held in Nashville, right next to the scene of the massacre. 

There at the Covenant Presbyterian Church, the parents of 9-year-old Hallie Scruggs held a funeral for their only daughter in the sacred place where her father is pastor.

She was remembered as a “vibrant little girl who was well-loved and loved others.” 

The same day, substitute teacher Cindy Peak, 61, received a final farewell just a few miles away, at Christ Presbyterian Church, where the congregation was told she “died a hero.” 

Memorials for the victims at the entrance to the Covenant School.
Memorials for the victims at the entrance to the Covenant School.
Mickey Bernal/ZUMA Press Wire

On Sunday, at the same church, was the funeral for 9-year-old William Kinney, a keen baseball player who was remembered as “unfailingly kind, gentle when the situation called for it, quick to laugh, and always inclusive of others.” 

Funerals will be held this week for the other victims of last week’s massacre: head of school Katherine Koonce, 60, and school custodian Mike Hill, 61, a “strong man of faith.” 

Both are said to have given their lives trying to protect the children in their care. 

Such selflessness is an alien concept to those who view everything through the lens of political advantage. 

Political narrative 

You can see that from the sociopathic lack of empathy exhibited by the White House as it plowed ahead with its transgender talking points, effectively valorizing the cause of the Nashville killer. 

It cast as villains “conservative politicians [who] have advanced hundreds of anti-transgender laws in states across the country … putting the fundamental rights and freedoms of trans Americans at risk … Over half of transgender youth say they have seriously considered suicide in the last year because of the discrimination and rejection they face.” 

The suicide narrative is a political cudgel used to silence opposition to this perverse medicalization and mutilation of healthy children. 

But it is essential to the new political narrative Biden and his party have designed for the 2024 political cycle. 

Before the 2020 election, they seized on George Floyd’s death as an opportunity to race-bait, foment unrest and demonize Republicans as racist bigots. 

For 2024, you can see them setting the stage to do it all again with a new identity group of “oppressed” victims, who need Biden to be their champion and “have their backs.” 

Nashville was just an inconvenient interruption, so they ignored it.

https://nypost.com/2023/04/02/the-biden-white-house-is-uninterested-in-honoring-the-nashville-shooting-victims/

Chinese balloon gathered sensitive intelligence despite Biden administration efforts

 The Chinese surveillance balloon that flew over the U.S. for days before it was shot down off the east coast earlier this year was able to gather intelligence from sensitive military sites, according to a new NBC News report. 

China received the information collected by the balloon immediately and was able to control its flightpath, NBC News reported, citing two senior U.S. officials and a former senior administration official.

The intelligence Beijing was able to access was predominantly from electronic signals, according to the report, and the Biden administration’s work to limit the balloon’s ability to pick up those signals likely prevented much more sensitive intelligence from being gathered. 

President Biden ordered the U.S. military to shoot down the Chinese surveillance balloon that had spent days floating across the U.S., prompting concerns about what intel could have been gathered from the flight. 

Beijing has said that the aircraft was a civilian weather balloon blown off-course and accused the U.S. of overreacting with the takedown, but defense officials said the balloon had clearly been crossing over sensitive U.S. sites with the apparent intent to monitor military areas. 

U.S. officials said at the time that they’d taken steps to keep Beijing from accessing sensitive intel while the balloon was still crossing the country, but the NBC News report indicates the Biden administration’s efforts to protect against surveillance didn’t stop all of Beijing’s intelligence gathering.

https://thehill.com/policy/international/3931022-chinese-balloon-gathered-sensitive-intelligence-despite-biden-administration-efforts-report/

Intrinsic Calculation For UnitedHealth Group Suggests It's 39% Undervalued

 

  • The projected fair value for UnitedHealth Group is US$776 based on 2 Stage Free Cash Flow to Equity

  • UnitedHealth Group's US$470 share price signals that it might be 39% undervalued

  • Our fair value estimate is 32% higher than UnitedHealth Group's analyst price target of US$589

Today we'll do a simple run through of a valuation method used to estimate the attractiveness of UnitedHealth Group Incorporated (NYSE:UNH) as an investment opportunity by estimating the company's future cash flows and discounting them to their present value. Our analysis will employ the Discounted Cash Flow (DCF) model. It may sound complicated, but actually it is quite simple!

We use what is known as a 2-stage model, which simply means we have two different periods of growth rates for the company's cash flows. Generally the first stage is higher growth, and the second stage is a lower growth phase. In the first stage we need to estimate the cash flows to the business over the next ten years. Where possible we use analyst estimates, but when these aren't available we extrapolate the previous free cash flow (FCF) from the last estimate or reported value. We assume companies with shrinking free cash flow will slow their rate of shrinkage, and that companies with growing free cash flow will see their growth rate slow, over this period. We do this to reflect that growth tends to slow more in the early years than it does in later years.


Ocular Toxicity With New Drugs for Gynecologic Cancers

 Antibody–drug conjugates (ADCs) are relatively new in the gynecologic cancer space, and while they show promise, the novel ocular adverse events associated with this drug class mean that clinicians need to learn how to monitor and manage these patients.

This was the message from Colleen Bohnenkamp, PharmD, an oncology clinical pharmacist at the University of Kansas Health System, speaking at a special session during the recent Society of Gynecologic Oncology (SGO) 2023 Annual Meeting on Women's Cancer.

Patients with advanced/recurrent gynecologic cancers have few treatment options, and ADCs are of interest as targeted, biomarker-driven therapies for this population.

ADCs are designed to deliver cytotoxic agents directly to the tumor by using antibodies to target specific proteins in the tumor, Bohnenkamp explained.

"The 'cytotoxic payload' is not just any chemotherapy," she emphasized. "This is a highly toxic agent that if administered by itself would be lethal."

Bohnenkamp commented that she likes to think of ADCs as "dipping a dart into a highly lethal chemotherapy and, assuming you have the precision, you can hit the bullseye or target of choice."

Within the past 18 months, the US Food and Drug Administration has approved the first two ADC agents for gynecologic cancers, Bohnenkamp noted.

The first ADC, approved in September 2021, was tisotumab vedotin-tftv (Tivdak, Genmab), a tissue factor-directed antibody indicated for patients with recurrent or metastatic cervical cancer with disease progression on or after chemotherapy.

A year later, mirvetuximab soravtansine (Elahere, Immunogen) was approved in November 2022. This ADC has an antibody that targets folate receptor alpha and is indicated for the treatment of tumors that show high expression of this protein as well as being platinum-resistant epithelial and are located in the ovary, fallopian tube, or peritoneum, in patients who have received one to three prior systemic treatment regimens.

Bohnenkamp cautioned that both drugs received accelerated approval based on single-arm studies. "This means that approval is contingent on phase 3 studies, which are ongoing," she said.

Tisotumab Vedotin-tftv

Tisotumab vedotin-tftv was approved based on the innovaTV 204 clinical trial, a multicentered, open-label, single-arm, phase 2 trial that included 101 patients with metastatic or recurrent cervical cancer. Patients received tisotumab vedotin at a dose of 2 mg/kg (maximum 200 mg/dose) intravenously every 3 weeks until disease progression or unacceptable toxicities.

At a median follow-up of 10 months at the time of data cutoff, 24 patients had an objective response and seven were complete responses. "I think that's very impressive for this late in the game," commented Bohnenkamp.

The 6-month survival rate was 79% with a median overall survival rate of 12.1 months and a median time to response of 1.4 months.

"For safety, 65% of patients had a low-grade toxicity and 27% a high-grade toxicity," she pointed out. "Unlike chemotherapy, we don't see a lot of high-grade cytopenias."

Common side effects included alopecia, bleeding events, fatigue, nausea, peripheral neuropathy, and ocular toxicities. Reported in 53% of patients in the trial, ocular toxicities included conjunctivitis, dry eye, keratitis, and vision changes, with rare cases of corneal ulceration and severe vision loss.

"The National Comprehensive Cancer Network (NCCN) guidelines recommend tisotumab vedotin as a preferred regimen in second or subsequent therapies," she noted.

Mirvetuximab Soravtansine

Mirvetuximab soravtansine agent received approval based on the single-arm, phase 2 SORAYA trial, which looked at safety and efficacy in platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer.

The objective response rate was 32.4%, with five complete responses and 29 partial responses, and 20 patients had disease progression. The median duration of response in this population was 6.9 months and progression free survival was 4.3 months.

"For safety, 89% of patients had any grade toxicity and 29% had grade 3 or 4," she pointed out. "The most common toxicities were ocular, and we don't usually see alopecia or high rates of hematologic toxicities with this medication."

Of note, mirvetuximab soravtansine is indicated specifically for patients with tumors that have high expression of folate receptor alpha, so patients will need to be tested, Bohnenkamp noted. "This isn't a routine test and it needs to be sent out," she said. "There are currently four labs that will run this test."

NCCN guidelines have included mirvetuximab as a preferred regimen for targeted therapy with a single agent. And as with tisotumab, confirmatory trials are ongoing.

Ocular Toxicities

Ocular adverse events are common with both tisotumab vedotin and mirvetuximab soravtansine, and product labels for both include boxed warnings regarding ocular toxicity.

These can present as reduced visual acuity, blurred vision, light sensitivity, redness, dryness, and irritation, which may result in conjunctival or corneal inflammation.

Symptoms are often detectable before they become severe, and this allows for early referral for management, commented Meghan Berkenstock, MD, associate professor of ophthalmology, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland.

"Close communication between oncologists and eye care providers is needed," she said. "Patients should be referred to us if they are having any issues."

"But most important is coordination of care," Berkenstock emphasized. "The oncology care team needs to monitor patients for ocular signs and symptoms."

Ocular toxicity can be prevented and mitigated by utilizing recommended eye care strategies, Berkenstock commented.

While there are some differences in mitigation strategies between the two drugs, the basic protocols are similar. "All patients should have baseline eye exams prior to each infusion and repeated prior to infusion," she said. Also, patients should be instructed not to wear contact lenses during treatment in order to avoid infectious keratitis or increased surface dryness, she said. Prophylactic steroid eye drops should be given prior to starting the infusion and continued use for 72 hours after infusion for tisotumab and through day 10 for mirvetuximab. "Patients who are using steroid drops for symptom management require follow-up to monitor for cataract progression and to check intraocular pressure," she commented.

Lubricating eye drops are also used prophylactically throughout treatment as they add moisture to the eye, she explained. "They can be used for self-use as needed through the day from the infusion until 30 days after the last dose."

Tisotumab also requires vasoconstrictor eye drops that are given prior to each infusion, and cold packs are applied during and after the infusion to decrease blood flow.

Berkenstock finished her talk by adding a "disclaimer." These are new drugs and these are new ocular toxicities, so many ophthalmologists may not be familiar with these drugs and the associated side effects. They may need background information on the drugs to get up to speed.

But overall, oncologists and eye care providers need to work together, she emphasized. "Make friends with us, get our cell numbers," she joked. "We are happy to help."

Bohnenkamp has reported relationships with AstraZeneca, GlaxoSmithKline, MSD, and Novocure. Berkenstock has reported a relationship with Eyepoint Pharmaceuticals.

Presented at the Society of Gynecologic Oncology (SGO) 2023 Annual Meeting on Women's Cancer. Presented March 25, 2023.

https://www.medscape.com/viewarticle/990372

Semler: CMS Risk Adjustment Changes in 2024 Medicare Advantage, Part D Final Rates

 Semler Scientific, Inc. (Nasdaq: SMLR), a company that provides technology solutions to improve the clinical effectiveness and efficiency of healthcare providers, commented on the recent Centers for Medicare and Medicaid Services (CMS) 2024 Medicare Advantage and Part D Final Rate Announcement.

"Semler Scientific remains confident that screening for peripheral artery disease (PAD) using our QuantaFlo® product is in the best interest of at-risk Medicare beneficiaries, despite CMS' decision to finalize removal of PAD without complications from its Medicare Advantage risk adjustment model," said Wayne T. Pan, Ph.D., M.D., chief executive officer of Semler Scientific. "Furthermore, a three-year phase-in of the changes to the risk adjustment model will support continued screening of at-risk asymptomatic patients for PAD during the transition period, which will contribute to the collection of even more clinical outcome data underscoring the importance of asymptomatic screening going forward." The removal of PAD without complications from the Medicare Advantage risk adjustment model was originally proposed by CMS in its 2024 Medicare Advantage and Part D Advance Notice, which CMS released in February 2023.

Using the American Heart Association/American College of Cardiology guidelines for PAD testing, Semler Scientific's QuantaFlo® has proven to be a fast, portable, cost-effective, and accurate tool that provides value to patients and payors. QuantaFlo aids in the diagnosis of previously undetected early-stage PAD and heart dysfunction (HD), enabling primary care physicians to treat risk factors that contribute to the progression of these serious vascular and cardiac diseases.

Semler Scientific believes it is essential that current testing protocols remain in place. With the potential to modify disease progression, Semler Scientific is optimistic that earlier diagnosis and treatment can lead to improved long-term clinical outcomes for patients. This was supported in the February 2022 publication of the Journal of Vascular Surgery, which found that a positive PAD screening test in Medicare Advantage patients was independently associated with an increase of ~60% to 70% for 1-year all-cause mortality and/or major adverse cardiac events (MACE) and a 40% to 50% increase for 3-year all-cause mortality and MACE. The authors concluded that these findings highlight an "enormous potential to realize cost-savings by reducing cardiovascular event rates and deploying population-based PAD risk mitigation strategies." Semler Scientific believes that the paradigm of earlier diagnosis and intervention will become the standard of care in managing patients with PAD and/or HD.

Twitter Algorithm Reveals Tool For Government Intervention

 by Eric Lendrum via American Greatness,

A researcher claims to have found a tool allowing for government intervention in Twitter’s algorithm, upon Elon Musk’s decision to allow the algorithm to become open sourced to the public.

Breitbart reports that Musk honored his promise on Friday by releasing a portion of Twitter’s recommendation algorithm on the website GitHub, where computer programmers often go to share and collaborate on work dealing with open-source code.

Web developer Steven Tey then claimed to have discovered a particular mechanism within the code that allows the U.S. government to make changes to the website’s algorithm.

“When needed, the government can intervene with the Twitter algorithm. In fact, @TwitterEng (Twitter Engineering) even has a class for it – ‘GovernmentRequested,” Tey tweeted, including a link to the code on GitHub.

Upon purchasing Twitter for $44 billion in October, Musk vowed to increase transparency and loosen restrictions on certain speech and accounts that had been imposed by previous leadership. One of his goals was to make the algorithm open source for public viewing; he later said that “our ‘algorithm’ is overly complex & not fully understood internally,” and that “people will discover many silly things, but we’ll patch issues as soon as they’re found!”

In addition, Tey discovered that the algorithm takes such factors into account as following-to-follower ratio when determining which users to promote; users with a low number of followers but a high amount of followed accounts would be negatively affected.

The algorithm also promotes those who are subscribed to the “Twitter Blue” program, where users must pay $8 a month for a blue checkmark signaling that their account is “verified.” These users are subsequently put into different categories, including “power users,” “Democrats,” and “Republicans.”

The discovery of the government intervention tool is just the latest example of controversy surrounding Twitter’s relationship with the federal government prior to Musk’s takeover. In his signature transparency effort, Musk has been periodically releasing information about Twitter’s past leadership, in the form of screenshots of emails and other forms of correspondence, revealing the levels of collusion between Twitter executives and government officials, often for the purpose of targeting conservative users. The information would be given to independent journalists and shared in extensive Twitter threads, becoming known as “The Twitter Files.”

https://www.zerohedge.com/political/twitter-algorithm-reveals-tool-government-intervention

Remittances to Mexico climb 11.2% year on year in February

 Remittances to Mexico from abroad jumped 11.2% year on year in February, while dropping from the prior month, according to data published by the country's central bank on Monday.

Remittances hit $4.3 billion in February, down from the $4.4 billion sent in January.

The number of transactions, made mainly from the United States, increased in February by 10.9% year on year, while the average amount per transfer grew 0.3% to $375.

In the first two months of 2023, remittances reached $8.9 billion, up 11.8% from the $7.8 billion posted in the year-earlier period.

Mexican President Andres Manuel Lopez Obrador has been a strong advocate of remittances in the midst of weak domestic economic growth and high inflation.

Remittances to Mexico from abroad hit a record high $58.5 billion in 2022.

https://finance.yahoo.com/news/remittances-mexico-climb-11-2-154335667.html