'UNRWA head warns of 'concerted campaign' to end its operations'

 The head of the U.N. Palestinian refugee agency warned on Monday of "a deliberate and concerted campaign" aimed at ending its operations as Israel accused the organization of employing over 450 "military operatives" from Hamas and other armed groups.

Philippe Lazzarini did not specifically address the latest allegations made by the Israeli military on Monday, but he called out Prime Minister Benjamin Netanyahu for "openly stating that UNRWA will not be part of post-war Gaza."

"UNRWA is facing a deliberate and concerted campaign to undermine its operations, and ultimately end them," Lazzarini - head of the U.N. Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) - told the U.N. General Assembly.

"The implementation of this plan is already underway with the destruction of our infrastructure across the Gaza Strip," he said. "Dismantling UNRWA is short sighted. By doing so, we will sacrifice an entire generation of children, sowing the seeds of hatred, resentment, and future conflict."

Lazzarini told the 193-member assembly that UNRWA was "functioning hand-to-mouth" after 16 countries paused a total of $450 million in funding when Israel in January accused 12 UNRWA staff of taking part in the Oct. 7 attack by Hamas militants.

The UNRWA staff were fired and an independent internal U.N. investigation launched.

"The fate of the agency, and the millions of people who depend on it, hang in the balance," Lazzarini told the General Assembly, describing UNRWA as "the backbone of humanitarian assistance in Gaza."

UNRWA employs 13,000 people in Gaza, running schools, healthcare clinics and other social services, and distributing humanitarian aid. The U.N. has said some 3,000 are currently still working to deliver aid in Gaza, where 576,000 people - one quarter of the population - are one step away from famine.

"In Gaza, the U.N. is a terror organization itself," Israel's U.N. Ambassador Gilad Erdan told the General Assembly earlier on Monday.

The war in Gaza was triggered by the Hamas attack on Israel on Oct. 7, when around 1,200 people were killed and 253 hostages seized, according to Israeli tallies. Israel's air and ground campaign in Gaza has since killed around 30,000 Palestinians, health authorities in the Hamas-run enclave say.

https://www.yahoo.com/news/unrwa-head-warns-concerted-campaign-230020904.html

California bill could extend hospital stay for violent offenders

 California is considering a bill that would allow people with severe mental illness who commit violent crimes to be held in a state mental hospital for up to 30 days instead of only five, the San Francisco Chronicle reported Mar. 4.

Currently, people with severe mental illness who are convicted of violent crimes and pose a "substantial danger of physical harm to others" are kept in mental hospitals following their prison sentences. Within five days, a judge determines if their mental illness is in remission and if determined to be in remission with treatment or no longer pose a threat, are released into the community. 

The proposed bill would increase the time the state could keep a person after a judge determines they need to be released from five days to 30 days. This would give officials time to create and enact treatment plans.

The proposal comes a year after a man who was convicted of stabbing a bakery owner was released from the hospital without time to receive medication and other treatment. He went on to stab a bakery worker. 

"Five days is not enough to transition anyone, let alone someone who has committed a violent offense and has a serious mental disorder," Assembly Member Matt Haney, who proposed the bill, told the Chronicle. "Even if a judge has found that that person can be released, we absolutely need time to transition that person for the community's safety and well-being and for the individual's safety and well-being."

Between January 2018 and October 2023, 1,656 violent offenders were released from state mental hospitals. The bill would not only expand the stay for these offenders, but would also require probation departments in the county where the person will be released to be notified within five days of a judge ruling the offender would be allowed to leave the hospital. 

A decade ago, a similar law was rejected by lawmakers. Advocacy group Legal Services for Prisoners with Children called the proposed 30-day hold "excessively long," according to the Chronicle.

https://www.beckershospitalreview.com/patient-safety-outcomes/california-bill-could-extend-hospital-stay-for-violent-offenders.html

CommonSpirit 'having real issues' with Medicare Advantage, CFO says

 Chicago-based CommonSpirit is having significant challenges getting paid appropriately for care provided through some of its Medicare Advantage programs, CFO Dan Morissette said during the health system's Feb. 29 investor call. 

"We're having real issues with some of our Medicare Advantage programs, where we have contracts in place to pay us one rate and they're paying us a rate much less than that," Mr. Morissette said. 

The news comes as a growing number of hospitals and health systems across the U.S. are pushing back and dropping MA contracts with certain commercial payers.

Excessive prior authorization denial rates and slow payments from insurers are some of the biggest challenges that health systems across the country are seeing with MA. Some MA carriers have also faced federal billing fraud allegations and are being probed by lawmakers for high denial rates. 

Insurers are also pushing back against CMS' proposed MA rates for 2025. Payers argue that the proposed rule released Jan. 31 would cut payments by 0.16% in 2025, but CMS said it would lead to a 3.7% increase after adjusting payments to account for the insured population's health.

Speaking about the insurance landscape overall, Mr, Morissette said he has "rarely, if ever, seen the kind of payer behavior that we've seen recently."

"Denials that are absolutely not in accordance with the contracts that we have, delayed payments where we need to go to arbitration and/or litigation to try to get paid for work that we're clearly entitled to," he said. "The behavior overall has been egregious."

CommonSpirit said that certain markets are seeing a higher concentration of these challenges, but most markets are experiencing at least some problems.

"We have payers that owe us a substantial amount of these inappropriate denials," Mr. Morissette said. "We have some markets in which the payers themselves have a near-monopoly on the commercial insurance market and therefore we do not receive enough reimbursement to offset the costs of Medicaid, self-pay and even some of the Medicare outpatient things."

Interestingly, CommonSpirit said it tends to fare better in markets where it is more relevant. 

"I don't want to cite markets because there is minor payer behavior in all the markets, but typically where we have a bigger market share or really solid clinically integrated network we tend to do a little bit better," he said. "It's a major concern and a major focus."

The 162-hospital system typically loses the most money from non-payers from an operating perspective, Mr. Morisette said. Medicaid is generally a significant loss to the system while Medicare, which pays quickly, is okay on an inpatient basis but on an outpatient basis does not usually pay enough to cover CommonSpirit's costs in that care setting.

In terms of commercial payments, CommonSpirit's CFO said the trend is higher now but not nearly high enough. 

"We expect more of a share of inflation to be borne by [commercial payers]," he said. "Some of our states have had so much inflation. For example the State of Washington has had 30-40% of inflation plus or minus the last three or four years. There's no way you can make up for that in volume, so there are states where we are going to need higher increases just to partially offset the costs of inflation together with the staff shortages, etc."

https://www.beckershospitalreview.com/finance/commonspirit-having-real-issues-with-medicare-advantage-cfo-says.html

Scammers target Nebraska patients amid Change Healthcare attacks

 The Nebraska Hospital Association has received patient reports that scammers are reaching out and claiming to be representatives from state hospitals amid the ongoing challenges that Optum's Change Healthcare has faced since a ransomware attack took the company offline on Feb. 29.

"Scammers are informing patients they're entitled to a full refund if they provide them with a credit card number," the NHA said in a March 4 LinkedIn public advisory post. 

The NHA post assured patients that Nebraska hospitals would never ask them for credit card information over the phone regarding payment refunds. 

A spokesperson for the NHA told Becker's that they are being proactive by posting this public advisory alerting Nebraska hospital patients to ensure that they don't fall for these schemes. 

https://www.beckershospitalreview.com/cybersecurity/scammers-target-nebraska-patients-amid-change-healthcare-attacks.html

Blocking this protein could help prevent 40% of uterine cancer deaths

 Uterine cancer is the only cancer that has seen survival rates continuously fall in the last 40 years, but research published March 4 in the British Journal of Cancer suggests that using a medication to block a protein called Galectin-3 could be a more effective treatment.

Elevated levels of the protein, also referred to as Gal3, has also been associated with worse outcomes for patients with uterine serous cancer — a more aggressive type of uterine cancer, which affects about 10% of uterine cancer patients, but accounts for about 40% of uterine cancer deaths.

The study also revealed that tumors with lower levels of Gal3 present were less likely to grow and spread. Testing medications to block Gal3 in animals yielded fewer and smaller tumors. 

"[O]ur results suggest that Gal3 can contribute via a variety of mechanisms to the highly aggressive nature of uterine serous cancers," the researchers wrote of their results. 

The study is said to be the first providing evidence that Gal3 "has the potential to influence either directly, or indirectly cell proliferation, stemness, cell adhesion, migration, invasive potential, and or tumor microenvironment, supporting the concept that Gal3 likely contributes to the more aggressive clinical properties of [uterine serous cancer]," the authors claim. 

https://www.beckershospitalreview.com/oncology/blocking-this-protein-could-help-prevent-40-of-uterine-cancer-deaths.html

Providers losing $100M daily over Unitedhealth hack

 Some larger health systems are losing more than $100 million a day due to the Change Healthcare cyberattack, one cybersecurity firm estimated, causing industry associations to continue to urge action.

The American Hospital Association wrote to Congressional leaders March 4 to urge HHS to take action and to consider any "statutory limitations" that exist for federal agencies to help hospitals, while the American Medical Association asked HHS to issue guidance and provide emergency funding to providers unable to get paid because of the IT outage. "This is an immense crisis demanding immediate attention," AMA President Jesse Ehrenfeld, MD, said in a March 4 news release.

Some larger health systems are bleeding over $100 million daily because of the interruptions to the Optum subsidiary's payer systems, cybersecurity company First Health Advisory told multiple news outlets.

Change Healthcare set up a temporary funding assistance program for providers facing cash-flow issues because of the cyberattack, but the AHA called the measure inadequate.

https://www.beckershospitalreview.com/cybersecurity/providers-losing-100m-daily-over-change-healthcare-hack-report.html

Refrigerate lettuce to reduce risk of E. coli contamination

 Leafy green vegetables are important sources of dietary fiber and nutrients, but they can harbor harmful pathogens. In particular, lettuce has often been involved in outbreaks of foodborne illness across the U.S. A new study from the University of Illinois Urbana-Champaign examines factors that affect E. coli contamination on five different leafy greens -- romaine lettuce, green-leaf lettuce, spinach, kale, and collards.

"We are seeing a lot of outbreaks on lettuce, but not so much on kale and other brassica vegetables. We wanted to learn more about the susceptibility of different leafy greens," said lead author Mengyi Dong, now a postdoctoral research associate at Duke University. Dong conducted the research as a doctoral student in the Department of Food Science and Human Nutrition (FSHN), part of the College of Agricultural, Consumer and Environmental Sciences (ACES) at the U. of I.

The researchers infected whole leaves from each of the five vegetables with E. coli O157:H7 and observed what happened after storage at 4° C (39° F), 20° C (68° F), and 37° C (98.6° F). Overall, they found that susceptibility was determined by a combination of temperature and leaf surface properties such as roughness and the natural wax coating.

"At room temperature or higher, E. coli grows very fast on lettuce, but if lettuce is refrigerated at 4° C (39° F), we see a sharp decline in the E. coli population. However, for waxy greens like kale and collard, we get the opposite results. On these vegetables, E. coli grows slower under warmer temperatures, but if it is already present, it can survive longer under refrigeration."

Even so, kale and collard are overall less susceptible to E. coli contamination than lettuce. Furthermore, these vegetables are usually cooked -- which kills or inactivates E. coli -- while lettuce is consumed raw. Rinsing lettuce does help, Dong said, but doesn't remove all the bacteria because of their tight attachment to the leaf.

The researchers also inoculated cut leaves with E. coli O157:H7 to compare the intact surface of a whole leaf to the damaged surface of a cut leaf.

"Whole leaves and freshly cut leaves present different situations. When the leaf is cut, it releases vegetable juice, which contains nutrients that stimulate bacterial growth," Dong explained. However, the researchers found that spinach, kale, and collard juice actually exhibited antimicrobial properties that protect against E. coli.

To further explore these findings, they isolated juice (lysate) from kale and collards and applied the liquid to lettuce leaves, finding that it can be used as a natural antimicrobial agent. The potential applications could include antimicrobial spray or coating to control foodborne pathogen contaminations at both pre-harvest and post-harvest stages, the researchers said.

"We can't completely avoid pathogens in food. Vegetables are grown in soil, not in a sterile environment, and they will be exposed to bacteria," said co-author Pratik Banerjee, associate professor in FSHN and Illinois Extension specialist.

"It's a complex problem to solve, but we can embrace best practices in the food industry and food supply chain. There's a lot of interest from the research community and federal agencies to address these issues, and the USDA imposes high standards for food production, so overall the U.S. food supply is quite safe."

Banerjee and Dong emphasize they do not want to discourage people from eating fresh fruit and vegetables; they are part of a healthy diet. Just follow food safety guidelines, wash your lettuce thoroughly, store it in the refrigerator, and pay attention to any food safety recalls in your area, they conclude.

This project was supported by the USDA Specialty Crop Block Grant Program (SCBGP) through the Illinois Department of Agriculture [grant numbers IDOA SC-22-20].

Journal Reference:

1. Mengyi Dong, Maxwell J. Holle, Michael J. Miller, Pratik Banerjee, Hao Feng. Fates of attached E. coli o157:h7 on intact leaf surfaces revealed leafy green susceptibility. Food Microbiology, 2024; 119: 104432 DOI: 10.1016/j.fm.2023.104432

https://www.sciencedaily.com/releases/2024/02/240229182838.htm