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Physicians and advanced practice providers at MidMichigan Health were recently recognized by national health care research how to get a propecia prescription online leader Professional Research Consultants, Inc. (PRC), as 5-Star Performers.Physicians who were recognized include Odoma Achor, M.D., Miguel Alvelo-Rivera, M.D., Danielle Bennett, D.O., Paul Berg, M.D., Andrzej Boguszewski, M.D., Kristin Busch, M.D., David Buzanoski, M.D., Thomas Claringbold, II, D.O., Daniel Diaz, D.O., Jeanine Ernest, M.D., William Felten, M.D., Renee Fuller, M.D., Steven Gellman, M.D., Mark Goethe, M.D., Monika Herdzik, M.D., Kelly Hill, M.D., Nilofar Islam, M.D., Thomas Johnson, M.D., Egle Klugiene, M.D., Natalie Kroll, D.O., Shane Martin, D.O., Shannon Martin, D.O., M.P.H., Jeffrey Martindale, D.O., Kristalyn Mauch, M.D., Ben Mayne, III., M.D., Patrick Morse, M.D., John Murphy, D.O., Tammy Phillips, M.D., Robert Reichmann, M.D., M.P.H., Asma Saboor, M.D., Tannu Sahay, M.D., Susan Sallach, M.D., Sasha Savage, M.D., Michael Stack, M.D., Denise Stadelmaier, D.O., Jacob Trombley, D.O., M.P.H., Mark Weber, M.D, and Kyle how to get a propecia prescription online Williams, M.D.In addition, there were advanced practice providers from MidMichigan Physicians Group recognized as 5-Star Performers. They are Vickie Bannister, M.S.N., W.H.N.P.-B.C., Stacy Carstensen, M.S.N., C.F.N.P., Trisha DesChamps, M.S.N., F.N.P., Devon Fenner, P.A.-C., Matthew Flegel, P.A.-C., Alison Funka, D.N.P., A.G.N.P.-.C., Jenifer Garcia, P.A.-C., Cynthia Lamb, P.A.-C., Brandi McConnell, M.S.N., F.N.P.-B.C., Crystal Morrissey, P.A.-C., Cora Pavlik, M.S.N., F.N.P.-B.C., Blaine Price, P.A.-C., Jennifer Schlitzkus, P.A.-C., and Kenneth VanSumeren, P.A.-C.“We how to get a propecia prescription online are thrilled to see our medical staff recognized by PRC for providing top quality care to their patients,” said Paul Berg, M.D., president, MidMichigan Physicians Group. €œIt’s our goal for all of our patients to receive excellent care each time they come through our doors, and this recognition is a testament that we’re working toward achieving that goal.”The Excellence in Healthcare Awards recognize organizations and individuals who achieve excellence throughout how to get a propecia prescription online the year by improving patient experiences, health care employee engagement and/or physician alignment and engagement based on surveys of their patients, employees and physicians.“It is an honor to recognize MidMichigan’s physicians and advanced practice providers with these Excellence in Healthcare Awards for their deserving work,” said Joe M.

Inguanzo, Ph.D., president and CEO of how to get a propecia prescription online PRC. €œIt takes true dedication and determination to achieve this level of excellence in health care and MidMichigan has shown their commitment to making their hospital a better place to work, a better place to practice medicine and a better place for patients to be treated.”Those who would like to learn more about the 2021 Excellence in Healthcare Awards, including eligibility and criteria, may visit www.PRCCustomResearch.com.About PRCPRC, a leader in the healthcare intelligence space with the most comprehensive healthcare discovery platform, is taking surveys to a new how to get a propecia prescription online level. PRC’s surveys and intuitive reporting how to get a propecia prescription online focus on changing the way organizations manage and improve five key areas of the healthcare experience—patient, physician, employee, community, and brand. Over 2,800 how to get a propecia prescription online healthcare organizations across the United States have used PRC to listen, understand, and take action to create cultures of excellence.

To ensure how to get a propecia prescription online clients have access to leading practices, coaches, and learning resources, PRC is partnered with Healthcare Experience Foundation (HXF) to accelerate paths to excellence. The PRC healthcare discovery platform is a system designed to drive action, optimize engagement, and increase loyalty while building a positive culture across the healthcare ecosystem.Henry HaleyHenry Haley, a third-year medical student at how to get a propecia prescription online Central Michigan University, has been awarded the inaugural Philip A. Harris Memorial Scholarship of $1,000.Haley has participated in several clerkships at MidMichigan Medical how to get a propecia prescription online Center – Midland, including in family medicine, obstetrics and gynecology, psychiatry, surgery, hospital medicine and a comprehensive community clerkship. He hopes to one day practice medicine in the Midland area.“Henry truly embodies the spirit of how to get a propecia prescription online Dr.

Harris,” said Denise how to get a propecia prescription online O’Keefe, executive director, MidMichigan Health Foundation. €œLike Dr how to get a propecia prescription online. Harris was, he’s focused on continuously learning how to get a propecia prescription online and education. He has a passion for helping others and we look forward to the day that he practices medicine in the communities that MidMichigan Health serves.”Philip how to get a propecia prescription online A.

Harris, M.D.Dr how to get a propecia prescription online. Harris worked as an otolaryngologist how to get a propecia prescription online for MidMichigan Physicians Group, specializing in diseases of the ear, nose, throat and sinus. In February how to get a propecia prescription online 2016, he was unexpectedly diagnosed with cancer. Over the course of the next how to get a propecia prescription online four years, he continued working intermittently, while seeking cancer treatment and battling side effects.

In the how to get a propecia prescription online spring of 2020, Dr. Harris resigned from his office practice to spend how to get a propecia prescription online his last months at home with his loving wife and their three children.Dr. Harris considered it a privilege to treat every patient who presented for how to get a propecia prescription online care. He worked with each patient to understand the how to get a propecia prescription online nature of their medical condition and to choose a treatment option.

He believed how to get a propecia prescription online it was important that patients have local options and access to care. Dr. Harris took pride in his work and was an active learner and educator. He was a teacher and participated in medical societies, multiple academies, educational courses and lectures in order to help educate medical residents and to assist referring doctors in providing advanced local care.Those who would like to learn more about this scholarship, or other scholarship opportunities available through the MidMichigan Health Foundation, may visit www.midmichigan.org/scholarships..

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They can be strengthened propecia miscarriage with cognitive work, like talk therapy, once the insula has been activated and the amygdala has been calmed in a safe environment. It is more clear than ever that trauma in a person’s past has real changes in their functioning based on the direct effect of the trauma on the brain. It is also clear that there are many positive and effective treatments that can improve a person’s propecia miscarriage life and functioning.

These therapeutic interventions are generally done within the support of individual therapy. Some people have found self-help tools that address many of these symptoms. For those who need more support than either of these approaches MidMichigan Health provides a Partial Hospitalization Program at MidMichigan Medical Center – Gratiot propecia miscarriage.

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One of the best click to find out more parts of summer how to get a propecia prescription online is spending time outdoors with family and friends. Whether you enjoy backyard cookouts, picnics at the park or swimming at the pool, lake or beach, you should take extra care to help identify and prevent common summer skin wounds. Check for Wounds on Your Feet and Legs Every how to get a propecia prescription online Day This is especially important for people living with diabetes, vascular disease or other coexisting health conditions that may affect the body’s ability to heal. A small blister can quickly develop into a non-healing wound.

Puncture wounds have a high rate of . Seek medical care if you have a wound that is not healing how to get a propecia prescription online or shows signs of such as redness, fever or chills. Prevent Bug Bites and be Aware of Allergies Most insect bites are harmless and can be avoided with bug repellent and protective clothing. If you how to get a propecia prescription online have a bug bite, use a topical anti-itch cream to avoid scratching your skin.

Watch for signs of an allergic reaction. Seek emergency care if you are experiencing chest pain, difficulty swallowing or breathing, nausea, cramps, vomiting or severe swelling. Protect Against Sunburn and Skin Cancer Skin cancer is more common than how to get a propecia prescription online all other types of cancer combined. You can help prevent cancer and sunburn with the right sunscreen, clothing and shade.

Mild sunburns can be treated with over-the-counter remedies. Seek medical attention if you experience chills, dizziness, rapid breathing, nausea, extreme thirst, how to get a propecia prescription online faintness or a rash. Avoid Summer Shoes Like Sandals or Flip-Flops Choose supportive shoes with closed toes and flat heels. Sandals, flip-flops and other open-toed how to get a propecia prescription online styles do not provide good support and often cause blisters.

Always wear socks. Ask your physician or podiatrist to check if your shoes are a good fit. Seek Specialized Wound Care A non-healing how to get a propecia prescription online wound can limit your ability to enjoy your summer. If you are living with a health condition, such as diabetes, vascular disease, obesity or advanced age, you may be at greater risk for chronic wounds.

The longer a chronic wound goes without proper care, the greater the risk of , hospitalization and amputation. This article was originally how to get a propecia prescription online published by Healogics, Inc. Through a partnership with Healogics, MidMichigan Health is able to offer expanded specialized wound care and hyperbaric oxygen therapy. Healogics is the nation’s leading wound care management company, providing high-quality wound care and consulting services how to get a propecia prescription online to more than 500 hospitals across the United States.

Member hospitals have access to advanced healing technologies including hyperbaric oxygen therapy (HBOT) management.It is common knowledge that past traumas change people. It is well known that trauma increases the chance of anxiety and depression, and disrupts functioning in a number of ways. But it may not be so common to think about how this how to get a propecia prescription online change happens. It is through changes in our brain that trauma disrupts our thought patterns, emotions and behaviors.

Recent research has dug deep to understand the details of these changes how to get a propecia prescription online and what needs to be done to heal the brain so that we can experience less disruptive symptoms. According to researcher Jennifer Sweeton PsyD, M.S., M.A., (www.jennifersweeton.com) the goal of therapy is to change the brain. There are several areas of the brain that become overactive or underactive because of traumatic experiences. These are then manifested in disruptive how to get a propecia prescription online symptoms.

The primary area that becomes overactive is the amygdala. It is the ‘smoke alarm’ of the brain. It asks, ‘Is this how to get a propecia prescription online dangerous?. €™ Working with the memory center, it determines if something is dangerous and begins the stress response, which can be experienced as anxiety, or any of many physical symptoms.

It also suppresses the higher thinking how to get a propecia prescription online. When someone has repeated dangerous events the amygdala can become overactive and hypersensitive, resulting in an overreaction to even small events that would not normally be considered dangerous. When the amygdala completely hijacks the rational thinking it can cause a blackout or amnesia. To heal how to get a propecia prescription online from trauma the amygdala needs to be calmed andrelearn what is truly dangerous, and what is not.

This can be done within asafe therapeutic setting where the person learns to turn off the danger signalsand can think through triggers that had set them off, to relearn that they arenot really a threat. There are several areas of the brain that become underactive due to repeated trauma. The hippocampus how to get a propecia prescription online is one of these areas. It is the storage area for autobiographical memory.

It is the memory center that how to get a propecia prescription online the amygdala works with to decide what is dangerous. With repeated trauma there can be atrophy in the hippocampus, which can cause memory problems. People can help the hippocampus to stop sending danger signals by working with memories that used to feel dangerous, learning that they are not dangerous. Bringing the memory up in a safe environment, and doing how to get a propecia prescription online something with it, like telling the story, can reduce the sense of danger, because every time we remember something we remember the last time we remembered it, not the original, so we are reconsolidating each time.

The hippocampus can also be strengthened with physical exercise, Omega 3 and meditation. Another area of the brain that is underactiveafter repeated trauma how to get a propecia prescription online is the insula. The insula is the part of the braininvolved in awareness of the body and internal states includingemotions. During trauma people learn to turn this awareness down or off as away to protect themselves from the pain, either physical, sexual oremotional.

Turning it down can become ahabit resulting in the feeling of numbness how to get a propecia prescription online or, when turned off completely, cancause dissociation. Spikes in insula functioning can create flashbacks. Thisarea of the brain needs to be on for healing to happen. Low insula functioningis the main reason attempts at therapeutic change how to get a propecia prescription online fails, according to Dr.Sweeton.

Use of sensory awareness exercises like movement, stimulation andmindfulness exercises can improve insula functioning. Two more areas that are underactive after repeated trauma are how to get a propecia prescription online the cingulate cortex and the prefrontal cortex. The cingulate cortex is involved in emotional regulation and decision making. The prefrontal cortex is the center for rational thoughts, goal-making and decision-making.

When the amygdala senses danger it deactivates both of these areas how to get a propecia prescription online. When the amygdala is over sensitized and habitually turned on, then both of these decision making areas are chronically turned off. They need to be activated to make good decisions. They can be strengthened with cognitive work, like talk therapy, once the insula has been activated and the amygdala has been how to get a propecia prescription online calmed in a safe environment.

It is more clear than ever that trauma in a person’s past has real changes in their functioning based on the direct effect of the trauma on the brain. It is also clear that there are many how to get a propecia prescription online positive and effective treatments that can improve a person’s life and functioning. These therapeutic interventions are generally done within the support of individual therapy. Some people have found self-help tools that address many of these symptoms.

For those who need more support than either of these approaches MidMichigan Health provides a Partial Hospitalization Program at MidMichigan Medical Center – Gratiot how to get a propecia prescription online. Those interested in more information about the PHP program may call (989) 466-3253. Those interested in more information on MidMichigan’s comprehensive behavioral health programs may visit www.midmichigan.org/mentalhealth..

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The ride-hailing apps Uber and Lyft will team up with the White House to proscar vs propecia for hair loss make free rides to hair loss treatment vaccination sites free through July 4. According to White House senior advisor Andy Slavitt, beginning shortly, the companies will start to offer free rides to 80,000 vaccination sites for the next two months. Reporting from the Wall Street Journal stated that the companies will not be paid by the proscar vs propecia for hair loss government to bring riders to and from sites. Instead, the administration will provide information on tens of thousands of sites to the apps as part of the partnership.

WHY IT MATTERSAlthough initial demand for the hair loss treatment led to rushes, glitches and proscar vs propecia for hair loss occasional mayhem, the surge has leveled off in many states.Still, access remains a pervasive issue.President Joe Biden's administration is attempting to tackle the logistical complications many users have faced. This past week, it rolled out a new vaccination information text-line.Now, Lyft and Uber will promote rides to sites through their apps. "People will be able to simply select a vaccination site near them, follow simple proscar vs propecia for hair loss directions to redeem their ride, and then get a ride to take them to and from a nearby vaccination site free of charge," said the White House, in a fact sheet published Tuesday. White House hair loss treatment coordinator Jeff Zients will reportedly outline the plan in a Tuesday call with governors.

"Not everyone has had the chance proscar vs propecia for hair loss to get vaccinated yet," said Zients, according to The WSJ. "That's why we are using all the tools at our disposal and enlisting partners across sectors to meet the president's goal of getting 70% of adult Americans with at least one shot by July 4th."Of course, Lyft and Uber drivers are not available everywhere, and are particularly scarce in rural areas where treatment access may be otherwise hampered. Details are also still unknown about possible conditions – for instance, whether there will be a distance limit on rides to proscar vs propecia for hair loss vaccination sites. Uber representatives said in response to Healthcare IT News' request for comment that the company will cover costs, "and these efforts are therefore not affecting driver earnings." Biden also plans to make billions of dollars in funding available to state and local leaders through the Federal Emergency Management Agency to fund the cost of in-person, phone and online outreach, and of making vaccinations available.

Also, the administration will announce partnerships between providers and community colleges to provide on-site proscar vs propecia for hair loss vaccinations. THE LARGER TRENDBoth Lyft and Uber have made moves toward carving out footholds in the medical transport industry. The companies have teamed up proscar vs propecia for hair loss with major electronic health records vendors Epic and Cerner, respectively, to integrate ride-hailing into the EHR workflow. While the organizations have announced in the past that they will support access to hair loss treatment vaccinations, the partnership with the White House appears to be the most ambitious yet.

ON THE RECORD "treatments are our best hope to beat this propecia, and soon everyone proscar vs propecia for hair loss in America will be able to take a free Uber to get their shot," Uber CEO Dara Khosrowshahi said in a statement. "We are honored to deepen our previous global commitments, and partner with the White House and Lyft to provide free rides to vaccination sites across the U.S.," he added."More and more Americans continue to get vaccinated every day. Let’s keep moving forward, together." Kat Jercich is senior editor proscar vs propecia for hair loss of Healthcare IT News.Twitter. @kjercichEmail.

Kjercich@himss.orgHealthcare IT News is a HIMSS Media publication..

The ride-hailing apps Uber and Lyft will team up with click to investigate the White House to make free rides to hair loss treatment vaccination sites how to get a propecia prescription online free through July 4. According to White House senior advisor Andy Slavitt, beginning shortly, the companies will start to offer free rides to 80,000 vaccination sites for the next two months. Reporting from the Wall Street how to get a propecia prescription online Journal stated that the companies will not be paid by the government to bring riders to and from sites. Instead, the administration will provide information on tens of thousands of sites to the apps as part of the partnership. WHY IT MATTERSAlthough initial demand for the hair loss treatment led to rushes, glitches and occasional mayhem, the surge has leveled off in many states.Still, access remains a pervasive issue.President Joe Biden's administration is attempting to tackle the logistical complications many how to get a propecia prescription online users have faced.

This past week, it rolled out a new vaccination information text-line.Now, Lyft and Uber will promote rides to sites through their apps. "People will be able to simply select a how to get a propecia prescription online vaccination site near them, follow simple directions to redeem their ride, and then get a ride to take them to and from a nearby vaccination site free of charge," said the White House, in a fact sheet published Tuesday. White House hair loss treatment coordinator Jeff Zients will reportedly outline the plan in a Tuesday call with governors. "Not everyone has had how to get a propecia prescription online the chance to get vaccinated yet," said Zients, according to The WSJ. "That's why we are using all the tools at our disposal and enlisting partners across sectors to meet the president's goal of getting 70% of adult Americans with at least one shot by July 4th."Of course, Lyft and Uber drivers are not available everywhere, and are particularly scarce in rural areas where treatment access may be otherwise hampered.

Details are also how to get a propecia prescription online still unknown about possible conditions – for instance, whether there will be a distance limit on rides to vaccination sites. Uber representatives said in response to Healthcare IT News' request for comment that the company will cover costs, "and these efforts are therefore not affecting driver earnings." Biden also plans to make billions of dollars in funding available to state and local leaders through the Federal Emergency Management Agency to fund the cost of in-person, phone and online outreach, and of making vaccinations available. Also, the administration will how to get a propecia prescription online announce partnerships between providers and community colleges to provide on-site vaccinations. THE LARGER TRENDBoth Lyft and Uber have made moves toward carving out footholds in the medical transport industry. The companies have teamed up with major electronic health how to get a propecia prescription online records vendors Epic and Cerner, respectively, to integrate ride-hailing into the EHR workflow.

While the organizations have announced in the past that they will support access to hair loss treatment vaccinations, the partnership with the White House appears to be the most ambitious yet. ON how to get a propecia prescription online THE RECORD "treatments are our best hope to beat this propecia, and soon everyone in America will be able to take a free Uber to get their shot," Uber CEO Dara Khosrowshahi said in a statement. "We are honored to deepen our previous global commitments, and partner with the White House and Lyft to provide free rides to vaccination sites across the U.S.," he added."More and more Americans continue to get vaccinated every day. Let’s keep moving forward, together." Kat Jercich how to get a propecia prescription online is senior editor of Healthcare IT News.Twitter. @kjercichEmail.

Kjercich@himss.orgHealthcare IT News is a HIMSS Media publication..

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€˜None of us will be buy propecia usa safe until everyone Renova 0.025 cream price is safe. Global access to hair loss treatments, buy propecia usa tests and treatments for everyone who needs them, anywhere, is the only way out’. This statement by Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO and Ursula von der Leyen, President of the European Commission1 has become the rallying call for hair loss treatment vaccination. The success buy propecia usa of a safe and efficacious hair loss treatment depends just not only on production and availability but also crucially on uptake.In countries such as the UK where hair loss treatment prioritisation and rollout are proceeding quickly, attitudes to vaccination have rapidly become a priority.2 treatment hesitancy (‘behavioural delay in acceptance or refusal of treatments despite availability of treatment services’)3 is not a single entity.

Reasons vary and there is a continuum from complete acceptance to refusal of all treatments, with treatment hesitancy lying buy propecia usa between the two poles. Factors involved include confidence (trusting or not the treatment or provider), complacency (seeing the need or value of a treatment) and convenience (easy, convenient access to the treatment).3 4 Importantly, attitudes to vaccination can change and people who are initially hesitant can still come to see a treatment’s safety, efficacy and necessity.5Developing strategies to address hesitancy is key.6 The expedited development and relative novelty of the hair loss treatments have led to public uncertainty.4 In addition, efforts to explain the mode of action of these treatments involve a degree of complexity (eg, immune response and genetic mechanisms), which is difficult to communicate quickly and simply. There are genuine knowledge voids (eg, long-term safety data), which in some cases have been filled with misinformation.7 Recent studies have assessed potential acceptance rates specifically for buy propecia usa the hair loss treatment. A UK study of more than 5000 adults using a validated scale found 71.7% were willing to be vaccinated, 16.6% were very unsure and 11.7% were strongly hesitant, with hesitancy relatively buy propecia usa evenly spread across the population.8 Willingness to take a treatment was closely bound to recognition of the collective importance of this decision as well as beliefs about the likelihood of hair loss treatment , the efficacy, speed of development and side effects of the treatment.

This implies that public information emphasising social benefits may be especially effective, at least in a majority of a population, and information that encourages mistrust or undermines social cohesion will lower treatment uptake.We also need to consider more focused strategies about treatment hesitancy for particular groups, including those groups who are most at risk of hesitancy and severe course of illness. As mental health clinicians, we assessed the impact of mental health conditions on hair loss treatment hesitancy and searched for current guidance in this area using a validated approach.9 We found that there is currently no specific buy propecia usa guidance in addressing treatment hesitancy in those with mental health difficulties,10 although it is recognised that this is a high-risk group who should be monitored. People with mental health issues, particularly with severe mental illness (SMI), are at particular risk both for with hair loss treatment and for more severe complications and higher mortality.11 Historically, the uptake of similar treatments such as the buy propecia usa influenza treatment in those with SMI can be as low as 25%,12 and so, similar to other low uptake groups, focused efforts are needed to increase this. Suggestions for change include offering specific discussions from mental health professionals and peer workers, treatment education and awareness focused for those with SMI, vaccination programmes within mental health services (with coexistent organisational change to facilitate this), alignment with other preventative health strategies (such as influenza vaccination, smoking cessation, metabolic monitoring), focused outreach and monitoring uptake.13Monitoring of vulnerable groups treatment uptake itself presents problems.

In the example of the UK, monitoring of buy propecia usa treatment coverage of most routine immunisation programmes relies on data extracted from primary care systems. To monitor vulnerable buy propecia usa groups, the data need to be specifically recorded. For example, Public Health England’s national immunisation equity audit in 2019 identified inequalities in uptake by a number of important variables (such as age, geography, ethnicity) but could not assess others including mental illness due to a lack of systematically collected data.14 Inequalities that were assessed by the audit were not only in overall coverage but also in timing of treatments and completion of treatment schedules. In addition, the extent of a particular inequality varies when it intersects buy propecia usa with one or more other factors.

In the case of mental illness, multiple long-term conditions across mental and physical health domains as well as socio-economic factors means that both vulnerability and inequality are likely to be additive.11 However, treatment impact may be greater among the most vulnerable despite lower treatment uptake because the baseline absolute risk is so high.15 Therefore, in the context of a hair loss treatment programme, even if treatment uptake falls short in some high-risk groups, even small increases in treatment uptake will still have significant health benefits.14Uptake of vaccination is crucial both buy propecia usa for the individual and protection of others. It is in everyone’s interests to ensure that groups where a low uptake is predicted have extra care and input. At the moment there is little formal guidance on how to support those buy propecia usa with mental health issues to access clear and reliable information, and practical and easy access to vaccination for those who are willing. If we are to ensure that ‘everyone is safe’, we need a concerted and global effort16 to guide and focus strategies to support and inform those who are both potentially most hesitant and most vulnerable, including and prioritising those with mental health difficulties..

€˜None of us will Renova 0.025 cream price be safe how to get a propecia prescription online until everyone is safe. Global access how to get a propecia prescription online to hair loss treatments, tests and treatments for everyone who needs them, anywhere, is the only way out’. This statement by Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO and Ursula von der Leyen, President of the European Commission1 has become the rallying call for hair loss treatment vaccination.

The success of a safe and efficacious hair loss treatment depends just not only on production and availability but also crucially on uptake.In countries such as the UK where hair loss treatment prioritisation and rollout are proceeding quickly, attitudes to vaccination have rapidly become a priority.2 treatment hesitancy (‘behavioural delay in acceptance or refusal of treatments despite how to get a propecia prescription online availability of treatment services’)3 is not a single entity. Reasons vary and there is a continuum from complete acceptance to refusal of all treatments, with treatment hesitancy lying how to get a propecia prescription online between the two poles. Factors involved include confidence (trusting or not the treatment or provider), complacency (seeing the need or value of a treatment) and convenience (easy, convenient access to the treatment).3 4 Importantly, attitudes to vaccination can change and people who are initially hesitant can still come to see a treatment’s safety, efficacy and necessity.5Developing strategies to address hesitancy is key.6 The expedited development and relative novelty of the hair loss treatments have led to public uncertainty.4 In addition, efforts to explain the mode of action of these treatments involve a degree of complexity (eg, immune response and genetic mechanisms), which is difficult to communicate quickly and simply.

There are genuine knowledge voids how to get a propecia prescription online (eg, long-term safety data), which in some cases have been filled with misinformation.7 Recent studies have assessed potential acceptance rates specifically for the hair loss treatment. A UK study of more than how to get a propecia prescription online 5000 adults using a validated scale found 71.7% were willing to be vaccinated, 16.6% were very unsure and 11.7% were strongly hesitant, with hesitancy relatively evenly spread across the population.8 Willingness to take a treatment was closely bound to recognition of the collective importance of this decision as well as beliefs about the likelihood of hair loss treatment , the efficacy, speed of development and side effects of the treatment. This implies that public information emphasising social benefits may be especially effective, at least in a majority of a population, and information that encourages mistrust or undermines social cohesion will lower treatment uptake.We also need to consider more focused strategies about treatment hesitancy for particular groups, including those groups who are most at risk of hesitancy and severe course of illness.

As mental health clinicians, we assessed the impact of mental health conditions on hair loss treatment hesitancy and how to get a propecia prescription online searched for current guidance in this area using a validated approach.9 We found that there is currently no specific guidance in addressing treatment hesitancy in those with mental health difficulties,10 although it is recognised that this is a high-risk group who should be monitored. People with mental health issues, particularly with severe mental illness (SMI), are at particular risk both for with hair loss treatment and for more how to get a propecia prescription online severe complications and higher mortality.11 Historically, the uptake of similar treatments such as the influenza treatment in those with SMI can be as low as 25%,12 and so, similar to other low uptake groups, focused efforts are needed to increase this. Suggestions for change include offering specific discussions from mental health professionals and peer workers, treatment education and awareness focused for those with SMI, vaccination programmes within mental health services (with coexistent organisational change to facilitate this), alignment with other preventative health strategies (such as influenza vaccination, smoking cessation, metabolic monitoring), focused outreach and monitoring uptake.13Monitoring of vulnerable groups treatment uptake itself presents problems.

In the example of the UK, monitoring of treatment coverage of most routine immunisation programmes relies on how to get a propecia prescription online data extracted from primary care systems. To monitor how to get a propecia prescription online vulnerable groups, the data need to be specifically recorded. For example, Public Health England’s national immunisation equity audit in 2019 identified inequalities in uptake by a number of important variables (such as age, geography, ethnicity) but could not assess others including mental illness due to a lack of systematically collected data.14 Inequalities that were assessed by the audit were not only in overall coverage but also in timing of treatments and completion of treatment schedules.

In addition, how to get a propecia prescription online the extent of a particular inequality varies when it intersects with one or more other factors. In the case of mental illness, multiple long-term conditions across mental and physical health domains as well as socio-economic factors means that both vulnerability and inequality are likely to be additive.11 However, treatment impact may be greater among the most vulnerable despite lower treatment uptake because the baseline absolute risk is how to get a propecia prescription online so high.15 Therefore, in the context of a hair loss treatment programme, even if treatment uptake falls short in some high-risk groups, even small increases in treatment uptake will still have significant health benefits.14Uptake of vaccination is crucial both for the individual and protection of others. It is in everyone’s interests to ensure that groups where a low uptake is predicted have extra care and input.

At the moment there is little formal guidance on how to support how to get a propecia prescription online those with mental health issues to access clear and reliable information, and practical and easy access to vaccination for those who are willing. If we are to ensure that ‘everyone is safe’, we need a concerted and global effort16 to guide and focus strategies to support and inform those who are both potentially most hesitant and most vulnerable, including and prioritising those with mental health difficulties..

Propecia case study solution

The items below are highlights from the free propecia case study solution newsletter, “Smart, useful, science stuff about hair loss treatment.” To receive newsletter issues daily in your inbox, sign up here. Katelyn Jetelina updated her hair loss treatment comparisons table on 5/20/21 at her site Your Local Epidemiologist. Highlights include the latest data on how well propecia case study solution various treatments protect against hair loss variants. The post also includes a helpful discussion of two ways that researchers measure how well a treatment works – efficacy (analyzing the extent of disease protection in experiments) and immunogenicity (analyzing levels of a type of antibodies made in response to a pathogen over time).

A total of 23 U.S. States and Washington, D.C., recently have changed their face-coverings and mask guidance in response to last week's Centers for Disease Control’s update to its guidance for fully vaccinated people, reports Lindsay Kalter propecia case study solution for WebMD (5/18/21). The WebMD story’s second page links to various state plans for lifting mask mandates. A growing body of evidence, including a study published 5/15/21 in The Lancet and another published 5/6/21 in JAMA, suggests that the Pfizer-BioNTech treatment not only protects us against moderate or propecia case study solution severe hair loss treatment.

It also protects us against getting infected at all with hair loss and thereby protects against us transmitting s to others. Lower amounts of the propecia persist in the nasal passages of vaccinated people than in those of unvaccinated people, Dr. Anthony Fauci said 5/16/21 on CBS News’ “Face the Nation.” There are very rare “breakthrough s” of hair loss in vaccinated people, but “almost always the people [with these s] are asymptomatic [feel no symptoms], and the level of propecia is so low, it makes it extremely unlikely, not impossible, but very, very low likelihood that they propecia case study solution are going to transmit it,” Fauci said. These findings, along with ongoing evidence that the treatments are safe and effective, even against hair loss variants, provided the scientific basis for the U.S.

Centers for Disease Control’s guidance (5/13/21) stating that vaccinated people no longer need to wear masks nor socially distance in most indoor and propecia case study solution outdoor settings, even crowded ones, reports Apoorva Mandavilli at The New York Times (5/14/21). In a New York Times survey conducted between April 28 and May 10, 85% of more than 700 epidemiologists responded that they think people in the U.S. Will be able to safely gather outdoors on the Fourth of July, as the nation “rounds the bend” (as some writers put it) on the hair loss treatment propecia. Nearly the same percentage of propecia case study solution epidemiologists think that U.S.

Schools can safely reopen in the fall, according to the survey results, as reported by the Times. Another notable finding from the survey. The majority (59%) of the surveyed epidemiologists think that vaccination rates are the most important propecia case study solution statistic to examine when considering whether to "resume most pre-propecia activities without new hair loss treatment-era precautions.” So, what vaccination rate or level should you look for?. "Half of respondents said at least 80 percent of Americans, including children, would need to be vaccinated before it would be safe to do most activities without precautions," write Claire Cain Miller, Kevin Quealy, and Margo Sanger-Katz (5/15/21).

And where propecia case study solution does one find U.S. Federal, state, and county vaccination rates?. Some experts frequently consult The New York Times' various hair loss treatment dashboards, including this U.S. Vaccinations tracker, which allows you to look up the percentage of people in each U.S propecia case study solution.

County who are fully vaccinated. Of course, propecia case study solution any single statistical measure provides limited information. Additional factors that influence a region’s hair loss risk include local immunity among people who have recovered from hair loss s or hair loss treatment in the past 14 months (areas that have recovered from hair loss surges will have higher rates of this “natural immunity”) as well as public-health measures such as masking and distancing requirements. In freelance journalist Tara Haelle’s 5/13/21 story for Scientific American about the recent U.S.

Authorization for use of the propecia case study solution Pfizer-BioNTech treatment in adolescents, I learned about a site called VaxTeen. The site states that it is designed to address “the decline in vaccinations” in the U.S. By directly informing teenagers and young adults about treatment misinformation and encouraging these groups to catch up on any missing shots propecia case study solution. One of the site’s main resources is a state-by-state index where teens may look up their legal rights to obtain a vaccination without parental consent.

Each state entry includes a statement on how the local laws pertain to hair loss treatment vaccinations. Accumulating research reveals that hair loss treatments propecia case study solution are safe and effective during pregnancy, even against some of the hair loss variants (e.g. B.1.1.7, first identified in the UK, and B.1.351, first identified in South Africa), reports Emily Anthes for The New York Times (5/13/21). €œVaccinated women can also pass protective antibodies to their fetuses through the bloodstream and to their infants through breast milk,” Anthes writes, describing the results of a study published 5/13/21 in JAMA.

And neither the Pfizer-BioNTech treatment nor the Moderna treatment harms the placenta during pregnancy, Anthes describes a 5/11/21 propecia case study solution study as concluding. More research is needed to study these same questions in women at earlier stages of pregnancy, the story states. You might propecia case study solution enjoy, “An open letter to sleep. We need to talk,” by Viktoria Shulevich for McSweeney’s (5/20/21).

This is an opinion and analysis article.The following essay is reprinted with permission from The Conversation, an online publication covering the latest research. The Food and Drug Administration propecia case study solution expanded emergency use authorization of the Pfizer-BioNTech hair loss treatment to include adolescents 12 to 15 years of age on May 10, 2021. The Centers for Disease Control and Prevention followed with recommendations endorsing use in this age group after their advisory group meeting on May 12. The American propecia case study solution Academy of Pediatrics also supports this decision.

Dr. Debbie-Ann Shirley is an associate professor of pediatrics at the University of Virginia specializing in pediatric infectious diseases. Here she addresses some of the concerns parents may have about their teen or preteen propecia case study solution getting the hair loss treatment. 1.

Does the propecia case study solution treatment work in adolescents?. Yes, recently released data from Pfizer-BioNTech shows that the hair loss treatment seems to work really well in this age group. The hair loss treatment was found to be 100% efficacious in preventing symptomatic hair loss treatment in an ongoing clinical trial of children in the U.S. Aged 12 to propecia case study solution 15.

Adolescents made high levels of antibody in response to the treatment, and their immune response was just as strong as what has been seen in older teens and young adults 16-25 years of age. 2. How do I know whether the treatment is safe propecia case study solution for my child?. So far, the hair loss treatment appears to be safe and well tolerated in adolescents.

All of the hair loss treatments authorized propecia case study solution for use in the U.S. Have undergone rigorous study, but we don’t want to assume that children are little adults. This is why it is so important to study these treatments just as carefully in children before health authorities could recommend use. Ongoing studies will continue to follow vaccinated children closely and robust safety monitoring will help propecia case study solution rapidly identify rare or unexpected concerns if they emerge.

3. I thought children were low-risk – do they still need propecia case study solution to get the treatment?. Currently, children represent nearly one-quarter of all new reported weekly hair loss treatment cases in the U.S. While serious illness from hair loss treatment is rare in children, it does occur – thousands of children have been hospitalized and at least 351 children have died from hair loss treatment in the U.S.

Some children who get seriously ill from hair loss treatment may have underlying health propecia case study solution conditions, but not all do. Vaccination will help protect children from developing serious illness. Additionally, since adolescents can transmit hair loss treatment to others, vaccinating children may prove to be an important part of safely getting back to normal activities of life, including attending school in person, participating in team sports and spending propecia case study solution time with friends. A large survey of school-aged children showed that children in full or partial virtual school reported lower levels of physical activity, less in-person time socializing with friends and worse mental or emotional health compared with those receiving full in-person schooling.

Children are experiencing unprecedented increases in indirect adverse health and educational consequences related to the propecia, and we need to find ways to help them get quickly and safely back to normal life. Vaccination is one of propecia case study solution them. 4. What side effects might I expect for my child?.

Nonsevere side effects may be experienced following vaccination propecia case study solution. The most commonly reported side effects have been pain and swelling at the injection site. Other common side effects include propecia case study solution tiredness and headache. Similar to young adults, some adolescents have experienced fever, chills, muscle aches and joint pain, which may be more common after the second dose.

These effects are short-lived, however, and most resolve within one to two days. Some adolescents may propecia case study solution faint when receiving an injection. If this is a concern for your child, let your treatment administration site know ahead of time – your child can be given the treatment while they’re seated or lying down to avoid injuries from falling. 5.

Have there been any severe reactions among children?. No serious adverse events related to vaccination were reported in the Pfizer-BioNTech clinical trial. Serious allergic reactions have rarely been reported in older people. Anyone with a known severe or immediate allergy to the treatment or any component of the treatment should not get the treatment.

If your child has a history of any severe allergic reactions or any type of immediate allergic reaction to a treatment or injectable therapy, let the treatment site administrator know so that your child can be monitored for at least 30 minutes after getting the treatment. Parents should talk to a trusted health care provider or allergist if they have specific questions about the possibility of an allergic reaction in their child. 6. When will a hair loss treatment be authorized for children younger than 12 years?.

hair loss treatment makers have begun or are planning to begin testing hair loss treatments in younger children. As more information becomes available, the authorized age recommendations may change. Children ages 2-11 years old could potentially be eligible as early as the end of this year. 7.

If I’ve been vaccinated but my child hasn’t, could I still give the propecia to them?. The hair loss treatments do not contain live hair loss treatment propecia, so they cannot cause hair loss treatment. Rather, getting vaccinated will help protect both you and your children from hair loss treatment. Studies have shown that vaccinated pregnant and lactating mothers can pass protective immunity on to their young infants across the placenta and in breast milk—one more benefit of vaccination.

Though researchers are still learning how well the treatment can help prevent spread, vaccination is still an important way to limit infecting people who are not yet eligible for the treatment, like younger children. This article was originally published on The Conversation. Read the original article.President Biden thrust his administration into a race to confront the economic risks of global warming by signing an executive order yesterday that brought the once niche issue of climate finance into the highest levels of government. The long-awaited directive requires federal agencies to assess the economic dangers that rising temperatures could have on the government—and homeowners, retirees, businesses and the U.S.

Financial system. It marks a major turning point for U.S. Financial policy, which until last year was mostly silent on an issue that had for years been a priority among European nations. The order directs White House officials and Cabinet secretaries to take a series of steps to prod regulators of banking, housing and other industries to identify and address the risks facing the economy.

€œOur modern financial system was built on the assumption that the climate was stable. And that assumption has largely dominated existing financial models, and it underpinned the way that we invest capital, the way that we have built society, and the way that we have forecasted for the long term,” said Brian Deese, director of the National Economic Council. €œToday, it’s clear that we no longer live in such a world.” Deese and national climate adviser Gina McCarthy will develop a strategy to identify and disclose the climate vulnerabilities faced by government programs, assets and liabilities. That plan is due within 120 days.

The Office of Management and Budget and the departments of the Treasury and Labor will also play key roles. Labor Secretary Marty Walsh will work to “bolster the resilience of life savings and pensions,” the order said. That could include revising and rescinding Trump-era rulemakings that targeted efforts by retirement fund managers to account for social and environmental factors while investing on their clients’ behalf (Climatewire, Oct. 2, 2020).

The White House budget office and other agencies will assess the government’s exposure to increased costs and lost revenue from the mounting effects of climate change. As part of that effort, federal suppliers could be required to report and reduce their carbon footprints. The order called on Treasury Secretary Janet Yellen to leverage her position as chair of the Financial Stability Oversight Council to work with the Federal Reserve, the Securities and Exchange Commission and other regulators to zero in on climate risks to the federal government and the nation’s financial system. Yellen and the council—which was established in the aftermath of the 2007-08 financial crisis—were instructed by Biden’s order to issue a report within 180 days.

The White House said the document should show how those regulators are accounting for the climate vulnerabilities of banks, insurers and other firms they supervise. Sustainable finance proponents say that’s a powerful lever, because the Financial Stability Oversight Council is the most direct point of contact between the administration and independent financial agencies—which don’t take orders from the White House. Justin Guay of the Sunrise Project said the provision is the “most important component of the whole order.” “It’s a starting gun sending Treasury on a 180 day race to define the plan. This is a nascent space [and] we have an incredible opportunity for ambitious regulation, not incremental change,” Guay tweeted yesterday.

Some financial regulators had already begun moving in that direction. The Commodity Futures Trading Commission in September became the first U.S. Agency to formally flag the possibility that rising temperatures could upend U.S. Financial stability.

A few months later, the Fed joined a global group of central banks and other regulators working to address systemic climate risks. And the SEC requested public input in March about steps it should take to ensure that public companies are transparent about their climate risks and impacts. Those efforts drew the ire of Republican lawmakers who question the validity of financial risks from climate change (Climatewire, May 13). McCarthy noted during a call with reporters yesterday that efforts to enhance climate risk disclosure have been spearheaded by companies in the absence of regulations.

€œBut it simply isn’t enough,” she said. €œThis cannot be optional. This cannot be voluntary. The stakes are simply too high.” Deese doubled down on that point.

A key purpose of the executive order, he said, is to “advance consistent, clear, intelligible, comparable and accurate disclosure of climate-related financial risk, including both physical and transitional risk.” Equally important, he said, is actually acting on that risk—and accounting for how it disproportionately affects disadvantaged communities, including people of color. Finance-focused climate advocates, who for months called on Biden to get going on the issue, applauded the move. The reports required by the order are due as world leaders will meet for a U.N. Climate conference, known as a COP, or conference of the parties to the U.N.

Framework Convention on Climate Change, in Scotland later this year. €œWe expect and hope to see action continue and accelerate over the next few months in the lead-up to COP, and regulators shouldn’t wait for these reports to be finalized to use the tools they already have,” said Ben Cushing, who directs the Sierra Club’s finance campaign. Cushing said he was pleased to see the Biden administration acknowledge that “it’s not enough to just focus on measuring and disclosing risks.” Guay of the Sunrise Project agreed. €œThis is a plan to mitigate systemic risk—not just disclose it.” Reprinted from E&E News with permission from POLITICO, LLC.

Copyright 2021. E&E News provides essential news for energy and environment professionals.From corn to coal to cannabis, cultures and economies are shaped by their surrounding ecology. Nations have been built on tobacco, communities defined by migrating salmon, and wars fought in the name of spices. Political and economic decisions can also alter a region’s ecology.

Post-Columbian maritime trade initiated the accidental and intentional redistribution of plants, animals, bacteria and propeciaes, which continues to this day. Ecological changes spurred by politics can also be positive. For example, wildlife thrives in the demilitarized zone (DMZ) between North and South Korea. The Cuban Revolution and the subsequent U.S.-sponsored economic blockade are preeminent global geopolitical events that define Cuba’s modern socioeconomic character.

Has Cuba’s distinctive economy also impacted its modern ecology?. Cuba is among the largest and most biodiverse islands in the world. Islands are hotspots of diversity and endemism, but they are also hotbeds of nonnative species—those far from their evolutionary home. One in three plant species on islands are typically nonnative, and bigger islands with a range of habitats and native plant diversity foster the most nonnatives.

Our team of U.S. And Cuban scientists, however, documented that Cuba hosts far fewer nonnative plants than expected. It lacks 177 nonnative plant species present on other Caribbean islands, despite the unparalleled and well-documented range of tropical habitats contained on the Cuban archipelago, which comprises over a third of the land area and more than half of the islands in the Caribbean. Only one in eight plant species found in Cuba originated elsewhere, less than half the global average for islands.

It supports about the same number of nonnative species as much smaller and less habitat-rich islands, such as Puerto Rico—a tenth its size. Cuba also has fewer nonnative reptile and amphibian species than neighboring islands. Cuba’s economic self-sufficiency may be the inadvertent mechanism that limited introduction of nonnative species. The worldwide spread of such species is largely a biproduct of the exchange of merchandise and services, which accelerated globally post-1960s just as Cuba’s economy became increasingly closed.

Although the establishment of nonnative species has increased over the past two centuries, invasion rates are highest in the last quarter century. In those recent decades, Cuba imported less than 20 percent of its gross domestic product (GDP), half the expectation for an island nation of its size. Cuba is the least import-dependent island in the Caribbean. The only island without a dominant U.S.-based import market.

And the least connected to inter-Caribbean trade. Many Caribbean island economies are powered by tourism. Tens of millions of visitors, along with the goods that support them, move to and among the islands each year. Here, too, Cuba is an outlier in the Caribbean.

Proportionally fewer visitors arrive in Cuba now than in the 1950s, and Cuba is excluded from the predominant US-based market, including Caribbean cruises that move nearly as many tourists as airplanes. Although international trade is more commonly implicated as the vector for nonnative species introductions, tourism is an essential factor in understanding nonnative species patterns. On the dozens of Caribbean islands that we studied, Cuba included, tourism combined with island area explained 90 percent of the pattern in nonnative plant occurrence. Larger islands with more tourists per unit area had the most nonnative species.

Trade was negligible—surprisingly so—in explaining invasion patterns. Tourists can directly transport plants and seeds in their luggage and footwear. Food and other goods for tourists can also encourage nonnative species and hitchhiking pests. Nonnative species are routinely planted for landscaping at hotels and other tourism infrastructure, and a recent study found that half of the invasive plants in the Caribbean were intentionally introduced for ornamental purposes.

Notwithstanding its past, Cuba is susceptible to future invasions. To the extent that its economic isolation provides an unintended defense from nonnative species, the expansion of tourism and trade may renew pathways for species to arrive and thrive. Cuba’s recent investment in the tourism sector has already increased visitors, and policy directives and port expansions will bring more trade. Cuba’s geography and native ecology predict the capacity of the island to support many more nonnative plants.

The eminent spread and the deleterious impacts of nonnative species threaten the immense biodiversity of Cuba and the Caribbean, which is the very foundation of the region’s ecological stability and an attraction to tourists. As the Cuban political leadership transitions to a new generation, and with prospects of thawing U.S.-Cuban relations, now is the time to consider shared policies between the countries to limit future exchange of nonnative species. As botanist and explorer Joseph Banks wrote during the Napoleonic Wars, “The science of two nations may be at peace while their politics are at war.” To that end, scientists and natural resource managers can identify species at most risk to establish in Cuba and also move from Cuba to the U.S. Mainland and Puerto Rico.

When U.S. Conflicts with China and Vietnam were resolved, more pests were intercepted in cargo originating from these countries at U.S. Borders, which is both a cautionary tale and support for the importance of biosecurity measures. With normalizing economic policies, best practices that intentionally stem invasions, such as those used by New Zealand, South Africa and Hawaii, will be important.

Islands are shaped by the oceans that isolate them, as economies and cultures are defined by their surrounding ecology. Those forces collide in the Caribbean, where islands have long been influenced by peripheral economies, including European colonization and slave-supported agriculture for tobacco and nonnative sugarcane. Contemporary tourism and trade continue the reciprocal linkage between an island’s environment and the culture, economy and politics of its people. The nonnative plant communities on Caribbean islands, as elsewhere, result from centuries of human influence and natural processes, which collectively demonstrate that forward-thinking policy can help conserve the ecology of the Caribbean as it responds to changing political, biological and climatic forces.

The items below are highlights how to get a propecia prescription online from the free newsletter, “Smart, useful, science stuff about hair loss treatment.” To receive newsletter issues daily in your inbox, sign up here. Katelyn Jetelina updated her hair loss treatment comparisons table on 5/20/21 at her site Your Local Epidemiologist. Highlights include the latest data on how well various treatments protect against how to get a propecia prescription online hair loss variants.

The post also includes a helpful discussion of two ways that researchers measure how well a treatment works – efficacy (analyzing the extent of disease protection in experiments) and immunogenicity (analyzing levels of a type of antibodies made in response to a pathogen over time). A total of 23 U.S. States and Washington, D.C., recently have changed their face-coverings and mask guidance in response to last week's Centers for Disease how to get a propecia prescription online Control’s update to its guidance for fully vaccinated people, reports Lindsay Kalter for WebMD (5/18/21).

The WebMD story’s second page links to various state plans for lifting mask mandates. A growing body of evidence, including a study published 5/15/21 in how to get a propecia prescription online The Lancet and another published 5/6/21 in JAMA, suggests that the Pfizer-BioNTech treatment not only protects us against moderate or severe hair loss treatment. It also protects us against getting infected at all with hair loss and thereby protects against us transmitting s to others.

Lower amounts of the propecia persist in the nasal passages of vaccinated people than in those of unvaccinated people, Dr. Anthony Fauci said 5/16/21 on CBS News’ “Face the Nation.” There how to get a propecia prescription online are very rare “breakthrough s” of hair loss in vaccinated people, but “almost always the people [with these s] are asymptomatic [feel no symptoms], and the level of propecia is so low, it makes it extremely unlikely, not impossible, but very, very low likelihood that they are going to transmit it,” Fauci said. These findings, along with ongoing evidence that the treatments are safe and effective, even against hair loss variants, provided the scientific basis for the U.S.

Centers for Disease Control’s guidance (5/13/21) stating that vaccinated people no longer need to wear masks nor socially distance in most indoor and outdoor settings, even crowded ones, reports Apoorva how to get a propecia prescription online Mandavilli at The New York Times (5/14/21). In a New York Times survey conducted between April 28 and May 10, 85% of more than 700 epidemiologists responded that they think people in the U.S. Will be able to safely gather outdoors on the Fourth of July, as the nation “rounds the bend” (as some writers put it) on the hair loss treatment propecia.

Nearly the same percentage of epidemiologists think that how to get a propecia prescription online U.S. Schools can safely reopen in the fall, according to the survey results, as reported by the Times. Another notable finding from the survey.

The majority (59%) of the surveyed epidemiologists think that vaccination rates are the most important statistic to examine when considering whether to "resume most pre-propecia activities without new how to get a propecia prescription online hair loss treatment-era precautions.” So, what vaccination rate or level should you look for?. "Half of respondents said at least 80 percent of Americans, including children, would need to be vaccinated before it would be safe to do most activities without precautions," write Claire Cain Miller, Kevin Quealy, and Margo Sanger-Katz (5/15/21). And where does one find how to get a propecia prescription online U.S.

Federal, state, and county vaccination rates?. Some experts frequently consult The New York Times' various hair loss treatment dashboards, including this U.S. Vaccinations tracker, which allows you to look up the percentage of people in each U.S how to get a propecia prescription online.

County who are fully vaccinated. Of course, any how to get a propecia prescription online single statistical measure provides limited information. Additional factors that influence a region’s hair loss risk include local immunity among people who have recovered from hair loss s or hair loss treatment in the past 14 months (areas that have recovered from hair loss surges will have higher rates of this “natural immunity”) as well as public-health measures such as masking and distancing requirements.

In freelance journalist Tara Haelle’s 5/13/21 story for Scientific American about the recent U.S. Authorization for use of the Pfizer-BioNTech treatment in adolescents, I how to get a propecia prescription online learned about a site called VaxTeen. The site states that it is designed to address “the decline in vaccinations” in the U.S.

By directly informing teenagers and how to get a propecia prescription online young adults about treatment misinformation and encouraging these groups to catch up on any missing shots. One of the site’s main resources is a state-by-state index where teens may look up their legal rights to obtain a vaccination without parental consent. Each state entry includes a statement on how the local laws pertain to hair loss treatment vaccinations.

Accumulating research reveals that hair loss treatments are safe and effective during pregnancy, even against how to get a propecia prescription online some of the hair loss variants (e.g. B.1.1.7, first identified in the UK, and B.1.351, first identified in South Africa), reports Emily Anthes for The New York Times (5/13/21). €œVaccinated women can also pass protective antibodies to their fetuses through the bloodstream and to their infants through breast milk,” Anthes writes, describing the results of a study published 5/13/21 in JAMA.

And neither the Pfizer-BioNTech treatment nor the Moderna treatment harms the how to get a propecia prescription online placenta during pregnancy, Anthes describes a 5/11/21 study as concluding. More research is needed to study these same questions in women at earlier stages of pregnancy, the story states. You might enjoy, “An how to get a propecia prescription online open letter to sleep.

We need to talk,” by Viktoria Shulevich for McSweeney’s (5/20/21). This is an opinion and analysis article.The following essay is reprinted with permission from The Conversation, an online publication covering the latest research. The Food and Drug Administration expanded emergency use authorization of the how to get a propecia prescription online Pfizer-BioNTech hair loss treatment to include adolescents 12 to 15 years of age on May 10, 2021.

The Centers for Disease Control and Prevention followed with recommendations endorsing use in this age group after their advisory group meeting on May 12. The American Academy how to get a propecia prescription online of Pediatrics also supports this decision. Dr.

Debbie-Ann Shirley is an associate professor of pediatrics at the University of Virginia specializing in pediatric infectious diseases. Here she addresses some of the concerns how to get a propecia prescription online parents may have about their teen or preteen getting the hair loss treatment. 1.

Does the how to get a propecia prescription online treatment work in adolescents?. Yes, recently released data from Pfizer-BioNTech shows that the hair loss treatment seems to work really well in this age group. The hair loss treatment was found to be 100% efficacious in preventing symptomatic hair loss treatment in an ongoing clinical trial of children in the U.S.

Aged 12 to how to get a propecia prescription online 15. Adolescents made high levels of antibody in response to the treatment, and their immune response was just as strong as what has been seen in older teens and young adults 16-25 years of age. 2.

How do I know whether the treatment is safe for how to get a propecia prescription online my child?. So far, the hair loss treatment appears to be safe and well tolerated in adolescents. All of the hair loss treatments how to get a propecia prescription online authorized for use in the U.S.

Have undergone rigorous study, but we don’t want to assume that children are little adults. This is why it is so important to study these treatments just as carefully in children before health authorities could recommend use. Ongoing studies will continue to follow vaccinated children closely and robust safety monitoring will help rapidly how to get a propecia prescription online identify rare or unexpected concerns if they emerge.

3. I thought children were low-risk how to get a propecia prescription online – do they still need to get the treatment?. Currently, children represent nearly one-quarter of all new reported weekly hair loss treatment cases in the U.S.

While serious illness from hair loss treatment is rare in children, it does occur – thousands of children have been hospitalized and at least 351 children have died from hair loss treatment in the U.S. Some children who get seriously how to get a propecia prescription online ill from hair loss treatment may have underlying health conditions, but not all do. Vaccination will help protect children from developing serious illness.

Additionally, since adolescents can transmit hair loss treatment to others, vaccinating children may prove to be an important part of safely getting back to normal activities of life, including attending school in person, participating in team sports and spending time with friends how to get a propecia prescription online. A large survey of school-aged children showed that children in full or partial virtual school reported lower levels of physical activity, less in-person time socializing with friends and worse mental or emotional health compared with those receiving full in-person schooling. Children are experiencing unprecedented increases in indirect adverse health and educational consequences related to the propecia, and we need to find ways to help them get quickly and safely back to normal life.

Vaccination is how to get a propecia prescription online one of them. 4. What side effects might I expect for my child?.

Nonsevere side how to get a propecia prescription online effects may be experienced following vaccination. The most commonly reported side effects have been pain and swelling at the injection site. Other common side effects include tiredness and how to get a propecia prescription online headache.

Similar to young adults, some adolescents have experienced fever, chills, muscle aches and joint pain, which may be more common after the second dose. These effects are short-lived, however, and most resolve within one to two days. Some adolescents may faint when receiving how to get a propecia prescription online an injection.

If this is a concern for your child, let your treatment administration site know ahead of time – your child can be given the treatment while they’re seated or lying down to avoid injuries from falling. 5. Have there been any severe reactions among children?.

No serious adverse events related to vaccination were reported in the Pfizer-BioNTech clinical trial. Serious allergic reactions have rarely been reported in older people. Anyone with a known severe or immediate allergy to the treatment or any component of the treatment should not get the treatment.

If your child has a history of any severe allergic reactions or any type of immediate allergic reaction to a treatment or injectable therapy, let the treatment site administrator know so that your child can be monitored for at least 30 minutes after getting the treatment. Parents should talk to a trusted health care provider or allergist if they have specific questions about the possibility of an allergic reaction in their child. 6.

When will a hair loss treatment be authorized for children younger than 12 years?. hair loss treatment makers have begun or are planning to begin testing hair loss treatments in younger children. As more information becomes available, the authorized age recommendations may change.

Children ages 2-11 years old could potentially be eligible as early as the end of this year. 7. If I’ve been vaccinated but my child hasn’t, could I still give the propecia to them?.

The hair loss treatments do not contain live hair loss treatment propecia, so they cannot cause hair loss treatment. Rather, getting vaccinated will help protect both you and your children from hair loss treatment. Studies have shown that vaccinated pregnant and lactating mothers can pass protective immunity on to their young infants across the placenta and in breast milk—one more benefit of vaccination.

Though researchers are still learning how well the treatment can help prevent spread, vaccination is still an important way to limit infecting people who are not yet eligible for the treatment, like younger children. This article was originally published on The Conversation. Read the original article.President Biden thrust his administration into a race to confront the economic risks of global warming by signing an executive order yesterday that brought the once niche issue of climate finance into the highest levels of government.

The long-awaited directive requires federal agencies to assess the economic dangers that rising temperatures could have on the government—and homeowners, retirees, businesses and the U.S. Financial system. It marks a major turning point for U.S.

Financial policy, which until last year was mostly silent on an issue that had for years been a priority among European nations. The order directs White House officials and Cabinet secretaries to take a series of steps to prod regulators of banking, housing and other industries to identify and address the risks facing the economy. €œOur modern financial system was built on the assumption that the climate was stable.

And that assumption has largely dominated existing financial models, and it underpinned the way that we invest capital, the way that we have built society, and the way that we have forecasted for the long term,” said Brian Deese, director of the National Economic Council. €œToday, it’s clear that we no longer live in such a world.” Deese and national climate adviser Gina McCarthy will develop a strategy to identify and disclose the climate vulnerabilities faced by government programs, assets and liabilities. That plan is due within 120 days.

The Office of Management and Budget and the departments of the Treasury and Labor will also play key roles. Labor Secretary Marty Walsh will work to “bolster the resilience of life savings and pensions,” the order said. That could include revising and rescinding Trump-era rulemakings that targeted efforts by retirement fund managers to account for social and environmental factors while investing on their clients’ behalf (Climatewire, Oct.

2, 2020). The White House budget office and other agencies will assess the government’s exposure to increased costs and lost revenue from the mounting effects of climate change. As part of that effort, federal suppliers could be required to report and reduce their carbon footprints.

The order called on Treasury Secretary Janet Yellen to leverage her position as chair of the Financial Stability Oversight Council to work with the Federal Reserve, the Securities and Exchange Commission and other regulators to zero in on climate risks to the federal government and the nation’s financial system. Yellen and the council—which was established in the aftermath of the 2007-08 financial crisis—were instructed by Biden’s order to issue a report within 180 days. The White House said the document should show how those regulators are accounting for the climate vulnerabilities of banks, insurers and other firms they supervise.

Sustainable finance proponents say that’s a powerful lever, because the Financial Stability Oversight Council is the most direct point of contact between the administration and independent financial agencies—which don’t take orders from the White House. Justin Guay of the Sunrise Project said the provision is the “most important component of the whole order.” “It’s a starting gun sending Treasury on a 180 day race to define the plan. This is a nascent space [and] we have an incredible opportunity for ambitious regulation, not incremental change,” Guay tweeted yesterday.

Some financial regulators had already begun moving in that direction. The Commodity Futures Trading Commission in September became the first U.S. Agency to formally flag the possibility that rising temperatures could upend U.S.

Financial stability. A few months later, the Fed joined a global group of central banks and other regulators working to address systemic climate risks. And the SEC requested public input in March about steps it should take to ensure that public companies are transparent about their climate risks and impacts.

Those efforts drew the ire of Republican lawmakers who question the validity of financial risks from climate change (Climatewire, May 13). McCarthy noted during a call with reporters yesterday that efforts to enhance climate risk disclosure have been spearheaded by companies in the absence of regulations. €œBut it simply isn’t enough,” she said.

€œThis cannot be optional. This cannot be voluntary. The stakes are simply too high.” Deese doubled down on that point.

A key purpose of the executive order, he said, is to “advance consistent, clear, intelligible, comparable and accurate disclosure of climate-related financial risk, including both physical and transitional risk.” Equally important, he said, is actually acting on that risk—and accounting for how it disproportionately affects disadvantaged communities, including people of color. Finance-focused climate advocates, who for months called on Biden to get going on the issue, applauded the move. The reports required by the order are due as world leaders will meet for a U.N.

Climate conference, known as a COP, or conference of the parties to the U.N. Framework Convention on Climate Change, in Scotland later this year. €œWe expect and hope to see action continue and accelerate over the next few months in the lead-up to COP, and regulators shouldn’t wait for these reports to be finalized to use the tools they already have,” said Ben Cushing, who directs the Sierra Club’s finance campaign.

Cushing said he was pleased to see the Biden administration acknowledge that “it’s not enough to just focus on measuring and disclosing risks.” Guay of the Sunrise Project agreed. €œThis is a plan to mitigate systemic risk—not just disclose it.” Reprinted from E&E News with permission from POLITICO, LLC. Copyright 2021.

E&E News provides essential news for energy and environment professionals.From corn to coal to cannabis, cultures and economies are shaped by their surrounding ecology. Nations have been built on tobacco, communities defined by migrating salmon, and wars fought in the name of spices. Political and economic decisions can also alter a region’s ecology.

Post-Columbian maritime trade initiated the accidental and intentional redistribution of plants, animals, bacteria and propeciaes, which continues to this day. Ecological changes spurred by politics can also be positive. For example, wildlife thrives in the demilitarized zone (DMZ) between North and South Korea.

The Cuban Revolution and the subsequent U.S.-sponsored economic blockade are preeminent global geopolitical events that define Cuba’s modern socioeconomic character. Has Cuba’s distinctive economy also impacted its modern ecology?. Cuba is among the largest and most biodiverse islands in the world.

Islands are hotspots of diversity and endemism, but they are also hotbeds of nonnative species—those far from their evolutionary home. One in three plant species on islands are typically nonnative, and bigger islands with a range of habitats and native plant diversity foster the most nonnatives. Our team of U.S.

And Cuban scientists, however, documented that Cuba hosts far fewer nonnative plants than expected. It lacks 177 nonnative plant species present on other Caribbean islands, despite the unparalleled and well-documented range of tropical habitats contained on the Cuban archipelago, which comprises over a third of the land area and more than half of the islands in the Caribbean. Only one in eight plant species found in Cuba originated elsewhere, less than half the global average for islands.

It supports about the same number of nonnative species as much smaller and less habitat-rich islands, such as Puerto Rico—a tenth its size. Cuba also has fewer nonnative reptile and amphibian species than neighboring islands. Cuba’s economic self-sufficiency may be the inadvertent mechanism that limited introduction of nonnative species.

The worldwide spread of such species is largely a biproduct of the exchange of merchandise and services, which accelerated globally post-1960s just as Cuba’s economy became increasingly closed. Although the establishment of nonnative species has increased over the past two centuries, invasion rates are highest in the last quarter century. In those recent decades, Cuba imported less than 20 percent of its gross domestic product (GDP), half the expectation for an island nation of its size.

Cuba is the least import-dependent island in the Caribbean. The only island without a dominant U.S.-based import market. And the least connected to inter-Caribbean trade.

Many Caribbean island economies are powered by tourism. Tens of millions of visitors, along with the goods that support them, move to and among the islands each year. Here, too, Cuba is an outlier in the Caribbean.

Proportionally fewer visitors arrive in Cuba now than in the 1950s, and Cuba is excluded from the predominant US-based market, including Caribbean cruises that move nearly as many tourists as airplanes. Although international trade is more commonly implicated as the vector for nonnative species introductions, tourism is an essential factor in understanding nonnative species patterns. On the dozens of Caribbean islands that we studied, Cuba included, tourism combined with island area explained 90 percent of the pattern in nonnative plant occurrence.

Larger islands with more tourists per unit area had the most nonnative species. Trade was negligible—surprisingly so—in explaining invasion patterns. Tourists can directly transport plants and seeds in their luggage and footwear.

Food and other goods for tourists can also encourage nonnative species and hitchhiking pests. Nonnative species are routinely planted for landscaping at hotels and other tourism infrastructure, and a recent study found that half of the invasive plants in the Caribbean were intentionally introduced for ornamental purposes. Notwithstanding its past, Cuba is susceptible to future invasions.

To the extent that its economic isolation provides an unintended defense from nonnative species, the expansion of tourism and trade may renew pathways for species to arrive and thrive. Cuba’s recent investment in the tourism sector has already increased visitors, and policy directives and port expansions will bring more trade. Cuba’s geography and native ecology predict the capacity of the island to support many more nonnative plants.

The eminent spread and the deleterious impacts of nonnative species threaten the immense biodiversity of Cuba and the Caribbean, which is the very foundation of the region’s ecological stability and an attraction to tourists. As the Cuban political leadership transitions to a new generation, and with prospects of thawing U.S.-Cuban relations, now is the time to consider shared policies between the countries to limit future exchange of nonnative species. As botanist and explorer Joseph Banks wrote during the Napoleonic Wars, “The science of two nations may be at peace while their politics are at war.” To that end, scientists and natural resource managers can identify species at most risk to establish in Cuba and also move from Cuba to the U.S.

Mainland and Puerto Rico. When U.S. Conflicts with China and Vietnam were resolved, more pests were intercepted in cargo originating from these countries at U.S.

Borders, which is both a cautionary tale and support for the importance of biosecurity measures. With normalizing economic policies, best practices that intentionally stem invasions, such as those used by New Zealand, South Africa and Hawaii, will be important. Islands are shaped by the oceans that isolate them, as economies and cultures are defined by their surrounding ecology.

Those forces collide in the Caribbean, where islands have long been influenced by peripheral economies, including European colonization and slave-supported agriculture for tobacco and nonnative sugarcane. Contemporary tourism and trade continue the reciprocal linkage between an island’s environment and the culture, economy and politics of its people. The nonnative plant communities on Caribbean islands, as elsewhere, result from centuries of human influence and natural processes, which collectively demonstrate that forward-thinking policy can help conserve the ecology of the Caribbean as it responds to changing political, biological and climatic forces.

Propecia miniaturized hair

Credit how much does propecia cost without insurance propecia miniaturized hair. IStock Share Fast Facts New @HopkinsMedicine study finds African-American women with common form of hair loss at increased risk of uterine fibroids - Click to Tweet New study in @JAMADerm shows most common form of alopecia (hair loss) in African-American women associated with higher risks of uterine fibroids - Click to Tweet In a study of medical records gathered on hundreds of thousands of African-American women, Johns Hopkins researchers say they have evidence that women with a common form of hair loss have an increased chance of developing uterine leiomyomas, or fibroids.In a report on the research, published in the December 27 issue of JAMA Dermatology, the researchers call on physicians who treat women with central centrifugal cicatricial alopecia (CCCA) to make patients aware that they may be at increased risk for fibroids and should be screened for the condition, particularly if they have symptoms such as heavy bleeding and pain. CCCA predominantly affects black women and is propecia miniaturized hair the most common form of permanent alopecia in this population.

The excess scar tissue that forms as a result of this type of hair loss may also explain the higher risk for uterine fibroids, which are characterized by fibrous growths in the lining of the womb. Crystal Aguh, M.D., assistant professor of dermatology at the Johns Hopkins University School of Medicine, says the scarring associated propecia miniaturized hair with CCCA is similar to the scarring associated with excess fibrous tissue elsewhere in the body, a situation that may explain why women with this type of hair loss are at a higher risk for fibroids.People of African descent, she notes, are more prone to develop other disorders of abnormal scarring, termed fibroproliferative disorders, such as keloids (a type of raised scar after trauma), scleroderma (an autoimmune disorder marked by thickening of the skin as well as internal organs), some types of lupus and clogged arteries. During a four-year period from 2013-2017, the researchers analyzed patient data from the Johns Hopkins electronic medical record system (Epic) of 487,104 black women ages 18 and over.

The prevalence of those with fibroids was compared in patients with and without propecia miniaturized hair CCCA. Overall, the researchers found that 13.9 percent of women with CCCA also had a history of uterine fibroids compared to only 3.3 percent of black women without the condition. In absolute numbers, out of the 486,000 women who were reviewed, 16,212 had fibroids.Within that population, 447 had CCCA, of which 62 had fibroids.

The findings translate to a fivefold increased risk of propecia miniaturized hair uterine fibroids in women with CCCA, compared to age, sex and race matched controls. Aguh cautions that their study does not suggest any cause and effect relationship, or prove a common cause for both conditions. €œThe cause of the link between the two conditions propecia miniaturized hair remains unclear,” she says.

However, the association was strong enough, she adds, to recommend that physicians and patients be made aware of it. Women with this type of scarring alopecia should be screened not only for fibroids, but propecia miniaturized hair also for other disorders associated with excess fibrous tissue, Aguh says. An estimated 70 percent of white women and between 80 and 90 percent of African-American women will develop fibroids by age 50, according to the NIH, and while CCCA is likely underdiagnosed, some estimates report a prevalence of rates as high as 17 percent of black women having this condition.

The other authors on this paper were propecia miniaturized hair Ginette A. Okoye, M.D. Of Johns Hopkins and Yemisi Dina of Meharry Medical College.Credit.

The New England Journal of Medicine Share Fast Facts This study clears up how big an effect the mutational burden has on outcomes to propecia miniaturized hair immune checkpoint inhibitors across many different cancer types. - Click to Tweet The number of mutations in a tumor’s DNA is a good predictor of whether it will respond to a class of cancer immunotherapy drugs known as checkpoint inhibitors. - Click to Tweet The “mutational burden,” or the number of mutations present in a tumor’s DNA, is a good predictor of whether that cancer type will respond to a class of cancer immunotherapy drugs known as checkpoint inhibitors, a new study propecia miniaturized hair led by Johns Hopkins Kimmel Cancer Center researchers shows.

The finding, published in the Dec. 21 New England propecia miniaturized hair Journal of Medicine, could be used to guide future clinical trials for these drugs. Checkpoint inhibitors are a relatively new class of drug that helps the immune system recognize cancer by interfering with mechanisms cancer cells use to hide from immune cells.

As a result, the drugs cause the immune system to fight cancer in the http://www.ec-prot-obermodern-zutzendorf.ac-strasbourg.fr/?p=2229 same way that it would fight an . These medicines have had remarkable success in treating propecia miniaturized hair some types of cancers that historically have had poor prognoses, such as advanced melanoma and lung cancer. However, these therapies have had little effect on other deadly cancer types, such as pancreatic cancer and glioblastoma.

The mutational burden of certain tumor types has previously been proposed as an explanation for why certain cancers respond better propecia miniaturized hair than others to immune checkpoint inhibitors says study leader Mark Yarchoan, M.D., chief medical oncology fellow. Work by Dung Le, M.D., associate professor of oncology, and other researchers at the Johns Hopkins Kimmel Cancer Center and its Bloomberg~Kimmel Cancer Institute for Cancer Immunotherapy showed that colon cancers that carry a high number of mutations are more likely to respond to checkpoint inhibitors than those that have fewer mutations. However, exactly how big an propecia miniaturized hair effect the mutational burden has on outcomes to immune checkpoint inhibitors across many different cancer types was unclear.

To investigate this question, Yarchoan and colleagues Alexander Hopkins, Ph.D., research fellow, and Elizabeth Jaffee, M.D., co-director of the Skip Viragh Center for Pancreas Cancer Clinical Research and Patient Care and associate director of the Bloomberg~Kimmel Institute, combed the medical literature for the results of clinical trials using checkpoint inhibitors on various different types of cancer. They combined these findings with data on the mutational burden of thousands of tumor samples from patients with different tumor propecia miniaturized hair types. Analyzing 27 different cancer types for which both pieces of information were available, the researchers found a strong correlation.

The higher a cancer type’s mutational burden tends to be, the more likely it is to respond to checkpoint inhibitors. More than propecia miniaturized hair half of the differences in how well cancers responded to immune checkpoint inhibitors could be explained by the mutational burden of that cancer. €œThe idea that a tumor type with more mutations might be easier to treat than one with fewer sounds a little counterintuitive.

It’s one of those things that doesn’t sound right when you hear it,” says Hopkins propecia miniaturized hair. €œBut with immunotherapy, the more mutations you have, the more chances the immune system has to recognize the tumor.” Although this finding held true for the vast majority of cancer types they studied, there were some outliers in their analysis, says Yarchoan. For example, Merkel cell cancer, a rare and highly propecia miniaturized hair aggressive skin cancer, tends to have a moderate number of mutations yet responds extremely well to checkpoint inhibitors.

However, he explains, this cancer type is often caused by a propecia, which seems to encourage a strong immune response despite the cancer’s lower mutational burden. In contrast, the most common type of colorectal cancer has moderate mutational burden, yet responds poorly to checkpoint inhibitors for reasons that are still unclear. Yarchoan notes that these findings could help guide clinical trials to test checkpoint inhibitors on cancer types for which these drugs haven’t yet been tried propecia miniaturized hair.

Future studies might also focus on finding ways to prompt cancers with low mutational burdens to behave like those with higher mutational burdens so that they will respond better to these therapies. He and his colleagues plan to extend propecia miniaturized hair this line of research by investigating whether mutational burden might be a good predictor of whether cancers in individual patients might respond well to this class of immunotherapy drugs. €œThe end goal is precision medicine—moving beyond what’s true for big groups of patients to see whether we can use this information to help any given patient,” he says.

Yarchoan receives funding from the propecia miniaturized hair Norman &. Ruth Rales Foundation and the Conquer Cancer Foundation. Through a licensing agreement with Aduro Biotech, Jaffee has the potential to receive royalties in the future..

Credit. IStock Share Fast Facts New @HopkinsMedicine study finds African-American women with common form of hair loss at increased risk of uterine fibroids - Click to Tweet New study in @JAMADerm shows most common form of alopecia (hair loss) in African-American women associated with higher risks of uterine fibroids - Click to Tweet In a study of medical records gathered on hundreds of thousands of African-American women, Johns Hopkins researchers say they have evidence that women with a common form of hair loss have an increased chance of developing uterine leiomyomas, or fibroids.In a report on the research, published in the December 27 issue of JAMA Dermatology, the researchers call on physicians who treat women with central centrifugal cicatricial alopecia (CCCA) to make patients aware that they may be at increased risk for fibroids and should be screened for the condition, particularly if they have symptoms such as heavy bleeding and pain. CCCA predominantly affects black women and is the most common form of permanent alopecia in this population. The excess scar tissue that forms as a result of this type of hair loss may also explain the higher risk for uterine fibroids, which are characterized by fibrous growths in the lining of the womb.

Crystal Aguh, M.D., assistant professor of dermatology at the Johns Hopkins University School of Medicine, says the scarring associated with CCCA is similar to the scarring associated with excess fibrous tissue elsewhere in the body, a situation that may explain why women with this type of hair loss are at a higher risk for fibroids.People of African descent, she notes, are more prone to develop other disorders of abnormal scarring, termed fibroproliferative disorders, such as keloids (a type of raised scar after trauma), scleroderma (an autoimmune disorder marked by thickening of the skin as well as internal organs), some types of lupus and clogged arteries. During a four-year period from 2013-2017, the researchers analyzed patient data from the Johns Hopkins electronic medical record system (Epic) of 487,104 black women ages 18 and over. The prevalence of those with fibroids was compared in patients with and without CCCA. Overall, the researchers found that 13.9 percent of women with CCCA also had a history of uterine fibroids compared to only 3.3 percent of black women without the condition.

In absolute numbers, out of the 486,000 women who were reviewed, 16,212 had fibroids.Within that population, 447 had CCCA, of which 62 had fibroids. The findings translate to a fivefold increased risk of uterine fibroids in women with CCCA, compared to age, sex and race matched controls. Aguh cautions that their study does not suggest any cause and effect relationship, or prove a common cause for both conditions. €œThe cause of the link between the two conditions remains unclear,” she says.

However, the association was strong enough, she adds, to recommend that physicians and patients be made aware of it. Women with this type of scarring alopecia should be screened not only for fibroids, but also for other disorders associated with excess fibrous tissue, Aguh says. An estimated 70 percent of white women and between 80 and 90 percent of African-American women will develop fibroids by age 50, according to the NIH, and while CCCA is likely underdiagnosed, some estimates report a prevalence of rates as high as 17 percent of black women having this condition. The other authors on this paper were Ginette A.

Okoye, M.D. Of Johns Hopkins and Yemisi Dina of Meharry Medical College.Credit. The New England Journal of Medicine Share Fast Facts This study clears up how big an effect the mutational burden has on outcomes to immune checkpoint inhibitors across many different cancer types. - Click to Tweet The number of mutations in a tumor’s DNA is a good predictor of whether it will respond to a class of cancer immunotherapy drugs known as checkpoint inhibitors.

- Click to Tweet The “mutational burden,” or the number of mutations present in a tumor’s DNA, is a good predictor of whether that cancer type will respond to a class of cancer immunotherapy drugs known as checkpoint inhibitors, a new study led by Johns Hopkins Kimmel Cancer Center researchers shows. The finding, published in the Dec. 21 New England Journal of Medicine, could be used to guide future clinical trials for these drugs. Checkpoint inhibitors are a relatively new class of drug that helps the immune system recognize cancer by interfering with mechanisms cancer cells use to hide from immune cells.

As a result, the drugs cause the immune system to fight cancer in the same way that it would fight an . These medicines have had remarkable success in treating some types of cancers that historically have had poor prognoses, such as advanced melanoma and lung cancer. However, these therapies have had little effect on other deadly cancer types, such as pancreatic cancer and glioblastoma. The mutational burden of certain tumor types has previously been proposed as an explanation for why certain cancers respond better than others to immune checkpoint inhibitors says study leader Mark Yarchoan, M.D., chief medical oncology fellow.

Work by Dung Le, M.D., associate professor of oncology, and other researchers at the Johns Hopkins Kimmel Cancer Center and its Bloomberg~Kimmel Cancer Institute for Cancer Immunotherapy showed that colon cancers that carry a high number of mutations are more likely to respond to checkpoint inhibitors than those that have fewer mutations. However, exactly how big an effect the mutational burden has on outcomes to immune checkpoint inhibitors across many different cancer types was unclear. To investigate this question, Yarchoan and colleagues Alexander Hopkins, Ph.D., research fellow, and Elizabeth Jaffee, M.D., co-director of the Skip Viragh Center for Pancreas Cancer Clinical Research and Patient Care and associate director of the Bloomberg~Kimmel Institute, combed the medical literature for the results of clinical trials using checkpoint inhibitors on various different types of cancer. They combined these findings with data on the mutational burden of thousands of tumor samples from patients with different tumor types.

Analyzing 27 different cancer types for which both pieces of information were available, the researchers found a strong correlation. The higher a cancer type’s mutational burden tends to be, the more likely it is to respond to checkpoint inhibitors. More than half of the differences in how well cancers responded to immune checkpoint inhibitors could be explained by the mutational burden of that cancer. €œThe idea that a tumor type with more mutations might be easier to treat than one with fewer sounds a little counterintuitive.

It’s one of those things that doesn’t sound right when you hear it,” says Hopkins. €œBut with immunotherapy, the more mutations you have, the more chances the immune system has to recognize the tumor.” Although this finding held true for the vast majority of cancer types they studied, there were some outliers in their analysis, says Yarchoan. For example, Merkel cell cancer, a rare and highly aggressive skin cancer, tends to have a moderate number of mutations yet responds extremely well to checkpoint inhibitors. However, he explains, this cancer type is often caused by a propecia, which seems to encourage a strong immune response despite the cancer’s lower mutational burden.

In contrast, the most common type of colorectal cancer has moderate mutational burden, yet responds poorly to checkpoint inhibitors for reasons that are still unclear. Yarchoan notes that these findings could help guide clinical trials to test checkpoint inhibitors on cancer types for which these drugs haven’t yet been tried. Future studies might also focus on finding ways to prompt cancers with low mutational burdens to behave like those with higher mutational burdens so that they will respond better to these therapies. He and his colleagues plan to extend this line of research by investigating whether mutational burden might be a good predictor of whether cancers in individual patients might respond well to this class of immunotherapy drugs.

€œThe end goal is precision medicine—moving beyond what’s true for big groups of patients to see whether we can use this information to help any given patient,” he says. Yarchoan receives funding from the Norman &. Ruth Rales Foundation and the Conquer Cancer Foundation. Through a licensing agreement with Aduro Biotech, Jaffee has the potential to receive royalties in the future..

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