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Sabril Approved for Younger Patients With Complex Partial Seizures – Monthly Prescribing Reference

Posted: January 29, 2020 at 5:46 pm

The Food and Drug Administration (FDA) has expanded the approval of Sabril (vigabatrin; Lundbeck) to include treatment of refractory complex partial seizures (CPS) in pediatric patients aged 2 to <10 years of age who have inadequately responded to several alternative treatments and for whom the potential benefits outweigh the risk of vision loss. Previously, the treatment had only been approved for CPS in patients 10 years of age and older.

The approval was based on data from 3 randomized, double-blind, placebo-controlled, parallel-group, adjunctive-treatment studies in patients aged 3-16 years with uncontrolled CPS with or without secondary generalization (N=373). Data from these studies were pooled and used in a pharmacometric bridging analysis, which consisted of defining a weight-normalized dose response, and showing that a similar dose response relationship exists between pediatric patients and adult patients when Sabril was given as adjunctive therapy. The dosing recommendations in pediatric patients 2 to 16 years of age were derived from simulations using these pharmacometric dose-response analyses.

Commenting on the approval, Darcy Krueger, MD, PhD, Director of the Cincinnati Childrens Hospital Medical Center Tuberous Sclerosis Complex (TSC) Clinic, said: Vigabatrin has been used safely for many yearsyet patients were having difficulty getting medication approved by their insurance because the previous FDA approval didnt include patients aged 2 to 10. We were able to work with TSC Clinics like ours with considerable experience treating children in this age range to collect safety and efficacy data so it could be included in the FDAs new review.

With regard to safety, among pediatric patients with CPS, weight gain was observed to be the most common adverse reaction. Sabril carries a Boxed Warning regarding the risk of permanent vision loss. Because of this risk, the drug is only available through a restricted distribution program called the Vigabatrin REMS Program.

Sabril is also indicated for use as monotherapy for pediatric patients 1 month to 2 years of age with infantile spasms for whom the potential benefits outweigh the potential risk of vision loss.

The product is supplied in 500mg tablets and 500mg packets of powder for oral solution.

For more information visit sabril.net.

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Sabril Approved for Younger Patients With Complex Partial Seizures - Monthly Prescribing Reference

Integrated Health: running and jogging injury prevention – Post South

Posted: January 29, 2020 at 5:46 pm

There are four periods of time when runners are most vulnerable to injury.

Most running and jogging injuries are caused by recurring factors that runners and joggers can often prevent or avoid:

What causes running injuries?

There are four periods of time when runners are most vulnerable to injury:

--During the initial 4 to 6 months of running

--Upon returning to running after an injury

--When the quantity of running is increased (distance)

--When the quality of running is increased (speed)

Training errors are the most common source of injury, particularly lack of adequate stretching; rapid changes in mileage; an increase in hill training; interval training (going from slow speeds over long distances to faster over less ground); and insufficient rest between training sessions.

Running and Jogging Injuries

Runners should also keep in mind potential anatomic abnormalities:

--Hip disorders typically manifest themselves as groin pain. Back discomfort that radiates down the leg is cause for referral to a sports medicine specialist.

--The patella (kneecap) is a common site of overuse injuries that can benefit from a 20 minute ice massage, a program of stretching and strengthening of the hamstring and quadriceps muscles, and a short course of an over-the-counter anti-inflammatory medication. Surgery is rarely indicated.

--Ankle laxity can lead to frequent ankle sprains and pain. Beneficial treatment includes muscle strengthening to increase stability, shoe modification to alter gait, and change of a running surface. Foot problems in runners are related to foot.

How are running injuries treated?

The basic approach to treating running injuries includes rest or modification of activity to allow healing and reduction of inflammation. To avoid overuse injuries, or to allow for a safe return to running after a break, a runner should follow the 10 percent rule (limit the increase in weekly mileage or pace by 10% per week). Thus, if you are running 10 miles per week and want to increase your training regimen, run 11 miles the next week, and 12 miles the week after that. This program should be followed while flexibility, strength, and endurance are restored. When severe pain, swelling, loss of motion, and/or other alterations in running form are present, immediate medical treatment is advised (see reverse for specific injuries).

Cross-training can be extremely beneficial to the runner in times of recovery from injury or when starting out a running program. This may involve swimming, aqua jogging, stationary bike, or any other low impact activity that helps build endurance. Start with a higher percentage of low impact activities and then increase your mileage while decreasing the cross-training activity.

The goal of rehabilitation is to safely return the runner to the desired level of running. Remember, training errors constitute the most common cause of injuries. A well-planned program prevents injury while benefiting the athlete.

Prevention running/jogging injuries:

When selecting a running shoe, the athlete should look for a style that will fit comfortable and that will accommodate his or her particular foot anatomy. When a shoes mileage exceeds 500600 miles, it should be replaced.

The ideal surface on which to run is flat, smooth, resilient, and reasonably soft. Avoid concrete or rough road surfaces. If possible, use community trails that have been developed specifically for jogging and running. Hills should be avoided at first because of the increased stress placed on the knee and ankle.

During warmer, humid weather, increase fluid intake; in cool weather, dress appropriately. It is often helpful to weigh yourself before and after running on a hot, humid day. One pint of water should be consumed for every pound of weight lost. Avoid running during extremely hot and cold temperatures or when the air pollution levels are high. When running at higher altitudes, the runner should gradually acclimate to the lower oxygen levels by slow, steady increases in speed and distance

Pre-participation Musculoskeletal Health Assessment can identified asymmetries and imbalances. Integrated Health provides a 3d imaging musculoskeletal assessment. The assessment tool is state of the art technology utilized by Professional Sports and Corporations for preventing and increasing performances. For more information on the assessment contact Jeff Faucheux LAT, ATC,CES at 225-933-1526.

Integrated Health is a health management solutions company that promotes musculoskeletal health via active and passive range of motion assessments. Benefits include injury prevention, improved performance, faster recovery, and feeling healthy. Jeff Faucheux LAT ATC CTPS CES specializes in Ergonomics in the Workplace. Brandon Albin, MHRD, ATC, director of musculoskeletal assessments, is a former Division 1 collegiate director of sports medicine who specializes in injury prevention and corrective exercise. http://www.integrated-health.com, 800-292-1617, Choices Family Medical Clinic.

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Integrated Health: running and jogging injury prevention - Post South

High Waters, More Hazardous Cargo In The Ohio Watershed Complicate The Job Of Keeping Waterways Safe – West Virginia Public Broadcasting

Posted: January 29, 2020 at 5:46 pm

Just before dawn in January 2018, 27 barges were floating like a net along the banks of the Ohio River, downstream of the city of Pittsburgh. Instead of fish, the fleet caught chunks of ice that broke off in the warming, fast-moving waters as it waited for a tow through the nearby Emsworth Locks and Dams.

The area had experienced record rainfall, and the river rose more than 12 feet in about 30 hours. The barges, some loaded with coal and cement, were lashed together with steel cables in a grid-like pattern, then secured to pilings equipped with large metal mooring rings.

Crews had worked through the night to monitor the cable tension as ice and rising waters caused the lines to tighten. At 6:15 a.m., a towing vessel captain saw sparks.

His vessel and all of the 27 barges began drifting downstream, propelled by the fast current and extreme weight of ice. Unable to control the barges, the towing vessels saved two and let the rest go.

In the first light of day, they reached the Locks and Dams and met their fate. Seven flowed through the open lock gate. Three hit the dams and sank, taking their cargo with them. The rest grounded on the banks of the river or lodged themselves between the dams and the raging river.

As is typical with marine accidents, no single factor can be blamed. But federal investigators determined the problem that pushed everything over the edge was the weather. The same day, just south of Wheeling, West Virginia, another 27 barges set loose on the Ohio River due to increased rainfall and ice buildup.

Over the past decade in the Ohio watershed, which encompasses 15 states from southwestern New York to the northeast corner of Mississippi, extreme weather has been cited more and more frequently as a contributing cause in serious marine accidents. At the same time, a KyCIR analysis found that shipping of hazardous materials like crude oil and kerosene are rising.

These issues have ramifications all along the Ohio River, but particularly in Louisville, home to one of the most difficult passages to navigate. As the conditions on the Ohio and its cargo become more hazardous, key regulatory organizations struggle to keep up with the growing demands of this water highway.

More Serious Marine Accidents

Inland marine accidents dont attract as much publicity as accidents on the oceans. Generally, inland vessels are much smaller, and fewer deaths result from single incidents.

But navigating inland waterways can still be a treacherous endeavour, made more hazardous when the river is high. A 2017 U.S. Army Corps of Engineers report estimates that up to 50% more water could be coursing through the Ohio River watershed within this century due to climate change.

The rivers rise obscures river banks and changes river beds. It creates currents that can pull vessels off course, or throw debris into mariners paths.

KyCIR analyzed federal data from 2010 to 2018 on serious marine accidents, which the U.S. Coast Guard defines as incidents involving death or serious injury, excessive property damage or a discharge of hazardous materials.

Nearly 3,400 marine incidents occurred in a nine-year period in the Ohio watershed. In 2010, about 8% were serious. By 2018, serious incidents accounted for 12%.

Incidents citing high waters as a contributing factor are on the rise, data show.

Coast Guard serious incident reports from 2010 to 2015 occasionally cited high waters or fast-moving currents as contributing factors to the accidents. But these terms began to show up more frequently in accident descriptions starting in 2016, data show.

In one 2018 incident near Louisville, barges loaded with crude oil condensate got stuck on the river bank. The pilot struggled to avoid being overtaken by strong currents.

Liam LaRue, chief of investigations for the Office of Marine Safety at the National Transportation Safety Board [NTSB], said the agency has noticed more and more accidents tied to high rivers.

We'd get a few accidents a week, and they were all just high-water related, LaRue said. That's definitely something that we've seen a lot of.

NTSB only investigates major marine accidents, which involves six or more fatalities, $500,000 of damage or the total loss of a vessel.

LaRue has been with NTSB for 14 years, and he said their normal annual workload is between 30 and 40 major cases nationwide. Last year was a record year for his team, he said: they investigated 52 major marine accidents. Most happened on oceanic routes or at coastal shipping ports. But inland accidents like the Emsworth barge breakaway outside of Pittsburgh make the list because of the costly property damage they leave in their wake.

And these accidents are not uncommon in the Ohio watershed, in part because the Ohio River is so difficult to navigate.

Louisvilles section of the Ohio River is one of only 12 places in the country with a Vessel Traffic Service essentially an escort system to help vessels navigate dangerous or congested stretches of river. It is the only inland traffic service and the only one that operates solely during times of high water.

Louisvilles service was established in 1973 after a series of accidents, such as the February 1972 incident when a barge carrying chlorine gas became lodged in the McAlpine dam, threatening lives and requiring the evacuation of the nearby Portland neighborhood.

Between 2012 and 2016, Louisvilles traffic service was activated for an average of 59 days a year. In the last two years, it was active for 151 days and 130 days, respectively.

More Hazardous Cargo

More than 180 million tons of cargo travel up and down the rivers of the Ohio watershed each year, according to a KyCIR analysis of commodities data from the U.S. Corps of Engineers. The river carries shipments of food, alcohol, fuel, construction supplies and even rocket parts.

More and more, those cargo vessels are carrying non-solid fuels.

Kerosene shipments increased 1,372% in 2017 when compared to data from 2000. Crude petroleum shipments increased 675%. By contrast, coal and lignite shipments decreased 35%.

This trend follows the decline of coal and the increase in natural gas production in this region. Less coal is being mined as more companies go bankrupt and coal becomes harder to extract. Power plants are retiring coal generators in favor of natural gas units, which are not only cheaper but cleaner.

But the non-solid materials taking their place are more hazardous to ship. When a coal barge sinks, it generally stays in one place, said Sam Dinkins, a technical programs manager at the Ohio River Valley Water and Sanitation Commission, an interstate water quality agency known as ORSANCO. But when an oil or liquid hazardous material spills, things get messier, faster.

Containment of that release becomes problematic because it's going to flow with the river downstream, Dinkins said. And so it spreads out, along with the river flow.

In many cases, the liquid can change the composition and quality of the water water that residents in the watershed ultimately drink.

The Louisville water supply faced a potential disaster in December 2017. A barge holding more than 300,000 gallons of liquid fertilizer broke in half just south of Cincinnati, Ohio, threatening the citys water supply downstream.

This particular spill wasnt due to high water, but it illustrates the potential for danger. As thousands of gallons of urea ammonium nitrate drifted downriver toward Louisville, the citys water authority took action.

This spill was unique because it wasnt like an oil spill where you could see it on the river, Louisville Water Company spokeswoman Kelley Dearing Smith told WFPL in 2017. The chemical was soluble, so our scientists really had to track the spill ... to understand how this plume was moving.

In this case, rain diluted the contamination, and helped it move swiftly through the city. But less than a month later, the rain would cause the barge breakaways near Pittsburgh and in West Virginia.

These inland spills may seem less catastrophic than ocean spills, but theyre more likely to cause harm to the surrounding area, said Lt. Cmdr. Takila Powell, U.S. Coast Guard marine investigations supervisor for the district that includes most of the Ohio watershed.

When you have an oil spill on an inland river, Powell said, water is more shallow and the currents are different than on the ocean. It takes a lot less oil to pose a big threat.

And plus, there's a higher chance of impact to the shoreline because you're on a river and there's two banks on either side, Powell said. So at least one could potentially be impacted.

Whats Being Done

Government agencies and regulatory bodies say they are working together to improve safety and mitigate harm after accidents occur. But change is slow to come.

For example, Congress passed legislation in 2004 that established mandatory inspections for towing vessels. But mandatory inspections didnt actually begin until 2018, nearly 14 years later.

But as each year brings more volatile weather than the year before, the agencies say theyre trying to be proactive, rather than reactive.

Only recently did the NTSB begin documenting its accident investigations with an internal database. LaRue said the effort will help provide a better idea about trending and things like that, and hopefully spot safety issues.

Such a database, when implemented, could help NTSB create a recommendation report on how to avoid weather-related incidents in the future, but the NTSB still lacks enforcement power. Even if its investigators identify safety protocols that could help mariners deal with extreme weather, it would be up to the Coast Guard to implement them.

Currently, the Coast Guard maintains and operates regional plans that help mariners respond to hazards such as high water or inclement weather on specific stretches of river.

Powell said that during times of high water, the Coast Guard subsectors hold conference calls to discuss river levels, vessel restrictions and weather and river forecasts.

Those forecasts are available for mariners from the National Oceanic Atmospheric Association [NOAA], which uses various data points about rainfall and terrain to predict how waterways will react to extreme weather up to 10 days ahead of time.

That gives them the opportunity to make decisions that are going to help them navigate the rivers safely if the water is coming up quickly, said Trent Schade, hydrologist in charge of NOAAs Ohio River Forecast Center. They have an opportunity to move their boat into a safe harbor.

But these forecasts give only a short lead on the future of the river. Both the Coast Guard and NOAA say they arent focused right now on climate changes long-term impacts on river safety. When it comes to next year or the next 10 years, the state of the water is much murkier.

Alexandra Kanik is the data reporter for Kentucky Center for Investigative Reporting which is part of Louisville Public Media. She can be reached at akanik@louisvillepublicmedia.org

Caitlin McGlade contributed to this report.

Good River: Stories of the Ohio is a series about the environment, economy, and culture of the Ohio River watershed, produced by seven nonprofit newsrooms. To see more, please visit ohiowatershed.org.

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High Waters, More Hazardous Cargo In The Ohio Watershed Complicate The Job Of Keeping Waterways Safe - West Virginia Public Broadcasting

The 5 most common travel-related illnesses and how to avoid them – Canada.com

Posted: January 29, 2020 at 5:46 pm

Staying healthy while travelling means you can spend more time enjoying yourself so take precautions.Xavier Mouton Photographie on Unsplash

With the news of the coronavirus, a flu-like illness that started in Wuhan, China, making headlines, falling ill abroad is top of mind for many. And while this and other past viruses, like SARS and swine flu, can cause serious outbreaks and cause for concern, there other more common illnesses that you can still easily catch while travelling.

Read on to discover five of the most common illnesses you can get abroad, plus some advice on how to avoid them in the first place.

Where: Anywhere, though places with poor food handling and sanitation are higher risk

Theres no mistaking that rumbling feeling that strikes your lower guts before a bout of travellers diarrhea. Its the most common sickness people face when travelling. Generally, you wind up with travellers diarrhea by eating or drinking something thats been contaminated with a variety of bacteria, including E. coli or salmonella. Symptoms include sudden diarrhea, painful stomach cramps, fever and vomiting. Usually, it will clear up on its own within two days to a week.

How to avoid it: Always choose a safe water source (avoid tap water in certain places) and ensure that the spots youre dining at are preparing food safely. Wash your hands with soap and water often to avoid the spread of gems. Opting for hot/cooked foods and skipping undercooked meats can also help.

Where: the Caribbean, Central and South America, Southeast Asia and even parts of the United States, like Hawaii

Mosquitoes arent just worth avoiding because of the relentless itching caused by their bites. Dengue fever is the number one mosquito-borne virus, despite zika getting more media play as of late. Dengue symptoms, which include headache, body pain (and specifically eye pain), nausea and vomiting come on rapidly once youve been bitten by an infected mosquito. Following infection, a rash will also present itself.

How to avoid it: Use bug spray when in mosquito-dense areas and cover up at dusk and dawn when theyre most active. In some cases, sleeping beneath a bug net can also keep the pests at bay while you rest.

Where: Parts of the Caribbean, Mexico, Southeast Asia, Central and South America, Africa and parts of the Middle East

Malaria is another sickness that you can get from mosquito bites. It causes unpleasant flu-like symptoms including chills, sweating, headache, nausea and vomiting and abdominal pain.

How to avoid it: Like dengue, malaria can be avoided by using mosquito repellent and covering your skin. Some people might choose to use prescription medication that provides protection from the disease, which can be taken orally two days before you arrive in an at-risk area and for four weeks after you get home.

Where: Worldwide

Tetanus, also known as lock-jaw syndrome, is a bacterial infection that you get from cutting yourself on a dirty metal or stepping on an old, rusty nail and puncturing your skin. It will cause severe stiffness of the jaw and neck muscles, tremors and difficulty swallowing and in many cases, death.

How to avoid it: Stay vaccinated. If youre unsure when you had your last tetanus shot, visit your medical practitioner to determine whether you need a booster or fresh round of vaccinations.

Where: Most common in South and Central America, Asia and parts of AfricaTuberculous, also known as TB, is a bacteria that can be spread by coughing, sneezing or even speaking, which makes it incredibly contagious. It causes a persistent cough that result in coughing up blood, as well as chest pain, weight loss and chills. Many people die from TB.

How to avoid it: The Bacillus CalmetteGurin (BCG) vaccine, which is most commonly administered during childhood here in Canada, is the best form of protection against TB.

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The 5 most common travel-related illnesses and how to avoid them - Canada.com

‘The Biggest Loser’ is back on TV. Get ready for ramped-up fat-shaming and dangerous diets. – NBC News

Posted: January 29, 2020 at 2:46 am

There was a time in the mid-2000s when I was a huge fan of "The Biggest Loser" (no pun intended), a weight loss competition show that aired on NBC for 17 seasons from 2004 to 2016. I wasn't alone: Throughout its run, the show, which featured teams competing to lose the largest percentage of their original weight under the guidance of a seemingly sadistic personal trainer, brought in 5 million to 10 million viewers an episode.

When I was watching the show, I was unsurprisingly as consumed with losing weight as the contestants were: I did everything you saw on the show, from keeping a meticulous food and exercise journal to counting Weight Watchers points to obsessively weighing myself throughout the day. I also hid diet pills in my sock drawer, I went on "cleanses," and I misused laxatives to prevent myself from absorbing calories properly. Some days, I wouldn't eat at all eventually collapsing into bed lightheaded and deeply proud of myself.

And the whole time, I'd be watching "The Biggest Loser" for the sweet validation that everything I was doing to my body much of which was dangerous was for my own good. I, like so many others, believed that my weight "problem" was about my weakness, my lack of self-control, my failure.

I eventually let go of my obsession with becoming thin, and NBC seemingly let go of "The Biggest Loser" when it faded out without ceremony after its final season in February 2016. But now NBCUniversal (the parent company of NBC News) has revived the show on the USA Network this month as "a new holistic, 360-degree look at wellness."

Perhaps NBCUniversal executives hope that we've all forgotten that the show's "weight loss program" doesn't work in the long term: The majority of contestants gain the weight back and ruin their metabolisms. Or maybe the executives who approved its return to our airwaves think we don't care about the litany of former contestants' testimonies detailing the verbal abuse, eating disorders, mental illness and drug abuse that they experience on or after the show.

Ryan C. Benson, the show's first winner, warned about the dangerous fasting and dehydration he experienced while on the show, "to the point that he was urinating blood." Season Two's Lezlye Mendonca reported that contestants would use "amphetamines, water pills, diuretics, and throw up in the bathroom." Former trainer Jillian Michaels who most recently made headlines for concern-trolling Lizzo admitted that she gave her team caffeine pills to give them "more energy" to exercise. (Michaels, who was among the worst offenders among the trainers, seemingly took particular joy in berating the contestants, saying things like "it's fun watching other people suffer like that" a quote NBC thought was so great that it put it in that season's promo.)

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Joelle Gwynn from the 2008 "Couples" season reported that the show's doctor gave her "yellow and black pills" which, according to the New York Post, she later found out were most likely ephedra, a weight loss supplement banned by the Food and Drug Administration in 2004 after it killed over 150 people to help her lose weight (he denied it) and that trainer Bob Harper (the host of the USA Network reboot) encouraged contestants to consume fewer calories than the doctors deemed safe and that he even supported vomiting.

One of the most outspoken former contestants has been Kai Hibbard, the second-place winner on the third season, in 2006. A year after her season ended, she would become one of the show's biggest critics, eventually calling her participation "the biggest mistake of my life."

I spoke with Hibbard, who is now a social worker and activist and the author of "Losing It: A Fictional Reimagining of My Time on Weight Loss Reality TV." She said, "I had hoped with all the studies, all the other contestants who have spoken out I thought it was enough to kill" the show.

"When I joined the show, I was like most other people: I was spoon-fed this myth my entire life that being thin meant you were healthier," Hibbard added. "Then I went through the whole process of the show and discovered the techniques they gave me to be thinner. I realized how sick, how physically ill they made me. That connection between thin and healthy was broken for me."

Hibbard said people still feel entitled to comment about her body, particularly because she's remained straight size because of a battle with lupus. "When people praise me for my body now, it's a reminder of how much size is not related to health, because right now I'm the sickest I've ever been," she said.

Dr. Lindo Bacon, author of "Health at Every Size: The Surprising Truth About Your Weight," told me: "The misinformation that the show gives about dieting is abhorrent. We know these tactics aren't successful to lose weight that will be maintained in the long term. All it is doing is helping people feel bad."

Unlike dieting, the negativity the show encourages about fat people does work. A 2012 study found that watching just one episode of "The Biggest Loser" exacerbated people's dislike of fat people and heightened viewers' belief that weight is controllable. Another study in 2013 also found that watching the show reinforced beliefs that weight gain is entirely in one's individual control thus the idea that fat people are to blame for not taking personal responsibility for their health.

"It's a myth that we have any data to support losing weight is going to be helpful," Bacon said.

Another 2013 study reviewed the literature on how dieting affects health indicators like cholesterol, blood pressure and blood glucose levels pretty much every area of concern that trolls purport to be so worried about when criticizing fat people. It showed that across all studies, virtually nothing improved with weight loss. The authors were unequivocal: "Weight, as we reviewed here, turns out to be an inadequate proxy for health outcomes."

While there's no proof that losing weight does anything for a fat person's health, we have plenty of evidence that anti-fat bias and weight discrimination compounded by shows like "The Biggest Loser" contribute to fat people being paid less, facing a higher risk for suicide and depression and receiving terrible medical care.

If people like former trainer Jillian Michaels really care so much about fat people's health and well-being, perhaps they should start by attacking anti-fat bias, rather than attacking fat people.

As a fat person, you're bombarded with messages that you are something to be fixed, rather than someone to be loved and accepted. "These outside messages are telling you that you would be treated better if you changed yourself," Bacon said. "No matter how much we hear this, the problem is not you. It's our culture."

In the new trailer, a contestant says: "I'm hoping to gain confidence. I'm hoping to gain self-love." Those words broke my heart, because I know exactly how he feels. Diet culture and shows like "The Biggest Loser" thrive on the lie that fat people are unhappy, unhealthy and unmotivated; there is no space in "The Biggest Loser" for a happy fat person. But we don't have to live like that.

Despite everything she's been through, Hibbard is optimistic. "When I went on the show, I wanted to change myself to fit into a society that told me I was wrong. At this point in my life, I want to change society," she said.

I'm hopeful, too, because now, for every executive who greenlights a show like " The Biggest Loser," there are people like Hibbard, Bacon and me insisting that fat people are worth more than just a number on a scale.

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'The Biggest Loser' is back on TV. Get ready for ramped-up fat-shaming and dangerous diets. - NBC News

Resolve to make real nutrition a new year priority – Goshen News

Posted: January 29, 2020 at 2:46 am

A new year signals a chance to renew your commitment to healthier eating, but many of the most popular diets, like the keto diet and paleo diet, eliminate entire food groups, which can cause you to fall short on nutrients you need.

For example, a study in the Journal of Clinical Lipidology suggests low-carb diets may not have meaningful long-term benefits for weight or heart health compared to other diets and could actually restrict foods that are good for your heart.

This new year, instead of jumping on restrictive diet bandwagons, focus instead on consuming real, wholesome foods you can still enjoy that deliver benefits backed by decades of research.

Consider these tips for incorporating nutrient-rich foods into a few trending diets to make them work for you.

Intermittent Fasting: Skipping meals could do more harm than good if youre not getting the nutrients you need to be your best. A better bet: balanced, flavorful meals that incorporate multiple food groups. If you really want to try intermittent fasting, consider not eating past a certain time in the evening so you can fast throughout the night, and make sure to eat a nourishing breakfast in the morning, like oatmeal made with real milk, topped with fruit and a handful of nuts.

Plant-Packed Plates: If youre considering a vegetarian or plant-based diet in the new year, its important to pack the right nutrients into your meatless meals, particularly protein, calcium, vitamin D and vitamin B12. Make sure youre getting enough by enjoying a variety of plant-based foods like beans, nuts, fruits and vegetables along with some other thoughtfully chosen options. Real dairy milk is a good choice in a vegetarian diet, providing as much as eight times more protein than many non-dairy milk alternatives. Each 8-ounce glass is also a source of vitamin D, and an excellent source of calcium and vitamin B12.

Focus On Fats: If youre keeping closer tabs on your fat intake, its important to choose the right ones and know that a growing body of evidence suggests not all saturated fats are the same. For example, whole milk, which has more dairy fat than skim or low-fat varieties, may actually help raise good cholesterol and could be considered part of a diet thats also good for your heart, according to research in the European Journal of Clinical Nutrition.

Calorie Conscious: Monitoring the calories you consume versus the calories you burn through exercise and everyday activity can help manage the fuel your body needs.

When you consistently burn more calories than you eat, you are more likely to effectively lose weight. However, that doesnt mean you have to forgo all your favorite foods. For example, when it comes to dairy, swapping full-fat options for skim or low-fat alternatives is one way to receive the same nutrient package with less fat and calories.

Make better nutritional balance a priority this new year and find more advice and recipes at MilkLife.com.

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Resolve to make real nutrition a new year priority - Goshen News

Food as Medicine: Finding relief to chronic and mental health conditions – WMTV

Posted: January 29, 2020 at 2:46 am

MADISON, Wis. (WMTV) What we put in our bodies plays a significant role in our well-being and it may be fueling some chronic problems.

Numbers from the Center for Disease Control and Prevention show 90 percent of the nation's $3.5 trillion in annual health care costs are for people with chronic and mental health conditions. So, when it comes to health and wellness, it's more than just vanity.

Vanessa Teff is a nutritional consultant says there are several reasons people are looking to change their diet.

"Digestion is number one," said Teff. "Hormonal issues is number two. We have a lot of kids, so they usually come in because they have a lot of skin stuff."

She also says depression and anxiety rank near the top for reasons why people are looking for help with their diets.

Based on health history and diagnostics at her clinic, she strives to get an idea of why issues are happening in the body. She said it could be a person is not getting enough of certain foods, but also not enough of the right combination for the person's microbiome.

Nic Schilling is one of Teff's clients. He went searching for help a little over a year ago after he was battling a number of GI-issues. Schilling was working out five to six days a week, but he said his diet was far from perfect.

"We all know what we're supposed to do, but it's more fun to play and eat whatever," admitted Schilling.

He said he thought since he spent at least five days a week in the gym, he could eat what ever he wanted. Some of his favorites to indulge in included ice cream, Funyuns, and drinking alcohol. He had also tried a number of fad diets, but only found short-term success.

"The big thing for me was creating a lifestyle," said Schilling.

When Schilling consulted with Teff, she didn't immediately strip things out of his diet. Instead, she added things like pickled ginger in the morning, a yeast supplement before lunch, and 800 grams a day of fruits and veggies.

"My pantry is not fancy," said Schilling. "I have chips and snacks in there and I'll work them into my day because I like them."

In just three months time, Schilling said many of his GI-issues started going away. He was hitting personal records in the gym, sleeping better, and noticed his overall well being improved.

"I'm buying less supplements and eating real food," said Schilling.

Through consulting with Teff, Schilling started counting his macros. It is where he has a set amount of carbs, fats, and proteins allotted for each day. He then weighs his food and tracks it all on an app on his phone.

"Just focusing on the right nutrition has been quite earth shattering," said Schilling.

When other diets didn't worked, he said this is the first one where he's really noticed long term success. Schilling said if you want to take your health and well being serious, don't do it on your own.

"My biggest suggestion, work with a coach. Figure out someone who can help you out with your diet or a program and that will help you be accountable," said Schilling.

Counting macros may seem intense for some, Schilling said it is something he doesn't even think twice about anymore.

"It was certainly a practice when I started a year ago. It drove me crazy and was certainly tough," said Schilling. "But, anything worth doing is worth making it into a habit."

Teff agreed and said this is not a program that works for everyone. While nutrition is the foundation that she starts with, she said there are a number of things to take into consideration including:

"What are people doing all day long?""What's there lifestyle like?"What are they surrounded by to get that shift?"

"Because with that busy mom, you want - if she can - you want to step back and breathe," said Teff. "Just give her 'her time.' She doesn't need more supplements and herbs."

If you're looking to make some lifestyle changes, Teff suggest starting with adding water and veggies to your diet. She said by adding healthy items in before trying to cut something will increase your chances of being successful in implementing a lifestyle change.

"When we take something out, we always feel like we're at a disadvantage and we're missing something," said Teff.

UW-Madison research to heal from within - all by what we eat

Tucked inside of a lab room in Babcock Hall on UW-Madison's campus, Dr. Bradley Bolling, an assistant professor of food science, and a team of researchers and students are working to learn what is in food. Different graphs show the chemical properties which then helps researchers understand the foods impact on health.

"In our lab we are studying specifically nuts, berries, vegetables, and dairy products and how their components can inhibit inflammation which is related to a number of many chronic diseases," said Dr. Bolling.

Over the past two years, Dr. Bolling and his team have published studies about how eating yogurt can prevent inflammation in women who eat it over a period of 9 weeks. Their findings show, what he calls, a modest benefit.

Another study on aronia berries and their anti-inflammatory properties just wrapped up this past year.

"Those were experimenter conducted primarily in mice that had inflammation in their gut," described Dr. Bolling. "We see that the aronia berry consumption decreased that inflammation that results in the gut."

Using food for healing is growing in interest. Dr. Bolling said there's been an increased interest among students at UW-Madison and by the creation of new food products on the market. While the market is flooded with food labels and new headlines that make these claims, he said this is process that moves quite slowly.

"To build information, to really make a dietary recommendation takes years and hundreds of thousands of human participants in studies," said Dr. Bolling. "The work that you see popping up in headlines tends to be sometimes animal studies or chemical-based studies which are promising, but maybe haven't been as well justified b corresponding human studies."

He also warns consumers to beware of marking labels on food products and encourages consumers to do their own research to see where the study maybe in the process. Dr. Bolling recommends reviewing this this link from the FDA on Health Claims in Food Labeling.

In the future though, Dr. Bolling believes studying the healing properties of food is going to lead to specific heath recommendations, rather than making broad scale recommendations.

Below are links to some of the recent research being done at UW-Madison:

Dairy Foods and Dairy Fats: New Perspectives on Pathways Implicated in Cardiometabolic HealthAronia Berry Supplementation Mitigates Inflammation in T Cell Transfer-Induced Colitis by Decreasing Oxidative Stress.Dietary Prevention of Colitis by Aronia Berry is Mediated Through Increased Th17 and TregPremeal Low-Fat Yogurt Consumption Reduces Postprandial Inflammation and Markers of Endotoxin Exposure in Healthy Premenopausal Women in a Randomized Controlled TrialhereLow-fat yogurt consumption reduces biomarkers of chronic inflammation and inhibits markers of endotoxin exposure in healthy premenopausal women: a randomised controlled trial

As always, before you make any lifestyle changes, be sure to talk with your doctor or nutritionist.

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Food as Medicine: Finding relief to chronic and mental health conditions - WMTV

How to Travel Without Sacrificing Healthy Habits and a Plant-Based Diet – Men’s Journal

Posted: January 29, 2020 at 2:46 am

Outdoor-adventure photographer Jeff Brockmeyer highlights five daily habits that allow him to effectively take a plant-based diet on the road

After a 4 a.m. wake-up and an hour drive south to the Mexican border, Jeff Brockmeyer marches into the Tijuana International Airports TSA checkpoint officers, unzips his trusty cooler bag, and presents 120 ounces of pure, organic orange juice loaded with Vitamin C and ready for inspection.

Traveling from San Diego to Cabo San Lucas means a busy day with international borders and airport security checks before arriving in an unfamiliar land. Brockmeyer, however, has zero intention of letting hectic travel negatively impact his healthy diet. While vegan, he is first and foremost a dedicated produce-juicer who consumes three-quarters of all meals as fresh juice.

Brockmeyer, 35, is a talented and respected outdoors and action sports photographer whos made a career out of traveling the world. That is, until two years ago, when Brockmeyers on-the-road lifestyle came to screeching halt. Health issues related to Crohns disease forced his hand to make a life-changing choice:Undergo a major surgery to remove an inflamed part of his intestine; or begin a series of chemotherapy treatments. Either way, traveling for work was out of the picture and Brockmeyer felt that he was losing grip on the life he had worked hard to create.

Then, lying awake one night in the hospital, Brockmeyer realized a third option: Adapt to a 100 percent plant-based diet. He made a choice to forgo doctors recommendations and committed to implementing the diet, regardless of the extra effort.

Today, Brockmeyer is back to living his life, traveling to the fullest and making breathtaking images. Only now, he has become a master of planning out plant-based meals. Because of the high health stakes to make a mobile juice-based diet work, we needed to hear his best tips for taking such a high-health, high-effort production on the road or into the air.

Back in Cabo, Brockmeyer hits the ground and immediately finds a local market to stock up on all of the fresh fruits and vegetables needed for his week ahead. With necessities in hand, we connect in the evening to unlock a few keys to not sacrificing healthy habits while traveling.In short, the recipe to success starts with proper planning and following through on a few routines. Healthy habits are a byproduct of healthy routines. Brockmeyers best advice for health on the road? Plan for it by making new routinesand stick to them!

For Dramatic Weight Loss, You Cant Beat a Whole-Food, Plant-Based Diet

Brockmeyers 5 Routines for a Healthy Travel Diet

Do Your Research: As soon as a trip is booked, find the nearest grocery store. Plan the meals you will be shopping for based on what foods will be available in that area. Upon arrival in Cabo San Lucas, Brockmeyer already had the name and location of the nearest market and wasted zero time stockpiling produce.The first thing I type in on Google is the city Im going to and organic farmers market, Brockmeyer says. Organic and local is my favorite. It tastes the best and is the most nutrient-dense. Thats what I strive for.

Prepare at Home: The day before hitting the road, prepare all of the meals needed for the entire day of travel. For Brockmeyer this includes around 120 ounces of juice and a variety of dried fruits. His strategy here is to have enough nutrients prepared for an entire day regardless of what it will entail.Ill take about two hours the night before preparing, he says. Ill make my juice, cut up different fruit and store everything in the fridge. I always pack four jars of juice and some backup dried fruit so that I can get through an entire day, in case there is an emergency. Even if it is a two-hour flight, bring snacks for the whole day.

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$120 in local organic freshly picked produce. This will last about a week. If you have farmers markets in your area, I highly recommend supporting them. Not only is their quality of produce far superior, but it is usually way cheaper too! Food is medicine. Pills are not medicine, pills are poison. Choosing to pay your farmers for the life force of nutrient dense organic produce keeps the system alive that is designed to keep us alive. Farmers are our key to radiant health. Monsanto would love to pump you up full of GMO corn and soy based processed crap, Merk would love to pump you up full of aluminum and formaldehyde vaccines to give you autism, Tyson would love to pump you full of hormone infused chicken thighs, AND.. your local organic farmers would love to pump you up full of the best nutrients in earth grown by the sun and the king himself to give you a thriving and perfectly healthy body. Lets give the local growers our support to keep on going so Costco and Walmart arent the only options to get organic food in 10 years. Ive drink 200oz of fresh Valencia orange juice in the past two days and Ive never felt better. The cure to all these bull crap diseases is to stop listening to your doctor recite research studies and prescribe you medicine, listen to your heart, to nature, it is listening to the healers, and the self healers who have put in the hard as hell work, regenerating their bodies the hard way, all on the one tool given to us to keep us healthy and bring us back to health. The Food! Its the food. Its everything! Im about to blow a fuse out of my brain socket Im so pumped up on 64 oz of OJ. Thanks for listening to my rants. Happy holidays may the juice be with you.

A post shared by JUICING + Natural Healing (@jeffjuices) on Dec 24, 2019 at 12:48pm PST

Pack Accordingly: Brockmeyer prepares two bags to ensure his healthy travel is a success. One bag is typically a carry-on cooler containing the prepared juices and cut dried fruits for his travel. This bag is also equipped with coldpacks and a doctor note confirming his diet. Although he has never had any issues with TSA while flying domestically, he has been asked to present a doctor note during international travel inspections. The second bag gets checked and contains all of the tools necessary to prepare meals while on the road. Example packlist includes: knives, cutting boards, bowls, strainers, a juicer or blender and lots of storage such as water bottles, grocery bags, mason jars and Tupperware.

I make sure all of my stuff is extremely organized, and I bring a doctor note in addition to saying that I have a health condition, Brockmeyer says. It has never been an issue. The other thing I do is take everything I would need for an extended period of time.

Groceries on Arrival: The number one biggest tip and most important step: Grocery shop as soon as you arrive to your destination. Brockmeyer cant stress the importance of this step enough. If you are traveling with others, dont feel awkward about breaking off to shop or asking the group to make the stop with you. Either way, it is imperative that you take responsibility for your diet and that means buying the ingredients you need.If you want to live a healthy life and travel, he says, the first thing you have to do is go to the grocery store no matter where you go! You dont go to a restaurant, you dont go to a gas station. You go to a grocery store and get what you need. You are in charge of your body.

Prepare Meals Daily: Each morning Brockmeyer prepares all of his meals, this requires setting aside the time in advance. If you know you wont have time to cook your meals directly before you eat them, plan ahead and prepare for your day. If you fail to prepare, prepare to fail.You need to prep your own food, Brockmeyer insists. If you will be on the go all day, wake up early and make all of your meals. That is your routine.

Follow Brockmeyers juicing journey @JeffJuices / jeffjuices.com, and his adventure photography @JeffBrockmeyer / jeffbrockmeyer.com

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How to Travel Without Sacrificing Healthy Habits and a Plant-Based Diet - Men's Journal

How effective diets boost weight loss and improve health – Telangana Today

Posted: January 29, 2020 at 2:46 am

As people rely on diets to lose weight and following a balanced diet helps people in achieving the perfect body shape. Intermittent fasting, Mediterranean diet, and Paleo diets are some of the diets that help people with overweight issues. In a recent study, scientists have explored how effective these diets are.

The University of Otagos research on 250 participants shows an intermittent diet that proves to be more efficient in weight loss than others. The aim of the research was to examine how effective all three diets were in reality, where participants self-selected which diet they wished to follow, without any ongoing support from a dietician.

This work supports the idea that there isnt a single right diet there is a range of options that may suit different people and be effective. In this study, people were given dietary guidelines at the start and then continued with their diets in the real world while living normally, explained Melyssa. About half of the participants were still following their diets after a year and had experienced improvements in markers of health.

Like the Mediterranean diet, intermittent fasting and paleo diets can also be valid healthy eating approaches the best diet is the one that includes healthy foods and suits the individual.Co-lead author Dr. Michelle Jospe, a Postdoctoral Fellow in the Department of Medicine, said that the results showed people found the Mediterranean diet to be the easiest to adhere to.

54 percent of participants chose the fasting diet, while 27 per cent chose the Mediterranean and 18 per cent the paleo.After 12 months, the Mediterranean diet had the best retention rate with 57 per cent of participants continuing, with 54 per cent still fasting and 35 per cent still on the paleo diet.

Reduced systolic blood pressure was observed among those participating in the fasting and Mediterranean diets, together with reduced blood sugar levels in the Mediterranean diet.Dr Jospe explains participants who said they were still following their diet at 12 months lost even more weight, showing the importance of choosing a diet that is sustainable.She believes the results of this study are relevant to the thousands of people following self-chosen diets with little supervision and indicates more realistic outcomes.

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How effective diets boost weight loss and improve health - Telangana Today

Codexis Is Chasing a Blockbuster Opportunity. Can It Compete With Gene Therapies? – Motley Fool

Posted: January 29, 2020 at 2:46 am

Genetic medicines and cellular therapies have an enormous potential to treat, and possibly cure, currently untreatable diseases. Nonetheless, it's important for investors to remember that "simpler" treatment options won't become obsolete just because gene therapy, gene editing, and immunotherapy approaches are becoming feasible.

Investors are hoping that the 'simple is better' approach proves true for Codexis (NASDAQ:CDXS).The company's first drug candidate, the enzyme-based CDX-6114, is being developed to treat a rare disease called phenylketonuria (PKU). Can the simpler approach of Codexis compete with a growing list of gene therapies that are also targeting the disease?

Image source: Getty Images.

Codexis isn't a biopharmaceutical company. It has developed a platform for engineering enzymes, which are complex molecules that power virtually all biological processes in living cells. Enzymes can also be added to industrial processes, health diagnostics, and consumer products to reduce energy consumption, lower input requirements, improve functionality, and eliminate toxic wastes.

Today, the company generates most of its revenue from three sources: selling enzymes that improve drug manufacturing processes, selling enzymes that improve the manufacturing process for a zero-calorie sweetener ingredient from Tate & Lyle, and selling licenses to its enzyme engineering software platform. But Codexis is also eyeing a large opportunity in developing novel therapeutics.

In late 2017, Codexis and Nestle Health Science, owned by Nestle, entered into an agreement to develop rare-disease drug candidates. The goal is to engineer enzymes that can be administered orally, rather than injected or given intravenously, which would provide a significant advantage in cost and convenience relative to treatments for many rare diseases.

Designing medicines that can be taken orally may not sound very novel, but enzyme-based treatments are typically degraded as they journey through the gastrointestinal (GI) tract. That requires enzymatic medicines to be administered subcutaneously, which can trigger severe allergic reactions and doesn't efficiently deliver them to the liver, where they're most effective. Therefore, Codexis must engineer enzymes that are stable enough to make it through the GI tract so they can be transported into the liver -- a capability uniquely accessible to Codexis.

The first asset to advance into clinical trials was the experimental PKU treatment called CDX-6114. Individuals born with PKU have a nonfunctioning copy of the enzyme phenylalanine hydroxylase (PAH) that metabolizes the amino acid phenylalanine (Phe). When Phe accumulates to dangerous levels, it can cause significant intellectual disabilities in newborns and mental impairments in adults. Individuals must follow a strict (and expensive) diet that limits daily protein intake to just five grams and avoids the artificial sweetener aspartame, which breaks down into Phe. CDX-6114 was designed to help individuals metabolize Phe and live a normal lifestyle.

In early 2019, Nestle Health Science, which sells many nutritional products for PKU patients, exercised an option granting it exclusive rights to develop and commercialize CDX-6114. Codexis is eligible to receive up to $85 million in remaining development and approval milestones, up to $250 million in revenue milestones, and royalties on sales.

For comparison, Codexis generated $44 million in the first nine months of 2019. While the industrial business is growing, achieving success with the therapeutic pipeline could provide a significant boost. Will gene therapies stand in the way?

Image source: Getty Images.

The hypothesis supporting the collaboration between Codexis and Nestle Health Science is pretty simple to understand: Many rare diseases are caused when individuals fail to make a specific functioning enzyme, so treatments that provide a working copy could prove valuable. Of course, that's the exact hypothesis supporting the industry's pursuit of genetic medicines.

Whereas Codexis wants to provide an enzyme substitute through an orally available drug, a gene therapy aims to provide direct replacement of an enzyme by potentially fixing the genetic error at the root of a disease.

It might be tempting to think that gene therapy is the ideal solution for PKU, but not every gene therapy will succeed in providing a cure. If a gene therapy only partially succeeds in replacing adequate levels of the gene responsible for producing the PAH enzyme, then individuals might still be dependent on strict diets and imperfect treatment options. Simply put, barring the successful development of a curative gene therapy, the enzyme-based approach of Codexis and Nestle Health Science could be a competitive option.

It's not much of a competition at the moment, as there's not much to compare. CDX-6114 is being studied in a phase 1b study, while early-stage results for gene therapies have been unimpressive or non-existent.

Company

PKU Drug Candidate

Results

Codexisand Nestle Health Science

CDX-6114 (enzymatic)

Phase 1a trial: well tolerated at all four dose levels in 32 healthy volunteers, but not tested in PKU patients

Homology Medicines (NASDAQ:FIXX)

HMI-102 (gene therapy)

Phase 1/2 trial (ongoing): two individuals with PKU receiving low-dose showed no reduction in Phe at three months, one individual receiving high-dose achieved a reduction in Phe

BioMarin (NASDAQ:BMRN)

BMN 307 (gene therapy)

Expects to initiate phase 1/2 trial in the United Kingdom in early 2020

Data sources: Codexis, Homology Medicines, and BioMarin.

Despite the early-stage nature of the industry's pipeline, the opportunity is large and the bar is relatively low.

Individuals with PKU currently have two main drug options: Kuvan and Palynziq. The two drugs, both sold by BioMarin, generated combined revenue of $396 million in the first nine months of 2019. But they're only partial solutions.

Kuvan is a coenzyme that can help to break down Phe, but it only works for individuals with milder PKU and comes with a relatively long list of side effects. It still generated $341 million in revenue in the first nine months of 2019.

Palynziq is a newer therapy. It's a substitute to working PAH enzymes required to metabolize Phe, but the drug can take up to 12 months to begin working and triggers significant side effects in most people. It comes with a black-box warning for severe allergic reactions (observed in 9% of individuals in clinical trials), requires daily injections, and costs $192,000 per year. While doctors have been generally impressed with results for patients that stick with treatment, there's much room for improvement.

Codexis is hoping that CDX-6114 can provide a convenient and safe enzyme-based treatment option for individuals with PKU. If the asset demonstrates promising clinical results in an ongoing phase 1b trial, then it could begin to factor into the pharma stock's price and the company's market valuation. After all, analysts expect Palynziq to generate over $1 billion in peak annual sales despite the drug's inconveniences and safety issues, and Codexis is valued at just $1 billion today.

However, investors do need to keep track of genetic medicines in development at Homology Medicines, BioMarin, and any other companies that throw their hats into the ring (RNA interference seems uniquely suited for a PKU treatment, but no such drugs are in development yet). If genetic medicines demonstrate a consistent safety profile and provide a cure for most individuals with PKU in early clinical trials, then CDX-6114 might have its market potential severely reduced before it even leaves the clinic. If genetic medicines only provide partial solutions, then the details and nuance might determine which approach, if any, will dominate the market.

The next batch of results from each company is likely to be available before the end of 2020, which means investors will learn quite a bit about the shape of the competitive landscape soon.

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Codexis Is Chasing a Blockbuster Opportunity. Can It Compete With Gene Therapies? - Motley Fool


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