A teen gets a dose of Pfizer's COVID-19 vaccine at Holtz Children's Hospital in Miami on May 18. Nearly 7 million U.S. teens and pre-teens (ages 12 through 17) have received at least one dose of a COVID-19 vaccine, so far, the CDC says.; Credit: Eva Marie Uzcategui/Bloomberg via Getty Images

It's been a little more than a month since adolescents as young as 12 became eligible in the United States to receive the Pfizer vaccine against COVID-19, and nearly all reports have been positive: The vaccine is very effective in this age group, and the vast majority of kids experience mild side effects, if any — the same sore arm or mild flu-like symptoms seen among adults who get the shot.

The Centers for Disease Control and Prevention has recommended that everyone 12-years-old and older get vaccinated against COVID-19, and the rollout is well underway: According to the CDC, nearly 7 million U.S. teens and pre-teens (ages 12 through 17) have received at least one dose of a COVID-19 vaccine, so far.

Still, soon after the FDA authorized the use of Pfizer's vaccine in young people, federal agencies began receiving reports of mild chest pain or other signs of possible heart inflammation (known as myocarditis) in a very small percentage of recently vaccinated teens.

CDC director Rochelle Walensky said at a White House briefing Friday that there have been more than 300 cases of heart inflammation reported among more than 20 million teens and young adults who have received one of the vaccines made by Moderna or Pfizer. She said that in the "vast majority" of cases, the inflammation went away.

An expert advisory committee to the health agency is expected to review the cases in more depth at a meeting Friday.

So, in the meantime, should parents of teens hesitate to have their kids vaccinated against COVID-19? Vaccine experts and the American Academy of Pediatrics say no, don't hesitate. It's good for doctors and patients to be aware that there might be a connection between the mRNA vaccines and heart inflammation, and to report to their pediatrician anything they see in that first week after vaccination. But it is also important, the CDC notes, to recognize that even if this does turn out to be an extremely rare side effect of the vaccine, "most patients who received care responded well to medicine and rest and quickly felt better." And the serious risks of COVID -19 — even for young healthy people — outweigh the risks of any possible side effects from the vaccine. Here are some questions you may have, and what's known:

What exactly is myocarditis?

Myocarditis is an inflammation of the heart muscle, and pericarditis, also being investigated, is an inflammation of the sac around the heart.

Long before the pandemic, thousands of cases of myocarditis were diagnosed in the U.S. and around the world each year, often triggered by the body's immune response to infections. SARS-CoV-2 can trigger it, and so can cold viruses, and staph and strep and HIV. Other causes include toxins and allergies.

Symptoms include chest pain and shortness of breath. It's often mild enough to go unnoticed, but a full-blown case in adults can cause arrhythmias and heart failure that require careful treatment with multiple medications, and several months of strict rest. In a case study of seven teenagers who got myocarditis following vaccination published last week in the journal Pediatrics, all seven got better after routine treatment with anti-inflammatory drugs.

Pediatric cardiologist Dr. Stuart Berger of the Northwestern University Feinberg School of Medicine, a spokesperson for the American Academy of Pediatrics, says vaccine-related myocarditis in teens is not all that worrisome. "Although they appear with some symptoms of chest pain, and maybe some findings on EKGs, all of the cases we've seen have been on the mild end of the spectrum," he says.

So, what's the concern?

Several hundred reports about the inflammation have been filed with the federal government's Vaccine Adverse Event Reporting System (VAERS); that's a repository of reports sent in by health professionals and patients about any health events they spot in the hours or days after vaccinations. Many of the events reported turn out to be coincidental — not caused by a vaccine. The database is just meant as a starting point for further investigation and not proof of cause and effect. But as NPR's Geoff Brumfiel noted this week, "when millions of people are vaccinated within a short period, the total number of these reported events can look big."

That said, anecdotes reported by doctors in medical journals and reports to VAERS suggest that both of the mRNA vaccines authorized for use in the U.S. — the Pfizer and Moderna vaccines — might slightly increase the incidence of myocarditis in young people. In 2003, a report in the New England Journal of Medicine estimated the background incidence of myocarditis to be 1.13 cases in 100,000 children per year.

Paul Offit, professor of pediatrics at the Children's Hospital of Philadelphia and a member of a Food and Drug Administration vaccine advisory committee says there likely is a causal link between the heart inflammation some doctors are seeing in these teens and the second dose of vaccine. "I think it's real," he says, but hastens to add that the effect is exceedingly small – based on the data collected so far, maybe one in 50,000 vaccinees between the ages of 16 and 39. "And the good news is at least so far it looks to be transient and self-resolving."

Still, maybe I should wait to get my teen vaccinated and see how this plays out?

Uhm, no, according to several vaccine experts contacted by NPR. And this is where a little math comes in handy.

"Take a stadium full of 100,000 people between the ages of 16 and 39, which is the subset that appears to be at greater risk," Offit says. "Vaccinate all of them, and two might get myocarditis." But if you don't vaccinate any of the 100,000, he estimates that about 1,300 would eventually get COVID-19. And those numbers are likely to increase this winter.

About one in 1,000 children who get COVID-19 have gone on to develop a condition called MIS-C (multisystem inflammatory syndrome in children), says Offit, and most of those kids have had some level of myocarditis. In addition, the new coronavirus has directly caused myocarditis in some children and adults. Which of the two stadiums in Offit's metaphor would have more cases of myocarditis — the vaccinated children or unvaccinated kids — is not known precisely. But Offit says he suspects it would be the unvaccinated group. And there's no doubt that 1,000 unvaccinated children would suffer more COVID-19-related illnesses. "A choice not to get a vaccine is not a choice to avoid myocarditis," he says. "It's a choice to take a different risk — and I would argue a more serious one" — of developing a bad case of COVID-19 or long-COVID or COVID-caused myocarditis.

Are the experts advising their own kids in this age group to get vaccinated?

Yes. "I understand people having concerns," says Dr. Judith Guzman-Cottrill. She's a parent and professor of pediatric infectious diseases at the Oregon Health and Science University, as well as the senior author on a small study that came out this month in the journal Pediatrics. In the report, Guzman-Cottrill and her colleagues analyzed the cases of seven boys around the country who developed myocarditis within four days of receiving the Pfizer-BioNTech vaccine.

She and her family recently faced the vaccination decision for her own 13-year-old daughter — and said a whole-hearted yes to the shot.

Guzman-Cottrill suspects there may turn out to be a slightly increased risk of heart inflammation from vaccination in young people, but she and her co-authors note in the Pediatrics report that a direct cause-and-effect connection — even in these seven cases — has yet to be established. And she's impressed that despite the millions of doses that have so far been delivered to teens, no clear and serious post-vaccination problems have shown up. "The emergency departments and urgent care clinics are not filled with teenagers complaining of chest pain," she says.

She's treated unvaccinated teens who developed severe myocarditis from an infection with the COVID-19 virus, and others who developed COVID-19 pneumonia and respiratory failure. Seeing those teens struggle — teens who lacked the powerful immune protection the vaccine provides — was enough for her to suggest vaccination to her daughter, who got her second vaccination earlier this week.

"She saw it as a pathway back to a normal post pandemic life," Guzman-Cottrill says.

And that's where public health comes in. "We really need a highly vaccinated student body when kids return to the classroom this fall," says Guzman-Cottrill, "so we don't see surges in COVID-19 cases."

Joanne Silberner, a former health policy correspondent for NPR, is a freelance journalist living in Seattle.

This content is from Southern California Public Radio. View the original story at SCPR.org.

The pandemic has taken a massive toll on people's mental health. But a new report by the U.S. Centers for Disease Control and Prevention confirms what many of us are seeing and feeling in our own lives: The impact has been particularly devastating for parents and unpaid caregivers of adults.

Two-thirds of survey respondents who identified as unpaid caregivers said they experienced mental health challenges during the pandemic, such as symptoms of anxiety or depression, or suicidal thoughts.

Only one-third of people with no caregiving responsibilities reported the same symptoms.

Of the more than 10,000 survey respondents, more than 40% identified as being unpaid caregivers.

"What is striking here is just how widespread unpaid caregiving responsibilities are in the population and how much of a burden and a toll these responsibilities" are having, says Shantha Rajaratnam, a co-author of the study and a psychologist at the Turner Institute of Brain and Mental Health at Monash University in Australia.

The study also found that people who care for both children under 18 and adults — many of them part of the sandwich generation — are faring the worst, with 85% of this group experiencing adverse mental health symptoms.

"It's an extremely important study," says psychologist Dolores Gallagher-Thompson, professor emeritus at Stanford University who has researched family caregivers and their challenges.

The study is the first to document the problems caregivers have experienced during COVID-19, she notes, and underscores "the importance of paying attention to caregiver issues, caregiver mental health" and the need for education and resources to better support them.

The contrast between caregivers and others is stark

The study, part of ongoing research by The COVID-19 Outbreak Public Evaluation (COPE) Initiative, is based on surveys conducted in December 2020 and February-March 2021.

More than half of those who identified as caregivers said they had experienced symptoms of anxiety or depression, or of disorders like PTSD related to the stress and trauma of COVID-19.

A significant number of caregivers said they had contemplated suicide. Nearly 40% reported having passive suicidal thoughts, meaning "wishing that they had gone to bed and didn't wake up," says study co-author Mark Czeisler, a graduate student at Monash University and a research trainee at Brigham and Women's Hospital in Boston.

And more than 30% had seriously considered taking their own life — about five times the number of noncaregivers, the study found.

Across the board, mental health impacts have been more severe for people who care for both children and adults. Half of this group said it had seriously considered suicide in the past month.

The pandemic worsened the challenges caregivers face

Even before the pandemic, being an unpaid caregiver was stressful and associated with a higher risk of mental health issues, says Gallagher-Thompson. The COVID-19 pandemic has made things even harder.

For instance, the pandemic has taken away many formal and informal sources of support for caregivers.

That was the case for Dr. Nicole Christian-Brathwaite. She's a Boston-based child psychiatrist and lives with her husband, her mother, her husband's father and two sons, who are 4 and 6.

Before the pandemic, her father-in-law, who has dementia, went to a day program for seniors with cognitive decline. Her mother, a survivor of breast and lung cancers, went to physical therapy twice a week, doctor appointments and met with friends.

When the pandemic hit, they lost those services and social support — at the same time Christian-Brathwaite and her husband began working from home while taking care of their sons and parents.

Life at home became much more complicated. Her sons developed behavioral problems with the transitions and stresses of the pandemic. Her mother struggled with chronic pain, and was hospitalized during the pandemic. And there were days when her father-in-law was confused, disoriented or aggressive.

"Many days I was walking around on edge waiting for something to happen because our entire setup was so very fragile and vulnerable," says Christian-Brathwaite. "It's been exhausting."

And her mental health has suffered. "I certainly was dealing with insomnia," she says. "I was short tempered. I was more irritable. I didn't have the same tolerance for things."

More support needed to help caregivers cope

The new study highlights the extent to which unpaid caregivers have struggled during the pandemic, says Gallagher-Thompson.

"There are some serious issues here that shouldn't be ignored," she says.

And yet caregivers are often ignored by the health system, which is set up to focus only on patients.

"Family members are rarely asked, 'How does this affect you? What is difficult? How can we help you? How can we support you in being able to carry out your role, your tasks, your responsibilities?'" Gallagher-Thompson says.

As the new study shows, support can make a big difference — respondents who could rely on others for help with caregiving had a lower incidence of mental health symptoms.

So it's important to educate and support caregivers. For example, physicians can start by screening their patients' caregivers for mental health symptoms and provide more resources to those who need it, says Gallagher-Thompson.

Christian-Brathwaite hopes the new study will help physicians recognize that family caregivers are just as important to consider while treating patients.

"We really need to take a step back and look at the village that's around them because our patients can't be successful without having the support from family," she says.

This content is from Southern California Public Radio. View the original story at SCPR.org.

Chiquita Brooks-LaSure, administrator of the Centers for Medicare & Medicaid Services, leads some of the Biden administration's efforts to expand Medicaid access.; Credit: Caroline Brehman/CQ-Roll Call, Inc via Getty Imag

The Biden administration is quietly engineering a series of expansions to Medicaid that may bolster protections for millions of low-income Americans and bring more people into the program.

Biden's efforts — which have been largely overshadowed by other economic and health initiatives — represent an abrupt reversal of the Trump administration's moves to scale back the safety-net program.

The changes could further boost Medicaid enrollment — which the pandemic has already pushed to a record 80.5 million. Some of the expansion is funded by the COVID-19 relief bill that passed in March, including coverage for new mothers.

Others who could also gain coverage under Biden are inmates and undocumented immigrants. At the same time, the administration is opening the door to new Medicaid-funded services such as food and housing that the government insurance plan hasn't traditionally offered.

"There is a paradigm change underway," said Jennifer Langer Jacobs, Medicaid director in New Jersey, one of a growing number of states trying to expand home-based Medicaid services to keep enrollees out of nursing homes and other institutions.

"We've had discussions at the federal level in the last 90 days that are completely different from where we've ever been before," Langer Jacobs said.

Taken together, the Medicaid moves represent some of the most substantive shifts in federal health policy undertaken by the new administration.

"They are taking very bold action," said Rutgers University political scientist Frank Thompson, an expert on Medicaid history, noting in particular the administration's swift reversal of Trump policies. "There really isn't a precedent."

The Biden administration seems unlikely to achieve what remains the holy grail for Medicaid advocates: getting 12 holdout states, including Texas and Florida, to expand Medicaid coverage to low-income working-age adults through the Affordable Care Act.

And while some of the recent expansions – including for new mothers -- were funded by close to $20 billion in new Medicaid funding in the COVID relief bill Biden signed in March, much of that new money will stop in a few years unless Congress appropriates additional money.

The White House strategy has risks. Medicaid, which swelled after enactment of the 2010 health law, has expanded further during the economic downturn caused by the pandemic, pushing enrollment to a record 80.5 million, including those served by the related Children's Health Insurance Program. That's up from 70 million before the COVID crisis began.

The programs now cost taxpayers more than $600 billion a year. And although the federal government will cover most of the cost of the Biden-backed expansions, surging Medicaid spending is a growing burden on state budgets.

The costs of expansion are a frequent target of conservative critics, including Trump officials like Seema Verma, the former administrator of the Centers for Medicare & Medicaid Services, who frequently argued for enrollment restrictions and derided Medicaid as low-quality coverage.

But even less partisan experts warn that Medicaid, which was created to provide medical care to low-income Americans, can't make up for all the inadequacies in government housing, food and education programs.

"Focusing on the social drivers of health ... is critically important in improving the health and well-being of Medicaid beneficiaries. But that doesn't mean that Medicaid can or should be responsible for paying for all of those services," said Matt Salo, head of the National Association of Medicaid Directors, noting that the program's financing "is simply not capable of sustaining those investments."

Restoring federal support

However, after four years of Trump administration efforts to scale back coverage, Biden and his appointees appear intent on not only restoring federal support for Medicaid, but also boosting the program's reach.

"I think what we learned during the repeal-and-replace debate is just how much people in this country care about the Medicaid program and how it's a lifeline to millions," Biden's new Medicare and Medicaid administrator, Chiquita Brooks-LaSure, told KHN, calling the program a "backbone to our country."

The Biden administration has already withdrawn permission the Trump administration had granted Arkansas and New Hampshire to place work requirements on some Medicaid enrollees.

In April, Biden blocked a multibillion-dollar Trump administration initiative to prop up Texas hospitals that care for uninsured patients, a policy that many critics said effectively discouraged Texas from expanding Medicaid coverage through the Affordable Care Act, often called Obamacare. Texas has the highest uninsured rate in the nation.

The moves have drawn criticism from Republicans, some of whom accuse the new administration of trampling states' rights to run their Medicaid programs as they choose.

"Biden is reasserting a larger federal role and not deferring to states," said Josh Archambault, a senior fellow at the conservative Foundation for Government Accountability.

But Biden's early initiatives have been widely hailed by patient advocates, public health experts and state officials in many blue states.

"It's a breath of fresh air," said Kim Bimestefer, head of Colorado's Department of Health Care Policy and Financing.

Chuck Ingoglia, head of the National Council for Mental Wellbeing, said: "To be in an environment where people are talking about expanding health care access has made an enormous difference."

Mounting evidence shows that expanded Medicaid coverage improves enrollees' health, as surveys and mortality data in recent years have identified greater health improvements in states that expanded Medicaid through the 2010 health law versus states that did not.

Broadening eligibility

In addition to removing Medicaid restrictions imposed by Trump administration officials, the Biden administration has backed a series of expansions to broaden eligibility and add services enrollees can receive.

Biden supported a provision in the COVID relief bill that gives states the option to extend Medicaid to new mothers for up to a year after they give birth. Many experts say such coverage could help reduce the U.S. maternal mortality rate, which is far higher than rates in other wealthy nations.

Several states, including Illinois and New Jersey, had sought permission from the Trump administration for such expanded coverage, but their requests languished.

The COVID relief bill — which passed without Republican support — also provides additional Medicaid money to states to set up mobile crisis services for people facing mental health or substance use emergencies, further broadening Medicaid's reach.

And states will get billions more to expand so-called home and community-based services such as help with cooking, bathing and other basic activities that can prevent Medicaid enrollees from having to be admitted to expensive nursing homes or other institutions.

Perhaps the most far-reaching Medicaid expansions being considered by the Biden administration would push the government health plan into covering services not traditionally considered health care, such as housing.

This reflects an emerging consensus among health policy experts that investments in some non-medical services can ultimately save Medicaid money by keeping patients out of the hospital.

In recent years, Medicaid officials in red and blue states — including Arizona, California, Illinois, Maryland and Washington — have begun exploring ways to provide rental assistance to select Medicaid enrollees to prevent medical complications linked to homelessness.

The Trump administration took steps to support similar efforts, clearing Medicare Advantage health plans to offer some enrollees non-medical benefits such as food, housing aid and assistance with utilities.

But state officials across the country said the new administration has signaled more support for both expanding current home-based services and adding new ones.

That has made a big difference, said Kate McEvoy, who directs Connecticut's Medicaid program. "There was a lot of discussion in the Trump administration," she said, "but not the capital to do it."

Other states are looking to the new administration to back efforts to expand Medicaid to inmates with mental health conditions and drug addiction so they can connect more easily to treatment once released.

Kentucky health secretary Eric Friedlander said he is hopeful federal officials will sign off on his state's initiative.

Still other states, such as California, say they are getting a more receptive audience in Washington for proposals to expand coverage to immigrants who are in the country without authorization, a step public health experts say can help improve community health and slow the spread of communicable diseases.

"Covering all Californians is critical to our mission," said Jacey Cooper, director of California's Medicaid program, known as Medi-Cal. "We really feel like the new administration is helping us ensure that everyone has access."

The Trump administration moved to restrict even authorized immigrants' access to the health care safety net, including the "public charge" rule that allowed immigration authorities to deny green cards to applicants if they used public programs such as Medicaid. In March, Biden abandoned that rule.

KHN correspondent Julie Rovner contributed to this report.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

This content is from Southern California Public Radio. View the original story at SCPR.org.

Advocates for expanding Medicaid in Kansas staged a protest outside the entrance to the statehouse parking garage in Topeka in May 2019. Today, twelve states have still not expanded Medicaid. The biggest are Texas, Florida, and Georgia, but there are a few outside the South, including Wyoming and Kansas.; Credit: John Hanna/AP

There are more than 2 million people across the United States who have no option when it comes to health insurance. They're in what's known as the "coverage gap" — they don't qualify for Medicaid in their state, and make too little money to be eligible for subsidized health plans on the Affordable Care Act insurance exchanges.

Briana Wright is one of those people. She's 27, lives near Jackson, Miss., works at McDonalds, and doesn't have health insurance. So to figure out her options when she recently learned she needed to have surgery to remove her gallbladder, she called Health Help Mississippi, a nonprofit that helps people enroll in health insurances.

Because she lives in Mississippi, "I wasn't going to be eligible for Medicaid — because I don't have children [and] I'm not pregnant," she tells NPR. When she had her income checked for Healthcare.gov, it was just shy of the federal poverty line — the minimum to qualify for subsidies. "It was $74 [short]. I was like, oh wow," she says.

Wright's inability to get a subsidized policy on Healthcare.gov is related to how the Affordable Care Act was originally designed. People needing insurance who were above the poverty line were supposed to be funneled via the federal and state insurance exchanges to private policies — with federal subsidies to help make those policies affordable. People who were under the poverty line were to be funneled to a newly-expanded version of Medicaid — the public health insurance program that is jointly funded by states and the federal government. But the Supreme Court made Medicaid expansion essentially optional in 2012, and many Republican-led states declined to expand. Today, there are 12 holdout states that have not expanded Medicaid, and Mississippi is one of them.

So, Wright is still uninsured. Her gallbladder is causing her pain, but she can't afford the surgery without shuffling household bills, and risking leaving something else unpaid. "I'm stressed out about it. I don't know what I'm going to do," she says. "I'm going to just have to pay it out of pocket or get on some payment plan until it all gets paid for."

Hoping to finally find a fix for Wright and the millions like her who are in Medicaid limbo, several teams of Democratic lawmakers have recently been hashing out several options — hoping to build on the momentum of the latest Supreme Court confirmation that the ACA is here to stay.

OPTION 1: Sweet-talk the 12 holdout states

The COVID-19 relief bill passed in March included financial enticements for these 12 states to expand Medicaid. Essentially, the federal government will cover 90% of the costs of the newly eligible population, and an additional 5% of the costs of those already enrolled.

It's a good financial deal. An analysis by the nonprofit Kaiser Family Foundation estimates that the net benefit for these states would be $9.6 billion. But, so far — publicly, at least — no states have indicated they intend to take the federal government up on its offer.

"If that is not getting states to move, then that suggests that the deep root of their hesitation is not about financial constraint," says Jamila Michener, a professor of government at Cornell University and author of the book Fragmented Democracy: Medicaid Federalism And Unequal Politics.

Instead, Michener says, the reluctance among some Republican-led legislatures and governors to expand Medicaid may be a combination of partisan resistance to President Obama's signature health law, and not believing "this kind of government intervention for these groups of people is appropriate."

What's Next: When asked about progress on this front in an April press briefing, Biden's press secretary Jen Psaki said "the President is certainly supportive of — and an advocate for — states expanding Medicaid," but did not answer a follow up about whether the White House was directly reaching out to governors regarding this option.

OPTION 2: Create a federal public option to fill the gap

Some have advocated for circumventing these holdout states and creating a new, standalone federal Medicaid program that people who fall into this coverage gap could join. It would be kind of like a tailored public option just for this group.

This idea was included in Biden's 2022 budget, which says, in part: "In States that have not expanded Medicaid, the President has proposed extending coverage to millions of people by providing premium-free, Medicaid-like coverage through a Federal public option, paired with financial incentives to ensure States maintain their existing expansions."

But it wouldn't be simple. "That can be quite complex — to implement a federal program that's targeted to just these 2.2 million people across a handful of states," says Robin Rudowitz, co-director of the Medicaid program at the Kaiser Family Foundation, who wrote a recent analysis of the policy options.

It also may be a heavy lift, politically, says Michener. "Anything that expanded the footprint of the federal government and its role in subsidizing health care would be especially challenging," she says.

What's next: This idea was raised as a possible solution in a letter last month from Georgia's Democratic senators to Senate leaders, and Sen. Raphael Warnock said this week he plans to introduce legislation soon.

OPTION 3: Get around stubborn states by letting cities expand Medicaid

Instead of centralizing the approach, this next idea goes even more local. The COVER Now Act, introduced by Rep. Lloyd Doggett, D-Texas, would empower local jurisdictions to expand Medicaid. So, if you live in Austin, Texas, maybe you could get Medicaid, even if someone in Lubbock still couldn't.

The political and logistical challenges would be tough, policy analysts say. Logistically, such a plan would require counties and cities to create new infrastructure to run a Medicaid program, Rudowitz notes, and the federal government would have to oversee how well these new local programs complied with all of Medicaid's rules.

"It does not seem feasible politically," Michener says. "The legislators who would have to vote to make this possible would be ceding quite a bit of power to localities." It also might amplify geographic equity concerns, she says. People's access to health insurance would not just "be arbitrarily based on what state you live in — which is the current state of affairs — It's also going to be arbitrary based on what county you live in, based on what city you live in."

What's next: Doggett introduced the bill earlier this month. There's no guarantee it would get a vote on the House floor and — even if it did — it wouldn't survive a likely filibuster in the evenly divided Senate.

OPTION 4: Change the ACA to open up the exchanges

A fourth idea, Rudowitz says, is to change the law to remove the minimum cutoff for the private health insurance exchanges, since "right now, individuals who are below poverty are not eligible for subsidies in the marketplace." With this option, states wouldn't be paying any of the costs, since the federal government pays premium subsidies, Rudowitz says, but "there are issues around beneficiary protections, benefits, out-of-pocket costs."

What's next: This idea hasn't yet been included in any current congressional bills.

Will any of these ideas come to fruition?

Even with a variety of ideas on the table, "there's no slam dunk option, it's a tough policy issue," Rudowitz says. All of these would be complicated to pull off.

It's possible Democrats will include one of these ideas in a reconciliation bill that could pass without the threat of a Republican filibuster. But that bill has yet to be written, and what will be included is anyone's guess.

Even so, Michener says she's glad the discussion of the Medicaid coverage gap is happening, because it's sensitizing the public, as well as people in power, to the problem and potentially changing the political dynamic down the line. "Even in policy areas where you don't have any kind of guaranteed victory, it is often worth fighting the fight," she says. "Politics is a long game."

This content is from Southern California Public Radio. View the original story at SCPR.org.

Many hospitals around the country, including Medstar Washington Hospital in Washington DC., have started sharing their prices online in compliance with a recent federal rule.; Credit: DANIEL SLIM/AFP via Getty Images

A colonoscopy might cost you or your insurer a few hundred dollars — or several thousand, depending on which hospital or insurer you use.

Long hidden, such price variations are supposed to be available in stark black and white under a Trump administration price transparency rule that took effect at the start of this year. It requires hospitals to post a range of actual prices — everything from the rates they offer cash-paying customers to costs negotiated with insurers.

Many have complied.

But some hospitals bury the data deep on their websites or have not included all the categories of prices required, according to industry analysts. A sizable minority of hospitals have not disclosed the information at all.

While imperfect and potentially of limited use right now to the average consumer, the disclosures that are available illustrate the huge differences in prices — nationally, regionally and within the same hospital. But they're challenging for consumers and employers to use, giving a boost to a cottage industry that analyzes the data.

While it's still an unanswered question whether price transparency will lead to overall lower prices, KHN took a dive into the initial trove of data to see what it reveals. Here are five takeaways from the newly public data and tips for how you might be able to use it to your benefit

1) As expected, prices are all over the map

The idea behind the requirement to release prices is that the transparency may prompt consumers to shop around, weighing cost and quality. Perhaps they could save a few hundred dollars by getting their surgery or imaging test across town instead of at the nearby clinic or hospital.

Under the Trump-era rule, hospitals must post what they accept from all insurers for thousands of line items, including each drug, procedure or treatment they provide. In addition, hospitals must present this in a format easily readable by computers and include a consumer-friendly separate listing of 300 "shoppable" services, bundling the full price a hospital accepts for a given treatment, such as having a baby or getting a hip replacement.

The negotiated rates now being posted publicly often show an individual hospital accepting a wide range of prices for the same service, depending on the insurer, often based on how much negotiating power each has in a market.

In some cases, the cash-only price is less than what insurers pay. And prices may vary widely within the same city or region.

In Virginia, for example, the average price of a diagnostic colonoscopy is $2,763, but the range across the state is from $208 to $10,563, according to a database aggregated by San Diego-based Turquoise Health, one of the new firms looking to market the data to businesses, while offering some information free of charge to patients.

2) Patients can look up the information, but it's incomplete

Patients can try to find the price information themselves by searching hospital websites, but even locating the correct tab on a hospital's website is tricky.

Typically, consumers don't comparison-shop, preferring to choose convenience or the provider their doctor recommends. A recent Peterson-KFF Health System Tracker brief, for instance, found that 85% of adults said they had not researched online the price of a hospital treatment.

And hospitals say the transparency push alone won't help consumers much, because each patient's situation is different and may vary from the average— and individual deductibles and insurance plans complicate matters.

But if you do want to try, here's one tip: "You can Google the hospital name and the words 'price transparency' and see where that takes you," says Caitlin Sheetz, director and head of analytics at the consulting firm ADVI Health in the Washington, D.C., metro area.

Typing in "MedStar Health hospital transparency," for example, likely points to the MedStar Washington Hospital Center's "price transparency disclosure" page, with a link to its full list of prices, as well as its separate list of 300 shoppable services.

By clicking on the list of shoppable services, consumers can download an Excel file. Searching it for "colonoscopy" pulls up several variations of the procedure, along with prices for different insurers, such as Aetna and Cigna, but a "not available" designation for the cash-only price. The file explains that MedStar does not have a standard cash price but makes determinations case by case.

Performing the same Google search for the nearby Inova health system results in less useful information.

Inova's website links to a long list of thousands of charges, which are not the discounts negotiated by insurers, and the list is not easily searchable. The website advises those who are not Inova patients or who would like to create their own estimate to log into the hospitals' "My Chart" system, but a search on that for "colonoscopy" failed to produce any data.

3) Third-party firms are trying to make searching prices simpler – and cash in

Because of the difficulty of navigating these websites — or locating the negotiated prices once there — some consumers may turn to sites like Turquoise. Another such firm is Health Cost Labs, which will have pricing information for 2,300 hospitals in its database when it goes live July 1.

Doing a similar search for "colonoscopy" on Turquoise shows the prices at MedStar by insurer, but the process is still complicated. First, a consumer must select the "health system" button from the website's menu of options, click on "surgical procedures," then click again on "digestive" to get to it.

There is no similar information for Inova because the hospital has not yet made its data accessible in a computer-friendly format, said Chris Severn, CEO of Turquoise.

Inova spokesperson Tracy Connell said in a written statement that the health system will create personalized estimates for patients and is "currently working to post information on negotiated prices and discounts on services."

Firms like Turquoise and Health Cost Labs aim to sell the data gathered from hospitals nationally to insurers, employers and others. In turn, those groups may use it in negotiations with hospitals over future prices. While that may drive down prices in areas with a lot of competition, it might do the opposite where there are few hospitals to choose from, or in situations where a hospital raises its prices to match competitors.

4) Consumers could use this data to negotiate, especially if they're paying cash

For consumers who go the distance and can find price data from their hospitals, it may prove helpful in certain situations:

• Patients who are paying cash or who have unmet deductibles may want to compare prices among hospitals to see if driving farther could save them money.
• Uninsured patients could ask the hospital for the cash price or attempt to negotiate for the lowest amount the facility accepts from insurers.
• Insured patients who get a bill for out-of-network care may find the information helpful because it could empower them to negotiate a discount off the hospitals' gross charges for that care.

While there's no guarantee of success, "if you are uninsured or out of network, you could point to some of those prices and say, 'That's what I want,'" says Barak Richman, a contract law expert and professor of law at Duke University School of Law.

But the data may not help insured patients who notice their prices are higher than those negotiated by other insurers.

In those cases, legal experts say the insured patients are unlikely to get a bill changed because they have a contract with that insurer, which has negotiated the price with their contracted hospitals.

"Legally, a contract is a contract," says Mark Hall, a health law professor at Wake Forest University.

Richman agrees.

"You can't say, 'Well, you charged that person less,'" he notes, but neither can they say they'll charge you more.

Getting the data, however, relies on the hospital having posted it.

5) Hospitals still aren't really on board

When it comes to compliance, "we're seeing the range of the spectrum," says Jeffrey Leibach, a partner at the consulting firm Guidehouse, which found earlier this year that about 60% of 1,000 hospitals surveyed had posted at least some data, but 30% had reported nothing at all.

Many in the hospital industry have long fought transparency efforts, even filing a lawsuit seeking to block the new rule. The suit was dismissed by a federal judge last year.

They argue the rule is unclear and overly burdensome. Additionally, hospitals haven't wanted their prices exposed, knowing that competitors might then adjust theirs, or health plans could demand lower rates. Conversely, lower-cost hospitals might decide to raise prices to match competitors.

The rule stems from requirements in the Affordable Care Act. The Obama administration required hospitals to post their chargemaster rates, which are less useful because they are generally inflated, hospital-set amounts that are almost never what is actually paid.

Insurers and hospitals are also bracing for next year when even more data is set to come online. Insurers will be required to post negotiated prices for medical care across a broader range of facilities, including clinics and doctors' offices.

In May, the Centers for Medicare & Medicaid Services sent letters to some of the hospitals that have not complied, giving them 90 days to do so or potentially face penalties, including a $300-a-day fine.

"A lot of members say until hospitals are fully compliant, our ability to use the data is limited," says Shawn Gremminger, director of health policy at the Purchaser Business Group on Health, a coalition of large employers.

His group and others have called for increasing the penalty for noncomplying hospitals from $300 a day to $300 a bed per day, so "the fine would be bigger as the hospital gets bigger," Gremminger says. "That's the kind of thing they take seriously."

Already, though, employers or insurers are eyeing the hospital data as leverage in negotiations, says Severn, Turquoise's CEO. Conversely, some employers may use it to fire their insurers if the rates they're paying are substantially more than those agreed to by other carriers.

"It will piss off anyone who is overpaying for health care, which happens for various reasons," he says.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation).

This content is from Southern California Public Radio. View the original story at SCPR.org.

People rest while riding a Los Angeles Metro Rail train amid the coronavirus pandemic on April 1, 2020 in Los Angeles, California.; Credit: Mario Tama/Getty Images

Despite the racial reckoning going on in America right now, and despite the fact that attitudes towards race, inclusion and representation are different now than they were 30 years ago, new research from UC Berkeley shows that a large majority of American metro areas are more segregated now than they were in 1990. The new report from Berkeley’s Institute covers a number of topic areas, but among the key findings were from the national segregation report component of the project, which found Los Angeles to be the sixth-most segregated metro area with more than 200,000 people.

Today on AirTalk, we’ll talk with the lead researcher on the new report and a local historian to talk about how we see the findings of the report play out in Southern California.

Guests:

Stephen Menendian, assistant director and director of research at the Othering & Belonging Institute at UC Berkeley, which works to identify and eliminate the barriers to an inclusive, just, and sustainable society in order to create transformative change; he tweets @SMenendian

Eric Avila, professor of history, urban planning, and Chicano/a studies at UCLA

This content is from Southern California Public Radio. View the original story at SCPR.org.

From wooden boxes and nets to 3D printers and gene editing, USGS scientists use tools old and new to tackle the tricky problems of bat science

USGS groundwater and surface water monitoring data contributed to the Pennsylvania Department of Environmental Protection's (PaDEP) November 1, 2024, declarations of drought watches and warnings for 35 Pennsylvania counties.

USGS Western Fisheries Research Center (WFRC) biological science technician, Genevieve Kent, is the winner of this issue’s photo contest. 

Assistant Attorney General Kristen Clarke for the Justice Department's Civil Rights Division speaks during a news conference Friday announcing a lawsuit against the state of Georgia for its new voting law. Attorney General Merrick Garland is at right.; Credit: Jim Watson/AFP via Getty Images

Attorney General Merrick Garland announced Friday that the U.S. Justice Department is suing the state of Georgia over its new voting law, saying that the controversial measure is intended to restrict ballot access to Black voters.

"Our complaint alleges that recent changes to Georgia's election laws were enacted with the purpose of denying or abridging the right of Black Georgians to vote on account of their race or color, in violation of Section 2 of the Voting Rights Act," Garland said at a news conference.

The lawsuit marks the first major action from the Biden administration to combat a series of new restrictive voting measures passed by Republican-led state legislatures. And it came on the eighth anniversary of the U.S. Supreme Court decision to gut another key provision of the landmark Voting Rights Act, Section 5.

Garland noted that Georgia experienced record voter turnout and participation in the 2020 election cycle.

In March, Georgia Gov. Brian Kemp, a Republican, signed Senate Bill 202, a 98-page omnibus measure that makes sweeping changes to the state's absentee voting rules, adds new voter identification mandates and nearly cuts in half the amount of time for voters to request a mail-in ballot. It also expands early voting access for most counties and formally codifies Sunday voting hours as optional.

The legislation outlaws passing out food or drinks to voters within 150 feet of a polling place or too close to voters waiting in line, a provision that Assistant Attorney General Kristen Clarke, who heads the department's Civil Rights Division, highlighted at the press conference.

"Historically, minority voters in Georgia have been disproportionately more likely to wait in long lines to vote in person on Election Day," she said. "Given those long and protracted wait times, civic groups, including churches, have at times provided food and water to voters in line to make their wait more comfortable. As we allege in our complaint, this needless ban was passed with unlawful discriminatory intent."

Clarke also said the Georgia Legislature passed the bill through "a rushed process that departed from normal practice and procedure."

"The version of the bill that passed the state Senate ... was three pages long. Days later, the bill ballooned into over 90 pages in the House. The House held less than two hours of floor debate on the newly inflated SB 202 before Gov. Kemp signed it into law the same day," she said. "These legislative actions occurred at a time when the Black population in Georgia continues to steadily increase, and after a historic election that saw record voter turnout across the state, particularly for absentee voting, which Black voters are now more likely to use than white voters."

Garland said the lawsuit is the first of "many steps" the department is taking to protect the right to vote for all eligible voters. He said the Civil Rights Division will continue to examine voting laws that other states have passed.

"We will not hesitate to act," Garland said.

The Justice Department announced this month it would vigorously defend voting rights. Garland said that the department will double the number of voter enfranchisement lawyers and focus attention on litigation related to voting rights.

In response to the filing, Kemp said the lawsuit is "born out of the lies and misinformation the Biden administration has pushed against Georgia's Election Integrity Act from the start."

"[Biden and his allies] are weaponizing the U.S. Department of Justice to carry out their far-left agenda that undermines election integrity and empowers federal government overreach in our democracy," he said in a statement.

Georgia Secretary of State Brad Raffensperger, another Republican who notably defended the state's administration of the 2020 election, said in a statement he "looks forward to ... beating [the administration] in court."

Garland's announcement comes just days after Senate Republicans united to block Democrats' attempts to pass sweeping voting rights legislation.

Senate Judiciary Chairman Dick Durbin, D-Ill., tweeted his approval of the lawsuit shortly after the announcement Friday.

"If Republicans think the fight for voting rights ended with their filibuster of the For the People Act, they are sorely mistaken," he wrote. "Glad to see the Biden Administration is joining this effort. We must protect our democracy."

The Republican National Committee also linked the failed Senate vote to the Department of Justice's lawsuit.

"After failing to sell the partisan federal election takeover known as H.R. 1 to the American people, Joe Biden is now weaponizing the Justice Department to attack election integrity," RNC Chair Ronna McDaniel said in a statement.

This content is from Southern California Public Radio. View the original story at SCPR.org.

The closely-watched New York City mayoral primary election tumbled into chaos this week as the NYC Board of Elections announced it had released incorrect preliminary results on Tuesday.

City officials admitted they failed to remove 135,000 test ballots from the election management system before starting to count the real votes from Election Day and early voting, skewing the results.

"The Board apologizes for the error and has taken immediate measures to ensure the most accurate up to date results are reported," the agency tweeted.

The error is complicated by the fact that New York City is using ranked-choice voting, in which each round of vote counting hinges on the results from the previous round.

Some of the top candidates vying to lead the country's largest city blasted the board's mistake as they — and about 8.5 million other New Yorkers — awaited the results of a revised tally expected to be released on Wednesday.

Ranked-choice voting, explained

Instead of choosing just one candidate to vote for, New York City voters in last week's election were able to rank their top five candidates in order of preference.

It was the first time in decades New York used ranked-choice voting, which city voters overwhelmingly approved in a 2019 ballot measure.

NPR's Domenico Montanaro explained how the process works:

1. "If someone gets 50% plus one after all the first-choice votes are counted, then the election is over and that candidate wins. 
2. "But if no one gets 50% plus one, it's on to Round 2.
3. "The person with the lowest number of first-place votes is eliminated, and that candidate's voters' second choices get redistributed as votes for other candidates.
4. "This reallocation of votes goes on until someone reaches 50% plus one."

If just two candidates remain at the end, the candidate with the most votes wins.

What happened this week

On Tuesday, the city Board of Elections released the first ranked-choice voting reports from the election.

With only first-preference votes counted as of election night, Brooklyn Borough President Eric Adams boasted a nine-point lead over attorney Maya Wiley. Those first reported ranked-choice results shrank Adam's lead to just two points ahead of former Sanitation Commissioner Kathryn Garcia, Gothamist reported.

But just hours later, the board tweeted that it had become aware of a "discrepancy" in the ranked-choice voting results and pulled them from its website.

In a follow-up apology, the board acknowledged that it had erroneously left 135,000 test votes in its election system, producing "additional records" that likely impacted an accurate tally.

"At this point it really seems like an issue of human error," WNYC reporter Brigid Bergin told NPR's Morning Edition.

"The board does conduct a lot of pre-election testing to make sure their systems are working and, obviously, that was even more important this time, because it was the first time they were using this new ranked-choice voting system," she added.

Bergin said the board is expected to release a corrected ranked-choice voting report Wednesday, but it will still be preliminary and it won't include 124,000 absentee ballots.

How the candidates are reacting

All of the mayoral contenders expressed frustration with the board's blunder.

"Today's mistake by the Board of Elections was unfortunate," Adams tweeted Tuesday. "It is critical that New Yorkers are confident in their electoral system, especially as we rank votes in a citywide election for the first time."

Garcia, who was fleetingly thrust into second place by the incorrect ranked-choice voting report, called for a more thorough accounting of what went wrong.

"The Board of Elections' release of incorrect ranked choice votes is deeply troubling and requires a much more transparent and complete explanation. Every ranked choice and absentee vote must be counted accurately so that all New Yorkers have faith in our democracy and our government," she tweeted.

Progressive candidate Maya Wiley said this week's misstep was just the latest in a string of mistakes by the board.

"This error by the Board of Elections is not just failure to count votes properly today, it is the result of generations of failures that have gone unaddressed," Wiley said. "Today, we have once again seen the mismanagement that has resulted in a lack of confidence in results, not because there is a flaw in our election laws, but because those who implement it have failed too many times."

WNYC's Bergin said she thought the misstep would not cause voters to question the election results but that it may diminish the board's reputation in the eyes of the public.

"This agency is really the last bastion of true patronage politics in New York," she said. "There's been a push to overhaul the agency, to give the staff more authority over political appointees. But ultimately that's all up to state lawmakers to do."

This content is from Southern California Public Radio. View the original story at SCPR.org.

Allen Weisselberg, the Trump Organization's longtime chief financial officer, watches as then-U.S. Republican presidential candidate Donald Trump addresses a 2016 news conference at Trump Tower in New York City.; Credit: Carlo Allegri/Reuters

Former President Donald Trump's family business and its longtime chief financial officer, Allen Weisselberg, have been charged by the Manhattan district attorney's office in a case involving alleged tax-related crimes.

Before the indictment was released Thursday, Weisselberg's personal attorneys, Mary Mulligan and Bryan Skarlatos, said in a statement that the CFO "intends to plead not guilty and he will fight these charges in court."

Trump has long denied any wrongdoing.

In a statement Thursday afternoon, the former president said:

"The political Witch Hunt by the Radical Left Democrats, with New York now taking over the assignment, continues. It is dividing our Country like never before!"

The investigation by Manhattan District Attorney Cyrus Vance Jr. began in 2018 around the time Trump's former personal lawyer, Michael Cohen, pleaded guilty to campaign finance charges related to payments of hush money. These were made in the final months of the 2016 presidential campaign, as Cohen put it in court, "in coordination with, and at the direction of, a candidate for federal office." The goal was to block two women who claimed they had extramarital affairs with Trump — former Playboy model Karen McDougal and adult film star Stephanie Clifford, whose stage name is Stormy Daniels — from telling their stories publicly.

New York state Attorney General Letitia James' office launched its own probe in 2019 after Cohen testified in a congressional hearing that Trump manipulated property values to lower his tax obligations and to obtain bank loans. James' investigation was initially focused on potential civil charges, but it recently expanded to include a criminal probe in partnership with Vance.

This year, the investigators have homed in on noncash payments made to top officials in Trump's companies, including Weisselberg.

The U.S. Supreme Court paved the way for the charges, declining in February to block a subpoena from Vance's office seeking Trump's financial records. Vance first requested tax filings and other financial records from Trump's accounting firm, Mazars USA, in 2019.

In a statement released in May, Trump said the New York-based investigations were part of a "Witch Hunt," adding, with a reference to how his presidential campaign started in 2015: "It began the day I came down the escalator in Trump Tower, and it's never stopped."

This content is from Southern California Public Radio. View the original story at SCPR.org.

Emerita Resources Corp. (EMO:TSX.V; EMOTF:OTCQB; LLJA:FSE) announces results from a metallurgical testing program at its wholly-owned Iberian Belt West (IBW) project in Spain. Read why one expert says the company is in "the right place to be."

Catawba County Animal Services has a DOMESTIC MH CAT ready for you to adopt! She is approximately 2 year(s) old.

Catawba County Animal Services has a DOMESTIC SH CAT ready for you to adopt! He is approximately 2 year(s) old.

Catawba County Animal Services has a DOMESTIC SH CAT ready for you to adopt! He is approximately 1.5 month(s) old.

Full Text:

Needle pricks not your thing? A team of National Science Foundation-funded scientists is developing wearable skin sensors that can detect what's in your sweat. They hope that one day, monitoring perspiration could bypass the need for more invasive procedures like blood draws, and provide real-time updates on health problems such as dehydration or fatigue. In a new paper, the team describes a new sensor design that can be rapidly manufactured using a "roll-to-roll" processing technique that essentially prints the sensors onto a sheet of plastic like words on a newspaper. They used the sensors to monitor the sweat rate, and the electrolytes and metabolites in sweat, from volunteers who were exercising, and others who were experiencing chemically induced perspiration. The new sensors contain a spiraling microscopic tube, or microfluidic, that wicks sweat from the skin. By tracking how fast the sweat moves through the microfluidic, the sensors can report how much a person is sweating, or their sweat rate. The microfluidics are also outfitted with chemical sensors that can detect concentrations of electrolytes like potassium and sodium, and metabolites like glucose.

Image credit: Bizen Maskey/Sunchon National University

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Earth's magnetic field seems steady and true -- reliable enough to navigate by. Yet, largely hidden from daily life, the field drifts, waxes and wanes. The magnetic North Pole is currently shifting toward Siberia, forcing the Global Positioning System that underlies modern navigation to update its software sooner than expected. Every several hundred thousand years, the magnetic field dramatically shifts and reverses its polarity. Magnetic north flips to the geographic South Pole and, eventually, back again. This reversal has happened countless times over Earth's history, but scientists' understanding of why and how the field reverses is limited. The researchers find that the most recent field reversal 770,000 years ago took at least 22,000 years to complete, several times longer than previously thought. The results call into question controversial findings that some reversals could occur within a human lifetime.

Image credit: Brad Singer

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A National Science Foundation-funded study found that Charles Darwin's famous finches defy what has long been considered a key to evolutionary success: genetic diversity. The research on finches of the Galapagos Islands could change the way conservation biologists think about a species' potential for extinction in naturally fragmented populations. Researchers examined 212 tissue samples from museum specimens and living birds. Some of the museum specimens in the study were collected by Darwin himself in 1835. Only one of the extinct populations, a species called the vegetarian finch, had lower genetic diversity compared to modern survivors. Specifically, researchers believe a biological phenomenon called sink-source dynamics is at play in which larger populations of birds from other islands act as a "source" of immigrants to the island population that is naturally shrinking, the "sink." Without these immigrant individuals, the natural population on the island likely would continue to dwindle to local extinction. The immigrants have diverse genetics because they are coming from a variety of healthier islands, giving this struggling "sink" population inflated genetic diversity.

Image credit: Jose Barreiro

Source: Dr. David Nierengarten 10/29/2024

Wedbush analysts Dr. David Nierengarten, Dennis Pak, and Dr. Martin Fan, in a research report published on October 29, 2024, maintained their Outperform rating on Kiniksa Pharmaceuticals Ltd. (KNSA:NASDAQ) with a price target of US$34.00. The report follows Kiniksa's Q3 2024 earnings announcement, which showed continued strong growth for Arcalyst.

The analysts highlighted the company's strong quarterly performance, stating, "Net product revenues of US$112.2MM (+73% y/y) slightly edged out our US$112.0MM estimate. Management's updated FY revenue guidance to US$410-US$420MM (previously US$405-US$415MM) implies Q4 revenue of US$115.5-US$125.5MM (3%-12% q/q growth)."

Regarding market penetration, the analysts noted, "More than 11% of patients in KNSA's target RP population of 14,000 patients that suffer from two or more recurrences are now actively on Arcalyst therapy, compared to 9% penetration at YE23." They added, "Notably, ~45% of all new prescriptions were written by repeat prescribers, which accounted for ~25% (640) of total prescriber base."

The analysts emphasized the growing duration of therapy, stating, "Importantly, average total duration of Arcalyst therapy in RP continues to grow, increasing to ~27 months as of 3Q24 from ~23 months as of 1Q24."

Regarding the company's pipeline, the report highlighted progress with abiprubart, noting, "Abiprubart's subcutaneous formulation and potential for once-monthly dosing should provide a greater dosing convenience relative to other agents and support uptake in a crowded but large market (300,000+ patients in the U.S.A.) assuming comparable efficacy."

The analysts addressed the stock's recent performance, stating, "We think today's share action reflects overoptimistic expectations investors may have had following the outsized Q2 sequential growth over a seasonally weak Q1. Net-net, we believe Arcalyst fundamentals remain strong and view current trading levels as an attractive entry point."

Wedbush's valuation methodology is based on a sum-of-parts approach. The analysts explained, "Our PT is derived from a sum-of-parts valuation for each of the company's clinical programs: an 8x multiple to KNSA's share of estimated US sales of Arcalyst in RP in 2027 and CAPS in 2025 (discounted back by 15%), and an 8x multiple to abiprubart's estimated sales in Sjogren's disease in 2029/30 (discounted back by 35%)."

In conclusion, Wedbush's maintenance of its Outperform rating and US$34 price target reflects confidence in Kiniksa's commercial execution with Arcalyst and pipeline potential. The share price at the time of the report of US$23.76 represents a potential return of approximately 43% to the analysts' target price, suggesting a significant upside as the company continues to expand its market penetration and advance its pipeline.

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Important Disclosures:

1. This article does not constitute investment advice and is not a solicitation for any investment. Streetwise Reports does not render general or specific investment advice and the information on Streetwise Reports should not be considered a recommendation to buy or sell any security. Each reader is encouraged to consult with his or her personal financial adviser and perform their own comprehensive investment research. By opening this page, each reader accepts and agrees to Streetwise Reports' terms of use and full legal disclaimer. Streetwise Reports does not endorse or recommend the business, products, services or securities of any company.
2. This article does not constitute medical advice. Officers, employees and contributors to Streetwise Reports are not licensed medical professionals. Readers should always contact their healthcare professionals for medical advice.

For additional disclosures, please click here.

Disclosures for Wedbush, Kiniksa Pharmaceuticals, October 29, 2024

Analyst Certification We, David Nierengarten, Dennis Pak and Martin Fan, certify that the views expressed in this report accurately reflect our personal opinions and that we have not and will not, directly or indirectly, receive compensation or other payments in connection with our specific recommendations or views contained in this report.

Company Specific Disclosures This information is subject to change at any time. 1. WS makes a market in the securities of Kiniksa Pharmaceuticals.

Wedbush disclosure price charts are updated within the first fifteen days of each new calendar quarter per FINRA regulations. Price charts for companies initiated upon in the current quarter, and rating and target price changes occurring in the current quarter, will not be displayed until the following quarter. Additional information on recommended securities is available on request. Disclosure information regarding historical ratings and price targets is available: Research Disclosures *WS changed its rating system from (Strong Buy/ Buy/ Hold/ Sell) to (Outperform/ Neutral/ Underperform) on July 14, 2009. Applicable disclosure information is also available upon request by contacting the Research Department at (212) 833-1375, by email to leslie.lippai@wedbush.com. You may also submit a written request to the following: Wedbush Securities, Attn: Research Department, 142 W 57th Street, New York, NY 10019.

OTHER DISCLOSURES The information herein is based on sources that we consider reliable, but its accuracy is not guaranteed. The information contained herein is not a representation by this corporation, nor is any recommendation made herein based on any privileged information. This information is not intended to be nor should it be relied upon as a complete record or analysis: neither is it an offer nor a solicitation of an offer to sell or buy any security mentioned herein. This firm, Wedbush Securities, its officers, employees, and members of their families, or any one or more of them, and its discretionary and advisory accounts, may have a position in any security discussed herein or in related securities and may make, from time to time, purchases or sales thereof in the open market or otherwise. The information and expressions of opinion contained herein are subject to change without further notice. The herein mentioned securities may be sold to or bought from customers on a principal basis by this firm. Additional information with respect to the information contained herein may be obtained upon request. Wedbush Securities does and seeks to do business with companies covered in its research reports. Thus, investors should be aware that the firm may have a conflict of interest that could affect the objectivity of this report. Investors should consider this report as only a single factor in making their investment decision. Please see pages 3–7 of this report for analyst certification and important disclosure information. Retail Investors The information provided is for general informational purposes only and should not be considered an individual recommendation or personalized investment advice. The companies/investments mentioned may not be suitable for everyone. Each investor needs to review their own respective situation(s) before making any investment decisions. All expressions of opinion are subject to change without notice due to shifting market(s), economic or political conditions. Investment involves risks including the risk of principal. Past performance is no guarantee of future results and the opinions presented cannot be viewed as an indicator of future performance.

( Companies Mentioned: KNSA:NASDAQ, )

Source: Streetwise Reports 10/31/2024

Healthcare artificial intelligence (AI) company Treatment.com AI Inc. (TRUE:CSE; TREIF:OTCMKTS; 939:FRA) announced that it has closed a non-brokered private placement for aggregate gross proceeds of CA$1.95 million.

A total of 2,138,766 special warrants of the company were offered at CA$0.75 per special warrant with proceeds of CA$1.6 million. The company also said 466,666 units of the company were offered at CA$0.75 per unit for proceeds of CA$349,999.50.

The company said it intends to use the proceeds for working capital purposes.

"We are very encouraged by the support from our investors with their overwhelming response to the financing and the subsequent over-subscription," Chief Executive Officer Dr. Essam Hamza said. "This money will help expedite our aggressive growth plans over the next year."

Technical Analyst Clive Maund noted on October 9* that the outlook for the company is "outstandingly bright" because it has "positioned itself to revolutionize the healthcare industry using AI and advanced machine learning technologies."

The company "is set to transform the current archaic system so that no longer do patients have to sit for hours in waiting rooms to see a doctor or doctors, and doctors and other healthcare professionals have to suffer a crushing burden of often unnecessary patient visits and tedious repetitive bureaucracy," he wrote. "Treatment AI's platform will take care of most of it."

Healthcare Professionals Worldwide Contribute to AI Engine

Treatment.com AI said it is a company utilizing AI and best clinical practices with a goal to positively improve the healthcare sector and impact current inefficiencies and challenges.

With the input of hundreds of healthcare professionals globally, Treatment.com AI said it has built a comprehensive, personalized healthcare AI engine called the Global Library of Medicine (GLM). With more than 10,000 expert medical reviews, the GLM is designed to provide tested clinical information and support to all healthcare professionals, as well as providing recommended tests (physical and lab), X-rays, and billing codes.

According to the company, the GLM will help healthcare professionals (doctors, nurses, and pharmacists) reduce administrative burdens, creating more time for face-to-face patient appointments.

"AI is set to expedite and streamline the healthcare industry, making it vastly more efficient for the benefit of both healthcare professionals and patients," Maund noted.

The Catalyst: A 'Profound Transformation' in the Industry

AI has an important role to play in the healthcare offerings of the future, a 2019 report from the National Center of Biomechanical Medicine listed in the National Library of Medicine said. "In the form of machine learning, it is the primary capability behind the development of precision medicine, widely agreed to be a sorely needed advance in care."

Healthcare organizations are increasingly turning to the technology to address both clinical and administrative challenges. The combination of generative AI, as noted by Appinventiv in September, and operational tools like those developed by Treatment.com AI are driving this transformation.

Generative AI is "catalyzing a profound transformation within the healthcare industry" by generating synthetic data, predicting patient outcomes, and optimizing treatment plans, all of which revolutionize clinical decision-making processes, Appinventiv reported. This aligns with Treatment.com AI's announced collaboration with SPRYT on September 17 whereby integrating SPRYT’s AI receptionist "Asa" with its GLM has the goal of enhancing patient access to healthcare while reducing administrative burdens.

A CBC report from September 16 said real-world applications of AI in healthcare are already showing promising results. Dr. Muhammad Mamdani, co-author of a study on the topic, expressed optimism about AI's ability to "complement clinicians' own judgment and lead to better outcomes for fragile patients."

According to a report by Markets and Markets, the global AI in healthcare market in total was valued at US$20.9 billion this year and will reach an estimated US$148.4 billion by 2029, a compound annual growth rate (CAGR) of 48.1%.

"The growth of AI in the healthcare market is driven by the generation of large and complex healthcare datasets, the pressing need to reduce healthcare costs, improving computing power and declining hardware costs, and the rising number of partnerships and collaborations among different domains in the healthcare sector, and growing need for improvised healthcare services due to imbalance between healthcare workforce and patients," the report said.

Analyst: A 'Genuine Breakout Soon' for Stock

Maund said its stock charts are also looking "very positive indeed" for the company.

Of particular note is the big upleg late in June and early in July on persistent heavy volume, which broke the price clear above the May high and drove volume indicators steeply higher," the analyst noted. [OWNERSHIP_CHART-10594]

"This is very bullish price/volume action, especially as the volume indicators have not just held up but have actually advanced as the price has reacted back in a normal manner from the early July high to arrive at a support level where it has stabilized above the 200-day moving average in readiness for renewed advance, so the correction looks like a large bull Pennant that, as it is now closing up, promises renewed advance soon," continued Maund, who said holders should stay long and rated the stock a Strong Buy that "is thought worth going overweight on."

"The June-July rally must be classed as a 'preliminary' breakout," he noted. "But that said, the exceptionally bullish price/volume action of recent months does promise a genuine breakout soon that looks set to lead to a sustained and substantial uptrend."

Ownership and Share Structure

According to Sedi.ca, insiders own approximately 8% of Treatment.com AI. Retail investors own the remaining 92%.

The company has 48.84 million outstanding common shares and has 41.3 million free float traded shares.

As of October 31, the market cap is approximately CA$31.75 million. Over the past 52 weeks, the company traded between CA$0.355 and CA$1.11 per share.

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Important Disclosures:

1. Treatment.com AI has a consulting relationship with Street Smart an affiliate of Streetwise Reports. Street Smart Clients pay a monthly consulting fee between US$8,000 and US$20,000.
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4. This article does not constitute investment advice and is not a solicitation for any investment. Streetwise Reports does not render general or specific investment advice and the information on Streetwise Reports should not be considered a recommendation to buy or sell any security. Each reader is encouraged to consult with his or her personal financial adviser and perform their own comprehensive investment research. By opening this page, each reader accepts and agrees to Streetwise Reports' terms of use and full legal disclaimer. Streetwise Reports does not endorse or recommend the business, products, services or securities of any company.
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* Disclosure for quotes from the Clive Maund source October 9, 2024

1. For the quote (sourced on October 9, 2024), the Company has paid Street Smart, an affiliate of Streetwise Reports, US$1,500.
2. Author Certification and Compensation: [Clive Maund of clivemaund.com] is being compensated as an independent contractor by Street Smart, an affiliate of Streetwise Reports, for writing the article quoted. Maund received his UK Technical Analysts’ Diploma in 1989. The recommendations and opinions expressed in the article accurately reflect the personal, independent, and objective views of the author regarding any and all of the designated securities discussed. No part of the compensation received by the author was, is, or will be directly or indirectly related to the specific recommendations or views expressed.

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The quoted article represents the opinion and analysis of Mr. Maund, based on data available to him, at the time of writing. Mr. Maund's opinions are his own, and are not a recommendation or an offer to buy or sell securities. As trading and investing in any financial markets may involve serious risk of loss, Mr. Maund recommends that you consult with a qualified investment advisor, one licensed by appropriate regulatory agencies in your legal jurisdiction and do your own due diligence and research when making any kind of a transaction with financial ramifications. Although a qualified and experienced stock market analyst, Clive Maund is not a Registered Securities Advisor. Therefore Mr. Maund's opinions on the market and stocks cannot be only be construed as a recommendation or solicitation to buy and sell securities.

( Companies Mentioned: TRUE:CSE; TREIF:OTCMKTS;939:FRA, )

Source: Dr. Douglas Loe 10/31/2024

Leede Financial analysts Dr. Douglas Loe and Siew Ching Yeo, in a research report published on October 30, 2024, maintained their Speculative Buy rating on ProMIS Neurosciences Inc. (PMN:TSX; PMN:NCM) with a price target of US$9.50. The report follows ProMIS's presentation of interim Phase I data for PMN310, its Alzheimer's disease (AD) candidate, at the Clinical Trials on Alzheimer's Disease (CTAD) conference.

The analysts highlighted the positive safety and pharmacokinetic (PK) data, stating, "We were encouraged (though not overly surprised) to see that the mAb was well-tolerated at all five test doses ranging from 2.5mg/kg-to-40mg/kg." They added, "PK analysis of all of these patient cohorts in this single-ascending dose (SAD) trial suggests that once-monthly dosing may be sufficient to sustain mAb levels both in plasma and in cerebrospinal fluid over time."

Regarding dosing efficacy, the analysts noted, "Importantly, ProMIS indicated in the Jul/24 update that even at 2.5mg/kg dosing, PMN310 levels in CSF were over 100x higher than predicted to be necessary to bind to all beta-amyloid oligomers that could accumulate in CSF in diseased patients."

The analysts emphasized the significance of recent industry developments, particularly AbbVie's acquisition of Aliada Therapeutics, stating, "AbbVie's tangible interest in Phase I-stage AD assets shows us that ProMIS could itself be attractive to future suitors if/when it can document direct impact on cognitive impairment in diseased patients."

The report highlighted ProMIS's financial position following its recent equity offering, noting that the company raised US$30.3M with multiple layers of warrant coverage tied to development milestones.

Leede Financial's valuation methodology combines multiple approaches. The analysts explained, "We are maintaining our Speculative Buy rating and one-year PT of US$9.50 on PMN, with our valuation still based on NPV (30% discount rate) and multiples of our F2029 EBITDA/fd EPS forecasts."

They added, "By direct comparison to Aliada's US$1.4B value, PMN shares would notionally be valued on a fully-diluted basis at US$17.65/shr."

In conclusion, Leede Financial's maintenance of their Speculative Buy rating and US$9.50 price target reflects confidence in ProMIS's development of PMN310 and its potential in the Alzheimer's disease market. The share price at the time of the report of US$1.03 represents a potential return of approximately 822% to the analysts' target price, highlighting the significant upside potential if the company's clinical development plans prove successful.

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Disclosures for Leede Financial Inc., ProMIS Neurosciences Inc., October 30, 2024

Important Information and Legal Disclaimers Leede Financial Inc. (Leede) is a member of the Canadian Investment Regulatory Organization (CIRO) and a member of the Canadian Investor Protection Fund (CIPF). This document is not an offer to buy or sell or a solicitation of an offer to buy or sell any security or instrument or to participate in any particular investing strategy. Data from various sources were used in the preparation of these documents; the information is believed but in no way warranted to be reliable, accurate and appropriate. All information is as of the date of publication and is subject to change without notice. Any opinions or recommendations expressed herein do not necessarily reflect those of Leede. Leede cannot accept any trading instructions via e-mail as the timely receipt of e-mail messages, or their integrity over the Internet, cannot be guaranteed. Dividend yields change as stock prices change, and companies may change or cancel dividend payments in the future. All securities involve varying amounts of risk, and their values will fluctuate, and the fluctuation of foreign currency exchange rates will also impact your investment returns if measured in Canadian Dollars. Past performance does not guarantee future returns, investments may increase or decrease in value, and you may lose money. Leede employees may buy and sell shares of the companies that are recommended for their own accounts and for the accounts of other clients. Disclosure codes are used in accordance with Policy 3600 of CIRO.

Description of Disclosure Codes 1. Leede and its affiliates collectively beneficially own 1% or more of any class of equity securities of the company as of the end of the preceding month or the month prior to the preceding month if the report was issued prior to the 10th. 2. The analyst or any associate of the analyst responsible for the report or public comment hold shares or is short any of the company's securities directly or through derivatives. 3. Leede or a director or officer of Leede or any analyst provided services to the company for remuneration other than normal investment advisory or trade execution services within the preceding 12 months. 4. Leede provided investment banking services for the company during the 12 months preceding the publication of the research report. 5. Leede expects to receive or intends to seek compensation for investment banking services in the next three months. 6. The analyst preparing the report received compensation based upon Leede investment banking revenues for this issuer within the preceding 12 months. 7. The director, officer, employee, or research analyst is an officer, director or employee of the company, or serves in an advisory capacity to the company. 8. Leede acts as a market maker of the company. 9. The analyst has conducted a site visit and has viewed a major facility or operation of the issuer. 10. The company has paid for all, or a material portion, of the travel costs associated with the site visit by the analyst.

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( Companies Mentioned: PMN:TSX; PMN:NCM, )

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Atlas Lithium Corp. (ATLX:NASDAQ) announced that it has received the operational permit for its Neves Project. Read what this permit, unanimously approved by Minas Gerais government in Brazil, allows Atlas to do.

Poet Amanda Gorman speaks at the inauguration of U.S. President Biden on the West Front of the U.S. Capitol on Wednesday.; Credit: Alex Wong/Getty Images

When Amanda Gorman, a 22-year-old poet from Los Angeles, took to the stage on Wednesday, it was immediately clear why the new president had chosen her as his inaugural poet.

Gorman echoed, in dynamic and propulsive verse, the same themes that Biden has returned to again and again and that he wove throughout his inaugural address: unity, healing, grief and hope, the painful history of American experience and the redemptive power of American ideals.

Where Biden said, "We must end this uncivil war," Gorman declared, "We lay down our arms so we can reach out our arms to one another."

And where Biden called for an American story of "love and healing" and "greatness and goodness," Gorman saw strength in pain: "Even as we grieved, we grew," she said.

Gorman opened by acknowledging the reasons why hope can be challenging. "Where can we find light in this never-ending shade?" she asked.

But she continued: "And yet, the dawn is ours before we knew it. Somehow we do it. Somehow we weathered and witnessed a nation that isn't broken but simply unfinished."

She acknowledged the power of her own presence on the stage in "a country and a time where a skinny black girl descended from slaves and raised by a single mother can dream of becoming president, only to find herself reciting for one."

Like Obama inaugural poet Richard Blanco, who invoked the grand sweep of American geography in a call for unity in "One Today," Gorman dedicated a portion to "every corner called our country" from the South to the Midwest. She ended with an invitation to "step out of the shade."

"The new dawn blooms as we free it," she said. "For there is always light, if only we are brave enough to see it – if only we are brave enough to be it."

Gorman was following in the footsteps of poets like Blanco, Robert Frost and Maya Angelou as she composed the poem "The Hill We Climb" for the inauguration.

She also took her cues from orators like Frederick Douglass, Abraham Lincoln and Martin Luther King, Jr. — people who knew a thing or two about calling for hope and unity in times of despair and division.

Gorman told NPR she dug into the works of those speakers (and Winston Churchill, too) to study up on ways "rhetoric has been used for good." Over the past few weeks, she composed a poem that acknowledges the previous president's incitement of violence, but turns toward hope.

"The Hill We Climb" reads, in part:

We've seen a force that would shatter our nation rather than share it,

Would destroy our country if it meant delaying democracy.

And this effort very nearly succeeded.

But while democracy can be periodically delayed,

It can never be permanently defeated.

In this truth, in this faith, we trust.

For while we have our eyes on the future,

history has its eyes on us.

Gorman, like Biden, had a speech impediment as a child. (Biden had a stutter; Gorman had difficulty pronouncing certain sounds.) She told NPR's Steve Inskeep that her speech impediment was one reason she was drawn to poetry at a young age.

"Having an arena in which I could express my thoughts freely was just so liberating that I fell head over heels, you know, when I was barely a toddler," she said.

For Gorman, a former National Youth Poet Laureate, her struggle to speak provided a connection not only to the incoming president, but also to previous inaugural poets, too.

"Maya Angelou was mute growing up as a child and she grew up to deliver the inaugural poem for President Bill Clinton," she says. "So I think there is a real history of orators who have had to struggle with a type of imposed voicelessness, you know, having that stage in the inauguration."

Barack Obama, Bill Clinton and John F. Kennedy were the only presidents in the past who chose to have poems read at their inaugurations. You can read all the previous poems here.

This content is from Southern California Public Radio. View the original story at SCPR.org.

Halima Aden attends the premiere of Netflix's Travis Scott: Look Mom I Can Fly at Barker Hangar on Aug. 27, 2019, in Santa Monica, Calif.; Credit: Rich Fury/Getty Images

For Halima Aden, the decision to walk away from a career as the world's first hijab-wearing supermodel was fairly clear cut. She's felt used for so long, she says — by the modeling industry and by UNICEF, the organization she was photographed by as a child in a refugee camp in Kenya and later served as an ambassador for.

Aden has been featured on the covers of Vogue, Elle and Allure magazines. And she walked the runway for Rihanna's Fenty Beauty and Kanye West's Yeezy.

She tells Morning Edition host Rachel Martin she wanted to be a role model for young girls while being true to herself, but she wasn't accomplishing either. Modeling, she realized, was in "direct conflict" with who she is.

"I'm not a cover girl, I'm Halima from Kakuma," she says. "I want to be the reason why girls have confidence within themselves, not the reason for their insecurity."

Aden was raised in the Kakuma refugee camp in northwestern Kenya. She and her family moved to Minnesota in 2004 when she was 7.

It was there her journey as a model began, competing for Miss Minnesota USA in 2016, seeking a scholarship. She finished in the semifinals, and says from there, modeling "fell from the sky" into her lap.

Interview Highlights

You saw [modeling] not just as a chance to wear gorgeous clothes and to have your photo in magazines but also as a way to help people.

Growing up in America, not seeing representation, not seeing anybody who dressed like me look like me, it did make me feel like, wow, what's wrong with me, you know? And I'm sure if I had if I would have had representation growing up, I would have been so much more confident to wear my hijab, to be myself, to be authentic. But to be that person, to grow up and be on the cover of magazines, I've covered everything from Vogue to Allure, some of the biggest publications in fashion. And yet I still couldn't relate personally to my own image because that's not who I really am. That's not how I really dress. That's not how my hijab really looks. And, you know, fashion, it can be a very creative field, and I completely appreciate that. But my hijab was just getting spread so thin that I knew I had to give it all away, give it up. I'm not a cover girl. I am Halima from Kakuma. I want to be the reason why girls have confidence within themselves, not the reason for their insecurity.

When you say your hijab was being kind of styled out of existence, what passed for a hijab as you were walking down those runways?

Everything. Oh, my goodness. I had jeans at one point on my head as a hijab. I had Gucci pants styled as a turban. It just didn't even make sense, and I felt so far removed from the image itself.

During the pandemic you decided to walk away from fashion and UNICEF. Was it a complicated decision?

I'll be honest with you, the feelings that I've had towards the fashion industry and UNICEF, it was just multiplying as the years went on, so it was just festering. You know, because the fashion industry is very known to use these young girls and boys while their young, age 14 to like 24, I think is the average career of a model. And then they just replace them and move on to a newer model. And same with UNICEF. They've been photographing me and using me since the time I was a baby in a refugee camp. I remember getting those headshots taken and it made me feel, it's very dehumanizing. And so I wanted to show UNICEF, too. How does it feel to be used? It's not a good feeling. And so let's stop using people.

What are you going to do [next]?

For me right now, I don't know what's next. And that's OK. That's OK, because I'm young and I have time to figure it out. And I'm grateful. I'm grateful to the people that I've met. I'm grateful to the agents that I worked with. I'm grateful for the experiences I was able to have these last four years. But at the same time, I just am also grateful that I don't have to do that anymore because it was in direct conflict with who I am as an individual, as a human being.

This content is from Southern California Public Radio. View the original story at SCPR.org.

The pandemic has once again felled Burning Man. Some burners still plan to gather for informal events on the dusty Black Rock Desert Playa this summer.; Credit: Bernard Friel/Education Images/Universal Images Group via Getty Images

And so it goes: Burning Man 2021 is canceled. It's the second year in a row, the popular arts festival won't be held in Nevada's Black Rock Desert due to the pandemic.

"We have decided to set our sights on Black Rock City 2022," event officials announced in a blog post on Tuesday. In a frequently-asked-questions section, organizers added: "We've heard from many who don't feel ready to come to Black Rock City. While we're confident in our ability to get a permit and to safeguard public health, we know that co-creating Black Rock City in 2021 would put tremendous strain on our community while we are still ironing out uncertainty."

Many would-be attendees praised the decision in comments on the Burning Man website and on social media as a safe one; others are anxiously anticipating a bigger and better 2022 Burn.

But the cancellation has put many people in the event's host community at ease.

Wary of a trend of rising coronavirus cases in some parts of the region, Washoe County's district health officer Kevin Dick said "the right call was made," in order to lower the risk of spreading infection.

"The event draws thousands of people from all over the world," Dick said in an email. "We are seeing large outbreaks of COVID-19 occurring in a number of countries, areas where very contagious COVID-19 variants of concern are prevalent and where low rates of vaccination are occurring."

The head of a local Paiute tribe is also feeling less burdened knowing there won't be the annual pilgrimage. The main highway to get to the Black Rock Desert playa, which normally draws tens of thousands of people to the summer event, cuts through tribal lands.

"For us it is a sigh of relief," said Janet Davis, chairwoman of the Pyramid Lake Paiute Tribe.

Although the event — which brings in about $63 million to the state annually — gives the tribal community a welcome financial boost, Davis said.

"We don't know who's vaccinated and who's not," she said. "We've been trying to keep our reservation safe and that happening was too soon for us to open."

As with last year, the organization will offer virtual programming during Burn Week, from Aug. 29 through Sept. 7, an experience they say drew 165,000 participants in 2020.

In response to a request for more details on the reasons for the cancellation, Burning Man organizers declined to comment further. Earlier this month, though, CEO Marian Goodell said the organization was "weighing the gravity" of implementing a vaccination requirement that she said challenged "radical inclusion," one of the group's 10 principles.

Still, for many burners, the news won't extinguish their plans to trek to the desert in droves. Just like last year, revelers are preparing to hold unofficial gatherings on public land in place of the annual event.

Last summer, those events — the so-called "rogue" and "free" burns or, unmistakably, "Not Burning Man" — drew an estimated 3,000 people to Black Rock Desert during the time Burning Man is normally held, according to the Bureau of Land Management, the federal agency that approves the organization's permits each year.

Kevin Jervis, one such attendee who now lives in Gerlach — a tiny desert town near the event site — welcomed this year's cancellation.

He called it "more of a relief than anything. ... A lot of us liked it better the way it happened last year."

During the informal festivities, Jervis spent a few days between the playa and its outskirts. He said he and his fellow burners felt like it represented the festival's freewheeling roots.

"I've had friends that have been going since '94 and they said it was a lot more like it used to be. We didn't have to go by regulations," he said. "We could have guns, dogs ... it was a lot freer."

Even before the pandemic, burners increasingly saw an annual gathering under siege.

Event-goers who adhere to Burning Man's counterculture beginnings say the festival's explosion in popularity in the past decade has welcomed a host of bad actors who trash the desert and surrounding communities and disregard the event's founding principles, including "decommodification" and the eco-friendly philosophy of "leave no trace."

Some of those perceived threats come from festival officials themselves, he said. A ticket to the main event alone cost over $400 in 2019 — a financial hurdle critics say goes against another tenet long espoused, that "everyone is invited."

"People that have never been before came out last year because they either couldn't get a ticket other years or they were just kind of curious. Or they didn't have the money to go to the actual Burn," said Jervis.

As for the Pyramid Lake Paiute community, with the reservation largely closed during that period last year, Davis said, "we really didn't see the impact" from a public health standpoint.

"You're not talking about 65 — 75,000 people." While there was more traffic, she said, "they moseyed on through and moseyed on out."

In the years leading up to the pandemic, BLM had been cracking down on the event's growth. Were the festival to return this year, Burning Man organizers said they would have had to meet a population cap of 69,000, down from its 80,000 limit for previous events.

Jervis says he won't miss what he describes as organizers' leniency toward "elites" who set up VIP areas at their camps and hire out to construct their art creations instead of making their own.

"A lot of people have gotten sick of what Burning Man's kind of become," he said.

Even if this year was a go, he said, burners would still be setting up their own Burning Man-adjacent happenings.

Following the announcement of the event's cancellation, people are taking to Facebook groups to reminisce about last year's unsanctioned burns and discuss preparations for their own this summer.

"So it seems that as of today there isn't going to be an official [Burning Man Ceremony] this year," James Zapata wrote. "So who's joining me in the dust?"

This content is from Southern California Public Radio. View the original story at SCPR.org.

Tanitoluwa Adewumi, pictured in 2019, just became the newest national chess master in the U.S. at age 10.; Credit: Dia Dipasupil/Getty Images

Tanitoluwa Adewumi, a 10-year-old in New York, just became the country's newest national chess master.

At the Fairfield County Chess Club Championship tournament in Connecticut on May 1, Adewumi won all four of his matches, bumping his chess rating up to 2223 and making him the 28th youngest person to become a chess master, according to US Chess.

"I was very happy that I won and that I got the title," he says, "I really love that I finally got it."

"Finally" is after about three years — the amount of time that Adewumi has been playing chess. When he started, Adewumi and his family were living in a homeless shelter in Manhattan after fleeing religious persecution by the Islamist militant group Boko Haram in their home country of Nigeria.

Now, Adewumi practices chess "every day" after school for "10, 11 hours" — and still manages to get some sleep.

His hours of practice have paid off. As a chess player, he describes himself as a bit of an every man, "aggressive" or "calm" when he needs to be, and always thinking ahead.

"On a normal position, I can do up to 20 moves [in advance]", he says. Keeping all of the pieces straight in his head might seem like a challenge but Adewumi says it's a skill that "when you master, it just keeps coming back."

Adewumi competes against other chess players at all levels. But his favorite match?

"I guess Hikaru Nakamura is my favorite person I've ever played," he says. "He's a grandmaster, a very strong one. He's on the top of the rankings."

Nakamura won that match. But Adewumi takes each loss in stride — and there's always the possibility of a comeback.

"I say to myself that I never lose, that I only learn," he says. "Because when you lose, you have to make a mistake to lose that game. So you learn from that mistake, and so you learn [overall]. So losing is the way of winning for yourself."

Since the last time NPR spoke with Adewumi, his family moved out of the shelter and he's written a book about his life called My Name Is Tani . . . and I Believe in Miracles. That book has been optioned for a Trevor Noah-produced film adaptation with a script by The Pursuit of Happyness screenwriter Steven Conrad.

But Adewumi's journey is not over yet. He says his goal is to become the world's youngest grandmaster. At 10 years 8 months, he has a little under two years to beat the current record holder, Sergey Karjakin, who gained his title at 12 years 7 months.

This content is from Southern California Public Radio. View the original story at SCPR.org.

#FreeBritney activists protest outside the Los Angeles Superior Court during one of Britney Spears' hearings this April.; Credit: Matt Winkelmeyer/Getty Images

Pop star Britney Spears hasn't been in charge of her personal life or her finances for 13 years — that's how long she has been in a court-dictated legal arrangement called a conservatorship.

But on Wednesday, the artist will be speaking directly, albeit from a remote location, to a Los Angeles Superior Court judge about her situation. What exactly she intends to say in her appearance and what her goals might be are anyone's guess.

Before then, here's a quick look at what conservatorships are and why they exist, the specifics of Spears' arrangements, the #FreeBritney movement and what Spears and others have said publicly — and privately — about her conservatorship.

What is a conservatorship, and why does one get put in place?

Typically, legal and financial conservatorships are arranged for people who are unable to make their own decisions in their own best self-interest, such as in the case of an elderly person or someone with some kind of cognitive impairment.

Why does Britney Spears have one?

The exact reasons that the 39-year-old Spears is under a conservatorship have not been publicly disclosed. She lost her autonomy 13 years ago, in 2008, after apparently suffering a mental health crisis.

During the time that Spears has lived under this arrangement, though, she has released four albums (two of which, 2008's Circus and 2011's Femme Fatale, achieved platinum sales); appeared as a judge on both The X Factor and American Idol; and had a four-year residency in Las Vegas that reportedly grossed close to $138 million. Those accomplishments don't exactly line up with the typical profile of someone unable to look after themselves.

What does Spears' conservatorship cover?

Essentially, it controls all the major aspects of Spears' life, including decisions regarding her financial, medical and personal well-being. The conservators also oversee visitation arrangements with her two teenage sons, who are under the full custody of her ex-husband, Kevin Federline.

According to Forbes, Spears' current net worth is around $60 million.

Who controls Spears' conservatorship?

Up until recently, both the financial and personal arms of the conservatorship were controlled by Spears' father, Jamie Spears.

In 2020, her lawyer, Samuel D. Ingham III, stated in a filing that Spears "strongly opposed" her father as conservator and that she refused to perform if he remained in charge of her career. Spears asked the court for her father to be suspended from his role as conservator. (He had temporarily stepped away in 2019 for health reasons.)

In February, Los Angeles Superior Court Judge Brenda Penny overruled an objection from Jamie Spears to having a third party help look after his daughter's financial affairs. A wealth-management company, Bessemer Trust, is now a co-conservator for the financial side of Spears' situation. But Jamie Spears is still the main conservator for all other aspects of Spears' arrangement.

Why is Spears planning to talk to the court now?

Back in April, Spears' legal team asked Penny to allow her to speak to the court directly about the conservatorship, and they agreed that June 23 would be the date for this to happen. At the time, Ingham did not disclose why Spears wants to speak or what she intends to say.

Has Spears ever asked for the conservatorship to end?

Up until now, Spears has never voiced a desire for the conservatorship to be removed completely — at least not publicly. In a court filing, she has stated that the conservatorship "rescued her from a collapse, exploitation by predatory individuals and financial ruin" and allowed her to "regain her position as a world class entertainer."

But on Tuesday afternoon, The New York Times reported that it had obtained confidential court records that purport to show that Spears has opposed the conservatorship privately for years. The Times quoted a 2016 report from a court investigator assigned to Spears' case, in which the investigator wrote that Spears told her that the conservatorship had "become an oppressive and controlling tool against her" and that she wanted the arrangement to end quickly.

According to the Times, Spears told the court in 2019 that the conservatorship had forced her into a stay at a mental health facility, as well as into making public performances against her will. The article further reported that the conservatorship had dictated Spears' friendships, her dating life and her spending habits, even preventing her from refinishing kitchen cabinets according to her taste.

As early as 2014, the article states, Spears wanted to consider removing her father from his prime role in the conservatorship, citing his reportedly heavy drinking.

Does Spears herself support the #FreeBritney movement?

Certain Spears fans have organized themselves into a grassroots movement — #FreeBritney — to help Spears regain autonomy over her life. The dynamics between Spears and her dedicated #FreeBritney fans are murky, as are her various declarations on social media.

In a court filing last September, her lawyer, Ingham, wrote: "At this point in her life when she is trying to regain some measure of personal autonomy, Britney welcomes and appreciates the informed support of her many fans."

On the other hand, Spears to date has never publicly asked to be released from the conservatorship and regain her autonomy — which is the main goal of #FreeBritney.

A very sympathetic New York Times television documentary, Framing Britney Spears, debuted on FX in February. The project reckons with the way the media, comedians and the music industry itself characterized Spears during her ascent to global fame and during her later, very public struggles — and it also profiles some #FreeBritney activists.

After it aired, Spears wrote on Instagram: "My life has always been very speculated [sic] ... watched ... and judged really my whole life !!! ... I didn't watch the documentary but from what I did see of it I was embarrassed by the light they put me in ... I cried for two weeks and well .... I still cry sometimes !!!!"

Some #FreeBritney supporters don't believe Spears writes her own Instagram messages, leaving them to speculate about the pop star's true feelings. But Spears reportedly told TMZ in April that she writes her own captions.

What's next for Britney Spears?

Unclear. In an Instagram video posted last week, a visibly jittery Spears professed to be answering fans' most burning questions, including her shoe size and her favorite business trip (answer: "a trip to Italy [to] Donatella Versace. ... She fined [sic] and dined us").

The last question Spears put forward to herself was a crucial one: Would she ever return to the stage again?

"I have no idea," she said. "I'm having fun right now. I'm in transition in my life, and I'm enjoying myself."

This content is from Southern California Public Radio. View the original story at SCPR.org.

A judge has denied Britney Spears' request to remove her father, Jamie Spears (left), as a co-conservator.; Credit: /AP

A Los Angeles Superior Court judge signed an order Wednesday denying Britney Spears' request to have her father, Jamie Spears, removed from the financial aspects of her conservatorship.

Judge Brenda Penny denied the request, which was first filed by Spears' attorney, Samuel D. Ingham III, last November. The judge's decision comes after the singer appeared in court last Wednesday to make a direct appeal to the court. In that emotional statement, Spears said that she was being exploited and "bullied" by the conservatorship — and specifically, by her father.

Until recently, both the financial and personal arms of the conservatorship were controlled by Spears' father, Jamie Spears.

Last year, Ingham stated in a filing that Spears "strongly opposed" her father as conservator, and that she refused to perform if he remained in charge of her career.

In February, Judge Penny allowed a wealth-management company, Bessemer Trust, to come in as a co-conservator for the financial arm of Spears' arrangement. Jamie Spears remains the main conservator for all other aspects of Spears' conservatorship.

The next hearing in the case is currently scheduled for July 14. It is possible that Spears will submit a petition for the conservatorship to be terminated. In her comments to Judge Penny last week, Spears said that she had been unaware that she could take such an action. "I didn't know I could petition the conservatorship to end it," she said. "I'm sorry for my ignorance, but I honestly didn't know that."

This content is from Southern California Public Radio. View the original story at SCPR.org.

Michael Ballanger of GGM Advisory Inc. shares his thoughts on the current state of the market, and one stock he says is his top exploration/development play.

Centerra Gold Inc. (CG:TSX; CADGF:OTCPK) has received varied analyst ratings following updates to its Q3 2024 financial results and projections. Read more on the latest analyst insights and how Q3 projections have shaped varied ratings for this gold producer.

Michael Ballanger of GGM Advisory Inc. shares his thoughts on the current state of the market.

Vehicles are covered with ash coming from the St. Vincent eruption of La Soufrière volcano, on the outskirts of Bridgetown, Barbados, on Sunday.; Credit: Chris Brandis/AP

Conditions on the Caribbean island of St. Vincent have worsened, as La Soufrière volcano continues to push ash and debris into the atmosphere. Dozens of individuals have been rescued from the northern part of the island after refusing to evacuate last week. Officials are warning anyone still in the red and orange zones to flee as the mountain presents a new danger to anyone still in the area.

There is evidence of pyroclastic flows, an avalanche of super-heated gas and debris traveling as fast as more than 120 miles per hour along the mountainside, in the areas around the volcano, University of the West Indies Seismic Research Center's lead scientist Richard Robertson said in a Sunday news conference. These flows are the most dangerous trait of the volcano, he said, as opposed to a slow-moving river of lava.

As La Soufrière continues to explosively erupt, ash and debris are launched into the air. Sometimes there isn't enough force behind the materials to continue upwards and the ash plume collapses on itself and it shoots back down, Robertson said. These clouds of gas can reach scalding-hot temperatures and carry car-sized boulders as the flows make their way through valleys along the mountain. Once the pyroclastic flows hit the coast, the sea water begins to boil and the clouds pick up speed, racing across the surface of the water and away from land until they run out of energy.

"These flows are really moving masses of destruction," Robertson said. "They just destroy everything in its path. Even if you have the strongest house in the world, they will just bulldoze it off the ground."

These flows can happen as the volcano goes through periods of explosive activity and venting. Every hour-and-a-half to 3 hours, Robertson explained, La Soufrière rumbles and produces tremors as the mountain vents more ash. This activity can create pyroclastic flows anywhere on the volcano, threatening anyone who didn't evacuate last week.

During the news conference, St. Vincent and the Grenadines Prime Minister Ralph Gonsalves said the coast guard has rescued dozens of people from the northern part of the island since the volcano started to erupt Friday morning. The areas closest to the volcano were ordered to be evacuated last week, but some people decided to stay, putting rescuers at risk.

"I'm pleading with persons, please, it's past the hour to get out," Gonsalves said. "And we will still have to try and get you out."

Some 16,000 people have already evacuated, The Associated Press reported, about 3,200 of whom have fled to 78 government-run shelters.

Robertson said things will likely get worse before they get better. Instruments monitoring the eruption have shown no sign of activity dying down. The volcano, he explained, is showing a similar pattern to the volcano's eruption in 1902 that killed about 1,600 people.

"That means it's probably, unfortunately, going to cause more damage and destruction to St. Vincent," Robertson said.

But the volcano isn't just affecting the people of St. Vincent. The winds have carried ash all the way to Barbados, about 120 miles east. Barbadian Prime Minister Mia Amor Mottley said the country needs to prepare itself for weeks of ashfall and harsh times.

"As bad as it is, it can be worse, and that's the first thing that we need to recognize," she said in a news conference Sunday. "We are living in uncertain times."

Dr. Erouscilla Joseph, director of the UWI Seismic Research Center, said the winds that carry the debris east over the island can then also circle back around, blanketing the island with more ash from the west.

"Unfortunately, the worst case scenario is this can go on for weeks because of the changes and the dynamics of this system," Joseph said. "We have to keep monitoring the seismicity associated with the volcano and advise based on that."

This content is from Southern California Public Radio. View the original story at SCPR.org.

Special Presidential Envoy for Climate John Kerry tells NPR that the U.S., China and other major emitters aren't doing enough to stem climate change.; Credit: Alex Wong/Getty Images

President Biden is pledging to reduce greenhouse gas emissions by 50-52% from 2005 levels by 2030.

It's an ambitious goal that requires transforming much of the economy. Renewable energy would need to make up half of the U.S. power supply from roughly 21% currently. Electric cars make up about 2% of sales now — by 2030, at least half, potentially all, new car sales would need to be electric, according to estimates. Many industrial manufacturing facilities would need to use technologies that haven't been developed.

It's part of Biden's effort to get the U.S. on track to reach the goals of the 2015 Paris Climate Agreement to keep global temperatures from rising more than 1.5 degrees Celsius. Former President Donald Trump withdrew the U.S. from the agreement but Biden has formally rejoined.

John Kerry is Biden's special envoy for climate, a position that involves meeting with countries around the world about efforts to stem emissions.

He calls the threat of climate change "existential."

"That means life and death. And the question is, are we behaving as if it is? And the answer is no," Kerry said in an interview on NPR's All Things Considered.

This interview has been edited for length and clarity and includes extended Web-only answers.

Interview Highlights

Is this more a matter of shoot for the moon and if you miss, at least you'll land among the stars?

No, I think it's achievable. And I think that people who've really studied this, analyzed it and thought about it for a long period of time believe it is achievable.

Already the [car] marketplace is moving towards electric. I mean, you know, Joe Biden didn't create the value of Tesla as the most valuable automobile company in the world. The market did that. And the market did it because that's where people are moving.

The scale of change that you're talking about in the timeframe that is required is something we've never seen in human history.

Let me put it to you this way. How many politicians, how many scientists, how many people have stood up and said, "This is existential for us on this planet"? Existential. That means life and death. And the question is, are we behaving as if it is? And the answer is no.

So why are younger generation folks so angry? Why are they standing up and demonstrating and asking adults to accept adult responsibility to move our nations in the right direction? Because the scientists are telling them that. They learn about this in high school and college. They read. They know what's happening. They know we're experiencing the hottest day in human history, the hottest week, the hottest month, the hottest year. And we see the results. Fires, floods, mudslides, drought, crop disruption, ice melting in the Arctic, run the list.

Climate change is still seen as a partisan issue in the U.S., and Republicans could take over Congress next year. A Republican could win the White House in three years. So why should global leaders view this as a reliable commitment from the United States when GOP leaders have not bought in?

For two reasons. No. 1, when Donald Trump was president of the United States and he pulled out of the agreement, 37 governors in the United States, Republican and Democrats alike, stood up and said, "We're still in." And states, those 37 states, have passed renewable portfolio laws. So at the state level, people are moving because they know it's better for their state. It's a safer, better delivery of power to their state, and it's the way it's going to move.

The second part of the answer: Masses of capital, trillions of dollars, are going to move into the energy market, which is the largest market the world has ever seen and going to grow now. Multiple double-digit trillions of dollars of market. And no politician can come along and tell those banks, or those asset managers or those investors or those venture capitalists or the companies, the corporations that are doing this, they know this is where the market's going to be in the future.

If the $2 trillion infrastructure and jobs plan that the president has put forth does not pass the Senate, does this goal to cut emissions in half by 2030 effectively die with the bill?

Well, it doesn't die, but it certainly takes a blow, a serious one. But the companies I've talked about are going to move in this direction no matter what. I mean, if you look at the biggest companies in America, these folks are all pushing to get this done because they know that the world is going to be better off and that their businesses are going to be better off if we do that. This is a real challenge for all of us, and I think people are waking up to it all around the world.

Let me ask you a question. Why do you think 40 heads of state, including President Xi of China, President Putin of Russia, Prime Minister Modi of India, huge populations come together and say, "We have to do this"? Do they know something that some of these opponents of it don't know or aren't willing to admit? I mean, the only leader in the entire world that saw fit to pull out of the Paris agreement was Donald Trump.

But it's so easy to make commitments and we haven't seen countries follow through on those commitments.

This is accurate. They're doing things; they're not doing enough. There are very few countries that are doing enough. Most countries are not. And of the 20 countries that equal 81% of all the emissions, they are the critical ones that have to do more. And we're among them. We are 15% of all the world's emissions. China is 30%. Does China need to do more? Absolutely. All of the 20 need to do more.

This content is from Southern California Public Radio. View the original story at SCPR.org.

Cars make their way toward downtown Los Angeles on April 22. California could regain the right to set its own vehicle emissions standards after the Environmental Protection Agency announced it was moving to curb a Trump-era policy that sought to erode the state's previously-held power.; Credit: Mario Tama/Getty Images

The Environmental Protection Agency (EPA) said on Monday it is preparing to restore California's right to set its own vehicle emissions standards, in a widely anticipated reversal of Trump-era policies.

The decision, which will take several months to be finalized, reaffirms the Golden State's powerful position as an environmental regulator after the Trump administration had in 2019 sought to remove California's powers to set its own emissions standards.

It also sets the stage for negotiations over how strict federal vehicle standards will be under President Biden.

"I am a firm believer in California's long-standing statutory authority to lead," EPA administration Michael Regan said in a statement.

"The 2019 decision to revoke the state's waiver to enforce its greenhouse gas pollution standards for cars and trucks was legally dubious and an attack on the public's health and wellbeing," he added.

The EPA will be accepting public comment until July 6 as part of the process of reversing the Trump-era rule.

The populous, car-loving state has been waging a battle against smog for decades.

And in recognition of that history, the EPA has long granted a waiver giving the state the authority to set its own standards for vehicle emissions, as long as they're more stringent than the national regulations.

That's an unusual exemption — other states can't set their own policies, although they can choose to adopt California's standards as their own.

Between California and the states that follow suit, about a third of the U.S. new car market is covered by the Golden State's policies, giving California regulators a remarkable amount of sway over the auto industry.

However, when the Trump administration weakened federal clean car standards, it also sought to revoke the waiver allowing California to set a higher bar.

That triggered a legal battle and divided the auto industry, with some carmakers choosing to side with California and voluntarily accept somewhat stricter vehicle emissions standards while the rest backed the Trump administration.

After Biden won the White House, every major automaker eventually dropped their support for the now-doomed Trump position.

The EPA has now started the process of reversing Trump's decision. The Department of Transportation last week also proposed to "wipe clean the regulatory slate," indicating that the National Highway Traffic Safety Administration would no longer seek to block state emissions standards, as it had under Trump.

It's still not clear what federal regulations on vehicle emissions and fuel economy will be under the Biden administration. Some environmental groups and progressive lawmakers are pushing for the reinstatement of the Obama-era standards, with more ambitious targets to follow.

The auto industry, meanwhile, is calling for standards midway between the Obama-era and Trump-era policies.

The EPA says it will propose new fuel economy rules in July.

This content is from Southern California Public Radio. View the original story at SCPR.org.

Florida Gov. Ron DeSantis speaks to the media about the cruise industry during a press conference at PortMiami in April. DeSantis faces criticism for failing to do all he could on Florida's biggest environmental threat: climate change.; Credit: Joe Raedle/Getty Images

Brick by brick, the stucco shell of a new flood-resilient public works building is taking shape blocks from the beach, the most visible sign yet of a small community's enormous task staving off the rising sea.

"This is actually the highest point in the city," Satellite Beach City Manager Courtney Barker said, adding that right next door to the new public works building will be a new fire station.

It's a close-knit community established by rocket scientists south of Kennedy Space Center, on a low-slung barrier island between the Atlantic Ocean and Indian River Lagoon.

By 2040, community leaders expect significant impacts associated with climate change. Already flooding is a problem, and beach-front homes perch precariously atop a sand dune left exposed after a series of storms and hurricanes washed away a sea wall.

The needs are great, and in Gov. Ron DeSantis, Barker sees a potential ally.

"At least he talks about climate change as actually being real, so that's good," she said. "And he's putting money toward it so that's encouraging."

But Barker also feels DeSantis is doing only part of the job.

"We desperately need to grow up as a state and realize that we need to get our emissions down," Barker said.

Since his election in November 2018, DeSantis is making good on some of his environmental promises, including what he likes to call "resilience," a new buzzword for climate adaptation. But as the governor prepares for a reelection bid in 2022, and is seen as a potential Republican frontrunner for the presidency in 2024, DeSantis faces criticism for failing to do all he could on Florida's biggest environmental threat: climate change.

Some of his critics acknowledge that the $1 billion Resilient Florida plan he announced in January could be a first step toward helping some communities pay for adaptation. But critics also point out that DeSantis has done almost nothing to put Florida on a path to scaling back the state's heavy reliance on fossil fuels.

"I would give him probably a C-minus," said former Republican Gov. Charlie Crist, who served from 2007 to 2011, and now represents St. Petersburg in the U.S. House of Representatives as a Democrat.

Crist still gets plaudits from environmentalists for his administration's climate initiatives, including a cap-and-trade system to curb carbon emissions and an executive order that was intended to put the state on a path to reducing its greenhouse gas emissions 80% by 2050. But those were basically abandoned by Gov. Rick Scott, the Republican now serving in the U.S. Senate.

Crist, who switched parties and this week announced he is running for governor in 2022, said DeSantis should be "encouraging renewables such as wind energy, solar energy, and particularly solar. I mean, my goodness, we're the Sunshine State."

DeSantis' press office declined to make the governor available for an interview and did not respond to written questions.

In comments at two press conferences earlier this year, the governor cited his support for spending hundreds of millions of dollars on water projects and Everglades restoration as evidence of his environmental credentials, while promising to double down on funding for coastal resilience.

Florida needs "to tackle the challenges posed by flooding, intensified storm events [and] sea level rise," he said. "When you look at how an insurance market would view property insurance, and to see that Florida is leading and trying to get ahead of some of these impacts, we think it'll be a very smart thing to do."

Lawmakers have had their own ideas on how to handle climate threats, and have passed two bills that, when taken together, are similar to DeSantis' Resilient Florida proposal.

"It's not exactly as he said he wanted it, but it's close," said Jonathan Webber, deputy director of Florida Conservation Voters. "These are policies that need to happen. It would have been better if they happened 20 years ago."

"I am not a global warming person"

In his 2018 campaign, DeSantis appealed directly to supporters of former President Donald Trump, such as in this ad where he tells one of his children to "build the wall" with toy blocks. The environment was a major issue in that election.

Residents were grappling with a toxic red tide and blue-green algae crisis that made beaches and waterways unsafe, and left marine-life belly-up.

In recent years Floridians have also experienced deadly, devastating consequences of back-to-back major hurricanes.

All the while, advocates were highlighting likely links between the state's environmental woes and global warming.

Florida's climate challenges are among the biggest in the country. Beyond those related to hurricanes intensified by climate change, they include sea level rise, extreme heat, drought and increasing health threats from mosquito-borne diseases.

By its own numbers, the DeSantis administration predicts that with sea level rise, $26 billion in residential property statewide will be at risk of chronic flooding by 2045.

But in 2018, DeSantis let voters know that he had clear limits when it came to climate change.

"I am not in the pews of the church of the global warming leftists," DeSantis told reporters at one 2018 campaign stop. "I am not a global warming person. I don't want that label on me."

Early plaudits from environmentalists

Once in office, DeSantis won early plaudits for directives aimed at cleaning up water and helping Florida adapt to climate change. He appointed the first state resilience officer and the first chief scientist, and ordered Florida's Department of Environmental Protection to make sure its decisions were based on the best available science.

In 2019, they approved of DeSantis' order to his environmental regulators to oppose fracking, but he since has failed to get his Republican colleagues in the legislature to pass a statewide fracking ban, something he advocated for during his campaign. The state's oil and gas industry does not currently use fracking as a drilling method, but environmentalists are worried it might start doing so, resulting in water pollution.

Environmental groups also praised DeSantis in 2020 when the governor announced the state was backing a plan to buy 20,000 acres of the Everglades to prevent oil development there.

And they did the same when DeSantis backed spending $166 million in settlement money Florida received from Volkswagen on electric vehicle charging stations and cleaner electric buses. The money, part of a larger $14.7 billion settlement, came after the German automaker was caught lying about its cars' diesel emissions.

"Everyone was optimistic," said Susan Glickman, the Florida director for the Southern Alliance for Clean Energy. "I kept hearing an opening on climate."

Two years later, though, Glickman and other advocates are assessing DeSantis' climate record much like this: He's done more than previous Governor Scott, but that's not saying much.

DeSantis quietly replaced his chief science officer in March with Mark Rains, a professor, and chair and director of the School of Geosciences at the University of South Florida. But he never has replaced his chief resilience officer after she left for the Trump administration after only a few months in the position.

"Missing in action" on renewables

In many ways, it's what DeSantis hasn't done that defines his climate record. He has chosen not to use his bully pulpit to advocate for a clean-energy future, like his Democratic Party counterparts in the Southeast states of North Carolina and Virginia, or like the mayors of Orlando and Tampa.

DeSantis has also been "missing in action" in debate over bills this year in the Florida legislature that would undermine local government efforts to transition to clean energy, said Webber, with the Florida Conservation Voters group.

One such bill, that has passed the House and Senate and awaits DeSantis' consideration, would ban local governments from restricting fuel sources. The oil and gas industry has supported such measures around the country. They aim to block the push by climate activists to ban natural gas hook-ups in new buildings, and electrify them instead to reduce carbon emissions.

Of course, electrification only reduces emissions if it's powered by renewable energy. But Florida has no requirement that utilities provide a certain amount of that. Solar power accounts for only about 2.5% of the electricity produced by utilities, while they rely on fossil fuels for about 84%.

When DeSantis had a chance to appoint someone to the state's powerful Florida Public Service Commission, a regulatory body with a big say in state energy policy, he chose the Florida chairman of the American Legislative Exchange Council, a group known for its support of fossil fuels.

"We are very frustrated by the messaging, and the lack of acknowledgement of the root of the problem of all these issues," said Yoca Arditi-Rocha, executive director of The CLEO Institute, a nonprofit that focuses on climate science education.

"We need to acknowledge the warming temperatures and the rising seas are a result of our warming climate," she said. "We cannot adapt our way out of it. We need to aggressively tackle mitigation."

"What places can we not save?"

In Satellite Beach, Courtney Barker, the city manager who welcomes the governor's help with adapting to climate change, also wants to see him tackle the emissions side of the equation.

Besides moving the public works building and fire station to higher ground, the community is fortifying its system of flood control. Barker said the community needs more funding opportunities from the state.

"We're looking for assistance in helping us engineer our way out of it," she said.

Marine and climate scientist Jeff Chanton, of Florida State University, thinks there's too much emphasis on sea walls, which can cause beach erosion and destroy tidal zones vital to marine life, including crabs and turtles.

"An ideal governor would try to lessen the impacts of growth in this state, especially along our coastlines," he said.

Before her departure, Julia Nesheiwat, DeSantis' chief resilience officer, characterized the state's infrastructure as "outdated" in a report, and called its resilience strategy "disjointed."

For Thomas Ruppert, an attorney and coastal planning specialist with Florida Sea Grant, DeSantis' emphasis on hardening infrastructure ignores that — for some communities — the investments will be futile in staving off the inevitable.

"Ultimately, what we really need is to start talking seriously [about] what places can we not save? And what is an exit strategy? Because we have no idea," Ruppert said.

Barker hopes it doesn't come to that in Satellite Beach, where she grew up.

"It's personal to all of us, because I think everyone can look at their own hometown, and you can't imagine being anywhere else."

This story is a collaboration between Inside Climate News and WMFE Orlando, a member of ICN's National Reporting Network-Southeast.

This content is from Southern California Public Radio. View the original story at SCPR.org.

A rollercoaster that once sat on the Funtown Pier in Seaside Heights, N.J., rests in the ocean on Wednesday, Oct. 31, 2012 after the pier was washed away by superstorm Sandy.; Credit: Julio Cortez/AP

When Hurricane Sandy swept up the eastern seaboard in 2012, it left a trail of damage from Florida to Maine. Subways were inundated in New York City. Hurricane-force winds tore across New Jersey. Blizzard conditions walloped Appalachia.

The hurricane — also known as Superstorm Sandy — caused an estimated $70 billion in damages in the U.S., mostly from flooding. And while scientists have long believed that some of the carnage was attributable to a warming climate, it's been unclear just how much of a role human-caused warming played in the storm's impacts. New research, published Tuesday in the journal Nature Communications, puts a dollar amount on some of those damages and it's a startling figure.

Using flood maps and sea-level rise measurements, researchers found that human-induced sea-level rise caused an estimated $8 billion in excess flooding damage during Hurricane Sandy and affected an additional 70,000 people.

"I often hear people say when we're trying to help them adapt to increasing coastal flooding, 'Well, it's not going to happen in my lifetime, the sea-level rise won't happen in my lifetime,'" said Philip Orton, a co-author of the study from the Stevens Institute of Technology in New Jersey. "But it's already happening to people. It's already here."

Sea levels at the tip of Manhattan have risen about 8 inches since 1950, according to the National Oceanic and Atmospheric Administration. Estimates range for how much additional sea-level rise is likely to occur, but on average, the expectation is that by mid-century water levels could rise by more than a foot in New York City, compared to the year 2000.

In worst case scenarios, in which humanity does not significantly cut its climate-warming greenhouse gas emissions and the world's ice sheets rapidly melt, sea levels could rise by more than 6 feet by the end of the century, putting hundreds of millions of people at risk worldwide.

Higher water levels mean more areas are susceptible to flooding, storm surge and other problems associated with hurricanes, as well as more chronic flooding from high tides.

The Biden administration has made addressing climate change one of its top priorities. It's proposed a major reconfiguration of the nation's energy and transportation sectors to cut the country's outsized contribution to global warming, with the goal of making the U.S. carbon neutral by the year 2050. Accomplishing that feat will require major federal investments and likely bipartisan support. It's unclear if the administration will be able to procure the latter.

The new study, which joins a growing body of broader attribution science, aims to quantify the cost of inaction and business as usual. Similar studies found that climate change fueled the strength of Hurricane Harvey, increased the risk of Australia's recent unprecedented fire season and contributed to a record-breaking heatwave in Europe.

Scientists have debated whether Hurricane Sandy was made more intense by a warming climate, but it's difficult to know. Generally, there's agreement in the scientific community that hotter global temperatures and warmer ocean waters will lead to more rapid intensification of hurricanes.

Quantifying exactly how much those climatic differences affected a storm like Sandy is difficult. That's why Orton and the team of researchers focused their efforts on sea-level rise, where there's a bevvy of good data. They used that data to model the impacts of Hurricane Sandy in a world without climate change and found the estimated $8 billion difference.

"Increasingly we have the tools to simulate these events and study and quantify the impact of climate change on people's lives," Orton said. "People's lives were dramatically changed by Hurricane Sandy and a lot of them don't realize it had to do with climate change at all."

This content is from Southern California Public Radio. View the original story at SCPR.org.

Washington State Department of Agriculture entomologist Chris Looney displays a dead Asian giant hornet, a sample sent from Japan and brought in for research last year in Blaine, Wash.; Credit: Elaine Thompson /AFP via Getty Images

Murder hornets. They're back.

Authorities in Washington state have announced that they've confirmed the first U.S. report this year of an Asian giant hornet, or Vespa mandarinia, in a town north of Seattle.

"Basically the only information we have is that a slightly dried out, dead specimen was collected off of a lawn in Marysville," said Sven Spichiger, managing entomologist with the state agriculture department, during a press conference.

"There really isn't even enough information to speculate on how it got there or how long it had been there," Spichiger added.

Because of its withered condition and the fact that male giant hornets don't typically emerge until July, agriculture officials believe the hornet discovered in early June was likely from a previous season and just recently found.

So-called "murder hornets" are native to Asia but have been spotted in Washington state and Canada over the past two years. The sting of the Vespa mandarinia can be life-threatening to humans, and the killer insects are known to wipe out the colonies of their fellow bugs, particularly honey bees.

According to genetic testing of the specimen discovered in Washington this month, the dead hornet was not the same as the other giant hornets discovered in North America since 2019. The hornet's coloration, which indicates it came from southern Asia, also suggested it arrived in "probably a separate event" than the ones previously known, Spichiger said.

But he emphasized that that was not necessarily cause for alarm.

"I want to very much clarify that a single dead specimen does not indicate a population," Spichiger said.

Washington agriculture officials are now setting murder hornet traps in the area of the discovery and are encouraging "citizen scientists" to do the same.

This content is from Southern California Public Radio. View the original story at SCPR.org.

As search and rescue efforts at the site of the Surfside, Fla., condo collapse stretch into day nine, officials have said that the number of confirmed fatalities has risen to 20, while the number of people unaccounted for has dropped from 145 to 128.

Miami-Dade County Mayor Daniella Levine Cava told reporters Friday that one of the two fatalities recovered overnight was the 7-year-old daughter of a firefighter for the city of Miami.

"It goes without saying that every night since this last Wednesday has been immensely difficult for everybody, particularly the families that have been impacted," Levine Cava said. "But last night was truly different and more difficult for our first responders. These men and women are paying an enormous human toll each every day, and I ask that all of you please keep all of them in your thoughts and prayers."

"They truly represent the very best in all of us, and we need to be there for them as they are here for us," she said.

The number of people who have been accounted for has grown to 188, officials also confirmed Friday. In many cases, detectives followed leads regarding individuals who were unaccounted for but then reached them and discovered they were safe.

They even discovered additional family members who were safe and who could have been in the building, and added them to the tally of accounted for individuals.

Officials have not yet released the names of all of the dead and missing people, and asked Friday that the privacy of the families be respected.

This content is from Southern California Public Radio. View the original story at SCPR.org.

To help keep weak swimmers safe, stay "touch-close" and don't rely on a busy lifeguard to be the only eyes on a crowded pool or beach. It's best, say experts working to prevent drownings, to designate a nondrinking adult to scan the water at any pool party or beach outing, and to rotate that "watching" shift every 30 minutes to keep fresh eyes on the kids.; Credit: Imgorthand/Getty Images

I'm going to let you in on one of the most important lessons I learned early on, in my years of training to become a doctor: Absolutely anyone can drown, or lose a loved one to a drowning.

The Centers for Disease Control and Prevention estimates that more than 3,900 people die from unintentional drowning in the US each year — with one in five under 14-years-old. And for each pediatric fatality, another five children require emergency care for nonfatal drownings that can cause irreversible organ damage.

Every patient or family I've cared for after a drowning accident has said they didn't think it could happen to them. And yet, it happens, along with the cruel "if onlys" that haunt cautious and well-intentioned people in the aftermath: "If only I'd done something different, or known what to look for." I hear this again and again, especially from those who've lost a child.

Unfortunately, research shows that in the majority of drowning cases, the child was being supervised by an adult when the accident happened. So, as our summer of post-vaccination reunions and vacations heats up, remember just how vulnerable kids are in water. The rate of admissions for nonfatal drownings at the Arnold Palmer Children's Hospital in Orlando, for example, was already double in May what it was in the last three years at that same time.

Among basic water supervision precautions, a few potentially life-saving details are often overlooked. Here are some essentials to help keep our young swimmers safe this summer:

Follow the 'arm's length' rule

It may sound commonsensical to stay close by when kids are in or near a pool or other body of water, but it's important to know what safety experts consider close enough supervision to avoid a drowning event.

The American Academy of Pediatrics recommends that adults who are supervising a child of any age who isn't a strong swimmer should be within one arm's length at all times when kids are in the water, offering "touch supervision" this way.

Dr. Andrew Schmidt, a lifeguard-turned-ER doctor at University of Florida Health-Jacksonville and an expert in water safety, notes the definition of a "strong swimmer" is subjective — and overestimating a child's independence in the water has led to tragic accidents.

Schmidt falls back on the way the American Red Cross, a longtime leader in teaching water safety, defines a "water competent" swimmer. According to the Red Cross guidelines , someone is water-competent if they find themselves in water over their head and are able to:

• Swim to the surface after being submerged, then float or tread water for at least one minute.
• Swim in a full circle and find an exit, then swim about 25 yards to that exit.
• Get out of the water on their own, which means exiting the water without a ladder if they're in a pool.

That's a good starting point for judging kids' vulnerability in the water, but adults still need to stay vigilant. "Even a strong swimmer can get into trouble," warns Dr. Terri McFadden, a professor in the department of pediatrics at Emory University's School of Medicine and medical director of the Injury Free Coalition for Kids in Atlanta.

Treat water safety supervision like a job

Calling appropriate water supervision an "intense job," McFadden is quick to remind the parents of her patients to stay alert even if the child is a proficient swimmer.

Having older kids or young teens — or adults that are weak swimmers — acting as chaperones isn't safe, she says. And if you're the adult in charge, doing anything that draws your eyes away from the water for just a moment is risky. Reading, using your phone in any capacity, socializing, fiddling with the bluetooth speaker or doing household chores – all such lapses are dangerous when children are swimming or playing in water. Drowning accidents have happened in the time it takes for a caretaker to run inside just long enough to put wet clothes in the dryer, or while they were looking on from a kitchen window and doing dishes. No distraction is quick enough to be safe when it comes to kids in or around water – not seconds, not minutes.

Mcfadden is among many leaders in child safety who recommend assigning an adult "watcher" at the pool or waterfront who can agree to be totally attentive for a brief period of time (15 to 30 minutes or so), then switching to another watcher in intervals; short spurts of duty making it easier to stay focused. It doesn't matter at a pool party that there are a dozen responsible adults nearby; if there isn't one pair of mature eyes devoted to watching the young swimmers 100% of the time, the risk of a deadly accident goes up.

Similarly, it's never safe to simply rely on lifeguards. Though trained to scan for emergencies and quickly respond, they can also get distracted, especially when there are lots of people bobbing along or jumping in and out of the water.

Stay sober when you're the adult in charge

There's also been a well-documented spike in alcohol use during the pandemic, and coupling that increase with an uptick in warm weather and waterside celebrations with friends and family can be a drowning accident waiting to happen.

Not only does alcohol lower our level of alertness and slow the reflexes needed to act quickly when we spot danger, it will also make swimming and helping someone to safety slower and more difficult as well.

And I'm not just talking about avoiding being drunk; cognitive processes and reflexes can slow after just a drink or two. Should something bad happen, it's not worth the heartbreak of wondering if the outcome could have been different without alcohol — something I've witnessed first-hand among some families of drowning victims.

The safest bet is to designate one fully sober adult as the watcher for 15 to 30 minutes at a time when kids are in or near the water. "Sober" means those adults agree to not use any mind-altering substances in that time — not alcohol, marijuana or even some allergy medicines or other prescription drugs that can cause drowsiness.

Use the safest life jacket, but don't rely on it alone

Life jackets do provide an added layer of protection against drowning, and most states require kids to wear them at all times when on a boat — regardless of their swimming strength.

Water safety and drowning experts recommend kids only wear life vests or jackets that are US Coast Guard-approved, which includes many different brands and will be noted clearly on the tag or printed onto the life jacket itself, along with a number that tells you what federal regulation it's approved under.

Pay close attention to what's printed there; the labels will tell you if it's not meant for weak or non-swimmers. You'll also find the weight range the vest is designed to fit. It should be nice and snug; wearing a loose life vest is like not wearing one at all.

Schmidt also cautions parents against relying on any unregulated flotation devices — including arm floaties, swimsuits with built-in floats or blow up neck rings. They may be cute, but can provide a false sense of safety that supports distracted supervision, he says.

Don't let shallow water deceive you

The risk to kids isn't equal to the depth of the water when we're talking about drowning. Small children can drown in baby pools, bathtubs or even household water buckets or tide pools — anything with enough water in it to cover their mouth and nose if they can't lift themselves out easily. They need adult supervision in these places, too.

And be forewarned — though child gates, locks and other safety measures are additional safety layers, if you've ever seen a kid use an iPhone you know that they're smart, and craftier than we realize. Most can still problem-solve their way around those barriers and into the water no matter the physical precautions.

Be ready to recognize what drowning or distress looks like

Parents and caretakers are often surprised to hear that drowning can look like nothing you'd notice, hear, or even expect — which is why it takes 100% visual and/or touch supervision to pick up the signs. The splashing, yelling and commotion you've seen in movies could certainly be a signal a child is in trouble, but it doesn't always happen that way.

Instead, be on the lookout for subtle and quick: a child motionless or face down in water or swimming upright but not making any progress forward; a lowered head, or a head tilted way back or with hair covering the eyes or face; a look of fear or doom in a child's eyes; or perhaps just a constant gaze toward shore or an exit/ladder. And a child that jumps or dives into the water but doesn't come up quickly could be missed without sharp visual supervision.

A swimmer of any skill level might need your help, and it can often take all of our senses on full-alert to identify a drowning in progress.

Swim classes are available for even very young kids. Enroll your child ASAP

Many 1-year-old babies can benefit from swim classes taught by a skilled instructor, according to the AAP. Children develop along different timelines, so check with your doctor to see if your child's ready to start.

And swim classes aren't just for beginners or kids — people of any age or ability can benefit. Even if you already know the fundamentals, swim instruction will help you expand your skills and be even safer in the water. Many instructors nowadays teach safety tactics like safer ways to jump into the water, how to safely escape an ocean's riptide or undertow, and how to save others from drowning without putting yourself in danger.

You can find classes through community pools, health departments or regional chapters of the American Red Cross or YMCA; some local nonprofits offer scholarships, so cost shouldn't be a barrier. Plus, the same groups can help you find CPR classes, which is a must for all chaperones and other adults — whether or not water is involved.

It's impossible to fully control environments where water and kids mix, but what we know about drowning is this: Sharp-eyed, adult supervision is key to prevention. And parents can't do it alone — if we all share the responsibility whenever we're near the water, we can save lives.

Dr. Kristen Kendrick is a board-certified family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine.

This content is from Southern California Public Radio. View the original story at SCPR.org.

Rescuers search for bodies from the site where a Philippine military C-130 plane crashed in Patikul town, Sulu province, southern Philippines on Sunday, July 4, 2021.; Credit: /Joint Task Force-Sulu via AP

MANILA, Philippines — A Philippine air force C-130 aircraft carrying combat troops crashed in a southern province while landing Sunday, killing at least 29 army soldiers on board and two civilians on the ground, while at least 50 were rescued from the burning wreckage, officials said.

Some soldiers were seen jumping off the aircraft before it crashed and exploded around noon in the periphery of the Jolo airport in Sulu province, military officials said. Two of six villagers who were hit on the ground have died.

Defense Secretary Delfin Lorenzana said rescue and recovery efforts were ongoing. The aircraft had 96 people on board, including three pilots and five crew and the rest were army personnel, the military said, adding 17 soldiers remained unaccounted for by nightfall. The pilots survived but were seriously injured, officials said.

The Lockheed C-130 Hercules was one of two ex-U.S. Air Force aircraft handed over to the Philippines as part of military assistance this year. It crashed while landing shortly before noon Sunday in Bangkal village in the mountainous town of Patikul, military chief of staff Gen. Cirilito Sobejana said.

Military officials said at least 50 people on board were brought to a hospital in Sulu or flown to nearby Zamboanga city and troops were trying to search for the rest. "Per eyewitnesses, a number of soldiers were seen jumping out of the aircraft before it hit the ground, sparing them from the explosion caused by the crash," a military statement said.

Initial pictures released by the military showed the tail section of the cargo plane relatively intact. The other parts of the plane were burned or scattered in pieces in a clearing surrounded by coconut trees. Soldiers and other rescuers with stretchers were seen dashing to and from the smoke-shrouded crash site.

The plane was transporting troops, many of them new soldiers who had just undergone basic training, from the southern Cagayan de Oro city for deployment in Sulu, officials said.

"They were supposed to join us in our fight against terrorism," Sulu military commander Maj. Gen. William Gonzales said. Government forces have been battling Abu Sayyaf militants in the predominantly Muslim province of Sulu for decades.

It was not immediately clear what caused the crash. Regional military commander Lt. Gen. Corleto Vinluan said it was unlikely that the aircraft took hostile fire, and cited witnesses as saying that it appeared to have overshot the runway then crashed in the periphery of the airport.

"It's very unfortunate," Sobejana told reporters. "The plane missed the runway and it was trying to regain power but failed and crashed."

An air force official told The Associated Press that the Jolo runway is shorter than most others in the country, making it more difficult for pilots to adjust if an aircraft misses the landing spot. The official, who has flown military aircraft to and from Jolo several times, spoke on condition of anonymity because of a lack of authority to speak publicly.

Initial pictures showed that the weather was apparently fine in Sulu although other parts of the Philippines were experiencing rains due to an approaching tropical depression. The airport in Sulu's main town of Jolo is located a few kilometers (miles) from a mountainous area where troops have battled Abu Sayyaf militants. Some militants have aligned themselves with the Islamic State group.

The U.S. and the Philippines have separately blacklisted Abu Sayyaf as a terrorist organization for bombings, ransom kidnappings and beheadings. It has been considerably weakened by years of government offensives but remains a threat.

President Rodrigo Duterte expanded the military presence in Sulu into a full division in late 2018, deploying hundreds of additional troops, air force aircraft and other combat equipment after vowing to wipe out the Abu Sayyaf and allied foreign and local gunmen.

Government forces at the time were running after Muslim armed groups a year after quelling the five-month siege of southern Marawi city by hundreds of militants linked to the Islamic State group. More than 1,000 people, mostly militants and long-elusive Abu Sayyaf commanders, were killed in months of intense air and ground assaults.

Sunday's crash comes as the limited number of military aircraft has been further strained, as the air force helped transport medical supplies, vaccines and protective equipment to far-flung island provinces amid spikes in COVID-19 infections.

The Philippine government has struggled for years to modernize its military, one of Asia's least equipped, as it dealt with decades-long Muslim and communist insurgencies and territorial rifts with China and other claimant countries in the South China Sea.

This content is from Southern California Public Radio. View the original story at SCPR.org.

Bill Cosby gestures outside his home in Elkins Park, Pa., on June 30, 2021, after being released from prison when the Pennsylvania's supreme court overturned his sexual assault conviction. Cosby expressed support for former TV co-star Phylicia Rashad's freedom of speech after she defended him in a tweet.; Credit: Matt Rourke/AP

Bill Cosby called on Howard University to support former co-star Phylicia Rashad's freedom of speech after she expressed support for him when his sexual assault conviction was overturned.

In a statement, Cosby also lashed out at the media, comparing journalists to the rioters who stormed the Capitol in January.

"Howard University you must support ones Freedom of Speech (Ms. Rashad), which is taught or suppose to be taught everyday at that renowned law school, which resides on your campus," Cosby said in a statement provided to NPR by his spokesman Andrew Wyatt.

"This mainstream media has become the Insurrectionists, who stormed the Capitol," Cosby continued in his statement. "Those same Media Insurrectionists are trying to demolish the Constitution of these United State of America on this Independence Day."

Cosby concluded by saying, "WE THE PEOPLE STAND IN SUPPORT OF MS. PHYLICIA RASHAD" in all caps.

Cosby's support of Rashad comes after the actress, who played his TV wife in The Cosby Show, defended the comedian in a tweet. Cosby was released from prison last week when the Pennsylvania Supreme Court vacated his sexual assault conviction on the grounds that his due process rights were violated.

"FINALLY!!!! A terrible wrong is being righted- a miscarriage of justice is corrected!" Rashad said last week.

The tweet has since been removed and Rashad later backpedaled, writing that she "fully support survivors of sexual assault coming forward." She also sent a letter of apology to Howard students

Many Howard alumni had expressed disappointment at the remarks. Howard University responded with its own tweet, stating that Dean Rashad's "initial tweet lacked sensitivity towards survivors of sexual assault."

Rashad was recently named Dean of Howard University's Chadwick Boseman College of Fine Arts.

Rashad, an acclaimed stage and screen artist, graduated from Howard magna cum laude in 1970 with a bachelor's in fine arts. She returned as a guest lecturer and adjunct faculty member.

In a statement announcing her appointment in May, Provost Anthony K. Wutoh said Rashad's "passion for the arts and student success makes her a perfect fit for this role."

One of the students Rashad mentored at Howard was the late actor Chadwick Boseman, for whom the school's College of Fine Arts is named.

This content is from Southern California Public Radio. View the original story at SCPR.org.

When a promising new drug to treat obesity was approved by the Food and Drug Administration for sale in the U.S. last month, it was the first such treatment to gain approval since 2014.

In clinical trials, weekly injections of semaglutide — or Wegovy, as it's been branded -- helped people drop an average of 15% of their body weight. That's an average of about 34 pounds over 16 months, before their weight plateaued, a far greater weight loss, obesity specialists say, than achieved with other drugs on the market. At least as important, Wegovy raised none of the alarm bells with the FDA or obesity doctors that it might trigger serious side effects of the sort experienced by some people taking fen-phen or some previous medical treatments for obesity.

But with a price tag for Wegovy of $1,000 to $1,500 a month, a very big question remains: Will insurers cover its significant cost for the many millions of people like Marleen Greenleaf, who might benefit?

Greenleaf grew up on the island of Trinidad, where her entire family paid little heed to what they ate and paid a high medical price, she says: "My husband has diabetes, my sister has diabetes, my brother has diabetes."

Since then, she's tried — and failed — at numerous diets, says Greenleaf, now 58 and an administrator at a charter school in Washington, D.C. Then, in 2018, she signed up for the clinical trial of a new drug — a once-weekly shot that changes the way her brain signals hunger.

A drug that finally stops her cravings

She noticed the change soon after her first injection of Wegovy: "For me, there was something that triggered in my brain to tell me that I was not hungry," she says. No more fierce cravings for the chocolate chip cookies she adores. Without the cravings she was able to slow down and reconsider the foods she'd been reaching for.

"I also wanted to eat healthier," she says. "I was looking at options, reading labels, looking at the calories — not just the calories, but also the sugar."

Over the 68-week research trial, Greenleaf dropped 40 pounds. Her blood pressure fell, which meant she qualified to donate her kidney to her husband, who was on dialysis.

"It was one of the best gifts of life that I could have ever given," she says.

But after that study ended, Greenleaf regained some of the weight. Wegovy is considered a long-term, possibly lifelong medication to treat chronic obesity. In the pre-marketing clinical studies, weight loss topped out at a total average weight loss of 15-18%, even as people continued to take the drug. And, as was the case with Greenleaf, once they stopped getting the weekly injections some of that weight came back.

Now, Greenleaf wants to resume the Wegovy shots.

"My only challenge actually is getting the insurance company to approve it," she says.

Reimbursement for obesity drugs' cost is patchy

Insurance coverage, it turns out, is a giant question — not just with Wegovy, but with obesity drugs in general. Some private insurers do include some prescription obesity drugs in the list of medicines they'll cover; it's too early to tell whether Wegovy will make those lists. Many doctors and patients are optimistic, because it is a higher dose of an existing diabetes medication called Ozempic, which is often covered by insurers.

A few select state Medicaid programs will cover medications that treat obesity, in some circumstances. But, significantly, Medicare does not cover obesity drugs — and many private insurers typically follow Medicare's lead.

Yet the demand for a good treatment is there, says Dr. Fatima Cody Stanford, a leading obesity researcher at Harvard. She was not involved in conducting the Wegovy clinical trial, but closely followed it. "I'm excited about it," she says, because of the dramatic weight loss.

The drug acts on the brain so people eat less and store less of what they eat. That helps address the excess weight as well as helping with numerous related diseases of the liver or heart, for example.

Why the FDA has been slow to approve obesity treatments

There is a long history of drugs that have looked like promising treatments for obesity, then failed. Decades ago, amphetamines, were prescribed, until their addictive properties became apparent. In the 1990s, the combination of fenfluramine and phentermine — administered as the diet drug fen-phen — was heavily marketed, only to later be pulled from the market for causing heart valve problems.

Those experiences and others have made physicians skeptical.

"In obesity medicine field, we've learned to be cautiously optimistic each time we have a new medication that looks promising," says Dr. Ihuoma Eneli, director of the Center for Healthy Weight and Nutrition at Nationwide Children's Hospital in Columbus, Ohio, who was not involved in the study of Wegovy.

So far, Eneli does not see any obvious concerns with the class of drugs that includes Wegovy, and calls the results so far "very promising." Wegovy is similar to another drug made by Novo Nordisk — Saxenda — which has been on the market since 2014, and which Eneli occasionally prescribes to her pediatric patients who are struggling with obesity.

In clinical research studies, the primary side effects reported after taking Wegovy affected the digestive system: nausea, diarrhea, vomiting, constipation, abdominal pain or intestinal infections.

Eneli says such side effects and their frequency are milder than the problems that have arisen in the past. That good safety profile may mean the drug is "less likely to come up with unanticipated risks," she says.

But, the new drug will be of little use, she and other doctors who treat obesity say, if it's not also affordable for patients.

"Before I even bring up that drug with my patients, I'm looking to see which insurance they are having on the left side of my screen — because that will determine whether I bring it up," Stanford, the Harvard physician, says. "If it's out of reach, like I said, I won't bring it up."

Stanford says her patients on existing obesity medications do extraordinary things to keep their coverage so they can afford to stay on the drugs.

"Several nurses here at the hospital that are my patients stayed working — they were supposed to retire — so they could stay on their injectable medication," Stanford says,"because that's how beneficial it was to them."

Why some are willing to pay out of pocket

Some people, like David Scheesley, 42, says he would consider paying for Wegovy, even if he had to pay the full sticker price. The Hanford, Calif., correctional officer has tried since 2019 to lose weight on various diets — low-fat, all-meat, all-vegetable — without success. His weight has led to other health concerns — with his blood fats and his heart — which makes Scheesley think of his 5-year-old son.

"I want to see him for a lot of years; I don't want to have a stroke," he says. "I don't want to have diabetes. I want to be there for him. So, for me personally, that [monetary cost] is not astronomical, if it can give me some more time."

Novo Nordisk, the company that makes Wegovy, is in talks with insurers, and acknowledges that ensuring health insurance coverage of its drug is critical. The challenge, says Douglas Langa, executive vice president of Novo Nordisk North America, is getting doctors, patients, and politicians to recognize obesity as a disease — and that therefore insurance should cover the cost of medicine to treat it.

"There's a medical component to [obesity] that needs to be recognized; this is a disease state like we should be treating any other disease state," Langa says. He says about 40% of private insurers cover Saxenda, the similar weight-loss medication the company makes.

Langa tells insurance companies this, making the case for why prescriptions for Wegovy should be covered. His company is also heavily lobbying Congress to pass legislation to allow Medicare to cover obesity medications. It makes sense from a financial perspective, he argues, because obesity is the root disease underlying so many other diseases.

"We do believe insurers understand that [untreated obesity] is a gateway into 60 other health conditions," Langa says. The need is hard to ignore, he adds. More than 100 million people in the U.S. alone struggle with obesity.

This content is from Southern California Public Radio. View the original story at SCPR.org.

Crews searching the building collapse site in Surfside, Fla., have discovered four more victims since Monday, bringing the death toll to 32. Authorities have identified 26 of the bodies.

Another 113 people were unaccounted for, though local officials said they had only been able to confirm that about 70 of those people were in the building at the time of the collapse nearly two weeks ago.

Detectives are continuing to follow up on reports submitted about possible victims in the partial collapse, but in some cases they have been unable to reach those who submitted the tips in the first place.

"People call anonymously. People call and don't leave return phone numbers. People call with partial information, not enough to really secure whether that person may or may not have been in the building," Miami-Dade County Mayor Daniella Levine Cava told reporters on Tuesday.

Some of the reports of possible victims are also incomplete, she said, including a name but no apartment number or no date of birth.

Levine Cava urged people who are missing loved ones to communicate with local authorities. She said there may also be victims of the collapse who have not been reported missing.

The rescue effort stopped briefly overnight due to lightning from a passing storm. Surfside Mayor Charles Burkett said high winds were hampering the cranes moving heavy debris from the collapse site.

Lt. Gov. Jeanette Nuñez said Florida has declared a state of emergency ahead of Tropical Storm Elsa, which is expected to reach hurricane strength before making landfall Wednesday morning on the state's west coast.

This content is from Southern California Public Radio. View the original story at SCPR.org.

"The Commission made binding commitments offered by T-Mobile CZ, CETIN and O2 CZ that will keep the benefits of network sharing whilst removing technical and financial disincentives to unilateral deployments and limiting information exchange, all to the benefit of Czech mobile user," Commission Vice-President Margrethe Vestager said in a statement.

​So, we think that now we are entering into earnings season with this business update and particularly the banking sector should do well, both PSU and private banks.

Children learn their habits, attitudes and beliefs from their parents and other caregivers, and that includes their willingness to try new and healthy foods. The American Dietetic Association and Catawba County Women, Infants, and Children (WIC) encourages adults to be good role models and teach children how to appreciate nutrition and enjoy healthful eating.