According to an analysis by the Urban Institute, between 2010 and 2015, more than 19 million non-elderly people gained health insurance under the  Affordable Care Act. The top 10 states that ranked the highest based on percent of total population insured through the A.C.A. are Nevada (1), California (2), Oregon (3), Kentucky (4), New Mexico (5), West Virginia (6), Florida (7), Arkansas (8), Colorado (9), and Washington (10).

Some say it was the taking down of the Robert E. Lee monument that caused the torch-wielding Nazi/white supremacists to rage. Others are confident that it had nothing to do with the statue, and everything to do with racist and anti-Semitic rage of monumental proportions that inspired the Nazis/white supremacists/white nationals to storm Charlottesville, Virginia.    

[Radio Dalsan] Two soldiers from Somalia's Southwest State were ambushed and killed by al-Shabab militants on Tuesday while travelling by motorcycle between Wanlaweyn and Afgoye districts in the Lower Shabelle region, residents reported.

With Arizona Trump has now won all seven battleground states

Russian warship armed with hypersonic missiles trains in English Channel, state media reports

The ongoing, escalating violence in Lebanon forces millions of Lebanese civilians to face daily bombardment, repeated orders of evacuation, routine destruction of critical infrastructure, and limited access to basic services. With the death toll and rates of displacement on the rise, humanitarian organizations fear that the upcoming winter season is expected to exacerbate these harsh […]

A British business person is keeping the skeleton of the dilapidated R20 million Upper Constantia house, but has to replace the roof and the interior

Queen Camilla makes first statement after missing key royal eventQueen Camilla marked her comeback to royal duties after she was forced to miss an important event on the royal calendar on doctor’s advice.A week after palace had cancelled her scheduled engagements, Camilla on Tuesday attended...

India’s federal power minister on Tuesday asked the states that are away from coal resources to consider setting up nuclear-based power plants, besides identifying and listing the power utilities to meet investments to support growing power demand.

The Indian government in its federal budget this year had proposed to partner with private players to develop small nuclear reactors to increase the amount of electricity from sources that do not produce carbon dioxide emissions.

States should consider setting up nuclear power plants at the sites where coal-based thermal power plants have completed their life, Manohar Lal, the country’s power minister, told states as per a government statement.

India’s stringent nuclear compensation laws have hampered talks with foreign power plant builders such as General Electric GE.N and Westinghouse.

The country, which currently has about 8 gigawatts of nuclear capacity, aims to increase it to 20 GW by 2032.

The minister also asked the states to identify and list their power utilities in the country’s stock exchange to meet increasing investment demand in the power sector as well as improve the transmission system to add more renewable capacity.

India has pledged to achieve a net zero carbon emission target by 2070 and has a target of 500 GW of renewable energy by 2030.

Never underestimate what a single gopher can achieve in a day: one of the burrowing mammals helped boost soil fungi in an area blanketed by ash from the explosive eruption of Mount St Helens in Washington state

Cases of prostate cancer are surging alarmingly around the world. Thankfully, we are developing more accurate tests that can catch the condition early

Never underestimate what a single gopher can achieve in a day: one of the burrowing mammals helped boost soil fungi in an area blanketed by ash from the explosive eruption of Mount St Helens in Washington state

Title: Vaccinated Foreign Travelers Can Enter United States Beginning Nov. 8
Category: Health News
Created: 10/15/2021 12:00:00 AM
Last Editorial Review: 10/18/2021 12:00:00 AM

Title: Initial Savings May Hide True Cost of Prostate Cancer Care
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Title: Breast Cancer Drug Might Help Men on Prostate Cancer Therapy
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Title: Daily Aspirin May Help Fight Prostate Cancer, But Not Breast Cancer
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Title: Race May Affect Quality of Prostate Cancer Surgical Care
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Title: Could Heavy Coffee Drinking Help Men Battle Prostate Cancer?
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Title: Salmonella Outbreak in 4 States Linked to Kosher Chicken: CDC
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Title: States Struggle With Onslaught of Opioid OD Deaths
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Title: Salmonella Outbreak Linked to Peaches Has Now Sickened 78 People in 12 States: CDC
Category: Health News
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Title: Prostate Problems
Category: Diseases and Conditions
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Title: Prostatitis (Inflammation of the Prostate Gland)
Category: Diseases and Conditions
Created: 12/31/1997 12:00:00 AM
Last Editorial Review: 7/29/2022 12:00:00 AM

The management of chylothorax remains challenging given the limited evidence and significant heterogeneity in practice. In addition, there are no practical guidelines on the optimal approach to manage this complex condition. We convened an international group of 27 experts from 20 institutions across five countries and four specialties (pulmonary, interventional radiology, thoracic surgery and nutrition) with experience and expertise in managing adult patients with chylothorax. We performed a literature and internet search for reports addressing seven clinically relevant PICO (Patient, Intervention, Comparison and Outcome) questions pertaining to the management of adult patients with chylothorax. This consensus statement, consisting of best practice statements based on expert consensus addressing these seven PICO questions, was formulated by a systematic and rigorous process involving the evaluation of published evidence, augmented with provider experience. Panel members participated in the development of the final best practice statements using the modified Delphi technique. Our consensus statement aims to offer guidance in clinical decision making when managing patients with chylothorax while also identifying gaps in knowledge and informing future research.

Organic anion transporting polypeptide (OATP) 1B1 and OATP1B3 are important hepatic transporters. We previously identified OATP1B3 being critically implicated in the disposition of abiraterone. We aimed to further investigate the effects of abiraterone on the activities of OATP1B1 and OATP1B3 utilizing a validated endogenous biomarker coproporphyrin I (CP-I). We used OATP1B-transfected cells to characterize the inhibitory potential of abiraterone against OATP1B-mediated uptake of CP-I. Inhibition constant (K_i) was incorporated into our physiologically based pharmacokinetic (PBPK) modeling to simulate the systemic exposures of CP-I among cancer populations receiving either our model-informed 500 mg or clinically approved 1000 mg abiraterone acetate (AA) dosage. Simulated data were compared with clinical CP-I concentrations determined among our nine metastatic prostate cancer patients receiving 500 mg AA treatment. Abiraterone inhibited OATP1B3-mediated, but not OATP1B1-mediated, uptake of CP-I in vitro, with an estimated K_i of 3.93 μM. Baseline CP-I concentrations were simulated to be 0.81 ± 0.26 ng/ml and determined to be 0.72 ± 0.16 ng/ml among metastatic prostate cancer patients, both of which were higher than those observed for healthy subjects. PBPK simulations revealed an absence of OATP1B3-mediated interaction between abiraterone and CP-I. Our clinical observations confirmed that CP-I concentrations remained comparable to baseline levels up to 12 weeks post 500 mg AA treatment. Using CP-I as an endogenous biomarker, we identified the inhibition of abiraterone on OATP1B3 but not OATP1B1 in vitro, which was predicted and observed to be clinically insignificant. We concluded that the interaction risk between AA and substrates of OATP1Bs is low.

Over the past 20 years, quantitative proteomics has contributed a wealth of protein expression data, which are currently used for a variety of systems pharmacology applications, as a complement or a surrogate for activity of the corresponding proteins. A symposium at the 25th North American International Society for the Study of Xenobiotics meeting, in Boston, in September 2023, was held to explore current and emerging applications of quantitative proteomics in translational pharmacology and strategies for improved integration into model-informed drug development based on practical experience of each of the presenters. A summary of the talks and discussions is presented in this perspective alongside future outlook that was outlined for future meetings.

The role of gastrin-releasing peptide receptor (GRPR) in various diseases, including cancer, has been extensively studied and has emerged as a promising therapeutic target. In this study, we successfully achieved the use of [²¹²Pb]Pb-DOTAM-GRPR1, comprising the α-particle generator, ²¹²Pb, combined with a GRPR-targeting peptide, GRPR1, in a prostate cancer model. Methods: Pharmacokinetics, toxicity, radiation dosimetry, and efficacy were assessed in GRPR-positive prostate tumor–bearing mice after intravenous administration of [²¹²Pb]Pb-DOTAM-GRPR1 (where DOTAM is 1,4,7,10-tetrakis(carbamoylmethyl)-1,4,7,10-tetraazacyclododecane). Results: Preclinical studies have shown tumor targeting of up to 5 percent injected dose per gram over 24 h, and optimization of the drug formulation and quantity has led to minimized oxidation and off-target binding, respectively. Particularly, an increase in peptide amount from 28 to 280 ng was shown to reduce off-target uptake, especially at the level of the pancreas, by about 30%. Furthermore, dosimetry studies confirmed the kidney as the dose-limiting organ, and toxicity studies revealed that a nontoxic dose of up to 1,665 kBq could be injected into mice. Efficacy studies indicated a median survival time of 9 wk in the control group, which received only a buffer solution, compared with 19 wk in the group that received 4 injections of 370 kBq at 3-wk intervals. Conclusion: Taken together, these combined data demonstrate the safety, tolerability, and efficacy of [²¹²Pb]Pb-DOTAM-GRPR1, thus warranting further exploration in clinical trials.

The phase 3 VISION trial demonstrated that [¹⁷⁷Lu]Lu-PSMA-617 prolonged progression-free survival and overall survival (OS) in prostate-specific membrane antigen [PSMA]–positive metastatic castration-resistant prostate cancer (mCRPC) patients who progressed on taxane-based chemotherapy and androgen receptor–signaling inhibitors (ARSIs). The U.S. expanded-access program (EAP; NCT04825652) was opened to provide access to [¹⁷⁷Lu]Lu-PSMA-617 for eligible patients until regulatory approval was obtained. This study aimed to evaluate the efficacy and safety profile of [¹⁷⁷Lu]Lu-PSMA-617 within the EAP and compare the results with those from the VISION trial. Methods: Patients enrolled in the EAP at 4 institutions in the United States with available toxicity and outcome data were included. Outcome measures included OS, a prostate-specific antigen (PSA) response rate (RR) of at least 50%, and incidences of toxicity according to Common Terminology Criteria for Adverse Events version 5.0. Differences in baseline characteristics, outcome data, and toxicity between the EAP and VISION were evaluated using t testing of proportions and survival analyses. Results: In total, 117 patients with mCRPC who received [¹⁷⁷Lu]Lu-PSMA-617 within the EAP between May 2021 and March 2022 were eligible and included in this analysis. Patients enrolled in the EAP were more heavily pretreated with ARSI (≥2 ARSI regimens: 70% vs. 46%; P < 0.001) and had worse performance status at baseline (Eastern Cooperative Oncology Group score ≥ 2: 19% vs. 7%; P < 0.001) than VISION patients. EAP and VISION patients had similar levels of grade 3 or higher anemia (18% vs. 13%; P = 0.15), thrombocytopenia (13% vs. 8%; P = 0.13), and neutropenia (3% vs. 3%; P = 0.85) and similar PSA RRs (42% vs. 46%; P = 0.50) and OS (median: 15.1 vs. 15.3 mo; P > 0.05). Conclusion: Patients with PSMA-positive mCRPC who received [¹⁷⁷Lu]Lu-PSMA-617 within the EAP were later in their disease trajectory than VISION patients. Patients enrolled in the EAP achieved similar PSA RRs and OS and had a safety profile similar to that of the VISION trial patients.

In Canada and across the globe, access to PSMA PET/CT is limited and expensive. For patients with biochemical recurrence (BCR) after treatment for prostate cancer, novel strategies are needed to better stratify patients who may or may not benefit from a PSMA PET scan. The role of the free-to-total prostate-specific antigen (PSA) ratio (FPSAR) in posttreatment prostate cancer, specifically in the PSMA PET/CT era, remains unknown. Our aim in this study was to determine the association of FPSAR in patients referred for ¹⁸F-DCFPyL PSMA PET/CT in the BCR setting and assess the correlation between FPSAR and ¹⁸F-DCFPyL PSMA PET/CT positivity (local recurrence or distant metastases). Methods: This prospective study included 137 patients who were referred for ¹⁸F-DCFPyL PSMA PET/CT and had BCR with a total PSA of less than 1 ng/mL after radical prostatectomy (RP) (including adjuvant or salvage radiotherapy). Blood samples were collected on the day of ¹⁸F-DCFPyL PSMA PET/CT. FPSAR was categorized as less than 0.10 or as 0.10 or more. A positive ¹⁸F-DCFPyL PSMA PET/CT scan was defined by a PROMISE classification lesion score of 2 or 3, irrespective of the site of increased tracer uptake (e.g., prostate, pelvic nodes, bone, or viscera). Results: Overall, 137 blood samples of patients with BCR after RP were analyzed to calculate FPSAR. The median age at ¹⁸F-DCFPyL PSMA PET/CT was 68.6 y (interquartile range, 63.0–72.4 y), and the median PSA at ¹⁸F-DCFPyL PSMA PET/CT was 0.3 ng/mL (interquartile range, 0.3–0.6 ng/mL). Eighty-six patients (62.8%) had an FPSAR of less than 0.10, whereas 51 patients (37.2%) had an FPSAR of 0.10 or more. An FPSAR of 0.10 or more was identified as an independent predictor of a positive ¹⁸F-DCFPyL PSMA PET/CT scan, with an odds ratio of 6.99 (95% CI, 2.96–16.51; P < 0.001). Conclusion: An FPSAR of 0.10 or more after RP independently correlated with increased odds of a positive ¹⁸F-DCFPyL PSMA PET/CT scan among BCR post-RP patients. These findings may offer an inexpensive method by which to triage access to ¹⁸F-DCFPyL PSMA PET/CT in jurisdictions where availability is not replete.

[¹⁷⁷Lu]Lu-PSMA-617 was approved by the U.S. Food and Drug Administration for patients with prostate-specific membrane antigen (PSMA)–positive metastatic castration-resistant prostate cancer (mCRPC). Since the time of regulatory approval, however, real-world data have been lacking. This study investigated the efficacy, safety, and outcome predictors of [¹⁷⁷Lu]Lu-PSMA-617 at a major U.S. academic center. Methods: Patients with mCRPC who received [¹⁷⁷Lu]Lu-PSMA-617 at the Johns Hopkins Hospital outside clinical trials were screened for inclusion. Patients who underwent [¹⁷⁷Lu]Lu-PSMA-617 and had available outcome data were included in this study. Outcome data included prostate-specific antigen (PSA) response (≥50% decline), PSA progression-free survival (PFS), and overall survival (OS). Toxicity data were evaluated according to the Common Terminology Criteria for Adverse Events version 5.03. The study tested the association of baseline circulating tumor DNA mutational status in homologous recombination repair, PI3K alteration pathway, and aggressive-variant prostate cancer–associated genes with treatment outcome. Baseline PSMA PET/CT images were analyzed using SelectPSMA, an artificial intelligence algorithm, to predict treatment outcome. Associations with the observed treatment outcome were evaluated. Results: All 76 patients with PSMA-positive mCRPC who received [¹⁷⁷Lu]Lu-PSMA-617 met the inclusion criteria. A PSA response was achieved in 30 of 74 (41%) patients. The median PSA PFS was 4.1 mo (95% CI, 2.0–6.2 mo), and the median OS was 13.7 mo (95% CI, 11.3–16.1 mo). Anemia of grade 3 or greater, thrombocytopenia, and neutropenia were observed in 9 (12%), 3 (4%), and 1 (1%), respectively, of 76 patients. Transient xerostomia was observed in 23 (28%) patients. The presence of aggressive-variant prostate cancer–associated genes was associated with a shorter PSA PFS (median, 1.3 vs. 6.3 mo; P = 0.040). No other associations were observed between circulating tumor DNA mutational status and treatment outcomes. Eighteen of 71 (25%) patients classified by SelectPSMA as nonresponders had significantly lower rates of PSA response than patients classified as likely responders (6% vs. 51%; P < 0.001), a shorter PSA PFS (median, 1.3 vs. 6.3 mo; P < 0.001), and a shorter OS (median, 6.3 vs. 14.5 mo; P = 0.046). Conclusion: [¹⁷⁷Lu]Lu-PSMA-617 offered in a real-world setting after regulatory approval in the United States demonstrated antitumor activity and a favorable toxicity profile. Artificial-intelligence–based analysis of baseline PSMA PET/CT images may improve patient selection. Validation of these findings on larger cohorts is warranted.

Veterans are at an increased risk for prostate cancer, a disease with extraordinary clinical and molecular heterogeneity, compared with the general population. However, little is known about the underlying molecular heterogeneity within the veteran population and its impact on patient management and treatment. Using clinical and targeted tumor sequencing data from the National Veterans Affairs health system, we conducted a retrospective cohort study on 45 patients with advanced prostate cancer in the Veterans Precision Oncology Data Commons (VPODC), most of whom were metastatic castration-resistant. We characterized the mutational burden in this cohort and conducted unsupervised clustering analysis to stratify patients by molecular alterations. Veterans with prostate cancer exhibited a mutational landscape broadly similar to prior studies, including KMT2A and NOTCH1 mutations associated with neuroendocrine prostate cancer phenotype, previously reported to be enriched in veterans. We also identified several potential novel mutations in PTEN, MSH6, VHL, SMO, and ABL1. Hierarchical clustering analysis revealed two subgroups containing therapeutically targetable molecular features with novel mutational signatures distinct from those reported in the Catalogue of Somatic Mutations in Cancer database. The clustering approach presented in this study can potentially be used to clinically stratify patients based on their distinct mutational profiles and identify actionable somatic mutations for precision oncology.

U.S.-backed Syrian Democratic Forces announced Tuesday that they had captured the city of Raqqa from Islamic State militants.

“Everything is finished in Raqqa, our forces have taken full control of Raqqa,” SDF spokesman Talal Sello told AFP. A formal declaration would be announced after operations to clear any remaining sleeper cells and to remove landmines in the city were completed, Sello added.

The move is a major setback for the Islamic State which considered Raqqa the de-facto capital of its self-declared caliphate. It comes on the third anniversary of the global effort to defeat ISIS.

Raqqa was the first provincial capital to fall from government control in March 2013 after it was captured by a rebel army. The army included both Syrian opposition groups and more hard line  parties including al-Nusra and the Islamic State.

A civilian government  that was established in the city divided two months later, and less than a year later ISIS recaptured Raqqa and named the the capital of their caliphate.

About 900 civilians have been killed since the the start of the five-month operation, including 570 people in coalition air raids, according to the Syrian Network for Human Rights. The Britain-based Syrian Observatory for Human Rights put the civilian death toll at 1,130 people. American journalist James Foley was beheaded in the mountains south of the city.

SDF fighters pulled down the Islamic State’s black flag from the city’s National Hospital near the city’s stadium, according to a Reuters report.

Special presidential envoy for the Global Coalition to Defeat ISIS Brett McGurk said in August that the U.S. would attempt to perform a “stabilization” in Raqqa — including demining, removing rubble from major pathways to allow trucks and equipment through, and “basic electricity, sewage, water, the basic essentials to allow populations to come back to their home.”

It is not clear when the 300,000 civilians who have fled Raqqa since April during the operation will be able to return.

The post U.S.-backed Syrian forces recapture Raqqa from Islamic State group appeared first on PBS NewsHour.

What does 2023's Scottish Health Survey tell us about Scotland's population - from smoking rates to obesity, and alcohol consumption?

Moin Hussain's debut feature film Sky Peals sees a man discover his father may be from outer space. Part sci-fi, part family drama, part coming-of-age tale, it is odd and otherworldly

Gary Lineker is the longest-serving Match of the Day host since the BBC first aired the show in 1964.

Cases of prostate cancer are surging alarmingly around the world. Thankfully, we are developing more accurate tests that can catch the condition early

Speculation has already run rampant on who Florida Gov. Ron DeSantis will appoint to replace Sen. Marco Rubio if Rubio becomes President-elect Trump's secretary of state.

President-elect Trump announced that he had picked real estate investor and campaign donor Steve Witkoff to be his special envoy to the Middle East.

While many states focused on issues like abortion and immigration throughout this election cycle, voters in California and Colorado approved tougher crime laws.

The European Commission has revealed the progress of potential European Union countries in areas including food safety. As part of the Enlargement Package, the EU Commission has assessed how prepared Albania, Bosnia and Herzegovina, Kosovo, Montenegro, North Macedonia, Serbia, Georgia, Moldova, Ukraine, and Turkey are as they work towards EU... Continue Reading

The U.S. Food and Drug Administration has published the 2022 Food Code Supplement. The Supplement updates the 2022 Food Code with recommendations from regulatory officials, industry, academia, and consumers at the 2023 Biennial Meeting of the Conference for Food Protection.  The Food Code and its Supplement provide the government and industry with... Continue Reading