changes

DPH Shares Monthly COVID-19 Update, Announces Changes to Data Reporting and Booster Guidance

DOVER, DE (Dec. 15, 2022) – The Delaware Division of Public Health (DPH) is providing several key updates related to COVID-19 data and vaccines.  According to the most recent data on the state’s My Healthy Community data dashboard, the statewide 7-day average of new positive COVID-19  cases has increased slightly following Thanksgiving and other gatherings over the past month. Hospitalizations have also increased. As holiday travel […]




changes

Delaware Division of Public Health Announces Changes to Access for COVID-19 Testing in Delaware

DOVER, DE (Dec. 20, 2022) – The Delaware Division of Public Health (DPH) is announcing changes to COVID-19 testing access in Delaware. Based on operational needs, DPH’s valued partner Curative has decided not to renew its testing contract with the state when it ends in the next two weeks. As a result, Wednesday, Dec. 28 will […]




changes

UPDATE: DMV Operational Changes for June 8, 2023, Cash Booths at Tolls Plazas Now Open

Due to a reduction in the Air Quality Index (AQI) CASH BOOTHS at the toll plazas OPENED at 4:45 pm today, June 8, 2023. The Delaware Division of Motor Vehicles (DMV) will continue to monitor the AQI forecast and determine the effects it may have, if any, on DMV operations for Friday, June 9, 2023. Residents […]



  • Delaware Health and Social Services
  • Department of Transportation
  • Division of Motor Vehicles
  • Division of Public Health
  • News
  • air quality
  • air quality index
  • Delaware Department of Transportation
  • Delaware Division of Motor Vehicles
  • Delaware DMV
  • Delaware DNREC
  • Delaware E-ZPass
  • DMV
  • DMV on the Go
  • E-ZPass

changes

AG Jennings announces leadership changes at DOJ

Attorney General Kathy Jennings announced Thursday that State Prosecutor Dan Logan will succeed Alex Mackler as the Department of Justice’s Chief Deputy Attorney General. Mackler, who has served as CDAG for more than five years, will serve as counsel on President Biden’s reelection campaign.   Mackler joined the DOJ as CDAG in May 2019 after […]



  • Department of Justice Press Releases

changes

Governor Carney Announces Changes to Leadership Team

WILMINGTON, Del. — Governor John Carney on Friday announced changes to his leadership team in the Office of the Governor.   Jonathan Starkey, who has served as chief of staff since 2022, will leave the Governor’s office later this month to serve as senior advisor to Dr. Tony Allen, the president at Delaware State University. Before […]




changes

3 Biggest Changes Of iOS 16.2 Update That Every iPhone User Should Know!

In its latest update Apple said that it is preparing for the iOS 16.2 update for iPhones across the world. Notably, like the previous release, there are a couple of changes coming for the iPhones.  iOS 16.2 Update Release Date So far, Apple has not announced a release date for iOS 16.2 update. Reportedly, the […]




changes

Achieve 80% Less Late-Stage RTL Changes and Early RTL Bug Detection

It has become challenging to ensure that the designs are complete, correct, and adhere to necessary coding rules before handing them off for RTL verification and implementation. RTL Designer Signoff Solution from Cadence helps the user identify RTL bugs at a very early development stage, saving a lot of effort and cost for the design and verification team. Our reputed customers have confirmed that using RTL signoff for their design IP helped save up to 4 weeks and reduce the late-stage RTL changes by up to 80%.(read more)



  • Jasper RTL Designer Signoff App
  • Jasper
  • Early Bug Detection

changes

Visitor economy to benefit from temporary changes to the Work Bonus

Temporary changes to the Work Bonus offer an opportunity for the visitor economy to employ mature-aged workers and overcome labour shortfalls.



  • Latest from Austrade

changes

Shanghai-Republic of Korea relations get closer through cultural exchanges

Kim Seung-ho initiated the idea to host an exhibition featuring artworks by 30 Chinese and South Korean artists born in 1992, when China and the Republic of Korea established formal diplomatic relatio




changes

Jonas Brothers sing One Direction's 'Night Changes' after Liam Payne's death

The Jonas Brothers left Directioners in tears during their recent concert.During their Sunday night concert at Highland, California, the Jonas Brothers covered One Direction’s Night Changes in what appeared to be a tribute to the late Liam Payne. On November 11, Nick, Joe, and Kevin Jonas...




changes

Q&A: Sovereign Exposure Exchanges Allow MDBs to Reduce Portfolio Concentration Risks

A sovereign exposure exchange is a cost-effective risk management tool used by multilateral development banks (MDBs) to reduce sovereign portfolio concentration risks. It provides capital relief for MDBs by exchanging loan guarantees on credit exposure from borrowing countries where an MDB is highly concentrated for exposure to countries where the MBD’s exposure is lower or nonexistent.




changes

Slowed Reflexes in Aging Could Be Due to Brain Changes

Title: Slowed Reflexes in Aging Could Be Due to Brain Changes
Category: Health News
Created: 8/24/2010 2:10:00 PM
Last Editorial Review: 8/25/2010 12:00:00 AM




changes

Migraines Linked to Changes in Brain Structure

Title: Migraines Linked to Changes in Brain Structure
Category: Health News
Created: 8/28/2013 4:36:00 PM
Last Editorial Review: 8/29/2013 12:00:00 AM




changes

Pediatricians Sound Alarm on Rapid Weight Changes in Young Athletes

Title: Pediatricians Sound Alarm on Rapid Weight Changes in Young Athletes
Category: Health News
Created: 9/1/2017 12:00:00 AM
Last Editorial Review: 9/1/2017 12:00:00 AM




changes

Changes to CDC's COVID-19 Testing Guidelines Trigger Concern

Title: Changes to CDC's COVID-19 Testing Guidelines Trigger Concern
Category: Health News
Created: 8/26/2020 12:00:00 AM
Last Editorial Review: 8/27/2020 12:00:00 AM




changes

Changes in Menstrual Cycle Can Come After COVID Shot

Title: Changes in Menstrual Cycle Can Come After COVID Shot
Category: Health News
Created: 7/18/2022 12:00:00 AM
Last Editorial Review: 7/18/2022 12:00:00 AM




changes

Global characterization of somatic mutations and DNA methylation changes during vegetative propagation in strawberries [RESEARCH]

Somatic mutations arise and accumulate during tissue culture and vegetative propagation, potentially affecting various traits in horticultural crops, but their characteristics are still unclear. Here, somatic mutations in regenerated woodland strawberry derived from tissue culture of shoot tips under different conditions and 12 cultivated strawberry individuals are analyzed by whole genome sequencing. The mutation frequency of single nucleotide variants is significantly increased with increased hormone levels or prolonged culture time in the range of 3.3 x 10–8–3.0 x 10–6 mutations per site. CG methylation shows a stable reduction (0.71%–8.03%) in regenerated plants, and hypoCG-DMRs are more heritable after sexual reproduction. A high-quality haplotype-resolved genome is assembled for the strawberry cultivar "Beni hoppe." The 12 "Beni hoppe" individuals randomly selected from different locations show 4731–6005 mutations relative to the reference genome, and the mutation frequency varies among the subgenomes. Our study has systematically characterized the genetic and epigenetic variants in regenerated woodland strawberry plants and different individuals of the same strawberry cultivar, providing an accurate assessment of somatic mutations at the genomic scale and nucleotide resolution in plants.




changes

Downstream Effects of Market Changes on Inhalers: Impacts on Individuals With Chronic Lung Disease

COPD and asthma are two of the most common chronic lung diseases, affecting over 545 million people globally and 34 million in the United States. Annual health care costs related to chronic lung disease are estimated at €380 billion in the European Union, and $24–$50 billion in the United States averaging to $4,000 in out-of-pocket costs per person in the U.S. A full-text literature search was conducted for English publications between January 1, 2005–March 18, 2024. It returned over 5,000 publications that were further narrowed using key search words, resulting in 172 peer-reviewed articles. Using their experience and subject expertise, the authors further narrowed the peer-reviewed articles to 55 that were in their opinion relevant. Also, 38 recently published industry reports and news articles specific to downstream effects of inhaler market changes and the future impact were included. The literature suggests that individuals with chronic lung disease face increased challenges with access to inhaled medication due to rising medication costs, discontinuation of branded medications, introduction of generic medications not covered by insurance, exclusionary preferred drug list tactics that force health care providers into non-medical switching of medication or devices, and ongoing medication shortages. Providers experience ongoing hurdles in prescribing appropriate inhaled medications for individuals with chronic lung disease, including increased time and costs spent on administrative tasks due to inhaler denials, a loss of patient trust, and limits on their ability to prescribe appropriate inhaled medication for individuals with chronic lung disease.




changes

A cellular identity crisis? Plasticity changes during aging and rejuvenation [Reviews]

Cellular plasticity in adult multicellular organisms is a protective mechanism that allows certain tissues to regenerate in response to injury. Considering that aging involves exposure to repeated injuries over a lifetime, it is conceivable that cell identity itself is more malleable—and potentially erroneous—with age. In this review, we summarize and critically discuss the available evidence that cells undergo age-related shifts in identity, with an emphasis on those that contribute to age-associated pathologies, including neurodegeneration and cancer. Specifically, we focus on reported instances of programs associated with dedifferentiation, biased differentiation, acquisition of features from alternative lineages, and entry into a preneoplastic state. As some of the most promising approaches to rejuvenate cells reportedly also elicit transient changes to cell identity, we further discuss whether cell state change and rejuvenation can be uncoupled to yield more tractable therapeutic strategies.




changes

Chronic Administration of Cannabinoid Agonists ACEA, AM1241, and CP55,940 Induce Sex-Specific Differences in Tolerance and Sex Hormone Changes in a Chemotherapy-Induced Peripheral Neuropathy [Special Section: Cannabinoid Signaling in Human Health and Dise

Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of chemotherapy treatment, routinely manifesting as increased pain sensitivity (allodynia) in distal extremities. Despite its prevalence, effective treatment options are limited. Cannabinoids are increasingly being evaluated for their ability to treat chronic pain conditions, including CIPN. While previous studies have revealed sex differences in cannabinoid-mediated antinociception in acute and chronic pain models, there is a paucity of studies addressing potential sex differences in the response of CIPN to cannabinoid treatment. Therefore, we evaluated the long-term antiallodynic efficacy of cannabinoid receptor type 1 (CB1)-selective, cannabinoid receptor type 2 (CB2)-selective, and CB1/CB2 mixed agonists in the cisplatin CIPN model, using both male and female mice. CB1 selective agonism was observed to have sex differences in the development of tolerance to antiallodynic effects, with females developing tolerance more rapidly than males, while the antiallodynic effects of selective CB2 agonism lacked tolerance development. Compound-specific changes to the female estrous cycle and female plasma estradiol levels were noted, with CB1 selective agonism decreasing plasma estradiol while CB2 selective agonism increased plasma estradiol. Chronic administration of a mixed CB1/CB2 agonist resulted in increased mRNA expression of proinflammatory cytokines and endocannabinoid regulatory enzymes in female spinal cord tissue. Ovarian tissue was noted to have proinflammatory cytokine mRNA expression following administration of a CB2 acting compound while selective CB1 agonism resulted in decreased proinflammatory cytokines and endocannabinoid regulatory enzymes in testes. These results support the need for further investigation into the role of sex and sex hormones signaling in pain and cannabinoid-mediated antinociceptive effects.

SIGNIFICANCE STATEMENT

CIPN is a common side effect of chemotherapy. We have found that both CB1 and CB2 receptor agonism produce antinociceptive effects in a cisplatin CIPN model. We observed that tolerance to CB1-mediated antinociception developed faster in females and did not develop for CB2-mediated antinociception. Additionally, we found contrasting roles for CB1/CB2 receptors in the regulation of plasma estradiol in females, with CB1 agonism attenuating estradiol and CB2 agonism enhancing estradiol. These findings support the exploration of cannabinoid agonists for CIPN.




changes

No In Vivo Evidence for Estrogen Receptor Density Changes in Human Neuroendocrine Aging or Their Relationship to Cognition and Menopausal Symptoms




changes

Evaluation of Fibroblast Activation Protein Expression Using 68Ga-FAPI46 PET in Hypertension-Induced Tissue Changes

Chronic hypertension leads to injury and fibrosis in major organs. Fibroblast activation protein (FAP) is one of key molecules in tissue fibrosis, and 68Ga-labeled FAP inhibitor-46 (FAPI46) PET is a recently developed method for evaluating FAP. The aim of this study was to evaluate FAP expression and fibrosis in a hypertension model and to test the feasibility of 68Ga-FAPI46 PET in hypertension. Methods: Hypertension was induced in mice by angiotensin II infusion for 4 wk. 68Ga-FAPI46 biodistribution studies and PET scanning were conducted at 1, 2, and 4 wk after hypertension modeling, and uptake in the major organs was measured. The FAP expression and fibrosis formation of the heart and kidney tissues were analyzed and compared with 68Ga-FAPI46 uptake. Subgroups of the hypertension model underwent angiotensin receptor blocker administration and high-dose FAPI46 blocking, for comparison. As a preliminary human study, 68Ga-FAPI46 PET images of lung cancer patients were analyzed and compared between hypertension and control groups. Results: Uptake of 68Ga-FAPI46 in the heart and kidneys was significantly higher in the hypertension group than in the sham group as early as week 1 and decreased after week 2. The uptake was specifically blocked in the high-dose blocking study. Immunohistochemistry also revealed FAP expression in both heart and kidney tissues. However, overt fibrosis was observed in the heart, whereas it was absent from the kidneys. The angiotensin receptor blocker–treated group showed lower uptake in the heart and kidneys than did the hypertension group. In the pilot human study, renal uptake of 68Ga-FAPI46 significantly differed between the hypertension and control groups. Conclusion: In hypertension, FAP expression is increased in the heart and kidneys from the early phases and decreases over time. FAP expression appears to represent fibrosis activity preceding or underlying fibrotic tissue formation. 68Ga-FAPI46 PET has potential as an effective imaging method for evaluating FAP expression in progressive fibrosis by hypertension.




changes

An elderly woman with acute respiratory failure and diffuse pulmonary changes




changes

No changes involving animals came about in Colorado elections

On Tuesday, three of nine ballot issues Denver voters had to decide dealt with animals and animal products. But nothing changed because all of them were slaughtered at the ballot  box. One of the ballot issues called for prohibiting any slaughterhouse from operating in the City or County of Denver. That... Continue Reading




changes

Israel plans changes to food licensing rules

Israel has proposed a revised system of food business licensing to ease the regulatory burden on industry and improve sanitary conditions. The Ministry of Health said the current regulation, regarding business licensing in general and food businesses in particular, is outdated and places a heavy regulatory burden on companies. This... Continue Reading




changes

What Changes After Supreme Court Ruling On Voting Rights Act

In a 5-4 decision, the Supreme Court struck down a key provision of the Voting Rights Act of 1965, stating that the legislation was based on now outdated data. The ruling removes the coverage formula that required federal oversight for voting processes in nine states.




changes

What Changes After Supreme Court Rulings On Prop 8 And DOMA

In a 5-4 decision in U.S. v. Windsor, the Supreme Court ruled the federal Defense Of Marriage Act unconstitutional. The court rules that supporters of California's Proposition 8 case did not have standing to bring the case to court, which means same-sex marriages in California may resume.




changes

The Law Must Respond When Science Changes

What was once fair under the law may become unfair when science changes. The law must react to uphold due process




changes

Waiver of Informed Consent - proposed changes in the 21st Century Cures Act

Adam Feuerstein points out - and expresses considerable alarm over - an overlooked clause in the 21st Century Cures Act:


In another tweet, he suggests that the act will "decimate" informed consent in drug trials. Subsequent responses and retweets  did nothing to clarify the situation, and if anything tended to spread, rather than address, Feuerstein's confusion.

Below is a quick recap of the current regulatory context and a real-life example of where the new wording may be helpful. In short, though, I think it's safe to say:


  1. Waiving informed consent is not new; it's already permitted under current regs
  2. The standards for obtaining a waiver of consent are stringent
  3. They may, in fact, be too stringent in a small number of situations
  4. The act may, in fact, be helpful in those situations
  5. Feuerstein may, in fact, need to chill out a little bit


(For the purposes of this discussion, I’m talking about drug trials, but I believe the device trial situation is parallel.)

Section 505(i) - the section this act proposes to amend - instructs the Secretary of Health and Human Services to propagate rules regarding clinical research. Subsection 4 addresses informed consent:

…the manufacturer, or the sponsor of the investigation, require[e] that experts using such drugs for investigational purposes certify to such manufacturer or sponsor that they will inform any human beings to whom such drugs, or any controls used in connection therewith, are being administered, or their representatives, that such drugs are being used for investigational purposes and will obtain the consent of such human beings or their representatives, except where it is not feasible or it is contrary to the best interests of such human beings.

[emphasis  mine]

Note that this section already recognizes situations where informed consent may be waived for practical or ethical reasons.

These rules were in fact promulgated under 45 CFR part 46, section 116. The relevant bit – as far as this conversation goes – regards circumstances under which informed consent might be fully or partially waived. Specifically, there are 4 criteria, all of which need to be met:

 (1) The research involves no more than minimal risk to the subjects;
 (2) The waiver or alteration will not adversely affect the rights and welfare of the subjects;
 (3) The research could not practicably be carried out without the waiver or alteration; and
 (4) Whenever appropriate, the subjects will be provided with additional pertinent information after participation.

In practice, this is an especially difficult set of criteria to meet for most studies. Criterion (1) rules out most “conventional” clinical trials, because the hallmarks of those trials (use of an investigational medicine, randomization of treatment, blinding of treatment allocation) are all deemed to be more than “minimal risk”. That leaves observational studies – but even many of these cannot clear the bar of criterion (3).

That word “practicably” is a doozy.

Here’s an all-too-real example from recent personal experience. A drug manufacturer wants to understand physicians’ rationales for performing a certain procedure. It seems – but there is little hard data – that a lot of physicians do not strictly follow guidelines on when to perform the procedure. So we devise a study: whenever the procedure is performed, we ask the physician to complete a quick form categorizing why they made their decision. We also ask him or her to transcribe a few pieces of data from the patient chart.

Even though the patients aren’t personally identifiable, the collection of medical data qualifies this as a clinical trial.

It’s a minimal risk trial, definitely: the trial doesn’t dictate at all what the doctor should do, it just asks him or her to record what they did and why, and supply a bit of medical context for the decision. All told, we estimated 15 minutes of physician time to complete the form.

The IRB monitoring the trial, however, denied our request for a waiver of informed consent, since it was “practicable” (not easy, but possible) to obtain informed consent from the patient.  Informed consent – even with a slimmed-down form – was going to take a minimum of 30 minutes, so the length of the physician’s involvement tripled. In addition, many physicians opted out of the trial because they felt that the informed consent process added unnecessary anxiety and alarm for their patients, and provided no corresponding benefit.

The end result was not surprising: the budget for the trial more than doubled, and enrollment was far below expectations.

Which leads to two questions:

1.       Did the informed consent appreciably help a single patient in the trial? Very arguably, no. Consenting to being “in” the trial made zero difference in the patients’ care, added time to their stay in the clinic, and possibly added to their anxiety.
2.       Was less knowledge collected as a result? Absolutely, yes. The sponsor could have run two studies for the same cost. Instead, they ultimately reduced the power of the trial in order to cut losses.


Bottom line, it appears that the modifications proposed in the 21st Century Cures Act really only targets trials like the one in the example. The language clearly retains criteria 1 and 2 of the current HHS regs, which are the most important from a patient safety perspective, but cuts down the “practicability” requirement, potentially permitting high quality studies to be run with less time and cost.

Ultimately, it looks like a very small, but positive, change to the current rules.

The rest of the act appears to be a mash-up of some very good and some very bad (or at least not fully thought out) ideas. However, this clause should not be cause for alarm.




changes

Smart is Evolving: Efficient High-rise Changes Corporate Landscape with 'Urban Genius' Concept - Video OneTitle

Virtual tour of 350 Fifth, a new 20-story office building in one of the top-ranked U.S. cities for sustainable buildings. Pt. 1 Pittsburgh-Gateway to the World & 350 Fifth Urban Genius.




changes

Study finds changes in treatment have increased life span for childhood cancer survivors - Hear more from Dr. Armstrong

Hear more from Dr. Armstrong




changes

St. Baldrick's Foundation Changes the Narrative for Kids with Cancer - Paint Boys

With this bold new campaign, St. Baldrick�s shows kids as their truest selves � fun-loving, carefree, refreshingly honest, and always a little goofy. Donate today at StBaldricks.org.




changes

Upcoming Changes to Email Delivery

Just a note to those readers who receive my blog post via email: The service that provides this, Feedburner, is shutting down in a couple of weeks, so I'm going to be migrating my subscribers to a new service. If you get an email from me in the next couple of weeks, please pay attention, because you may need to reconfirm your subscription with the new service! 

Thanks, and stay tuned!





changes

Social media faces big changes under new Ofcom rules

Ofcom warns social media companies could face fines if they don’t comply with the new Online Safety Bill




changes

Tax-News.com: Malta, Luxembourg Agree To Russian DTA Changes

The Russian Government has disclosed that both Luxembourg and Malta have agreed to change their double tax agreement with Russia to increase withholding tax rates on cross-border dividends and interest income.




changes

Tax-News.com: Russian Duma Approves Changes To Luxembourg And Cyprus DTAs

At its December 22 plenum, Russia's lower house of parliament approved revisions to the country's double tax agreements with Cyprus and Luxembourg.




changes

India Nature Watch - The scape changes every minute - another view of glorious sunset over Himalayan ranges and valley below

Shot from village Timila in Ranikhet Tehsil of Uttarakhand




changes

Tax-News.com: Singapore Explains Changes To 2021 Tax Filing Rules

The Inland Revenue Authority of Singapore has said that it will be sending tax bills directly to certain taxpayers this tax filing season and will be simplifying filing arrangements for the self-employed.




changes

Tax-News.com: Singapore Gazettes Legislation For 2021 Budget Changes

The Income Tax (Amendment) Bill 2021 was published in Singapore's Official Gazette on November 16, 2021, following approval earlier by Singapore's President.




changes

Tax-News.com: IRAS Updates GST Guidance On Impending Media Sales Changes

The Inland Revenue Authority of Singapore has released an update to its goods and services tax guide for the advertising industry.




changes

Tax-News.com: Few Tax Changes In Guernsey's 2021 Budget

Guernsey announced no major tax changes to its tax regime in its 2021 Budget, released on November 17, 2020.




changes

Tax-News.com: Malta, Luxembourg Agree To Russian DTA Changes

The Russian Government has disclosed that both Luxembourg and Malta have agreed to change their double tax agreement with Russia to increase withholding tax rates on cross-border dividends and interest income.




changes

Tax-News.com: Dutch Senate Approves 2021 Tax Changes

The Dutch Senate has approved the 2021 Tax Plan package, which introduces a lower rate of corporate tax for small- and medium-sized businesses.




changes

Tax-News.com: Russian Duma Approves Changes To Luxembourg And Cyprus DTAs

At its December 22 plenum, Russia's lower house of parliament approved revisions to the country's double tax agreements with Cyprus and Luxembourg.




changes

Tax-News.com: Italy Explains Tax Break For COVID-19 Changes To Workplaces

On July 10, 2020, the Italian tax authority issued a ruling to explain the rules concerning tax credits for expenditure on adapting workplaces to prevent the spread of COVID-19.




changes

Tax-News.com: Switzerland Rules Out Tax Changes For Blockchain Technology

The Swiss Finance Department has said that changes to tax law are not currently needed in response to developments in distributed ledger technology and blockchain.




changes

Tax-News.com: UK Eyeing VAT Rule Changes For Sharing Economy

The UK Government is inviting input on the tax challenges associated with the rise of the sharing economy.




changes

Tax-News.com: Mexico Enacts Outsourcing Tax Law Changes

Mexico has recently enacted legislative amendments to various tax laws in a bid to restrict the ability of companies to enter into outsourcing arrangements.




changes

Tax-News.com: EU Finance Ministers Agree Landmark VAT Rate Rule Changes

EU finance ministers have agreed an update to the rules governing value-added tax rates for goods and services.