The controversy over the new crop of hepatitis C treatments has taken yet another turn as consumers are starting to file lawsuits against insurers that deny them access to the medicines. Over the past two weeks, two different women alleged that Anthem Blue Cross refused to pay for the Harvoni treatment sold by Gilead Sciences because it was not deemed “medically necessary.” The issue emerges after more than a year of debate over the cost of the medicines and complaints by public and private payers that the treatments have become budget busters. The new hepatitis C treatments, which are sold by Gilead Science and AbbVie, cure more than 90% of those infected and, in the U.S., cost from $63,000 to $94,500, depending upon the drug and regimen, before any discounts. (Silverman, 5/26) Politico Pro: Supreme Court Turns Down Drug-Disposal Law Challenge Express Scripts Holding Co., a large manager of prescription-drug benefits for U.S. employers and insurers, is seeking deals with pharmaceutical companies that would set pricing for some cancer drugs based on how well they work. The effort is part of a growing push for so-called pay-for-performance deals amid complaints about the rising price of medications, some of which cost more than $100,000 per patient a year. Some insurers and prescription-benefit managers are pushing back by arguing that they should pay less when drugs don’t work well in certain patients. Drug companies are countering with pricing models of their own, such as offering free doses during a trial period. (Loftus, 5/26) Insurers, Drug-Benefit Managers Seek To Link Drug Prices To Effectiveness The sky-rocketing costs for new drugs are propelling the effort. But pharmaceutical companies suggest there are better ways to set new pricing models. Also in the news, two patients are suing Anthem Blue Cross, alleging that the insurer would not pay for an expensive new Hepatitis C drug, and a rebuff by the Supreme Court is raising interest among drug makers. Local drug disposal laws are likely to be high on the pharmaceutical industry’s radar now that the Supreme Court has declined to review an Alameda County, Calif., ordinance that puts drug manufacturers on the hook for funding a prescription drug take-back program. (Karlin, 5/26) The Wall Street Journal: New Push Ties Cost Of Drugs To How Well They Work The Wall Street Journal’s Pharmalot: Consumers Sue Anthem For Denying Coverage For A Gilead Hepatitis C Drug This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
Whenever a health insurer announces that it will be requesting significant premium increases in the coming year, it’s guaranteed to generate news stories that are waved triumphantly by conservatives as proof that the Affordable Care Act is a failure and, just as they predicted, premiums are skyrocketing because the government is messing around in health care. (Paul Waldman, 7/28) There’s one especially eye-catching number in a new report by Medicare actuaries about U.S. healthcare spending: 12.6%. That’s the leap in prescription drug spending last year over the year before. How sharp an increase is it? It was five times as much as the increase for 2013 over 2012, which was a mere 2.5%. (Michael Hiltzik, 7/28) Viewpoints: The Role Of High-Priced Drugs In The Nation’s Health Care Spending; Ushering In A New Age Of Preventive Health Care A selection of opinions on health care from around the country. The New York Times’ The Upshot: Health Spending Forecast: No Drastic Rise, But Slowdown Seems Over Los Angeles Times: Covered California’s Good News On Premium Hikes Comes With Trade-Offs Twenty-five years ago, America took a bold leap toward becoming a more perfect union when we rejected the old prejudices that restricted people with disabilities to institutions, isolation and exclusion from American life. In enacting the Americans with Disabilities Act in 1990, our nation embraced the idea that all Americans should be able to participate fully in our society. The ADA guarantees equal access for Americans with disabilities to education, jobs, health care, transportation, housing, polling places and other public places such as restaurants, hotels and entertainment venues. (Barbara McQuade, 7/28) The Washington Post’s Plum Line: Here’s Some More Good News About Obamacare. Too Bad It Won’t Dent The Debate. The Wall Street Journal: How To Usher In A New Era Of Preventive Health Care Los Angeles Times: How A Hugely Overpriced Hepatitis Drug Helped Drive Up U.S. Health Spending Laboratory tests drive 70% of all clinical decisions in health care. They’re used to determine whether a patient should start taking medication and, if so, which one. They help doctors decide whether a patient should undergo medical procedures or be admitted to the hospital. And they’re used to identify an individual’s risk of developing health conditions such as diabetes or heart disease. (Elizabeth Holmes, 7/28) The Detroit Free Press: A Look At ADA’s Lasting Impact In Metro Detroit New projections by federal government actuaries suggest that the nation’s five-year run of tiny increases in health care spending is coming to an end. The projections released on Tuesday estimate that health spending will average 5.8 percent a year through 2024, higher than the 4 percent annual growth measured between 2007 and 2013. That means health spending will be growing faster than is expected for the overall economy, but it isn’t expected to grow as fast as it did in the years before the Great Recession. (Margot Sanger-Katz, 7/29) Why is it that Americans seem to be the only people on the planet who live their lives as though death were an optional event? For many of us who have worked for years helping families and clinicians grapple with difficult choices in “shared decision making,” we’ve been challenged by that convention despite the evidence that 75 percent of us claim that preparing a living will and appointing a health care proxy are critically important. Yet fewer than one-third of us do anything to make it happen. Perhaps it’s our willing adherence to myths, most notably our believing that when the time comes, we’ll know, and we’ll have time to get our affairs in order, making our wishes known. This “just in time” approach may be comforting but, in reality, it’s magical thinking. For most of us, the “right time” never comes, but the crisis does. Believing in a scenario that we’ll luck into a peaceful passing without ever having so much as an uncomfortable conversation with anyone doesn’t support the reality that 80 percent of us will eventually rely on a proxy to make decisions for us. (John G. Carney, 7/29) The Kansas City Star: How Do We Prepare For The Realities Of Dying? This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. The 2010 federal healthcare reform law made it easier for millions of Americans to obtain insurance coverage, but it didn’t stop the cost of that coverage from rising considerably faster than inflation. So it was a welcome surprise Monday when officials at Covered California, the state’s health insurance exchange, announced that the average premiums for individual policies in 2016 would be only about 4% higher than they are this year, and only about 2% higher in Los Angeles County. Mixed in with the good news for consumers, though, were some trade-offs that won’t make everyone happy. The announcement offers lessons for consumers and policymakers, not all of which are easy to stomach. (7/28)
Stat: New Rule On Clinical Trial Reporting Doesn’t Go Far Enough Bloomberg: The Myth Of The Medical Bankruptcy It has been nearly 30 years since the first needle exchange program opened in the United States, in Takoma, Wash., in 1988. It was a health measure to prevent injecting drug users from sharing needles, and therefore spreading H.I.V. and hepatitis. The idea was controversial, to say the least. Many people felt — and still feel — that it enables drug use and sends a message that drug use is O.K. and can be done safely. (Tina Rosenberg, 1/18) Did medical bills single-handedly account for more bankruptcies than anything else? No. This is an exaggerated half-remembering of a series of studies, authored by (among others) Elizabeth Warren, that were themselves exorbitant exaggerations. I went into detail on the problems with the work seven years ago, but the highlight reel is that these authors have an aggressive tendency to employ any technique that ratchets the count of “medical bankruptcy” upward, while not using similar techniques that would tend to ratchet up other categories and diminish the number of bankruptcies counted as medical, and to present their results in misleading ways — so as to obscure, for example, the fact that by their own accounting, the number of medical bankruptcies actually fell by hundreds of thousands between 2001 and 2007. (Megan McArdle, 1/17) The New York Times: Injecting Drugs, Under A Watchful Eye Viewpoints: The Medical Bankruptcy Myth; Needle Exchange And Reducing Harm A selection of opinions on health care from around the country. Roughly half of clinical trials go unreported. Industry-sponsored trials are four times more likely to produce positive results than non-industry trials. And even when trials are reported, the investigators usually fail to share their study results: nearly 90 percent of trials on ClinicalTrials.gov lack results. Failure to report clinical trial results puts patients in danger. (Chris Cai, 1/17) This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
State Highlights: Minn. Gov. Blasts Medica For $120M Funds Transfer; In Mass., Closing Arguments In Murder Trial Related To Compounding Pharmacy Meningitis Outbreak Media outlets report on news from Minnesota, Massachusetts, Texas, New Hampshire, Kansas, Arizona, Pennsylvania, Ohio, Georgia and Ohio. The Star Tribune: Dayton, Consumer Advocates Blast Minnesota HMO For $120 Million Transfer WBUR: BU Study: States With Tighter Laws On Concealed Carry Have Lower Rates Of Handgun Homicides This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription. Georgia Health News: Director Who Steered DFCS Through Crisis Leaving For Calif. Post Bobby Cagle, who as DFCS director is credited with stabilizing the long-troubled state agency, is departing for a child welfare position in Los Angeles. He is being replaced by the agency’s chief of staff, Virginia Pryor, who will be interim DFCS director, the governor’s office announced this week. (Miller, 10/19) Arizona Republic: Arizona Heat Takes An Extra Toll On People With Mental Illness Two North Texas free-standing emergency room operators want tech giant Google to give up the identities of nearly two dozen reviewers who rated them poorly online. Highland Park Emergency Center on Lemmon Avenue and Preston Hollow Emergency Room on Walnut Hill Lane filed a joint petition Tuesday in Dallas County District Court. The 30-page pre-suit deposition lists the screen names used by 22 individuals, who the facilities claim never were treated in their emergency centers. (Rice, 10/19) Kansas City Star: Fungus Destroyed Inmate’s Brain While Kansas Prison Contractor Did Nothing, Suit Says WBUR: Study: Mass. Has The Highest Percentage Of Inmates Over 55 Des Moines Register: Quadriplegic Spent Hours In Dirty Diaper After Services Cut Dallas Morning News: Two Texas ERs Got Bad Reviews Online. Now They Want Google To Help Them Find Out Who Did It Cleveland HeartLab, a cardiovascular diagnostic testing company, has proprietary tests that use biomarkers to predict cardiovascular disease. With the deal, Quest, a New Jersey-based medical testing laboratory with locations around the world, will be able to add those diagnostic tests, and others, to its offerings. (Christ, 10/19) The Associated Press: Closing Arguments Set In Deadly Meningitis Outbreak Trial States like Massachusetts, which have some of the tightest laws regulating who can carry a concealed handgun, have significantly lower rates of handgun homicides than states with more lax handgun permitting laws. That’s according to a new study from Boston University, released Thursday in the American Journal of Public Health. (Brooks, 10/19) Medica Health Plans transferred the money this month to shore up the finances of its for-profit and Wisconsin insurance businesses, using reserves from its nonprofit HMO. The move is also reigniting a debate about the role of Minnesota’s nonprofit health plans. (Howatt, 10/19) Out of all the people who died of heat-associated causes in Maricopa County in 2016, around 15 percent had a history of mental illness, according to an Arizona Republic analysis of autopsy reports. …Some medications, including certain types of antidepressants and antipsychotics, block the body’s ability to regulate its temperature, said Dr. David Eisenman, a professor of medicine at the University of California, Los Angeles. (Altavena, 10/19) Cleveland Plain Dealer: Quest Diagnostics To Acquire Cleveland Clinic Spinoff Cleveland HeartLab The Pennsylvania Department of Health revoked the regular license of St. Francis Center for Rehabilitation & Healthcare last month and installed a temporary manager at the Darby nursing home after an August inspection found that a patient had developed “wounds that went down to the bone with exposed tendon.” The 273-bed facility, one of five sold in 2014 by the Archdiocese of Philadelphia to Center Management Group of New York, appealed the decision and remains open under a temporary manager installed by the health department. The revocation was the first in Pennsylvania since at least the beginning of 2014. (Brubaker, 10/20) The Philadelphia Inquirer/Philly.com: Major Sanctions At Darby Nursing Home After Neglect Found New Hampshire Public Radio: Outcry From Child Care Community Sinks State’s Attempt To Overhaul Licensing Rules Attorneys are preparing to make their closing arguments in the case of a Massachusetts pharmacist charged with second-degree murder in a deadly meningitis outbreak. Closing arguments in Glenn Chin’s trial are expected Friday in Boston’s federal courthouse. Chin faces second-degree murder, mail fraud and other charges under federal racketeering law. (Richer, 10/20) Marques Davis was in the infirmary at Hutchinson Correctional Facility on Dec. 27, 2016, back with the same symptoms he’d been complaining of for months, including numbness and weakness in his legs. But on that day there was something new. “It feels like something is eating my brain,” Davis told Corizon Health employees who staff the prison infirmary. According to a lawsuit filed in federal court Monday, something was infecting his brain: a fungus that slowly killed the 27-year-old over the next four months, as he pleaded for help. (Marso, 10/17) The state’s attempt to overhaul its childcare rules has been stalled yet again, after childcare providers across the state mobilized against the proposed changes. The Joint Legislative Committee on Administrative Rules sent the Department of Health and Human Services back to the drawing board after a hearing on the issue Thursday morning. (McDermott, 10/19) Throughout last summer, 25-year-old quadriplegic Louis Facenda Jr. spent as much as half of each day in a dirty diaper after his caregiver services provided through Iowa’s Medicaid program were dramatically cut. …The cuts ended payments for at least 16 visits each week for an in-home care program that helped the family dress, feed and change the diapers of Facenda Jr. two to three times each day. (Clayworth, 10/19) The study, from the Pew Charitable Trusts, finds that more than 14 percent of Massachusetts inmates are over the age of 55. And the state spends more than $8,900 per inmate per year on health care. (Becker, 10/19)
Scootin’ just got funkier.The Vespa is the staple for classic-looking scooters. I know I’m stating the obvious here, and while the look has inspired a number of companies in their choice of scooter designs, in my opinion, none of these models quite has the old school charm of the Vespa. That is until now and this new model of “scooter” isn’t what you are expecting: it’s electric and it only has one wheel.More E-Bikes Mad Max Motorcycle Road Rage Captured On TeslaCam Energica Unveils Stunning Bolid-E Electric Motorcycle Prototype You Can 3D Print Anything, Even An Electric Motorcycle This is a friendly warning: if you visit the Bel&Bel Website, be prepared to want to buy all the items in their collection. See, the Spanish company doesn’t specialize in scooters; it recycles and reuses cars and scooter components to make perfectly stylish and retro furniture. Seriously, how cool is that scooter office chair? Keeping in their eco-friendly spirit, the team came up with an admittedly pretty cool-looking scooter inspired by none other than the Vespa, minus one wheel and an engine. The shield with beak-like swooping feature sporting the badge and wheel wells of the Z-One are reminiscent of the original, mid-1900s Vespa; the riveted saddle is an original seat modified to fit the peculiar silhouette of the monowheel scooter. Don’t worry about faceplanting on the Z-One: it is actually self-balancing which means that’s one less thing you have to worry about.The tiny commuter is fully electric and is powered by a 60V Lithium-ion battery and is capable of a top speed of 20 mph (yes, we’re talking strictly city commute). Its range varies between 30 and 40 miles which is perfect if you live and work in the city. The handlebar is fitted with a charge indicator and the light switch.The company has actually been interested in the idea of the monocycle for urban commuting for a decade now. Back then, it had already introduced a first monowheel concept. Ten years later, thanks to new technologies, the Bel&Bel team has now come up with this new monowheel design.While no pricing or distribution scheme have been announced yet, but until then, we get to appreciate the design and quirkiness of the monowheel scooter and think of how weird and wonderful the future of commute will be.Source: Bel&Bel Source: Electric Vehicle News Author Liberty Access TechnologiesPosted on December 16, 2018Categories Electric Vehicle News
Mercedes-Benz Trademarks EQA, EQC, EQE, EQG and EQS For Electric Car Sub Brand Source: Electric Vehicle News Two roads diverged in a German wood. The Mercedes S-Class will take them both.The Mercedes S-Class is about to undergo a significant change. The standard version of the luxury car’s upcoming 7th generation will remain the brand’s flagship model and will see increasing electrification, including a plug-in hybrid. At the same time, but on a different platform, the German automaker will introduce an all-electric version. This one — the EQS — will be the flagship for its battery-powered EQ sub-brand.More about the Mercedes EQS Mercedes EQC To Be Followed By 9 M-B Electric Cars In 4 Years According to Autocar, the EQS will be built on the modular electric architecture (MEA) platform. More aerodynamic than its siblings, when it reaches showrooms in 2022 it will boast a WLTP range of 310 miles (expect less in “real-world” conditions). We’re told the car will be full-time all-wheel drive, with dual electric motors powering front and rear axles.Power-wise, the publication says it will feature more ponies than the 2019 EQC. This sporty crossover SUV boasts over 400 horsepower and 516 pound-feet of torque. While we don’t yet have a figure for the new sedan, we are told that an AMG performance variant will put out over 600 hp.The new all-electric won’t be confused with the hybridized S-Class, either. Though the latter will have its appearance updated with a new grill design and feature flush-mounted door handles, the former will take stylistic advantage of its unique architecture. Look, we’re told, for a shorter hood and sharply-raked windshield. Interestingly, beneath the sheet metal we understand both versions will soften their ride with the same active suspension system.For its part, the plug-in hybrid S-Class, built on the MRA platform, will offer an electric range of over 62 miles under the WLTP regime (again, expect fewer miles in real-world use). Autocar says it will also have the option of a four-wheel drive system featuring “fully variable apportioning of drive between the front and rear axles.”Source: Autocar Mercedes-Benz EQS To Top Lineup Of 130 Electrified Vehicles Author Liberty Access TechnologiesPosted on January 7, 2019Categories Electric Vehicle News
HOW ELECTRIC CARS CAN END THE AGE OF OILAn excerpt from Insane Mode: How Elon Musk’s Tesla Sparked an Electric Revolution to End the Age of Oil by Hamish McKenzie.*To understand how electric cars can end the Age of Oil, you might want to visit a fast food restaurant. Oil may have dominated our economic times, but it fades in significance when compared to salt. Civilization was built on the stuff that McDonald’s now gives its customers for free. Author Liberty Access TechnologiesPosted on March 24, 2019Categories Electric Vehicle News Source: Electric Vehicle News Photo by Zbynek Burival on Unsplash*This article comes to us courtesy of EVANNEX (which also makes aftermarket Tesla accessories). Posted by Matt Pressman. The opinions expressed in these articles are not necessarily our own at InsideEVs.Check Out These Stories: Tesla CEO Elon Musk: A Genius With A Grand Quest Full Of Goodness While Elon Musk Tweets Can Be Stupid, We Should Hope Tesla Succeeds Salt is essential to the human diet—without it, your body would gradually shed water in an attempt to maintain constant salt levels in your blood, eventually leading to your death from thirst. But it has been almost as important as a means to preserve food. Over the centuries, humans have harvested salt in a number of ways, from mining to evaporation to digging up bogs that had been soaked with seawater. Such methods have been traced back at least 3,500 years, with evidence that they stretch back even 5,000 years, and some bear similarities with how oil is extracted today. In AD 400, the Chinese discovered a way to drill into mountains and extract brine with bamboo pipes, some of which reached as deep as three thousand feet.Salt, like oil, was unevenly distributed around the world. Thriving settlements arose around salt sources in Jordan by the Dead Sea; in North Africa, where salt could be dug from the ground; in the Austrian Alps, where salt was mined; and in Persia, Egypt, and the Sahara, where there were salt swamps in the deserts. In parts of Africa where salt was scarce, people got their salt hits by drinking the blood and urine of cattle and wild animals. It was the world’s most important commodity and so became the subject of transport, trade, and conflict.“A certain political pattern seems to emerge,” wrote the journalist M. R. Bloch in Scientific American in 1963. “Where salt was plentiful, the society tended to be free, independent, and democratic; where it was scarce, he who controlled the salt controlled the people.” In the civilizations of the Nile, Babylon, India, China, Mexico, and Peru, autocratic rulers controlled their subjects by maintaining a monopoly on salt, and taxing it.While today’s global economy remains inextricably linked with the fortunes of the oil industry, salt’s connection to the economy was even more direct. Salt was synonymous with money, and in some cases literally was money. Ethiopia used bars of salt as currency as early as the sixteenth century and, in remote areas, as recently as the twentieth. The word salary has its origins in the Latin word for “salt money.” The Romans paid their civil servants in salt. Slave traders bought humans with it.There were, of course, wars. In Roman times, German tribes fought over salt sources. France’s salt tax, the gabelle, caused such outrage that it was an aggravating factor leading to the French Revolution. Even during the American Civil War, salt was a military target. At the end of 1864, for instance, Union forces captured Saltville, Virginia, a leading producer of the stuff, then embarked on a destructive two-day rampage that, according to the historian Rick Beard, effectively brought an end to salt making in the South of the United States.These days, dieticians say our problem is too much salt, not too little. So if salt carried such strategic importance only 150 years ago, why is it so cheap today? The answer is that it was supplanted by an invention that changed the course of history.THE TECHNOLOGY THAT ENDED SALT’S REIGNThe first refrigerated ships appeared in the mid-1870s, and General Electric started marketing the first household refrigerator in 1911. Instead of relying on salt for food preservation, or using large ice blocks to keep their food cold, people in developed countries started storing it in electrically chilled boxes. Food became safer, lasted longer, and tasted better. This revolutionary development facilitated the rise of large modern cities, the opening of global markets for food, and the spread of population. It also made salt a lot less valuable. There would be no more wars over sodium chloride. Its multithousand-year reign as the world’s most important commodity was over.What happened with salt is not that it was displaced by a superior ionic compound. It was displaced by a superior system. The same thing is happening with oil.“The idea electric cars pose a serious threat to oil might seem fanciful”The oil industry may be the most lucrative the world has ever known, and the idea that still-scarce electric cars pose a serious imminent threat to it might seem fanciful. The industry is worth trillions of dollars a year. The production, supply, and distribution of oil is the subject and cause of much geopolitical instability, and it has been central to conflicts on every continent, from the Middle East to Sudan and the South China Sea. While it continues to be fought over, and while the burning of oil continues to warm the Earth’s atmosphere in an unsustainable way, it’s also important to acknowledge that oil, like salt, has been essential to the vitality of modern society. The United States of America as we know it would scarcely hold together without an abundant supply of gasoline to fuel the cars and trucks that connect its highly dispersed towns, cities, and agricultural areas. We still depend on oil to maintain our quality of life, to enjoy freedom of travel, and to connect global economies. If oil disappeared immediately, life for many would quickly become grim.None of that, however, means that oil is not vulnerable to the same forces that made packaged salt a free item at fast-food outlets. In 2014, about 47 percent of petroleum products consumed in the United States were used for gasoline, according to the US Energy Information Administration (EIA). While oil is used for many other products, such as jet fuel, plastics, and detergents, the wealth of the industry is fundamentally dependent on cars, trucks, and buses. Without gasoline and diesel filling the tanks of motor vehicles, the oil giants of today would be far less significant players in the global economy.CRISIS BY THE BARRELIt doesn’t take much to trigger an oil market crisis. From June 2014 to January 2015, an oversupply of oil sent prices crashing from $116 a barrel to $47 a barrel, prompting an industry panic. Oil companies big and small laid off staff and canceled hundreds of billions of dollars of projects. Supply had been driven up by a number of factors, including the shale boom, which, in 2012 and 2013, resulted in the fastest growth in United States oil production history. The improving fuel efficiency of America’s vehicle fleet also contributed. According to the EIA, the US transportation system used 10 percent less oil in 2014 than it did in 2007. As electric cars become more widespread, the demand for oil will further decrease, putting more pressure on oil prices and creating more economic stress in the industry. Shell has said that oil demand could peak in as little as three years.“Shell has said that oil demand could peak in as little as three years”The displacement of two million barrels of oil a day—about 2 percent of global daily production—would be enough to trigger oil price decreases equivalent to those seen at the start of the crisis in 2014, according to a story by Bloomberg that drew on a 2016 study by Bloomberg New Energy Finance. Electric cars could do that by the early 2020s, the study found. The growth rate of electric cars from 2014 to 2015 was 60 percent, which was similar to the growth rate Tesla was projecting for the years ahead. If that rate continued, electric cars could displace two million barrels of oil a day by 2023, Bloomberg noted. A more conservative estimate based on the component costs of electric vehicles and when they would be affordable to mainstream car buyers found that the two-million-barrel threshold would be crossed in 2028.But might that time come even sooner? Both Tesla and GM think battery prices will come down fast enough for electric cars to be more affordable than equivalent gasoline cars by the early 2020s. The Chevy Bolt sells for less than $35,000, after subsidies. Tesla is producing Model 3s at a rate of hundreds of thousands a year. Other electric car companies, new and old, are developing competitive strategies.It is still difficult to predict how quickly the sales of electric cars will overtake those of gasoline vehicles. Even assuming all goes well for Tesla and their electric competitors, it could take years, or decades. Bloomberg New Energy Finance’s study estimated that electric cars will account for 35 percent of new car sales by 2040. That’s based on battery prices decreasing at a slower rate than Tesla and GM anticipate. But, as noted earlier, gasoline cars will face the difficult task of competing with electric cars that are both cheaper and better.BEHOLD THE POWER OF THE S-CURVEOne characteristic of disruptive technologies, as the electric car has the potential to be, is that their market penetration tends to start slowly and then accelerate rapidly. In 1900, less than 10 percent of US households had access to electricity. In 1960, less than 10 percent of US households owned a color TV. In 1990, less than 10 percent of US households had a cell phone. The first versions of all these products tended to be expensive, clunky, inconvenient, or all of the above. But then, as the technology improved, manufacturing processes were refined, and economies of scale kicked in, prices came down dramatically and the technologies found their way into homes and pockets. In 1990, there were 5.3 million cell phone subscribers in the United States—about 2 percent of the population. Twenty-five years later, 92 percent of Americans owned a cell phone.When mapped on a graph, this adoption curve looks roughly like a stretched S—a gentle incline at first, followed by an inflection point that triggers a sudden and steep rise, and then, ultimately, a leveling off when the technology reaches saturation point. Over the last hundred years in the United States, the “S-curve” has occurred with the automobile, the radio, the color TV, the microwave, the VCR, the personal computer, the cell phone, and the Internet. Oh, and the refrigerator.Could the electric car follow the same path?Many of the effects that spur demand for electric vehicles are only just starting to take hold. The decline of battery prices, which will make electric cars more affordable, is probably the biggest factor influencing demand, but there are others. For a start, many hundreds of millions of people still don’t know a thing about electric vehicles that aren’t golf carts or hybrids like the Toyota Prius. They might be unaware of the benefits of instant torque, or the near-total silence of the propulsion, or that the vehicles can be charged at any power point. Tesla, with its fancy stores, slick websites, and high media profile, has captured a hard-core loyal market, but there’s a lot more market to be had.“In 2013, GM alone spent $5.5 billion on advertising”Traditional automakers spend billions of dollars a year on advertising to encourage people to buy their products. In 2013, GM alone spent $5.5 billion on advertising. Tesla, on the other hand, has spent virtually nothing on advertising its cars. Automakers invest in advertising because it correlates with increased demand. What will happen once Tesla and others start paying to advertise the benefits of electric mobility?But no matter how much you spend on ads, if customers can’t get near the cars, they won’t buy them. If you live in New Zealand, for instance, you weren’t able to buy a Tesla through official channels until 2017. Many cities in the United States don’t have a Tesla store, and most Americans haven’t sat in a Model S or Model X—or any other electric car. As more full-electric cars get on the road, more people will be able to experience what they’re like and realize that they’re much different from golf carts and Priuses. Tesla has long believed that the best way to sell its cars is to get people in them. Once a potential customer has taken a Tesla for a test drive, she is more likely to buy one. Many Nissan Leaf owners say they’ll never go back to gasoline cars.POLICIES THAT PROTECT THE FUTUREAnd then there’s the wild card of regulation. Market forces already suggest that electric cars will soon be more affordable than gasoline cars independent of rebates and other incentives, but even slow-moving governments with conservative expectations for how quickly things can change are considering regulatory packages that seek to end the sale of gasoline cars within two decades. Every country in the United Nations, except the United States, has committed to drastically reducing its carbon emissions, and automakers have been expected to continue to improve the fuel economy of their vehicles.But the global political environment could get even worse for gasoline cars if the effects of climate change wreak more havoc with the world’s economy and way of life—particularly if affordable, low-emissions alternatives are readily available. For example, Norway is working on a combination of taxes, subsidies, infrastructure, and other incentives in an effort to end sales of gasoline cars in the country by 2025. In October 2016, Germany’s federal council voted for a nonbinding resolution to end all sales of gasoline cars with internal combustion engines by 2030. In May 2017, India’s power minister announced a plan to have only electric cars—and “not a single petrol or diesel car”— sold in the country from 2030 on. France has said it will end sales of diesel and gasoline cars by 2040. And even China has said it will set a date that will signal the end of all gasoline car sales in the country (although it hasn’t said what that date will be).All these scenarios could have a drastic effect on the uptake of electric vehicles, which would in turn have a dramatic impact on the consumption of oil. By Bloomberg New Energy Finance’s estimates, there will be enough electric cars on the road to cause an oil crash in the late 2020s. And every year from then on, the story will only get worse for the oil companies. Bloomberg’s study forecast that electric vehicle sales will leap from 462,000 in 2015 to forty-one million in 2040. Every new electric car on the road represents another dent in the oil companies’ profits.“It’s clear that the sector is going through one of the most transformative periods in its history, which will ultimately redefine the energy business as we know it,” said a PricewaterhouseCoopers report on oil and gas trends in 2016. But it’s not just industry job losses, write-downs, and budget cuts that will come. Geopolitical power structures will be rewritten, from oil-rich regions in the Middle East and Africa to oil-import-dependent nations elsewhere. National security priorities will shift.Saudi Arabia, which has traditionally relied on the petroleum sector for 90 percent of its state budget, is responding. Prince Mohammed bin Salman, next in line to the throne, has control over Saudi Aramco (Saudi’s oil monopoly), economic policy, and the national investment fund. He has announced plans to create a $2 trillion fund to make returns from investments, not oil, the primary source of Saudi government revenue.Saudi Arabia, the world’s largest exporter of black gold, fears that the S-curve could cause oil to go the same way as salt.===*Hamish McKenzie is a journalist and the author of Insane Mode: How Elon Musk’s Tesla Sparked an Electric Revolution to End the Age of Oil, a book about the transition to electric cars and a clean energy economy. He was hired by Elon Musk and worked for Tesla in 2014/15 before leaving to write the book, and now he’s one of the founders of Substack, a subscription publishing platform. He’s from New Zealand originally but lives in San Francisco.*InsideEVs Editor’s Note: EVANNEX, which also sells aftermarket gear for Teslas, has kindly allowed us to share some of its content with our readers, free of charge. Our thanks go out to EVANNEX. Check out the site here. Elon’s Custom Tesla Kicks: How To Buy Your Own Pair Today
Source: Charge Forward B&H offers a three-pack of TP-Link HS100 Smart Plugs for $29.99 shipped. As a comparison, that’s the regular price at Amazon for a two-pack. At under $10 per plug, this is a solid value buy for any Alexa or Google Assistant-powered smart home. Great for creating automated schedules and cutting down on energy usage. Rated 4.4/5 stars. Head below for more deals. more…Subscribe to Electrek on YouTube for exclusive videos and subscribe to the podcast.https://www.youtube.com/watch?v=N8COKnXNH-EThe post Get a three-pack of TP-Link Smart Plugs for $30, plus deals on Miracle-Gro Indoor Plant Systems, more appeared first on Electrek.
Lost your password? Not a subscriber? Sign up for The Texas Lawbook. Remember me © 2013 The Texas Lawbook.By Brooks IgoStaff Writer for The Texas LawbookKansas City-based Polsinelli has named Jonathan Henderson managing partner of its Dallas office. Henderson focuses his practice on mergers and acquisitions in the health care industry and is also the chair of the firm’s national corporate and transactional practice.The 1992 graduate of St. Mary’s University School of Law will manage an office of more than 20 attorneys. © 2013 The Texas Lawbook. Content of The Texas . . .You must be a subscriber to The Texas Lawbook to access this content. Username Password
Lost your password? Not a subscriber? Sign up for The Texas Lawbook. Amid all the fuss and flurry of national corporate law firms opening new offices in Texas and spate of major mergers, some simple facts are frequently overlooked . . .You must be a subscriber to The Texas Lawbook to access this content. Username Password Remember me
May 11 2018In a British Journal of Clinical Pharmacology study of 259 older adults discharged from a general medical hospital, more than 4 in 5 patients were issued a potentially inappropriate prescription containing at least 1 potentially inappropriate medication (PIM) or potential prescribing omission (PPO).Medications that constitute a greater risk than benefit to a patient are considered PIMs, while failures to prescribe medications of potential benefit are considered PPOs.Prescription of more than 5 medications was significantly associated with PIMs and PPOs. Also, PIMs and PPOs were associated with increased odds of hospital readmissions and death, respectively.The study used the STOPP (Screening Tool of Older Person’s Prescriptions) START (Screening Tool to Alert doctors to the Right Treatment) criteria to identify PIMs and PPOs. Source:http://newsroom.wiley.com/press-release/many-older-adults-discharged-hospital-receive-inappropriate-prescriptions
May 26 2018Triggers of acute heart failure vary globally, according to late breaking results from the REPORT-HF registry presented today at Heart Failure 2018 and the World Congress on Acute Heart Failure, a European Society of Cardiology Congress.REPORT-HF is a global, prospective registry comparing regional differences in causes of acute heart failure, therapies, time to treatment, and outcomes. Professor Sean Collins, one of the authors of the study and Professor and Vice Chair for Research, Vanderbilt University Medical Center, Nashville, Tennessee, US, said: “Prior acute heart failure registries have focused on a single country or region. REPORT-HF is the first to simultaneously enrol patients from across the world using identical protocols. This enables us to directly compare patient management in healthcare systems in different regions of the world.”The registry enrolled 18,805 adult patients hospitalized with acute heart failure, which was either a new diagnosis or decompensation of previously diagnosed chronic heart failure. Patients were admitted to 358 hospitals over 32 months in 44 countries across seven regions worldwide. The first analysis of the registry, which evaluates the initial hospital admission, is presented today.A total of 2,810 patients were admitted in Eastern Europe, 3,661 in Western Europe, 1,622 in North America, 2,686 in Central and South America, 2,265 in the Eastern Mediterranean and Africa, 2,369 in Southeast Asia, and 3,392 in the Western Pacific. The median age of patients was 67 years, 52% were Caucasian, 31% were Asian, 5% were Black, and 61% were men.In North America, acute heart failure was primarily caused by nonadherence to diet and medications (19.2% of cases), followed by uncontrolled hypertension (8.2%), arrhythmia (7.6%), ischaemia/acute coronary syndrome (ACS)/infarction (3.5%), and pneumonia/respiratory process/infection (4.1%). In Southeast Asia the main cause was ischemia/ACS/infarction (25.6%), followed by nonadherence to diet and medications (5.4%), uncontrolled hypertension (5.2%), arrhythmia (4.7%), and pneumonia/respiratory process/infection (4.5%).3Related StoriesTeam approach to care increases likelihood of surviving refractory cardiogenic shockRepurposing a heart drug could increase survival rate of children with ependymomaStroke should be treated 15 minutes earlier to save lives, study suggestsThe time between contacting medical services and receiving intravenous diuretics was longer in North America compared to other regions – a median of 3.5 hours versus just over one hour, respectively. Professor Collins said: “This could be due to a number of factors. Patients in North America had less dyspnoea at rest and may have been perceived to be less ill. Further, in North America patients are most often triaged in the emergency department which becomes crowded, causing delays in treatment. In other regions, like Europe, patients bypass the emergency department and go directly to a hospital bed to get treated.”The medications patients received in hospital had similarities and differences. Inotropic agents, which increase the ability of the heart to contract, were used three times more often in Southeast Asia, Western Pacific, and Eastern Europe (11.3-13.5%) compared to Western Europe and North America (3.1-4.3%). Professor Collins said: “These drugs are indicated for patients with low blood pressure. Patients presented with similar blood pressures across regions, so further investigation is needed to determine why prescribing practices differ.”Treatment with intravenous vasodilators within six hours of hospital presentation was associated with a significantly shorter hospital stay across all regions. Kidney function, systolic blood pressure, signs of congestion on chest X-ray, and cause of acute heart failure had an even greater impact on length of hospital stay.Professor Collins said: “The registry shows that the causes and treatment of acute heart failure differ by region. Varying use of medications could be due to local practices or availability of medications. REPORT- HF will identify opportunities to improve care and inform future clinical trial design. Differences in etiology and initial therapy may exclude patients from subsequent studies and hinder the ability to detect the benefit of novel therapies.”Patients in REPORT-HF will be followed-up for three years after hospital discharge to collect information on treatment, rehospitalization, and death.Source: https://www.escardio.org/
Jul 18 2018In spite of high level of modern medicine development many problems of this sphere are not solved till the present. For example, post-traumatic stress disorder syndrome (PTSD) which is a consequence of experienced psychological injury after military actions, bodily injuries, industrial or natural catastrophes poorly responds to drug therapy. Though, scientists of South Ural State University found an alternative method of syndrome treatment.Method which can substitute drug therapy and which was suggested by SUSU scientific team in the frames of Project 5-100 consists in moderate hypoxic trainings or one’s temporary placement in the conditions of reduced level of oxygen. The method was experimentally-verified in rats in cooperation with the Institute of General Pathology and Pathophysiology (Moscow) and Research Institute of Human Morphology (Moscow) as a result of what SUSU scientists proved a positive dynamics of disease development. Results of Investigation were published in a scientific publication Journal of Applied Physiology in June 2018.Director of School of Medical Biology, Doctor of Biological Studies, Professor Vadim Tseilikman: “Syndrome of post-traumatic stress disorders is being accompanied not only by intellectual disabilities but by internal injuries as well. When it is not possible to adapt therapy then it is necessary consequently to seek for the ways in other directions. One of such directions is adaptive medicine. This is a drug-free influence by moderate hypoxic trainings which are held in the following way: a man or an animal is being placed temporarily in the conditions of reduced level oxygen upon that an organism experiences a hypoxic training without sharp discomfort. An organism is placed in the conditions of low oxygen partial pressure and therefore oxygen partial pressure in blood reduces that means hypoxia appears. Moderate hypoxic trainings can activate the defensive reserve of an organism.”Related StoriesStudy reveals long-term benefits of stress urinary incontinence surgeryStress-induced changes in heart rate may impair auditory perceptionEarly adversity could make individuals more vulnerable to stress-related drinking during adulthoodHypoxic trainings are being undertaken in special aerospace chambers where the level of oxygen is being controlled. The length of therapy is determined by a doctor.World practice has already got an experience of hypoxic trainings usage while treating other health problems and diseases and the effectiveness of trainings is proved by many investigations. So, hypoxic trainings are mostly effective for heart diseases as well as for correction of Alzheimer disease. But just SUSU scientists determined the possibility to apply this method for treating PTSD.High level of anxiety and involuntary memories of psycho-traumatic situation arousing stress are the characteristics of post-traumatic stress disorder. Signs of PTSD are preserved during a long time after the experienced psychological injury and the disorder is practically not amenable to drug effects. That is why the necessity in applying a new method of treatment appeared.Moreover SUSU scientists’ team proved the connection of post-traumatic stress disorder with animals’ adrenal deficiency. In other words adrenal deficiency becomes the consequence of PTSD syndrome. It was discovered that correction of adrenal function allows improving the behavioral status of organism and the hypoxic trainings are helpful in this case.The discovery of SUSU scientists gives wide perspectives for people’s PTSD syndrome treatment. Though before a wide implementation of the innovative method in practice the new method of treating PTSD syndrome must be tested seriously in health establishments what can require several decades. However, today an advantage of new method which can be helpful in cases of non-efficient drug therapy is clear.Source: https://www.susu.ru/en/news/2018/07/18/new-treatment-method-post-traumatic-stress-disorder-syndrome-discovered-russia
ShareTweetSharePinThe Waitukubuli Artists Association (WAA) is pleased to announce the fifth installment in our ‘Year of the Artist’ presentations. ‘Rîzë’. This three day exhibition will take place from June 28th-30th at the Rejens Hotel in Portsmouth and the general public is urged to attend this once-in-a-lifetime experience.Created by WAA President Lowell Royer, also known as OMtNI (silent ‘t’), Rîzë is about arriving at an elevated state – physically, mentally, and spiritually.Rîzë was inspired by: the way Dominicans are quick to get back on their feet after disasters like Maria; Dominican women being strong; and the Dominican youth always striving to be positive and looking towards a brighter future.These unique pieces are on wood, done with wood stain and sand paper, with some acrylic paint for colour (much different from what we are used to in Dominica, and you most likely won’t find art fitting that description on the internet either).With a style dubbed ‘Dramatic Realism’, Royer showcases his love for nature with exaggerated effects to bring out the features that strike him the most.The three day event will feature the Rîzë presentation/exhibition, a live painting by OMtNI himself, various live dance and percussion instruments performances and an artist talk to close off the event.The Waitukubuli Artists Association is encouraging the general public to help to make this event one of the WAA’s best.
Source:https://www.salford.ac.uk/ Reviewed by James Ives, M.Psych. (Editor)Oct 3 2018SCIENTISTS fighting cancer have carried out the first successful trial of the effects of the antibiotic Doxycycline on cancer reoccurrence in patients after surgery.Breast cancer patients were given the orally-administered antibiotic for 14 days before surgery and almost all saw a significant drop in cancer stem cells, the aggressive cells that drive tumor recurrence.Although small – restricted to 15 patients at the University Hospital in Pisa, Italy – the trial is highly significant, giving hope for the efficacy of cheap, over-the-counter drugs being used alongside standard treatments to prevent cancer regrowth.Doxycycline is one of the most commonly-prescribed antibiotics, effective in treating pneumonia, sinusitis, chlamydia, syphilis, cholera and Lyme disease.The research, reported in the journal Frontiers in Oncology, was led by Professors Michael Lisanti and Federica Sotgia at the University of Salford and supported by the Healthy Life Foundation, the Pisa Science Foundation and the Foxpoint Foundation.Lisanti, chair of translational medicine, said: “We have very few FDA-approved drugs to target and reduce cancer stem cells, so to find that a drug that is effective, readily-available and costs just 10pence per patient per day and is highly significant, particularly as around two-thirds of cancer deaths occur due to recurrence after initial treatment.”The University of Salford specializes in discovering non-toxic remedies and repurposing approved drugs as complementary treatments for cancer.In the trial, doxycycline was administered to 9 patients whilst a further 6 were observed as ‘controls’ (no treatment). Immuno-histochemical analysis was performed with known biomarkers of “stemness” (CD44, ALDH1), mitochondrial mass (TOMM20), cell proliferation (Ki67, p27), apoptosis (cleaved caspase-3) and neo-angiogenesis (CD31). For each patient, the analysis was performed both on pre-operative specimens (core-biopsies) and surgical specimens.Related StoriesNew protein target for deadly ovarian cancerNew research links “broken heart syndrome” to cancerSpecial blood test may predict relapse risk for breast cancer patientsPost-doxycycline tumor samples demonstrated a statistically significant decrease in CD44 – between 17.65% and 66.67%, in 8 out of 9 patients treated. One patient showed a rise in CD44, by 15%. Overall, this represents a positive response rate of nearly 90%. Similar results were also obtained with ALDH1, another marker of stemness.”What we infer here is that the stem cells selectively over-express key mitochondrial-related proteins, which means that if we can inhibit mitochondrial function we can disrupt the stem cells,” explained Prof Sotgia.Because mitochondria evolved from bacteria, they explain, many classes of antibiotics including Doxycycline actually target mitochondria and inhibit the reproduction of stem cells. These latest observations, they say, are further evidence that mitochondria are both biomarkers and potential drug targets.Professor Lisanti added: “Our ability to treat cancer can only be enhanced by utilising drugs that are not only cheap but also widely available. Since Doxycycline first became clinically available in 1967, its anti-cancer activity has been right under our nose, for more than 50 years.”
Source:Chemical Conversion of Human Fetal Astrocytes into Neurons through Modulation of Multiple Signaling Pathways We identified the most efficient chemical formula among the hundreds of drug combinations that we tested. By using four molecules that modulate four critical signaling pathways in human astrocytes, we can efficiently turn human astrocytes — as many as 70 percent — into functional neurons.”Jiu-Chao Yin, Study Author By Sally Robertson, B.Sc.Feb 12 2019Reviewed by Kate Anderton, B.Sc. (Editor)Researchers at the University of Pennsylvania have made important progress in designing a drug that could recover brain function in cases of severe brain damage due to injury or diseases such as Alzheimer’s. Vitaly Sosnovskiy | ShutterstockThe work builds on a previous study where the team managed to convert human fetal glial cells called astrocytes into functional neurons. However, that required using a combination of nine molecules – too many for the formula to be translated into a clinically useful solution.As reported in the journal Stem Cell Reports, the team has now successfully streamlined the process so that only four molecules are needed – an achievement that could lead to pill for repairing brain damage. The researchers report that the new neurons survived for more than seven months in the laboratory environment and that they functioned like normal brain cells, forming networks and communicating with one another using chemical and electrical signaling.“The most significant advantage of the new approach is that a pill containing small molecules could be distributed widely in the world, even reaching rural areas without advanced hospital systems,” says Chen.“My ultimate dream is to develop a simple drug delivery system, like a pill, that can help stroke and Alzheimer’s patients around the world to regenerate new neurons and restore their lost learning and memory capabilities,” he continued.Now, the years of effort the team has put into simplifying the drug formula has finally paid off and taken the researchers a step closer towards realizing that dream.
Reviewed by Alina Shrourou, B.Sc. (Editor)Apr 8 2019A recent study found that nearly 18 percent of patients diagnosed with multiple sclerosis before being referred to two major Los Angeles medical centers for treatment actually had been misdiagnosed with the autoimmune disease.The retrospective study, led by investigator Marwa Kaisey, MD, along with Nancy Sicotte, MD, interim chair of Neurology and director of the Cedars-Sinai Multiple Sclerosis and Neuroimmunology Center, and researchers from UCLA and the University of Vermont, analyzed the cases of 241 patients who had been diagnosed by other physicians and then referred to the Cedars-Sinai or UCLA MS clinics over the course of a year.Investigators sought to determine how many patients were misdiagnosed with MS, and identify common characteristics among those who had been misdiagnosed.”The diagnosis of MS is tricky. Both the symptoms and MRI testing results can look like other conditions, such as stroke, migraines and vitamin B12 deficiency,” Kaisey said. “You have to rule out any other diagnoses, and it’s not a perfect science.”The investigators found that many patients who came to the medical centers with a previous diagnosis of MS did not fulfill the criteria for that diagnosis. The patients spent an average of four years being treated for MS before receiving a correct diagnosis.”When we see a patient like that, even though they come to us with an established diagnosis, we just start from the beginning,” Sicotte said.The most common correct diagnosis was migrane (16 percent), followed by radiologically isolated syndrome, a condition in which patients do not experience symptoms of MS even though their imaging tests look similar to those of MS patients. Other correct diagnoses included spondylopathy (a disorder of the vertebrae) and neuropathy (nerve damage).Related StoriesNature of social cognitive deficits in people with progressive multiple sclerosisHigh levels of blood lipids may worsen multiple sclerosis symptoms in obese patientsNovel imaging molecule reveals brain changes linked to progressive MSAmong those misdiagnosed, 72 percent had been prescribed MS treatments. Forty-eight percent of these patients received therapies that carry a known risk of developing progressive multifocal leukoencephalopathy, a serious disease in the white matter of the brain, caused by viral infection.”I’ve seen patients suffering side effects from the medication they were taking for a disease they didn’t have,” Kaisey said. “Meanwhile, they weren’t getting treatment for what they did have. The cost to the patient is huge–medically, psychologically, financially.”Investigators estimated that the unnecessary treatments identified in this study alone cost almost $10 million.The investigators hope that the results of this study, which will be published in May’s issue of the peer-reviewed journal Multiple Sclerosis and Related Disorders, along with recently funded research into new biomarkers and improved imaging techniques, will help improve diagnostic procedures and help prevent future MS misdiagnoses.Funding for the new research includes $60,000 from Cedars-Sinai Precision Health, a partnership among scientists, clinicians and industry designed to advance personalized medicine. Kaisey said that she hopes these studies will also lead to better availability of treatment for patients who do have the disease.”The first step, which is what we’ve done here, is to identify the problem, so now we’re working on potential solutions,” she said. Source:https://www.cedars-sinai.org/newsroom/study-of-multiple-sclerosis-patients-shows-18-percent-misdiagnosed/