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How to cite this zithromax generic price article:Singh OP. Psychiatry research in India. Closing the zithromax generic price research gap.

Indian J Psychiatry 2020;62:615-6Research is an important aspect of the growth and development of medical science. Research in zithromax generic price India in general and medical research in particular is always being criticized for lack of innovation and originality required for the delivery of health services suitable to Indian conditions. Even the Indian Council of Medical Research (ICMR) which is a centrally funded frontier organization for conducting medical research couldn't avert criticism.

It has been criticized heavily for not producing quality research papers which are pioneering, ground breaking, or pragmatic solutions for health issues plaguing India. In the words of a leading daily, The ICMR could not even list one practical application of its hundreds of research papers published in various national and international research journals which helped cure any disease, or diagnose it with better accuracy or zithromax generic price in less time, or even one new basic, applied or clinical research or innovation that opened a new frontier of scientific knowledge.[1]This clearly indicates that the health research output of ICMR is not up to the mark and is not commensurate with the magnitude of the disease burden in India. According to the 12th Plan Report, the country contributes to a fifth of the world's share of diseases.

The research conducted zithromax generic price elsewhere may not be generalized to the Indian population owing to differences in biology, health-care systems, health practices, culture, and socioeconomic standards. Questions which are pertinent and specific to the Indian context may not be answered and will remain understudied. One of the vital elements in improving this situation is the need for relevant research base that would equip policymakers to take informed health policy decisions.The Parliamentary Standing Committee on Health and Family Welfare in the 100th report on Demand for Grants (2017–2018) of the Department of Health Research observed that “the biomedical research output needs to be augmented substantially to cater to the health challenges faced by the country.”[1]Among the various reasons, lack of fund, infrastructure, and resources is the prime cause which is glaringly evident from the inadequate budget allocation for biomedical research.

While ICMR has a budget of 232 million dollars per year on health research, zithromax generic price it is zilch in comparison to the annual budget expenditure of the National Institute of Health, USA, on biomedical research which is 32 billion dollars.The lacuna of quality research is not merely due to lack of funds. There are other important issues which need to be considered and sorted out to end the status quo. Some of the factors which need our immediate attention are:Lack of research training and teachingImproper allocation of research facilitiesLack of information about research work happening globallyLack of promotion, motivation, commitment, and passion in the field of researchClinicians being overburdened with patientsLack of collaboration between medical colleges and established research institutesLack of continuity of research in successive batches of postgraduate (PG) students, leading to wastage of previous research and resourcesDifficulty in the application of basic biomedical research into pragmatic intervention solutions due to lack of interdisciplinary technological support/collaboration between basic scientists, clinicians, and technological experts.Majority of the biomedical research in India are conducted in zithromax generic price medical institutions.

The majority of these are done as thesis submission for fulfillment of the requirement of PG degree. From 2015 onward, publication of papers had been made an obligatory requirement for promotion of zithromax generic price faculty to higher posts. Although it offered a unique opportunity for training of residents and stimulus for research, it failed to translate into production of quality research work as thesis was limited by time and it had to be done with other clinical and academic duties.While the top four medical colleges, namely AIIMS, New Delhi.

PGIMER, Chandigarh. CMC, Vellore zithromax generic price. And SGIMS, Lucknow are among the top ten medical institutions in terms of publication in peer-reviewed journals, around 332 (57.3%) medical colleges have no research paper published in a decade between 2004 and 2014.[2]The research in psychiatry is realistically dominated by major research institutes which are doing commendable work, but there is a substantial lack of contemporary research originating from other centers.

Dr. Chittaranjan Andrade (NIMHANS, Bengaluru) and Dr. K Jacob (CMC, Vellore) recently figured in the list of top 2% psychiatry researchers in the world from India in psychiatry.[3] Most of the research conducted in the field of psychiatry are limited to caregivers' burden, pathways of care, and other topics which can be done in limited resources available to psychiatry departments.

While all these areas of work are important in providing proper care and treatment, there is overabundance of research in these areas.The Government of India is aggressively looking forward to enhancing the quality of research and is embarking on an ambitious project of purchasing all major journals and providing free access to universities across the country. The India Genome Project started in January, 2020, is a good example of collaboration. While all these actions are laudable, a lot more needs to be done.

Following are some measures which will reduce the gap:Research proposals at the level of protocol can be guided and mentored by institutes. Academic committees of different zones and journals can help in this endeavorBreaking the cubicles by establishing a collaboration between medical colleges and various institutes. While there is a lack of resources available in individual departments, there are universities and institutes with excellent infrastructure.

They are not aware of the requirements of the field of psychiatry and research questions. Creation of an alliance will enhance the quality of research work. Some of such institutes include Centre for Neuroscience, Indian Institute of Science, Bengaluru.

CSIR-Institute of Genomics and Integrative Biology, New Delhi. And National Institute of Biomedical Genomics, KalyaniInitiation and establishment of interactive and stable relationships between basic scientists and clinical and technological experts will enhance the quality of research work and will lead to translation of basic biomedical research into real-time applications. For example, work on artificial intelligence for mental health.

Development of Apps by IITs. Genome India Project by the Government of India, genomic institutes, and social science and economic institutes working in the field of various aspects of mental healthUtilization of underutilized, well-equipped biotechnological labs of nonmedical colleges for furthering biomedical researchMedical colleges should collaborate with various universities which have labs providing testing facilities such as spectroscopy, fluoroscopy, gamma camera, scintigraphy, positron emission tomography, single photon emission computed tomography, and photoacoustic imagingCreating an interactive, interdepartmental, intradepartmental, and interinstitutional partnershipBy developing a healthy and ethical partnership with industries for research and development of new drugs and interventions.Walking the talk – the psychiatric fraternity needs to be proactive and rather than lamenting about the lack of resource, we should rise to the occasion and come out with innovative and original research proposals. With the implementation of collaborative approach, we can not only enhance and improve the quality of our research but to an extent also mitigate the effects of resource crunch and come up as a leader in the field of biomedical research.

References 1.2.Nagoba B, Davane M. Current status of medical research in India. Where are we?.

Walawalkar Int Med J 2017;4:66-71. 3.Ioannidis JP, Boyack KW, Baas J. Updated science-wide author databases of standardized citation indicators.

PLoS Biol 2020;18:e3000918. Correspondence Address:Dr. Om Prakash SinghAA 304, Ashabari Apartments, O/31, Baishnabghata, Patuli Township, Kolkata - 700 094, West Bengal IndiaSource of Support.

None, Conflict of Interest. NoneDOI. 10.4103/indianjpsychiatry.indianjpsychiatry_1362_2Abstract Background.

The burden of mental illness among the scheduled tribe (ST) population in India is not known clearly.Aim. The aim was to identify and appraise mental health research studies on ST population in India and collate such data to inform future research.Materials and Methods. Studies published between January 1980 and December 2018 on STs by following exclusion and inclusion criteria were selected for analysis.

PubMed, PsychINFO, Embase, Sociofile, Cinhal, and Google Scholar were systematically searched to identify relevant studies. Quality of the included studies was assessed using an appraisal tool to assess the quality of cross-sectional studies and Critical Appraisal Checklist developed by Critical Appraisal Skills Programme. Studies were summarized and reported descriptively.Results.

Thirty-two relevant studies were found and included in the review. Studies were categorized into the following three thematic areas. Alcohol and substance use disorders, common mental disorders and sociocultural aspects, and access to mental health-care services.

Sociocultural factors play a major role in understanding and determining mental disorders.Conclusion. This study is the first of its kind to review research on mental health among the STs. Mental health research conducted among STs in India is limited and is mostly of low-to-moderate quality.

Determinants of poor mental health and interventions for addressing them need to be studied on an urgent basis.Keywords. India, mental health, scheduled tribesHow to cite this article:Devarapalli S V, Kallakuri S, Salam A, Maulik PK. Mental health research on scheduled tribes in India.

Indian J Psychiatry 2020;62:617-30 Introduction Mental health is a highly neglected area particularly in low and middle-income countries (LMIC). Data from community-based studies showed that about 10% of people suffer from common mental disorders (CMDs) such as depression, anxiety, and somatic complaints.[1] A systematic review of epidemiological studies between 1960 and 2009 in India reported that about 20% of the adult population in the community are affected by psychiatric disorders in the community, ranging from 9.5 to 103/1000 population, with differences in case definitions, and methods of data collection, accounting for most of the variation in estimates.[2]The scheduled tribes (ST) population is a marginalized community and live in relative social isolation with poorer health indices compared to similar nontribal populations.[3] There are an estimated 90 million STs or Adivasis in India.[4] They constitute 8.6% of the total Indian population. The distribution varies across the states and union territories of India, with the highest percentage in Lakshadweep (94.8%) followed by Mizoram (94.4%).

In northeastern states, they constitute 65% or more of the total population.[5] The ST communities are identified as culturally or ethnographically unique by the Indian Constitution. They are populations with poorer health indicators and fewer health-care facilities compared to non-ST rural populations, even when within the same state, and often live in demarcated geographical areas known as ST areas.[4]As per the National Family Health Survey, 2015–2016, the health indicators such as infant mortality rate (IMR) is 44.4, under five mortality rate (U5MR) is 57.2, and anemia in women is 59.8 for STs – one of the most disadvantaged socioeconomic groups in India, which are worse compared to other populations where IMR is 40.7, U5MR is 49.7, and anemia in women among others is 53.0 in the same areas.[6] Little research is available on the health of ST population. Tribal mental health is an ignored and neglected area in the field of health-care services.

Further, little data are available about the burden of mental disorders among the tribal communities. Health research on tribal populations is poor, globally.[7] Irrespective of the data available, it is clear that they have worse health indicators and less access to health facilities.[8] Even less is known about the burden of mental disorders in ST population. It is also found that the traditional livelihood system of the STs came into conflict with the forces of modernization, resulting not only in the loss of customary rights over the livelihood resources but also in subordination and further, developing low self-esteem, causing great psychological stress.[4] This community has poor health infrastructure and even less mental health resources, and the situation is worse when compared to other communities living in similar areas.[9],[10]Only 15%–25% of those affected with mental disorders in LMICs receive any treatment for their mental illness,[11] resulting in a large “treatment gap.”[12] Treatment gaps are more in rural populations,[13] especially in ST communities in India, which have particularly poor infrastructure and resources for health-care delivery in general, and almost no capacity for providing mental health care.[14]The aim of this systematic review was to explore the extent and nature of mental health research on ST population in India and to identify gaps and inform future research.

Materials and Methods Search strategyWe searched major databases (PubMed, PsychINFO, Embase, Sociofile, Cinhal, and Google Scholar) and made hand searches from January 1980 to December 2018 to identify relevant literature. Hand search refers to searching through medical journals which are not indexed in the major electronic databases such as Embase, for instance, searching for Indian journals in IndMed database as most of these journals are not available in major databases. Physical search refers to searching the journals that were not available online or were not available online during the study years.

We used relevant Medical Subject Heading and key terms in our search strategy, as follows. €œMental health,” “Mental disorders,” “Mental illness,” “Psychiatry,” “Scheduled Tribe” OR “Tribe” OR “Tribal Population” OR “Indigenous population,” “India,” “Psych*” (Psychiatric, psychological, psychosis).Inclusion criteriaStudies published between January 1980 and December 2018 were included. Studies on mental disorders were included only when they focused on ST population.

Both qualitative and quantitative studies on mental disorders of ST population only were included in the analysis.Exclusion criteriaStudies without any primary data and which are merely overviews and commentaries and those not focused on ST population were excluded from the analysis.Data management and analysisTwo researchers (SD and SK) initially screened the title and abstract of each record to identify relevant papers and subsequently screened full text of those relevant papers. Any disagreements between the researchers were resolved by discussion or by consulting with an adjudicator (PKM). From each study, data were extracted on objectives, study design, study population, study duration, interventions (if applicable), outcomes, and results.

Quality of the included studies was assessed, independently by three researchers (SD, SK, and AS), using Critical Appraisal Checklist developed by Critical Appraisal Skills Programme (CASP).[15] After a thorough qualitative assessment, all quantitative data were generated and tabulated. A narrative description of the studies is provided in [Table 1] using some broad categories. Results Search resultsOur search retrieved 2306 records (which included hand-searched articles), of which after removing duplicates, title and abstracts of 2278 records were screened.

Of these, 178 studies were deemed as potentially relevant and were reviewed in detail. Finally, we excluded 146 irrelevant studies and 32 studies were included in the review [Figure 1].Quality of the included studiesSummary of quality assessment of the included studies is reported in [Table 2]. Overall, nine studies were of poor quality, twenty were of moderate quality, and three studies were of high quality.

The CASP shows that out of the 32 studies, the sample size of 21 studies was not representative, sample size of 7 studies was not justified, risk factors were not identified in 28 studies, methods used were not sufficiently described to repeat them in 24 studies, and nonresponse reasons were not addressed in 24 studies. The most common reasons for studies to be of poor-quality included sample size not justified. Sample is not representative.

Nonresponse not addressed. Risk factors not measured correctly. And methods used were not sufficiently described to repeat them.

Studies under the moderate quality did not have a representative sample. Non-responders categories was not addressed. Risk factors were not measured correctly.

And methods used were not sufficiently described to allow the study to be replicated by other researchers.The included studies covered three broad categories. Alcohol and substance use disorders, CMD (depression, anxiety, stress, and suicide risk), socio-cultural aspects, and access to mental health services.Alcohol and substance use disordersFive studies reviewed the consumption of alcohol and opioid. In an ethnographic study conducted in three western districts in Rajasthan, 200 opium users were interviewed.

Opium consumption was common among both younger and older males during nonharvest seasons. The common causes for using opium were relief of anxiety related to crop failure due to drought, stress, to get a high, be part of peers, and for increased sexual performance.[16]In a study conducted in Arunachal Pradesh involving a population of more than 5000 individuals, alcohol use was present in 30% and opium use in about 5% adults.[17] Contrary to that study, in Rajasthan, the prevalence of opium use was more in women and socioeconomic factors such as occupation, education, and marital status were associated with opium use.[16] The prevalence of opium use increased with age in both sexes, decreased with increasing education level, and increased with employment. It was observed that wages were used to buy opium.

In the entire region of Chamlang district of Arunachal Pradesh, female substance users were almost half of the males among ST population.[17] Types of substance used were tobacco, alcohol, and opium. Among tobacco users, oral tobacco use was higher than smoking. The prevalence of tobacco use was higher among males, but the prevalence of alcohol use was higher in females, probably due to increased access to homemade rice brew generally prepared by women.

This study is unique in terms of finding a strong association with religion and culture with substance use.[18]Alcohol consumption among Paniyas of Wayanad district in Kerala is perceived as a male activity, with many younger people consuming it than earlier. A study concluded that alcohol consumption among them was less of a “choice” than a result of their conditions operating through different mechanisms. In the past, drinking was traditionally common among elderly males, however the consumption pattern has changed as a significant number of younger men are now drinking.

Drinking was clustered within families as fathers and sons drank together. Alcohol is easily accessible as government itself provides opportunities. Some employers would provide alcohol as an incentive to attract Paniya men to work for them.[19]In a study from Jharkhand, several ST community members cited reasons associated with social enhancement and coping with distressing emotions rather than individual enhancement, as a reason for consuming alcohol.

Societal acceptance of drinking alcohol and peer pressure, as well as high emotional problems, appeared to be the major etiology leading to higher prevalence of substance dependence in tribal communities.[20] Another study found high life time alcohol use prevalence, and the reasons mentioned were increased poverty, illiteracy, increased stress, and peer pressure.[21] A household survey from Chamlang district of Arunachal Pradesh revealed that there was a strong association between opium use and age, occupation, marital status, religion, and ethnicity among both the sexes of STs, particularly among Singhpho and Khamti.[15] The average age of onset of tobacco use was found to be 16.4 years for smoked and 17.5 years for smokeless forms in one study.[22]Common mental disorders and socio-cultural aspectsSuicide was more common among Idu Mishmi in Roing and Anini districts of Arunachal Pradesh state (14.2%) compared to the urban population in general (0.4%–4.2%). Suicides were associated with depression, anxiety, alcoholism, and eating disorders. Of all the factors, depression was significantly high in people who attempted suicide.[24] About 5% out of 5007 people from thirty villages comprising ST suffered from CMDs in a study from West Godavari district in rural Andhra Pradesh.

CMDs were defined as moderate/severe depression and/or anxiety, stress, and increased suicidal risk. Women had a higher prevalence of depression, but this may be due to the cultural norms, as men are less likely to express symptoms of depression or anxiety, which leads to underreporting. Marital status, education, and age were prominently associated with CMD.[14] In another study, gender, illiteracy, infant mortality in the household, having <3 adults living in the household, large family size with >four children, morbidity, and having two or more life events in the last year were associated with increased prevalence of CMD.[24] Urban and rural ST from the same community of Bhutias of Sikkim were examined, and it was found that the urban population experienced higher perceived stress compared to their rural counterparts.[25] Age, current use of alcohol, poor educational status, marital status, social groups, and comorbidities were the main determinants of tobacco use and nicotine dependence in a study from the Andaman and Nicobar Islands.[22] A study conducted among adolescents in the schools of rural areas of Ranchi district in Jharkhand revealed that about 5% children from the ST communities had emotional symptoms, 9.6% children had conduct problems, 4.2% had hyperactivity, and 1.4% had significant peer problems.[27] A study conducted among the female school teachers in Jharkhand examined the effects of stress, marital status, and ethnicity upon the mental health of school teachers.

The study found that among the three factors namely stress, marital status, and ethnicity, ethnicity was found to affect mental health of the school teachers most. It found a positive relationship between mental health and socioeconomic status, with an inverse relationship showing that as income increased, the prevalence of depression decreased.[28] A study among Ao-Nagas in Nagaland found that 74.6% of the population attributed mental health problems to psycho-social factors and a considerable proportion chose a psychiatrist or psychologist to overcome the problem. However, 15.4% attributed mental disorders to evil spirits.

About 47% preferred to seek treatment with a psychiatrist and 25% preferred prayers. Nearly 10.6% wanted to seek the help of both the psychiatrist and prayer group and 4.4% preferred traditional healers.[28],[29] The prevalence of Down syndrome among the ST in Chikhalia in Barwani district of Madhya Pradesh was higher than that reported in overall India. Three-fourth of the children were the first-born child.

None of the parents of children with Down syndrome had consanguineous marriage or a history of Down syndrome, intellectual disability, or any other neurological disorder such as cerebral palsy and epilepsy in preceding generations. It is known that tribal population is highly impoverished and disadvantaged in several ways and suffer proportionately higher burden of nutritional and genetic disorders, which are potential factors for Down syndrome.[30]Access to mental health-care servicesIn a study in Ranchi district of Jharkhand, it was found that most people consulted faith healers rather than qualified medical practitioners. There are few mental health services in the regions.[31] Among ST population, there was less reliance and belief in modern medicine, and it was also not easily accessible, thus the health-care systems must be more holistic and take care of cultural and local health practices.[32]The Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health project was implemented in thirty ST villages in West Godavari District of Andhra Pradesh.

The key objectives were to use task sharing, training of primary health workers, implementing evidence-based clinical decision support tools on a mobile platform, and providing mental health services to rural population. The study included 238 adults suffering from CMD. During the intervention period, 12.6% visited the primary health-care doctors compared to only 0.8% who had sought any care for their mental disorders prior to the intervention.

The study also found a significant reduction in the depression and anxiety scores at the end of intervention and improvements in stigma perceptions related to mental health.[14] A study in Gudalur and Pandalur Taluks of Nilgiri district from Tamil Nadu used low cost task shifting by providing community education and identifying and referring individuals with psychiatric problems as effective strategies for treating mental disorders in ST communities. Through the program, the health workers established a network within the village, which in turn helped the patients to interact with them freely. Consenting patients volunteered at the educational sessions to discuss their experience about the effectiveness of their treatment.

Community awareness programs altered knowledge and attitudes toward mental illness in the community.[33] A study in Nilgiri district, Tamil Nadu, found that the community had been taking responsibility of the patients with the system by providing treatment closer to home without people having to travel long distances to access care. Expenses were reduced by subsidizing the costs of medicine and ensuring free hospital admissions and referrals to the people.[34] A study on the impact of gender, socioeconomic status, and age on mental health of female factory workers in Jharkhand found that the ST women were more likely to face stress and hardship in life due to diverse economic and household responsibilities, which, in turn, severely affected their mental health.[35] Prevalence of mental health morbidity in a study from the Sunderbans delta found a positive relation with psycho-social stressors and poor quality of life. The health system in that remote area was largely managed by “quack doctors” and faith healers.

Poverty, illiteracy, and detachment from the larger community helped reinforce superstitious beliefs and made them seek both mental and physical health care from faith healers.[36] In a study among students, it was found that children had difficulties in adjusting to both ethnic and mainstream culture.[27] Low family income, inadequate housing, poor sanitation, and unhealthy and unhygienic living conditions were some environmental factors contributing to poor physical and mental growth of children. It was observed that children who did not have such risk factors maintained more intimate relations with the family members. Children belonging to the disadvantaged environment expressed their verbal, emotional need, blame, and harm avoidances more freely than their counterparts belonging to less disadvantaged backgrounds.

Although disadvantaged children had poor interfamilial interaction, they had better relations with the members outside family, such as peers, friends, and neighbors.[37] Another study in Jharkhand found that epilepsy was higher among ST patients compared to non-ST patients.[31] Most patients among the ST are irregular and dropout rates are higher among them than the non-ST patients. Urbanization per se exerted no adverse influence on the mental health of a tribal community, provided it allowed preservation of ethnic and cultural practices. Women in the ST communities were less vulnerable to mental illness than men.

This might be a reflection of their increased responsibilities and enhanced gender roles that are characteristic of women in many ST communities.[38] Data obtained using culturally relevant scales revealed that relocated Sahariya suffer a lot of mental health problems, which are partially explained by livelihood and poverty-related factors. The loss of homes and displacement compromise mental health, especially the positive emotional well-being related to happiness, life satisfaction, optimism for future, and spiritual contentment. These are often not overcome even with good relocation programs focused on material compensation and livelihood re-establishment.[39] Discussion This systematic review is to our knowledge the first on mental health of ST population in India.

Few studies on the mental health of ST were available. All attempts including hand searching were made to recover both published peer-reviewed papers and reports available on the website. Though we searched gray literature, it may be possible that it does not capture all articles.

Given the heterogeneity of the papers, it was not possible to do a meta-analysis, so a narrative review was done.The quality of the studies was assessed by CASP. The assessment shows that the research conducted on mental health of STs needs to be carried out more effectively. The above mentioned gaps need to be filled in future research by considering the resources effectively while conducting the studies.

Mental and substance use disorders contribute majorly to the health disparities. To address this, one needs to deliver evidence-based treatments, but it is important to understand how far these interventions for the indigenous populations can incorporate cultural practices, which are essential for the development of mental health services.[30] Evidence has shown a disproportionate burden of suicide among indigenous populations in national and regional studies, and a global and systematic investigation of this topic has not been undertaken to date. Previous reviews of suicide epidemiology among indigenous populations have tended to be less comprehensive or not systematic, and have often focused on subpopulations such as youth, high-income countries, or regions such as Oceania or the Arctic.[46] The only studies in our review which provided data on suicide were in Idu Mishmi, an isolated tribal population of North-East India, and tribal communities from Sunderban delta.[24],[37] Some reasons for suicide in these populations could be the poor identification of existing mental disorders, increased alcohol use, extreme poverty leading to increased debt and hopelessness, and lack of stable employment opportunities.[24],[37] The traditional consumption pattern of alcohol has changed due to the reasons associated with social enhancement and coping with distressing emotions rather than individual enhancement.[19],[20]Faith healers play a dominant role in treating mental disorders.

There is less awareness about mental health and available mental health services and even if such knowledge is available, access is limited due to remoteness of many of these villages, and often it involves high out-of-pocket expenditure.[35] Practitioners of modern medicine can play a vital role in not only increasing awareness about mental health in the community, but also engaging with faith healers and traditional medicine practitioners to help increase their capacity to identify and manage CMDs that do not need medications and can be managed through simple “talk therapy.” Knowledge on symptoms of severe mental disorders can also help such faith healers and traditional medicine practitioners to refer cases to primary care doctors or mental health professionals.Remote settlements make it difficult for ST communities to seek mental health care. Access needs to be increased by using solutions that use training of primary health workers and nonphysician health workers, task sharing, and technology-enabled clinical decision support tools.[3] The SMART Mental Health project was delivered in the tribal areas of Andhra Pradesh using those principles and was found to be beneficial by all stakeholders.[14]Given the lack of knowledge about mental health problems among these communities, the government and nongovernmental organizations should collect and disseminate data on mental disorders among the ST communities. More research funding needs to be provided and key stakeholders should be involved in creating awareness both in the community and among policy makers to develop more projects for ST communities around mental health.

Two recent meetings on tribal mental health – Round Table Meeting on Mental Health of ST Populations organized by the George Institute for Global Health, India, in 2017,[51] and the First National Conference on Tribal Mental Health organized by the Indian Psychiatric Society in Bhubaneswar in 2018 – have identified some key areas of research priority for mental health in ST communities. A national-level policy on mental health of tribal communities or population is advocated which should be developed in consultation with key stakeholders. The Indian Psychiatric Society can play a role in coordinating research activities with support of the government which can ensure regular monitoring and dissemination of the research impact to the tribal communities.

There is a need to understand how mental health symptoms are perceived in different ST communities and investigate the healing practices associated with distress/disaster/death/loss/disease. This could be done in the form of cross-sectional or cohort studies to generate proper evidence which could also include the information on prevalence, mental health morbidity, and any specific patterns associated with a specific disorder. Future research should estimate the prevalence of mental disorders in different age groups and gender, risk factors, and the influence of modernization.

Studies should develop a theoretical model to understand mental disorders and promote positive mental health within ST communities. Studies should also look at different ST communities as cultural differences exist across them, and there are also differences in socioeconomic status which impact on ability to access care.Research has shown that the impact and the benefits are amplified when research is driven by priorities that are identified by indigenous communities and involve their active participation. Their knowledge and perspectives are incorporated in processes and findings.

Reporting of findings is meaningful to the communities. And indigenous groups and other key stakeholders are engaged from the outset.[47] Future research in India on ST communities should also adhere to these broad principles to ensure relevant and beneficial research, which have direct impact on the mental health of the ST communities.There is also a need to update literature related to mental health of ST population continuously. Develop culturally appropriate validated instruments to measure mental morbidity relevant to ST population.

And use qualitative research to investigate the perceptions and barriers for help-seeking behavior.[48] Conclusion The current review helps not only to collate the existing literature on the mental health of ST communities but also identify gaps in knowledge and provide some indications about the type of research that should be funded in future.Financial support and sponsorshipNil.Conflicts of interestThere are no conflicts of interest. References 1.Gururaj G, Girish N, Isaac MK. Mental.

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Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 2004;291:2581-90. 9.Ministry of Health and Family Welfare, Government of India and Ministry of Tribal Affairs, Report of the Expert Committee on Tribal Health.

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18.Chaturvedi HK, Mahanta J, Bajpai RC, Pandey A. Correlates of opium use. Retrospective analysis of a survey of tribal communities in Arunachal Pradesh, India.

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Reasons for substance use. A comparative study of alcohol use in tribals and non-tribals. Indian J Psychol Med 2012;34:242-6.

[PUBMED] [Full text] 21.Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, et al. Global burden of disease attributable to mental and substance use disorders. Findings from the Global Burden of Disease Study 2010.

Lancet 2013;382:1575-86. 22.Janakiram C, Joseph J, Vasudevan S, Taha F, DeepanKumar CV, Venkitachalam R. Prevalence and dependancy of tobacco use in an indigenous population of Kerala, India.

Oral Hygiene and Health 2016;4:1 23.Manimunda SP, Benegal V, Sugunan AP, Jeemon P, Balakrishna N, Thennarusu K, et al. Tobacco use and nicotine dependency in a cross-sectional representative sample of 18,018 individuals in Andaman and Nicobar Islands, India. BMC Public Health 2012;12:515.

24.Singh PK, Singh RK, Biswas A, Rao VR. High rate of suicide attempt and associated psychological traits in an isolated tribal population of North-East India. J Affect Dis 2013;151:673-8.

25.Sushila J. Perception of Illness and Health Care among Bhils. A Study of Udaipur District in Southern Rajasthan.

2005. 26.Sobhanjan S, Mukhopadhyay B. Perceived psychosocial stress and cardiovascular risk.

Observations among the Bhutias of Sikkim, India. Stress Health 2008;24:23-34. 27.Ali A, Eqbal S.

Mental Health status of tribal school going adolescents. A study from rural community of Ranchi, Jharkhand. Telangana J Psychiatry 2016;2:38-41.

28.Diwan R. Stress and mental health of tribal and non tribal female school teachers in Jharkhand, India. Int J Sci Res Publicat 2012;2:2250-3153.

29.Longkumer I, Borooah PI. Knowledge about attitudes toward mental disorders among Nagas in North East India. IOSR J Humanities Soc Sci 2013;15:41-7.

30.Lakhan R, Kishore MT. Down syndrome in tribal population in India. A field observation.

J Neurosci Rural Pract 2016;7:40-3. [PUBMED] [Full text] 31.Nizamie HS, Akhtar S, Banerjee S, Goyal N. Health care delivery model in epilepsy to reduce treatment gap.

WHO study from a rural tribal population of India. Epilepsy Res Elsevier 2009;84:146-52. 32.Prabhakar H, Manoharan R.

The Tribal Health Initiative model for healthcare delivery. A clinical and epidemiological approach. Natl Med J India 2005;18:197-204.

33.Nimgaonkar AU, Menon SD. A task shifting mental health program for an impoverished rural Indian community. Asian J Psychiatr 2015;16:41-7.

34.Yalsangi M. Evaluation of a Community Mental Health Programme in a Tribal Area- South India. Achutha Menon Centre For Health Sciences Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Working Paper No 12.

2012. 35.Tripathy P, Nirmala N, Sarah B, Rajendra M, Josephine B, Shibanand R, et al. Effect of a participatory intervention with women's groups on birth outcomes and maternal depression in Jharkhand and Orissa, India.

A cluster-randomised controlled trial. Lancet 2010;375:1182-92. 36.Aparajita C, Anita KM, Arundhati R, Chetana P.

Assessing Social-support network among the socio culturally disadvantaged children in India. Early Child Develop Care 1996;121:37-47. 37.Chowdhury AN, Mondal R, Brahma A, Biswas MK.

Eco-psychiatry and environmental conservation. Study from Sundarban Delta, India. Environ Health Insights 2008;2:61-76.

38.Jeffery GS, Chakrapani U. Eco-psychiatry and Environmental Conservation. Study from Sundarban Delta, India.

Working Paper- Research Gate.net. September, 2016. 39.Ozer S, Acculturation, adaptation, and mental health among Ladakhi College Students a mixed methods study of an indigenous population.

J Cross Cultl Psychol 2015;46:435-53. 40.Giri DK, Chaudhary S, Govinda M, Banerjee A, Mahto AK, Chakravorty PK. Utilization of psychiatric services by tribal population of Jharkhand through community outreach programme of RINPAS.

Eastern J Psychiatry 2007;10:25-9. 41.Nandi DN, Banerjee G, Chowdhury AN, Banerjee T, Boral GC, Sen B. Urbanization and mental morbidity in certain tribal communities in West Bengal.

Indian J Psychiatry 1992;34:334-9. [PUBMED] [Full text] 42.Hackett RJ, Sagdeo D, Creed FH. The physical and social associations of common mental disorder in a tribal population in South India.

Soc Psychiatry Psychiatr Epidemiol 2007;42:712-5. 43.Raina SK, Raina S, Chander V, Grover A, Singh S, Bhardwaj A. Development of a cognitive screening instrument for tribal elderly population of Himalayan region in northern India.

J Neurosci Rural Pract 2013;4:147-53. [PUBMED] [Full text] 44.Raina SK, Raina S, Chander V, Grover A, Singh S, Bhardwaj A. Identifying risk for dementia across populations.

A study on the prevalence of dementia in tribal elderly population of Himalayan region in Northern India. Ann Indian Acad Neurol 2013;16:640-4. [PUBMED] [Full text] 45.Raina SK, Chander V, Raina S, Kumar D.

Feasibility of using everyday abilities scale of India as alternative to mental state examination as a screen in two-phase survey estimating the prevalence of dementia in largely illiterate Indian population. Indian J Psychiatry 2016;58:459-61. [PUBMED] [Full text] 46.Diwan R.

Mental health of tribal male-female factory workers in Jharkhand. IJAIR 2012;2278:234-42. 47.Banerjee T, Mukherjee SP, Nandi DN, Banerjee G, Mukherjee A, Sen B, et al.

Psychiatric morbidity in an urbanized tribal (Santal) community - A field survey. Indian J Psychiatry 1986;28:243-8. [PUBMED] [Full text] 48.Leske S, Harris MG, Charlson FJ, Ferrari AJ, Baxter AJ, Logan JM, et al.

Systematic review of interventions for Indigenous adults with mental and substance use disorders in Australia, Canada, New Zealand and the United States. Aust N Z J Psychiatry 2016;50:1040-54. 49.Pollock NJ, Naicker K, Loro A, Mulay S, Colman I.

Global incidence of suicide among Indigenous peoples. A systematic review. BMC Med 2018;16:145.

50.Silburn K, et al. Evaluation of the Cooperative Research Centre for Aboriginal Health (Australian institute for primary care, trans.). Melbourne.

Correspondence Address:S V. Siddhardh Kumar DevarapalliGeorge Institute for Global Health, Plot No. 57, Second Floor, Corporation Bank Building, Nagarjuna Circle, Punjagutta, Hyderabad - 500 082, Telangana IndiaSource of Support.

None, Conflict of Interest. NoneDOI. 10.4103/psychiatry.IndianJPsychiatry_136_19 Figures [Figure 1] Tables [Table 1], [Table 2].

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The hospital has its own generator and hospital administrator Alesha Alford said it was built to withstand hurricane force winds. But in the single story facility, there's does zithromax affect birth control pills no room to move up and storm surge in that area was expected to hit nine feet. In a roughly two-hour operation the babies in the intensive care unit were transferred by ambulance to Lake Charles Memorial Hospital, a ten-story facility on the northern side of the city. Trucks carried needed equipment such as incubators.Alford does zithromax affect birth control pills said the storm hadn't yet hit but "the skies looked very ominous." She said everyone pitched in to get supplies moved to the other hospital."It went as smooth as could be because we had everyone helping," she said.Alford said three mothers who couldn't be discharged from the women's hospital were also transferred. Two of them had their newborns with them while the child of the third mom was in the intensive care unit.

Parents of the other children in the neonatal intensive care unit couldn't stay with them during the storm because there wasn't enough room so Bossano said one nurse was tasked does zithromax affect birth control pills with calling parents to keep them informed of how their children were doing. Bossano occasionally posted updates on Facebook.Once they got situated at the larger hospital and the winds picked up, Alford said the patients were moved into the hallways. To "protect our babies," mattresses were pushed up against the windows to prevent flying glass although none of the windows ended up breaking.She said as huge gusts of wind started coming in, they could feel the building vibrate does zithromax affect birth control pills. In addition to Bossano, the medical staff consisted of two neonatal nurse practitioners, 14 nurses and three respiratory therapists who worked on 12-hour shifts. Some of the staff slept does zithromax affect birth control pills on air mattresses in the hallway, Alford said.

After making it through the hurricane, the plan was to have the babies stay in Lake Charles. While electricity was out in the city, the hospital has its own does zithromax affect birth control pills generator. But Alford said the city's water system has been so heavily damaged that it ultimately forced them to transfer the babies as well as other patients to other hospitals around the state Friday.Both Alford and Bossano repeatedly praised the nursing staff for their work in caring for the babies that in some cases were born weighing only a pound or two. Some of the nursing staff lost their houses in the storm, and they were worried does zithromax affect birth control pills about their own families, but they put those concerns aside to care for their tiny patients."Really the nurses and the respiratory therapists are the heroes here," Bosanno said. "They showed that very clearly the way they performed."There aren’t many hospital visitors amid the buy antibiotics zithromax.

But, if you were to walk through intensive-care units at one New York City hospital, you’d see internet-connected speakers—about the size of a stack does zithromax affect birth control pills of Post-it Notes—affixed to the bedrails of some patient beds.It’s part of a project by two Weill Cornell Medicine doctors to help family members speak with ICU patients, often intubated or otherwise not able to hold up a phone themselves, from afar.“The patients could be completely sedated, they could be in a coma,” but families still want to be there with them, said Dr. Marc Schiffman, an interventional radiologist and one of the doctors who spearheaded bringing the devices into ICUs.The speakers, now in 11 units at Weill Cornell, are part of a two-way communication system from company Relay, originally developed as a walkie-talkie system of sorts for children to stay in touch with their parents throughout the day. Users on one end record snippets of conversation using a mobile app, which are automatically played out loud through the does zithromax affect birth control pills small speaker.Users on the other end push a button on the device to record a response.“Whenever (families) have a story they want to recount, they can just talk into their phone,” Schiffman said. €œIt gives the families a sense of autonomy (and) connection,” even when the patient can’t respond.The effort, dubbed the VoiceLove Project, began about four months ago, at the height of the buy antibiotics zithromax in New York City.Families and other visitors were no longer allowed inside Weill Cornell, but still wanted a way to connect with patients who were sick with buy antibiotics. Initially, that involved a nurse standing in the ICU and holding up a phone or tablet does zithromax affect birth control pills so families could see the patient—a task that took time out of their already busy day, potentially exposed them to buy antibiotics and often meant using scarce personal protective equipment.“It really wasn’t a practical solution,” said Dr.

Tamatha Fenster, a minimally invasive gynecologic surgeon.So Fenster and Schiffman began brainstorming hands-free technologies they could install directly at the bedside. Schiffman drove to a local Target store and bought a does zithromax affect birth control pills few Relay walkie-talkie devices. After testing it with families and patients in the ICU, the two decided it was a “grand slam,” Schiffman said.Since March, hospitals have been trying new ways to keep patients connected to families at home, said Bill Flatley, senior service delivery manager at consulting firm OST. He said he’s mainly seen hospitals repurpose technology usually used for telemedicine, like tablets and cameras mounted on telemedicine carts.It’s likely hospitals will have to continue to restrict visitors, at least as long as there’s uncertainty around buy antibiotics does zithromax affect birth control pills treatment. So it’s integral for staff to figure out processes that make it easy for families to talk to patients—without putting an additional burden on clinicians or expecting them to serve as tech support.For Fenster and Schiffman, deploying walkie-talkies in the ICU for the first time took some leg work.To scale the walkie-talkie system, Schiffman reached out to Relay’s team via the company’s website, and the company agreed to donate roughly 130 devices and waived the per-user subscription fee.

The doctors and Relay have continued to work together on best practices for using the devices in ICUs, a use case Relay is marketing and could sell to other hospitals, according to Jon Schniepp, Relay’s senior vice president of marketing.But Fenster and Schiffman does zithromax affect birth control pills couldn’t just bring walkie-talkies into the ICU. In the hospital setting, there are additional quality and privacy concerns. To address those, the doctors created a disposable case, which made it easier to keep the device sterile and blocked passersby from accidentally pressing the button that would transmit sounds to a family’s Relay app.The two spent thousands of dollars out of does zithromax affect birth control pills their own pockets to devise the best case design, Fenster said, working with an industrial designer in New Jersey to 3D print different models. The final plastic case, customized with the phrase “VoiceLove” on the front, costs about $10 per case to print and ship. They’ve started reaching out to acute-care and post-acute facilities in California, Texas and other buy antibiotics hot spots to explain how the VoiceLove Project works, hoping to connect other groups does zithromax affect birth control pills with Relay and share the case design.

But the doctors say they’re still working out the logistics of getting the equipment to interested organizationsWhen Dr. George Wanna does zithromax affect birth control pills saw how devastated St. George Hospital University Medical Center was by an explosion that shook Beirut, he felt a need to help his hometown. The Aug does zithromax affect birth control pills. 4 blast in the city’s harbor ravaged St.

George’s, so Wanna launched a GoFundMe page to help the hospital, where a good friend of his, does zithromax affect birth control pills Dr. Alexander Nehme, is chief medical officer.At deadline, more than $86,600 had been raised, with a goal of $100,000. €œThis is does zithromax affect birth control pills the first time in their 140-year history when St. George’s Hospital was damaged so severely that it is unable to function,” said Wanna, chair of the otolaryngology department at New York Eye and Ear Infirmary of Mount Sinai and Mount Sinai Beth Israel in New York. €¨St.

George Hospital even remained open during Lebanon’s 15-year civil war, a conflict that wracked Beirut and forced Wanna to spend much of his childhood in bomb shelters. Wanna is also working with Mount Sinai to send medical supplies. €œSt. George Hospital is in need of everything needed to run a hospital—beds, ventilators, protective equipment.” The tragedy also affected Wanna’s family. His parents weren’t home when the blast struck and were unharmed.

But “my parents’ home was severely damaged by the blast. Sadly, we lost the lives of several of my dad’s relatives,” he said via email. Wanna, who spent his residency at Mount Sinai, is grateful to the system. €œThey have given me a chance to have the kind of life I could never have hoped for—they helped me build a home and a life in this great country.”Healthcare leaders tell stories about incidents of racism or discrimination in their careers.Dr. Garth GrahamVP and Chief Community Health OfficerCVS HealthDr.

Patrice HarrisImmediate Past PresidentAmerican Medical AssociationDr. James HildrethPresident and CEOMeharry Medical CollegeDr. Carol MajorAssistant Dean of Diversity and InclusionUniversity of California, Irvine School of MedicineDr. Suzet McKinneyCEO and Executive DirectorIllinois Medical DistrictMarvin O’QuinnPresident and COOCommonSpirit Health.

As the wind howled and the rain http://www.margraf-publishers.eu/generic-zithromax-online-for-sale/ slammed down, a team of nurses, respiratory therapists and a doctor worked through the night to care for 19 tiny babies as Hurricane Laura slammed southwestern Louisiana.The babies, some zithromax generic price on ventilators or eating through a feeding tube, seemed to weather the storm just fine, said Dr. Juan Bossano, the medical director of the neonatal intensive care unit at Lake Charles Memorial Hospital for Women. "They did zithromax generic price very well.

They tolerated it very well. We had a very good day," he said.Laura made landfall early Thursday morning as a Category 4 storm, packing top winds of 150 mph (241 kph), and pushing a zithromax generic price storm surge as high as 15 feet in some areas.Hours before it made landfall, officials had to move the babies from the women's hospital to the main hospital in the system after it became clear that storm surge could inundate the women's hospital, located on the southern end of Lake Charles. The hospital has its own generator and hospital administrator Alesha Alford said it was built to withstand hurricane force winds.

But in zithromax generic price the single story facility, there's no room to move up and storm surge in that area was expected to hit nine feet. In a roughly two-hour operation the babies in the intensive care unit were transferred by ambulance to Lake Charles Memorial Hospital, a ten-story facility on the northern side of the city. Trucks carried needed equipment such as incubators.Alford said the storm hadn't yet hit but "the skies looked very ominous." She said everyone pitched in to get supplies moved to zithromax generic price the other hospital."It went as smooth as could be because we had everyone helping," she said.Alford said three mothers who couldn't be discharged from the women's hospital were also transferred.

Two of them had their newborns with them while the child of the third mom was in the intensive care unit. Parents of the other children in the neonatal intensive care unit couldn't stay with them during the storm because zithromax generic price there wasn't enough room so Bossano said one nurse was tasked with calling parents to keep them informed of how their children were doing. Bossano occasionally posted updates on Facebook.Once they got situated at the larger hospital and the winds picked up, Alford said the patients were moved into the hallways.

To "protect our babies," zithromax generic price mattresses were pushed up against the windows to prevent flying glass although none of the windows ended up breaking.She said as huge gusts of wind started coming in, they could feel the building vibrate. In addition to Bossano, the medical staff consisted of two neonatal nurse practitioners, 14 nurses and three respiratory therapists who worked on 12-hour shifts. Some of zithromax generic price the staff slept on air mattresses in the hallway, Alford said.

After making it through the hurricane, the plan was to have the babies stay in Lake Charles. While electricity was out in the city, the hospital has its own generator zithromax generic price. But Alford said the city's water system has been so heavily damaged that it ultimately forced them to transfer the babies as well as other patients to other hospitals around the state Friday.Both Alford and Bossano repeatedly praised the nursing staff for their work in caring for the babies that in some cases were born weighing only a pound or two.

Some of the nursing staff lost their houses in the storm, and they were worried about their own families, but they zithromax generic price put those concerns aside to care for their tiny patients."Really the nurses and the respiratory therapists are the heroes here," Bosanno said. "They showed that very clearly the way they performed."There aren’t many hospital visitors amid the buy antibiotics zithromax. But, if you were to walk through intensive-care units at one New York City hospital, you’d see internet-connected speakers—about the size of a stack of Post-it Notes—affixed to the bedrails of some patient beds.It’s part of a project by two Weill Cornell Medicine doctors to help family members speak with ICU patients, often intubated zithromax generic price or otherwise not able to hold up a phone themselves, from afar.“The patients could be completely sedated, they could be in a coma,” but families still want to be there with them, said Dr.

Marc Schiffman, an interventional radiologist and one of the doctors who spearheaded bringing the devices into ICUs.The speakers, now in 11 units at Weill Cornell, are part of a two-way communication system from company Relay, originally developed as a walkie-talkie system of sorts for children to stay in touch with their parents throughout the day. Users on one end record snippets of conversation using a mobile app, which are automatically played out loud through the small speaker.Users on the other zithromax generic price end push a button on the device to record a response.“Whenever (families) have a story they want to recount, they can just talk into their phone,” Schiffman said. €œIt gives the families a sense of autonomy (and) connection,” even when the patient can’t respond.The effort, dubbed the VoiceLove Project, began about four months ago, at the height of the buy antibiotics zithromax in New York City.Families and other visitors were no longer allowed inside Weill Cornell, but still wanted a way to connect with patients who were sick with buy antibiotics.

Initially, that involved zithromax generic price a nurse standing in the ICU and holding up a phone or tablet so families could see the patient—a task that took time out of their already busy day, potentially exposed them to buy antibiotics and often meant using scarce personal protective equipment.“It really wasn’t a practical solution,” said Dr. Tamatha Fenster, a minimally invasive gynecologic surgeon.So Fenster and Schiffman began brainstorming hands-free technologies they could install directly at the bedside. Schiffman drove to a local zithromax generic price Target store and bought a few Relay walkie-talkie devices.

After testing it with families and patients in the ICU, the two decided it was a “grand slam,” Schiffman said.Since March, hospitals have been trying new ways to keep patients connected to families at home, said Bill Flatley, senior service delivery manager at consulting firm OST. He said zithromax generic price he’s mainly seen hospitals repurpose technology usually used for telemedicine, like tablets and cameras mounted on telemedicine carts.It’s likely hospitals will have to continue to restrict visitors, at least as long as there’s uncertainty around buy antibiotics treatment. So it’s integral for staff to figure out processes that make it easy for families to talk to patients—without putting an additional burden on clinicians or expecting them to serve as tech support.For Fenster and Schiffman, deploying walkie-talkies in the ICU for the first time took some leg work.To scale the walkie-talkie system, Schiffman reached out to Relay’s team via the company’s website, and the company agreed to donate roughly 130 devices and waived the per-user subscription fee.

The doctors and Relay have continued to work zithromax generic price together on best practices for using the devices in ICUs, a use case Relay is marketing and could sell to other hospitals, according to Jon Schniepp, Relay’s senior vice president of marketing.But Fenster and Schiffman couldn’t just bring walkie-talkies into the ICU. In the hospital setting, there are additional quality and privacy concerns. To address those, zithromax generic price the doctors created a disposable case, which made it easier to keep the device sterile and blocked passersby from accidentally pressing the button that would transmit sounds to a family’s Relay app.The two spent thousands of dollars out of their own pockets to devise the best case design, Fenster said, working with an industrial designer in New Jersey to 3D print different models.

The final plastic case, customized with the phrase “VoiceLove” on the front, costs about $10 per case to print and ship. They’ve started reaching out to acute-care and post-acute facilities in California, Texas and other buy antibiotics hot spots to explain how the VoiceLove Project works, hoping to zithromax generic price connect other groups with Relay and share the case design. But the doctors say they’re still working out the logistics of getting the equipment to interested organizationsWhen Dr.

George Wanna saw zithromax generic price how devastated St. George Hospital University Medical Center was by an explosion that shook Beirut, he felt a need to help his hometown. The Aug zithromax generic price.

4 blast in the city’s harbor ravaged St. George’s, so Wanna launched zithromax generic price a GoFundMe page to help the hospital, where a good friend of his, Dr. Alexander Nehme, is chief medical officer.At deadline, more than $86,600 had been raised, with a goal of $100,000.

€œThis is the first time in their 140-year history when zithromax generic price St. George’s Hospital was damaged so severely that it is unable to function,” said Wanna, chair of the otolaryngology department at New York Eye and Ear Infirmary of Mount Sinai and Mount Sinai Beth Israel in New York. €¨St.

George Hospital even remained open during Lebanon’s 15-year civil war, a conflict that wracked Beirut and forced Wanna to spend much of his childhood in bomb shelters. Wanna is also working with Mount Sinai to send medical supplies. €œSt.

George Hospital is in need of everything needed to run a hospital—beds, ventilators, protective equipment.” The tragedy also affected Wanna’s family. His parents weren’t home when the blast struck and were unharmed. But “my parents’ home was severely damaged by the blast.

Sadly, we lost the lives of several of my dad’s relatives,” he said via email. Wanna, who spent his residency at Mount Sinai, is grateful to the system. €œThey have given me a chance to have the kind of life I could never have hoped for—they helped me build a home and a life in this great country.”Healthcare leaders tell stories about incidents of racism or discrimination in their careers.Dr.

Garth GrahamVP and Chief Community Health OfficerCVS HealthDr. Patrice HarrisImmediate Past PresidentAmerican Medical AssociationDr. James HildrethPresident and CEOMeharry Medical CollegeDr.

Carol MajorAssistant Dean of Diversity and InclusionUniversity of California, Irvine School of MedicineDr. Suzet McKinneyCEO and Executive DirectorIllinois Medical DistrictMarvin O’QuinnPresident and COOCommonSpirit Health.

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July 12, 2021 -- Now that the buy antibiotics view treatments i took zithromax for chlamydia how long are available for children ages 12 and older, some divorced parents are facing a challenge. What to do when one parent wants the kids to get the buy antibiotics treatment and the other parent doesn’t. This is the situation facing Michelle Roy-Augustin*, a divorced mom of two sons, ages 12 and 10, who lives i took zithromax for chlamydia how long in Los Angeles.

While her ex-wife wants their 12-year-old-son to get vaccinated right away, Roy-Augustin would rather wait, as some teenagers, albeit rarely, have had heart inflammation after their second dose of the Pfizer or Moderna treatment, according to the CDC. €œI’d prefer to wait for there to be a larger sample size of kids getting the treatment to see if there any other problems,” says Roy-Augustin. She says that she and her ex-wife are vaccinated and that the two have never disagreed i took zithromax for chlamydia how long about any of the other vaccinations their sons have received throughout their childhood.

€œThis is the first time we’ve disagreed about something like this. We’ve been i took zithromax for chlamydia how long remarkably on the same page with most of our co-parenting decisions -- until now.” Ask divorce attorneys, and they’ll tell you that they’ve litigated plenty of treatment issues between ex-spouses lately. But the law is clear.

Generally speaking, if the parents aren’t divorced or living under an order, either parent can give consent for a child to be vaccinated, says Jennifer S. Hargrave, a i took zithromax for chlamydia how long divorce attorney at Hargrave Family Law in Dallas. €œHowever, once the parents separate and are living under a parenting order [such as a divorce decree], the order will govern which parent has the rights to decide on a child’s medical care, including ‘invasive medical procedures’ such as treatments, since these puncture the skin,” she says.

Depending on the agreement, the right to consent to this sort of procedure requires both parents to agree. In other words, if one parent does not agree to it, then the other parent can stop the child from getting the treatment, Hargrave says i took zithromax for chlamydia how long. €œThe other parent can ask the court to use their judgment to step in and determine whether the child should have the treatment,” she says.

For Roy-Augustin, the i took zithromax for chlamydia how long to-treatment-or-not negotiation with her ex-spouse remains ongoing -- and stressful. €œI text my ex studies about the side effects of the treatment, but I doubt she reads them,” she says. €œMy ex operates in a state of constant health anxiety.

I think she’s assuming the schools will mandate the treatment and then I’ll have no choice.” Until the buy antibiotics i took zithromax for chlamydia how long treatment becomes mandatory -- if that happens, that is -- neither parent should unilaterally sign off on a child’s treatment without the other’s consent, says Chantelle A. Porter, a family law attorney at A. Traub & i took zithromax for chlamydia how long.

Associates in Lombard, IL. €œIt’s best to inform the other parent if you have the sole decision-making responsibility or get consent from your ex-spouse if you have joint decision-making,” she says. If you still can’t come i took zithromax for chlamydia how long to a resolution and you remain in two separate treatment camps, with neither party even coming close to a concession, you might consider sitting down with your child’s pediatrician or a mediator.

€œI believe it helps for both parents to sit down and have a conversation with an expert about the pros and cons of the treatment,” Porter says. €œIt’s also a neutral place where you can raise any concerns you might have.” As for Roy-Augustin, she’s hoping to decide by the fall. "We now have millions i took zithromax for chlamydia how long of kids getting their second shot,” she says.

€œIf there aren’t any problems by October, then I will consider it -- but maybe the J&J and not two shots?. € Three Ways to Bridge the buy antibiotics treatment Gap If you and your spouse just can’t decide whether or i took zithromax for chlamydia how long not to have your child vaccinated against buy antibiotics, you should find a way to discuss this maturely, because this issue isn’t going to disappear overnight, says Elizabeth Cohen, PhD, a clinical psychologist in private practice in New York City and author of Light on the Other Side of Divorce. Below, Cohen, also the self-described “Divorce Doctor,” suggests three ways to best communicate about this.

1. Separate your feelings for your ex from your co-parenting i took zithromax for chlamydia how long responsibilities In fact, your goal should be to rethink the entire way you’re talking to your ex, Cohen says. €œAsk yourself.

€˜If I was negotiating with a i took zithromax for chlamydia how long business partner, how would I approach this situation?. €™â€ she suggests. €œYes, your ex is someone you have likely had a long history of not feeling heard.

And, yes, i took zithromax for chlamydia how long this is playing into your conversations with your ex, but you have to put those feelings aside for the sake of resolving this.” 2. Stay factual Avoid saying things like, “‘You always’ or ‘You never cared about the kids’ medical stuff before, why do you care now?. €™â€ Cohen suggests.

€œInstead, be very clear about why you feel like this is the right i took zithromax for chlamydia how long decision,” she says. €œAgain, explain it as if you were talking to a neutral person and take any emotional language out of the discussion.” 3. Respect your ex’s point of view It can be very challenging, but it’s very important to come from i took zithromax for chlamydia how long a place of respect for the other person’s opinion, Cohen says.

€œRemember, your ex feels just as strongly about this as you do,” she says. €œAsk him or her to explain how they came to their decision. Remember.

Your underlying anger and resentment towards this person has nothing to do with whether your child should get the treatment -- or not.” *Name has been changed for privacy purposes WebMD Health News Sources Michelle Roy-Augustin, Los Angeles. Jennifer S. Hargrave, divorce attorney, Hargrave Family Law, Dallas.

Chantelle A. Porter, family law attorney, A. Traub &.

Associates, Lombard, IL. Elizabeth Cohen, PhD, clinical psychologist, New York City. Author, Light on the Other Side of Divorce.

© 2021 WebMD, LLC. All rights reserved.CDC. €œantibiotics Variant Classifications and Definitions.

Variant of Interest,” “antibiotics Variant Classifications and Definitions. Variant of Concern,” “antibiotics Variant Classifications and Definitions. Variant of High Consequence,” “Selected Characteristics of antibiotics Variants of Concern.

B.1.617.2,” “buy antibiotics Data Tracker. Global Variants Report,” “Selected Characteristics of antibiotics Variants of Interest. B.1.427.” The Washington Post.

€œWhat you need to know about the highly contagious delta variant.” Yale Medicine. €œ5 Things To Know About the Delta Variant.” CBS News. €œDelta Plus.

As U.S. Grapples with Delta variant, India raises alarm over a new buy antibiotics strain mutated from it.” Public Health England. €œantibiotics variants of concern and variants under investigation in England, July 9, 2021,” “treatments highly effective against hospitalisation from Delta variant.” ZOE buy antibiotics Symptom Study.

€œWhat are the new top 5 buy antibiotics symptoms?. € The Lancet. €œantibiotics Delta VOC in Scotland.

Demographics, risk of hospital admission, and treatment effectiveness.” Imperial College London. €œREACT-1 round 12 report. Resurgence of antibiotics s in England associated with increased frequency of the Delta variant.” CNN.

€œPfizer says it’s time for a buy antibiotics booster. FDA and CDC say not so fast.” NBC News. €œThe delta variant.

Everything you need to know.” Science. €œantibiotics immune evasion by the B.1.427/B.1.429 variant of concern.” The New York Times. €œbuy antibiotics’s Lambda Variant.

Worth Watching, but No Cause for Alarm.”MRI-guided focused uasound combined with microbubbles can open the blood-brain barrier (BBB) and allow therapeutic drugs to reach the diseased brain location under the guidance of MRI. It is a promising technique that has been shown safe in patients with various brain diseases, such as Alzheimer's diseases, Parkinson's disease, ALS, and glioblastoma. While MRI has been commonly used for treatment guidance and assessment in preclinical research and clinical studies, until now, researchers did not know the impact of the static magnetic field generated by the MRI scanner on the BBB opening size and drug delivery efficiency.In new research published in Radiology, Hong Chen and her lab at Washington University in St.

Louis have found for the first time that the magnetic field of the MRI scanner decreased the BBB opening volume by 3.3-fold to 11.7-fold, depending on the strength of the magnetic field, in a mouse model.Chen, associate professor of biomedical engineering in the McKelvey School of Engineering and of radiation oncology in the School of Medicine, and her lab conducted the study on 30 mice divided into four groups. After the mice received the injection of the microbubbles, three groups received focused-uasound sonication at different strengths of the magnetic field. 1.5 T (teslas), 3 T and 4.7 T, while one group never entered the magnetic field.They found that the activity of the microbubble cavitation, or the expansion, contraction and collapse of the microbubbles, decreased by 2.1 decibels at 1.5 T.

2.9 decibels at 3 T. And 3 decibels at 4.7 T, compared with those that had received the dose outside of the magnetic field. In addition, the magnetic field decreased the BBB opening volume by 3.3-fold at 1.5 T.

4.4-fold at 3 T. And 11.7-fold at 4.7 T. None of the mice showed any tissue damage from the procedure.Following focused-uasound sonication, the team injected a model drug, Evans blue, to test whether the static magnetic field affects trans-BBB drug delivery efficiency.

The images showed that the fluorescence intensity of the Evans blue was lower in mice that received the treatment in one of the three strengths of magnetic fields compared with mice treated outside the magnetic field. The Evans blue trans-BBB delivery was decreased by 1.4-fold at1.5 T, 1.6-fold at 3.0 T and 1.9-fold at 4.7 T when compared with those treated outside of the magnetic field."The dampening effect of the magnetic field on the microbubble is likely caused by the loss of bubble kinetic energy due to the Lorentz force acting on the moving charged lipid molecules on the microbubble shell and dipolar water molecules surrounding the microbubbles," said Yaoheng (Mack) Yang, a doctoral student in Chen's lab and the lead author of the study."Findings from this study suggest that the impact of the magnetic field needs to be considered in the clinical applications of focused uasound in brain drug delivery," Chen said.In addition to brain drug delivery, cavitation is also the fundamental physical mechanism for several other therapeutic techniques, such as histotripsy, the use of cavitation to mechanically destroy regions of tissue, and sonothrombolysis, a therapy used after acute ischemic stroke. The dampening effect induced by the magnetic field on cavitation is expected to affect the treatment outcomes of other cavitation-mediated techniques when MRI-guided focused-uasound systems are used.

Story Source. Materials provided by Washington University in St. Louis.

Original written by Beth Miller. Note. Content may be edited for style and length.Recall a phone number or directions just recited and your brain will be actively communicating across many regions.

It is thought that working memory relies on interactions between these regions, but how these brain areas interact and properly represent memory has remained a mystery.At Baylor College of Medicine, Dr. Nuo Li, assistant professor of neuroscience and a McNair Scholar, and his colleagues investigated the nature of the communication between brain regions involved in working memory and found evidence that a modular network organization is critical for persistent neural activity.How brain regions communicateLi and his colleagues were able to see that each hemisphere of the brain has a separate representation of a memory. However, the hemispheres are tightly coordinated on a moment-to-moment basis, resulting in highly coherent information across them during working memory.In their study, the researchers engaged mice in a simple behavior that would require them to store specific information.

They were trained to delay an instructed action for a few seconds. This time delay gave researchers the chance to look at brain activity during the memory process."We saw many neurons simultaneously firing from both hemispheres of the cortex in a coordinated fashion. If activity went up in one region, the other region followed closely.

We hypothesized that the interactions between brain hemispheres is what was responsible for this memory," Li said.Li and his colleagues recorded activity in each hemisphere, showing that each one made its own copy of information during the memory process. So how are the two hemispheres communicating?. Li explained that through the use of optogenetics they were able to corrupt information in a single hemisphere, affecting thousands of neurons during the memory period.

What they found was unexpected."When we disrupted one hemisphere, the other area turned off communication, basically preventing the corruption from spreading and affecting activity in other regions," Li said. "This is similar to modern networks such as electricity grids. They are connected to allow for the flow of electricity but also monitor for faults, shutting down connections when necessary so the entire electrical grid doesn't fail."In collaboration with Dr.

Shaul Druckmann and Ph.D. Student Byungwoo Kang at Stanford University, the researchers developed theoretical analyses and network simulations of this process, showing that this modular organization in the brain is critical for the robustness of persistent neural activity. This robustness could be responsible for the brain being able to withstand certain injuries, protecting cognitive function from distractions."Understanding redundant modular organization of the brain will be important for designing neural modulation and repair strategies that are compatible with the brain's natural processing of information," Li said.

Story Source. Materials provided by Baylor College of Medicine. Original written by Graciela Gutierrez.

Note. Content may be edited for style and length.The function of a protein can depend on its abundance in a cell. So, when investigating the properties of a new protein, it is essential to make sure that the same amount is produced by every cell.

Researchers at Baylor College of Medicine and Rice University have found a new way to do just that through the creation of new genetic circuits called Equalizers.The findings, in the current edition of Nature Communications, show how researchers engineered these genetic circuits to buffer protein output from variations in the number of copies of the gene inside the cell, thereby helping to create consistent protein expression. This property is called "gene dosage compensation."The researchers use an analogy of heating a house to help explain how Equalizers work. Imagine using randomly placed space heaters to heat your home.

To ensure each room gets a heater you would purchase some extra ones, but that would mean some rooms might have extra heaters. Those rooms might be too hot, so a solution would be to have thermostats on each heater to downregulate the heat when a room becomes too hot. Those thermostats act as the Equalizer.Researchers typically encode genes to be expressed on circular pieces of DNA called plasmids.

Excess plasmids are often used to ensure that most cells get one, but some cells will get several. The Equalizer is composed of transcriptional negative feedback and post-transcriptional incoherent feedforward loops. These loops counteract the presence of extra plasmids.

They sense the outputs, in this case the proteins and mRNAs that the plasmids produce, and tune down their expression if they rise too high."We didn't invent the parts, but rather we invented a new way to connect them together into a circuit," said Jin Yang, who shared co-first authorship of the paper with graduate student Jihwan Lee of Rice University. Jin was a bioengineering undergrad at Rice University while developing this work and currently is a Ph.D. Student at the Massachusetts Institute of Technology.

"In natural systems, some gene networks must control gene dosage variation to remain functional and conserve their properties.We repurposed and combined two types of gene dosage compensation circuits to create a version that enables uniform expression of any protein scientists want to produce in the lab."Negative feedback and incoherent feedforward circuit subcircuits can each help compensate for gene dosage, but the researchers found that coupling the two improved overall performance. This is because each circuit is not perfect. For example, the incoherent feedforward loop can saturate because it requires other proteins that are present in limited quantities in the cell.

The negative feedback loop is limited in its inhibitory capacity, similar to a leaky sink faucet that cannot be fully closed. But combining these two imperfect circuits produced robust performance, with each circuit helping mitigate the limitation of the other."The process we used for these findings was a collaborative effort bringing together computer simulations and biology. This is similar to how engineers work -- they draw up their plans, create a model and then build their structure," said Dr.

Oleg Igoshin, professor of bioengineering, of biosciences and of chemistry at Rice University and a senior author on the paper. "In this case we were able to create our model and show the effectiveness through computational models before it was then synthetically engineered in the lab."But why is minimizing expression variation important when it comes to biological research?. "The effect of a protein can depend on its abundance in a cell.

If you're studying a new protein and its concentration is too low, you may not be able to observe its function in the cell. If its concentration is too high, the protein may mislocalize, aggregate, produce cytotoxicity or otherwise produce responses that are not physiological. It is therefore important that a protein is expressed at the desired level in every cell under investigation," said Dr.

François St-Pierre, assistant professor of neuroscience and McNair Scholar at Baylor and corresponding author of this study. "We believe Equalizers will be of high value both for basic research and for industry."Others who took part in this research include Michelle A. Land and Shujuan Lai, both with Baylor College of Medicine.The research was supported by the Welch Foundation, a Klingenstein-Simons Fellowship Award in Neuroscience, the McNair Medical Foundation, the National Science Foundation (including the NSF-supported Center for Theoretical Biological Physics), the National Institutes of Health, and the Cancer Prevention and Research Institute of Texas.

Story Source. Materials provided by Baylor College of Medicine. Note.

Content may be edited for style and length..

July 12, 2021 -- Now that the buy antibiotics treatments are available for children ages 12 and older, zithromax generic price some divorced parents are facing http://mcgrawleague.net/best-price-for-levitra-20mg/ a challenge. What to do when one parent wants the kids to get the buy antibiotics treatment and the other parent doesn’t. This is the situation facing Michelle Roy-Augustin*, a divorced mom zithromax generic price of two sons, ages 12 and 10, who lives in Los Angeles.

While her ex-wife wants their 12-year-old-son to get vaccinated right away, Roy-Augustin would rather wait, as some teenagers, albeit rarely, have had heart inflammation after their second dose of the Pfizer or Moderna treatment, according to the CDC. €œI’d prefer to wait for there to be a larger sample size of kids getting the treatment to see if there any other problems,” says Roy-Augustin. She says that she and her ex-wife are vaccinated and that the two have never disagreed zithromax generic price about any of the other vaccinations their sons have received throughout their childhood.

€œThis is the first time we’ve disagreed about something like this. We’ve been remarkably on the same page with most of our co-parenting decisions -- until now.” Ask divorce attorneys, and they’ll tell you zithromax generic price that they’ve litigated plenty of treatment issues between ex-spouses lately. But the law is clear.

Generally speaking, if the parents aren’t divorced or living under an order, either parent can give consent for a child to be vaccinated, says Jennifer S. Hargrave, a divorce attorney at Hargrave Family Law in Dallas zithromax generic price. €œHowever, once the parents separate and are living under a parenting order [such as a divorce decree], the order will govern which parent has the rights to decide on a child’s medical care, including ‘invasive medical procedures’ such as treatments, since these puncture the skin,” she says.

Depending on the agreement, the right to consent to this sort of procedure requires both parents to agree. In other words, if one parent does not agree to it, then the other parent can stop the zithromax generic price child from getting the treatment, Hargrave says. €œThe other parent can ask the court to use their judgment to step in and determine whether the child should have the treatment,” she says.

For Roy-Augustin, the to-treatment-or-not negotiation with her ex-spouse remains ongoing zithromax generic price -- and stressful. €œI text my ex studies about the side effects of the treatment, but I doubt she reads them,” she says. €œMy ex operates in a state of constant health anxiety.

I think she’s assuming the schools will mandate the treatment and then I’ll have no choice.” Until the buy antibiotics treatment becomes mandatory -- if that happens, that is -- neither parent should zithromax generic price unilaterally sign off on a child’s treatment without the other’s consent, says Chantelle A. Porter, a family law attorney at A. Traub & zithromax generic price.

Associates in Lombard, IL. €œIt’s best to inform the other parent if you have the sole decision-making responsibility or get consent from your ex-spouse if you have joint decision-making,” she says. If you still can’t come to a resolution and zithromax generic price you remain in two separate treatment camps, with neither party even coming close to a concession, you might consider sitting down with your child’s pediatrician or a mediator.

€œI believe it helps for both parents to sit down and have a conversation with an expert about the pros and cons of the treatment,” Porter says. €œIt’s also a neutral place where you can raise any concerns you might have.” As for Roy-Augustin, she’s hoping to decide by the fall. "We now have millions of kids getting their second shot,” she zithromax generic price says.

€œIf there aren’t any problems by October, then I will consider it -- but maybe the J&J and not two shots?. € Three Ways to Bridge the buy antibiotics treatment Gap If you and your spouse just can’t decide whether or not to have your child vaccinated against buy antibiotics, you should find a way to discuss this maturely, because this issue isn’t going to disappear overnight, says Elizabeth Cohen, PhD, a clinical psychologist in private practice in New York City and zithromax generic price author of Light on the Other Side of Divorce. Below, Cohen, also the self-described “Divorce Doctor,” suggests three ways to best communicate about this.

1. Separate your feelings zithromax generic price for your ex from your co-parenting responsibilities In fact, your goal should be to rethink the entire way you’re talking to your ex, Cohen says. €œAsk yourself.

€˜If I was negotiating with a business zithromax generic price partner, how would I approach this situation?. €™â€ she suggests. €œYes, your ex is someone you have likely had a long history of not feeling heard.

And, yes, this is playing into your conversations with your ex, but you have to put those feelings aside for zithromax generic price the sake of resolving this.” 2. Stay factual Avoid saying things like, “‘You always’ or ‘You never cared about the kids’ medical stuff before, why do you care now?. €™â€ Cohen suggests.

€œInstead, be very clear about why you feel like this is the zithromax generic price right decision,” she says. €œAgain, explain it as if you were talking to a neutral person and take any emotional language out of the discussion.” 3. Respect your ex’s point of zithromax generic price view It can be very challenging, but it’s very important to come from a place of respect for the other person’s opinion, Cohen says.

€œRemember, your ex feels just as strongly about this as you do,” she says. €œAsk him or her to explain how they came to their decision. Remember.

Your underlying anger and resentment towards this person has nothing to do with whether your child should get the treatment -- or not.” *Name has been changed for privacy purposes WebMD Health News Sources Michelle Roy-Augustin, Los Angeles. Jennifer S. Hargrave, divorce attorney, Hargrave Family Law, Dallas.

Chantelle A. Porter, family law attorney, A. Traub &.

Associates, Lombard, IL. Elizabeth Cohen, PhD, clinical psychologist, New York City. Author, Light on the Other Side of Divorce.

© 2021 WebMD, LLC. All rights reserved.CDC. €œantibiotics Variant Classifications and Definitions.

Variant of Interest,” “antibiotics Variant Classifications and Definitions. Variant of Concern,” “antibiotics Variant Classifications and Definitions. Variant of High Consequence,” “Selected Characteristics of antibiotics Variants of Concern.

B.1.617.2,” “buy antibiotics Data Tracker. Global Variants Report,” “Selected Characteristics of antibiotics Variants of Interest. B.1.427.” The Washington Post.

€œWhat you need to know about the highly contagious delta variant.” Yale Medicine. €œ5 Things To Know About the Delta Variant.” CBS News. €œDelta Plus.

As U.S. Grapples with Delta variant, India raises alarm over a new buy antibiotics strain mutated from it.” Public Health England. €œantibiotics variants of concern and variants under investigation in England, July 9, 2021,” “treatments highly effective against hospitalisation from Delta variant.” ZOE buy antibiotics Symptom Study.

€œWhat are the new top 5 buy antibiotics symptoms?. € The Lancet. €œantibiotics Delta VOC in Scotland.

Demographics, risk of hospital admission, and treatment effectiveness.” Imperial College London. €œREACT-1 round 12 report. Resurgence of antibiotics s in England associated with increased frequency of the Delta variant.” CNN.

€œPfizer says it’s time for a buy antibiotics booster. FDA and CDC say not so fast.” NBC News. €œThe delta variant.

Everything you need to know.” Science. €œantibiotics immune evasion by the B.1.427/B.1.429 variant of concern.” The New York Times. €œbuy antibiotics’s Lambda Variant.

Worth Watching, but No Cause for Alarm.”MRI-guided focused uasound combined with microbubbles can open the blood-brain barrier (BBB) and allow therapeutic drugs to reach the diseased brain location under the guidance of MRI. It is a promising technique that has been shown safe in patients with various brain diseases, such as Alzheimer's diseases, Parkinson's disease, ALS, and glioblastoma. While MRI has been commonly used for treatment guidance and assessment in preclinical research and clinical studies, until now, researchers did not know the impact of the static magnetic field generated by the MRI scanner on the BBB opening size and drug delivery efficiency.In new research published in Radiology, Hong Chen and her lab at Washington University in St.

Louis have found for the first time that the magnetic field of the MRI scanner decreased the BBB opening volume by 3.3-fold to 11.7-fold, depending on the strength of the magnetic field, in a mouse model.Chen, associate professor of biomedical engineering in the McKelvey School of Engineering and of radiation oncology in the School of Medicine, and her lab conducted the study on 30 mice divided into four groups. After the mice received the injection of the microbubbles, three groups received focused-uasound sonication at different strengths of the magnetic field. 1.5 T (teslas), 3 T and 4.7 T, while one group never entered the magnetic field.They found that the activity of the microbubble cavitation, or the expansion, contraction and collapse of the microbubbles, decreased by 2.1 decibels at 1.5 T.

2.9 decibels at 3 T. And 3 decibels at 4.7 T, compared with those that had received the dose outside of the magnetic field. In addition, the magnetic field decreased the BBB opening volume by 3.3-fold at 1.5 T.

4.4-fold at 3 T. And 11.7-fold at 4.7 T. None of the mice showed any tissue damage from the procedure.Following focused-uasound sonication, the team injected a model drug, Evans blue, to test whether the static magnetic field affects trans-BBB drug delivery efficiency.

The images showed that the fluorescence intensity of the Evans blue was lower in mice that received the treatment in one of the three strengths of magnetic fields compared with mice treated outside the magnetic field. The Evans blue trans-BBB delivery was decreased by 1.4-fold at1.5 T, 1.6-fold at 3.0 T and 1.9-fold at 4.7 T when compared with those treated outside of the magnetic field."The dampening effect of the magnetic field on the microbubble is likely caused by the loss of bubble kinetic energy due to the Lorentz force acting on the moving charged lipid molecules on the microbubble shell and dipolar water molecules surrounding the microbubbles," said Yaoheng (Mack) Yang, a doctoral student in Chen's lab and the lead author of the study."Findings from this study suggest that the impact of the magnetic field needs to be considered in the clinical applications of focused uasound in brain drug delivery," Chen said.In addition to brain drug delivery, cavitation is also the fundamental physical mechanism for several other therapeutic techniques, such as histotripsy, the use of cavitation to mechanically destroy regions of tissue, and sonothrombolysis, a therapy used after acute ischemic stroke. The dampening effect induced by the magnetic field on cavitation is expected to affect the treatment outcomes of other cavitation-mediated techniques when MRI-guided focused-uasound systems are used.

Story Source. Materials provided by Washington University in St. Louis.

Original written by Beth Miller. Note. Content may be edited for style and length.Recall a phone number or directions just recited and your brain will be actively communicating across many regions.

It is thought that working memory relies on interactions between these regions, but how these brain areas interact and properly represent memory has remained a mystery.At Baylor College of Medicine, Dr. Nuo Li, assistant professor of neuroscience and a McNair Scholar, and his colleagues investigated the nature of the communication between brain regions involved in working memory and found evidence that a modular network organization is critical for persistent neural activity.How brain regions communicateLi and his colleagues were able to see that each hemisphere of the brain has a separate representation of a memory. However, the hemispheres are tightly coordinated on a moment-to-moment basis, resulting in highly coherent information across them during working memory.In their study, the researchers engaged mice in a simple behavior that would require them to store specific information.

They were trained to delay an instructed action for a few seconds. This time delay gave researchers the chance to look at brain activity during the memory process."We saw many neurons simultaneously firing from both hemispheres of the cortex in a coordinated fashion. If activity went up in one region, the other region followed closely.

We hypothesized that the interactions between brain hemispheres is what was responsible for this memory," Li said.Li and his colleagues recorded activity in each hemisphere, showing that each one made its own copy of information during the memory process. So how are the two hemispheres communicating?. Li explained that through the use of optogenetics they were able to corrupt information in a single hemisphere, affecting thousands of neurons during the memory period.

What they found was unexpected."When we disrupted one hemisphere, the other area turned off communication, basically preventing the corruption from spreading and affecting activity in other regions," Li said. "This is similar to modern networks such as electricity grids. They are connected to allow for the flow of electricity but also monitor for faults, shutting down connections when necessary so the entire electrical grid doesn't fail."In collaboration with Dr.

Shaul Druckmann and Ph.D. Student Byungwoo Kang at Stanford University, the researchers developed theoretical analyses and network simulations of this process, showing that this modular organization in the brain is critical for the robustness of persistent neural activity. This robustness could be responsible for the brain being able to withstand certain injuries, protecting cognitive function from distractions."Understanding redundant modular organization of the brain will be important for designing neural modulation and repair strategies that are compatible with the brain's natural processing of information," Li said.

Story Source. Materials provided by Baylor College of Medicine. Original written by Graciela Gutierrez.

Note. Content may be edited for style and length.The function of a protein can depend on its abundance in a cell. So, when investigating the properties of a new protein, it is essential to make sure that the same amount is produced by every cell.

Researchers at Baylor College of Medicine and Rice University have found a new way to do just that through the creation of new genetic circuits called Equalizers.The findings, in the current edition of Nature Communications, show how researchers engineered these genetic circuits to buffer protein output from variations in the number of copies of the gene inside the cell, thereby helping to create consistent protein expression. This property is called "gene dosage compensation."The researchers use an analogy of heating a house to help explain how Equalizers work. Imagine using randomly placed space heaters to heat your home.

To ensure each room gets a heater you would purchase some extra ones, but that would mean some rooms might have extra heaters. Those rooms might be too hot, so a solution would be to have thermostats on each heater to downregulate the heat when a room becomes too hot. Those thermostats act as the Equalizer.Researchers typically encode genes to be expressed on circular pieces of DNA called plasmids.

Excess plasmids are often used to ensure that most cells get one, but some cells will get several. The Equalizer is composed of transcriptional negative feedback and post-transcriptional incoherent feedforward loops. These loops counteract the presence of extra plasmids.

They sense the outputs, in this case the proteins and mRNAs that the plasmids produce, and tune down their expression if they rise too high."We didn't invent the parts, but rather we invented a new way to connect them together into a circuit," said Jin Yang, who shared co-first authorship of the paper with graduate student Jihwan Lee of Rice University. Jin was a bioengineering undergrad at Rice University while developing this work and currently is a Ph.D. Student at the Massachusetts Institute of Technology.

"In natural systems, some gene networks must control gene dosage variation to remain functional and conserve their properties.We repurposed and combined two types of gene dosage compensation circuits to create a version that enables uniform expression of any protein scientists want to produce in the lab."Negative feedback and incoherent feedforward circuit subcircuits can each help compensate for gene dosage, but the researchers found that coupling the two improved overall performance. This is because each circuit is not perfect. For example, the incoherent feedforward loop can saturate because it requires other proteins that are present in limited quantities in the cell.

The negative feedback loop is limited in its inhibitory capacity, similar to a leaky sink faucet that cannot be fully closed. But combining these two imperfect circuits produced robust performance, with each circuit helping mitigate the limitation of the other."The process we used for these findings was a collaborative effort bringing together computer simulations and biology. This is similar to how engineers work -- they draw up their plans, create a model and then build their structure," said Dr.

Oleg Igoshin, professor of bioengineering, of biosciences and of chemistry at Rice University and a senior author on the paper. "In this case we were able to create our model and show the effectiveness through computational models before it was then synthetically engineered in the lab."But why is minimizing expression variation important when it comes to biological research?. "The effect of a protein can depend on its abundance in a cell.

If you're studying a new protein and its concentration is too low, you may not be able to observe its function in the cell. If its concentration is too high, the protein may mislocalize, aggregate, produce cytotoxicity or otherwise produce responses that are not physiological. It is therefore important that a protein is expressed at the desired level in every cell under investigation," said Dr.

François St-Pierre, assistant professor of neuroscience and McNair Scholar at Baylor and corresponding author of this study. "We believe Equalizers will be of high value both for basic research and for industry."Others who took part in this research include Michelle A. Land and Shujuan Lai, both with Baylor College of Medicine.The research was supported by the Welch Foundation, a Klingenstein-Simons Fellowship Award in Neuroscience, the McNair Medical Foundation, the National Science Foundation (including the NSF-supported Center for Theoretical Biological Physics), the National Institutes of Health, and the Cancer Prevention and Research Institute of Texas.

Story Source. Materials provided by Baylor College of Medicine. Note.

Content may be edited for style and length..

Zithromax precio usa

The term “mRNA” only entered the average household in the zithromax precio usa past few months, as Moderna and http://steveplattner.com/where-can-i-buy-zithromax-online/ Pfizer-BioNTech released their buy antibiotics treatments. But a handful of scientists have spent decades studying this novel approach to immunization. By the start of the zithromax the technology was already so advanced that, when Chinese researchers published the genetic sequence for the antibiotics zithromax precio usa in mid-January, Moderna was able to concoct a treatment within 48 hours. Clinical trials began a matter of weeks after that.

In nine months, the world was well on its way to viral security.It was a stunning debut for mRNA — shorthand for messenger ribonucleic acid, DNA’s zithromax precio usa sidekick — which had long ranked as a promising but unproven treatment. After this encouraging success, its proponents predict an equally impressive future. They have always believed in mRNA’s ability to protect against not only the likes of antibiotics, but also a host of deadly diseases that resist traditional treatments, from malaria to HIV to cancer. In 2018, long before zithromax precio usa the past year’s confidence-boosting display, a group of researchers announced “a new era in vaccinology.”It remains to be seen whether mRNA will live up to the hype.

With concrete results attesting to its potential, though, interest is growing among investors and researchers alike. It helps that regulatory agencies and the public are familiar with it now, too, zithromax precio usa says Yale immunologist Rick Bucala. €œThat has really changed the landscape.”Andrew Geall, co-founder of one company testing RNA treatments and chief scientific officer of another, notes that mRNA has only just entered its infancy after a long gestation. Such is the nature zithromax precio usa of scientific progress.

€œWe’ve had the technology bubbling for 20 years, and the major breakthrough is this clinical proof of two treatments,” he says. €œNow we’re set for 10 years of excitement.”Next Steps for mRNAThe goal of any treatment is to train the immune system to recognize and defend against a zithromax. Traditional treatments do so by zithromax precio usa exposing the body to the zithromax itself, weakened or dead, or to a part of the zithromax, called an antigen. The new shots, as their name suggests, introduce only mRNA — the genetic material that, as you may remember from high school biology, carries instructions for making proteins.

Once the mRNA enters the cells, particles called ribosomes read its instructions and use them to build the encoded proteins zithromax precio usa. In the case of the buy antibiotics treatments, those proteins are the crown-shaped “spike” antigens from which the antibiotics derives its name (“corona” means crown in Latin). By themselves they are zithromax precio usa harmless, but the immune system attacks them as foreign invaders, and in doing so learns how to ward off the real zithromax. If it ever rears its spiky head thereafter, the body will remember and swiftly destroy it.But besides liberating the world from the worst zithromax in generations, mRNA could help to vanquish many an intractable illness.

If all the dreams of its advocates are realized, the buy antibiotics treatments may, in hindsight, be only a proof of concept. In February, for example, zithromax precio usa Bucala and his colleagues patented a treatment against malaria, which has likely killed more humans than any other single cause and has mostly withstood immunization.Justin Richner, an immunologist with the University of Illinois, Chicago, is developing an mRNA treatment for dengue, another highly resistant zithromax. Because mRNA is simply a genetic sequence, scientists can easily tweak it as necessary to find the most effective combination. €œOne of the advantages of the mRNA platform is how it can be so easily modified and manipulated to test novel hypotheses,” zithromax precio usa Richner says.Read more.

Dengue Fever Is on the Rise — a Ticking Time Bomb in Many Places Around the WorldGeall says the obvious candidates for mRNA treatments include what he calls the “Big 6,” all of which remain crafty foes. Malaria, cancer, zithromax precio usa tuberculosis HIV, cytomegalozithromax, and respiratory syncytial zithromax. His own company, Replicate Bioscience, is working on the cancer front, as are several others, including BioNTech. Through genetic analysis of individual tumors, patients could one day receive personalized treatments, designed to target the specific mutations afflicting them.Currently, it’s difficult to tell whether an mRNA treatment will work on any particular pathogen.

Many have shown promise in animal trials, only to falter in zithromax precio usa our species. As Geall put it, “mice are not humans.” Some appear to be better bets than others — cytomegalozithromax and RSV respiratory syncytial zithromax in particular — but for now, it’s too early to say where mRNA will next bear fruit. €œDespite all we know about immunology, a lot of it is really zithromax precio usa empiric,” Bucala says. €œYou just have to try things and see if they work.” The zithromax TamerBased on its recent achievements, mRNA’s next act may well involve the next zithromax.

Perhaps its biggest strength is that it can be manufactured at speeds unheard of in the realm of traditional treatments, making it well-suited zithromax precio usa to addressing sudden surges of zithromaxes. €œOne of the great things about the mRNA field is how quickly you can go from a concept into a therapy that is ready for clinical trials,” Richner says. €œWe can make multiple different treatments and test them in a really rapid process.”Read more. buy antibiotics.

A Basic Guide to Different treatment Types and How They WorkSince 2018, Pfizer and BioNTech have been working on an mRNA treatment for seasonal flu. Under the status quo, experts must predict which variation of the zithromax will pose the greatest threat each year and produce treatments to match it. But because mRNA is so easy to edit, it can be modified more efficiently to keep pace with the ever-mutating strains. €œI do think the influenza treatment field will be transformed in the not too distant future,” Richner says.

A similar kind of gene-based treatment, made with self-amplifying RNA (saRNA), is even more nimble. Whereas basic mRNA treatments — like Moderna’s and Pfizer-BioNTech’s — inject all the genetic material at once, the self-amplifying version replicates itself inside the cell. Just a small dose of this potent product can trigger the same immune response as a syringe-full of the current shots. Bucala’s malaria treatment and Geall’s cancer treatments both use this technology.

€œThe big problem is that treatments don’t prevent s,” Bucala says. €œVaccinations prevent s.” With saRNA, manufacturers can ensure a lot more of them. After mRNA’s brilliant battle against buy antibiotics, it’s tempting to think of it as a panacea. But, Bucala says, “Is there something intrinsically revolutionary about mRNA?.

We don’t know yet.”It does come with some logistical challenges. For example, mRNA breaks down easily, so it must be refrigerated throughout the distribution process. Hurdles aside, though, the possibilities are vast, and investment may rise to meet the industry’s ambitions. treatment development isn’t typically a lucrative business, but buy antibiotics has made more than a few billionaires, “and others are watching,” Bucala says.

€œI think it should become economically viable in our [current] model to get into treatment work again.”Geall agrees. Even if some mRNA endeavors fizzle out, at least a few are bound to make the world proud. €œThere’s a lot of money out there that is going to be invested into these new approaches,” he says. €œWe’re going to see failures, but we’re going to see successes for sure.”When the U.S.

Cracked down on drugs in the 1970s, the effort dried up most funding and research into psychedelic substances — which only in the past few years have regained momentum in the field of psychotherapy. In the ’70s, rather than shut down all his work, one psychedelic researcher at Johns Hopkins University, Stan Grof, turned his attention to another potential avenue for attaining non-ordinary states of consciousness. Breathing.Grof, alongside his wife at the time, Christina Grof, developed the term Holotropic Breathwork for this technique, which loosely translates as “moving toward wholeness.” The practice in experiential psychotherapy emerged in the 1980s as a tool for self-exploration and inner healing, and has certified teaches who now facilitate it around the world. The framework integrates music with modern consciousness research, psychology and Eastern spiritual practices, according to the Grof Transpersonal Training program.Many people today teach this intense breathing practice, and other similar techniques that preceded it, such as kundalini yoga or pranayama.

But questions remain about the science behind what exactly is happening in the mind and body while practitioners lie on the floor and breathe persistently in rapid patterns. And some clinicians have raised concerns about the safety, and risks, in a field with limited peer-reviewed studies.Meditation on a Freight TrainStacia Butterfield has been a certified Holotropic Breathwork teacher with Grof Transpersonal Training for roughly 15 years. She committed to the work after having her own life-changing experience at a workshop, and has since worked closely with Grof himself and guided thousands of people in the practice. €œIt’s deceptively simple.

It seems like just turning on music, laying down and taking some breaths, and away you go,” Butterfield says. €œWhat we’re actually relying on is the spontaneous mobilization of the psyche.”First and foremost, a guided Holotropic Breathwork session requires creating a safe container, Butterfield says, where people can let go of inhibitions or mental blocks. Facilitators are trained to guide people through that process in a group setting.One session lasts between two and three hours — often as part of a weekend or week-long retreat. People pair off and alternate in the roles of “sitter” (assisting the other) and “breather” (the person doing the heavy breathing).

To begin, rhythmic drumming sets the mood. The breather lays down and starts breathing rapidly, in a continuous way with no real break between inhales and exhales.The music typically has an emotional arc, almost like a movie soundtrack. It might start off evocative and stimulating, then turn “increasingly dramatic and dynamic, and finally it reaches a breakthrough quality,” according to a guide written by Stan and Christina Grof. This guide notes that when the breathing leads to non-ordinary states of consciousness in a practitioner, “there is a potential for unusually intense projections, including regressed longings for nurturing, sexual contact, or spiritual connection.” Facilitators are advised to assist clients with these feelings as they arise, while following their agreement to conduct the practice in an ethical manner.Butterfield says one core principle, like somatic therapy, is for participants to become aware of the messages and wisdom in their own body.

€œSo many people are so busy, just cruising around [and] keeping the lid on everything else that is going on internally,” she says. €œ[In a session] they can just close their eyes and go inward, and see what’s there.” She says visions, strong bodily sensations and emotions often arise. And she has watched people who had tried years of talk therapy make substantial progress in processing grief and loss, past trauma, life changes or even mental illnesses.One practitioner aptly described this practice as “meditation on a freight train,” Butterfield adds. The reported dramatic experiences spark questions about what might actually be happening within the body and brain.Mysticism or Hyperventilation?.

Pulmonologist Michael Stephen, author of the book Breath Taking, says the practice of Holotropic Breathwork raises red flags for him because of its use of over-breathing, or hyperventilation. Biologically, when someone breathes heavily for an extended period, they can lose too much carbon dioxide, which makes the blood overly alkaline. The phenomenon often triggers an immediately physiological response. €œWe start to get tingly in our fingers and dizzy when we hyperventilate, as our pH is rising too much,” says Stephen.Prolonged, excessive pH levels in the blood can also cause seizures, he adds.

€œJust before seizures happen, you can get lightheaded, a sort of high.” He attributes this to the non-ordinary states of consciousness that people might feel during Holotropic Breathwork. But he says few proper studies have been done on the practice because of the dangers and ethics involved.Casualties of Heavy BreathingAnother breath specialist and integrative psychiatrist, Patricia Gerbarg, says that Holotropic Breathwork, and other forceful respiratory practices such as breath of fire, do have the potential to alter the mind. They can also bring about a lasting impact on people, but it’s not always beneficial or predictable.“It’s a stress on the system. You’re going through rapid changes in oxygen levels and the balance of various substances in the body and the brain,” she says.

And similar to drugs, “people can use them to attain different mental states,” she adds.Read More. Can Breathing Like Wim Hof Make Us Super Human?. Healthy people tend to have a broader tolerance to endure these shifts and unpredictable outcomes. But the same behavior can be harmful to someone who is less healthy, or dealing with a psychological disorder, says Gerbarg, who teaches psychiatry at New York Medical College.“Those kinds of intense, rapid shifts in your brain chemistry can cause adverse effects,” she says, adding that she is familiar with cases where people feel they “never recovered” from what these states did to them.

Some literature uses the term kundalini psychosis, or physio kundalini syndrome, to describe people who cognitively lose touch with reality in pursuit of "spiritual awakening."One of Gerbarg’s concerns about the rise in popularity of these advanced, Eastern breathing practices is how they are inserted into the Western world and modern mindset. (Two other intense and forceful breathing practices include Tummo breathing, with a Tibetan buddhist lineage, and the Wim Hof Method.) The breathwork is often tied closely to a lifestyle and belief system, and many traditional practitioners dedicate hours a day for many years to master the techniques in a healthy way. Alternatively, people in modern Western cultures often struggle to commit to a new practice for 20 minute a day. €œ[Intense breathwork] is becoming increasingly popular and people are doing it online,” Gerbarg says.

€œThey aren’t often aware that there are risks,” or they might not know the pre-existing conditions their students have. The big responsibility ultimately falls on the teachers and facilitators to ensure everyone is safe. A Gentler TouchGerbarg and her husband Richard Brown, a professor of psychiatry at Columbia College of Physicians and Surgeons, have published several books on the healing potential of breath. And they offer evidence-based workshops and teaching resources through their Breath-Body-Mind Foundation.One of their most popular techniques, called coherent breathing, teaches gentle, slower and relaxed respiration.

Once practitioners learn it, they can use it any point throughout the day when stress or anxiety is likely to rise up — even in mundane circumstances like being stuck in a long line — and trigger a string of reactions in the body.The goal is to inhale and exhale slowly through the nose at a rate of about five breaths per minute, or one breath cycle every 12 seconds. Gerbarg says this process can promptly activate the rest-and-restore parasympathetic nervous system throughout the body, with millions of reactions and signals firing every second.Read More. How Slow, Deep Breathing Taps Into a Natural Rhythm in Our Bodies“It tells the brain, ‘the conditions are safe,’ ” she says. €œThe less effort, the more you get out of this one.”The results of this technique may not feel like the freight-train experience of altered consciousness.

But it carries less risk and broader appeal to anyone interested in channeling their own breath for health and wellness..

The term “mRNA” only zithromax generic price entered the average household in the past few months, Where can i buy zithromax online as Moderna and Pfizer-BioNTech released their buy antibiotics treatments. But a handful of scientists have spent decades studying this novel approach to immunization. By the start of the zithromax the technology was already so advanced that, when Chinese researchers published the genetic sequence for the antibiotics in mid-January, Moderna was able to concoct a zithromax generic price treatment within 48 hours. Clinical trials began a matter of weeks after that. In nine months, the world was well on its way to viral security.It was a stunning debut for mRNA — shorthand for zithromax generic price messenger ribonucleic acid, DNA’s sidekick — which had long ranked as a promising but unproven treatment.

After this encouraging success, its proponents predict an equally impressive future. They have always believed in mRNA’s ability to protect against not only the likes of antibiotics, but also a host of deadly diseases that resist traditional treatments, from malaria to HIV to cancer. In 2018, long before the past year’s confidence-boosting display, a group of researchers announced “a new era in vaccinology.”It remains to be seen whether zithromax generic price mRNA will live up to the hype. With concrete results attesting to its potential, though, interest is growing among investors and researchers alike. It helps that regulatory agencies and the public are zithromax generic price familiar with it now, too, says Yale immunologist Rick Bucala.

€œThat has really changed the landscape.”Andrew Geall, co-founder of one company testing RNA treatments and chief scientific officer of another, notes that mRNA has only just entered its infancy after a long gestation. Such is zithromax generic price the nature of scientific progress. €œWe’ve had the technology bubbling for 20 years, and the major breakthrough is this clinical proof of two treatments,” he says. €œNow we’re set for 10 years of excitement.”Next Steps for mRNAThe goal of any treatment is to train the immune system to recognize and defend against a zithromax. Traditional treatments do so by zithromax generic price exposing the body to the zithromax itself, weakened or dead, or to a part of the zithromax, called an antigen.

The new shots, as their name suggests, introduce only mRNA — the genetic material that, as you may remember from high school biology, carries instructions for making proteins. Once the mRNA enters the cells, particles called ribosomes read its instructions and use them to build zithromax generic price the encoded proteins. In the case of the buy antibiotics treatments, those proteins are the crown-shaped “spike” antigens from which the antibiotics derives its name (“corona” means crown in Latin). By themselves they are harmless, zithromax generic price but the immune system attacks them as foreign invaders, and in doing so learns how to ward off the real zithromax. If it ever rears its spiky head thereafter, the body will remember and swiftly destroy it.But besides liberating the world from the worst zithromax in generations, mRNA could help to vanquish many an intractable illness.

If all the dreams of its advocates are realized, the buy antibiotics treatments may, in hindsight, be only a proof of concept. In February, for example, Bucala and his colleagues patented zithromax generic price a treatment against malaria, which has likely killed more humans than any other single cause and has mostly withstood immunization.Justin Richner, an immunologist with the University of Illinois, Chicago, is developing an mRNA treatment for dengue, another highly resistant zithromax. Because mRNA is simply a genetic sequence, scientists can easily tweak it as necessary to find the most effective combination. €œOne of the advantages zithromax generic price of the mRNA platform is how it can be so easily modified and manipulated to test novel hypotheses,” Richner says.Read more. Dengue Fever Is on the Rise — a Ticking Time Bomb in Many Places Around the WorldGeall says the obvious candidates for mRNA treatments include what he calls the “Big 6,” all of which remain crafty foes.

Malaria, cancer, zithromax generic price tuberculosis HIV, cytomegalozithromax, and respiratory syncytial zithromax. His own company, Replicate Bioscience, is working on the cancer front, as are several others, including BioNTech. Through genetic analysis of individual tumors, patients could one day receive personalized treatments, designed to target the specific mutations afflicting them.Currently, it’s difficult to tell whether an mRNA treatment will work on any particular pathogen. Many have shown promise in animal zithromax generic price trials, only to falter in our species. As Geall put it, “mice are not humans.” Some appear to be better bets than others — cytomegalozithromax and RSV respiratory syncytial zithromax in particular — but for now, it’s too early to say where mRNA will next bear fruit.

€œDespite all we know about immunology, a lot of it zithromax generic price is really empiric,” Bucala says. €œYou just have to try things and see if they work.” The zithromax TamerBased on its recent achievements, mRNA’s next act may well involve the next zithromax. Perhaps its biggest strength is that it can be manufactured at speeds unheard of in the realm of traditional treatments, making it zithromax generic price well-suited to addressing sudden surges of zithromaxes. €œOne of the great things about the mRNA field is how quickly you can go from a concept into a therapy that is ready for clinical trials,” Richner says. €œWe can make multiple different treatments and test them in a really rapid process.”Read more.

buy antibiotics. A Basic Guide to Different treatment Types and How They WorkSince 2018, Pfizer and BioNTech have been working on an mRNA treatment for seasonal flu. Under the status quo, experts must predict which variation of the zithromax will pose the greatest threat each year and produce treatments to match it. But because mRNA is so easy to edit, it can be modified more efficiently to keep pace with the ever-mutating strains. €œI do think the influenza treatment field will be transformed in the not too distant future,” Richner says.

A similar kind of gene-based treatment, made with self-amplifying RNA (saRNA), is even more nimble. Whereas basic mRNA treatments — like Moderna’s and Pfizer-BioNTech’s — inject all the genetic material at once, the self-amplifying version replicates itself inside the cell. Just a small dose of this potent product can trigger the same immune response as a syringe-full of the current shots. Bucala’s malaria treatment and Geall’s cancer treatments both use this technology. €œThe big problem is that treatments don’t prevent s,” Bucala says.

€œVaccinations prevent s.” With saRNA, manufacturers can ensure a lot more of them. After mRNA’s brilliant battle against buy antibiotics, it’s tempting to think of it as a panacea. But, Bucala says, “Is there something intrinsically revolutionary about mRNA?. We don’t know yet.”It does come with some logistical challenges. For example, mRNA breaks down easily, so it must be refrigerated throughout the distribution process.

Hurdles aside, though, the possibilities are vast, and investment may rise to meet the industry’s ambitions. treatment development isn’t typically a lucrative business, but buy antibiotics has made more than a few billionaires, “and others are watching,” Bucala says. €œI think it should become economically viable in our [current] model to get into treatment work again.”Geall agrees. Even if some mRNA endeavors fizzle out, at least a few are bound to make the world proud. €œThere’s a lot of money out there that is going to be invested into these new approaches,” he says.

€œWe’re going to see failures, but we’re going to see successes for sure.”When the U.S. Cracked down on drugs in the 1970s, the effort dried up most funding and research into psychedelic substances — which only in the past few years have regained momentum in the field of psychotherapy. In the ’70s, rather than shut down all his work, one psychedelic researcher at Johns Hopkins University, Stan Grof, turned his attention to another potential avenue for attaining non-ordinary states of consciousness. Breathing.Grof, alongside his wife at the time, Christina Grof, developed the term Holotropic Breathwork for this technique, which loosely translates as “moving toward wholeness.” The practice in experiential psychotherapy emerged in the 1980s as a tool for self-exploration and inner healing, and has certified teaches who now facilitate it around the world. The framework integrates music with modern consciousness research, psychology and Eastern spiritual practices, according to the Grof Transpersonal Training program.Many people today teach this intense breathing practice, and other similar techniques that preceded it, such as kundalini yoga or pranayama.

But questions remain about the science behind what exactly is happening in the mind and body while practitioners lie on the floor and breathe persistently in rapid patterns. And some clinicians have raised concerns about the safety, and risks, in a field with limited peer-reviewed studies.Meditation on a Freight TrainStacia Butterfield has been a certified Holotropic Breathwork teacher with Grof Transpersonal Training for roughly 15 years. She committed to the work after having her own life-changing experience at a workshop, and has since worked closely with Grof himself and guided thousands of people in the practice. €œIt’s deceptively simple. It seems like just turning on music, laying down and taking some breaths, and away you go,” Butterfield says.

€œWhat we’re actually relying on is the spontaneous mobilization of the psyche.”First and foremost, a guided Holotropic Breathwork session requires creating a safe container, Butterfield says, where people can let go of inhibitions or mental blocks. Facilitators are trained to guide people through that process in a group setting.One session lasts between two and three hours — often as part of a weekend or week-long retreat. People pair off and alternate in the roles of “sitter” (assisting the other) and “breather” (the person doing the heavy breathing). To begin, rhythmic drumming sets the mood. The breather lays down and starts breathing rapidly, in a continuous way with no real break between inhales and exhales.The music typically has an emotional arc, almost like a movie soundtrack.

It might start off evocative and stimulating, then turn “increasingly dramatic and dynamic, and finally it reaches a breakthrough quality,” according to a guide written by Stan and Christina Grof. This guide notes that when the breathing leads to non-ordinary states of consciousness in a practitioner, “there is a potential for unusually intense projections, including regressed longings for nurturing, sexual contact, or spiritual connection.” Facilitators are advised to assist clients with these feelings as they arise, while following their agreement to conduct the practice in an ethical manner.Butterfield says one core principle, like somatic therapy, is for participants to become aware of the messages and wisdom in their own body. €œSo many people are so busy, just cruising around [and] keeping the lid on everything else that is going on internally,” she says. €œ[In a session] they can just close their eyes and go inward, and see what’s there.” She says visions, strong bodily sensations and emotions often arise. And she has watched people who had tried years of talk therapy make substantial progress in processing grief and loss, past trauma, life changes or even mental illnesses.One practitioner aptly described this practice as “meditation on a freight train,” Butterfield adds.

The reported dramatic experiences spark questions about what might actually be happening within the body and brain.Mysticism or Hyperventilation?. Pulmonologist Michael Stephen, author of the book Breath Taking, says the practice of Holotropic Breathwork raises red flags for him because of its use of over-breathing, or hyperventilation. Biologically, when someone breathes heavily for an extended period, they can lose too much carbon dioxide, which makes the blood overly alkaline. The phenomenon often triggers an immediately physiological response. €œWe start to get tingly in our fingers and dizzy when we hyperventilate, as our pH is rising too much,” says Stephen.Prolonged, excessive pH levels in the blood can also cause seizures, he adds.

€œJust before seizures happen, you can get lightheaded, a sort of high.” He attributes this to the non-ordinary states of consciousness that people might feel during Holotropic Breathwork. But he says few proper studies have been done on the practice because of the dangers and ethics involved.Casualties of Heavy BreathingAnother breath specialist and integrative psychiatrist, Patricia Gerbarg, says that Holotropic Breathwork, and other forceful respiratory practices such as breath of fire, do have the potential to alter the mind. They can also bring about a lasting impact on people, but it’s not always beneficial or predictable.“It’s a stress on the system. You’re going through rapid changes in oxygen levels and the balance of various substances in the body and the brain,” she says. And similar to drugs, “people can use them to attain different mental states,” she adds.Read More.

Can Breathing Like Wim Hof Make Us Super Human?. Healthy people tend to have a broader tolerance to endure these shifts and unpredictable outcomes. But the same behavior can be harmful to someone who is less healthy, or dealing with a psychological disorder, says Gerbarg, who teaches psychiatry at New York Medical College.“Those kinds of intense, rapid shifts in your brain chemistry can cause adverse effects,” she says, adding that she is familiar with cases where people feel they “never recovered” from what these states did to them. Some literature uses the term kundalini psychosis, or physio kundalini syndrome, to describe people who cognitively lose touch with reality in pursuit of "spiritual awakening."One of Gerbarg’s concerns about the rise in popularity of these advanced, Eastern breathing practices is how they are inserted into the Western world and modern mindset. (Two other intense and forceful breathing practices include Tummo breathing, with a Tibetan buddhist lineage, and the Wim Hof Method.) The breathwork is often tied closely to a lifestyle and belief system, and many traditional practitioners dedicate hours a day for many years to master the techniques in a healthy way.

Alternatively, people in modern Western cultures often struggle to commit to a new practice for 20 minute a day. €œ[Intense breathwork] is becoming increasingly popular and people are doing it online,” Gerbarg says. €œThey aren’t often aware that there are risks,” or they might not know the pre-existing conditions their students have. The big responsibility ultimately falls on the teachers and facilitators to ensure everyone is safe. A Gentler TouchGerbarg and her husband Richard Brown, a professor of psychiatry at Columbia College of Physicians and Surgeons, have published several books on the healing potential of breath.

And they offer evidence-based workshops and teaching resources through their Breath-Body-Mind Foundation.One of their most popular techniques, called coherent breathing, teaches gentle, slower and relaxed respiration. Once practitioners learn it, they can use it any point throughout the day when stress or anxiety is likely to rise up — even in mundane circumstances like being stuck in a long line — and trigger a string of reactions in the body.The goal is to inhale and exhale slowly through the nose at a rate of about five breaths per minute, or one breath cycle every 12 seconds. Gerbarg says this process can promptly activate the rest-and-restore parasympathetic nervous system throughout the body, with millions of reactions and signals firing every second.Read More. How Slow, Deep Breathing Taps Into a Natural Rhythm in Our Bodies“It tells the brain, ‘the conditions are safe,’ ” she says. €œThe less effort, the more you get out of this one.”The results of this technique may not feel like the freight-train experience of altered consciousness.

But it carries less risk and broader appeal to anyone interested in channeling their own breath for health and wellness..

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