Walmart created an insulin brand to undercut the market.
The American Diabetes Association (ADA) released in 2018 estimating the total costs of diagnosed diabetes have risen to $327 billion in 2017 from $245 billion in 2012 when the cost was last examined. This represents a 26% increase over a Five-year period.
So, Walmart just launched a more affordable analog insulin branded ReliOn. The Brand is designed to overcome common impediments, like the affordability of and access to diabetes care, especially for those without health insurance. There are three different kinds of ReliOn Novolin insulins available. There is regular, or short-acting, intermediate (N), and a mixed 70/30 available in the ReliOn line of insulins.
ReliOn/NovoLIN N is an intermediate-acting insulin that starts to work within 2 to 4 hours after injection, peaks in 4 to 12 hours, and keeps working for 12 to 18 hours.
The analog insulin vials and will save customers between 58% to 75% off the cash price of branded insulin products, or up to $101 per vial or $251 per package of “FlexPens,” the retailer said. The medication will be available in Walmart pharmacies and Sam’s Club pharmacies in July.
More than 34 million people in the country (11%) suffer from diabetes, with an additional 1.5 million diagnosed within the United States every year, according to the American Diabetes Association.
According to data from the Health Care Cost Institute, people with Type 1 diabetes in the U.S. had to dish out $5,700 per year in 2016, up from $2,600 in 2012.
“The price point, we hope, will improve and hopefully revolutionize the accessibility and affordability of insulin,” said Walmart’s Executive Vice President Cheryl Pegus of the company’s health and wellness department, according to the report.
Seems purely philanthropic but this is the largest grocer and employer in the U.S and now, just like Amazon, will take a cut in the healthcare brand market.
Walmart so far has opened 20 clinics adjacent to its stores with budget-level medical care, including $25 dental cleanings, and $30 annual checkups. They even bought a telehealth company called MeMD in May to offer virtual care and has exerted pressure on the entire pharmaceuticals industry before sending its prescription program to market, which provides monthly supplies of ubiquitous generic drugs for wildly low prices of $4.
Psychedelic Mushrooms Can Regrow Brain Tissue Lost in Depression
According to a new study in the journal of Neuron, psilocybin, which shows up naturally in some mushrooms, has shown signs of increasing durable connections between neurons in mouse brains.
In this study, they used two-photon microscopy to image longitudinally the apical dendritic spines of layer 5 pyramidal neurons in the mouse medial frontal cortex.
What are pyramidal neurons?
Pyramidal neurons are the most populous members of the excitatory family in the brain areas they inhabit. They comprise about two-thirds of all neurons in the mammalian cerebral cortex, which places them center-stage for many important cognitive processes.
What do pyramidal neurons do?
Like many other types of neuron, their main job is to transform synaptic inputs into a patterned output of action potentials. What makes them special is their numerical dominance, as well as the fact that they are ‘projection neurons’ — they often send their axons for long distances, sometimes out of the brain altogether. For example, pyramidal neurons in layer 5 of the motor cortex send their axons down the spinal cord to drive muscles. Pyramidal neurons might thus be thought of as the ‘movers and shakers of the brain.
- Psilocybin improves stress-related behavioral deficit in mice
- Psilocybin increased spine density and spine size in frontal cortical pyramidal cells
- Psilocybin-evoked structural remodeling is persistent for at least 1 month
- The dendritic rewiring is accompanied by elevated excitatory neurotransmission
The researchers observed rising numbers and girth of dendritic spines on the first day following exposure to psilocybin. The girth increase happens to create small protrusions on nerve cells capable of enhancing the way information transmits from one neuron to the next.
These changes persisted for at least a month, and the mice previously placed in stressful situations exhibited improved behavior, with increased neurotransmitter activity, following the administration of psilocybin.
How Depression Affects the Brain
No one knows for sure what causes depression, but researchers have determined that it is definitely a disorder that has biological underpinnings and that the chemistry of the brain plays a big role.
- The hippocampus releases the hormone cortisol when you’re stressed, which includes episodes of depression. When your brain gets flooded with cortisol for long periods of time, it can slow or stop the growth of new neurons in the hippocampus. This results in the hippocampus actually shrinking in size, which in turn leads to memory problems.
- Cortisol and the amygdala
- The influx of cortisol triggered by depression also causes the amygdala to enlarge. This is a part of the brain associated with emotional responses. When it becomes larger and more active, it causes sleep disturbances, changes in activity levels, and changes in other hormones.
- Inflammation shuts down energy production in the neurons, so brain endurance drops, making it harder to read, work, or concentrate for any length of time. This also leads to depression. In the long run, chronic neuroinflammation results in neuron death and brain degenerative disorders.
Nitrates and Nitrites
Manufacturers add nitrites to meat to preserve them. They’re the reason why cured meat is pink or red. In meat, nitrites turn into nitric oxide. This reacts with proteins in the meat, changing its color and helping preserve it.
Nitrates are fairly stable by themselves and not likely to cause direct harm. However, bacteria in your mouth and other enzymes in the body can convert nitrates into nitrites, and those are harmful.
Most of the nitrites we encounter aren’t consumed directly but are converted from nitrates. Nitrites can either turn into:
- nitric oxide, which is beneficial for the body
- nitrosamines, which can be harmful
The relationship between dietary nitrates/nitrites and health is a lot more complex than just saying “they’re bad for us”. For example, the high natural nitrate content of beetroot juice has been credited with lowering blood pressure and enhancing exercise performance. Nitrates are also the active ingredient in some medications for angina.
The difference between the nitrates in vegetables and meat is that the plants absorb them from the ground while for meats it is an additive.
When the nitrites are ingested, one of the things that happen is they react in the acidic environment of the stomach and form nitrosamines.
- Nitrosamines are considered to be cancerous and linked to bowel cancer
For this to occur amines need to be present, chemicals related to ammonia that are found abundantly in protein foods. Nitrosamines can also be created directly in foods through high-heat cooking, as with fried bacon.
Nitrites and cancer link
A total of 22 articles consisting of 49 studies—19 studies for nitrates, 19 studies for nitrites, and 11 studies for N-nitrosodimethylamine (NDMA)
- High nitrates intake was associated with a weak but statistically significant reduced risk of gastric cancer. Whereas increased consumption of nitrites and NDMA seemed to be risk factors for cancer.
According to the IARC, International Agency for Research on Cancer, run by WHO states:
Nitrates or nitrites found primarily in meat sources are probably carcinogenic to humans, conclusions from epidemiologic studies are somewhat mixed. High nitrate intake may be associated with a decreased risk of gastric cancer, whereas nitrite intake may increase the risk of glioma and thyroid and gastric cancers
The North American Meat Institute
“…Nitrates and Nitrites provide a critical food safety function by helping to prevent Botulism and other foodborne illnesses.”
What is NMN
NMN is short for nicotinamide mononucleotide, a molecule naturally occurring in all life forms. NMN is the precursor of the essential molecule nicotinamide adenine dinucleotide (NAD+).
NAD+ is an essential coenzyme required for all cellular life and function. Coenzymes are ‘helper’ molecules that enzymes need in order to function.
Why is NAD and MNM Important
As organisms grow older, they accrue DNA damage due to environmental factors such as radiation, pollution, and imprecise DNA replication. According to the current aging theory, the accumulation of DNA damage is the main cause of aging. Almost all cells contain the ‘molecular machinery’ to repair this damage. This machinery consumes NAD+ and energy molecules. Therefore, excessive DNA damage can drain valuable cellular resources.
- One important DNA repair protein, PARP (Poly (ADP-ribose) polymerase), depends on NAD+ to function. Older individuals experience decreased levels of NAD+. The accumulation of DNA damage as a result of the normal aging process leads to increased PARP, which causes decreased NAD+ concentration. This depletion is exacerbated by any further DNA damage in the mitochondria.
NAD+ plays an especially active role in metabolic processes, such as glycolysis, the TCA Cycle (AKA Krebs Cycle or Citric Acid cycle), and the electron transport chain, which occurs in our mitochondria and is how we obtain cellular energy.
NAD has been shown to effects many parts and functions of our body. Research is currently looking at the potential effects NAD might have on human health and lifespan.
Potential for NAD
- NAD+ is the fuel that helps sirtuins (Sirtuins play a key role in regulating cellular homeostasis) sustain genome integrity and promote DNA repair. Like a car cannot drive without fuel, sirtuins’ activation requires NAD+. Results from animal studies showed that raising NAD+ levels in the body activates sirtuins and increases the lifespans of yeast, worms and mice. Although animal studies showed promising results in anti-aging properties, scientists are still studying how these results can translate to humans.
- Boosting NAD+ levels protects the heart and improves cardiac functions. High blood pressure can cause an enlarged heart and blocked arteries that lead to strokes. In mice, NAD+ boosters have replenished NAD+ levels in the heart and prevented injuries to the heart caused by a lack of blood flow. Other studies have shown that NAD+ boosters can protect mice from abnormal heart enlargement.
- As adults get older the immune system declines, people get ill more easily, and it becomes harder for people to bounce back from illnesses such as the seasonal flu, or even COVID-19. Recent studies have suggested that NAD+ levels play an important role in regulating inflammation and cell survival during the immune response and aging. The study underscored the therapeutic potential of NAD+ for immune dysfunction.
Nicotinamide adenine dinucleotide (NAD) + hydrogen (H) is used as a supplement as well. NADH is used for improving mental clarity, alertness, concentration, and memory; as well as for treating Alzheimer’s disease and dementia. Because of its role in energy production, NADH is also used for improving athletic performance and treating chronic fatigue syndrome (CFS). Unfortunately, there isn’t enough evidence to know whether the supplementation works.
In this episode, we are going to talk about a new breakthrough in CRISPR technology and Ivermectin.
CRPSIR Injected Into Bloodstream treats a Genetic Disease for the First Time
Ever since we started to talk about CRISPR-Cas9, they have been pushing the boundaries of genome modifications. Just in May researchers were using CRISPR to fix cholesterol in monkeys.
Just last year, researchers used CRISPR to turn on a fetal form of hemoglobin to correct sickle cell disease or related disease in several people. The treatment required removing a patient’s diseased blood stem cells, modifying them with CRISPR in a dish, and then infusing them back into the body.
The new major breakthrough in gene modification, researchers at University College London (UCL) injected CRISPR into the blood of six people with a genetic condition between the ages 46 and 64. Three of those people showed positive results, creating the opportunity to further trials using this approach.
The genetic condition is known as transthyretin amyloidosis (TRR). Amyloidosis is a protein misfolding disorder. In this disease, proteins change shape (misfold), then bind together and form amyloid fibrils which deposit in organs. They frequently occur in the peripheral nervous system, which results in a loss of sensation in the extremities (peripheral neuropathy). The autonomic nervous system, which controls involuntary body functions such as blood pressure, heart rate, and digestion, may also be affected by amyloidosis.
These amyloid fibrils usually deposit in:
- The wrist is called the carpal tunnel. This can cause carpal tunnel syndrome, which causes your hand and arm to become numb and tingle.
- The spinal canal, which can cause narrowing of the spinal column (spinal stenosis).
- The heart, which can cause heart failure and/or an irregular heart rhythm called atrial fibrillation.
- Carpal tunnel syndrome and spinal stenosis can develop several years before heart failure.
Most CRISPR-related treatments involve treatment of the cells in-vitro, injecting into the target organ. This study was different because it required a mode of transport of the whole editing assembly inside the cells. Researchers at Regeneron Pharmaceuticals used messenger RNAs (mRNAs), which carry instructions for making proteins. Since the host cell can use the mRNAs to make its own proteins, researchers simply needed to send enough information to enable CRISPR editing inside the cell.
They injected two messenger RNAs (mRNAs), one identified the mutation on the TTR gene and one made the Cas protein that can cut the DNA at the directed site. It also made it easier for the researchers, since the liver is the site of origin for the disease.
The mRNAs were encased in lipid particles, which were taken up by the liver cells, allowing the mRNAs entry inside the cell. Once there, the cellular machinery made the necessary Cas protein, which cut the mutation site recognized by the other mRNA. The in-house DNA repair mechanism kicks in and repairs the cut site but this time, leaves the gene out, thereby stopping the production of misfolded protein.
After 28 days, three men given the higher of two doses of the treatment had an 80% to 96% drop in TTR levels, better than the average of 81% with Patisiran, the current treatment for TTR. This new RNA silences TRR’s production temporarily meaning it must be injected on a regular basis.
Patisiran (ONPATTRO) costs $13,022 per vial. The annual cost is between $451,430 and $677,145 per patient depending on the weight of the patient.
Jennifer Dounda who last year shared a Nobel prize for developing the gene editor CRISPR says “a critical first step in being able to inactivate, repair, or replace any gene that causes disease, anywhere in the body.”
Ivermectin in the Fight against COVID 19
Ivermectin is being talked about in greater numbers. Research is coming out this antiparasitic drug might be used for covid 19 in prophylaxis and even in possible treatment. It seems that ivermectin interferes with COVID 2 possible ways.
- Reports from in vitro studies suggest that ivermectin acts by inhibiting the host importin alpha/beta-1 nuclear transport proteins, which are part of a key intracellular transport process that viruses hijack to enhance infection by suppressing the host’s antiviral response.
- Ivermectin docking may interfere with the attachment of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein to the human cell membrane.
- Between 1995 and 2010 the program using donated ivermectin to prevent river blindness is estimated to have prevented seven million years of disability whilst costing US$257 million.
- Costs about 7 dollars per pill and generics are available.
What is the research showing
- Ivermectin: a systematic review from antiviral effects to COVID-19 complementary regimen
- Examined the antiviral properties of Ivermectin
- Ivermectin proposes many potential effects to treat a range of diseases, with its antimicrobial, antiviral, and anti-cancer properties as a wonder drug.
- In this comprehensive systematic review, the antiviral effects of ivermectin are summarized including in vitro and in vivo studies over the past 50 years. Several studies reported antiviral effects of ivermectin on RNA viruses
- There are some studies showing antiviral effects of ivermectin against DNA viruses
- Ivermectin plays a role in several biological mechanisms, therefore it could serve as a potential candidate in the treatment of a wide range of viruses including COVID-19 as well as other types of positive-sense single-stranded RNA viruses.
- Ivermectin, a US Food and Drug Administration-approved anti-parasitic agent, was found to inhibit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication in vitro.
- The trial included 72 hospitalized patients in Dhaka, Bangladesh, who were assigned to one of three groups:
- oral ivermectin alone (12 mg once daily for 5 days.
- oral ivermectin in combination with doxycycline (12 mg ivermectin single dose and 200 mg doxycycline on day 1, followed by 100 mg every 12 h for the next 4 days)
- A placebo control group.
- Clinical symptoms of fever, cough, and sore throat were comparable among the three groups.
- Virological clearance was earlier in the 5-day ivermectin treatment arm when compared to the placebo group (9.7 days vs 12.7 days; p = 0.02), but this was not the case for the ivermectin + doxycycline arm (11.5 days; p = 0.27).
- There were no severe adverse drug events recorded in the study. A 5-day course of ivermectin was found to be safe and effective in treating adult patients with mild COVID-19.
- Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19
- A large majority of randomized and observational controlled trials of ivermectin are reporting repeated, large magnitude improvements in clinical outcomes. Numerous prophylaxis trials demonstrate that regular ivermectin use leads to large reductions in transmission.
- Meta-analyses based on 18 randomized controlled treatment trials of ivermectin in COVID-19 have found large, statistically significant reductions in mortality, time to clinical recovery, and time to viral clearance.
- Results from numerous controlled prophylaxis trials report significantly reduced risks of contracting COVID-19 with the regular use of ivermectin.
- The many examples of ivermectin distribution campaigns leading to rapid population-wide decreases in morbidity and mortality indicate that an oral agent effective in all phases of COVID-19 has been identified.
After 8 months of staying in California, it’s time for the well-deserved break from travel nursing.
Being travel nurses, we are privileged to take mini-vacations in between contracts. To start our break, we took a little RV trip for 2 weeks exploring the Pacific West to reconnect with ourselves and keep grounded amidst all the chaos in reality and the internet.
We strongly recommend taking these mini nature trips to take some time away and experience calmness once in a while. Not just for nurses but for anyone who has been working so hard to strengthen your mental health.
While reconnecting with nature, we prepared this episode to show you how peaceful and relaxing it is to reconnect with nature. Follow our trip by watching our vlogs on Youtube to get inspiration for your next getaway.
What Is the Future of Medicine & Health Technologies in 25 Years?
Universal health coverage in the U.S.
- Nearly 92 percent of the population was estimated to have coverage in 2018, leaving 27.5 million people, or 8.5 percent of the population, uninsured. Medicare ensures a universal right to health care for persons age 65 and older.
- Ensuring that all people in the United States have affordable health care coverage that provides a defined set of essential health benefits (EHB) is necessary in order to move toward a healthier and more productive society.
Patient empowerment due to the tech revolution
- From the patients’ side, the advancement of technology is the result of the ‘e-patient’ – where the ‘e’ stands for ‘electronic, empowered or engaged.
- A patient who takes responsibility for their health, and actively engages in shaping their future. This can possibly lead to an equal level partnership between physicians and patients with shared decision-making and the democratization of care.
Brain-computer interfaces bring hope for the paralyzed
- Imagine creating a Brain-computer interface (BCI) like a retinal chip giving you perfect eyesight or the ability to see in the dark, a cochlear implant granting you perfect hearing, or a memory chip bestowing you with almost limitless memory. What if you could type into a computer with only your thoughts or control your entire smart house by sending out the necessary brainwaves?
- The first neuroprosthetics is already on the market: you can purchase cochlear implants, and retinal implants – the latter was approved by the FDA in 2013. Moreover, implants for people with Parkinson’s disease send electrical pulses deep into the brain, activating some of the pathways involved in motor control.
3D printing drugs
- If the entire house can be 3D printed, why wouldn’t 3D printed drugs be a surprise? In 2015 University of College of London experimented with 3D printing drugs in odd shapes; such as dinosaurs or octopuses, in order to make it easier for kids to take pills.
- In August 2015, the FDA approved an epilepsy drug called Spritam that is made by 3D printers. It prints out the powdered drug layer by layer to make it dissolve faster than average pills.
Do new technologies potentially bring new diseases?
- New types of diseases might appear due to the excessive use of virtual reality solutions, video consoles or smartphones. Examples include virtual post-traumatic stress disorder (v-PTSD), which might be the diagnosis for gamers who participate in large virtual battles wearing VR masks (such as Call of Duty) and experience similar symptoms as those soldiers who fought in real wars.
- Video-game epilepsy has been well documented, where games provoke a higher likelihood of seizures vs standard television programs.
Artificial food will bring hope against food shortages?
- Researchers of the Cultured Beef Project remove muscle cells from the shoulder of a cow and feed the cells with a nutrient mix in a Petri dish, and then they grow into muscle tissue. From a few starter cells, one can derive tons of meat.
- Bill Gates advocated for citizens of the richest countries in the world to switch to diets consisting entirely of what he called synthetic meat in an effort to curb greenhouse gas emissions.
- Total U.S Greenhouse Gas Emissions by economic sector in 2019
- Transportation (29%) – Greenhouse gas emissions from transportation primarily come from burning fossil fuel for our cars, trucks, ships, trains, and planes. Over 90 percent of the fuel used for transportation is petroleum-based, which includes primarily gasoline and diesel.
- Electricity production (25%) – Approximately 62 percent of our electricity comes from burning fossil fuels, mostly coal and natural gas.
- Industry (23%) – Greenhouse gas emissions from industry primarily come from burning fossil fuels for energy, as well as greenhouse gas emissions from certain chemical reactions necessary to produce goods from raw materials.
- Commercial and residential (13%) – Greenhouse gas emissions from businesses and homes arise primarily from fossil fuels burned for heat, the use of certain products that contain greenhouse gases, and the handling of waste.
- Agriculture (10%) – Greenhouse gas emissions from agriculture come from livestock such as cows, agricultural soils, and rice production.
- Emission trend – In 2019, U.S. greenhouse gas emissions decreased compared to 2018 levels.
The merger of wearable manufacturers and health insurance companies
- In November 2017, Qualcomm and United Healthcare announced that they have integrated Samsung and Garmin wearables into their national wellness program. It enables eligible plan participants to earn more than $1,000 per year by meeting daily walking goals.
- Could this motivate people into desired behavior such as a healthy way of life? Could this increase premiums for high-risk patients or to reduce their business risks by alerting patients about bad lifestyle choices? What will happen to the patients’ private data? Should we prepare for Dr. Big Brother? How will the relationship between employers, employees, and health insurance companies change in the light of easily obtainable personal fitness and health data?
Director, Africa Centres for Disease Control and Prevention
- Population-wise, Africa is the continent of the future. By 2050, it is estimated that its population will be 2.5 billion people. This means that one in every four persons in the world might be an African, with rapidly growing economies and a rising middle class.
- Precision medicine will need to take center stage in a new public health order—whereby a more precise and targeted approach to screening, diagnosis, treatment, and, potentially, the cure is based on each patient’s unique genetic and biological make-up.
- Based on the Africans Union’s Agenda 2063, goals include national strategies to improve healthcare—including genomic data policy—and increase diagnostic capacity, and the creation of biobanks, such as H3Africa, that encompass both physical and bioinformatics facilities.
Is it possible for Amazon to run the world’s largest HMO?
HMO stands for health maintenance organization. HMOs have their own network of doctors, hospitals, and other healthcare providers who have agreed to accept payment at a certain level for any services they provide. This allows the HMO to keep costs in check for its members.
- Amazon has confirmed that the services will be available nationwide starting the summer of 2021. An Amazon spokesperson confirmed that the service would be delivered through Care Medical, an independent private medical practice consisting of licensed clinicians with whom Amazon has contracted as Amazon Care’s clinical team.
- This is the first time a big tech firm will be directly in the healthcare services business. Will it be another failed experiment or the breakthrough we’ve been waiting for?
- Amazon care addresses two major emerging trends in healthcare delivery: telehealth and home-based care.
- The future of healthcare in-home care and mobile care nurse
- They can offer in-person treatments, exams, and medicine
- Delivering prescriptions