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Will Tiger Woods Play Golf Once more? Medical doctors Predict a Troublesome Restoration

Will Tiger Woods Play Golf Again? Doctors Predict a Difficult Recovery

The severe lower leg injuries Tiger Woods sustained in a car accident on Tuesday usually lead to a long and dangerous recovery that, according to medical experts who have treated similar injuries, calls into question his ability to return to professional golf.

Athletes with severe leg injuries believed to ruin their careers have returned – quarterback Alex Smith returned to play football after a cruel broken leg last season, and golfer Ben Hogan returned after a car accident decades ago .

But Woods’ injuries are more extensive and his path to recovery is littered with serious obstacles. Infection, inadequate bone healing, and in Woods’ case, previous injuries and chronic back problems can make months or even years of recovery even more difficult and reduce the chances of him playing again.

In the accident near Los Angeles, Woods’ right lower leg was bruised, his right foot was badly injured, and his leg muscles became so swollen that surgeons had to cut open the tissue covering them to relieve the pressure, Dr. Anish Mahajan, the chief physician at Harbor-UCLA Medical Center where Woods, 45, was treated, wrote in a Twitter message on Wood’s account.

Doctors also inserted a bar into Wood’s shin and screws and pins into his foot and ankle. Doctors familiar with these types of injuries described the complications that they typically pose.

The injuries are common among drivers involved in car accidents, said Dr. R. Malcolm Smith, chief of orthopedic trauma at Massachusetts General Hospital in Boston. Usually they happen when the driver desperately hits the brakes while a car is spiraling out of control.

When the front end of the car is smashed, immense force is transferred to the driver’s right leg and right foot. “This happens every day with car accidents in this country,” said Dr. Smith.

Such lower leg fractures occasionally bring “massive disabilities” and other serious consequences, said Dr. Smith. “A very rough estimate is that there is a 70 percent chance that it will heal completely,” he added.

The crash caused a cascade of injuries. It shattered Woods’ tibia with primary fractures in the upper and lower portions of the bones and a scattering of bone fragments. When the bones in Wood’s shin burst, they damaged muscles and tendons; Pieces protruded from his skin.

The trauma caused bleeding and swelling in his leg and threatened his muscles. Surgeons had to quickly cut into the thick layer of tissue covering his leg muscles to relieve the swelling. If it hadn’t been for them, the tissue covering the swelling muscle would have acted like a tourniquet, restricting blood flow. The muscle can die within four to six hours.

It is possible that a muscle may have died between the accident and the operation anyway. Dr. Smith said, “Once you’ve lost it, you can’t get it back.”

Patients who are used this procedure must be hospitalized until the muscle swelling subsides. This can take a week or more. Sometimes, even after a few weeks, the swelling has not gone down enough to close the wound, requiring surgeons to transplant skin over the opening.

Dr. Kyle Eberlin, a reconstructive surgeon at Massachusetts General Hospital, said doctors often need to transplant skin from the thigh or back to plug the holes where bones protrude from the skin. This is known as a free flap. They cut pieces of skin the size of a football and carefully use a microscope to connect tiny blood vessels about a millimeter in diameter from the skin graft to the blood vessels near the wounds.

Infection is a risk with fractures that break through the skin and insert chopsticks and pens into the bones after surgery, with an amputation in the worst case, said Dr. Smith. The likelihood of infection depends on the level of contamination and the size of the wound.

In car accidents, gravel and sometimes dirt can get into wounds and increase the chances of infection, said Dr. Eberlin.

Opening the muscle shell can increase the risk of infection, said Dr. Reza Firoozabadi, an orthopedic trauma surgeon at Harborview Medical Center in Seattle.

In large trauma centers like Massachusetts General or UCLA, the free flap procedures are performed within 48 hours. However, it is more typical to operate within a week of the injury, said Dr. Eberlin.

Rehabilitation will be long and arduous. If Woods needed a free valve – which trauma surgeons say is likely – “it will be months and months before he can put weight back on his leg,” said Dr. Eberlin.

Woods also risks fractures that do not heal or grow together very slowly, said Dr. Firoozabadi. “To heal things, you need good blood circulation,” he said. “With such an injury, the blood flow is disturbed.”

As a result, Wood’s lower leg bones could take five to 14 months to grow together, provided they do so at all.

The biggest hurdle will be his foot and ankle injuries, said Dr. Firoozabadi and others. Restoring mobility and strength can take three months to a year. Depending on the extent of these injuries, Woods can barely walk even after rehabilitation.

His rehabilitation can be made more difficult by a back operation in December. Woods also went to rehab for an addiction to pain medication; Managing pain while he is recovering can now be difficult.

Still, some athletes have returned from serious injuries. Smith, the Washington Football Team quarterback, had a similar leg injury and returned to play in October. But it took two years and 17 operations, and along the way he developed infection of the wounds and sepsis, a life-threatening condition. And Smith had no injuries to his foot or ankle.

Golfer Ben Hogan broke his collarbone, pelvis, left ankle, and a rib. The injuries were severe but not comparable to Woods’ injuries.

With his foot and ankle injuries and severe injuries to his leg, “Woods may never play golf again,” said Dr. Smith.

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These are the commonest unwanted side effects from J&J’s

These are the most common side effects from J&J's

A Johnson & Johnson logo is seen in this photo image in front of a medical syringe and vial of coronavirus vaccine.

Pavlo Gonchar | SOPA pictures | LightRocket | Getty Images

Headache, fatigue, and muscle aches were some of the most common side effects in people who received Johnson & Johnson’s one-off coronavirus vaccine in clinical trials, according to a report by the U.S. Food and Drug Administration released Wednesday.

In the report, FDA staff endorsed J & J’s one-shot coronavirus vaccine for approval for emergency use. If approved, it will be the third vaccine to be approved in the US after Pfizer-BioNTech and Moderna.

Post-vaccination side effects are common, doctors say, and usually signs that they are helping to protect against the disease. The FDA determined that the clinical trial results and safety data “are in accordance with the recommendations in the FDA guidelines on emergency approval of vaccines to prevent COVID-19.”

The most common, least severe “local” side effect among vaccinated subjects was injection site pain, which was reported by nearly half of vaccine recipients compared with about 17% in the placebo group. Skin redness or erythema and swelling were reported less frequently, the FDA said.

The most common “systemic” side effects, typically less common than local reactions but more serious, were headache and fatigue, according to the report. Almost 40% of people who received the vaccine reported having a headache, and just over 38% reported feeling tired.

More than 33% of people vaccinated said they had muscle pain, around 14% reported nausea, and under 10% had a fever, according to the report. Most of the side effects were reported in younger people ages 18 to 59, according to the FDA, although most age groups reported similar nausea rates.

FDA staff found that most people who received the vaccine were able to shake off the side effects within days of their shot.

While the rate of unexpected side effects was similar between the vaccine and placebo groups, there was a slight imbalance in some responses in the vaccine group compared to those given a placebo. The vaccine group reported 15 cases of “embolic and thrombotic events” or blood clots in 14 recipients compared to 10 in the placebo group.

There were also six cases of tinnitus, a ringing or buzzing in at least one ear, among vaccine recipients compared to none in the placebo group, the FDA found.

However, the agency said current data “is insufficient to establish a causal link between these events and the vaccine”.

The report found a “balanced” number of cases of Bell Paralysis, a condition in which half of your face falls off. The FDA previously announced that the condition would be monitored in recipients of other vaccines and noted that this isn’t necessarily a side effect, but it’s worth looking out for.

The FDA said there have been no reports of anaphylaxis – a serious and life-threatening allergic reaction that rarely occurs after vaccination – immediately after vaccination.

Some cases of anaphylaxis have been reported in people who received either Pfizer’s or Moderna’s shot, although researchers say they occurred in the range of cases reported for the influenza vaccine, according to a report published Friday by the U.S. Centers for the Disease control and prevention stating.

J&J first submitted its Covid vaccine data to the FDA on February 4th. While the vaccine’s level of protection varied by region, the company said the vaccine prevented 100% of hospital admissions and deaths.

– CNBC’s Berkeley Lovelace Jr. contributed to this report.

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Journey Quarantines: Enduring the Mundane, One Day at a Time

Travel Quarantines: Enduring the Mundane, One Day at a Time

May Samali knew she had reached her limit when she saw a tentacle emerge from her hotel dinner in Sydney, Australia.

“I called downstairs and said, ‘I’m vegan now, thanks!'” She said. “It was just so much fish. I got to the point where I thought about myself gagging. “

Ms. Samali swore off the seemingly unlimited seafood while she was in the middle of a required quarantine at the Sofitel Hotel in Sydney this December and early January. She returned to Australia as an executive coach after her US work visa expired. In addition to having an excess of fish, Ms. Samali was locked in her room all day and was not allowed to go outside for two weeks.

Air travelers around the world are in similar situations and suffer mandatory state quarantines in hotels when traveling to countries where coronavirus containment is very serious.

Your quarantine is not the convenient experience of short-term quarantines or “resort bubbles” found in some destinations such as Kauai and the British Virgin Islands, where you can move relatively freely around a sprawling resort area while you are on a negative coronavirus. Test wait.

This is the more extreme, yet typical, experience of quarantine life. These mandatory quarantines include being restricted to your room 24 hours a day for up to two weeks (assuming you test negative, ie). And with a few exceptions, you pay the bill – quarantine in New South Wales, Australia, for example, costs around $ 2,300 or A $ 3,000 for a two-week quarantine for an adult and up to A $ 5,000 for a family of four for two weeks in quarantine (in January the UK announced mandatory 10-day quarantine from risk areas with similar costs of around $ 2,500 for an adult).

Travelers now traveling to countries with mandatory hotel quarantines, which include New Zealand, mainland China and Tunisia, must generally have compelling reasons – to visit sick family members, take “essential” business trips, or move permanently.

Most accept the inconvenience and inevitable claustrophobia of quarantine as the price of travel. But while establishing a routine similar to normal life can be comforting, travelers crave human connection, fresh air, and other food (the staff at Sofitel was happy to take Ms. Samali’s request; she still has no fish).

The travel quarantine seems manageable or even familiar to those who have lived in local sheltered locations and work from home. Pete Lee, a San Francisco-based filmmaker, wasn’t worried about the quarantine when he flew to Taiwan to work and visited family.

“I was a little cocky when I first heard of the request,” said Mr. Lee on his eighth day at the Roaders Hotel in Taipei, Taiwan. “I was in my apartment in San Francisco 22 hours out of the 24! But it’s a surprisingly intense experience. Those two hours make a huge difference. “

Much of the quarantine life is determined by your hotel. And depending on where you are going, you may be able to choose your quarantine hotel or you may be assigned when you arrive. Mr. Lee in Taiwan was able to select and book his quarantine hotel from a list compiled by the Taiwanese government, which included information about the location, cost, room size and the presence (or absence) of windows. He also paid the bill.

Similarly, Ouiem Chettaoui, a public order specialist who splits her time between Washington, DC and Tunisia, was able to pick a hotel for her week-long quarantine when she returned to Tunis with her husband in September. She based her selection, the Medina Belisaire & Thalasso, on the price and the proximity to the Mediterranean (“We couldn’t see it, but we could hear it … at least we said we could!” She said).

Brett Barna, an investment manager who had moved to Shanghai with his fiancée in November, was able to choose a neighborhood but not the hotel itself. To improve her chances, Mr. Barna chose the upscale Huangpu neighborhood, which will hopefully be home to hotels would be higher quality.

“There were four possible hotels in the district, three of which were nice enough. And then there was the budget option, the Home Inn, ”he said. To their dismay, Mr Barna and his fiancée paid for quarantine on this option, which had peeling wallpaper and bleach stains on the floor thanks to aggressive cleaning protocols.

In Australia and New Zealand there is no choice – upon landing, your entire flight will be taken to a quarantine hotel with capacity. In most cases, travelers don’t know where they are going until the bus stops at the hotel itself.

Joy Jones, a San Francisco-based trainer and educator, traveled to New Zealand in January with her husband, a New Zealand citizen, and two young daughters. She learned before leaving that they would not say where in the country they would be quarantined.

“That was probably the hardest part,” she said. “I could put together a bag of activities for my older daughter and plan to do laundry in the sink. But if we didn’t have an answer to where we were – after more than 21 hours of flying with masks – would we have to get another flight? A three hour bus ride? “They didn’t. Ms. Jones and her family were taken to Stamford Plaza in Auckland, just 25 minutes from the airport.

However, Pim Techamuanvivit and her New Zealand husband weren’t that lucky. After arriving in Auckland from San Francisco, they were immediately instructed to board another flight to Christchurch and the Novotel Christchurch Airport Hotel. “At that point we really, really wanted to go to the hotel!” said Ms. Techamuanvivit, the head chef at Nari and Kin Khao restaurants in San Francisco and the head chef at Nahm in Bangkok.

The relief on arrival – finally – may be the first reaction, but it doesn’t take long for reality to kick in. The hotel room is everything you will see for a not insignificant amount of time.

Adrian Wallace, a technology project manager who was quarantined at the Sydney Hilton in August after visiting his sick father in the UK, said: “That door-slam moment … reminds us of the opening scene of ‘The Shawshank Redemption ‘! ” Wallace said, referring to the 1994 prison film with Tim Robbins and Morgan Freeman.

The challenge is to manage the boredom. Working remotely helped some travelers take their time, including Tait Sye, senior director at the Planned Parenthood Federation of America, who traveled from Washington DC to Taipei, Taiwan in November. Mr Sye tried to maintain most of his quarantine at the Hanns House Hotel from 10 p.m. to 6 a.m. on the east coast

Mr. Wallace ran a half marathon around his hotel room in Sydney (he couldn’t turn on the air conditioning in the room and got very sweaty). Mr Barna and his fiancée in Shanghai had date nights at Zoom as official policy required them to be quarantined in separate rooms. A big highlight of their days came when a hotel employee in full Hazmat-style PPE knocked on the door and pointed an infrared thermometer at their heads. They weren’t allowed outside.

In New Zealand, travelers who tested negative for the virus are allowed to perform supervised constitutions after checking in with guards at multiple checkpoints on hotel grounds (masks and distancing are still required, and rules can change quickly if there is a risk of an outbreak the country). The ability to get some fresh air and walk was vital for Ms. Jones and an important part of the routine she created for her family. Other aspects included morning yoga, distance learning, afternoon nap, playtime and art projects (her husband worked away from the bathroom).

“We decorated a paper horse that we hung in our window – a different part of it every day – that was a favorite pastime. We have dance parties. And we saw a movie every night. We did everything to have fun with it, ”said Ms. Jones.

Meals become very important in quarantine life to mark the passage of time and as regular events to break up the monotony of the day. However, the quality of the food varies greatly, as Mr. Sye found out in Taipei, where meals were ordered in nearby restaurants.

He shared the highs of a Michelin-starred meal of Kam’s Roast Goose and the thoughtfulness of a Thanksgiving dinner decorated with a paper turkey to the bottom of an absolutely terrible pizza (at least it was accompanied by a beer).

Ordering groceries and groceries was a lifesaver for Ms. Techamuanvivit, who documented her quarantine in Christchurch on Twitter. “I’m the boss. I guess I’m a snob!” She said. “As a restaurateur, I don’t have much love for UberEats. Ordering from Indian food stalls, however, proved important.” (Others who had delivery options available , also called them groundbreaking).

Ms. Techamuanvivit spiced up hotel meals with leftover Indian cucumber and found the Greek tzatziki sauce ordered at the grocery store worked well as a salad dressing. She and her husband also indulged in nice bottles of wine from the hotel restaurant’s wine list (In Australia and New Zealand, quarantined guests were limited to delivering six beers or one bottle of wine per person per day to fend off possible disputes, while Shanghai was alcohol not allowed.

There are Facebook groups devoted to hotel quarantine, by region and even by hotel, where members share tips on boiling eggs with kettles in the room and “boiling” with an iron. You were also a source of fellowship; Learning about the Sydney Hilton Facebook group on the bus from the airport, Mr. Wallace participated in a daily Zoom call with members of the group (the meals of the day were a constant topic of conversation).

Mr. Lee moderated conversations about filmmaking at Clubhouse, an invitation-only social media app, and spent time in quarantine at Tinder. He bonded with a woman who was nearing the end of her detention at another hotel in town.

Ms. Jones documented her family’s quarantine experience on her private Instagram account, showing forts made of blankets, paper airplane competitions, and “bowling” with water bottles and a crumpled ball of paper. She was touched that friends and family, in both New Zealand and the United States, sent their family meals, treats, and toys for their daughters in response to their contributions.

“It was a really cool way to feel love and connection from such an isolated space,” she said.

Follow the New York Times Travel on Instagram, Twitter and Facebook. Sign up for our weekly Travel Dispatch newsletter for expert tips on smart travel and inspiration for your next vacation.

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IATA app may restart quarantine-free, worldwide flights

IATA app could restart quarantine-free, international flights

People wait for passengers in one of the international arrivals lounges at London Heathrow Airport in west London on February 14, 2021

JUSTIN TALLIS | AFP | Getty Images

A new app to be released within a few weeks could represent the first step towards resuming quarantine-free international travel.

With the travel app of the International Air Travel Association (IATA), governments and airlines can digitally collect, access and share information about the status of the Covid-19 test and the vaccination of individual passengers.

The industry association, which includes 290 airlines, said the tool will make health documentation reviews more efficient while also accelerating the recovery of the hardest-hit travel sector.

“It’s really about digitizing an existing process,” Nick Careen, IATA’s senior vice president of passenger cargo and security, told CNBC on Wednesday.

If we do the manual processing, we will stall the moment we see a reboot.

Nick Careen

Senior Vice President (APCS), IATA

“This is the way forward because if we work manually we will stall the moment we see a restart,” he said.

Singapore Airlines will be the first airline to pilot the tool on a continuous London Heathrow route. Thirty other airlines, including Air New Zealand and Emirates and Etihad in the United Arab Emirates, are scheduled to conduct trials by March and April.

IATA is not the only one to develop so-called digital health passports with which cross-border trips can be resumed. International agencies, governments and technology companies also participate. However, Careen hopes the app will set “minimum requirements” to allow for better interoperability.

“At some point you will see several people in this area,” he said, “but we are setting the baseline in terms of the standard.”

With the new app and the ongoing vaccine rollouts, the global airline association It is estimated that by the end of this year, travel could hit around 50% of 2019 levels.

Previously, analysts had expected a greater increase in travel in early 2021, but the continued spread of the virus and the emergence of new strains have pushed those expectations back on.

“That is the current economic forecast,” said Careen. “There are many variables that contribute to this.”

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New California Variant Extra Contagious, Two Research Verify

New California Variant More Contagious, Two Studies Confirm

A variant, first discovered in California in December, is more contagious than previous forms of the coronavirus. Two new studies have shown concerns that emerging mutants like these could hamper the sharp decline in cases across the state and potentially elsewhere.

In one of the new studies, researchers found that the variant had spread rapidly in a neighborhood of San Francisco in the past few months. The other report confirmed that the variant has risen sharply across the state and revealed that it produces twice as many virus particles in a person’s body as other variants. This study also suggested that the variant can bypass the immune system – and vaccines – better than others.

“I wish I had better news for you – that this variant doesn’t matter at all,” said Dr. Charles Chiu, a virologist at the University of California at San Francisco. “But unfortunately we just follow science.”

None of the studies have yet been published in a scientific journal. And experts don’t know how much this variant is public health compared to others that are also spreading in California.

A variant called B.1.1.7 came to the US from the UK, where it quickly became the dominant form of the virus and overloaded hospitals there. Studies of UK medical records suggest that B.1.1.7 is not only more communicable, but also more lethal than previous variants.

Some experts said the new variant in California is of concern, but is unlikely to be as much of a burden as B.1.1.7.

“I’m becoming increasingly convinced that this one transmits more than anyone else in the field,” said William Hanage, an epidemiologist at Harvard TH Chan School of Public Health who was not involved in the research. “But there is no evidence that it is in the same stadium as B.1.1.7.”

Dr. Chiu accidentally stumbled upon the new variant for the first time. In December, he and other researchers in California were concerned about the discovery of B.1.1.7 in the UK. They began screening their samples from positive coronavirus tests in California and sequencing viral genomes to see if B.1.1.7 had made it to their state.

On New Year’s Eve, Dr. Chiu is shocked to find a previously unknown variant that made up a quarter of the samples he and his colleagues had collected. “I thought that was crazy,” he said.

It turned out that researchers at Cedars-Sinai Medical Center in Los Angeles discovered the same variant that soared to high levels in Southern California. Dr. Chiu announced his first finding and the Cedars-Sinai team went public two days later.

Since then, researchers have studied the new variant, known as B.1.427 / B.1.429, in more detail to determine its origin and track its spread. It has performed in 45 states and several other countries so far, including Australia, Denmark, Mexico, and Taiwan. But it has only launched in California so far.

It was initially unclear whether the variant was inherently more transferable than others, or whether it had risen sharply in California due to gatherings that became overarching events.

“Just by chance, poor wedding or choir practice can cause a large frequency difference,” said Joe DeRisi, co-president of the Chan Zuckerberg Biohub, who studied the spread of the variant.

In a new study that will be posted online shortly, Dr. Chiu and his colleagues received 2,172 virus samples from across the state between September and January. In early September, the researchers found no signs of B.1.427 / B.1.429. But by the end of January it had become the predominant variant in California. Dr. Chiu and his colleagues estimate that the cases caused by the variant now double every 18 days.

Dr. Chiu and his colleagues reviewed the medical records of 308 cases of Covid-19 in San Francisco and found that a greater percentage of people had died from the new variant than others. However, this result could be a statistical coincidence: there were only 12 deaths in the group, so the difference in deaths from one subgroup to another in a larger sample may not apply.

Updated

Apr. 23, 2021, 8:18 p.m. ET

The researchers also conducted experiments in the laboratory to find evidence that the new variant had a biological benefit. In one study, they showed that it was at least 40 percent more effective than previous variants at infecting human cells. When measuring the genetic material of swabs used for coronavirus testing, the researchers found that people infected with the variant produce a viral load twice as high as other variants.

The study also found that the new variant can bypass the immune system better than other variants. Antibodies from people who had recovered from infections with other variants were less effective at blocking the new variant in the laboratory. The same was true when the researchers used blood serum from people who had been vaccinated.

Still, the effect of the variant on immunity appears to be much less than that caused by a variant from South Africa called B.1.351. Dr. Chiu said it was not clear whether the vaccines used against B.1.427 / B.1.429 will be less effective.

“If we can get enough people vaccinated, we can deal with these variants simply because we don’t have ongoing transmission,” he said.

In a separate study that has not yet been published, Dr. DeRisi and his colleagues are carefully investigating how the variant is spreading in the Mission District, a predominantly Latin American neighborhood in San Francisco.

When examining samples in late November, the researchers found that 16 percent of the coronaviruses belonged to B.1.427 / B.1.429. After sequencing 630 genomes in January, they found that they made up 53 percent.

The researchers also looked at the distribution of this and other variants in 326 households. They found that people had a 35 percent chance of getting infected if someone had B.1.427 / B.1.429 in their home. If the person was infected with another variant, the rate was only 26 percent.

“What we see is a modest but significant difference,” said Dr. DeRisi.

Dr. Chiu said the San Francisco study provided a microcosm of how the variant has spread across the state. “The data they have from the mission district really supports our data and vice versa,” he said.

Dr. However, Harvard-based Hanage is not convinced that the variant poses a major threat. Every time B.1.1.7 appeared in a new country, it quickly exploded. In contrast, the variant discovered in California seems to have slowly gained dominance.

Dr. Chiu and his colleagues were able to estimate when B.1.427 / B.1.429 arose by comparing the mutations that have occurred in the viruses since they separated from their common ancestor. This analysis pointed to late spring. If that’s correct, it means the variant may have lurked at extremely low levels in California for four months or more.

“It’s not as big a deal as the others,” said Dr. Hanage. He speculates that if scientists sequence more coronavirus genomes elsewhere, they will find more of these moderately fast-spreading mutants. “Maybe there are variants everywhere, and we only see them where sequencing happens,” he said.

We may soon have new insights into how seriously these new variants should be taken. B.1.1.7 didn’t arrive in California until early December, and although it has doubled about every 12 days, it’s still about 2 percent of the coronaviruses in the state.

Now California is becoming a kind of virus cage match between the two variants. “My suspicion is that the B.1.1.7 will win,” said Dr. Hanage.

Dr. However, Chiu thinks it is possible that B.1.427 / B.1.429 will suppress the newcomer and continue to dominate the state.

“We’ll find out in the next few weeks,” he said.

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Elizabeth Holmes denies destroying proof in Theranos case

Elizabeth Holmes denies destroying evidence in Theranos case

Elizabeth Holmes, founder and former executive director of Theranos, arrives for a hearing in the U.S. District Court in the Federal Building of Robert F. Peckham in San Jose, California on Monday, November 4, 2019.

Yichuan Cao | NurPhoto | Getty Images

The mystery of what happened to critical evidence proving Theranos’ blood testing technology was not working deepened when Elizabeth Holmes accused the government of what she calls an “investigative failure”.

In a file filed late Tuesday, Holmes lawyers shot back prosecutors to rule out evidence of so-called test results, saying they were to blame for losing a database called the Laboratory Information System (LIS) that contained three years of accuracy and failure rates of Theranos tests.

“Rather than accepting responsibility for this investigation failure and the resulting gaps in evidence in their case, the government has taken a different path,” write Holmes’ attorneys, adding, “The government has assumed that the loss of LIS data reflects the woman . Holmes’ alleged guilt, although it had nothing to do with it. “

“The reason the government lacks this evidence is because prosecutors sat on their hands for years before attempting to acquire them and then sat on their hands again after acquiring them. It is entirely their fault,” the lawyers write from Holmes.

“The reason the government built their case on this fluctuating house of cards of irrelevant evidence is because they lost – or, worse, didn’t want to analyze – the actual evidence of the test results in this case,” argued Holmes’ attorneys.

However, prosecutors claim that Theranos executives destroyed the LIS system, which proved their blood test product was inaccurate.

In a filing last month, the government said that three months after a federal grand jury issued a subpoena for a copy of the database in August 2018, “the LIS was destroyed”. They wrote that “the government was never given the full records in the LIS, nor were they given the tools available in the database to search for evidence as critical as any Theranos blood test with validation errors. The Data disappeared “”

Prosecutors say the failure rate in one of these tests was 51.3%, adding that Theranos’ test results “were so inaccurate that it was essentially a toss of a coin whether the patient got the correct result. The data was devastating.” You want to invite 11 patients and 11 physicians to testify about the accuracy and reliability issues.

Holmes says there is a certain amount of expected errors in all laboratory tests: “Just as the fact of a heart attack does not prove what caused the heart attack, the fact of a wrong blood test does not prove what caused the error.”

Prosecutors point to internal emails that prove Theranos and his lawyer tried to cover up the grand jury’s test results in the database. Theranos provided backup copies of the database for investigators to put together. However, prosecutors claim that the backup required a password that Theranos executives could not remember.

Once a Silicon Valley darling, Theranos attracted the who’s who of venture capitalists and a $ 9 billion private valuation before closing in 2018.

Holmes and her co-defendant Ramesh “Sunny” Balwani each face a dozen fraud charges related to deceiving investors, patients and doctors about Theranos technology.

Holmes will face prosecutors next month for believing that evidence should not be presented to a jury that will determine her fate.

The judge’s verdicts will set the stage for her long-awaited trial, due to begin in July.

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For Some Teenagers, It’s Been a Yr of Nervousness and Journeys to the E.R.

For Some Teens, It’s Been a Year of Anxiety and Trips to the E.R.

In a recent report, a CDC-led research team found that fewer than half of emergency rooms in US hospitals had clear guidelines for dealing with children with behavioral problems. In order to get to the bottom of a complex behavior problem, it can take at least days before patients are observed, say psychiatrists. And many emergency rooms don’t have specialists, dedicated space, or outside resources to do the job well.

For Jean, her son’s diagnosis was complicated. He has since developed irritable bowel syndrome. “He lost weight and started smoking pot because of the boredom,” said Jean. “It’s all due to fear.”

The Columbus, Ohio National Children’s Hospital has an emergency room the size of a children’s hospital with a capacity for 62 children or adolescents. But long before the coronavirus arrived, the department was trying to treat more and more patients with behavioral problems.

“This was a big problem before the pandemic,” said Dr. David Axelson, chief of psychiatry and behavioral health at the hospital. “We saw an increase in visits to the emergency room for mental health problems in children, particularly thoughts of suicide and self-harm. Our emergency room was overwhelmed by this, and children had to get into the medical department while they waited for psychiatric beds. “

In March last year, Nationwide Children’s opened a new pavilion, a nine-story facility with 54 dedicated observation and extended stay beds for people with intellectual disabilities. It has taken the strain off the hospital’s regular emergency department and significantly improved care, said Dr. Axelson.

In this pandemic year, when the number of patients with mental health problems has increased by around 15 percent compared to previous years, it is difficult to imagine what it would have been like without the additional, dedicated behavioral clinic, said Dr. Axelson.

Other hospitals out of state often call in hopes of getting a patient into crisis, but there just isn’t enough room. “We have to say no,” said Dr. Axelson.

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Biden Covid staff holds briefing as U.S. demise toll reaches grim milestone

Biden Covid team holds briefing as U.S. death toll reaches grim milestone

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President Joe Biden’s Covid-19 Response Team is holding a press conference Monday on the coronavirus pandemic that killed nearly 500,000 Americans, according to Johns Hopkins University.

Earlier in the day, White House Press Secretary Jen Psaki said Biden would order that all flags on federal properties be lowered to half the staff for the next five days to mark the grim milestone of 500,000 American deaths from Covid-19 .

Regardless, the Chief Medical Officer of the White House, Dr. Anthony Fauci, Americans, fight back a sense of Covid-19 complacency even as coronavirus infections are falling and some scientists predict herd immunity is just around the corner.

Read CNBC’s live updates for the latest news on the Covid-19 outbreak.

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Received a Pandemic Pet? Study How you can Stop Canine Bites

Got a Pandemic Puppy? Learn How to Prevent Dog Bites

The bites that require hospitalization and surgical repair are the most serious injuries, such as: B. Infants bitten in the face and neck, which can damage many critical structures, including eyes and ears, and can also cause devastating cosmetic damage. But hand injuries can also have very permanent effects and must be repaired by experts.

As for dog bite prevention, Dr. Dixon: “Strategy # 1 remains supervision.” Children should learn to leave dogs alone when they are eating, when they are sleeping with a favorite toy, when they are caring for their puppies. You shouldn’t turn to unfamiliar dogs. And dog owners should keep their dogs healthy and socialize and train them from an early age.

“It’s important that we take responsibility for our animals,” said Ms. Goff, who has a dog called Daisy that she brings to the office. “Most dogs don’t bite to attack, they bite because they’re afraid or provoked.”

Ms. Goff also stressed that from a liability perspective, anyone who owns a dog should have insurance coverage. In her state of Connecticut, a state with strict liability, “I don’t have to prove anyone was at fault,” she said, and the dog owner is responsible for the damage. “If you can afford the dog, you can afford the insurance,” she said.

She said it was also important to report dog bites as dogs that bite multiple times need to be tracked, but reassured those who feared a dog could be destroyed, at least in Connecticut unless there is a disaster or death from injury, “our forgiveness for animals extends quite a bit.”

If dogs exhibit aggressive behavior, owners should, Dr. Dixon, get expert help from a veterinarian or “canine behavioral expert – ideally before something bad happens”.

Dr. Judy Schaechter, Professor of Pediatrics and Public Health at the University of Miami, said in light of the surge in puppy purchases during the Covid epidemic, “We have been in this area for a year now; Puppies can be big, strong dogs at this point. “And since many parents balance working from home with their children’s school problems, it can be difficult for them to keep all children (and pets) under constant supervision.

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U.S. Covid vaccine provide to considerably improve in March, drugmakers inform Congress

U.S. Covid vaccine supply to substantially increase in March, drugmakers tell Congress

Lillie McCray (R) receives Pfizer BioNTech’s Coronavirus Disease (COVID-19) vaccine from Walgreens Doctor Ghassan Ayyad (L) at the Victor Walchirk Apartments in Evanston, Illinois on February 22, 2021.

Kamil Krzaczynski | Reuters

The supply of Covid-19 vaccines in the US is expected to increase significantly next month as manufacturers double the production pace, company executives said in prepared remarks to be delivered to Congress on Tuesday.

Pfizer expects to ship more than 13 million doses of its two-shot vaccine per week to the US by mid-March, more than double the weekly number of doses the company shipped earlier this month, said John Young, chief Pfizer business officer, writing testimonial. The testimony was released prior to a hearing before the House Committee on Energy and Trade.

Young also said Pfizer is on track to dispense 120 million doses by the end of March, and another 80 million doses are expected to expire by the end of May.

The President of Moderna, Dr. Stephen Hoge said his company is similarly working to double its shipments to the US by April, according to the testimony prepared by Hoge. Moderna hopes to ship 40 million cans a month, which is roughly double the pace, he said.

“We have doubled our monthly shipments to the US government since late 2020 and are working to double them again to more than 40 million cans per month by April,” said Hoge. “As we work to achieve these goals, we are continuously learning and working closely with our partners and the federal government to find ways to remove bottlenecks and speed up our production.”

He added in the document that if the Food and Drug Administration authorizes the company to put more vaccine doses in each vial, it would “improve performance”.

U.S. supplies are also expected to be supported by new manufacturers entering the fray. The FDA is expected to review Johnson & Johnson’s one-shot vaccine on Thursday. J&J Vice President for Medical Affairs, Dr. Richard Nettles, said in his prepared testimony that the company plans to ship more than 20 million cans in the US by the end of March.

Nettles added that the company is confident of delivering 100 million cans in the first half of the year.

Taken together, the remarks suggest the US is on track to have received 240 million doses of vaccine by the end of March, enough to vaccinate about 130 million people.

That could be a huge boon to the vaccine launch. State and local officials said the biggest restriction was the delivery of cans by the federal government. According to the Centers for Disease Control and Prevention, more than 75.2 million doses have been given to states, and over 64.1 million doses have been given.

The House hearing is scheduled to begin at 10:30 a.m. ET.