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Latest Pregnancy News THURSDAY, July how to get viagra online 1, 2021 (American Heart Association News) Always game for a new challenge, Andrea Engfer began running viagra 100mg cost with a friend in her small town of Orting, Washington. She liked it so much, she signed up for a 5K. Then another – and so viagra 100mg cost on. "I try to improve every time, even if it's by 10 seconds," she said. "That gets me going." That competitive spirit served her well for the toughest challenge of her life.

Recovering from a severe stroke viagra 100mg cost five days after giving birth. Andrea and her husband, Martin, were excited about the arrival of their first child last spring. The pregnancy was relatively uneventful until the last three weeks, when Andrea's blood pressure started to increase. She developed preeclampsia, a form of high blood pressure during pregnancy viagra 100mg cost that affects the mother's liver and kidneys. Her OB-GYN induced labor 12 days early.

After two days of waiting for her daughter to arrive, Emma was delivered via cesarean section. As typically happens with preeclampsia, Andrea's blood pressure viagra 100mg cost went back to normal after she gave birth. Less than a week later, though, she woke up with a migraine. No matter what she tried, the headache worsened. Worried, Martin drove her viagra 100mg cost to urgent care.

On the way, Andrea had the excruciating sensation that something burst in her head. "On a scale of one to 10, the pain was a 10-plus," she said. It's the viagra 100mg cost last thing she remembers before losing consciousness. The staff at urgent care took one look at Andrea and called 911. At the hospital, doctors determined she had suffered a hemorrhagic stroke and arranged to transfer her to another facility better equipped to treat cases like hers.

Before they loaded her into the ambulance, a viagra 100mg cost doctor told Martin that most people in her condition don't survive. Andrea was 34 years old at the time. Doctors at the better-equipped hospital were able to surgically repair the damage in her brain. She was left in viagra 100mg cost a medically induced coma to help her body heal from the trauma of the stroke and the operation. After 12 days, she regained consciousness.

When Andrea arrived at a rehabilitation hospital in Seattle, she couldn't sit up by herself. Speaking was viagra 100mg cost extremely difficult. She couldn't read or write and struggled to identify everyday objects such as an apple. Many times, she couldn't remember if she had given birth to a boy or a girl. "I cried a viagra 100mg cost lot," she said.

Tears flowed, for example, when Andrea's doctor told the couple that if she ever got pregnant again, she might face the same sort of complications. While the couple had intended to have one child, Andrea struggled with the fact "it had been decided for me." "That was hard to hear," she said. As difficult as things seemed, Andrea knew from her 5K training viagra 100mg cost that small steps could make a big difference. For instance, in learning to read again, she sounded out each word. She progressed from words to sentences.

Then to viagra 100mg cost entire books. She made the same sort of progress with using her arms and legs, speaking and writing. There have been some bumps along the way. Almost exactly on the one-year anniversary of her stroke, a seizure left her unable viagra 100mg cost to speak. It hardly helped that doctors had warned she was at higher risk for seizures until her brain healed fully.

SLIDESHOW Stroke Causes, Symptoms, and Recovery See Slideshow "I was freaking out, but it was just a setback," she said. "I still have difficulty at times, but I've come so far." Indeed, when Andrea heard about a virtual viagra 100mg cost 5K sponsored by the American Heart Association, she convinced Martin they should sign up. "We ran the entire thing," she said. Martin marvels at Andrea's recovery, knowing that her competitive spirit will push her to continue erasing her limitations. "She's inspiring," he viagra 100mg cost said.

Determined to make something positive out of her experience, Andrea gladly shares her story on local radio and TV spots as an AHA ambassador. "My story could help another person," she said. "I want people to know that viagra 100mg cost there's hope out there." American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved.

If you have questions or comments about this story, please viagra 100mg cost email [email protected]. By Tate Gunnerson American Heart Association News Copyright © 2021 HealthDay. All rights reserved. From Healthy Resources Featured Centers Health Solutions From viagra 100mg cost Our SponsorsLatest erectile dysfunction News THURSDAY, July 1, 2021 (HealthDay News) A steep rise in vaccination rates has dropped erectile dysfunction treatment from the first to the seventh leading cause of death in the United States, a new analysis shows. The disease was the third leading cause of death for much of 2020, but became the leading cause of death in December 2020 and early 2021, reaching a peak of 3,136 deaths per day in January 2021 and far surpassing U.S.

Deaths from heart disease and cancer during that time. Heart disease is typically the number viagra 100mg cost one cause of death (about 2,000 a day), while cancer claims about 1,600 lives a day, according to the Peterson-KFF Health System Tracker. The tracker provides up-to-date information on trends and issues that impact the performance of the health system. erectile dysfunction treatment dropped to the seventh leading cause of death in the United States in June 2021, with an average of 342 deaths a day. Heart disease was again the leading cause of death (2,101 per day) in viagra 100mg cost June, with the others being cancer (1,614), accidents (474), stroke (451), chronic lower respiratory disease (377) and Alzheimer's disease (351), according to the report.

erectile dysfunction treatment deaths have fallen sharply as vaccination rates have surged in recent months. As of June 30, about two-thirds of U.S. Adults have received at least one erectile dysfunction treatment viagra 100mg cost treatment dose. However, it appears that the federal government won't achieve its goal of getting at least one shot into the arms of 70% of adults by July 4 due to lagging vaccination rates, particularly among younger adults and residents of certain states. The total number of erectile dysfunction treatment deaths in the United States as of June 30 was 604,656, and nearly all deaths have been among unvaccinated people, the researchers reported.

A recent KFF poll found that half of unvaccinated viagra 100mg cost U.S. Adults said the number of cases is so low there is no need for more people to get vaccinated. But if vaccination rates plateau, erectile dysfunction treatment could remain among the top 10 leading causes of death in the United States, despite the availability of safe and highly effective treatments, according to the Peterson-KFF report. More information The viagra 100mg cost U.S. Centers for Disease Control and Prevention has more on erectile dysfunction treatment.

SOURCE. Peterson-KFF report, July viagra 100mg cost 1, 2021 Robert Preidt Copyright © 2021 HealthDay. All rights reserved.Latest erectile dysfunction News By Steven Reinberg HealthDay ReporterTHURSDAY, July 1, 2021 (HealthDay News) Can pets get erectile dysfunction treatment from their beloved owners?. Yes, they can. In fact, a pair of new studies suggest that erectile dysfunction treatment is quite common among cats and dogs in households where someone has contracted viagra 100mg cost the viagra.

But at a virtual meeting of the European Congress of Clinical Microbiology slated for next week, both research teams will report that infected pets do not, as yet, appear to pose any erectile dysfunction treatment risk to their owners. Instead, said investigators, the risk of transmission appears to head in the other direction, with infected owners very often -- though not always -- passing the viagra on to Fido and Fluffy. "If someone has erectile dysfunction treatment, there is a surprisingly high chance viagra 100mg cost they will pass it on to their pet," said Dr. Dorothee Bienzle. She's the lead author of one study, and a professor and veterinary pathologist with the Veterinary College at the University of Guelph in Ontario, Canada.

That's particularly the case among cats, said Bienzle, who found that cats appear viagra 100mg cost to be considerably more vulnerable to erectile dysfunction treatment via their owners than dogs. "We knew that [both] cats and dogs are susceptible to erectile dysfunction treatment, but we did not expect such a high rate in cats living with erectile dysfunction treatment-positive persons," she said. After running antibody tests on 48 cats and 54 dogs drawn from 77 different households in which an owner had been diagnosed with erectile dysfunction treatment, Bienzle and her colleagues found that more than two-thirds of cats in erectile dysfunction treatment households ultimately came down with the viagra, compared with just 43% of the dogs. Bienzle said that viagra 100mg cost for now it remains unclear precisely why cats appear to be more vulnerable. "Susceptibility to depends on many factors," she noted, "such as how much of the receptor is expressed in the nose, mouth, eyes, trachea [windpipe] and lung, and how efficiently the viagra can get inside cells after binding to the receptor.

Those factors are likely different between dogs and cats, but we don't know for sure yet." What Bienzle's team does know, however, is that the vulnerability is far lower among pets who do not live in close proximity to erectile dysfunction treatment patients. Antibody tests conducted among 75 cats living in animal shelters revealed that less than 10% viagra 100mg cost had antibodies for erectile dysfunction treatment. And among 75 stray cats that were tested, that figure fell to just 3%. Bienzle's take-away. "I don't think there is a broad health threat to humans from pets." That conclusion viagra 100mg cost is shared by Dr.

Els Broens, a European veterinary specialist in veterinary microbiology at Utrecht University in the Netherlands. Broens, co-author of the second pet study, agreed that "the most likely route of transmission seems to be from human to pet." She and her colleagues came to that conclusion after testing 156 dogs and 155 cats drawn from 196 households with erectile dysfunction treatment-positive household members. "In 20% of households, pets tested erectile dysfunction positive," Broens viagra 100mg cost noted. "[But] this percentage is rather high compared to other studies in dogs and cats that were not in close contact with erectile dysfunction treatment positive persons." This finding, she said, strongly suggests that it's "unlikely that pets play a significant role in the viagra," with the direction of transmission running from owner to pet, rather than the other way around. Before pet owners become overly concerned about their furry best friends, both Broens and Bienzle have good news.

Although a minority of pet erectile dysfunction treatment cases may turn out to be severe, both investigations found that when cats and dogs do viagra 100mg cost contract erectile dysfunction treatment their symptoms are typically mild, and a full recovery is the norm. And there may actually be simple ways to reduce the risk for pet altogether. To that end, Broens said that infected pet owners should strive "to avoid contact with their pets as much as possible, and to keep their pets indoor as much as possible." Similarly, Bienzle said infected owners can protect their pets by handling the situation "the same way that they would protect themselves from an infected person. Don't breathe the same air, keep distance, practice good hand hygiene." And that's particularly important to keep in mind among cats, she said, as the study revealed that viagra 100mg cost risk appears to be higher among cats that spend more time with their owners, particularly among cats who sleep in the same bed as an infected owner. The same concern does not appear to hold among dogs, Bienzle noted, adding that the particulars of cat biology -- and their tendency to sleep nearer to their owner's face than dogs -- may explain the heightened risk among felines.

But Bienzle acknowledged that in certain circumstances pet isolation or social distancing simply isn't possible or practical. Unfortunately in such cases, she said, owners would do well to view their pets viagra 100mg cost "as potentially infected." Research presented at meetings is considered preliminary until published in a peer-reviewed journal. More information There's more information on pets and erectile dysfunction treatment at the U.S. Centers for Disease Control and Prevention. SOURCES.

Dorothee Bienzle, DVM, PhD, professor and veterinary pathologist, Veterinary College, University of Guelph, Ontario, Canada. Els Broens, DVM, PhD, veterinary specialist in veterinary microbiology, and associate professor and director, Department of Biomolecular Health Sciences (clinical infectiology), Faculty of Veterinary Medicine, Utrecht University, the Netherlands. Presentation, European Congress of Clinical Microbiology virtual meeting, July 9-12, 2021 Copyright © 2021 HealthDay. All rights reserved.Latest Pregnancy News By Dennis Thompson HealthDay ReporterTHURSDAY, July 1, 2021 (HealthDay News) The notion of parents picking out genetically perfect babies may seem like science fiction, but bioethicists warn in a new report that some companies have already started to offer couples going through in vitro fertilization (IVF) the means to pick better embryos through polygenic scoring. Polygenic scores are a "weighted average of the contributions of all of the genes we have information on in the genome, to try to predict whether one person has a higher or lower rate of a disease or some trait," explained Patrick Turley, an assistant professor of research with the University of Southern California's Center for Economic and Social Research, in Los Angeles.

Couples might be tempted to use polygenic scoring to pick embryos predicted to have specific traits they treasure, hoping to produce kids who are taller, smarter, or less likely to develop cancer or heart disease. However, polygenic scores aren't as predictive right now as genetics companies might claim, and there are a lot of potential pitfalls about using them to select an embryo, the experts argue. "People are just lousy at understanding probabilities. We're just not good at it and that's what polygenic scores involve," said Michelle Meyer, assistant director of research ethics with Geisinger Health System's Center for Translational Bioethics and Health Policy in Danville, Penn. "They aren't guarantees at all.

They are very much predictions, and they are infinitely worse than predictions about the weather, which we all know are imperfect." But even though the technology is currently flawed, it is expected to improve as scientists expand their understanding of genetic risk. As it does, this service will open up the possibility of a future where there will be genetic haves and have-nots, Meyer added. Given the disparities already present in medicine, it's not too far-fetched to consider, said Meyer, who co-authored a report on the trend in the July 1 issue of the New England Journal of Medicine. "You're going to have a narrow segment of society who is more likely to benefit from [polygenic scoring] than others, so there's some danger of furthering disparities," Meyer said. For the moment, experts are mainly concerned that prospective parents are being given false promises related to polygenic scoring of embryos.

Still an uncertain science Genetics firms have promised polygenic scoring of embryos that will weigh risk of cancer, heart disease, high blood pressure, high cholesterol, inflammatory bowel disease, Alzheimer's disease, intellectual disability, dwarfism, and a host of other common medical conditions, the researchers noted in their report. Scientists just don't know enough about human genetics to make firm promises that these scores will have significant bearing on the individual traits of such "chosen" children, Meyer said. "There's a lot of risk and uncertainty, and we worry about whether people really know that," Meyer said. "Companies don't have the incentive to help consumers understand the limitations of the service that they're offering. Their built-in incentive is to emphasize and perhaps overemphasize the benefits and underemphasize the limitations." For example, parents might want to use polygenic scoring to reduce the risk of having a child of short stature.

But a child chosen in this manner could be expected to be just 1 inch taller than average, "an outcome that is unlikely to be practically meaningful and that in any case might surprise parents who believe they had successfully selected against short stature," the report stated. There's also a serious danger of unintended consequences, given that individual genes often perform multiple duties in humans, Turley noted. "Genes don't usually do just one thing. When you select an embryo based on a decreased risk for one disease, like cancer or diabetes, you may be selecting an embryo that's at increased risk for some other disease that we just don't know about," he said. QUESTION The first sign of pregnancy is most often.

See Answer "If you select an embryo that's predicted to have the highest educational attainment, that also would theoretically increase the risk of your child eventually having bipolar disorder," Turley said. "That's a relationship we know about." An embryo selected on the basis of the polygenic score for educational attainment would have a 16% increased risk of bipolar disorder, for instance, with the resulting child's absolute genetic risk for bipolar increasing from 1% to 1.16%, the report stated. Broader societal implications come into play when you consider who can afford IVF in the first place, and which groups now benefit from more knowledge of human genetics. Who can afford it?. IVF costs tens of thousands of dollars per cycle and is not covered by most insurance, Meyer said, making it a procedure that only well-off couples can afford.

People with means also are more likely to be on the winning side of health disparities already present in the United States. "There's a separate risk that over time and in the aggregate this could widen or exacerbate health disparities and other sorts of disparities that already exist," Meyer said. "That's because not everybody is going to have equal access to this technology." And even if a Black, Asian or Hispanic couple can afford IVF today, they're not likely to benefit as much from polygenic scoring of their embryos. That's because most of the genetic information gathered thus far has focused on people of European ancestry, making the scoring more accurate for those folks, the authors said. "Right now, polygenic scores are going to be more predictive for people of European ancestries than for people of other ancestries.

That's only because the research underlying the polygenic scores just happens to come overwhelmingly from people of European genetic ancestry," Meyer said. Meyer would like the Federal Trade Commission (FTC) to step in and protect couples from the false promises of genetic analysis companies. "The Federal Trade Commission should simply enforce its truth in advertising laws," Meyer said. "The agency should become aware of these companies, that in a very short space of time there are multiple companies that have sprung up. They should monitor their marketing materials and campaigns, and ensure that the materials, per FTC law, are truthful and non-misleading.

"They have done that in the past with IVF clinics, when they would advertise certain pregnancy rates, so there's some precedent for that," Meyer continued. Beyond that, the field of polygenic scoring needs more research to determine how to best communicate the risks and promises of this technology to average people, Meyer added. Weeding out certain traits "We are at the cutting edge," Meyer said. "People who study things like risk communication are just beginning to do empirical research to figure out how people understand or fail to understand polygenic scores, and how can we communicate them to them in a way that mitigates those risks of communication." Armed with that research, professional medical societies should develop policies and guidance regarding the use of polygenic scoring and how it's explained to couples, Meyer said. There also needs to be a society-wide conversation about whether polygenic scoring is something that ought to be done.

"Do we want to be choosing the kinds of kids we have?. Should we look at parenthood more as a gift, and should we try not to select so much for it?. " Meyer said. Meyer noted that the door is already firmly open for this sort of testing in IVF. Pre-implantation genetic diagnosis is a common procedure used during IVF for couples with a high risk of transmitting a known genetic condition to their offspring.

"Bioethicists have been working on these types of issues for a few decades, so I think a lot of people would say we're pretty well down the slope at this point," Meyer said. "That Rubicon has been crossed already, and there are people who use it to select for or against traits that are controversial," such as deafness, dwarfism and Down syndrome. "The number of people who are born with Down syndrome has dwindled over time in part because of reproductive technologies. That is not without controversy. What does that mean for people who are living with Down syndrome, to know that other people are choosing specifically to not have kids with Down syndrome.

How does that affect them in life?. " Meyer said. "Here we are expanding that problem to a lot of other traits," Meyer said of polygenic scoring. "In theory, if you start selecting against embryos with different traits, you then wonder about the people whose parents didn't use that technology, or they used it but because it's not a perfect predictor their child ended up having that trait anyway. How do their parents view them?.

How does society view them, when there's a signal that this trait or outcome is not valued?. " More information The National Society of Genetic Counselors has more about polygenic risk scores. SOURCES. Patrick Turley, PhD, assistant professor, research, University of Southern California's Center for Economic and Social Research, Los Angeles. Michelle Meyer, PhD, JD, assistant director, research ethics, Geisinger Health System's Center for Translational Bioethics and Health Care Policy, Danville, Penn..

New England Journal of Medicine, July 1, 2021 Copyright © 2021 HealthDay. All rights reserved. From Healthy Resources Featured Centers Health Solutions From Our SponsorsLatest Heart News By Amy Norton HealthDay ReporterTHURSDAY, July 1, 2021 (HealthDay News) A gene therapy aimed at freeing the heart's capacity for self-repair has shown early promise in an animal study. The study -- done in pigs -- found that the treatment approach was not only feasible, but also improved the animals' heart function after they sustained heart attack damage. There is a long way to go before a similar gene therapy could be applied to human heart attack sufferers.

But researchers said the findings offer proof that heart muscle cells can be coaxed into dividing and spreading to help repair damaged tissue. The hope is to one day have a therapy that can prevent heart attack sufferers from developing heart failure, according to senior researcher Dr. James Martin, a professor at Baylor College of Medicine in Houston. Heart failure is a chronic condition in which the heart can no longer pump blood efficiently enough to meet the body's needs. It has various causes, but heart attack is a common one.

During a heart attack, the organ is starved of blood and oxygen, which kills a portion of the muscle. That damaged area is replaced by scar tissue, which hinders the heart's pumping ability -- often leading to heart failure. The ultimate goal of this gene therapy research is to halt that "downward spiral," Martin said. As ingenious as the human heart is, it lacks a way to self-repair. Cardiomyocytes (heart muscle cells) have only a very limited capacity for renewal.

As Martin explained, it's thought that human heart cells evolved to become highly specialized, dedicated to their job of providing a strong, steady pump that lasts for decades. They do not divide and proliferate in a way that would be necessary for tissue regeneration. The experimental gene therapy used in this study targets a system in the human body -- known as the Hippo signaling pathway -- that normally inhibits cells in the heart and other organs from proliferating. That's a necessary function. If the Hippo pathway were dialed down throughout the heart, that would likely spell trouble, Martin said.

But his team reasoned that trying to inhibit the Hippo pathway in a limited way, among surviving cells bordering the area of heart attack damage, might prove effective. To do that, they turned to gene therapy. The researchers used a non-infectious viagra as a vehicle to deliver genetic material -- a piece of RNA -- designed to "knock down" a particular gene in the Hippo pathway. They injected the viral vector directly into areas bordering heart attack damage in pig hearts. After three months, the treated pigs showed signs of newly generated heart cells, less scar tissue and some small blood vessel growth, the researchers reported.

On average, there was a 14% improvement in the animals' ejection fraction -- a measure of the heart's pumping ability. The findings were published June 30 in the journal Science Translational Medicine. "This is an elegant study," said Dr. Arthur Feldman, a professor at Temple University Lewis Katz School of Medicine in Philadelphia. Feldman, who was not involved in the research, is studying gene therapy for a form of heart failure caused by mutations in a specific gene, called BAG3.

He said that approach -- aiming to replace a defective gene -- is different from the one used here, where the goal was to suppress a normal pathway in the heart and encourage self-repair. Feldman called the concept "fascinating," but also said important questions remain before the tactic could move into human testing. The Hippo pathway limits cellular spread for good reason. It controls organ size, and also contains genes involved in tumor suppression. So one concern, Feldman said, is that inhibiting the Hippo pathway could cause too much cell proliferation, including in other organs.

Another question, he said, is whether spurring muscle growth in just one part of the heart could trigger arrhythmias. In this study, researchers found no signs of tumors in the treated pigs' lungs or livers. And in the heart, Martin said, the treatment may be "self-limiting." One reason is that once heart muscle cells start dividing and achieve a greater density, the Hippo pathway is turned back on. That said, Martin agreed that plenty of work lies ahead. He said researchers will continue to study the approach in animals, to ensure it's safe for the heart and shows no unintended effects on other organs.

And while pig hearts are similar to human hearts, there are also differences. Figuring out how human cardiomyocytes respond to the gene therapy will be "essential," the researchers said. SLIDESHOW Heart Disease. Symptoms, Signs, and Causes See Slideshow More information The American Heart Association has more on causes of heart failure. SOURCES.

James Martin, MD, PhD, professor and chairman, regenerative medicine, Baylor College of Medicine, Houston, and director, Cardiomyocyte Renewal Lab, Texas Heart Institute, Houston. Arthur Feldman, MD, PhD, professor, medicine, Cardiovascular Research Center, Temple University Lewis Katz School of Medicine, Philadelphia. Science Translational Medicine, June 30, 2021, online Copyright © 2021 HealthDay. All rights reserved. From Healthy Heart Resources Featured Centers Health Solutions From Our Sponsors.

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About This TrackerThis tracker provides the number of confirmed cases and viagra drug class deaths from novel erectile dysfunction by country, the trend in confirmed case and death counts by country, and a global map showing which countries have confirmed cases and deaths. The data are drawn from the Johns Hopkins University (JHU) erectile dysfunction Resource Center’s erectile dysfunction treatment Map and the World Health Organization’s (WHO) erectile dysfunction Disease (erectile dysfunction treatment-2019) situation reports.This tracker will be updated regularly, as new data are released.Related Content. About erectile dysfunction treatment viagra drug class erectile dysfunctionIn late 2019, a new erectile dysfunction emerged in central China to cause disease in humans. Cases of this disease, known as erectile dysfunction treatment, have since been reported across around the globe. On January 30, 2020, the World Health Organization (WHO) declared the viagra represents a public health emergency of international concern, and on January 31, 2020, the U.S viagra drug class.

Department of Health and Human Services declared it to be a health emergency for the United States.Few issues are likely to matter as much to voters in November’s presidential election as President Trump’s response to the erectile dysfunction treatment viagra and resulting economic crisis, which have left almost 200,000 Americans dead and prompted job layoffs and furloughs affecting tens of millions of Americans.A new election brief compares President Trump and Democratic nominee Joe Biden on their records, actions and proposals related to the viagra and its health and economic consequences, including a detailed side-by-side table summarizing different aspects of their approaches. These matters have been generally viewed through a partisan lens by the electorate, a phenomenon well documented in KFF polling.It is part of KFF’s ongoing efforts to provide viagra drug class timely and useful information related to the health policy issues relevant for the 2020 elections, including policy analysis, polling, and journalism. Find more on our Election 2020 resource page..

About This TrackerThis tracker provides the number of confirmed cases and deaths from novel erectile dysfunction by country, the viagra 100mg cost trend in confirmed case and death counts by country, and a global map showing which countries have confirmed cases and deaths. The data are drawn from the Johns Hopkins University (JHU) erectile dysfunction Resource Center’s erectile dysfunction treatment Map and the World Health Organization’s (WHO) erectile dysfunction Disease (erectile dysfunction treatment-2019) situation reports.This tracker will be updated regularly, as new data are released.Related Content. About erectile dysfunction treatment erectile dysfunctionIn late 2019, a viagra 100mg cost new erectile dysfunction emerged in central China to cause disease in humans. Cases of this disease, known as erectile dysfunction treatment, have since been reported across around the globe. On January 30, 2020, the World Health Organization (WHO) declared the viagra 100mg cost viagra represents a public health emergency of international concern, and on January 31, 2020, the U.S.

Department of Health and Human Services declared it to be a health emergency for the United States.Few issues are likely to matter as much to voters in November’s presidential election as President Trump’s response to the erectile dysfunction treatment viagra and resulting economic crisis, which have left almost 200,000 Americans dead and prompted job layoffs and furloughs affecting tens of millions of Americans.A new election brief compares President Trump and Democratic nominee Joe Biden on their records, actions and proposals related to the viagra and its health and economic consequences, including a detailed side-by-side table summarizing different aspects of their approaches. These matters have been generally viewed through a partisan lens by the electorate, a phenomenon well documented viagra 100mg cost in KFF polling.It is part of KFF’s ongoing efforts to provide timely and useful information related to the health policy issues relevant for the 2020 elections, including policy analysis, polling, and journalism. Find more on our Election 2020 resource page..

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Wealthy nations must do much more, much faster.The United Nations General Assembly in September 2021 will watermelon natural viagra bring countries together at a critical time for marshalling collective action to tackle the global environmental crisis. They will meet watermelon natural viagra again at the biodiversity summit in Kunming, China, and the climate conference (Conference of the Parties (COP)26) in Glasgow, UK. Ahead of these pivotal meetings, we—the editors of health journals worldwide—call for urgent action to keep average global temperature increases below 1.5°C, halt the destruction of nature and protect health.Health is already being harmed by global temperature increases and the destruction of the natural world, a state of affairs health professionals have been bringing attention to for decades.1 The science is unequivocal. A global increase of 1.5°C above the preindustrial average and the continued loss of biodiversity risk catastrophic harm to health that will be impossible to reverse.2 3 Despite the watermelon natural viagra world’s necessary preoccupation with erectile dysfunction treatment, we cannot wait for the viagra to pass to rapidly reduce emissions.Reflecting the severity of the moment, this editorial appears in health journals across the world.

We are united in recognising that only fundamental and equitable changes to societies will reverse our current trajectory.The risks to health of increases above 1.5°C are now well established.2 Indeed, no temperature rise is ‘safe’. In the past 20 years, heat-related mortality among people aged over 65 has increased by more than 50%.4 Higher temperatures have brought increased dehydration and renal function loss, dermatological malignancies, tropical s, adverse mental health outcomes, pregnancy complications, allergies, and cardiovascular and pulmonary morbidity and mortality.5 6 Harms watermelon natural viagra disproportionately affect the most vulnerable, including children, older populations, ethnic minorities, poorer communities and those with underlying health problems.2 4Global heating is also contributing to the decline in global yield potential for major crops, falling by 1.8%–5.6% since 1981. This, together with the effects of extreme weather and soil depletion, is hampering efforts to reduce undernutrition.4 Thriving ecosystems are essential watermelon natural viagra to human health, and the widespread destruction of nature, including habitats and species, is eroding water and food security and increasing the chance of viagras.3 7 8The consequences of the environmental crisis fall disproportionately on those countries and communities that have contributed least to the problem and are least able to mitigate the harms. Yet no country, no matter how wealthy, can shield itself from these impacts.

Allowing the consequences to fall disproportionately on the most vulnerable will breed more conflict, food insecurity, forced displacement and zoonotic disease, with severe watermelon natural viagra implications for all countries and communities. As with the erectile dysfunction treatment viagra, we are globally as strong as our weakest member.Rises above 1.5°C increase the chance of reaching tipping points in natural systems that could lock the world into an acutely unstable state. This would critically impair our ability to mitigate harms and to prevent catastrophic, runaway environmental change.9 10Global targets are not enoughEncouragingly, many governments, financial institutions and businesses are setting targets to reach net-zero emissions, including watermelon natural viagra targets for 2030. The cost of renewable energy is dropping rapidly.

Many countries are watermelon natural viagra aiming to protect at least 30% of the world’s land and oceans by 2030.11These promises are not enough. Targets are easy to set watermelon natural viagra and hard to achieve. They are yet to be matched with credible short-term and longer-term plans to accelerate cleaner technologies and transform societies. Emissions reduction plans do not adequately incorporate health considerations.12 Concern is growing that temperature rises above 1.5°C are beginning to be seen as inevitable, or even acceptable, to powerful members of the global community.13 Relatedly, current strategies for reducing emissions to net zero by the middle of the century implausibly assume that the world will acquire great capabilities to remove greenhouse gases watermelon natural viagra from the atmosphere.14 15This insufficient action means that temperature increases are likely to be well in excess of 2°C,16 a catastrophic outcome for health and environmental stability.

Critically, the destruction of nature does not have parity of esteem with the climate element of the crisis, and every single global target to restore biodiversity loss by 2020 was missed.17 This is an overall environmental crisis.18Health professionals are united with environmental scientists, businesses and many others in rejecting that this outcome is inevitable. More can and must be done now—in Glasgow and Kunming—and in the immediate years watermelon natural viagra that follow. We join health professionals worldwide who have already supported calls for rapid action.1 19Equity must be at the centre of the global response. Contributing a fair share to the global effort means that reduction commitments must account for the cumulative, historical contribution each country watermelon natural viagra has made to emissions, as well as its current emissions and capacity to respond.

Wealthier countries will have to cut emissions more watermelon natural viagra quickly, making reductions by 2030 beyond those currently proposed20 21 and reaching net-zero emissions before 2050. Similar targets and emergency action are needed for biodiversity loss and the wider destruction of the natural world.To achieve these targets, governments must make fundamental changes to how our societies and economies are organised and how we live. The current strategy of encouraging markets to swap watermelon natural viagra dirty for cleaner technologies is not enough. Governments must intervene to support the redesign of transport systems, cities, production and distribution of food, markets for financial investments, health systems, and much more.

Global coordination is needed to ensure that the rush watermelon natural viagra for cleaner technologies does not come at the cost of more environmental destruction and human exploitation.Many governments met the threat of the erectile dysfunction treatment viagra with unprecedented funding. The environmental watermelon natural viagra crisis demands a similar emergency response. Huge investment will be needed, beyond what is being considered or delivered anywhere in the world. But such investments will produce huge positive health and watermelon natural viagra economic outcomes.

These include high-quality jobs, reduced air pollution, increased physical activity, and improved housing and diet. Better air quality alone would realise health benefits that easily offset the global costs of emissions reductions.22These measures will also improve the social and economic determinants of health, the poor state of which may have made populations more vulnerable to the erectile dysfunction treatment viagra.23 But the changes cannot be achieved through a return to damaging austerity policies or the continuation of the large inequalities of wealth and power within and between watermelon natural viagra countries.Cooperation hinges on wealthy nations doing moreIn particular, countries that have disproportionately created the environmental crisis must do more to support low-income and middle-income countries to build cleaner, healthier and more resilient societies. High-income countries must meet and go beyond their outstanding commitment to provide $100 billion a year, making up for any shortfall in 2020 and increasing contributions to and beyond 2025. Funding must be equally split between mitigation and adaptation, including improving the resilience of health systems.Financing should be through grants rather than loans, building local capabilities watermelon natural viagra and truly empowering communities, and should come alongside forgiving large debts, which constrain the agency of so many low-income countries.

Additional funding must be marshalled to compensate for inevitable loss and watermelon natural viagra damage caused by the consequences of the environmental crisis.As health professionals, we must do all we can to aid the transition to a sustainable, fairer, resilient and healthier world. Alongside acting to reduce the harm from the environmental crisis, we should proactively contribute to global prevention of further damage and action on the root causes of the crisis. We must hold global leaders to account and continue to educate watermelon natural viagra others about the health risks of the crisis. We must join in the work to achieve environmentally sustainable health systems before 2040, recognising that this will mean changing clinical practice.

Health institutions have already divested more than $42 billion of assets from fossil fuels watermelon natural viagra. Others should join them.4The greatest threat to global public health is the continued failure of world leaders to keep the global temperature rise below 1.5°C and to restore nature. Urgent, society-wide changes must be made watermelon natural viagra and will lead to a fairer and healthier world. We, as editors of health journals, call for governments and other watermelon natural viagra leaders to act, marking 2021 as the year that the world finally changes course.Ethics statementsPatient consent for publicationNot required.Furukawa et al1 posed the question.

How can we estimate quality-adjusted life years (QALYs) based on Patient Health Questionnaire-9 (PHQ-9) scores?. They recommend equipercentile linking analysis between watermelon natural viagra the depression severity PHQ-9 and preference-based EQ-5D three-level version (EQ-5D-3L. UK value set), the latter used to estimate utility data for QALYs.Furukawa et al1 refer to the process of ‘cross-walking’, whereby the practice of fitting a statistical model to health utility data has been referred to as ‘mapping’ and 'cross-walking’.2 Furukawa et al1 reference two mapping-related papers (their references 7 and 9). However, their analysis seems to have missed rigorous mapping methodology and previous studies which have used these mapping processes, alongside other conceptual considerations when wanting to ‘cross-walk’/‘map’ from a non-preference-based (often condition-specific) measure such as watermelon natural viagra the PHQ-9 to the preference-based EQ-5D-3L.

Wealthy nations must do much more, much faster.The United Nations General Assembly in September 2021 will bring countries together at a critical time for marshalling collective action to tackle the global environmental viagra 100mg cost crisis. They will meet again at the viagra 100mg cost biodiversity summit in Kunming, China, and the climate conference (Conference of the Parties (COP)26) in Glasgow, UK. Ahead of these pivotal meetings, we—the editors of health journals worldwide—call for urgent action to keep average global temperature increases below 1.5°C, halt the destruction of nature and protect health.Health is already being harmed by global temperature increases and the destruction of the natural world, a state of affairs health professionals have been bringing attention to for decades.1 The science is unequivocal.

A global increase of 1.5°C above the preindustrial average and the continued loss of biodiversity risk catastrophic harm to health that will be impossible to reverse.2 3 Despite the world’s necessary preoccupation with erectile dysfunction treatment, we cannot wait for the viagra to pass to rapidly reduce emissions.Reflecting the severity of viagra 100mg cost the moment, this editorial appears in health journals across the world. We are united in recognising that only fundamental and equitable changes to societies will reverse our current trajectory.The risks to health of increases above 1.5°C are now well established.2 Indeed, no temperature rise is ‘safe’. In the past 20 years, heat-related mortality among people aged over 65 has increased by more than 50%.4 Higher viagra 100mg cost temperatures have brought increased dehydration and renal function loss, dermatological malignancies, tropical s, adverse mental health outcomes, pregnancy complications, allergies, and cardiovascular and pulmonary morbidity and mortality.5 6 Harms disproportionately affect the most vulnerable, including children, older populations, ethnic minorities, poorer communities and those with underlying health problems.2 4Global heating is also contributing to the decline in global yield potential for major crops, falling by 1.8%–5.6% since 1981.

This, together with the effects of extreme weather and soil depletion, is hampering efforts to reduce undernutrition.4 Thriving ecosystems are essential to human viagra 100mg cost health, and the widespread destruction of nature, including habitats and species, is eroding water and food security and increasing the chance of viagras.3 7 8The consequences of the environmental crisis fall disproportionately on those countries and communities that have contributed least to the problem and are least able to mitigate the harms. Yet no country, no matter how wealthy, can shield itself from these impacts. Allowing the consequences to fall disproportionately on the most vulnerable will breed more conflict, food insecurity, forced displacement viagra 100mg cost and zoonotic disease, with severe implications for all countries and communities.

As with the erectile dysfunction treatment viagra, we are globally as strong as our weakest member.Rises above 1.5°C increase the chance of reaching tipping points in natural systems that could lock the world into an acutely unstable state. This would critically impair our ability to mitigate harms and viagra 100mg cost to prevent catastrophic, runaway environmental change.9 10Global targets are not enoughEncouragingly, many governments, financial institutions and businesses are setting targets to reach net-zero emissions, including targets for 2030. The cost of renewable energy is dropping rapidly.

Many countries are aiming to protect at least 30% of the world’s land and oceans by 2030.11These promises are not viagra 100mg cost enough. Targets are easy viagra 100mg cost to set and hard to achieve. They are yet to be matched with credible short-term and longer-term plans to accelerate cleaner technologies and transform societies.

Emissions reduction plans do not adequately incorporate health considerations.12 Concern is growing that temperature rises above 1.5°C are beginning to be seen as inevitable, or even acceptable, to powerful members of the global community.13 Relatedly, current strategies for reducing emissions to net zero by the middle of the century implausibly assume that the world will acquire great capabilities to remove greenhouse gases from the atmosphere.14 15This insufficient action viagra 100mg cost means that temperature increases are likely to be well in excess of 2°C,16 a catastrophic outcome for health and environmental stability. Critically, the destruction of nature does not have parity of esteem with the climate element of the crisis, and every single global target to restore biodiversity loss by 2020 was missed.17 This is an overall environmental crisis.18Health professionals are united with environmental scientists, businesses and many others in rejecting that this outcome is inevitable. More can and must be done viagra 100mg cost now—in Glasgow and Kunming—and in the immediate years that follow.

We join health professionals worldwide who have already supported calls for rapid action.1 19Equity must be at the centre of the global response. Contributing a fair share to the global effort means that viagra 100mg cost reduction commitments must account for the cumulative, historical contribution each country has made to emissions, as well as its current emissions and capacity to respond. Wealthier countries will have to cut emissions more quickly, viagra 100mg cost making reductions by 2030 beyond those currently proposed20 21 and reaching net-zero emissions before 2050.

Similar targets and emergency action are needed for biodiversity loss and the wider destruction of the natural world.To achieve these targets, governments must make fundamental changes to how our societies and economies are organised and how we live. The current strategy of viagra 100mg cost encouraging markets to swap dirty for cleaner technologies is not enough. Governments must intervene to support the redesign of transport systems, cities, production and distribution of food, markets for financial investments, health systems, and much more.

Global coordination is needed to ensure that the rush for cleaner technologies does not come at the cost of more environmental destruction and human exploitation.Many governments met the threat of the erectile dysfunction treatment viagra with viagra 100mg cost unprecedented funding. The environmental crisis demands a similar emergency viagra 100mg cost response. Huge investment will be needed, beyond what is being considered or delivered anywhere in the world.

But such investments will produce huge positive health and viagra 100mg cost economic outcomes. These include high-quality jobs, reduced air pollution, increased physical activity, and improved housing and diet. Better air quality alone would realise health benefits that easily offset the global costs of emissions reductions.22These measures will also improve the social and economic determinants of health, the poor state of which may have made populations more vulnerable to the erectile dysfunction treatment viagra.23 But the changes cannot be achieved through a return to damaging austerity policies or the continuation of the large inequalities of wealth and power within and between countries.Cooperation hinges on wealthy nations doing moreIn particular, countries that have disproportionately created the environmental crisis must do more to support low-income viagra 100mg cost and middle-income countries to build cleaner, healthier and more resilient societies.

High-income countries must meet and go beyond their outstanding commitment to provide $100 billion a year, making up for any shortfall in 2020 and increasing contributions to and beyond 2025. Funding must be equally split between mitigation and adaptation, including improving the resilience of health systems.Financing should be through grants rather than loans, building local capabilities and truly empowering communities, and should come alongside forgiving large debts, viagra 100mg cost which constrain the agency of so many low-income countries. Additional funding must be marshalled to compensate for inevitable loss and damage caused by the consequences of the environmental crisis.As viagra 100mg cost health professionals, we must do all we can to aid the transition to a sustainable, fairer, resilient and healthier world.

Alongside acting to reduce the harm from the environmental crisis, we should proactively contribute to global prevention of further damage and action on the root causes of the crisis. We must viagra 100mg cost hold global leaders to account and continue to educate others about the health risks of the crisis. We must join in the work to achieve environmentally sustainable health systems before 2040, recognising that this will mean changing clinical practice.

Health institutions have already divested more than $42 viagra 100mg cost billion of assets from fossil fuels. Others should join them.4The greatest threat to global public health is the continued failure of world leaders to keep the global temperature rise below 1.5°C and to restore nature. Urgent, society-wide changes must be made and will lead to a fairer and healthier viagra 100mg cost world.

We, as editors of health journals, call for governments and other leaders to act, marking 2021 as the year that the world finally changes course.Ethics statementsPatient consent for publicationNot viagra 100mg cost required.Furukawa et al1 posed the question. How can we estimate quality-adjusted life years (QALYs) based on Patient Health Questionnaire-9 (PHQ-9) scores?. They recommend equipercentile linking analysis between the depression severity viagra 100mg cost PHQ-9 and preference-based EQ-5D three-level version (EQ-5D-3L.

UK value set), the latter used to estimate utility data for QALYs.Furukawa et al1 refer to the process of ‘cross-walking’, whereby the practice of fitting a statistical model to health utility data has been referred to as ‘mapping’ and 'cross-walking’.2 Furukawa et al1 reference two mapping-related papers (their references 7 and 9). However, their analysis seems to have missed rigorous mapping methodology and previous studies which have used these mapping processes, alongside other conceptual considerations when wanting to ‘cross-walk’/‘map’ from a non-preference-based (often condition-specific) measure such as viagra 100mg cost the PHQ-9 to the preference-based EQ-5D-3L. €¦.

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The erectile dysfunction treatment viagra triggered a flurry of changes to regulations around telehealth and virtual care – the viagra for sale online vast majority of which expire once the public health emergency ends.The current presidential administration and 116th Congress have each signaled their support for virtual care to various degrees over the past year. But neither took decisive, sweeping action that would permanently enshrine some of the major changes to telehealth policy.So, the question on the minds of many telehealth advocates as President-elect viagra for sale online Joe Biden prepares to take office is. What's next?. "We are at an inflection point, and inflections viagra for sale online bring new challenges," said former senate majority leader Dr.

William Frist, R-Tennessee, during the first day of the American Telemedicine Association's four-part EDGE policy conference on Tuesday."Inflections demand changed perspectives, changed understanding, changed behaviors on our parts," said Frist, a surgeon who is now a director at Teladoc and partner at Frist Cressey Ventures.Frist noted that virtual care has exploded in the wake of the erectile dysfunction treatment crisis. But the next steps, viagra for sale online he said, will be safeguarding access to that care. He noted the importance of allowing telehealth access regardless of patient and provider location, codifying a broader range of practitioners that can provide Medicare-reimbursable telehealth services, authorizing federally qualified health centers and rural health centers to continue offering telehealth, addressing cross-state licensing barriers, and treating all forms of communication equally, with regard to reimbursement, if providers can meet the same standards of care. "There is a risk that broad telehealth deployment – if not carefully and thoughtfully designed – could replicate the barriers of the traditional bricks-and-mortar health system that produced disparities," Frist cautioned.Multiple panelists throughout the day raised payment parity as a viagra for sale online particularly thorny issue.

Frist noted, for example, while it was necessary to motivate physician participation during the viagra, "since many overhead costs are totally eliminated in virtual transactions … some of these savings should flow to the patient as well as the provider."Similarly, Meghan O'Toole, health policy advisor for Sen. Brian Schatz, D-Hawaii, viagra for sale online said "there's a difference between payment during a viagra ... Versus beyond.""Congress may not be the best suited to establishing payment rates for certain services," O'Toole said."The [Congressional Budget Office] has consistently evaluated telehealth legislation as very expensive," added Crozer Connor, senior legislative assistant for Rep. Mike Thompson, D-Calif.In order for more lawmakers to give their full-throated support to telehealth reform Connor stressed the need for more data to support the quality of virtual patient care, saying, "What we need is payer data." "If we viagra for sale online offer telehealth as an insurer, does that drive up utilization?.

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We just don't have it at the scale that erectile dysfunction treatment has now caused telehealth to be used," Coye said. Coye and her co-panelist Avalere Health senior advisor Wendy Everett forecast an overall rosy future for telehealth under President-elect Joe Biden's administration."It's mostly viagra for sale online very good news," Coye said. She predicted that Biden's administration will support the idea that broadband infrastructure alone will not be enough for parity in digital health.It's not just obtaining access to broadband, she said, but the ability to "pay for data charges, to have the appropriate devices and to have digital literacy" that makes a difference.She pointed to "what I would call 'the Geek Squad capability' to come out and help people when it's blowing up, and they just don't know what to do, and they can't make it work."Everett agreed with Coye that Biden's administration "will absolutely keep the conceptual foundation that the Trump administration put in place."However, she noted, "there are some elements that the new administration will need to review." Again returning to payment for telehealth, Everett said, "We'll likely move toward determining some level of fair payment rather than moving toward payment parity across the board." She also raised the importance of addressing the multi-channel delivery potential of telemedicine. "How is [audio-only care] covered? viagra for sale online.

What are we going to do about covering for text, for chatbots, for AI, for other ways of getting healthcare services to people who currently can't get them?. " she said.One major way the next presidential viagra for sale online term will be different, she predicted. "There's going to be a lot of work done on expanding access to telehealth for those people who are broadly underserved.""Think about what they come in facing," added Coye. "They are under the gun to show the public that they are going to do something really good for them in the next two years."Telehealth, she said, "is one of your key ways to make viagra for sale online sure the public sees better access resulting from more insurance coverage.""We know there's a very strong focus on equity and on access.

But obviously the two are very tied together," said Everett. If she were given the chance to pitch telehealth to senior government officials, she said viagra for sale online she would propose, "Let's come up with a plan for how to solve that digital divide. How to reduce the inequities and how to move telehealth across the country ubiquitously." Kat Jercich is senior editor of Healthcare IT News.Twitter. @kjercichEmail.

Kjercich@himss.orgHealthcare IT News is a HIMSS Media publication..

The erectile dysfunction treatment viagra triggered a flurry of changes to regulations around telehealth and virtual care – the vast majority of which expire once the public health emergency ends.The current presidential administration and 116th Congress have each signaled their support for virtual care to various degrees viagra 100mg cost over the past year. But neither took decisive, sweeping action that viagra 100mg cost would permanently enshrine some of the major changes to telehealth policy.So, the question on the minds of many telehealth advocates as President-elect Joe Biden prepares to take office is. What's next?. "We are at an inflection point, and inflections bring new challenges," said former senate majority viagra 100mg cost leader Dr. William Frist, R-Tennessee, during the first day of the American Telemedicine Association's four-part EDGE policy conference on Tuesday."Inflections demand changed perspectives, changed understanding, changed behaviors on our parts," said Frist, a surgeon who is now a director at Teladoc and partner at Frist Cressey Ventures.Frist noted that virtual care has exploded in the wake of the erectile dysfunction treatment crisis.

But the next steps, he said, will be safeguarding access viagra 100mg cost to that care. He noted the importance of allowing telehealth access regardless of patient and provider location, codifying a broader range of practitioners that can provide Medicare-reimbursable telehealth services, authorizing federally qualified health centers and rural health centers to continue offering telehealth, addressing cross-state licensing barriers, and treating all forms of communication equally, with regard to reimbursement, if providers can meet the same standards of care. "There is a risk that broad telehealth deployment – if not carefully and thoughtfully designed – could replicate the barriers of the traditional bricks-and-mortar health system that produced disparities," Frist cautioned.Multiple panelists throughout the day raised payment parity as a particularly viagra 100mg cost thorny issue. Frist noted, for example, while it was necessary to motivate physician participation during the viagra, "since many overhead costs are totally eliminated in virtual transactions … some of these savings should flow to the patient as well as the provider."Similarly, Meghan O'Toole, health policy advisor for Sen. Brian Schatz, D-Hawaii, said "there's a difference between payment during a viagra .. viagra 100mg cost.

Versus beyond.""Congress may not be the best suited to establishing payment rates for certain services," O'Toole said."The [Congressional Budget Office] has consistently evaluated telehealth legislation as very expensive," added Crozer Connor, senior legislative assistant for Rep. Mike Thompson, D-Calif.In order for more lawmakers to give their full-throated support to telehealth reform Connor stressed the need for more data to support the quality of virtual patient care, saying, "What we need is payer data." "If we viagra 100mg cost offer telehealth as an insurer, does that drive up utilization?. Or is there a substitution effect?. " Connor viagra 100mg cost continued.AVIA executive in residence Dr. Molly Joel Coye countered that in her panel, noting that plenty of data regarding telehealth's effect on care exists, especially from the Veterans Administration.

"We do viagra 100mg cost have data. We just don't have it at the scale that erectile dysfunction treatment has now caused telehealth to be used," Coye said. Coye and her co-panelist Avalere Health senior advisor Wendy Everett forecast viagra 100mg cost an overall rosy future for telehealth under President-elect Joe Biden's administration."It's mostly very good news," Coye said. She predicted that Biden's administration will support the idea that broadband infrastructure alone will not be enough for parity in digital health.It's not just obtaining access to broadband, she said, but the ability to "pay for data charges, to have the appropriate devices and to have digital literacy" that makes a difference.She pointed to "what I would call 'the Geek Squad capability' to come out and help people when it's blowing up, and they just don't know what to do, and they can't make it work."Everett agreed with Coye that Biden's administration "will absolutely keep the conceptual foundation that the Trump administration put in place."However, she noted, "there are some elements that the new administration will need to review." Again returning to payment for telehealth, Everett said, "We'll likely move toward determining some level of fair payment rather than moving toward payment parity across the board." She also raised the importance of addressing the multi-channel delivery potential of telemedicine. "How is [audio-only viagra 100mg cost care] covered?.

What are we going to do about covering for text, for chatbots, for AI, for other ways of getting healthcare services to people who currently can't get them?. " she said.One major way the next viagra 100mg cost presidential term will be different, she predicted. "There's going to be a lot of work done on expanding access to telehealth for those people who are broadly underserved.""Think about what they come in facing," added Coye. "They are under the gun to show the public that they are going to do something really good for them in the next two years."Telehealth, she said, "is one of your key ways to make sure the public sees better access resulting from more insurance coverage.""We know there's a very strong focus on equity and on viagra 100mg cost access. But obviously the two are very tied together," said Everett.

If she were given the chance to pitch telehealth to senior government officials, she said she viagra 100mg cost would propose, "Let's come up with a plan for how to solve that digital divide. How to reduce the inequities and how to move telehealth across the country ubiquitously." Kat Jercich is senior editor of Healthcare IT News.Twitter. @kjercichEmail. Kjercich@himss.orgHealthcare IT News is a HIMSS Media publication..

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In this issue of the Journal of Medical Ethics arguments are cogently made that sustainability and solidarity should be considered as core medical ethical principles, and that more explicit attention should be given to the complex context in which a decision buy viagra connect usa is made.Munthe et al propose that sustainability should become an established principle for justifying healthcare resource allocation, and should be an explicit factor in procuring drugs and other resources.1 They argue that the current operational norms which guide decision making (need, prognosis, equal treatment and cost-effectiveness) can lead to what they where to buy viagra online call ‘negative dynamics’. The gradual depletion of resource available for healthcare.They illustrate this first by examining some well recognised examples of ‘positive dynamics’ which are considered in health policy. Immunisation programmes are funded because lead to reduction or absence of disease in the population, thus buy viagra connect usa freeing up resource for other uses.

Public health measures are offset by future cost reductions or income increases for healthcare via reduction of sick leave.‘Negative dynamics’ however, are not routinely considered in operational decisions and they persuasively argue that they should be. Resource depletion (not only fiscal resource, but environmental and human resource) has a negative effect on future cycles of healthcare. As an buy viagra connect usa illustrative example, they discuss the emission of resistance-driving residue in the production of antibiotics.

The accepted principles, particularly of cost effectiveness, drive producers to make antibiotics cheaply, without consideration of gradual contribution to antibiotic resistance. If a principle of sustainability was included when considering procurement, subsidy and prioritisation, this would provide an incentive to change production practices. This argument can be extended to buy viagra connect usa many aspects of the healthcare.

System including how we recruit, train and treat our staff. How we invest in infrastructure and how we plan for viagras. Munthe et al go on to provide a robust definition of their sustainability principle, and to address possible buy viagra connect usa objections.

It is an excellent example of reasoned ethical argument which has the potential to change clinical practice.With the roll out of vaccinations for erectile dysfunction treatment across the globe, Julian Savulescu proposes an algorithm for when mandatory vaccination might be ethically justified.2 Drawing and expanding upon the 2007 Nuffield Council of Bioethics report he suggests that four criteria are required. 1. There is a grave buy viagra connect usa threat to public health 2.

The treatment is safe and effective 3. Mandatory vaccination has a superior cost/benefit profile compared with other alternatives 4. The level buy viagra connect usa of coercion is proportionate.

Discussing the value judgement associated with each criterion, he concludes that, at least initially (where uncertainty around safety is greater), mandatory vaccination for erectile dysfunction treatment would be ethically problematic.He goes on to explore alternative approaches, including non-financial (eg, immunisation passports) and financial incentives. He argues that individuals could essentially be paid for the risk they are undertaking (by being early adopters of a treatment) for societal benefit, but to do this government would need to be ‘transparent, explicit and comprehensive in disclosure of data’, a standard which unfortunately has not always (or even often?. ) been kept buy viagra connect usa.

The danger that payment might signal a lack of confidence in safety is real. Clearly payment should only be offered for a treatment which was considered safe enough to be used in any circumstances. Payment for a treatment which was not considered buy viagra connect usa safe without payment would not be morally acceptable.

Payment may also erode the sense of solidarity that people feel when contributing to societal well-being. To ensure that this was maintained he suggests the option of ‘donating back’ the fee to the NHS could be made available. People could be rewarded for taking the treatment with an increasing sense of civic duty as they not only protect themselves and the vulnerable, but contribute to the (fiscal) sustainability of the health service which treats them.While Savulescu acknowledges the worth of solidarity, Avery Kolers proposes that solidarity plays not just buy viagra connect usa an auxillary part in the interests of acknowledged bioethical values (justice, beneficence etc) but has a freestanding role, which should be independently assessed.3 He acknowledges that solidarity per se is not valuable.

There is solidarity, he notes, among a firing squad and within a terrorist cell. He develops Prainsack and Buyx metaphor of solidarity as the putty of justice4 and suggests five individually necessary and sufficient conditions of morally valuable solidarity. It must buy viagra connect usa be (1) norm grounded (2) acknowledged (3) political (4) action and (5) on others’ behalf.

He suggests that solidarity (with X) is morally required ‘when it constitutes equitable treatment of X such as to countermand or resist inequitable treatment of X’. He notes that moral dilemmas may arise where solidarity with X may lead to inequitable treatment of Y and emphasises that solidarity with the most vulnerable in society will help address inequities in healthcare and in healthcare institutions.The complexities and competing moral demands of healthcare institutions, and primary care in particular, are explored by Spicer et al, who question the use of normative moral theories to determine the ‘best’ actions.5 They argue that the context in which ethical decisions are made is not sufficiently acknowledged. If complex contextual factors are not considered, then predictions about outcomes will be flawed, as will the resulting ethical analyses.Examples of contextual factors which might influence decision-making include power relations within the staff and external regulators (including achieving externally determined quality markers and ‘standard’ practice) and the need to maintain buy viagra connect usa both group and individual professional identities.It is often helpful to peel back the layers of complexity in order to reveal a specific ethical question.

Before coming to a conclusion, however, we must remember to reapply the layers and reconsider the question in the context of its complex environment. Integrating this proposal with others in the journal, this might include considerations of sustainability and solidarity..

In this issue of the Journal of Medical Ethics arguments are cogently made that sustainability and solidarity should be considered as core medical ethical principles, and that more explicit attention should be given to the complex context in which a decision is made.Munthe et al propose that sustainability should become an buy generic viagra established principle for justifying healthcare resource allocation, and should be an explicit factor in procuring drugs and other resources.1 They argue that the current operational norms which guide viagra 100mg cost decision making (need, prognosis, equal treatment and cost-effectiveness) can lead to what they call ‘negative dynamics’. The gradual depletion of resource available for healthcare.They illustrate this first by examining some well recognised examples of ‘positive dynamics’ which are considered in health policy. Immunisation programmes are funded because lead to reduction or absence of disease in the population, thus freeing up resource for other uses viagra 100mg cost. Public health measures are offset by future cost reductions or income increases for healthcare via reduction of sick leave.‘Negative dynamics’ however, are not routinely considered in operational decisions and they persuasively argue that they should be.

Resource depletion (not only fiscal resource, but environmental and human resource) has a negative effect on future cycles of healthcare. As an illustrative example, they discuss the viagra 100mg cost emission of resistance-driving residue in the production of antibiotics. The accepted principles, particularly of cost effectiveness, drive producers to make antibiotics cheaply, without consideration of gradual contribution to antibiotic resistance. If a principle of sustainability was included when considering procurement, subsidy and prioritisation, this would provide an incentive to change production practices.

This argument viagra 100mg cost can be extended to many aspects of the healthcare. System including how we recruit, train and treat our staff. How we invest in infrastructure and how we plan for viagras. Munthe et al go on to provide a viagra 100mg cost robust definition of their sustainability principle, and to address possible objections.

It is an excellent example of reasoned ethical argument which has the potential to change clinical practice.With the roll out of vaccinations for erectile dysfunction treatment across the globe, Julian Savulescu proposes an algorithm for when mandatory vaccination might be ethically justified.2 Drawing and expanding upon the 2007 Nuffield Council of Bioethics report he suggests that four criteria are required. 1. There is viagra 100mg cost a grave threat to public health 2. The treatment is safe and effective 3.

Mandatory vaccination has a superior cost/benefit profile compared with other alternatives 4. The level of coercion is proportionate viagra 100mg cost online viagra prescription. Discussing the value judgement associated with each criterion, he concludes that, at least initially (where uncertainty around safety is greater), mandatory vaccination for erectile dysfunction treatment would be ethically problematic.He goes on to explore alternative approaches, including non-financial (eg, immunisation passports) and financial incentives. He argues that individuals could essentially be paid for the risk they are undertaking (by being early adopters of a treatment) for societal benefit, but to do this government would need to be ‘transparent, explicit and comprehensive in disclosure of data’, a standard which unfortunately has not always (or even often?.

) been viagra 100mg cost kept. The danger that payment might signal a lack of confidence in safety is real. Clearly payment should only be offered for a treatment which was considered safe enough to be used in any circumstances. Payment for a treatment which was not considered viagra 100mg cost safe without payment would not be morally acceptable.

Payment may also erode the sense of solidarity that people feel when contributing to societal well-being. To ensure that this was maintained he suggests the option of ‘donating back’ the fee to the NHS could be made available. People could be rewarded for taking the treatment with an increasing sense of civic duty as they not only protect themselves and the vulnerable, but contribute to the (fiscal) sustainability of the health service which treats them.While viagra 100mg cost Savulescu acknowledges the worth of solidarity, Avery Kolers proposes that solidarity plays not just an auxillary part in the interests of acknowledged bioethical values (justice, beneficence etc) but has a freestanding role, which should be independently assessed.3 He acknowledges that solidarity per se is not valuable. There is solidarity, he notes, among a firing squad and within a terrorist cell.

He develops Prainsack and Buyx metaphor of solidarity as the putty of justice4 and suggests five individually necessary and sufficient conditions of morally valuable solidarity. It must be (1) norm grounded (2) acknowledged (3) political (4) action and viagra 100mg cost (5) on others’ behalf. He suggests that solidarity (with X) is morally required ‘when it constitutes equitable treatment of X such as to countermand or resist inequitable treatment of X’. He notes that moral dilemmas may arise where solidarity with X may lead to inequitable treatment of Y and emphasises that solidarity with the most vulnerable in society will help address inequities in healthcare and in healthcare institutions.The complexities and competing moral demands of healthcare institutions, and primary care in particular, are explored by Spicer et al, who question the use of normative moral theories to determine the ‘best’ actions.5 They argue that the context in which ethical decisions are made is not sufficiently acknowledged.

If complex contextual factors are not considered, then predictions about outcomes will be flawed, as will the resulting ethical analyses.Examples of contextual factors which might influence decision-making include power relations within the staff and external regulators (including achieving externally determined quality markers and ‘standard’ practice) and the need to maintain both group and individual professional identities.It is often helpful to peel viagra 100mg cost back the layers of complexity in order to reveal a specific ethical question. Before coming to a conclusion, however, we must remember to reapply the layers and reconsider the question in the context of its complex environment. Integrating this proposal with others in the journal, this might include considerations of sustainability and solidarity..

Maximum dose of viagra

The term “mRNA” only entered the average household in the maximum dose of viagra how to get viagra or cialis past few months, as Moderna and Pfizer-BioNTech released their erectile dysfunction treatments. But a handful of scientists have spent decades studying this novel approach to immunization. By the start of the viagra maximum dose of viagra the technology was already so advanced that, when Chinese researchers published the genetic sequence for the erectile dysfunction 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 sidekick — which had long ranked as a promising but unproven treatment. After this encouraging success, its proponents predict an equally impressive future maximum dose of viagra.

They have always believed in mRNA’s ability to protect against not only the likes of erectile dysfunction, 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 mRNA maximum dose of viagra 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, 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 maximum dose of viagra. Such is 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 maximum dose of viagra 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 viagra. Traditional treatments do so by exposing the body to the viagra itself, weakened or dead, or to a part of the viagra, called an antigen.

The new shots, as their name suggests, introduce only mRNA — the genetic material that, as you maximum dose of viagra 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. In the case of the erectile dysfunction treatments, those proteins are the crown-shaped “spike” antigens from which maximum dose of viagra the erectile dysfunction derives its name (“corona” means crown in Latin).

By themselves they are harmless, but the immune system attacks them as foreign invaders, and in doing so learns how to ward off the real viagra. If it ever rears its spiky head thereafter, the body will remember and swiftly destroy it.But besides liberating the world from the worst viagra in generations, mRNA could help to vanquish many an intractable illness. If all the dreams of its advocates are realized, the erectile dysfunction treatments may, in hindsight, be only a proof of concept maximum dose of viagra.

In February, for example, 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 viagra. Because mRNA is simply a genetic sequence, scientists can easily tweak it as necessary to maximum dose of viagra 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,” 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, tuberculosis HIV, maximum dose of viagra cytomegaloviagra, and respiratory syncytial viagra. 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 maximum dose of viagra in our species. As Geall put it, “mice are not humans.” Some appear to be better bets than others — cytomegaloviagra and RSV respiratory syncytial viagra in particular — but for now, it’s too early to say where mRNA will next bear fruit.

€œDespite all we know about maximum dose of viagra immunology, a lot of it is really empiric,” Bucala says. €œYou just have to try things and see if they work.” The viagra TamerBased on its recent achievements, mRNA’s next act may well involve the next viagra. Perhaps its biggest strength is that it can be manufactured at speeds unheard of in the realm of traditional treatments, making it well-suited to addressing sudden surges of viagraes.

€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,” maximum dose of viagra Richner says. €œWe can make multiple different treatments and test them in a really rapid process.”Read more. erectile dysfunction treatment.

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 viagra 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 erectile dysfunction treatment, 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 erectile dysfunction treatment 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.”.

The term “mRNA” only entered the average household in viagra 100mg cost the past few months, as Moderna and Pfizer-BioNTech released their erectile dysfunction treatments. But a handful of scientists have spent decades studying this novel approach to immunization. By the start of the viagra the technology was already so advanced that, when Chinese researchers viagra 100mg cost published the genetic sequence for the erectile dysfunction 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 sidekick — which had long ranked as a promising but unproven treatment.

After this encouraging success, viagra 100mg cost its proponents predict an equally impressive future. They have always believed in mRNA’s ability to protect against not only the likes of erectile dysfunction, 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 viagra 100mg cost 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, says Yale immunologist Rick Bucala.

€œThat has really changed viagra 100mg cost 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 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 viagra 100mg cost. €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 viagra. Traditional treatments do so by exposing the body to the viagra itself, weakened or dead, or to a part of the viagra, called an antigen.

The new shots, as their name suggests, introduce only viagra 100mg cost 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. In the case of the erectile dysfunction treatments, those proteins are the crown-shaped “spike” antigens from which viagra 100mg cost the erectile dysfunction derives its name (“corona” means crown in Latin). By themselves they are harmless, but the immune system attacks them as foreign invaders, and in doing so learns how to ward off the real viagra. If it ever rears its spiky head thereafter, the body will remember and swiftly destroy it.But besides liberating the world from the worst viagra in generations, mRNA could help to vanquish many an intractable illness.

If all the dreams of its advocates are realized, the erectile dysfunction treatment viagra 100mg cost treatments may, in hindsight, be only a proof of concept. In February, for example, 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 viagra. Because mRNA is simply a genetic sequence, scientists can easily tweak it as necessary to find the most viagra 100mg cost effective combination. €œOne of the advantages 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, viagra 100mg cost tuberculosis HIV, cytomegaloviagra, and respiratory syncytial viagra. 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 viagra 100mg cost falter in our species. As Geall put it, “mice are not humans.” Some appear to be better bets than others — cytomegaloviagra and RSV respiratory syncytial viagra 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 viagra 100mg cost is really empiric,” Bucala says. €œYou just have to try things and see if they work.” The viagra TamerBased on its recent achievements, mRNA’s next act may well involve the next viagra. Perhaps its biggest strength is that it can be manufactured at speeds unheard of in the realm of traditional treatments, making it well-suited to addressing sudden surges of viagraes. €œOne of the great things about viagra 100mg cost 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.

erectile dysfunction treatment. 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 viagra 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 erectile dysfunction treatment, 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 erectile dysfunction treatment 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.”.