17/11/2017

NORTH KOREA: GRUESOME FACTS ABOUT ROUNDWORM—THE PARASITE THAT CAN GROW TWO FEET AND LIVE INSIDE YOU FOR YEARS

NORTH KOREA: GRUESOME FACTS ABOUT ROUNDWORM—THE PARASITE THAT CAN GROW TWO FEET AND LIVE INSIDE YOU FOR YEARS
BY KATE SHERIDAN ON 11/16/17 AT 11:20 AM

A North Korean defector was shot crossing the country’s border with South Korea and his doctors discovered many, many parasites inside him. But if he hadn’t been shot, it’s possible one particular type of worm—a roundworm—could have continued to live inside of him and grow without any signs that something was wrong.

Based on information in the Korea Biomedical Reviewone particular parasite that infected the defector may be Ascaris lumbricoides, a roundworm that is rarely found in the United States.
The worm described is about the right size for Ascaris—ten inches is within the worm’s typical length, which can reach up to 19 inches. The Review reported that the worm was spread through plants fertilized with human feces, which is also typical for Ascaris. The patient seemed to be suffering from malnutrition—also something that can occur as a result of becoming infected with this worm. And Ascaris is more often found in tropical climates, according to information from the Centers for Disease Control and Prevention’s website on the worm, which would explain Korean doctors’ surprise when they found it.
"I have been doing surgery for more than 20 years, but I have not seen such parasites. I will not be able to find them in [South] Korea," Dr. Lee Guk-jong, the surgeon who operated on the patient, told the Review .
Ascaris worms may be living in up to 1 billion people. This particular infection blocked the intestine of a 3-year-old boy, who survived.SOUTH AFRICAN MEDICAL RESEARCH COUNCIL VIA FLICKR
The worms live in a person’s intestine, but they don’t stay there. After hatching from an egg, an immature worm can move into a person’s bloodstream and go to the lungs and stomach.
About one billion people in the world may be infected with Ascaris, and roundworm infections as a whole are even more common. Other roundworms includes whipworm and hookworm, as well as one type found in pet poop.
Ascaris infections can be nearly undetectable. According to the CDC’s website, people who are infected may have no symptoms until there are a profuse amount of the worms. Some of the symptoms that can happen are relatively subtle; worms can be found in a person's poop, and an infected person might have stomach pain or a cough.
Roundworms can be resilient; according to Medline PlusAscaris eggs can live for 10 to 24 months. Thankfully, there are treatments that will kill them; three drugs are commonly used for this purpose, according to the UK's NHS.
Unfortunately for the North Korean defector, however, the parasites are making his recovery more difficult; Lee told the Review that the doctors are "struggling with treatment" and that the worms are eating the wounded areas.


13/11/2017

Your Boss Just Rejected Your Idea? Ask These 3 Questions Right Away

With every rejection, there is a valuable lesson to be learned.



BY RICHARD MOY—THE MUSE3 MINUTE READ
I wish I could tell you that your manager will always love your ideas. But unfortunately, as you probably already know, that’s not the case.
And whenever she shoots something down, you’ll want to deliver a monologue along the lines of, “You’re missing the brilliance behind my thinking and should be taken to a hospital.” Or, you might let yourself believe that you’re a failure and that you should just quit now. Or you might even lash out and holler about how they “never” listen to you.
As cathartic as those reactions might feel, none of them are actually productive. To help you move on and learn from every rejection, make these phrases a regular part of your vocabulary.
1. “WHAT WOULD MAKE YOU SAY YES TO THIS IDEA?”
Your idea is toast when your manager shuts it down, right? Well, it doesn’t have to be. Your original thinking might’ve been off the mark, but that doesn’t mean there isn’t anything worth salvaging from it. And chances are, your boss would agree with with that.
So instead of accepting defeat, ask questions like “What would make you say yes?” and “Is there any part of the idea that did resonate?”


Those answers will help you understand what worked and what didn’t. Then, use that feedback to come up with something else that’s more impactful and even more difficult for your boss to shake her head at.
2. “THANKS FOR YOUR FEEDBACK, WOULD IT MAKE SENSE FOR ME TO BRING IT UP AGAIN IN A FEW WEEKS/MONTHS?”
It’s worth saying this again, so I will: You’re smart, you bring a lot to the table, and you have a lot of good ideas. But nobody on the face of the planet has ever had 100% of their ideas implemented. At the same time, it doesn’t necessarily mean that they’re bad. I’ve lost count of the number of times my manager has said to me, “This is interesting, but we have bigger fish to fry. Let’s revisit this in the future.”
But why not now, right? After all, you haven’t presented something ridiculous. Why can’t your manager move things around to accommodate you? Reread those questions and think about how they sound. Would you respond in kind to someone who made this much of a push?


Instead, simply thank your manager for the feedback and ask if there’s a specific time period during which she feels you could explore it further. You’ll be able to gauge from her response whether she’s genuinely into the idea or just avoiding shutting you down altogether.
3. “WHAT SHOULD I FOCUS ON INSTEAD?”
You could very easily shut down after you, well, get shut down. It might even feel like you don’t have anything else worth working on, especially now that your idea is off the table. But it’s also important to remember that you still have plenty of other things to do at work. And even though your manager said “no thanks,” I’m willing to bet that she has bigger priorities on her plate that she could use your help with.
So, instead of pouting, find out what you can be working on instead. This response will show her that you’re truly a team player, even when you’ve been shut down. And if and when there is a fit for one of your brilliant ideas, your boss will remember just how helpful you are and make sure you get the resources needed to accomplish it.


So far, we’ve talked about what to do when your idea gets shot down. And that’s a great start. But are you still feeling like you should keep your “big” mouth shut? Does it seem easier to keep your thoughts to yourself, especially if your boss always says no to your ideas?
I hope you don’t buy into that idea.
Raising your hand (either literally or metaphorically) takes guts. And every time you do it, it gets a little easier and a little less scary. So don’t stop speaking up. Instead, push yourself to turn every single rejection into a lesson. Eventually, you’ll get so good at pitching your ideas that they’ll be (almost) impossible to turn down


Trump casts doubt on allegations against Roy Moore, leaving Republicans an impossible choice

Trump casts doubt on allegations against Roy Moore, leaving Republicans an impossible choice
By Aaron Blake November 10 



Then-President-elect Trump gives the thumbs-up as Mitt Romney leaves Trump National Golf Club in Bedminster, N.J. (Carolyn Kaster/AP)
A day after Senate Republicans tried to buy some time amid the allegation that Alabama's GOP Senate candidate Roy Moore had initiated sexual contact with a 14-year-old when he was 32, the last two GOP presidential nominees pulled them in opposite directions.
While President Trump cast increasing doubt on the accusations, Mitt Romney issued a strong statement that puts pressure on other Republicans to denounce Moore.
In a written statement delivered by press secretary Sarah Huckabee Sanders, Trump joined in the Senate GOP's he-should-drop-out-if-it's-true chorus, but also noticeably upped the doubt factor as to whether the accusations are true.
“Like most Americans, the president believes that we cannot allow a mere allegation — in this case, one from many years ago — to destroy a person's life,” Sanders said. “However, the president also believes that if these allegations are true, Judge Moore will do the right thing and step aside.”
Two parts of that stand out: The words “mere allegation” and “one from many years ago.” Up front — and unlike the reactions from Senate Republicans — Trump decided he would like to stress that these accusations might not be true. This is perhaps understandable and to be expected from another politician who has been accused of sexual misconduct and strenuously denied it.
Alabama Senate candidate Roy Moore denied allegations of sexual misconduct on Nov. 10 and called them "politically motivated." Senate Majority Leader Mitch McConnell (R-Ky.) said Moore should withdraw from the race if allegations are true. (Video: Jordan Frasier, Bastien Inzaurralde/Photo: Melina Mara/The Washington Post)
Given that Trump called his own accusers liars during the 2016 campaign, it stands to reason that he might think that Moore's accusers are also liars. Indeed, it would be somewhat odd if Trump took these accusations to be true and called on Moore to drop out, given his own responses to allegations against him and his own decision to avoid calls to drop out. Trump also defended Bill O'Reilly against sexual harassment claims, saying he didn't think the former Fox News host “did anything wrong.” O'Reilly settled one of those claims for $32 million.
But Trump's comments also are in stark contrast to the previous Republican presidential nominee, Romney, who tweeted Friday morning that the GOP shouldn't bother with reasonable doubt and said Moore should drop out now.
It's not clear that Romney's tweet is a direct response to the president or even just to the Senate Republicans who have decided to withhold final judgment on all of this. While those Republicans have said Moore should drop out if the allegations are true, Moore seems bent on denying them to the end, and it's very unlikely we'll ever have definitive proof of a decades-old encounter between two people. In other words, Senate Republicans' comments don't seem all that likely to force Moore out.
But buying time is about all these comments did. At some point (and soon, given that the election is a little more than a month away), Republicans are going to have to decide whether to line up with Trump or with Romney — whether to grant Moore the reasonable doubt that Trump emphasizes or to decide that reasonable doubt need not apply here.
As James Hohmann notes in today's Daily 202, the Alabama Republican Party holds the power to boot Moore from the race and spur a write-in campaign to hold the seat for Republicans. But those same Alabama Republicans seem to be standing behind Moore. Unless and until the Senate GOP and the GOP establishment decides it is going to force the issue more than it did Thursday, it seems unlikely they'll ever get any resolution besides Moore finishing the race.


AP FACT CHECK: Trump on veterans' health care, economy

AP FACT CHECK: Trump on veterans' health care, economy
الوصف: Associated Press CALVIN WOODWARD and HOPE YEN,Associated Press 3 hours ago 

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U.S. President Donald Trump, left, speaks with Philippine President Rodrigo Duterte before the opening ceremony of the 31st Association of Southeast Asian Nations (ASEAN) Summit in Manila, Philippines, Monday, Nov. 13, 2017. (Mark Cristino/Pool Photo via AP)
WASHINGTON (AP) — Veterans Day prompted President Donald Trump and his administration to take stock of what's been done to fix health care for those in uniform. They claimed more progress than has been made.
That tendency to overreach extended to trade and the economy as Trump visited Japan, South Korea, Japan and then Vietnam, where he told U.S. veterans of the Vietnam War that the Department of Veterans Affairs has made "amazing" strides and already "is a whole new place."
His remarks and a White House account of progress at the VA did not acknowledge old problems that persist. For example, a key effort to improve waiting times by revamping the VA's electronic medical record system may not be completed for eight more years — when Trump will be out of office.
A look at some statements about the VA and other topics arising from his travels and over the past week:
WHITE HOUSE: "President Trump signed the Veterans Appeals Improvement and Modernization Act of 2017, taking action to streamline the appeals process for disability compensation claims within the VA. More than 470,000 veterans are awaiting pending decisions regarding their appeals."
THE FACTS: Trump signed the bill in August, part of a bid to reduce a rapidly growing claims backlog, but its immediate impact is overstated, as it will have no effect on the 470,000 pending claims.
Under the legislation, veterans will be able to file "express" appeals if they waive their right to a hearing or the ability to submit new evidence.
While lawmakers hope the legislation ultimately could reduce average wait times to less than a year, it applies almost entirely to newly filed appeals.
Veterans Affairs Secretary David Shulkin has said the VA would need Congress to approve an additional $800 million for "hiring surges" of additional appeals processors if the VA hoped to clear its current backlog within 10 years.
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TRUMP: "Right now, our trade with Japan is not fair and it's not open, but I know it will be, soon. We want free and reciprocal trade, but right now our trade with Japan is not free and it's not reciprocal." And: "Many millions of cars are sold by Japan into the United States, whereas virtually no cars go from the United States into Japan." — remarks to business leaders in Tokyo on Monday.
THE FACTS: When Trump calls for reciprocity in Japan-U.S. trade, he might want to be careful what he wishes for.
With autos, for example, Japan places no tariff on fully assembled vehicles that are imported. But the U.S. has a 2.5 percent tariff on most imported vehicles — 25 percent on pickup trucks. That imbalance — or lack of reciprocity — favors the U.S.
It's true U.S. vehicle sales in Japan pale in comparison with Japanese sales in the U.S. Detroit has long complained about regulations that stop U.S. carmakers from opening dealerships or selling cars in Japan. But there are other reasons for the disparity in the auto trade, as well. For example, Japan uses right-hand-drive vehicles; the U.S. mainly makes left-hand-drive vehicles in its domestic industry.
And Trump's point about Japanese vehicles pouring into the U.S. is somewhat off the mark. Made-in-Japan vehicles are a distinct minority of the vehicles sold in the U.S. by Japanese automakers.
More than half the vehicles sold in the U.S. by Japanese manufacturers are built in the U.S., says the Japan Automobile Manufacturers Association. Three-quarters of them are built in North America.
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WHITE HOUSE statement Thursday: "President Trump announced that the Department of Veterans Affairs will adopt the same Electronic Health Record as the Department of Defense. VA's adoption ... will ultimately result in all patient data residing in one common system, enabling the immediate availability of service members' medical records and seamless care between the departments."
THE FACTS: While the administration did announce in June that it would overhaul the VA's aging information technology system, Shulkin admitted to Congress last month that the project to revamp electronic medical records won't be completed for seven to eight years. The full costs of the project also are not known and have yet to be budgeted.
An upgraded IT system is central to the VA's effort to reduce wait times for medical care as well as to fulfill Trump's promise of increasing private care options for veterans. Under Shulkin's plan to expand the Choice private-sector program, the VA would outsource more routine veterans' care to private providers including MinuteClinics while treating more complex injuries. Success of that plan requires a seamless sharing of medical records not only with the Pentagon but also with private physicians, a capability the VA does not currently have.
Shulkin also has yet to negotiate pricing for the no-bid contract with the company that designed the Pentagon's IT system, estimated to cost at least $16 billion. The big price tag has spurred bills in Congress to require regular updates from the VA on timeliness and cost projections, as well as risks such as breaches to patient privacy.
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WILBUR ROSS, U.S. commerce secretary: "Today's signings are a good example of how we can productively build up our bilateral trade." — remarks Thursday in Beijing.
XI JINPING, China's president: "During this visit, the two sides signed over $250 billion U.S. of commercial deals and two-way investment agreements." — remarks Thursday in Beijing.
THE FACTS: Papers signed in China during Trump's visit were largely a packaging of previously worked-out deals, tentative investments, statements of intent and extensions of business with existing Chinese customers, with some new orders. They do not point to a turnaround in deep-seated trade tensions between China and the U.S.
Such signing ceremonies in China are often just that, ceremonial. They typically represent purchases that Chinese customers already planned to make and held off on announcing. General Motors' $2.2 billion piece of the package, for example, consists mostly of selling parts to its existing joint venture with the Chinese government.
Alaska, however, welcomed an agreement that could spur construction of a long-sought pipeline to ship natural gas from the North Slope to a port for export to Asia. Oil companies backed away from the project, but the agreement with Chinese interests means all parties will work toward a decision by the end of next year on whether to proceed.
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WHITE HOUSE: "President Trump has ensured continued access to care in the Veterans Choice Program by signing the VA Choice and Quality Employment Act, authorizing $2.1 billion in additional funds for the Veterans Choice Program."
THE FACTS: This statement glosses over one of several budget shortfalls by the VA. Congress was forced in August to approve $2.1 billion in emergency money to keep Choice running after the VA had repeatedly understated costs of the program, assuring lawmakers for much of the year that money would last until January. Shulkin subsequently revealed an emergency shortfall in June that threatened medical care for tens of thousands of veterans.
The $2.1 billion was intended to last until February. But weeks after receiving the money, the VA acknowledged that money for Choice would again run out sooner than expected, requiring Congress to approve additional stopgap financing before the end of the year or face disruptions to veterans' health care.
Lawmakers have yet to act, in part as the Trump administration sorts out longer-term costs to the private-sector program.
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WHITE HOUSE: "The VA has launched its 'Access and Quality Tool,' allowing veterans to see online the wait times at VA locations."
THE FACTS: An effort started by Shulkin when he was VA undersecretary of health in President Barack Obama's administration, the VA website www.accesstocare.va.gov provides data on wait times as well as on veterans' satisfaction ratings in getting timely appointments, something that no other health care system in the country does.
Still, major veterans groups such as Veterans of Foreign Wars have faulted the data for being misleading and not depicting wait times the way a typical person would view it.
The Government Accountability Office, for instance, has noted that the data for returning patients do not include the amount of wait time from when a veteran initially asks for care and when a scheduler reaches out to set an appointment, which it said could be lengthy. In addition, GAO earlier this year continued to find evidence that VA data can be unreliable because of schedulers recording wrong dates or changing dates outright, though the VA says it is implementing new checks and training to help identify "outliers" in scheduling.
Veterans of Foreign Wars told Congress last month that its survey found only 67 percent of veterans said they had obtained a VA appointment within 30 days, less than the 93 percent that VA reports.
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WHITE HOUSE: "The White House has opened a brand new VA Hotline staffed principally by veterans and direct family members of veterans to ensure that no complaint goes unaddressed."
THE FACTS: It opened, but it did not get off to a smooth start. Trump pledged during the presidential campaign to create a "private White House hotline" answered by a real person 24 hours a day to take complaints from veterans, leading the VA to create a hotline beginning in June. Originally scheduled to be fully operational by Aug. 15, it has encountered some delays. In a letter to the VA last month, Sen. Jon Tester, the top Democrat on the Veterans Affairs Committee, complained, "The White House is frequently routing these calls back to local VA offices, which are often understaffed and do not have the ability to address the additional casework in a timely manner."
Tester noted the VA already had several existing options for receiving complaints from veterans and urged better coordination to make sure no one falls through the cracks.
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TRUMP: "Numbers are phenomenal over the last — since November 8th, Election Day. Our unemployment is at a 17-year low. We've gotten almost 2 million more people in the workforce in just that short period of time. I've reduced regulations terrifically, frankly, if I do say so myself." — remarks to business leaders in Tokyo, Monday. Tweet from previous weekend: "Unemployment is down to 4.1%, lowest in 17 years. 1.5 million new jobs created since I took office. Highest stock Market ever, up $5.4 trill."
THE FACTS: His numbers are close to the mark. Trump can rightfully brag about the U.S. economy, but it's not quite as exceptional as he says, and he can't yet legitimately claim that his record on job creation is vastly superior to Obama's. Many of the economic figures he cites are advancing a recovery from the Great Recession that dates back to the middle of 2009.
The unemployment rate did slip to 4.1 percent in October. But that was in part because many Americans gave up searching for work — one of the criticisms Trump made of Obama's record during the 2016 campaign.
Trump also takes credit for helping create on average 168,500 jobs a month, but Obama in 2016 averaged about 187,000 jobs a month. Of course, hiring should slow as the unemployment rate declines because fewer people are searching for work. When someone stops seeking a job and drops out of the labor force, this person is no longer counted among the officially unemployed.
As for the stock market, the Dow Jones Industrial Average returned to its previous peak in March 2013 and has been setting records ever since. The promise of corporate tax cuts by Trump has helped the stock market, but many of the gains rest on the foundations of an economic recovery that saw corporate profits climb.
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Associated Press writers David Koenig in Dallas, Tom Krisher in Detroit and Joe McDonald in Beijing contributed to this report.


Research Reveals AI Health Coaches As Effective as In-Person Professionals for Diabetes Prevention

Research Reveals AI Health Coaches As Effective as In-Person Professionals for Diabetes Prevention
by Jasmine Pennic 11/10/2017 1 Comment




New peer-reviewed findings published in JMIR Diabetes reveals that an artificial intelligence (AI) health coaches is just as effective as in-person weight loss programs, such as the Centers for Disease Control and Prevention-led National Diabetes Prevention Program (DPP), a clinically-proven weight loss program focused on type 2 diabetes prevention.
The peer-reviewed research suggests AI has comparable results to the Diabetes Prevention Program by observing Lark, an AI chronic disease platform that brings unlimited, one-on-one chronic disease prevention and management to payors and employers. Lark’s AI Health Coach monitors a patient’s health through phone sensors and integrated health devices, then mimics nurses’ empathetic counseling through text-based communication. For example, if you wake up in the middle of the night craving a treat, Lark can steer you towards a healthier option.
Study Findings & Results
Participants in the study could have unlimited coaching sessions with Lark. They averaged 103 individual coaching sessions over the course of the study. Users lost an average of 2.4 kg (or 2.4 percent body weight), compared with an average of 2.32 kg reported in a DPP meta-analysis of 22 lifestyle intervention studies with in-person components. Additionally, the percentage of healthy meals eaten increased by 31 percent. Patients were engaged with their health coach and reported a satisfaction score of 87 out of 100.
The longitudinal study observed weight loss, changes in meal quality, and app acceptability among 239 overweight (body mass index ≥ 25) patients who used the Lark Weight Loss Health Coach, which encourages weight loss through elements of cognitive behavioral therapy. The Lark AI Health Coach monitors a patient’s health through phone sensors and integrated health devices, and then mimics nurses’ empathetic counseling through casual conversations that use text-based communication and other interactive elements.
Lark is the only fully-AI driven Diabetes Prevention Program recognized by CDC, and was designed by leading behavior change experts and health faculty from Harvard and Stanford. Its AI chronic disease solution was developed over the past six years through 355 million interactions with a million patients. Lark is available to patients anytime, anywhere, and is infinitely scalable. With this ease of use, Lark has engaged 83 percent of DPP-eligible patients within 72 hours of being referred to its AI platform. This year, Lark became the first AI-led DPP to be fully reimbursable with a CPT code.
The full study, “A Fully Automated Conversational Artificial Intelligence for Weight Loss: Longitudinal Observational Study Among Overweight and Obese Adults” is available at https://diabetes.jmir.org/.