WILMINGTON, MA — Below are a couple of recent Wilmington Little League game summaries:AAA: Astros vs. Pirates on Saturday, May 4, 2019 at Boutwell FieldAnother hard-fought game was waged between the Pirates and the Astros. After leading for most of the game, the Pirates were unable to hold off the tenacious Astros, falling 10 to 8 in 5 innings. Mickey Moroney was stellar for the Pirates in his first game on the mound pitching two solid innings. With some timely hitting, the Pirates held leads of 4 to 1 and 5 to 3 into the middle innings. The Astros’ starter Dylan Costantiello struck out one and made a nice play in the field during his inning of work. Tony Cummings then pitched three innings, striking out seven and making two plays of his own. Finally, Cael Considine baffled the Pirates’ hitters in the last inning, striking out two. Solid fielding is emerging as one of the Astros’ strengths. Considine’s two putouts at first base, Aidan Raposa’s great play at third for an unassisted putout, and Owen Wills snaring a sharp grounder at third holding the Pirates’ batter to a single were three examples. Every Astro found his way on base during the game led by Kevin Pruslin, John Roofe, Patrick Moriarty, and Jake Gryglik who were each on base three times. Roofe continued his hot hitting with a single and a booming double. Moriarty ripped two singles as the other player with a two-hit afternoon. Raposa launched a screaming single up the middle in the third inning and Pruslin, Cummings, Considine, Andrew Santo, and Kyle Price added singles of their own. Costantiello, Connor Jamieson, Gryglik, and Wills were among those who displayed their keen batting eyes working walks and Gryglik again showed his blazing speed with a stolen base. The final rally included clutch hits and walks by Roofe, Santo, Raposa, Jamieson, and then the game-winning single by Moriarty scoring Santo. Overall, the Pirates and Astros left it all out on the field and had a great time doing so!Single A: Ray vs. Pirates on Monday, May 6, 2019 at Boutwell FieldThe Pirates and Rays played a close game. The Rays made several great plays and had strong pitching performances from Michael Crowley, Tommy Roofe, and Ryan Doherty. Defense was impressive tonight featuring great plays by Brendan Cyr and an impressive inning as catcher by Sean Witalisz. The bats were alive early on with some big hits by Benji Hebert, Alex Sullivan, Chris Gattineri, Jackson Childs, and Cameron White. The Pirates were led on the mound by Zach Maiella, Ryan Biggins, and Bart Zaino, while Joshua Lopez and Colby O’Brien were strong behind the plate. Jack Jamieson had a great defensive game at first base as well. The bats were on fire early, with Nico McCollem starting things with a leadoff hit. Bradley Stephen, Sam Beaudoin, and Sean Theodos joined in with their own timely hits, and Ben Sawyer showed off his speed running the bases.(NOTE: Summaries provided by the Wilmington Little League.)Like Wilmington Apple on Facebook. Follow Wilmington Apple on Twitter. Follow Wilmington Apple on Instagram. Subscribe to Wilmington Apple’s daily email newsletter HERE. Got a comment, question, photo, press release, or news tip? Email email@example.com.Share this:TwitterFacebookLike this:Like Loading… RelatedWilmington Little League’s Latest Game SummariesIn “Sports”Wilmington Little League’s Latest Game SummariesIn “Sports”Wilmington Little League’s Latest Game SummariesIn “Sports”
How many times have you tried and failed at achieving that fit, no-flab body? ‘Eat good, feel good’ only remains as a saying for many people who ‘cannot resist the desire of that one last sweet bite off the brownie. With changing situations many are turning towards food with high nutrition value. But compromising with taste just to eat a healthy snack doesn’t really make one happy. “A healthy diet doesn’t have to be devoid of carbs or fats, when you can simultaneously make healthy delicious,” said Chef Vinod Saini, Master Chef Indian, The Leela Palace, who at Banarsidas Chandiwala Institute of Hotel Management and Catering, recently judged a hospitality competition organised by Association of Hospitality Professionals. Also Read – Add new books to your shelfThe Chef has suggested some scrumptious recipes that can be easily made and is a healthy yet tasty option for people who want to eat well:QUINOA SALAD:Quinoa is the most protein rich food and contains twice as much as fibre as other grains. Ingredients Qty Quinoa Grains white 30 gmsQuinoa Grains black 50 mlAssorted nuts 20 mlOrange Segments 70 gmsGrapefruit segments 70 gmsChopped parsley 5 gmsFresh Strawberries 100 gmsCherry tomatoes 80 gmsDried cranberries 60 ml Also Read – Over 2 hours screen time daily will make your kids impulsiveMandarins juice 100 mlMixed Lettuce 30gmsSalt to taste Honey Lemon Vinaigrette dressing 40mlMethodBoil water in a large saucepan. Add both Quinoa black/white separately and let it cool in fridge. Chop the nuts and citrus fruits length wise along with strawberries. Keep the dried cranberries whole and cut the cherry tomatoes into halves. Mix everything together gently and add dressing and a pinch of salt. Serve chilled.Wild rice khichadi:Ingredients Qty Wild rice 40gmsBrown rice 30gmsBroccoli 100gmsGreen beans 80gemsOlive oil 70mlCrushed pepper 2gmsGinger chopped 5 gmsCherry tomatoes 50 gmsFresh coriander 20 gmsChop green chilli 10 gmsCoconut milk 80 mlMethod of preparationSoak wild and brown rice separately for half an hour and then boil them by adding salt. Blanch broccoli and green beans and keep aside. Take a thick bottom saucepan, add olive oil and sauté green chilli and ginger with vegetables. Add boiled rice and cook for few minutes and then add cherry tomatoes and coconut milk. Garnish with chopped coriander and serve.
Related posts:Envision kicks off with long lines, high spirits, community service The band plays on: “Summer Series” serenades Plaza de la Democracia A passion, not a profession: new orchestra aims to broaden access to music U.S. blues phenomenon to play Barrio Amón Cantoamérica, which is Calypsonian or “Caribbean Fusion,” as they describe themselves, will blow out 35 candles this year. Instead if cekebrating it with a birthday cake, they are releasing a new album named “Vuela Otra Vez” (“Fly again“) eight years after their last release, “Vientos del Caribe.”The Tico Times talked to three of the nine members of the group: singer, guitarrist and songwriter Manuel Monestel, who has been part of the band since the start; trombonist Alfredo Chavarría, who joined the band in 2008; and percussionist José (Momo) Valverde, who joined in 2001.TT: As you, Manuel, have been part of the band sice it was created, where did the idea of Cantoamérica came from?MM: In the 1970s there was a musical movement called “The new Costa Rican song,” part of a larger, regional movement of Latin American identity, which tried to balance U.S. influence on Latin American music. We played Latin American music using Latin American instruments. I was playing with a group called “Tayacan,” directed by the great Nicaraguan musician Luis Enrique Mejía Godoy, who after a while went back to Nicaragua because of the Sandinista Revolution at that time.After he left, the group came to an end, but some of us wanted to continue. That is how Cantoamérica was created in 1980 by Rodrigo Salas, Roberto Salas, Carlos Svedra, Bernal Monestel (my brother) and me.Why Calypsonian music? Why the Caribbean?MM: In 1978-1979 I started questioning what happened with music on the Caribbean side of the country, understanding that we have a Caribbean province populated and influenced by an Afro-descendent culture. We found that approximately 95% of the music heard all around the world has African roots. Without the African Diaspora there would be no jazz, no blues, no salsa, no cumbia, no merengue, no calypso, no reggae. So I thought there must be interesting music in Limón. I started making contacts, getting to know their culture, reading about that region’s music that so few people knew; casually all written by foreigners, because, as you must know, ‘Ticos’ don’t get interested in those things. So, there I discovered Calypso, found musicians such as Walter Ferguson, and understood there was a whole musical culture led by Calypsonians. That is how I decided to bring in that kind of music to Cantoamerica. The group started with a Latin American emphasis; now it is more Afro-American.AC: I would’t like to label it, I mean, I wouldn’t say “we play calypso.” I think it is more like Manuel said, a fusion. I think that is an important and faithful reflection of what Costa Rican culture is: a mixed culture. I would also say that the great legacy of the group is the reinvindication of that mixed heritage which, from my point of view, has been historically invisible.It seems to me that, not only in Costa Rica but worldwide, those fusions are very successful because, at some point, people feel identified with them, unless they don’t quite understand why. I’m sure that when people listen to Cantoamérica they inmediately identify with it. They feel Costa Rican.MM: We are often described as a ‘World Caribbean Music’ group, and it is exactly that. A fusion of roots of our musical identities.How would you describe the trajectory of the group?MM: There are nine members; I am the only one who has been in the group since the start. We have toured through Asia, Africa, Europe and America, with approximately 28 international tours and 13 albums. We have worked with soloists and bands from Limón.JV: For this new album we had the opportunity to visit Africa, where we could see our roots, the roots of the Caribbean. We worked with African musician Eleuthere Gabon Assouramou, who gave a special feel to the new album. You can find some African drums in some songs.MM: A characteristic of the group right now, that I really like actually, is the participation of very young musicians. Most of them are less than 30. I like it because they bring young ideas, young energies. They give the group oxygen.AC: Another thing to highlight about the group today is female participation. They give a very special touch to the group.MM: They make us ‘politically correct’ [laughs].AC: Basically [laughs again]. Well, more than that, I think that the female energy creates a balance, a very important energy in any kind of human group. And the album reflects that female influence.José, can you describe the characteristic percussion of Cantoamérica?JV: We play many rhythms such as Cha Cha Cha and bolero, but we are mainly focused on Calypso, which is a rhythm that does exist in our country and that we must exploit. Thus, our percussion is basically based on drums, timbales, bongo, large conga drums, effects and minor percussion.José and Alfredo, what has your experience been since joining the band?AC: I joined in 2008, and about the experience – I could talk for hours about it. I could easily compare what I learned at university with what I have learned in Cantoamérica. That says quite a lot. Manuel’s guidance have been really important.JV: I started to play in the group in 2001, and I can say that Cantoamérica has given many musicians the opportunity to learn, be creative, and experiment. This has been a school for all of us. This is a group which through the passage of the years always keeps its charisma and joy. Before I joined the group, I used to listen to Cantoamérica and think, “So nice! I’d love to play with them” and, well, here I am.AC: Cantoamérica is an emblematic group within Costa Rican music, and I don’t say that because I’m part of it, but because there are many generations of Costa Rican musicians who has passed through Cantoamérica and have carried all the learning they obtained to other different projects and groups. The most rewarding aspect is all that daily coexistence with musicians.Tell us about this new album, “Vuela Otra Vez.”MM: Most of the music is original, mainly written by me. When we use non-original songs, they are music of Calypsonians authors from Limón. One track, ‘Orire,’ is a mixture of our music with the traditional African song of that name. It expresses both cultural sides, African and Caribbean.The name of the album has a double function. Frst, is the name of one of the songs which tells the story of a girl whose husband cheats on her and abandons her; the song encourages her to get free of her situation, to open her wings and fly, as the chorus says: ‘Vuela otra vez mariposa, vuela otra vez’ [‘Fly again butterfly, fly again’]. And, second, since Cantoamérica had several years of not releasing an album, the message is like: ‘Vuela otra vez Cantoamérica.’ We are back.We received financial support from approximately 100 people to make the album, and we are really thankful to all of them.What does Cantoamérica wants to communicate with its music?MM: Costa Rica is a complex country, and I say complex beacuse it is a country that focuses on the outside instead of the inside. It still doesn’t value its cultural production, our ethnic-cultural roots. The country is still thinking about itself as a ‘white country’ and most of its radio is virtually closed to any national music. The country follows a mainstream which makes invisible all those movements that go against that, and groups such as Cantoamérica must try harder. It is gratifying to me to write my own music, the music we like and we want to play, and not write in function of commercial impositions and opportunism.I don’t critize musicians who play covers, but I think that Costa Rica will not represent itself internationally with its music if we keep that way. You don’t go to the United States or England and play covers. The country must progress, look for its roots and base itself on those roots to create. I’m not talking about folklore. I’m talking about assimilating our real roots and transmitting them along with contemporary music, and relating all this to our history.Cantoamérica is offering a free concert today at the National Cultural Center (CENAC) in downtown San José at 3:30p.m. More info at 2255-3188. Facebook Comments
09May Rep. Huizenga: Legislature has delivered historic car insurance reforms House approves landmark legislation addressing no-fault systemState Rep. Mark Huizenga today voted to bring lower car insurance prices to residents and families in the greater Grand Rapids area, joining House legislators in approving a plan to reform Michigan’s broken no-fault system.The House plan guarantees lower rates for all drivers in Michigan, reducing what currently is the highest average car insurance premium in the nation. The bill also gives drivers a choice on car insurance policies, stops price gouging on medical services for car accident victims and combats fraudulent claims to help lower costs.“Residents in our communities across the state gave us a very clear message going into this legislative term: get Michigan’s out-of-control car insurance rates to an affordable level,” said Huizenga, of Walker. “We prioritized the issue with a special committee and website devoted to input from residents and we are now acting on that work with real reform. This is a great first step in a process to bring real relief to drivers.”Michigan’s costs are high largely because it’s the only state mandating unlimited lifetime health care coverage through car insurance. The House plan allows those currently using the coverage to keep it, and those who want it in the future to continue buying it – all while providing more affordable options for individuals and families statewide with a mandatory rate reduction.The sweeping legislation now advances to the Senate for consideration. Categories: Huizenga News,News
Add to Queue Opinions expressed by Entrepreneur contributors are their own. Niche marketing Twin brothers in Paris left the insurance business to open a restaurant catering to nude vegans. Contributor President of The Marks Group Image credit: O’naturel | Facebook Next Article Apply Now » The only list that measures privately-held company performance across multiple dimensions—not just revenue. –shares 3 min read Gene Marks 2019 Entrepreneur 360 List November 8, 2017 The Dress Code for This New Restaurant Is Your Birthday Suit If you’ve ever had the desire to eat an entire meal in public and be completely naked at the same time well…now’s your chance. Just go to Paris and make a reservation at O’naturel.Yes, that’s the actual name and at the 40-seat O’naturel, which opened its doors last week, customers are asked to leave their clothes in the cloakroom and proceed – in all their splendidness – to dine with other clothe-less patrons. The “bistronomic” menu starts around € 39 (about $45) and features vegan dishes, whitch are popular among naturists, and of course a great wine selection. This is Paris, let’s not forget.Related: Dear Entrepreneurs: Small Is Still BeautifulDon’t worry, health officials, the staff are clothed, patrons wear slippers and the seats have disposable covers.According to two reports last week here and here in Le Parisian, would-be voyeurs on the street won’t get a peep show. The establishment sports a “neutral” front, with a heavy blackout curtain and other screens covering the main windows. The entrance is designed to prevent anyone from seeing inside, even when the doors are opened. The establishment received a hearty thumbs up from members of the Association des Naturists de Paris, who were invited to be the very first diners.Related: 9 Startups Changing the Fabric of FashionThe French, being French, aren’t ruffled. In fact, residents in the restaurant’s neighborhood are mostly indifferent to its uniqueness. “When we learned what was going to be here, obviously it made us laugh. Especially since there is a nursery next door,” one resident who lives above the restaurant said. “But it does not bother me.”Even though it’s early days, things seem to be going pretty well for Mike and Stéphane Saada, the twin-brothers who own the restaurant. The Saada twins are ex-insurance industry executives and, unsurprisingly, ardent naturists. The restaurateurs are hoping to tap into the two-million strong naturist community in France. “We have already had quite a few reservations on the Internet,” they said, adding the comments coming in on their website are “very nice.”Related: 7 Steps to Defining Your Niche MarketLots of people open up restaurants and it’s no secret that many of them fail. It’s a hard and competitive business. Which is why a potential road to success is picking a demographic — whether it’s vegans, naked people or even lovers of the Golden Girls — and (of course) serving up good food. In this highly specialized world, many smart business owners I know are zeroing in on a targeted industry and becoming excellent at a particular skill to stand out and profit. So why not excellent food that caters to the community of French naturists?Oh, and the best thing about O’naturel? Well, in my opinion, it’s that no matter how high the bill is, you’ll never feel like you’ve lost your shirt.
Guest Writer Green Entrepreneur Podcast Lawmakers loath to raise taxes but eager for new revenue are increasingly open-minded about legal marijuana. August 9, 2018 Add to Queue Marijuana Is a $794 Million Windfall for the States That Have Legalized Adult Use Image credit: Hillary Kladke | Getty Images Easy Search. Quality Finds. Your partner and digital portal for the cannabis community. Each week hear inspiring stories of business owners who have taken the cannabis challenge and are now navigating the exciting but unpredictable Green Rush. Opinions expressed by Entrepreneur contributors are their own. Next Article 3 min read There are several good reasons for state lawmakers to embrace legal adult-use marijuana — criminal justice reform, ending mass incarceration, respect for individual rights — but for many the most compelling reason is this number: $793.6 million.That is the estimated 2017 total of taxes and fees raked in by five states where adult-use marijuana is legal, according to a report from the National Cannabis Industry Association. The NCIA, founded in 2010, represents about 1,500 businesses in the marijuana industry across the United States.Much of the rhetoric advocating legal marijuana revolves around arguments such as cannabis being less dangerous than alcohol or the social justice issues surrounding the implementation of drug laws. Those are strong, valid arguments but when it comes to actually changing minds, it’s wise to remember that money really does change everything.Related: Education and Employment Is High in Cannabis-Friendly StatesA windfall where the law allows it.The cannabis economy offers ambitious entrepreneurs the chance to flourish in an already competitive environment, but it’s the money governments are bringing in that is really turning heads in many public offices around the country. The NCIA-reported revenue for just five states. The numbers (rounded) from each are:Washington — $441 millionColorado — $234 millionOregon — $68.6 millionAlaska — $6.1 millionNevada — $43.7 millionThat Nevada number is particularly eye-catching because the state only started regulated sales of marijuana in July 2017.For state governments, there is simply nothing else aside from a gargantuan tax increase that can generate that much additional money this fast. Many observers think the potential for a large and reliable new source of marijuana tax revenue will push more states to legalize, just as New Hampshire’s legalization of a state lottery in 1964 prompted most other states to eventually follow suit. There are currenly just six states — Alabama, Alaska, Hawaii, Mississippi, Nevada, and Utah — without a state lottery. Related: Jimmy Kimmel’s ‘Dr. Quinn Medicinal Marijuana Woman’ Spoof Is HilariousEstimates of potential marijuana tax revenue has energized the push for legalization in other states.This talk heated up especially in Illinois last year, with even the Chicago Tribune weighing in that legalizing marijuana could help solve the state’s intractable budget problems. Voters will get a chance to approve recreational marijuana sales in November. However, it’s just an “advisory” ballot question. State lawmakers would still need to act. But a majority “yes” vote on legal adult-use cannabis would give lawmakers on the fence the political cover they need to move forward on legalization.Late last year, the Pennsylvania auditor general also advocated legalized marijuana to solve that state’s budget crisis, conservatively estimating $200 million in new revenue.Legalizing and taxing adult-use recreational marijuana is an increasingly viable option for states. The biggest barrier, as always, is lawmakers and state executives who led these states into a budget crisis in the first place. Voters who remember the promise of those who promoted state lotteries also might be skeptical about what marijuana tax dollars can accomplish.That said, for embattled state leaders, legalizing adult-use marijuana is a path more and more are willing to take — or at least seriously consider.Follow dispensaries.com on Instagram to stay up to date on the latest cannabis news. –shares dispensaries.com Legal Marijuana Listen Now
Source:http://ewww.kumamoto-u.ac.jp/en/ Reviewed by Alina Shrourou, B.Sc. (Editor)Oct 31 2018Scientists in Japan have found a ‘skeleton key’ for congenital kidney disease research. Using iPS cells generated from the skin cells of a patient with a nephrin mutation, Kumamoto University scientists have successfully developed kidney tissue that exhibits the early stages of congenital kidney disease. The protein nephrin is a constituent of the kidney filtration membrane and abnormalities of this protein are commonly found in other types of kidney diseases. The results of this work are expected to unlock several doors in future kidney disease research.The kidneys are organs that filter out and discharge waste products from the blood. During this process, proteins in the blood should not leak into the urine. The membrane responsible for this filtration is part of the glomerular podocyte and nephrin is its main constituent. If there is a genetic mutation affecting the nephrin, a large amount of protein in the blood can leak into the urine resulting in congenital nephrotic syndrome. The treatment of this syndrome is radical and difficult, and the absence of a technique to artificially reproduce a mutated filtration membrane has been a bottleneck in research progress.In 2014, this Kumamoto University research group succeeded in the extremely difficult task of producing artificial kidney tissue in vitro from human iPS cells–a world first. And in 2016, they found that glomerular podocytes derived from iPS cells strongly express nephrin, that the human glomeruli readily connects with mouse blood vessels, and that induced podocytes continue to mature after transplantation into mice. With this knowledge, they applied their techniques to iPS cells derived from a single patient for their most recent project.Related StoriesNew imaging probe allows earlier detection of acute kidney failureLow dose of endotoxin could have protective effect on men at risk of acute kidney injuryBordeaux University Hospital uses 3D printing to improve kidney tumor removal surgeryFirst, they established iPS cells from the skin cells of a patient with congenital nephrotic syndrome having a single nephrin mutation. When they induced kidney tissue from these iPS cells in vitro, they found that nephrin, which should exist on the surface of the glomerular podocyte, remained inside the cell, and that almost no filtration membrane precursor could develop. When podocyte maturation was performed by transplantation into mice, nephrin, which typically moves toward the blood vessel side of normal podocytes again remained inside the patient-derived cells. In other words, the initial pathology of this congenital kidney disease was reproduced by the iPS cells derived from the diseased patient.Furthermore, when the nephrin mutation in patient-derived iPS cells were repaired and then induced into kidney tissue, the abnormalities were normalized. Put simply, the researchers found that this single mutation is the cause of the disease, and showed that it could possibly be treated by repairing the mutation.”Because we can now reproduce the pathology of congenital nephrotic syndrome, it should be much easier to explore therapeutic drugs using this podocyte,” said project leader Professor Ryuichi Nishinakamura. “Even when kidney disease develops in adults, it often begins with abnormal quantities of protein in the urine. It is believed that this is often caused by trouble in the nephrin protein of the filtration membrane. If a medication is discovered that controls nephrin protein, there is a strong possibility that it will be highly effective for kidney disease. What we have achieved here is a big step towards the development of drugs that act on podocytes and reduce proteinuria.”
It’s a difficult condition and the traditional method of immediate open repair had limited outcomes. We needed to try something else.”Bo Yang, M.D., Ph.D, Michigan Medicine cardiac surgeon Reviewed by James Ives, M.Psych. (Editor)Jul 17 2019When a patient comes to the hospital with acute type A aortic dissection (ATAAD), a tearing of the inner lining of the aorta, surgeons typically perform an immediate open repair to prevent death from aortic rupture.However, 20 years ago, G. Michael Deeb, M.D., a cardiac surgeon at Michigan Medicine’s Frankel Cardiovascular Center, noticed some patients were still dying after their successful open repair. They thought this subset of aortic dissection patients might be succumbing to a different problem: malperfusion syndrome (MPS), which was causing organ failure due to inadequate blood supply.In cases of malperfusion, a patient experiences inadequate blood flow to their end organs, such as the heart, because of obstruction of the aorta and its branches, which can be caused by aortic tearing. Malperfusion develops into a syndrome when this inadequate blood flow causes cell, tissue and organ death, with the consequence of functional failure in vital organs. That led U-M cardiac surgeons to a discussion with interventional radiologists about improving aortic dissection patient outcomes. David Williams, M.D., a vascular and interventional radiologist at Michigan Medicine, brought up the idea of opening a vessel to perfuse the organ again before the cardiac surgeon performs an open repair. Yang and other surgeons continue to optimize this approach by including aggressive blood pressure control, better ICU care and carrying out earlier open aortic repairs.In a recent Circulation study, which spanned two decades and included 597 participants with ATAAD, Yang and colleagues reported a 12 percent decrease (from 16 percent to 4 percent) in the risk of death from aortic rupture for MPS patients using this updated protocol.”The idea was radical because immediate open repair was considered the gold standard of treatment for patients with aortic tear,” says co-author Elizabeth Norton, M.S., a student at Creighton University School of Medicine.Weighing the risksYang and his team hypothesized that endovascular reperfusion (fenestration/stenting) as the first intervention before definitive operative repair would be more beneficial than upfront open aortic repair in stable patients diagnosed with both ATAAD and MPS.Endovascular reperfusion, Norton says, involves “percutaneous access in the groin to allow vascular access without an incision, from which catheters are inserted into the artery allowing access to the aorta and the ability to resolve the malperfusion with fenestration and stenting.””Fenestration creates a large opening in the aortic flap that could be causing the malperfusion, allowing blood flow on both sides of the flap,” she adds. “Stenting involves inserting a metal stent into the aorta and/or branch vessels to open the vessel, similar to stent placement in the coronary arteries in a heart attack; essentially opening the vessel to permit blood flow.”Surgeons have to balance the 30 percent risk of operative mortality and the 4 percent risk of aortic rupture.”The premise of the approach is that not every untreated ATAAD patient will rupture, but every untreated MPS patient will result in death,” Yang says. A premise that, Williams says, epitomizes the philosophy shared by cardiac surgery and interventional radiology.Related StoriesNanoparticles used to deliver CRISPR gene editing tools into the cellStroke should be treated 15 minutes earlier to save lives, study suggestsAlternate cell growth pathway could open door to new treatments for metastatic cancers”The stakes of a missed diagnosis are high, so the threshold for evaluating and, if appropriate, treating MPS in stable patients is low,” Williams says.In this study, physicians treated 135 patients with upfront endovascular reperfusion followed by open repair. The operative mortality was 4 percent at Michigan Medicine compared to 30-40 percent reported in the literature.After the study the research team concluded that immediate open repair is still the best strategy to prevent death from aortic rupture for the majority of patients with ATAAD. However, they report that relatively stable patients with MPS benefit from a staged approach: upfront endovascular reperfusion followed by aortic open repair after the patient recovers from malperfusion.U-M method advantagesCompared to the traditional method of upfront open repair for every patient, Yang says this new method of care came with several advantages.The approach resolves the arterial obstruction immediately and completely, through the skin. This is significantly less invasive than open repair and the average time to resolve the obstruction is 30 minutes.The Michigan Medicine approach also gives borderline operative candidates with MPS time to recover and avoid pointless open repair in those with progressed organ failure, Yang says. Patients with MPS are critically ill and operative mortality has been reported to be as high as 45 percent if upfront open repair is performed.Clinical implicationsAfter patients were treated with endovascular reperfusion and had recovered from MPS, the operative mortality of open repair was six to eight times lower than the expected mortality calculated from all five literature models compared in the study. The long-term survival (80 percent at five years; 63 percent at 10 years) was similar to patients with ATAAD without MPS.In other reports, patients with MPS treated with upfront open repair had worse long-term survival rates when compared to patients without MPS.Researchers say this new approach could change the algorithm for treating patients with acute type A aortic dissection and MPS.”We worked to decrease the risk of rupture for MPS patients by using aggressive blood pressure control after malperfusion recovery and before their open repair surgery,” Yang says. “High blood pressure can cause rupture if the aorta is dissected because the aortic wall becomes paper thin.”Ninety-six percent of patients either survived to discharge or underwent delayed open repair (69.5 percent) or died from end-organ failure (26.5 percent) before delayed open repair. Even after the arterial obstruction was resolved with endovascular reperfusion, the risk of dying from end-organ failure due to severe organ damage from malperfusion was approximately seven times higher than the risk of aortic rupture, proving Yang’s hypothesis.”This method is a landmark. It’s changing lives. It will take us into the future of healthcare,” says Yang, who is already talking with other institutions about the strategy. “I want every physician to know about it.” Source:Michigan Medicine – University of MichiganJournal reference:Yang, B. et al. (2019) Endovascular Fenestration/Stenting First Followed by Delayed Open Aortic Repair for Acute Type A Aortic Dissection With Malperfusion Syndrome. Circulation. doi.org/10.1161/CIRCULATIONAHA.118.036328.
The logo of US company General Electric is seen at a factory of the group in Montoir-de-Bretagne, western France This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only. Citation: General Electric shares rise despite 1Q loss on hefty legal charge (2018, April 20) retrieved 18 July 2019 from https://phys.org/news/2018-04-electric-bn-loss-1q-reaffirms.html Slumping industrial conglomerate General Electric won a reprieve on Wall Street Friday after reporting strong results in some divisions even as it suffered a quarterly loss due to a hefty legal charge. Explore further © 2018 AFP GE reports 4Q loss of $9.8 bn on insurance, tax charges GE, which has been hurt by weakness in its power and oil and gas businesses, reported a first-quarter loss of $1.2 billion, due to $1.5 billion in reserves to cover legal settlements connected to a subprime lending unit it exited.However, investors took heart after GE reaffirmed its full-year financial targets and avoided fresh negative surprise announcements that have plagued recent results. Revenues increased 6.7 percent to $28.7 billion.”The first quarter is a step forward in executing on our 2018 plan and we are seeing signs of progress,” said chief executive John Flannery. GE has been signaling for months that its encumbered power division would be an earnings vulnerability for some time to come, but Flannery said Friday that the outlook was even worse than previously thought.The company now expects the overall market for new gas turbine orders to be less than 30 gigawatts, compared with the prior estimate of 30 to 34. Factors driving the weakness include the rising share of renewable energy, energy efficiency efforts and some delays in orders, Flannery said. Since Flannery became CEO last summer, GE has trimmed costs, streamlined its board, cut its dividend and revamped employee compensation. The company also has announced plans to sell $20 billion in industrial assets. Flannery reaffirmed he is open to further overhauling GE, raising speculation of a breakup of the company.”There’s no sacred cows,” he said during a conference call with analysts. “We’re reviewing a number of structures. We’re working through this right now in great detail with the board, including new board members.”GE was the biggest gainer in the Dow, rising 2.8 percent to $14.38 in midday trading.Oil rebound?GE’s other problem division of late, oil and gas, could be poised for a turnaround in the foreseeable future due to strengthening oil prices. Major producers including Saudi Arabia and Russia signaled Friday they plan to extend a production accord to defend higher oil prices.Baker Hughes, an oil services company in which GE holds a majority stake, offered an upbeat outlook when it reported results Friday, saying “market fundamentals remain supportive” due to stable oil prices.GE scored higher profits compared with the year-ago period in four divisions, including healthcare and aviation, which have been the strongest businesses.GE has previously signaled that it expected additional legal costs connected to WMC. In a February US securities filing, the company said it believed the US Department of Justice would assert the company violated US law “in connection with WMC’s origination and sale of subprime mortgage loans in 2006 and 2007.”GE chief financial officer Jamie Miller said the company set aside the $1.5 billion in reserves “based on our discussions with the DOJ and a review of settlements by other banks.”CFRA Research analyst Jim Corridore praised some aspects of GE’s performance and noted that it exceeded its cost-cutting targets. But he cut his earnings estimate and share price target.”Given the severity of the downturns at oil & gas and power, and ongoing losses from GE Capital, we do not think it’s worth wading into the shares despite the below-market valuation,” Corridore said in a note.