StemCell Therapy

CAMBRIDGE, Mass.--(BUSINESS WIRE)--AVROBIO, Inc. (NASDAQ: AVRO) (the Company) today announced that the first patient has been dosed in the Companys AVR-RD-04 investigational gene therapy program for cystinosis, a devastating lysosomal storage disease, in an ongoing Phase 1/2 clinical trial sponsored by academic collaborators at the University of California San Diego. The gene therapy is derived from the patients own hematopoietic stem cells, which are genetically modified to produce functional cystinosin, a crucial protein that patients with cystinosis lack.

The trial will enroll up to six patients with cystinosis, a rare inherited disease caused by a defect in the gene that encodes for cystinosin. The cystinosin protein enables transport of the amino acid cystine out of lysosomes. When it is absent, cystine accumulates and crystalizes, causing progressive damage to the kidneys, liver, muscles, eyes and other organs and tissues. Cystinosis affects both children and adults; they face shortened life spans and often painful symptoms, including muscle wasting, difficulty breathing, blindness and kidney failure.

Cystinosis is a debilitating and progressive disease, and new treatment options are sorely needed. The current standard of care does not avert deterioration; at best, it can attenuate symptoms. Thats why gene therapy is particularly exciting: It has the potential to change the course of disease -- and the lives of patients -- by addressing the underlying cause of cystinosis, said Birgitte Volck, MD, PhD, President of Research and Development at AVROBIO. We believe we can engineer patients own stem cells so they sustainably produce the functional protein that is needed to prevent a toxic buildup of cystine and halt progression of the disease. We are so pleased that this investigational gene therapy is now in the clinic in collaboration with Dr. Stephanie Cherqui at UC San Diego.

The single-arm trial will enroll four adults and a potential follow-on cohort of two adults or adolescents at least 14 years of age who are currently being treated with cysteamine, the standard of care for cystinosis. If started at an early age and taken on a strict dosing schedule, cysteamine can delay kidney failure. However, the treatment regimen is highly burdensome, with side effects that can be severe and unpleasant, and many patients find it difficult to adhere to this treatment regimen. Even if compliance is high, cysteamine therapy cannot prevent kidney failure or avert other complications.

For people with cystinosis, there are no healthy days. They must take dozens of pills a day, around the clock, just to stay alive. It is a relentless disease and we urgently need new treatments, said Nancy J. Stack, President of the Cystinosis Research Foundation, which supported development of the gene therapy with more than $5.4 million in grants to Dr. Cherquis lab at UC San Diego. We believe that we are now an important step closer to the potential cure that our community has been working toward for many years.

The trials primary endpoints are safety and tolerability, assessed for up to two years after treatment, as well as efficacy, as assessed by cystine levels in white blood cells. Secondary endpoints to assess efficacy include changes in cystine levels in the blood, intestinal mucosa and skin and cystine crystal counts in the eye and skin. Efficacy will also be evaluated through clinical tests of kidney function, vision, muscle strength, pulmonary function and neurological and psychometric function, as well as through assessments of participants quality of life after treatment. The trial is funded by grants to UC San Diego from the California Institute for Regenerative Medicine (CIRM) as well as the Cystinosis Research Foundation.

This investigational gene therapy starts with the patients own stem cells, which are genetically modified so that their daughter cells can produce and deliver functional cystinosin to cells throughout the body. With this approach we aim to prevent the abnormal accumulation of cystine that causes so many devastating complications, said Stephanie Cherqui, PhD, an Associate Professor of Pediatrics at UC San Diego School of Medicine, and consultant to AVROBIO. We have been working toward this trial for years and we are grateful for all the support that brought us to this moment.

About AVR-RD-04

AVR-RD-04 is a lentiviral-based gene therapy designed to potentially halt the progression of cystinosis with a single dose of the patients own hematopoietic stem cells. The stem cells are genetically modified so they can produce functional cystinosin with the aim of substantially reducing levels of cystine in cells throughout the patients body. Before the infusion of the cells, patients undergo personalized conditioning with busulfan to enable the cells to permanently engraft. The Phase 1/2 clinical trial is being conducted under the name CTNS-RD-04 by AVROBIOs academic collaborators at the University of California, San Diego.

About Cystinosis

Cystinosis is a rare, inherited lysosomal storage disorder characterized by the accumulation of cystine in all the cells of the body, resulting in serious and potentially fatal damage to multiple organs and tissues and the shortening of patients life spans. The kidneys and eyes are especially vulnerable; more than 90% of untreated patients require a kidney transplant before age 20. An estimated 1 in 170,000 people are diagnosed with cystinosis.

About AVROBIO, Inc.

AVROBIO, Inc. is a leading, Phase 2 gene therapy company focused on the development of its investigational gene therapy, AVR-RD-01, in Fabry disease, as well as additional gene therapy programs in other lysosomal storage disorders including Gaucher disease, cystinosis and Pompe disease. The Companys plato platform includes a proprietary vector system, automated cell manufacturing solution and a personalized conditioning regimen deploying state-of-the-art precision dosing. AVROBIO is headquartered in Cambridge, MA and has offices in Toronto, ON. For additional information, visit http://www.avrobio.com.

Forward-Looking Statements

This press release contains forward-looking statements, including statements made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. These statements may be identified by words such as aims, anticipates, believes, could, estimates, expects, forecasts, goal, intends, may, plans, possible, potential, seeks, will and variations of these words or similar expressions that are intended to identify forward-looking statements. These forward-looking statements include, without limitation, statements regarding the therapeutic potential of our product candidates, the design, commencement, enrollment and timing of ongoing or planned clinical trials, including the ongoing Phase 1/2 trial of the Companys AVR-RD-04 investigational gene therapy, the anticipated benefits of our gene therapy platform, the expected safety profile of our product candidates, timing and likelihood of success of our current or future product candidates, and the market opportunity for our product candidates. Any such statements in this press release that are not statements of historical fact may be deemed to be forward-looking statements. Results in preclinical or early stage clinical trials may not be indicative of results from later stage or larger scale clinical trials and do not ensure regulatory approval. You should not place undue reliance on these statements, or the scientific data presented.

Any forward-looking statements in this press release are based on AVROBIOs current expectations, estimates and projections about our industry as well as managements current beliefs and expectations of future events only as of today and are subject to a number of risks and uncertainties that could cause actual results to differ materially and adversely from those set forth in or implied by such forward-looking statements. These risks and uncertainties include, but are not limited to, the risk that any one or more of AVROBIOs product candidates will not be successfully developed or commercialized, the risk of cessation or delay of any ongoing or planned clinical trials of AVROBIO or our collaborators, the risk that AVROBIO may not realize the intended benefits of our gene therapy platform, including the features of our plato platform, the risk that our product candidates or procedures in connection with the administration thereof will not have the safety or efficacy profile that we anticipate, the risk that prior results, such as signals of safety, activity or durability of effect, observed from preclinical or clinical trials, will not be replicated or will not continue in ongoing or future studies or trials involving AVROBIOs product candidates, the risk that we will be unable to obtain and maintain regulatory approval for our product candidates, the risk that the size and growth potential of the market for our product candidates will not materialize as expected, risks associated with our dependence on third-party suppliers and manufacturers, risks regarding the accuracy of our estimates of expenses and future revenue, risks relating to our capital requirements and needs for additional financing, and risks relating to our ability to obtain and maintain intellectual property protection for our product candidates. For a discussion of these and other risks and uncertainties, and other important factors, any of which could cause AVROBIOs actual results to differ materially and adversely from those contained in the forward-looking statements, see the section entitled Risk Factors in AVROBIOs most recent Quarterly Report on Form 10-Q, as well as discussions of potential risks, uncertainties and other important factors in AVROBIOs subsequent filings with the Securities and Exchange Commission. AVROBIO explicitly disclaims any obligation to update any forward-looking statements except to the extent required by law.

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AVROBIO Announces First Patient Dosed in Phase 1/2 Trial of Gene Therapy for Cystinosis - Business Wire

I grew up in Ohio and met my first real Westerner at age 27. Kate was from Durango, Colorado and lived next door to me for two months during a rural primary care rotation in medical school. They rolled up the sidewalks at night in Twin Falls, Idaho and so we had plenty of time to talk. Books always figured prominently in the conversation and she recommended her favorite book about the West

Reading that first iconic chapter, Time Spent, led to a 25-year Doig odyssey that eventually landed me in a Montana State University archive reading the final draft of that same chapter, marked up with Ivans own red pen.

It begins, That start of memorys gather: June 27, 1945. I have become 6 years old, my mothers life has drained out at 31 years. And in the first grey daylight, dully heading our horses around from that cabin of the past, my father and I rein away toward all that would come next.

The Doig archive at Montana State is a treasure trove for fans. Its extensively indexed and entirely on line and filled with pictures, original manuscripts and the collection of 3 x 5 and 5 x 8 cards on which Doig kept quotes and observations from his extensive research travels in Montana.

Ivan kept box after box of these cards, many of them with only a single type written sentence, sometimes annotated in longhand. He shuffled and reshuffled these bits of memory assembling them into temporary collections as material to flesh out a particular character or story line and then returned them to their boxes only to be reshuffled and reassembled for the next novel.

In summer 2019, Carol Doig met with a group of visitors and discussed her husband's journey in his last years. Joining them was her close friend, Betty Mayfield, who helped assemble Doig's edited manuscripts, diaries, correspondence and other documents that today are part of the MSU Doig collection. Those joining Carol in her living are, left to right, Betty Mayfield, Dr. Rob Patrick, Justin Shanks a post-doctoral fellow working on the Doig material to make it digitally accessible, and writer Todd Wilkinson of Mountain Journal. Photo by Kenning Arlitsch, dean of MSU Libraries

Sometimes this shuffling was frozen into a more permanent form when he collected them into 2-to-3 page novellas with titles like Scotchisms and Curses.Most assumptions arent conscious until they are shattered. Without realizing it, I had cast my favorite writer in his own movie that ran only in my head.

He woke up in the morning, hunted big game, slept with the world's most beautiful women, cavorted at the Algonquin round table, drank his weight in scotch and then, late at night, great work flowed forth from his pen in a tortured and inspired torrent. He threw himself down exhausted, only to arise and repeat the performance with the dawn. The truth that emerged from touching the physical remnants of his process was far different.

Ivan Doig was . . . a nerd . . .just like me. I clipped articles and collected them in folders, wrote down random thoughts and observations on cards, restacked, hoarded and recombined information. My stories were just about thrombocytopenia and clonal proliferation instead of resilient ranchers scraping out an existence under the Big Sky.

The champion of the lariat proletariat was a closet geek. How disappointing.But my biggest disappointment was yet to come.The archive contained an odd and alluring folder title medical journey that was irresistible to me as a physician. I hadnt realized that Ivan suffered from multiple myeloma for the last eight years of his life and had written four books after being diagnosed with a terminal disease.

Myeloma is a strange form of cancer as cancers go, it is both painstakingly slow to progress and inexorably fatal. Patients rack up complications from the treatment, not because treatment is so toxic, but because they live long enough to suffer from the cure as well as the disease.

The core of the pathology is something called a plasma cell which under normal circumstances produces the antibodies that help fight off invading viruses and bacteria. In myeloma, a single plasma cell mutates and grows uncontrollably crowding out everything else in a patients bone marrow and gumming up their organs with immunoglobulin. The mutant cells eventually cant be contained inside the bone marrow and invade the surrounding solid bone causing painful fractures in the spine and long bones of the skeleton.

As if that was not bad enough, the core of chemotherapy is high dose steroids, usually dexamethasone or prednisone. Steroids are the poster child for double edged swords in medicine. They are simultaneously incredibly useful for suppressing the immune system in autoimmune diseases, cancer and anything that involves inflammation, while at the same time having the most broad ranging side effect profile of almost any medication.

It was a love for wildlands in the West that led Rob Patrick, at right, down the trail of Ivan Doig's books and when he had an opportunity to dive deeper into Doig's final years he jumped at the chance. Another thing that brought him to Bozeman and Greater Yellowstone is his close friendship with Kenning Arlitsch, Dean of MSU Libraries. Here they are on an autumn trip into the Yellowstone backcountry.

Probably the most serious side effects for myeloma patients are immunosuppression leading to increased risk for infection, a softening of the bones accelerating the tendency of the disease to cause fractures and emotional lability. The last of these sounds trivial, but isnt.

My first patient who suffered from this particular side effect literally started a sentence laughing and ended it crying. The cognitive effects can be especially debilitating, because at its peak, the drug lulls one into a false sense of security. It can make patients feel super human and I had one multiple sclerosis patient tell me it was the most powerful antidepressant she had ever taken and she almost looked forward to her next flare so she could get it again. However, on the way up and the way down it can cause confusion and a loss of emotional control that is profoundly disturbing, especially to someone who depends on their brain to make a living. Truly a blessing and a curse of modern medicine.

One of my biggest losses of innocence after medical school was realizing that professors had pulled the wool over my eyes concerning one of the fundamental diagnostic tools in medicinethe patient history. During the pre-clinical years you seldom get to talk to an actual patient and instead hone your skills using case presentations which I later came to understand were carefully curated stories masquerading as actual patients in which the non-salient details were conveniently expunged and the salient ones amplified for teaching purposes.

My teachers smugly told me, If you dont know whats wrong by the time you finish taking the history, take the history again." This illusion is perpetuated during third year clerkships when cases are cherry picked for medical students so as not to dispel the myth. The gloves come off during internship when it is too late to turn back and you realize that most patients have a hard time telling you how they feel no matter how many creative ways you come up with to ask the same question. Its not their fault, they usually just have never felt like this before and dont have the words to describe it.

When you add intoxication, mental illness, dementia, etc. to the mix, taking a history often becomes an exercise in communication breakdown and frustration. So imagine my joy at finding a history written by a professional communicator whose livelihood depended on his ability to observe the world and record it. It was like winning the internal medicine lottery.

Doig observed of myeloma: The waiting room of hell, furnished with side effects.

Of those side effects, he observed, The dex makes me longitudinal - - concentrated on a single line of endeavor at a time, no latitude to speak of and I would go to blow my nose and find there was not a handkerchief within 50 of me. Pill bottle caps leapt for the floor. My ordinary thought process resembles a homesteader digging out a stump, when loaded with dex I plodded right past nuances of life in temporary fixations on getting to my desk and writing things down. Which, amazingly, produced pages of a novel faster than when I wasnt taking the stuff. Dex gave me a mental pop, off-the-chart energy upstairs while it played games with the rest of me. Writing proved to be therapy for therapy.

On the topic of mortality, he explained in a written passage, I am now in remission, that terra incognita but better than being off the map(oblivion). He would add, I have not come out of this as any cheerleader for Nietzche: thera are countless preferable ways to strengthen in life without having something trying to kill you.

Facing the reality, he noted, Invariably fatal. Damn. But then, so is life. Its probably not polite to laugh out loud at the writings of a dying man, but I couldnt help myself and I also couldnt help wondering what a pleasure it would have been to take care of him. There was plenty of correspondence in the archive between Ivan and his doctors, but the most striking examples would probably have been overlooked by the uninitiated. The age of electronic medical records and e-mail allow patients unprecedented access to providers.

Like most technology, this chart messaging is both a blessing and a curse. The blessing is that it doesnt take three phone calls to catch a patient at home and tell them about their lab results.

The curse is the dozens of chart messages to return at the end of a busy day. Consequently, as Doig chronicled, brevity is the rule: Everything normal on your labs today, see you in 6 months."

Doig, when in his prime, trying to instill the lessons of history into his work. Here he absorbs the vibe in an abandoned farm house where heart-felt dreams rose, fell part like a heartache and drifted away. Photo by Carol Doig, courtesy MSU Library Doig Archives

The messages from Ivans providers went on for paragraphs, like post cards from your grandmother, and often came close to open displays of affection. All patients are equal, but some are more equal than others.

My day in the Doig archive was followed by an evening at the annual trout lecture hosted by the MSU library and I happened to find the only other Doig nerd who had spent any time with the medical journey files. Todd Wilkinson, the editor of Mountain Journal, shared my fascination with this little known part of Ivan Doigs life and suggested we pursue an event centered around his medical journey.

I couldnt imagine who else would show up to hear about such a niche topic, but didnt want to spoil the glow of our mutual fandom and encouraged him to pursue it. Three months later I found myself sitting in Carol Doigs living room in Seattle.This would be a good time to disclose that I am not a casual Doig fan. Im not a religious person, but I have made two literary pilgrimages in my life. The first was to Arches National Park to find the location of Edward Abbeys trailer from Desert Solitaire and the second was to White Sulfur Springs, Montana to see the place that had figured so prominently in Doig'sThis House of Sky.

Something still haunted me about the archives. Aside from the few pithy quotes above, there wasnt much mention of how Ivan faced his own mortality. How does an author get up every day and write four more novels when he knows hes dying? More importantly, why does he do it?

My practice over the last 20 years was working as a hospitalist. All of my patients were sick enough to be in the hospital and these days you have to be pretty sick to make it through those doors. I had seen hundreds of patients die and typically had end of life conversations with patients and families several times a week. Indeed, I had been on a personal crusade in the last few years to get doctors to talk with their terminally ill patients about their goals for the end of life and had coached other providers about how to do it.

So here was my chance to salvage something of my shattered romantic ideal about writers. Ivan must have had some big epiphany, I thought, that just wasnt there in his writing and my task was to extract it from his widow. I was as if a literary anthropologist on a mission.

It led to having a wonderful day in Seattle, sunny and warm; the Doig living room had a commanding view of Puget Sound. The house was spare and elegant and warm and inviting all at the same time and I got to see Ivans personal desk with his typewriter and his book collection.

Carol was charming and intelligent and well educated and everything you would expect from the spouse of your literary hero. Todd Wilkinson was there and Kenning Arlitsch, Dean of Libraries at MSU, too, and the person responsible for securing the Doig archive. Our conversation flowed easily.

Todd had a flurry of journalistic questions for Carol about Ivan and his writing. I was the final interviewer and my experience told me that it was almost always the wife that was the keeper of the medical history. So I started with some easy logistical questions.

Doig's desk, where he completed five books in eight years, battling through pain, the effects of medicines and a bone marrow transplant. All this and yet critics say these final works contain passages that are among the most incisive and moving of his four-decade long career. Photo by Todd Wilkinson

No, she did not go to all of his medical appointments with him and she didnt even know about the folder where he had kept all of the materials about his illness until after his death. There goes my first assumption.

We walked through the chronology of his illness, his initial diagnosis, the stem cell transplant, chemotherapy, remission, relapse, second line chemotherapy. What was daily life like? How did they deal with telling friends and family since he was not obviously ill until the end? How long was he on hospice? What was it like at the end? I probed, I rephrased, I asked the same question a different way. But there was no profound epiphany.

What she described instead was a guy who got up every day, made breakfast, went to his study and pounded out his words for the day. If he finished a novel on Friday, he started the next on Monday. A literary proletarian if there ever was one.

I have watched plenty of people die in my career, some face it with grace and dignity and resolve and some fight it and raise their fist against the sky until the last breath. What separated those who faced their end well from those who didnt?

Regret. Regret for things they hadnt done or relationships that had soured, but it boiled down to not living life the way they wanted to. My epiphany was that there was no epiphany. Epiphanies are extraneous when you are already living your best life. Ivan Doig was a wonderful writer, husband, friend, and colleague. If it isnt broken, dont fix it.

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A Doctor Plumbs The Depths Of Ivan Doig's Illness And Asks: 'Did He Have An Epiphany?' - Mountain Journal

Power couple Priyanka Chopra and Nick Jonas walk the red carpet for Chopard party, along with Amber Heard, Elle Fanning, Julianne Moore and Richard Madden (May 18). AP, AP

Priyanka Chopra is opening up about what life is like with husband Nick Jonas, who is a type 1 diabetic.

The 37-year old actress described how much she admires Jonas' dedication to his healthon "The View"Tuesday.

Initially, when we first got married, I couldnt wrap my brain around the fact that he knew when his sugar dropped, even whilehe was sleeping, shesaid. He feels it.

Though she trusts Jonas' "crazy discipline" about monitoring his blood sugar, Chopra confessed she "used to wake up in the middle of the night" to make sure her husband was OK.

She also praised Jonas, 27, for not letting his disorder affect the way he lives.

"He lives the biggest life possible," she said."He's not restricted himself from anything. He plays sports. He's touring. He lives an incredible life, and it's so inspiring to see."

This passion for living life to the fullest, Chopra said, is what inspired Jonas to found Beyond Type 1, a nonprofit organization dedicated to diabetes education, advocacy and the path to a cure.

More: Priyanka Chopra explains why she took Nick Jonas' name: I'm 'old-school like that'

More: Priyanka Chopra spars with upset fan at BeautyCon: 'Girl, don't yell'

"That's what he wanted to show people," Chopra said. "That even if you have type 1 diabetes doesn't mean that your life has to be different. You can live it to its fullest, and it's so inspiring to me."

According to Mayo Clinic, type 1 diabetes is a chronic condition in which the pancreas produces little or no insulin. Though there is no cure, treatment "focuses onmanaging blood sugar levels with insulin, diet and lifestyle to prevent complications."

More: Awww! Nick Jonas writes fairy-tale 'one year' love letter to wife Priyanka Chopra

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(Reuters Health) - People who increase their consumption of sodas, juices and other sweet drinks over time are more likely than those who dont to develop diabetes, a U.S. study suggests.

Researchers examined over two decades of data from more than 192,000 men and women who worked in nursing or other healthcare jobs. None of the participants had diabetes at the start of the study; by the end almost 12,000 people had developed the disease.

After accounting for how much people weighed and their overall eating patterns, researchers found that those who increased their total consumption of sugary drinks by a half serving a day over four years were 16% more likely to develop diabetes over the next four-year period. With the same daily half-serving increase in artificially-sweetened drinks, the odds went up 18%.

Even though consumption of 100% fruit juices has been considered a healthy alternative to sugar-sweetened beverages because of the vitamins and minerals in fruit juices, they typically contain similar amounts of sugar and calories as sugar-sweetened beverages, said Jean-Philippe Drouin-Chartier, lead author of the study and a nutrition researcher at the Harvard T.H. Chan School of Public Health in Boston.

The study results raise concerns about the negative health effects of sugary beverages, regardless of whether the sugar is added or naturally occurring, Drouin-Chartier said by email.

The researchers focused on type 2 diabetes in the study, the most common form of the disease, which is associated with obesity and aging.

They also found that when people replaced sodas, juices and other sugary beverages with other kinds of drinks, their risk of developing diabetes went down.

Replacing one serving a day of sugary drinks with water, coffee or tea, was associated with a 2% to 10% lowering of diabetes risk. The data did not include information about whether people added sugar to their coffee or tea, the study team notes.

The analysis also wasnt designed to prove whether or how drink selections might directly impact the development of diabetes.

Its possible that diet sodas and other artificially-sweetened drinks were tied to higher diabetes risk because people switched to these beverages after they developed diabetes or realized they were on track to get the disease, the study team acknowledges in Diabetes Care.

However, the results should still serve as a reminder that even some sugary drinks that people think of as healthy - like orange juice - can still lead to elevated blood sugar and contribute to the development of diabetes, said Dr. Robert Cohen, a diabetes researcher at the University of Cincinnati College of Medicine in Ohio, who wasnt involved in the study.

Sugary beverages that people might otherwise think of as being healthy provide a load of sugar (sucrose) which gets broken down to glucose and raises blood glucose, Cohen said by email. Removing or markedly reducing beverages like fruit juices can have a dramatic effect to improve blood sugar control.

SOURCE: bit.ly/321TZI0 Diabetes Care, online October 3, 2019.

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Drinking more soda and juice tied to increased diabetes risk - Reuters

This transcript has been edited for clarity.

I first became passionate about diabetes and humanitarian crises when I spent a month practicing general internal medicine at a small district hospital near the Congo-Rwanda border. We had many refugees come through from the Congo at that time, including a number of young men who were clearly in diabetic ketoacidosis.

Because we did not have insulin or glucose strips with which to monitor them, they all died within hours of presenting to the hospital. None of them survived. Those with type 2 diabetes kept being readmitted to the hospital because we were unable to manage their hyperglycemia, although we were able to manage their infections or trauma.

This experience led me to dedicate my career to this issue. Today, about half a billion people worldwide are affected by diabetes, 80% of whom are living in low- and middle-income countries. This is projected to increase over the next 20 years as a result of urbanization, climate change, global warming, etc., so the crisis will get even worse.

At the same time, low- and middle-income countries are predominantly and disproportionately affected by humanitarian crises. Most people who are displaced due to conflict spend decades as refugees or internally displaced people. The average duration of this conflict-induced displacement is 27 years, and these people have diabetes. As a result, humanitarian actors are now having to take on broader roles.

Yet, at present, data on this issue are not being collected. There are no evidence-based guidelines on how to manage diabetes best in these circumstances, and there is no education. Medicines, including insulin, are not routinely supplied in these contexts, which is a death sentence for anyone with type 1 diabetes.

For this reason, we organized a symposium in early April at Harvard University, where we convened more than 100 leaders in global and humanitarian health, including various academic institutions, the Centers for Disease Control and Prevention, the World Health Organization, and pharmaceutical and diagnostics companies. The objectives were to discuss this issue, build partnerships, figure out how to collaborate, prioritize the most immediate needs as a community, and design projects going forward.

Out of that meeting, we published the Boston Declaration in TheLancet Diabetes & Endocrinology, which outlines this incredible and urgent need for insulin, especially for those with type 1 diabetes, and the need for chronic care for people with type 2 diabetes.[1] This care includes cardiovascular risk management and all comorbidities, which would hopefully pave the way for improved care for other chronic diseases.

The group, comprising 64 signatories from about 43 different organizations, outlined four major targets to work toward. The first is improved advocacy and global awareness, which is a major need. The second is improved access to insulin, essential medicines, and diagnostics for diabetes and hypertension. The third major target is to develop improved clinical and operational guidelines that are coherent among organizations, and the last target is improved data collection, surveillance, and monitoring across organizations. These are the four main targets that we're setting out to tackle over the next 3 years.

Many new projects are beginning, and we would love everyone's involvement. If you would like to get involved, you can contact me via the Global Endocrinology website, or contact any humanitarian organization, including Doctors Without Borders, the International Committee of the Red Cross, and Save the Children. They're all doing phenomenal work, they definitely need this money, and they will put it to good use.

Thank you.

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'None of Them Survived': Diabetes in the Time of Humanitarian Crises - Medscape

DUBLIN, Oct. 9, 2019 /PRNewswire/ -- The "Diabetes Management: Insulin Pumps Market (2019)" report has been added to ResearchAndMarkets.com's offering.

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Valued at nearly $3bn in 2018, the Global Insulin Pumps Market is growing at a fast pace - at a compound annual growth rate (CAGR) of approximately 12% - reaching more than $5bn by 2023

The Global Insulin Pumps market is being driven by strong demand, increasing awareness and adoption of next-generation hybrid closed-loop systems, solid clinical outcomes, and good reimbursement. Market penetration is low, leaving much room for growth.

According to the International Diabetes Federation (IDF), approximately 425 million adults (20-79 years of age) have diabetes worldwide, and this number is expected to rise nearly 50% to approximately 629 million by 2045. More than 1.25 million people have type 1 diabetes in the US alone.

There is a strong need for automated continuous insulin delivery as a replacement for cumbersome multiple daily (insulin) injections (MDI) using painful pens/needles, which are prone to user error and may leave many type 1 (and insulin-requiring type 2) patients at risk for dangerous complications.

Overall, the insulin pumps market is an evolving market driven by innovation. While Medtronic clearly dominates, technological advances are spurring intense competition. There is a rush to develop even smarter automated hybrid closed-loop systems (artificial pancreas or AP systems) driven by machine learning or artificial-intelligence-based algorithms. These systems lessen patient burden and autonomously adapt to individuals' glycemic needs and lifestyles to significantly improve blood glucose control and quality of life for millions of diabetes patients worldwide.

This comprehensive medical market and technology report provides:

Markets covered by this analysis include the US, Japan, the five major EU markets (France, Germany, Italy, Spain, and the UK), and the Rest of World (RoW) markets, which includes all other countries. Market forecasts are for the 2018-23 time period.

Highlights

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For more information about this report visit https://www.researchandmarkets.com/r/ghc0vu

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The Number of Adults with Diabetes Worldwide is Set to Rise Nearly 50% to Approximately 629 Million by 2045 - Yahoo Finance

Type 2 diabetes means a persons pancreas cannot produce enough insulin to regulate blood sugar levels. Overtime, unchecked blood sugar levels pose serious health risks, such as heart disease. Fortunately, certain dietary decisions can help to control blood sugar levels. Evidence singles out a particular fruit.

According to research presented at the American Diabetes Association's 72nd Annual Scientific Session, eating raisins three times per day may reduce post-meal sugar spikes significantly.

The research, conducted by Harold Bays, MD, medical director and president of Louisville Metabolic and Atherosclerosis Center (L-MARC), involved 46 adults who had slight increases in glucose levels, but no previous diagnosis of diabetes mellitus.

The researchers randomly assigned participants to two groups.

The first group was told to snack on raisins three times per day for 12 weeks, while the second group snacked on pre-packaged snacks that did not contain raisins or other fruits or vegetables.

The researchers found that raisins slashed post-meal glucose levels by 16 per cent and reduced mean hemoglobin A1c by 0.12 per cent from baseline.

Pre-packaged commercial snacks on the other hand, did not significantly reduce mean post-meal glucose or hemoglobin A1c.

As Diabetes UK explained, HbA1c is a persons average blood glucose (sugar) levels for the last two to three months. A high HbA1c means a person has too much sugar in their blood.

Commenting on the findings, Dr. Bays said: "Compared to the snacking control group, the group consuming raisins had a significant statistical reduction in their after-liquid meal blood sugar levels among study participants who had mean baseline fasting glucose levels between 90 and 100 mg/dl.

Adding: This favourable glucose effect of raisins was further supported by the statistically significant reduction in hemoglobin A1c (a standard test for overall blood sugar control in diabetes mellitus) in the within group comparison to baseline. The within group comparisons from baseline with snacks did not demonstrate a reduction in hemoglobin A1c."

Accounting for the results, James Painter, Ph.D., R.D., and nutrition research advisor for the California Raisin Marketing Board, said: "Raisins have a relatively low glycemic index and contain fiber and antioxidants, all factors which contribute to blood sugar control. Decreasing blood sugar and maintaining normal hemoglobin A1c levels is important because it can prevent long-term damage to the heart and circulatory system."

Why eat fruit?

As Diabetes UK explained, there is a popular misconception that the sugar content of fruit means it is off-limits for people with type 2 diabetes. But the sugar in whole fruit does not count towards free sugars, so it is not this type of sugar we need to cut down on, said the health body.

Adding: This is different to the free sugar in drinks, chocolate, cakes and biscuits.

In fact, carbohydrate intake has the biggest impact on blood sugar levels, and fruit is a low-carb alternative to sugary foods, noted the health site.

It said: A portion of fruit, such as a medium apple, generally contains about 15 to 20g carbs, a chocolate muffin has 55g carbs and a 500ml ordinary fizzy drink has 54g carbs.

Here is another superfood proven to lower blood sugar levels.

What are the symptoms of type 2 diabetes?

Symptoms of type 2 diabetes include:

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Type 2 diabetes: Eat this fruit three times a day to lower your blood sugar levels - Express

Pfizer has signed a deal with Ionis affiliate Akcea Therapeutics, to develop a potential blockbuster antisense therapy to treat patients with certain cardiovascular and metabolic diseases including type 2 diabetes.

The terms of the deal give a clue as to Pfizers assessment of the drugs potential: Akcea and Ionis will receive a fairly modest $250 million up front, split between the two companies, and Akcea will settle its $125 million obligation to Ionis in common stock.

But the companies are also eligible to receive development, regulatory and sales milestone payments of up to$1.3 billionand tiered, double-digit royalties on annual worldwide net sales following marketing approval of the drug codenamed AKCEA-ANGPTL3-LRx.

AKCEA-ANGPTL3-LRx is designed to reduce the production of angiopoietin-like protein 3 (ANGPTL3) and is a regulator of triglycerides, cholesterol, glucose, and energy metabolism.

It is currently in a phase 2 study in patients with type 2 diabetes, hypertriglyceridemia, and non-alcoholic steatohepatitis (NASH) indications that could generate substantial sales following approval from regulators.

Akceas antisense drugs work by blocking the action of messenger RNA, which carries instructions to the cell from the DNA to code for a particular protein.

Antisense drugs are made from components such as synthetic strands of DNA, which target a specific RNA sequence and stop it from producing the protein.

Future milestone payments and royalties will be split equally between Akcea and Ionis, and Pfizer will pay for all development and regulatory costs beyond the ongoing phase 2 study.

Before a filing for marketing approval, Akcea has an option to take part in some marketing activities with Pfizer in the US, and some other markets if certain conditions are met.

Akcea already has two antisense therapies approved Tegsedi (inotersen) for the rare disease hereditary transthyretin-related amyloidosis (hATTR) and Waylivra (volanesorsen) for familial chylomicronemia syndrome.

Damien McDevitt, interim chief executive officer at Akcea, said: AKCEA-ANGPTL3-LRxhas the potential to treat people suffering from certain cardiovascular and metabolic diseases.

Given the unmet medical need for this patient population and the broad market potential, we believe Pfizers expertise and breadth of experience in cardiovascular and metabolic diseases makes it well suited to accelerate clinical development of AKCEA-ANGPTL3-LRx, and to deliver it to patients in need of additional therapies for these life threatening diseases.

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Pfizer inks deal with Ionis and Akcea for potential blockbuster diabetes and NASH drug - - pharmaphorum

Two new studies, one surgical, the other medical come to similar conclusions - significant weight loss alters the course of Type 2 diabetes.

In the first study, 867 40 to 69-year-old, patients with new-onset diabetes were randomized into treatment or control groups. Seven hundred thirty had both their weights and HbA1c measured initially and at five years and represented the study group. It was predominately Caucasian (97%), male (61%), and with a BMI of about 34. At the end of 5-years, 30% of patients who lost 10% or more of their body were in remission from diabetes. And the incidence of remission followed the degree of weight loss the kind of dose-response to treatment that suggests underlying physiologic changes. The researchers considered several associated behavioral changes, smoking cessation, less alcohol or caloric intake, fewer fats, more exercise, you know the litany. But with the exception of a small improvement with diminished alcohol intake, none of those changes made a difference it was solely that drop in weight.

"These findings suggest that remission is achievable without intensive lifestyle interventions or extreme calorie restrictions."

Of course, the study has some fine print. First, while a weight loss of this magnitude during the five years achieved this result for some patients, it was more effective earlier in the course of the disease. The more important caveat and one many of us know first-hand, losing that amount of weight and keeping it off is far easier said than done. And that brings us to the second study.

When is a "bug" a feature?

One of the most frequently performed operations in the mid-20th century was a host of procedures for treating peptic ulcers, stomach ulcers. They have been substantially entirely supplanted by medications like ranitidine (Zantac currently under recall). But even though all those different operations on the stomach "cured" the ulcers, many had an adverse side effect, significant weight loss. Innovative surgeons turned that adverse effect, that operative "bug" into an operative benefit with the introduction of bariatric surgery alterations of the GI tract meant to reduce a patient's weight.

There are several operations categorized as bariatric surgery, some designed to diminish the size of the stomach, increasing the onset of satiety and reducing caloric intake; others that re-arrange the GI tract to reduce capacity and alter metabolism. All are associated with significant weight reduction and have been offered to patients who are significantly obese. A new study looks at how patients, with Type 2 diabetes, undergoing bariatric procedures fare for adverse cardiovascular outcomes the usual concerns of heart attacks, strokes, and other problems.

Roughly 2300 patients undergoing bariatric surgery and with a history of Type 2 diabetes were followed for approximately four years and compared with control patients who did not undergo bariatric surgery. An inspection of the two groups suggests that the control patients were at best "similar" rather than the same, so the effect size I am reporting should be taken with a grain of salt. These patients were far more overweight at a BMI of 40 or higher than the previous study. The surgical group had more dyslipidemia and hypertension; the control group more smokers and blacks. The cumulative incidence of all-cause mortality, coronary artery disease, heart failure, cerebrovascular disease (strokes) atrial fibrillation, and nephropathy (kidney disease) were all reduced over the 8-year follow up for the surgical patients as compared to the controls.

But for me, the critical finding is the profound and long-standing weight loss from the surgery, as depicted on the right. These patients not only had remission from diabetes but significant reductions in the need for medications for both hypertension and dyslipidemia.

"We speculate that the lower rate of MACE after metabolic surgery observed in this study may be related to substantial and sustained weight loss with subsequent improvement in metabolic, structural, hemodynamic, and neurohormonal abnormalities."

The surgery is not a free ride, as with all procedures, there can and were complications; 0.7 % of patients died within 90 days of surgery (for open-heart surgery that percentage is about 3.7%). Five percent needed open surgical revision, while 16% had revisions of their operation by more non-invasive means. The authors are not suggesting that bariatric surgery be the primary treatment.

What I think is clear is that in well-motivated patients, a 10% weight loss can "reverse" Type 2 diabetes and show significant improvements in many associated cardiovascular diseases. And weight loss, whether or not assisted by bariatric surgery, had a more substantial impact on adverse cardiovascular outcomes than the new generation of medications for diabetes advertised with an "added cardiovascular benefit." The signal from the studies is strong; at least for me, losing a significant amount of your "over" weight is strong medicine.

Source: Behaviour change, weight loss and remission of Type 2 diabetes: a communitybased prospective cohort study Diabetic Medicine DOI:10.1111/dme.14122 and Association of Metabolic Surgery With Major Adverse Cardiovascular Outcomes in Patients With Type 2 Diabetes and Obesity JAMA DOI: 10.1001/jama.2019.14231

Excerpt from:
The Weighty Cost of Diabetes - American Council on Science and Health

Type 2 diabetes is a condition which causes the body to lose control of the amount of glucose in the blood. The body doesnt respond to insulin properly and may not produce enough, and this causes blood glucose levels to become too high. If blood glucose levels stay to high, a number of health complications can occur, including kidney failure, nerve damage, heart disease and stroke. So what can you do to prevent the condition and reduce high blood glucose levels?

Simple lifestyle changes can help get a persons blood glucose levels back into the normal range, with one of these changes being to lose weight.

In a new study carried out by the University of Cambridge, nine of 10 people who reduced their body weight by just 10 per cent within five years of being diagnosed with diabetes were able to achieve remission from the condition.

Diabetes remission in people with type 2 diabetes means blood glucose levels are healthy without the need for diabetes medication.

This reinforces the importance of managing ones weight, which can be achieved through changes in diet and increasing physical activity, said Dr Simon Griffin, a University of Cambridge researchers and study senior author.

Previous research has shown people who follow an intensive, low-calorie diet for eight weeks be successful in normalising blood sugar.

But the new study, led by Hajira Dambha-Miller, of the universitys department of public health and primary care, is one of the few demonstrating a less intensive intervention can also be effective in controlling the disease.

Researchers studied data on 867 people aged 40 to 69 who were newly diagnosed with diabetes.

They found 257 participants in the ADDITION-Cambridge clinical trial were in remission from diabetes five years after diagnoses.

Hajira said: Weve known for some time now that its possible to send diabetes into remission using fairly drastic measures such as intensive weight loss programmes and extreme calorie restriction.

These interventions can be very challenging to individuals and difficult to achieve.

But our results suggest that it may be possible to get rid of diabetes, for at least five years, with a more modest weight loss of 10 pre cent.

This will be more motivating and hence more achievable for many people.

Looking at the overall findings, this who lost 10 per cent or more of their body weight within five years of diagnosis were twice as likely to be in remission as those who did not achieve significant weight loss.

Losing this amount of weight was shown to be most effective among newly diagnosed participants.

But it also worked to stabilise blood sugar in around half of people who have had diabetes for a number of years.

Alongside weight loss, drinking a certain drink before bed has also been shown to lower blood sugar.

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Type 2 diabetes: The simple lifestyle change to put the condition in remission - Express

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For people with obesity, a procedure rarely performed in the US more effectively eliminates type 2 diabetes than Roux-en-Y gastric bypass, a small study shows.

Researchers thought that the less common procedurecalled biliopancreatic diversionbetter reduces diabetes because it typically causes greater weight loss than the more common surgery. But in a small study, the researchers found that biliopancreatic diversion appears more effective at eliminating diabetes not just because of greater weight loss but also because the procedure itself seems to make patients more sensitive to insulin.

Our results help explain the high rate of diabetes remission in patients who have biliopancreatic diversion surgery, says senior author Samuel Klein, professor of medicine and nutritional science at Washington University in St. Louis. These data suggest that we should take a closer look to see whether it might be a better option for some bariatric surgery patients.

For the study, published in Cell Metabolism, researchers compared the effects of the two surgeries on insulin and glucose sensitivity in patients who, after their operations, lost 20% of their body weight.

Insulin is the hormone that helps the body keep blood sugar under control. Being more sensitive to insulin allows cells in the body to use glucose in the blood more effectively and helps lower blood sugar.

Roux-en-Y gastric bypass surgery makes a patients stomach smaller by sewing parts of the stomach together to create a pouch about the size of an egg. Surgeons then connect that pouch to the upper section of the small intestine, bypassing a small portion of the upper intestine.

Biliopancreatic diversion is a more complicated surgery. Past studies have found that patients who have the surgery tend to have more postoperative complications.

In this procedure, the surgeon removes the lower part of the stomach, and connects the upper part of the stomach to the end of the small intestine, close to where it empties into the large intestine. Because the procedure bypasses so much of the intestine, the intestine absorbs fewer nutrients from food, putting patients at a higher risk for long-term nutritional deficiencies. So doctors need to closely monitor patients to make sure theyre getting adequate amounts of vitamins and minerals.

The less common procedure, however, results in better blood sugar control and higher rates of diabetes remission than Roux-en-Y gastric bypass surgery. Researchers didnt understand why until, in this study, Kleins team followed 24 patients, half of whom had Roux-en-Y gastric bypass surgery and the other half, biliopancreatic diversion.

The gastric bypass group in the study had average body mass indexes (BMI) of 48. A persons BMI is calculated using weight and height. A higher BMI increases risk of health problems related to weight; a BMI of 30, for example, is considered obese. Those who had biliopancreatic diversion had average BMIs of 56.

Surgeons performed the procedures overseas at Catholic University in Rome because biliopancreatic diversion is more commonly performed in Italy. In the US, surgeons performed some 228,000 bariatric procedures in 2017. Fewer than 3% were biliopancreatic diversion.

After surgery and a 20% loss of body weight, researchers measured the patients metabolic reactions to meals, with close attention paid to glucose levels, sensitivity to insulin, and how much insulin they secreted after eating.

The researchers found no difference in the benefit of surgery-induced weight loss to patients pancreatic function, in terms of insulin secretion, but patients who received biliopancreatic diversion surgery were more sensitive to insulin.

Klein notes that while the patients had obesity, none had a type 2 diabetes diagnosis. Researchers structured the study that way because they wanted to independently measure the insulin sensitivity after a meal, without potential complications caused by diabetes medications.

This study demonstrates that biliopancreatic diversion has unique, beneficial effects on insulin action, independent of any weight loss, he says.

As to whether the findings mean that surgery is preferable, Klein says thats less clear. The main consideration, he says, should be patient safety.

This study demonstrates additional metabolic benefits from biliopancreatic diversion, compared to Roux-en-Y gastric bypass, he says. But the type of bariatric surgery performed on any individual patient depends on many considerations, including an assessment of the effectiveness and safety of the procedure, patient preference, and the surgeons experience.

Klein, chief of the geriatrics and nutritional science division, adds that Roux-en-Y gastric bypass provides considerable benefits in helping people lose weight and in treating type 2 diabetes but does not have the weight-loss-independent benefits on insulin sensitivity of biliopancreatic diversion.

The National Institute of Diabetes and Digestive and Kidney Diseases, the National Heart, Lung and Blood Institute of the National Institutes of Health, and the Pershing Square Foundation suppported the work.

Source: Washington University in St. Louis

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This other bariatric surgery better reduces diabetes - Futurity: Research News

Love Island contestants Theo Campbell and Idris Virgo have been beefing online after Idris accused Theo of faking his blindness in one eye.

Idris posted a screenshot of an argument he was having with Theo on Instagram DM on Twitter.

Theo replied to him with a screenshot of a group chat Idris was allegedly a part of. In this group chat, Idris writes: "Think it's fake tbh" when talking about Theo's partial blindness.

Theo wrote on Twitter: "You missed out the part where youre telling youre little people Im lying about my eye.. only a idiot like yourself would lie about such a thing. And that fact youre putting our convo on Twitter just proves once again what a BEG you are. BEG BEG BEG such a loser."

Theo then also added: "Youre boring. You didnt get an invite to the reunion because you had 0 personality on the show. Everyone else should, only you shouldnt. And because your a puppet thats why you wont get casted again. I duno [sic.] why you try so hard online to make noise. But carry on its laughable. [sic.]"

Idris then replied: "Who are you again? People only know who you are because of your girlfriend other than that youre irrelevant. Man had to shoot him self with a cork to get clout."

Idris Virgo was part of Love Island 2019

Theo went blind in one eye in August, after being hit by a champagne cork at a party in Ibiza.

The accident left him blind in one eye, undergoing surgery and holding out hope of restoring his sight in the eye.

In the aftermath, Kaz, Theo's girlfriend, has been at his side and Josh Denzel was accused of mocking him.

Josh Denzel posted a picture of the "and I ooop" meme with no caption, hours after news broke of Theo's accident, which left him permanently blind in one eye.

Josh later deleted the tweet, however users have been quick to repost screenshots accusing him of making fun of Theo's injury. Kaz has since weighed in on the drama to say Josh has privately messaged them with a "sob story", adding: "Theo couldn't care less."

Watch the moment Theo Campbell got blinded by a champagne cork

Love Islands Theo left blinded in one eye by flying champagne cork

Josh Denzel accused of mocking Theo Campbells blindness on Twitter

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Theo Campbell accused of faking blindness by fellow Love Island contestant - The Tab

Mississippi State Universitys National Research and Training Center on Blindness and Low Vision is hosting an informational event in honor of White Cane Awareness Day Oct. 15. The event is taking place from 10 a.m. to 2 p.m. on the Drill Field and will include booths, an obstacle course and games.

White Cane Awareness Day occurs annually on Oct. 15. According to Kendra Farrow, the NRTCs Research and Training associate, this day is designed to bring awareness to people with blindness and low vision and to teach people about white canes.

While gesturing to her white cane, Farrow explained its significance.

It is a mobility tool that helps the individual who cannot see to know what is in front of them, Farrow said. They can detect surface changes, drop-offs and stairs.

The informational booths will allow people to experience what it is like to have blindness or low vision. According to Emily Damm, the NRTCs communications specialist, visitors can go to the welcome booth to learn about interacting with a person who uses a white cane, the laws regarding white canes and blindness-related professions.

At another booth, visitors can braille their name and interact with an off-duty guide dog. A representative will talk about the importance of braille and how those with blindness and low vision use it to read, Damm said.

Visitors can also put on simulator glasses at the booth. Damm said people can wear glasses or a bandanna while participating in a smell test with different spices. The smell test allows people to see what it would be like to cook in the kitchen with a visual impairment.

We have simulator glasses that show what it would be like to see with Glaucoma or a diabetes condition, Damm said. They can pick out one of these eye conditions to wear or use a bandanna to have complete blindness.

While wearing glasses or a bandanna, visitors can go through an obstacle course that is run by MSU sorority, Delta Gamma. According to Andrea Black, a senior studying biological sciences and the Delta Gamma vice president of Foundation, participants can navigate through a path that contains boxes and other objects.

The course brings an educational opportunity about the world of blindness, but it is still in a fun way, Black said. It allows people to really understand what is going on, but it is not a presentation. People are still having fun while promoting awareness and understanding.

According to Clare Baumhauer, a senior marketing major and the president of Delta Gamma, the sororitys philanthropy is Service for Sight, and they share the same mission as the NRTC. The sorority wants to help educate students on this campus about blindness and visual impairment.

Visitors can also participate in games designed for people with blindness and low vision. According to Damm, participants can play goalball and beep baseball while wearing simulator glasses or a blindfold.

Goalball is a game of goalies versus goalies. The ball has bells attached to it, so the players can locate the ball. In beep baseball, players run between two bases and play with a ball that beeps.

Damm expressed that the NRTC typically works to help individuals who are blind and visually impaired through research, programs and other service providers. She said she is excited to do something different and work with the community through this event.

This is new for us to go directly into the community and have this awareness event, but we felt like the celebration of the white cane aligns perfectly with our mission of providing education to the community, Damm said.

Speaking as a person with blindness, Farrow notices the lack of understanding about blindness and low vision. She experiences people who do not understand her condition and treat her like she is not capable.

Farrow believes this event can allow people to change their mindset and appropriately interact with those who are blind and visually impaired.

If someone loses their vision, it is not the end. There are plenty of activities that a person can do. There are plenty of jobs that a person can do, Farrow said. If someone loses their vision, it is important to have the idea planted in your mind that they can still be a successful person.

Farrow said she hopes NRTC's activities in honor of White Cane Awareness Day serve as an educational opportunity that the community can enjoy.

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MSU's NRTC to host games, obstacle course in honor of White Cane Awareness Day - The Reflector online

Fans cant stop thinking about the This Is Us Season 4 premiere. After introducing a variety of new characters with seemingly no connection to the Pearson family, the writers flipped the switch and revealed how they fit in with the narrative. One of the most shocking revelations was Jack Damon (Blake Stadnik), the adult version of Kate (Chrissy Metz) and Tobys (Chris Sullivan) blind baby boy. Now, This Is Us is back in the present day, where Kate and Toby are learning to raise a blind child. And while some viewers may know Stadnik is visually-impaired in real life, others are questioning if baby Jack is really blind.

In an interview with People, Metz and Sullivan opened up about their characters storyline for This Is Us Season 4. They also shared how baby Jacks blindness will affect them moving forward.

I did learn about how, instead of, of course saying, Oh, look at this, you have to narrate whats going on, Metz told the publication. We sort of take for granted when a child is able to see. Then with a child whos seeing impaired, there are times where people are like, Oh, Jack look at this. You just forget.

Metz then revealed that the baby playing little Jack in This Is Us isnt blind in real life. The real baby is not seeing impaired, the actress explained. So its really about training your mind to narrate, or before something happens, to make sure that youre explaining whats going to happen as to not surprise the baby.

Meanwhile, Sullivan shared what it was like working with the babies. Once we got the hang of it, everything seemed to kind of fall into place. The babies that were working with are great, and theyre actually very easy, he said. Its easier than working with the puppy.

According to the Los Angeles Times, Stadnik is legally blind. He has Stargardt disease, a form of juvenile macular degeneration. And since he first appeared in This Is Us, Stadnik has opened up about his blindness with his fans. When asked if he was blind in real life on Instagram, Stadnik responded graciously.

Its ok to be curious, Stadnik wrote with a smiley emoji. Yes, I am legally blind. I have some vision; enough to get around in my everyday life, but I occasionally use a cane. I also use a number of assistive tech devices to do things like read or use my computer. Thank you for watching the show!

The actor also thanked viewers for their support and noted the importance of representation. Thank you to everyone who has shown me so much love after last nights episode, Stadnik wrote on Instagram. It is a dream come true to be on screen with the incredible cast of This Is Us, and its an enormous honor to represent a low-vision character who is so powerful and nuanced.

Creator Dan Fogelman always knew Kate and Tobys son would be blind, per Entertainment Tonight. So, the This Is Us team began searching for the right actor for the part between seasons three and four.

It was an interesting casting process because we wanted to cast a blind actor, Fogelman said. We had started our casting process very early, even in our off-season. I was looking for a leading man who was without sight and who could be funny, charming, accessible and sweet.

And of course, when they found Stadnik, everything fell into place. One of the wonderful things about our casting department was it wasnt like they only found Blake, Fogelman continued. There were a bunch of really viable, wonderful casting choices that came through our casting department. Blake, when he came to us, was clearly the guy.

Although the babies portraying baby Jack arent visually-impaired, its clear the This Is Us team is trying to be inclusive with Stadniks casting. And since Jack Damon is an adult, who knows? Perhaps fans will one-day meet teenage Jack, represented by another blind actor. But, as of now, only time will tell. So stay tuned.

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'This Is Us': Is Baby Jack Blind in Real Life? - Showbiz Cheat Sheet

Whats your favourite thing to look at? Your dogs face? The most unbelievably Instagrammable pok bowl EVER? A sprawling autumn sunset where the sky is on fire? Now imagine that you know youre going blind: whats the last image you would want to see, the one that would stay with you? Thats the agonising question asked by a new free photography show, Blink, at Oxo Tower, supporting trachoma charity Sightsavers.

Trachoma is a condition that affects nearly 142 million people across the world, many of them children. Its painful, slow, and untreated leads to permanent, total blindness. But its also curable and preventable. Sightsavers is hoping to end the disease for good by 2025.

To highlight the plight of global trachoma sufferers, some world-famous photographers including fashion don Nick Knight have contributed to the show, which runs October 9-13. Each of them has been asked to choose an image of theirsthat they would want to be the last thing they ever saw. But theres a twist. Trachoma is characterised by compulsive blinking, and in Blink created by MET Studio as the viewers stand in front of the images, their normal, natural blinking will be captured by movement technology and gradually make the images degrade and fade until they completely disappear. Its literally blink and youll miss it. So dont miss it.

Blink is at Oxo Gallery, Oxo Tower Wharf, Bargehouse St, SE1 9PH. Tube: London Bridge. Oct 9-13. Free. Find out more here.

Looking for more photography in London? Find out why we gave Tim Walkers V&A show five stars.

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World-famous photographers are part of this interactive show about blindness - Time Out

2020 is a critical year for Orbis International and other leaders in the global eye health community. Next year will mark the end of Vision 2020, a global project of the World Health Organization and the International Agency for the Prevention of Blindness to reduce avoidable blindness.

When the project was launched just over 20 years ago, the number of blind people worldwide then 45 million was expected to double by 2020. Thanks to the coordinated efforts of the global eye health community galvanized by Vision 2020, the doubling never occurred.

Despite this progress, the World Health Organization's first-ever World report on vision, launched today, shows that 2.2 billion people around the world live with vision impairment or blindness. Of those, at least 1 billion people have conditions that could have been prevented or have yet to be treated. The vast majority of this burden is borne by people from low- and middle-income countries, women, older persons and those from rural communities and ethnic minorities.

Experts had already predicted that global blindness and vision impairment are set to triple by 2050 because of population growth, aging and changes in lifestyle. This increase in patient load will result in a tripling of global demand for eye care; already the number of people in need of care is outpacing the number of trained ophthalmologists.

"As 2020 approaches, we have much progress to celebrate, but if we are to prevent the looming crisis, we cannot rest on our laurels," said Bob Ranck, President & CEO of Orbis International. "We have to take what we've learned over the past two decades and use it to make our future efforts laser-focused on what we know will preserve vision for the greatest number of people."

Taking a people-centered approach: Training local eye health teams is the most sustainable way to ensure that vulnerable communities gain long-term access to the quality eye care they need in their communities. 75% of all blindness and visual impairment is treatable or preventable. A lack of access to screening and treatment is the primary barrier keeping hundreds of millions of people living in low- and middle-income countries from saving or restoring their sight.

Going to scale: Leveraging innovation and technology is one of the most cost-effective ways to help local eye health teams improve their quality of patient care. Tools like artificial intelligence, virtual reality and telemedicine have already shown their potential to change the way eye health teams in rural and resource-poor communities conduct screenings for common conditions that endanger vision, and deepen their skills by learning from colleagues around the world. These tools will become even more vital as population rises and patient loads increase.

"We know what needs to be done to avert the looming vision crisis, but it can't be accomplished alone," said Danny Haddad, M.D., Chief of Program at Orbis International. "The achievements made over the past twenty years prove that there is strength in numbers, and collaboration will be key as we continue our fight against avoidable blindness."

Orbis International's contributions to preventing the looming crisis are evident in our recent impact. In 2018 alone:

Learn more about Orbis's impact in our recent report.

About Orbis InternationalOrbis is a leading global non-governmental organization that has been a pioneer in the prevention and treatment of avoidable blindness for over 30 years. Orbis transforms lives by delivering the skills, resources and knowledge needed to deliver accessible quality eye care. Working in collaboration with local partners, including hospitals, universities, government agencies and ministries of health, Orbis provides hands-on ophthalmology training, strengthens healthcare infrastructure and advocates for the prioritization of eye health on public health agendas. Orbis operates the world's only Flying Eye Hospital, a fully accredited ophthalmic teaching hospital on board an MD-10 aircraft, and an award-winning telemedicine platform, Cybersight. To learn more, please visit orbis.org.

Media ContactKristin Taylor Associate Director, Global Marketing and Communications kristin.taylor@orbis.org

SOURCE Orbis International

http://www.orbis.org

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This World Sight Day, Orbis International Calls for All Eyes on 2020 and Preserving the Future of Vision - PRNewswire

(PRESS RELEASE) CHICAGO National non-profit organizations Fight for Sight and Prevent Blindness are announcing a call for applications for the Joanne Angle Public Health Award, a $25,000 grant to support a public health research project seeking to put an end to unnecessary vision loss.

The award was named for Ms. Joanne Angle who served on the National Board of Directors for Prevent Blindness, and both its Government Affairs and Audit committees, in addition to her work with the Association for Research in Vision and Ophthalmology (ARVO).

The deadline for the Fight for Sight-Prevent Blindness Joanne Angle Public Health Award is Friday, Nov. 15, 2019, at 12 p.m. (ET). Applications must be submitted on the Fight for Sight grant portal, https://www.fightforsight.org/Grants/Application/. The recipient will be announced in Spring of 2020.

The Fight for Sight-Prevent Blindness Joanne Angle Public Health Award was established to provide much-needed funding for research investigating public health related to eye health and safety. Applications will be accepted in the following priority areas:

We are proud to join with Fight for Sight to provide financial support to research programs that are working toward our shared goal of ending preventable vision loss, said Jeff Todd, president and CEO of Prevent Blindness. Today, through the Joanne Angle Public Health Award, we continue to support individuals and institutions that are working towards that same mission.

Arthur Makar, Fight for Sights executive director remarked, We are thrilled to be partnering with Prevent Blindness on the Joanne Angle Public Health Award. It is allowing us to expand our grantmaking from traditional scientific research and into the public health arena. We have collaborated with Prevent Blindness unofficially on various projects. This is a lovely way to solidify our relationship.

Past recipients of the Prevent Blindness Joanne Angle Award include Brian J. Song, MD, MPH, at the Massachusetts Eye and Ear, and the Department of Ophthalmology at Harvard Medical School, for his study Glaucoma Detection in Diabetes Teleretinal Programs. And, Rajeev S. Ramchandran, MD, MBA, Associate Professor of Ophthalmology, University of Rochester School of Medicine and Dentistry, for his study, Implementation Science Based Study of Teleophthalmology for Diabetic Retinopathy Surveillance.

For more information on the Fight for Sight-Prevent Blindness Joanne Angle Public Health Award, contact Arthur Makar, FFSs Executive Director, arthur@fightforsight.org.

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Fight For Sight and Prevent Blindness Announce Call for Entries for the 2020 Joanne Angle Public Health Award - InvisionMag

Biotechnology company Phylogica (ASX: PYC) is one step closer to finding a treatment for the leading cause of childhood blindness, achieving a major milestone in its human retina in a dish study.

The company today reported results from its flagship drug program, in which its proprietary drug delivery technology was used on a 3D model of a retina created from human stem cells.

According to Phylogica, the study achieved greater than 90% effectiveness after a single dose.

Phylogica chief executive officer Dr Rohan Hockings said the success of the study is an important milestone for the company as it materially increases the probability that its flagship drug program will prove effective in human studies.

The results also complement Phylogicas earlier outcomes in animal models and functional studies in human cells with the targeted disease, retinitis pigmentosa.

Retinitis pigmentosa is a genetic degenerative eye disease that is considered to be the leading cause of childhood blindness.

It affects between 4,000-8,000 people in the western world and is estimated to be a $1 billion per annum market. There are currently no treatment options for the disease.

The company is very excited by the result of this study given its implications for our objective of taking a treatment to market, Dr Hockings said.

In summary, Phylogicas drug program for treating retinitis pigmentosa has now shown highly effective delivery in animal models with sustained duration of effect; the ability to reverse the disease process in human cells; highly effective outcomes in complex models of the human eye; and a favourable proof of concept toxicity profile.

Phylogicas next aim is to seek validation of its latest results across multiple patients with different genetic mutations in the same retina in a dish models.

This will allow the company to begin investigational new drug enabling studies, including large animal toxicology studies, before progressing to human clinical trials.

By afternoon trade, Phylogica shares were sitting 8.51% higher at $0.051.

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Phylogica achieves milestone in drug study aimed at treating childhood blindness - Small Caps

Visual acuity testing during a rapid assessment of avoidable blindness in Mexico. Photo by: Sarah Polack / International Centre for Eye Health/ CC BY-NC

MANILA Population growth and aging are fast outpacing reductions made in the prevalence of visual impairment over the past three decades, according to the World Health Organizations first-ever report on vision published Tuesday.

At least 2.2 billion people are currently estimated to be suffering from a form of vision impairment or blindness globally. The number of people with myopia, an eye condition that makes it difficult for a person to see distant objects, is expected to increase from the estimated 1.95 billion people in 2010 to 3.36 billion people by 2030, according to the report. People in need of yearly or biennial retinal examination for diabetic retinopathy will increase by 50% in 2040.

A bolder vision for eye care

As a two-decade push to end blindness by 2020 draws to a close, advocates indicate the goal is unlikely to be met. In hindsight, they admit they could have framed the goal better. Going forward, bold action is needed.

The anticipated rise in the numbers of people suffering from different forms of visual impairments and at-risk of blindness is expected to pose challenges to countries health systems, which are already constrained in reaching all affected populations and providing quality interventions.

Although increases in cataract surgical rates have been documented in many countries, recent evidence suggests that post-operative vision results are, at times, suboptimal, the report states.

If eye care services are integrated in countries national health systems, we stand a better chance of making sure that people can access the health services that they need across the course of their lives.

People living in rural areas, women, the elderly, people with disabilities, ethnic minorities, and refugees often burdened with higher rates of vision impairment and blindness are also often unable to access eye care services. One issue is that eye care services are often restricted to urban and larger regional settings.

One-third of countries that completed WHOs eye care service assessment tool in 2014-2016 also revealed equity gaps in the distribution of health care workers specializing in eye care across countries geographic areas. In some of these countries, optometry is not recognized as a profession.

A number of countries health insurance schemes dont provide coverage for eye-related medicines and interventions such as cataract surgery. The cost of these interventions often comes out of patients own money.

Where patients are covered, the challenge is accommodating the increase in the number of surgical interventions while ensuring benefits are not taken advantage of by schemes.

In the Philippines, PhilHealth, which oversees the countrys public health insurance scheme, limited the number of cataract surgical procedures per accredited surgeon to 50 per month after reports emerged in 2015 of fraudulent schemes by providers who prioritize profit over need for surgery.

But one of the biggest challenges is lack of data. Without it, it would be difficult for decision-makers and implementers to identify the problems and provide targeted solutions, as well as make the case for resource allocation.

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As the report itself states, more reliable data on the met and unmet eye care needs is required for planning eye care services, so we can identify who needs eye care services, who is not currently accessing them and where they are located, said Dominic Haslam, director of policy and program strategy atSightsavers, an international charity working to address avoidable blindness and other disabilities.

In many of the countries where international NGOs work however, health management information systems are still being developed. Haslam said efforts to strengthen health systems should extend to these vital information systems, and include eye health data.

Over the next few years, WHO is planning to publish a suite of tools to help countries develop comprehensive eye care services and we look forward to supporting this in the countries where we work, he said.

The report underlined the importance of integration in addressing the burden of eye conditions. It recommends countries integrate eye care in their national health plans and care packages and services. It also underscored the importance of coordination between the public and private sectors.

Every country has a health and strategic plan, but eye care is frequently not seen as an integral part of it. The eye care agenda has been frequently planned and delivered as in a parallel system and not as an integral part of health, said Alarcos Cieza, coordinator of blindness and deafness prevention at WHO, in a Devex interviewlast July.

Also, in many countries, a high percentage of eye care services are delivered by the private sector, and usually the public and private sectors are not well coordinated, she added.

Haslam hopes the report will galvanize governments to action, and lead to greater awareness and the political will to deliver better eye health for all.

If eye care services are integrated in countries national health systems, we stand a better chance of making sure that people can access the health services that they need across the course of their lives, he said.

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Aging and population growth, challenges for vision care: WHO report - Devex

Credit: nters for Disease Control and Prevention

Above: This 1975 file microscope image made available by the Centers for Disease Control and Prevention shows chlamydia trachomatis bacteria magnified 200 times.

The number of cases of three major sexually transmitted diseases in California reached a 30-year high in 2018, according to a state report released Tuesday.

More than 336,000 cases of chlamydia, gonorrhea and syphilis were reported last year, as rates of all three STDs continued to increase across the state, the California Department of Public Health reported.

Officials said they are particularly concerned by the number of congenital syphilis cases, which were 14% higher than the previous year and nearly 900% higher than in 2012.

There were 22 stillbirths or neonatal deaths because of syphilis last year, the report said.

If left untreated, syphilis can result in blindness, hearing loss and neurological problems. Chlamydia and gonorrhea can lead to infertility, ectopic pregnancy and chronic pelvic pain.

Many STDs can be cured with antibiotics.

The highest rates of STDs are among young people ages 15 to 24, officials said.

The department's acting director, Dr. Charity Dean, urged sexually active people to use condoms and get tested.

"Regular testing and treatment are essential prevention strategies, even for people who have no symptoms," Dean said in a statement. "Most people infected with an STD do not know it."

State officials are collaborating with local agencies to coordinate efforts to control STDs, the health department said.

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Cases Of STDs Reach 30-Year High In California - KPBS