StemCell Therapy

Legal Issues in Stem Cell Therapy in the U.S.Jul 30, 2019 | Fred Greguras

My wife has had osteoarthritis, sometimes called wear-and-tear arthritis, in both of her knees since 2011. She first saw an advertisement for stem cell treatment in 2012 and continued to do research on the treatment. Late in 2018, after ultrasounds on her knees and consultation with several doctors and clinics in California and Colorado, she decided to have stem cell therapy that could regenerate the meniscus cartilage of her knees. Such therapy is a minimally invasive procedure that has the potential to slow the progress of the arthritic damage, repair joint cartilage and avoid or delay invasive knee replacement surgery. Such therapy can help the body repair itself naturally.

We thought it was best to act now before her knees worsened since the earlier the stem cell treatment began, the greater the chances for a successful outcome there would be. The present lack of health insurance coverage was considered, but the treatment cost was reasonable given the potential to avoid more invasive surgery and the timing of treatment. Most insurance plans, including Medicare, define the procedure as experimental and investigational and do not cover the therapy.

Based on her research, my wife selected Dr. Jason Glowney of Boulder Biologics to perform the treatment. Her treatment took place in the second week of January, 2019, as an outpatient at a hospital in Boulder, Colorado. The procedure was completed in under four hours. She was injected with her own stem cells (called an autologous donation), reducing the risk of immune rejection and other complications.

The medical team used ultrasound to identify the best sites for injection into the damaged tissue of her knees. The same needle remained in each knee site during the treatment, but the injections in each step described below were all done with separate syringes in sequence. There was no mixture of any of the multiple components in a single syringe.

The doctor gave her light oral sedation to help her relax for the procedure and used local anesthetic at the points of cell harvest and injection. No general anesthetic was administered. The procedure began with a harvest of platelet-rich plasma (PRP) from her blood. Her blood was quickly processed through a centrifuge to separate the blood and concentrate the platelets in the plasma, which was then injected to fertilize the knee sites to enhance cell growth. The concentrated platelets contain growth factors along with bioactive proteins that help initiate and stimulate tissue repair and regeneration. (In late May, 2019, she had another PRP injection to stimulate and enhance the growth of the stem cells.)

The next step in the procedure was to harvest her bone marrow, centrifuge it into an injectable volume of aspirate concentrate and then inject the concentrate in both knees. The bone marrow aspirate contains stem cells that can help regenerate bone and cartilage.

The adipose (fat-derived) stem cells used in the next step compliment the bone marrow stem cells. The adipose cells were harvested by a minimally invasive liposuction procedure, centrifuged to isolate the cells and then injected in both knees. The fat on our bodies can be a rich source of stem cells.

Hundreds of thousands of cells were harvested and injected in each step in order to have an adequate number of stem cells for the treatment. The stem cells decide whether to differentiate into bone, meniscus or other cartilage or to simply renew.

My wife was given antibiotic (doxycycline) tablets to take at the end of the procedure and, for a period thereafter, to assist the differentiation process and to help decrease cartilage degradation.

As discussed in more detail below, the doctors procedure was designed to involve only simple human cellular and tissue products from the same patient and not to be a new biological product or drug which requires FDA approval. The procedure would be a new biological product or drug requiring FDA approval if there had been more than minimal manipulation of each component part. Even a mixture of a patients own stem cells and an antibiotic administered from the same syringe would be deemed a new biological product or drug by the FDA.

The doctor gave my wife guidelines for physical activity and medications during the post-injection period. The guidelines were designed to promote the growth of the stem cells to regenerate tissue. The cells are fragile, and she had to be careful not to cause too much stress or shearing on them which could impede growth. Her pain was intense during the first 24 hours, and she stayed in bed much of the time. She used a walker for about the first week. She started physical therapy about six days after the injections with the doctors approval. The doctor recommended that she not take any anti-inflammatory medications (like ibuprofen or motrin), for six weeks since they could impede the differentiation of the stem cells. The doctor advised her that most patients dont feel any knee improvement for at least three weeks and possibly for up to six to eight weeks. If there is no improvement by the six-month point after the injections, then the therapy has not worked.

A self-reporting instrument is used for assessing a patients knee status. The 33 items measured are intended to represent all major indicators of knee status. My wifes measures are all very positive at this six-month point after the procedure. The measurement factors include: (1) knee symptoms such as knee swelling, stiffness and frequency of pain; (2) amount of pain in activities such as walking, standing and going up and down stairs; and (3) degree of difficulty in activities such as walking, bending down and going up and down stairs. Each item is rated on a five-point scale relating to the extent of its occurrence or severity during the past week.

Stem Cell Background

Stem cells are different from other cell types in our bodies because they are capable of renewing (copying) themselves through cell division, sometimes after long periods of inactivity. Stem cells also have the potential to differentiate into other cell types in our body. When a stem cell divides, each new cell has the potential either to remain a stem cell or to differentiate into more specialized cells that form the bodys tissues and organs. In some organs, stem cells regularly divide to repair and replace worn out or damaged tissues. In other organs, stem cells only divide under special conditions.

There are several types of stem cells that are formed at different times in our lives or come from different places in our body. Embryonic stem cells (ESCs) exist in the embryo only at the earliest stages of human development. ESCs are pluripotent, meaning they have the potential to differentiate into almost all cell types in the body. There are social and ethical issues relating to the use of ESCs, since harvesting the cells causes the destruction of an embryo. Many countries, including the U.S., have government-imposed restrictions on either ESC research or the production of new ESC lines.

Somatic or adult non-embryonic tissue-specific stem cells (ASCs) exist in specific tissues throughout the body after early human development. The stem cells injected into my wifes knees were ASCs. ASCs are multipotent, meaning they can differentiate into more than one type of specialized cell of the body, but not all types. ASCs are generally limited to differentiating into cell types of their tissue of origin, which can help with the replacement of cells from damaged tissue. ASCs can be an autologous stem cell donation, which is less likely to be rejected.

Amniotic stem cells (AMSCs) exist in the amniotic sac, which surrounds a baby in the uterus and remains until the babys birth. AMSCs are harvested right after the mother gives birth, without harming the baby. Some clinics make exaggerated claims about the therapeutic potential of ASMCs. AMSCs, however, are also multipotent, and the tissues they can differentiate into are substantially the same as stem cells from adipose (fat) and bone marrow. AMSCs exist only for a limited time, but adipose and bone marrow ASCs continue to be produced throughout our lives and can be harvested from the patient seeking therapy.

Some tissues and organs contain small amounts of ASCs whose function is to replace cells from that same tissue that deteriorate over time or are damaged by injury. For example, blood-forming stem cells in bone marrow can differentiate into red blood cells, white blood cells and platelets. However, blood-forming stem cells dont generate liver or lung or brain cells, and stem cells in other tissues and organs dont generate red or white blood cells or platelets.

Pluripotent stem cells have great therapeutic potential but still have major technical issues. Scientists cant control their differentiation into the many types of cells in the body which can result in unwanted tissue such as tumors. Since such stem cells are not from the recipient, they may also lack the compatibility needed to prevent rejection by the immune system.

Over 10 years ago, researchers identified conditions that enabled some specialized ASCs to be reprogrammed genetically back to an ESC-like state. The reprogrammed cells function similarly to ESCs and are called induced pluripotent stem cells (iPSCs). The iPSCs function similarly to ESCs, with the ability to differentiate into almost any cell of the body and to create an unlimited source of cells. iPSCs may ultimately help address the ethical concerns of ESCs and provide new potential for therapy, but there are still technical issues including whether they are actually equivalent to ESCs and the capability to control the differentiation process.

Legal Issues

FDA Approval Requirements

While the U.S. Food and Drug Administration (FDA) moves agonizingly slowly, its priority is human safety which is not the case in many other countries. Some other countries are the Wild West of stem cell therapy and have become medical tourism destinations for high-risk stem cell treatment. The FDA recommends that stem cell therapy is either FDA-approved or is done pursuant to an Investigational New Drug Application (IND), a clinical investigation plan submitted to and permitted to proceed by the FDA. There are many active clinical trials investigating the potential of ASCs listed on the U.S. National Institutes of Healths website.[1] Stem cell products approved by the FDA are listed on its web site.[2] There is no FDA-approved therapy involving the transplantation of ESCs. ESCs must be not be added to an injection, such as PRP, before it goes into a human.

The FDA regulates human tissues intended for transplant under 21 C.F.R. Part 1271: Human Cells, Tissues and Cellular and Tissue-Based Products (HCT/Ps). Cellular and tissue-based therapies are regulated by the Office of Cellular, Tissue and Gene Therapies within the FDA Center for Biologics Evaluation. There are two primary regulatory pathways for these products. Cellular therapy products that meet all the criteria in 21 CFR 1271.10(a) are regulated solely as HCT/Ps and are not required to be licensed, approved or cleared by the FDA. These products are often referred to as 361 products because they are regulated solely under Section 361 of the Public Health Service Act (PHSA).[3] The regulatory purpose for such products is to prevent the introduction, transmission and spread of communicable diseases.

If a cellular therapy product does not meet all the criteria in 21 CFR 1271.10(a), it is regulated as a drug, device and/or biological product under the Federal Food, Drug and Cosmetic Act (FDCA)[4] and Section 351 of the PHSA (a 351 product). The FDA requires premarket approval for such a product. The criteria that determine whether a product is a Section 361 HCT/P or a Section 351 biological product include, primarily, whether a product has been minimally manipulated and is intended for homologous use. Stem cell therapies generally do not satisfy these criteria and therefore are usually regulated as Section 351 products.

In the 2014 decision, United States of America v. Regenerative Sciences, LLC,[5] the court held that a mixture of autologous ASCs and other components was a 351 product and subject to FDA approval. Regenerative Sciences, LLC argued that its process did not create a mixture but only expanded the patients own cells and, therefore, was a simple 361 product which does not require FDA approval. The FDAs position is that any process involving human cellular and tissue products that includes culturing, expansion and added growth components or antibiotics requires FDA approval as a biological product or new drug because the process constitutes significant manipulation.

The FDA alleged that the product was a 351 product for failure to comply with its minimal manipulation provisions and because the resulting stem cells were not intended for homologous use. Homologous use means that a human cellular or tissue product is used clinically in a manner that is essentially the same as the natural function. The homologous use definition is strictly interpreted by the FDA, so that most innovative ways to use stem cells to potentially treat patients would be through non-homologous usage. The FDA will generally define even modestly different uses as non-homologous.

There are many clinics offering stem cell therapy in the U.S., some which carefully follow the law and others which do not. The FDA has only has brought a small number of enforcement actions because of resource limitations and proof concerns. Enforcement usually occurs in high-profile situations where a patient has died or is severely harmed.

Intellectual Property Issues

The two important types of intellectual property protection relating to stem cell therapy are trade secret and patent protection. For example, the cell harvesting techniques and settings for the centrifuge processing in each step in my wifes treatment can be protected as trade secret know-how. The culturing and cocktails of growth factors and/or other components in the Regenerative Sciences, LLC case are another example.

There are many patents registered with the USPTO that contain the term stem cell, but recently, many human stem-based inventions have been rejected for not being eligible patentable subject matter. Patent-eligible subject matter is defined in 35 U.S.C. Section 101 as: Whoever invents or discovers any new and useful process, machine, manufacture or composition of matter, or any new and useful improvement thereof, may obtain a patent therefor, subject to the conditions and requirements of this title. There are three exceptions to subject matter eligibility: laws of nature, physical phenomena and abstract ideas.[6] The laws of nature exception has been the basis for rejection of patent eligibility for certain stem cell-related inventions.

There were two important court decisions in 1977 and 1980 relating to patent protection eligibility for the biotechnology industry.[7] The USPTO issued many stem cell patents following these decisions.

Several Supreme Court decisions in the past 10 years, however, have narrowed the scope of patent-eligible subject matter under Section 101.[8] In the Mayo decision, the Court held the invention was not patentable, stating that it effectively claimed the underlying laws of nature. The Court held that a claim that encompasses the use of a natural law must also include additional elements, sometimes referred to as an inventive concept, sufficient to ensure that the patent amounts to significantly more than a patent upon the natural law itself.

The scope of patent-eligible subject matter was further narrowed in the Myriad decision, which held that a naturally occurring DNA segment is a product of nature and not eligible for patent protection merely because it had been isolated. The Court looked for markedly different characteristics from any found in nature of the isolated gene to determine patent eligibility. The changes resulting from isolation of a gene sequence were considered incidental and not enough to make the isolated gene markedly different.

Three recent decisions in the Federal Circuit indicate that method-of-treatment claims that may involve a law of nature are patent-eligible.[9] Each of the patents required an affirmative treatment step. The decisions seem to hold that a patent directed to detecting a condition in a patient is not Section 101-eligible under Mayo, while a patent directed to using that detection to change some aspect of the patient is eligible. The patent may have been based upon the inventors discovery of a law of nature but the patent did not simply claim that law of nature. Rather, it was directed to a specific method of treatment.

The United States Patent and Trademark Office (USPTO) has published guidelines for patent examiners on how to analyze a claim which includes a nature-based product for patent eligibility.[10] Claims are to be examined for an inventiveness that has markedly different characteristics from naturally occurring products. Patent eligibility for a natural product is to be determined primarily by whether the claimed product possesses any structural, functional and/or other properties that represent markedly different characteristics from the natural counterpart. If the claim includes a nature-based product that has markedly different characteristics, then the claim is not within the product of nature exception. On the other hand, if the claim includes a nature-based product that does not have markedly different characteristics from its naturally occurring counterpart in its natural state, then the claim is within the product of nature exception and is not eligible for patent protection.[11]

The first step in the analysis is to select the counterpart(s) to compare to the nature-based product. The second step is to identify characteristics to compare, since the analysis is based on comparing the characteristics of the claimed nature-based product and its counterpart. Characteristics can be expressed as the nature-based products structure, function and/or other properties, and are evaluated on a case-by-case basis. The final step is to compare the characteristics of the claimed nature-based product to the characteristics of its naturally occurring counterpart in its natural state to determine if the characteristics of the claimed product are markedly different. If there is a change in at least one characteristic resulting from, or produced by, the patent applicants efforts or influences, then the change will generally be found to be a markedly different characteristic.

Consumer Protection

My wife was provided with disclosures from the doctors office and requested to sign a number of consents and waivers as a condition of receiving therapy. One of the waivers was a no assurance of successful treatment agreement.

State laws protecting consumers against deceptive advertising are applicable to representations about the effectiveness of stem cell treatment. Several state legislatures have debated additional protections for consumers relating to such treatment. California enacted a consumer protection law in late 2017 that requires clinics offering stem cell treatments to disclose if the treatment is not approved by the FDA.

The Federal Trade Commission (FTC) and FDA are pursuing enforcement actions in selected cases that may cause stem cell clinics to be more careful about their representations and activity. In late 2018, the FTC settled charges with a California-based physician and his businesses of deceptively advertising that amniotic stem cell therapy can treat serious diseases.[12] The settlement prohibits the defendants from making any health claims in the future unless the claims are true and supported by competent and reliable scientific evidence. This was the first enforcement action brought by the FTC against a stem cell clinic.

In early June, 2019, a federal judge granted the FDA an injunction to prevent the U.S. Stem Cell Clinic (based in Florida) from offering treatments using adipose stem cells injected into the spinal cords of patients to treat Parkinsons disease, chronic obstructive pulmonary disease and other serious conditions.[13] The court held that the defendants misbranded the possible therapeutic effects. The court also determined the clinic failed to prevent microbiological contamination of products which put patients at risk for infections.

Conclusion

As indicated, the status measures for my wifes knees are all very positive six months after the procedure. She is glad she tried it. I would try the therapy if I have problems with my knees.

The FDA will continue to move slowly to approve stem cell therapies since its priority is human safety. Some other countries have become medical tourism destinations for high-risk stem cell treatment. Many of the claims of such foreign clinics and of some clinics in the U.S. are medically unproven. The FDA and other regulators will continue to bring enforcement actions based on the severity of patient risk and available resources. Obtaining patent protection for stem cell-related inventions is challenging because of the subject matter eligibility issue under Section 101. The recent method-of-treatment decisions in the Federal Circuit may provide a helpful eligibility precedent for some inventions.

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Legal Issues in Stem Cell Therapy in the U.S. - Inventus Law

Welcome to the Institute of Ophthalmology and Visual Science. The Institute's ophthalmic surgeons are members of University Hospital's medical staff. They are dedicated to providing outstanding, compassionate patient care. Because the physicians work in close physical proximity, patients are readily afforded consultation from our many ophthalmic subspecialists. The Institute features state-of-the-art diagnostic equipment (housed in the Ocular Imaging Center and in the Ophthalmic Electrodiagnostic Laboratory) and offers the most advanced therapies available.

The Institute is the only one in New Jersey that provides 24-hour coverage for every disease and/or condition of the eye. Our highly skilled, dedicated team has the expertise to treat even the most complex cases, no matter when a problem occurs.

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The Institute offers diagnosis and medical and surgical treatments for cornea and external ocular diseases, glaucoma and retinal diseases/disorders. Our team also has experts in pediatric ophthalmology; neuro-ophthamology; oculoplastic and reconstructive surgery; orbital surgery, and low vision optometric and rehabilitative care.

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Opthalmology Pacs Market 2020, by Services, Company Profiling, Business Revenue, and Growth Opportunities to 2025 - Cole of Duty

Active Pharmaceutical Ingredients (API) market size was valued at USD 179.77 billion in 2018 and is projected to reach to USD XX billion by 2026 at a CAGR of XX %.

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An active pharmaceutical ingredient is a biologically active portion of a pharmaceutical drug intended to perform certain pharmacological actions or have prominent effects for the diagnosis, cure, treatment or prevention of chronic and acute diseases.

The rising prevalence of chronic diseases and increasing uptake of biopharmaceuticals is expected to majorly drive the market growth.

As per data published by the World Health Organization (WHO), chronic disease prevalence is anticipated to rise by 57.0% by the year 2020. The number of people suffering from diabetes in developing countries was 84.0 million in 1995, which is projected to increase by 2.5-fold to 228.0 million in 2025. Chronic diseases include diabetes, obesity, and cardiovascular diseases, cancer, neurological diseases, and other diseases; the rise in prevalence of these diseases are augmenting the demand for treatment that may support the market growth over the forecast period.

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North America is expected to hold a major chunk of the market during the forecast period.

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Active pharmaceutical ingredients market size analysis and forecast Comprehensive study and analysis of market drivers, restraints, and opportunities influencing the growth of the active pharmaceutical ingredients market Active pharmaceutical ingredients market segmentation on the basis of synthesis type, drug type, manufacturer type, therapeutic area, and geography (regional) Active pharmaceutical ingredients market strategic analysis with respect to individual growth trends, future prospects along with a contribution of various sub-market stakeholders have been considered under the scope of a study Active pharmaceutical ingredients market analysis and forecast for five major regions such as North America, Europe, Asia Pacific, Latin America, and MEA. Profiling of key industry players, their strategic perspective, market positioning and analysis of core competencies Competitive landscape of the key players operating in the active pharmaceutical ingredients market including competitive developments, investments, and strategic expansion

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Base Year 2018 Estimated Year 2019 Forecast Period 2019 to 2026

For company profiles, 2018 has been considered as the base year. In cases, wherein information was unavailable for the base year, the years prior to it have been considered.

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Healthcare companies Corporate healthcare entities Government agencies Market research and consulting firms Venture capitalists Technical StudentsScope of the Active Pharmaceutical Ingredients Market Report:

The research report segments the active pharmaceutical ingredients market based on synthesis type, drug type, manufacturer type, therapeutic area, and geography.Active Pharmaceutical Ingredients Market, By Synthesis Type

Biotech Monoclonal Antibodies Recombinant Proteins Vaccines SyntheticActive Pharmaceutical Ingredients Market, By Drug Type

Branded Drugs Generic Drugs Over-the-counter (OTC) DrugsActive Pharmaceutical Ingredients Market, By Manufacturer Type

Captive Manufacturers Merchant ManufacturersActive Pharmaceutical Ingredients Market, By Therapeutic Area

Cardiology Pulmonology Opthalmology Neurology Oncology Orthopedics OthersActive Pharmaceutical Ingredients Market, By Geography

North America U.S. Canada Europe UK Germany France Italy Spain Rest of Europe Asia Pacific Japan China India Rest of Asia Pacific Latin America Brazil Mexico Rest of Latin America MEA South Africa Saudi Arabia Rest of MEA

MAJOR TOC OF THE REPORT

Chapter One: Active Pharmaceutical Ingredients (API) Market Overview

Chapter Two: Manufacturers Profiles

Chapter Three: Global Active Pharmaceutical Ingredients (API) Market Competition, by Players

Chapter Four: Global Active Pharmaceutical Ingredients (API) Market Size by Regions

Chapter Five: North America Active Pharmaceutical Ingredients (API) Revenue by Countries

Chapter Six: Europe Active Pharmaceutical Ingredients (API) Revenue by Countries

Chapter Seven: Asia-Pacific Active Pharmaceutical Ingredients (API) Revenue by Countries

Chapter Eight: South America Active Pharmaceutical Ingredients (API) Revenue by Countries

Chapter Nine: Middle East and Africa Revenue Active Pharmaceutical Ingredients (API) by Countries

Chapter Ten: Global Active Pharmaceutical Ingredients (API) Market Segment by Type

Chapter Eleven: Global Active Pharmaceutical Ingredients (API) Market Segment by Application

Chapter Twelve: Global Active Pharmaceutical Ingredients (API) Market Size Forecast (2019-2026)

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Active Pharmaceutical Ingredients (API) Market Industry Analysis and Forecast (2019-2026)_by Synthesis Type (Biotech, Synthetic), by Drug Type...

University of Otago researchers have discovered some of the secrets to longevity with new research revealing not smoking and being social engaged throughout older age are common traits of New Zealand centenarians.

Associate Professor Yoram Barak, a consultant psychogeriatrician, says the results show people can have some control over the ageing process.

Electing not to smoke and committing to maintain social networking will be the best investment one can make towards successful ageing, he says.

Being socially active means physically going out of your home and away from families and interacting with people whether that is visiting friends, volunteering or participating in activities such as attending a concert or playing golf, Professor Barak says.

Together with his colleague Professor Paul Glue, from the Department of Psychological Medicine, and Dr Sharon Leitch from the Department of General Practice and Rural Health, Associate Professor Barak set out to investigate the variables associated with exceptionally healthy extreme old age.

This is so we can make some recommendations to try and help people age well.

The researchers examined data relating to 292 centenarians who were free of common chronic diseases such as diabetes, depression, dementia and hypertension. They also included information relating to a further 103,377 older people aged over 60. All of these people were living in private accommodation in the community and not in aged residential care.

Results showed social engagement of participants, whereby they are participating in social activities of long-standing interest was similar across all age groups.

Rates of depression and diabetes declined steadily with increasing age and rates of dementia declined after the age of 80. Hypertension rates increased by nearly 30 per cent from age 60 to 100 years.

There is evidence that exercise improves health and length of life but in this study most participants had a similar profile of physical activity and there was not sufficient spread of duration or intensity of physical activities to test the effects on ageing.

However, among those surveyed the highest physical activity groups were at the lowest risk of dementia.

As of 2011, there are estimated to be between 400 to 500 centenarians living in New Zealand. Of these, fewer than 40 would be aged over 105. The mean age of those interviewed in the study was 101.

The centenarians were more likely to be female (75 per cent) and in any age group, women were more likely to be free of the common chronic diseases outlined above.

Women have a longer life expectancy and are therefore more likely to be represented in centenarian studies. However, after correcting for this advantage, men who do make it to 100 years of age are more likely to be free of common illnesses, Associate Professor Barak says.

This study found higher rates of centenarians free of common chronic diseases in New Zealand than reported in other countries.

However, one explanation is that this survey considered only centenarians living in the community, who were likely to be in better health compared with those living in residential care or hospital settings.

Professor Barak explains the biopsychosocial foundations of remarkable health and longevity among centenarians is unclear. Genetic factors, certain geographical locations and life-style characteristics have all been studied in an effort to identify potential predisposing factors of exceptional longevity.

The research was recently published in international scientific journal Aging Clinical and Experimental Research.

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Not smoking and being socially active keys to longevity, Otago research shows - New Zealand Doctor Online

International Mens Health Week: Men may seem physically stronger than women, they are mentally weak. Also, most of them are extremely careless towards their health and ignore common signs that may be signals of a bigger health issue than they think. This negligence when mixed with the daily stress of work, family issue etc., can gradually lead to depression or any other ailment that can be quite debilitating. So, in order to live a happy, healthy, and longer life, they must bring some changes in their lifestyle. Here we tell you about those changes. Also Read - International Mens Health Week 2020: 4 Common Ailments That Are Prevalent in Men And Shouldn't be Ignored

Needless to say, smoking is known to cause both physical and mental damage. From damaging your lungs to causing heart diseases, and leading to behavioural issues, smoking is associated with an array of health ailments. Nicotine present in cigarettes may even cause uncontrolled growth of some cells in your lungs and cause cancer. Additionally, it can significantly lower your sperm count and affect your sex life.

A sedentary lifestyle is one of the major reasons behind a bulging belly and problems associated with it. Obesity can affect your cardiovascular health, impact your blood pressure, and increase your risk of suffering from a stroke. Thats why it is important to stay fit. For that, you need to exercise. If nothing, you can at least start jogging or cycling. These aerobic exercises can bring a big difference in your health.

Eating junk foods like burger, french fries etc. can increase the level of bad cholesterol in your blood and that can lead to a heart attack or stroke. Also, it can cause obesity which is again linked to diabetes, high blood pressure and many other ailments. So, men must include vitamins, carbohydrates, minerals, and protein in their daily diet. For that, they can have lentils, green leafy vegetables, fruits, eggs etc.

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International Mens Health Week: All Men Must Make These Lifestyle Changes For Better Health And Longevity - India.com

People are now living longer worldwide while birth rates have declined well below replacement levels in the western world. This is widely interpreted in a negative light, and I have done so myself, but an article by Andrew Scott published by the World Economic Forum points out that when chronological age statistics (number of years one is alive) are converted to biological age (the health of your cells, or how old you really are) little or no increase in average real age can be discerned in most developed economies since the 1950s.

And another report by Mark Haas in The National Interest earlier this year claims ageing populations increase the likelihood of international peace. So, increased longevity offers unexpected dividends and public policy should be framed to harvest these dividends.

The UN estimates the share of population aged 60 years and over will increase in every country up to 2050. Life expectancy is growing fastest in emerging markets where the number of people aged 60 years and over is double that in the developed world. This ratio will increase to 4:1 by 2050.

Increased life expectancy and declining birth rates increase the average population age, eg in Japan median age rose from 26 years in 1952 to 46 years today. It is popularly argued that such ageing weakens economies because it increases the old-age dependency ratio (OADR), thereby slowing economic growth and putting pressure on public budgets. OADR is the proportion of the population over 64 years relative to the working age population (15 years to 64 years). The OADR concept assumes that older people are unproductive consumers of the government benefits generated by 15- to 64 year-olds.

As countries industrialise, birth rates decline, increasing the relative size of the elderly sector and one would expect average mortality to rise because mortality rates are higher for older people. However, while the average age in advanced economies has been increasing since 1950, average mortality rates have declined for all ages for several reasons medical advances, falling smoking rates etc. Chronological ageing is offset by a longevity effect. The average citizen has become chronologically older but biologically younger.

The conventional demographic time-bomb picture described previously makes no distinction between ageing and longevity effects and predicts a very negative picture of the future. The picture is much brighter when the longevity effect is factored in and would become even brighter if birth rates were restored to replacement levels in the western world in the near term.

In advanced economies today 75-year-olds have the same mortality rates as 65-year-olds in 1950. Scott reports that when changed mortality rates are used to adjust for age inflation in order to determine real average age, little or no increase in real age is seen in recent decades in the UK, Sweden, France, Germany and the US. Japan is an exception with an increase of average real age from 31 years to 44 years. This is attributed to the dramatic collapse of birth rates in Japan since the end of the second World War.

Of course, as Scott points out, while the average person now lives a longer healthier life this does not apply to everybody and significant differences can be discerned based on income, lifestyle, education, environment and genetics. And, so, public policies must be devised both to help those who still age in the traditional sense and to harness the dividends offered by the many older-but-productive citizens, facilitating them in full employment or offering more flexible working arrangements.

Huge monies are now expended on anti-ageing research and it may be possible to significantly extend the span of healthy living further by developing medicines that slow down ageing while boosting the bodys defences against diseases. Some geneticists predict that people may live to 150 years by 2100.

Increased likelihood of world peace is a further dividend offered by our ageing societies. The big fear in this context is of war between the superpowers US, Russia and China. Each power has a rapidly ageing population, particularly Russia and China. It is known that countries with a surplus of military-aged citizens (18-30 years) as a percentage of total population are more likely to engage in international hostilities than countries with older populations.

William Reville is an emeritus professor of biochemistry at UCC

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Are societies really ageing? - The Irish Times

Every fall is not the same, but similar. It is a good time to pick up businesses having longevity, and ride through this volatility. But, investors cannot expect to reap benefits immediately as markets don't like uncertainty, Hemang Kapasi, Portfolio Manager Equity Investment Products, Sanctum Wealth Management, said in an interview with Moneycontrols Kshitij Anand.

Edited excerpt:

Q) Indian market snaped two-weeks of positive close and turned negative. What led to the fall on D-Street especially when it started off on a bullish note?

A) If one does an analysis of equity market performance for the last one month, all the major world equity market indices are in positive territory from ~5-15 percent.

Investors worldwide turned euphoric about the resumption of economic activities as lockdowns are being lifted across the world supported by stimulus packages by the governments and liquidity pumped in by the central banks.

Even Indian equity markets participated in this rally with gains of about ~11 percent in the last one month. Post a sharp up move in the equity markets world over, and just before the FOMC meeting, investors were seen booking profits ahead of an important event, and Indian equity markets were no exception.

A) Going forward, equity markets would be a function of economic recovery and sustained liquidity support provided by central banks to support financial markets.

As India is still coming out of lockdown and if one goes by forecasted negative GDP growth for the year, then we are likely to be trading on the higher range on indices.

A) Lockdown would not be a solution as the pandemic is here to stay for some time till the vaccine is found. Lockdown can be used to create health infrastructure, but it cant contain cases as seen in this lockdown.

Lockdown impacts the whole economy and impacts each and every one. Governments, Corporates, and individuals will have to work around this taking precautions and move ahead as economic implications are far more severe if lockdown is implemented

A) As a lender of last resort, theGovernment has to take measures to support the economy. To predict the manner in which it can be implemented is a futile exercise, governments have to step up to revive demand when the need arises.

A) With equity markets having a big up move in the last one month, there is some positivity seen in mid & small-cap space. Having said that they are still down 22 percent from their 1 year high and 32 percent down from their all-time high in December 2017

A) Financials are a place of uncertainty for the next 6 months. In the coming days they might be struggling on both topline and bottom-line.

Credit growth pick-up might take a bit of time to pick up as banks have become risk-averse to lending in these uncertain environments and on the other hand they will have to deal with rising NPAs related provisions.

Thats the reason the financial sector is among the worst-performing sector in the last 3 months, having said that any improvement in the above two-aspect will lead to huge re-rating for this sector.

A) Its true, history may not repeat but it does rhyme. Every fall is not the same but similar. It is a good time to pick up businesses having longevity and ride through this volatility. But, investors cannot expect to reap benefits immediately as markets don't like uncertainty.

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'Good time to invest in firms having longevity, but don't expect returns immediately' - Moneycontrol.com

Years ago sometimes it seems like eons ago I wrote a book and did a PBS special titled The Longevity Code: Your Personal Prescription for a Longer, Sweeter Life.

I learned a lot about writing a book. If youve never had this experience, let me clue you in its not that easy. When youre done, you realize you learned so much that youd like to change the whole thing and start over again.

The problem is you have the publishers deadline. Crown Publishing, an imprint of Random House, had its deadline for my book, so out the door it went.

In that book, I postulated there were five spheres that affect our wellness: physical, mental, family/social, spiritual and material. I thought and still do think these are ways you can organize your life space, learning what you need to do to improve your longevity, keep robust and healthy and avoid disease and disability.

Its kind of like buckling your seat belt. Taking action reduces risk but doesnt eliminate it.

I put physical first because I am first and foremost a doctor using science and medicine to guide my judgment but realizing they dont have all the answers. Some of those whether or not youre happy or sad, pleased with your life or not might not be up to science at all. Thats why life balance and the other four spheres are so important.

Now that were dealing with social distancing, I am starting to realize perhaps I have been wrong in my analysis the social sphere should come first.

When lecturing, I like to pepper my talk with stories and jokes. Thats the only way to keep an audience on task; anecdotes help us emote.

When I get to the social sphere, I often say, Why go to the gym to get the best body you can if you dont have someone to share it with? Its a cute, trite thing to say and usually gets a laugh.

But, truth be told, I see now with the latest isolation situations that we crave our social connections. Yes, we have phones, FaceTime, etc., but the lack of in-person contact comes with a cloud that seems to hang over all of us.

We want these connections with others more than ever now that we must keep them at a distance.

Getting together with friends and family, exchanging ideas and checking in with others are critical to our health. When I have patients who retire, I always ask them how its going. Often, they say they dont miss the job, but they do miss seeing their co-workers.

Social connectedness gives us pleasure, influences our health and motivates us to take action for ourselves and others.

A recent study of more than 300,000 people showed that a lack of strong social relationships could increase death by up to 50% which is about the same as smoking half a pack a day.

So why is this so important? Ive read about this for more than 20 years and have distilled what I think are the most salient points.

Being connected gives us joy and pleasure because we are incredibly social. In the book Sapiens: A Brief History of Humankind, by Yuval Noah Harari, the author postulates that the reason Homo sapiens took over from other humanoid species was our ability to form social relationships and engage in cooperative behavior.

My spin: During this time of physical distancing, its critical to use all the electronic tools we have to stay connected it benefits our health. As we come out of hibernation from winter and look to resume connecting in our usual physical way, we now need to take a little bit different action.

Handshakes, fist bumps and high fives will return. And those hugs from friends and family that make us feel so good will feel even better when we get to share them once again. Stay well.

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Dr. Zorba Paster: Pandemic helps doctor realize our social spheres of prime importance to our health - The Spokesman-Review

Its an undeniable truth that aging is inevitable. Or is it? What if almost everything we have been taught about aging is wrong? What if we could change how long we live? In other words, could we choose our lifespan? David Sinclair, a Harvard professor, medical researcher and author of Lifespan, was recently a guest on the Aspen Brain Lab expert series. He explained to host Dr. Marc Hodosh why he believes we can really influence our longevity.

Sinclair explained that aging is a disease. Aging should be redefined as a medical condition and approached as a disease both causing fragility and often death.

The reality is aging is the root cause of most of the planets suffering and kills 100,000 people every day. Sinclair believes that when we come to this realization, then we will be able to address aging more productively.

The statistics show that the age of our community is rising, especially in the developed world. In 2017, one in eight people worldwide was aged 60 or over. In 2050, older people are projected to account for one in five people globally. So by 2050, this group will be around two billion.

An individuals lifespan is linked to lifestyle factors, more than genetics. In fact, science reveals that your lifespan will be determined by your lifestyle accounting for up to 70% Genetics will determine only 30%.

Sinclair told Hadosh that individual diseases occur in the minority, and aging to the majority. So why arent we taking aging far more seriously than we are currently? he questions.

He believes there is a need for more international attention to social, economic and political risks as well as the benefits of a world in which billions of people can live much longer and much healthier lives.

Sinclair explained that ones chronological age (the number of times weve travelled around the sun) is not the same as our biological age (how our cells have changed over that same period of time). He defines the nine different hallmarks of aging :

Like many other scientists involved in the study of aging, Sinclair believes we need to approach aging from a preventative health perspective over ones lifespan. This is a more cost-effective approach than addressing acute symptoms of the disease later on in life, he told Hadosh.

And hes pretty optimistic that science may soon have the tools to put this disease into remission.

During the discussion Sinclair spoke about the importance of hormesis and its role in lifespan and the aging process. The application of hormesis in aging research and interventions is becoming increasingly attractive and successful. The reason for this is that the research conducted over many years, is showing that mild stress-induced activation of one or more stress response (SR) pathways, and its consequent stimulation of repair mechanisms, is effective in reducing the age-related accumulation of molecular damage.

Hormesis is the what doesnt kill you makes you stronger type of stress. Stress is the disruption of homeostasis, or your bodys state of equilibrium. In fact, your body thrives on occasional stress or toxin exposure, and responds by ramping up growth and repair to bring you back to balance. Thats hormesis your bodys positive response to minor stressors. Over time, you can use hormesis to build an adaptive stress response, where you learn to benefit from sources of stress.

With exercise, for example, you need to exert your muscles, otherwise your body wont build them back stronger. Also your brain needs to be challenged. You can do this by learning a new language, or doing something creative. Its important to continually build new connections between brain cells. You can even stimulate new collagen growth in your skin with lasers and microneedling both of which cause micro-injuries. Sitting in a sauna, followed by a cold shower is also another simple way to practice hormesis.

Sinclair believes youthfulness can also be reset in the body using epigenetic reprogramming. Soon we will be able to tweak cells in a particular way that the central nervous system behaves as if it were young again.

The central nervous system is one of the first body tissues to lose regenerative capacity. His research group was able to show that the expression of 3 specific genes in mice was able to reset youthful gene expression patterns. Promoting regeneration following optic nerve crash injury also restored vision in a mouse model of glaucoma.

The group also concluded that old tissues retain a faithful record of youthful information that can be accessed for functional age reversal.

This is an exciting moment in time for the science of longevity. Researchers are on the verge of understanding the process of aging and how to create drugs that promote extended healthy longevity.

Some may argue that humans and mice are not the same, so we shouldnt get overly optimistic about these studies. However, without a doubt the work being done in their laboratory at Harvard Medical School is forward thinking and may well be lifechanging. As Sinclair attests, This is the golden era of genetics. Anything is possible. We are only limited by our imagination.

We took a look at how Sinclair is approaching his own lifespan? While hes written a lot on the subject, these 4 lifestyle interventions to improve the way we age offer a good summary from the scientist.

Sinclair says if there is one lesson weve learned this past decade it is this: aging is malleable. He has made certain changes in his own life to give himself a decent shot at having a long, healthy life.

We all need to be pushing ourselves, physically, especially as we get older and yet, Sinclair says, only 10 percent of people over the age of 65 do. The good news is that we dont have to exercise for hours on end. People who run four to five miles a week (for most people, thats an amount of exercise that can be done in less than 30 minutes every other day) reduce their chance of death from a heart attack by 40 percent and all-cause mortality by 45 percent. Thats a massive effect.

Youll know you are doing vigorous activity when it feels challenging. Your breathing should be deep and rapid, you should sweat and be unable to say more than a few words without pausing for breath. This is the hypoxic response, and its great for inducing just enough stress to activate your bodys defenses against aging without doing permanent harm.

David Sinclair believes theres nothing revolutionary about fasting. As far back as Hippocrates, the ancient Greek physician, doctors have been espousing the benefits of limiting what we eat. This is not the same thing as malnutrition. This is when the systems of our bodies begin to prey upon one another. But allowing our bodies to exist in a state of want is unquestionably good for our health and longevity.

Increasingly, research is showing through studies that reducing food availability over a lifetime has remarkable effects on aging and lifespan of animals, so most likely will on humans too.

Sinclair is a firm believer in the benefits of intermittent fasting, citing numerous studies pointing to the health benefits of intermittent fasting. In one such study, participants ate a normal diet most of the time, but five days a month ate a restricted diet. In three months, those who maintained the fasting mimicking diet lost weight, reduced their body fat and lowered their blood pressure, too. Participants also had lower levels of a hormone primarily made in the liver called insulin-like growth factor 1, or IGF-1. Mutations in the IGF-1 and IGF-1 receptor genes are associated with lower rates of death and disease.

So how does Sinclair do it? My blood sugar rises in the morning and I am not hungry. So I skip breakfast, except for two tablespoons of homemade yogurt. I try to skip lunch or eat a late lunch of a small soup or salad. At dinner I eat a normal dinner, with a focus on plant-based foods. I do not overeat. My downfall is alcohol. I often have a glass of wine for dinner a few times a week.

According to this aging specialist, the bottom line is that there is no best diet. What works for someone may not work for another. We are all different. With different ages, circadian rhythms, jobs, body compositions, microbiomes, stresses, and wants. No matter what you do, a little fasting goes a long way.

Even eating certain plants will make a difference, suggests Sinclair. Health-promoting molecules are produced in abundance by stressed plants. Sinclair explains that we get resveratrol from grapes, aspirin from willow bark, metformin from lilacs. We obtain epigallocatechin gallate from green tea, quercetin from fruits, and allicin from garlic.

This may be evidence of xenohormesisthe idea that plants respond to stress by producing chemicals that tell their cells to hunker down and survive.

In 2008, together with Konrad Howitz they penned the term xenohormesis Their theory is that animals evolved to sense certain chemicals in stressed plants as an early-warning system, of sorts. . Over the long-term, this provides humans with health and longevity. In the same way intermittent fasting and exercise are thought to. In fact, he says, they activate the same hormetic pathways.

Sinclair says we should be eating plants and foods raised under less-than-ideal conditions, organic, small farm-raised, or from our own backyard. When plants are stressed, they often add extra color to their stems or leaves.

For example, when a plant or a fruit is exposed to too much light, you may have noticed it produces extra red, blue or purple pigments. These are anthocyanins and they are produced not only by radiation damage, but drought, adverse temperatures, nutrient restriction, pathogens, and wounding. Xenohormetic molecules are typically produced alongside anthocyanidins. I look for leafy vegetables that are bright in color, not light green. I dont mind if they have holes eaten in them or are limp.

And if youre wondering which wine grapes have the highest resveratrol content? Sinclair says its pinot noir, because they are so stress-sensitive.

Sinclair suggests cold therapy is another way to better your lifespan chances. Cold therapy helps activate the mitochondria in your brown fat. He writes that his interest in the potential health benefits of cold therapy began in 2008 with a chance meeting at TEDMED with Ray Cronis former NASA scientist turned expert in nutrition and bioenergetics. The two began working together and they published a paper together with Andrew Bremmer at the NIH, titled The Metabolic Winter Hypothesis: A Cause of the Current Epidemics of Obesity and Cardiometabolic Disease.

Writes Sinclair: We propose that our 7-million-year evolutionary history, which was dominated by two seasonal challenges, lead to calorie scarcity and mild cold stress. But in the last 0.9 inches of our evolutionary mile, we solved them both. Put another way, we may be in evolutionary discordance between our biology that evolved to counter seasonal calorie scarcity and mild cold stress and our modern world of ubiquitous calories and excess warmth. Very few of us experience the outdoor cold of winter, and even fewer of us sleep at cool temperatures.

Yes, you guessed it. Sinclair takes a colder view of life. He leaves a window slightly open at night and avoids heavy blankets while he sleeps. He says he also turns the thermostat down to 67 at night. At the gym, he plunges into a cold pool up to his neck for at least 20 seconds. The scientist says doing this leaves him feeling refreshed and energized for the rest of the day. He expects his healthy brown fat to be turning even browner.

This is a controversial area for anyone in the scientific world to venture into. Perhaps more so for an academic specializing in aging. Realistically though, who wouldnt want to know what he is personally taking to age better? David Sinclair definitely looks a lot younger than his 51 years. According to multiple reports and broadcast material on the subject, he regularly tracks his biomarkers and takes vitamin D, vitamin K2, and aspirin.

Sinclair also uses three other longevity-specific substances each morning. These include resveratrol, NMN, and metformin, a diabetes drug currently being studied for its potential anti-aging effects. The researcher is always quick to point out to the media that hes not a medical doctor and that hes not recommending anyone do what he does. This is purely what he does personally, based on what he is learning.

While the natural human inclination is to seek the fountain of youth, theres never a shortage of naysayers. The stakes are particularly high in this area of health. David Sinclair may well be conducting his own real-time personal longevity experiment alongside his lab. However, whatever your viewpoint, I think we can all agree, the best advice is not to wait until the science is proven. You can already adopt many of these strategies without any risk. Be proactive about improving your lifespan now.

David A. Sinclair, Ph.D. A.O. is a professor in the Department of Genetics and co-director of the Paul F. Glenn Center for the Biology of Aging at Harvard Medical School. He obtained his Ph.D. in Molecular Genetics from the University of New South Wales, Sydney in 1995. Dr. Sinclair is co-founder of several biotechnology companies (Sirtris, Ovascience, Genocea, Cohbar, MetroBiotech, ArcBio, Liberty Biosecurity) and is on the boards of several others. He is also co-founder and co-chief editor of the journal Aging.

His work is featured in five books, two documentary movies, 60 Minutes, Morgan Freemans Through the Wormhole and other media. He is the inventor of 35 patents.

Sinclair and has received more than 25 awards and honors. These include the CSL Prize, The Australian Commonwealth Prize, Thompson Prize, Helen Hay Whitney Postdoctoral Award. As well as the Charles Hood Fellowship, Leukemia Society Fellowship, Ludwig Scholarship, Harvard-Armenise Fellowship, American Association for Aging Research Fellowship. Included are the Nathan Rodriguez Award from the National Institutes of Health, Ellison Medical Foundation Junior and Senior Scholar Awards. Merck Prize and the Genzyme Outstanding Achievement in Biomedical Science Award.

Sinclair was also awarded the Bio-Innovator Award, David Murdock-Dole Lectureship, Fisher Honorary Lectureship, Les Lazarus Lectureship and the Australian Medical Research Medal. His work has been recognized with The Frontiers in Aging and Regeneration Award, Top 100 Australian Innovators, and TIME magazines list of the 100 most influential people in the world.

David Sinclair is the author of the book Lifespan. A must-read for anyone interested in aging.

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Has Everything We've Been Taught About Aging Wrong? - Longevity LIVE

Randy Orton and Tommaso Ciampa got into a Twitter beef following NXT TakeOver: In Your House when Orton sent out a backhanded compliment about leg slaps.

Ciampa responded by saying he uses Orton matches to put his daughter to sleep and Orton noted that he seemed to upset one of the locker room leaders in NXT.

Speaking to CBS Sports, Orton clarified his "leg slap" comments and how he views NXT.

"So, the leg slap comment was just me having fun and it got taken a little too seriously," he noted before saying he's seen more leg slaps and repeated moves as so many wrestlers use a superkick or running knee.

"That has nothing to do with the state of Tommaso's physical wellbeing, but there's that style. If you're a talent and you've made it as far as NXT, which is very close to the top of the mountain ... if you think that you have to go out there and get powerbombed on the apron after neck surgery, or if you think you have to go out there and do these dives and flips bell to bell just because the fans want to see half a dozen near-death experiences? I feel sorry for you because you're not going to reap the benefits of what this business offers," said Orton. "One of those is longevity. I don't know anything about what NXT pay is like, but it certainly ain't Raw and SmackDown pay. I don't know what you get paid for a TakeOver, but I'm going to go out on a limb and guess that, at WrestleMania, my paycheck was bigger than the TakeOver guys. Now, I hate when guys talk about 'my big bank account' or 'my big check' or this or that and 'I'm more rich than you.' That's not what I'm saying here. I'm saying that NXT shouldn't be the goal. Raw or SmackDown should be the goal."

Orton went on to say that he wants Ciampa to have a long and healthy career where he can retire and not have to learn a new trade.

"I want to see all these guys succeed. When you're talking about that? Making money. It's a business. It's a business. You've got to make money. I would think, no matter how much you love NXT, you've got to look at the bigger picture. If you don't think you're going to last on the road for Raw and SmackDown? Do something about it. Go and sign a contract that calls for you to only show up at TV. They do NXT every week and they do a TakeOver whenever. They're wrestling about as much as we're wrestling, especially right now. With the future and no one knowing how many shows we're going to be putting on, I think it's a bit of a cop out to say, 'I can get four years of NXT versus one year of Raw or SmackDown,'" said Orton before noting that he would love to work with Ciampa and believes he's great at telling stories.

He continued, "All different kind of fans love all different kinds of styles and there's definitely a popular style down in NXT. I'm not saying fans are wrong and I'm not saying the wrestlers are wrong. I'm just saying there's no longevity in it. There's no chance you're going to be able to have a 10, 15, 20-year career and be able to support your family. If you have multiple kids, especially, there's no way to do that in NXT. That's why there's the major leagues and the major leagues are Raw and SmackDown. The major leagues are main eventing WrestleMania. Main eventing a TakeOver should be a huge notch on your belt. Winning the NXT championship should be a huge notch on your belt. But, I know when Kevin Owens won the NXT championship, he couldn't wait to get called up to the main roster because that dude is a bad motherf--ker and he can go. He wanted to show the world and he was going to reach more fans being on Raw, being on SmackDown, being in marquee matches in Madison Square Garden, being in WrestleMania on the Network. By doing that, he was going to be able to show how awesome of a talent he is."

Orton finished by saying NXT is one step away from the top and he doesn't want anyone to stop there.

As of now, Ciampa remains in NXT while Orton is one of the top stars on WWE Raw.

Continued here:
Randy Orton: Theres No Longevity In The NXT Style The Goal Should Be Raw Or SmackDown - Fightful

Saturday, June 13, 2020 4:00 AM

Dear Overseas Worker:To answer your second question first, n o, your benefit amounts will not change because you are married and both collecting. Based upon the numbers you provided, neither of you will be eligible for a spousal boost from the other because your benefit amounts at your FRA are too similar, so maximizing your individual benefits should be your goal.As for your other question, when you should start collecting depends upon a number of factors, including your financial needs and, importantly, your expected longevity. Both of you can get the maximum benefit available to you by waiting until you are 70 years old to claim, but that only makes sense if you are in good health and expect at least average longevity (about 84 for a man and 87 for a woman).If you claim benefits before you reach your full retirement age (66 for you and 66 plus 4 months for your husband), those benefits will be cut. If you collect now, your benefit would be cut by about 27% and your husbands by about 22% (based upon your respective years of birth). Further, if you claim before your full retirement ages and continue to work, youll be subject to Social Securitys earnings test, which limits the amount you can earn before they take back some of your benefits (the 2020 earnings limit is $18,240; if you exceed that theyll take back half of anything you earn over the limit). The earnings limit changes annually but goes away at your FRA.At your full retirement ages, youll be entitled to 100% of the benefits youve earned from your lifetime of working (approximately the amounts estimated now). If you can and do wait beyond your full retirement age (FRA), for each month you delay youll earn delayed retirement credits of 2/3 of 1% per month of delay (8% per year of delay), up to age 70 when your maximum benefit is reached. As a point of information, if you wait until your full retirement age to claim, you will have collected the same amount of money at age 78 as if you had claimed at age 62; and if you wait until age 70 to claim youll have collected the same amount of money at age 82 as if you had collected at your full retirement age. If you live at least until average longevity, youll collect more in cumulative Social Security benefits by waiting.So, when should you claim? If youre still working and earning professional salaries, then waiting at least until your full retirement age would be a wise choice. If you expect at least average longevity and dont need the money right away, waiting until age 70 would be a prudent strategy. But if you dont work and expect less than average longevity, then claiming at any time you need the money would be a reasonable decision. This is a choice only each of you can make.

By AMAC Certified Social Security Advisor Russell Gloor. This article is intended for information purposes only and does not represent legal or financial guidance. It presents the opinions and interpretations of the Association of Mature American Citizens Foundations staff, trained and accredited by the National Social Security Association.. NSSA and the AMAC Foundation and its staff are not affiliated with or endorsed by the Social Security Administration or any other governmental entity. To submit a question, visit our website (amacfoundation.org/programs/social-security-advisory) or email us atssadvisor@amacfoundation.org.

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In an industry flooded with content standing out from the crowd has arguably never been more crucial, but how is that achieved?Andy Sekula, head of games at Kalamba, believes that withmechanics and math originality you stand a fair chance of succeeding.

The theme and visuals of a slot game are what draws a player in, but its the mechanics that keeps them returning time and again. Innovations introduced in the last few years such as the Megaways engine have demonstrated how transformational a new feature can be for the whole gaming community particularly in an age of content overload where players are faced with myriad choice of games that barely differentiate.

For developers striving for originality, the race is now on between suppliers, both large and small, to create the next big feature that defines a new era. But that doesnt mean trying to reinvent the wheel every time.

Innovation in slot mechanics is a balancing act: introducing something that is too foreign can be off-putting to players, while leaning too heavily on proven successes means you fail at delivering something new.

The sweet spot lies in keeping with what is mostly familiar, improving on it, and introducing some novelty so that the gameplay feels fresh and exciting. And since its the games mechanics which define the math model and monetisation getting it right from the start can be the make or break of a games performance.

Fully understanding player preferences and behaviour is a fundamental component to the development of new features. It is important that studios make informed decisions based on objective evidence, rather than opinion keeping players top of mind from the early stages.

Creating that stickiness with players is an important part of ensuring a games success, longevity and profitability

When developers spend so much time with a game, it is easy to forget that players arecompletely new to it when released. A games creators therefore need to constantly consider how a player will interact with the slots features and mechanics, making sure they are easy to understand and, of course, add to the overall enjoyment.

Tracking engagement with previous releases provides a useful tool to gauge what works and what doesnt, offering a foundation of information on how features can be improved in future iterations.

At Kalamba, we look at the session lengths and number of rounds played to get an indication of the games instant performance, while the number of times a player returns determines whether the experience is appealing enough to come back to even after the games disappears from the lobby.

Creating that stickiness with players to which the mechanics are fundamental is an important part of ensuring a games success, longevity and profitability.

This performance data has been central to Kalambas design process and shaped thedirection of our portfolio in the last few years through feature enhancements. In the earlydays, we concentrated on high-volatility titles with complex mechanics that were targeted at slot enthusiasts.

While these performed well with the intended audience, with analysis of KPIs over time, combined with feedback from operators, we decided to switch tactics.

We now look at developing games with a lower base level but introducing customisable mechanics, such as our HyperBet feature, which allows players to increase the base bet amount of the game as well as the volatility, and HyperBonus, which provides a shortcut tothe bonus round.

It is only with new mechanics and math originality that new hits are created

By enabling players to adapt the gameplay to suit their preferred playstyle, weve broadened the appeal of portfolio, making our titles more accessible to casual players, whilst allowing those with more experience to increase the volatility to meet their risk appetite.

Using these innovations as a foundation for our game development, the Kalamba feature set has advanced dramatically, with new additions like LuckyLoops and progressive free spins moving the engagement dial even further.

The new LuckyLoops feature lets players accumulate special symbols on every base game spin and every tenth spin, the player is rewarded with a special spin, for example expanding accumulated symbols.

To complement our in-game concepts, we are also developing Bullseye, our promotional tools and social gaming inspired elements (think leaderboards and tournaments) that connect our portfolio.

In a content-flooded industry that is full of imitation and skins, it is only with new mechanics and math originality that new hits are created. And although not every feature iteration or new concept is going to be a winner, using data as a guide and of course, taking the occasional risk on an experiment you stand a fair chance of succeeding.

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Kalamba Games: Striving for mechanics that break the mould - Casino Beats

(Daniel Taylor - Kelowna Capital News)

Your morning start for Wednesday, June 17, 2020

Good morning, Okanagan! Happy hump day!

One study, conducted by a University of Sydney professor, titled Stairway to Hell: Life and Death in the Pop Music Industry, examined the deaths of artists which took place between 1950 and June 2014. The study specifically looked at longevity and the proportion of suicides, homicides, and accidental deaths. Longevity was determined by calculating the average age of death for each musician by sex and decade of their death. These averages were then compared with averages by sex and decade for the general U.S. population. The results? Musicians lifespans are 25 years shorter.

In Kelowna:

In Vernon:

In Penticton:

In Salmon Arm:

A South Okanagan massage therapist is no longer allowed to treat female patients after accusations he sexted during appointments and sneaked looks at patients naked bodies.

Last week, the College of Massage Therapists of British Columbia announced it launched an investigation into Brent Rowland, formerly of Naramatas now closed Equilibrium Massage Therapy.

A note posted to the Equilibrium Massage Therapy by Rowland, stated the practice is being suspended for the foreseeable future.

READ MORE: Central Okanagan teacher suspended for showing South Park, John Oliver to students

Daniel Taylor

Reporter, Kelowna Capital News

Environment Canada weather

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Morning Start: Musicians have shorter life spans than the general population - Vernon Morning Star

Retirement can be joyous and less expensive if we take care of ourselves

In a recent survey of more than 5,000 workers, ranging from millennial to baby boomer, conducted by the Transamerica Center for Retirement Studies, eight in 10 participants asserted that they are in excellent or good health.

Those self-assessments seem optimistic when viewed aside national health data:

According to the Centers for Disease Control and Prevention, some 40% of adults are obese.

High blood pressure is an issue for more than four in 10 adult Hispanic and white Americans, and nearly six in 10 non-Hispanic black Americans.

An estimated one in four Americans at least 65 years old is diabetic, with 90%-plus of those cases being Type 2 diabetes that can be moderated, if not eliminated, through dietary changes.

Yes, there is a much longer list of illness and disease absolutely out of ones personal control. But weight, blood pressure and Type 2 diabetes are often conditions that can be managed or moderated through the personal initiative of a healthier diet and (more) exercising. Quality sleep is another lever that can improve health and quality of life, now and down the line.

A visit with your primary care physician, during which you dont minimize your health concerns but seek strong advice on addressing them, is a good start to feeling better. Dont leave the doctors office without a plan.

Additional motivation can come from the financial implications of being in poor health. Medical bills are a leading cause of bankruptcy in the U.S., and a relatively healthy retirement is a lot cheaper to fund than one burdened by heavy drug costs, doctor visits and hospitalizations.

The nonpartisan Employee Benefit Research Institute takes a deep data dive each year to estimate the out-of-pocket medical expenses 65-year-olds might encounter over the rest of their lives. The estimate accounts for Medicare premiums, deductibles and co-payments, and prescription drug costs not covered by Medicare supplemental plans. It explicitly does not include the cost of long-term care.

If a 65-year-old couple today wants a high probability (90%) that they will have the funds to pay for all those medical costs through the rest of their lives, they are estimated to need a combined $325,000 if they end up with high prescription drug costs (again, the 90th percentile). If their drug costs are at the median they would need $270,000.

Yes, both estimates are eye-openers, but remember, this is for two people, and it is for total expenses in retirement. Given increased longevity of retirees,

there is a 50 percent probability someone in average health at 65 will still be alive in their mid-80s. So that total cost is spread out over plenty of years. But even so, the difference between typical and high drug costs adds up to a big chunk of retirement funds. To understand longevitys impact on your retirement planning, read this:https://www.rate.com/research/news/retirement-expectancy

Taking better care of yourself is a key retirement-planning strategy. And its one of the rare times where doing something for your future self also provides a payoff in the here and now. A healthier approachbe it physical or mental (ideally both)is bound to help you feel better today.

Consider a couple hacks:

Share your goal with someone, an exercise or diet buddy, and make plans to check in together regularly. Sounds simple, but so often we keep this sort of stuff to ourselves. Yet having an accountability friend has been shown to help people stick to goals.

Write a letter to your 65- or 75-year-old self, sharing what you hope to be doing then. An academic research project found that people who went through this exercise were more likely to keep going to a gym.

Write it down. A record of exercise, eating, weight and blood pressure can help connect your daily activities to your longer-term goals.

Visit link:
'Oh, I'm Fine' the Cost of Self-Deception About Health - Guaranteed Rate

ONE Championship announced on Monday that theyre laying off 20% of their workforce.

The Singapore-based MMA promotion, which has been known for making very bold claims, unsurprisingly had their unique way of revealing the unfortunate news.

Their press release was mainly about claiming to add $70 million to its war chest from undisclosed existing and new investors, but they also mention a decision to have a 20% reduction of total worldwide headcount. The news was something their President was apparently thrilled to announce.

ONE Championship Adds US$70 Million To Its War ChestExisting And New Institutional Investors Participate

The largest global sports media property in Asian history, ONE Championship (ONE), today announced that it has added US$70 million to its war chest, bringing total capital to US$346 million. ONE Championship has also streamlined operations, including a 20% reduction of total worldwide headcount.

Hua Fung Teh, Group President of ONE Championship, stated: I am thrilled to announce that ONE Championship closed another round of funding a few weeks ago with existing institutional investors as well as a new institutional investor. I am full of gratitude for this strong vote of confidence amidst the worst global economic crisis in 100 years. With 9 figures of cash on the balance sheet and a streamlined organization, ONE Championship looks forward to continuing to delight our fans around the world with more heroes and new experiences for many years to come.

Apart from receiving flack from media and pundits on social media, the announcement also caught the attention of UFC President Dana White:

ONEs CEO Chatri Sityodtong also issued a separate memo to his employees that were being laid off. He spoke about a sad, heart-wrenching decision to let them go, noting how its necessary to ensure the companys longevity, while also boasting and claiming to have a strong balance sheet and a 9-digit war chest for the billion-dollar company.

Heres a snippet from the letter obtained by Tech in Asia:

The world is suffering from the single worst economic crisis in a hundred years due to Covid-19. After weeks of consultation with both our leadership team and our board of directors, I have made the decision to future-proof ONE Championship by both streamlining operations and sharpening core strategic priorities.

It is one of the most heart-wrenching decisions I have ever had to make in life. On the one hand, ONE has a strong balance sheet with a 9-digit war chest after todays new funding announcement. It puts us in the perfect position to continue aggressively building Asias largest global sports media property. On the other hand, these extraordinary times for the world require unusual prudence to protect our company and to ensure its longevity for many years to come. With the decision to sharpen our focus around core strategic priorities, ONE will undergo a 20% reduction in total worldwide headcount.

Josh Gross also spoke about the announcement, reporting that the layoffs go far beyond the 20% that ONE announced, with a figure closer to 50% - 60% of its workers, which includes all freelance contractors.

ONE spoke about COVID-19 and the economic crisis being the major reason for these layoffs. Like many companies, the MMA promotion has indeed been hit hard by the pandemic, and they havent hosted an event since February. That being said, their financial struggles date back years now.

As Bloody Elbow reported previously, documents that ONE themselves have filed with the Singapore government show massive losses that have increased each year. In 2018 alone, the company had losses of almost $59 million, with accumulated losses have amounted to a whopping $126 million.

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ONE Championship lays off sizable chunk of workforce to ensure its longevity - Bloody Elbow

Aunt Jemima, the long-standing brand that finally was put to rest this week, has slavery in its corporate DNA.

Nancy Green, who portrayed Aunt Jemima when the character was introduced at the Worlds Columbian Exposition in Chicago in 1893, was born into enslavement six decades earlier, on a plantation in Montgomery County, Ky.

By all accounts, Greens friendly personality made her a perfect corporate mascot, launching the Aunt Jemima name and commencing more than a century of dubious marketing. She was offered a lifetime contract to continue appearing as the character, the first of numerous Black women to play the part.

Aunt Jemima, along with Uncle Ben, who it was announced this week will also be getting the heave-ho, were not responsible for creating stereotypes. Bigotry isnt new.

But the indisputably racist brands, and their bewildering longevity, speak to the power of marketing in reinforcing offensive stereotypes.

Simply put, if corporate America hadnt given its full backing to creating and promoting these images as sales tools, making them both culturally legitimate and highly profitable, its debatable whether the countrys racial divisions would have run so deep for so long.

Theres very strong support for that premise, said Jerome Williams, a business professor at Rutgers University. Corporate America perpetuated this situation.

Judy Davis, a marketing professor at Eastern Michigan University, was even more emphatic.

Advertising and marketing play an important role in selling whiteness, she told me. They have played a role in perpetuating an image that whites are superior.

Williams related how, as a kid, his mom would serve Aunt Jemima pancakes or Uncle Bens rice, and the stereotypical branding never registered as overtly racist.

It was just part of the background noise, he said. I remember watching Amos and Andy on television and laughing along with the show.

In hindsight, he realizes how much cultural damage was being done.

They were very abhorrent images, Williams said. But like many African Americans, I just accepted this as the way the world was.

Thats now changing, hopefully forever, as America and other nations shine a harsh spotlight on racial mistreatment, inequality and insensitivity following the death of George Floyd and amid a resurgence of the Black Lives Matter movement.

Quaker Oats said Wednesday its retiring Aunt Jemima after more than 130 years of pitching the brand.

As we work to make progress toward racial equality through several initiatives, we also must take a hard look at our portfolio of brands and ensure they reflect our values and meet our consumers expectations, the Pepsi-owned company said in a statement.

Mars, owner of the Uncle Bens brand, quickly followed suit, declaring that the time has come to change the products brand identity.

Now is the right time to evolve the Uncle Bens brand, including its visual brand identity, which we will do, the company said. We dont yet know what the exact changes and timing will be, but we are evaluating all possibilities.

These are laudable moves. But its hard not to wonder if theyre less an an indication of corporate enlightenment and more an awareness that theres no longer money to be made perpetuating archaic and ugly stereotypes.

When it starts affecting corporate profits, thats when it starts having an impact, Williams said of criticism from consumers.

The Aunt Jemima brand has long reflected the values of a less-woke time. Case in point, a magazine ad from 1938 that depicted the white Jones family lamenting the sorry state of Moms pancakes.

And theres Aunt Jemima, in full Mammy regalia, standing in the window declaring, Dey sure needs me in dis house!

Marketing that way may not make people prejudiced. But it lends a corporate seal of approval to such thinking.

Branding is incredibly powerful. It can teach the world to sing and enjoy a bottle of Coke. And it can promote a smug sense of white superiority.

Once something is seen as normative, its typically not questioned and taken for granted, said Sonya Grier, a marketing professor at American University. Like fish in water. And this would allow such stereotypes to be perpetuated consciously or unconsciously in society.

Seeing Aunt Jemima on a box of pancake mix, she said, drives home the idea that a Black woman belongs in the kitchen as a servant or caretaker.

The lack of discussion, especially cross-race discussion of these issues traditionally, doesnt allow for the stereotypes to be challenged on a personal individual level, Grier said.

It goes even deeper than that.

While brands such as Aunt Jemima and Uncle Ben cant solely be blamed for systemic racism, by using these stereotypical icons to represent their brands they are giving credence to such stereotypes on a global platform, said Monique Bell, an associate professor of marketing at Fresno State.

Black people, and other underrepresented groups, already face implicit biases, and these representations only encourage prejudice and further dehumanization, she said.

Recently, its felt like every company under the sun has wanted to demonstrate its commitment to racial harmony and diversity.

Some of these declarations are undoubtedly sincere and aim to promote positive change. Others may be little more than me-too pandering.

Im a little skeptical, said Kevin Thomas, an assistant professor of multicultural branding and strategic communication at Marquette University. I believe its more of a calculation at this point on the part of marketers.

Well see.

If your company is committed to change, it cant just be about changing the symbolism, said Davis at Eastern Michigan University. Dropping certain names and imagery is a start, but theres a lot more companies can do.

It could take generations, in fact, for the influence of decades of racially questionable marketing to be undone.

Davis said that when she first heard the news about Aunt Jemima, she felt gratified. Then she made herself some pancakes.

They werent Aunt Jemima, but the connection was made.

Brands are mighty things. And they must not be tolerated when they do wrong.

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The Aunt Jemima and Uncle Ben brands marketed racism - Los Angeles Times

KEY POINTS

Plant-based diet plans like the Mediterranean diet reduceheart disease risk by nearly 20%, according to recent research.

The experts at the Harvard T.H. Chan School of Public Health reported that people who followed the Mediterranean diet, Greek and Italian cuisine-based fight-and plant-based meals, or other plant-based diets had a 14-21% lower risk for cardiovascular diseases, depending on how well they adhered to it.

Higher compliance with a healthy eating plan was linked to a 10-20% reduced risk of heart diseases, according to the researchers.

We found that following a variety of healthy eating patterns confers significant health benefits in reducing the risk of cardiovascular disease," Dr. Frank B. Hu, the study author, professor, and chair of the Department of Nutrition at Harvard T.H. Chan School of Public School told UPI.

These heart-healthy diets share common characteristics such as higher consumption of fruits, vegetables, whole grains, legumes and nuts, and lower consumption of red and processed meats and added sugar," Hu told UPI.

The Study:

The researchers tracked the heart health of 165,794 women and 43,338 men for nearly 32 years. None of them had any history of heart disease. They evaluated the effects of four different dietary approaches on heart disease risk using several measures of adherence including the following:

Key Findings:

The researchers highlighted the fact that there is no magic bullet diet to health and longevity and that there is no such thing called a magic diet solution. They recommend consuming a variety of healthy foods in flexible ways and follow a healthy eating pattern according to each persons health needs, food preferences, as well as, cultural traditions.

mediterranean diet for longevity Photo: aytalina - Pixabay

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Higher Compliance With Mediterranean And Plant-Based Diets Reduce Heart Disease Risk Up To 21% - International Business Times

Peripheral neuropathy is frequently seen in patients with Parkinsons disease (PD) and may increase the functional disability in these individuals. A review article published in Neurological Sciences discussed the etiology of peripheral neuropathy in the context of PD.

Previous studies have shown that peripheral neuropathy can adversely affect the lives of patients with PD. As limited data are available on small fiber neuropathy (SFN) and effective treatments for peripheral neuropathy in PD, the current review focused on the etiology, pathological mechanisms, subtypes, and management of the neurological problem in PD.

The exact pathogenic mechanism of neuropathy in PD is not entirely clear and there are many potential factors involved in the disease process, including medication, mitochondrial dysfunction, oxidative stress, and genetic susceptibility.

Diagnosis

The diagnosis is based on clinical findings along with nerve conduction studies and electromyography. As some neuropathies may present with normal findings on peripheral nerves testing, a thorough patient history is vital.

The initial investigation of peripheral neuropathy often includes glucose tolerance testing, fasting glucose levels, measurement of vitamin B12, methylmalonic acid (MMA), homocysteine (Hcy), and serum protein electrophoresis.

The diagnosis of SFN is commonly difficult to be made on the basis of peripheral nerve testing and clinical criteria are more important. Intraepidermal nerve fiber density in skin biopsy or analysis of quantitative sensory testing can help in establishing the diagnosis.

Additional tools that may aid in the diagnosis and severity assessment of SFN include autonomic testing utilizing a variety of reflex tests, intraepidermal electrical stimulation tests, corneal confocal microscopy, and microneurography.

Parkinson Disease Treatment and Neuropathy

Levodopa, the gold standard treatment for PD, may play an important role in the development of peripheral neuropathy . Long-term use of levodopa can lead to increased levels of Hcy and MMA which have been linked to neuropathy, as well as increased risk for cardiovascular diseases, neurodegenerative diseases, and neural tube defects. While many studies have pointed at B12 deficiency as the potential cause for levodopa-associated neuropathy, others suggested that folate deficiency is a more important cause.

As not all patients taking levodopa develop neuropathy, experts have suggested there may be a genetic susceptibility for the development of neuropathy in some patients. Potential candidate genes involved in PN with PD may be the parkin or MTHFR genes.

Levodopa-carbidopa intestinal gel (LCIG) are additional treatment options that were found to be associated with peripheral neuropathy. Studies have suggested a higher incidence of neuropathy in PD patients treated with duodopa or LCIG. While limited data exist on the risk for SFN, there are reports suggesting an association between LCIG treatment with neuropathy of small fibers.

Administration of catechol-O-methyltransferase (COMT) inhibitors may attenuate the levodopa-induced increase in plasma Hcy and MMA levels. However, due to the limited available data, more studies are required to better understand the efficacy of COMT inhibitors in preventing peripheral neuropathy.

Treatments of Peripheral Neuropathy

The data on treatment of peripheral neuropathy in PD remain limited and additional studies are needed to explore the benefits of cobalamin injections with folate supplements and COMT inhibitors, especially in levodopa-treated patients. Novel treatment options include electromagnetic and laser therapy.

At this point in time, COMT inhibitors, such as entacapone, are the main treatment options for peripheral neuropathy. One study has shown that the addition of COMT inhibitors may improve levodopa-associated neuropathy. However, as COMT inhibitors were not found to be effective against peripheral neuropathy secondary to causes other than levodopa exposure, other therapeutic options are needed.

Combination of vitamin B12 and methylcobalamin is recommended by some experts in the field and there are reports this may improve pain and paresthesia, but most of the data are based on studies in patients with diabetic neuropathy.

Several enzymes and genetic markers were suggested as therapeutic targets for peripheral neuropathy and have shown promising results. Furthermore, monoclonal antibodies may prove to be useful, as there are reports from patients with malignant tumors in which the combination of bendamustine-rituximab was found to alleviate immune-mediated neuropathies. Early reports have suggested a potential role for ultrasound guided vitamin B12 injections.

Future studies should investigate the toxic effects of elevated Hcy and MMA levels in patients with PD along with viable treatment options that include vitamin B12 and folate therapy. Large scale studies are required in order to understand the role and efficacy of COMT-Is along with other IPD interventions in [peripheral neuropathy], concluded the investigators.

Reference

Paul DA, Qureshi ARM, Rana AQ. Peripheral neuropathy in Parkinsons disease [published online May 1, 2020]. Neurol Sci. doi:10.1007/s10072-020-04407-4

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Therapeutic Options for Peripheral Neuropathy in Parkinson Disease - Neurology Advisor

Neuropathy Pain Treatment Market 2020 Industry increasing incidence of neuropathic pain caused by damage or disease affecting the somatosensory nervous system. Growing awareness among patients and increase in the demand for generic drugs boost the market growth. However, severe side effects of opioids and steroids and rising costs of branded drugs might hamper the market growth.

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Neuropathy Pain Treatment Marketreport offers a comprehensive insight into the development policies and plans in addition to manufacturing processes and cost structures. On the basis of product, this report displays the cost structure, sales revenue, sales volume, gross margin, market share and growth rate.

Report Covers Industry Segment by Manufacturers:

Report Covers Market Segment by Types:

Global Neuropathy Pain Treatment Industry 2020 Market Research Report is spread across 121 pages and provides exclusive vital statistics, data, information, trends and competitive landscape details in this niche sector.

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Report Covers Market Segment by Applications:

Key Benefits of the Report:

Target Audience:

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Research Methodology

The market is derived through extensive use of secondary, primary, in-house research followed by expert validation and third party perspective like analyst report of investment banks. The secondary research forms the base of our study where we conducted extensive data mining, referring to verified data sources such as white papers government and regulatory published materials, technical journals, trade magazines, and paid data sources.

For forecasting, regional demand & supply factor, investment, market dynamics including technical scenario, consumer behavior, and end use industry trends and dynamics, capacity Types, spending were taken into consideration.

We have assigned weights to these parameters and quantified their market impacts using the weighted average analysis to derive the expected market growth rate.

The market estimates and forecasts have been verified through exhaustive primary research with the

Key Industry Participants (KIPs) which typically include:

Table of Content

1 Executive Summary

2 Methodology And Market Scope

3 Neuropathy Pain Treatment Market Industry Outlook

4 Neuropathy Pain Treatment Market By End User

5 Neuropathy Pain Treatment Market Type

6 Neuropathy Pain Treatment Market Regional Outlook

7 Competitive Landscape

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COVID 19 Impact on Neuropathy Pain Treatment Market 2020 Industry Size, Share, Applications, Manufacturers and Forecasts to 2026 - Farmers Ledger