Festival organisers have confirmed that coronavirus, after a busy world tour, will be on the main stage at Reading and on pretty much everything else. Although it will be a short appearance, the impact of the concert could last a lifetime – which might be up to a few days.

Fans are looking forward to breathing in the atmosphere and then spending time in hospital. Known for their hit song ‘My Corona’, the band also does a series of Police covers; including ‘Every breath you take, Every sneeze you make’, ‘So Lonely, under House Quarantine’ and ‘Don’t stand so close me – really, Please Don’t.’

Said one excited fan of old-school influenza: ‘The great thing about seeing the band, is that you have wonderful sight-lines no matter where you are. In the portaloo, by the breakfast tent – COVID-19 is everywhere. It’s like you can reach out and touch it – without the hand gel. It’s like your own personal concert, with non-stop vomiting and diahorrea– a bit like when Oasis played’.

Coronavirus’ set is usually followed by a standing ovation and then three weeks lying in bed. For those who cannot afford to get tickets, not worry, COVID-19 is coming soon to an arena/bedroom near you.

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Sometimes, the most valuable thing you need on your journey to a healthy lifestyle is some guidance and motivation. Luckily, some user-friendly apps and gadgets can help you achieve your fitness goals in 2024.

The following devices are some of the newer products health enthusiasts are raving about this year. They are designed to track your progress, help you recover, keep you up to date on trends, and inform you about proper healthy habits. How many of these tools are you going to check out or add to your gym bag?

1. Lumen Metabolism Tracker

Lumen Metabolism TrackerLumen Metabolism Tracker
Image Credit: Metaflow LTD.

The Lumen metabolism tracker allows users to blow into a sensor, which tracks the carbon dioxide concentration in their breath. This indicates whether their body is burning fat or carbohydrates. From there, it breaks down a daily nutritional plan to give you the optimal time to eat or fast. It can tell you if you are fasting too long and no longer burning fat or if you are comfortably shedding weight. If you have a goal of slimming down this year, this ground-breaking technology could be your answer.

2. Apollo Neuro Stress Relief Band

Apollo Neuro Stress Relief BandApollo Neuro Stress Relief Band
Image Credit: Apollo Neuroscience, Inc.

The Apollo Neuro bracelet wraps around your wrist. It uses scientifically proven touch therapy to send tiny vibrations through your body. The goal is to calm your nervous system and improve your body’s reaction to stress triggers. Users have reported better quality of sleep, heightened focus, and lower levels of anxiety.

The device only needs to be worn when your body needs it. When you need to relax and unwind, this device is ideal for naturally training your body to deal with stress.

3. Fitbit Aria Air Scale

Image Credit: Google LLC.

This smart scale syncs with your smartphone and tracks body weight and BMI while analyzing the data. It works with any Fitbit smartwatch and helps users gather more comprehensive data and trends about their health, workout routines, lifestyle, and body weight.

The scale can connect to multiple users to create a support system for people taking charge of their health. For as little as $40, this gadget is a must-have for fitness enthusiasts.

4. Molekule Air Purifier

Molekule Air PurifierMolekule Air Purifier
Image Credit: Molekule.

Whether you suffer from allergies or want to breathe the freshest air possible, this home air purifier is a life changer. The Molecule Air Purifier can easily and automatically clean the air in a room as big as 600 square feet.

The device comes with two separate filters. The first filter traps bigger particles like dust and pet hair, while the second breaks down pollutants at a molecular level. Bacteria, mold, viruses, allergens, and other contaminants don’t stand a chance of breaking through the proprietary light-activated catalyst technology this purifier boasts.

The device can be controlled by an app, sits quietly in the corner, and provides endless amounts of healthy air for you and your family.

5. MUSE S: The Brain Sensing Headband

Image Credit: Muse.

Studies have proven that regular meditation can reduce stress, improve sleep quality, fight addiction, and lower blood pressure. The MUSE S is determined to make your meditation sessions that much better by tracking and analyzing your body’s measurements.

Worn across the user’s forehead, the MUSE S measures heart rate, breathing, subtle body movements, and brain waves. The MUSE app provides biofeedback in real-time. Users can also use the device to track sleep habits, assist in guided meditation, and perform breathing exercises.

6. Noom Weight Loss App

Noom Weight Loss AppNoom Weight Loss App
Image Credit: Noom, Inc.

I’m sure some of you have seen the commercials for the weight loss app Noom. The brand’s approach to weight loss includes science and personalized programs to lose weight permanently. They believe in teaching their clients how to cope with their relationship with food, be conscious of their habits, and instill healthy lifestyle knowledge.

Daily lessons promote the company’s core beliefs. They want you to lose weight and understand why you are losing it. Food trackers and exercise logs are included to keep you consistent and on track to a healthier body.

A four-month subscription costs only $149, making it a fantastic resource for users looking to shed some pounds before summer.

7. Oral-B iO Series 9 Toothbrush

Oral-B iO Series 9 ToothbrushOral-B iO Series 9 Toothbrush
Image Credit: Procter & Gamble.

It seems like every gadget we use daily is getting upgraded to a smarter version. This smart technology automatic toothbrush is designed to keep our teeth clean, kill bad breath, and brighten our smiles. The toothbrush pairs with the mobile app and assures the user that it hits 100% of their mouth with the proper pressure and length of time. The device will also inform you when to replace the brush head for optimal oral care.

8. Dr. Relief Acupressure Mat

Dr. Relief Acupressure MatDr. Relief Acupressure Mat
Image Credit: Dr. Relief.

I have personally never tried acupuncture, but many fitness experts swear by the results of this ancient Chinese medicine. Studies have shown that the practice of acupuncture can improve sleep, erase migraines, improve mental health, and temper chronic pain. Still, for some, the thought of needles in our bodies is beyond scary.

That is where this Dr. Relief mat comes in. It is thought to mimic the results without using those terrifying needles. The mat has a comfortable headrest that allows you to lie down for a full-body, acupuncture-like experience.

9. TheraGun Percussion Massager

Image Credit: Therabody, Inc.

If you ask any personal trainer or fitness expert, they will tell you that recovery is just as important as the actual workout. Tired muscles need time to recover and grow before training again, and failure to do so can risk serious injury. Massages can be the ideal recovery tool for a sore body but can be expensive. The TheraGun percussion massager lets you get quality massages at home quickly and easily.

The machine provides various speeds and pressures and effectively works out knots and target spots. Its compact design makes it portable, so you can use it at home, in the office, or on vacation.

10. Oura Ring

Oura RingOura Ring
Image Credit: Ōura Health Oy.

The fashionable Oura Ring has built-in sensors to track and collect data 24 hours a day. It is quickly becoming one of the more advanced fitness trackers on the market. The third-generation Oura can successfully track sleep patterns, heart rate, body temperature, blood oxygen level, steps, distance traveled, calories burned, and downtime. The ring can also alert you if you are getting sick, experiencing high levels of stress, or need more sleep.

You might think a resource like this would cost a fortune. Nope. The ring has a price tag of $299, making it a great option for fitness fanatics or people looking to better understand their bodies.

11. QardioArm Wireless Smart Blood Pressure Monitor

QardioArm Wireless Smart Blood Pressure MonitorQardioArm Wireless Smart Blood Pressure Monitor
Image Credit: Qardio, Inc.

This QardioArm monitor takes the difficulty out of monitoring your blood pressure. The device wraps around your upper arm and instantly connects with your smartphone, making it super simple to send analyzed data to your medical provider.

The QardioArm is designed to measure systolic and diastolic blood pressure levels and irregular heartbeat. You can set reminders, geo-tracking, and a relaxation mode. It is compact and portable with a rechargeable battery, making it one of the most convenient blood pressure monitors on the market.

12. Fitbit Sense 2 Fitness & Health Tracker

Image Credit: Google LLC.

Fitbit has continued to make high-quality fitness trackers, and the newest Sense 2 is no different. Not only is the futuristic case stylish and cool, but the technology has grown to help us store our fitness habits even better.

The watch is capable of tracking many bodily functions. It monitors heart rate, calories burned, steps, distance, elevation gain, and health trends. You can set the watch to different workout modes, rate your quality of sleep, and alert you to irregular heartbeats that could be a cause of an underlying health factor. All in all, this gadget is an amazing tool to have if you want to be informed of your body’s actions at all times.

14. Apple Fitness +

Apple Fitness +Apple Fitness +
Image Credit: Apple, Inc.

Since the pandemic hit, people have preferred at-home workouts over gym memberships. Naturally, more options for home workouts have become available. One of the most popular apps for a quality home workout is Apple Fitness +.

For only $10 a month, Apple Fitness + will help you achieve your goals. You can choose from various workouts, up to 45 minutes long, taught by actual fitness professionals. Your results are tracked in the app, making it easy to stay consistent and track your actions.

No more crowded gym floors or influencers hogging the equipment. Bring the gym to you or wherever you travel with the Apple Fitness + app.

15. Tonal Mirror

Image Credit: Tonal.

It is hard to replicate lifting heavy weights and bars as you would in a gym, but the Tonal Mirror resistance technology is as close as you can get. The all-in-one workout machine comes with a wall-mounted screen that provides personalized coaching and fitness tracking. The equipment can hit all muscle groups and provide lifts like bench presses, squats, curls, and deadlifts.

The device can be a little pricey. At $3,000, it is a commitment, but over the course of a few years, the money saved on gym fees will pay for itself.


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Displaced Palestinians in a makeshift refugee camp in Gaza. (Photo: Abdallah Aljamal, Palestine Chronicle)

By Abdallah Aljamal – Gaza

“We have no alternative for cooking food but to light fires. Our hands have turned black and burnt, and so have our faces”.

The Government Media Office in the Gaza Strip has announced that diseases and health complications such as chest pain, breathing difficulties, respiratory illnesses, and asthma have spread across the region due to the lack of cooking gas, which forces residents to rely on open fires for cooking.

Along with a genocidal war, which has killed and wounded well over 110,000 Palestinians in Gaza, Israel has also imposed a complete siege on the enclave.

“There will be no electricity, no food, no fuel, everything is closed,” Israeli Defense Minister Yoav Gallant said on October 9. Since that moment, only a very limited quantity of aid has entered Gaza, leading to a catastrophic humanitarian situation. 

The Palestine Chronicle spoke with three residents from Gaza, who talked about the hardship they have been enduring during the last seven months.

Secrets by the Sea – Gaza Survivors Seek Respite from Israeli Bombs, Heat and Tents

Our Faces are Burnt 

“We have been out of cooking gas in my house since the first month of the war, and there is no cooking gas in Gaza City to refill our cylinders,” Hajj Abu Mahmoud Shhaiber told The Palestine Chronicle. 

“I have searched everywhere, but there is no gas available, and the occupation prevents its entry into the north of the Gaza Strip,” he added.

Therefore, for the last seven months, the Shhaiber family has been forced to cook our food on firewood. This, however, has caused us significant health complications.

“My wife, my daughters who help us with cooking and myself, we all suffer from chest pain, respiratory issues, and breathing difficulties,” he told us, explaining that the problem is exacerbated by the fact that there is no medicine in Gaza City, and that all health centers and hospitals have been destroyed or shut down. 

‘Domicide’ – How and Why Israel Destroyed the Al-Sahli Towers in Gaza’s Nuseirat Refugee Camp

“We have no alternative for cooking food but to light fires. Our hands have turned black and burnt, and so have our faces,” Shhaiber continued. 

“I always feel short of breath, and I am constantly coughing and wheezing, but unfortunately, we have no alternative, due to the Israeli siege.”

No Other Option

“I still live with my children in the Northern Governorate. My home and my family’s home were destroyed, but we live in displacement centers,” Rond al-Masri told us. 

“I lost my gas cylinders during the bombing of my house, and I don’t have a stove or gas for cooking. Therefore, I have to rely on canned food when it’s available to feed my children,” she continued. 

Rond told us that they are forced to light fires to prepare food.

“There is no other option available to us, and there is no alternative to cooking gas but to light fires. Throughout the day, my children search for wood and cardboard for us, and if available, we light a fire and prepare food,” Rond said.

‘My Life is Sad’ – Palestine Chronicle Children’s Press Conference in Gaza

Rond’s children got sick and the woman explained that this is due to a combination of factors. 

“They have fallen ill due to poor hygiene, and from spending long hours under the sun searching for food. Moreover, exposure to carbon monoxide from the fires and the smoke they constantly inhale have caused us respiratory diseases,” the woman said, desperately.

“In northern Gaza, there are no hospitals or clinics to obtain medication . I can only heat some water for my children to drink and alleviate chest and respiratory pains,” Rond said. 

‘Immediate Actions’ 

According to another resident, Muatasim Jabr, this is part of Israel’s deliberate policy to kill Palestinians in every way possible. 

“They kill us by bombing and gunfire, but death by hunger is the most painful and agonizing. Killing through disease by spreading respiratory illnesses in the absence of treatment is also incredibly painful and deadly,” he said.

“Many respiratory diseases require oxygen, and the occupation destroyed the central oxygen room at Al-Shifa Hospital,” Jabr explained, adding that now there is only a small oxygen room at the Kamal Adwan Hospital, in the Jabaliya refugee camp.

‘Dizzy, Tired, Exhausted’ – How Palestinians in Gaza Speak about the Widespread Famine

“Unfortunately, it is insufficient to cover the thousands of cases in need of oxygen due to bombings, killings, and the spread of diseases,” the main said.

Jabr called on international institutions, the United States, Arab countries, and European countries to pressure the occupation to stop the war and to provide the basic needs for the residents of the Gaza Strip. 

“We need immediate action to save Gaza from the environmental, health, and humanitarian disasters caused by the occupation during this war”.

(The Palestine Chronicle)

Abdallah Aljamal is a Gaza-based journalist. He is a correspondent for The Palestine Chronicle in the Gaza Strip. His email is [email protected]

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 (Getty/iStockphoto)

(Getty/iStockphoto)

Ever since the British government ended all legal Covid-19 restrictions earlier this year, cases numbers have continued to fluctuate.

Even as former prime minister Boris Johnson published his Living with Covid plan in February, ending mandatory masks, social distancing and self-isolation measures, the arrival of the contagious Omicron BA.2 sub-variant quickly drove the infection rate up before it fell away in spring, a pattern of ebb and flow that has continued ever since.

While lockdowns and tiers may now seem a distant memory, the virus is very much still with us. Cases have begun to rise again, with warnings that Covid will once again put pressure on the NHS this winter.

The Living with Covid plan brought an end to the legal requirement for employees to tell their employers when they have tested positive for the virus and need to self-isolate. But with the threat from Covid still very real, is going to work when sick really such a good idea?

Can I go to work with Covid?

Yes, you can go to work even after testing positive for Covid and there is no legal obligation to tell your employer if you are infected.

However, workers are encouraged to follow the government’s guidance for people who become infected with the virus and self-isolate for seven days.

Do I have to test for Covid before going to work?

No, you don’t have to test for Covid before going anywhere, including to work.

Most people in England are no longer advised to get tested and can no longer get free lateral flow tests from the NHS unless you are one of a small number of people who are eligible.

Those who want to get tested must buy a Covid-19 test from pharmacies and other retailers.

What should I do if I feel unwell?

The government has set out guidance for people who have symptoms of a respiratory infection but have not taken a test for Covid-19, as well as for those who have taken a test and received a positive result.

Symptoms of common respiratory infections and Covid-19 include a continuous cough; high temperature or fever; loss of, or change in normal sense of taste or smell; shortness of breath; lack of energy; lack of appetite; headache; sore throat and stuffy or runny nose.

According to the Department for Health and Social Care, you should work from home if you can and avoid contact with other people if you are experiencing these symptoms.

It is especially important to avoid close contact with anyone you know who may be at higher risk of becoming seriously sick if they catch Covid-19.

If you must leave your home, you should wear a face covering and avoid crowded or poorly ventilated places.

If you receive a positive Covid-19 test, you are also advised to stay at home and avoid contact with other people for five days after the day you took your test.

However, you should avoid meeting people at higher risk of serious illness from Covid-19 for 10 days after the day you took your test.

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Jan Hanson Ma President Aafa New England

Jan Hanson

BY JAN HANSON

Granite Staters need relief from the high cost of prescription drugs. SB 555, a bipartisan bill, sponsored by Sen. Kevin Avard, recently passed the Senate 19-4 and is now making its way to the House, which will help provide important savings to patients at the pharmacy counter.

High drug costs are a burden for many Americans, but they are especially burdensome for people with a chronic disease that requires long-term treatment with medications. For example, consider asthma which affects 27 million people in the United States. Asthma is a chronic disease, which causes the airways to narrow and become inflamed, which can make breathing very difficult. Symptoms include shortness of breath, coughing, wheezing and chest tightness (pain).

Asthma patients may also be affected by workplace and school environments that have irritants and other common triggers such as pollen, certain gases, dust mites and smoke. Asthma episodes affect job performance, school performance and lead to emergency department visits and hospitalizations. Asthma can’t be cured, but it can be managed, including with prescribed medications that help prevent symptoms. When a patient is prescribed a medicine to treat asthma, it is critical that the medication is affordable. Unfortunately, issues in our health care system often make medicines too expensive and unaffordable.

Drugmakers set the initial price for medicines, and while they must do better at keeping those prices low, they don’t decide what is being paid at the pharmacy. That responsibility lies with middlemen, known as pharmacy benefit managers, or PBMs. These intermediaries work for insurance companies and decide what medicines are covered by insurance and how much people pay out of pocket. Just three PBMs control 80% of this market, and either own or are owned by the largest insurance companies.

PBMs negotiate with drugmakers and extract rebates that lower the price of medicines. Rebates collected by PBMs aren’t shared directly with patients. If you have a deductible or pay coinsurance (a percentage of the drug’s cost), your out-of-pocket expenses are based on the full price of that medicine. The insurance company and PBMs often retain a significant rebate. While rebates can reduce the price of medicines by half or more, these cost-savings are not always fully passed on to the consumers of prescription drugs.

SB 555, a bill being considered by the state legislature, would help improve this system. This bill would require that 50% of all rebates be passed along to patients through lower costs at the pharmacy. It would also improve transparency by strengthening reporting requirements around the total number and value of rebates health insurers and PBMs collect.

Other states, such as West Virginia and Arkansas, have tackled high drug costs with a similar approach. The results of these changes are in: People are paying less, and there has been no impact on the cost of insurance premiums. It’s a win-win for patients and families.

When managing a chronic disease that requires treatment with prescription medicine, the last thing anyone should worry about is whether they can afford their medicine. SB 555 would require that savings in the system go to the patients who need them and would bring meaningful relief to patients with asthma and other chronic diseases so that better health outcomes are achieved.

Jan Hanson is president of the Asthma and Allergy Foundation of America, New England Chapter.



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Respiratory ailments never bothered my husband, Randy, or me in Fort Worth, Texas, where we grew up. Columbia, South Carolina, our destination in 1985, was wretchedly muggy but didn’t prompt any allergy issues, either.

In the early 1990s, we moved to Lenoir, North Carolina, where furniture factories thrived. That would’ve been fine had our son, Matthew, not attended an elementary school smack-dab in the middle of prolific pollution. His allergy symptoms gradually worsened over the next few years until one night, his breathing struggles landed us in the emergency room for an asthma diagnosis. An inhaler was prescribed.

Asthma was quite prevalent in Lenoir, so sure enough, not long after our daughter, Katie, entered kindergarten at the same school, she snagged an inhaler of her own.

In the middle of the following school year, with Matthew in fourth grade and Katie in first, we moved to the North Carolina mountains. The myriad adjustments kept life lively: a blizzard, flying squirrels in the house, salamanders in our drinking water, and a single bathroom with a temperamental toilet, for starters.

It didn’t take long to recognize the most exciting revelation: The clear air in our new rural area apparently rendered inhalers unnecessary. I was elated that respiratory issues were history!

But I was wrong.

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SMA’s destructive nature

Our third baby, Jeffrey, delivered a few surprises to us, starting with the positive pregnancy test. His arrival on May 18, 1997, came two weeks ahead of schedule. He was such an exceptionally contented, quiet baby that I jokingly wondered if we’d be making up for it during his teen years.

We didn’t get the opportunity to find out. A diagnosis of spinal muscular atrophy (SMA) gobsmacked us eight weeks after Jeffrey’s arrival. Life for the next three and a half months was spent in survival mode, both for him and for us.

A newborn baby lies in a bed, sleeping.

Baby Jeffrey Baldwin in 1997. (Photo by Helen Baldwin)

Although SMA packs a potent punch, it was the respiratory struggles that left me limp. Seared into my memory are images of the panic in Jeffrey’s eyes during an impromptu, ill-fated In-Exsufflator trial and as SMA’s progression wreaked unforgiving havoc on his ability to breathe.

Jeffrey wrangled free from SMA’s deadly clutches before he reached six months. Witnessing your child’s final breath is devastatingly surreal. It isn’t normal in the scheme of things. However, neither is pumping your baby full of morphine, suctioning secretions every few minutes, and praying for God to take him.

As we adjusted to the unthinkable, our heavy hearts relied on reminders that Jeffrey was in the perfect place, safe from harm.

Incredibly, our family remained fairly and uneventfully upright for years.

Gasping for air

Years after our SMA assignment ended, I awoke one morning gasping for air. It was promptly deemed an emergency. I was treated in a hospital emergency room for reactive airway disease and given several prescriptions, including a pearl that would paralyze my throat if I bit down on it. I didn’t.

Since the ER folks couldn’t tell what had happened, I racked my brain until I hit upon a plausible culprit. Our old farmhouse doesn’t have air conditioning, so unless there’s a monsoon, the windows generally remain open from spring until fall. My computer is situated in front of a tall window on the side of the house mere yards from a small creek. The property on the other side of the creek tends to be untamed, as they say.

During a particularly chaotic schedule, Randy and I had hired someone to mow and cut weeds. It happened to be unusually dry at the time. Because our yard person mowed and used a Weed Eater with abandon, it was likely that the dry stuff being churned up and spit out in the direction of my window — and my lungs — included poison ivy, poison oak, and other irritants. It made sense that I’d likely breathed dust from pulverized poison ivy — an unfortunate event because now I know what to do next time.

Thankfully, next time didn’t come, and breathing issues became a moot point.

And then came James.

Battling different breathing challenges

A newborn baby lies in a bed sleeping.

Our grandson, James Baldwin, in 2018. (Photo by Helen Baldwin)

Randy and I are PopPop and MomMom to two delightful grandchildren, Clara and James. Clara’s diagnosis of Beckwith-Wiedemann syndrome caught us off guard. Her case is mild, and we breathed a sigh of relief when it seemed a certainty that James wouldn’t follow suit.

At 14 months, though, James experienced such a horrific case of croup that he was admitted to a local hospital. Within hours of dismissal, he was on his way to a more sophisticated hospital for additional treatment. Seeing Matthew and our daughter-in-law, Jill, being utterly exhausted while driving off with a very sick little James unleashed a few memories, especially since their destination was Brenner Children’s Hospital in Winston-Salem, North Carolina, where Jeffrey was diagnosed.

Today, James, 6, still experiences occasional respiratory issues that are significant. The doctor expects him to outgrow them, but until then, I’m confident that his angel “twin” will be breathing right along with him.

Because he can.


Note: SMA News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of SMA News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to spinal muscular atrophy.

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Inspired by the medical bay of the USS Enterprise from “Star Trek”, a research team from the University of Waterloo uses radar technology to monitor people’s health while at the wheel, turning an ordinary car or truck into a mobile medical hub. 

Dr. George Shaker, an adjunct professor in the Department of Electrical and Computer Engineering at the University of Waterloo, is working with a team of graduate students to integrate radar with evolving vehicle technology to make health checks easier. The idea is to use the time people spend in their cars to gather data on their health for accurate analysis and proactive treatment — without the need for any type of wearable.

The radar, smaller than a USB thumb drive, is integrated into the vehicle cabin and sends out signals that detect human vibrations, which are then sent back to the radar. The built-in AI system collects and analyzes the data to build a medical picture and identify any potential conditions. At the end of the driver’s commute, the system sends the report directly to their cell phone for review.

“This radar technology is not new,” Shaker said. “Our first demos using radars for in-cabin sensing were developed back in 2017 for infotainment touchless control and to alert people to children and pets left alone in parked vehicles. This application, using the technology to monitor vehicle occupants’ health, is a step towards achieving our vision of cars as medical hubs of the future. 

The technology, which is the latest from Waterloo aimed at disrupting the boundaries of health, can detect tiny movements like the rise and fall of a chest from breathing or heartbeats. For Shaker and his team, the challenge was evolving the tech to identify changes in breathing patterns or heart rhythms that signify potential health issues related to cardiovascular conditions like Tachycardia and Bradycardia as well as respiratory system conditions like Tachypnea, Bradypnea and Apnea.

“We focused on enhancing data extraction for exact information related to people’s respiratory and cardiovascular systems and teaching the AI how to make medical interpretations from this data. Another important consideration was personal privacy and security — no data is stored on the cloud; it is sent to the monitored person’s cellphone only,” said Ali Gharamohammadi, the lead PhD student on the project.

A series of tests using synthetic data, i.e. subjects mimicked respiratory conditions’ symptoms by holding their breath and taking shallow breaths, validated the system’s capability for accurately detecting and interpreting respiratory conditions. The system has also been tested on individuals with heart conditions which it successfully detected and accurately identified. 

The research team is building on this work to expand the radar technology’s capabilities to monitor all vehicle occupants’ overall health and well-being, run diagnostics and generate quality medical reports that flag any issues that need attention, as well as assist with emergency communication in the event of an accident. 

More information about this work can be found in the research paper, “Multibin Breathing Pattern Estimation by Radar Fusion for Enhanced Driver Monitoring”, recently published in IEEE Transactions on Instrumentation and Measurement. 

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

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Asthma Inhaler Device Market

Asthma Inhaler Device Market

Market Overview

Based on the research findings, the Asthma Inhaler Device Market is anticipated to grow at a Compound Annual Growth Rate (CAGR) of 6.42% throughout the forecast period, reaching a revenue of USD 19,677.54 million by the end of 2030.

Asthma, a chronic lung condition, causes inflammation and narrowing of the airways, leading to symptoms such as coughing, chest tightness, difficulty breathing, and shortness of breath. Asthma inhaler devices, handheld devices, are crucial in managing these breathing difficulties by delivering medication directly to the airways, thereby treating or preventing associated diseases.

The report comprehensively covers the driving factors fueling market growth, shedding light on key players and their strategies to navigate the competitive landscape of the Asthma Inhaler Device Market. Furthermore, the report addresses the post-COVID-19 scenario of the market and provides insights into market segmentation and regional analysis.

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Market dynamics

Drivers:

The Asthma Inhaler Device Market is poised for growth during the forecast period, primarily driven by the increasing prevalence of asthma worldwide. Rising cases of asthma, particularly among children, coupled with growing awareness among the general population, are fueling the demand for metered dose inhalers and other asthma inhaler devices. This surge in demand, alongside heightened awareness of asthma-related issues, is a key factor propelling market growth.

Opportunities:

The Asthma Inhaler Device Market presents numerous opportunities, with many prominent key players investing significantly in research and development activities. These investments, coupled with new product launches and collaborations among market players, are expected to create a multitude of opportunities within the market. Collaborative efforts and innovative product introductions not only enhance the competitiveness of the market but also expand the range of options available for asthma management, thereby driving growth and meeting the evolving needs of patients.

Competitive landscape

Major key players

GlaxoSmithKline plc (UK)

Koninklijke Philips NV (Netherlands)

AstraZeneca (UK)

Cipla Inc. (India)

Boehringer Ingelheim International GmbH (Germany)

Beximco Pharmaceuticals Ltd (Bangladesh)

Merck & Co., Inc. (the US)

Teva Pharmaceutical Industries Ltd (Israel)

Chiesi Farmaceutici SpA (Italy)

Medisol Lifescience Pvt. Ltd (India).

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Segmental Analysis:

The Asthma Inhaler Device Market offers a variety of inhaler options, including metered dose inhalers, dry powder inhalers, and soft mist inhalers. These inhaler devices come in both digitally and manually operated forms, catering to various preferences and needs. The market serves hospitals & clinics, homecare settings, and other end users.

Detailed Regional Analysis:

North America:Currently dominates the asthma inhaler device market due to the increasing prevalence of asthma, demand for cutting-edge technologies, and the popularity of metered-dose inhalers in the region. The region’s robust healthcare system, easy access to medical care, and substantial disposable income contribute to market growth. Government support and funding for innovative asthma monitoring devices further drive market growth.

Asia Pacific:Expected to witness rapid growth during the forecast period, attributed to the rising prevalence of asthma and respiratory diseases, improvements in the healthcare system, and increased awareness regarding asthma symptom tracking and monitoring benefits. Countries like China, India, and South Korea, with rapidly growing economies and high asthma prevalence, are driving market expansion.

Europe:Anticipated to be the second-largest market, driven by healthcare authorities’ initiatives to increase asthma awareness and improve asthma management.

Browse In-depth Market Research Report (124 Pages) on Asthma Inhaler Device: www.marketresearchfuture.com/reports/asthma-inhaler-device-market-1653

Competitive Analysis:

Innovation is expected to play a crucial role in the success of companies in the asthma inhaler device market. Factors such as the growing elderly population, increased awareness of respiratory disorders, rising disposable income, research and development efforts, and healthcare cost inflation positively impact market growth. Better distribution and commerce policies are expected to further boost market expansion. Mergers and acquisitions are likely to increase, with government organizations playing a crucial role in market growth. The market is poised for significant expansion in the coming years, driven by high asthma-related mortality rates and increased expenditures on asthma treatment. The presence of key market players and advancements in product technologies also contribute to market growth.

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Getting Started

  • Find a quiet place to sit comfortably upright—at the edge of your bed, on the floor, or in a chair
  • Close your eyes and tune into the breath or another point of focus to be fully present
  • Relax your body—loosen your shoulders, unclench your jaw, and soften your brows

Mindful Meditation for Calm Breathing Practice

If you take away anything from this meditation series, let it be the 4-7-8 breathing technique outlined in this video. This technique can work in a pinch whenever you’re feeling anxious, experiencing overwhelming emotions, or looking to wind down and relax before bed in less than five minutes.

The 4-7-8 breathing method activates your parasympathetic nervous system, AKA the system responsible for relaxation. This calms down the sympathetic nervous system that’s responsible for the opposite response: the stress/fight-or-flight response.

Here’s how:

  • Close your mouth and then inhale for a count of four through your nose.
  • Now, count to seven as you hold your breath.
  • Exhale through your mouth audibly for a count of eight. Make sure to exhale fully as if you’re a balloon that has completely deflated.
  • Repeat the cycle 4-8 times as often as you’d like each day to reap the benefits.

This meditation is also a part of Verywell Mind’s 30-day meditation email series, Pause & Play. Sign up here to subscribe and continue your mindfulness journey with us. For more videos, check out our meditation library.

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Getting Started

  • Find a quiet place to sit comfortably upright—at the edge of your bed, on the floor, or in a chair
  • Close your eyes and tune into the breath or another point of focus to be fully present
  • Relax your body—loosen your shoulders, unclench your jaw, and soften your brows

Mindful Meditation to Find Your Most Energetic Breath

When we think of meditation, we generally view it as a calming practice; one associated with relieving stress, feeling more at ease, evoking a sense of relaxation and mindfulness. And yes, while it does cultivate all those cozy, low-key feelings, it can also boost your energy, even if you don’t feel like you’re doing much in the moment.

The secret is diaphragmatic breathing, also known as abdominal or belly breathing. As you breathe in deeply, the amount of oxygen delivered to your body gets picked up by your blood cells to make the energy your cells need to get the blood flowing. Get your healthy dose of chill and alertness through this diaphragmatic breathing meditation.

This meditation is also a part of Verywell Mind’s 30-day meditation email series, Pause & Play. Sign up here to subscribe and continue your mindfulness journey with us. For more videos, check out our meditation library.

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  • Announces next-generation COVID-19 vaccine candidate as fourth respiratory vaccine to successfully meet its Phase 3 endpoints
  • Expects two more Phase 3 readouts in 2024, including combination vaccine against flu and COVID-19, and vaccine against CMV
  • Announces positive clinical trial data from three new vaccines against viruses that cause significant burden (Epstein-Barr virus, Varicella-Zoster virus, norovirus) and advances programs toward Phase 3 development
  • Anticipates U.S. launch of vaccine against RSV following FDA approval and ACIP recommendation in 2024
  • Announces development and commercialization funding agreement with Blackstone Life Sciences for up to $750 million to advance flu program

CAMBRIDGE, MA / ACCESSWIRE / March 27, 2024 / Moderna, Inc. (NASDAQ:MRNA) today announced at its fifth Vaccines Day event clinical and program updates demonstrating advancement and acceleration of its mRNA pipeline. The updates include data readouts in the Company’s respiratory and latent and other vaccine portfolios, as well as commercial, manufacturing and financial announcements for its vaccines business.

“Our mRNA platform continues a remarkable track record across our broad vaccine portfolio. Today, we are excited to share that four vaccines in our pipeline have achieved successful clinical readouts across our respiratory, latent and other virus franchises,” said Stéphane Bancel, Chief Executive Officer of Moderna. “With five vaccines in Phase 3, and three more moving toward Phase 3, we have built a very large and diverse portfolio addressing significant unmet medical needs. We are focused on execution to further build momentum across our pipeline and business, and to deliver for patients who are impacted by these infectious diseases.”

Portfolio Overview

The vaccine portfolio seeks to address infectious diseases that cause considerable health burdens and includes 28 vaccines addressing respiratory, latent and other pathogens.

Latent and Other Vaccine Portfolio

Moderna is advancing five vaccine candidates against viruses that cause latent infections, all of which are in clinical trials. When latent, a virus is present in the body but exists in a resting state, typically without causing any noticeable symptoms. Latent viruses can reactivate and cause clinical symptoms as a person ages, during times of stress or when immunity is compromised. The capacity for latency is a defining feature of members of the Herpesviridae family, including cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus (HSV) and Varicella-Zoster virus (VZV).

Cytomegalovirus (CMV)

CMV is the most common infectious cause of birth defects in the U.S. and is responsible for several billion dollars in annual healthcare costs. One in 200 babies in the U.S. are born with a congenital CMV infection, and of those affected, one in five will have severe, life-altering health problems. Possible short- and long-term sequelae of CMV infection include microcephaly, chorioretinitis, seizures, sensorineural hearing loss, cognitive impairment and cerebral palsy. There is currently no approved vaccine to prevent congenital CMV.

CMVictory is a pivotal Phase 3 trial evaluating mRNA-1647 against primary CMV infection in women 16 to 40 years of age. The trial is a randomized, observer-blind, placebo-controlled study designed to evaluate the efficacy, safety and immunogenicity of mRNA-1647. The trial is fully enrolled with approximately 7,300 participants from 290 clinical sites globally.

To date, 50 primary infection cases have accrued and are undergoing confirmation. The first interim analysis for the evaluation of vaccine efficacy, which will be triggered when both 81 confirmed per-protocol cases and 12 median months of safety follow-up have occurred, is expected as early as the end of 2024.

Moderna’s CMV vaccine candidate mRNA-1647 has advanced to indication expansion studies in adolescents 9 to 15 years of age and adult transplant patients, both of which have begun enrollment.

Epstein-Barr virus (EBV)

EBV is a major cause of infectious mononucleosis (IM) in the U.S., accounting for more than 90% of IM cases annually. Importantly, EBV and IM are associated with a higher lifetime risk of more serious sequelae including certain cancers such as gastric carcinoma, nasopharyngeal carcinoma and multiple types of lymphoma. The lifetime risk of developing multiple sclerosis (MS) is increased by 32-fold after EBV infection. There is currently no approved vaccine to prevent EBV.

Moderna’s EBV vaccine candidates are designed to tackle multiple EBV-associated conditions, including prevention of IM (mRNA-1189) and MS and post-transplant lymphoproliferative disorder, a subcategory of lymphoma in solid organ transplant patients (mRNA-1195). The Phase 1 trial for mRNA-1189 was designed to test the safety, reactogenicity and immunogenicity of four different dose levels in participants 12 to 30 years of age in the U.S. The randomized, observer-blind, placebo-controlled study showed mRNA-1189 was immunogenic and generally well tolerated across all dose levels. The Company is advancing mRNA-1189 toward a pivotal Phase 3 trial.

The Phase 1 trial for mRNA-1195 was designed to test the safety, reactogenicity and immunogenicity of two drug products at four different dose levels in healthy EBV seropositive participants 18 to 55 years of age in the U.S. The randomized, observer-blind, placebo-controlled study is fully enrolled.

Herpes simplex virus (HSV)

Herpes simplex virus type 2 (HSV-2) infects approximately 13% of adults globally and is the primary cause of genital herpes. There are an estimated four billion people globally infected with HSV, of which 491 million cases are HSV-2. Recurrent genital herpes causes a reduction in quality of life, which antivirals (current standard of care) only partially restore. Moderna expects that if an HSV vaccine candidate could deliver similar efficacy as a suppressive antiviral treatment, compliance with recommended therapy and associated quality of life would improve. There is currently no approved vaccine to treat HSV-2.

The first in human, fully enrolled Phase 1/2 trial of mRNA-1608 is designed to test safety and immunogenicity and to establish a proof-of-concept of clinical benefit in adults 18 to 55 years of age with recurrent HSV-2 genital herpes. The randomized 1:1:1:1, observer-blind, controlled study is fully enrolled with 300 participants in the U.S.

Varicella-Zoster virus (VZV)

Herpes zoster, also known as shingles, is caused by reactivation of latent VZV, the same virus that causes chickenpox. Declining immunity in older adults decreases immunity against VZV, allowing reactivation of the virus from latently infected neurons, causing painful and itchy lesions. Herpes Zoster occurs in one out of three adults in the U.S. in their lifetime and the incidence increases at 50 years of age. There is potential to reach a growing and underserved patient population.

Moderna’s VZV vaccine candidate mRNA-1468 has initial data available from a Phase 1/2 trial, which was designed to test safety and immunogenicity in healthy adults 50 years of age and older in the U.S. The randomized 1:1:1:1:1, observer-blind, active-controlled study of mRNA-1468 elicited strong antigen-specific T cell responses at one month after the second dose and was generally well tolerated. Results of the first interim analysis support the further clinical development of mRNA-1468 for the prevention of shingles. Additional results from the ongoing Phase 1/2 study will be available later this year, including persistence data. The Company is planning for a pivotal Phase 3 trial.

Norovirus

Enteric viruses, including norovirus, are a leading cause of diarrheal diseases, resulting in significant morbidity and mortality worldwide, particularly among young children and older adults. Norovirus is highly contagious and a leading cause of diarrheal disease globally, associated with 18% of all acute gastroenteritis (AGE), resulting in approximately 200,000 deaths per year and substantial healthcare costs. Given the wide diversity of norovirus genotypes, a broadly effective norovirus vaccine will require a multivalent vaccine design. There is currently no approved vaccine to prevent norovirus.

The randomized, observer-blind, placebo-controlled Phase 1 trial was designed to evaluate the safety, reactogenicity and immunogenicity of trivalent (mRNA-1403) and pentavalent (mRNA-1405) norovirus vaccine candidates in 664 participants 18 to 49 years of age and 60 to 80 years of age in the U.S. An interim analysis showed that a single dose of mRNA-1403 elicited a robust immune response across all dose levels evaluated with a clinically acceptable reactogenicity and safety profile. The Company is advancing mRNA-1403 toward a pivotal Phase 3 trial.

Respiratory Vaccine Portfolio

Moderna’s approach to ease the global burden of respiratory infections includes vaccine candidates against major causative pathogens, including SARS-CoV-2, respiratory syncytial virus (RSV) and influenza virus. Respiratory infections are a top cause of death in the U.S. and are particularly harmful to the young, immunocompromised, and older adults who experience more severe illness, greater incidence of hospitalization, and greater mortality than younger adults.

Moderna’s respiratory pipeline includes Phase 3 trials for investigational vaccines including a next-generation COVID-19 vaccine, an RSV vaccine, a flu vaccine, and a flu and COVID-19 combination vaccine. The pipeline includes three additional flu vaccine candidates with expanded antigen coverage as well as combination vaccine programs.

COVID-19

Moderna continues to address the needs of the endemic COVID-19 market by focusing on public health efforts to increase vaccination coverage rates to reduce the substantial burden of COVID-19 as well as by advancing next-generation vaccines. The Company’s mRNA platform can produce variant-matched vaccines on an accelerated time horizon, consistent with recent U.S. Food and Drug Administration (FDA) comments on the timing of potential strain selection for the fall booster season.

A recent announcement of positive interim results from the NEXTCove Phase 3 trial showed that mRNA-1283 elicited a higher immune response against both the Omicron BA.4/BA.5 and original virus strains of SARS-CoV-2 compared to mRNA-1273.222, Moderna’s licensed COVID-19 vaccine. mRNA-1283 is designed to be refrigerator-stable and paves the way for a combination vaccine against influenza and COVID-19, mRNA-1083, enhancing the Company’s overall respiratory portfolio. This is Moderna’s fourth infectious disease vaccine program with Phase 3 data.

Respiratory Syncytial Virus (RSV)

RSV is the leading cause of respiratory illness in young children, and older adults are at increased risk relative to younger adults for severe outcomes. In addition to acute mortality and morbidity, RSV infection is associated with long-term sequelae such as asthma and impaired lung function in pediatric populations, and exacerbation of chronic obstructive pulmonary disease in older adults. Annually, there are approximately two million medically attended RSV infections and 58,000 to 80,000 hospitalizations in children younger than five years old in the U.S. In the U.S., each year there are up to 160,000 hospitalizations and 10,000 deaths in adults 65 years and older due to RSV. Across high-income countries in 2019, RSV caused an estimated 5.2 million cases, 470,000 hospitalizations and 33,000 in-hospital deaths in adults 60 years and older.

mRNA-1345

Moderna’s RSV vaccine candidate, mRNA-1345, is in an ongoing Phase 2/3, randomized, observer-blind, placebo-controlled case-driven trial (ConquerRSV) in adults over 60 years of age. In this study, approximately 37,000 participants from 22 countries were randomized 1:1 to receive one dose of mRNA-1345 or placebo.

Based on positive data from the ConquerRSV trial, Moderna has filed for regulatory approvals for mRNA-1345 for the prevention of RSV-associated lower respiratory tract disease (RSV-LRTD) and acute respiratory disease (ARD) in adults over 60 years of age.

The trial met both its primary efficacy endpoints, with a vaccine efficacy (VE) of 83.7% (95.88% CI: 66.1%, 92.2%; p<0.0001) against RSV-LRTD as defined by two or more symptoms, and a VE of 82.4% (96.36% CI: 34.8%, 95.3%; p=0.0078) against RSV-LRTD defined by three or more symptoms. These data were published in the New England Journal of Medicine in December 2023.

A subsequent analysis from the ConquerRSV study with a longer median follow-up duration of 8.6 months (versus 3.7 months in the primary analysis), with a range of 15 days to 530 days, and including subjects from the Northern and Southern Hemispheres was recently presented at the RSVVW’24 conference. In this supplemental analysis, mRNA-1345 maintained durable efficacy, with sustained VE of 63.3% (95.88% CI: 48.7%, 73.7%) against RSV-LRTD including two or more symptoms. VE was 74.6% (95% CI: 50.7%, 86.9%) against RSV-LRTD with ≥2 symptoms, including shortness of breath and 63.0% (95% CI: 37.3%, 78.2%) against RSV-LRTD including three of more symptoms. The stringent statistical criterion of the study, a lower bound on the 95% CI of >20%, continued to be met for both endpoints.

mRNA-1345 has been granted Breakthrough Therapy designation by the FDA for the prevention of RSV-LRTD in adults over 60 years of age. The Company is awaiting regulatory approvals and the U.S. ACIP recommendation in 2024.

Indication expansion studies for mRNA-1345

mRNA-1345 has the potential to protect all vulnerable populations from RSV. Moderna has initiated multiple Phase 3 expansion studies in adults over 50 years of age to evaluate co-administration and revaccination. Additional trials (Phase 1 – Phase 3) have been initiated for high-risk adults, as well as maternal and pediatric populations. Interim data from these studies could be available as early as 2024.

Influenza (Flu)

Worldwide, influenza leads to 3-5 million severe cases of flu and 290,000-650,000 flu-related respiratory deaths annually. Two main types of influenza viruses (A and B) cause seasonal flu epidemics, and the influenza A viruses lead to most flu-related hospitalization in older adults.

The Company has several seasonal influenza vaccine candidates in clinical development. Moderna’s seasonal flu vaccine, mRNA-1010, demonstrated consistently acceptable safety and tolerability across three Phase 3 trials. In the most recent Phase 3 trial (P303), which was designed to test the immunogenicity and safety of an optimized vaccine composition, mRNA-1010 met all immunogenicity primary endpoints, demonstrating higher antibody titers compared to a currently licensed standard-dose flu vaccine. In an older adult extension study of P303, mRNA-1010 is being studied against high dose Fluzone HD®; the trial is fully enrolled. The Company is in ongoing discussions with regulators and intends to file in 2024.

Combination Respiratory Vaccines

Moderna’s combination vaccine candidates cover respiratory viruses associated with the largest disease burden in the category. The Phase 3 combination study of the Company’s investigational combination vaccine against flu and COVID-19 (mRNA-1083) for adults aged 50 years and older is fully enrolled and data are expected in 2024. mRNA-1083 was granted Fast Track designation by the FDA in May 2023.

Commercial Updates

Respiratory viruses in addition to latent and other viruses represent large unmet or underserved medical needs, and the human and economic costs from these infectious diseases highlight the need for effective vaccines. To help address this need, Moderna expects multiple vaccine product launches in the next few years, each with significant addressable markets.

The 2024 global endemic COVID-19 vaccine market alone is estimated by Moderna to be approximately $10 billion. COVID-19 continues to show a high burden of disease, and while COVID-19 hospitalizations remain high relative to RSV and flu, the risks of Long COVID are also becoming better understood. Moderna is focused on improving education and awareness to increase vaccination rates as Long COVID data suggests even traditionally low-risk groups should be vaccinated. Moderna is also working with health authorities to align the timing of COVID-19 and flu vaccine launches to help improve public health.

For RSV, Moderna estimates the peak annual market to be approximately $10 billion. The Company expects a strong RSV vaccine launch into a large market in 2024. As the only mRNA investigational vaccine with positive Phase 3 data, Moderna’s RSV vaccine candidate has a strong profile with consistently strong efficacy across vulnerable and older populations, a well-established safety and tolerability profile, and ease of administration with a ready-to-use, pre-filled syringe formulation, which could relieve some of the burden that falls on pharmacies during the fall vaccination season.

An interim analysis from an ongoing time and motion study evaluating differences in preparation time between a pre-filled syringe (PFS) presentation and vaccines that require reconstitution showed that a PFS presentation could relieve some of the burden that falls on pharmacies during the fall vaccination season. Results from this study suggest that pharmacies may be capable of preparing up to four times as many doses of PFS in an hour compared to vaccines requiring reconstitution.

Moderna estimates flu vaccines represent an approximately $7 billion market in 2024. The market is expected to grow with the rise of more effective vaccines and there is an opportunity to expand the market with next-generation premium flu vaccines as well as combination respiratory vaccines, adding increased value to the health ecosystem.

CMV is expected to be a $2-5 billion annual market. With no vaccine currently on the market and a potential vaccine launch in 2026, Moderna could be the first CMV vaccine in multi-billion-dollar latent vaccine market. In addition, EBV has the potential to address and reduce the burden and cost of EBV infection in multiple populations, while VZV provides the opportunity to enter a large and growing market, which could be $5-6 billion annually. The market for norovirus vaccines is similar to that of rotavirus in pediatrics with opportunity to expand into the adult population, and represents a $3-6 billion annual market.

Moderna’s vaccine portfolio targets large addressable markets, with an estimated total addressable market (TAM) of $52 billon for Moderna infectious disease vaccines, which includes a respiratory vaccines TAM of more than $27 billion and a latent and other vaccines TAM of more than $25 billion.

Manufacturing

The Company’s manufacturing innovation supports expanding commercialization of a diverse pipeline through efficiency and productivity gains. Its mRNA manufacturing platform enables benefits such as quality, speed, scale and cost efficiency across a footprint that broadly includes the manufacture of plasmid, mRNA, lipid nanoparticles, as well as fill/finish and quality control capabilities.

As the Company continues to build its footprint for the future, it is developing an agile global manufacturing network to meet commercial demand and support its growing pipeline. Pre-clinical through commercial manufacturing occurs at the Moderna Technology Center in Norwood, Massachusetts, which remains central to the Company’s network. New facilities being constructed in Australia, Canada and the UK are expected to come online in 2025, and drug product capacity is achieved through a flexible contract manufacturing network. Additionally, the Company has purchased and started build-out of a manufacturing site in Marlborough, Massachusetts, to enable commercial scale of its individualized neoantigen therapy program.

By continuing to pioneer new technologies, including advanced robotics, applying AI and other digital solutions, and driving network and capital efficiency, Moderna’s manufacturing network is expected to also drive more predictable cost of sales.

Research and Development Investment Strategy

Today’s updates provide further evidence that Moderna’s mRNA technology platform is working, and with a rate of success higher than industry standard. Looking ahead, research and development will continue to be the Company’s top capital allocation priority.

As Moderna looks to create value through the research and development strategy for its vaccine portfolio, it is taking three prioritization parameters into consideration: pipeline advancement, revenue diversification and risk reduction. As part of its strategy, the funding options Moderna considers are self-funding, project financing and partnerships.

Moderna recently entered into a development and commercialization funding agreement with Blackstone Life Sciences to advance the Company’s flu program. As part of the agreement, Blackstone will fund up to $750 million with a return based on cumulative commercial milestones and low-single digit royalties. Moderna expects to recognize the funding as a reduction in research and development expenses and will retain full rights and control of the Company’s flu program. This funding does not result in any change to Moderna’s 2024 research and development framework of approximately $4.5 billion.

About Moderna

Moderna is a leader in the creation of the field of mRNA medicine. Through the advancement of mRNA technology, Moderna is reimagining how medicines are made and transforming how we treat and prevent disease for everyone. By working at the intersection of science, technology and health for more than a decade, the company has developed medicines at unprecedented speed and efficiency, including one of the earliest and most effective COVID-19 vaccines.


Moderna’s mRNA platform has enabled the development of therapeutics and vaccines for infectious diseases, immuno-oncology, rare diseases and autoimmune diseases. With a unique culture and a global team driven by the Moderna values and mindsets to responsibly change the future of human health, Moderna strives to deliver the greatest possible impact to people through mRNA medicines. For more information about Moderna, please visit modernatx.com and connect with us on X (formerly Twitter), Facebook, Instagram, YouTube and LinkedIn.

INDICATION (U.S.)

SPIKEVAX (COVID-19 Vaccine, mRNA) is a vaccine indicated for active immunization to prevent coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in individuals 18 years of age and older.

IMPORTANT SAFETY INFORMATION

  • Do not administer to individuals with a known history of severe allergic reaction (e.g., anaphylaxis) to any component of the vaccine.
  • Appropriate medical treatment to manage immediate allergic reactions must be immediately available in the event an acute anaphylactic reaction occurs following administration of the vaccine.
  • Postmarketing data demonstrate increased risks of myocarditis and pericarditis, particularly within 7 days following the second dose. The observed risk is higher among males under 40 years of age than among females and older males. The observed risk is highest in males 18 through 24 years of age.
  • Syncope (fainting) may occur in association with administration of injectable vaccines. Procedures should be in place to avoid injury from fainting.
  • Immunocompromised persons, including individuals receiving immunosuppressive therapy, may have a diminished response to the vaccine.
  • The vaccine may not protect all vaccine recipients.
  • Adverse reactions reported in clinical trials following administration of the vaccine include pain at the injection site, fatigue, headache, myalgia, arthralgia, chills, nausea/vomiting, axillary swelling/tenderness, fever, swelling at the injection site, and erythema at the injection site, and rash.
  • The vaccination provider is responsible for mandatory reporting of certain adverse events to the Vaccine Adverse Event Reporting System (VAERS) online at vaers.hhs.gov/reportevent.html or by calling 1-800-822-7967.
  • Please see the SPIKEVAX Full Prescribing Information. For information regarding authorized emergency uses of the Moderna COVID-19 Vaccine, please see the EUA Fact Sheet.

Spikevax® is a registered trademark of Moderna.
Fluzone® is a registered trademark of Sanofi Pasteur.

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, as amended, including statements regarding: the advancement of Moderna’s programs under clinical development; the timing for anticipated approvals of vaccine candidates; the efficacy, safety and tolerability of vaccine candidates; the total addressable markets for programs under development; the efficiencies and advantages of Moderna’s mRNA platform; future capital allocation and financing efforts; and anticipated spending for R&D in 2024. In some cases, forward-looking statements can be identified by terminology such as “will,” “may,” “should,” “could,” “expects,” “intends,” “plans,” “aims,” “anticipates,” “believes,” “estimates,” “predicts,” “potential,” “continue,” or the negative of these terms or other comparable terminology, although not all forward-looking statements contain these words. The forward-looking statements in this press release are neither promises nor guarantees, and you should not place undue reliance on these forward-looking statements because they involve known and unknown risks, uncertainties, and other factors, many of which are beyond Moderna’s control and which could cause actual results to differ materially from those expressed or implied by these forward-looking statements. These risks, uncertainties, and other factors include, among others, those risks and uncertainties described under the heading “Risk Factors” in Moderna’s Annual Report on Form 10-K for the fiscal year ended December 31, 2023, filed with the U.S. Securities and Exchange Commission (SEC), and in subsequent filings made by Moderna with the SEC, which are available on the SEC’s website at www.sec.gov. Except as required by law, Moderna disclaims any intention or responsibility for updating or revising any forward-looking statements contained in this presentation in the event of new information, future developments or otherwise. These forward-looking statements are based on Moderna’s current expectations and speak only as of the date of this press release. ​

###

Moderna Contacts

Media:
Chris Ridley
Head, Global Media Relations
+1 617-800-3651
[email protected]

Investors:
Lavina Talukdar
Senior Vice President & Head of Investor Relations
+1 617-209-5834
[email protected]

SOURCE: Moderna, Inc.

View the original press release on accesswire.com

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We can get hypothermia in the air when the temperature is 60 degrees, but cold water saps the body of heat much faster. 

Hypothermia can happen in water as warm as 80 degrees, while water that is 64 degrees could be deadly, according to the University of Michigan.

“Immersion in cold water can become life-threatening very quickly,” wrote the NWS office in Burlington, Vermont. “Since water conducts body heat away up to 25 times faster than air of the same temperature, the cold water rapidly causes extremities to become numb, weakens the ability of muscles to work effectively and eventually leads to hypothermia.” 

The U.S. Search and Rescue Task Force reported that cold water can rob the body of heat up to 32 times faster than air.

WHAT ARE COLD-STUNNED SEA TURTLES?

It doesn’t necessarily mean that just people falling through ice are in danger. Even during a heatwave, water temperatures can be chilly.

Cold shock

The first danger of cool water is “cold shock.”

Cold shock can be just as severe and dangerous from water temperatures of 50-60 degrees as it is from water at 35, according to the NWS.

Gasping for a breath or rapid breathing from sudden immersion can be triggered by water as warm as 77, according to the NWS.

“When your body hits cold water, ‘cold shock’ can cause dramatic changes in breathing, heart rate and blood pressure,” wrote NOAA. “The sudden gasp and rapid breathing alone creates a greater risk of drowning even for confident swimmers in calm waters. In rougher open water, this danger increases.”

AT LEAST 6 MISSING AS UNDERWATER SEARCH CONTINUES AFTER BALTIMORE BRIDGE COLLAPSE

Cold shock can cause panic, which impairs clear thinking and decision-making. It can also cause a sudden spike in heart rate and blood pressure, which can lead to a heart attack or stroke. Severe pain from the cold also clouds thinking.

While cold shock diminishes after the first 1-3 minutes of sudden immersion, the body continues to lose heat. Even a person who has been pulled out of the water can still lose body heat. Wet clothes increase the body’s heat loss by five times over the general 2% of body heat lost to the environment. Hypothermia, the body dropping to or below 95 degrees, comes in stages and degrees.

WHAT IS HYPOTHERMIA?

“So initially, you are in the water, and you start getting cold, and you start shivering, maybe develop slurred speech. You have some confusion, pulse may get a little weak,” Audie Liametz, Vice Chariman of the NYU Lagone Hospital Emergency Department, told FOX Weather over the summer. “And then it can progress from mild hypothermia to moderate hypothermia, where you start having alteration in the mental status.” 

Mild, moderate and severe hypothermia

7 WAS TO STAY SAFE ON ICE AND WHAT TO DO IF YOU FALL THROUGH

Coordinated hand and finger movements can cease within minutes, which makes grabbing the edge of the water or a float for self-rescue difficult, according to the University of Minnesota Sea Grant, a water safety program.

“Swimming or treading water will greatly increase heat loss and can shorten survival time by more than 50%,” warned USSARTF.

WHY 50 DEGREES FEELS FRIGID TO SOME BUT WARM TO OTHERS: THE SCIENCE OF ACCLIMATION

As hypothermia progresses, it strips the body of its automatic responses to combating cold.

“When it gets to very severe hypothermia, you can actually lose the shivering response,” Liametz said. “Because the shivering response is the body’s reaction to keeping the temperature warm. It warms you up by contracting the muscles,” Liametz continued.

The normal body temperature is 98.6 degrees. Shivering starts at 96.5. Amnesia can start at 94. Brain function declines when the body temperature is 91 degrees, with unconsciousness at 86 degrees. The heart and breathing slow at 84 degrees. The human heart can stop at 64 degrees, according to Sea Grant. USSARTF stated that death can happen when the body is 79 degrees.

Flotation devices can prevent drowning even if a person is unable to swim, allowing more time for rescue. A person can become incapacitated or unconscious in cold water in as little as 9 minutes without a life jacket. With a life jacket, that time rises to 15 minutes.

HOW TO WATCH FOX WEATHER

Surviving hypothermia

The U.S. Coast Guard listed the following steps to increase your chances for survival if you are experiencing hypothermia:

  1. Stay calm.
  2. Get out of the water as soon as possible or grab something to float on to keep body parts out of the water.
  3. Swim to safety if possible. If not, conserve energy and heat until help arrives.

Once out of the water:

  1. Call 911.
  2. Move the person to a warm place, remove wet clothing and dry the person.
  3. Give CPR if needed.
  4. Wrap blankets around the person’s torso. Don’t warm the extremities first, as that may lead to shock.
  5. Do not submerge the person in warm water or warm them too quickly, which leads to a danger of heart arrhythmia.

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Approximately seven million Americans have scoliosis, a spine condition characterized by a curvature in the back. While it is most often diagnosed in children, adults can also develop scoliosis. Either way, you may wonder if it affects running.

Here, two scoliosis experts, Juan C. Rodriguez-Olaverri, M.D., Ph.D., a former runner with scoliosis and the director of pediatric deformity surgery and early onset scoliosis in the NYU Langone Department of Orthopedic Surgery, and Michelle Yang, DPT, C.S.C.S., a physical therapist at the Hospital for Special Surgery, answer questions about scoliosis and how it may affect runners.

What is scoliosis?

Everyone’s spine has normal curves from front to back, says Rodriguez-Olaverri. When you look at someone’s back from behind, most spines also appear straight from side to side. People with scoliosis, however, have spines that curve sideways when viewed from behind. Depending on where the spine curves, it may form an “S” or a “C” shape.

“There are many types of scoliosis,” Rodriguez-Olaverri tells Runner’s World. “You can have scoliosis in the thoracic [upper] spine or in the lumbar [lower] spine, [and] you can get scoliosis when you’re an adolescent or you can get scoliosis as an adult, and there’s scoliosis that needs surgery and scoliosis that doesn’t need surgery.”

In most scoliosis cases, the problem begins to develop for an unknown, or “idiopathic” reason, per the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Idiopathic scoliosis typically occurs in children aged 11 and older, and is more common in girls than boys. However, genetics may play a role in its development. Patients are more likely to have scoliosis if a parent or sibling has it.

More uncommonly, some babies are born with spinal abnormalities that develop before birth (congenital scoliosis). Others, as they get older, develop spinal changes that occur because of neurological or muscular diseases like cerebral palsy, muscular dystrophy (MS), and spinal cord injury, according to the American Association of Neurological Surgeons (AANS).

Sometimes, scoliosis can be so mild that it doesn’t cause symptoms or pain. In other cases, the curve can become so exaggerated that someone may have uneven shoulders (one or both shoulder blades may stick out), one hip appears higher than the other, or one side of the rib cage is higher than the other when bending forward. When scoliosis is severe, a person may have back pain and even difficulty breathing.

Can adults develop scoliosis?

Adults are at risk for developing degenerative scoliosis, which is also known as adult onset scoliosis. It is caused by degeneration of the spine as people age, and is considered completely different from juvenile or adolescent scoliosis. The difference is that an adult is considered “skeletally mature,” and is no longer growing.

Symptoms of degenerative scoliosis are similar to those found in other age-related back problems. You might feel back pain, pins and needles tingling in the leg, or numbness in the buttocks and legs. Finally, someone may feel sharp pain or one side of the spine may stick out a bit more than the other.

How is scoliosis diagnosed?

A doctor performs a physical examination to evaluate posture and check for asymmetries, and will likely order an X-ray to evaluate and measure the curve of the spine. If the curve is greater than 10 degrees, it is likely scoliosis. A curve is considered “significant,” say the experts, if it measures greater than 25 to 30 degrees and “severe” if it exceeds 45 to 50 degrees.

How is scoliosis treated?

Treatment for scoliosis varies depending on the age at diagnosis, the degree of curvature, and whether symptoms are present. The overall treatment goals are to stop or slow the spinal curve from worsening, prevent or decrease pain, improve posture, prevent or manage breathing problems, and boost quality of life.

You may not need treatment if the curve is mild, or if there is minimal concern that it will increase. However, people with scoliosis of any type and degree of curvature can benefit from physical activity. Yang encourages people to see a physical therapist for a top-down assessment to learn which exercises can help improve posture and prevent their scoliosis from progressing.

In addition, your doctor may recommend taking a spinal X-ray every five years—or sooner, if symptoms present—to ensure the curve isn’t worsening.

In general, surgery is only recommended if the spinal curve is greater than 50 degrees, the patient has nerve damage to their legs, and/or is experiencing curve-related bowel or bladder issues.

How does scoliosis affect running?

If you suffered with scoliosis as a teenager you should be able to run without limitations, unless you need future surgery, says Rodriguez-Olaverri. Those with degenerative scoliosis who have lower back pain should not run, he cautions, because that will place additional pressure on the lumbar spine and worsen the pain.

If your spinal curve affects your lungs, running may be less comfortable. Sometimes, the curves can decrease space in the ribcage, which can limit how much air you’re able to inhale with one breath, which is known as vital capacity, Yang says. So, you may find that you get out of breath easily. One major benefit of running, though, is that it forces you to breathe harder, repeatedly, which makes your lungs stronger over time, Yang notes.

Scoliosis may also create issues with running if there are significant asymmetries between the two sides of the body. “Some people with scoliosis actually have leg-length discrepancies, so one leg might be a bit shorter than the other,” Yang says. This asymmetry can put more load on one leg while you run, increasing your risk for injuries like bone stress fractures.

Also, asymmetries between your shoulder heights can affect running posture. Having one shoulder that’s higher than the other can cause you to slouch forward or lean more heavily to one side, Yang says. As you get fatigued, this forward slouch or side-lean can become more exaggerated.

One of the primary goals for people with scoliosis is improving their posture to prevent the spinal curve from worsening. Running with poor posture won’t help you achieve this goal. Yang recommends seeing a physical therapist or orthopedist if you experience pain, discomfort, or have questions about running safely. People with scoliosis benefit from a running form assessment, and the healthcare professional can offer specific exercises and advice to improve posture and form.

Can running improve scoliosis?

Despite the potential risks, running can be helpful for people with scoliosis. “I’m a huge advocate for people with scoliosis participating in any type of physical activity, which includes running,” Yang says. “It allows for symmetrical movement and helps engage your postural muscles overall, as well as keeping your core strong, which is really important” Strong core muscles help support your trunk, taking some of the burden off your spine.

Watching your running form is essential to reaping these benefits. If you can, get a running gait analysis. This way, a running professional can recommend how to improve your form and technique.

Here is a general running form checklist from the experts:

  • Move your arms from the shoulders, not the elbows.
  • Bring your heels toward your buttocks.
  • Gaze directly in front of you; don’t tilt your chin up or down.
  • Pull your shoulder blades back (pretend you’re squeezing a pencil between your shoulder blades).
  • Lean forward slightly from your ankles.

It’s always best to chat with your doctor first, though, before starting a running routine. That’s especially true for those with degenerative scoliosis, because as lumbar disks (spongy pads between the bones that make up the lower portion of the spine) wear down, you may need to do low- or no-impact exercise. “If you have scoliosis in the lumbar spine and your disks are degenerating, you don’t want to keep banging on those disks because they’re going to get worse,” Rodriguez-Olaverri says.

Having your doctor on board is especially important if you have higher-degree curvature. “With the higher-degree curvature, you worry about posture getting worse over time, so that’s a conversation to have with a doctor to make sure they’re doing the proper things to help decrease the curvature in their spine,” Rodriguez-Olaverri says.

Lettermark

Lauren Bedosky is a freelance health and fitness writer who specializes in covering running and strength training topics. She writes for a variety of national publications, including Runner’s WorldPrevention, Experience Life and Women’s Running.

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WalletHub recently released its Most & Least Stressed States 2024 report to help understand which areas offer the most relaxing lifestyle with as little stress as possible. The personal finance company compared all 50 states nationwide, focusing on four key stress-related factors, including work, money, family, and health and safety. Here is what the company found in their research.

What Are the Most and Least Stressed States?

Louisiana is the country’s most stressed state because of its high crime rate and the third-highest divorce rate nationwide. The state also has the second-highest poverty rate and second-lowest median credit score, so financial stability and chance for improvement have been major stress factors for many residents.

On the other side of the scale, Minnesota is the least stressed state in the country. The state has one of the lowest poverty ratings in the nation (third after Utah and New Hampshire), is one of the top five states with the lowest divorce rates, and has the highest credit score rating in the nation.

Top 10 Most Stressed States in the U.S.

  1. Louisiana
  2. Mississippi
  3. Nevada
  4. New Mexico
  5. Arkansas
  6. West Virginia
  7. Alabama
  8. Kentucky
  9. Oklahoma
  10. Texas

Top 10 Least Stressed States in the U.S.

  1. Minnesota
  2. South Dakota
  3. Utah
  4. New Hampshire
  5. Iowa
  6. Idaho
  7. North Dakota
  8. Delaware
  9. Nebraska
  10. Hawaii

The top five least stressed states include Minnesota, South Dakota, Utah, New Hampshire, and Iowa, where many residents are getting more sleep at night, can often find more affordable housing, and some are working fewer hours each week when compared to other states. You can view the report for the full list to see how every state ranked.

Tips for Managing Stress

Whether or not you live in one of the most stressed states, a variety of lifestyle factors can play a role in how stressed out you feel on a regular basis. And everyone needs some help to relax and unwind from time-to-time. Here are some ideas to help you decompress.

  • Slow down your breathing: Be more mindful of each breath so you aren’t shallow breathing, which can cause stress levels to increase thanks to adding more tension to the body. Try the 4-7-8 breathing strategy that focuses on first inhaling through your nose, holding your breath, and exhaling through your mouth.
  • Get enough sleep: Make sure you’re lying down in bed early enough to get the recommended 7 to 9 hours of rest per night. If you struggle to fall asleep, these techniques can help.
  • Meditate or try yoga: These activities help unwind your mind and body. Plus, it’s important to move your body, and yoga helps do just that.
  • Journal about what you are feeling: Simply putting everything down on the page can help release negative thoughts.
  • Spend time doing activities that make you laugh: A good laugh can relieve stress and allow your mind and muscles to relax. Watch a funny show or schedule a hangout with friends who make you laugh.
  • Set a budget: If finances are stressing you out, consider planning a monthly budget (and stick to it). Consider areas of your life that cost the most (like grocery shopping) and see where you can make adjustments.
  • Build your credit: Poor credit is another major financial stressor for many people. Consider these ways to build and maintain good credit so you can develop consistent good financial habits and open up new opportunities for yourself.
  • Make a list: When we are stressed we often feel less in control of what is going on with our lives. Gain back more control by making lists with tasks you can quickly and easily accomplish to give you the satisfaction of checking them off. Plus, lists can help you remember your to-dos without having to actively think about them.
  • Consider therapy: If your stress stems from your relationships, therapy (including individual, couple’s, and family therapy) is a great way to learn communication and coping strategies to alleviate some of life’s biggest hurdles.
  • Set healthy boundaries: Both in personal relationships and at work, setting boundaries can help you avoid burnout and positively impact your overall emotional well-being.
  • Stay hydrated: Lastly, hydration is key as it helps your body react to stress better, among many other health benefits.

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Officials with Health P.E.I. say wait times at the emergency room can be long, but people who are positive for COVID-19 who experience severe symptoms should seek care at the hospital if they feel they need it.  (Steve Bruce/CBC - image credit)

Officials with Health P.E.I. say wait times at the emergency room can be long, but people who are positive for COVID-19 who experience severe symptoms should seek care at the hospital if they feel they need it. (Steve Bruce/CBC – image credit)

One woman on P.E.I. who tested positive for COVID-19 says she’s left with questions after spending hours in an Island emergency room without seeing a doctor.

Kendal Winegarden said when she arrived at the hospital, staff questioned her about why she would come when she knew she was positive for COVID-19 – and now she’s asking where people who are positive for the virus should turn when symptoms get worse?

Winegarden found out she had tested positive for COVID-19 last Monday. She had a number of symptoms – a cough, sore throat and fatigue. But by Thursday morning those symptoms began to get worse.

“I was short of breath, I couldn’t do anything and I was feeling tightness in my chest,” Winegarden said.

Even something like taking a shower left her unable to catch her breath, she said. Winegarden is immune-compromised and lives in rural P.E.I. and said she was worried about being stuck without care if her symptoms were to get much worse.

She called 811 and the province’s COVID-19 line with no luck speaking to anyone. When her breathing hadn’t improved she called the Queen Elizabeth Hospital in Charlottetown and was told to come into the emergency department right away.

But when she got there, staff asked her why she would come when she knew she had COVID-19.

Submitted by Kendal WinegardenSubmitted by Kendal Winegarden

Submitted by Kendal Winegarden

“I said ‘Because I was told to and because I had trouble breathing.’ And her response was, ‘Well we try to keep people with COVID out of the hospital’ and I said, ‘Well I wouldn’t be here if I didn’t feel like maybe I should be checked out.'”

Winegarden said the triage nurse checked her vitals and she was told to sit in a COVID-19 waiting area. She said she waited there for more than six hours and was told the hospital was very busy and it could be morning before she was seen by a physician. At that point it was only 6 p.m., so Winegarden said she gave up and went home.

She said her fever broke the following morning and she’s now feeling much better. But the experience left her with one pressing question:

“What are people supposed to do, really? If you have COVID symptoms and you’re positive, you do the right thing, you isolate … what are people who have COVID symptoms worsening supposed to do?”

If you’re feeling awful, come to the ER

Dr. Tom Kaul, co-chief of the QEH emergency department, said the evening Winegarden came into the hospital was a very busy one, which is common.

But her decision to come to the emergency room was the right one.

“If you’re feeling awful, and you feel like trying to get from your couch to the bathroom renders you very short of breath, then absolutely you should come in for assessment and I hope that assessment will be reassuring,” Kaul said.

Dr. Kaul said he knows wait times in the emergency department can be long. He was working the night Winegarden came to seek care.

ZoomZoom

Zoom

In the past few weeks, he said about 20 per cent of people visiting the QEH emergency department leave without seeing a physician. He said that’s because of the ER’s limited capacity, caused by a combination of staffing shortages and high number of people seeking care.

Something COVID-19 hasn’t helped.

But, Dr. Kaul said anyone coming to the ER should be reassured that an assessment by a triage nurse will tell you whether you need to be admitted to hospital.

“I would certainly put forward how valuable the assessments by our nursing staff are because your vital signs and things we do readily get at the door — listen to your chest, and an assessment of your breathing — are really critical and replicate what we’re going to do as physicians as well,” he said.

“That triage assessment is really valuable and — if reassuring to the triage nurse — should hopefully be reassuring to patients as well.”

Cough and fever clinics also an option

Winegarden said she’s feeling better now and, after isolating with her family, she hopes they can all put their experience with COVID-19 behind them.

Dr. Kaul said the goal is to see every patient who comes into the ER for care and while there can be long waits, that shouldn’t deter people from coming to the hospital if they are worried about their condition — whether they’ve been diagnosed with COVID-19 or not.

He said people with COVID-19 can also visit the province’s cough and fever clinics if they’re worried about their symptoms.

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Inspired by the medical bay of the USS Enterprise from “Star Trek”, a research team from the University of Waterloo uses radar technology to monitor people’s health while at the wheel, turning an ordinary car or truck into a mobile medical hub.

Dr. George Shaker, an adjunct professor in the Department of Electrical and Computer Engineering at the University of Waterloo, is working with a team of graduate students to integrate radar with evolving vehicle technology to make health checks easier. The idea is to use the time people spend in their cars to gather data on their health for accurate analysis and proactive treatment — without the need for any type of wearable.

The radar, smaller than a USB thumb drive, is integrated into the vehicle cabin and sends out signals that detect human vibrations, which are then sent back to the radar. The built-in AI system collects and analyzes the data to build a medical picture and identify any potential conditions. At the end of the driver’s commute, the system sends the report directly to their cell phone for review.

Radar sensor held up next to a 10-cent coin to give a size comparison.

Radar sensor held up next to a 10-cent coin to give a size comparison.

“This radar technology is not new,” Shaker said. “Our first demos using radars for in-cabin sensing were developed back in 2017 for infotainment touchless control and to alert people to children and pets left alone in parked vehicles. This application, using the technology to monitor vehicle occupants’ health, is a step towards achieving our vision of cars as medical hubs of the future.

The technology, which is the latest from Waterloo aimed at disrupting the boundaries of health, can detect tiny movements like the rise and fall of a chest from breathing or heartbeats. For Shaker and his team, the challenge was evolving the tech to identify changes in breathing patterns or heart rhythms that signify potential health issues related to cardiovascular conditions like Tachycardia and Bradycardia as well as respiratory system conditions like Tachypnea, Bradypnea and Apnea.

“We focused on enhancing data extraction for exact information related to people’s respiratory and cardiovascular systems and teaching the AI how to make medical interpretations from this data. Another important consideration was personal privacy and security — no data is stored on the cloud; it is sent to the monitored person’s cellphone only,” said Ali Gharamohammadi, the lead PhD student on the project.

A series of tests using synthetic data, i.e. subjects mimicked respiratory conditions’ symptoms by holding their breath and taking shallow breaths, validated the system’s capability for accurately detecting and interpreting respiratory conditions. The system has also been tested on individuals with heart conditions which it successfully detected and accurately identified.

The research team is building on this work to expand the radar technology’s capabilities to monitor all vehicle occupants’ overall health and well-being, run diagnostics and generate quality medical reports that flag any issues that need attention, as well as assist with emergency communication in the event of an accident.

More information about this work can be found in the research paper, “Multibin Breathing Pattern Estimation by Radar Fusion for Enhanced Driver Monitoring”, recently published in IEEE Transactions on Instrumentation and Measurement.

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Star Trek's medical bay coming to your car?
Radar sensor held up next to 10c coin to give size comparison. Credit: University of Waterloo

Inspired by the medical bay of the USS Enterprise from “Star Trek,” a research team from the University of Waterloo uses radar technology to monitor people’s health while at the wheel, turning an ordinary car or truck into a mobile medical hub. The research paper, “Multibin Breathing Pattern Estimation by Radar Fusion for Enhanced Driver Monitoring,” was published in IEEE Transactions on Instrumentation and Measurement.

Dr. George Shaker, an adjunct professor in the Department of Electrical and Computer Engineering at the University of Waterloo, is working with a team of graduate students to integrate radar with evolving vehicle technology to make health checks easier. The idea is to use the time people spend in their cars to gather data on their health for accurate analysis and proactive treatment—without the need for any type of wearable.

The radar, smaller than a USB thumb drive, is integrated into the vehicle cabin and sends out signals that detect human vibrations, which are then sent back to the radar. The built-in AI system collects and analyzes the data to build a medical picture and identify any potential conditions. At the end of the driver’s commute, the system sends the report directly to their cell phone for review.

“This radar technology is not new,” Shaker said. “Our first demos using radars for in-cabin sensing were developed back in 2017 for infotainment touchless control and to alert people to children and pets left alone in parked vehicles. This application, using the technology to monitor vehicle occupants’ health, is a step towards achieving our vision of cars as medical hubs of the future.”

The technology, which is the latest from Waterloo aimed at disrupting the boundaries of health, can detect tiny movements like the rise and fall of a chest from breathing or heartbeats.

For Shaker and his team, the challenge was evolving the tech to identify changes in breathing patterns or heart rhythms that signify potential health issues related to cardiovascular conditions like tachycardia and bradycardia as well as respiratory system conditions like tachypnea, bradypnea and apnea.

“We focused on enhancing data extraction for exact information related to people’s respiratory and cardiovascular systems and teaching the AI how to make medical interpretations from this data. Another important consideration was personal privacy and security—no data is stored on the cloud; it is sent to the monitored person’s cellphone only,” said Ali Gharamohammadi, the lead Ph.D. student on the project.

A series of tests using synthetic data, i.e. subjects mimicked respiratory conditions’ symptoms by holding their breath and taking shallow breaths, validated the system’s capability for accurately detecting and interpreting respiratory conditions. The system has also been tested on individuals with heart conditions which it successfully detected and accurately identified.

The research team is building on this work to expand the radar technology‘s capabilities to monitor all vehicle occupants’ overall health and well-being, run diagnostics and generate quality medical reports that flag any issues that need attention, as well as assist with emergency communication in the event of an accident.

More information:
Ali Gharamohammadi et al, Multibin Breathing Pattern Estimation by Radar Fusion for Enhanced Driver Monitoring, IEEE Transactions on Instrumentation and Measurement (2023). DOI: 10.1109/TIM.2023.3345909

Citation:
Researchers use radar technology to monitor the health status of a driver (2024, March 26)
retrieved 26 March 2024
from techxplore.com/news/2024-03-radar-technology-health-status-driver.html

This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no
part may be reproduced without the written permission. The content is provided for information purposes only.



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My wife, Susan, and I have traveled around the world by trains, planes, ships, and automobiles finding new adventures. We are now in Amsterdam — our first international trip since 2019.

When I was diagnosed with idiopathic pulmonary fibrosis (IPF) in January 2017, my care team encouraged me to live my best life. I did, including by traveling to places Susan and I wanted to ensure we could visit together.

When COVID-19 hit, my care team advised against unnecessary travel. Plus, my IPF had begun to progress more quickly. I was approved for a lung transplant in March 2020 but deferred, due to the pandemic. It was a year later, almost to the day, when I was listed. I received my bilateral lung transplant in July 2021, which restricted my travel for another year.

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Preparation

We have traveled to all seven continents, taken an untold number of cruises, and consider ourselves to be seasoned travelers. I typically get excited before a new adventure, especially when it involves international travel. Yet preparing for this trip as a post-transplant patient was a completely different experience.

I arranged to see my kidney care team, my cardiac surgeon, and my transplant care team during the first half of March. All of them gave me guidance on things to be aware of while traveling abroad.

Because I am immunosuppressed to reduce the risk of my body rejecting my transplanted lungs, I am more susceptible to illness. Even though I’m vaccinated against the flu, COVID-19, and respiratory syncytial virus, I will be masked during our flight and when we are among crowds.

Due to swelling in my lower legs, I will not spend the seven-hour flight sitting. I will walk up and down the aisle and otherwise keep my legs elevated for as much time as possible. Anticipating the need for elevation, we opted to splurge on business class seats, which will allow us to lie flat during the flight.

A photo taken from an aerial perspective shows a table covered with pill organizers and pill bottles.

Packing for vacation post-transplant requires some level of concentration. (Photo by Sam Kirton)

The most challenging aspect of packing for this trip was not deciding what to wear, but thinking through all of my medication requirements.

My care team’s guidance was clear: Prepare for the unexpected. Pack twice the amount of medication you think you’ll need.

I did just that, preparing a 20-day supply of my medications for our seven-night cruise.

Additionally, I asked my care team to prepare a letter listing all of my medications. During a cruise around Australia and New Zealand, local authorities met with all passengers carrying prescription medication during the ship’s immigration processing. The trip documentation suggested that some countries require prescriptions to be carried in their original containers.

When we left our home in Virginia to embark on the trip to Amsterdam, we double-checked that we had all the necessary medications. I also had a plan to adjust my medication schedule to accommodate the time zone change.

Why Amsterdam?

My IPF journey has affected our ability to travel, especially internationally, which we both love to do. Susan sacrificed so much when she assumed the role of caregiver. Some years ago, she talked about wanting to see the tulips bloom in Amsterdam. This trip will allow her to realize that dream.

We are aboard the AmaLucia, sailing out of Amsterdam for a seven-night “Tulip Time” river cruise. The ship carries 156 passengers, so it’s not like the larger ones we’re accustomed to. Two days before we flew to Amsterdam, we received photos of the tulip fields we will be visiting in full bloom.

Next week, I will share more with you about navigating a river cruise as a post-transplant IPF patient. I started taking notes on the day we left so I can report back to you about this vacation. I want you to ask questions; feel free to post them in the comments. Sharing my experience is how I can continue to make every breath count.


Note: Pulmonary Fibrosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Fibrosis News or its parent company, BioNews, and are intended to spark discussion about issues pertaining to pulmonary fibrosis.

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Introduction

The high-flow nasal cannula (HFNC) has become an essential non-invasive oxygen therapy device. Recently, it has been used widely in clinical settings as a non-invasive respiratory support method to improve oxygenation in adult patients.1 HFNC has several advantages over conventional low-flow devices (eg, nasal cannula or simple face masks): enhanced patient comfort, increased humidification, improved secretion clearance and reduced effort in breathing.2,3 The HFNC system is a unique device that is simple and easy to use, needing only an active heated humidifier, flow generator, single circuit, and soft nasal cannula.4 This device was developed to maintain high oxygen flow and improve the efficiency of ventilation by delivering warmed and humidified oxygen with a flow rate as high as 60 L/minute and a fraction of inspired oxygen (FiO2) of 0.21 to 1.0. An increased flow rate can help reduce inspiratory effort and improve dynamic lung compliance, which can lead to improving oxygenation and ventilation.1,5,6 During the COVID-19 pandemic, several studies showed that the use of HFNC as an alternative oxygen device for respiratory failure patients can provide higher oxygen concentrations than can be achieved with conventional devices, reduce the need for endotracheal intubation, and decrease the length of stay in intensive care units (ICUs).7–9 In addition, HFNC has a valuable effect in reducing anatomical dead space, which provides low positive end-expiratory pressure (PEEP) and can be more tolerable for patients with chronic obstructive pulmonary disease (COPD).10 Moreover, the immediate use of HFNC for postoperative respiratory failure patients was associated with lower risks of reintubation and respiratory failure.11

Even though the use of HFNC is prevalent in clinical settings, RTs still lack evidence-based guidelines for implementing HFNC.12 Moreover, HFNC is frequently utilized by RTs but controversy remains on the initiation, management and weaning of HFNC due to scant evidence.12–14 A cross-sectional study of French ICU physicians found that there was a great deal of variability in the current use of HFNC, including the criteria for initiation and weaning.15 Furthermore, a global survey of intensive care unit (ICU) healthcare providers reported that there was considerable variation in the daily application of HFNC with regard to initial settings and management criteria for HFNC parameters.16 HFNC failure may result from these notable differences in clinical practice, which is probably due to lack of educational training and standardized protocols.17

Despite the wide use of HFNC and the studies exploring the benefits of using HFNC with ARDS patients, research into assessing the knowledge, practice, and barriers to using HFNC among respiratory therapists in Saudi Arabia is lacking. Therefore, this study aimed to assess the current practice of HFNC in multiple centers in Saudi Arabia and identify the barriers to using HFNC among respiratory therapists.

Methods

Study Design

In this cross-sectional study, a survey was distributed through an electronic platform SurveyMonkey between December 19, 2022, and July 15, 2023.

Instrument

Experts in the use of HFNC (namely ICU physicians, respiratory therapists, and ICU nurses) formulated this questionnaire, which was adapted and modified from previous studies.8,15,16,18 Next, face and content validity were assessed by an expert panel and the survey was then pilot-tested. After receiving feedback from the experts, adjustments were made, and the survey was distributed. The survey consisted of six main parts:

  • The first part asked the participants about their demographic information (eg, gender, number of years working in critical care areas, and geographical location).
  • The second part focused on assessing the study participants’ knowledge of indications for the use of HFNC. This part consists of 13 statements with a five-point Likert scale ranging from 1 to 5 (1 = strongly agree; 5 = strongly disagree).
  • The third part consisted of four statements with a five-point Likert scale ranging from 1 to 5 (1 = strongly agree; 5 = strongly disagree). This section assessed whether respiratory therapists agree that 1) the HFNC device is tolerable for patients, 2) HFNC is used to help patients eat and speak, 3) HFNC improves dyspnea, and 4) HFNC is used to avoid the need for intubation and invasive mechanical ventilation.
  • The fourth part assessed the study participants’ ability to determine the timing for switching to HFNC, the most appropriate initial settings for HFNC, the management of patients on HFNC, and the criteria required for weaning.
  • The fifth part consisted of four statements to evaluate whether the study participants were aware of the criteria for HFNC failure and the time to intubate and use invasive mechanical ventilation.
  • The last part consisted of one question about barriers to HFNC use.

Data Collection and Sampling

A convenience sampling strategy was used to recruit the study participants, and the main target population for this study were respiratory therapists who work in Saudi Arabian hospitals and hold a bachelor degree. To reach a larger population of respiratory therapists, we distributed the survey through Saudi scientific non-profit organizations (eg, the Saudi Society for Respiratory Care) along with social media platforms (X and WhatsApp). In addition, each data collector visited and circulated the survey to respiratory therapists working at their nearby tertiary hospitals.

Data Analysis

The collected data were managed and analyzed using the Statistical Package for the Social Sciences (SPSS) version 27. Data were presented as means and standard deviation or frequency and percentages, as appropriate. A Chi-square test was used to compare RT staff who have existing HFNC protocols and those who do not. A p-value of <0.05 was considered statistically significant.

Ethical Approval

Before the commencement of the study, ethical approval was obtained from the Bioethical Committee at Batterjee Medical College (Reference Number RES-2022-0077).

Results

Participant Characteristics

In this study, 1001 RT practitioners completed the online survey. Over half of the participants were female (573, or 57.2%). The majority of our sample was staff specialists (824, or 82.3%), while directors of RT departments accounted for 29 (2.9%). High numbers of representatives were from the country’s Western and Central Regions (52.8% and 26.4%, respectively). More than half (56.1%) of the participants had one to five years of clinical experience. In addition, we documented the areas where the respiratory therapists were assigned, such as critical care (78.6%), non-critical care (65.5%), and ER (57.9%). Two-thirds of the respiratory therapists (659, or 65.8%) had received training on HFNC and 785 (78.4%) had used HFNC in clinical settings. (See Table 1).

Table 1 Demographic Data and Characteristics of Study Respondents (n = 1001)

Indications of Using High-Flow Nasal Cannula from the Perspective of RT Staff

We asked the participants if they agreed about the relevant indications or conditions that require HFNC. The top responses were COVID-19 (78%), post-extubation (65%), and do-not-intubate patients (64%). The lowest responses were pre-oxygenated patients before intubation (38%), obesity-induced hypoventilation syndrome (34%), and sleep apnea syndrome (33%). (See Table 1 and Figure 1).

Figure 1 Indications for using HFNC from the perspective of RT staff (n=1001).

Advantages of Using High-Flow Nasal Cannula

Four advantages of HFNC (ie, has high tolerability, helps maintain conversation and eating abilities, improves shortness of breath (SOB), and avoids intubation) were reported from the perspective of respiratory therapists. Participants strongly agreed that the advantages of HFNC were helping to maintain conversation and eating abilities (32.95%) and improving SBO (34.1%) (See Table 2 and Figure 2).

Table 2 Advantages of Using HFNC from the Perspective of RT Staff

Figure 2 Advantages of using HFNC from the prospective of RT staff (n=1001).

Initial Settings, Weaning and Disconnect of High-Flow Nasal Cannula

Surprisingly, 568 (57%) of RT staff do not follow a protocol for initiation, weaning and disconnection of HFNC with ARDS patients.

When starting HFNC, 40.2% of the participants started with FiO2 of 61% to 80%. Additionally, a high percentage of RT staff (40.6%) started with a flow rate between 30 L/minute and 40 L/minute and a temperature of 37°C (57.7%). When weaning ARDS patients from HFNC, 482 (48.1%) recommended first reducing gas flow by 5–10 L/minute every two to four hours, followed by 362 (36.2%) who recommended first reducing FiO2 by 5–10% every two to four hours. Moreover, 549 (54.8%) believed that ARDS patients could be disconnected from HFNC if they achieved a flow rate < 20 L/minute and FiO2 <35%. (See Table 3).

Table 3 Clinical Practice of HFNC

In addition, we compared the responses between participants who followed a standardized protocol versus those who did not follow a protocol to initiate, wean and disconnect HFNC. (See Table 3).

Of the 402 RT staff who would start with FiO2 between 61% and 80%, 289 (28.87%) reported not following a standardized protocol. Additionally, half of the RT staff (214, or 21.42%) who would start with a flow rate between 30 and 40 L/minute do not have a standardized protocol to follow. Among all participants, we observed a statistically significant difference between respiratory therapists who follow a protocol versus those who do not (p-value <0.001). For those who recommended first reducing gas flow by 5–10 L/minute every two to four hours when weaning ARDS patients, 356 (35.51%) did not follow a standardized protocol. Among all participants, we observed statistically significant differences between respiratory therapists who follow a protocol and those who do not follow a protocol (p-value <0.001). (See Table 3).

Criteria to Stop High-Flow Nasal Cannula and Intubate Acute Respiratory Distress Syndrome Patients

Regarding the criteria to stop providing HFNC and initiate intubation, 39.5% of the participants would stop providing HFNC if the patient paused or stopped breathing. Indeed, 34.7% of the participants would stop providing HFNC in cases of refractory hypoxemia (SpO2 < 90% with FiO2 100% and flow rate of 60 L/minute), 35% in cases of severe respiratory acidosis (pH is unacceptably low (<7.25) and the PaCO2 is elevated), and 39.3% in cases of reduced level of consciousness (GCS score ≤8). (See Table 4).

Table 4 Criteria to Stop HFNC and Intubate ARDS Patients

Challenges in Using High-Flow Nasal Cannula

Regarding the challenges that impede the use of HFNC, participants ranked lack of knowledge, lack of devices, and the absence of protocol as the highest challenges (57.3%, 49.6, and 49%, respectively) while lack of evidence and diversity of HFNC devices were the lowest challenges 34.5% and 17.2%, respectively. (See Figure 3).

Figure 3 Challenges toward using HFNC from the perspective of RT staff (n=1001).

Discussion

To the best of our knowledge, this is the first national study to shed light on the knowledge, attitudes, and current practice of HFNC in ARDS patients among respiratory therapists in Saudi Arabia and the barriers to its use in clinical settings. The study findings revealed nuanced applications marked by significant endorsement in certain clinical scenarios and a lack of protocol adherence, underscoring the need for uniform, evidence-based guidelines and enhanced training for respiratory therapists.

A significant finding in our study is the prominent endorsement of HFNC use in COVID-19 patients, post-extubation cases, and do-not-intubate patients. These results corroborate existing literature that underscores HFNC’s role in enhancing oxygenation and reducing the effort of breathing in acute hypoxemic respiratory failure.2,3 Similarly, a cross-sectional study disclosed that respiratory physicians in Japan regarded COVID-19 as a primary indicator for HFNC application given its propensity to reduce the frequency of sustained sedation, physical restraint, and length of stay in the ICU compared to patients undergoing non-invasive ventilation (NIV).8 Nevertheless, the lower agreement on HFNC’s application in pre-oxygenation, obesity-induced hypoventilation, and sleep apnea conditions indicates potential knowledge gaps or diverse clinical experiences that warrant further investigation.

HFNC therapy has garnered widespread clinical validation for its efficacy in the management of patients with ARDS. Its capacity to deliver a precise and adjustable flow of warmed, humidified oxygen optimizes patient comfort and oxygenation status and decreases respiratory distress symptoms and the risk of endotracheal intubation.19,20 Within the scope of the present study, a substantial level of consensus was observed among participants, indicating that HFNC application is associated with a notable amelioration of SOB while concurrently preserving speech and eating capabilities. In line with these findings, previous literature has demonstrated the superiority of HFNC over alternative non-invasive respiratory modalities, underscored by its high patient tolerance and preservation of patients’ daily activities, emphasizing HFNC’s pivotal role in enhancing patient-centered outcomes.8

In the current study, significant discrepancies were observed in the setting of initial parameters, weaning strategies, and disconnection criteria pertaining to HFNC. Specifically, a majority of respiratory therapists reported an initial application of FiO2 within the range of 60% to 80%, a flow rate of 30–40 L/minute, and a temperature of 37°C. Notably, these findings are inconsistent with established HFNC protocols, which advocate initiating FiO2 at 1.00, a flow rate of 60 L/minute, and a temperature of 37°C.21,22 Furthermore, a substantial proportion of respiratory therapists expressed a preference for initially weaning the flow rate by 5–10 L/minute every two to four hours, deviating from the guidelines stipulated by the Canadian Society of Respiratory Therapists, which prioritize reducing FiO2 to less than 40% before commencing a gradual decrement in flow rate by increments of five.21 Analogously, heterogeneous practices were observed among French ICU physicians during the weaning process of HFNC settings.15 Despite these variations, a significant consensus emerged among over half of the respiratory therapists regarding the disconnection of HFNC, advocating for disconnection when the FiO2 is below 35% and the flow rate falls below 20 L/minute, aligning with published guidelines.1,21 A noteworthy revelation is the lack of adherence to standardized protocols for initiating, weaning, and disconnecting HFNC for ARDS patients. This inconsistency in clinical practices underscores the urgent need for the development and dissemination of evidence-based guidelines to enhance the quality and consistency of patient care.

Regarding the criteria dictating the transition from HFNC therapy to invasive mechanical ventilation in patients with ARDS, our study revealed a moderate consensus. This alignment was substantiated through the initiation of endotracheal intubation in cases of spontaneous breathing cessation, refractory hypoxemia, severe respiratory acidosis, or diminished consciousness. Concomitantly, a subsequent study yielded analogous outcomes, thereby affirming our findings. Notably, it illuminated the exacerbation of respiratory distress and the presence of bronchial congestion as substantive contributors to the ineffectiveness of HFNC therapy, consequently augmenting the imperative for invasive ventilation.15 Additionally, a retrospective analysis furnished empirical evidence identifying hypoxemic and hypercapnic respiratory failure as crucial indicators denoting the failure of HFNC therapy, particularly in scenarios wherein patients cannot sustain SpO2 above 90% despite receiving maximal FiO2. This insufficiency is accentuated by concomitant findings of arterial pH below 7.3 and respiratory rates exceeding 35 breaths per minute.23 The diverse criteria employed by respiratory therapists to discontinue HFNC and commence intubation emphasize the need for standardization in this aspect. Precisely articulated and evidence-based criteria are instrumental in optimizing patient outcomes and mitigating the potential risks associated with delayed intubation.

Several barriers impede the widespread adoption of HFNC therapy in clinical settings. In the present study, RT staff identified a lack of knowledge, the unavailability of devices, and the absence of protocols as the foremost challenges hindering the optimal use of HFNC. In accordance with these results, existing literature has shown that a lack of skill and familiarity hampers the implementation of HFNC in the ICU.24,25 Likewise, a pertinent study revealed that the absence of established objective criteria for initiating and managing HFNC settings significantly restricts its application, potentially leading to ineffective healthcare practices.26 These findings underscore the necessity for targeted interventions to enhance the capabilities of respiratory therapists, ensure the availability of essential equipment, and establish evidence-based protocols and the importance of concerted efforts to fortify strengths and mitigate the challenges associated with HFNC application in clinical settings.

Strengths and Limitations

One of the notable strengths of this study is the breadth of the participant sample, offering a robust spectrum of insights and experiences from a diverse group of respiratory therapists. The comprehensive survey methodology enabled the capture of nuanced, multifaceted data, allowing for a granular analysis of HFNC practices and challenges. Additionally, the alignment of the study’s findings with existing literature accentuates its validity and contribution to the ongoing discourse on the clinical applications of HFNC. Nevertheless, the study has limitations. We did not assess the current practice and barriers of using HFNC from the prospective of physicians whose practices maybe different from RTs. The reliance on self-reported data introduces the potential for response biases, wherein participants might either consciously or unconsciously misreport their practices. The cross-sectional nature of the study design precludes causal inferences and the assessment of HFNC practice evolution over time. Moreover, the geographical and institutional diversity of participants, while a strength, also raises questions about the generalizability of the findings across different contexts and healthcare systems.

Conclusion

Respiratory therapists in Saudi Arabia demonstrated a profound understanding of the clinical advantages associated with the utilization of HFNC for adult patients with ARDS. However, significant discrepancies were observed concerning the setting of initial parameters, the formulation of weaning strategies, and the determination of disconnection criteria related to HFNC. These variations primarily stemmed from inadequate adherence to established protocols and limitations in available resources. Such observations underscore the imperative for the development and implementation of standardized, evidence-based guidelines, alongside comprehensive training initiatives aimed at enhancing respiratory therapists’ compliance with HFNC protocols.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Ethical Approval

This study was approved from Bioethical Committee at Batterjee Medical College (Reference Number RES-2022-0077) and conducted in accordance with the Declaration of Helsinki. Informed consent was obtained from all RTs participated in the study.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Funding

There is no financial supporting body for this study.

Disclosure

The authors report no conflicts of interest in this work.

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We are into the holy month of Ramadan and this means that Muslims worldwide are preparing for a period defined by fasting, prayer, and reflection. During this observance, it is important to be keen on oral health to prevent bad breath or halitosis. Fasting during Ramadan can alter your mouth’s environment hence increasing the risk of having bad breath.
However, through being careful with your oral health, you can easily have a breath smelling fresh throughout the whole month.Below are some tips on how to maintain proper hygiene in your mouth and avoid halitosis during Ramadan:

Dehydration

Being dehydrated is a major reason for bad breath during fasting times. Your mouth tends to dry up due to inadequate water intake throughout the day leading to a low saliva production rate in your body that helps eliminate food particles and bacteria in your mouth resulting from which halitosis may be caused due to insufficient saliva content. Drinking enough water between fasts particularly at suhoor (meal before dawn) and iftar (breaking of fast) should be aimed.

bad breath (2)

Consistently brush your teeth

It is important to brush regularly to counteract bad breath. To keep your mouth clean and fresh, always remember to brush your teeth at least twice a day; after Suhoor in the morning and before sleeping again. Use fluoride toothpaste for thorough cleaning of all dental surfaces including the tongue and palate where bacteria usually accumulate. Choose a toothbrush with soft bristles to avoid irritating the gum when brushing before Suhoor. One can also use miswak during the day as it does not break the fast.

Floss daily

According to Dr. Akshay Bhushan, BDS, MDS – Prosthodontics, FICOI Dentist, “Flossing on the other hand does not receive much attention yet it is as important in oral hygiene as brushing. Through flossing, food particles and plaques are removed from between teeth or along gums where they may be left untouched by a toothbrush. Make it an obligation to floss once every day, preferably before bedtime to maintain fresh breath while promoting gum health.”

bad breath (3)

Use mouthwash

Mouthwash that lacks alcohol can assist you attain clean breath by removing bacteria and neutralizing compounds that cause terrible smells. Rinse your mouth with a mouthwash after brushing and flossing, this will enable it to reach areas that were missed by your toothbrush.

Quit the sweet stuff

After a long day of fasting, it can be hard to resist sugary treats. However, excessive amounts of sugar lead to bacterial growth in the mouth which causes plaque and bad breath. Instead of eating sugary foods, try eating fruit and vegetables.

Chew sugar-free gum

Chewing Sugar-free gum during the non-fasting period stimulates saliva production thus helping to fight bad breath. Increased saliva flow also flushes the oral cavity and neutralizes acids that cause halitosis. Chewing gum with xylitol, a natural sweetening agent is recommended as it hampers bacterial colonization in your mouth.

Avoid strong-smelling foods

Some strong-smelling foods like garlic, onions or spices can leave an enduring smell in your mouth. While such kinds of food are often enjoyed during iftar meals, try to limit their consumption on your part or brush your teeth afterward to counterbalance their effects on your breath.

Have regular dental checkups

Even though you are fasting during Ramadan, make sure that you go for regular dental check-ups. Your dentist can evaluate your oral health status, discuss any concerns with you, and give professional teeth cleaning services that will help remove plaque and tartar build-up—two factors contributing to bad breath.
By following these suggestions, you can maintain fresh breath and optimal oral health during the sacred month of Ramadan. Remember, good oral hygiene not only preserves dental health but also plays a crucial role in overall well-being. Wishing you a blessed and healthy Ramadan ahead.

Skincare tips to follow before you go out to play Holi



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