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Archive for the ‘Personalized and Precision Medicine & Genomic Research’ Category

New York Times vs. Personalized Medicine? PMC President: Times’ Critique of Streamlined Regulatory Approval for Personalized Treatments ‘Ignores Promising Implications’ of Field

Posted in Personalized and Precision Medicine & Genomic Research, Personalized Medicine Coalition on June 13, 2018| 1 Comment »


Contact: Christopher J. Wells

Personalized Medicine Coalition

cwells@personalizedmedicinecoalition.org

202-589-1770

FOR IMMEDIATE RELEASE

 

New York Times vs. Personalized Medicine?

PMC President: Times’ Critique of Streamlined Regulatory Approval for Personalized Treatments ‘Ignores Promising Implications’ of Field

WASHINGTON (June 13, 2018) — In response to an editorial published on June 9 by the New York Times titled “Easier Drug Approval, at What Price?,” Personalized Medicine Coalition (PMC) President Edward Abrahams today defends a series of decisions by the U.S. Food and Drug Administration (FDA) over the last several years that have streamlined the regulatory review process for personalized medicines.

“Unlike FDA, which has been an engine for innovation under the direction of Scott Gottlieb and his predecessors, ‘Easier Drug Approval, at What Price?’ ignores the promising implications of reforms in regulatory science that FDA has put in place to facilitate a new appreciation of how different individuals respond to selected treatments,” Abrahams said.

As PMC underlined earlier this year in a report titled Personalized Medicine at FDA: 2017 Progress Report, personalized medicines now account for one of every four drugs the agency approves. The Times’ editorial, which was also published online under the headline “Easier Drug Approval Isn’t Cutting Drug Prices,” contends that “it’s not clear that people, as opposed to drug companies, are feeling much benefit” from the streamlined regulatory review pathways that bring personalized treatments to market faster.

Abrahams disagrees, noting that in non-small cell lung cancer, for example, a disease that was nearly untreatable 20 years ago, there are now multiple drugs on the market that target a patient’s particular tumor. As indicated by the U.S. National Cancer Institute (NCI), these treatments “improve the survival of subsets of patients with metastatic disease.”

Furthermore, because targeted therapies zero in on specific cancerous mutations, doctors can use diagnostic tests to identify with much greater certainty the patients who will likely benefit from them, sparing expenses and side effects for those will not. That logic underpins FDA’s decision to streamline its regulatory processes, to ensure that patients who will benefit from promising targeted therapies — many of whom have few remaining options — can access those treatments without unnecessary delay.

“By putting in place smarter policies to encourage the efficient development of personalized drugs whose safety and efficacy profiles are often higher than one-size-fits-all, trial-and-error treatments, FDA serves the interests not only of patients but also the health system, which spends too much money on ineffective treatments,” Abrahams said.

To evaluate the American public’s interest in personalized medicine, PMC and GenomeWeb recently commissioned Public Perspectives on Personalized Medicine: A Survey of U.S. Public Opinion, which was published in May. Two-thirds of Americans indicated in the survey that they appreciate personalized medicine’s potential, and the majority expressed concerns about whether they will have access to personalized tests and treatments in the future.

###

About the Personalized Medicine Coalition:
The Personalized Medicine Coalition, representing innovators, scientists, patients, providers and payers, promotes the understanding and adoption of personalized medicine concepts, services and products to benefit patients and the health system. For more information, please visit www.personalizedmedicinecoalition.org.

SOURCE

From: “Christopher Wells (PMC)” <cwells@personalizedmedicinecoalition.org>

Date: Wednesday, June 13, 2018 at 3:15 PM

To: Aviva Lev-Ari <AvivaLev-Ari@alum.berkeley.edu>

Subject: Re: New York Times vs. Personalized Medicine?

 

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Patient-Reported Outcomes Study, Presented at SLEEP 2018, Provides Confirmatory Real-World Evidence of the Previously Presented 7-hour Action of REMfresh®, the First Continuous Release and Absorption Melatonin™

Posted in Circadian Rhythm and Sleep, Melatonin & Circadian Regulation, Patient Experience, Patient Outlook, Patient-centered Medicine, Uncategorized, tagged , , , , on June 10, 2018| Leave a Comment »


  • More than 77 percent of patients in the REMfresh® Patient Reported Outcomes DURation (REMDUR) study reported achieving 6 or more hours of sleep after taking REMfresh®, the first continuous release and absorption melatonin™ (CRA-melatonin™)
  • More than 91 percent experienced improvements in sleep onset, sleep maintenance and total sleep quality, after taking REMfresh® (CRA-melatonin™)
  • Post-marketing, patient-reported outcomes data reinforces clinical trial evidence demonstrating the potential of non-prescription REMfresh®, as a new, non-prescription, drug-free hypnotic (sleep) product designed to achieve 7-hour sleep
  • New data confirms previously presented SLEEP 2017 study showing the patented Ion Powered Pump™ (IPP™) technology in REMfresh® helps extend melatonin-targeted sleep maintenance levels in the body from 3.7 hours (with marketed immediate-release melatonin) to 6.7 hours, while mimicking the pattern of the body’s natural melatonin blood levels during the nightly sleep cycle

Real Time Coverage at SLEEP 2018 meeting, Baltimore.

Reporters: Aviva Lev-Ari, PhD, RN, and Gail S. Thornton, MA

BALTIMORE – (June 6, 2018) – A patient-reported outcomes study presented at SLEEP 2018 provides confirmatory real-world evidence of the previously peer-reviewed and presented data showing the 7-hour action of REMfresh®, a new product for sleep. REMfresh® Ion-Powered Melatonin™ is the first and only, continuous release and absorption melatonin™ (CRA-melatonin™) to mimic the body’s own 7-hour Mesa Wave™, the natural pattern of melatonin blood levels during a normal night’s sleep cycle. This induces sleep onset and provides lasting and restorative sleep for up to 7 hours.

This new data shows a correlative relationship between a 7-hour Mesa Wave™ pharmacokinetic (PK) profile and real-world evidence of improvements in sleep duration, onset, maintenance and sleep quality after taking REMfresh® (CRA-melatonin™).

The post-marketing REMfresh® Patient Reported Outcomes DURation (REMDUR) study was presented at SLEEP 2018, the 32nd Annual Meeting of the Associated Professional Sleep Societies (APSS), LLC, a joint partnership of the American Academy of Sleep Medicine (AASM) and the Sleep Research Society (SRS).

 

Brodner and Seiden

Pictured here is David C. Brodner, M.D., and David J. Seiden, M.D., FAASM, after presenting the latest study data which found REMfresh is the first and only continuous release and absorption melatonin™ to mimic the body’s own 7-hour Mesa Wave™.

 

In a sample of 500 patients on REMfresh® (CRA-melatonin™) responding to an online survey, 77.6 percent achieved 6 or more hours of sleep compared to 23.6 percent who slept that duration prior to taking REMfresh® (p<.0001). A vast majority of respondents also reported a major or moderate improvement in sleep onset (91.6 percent, p<.0001), sleep maintenance (94.8 percent, p<.0001) and total sleep quality (97.2 percent, p<.0001). More than three-quarters (76.6 percent) of patients indicated they take REMfresh® (CRA-melatonin™) nightly. The proportion of patients reporting nightly CRA-melatonin™ use was significantly greater than the proportion of patients with less than nightly use (p<.0001). Most importantly, over 98 percent of patients reported they were very likely or likely to continue taking REMfresh® (CRA-melatonin™) to treat their sleep complaints.

“The real-world evidence reported today in REMDUR provides further confirmation that REMfresh® represents a significant advance in the use of melatonin as a baseline therapy for treating sleep complaints,” said David C. Brodner, M.D., a leading sleep specialist who is Double Board-Certified in Otolaryngology — Head and Neck Surgery and Sleep Medicine, founder and principle Physician at the Center for Sinus, Allergy, and Sleep Wellness, in Palm Beach County, Florida, and Senior Medical Advisor for Physician’s Seal, LLC®.

“REMfresh® Ion-Powered Melatonin™ has been shown to be an effective drug-free solution that is now available to the millions of Americans in need of a good night’s sleep, many of whom seek new therapies that will induce sleep and keep them asleep until the morning, without causing residual effects they’ll feel the next day. With its unique delivery system that imitates the body’s own natural sleep pattern, REMfresh® has revolutionized the role of melatonin, when delivered in the CRA form. It is no longer just a treatment for jet lag, but the CRA-melatonin™ found in REMfresh® has been shown to provide substantial relief to individuals having nightly sleep challenges,” said Dr. Brodner.

The scientifically advanced, patented delivery system in REMfresh® (CRA-melatonin™), called Ion Powered Pump™ (IPP™) technology, replicates the way in which the body naturally releases and absorbs melatonin, unlike conventional melatonin sleep products. Since REMfresh® is not a drug, there is no drug hangover.

Nearly one-third of U.S. adults sleep less than the recommended seven hours daily.[1],[2] Increasing evidence suggests an association between sub-optimal sleep duration and adverse health outcomes including a higher risk of diabetes, hypertension, heart attack, stroke, obesity and depression.[3] A pooled analysis of 16 studies and over one million patients found short sleep duration corresponded with greater risk of morbidity and mortality.[4]

 REMDUR Study Design

The post-marketing REMfresh® Patient Reported Outcomes DURation (REMDUR) study was designed to obtain real-world evidence about patients’ sleep patterns, duration of sleep before and after REMfresh® (CRA-melatonin™), daily REMfresh® (CRA-melatonin™) use, onset of action, sleep maintenance, quality of sleep, and overall satisfaction with REMfresh® (CRA-melatonin™).

Patients with sleep disturbances in the general population who received a sample of CRA-melatonin™ (REMfresh®) from their physicians were invited to complete a 12-question survey. Survey responses were received from 500 patients.

Confirmation of the REMAKT Clinical Study

REMDUR confirmed clinical trial findings from REMAKT (REM Absorption Kinetics Trial), a U.S.-based randomized, crossover pharmacokinetic (PK) evaluation study in healthy, non-smoking adults that compared REMfresh® (CRA-melatonin™) with a market-leading, immediate-release melatonin (IR-melatonin).[5]

The study results, peer-reviewed and presented last year at SLEEP 2017, showed that melatonin levels with REMfresh® (CRA-melatonin™) exceeded the targeted sleep maintenance threshold for a median of 6.7 hours, compared with 3.7 hours with the leading IR-melatonin. Conversely, the levels of the market-leading IR-melatonin formulation dramatically increased 23 times greater than the targeted levels of exogenous melatonin for sleep maintenance and had a rapid decline in serum levels that did not allow melatonin levels to be maintained beyond 4 hours.

The REMfresh® (CRA-melatonin™) studies build upon the body of evidence from prolonged-release melatonin (PR-M), marketed in Europe, which demonstrated in well-conducted, placebo-controlled studies, statistically significant improvement in sleep quality, morning alertness, sleep latency and quality of life in patients aged 55 years and older compared with placebo. REMfresh® (CRA-melatonin™) was designed to overcome the challenges of absorption in the intestines, thereby extending the continual and gradual release pattern of melatonin through the night (known as the Mesa Wave™, a flat-topped hill with steep sides). There was a fast time to Cmax, which is anticipated to result in improved sleep onset, while the extended median plateau time to 6.7 hours and rapid fall-off in plasma levels at the end of the Mesa Wave™, may help to improve sleep maintenance and morning alertness.

Conventional melatonin products have had challenges at mimicking the profile of a Mesa Wave™. The scientific work behind REMfresh® (CRA-melatonin™) sought to overcome these challenges by having the melatonin formulation in a matrix that maintains a patented, solubility-enhancing pH environment to help with the transport to the brush border of the gut and its subsequent absorption.

Designed as a hydrogel matrix tablet, REMfresh® (CRA-melatonin™) provides rapid release of the melatonin from the surface of the tablet, as the hydrogel release-controlling matrix is setting up in the acidic environment (pH of 1 to 3.5) in the stomach. As the tablet moves into the higher pH (5.5 to 6.5) environment of the small-intestine, which is above the pKa of melatonin (~4.0), the acidic moiety in the tablet is designed to maintain the pH within the tablet below 4.0 for 7+ hours. The hydrogel matrix, after proper hydration, allows continuous release of the active melatonin and acidic moiety into the lumen of the intestines.

Melatonin: The Body’s Natural Sleep Ingredient

Melatonin is produced by the pineal gland in the brain and is the body’s natural sleep ingredient. Melatonin levels normally begin to rise in the mid-to late evening and remain high for the majority of the night. Levels begin to decline towards early morning, as the body’s wake cycle is triggered. As people age, melatonin levels can drop by as much as 70 percent[6] and their bodies may no longer produce enough melatonin to ensure adequate sleep.

Other available products, such as immediate-release melatonin, help initiate the onset of sleep but are usually unable to sustain prolonged sleep maintenance due to an immediate burst of melatonin, which is quickly degraded due to its relatively short half-life (60 minutes). Absorption in the lower digestive tract is limited by melatonin’s limited ability to be absorbed in a low acidity or neutral pH environment.

Importance of Sleep

Sleep is an essential part of every person’s life. The body requires a certain amount of sleep in order to properly rest, repair and renew itself. Sleep is customarily divided in four different stages, with each stage having a different effect. These four stages are:

N1, N2, deep sleep and REM sleep. The body moves among these four stages several times while asleep. If sleep is disrupted for any reason, a person’s body may not have a chance to properly restore itself, especially if it is struggling to get to the later stages, called deep sleep and REM sleep. Studies have shown that sound and sufficient sleep is important for learning, memory and a healthy immune system. A regular pattern of deep sleep and REM sleep will help a person begin the next day feeling refreshed and ready to go.

About Non-Prescription REMfresh®

REMfresh® (CRA-melatonin™) is the first and only, continuous release and absorption formulation of UltraMel® melatonin (available as 2 mg and 5 mg and with a 0.5 mg anticipated in the second half of 2018). UltraMel® melatonin is a high-quality, 99 percent ultra-pure melatonin sourced from Western Europe exclusively for Physician’s Seal®.

REMfresh® (CRA-melatonin™) is a dietary supplement and is regulated under the Federal Dietary Supplement Health and Education Act, which does not require pre-approval. Melatonin has been in common use for over two decades and has a well-established profile of safe use by millions of people around the world. As with all supplements, individual results may vary.

REMfresh® (CRA-melatonin™) is non-habit forming and does not contain narcotics, hypnotics, barbiturates, sedatives, antihistamines, alcohol or other harsh or additive chemicals. The usual adult recommended dose is 1-2 tablets 30-60 minutes before bedtime. Follow specific dosing instructions found on the back of the box for proper use of supplements.

REMfresh® (CRA-melatonin™) is available at Walmart, Rite Aid and CVS/pharmacy. In 2017 REMfresh® was ranked as  the #1 recommended brand for sleep management by sleep doctors[7].

About Physician’s Seal®

Physician’s Seal® is the innovator of REMfresh®, the first and only continuous release and absorption, 99 percent ultra-pure melatonin™ (CRA-melatonin™) that mimics the way the body naturally releases and maintains melatonin over a 7-hour period. Physician’s Seal®, founded in 2015, is a privately held company based in Boca Raton, Florida. It is committed to bringing cutting-edge life science applications to doctors and their patients. For more information, visit www.remfresh.com and connect with us on Facebook and You Tube.

Its sister subsidiary, IM HealthScience® (IMH) is the innovator of IBgard® and FDgard® for the dietary management of Irritable Bowel Syndrome (IBS) and Functional Dyspepsia (FD), respectively. In 2017, IMH added Fiber Choice®, a line of prebiotic fibers, to its product line via an acquisition. IMH® is a privately held company based in Boca Raton, Florida. It was founded in 2010 by a team of highly experienced pharmaceutical research and development and management executives. The company is dedicated to developing products to address overall health and wellness, including conditions with a high unmet medical need, such as digestive health. The IM HealthScience® advantage comes from developing products based on its patented, targeted-delivery technologies called Site Specific Targeting® (SST®). For more information, visit www.imhealthscience.com to learn about the company, or www.IBgard.com,  www.FDgard.com,and www.FiberChoice.com.

This information is for educational purposes only and is not meant to be a substitute for the advice of a physician or other health care professional. You should not use this information for diagnosing a health problem or disease. The company will strive to keep information current and consistent but may not be able to do so at any specific time. Generally, the most current information can be found on www.remfresh.com. Individual results may vary.

Data Presented at SLEEP 2018 Poster Session on Sleep Maintenance/Sleep Quality

Tuesday, June 5, 2018, 5-7pm

  • (Abstract 0419, Poster Board #104) Improvement in Sleep Maintenance and Sleep Quality with Ion Powered Pump Continuous Release and Absorption Melatonin: Results from a Self-Reported Patient Outcomes Study
    • David J. Seiden, M.D., FAASM, David C. Brodner, M.D., Syed M. Shah, Ph.D.

Visit Physician’s Seal® at booth 220 to learn more about REMfresh®.

The abstract is published in an online supplement of the journal, Sleep, which is available at http://www.sleepmeeting.org/docs/default-source/default-document-library/abstractbook2018.pdf?sfvrsn=2

[1] Ford, E.S., Cunningham, T.J., & Croft, J.B. (2015, May 1). Trends in Self-Reported Sleep Duration among US Adults from 1985 to 2012. Sleep, 38(5):829-832. doi: 10.5665/sleep.4684.

[2] Watson, N.F., Badr, M.S., Belenky, G., Bliwise, D.L., Buxton, G.M., Buysse, D.,…Tasali, E. (2015). Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion. Journal of Clinical Sleep Medicine, 11(8):931-952. doi:10.1176/appi.ajp.158.11.1856.

[3] Colten, H.R., & Altevogt, B.M. (Eds). (2006). Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem.  Institute of Medicine (US) Committee on Sleep Medicine and Research. Washington, DC: National Academies Press (US). doi: https://doi.org/10.17226/11617.

[4] Cappuccio, F.P., D’Elia, L., Strazzullo, P.,&  Miller, M.A. (2010). Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep, 33(5):585-592

[5] For this clinical trial, the head-to-head comparison was with the 5 mg form; a 2 mg form of the comparator was not available.

[6] Zisapel, N. (2010). Melatonin and sleep. The Open Neuroendocrinology Journal, 3: 85-95.

[7] Among primary care physicians with a certification in sleep disorders who recommended a brand of modified-release melatonin. Quintiles IMS ProVoice July-September 2017 survey.

REFERENCE/SOURCE

Physician’s Seal® and REMfresh® (www.remfresh.com)

Dr. David C. Brodner, Center for Sinus, Allergy, and Sleep Wellness (http://www.brodnermd.com/sleep-hygiene.html)

Other related articles published in this Open Access Online Scientific Journal include the following:

2017

Ultra-Pure Melatonin Product Helps Maintain Sleep for Up to 7 Hours

https://pharmaceuticalintelligence.com/2017/06/11/ultra-pure-melatonin-product-helps-maintain-sleep-for-up-to-7-hours/

2016

Sleep Science

Genetic link to sleep and mood disorders

https://pharmaceuticalintelligence.com/2016/02/27/genetic-link-to-sleep-and-mood-disorders/

2015

Sleep quality, amyloid and cognitive decline

https://pharmaceuticalintelligence.com/2015/10/31/sleep-quality-amyloid-and-cognitive-decline/

2013

Day and Night Variation in Melatonin Level affects Plasma Membrane Redox System in Red Blood Cells

https://pharmaceuticalintelligence.com/2013/02/23/httpwww-ncbi-nlm-nih-govpubmed22561555/

 

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Personalized Medicine & Diagnostics, June 5, 11-12, BIO 2018! Boston, BCEC

Posted in Conference Coverage with Social Media, Personalized and Precision Medicine & Genomic Research on June 5, 2018| Leave a Comment »


Personalized Medicine & Diagnostics, June 5, 11-12, BIO 2018! Boston, BCEC

 

11:00 AM–12:00 PM Jun 5, 2018

personalmedicine

Personalized Medicine & Diagnostics

Precision Medicine Coming of Age with Dr. Raju Kucherlapati, Paul C. Cabot Professor of Genetics and Professor of Medicine, Harvard Medical School
  • Ed Abrams, President PMC – 13% of American are adequately informed on Personalized Medicine. Supporting infrastructure, Scientific and public
Speakers
  • Precision Medicine & Personalized Medicine (PM-PM)
  • cloning gene for CF took 10 years
  • 1990 – Human Genome Program – NIH – sequence the entire Human Genome – for improving disease
  • completed in 2000 at $2.5 Billion cost  – NIH
  • Illumina  – second company to sequence CHinese company will be able to sequence Human Genome for $600
  • Physicians were excited about the Human genome sequencing for PM-PM
  • Millenium , Celera,
  • Genetech –  1998 – Receptin – subset of women Breast Cancer over expression of a gene BR
  • Cancer drug 2001 – Reva – Novartis, CML – only patients with good outocme increased from 30% to 98%
  • Gleevac – is a Blockbuster drug – encouraged development of drugs for rare disease
  • Prevention of Disease  – detect at-risk patients, i.e., CF
  • Meryad Genetics acquired a company that developed technology to detect at-risk in multiple genes not one at a time
  • Amniotic fluid carry fetal DNA — Testing developed to detect fetal disorders
  • Detection at pre-natal stages of multiple fetal disorders, abnormality, diagnosis drive treatment – genetic testing critical in cost containment
  • Cardiomayopaty: in Young athlete genetic disorder, other are related to increased age, 100 genes are involved in right side heart enlargement
  • 10% of Lung Cancer Patients responded to treatment in 2004 – genetic based drug is prescribed only to Patient with EGFR – all positively respond
  • Immune therapies initially in melanoma, improvement in progression pre-survival – if free of Cancer over 5 yeras, patient considered ot be cured
  • Mutation burden measures – drug approved based on probability of positive response
  • Reimbursement – CMS – determineat the National level appproved test in Cancers for reimbursement – it was a challenge
  • Database with million of people with genetic and medical information — searches of profile too group patients for optimal drug matching, integration of EMR with DB of genetics – IBM technologies, Google, Amazon, Microsoft – integrate information
LOCATION

Room 259B, Level 2

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Edward Abrahams, President, Personalized Medicine Coalition: “A Focus on Cost Instead of Value Threatens the Future of Personalized Medicine”

Posted in Personalized and Precision Medicine & Genomic Research on May 24, 2018| Leave a Comment »


Edward Abrahams, President, Personalized Medicine Coalition: “A Focus on Cost Instead of Value Threatens the Future of Personalized Medicine”

Reporter: Aviva Lev-Ari, PhD, RN

 

 

 

 

“A Focus on Cost Instead of Value Threatens the Future of Personalized Medicine”

by Edward Abrahams, President, Personalized Medicine Coalition

May 23, 2018

One size fits all never worked as a strategy for the fashion industry. Or the auto, furniture, and most other industries. It shouldn’t be the strategy for medicine either, but unfortunately more often than not it is. And it may stay that way if the focus on cost rather than value precludes the improved health care strategies made possible by personalized medicine.

According to the World Health Organization, an effective health system requires “reliable information on which to base decisions and policies.” The evolving field of personalized medicine delivers just that kind of information in the form of data about the unique biological characteristics of each patient. Doctors can often use that information to make medical decisions based on an understanding of how a patient will respond at a molecular level to a specific therapy. This helps ensure that therapies are prescribed only to those who will benefit from them, sparing side effects and expenses to those who will not.

Although the majority of patients say they aren’t yet aware of personalized medicine, they also say they don’t want to miss out on this opportunity.

Survey results released Wednesday by the Personalized Medicine Coalition, a nonprofit education and advocacy organization, and GenomeWeb, an online news service, show that although two-thirds of Americans have never heard of personalized medicine, two-thirds of them also react positively to a description of the approach and only 1 percent react negatively to it. The overwhelming majority agree that replacing one-size-fits-all, trial-and-error medicine with an approach that proactively identifies the right treatment for the right patient is worth pursuing and paying for.

One of every four new drugs approved by the Food and Drug Administration over the last four years was designed to become a personalized (or “targeted”) therapy that zeros in on the subset of patients likely to respond positively to it. That’s a sea change from the way drugs were developed and marketed 10 years ago.

Some of these new treatments have extraordinarily high list prices. But focusing solely on the cost of these therapies rather than on the value they provide threatens the future of personalized medicine.

Most Americans are unfamiliar with the principles and benefits of personalized medicine, with only 13 percent of survey respondents indicating that they feel “very informed” about the field. So they are not yet asking policymakers to make the changes that would ensure continued investment in and adoption of personalized medicine. Patients, like health systems, are still locked into a one-treatment-fits-all world.

At the same time, most policymakers are not asking the right questions about the benefits of these treatments for patients and society. Influenced by cost concerns, they assume that prices for personalized tests and treatments cannot be justified even if they make the health system more efficient and effective by delivering superior, longer-lasting clinical outcomes and increasing the percentage of patients who benefit from prescribed treatments.

Goldman Sachs, for example, issued a report titled The Genome Revolution. It argues that while “genome medicine” offers “tremendous value for patients and society,” curing patients may not be “a sustainable business model.” The analysis underlines that the health system is not set up to reap the benefits of new scientific discoveries and technologies. Just as we are on the precipice of an era in which gene therapies, gene-editing, and immunotherapies promise to address the root causes of disease, Goldman Sachs says that these therapies have a “very different outlook with regard to recurring revenue versus chronic therapies.”

In other words, Goldman Sachs suggests that if the pharmaceutical industry wants to make money, it should be cautious about developing one-shot therapies that cure patients and lower costs over time, because decision-makers are more focused on the price of a product than its value to a particular patient or to the health system itself.

If ongoing concerns among policymakers and the public add to the validity of this logic by discouraging payers from covering personalized “cures,” Goldman Sachs and others could choose not to make investments in innovative medicines that patients clearly want and need.

It falls on Congress, the FDA, and the Centers for Medicare and Medicaid Services to put in place an infrastructure that supports personalized medicine by:

  • Spearheading the efficient approval of personalized tests and treatments
  • Developing innovative reimbursement models that provide incentives for targeting treatment to only those patients who will benefit
  • Implementing programs that encourage the clinical adoption of personalized medicine by health systems around the country

With such efforts, policymakers can accelerate the pace of medical progress upon which patients and the health system depend.

As Tango Therapeutics President and CEO Dr. Barbara Weber summarized at the 12th Annual Personalized Medicine Conference at Harvard Medical School in 2016, “It’s not really ‘should we do this.’ We have to do this. We don’t get to decide what the biology of these diseases are, we just have to work with it.”

SOURCE

From: “Christopher Wells (PMC)” <cwells@personalizedmedicinecoalition.org>

Date: Thursday, May 24, 2018 at 11:18 AM

To: Aviva Lev-Ari <AvivaLev-Ari@alum.berkeley.edu>

Subject: Re: PMC in STAT News: “A Focus on Cost Instead of Value Threatens the Future of Personalized Medicine”

Aviva:

We would be honored if you highlighted the piece on your channels. I know you have a broad reach.

 Thank you so much.

 Best,

 Chris

Christopher J. Wells, M.P.A.

Vice President, Public Affairs

Cwells@personalizedmedicinecoalition.org

Direct: 202-589-1755 I Mobile: 202-580-9780

 

Personalized Medicine Coalition

Blog:Education & Advocacy

Twitter: @PerMedCoalition

1710 Rhode Island Ave. NW I Suite 700 I Washington, DC 20036
www.PersonalizedMedicineCoalition.org  

 

 

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NIH announces May 6, 2018 as national enrollment date for All of Us Research Program to advance Precision Medicine

Posted in Personalized and Precision Medicine & Genomic Research on May 1, 2018| Leave a Comment »


NIH announces May 6, 2018 as national enrollment date for All of Us Research Program to advance Precision Medicine

Reporter: Aviva Lev-Ari, PhD, RN

 

On May 6, the National Institutes of Health will open national enrollment for the All of UsResearch Program(link is external)

“The All of Us Research Program is an opportunity for individuals from all walks of life to be represented in research and pioneer the next era of medicine,” said NIH Director Francis S. Collins, M.D., Ph.D. “The time is now to transform how we conduct research — with participants as partners — to shed new light on how to stay healthy and manage disease in more personalized ways. This is what we can accomplish through All of Us.”

By partnering with 1 million diverse people who share information about themselves over many years, the All of Us Research Program will enable research to more precisely prevent and treat a variety of health conditions.

“All of us are unique, but today we live mostly in an era of ‘one-size-fits-all’ medicine,” said Eric Dishman, director of the All of Us Research Program. “I’m alive today because of precision medicine and I think everyone deserves that same opportunity no matter the color of your skin, your economic status, your age or your sex or gender. In other words, it will truly take all of us.”

 

About the All of Us Research Program: The mission of the All of Us Research Program is to accelerate health research and medical breakthroughs, enabling individualized prevention, treatment, and care for all of us. The program will partner with one million or more people across the United States to build the most diverse biomedical data resource of its kind, to help researchers gain better insights into the biological, environmental, and behavioral factors that influence health. For more information, visit www.JoinAllofUs.org(link is external) and www.allofus.nih.gov.

Community-based launch events

On the program’s May 6 launch date, the All of Us Research Program will host special events(link is external) in diverse communities around the country, including:

  • Birmingham, Alabama
  • Chicago
  • Detroit
  • Kansas City, Missouri
  • Nashville, Tennessee
  • New York City
  • Pasco, Washington

People also may take part in social media activities (#JoinAllofUs) or tune in at https://Launch.JoinAllofUs.org(link is external) to watch speakers across the country talk about precision medicine and the power of volunteering for research.

To learn more about the program and how to join, please visit www.JoinAllofUs.org(link is external).

“All of Us” is a registered service mark of the U.S. Department of Health & Human Services (HHS).

SOURCE

https://www.nih.gov/news-events/news-releases/nih-announces-national-enrollment-date-all-us-research-program-advance-precision-medicine

What is the All of Us Research Program?

All of Us is a new research program from the National Institutes of Health (NIH). The goal is to advance precision medicine. Precision medicine is health care that is based on you as an individual. It takes into account factors like where you live, what you do, and your family health history. Precision medicine’s goal is to be able to tell people the best ways to stay healthy. If someone does get sick, precision medicine may help health care teams find the treatment that will work best.

To get there, we need one million or more people. Those who join will share information about their health over time. Researchers will study this data. What they learn could improve health for generations to come. Participants are our partners. We’ll share information back with them over time.

How It Works

Participants Share Data

Participants Share Data

Participants share health data online. This data includes health surveys and electronic health records. Participants also may be asked to share physical measurements and blood and urine samples.

Data Is Protected

Data Is Protected

Personal information, like your name, address, and other things that easily identify participants will be removed from all data. Samples—also without any names on them—are stored in a secure biobank.

Researchers Study Data

Researchers Study Data

In the future, approved researchers will use this data to conduct studies. By finding patterns in the data, they may make the next big medical breakthroughs.

Researchers Share Discoveries

Participants Get Information

Participants will get information back about the data they provide, which may help them learn more about their health.

Researchers Share Discoveries

Researchers Share Discoveries

Research may help in many ways. It may help find the best ways for people to stay healthy. It may also help create better tests and find the treatments that will work best for different people.

LEARN MORE

SOURCE

https://www.joinallofus.org/en

 

Additional Media Resources:

What partners are saying about the All of Us Research Program

Multimedia: Sound Bites, Images, B-Roll and Videos

All of Us Research Program backgrounder

All of Us news release – Spanish 

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CHI’s Discovery on Target, Sheraton Boston, Sept. 25-28, 2018

Posted in Conference Coverage with Social Media, Drug Delivery Platform Technology, Drug Development Process, Drug Discovery Chemistry, Personalized and Precision Medicine & Genomic Research, Pharmaceutical Analytics, Pharmaceutical Discovery, Pharmaceutical Drug Discovery, Pharmaceutical Industry Competitive Intelligence, Pharmaceutical R&D Investment, Pharmaceuticall R&D Informatics, Pharmacodynamics and Pharmacokinetics, Pharmacogenomics, Pharmacologic toxicities on February 21, 2018| Leave a Comment »


CHI’s Discovery on Target, Sheraton Boston, Sept. 25-28, 2018

Reporter: Aviva Lev-Ari, PhD, RN

 

ANNOUNCEMENT

Leaders in Pharmaceutical Business Intelligence (LPBI) Group is a selected CHI Business Partner for Media Communication for this event as well a provider of REAL TIME PRESS COVERAGE for this cardinal event in the domain of  Drug Discovery and Drug Delivery.

Dr. Aviva Lev-Ari, PhD, RN, Editor-in-Chief, PharmaceuticalIntelligence.com  will be in attendance covering this event for the Press using Social Media via 12 Channels

LOGO of LPBI Group

Follow us on ALL our Media Communication Channels:

Channels for e-Marketing of Biotech Conferences

  • Our Journal has 1,373,977  eReaders on 1/29/2018, for All Time and 7,283 Scientific Comments

http://pharmaceuticalintelligence.com

  • Aviva’s – +6,430 BIOTECH Followers on LinkedIn

http://www.linkedin.com/in/avivalevari

  • Aviva is a Member of +60 LinkedIn Groups in Biotech related fields

https://www.linkedin.com/groups/my-groups

  • LPBI Group’s FaceBook Page

http://www.facebook.com/LeadersInPharmaceuticalBusinessIntelligence

  • LPBI Group’s Twitter Account

http://twitter.com/pharma_BI

  • LPBI Group’s Company’s Page on LinkedIn

https://www.linkedin.com/company/9325543?trk=tyah&trkInfo=clickedVertical%3Acompany%2CclickedEntityId%3A9325543%2Cidx%3A1-1-1%2CtarId%3A1439226813927%2Ctas%3ALeaders%20in%20Pharmaceutica

 

 

For UPDATES on this Cardinal Conference and for REGISTRATION, go to 

http://www.discoveryontarget.com/?utm_source=partner

 

For PROGRAMS, go to 

http://www.discoveryontarget.com/programs

September 26-27

September 27-28

September 26-27

September 27-28

September 26-27

September 27-28

September 26-27

September 27-28

September 25

What is the Role of the Editor-in-Chief at PharmaceuticalIntelligence.com 

Editor-in-Chief’s Roles and Accomplishments

1        Curation Methodology Development

Leadership we provide on curation of scientific findings in the eScientific publishing for Medical Education contents.

In Section 1, the Leadership we provide on curation of scientific findings in the eScientific publishing for Medical Education contents is demonstrated by a subset of several outstanding curations with high electronic Viewer volume. Each article included presents unique content contribution to Medical Clinical Education.

·       These articles are extracted from the list of all Journal articles with >1,000 eReaders, 4/28/2012 to 1/29/2018.

Article Title,         # of electronic Viewers,         Author(s) Name

Is the Warburg Effect the Cause or the Effect of Cancer: A 21st Century View?                      16,114 Larry H. Bernstein, MD, FCAP

Do Novel Anticoagulants Affect the PT/INR? The Cases of XARELTO (rivaroxaban) and PRADAXA (dabigatran) 11,606 Vivek Lal, MBBS, MD, FCIR,

Justin D. Pearlman, MD, PhD, FACC and

Aviva Lev-Ari, PhD, RN
Clinical Indications for Use of Inhaled Nitric Oxide (iNO) in the Adult Patient Market: Clinical Outcomes after Use, Therapy Demand and Cost of Care

 

  5,865 Aviva Lev-Ari, PhD, RN
Peroxisome proliferator-activated receptor (PPAR-gamma) Receptors Activation: PPARγ transrepression for Angiogenesis in Cardiovascular Disease and PPARγ transactivation for Treatment of Diabetes                  1,919 Aviva Lev-Ari, PhD, RN  

 

Bystolic’s generic Nebivolol – Positive Effect on circulating Endothelial Progenitor Cells Endogenous Augmentation  1,059 Aviva Lev-Ari, PhD, RN

 

Triple Antihypertensive Combination Therapy Significantly Lowers Blood Pressure in Hard-to-Treat Patients with Hypertension and Diabetes  1,339 Aviva Lev-Ari, PhD, RN

 

Clinical Trials Results for Endothelin System: Pathophysiological role in Chronic Heart Failure, Acute Coronary Syndromes and MI – Marker of Disease Severity or Genetic Determination?  1,472 Aviva Lev-Ari, PhD, RN
Treatment of Refractory Hypertension via Percutaneous Renal Denervation  1,085 Aviva Lev-Ari, PhD, RN

2        Content Creation and Key Opinion Leader (KOL) Recognition

2.1     Volume of Articles in the Journal and in the 16 Volume-BioMed e-Series

Select

Aviva Lev-Ari, PhD, RN 2012pharmaceutical

3,064 Articles

·       All  (5,288)

 avivalev-ari@alum.berkeley.edu Administrator 3064

2.1     Volume of Articles in the Journal and in the 16 Volume-BioMed e-Series

1.   Volume of Articles in the Journal since Journal inception on 4/28/2012:

·       Total articles by ALL authors in Journal Archive on 1/29/2018 = 5,288

·       ALL articles/posts Authored, Curated, Reported by Aviva Lev-Ari, PhD, RN = 3,064

2.   Volume of Articles in the 16 Volume-BioMed e-Series

·    Editorial & Publication of Articles in e-Books by Leaders in Pharmaceutical Business Intelligence: Contributions of Aviva Lev-Ari, PhD, RN

https://pharmaceuticalintelligence.com/2014/10/16/editorial-publication-of-articles-in-e-books-by-leaders-in-pharmaceutical-business-intelligence-contributions-of-aviva-lev-ari-phd-rn/

·       LPBI Group’s Founder: Biography and Bibliographies – Aviva Lev-Ari, PhD, RN

https://pharmaceuticalintelligence.com/founder/

 

2.2     Digital Presence measured by eViews: Clicks on article by Author Name

Top Authors for all days ending 2018-01-29 (Summarized)

All Time

Author Name electronic Views
Aviva Lev-Ari, PhD, RN [2012pharmaceutical]

352,153

 

Our TEAM 5,934  

 
Founder 3,257
BioMed e-Series 3,140

 

Journal PharmaceuticalIntelligence.com 2,214
About 2,054
  VISION   2,803  

 


LPBI Group		             1,201

2.3     Digital KOL Parameters

Key Opinion Leader (KOL) – Aviva Lev-Ari, PhD, RN, as Evidenced by

https://pharmaceuticalintelligence.com/2016/07/21/key-opinion-leader-kol-aviva-lev-ari-phd-rn-as-evidenced-by/

 

3        Team building: Editors and Expert, Authors, Writers

Our Team

Selection of Journal’s Chief Scientific Officer (CSO) and BioMed e-Series Content Consultant (CC): Series B, C, D, E

L.H. Bernstein, MD, FCAP

Editorial & Publication of Articles in e-Books by  Leaders in Pharmaceutical Business Intelligence:  Contributions of Larry H Bernstein, MD, FCAP

https://pharmaceuticalintelligence.com/2014/10/16/editorial-publication-of-articles-in-e-books-by-leaders-in-pharmaceutical-business-intelligence-contributions-of-larry-h-bernstein-md-fcap/

4        Book Title Generation and Cover Page Design

As BioMed e-Series Editor–in-Chief, I was responsible for the following functions of product design and product launch

·       16 Title creations for e-Books

·       Designed 16 Cover Pages for a 16-Volume e-Books e-Series in BioMed

·       Designed Series A eTOCs and approved of all 16 electronic Table of Contents (eTOCs), working in tandem with all the Editors of each volume and all the Author contributors of article contents in the Journal.

·       Commissioned Articles by Authors/Curators per Author’s expertise on a daily basis

 

Below, see Volume Titles and Cover Pages:

13 LIVE results for Kindle Store: “Aviva Lev-Ari”

 

 

The VOICES of Patients, Hospitals CEOs, Health Care Providers, Caregivers and Families: Personal Experience with Critical Care and Invasive Medical Procedures … E: Patient-Centered Medicine Book 1)

Oct 16, 2017 | Kindle eBook

by Larry H. Bernstein and Aviva Lev-Ari

$0.00

Subscribers read for free.

Read for Free

$49.00$ 49 00 to buyKindle Edition

Get it TODAY, Jan 29

Sold by: Amazon Digital Services LLC

Cancer Therapies: Metabolic, Genomics, Interventional, Immunotherapy and Nanotechnology in Therapy Delivery (Series C Book 2)

May 13, 2017 | Kindle eBook

by Larry H. Bernstein and Demet Sag

$0.00

Subscribers read for free.

Read for Free

$100.00$ 100 00 to buyKindle Edition

Get it TODAY, Jan 29

Sold by: Amazon Digital Services LLC

The Immune System, Stress Signaling, Infectious Diseases and Therapeutic Implications: VOLUME 2: Infectious Diseases and Therapeutics and VOLUME 3: The … (Series D: BioMedicine & Immunology)

Sep 4, 2017 | Kindle eBook

by Larry H. Bernstein and Aviva Lev-Ari

$0.00

Subscribers read for free.

Read for Free

$115.00$ 115 00 to buyKindle Edition

Get it TODAY, Jan 29

Sold by: Amazon Digital Services LLC

Perspectives on Nitric Oxide in Disease Mechanisms (Biomed e-Books Book 1)

Jun 20, 2013 | Kindle eBook

by Margaret Baker PhD and Tilda Barliya PhD

$0.00

Subscribers read for free.

Read for Free

$75.00$ 75 00 to buyKindle Edition

Get it TODAY, Jan 29

5 out of 5 stars 6

Sold by: Amazon Digital Services LLC

Medical Scientific Discoveries for the 21st Century & Interviews with Scientific Leaders (Series E)

Dec 9, 2017 | Kindle eBook

by Larry H. Bernstein and Aviva Lev-Ari

$0.00

Subscribers read for free.

Read for Free

$75.00$ 75 00 to buyKindle Edition

Get it TODAY, Jan 29

Sold by: Amazon Digital Services LLC

Etiologies of Cardiovascular Diseases: Epigenetics, Genetics and Genomics

Nov 28, 2015 | Kindle eBook

by Justin D. Pearlman MD ME PhD MA FACC and Stephen J. Williams PhD

$0.00

Subscribers read for free.

Read for Free

$75.00$ 75 00 to buyKindle Edition

Get it TODAY, Jan 29

Sold by: Amazon Digital Services LLC

Cardiovascular Original Research: Cases in Methodology Design for Content Co-Curation: The Art of Scientific & Medical Curation

Nov 29, 2015 | Kindle eBook

by Larry H. Bernstein MD FCAP and Aviva Lev-Ari PhD RN

$0.00

Subscribers read for free.

Read for Free

$75.00$ 75 00 to buyKindle Edition

Get it TODAY, Jan 29

Sold by: Amazon Digital Services LLC

Medical 3D BioPrinting – The Revolution in Medicine Technologies for Patient-centered Medicine: From R&D in Biologics to New Medical Devices (Series E: Patient-Centered Medicine Book 4)

Dec 30, 2017 | Kindle eBook

by Larry H. Bernstein and Irina Robu

$0.00

Subscribers read for free.

Read for Free

$75.00$ 75 00 to buyKindle Edition

Get it TODAY, Jan 29

Sold by: Amazon Digital Services LLC

Metabolic Genomics & Pharmaceutics (BioMedicine – Metabolomics, Immunology, Infectious Diseases Book 1)

Jul 21, 2015 | Kindle eBook

by Larry H. Bernstein MD FCAP and Prabodah Kandala PhD

$0.00

Subscribers read for free.

Read for Free

$75.00$ 75 00 to buyKindle Edition

Get it TODAY, Jan 29

5 out of 5 stars 1

Sold by: Amazon Digital Services LLC

Cancer Biology and Genomics for Disease Diagnosis (Series C: e-Books on Cancer & Oncology Book 1)

Aug 10, 2015 | Kindle eBook

by Larry H Bernstein MD FCAP and Prabodh Kumar Kandala PhD

$0.00

Subscribers read for free.

Read for Free

$75.00$ 75 00 to buyKindle Edition

Get it TODAY, Jan 29

Sold by: Amazon Digital Services LLC

Genomics Orientations for Personalized Medicine (Frontiers in Genomics Research Book 1)

Nov 22, 2015 | Kindle eBook

by Sudipta Saha PhD and Ritu Saxena PhD

$0.00

Subscribers read for free.

Read for Free

$75.00$ 75 00 to buyKindle Edition

Get it TODAY, Jan 29

Sold by: Amazon Digital Services LLC

Milestones in Physiology: Discoveries in Medicine, Genomics and Therapeutics (Series E: Patient-Centered Medicine Book 3)

Dec 26, 2015 | Kindle eBook

by Larry H. Bernstein MD FACP and Aviva Lev-Ari PhD RN

$0.00

Subscribers read for free.

Read for Free

$75.00$ 75 00 to buyKindle Edition

Get it TODAY, Jan 29

Sold by: Amazon Digital Services LLC

Regenerative and Translational Medicine: The Therapeutic Promise for Cardiovascular Diseases

Dec 26, 2015 | Kindle eBook

by Justin D. Pearlman MD ME PhD MA FACC and Ritu Saxena PhD

$0.00

Subscribers read for free.

Read for Free

$75.00$ 75 00 to buyKindle Edition

Get it TODAY, Jan 29

Sold by: Amazon Digital Services LLC

5        Style Setting: Instruction manuals for Journal, Articles, Books

As BioMed e-Series Editor–in-Chief, Aviva Lev-Ari, PhD, RN was responsible for

·       All the documentation (Instruction manuals) on Style setting, and for

·       Training all team members

·       Journal Articles Format

·       Journal Comment Exchange Format

·       e-Books Production Process:

1.               Volume creation from Journal’s Article Archive,

2.               Format Translation from HTML to .mobi for Kindle devices,

3.               Proof reading process,

4.               Title release,

5.               Book electronic Upload to Amazon.com Cloud.

6.               Connection of all articles and e-Books to Social Media, Ping back generation by mentioning other related articles published in the Journal

 

Lastly, 6, below

6        Annual Workflow Management of Multiple eTOCs – Multi-year Book Publishing Scheduling Plan, 2013 – Present

 

Title Date of Publication Number of Pages
Perspectives on Nitric Oxide in Disease Mechanisms 6/21/2013 895
Cardiovascular Original Research: Cases in Methodology Design for Content Co-Curation 11/30/2015 11039 KB
Etiologies of Cardiovascular Diseases: Epigenetics, Genetics and Genomics 11/29/2015 12333 KB
Regenerative and Translational Medicine: The Therapeutics Promise for Cardiovascular Diseases 12/26/2015 11668 KB
Genomics Orientations for Personalized Medicine 11/23/2015 11724 KB
Cancer Biology & Genomics for Disease Diagnosis 8/11/2015 13744 KB
Cancer Therapies: Metabolic, Genomics, Interventional, Immunotherapy and Nanotechnology in Therapy Delivery 5/18/2017 5408 pages
Metabolic Genomics and Pharmaceutics 7/21/2015 13927 KB
The Immune System, Stress    Signaling, Infectious Diseases and Therapeutic Implications 9/4/2017 3747 pages
The VOICES of Patients, Hospitals CEOs, Health Care Providers, Caregivers and Families: Personal Experience with Critical Care and Invasive Medical Procedures 10/16/2017 826 pages
Medical Scientific Discoveries for the 21st Century & Interviews with Scientific Leaders 12/9/2017 2862 pages
Milestones in Physiology: Discoveries in Medicine, Genomics and Therapeutics 12/27/2015 11125 KB
Medical 3D BioPrinting – The Revolution in Medicine, Technologies for Patient-centered Medicine: From R&D in Biologics to New Medical Devices 12/30/2017 1005 pages
Pharmacological Agents in Treatment of Cardiovascular Disease

 

 Work-in-Progress, Expected Publishing date in 2018 ???
Interventional Cardiology and Cardiac Surgery for Disease Diagnosis and Guidance of Treatment Work-in-Progress, Expected Publishing date in 2018

 

 ???

 

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Community Involvement and Marriage Relations are key to Longevity: Longitudinal nearly 80 years Study of surviving Crimson men, one of the world’s longest studies of adult life

Posted in Longevity on February 12, 2018| Leave a Comment »


Community Involvement and Marriage Relations are key to Longevity: Longitudinal nearly 80 years Study of surviving Crimson men, one of the world’s longest studies of adult life

 

Reporter: Aviva Lev-Ari, PhD, RN

“When the study began, nobody cared about empathy or attachment,” said Vaillant. “But the key to healthy aging is relationships, relationships, relationships.”

The study showed that the role of genetics and long-lived ancestors proved less important to longevity than the level of satisfaction with relationships in midlife, now recognized as a good predictor of healthy aging. The research also debunked the idea that people’s personalities “set like plaster” by age 30 and cannot be changed.

“Those who were clearly train wrecks when they were in their 20s or 25s turned out to be wonderful octogenarians,” he said. “On the other hand, alcoholism and major depression could take people who started life as stars and leave them at the end of their lives as train wrecks.”

Professor Robert Waldinger is director of the Harvard Study of Adult Development, one of the world’s longest studies of adult life. Rose Lincoln/Harvard Staff Photographer

The study’s fourth director, Waldinger has expanded research to the wives and children of the original men. That is the second-generation study, and Waldinger hopes to expand it into the third and fourth generations. “It will probably never be replicated,” he said of the lengthy research, adding that there is yet more to learn.

“We’re trying to see how people manage stress, whether their bodies are in a sort of chronic ‘fight or flight’ mode,” Waldinger said. “We want to find out how it is that a difficult childhood reaches across decades to break down the body in middle age and later.”

SOURCE

https://news.harvard.edu/gazette/story/2017/04/over-nearly-80-years-harvard-study-has-been-showing-how-to-live-a-healthy-and-happy-life/

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