#Florida medical

[aplus123]

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[reasonsforhope]

"In a first-ever human clinical trial, an mRNA cancer vaccine developed at the University of Florida successfully reprogrammed patients’ immune systems to fiercely attack glioblastoma, the most aggressive and lethal brain tumor.

The results in four adult patients mirrored those in 10 pet dog patients suffering from brain tumors whose owners approved of their participation.

The discovery represents a potential new way to recruit the immune system to fight treatment-resistant cancers using an iteration of mRNA technology and lipid nanoparticles, similar to COVID-19 vaccines, but with two key differences: use of a patient’s own tumor cells to create a personalized vaccine, and a newly engineered complex delivery mechanism within the vaccine.

“Instead of us injecting single particles, we’re injecting clusters of particles that are wrapping around each other like onions,” said senior author Elias Sayour, M.D., Ph.D., a UF Health pediatric oncologist who pioneered the new vaccine, which like other immunotherapies attempts to “educate” the immune system that a tumor is foreign.

“These clusters alert the immune system in a much more profound way than single particles would.”

Among the most impressive findings was how quickly the new method spurred a vigorous immune-system response to reject the tumor, said Sayour, principal investigator at the University’s RNA Engineering Laboratory and McKnight Brain Institute investigator who led the multi-institution research team.

“In less than 48 hours, we could see these tumors shifting from what we refer to as ‘cold’—very few immune cells, very silenced immune response—to ‘hot,’ very active immune response,” he said.

“That was very surprising given how quick this happened, and what that told us is we were able to activate the early part of the immune system very rapidly against these cancers, and that’s critical to unlock the later effects of the immune response,” he explained in a video (below).

Glioblastoma is among the most devastating diagnoses, with median survival around 15 months. Current standard of care involves surgery, radiation and some combination of chemotherapy.

The new report, published May 1 in the journal Cell, is the culmination of seven years of promising studies, starting in preclinical mouse models.

In the cohort of four patients, genetic material called RNA was extracted from each patient’s own surgically removed tumor, and then messenger RNA (mRNA)—the blueprint of what is inside every cell, including tumor cells—was amplified and wrapped in the newly designed high-tech packaging of biocompatible lipid nanoparticles, to make tumor cells “look” like a dangerous virus when reinjected into the bloodstream to prompt an immune-system response.

The vaccine was personalized to each patient with a goal of getting the most out of their unique immune system...

While too early in the trial to assess the clinical effects of the vaccine, the patients either lived disease-free longer than expected or survived longer than expected. The 10 pet dogs lived a median of 4.5 months, compared with a median survival of 30-60 days typical for dogs with the condition.

The next step, with support from the Food and Drug Administration and the CureSearch for Children’s Cancer foundation, will be an expanded Phase I clinical trial to include up to 24 adult and pediatric patients to validate the findings. Once an optimal and safe dose is confirmed, an estimated 25 children would participate in Phase 2."

-via Good News Network, May 11, 2024

-video via University of Florida Health, May 1, 2024

[mostlysignssomeportents]

When private equity destroys your hospital

I'm on tour with my new novel The Bezzle! Catch me TOMORROW in PHOENIX (Changing Hands, Feb 29) then Tucson (Mar 9-10), San Francisco (Mar 13), and more!

As someone who writes a lot of fiction about corporate crime, I naturally end up spending a lot of time being angry about corporate crime. It's pretty goddamned enraging. But the fiction writer in me is especially upset at how cartoonishly evil the perps are – routinely doing things that I couldn't ever get away with putting in a novel.

Beyond a doubt, the most cartoonishly evil characters are the private equity looters. And the most cartoonishly evil private equity looters are the ones who get involved in health care.

(Buckle up.)

Writing for The American Prospect, Maureen Tcacik details a national scandal: the collapse of PE-backed hospital chain Steward Health, a company that bought and looted hospitals up and down the country, starving them of everything from heart valves to prescription paper, ripping off suppliers, doctors and nurses, and callously exposing patients to deadly risk:

https://prospect.org/health/2024-02-27-scenes-from-bat-cave-steward-health-florida/

Steward occupies a very special place in the private equity looting cycle. Private equity companies arrange themselves on a continuum of indiscriminate depravity. At the start of the continuum are PE funds that buy productive and useful firms (everything from hospitals to car-washes) using "leveraged buyouts." That means that they borrow money to buy the company and use the company itself as collateral: it's like you getting a bank-loan to buy your neighbor's mortgage out from under them, and using your neighbor's house as collateral for that loan.

Once the buyout is done, the PE fund pays itself a "special dividend" (stealing money the business needs to survive) and then starts charging the business a "management fee" for the PE fund's expertise. To pay for all this, the PE bosses start to hack away at the company. Quality declines. So do wages. Prices go up. The company changes suppliers, opting for cheaper alternatives, often stiffing the old company. There are mass layoffs. The remaining employees end up doing three peoples' jobs, for lower wages, with fewer materials of lower quality.

Eventually, that top-feeding PE company finds a more desperate, more ham-fisted PE company to unload the business onto. That middle-feeding company also does a leveraged buyout, pays itself another special dividend, cuts wages, staffing and quality even further. They switch to even worse suppliers and stiff the last batch. Prices go up even higher.

Then – you guessed it – the middle-feeding PE company finds an even more awful PE bottom-feeder to unload the company onto. That bottom feeder does it all again, without even pretending to leave the business in condition to do its job. The company is a shambling zombie at this point, often producing literal garbage in place of the products that made its reputation. Employees' paychecks bounce, or don't show up at all. The company stops bothering to pay the lawyers that have been fending off its creditors. Those lawyers sue the company, too.

That's the kind of PE company Steward Health was, and, as the name suggests, Steward Health is in the business of stripping away the very last residue of value from community hospitals. As you might imagine, this gets pretty fucking ugly.

Steward owns 32 hospitals up and down the country, though its holdings are dwindling as the company walks away from its debt-burdened holdings, after years of neglect that have rendered them unfit for use as health facilities – or for any other purpose. Tcacik's piece offers a snapshot of one such hospital: Florida's Rockledge Regional Medical Center, just eight miles from Cape Canaveral.

Rockledge is a disaster. The fifth floor was, at one point, home to 5,000 bats.

Five.

Thousand.

Bats.

(Rockledge stiffed the exterminators.)

The bats were just the beginning. One of the internal sewage pipes ruptured. Whole sections of the hospital were literally full of shit, oozing out of the walls and ceiling, slopping over medical equipment.

That's an urgent situation for any hospital, but for Rockledge, it's catastrophic, because Rockledge is a hospital without any hospital supplies. Steward has stiffed the companies that supply "heart valves, urology lasers, Impella catheters, cardiac catheterization balloons, slings for lifting heavier patients, blood and urine test reagents, and most recently, prescription paper." Key medical equipment has been repossessed. So have the Pepsi machines. The hospital cafeteria had its supply of cold cuts repossessed:

https://www.reddit.com/r/massachusetts/comments/1agc1j4/comment/kolicqo/

It's not just Steward's nonpayments that reek of impending doom. Its payments also bear the hallmarks of a scam artist on the brink of blowing off the con. The company recently paid off a vendor with five separate checks for $1m, each drawn on "a random hospital in Utah" (Steward recently walked away from its Utah hospitals; its partners there are suing it for stealing $18m on their way out the door).

This company – which owns 32 hospitals! – has resorted to gambits like sending photos of fake checks to doctors it hasn't paid in months as "proof" that the money was coming (the checks arrived 22 days later).

Steward owes so much money to its employees – $1.66m to just one doctors' group. But the medical staff keep doing their jobs, and are reluctant to speak on the record, thanks to Steward's reputation for vicious retaliation. Those health workers keep showing up to take care of patients, even as the hospital crumbles around them. One clinician told Tcacik: "I watched a bed collapse underneath a [patient] who had just undergone hip surgery."

Rockledge has nine elevators, but only five of them work – the other four have been broken for a year. The hospital's fourth floor has been converted to "a graveyard of broken beds." The sinks are clogged, or filled with foul gunk. There's black mold. Nurses have noted on the maintenance tags that the repair service refuses to attend the hospital until their overdue bills are paid. The fifteen-person on-site maintenance team was cut to just two workers.

Steward is just the latest looting owner of Rockledge. After the Great Financial Crisis, private equity consultants helped sell it to Health Management Associates. The hospital's CEO took home a $10m bonus for that sale and exited; Health Management Associates then quickly became embroiled in a Medicare fraud and kickback scandal. Soon after, Rockledge was passed on to Community Health Systems, who then sold it on to Rockledge.

Steward, meanwhile, was at that time owned by an even bigger private equity giant, Cerberus, which then sold Steward off. That deal was performatively complex and hid all kinds of mischief. Prior to Cerberus's sell-off of Steward, they sold off Steward's real-estate. The buyer was Medical Properties Trust, who gave Cerberus $1.25b for the real-estate: three hospitals in Florida and three more in Ohio. Steward then contracted to operate these hospitals on MPT's behalf, and pay MPT rent for the real-estate.

This complex arrangement was key to siphoning value out of the hospital and to keeping angry creditors at bay – if you can't figure out who owes you money, it's a lot harder to collect on the debt. The scheme was masterminded by Steward founder/CEO Ralph de la Torre. De la Torre is notorious for taking a massive dividend out of the company while it owed $1.4b to its creditors. He bought a $40m yacht with the money.

De la Torre was once feted as a business genius who would "disrupt" healthcare. But as Steward's private jet hops around "Corfu, Santorini, St. Maarten and Antigua" as its hospitals literally crumble, he's becoming less popular. In Massachusetts, politicians have railed against Steward and de la Torre (Governor Healey wants the company to leave the state "as soon as possible").

Florida, by contrast, is much more friendly to Steward. The state Health and Human Services Committee chair Randy Fine is an ardent admirer of hospital privatization and is currently campaigning to sell off the last community hospital in Brevard County. The state inspectors are likewise remarkably tolerant of Steward's little peccadillos. The quasi-governmental agency that inspects hospitals has awarded this shit-and-bat-filled, elevator-free, understaffed rotting hulk "A" grades for quality.

These inspectors jointly represent a mismatched assortment of private and public agencies, dominated by a nonprofit called Leapfrog, the brainchild of Harvard public-health prof Lucian Leape, who founded it in 2000. Leapfrog likes to tout its "transparent" assessment criteria, and Steward are experts at hitting those criteria, spending the exact minimum to tick every box that Leapfrog inspectors use as proxies for overall quality and safety.

This is a pretty great example of Goodhart's Law: "every measurement eventually becomes a target, whereupon it ceases to be a good measurement":

https://xkcd.com/2899/

But despite Steward's increasingly furious creditors and its decaying facilities, the company remains bullish on its ability to continue operations. Medical Properties Trust – the real estate investment trust that is nominally a separate company from Steward – recently hosted a conference call to reassure Wall Street investors that it would be a going concern. When a Bank of America analyst asked MPT's CFO how this could possibly be, given the facility's dire condition and Steward's degraded state, the CFO blithely assured him that the company would get bailouts: "We own hospitals no one wants to see closed."

That's the thing about PE and health-care. The looters who buy out every health-care facility in a region understand that this makes them too big to fail: no matter how dangerous the companies they drain become, local governments will continue to prop them up. Look at dialysis, a market that's been cornered by private equity rollups. Today, if you need this lifesaving therapy, there's a good chance that every accessible facility is owned by a private equity fund that has fired all its qualified staff and ceased sterilizing its needles. Otherwise healthy people who visit these clinics sometimes die due to operator error. But they chug along, because no dialysis clinics is worse that "dialysis clinics where unqualified sadists sometimes kill you with dirty needles":

https://www.thebignewsletter.com/p/the-dirty-business-of-clean-blood

The bad news is that private equity has thoroughly colonized the entire medical system. They took hospitals, fired the doctors, then took over the doctors' groups that provided outsource staff to the hospital:

https://pluralistic.net/2020/04/04/a-mind-forever-voyaging/#prop-bets

It's illegal for private equity companies to own doctors' practices (doctors have to own these), but they obfuscated the crime with a paper-thin pretext that they got away with despite its obvious bullshittery:

https://pluralistic.net/2020/05/21/profitable-butchers/#looted

The financier who decides whether you live or die depends on an algorithm that literally sets a tolerable level of preventable deaths for the patients trapped in the practice:

https://pluralistic.net/2023/08/05/any-metric-becomes-a-target/#hca

Private equity also took over emergency rooms and boobytrapped them with "surprise billing" – junk fees that ran to thousands of dollars that you had to pay even if the hospital was in network with your insurer. They made billions from this, and spent a many millions from that booty keeping the scam alive with scare ads:

https://pluralistic.net/2020/04/21/all-in-it-together/#doctor-patient-unity

The whole health stack is colonized by private equity-backed monopolies. Even your hospital bed!

https://pluralistic.net/2022/01/05/hillrom/#baxter-international

Then there's residential care. Private equity cornered many regional markets on nursing homes and turned them into slaughterhouses, places where you go to die, not live:

https://pluralistic.net/2021/02/23/acceptable-losses/#disposable-olds

The palliative care sector is also captured by private equity. PE bosses hire vast teams of fast-talking salespeople who con vulnerable older people into entering an end-of-life system before they are ready to die. Thanks to loose regulation, the nation is filled with fake hospices that can rake in millions from Medicare while denying all care to their patients (hospice patients don't get life-extending medication or procedures, by definition):

https://pluralistic.net/2023/04/26/death-panels/#what-the-heck-is-going-on-with-CMS

If you survive this long enough, Medicare eventually tells the hospice that you're clearly not dying and you get kicked off their rolls. Now you have to go through the lengthy bureaucratic nightmare of convincing the system – which was previously informed that you were at death's door – that you are actually viable and need to start getting care again (good luck with that).

If that kills you, guess what? Private equity has rolled up funeral homes up and down the country, and they will scam your survivors just as hard as the medical system that killed you did:

https://pluralistic.net/2022/09/09/high-cost-of-dying/#memento-mori

The PE sector spent more than a trillion dollars over the past decade buying up healthcare companies, and it has trillions more in "dry powder" allocated for further medical acquisitions. Why not? As the CFO of Medical Properties Trust told that Bank of America analyst last week, when you "own hospitals no one wants to see closed." you literally can't fail, no matter how many people you murder.

The PE sector is a reminder that the crimes people commit for money far outstrip the crimes they commit for ideology. Even the most ideological killers are horrified by the murders their profit-motivated colleagues commit.

Last year, Tkacic wrote about the history of IG Farben, the German company that built Monowitz, a private slave-labor camp up the road from Auschwitz to make the materiel it was gouging Hitler's Wehrmacht on:

https://pluralistic.net/2023/06/02/plunderers/#farben

Farben bought the cheapest possible slaves from Auschwitz, preferentially sourcing women and children. These slaves were worked to death at a rate that put Auschwitz's wholesale murder in the shade. Farben's slaves died an average of just three months after starting work at Monowitz. The situation was so abominable, so unconscionable, that the SS officers who provided outsource guard-labor to Monowitz actually wrote to Berlin to complain about the cruelty.

The Nuremberg trials are famous for the Nazi officers who insisted that they were "just following order" but were nonetheless executed for their crimes. 24 Farben executives were also tried at Nuremberg, where they offered a very different defense: "We had a fiduciary duty to our shareholders to maximize our profits." 19 of the 24 were acquitted on that basis.

PE is committed to an ideology that is far worse than any form of racial animus or other bias. As a sector, it is committed to profit above all other values. As a result, its brutality knows no bounds, no decency, no compassion. Even the worst crimes we commit for hate are nothing compared to the crimes we commit for greed.

If you'd like an essay-formatted version of this post to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

https://pluralistic.net/2024/02/28/5000-bats/retaliation#charnel-house

[starlet-sky]

No filter. No edit. As raw as the papers in my J.

[thurisazsalail]

Uh. I just spent $1000 usd on a dentist. That was unexpected. Sure. Okay.

The cat's bloodwork for his serious heart problem is ~$400 at the cheap vet tomorrow. Fuck.

This is the cat in question. He's dreaming but he's ALWAYS this huffy + puffy. There is fluid building up in his chest but now he's so far gone, he can't have surgery. All we can do is bloodwork, x-rays, and medication. His meds can't be refilled without new bloodwork.

I could use the help. Even $1 at a time.

$A - DanielOneiroi

I also do paypal, but message for email address <3

[cosmicvaca]

As a Kakyoin fan and artist, I'm doing my part in giving him a part 4 design 🫡 (OG ask) Throwing my headcanons at you and hitting you square in the face

Ramble under the cut

Noriaki is a successful gallery artist living with his "roommate" on Florida's Gulf Coast (I think the Tampa Bay area, specifically Bradenton, FL). They have a small bungalow near the water, Perfect for them, their office/studios, Jotaro's fish tanks, and Jolyne when she comes from her mother's during the holidays or for summer break. Jotaro is definitely a boat guy they have theirs parked on the side of the house and take it for a spin over at least once a month (or once a week when Jolyne is with them over the summer)

He still does missions for the SWF with Jotaro, but his day job is his art. He works in an abstract/contemporary style and his pieces are large and textural. Jotaro doesn't really get it but still supports his partner, Jolyne loves them though.

Also, he and Jotaro have matching wedding rings: platinum bands with emerald Inserts.

[ratatatastic]

quite honestly i think they both have their fingers stuck like that...(x)

[yeoldenews]

Hi! It seems like fireworks and firecrackers were a very common item in Santa letters, to the extent that they’re often thrown in at the end along with fruit like a ‘default’ Santa gift. If you know, why and when did fireworks stop being a go-to present for kids to ask from Santa?

This is actually something I keep meaning to dig into more.

It was almost exclusively a Southern practice (particularly in the Deep South), but was so universal there that it's honestly more unusual for Southern kids to NOT ask for fireworks than to ask for them. I'm not sure if there were cultural aspects to this or was just because it makes more sense to give them where it's actually warm enough to shoot them off.

They seem to have been given primarily as a stocking-stuffers, as they are almost always listed alongside the standard fruit, nuts and candy.

From what I've seen, requests for fireworks dropped off sharply in the early 60s, though I as of yet haven't found any convincing reason as to why.

That's a bit early to coincide with the general shift away from little boys asking for firearms, which seems (from my observations at least) to be largely correlated with the advent of video games in the 70s and 80s.

It's possible it may have been a natural result of child safety standards evolving beyond the 'sure, give your six-year-old explosives, what's the worst that could happen?' that seems to have been the dominant attitude for the first half of the 20th century.

If anyone from the South has any insight on this I'd love to hear it.

[zinniajones]

FLORIDA HRT CRISIS: SB 254, effective May 17 2023, banned nearly all new HRT prescriptions and refills of existing prescriptions for trans adults, for up to 6 more weeks or until “emergency” state-mandated consent forms are published by the Boards of Medicine.

Trans care bans were never about “protecting children” — they were about making all trans existence completely impossible. See for yourself.

(Full quality version)

Please share to help Florida's trans community survive SB 254!

[grif-hawaiian-rolls]

The Reds the Feds and Wash : GOSSIP

Look. This is as legible as i get ok i tried

Also known as Neko_you_Lying_Little_Shit (affectionate)

[scopophobia-polaris]

My farmer arc

[poisonousquinzel]

"a dude in Texas legally changed his name to "Literally Anyone Else" and he's attempting to run for President against Biden & Trump" [source]

okay, but putting aside the comedic aspect of this, it is concerning the amount of people who are prompted to vote for candidates just because it's funny. I'm not the biggest fan of how his policy about the boarder sounds [Site], but I do implore anyone who is able to vote in the 2024 US election to please research other candidates.

The media is only going to continue pushing the idea it's inevitably going to be Trump vs Biden 2.0 and we have no other options, that we have to vote for Biden again because of Project 2025. Is that whole thing terrifying?

Yeah, fucking absolutely.

But voting for Biden will not solidify our safety from that. Biden is exactly like the rest of them. He always has been. You can't make the lesser of two evils argument when they're both just plain evil.

You cannot say that Biden is even mildly a better choice than Trump when he is currently directly involved in a genocide. That is not some little fucking thing. That in and of itself disqualifies him as a lesser evil. Biden is just as bad as him and he will not save us because he doesn't fucking care.

Cornel West [Site] is an Independent candidate running for President in the 2024 Election. [Policies]

Claudia De la Cruz and Karina Garcia [Site] are running for President and Vice-President as the candidates of the Party for Socialism and Liberation in the 2024 Election. [Policies]

There are options.

There are people trying to change the corrupt foundation our system is built on, but we have to help amplify them because the mainstream media will not.

[starlet-sky]

Cheers besties

[thurisazsalail]

This is Vash. Vash likes to eat rice and teriyaki cabbage. Or just rice. He loves rice so much.

This is Vash, perhaps worried that there is not MORE snacks.

Now that I have your attention

My friends got flooded out of their home (thanks Helene!) Insurance will cover much of the damage, but I've easily spent $300 since Saturday, and they've put out maybe $500 so far.

The kitchen is unusable so all food must be eaten out, and even McDonalds is $12+ in our area, per person. A sushi lunch special is $15, so. The appliances are unusable, so they've just packet wet clothes into bags. We'll see if it can be salvaged later.

The cpap machines are dead. I'm still trying to convince one that sewer + river water in plastics like hoses CANNOT be sterilized.

Plus, they are 70+ years old. They *cannot* do all this, and I have EDS. Everyone we know is either also flooded, helping flooded friends, or also medically unstable. It's costing even more to pay people to lift boxes and such.

I've been working for 5 days so far. Today was short, only 4 hours not including logistics like driving and securing storage.

If you can help with $5, please $@ me with note TKO (helps me separate btw other job payments.)

[paoladarling]

Back at it with your daily dose of the devils lettuce. BBY TRTL , Indica Kush coming in at 31.80% .

10/10 for taste,smell and effect 🌟

Thanks Wiz for growing some good stuff and sharing it ☺️

[gxlden-angels]

I think it's so funny when Christian flat out reject the concept of being intersex like oh so me and about 2% of the population aren't real but you expect me to believe homeboy's gonna come back after (holy) ghosting us for over 2000 years?