upi--2020-05-12--ApiJect Systems awarded $138M for syringes in anticipation of COVID-19 vaccine

May 12 ( UPI ) -- The Department of Defense announced Tuesday that it has awarded a $ 138 million contract to ApiJect Systems America to create a ready supply chain for prefilled syringes when a COVID-19 vaccine is available .
According to the Pentagon , the contract was spearheaded by the DoD 's Joint Acquisition Task Force in conjunction with the U.S. Department of Health and Human Services .
Under the contract , ApiJect 's subsidiary RAPID USA Inc. will operate under the initiative Project Jumpstart to create a U.S.-based high-speed supply chain for prefilled syringes using blow-fill-seal plastics @ @ @ @ @ @ @ medical-grade injection devices by October 2020 .
`` By immediately upgrading a sufficient number of existing domestic BFS facilities with installations of filling-line and technical improvements , 'Jumpstart ' will enable the manufacture of more than 100 million prefilled syringes for distribution across the United States by year-end 2020 , '' said Pentagon spokesman Lt. Col. Mike Andrews .
According to Andrews , the Jumpstart initiative will enable the manufacture of more than 100 million prefilled syringes for distribution across the United States by the end of the year .
ApiJect announced Tuesday @ @ @ @ @ @ @ production of syringes in 2021 , producing 330 million prefilled BFS syringes per month by the end of the year .
`` RAPID USA is led by our multi-disciplinary team of experienced engineers , pharmaceutical technology experts , and management leadership .
Our team is expending extraordinary efforts to ensure that when drugs are developed and tested all Americans can receive critical injections , '' said ApiJect Systems America CEO Jay Walker .
`` We will have done our part by providing the manufacturing capacity to support the necessary volume of ready-to-use prefilled @ @ @ @ @ @ @ they therapeutics or vaccines . ''
Initial manufacturing sites will be in Connecticut , South Carolina and Illinois , with potential expansion to other U.S. locations .
`` RAPID will provide increased lifesaving capability against future national health emergencies that require population-scale vaccine administration on an urgent basis , '' Andrews said .

May 12 (UPI) -- The Department of Defense announced Tuesday that it has awarded a $138 million contract to ApiJect Systems America to create a ready supply chain for prefilled syringes when a COVID-19 vaccine is available.
According to the Pentagon, the contract was spearheaded by the DoD's Joint Acquisition Task Force in conjunction with the U.S. Department of Health and Human Services.
Advertisement
Under the contract, ApiJect's subsidiary RAPID USA Inc. will operate under the initiative Project Jumpstart to create a U.S.-based high-speed supply chain for prefilled syringes using blow-fill-seal plastics manufacturing technology, enabling the manufacture of medical-grade injection devices by October 2020.
"By immediately upgrading a sufficient number of existing domestic BFS facilities with installations of filling-line and technical improvements, 'Jumpstart' will enable the manufacture of more than 100 million prefilled syringes for distribution across the United States by year-end 2020," said Pentagon spokesman Lt. Col. Mike Andrews.
According to Andrews, the Jumpstart initiative will enable the manufacture of more than 100 million prefilled syringes for distribution across the United States by the end of the year.
ApiJect announced Tuesday that it also plans to ramp up production of syringes in 2021, producing 330 million prefilled BFS syringes per month by the end of the year.
Advertisement
"RAPID USA is led by our multi-disciplinary team of experienced engineers, pharmaceutical technology experts, and management leadership. Our team is expending extraordinary efforts to ensure that when drugs are developed and tested all Americans can receive critical injections," said ApiJect Systems America CEO Jay Walker. "We will have done our part by providing the manufacturing capacity to support the necessary volume of ready-to-use prefilled syringes that contain essential medicines, be they therapeutics or vaccines."
Initial manufacturing sites will be in Connecticut, South Carolina and Illinois, with potential expansion to other U.S. locations.
"RAPID will provide increased lifesaving capability against future national health emergencies that require population-scale vaccine administration on an urgent basis," Andrews said.


upi--2020-05-12--Five surfers found dead off the coast of the Hague

May 12 ( UPI ) -- Five surfers have died after surfing amid dangerous weather conditions off the coast of the Netherlands , Dutch authorities said Tuesday .
Two surfers died after being pulled from the sea Monday , two bodies were found Tuesday morning , while a fifth body was found but not immediately recovered later Tuesday .
`` The strong wind from a northern direction and strong sea current due to the spring tide made the joint search actions a tricky job , '' lifeguard service KNRM said .
Men and women aged 22 to 38 who lived @ @ @ @ @ @ @ among the victims .
Ten experienced surfers are believed to have been in the water at the time of the incident including a group of six , a group of three and a single surfer .
It is believed they were overwhelmed by heavy winds and seafoam that hit the Dutch coast .
The Hague Mayor Johan Remkes said it was too early to determine the cause of the incident , adding the surfers had sufficient experience to assess the dangers presented by the waters .
`` How can it be that people @ @ @ @ @ @ @ this place so well came to die ? ''
Remkes said .

Men and women aged 22 to 38 who lived in the area are believed to be among the victims. Photo by Sem Van Der Wal/EPA-EFE
May 12 (UPI) -- Five surfers have died after surfing amid dangerous weather conditions off the coast of the Netherlands, Dutch authorities said Tuesday. Two surfers died after being pulled from the sea Monday, two bodies were found Tuesday morning, while a fifth body was found but not immediately recovered later Tuesday. Advertisement
"The strong wind from a northern direction and strong sea current due to the spring tide made the joint search actions a tricky job," lifeguard service KNRM said.
Men and women aged 22 to 38 who lived in the area are believed to be among the victims.
Ten experienced surfers are believed to have been in the water at the time of the incident including a group of six, a group of three and a single surfer.
It is believed they were overwhelmed by heavy winds and seafoam that hit the Dutch coast.
The Hague Mayor Johan Remkes said it was too early to determine the cause of the incident, adding the surfers had sufficient experience to assess the dangers presented by the waters.
"How can it be that people with so much experience and who knew this place so well came to die?" Remkes said.
Advertisement


upi--2020-05-12--Alabama State hires ex-NBA All-Star Mo Williams as men's basketball coach

May 12 ( UPI ) -- Former NBA point guard Mo Williams was named head coach of the men 's basketball program at Alabama State , the school announced Tuesday .
`` It 's a great day to be a Hornet , '' Williams said in a statement .
`` I am extremely excited to become part of the family , and I am looking forward to the challenge .
Go Hornets ! ''
Williams , 37 , played 13 seasons in the NBA with the Utah Jazz , Milwaukee Bucks , Cleveland Cavaliers , Los Angeles Clippers , Portland @ @ @ @ @ @ @ Hornets .
He was named an All-Star with the Cavs in the 2008-09 campaign .
Williams ' last season in the league came in 2015-16 , when he returned to Cleveland and was a member of the Cavaliers team that beat the Golden State Warriors in seven games to win an NBA championship .
Over the past two seasons , Williams served as an assistant on Mark Gottfried 's coaching staff at California State University at Northridge .
Williams played under Gottfried at Alabama , where he was named SEC Freshman of the @ @ @ @ @ @ @ excited about the direction of our men 's basketball program as we moved forward into this new era , '' Alabama State athletic director Jennifer Lynne Williams said in a statement .
`` Mo Williams checked the boxes that we were looking for in the next head coach of Alabama State men 's basketball , and his passion and leadership speak volumes .
`` He is no stranger to the South , having played high school basketball in Mississippi and college basketball in Alabama .
I want to thank the committee for all @ @ @ @ @ @ @ , as they vetted many qualified applicants for the position .
Over the last few weeks and during this national [ coronavirus ] pandemic , they took time away from their daily schedules to find the right fit for Alabama State men 's basketball . ''
The school said it plans to hold a virtual press conference next week to officially introduce Mo Williams .

Former Cleveland Cavaliers guard Mo Williams (52) was an All-Star with the Cavs in the 2008-09 season. He last played in the league during the 2015-16 campaign. File Photo by Kamil Krzaczynski/UPI | License Photo
May 12 (UPI) -- Former NBA point guard Mo Williams was named head coach of the men's basketball program at Alabama State, the school announced Tuesday. "It's a great day to be a Hornet," Williams said in a statement. "I am extremely excited to become part of the family, and I am looking forward to the challenge. Go Hornets!" Advertisement
Williams, 37, played 13 seasons in the NBA with the Utah Jazz, Milwaukee Bucks, Cleveland Cavaliers, Los Angeles Clippers, Portland Trail Blazers, Minnesota Timberwolves and Charlotte Hornets. He was named an All-Star with the Cavs in the 2008-09 campaign.
Williams' last season in the league came in 2015-16, when he returned to Cleveland and was a member of the Cavaliers team that beat the Golden State Warriors in seven games to win an NBA championship.
Over the past two seasons, Williams served as an assistant on Mark Gottfried's coaching staff at California State University at Northridge. Williams played under Gottfried at Alabama, where he was named SEC Freshman of the Year in 2002.
Advertisement It's a great day to be a Hornet. Go Hornets!!!!!!! pic.twitter.com/HhQSo8VpOh— Mo Williams (@mowilliams) May 12, 2020
"We are excited about the direction of our men's basketball program as we moved forward into this new era," Alabama State athletic director Jennifer Lynne Williams said in a statement. "Mo Williams checked the boxes that we were looking for in the next head coach of Alabama State men's basketball, and his passion and leadership speak volumes.
"He is no stranger to the South, having played high school basketball in Mississippi and college basketball in Alabama. I want to thank the committee for all of their hard work during this process, as they vetted many qualified applicants for the position. Over the last few weeks and during this national [coronavirus] pandemic, they took time away from their daily schedules to find the right fit for Alabama State men's basketball."
The school said it plans to hold a virtual press conference next week to officially introduce Mo Williams.


upi--2020-05-12--Facebook ant colony roleplaying group grows to 1.8M members amid pandemic

May 12 ( UPI ) -- A Facebook group in which users pretend to be an ant colony has grown to more than 1.8 million members since social distancing procedures to prevent the spread of COVID-19 were implemented in the United States .
The group -- titled `` A group where we all pretend to be ants in an ant colony '' -- has grown from 100,000 members at the beginning of March to more than 1.8 million , its creator , Tyrese Childs , told NBC News .
Members of the group role play as members of an ant @ @ @ @ @ @ @ in various activities including crawling on food and carrying leaves .
They then type actions such as `` DIG , '' `` LIFT '' and `` BITE '' as they act out tasks in service of the colony 's queen .
The group is private , requiring an approval period before prospective members can join and post .
It asks those interested in joining a series of questions including whether they have watched the Pixar film A Bug 's Life .
`` We have so many user requests and pending posts that it @ @ @ @ @ @ @ '' said Childs , a college student from North Dakota .
`` I think people are searching for something to do right now .
You can scroll so much on social media . ''
It also has a list of rules that guide the role-playing experience and bar any discussion of `` human politics '' in addition to hate speech and sexually explicit , gross or violent content .
`` We have filtered out all the COVID-19 posts so it 's like an escape , '' Childs said .

Subscribe | UPI Odd Newsletter Subscribe
May 12 (UPI) -- A Facebook group in which users pretend to be an ant colony has grown to more than 1.8 million members since social distancing procedures to prevent the spread of COVID-19 were implemented in the United States.
The group -- titled "A group where we all pretend to be ants in an ant colony" -- has grown from 100,000 members at the beginning of March to more than 1.8 million, its creator, Tyrese Childs, told NBC News.
Advertisement
Members of the group role play as members of an ant colony, posting pictures of ants participating in various activities including crawling on food and carrying leaves.
They then type actions such as "DIG," "LIFT" and "BITE" as they act out tasks in service of the colony's queen.
The group is private, requiring an approval period before prospective members can join and post. It asks those interested in joining a series of questions including whether they have watched the Pixar film A Bug's Life.
"We have so many user requests and pending posts that it has become a job for me," said Childs, a college student from North Dakota. "I think people are searching for something to do right now. You can scroll so much on social media."
Advertisement
It also has a list of rules that guide the role-playing experience and bar any discussion of "human politics" in addition to hate speech and sexually explicit, gross or violent content.
"We have filtered out all the COVID-19 posts so it's like an escape," Childs said.


upi--2020-05-12--AFRICOM, U.S. Army conduct vehicle maintenance training in Senegal

May 12 ( UPI ) -- U.S. Africa Command announced Tuesday that Logistics Advisor Team 1610 , 6th Battalion , 1st Security Force Assistance Brigade earlier this year delivered a three-week long vehicle maintenance and recovery course in Dakar , Senegal .
The course -- in which U.S. Army advisors from Fort Benning in March provided training on recovering the M36 Puma armored personnel carrier -- was designed to prepare the Senegalese Armed Forces as they support United Nations Peacekeeping Operations , AFRICOM said .
`` Improving the logistics capabilities of our partners in the Senegalese Armed Forces , to @ @ @ @ @ @ @ task for U.S. Army Africa , '' Col. Layton Dunbar , U.S. Army Africa director of logistics , said in a press release .
`` The U.S. Army 's 1st SFAB logistics advisors did a tremendous job training our Senegalese partners and enhancing their Armed Force 's readiness through this security cooperation event . ''
The training was the 1st SFAB 's first advising mission after being sent to AFRICOM in February .
The 1st SFAB 's operations in Africa have been interrupted by the coronavirus , but the unit working with U.S. @ @ @ @ @ @ @ once conditions allow advisors to return , AFRICOM officials said .
`` Our mission is about way more than just training maintenance and logistics .
It 's really about building long-lasting partnerships and enhancing their skills in order to increase their capability and survivability during operations , '' said Maj. Michael Pachucki , 1st SFAB logistics advisor company commander .

Chief Warrant Officer 3 Yagmur Saylak, logistics advisor, Team 1610, 1st Security Force Assistance Brigade, teaches a group of Senegalese soldiers how to complete a vehicle inspection form in March in Dakar, Senegal. Photo courtesy of AFRICOM
May 12 (UPI) -- U.S. Africa Command announced Tuesday that Logistics Advisor Team 1610, 6th Battalion, 1st Security Force Assistance Brigade earlier this year delivered a three-week long vehicle maintenance and recovery course in Dakar, Senegal. The course -- in which U.S. Army advisors from Fort Benning in March provided training on recovering the M36 Puma armored personnel carrier -- was designed to prepare the Senegalese Armed Forces as they support United Nations Peacekeeping Operations, AFRICOM said. Advertisement
"Improving the logistics capabilities of our partners in the Senegalese Armed Forces, to extend their operational reach is an essential task for U.S. Army Africa," Col. Layton Dunbar, U.S. Army Africa director of logistics, said in a press release. "The U.S. Army's 1st SFAB logistics advisors did a tremendous job training our Senegalese partners and enhancing their Armed Force's readiness through this security cooperation event."
The training was the 1st SFAB's first advising mission after being sent to AFRICOM in February.
The 1st SFAB's operations in Africa have been interrupted by the coronavirus, but the unit working with U.S. Army Africa and the U.S. State Department once conditions allow advisors to return, AFRICOM officials said.
Advertisement
"Our mission is about way more than just training maintenance and logistics. It's really about building long-lasting partnerships and enhancing their skills in order to increase their capability and survivability during operations," said Maj. Michael Pachucki, 1st SFAB logistics advisor company commander.


upi--2020-05-12--Aimee Stephens, woman at center of transgender Supreme Court case, dies at 59

May 12 ( UPI ) -- Aimee Stephens , the woman at the center of a landmark Supreme Court case on transgender rights , died Tuesday , the American Civil Liberties Union announced .
She was 59 .
`` With heavy hearts , we share that Aimee Stephens , our client and dear friend , whose landmark case is the first about the civil rights of transgender people to be heard by the Supreme Court , died today at home in Metro Detroit with her wife , Donna Stephens , at her side , '' the ACLU of Michigan wrote @ @ @ @ @ @ @ on behalf of Stephens and her family said that she developed a kidney disease five years ago that required frequent dialysis .
Being fired from her job caused `` an immediate financial strain '' leading her wife to take on several jobs .
The Supreme Court in October heard a combined employment rights case including Stephens who was fired from her job after coming out as transgender to her employer .
Thomas Rost , the owner of R.G .
& G.R .
Harris Funeral Homes , said Stephens was dismissed due to her @ @ @ @ @ @ @ code requiring men to wear a suit and women to wear a skirt and suit jacket .
ACLU attorney John A. Knight , argued that the funeral home discriminated against Stephens because she is transgender and the basis provided for the firing ignored that the business was firing her `` because she would be expressing herself as a woman in the workplace . ''
Stephens filed a complaint with the Equal Opportunity Employment Commission alleging sex discrimination and the organization filed a lawsuit alleging the R.G .
& G.R .
Harris Funeral Homes @ @ @ @ @ @ @ Act of 1964 .
A district court ruled in favor of the funeral home , but the 6th U.S .
Circuit Court of Appeals overturned the ruling , leading the business to appeal to the Supreme Court .
The Supreme Court 's ruling is expected sometime this year .

Aimee Stephens, who was at the center of a Supreme Court case regarding transgender employment rights, died at the age of 59 on Tuesday. File Photo by Charles William Kelly/ACLU
May 12 (UPI) -- Aimee Stephens, the woman at the center of a landmark Supreme Court case on transgender rights, died Tuesday, the American Civil Liberties Union announced. She was 59. "With heavy hearts, we share that Aimee Stephens, our client and dear friend, whose landmark case is the first about the civil rights of transgender people to be heard by the Supreme Court, died today at home in Metro Detroit with her wife, Donna Stephens, at her side," the ACLU of Michigan wrote on Twitter. Advertisement
A GoFundMe set up on behalf of Stephens and her family said that she developed a kidney disease five years ago that required frequent dialysis. Being fired from her job caused "an immediate financial strain" leading her wife to take on several jobs.
The Supreme Court in October heard a combined employment rights case including Stephens who was fired from her job after coming out as transgender to her employer.
Thomas Rost, the owner of R.G. & G.R. Harris Funeral Homes, said Stephens was dismissed due to her intention to violate the business' dress code requiring men to wear a suit and women to wear a skirt and suit jacket.
Advertisement
ACLU attorney John A. Knight, argued that the funeral home discriminated against Stephens because she is transgender and the basis provided for the firing ignored that the business was firing her "because she would be expressing herself as a woman in the workplace."
Stephens filed a complaint with the Equal Opportunity Employment Commission alleging sex discrimination and the organization filed a lawsuit alleging the R.G. & G.R. Harris Funeral Homes violated Title VII of the Civil Rights Act of 1964.
A district court ruled in favor of the funeral home, but the 6th U.S. Circuit Court of Appeals overturned the ruling, leading the business to appeal to the Supreme Court.
The Supreme Court's ruling is expected sometime this year.


upi--2020-05-12--Brain power in numbers: Ants use collective cognition to navigate obstacles

May 12 ( UPI ) -- For a single ant , the world can be an overwhelmingly big place .
To safely navigate their environs , ants rely on collective cognition .
According to a new study , published Tuesday in the journal eLife , collective brainpower makes seemingly chaotic environs navigable .
`` Cooperation is a common means by which animals can increase their cognitive capacity , and we were intrigued as to whether this cooperation allows ants to extend the range of environments in which they can efficiently collect food , '' first study author Aviram Gelblum , @ @ @ @ @ @ @ of Science in Israel , said in a news release .
`` We addressed this question by studying the cooperative transport of ants as they attempted to transport large loads through semi-natural environments , '' Gelblum added .
In the lab , researchers created a labyrinth to test the navigational skills of ants .
Inside the labyrinth , scientists randomly scattered cubes to mimic terrain strewn with stones .
Image processing helped scientists track the ants and their movements around the different cubes as they moved back and forth between their nest and @ @ @ @ @ @ @ cubes to the labyrinth , the ants moved at slower speeds , but the insects were still able to successfully navigate the labyrinth with up to 55 percent cube coverage .
To measure the ants navigation abilities , researchers used a common movement model that simulates random walking paths biased toward a certain direction .
The direction of each simulated path shifts as it runs into barriers until , eventually , an unblocked route is identified .
Ants were more efficient than the computer model at finding a clear path through the cubes @ @ @ @ @ @ @ over the simulation increased as the cube coverage increased and the labyrinth became more complex .
Detailed analysis of the ants ' movements through the labyrinth showed ants carrying food loads were loosely surrounded by ants without food on their trek home .
The ants without food help those encumbered by large loads avoid obstacles .
`` We show that , in this environment , the ants use their numbers to collectively extend their sensing range , '' researchers wrote in their newly published paper .
`` Although this extension is moderate , @ @ @ @ @ @ @ times that overshadow known physical solutions . ''
When food-carrying ants got stuck , the ants without food revealed potential crossing routes , helping the parade of food-carrying ants find an alternate path .
The ants without food effectively expand the `` sensing '' abilities of the ants carrying loads .
Once programmed with similar sensing abilities , the movement model became much more adept at identifying obstacle-free routes through the labyrinth .
When sensing range of the simulation was set to match the expanded sensing range of the ants , the model @ @ @ @ @ @ @ But when researchers expanded the model 's sensing range farther , the simulations failed to reveal added performance benefit , suggesting the ants have determined the optimal distance at which to expand their sensing range .
`` We have shown that , in this environment , ants use their numbers to collectively extend how far they can sense , '' said senior study author Ofer Feinerman , professor of physics at the Weizmann Institute of Science .
`` Although this extension is modest , it allows for extremely fast traversal times that are @ @ @ @ @ @ @ navigating disordered environments . ''

Ants rely on their collective brainpower to navigated obstacle-riddled environs. Photo by Judy Gallagher
May 12 (UPI) -- For a single ant, the world can be an overwhelmingly big place. To safely navigate their environs, ants rely on collective cognition. According to a new study, published Tuesday in the journal eLife, collective brainpower makes seemingly chaotic environs navigable. Advertisement
"Cooperation is a common means by which animals can increase their cognitive capacity, and we were intrigued as to whether this cooperation allows ants to extend the range of environments in which they can efficiently collect food," first study author Aviram Gelblum, a postdoctoral fellow at the Weizmann Institute of Science in Israel, said in a news release.
"We addressed this question by studying the cooperative transport of ants as they attempted to transport large loads through semi-natural environments," Gelblum added.
In the lab, researchers created a labyrinth to test the navigational skills of ants. Inside the labyrinth, scientists randomly scattered cubes to mimic terrain strewn with stones.
Advertisement
Image processing helped scientists track the ants and their movements around the different cubes as they moved back and forth between their nest and food sources. When researchers added more cubes to the labyrinth, the ants moved at slower speeds, but the insects were still able to successfully navigate the labyrinth with up to 55 percent cube coverage.
To measure the ants navigation abilities, researchers used a common movement model that simulates random walking paths biased toward a certain direction. The direction of each simulated path shifts as it runs into barriers until, eventually, an unblocked route is identified.
Ants were more efficient than the computer model at finding a clear path through the cubes. The performance advantage of the ants over the simulation increased as the cube coverage increased and the labyrinth became more complex.
Detailed analysis of the ants' movements through the labyrinth showed ants carrying food loads were loosely surrounded by ants without food on their trek home. The ants without food help those encumbered by large loads avoid obstacles.
"We show that, in this environment, the ants use their numbers to collectively extend their sensing range," researchers wrote in their newly published paper. "Although this extension is moderate, it nevertheless allows for extremely fast traversal times that overshadow known physical solutions."
Advertisement
When food-carrying ants got stuck, the ants without food revealed potential crossing routes, helping the parade of food-carrying ants find an alternate path. The ants without food effectively expand the "sensing" abilities of the ants carrying loads.
Once programmed with similar sensing abilities, the movement model became much more adept at identifying obstacle-free routes through the labyrinth.
When sensing range of the simulation was set to match the expanded sensing range of the ants, the model matched the performance of the ants. But when researchers expanded the model's sensing range farther, the simulations failed to reveal added performance benefit, suggesting the ants have determined the optimal distance at which to expand their sensing range.
"We have shown that, in this environment, ants use their numbers to collectively extend how far they can sense," said senior study author Ofer Feinerman, professor of physics at the Weizmann Institute of Science. "Although this extension is modest, it allows for extremely fast traversal times that are better than known physical movement models for navigating disordered environments."


upi--2020-05-12--Special footwear might reduce pain from knee osteoarthritis, study finds

May 12 ( UPI ) -- Specially designed shoes can help reduce the pain of knee osteoarthritis , a study published Tuesday in JAMA has found .
Using biomechanical footwear -- specially designed shoes with a novel sole -- the researchers were able to reduce the pain experienced by those with osteoarthritis , or OA , of the knee by more than 60 percent .
`` These findings provide strong evidence supporting the effectiveness of a new treatment for knee osteoarthritis , '' co-author David Felson , a rheumatologist and professor of medicine at Boston University School of Medicine , @ @ @ @ @ @ @ OA affects approximately 275 million people worldwide , according to the World Health Organization -- most of them older adults .
Often called wear-and-tear arthritis , OA causes cartilage , the natural cushioning between joints , to wear away .
As a result , the bones of joints rub against one another without the shock-absorbing cartilage , causing pain , swelling and stiffness , among other symptoms .
Acetaminophen , non-steroidal anti-inflammatory drugs like aspirin and ibuprofen , and prescription opioids are the most commonly used treatments for the pain associated with the @ @ @ @ @ @ @ , however , is limited .
The shoes assessed in the study are designed to reduce pressure placed on the knee joint .
They feature two convex , adjustable rubber pods attached to the outsole , where they come into contact with the ground at the heel and forefoot .
Wearers can adjust the pods to reduce the impact felt by joints in the feet and legs to effectively create a convex surface between the outsoles of the shoes and the ground , the authors said .
For the study , the first @ @ @ @ @ @ @ , Felson and his colleagues enrolled 213 adults with the disease and asked them to wear either the special shoes or `` control footwear '' with a similar appearance for six months .
Those who wore the special shoes experienced significantly reduced pain in their knees , based on self-reported scores on the Western Ontario and McMaster Universities Osteoarthritis Index , or WOMAC , a zero to eight scale commonly used to measure pain and other symptoms in OA .
Mean WOMAC scores for participants who wore the special shoes fell from 4.3 @ @ @ @ @ @ @ comparison , mean WOMAC scores for those in the control group dropped from 4.0 to 2.6 .
Felson believes the treatment probably works by re-educating and reconditioning muscles in the legs .
`` This treatment may help many persons with this disorder , '' he said .

A new study found that specially designed footwear can help reduce knee pain from osteoarthritis. File photo by Esther Max/Flickr
May 12 (UPI) -- Specially designed shoes can help reduce the pain of knee osteoarthritis, a study published Tuesday in JAMA has found. Using biomechanical footwear -- specially designed shoes with a novel sole -- the researchers were able to reduce the pain experienced by those with osteoarthritis, or OA, of the knee by more than 60 percent. Advertisement
"These findings provide strong evidence supporting the effectiveness of a new treatment for knee osteoarthritis," co-author David Felson, a rheumatologist and professor of medicine at Boston University School of Medicine, said in a press release.
Knee OA affects approximately 275 million people worldwide, according to the World Health Organization -- most of them older adults. Often called wear-and-tear arthritis, OA causes cartilage, the natural cushioning between joints, to wear away.
As a result, the bones of joints rub against one another without the shock-absorbing cartilage, causing pain, swelling and stiffness, among other symptoms.
Acetaminophen, non-steroidal anti-inflammatory drugs like aspirin and ibuprofen, and prescription opioids are the most commonly used treatments for the pain associated with the disease. The effectiveness of these drugs, however, is limited.
The shoes assessed in the study are designed to reduce pressure placed on the knee joint. They feature two convex, adjustable rubber pods attached to the outsole, where they come into contact with the ground at the heel and forefoot.
Advertisement
Wearers can adjust the pods to reduce the impact felt by joints in the feet and legs to effectively create a convex surface between the outsoles of the shoes and the ground, the authors said.
For the study, the first to assess the footwear in knee OA, Felson and his colleagues enrolled 213 adults with the disease and asked them to wear either the special shoes or "control footwear" with a similar appearance for six months.
Those who wore the special shoes experienced significantly reduced pain in their knees, based on self-reported scores on the Western Ontario and McMaster Universities Osteoarthritis Index, or WOMAC, a zero to eight scale commonly used to measure pain and other symptoms in OA.
Mean WOMAC scores for participants who wore the special shoes fell from 4.3 to 1.3 after six months. In comparison, mean WOMAC scores for those in the control group dropped from 4.0 to 2.6.
Felson believes the treatment probably works by re-educating and reconditioning muscles in the legs. "This treatment may help many persons with this disorder," he said.


upi--2020-05-12--Broadway issues refunds for canceled performances through Sept. 6

Kathy Ross of New Jersey waves to her her son who is onboard one of the vintage WWII aircraft as they fly over over the Hudson River as part of a celebration for the 75th anniversary of VE Day , which signaled the end of World War II on May 8 .
Photo by John Angelillo/UPI | A backhoe is parked on Hart Island in New York City .
For almost two centuries , the city has used Hart Island as a place where unclaimed bodies can be buried and laid to rest .
Due to the coronavirus pandemic , @ @ @ @ @ @ @ John Angelillo/UPI | Hila Revilla of Queens sobs as workers from the The Humane Society of New York take her 17-year-old dog Bambi to be euthanized on April 3 .
Revilla was not allowed inside the building and had to say her final goodbye on the 59th Street sidewalk .
Photo by John Angelillo/UPI | A woman walks a dog in Central Park where a field hospital is ready to take in sick patients on April 1 .
The tents are located along the East Meadow near Mount Sinai Hospital and are being @ @ @ @ @ @ @ They were erected in 48 hours by the non-profit charity Samaritan 's Purse .
Photo by John Angelillo/UPI | Newly erected hospital rooms are sectioned off with white curtains after Gov .
Andrew Cuomo speaks with the New York National Guard at the Jacob K. Javits Convention Center on March 27 .
The Javits Center is setting up to be turned into field hospitals to test and possibly treat cases of COVID-19 .
Photo by John Angelillo/UPI |

"Sing Street" is one of 31 scheduled Broadway shows that will issue refunds for performances through Sept. 6 as Broadway remains closed. Photo by John Angelillo/UPI | License Photo
May 12 (UPI) -- The Broadway League announced Tuesday that all summer performances would be canceled. Productions will issue refunds for any tickets held for performances through Sept. 6. The trade association for Broadway's New York and touring theater industry does not know when theaters in New York will be able to reopen, but confirmed cancellations through Sept. 6. Advertisement
Ticket holders should expect an email regarding a refund or exchange of their purchase. If an email does not arrive by May. 18, The Broadway League recommends following up with the issuer of the ticket.
Broadway suspended performances on March 12 out of an abundance of caution regarding the spread of the coronavirus (COVID-19). The Broadway League says the suspension put 31 productions on hiatus and canceled rehearsals for eight more.
New York Gov. Andrew Cuomo issued stay-at-home orders. The state will reopen some regions beginning May 15. The Tony Awards also postponed the theater honors.
Broadway League President Charlotte St. Martin said in a statement that they are eager to reopen Broadway, but only when it is safe for the performers, productions and theater guests.
Advertisement
"While all Broadway shows would love to resume performances as soon as possible, we need to ensure the health and well-being of everyone who comes to the theatre -- behind the curtain and in front of it -- before shows can return," she said.
St. Martin added that the League has been in communication with Gov. Cuomo's office regarding when such a time may come.
COVID-19 pandemic alters life in New York City
Mannequins with face masks and designer clothing fill a window at a Diane Von Furstenberg store in New York City on September 8, 2020. Photo by John Angelillo/UPI | License Photo
c


upi--2020-05-12--Attackers kill at least 14 in Afghanistan at Kabul hospital

May 12 ( UPI ) -- At least 14 people were killed , including two newborns , Tuesday during an @ @ @ @ @ Kabul , Afghanistan , authorities said .
Interior Ministry spokesman Tariq Aryan told CBS News @ @ @ @ @ new mothers and nurses dead at the maternity clinic run by Doctors Without Borders .
@ @ @ @ @ Witnesses heard gunfire and two explosions at the onset of the attacks by suicide bombers @ @ @ @ @ said several assailants were involved in the attack .
He said special forces killed all @ @ @ @ @ operation . ''
The special forces also moved about 100 people to safety .
The @ @ @ @ @ the minority Shiite Hazara community of the Afghan capital .
The Taliban , which signed @ @ @ @ @ United States in February , denied responsibility for the assault .

Security forces respond to an attack Tuesday at a medical facility in Kabul, Afghanistan. Photo by Hedayatullah Amid/EPA-EFE
May 12 (UPI) -- Dozens of people, mostly civilians, have been killed in a series of attacks in Afghanistan conducted over the past 24 hours, including a siege Tuesday on a hospital in Kabul that resulted in the deaths of mothers and babies, authorities said. At least 14 people, including two newborns, mothers and medical staff, were killed Tuesday when gunmen stormed one of Kabul's busiest hospitals, which contained a maternity ward run by Doctors Without Borders. Advertisement
Shortly after in the eastern province of Nangarhar, at least 26 people were killed and 68 others were injured after a suicide bomber attacked the funeral of a local police commander.
In response, Afghan President Ashraf Ghani ordered security forces to resume offensive operations against the Taliban.
"I strongly condemn recent attacks in a hospital in Kabul and Nangarhar province, which killed a number of innocent people, including women and children," he said Tuesday in a national address. "Taliban have rejected our repeated calls for a cease-fire, calls for cease-fire don't mean weakness."
Advertisement
Interior Ministry spokesman Tariq Aryan told CBS News the attack also left some new mothers and nurses dead at the maternity clinic. Fifteen people sustained injuries.
"Who attacks newborn babies and new mothers? Who does this?" tweeted Deborah Lyons, the head of the U.N. mission in Afghanistan, in condemnation of the attack. "The most innocent of innocents, a baby! Why?"
Medicins Sans Frontieres confirmed the attack on its maternity ward, reporting explosions and gunfire.
"We can confirm the attack is over, but details remain unclear," it said. "All our efforts at this time are focused on the safety of our patients and staff."
According to its website, it focuses on emergency, pediatric and maternal healthcare.
Witnesses heard gunfire and two explosions at the onset of the attacks by suicide bombers, officials said.
Aryan said several assailants were involved in the attack. He said special forces killed all attackers during a "clearing operation."
The special forces also moved about 100 people to safety.
The 100-bed facility is located in the minority Shiite Hazara community of the Afghan capital.
The attacks attracted widespread condemnation from human rights groups, the United Nations and the United States.
Advertisement
Amnesty International South Asia described the attacks as "unconscionable war crimes" that should act as a wake-up call for the world "to the horrors civilians continue to face."
"There must be accountability for these grave crimes, and civilians must be protected," it tweeted.
Secretary of State Mike Pompeo condemned the attacks, describing the hospital siege as "an act of sheer evil."
The Taliban has denied responsibility for the assaults, blaming them instead on the Islamic State terrorist organization.
Afghan officials have blamed the Taliban for the attacks amid an increase in violence that has followed the militant group and the United States signing a peace agreement in February.
"The attacks of the last two months show us and the world that Taliban & their sponsors do not and did not intend to pursue peace," said Hamdullah Mohib, Afghanistan's national security advisor, in a series of tweets. "Their attacks this spring against Afghans are comparable to the level of fighting in past fighting seasons."
He said the Afghan government has a responsibility to hold them accountable, threatening to end ongoing peace negotiations.
"If the Taliban can not control the violence, or their sponsors have no subcontracted their terror to other entities -- which was one of our primary concerns form the beginning -- then there seems little point in continuing to engage Taliban in 'peace talks,'" he said.
Advertisement
The Taliban said in a statement it "strongly condemns" the attacks though warned Ghani that it will protect itself.
Pompeo, in his statement, acknowledged the Taliban's rejection of responsibility, urging it and the Afghan government to cooperate "to bring the perpetrators to justice."
"As long as there is no sustained reduction in violence and insufficient progress towards a negotiated political settlement, Afghanistan will remain vulnerable to terrorism," Pompeo said. "The Afghan people deserve a future free from terror, and the ongoing peace process continues to present a critical opportunity for Afghans to come together to build a united front against the menace of terrorism."


upi--2020-05-12--Dow drops 457 points as concerns about reopening drag down markets

May 12 (UPI) -- U.S. stocks fell on Tuesday amid growing concerns about plans to reopen the economy following measures to prevent the spread of COVID-19.
The Dow Jones Industrial Average was down 457.21 points, or 1.89 percent, at the end of trading on Tuesday, while the S&P 500 fell 2.05 percent and the Nasdaq Composite dropped 2.06 percent.
Advertisement
Influencing the U.S. markets on Tuesday was a Senate hearing that featured testimony from members of the White House Coronavirus Task Force. Appearing via videoconference, Dr. Anthony Fauci cautioned against reopening the U.S. and state economies too soon.
Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, told the health, education, labor and pensions committee he would be concerned about reopening before seeing a steady decline in cases.
Stocks expected to benefit most from reopening economies dropped on Tuesday as Disney fell 3 percent and Nike slid 2.98 percent.
Bank stocks also experienced a decline as Citigroup dropped 3.88 percent, JPMorgan Chase slid 3.27 percent and Bank of America fell 3.14 percent.
Advertisement
Meanwhile, tech stocks, which had driven the market to recent gains slipped on Tuesday as Alphabet stock dropped 2.16 percent, Alphabet fell 2.02 percent, Netflix slid 1.97 percent, Facebook lost 1.44 percent and Apple dropped 1.14 percent.
Remove
COVID-19 pandemic alters life in New York City


upi--2020-05-12--'Steering wheel' brain neurons control if mouse turns left, right, researchers find

May 12 ( UPI ) -- Scientists have found a group of neurons responsible for controlling the direction that mice turn .
The `` steering wheel '' neurons , found in the brainstems of mice models , could help researchers better understand motor control in both animals and humans .
`` It is an important discovery because movement is fundamentally one of the most basic features controlled by the brain , '' Ole Kiehn , professor of neuroscience at the University of Copenhagen in Denmark , said in a news release .
`` At the same time , motor disorders @ @ @ @ @ @ @ knowledge of the basic mechanisms of the brain and the spinal cord which control our movements is important . ''
Scientists have previously documented the group of neurons , located in the spinal cord , responsible for the coordination of walking .
However , the latest research , published this week in the journal Nature Neuroscience , marks the first time scientists have identified neurons specifically responsible for direction , or turning .
The newly identified neurons can be identified by their expression of a molecular marker called Chx10 .
According to researchers @ @ @ @ @ @ @ kind of motor turning system .
`` The control is done by simply applying the 'brake ' to the walking movement on the side that the mice turn to -- then the muscles will contract on the same side , '' said neuroscientist Jared Cregg , first author of the new study and a postdoctoral researcher at the University of Copenhagen .
`` In this way , the length of the steps on one side becomes short and on the other side long , making the mouse turn . ''

May 12 (UPI) -- Scientists have found a group of neurons responsible for controlling the direction that mice turn. The "steering wheel" neurons, found in the brainstems of mice models, could help researchers better understand motor control in both animals and humans.
"It is an important discovery because movement is fundamentally one of the most basic features controlled by the brain," Ole Kiehn, professor of neuroscience at the University of Copenhagen in Denmark, said in a news release. "At the same time, motor disorders can be very disabling. Therefore, knowledge of the basic mechanisms of the brain and the spinal cord which control our movements is important."
Advertisement
Scientists have previously documented the group of neurons, located in the spinal cord, responsible for the coordination of walking. However, the latest research, published this week in the journal Nature Neuroscience, marks the first time scientists have identified neurons specifically responsible for direction, or turning.
The newly identified neurons can be identified by their expression of a molecular marker called Chx10. According to researchers, cells expressing Chx10 make up a kind of motor turning system.
"The control is done by simply applying the 'brake' to the walking movement on the side that the mice turn to -- then the muscles will contract on the same side," said neuroscientist Jared Cregg, first author of the new study and a postdoctoral researcher at the University of Copenhagen. "In this way, the length of the steps on one side becomes short and on the other side long, making the mouse turn."


upi--2020-05-12--Monthly federal deficit hits record high $738B in April

May 12 ( UPI ) -- The federal deficit for the month of April reached a record high of $ 738 billion , the U.S. Treasury Department said Tuesday .
The monthly figure was about three-quarters of the entire fiscal year 2019 's deficit , which came to $ 984 million .
The total deficit for the first seven months of the 2020 fiscal year stands at $ 1.48 trillion , bypassing the previous record year in 2009 , which had a $ 1.4 trillion deficit , according to the Treasury report .
The public debt ballooned thanks to some @ @ @ @ @ @ @ Congress to fight the coronavirus pandemic and spur the economy amid widespread business closures .
The biggest of those packages was the $ 2.3 trillion Coronavirus Aid , Relief and Economic Security Act , which President Donald Trump signed March 27 .
The legislation provided direct stimulus payments of up to $ 1,200 to eligible Americans and $ 500 for each child .
It also created a small business loan program .
The Treasury Department said it paid out $ 217 billion in the individual stimulus checks , $ 142 billion in state @ @ @ @ @ @ @ billion in healthcare costs , and $ 46 billion in unemployment benefits .
Meanwhile , tax receipts were down $ 294 billion compared to April 2019 after the Trump administration delayed tax payments until July .

The Treasury Department reported a sharp drop in tax receipts for April 2020 compared to 2019 after delaying tax payments until July. File Photo by Roger L. Wollenberg/UPI | License Photo
May 12 (UPI) -- The federal deficit for the month of April reached a record high of $738 billion, the U.S. Treasury Department said Tuesday. The monthly figure was about three-quarters of the entire fiscal year 2019's deficit, which came to $984 million. Advertisement
The total deficit for the first seven months of the 2020 fiscal year stands at $1.48 trillion, bypassing the previous record year in 2009, which had a $1.4 trillion deficit, according to the Treasury report.
The public debt ballooned thanks to some $3.6 trillion in legislation passed by Congress to fight the coronavirus pandemic and spur the economy amid widespread business closures.
The biggest of those packages was the $2.3 trillion Coronavirus Aid, Relief and Economic Security Act, which President Donald Trump signed March 27. The legislation provided direct stimulus payments of up to $1,200 to eligible Americans and $500 for each child. It also created a small business loan program.
The Treasury Department said it paid out $217 billion in the individual stimulus checks, $142 billion in state and local government payments, $146 billion in healthcare costs, and $46 billion in unemployment benefits.
Advertisement
Meanwhile, tax receipts were down $294 billion compared to April 2019 after the Trump administration delayed tax payments until July.


upi--2020-05-12--Niall Horan to join BBC Radio One at Big Weekend remote festival

May 12 ( UPI ) -- Niall Horan announced Tuesday that he will join BBC Radio One at its annual Big Weekend festival in Britain in May , which will be done remotely for the first time due to the coronavirus .
The Irish singer and songwriter is one of the singers for the Big Weekend festival that the radio station announced Tuesday .
Horan said it 's a challenge to adapt from performing live before a crowd at festivals to a virtual platform , but he is `` excited to be joining '' the remote festival and is preparing @ @ @ @ @ @ @ Some of my favorite memories have been at festivals , '' Horan said .
`` This time with no audience , no crew and an amateur like me setting the sound up will be interesting , but I 'm going to give it a right go .
Also my toilets are super clean unlike some of the literal pits I 've seen at previous things . ''
British hip hop duo Young T and Bugsey were also excited to be included this year .
`` Big up Radio 1 for including us on @ @ @ @ @ @ @ '' the duo said in a statement .
`` It 's gon na be a special one , and we 're gon na be bringing the vibes to you , wherever you are . ''
Among the other singers performing , are English singer/songwriter Sam Smith , U.S. band Jonas Brothers , British rappers Aitch and AJ Tracey , English singer/songwriter Anne-Marie and English singer/songwriter Yungblud .
Some DJs will also be spinning music for festival dancing , with Armand Van Helden , Disclosure , High Contrast and The Black Madonna among them @ @ @ @ @ @ @ May 22 through May 24 with performances streamed on BBCiPlayer and heard through Radio 1 and BBC Sounds .
New performances will be featured on four virtual stages , including The Radio 1 Stage , the 1Xtra Stage , the BBC Music Introducing Stage .
There will also be a fifth stage , the Headliner Stage , which will feature memorable performances from past festivals , including Katy Perry 's set at Radio 1 's Big Weekend in Glasgow , Scotland , and Miley Cyrus ' performance from Middlesbrough , England .
`` @ @ @ @ @ @ @ to bring you a virtual festival , '' BBC 's Radio One 's Greg James said .
`` Whatever you 're doing that weekend , get the radio on and you can experience a load of stuff from Big Weekends gone by , and some brand new festival performances . ''

excited to be joining @BBCR1 at their first ever #BigWeekend remote festival on the 22nd-24th of May ! https://t.co/hIipFT7Zae pic.twitter.com/TmVgMWPhAI— Niall Horan (@NiallOfficial) May 12, 2020
May 12 (UPI) -- Niall Horan announced Tuesday that he will join BBC Radio One at its annual Big Weekend festival in Britain in May, which will be done remotely for the first time due to the coronavirus.
The Irish singer and songwriter is one of the singers for the Big Weekend festival that the radio station announced Tuesday.
Advertisement
Horan said it's a challenge to adapt from performing live before a crowd at festivals to a virtual platform, but he is "excited to be joining" the remote festival and is preparing a special set from home.
"Some of my favorite memories have been at festivals," Horan said. "This time with no audience, no crew and an amateur like me setting the sound up will be interesting, but I'm going to give it a right go. Also my toilets are super clean unlike some of the literal pits I've seen at previous things."
British hip hop duo Young T and Bugsey were also excited to be included this year.
"Big up Radio 1 for including us on this year's Big Weekend lineup," the duo said in a statement. "It's gonna be a special one, and we're gonna be bringing the vibes to you, wherever you are."
Advertisement
Among the other singers performing, are English singer/songwriter Sam Smith, U.S. band Jonas Brothers, British rappers Aitch and AJ Tracey, English singer/songwriter Anne-Marie and English singer/songwriter Yungblud.
Some DJs will also be spinning music for festival dancing, with Armand Van Helden, Disclosure, High Contrast and The Black Madonna among them.
The virtual festival will be held May 22 through May 24 with performances streamed on BBCiPlayer and heard through Radio 1 and BBC Sounds.
New performances will be featured on four virtual stages, including The Radio 1 Stage, the 1Xtra Stage, the BBC Music Introducing Stage. There will also be a fifth stage, the Headliner Stage, which will feature memorable performances from past festivals, including Katy Perry's set at Radio 1's Big Weekend in Glasgow, Scotland, and Miley Cyrus' performance from Middlesbrough, England.
"We're going to do our best to bring you a virtual festival," BBC's Radio One's Greg James said. "Whatever you're doing that weekend, get the radio on and you can experience a load of stuff from Big Weekends gone by, and some brand new festival performances."


upi--2020-05-12--COVID-19 reaches rural America as number of cases rises

Until now , cities such as New York , Seattle , Los Angeles and New Orleans have been hot spots for COVID-19 outbreaks in the United States .
But the coronavirus threat is growing in America 's rural areas -- and in many ways , the risk there is even more dire than it has been in big cities , experts say .
That 's because people tend to be older and sicker in rural areas , and have far less access to the health care services needed to help them get well and prevent community-wide spread of COVID-19 , @ @ @ @ @ @ @ of the National Rural Health Association .
`` Rural America is a geographic area that continues to face significant health care workforce shortages at a time when the population is elderly , with a higher percentage of chronic health issues , '' Morgan said .
`` You 've got that population most at risk for COVID-19 in a location together where you have a lack of health care access .
It 's unfortunately a perfect storm . ''
The risk posed by coronavirus to rural areas is not as remote as one might @ @ @ @ @ @ @ with the highest COVID-19 death rates are in the rural South , according to statistics gathered by the Washington Post .
They include three in rural Georgia and St. John the Baptist Parish in Louisiana .
`` As of last week , 86 percent of rural counties had at least one COVID-19 case , and one-third of rural counties had at least one COVID-19 death , '' said Carrie Henning-Smith , an assistant professor of health policy and management at the University of Minnesota .
And things are getting worse .
Data that @ @ @ @ @ @ @ using shows infection rates are hitting new highs in smaller communities across the country , NBC News reported Tuesday .
The 10 top areas recorded surges of 72.4 percent or greater over a seven-day period , a set of tables produced for the task force shows .
They included Des Moines , Iowa Amarillo , Texas and Central City , Ky. , which saw a whopping 650 percent increase in cases , NBC News reported .
The spiking infection rates suggest the coronavirus is spreading quickly outside major coastal cities that were early @ @ @ @ @ @ @ has invaded rural America in a succession of waves .
The first wave came in rural communities that depend on tourism , such as ski resorts in Colorado , Utah and Idaho , experts said .
`` You had people who did n't live permanently in the town , but were coming to visit for recreational purposes and spreading COVID-19 and suddenly overwhelming the health care systems and grocery stores and other resources in those places , '' Henning-Smith said .
The next wave involved rural areas located next to large metropolitan areas @ @ @ @ @ @ @ James Parish in Louisiana as one example .
`` People in St. James commute to either Baton Rouge or New Orleans , and they brought it back into the community , '' Morgan explained .
After that , COVID-19 started cropping up in rural communities with interstate highways running through them , where large truck stops serve as a revolving door for truckers from all parts of the country , Morgan said .
Batesville , Ind.
, is one small town that saw a huge leap in coronavirus infections thanks to highway travel @ @ @ @ @ @ @ to occur in rural workplaces such as meatpacking facilities , as well as in prisons out in the country , Morgan said .
Country folks do n't live on top of each other as their city cousins do , but they do congregate in places where they could readily pass coronavirus from person to person , Morgan said .
`` When you say rural America , everyone thinks about farmers and ranchers in Wyoming and Montana , right ?
These are the people who pioneered the concept of social distancing .
They got @ @ @ @ @ @ @ `` What we 're really talking about are these hundreds of small towns across the U.S. , with two to four stoplights . ''
People in these communities `` are all going to be at the same Walmart .
They 're all going to be at the same grocery store .
They 're all going to be at the same post office .
It really is a bad situation , '' Morgan said .
At the same time , rural folks live far enough apart that it can be tough for public health @ @ @ @ @ @ @ work needed to head off outbreaks , like contact tracing and viral testing , Henning-Smith said .
`` It 's really challenging to do track-and-trace when you have to drive 45 minutes to an hour to get to the next town , '' Henning Smith said .
`` It takes more time and a lot more effort to reach people in places where people are not living close to one another . ''
Folks living in rural areas also tend to be older and sick with chronic health conditions , which puts them @ @ @ @ @ @ @ , Henning-Smith said .
They also have to travel farther for health care , usually , and whatever local hospitals and clinics they have are struggling to stay open , experts added .
There are about 2,000 rural hospitals in the United States , and two-thirds of them have 25 or fewer inpatient beds available , Morgan said .
More than half these rural hospitals operate in the red on an annual basis , Henning-Smith added .
`` Since 2010 , 128 rural hospitals have closed , eight in 2020 alone , '' @ @ @ @ @ @ @ have closed since the pandemic began . ''
The lockdowns required to keep COVID-19 from overwhelming the U.S. health care system also unfortunately robbed these rural hospitals of a key source of income .
Hospitals had to cancel elective procedures and stop treating outpatients , which represented up to 80 percent of the revenue of rural hospitals , Morgan explained .
`` Rural hospitals were in trouble already , even before all this happened , '' said Leighton Ku , director of the George Washington University Center for Health Policy Research in Washington @ @ @ @ @ @ @ the losses right now are that extra little thing that would push them off the edge .
I would n't be surprised to hear that some more rural hospitals or very small hospitals , this was the thing that pushed them into bankruptcy . ''
To make matters worse , rural hospitals are not in a good position to deal with a sudden COVID-19 outbreak .
Small-town hospitals and clinics have to work harder to locate and buy the equipment they need , Henning-Smith said .
`` You have a lot of very @ @ @ @ @ @ @ which are independent .
They just do n't have the buying power to jump to the front of the queue or to negotiate a reasonable price for additional equipment , '' Henning-Smith said .
These facilities also tend to be very lean operations , and the loss of some staffers to COVID-19 infection during an outbreak would put them squarely behind the eight ball , Morgan said .
`` We 've done a great job of building efficient small-town hospitals .
By efficient , I mean absolutely no surge capacity , '' Morgan @ @ @ @ @ @ @ have faced the pandemic , a common thread is one or two of the clinicians become COVID-19-positive .
You have no room for error , and you start losing clinical staff .
It compounds the problem , from a small town 's perspective . ''
The federal government is distributing $ 10 billion in emergency relief to rural hospitals and clinics , and both Morgan and Henning-Smith are hopeful that money will help keep rural health care open until social distancing requirements are eased .
`` What we 're hearing from our membership @ @ @ @ @ @ @ and are taking outpatients again , '' Morgan said .
`` In a perfect world , this works out .
As they utilize these federal funds , they 're beginning to have revenue come back in their doors .
Hopefully this is a glide path to keep rural hospitals open during this crisis . ''
`` Rural hospitals have taken matters into their own hands as well , in some places forming buyers ' consortiums so that they gain some extra leverage getting tests , ventilators , gloves , masks , gowns and @ @ @ @ @ @ @ .
`` Clinics banding together to make up one big order can be a big help here , '' she said .
`` Otherwise , many rural providers just wo n't come up to the top of the queue . ''
The U.S. Centers for Disease Control and Prevention has more about COVID-19 .

A masked and gloved farm worker drives a tractor in Salinas, Calif, on April 28. Photo by Terry Schmitt/UPI | License Photo
Until now, cities such as New York, Seattle, Los Angeles and New Orleans have been hot spots for COVID-19 outbreaks in the United States. But the coronavirus threat is growing in America's rural areas -- and in many ways, the risk there is even more dire than it has been in big cities, experts say. Advertisement
That's because people tend to be older and sicker in rural areas, and have far less access to the health care services needed to help them get well and prevent community-wide spread of COVID-19, said Alan Morgan, chief executive officer of the National Rural Health Association.
"Rural America is a geographic area that continues to face significant health care workforce shortages at a time when the population is elderly, with a higher percentage of chronic health issues," Morgan said. "You've got that population most at risk for COVID-19 in a location together where you have a lack of health care access. It's unfortunately a perfect storm."
Advertisement
The risk posed by coronavirus to rural areas is not as remote as one might think.
Four of the 10 counties with the highest COVID-19 death rates are in the rural South, according to statistics gathered by the Washington Post. They include three in rural Georgia and St. John the Baptist Parish in Louisiana.
"As of last week, 86 percent of rural counties had at least one COVID-19 case, and one-third of rural counties had at least one COVID-19 death," said Carrie Henning-Smith, an assistant professor of health policy and management at the University of Minnesota.
COVID-19 hits smaller towns
And things are getting worse. Data that the White House coronavirus task force is using shows infection rates are hitting new highs in smaller communities across the country, NBC News reported Tuesday.
The 10 top areas recorded surges of 72.4 percent or greater over a seven-day period, a set of tables produced for the task force shows. They included Des Moines, Iowa Amarillo, Texas and Central City, Ky., which saw a whopping 650 percent increase in cases, NBC News reported.
The spiking infection rates suggest the coronavirus is spreading quickly outside major coastal cities that were early hot spots.
Morgan noted that COVID-19 has invaded rural America in a succession of waves.
Advertisement
The first wave came in rural communities that depend on tourism, such as ski resorts in Colorado, Utah and Idaho, experts said.
"You had people who didn't live permanently in the town, but were coming to visit for recreational purposes and spreading COVID-19 and suddenly overwhelming the health care systems and grocery stores and other resources in those places," Henning-Smith said.
The next wave involved rural areas located next to large metropolitan areas, Morgan said, pointing to St. James Parish in Louisiana as one example.
"People in St. James commute to either Baton Rouge or New Orleans, and they brought it back into the community," Morgan explained.
After that, COVID-19 started cropping up in rural communities with interstate highways running through them, where large truck stops serve as a revolving door for truckers from all parts of the country, Morgan said. Batesville, Ind., is one small town that saw a huge leap in coronavirus infections thanks to highway travel.
Hotbeds for infections
Now, COVID-19 outbreaks are starting to occur in rural workplaces such as meatpacking facilities, as well as in prisons out in the country, Morgan said.
Country folks don't live on top of each other as their city cousins do, but they do congregate in places where they could readily pass coronavirus from person to person, Morgan said.
Advertisement
"When you say rural America, everyone thinks about farmers and ranchers in Wyoming and Montana, right? These are the people who pioneered the concept of social distancing. They got that down," Morgan said. "What we're really talking about are these hundreds of small towns across the U.S., with two to four stoplights."
People in these communities "are all going to be at the same Walmart. They're all going to be at the same grocery store. They're all going to be at the same post office. It really is a bad situation," Morgan said.
At the same time, rural folks live far enough apart that it can be tough for public health officials to do the sort of investigative work needed to head off outbreaks, like contact tracing and viral testing, Henning-Smith said.
"It's really challenging to do track-and-trace when you have to drive 45 minutes to an hour to get to the next town," Henning Smith said. "It takes more time and a lot more effort to reach people in places where people are not living close to one another."
Folks living in rural areas also tend to be older and sick with chronic health conditions, which puts them at greater risk of dying from COVID-19, Henning-Smith said.
Advertisement
Local hospitals struggle
They also have to travel farther for health care, usually, and whatever local hospitals and clinics they have are struggling to stay open, experts added.
There are about 2,000 rural hospitals in the United States, and two-thirds of them have 25 or fewer inpatient beds available, Morgan said.
More than half these rural hospitals operate in the red on an annual basis, Henning-Smith added.
"Since 2010, 128 rural hospitals have closed, eight in 2020 alone," Henning-Smith said. "At least three have closed since the pandemic began."
The lockdowns required to keep COVID-19 from overwhelming the U.S. health care system also unfortunately robbed these rural hospitals of a key source of income.
Hospitals had to cancel elective procedures and stop treating outpatients, which represented up to 80 percent of the revenue of rural hospitals, Morgan explained.
"Rural hospitals were in trouble already, even before all this happened," said Leighton Ku, director of the George Washington University Center for Health Policy Research in Washington, D.C. "It could be that the losses right now are that extra little thing that would push them off the edge. I wouldn't be surprised to hear that some more rural hospitals or very small hospitals, this was the thing that pushed them into bankruptcy."
Advertisement
Supply shortages
To make matters worse, rural hospitals are not in a good position to deal with a sudden COVID-19 outbreak. Small-town hospitals and clinics have to work harder to locate and buy the equipment they need, Henning-Smith said.
"You have a lot of very small clinics and hospitals, many of which are independent. They just don't have the buying power to jump to the front of the queue or to negotiate a reasonable price for additional equipment," Henning-Smith said.
These facilities also tend to be very lean operations, and the loss of some staffers to COVID-19 infection during an outbreak would put them squarely behind the eight ball, Morgan said.
"We've done a great job of building efficient small-town hospitals. By efficient, I mean absolutely no surge capacity," Morgan said. "For the facilities that have faced the pandemic, a common thread is one or two of the clinicians become COVID-19-positive. You have no room for error, and you start losing clinical staff. It compounds the problem, from a small town's perspective."
The federal government is distributing $10 billion in emergency relief to rural hospitals and clinics, and both Morgan and Henning-Smith are hopeful that money will help keep rural health care open until social distancing requirements are eased.
Advertisement
"What we're hearing from our membership, many are restarting their elective procedures and are taking outpatients again," Morgan said. "In a perfect world, this works out. As they utilize these federal funds, they're beginning to have revenue come back in their doors. Hopefully this is a glide path to keep rural hospitals open during this crisis."
"Rural hospitals have taken matters into their own hands as well, in some places forming buyers' consortiums so that they gain some extra leverage getting tests, ventilators, gloves, masks, gowns and other needed supplies," Henning-Smith added.
"Clinics banding together to make up one big order can be a big help here," she said. "Otherwise, many rural providers just won't come up to the top of the queue."
More information
The U.S. Centers for Disease Control and Prevention has more about COVID-19.
Copyright 2020 HealthDay. All rights reserved.


upi--2020-05-12--Cameran Eubanks won't return for 'Southern Charm' Season 7

May 12 ( UPI ) -- Southern Charm star Cameran Eubanks says she wo n't return for Season 7 .
The 36-year-old television personality announced Tuesday on Instagram that she is leaving the Bravo reality series .
Eubanks shared the news in the comments of her latest post .
She responded to a fan who asked when the show will be returning .
`` I will not be returning , '' Eubanks said .
Entertainment Tonight confirmed Eubanks is leaving Southern Charm after six seasons .
Eubanks has starred on the show since its premiere in 2014 .
Production on @ @ @ @ @ @ @ but was later put on hold due to the coronavirus ( COVID-19 ) pandemic .
Craig Conover told Decider in April that filming got off to a good start .
`` It 's a bummer with this unprecedented situation but it really felt like we got back to our roots .
It 's very organic and transparent , '' he said of the season .
`` [ After ] having such a long break , everyone kinda came in full steam ahead , so it was pretty wild and a lot of drama @ @ @ @ @ @ @ , Kathryn Dennis , Austen Kroll , Chelsea Meissner , Eliza Limehouse and Naomie Olindo .
The series follows the personal and professional lives of a group of people in Charleston , S.C. Eubanks has a 2-year-old daughter , Palmer Corinne , with her husband , Jason Wimberly .

May 12 (UPI) -- Southern Charm star Cameran Eubanks says she won't return for Season 7.
The 36-year-old television personality announced Tuesday on Instagram that she is leaving the Bravo reality series.
Advertisement
Eubanks shared the news in the comments of her latest post. She responded to a fan who asked when the show will be returning.
"I will not be returning," Eubanks said.
Entertainment Tonight confirmed Eubanks is leaving Southern Charm after six seasons. Eubanks has starred on the show since its premiere in 2014.
Production on Southern Charm Season 7 started in February but was later put on hold due to the coronavirus (COVID-19) pandemic. Craig Conover told Decider in April that filming got off to a good start.
"It's a bummer with this unprecedented situation but it really felt like we got back to our roots. It's very organic and transparent," he said of the season. "[After] having such a long break, everyone kinda came in full steam ahead, so it was pretty wild and a lot of drama."
Southern Charm co-stars Shep Rose, Kathryn Dennis, Austen Kroll, Chelsea Meissner, Eliza Limehouse and Naomie Olindo. The series follows the personal and professional lives of a group of people in Charleston, S.C.
Advertisement
Eubanks has a 2-year-old daughter, Palmer Corinne, with her husband, Jason Wimberly.


upi--2020-05-12--Luckin Coffee fires CEO, COO amid fraud probe

May 12 ( UPI ) -- China 's rival to Starbucks , Luckin Coffee , announced Tuesday the departure of @ @ @ @ @ in a fraud investigation .
The board of directors fired CEO Jenny Zhiya Qian and @ @ @ @ @ .
Both also resigned from the company 's board .
Jinya Guo , senior vice @ @ @ @ @ CEO , and Wenbao Cao and Gang Wu , both senior vice presidents , were @ @ @ @ @ replacements .
The departures come after six other employees who were involved in or had @ @ @ @ @ suspended or placed on leave .
In April , Luckin revealed that Liu fabricated about @ @ @ @ @ in 2019 , prompting the company 's stock to fall 80 percent .
`` The @ @ @ @ @ and responding to inquiries from regulatory agencies in both the United States and China , @ @ @ @ @ The company will continue to cooperate with the internal investigation and focus on growing its @ @ @ @ @ the board and current senior management . ''

May 12 (UPI) -- China's rival to Starbucks, Luckin Coffee, announced Tuesday the departure of two senior management officials implicated in a fraud investigation.
The board of directors fired CEO Jenny Zhiya Qian and Chief Operating Officer Jian Liu. Both also resigned from the company's board.
Advertisement
Jinya Guo, senior vice president, was named acting CEO, and Wenbao Cao and Gang Wu, both senior vice presidents, were named to the board as replacements.
The departures come after six other employees who were involved in or had knowledge of the scandal were suspended or placed on leave.
In April, Luckin revealed that Liu fabricated about $310 million in sales in 2019, prompting the company's stock to fall 80 percent.
"The company has been cooperating with and responding to inquiries from regulatory agencies in both the United States and China," Luckin said. "The company will continue to cooperate with the internal investigation and focus on growing its business under the leadership of the board and current senior management."


upi--2020-05-12--Run the Jewels hip hop duo announces fourth album, track list

May 12 ( UPI ) -- Run the Jewels hip hop duo announced Tuesday details of their fourth album , track list and 2021 tour dates .
The duo of EI-P and Killer Mike is set to release a fourth album through digital streaming June 5 , the website shows .
It has an 11-song track with `` yankee and he brave , '' as the first song , which first debuted during an Instagram Live session amid stay-at-home orders to control the coronavirus pandemic .
The second song , `` ooh la la , '' featuring DJ Premier and @ @ @ @ @ @ @ Netflix series Ozark 's season finale and rose to the rank of No .
5 from listeners using Shazam application to identify its name .
`` Ooh la la '' was also released through a music video , which got over 1.5 million viewers in the first week and rose to No .
7 trending on YouTube , building anticipation for the release of Run the Jewels 4 album .
The new album also features guest appearances by Rage Against the Machine 's Zack de La Rocha , Pharrell , 2 Chainz , @ @ @ @ @ @ @ Homme and Mavis Staples .
Physical vinyl and other RTJ products are also available for pre-order by September , the website shows .
The duo were originally scheduled to start a world tour with Rage Against the Machine in March , but dates have now been rescheduled for 2021 due to cancellations because of the coronavirus .
The starting date is now June 3 , 2021 at the Don Haskins Center in El Paso , Texas , with appearances later in Toronto , Canada before returning back to the United States later in @ @ @ @ @ @ @ in August .
Rapper Killer Mike and rapper/producer EI-P released their last album in late 2016 .
Their first album was released as a free digital download in 2013 , followed by RTJ 2 album in 2014 .

Killer Mike (L) and EI-P of Run The Jewels announced Tuesday details on the release of their fourth album. File Photo by Will Newton/UPI | License Photo
May 12 (UPI) -- Run the Jewels hip hop duo announced Tuesday details of their fourth album, track list and 2021 tour dates. The duo of EI-P and Killer Mike is set to release a fourth album through digital streaming June 5, the website shows. It has an 11-song track with "yankee and he brave," as the first song, which first debuted during an Instagram Live session amid stay-at-home orders to control the coronavirus pandemic. The second song, "ooh la la," featuring DJ Premier and Greg Nice, first debuted during the Netflix series Ozark's season finale and rose to the rank of No. 5 from listeners using Shazam application to identify its name. Advertisement
"Ooh la la" was also released through a music video, which got over 1.5 million viewers in the first week and rose to No. 7 trending on YouTube, building anticipation for the release of Run the Jewels 4 album.
The new album also features guest appearances by Rage Against the Machine's Zack de La Rocha, Pharrell, 2 Chainz, Queens of the Stone Age's Josh Homme and Mavis Staples.
Advertisement
Physical vinyl and other RTJ products are also available for pre-order by September, the website shows.
The duo were originally scheduled to start a world tour with Rage Against the Machine in March, but dates have now been rescheduled for 2021 due to cancellations because of the coronavirus. The starting date is now June 3, 2021 at the Don Haskins Center in El Paso, Texas, with appearances later in Toronto, Canada before returning back to the United States later in the summer to finish off the tour in August.
Rapper Killer Mike and rapper/producer EI-P released their last album in late 2016.
Their first album was released as a free digital download in 2013, followed by RTJ 2 album in 2014.


upi--2020-05-12--House Democrats unveil $3T HEROES Act to provide new coronavirus aid

May 12 ( UPI ) -- House Speaker Nancy Pelosi and Democratic leaders unveiled a $ 3 trillion coronavirus relief package Tuesday that addresses elements that were left out of previous measures , on which the lower chamber is expected to vote on Friday .
The 1,800-page Helping Emergency Responders Overcome Emergency Situations , or HEROES , Act is intended to provide money for state and local governments , rent and mortgage relief , hazard pay for front-line workers and funds to aid mail-in voting programs .
House Democratic leader Steny Hoyer told lawmakers Tuesday the chamber will meet Friday @ @ @ @ @ @ @ The legislation includes funding for state , local , tribal governments ; hospitals and health care workers ; USPS ; rental and mortgage assistance ; and more , '' Hoyer said .
Some are doubtful , however , that the relief package has much chance to succeed .
Senate Republican leader Mitch McConnell said the proper step now is to assess whether the first relief package , passed in late March , is working as intended .
That $ 2 trillion package included stimulus payments to most Americans .
`` We now have @ @ @ @ @ @ @ , '' McConnell said .
`` So I 've said , and the president has said as well , that we have to take a pause here and take a look at what we 've done . ''
Some Democratic lawmakers , including Reps. Pramila Jayapal of Washington and Mark Pocan of Wisconsin , say the measure does n't go far enough .
They say it should include a $ 600 billion `` Paycheck Guarantee '' program , which House leaders say is too expensive .

1/9
Speaker of the House Nancy Pelosi speaks Tuesday about The HEROES Act, a $3 trillion bill to aid in recovery from COVID-19 at the U.S. Capitol in Washington, D.C. Photo by Saul Loeb/UPI | License Photo
May 12 (UPI) -- House Speaker Nancy Pelosi and Democratic leaders unveiled a $3 trillion coronavirus relief package Tuesday that addresses elements that were left out of previous measures, on which the lower chamber is expected to vote on Friday. The 1,800-page Helping Emergency Responders Overcome Emergency Situations, or HEROES, Act is intended to provide money for state and local governments, rent and mortgage relief, hazard pay for front-line workers and funds to aid mail-in voting programs. Advertisement
House Democratic leader Steny Hoyer told lawmakers Tuesday the chamber will meet Friday to vote on the proposal.
"The legislation includes funding for state, local, tribal governments; hospitals and health care workers; USPS; rental and mortgage assistance; and more," Hoyer said.
Some are doubtful, however, that the relief package has much chance to succeed.
Senate Republican leader Mitch McConnell said the proper step now is to assess whether the first relief package, passed in late March, is working as intended. That $2 trillion package included stimulus payments to most Americans.
"We now have a debt the size of our economy," McConnell said. "So I've said, and the president has said as well, that we have to take a pause here and take a look at what we've done."
Advertisement
Some Democratic lawmakers, including Reps. Pramila Jayapal of Washington and Mark Pocan of Wisconsin, say the measure doesn't go far enough. They say it should include a $600 billion "Paycheck Guarantee" program, which House leaders say is too expensive.


upi--2020-05-12--Gap between urban, rural heart disease death rates doubles

May 12 ( UPI ) -- The gap in heart disease death rates between urban and rural areas of the United States has doubled in the last two decades , despite continued improvement across the country to survival rates , a new analysis shows .
Research published Tuesday in JAMA reveals that just under half of the more than 16.1 million deaths linked to cardiovascular conditions from 1999 to 2017 occurred in large metropolitan areas , but residents of rural areas also saw declines in life expectancy and slower reductions to heart-linked mortality rates over that period .
`` We @ @ @ @ @ @ @ mortality than urban areas , '' Dr. Haider J. Warraich , associate director for the heart failure program at the VA Boston Healthcare System , told UPI .
`` This study not only confirms that finding , but shows that the difference is actually increasing over time rather than getting better , '' he said .
Nearly half of all Americans have some form of heart disease , according to the U.S. Centers for Disease Control and Prevention , and roughly 650,000 die annually as a result of related causes .
For the @ @ @ @ @ @ @ findings from the CDC 's Wide-ranging Online Data for Epidemiologic Research , or WONDER , database , focusing on deaths from cardiovascular disease between 1999 and 2017 .
They calculated age-adjusted mortality rates , or AAMRs , for metropolitan , suburban and rural areas by multiplying the age-specific death rate for each age group by the corresponding per capita ratio for each region type based on the 2000 U.S. census population , and then multiplying by 100,000 .
The researchers found that between 1999 and 2017 , roughly 16.1 million deaths were caused @ @ @ @ @ @ @ .
Of these , 49.6 percent occurred in large metropolitan areas , 30.7 percent in medium and small metropolitan areas , and 19.7 percent in rural areas .
However , over the same period , the researchers determined that AAMRs declined 4.1 percent in large metro areas and 3.7 percent in smaller metro areas , while declining just 3.2 percent in rural regions .
As a result , the difference between AAMRs in rural areas and large metropolitan areas nearly doubled between from 1999 and 2017 , increasing from 24 deaths per 100,000 @ @ @ @ @ @ @ 100,000 population in 2017 .
`` This should be a wake-up call for the American people and policymakers : rural health has been ignored far too long and the rural health system has not been designed to help patients with chronic conditions like cardiovascular diseases , '' Warraich said .
`` The rural health system is in dire need of transformation , '' he said .
`` What we need is a more robust outpatient and population-focused healthcare system that incentivizes improvement in outcomes rather than rewards hospitalizations and procedures . ''

A new study has found rising rates of deaths from heart disease among residents of rural areas. Photo by Håkon Fossmark/Pixabay
May 12 (UPI) -- The gap in heart disease death rates between urban and rural areas of the United States has doubled in the last two decades, despite continued improvement across the country to survival rates, a new analysis shows. Research published Tuesday in JAMA reveals that just under half of the more than 16.1 million deaths linked to cardiovascular conditions from 1999 to 2017 occurred in large metropolitan areas, but residents of rural areas also saw declines in life expectancy and slower reductions to heart-linked mortality rates over that period. Advertisement
"We have known that rural areas have higher mortality than urban areas," Dr. Haider J. Warraich, associate director for the heart failure program at the VA Boston Healthcare System, told UPI.
"This study not only confirms that finding, but shows that the difference is actually increasing over time rather than getting better," he said.
Nearly half of all Americans have some form of heart disease, according to the U.S. Centers for Disease Control and Prevention, and roughly 650,000 die annually as a result of related causes.
For the analysis, Warraich and his colleagues reviewed findings from the CDC's Wide-ranging Online Data for Epidemiologic Research, or WONDER, database, focusing on deaths from cardiovascular disease between 1999 and 2017.
Advertisement
They calculated age-adjusted mortality rates, or AAMRs, for metropolitan, suburban and rural areas by multiplying the age-specific death rate for each age group by the corresponding per capita ratio for each region type based on the 2000 U.S. census population, and then multiplying by 100,000.
The researchers found that between 1999 and 2017, roughly 16.1 million deaths were caused by cardiovascular disease in the United States. Of these, 49.6 percent occurred in large metropolitan areas, 30.7 percent in medium and small metropolitan areas, and 19.7 percent in rural areas.
However, over the same period, the researchers determined that AAMRs declined 4.1 percent in large metro areas and 3.7 percent in smaller metro areas, while declining just 3.2 percent in rural regions.
As a result, the difference between AAMRs in rural areas and large metropolitan areas nearly doubled between from 1999 and 2017, increasing from 24 deaths per 100,000 population in 1999 to 42.8 deaths per 100,000 population in 2017.
"This should be a wake-up call for the American people and policymakers: rural health has been ignored far too long and the rural health system has not been designed to help patients with chronic conditions like cardiovascular diseases," Warraich said.
"The rural health system is in dire need of transformation," he said. "What we need is a more robust outpatient and population-focused healthcare system that incentivizes improvement in outcomes rather than rewards hospitalizations and procedures."