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      "body": "1= Every small change is part of the big success.\n\n2= Confidence is not that people will like you, the confidence is that when you do not like it, you are even fine.\n\nकॉन्फिडेंस यह नहीं है कि लोग आपको पसंद करेंगे ही, कॉन्फिडेंस यह है कि जब वो पसंद ना भी करें, तब भी आप ठीक हो।\n\n3= जो आसानी से मिल जाता है वो हमेशा तक नहीं रहता, जो हमेशा तक रहता है वो आसानी से नहीं मिलता।\n\nThe one who gets easily, does not live forever, who does not get it easily.\n\n4= जो बदलता है वो आगे बढ़ता है।\n\nWho changes, he moves forward\n\n5= खुशी आपके एटिट्यूड पर निर्भर करती है, आपके पास क्या है उसपर नहीं।\n\nHappiness depends on your attitudes, not on what you have.\n\n6= लक्ष्य हासिल की इच्छा का अनुमान इसी बात से लगा रहा है कि लक्ष्य ना मिलने से जो रात रात भर बेचैनी होगी ना, हमें उस बेचैनी से भी प्यार है।\n\nEstimates of the desire to achieve the goal is to say that we will love the restlessness that night will not be unnecessarily due to failure of our goal.\n\n7= अपने मन को कंट्रोल करो, इससे पहले कि मन आपको कंट्रोल करे।\n\nControl your mind, before the mind can control you.\n\n8= कमजोर लोग बदला लेते हैं, शक्तिशाली लोग माफ कर देते हैं, बुद्धिमान लोग नजरअंदाज कर देते हैं।\n\nWeak people take revenge, powerful people forgive, wise people ignore.\n\n9= आपका समय सीमित है, इसीलिए इसे किसी और की ज़िन्दगी जी कर व्यर्थ मत करो।\n\nYour time is limited, so do not waste it on someone else's life.\n\n10= कामयाब होने के लिए कई बार हमें जो है उसी में शुरुआत कर लेनी होती है, भले तैयारी पूरी ना हो क्योंकि यह इंतजार करने से काफी बेहतर है।\n\nTo succeed, many times we have to get started in the same way, even if the preparation is not complete because it is much better than waiting.\n\n11= जब एक ही जोक पर दोबारा नहीं हंसते, तो एक ही दुख पर भी दोबारा परेशान नहीं होना चाहिए।\n\nWhen one does not laugh at the same joke again, then one should not be troubled again even on the same sadness.\n\n12= जब तक शिक्षा का मकसद नौकरी पाना होगा, तब तक समाज में नौकर ही पैदा होंगे, मालिक नहीं।\n\nUnless the purpose of education is to get a job, only then servants will be born in society, not the boss.\n\n13= सफल वह है जो अपने दुश्मनों पर नहीं बल्कि अपनी इच्छाओं पर विजय पा लेता है।\n\nThe successful one is the one who conquers his desires, not on his enemies.\n\n14= जब भविष्य धुंधला पड़ने लग जाता है, तब आपको अपने वर्तमान में फोकस करने की जरूरत है।\n\nWhen the future starts to blur, then you need to focus on your present.\n\n15= सिर्फ मरी हुई मछली को ही पानी का बहाव चलाती है, जिस मछली में जान होती है, वो अपना रास्ता खुद तय करती है।\n\nOnly the dead fish runs the flow of water, the fish in which they live lives, they decide their own path.\n\n16= कामयाब लोगों के चेहरों पर दो चीजें होती है, एक साइलेंस और दूसरा स्माइल।\n\nThere are two things on the faces of successful people, one silence and another smile.\n\n17= सब कुछ ईज़ी है जब आप बिजी होते हो और कुछ भी ईज़ी नहीं होता जब आप लेज़ी होते हो।\n\nEverything is easiest when you are busy and nothing happens when you are lazy.\n\n18= नीचे गिरना एक्सीडेंट होता है, लेकिन पढ़े ही रहना यह आप की चॉइस होती है।\n\nBelow is an accident, but it is your choice to keep reading.\n\n19= अपने हौसले को ये मत बताओ कि तुम्हारी परेशानी कितनी बड़ी है, अपनी परेशानी को यह बताओ कि तुम्हारा हौसला कितना बड़ा है।\n\nDo not tell this to your fate that how big your problem is, tell your trouble how big your courage is.\n\n20= अगर एक दिन अपने आप पर गर्व करना है तो आज हार मत मानो।\n\nIf one day has to be proud of yourself then do not give up today.\n\n21= कोई इंसान चाहे लाखों चीजें जान ले, चाहें वो पूरे वर्ल्ड को जान ले, लेकिन अगर वह खुद को नहीं जानता तो वो अज्ञानी है।\n\nWhether a person knows a lot of things, he wants to know the whole world, but if he does not know himself, then he is ignorant.\n\n22= अगर आज आप कमाई से ज्यादा मेहनत करते हो, तो बहुत जल्द मेहनत से ज्यादा कमाई करोगे।\n\nIf you work harder than earning today, then you will earn more than hard work.\n\n23= ज्ञान से ज्यादा जरूरी है, आपकी अपने लक्ष्य को पाने की इच्छा।\n\nMore than knowledge, the desire to get your own goal.\n\n24= पहाड़ की ऊंचाई आगे बढ़ने से नहीं रोकती बल्कि आपके जूते में पड़े कंकड़ आपको आगे बढ़ने से रोकते हैं।\n\nThe height of the mountain does not stop you from growing, but the pebbles in your shoes prevent you from proceeding.\n\n25= ख्वाब जिनके ऊंचे और मस्त होते हैं, इम्तिहान भी उनके जबरदस्त होते हैं\n\nDream whose high and cool are also immeasurable.\n\n26= उड़ा देती है नींदें कुछ जिम्मेदारियां घर की, रात में जागने वाला हर शख्स आशिक नहीं होता।\n\nBlows sleepy, some responsibilities of the house, not every person awakens at night.\n\n27= सच परेशान हो सकता है लेकिन हार नहीं सकता।\n\nThe truth can be disturbing but can not be lost.\n\n28= अच्छे काम में डर लगे तो याद रखना, यह संकेत है कि आप का काम वाकई में बहादुरी से भरा है। अगर इसमें डर और रिस्क नहीं होता तो हर कोई कर लेता।\n\nRemember to be afraid of good work, it is a sign that your work is truly filled with bravery. If there is no fear and no risk, then everyone would do it.\n\n29= अपनी किसी से तुलना मत करो, जैसे चांद और सूरज की तुलना नहीं की जा सकती क्योंकि यह दोनों अपने वक्त पर चमकते हैं।\n\nDo not compare to any of you, like the moon and the sun can not be compared because these two shine at their own time.\n\n30= अगर केवल इसलिए आप अपने काम को करना बंद कर रहे हो क्योंकि किसी को लगता है कि आप नहीं कर सकते, तो वो आपका सपना नहीं था बस एक छोटी सी इच्छा थी।\n\nIf only you are stopping your work because someone thinks you can not do it, then that was not your dream, it was just a small desire.\n\n31= अच्छे वक्त का इंतजार करो, संघर्ष और धैर्य के साथ।\n\nWait for good times, with struggle and patience.\n\n32= जो लोग आपको पर्सनली नहीं जानते उनकी बातों को पर्सनली मत लो।\n\nDo not take personal information to people who do not know you personally.\n\n33= एक पागल और होशियार मैं यहीं फ़र्क़ है कि होशियार की एक सीमा होती है और पागल की कोई सीमा नहीं होती।\n\nA crazy and clever I have to point out that there is a limit to cleverness and there is no limit to the crazy.",
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      "body": "Hi! I am a robot. I just upvoted you! I found similar content that readers might be interested in:\nhttps://www.forbes.com/sites/hennainam/2018/05/13/how-to-be-the-boss-everyone-wants-to-work-for/",
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      "author": "toni.crypto",
      "body": "Hello! Good article! I'm interested in the them of ICO and crypto-currency, I'll subscribe to your channel. I hope you will also like my content and reviews of the most profitable bounties and ICO, subscribe to me @toni.crypto\nThere will be a lot of interesting!",
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      "body": "![960x0.jpg](https://steemitimages.com/DQmYFAFuA3ryaH2BWYgbH2F8VPFRB7mM5b8TGYYw7u5MMKV/960x0.jpg)\n\nQuick, think about a great boss you had in your career. What made them great?\n\nChances are you thought about a boss who had your back. Likely it was also someone that helped you learn and grow. In my twenty year corporate career I was lucky to have three bosses who really stand out for me. Each of them were people who grew me by giving me tough challenges, but also helped me succeed in those challenges.\n\nI sat down to discuss this topic of how great leaders build people and teams with Whitney Johnson. Whitney is an innovation and disruption theorist, an executive and performance coach, strategist, and the critically-acclaimed author of Build an A Team, newly published by Harvard Business Press.\n\nHenna Inam: Can you share your thoughts about why this book is particularly needed in today’s workplaces?\n\nWhitney Johnson: Too often, organizations lose their top talent because they don’t understand that every person on their team is a learning machine. You want the challenge of not knowing how to do something, learning how to do it, mastering it, and then learning something new. We want to learn. Leap. And repeat. My own story illustrates this. I had been an equity analyst for eight years, at the top of my game. I had always enjoyed mentoring and coaching and approached my senior leader about moving into a management track. Instead of being supportive, he was dismissive. In retrospect, I probably could have gone about this differently, but the fact is, I was a top performer. It was time to do something new. And the answer was no. I quit within the year. This scenario plays out every day in workplaces across the globe. It’s costing companies time. It’s costing them money. Not to mention, you become that boss-the one no one wants to work for.\n\nInam: In your book, you make the connection between personal disruption and employee engagement. How are the two connected?\n\nJohnson: Studies show that nationally, only 33 percent of employees are engaged in their work, and worldwide, just 15 percent of employees say they’re engaged. For companies that practice personal disruption, early indications are that these numbers are reversed. For example, one company we studied shows 93% engagement levels, and 97% are excited about their work. This is an outlier as far as engagement goes, but still indicative.\n\nOur research has shown that employees are most engaged when they are in the “sweet spot’ of their learning curve, that middle section where they have moved past being a beginner and are now quickly learning, growing and starting to master their responsibilities. A company that encourages personal disruption, allowing their people to move into new roles, work on stretch assignments, and continue learning on the job, have employees that are happy, productive, motivated and engaged.\n\nInam: How do you define personal disruption?\n\nJohnson: In 2015 I published Disrupt Yourself, a guide to radically reinventing your own career, where I introduced the concept of Personal Disruption. Personal disruption is a strategy that is centered around learning: You start as a beginner, embracing the confusion that comes with being a novice; you experience a state of deep engagement as you learn, grow and gain traction; and you feel the joy of mastery once you get to the top of your learning curve. But then—crucially—you find a new challenge to tackle, or else you risk becoming bored, complacent and ineffectual, and the cycle starts over.\n\nInam: How can a great boss help their team members engage in personal disruption?\n\nJohnson: Great bosses allow, encourage, even require their employees to move along their personal S-curve. Whether they oversee a team of ten or ten thousand, they can encourage disruption by saying yes when employees want to move on to new projects, by promoting them, by hiring individuals that show potential rather than proficiency, by giving people work that will stretch and challenge them. And most important,  they ensure that for individuals that have proven mastery in their role – they come up with a new plan for them before they get bored or worse, want to quit. The best bosses facilitate growth and celebrate the success of others, and this establishes their reputation as a talent developer and a boss who people love to work for.\n\nInam: Most people today are fairly exhausted with the pace of change and ambiguity in their organizations. The last thing they want to hear about is more disruption. How is your book a great tool for them to work in the disruptive environment around them?\n\nJohnson: It may seem counter-intuitive, but our framework of personal disruption actually helps to calm the seas of constant change and volatility in the workplace. This is because it gives individuals and managers an internal guidepost within the organization that paves the path for intentional change–change that they can control and manage. When an individual is moving along their personal S-curve, they are in a flow of learning and growth, change that is intentional and foundational, not volatile. It is the same for managers: when they know their team is moving along the S-curve, with an optimal proportion of beginners (15%), engaged learners (70%) and masters (15%) they are assured that their team is on course and primed for excellence. Eager, capable employees, tackling new challenges are a key driver of innovation within an organization.\n\nInam: Some people are naturally more excited about personal disruption and change than others. How can this book help everyone?\n\nJohnson: Within an organization, this is where leadership and management come in. Leaders that build A teams create a culture that oozes personal disruption. It needs to be part of the organization’s vision and mission. When new hires are onboarded, they need to be immersed in the walk and talk of learning curves, personal growth and change. As a culture of learning sets hold in an organization, HR will start making hiring decisions based on a prospective employee’s willingness to try new things. They hire those who are unafraid to start at the bottom of the S-curve. They bring in managers who can spot talent and who are willing to sponsor and facilitate jumps to new curves.\n\nImportantly, they look for prospects that have expansive potential rather than proficiency.\n\nInam: What are the biggest challenges to motivating employees? How can the ideas in your book help bosses?\n\nJohnson: That’s an interesting question, because we actually found that motivation is not the core problem for bosses to be addressing head on: it’s learning. Employees become un-motivated because they are bored and unchallenged at work. Change, not stasis, is the natural mode of human life, we are wired for change. Stasis, standing still, being stuck in a non-challenging role, is what leads to boredom, un-engagement and a lack of motivation. Whether managing a small team or overseeing thousands of people across several business units, the best bosses get this. They cultivate environments that keep the work experience fresh. They encourage and facilitate personal disruptions. They recognize that the best reward they can give their people—the thing that motivates and engages beyond money or praise—is learning. It’s what makes each of us more productive. It’s what turns our organizations into talent magnets.\n\nNow, it’s time to look in the mirror. Regardless of whether you’re a boss who leads others or someone who doesn’t yet have direct reports, how will you use these compelling insights to engage in personal and team growth?",
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      "author": "cheetah",
      "body": "Hi! I am a robot. I just upvoted you! I found similar content that readers might be interested in:\nhttps://www.indiafinancenews.com/itel-s42-this-phone-is-value-for-money/",
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      "body": "Itel S42 runs on Android 8.0 and is powered by a 1.4GHz quad-core Qualcomm Snapdragon 425 processor and 3 GB RAM.\n\n![itel.jpg](https://steemitimages.com/DQmbMrVsNc341WPFipSKifFyVR2sp76rxMbVpTtF1Y3Uei6/itel.jpg)\n\nMonths after the successful launch of itel S41, Itel Mobile, the smartphone arm of Hong Kong-based Transsion Holdings in India, has debuted its itel S42 smartphone here. The new device has a judicious mix of good design and decent performing hardware and software. Priced at Rs 8,499, itel S42 offers a full-view sharp display, Android Oreo, an entry-level Snapdragon chipset, decent front and rear cameras, and a 3000mAh battery. Out of the box, the overall design seems to be more or less similar to S41. The front of the device is dominated by a 5.65-inch touchscreen display with a resolution of 720 pixels by 1440 pixels at a PPI of 285 pixels per inch. In actual usage, the display quality is satisfactory with sharp and crisp resolution—icons look sharp and pixels are visible but reading is a bit of a challenge in direct sunlight. It also houses a front camera on the top, while three capacitive touch keys are placed in the bottom.\n\nThe power and volume rocker keys are placed on the right edge while the left has space for SIM cards. A 3.5 mm headset jack is on the top edge while the bottom is dedicated to a Micro-USB port and speaker’s grille. The rear panel is home to itel branding along with rear camera, LED flash and fingerprint reader. The smartphone feels sturdy and good to hold. Itel S42 runs on Android 8.0 and is powered by a 1.4GHz quad-core Qualcomm Snapdragon 425 processor and 3 GB RAM. The phone packs 16 GB of internal storage that can be expanded up to 128 GB via a microSD card. During the review period, the smartphone handled browsing, reading and non-graphic intensive games quite smoothly. Also, shuffling between different apps and multitasking was easy. It did not stutter or showed any lag.\n\nOn the camera front, itel S42 has more to offer. It comes with 13-megapixel rear camera and front camera. Both the cameras are decent and take good pictures in vivid details. Some of the pictures that we clicked in daylight conditions turned out to be sharp with great details but same could not be repeated in lowlight conditions. The itel S42 is a dual SIM (GSM and GSM) smartphone that accepts two Nano-SIM. Connectivity options include Wi-Fi, Bluetooth, USB OTG, 3G and 4G. Sensors on the phone include Proximity sensor, Accelerometer and Ambient light sensor. The S42 is backed by a 3000mAh battery which helped the device clock around 12 hours of use. With continuous data usage, the battery could last 6-8 hours. Overall, the itel S42 is a decent entry-level smartphone with rich features, nice camera performance and good battery life. It is value for money.\n\n* Estimated Street Price: Rs 8,499",
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      "author": "toni.crypto",
      "body": "Hello! Good article! I'm interested in the them of ICO and crypto-currency, I'll subscribe to your channel. I hope you will also like my content and reviews of the most profitable bounties and ICO, subscribe to me @toni.crypto\nThere will be a lot of interesting!",
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      "body": "Hello! Good article! I'm interested in the ICO and crypto-currency, I'll subscribe to your channel. I will be very grateful if you subscribe to me @zabramson",
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      "body": "![AHA0508182.jpg](https://steemitimages.com/DQmd8ptr3yKmxN1ajnQxU9AKkLiS84j8hbvjwdySuvNGzPN/AHA0508182.jpg)\n\nTUESDAY, May 8, 2018 (American Heart Association) -- It's a familiar scenario: You find yourself at the doctor's office, sitting on the edge of an exam table with your feet dangling inches above the floor. The nurse or medical assistant who seconds ago instructed you to sit now asks you questions about the reason for your visit -- all while taking your blood pressure.\n\nThat measurement, however, could come back dangerously high -- and flat wrong.\n\nTogether, the dangling feet, the unsupported back, even the chit chat are more than enough to throw off a blood pressure reading and classify a patient as having high blood pressure when he or she doesn't.\n\nAnd if that measurement was taken with the blood pressure cuff on top of a shirt sleeve instead of a bare arm? It could push a patient's reading high enough to qualify for medication that might not be needed.\n\nUntil recently, high blood pressure, or hypertension, was defined by any measurements with 140 or higher as the top number, and 90 or greater as the bottom.\n\nLast November, the American Heart Association updated its high blood pressure guidelines and established a new threshold for diagnosing high blood pressure at 130/80. That change of 10 mmHg (millimeters of mercury) was enough to classify nearly half of all Americans as having high blood pressure.\n\nIt also has served as a reminder about the importance of getting blood pressure measured properly.\n\nYet, for a procedure performed millions of times every day across the country, very few medical professionals -- even nurses and doctors -- nail the routine correctly, said Dr. Michael Rakotz, a family physician and the vice president of health outcomes for the American Medical Association.\n\nAn ongoing AMA campaign has tried to raise awareness about how to correct the most common errors people make when measuring blood pressure, whether at the doctor's office or at home.\n\n\"Every time we go out and conduct blood pressure measurement trainings, people tell us afterward that they've been doing it wrong for years,\" Rakotz said.\n\nPosters tacked inside exam rooms and vital stations are aimed just as much at patients as they are at clinical staff because \"once the patients learn how their blood pressure should be measured, they aren't going to let anybody measure it incorrectly again,\" he said.\n\nWhen getting blood pressure measured, both feet need to rest on the ground or a stool. The back needs to be supported, as well as the arm, which should be propped at heart level. Many times, these procedures fail to be observed.\n\nOther common mistakes include:\n\nFailing to rest before a measurement. Sitting quietly for about five minutes can help relax the body.\nPlacing a cuff over clothing. Depending on the thickness of the sleeve, clothing can add up to 50 mmHg to a reading. The blood pressure cuff needs to be placed on a bare arm -- so roll up your sleeve or come wearing short sleeves.\nUsing the wrong sized cuff. Squeezing an arm into a cuff that's too small can add anywhere between 2 mmHg and 10 mmHg to a measurement.\nEngaging in conversation. Avoid the small talk. Even active listening can add 10 mmHg.\nWith just one or two simple errors in measurement techniques, a patient could suddenly find himself classified as having high blood pressure, said Dr. Raymond Townsend, a nephrologist.\n\n\"Suddenly, they have a disease that they didn't have yesterday,\" said Townsend, director of the hypertension program at the University of Pennsylvania Hospital. \"When you label someone as having hypertension, you actually have given them a chronic disease label. That can be a downer in our outlook on life so getting it right is important.\"\n\nTownsend worked with Rakotz on a study where they implemented a \"blood pressure check challenge\" to nearly 160 medical students during the 2015 AMA annual meeting.\n\nOnly one student performed all 11 measurement elements correctly.\n\n\"It didn't matter if you were a guy or a gal, whether you were a first-year medical student or fourth-year, whether you were going into internal medicine or obstetrics. They just didn't know what they were doing,\" Townsend said. \"Out of 11 possible things to do right, the average they got was four.\"\n\nTownsend knows that doctors have a lot of information to balance in their minds when seeing patients.\n\n\"But of all the things that we do in clinical medicine, what is the single most important difference we can make to help someone live longer and live free of target organ damage? There's only one answer,\" he said. \"It's to measure and treat blood pressure correctly.\"",
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      "body": "![DQmZ1jgNCEPLNmWUgt3dVp1QGpQe5vPsowbp1gVk9efd5Jp_1680x8400.jpeg](https://steemitimages.com/DQmSUaA5WQBk5Ns7nFbCtdxsVSadW66PywvizZjHU5KTDce/DQmZ1jgNCEPLNmWUgt3dVp1QGpQe5vPsowbp1gVk9efd5Jp_1680x8400.jpeg)\n\nIn the quest to keep the pilot light that is our metabolism burning at all times, there's no sweeter sound than finding out that something we're already doing is helping to keep it aflame. Case in point: drinking coffee. 83% of adult Americans sip java daily, and lucky for this (large chunk) of the population, reaching for a cup first thing in the morning is actually fueling the flame a lot more than we knew.\n\n\"Your daily cup of coffee can help boost your metabolic rate by stimulating thermogenesis, helping you burn more fat,\" nutritionist Sarah Flowers tells The Express. She continues, \"Coffee also contains chlorogenic acid, which helps to slow down the absorption of carbohydrates, as well as stimulate the hormone epinephrine, which helps to break down fat.\" Chlorogenic acid also slows down the absorption of carbohydrates and suppresses our hunger hormone, ghrelin.\n\nStudies back these claims, finding that drinking coffee significantly increased the metabolic rate of participants during the three hours after caffeine ingestion as well as significantly increased fat oxidation during the last hour of the test. These findings occurred only in participants who were of average weight, though—obese participants only saw an increase in metabolic rate, not fat oxidation.\n\nBut before you preorder a few ventis on Starbucks's app, there are a few things to know first: Flowers warns that drinking several cups of coffee will actually decrease these effects and you could eventually become intolerant. Because of this, she suggests sticking to just one or two cups per day. Additionally, a latte, cappuccino, or any drink with loads of sugar and fat won't elicit these positive effects—stick to a regular cup of dark roast coffee (more antioxidants) with unsweetened almond milk or oat milk. Flowers is a fan of Skinny Coffee Club ($39), which makes a blend of ground coffee, green coffee bean extract, green tea extract, garcinia cambogia, and Siberian ginseng, all of which work together to help speed up metabolism, suppress appetite, and burn more fat.\n\nIf caffeine isn't your thing, you haven't been ruled out: Decaf coffee still contains that magic chlorogenic acid.\n\nAnd if all of this didn't motivate you to continue your daily brew already (or pick up the habit), coffee also helps decrease mortality rates, helps you power through a workout, and has a bevy of antioxidants to fight against inflammatory diseases.",
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      "body": "![rtsrmd3.jpg.png](https://steemitimages.com/DQmQU5qgFyACt2sd6rY2icxNuEPsim4VPAp6E9Fa38wvdEt/rtsrmd3.jpg.png)\n\nThe FDA just approved a cutting-edge therapy to treat more patients with certain forms of blood cancer.\n\nIt's the second approval for the drug, Kymriah, which is now approved to treat certain forms of leukemia and lymphoma.  \n\nThe therapy works by taking a person's own cells, reprogramming them, and inserting them back into the body to fight the cancer — in this case, certain forms of blood cancer.\n\nThe FDA just approved a cutting-edge cancer therapy to treat another form of blood cancer. \nIt's the second approval for Kymriah, also known as tisagenlecleucel, this time to treat patients with large B-cell lymphoma, and the first for adult patients. An August approval of Kymriah approved the therapy to treat pediatric acute lymphoblastic leukemia in people up to age 25.\nThe highly personalized treatment is called CAR T-cell therapy (CAR is short for chimeric antigen receptor). It's a type of cancer immunotherapy, which harnesses the body's immune system to take on cancer cells. It removes a person's cells, reengineers them, then puts them back in their body to attack cancer cells.\n\"I think this is the most exciting thing I've seen in my lifetime,\" said Dr. Tim Cripe, an oncologist who was part of the FDA advisory committee panel that voted in July to recommend the drug's initial approval.\nThe approval now puts Kymriah, made by Novartis, into direct competition with Yescarta, another CAR-T cell therapy that was approved in August made by Kite Pharma, a company Gilead Sciences acquired in 2017. There are more than 10,000 adults with large B-cell lymphoma who might benefit from these treatments, Dr. Fred Locke, an oncologist and researcher at Moffitt Cancer Institute in Tampa, Florida told Business Insider in October. That increases the potential use of the medication from the 600 people a year who could initially benefit from Kymriah based on its pediatric leukemia approval. \nYescarta and Kymriah aren't your run-of-the-mill pill — or even a biologic drug, like insulin — that can be mass produced. Since the therapy is made from a person's own immune system, the process can take about three weeks.\nTo start, a doctor removes some white blood cells, the part of our body's immune system responsible for combatting infections and foreign substances, from a patient. In a healthy body, the immune system can recognize abnormal, cancerous cells, but for people with cancer, it doesn't recognize that the cells are spreading.\nThen the cells are taken to a manufacturing facility at which point the cells are reengineered to recognize cancer cells and wipe them out.\nThose reprogrammed cells are sent back and administered to the patient.\n\n![cancer-chart.png](https://steemitimages.com/DQmP3tYhkd43tNacAfPUsTtP1c8faTim5N1vP2yx3ug4PD7/cancer-chart.png)\n\nThe one-time treatments won't come cheap. Yescarta has a list price of $373,000, which is lower than Kymriah's $475,000 price tag. \n'A big new field of medicine'\nKymriah, and Yescarta are the first two CAR-T cell therapies to get approved, and several more are in the works. Juno Therapeutics, and Bluebird Bio are among a growing group of biotech companies working with CAR-T.\n\"We're at the very beginning of what's going to be a big new field of medicine,\" David Epstein, who helped license Kymriah from the University of Pennsylvania while at Novartis told Business Insider in August.\nEpstein left Novartis in 2016 as CEO of its pharmaceuticals divisions. He's now the executive chairman of Rubius Therapeutics, a biotech firm that's also working with cell therapy to develop treatments like Kymriah that don't have to be as personalized. The hope is that one day doctors will be able to prescribe a cell therapy and use it that same day instead of waiting weeks to get it back, and possibly extend beyond the blood cancers treatments like Kymriah and Yescarta are able to treat.",
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      "body": "![5089.jpg](https://steemitimages.com/DQmYYkKsWmQszrP4cx5K68hTr1R2WsYNAUNqoZTWDvnh9uP/5089.jpg)\nScientists say doctors should consider weaning patients with depression, Parkinsons or bladder problems off anticholinergic drugs\n\nSome antidepressants and bladder medicines could be linked to dementia, according to a team of scientists who are calling for doctors to think about “de-prescribing” them where possible.\n\nTricyclic antidepressants such as amitriptyline, which are also prescribed for pain and to help with sleeping, and one of the SSRI class, paroxetine (also known as Seroxat), are implicated by the largest ever study to look at this possible risk.\n\nAmitriptyline was in the news in February, named as the most effective of the antidepressants in a study. Some Parkinson’s drugs are also linked to a raised dementia risk.\n\nAs a group, these are known as anticholinergic drugs. There are 1.5 to 2 million people in England alone on this type of drug. It is already known that they can cause short-term confusion and raise people’s risk of a fall. One in five people taking an antidepressant is on an anticholinergic drug, usually amitriptyline.\n\nThe researchers warn that the increasing tendency for older people to be taking a cocktail of drugs for different conditions may be part of the problem.\n\n“In the last 20 years, the number of older individuals taking five or more medicines has quadrupled,” said Dr Ian Maidment, senior lecturer in clinical pharmacy at Aston University. “Many of these medicines will have some anticholinergic activity and, in the light of today’s findings, we have to consider whether the risks of dementia outweigh the benefits from taking a cocktail of prescribed drugs.\n\n“The focus should be on de-prescribing at least some medicines. That means pharmacists, doctors and nurses working with patients who are prescribed multiple drugs, to ascertain if the benefits clearly outweigh the potential harm that could be caused by anticholinergics.”\n\nThe drugs for various conditions have in common their mode of action – they work by blocking a neurotransmitter – chemical messenger – called acetylcholine which has effects on the bladder, mouth, stomach, eye and heart but is also present in the brain and important in cognition, memory and learning.\n\nThe researchers, who report their findings in the British Medical Journal, investigated GP records for more than 40,000 people over the age of 65 with dementia and nearly 300,000 without dementia. They looked back at prescribing records for up to 20 years earlier, to find out whether there was a link between the anticholinergic drugs they were given and a later diagnosis of dementia.\n\nThey found that people who were on the drugs between four and 20 years earlier were more likely to have been diagnosed with dementia.\n\nAntihistamines for hayfever and gastrological drugs were given a clean bill of health even though these are also anticholinergic.\n\nBut for those who have been prescribed these drugs for depression, Parkinson’s and bladder problems, the risk of dementia rose from 10% which everybody has, to 13% – so three extra people in every 100 might be diagnosed.\n\nThe researchers, led by the University of East Anglia, stop short of claiming that the drugs cause dementia. The early symptoms of dementia include depression and urinary incontinence, so it is possible the drugs were sometimes being prescribed for people who already had the early stages. But there was a “dose response” – the more of the pills people had taken over time, the more likely they were to be diagnosed with dementia.\n\nProfessor Chris Fox from East Anglia, one of the authors, thinks doctors should de-prescribe. “When I review my patients I make a joint decision to switch or stop such medicines. In addition I write to GP’s indicating that they may wish to change as there are alternatives,” he said.\n\nBut the researchers warned that patients should not stop taking the drugs without talking to their doctor first.\n\nA spokesperson for the Medicines and Healthcare Products Regulatory Authority said it would look to see if any action should be taken. “Patient safety is our highest priority and we continuously monitor the safety of all medicines on the UK market. These findings will be carefully evaluated, as with any study, to determine whether they have any implications for the safe use of anticholinergic medicines,” he said.\n\nOther scientists said the study was well done but cautioned that it did not prove the drugs were a cause of dementia. Dr Parastou Donyai, associate professor of social and cognitive pharmacy at the University of Reading, said: “This paper ties in well with current advice for doctors to be careful when using drugs with anticholinergic effects in older people, those who are frail and others with numerous health conditions. The warning to not use anticholinergic drugs in Parkinson’s disease is also important.\n\nBut the headline claim that some drugs, especially antidepressants, can cause dementia up to 20 years later should be looked at closely. This type of study imagines that patients actually take their drugs as they were prescribed for them. But we know from other research that people with long-term health conditions really only take their medication as prescribed around half of the time – the other half, people either take more or less of their medication or not at all.”",
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      "body": "Hi! I am a robot. I just upvoted you! I found similar content that readers might be interested in:\nhttps://www.wxyz.com/news/region/detroit/hiv-a-growing-concern-in-detroit-with-infection-rate-four-times-some-counties?autoplay=true",
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      "author": "a-0-0",
      "body": "Do you want me to resteem your post to my 35,000+ followers? https://steemit.com/@a-0-0",
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      "body": "![poster_9faeb09104554e139e0da0fbf8cbcb44_84726511_ver1.0_320_240.jpg](https://steemitimages.com/DQmSUQiF5oH23sgsjp4XRAMZtSavCZ6BCu4kC9Qj8QscfVE/poster_9faeb09104554e139e0da0fbf8cbcb44_84726511_ver1.0_320_240.jpg)\n\nAccording to the Michigan Department of Health and Human Services more than 11,000 people are living in metro Detroit with HIV and more than 40 percent of them are in Detroit. \n\nCommunity activist and mother of four Chunnika Hodges was diagnosed with HIV. \n\n\"I was in a monogamous relationship for two years but didn't find out until after I was in another relationship. That just goes to show you how tricky HIV is,” Hodges says. \n\nNearly 5,000 people live in Detroit with HIV. The state says Detroit’s rate is nearly four times higher than Ingham and Saginaw Counties.\n\nDoctor Johnathan Cohn with Wayne State says there’s a growing problem with teens and young adults, especially in the African American community.\n\n“They are more worried about the other STD’s and things like that, but HIV seems to be a taboo topic around sex and diagnosis,” Cohn says.\n\nCohn says many of those cases could have been prevented if people knew about Pre-exposure prophylaxis, also known as PREP. \n\nPrep is a pill that prevents you from getting HIV. \n\n\"I just take the pill once a day. it's just like a multivitamin,” says Community Health Worker Christopher Woolfolk.\n\nWhile it’s been around for years, Woolfolk who’s been on PREP before, says the word is still not getting out. \n\n\"I think that there are attempts for visibility for the medication, but I think that people are so unaware of it that, if they just see the word PREP, they're not really associating it with anything else.\"\n\nPatients have to see a doctor several times throughout the year, Cohn says sometimes that turns people away. \n\nIt’s also been difficult getting doctors to talk about it with their patients. \n\n\"Not everybody jumps at it. I think part of it is the technical training - having the technical knowledge,” Cohn explains. \n\nThe state is trying to change that by providing more education and training. Parents are encouraged to talk to their children about sex. \n\n“Some parents do that, some parents avoid it, if you want your children to be safe it's better to talk about it than to avoid it.\"",
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