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[U.S.A.] A New Universal Vaccine Is On Its Way
The University of Oxford with the help of Vaccitech is currently developing a universal flu vaccine. Vaccitech has raised nearly $27 million in series A financing backed by Alphabet venture (formerly known as Google Ventures), Sequoia China and Oxford Science Innovation. The funding will support the development of Vaccitech’s lead vaccine contender, which is intended to protect against all strains of influenza A virus. Vaccitech is also working on a cancer vaccine that is expected to begin in early 2018. According to FiercePharma, “traditional flu vaccines target antigens on the surface of the flu virus, whose constant mutations force scientists to update flu shots every year to fight the circulating strains. But Vaccitech’s version uses Modified Vaccinia Ankara (MVA) as a vector to encode two types of proteins that remain unchanged in the core of the virus.” Professor Adrian Hill, who co-developed Vaccitech’s technology at the University of Oxford, explained that with the natural exposure of influenza, most people have developed low levels of T cells. “These low levels offer very little protection, but we found in several phase 1 trials that these levels can be boosted about tenfold by a single dose of our MVA-NP+M1 vaccine.” The vaccine is currently testing the phase 2 of the study in the United Kingdom and Vaccitech plans to enroll about 2,000 more patients. However, Vaccitech isn’t the only company to be working on a universal flu shot. Companies like Big Pharma Johnson & Johnson, Sanofi, FlueGen and BiondVax are also developing their own version of the vaccine. 
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[U.S.A.] Hurricane Irma and Maria still affect Florida and Puerto Rico
Hospitals in Florida have been faced with a critical shortage of IV fluids since the production shutdowns in Puerto Rico due to the series of deeply damaging hurricane that hit the island in 2017. The IV products, like saline solutions, are some of the highest-demand supplies in hospitals. According to John Armistead, "it's unprecedented to have this kind of large-scale, nationwide drug shortage of such a basic item in U.S. healthcare, so, it's quite dramatic." Baxter International, the Deerfield, Illinois based leading supplier of the IV products has three manufacturing plants in Puerto Rico. According to the Naples Daily News, Baxter International stated in Mid-January 2018, that all three manufacturing plants “are now connected to the electrical grid and have backup generators to deal with sporadic outages on the island.” Federal Drug Administration Commissioner Scott Gottlieb claims that the shortage is expected to end but gave no official time limit. Gottlieb stated that “the production situation in Puerto Rico remains fragile. As many risks and challenges remain and there are still shortages affecting patient care, we’ll continue to take all possible steps to help improve shortage situations." However, Sen. Bill Nelson, D-Orlando, urges the FDA to make the supply shortage a top priority. As IV solution bags are used on a number of patients for fluids, as well as other medications like antibiotics. Armistead assures that Lee Health Hospital will not run out of IV supply, they have already begun using other methods to treat patients.  NCH Healthcare system has used the same approach instead of using IV solution for some antibiotics the staff has switched to give the antibiotics via injections. Baxter International has directed shipments from other production facilities in Ireland and Australia to make up for the shortage. In contrast, in Tallahassee Memorial HealthCare stated that “our patients, and the quality of care we provide, have not been affected by the change in supply. We are working with alternative vendors/manufacturers, utilizing adaptors to connect with different fluid bag types, and combining solution sizes to reach the desired amount of fluid needed for each patient." Angela Dickens, Vice President of Marketing for Indian River Medical Center in Vero Beach said that they have found other vendors for their IV bags after its factory supplier in Puerto Rico were damaged by hurricanes Irma and Maria. According to Naples Daily News, the pharmaceutical production is a $14.5 billion industry in Puerto Rico and accounts for 72.4 percent of its exports.
Medical Service
[U.S.A.] Less Surgery for Orthopedics Conditions
Sports medicine Dr. Michael Seifert is now part of the growing group of who specialize in non-operative treatments for many sports and orthopedic conditions. Seifert says “I try to keep people away from the surgeon’s table if I can.” In recent years, Florida Orthopedists have been operating less on conditions like rotator-cuff injuries and meniscus tears in patients of certain some age groups. Physical therapy has proved in some cases to be just as beneficial. There’s also been a swift towards “incision-less” treatments to extend function and delay knee and hip replacements. Seifert states that “one long-emerging treatment is platelet rich plasma (PRP) injection, in which a patient’s own platelets are injected into the knee or problem area seems to work better in the lab than in people.” Nonetheless it does show indication of functioning. According to Florida Trend, PRP started in dentistry and was then practiced in spinal care it didn’t take off until high-profile athletes started used it. However, quality studies support it has been slow to come, and typically insurances doesn’t cover it. In some places, it’s also been used to treat hip ailments and tennis elbow. Dr. David Westerdahl and colleagues in Cleveland Clinic Florida in Weston started “using cooled radio frequency ablation to treat people who are not yet candidates for knee replacement surgery.” Westerdahl states “right now it can provide pain relief for up to two years. The technique knocks out the nerves that provide pain feedback in the knee while leaving motor nerves intact. It takes the body a long time to reroute the nerve pain signal, letting people be more active and continue working. It gets people active again, which helps with, among other things, weight management. There have been lots of studies that for arthritis, being more active is better than less.” Westerdahl also states that, he believes “there are many surgical treatments that over time have gone away in orthopedics. Many of the things we did 10 years ago weren’t always the best thing for patients.” However, people should try their best to minimize their chances of needing anything done. Seifert states that maintaining a healthy weight to keep from stressing joints, exercising to keep the muscles controlling joints strong, and vary exercise to stave off injury and to keep all muscles conditioned are great ways to minimize the chances. Although there is no such things as a “miracle drug”, supplements like Vitamin D and CoenzyemeQ10 are worth a look, according to Dr. Charles Nofsinger who also notes that “there’s an epidemic of vitamin D deficiency in Florida. Even though it can be miserably hot out and we need to protect our skin, we still need sun.”  
Franchise Industry
63 Sam’s Club to be Closed Across the US
Sam’s Club has nearly 650 locations in the United States and Puerto Rico, however, parent company Wal-Mart is planning to close 63 Sam’s Club wholesale club store locations beginning January 2018. The report came in on the same day that Wal-Mart announced it will be increasing their employee’s minimum wage and expanding their benefits. Out of the 63 clubs that will be closed roughly 10 to 12 will be converted in regional e-commerce fulfillment centers. Sam’s Club tweeted the news about the closing in the following tweet:  “After a thorough review of our existing portfolio, we’ve decided to close a series of clubs and better align our locations with our strategy.” According to Chain Store Age, the close comes after “a review found stores that were hindering business at other locations, or operating in areas that had not seen the population growth that was expected.” However, these closures will cause negative impacts on local business owners throughout the nation. Sam’s Club is famously known for the services it provides for small business such as “discounts on bulk purchases on office supplies, food, materials and other goods, financing, payment solutions and even health care insurance. The chain also has special hours to accommodate its small business customers - many of whom start the day early.” Roberto Torres, owner of Blind Tiger Cafe in St. Petersburg, Florida said “I go to that Sam’s three times a week. It’s an integral part of our business. We buy 30 percent of our cleaning supplies there. I was going to buy a safe and some security cameras. I mean this is a very important store." According to the Tampa Bay Times this isn’t the first time this happens, back in 2016, Wal-Mart closed 250 Sam’s Club locations. Competitors like BJ’s Wholesale and Costco are stepping in to fill the void.  
Medical Service
Florida to Make Changes to Children's Medical Services
The Florida Department of Health (FDOH) is looking to make some big changes to the Children’s Medical Services. FDOH is issuing an invitation to discuss soliciting proposals from outside vendors to run the Children’s Medical Services as a value-based plan. According to Dr. Jeffrey Brosco, Deputy Secretary for Children’s Medical Services and Pediatrician at the University of Miami, “we hope that it is a change that really makes our health care system work in a direction that helps families experience everyday life value, and not just say, ‘OK, here's the doctor, here's the medicine you need to take.’” Dr. Broscos describes the program as the following, “so if I gave you the example of asthma: Right now, I as a physician can get paid for seeing a child in my office. And if that child had to go to the emergency room, we can pay the emergency room doctors and the hospital. What we can't do, for example, is pay for someone to go into the home and do a look around and see: Is it allergens that's causing it? Are there certain things in the home that we can fix?” Children’s Medical Services is currently tied to Florida’s Medicaid rules and limits the types of services that the state can offer. Children’s Medical Services hopes offer more telemedicine options in the new plan. According to WLRN, “shifting to a value-based model—in which an insurance company is paid a certain amount per patient per month—will allow for more flexibility in spending on preventive services outside a clinical setting. And it would change the incentives to keep a child healthy.” About 60,000 children would be protected in the new version of the program. Dr. Brosco anticipates the new plan to begin in 2019.

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