Honor Band 6 With 24-Hour Heart Rate Monitoring, 10 Sports Modes, 14-Day Battery Life Launched

first_imgHonor Band 6 has been launched in China as a median between a smart band and a smartwatch. It is not as sleek as a smart band but not as big as a typical smartwatch. Honor Band 6 comes with a rectangular 1.47-inch colour display with touch support. It is offered in three colour options and boasts of features like 24-hour hear rate monitoring, tracking for 10 sports modes, and women’s health management. Honor Band 6 also offers up to 14 days of battery life on typical usage.Honor Band 6 priceHonor Band 6 is priced at CNY 249 (roughly Rs. 2,800) for the standard variant and the NFC variant is priced at CNY 289 (roughly Rs. 3,300). It is currently up for pre-orders in China and will go on sale starting November 11. It is offered in three colour options – Coral Powder, Meteorite Black, and Seagull Grey. As of now, it is unclear if and when Honor Band 6 will come to the Indian market.Honor Band 6 specifications, features- Advertisement – Is OnePlus 8T the best ‘value flagship’ of 2020? We discussed this on Orbital, our weekly technology podcast, which you can subscribe to via Apple Podcasts, Google Podcasts, or RSS, download the episode, or just hit the play button below. – Advertisement –center_img Honor Band 6 comes with a 1.47-inch colour display with 2.5D curved glass. It offers more than 100 dial faces to choose from. Honor Band 6 boasts of up to 14 days of battery life with typical use and up to 10 days with heavy use with its 180mAh battery. The smart band can last for two days with just a five-minute charge. It is also water resistant up to 50 metres.Honor Band 6 has 24-hour hear rate monitoring that uses Huawei’s TruSeen 4.0 tech. It also features sleep tracking, blood oxygen level sensor, and women’s health management including ovulation tracking, menstrual cycle tracking, and more. Honor Band 6 comes with 10 sports modes including running, treadmill, cycling, swimming, and more. It also has automatic activity tracking. You get voice control support to activate digital assistants and the NFC variant supports digital payments.It works with Android 5.0 and above using Bluetooth 5.0, and being a smart band, it can show notifications, alarms, reminders, and more.- Advertisement –last_img read more

Democrats’ hopes of a blowout in New York fade as incumbents and candidates fall to Republicans.

first_imgBut the results, particularly in the suburbs, seemed to validate the message of Republican candidates who campaigned on “law and order” and who tied Democrats to progressive radicalism and efforts to defund the police.The results showed a widening political divide between New York City and other urban areas and the rest of the state. And they also reflected a shift back toward Republicans after Democrats had made inroads in swing districts in 2018. – Advertisement – In Central New York, Claudia Tenney, a former Republican congresswoman and close ally of Mr. Trump, was leading against Anthony Brindisi, a moderate Democrat who defeated Ms. Tenney in 2018 in a narrow upset.And on Long Island, Andrew Garbarino, a Republican, declared victory over Jackie Gordon, a veteran of the Army Reserve, in a race to replace Representative Peter King, the 14-term congressman who was retiring.Lee Zeldin, a Republican incumbent on Long Island, had a sizable lead over Nancy Goroff, a chemist and a professor at Stony Brook University.- Advertisement – In one swing district encompassing Staten Island and parts of Brooklyn, Nicole Malliotakis, a Republican state assemblywoman endorsed by President Trump, was leading Representative Max Rose, a first-term Democrat, by about 37,000 votes. While she had already delivered a victory speech, Mr. Rose has not conceded and about 52,000 absentee ballots still need to be counted.- Advertisement –center_img Thomas Suozzi, a Democrat incumbent on Long Island, was losing to George Santos, a Republican private equity executive, by a small margin. Democrats in New York who had hoped to capitalize on anti-Trump sentiment and pick up several congressional seats across the state were delivered sobering news this week, with two first-term Democratic congressmen in danger of losing and candidates far behind in three other districts the party had hoped to flip.Millions of mail-in ballots are still uncounted and over all the state remains a Democratic stronghold — the party predictably faired well in urban areas with heavy Democratic representation.- Advertisement –last_img read more

Celebrations break out in the streets of Washington, about a mile from the White House.

first_img“It’s a new day in America,” said Barry Karas, 74, a retired actor and political activist, who was hoisting two Biden signs onto his black wrought-iron fence. Passers-by shouted back. “If it wasn’t a pandemic I’d hug you!” said a tall man wearing a black jacket and a blue medical mask.- Advertisement – Mr. Biden overwhelmingly won the votes tallied so far in Washington: He currently holds more than 260,000 votes compared to just over 15,000 for Mr. Trump. “It’s more than a wedding, more than a wedding,” she said, smiling widely. “Just look at the joy of people.” A couple riding by on a scooter were both doing a victory whoop and gave Mr. Karas a high five. A jogger held both her arms aloft, looked his way and said, “We did it.”At 12:02 p.m., the corner of 16th and U streets was exploding with beeping horns and applause.Magdalene Mbanga, an immigrant from Cameroon, whose daughter is an American citizen and voted for Mr. Biden, was standing next to a street sign recording the scene with her phone. WASHINGTON — Strangers were congratulating each other on the streets of the nation’s capital in the hour after major news outlets declared Joseph R. Biden Jr. as the winner of the presidential race.“Joe Biden!” A woman screamed from a six-story window in a yellow brick apartment building on the corner of 17th and Swann streets, about a mile north of the White House. Nearby, cars honked repeatedly at an intersection, and a woman on a bicycle rode through shouting with joy. – Advertisement – – Advertisement – – Advertisement –last_img read more

New Orleans Saints 38-3 Tampa Bay Buccaneers: Tom Brady throws three interceptions in blowout loss | NFL News

first_imgScoring summary Saints 31-0 BuccaneersWill Lutz 36-yard field goal A Will Lutz 36-yard field goal made it 31-0 to New Orleans going into the break, with Brady – who threw a second pick to Marcus Williams in the dying seconds – staring down the largest ever half-time deficit of his storied career.The start of the third quarter offered a glimmer of hope, as the Buccaneers recovered a Brees fumble on the first possession and subsequently drove down to the Saints one-yard line, only to then turn the ball over on downs for the second time in the game when failing to convert on fourth down.Brady’s third and final interception was picked off by Malcolm Jenkins late in the third quarter, and Brees then turned that turnover into a three-yard touchdown pass to Josh Hill early in the fourth, seeing him streak ahead of Brady by three on the all-time passing TDs list.Ryan Succop’s 48-yard field goal with just under six minutes remaining ensured Tampa Bay were at least able to avoid a shutout, but the 38-3 scoreline represents the most lopsided loss of Brady’s career. Saints 38-0 BuccaneersDrew Brees three-yard TD pass to Josh Hill (extra point) – Advertisement – It was clear early on in the game that it was going to prove a far trickier contest for Tampa Bay than many had predicted; having averaged 36 points per game in a three-game win streak coming into Sunday’s meeting with the Saints, Brady’s Bucs badly stumbled out of the gate, particularly on offence.Buccaneers stats: Tom Brady, 22/38, 209 yards, 0 TDs, 3 INTsRushing leader: Ronald Jones, three carries, nine yardsReceiving leader: Mike Evans, four catches, 64 yardsTampa Bay went three-and-out on each of their opening four possessions, while Brady threw his first interception to David Onyemata on their next series, seeing his stat line read a paltry 4-of-12 passing at the time, for 27 yards and a pick.By that point, contrastingly, Brees had expertly led three Saints touchdown drives – finding Tre-Quan Smith, Adam Trautman and Emmanuel Sanders in the endzone – and, following on from Brady’s interception, Alvin Kamara went over at the goal line for a fourth first-half score.- Advertisement – Saints 38-3 BuccaneersRyan Succop 48-yard field goal Tom Brady was intercepted three times and suffered the largest defeat of his career on Sunday night against the Saints Saints 21-0 BuccaneersDrew Brees 12-yard TD pass to Emmanuel Sanders (extra point) Drew Brees throws four touchdown passes to overtake Tom Brady for the most in NFL history (564 to 561); Antonio Brown has three catches for 31 yards in Buccaneers debut, while Michael Thomas had five grabs for 51 yards in his return for the Saints Last Updated: 09/11/20 5:48am Saints 7-0 BuccaneersDrew Brees 14-yard TD pass to Tre’Quan Smith (extra point)center_img SECOND QUARTER Tom Brady was intercepted three times and suffered the largest defeat of his career on Sunday night against the Saints
Tom Brady was intercepted three times and suffered the largest defeat of his career on Sunday night against the Saints

Goodtimer educational toy helps your child develop good habits » Gadget Flow

first_img– Advertisement – Goodtimer acts as a behavior chart reinvented for modern families. It encourages kids to do their best using positive reinforcement, tangible incentives, and family participation. An interactive and friendly clock-like companion that glows with soothing green lights and encouraging sounds, Goodtimer is a fun game where kids earn Good Time© when they make good choices. What’s Good Time? Unlike time-outs that punish bad behavior, Goodtimer encourages your kids when they follow your family’s house rules. With Goodtimer, it’s totally up to your family. Kids LOVE feeling celebrated for their accomplishments when they earn Goodtimer tokens they can save and exchange for fun incentives. And parents LOVE that their kids are finally listening without the need for nagging, yelling, and time-outs. Best of all, with Goodtimer’s patented approach and adjustable difficulty settings, it grows with your child, encouraging them to form healthy habits for years to come.last_img read more

Irvin Baxter, Who Preached the End Was Near, Dies at 75

first_imgMr. Baxter had spent decades finding signs of an impending final judgment in an amalgam of Bible verses and current events. His April prediction was based on, among other things, his reading of developments in the Israeli-Palestinian accord being pushed by the Trump administration.“The way it appears to me that it’s coming down,” he told his listeners, “it is very likely that you and me and the entire world will enter the final seven years to Armageddon yet in 2020.” – Advertisement – He became a traveling evangelist at 19, and by 1973 he was pastor of the Oak Park Church, a position he held for more than 30 years. But he found himself devoting an increasing amount of energy to what he saw as a calling: to alert the world to prophecies that he thought were soon to be fulfilled.In 1991, he founded Endtime Magazine. He also began a radio program and started marketing DVDs and other materials to sell his vision of the future. He left Richmond and the Oak Park Church and moved his Endtime business to Texas in 2005.Mr. Baxter’s broadcasts were carried by various outlets, including the Trinity Broadcasting Network. He was quoted in news articles whenever end-times fears surged — in 2003 as the United States prepared to invade Iraq, in 2018 during a celestial phenomenon known as a blood moon.His reach was moderate compared with that of famous televangelists like Billy Graham. One of Mr. Baxter’s regular “prophecy conferences” in Texas drew 2,500 people; Mr. Graham routinely filled stadiums. The Endtime Ministries Facebook page shows 211,000 followers; the Billy Graham Evangelistic Association has 2.5 million.Mr. Baxter was an ardent supporter of President Trump and his policies. That included Mr. Trump’s playing down of the severity of the Covid-19 pandemic.“When you talk about the coronavirus, the choice is this: We either open back up as far as we can as fast as we can, or we close everything down,” he said in a program broadcast on Oct. 23. “If you close everything down like we did once — it had disastrous effects. President Trump is rightly saying we can’t do that again. The cure is worse than the disease.”Mr. Baxter was hospitalized four days later, the ministry said.He is survived by his wife of 55 years, Judith; three daughters, Karla Denise Sistrunk, Kara Michelle McPeak and Jana Gayle Robbins; eight grandchildren; and 10 great-grandchildren. One night in his teens, when listening to a traveling preacher at a revival meeting, Irvin Baxter was overcome.- Advertisement – “I heard someone speaking in tongues over the microphone system,” he said, and realized that the voice was his. He had found his calling.center_img Mr. Baxter, who was 75, died on Nov. 3. An announcement by Endtime Ministries said the cause was complications of Covid-19, a disease that, in other broadcasts, Mr. Baxter had implied was a punishment from God for the world’s sins, which to him included homosexuality, abortion and unmarried couples living together.- Advertisement – The announcement did not say where he died. The ministry’s headquarters is in Plano, Tex.Irvin Lee Baxter Jr. was born on July 8, 1945, and grew up in Richmond, Ind., in the east-central part of the state near the Ohio border. His father was a Pentecostal minister and pastor of the Oak Park Church there. This obituary is part of a series about people who have died in the coronavirus pandemic. Read about others here.“We are on the brink of the greatest prophetic fulfillment in 2,000 years,” the Rev. Irvin Baxter Jr., the founder of Endtime Ministries, told listeners as he opened an April episode of “End of the Age,” his television program. “It appears that all the pieces of the puzzle are in place for the final seven years to Armageddon to begin yet this year.”- Advertisement –last_img read more

The Masters: Bryson DeChambeau loses a ball, triple-bogeys, and slips outside cut line | Golf News

first_imgWayward drive to the third results in an unfortunate lost ball and leads to triple-bogey for DeChambeau, who will need to dig deep to avoid missing the halfway cut when play resumes at Augusta National. By Keith JacksonLast Updated: 14/11/20 1:35am Realising his ball was likely to be plugged in the soft ground, DeChambeau and playing partners Jon Rahm and Louis Oosthuizen conducted an extensive search which proved unsuccessful within the three-minute time allocation.His ball was later found, but not in time for him to have to be carted back to the tee, from where he hit another towering drive on a similar line, over-hit his pitch and eventually holed out for a seven.- Advertisement – Bryson DeChambeau lost a ball at the third hole “I know they found it afterwards, but we must have been close,” said Rahm, who will have a five-foot putt for birdie on the 13th that would get him into a tie for the lead on nine under when the second round resumes on Saturday morning. DeChambeau was taken back to the tee after failing to find his ball in time DeChambeau was taken back to the tee after failing to find his ball in time

Tesla stock jumps on carmaker’s addition to the S&P 500

first_imgElon Musk, Tesla boss, runs to a Tesla at the Tesla Gigafactory construction site. In Grünheide near Berlin, a maximum of 500,000 vehicles per year are to roll off the assembly line starting in July 2021.Julian Stahle | picture alliance | Getty Images – Advertisement – – Advertisement – The company, led by CEO Elon Musk, has long been plenty valuable for inclusion in the S&P 500 — the market cap minimum is $8.2 billion — but there are other factors that have kept Tesla out. The make-up of the S&P 500 is determined by what’s known as the “Index Committee” at S&P Dow Jones Indices, which analyzes quantitative as well as qualitative factors.Tesla was snubbed in September after it met criteria to be included in the index but was not initially picked by the committee. Companies must report four straight quarters of profit as determined by U.S. generally accepted accounting principles (GAAP).Tesla recently reported its fifth consecutive quarter of profit on third-quarter revenue of $8.77 billion. The company also reported that it delivered 139,300 vehicles during the third quarter, a new record for Tesla. – Advertisement – The committee meets on a quarterly basis to rebalance the index, though companies can be added or removed from the S&P at any time. Given the potentially market-moving nature of additions and deletions from the index, the process is tightly guarded. Even companies that are set to be added receive no advance warning.center_img Tesla CEO Elon Musk gestures as he arrives to visit the construction site of the future US electric car giant Tesla, on September 03, 2020 in Gruenheide near Berlin.Odd Andersen | AFP | Getty Images Tesla is finally joining the S&P 500.S&P Dow Jones Indices announced on Monday that the carmaker will be added to the benchmark index prior to trading on Monday, Dec. 21. Based on Monday’s closing prices, Tesla would be one of the 10 most valuable companies in the index.Tesla shares spiked more than 13% in extended trading on the news, as money managers with funds that track the S&P 500 will need to buy the stock for their portfolios.- Advertisement – Adding Tesla is no easy feat after the stock’s record run pushed the company’s market cap above $380 billion, making it the largest company ever to be added to the S&P, according to analysis from equity research firm Baird. The stock, which split 5 for 1 in August, has more than quadrupled in value in 2020.There’s currently over $11.2 trillion in assets benchmarked to the S&P 500, with roughly $4.6 trillion of the total in indexed funds, according to S&P Dow Jones Indices.“Due to the large size of the addition, S&P Dow Jones Indices is seeking feedback through a consultation to the investment community to determine if Tesla should be added all at once on the rebalance effective date or in two separate tranches ending on the rebalance effective date,” S&P said in a statement.The addition represents a historic milestone for Musk and his electric car company, which has seen its fair share of ups and downs.“This is another major feather in the cap for Tesla bulls joining the S&P 500,” said Dan Ives, an analyst at research firm Wedbush Securities who has a neutral rating on the stock. “It speaks to the sustained profit trajectory that Tesla is now finally getting into this elusive club after much noise on the Street.” CNBC’s Jennifer Elias contributed to this story.WATCH: Tesla provides refunds to some Model S and Model X owners over touchscreenlast_img read more

Research sheds light on plague agent and potential vaccine

first_img Prior studies have pointed to the role of the bacterial protein LcrV as a critical element of plague virulence. LcrV acts a molecular “needle” to inject toxins into host cells, and it also suppresses the immune response through two mechanisms. First, it stimulates the host to release interleukin-10 (IL-10), which dampens the innate immune response. Second, it prevents the release of two pro-inflammatory cytokines, tumor necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma). This immunosuppressive activity makes native LcrV a poor vaccine candidate, despite its immunogenicity. Senior author Olaf Schneewind led the two research teams at the University of Chicago, whose results were published online Jul 28 in Science and in the August issue of Infection and Immunity. Aug 19, 2005 (CIDRAP News) – Two research reports on plague were recently released, one describing the mechanism that the plague bacterium uses to evade the body’s immune system and the other describing a potential vaccine that was tested successfully in mice. Today, about 1,000 to 3,000 cases of plague (primarily bubonic) occur worldwide each year, including approximately a dozen in the western and southwestern United States. Although plague killed hundreds of millions of people in past pandemics, no human plague vaccine is currently licensed in the United States. Marketon MM, Depaolo RW, Debord KL, et al. Plague bacteria target immune cells during infection. Science 2005 (published online Jul 28) [Abstract] The bacterium Yersinia pestis causes different forms of plague, depending on the route of exposure. Bubonic plague, infamous as the “Black Death” of the Middle Ages, is transmitted by flea bites. The disease persists in its natural reservoir of wild animals, primarily rodents, passing to humans via fleas that first bite an infected animal. Inhalation of the bacteria causes pneumonic plague, a disease that is seen less often in nature but could develop if aerosolized plague bacteria were released in an act of bioterrorism. Mice were first infected with the modified plague strains and then sacrificed and their spleen tissues separated into specific cell populations. Staining with CCF2-A dye allowed visualization of cells injected with Yop-Bla, because only cells containing this engineered protein glowed blue. Despite the predominance of CD4 and CD8 cells in the spleen, the majority of cells targeted by the modified Y pestis were macrophages, neutrophils, and dendritic cells. This strategy, the authors wrote, allows the bacterium to “destroy cells with innate immune function that represent the first line of defense, thereby preventing adaptive responses and precipitating the fatal outcome of plague.” Finally, the authors tested the rV10 protein in a mouse immunization experiment. The protein elicited high titers of immunoglobulin G (mean, 112,500 by ELISA), which were comparable to those induced by native LcrV. Additionally, two intramuscular doses of rV10 (100 mcg each, with alhydrogel adjuvant) protected 100% of mice challenged with heavy doses of Y pestis. In the Infection and Immunity article, the researchers describe how they investigated modified LcrV proteins for three criteria of a successful vaccine: lack of IL-10 stimulation, preservation of pro-inflammatory cytokine secretion, and robust antigenicity. The authors deleted sequential 30-amino-acid portions of LcrV to create 12 candidate deletion proteins. Two of these, rV7 and vV10, failed to induce IL-10 secretion in mouse macrophages. Further testing showed that the rV10 peptide was not capable of significantly suppressing TNF-alpha secretion.center_img Overheim KA, Depaolo RW, Debord KL, et al. LcrV plague vaccine with altered immunomodulatory properties. Infect Immun 2005 Aug;73(8):5152-9 [Abstract] The authors of the Science paper wanted to know exactly which immune cells are targeted by plague. The authors engineered a protein to identify the cell types injected with toxin by the plague bacterium. They created a piece of DNA containing genes for both Yersinia outer proteins (Yop) effectors and beta-lactamase (Bla). Yops are the toxins normally injected by plague into host cells; Bla is an enzyme that cuts a dye called CCF2-AM, making it fluoresce blue instead of green. The team inserted this piece of DNA into Y pestis strains. Both studies received support from the National Institute of Allergy and Infectious Diseases. Thus rV10, the authors explained, “satisfied our experimental criteria and displayed significant defects in immune suppression without reducing the protective properties of plague vaccines.” They conclude, “It appears that LcrV variants with reduced immune modulatory properties could be used as a human vaccine to generate protective immunity against plague.” Without prompt antibiotic treatment, the case-fatality rate of plague approaches 100%. A major reason for this high mortality is that the invading bacteria suppress the body’s immune response. The plague bacterium uses a system that injects toxins directly into host cells. Previous studies have indicated that Y pestis evades the immune system by resisting phagocytosis and suppressing the inflammatory response. See also: CIDRAP plague overviewlast_img read more

Tamiflu resistance in avian flu victims sparks concern

first_imgDec 22, 2005 (CIDRAP News) – A new report says oseltamivir-resistant forms of H5N1 avian influenza virus were found in two Vietnamese girls who died of the infection, raising doubts about the antiviral drug that many countries are counting on to help protect them from a potential flu pandemic.One of the two girls died even though she started receiving oseltamivir (Tamiflu) within the first 2 days of her illness, the recommended window for effective treatment, according to the report in today’s New England Journal of Medicine. The other girl was not treated until the sixth day of her illness.The authors of the report say their findings suggest that a higher dosage, longer treatment course, or combination with other antiviral drugs may be necessary to ensure the effectiveness of oseltamivir.Roche, the manufacturer of oseltamivir, agrees with that assessment and says that studies of the safety of a higher dosage are about to get under way.Second study weighs in on stockpilingIn a separate article published today, a group of experts who have been monitoring resistance to oseltamivir and similar drugs says the evidence so far—including the New England Journal report—does not suggest that stockpiling of the drug is useless.”The available data do not indicate that potential oseltamivir resistance should be a deterrent to its stockpiling for pandemic response,” says the report by Frederick Hayden and other members of the Neuraminidase Inhibitor Susceptibility Network (NISN). It was published online today in Antiviral Therapy.The report on the Vietnamese patients was prepared by a team from the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam, and Hong Kong University, with Menno D. de Jong of the Vietnamese hospital as first author.Their study focuses on eight patients who were treated for confirmed H5N1 infection at the Hospital for Tropical Diseases between February 2004 and January 2005. Throat samples were collected from the patients for analysis at admission and later in their illness. H5N1 infection was confirmed by polymerase chain reaction.All the patients were started on oseltamivir the day of admission to the hospital, which varied from 2 to 8 days after the onset of illness. They received the recommended regimen of 75 mg twice a day for 5 days. Four of the patients died.The researchers did a sequence analysis of the H5N1 virus’s neuraminidase gene to look for resistance, signaled by the substitution of tyrosine for histidine at amino acid position 274. This mutation was found in two patients, a 13-year-old girl and an 18-year-old girl.The 13-year-old was hospitalized the day after she fell ill with a fever and cough, which was also the day after her mother had died of H5N1 infection. Despite oseltamivir treatment, the girl’s condition worsened on her fourth day in the hospital, and she died of severe pneumonia on the seventh day.The viral load in her throat was higher by the time of her death than it had been earlier, which, along other laboratory evidence, suggests that “the development of drug resistance contributed to the failure of therapy and, ultimately, the death of this patient,” the report says.The 18-year-old was hospitalized and started on oseltamivir 6 days after she had fallen ill, but she died after 2 weeks in the hospital. Nonresistant H5N1 virus was found in a sample taken 2 days after she was hospitalized, but the resistant form was found 6 days later.Although the connection between viral resistance and the 18-year-old girl’s death was less clear than in the case of the 13-year-old, “The presence of replicating virus after 14 days of illness suggests an effect on the outcome,” the article says.It also says the viral load in throat specimens from the four patients who survived dropped quickly to undetectable levels during their treatment.”Our observations suggest that at least in some patients with influenza A (H5N1) virus infection, treatment with the recommended dose of oseltamivir incompletely suppresses viral replication,” the authors write. Consequently, “Strategies aimed at improving antiviral efficacy (e.g., the use of higher doses, longer durations of therapy, or combination therapy) may deserve further evaluation.”Tamiflu manufacturer, study authors commentRoche, Swiss-based maker of Tamiflu, released a statement today agreeing that such strategies deserve consideration. The company said some data already support the safety of using a higher dosage of the drug, and clinical trials assessing the efficacy of a higher dose are scheduled. Roche is collaborating with the National Institutes of Health and the World Health Organization (WHO) on that research, the statement said.Tran Tinh Hien of the Hospital for Infectious Diseases, one of the study’s authors, says Vietnamese health officials are already recommending increasing the dosage of oseltamivir for avian flu patients, according to a Reuters report published today.”We still recommend the use of Tamiflu for bird flu cases as soon as possible and at higher doses as there is no replacement yet,” he said. He added that the Vietnamese Ministry of Health has increased the treatment period to 7 days from 5 days.The article published today by NISN, the experts who have been monitoring resistance to the neuraminidase inhibitors, say the new findings do not contraindicate stockpiling of oseltamivir, but much more research is needed. The neuraminidase inhibitors include oseltamivir and zanamivir (Relenza).The group said no one knows how often resistance emerges in H5N1 patients being treated with oseltamivir, and the clinical consequences of such resistance are also unclear.Many H5N1 patients treated with oseltamivir have died, but in most cases treatment was started late, after pneumonia had already developed, the report says. Some evidence suggests that the emergence of oseltamivir resistance early in treatment may lead to treatment failure, but more studies are needed.The group also said there is no indication that H5N1 viruses now circulating in birds are resistant to neuraminidase inhibitors. Further, the likelihood that oseltamivir-resistant strains will spread in the community appears low, in contrast to the situation with two older antiviral drugs, amantadine and rimantadine, to which ordinary flu viruses are often resistant. In animal studies, the article says, the mutation that confers resistance in both H5N1 and H1N1 viruses reduces infectiousness 100-fold and reduces viral replication more than 10-fold.The NISN statement also says that all avian and human H5N1 isolates tested so far by the Centers for Disease Control and Prevention have been susceptible to zanamivir. However, zanamivir, which is inhaled, has not been tried in human H5N1 patients.Despite this, “Inhaled zanamivir would be a therapeutic consideration if oseltamivir resistance were likely to be present,” the NISN members write. They also say the drug would be “an appropriate choice for pandemic response stockpiles.”Other experts offer opinionsTo infectious disease expert Michael T. Osterholm, PhD, MPH, the report from Vietnam “reminds us again that none of us know how much drug [oseltamivir] we have in the stockpile.” If a longer, higher-dose regimen is needed, a stockpile now described as 3 million treatment courses is actually smaller, said Osterholm, director of CIDRAP, publisher of this Web site.Osterholm also said the report suggests oseltamivir resistance can have much graver consequences in H5N1 cases than in ordinary flu. In the latter, drug resistance has not been associated with treatment failure or a severe outcome, but “with H5N1 this may be a very different outcome,” he said.Osterholm called for clinical studies of the use of oseltamivir very early in the illness and at a much higher dosage than is used in ordinary seasonal flu. If that approach improves outcomes, it would have “tremendous implications for how we get Tamiflu to patients in a timely manner,” he said.A WHO official said the resistance findings are “not necessarily alarming” but do point up the need for more information, according to the Reuters report.”What really is critical is understanding whether the way we are using the drugs contributes” to resistance, said Keiji Fukuda of the WHO’s global influenza program.Some resistance is expected whenever antivirals and antibiotics are used, Fukuda said, adding that using too-small doses or too short a treatment regimen can promote resistance.De Jong MD, Thanh TT, Khanh TH, et al. Oseltamivir resistance during treatment of influenza A (H5N1) infection. N Engl J Med 2005 Dec 22;353(25):2667-72 [Full text]Hayden F, Klimov A, Toshiro M, et al. Neuraminidase Inhibitor Susceptibility Network position statement: antiviral resistance in influenza A/H5N1 viruses. Antivir Ther 2005;10(8):873-7 [Abstract]See also:Dec 22 statement by Rochelast_img read more