Category: PHILLY & PA. NEWS

This Penn heart patient is a 9-year-old boxer dog named Sophie

Cardiology resident Alexandra Crooks and cardiologist Anna Gelzer of Penn Vet headed up care for 9-year-old Sophie, the beloved pet of Karen Cortellino, pictured here with her son Alex Peña. Not long after the ablation procedure, Cortellino says the boxer was “back to her perky self.”

For Karen Cortellino, her 9-year-old dog Sophie is more than just a companion.

“There’s this bumper sticker that says, ‘Rescue dogs: Who rescued who?’” says Cortellino, a physician from New Jersey. “That’s exactly how I feel.” Eight years ago, she adopted Sophie, a boxer, two weeks after the death of the family’s first boxer, and “she’s been Mommy’s baby ever since.”

A few months ago, however, Sophie’s star rose even higher: She became the first dog with a particular type of heart disease—arrhythmogenic right ventricle cardiomyopathy (ARVC)—to be treated with cardiac ablation.

Anna Gelzer

, a cardiologist in Penn’s

School of Veterinary Medicine

, led Sophie through the procedure, together with cardiology resident Alexandra Crooks. But the equipment and expertise to perform an ablation, in which a high energy catheter tip burns tiny portions of damaged heart tissue to restore normal rhythms, wouldn’t have been possible without collaborators from just down the street. At the

Perelman School of Medicine

’s

Translational Cardiac Electrophysiology Laboratory

, Director

Cory Tschabrunn

and members of his team worked hand-in-hand with their veterinary colleagues to plan out and provide Sophie a procedure that mirrors the best that human medicine has to offer.

“This collaboration and this close distance between our hospitals allows us to be able to utilize the tremendous access to all this knowledge,” says Gelzer. “And from our experience with Sophie and other dogs to come, we may able to glean information that will be valuable to human medicine. It’s the best of both worlds.”

For Gelzer and Crooks, Sophie is a pilot case for a study now backed by two grants that will support cardiac mapping and ablation procedures for six additional dogs. Currently, cardiac ablation is only available for pet dogs in two other sites in the world, one in Italy and one in Ohio. Sophie’s case puts Penn Vet on the map. While the equipment necessary to perform ablations is costly, access to Penn Medicine’s translational electrophysiology lab has opened the possibility that Penn Vet may one day be able to provide committed dog owners a more durable alternative to medication for treating their pets’ arrhythmias.

A scary spell

ARVC is not an uncommon diagnosis in boxers. Some studies estimate as much as a quarter of the breed may have the inherited disease, which is also prevalent in American bulldogs. But Sophie’s heart was not top of mind in early July, when she had surgery to repair a torn ligament in her left knee. Two weeks later, Cortellino took her for a follow-up visit at their local veterinary hospital to have her stitches removed.

Sophie’s diagnosis of ARVC meant she could suffer a life-threatening arrhythmia, despite starting medications to reduce that risk.

“Everything was great and literally we were just about walking out the door when Sophie collapsed,” Cortellino says.

Sophie received emergency care, was transferred to another veterinary facility with a cardiac department, and was soon diagnosed with ARVC. A strikingly similar condition affects roughly 1 in 1,000 humans. In both dogs and humans, the disease, which doesn’t manifest until adulthood, causes a deterioration of the tissues in the heart muscle, leading to occasional episodes when the heart beats very fast.

The condition increases the risk of sudden death. While drugs like beta blockers and sodium channel blockers can mitigate this risk, arrhythmias can sometimes break through these medications.

“It was kind of a somber picture when she was diagnosed,” Cortellino says. “She could have a fatal arrhythmia at any time: today, next month, next year, three years from now.”

Cortellino, capitalizing on her medical training, began researching alternative treatment options. In humans with a diagnosis similar to Sophie’s, the treatment of choice is an implantable cardiac defibrillator (ICD). But, as Gelzer explained to Cortellino when she reached out about this possibility, that option is not yet tenable for dogs.

“ICDs are designed to recognize human arrhythmias,” Gelzer says. “But they’re not able to distinguish the normal variation in heart rate that a dog is capable of from a life-threatening arrhythmia.”

An affectionate dog awaiting its owners’ return home for work, for example, might get so excited upon hearing a key turn in the door that its heart rate could jump from 40 to 200 beats per minute within the space of a few heartbeats. If that dog was outfitted with an ICD, the device might interpret the rate change as an arrhythmia and misfire, triggering a painful and possibly traumatic shock.

But Gelzer did have an alternative proposal for Cortellino, one that could address the underlying cause of Sophie’s heart condition. The only catch was that it had never been done in a dog with ARVC before.

Ideal expertise

When Cortellino emailed Gelzer, the timing was good. Gelzer had been thinking about options for curing cases like Sophie’s for many years. And she had the right kind of expertise to be considering that possibility.

In 2000, when Gelzer was a junior faculty member at Penn Vet, she worked with

David Callans

, an expert on cardiac electrophysiology at the School of Medicine. At the time, they collaborated on basic cardiac research, using pig models. Gelzer remembers wishing they could apply the technique of ablations to dogs, which develop heart conditions similar to humans.

Fast forward 15 years, after time away from Penn Vet in positions at Cornell and University of Liverpool, Gelzer returned and reconnected with Callans. His old basic research lab was no longer operating, but Gelzer continued to reach out to him for consultations from time to time, or attended rounds for human patients in his group.

Roughly a year ago, when discussing one of Gelzer’s cases, Callans connected her with Tschabrunn, who had recently set up his lab in Penn Medicine’s

Smilow Center for Translational Research

as part of the recently established Electrophysiology Translational Center of Excellence (EP-TCE) initiative, led by

Francis Marchlinski

, director of cardiac electrophysiology for Penn Medicine. Marchlinski and the Penn EP team have been pioneers in the evaluation and treatment of patients with inherited arrhythmia disorders like ARVC.

Tschabrunn’s primary research interests focus on the development of clinically relevant translational research models to elucidate the underlying pathophysiology and mechanisms of complex arrhythmias and the creation of new diagnostic and therapeutic technologies for treating cardiovascular diseases. He also performs, in close collaboration with Marchlinski and with support from the Winkelman Family Fund in Cardiovascular Innovation, clinical research in human patients with ARVC.

As such, Tschabrunn responded with enthusiasm upon hearing of Gelzer’s interest in pursuing ablations in dogs, particularly those with ARVC. The two struck up a collaboration that brought together the latest in technique and technology in cardiac electrophysiology with deep knowledge in veterinary cardiology.

“This was an exciting opportunity not only in terms of a research collaboration,” says Tschabrunn, “but we also had the chance to help a patient by combining our expertise and resources that are really only available at just a few institutions in the world.”

Not a bandage

Ablations are “routine care” for many cases of arrhythmias in people. “You approach the heart through the blood vessel, get in the right spot, and—with all the expertise and knowledge of the practitioner—you can find the damaged area and burn it,” says Gelzer. “And then maybe the patient doesn’t need to be on medications that can have side effects and are in some cases not that effective.”

Gelzer saw Sophie, a healthy dog aside from her heart condition, as an excellent candidate for an ablation. Cortellino, while a bit nervous about putting her beloved dog into uncharted medical territory, was comforted by Gelzer’s and Crooks’s clear expertise, their warm manner with Sophie, and their openness and honesty about the procedure’s upsides—and possible risks.

“I was a little nervous—a lot nervous—but we thought to ourselves, really, what’s our alternative?” Cortellino says. “As my son said, ‘Look Mom, at the very least, Sophie is contributing to the possible welfare of other dogs.’ So there was a small element of altruism in putting Sophie through this, in addition to hoping for a more definitive treatment for her condition.”

Before the surgery, the veterinarians gathered data on the patterns of Sophie’s arrhythmias using a device called a Reveal LINQ, implanted just beneath her skin. The LINQ—which is also used in humans—records a continuous electrocardiogram (ECG) as a loop recorder, storing abnormal rhythm strips for up to three years, giving clinicians a more complete picture of abnormal heart activity than a quick office visit ECG. That information was used during the procedure to zero in on the correct area of the heart to target with the ablation.

Performing the mapping of Sophie’s heart and the ablation procedure was a team effort, involving experts from both Penn Vet and the Perelman School of Medicine. “I think the openness and enthusiasm for this type of multidisciplinary collaboration is a major strength of this University,” says Cory Tschabrunn (to right of Sophie, with black glasses around neck), who directs the translational electrophysiology lab where it happened.

The morning of the procedure, Gelzer used her own car to drive Sophie the short distance from Penn Vet’s

Ryan Hospital

to the Smilow Center. When she brought the dog up to the lab, a full complement of experts awaited her: not only Crooks, Tschabrunn and his team, and

Giacomo Gianotti

, head of anesthesia at Ryan, but also two anesthesia residents, Penn Vet’s two other cardiology faculty, Marc Kraus and Mark Oyama, two other cardiology residents, a cardiology research intern, experts on the machines that were used in the procedure, veterinary nurses, and interested observers.

“The number of people we had in one room for one patient, it blows my mind,” says Gianotti. “Everyone had a specific role, and it took a lot of training and cooperation to get there.”

The procedure was long and complex, taking place in different stages. First, to locate the areas of unhealthy heart tissue that had been indicated by the ECG, the clinicians used an advanced mapping system based on GPS technology called CARTO.

“You put a patch on the bottom and top of the dog,” Gelzer says. “You then use those as your points of orientation as you advance the catheter and create a map of the inside of the heart. It’s great because you don’t have to use fluoroscopy, so nobody is exposed to X-rays.”

The technology Tschabrunn and Gelzer and colleagues used during the procedure mirrors that employed during a human intervention. At right, a map of Sophie’s heart guided the clinicians in making tiny burns to eliminate damaged heart tissue.

The CARTO system maps the voltage of the heart tissue, a technique pioneered by Marchlinski and Callans nearly two decades ago and a continued area of Tschabrunn\’s research focus today in both the translational and clinical PE laboratories. Decreased voltage corresponds with diseased tissue. They confirmed these areas by artificially introducing extra heart beats into Sophie’s normal rhythm. But Sophie’s heart resisted these challenges, a sign that her disease was being kept in check by her medications.

The heart mapping and challenges did, however, allow the clinicians to reproduce the abnormal beats that they had seen on the ECG, giving them more evidence that they were targeting the right areas for ablation. Guided by that information, Tschabrunn used precisely directed radiofrequency to burn millimeter-sized portions of the tissue inside Sophie’s right ventricle, one of the lower chambers of the heart.

Throughout the several-hours-long procedure, Gelzer and Crooks sent texts with updates to Cortellino. “While it was nerve-wracking, I really felt that Sophie was in good hands,” she says.

And all went smoothly. “Sophie did amazing,” Gelzer says. “After we were done, we pulled the catheter out, she rested, and then went home the next day.”

Paving the way

Gelzer and Tschabrunn recently performed another ablation on a canine patient, and they are hopeful that the outcomes from the study will lay the groundwork for ablation to become a more routine option for dogs and their owners.

“My long-term hope for Penn Vet is that any arrhythmia that is potentially ablatable, we will be able to offer ablation therapy,” she says. “It’s not going to be the right option for every owner or dog, but with the right case, the right circumstance, it’s a very promising and rewarding treatment to be able to provide.”

Members of the team on both the veterinary and medical sides share enthusiasm about the information that canine patients will be able to lend to human medicine as well. “There is a lot we can learn about cardiac disease pathology from veterinary patients like Sophie,” says Tschabrunn. “It is extremely difficult or nearly impossible to model human-like inherited cardiac diseases and complex arrhythmias in the laboratory, but similar diseases can occur naturally in dogs. This provides us a unique opportunity to improve our understanding of these diseases and develop new treatments for human and veterinarian patients alike.”

From Sophie’s case and others that follow, researchers hope to glean information that could benefit both human and veterinary patients in the future.

This type of mutually beneficial exchange highlights the value of a One Health approach to medicine, one that takes advantage of the remarkable similarities between humans and our companion animals, says

Oliver Garden

, who heads the

Department of Clinical Sciences and Advanced Medicine

at Penn Vet.

“If ever there was a thrilling example of One Health in action, this is it,” says Garden. “Sophie’s case brings new heights to our department’s ethos of advanced medicine. And the work of such a transdisciplinary team, in this case involving members of our own esteemed faculty collaborating with experts at the Perelman School of Medicine, is nothing short of breathtaking.”

Tschabrunn concurs. “I think the openness and enthusiasm for this type of multi-disciplinary collaboration is a major strength of this University,” he says. “It is only possible in places like Penn, which brings together the expertise from faculty across so many diverse schools coupled with extraordinary facilities and resources all on a single campus. There’s always something incredible going on that you can be a part of.”

And Cortellino and her family are reaping the benefits: “Sophie is back to her perky self.”

Anna Gelzer is professor of cardiology at the University of Pennsylvania School of Veterinary Medicine.

Alexandra Crooks is a resident in cardiology at the University of Pennsylvania School of Veterinary Medicine.

Giacomo Gianotti is associate professor of clinical anesthesiology at the University of Pennsylvania School of Veterinary Medicine.

Oliver Garden is the Henry and Corinne R. Bower Professor of Medicine and chair of the Department of Clinical Sciences and Advanced Medicine at the University of Pennsylvania School of Veterinary Medicine.

Cory Tschabrunn is an instructor of medicine and director of the Translational Cardiac Electrophysiology Laboratory at the University of Pennsylvania Perelman School of Medicine.

David Callans is professor of medicine at the University of Pennsylvania Perelman School of Medicine.

Francis Marchlinksi is the Richard T. and Angela Clark President’s Distinguished Professor in the Department of Medicine at the University of Pennsylvania Perelman School of Medicine.

source https://www.vet.upenn.edu/

Migratory Game Bird Stamp Design Contest Winner Announced

Indiana Artist’s Blue-Winged Teal to Adorn Hunting Stamps

The

Maryland Department of Natural Resources

is pleased to announce that Jeffrey Klinefelter of Etna Green, Ind. won the 46th Annual Maryland Migratory Game Bird Stamp Design Contest. Judges selected his stunning depiction of a hen and a drake blue-winged teal, complete with leg band and mirror-like reflection in the water, aptly named “Quiet Waters.”

The artwork will be featured on the

stamps that hunters purchase to hunt all migratory game birds in the state

, with the proceeds funding migratory game bird research and habitat enhancement on public lands.

The winner was chosen by a panel of judges on Nov. 10 at the 49th Annual Waterfowl Festival in Easton in front of art enthusiasts, as well as some of the entrants and their families.

“I am happy to win and am grateful to be a part of the event,” said a surprised Klinefelter.

“Congratulations to our winner and all participants. It was a great experience for our judges and staff to witness such a remarkable collection of entries,”

Wildlife and Heritage Service

Director Paul Peditto said. “We appreciate and thank all of the artists who participated this year.”

Retired Gen. Frank Sullivan Charged with 15 Felony Counts

of Possessing Child Pornography

HARRISBURG – Pennsylvania Attorney General Josh Shapiro today

charged

retired U.S. Air Force Brig. Gen. Frank Sullivan (photo)with more than a dozen felony counts related to his possession of child pornography after a search of his Mechanicsburg home turned up computers replete with thousands of searches for “preteen”

images, as well as pictures of children “engaged in very graphic sexual acts.”

Sullivan, the former executive director of the Pennsylvania Military Community Enhancement Commission and a decorated veteran with tours of duty in Iraq and Afghanistan, was arrested today in Cumberland County and charged with 15 second degree felony counts of sexual abuse of children and one count of criminal use of a communication facility after investigators found images of child porn on a home desktop and laptop.

“General Sullivan’s alleged actions disgrace his work and besmirch the Pennsylvania National Guard, an organization that has bravely and dutifully come to the aid of Pennsylvanians whenever they have been called,” said Attorney General Josh Shapiro. “I’ve said it time and time again—nobody is above the law. My Office will investigate and prosecute anyone who harms Pennsylvanians, no matter what positions of power they may hold.”

Shapiro said Office of Attorney General agents discovered Sullivan’s penchant for viewing images of preteen children during an investigation on a file sharing network. In October, a search of Sullivan’s Tunbridge Lane, Mechanicsburg, home revealed a desktop and a laptop that were filled with searches and images of preteen children. In addition to finding child pornography on the laptop, a computer forensic analysis identified 37 search terms commonly used by people looking for child pornography.

Related to the charges against Sullivan, Attorney General Shapiro’s Child Predator Unit arrested one of the accused’s tenants in October, Bobby Glenn Williams Jr., and charged him with 14 felony counts of disseminating photos of child sex acts, 11 felony counts of child pornography, and one felony count of criminal use of a communication facility. Williams was renting a room in Sullivan’s Mechanicsburg home.

Sullivan was arrested and arraigned by Magisterial District Judge Kathryn Silcox. Senior Deputy Attorney General Christopher Jones will prosecute the case. All charges discussed are accusations. The defendant is presumed innocent unless and until proven guilty.

The achievement gap: Is your school helping all students succeed?

Is your school equitably serving its students? Successful schools have found fair, effective ways to raise the performance of all.

by:

GreatSchools Staff

|

Many diverse schools experience an achievement gap, meaning that some groups of students achieve at a much higher level than other groups, especially on standardized tests. It is common to see persistent patterns of underachievement for lower-income, African American, and Hispanic students on standardized test scores. More and more, standardized tests are serving as gatekeepers to a child’s academic future. As a result, schools are being asked to close this gap and to help all children reach high standards.

If your school, or the school you are considering for your child, has disparities in outcomes between groups of students, you should look into why this gap exists and what measures the school is taking to close the gap. Schools should strive to create an environment where all children feel valued and all children are learning to high standards. To find out if your school is working to close the achievement gap, schedule a school visit to meet with the principal and observe some classes.

Meeting with the principal: Questions to ask about equity

Here are some questions to ask the principal that will help you assess the school’s commitment to helping all children reach high standards:

Ask:

How are students achieving in the school now? Are there any groups of students that are scoring below others on standardized tests? If so, what is the school doing to address this challenge?

Listen for:

Exact achievement data for each group of students in the school; specific strategies the school is using (curricular programs, interventions, etc.) to raise the achievement of low-performing students; and concrete, measurable school goals for improving test scores.

Ask:

How do the teachers hold all children to high expectations and measure progress to ensure that all students are learning?

Listen for:

Concrete examples of assessments that teachers use to gauge student learning and ways that teachers analyze this assessment data to make sure all students are on track.

Ask:

How is the school working to close the achievement gap? Are teachers using any new curriculum or instruction? Are they offering extra academic support for students?

Listen for:

Specific actions the school is taking to raise achievement for low-performing students. Potential actions include: Implementing new teaching strategies that have been proven successful in other schools and providing additional academic support for students, during the school day and after school. Ask how many children take advantage of these resources and how parents are notified about this extra help.

Ask:

Do all students have equal access to the most challenging classes or are lower-achieving students grouped in remedial programs?

Listen for:

Evidence that all students have access to high-level courses and enriched curriculum and the school discourages permanent “ability grouping” and remedial programs. If you’re not sure, ask to see the demographics of the students in accelerated courses vs. remedial courses.

Walking around the school: Looking for signs of equity

Take a walk around the school, visiting classrooms and observing the surroundings. As you walk, keep an eye out for some of the following signs that this school is striving to be equitable for all students:

Teachers using a variety of instructional strategies, including cooperative learning (students working in groups) and directed lessons to meet the learning needs of the students. Watch to see if students look engaged in the lessons and if the purpose of the lesson is clear.

Artwork and decorations, both in the hallways and in classrooms, that value and affirm the culture, language and backgrounds of the students.

Evidence that the school makes an effort to communicate with parents through their home language and encourages parents of all ethnic and cultural groups to participate in the school.

Accommodations for students with physical handicaps to access all parts of the school.

It may take years for a school to reverse historical trends of underachievement and inequity. The key is to look and listen for evidence that the school is aware of its challenges and is working actively to raise the achievement of all students.

source

https://www.greatschools.org/

PRELIMINARY THREE-DAY BEAR HARVEST RESULTS

HARRISBURG, PA

– Through three days of Pennsylvania’s general bear season, hunters have harvested 1,498 bears, with bears taken in 52 counties.

That compares to a three-day 1,833 in the 2018 general season. However, the 2019 general season harvest is complemented by a large bear harvest during new and expanded early bear seasons for muzzleloader, firearms and archery hunters. Factoring in the early season harvest, 3,373 bears have been taken through Tuesday. That already tops the 2018 total bear harvest of 3,153, with plenty more bear hunting still to go.

After the season’s third day, two bears of more than 600 pounds have been added to the list.

A 743-pound bear taken Tuesday morning with a rifle in Greene Township, Pike County, by Matthew J. Erdie Jr., of Nazareth, ranks as the third-heaviest bear taken across all 2019 bear seasons.

Meanwhile, a 661-pounder taken Monday morning with a rifle in Lake Township, Wayne County, by Michael A. Biduck II, of West Abington, now ranks as the fifth-heaviest bear in 2019.

The largest bear through all 2019 seasons continues to be the 813-pound male taken with a rifle on the opening day of the general season in Smithfield Township, Monroe County, by Victor M. Vassalluzzo, of Kintnersville.

The heaviest bear ever taken in Pennsylvania was an 875-pounder harvested in 2010 in Middle Smithfield Township, Pike County. Since 1992, seven black bears weighing at least 800 pounds have been lawfully harvested in Pennsylvania hunting seasons.

Other large bears taken in the 2019 general season’s first three days – all taken with a rifle – include: a 747-pound male taken in Wright Township, Luzerne County, by J. Kripp Jr., of Mountaintop; a 696-pound male taken in Penn Forest Township, Carbon County, by Brian J. Borosh, of Jim Thorpe; a 657-pound male taken in Franklin Township, Columbia County, by Nicholas A. Podgurski, of Elysburg; a 656-pound male taken in Hanover Township, Luzerne County, by Dale J. Kobal, of Hunlock Creek; a 623-pound male taken in Beech Creek Township, Clinton County, by Mikael J. Catanese, of Sewickley; a 620-pound male taken in Miles Township, Centre County, by Reuben Kennel, of Turbotville; and a 604-pound male taken in Gallagher Township, Clinton County, by Steven Z. Rohrbach, of Lock Haven.

The top bear-hunting county in the state over the general season’s first three days was Lycoming County with 113 bears. It was followed by Tioga County with 107 bears.

Three-day preliminary harvests by county and region are:

The preliminary three-day bear harvest by Wildlife Management Unit was as follows:

WMU 1A

, 11 (17 in 2018);

WMU 1B

, 44 (100);

WMU 2A

, 3 (5);

WMU 2C

, 69 (115);

WMU 2D

, 92 (114);

WMU 2E

, 38 (56);

WMU 2F

, 170 (198);

WMU 2G

, 309 (344);

WMU 2H

, 49 (59);

WMU 3A

, 85 (99);

WMU 3B

, 138 (117);

WMU 3C

, 56 (45);

WMU 3D

, 161 (141);

WMU 4A

, 76 (123);

WMU 4B

, 32 (53);

WMU 4C

, 50 (83);

WMU 4D

, 92 (112);

WMU 4E

, 21 (48);

WMU 5A

, 1 (4);

WMU 5C

, 1 (0).

Three-day harvests by county and region are:

Northwest (221)

: Warren, 61 (52); Clarion, 35 (37); Venango, 30 (68); Forest, 26 (52); Jefferson, 25 (64); Butler, 20 (17); Crawford, 19 (49); Mercer, 4 (12); and Erie, 1 (15).

Southwest (114)

: Somerset, 34 (57); Armstrong, 30 (25); Indiana, 24 (30); Fayette, 14 (32); Cambria, 7 (13); Westmoreland, 4 (11); and Greene, 1 (0).

Northcentral (626)

: Lycoming, 113 (103); Tioga, 107 (86); Clinton, 87 (119); Potter, 76 (54); McKean, 59 (43); Clearfield, 53 (72); Elk, 51 (46); Centre, 35 (46); Cameron, 30 (61); and Union, 15 (13).

Southcentral (154)

: Huntingdon, 49 (76); Bedford, 34 (51); Fulton, 17 (33); Perry, 16 (14); Blair, 15 (21); Juniata, 8 (15); Mifflin, 6 (10); Franklin, 5 (14); Cumberland, 3 (4); and Adams, 1 (4).

Northeast (349)

: Pike, 66 (46); Monroe, 44 (46); Luzerne, 39 (50); Bradford, 36 (46); Wayne, 35 (29); Sullivan, 30 (30); Susquehanna, 29 (10); Wyoming, 19 (24); Lackawanna, 18 (15); Carbon, 16 (25); Columbia, 12 (17); and Northumberland, 5 (17).

Southeast (34)

: Dauphin, 14 (25); Schuylkill, 13 (17); Berks 6 (1); and Lebanon, 1 (7).

The Top 6 Frequently Made Automation Mistakes and How to Solve Them

Gloucestercitynews.net (Dec. 1, 2019)–Testing is a vital procedure in the development of products, software or hardware, separate components in order to find and eradicate errors, ensure that it’ll perform well and have good output.

Test automation can also be described as a method of utilizing an automated testing tool to check, analyze and predict expected results to actual ones. It intends using software to automatically perform the  most difficult testing jobs or carry out ones that may appear many times, usually more than once or twice. The main advantage of

automation testing

over manual is that it’s much faster and more correct and accurate.

While automation is anything but difficult to perform whenever done right, it\’s much simpler to fail to understand the situation.

Using test automation every time

Automation shouldn\’t be viewed each time since certain issues don\’t even require robotization. Some of the tests ought to be done manually. A strategy for figuring out which test way to employ ought to be created to spare automation testers from burning through their time and vitality on automating what must be done in manual way or doing manually what should be automated.

Here’s the solution: Automated testing is reasonable for tests with a great deal of information, tests that give precise results, rehashed tests, and so on, while manual testing is appropriate for API,UX and UI tests.

Utilization wrong automation tools

Using an inappropriate device to take care of the correct issue will prompt awful results. Additionally, in the event that you have very few testings\’ to mechanize, it wouldn\’t be right to utilize only one computerization device. Thus, utilizing only a device to tackle every one of your issues via automated testing will bring terrible outcomes in light of the fact that various issues more often than not may require various methodologies and instruments.

Proposed solution: Analyze each issue you have and decide which tool is the most appropriate in each case.

Neglecting validation test

Validation

is significant in testing automation since it is required to affirm the framework is working as wanted and the normal outcomes are acquired. In this manner, dismissing the approval stage may prompt getting undesired results if there had been bugs in the framework that wasn\’t recognized in light of the fact that approval was skipped during testing.

Consider this solution: Validation testing can be performed successfully utilizing instruments like Appium, HP quality focus or Selenium.

Drive testing through the UI

Embracing this technique means one thing: slow results. The whole process initially runs smoothly, but then becomes slower and slower over time. There are continuous delays in the display of test results and if there was a mistake during the procedure, the results are affected and the whole procedure has to be started all over again.

Solution: use of a test tooling system through an upgraded UI

Separating tests from advancement

Initial stage

of automation testing is writing of codes. The written codes may along the line contain bugs which will be corrected, and then the test runs smoothly. The problem is, there is set back on the feedback from development to testing. The code may not have the necessary qualities to test it.

Solution: create tests at the beginning that can be managed by a tester or software.

Duplicating or pasting test codes

In the case of a rush and the programmer decides to save time by copying and pasting instead of writing the codes. Some procedures will have an intermediary link or phase before proceeding. Copying/pasting will break off the automation of each stage. This makes the testing procedure disorganized. This makes the testing methodology complicated.

Proposed solution: fix duplicated codes or even better, compose new codes. Capacities for intelligent procedures can also be made.

West Philadelphia Pharmacy Employee Convicted

in Illegal Oxy Pill Mill Scheme

PHILADELPHIA – United States Attorney William M. McSwain announced that Anmol Singh Kamra, 27, of Upper Darby, PA was convicted today at trial with conspiracy to distribute oxycodone outside the usual course of professional practice and with no legitimate medical purpose.

Kamra, a pharmacy technician at Campus Pharmacy in West Philadelphia, conspired with George Fisher, a physician, and Frank Brown, both charged separately, to illegally distribute thousands of oxycodone pills to people suffering from addiction.  From about December 2012 through about March 2016, Kamra, Fisher, and Brown orchestrated and executed a scheme to turn the pharmacy into a “pill mill” in which Kamra knowingly filled fake oxycodone prescriptions written by Fisher in sham “patient” names, and gave the oxycodone pills to Brown to sell in street level drug deals.

At times, Kamra would sell drugs without a prescription and then request that Fisher backdate a fake prescription in an attempt to cover the tracks.  At trial, Kamra testified that this backdating of prescriptions was a mere “courtesy” on behalf of the doctor so patients could receive their prescriptions in a timely manner, but undercover video evidence showed otherwise.  This small pharmacy in West Philadelphia sold so many opioids that some were hidden some under the sink for fear that their distributor would notice the over-abundance and cut them off for exceeding the allowable limit.

“Kamra was operating nothing more than a corrupt pill mill,” said U.S. Attorney McSwain. “The misuse of opioids is killing our citizens, and this defendant significantly contributed to our region’s crippling opioid epidemic.  We have to do everything possible to stop the illegal distribution of these deadly drugs, especially by professionals entrusted to prescribe and monitor their use.”

“Kamra diverted thousands of oxycodone pills to the street, taking advantage of those struggling with addiction amid our area’s devastating opioid crisis,” said Michael T. Harpster, Special Agent in Charge of the FBI’s Philadelphia Division. “Yet another medical professional, looking to profit from someone else’s misery. The FBI will never stop working to put pill mills out of business, and the people who run them behind bars.”

The case was investigated by the Federal Bureau of Investigation, and is being prosecuted by Assistant United States Attorneys Mary Kay Costello and Amanda Reinitz.

Seniors in Pain find Relief with Cannabis

Stephanie O\’Neill:

September 18, 2018

Megan Baker (left) of Papa & Barkley Co., a cannabis company based in Eureka, Calif., shows Shirley Avedon different products intended to help with pain relief. (Stephanie O’Neill for KHN)

Shirley Avedon, 90,­­ had never been a cannabis user. But carpal tunnel syndrome that sends shooting pains into both of her hands and an aversion to conventional steroid and surgical treatments is prompting her to consider some new options.

“It’s very painful, sometimes I can’t even open my hand,” Avedon said

.

So for the second time in two months, she’s climbed on board a bus that provides seniors at the Laguna Woods Village retirement community in Orange County, Calif., with a free shuttle to a nearby marijuana dispensary.

The retired manager of an oncology office says she’s seeking the same relief she saw cancer patients get from smoking marijuana 25 years ago.

“At that time [marijuana] wasn’t legal, so they used to get it off their children,” she said with a laugh. “It was fantastic what it did for them.”

Avedon, who doesn’t want to get high from anything she uses, picked up a topical cream on her first trip that was sold as a pain reliever. It contained cannabidiol, or CBD, but was formulated without THC, or tetrahydrocannabinol, marijuana’s psychoactive ingredient.

“It helped a little,” she said. “Now I’m going back for the second time hoping they have something better.”

As more states legalize marijuana for medical or recreational use — 30 states plus the District of Columbia to date — the cannabis industry is booming. Among

the fastest growing group

of users: people over 50, with especially steep increases among those 65 and older. And some dispensaries are tailoring their pitches to seniors like Avedon who are seeking alternative treatments for their aches, pains and other medical conditions

.

On this particular morning, about 35 seniors climb on board the free shuttle — paid for by Bud and Bloom, a licensed cannabis dispensary in Santa Ana. After about a half-hour drive, the large white bus pulls up to the parking lot of the dispensary.

About half of the seniors on board today are repeat customers; the other half are cannabis newbies who’ve never tried it before, said Kandice Hawes, director of community outreach for Bud and Bloom.

Residents of Laguna Woods Village, a retirement community in Orange County, Calif., ride a free shuttle to a marijuana dispensary in August.

(Stephanie O’Neill for KHN)

“Not everybody is coming to be a customer,” Hawes said. “A lot are just coming to be educated.”

Among them, Layla Sabet, 72, a first-timer seeking relief from back pain that keeps her awake at night, she said.

“I’m taking so much medication to sleep and still I can’t sleep,” she said. “So I’m trying it for the back pain and the sleep

.”

Hawes invited the seniors into a large room with chairs and a table set up with free sandwiches and drinks. As they ate, she gave a presentation focused on the potential benefits of cannabis as a reliever of anxiety, insomnia and chronic pain and the various ways people can consume it.

Several vendors on site took turns speaking to the group about the goods they sell. Then, the seniors entered the dispensary for the chance to buy everything from old-school rolled joints and high-tech vaporizer pens to liquid sublingual tinctures, topical creams and an assortment of sweet, cannabis-infused edibles.

Jim Lebowitz, 75, is a return customer who suffers pain from back surgery two years ago.

He prefers to eat his cannabis, he said.

“I got chocolate and I got gummies,” he told a visitor. “Never had the chocolate before, but I’ve had the gummies and they worked pretty good.”

“Gummies” are cannabis-infused chewy candies. His contain both the CBD and THC, two active ingredients in marijuana.

Derek Tauchman rings up sales at one of several Bud and Bloom registers in the dispensary. Fear of getting high is the biggest concern expressed by senior consumers, who make up the bulk of the dispensary’s new business, he said.

“What they don’t realize is there’s so many different ways to medicate now that you don’t have to actually get high to relieve all your aches and pains,” he said.

But despite such enthusiasm, marijuana isn’t well researched, said Dr. David Reuben, the Archstone Foundation professor of medicine and geriatrics at UCLA’s David Geffen School of Medicine.

While cannabis is legal both medically and recreationally in California, it remains a Schedule 1 substance — meaning it’s illegal under federal law. And that makes it harder to study.

The limited research that exists suggests that marijuana may be helpful in treating pain and nausea, according to a

research overview

published last year by the National Academies of Sciences, Engineering and Medicine. Less conclusive research points to it helping with sleep problems and anxiety.

Reuben said he sees a growing number of patients interested in using it for things like anxiety, chronic pain and depression.

“I am, in general, fairly supportive of this because these are conditions [for which] there aren’t good alternatives,” he said.

But Reuben cautions his patients that products bought at marijuana dispensaries aren’t FDA-regulated, as are prescription drugs. That means dose and consistency can vary.

“There’s still so much left to learn about how to package, how to ensure quality and standards,” he said. “So the question is how to make sure the people are getting high-quality product and then testing its effectiveness.”

And there are risks associated with cannabis use too, said

Dr. Elinore McCance-Katz,

who directs the Substance Abuse and Mental Health Services Administration.

“When you have an industry that does nothing but blanket our society with messages about the medicinal value of marijuana, people get the idea this is a safe substance to use. And that’s not true,” she said.

Side effects can include increased heart rate, nausea and vomiting, and with long-term use, there’s a potential for addiction, some studies say.

Research suggests

that between 9 and 30 percent of those who use marijuana may develop some degree of marijuana use disorder.

Still, Reuben said, if it gets patients off more addictive and potentially dangerous prescription drugs — like opioids — all the better.

Jim Levy, 71, suffers a pinched nerve that shoots pain down both his legs. He uses a topical cream and ingests cannabis gelatin capsules and lozenges.

“I have no way to measure, but I’d say it gets rid of 90 percent of the pain,” said Levy, who — like other seniors here — pays for these products out-of-pocket, as Medicare doesn’t cover cannabis.

“I got something they say is wonderful and I hope it works,” said Shirley Avedon. “It’s a cream.”

The price tag: $90. Avedon said if it helps ease the carpal tunnel pain she suffers, it’ll be worth it.

“It’s better than having surgery,” she said.

Precautions To Keep In Mind

Though marijuana use remains illegal under federal law, it’s legal in some form in 30 states and the District of Columbia. And a growing number of Americans are considering trying it for health reasons. For people who are, doctors advise the following cautions.

Talk to your doctor.

Tell your doctor you’re thinking about trying medical marijuana. Although he or she may have some concerns, most doctors won’t judge you for seeking out alternative treatments.

Make sure your prescriber is aware of all the medications you take. Marijuana might have dangerous interactions with prescription medications, particularly medicines that can be sedating, said Dr. Benjamin Han, a geriatrician at New York University School of Medicine who studies marijuana use in the elderly.

Watch out for dosing.

Older adults metabolize drugs differently than young people. If your doctor gives you the go-ahead, try the lowest possible dose first to avoid feeling intoxicated. And be especially careful with edibles. They can have very concentrated doses that don’t take effect right away.

Elderly people are also more sensitive to side effects. If you start to feel unwell, talk to your doctor right away. “When you’re older, you’re more vulnerable to the side effects of everything,” Han said. “I’m cautious about everything.”

Look for licensed providers.

In some states like California, licensed dispensaries must test for contaminants. Be especially careful with marijuana bought illegally. “If you’re just buying marijuana down the street … you don’t really know what’s in that,” said Dr. Joshua Briscoe, a palliative care doctor at Duke University School of Medicine who has studied the use of marijuana for pain and nausea in older patients. “Buyer, beware.”

Bottom line:

The research on medical marijuana is limited. There’s even less we know about marijuana use in older people. Proceed with caution.

Jenny Gold and Mara Gordon contributed to this report.

This story is part of a partnership that includes

NPR

and Kaiser Health News.

KHN’s coverage of these topics is supported by

John A. Hartford Foundation

and

The SCAN Foundation

SUNDAY HUNTING BILL SIGNED INTO LAW

HARRISBURG, PA

– It’s official: expanded Sunday hunting is coming to Pennsylvania in 2020.

Gov. Tom Wolf today signed into law Senate Bill 147, which permits additional hunting on three Sundays per calendar year – one within the archery deer season, one within the firearms deer season and one selected by the Pennsylvania Game Commission.

The law will take effect Feb. 25, 2020, and the first new Sunday hunting opportunities will be identified by the Game Commission thereafter.

In Pennsylvania, Sunday hunting generally is limited to the hunting of foxes, coyotes, crows and feral hogs during open seasons.

Introduced by state Sen. Dan Laughlin, R-Erie, Senate Bill 147 passed the state House of Representatives by a 144-54 vote Oct. 29, then passed the state Senate by a 38-11 vote Nov. 18.

Game Commission Executive Director Bryan Burhans said today’s signing of Senate Bill 147 by Gov. Wolf is a win for Pennsylvania’s hunters.

“People today tend to lead busy lives, and hunters are no exception,” Burhans said. “No matter how badly a hunter might want to get out and enjoy the outdoors during hunting season, other responsibilities might take priority and make it difficult.

“Providing opportunity to experience hunting on previously closed Sundays has game-changing potential for hunters with tight schedules and, in many cases, will make a difference by enabling those hunters to hunt alongside their children, setting them on a path they’ll follow the rest of their lives,” Burhans said. “To Sen. Dan Laughlin and to all of those who supported the bill and helped to make it a reality, please accept a heartfelt thank you on behalf of the Game Commission and hunters statewide.”

Laughlin, Chair of the Senate Game and Fisheries Committee, said the new law will create opportunities for tens of thousands of working families across Pennsylvania.

“I believe this has been a long time in coming and is truly a tribute to the thousands of hunters and the many organizations who have supported this effort,” he said. “Weekends are essentially the only time that most working men and women can get out into the woods. The same could be said for many young people, the ones who represent the future of the sport. Lifting the ban will give them increased opportunities to pursue the activity that they love.”

Sen. Jim Brewster, D-McKeesport, who serves on the Senate Game and Fisheries Committee as Minority Chair, sees the new law as an important tool in helping to recruit new hunters and keep them active.

“Sunday hunting will boost interest in the sport and open up new opportunities for hunters who are unable to get into the woods on other days of the week,” Brewster said. “I have been a longtime supporter of adding days when hunters are able to be in the field.

“This law will create access yet provide reasonable protections for farmers and landowners,” he said. “Sunday hunting will allow us to usher in new generations of sportsmen and women to enjoy our woodlands.”

State Rep. Bill Kortz, D-Dravosburg, the Democratic Chair of the House Game and Fisheries Committee, said Sunday hunting provides for hunters who otherwise have little time to hunt.

“It opens up opportunities for hunters who work six days a week, for students in college, and for junior hunters who can spend an extra day being introduced to our sport,” Kortz said. “It’s a big win for hunters, while respecting the concerns of all who enjoy our state’s outdoor traditions.”

Prior to passing the House of Representatives, Senate Bill 147 was amended to require all hunters on private land on the selected Sundays to carry written permission from the landowner. This requirement does not apply on Sundays when only foxes, coyotes, crows and feral hogs may be hunted.

The bill also gives Game Commission officers the authority to investigate private-land trespassing complaints and enforce trespassing violations as a primary offense. Previously, trespassing violations were referred to police unless a Game & Wildlife Code violation also was alleged. Once the new law takes effect, hunting-related private-land trespassing violations will be enforced year-round by the Game Commission.

MEDIA CONTACT:

Travis Lau – 717-705-6541

# # #

Pennsylvania Lawmakers to Raise Minimum Wage

By Todd DeFeo |

The Center Square

The state Senate has

passed legislation

to raise the minimum wage in Pennsylvania from $7.25 per hour to $9.50 per hour by 2022, but the move, which now heads to the state House for consideration, does not have universal support.

Raising the minimum wage “will cut off access to work experience for those trying to enter or re-enter the workforce, such as teenagers and former inmates, halting economic progress in its tracks for many Pennsylvanians,” Commonwealth Foundation Vice President & COO Nathan Benefield charged in a statement.

“Instead of pushing counterproductive wage mandates, policymakers should focus on proven ways to boost economic opportunity for all, including enacting commonsense spending limits to prevent tax hikes, lowering Pennsylvania’s extreme corporate tax rate to promote job growth, and cutting licensing requirements so low-income earners can start their own businesses and control their own futures,” Benefield added.

The Keystone State is one of 21 states where the minimum wage is set to the federal rate, “while half of the states have authorized an automatic future wage increase of some sort,” Senate Majority Leader Jake Corman, R-Benner Township, said

in a tweet

. “Senate Bill 79 is a responsible approach to increase the minimum wage rate incrementally.”

“Pennsylvania residents – especially those in my community – have indicated that they support raising the minimum wage in a way that is not disruptive for small employers,” Corman said in a news release. “Compromise is not a four-letter word. You know what is? Zero. Zero is what you get when you don’t compromise. This bill reflects a compromise that will help low-wage earners and reflect the economic realities … small employers face.”

A 2018 Independent Fiscal Office (IFO) analysis found there were 23,000 people out of 101 million working full time and earning between $7.25 and $8 per hour, according to Corman. Another 89,000 people worked part-time and fell within that hourly wage rate range.

“I’ve heard from those who wanted more that it’s not enough,” House Majority Leader Bryan Cutler, R-Lancaster, said on the

Pennsylvania Newsmakers program

. \”I’ve heard from some that it’s too much, and I think that we just need to dig into the issues and see what reforms can come with it.\”

Pennsylvania Gov. Tom Wolf has called for an increase in the minimum wage. A previous proposal would have increased the minimum wage to $12 per hour on July 1 and $15 per hour by 2025.

“We know that over 30 percent of college students go hungry because they can’t afford proper nutrition,” first lady Frances Wolf said in a release after touring Penn State’s student-run food pantry. “We also know that many of these students carry jobs in addition to their studies. Raising the commonwealth’s minimum wage would help these struggling students meet their basic needs so they can succeed in school and get the skills they need to attain jobs after graduation.”

published here with permission