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US abortion ruling threatens access to arthritis drug

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US abortion ruling threatens access to arthritis drug
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When Alabama nurse Melissa went to pick up her regular prescription for rheumatoid arthritis last week, she was told the drug was “on hold” while the pharmacist checked she wasn’t going to use it to induce an abortion.

“He said, ‘Well I have to verify if you’re on any contraceptives to prevent pregnancy.’ The hell you do,” she recalled thinking.

Melissa — who is in her early forties and asked to be identified only by her first name for fear that speaking out might affect her livelihood — then called her doctor, who succeeded in having the pharmacy in the southern US state release the medicine.

“I picked it up a couple hours later, but I felt violated,” she told AFP, explaining she had had a hysterectomy six years ago, and that her lack of recent contraceptive history may have led the pharmacist to suspect she was pregnant.

Stories of people facing similar struggles have come to light in the weeks since the United States Supreme Court overturned Roe v Wade on June 24, highlighting an overlooked consequence of new state-level bans or severe restrictions on abortion. 

It’s not yet clear how widespread the cases are, but national organizations including the Lupus Foundation of America and the American College of Rheumatology said they were aware of such concerns and asking people affected to come forward.

“The Arthritis Foundation supports unencumbered access to and coverage of FDA-approved drugs for managing arthritis in alignment with scientific and clinical guidelines, as well as evidence-based medical recommendations,” the organization said.

The issue centers on methotrexate, a drug which tempers inflammation and is commonly used against autoimmune conditions including inflammatory arthritis, psoriasis and lupus. 

Methotrexate stops cell division and is given in higher doses as a cancer drug. 

It can also sometimes be used in medical abortions, though not as frequently as the Food and Drug Administration-approved combination of two other drugs, mifepristone and misoprostol.

Nevertheless, many states have passed laws carrying threats of legal action against health care workers and pharmacies providing methotrexate.

– ‘It’s terrifying’  –

Another woman contacted by AFP, a 20-year-old university student from Ohio, said she has had a methotrexate prescription since 2020 to treat her lupus, which affects her kidney and liver and causes joint pain.

A pharmacist at a national chain told her they were “no longer accepting prescriptions for methotrexate unless it was for the FDA-approved use of (treating) breast cancer, or the patient was not presumably fertile,” she said.

She tried again, without success, to fill her prescription at a family-owned pharmacy, and this week got a letter from her doctor’s office stating the practice would no longer be prescribing methotrexate because of the number of patients having difficulty accessing it.

Though the first pharmacy later changed its position, the experience left her “annoyed and angry,” she said.

A third woman, 48-year-old Jennifer Crow, a writer and produce gardener in Tellico Plains, Tennessee, told AFP she received an automated call from CVS saying her methotrexate refill had been declined “pending provider approval.”

Crow said Methotrexate had helped her enormously in managing her inflammatory arthritis, allowing her to roll out of bed and get dressed without severe pain, and walk without a cane for the first time in years.

Though her doctor was able to resolve the situation, Crow, who has also had a hysterectomy, said she was worried for other chronic illness patients who didn’t have the same access to resources that she does.

In statements to AFP, national pharmacy chains CVS and Walmart confirmed they were working to adhere to new state regulations in light of the high court’s decision to revoke the constitutional right to an abortion.

CVS added: “We encourage providers to include their diagnosis on the prescriptions they write to help ensure patients have quick and easy access to medications.”

Alisa Vidulich, policy director of the Arthritis Foundation, told AFP she was hopeful the situation might be remedied quickly as medical professionals and pharmacies developed new guidelines.

“But that may not actually be the case in all states and it may in fact turn into a longer term issue,” she acknowledged.

Melissa, the nurse, said she was incensed at the double standard that allowed one of her best friends, who is a man, to get his methotrexate prescription filled right away with no questions asked.

“We’re headed in the wrong direction and it’s terrifying. I have two daughters. I don’t want to see this,” she said.

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Contech leaders say convergence is driving a construction industry renaissance

In the building industry, convergence is a blurring of lines between tech, process, and sectors such as architecture and manufacturing.

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The content featured in this article is brand produced

In the building industry, convergence is a blurring of lines between technology, process, and sectors such as architecture, manufacturing, and entertainment. 

The goal? Finding better ways to design, build, and make space.

“Architects and builders are looking to manufacturing to make the construction process more like industrial assembly lines — modular, repeatable, and efficient,” Autodesk University writes. “And they’re finding ways to use standardized parts and digital tools to improve safety and accelerate project timelines.”

As VP Industrialized Construction at Autodesk, Amy Marks says construction business models are shifting to meet demands from a growing client segment called “convergence customers.”

“When you think about what a convergence customer needs, it’s very different than what just a general contractor needs, or just an architect needs, or just an owner needs, or just a building product manufacturer needs,” says Marks. 

“They need a platform of connected data. They need the interoperability between many different ecosystem partners, whether that’s in services, or technology, or products. They’re looking across the silos — they’re basically burning them to the ground at this point. And I think that changes everything.”

During her keynote address at the Advancing Prefabrication 2022 conference, Marks said 82% of the audience considered themselves convergence customers. 

But they’re not explicitly asking for convergence solutions, Marks notes. 

Rather, clients tell her they are looking for integrated support because their business models are changing and “there are forces on my business, and the way in which I do business, and how I make money that have changed.”

So if a contractor responds to an RFP by offering up an evolved framework that incorporates a convergence of prefabrication, technology, and advanced processes, the customer feels better enabled to achieve their project goals.

How convergence in construction actually works

Marks touches on two key ways convergence takes place in construction.

The first is a “horizontal” integration of different — but often adjacent — business types that merge, or incorporate another offering, to increase their shared value. “Architects are buying [pre]fab shops, and general contractors are becoming makers and makers are becoming designers of things,” she explains. 

We’re seeing “vertical” compression too, according to Marks. “Whether it’s the GC or the mechanical, electrical, or plumbing subcontractor, or the traditional building product manufacturer — they are merging together as makers.”

For example, she describes how an electrical contractor might not actually produce anything that’s included in the electrical skids they supply.

Instead, they function as a “product and system integrator” of the manufactured items provided to clients. Or the building product manufacturer who creates those items offers the entire skid as an aggregated solution. 

If you think bigger, Marks says, this type of convergence can enable the creation of smart buildings and even whole smart cities that function as vertically integrated environments. 

Envision future cities where “platform companies like Meta and Google own undersea cables to emerging geographies. The data center will be owned by them, the infrastructure that gets built around them potentially…I’m sure they would like it to integrate with their platforms down to the end use in their home,” says Marks. 

“And so I think it’s a very interesting conversation about convergence and platforms that’s much more far reaching than we think.”

DIRTT Workplace
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Shared context is key to evolve your business model

Merging previously separate industries or processes is not a simple task. To make it work, all the stakeholders involved must learn how to speak different languages (in a figurative as well as terminology sense) to bridge contextual gaps, Marks says.

“As you’re starting out and these business models are first changing, you have to understand the language of the genesis of the original core competencies. And then you have to understand the language of your adjacencies.” 

For instance, “the DfMA in a manufacturing setting has different interpretations than DfMA may in an architectural setting. You’re converging with and reconciling the [industry] language to make sure that you both mean the same thing.”

Merging with other specialties requires an appreciation of diversity and perspective to create shared understanding, and perhaps in the future, even a new language, Marks says. 

Randee Herrin, Senior VP of Construction Technologies & Manufacturing at TDIndustries Inc., says her construction and facilities services company utilizes a “model-led workflow” to spark collaborative understanding.

With this approach, all stakeholders come together to make shared decisions earlier than usual in the construction process, producing a virtual model (thank you, technology) for the project. 

“You have to step outside of just [your company], and engage the entire team — the general contractor and the owner or the other key subs — that means those decisions between the entire team need to happen earlier. And it needs to be much more cooperative and a partnership upfront, to have a better outcome at the end,” Herrin explains. 

Industrialized Construction
Image by: DIRTT

Perceptions of industrialized construction have evolved too

“The future is about data. It’s enabled by the [virtual] model and…by offsite manufacturing,” says Herrin, who thinks the construction industry is in the midst of a renaissance, as future-oriented firms rethink their approach to building spaces.

After all, who doesn’t want their job to be made easier and to access greater project certainty through data, she says. 

“To me, it’s how many constraints can we remove? We’re managing a workforce that’s hard to find right now — a declining workforce. And we could sit with that problem or we could say ‘how can we solve it through off-site manufacturing?’”

In addition to the obvious benefits of industrialized construction, some old-school misconceptions are also being debunked, says Marks.

She scoffs at the idea that manufactured building products — a key element of construction convergence — are not considered beautiful or that architects and designers say, “I will not have prefab on my project.” 

“Those kinds of things are so 10 years ago,” she says. Now there’s widespread interest and acknowledgement of industrialized construction. Project stakeholders just need help understanding how to incorporate prefabricated solutions into their construction plan. 

One way or another, every building now incorporates manufactured products in construction, she points out. 

“So yeah, I think at the end of the day, the word prefab won’t exist. It’ll just be products.”

This article originally appeared on Make Space, DIRTT’s editorial platform that shares perspectives from the design and construction industries.

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Hong Kong billionaire Li Ka-shing’s firm to sell stake in fintech upstart

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Li's CK Group said in a statement that it holds less than four percent of AMTD Digital's parent company, AMTD Group, and has entered negotiations to sell those shares
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Hong Kong billionaire Li Ka-shing’s firm is selling its stake in the parent company of fintech upstart      AMTD Digital, according to a statement released Thursday, after the company enjoyed a massive rally this week.

Hong Kong-based AMTD Digital was worth more than $203 billion when New York markets closed on Wednesday, making it the world’s fifth-biggest financial company on paper, Bloomberg reported.

AMTD Digital was listed just three weeks ago, and reported $25 million in revenue for the financial year that ended in April 2021. 

Li’s CK Group said in a statement that it holds less than four percent of AMTD Digital’s parent company, AMTD Group, and has entered negotiations to sell those shares.

CK added that it has no representatives on AMTD Group’s board and has no business dealings with or shareholdings in AMTD Digital directly.

The sale would put distance between CK and AMTD Digital’s founder Calvin Choi, a former investment banker who is appealing a ban by Hong Kong regulators for failing to disclose conflicts of interest.

Li’s CK said its current four percent stake was left over from a sale nearly a decade ago, where CK sold a majority of its AMTD Group shares.

AMTD Group was set up in 2003 and lists CK Asset Holdings as a co-founder, according to its website.

Analysts have partly attributed AMTD Digital’s current rally to the small portion of shares that were made available for trading.

“The low free float in the company’s shares means it will be easier for big shareholders to push up the stock price,” research analyst Thomas Nip at Valuable Capital in Hong Kong told Bloomberg, adding that the stock is highly overvalued.

Oktay Kavrak, director at Leverage Shares, told Bloomberg that AMTD Digital was heading for a “nosedive” given the speed of its ascent.

AMTD Digital’s swift rally had prompted questions of whether it was the next “meme stock” — shares that skyrocket due to retail trading mania — similar to video game chain GameStop.

In January 2021, small-time stock traders banded together and rocked Wall Street by driving up the prices of shares like GameStop and cinema chain AMC, reaping massive profits.

But there is no evidence yet of a clear link between AMTD Digital’s stock movements this week and trades driven by social media interest, with some users of Reddit forum WallStreetBets dismissing the connection.

On Tuesday, AMTD Digital said it knew of “no material circumstances, events nor other matters relating to our company’s business and operating activities since the IPO date”.

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Blue Origin sends first Egyptian and Portugese nationals to space

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A Blue Origin New Shepard rocket launches from Launch Site One in West Texas north of Van Horn
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Jeff Bezos’ Blue Origin on Thursday launched six people to space, including the first from Egypt and Portugal, on the company’s sixth crewed flight. 

Mission “N-22” saw the New Shepard suborbital rocket blast off around 8:58 am local time (1358 GMT) from Blue’s base in the west Texas desert.

The autonomous, re-usable vehicle sent its crew capsule soaring above the Karman line, the internationally recognized space boundary, 62 miles (100 kilometers) above sea level. 

“I’m floating!” a crew mate could be heard saying on a livestream, as the capsule coasted to its highest point and the passengers experienced a few minutes of weightlessness. 

Both the rocket and capsule separately returned to the base — the latter using giant parachutes — completing the mission around 11 minutes after lift-off.

The crew included Egyptian engineer Sara Sabry, and Portuguese entrepreneur Mario Ferreira, both the first people of their countries to leave Earth.

It also included Coby Cotton, one of five co-founders of the YouTube sports and comedy channel Dude Perfect, which boasts more than 57 million followers.

A Blue Origin spokeswoman confirmed all six crew were paying passengers — though Sabry’s seat was sponsored by nonprofit Space for Humanity.

Blue Origin has not revealed its ticket prices. 

Past flights have included celebrity guests who have flown for free, including Star Trek legend William Shatner. 

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