Houston Medical Times

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Serving Harris, Brazoria, Fort Bend, Montgomery and Galveston Counties

HOUSTON

Volume 12 | Issue 7

Inside This Issue

July Edition 2022

Memorial Hermann and Houston Rockets Announce Memorial Hermann | Rockets Orthopedics

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UH Chief Population Health Officer Appointed to National Board for Health and Wellness Coaching See pg. 9

INDEX Legal Matters........................ pg.3 Oncology Research......... pg.4 Mental Health...................... pg.6 Healthy Heart....................... pg.8 Financial Forecast............ pg.12

Walking Towards Healthier Knees See pg. 11

fter nearly two decades of working together, Memorial Hermann Health System and the Houston Rockets are excited to announce a unique, first-of-its-kind collaboration and branding partnership. Effective July 1, 2022, Memorial Hermann’s entire orthopedics and sports medicine service line will be rebranded as Memorial Hermann | Rockets Orthopedics. In addition, Memorial Hermann’s sports medicine institute clinics will be named Memorial Hermann | Rockets Sports Medicine Institute, and Memorial Hermann Orthopedic & Spine Hospital will be named Memorial Hermann | Rockets Orthopedic Hospital. With the trust and support of the Houston Rockets, Memorial Hermann is proud to be the first health system in the country to be able to co-brand its orthopedic programs with a national sports team partner. “Memorial Hermann and the Houston Rockets have had a long, proud history and partnership. We’re also proud that this partnership unites two local institutions to work together for the people of Houston,” said Dr. David Callender, President and CEO of Memorial Hermann Health System. “Memorial Hermann has been caring for Houstonians for 115 years, and the Rockets have been making this city proud for more than half a century. Our roots go deep in the city we love. So, we’re joining forces to offer exceptional, best-in-class orthopedic care, yes – but also to help build a healthier Houston – and we are excited to show Greater Houston what we can accomplish by bringing our two exceptional teams together.” Both the Houston Rockets and Memorial Hermann strive to create the best experience for fans and patients alike, making the two organizations

a perfect fit for a union such as this. Memorial Hermann and the Rockets first entered into a sponsorship agreement in 2005, making Memorial Hermann the official healthcare provider of the Houston Rockets. The two organizations have a long-standing cooperation on community wellness initiatives and more. For over 10 years, the Houston

Rockets and Children’s Memorial Hermann Hospital have presented the ‘Be Fit Challenge’ which encourages and rewards students for healthy nutrition and physical activities. In addition, Memorial Hermann recently provided funding for numerous new breast-feeding stations to be installed in Toyota Center, providing private, tech-savvy breast-feeding and lactation spaces for mothers. Memorial Hermann is also funding the installation of

additional baby-changing stations in all men’s and women’s restrooms throughout the arena. And just last month, Memorial Hermann, in partnership with the Houston Rockets and the City of Houston, unveiled two newly refurbished basketball courts at the Moody Community Center in north Houston. Local children were treated to mini-clinics by Rockets players and coaches and given backpacks filled with items from Children’s Memorial Hermann and the Rockets. The refurbished basketball courts, one inside and one outside, will provide this northeast Houston community with a quality place for kids and adults to get active and engage with one another through basketball, exercise classes, children’s activities, and more. This collaboration was the first of many planned efforts and initiatives that will improve health and the quality of life for Greater Houston. “This collaboration with Memorial Hermann is truly an honor for the Rockets organization, and it strengthens our fantastic long-standing see Rockets Orthopedics...page 13

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Legal Matters SCOTUS Sides With 340B Hospitals and Denies CMS’s Attempt To Cut Reimbursement For 340B Drugs

By Kyle A. Vasquez, J.D., LL.M. and Mary H. Canavan, J.D. Polsinelli, PC

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he United States Supreme Court recently handed down a highly anticipated, unanimous opinion, AHA v. Becerra, confirming that CMS exceeded its statutory authority when it implemented a discriminatory reimbursement structure in 2018 and 2019 that resulted in certain 340B hospitals receiving lower Part B drug reimbursement than non-340B hospitals. The opinion is welcome news for 340B hospitals that continue to face financial pressures related to the 340B Program and contract pharmacies. Now, CMS and potentially

including how CMS will fund and pay underpaid claims to 340B hospitals for payment years 2018 and 2019, how will the Supreme Court’s decision impact payments in 2020-2022, and how will CMS change its payment policy on a go-forward basis, if at all. One key item to watch closely is CMS’s upcoming CY 2023 Outpatient Prospective Payment System proposed rule (Proposed Rule). CMS’s payment policy in the Proposed Rule could shed some light into its approach to not only payment going forward, but also into its approach to remedying past underpayments. For example, it’s possible that the Supreme Court’s unanimous decision influences CMS to revisit its 340B drug payment policy in its upcoming CY 2023 Outpatient Prospective Payment System proposed rule (Proposed Rule) and reinstate its ASP plus 6% payment rate. If CMS took this step, it could shed light into CMS’s approach to payment years 2021 and 2022 where it relied, in part, on its flawed 2020 acquisition cost survey

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the lower court must sort through difficult matters involving payment of damages for 2018 and 2019 underpaid claims given potential Part B budget neutral constraints, but the opinion does confirm that CMS must operate within a specific set of parameters if it intends to setup up a Part B payment structure that varies by hospital group. Namely, CMS may only vary Part B reimbursement by hospital group if it conducts a statistically valid survey pursuant to 42 U.S.C. § 1395l(t)(14) (D). Absent survey data, CMS must reimburse all hospitals at the same rate. The decision does not change reimbursement for 340B drugs in the near term. However, key issues remain

to continue its ASP minus 22.5% payment policy. Alternatively, CMS may attempt to rely on acquisition cost data obtained in its 2020 acquisition cost survey to continue its ASP minus 22.5%. If it does, there may be litigation challenging the validity of the survey itself and any resulting payment rules that vary reimbursement by hospital group. When CMS conducted its survey, it did not seek acquisition cost data from non-340B hospitals, and the data collection methods presented challenges with reporting consistent data. SCOTUS’s opinion is a much see Legal Matters...page 14

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Oncology Research What You Should Know About Sarcoma, A ‘Forgotten Cancer’ By Lawrence E. Foote, M.D., Texas Oncology Houston Medical Center and Texas Oncology Sugar Land

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sarcomas begin in the abdomen. The symptoms often come from other problems caused by the tumor, such as blockage or bleeding of the stomach or bowels. The tumor can press on nerves, blood vessels, or nearby organs and may even grow large enough to be felt in the belly. How is sarcoma treated? Once sarcoma is diagnosed, treatment is based on a variety of factors including the type, size, location, and stage of the tumor, as well as the patient’s overall health. If the tumor is found at an early stage and has not spread, surgery is often an effective option, and many patients are cured. Some patients may receive additional treatments, see Oncology ...page 14

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ou’ve discovered an unexplained lump in your child’s knee that isn’t painful and can’t be connected to an injury or fall. Surely it isn’t cancer. Or could it be a rare form of cancer known as sarcoma? Referred to as a “forgotten cancer” due to its rarity, sarcoma accounts for about one percent of all adult cancer diagnoses but is seen more commonly in children and teens. Because it forms deep in the body, sarcoma can be difficult to detect in its early stages. With Sarcoma Awareness Month in July, here’s what you should know about the signs and risk factors associated with sarcoma. What is sarcoma?

Sarcomas are a rare and varied group of cancers and are more prevalent in children than adults. They affect the body’s connective tissue and are categorized based on whether they arise in soft tissue or bone. They can occur anywhere in the body, but most usually form in the legs, hands, arms, abdomen, head, neck, and chest. Soft tissue sarcomas typically originate from cells of muscle, fat, nerves, fibrous tissue, or blood vessels, primarily found in the arms and legs. The most common types that affect bone include osteosarcoma and Ewing sarcoma. • Osteosarcoma is found most often in the bones around the knee, and it impacts the part of the bone that gives bone its strength. • Ewing sarcoma most often occurs in the bones of the pelvis, chest wall, or the middle of long leg bones, but it can also present in soft tissue. What is my – or my child’s – risk of developing sarcoma?

While there are no definitive reasons for the development of sarcoma, risk factors include receiving high doses of radiation therapy (likely treating other cancers) or damage to the lymph system through surgery or radiation. Other risk factors include exposure to certain herbicides and individuals with inherited diseases, such as Li-Fraumeni syndrome and retinoblastoma. If your family has a history of sarcoma or other cancers that developed at a young age, you should discuss the benefits of genetic testing with your physician. What are the signs and symptoms of sarcoma? Sarcoma can go undetected for a long period of time. Often, people will notice a lump that may or may not hurt and has grown over time (weeks to months). As the tumor grows, it can cause increasing pain, swelling, bone fractures, numbness, tingling, or weakness in the affected limbs. Approximately four in 10

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Houston Medical Times

The McNair Medical Institute Names Dr. Kara Marshall as a New McNair Scholar

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r. Kara Marshall, assistant professor of neuroscience at Baylor College of Medicine and faculty member at the Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital, has been named the newest McNair Scholar. The McNair Scholars program, launched by The Robert and Janice McNair Foundation and managed by the McNair Medical Institute, identifies and recruits the best and brightest physician-scientists in neuroscience, with a focus on neuromodulation. “I am honored and grateful for this generous support from the McNair Scholars program. It was critical for enabling me to start my laboratory at Baylor College of Medicine and in supporting my work with the Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital,” Marshall said. Marshall joined Baylor in

April to establish her lab focused on understanding how the brain and nervous system detect mechanical forces in the body. Although we often take it for granted, mechanical force-sensing plays a critical role in several processes, such as blood pressure control, feeding, digestion and urination. She and her team aim to uncover how your gastrointestinal tract tells your brain that you are full, what causes internal organ pain and how these internal cues affect behavior and physiology. “Our work is inherently cross-disciplinary because we plan to investigate how the nervous system functions in many different organ systems in both health and disease. The lab will be able to delve into these exciting questions thanks to the wonderful, supportive community at Baylor College of Medicine, the NRI and within the McNair Scholars program. The breadth of excellent

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science done here provides so much inspiration and opportunities for collaboration,” Marshall said. This is not the first time Marshall has been a part of the Baylor community. After graduating from Texas A&M University with a Bachelor of Science in biology, she began a Ph.D. program at Baylor. During that time, she earned a Master of Science in neuroscience but later followed her mentor to Columbia University, where she completed her Ph.D. in molecular and biomedical science. As a student, Marshall discovered a new phenomenon of rapid touch-receptor remodeling in the context of healthy skin renewal and described the Dr. Kara Marshall anatomical and organizational structure of somatosensory neurons Laureate Dr. Ardem Patapoutian. In in the bat wing that provide sensory these projects, Marshall identified feedback during flight. that the mechanotransduction ion During her postdoctoral channel PIEZO2, which mediates fellowship at the Howard Hughes external senses like touch, also is Medical Institute and the Scripps essential for internal force sensing. Research Institute, Marshall participated in multiple projects see McNair Scholar...page 14 under the mentorship of recent Nobel

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Mental Health Major Depressive Episodes Rising in Adolescents, Especially Minorities Study shows racial and ethnic minority adolescents are more likely to experience major depressive episodes, but less likely to use mental health services By George Hale

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growing number of adolescents have been facing mental health challenges in recent years. In 2017, more than 13 percent of Americans between the ages of 12 and 17 had been diagnosed with a major depressive episode (MDE), and one study from 2019 found that nearly 20 percent of U.S. high school students reported suicidal thoughts during a one-year period. Major depression can lead to a variety of problems with adolescents’ family and social lives and academic performance. Researchers have investigated various individual risk factors for MDE, rates of diagnosis and use of

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mental health services. However, fewer studies have looked into how social involvement may affect MDE rates or explored possible racial and ethnic disparities in MDE rates and mental health service use. A new study published in the Journal of Affective Disorders attempts to build on what we know about major depression in adolescents. Ping Ma, PhD, assistant professor at the Texas A&M University School of Public Health, doctoral candidate Qiping Fan and others examined MDE in adolescents from 2010 to 2018. Their analysis estimated trends in MDE prevalence over that period, looked into possible racial and ethnic disparities in MDE prevalence and mental health services use, and investigated how factors like social engagement and family structure affect MDE and mental health services use. Having experienced a major depressive episode can be defined as having five or more of nine symptoms,

including depressed mood, loss of interest in daily activities, problems with weight, sleep, energy, concentration or self-worth, or thoughts of death during a period of two weeks or more. MDE can have varying effects on life activities, with some cases causing severe disruption to school, family life and other activities. Participating in school, community and other activities may promote mental health by improving social connections and support. Getting timely help from mental health care service providers can reduce MDE-related negative effects on an adolescent’s life activities. The researchers used data from the National Survey on Drug Use and Health from 2010 to 2018. This nationally representative dataset included responses from more than 130,000 American adolescents aged 12 to 17. The study looked at weighted percentages of adolescents receiving a major depressive episode diagnoses

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in the past year, the degree to which the MDE affected life activities like school, chores at home and close relationships with family and friends, and whether the respondents had seen a health professional for their MDE symptoms in the past year. In their analysis, the researchers included data on family structure, participation in youth activities, substance use, and demographic characteristics like age, gender, race and ethnicity. The analysis found that MDE prevalence in adolescents grew from around 8 percent in 2010 to more than 14 percent in 2018. At the same time,

see Mental Health...page 14


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Healthy Heart Lifestyle Changes, Meds Effective to Prevent or Delay Type 2 Diabetes: No Change in CVD By The American Heart Association

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lifestyle intervention program of increased physical activity, healthy eating and aiming for weight loss of 7% or more, or taking the medication metformin were effective long-term to delay or prevent Type 2 diabetes in adults with prediabetes. Neither approach, however, reduced the risk of cardiovascular disease for study participants over 21 years of the study, according to the findings of the multicenter Diabetes Prevention Program Outcomes Study (DPPOS), published in the American Heart Association’s flagship, peer-reviewed journal Circulation. The DPPOS evaluated 21-years of follow-up (through 2019) for the 3,234 adults who participated in the original, 3-year Diabetes Prevention Program (DPP) trial. After an average

July 2022

21 years of follow-up, researchers found no significant differences in the incidence of heart attacks, stroke or cardiovascular death among the three intervention groups: • There was a continued reduction or delay in the development of T2D for up to 15 years. • The number of non-fatal heart attacks across each group was similar: 35 heart attacks occurred in the lifestyle intervention group; 46 in the metformin group; and 43 in the placebo group. • Similarities were also found in the number of non-fatal strokes: 39 incidences of stroke in the lifestyle intervention group; 16 in the metformin-only group; and 28 in the placebo group. • The number of deaths due to cardiovascular occurrences were low: 37 deaths among the lifestyle

intervention participants; 39 in the metformin group; and 27 in the participants who took the placebo during the original DPP trial. “It’s important to note that most study participants also received treatment with cholesterol and blood pressure medications,” said Ronald B. Goldberg, M.D., chair of the writing group for the DPPOS and a professor of medicine, biochemistry and molecular biology in the division of diabetes, endocrinology and metabolism, and senior faculty member and co-director

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of the Diabetes Research Institute Clinical Laboratory at the University of Miami’s Miller School of Medicine in Miami, Florida. “Therefore, the low rate of development of cardiovascular disease found overall may have been due to these medications, which would make it difficult to identify a beneficial effect of lifestyle or metformin intervention.” ”These long-term findings confirm the link between Type 2 see Healthy Heart ...page 13


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UH Chief Population Health Officer Appointed to National Board for Health and Wellness Coaching Bettina Beech Ready to Provide Population Health Perspectives to NBHWC Board of Directors By Mike Emery

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ach day, Americans of all ages are challenged by lack of sleep, poor nutrition and inadequate physical activity, among a myriad of other health issues. Through the guidance of health and wellness coaches, those struggling with health or self-care challenges can begin new journeys on the road to recovery. Credit the National Board for Health and Wellness Coaching (NBHWC) for supporting the professional development and certification of health and wellness coaches. The NBHWC’s Board of Directors includes a who’s who of

professionals from academia and health care. Among its newest members is UH Chief Population Health Officer Bettina Beech. Beech was selected from among nearly 200 candidates for this role and is eager to share her experience and expertise as a newly minted board member. “I am honored and humbled to be selected to join the National Board of Health and Wellness Coaching,” Beech said. “I am particularly excited to be part of a group shaping the development of this noble and rapidly growing field.” Beech’s NBHWC board position complements her role leading UH

Bettina Beech

Population Health. The initiative, which launched in January, takes a unique approach to advancing health equity within the region by addressing the full range of factors affecting the well-being of community members. Her appointment also complements the future launch of UH Population

Health’s Center for Excellence in Health Coaching. According to the Bureau of Labor Statistics, jobs for health and wellness coaches are on the rise. Certified coaches work in physicians’ see UH ...page 13

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UTSW Researchers Develop Blood Test to Predict Liver Cancer Risk Protein Levels in Blood Samples of Patients with Nonalcoholic Fatty Liver Disease Reveal Those At Highest Risk Who Should Be Screened Regularly For Liver Cancer

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n estimated one-quarter of adults in the U.S. have nonalcoholic fatty liver disease (NAFLD), an excess of fat in liver cells that can cause chronic inflammation and liver damage, increasing the risk of liver cancer. Now, UT Southwestern researchers have developed a simple blood test to predict which NAFLD patients are most likely to develop liver cancer. “This test lets us noninvasively identify who should be followed most closely with regular ultrasounds to screen for liver cancer,” said Yujin Hoshida, M.D. Ph.D., Associate Professor of Internal Medicine in the Division of Digestive and Liver Diseases at UTSW, a member of the Harold C. Simmons Comprehensive

July 2022

Cancer Center, and senior author of the paper published in Science Translational Medicine. NAFLD is rapidly emerging as a major cause of chronic liver disease in the United States. With rising rates of obesity and diabetes, its incidence is expected to keep growing. Studies have found that people with NAFLD have up to a seventeenfold increased risk of liver cancer. For NAFLD patients believed to be most at risk of cancer, doctors recommend a demanding screening program involving a liver ultrasound every six months. But pinpointing which patients are in this group is challenging and has typically involved invasive biopsies. Naoto Fujiwara, M.D., Ph.D., Research Scientist in the Hoshida

lab, and his colleagues wondered whether blood samples from NAFLD patients could reveal those at highest risk of hepatocellular carcinoma (HCC), the most common form of liver cancer. In the new study, they analyzed samples from 409 NAFLD patients to reveal a set of 133 genes that were expressed at levels higher or lower than average in the livers of patients who developed HCC over a 15-year follow-up period. The patients Hoshida, M.D., Ph.D., Associate Professor of Internal Medicine were then stratified Yujin Credit: UT Southwestern Medical Center into high- and low-risk groups based on how much these genes UTSW’s Liver Tumor Translational were expressed. Over 15 years after the Research Program. “We can much samples were taken, 22.7% of those in more confidently say now that those the high-risk group were diagnosed patients don’t need to be followed very with HCC while no patients in the closely.” low-risk group were diagnosed. The researchers also converted “This test was especially good the liver gene panel into four proteins at telling us who was in that low-risk see Liver Cancer ...page 13 group,” said Dr. Hoshida, who directs

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Walking Towards Healthier Knees

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new study published today in Arthritis & Rheumatology led by researchers at Baylor College of Medicine reveals that walking for exercise can reduce new frequent knee pain among people age 50 and older diagnosed with knee osteoarthritis, the most common form of arthritis. Additionally, findings from the study indicate that walking for exercise may be an effective treatment to slow the damage that occurs within the joint. “Until this finding, there has been a lack of credible treatments that provide benefit for both limiting damage and pain in osteoarthritis,” said Dr. Grace Hsiao-Wei Lo, assistant professor of immunology, allergy and rheumatology at Baylor,

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PlAN WISElY. YOU

“These findings are particularly useful for people who have radiographic evidence of osteoarthritis but don’t have pain every day in their knees,” said Lo, who also is an investigator at the Center for Innovations in Quality, Effectiveness, and Safety at Baylor and the VA. “This study supports the possibility that walking for exercise can help to prevent the onset of daily knee pain. It might also slow down the worsening of damage inside the joint from osteoarthritis.” Lo said that walking for exercise has added health benefits such as improved cardiovascular health and decreased risk of obesity, diabetes and some cancers, the

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chief of rheumatology at the Michael E. DeBakey VA Medical Center and first author of the paper. The researchers examined the results of the Osteoarthritis Initiative, a multiyear observational study where participants self-reported the amount of time and frequency they walked for exercise. Participants who reported 10 or more instances of exercise from the age of 50 years or later were classified as “walkers” and those who reported less were classified as “non-walkers.” Those who reported walking for exercise had 40% decreased odds of new frequent knee pain compared to non-walkers.

driving reasons for the Center for Disease Control recommendations on physical activity, first published in 2008 and updated in 2018. Walking for exercise is a free activity with minimal side effects, unlike medications, which often come with a substantial price tag and possibility of side effects. “People diagnosed with knee osteoarthritis should walk for exercise, particularly if they do not have daily knee pain,” advises Lo. “If you already have daily knee pain, there still might be a benefit, especially if you have the kind of arthritis where your knees are bow-legged.”

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Financial Forecast Navigating Social Security Retirement Benefits By Grace S. Yung, CFP Midtown Financial Group, LLC

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f asked what your largest asset is, you may reply that it’s your home or retirement savings account. But for many people, their most valuable “asset” is their Social Security retirement income benefits. I say this because we should look at the income Social Security will yield and what the equivalent asset base would have to be to generate the same amount of income. It is important to understand what you’re eligible for, and how it may coordinate with other future income sources that you and your spouse may have. Marital status is important when it comes to the collection of Social Security benefits because individuals who are married could strategize for higher benefits overall compared to

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singletons or divorced individuals who have been in marriages lasting less than 10 years. How Much Social Security Will You Receive? According to the Social Security Administration, an average wage earner replaces approximately 40% of their pre-retirement earnings with Social Security retirement income benefits. As an example, if you generate an average of $2,000 per month from Social Security, and you collect these benefits for 20 years, the total received would equal $480,000! If your spouse also generates that much, this “asset” alone could be worth just shy of $1 million in lifetime income to your household! When is the Right Time to Claim Your Social Security Benefits? If you’re qualified to receive Social Security retirement benefits, you can file for them as early as age 62. But if you start to collect before your “full retirement age,” the dollar amount of your monthly benefit will be reduced – and it will remain that way

for the remainder of your lifetime. The amount of this reduction is based on how “early” you claim your income. Your full retirement age can be anywhere between 65 and 67, depending on when you were born. So, if you were born in 1937 or before, you’ll receive the full amount of your benefit at age 65. Those who were born in 1960 or later, though, must wait until age 67 to file if you want to receive your full benefit amount. While it may sound like it makes sense to file for Social Security early, it is important to first do the math so that you know just how much it could “cost” you. In this case, for instance, if your full retirement age is 66, and you file for Social Security at age 62, your benefit would be reduced by 25%. Conversely, if you wait to file for Social Security until after your full retirement age, you can increase the dollar amount of the benefit. In this case, the “delayed retirement credit” raises benefits by approximately 8% for every year that you hold off filing (until you reach age 70). Social Security Spousal, Ex-Spouse,

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Rockets Orthopedics

Continued from page 1 partnership while further aligning the commitment we both have to the Houston community,” said Rockets President of Business Operations Gretchen Sheirr. “The world-class service Memorial Hermann has provided to Rockets players over the years is indicative of the care they bring to all patients with unmatched knowledge and passion.” While the name may be changing, the convenient, high-quality care in orthopedics and sports medicine that Memorial Hermann currently

offers at facilities located throughout the Greater Houston area is not. Our team of affiliated physicians, orthopedic surgeons, therapists and trainers work with patients to develop individualized and comprehensive treatment programs – from injury prevention and evaluation to orthopedic surgery and post-injury rehabilitation – so patients of all ages and physical conditions can return to leading active lifestyles in a safe, effective and timely manner. Of course, one does not need to be an athlete to receive orthopedic care from Memorial

Hermann, but all patients can expect to receive the same, exceptional care that the Houston Rockets have relied on for their athletes for nearly 20 years. “We will continue to provide the highest level of care for athletes and non-athletes alike, of all ages and abilities,” said Dr. Walt Lowe, Chairman and Professor of the Department of Orthopedic Surgery at McGovern Medical School at UTHealth Houston, Medical Director of the Memorial Hermann | Rockets Sports Medicine Institute and Head Team Physician of

the Houston Rockets. “Whether it is your job to play a sport for a living, or if the closest you get to a sports arena is watching it on TV, you can trust that we have a team of specialists ready to get you back to doing the sport or activity you enjoy.”

FAHA, FAAFP, and clinical lead for Know Diabetes by Heart, a collaborative initiative between the American Heart Association and the American Diabetes Association addressing the link between diabetes

and cardiovascular disease. “However, these important results also tell us that lifestyle intervention is incredibly effective to delay or prevent Type 2 diabetes, which, itself, reduces the risk for cardiovascular disease. The CDC

estimates nearly 1 of every 3 adults in the U.S. has prediabetes, therefore, preventing or delaying Type 2 diabetes is a public health imperative to help extend and improve the lives of millions of people.”

certifications to broaden their services for patients. “Health coaches are playing an integral role in people’s lives,” Beech said. “This is a rising industry

with practitioners providing essential services to communities right here in Houston and throughout the region. I look forward to working alongside the NBHWC board in advancing this

profession and sharing my perspectives as a population health scholar.”

were immune and inflammatory molecules, which points toward the importance of inflammation in HCC development. Moreover, the researchers showed that levels of the molecules changed in conjunction with therapies known to decrease liver inflammation and HCC risk, including bariatric surgery, cholesterol drugs, and an immunotherapy. “This means we could actually use these panels of molecules to track

how well patients are doing over time or to inform potential effectiveness of medical interventions to reduce liver cancer risk,” said Dr. Hoshida. For instance, the protein blood test, dubbed PLSec-NAFLD, is already being used to monitor the effectiveness of a cholesterol drug in reducing liver cancer risk in an ongoing clinical trial. Dr. Hoshida’s team is planning to continue assessing the utility of

PLSec-NAFLD in larger groups of patients around the world. They also say that in the future, blood tests could be developed to measure cancer risk in other major liver diseases such as hepatitis B and alcoholic liver disease

Healthy Heart Continued from page 8 diabetes and cardiovascular disease is complex and requires more research to understand it better,” said the American Heart Association’s Chief Medical Officer for Prevention Eduardo Sanchez, M.D., M.P.H.,

UH Continued from page 9 offices, community centers, gyms and other settings. Likewise, professionals from across health disciplines (nurses, psychologists, chiropractors, nutritionists) earn coaching

Liver Cancer Continued from page 10 whose levels could be measured in blood samples for easier risk assessment. When patients were stratified into high- and low-risk groups based on these proteins, 37.6% of patients in the high-risk group were diagnosed with HCC during the 15-year follow-up period while no patients in the low-risk group were diagnosed. Most of the genes and proteins found to be predictive of HCC risk

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Houston Medical Times

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Continued from page 3 needed and clear win for 340B hospitals. Impacted 340B hospitals should assess claims from 2018 and 2019 for separately payable, non-passthrough Part B drugs that were paid at the lower

ASP minus 22.5% rate and calculate what overall reimbursement should have been had the claims been paid at the standard ASP plus 6% rate. While CMS’s upcoming Proposed Rule could

answer several unanswered questions, impacted hospitals may need to conduct a similar review for 2020-present claims at some point soon. 

Senior Designer Jamie Farquhar-Rizzo Web Development Lorenzo Morales

Oncology

Distribution Robert Cox Brad Jander

Continued from page 4 such as radiation or chemotherapy, to improve the chances of eliminating all cancerous cells. While there are no known ways to completely prevent the development

of sarcoma, regular checkups with your physician are important for early detection. If you are diagnosed with sarcoma or any other type of cancer, an early diagnosis is key to a better

outcome from treatment and an increased chance of survival.

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Continued from page 5 such as Nature, Science and Cell Reports. She is the recipient of prestigious awards, including being named a Kavli Fellow in 2021 and earning the Dean’s Award for Excellence in Research at Columbia

University. She also has been involved in science-related community outreach to promote science education and careers 

care system as possible contributing issues; however, there is a need for more research into these disparities. The disparities in MDE diagnosis and services use point to a need for further study and for improving mental health care interventions for more vulnerable populations. Developing a more diverse population of mental health professionals and training providers to be more culturally aware and responsive when working with minority adolescents could lead to improved care. In addition, future interventions that consider gender differences in mental health and service use could be beneficial as this study found differences between

male and female MDE prevalence and service use across the board. The researchers also identified a need to improve social support in depressed adolescents. The findings of this study show increasing trends in major depressive episode prevalence and the need for tailored interventions to increase use of mental health services, especially in vulnerable adolescent populations.

Mental Health Continued from page 6 use of mental health services remained low, with only about one-third of adolescents getting help from qualified professionals. The researchers also found that adolescents in racial and ethnic minority populations had higher MDE rates and lower services use than white adolescents. However, their analysis also found an association between participating in school, community or other activities and lower MDE prevalence. The reasons for the racial and ethnic disparities are unclear. The researchers identified sociodemographic factors, discrimination, cultural perceptions of mental illness and mistrust of the health

July 2022

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McNair Scholar Her primary work found that this ion channel mediates urinary reflexes and the sensation of bladder fullness in mice and humans. Marshall has had several publications in high profile journals

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After nearly two decades of working together, Memorial Hermann Health System and the Houston Rockets are excited to announce a unique, first-of-its-kind collaboration and branding partnership. Effective July 2022, Memorial Hermann’s entire orthopedics and sports medicine service line will be rebranded as Memorial Hermann | Rockets Orthopedics. In addition, Memorial Hermann’s sports medicine institute clinics will be named Memorial Hermann | Rockets Sports Medicine Institute, and Memorial Hermann Orthopedic & Spine Hospital will be named Memorial Hermann | Rockets Orthopedic Hospital. With the trust and support of the Houston Rockets, Memorial Hermann is proud to be the first health system in the country to be able to co-brand its orthopedic programs with a national sports team partner. “Memorial Hermann and the Houston Rockets have had a long, proud history and partnership. We’re also proud that this partnership unites two local institutions to work together for the people of Houston,” said Dr. David Callender, President and CEO of Memorial Hermann Health System. “Memorial Hermann has been caring for Houstonians for 115 years, and the Rockets have been making this city proud for more than half a century. Our roots go deep in the city we love. So, we’re joining forces to offer exceptional, best-in-class orthopedic care, yes – but also to help build a healthier Houston – and we are excited to show Greater Houston what we can accomplish by bringing our two exceptional teams together.” Both the Houston Rockets and Memorial Hermann strive to create the best experience for fans and patients alike, making the two organizations

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