Houston Medical Times by Rick Delarosa

HOUSTON

Volume 13 | Issue 11

Inside This Issue

November Edition 2023

Opening Of TMC3 Collaborative Building Marks Launch of Helix Park, A 37-Acre Campus Fostering Innovation In Health Care And Life Science By Cameron Johnson

T Improving Quality of Theta Oscillations Could Lead To New Therapeutic Approaches For Alzheimer’s See pg. 10

INDEX Legal Matters........................ pg.3 Oncology Research......... pg.4 Mental Health...................... pg.5 The Framework...................pg.11 Financial Forecast............ pg.13

Texas Children’s Announces New President See pg. 12

exas Medical Center (TMC), The University of Texas MD Anderson Cancer Center, Texas A&M University Health Science Center (Texas A&M Health), and The University of Texas Health Science Center at Houston (UTHealth Houston) today celebrated the opening of the TMC3 Collaborative Building and the launch of Helix Park. “Today, we lay the cornerstone of a new campus fully dedicated to streamlining the commercialization of life-changing innovations in medicine and technologies,” said William McKeon, president and CEO of TMC. The 250,000 square-foot TMC3 Special guest, officials and keynote speakers gathered for the TMC3 Grand Opening Celebration at Helix Park in Collaborative Building is located at the Houston on Oct. 26, 2023 heart of Helix Park and incorporates research initiatives for the four as we come together to officially open deliver game-changing therapies for founding institutions. Designed to the TMC3 Collaborative Building,” the toughest diseases impacting Texans foster collaboration between academic said Peter WT Pisters, MD, president, and citizens worldwide,” said John institutions and industry partners, MD Anderson. “Our clinicians and Sharp, Chancellor of The Texas A&M the building includes University System. purpose-built wet laboratories “Texas A&M Health’s and office/co-working space Founding Institutions Celebrate the Institute of Biosciences to facilitate the seamless and Technology has Opening Of The 250,000-Square-Foot long been a trailblazer exchange of life science ideas and advancements. In Building, And Highlight Potential in drug discovery, addition, the building will now, in the heart Impacts For The Future Of Research, and host commercial life sciences of this resource-rich Discovery And Patient Care companies including Portal ecosystem of the Texas Innovations, as well as the Medical Center, we’re TMC Venture Fund. taking it up a notch. “We are incredibly excited to both scientists work daily to advance By positioning our scientists near their welcome our founding institutions and innovations in cancer research and peers and esteemed clinicians, we’re industry partners to the Collaborative care—all of which will be amplified in igniting a spark that will fuel innovation Building and to invite the community this new environment within Helix Park and forge dynamic research programs.” to experience the Helix Park campus that further cultivates collaboration, “With a shared commitment and its beautiful parks with a series of connectivity and creativity.” to improving the health and well-being “As we open this state-of-the-art of individuals and communities, we special events in the months ahead,” facility, we’re opening the door to a are bringing together academics and McKeon said. “The future of life sciences in new era of collaboration. This building industry to accelerate discovery and Houston is brighter than ever before signifies the dismantling of silos to see TMC3 ...page 14

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Legal Matters DEA Issues Second Temporary Rule Extending Controlled Substance Prescribing Flexibilities Through December 2024

By Joelle M. Wilson, JD & Erica Beacom, JD Polsinelli, PC

•

ecently, the Drug Enforcement Agency (DEA) and the Department of Health and Human Services (HHS) issued a Second Temporary Rule further extending the ability to prescribe controlled substance via telemedicine through the end of 2024. Key Takeaways • On November 11, 2023, the Second Temporary Rule takes effect and extends the COVID-19 Public Health Emergency (PHE) telemedicine controlled substance prescribing flexibilities through December 31, 2024. • The Second Temporary Rule

•

removes the “grace period” established by the previous temporary rule. Instead, it extends telemedicine prescribing flexibilities to all practitioner-patient relationships regardless of when the relationship was established, thereby removing the distinction between new and established telemedicine patients. It is unclear whether the DEA will create a special registration process, which it declined to do through past proposed rules. The DEA stated in comments set forth in the DEA’s listening sessions notice that they are “open to considering – for some controlled substances” a special registry without in-person requirements, although additional prescribing data collection requirements to prevent diversion would likely be included. The DEA continues to review both the 38,000+ comments it received in response to its two February 2023 proposed rules, and the comments and presentations received during

the recent DEA telemedicine l i s t e n i n g sessions. Further stakeholder commentary may be forthcoming. As a result of the PHE, the DEA granted temporary exceptions to the Rya n Haig ht Act a nd t he DEA’s implementing regulations under 21 U.S.C. §802(54) (D), allowing the prescribing of controlled substances via telemedicine absent an in-person medical evaluation of the patient. These flexibilities authorize practitioners to prescribe schedule II-V controlled substances via audio-video telemedicine encounter. Additionally, practitioners may prescribe schedule III-V narcotic-controlled medications approved by the Food and Drug Administration (FDA) for maintenance and withdrawal management treatment of opioid use disorder via audio-only telemedicine encounters, without requiring an in-person medical evaluation. The DEA extended the “full set” of telemedicine prescribing flexibilities through an initial temporary rule issued on May

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10, 2023. The initial temporary rule allows for the prescribing of controlled substances for new patients, absent an initial in-person evaluation, through November 11, 2023; and provides an additional one-year grace period for established telemedicine patients through November 11, 2024. The Second Temporary Rule extends PHE flexibilities through December 31, 2024, for all patients regardless of when the practitioner-patient relationship is established. The Second Temporary Rule follows a series of telemedicine listening sessions, which the DEA hosted on September 12th and 13th in response to wide-spread criticism of its release of two Notices of Proposed see Legal Matters...page 14

November 2023

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Oncology Research Navigating The Myths And Realities Of Hospice Care And Cancer By Stacey C. Muhammad, M.D., Deke Slayton Cancer Center Texas Oncology

or people experiencing a major illness like cancer, quality of life matters greatly throughout the care and treatment journey. One of the most emotionally charged, deeply personal, and perhaps misunderstood aspects of care and quality of life is hospice care. Patients and their loved ones who are confronted with difficult decisions as cancer progresses need to be able to discern myths versus facts when it comes to hospice and its role in cancer care. What is the difference between hospice and palliative care? People often confuse hospice and palliative care. While they both provide emotional and comfort care, including

pain or symptom management, that’s where the similarity ends. Palliative care, or palliative medicine, is specialized medical care for patients at any stage of a serious illness, with a focus on managing symptoms caused by cancer and side effects of treatment. Hospice is designed to provide end-of-life comfort, support, and dignity to those facing an advanced, late-stage disease or illness that has become unresponsive to treatment. Hospice can also be appropriate for patients who decide the burden of treatment is overwhelming their quality of life and no longer consistent with their personal goals. Myth vs. Reality in Hospice Care Myth #1: Hospice care is only available at specific hospice facilities or hospitals. Reality: About 70% of hospice care takes place where the patient lives, which may be a patient’s home, nursing home, or community living arrangement. This approach allows the

patient to be with important objects, memories, and family which can support improved quality of life. Myth #2: Hospice care is only for cancer patients. Reality: More than one-half of hospice patients nationwide have diagnoses other than cancer. Those suffering from illnesses such as dementia, stroke, heart disease, ALS, or Parkinson’s disease with a lifetime prognosis of six months or less, may benefit from the support of hospice care. Hospice may also be considered if therapies are not effective and one’s condition continues to deteriorate. Myth #3: Hospice care means a patient stops receiving all medications and treatments. Reality: One of the main facets of hospice is an emphasis on pain management and symptom relief – maintaining patient comfort which can include administering medications. However, it is important to note that hospice is not focused on curative therapies or interventions to prolong life. Myth #4: Hospice is only for patients who are experiencing extreme states of physical or

cognitive decline, can’t get out of bed, or for those who have only days to live. Reality: A patient does not have to be confined to his or her bed or in their final days of life to receive hospice care. In fact, hospice is most beneficial when the patient can receive care early on. It should be considered when there is a noticeable decline in physical or cognitive ability despite medical treatment. This may include increased pain, significant weight loss, extreme fatigue, or weakness. Myth #5: Hospice care has no real benefits. Reality: Hospice offers state-of-the-art symptom management care 24 hours a day, 7 days a week. Hospice staff are see Oncology ...page 14

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Mental Health In A Toxic Relationship? Four Possible Coping Strategies.

By Michael Jones

Ph.D

n a toxic relationship with a partner, friend, family member, or work? Consider four potential coping strategies: Change. We can ask ourselves: “What in this situation can I change?” Maybe I can work on confronting abusive behavior. If I am criticized, I may try to be less defensive. Can I change how I react to situations in my work environment? Is there anything I can do differently about interacting with other parties at work? Can I change how I allow the situation to affect me? Accept. Sometimes you can try every which way to make healthy changes, but nothing works. The toxic

nature of the situation persists. The next thing to ask yourself is “Can I work at acceptance?” Often things are stressful because we don’t accept things as they are. Sometimes people confuse acceptance with preference. Acceptance does not mean you approve of the situation, condone destructive behavior, or prefer things this way. Acceptance means aligning with the reality of the situation. If the boss usually behaves in a selfish and rude manner, acceptance helps me not to be shocked and amazed every time they act in character. We can healthily work on acceptance. Leave. If things are not changing and I cannot accept how things are, I might consider leaving. One effect of stress, particularly the kind that comes from an unhealthy situation, is tunnel vision—a narrow view that makes it hard to explore options. That can lead to a feeling of being trapped, as if

there are no viable options, but that is rarely the case. I might feel that there are no options because I feel trapped by all the givens I take for granted. I take the different elements of my life as fixed and fret about maintaining it, rather than considering that it might be best for me to leave and cultivate a different situation. We can then work on leaving thoughtfully, intentionally and healthily. Limbo. The last approach is limbo. Limbo is when things are not

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physiology, injury prevention Rice, Houston Methodist and rehabilitation. Showcase New Center for Human “The collaborative nature of this multiPerformance at Kickoff Event institutional center will

Facility To Enhance Research, Testing of Patients and Athletes

ice and Houston Methodist unveiled the Houston Methodist-Rice University Center for Human Performance during a kickoff event Oct. 10. The 6,000-square-foot facility, located in Rice’s Tudor Fieldhouse, will enable researchers to combine the science of human movement and disease prevention with new tools from data science, neuroscience and wearable technologies and materials to advance injury prevention and recovery and improve overall public health. The facility includes state-of-the-art laboratory, clinical and rehabilitation space and is equipped for studies requiring the latest technology for advanced 3D motion capture, forceplate measurement, region-by-region quantification of bone density, metabolic analysis, cardiovascular screening and aerobic performance testing.

“This center will help athletes, older adults, people with disabilities and surgical patients improve their quality of life through a combination of physical activity, nutrition and advanced technologies,” Rice President Reginald DesRoches said. “The mission of the center is to enhance human physical performance for both patients and athletes through research, clinical and educational activities and a commitment to advancing technology,” said Thomas Killian, dean of the Wiess School of Natural Sciences. “The facility is new, but the partnership between its core members — the Department of Orthopedics at Houston Methodist, the Department of Kinesiology at Rice and Rice Athletics — is longstanding.” The center will facilitate joint research, clinical care initiatives and educational activities in exercise

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allow us to broaden the scope of the type of research programs that we can do and also allow us to reach higher for bigger, multi-institution grants that can help to sustain this longer in the future,” said Pictured from left: Augusto Rodriguez, chair of Rice’s Department of Marc Boom, president and CEO of Houston Methodist; Patrick McCulloch, vice Kinesiology; Thomas Killian, dean of Rice’s Wiess School of Natural Sciences chair of the Department Reginald DesRoches, president of Rice; Patrick McCulloch, the John S. of Orthopaedic Surgery Dunn Chair of Orthopedic Surgery at Houston Methodist. at Houston Methodist and head team T he center will suppor t physician at Rice. “This center is really the first of Rice Athletics and Rice student its kind in Texas,” said Marc Boom, athletes by both improving physical president and CEO of Houston performance and providing on-campus Methodist. “It will enable our orthopedic clinical assessments, treatments and team to customize treatment plans to rehabilitation as well as educational and patients based on their personal health, internship opportunities. “What’s really going to happen their metabolic profiles and biomedical here is the ability for baseline testing data.” Augusto Rodriguez, chair of and as it relates to injury and recovery,” Rice’s Department of Kinesiology and said Tommy McClelland, vice president co-director of the Center for Human and director of athletics. “We will be Performance, said the partnership will able to say with more certainty and create fruitful research opportunities for more confidence to a student athlete, students and faculty at both Rice and ‘You’re ready to re-enter.’ It’s going to be a game-changer in that aspect.”  Houston Methodist.

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University of St. Thomas’ Cameron School of Business Launches a Master in Healthcare Administration Degree Program

niversity of St. Thomas-Houston’s Cameron School of Business announces a new 100% online graduate degree - Master of Healthcare Administration (MHA) beginning in spring 2024. The 30-hour degree program is designed for individuals who are currently, or aspire to be, leaders in various health care settings. “Today’s health organizations are in need of administrators who can manage the complex components of health care, as well as lead the health sector in new directions,” said Dr. Michael Sullivan who will serve as the MHA Program director, in addition to his leadership and teaching roles. Ethical Health Care Leadership Cameron School of Business (CSB) desires its students to become health care leaders by learning to do ‘good business.’

“Rooted in the Catholic moral tradition, the MHA program offers students the opportunity to understand and master the organizational, legal, financial, ethical, political and managerial aspects of health systems management,” Sullivan said. “The MHA program provides a unique curriculum designed specifically to meet the career needs of future health

moral and ethical questions faced in today’s marketplace. Programs at the CBS focus on: • Developing ethical leadership • Taking high-level views of the health care administration process • Providing quality health-related products and services to diverse communities

Today’s medical organizations need leaders who are capable of managing and leading health institutions to greater heights. Dr. Michael Sullivan, MHA Program director care leaders.” As with CSB’s graduate programs. MHA Students will experience a highly interactive and discussion-based approach to business education. Cameron professor’s often focus on the

MHA Internship Component Part of the academic plan for the MHA degree is a capstone practicum in health care management. Sullivan is exploring Internship opportunities throughout the Houston market and

beyond for MHA students. Information Sessions via Zoom & In-Person MHA Program Overviews will be offered via Zoom on Wednesday evenings at 7 p.m. on • Oct. 18 • Nov. 1 tinyurl.com/mhainfos Meeting ID: 916 0070 6911 Passcode: 238019 • Nov. 15 - An in-person information session will be held at 6:30 p.m. in the Basilian Room, Welder Hall, 1st floor. RSVP here. For more information or to apply, go to www.stthom.edu/mha. Contact CSB at 713-525-2100 or csbaction@sttthom. edu.

AI Tech Accurately Diagnoses Knee Arthritis from Medical Images

any people over the age of 50 develop arthritis of the knee, a painful condition that can make it difficult to do everyday activities like stand, walk or climb stairs. New research published in Nature Digital Medicine on the use of artificial intelligence to analyze medical images demonstrates the potential for improving diagnoses of knee osteoarthritis and predicting a person’s risk of developing it in the future. A team led by researchers from The University of Texas at Austin’s College of Natural Sciences and Dell Medical School developed an AI model that can diagnose knee osteoarthritis with clinical-grade performance, based solely on images of the knee joint from medical x-rays. One potential application would be incorporating the model into existing software that technicians use to evaluate x-rays, flagging possible cases of knee osteoarthritis to assist clinicians in

November 2023

making a diagnosis. The goal wouldn’t be to replace human doctors but to assist them. “Imagine someone goes into the clinic and gets an x-ray for some other reason, and the clinic is running this AI system in the background on every image that automatically diagnoses arthritis,” said Vagheesh Narasimhan, an assistant professor in UT Austin’s Department of Statistics and Data Sciences and Department of Integrative Biology. “We could tell them, perhaps you should consult an orthopedic expert about this condition.” The study’s co-first authors are Brianna Flynn and Emily Javan, graduate students in UT Austin’s Department of Integrative Biology. Co-senior authors are Narasimhan and Prakash Jayakumar, M.D., Ph.D., assistant professor in the Department of Surgery and Perioperative Care at UT Austin’s Dell Medical School.

X-ray images of a healthy knee (left) compared to an individual with knee osteoarthritis.

Because arthritis of the knee is caused by the grinding of knee bones (the femur and tibia) against each other as protective cartilage wears down, the size of the gap between the bones is associated with how severe the condition is. This gap, known as the joint space can be used as a clinical biomarker to quantitatively assess disease severity. In their work the researchers were also able to provide automatic measurements on the knee joint space with high precision and replicability. This quantitative measure could help doctors more

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accurately track disease progression in one person over time. Arthritis of the knee is a leading cause of adult disability in the U.S., and it’s very costly to intervene once it develops into a severe case. “So we’re also thinking about ways to combine imaging, genetic data and other risk factors simultaneously into a single model, to provide a more comprehensive prediction for knee osteoarthritis,” Narasimhan said. The team trained their AI see Knee ...page 14

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Houston Medical Times

Improving Quality of Theta Oscillations Could Lead To New Therapeutic Approaches for Alzheimer’s, Dementia Disorders, UTSW Researchers Find

he brain circuitry that is disrupted in Alzheimer’s disease appears to influence memory through a type of brain wave known as theta oscillation, a team led by UT Southwestern Medical Center researchers report. The findings, published in Nature Communications, could help researchers design and evaluate new treatments for Alzheimer’s, a condition that affects millions of people around the globe and has no cure. “We hope to use this data to refine neuromodulation strategies so that they could have a greater ability to treat Alzheimer’s disease and other degenerative brain diseases,” said study leader Bradley Lega, M.D., Associate Professor of Neurological Surgery, Neurology, and Psychiatry and an Investigator in the Peter O’Donnell Jr. Brain Institute at UT Southwestern. Cholinergic circuits in the brain –

networks of cells that communicate with each other using the neurotransmitter acetylcholine – play a critical role in memory. These circuits heavily populate the hippocampus, a region that serves as the brain’s memory headquarters. Disruptions in this circuitry are a hallmark of Alzheimer’s disease and related dementias. Cholinesterase inhibitors, one of only two classes of drugs approved to treat the symptoms of Alzheimer’s disease, work by stimulating cholinergic pathways. However, the mechanisms behind how cholinergic circuits support human memory are unknown, Dr. Lega explained. To help answer this question, he and colleagues at the Texas Computational Memory Lab at UT Southwestern and Columbia University worked with 12 patients at UTSW’s Epilepsy Monitoring Unit who were being evaluated before surgery to remove

the damaged parts of their brains that spark seizures. Electrodes implanted in their brains not only help surgeons precisely identify the seizure foci, Dr. Lega said, but they also provide valuable information on the brain’s inner workings. As the electrodes recorded brain activity, the patients performed memory tasks in which they tried to memorize lists of words and then recall as many as they could. In separate sessions, these volunteers received either a small Bradley Lega, M.D., is Associate Professor of Neurological Surgery, Neurology, and Psychiatry and an Investigator in the Peter O’Donnell amount of intravenously Jr. Brain Institute at UT Southwestern. delivered scopolamine – a drug typically used for motion sickness word lists on average when given saline, that is also known to affect memory that dropped to about 10% when given by acting on cholinergic circuits – or scopolamine. saline, which has no discernible effect. When the researchers analyzed Between different recall tests in the the brain recordings, they saw that same session, the volunteers performed scopolamine appeared to disrupt theta math problems as a distraction to clear oscillations, which are associated with their minds. encoding memories. As patients were Not surprisingly, scopolamine given this drug, their theta oscillations significantly affected the volunteers’ ability to remember words. Although see Alzheimer’s...page 13 they could recall about 31% of the

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The Framework State-Of-The-Art Museo Institute for Medical Arts Officially Christens Its Completion with An Intimate Evening Soiree Hosted By Dr. Mike Mann, The Grand Opening Served as A Showcase For The Building’s Architectural Dynamism, Its Greek-Inspired Artistic Flair, And Its Newly Completed Exterior Landscaping And Fountains

he Museo Institute for Medical Arts a first-of-its-kind 10-story class “AA” LEED-certified medical office building totaling 153,000 square feet – formally celebrated its completion during a lively and festive evening Grand Opening party designed to welcome project partners, tenants, friends, and neighbors to toast

building. “This building is called the Museo Institute for Medical Arts, and it was erected to be a beautiful structure that represents a bridge between the visual arts – we’re in the Museum District – and the healing arts,” Dr. Mann noted. He added, “This is a medical building, so I wanted a facility

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UNCONVENTIONAL Career Path the structure’s exquisite architecture, striking art pieces, and multi-use event spaces. A year-and-a-half since the significant milestone of anchor tenant Mann Eye Institute moving into its top floor perch overlooking the world-renowned Houston Museum District, Mann Eye founder and Museo visionary Dr. Mike Mann played host for the evening, mingling with guests and brimming from ear to ear throughout the course of the night as he reflected fondly on his idea for this picturesque space becoming a tangible reality. Dr. Mann, PJMD Architects Principal Marko Dasigenis – the building’s design architect – and the evening’s special guest, Counsel of the Hellenic Republic in Houston Lambros Kakissis welcomed event attendees and remarked upon the incredible journey that the Museo Institute for Medical Arts has taken from blueprint to

where people would walk in and feel uplifted about coming to the doctor. I can’t tell you how many times I have personally dreaded going to the doctor. We’ve spent a lot of time [thinking about how] the building’s space, light, and color can uplift; the credit goes to Marko Dasigenis and [architectural colorist] Carl Black for working so hard. This is a temple of healing, and for me personally, it is a temple of love. That is what it represents to me, my family, and everyone who worked on this facility.” Dr. Mann thanked his family and numerous project partners before turning the microphone over to Dasigenis, who spoke eloquently on the building’s meticulous details. Marko then introduced Hellenic Republic Counsel Kakissis, who closed out the remarks portion by recognizing the contribution that Museo is making as

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Texas Children’s Announces New President Texas Children’s appoints Dr. Debra Feigin Sukin as its new President

exas Children’s is pleased to announce the appointment of Debra Feigin Sukin, Ph.D., as the new President of the organization. Sukin will join Texas Children’s on January 8, 2024, and report to Mark A. Wallace, who will continue to serve as Chief Executive Officer. “I am thrilled to welcome Debbie, an exemplary and talented leader, to Texas Children’s,” said Mark A. Wallace, President and CEO of Texas Children’s. “Her expertise, vision and values are a perfect fit for our organization and where we are headed in the future. Not only does Debbie have the necessary healthcare leadership experience, but she has lived and breathed Texas Children’s her entire life. Both of her parents worked at Texas Children’s, and she also began volunteering at Texas Children’s at age 16. As a parent of her two boys with special needs, she has spent the last two decades experiencing the world-class care, clinical research,

empathy and heart of Texas Children’s. Debbie’s passion for our culture, mission, vision and values is unparalleled.” Sukin currently serves at Houston Methodist as an Executive Vice President with responsibility for four Houston Methodist hospitals and is the Chief Executive Officer of Houston Methodist The Woodlands Hospital, in addition to system responsibilities leading Neurosciences and the Houston Methodist DeBakey Heart Center. Before joining Houston Methodist, she was the Senior Vice President of St. Luke’s Health System in the Texas Medical Center. She received her Master of Healthcare Administration from Washington University in St. Louis and her Ph.D. in Health Policy and Health Management at The University of Texas Health Science Center. “I am truly honored and excited to serve as the new President of Texas Children’s,” said Sukin. “Texas Children’s has always been a profoundly

Mark A. Wallace, President and CEO of Texas Children’s / Debra Feigin Sukin, Ph.D.,

special place to me, and I’m humbled to have this opportunity. This is an amazing organization and I look forward to working with the outstanding faculty and staff throughout the system and leading the next evolution of Texas Children’s. Mark has been a mentor and friend for many decades and I feel especially fortunate to serve under him as he continues on as CEO. I truly cannot wait to see what we can accomplish together as a team in the months and years to come.” “The Board of Trustees unanimously

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and collectively approved the appointment of Debra Feigin Sukin, Ph.D., as President of Texas Children’s. She is an exemplary leader with a proven track record of success across academic medicine and will no doubt elevate Texas Children’s to new heights,” said Michael C. Linn, Chair of the Texas Children’s Board of Trustees. “She is an incredible addition to the leadership team of our see Texas Children’s ...page 13

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Financial Forecast This is Not Your Grandfather’s Annuity Are Annuities Something that Deserve a Second Look? By Grace S. Yung, CFP Midtown Financial Group, LLC

or years annuities have had a bad reputation. And rightly so. The old annuities of the past had long surrender periods, offered little more than tax-deferral and standard death benefits as options, and were just not implemented properly. Today, these strategies have evolved. There are many applications where, if used appropriately, these investment vehicles may make sense as part of an overall financial plan. Supplemental Income Annuity simply means a fixed sum of money paid to someone yearly, typically for life. Annuity strategies can be purchased as a personal investment separate from having to work for a corporation. As a matter of fact, pensions from corporations have been

Alzheimer’s

Continued from page 10 decreased significantly in intensity. Additional characteristics of these affected oscillations suggested that the

Texas Children’s

Continued from page 12 vibrant and complex organization.” “This is a pivotal role for the organization, and it was our humble responsibility to find the absolute best person for the role and for Texas Children’s – and we have! Debbie is

The Framework

Continued from page 11 a welcome addition to the community. The next-generation Museo Institute for Medical Arts is ideally situated on the METRO Rail’s Red

going away and very few companies still offer this. This is one reason annuities should be getting a second look as the baby boomer generation continues to head into retirement. Today, annuities have many different options or features, called riders that can be added to the base contracts. For example, Guaranteed Withdrawal Benefit riders typically offer guaranteed income for life either to cover a single life or joint lives, without having to annuitize (to give up their entire contract value in exchange for a fixed payment for life) a contract. There are different variations of these riders depending on the issuing insurance company, but the gist of it is, this strategy allows one to plan on a predictable, guaranteed cash flow in retirement. Many times, this supplemental income, in addition to a retiree’s Social Security and / or pension income, if any creates a meaningful guaranteed base of income and can be used to meet a portion of one’s overall living expenses. Having this tool, allows one to count on income, no matter what

happens. Annuities as an Alternative? Other features include riders such as Long-term Care riders. Unfortunately, not everyone qualifies for or has Long-term care coverage. Actual long-term care insurance is usually a better solution, but for those who cannot obtain LTCI, this may be an alternative to consider. Similarly, for those who cannot qualify for life insurance, annuities typically offer a standard death benefit. There are annuities that also offer “enhanced” death benefits such as, roll-ups or step-ups in death benefit values that are over and above the initial investment. There are many variations to the different kinds of enhancements to fit one’s unique needs. There is no Free Lunch Annuity strategies can be costly, and the gains are taxed as ordinary

income upon withdrawal. In general, the average annuity solution is more expensive than a regular investment portfolio because of the guarantees and / or features it provides. Depending on what one is trying to accomplish, one may find the costs associated with annuities to be reasonable. It is a good idea to seek professional advice on your specific circumstances as annuity strategies are complex and may not be right for everyone. They are however, yet another tool in the financial toolbox and there can be a place for some of these strategies within a financial plan. Work with your CERTIFIED FINANCIAL PLANNER ™ practitioner to see if it makes sense for you and if it can add value to your financial plan. For more information: protectedincome.org 

hippocampus couldn’t communicate as well internally and with the rest of the brain. These disruptions were most pronounced in the volunteers with the worst recall after scopolamine, supporting the link between cholinergic circuits and theta oscillations.

Together, Dr. Lega said, these findings suggest that one of the principal ways that cholinergic circuits affect memory is through theta oscillations. Thus, improving the quality of theta oscillations could be a focus for developing new Alzheimer’s disease

therapies. Theta oscillations could also serve as a biomarker to determine whether experimental therapies are effective in clinical trials.

exactly who we need leading the next chapter of Texas Children’s, and we couldn’t be more thrilled to have such a dynamic, powerful and energetic leader stepping in as President,” said C. Park Shaper, Vice Chair of the Texas Children’s Board of Trustees and Chair of the Search Committee. “We remain immensely grateful to Mark for his longstanding dedication and his

commitment to continue to serve as CEO of Texas Children’s.” As President, Sukin will lead the largest children’s hospital in the nation, with 5.2 million patient encounters annually, more than 120 locations throughout Houston, Austin and Central Texas, and 17,000 world-class employees, faculty, specialists and pediatricians serving children and

women across the globe. Texas Children’s is consistently recognized as a leader in pediatric care, ranking third in U.S. News & World Report’s 2023-24 Best Children’s Hospitals survey.

Line near Texas Medical Center and represents phase I of a mixed-use project inspired by the surrounding neighborhood’s dedication to art, science, and culture. Nearly 60% leased at this time, Museo houses the services of two Houston-based medical practices – Texas Laparoscopic

Consultants (TLC) and Houston Cardiovascular Associates (HCVA) – in addition to the aforementioned Mann Eye Institute. TLC occupies the ninth floor, utilizing 10,255 square feet for performing pioneering weight loss procedures and minimally invasive surgeries. HCVA, a prominent

cardiology practice with locations in both Houston and Sugar Land, will soon open its 40,000-square-foot build out that encompasses the majority of the eighth floor and a portion of the first floor. 

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TMC3

Continued from page 1 medical breakthroughs,” said Giuseppe N. Colasurdo, MD, president and Alkek-Williams Distinguished Chair at UTHealth Houston. “Through the Texas Therapeutics Institute— already a signature collaborative enterprise at UTHealth Houston—our world-renowned leaders in therapeutic antibody development will have the

Legal Matters Continued from page 3 Rulemaking (the “proposed rules”) in February 2023. The proposed rules stated an intention to reinstate strict limitations on the virtual prescribing of controlled substances and signaled a significant roll back of the in-person medical evaluation flexibilities extended during the PHE. In response, most listening session presenters offered comments in four categories of concern: 1) the telemedicine controlled substance prescribing in-person visit requirement, 2) the proposed thirty-day prescribing limit, 3) proposed reporting requirements (e.g., notating on prescriptions that they were prescribed via telemedicine), and 4) the potential for a telemedicine prescribing special registration process. Stakeholder consensus highlighted

Oncology Continued from page 4 knowledgeable when it comes to pain treatments or helping patients feel comfortable with pain management alternatives. Hospice also offers the expertise of bereavement and spiritual counselors who help patients and

Knee Continued from page 8 model on medical records from tens of thousands of people in the UK Biobank, a large-scale biomedical database and research resource, containing in-depth genetic and health information from half a million UK participants. Using their model, the researchers diagnosed nearly twice as many cases of knee arthritis as were documented

November 2023

Houston Medical Times

opportunity to work closely with other leading researchers in the Texas Medical Center, greatly enhancing our collective ability to translate discoveries and ideas into effective treatments.” When complete, the 37-acre Helix Park campus will also include Dynamic One (a 700,000-square-foot industry research building), six future industry and institutional research buildings, a hotel, a residential tower, and a mixed-use building with retail. In addition, six linked green spaces form an 18.7-acre campus

“spine” that is now complete and open to the public. The State of Texas will benefit from an ongoing annual impact of over $5.4 billion once the Helix Park campus is fully built out and occupied. More than 23,000 permanent new Harris County jobs will drive that gain, representing virtually all industries, pay scales, tax levels, and educational backgrounds. In addition, 19,000 construction jobs will be created to help bring Helix Park to life.

the industry’s desire for a permanent extension of prescribing flexibilities to support patient access to necessary medications without the perceived arbitrary in-person visit requirement. Many stakeholders expressed interest in the creation of a special registration process for remote prescribing, which the 15-year old Ryan Haight Act mandates. Under the Ryan Haight Act, the DEA is required to establish a special registration process for the prescribing of controlled substances via telemedicine. Congress registered its support for the special registration process by delivering a letter addressed to DEA Administrator Anne Milgram on September 13 stating, “[Congress] created a ‘special registration’ exception, not as an option for DEA to utilize but a requirement to do so” acknowledging that DEA’s most recent proposed rules did not meet that obligation. The letter emphasized the potential for a special registration

process to balance the need for provider clinical judgement and flexibility in prescribing appropriateness via telemedicine encounters. During the listening sessions, Milgram indicated that a forthcoming comment period will take place in the fall of 2023, which will allow for additional written comments before any rules become final. DEA has indicated that it anticipates implementing a final set of regulations related to controlled substance prescribing via telemedicine by the fall of 2024. While the Second Temporary Rule provides additional flexibility for telemedicine companies and practitioners to continue prescribing to patients absent an in-person medical evaluation, it remains unclear whether the DEA will propose to implement similar flexibilities in 2024 on a permanent basis. 

families come to terms with the reality of dying. They can assist patients in finishing important tasks, saying final goodbyes, or completing a spiritual journey. National Hospice and Palliative Care Month in November is an opportunity to recognize the power of this important and deeply personalized care, and how hospice improves quality of life for patients near the end of life

and supports those who love them. Debunking myths and knowing the facts can help to dispel fears, clarify misconceptions, or provide guidance for those in need. To learn more about hospice care in Texas, talk with a health care provider or visit the Texas Department of Health and Human Services. 

in the UK Biobank health records. There are many possible reasons for the unreported cases in the medical records. Clinicians might set arbitrary thresholds, choosing not to diagnose milder cases. Patients themselves might ignore or downplay the condition due to varying levels of pain tolerance, or because they don’t want to consider treatment options such as surgery due to the high cost and long recovery time. Filling in these gaps could help researchers sifting through large sets

of health records in search of factors that might correlate with disease such as genetics, lifestyle (e.g., nutrition, exercise, addiction or medications) and environmental factors (e.g., pollutants or accidents). “An unbiased means of performing diagnosis on the entire cohort of half a million people is kind of exciting and will help improve those types of epidemiological association studies,” Narasimhan said.

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