San Carlos, CA, United States
San Carlos, CA, United States

Hawaii Medical Service Association is a nonprofit health insurer in the state of Hawaii. HMSA was founded in 1938, is an independent licensee of the Blue Cross Blue Shield Association, and is the largest insurer in the state of Hawaii serving more than 700,000 people. Wikipedia.

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The apolipoprotein E (APOE) ε4 allele may accelerate the progression of HIV disease, and increase the risk for developing HIV-associated neurocognitive disorder (HAND). Whether APOEε4 allele(s) and age may influence brain atrophy in HIV patients is unknown and was evaluated. Automated morphometry on magnetic resonance images, using FreeSurfer analyses, neuropsychological testing and APOE genotyping were performed in 139 subjects [70 seronegative controls (SN); 69 clinically-stable HIV subjects]. Compared to SN, HIV subjects had smaller volumes throughout the brain regardless of their HAND status. Compared to APOEε4- subjects, SN controls with APOEε4 had better memory and larger global brain volumes (cerebral white matter and cortex) while HIV subjects with the APOEε4 allele(s) had poorer cognition (verbal fluency, learning, executive function and memory) and smaller cerebral and cerebellar white matter and subcortical structures. Further stratification of age showed that younger (<50 years) APOEε4+SN subjects had larger putamen and cerebral white matter, while younger APOEε4+HIV subjects had poorer performance on verbal fluency and smaller brain volumes [3-way (HIV-status×APOEε4×Age) interaction-p-values=0.005 to 0.03]. These findings suggest that APOEε4 allele(s) may show antagonistic pleiotropy on cognition and brain atrophy in SN controls, but may lead to premature aging with neurodegeneration in younger HIV patients prior to the development of HAND. Potential mechanisms for such interactions may include stronger neuro-inflammation or greater amyloid deposition in younger HIV subjects with APOEε4 allele(s). Early screening for the APOEε4 allele and brain atrophy with morphometry may guide neuroprotective intervention of cognitively normal HIV subjects prior to the development of HAND. Longitudinal follow-up studies and larger sample sizes are needed to validate these cross-sectional results. Copyright © 2011 Elsevier Inc. All rights reserved.

ABSTRACT:: A Morel-Lavallee lesion (MLL) is a relatively rare condition that is caused by a traumatic shearing force. This force leads to a closed degloving injury of the subcutaneous tissue and fascia that creates a potential space that can fill with lymph, blood, and necrotic fat. The MLLs are traditionally seen after high impact trauma and typically located at the greater trochanter and pelvis, although recent reports have found them to be located at the knee, thigh, and lower leg. The MLLs typically present as swelling at the site of injury, which can be difficult to differentiate from several other diagnoses. This case report discusses an MLL in the lower extremity that occurred during a rugby game. A lack of familiarity with MLLs often leads to delayed diagnosis and treatment. The diagnosis was eventually made with an magnetic resonance imaging, and the lesion was successfully treated with ultrasound-guided aspiration and compression. The athlete was able to return to play without recurrence of the lesion. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

New opportunities explored for Freedom Leaf, Inc. to develop therapeutic nutraceutical cannabis/hemp products in the US and Internationally LAS VEGAS, NV--(Marketwired - Nov 28, 2016) - Clifford J. Perry CEO of Freedom Leaf, Inc. "The Marijuana Legalization Company™" ( : FRLF) announced today that Dr. Robert Melamede, Ph.D. and Dr. David J. Barton, MD are joining the company's new medical advisory board. Dr. Robert Melamede has a Ph.D. in Molecular Genetics and Biochemistry from the City University of New York. He retired as Chairman of the Biology Department at University of Colorado, Colorado Springs in 2005, where he taught and researched cannabinoids, cancer, and DNA repair. Dr. Melamede is recognized as a leading authority on the therapeutic uses of cannabis, and has authored or co-authored dozens of papers on a wide variety of scientific subjects. Dr. Melamede, along with Richard C. Cowan, FRLF Chairman, co-founded Cannabis Science, Inc., the second publicly traded company in the cannabis sector, and he served as its CEO from 2008 to 2014. Cowan said, "It is wonderful to have my old friend, 'Dr. Bob,' as he is known to so many admirers around the world, join us as we move forward." Dr. David J. Barton, MD is a clinician in Pain Medicine and a Medical Political Activist. He has been a physician for over 32 years. He is fellowship trained in Pain Medicine, and became board certified in Pain Medicine by the American Board of Pain Medicine in 2005. Past board certifications include General Surgery (1992) and Plastic Surgery (1995). Dr. Barton is a lifetime member of the American Society of Plastic Surgeons. Present member of the American Academy of Pain Medicine, the American Telemedicine Association, the International Cannabinoid Research Society, and the Hawaii Medical Association. Dr. David J Barton served in the United States Army Reserve, General Surgeon, Medical Corp Officer, Major, 1990-1999, with temporary active duty in Desert Storm. Current volunteer Chief Medical Officer of Malama First, LLC; A non-profit organization for the enhancement of healthcare and well-being in Native Hawaiians. Freedom Leaf, Inc., CEO Clifford J. Perry explained, "Freedom Leaf is honored to have these two distinguished scientists become the first members of our new Medical Advisory Board, as we explore the new opportunities for Freedom Leaf, Inc. to develop therapeutic and nutraceutical cannabis and hemp products in the US and internationally with our foreign licensees." Perry added, "Freedom Leaf, Inc. headquarters are in Las Vegas, where marijuana is now fully legal following the Nevada victory in the recent recreational initiative. With 8 states approving either medical or recreational or both on November 8th, there are now even more opportunities in other states that now either have medical and/or recreational marijuana laws or both. Internationally in Europe, Central and South America as well as Australia and Canada, we are seeing major accomplishments in the legality of marijuana which will create even more deal flow and revenue for Freedom Leaf, Inc. and our stockholders." Freedom Leaf, Inc., The Marijuana Legalization Company™, is a fully reporting and audited, publicly traded company trading under the symbol ( : FRLF). Freedom Leaf, Inc. is the leading go-to resource in the cannabis, medical marijuana, and industrial hemp industry. It is involved in mergers and acquisitions in the marijuana industry, including incubation/acceleration and spin offs of new marijuana/hemp related companies. Freedom Leaf Inc.'s flagship publication is Freedom Leaf Magazine, The Good News in Marijuana Reform. The company produces a portfolio of news, print and digital multi-media verticals, websites, and web advertising, for the ever changing emerging cannabis, medical marijuana and industrial hemp industry. Freedom Leaf, Inc. does not handle, grow, sell, or disperse marijuana or related products. Statements in this press release that are not strictly historical are "forward-looking" statements within the meaning of Section 27A of the Securities Act of 1933, as amended and Section 21E of the Securities Exchange Act of 1934, as amended. These forward-looking statements generally can be identified by phrases such as Freedom Leaf, Inc. or its management "believes," "expects," "anticipates," "foresees," "forecasts," "estimates" or other words or phrases of similar import. Similarly, statements herein that describe the Company's business strategy, outlook, objectives, plans, intentions or goals also are forward-looking statements. All such forward-looking statements are subject to certain risks and uncertainties that could cause actual results to differ materially from those in forward-looking statements. Factors that could cause or contribute to differences include the uncertainty regarding viability and market acceptance of the Company's products and services, changes in relationships with third parties, and other factors described in the Company's most recent periodic filings with the Securities and Exchange Commission, including its Annual Report on Form 10-K dated June 30, 2016 and quarterly reports on Form 10-Q. Investor relations information can be found on the Freedom Leaf, Inc.  website.

News Article | November 21, 2016

The Minnesota High Tech Association (MHTA) announced this week that Sovos Compliance is this year’s Tekne Award winner for innovation in the Established Software Companies category. The award recognized the Minnetonka-based company, which safeguards businesses from the burden and risk of tax and compliance, for its innovative solution to the challenges businesses face with Affordable Care Act compliance reporting. Past Tekne Award recipients include technology industry leaders such as 3M, Boston Scientific, Delta Air, Ecolab, Honeywell, and Medtronic. “We’re honored to be among such an elite list of Minnesota technology companies,” said Sovos CEO Andy Hovancik. “Like so many other regulatory mandates, ACA caught businesses off guard, and HR professionals were unprepared to deal with the burden. Our business-to-government reporting software is built for exactly that -- and our team was able to deliver a solution exactly when it was needed most.” Building on its long history of success in tax information reporting, which includes being the world’s largest private filer of 1099 forms, Sovos delivered ACA automation in time to service nearly 20 million households and over 1,000 companies, including, ArcBest Corporation, Deseret Mutual, Goodman, Hawaii Medical Service Association and TriHealth. “Like so many of the tax information reporting challenges our clients face, ACA emerged quickly and will continue to change and evolve quickly,” said Troy Thibodeau, Chief Product Officer for Sovos. “We’re happy that MHTA recognized how valuable it is to solve these ever-changing regulatory problems. And, we’re excited to see our solutions expanding to solve new and complex business problems.” “Minnesota continues to be a national leader in technology and science, and this year’s Tekne Award recipients are clear evidence of that,” said Margaret Anderson Kelliher, president and CEO of MHTA. “We are honored to recognize Sovos Compliance for their innovations and achievements.” About Sovos Sovos Compliance is a global leader in tax, compliance and business-to-government reporting software, safeguarding businesses from the burden and risk of compliance in thousands of tax jurisdictions around the world. With a 35-year track record of accurate and complete regulatory analysis and a global suite of software solutions, Sovos helps finance, tax and HR professionals in 4,500 companies, including half of the Fortune 500, stay ahead of complex and fast-changing government regulations. The company’s compliance platform integrates with a wide variety of business applications, providing the control and visibility required to manage global tax compliance activities. Based in Boston, Sovos has offices throughout North America, Latin America and Europe. For more information visit About Minnesota High Tech Association (MHTA) MHTA is an innovation and technology association united in fueling Minnesota’s prosperity. We help bring together the people of Minnesota’s technology ecosystem and lead the charge in directing technology issues to Minnesota’s state capitol. MHTA is the only membership organization that represents Minnesota’s entire technology-based economy. MHTA members include organizations of every size − involved in virtually every aspect of technology creation, production, application and education in Minnesota. Find out more online at or follow MHTA on Twitter at

News Article | February 16, 2017

CHARLOTTE, N.C. & HONOLULU--(BUSINESS WIRE)--Hawaii’s hospitals are seeing improvements in healthcare quality and patient safety through a statewide initiative with the Hawaii Medical Service Association (HMSA) and Premier Inc. (NASDAQ: PINC). This includes a 20 percent improvement in patient safety (based on an index of 33 measures) and an 18 percent reduction in readmission rates across the 13 hospitals in HMSA’s network. HMSA, an independent licensee of the Blue Cross and Blue Shield Association, and Premier, a leading healthcare improvement company, partnered to support providers in Hawaii through the Advanced Hospital Care program in 2011. The program is the nation’s first statewide collaboration between a health plan and hospitals to define and implement new standards of quality improvement. Over a four-year performance improvement period, one of the most prominent patient safety accomplishments has been a substantial reduction in the rate of hospital-acquired infections (HAIs), specifically reductions of: “Together, Hawaii hospitals are making significant improvements across the spectrum of patient safety, quality, and patient experience by sharing and comparing clinical data, outcomes, and experiences with each other and with Premier member hospitals across the U.S.,” said Mark M. Mugiishi, M.D., HMSA senior vice president and chief medical officer. “Our partnership with these hospitals and Premier allows us to focus on a common goal of sustainable, high-quality healthcare for the people of Hawaii.” In addition to patient safety and readmissions, Hawaii hospitals have also improved: “We use Premier data to identify opportunities that will enhance care for our community,” said Laura Westphal, chief nursing officer and vice president of patient care at Castle Medical Center in Kailua on Oahu. “We work with Premier and its alliance members to learn best practices and benchmark outcomes against top performers. This collaboration is part of our day-to-day work and commitment to streamlining high-quality care practices across our organization.” Advanced Hospital Care is among the few initiatives in the U.S. that uses national, as well as provider-designed and managed measures, to improve evidence-based care, safety, patient experience, readmissions, end-of life care, and mortality. The program uses concepts from national policies and initiatives such as the Centers for Medicare & Medicaid Services Hospital Value-Based Purchasing Program. Hawaii hospitals in the program also work with hundreds of other hospitals across the U.S. as part of Premier’s nationally recognized quality improvement collaborative, which is built on mutual trust, transparency, and a common framework for performance improvement. “The accomplishments these hospitals have made and this unique partnership is a key piece in scaling innovation across our industry,” said Merrie Wallace, BSN, MN, vice president of quality at Premier. “By seeking to exceed new performance levels, Hawaii hospitals are inspiring others to improve across all settings of care, benefitting patients and building the capabilities necessary for value-based payment models.” Through Advanced Hospital Care, HMSA provides funding for Hawaii hospitals to use Premier analytics and services, such as Premier’s quality improvement services and analytics, to accelerate advances in care delivery. A significant percentage of payments for both inpatient and outpatient care for participating hospitals are determined by their performance on quality outcomes measured in the Advanced Hospital Care program. Caring for the people of Hawaii is HMSA’s promise and privilege. Working together with employers, partners, physicians and other healthcare providers, HMSA promotes well-being; develops reliable, affordable health plans; and supports members with clear, thoughtful guidance. HMSA is the most experienced health plan in the state, covering more than half of Hawaii’s population. As a recognized leader, the organization embraces its responsibility to strengthen the health and well-being of its community. Headquartered in Honolulu with centers statewide to serve its members, HMSA is an independent licensee of the Blue Cross and Blue Shield Association. Premier Inc. (NASDAQ: PINC) is a leading healthcare improvement company, uniting an alliance of approximately 3,750 U.S. hospitals and more than 130,000 other providers of care. With integrated data and analytics, collaboratives, supply chain solutions, and advisory and other services, Premier enables better care and outcomes at a lower cost. Premier, a Malcolm Baldrige National Quality Award recipient, plays a critical role in the rapidly evolving healthcare industry, collaborating with members to co-develop long-term innovations that reinvent and improve the way care is delivered to patients nationwide. Headquartered in Charlotte, N.C., Premier is passionate about transforming American healthcare. Please visit Premier’s news and investor sites on

News Article | April 29, 2016

State lawmakers are poised to make Hawaii one of a handful of states that allow psychologists to prescribe medication in hopes of increasing access to mental health services. The Hawaii bill would allow psychologists to prescribe medication if they undergo special training. It sets requirements including 400 hours of training, supervision of 100 patients and passing an exam created by the American Psychological Association. So far, psychologists in the Department of Defense can prescribe medication, along with those in New Mexico, Louisiana and Illinois. Just this week, lawmakers in Iowa approved a similar bill. Supporters of the Hawaii bill say those states can serve as a model for increasing access to mental health care. Outreach workers say Hawaii is in the midst of a mental health crisis. More Hawaii residents die by suicide than in car accidents, according to the Hawaii Department of Health. There's long been a lack of mental health treatment options for teens, while mentally-ill adults face similar problems with overcrowding at the state's psychiatric hospital. The Hawaii Medical Service Association and the Hawaii Association of Professional Nurses were among organizations supporting the bill, saying it could fill a gap in services for those who live in rural areas of the state. "The mental health needs of individuals across our state continue to outweigh the capacity of our mental health system," said Jill Oliveira Gray, a clinical psychologist who has practiced in rural Hana, Maui and Molokai. The psychiatrists in rural areas are severely overbooked and unable to provide patients the attention they need, Gray said. But opponents including the American Psychiatric Association and the Hawaii Medical Association say the bill would put Hawaii residents with mental illness at serious risk. They say some psychologists might not have the proper medical training needed to safely prescribe drugs that can cause deadly reactions, especially when mixed with other medications. Depending on the school and degree program, some people may not be qualified to prescribe potentially harmful medication, especially if their courses were predominantly taught online, Rep. Richard Creagan said. The bill also doesn't ensure that psychologists will practice in rural areas, he added. "If they follow the money, as their colleagues expect, they will go to where the money is - and that is not in the rural areas," Creagan said. Saul Levin, medical director American Psychiatric Association, opposed the bill, saying psychologists would be required to take an exam created by the same organization that accredits "haphazard" degree programs. "These dangerously low and inadequate requirements must be taken into consideration," Levin said. "And any proposed training standards must be compared to the 12 or more years of medical education and training psychiatrists and other physicians receive to be able to safely care for any patient."

Crawford S.N.,University of Hawaii at Manoa | Lee L.S.K.,University of Hawaii at Manoa | Izuka B.H.,Hawaii Medical
Journal of Bone and Joint Surgery - Series A | Year: 2012

Background: Traditionally, distal radial fractures with marked displacement and angulation have been treated with closed or open reduction techniques. Reduction maneuvers generally require analgesia and sedation, which increase hospital time, cost, patient risk, and the surgeon's time. In our study, a treatment protocol for pediatric distal radial fractures was used in which the fracture was left shortened in an overriding position and a cast was applied without an attempt at anatomic fracture reduction. Methods: Consecutive patients three to ten years of age presenting between 2004 and 2009 with a closed overriding fracture of the distal radial metaphysis were followed prospectively. Our protocol consisted of no analgesia, no sedation, and a short arm fiberglass cast gently molded to correct only angulation. Patients were followed for at least one year. All parents or guardians were given a questionnaire assessing their satisfaction with the treatment. Financial analysis was performed with use of Current Procedural Terminology codes and the average total cost of care. Results: Fifty-one children with an average age of 6.9 years were included in the study. Initial radial shortening averaged 5.0 mm. Initial sagittal and coronal angulation averaged 4.0° and 3.2°, respectively. The average duration of casting was forty-two days. Residual sagittal and coronal angulation at the time of final follow-up averaged 2.2° and 0.8°, respectively. All fifty-one patients achieved clinical and radiographic union with a full range of wrist motion. All parents and guardians answered the questionnaire and were satisfied with the treatment. Cost analysis demonstrated that closed reduction with the patient under conscious sedation or general anesthesia is nearly five to six times more expensive than the treatment used in this study. Adding percutaneous pin fixation increases costs nearly ninefold. Conclusions: This treatment protocol presents an alternative approach to overriding distal radial fractures in children and provides the orthopaedic surgeon a simple, effective, and cost and time-efficient method of treatment. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2012 by The Journal of Bone and Joint Surgery Incorporated.

Use of supplement and alternative drugs continues to thrive and is becoming an increasing cause of concern since many of these substances may have unexpected or unexplained medical consequences. We present below the first reported case of hepatotoxicity from Hydroxycut(®) in Hawaii. Hawaii Medical Journal Copyright 2010.

Thompson D.,Hawaii Medical
Academic medicine : journal of the Association of American Medical Colleges | Year: 2010

Although depressive symptoms and suicidal ideation are common in medical students, few programs address this serious problem. The authors developed, and then tested the effectiveness of, an intervention meant to reduce reported depressive symptoms and suicidal ideation. To reduce the alarming reported rates of depression and suicidal ideation among medical students, the University of Hawaii John A. Burns School of Medicine implemented the following interventions: increased individual counseling for students, faculty education, and a specialized curriculum including lectures and a student handbook. Although counseling had always been available, a new emphasis was placed on facilitating an anonymous process and providing several options, including volunteer psychiatrists not involved in student education. In 2002 and 2003, the authors measured depressive symptoms and suicidal ideation in third-year medical students using, respectively, the Center for Epidemiologic Studies Depression Scale and a question about suicidal ideation from the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire. Before the intervention, 26 medical students (59.1%) had reported depressive symptoms, and 13 (30.2%) reported suicidal ideation. After the intervention, 14 medical students (24.1%) reported depressive symptoms (χ 2 = 12.84, df = 2, P < .01), and 1 (3%) reported suicidal ideation (χ 2 = 13.05, df = 1, P < .001). Programs that provide specific mental health support for medical students may significantly decrease the reported rates of depressive symptoms and suicidal ideation.

Yanagimachi R.,Hawaii Medical
Journal of Reproduction and Development | Year: 2012

Studies of mammalian fertilization progressed very slowly in the beginning because of difficulties in obtaining a large quantity of fully mature eggs at one time. With progression of techniques to collect and handle eggs and spermatozoa, research in mammalian fertilization advanced rapidly. Today, far more papers are published on mammalian gametes and fertilization than those of all other animals combined. The development of assisted fertilization and related technologies revolutionized basic research as well as human reproductive medicine and animal husbandry. Reproduction is fundamental to human and animal lives. The author lists a few subjects of his personal interest for further development of basic and applied research of gametes and fertilization. Each reader will probably have more exciting subjects of future investigation. © 2012 by the Society for Reproduction and Development.

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