Can George Ford’s return to fitness mask England’s Manu Tuilagi-shaped hole in their attack against Ireland?
Ireland will take on England for the first time in nearly a decade without Johnny Sexton or Conor Murray in their starting line-up on Saturday after Andy Farrell named an inexperienced half-back combination for Saturday’s Autumn Nations Cup showdown, but the absence of another high-profile player could well come to dictate how the encounter plays out.
The absence of Irish captain Sexton, forced by a hamstring strain suffered in last week’s win over Wales, and 89-Test veteran Conor Murray, who is left among the replacements, means Leinster fly-half Ross Byrne is trusted to marshall Ireland outside club colleague Jamison Gibson-Park, a pairing that have just two Test starts between them.
It is an area that England may look to expose by pressuring them in defence, just as they have done so in their last three outings. Earlier this year they secured a dominant 24-12 victory at Twickenham that could and should have been far larger given the dominance Eddie Jones’s side enjoyed, with the Six Nations victory coming six months after a record 57-15 thrashing in their World Cup warm up. The two wins came off the back of the victory that set England’s wheels in motion towards the Rugby World Cup final that year, with their 2019 Six Nations triumph in Dublin one of the performances of the Eddie Jones era to knock off the then-defending champions on their own turf.
But on all three of those occasions, England had a not-so-secret weapon: Manu Tuilagi.
The centre has featured six times against Ireland since his first appearance back in 2011, in a World Cup warm-up where he certainly made his presence felt. Tuilagi scored that day and nearly bagged another from an interception on his own 22, though Irish fans will also remember the painful memory of the tackle that ended David Wallace’s career that day.
READ MORE: How to watch Autumn Nations Cup on Amazon Prime
But rather notably, when Tuilagi plays, England win. Ireland have not won when the Sale Sharks midfielder has been involved, and given their back-to-back losses to the Irish in 2017 and 2018, his return to fitness 18 months ago and England’s sudden dominance in this fixture are no coincidence. Both sides operate on gainline success, and the presence of a 111kg powerhouse centre certainly helps to produce that.
Which is why his absence this week, and indeed through the whole of the Autumn Nations Cup and Six Nations next year due to a ruptured Achilles, provides the greatest intrigue of Saturday’s Twickenham encounter: can England beat Ireland without Tuilagi?
The answer is of course yes, but whether they have yet worked out how to do so remains a mystery. Though England have won their last two games by a cumulative 74-5, they did come against Italy and Georgia – tier two sides as both Eddie Jones and forwards coach Matt Proudfoot have hammered home in complete disregard of Italy’s efforts of late. Against an Irish side that
For the second time this week, a Dallas rapper has been shot as police grapple with a spate of violence in the city.
According to reports, a popular rapper – who is also a dentist – was shot inside of his Central Express Way office building just after 9:00 PM on just after 9:00 PM on Thursday night.
Dr. Rose, born Jerret Rosenborough, moonlights as a rapper, with over 150,000 followers on Instagram.
Unfortunately, Dr. Rose was one of three people wounded in a flurry of gunfire that shattered his office windows and riddled his SUV with bullets.
Dr. Rose and the other two victims drove themselves to local hospitals, where they are expected to survive their gunshot wounds.
The cops have no suspects as of press time, and they do not believe the shooting has anything to do with the death of rapper Mo3, who was gunned down on I-35 during an attack on Wednesday.
“My situation is completely unrelated to the death of Mo3, in fact, I’m a fan of Mo3. It hurts my heart to think a small portion of my city would think that I would join in on the controversy,” Dr. Rose said in a statement. “I’m a public figure, the work ethic and love that I put into my patients and community speaks volumes…I am very grateful to be able to say that I am recovering well with my family. I will be taking some time to focus on my recovery during this time. My office staff is working on reaching out to my patients to update them on next steps.”
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“The dentist was suffering from shock and trauma since he came back and wasn’t being able to get over that a family member was behind it. he was in shock,” said a police officer probing the case.
While the cops arrested 12 suspects within 24 hours, but the kingpin of the kidnapping racket identified as the brother-in-law of the dentist, is still at large and reportedly hiding in Maharashtra.
The kidnappers demanded a ransom of Rs 1 crore but the police foiled the plan.
Behjat Hussain suffered a heart attack on Wednesday morning upon which he was rushed to the hospital and later he died. The family members performed his funeral at a local graveyard in Hussaini Alam area in the old city.
On October 26, a team of 13 inter-state kidnappers abducted the dentist for ransom from his clinic at Qismatpur village, Bandlaguda Jagir under Rajendra Nagar police station limits and while the victim was being shifted to Bengaluru, a police team from Anantapur in Andhra Pradesh intercepted the car and rescued the doctor.
Former Vice President Joe BidenJoe BidenObama slams Trump in Miami: ‘Florida Man wouldn’t even do this stuff’ Trump makes his case in North Carolina, Ohio and Wisconsin Brad Pitt narrates Biden ad airing during World Series MORE (D) defended his mental acuity and took shots at President TrumpDonald John TrumpObama slams Trump in Miami: ‘Florida Man wouldn’t even do this stuff’ Trump makes his case in North Carolina, Ohio and Wisconsin Pence’s chief of staff tests positive for COVID-19 MORE during an interview airing Sunday on CBS’s “60 Minutes.”
Anchor Norah O’Donnell asked Biden about claims from the Trump campaign that he suffers from dementia, a general catch-all medical term for symptoms ranging from memory loss to impairment of problem-solving abilities.
“[You are] 78 years old. [You’ll be] 82 after four years. Donald Trump says you have dementia and it’s getting worse,” O’Donnell told Biden.
“Hey, the same guy who thought that the 911 attack was a 7-Eleven attack,” Biden responded, jokingly. “He’s talking about dementia?”
“All I can say to the American people is watch me, is see what I’ve done, is see what I’m going to do. Look at me,” Biden continued. “Compare our physical and mental acuity. I’m happy to have that comparison.”
If elected, Joe Biden would be the oldest president in American history. Here’s what he had to say about his physical and mental acuity: https://t.co/qh8sivDuZK pic.twitter.com/WSsHvN2dIT
— 60 Minutes (@60Minutes) October 26, 2020
The Trump campaign has sought to suggest in recent months that videos showing Biden speaking unclearly at times are evidence of the former vice president’s mental decline. Biden’s campaign has accused the Trump campaign in response of making light of the stutter from which the former vice president has suffered since he was a child.
“Did something happen to Joe Biden?” the text of an ad questioning his mental faculties produced by the Trump campaign asked in August.
Biden, who would be the oldest president ever elected, at 77, has frequently dismissed criticism on the manner from the Trump campaign. Trump himself was the oldest president ever elected upon his victory in 2016, when he was 70 years old.
“I’ve been tested and I’m constantly tested,” Biden said in June. “Look, all you gotta do is watch me, and I can hardly wait to compare my cognitive capability to the cognitive capability of the man I’m running against.”
Brian May thinks his heart attack may have been caused by coronavirus.
The 72-year-old rocker endured a “small heart attack” back in May this year, and at the time he said he was puzzled as to how the attack could have happened, because he is a “healthy guy” with “good blood pressure”.
And now, Brian thinks he might have gotten to the bottom of his health scare, as he believes he could have picked up coronavirus at the beginning of the year when his band Queen were still touring.
He said: “I think it’s possible that I had the COVID virus early on in the tour of Korea, Japan and Australia in January, and got through it, but it’s thickened the blood, which apparently it does, and that could have been the trigger that gave me the heart attack.
“I thought it was too early to get [COVID] but the evidence now seems to be that the virus was around.”
Brian previously said his heart attack lasted for “40 minutes”, and although he claimed he only experienced mild chest pain, he needed three tubes fitted into his arteries to help his blood flow.
And following his operation, Brian says it was his wife Anita who became his saving grace, as she helped nurse him back to health.
He added to the Daily Express newspaper: “She was incredible. She totally saved my life because I couldn’t do anything and she just kind of nursed me, so I will forever be in her debt. She did an incredible job on me.”
Brian’s heart attack was made worse by an unrelated gardening incident which occurred just days before, in which he suffered a torn muscle, and a compressed sciatic nerve.
Speaking about his injuries at the time, he said: “I had an MRI and yes, I did have a rip in my gluteus maximus. It’s so easy to make a connection, there’s a rip there so that must be the cause of the pain, end of story. And no other tests were done.
“Now, a week later I’m still in agony. I mean real agony. I wanted to jump at some points. I could not believe the pain. And people are saying, ‘That’s not like a ripped muscle’, so eventually I had another MRI.
“But this one I had one of the lower spine and sure enough we would discover that I had a compressed sciatic nerve, quite severely compressed, which is why I felt like someone had been putting a screwdriver in my back the entire time. It was excruciating …
“So that’s one side of the story, and I’m a lot better now. I’m free of that terrible pain that actually destroys your mind …”
Continued quality improvement in acute MI may be possible in the U.S. given lessons learned from another country with major geographic and other disparities in acute MI care and mortality: China.
Rural hospitals and those with fewer resources showed opportunities for improved care in China, according to findings from two registries now published online in JAMA Network Open.
“Many researchers believe that we have solved the STEMI [ST-segment elevation MI] problem, but the improvement in mortality has plateaued and we have made very little progress in reperfusion times for patients transferred from a non-PCI [percutaneous coronary intervention] center or outcomes for those with out-of-hospital cardiac arrest or cardiogenic shock,” wrote Timothy Henry, MD, of The Christ Hospital, Cincinnati, and James Jollis, MD, of Duke University School of Medicine in Durham, North Carolina, in an accompanying commentary.
The two studies suggest the U.S. still has a lead over China in acute MI care — but will it be able to keep it? The U.S. has been hurt by a fracturing of the national acute MI registry into multiple competing registries, which poses challenges to regional collaboration and quality improvement, Henry and Jollis suggested.
Meanwhile, they wrote, “China has rapidly embraced the best quality improvement models of the U.S.” and is even poised to surpass the collaborative systems of care in the States.
China saw persistent regional variations in the use of reperfusion and guideline-recommended medical therapy, one group reported from registry data.
Despite the launch of national health care reform in 2009, hospitals in the country’s center were 17% less likely to provide MI treatments to eligible patients than centers in western areas in 2011-2015 (adjusted OR 0.83, 95% CI 0.76-0.91), according to Yingling Zhou, MD, PhD, of Guangdong Provincial People’s Hospital.
“In the present study, we observed significant differences in the use of guideline-recommended treatments across China, with hospitals in the Western region having the best performance, particularly for clopidogrel [Plavix], ACEIs/ARBs [angiotensin-converting enzyme inhibitors/angiotensin receptor blockers], and statins,” the research group said.
Zhou’s team noted that the western region is the least economically developed region in China and has been subject to special government investment in public health starting in the year 2000.
Eastern China also improved processes of MI care from 2001-2006 to 2011-2015.
Across the board, use of guideline-recommended treatments increased from 2001-2006 to 2011-2015, and there was some improvement in care variation, study authors said.
“However, care delivery remains suboptimal and disparities remained across China when compared with that in the United States and United Kingdom where reperfusion therapy, β-blockers, and ACEIs/ARBs are used at much higher rates. Additional measures should be taken to further narrow regional care disparity across the country,” Zhou and colleagues urged.
Their cross-sectional study was based on the Patient-Centered Evaluative Assessment of Cardiac Events–Retrospective AMI project. A random sampling yielded 27,046 patients hospitalized for acute MI at 153 hospitals across China.
The country was divided into three geographic regions: eastern, central, and western. There were marked regional variations
By Steven Reinberg, HealthDay Reporter
THURSDAY, Oct. 22, 2020 (HealthDay News) — Homeless people are three times more likely to die after a heart attack than other patients, a new study finds.
“Our study shows a dramatically higher rate of mortality after heart attacks in people experiencing homelessness compared to non-homeless patients,” said researcher Dr. Samantha Liauw of the University of Toronto. “More research is needed to discover the reasons for this disparity in outcomes so that the chances of survival can be improved in this vulnerable population.”
Liauw and her colleagues compared more than 2,800 heart attack patients admitted to a Toronto hospital between 2008 and 2017. Of those, 75 were homeless.
Among homeless patients, 19% died in the hospital, compared with 6% of others. Homeless patients were younger than others and more likely to be men.
Eighty-four percent of homeless patients smoked compared to half of patients who were not homeless. Rates of high blood pressure, high cholesterol and diabetes were similar between the groups.
Also, more homeless patients suffered from mental conditions. They were more likely than others to abuse alcohol and drugs and were more likely to suffer a serious complication of heart attack called cardiogenic shock that occurs when the heart cannot supply enough blood and oxygen to the brain and other vital organs. They were more likely than other patients to go into cardiac arrest.
Both groups received medications, testing and stents, but the rate of stenting was lower in the homeless (80% versus 90% in non-homeless patients).
The findings were scheduled to be presented Wednesday at a virtual meeting of the 2020 Canadian Cardiovascular Congress.
“The elevated risk at a younger age could be related to chronic stress from being homeless, higher rates of smoking, poverty, and unreliable access to healthy food. Lack of trust in the medical system, poor access to health care for chronic conditions and slower receipt of emergency therapies may also have contributed,” Liauw said in a news release from the European Society of Cardiology, which will participate in the meeting.
Although both patient groups received timely treatment, she suspects the symptom start time listed for homeless people may be inaccurate, resulting in a longer gap before therapy began.
“This illustrates that we need new methods to study this disadvantaged part of society,” Liauw said.
Findings presented at meetings are considered preliminary until they’re published in a peer-reviewed journal.
Copyright © 2020 HealthDay. All rights reserved.
The virus now had the ability to potentially kill a patient — his patient — even if she wasn’t infected.
Hours before, Terry, a 47-year-old mother and wife, had suffered a heart attack in her Herriman, Utah, home. According to her sister, she had to be revived four times in the ambulance on the way to the nearest hospital.
Once there, the medical staff and her doctor quickly determined Terry would likely die if she didn’t get the more sophisticated life-saving treatment found in an intensive care unit of a larger hospital.
“He (the doctor) told us right away, we’re doing everything we can to try and find a hospital that can take Laurie, and we can’t find one,” Stephanie Deer, Terry’s sister, said.
“If you would have seen the look on that doctor’s face, he was incredulous. He couldn’t believe he was telling us this.”
Deer and her sister are not alone.
The state is experiencing “one of the worst (coronavirus) outbreaks in the country,” Utah Gov. Garry Herbert said Tuesday.
As a result, patients suffering other life-threatening medical events — non-Covid related — are in a dangerous competition for limited specialized medical care.
The state’s total ICU usage was at almost 70%, Herbert said Tuesday, and almost 16% of the state’s ICU beds are used to treat Covid-19 patients.
On Friday, the University of Utah hospital’s ICU was at 104% capacity.
Covid surge taking a toll on Utah doctors
Dr. Emily Spivak, among the doctors helping treat Covid patients in Utah, feels frustrated and upset by the surge in cases — because she said she knows this shouldn’t be happening. Coronavirus is preventable by hand washing, social distancing and mask wearing.
She reached her breaking point in a parking lot outside the level one trauma center where she works in Salt Lake City.
“Well I was trying so hard not to,” she said, referring to her tears. “I mean honestly this is just super frustrating.”
Spivak said she sees many people in public no longer following US Centers for Disease Control and Prevention guidelines — and believes they’ve just grown complacent.
“I don’t see an end. No one’s doing anything to stop what’s happening,” she said. “It’s kind of like people just are going out and living their lives not realizing that they are exhausting our healthcare system.”
Deer said she witnessed the frustration of doctors firsthand.
“I watched those nurses call for hours, trying other systems, doing everything they could, I mean desperate.” she said.
“I don’t know how the doctors and nurses and things are going to be able to keep this up when your whole life, your whole profession is dedicated to saving people’s lives and you can’t access medical care for a patient.”