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Life at a Grand Slam: What You Don’t See on TV at the U.S. Open

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When Mackenzie McDonald dueled Félix Auger-Aliassime for three and a half hours in the opening round of the U.S. Open, fans were only seeing a glimpse of the time McDonald put in toward his surprise win on Monday.

For both players, and hundreds of others at the sprawling tournament, a match day extends well beyond a warm-up and the contest itself. The preparation, of course, takes weeks and months, with the grueling men’s and women’s professional tennis tours pushing players to seek higher rankings to gain a more favorable path at the Grand Slam tournaments.

And once they arrive in Queens, a new series of obstacles emerges as players adapt to the feel of the courts, the ambience of New York and the demands of one of the world’s biggest sporting events.

For McDonald, the 28-year-old American who broke into the top 50 of the singles rankings in 2022 and upset Rafael Nadal in the second round of this year’s Australian Open, the preparation for the U.S. Open began on Aug. 22 when he arrived in New York. McDonald, who is scheduled to play Borna Gojo of Croatia in the second round on Wednesday, said he trained hard for his first few days, then tapered a bit to recover before his four-set duel against Auger-Aliassime.

Those practices, along with the travel, can become repetitive. Jessica Pegula, the American ranked third in women’s singles, last week compared the routine on tour to “Groundhog Day,” the 1993 film in which a man relives one day again and again. McDonald echoed that sentiment.

“Things can get monotonous week after week, locker room after locker room, hotel after hotel,” McDonald said. “It’s good to have those small goals or little things that drive you that make you believe that you can get better.”

Two days before his opening match, McDonald couldn’t focus solely on his play. Before practicing on Saturday, he had to stop by a fan event put on by Wilson, his racket sponsor.

His day began at about 8:45 a.m. as he made his way down to the lobby of his hotel in Manhattan’s Murray Hill neighborhood. A driver and S.U.V. were already waiting for him, his girlfriend and his trainer as they walked out of the hotel.

On a normal day, the drive from the east side of Manhattan to Billie Jean King National Tennis Center in Flushing Meadows Corona Park can take up to an hour in heavy traffic.

“It’s never easy,” McDonald said of the commute to Queens. “Day after day, it definitely adds up.”

But on a Saturday morning, with little traffic and an assertive driver familiar with shortcuts, the ride was a brisk 21 minutes 16 seconds.

The quick ride afforded McDonald some extra time to drop off his bags before heading to the Wilson event, where he spent about half an hour volleying with children, then posed for pictures and videos.

With that commitment filled, McDonald could focus on more intense tennis for the rest of his day, starting by working with a physiotherapist and finding time to eat, and following that with two hours of practice.

McDonald’s first hour of practice was scheduled at noon against Marcos Giron, another American player, on Court 4 near Arthur Ashe Stadium. As McDonald and Giron hit back and forth and played out points, dozens of fans stopped by to watch them. As their practice drew to a close, several of those fans began to gather courtside in hopes of an autograph or a picture. But McDonald had no time.

After shaking hands with Giron and his trainer, McDonald quickly grabbed his bags, and scurried off for his next practice on a court on the opposite end of the tennis center, nearly half a mile away.

To avoid having players walk that distance through a sea of fans, the U.S. Open has vans that shuttle them and their trainers out to the farthest practice courts. McDonald and his trainer hopped in a van, but the driver wanted to stay a few more minutes to see if any other players would come.

Already behind schedule, McDonald politely asked the driver if they could leave without waiting. In the early rounds of the tournament, when hundreds of players need to practice, court time is precious.

“They definitely show the glamour of the sport on TV,” McDonald said. “It is all the behind the scenes, it is the day to day and the around-the-year tournaments that we play that really get us to these moments.”

By the time McDonald arrived to his next practice court, it was just after 2 p.m., and the sun was beaming down with temperatures in the 80s. He trained for another hour before finally cooling down and heading back to his hotel to rest.

On Sunday, McDonald wanted to scale back his workload to only an hour of tennis, so he could be fresher for his match the next day. He still did not know his exact playing time, but because it would likely be in the afternoon, McDonald said he hoped to have an afternoon court slot on Sunday.

He was scheduled for 4 p.m. against Lloyd Harris of South Africa on Court 5, where McDonald was scheduled to play the next day.

“Way more of a chiller day for me,” McDonald said, adding that the rest of his Sunday would be spent resting, hydrating and taking “my mind off of tennis for a bit.”

But even when he’s not training, McDonald said there’s other preparation that goes into playing a match, including creating a game plan and looking over analytics.

“The mental preparation for my match on Monday started once that draw came out,” he said.

Before McDonald’s match on Monday, there were three others scheduled on Court 5, starting at 11 a.m. Being scheduled later in the day often leaves players trying to figure out how long each of those matches will last so they can plan an ideal time to leave their hotel.

But trying to make those predictions can be a gamble when rain or a lengthy five-set men’s match can delay another match’s start time. At majors, McDonald said that he likes to arrive four hours before a match to be treated by a physiotherapist, hit with a partner for half an hour, have lunch and then prepare his sports drinks and rackets.

“There’s definitely a lot of little nuances that go in part of each day that you’re really submerged in,” he said. “Everything’s invested toward what’s going to prepare me best to play this match today.”

McDonald and Auger-Aliassime finally took Court 5 around 5:45 p.m., and after a quick warm-up, it was 5:51 p.m. when the umpire, Jaume Campistol, said: “Ready? Play.”

From the beginning, it looked like the match was going to be a long duel. It took an hour and nine minutes for McDonald to win the first set on a tiebreaker.

Auger-Aliassime took the second set, but after that McDonald settled in. As McDonald and Auger-Aliassime played on, cheers from Arthur Ashe Stadium overflowed out of the venue, and they could be heard on Court 5. At one point in the fourth set, Auger-Aliassime appeared to complain to the chair umpire about the noise coming from Ashe.

Eventually, after more than three hours on the court, McDonald prevailed, winning the last five points of the fourth set to win, 7-6 (5), 4-6, 6-1, 6-1, and advance to the second round.

Before his win, McDonald said that each incremental victory is what motivates him on tour. The drive to advance, he said, pushes him through long practices, commutes and extensive travel.

“I want to win a title so bad,” said McDonald, who has made one singles final in his career, losing to Jannik Sinner of Italy at the 2021 Citi Open in Washington, D.C. “I always find that each week, your opportunity each week, can be that week that can shift things, and I think that dream is what we’re all chasing.”

And after he beat Auger-Aliassime, the routine of mental and physical preparation began again for Round 2.

Biden Administration Unveils First Drugs for Medicare Price Negotiations

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The Biden administration on Tuesday unveiled a long-awaited list of the first 10 medicines that will be subject to price negotiations with Medicare, kicking off a landmark program to reduce drug spending that is being fought by the pharmaceutical industry in court.

The medications — which treat diabetes, cancer and other conditions — are taken by millions of older Americans and cost Medicare billions of dollars annually. The Centers for Medicare & Medicaid Services selected the drugs through a process that prioritized ones that account for the highest Medicare spending, have been on the market for years and do not yet face competition from rivals. Additional medications will be selected for price negotiations in the coming years.


1. Eliquis, for preventing strokes and blood clots, from Bristol Myers Squibb and Pfizer

2. Jardiance, for diabetes and heart failure, from Boehringer Ingelheim and Eli Lilly

3. Xarelto, for preventing strokes and blood clots, from Johnson & Johnson

4. Januvia, for diabetes, from Merck

5. Farxiga, for diabetes, heart failure and chronic kidney disease, from AstraZeneca

6. Entresto, for heart failure, from Novartis

7. Enbrel, for arthritis and other autoimmune conditions, from Amgen

8. Imbruvica, for blood cancers, from AbbVie and Johnson & Johnson

9. Stelara, for Crohn’s disease, from Johnson & Johnson

10. Fiasp and NovoLog insulin products, for diabetes, from Novo Nordisk

Ukraine Steps Up Evacuation Calls as Russia Attacks in Northeast

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Yevgeny V. Prigozhin, the Russian mercenary chief who died in a plane crash last week, has been buried in a private ceremony in St. Petersburg, his press service said on Tuesday, ending days of speculation over how he would be laid to rest.

The announcement on the Telegram messaging app came as a surprise. Hours earlier, the Kremlin said it had no information about Mr. Prigozhin’s funeral except that President Vladimir V. Putin would not attend.

Mr. Prigozhin’s funeral “took place in a private format,” his press service said. “Those wishing to say goodbye can visit the Porokhovskoye cemetery” in St. Petersburg.

On Tuesday afternoon, the Porokhovskoye cemetery was being heavily guarded by Russian police, riot police, and national guardsmen, who did not allow people to enter, suggesting the lengths the state has gone to to keep the public mourning for Mr. Prigozhin at a minimum.

Details about Mr. Prigozhin’s funeral, including the date and whether members of the public would be allowed to attend, were unclear for days. Rumors had swirled about ceremonies at other cemeteries, though Porokhovskoye had not been mentioned, and police had cordoned off some of them and set up metal detectors at the Serafimovsky Cemetery, where Mr. Putin’s parents are buried.

Police officers at Mr. Prigozhin’s grave.Credit…Nanna Heitmann for The New York Times

The secrecy reflected the sensitivities surrounding Mr. Prigozhin, a longtime ally of Mr. Putin who launched a failed mutiny against Moscow’s military leadership in June. He was killed along with nine others, including top leaders of his Wagner private military company, in the crash of a private jet northwest of Moscow last Wednesday.

Mr. Prigozhin had received the Hero of Russia designation, one of the Russian military’s top honors, which generally accords special burials, including an honor guard and a military band.

The confusion was in line with the murky details about the crash. Its cause remains unclear, but U.S. and Western officials believe it was prompted by an explosion on board. Many Western officials have said they think it is likely that Mr. Putin may have played a role in having Mr. Prigozhin killed as retribution for the mercenary chief’s short-lived mutiny in June.

After the crash, Russian authorities released the plane’s flight manifest, showing the names of the 10 people who were supposed to be on board, and said that all aboard had been killed. That left room for days of speculation about whether Mr. Prigozhin was really on the plane.

The deaths were not officially confirmed until Sunday, when Russian investigators said that genetic testing showed that the victims of the crash matched the names on the manifest.

Video

People paid tribute to Yevgeny V. Prigozhin, the Russian mercenary chief, and Dmitri Utkin, a longtime lieutenant.CreditCredit…Nanna Heitmann for The New York Times

Wagner’s logistics chief, Valery Chekalov, who was also on the plane, was buried Tuesday morning in Northern Cemetery in St. Petersburg, in a ceremony that was not publicized in advance. Several hundred people came to pay their respects.

Some analysts speculated that the Russian authorities were seeking to avoid a public outpouring of support for Mr. Prigozhin and his top lieutenants.

“It seems that the authorities, as expected, want to avoid a spontaneous rally in memory of the top leadership of Wagner and to do so, have imposed a fog around the burial place,” Farida Rustamova, an independent journalist, wrote on the Telegram messaging app.

Valeriya Safronova, Nanna Heitmann and Jesus Jiménez contributed reporting.

U.K. Flights to Be Disrupted for Days After Air Traffic Control Glitch

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Flights in and out of Britain will be disrupted for days, the U.K. government said on Tuesday, after a technical issue with the country’s air traffic control system left thousands of passengers stranded abroad or facing severe delays.

Around 280 flights were canceled on Tuesday, about 5 percent of the total scheduled to leave or arrive in Britain, according to Cirium, an aviation analytics company, compounding travel woes for British holidaymakers after more than a thousand flights were canceled the day before.

The trouble came at a particularly busy time for travelers in Britain, many of whom were returning home from summer vacation or long weekends because Monday was a public holiday in the country.

“The timing was not at all helpful for people,” Mark Harper, the government minister responsible for transport policy, told the BBC on Tuesday morning. “It’s disrupted thousands of people. Lots of flights were canceled yesterday because of the imperative to keep the system working safely, and it is going to take some days to get completely everybody back to where they should be.”

He added that the government’s technical experts had concluded that the episode was not a cyberattack.

Britain’s National Air Traffic Service, which runs air traffic control, said on Monday that a failure of the automatic system that processes plane routes meant that, for several hours, flight plans had to be entered manually.

When air traffic control issues arise, the priority is to safely land planes that are already in the air, experts said, forcing hundreds of flights to be temporarily grounded or canceled. They added that the delays continued on Tuesday in part because aircraft and crews were out of position.

Juliet Kennedy, the operations director of the air traffic service, apologized in a video on Monday night, and added that “it will take some time for flights to return to normal.” She said the company would thoroughly investigate what had caused the glitch.

In a statement issued late Tuesday, the agency said its initial investigation found the problem related to “some of the flight data we received.” It said its findings would be made public.

Passengers have been urged to check the status of their flight with their airline before traveling to the airport.

How the War in Ukraine Turned Tennis Into a Battlefield

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Before becoming a soldier, Stakhovsky was a pro tennis player, and a very successful one: He was ranked as high as 31 in the world and had more than $5 million in career winnings. He is best remembered for beating Roger Federer at Wimbledon in 2013. I was there and watched slack-jawed as Stakhovsky, playing serve-and-volley tennis, a style that had become virtually obsolete, took out the then-seven-time champion on Centre Court. In the news conference that followed, the Ukrainian joked, “I can definitely tell my grandchildren that, yeah, I kicked the butt of Roger Federer.” He lost his next match, but the win over Federer ensured him a permanent place in tennis trivia. That he is now a combatant in war is hard to believe, and as I walked around Wimbledon this year, I found myself thinking about Stakhovsky and his journey from tennis whites to military fatigues.

In early August, while he was off-duty in Kyiv, I spoke with Stakhovsky by video. He told me that he was vacationing in Dubai with his family when the war started. The city was hosting a men’s tournament that week, and he said he was with two Russian players, Rublev and Karen Khachanov, the night before. Stakhovsky had just retired from tennis and was residing in Budapest; he had not lived in Ukraine since he was 12. But with his country under attack, he felt obliged to join the war effort. He left Dubai and arrived in Kyiv on Feb. 28, four days after the Russians invaded. “I did not have any other option,” he said. “I could not imagine sitting outside of Ukraine and screaming for other people to help Ukraine.”

He said he was friends with a number of Russians when he was on the tour and had heard from a few of them. Mikhail Youzhny, a former Top 10 player, texted him periodically. “Sometimes I reply, sometimes I don’t,” Stakhovsky said. He told me that at the French Open last year, where he was trying to raise money for Ukraine, he ran into Khachanov in a hallway, and the Russian simply brushed past him. He mentioned a comment that Medvedev made at Wimbledon this year, about being in favor of peace. “Everybody is in favor of peace,” Stakhovsky said. “I’ve been in Bucha; I’ve seen the bodies. For us, unfortunately, peace is something that we will have to earn with blood.” He recalled that Medvedev’s parents had once approached him about coaching their son early in his pro career. (Medvedev did not reply to a request for comment, and Khachanov declined to comment.)

Near the end of our conversation, we talked about the match against Federer, and I asked if he had been in touch with the Swiss star. Stakhovsky, who is 37, said that he had, and he began scrolling through his phone. He saw that Federer had reached out twice in March 2022, to check in on him and to express his sorrow over the situation. I brought up the comment that Stakhovsky had made about his grandchildren and kicking Federer’s butt. He laughed ruefully. “Now I just hope that I will get to see my grandkids,” he said.

Alexandr Dolgopolov, too, is in uniform for Ukraine. He played professionally for more than a decade and attained a career-high ranking of 13 before retiring in 2021. These days, he is a drone operator close to the front lines. He spoke to me from his apartment in Kyiv, where he was recuperating from a concussion he suffered when a shell landed near his trench. He was resigned to the danger he faces in combat. “They try to destroy us, we try to destroy them, that’s how it works,” he said with a shrug. He was wearing a Diadora T-shirt, a reminder of his past; Diadora is the Italian sportswear company that sponsored him.

‘The Mountain Will Make Cowards Out of All of Us’

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Nate Boyer looked up as he began his ascent of Hope Pass about 40 miles into the Leadville Trail 100-mile race. The four-mile section rose 3,200 feet in elevation, taking runners to 12,600 feet above sea level. He would have to conquer the steep grade, run seven miles down the other side to a turnaround and repeat the process. The sun beat down as he maneuvered the trail, devoid of any shade.

“It’s ironic it’s called Hope Pass, because that’s the most hopeless feeling,” Boyer, 42, said after the race. “Like you are pushing the hardest you can to take the next step — and you’re not gaining ground.”

At mile 47, Boyer accidentally jammed his left foot under a rock. His shin swelled, and his leg throbbed. Fifty-three miles to go, he told himself. Keep moving.

Life in football had involved an entirely different kind of pain.

David Vobora, 37, started throwing up when he began the Hope Pass climb. He alternated between walking and jogging as he vomited. A runner in her 50s stopped and rubbed his back as he hunched over again.

At one point, Boyer and Vobora met on the trail. They hugged and offered words of encouragement. The two have been friends for years — and their experience with difficult physical challenges set them apart from most of the other runners.

Vobora was the last pick in the 2008 N.F.L. draft, earning the annual title “Mr. Irrelevant.” He worked his way up to starting linebacker for the Rams and then the Seahawks during a four-year career.

Boyer, a former U.S. Army Green Beret who went on to play football at the University of Texas, was an undrafted free agent who played long snapper in preseason games for Seattle in 2015.

Now, both men were trying to become the first former N.F.L. team members to finish the punishing 100-mile race before the 30-hour cutoff.

“Just being up against that distance, that elevation, that length of time — the mountain will make cowards out of all of us,” Vobora said. “It feels more spiritual than you versus an opponent. It’s you versus who will show up internally.”

After Vobora’s N.F.L. career, he founded the Adaptive Training Foundation in Dallas, which provides free training and community to wounded, ill and injured military veterans and civilians. He became interested in running Leadville after pacing a friend for 18 miles in 2021.

Vobora had started running during the pandemic. He ran 10 miles one day and felt surprisingly fine afterward. In April 2021, he completed a marathon, running loops around a pond, and then tried 100 miles in 24 hours, finishing with nine minutes to spare.

“I was a total mess afterward,” Vobora said. “Laying on the ground. I couldn’t eat. I was peeing blood.”

But he said he had also thought, “How far could I take this?”

To prepare for Leadville, Vobora started an intense training schedule. He stopped drinking alcohol and ate only meat and fruit, dropping from 255 to 205 pounds to adopt a more runner-like build.

“Before Leadville, it was about taking on the task and having the buckle,” he said, referring to the belt buckle runners receive for finishing. “Now it was, ‘You’re going to do this because you said you would.’ The stakes were so high, and it took 100 percent of me to train, maybe for the first time since football. That was something I had missed.”

Boyer is a filmmaker and a co-founder of Merging Vets and Players, a nonprofit organization that helps combat veterans and former professional athletes make transitions to new lives. He also hosts the Discovery Channel show “Survive the Raft,” in which contestants work together on a raft to complete challenges.

In 2022, Boyer ran the Austin Marathon and, five weeks later, a 50K. After the latter race, he said, he didn’t feel the bone and joint soreness he had experienced after the marathon.

“I thought, ‘That’s interesting,’” Boyer said. “‘Maybe I’m more made for this distance?’”

So Leadville it was.

“I don’t know if it’s about running at all,” Boyer said. “It’s the challenge of seeing what your body is capable of. A lot comes from a very deep-seated insecurity, most likely — feeling like you need to do something incredible with your life..”

The Leadville 100, which begins and ends in Leadville, Colo., started at 4 a.m. on Aug. 19. Runners traverse the Rockies in what organizers describe as a “true elevation roller coaster.” High-altitude sections, trails and paved roads, and technical sections of the Colorado Trail combine for over 15,000 feet of net elevation gain.

Seven hundred runners ranging in age from 18 to 72 started the race. Only 365 finished within the time limit.

Six and a half hours after the start, Boyer entered Twin Lakes, the aid station at Mile 37.9. His three-person crew laid out gummy worms, bars and gels for energy, pretzels and other snacks. Boyer sat in a folding chair and changed his socks and shoes. He drank coconut water and ate blueberries and a banana.

“My legs are killing me,” Boyer said. “My back hurts. And I’m dehydrated.” He paused and smiled. “Otherwise, life is great.”

A couple of hours later, Vobora jogged into Twin Lakes. His eight-person crew had set up a tent near the aid station entrance.

His tone was all business. “The things that hurt the worst are my knees,” Vobora said, who also said he was cramping.

His wife, Sarah, unpacked and repacked his bag. “Pack the big gloves,” Vobora said. “My hands went fully numb this morning.” Temperatures seesawed from the low 40s at the start to the high 70s midday and back into the 40s that night.

“I feel like I should be further than 38 miles,” Vobora said, chuckling, as he started jogging away. “My energy is good. My stomach has been all over the place. I’m trying to force-feed myself so I can have all the energy for the climb back up Hope Pass the second time. My main thing is the clock. The time stamp getting back over to Twin Lakes before 10 p.m. That’s the cutoff, right?”

Vobora had arrived in Leadville two weeks before the race to acclimate to the elevation. He had a detailed 28-hour race plan: go fast on the downhills, aggressively hike the ascents. Remain steady on the flats. While football is a team sport in which everyone must work together, for Leadville, Vobora would be running alongside people with their own individual goals and motivations. He liked that distinctive challenge.

“Of the hundreds of miles leading up to this race, I’ve probably felt good in about 10 percent,” Vobora said before the race. “Maybe 20 if I’m being liberal. The rest have just been work.”

After almost 17 hours on the course, Vobora trudged back into Twin Lakes. On Hope Pass, he hadn’t stopped vomiting for three hours. He had experienced intense cramping. A medical official had recommended that he drop out, and he relented.

As he rode the shuttle down the mountain, he leaned his head against the window and bawled.

“Damn it, man,” he said, his voice catching. He started talking about his strategy for next time: He would put someone at every aid station. “They’ll have a bag and say, ‘Here,’ and I’ll keep running. I know I can run this thing.”

Vobora walked to the tent where his crew waited. He and his best friend, Mo Brossette, also a member of his support team, tried to determine what had happened: too many salt tablets? Too much food?

“I’m so mad right now, dude — and I’m so sorry, you guys,” Vobora said to his crew.

The next day, Vobora reflected in a text message: “More and more grateful each moment that I did not complete it. Because the questions I am asking and the places I am exploring … I couldn’t be here without it.”

Boyer had arrived in Colorado the day before the race, staying in a hotel 40 minutes away from the starting point. As darkness fell and the temperatures dropped, he tried not to overthink the miles he had left. “Focus on what you can do in these next few steps,” Boyer had said before the race. “The mountain won’t look like it’s getting any closer if you keep looking at it.”

Vobora said the physical challenge of an ultramarathon was entirely different from the pain of playing football, which he said involved “short bursts that are very aggressive, warring, violent actions.”

He continued: “Ultramarathoning is the complete opposite side of the coin. It involves patience. It involves the state of sort of equanimity to approach difficulty and pain.”

Chris Long, an 11-year N.F.L. veteran who now has a foundation dedicated to providing education and clean water around the world, is a friend of both Vobora and Boyer; both have worked with him on foundation projects.

He said their experience in football had prepared them well for the challenge of Leadville.

“Playing in the N.F.L. teaches you how to turn your brain off, put your head down and work,” Long wrote in an email. “You get good at going to your ‘happy place’ and distracting your mind from the challenge itself.”

After more than 24 hours on the course, Boyer crested the second-to-last hill. Stars were scattered across the sky as he ran, headlamp on, toward the finish line a block south of Leadville’s main street. Small pockets of spectators cheered as he jogged the final ascent.

“Let’s go, Nate — what a finish!” Mitch Moyer, his crew chief, yelled as he ran alongside Boyer.

Boyer finished in 24 hours 31 minutes 7 seconds. The announcer called his name out to the nearly empty stands. Boyer was the 57th male finisher and the 63rd finisher overall. He embraced Merilee Maupin and Ken Chlouber, the race’s co-founders.

“Do you want anything?” Moyer asked.

“Is there any beer?” Boyer asked, smiling. Moyer handed him a nonalcoholic beer. “That’s actually better,” Boyer said. His walk turned to a hobble, and he began to shiver.

Racers who finish in under 25 hours receive a bigger buckle than other finishers get. As Boyer walked to retrieve his, the pain started to set in.

“Is running fun for me?” he said, laughing. “No. It’s not. It’s therapeutic — but therapy is not always fun. There’s nothing better than finishing a run, no matter what the distance. The worst part is starting it, and the best part is finishing it. Everything in between is up and down.”

Live worm found in Australian woman’s brain

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STORY: The patient was first admitted to hospital at the start of 2021 following abdominal pain, fever and coughing, before being referred to Canberra Hospital the following year when Australian woman started experiencing memory loss and depression.

Infectious diseases physician Dr. Sanjaya Senanayake told Reuters he was working in the hospital the day of the discovery and was called in to provide advice as neurosurgeon Dr Hari Priya Bandi pulled the 8-centimetre (3.1-inch) long parasitic roundworm from the brain of the 64-year-old patient.

The patient was a “very courageous and patient patient who went through this long diagnostic and therapeutic process”, said Dr Senanayake, adding that the hospital was “keeping a close eye on her and keeping in touch” following treatment.

The worm, Ophidascaris Robertsi, is usually found in pythons and had not been documented in humans before.

Hundreds of Flights Canceled After ‘Technical Issue’ With U.K. Air Traffic Control

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Airlines were forced to cancel hundreds of flights and delay hundreds more on Monday after Britain’s air traffic control service experienced a “technical issue” that caused widespread disruption on one of the country’s busiest travel days of the year.

More than 200 flights departing from Britain were canceled, according to Cirium, the aviation analytics company, along with 271 that were scheduled to arrive in the country on Monday. Many other flights would be delayed by more than eight hours, “which will inevitably result in a cancellation,” Cirium added.

NATS, Britain’s National Air Traffic Service, said a technical problem had affected its ability to automatically process flight plans, which meant that the information had to be entered manually, slowing down the process.

While British airspace was not closed at any time, NATS restricted the number of flights departing from and landing at airports in order to maintain safety while its engineers tried to fix the problem. At about 3 p.m. local time, NATS said it had resolved the issue, but noted that air traffic remained disrupted. Britain’s government has a 49 percent stake in NATS, which is a public-private partnership.

The delays hit during a particularly heavy travel period, as people returned from summer vacations or extended weekend trips on Monday’s “bank holiday,” or national day off, in Britain.

Thousands of holidaymakers spent hours stuck in departure lounges or on runway tarmac, facing long delays and uncertain departure times.

In Palma de Mallorca, Jon Hughes, 49, boarded a plane bound for the English city of Leeds at about 1 p.m. local time with his two children, ages 13 and 15. Once seated, he said, they were told that the plane had been allotted a departure slot in about seven hours.

“It’s very hot and kids are getting restless,” he said in a message. “We don’t know how long we will be stuck on the plane. Or even if we will get home today.”

Two hours after NATS said it had resolved the technical issue, Mark Harper, the government minister responsible for transport policy, said flights were still affected, and advised travelers to “be aware” of their rights when flights were delayed or canceled.

Heathrow Airport, near London, advised passengers to contact their airline before heading there, and Edinburgh Airport told passengers not to leave home before checking the status of their flight.

Jamie Steele, 39, a British nurse returning to Manchester from a vacation in the Italian city of Pisa, had been set to depart at 10.30 a.m. local time. Four hours later, he was still sitting in the plane on the tarmac. The pilot told passengers that the plane would have a departure slot in the next three hours, but added that he was “not sure he trusts the time given.”

“It’s difficult not knowing the time we will get home,” Mr. Steele said in a message.

Louise Haigh, the lawmaker in charge of transportation policy for the opposition Labour Party, described the disruption as “extremely concerning for passengers” on “one of the busiest days of the year.”

The number of flight departures during the three-day holiday weekend had been scheduled to be 10 percent higher than the same period the year before, according to Cirium, and 83 percent higher than in 2021, when the Covid-19 pandemic drastically reduced air travel.

Alex Macheras, an aviation analyst, said the backlog of flights would cause flight disruptions for several days.

“That’s probably the worst timing ever given it’s the end of August, which is typically one of the busiest weeks of the calendar year,” he said.

Mr. Macheras said that compared with last summer, when there were numerous cancellations and delays, this summer’s air travel in Britain and continental Europe had been “smooth sailing” until Monday.

The disruption is expected to have little effect on overall operations for U.S. airlines, which collectively had just over 140 planned flights to or from Britain on Monday.

European flights were disrupted for hours in December 2014 because of a technical problem at NATS’s air traffic control center in Swanwick, England.

Niraj Chokshi contributed reporting.

Mental Health Spending Surged in Pandemic, Study Finds

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Use of mental health care increased substantially during the coronavirus pandemic, as teletherapy lowered barriers to regular visits, according to a large study of insurance claims published Friday in JAMA Health Forum.

From March 2020 to August 2022, mental health visits increased by 39 percent, and spending increased by 54 percent, the study found. Its examination of 1,554,895 claims for clinician visits also identified a tenfold increase in the use of telehealth.

The study covers visits for around seven million adults throughout the country who receive health insurance through their employers, so it excludes many patients with very severe mental illnesses, and it does not cover acute or residential care.

The increases are likely to be sustained, even as insurers weigh the benefit of continuing to pay more, said Christopher M. Whaley, a health care economist at the RAND Corporation and an author of the study.

“This is a huge cost, and we pay for that cost through increased premiums and higher deductibles,” said Mr. Whaley, an associate professor at Brown University.

On the other hand, he added, patients with unmet mental health needs are less likely to take their medications, and more likely to turn to emergency rooms in crisis, behaviors that also shift large costs onto insurance pools.

“The insurer’s challenge, and what we should think about as a health care system, is what cost is actually bigger,” Mr. Whaley said.

Most of the mental health visits were for anxiety and depression, which made up 45 percent and 33 percent of the total visits, respectively; post-traumatic stress disorder visits made up 10 percent; bipolar disorder, 9 percent; and schizophrenia, 2.6 percent.

Of the five diagnoses, anxiety disorders saw the steepest increase in visits during the pandemic, of 73.7 percent. PTSD visits increased by 37 percent; bipolar disorder visits by 32 percent; and depression visits by 31.9 percent. Schizophrenia visits did not change.

Researchers were surprised to discover that the use of telehealth for mental health did not decline with the end of the pandemic, as it did in other areas of medicine.

“This is the one area of the health care system where patients and providers in some sense are voting with their feet,” Mr. Whaley said.This is a change that seems to last beyond the pandemic.”

The rise in use of mental health services reflects both receding stigma and a lowering of practical barriers to mental health visits, said Dr. Robert L. Trestman, the chairman of psychiatry at Virginia Tech’s Carilion School of Medicine, who oversees a psychiatric system in western Virginia.

In his own system, Dr. Trestman said, the pandemic years brought an “incredible increase in billing” for patients with anxiety and depression. Historically, nearly half of all people with symptoms of these disorders have not received mental health care, he said.

As more people seek care, the numbers “are actually more consistent with the underlying epidemiology that we might expect,” he said.

“They were restricted by having to find a clinician, to take time off work to go see them,” said Dr. Trestman, who is also the chairman of the American Psychiatric Association’s council on health care systems and financing. “With the public health emergency and the expansion of telehealth, those limitations really evaporated.”

He added that he expected the trend to continue, as Americans manage financial and housing insecurity and repayment of loans after the pandemic.

“I’m seeing no evidence whatsoever of any decrease that we either see or can predict,” he said.

It is unclear whether insurers will try to rein in the higher level of spending.

Patients have long complained about the difficulty of getting mental health visits covered, despite the passage of a federal law, the 2008 Mental Health Parity and Addiction Equity Act.

Insurers will have to determine whether telehealth is preventing patients from accessing more expensive forms of care, like using emergency rooms for mental health crises, said Dr. Jane M. Zhu, an associate professor of medicine at Oregon Health and Science University who studied the accessibility of mental health services.

“It will trickle down at some point,” she said. “It will either mean that total spending is going to go up, if there’s a lot of people using telehealth, or insurers are going to be looking for ways to reduce their spending.”

Acceptance of telehealth varies among different populations, Dr. Zhu said. A study published in Health Affairs in 2022 found that people with schizophrenia were slower to switch to remote treatment, whereas those with anxiety and fear-related disorders were quicker.

A 2022 analysis by the federal Office of Health Policy found significantly lower adoption of telehealth among uninsured people and young adults. Video visits are highest among white people and higher earners, and lowest among less educated people; people over 65; and Latino, Asian and Black people.

Dr. Zhu said the rise in the use of services was striking.

“I have never seen anything like that in the literature,” she said. “Obviously, this is a completely new time period we’re in.”

Olivia Raymond Releases Her Debut Novel – “Deadly Secrets From Pond Island” The First Installment of Her Vanessa Hutchins Mystery Series

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“Deadly Secrets from Pond Island” is one of those rare mystery novels that has received 5-Star pre-publication accolades from major media book reviewers. Readers will have a difficult time putting the book down.

Indiana, August 28, 2023 – It may be Olivia Raymond’s debut novel, but Deadly Secrets from Pond Island establishes her as a master wordsmith. Released August 28 on Amazon, this captivating story offers everything mystery book enthusiasts crave. From start to finish, this author has managed to captivate the minds of all who open the book.

The book opens with its main character, Vanessa Hutchins, experiencing a strange vision that changes her life forever. Acting upon deep impulse, she ditches her successful law career, purchases a house sight unseen, and flees the big city in search of a more fulfilling life in rural America.

When she opens the door to her new small-town home, she’s greeted by a massive hoard three decades in the making. Left with no choice, she begins the great purge and soon reveals a horrific truth. Did someone go to great pains to protect these truths from ruin, or from fear they may confirm dark suspicions?

As rumors surrounding the new girl in town grow, Vanessa’s idyllic life becomes endangered. Does she ignore what she found? Or does she expose an even uglier truth destined to topple the town’s revered heroes, jeopardize her new friends’ lives, and possibly silence her own?

Reader Testimonials always tell the story. This book was able to gather memorable reviews before it was even published.

Janet Davies, ABC7 News, Chicago, said, “Deadly Secrets from Pond Island doesn’t disappoint. An intricate web of plot lines bringing to life the author’s characters in an extraordinary way. Don’t think as you read you have the story figured out. Clever plot twists!”

K.C. Finn, Author, The Book of Shade, had this to say, “Author Olivia Raymond has penned a truly compelling page-turner that deftly explores themes of discovery, justice, and the consequences of unveiling hidden truths. Reading Deadly Secrets from Pond Island was an engaging experience rocketing through a plot masterfully woven with suspenseful twists and turns, and I’d highly recommend it to other mystery and thriller fans to enjoy.”

Rabia Tanveer, Author, Melodies of the Mind, commented, “Packed with action and intense drama, Deadly Secrets from Pond Island was everything I expected it to be and more. Author Olivia Raymond weaved magic into the story with her words. The suspense surrounding the town and the secrets it held were fascinating. I hope Olivia Raymond has more planned for Vanessa because I want more.”

About The Author:

Olivia Raymond was born in the small town of Greensburg, Indiana, known as “Tree City,” due to the mulberry tree growing out of its courthouse tower. Her family moved to Indianapolis when she was seven years old, but by then, the allure of small-town living had already taken root. Olivia enjoyed several careers with a focus on public relations and marketing.

The experiences she gained provide inspiration for her stories. She now resides in a small town with her family and sweet furry companion, Mr. Ralf, where she enjoys her time as a writer and volunteer for the arts in her community.

To read more about Olivia Raymond’s new Vanessa Hutchins Mystery series, visit www.OliviaRaymond.com

Media Contact:

Olivia Raymond
Attn: Media Relations
Indiana
author@OliviaRaymond.com

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