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Nova Scotia rejects $900K request for cancer treatment covered by Ontario

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After three lines of chemotherapy and a clinical trial failed to cure Stephen Saunders, his doctors offered him hope: to send the Nova Scotia man to Boston and modify his T-cells to attack the cancer that’s otherwise left him with just months to live.

But at roughly $900,000 for treatment and the associated hospital stay, hope doesn’t come cheap.

Last week, Nova Scotia’s Health Department denied a funding request for Saunders, whose case highlights the ethical and economic dilemma that all provinces could soon be facing — whether to pay for a treatment that costs about five times more than other life-saving procedures like heart, lung and liver transplants.

Neither the health minister nor the medical director of the Nova Scotia Cancer Care Program would talk about the specifics of Saunders’s case.

But the Onslow Mountain man spoke openly to CBC about a life interrupted at 55 by a pain in his knee that turned out to be Stage 4 non-Hodgkins lymphoma. About how he tries to get in his 10,000 steps on the good days. And about how much he wants to live. 

« There’s all kinds of reasons why I want to stay living, things I want to do, » he said. « Watching my kids grow up and being with my partner… bigger projects, travel maybe if I could. »

The cost of a life

Work is underway to potentially offer CAR-T therapy closer to home, but that doesn’t change the question of funding. 

Health Canada approved the treatment in September and clinical trials have begun. And in about 18 months, the pan-Canadian Oncology Drug Review is expected to make a recommendation about the treatment’s value, which the provinces use when deciding whether it should be publicly covered.  

In the case of this treatment, it could be a life-and-death decision: in adults, CAR-T therapy is meant for patients whose blood cancer hasn’t responded to two or more lines of chemotherapy. 

Dr. Drew Bethune says that new treatments offer great promise but their cost can be challenging, especially when there’s limited data about their long-term success. (Steve Lawrence/CBC)

​ »It’s a very difficult world we live in, with very difficult heart-wrenching decisions, » said Dr. Drew Bethune, medical director of the cancer care program. Bethune is among those who advise the Health Department on whether to fund an out-of-province cancer care request, but he wouldn’t speak directly to Saunders’s case.

But he said that if looking at a request for CAR-T therapy, Nova Scotia would need to weigh the extreme cost, with the evidence of its success and how other Canadian patients who have received it have responded.

« As much as we just like to say, ‘Yes, let’s do it,’ it’s our responsibility to see what impacts it has on the whole [cancer] program, the expense of it. »

Other provinces

Exactly how many Canadians have gotten public coverage for the cancer therapy in the U.S. is unclear, but Ontario alone has sent 26 adult patients in the last two years, according to figures from that province’s Ministry of Health. 

Children might be more likely to qualify for out-of-province funding for this therapy, Bethune suggested. A 2018 clinical trial showed the children and young adults treated with CAR-T therapy had an 80 per cent chance of complete remission, while a trial involving adults with the same type of cancer as Saunders showed a 40 per cent complete remission rate.

« I think the evidence is fairly clear that the pediatric age group has a greater success rate with the treatment than the adult age group — but even in the adult age group some of the results are really excellent, » Bethune said.

And he said Nova Scotia would be watching how patients elsewhere in Canada have responded to CAR-T therapy.

Hailey MacDonald says it’s unfair that Ontario is paying for CAR-T therapy for some of its residents, while Nova Scotia has not offered to pay for her father. (Save Stephen Saunders/Facebook)

Saunders’s daughter, Hailey MacDonald, said the decision not to fund her father’s treatment is proof of the inequity in Canada’s health-care system.

The family can’t afford the cost on its own, but she’s holding out hope Nova Scotia may change its mind; she said she got a call from the Health Department on Friday saying it « hadn’t yet made a decision. » 

Her father is flying to the Dana-Farber Cancer Institute in Boston this week for a consultation, regardless of the response. 

« We understand as a family that this may not happen in time for my dad, » MacDonald said.

« We hope that that’s not the case, but there will be somebody else’s family member that will need this in the very near future. And Dad’s kind of paving the way for other patients. »

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Anglais

Nostalgia and much more with Starburst XXXtreme

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Get a taste of adventure with Starburst XXXtreme based on the legendary NetEnt Game. The nostalgic themes are sure to capture fans of the classic version as they get treated to higher intensity, better visuals, and features. The most significant element of the game is its volatility. Patience will not be an essential virtue considering the insane gameplay, and there is a lot of win potential involved. It retains the original makeup of the previous game while adding a healthy dose of adrenaline. 

Starburst Visuals and Symbols

The game is definitely more conspicuous than before. The setting happens over a 5-reel, 3-row game grid with nine fixed win lines, which function if a succession from the left to the right reel is present. Only those players that that attain the highest win per bet line are paid. From a visual standpoint, the Starburst XXXtreme slots illustrates lightning effects behind the reels, which is not surprising as it is inherited from the original version. Available themes include Classic, Jewels, and Space. The game is also available in both desktop and mobile versions, which is advantageous for players considering the global pandemic. According to Techguide, American gamers are increasingly having more engaging gaming experiences to socialize to fill the gap of in-person interaction. Starburst XXXtreme allows them to fill the social void at a time when there is so much time to be had indoors. 

Starburst XXXTreme Features

Players get to alternate on three features which are Starburst Wilds, XXXtreme Spins, and Random Wilds. The first appears on reels 2,3, or 4. When these land, they expand to cover all positions while also calculating the wins. They are also locked for a respin. If a new one hits, it also becomes locked while awarding another respin. Starburst XXXtreme offers a choice between two scenarios for a higher stake. In one scenario with a ten times stake, the Starburst Wild is set on random on reels 2,3, or 4, and a multiplier starts the respin. The second scenario, which has a 95 times stake, starts with two guaranteed starburst wilds on reels 2,3, or 4. it also plays out using respin game sequence and features. The game also increases the potential with the Random Wilds feature to add Starburst Wilds to a vacant reel at the end of a spin. Every Starburst Wild gives a random multiplier with potential wins of x2, x3, x5, x10, x25, x50, x100, or even x150.

The new feature is sure to be a big hit with the gaming market as online gambling has shown significant growth during the lockdown. AdAge indicates the current casino customer base is an estimated one in five Americans, so Starburst XXXtreme’s additional features will achieve considerable popularity. 

What We Think About The Game

The gambling market has continued to diversify post-pandemic, so it is one of the most opportune times to release an online casino-based game. Thankfully Starburst XXXtreme features eye-catching visuals, including the jewels and space themes. These attract audience participation and make the gameplay inviting. The game also has a nostalgic edge. The previous NetEnt iteration featured similar visuals and gameplay, so the audience has some familiarity with it. The producers have revamped this version by tweaking the features to improve the volatility and engagement. 

That is characterized by the potential win cap of 200,000 times the bet. Starburst XXXtreme does not just give betting alternatives for players that want to go big. The increase of multipliers also provides a great experience. If the respins in the previous version were great, knowing that multipliers can go hundreds of times overtakes the game to a new level. 

Players should get excited about this offering. All of the features can be triggered within a single spin. Whether one plays the standard game or takes the XXXtreme spin route, it is possible to activate all of the features. Of course, the potential 200,000 times potential is a huge carrot. However, the bet size is probably going to be restricted and vary depending on the casino. It is also worth pointing out that a malfunction during the gameplay will void all of the payouts and progress. Overall, the game itself has been designed to provide a capped win of 200,000 times the original bet. 

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Anglais

‘We’re back’: Montreal festival promoters happy to return but looking to next year

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In downtown Montreal, it’s festival season.

In the city’s entertainment district, a musical act was conducting a sound check on stage Friday evening — the second day of the French-language version of the renowned Just For Laughs comedy festival. Tickets for many of the festival’s free outdoor shows — limited by COVID-19 regulations — were sold out.

Two blocks away, more than 100 people were watching an acoustic performance by the Isaac Neto Trio — part of the last weekend of the Festival International Nuits d’Afrique, a celebration of music from the African continent and the African diaspora.

With COVID-19 restrictions continuing to limit capacity, festival organizers say they’re glad to be back but looking forward to next year when they hope border restrictions and capacity limits won’t affect their plans.

Charles Décarie, Just For Laughs’ CEO and president, said this is a “transition year.”

“Even though we have major constraints from the public health group in Montreal, we’ve managed to design a festival that can navigate through those constraints,” Décarie said.

The French-language Juste pour rire festival began on July 15 and is followed by the English-language festival until July 31.

When planning began in February and March, Décarie said, organizers came up with a variety of scenarios for different crowd sizes, ranging from no spectators to 50 per cent of usual capacity.

“You’ve got to build scenarios,” he said. “You do have to plan a little bit more than usual because you have to have alternatives.”

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Anglais

MELS new major movie studio to be built in Montreal

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MONTREAL — MELS Studios will build a new film studio in Montreal, filling some of the gap in supply to meet the demand of Hollywood productions.

MELS president Martin Carrier said on Friday that MELS 4 studio construction will begin « as soon as possible », either in the fall or winter of next year. The studio could host productions as early as spring 2023.

The total investment for the project is $76 million, with the Quebec government contributing a $25 million loan. The project will create 110 jobs, according to the company.

The TVA Group subsidiary’s project will enable it to stand out « even more » internationally, according to Quebecor president and CEO Pierre Karl Péladeau. In the past, MELS Studios has hosted several major productions, including chapters of the X-Men franchise. The next Transformers movie is shooting this summer in Montreal.

Péladeau insisted that local cultural productions would also benefit from the new facility, adding that the studio ensures foreign revenues and to showcase talent and maintain an industry of Quebec producers.

STUDIO SHORTAGE

The film industry is cramped in Montreal.

According to a report published last May by the Bureau du cinéma et de la télévision du Québec (BCTQ), there is a shortage of nearly 400,000 square feet of studio space.

With the addition of MELS 4, which will be 160,000 square feet, the company is filling part of the gap.

Carrier admitted that he has had to turn down contracts because of the lack of space, representing missed opportunities of « tens of millions of dollars, not only for MELS, but also for the Quebec economy. »

« Montreal’s expertise is in high demand, » said Montreal Mayor Valérie Plante, who was present at the announcement.

She said she received great testimonials from « Netflix, Disney, HBO and company » during an economic mission to Los Angeles in 2019.

« What stands out is that they love Montreal because of its expertise, knowledge and beauty. We need more space, like MELS 4, » she said.

There is still not enough capacity in Quebec, acknowledged Minister of Finance, the Economy and Innovation Eric Girard.

« It is certain that the government is concerned about fairness and balance, so if other requests come in, we will study them with the same seriousness as we have studied this one, » he said.

Grandé Studios is the second-largest player in the industry. Last May, the company said it had expansion plans that should begin in 2022. Investissement Québec and Bell are minority shareholders in the company.

For its part, MELS will have 400,000 square feet of production space once MELS 4 is completed. The company employs 450 people in Quebec and offers a range of services including studio and equipment rentals, image and sound postproduction, visual effects and a virtual production platform.

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