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A number of key events are likely to take place during the 2011-2019 forecast period that will serve to determine the size and course of various segments of the market for products in the clinical management of obesity. We have projected their occurrence (or not), and likely impact, following extensive industry participant interviews, our knowledge of the market approval processes in the various countries and regions, advantages and disadvantages of the various products as derived from clinical trial reports, and observations regarding the apparent attitude of the US FDA in 2010 when it comes to reviewing anti-obesity drugs for marketing in the USA.

• Drugs
  • Satiety
  • Malabsorption
  • Appetite suppression
  • Combination drugs
• Medical devices
  • Restrictive
  • Artificial fullness
  • Malabsorption
  • Gastric emptying
  • Appetite suppression

From a surgical perspective, which may or may not involve the use of an accompanying device, the options are:

• Gastric bypass, including a variation known as vertical banded gastroplasty (VBG); the latter is both malabsorptive and restrictive.
• Roux-en-Y (vertical division)
• Sleeve gastrectomy independent of biliopancreatic diversion.
• Biliopancreatic diversion with duodenal switch (both malabsorptive and restrictive)
• Gastric banding (restrictive)

These may be performed using either open surgery or laparoscopically, but are usually done via laparoscope.

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From, “Worldwide Surgical Sealants, Glues, Wound Closure and Anti-Adhesion Markets, 2008-2015″ (actual data through 2010, forecast 2011-2015) Report #S180.

Surgical sealants and fibrin glues are biologically based products designed to aid in the process of clot formation. Clotting is the first naturally occurring process in wound repair, and affects many subsequent biochemical processes in the wound-healing cascade.

During the wounding event, blood from capillaries at the damaged tissue site seeps out and reacts with tissue proteins and air to cause platelets and complement factors to trigger the cleavage of pro-thrombin into thrombin, which then changes fibrinogen into fibrin, the main insoluble component of a blood clot.

It was natural for practitioners, looking for effective hemostasis, to look at fibrin as a source of effective hemostatic activity. In the 19th century, physicians used fibrin powder to stop bleeding. During the period from 1940 to 1960, understanding of blood fractionation and the development of processes for preparing blood fractions meant that a pure form of fibrin could be prepared and manufactured in a stable format.

Fibrin sealants represent the most useful of surgical hemostats. These products can be used to clot blood but are also used to seal around suture lines for organ transplants, mastectomies, and various resection procedures, and to prevent leakage of fluids and gases. A number of companies have developed devices capable of preparing autologous fibrin and platelet formulations that can be used as sealants, and active mixes of growth factors to aid repair. Harvest Technologies, AccessClosure and Vivostat are some of the companies with products designed to address this need.

Because sealants are often available as multicomponent systems that need to be mixed immediately prior to surgical application, several innovative devices have been developed to facilitate application. During product manufacture, the thrombin component and the Factor XIII/fibrinogen components are kept separate until required. Addition of fibrin product to a bleeding surface primed with the other component results in accelerated hemostasis and a sealing effect on the bleeding surface.

Internal applications for fibrin glues in surgical procedures including cardiac, vascular and thoracic surgery account for the majority of sealant usage. General surgery, neurosurgery, plastic, ear, nose and throat, wound management, urology, and orthopedics are the other major uses of the products today. The majority of fibrin glue products and sealant products were first used for internal surgical hemostasis and sealant effects. This is now changing with the realization that appropriate hemostasis and gluing of surgical wounds during closure results in reduced infection rates and better cosmesis. Growth rates in the synthetic and biological adhesives segment of the surgical closure market will be more modest than in the high-strength segment of the market, since these technologies have most potential in niche opportunities, competing with established use of autologous and allogeneic fibrin products from a number of major established players (e.g., Baxter, CSL Behring) and a number of newer device suppliers such as Aeris Therapeutics, as well as future recombinant human fibrin producers such as Actamax Surgical Materials (a DuPont/Royal DSM joint venture).

The success of synthetic and biological sealants will be based on the uniqueness of procedure-based benefits, which enable niche high added-value segments to be created. Although these products offer potential for active delivery and adjunctive repair with sutures, their scope will be more limited than the stronger cyanoacrylate technologies.

Read More: http://feedproxy.google.com/~r/AdvancedMedicalTechnologies/~3/7K70w3RRj5Q/

Bookmark this page to check recent changes in individual financings and totals.)

Below is the spreadsheet listing of medtech financings for December 2010.

Source: MedMarket Diligence, LLC

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It’s nice to know that the liberals are not the only politicians who know how to form a circle, and then shoot directly into the center.

Today, with a critical procedural vote on the tax deal scheduled in the Senate, some Tea Party activists and other conservatives are denouncing an agreement that gives the Republican leadership virtually everything that they might conceivably hope to win from the White House. 

Not satisfied, the party’s right wing is launching an attack. According to The New York Times “a group called the Tea Party Patriots is circulating a petition accusing Republican lawmakers of cutting a bad, backroom deal with the president that violates the principles that Tea Party candidates campaigned on during the midterm elections.

No surprise, Rush Limbaugh has joined the chorus: “The economic benefit here, if we do this deal, is going to be minimal,” said Limbaugh insisting that Republicans should have fought for the permanent extension of the tax cuts rather than giving in to a temporary one. “Where is the Republican vision?”

The Times also quotes Erik Erickson, the conservative blogger, writing at Redstate.com: “The deal must now die. It must now be opposed by Republicans. Released now in print, the legislation is loaded up with budget busting pork of ridiculously absurd levels.”

Meanwhile, The Hill reports that Sen. Jim DeMint (R-S.C.) has announced his opposition to the deal. Today, Rep. Steve King (R-Iowa), another Tea Party favorite , told Fox News, “As I understand this, I'm likely to be a ‘no.’"

Finally, according to the Washington Post, Rep. Michele Bachmann (R. Minn.), head of the House Tea Party Caucus, said the agreement "ramps up spending in a big way and ramps up the deficit."   Senator-elect Rand Paul (R-Ky.), who will start his term in January, also has criticized the agreement.

Is this enough to derail the deal? I doubt it. As I write this, the Senate is preparing to give the bill the green light, paving the way to send the bill to the House Tuesday or Wednesday.

But opposition from the right might well hold up the vote in the House-- which could give liberals as well as conservatives time to spell out their objections. Even if the compromise was the best deal that President Obama could get, many liberals feel that it should have been debated, so that everyone understands just how much conservatives have won. Even when you can’t win, it is important that the truth be told.

How many voters recognize exactly how expensive this deal is—and where the money is going? How many seniors realize that by cutting the Social Security tax, conservatives are laying the groundwork for 2012, when they hope to gut Social Security? How many members of the public recognize what this deal means for health care reform—and Medicare?

Finally, how many liberals have analyzed just how many additional jobs the deal will create? The tax cuts for the middle-class are not new. And unemployed households lucky enough to receive a weekly check for $300 (the average benefit) are not going to go out and buy a new car. They’ll be happy if they can pay their utility bills. That won’t create jobs.

I’ll be writing more about how the tax deal will affect health care reform later this afternoon.

Read More: http://www.healthbeatblog.com/2010/12/tea-party-activists-protest-tax-dealwill-we-have-a-public-debate.html

Basically I have seen the health reform create some real positives but this part where individuals are required to purchase insurance from companies that are actively traded on the stock market has been one area that leaves a bad taste in the mouth of many as to why should healthcare be tied to profits?  This is only one small part of the entire reform bill that has not kicked in yet and it is a ways down the road.  I think health insurance needs to be reverted back to non profit status and those who have big interests in technology should or could divest those from the basic portions that provide insurance.  With the bundling today of subsidiaries and who’s collecting, mining and selling data for profits, it makes sense.  This group of doctors saw the light a long time ago and keep working towards a single pay plan.

Mad As Hell Doctors Hit the Road for California Tour

Why should premiums that I would pay go toward profits on Wall Street?  It doesn’t make sense as we can see all the algorithmic formulas in motion today to try to defeat the over all purpose anyway with such complicated formulas that everyone is complaining about, even the ones who like their insurance hate the processes and it creates side pools of companies who profit big time on the scoring and evaluation of human health analytics as well, money that could better be spent on care and preventive areas. It would certainly stand to create entirely new business models and allow for greater transparency if individuals didn’t have to worry about all the “scoring” and analytics and red tape involved just to get care.  Earlier today I suggested a route for consumers and those investing money to run those algorithms against the people they are trusting with their money, kind of turn the tables a bit if you will.  BD  

Behavioral Science for Hedge Fund Executives Hints At the Prospect of New Social Environments-Predictive Modeling Algorithms Showing Status of Well Being

RICHMOND, Va.—A federal judge ruled Monday that a central plank of the health law violates the Constitution, dealing the biggest setback yet to the Obama administration's signature legislative accomplishment.

In a 42-page ruling, U.S. District Judge Henry E. Hudson said the law's requirement that most Americans carry insurance or pay a penalty "exceeds the constitutional boundaries of congressional power."

He added: "At its core, this dispute is not simply about regulating the business of insurance—or crafting a scheme of universal health insurance coverage—it's about an individual's right to choose to participate."

Separately, federal Judge Roger Vinson in Pensacola, Fla., will hear arguments Thursday in a challenge brought by officials in 20 states, and he could offer the clearest indication yet of how he will rule.

Judge Sides With Virginia on Health Law - WSJ.com

Read More: http://ducknetweb.blogspot.com/2010/12/federal-judge-declares-requirement-for.html

Only a year ago we had one and now we have five so perhaps this gives some new meaning to the number of software applications out there for medical records.  There’s many and maybe too many.  BD 

The Office of the National Coordinator for Health Information Technology at HHS has named two more organizations as authorized testing and certification bodies.

They are ICSA Labs, Mechanicsburg, Pa., and SLI Global Solutions, Denver. Both organizations are now eligible to certify electronic health-record systems as well as modules of those systems as capable of letting a healthcare provider meet the meaningful-use criteria and qualify for IT incentive payments under the American Recovery and Reinvestment Act of 2009.

ONC names two new certifying bodies - Healthcare business news from Modern Healthcare

Read More: http://ducknetweb.blogspot.com/2010/12/onc-adds-2-new-certification.html

The donation came from the a Chinese American individual who plans to build a hybrid auto plant in the US and the hopes are here to open doors for collaboration.  As you can read through below the Peking Union Medical College was modeled after Johns Hopkins School of Medicine.  BD

A Chinese-American entrepreneur whose company recently unveiled plans to build a hybrid auto plant in Alabama has made a $10 million gift to The Johns Hopkins University to promote innovative new approaches to the study of China.

The gift from Benjamin Yeung and his wife, Rhea, will establish the Benjamin and Rhea Yeung Center for Collaborative China Studies.

The center’s role is to deepen the understanding between the United States and China through a unique collaboration among the various Johns Hopkins schools and academic programs. In the near term, Johns Hopkins envisions new academic and research initiatives funded through Yeung Center grants for collaborative projects across the institution; the proposal process is expected to begin next month. The Hopkins-Nanjing Center for Chinese and American Studies, run jointly in China by Johns Hopkins and Nanjing University, will be a natural host for some of this activity.

China’s most prestigious medical school, Peking Union Medical College, and its affiliated hospital were modeled on the Johns Hopkins University School of Medicine when it was founded in the early 20th century, and the first dean of the Johns Hopkins medical school, William Welch, made trips to China to help establish the school. His partner in this endeavor was Anna Wolf, who led the Johns Hopkins School of Nursing.

Yeung (pronounced “young”) is a pioneering automotive industrialist who founded the first Chinese company to be listed on the New York Stock Exchange and who introduced the Zhonghua sedan, widely considered the first truly Chinese car. In 2002, Yeung and his family immigrated to the United States. As chairman of the automotive start-up Hybrid Kinetic Motors, Yeung announced plans to build a $1.5 billion hybrid car manufacturing facility in Baldwin County, Ala., with the intent to begin production in 2013. Benjamin and Rhea’s son, Jack Yeung, earned his undergraduate degree from the university’s Krieger School of Arts and Sciences in 2005 and a certificate of graduate studies from the SAIS center in Bologna, Italy, in 2006.

The creation of the Yeung Center will provide Johns Hopkins faculty and students with the opportunity to develop new programs and initiatives, enhance multidisciplinary scholarship and nurture collaboration between research institutions in China and the United States.

Johns Hopkins center for China studies announced | Johns Hopkins University - The Gazette

Read More: http://ducknetweb.blogspot.com/2010/12/johns-hopkins-center-for-china-studies.html

I still have a hard time calling myself a writer or even press (although it’s convenient for getting into conferences). Plus, I think I reach, influence and interact with as many or more people than the traditional healthcare journalist. However, there’s something liberating about being called a blogger instead of a journalist because the standard and approach is

Read More: http://www.emrandhipaa.com/emr-and-hipaa/2010/12/13/terrible-forbes-article-open-source-debut-in-healthcare/

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Read More: http://www.thehealthcareblog.com/the_health_care_blog/2010/12/great-ideas-improving-heathcare-infrastructure.html

Here we go again with money owed to physicians and the big job of calculating the differences on claims already paid.  Again, I hope some folks soon come out of denial and come to understand he money and time involved here.  Certainly I would like to see the process work for the doctors, but again when underlying data systems are involved, resets and programming needs to occur and this is both expensive and time consuming. 

Do Some Think That Health IT Costs and Systems Grow On Trees-Certainly Starting To Give That Impression of Late

I was caught up myself with the little billing I do from the Congressional stall over the extension granted in June when the 10 day limit expired and had to re-submit all the claims as there as an “unidentified technical error” reported by the Medicare contractor, a wholly owned subsidiary of Blue Cross, and had to re-submit, so a bit of extra work on my part and several others on Twitter reported the same.  This is real life folks and the money and time that others had to incur due to Congressional delay so now we have this mess to figure out.  Is this a re-do of all claims for the year 2010 for each provider?  It seems like that is the answer and a lot of data work and expense so will that part of it be funded here or from a separate area to make this happen for the doctors? 

When it comes to top level management with CIOs and CTOs in time, there are going to be very few that want the pressure cooker as this is a tough place to be today and somewhat thankless too as politicians who are the big “non participants” in general digital IT literacy drive a lot of this and sometime they don’t look very smart when knowledge is needed and we end up with open mount and insert foot.

So what is the deal here for physicians to collect?  Resubmit claims again and cross fingers?  If it is not substantial enough then they won’t have time but the contractor no doubt will see additional transaction revenue from all of this so I’m sure they are ready to go for it as the bills resubmitted will again need to be analyzed for potential fraud and the rest of the processes that go along with it, so they will be securing additional money through this process and will this expense be greater than what is owed to the doctors?  Good question I think, but only the algorithms used to forecast will know for sure.  BD 

The American Medical Association (AMA), along with medical societies representing all 50 states and the District of Columbia and 57 national medical specialty societies, called on the Centers for Medicare and Medicaid Services (CMS) to use the $200 million allocated by Congress to provide physicians with long-overdue Medicare reimbursements for payments they should have received in 2010.  The funds were part of the Medicare & Medicaid Extenders Act of 2010, which was passed this week by Congress.

“After weathering a year filled with uncertainties from continuous threats of cuts to Medicare payments, many physicians are not in a position to rely on IOUs from the government,” said Cecil B. Wilson, M.D., AMA President.  “This week Congress allocated $200 million to help CMS comply with the new health reform law by reimbursing physicians for payments they should have received this year under the Affordable Care Act.  We urge CMS to provide physicians with prompt information about how these claims will be handled, and to make the reimbursement process as quick and simple as possible.

AMA and Others Urge CMS to Pay Overdue Reimbursements to Docs | Physicians News

Read More: http://ducknetweb.blogspot.com/2010/12/ama-and-others-urge-cms-to-pay-overdue.html

Read More: http://www.thehealthcareblog.com/the_health_care_blog/2010/12/sticker-shock.html

Read More: http://www.thehealthcareblog.com/the_health_care_blog/2010/12/letter-from-london.html

Read More: http://www.thehealthcareblog.com/the_health_care_blog/2010/12/welcome-to-the-cloud-clan.html

Read More: http://www.thehealthcareblog.com/the_health_care_blog/2010/12/facebook-saves-womans-life-newt-gingrich-and-reality-based-healthcare-systems-planning.html

1. ICSA Labs
2. SLI Global Solutions
3. Certification Commission for Health Information Technology (CCHIT)
4. Drummond Group, Inc. (DGI)
5. InfoGard Laboratories, Inc. 

Read More: http://feedproxy.google.com/~r/mdjosephkim/~3/IjWqBXCIzW0/expanded-list-of-onc-authorized-testing.html

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Initially the intestinal tissue cells and the growth there of will be used to study normal intestinal development in humans and what goes wrong with the intestine in people with diseases such as enterocolitis, inflammatory bowel disease and short bowel syndrome.

Eventually the process will lead to growing intestines tissue for implant and testing on animals will begin soon.  Within 28 days major intestinal cell types were developed and took on the characteristics of absorptive and secretory functionality of normal human intestinal tissues.  BD 

CINCINNATI, Dec. 12, 2010 /PRNewswire-USNewswire/ -- For the first time, scientists have created functioning human intestinal tissue in the laboratory from pluripotent stem cells.

In a study posted online Dec. 12 by Nature, scientists from Cincinnati Children's Hospital Medical Center say their findings will open the door to unprecedented studies of human intestinal development, function and disease. The process is also a significant step toward generating intestinal tissue for transplantation, researchers say.

"This is the first study to demonstrate that human pluripotent stem cells in a petri dish can be instructed to efficiently form human tissue with three-dimensional architecture and cellular composition remarkably similar to intestinal tissue," said James Wells, Ph.D., senior investigator on the study and a researcher in the division of Developmental Biology at Cincinnati Children's.

"The hope is that our ability to turn stem cells into intestinal tissue will eventually be therapeutically beneficial for people with diseases such as necrotizing enterocolitis, inflammatory bowel disease and short bowel syndromes," he added.

Because iPSC technology is new, it remains unknown if these cells have all of the potential of hESCs, Dr. Wells explained. This prompted the researchers to use both iPSCs and human embryonic stem cells in this study so they could further test and compare the transformative capabilities of each.

Stem Cells Turned Into Complex, Functioning Intestinal Tissue in Lab -- CINCINNATI, Dec. 12, 2010 /PRNewswire-USNewswire/ --

Read More: http://ducknetweb.blogspot.com/2010/12/stem-cells-turned-into-intestinal.html

This is an interesting company as they are involved in research and development of stem cells relating to diabetes, liver disease and more and have several patents in this area both internationally and in the US.  Now what is also interesting here is the launch of “stem cell” cosmetics as another part of their business model, with retail sales on the web.  Recently I posted about “spray on” stem cell use that is about ready for clinical trials, so I guess to assume, the cosmetic end of the business is ready to advance as well.  If you read further down there’s a bit of an explanation of the 4 types of stem cell technologies. 

Spray On Stem Cells for Treating Burns and Open Wounds–Regenerative Medicine

From the website:

International Stem Cell Corporation (OTCBB:ISCO) develops a powerful new stem cell technology called “parthenogenesis” that promises to significantly advance the field of regenerative medicine by addressing the significant problem of immune-rejection. Parthenogenesis utilizes unfertilized human eggs to create “parthenogenetic” stem cells (hpSC) that can be “immune-matched” to millions of persons of differing sexes and racial backgrounds. A relatively small number of hpSC lines could provide sufficient immune-matched cells to cover large parts of the world’s population. ISCO plans to create a bank of these valuable hpSC lines (UniStemCell™) to serve all populations across the world.
Human parthenogenetic stem cells have great therapeutic potential, yet do not require viable human embryos, thus avoiding ethical issues. ISCO’s scientists are focused on using hpSC to treat severe diseases of the eye, the nervous system and the liver where cell therapy has been proven clinically yet is limited by the availability of safe immune-matched human cells.
ISCO advances and operates three businesses.

“To derive and characterize the therapeutic cells derived from parthenogenetic stem cells we collaborate with the leading Universities and Companies:

• Novocell Inc, San Diego, California, endocrine pancreas cells;
• University of California, San Francisco, California, hepatocyte cells;
• University of California, Irvine, California, retinal pigment epithelium;
• University of Wurzburg, Germany, neuronal cells;
• The Scripps Research Institute, La Jolla, California, characterization of human parthenogenetic stem cells.
• The Acacio Fertility Center.
• California Center for Reproductive Medicine”.

From the website:

Parthenogenesis utilizes unfertilized human eggs to create “parthenogenetic” stem cells (hpSC) that are potentially histocompatible with millions of individuals of differing sexes and racial backgrounds. This means a relatively small number of hpSC lines could provide sufficient immune-matched cells to cover large parts of the world’s population.
Unlike human embryonic stem cells (hESC), hpSC do not require viable human embryos, thus avoiding most ethical concerns.
Unlike induced pluripotent stem cells (iPS), hpSC do not require the transfection of genes into somatic cells with the associated possibility of introducing unwanted additional genes.”

The chart below explains in brief the 4 types of stem cell processes. 

In following some of the recent developments with stem cells there’s a big move starting to continue and further advance stem cell storage areas around the world. 

Cord Blood America To Buy Mexican Stem Cell Storage Company

The new stem cell area of their business of course relates to avoiding the aging processes, which we all open ears when hearing news in this area.  The cosmetic end of the business has their own website as well which explains their stem cell technology serums and processes. 

The products state they use patented non-embryonic stem cell extract to help rejuvenate your skin.  The products are not cheap and be ready to shell out a few hundred dollars to order.  This is interesting as it is the first I have seen with cosmetic retail sales with stem cells and again based on their educational and research programs they have patented technologies included in the products.  If nothing else this post will give you a real quick summary about the different types of stem cell technologies that exist out there today.  BD 

The use of stem cells has often been a controversial issue in the media. International Stem Cell Corp. looks set to tackle the issue head on after launching its own line of stem cell based beauty products. According to reports online the skin care range was created by its wholly owned subsidiary Lifeline Skin Care.

CareFair.com - Stem Cell Based Cosmetics Launched

Read More: http://ducknetweb.blogspot.com/2010/12/stem-cell-based-cosmetics-developed.html

Everybody loads up the internet with how healthcare should take lessons from aviation, well maybe not this guy.  It turns out that yes he is a pilot but not an MD has he was billed to be and United added in here that he is not currently authorized to fly.  You really can’t believe everything you see on the web today can you.  If you read the entire story you can see where he was paid by Harvard, Michigan and other places for his presentations.  Granted to pull this off he’s not a dumb person by any means but deception is not in the game plan today.  Hopefully now we can stop hearing those posts about healthcare learning from pilots as there are tons of simulation schools and set ups across the US. 

The AMA had him scheduled to lead a seminar even after he had been grounded by United, and now that has been cancelled.  I did a quick search and found him as a speaker at the World Health Care Congress in 2006 and you can read his profile here.  He’s not a cardiologist and further more not a doctor as professed and to create a history of degrees, etc. is deception. 

“Dr. Hamman has been a pilot for thirty years and a clinician for fifteen years”

This story brings me back around to something I have written about on the Medical Quack when it comes to rating doctors.  Through my own research and comments added from other doctors, read the comment section, there was a doctor listed who worked for an IPA who never practiced medicine, so this is a problem with getting data correct and looking for those misrepresenting themselves. Here’s a quote from the comment section from one doctor who check out all the listed MDs in his area and what he found, a guy who never practiced medicine but did consulting work for HMOs and IPAs, so we could possibly run into a few more doctors that in fact are not really doctors at all.  We could have more doctor impersonators out there too that get themselves into data bases to show additional credentials. 

“Going further down the list, doctors # 22 and 27 are retired, and #28 is dead. Doctor #29 doesn’t actually practice medicine, and as far as I know has never practiced medicine in Texas and has never had a Texas medical license. (He did consulting for IPAs, PPOs.”

Avvo Physician Rating Service Can’t Get Accurate Information Listed on Doctors - One OC Oncologist Sitting in Jail for Fraud

Anyway the doctor made up that he did not have the medical and doctorial degrees from the University of Wisconsin in the 1980s.  I wonder if he spent years as a “check pilot” at United?  If his program was to assist doctors then he should have sold it to others on it’s real credentials as now people may start asking, what else did he lie about, I would.  BD

MILWAUKEE (AP) — He seemed like Superman, able to guide jumbo jets through perilous skies and tiny tubes through blocked arteries. As a cardiologist and United Airlines captain, William Hamman taught doctors and pilots ways to keep hearts and planes from crashing.

He shared millions in grants, had university and hospital posts, and bragged of work for prestigious medical groups. An Associated Press story featured him leading a teamwork training session at an American College of Cardiology convention last spring.

United would not discuss his job history, citing employee confidentiality. But the company confirmed that he is not currently authorized to fly. Hamman lives in Michigan and is based in Chicago.

After fessing up, Hamman asked the AMA and the cardiology group to let him continue, saying, "the work is the work."

They decided that a lie is a lie.

The Associated Press: AP EXCLUSIVE: Pilot duped AMA with fake M.D. claim

Read More: http://ducknetweb.blogspot.com/2010/12/pilot-at-united-airlines-claimed-to-be.html