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The so-called cone of uncertainty for Tropical Storm Jose now includes North Carolina's Outer Banks, Maryland and Delaware, after the National Hurricane Center on Thursday shifted its potential path west.The cone shows the probable track of the center of a storm over a five-day period.With maximum sustained winds of 70 mph, Jose is a tropical storm after being a hurricane through the week. The storm is expected to strengthen and become a hurricane again by this weekend, the center said. At one point last weekend, Jose was a Category 4 hurricane.Jose, which recently completed an odd clockwise loop, is forecast to move closer to the United States before turning north. The vast majority of computer models still keep the storm out to sea, but a few show it making a potential landfall along the East Coast, CNN meteorologist Brandon Miller said."Jose could produce other direct impacts next week along portions of the east coast of the United States from North Carolina northward to New England, but it is too soon to determine what those impacts might be or where they could occur," the hurricane center said.Track the storm hereThe inclusion of the Outer Banks in Thursday's advisories marked the first time the United States mainland has been in the forecast cone tracking Jose.As of 11 pm on Thursday, Jose was in the southwest Atlantic Ocean, about 375 miles northeast of the southeastern Bahamas, and was moving west-northwest at 8 mph.No matter its path, Tropical Storm Jose is expected to bring rough surf and rip current conditions in the next few days. The swells generated by Jose are affecting Bermuda, the Bahamas, the northern coasts of Hispaniola and Puerto Rico and the US Southeast coast. Those effects will spread north along the mid-Atlantic coast in the next few days.Jose is the sixth named hurricane of the Atlantic basin season, which lasts through November. The peak of hurricane season is generally from mid-August to mid-October. Two major hurricanes, Harvey and Irma, have hit the United States, with Irma also demolishing islands in the Caribbean. 2089

The US government announced additional sanctions and travel restrictions on Cuba Wednesday, following up on an announcement by President Donald Trump earlier this year.Among the specific changes outlined by the Treasury Department are restrictions on travel to Cuba for educational or cultural exchange groups, which will now be permitted only for sponsored groups in the United States, and with the participation of representatives from those groups.Individuals traveling for so called "people-to-people" outreach will no longer be able to visit the country, except where travel arrangements have already been made, or in cases where these individuals are accompanied by permitted, US-based sponsors, a senior administration official explained to reporters on a conference call. 787

The skies started darkening over Lake Charles, Louisiana, on Wednesday, as Hurricane Laura trekked toward the state.People planning to hunker down at home raced to a local home supply store.“My wife didn't want to travel this time,” said resident Robert Deboest. “So, we decided to go head on and kind of stick it out.”That includes Adam Johnson, who was busy buying plywood to cover the windows of his home.“It was like a sheet,” he said.Johnson moved to the Lake Charles area several years ago from Colorado. Laura will be the first hurricane he experiences.“[The] duplex I live in was built in 2015, so it should be pretty secure,” Johnson said.Others, though, feel far less secure.“I was going to stay because I didn’t have nowhere to go,” said resident Yvonne Lancto.However, local officials made arrangements at the Burton Coliseum Complex in Lake Charles for anyone wanting to evacuate, with the National Guard and dozens of buses ready to carry evacuees out of the danger zone and to shelter.Just a few days before her 77th birthday, Lancto chose to flee the storm.“I feel more safer now (sic),” she said, shortly before boarding a bus, “Because I was gonna have to drive - I was scared.”What is scaring a lot of people in Lake Charles is not just the potential for Category 4 winds from Hurricane Laura, but massive storm surge, especially along the coast – which can easily swamp the first floor of a building.Paul and Wanda Bertrand said that is why they are getting out of their home in coastal Cameron Parish.“I’m ready to get back you know,” Paul Bertrand said. “I just left and I’m ready to get back already.”His wife, Wanda, said their lives were far more important and hopes that evacuating will only be temporary.“Hopefully, this will be over soon,” she said, “and we can get back home and everything will be like it was normal.”It’s a normalcy that Hurricane Laura will put to the test. 1917

The Trump administration is taking steps to give telehealth a broader role under Medicare, with an executive order that serves as a call for Congress to make doctor visits via personal technology a permanent fixture of the program. The order President Donald Trump signed Monday applies to one segment of Medicare recipients — people living in rural communities. But administration officials say it’s intended as a signal to Congress that Trump is ready to sign more significant legislation that would permanently open up telehealth as an option for all people with Medicare. Trump says his administration is “taking action to make sure telehealth is here to stay.”"When the invisible enemy struck our shores, we took immediate action to eliminate regulatory barriers to telehealth, making it easier for patients to consult with doctors from safety and convenience and really, they have great safety and great convenience right from their homes," Trump said. While the CDC said in June it was working on expanding access to telehealth, it did list some drawbacks to the service:Situations in which in-person visits are more appropriate due to urgency, underlying health conditions, or inability to perform an adequate physical examThe need to address sensitive topics, especially if there is patient discomfort or concern for privacyLimited access to technological devices (e.g., smartphone, tablet, computer) needed for a telehealth visit or connectivity issuesLevel of comfort with technology for HCP and patientsCultural acceptance of conducting virtual visits in lieu of in-person visits by HCP and patientsInterstate licensure challenges and other regulatory issues that may vary by state 1701

The United States Air Force swore-in its first Black chief of staff on Thursday.Air Force Secretary Barbara Barrett administered the oath of office to Gen. Charles Q. Brown during a ceremony at Joint Base Andrews, Maryland.“This is a very historic day for our nation, and I do not take this moment lightly,” Brown said at the ceremony. “Today's possible due to the perseverance of those who went before me, serving as an inspiration to me and so many others." 467