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"content": "\u003cp>The other shoe dropped for Elizabeth Holmes today -- the criminal one.\u003c/p>\n\u003cp>A federal grand jury has indicted Holmes on criminal charges of allegedly defrauding investors, doctors and patients as the head of the once-heralded Bay Area blood-testing startup Theranos.\u003c/p>\n\u003caside class=\"alignright\">\u003ca href=\"https://www.kqed.org/futureofyou/442098/book-excerpt-one-execs-tumultuous-last-day-at-theranos\" target=\"_blank\" rel=\"noopener\">Excerpt from John Carreyrou's 'Bad Blood': What Happened When Theranos Exec Confronted Elizabeth Holmes About Her Lack of Ethics\u003c/a>\u003c/aside>\n\u003cp>The U.S. Attorney's Office for the Northern District of California said late Friday that Holmes and her former chief operating officer, Ramesh \"Sunny\" Balwani, have been charged with two counts of conspiracy to commit wire fraud and nine counts of wire fraud. They face a maximum of 20 years in prison, the U.S. Attorney's Office said.\u003c/p>\n\u003cp>Both Holmes and Balwani surrendered to the FBI and were arraigned in U.S. District Court in San Jose, CNBC \u003ca href=\"https://www.cnbc.com/2018/06/15/theranos-chief-elizabeth-holmes-arrested-on-federal-criminal-charges-.html\" target=\"_blank\" rel=\"noopener\">reports. \u003c/a>They were released on $500,000 bond each and ordered to surrender their passports at the arraignment, which was attended by Holmes' parents, the network reported.\u003c/p>\n\u003cp>The action comes three months after the Securities and Exchange Commission entered into a settlement with Holmes and Theranos over charges that the company perpetrated a \"massive\" and \"years-long\" fraud by exaggerating or making false statements to investors about the company's technology and financial performance. Balwani, 53, did not settle in that case.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Holmes, 34, is a Stanford University dropout who was once billed as the next Steve Jobs.\u003c/p>\n\u003cp>She claimed that Theranos could perform dozens of blood tests from a few finger-sticks of blood, an advance that would have disrupted the diagnostics industry now dominated by a handful of giant companies. But an investigation by Wall Street Journal reporter John Carreyrou exposed Theranos' claims as untrue, and its testing results as inaccurate. The company was forced to invalidate hundreds of thousands of blood tests performed on patients, and it eventually exited the consumer blood-testing business after the Centers for Medicare & Medicaid Services found deficiencies at the company's laboratory that the agency deemed life-threatening.\u003c/p>\n\u003cp>Acting U.S. Attorney Alex G. Tse portrayed the indictments against Holmes and Balwani as a warning against Silicon Valley companies who use deceit in their business dealings.\u003c/p>\n\u003cp>“Investors large and small from around the world are attracted to Silicon Valley by its track record, its talent, and its promise,\" Tse said. \"They are also attracted by the fact that behind the innovation and entrepreneurship are rules of law that require honesty, fair play, and transparency. This office, along with our other law enforcement partners in the Bay Area, will vigorously investigate and prosecute those who do not play by the rules that make Silicon Valley work.\"\u003c/p>\n\u003cp>It's unclear how many people still work at Theranos, which has had to lay off the vast majority of its workers in the face of mounting scandals. But the company remained feisty as recently as three weeks ago, when it issued a \u003ca href=\"https://news.theranos.com/2018/05/23/company-statement-regarding-may-20-2018-60-minutes-story/\" target=\"_blank\" rel=\"noopener\">rebuttal\u003c/a> to a \"\u003ca href=\"https://www.cbsnews.com/video/the-theranos-elizabeth-holmes-deception/\" target=\"_blank\" rel=\"noopener\">60 Minutes\u003c/a>\" story timed to coincide with the release of Carreyrou's book, which depicted rampant unethical behavior by Holmes and Balwani. (\u003ca href=\"https://www.kqed.org/futureofyou/442098/book-excerpt-one-execs-tumultuous-last-day-at-theranos\" target=\"_blank\" rel=\"noopener\">Read the prologue here. It's a doozy\u003c/a>.)\u003c/p>\n\u003cp>Peter Henning, a former senior attorney in the enforcement division of the SEC, said Theranos' statement came close to breaking a stipulation in its agreement with the SEC that prohibits it from denying the agency's allegations.\u003c/p>\n\u003cp>\u003cstrong>Vindication for Carreyrou\u003c/strong>\u003c/p>\n\u003cp>One aspect of the Theranos story is how one reporter, aided by whistleblowers, took on a Silicon Valley darling whose founder was well on her way to becoming a tech icon.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s vindicating. I put three-and a-half years of my life into covering this story.'\u003ccite>John Carreyrou, Wall Street Journal reporter who exposed Theranos as a fraud, on today's events\u003c/cite>\u003c/aside>\n\u003cp>After Carreyrou's first stories exposing Theranos, he became Public Enemy No. 1 at the company, as it fought back by depicting his reporting as riddled with inaccuracies. (That particular \u003ca href=\"https://news.theranos.com/2015/10/15/statement-from-theranos/\" target=\"_blank\" rel=\"noopener\">press release,\u003c/a> remarkably, is still available on the Theranos website.) Notoriously, at one point, employees who had gathered for a companywide meeting \u003ca href=\"https://www.vanityfair.com/news/2016/09/elizabeth-holmes-theranos-exclusive\" target=\"_blank\" rel=\"noopener\">chanted\u003c/a> \"F*** you, Carreyrou\" to voice their displeasure with him.\u003c/p>\n\u003cp>Carreyrou recently \u003ca href=\"https://www.kqed.org/forum/2010101865652/bad-blood-traces-theranos-fall-from-silicon-valley-grace\" target=\"_blank\" rel=\"noopener\">appeared\u003c/a> on KQED's Forum radio program, and I asked him today how he felt about the indictments of Holmes and Balwani.\u003c/p>\n\u003cp>\"It’s vindicating,\" he wrote in an email. \"I put three-and-a-half years of my life into covering this story.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The Associated Press contributed to this post.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The other shoe dropped for Elizabeth Holmes today -- the criminal one.\u003c/p>\n\u003cp>A federal grand jury has indicted Holmes on criminal charges of allegedly defrauding investors, doctors and patients as the head of the once-heralded Bay Area blood-testing startup Theranos.\u003c/p>\n\u003caside class=\"alignright\">\u003ca href=\"https://www.kqed.org/futureofyou/442098/book-excerpt-one-execs-tumultuous-last-day-at-theranos\" target=\"_blank\" rel=\"noopener\">Excerpt from John Carreyrou's 'Bad Blood': What Happened When Theranos Exec Confronted Elizabeth Holmes About Her Lack of Ethics\u003c/a>\u003c/aside>\n\u003cp>The U.S. Attorney's Office for the Northern District of California said late Friday that Holmes and her former chief operating officer, Ramesh \"Sunny\" Balwani, have been charged with two counts of conspiracy to commit wire fraud and nine counts of wire fraud. They face a maximum of 20 years in prison, the U.S. Attorney's Office said.\u003c/p>\n\u003cp>Both Holmes and Balwani surrendered to the FBI and were arraigned in U.S. District Court in San Jose, CNBC \u003ca href=\"https://www.cnbc.com/2018/06/15/theranos-chief-elizabeth-holmes-arrested-on-federal-criminal-charges-.html\" target=\"_blank\" rel=\"noopener\">reports. \u003c/a>They were released on $500,000 bond each and ordered to surrender their passports at the arraignment, which was attended by Holmes' parents, the network reported.\u003c/p>\n\u003cp>The action comes three months after the Securities and Exchange Commission entered into a settlement with Holmes and Theranos over charges that the company perpetrated a \"massive\" and \"years-long\" fraud by exaggerating or making false statements to investors about the company's technology and financial performance. Balwani, 53, did not settle in that case.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Holmes, 34, is a Stanford University dropout who was once billed as the next Steve Jobs.\u003c/p>\n\u003cp>She claimed that Theranos could perform dozens of blood tests from a few finger-sticks of blood, an advance that would have disrupted the diagnostics industry now dominated by a handful of giant companies. But an investigation by Wall Street Journal reporter John Carreyrou exposed Theranos' claims as untrue, and its testing results as inaccurate. The company was forced to invalidate hundreds of thousands of blood tests performed on patients, and it eventually exited the consumer blood-testing business after the Centers for Medicare & Medicaid Services found deficiencies at the company's laboratory that the agency deemed life-threatening.\u003c/p>\n\u003cp>Acting U.S. Attorney Alex G. Tse portrayed the indictments against Holmes and Balwani as a warning against Silicon Valley companies who use deceit in their business dealings.\u003c/p>\n\u003cp>“Investors large and small from around the world are attracted to Silicon Valley by its track record, its talent, and its promise,\" Tse said. \"They are also attracted by the fact that behind the innovation and entrepreneurship are rules of law that require honesty, fair play, and transparency. This office, along with our other law enforcement partners in the Bay Area, will vigorously investigate and prosecute those who do not play by the rules that make Silicon Valley work.\"\u003c/p>\n\u003cp>It's unclear how many people still work at Theranos, which has had to lay off the vast majority of its workers in the face of mounting scandals. But the company remained feisty as recently as three weeks ago, when it issued a \u003ca href=\"https://news.theranos.com/2018/05/23/company-statement-regarding-may-20-2018-60-minutes-story/\" target=\"_blank\" rel=\"noopener\">rebuttal\u003c/a> to a \"\u003ca href=\"https://www.cbsnews.com/video/the-theranos-elizabeth-holmes-deception/\" target=\"_blank\" rel=\"noopener\">60 Minutes\u003c/a>\" story timed to coincide with the release of Carreyrou's book, which depicted rampant unethical behavior by Holmes and Balwani. (\u003ca href=\"https://www.kqed.org/futureofyou/442098/book-excerpt-one-execs-tumultuous-last-day-at-theranos\" target=\"_blank\" rel=\"noopener\">Read the prologue here. It's a doozy\u003c/a>.)\u003c/p>\n\u003cp>Peter Henning, a former senior attorney in the enforcement division of the SEC, said Theranos' statement came close to breaking a stipulation in its agreement with the SEC that prohibits it from denying the agency's allegations.\u003c/p>\n\u003cp>\u003cstrong>Vindication for Carreyrou\u003c/strong>\u003c/p>\n\u003cp>One aspect of the Theranos story is how one reporter, aided by whistleblowers, took on a Silicon Valley darling whose founder was well on her way to becoming a tech icon.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s vindicating. I put three-and a-half years of my life into covering this story.'\u003ccite>John Carreyrou, Wall Street Journal reporter who exposed Theranos as a fraud, on today's events\u003c/cite>\u003c/aside>\n\u003cp>After Carreyrou's first stories exposing Theranos, he became Public Enemy No. 1 at the company, as it fought back by depicting his reporting as riddled with inaccuracies. (That particular \u003ca href=\"https://news.theranos.com/2015/10/15/statement-from-theranos/\" target=\"_blank\" rel=\"noopener\">press release,\u003c/a> remarkably, is still available on the Theranos website.) Notoriously, at one point, employees who had gathered for a companywide meeting \u003ca href=\"https://www.vanityfair.com/news/2016/09/elizabeth-holmes-theranos-exclusive\" target=\"_blank\" rel=\"noopener\">chanted\u003c/a> \"F*** you, Carreyrou\" to voice their displeasure with him.\u003c/p>\n\u003cp>Carreyrou recently \u003ca href=\"https://www.kqed.org/forum/2010101865652/bad-blood-traces-theranos-fall-from-silicon-valley-grace\" target=\"_blank\" rel=\"noopener\">appeared\u003c/a> on KQED's Forum radio program, and I asked him today how he felt about the indictments of Holmes and Balwani.\u003c/p>\n\u003cp>\"It’s vindicating,\" he wrote in an email. \"I put three-and-a-half years of my life into covering this story.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The Associated Press contributed to this post.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Does Vitamin D Really Protect Against Colorectal Cancer?",
"title": "Does Vitamin D Really Protect Against Colorectal Cancer?",
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"content": "\u003cp>It's been clear for many years that vitamin D helps keep bones strong, but studies have been inconclusive and conflicting about the vitamin's value in protecting against certain cancers, including \u003ca href=\"https://www.cancer.gov/types/colorectal\" target=\"_blank\" rel=\"noopener\">colorectal cancer\u003c/a>.[contextly_sidebar id=\"9k4uFVtwqiLPQYTYxUgc0nIsJORbVOWp\"]\u003c/p>\n\u003cp>Now a large international \u003ca href=\"https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djy087\" target=\"_blank\" rel=\"noopener\">study\u003c/a> provides the strongest evidence yet that vitamin D may indeed be protective against colorectal cancer and that a deficiency may increase the risk of this cancer. The findings appear Thursday in the \u003cem>Journal of the National Cancer Institute\u003c/em>.\u003c/p>\n\u003cp>\"For both men and women, deficient levels of vitamin D were associated with a 30 percent increased risk of colorectal cancer,\" says \u003ca href=\"https://www.cancer.org/research/acs-researchers/marjorie-mccullough-bio.html\" target=\"_blank\" rel=\"noopener\">Marji McCullough\u003c/a>, a nutritional epidemiologist with the American Cancer Society and study co-author. People who had higher circulating blood levels of vitamin D\u003cstrong>, \u003c/strong>above the range deemed \"sufficient,\" had a 22 percent lower risk, she says.\u003c/p>\n\u003cp>The study pooled findings from 17 previous studies that included 12,813 adults in the U.S., Europe and Asia. Those studies collectively looked at 5,706 people with colorectal cancer and 7,107 people of a similar age and race who didn't have cancer. Women's menopausal status was also taken into account.\u003c/p>\n\u003cp>To determine what role vitamin D might be playing, researchers looked at participants' blood samples collected in the years before their cancer diagnosis. They also considered the established risk factors for colorectal cancer, including smoking, low physical activity and high body mass index.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Our findings suggest what's optimal for bone health may not be optimal for colorectal risk reduction,\" McCullough says, which could mean higher doses are needed to prevent cancer. Current recommendations for vitamin D supplementation are based solely on studies showing conclusively that it does preserve bone health.\u003c/p>\n\u003cp>A particularly provocative finding of the study, McCullough says, is the relatively strong correlation between higher blood levels of vitamin D and lower risk of colorectal cancer in women.\u003c/p>\n\u003cp>\"We don't know why,\" she says. One hypothesis is that there is some interaction between vitamin D and female hormones. Or it's possible vitamin D prevents cancer by reducing the proliferation of tumor cells or by stopping their growth and \"actually killing those cells,\" she says.\u003c/p>\n\u003cp>Studies like this do not prove cause and effect but rather show only that there may be a connection between the levels of vitamin D circulating through the body and cancer. Still, the authors of the paper write that the results \"substantially strengthen the evidence, previously considered inconclusive, for a causal relationship\" between low vitamin D levels and colorectal cancer.[contextly_sidebar id=\"MAqLylPcwu1QCC3r4WiQXhzaSDOZfRPb\"]\u003c/p>\n\u003cp>Another interesting observation in the study, McCullough says, was that beyond a certain level, increasingly higher amounts of vitamin D in the blood had no additional benefit. At the highest levels above what is considered \"adequate,\" there was no further reduction in risk. In other words, she says, \"more is not necessarily better.\"\u003c/p>\n\u003cp>Her take-home message: Don't race out and buy high doses of vitamin D \"just in case.\" Overdoing it can be toxic. Taking too much vitamin D can cause kidney stones and, in very rare cases, death.\u003c/p>\n\u003cp>The issue of whether vitamin D supplements should be used at all to prevent colorectal cancer is still up in the air. \"The key question now is whether intervening with people who have low levels of vitamin D can make a difference,\" says \u003ca href=\"http://www.dana-farber.org/find-a-doctor/jeffrey-a-meyerhardt/\" target=\"_blank\" rel=\"noopener\">Dr. Jeffrey Meyerhardt\u003c/a>, director of the Gastrointestinal Cancer Center at Dana-Farber Cancer Institute in Boston, who was not involved in the study.\u003c/p>\n\u003cp>The study didn't evaluate whether adding vitamin D through food, sunlight or supplements made a difference in cancer risk. It was limited to looking at the level of vitamin D in people's blood.\u003c/p>\n\u003cp>Currently, a large \u003ca href=\"https://www.vitalstudy.org/\" target=\"_blank\" rel=\"noopener\">study\u003c/a> involving more than 25,000 patients is underway at Brigham and Women's Hospital in Boston to find out whether taking vitamin D supplements might reduce the risk of numerous cancers as well as heart disease and stroke. Meyerhardt says answers may be available in the coming year.\u003c/p>\n\u003cp>In the meantime, he suggests people talk with their health care provider about having a blood test to measure vitamin D levels. If you're starting in the deficient range, he says, some doctors might prescribe high doses, to be taken each week for a month or two, and then prescribe lower, maintenance levels.[contextly_sidebar id=\"x4oXchtt2cZV7lIWDVrGT7XXeJne7cWq\"]\u003c/p>\n\u003cp>The cancer society's McCullough says it is generally \u003ca href=\"https://www.bones.nih.gov/health-info/bone/bone-health/nutrition/calcium-and-vitamin-d-important-every-age\" target=\"_blank\" rel=\"noopener\">recommended\u003c/a> that adults have a daily intake of 600 international units of vitamin D up to age 70. Men and women over age 70 should increase their uptake to 800 IUs daily, she says.\u003c/p>\n\u003cp>People should talk with their doctor because different individuals have different needs, she says.\u003c/p>\n\u003cp>\"It depends on where you live and what race you are, because darker skin tends to absorb less vitamin D.\" Sun, age, genetics and weight also play a role in how the body processes vitamin D.\u003c/p>\n\u003cp>Vitamin D can be obtained from vitamin D-rich foods such as egg yolks, salmon, trout, swordfish, tuna and sardines. Numerous foods are fortified with vitamin D including cow's milk, almond milk, soy milk, some cereals and some orange juices.\u003c/p>\n\u003cp>\"If you have a serving of salmon, that's about 500 IUs, and a cup of milk would give you 100 IUs,\" McCullough says, which adds up to the daily recommended dose of 600 IUs.\u003c/p>\n\u003cp>But Meyerhardt says most people don't eat enough fatty fish to reach the recommended vitamin D intake.\u003c/p>\n\u003cp>\"Most vitamin D doesn't really come from your diet\" in most cases, he says. And he says multivitamins contain relatively low levels of vitamin D. \"So you really have to take a supplement\" to meet recommended doses.\u003c/p>\n\u003cp>Vitamin D is often called the \"sunshine\" vitamin, because exposure to sunlight can stimulate production of the vitamin. But exposure to sun is generally not recommended as a way to boost vitamin D, McCullough says, since at excessive levels it can raise the risk of melanoma and other skin cancers.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>More than 20 medical centers and organizations participated in the study, including Harvard, the American Cancer Society and the National Cancer Institute.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Does+Vitamin+D+Really+Protect+Against+Colorectal+Cancer%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It's been clear for many years that vitamin D helps keep bones strong, but studies have been inconclusive and conflicting about the vitamin's value in protecting against certain cancers, including \u003ca href=\"https://www.cancer.gov/types/colorectal\" target=\"_blank\" rel=\"noopener\">colorectal cancer\u003c/a>.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Now a large international \u003ca href=\"https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djy087\" target=\"_blank\" rel=\"noopener\">study\u003c/a> provides the strongest evidence yet that vitamin D may indeed be protective against colorectal cancer and that a deficiency may increase the risk of this cancer. The findings appear Thursday in the \u003cem>Journal of the National Cancer Institute\u003c/em>.\u003c/p>\n\u003cp>\"For both men and women, deficient levels of vitamin D were associated with a 30 percent increased risk of colorectal cancer,\" says \u003ca href=\"https://www.cancer.org/research/acs-researchers/marjorie-mccullough-bio.html\" target=\"_blank\" rel=\"noopener\">Marji McCullough\u003c/a>, a nutritional epidemiologist with the American Cancer Society and study co-author. People who had higher circulating blood levels of vitamin D\u003cstrong>, \u003c/strong>above the range deemed \"sufficient,\" had a 22 percent lower risk, she says.\u003c/p>\n\u003cp>The study pooled findings from 17 previous studies that included 12,813 adults in the U.S., Europe and Asia. Those studies collectively looked at 5,706 people with colorectal cancer and 7,107 people of a similar age and race who didn't have cancer. Women's menopausal status was also taken into account.\u003c/p>\n\u003cp>To determine what role vitamin D might be playing, researchers looked at participants' blood samples collected in the years before their cancer diagnosis. They also considered the established risk factors for colorectal cancer, including smoking, low physical activity and high body mass index.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Our findings suggest what's optimal for bone health may not be optimal for colorectal risk reduction,\" McCullough says, which could mean higher doses are needed to prevent cancer. Current recommendations for vitamin D supplementation are based solely on studies showing conclusively that it does preserve bone health.\u003c/p>\n\u003cp>A particularly provocative finding of the study, McCullough says, is the relatively strong correlation between higher blood levels of vitamin D and lower risk of colorectal cancer in women.\u003c/p>\n\u003cp>\"We don't know why,\" she says. One hypothesis is that there is some interaction between vitamin D and female hormones. Or it's possible vitamin D prevents cancer by reducing the proliferation of tumor cells or by stopping their growth and \"actually killing those cells,\" she says.\u003c/p>\n\u003cp>Studies like this do not prove cause and effect but rather show only that there may be a connection between the levels of vitamin D circulating through the body and cancer. Still, the authors of the paper write that the results \"substantially strengthen the evidence, previously considered inconclusive, for a causal relationship\" between low vitamin D levels and colorectal cancer.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Another interesting observation in the study, McCullough says, was that beyond a certain level, increasingly higher amounts of vitamin D in the blood had no additional benefit. At the highest levels above what is considered \"adequate,\" there was no further reduction in risk. In other words, she says, \"more is not necessarily better.\"\u003c/p>\n\u003cp>Her take-home message: Don't race out and buy high doses of vitamin D \"just in case.\" Overdoing it can be toxic. Taking too much vitamin D can cause kidney stones and, in very rare cases, death.\u003c/p>\n\u003cp>The issue of whether vitamin D supplements should be used at all to prevent colorectal cancer is still up in the air. \"The key question now is whether intervening with people who have low levels of vitamin D can make a difference,\" says \u003ca href=\"http://www.dana-farber.org/find-a-doctor/jeffrey-a-meyerhardt/\" target=\"_blank\" rel=\"noopener\">Dr. Jeffrey Meyerhardt\u003c/a>, director of the Gastrointestinal Cancer Center at Dana-Farber Cancer Institute in Boston, who was not involved in the study.\u003c/p>\n\u003cp>The study didn't evaluate whether adding vitamin D through food, sunlight or supplements made a difference in cancer risk. It was limited to looking at the level of vitamin D in people's blood.\u003c/p>\n\u003cp>Currently, a large \u003ca href=\"https://www.vitalstudy.org/\" target=\"_blank\" rel=\"noopener\">study\u003c/a> involving more than 25,000 patients is underway at Brigham and Women's Hospital in Boston to find out whether taking vitamin D supplements might reduce the risk of numerous cancers as well as heart disease and stroke. Meyerhardt says answers may be available in the coming year.\u003c/p>\n\u003cp>In the meantime, he suggests people talk with their health care provider about having a blood test to measure vitamin D levels. If you're starting in the deficient range, he says, some doctors might prescribe high doses, to be taken each week for a month or two, and then prescribe lower, maintenance levels.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The cancer society's McCullough says it is generally \u003ca href=\"https://www.bones.nih.gov/health-info/bone/bone-health/nutrition/calcium-and-vitamin-d-important-every-age\" target=\"_blank\" rel=\"noopener\">recommended\u003c/a> that adults have a daily intake of 600 international units of vitamin D up to age 70. Men and women over age 70 should increase their uptake to 800 IUs daily, she says.\u003c/p>\n\u003cp>People should talk with their doctor because different individuals have different needs, she says.\u003c/p>\n\u003cp>\"It depends on where you live and what race you are, because darker skin tends to absorb less vitamin D.\" Sun, age, genetics and weight also play a role in how the body processes vitamin D.\u003c/p>\n\u003cp>Vitamin D can be obtained from vitamin D-rich foods such as egg yolks, salmon, trout, swordfish, tuna and sardines. Numerous foods are fortified with vitamin D including cow's milk, almond milk, soy milk, some cereals and some orange juices.\u003c/p>\n\u003cp>\"If you have a serving of salmon, that's about 500 IUs, and a cup of milk would give you 100 IUs,\" McCullough says, which adds up to the daily recommended dose of 600 IUs.\u003c/p>\n\u003cp>But Meyerhardt says most people don't eat enough fatty fish to reach the recommended vitamin D intake.\u003c/p>\n\u003cp>\"Most vitamin D doesn't really come from your diet\" in most cases, he says. And he says multivitamins contain relatively low levels of vitamin D. \"So you really have to take a supplement\" to meet recommended doses.\u003c/p>\n\u003cp>Vitamin D is often called the \"sunshine\" vitamin, because exposure to sunlight can stimulate production of the vitamin. But exposure to sun is generally not recommended as a way to boost vitamin D, McCullough says, since at excessive levels it can raise the risk of melanoma and other skin cancers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>More than 20 medical centers and organizations participated in the study, including Harvard, the American Cancer Society and the National Cancer Institute.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Does+Vitamin+D+Really+Protect+Against+Colorectal+Cancer%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "U.S. Suicide Rates Are Rising Faster Among Women Than Men",
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"content": "\u003cp>The number of people dying by suicide in the United States has risen by about 30 percent in the past two decades. And while the majority of suicide-related deaths today are among boys and men, a study published Thursday by the \u003ca href=\"https://www.cdc.gov/nchs/index.htm\" target=\"_blank\" rel=\"noopener\">National Center for Health Statistics\u003c/a> finds that the number of girls and women taking their own lives is rising.\u003c/p>\n\u003cp>\"Typically there's between three and four times as many suicides among males as among females,\" says \u003ca href=\"https://www.cdc.gov/nchs/injury/ice/steering_committee.htm\" target=\"_blank\" rel=\"noopener\">Dr. Holly Hedegaard\u003c/a>, a medical epidemiologist at the NCHS and the main author of the new \u003ca href=\"https://www.cdc.gov/nchs/products/databriefs/db309.htm\">study\u003c/a>. In 2016, about 21 boys or men out of 100,000 took their own lives. On the other hand, just six girls or women out of 100,000 died by suicide that year.\u003c/p>\n\u003cp>But when Hedegaard and her colleagues compared the rise in the rates of death by suicide from 2000 to 2016, the increase was significantly larger for females — increasing by 21 percent for boys and men, compared with 50 percent for girls and women.\u003c/p>\n\u003cp>There's \"sort of a narrowing of the [gender] gap in rates,\" Hedegaard notes.\u003c/p>\n\u003cp>The biggest change was seen among women in late middle age. \"For females between the ages of 45 and 64, the suicide rate increased by 60 percent,\" she says. \"That's a pretty large increase in a relatively short period of time.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That the increase for women was more than double the increase for men \"did indeed surprise me,\" says \u003ca href=\"http://www.emory.edu/grady/emory-at-grady/doctors/kaslow.html\" target=\"_blank\" rel=\"noopener\">Nadine Kaslow\u003c/a>, a psychologist at Emory University and the \u003ca href=\"http://www.news.emory.edu/stories/2012/11/psych_kaslow_apa_president/campus.html\">past president\u003c/a> of the \u003ca href=\"http://www.apa.org/\">American Psychological Association\u003c/a>, who was not involved in the study. She says she finds the overall trends for both men and women \"disturbing.\"\u003c/p>\n\u003cp>Scientists don't yet know the reasons behind the steeper rise in the number of girls and women taking their own lives, says Kaslow. \"We're really just beginning to see these differences, and so people are just now beginning to look at this.\"[contextly_sidebar id=\"k6MDe9evjHueopXOQ84nJ1lOI9jYSpJm\"]\u003c/p>\n\u003cp>Though there are different factors at play in each case, excessive stress is a known risk factor for suicide overall, she says.\u003c/p>\n\u003cp>\"People often die by suicide when they just feel totally overwhelmed,\" Kaslow says.\u003c/p>\n\u003cp>According to the American Psychological Association, women say their \u003ca href=\"http://www.apa.org/news/press/releases/stress/2010/gender-stress.aspx\" target=\"_blank\" rel=\"noopener\">stress levels have risen\u003c/a> in recent years. And middle-aged women belonging to the \u003ca href=\"https://www.npr.org/sections/thetwo-way/2013/01/30/170694962/middle-aged-breadwinners-become-part-of-the-sandwich-generation\" target=\"_blank\" rel=\"noopener\">sandwich generation\u003c/a> are especially feeling the pressure of their many responsibilities at home and at work.\u003c/p>\n\u003cp>\"So they may be taking care of children, of parents, have work demands and then more responsibilities,\" Kaslow says.\u003c/p>\n\u003cp>There's also been \u003ca href=\"https://www.census.gov/newsroom/press-releases/2016/cb16-192.html\" target=\"_blank\" rel=\"noopener\">a rise\u003c/a> in the last few decades in the number of single-parent households headed by women. That means more women trying to do everything alone, she says.\u003c/p>\n\u003cp>\"And so there's, sort of, stress everywhere,\" she says. \"They may not have time to take care of themselves, to be kind to themselves, to get the social support they need.\"\u003c/p>\n\u003cp>The new report also shows that more adolescent girls are choosing to end their lives, notes Kaslow. So the problem is not specific to middle-aged women, but across all age groups.\u003c/p>\n\u003cp>\"Suicide is a public health concern,\" says \u003ca href=\"https://afsp.org/about-afsp/jill-harkavy-friedman-ph-d/\" target=\"_blank\" rel=\"noopener\">Jill Harkavy-Friedman\u003c/a>, the vice president of research at the American Foundation for Suicide Prevention. The statistics published Thursday underscore the need for a national prevention effort, she adds.\u003c/p>\n\u003cp>The report also looked at the means of suicide, as recorded in death certificates, and found that firearms remain an important method, particularly for boys and men.\u003c/p>\n\u003cp>\"For males, pretty much from age 15 and older, the majority of the suicides [involved] firearms,\" says Hedegaard.\u003c/p>\n\u003cp>\"We know that limiting access to lethal-means of any kind can reduce suicide,\" Harkavy-Friedman says, \"especially if you limit access during a crisis moment.\"\u003c/p>\n\u003cp>To help prevent suicide, society needs to offer better access to mental health care, she says. And each one of us can do our bit, too, by watching out for the warnings signs among friends and family.\u003c/p>\n\u003cp>Be aware, she says, if you notice something's changing in a loved one, friend or colleague. For example, if their mood is changing, she says, \"maybe they're more irritable, or withdrawn. Maybe they're talking about being a burden.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>At times like these, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23466401\" target=\"_blank\" rel=\"noopener\">it is important\u003c/a> to let people know they're not alone. \"It sounds simple,\" she says. \"But it does make a difference.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=U.S.+Suicide+Rates+Are+Rising+Faster+Among+Women+Than+Men&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "You can help prevent suicide, researchers say, by knowing the signs and reaching out. More boys and men in the U.S. take their own lives than women and girls, but that difference has narrowed.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The number of people dying by suicide in the United States has risen by about 30 percent in the past two decades. And while the majority of suicide-related deaths today are among boys and men, a study published Thursday by the \u003ca href=\"https://www.cdc.gov/nchs/index.htm\" target=\"_blank\" rel=\"noopener\">National Center for Health Statistics\u003c/a> finds that the number of girls and women taking their own lives is rising.\u003c/p>\n\u003cp>\"Typically there's between three and four times as many suicides among males as among females,\" says \u003ca href=\"https://www.cdc.gov/nchs/injury/ice/steering_committee.htm\" target=\"_blank\" rel=\"noopener\">Dr. Holly Hedegaard\u003c/a>, a medical epidemiologist at the NCHS and the main author of the new \u003ca href=\"https://www.cdc.gov/nchs/products/databriefs/db309.htm\">study\u003c/a>. In 2016, about 21 boys or men out of 100,000 took their own lives. On the other hand, just six girls or women out of 100,000 died by suicide that year.\u003c/p>\n\u003cp>But when Hedegaard and her colleagues compared the rise in the rates of death by suicide from 2000 to 2016, the increase was significantly larger for females — increasing by 21 percent for boys and men, compared with 50 percent for girls and women.\u003c/p>\n\u003cp>There's \"sort of a narrowing of the [gender] gap in rates,\" Hedegaard notes.\u003c/p>\n\u003cp>The biggest change was seen among women in late middle age. \"For females between the ages of 45 and 64, the suicide rate increased by 60 percent,\" she says. \"That's a pretty large increase in a relatively short period of time.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That the increase for women was more than double the increase for men \"did indeed surprise me,\" says \u003ca href=\"http://www.emory.edu/grady/emory-at-grady/doctors/kaslow.html\" target=\"_blank\" rel=\"noopener\">Nadine Kaslow\u003c/a>, a psychologist at Emory University and the \u003ca href=\"http://www.news.emory.edu/stories/2012/11/psych_kaslow_apa_president/campus.html\">past president\u003c/a> of the \u003ca href=\"http://www.apa.org/\">American Psychological Association\u003c/a>, who was not involved in the study. She says she finds the overall trends for both men and women \"disturbing.\"\u003c/p>\n\u003cp>Scientists don't yet know the reasons behind the steeper rise in the number of girls and women taking their own lives, says Kaslow. \"We're really just beginning to see these differences, and so people are just now beginning to look at this.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Though there are different factors at play in each case, excessive stress is a known risk factor for suicide overall, she says.\u003c/p>\n\u003cp>\"People often die by suicide when they just feel totally overwhelmed,\" Kaslow says.\u003c/p>\n\u003cp>According to the American Psychological Association, women say their \u003ca href=\"http://www.apa.org/news/press/releases/stress/2010/gender-stress.aspx\" target=\"_blank\" rel=\"noopener\">stress levels have risen\u003c/a> in recent years. And middle-aged women belonging to the \u003ca href=\"https://www.npr.org/sections/thetwo-way/2013/01/30/170694962/middle-aged-breadwinners-become-part-of-the-sandwich-generation\" target=\"_blank\" rel=\"noopener\">sandwich generation\u003c/a> are especially feeling the pressure of their many responsibilities at home and at work.\u003c/p>\n\u003cp>\"So they may be taking care of children, of parents, have work demands and then more responsibilities,\" Kaslow says.\u003c/p>\n\u003cp>There's also been \u003ca href=\"https://www.census.gov/newsroom/press-releases/2016/cb16-192.html\" target=\"_blank\" rel=\"noopener\">a rise\u003c/a> in the last few decades in the number of single-parent households headed by women. That means more women trying to do everything alone, she says.\u003c/p>\n\u003cp>\"And so there's, sort of, stress everywhere,\" she says. \"They may not have time to take care of themselves, to be kind to themselves, to get the social support they need.\"\u003c/p>\n\u003cp>The new report also shows that more adolescent girls are choosing to end their lives, notes Kaslow. So the problem is not specific to middle-aged women, but across all age groups.\u003c/p>\n\u003cp>\"Suicide is a public health concern,\" says \u003ca href=\"https://afsp.org/about-afsp/jill-harkavy-friedman-ph-d/\" target=\"_blank\" rel=\"noopener\">Jill Harkavy-Friedman\u003c/a>, the vice president of research at the American Foundation for Suicide Prevention. The statistics published Thursday underscore the need for a national prevention effort, she adds.\u003c/p>\n\u003cp>The report also looked at the means of suicide, as recorded in death certificates, and found that firearms remain an important method, particularly for boys and men.\u003c/p>\n\u003cp>\"For males, pretty much from age 15 and older, the majority of the suicides [involved] firearms,\" says Hedegaard.\u003c/p>\n\u003cp>\"We know that limiting access to lethal-means of any kind can reduce suicide,\" Harkavy-Friedman says, \"especially if you limit access during a crisis moment.\"\u003c/p>\n\u003cp>To help prevent suicide, society needs to offer better access to mental health care, she says. And each one of us can do our bit, too, by watching out for the warnings signs among friends and family.\u003c/p>\n\u003cp>Be aware, she says, if you notice something's changing in a loved one, friend or colleague. For example, if their mood is changing, she says, \"maybe they're more irritable, or withdrawn. Maybe they're talking about being a burden.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>At times like these, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23466401\" target=\"_blank\" rel=\"noopener\">it is important\u003c/a> to let people know they're not alone. \"It sounds simple,\" she says. \"But it does make a difference.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=U.S.+Suicide+Rates+Are+Rising+Faster+Among+Women+Than+Men&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Karl Deisseroth, a Stanford University professor of bioengineering and psychiatry, has been awarded an international prize worth more than $900,000 for his work in illuminating brain activity with light. The exact amount of the prize was 100 million yen.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Karl has created a revolutionary technology that has broadened our understanding of brain disorders and may one day yield treatments to the millions with these disorders.'\u003ccite>Lloyd Minor, Stanford School of Medicine\u003c/cite>\u003c/aside>\n\u003cp>Deisseroth is receiving the 2018 \u003ca href=\"https://www.kyotoprize.org/en/\" target=\"_blank\" rel=\"noopener\">Kyoto Prize\u003c/a> for advanced technology. Awards are also granted for basic sciences, and arts and philosophy. Some of its recipients have gone on to win the Nobel Prize.\u003c/p>\n\u003cp>\u003ca href=\"https://web.stanford.edu/group/dlab/about_pi.html\" target=\"_blank\" rel=\"noopener\">Deisseroth,\u003c/a> the youngest person to ever receive the prize, is being honored for developing \u003ca href=\"http://web.stanford.edu/group/dlab/optogenetics/\">optogenetics\u003c/a>, a technology that uses light-sensitive proteins to manipulate brain cell activity. The method allows scientists to glean more information about brain disorders and to probe how the nervous system works.\u003c/p>\n\u003cp>\"It is humbling to see all the distinguished people who have won the Kyoto Prize, and to be listed with them. It is wonderful to see pure basic science discoveries recognized in this way,\" said Deisseroth.\u003c/p>\n\u003cp>The technique developed by Deisseroth and his team manipulates cellular activity by delivering a pulse of light to a particular cell through an optical fiber that has been implanted in the animal’s brain. The method yields information on how brain cells give rise to sensations, memories and actions.\u003c/p>\n\u003cfigure id=\"attachment_442697\" class=\"wp-caption alignright\" style=\"max-width: 480px\">\u003cimg class=\"size-full wp-image-442697\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/06/image01.jpg\" alt=\"\" width=\"480\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/06/image01.jpg 480w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image01-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image01-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image01-375x281.jpg 375w\" sizes=\"(max-width: 480px) 100vw, 480px\">\u003cfigcaption class=\"wp-caption-text\">The Kyoto prize medal. \u003ccite>(Inamori Foundation)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“A brilliant and innovative investigator, Karl has created a revolutionary technology that has broadened our understanding of brain disorders and may one day yield treatments to the millions with these disorders,” said Dr. Lloyd Minor, dean of the \u003ca href=\"http://med.stanford.edu/\" target=\"_blank\" rel=\"noopener\">Stanford School of Medicine\u003c/a>, in a statement. “His receipt of the Kyoto Prize is inordinately well-deserved and the product of his unmatched scientific vision.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Deisseroth has said his research\u003ca href=\"https://www.scientificamerican.com/article/optogenetics-controlling/\" target=\"_blank\" rel=\"noopener\"> was motivated by\u003c/a> a desire to better understand psychiatric disorders, the leading cause of years of life lost to death or disability.\u003c/p>\n\u003cp>Deisseroth’s research, developed between 2004 and 2009, is used by laboratories around the world.\u003c/p>\n\u003cp>\"Thousands of laboratories around the world have used optogenetics to satisfy their own curiosity about the natural world, and to test ideas in a broad range of systems and species,\" he said. \"Many people are also studying brain diseases, and optogenetics-guided clinical trials have already started with some success, bringing a new kind of hope to people affected by these diseases such as substance dependence and depression.\"\u003c/p>\n\u003cp>\u003ciframe width=\"640\" height=\"360\" src=\"https://www.youtube.com/embed/CE6uNFFZ0qc?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen>\u003c/iframe>\u003c/p>\n\u003cp>What makes optogenetics so groundbreaking is its level of precision in controlling defined activity within specific cells, according to I-Han Chou, senior editor at the journal \"Nature\".[contextly_sidebar id=\"08EVHeybNXS0fTuglKI55A1KVy7EFUpl\"]\u003c/p>\n\u003cp>\"If you imagine the brain as this city, up until now we have been looking at it as if from space,\" Chou\u003ca href=\"https://www.weforum.org/agenda/2016/10/what-is-optogenetics/\" target=\"_blank\" rel=\"noopener\"> told the\u003c/a> World Economic Forum site. \"We haven't had the tools to do anything beyond seeing what the whole city block is doing. What you actually want to know is what the individual components of the city are, what the people are doing, and what's the information being transported from one part of the city to another.\"\u003c/p>\n\u003cp>The technique could transform how neurological disorders such as Parkinson's disease are treated.\u003c/p>\n\u003cp>\"When things go wrong with the brain it is just so devastating. One of the hopes for optogenetics is that if it can work in humans, it might be used as a tool for restoring brain function,\" Chou added.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "Karl Deisseroth, the Stanford University professor who developed a groundbreaking method for probing how brain cells behave and communicate, is the recipient of the 2018 Kyoto Prize for advanced technology. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Karl Deisseroth, a Stanford University professor of bioengineering and psychiatry, has been awarded an international prize worth more than $900,000 for his work in illuminating brain activity with light. The exact amount of the prize was 100 million yen.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Karl has created a revolutionary technology that has broadened our understanding of brain disorders and may one day yield treatments to the millions with these disorders.'\u003ccite>Lloyd Minor, Stanford School of Medicine\u003c/cite>\u003c/aside>\n\u003cp>Deisseroth is receiving the 2018 \u003ca href=\"https://www.kyotoprize.org/en/\" target=\"_blank\" rel=\"noopener\">Kyoto Prize\u003c/a> for advanced technology. Awards are also granted for basic sciences, and arts and philosophy. Some of its recipients have gone on to win the Nobel Prize.\u003c/p>\n\u003cp>\u003ca href=\"https://web.stanford.edu/group/dlab/about_pi.html\" target=\"_blank\" rel=\"noopener\">Deisseroth,\u003c/a> the youngest person to ever receive the prize, is being honored for developing \u003ca href=\"http://web.stanford.edu/group/dlab/optogenetics/\">optogenetics\u003c/a>, a technology that uses light-sensitive proteins to manipulate brain cell activity. The method allows scientists to glean more information about brain disorders and to probe how the nervous system works.\u003c/p>\n\u003cp>\"It is humbling to see all the distinguished people who have won the Kyoto Prize, and to be listed with them. It is wonderful to see pure basic science discoveries recognized in this way,\" said Deisseroth.\u003c/p>\n\u003cp>The technique developed by Deisseroth and his team manipulates cellular activity by delivering a pulse of light to a particular cell through an optical fiber that has been implanted in the animal’s brain. The method yields information on how brain cells give rise to sensations, memories and actions.\u003c/p>\n\u003cfigure id=\"attachment_442697\" class=\"wp-caption alignright\" style=\"max-width: 480px\">\u003cimg class=\"size-full wp-image-442697\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/06/image01.jpg\" alt=\"\" width=\"480\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/06/image01.jpg 480w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image01-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image01-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image01-375x281.jpg 375w\" sizes=\"(max-width: 480px) 100vw, 480px\">\u003cfigcaption class=\"wp-caption-text\">The Kyoto prize medal. \u003ccite>(Inamori Foundation)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“A brilliant and innovative investigator, Karl has created a revolutionary technology that has broadened our understanding of brain disorders and may one day yield treatments to the millions with these disorders,” said Dr. Lloyd Minor, dean of the \u003ca href=\"http://med.stanford.edu/\" target=\"_blank\" rel=\"noopener\">Stanford School of Medicine\u003c/a>, in a statement. “His receipt of the Kyoto Prize is inordinately well-deserved and the product of his unmatched scientific vision.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Deisseroth has said his research\u003ca href=\"https://www.scientificamerican.com/article/optogenetics-controlling/\" target=\"_blank\" rel=\"noopener\"> was motivated by\u003c/a> a desire to better understand psychiatric disorders, the leading cause of years of life lost to death or disability.\u003c/p>\n\u003cp>Deisseroth’s research, developed between 2004 and 2009, is used by laboratories around the world.\u003c/p>\n\u003cp>\"Thousands of laboratories around the world have used optogenetics to satisfy their own curiosity about the natural world, and to test ideas in a broad range of systems and species,\" he said. \"Many people are also studying brain diseases, and optogenetics-guided clinical trials have already started with some success, bringing a new kind of hope to people affected by these diseases such as substance dependence and depression.\"\u003c/p>\n\u003cp>\u003ciframe width=\"640\" height=\"360\" src=\"https://www.youtube.com/embed/CE6uNFFZ0qc?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen>\u003c/iframe>\u003c/p>\n\u003cp>What makes optogenetics so groundbreaking is its level of precision in controlling defined activity within specific cells, according to I-Han Chou, senior editor at the journal \"Nature\".\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"If you imagine the brain as this city, up until now we have been looking at it as if from space,\" Chou\u003ca href=\"https://www.weforum.org/agenda/2016/10/what-is-optogenetics/\" target=\"_blank\" rel=\"noopener\"> told the\u003c/a> World Economic Forum site. \"We haven't had the tools to do anything beyond seeing what the whole city block is doing. What you actually want to know is what the individual components of the city are, what the people are doing, and what's the information being transported from one part of the city to another.\"\u003c/p>\n\u003cp>The technique could transform how neurological disorders such as Parkinson's disease are treated.\u003c/p>\n\u003cp>\"When things go wrong with the brain it is just so devastating. One of the hopes for optogenetics is that if it can work in humans, it might be used as a tool for restoring brain function,\" Chou added.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Trump Administration To Shut Down Guidelines Bank for Doctors",
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"content": "\u003cp>Diagnostic and treatment guidelines aren’t sexy, but they play a vital role in the practice of medicine. Physician societies, government agencies, and others issue detailed recommendations for everything from who should receive cardiac stents to which antibiotics patients should get to avoid infections after knee surgery.[contextly_sidebar id=\"OZslp8wClgKtjgZF05JxjMNXhSPssdaO\"]\u003c/p>\n\u003cp>These documents are essential for the provision of evidence-based care, as opposed to seat-of-the-pants treatment that might be expedient or lucrative for doctors but less than ideal for patients.\u003c/p>\n\u003cp>Until now, the most rigorous of those guidelines have been available for doctors to peruse in a single location: the government’s Agency for Healthcare Research and Quality’s National Guidelines Clearinghouse (NGC). NGC also takes the time to summarize the more than 4,000 guidelines it maintains, an indispensible service for the physicians who come to the site seeking information.\u003c/p>\n\u003cp>It’s a niche site, but the NGC draws an average of 200,000 visitors per month, according to AHRQ.\u003c/p>\n\u003cp>After roughly a decade of budget cuts, however, AHRQ has defunded the repository, effective July 16. While the recommendations will still exist elsewhere after that date, anyone hoping to find out, say, how best to treat a teenager with asthma, or who should have a particular test, will have to work harder to locate the most current guidance. The NGC itself will disappear.[contextly_sidebar id=\"9HkdwjjGHZqkrMUudb7y4ILOnDncrFEI\"]\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Killing these resources to save a few hundred thousand dollars per year is a penny-wise, pound-foolish decision, and your health and mine will be poorer for it,” said Dr. Kenny Lin, a family physician in Washington, D.C., who is also on the faculty at Georgetown University’s medical school.\u003c/p>\n\u003cp>In fact, similar repositories do exist, but the NGC’s criteria for inclusion were set by the National Academy of Medicine, which established a high bar for rigor that other clearinghouses might lack. In addition to physicians, other users of the NGC include state and local governments, medical schools and other educational institutions, and health care organizations.\u003c/p>\n\u003cp>An AHRQ spokesperson acknowledged that “some clinicians and others may initially miss the NGC. But in today’s information-rich environment, they’ll have the ability to find guidelines in other places, such as with organizations that develop guidelines. Likewise, information about guidelines’ trustworthiness will be available from peer-reviewed publications and other sources.”\u003c/p>\n\u003cp>Others beg to differ. Dr. Roy Poses, a Brown University professor of medicine and president of the Foundation for Integrity and Responsibility in Medicine, said doctors “will be losing an important resource for research, education and evidence-based practice.” (It’s worth noting that some doctors are not fond of the proliferation of guidelines, which they blame for a culture of cookie-cutter care that’s bereft of art and flexibility — and that exposes them to liability if they happen to deviate from doctrine.)[contextly_sidebar id=\"uP9YVw1C4FCBYcJFLPHxKYEIBCgiiNn1\"]\u003c/p>\n\u003cp>As lamentable as the loss of the NGC would be for doctors and patients, it’s hardly surprising. Its parent agency has been suffering death by 1,000 cuts for years. Despite a modest bump in its 2018 funding, the AHRQ’s $334 million annual budget is $120 million below its 2010 level, adjusted for inflation.\u003c/p>\n\u003cp>The NGC — whose fiscal year 2017 budget was $1.2 million, down from $2.1 million the year before — didn’t survive the chopping block. “The decision to end support for the NGC was an Agency decision based on assessing how best to use our current resources, including both appropriated dollars and dollars from the Patient-Centered Outcomes Research Trust Fund,” the AHRQ spokesperson told STAT. The AHRQ budget for the 2019 fiscal year, as proposed by the Trump administration, “will re-focus support to only the highest priority research programs.” That doesn’t include the NGC — which is operated by ECRI, a health nonprofit — because it is considered a dissemination contract.\u003c/p>\n\u003cp>With the date of death for the NGG barely a month away, America’s doctors — and their patients — may, to paraphrase another clearinghouse, already be losers. Perhaps some physician group would like to ride in like a white knight and provide the funding to keep the NGC alive.\u003c/p>\n\u003cp>AHRQ “is receiving expressions of interest from stakeholders who may wish to carry on NGC’s work,” according to the AHRQ spokesperson. “If the work continues, we may be able to provide more information in the future, such as listing those potential stakeholders and opportunities for the public to comment.”\u003c/p>\n\u003cp>If that comes to pass, that funding, to borrow a phrase from politics, should be put in a lockbox.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This\u003ca href=\"https://www.statnews.com/2018/06/13/ahrq-practice-guidelines-clearinghouse-shutting-down/\" target=\"_blank\" rel=\"noopener\"> story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Killing these resources to save a few hundred thousand dollars per year is a penny-wise, pound-foolish decision, and your health and mine will be poorer for it,” said Dr. Kenny Lin, a family physician in Washington, D.C., who is also on the faculty at Georgetown University’s medical school.\u003c/p>\n\u003cp>In fact, similar repositories do exist, but the NGC’s criteria for inclusion were set by the National Academy of Medicine, which established a high bar for rigor that other clearinghouses might lack. In addition to physicians, other users of the NGC include state and local governments, medical schools and other educational institutions, and health care organizations.\u003c/p>\n\u003cp>An AHRQ spokesperson acknowledged that “some clinicians and others may initially miss the NGC. But in today’s information-rich environment, they’ll have the ability to find guidelines in other places, such as with organizations that develop guidelines. Likewise, information about guidelines’ trustworthiness will be available from peer-reviewed publications and other sources.”\u003c/p>\n\u003cp>Others beg to differ. Dr. Roy Poses, a Brown University professor of medicine and president of the Foundation for Integrity and Responsibility in Medicine, said doctors “will be losing an important resource for research, education and evidence-based practice.” (It’s worth noting that some doctors are not fond of the proliferation of guidelines, which they blame for a culture of cookie-cutter care that’s bereft of art and flexibility — and that exposes them to liability if they happen to deviate from doctrine.)\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>As lamentable as the loss of the NGC would be for doctors and patients, it’s hardly surprising. Its parent agency has been suffering death by 1,000 cuts for years. Despite a modest bump in its 2018 funding, the AHRQ’s $334 million annual budget is $120 million below its 2010 level, adjusted for inflation.\u003c/p>\n\u003cp>The NGC — whose fiscal year 2017 budget was $1.2 million, down from $2.1 million the year before — didn’t survive the chopping block. “The decision to end support for the NGC was an Agency decision based on assessing how best to use our current resources, including both appropriated dollars and dollars from the Patient-Centered Outcomes Research Trust Fund,” the AHRQ spokesperson told STAT. The AHRQ budget for the 2019 fiscal year, as proposed by the Trump administration, “will re-focus support to only the highest priority research programs.” That doesn’t include the NGC — which is operated by ECRI, a health nonprofit — because it is considered a dissemination contract.\u003c/p>\n\u003cp>With the date of death for the NGG barely a month away, America’s doctors — and their patients — may, to paraphrase another clearinghouse, already be losers. Perhaps some physician group would like to ride in like a white knight and provide the funding to keep the NGC alive.\u003c/p>\n\u003cp>AHRQ “is receiving expressions of interest from stakeholders who may wish to carry on NGC’s work,” according to the AHRQ spokesperson. “If the work continues, we may be able to provide more information in the future, such as listing those potential stakeholders and opportunities for the public to comment.”\u003c/p>\n\u003cp>If that comes to pass, that funding, to borrow a phrase from politics, should be put in a lockbox.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This\u003ca href=\"https://www.statnews.com/2018/06/13/ahrq-practice-guidelines-clearinghouse-shutting-down/\" target=\"_blank\" rel=\"noopener\"> story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>In May 1951, a 35-year-old Boston woman who had been treated for years for ulcerative colitis and a variety of mental disorders — with little success — entered the Lahey Clinic in Burlington, Mass., to have a \u003ca href=\"https://www.statnews.com/2016/10/27/not-all-there-my-mothers-lobotomy/\">lobotomy\u003c/a>. Her doctors drilled two holes into her skull and cut or melted away two wedges of her brain’s cerebral cortex using a technique developed by James Poppen, a Lahey neurosurgeon.[contextly_sidebar id=\"5M1H4hzsx74wwc9XwMscksYj8B3iW6Dm\"]\u003c/p>\n\u003cp>By August, according to Walter I. Tucker, a Lahey psychiatrist, she was largely free of her physical and mental ailments. By December, after a period of confusion and “laziness,” she was socially active and going to dances, Tucker wrote \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/14946997\" target=\"_blank\" rel=\"noopener\">in the Lahey Clinic Bulletin\u003c/a>. She was also gaining weight and working regularly, and was free of “inappropriate worries, phobias, obsessions, and compulsions.” There was no sign of colitis. Her mother, with whom she lived, “was amazed at the change and thinks that the patient is better than she has ever been in her life,” Tucker wrote.\u003c/p>\n\u003cp>Like most patients in medical history, we don’t know her name. And we have no idea whether she went on to live a normal life — many people who had a lobotomy did not.\u003c/p>\n\u003cp class=\"\">\u003cimg class=\"aligncenter size-full wp-image-148827\" src=\"https://www.statnews.com/wp-content/uploads/2016/09/SECTION-BREAK_black.png\" alt=\"\" width=\"205\" height=\"9\">\u003c/p>\n\u003cp>I’ve been searching for years for that woman, whom I call “patient zero.” She was the first person to have a lobotomy to treat ulcerative colitis. That barbaric operation helped cement the now-discredited notion that this painful and debilitating disease, which I developed as a boy, is a condition that we bring on ourselves.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For more than half a century, I believed that something in my character or emotions was responsible for the pain in my gut and my bloody diarrhea. I now know that’s not true, thanks to my doctors and to my deep dive into the history of this disease.\u003c/p>\n\u003cp>In my lifetime, a revolution has occurred in the treatment of ulcerative colitis. Unearthing its history has angered me, not so much because of how I was deceived but for the shattered lives of fellow sufferers. Even today it leaves people isolated, subject to therapeutic trial and error, fearful of long-term complications such as cancer, and stigmatized. One of the goals of my research is to make sure they don’t feel they are to blame for their disease.\u003c/p>\n\u003cp class=\"\">\u003cimg class=\"aligncenter size-full wp-image-148827\" src=\"https://www.statnews.com/wp-content/uploads/2016/09/SECTION-BREAK_black.png\" alt=\"\" width=\"205\" height=\"9\">\u003c/p>\n\u003cp>The radical idea of using lobotomy to treat ulcerative colitis arose from a theory in vogue at the time: The disease was psychosomatic, meaning it originated from mental or emotional causes. This concept evolved from ancient observations that emotions can cause physical changes. Think sweating under stress, stomachaches before marriage, battlefield diarrhea, and the like.”Emotions and Bodily Changes,” a persuasive collection of anecdotes published in 1935 by psychiatrist Helen Flanders Dunbar, helped set the stage for viewing many illnesses as psychosomatic.[contextly_sidebar id=\"RXnBj3rEPWYyJvBmos22z0oKGdeD3vxr\"]\u003c/p>\n\u003cp>The theory that ulcerative colitis was psychosomatic goes back to a single article published five years earlier in the American Journal of the Medical Sciences by Cecil Murray of Columbia University, who was a medical student at the time. He claimed that he found common traits in a dozen patients with ulcerative colitis. All were childish, the men were tied to their mothers’ apron strings, and they all got sick right after “a difficult psychologic situation.” Psychotherapy, he wrote, could help them.\u003c/p>\n\u003cp>Murray’s theory spread like wildfire through the gut medicine community. It was fueled by physician ignorance and impotence, the habit of looking askance at patients whose symptoms could not be explained, and the arrival in the U.S. of German psychoanalysts who were disciples of Sigmund Freud. They believed that emotions could make you sick, wrote Robert Aronowitz and Howard Spiro \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/2980765\" target=\"_blank\" rel=\"noopener\">in their 1988 article\u003c/a> “The Rise and Fall of the Psychosomatic Hypothesis in Ulcerative Colitis.”\u003c/p>\n\u003cp>No disease was more ripe for a Freudian fix than ulcerative colitis. Uncontrolled diarrhea could be blamed on a mother’s faulty potty training. By the late 1940s, dozens of medical journal articles described people with colitis as immature, fastidious, mother-clinging obsessives.\u003c/p>\n\u003cp>There were also no good treatments at the time for a disease that killed up to 30 percent of those it struck. Medications were few and largely ineffective, and the only known cure was the risky removal of the colon — at the Lahey Clinic, the surgery itself killed 22 percent of the patients who underwent it — which made the patient a shamed invalid with an uncontrolled fecal stream dribbling out of a red abdominal stump.\u003c/p>\n\u003cp>Not everyone bought into the psychosomatic theory. In a spirited 1947 conference debate, quoted in Aronowitz’s unpublished 1985 M.D. thesis at Yale University, Sarah Jordan, head of gastroenterology at the Lahey Clinic, described a typical patient as a “young vigorous human being with all-too-often superior type of striving, ambitious personality — the type of young person that we all like to have as sons and daughters.”[contextly_sidebar id=\"HDzCkAT4tKWQGeq11p0EorZRf5ATc6w7\"]\u003c/p>\n\u003cp>To which Yale’s Albert Sullivan, one of the \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2606404/\" target=\"_blank\" rel=\"noopener\">most prolific cheerleaders\u003c/a> of a psychosomatic origin for ulcerative colitis, retorted: “I have yet to see a patient with non-specific ulcerative colitis that I would have as part of my family.”\u003c/p>\n\u003cp>It was only a matter of time before the psychogenesis concept produced bizarre experiments. If the brain and its “nervous tensions” could be disconnected from the gut, the thinking went, then the gut could heal. At several major hospitals, patients were locked away in psychiatric wards and subjected to psychotherapy, electroshock, novocaine injections into the brain, and slicing sections of the vagus nerve, which connects the brain with the intestinal tract.\u003c/p>\n\u003cp>The first mention of performing a lobotomy to treat colitis that I could find appeared during a 1948 postmortem conference at the University of Iowa. A 23-year-old housewife, wasted and drained to a skeleton, had died from ulcerative colitis, and physicians pondered what more they could have done for her. Citing the growing literature on psychogenesis, a neurosurgeon suggested a lobotomy. The proposal touched off soul-searching among the doctors at the table, although there is no record that surgeons at the university followed through on the idea.\u003c/p>\n\u003cp>Three years later, the Lahey team performed the first known lobotomy for ulcerative colitis on patient zero, an only child born in 1916. She had previously undergone electroconvulsive therapy, insulin shock treatments, a temporary rerouting of the small intestine (called an ileostomy), and psychotherapy. According to her Lahey doctors, the lobotomy was a success.\u003c/p>\n\u003cp>In the decade that followed, dozens of colitis patients were given lobotomies in the U.S., Canada, and several European countries. A \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/14392178\" target=\"_blank\" rel=\"noopener\">1955 literature review\u003c/a> found mixed results in the U.S., with one or two successes and other cases that “have apparently not noted good results.” In 1964, the Belgian medical journal Le Scalpel reported that over the course of 10 years “positive results” were observed in two-thirds of 50 lobotomies done on people with ulcerative colitis “without impact to the psyche.”[contextly_sidebar id=\"2zg05PCjyu8qtJ1jfLVEgUBoX6uhmHLw\"]\u003c/p>\n\u003cp>At the University of Oklahoma, surgeons performed five lobotomies on three women and two men who had been diagnosed with mental illness as well as ulcerative colitis. The effects on the three women’s colons “were strikingly beneficial,” as their number of bowel movements returned to normal, according to an article \u003ca href=\"https://jamanetwork.com/journals/jama/article-abstract/304807\" target=\"_blank\" rel=\"noopener\">in the Journal of the American Medical Association\u003c/a>. But both of the men died of complications. I was able to track down the sons of one of them, Roy Mixer, who died after undergoing two lobotomies in 1954. They remembered twin scars on their dad’s skull and his empty staring.\u003c/p>\n\u003cp>“He was a guinea pig. He wasn’t my dad,” Richard Mixer told me.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-148827\" src=\"https://www.statnews.com/wp-content/uploads/2016/09/SECTION-BREAK_black.png\" alt=\"\" width=\"205\" height=\"9\">\u003c/p>\n\u003cp>Lobotomies for ulcerative colitis, and for mental illness, were halted in the late 1950s because of outrage at the barbarity of the procedure and the emergence of new drugs — antipsychotics for mental illness and corticosteroids for colitis. The era of the psychosomatic genesis of ulcerative colitis should have ended in 1990 when an American Journal of Psychiatry \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/2197886\" target=\"_blank\" rel=\"noopener\">review of 138 studies\u003c/a> that had linked ulcerative colitis with psychiatric factors found “serious flaws” and bias in 131 of them. Of the seven studies the authors determined were solid systematic investigations, all seven failed to find a link between psychiatric factors and ulcerative colitis. And yet, the reviewers added, “a substantial number of authors continue to subscribe to a psychosomatic model.”\u003c/p>\n\u003cp>Only one physician that I know of, renowned gastroenterologist Joseph Kirsner of the University of Chicago, apologized publicly in a speech at a German conference for getting drawn into the dark alley of psychogenesis, according to David Rubin, a professor of medicine and Kirsner’s successor at Chicago. The comment, made late in Kirsner’s life, was not published.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-148827\" src=\"https://www.statnews.com/wp-content/uploads/2016/09/SECTION-BREAK_black.png\" alt=\"\" width=\"205\" height=\"9\">\u003c/p>\n\u003cp>Although the belief that an individual’s character or emotions causes ulcerative colitis was discredited and has largely been abandoned by gastroenterologists, many people living with the condition today are still shadowed by the notion that their disease begins, worsens, or abates in their minds, and that because emotions can be controlled, they ought to be able to heal themselves.\u003c/p>\n\u003cp>“It’s so easy for people to analyze a physical problem and blame it on a psychological issue that is going on in your life,” according to Judith Alexander Brice, a Pittsburgh psychiatrist and poet who detailed her battle with inflammatory bowel disease and attitudes among her peers in an essay published in the book “When Doctors Get Sick.”\u003c/p>\n\u003cp>Before Brice had her colon removed in 1982, doctors in her psychiatric community suggested that she was “too anxious or too depressed,” and would not be sick “if I had a different psychological constitution,” she said in an interview. “It was enraging, demoralizing and it made me feel so estranged from people.”[contextly_sidebar id=\"97sd2Cql5tPz6Rjzkkm9hpXDIuJKqlOn\"]\u003c/p>\n\u003cp>Just last month, in a \u003ca href=\"https://www.facebook.com/groups/ulcerative/\" target=\"_blank\" rel=\"noopener\">private Facebook group\u003c/a> devoted to ulcerative colitis, Andrea Thornton Boggs, a mother from Illinois who was diagnosed at age 4, wrote: “I was a very timid and sensitive child and the doctors at the time attributed my UC to that. I was always told to relax and loosen up and I would feel better. Some of my family members still believe it’s all in my head. It causes me to doubt myself in every way.”\u003c/p>\n\u003cp>I didn’t react that way in 1962 when, as an 18-year-old farm boy and college freshman, I read in a medical textbook that my ulcerative colitis was psychosomatic. I took it as fact and stuffed it inside. For the next half century, I assumed that I was to blame, at least in part, for bringing on my symptoms.\u003c/p>\n\u003cp>Five years ago, I mentioned this to my family doctor. “We owe you an apology,” he said, putting his hand on my belly. “That’s not even taught anymore.”\u003c/p>\n\u003cp>Wrestling with that revelation, I decided to research my darkest secret, a miserable disease that I finally cured by asking a surgeon to remove my colon.\u003c/p>\n\u003cp>Here’s my hope: that some reader will know what happened to patient zero, whose treatment could be the opening chapter in my story of ulcerative colitis, a decimating disease whose shameful history deserves to be told.\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://jimcarrier.com/ABOUT/\" target=\"_blank\" rel=\"noopener\">Jim Carrier\u003c/a>, an award-winning journalist, is a member of the University of Vermont Committee on Human Research in the Medical Sciences. He is writing a history of ulcerative colitis and its treatment.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This\u003ca href=\"https://www.statnews.com/2018/06/12/lobotomy-ulcerative-colitis-shameful-medical-history/\" target=\"_blank\" rel=\"noopener\"> story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In May 1951, a 35-year-old Boston woman who had been treated for years for ulcerative colitis and a variety of mental disorders — with little success — entered the Lahey Clinic in Burlington, Mass., to have a \u003ca href=\"https://www.statnews.com/2016/10/27/not-all-there-my-mothers-lobotomy/\">lobotomy\u003c/a>. Her doctors drilled two holes into her skull and cut or melted away two wedges of her brain’s cerebral cortex using a technique developed by James Poppen, a Lahey neurosurgeon.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>By August, according to Walter I. Tucker, a Lahey psychiatrist, she was largely free of her physical and mental ailments. By December, after a period of confusion and “laziness,” she was socially active and going to dances, Tucker wrote \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/14946997\" target=\"_blank\" rel=\"noopener\">in the Lahey Clinic Bulletin\u003c/a>. She was also gaining weight and working regularly, and was free of “inappropriate worries, phobias, obsessions, and compulsions.” There was no sign of colitis. Her mother, with whom she lived, “was amazed at the change and thinks that the patient is better than she has ever been in her life,” Tucker wrote.\u003c/p>\n\u003cp>Like most patients in medical history, we don’t know her name. And we have no idea whether she went on to live a normal life — many people who had a lobotomy did not.\u003c/p>\n\u003cp class=\"\">\u003cimg class=\"aligncenter size-full wp-image-148827\" src=\"https://www.statnews.com/wp-content/uploads/2016/09/SECTION-BREAK_black.png\" alt=\"\" width=\"205\" height=\"9\">\u003c/p>\n\u003cp>I’ve been searching for years for that woman, whom I call “patient zero.” She was the first person to have a lobotomy to treat ulcerative colitis. That barbaric operation helped cement the now-discredited notion that this painful and debilitating disease, which I developed as a boy, is a condition that we bring on ourselves.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For more than half a century, I believed that something in my character or emotions was responsible for the pain in my gut and my bloody diarrhea. I now know that’s not true, thanks to my doctors and to my deep dive into the history of this disease.\u003c/p>\n\u003cp>In my lifetime, a revolution has occurred in the treatment of ulcerative colitis. Unearthing its history has angered me, not so much because of how I was deceived but for the shattered lives of fellow sufferers. Even today it leaves people isolated, subject to therapeutic trial and error, fearful of long-term complications such as cancer, and stigmatized. One of the goals of my research is to make sure they don’t feel they are to blame for their disease.\u003c/p>\n\u003cp class=\"\">\u003cimg class=\"aligncenter size-full wp-image-148827\" src=\"https://www.statnews.com/wp-content/uploads/2016/09/SECTION-BREAK_black.png\" alt=\"\" width=\"205\" height=\"9\">\u003c/p>\n\u003cp>The radical idea of using lobotomy to treat ulcerative colitis arose from a theory in vogue at the time: The disease was psychosomatic, meaning it originated from mental or emotional causes. This concept evolved from ancient observations that emotions can cause physical changes. Think sweating under stress, stomachaches before marriage, battlefield diarrhea, and the like.”Emotions and Bodily Changes,” a persuasive collection of anecdotes published in 1935 by psychiatrist Helen Flanders Dunbar, helped set the stage for viewing many illnesses as psychosomatic.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The theory that ulcerative colitis was psychosomatic goes back to a single article published five years earlier in the American Journal of the Medical Sciences by Cecil Murray of Columbia University, who was a medical student at the time. He claimed that he found common traits in a dozen patients with ulcerative colitis. All were childish, the men were tied to their mothers’ apron strings, and they all got sick right after “a difficult psychologic situation.” Psychotherapy, he wrote, could help them.\u003c/p>\n\u003cp>Murray’s theory spread like wildfire through the gut medicine community. It was fueled by physician ignorance and impotence, the habit of looking askance at patients whose symptoms could not be explained, and the arrival in the U.S. of German psychoanalysts who were disciples of Sigmund Freud. They believed that emotions could make you sick, wrote Robert Aronowitz and Howard Spiro \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/2980765\" target=\"_blank\" rel=\"noopener\">in their 1988 article\u003c/a> “The Rise and Fall of the Psychosomatic Hypothesis in Ulcerative Colitis.”\u003c/p>\n\u003cp>No disease was more ripe for a Freudian fix than ulcerative colitis. Uncontrolled diarrhea could be blamed on a mother’s faulty potty training. By the late 1940s, dozens of medical journal articles described people with colitis as immature, fastidious, mother-clinging obsessives.\u003c/p>\n\u003cp>There were also no good treatments at the time for a disease that killed up to 30 percent of those it struck. Medications were few and largely ineffective, and the only known cure was the risky removal of the colon — at the Lahey Clinic, the surgery itself killed 22 percent of the patients who underwent it — which made the patient a shamed invalid with an uncontrolled fecal stream dribbling out of a red abdominal stump.\u003c/p>\n\u003cp>Not everyone bought into the psychosomatic theory. In a spirited 1947 conference debate, quoted in Aronowitz’s unpublished 1985 M.D. thesis at Yale University, Sarah Jordan, head of gastroenterology at the Lahey Clinic, described a typical patient as a “young vigorous human being with all-too-often superior type of striving, ambitious personality — the type of young person that we all like to have as sons and daughters.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>To which Yale’s Albert Sullivan, one of the \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2606404/\" target=\"_blank\" rel=\"noopener\">most prolific cheerleaders\u003c/a> of a psychosomatic origin for ulcerative colitis, retorted: “I have yet to see a patient with non-specific ulcerative colitis that I would have as part of my family.”\u003c/p>\n\u003cp>It was only a matter of time before the psychogenesis concept produced bizarre experiments. If the brain and its “nervous tensions” could be disconnected from the gut, the thinking went, then the gut could heal. At several major hospitals, patients were locked away in psychiatric wards and subjected to psychotherapy, electroshock, novocaine injections into the brain, and slicing sections of the vagus nerve, which connects the brain with the intestinal tract.\u003c/p>\n\u003cp>The first mention of performing a lobotomy to treat colitis that I could find appeared during a 1948 postmortem conference at the University of Iowa. A 23-year-old housewife, wasted and drained to a skeleton, had died from ulcerative colitis, and physicians pondered what more they could have done for her. Citing the growing literature on psychogenesis, a neurosurgeon suggested a lobotomy. The proposal touched off soul-searching among the doctors at the table, although there is no record that surgeons at the university followed through on the idea.\u003c/p>\n\u003cp>Three years later, the Lahey team performed the first known lobotomy for ulcerative colitis on patient zero, an only child born in 1916. She had previously undergone electroconvulsive therapy, insulin shock treatments, a temporary rerouting of the small intestine (called an ileostomy), and psychotherapy. According to her Lahey doctors, the lobotomy was a success.\u003c/p>\n\u003cp>In the decade that followed, dozens of colitis patients were given lobotomies in the U.S., Canada, and several European countries. A \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/14392178\" target=\"_blank\" rel=\"noopener\">1955 literature review\u003c/a> found mixed results in the U.S., with one or two successes and other cases that “have apparently not noted good results.” In 1964, the Belgian medical journal Le Scalpel reported that over the course of 10 years “positive results” were observed in two-thirds of 50 lobotomies done on people with ulcerative colitis “without impact to the psyche.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>At the University of Oklahoma, surgeons performed five lobotomies on three women and two men who had been diagnosed with mental illness as well as ulcerative colitis. The effects on the three women’s colons “were strikingly beneficial,” as their number of bowel movements returned to normal, according to an article \u003ca href=\"https://jamanetwork.com/journals/jama/article-abstract/304807\" target=\"_blank\" rel=\"noopener\">in the Journal of the American Medical Association\u003c/a>. But both of the men died of complications. I was able to track down the sons of one of them, Roy Mixer, who died after undergoing two lobotomies in 1954. They remembered twin scars on their dad’s skull and his empty staring.\u003c/p>\n\u003cp>“He was a guinea pig. He wasn’t my dad,” Richard Mixer told me.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-148827\" src=\"https://www.statnews.com/wp-content/uploads/2016/09/SECTION-BREAK_black.png\" alt=\"\" width=\"205\" height=\"9\">\u003c/p>\n\u003cp>Lobotomies for ulcerative colitis, and for mental illness, were halted in the late 1950s because of outrage at the barbarity of the procedure and the emergence of new drugs — antipsychotics for mental illness and corticosteroids for colitis. The era of the psychosomatic genesis of ulcerative colitis should have ended in 1990 when an American Journal of Psychiatry \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/2197886\" target=\"_blank\" rel=\"noopener\">review of 138 studies\u003c/a> that had linked ulcerative colitis with psychiatric factors found “serious flaws” and bias in 131 of them. Of the seven studies the authors determined were solid systematic investigations, all seven failed to find a link between psychiatric factors and ulcerative colitis. And yet, the reviewers added, “a substantial number of authors continue to subscribe to a psychosomatic model.”\u003c/p>\n\u003cp>Only one physician that I know of, renowned gastroenterologist Joseph Kirsner of the University of Chicago, apologized publicly in a speech at a German conference for getting drawn into the dark alley of psychogenesis, according to David Rubin, a professor of medicine and Kirsner’s successor at Chicago. The comment, made late in Kirsner’s life, was not published.\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-148827\" src=\"https://www.statnews.com/wp-content/uploads/2016/09/SECTION-BREAK_black.png\" alt=\"\" width=\"205\" height=\"9\">\u003c/p>\n\u003cp>Although the belief that an individual’s character or emotions causes ulcerative colitis was discredited and has largely been abandoned by gastroenterologists, many people living with the condition today are still shadowed by the notion that their disease begins, worsens, or abates in their minds, and that because emotions can be controlled, they ought to be able to heal themselves.\u003c/p>\n\u003cp>“It’s so easy for people to analyze a physical problem and blame it on a psychological issue that is going on in your life,” according to Judith Alexander Brice, a Pittsburgh psychiatrist and poet who detailed her battle with inflammatory bowel disease and attitudes among her peers in an essay published in the book “When Doctors Get Sick.”\u003c/p>\n\u003cp>Before Brice had her colon removed in 1982, doctors in her psychiatric community suggested that she was “too anxious or too depressed,” and would not be sick “if I had a different psychological constitution,” she said in an interview. “It was enraging, demoralizing and it made me feel so estranged from people.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Just last month, in a \u003ca href=\"https://www.facebook.com/groups/ulcerative/\" target=\"_blank\" rel=\"noopener\">private Facebook group\u003c/a> devoted to ulcerative colitis, Andrea Thornton Boggs, a mother from Illinois who was diagnosed at age 4, wrote: “I was a very timid and sensitive child and the doctors at the time attributed my UC to that. I was always told to relax and loosen up and I would feel better. Some of my family members still believe it’s all in my head. It causes me to doubt myself in every way.”\u003c/p>\n\u003cp>I didn’t react that way in 1962 when, as an 18-year-old farm boy and college freshman, I read in a medical textbook that my ulcerative colitis was psychosomatic. I took it as fact and stuffed it inside. For the next half century, I assumed that I was to blame, at least in part, for bringing on my symptoms.\u003c/p>\n\u003cp>Five years ago, I mentioned this to my family doctor. “We owe you an apology,” he said, putting his hand on my belly. “That’s not even taught anymore.”\u003c/p>\n\u003cp>Wrestling with that revelation, I decided to research my darkest secret, a miserable disease that I finally cured by asking a surgeon to remove my colon.\u003c/p>\n\u003cp>Here’s my hope: that some reader will know what happened to patient zero, whose treatment could be the opening chapter in my story of ulcerative colitis, a decimating disease whose shameful history deserves to be told.\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://jimcarrier.com/ABOUT/\" target=\"_blank\" rel=\"noopener\">Jim Carrier\u003c/a>, an award-winning journalist, is a member of the University of Vermont Committee on Human Research in the Medical Sciences. He is writing a history of ulcerative colitis and its treatment.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This\u003ca href=\"https://www.statnews.com/2018/06/12/lobotomy-ulcerative-colitis-shameful-medical-history/\" target=\"_blank\" rel=\"noopener\"> story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "1 in 3 Adults In The U.S. Take Medications That Can Cause Depression",
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"content": "\u003cp>If you take Prilosec or Zantac for acid reflux, a beta blocker for high blood pressure, or Xanax for anxiety, you may be increasing your risk of depression.[contextly_sidebar id=\"HRiIrZXZvpwyxRdxPe5gDW5vYKh4YCMU\"]\u003c/p>\n\u003cp>More than 200 common medications sold in the U.S. include depression as a potential side effect. Sometimes, the risk stems from taking several drugs at the same time. Now, a new study finds people who take these medicines are, in fact, more likely to be depressed.\u003c/p>\n\u003cp>The list includes a wide range of commonly taken medications. Among them are certain types of proton pump inhibitors (PPIs) (used to treat acid reflux), beta blockers, anxiety drugs, painkillers including ibuprofen, ACE inhibitors (used to treat high blood pressure), and anti-convulsant drugs.\u003c/p>\n\u003cp>\"The more of these medications you're taking, the more likely you are to report depression,\" says study author \u003ca href=\"https://www.columbiapsychiatry.org/profile/mark-olfson-md\" target=\"_blank\" rel=\"noopener\">Mark Olfson\u003c/a>, a professor of psychiatry at Columbia University.\u003c/p>\n\u003cp>\u003ca href=\"https://jamanetwork.com/journals/jama/article-abstract/2684607\" target=\"_blank\" rel=\"noopener\">The study, which was published Tuesday\u003c/a> in the Journal of the American Medical Association, included 26,192 adults who participated in a federal survey, the National Health and Nutrition Examination Survey. All of the participants listed the medications they were taking at the time of the survey. In addition, they each completed a depression screening, the Patient Health Questionnaire (PHQ-9), which asks about sleep, mood and appetite.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>More than a third of the people who took the survey were taking medications known to have depression or suicidal thoughts as potential side effects. Olfson and his collaborators wanted to determine whether those participants were more or less likely to be depressed, compared to participants who didn't take any of these medications.\u003c/p>\n\u003cp>\"What we found is that, in fact, they're more likely,\" Olfson says. And they found that people who took three or more of the medications were three times as likely to be depressed.\u003c/p>\n\u003cp>About 15 percent of participants who simultaneously used three or more of these drugs were depressed. By comparison, among participants who didn't use any of the medications, just 5 percent were depressed. Even those who used just one of these medications were at slightly higher risk of depression: About 7 percent were depressed.[contextly_sidebar id=\"A2lw5SZLyDBTWtThuZRlIcKINySG188T\"]\u003c/p>\n\u003cp>Olfson says the study does not prove that the medications caused the depression. \"We're just showing that if you're already taking them, you are more likely to be depressed,\" he says. To determine causation, he says, researchers would need to follow people over time — beginning at the time they start taking the medications — to see if they're more likely to develop depression.\u003c/p>\n\u003cp>Nonetheless, Olfson says, he was surprised by the \"strength of the association between the number of medications and the likelihood of being depressed.\"\u003c/p>\n\u003cp>These findings may motivate people to ask their health care providers more questions. \"People should always be ready to ask, 'What are the risks and the benefits of me taking this medication?' \" says\u003ca href=\"https://mydoctor.kaiserpermanente.org/ncal/provider/donaldmordecai\" target=\"_blank\" rel=\"noopener\"> Don Mordecai\u003c/a>, a psychiatrist with Kaiser Permanente in San Jose, Calif. And he says doctors should be ready to have these conversations, too.\u003c/p>\n\u003cp>Mordecai says, if you start a new medicine it can be helpful to keep track of changes in how you feel.\u003c/p>\n\u003cp>\"People who don't have a history of depression and then, suddenly, start to have symptoms of depression should be concerned that it's potentially due to a side effect, or potentially, an interaction,\" Mordecai says.\u003c/p>\n\u003cp>It's also worth having a conversation with your doctor about whether you might be able to stop a medication, Mordecai says. For instance, it may be possible to go off — or reduce — a medication for high blood pressure if you make other changes \"such as changing your diet, limiting salt intake, or increasing exercise.\"[contextly_sidebar id=\"OVhdpjJFS6xtrzD3u8zENreJMFo4hrXo\"]\u003c/p>\n\u003cp>Use of medications with depression or suicidal thoughts as potential side effects has been on the rise, according to the study's lead author, \u003ca href=\"https://pharmacy.uic.edu/people-resources/directory/dimaqato\" target=\"_blank\" rel=\"noopener\">Dima Mazen Qato\u003c/a>, an assistant professor at the College of Pharmacy of the University of Illinois, Chicago.\u003c/p>\n\u003cp>\"People are not only increasingly using these medicines alone, but are increasingly using them simultaneously, yet very few of these drugs have warning labels, so until we have public or system-level solutions, it is left up to patients and health care professionals to be aware of the risks,\" Qato wrote in a release about the study findings.\u003c/p>\n\u003cp>Qato says physicians may want to consider including evaluations of medications when they screen for depression.\u003c/p>\n\u003cp>\"With depression as one of the leading causes of disability and increasing national suicide rates, we need to think innovatively about depression as a public health issue,\" Qato writes. She suggests that one strategy to reduce depression rates might be for health care providers to give more thought to the role these medications might play in depression risk.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Allison Aubrey is on Twitter \u003c/em>\u003ca href=\"https://twitter.com/AubreyNPRFood\" target=\"_blank\" rel=\"noopener\">\u003cem>@AubreyNPRFood\u003c/em>\u003c/a>\u003cem>. \u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=1+in+3+Adults+In+The+U.S.+Take+Medications+That+Can+Cause+Depression&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you take Prilosec or Zantac for acid reflux, a beta blocker for high blood pressure, or Xanax for anxiety, you may be increasing your risk of depression.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>More than 200 common medications sold in the U.S. include depression as a potential side effect. Sometimes, the risk stems from taking several drugs at the same time. Now, a new study finds people who take these medicines are, in fact, more likely to be depressed.\u003c/p>\n\u003cp>The list includes a wide range of commonly taken medications. Among them are certain types of proton pump inhibitors (PPIs) (used to treat acid reflux), beta blockers, anxiety drugs, painkillers including ibuprofen, ACE inhibitors (used to treat high blood pressure), and anti-convulsant drugs.\u003c/p>\n\u003cp>\"The more of these medications you're taking, the more likely you are to report depression,\" says study author \u003ca href=\"https://www.columbiapsychiatry.org/profile/mark-olfson-md\" target=\"_blank\" rel=\"noopener\">Mark Olfson\u003c/a>, a professor of psychiatry at Columbia University.\u003c/p>\n\u003cp>\u003ca href=\"https://jamanetwork.com/journals/jama/article-abstract/2684607\" target=\"_blank\" rel=\"noopener\">The study, which was published Tuesday\u003c/a> in the Journal of the American Medical Association, included 26,192 adults who participated in a federal survey, the National Health and Nutrition Examination Survey. All of the participants listed the medications they were taking at the time of the survey. In addition, they each completed a depression screening, the Patient Health Questionnaire (PHQ-9), which asks about sleep, mood and appetite.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>More than a third of the people who took the survey were taking medications known to have depression or suicidal thoughts as potential side effects. Olfson and his collaborators wanted to determine whether those participants were more or less likely to be depressed, compared to participants who didn't take any of these medications.\u003c/p>\n\u003cp>\"What we found is that, in fact, they're more likely,\" Olfson says. And they found that people who took three or more of the medications were three times as likely to be depressed.\u003c/p>\n\u003cp>About 15 percent of participants who simultaneously used three or more of these drugs were depressed. By comparison, among participants who didn't use any of the medications, just 5 percent were depressed. Even those who used just one of these medications were at slightly higher risk of depression: About 7 percent were depressed.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Olfson says the study does not prove that the medications caused the depression. \"We're just showing that if you're already taking them, you are more likely to be depressed,\" he says. To determine causation, he says, researchers would need to follow people over time — beginning at the time they start taking the medications — to see if they're more likely to develop depression.\u003c/p>\n\u003cp>Nonetheless, Olfson says, he was surprised by the \"strength of the association between the number of medications and the likelihood of being depressed.\"\u003c/p>\n\u003cp>These findings may motivate people to ask their health care providers more questions. \"People should always be ready to ask, 'What are the risks and the benefits of me taking this medication?' \" says\u003ca href=\"https://mydoctor.kaiserpermanente.org/ncal/provider/donaldmordecai\" target=\"_blank\" rel=\"noopener\"> Don Mordecai\u003c/a>, a psychiatrist with Kaiser Permanente in San Jose, Calif. And he says doctors should be ready to have these conversations, too.\u003c/p>\n\u003cp>Mordecai says, if you start a new medicine it can be helpful to keep track of changes in how you feel.\u003c/p>\n\u003cp>\"People who don't have a history of depression and then, suddenly, start to have symptoms of depression should be concerned that it's potentially due to a side effect, or potentially, an interaction,\" Mordecai says.\u003c/p>\n\u003cp>It's also worth having a conversation with your doctor about whether you might be able to stop a medication, Mordecai says. For instance, it may be possible to go off — or reduce — a medication for high blood pressure if you make other changes \"such as changing your diet, limiting salt intake, or increasing exercise.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Use of medications with depression or suicidal thoughts as potential side effects has been on the rise, according to the study's lead author, \u003ca href=\"https://pharmacy.uic.edu/people-resources/directory/dimaqato\" target=\"_blank\" rel=\"noopener\">Dima Mazen Qato\u003c/a>, an assistant professor at the College of Pharmacy of the University of Illinois, Chicago.\u003c/p>\n\u003cp>\"People are not only increasingly using these medicines alone, but are increasingly using them simultaneously, yet very few of these drugs have warning labels, so until we have public or system-level solutions, it is left up to patients and health care professionals to be aware of the risks,\" Qato wrote in a release about the study findings.\u003c/p>\n\u003cp>Qato says physicians may want to consider including evaluations of medications when they screen for depression.\u003c/p>\n\u003cp>\"With depression as one of the leading causes of disability and increasing national suicide rates, we need to think innovatively about depression as a public health issue,\" Qato writes. She suggests that one strategy to reduce depression rates might be for health care providers to give more thought to the role these medications might play in depression risk.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Allison Aubrey is on Twitter \u003c/em>\u003ca href=\"https://twitter.com/AubreyNPRFood\" target=\"_blank\" rel=\"noopener\">\u003cem>@AubreyNPRFood\u003c/em>\u003c/a>\u003cem>. \u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=1+in+3+Adults+In+The+U.S.+Take+Medications+That+Can+Cause+Depression&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Doctors Told Not To Order Electrocardiograms For Low-Risk Patients",
"title": "Doctors Told Not To Order Electrocardiograms For Low-Risk Patients",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Doctors shouldn't routinely perform electrocardiograms on patients at low risk for heart disease, an influential federal panel is recommending.[contextly_sidebar id=\"e1JGLWb5PPSqJTZMPu1oxhGludnQREkn\"]\u003c/p>\n\u003cp>While an ECG test of the heart's electrical activity is safe and inexpensive, the benefits for patients at low risk of heart disease are very low and the results can trigger possibly dangerous, unnecessary follow-up testing and treatment, according to the \u003ca href=\"https://www.uspreventiveservicestaskforce.org/\" target=\"_blank\" rel=\"noopener\">U.S. Preventive Services Task Force\u003c/a>.\u003c/p>\n\u003cp>\"In low-risk people, definitely don't do it,\" says \u003ca href=\"https://apps.medicine.uab.edu/facultydirectory/FacultyData.asp?Entity=SOM&FID=55574\" target=\"_blank\" rel=\"noopener\">Dr. Seth Landefeld\u003c/a>, chairman of the department of medicine at the University of Alabama at Birmingham. Landefeld is on the committee that developed the recommendations.\u003c/p>\n\u003cp>The \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.6848\" target=\"_blank\" rel=\"noopener\">recommendation against routine ECGs in low-risk patients\u003c/a> was published Tuesday in \u003cem>JAMA,\u003c/em> the \u003cem>Journal of the American Medical Association\u003c/em>.\u003c/p>\n\u003cp>\"In people who are at low risk for cardiovascular disease, there is no evidence of benefits of doing ECG screening that would outweigh the possible harms,\" he says. \"And, in fact, the harms may well outweigh the benefits.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For example, in rare cases, follow-up tests like \u003ca href=\"https://www.mayoclinic.org/tests-procedures/coronary-angiogram/about/pac-20384904\" target=\"_blank\" rel=\"noopener\">angiograms\u003c/a> can inadvertently damage the heart, Landefeld says.\u003c/p>\n\u003cp>Other doctors welcomed the new recommendations, noting they are consistent with those of many other medical groups. \"I think their recommendations are very reasonable,\" says \u003ca href=\"https://medicine.tulane.edu/departments/medicine-cardiology-clinical-radiology/faculty/robert-c-hendel-md\" target=\"_blank\" rel=\"noopener\">Robert Hendel\u003c/a>, chief of cardiology at Tulane University, speaking on behalf of the American College of Cardiology.[contextly_sidebar id=\"0v58FJHtga8wMvZaz5r88FbZKH9Smcv6\"]\u003c/p>\n\u003cp>ECGs use electrodes to measure the electrical activity of the heart and can identify irregular rhythms. Despite years of recommendations against routine ECGs, data collected by the National Center for Health Statistics \u003ca href=\"https://www.cdc.gov/nchs/data/ahcd/namcs_summary/2015_namcs_web_tables.pdf\" target=\"_blank\" rel=\"noopener\">indicate\u003c/a> the test is done as part of about 4 percent of routine exams. In 2015, the National Ambulatory Medical Care Survey \u003ca href=\"https://www.cdc.gov/nchs/data/ahcd/namcs_summary/2015_namcs_web_tables.pdf\" target=\"_blank\" rel=\"noopener\">found that about 40 million ECGs \u003c/a>were performed in doctors' offices.\u003c/p>\n\u003cp>Hendel and others hope the uniformity of the recommendations will finally persuade more doctors to stop using the test so commonly.\u003c/p>\n\u003cp>\"If there's really no benefit and it may open a can of worms, then why are we doing it?\" Hendel says.\u003c/p>\n\u003cp>Other routine tests that spot risk factors, such as high blood pressure and cholesterol, are much more useful in identifying people at elevated risk for heart attacks and strokes, the panel and others say. \u003ca href=\"https://www.cdc.gov/heartdisease/index.htm\" target=\"_blank\" rel=\"noopener\">Cardiovascular disease\u003c/a> is the leading cause of death in the United States.[contextly_sidebar id=\"aKFvcSrIqI0Llzq9ccxeP2ojnieKP0Vz\"]\u003c/p>\n\u003cp>\"What's happened is that the conventional risk factors have become so strong and so useful in preventing heart disease that the value of doing a routine ECG as part of an annual physical has faded,\" says \u003ca href=\"http://uhealthsystem.com/doctors/profile/1114\" target=\"_blank\" rel=\"noopener\">Dr. Robert Myerburg\u003c/a>, a professor of medicine at the University of Miami Miller School of Medicine, who wrote an editorial accompanying the recommendations.\u003c/p>\n\u003cp>But many doctors have continued to offer the test, often because patients want it, he says. An uncomplicated ECG on a patient at rest commonly costs about $50.\u003c/p>\n\u003cp>The panel concluded there was insufficient evidence to recommend for or against doing ECGs for people considered to be moderate or high risk because they have some other risk factors, such as high blood pressure or diabetes. So doctors should decide whether to order the test for those patients on an individual basis, the panel says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Some patients might also consider getting one ECG to have as a baseline for comparison later in life, Tulane's Hendel says.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Doctors+Told+Not+To+Order+Electrocardiograms+For+Low-Risk+Patients&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Doctors shouldn't routinely perform electrocardiograms on patients at low risk for heart disease, an influential federal panel is recommending.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>While an ECG test of the heart's electrical activity is safe and inexpensive, the benefits for patients at low risk of heart disease are very low and the results can trigger possibly dangerous, unnecessary follow-up testing and treatment, according to the \u003ca href=\"https://www.uspreventiveservicestaskforce.org/\" target=\"_blank\" rel=\"noopener\">U.S. Preventive Services Task Force\u003c/a>.\u003c/p>\n\u003cp>\"In low-risk people, definitely don't do it,\" says \u003ca href=\"https://apps.medicine.uab.edu/facultydirectory/FacultyData.asp?Entity=SOM&FID=55574\" target=\"_blank\" rel=\"noopener\">Dr. Seth Landefeld\u003c/a>, chairman of the department of medicine at the University of Alabama at Birmingham. Landefeld is on the committee that developed the recommendations.\u003c/p>\n\u003cp>The \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.6848\" target=\"_blank\" rel=\"noopener\">recommendation against routine ECGs in low-risk patients\u003c/a> was published Tuesday in \u003cem>JAMA,\u003c/em> the \u003cem>Journal of the American Medical Association\u003c/em>.\u003c/p>\n\u003cp>\"In people who are at low risk for cardiovascular disease, there is no evidence of benefits of doing ECG screening that would outweigh the possible harms,\" he says. \"And, in fact, the harms may well outweigh the benefits.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For example, in rare cases, follow-up tests like \u003ca href=\"https://www.mayoclinic.org/tests-procedures/coronary-angiogram/about/pac-20384904\" target=\"_blank\" rel=\"noopener\">angiograms\u003c/a> can inadvertently damage the heart, Landefeld says.\u003c/p>\n\u003cp>Other doctors welcomed the new recommendations, noting they are consistent with those of many other medical groups. \"I think their recommendations are very reasonable,\" says \u003ca href=\"https://medicine.tulane.edu/departments/medicine-cardiology-clinical-radiology/faculty/robert-c-hendel-md\" target=\"_blank\" rel=\"noopener\">Robert Hendel\u003c/a>, chief of cardiology at Tulane University, speaking on behalf of the American College of Cardiology.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>ECGs use electrodes to measure the electrical activity of the heart and can identify irregular rhythms. Despite years of recommendations against routine ECGs, data collected by the National Center for Health Statistics \u003ca href=\"https://www.cdc.gov/nchs/data/ahcd/namcs_summary/2015_namcs_web_tables.pdf\" target=\"_blank\" rel=\"noopener\">indicate\u003c/a> the test is done as part of about 4 percent of routine exams. In 2015, the National Ambulatory Medical Care Survey \u003ca href=\"https://www.cdc.gov/nchs/data/ahcd/namcs_summary/2015_namcs_web_tables.pdf\" target=\"_blank\" rel=\"noopener\">found that about 40 million ECGs \u003c/a>were performed in doctors' offices.\u003c/p>\n\u003cp>Hendel and others hope the uniformity of the recommendations will finally persuade more doctors to stop using the test so commonly.\u003c/p>\n\u003cp>\"If there's really no benefit and it may open a can of worms, then why are we doing it?\" Hendel says.\u003c/p>\n\u003cp>Other routine tests that spot risk factors, such as high blood pressure and cholesterol, are much more useful in identifying people at elevated risk for heart attacks and strokes, the panel and others say. \u003ca href=\"https://www.cdc.gov/heartdisease/index.htm\" target=\"_blank\" rel=\"noopener\">Cardiovascular disease\u003c/a> is the leading cause of death in the United States.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"What's happened is that the conventional risk factors have become so strong and so useful in preventing heart disease that the value of doing a routine ECG as part of an annual physical has faded,\" says \u003ca href=\"http://uhealthsystem.com/doctors/profile/1114\" target=\"_blank\" rel=\"noopener\">Dr. Robert Myerburg\u003c/a>, a professor of medicine at the University of Miami Miller School of Medicine, who wrote an editorial accompanying the recommendations.\u003c/p>\n\u003cp>But many doctors have continued to offer the test, often because patients want it, he says. An uncomplicated ECG on a patient at rest commonly costs about $50.\u003c/p>\n\u003cp>The panel concluded there was insufficient evidence to recommend for or against doing ECGs for people considered to be moderate or high risk because they have some other risk factors, such as high blood pressure or diabetes. So doctors should decide whether to order the test for those patients on an individual basis, the panel says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Some patients might also consider getting one ECG to have as a baseline for comparison later in life, Tulane's Hendel says.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Doctors+Told+Not+To+Order+Electrocardiograms+For+Low-Risk+Patients&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Simple Saliva Test Could Identify Men at Greatest Risk of Prostate Cancer",
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"content": "\u003cp>A team of scientists at London's\u003ca href=\"https://www.icr.ac.uk/\" target=\"_blank\" rel=\"noopener\"> Institute of Cancer Research\u003c/a> have developed a \"spit test\" that can be used to identify men most likely to develop prostate cancer, the second leading cause of cancer death in U.S. men.[contextly_sidebar id=\"KO4wdzhP8pt1tRs02KEaCVL4V511U4Nk\"]\u003c/p>\n\u003cp>About 1 in 9 men are diagnosed with prostate cancer at some point, according to the \u003ca href=\"https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html\" target=\"_blank\" rel=\"noopener\">American Cancer Society. \u003c/a>\u003c/p>\n\u003cp>The study, \u003ca href=\"https://www.nature.com/articles/s41588-018-0142-8\" target=\"_blank\" rel=\"noopener\">published \u003c/a>Monday in the journal Nature Genetics, identified the 1 percent of men with the highest genetic risk for prostate cancer. This group is nearly six times more likely to develop prostate cancer than the general population, according to\u003ca href=\"https://www.eurekalert.org/pub_releases/2018-06/iocr-pcd060818.php\" target=\"_blank\" rel=\"noopener\"> the study.\u003c/a>\u003c/p>\n\u003cp>Researchers, funded in part by the National Institutes of Health, utilized a new DNA analysis method to study the genes of more than 70,000 people. They looked at 150 DNA markers and found that the top 10 percent of men at highest risk for prostate cancer were found to nearly three times the risk of developing the disease. From Gizmodo:\u003c/p>\n\u003cblockquote>\u003cp>Some 45,000 of the subjects had already developed prostate cancer, while 25,000 hadn’t. So the researchers compared the two groups, singling out any inherited genetic variations that might have contributed to their cancer risk.\u003c/p>\u003c/blockquote>\n\u003cp>Based on this data, the study said that researchers discovered 63 new variants that have previously not been associated with prostate cancer. Rosalind Eeles, a geneticist and co-author of the study, said those men found to be at greater genetic risk can receive proper screenings.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“The reason we are particularly excited by the test is that this can be offered in general practice as a spit test to really try and identify who is most at risk of prostate cancer so we can offer them targeted screening,” Eeles \u003ca href=\"https://www.theguardian.com/science/2018/jun/11/trials-begin-of-a-saliva-test-for-prostate-cancer\" target=\"_blank\" rel=\"noopener\">told T\u003c/a>\u003ca href=\"https://www.theguardian.com/science/2018/jun/11/trials-begin-of-a-saliva-test-for-prostate-cancer\" target=\"_blank\" rel=\"noopener\">he Guardian.\u003c/a>\u003c/p>\n\u003cp>Most men diagnosed with the disease do not die from it, according to the American Cancer Society. Risk factors include family history, advanced age, and those of African descent.[contextly_sidebar id=\"go4zed6vsFCKAoaAAycufIdrqinev6En\"]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>About 6 in 10 cases of prostate cancer are diagnosed in men aged 65 or older. From Gizmodo:\u003c/p>\n\u003cblockquote>\u003cp>In the US, people over the age of 50 are \u003ca href=\"https://www.cancer.org/cancer/prostate-cancer/early-detection/acs-recommendations.html\" target=\"_blank\" rel=\"noopener\">generally screened\u003c/a> for prostate cancer via the prostate-specific antigen (PSA) blood test...But the saliva test could reveal especially high-risk people who need annual screening regardless of their PSA level.\u003c/p>\u003c/blockquote>\n\u003cdiv id=\"dfp-ad--inline2\" class=\"js-ad-slot ad-slot ad-slot--inline ad-slot--offset-right ad-slot--inline2 ad-slot--rendered\">\n\u003cdiv class=\"ad-slot__label\">\n\u003cp>Researchers\u003ca href=\"https://www.eurekalert.org/pub_releases/2018-06/iocr-pcd060818.php\" target=\"_blank\" rel=\"noopener\"> now plan a trial\u003c/a> run of the new test at a limited number of clinics to help devise treatments that could reduce cases of prostate cancer among this high-risk group.\u003c/p>\n\u003c/div>\n\u003cdiv>\"We are on the cusp of moving from theory to practice -- from explaining how genetics affect prostate cancer risk, to testing for genetic risk and attempting to prevent the disease,\" Paul Workman, chief executive at The Institute of Cancer Research, said in a \u003ca href=\"https://www.eurekalert.org/pub_releases/2018-06/iocr-pcd060818.php\" target=\"_blank\" rel=\"noopener\">statement\u003c/a>. \"This study also gives us important information about the causes of prostate cancer and the potential role of the immune system, which could ultimately be employed in the design of new treatments.\"\u003c/div>\n\u003c/div>\n\u003cdiv id=\"dfp-ad--inline2\" class=\"js-ad-slot ad-slot ad-slot--inline ad-slot--offset-right ad-slot--inline2 ad-slot--rendered\">\n\u003cdiv id=\"google_ads_iframe_/59666047/theguardian.com/science/article/ng_7__container__\" class=\"ad-slot__content\">\u003c/div>\n\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A team of scientists at London's\u003ca href=\"https://www.icr.ac.uk/\" target=\"_blank\" rel=\"noopener\"> Institute of Cancer Research\u003c/a> have developed a \"spit test\" that can be used to identify men most likely to develop prostate cancer, the second leading cause of cancer death in U.S. men.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>About 1 in 9 men are diagnosed with prostate cancer at some point, according to the \u003ca href=\"https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html\" target=\"_blank\" rel=\"noopener\">American Cancer Society. \u003c/a>\u003c/p>\n\u003cp>The study, \u003ca href=\"https://www.nature.com/articles/s41588-018-0142-8\" target=\"_blank\" rel=\"noopener\">published \u003c/a>Monday in the journal Nature Genetics, identified the 1 percent of men with the highest genetic risk for prostate cancer. This group is nearly six times more likely to develop prostate cancer than the general population, according to\u003ca href=\"https://www.eurekalert.org/pub_releases/2018-06/iocr-pcd060818.php\" target=\"_blank\" rel=\"noopener\"> the study.\u003c/a>\u003c/p>\n\u003cp>Researchers, funded in part by the National Institutes of Health, utilized a new DNA analysis method to study the genes of more than 70,000 people. They looked at 150 DNA markers and found that the top 10 percent of men at highest risk for prostate cancer were found to nearly three times the risk of developing the disease. From Gizmodo:\u003c/p>\n\u003cblockquote>\u003cp>Some 45,000 of the subjects had already developed prostate cancer, while 25,000 hadn’t. So the researchers compared the two groups, singling out any inherited genetic variations that might have contributed to their cancer risk.\u003c/p>\u003c/blockquote>\n\u003cp>Based on this data, the study said that researchers discovered 63 new variants that have previously not been associated with prostate cancer. Rosalind Eeles, a geneticist and co-author of the study, said those men found to be at greater genetic risk can receive proper screenings.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The reason we are particularly excited by the test is that this can be offered in general practice as a spit test to really try and identify who is most at risk of prostate cancer so we can offer them targeted screening,” Eeles \u003ca href=\"https://www.theguardian.com/science/2018/jun/11/trials-begin-of-a-saliva-test-for-prostate-cancer\" target=\"_blank\" rel=\"noopener\">told T\u003c/a>\u003ca href=\"https://www.theguardian.com/science/2018/jun/11/trials-begin-of-a-saliva-test-for-prostate-cancer\" target=\"_blank\" rel=\"noopener\">he Guardian.\u003c/a>\u003c/p>\n\u003cp>Most men diagnosed with the disease do not die from it, according to the American Cancer Society. Risk factors include family history, advanced age, and those of African descent.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>About 6 in 10 cases of prostate cancer are diagnosed in men aged 65 or older. From Gizmodo:\u003c/p>\n\u003cblockquote>\u003cp>In the US, people over the age of 50 are \u003ca href=\"https://www.cancer.org/cancer/prostate-cancer/early-detection/acs-recommendations.html\" target=\"_blank\" rel=\"noopener\">generally screened\u003c/a> for prostate cancer via the prostate-specific antigen (PSA) blood test...But the saliva test could reveal especially high-risk people who need annual screening regardless of their PSA level.\u003c/p>\u003c/blockquote>\n\u003cdiv id=\"dfp-ad--inline2\" class=\"js-ad-slot ad-slot ad-slot--inline ad-slot--offset-right ad-slot--inline2 ad-slot--rendered\">\n\u003cdiv class=\"ad-slot__label\">\n\u003cp>Researchers\u003ca href=\"https://www.eurekalert.org/pub_releases/2018-06/iocr-pcd060818.php\" target=\"_blank\" rel=\"noopener\"> now plan a trial\u003c/a> run of the new test at a limited number of clinics to help devise treatments that could reduce cases of prostate cancer among this high-risk group.\u003c/p>\n\u003c/div>\n\u003cdiv>\"We are on the cusp of moving from theory to practice -- from explaining how genetics affect prostate cancer risk, to testing for genetic risk and attempting to prevent the disease,\" Paul Workman, chief executive at The Institute of Cancer Research, said in a \u003ca href=\"https://www.eurekalert.org/pub_releases/2018-06/iocr-pcd060818.php\" target=\"_blank\" rel=\"noopener\">statement\u003c/a>. \"This study also gives us important information about the causes of prostate cancer and the potential role of the immune system, which could ultimately be employed in the design of new treatments.\"\u003c/div>\n\u003c/div>\n\u003cdiv id=\"dfp-ad--inline2\" class=\"js-ad-slot ad-slot ad-slot--inline ad-slot--offset-right ad-slot--inline2 ad-slot--rendered\">\n\u003cdiv id=\"google_ads_iframe_/59666047/theguardian.com/science/article/ng_7__container__\" class=\"ad-slot__content\">\u003c/div>\n\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "A Science Writer Explores The 'Perversions And Potential' Of Genetic Tests",
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"content": "\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://www.npr.org/player/embed/618870881/618969757\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\" title=\"NPR embedded audio player\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>As a science columnist for\u003cem> The New York Times, \u003c/em>Carl Zimmer had reported extensively about genetics and the role gene mutations play in various ailments. After a while, he got to wondering about what secrets his own genetic code holds.[contextly_sidebar id=\"AyWMyOjcCCjd9Wr45bM9omzK5fGeueow\"]\u003c/p>\n\u003cp>\"I wanted to know if there was anything I needed to worry about,\" Zimmer says. \"We all think back to our relatives who got sick and then wonder, 'Is that in me?'\"\u003c/p>\n\u003cp>So Zimmer worked with a genetics counselor to get his entire genome sequenced — an experience he describes as \"very nerve-wracking.\" He worried that he would discover a mutation that would put him on the path for a particular disease.\u003c/p>\n\u003cp>As it turned out, the counselor told Zimmer he has a \"boring genome.\" Though Zimmer initially hoped for a more \"exciting and exotic\" assessment, the counselor reminded him \"A boring genome is a really good genome.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Zimmer writes about the broader implications of genetic research and testing in his new book, \u003cem>She Has Her Mother's Laugh: The Powers, Perversions and Potential of Heredity\u003c/em>.[contextly_sidebar id=\"YtqF4uhyPE2pCelB55bttG0XpqJfRSq3\"]\u003c/p>\n\u003chr>\n\u003cp>\u003cstrong>Interview Highlights\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>On how the new genetic editing technology known as \u003ca href=\"https://www.npr.org/tags/419142387/crispr\" target=\"_blank\" rel=\"noopener\">CRISPR\u003c/a> works\u003c/strong>\u003c/p>\n\u003cp>What happens with CRISPR is that scientists will design a molecule — think of it as a probe — and it will search around in the DNA in a cell until if finds a very specific short sequence. And it will grab onto it, and it brings on with it basically molecular scissors, which will then cut the DNA at that spot — kind of like cutting tape. And you can cut out a segment of DNA. And if you just do that, DNA will heal itself. Basically the two loose ends will stitch themselves together, and now that piece is just missing. Or you can add in a little piece of different DNA, and you can actually get the cell to put in that new piece of DNA where you just cut out the old one.\u003c/p>\n\u003cp>\u003cstrong>On whether CRISPR technology could be used to treat diseases in humans\u003c/strong>\u003c/p>\n\u003cp>We're just on the verge of human trials. They will be starting, hopefully very soon, for diseases like sickle-cell anemia. There's actually a lot of research on muscular dystrophy as well. There are a few key diseases where scientists think these would be the best places to start. To basically inject CRISPR molecules into people's bodies; these CRISPR molecules would then go to certain kinds of cells and repair one particular spot in their DNA. And that treats the disease.\u003c/p>\n\u003cp>We shouldn't look at this as a panacea. ... There have been earlier kinds of treatments known as gene therapy, where you basically try to add an extra gene into someone's cells. And that [seemed] like it was just a slam dunk, but then it turned out to not work very well for years and years. ... So CRISPR could be even more exciting and truly revolutionary. We just have to wait and see what this first generation of human clinical trials show us.\u003c/p>\n\u003cp>\u003cstrong>On his visit to an insectarium where a scientist is breeding genetically modified mosquitoes that are resistant to malaria\u003c/strong>\u003c/p>\n\u003cp>First of all, you have to gown up before you go in there. ... And then you go through an air lock, and then you're in this room where there are mosquitoes living in all their different life cycles.\u003c/p>\n\u003cp>So there's a dark room where the female mosquitoes are laying their eggs, because they like to do it in the dark. And then the scientists pull the eggs out from these rooms and they inject DNA into them and then they put them in water, because that's where mosquito larvae like to develop.\u003c/p>\n\u003cp>And so you go into this other room where there are these tubs of water, and these snake-like things are slithering around in there and then they develop into adults. And the females need to drink blood; so [researchers] found that the containers for movie popcorn work really well. What they do is, they basically clamp a warm container of calves' blood on top of them, and then the mosquitoes are underneath — on the underside of the plastic lid — basically poking through and drinking the blood and fattening themselves up. ...\u003c/p>\n\u003cp>You can tell that they've been genetically altered because they have red eyes, which is kind of spooky. But you look at that and you say, well, that means that these could be the cure for malaria. It really could happen. And hundreds of thousands of people die every year of malaria. We've thrown everything we can at it and this parasite is still knocking us down worldwide. So, maybe this could be it – so, that's actually quite exciting.\u003c/p>\n\u003cp>\u003cstrong>On how genetic testing was used in the Golden State Killer case\u003c/strong>\u003c/p>\n\u003cp>For the \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/04/27/606624218/in-hunt-for-golden-state-killer-investigators-uploaded-his-dna-to-genealogy-site\" target=\"_blank\" rel=\"noopener\">Golden State Killer case\u003c/a>, what somebody decided to do was take the DNA that they had from these crime scenes, and upload it to one of these open-access sites — not a commercial site — and then see if they could find any close matches. And they found that there were some people that looked like they were distant cousins of this person. And they went and did the genealogical research to figure out \"Well, how would they be related?\" And then said \"OK, who are the possible relatives that this person could be, and where do they live?\" And that actually helped narrow down their search until they made an arrest.\u003c/p>\n\u003cp>\u003cstrong>On whether genetic testing companies will protect user privacy\u003c/strong>\u003c/p>\n\u003cp>You can choose different levels of privacy with a lot of these services. So, for example, some people will say \"I want you to look at my DNA. I want you to tell me about my ancestry.\" ... For 23 and Me they'll give you a few bits of information about your medical conditions, and that's it. But they will try to get you to opt in to sharing your data for their own basic research. At 23 and Me, for example, there's a whole team of researchers who are studying all sorts of ... diseases, sleep patterns and so on. And then they will also go into partnerships with drug development companies who will take their data, looking at, say, 50,000 people with lupus and 50,000 people who don't have lupus, and try to look for the genetic differences. Those could point the way toward possible drugs.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Phyllis Myers and Seth Kelley produced and edited the audio of this interview. Bridget Bentz and Seth Kelley adapted it for the Web.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Fresh Air. To see more, visit \u003ca href=\"http://www.npr.org/programs/fresh-air/\">Fresh Air\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+Science+Writer+Explores+The+%27Perversions+And+Potential%27+Of+Genetic+Tests&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://www.npr.org/player/embed/618870881/618969757\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\" title=\"NPR embedded audio player\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>As a science columnist for\u003cem> The New York Times, \u003c/em>Carl Zimmer had reported extensively about genetics and the role gene mutations play in various ailments. After a while, he got to wondering about what secrets his own genetic code holds.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"I wanted to know if there was anything I needed to worry about,\" Zimmer says. \"We all think back to our relatives who got sick and then wonder, 'Is that in me?'\"\u003c/p>\n\u003cp>So Zimmer worked with a genetics counselor to get his entire genome sequenced — an experience he describes as \"very nerve-wracking.\" He worried that he would discover a mutation that would put him on the path for a particular disease.\u003c/p>\n\u003cp>As it turned out, the counselor told Zimmer he has a \"boring genome.\" Though Zimmer initially hoped for a more \"exciting and exotic\" assessment, the counselor reminded him \"A boring genome is a really good genome.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Zimmer writes about the broader implications of genetic research and testing in his new book, \u003cem>She Has Her Mother's Laugh: The Powers, Perversions and Potential of Heredity\u003c/em>.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003chr>\n\u003cp>\u003cstrong>Interview Highlights\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>On how the new genetic editing technology known as \u003ca href=\"https://www.npr.org/tags/419142387/crispr\" target=\"_blank\" rel=\"noopener\">CRISPR\u003c/a> works\u003c/strong>\u003c/p>\n\u003cp>What happens with CRISPR is that scientists will design a molecule — think of it as a probe — and it will search around in the DNA in a cell until if finds a very specific short sequence. And it will grab onto it, and it brings on with it basically molecular scissors, which will then cut the DNA at that spot — kind of like cutting tape. And you can cut out a segment of DNA. And if you just do that, DNA will heal itself. Basically the two loose ends will stitch themselves together, and now that piece is just missing. Or you can add in a little piece of different DNA, and you can actually get the cell to put in that new piece of DNA where you just cut out the old one.\u003c/p>\n\u003cp>\u003cstrong>On whether CRISPR technology could be used to treat diseases in humans\u003c/strong>\u003c/p>\n\u003cp>We're just on the verge of human trials. They will be starting, hopefully very soon, for diseases like sickle-cell anemia. There's actually a lot of research on muscular dystrophy as well. There are a few key diseases where scientists think these would be the best places to start. To basically inject CRISPR molecules into people's bodies; these CRISPR molecules would then go to certain kinds of cells and repair one particular spot in their DNA. And that treats the disease.\u003c/p>\n\u003cp>We shouldn't look at this as a panacea. ... There have been earlier kinds of treatments known as gene therapy, where you basically try to add an extra gene into someone's cells. And that [seemed] like it was just a slam dunk, but then it turned out to not work very well for years and years. ... So CRISPR could be even more exciting and truly revolutionary. We just have to wait and see what this first generation of human clinical trials show us.\u003c/p>\n\u003cp>\u003cstrong>On his visit to an insectarium where a scientist is breeding genetically modified mosquitoes that are resistant to malaria\u003c/strong>\u003c/p>\n\u003cp>First of all, you have to gown up before you go in there. ... And then you go through an air lock, and then you're in this room where there are mosquitoes living in all their different life cycles.\u003c/p>\n\u003cp>So there's a dark room where the female mosquitoes are laying their eggs, because they like to do it in the dark. And then the scientists pull the eggs out from these rooms and they inject DNA into them and then they put them in water, because that's where mosquito larvae like to develop.\u003c/p>\n\u003cp>And so you go into this other room where there are these tubs of water, and these snake-like things are slithering around in there and then they develop into adults. And the females need to drink blood; so [researchers] found that the containers for movie popcorn work really well. What they do is, they basically clamp a warm container of calves' blood on top of them, and then the mosquitoes are underneath — on the underside of the plastic lid — basically poking through and drinking the blood and fattening themselves up. ...\u003c/p>\n\u003cp>You can tell that they've been genetically altered because they have red eyes, which is kind of spooky. But you look at that and you say, well, that means that these could be the cure for malaria. It really could happen. And hundreds of thousands of people die every year of malaria. We've thrown everything we can at it and this parasite is still knocking us down worldwide. So, maybe this could be it – so, that's actually quite exciting.\u003c/p>\n\u003cp>\u003cstrong>On how genetic testing was used in the Golden State Killer case\u003c/strong>\u003c/p>\n\u003cp>For the \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/04/27/606624218/in-hunt-for-golden-state-killer-investigators-uploaded-his-dna-to-genealogy-site\" target=\"_blank\" rel=\"noopener\">Golden State Killer case\u003c/a>, what somebody decided to do was take the DNA that they had from these crime scenes, and upload it to one of these open-access sites — not a commercial site — and then see if they could find any close matches. And they found that there were some people that looked like they were distant cousins of this person. And they went and did the genealogical research to figure out \"Well, how would they be related?\" And then said \"OK, who are the possible relatives that this person could be, and where do they live?\" And that actually helped narrow down their search until they made an arrest.\u003c/p>\n\u003cp>\u003cstrong>On whether genetic testing companies will protect user privacy\u003c/strong>\u003c/p>\n\u003cp>You can choose different levels of privacy with a lot of these services. So, for example, some people will say \"I want you to look at my DNA. I want you to tell me about my ancestry.\" ... For 23 and Me they'll give you a few bits of information about your medical conditions, and that's it. But they will try to get you to opt in to sharing your data for their own basic research. At 23 and Me, for example, there's a whole team of researchers who are studying all sorts of ... diseases, sleep patterns and so on. And then they will also go into partnerships with drug development companies who will take their data, looking at, say, 50,000 people with lupus and 50,000 people who don't have lupus, and try to look for the genetic differences. Those could point the way toward possible drugs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Phyllis Myers and Seth Kelley produced and edited the audio of this interview. Bridget Bentz and Seth Kelley adapted it for the Web.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Fresh Air. To see more, visit \u003ca href=\"http://www.npr.org/programs/fresh-air/\">Fresh Air\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+Science+Writer+Explores+The+%27Perversions+And+Potential%27+Of+Genetic+Tests&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Major CRISPR Hurdle: Edited Cells Might Cause Cancer, Find Studies",
"title": "Major CRISPR Hurdle: Edited Cells Might Cause Cancer, Find Studies",
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"content": "\u003cp>Editing cells’ genomes with CRISPR-Cas9 might increase the risk that the altered cells, intended to treat disease, will trigger cancer, two studies published on Monday warn — a potential game-changer for the companies developing CRISPR-based therapies.[contextly_sidebar id=\"Pbm72hAOjQOHNUgNeQaKv0l2d5rX0APO\"]\u003c/p>\n\u003cp>In the studies, published in Nature Medicine, scientists found that cells whose genomes are successfully edited by CRISPR-Cas9 have the potential to seed tumors inside a patient. That could make some CRISPR’d cells ticking time bombs, according to researchers from Sweden’s Karolinska Institute and, separately, Novartis.\u003c/p>\n\u003cp class=\"danger-zone\">\u003ca href=\"https://www.statnews.com/feature/crispr/tracker/\">CRISPR\u003c/a> has already dodged two potentially fatal bullets — a 2017 \u003ca href=\"https://www.nature.com/articles/nmeth.4293.epdf\" target=\"_blank\" rel=\"noopener\">claim\u003c/a> that it causes sky-high numbers of off-target effects was \u003ca href=\"https://www.nature.com/articles/nmeth.4664\" target=\"_blank\" rel=\"noopener\">retracted\u003c/a> in March, and a \u003ca href=\"https://www.biorxiv.org/content/early/2018/01/05/243345\" target=\"_blank\" rel=\"noopener\">report \u003c/a>of human immunity to Cas9 was largely shrugged off as \u003ca href=\"https://www.statnews.com/2018/01/08/immunity-crispr-cas9/\">solvable\u003c/a>. But experts are taking the cancer-risk finding seriously.\u003c/p>\n\u003cp class=\"danger-zone\">The CEO of CRISPR Therapeutics, Sam Kulkarni, told STAT the results are “plausible.” Although they likely apply to one of the main ways that CRISPR edits genomes (replacing disease-causing DNA with healthy versions) more than another (just excising DNA), he said, “it’s something we need to pay attention to, especially as CRISPR expands to more diseases. We need to do the work and make sure edited cells returned to patients don’t become cancerous.”\u003c/p>\n\u003cp class=\"\">Another leading CRISPR scientist, who asked not to be named because of involvement with genome-editing companies, called the new data “pretty striking,” and raised concerns that a potential fatal flaw in some uses of CRISPR had “been missed.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>On the other hand, the Novartis paper has been \u003ca href=\"https://www.biorxiv.org/content/early/2017/07/26/168443\" target=\"_blank\" rel=\"noopener\">available\u003c/a> in preliminary form since last summer, and CRISPR experts “haven’t freaked out,” said Erik Sontheimer of the University of Massachusetts Medical School, whose CRISPR research \u003ca href=\"https://www.statnews.com/2018/03/05/crispr-off-target-editing/\">centers\u003c/a> on novel enzymes and off-target effects. “This is something that bears paying attention to, but I don’t think it’s a deal-breaker” for CRISPR therapies.\u003c/p>\n\u003cp>The Karolinska and Novartis groups tested CRISPR on different kinds of human cells — retinal cells and pluripotent stem cells, respectively. But they found essentially the same phenomenon. Standard CRISPR-Cas9 works by cutting both strands of the DNA double helix. That injury causes a cell to activate a biochemical first-aid kit orchestrated by a gene called \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4235614/\" target=\"_blank\" rel=\"noopener\">p53,\u003c/a> which either mends the DNA break or makes the cell self-destruct.[contextly_sidebar id=\"X1qu0ifjesXey9YHHpOinoS4KNdNuyur\"]\u003c/p>\n\u003cp>Whichever action p53 takes, the consequence is the same: CRISPR doesn’t work, either because the genome edit is stitched up or the cell is dead. (The Novartis team calculated that p53 reduces CRISPR efficiency in pluripotent stem cells seventeenfold.) That might explain something found over and over: CRISPR is woefully inefficient, with only a small minority of cells into which CRISPR is introduced, usually by a virus, actually having their genomes edited as intended.\u003c/p>\n\u003cp>“We found that cutting the genome with CRISPR-Cas9 induced the activation of … p53,” said Emma Haapaniemi, the lead author of the \u003ca href=\"https://www.nature.com/articles/s41591-018-0049-z\" target=\"_blank\" rel=\"noopener\">Karolinska study\u003c/a>. That “makes editing much more difficult.”\u003c/p>\n\u003cp>The flip side of p53 repairing CRISPR edits, or killing cells that accept the edits, is that cells that survive with the edits do so precisely because they have a dysfunctional p53 and therefore lack this fix-it-or-kill-it mechanism.\u003c/p>\n\u003cp>The reason why that could be a problem is that p53 dysfunction can cause cancer. And not just occasionally. P53 mutations are \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2827900/figure/A001008F1/\" target=\"_blank\" rel=\"noopener\">responsible for\u003c/a> nearly half of ovarian cancers; 43 percent of colorectal cancers; 38 percent of lung cancers; nearly one-third of pancreatic, stomach, and liver cancers; and one-quarter of breast cancers, among others.\u003c/p>\n\u003cp>The Novartis team was trying to see how it could increase the efficiency of CRISPR editing of pluripotent stem cells. Because this kind of stem cell can morph into virtually any kind of cell, it might be able to treat a variety of diseases. Neuroscientist Ajamete Kaykas of the company’s Institutes for BioMedical Research in Cambridge, Mass., got CRISPR’s efficiency at inserting or deleting chunks of DNA up to 80 percent. Unfortunately, when CRISPR worked, it was because p53 didn’t, which raises cancer concerns.\u003c/p>\n\u003cp>As a result, the Novartis \u003ca href=\"https://www.nature.com/articles/s41591-018-0050-6\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> concludes that “it will be critical to ensure that [genome-edited cells] have a functional p53 before and after [genome] engineering.” The Karolinska team warns that p53 and related genes “should be monitored when developing cell-based therapies utilizing CRISPR-Cas9.”[contextly_sidebar id=\"f80ZxqMXgIrsBguckwJZNJRkL6wI6fMd\"]\u003c/p>\n\u003cp>The p53 finding doesn’t mean CRISPR is toast. For one thing, “the two papers present preliminary results,” biochemist Bernhard Schmierer of the Karolinska, co-leader of its study, told STAT. “It is unclear if the findings translate into cells actually used in current clinical studies.”\u003c/p>\n\u003cp>For another, the p53 problem might be worse with Cas9 than with other DNA-cutting enzymes used in CRISPR. And, crucially, it probably affects only one avenue of genome-editing.\u003c/p>\n\u003cp>CRISPR edits genomes in either of two ways. It slices out a chunk of disease-causing DNA, in a process called non-homologous end joining (NHEJ), or gene disruption. That’s how CRISPR Therapeutics is going after sickle cell disease. Alternatively, CRISPR both cuts out a disease-causing stretch of DNA and replaces it with healthy nucleotides, in homology-directed repair (HDR), or gene correction. Several university labs are investigating HDR to treat Duchenne \u003ca href=\"https://www.nature.com/articles/s41551-017-0137-2\" target=\"_blank\" rel=\"noopener\">muscular dystrophy,\u003c/a> among many other diseases.\u003c/p>\n\u003cp>In the normal, mature cells she and her team studied, Haapaniemi said, gene disruption “can happen even when p53 is activated.”\u003c/p>\n\u003cp>That’s good news for CRISPR Therapeutics’ sickle-cell and thalassemia \u003ca href=\"http://www.crisprtx.com/our-programs/our-pipeline.php\" target=\"_blank\" rel=\"noopener\">programs \u003c/a>as well as for Editas Medicine’s lead product, targeting a form of blindness, and others in its \u003ca href=\"http://www.editasmedicine.com/pipeline\" target=\"_blank\" rel=\"noopener\">pipeline\u003c/a>, all of which use NHEJ gene disruption. It also should not affect the gene-disruption approach that Intellia Therapeutics and Regeneron are \u003ca href=\"https://www.intelliatx.com/pipeline/\" target=\"_blank\" rel=\"noopener\">taking\u003c/a> to \u003ca href=\"https://ghr.nlm.nih.gov/condition/transthyretin-amyloidosis\" target=\"_blank\" rel=\"noopener\">transthyretin amyloidosis\u003c/a>.\u003c/p>\n\u003cp>CRISPR-based editing of T cells to treat cancer, as scientists at the University of Pennsylvania are studying in a \u003ca href=\"https://www.statnews.com/2016/06/21/crispr-human-trials/\">clinical trial,\u003c/a> should also not have a p53 problem. Nor should any therapy developed with CRISPR base editing, which does not make the double-stranded breaks that trigger p53. Developed by Harvard’s David Liu, base editing replaces a wrong DNA “letter” with the right one, without cutting, and is the basis for startup \u003ca href=\"https://www.statnews.com/2018/05/14/crispr-editas-beam-base-editing/\" target=\"_blank\" rel=\"noopener\">Beam Therapeutics\u003c/a>.\u003c/p>\n\u003cp>The p53 problem, however, might affect other products that companies hope to develop via gene correction, including glycogen storage disease, cystic fibrosis, and severe combined immunodeficiency.\u003c/p>\n\u003cp>It’s also a potential problem for stem cells. There, the Novartis team showed, p53 inactivation seems to be necessary for both NHEJ disruption and HDR correction. (Novartis’ Kaykas said he could not speak to a reporter without clearance from the company’s communications office.) That could be an issue for therapies using CRISPR’d stem cells: The same dysfunctional p53 that allows CRISPR to work its magic also makes cells likely to become cancerous.\u003c/p>\n\u003cp>Which raises an obvious question — if successfully CRISPR’d cells can seed cancers, why hasn’t this been seen before, and why haven’t the many CRISPR’d mice developed tumors?\u003c/p>\n\u003cp>Karolinska’s Haapaniemi said the effect shows up in large-scale experiments like hers and Novartis’ “but can be missed in small-scale studies where people only focus on editing one gene in one cell type.” In speaking to other scientists, she said, “it seems that other teams have noticed the effect of p53 on editing,” but have not highlighted it.\u003c/p>\n\u003cp>Jacob Corn of the University of California, Berkeley, said that although his lab has seen evidence of p53 activation in a few cases, they have “looked hard for growth effects after editing in [human stem cells] and found nothing.”\u003c/p>\n\u003cp>As for why no one has reported CRISPR’d mice getting cancer, Haapaniemi said, “This is a good question.” One reason might be that “laboratory mice are killed early,” perhaps leaving too little time for them to develop cancer.\u003c/p>\n\u003cp>But Corn said he and others “have all been looking for the possibility of cancer. So far, no one has seen evidence of [it] based on p53 status or induced by editing.”\u003c/p>\n\u003cp>Nevertheless, he called the two papers “important, since they remind everyone that genome editing isn’t magic.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This\u003ca href=\"https://www.statnews.com/2018/06/11/crispr-hurdle-edited-cells-might-cause-cancer/\" target=\"_blank\" rel=\"noopener\"> story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"description": "Editing cells’ genomes with CRISPR-Cas9 might increase the risk that the altered cells, intended to treat disease, will trigger cancer, two studies published on Monday warn — a potential game-changer for the companies developing CRISPR-based therapies. In the studies, published in Nature Medicine, scientists found that cells whose genomes are successfully edited by CRISPR-Cas9 have the",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Editing cells’ genomes with CRISPR-Cas9 might increase the risk that the altered cells, intended to treat disease, will trigger cancer, two studies published on Monday warn — a potential game-changer for the companies developing CRISPR-based therapies.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In the studies, published in Nature Medicine, scientists found that cells whose genomes are successfully edited by CRISPR-Cas9 have the potential to seed tumors inside a patient. That could make some CRISPR’d cells ticking time bombs, according to researchers from Sweden’s Karolinska Institute and, separately, Novartis.\u003c/p>\n\u003cp class=\"danger-zone\">\u003ca href=\"https://www.statnews.com/feature/crispr/tracker/\">CRISPR\u003c/a> has already dodged two potentially fatal bullets — a 2017 \u003ca href=\"https://www.nature.com/articles/nmeth.4293.epdf\" target=\"_blank\" rel=\"noopener\">claim\u003c/a> that it causes sky-high numbers of off-target effects was \u003ca href=\"https://www.nature.com/articles/nmeth.4664\" target=\"_blank\" rel=\"noopener\">retracted\u003c/a> in March, and a \u003ca href=\"https://www.biorxiv.org/content/early/2018/01/05/243345\" target=\"_blank\" rel=\"noopener\">report \u003c/a>of human immunity to Cas9 was largely shrugged off as \u003ca href=\"https://www.statnews.com/2018/01/08/immunity-crispr-cas9/\">solvable\u003c/a>. But experts are taking the cancer-risk finding seriously.\u003c/p>\n\u003cp class=\"danger-zone\">The CEO of CRISPR Therapeutics, Sam Kulkarni, told STAT the results are “plausible.” Although they likely apply to one of the main ways that CRISPR edits genomes (replacing disease-causing DNA with healthy versions) more than another (just excising DNA), he said, “it’s something we need to pay attention to, especially as CRISPR expands to more diseases. We need to do the work and make sure edited cells returned to patients don’t become cancerous.”\u003c/p>\n\u003cp class=\"\">Another leading CRISPR scientist, who asked not to be named because of involvement with genome-editing companies, called the new data “pretty striking,” and raised concerns that a potential fatal flaw in some uses of CRISPR had “been missed.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>On the other hand, the Novartis paper has been \u003ca href=\"https://www.biorxiv.org/content/early/2017/07/26/168443\" target=\"_blank\" rel=\"noopener\">available\u003c/a> in preliminary form since last summer, and CRISPR experts “haven’t freaked out,” said Erik Sontheimer of the University of Massachusetts Medical School, whose CRISPR research \u003ca href=\"https://www.statnews.com/2018/03/05/crispr-off-target-editing/\">centers\u003c/a> on novel enzymes and off-target effects. “This is something that bears paying attention to, but I don’t think it’s a deal-breaker” for CRISPR therapies.\u003c/p>\n\u003cp>The Karolinska and Novartis groups tested CRISPR on different kinds of human cells — retinal cells and pluripotent stem cells, respectively. But they found essentially the same phenomenon. Standard CRISPR-Cas9 works by cutting both strands of the DNA double helix. That injury causes a cell to activate a biochemical first-aid kit orchestrated by a gene called \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4235614/\" target=\"_blank\" rel=\"noopener\">p53,\u003c/a> which either mends the DNA break or makes the cell self-destruct.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Whichever action p53 takes, the consequence is the same: CRISPR doesn’t work, either because the genome edit is stitched up or the cell is dead. (The Novartis team calculated that p53 reduces CRISPR efficiency in pluripotent stem cells seventeenfold.) That might explain something found over and over: CRISPR is woefully inefficient, with only a small minority of cells into which CRISPR is introduced, usually by a virus, actually having their genomes edited as intended.\u003c/p>\n\u003cp>“We found that cutting the genome with CRISPR-Cas9 induced the activation of … p53,” said Emma Haapaniemi, the lead author of the \u003ca href=\"https://www.nature.com/articles/s41591-018-0049-z\" target=\"_blank\" rel=\"noopener\">Karolinska study\u003c/a>. That “makes editing much more difficult.”\u003c/p>\n\u003cp>The flip side of p53 repairing CRISPR edits, or killing cells that accept the edits, is that cells that survive with the edits do so precisely because they have a dysfunctional p53 and therefore lack this fix-it-or-kill-it mechanism.\u003c/p>\n\u003cp>The reason why that could be a problem is that p53 dysfunction can cause cancer. And not just occasionally. P53 mutations are \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2827900/figure/A001008F1/\" target=\"_blank\" rel=\"noopener\">responsible for\u003c/a> nearly half of ovarian cancers; 43 percent of colorectal cancers; 38 percent of lung cancers; nearly one-third of pancreatic, stomach, and liver cancers; and one-quarter of breast cancers, among others.\u003c/p>\n\u003cp>The Novartis team was trying to see how it could increase the efficiency of CRISPR editing of pluripotent stem cells. Because this kind of stem cell can morph into virtually any kind of cell, it might be able to treat a variety of diseases. Neuroscientist Ajamete Kaykas of the company’s Institutes for BioMedical Research in Cambridge, Mass., got CRISPR’s efficiency at inserting or deleting chunks of DNA up to 80 percent. Unfortunately, when CRISPR worked, it was because p53 didn’t, which raises cancer concerns.\u003c/p>\n\u003cp>As a result, the Novartis \u003ca href=\"https://www.nature.com/articles/s41591-018-0050-6\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> concludes that “it will be critical to ensure that [genome-edited cells] have a functional p53 before and after [genome] engineering.” The Karolinska team warns that p53 and related genes “should be monitored when developing cell-based therapies utilizing CRISPR-Cas9.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The p53 finding doesn’t mean CRISPR is toast. For one thing, “the two papers present preliminary results,” biochemist Bernhard Schmierer of the Karolinska, co-leader of its study, told STAT. “It is unclear if the findings translate into cells actually used in current clinical studies.”\u003c/p>\n\u003cp>For another, the p53 problem might be worse with Cas9 than with other DNA-cutting enzymes used in CRISPR. And, crucially, it probably affects only one avenue of genome-editing.\u003c/p>\n\u003cp>CRISPR edits genomes in either of two ways. It slices out a chunk of disease-causing DNA, in a process called non-homologous end joining (NHEJ), or gene disruption. That’s how CRISPR Therapeutics is going after sickle cell disease. Alternatively, CRISPR both cuts out a disease-causing stretch of DNA and replaces it with healthy nucleotides, in homology-directed repair (HDR), or gene correction. Several university labs are investigating HDR to treat Duchenne \u003ca href=\"https://www.nature.com/articles/s41551-017-0137-2\" target=\"_blank\" rel=\"noopener\">muscular dystrophy,\u003c/a> among many other diseases.\u003c/p>\n\u003cp>In the normal, mature cells she and her team studied, Haapaniemi said, gene disruption “can happen even when p53 is activated.”\u003c/p>\n\u003cp>That’s good news for CRISPR Therapeutics’ sickle-cell and thalassemia \u003ca href=\"http://www.crisprtx.com/our-programs/our-pipeline.php\" target=\"_blank\" rel=\"noopener\">programs \u003c/a>as well as for Editas Medicine’s lead product, targeting a form of blindness, and others in its \u003ca href=\"http://www.editasmedicine.com/pipeline\" target=\"_blank\" rel=\"noopener\">pipeline\u003c/a>, all of which use NHEJ gene disruption. It also should not affect the gene-disruption approach that Intellia Therapeutics and Regeneron are \u003ca href=\"https://www.intelliatx.com/pipeline/\" target=\"_blank\" rel=\"noopener\">taking\u003c/a> to \u003ca href=\"https://ghr.nlm.nih.gov/condition/transthyretin-amyloidosis\" target=\"_blank\" rel=\"noopener\">transthyretin amyloidosis\u003c/a>.\u003c/p>\n\u003cp>CRISPR-based editing of T cells to treat cancer, as scientists at the University of Pennsylvania are studying in a \u003ca href=\"https://www.statnews.com/2016/06/21/crispr-human-trials/\">clinical trial,\u003c/a> should also not have a p53 problem. Nor should any therapy developed with CRISPR base editing, which does not make the double-stranded breaks that trigger p53. Developed by Harvard’s David Liu, base editing replaces a wrong DNA “letter” with the right one, without cutting, and is the basis for startup \u003ca href=\"https://www.statnews.com/2018/05/14/crispr-editas-beam-base-editing/\" target=\"_blank\" rel=\"noopener\">Beam Therapeutics\u003c/a>.\u003c/p>\n\u003cp>The p53 problem, however, might affect other products that companies hope to develop via gene correction, including glycogen storage disease, cystic fibrosis, and severe combined immunodeficiency.\u003c/p>\n\u003cp>It’s also a potential problem for stem cells. There, the Novartis team showed, p53 inactivation seems to be necessary for both NHEJ disruption and HDR correction. (Novartis’ Kaykas said he could not speak to a reporter without clearance from the company’s communications office.) That could be an issue for therapies using CRISPR’d stem cells: The same dysfunctional p53 that allows CRISPR to work its magic also makes cells likely to become cancerous.\u003c/p>\n\u003cp>Which raises an obvious question — if successfully CRISPR’d cells can seed cancers, why hasn’t this been seen before, and why haven’t the many CRISPR’d mice developed tumors?\u003c/p>\n\u003cp>Karolinska’s Haapaniemi said the effect shows up in large-scale experiments like hers and Novartis’ “but can be missed in small-scale studies where people only focus on editing one gene in one cell type.” In speaking to other scientists, she said, “it seems that other teams have noticed the effect of p53 on editing,” but have not highlighted it.\u003c/p>\n\u003cp>Jacob Corn of the University of California, Berkeley, said that although his lab has seen evidence of p53 activation in a few cases, they have “looked hard for growth effects after editing in [human stem cells] and found nothing.”\u003c/p>\n\u003cp>As for why no one has reported CRISPR’d mice getting cancer, Haapaniemi said, “This is a good question.” One reason might be that “laboratory mice are killed early,” perhaps leaving too little time for them to develop cancer.\u003c/p>\n\u003cp>But Corn said he and others “have all been looking for the possibility of cancer. So far, no one has seen evidence of [it] based on p53 status or induced by editing.”\u003c/p>\n\u003cp>Nevertheless, he called the two papers “important, since they remind everyone that genome editing isn’t magic.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Will San Francisco's Ban on Flavored Tobacco Spark a National Trend?",
"title": "Will San Francisco's Ban on Flavored Tobacco Spark a National Trend?",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Despite a multimillion dollar campaign by tobacco giant R.J. Reynolds, San Francisco will soon implement the most comprehensive restrictions on e-cigarettes in the country. The move is already sparking other cities to follow.\u003c/p>\n\u003caside class=\"pullquote alignright\">'What California does, almost always spreads not only across the country, but globally.'\u003ccite>Matt Myers, Campaign for Tobacco-Free Kids\u003c/cite>\u003c/aside>\n\u003cp>This week's vote on San Francisco's Proposition E was expected to be close, but the measure is passing with nearly 70 percent of the vote. That's an insurmountable lead even though mail-in ballots are still being counted. The ban includes all flavored tobacco products from vaping liquids to menthol cigarettes to flavored hookah.\u003c/p>\n\u003cp>\"You know, I probably would have voted for it too,\" said Brian Richardson a resident of Los Angeles who owns a Bay Area vaping store. \"As much as I like to sell vape liquids at my store in San Francisco, I agree some type of regulation is necessary.\"\u003c/p>\n\u003cp>The law goes into effect 10 days after the election is certified, which will likely be sometime in July. If a San Francisco store violates the ban, it could result in the suspension of their tobacco sales permit or further penalties as defined under the city's \u003ca href=\"https://sfgov.legistar.com/LegislationDetail.aspx?ID=3027568&GUID=254D4A3A-859F-4995-AF06-3B57291332E2&Options=ID\">health code\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Growing Momentum in California\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The same week voters passed San Francisco's ban, the Board of Supervisors in San Mateo County unanimously passed a similar comprehensive ban that will also remove traditional tobacco products from pharmacies. Supervisor Carole Groom says the measure is about prevention, especially among young people.\u003c/p>\n\u003cp>\"Every day, 2,500 kids try their first cigarette and that's what we're trying to stop,\" said Groom. \"Eighty-one percent of the youth in a recent survey told us that their first cigarette was flavored. That's the kind of thing we're trying to stop with this ordinance.\"\u003c/p>\n\u003cp>Several other communities like Oakland, El Cerrito and Palo Alto have \u003ca href=\"http://www.publichealthlawcenter.org/sites/default/files/resources/US-Sales-Restrictions-Flavored-Tobacco-Products-2017.pdf\" target=\"_blank\" rel=\"noopener\">similar bans\u003c/a> pending, though none are as comprehensive as the ones in San Francisco and San Mateo County.\u003c/p>\n\u003cp>City officials like Groom say local initiatives are necessary because there is very little regulation of e-products at the federal level, even though use is increasing. A 2016 \u003ca href=\"https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Exec_Summ_508.pdf\" target=\"_blank\" rel=\"noopener\">report\u003c/a> from the U.S. Surgeon General cited a 900 percent increase in the use of e-cigarettes by high school students from 2011 to 2015.\u003c/p>\n\u003cfigure id=\"attachment_442462\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"wp-image-442462 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/06/image000000-1020x680.jpg\" alt=\"\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-1200x800.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-1180x786.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000.jpg 2000w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Brian Richardson vaping on a walk just north of Big Sur, California \u003ccite>(Andrea Cardenas Kline)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Brian Richardson owns the Vapor Den, a hip, Lower Haight-neighborhood vape shop with low lighting, leather couches and row after row of top-shelf vape liquids. He says he opened his doors in 2012 to help smokers quit.\u003c/p>\n\u003cp>\"We used to act as a center to essentially educate people on the alternatives to smoking,\" said Richardson, who smoked a pack a day for 25 years. \"My customers used to be people trying to kick the habit. But over the years the demographic kept getting younger. Now people in their 20s are just looking for the latest and greatest devices with new flavors.\"\u003c/p>\n\u003cp>\u003cstrong>Manipulative Marketing Ploys to Attract Kids\u003c/strong>\u003c/p>\n\u003cp>When Richardson started vaping in 2009, there were only two flavors on the market; menthol and tobacco. Now there's more than 7,000, like cotton candy, apple crumb and watermelon, which are often packaged in brightly colored bottles with clowns and cartoon characters.\u003c/p>\n\u003cp>\"Regulation is necessary today because of the abuse and marketing ploys some of these companies are using to attract kids who may have never smoked a cigarette in their life,\" said Richardson.\u003c/p>\n\u003cp>He says his best selling products are made by \u003ca href=\"https://www.juul.com/\" target=\"_blank\" rel=\"noopener\">Juul\u003c/a>, which makes liquids with significantly higher amounts of nicotine and which Richardson calls the most abusive company in the business.\u003c/p>\n\u003cp>\"You take a couple of puffs and you actually feel like you're kind of high,\" said Richardson.\u003c/p>\n\u003cfigure id=\"attachment_440488\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-440488\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/juul-promo_1350-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350.jpg 1350w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Colorful nicotine-filled pods, pictured on the right, are inserted into the Juul e-cigarette, which educators say looks deceptively like a flash drive, making it harder to identify. \u003ccite>(Juul Labs)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He says that even though San Francisco's ban will likely crush sales at the Vapor Den, he plans to stay open. He thinks customers will buy their vaping liquids online but visit his shop when seeking advice on a device or to stock up on batteries and coil replacements.\u003c/p>\n\u003cp>But many other small shop owners are terrified about the aftermath of the ban.\u003c/p>\n\u003cp>“Prop E is going to have a huge impact on businesses like mine,\" said Miriam Zouzounis, a board member of the Arab American Grocers Association, which represents over 400 businesses in San Francisco. \"I fear that many small businesses will close in the wake of its passage.\" She said the law would disproportionately affect Arab, Sikh and Asian store owners.\u003c/p>\n\u003cp>\u003cstrong>An Expensive Fight\u003c/strong>\u003c/p>\n\u003cp>The R.J. Reynolds Tobacco Company spent nearly $13 million blanketing the city in advertisements to stop the ban. The company sells the nation’s best-selling menthol cigarette and popular vaping products called Vuse. Jacob McConnico a spokesperson for R.J. Reynolds, called the vote a setback for tobacco harm-reduction efforts.\u003c/p>\n\u003cp>\"History has shown regulations that go to extremes to limit consumer choice result in unintended consequences, including criminal activity,\" McConico wrote in an email. He did not respond when asked whether the company planned to sue.\u003c/p>\n\u003cp>The tobacco industry sued in both New York and Providence, Rhode Island, when those cities passed limited bans on flavored tobacco products, but the industry lost in both cases.\u003c/p>\n\u003cp>\u003cstrong>Tobacco Industry Pushes Back\u003c/strong>\u003c/p>\n\u003cp>San Francisco’s Board of Supervisors unanimously approved \u003ca class=\"css-1g7m0tk\" title=\"\" href=\"http://sfelections.sfgov.org/sites/default/files/Documents/candidates/Legal_Text_Repeal_of_Flavored_Tobacco_Products_Ban.pdf\" target=\"_blank\" rel=\"noopener\">the ban\u003c/a> last year. It was scheduled to go into effect last April, but then an opposition campaign raised enough signatures to put a referendum on the ballot, which is why the measure was put before voters on Tuesday.\u003c/p>\n\u003cp>The fight in favor of the ban was primarily funded by a personal $1.8 million donation from Michael R. Bloomberg, the former mayor of New York City. The American Cancer Society, the American Heart Association, the American Lung Association and Tobacco-Free Kids Action Fund contributed a combined total of $500,000.\u003c/p>\n\u003cp>\u003cstrong>Advocates Predict a Domino Effect\u003c/strong>\u003c/p>\n\u003cp>Matt Myers, the president of the \u003ca href=\"https://www.tobaccofreekids.org/\" target=\"_blank\" rel=\"noopener\">Campaign for Tobacco-Free Kids\u003c/a>, one of the primary advocacy organizations behind the San Francisco ban, predicts this is just the first of many bans across the country.\u003c/p>\n\u003cp>\"California repeatedly has been the leader on innovation on tobacco control,\" said Myers. \"And what California does almost always spreads not only across the country, but globally.\"\u003c/p>\n\u003cp>San Francisco especially has a history of taking on Big Tobacco. In 1983, the city passed a \u003ca href=\"https://publishing.cdlib.org/ucpressebooks/view?docId=ft167nb0vq&chunk.id=d0e845&toc.depth=1&toc.id=d0e447&brand=ucpress\" target=\"_blank\" rel=\"noopener\">workplace smoking restriction\u003c/a>. Several tobacco companies tried to stop the ordinance by forcing a referendum. But their expensive campaigning efforts failed, as voters upheld the restrictions. The industry lost many similar fights across the country as communities successfully removed smoking from offices.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"San Francisco's ban is really going to be a trendsetter for all over the country,\" said Stanton Glantz, who heads the \u003ca href=\"https://tobacco.ucsf.edu/\">Center for Tobacco Control Research and Education\u003c/a> at UC San Francisco. \"I just came back from an international meeting in South Africa and people were talking about the San Francisco ordinance.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Despite a multimillion dollar campaign by tobacco giant R.J. Reynolds, San Francisco will soon implement the most comprehensive restrictions on e-cigarettes in the country. The move is already sparking other cities to follow.\u003c/p>\n\u003caside class=\"pullquote alignright\">'What California does, almost always spreads not only across the country, but globally.'\u003ccite>Matt Myers, Campaign for Tobacco-Free Kids\u003c/cite>\u003c/aside>\n\u003cp>This week's vote on San Francisco's Proposition E was expected to be close, but the measure is passing with nearly 70 percent of the vote. That's an insurmountable lead even though mail-in ballots are still being counted. The ban includes all flavored tobacco products from vaping liquids to menthol cigarettes to flavored hookah.\u003c/p>\n\u003cp>\"You know, I probably would have voted for it too,\" said Brian Richardson a resident of Los Angeles who owns a Bay Area vaping store. \"As much as I like to sell vape liquids at my store in San Francisco, I agree some type of regulation is necessary.\"\u003c/p>\n\u003cp>The law goes into effect 10 days after the election is certified, which will likely be sometime in July. If a San Francisco store violates the ban, it could result in the suspension of their tobacco sales permit or further penalties as defined under the city's \u003ca href=\"https://sfgov.legistar.com/LegislationDetail.aspx?ID=3027568&GUID=254D4A3A-859F-4995-AF06-3B57291332E2&Options=ID\">health code\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Growing Momentum in California\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The same week voters passed San Francisco's ban, the Board of Supervisors in San Mateo County unanimously passed a similar comprehensive ban that will also remove traditional tobacco products from pharmacies. Supervisor Carole Groom says the measure is about prevention, especially among young people.\u003c/p>\n\u003cp>\"Every day, 2,500 kids try their first cigarette and that's what we're trying to stop,\" said Groom. \"Eighty-one percent of the youth in a recent survey told us that their first cigarette was flavored. That's the kind of thing we're trying to stop with this ordinance.\"\u003c/p>\n\u003cp>Several other communities like Oakland, El Cerrito and Palo Alto have \u003ca href=\"http://www.publichealthlawcenter.org/sites/default/files/resources/US-Sales-Restrictions-Flavored-Tobacco-Products-2017.pdf\" target=\"_blank\" rel=\"noopener\">similar bans\u003c/a> pending, though none are as comprehensive as the ones in San Francisco and San Mateo County.\u003c/p>\n\u003cp>City officials like Groom say local initiatives are necessary because there is very little regulation of e-products at the federal level, even though use is increasing. A 2016 \u003ca href=\"https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Exec_Summ_508.pdf\" target=\"_blank\" rel=\"noopener\">report\u003c/a> from the U.S. Surgeon General cited a 900 percent increase in the use of e-cigarettes by high school students from 2011 to 2015.\u003c/p>\n\u003cfigure id=\"attachment_442462\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"wp-image-442462 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/06/image000000-1020x680.jpg\" alt=\"\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-1200x800.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-1180x786.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image000000.jpg 2000w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Brian Richardson vaping on a walk just north of Big Sur, California \u003ccite>(Andrea Cardenas Kline)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Brian Richardson owns the Vapor Den, a hip, Lower Haight-neighborhood vape shop with low lighting, leather couches and row after row of top-shelf vape liquids. He says he opened his doors in 2012 to help smokers quit.\u003c/p>\n\u003cp>\"We used to act as a center to essentially educate people on the alternatives to smoking,\" said Richardson, who smoked a pack a day for 25 years. \"My customers used to be people trying to kick the habit. But over the years the demographic kept getting younger. Now people in their 20s are just looking for the latest and greatest devices with new flavors.\"\u003c/p>\n\u003cp>\u003cstrong>Manipulative Marketing Ploys to Attract Kids\u003c/strong>\u003c/p>\n\u003cp>When Richardson started vaping in 2009, there were only two flavors on the market; menthol and tobacco. Now there's more than 7,000, like cotton candy, apple crumb and watermelon, which are often packaged in brightly colored bottles with clowns and cartoon characters.\u003c/p>\n\u003cp>\"Regulation is necessary today because of the abuse and marketing ploys some of these companies are using to attract kids who may have never smoked a cigarette in their life,\" said Richardson.\u003c/p>\n\u003cp>He says his best selling products are made by \u003ca href=\"https://www.juul.com/\" target=\"_blank\" rel=\"noopener\">Juul\u003c/a>, which makes liquids with significantly higher amounts of nicotine and which Richardson calls the most abusive company in the business.\u003c/p>\n\u003cp>\"You take a couple of puffs and you actually feel like you're kind of high,\" said Richardson.\u003c/p>\n\u003cfigure id=\"attachment_440488\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-440488\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/juul-promo_1350-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/juul-promo_1350.jpg 1350w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Colorful nicotine-filled pods, pictured on the right, are inserted into the Juul e-cigarette, which educators say looks deceptively like a flash drive, making it harder to identify. \u003ccite>(Juul Labs)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>He says that even though San Francisco's ban will likely crush sales at the Vapor Den, he plans to stay open. He thinks customers will buy their vaping liquids online but visit his shop when seeking advice on a device or to stock up on batteries and coil replacements.\u003c/p>\n\u003cp>But many other small shop owners are terrified about the aftermath of the ban.\u003c/p>\n\u003cp>“Prop E is going to have a huge impact on businesses like mine,\" said Miriam Zouzounis, a board member of the Arab American Grocers Association, which represents over 400 businesses in San Francisco. \"I fear that many small businesses will close in the wake of its passage.\" She said the law would disproportionately affect Arab, Sikh and Asian store owners.\u003c/p>\n\u003cp>\u003cstrong>An Expensive Fight\u003c/strong>\u003c/p>\n\u003cp>The R.J. Reynolds Tobacco Company spent nearly $13 million blanketing the city in advertisements to stop the ban. The company sells the nation’s best-selling menthol cigarette and popular vaping products called Vuse. Jacob McConnico a spokesperson for R.J. Reynolds, called the vote a setback for tobacco harm-reduction efforts.\u003c/p>\n\u003cp>\"History has shown regulations that go to extremes to limit consumer choice result in unintended consequences, including criminal activity,\" McConico wrote in an email. He did not respond when asked whether the company planned to sue.\u003c/p>\n\u003cp>The tobacco industry sued in both New York and Providence, Rhode Island, when those cities passed limited bans on flavored tobacco products, but the industry lost in both cases.\u003c/p>\n\u003cp>\u003cstrong>Tobacco Industry Pushes Back\u003c/strong>\u003c/p>\n\u003cp>San Francisco’s Board of Supervisors unanimously approved \u003ca class=\"css-1g7m0tk\" title=\"\" href=\"http://sfelections.sfgov.org/sites/default/files/Documents/candidates/Legal_Text_Repeal_of_Flavored_Tobacco_Products_Ban.pdf\" target=\"_blank\" rel=\"noopener\">the ban\u003c/a> last year. It was scheduled to go into effect last April, but then an opposition campaign raised enough signatures to put a referendum on the ballot, which is why the measure was put before voters on Tuesday.\u003c/p>\n\u003cp>The fight in favor of the ban was primarily funded by a personal $1.8 million donation from Michael R. Bloomberg, the former mayor of New York City. The American Cancer Society, the American Heart Association, the American Lung Association and Tobacco-Free Kids Action Fund contributed a combined total of $500,000.\u003c/p>\n\u003cp>\u003cstrong>Advocates Predict a Domino Effect\u003c/strong>\u003c/p>\n\u003cp>Matt Myers, the president of the \u003ca href=\"https://www.tobaccofreekids.org/\" target=\"_blank\" rel=\"noopener\">Campaign for Tobacco-Free Kids\u003c/a>, one of the primary advocacy organizations behind the San Francisco ban, predicts this is just the first of many bans across the country.\u003c/p>\n\u003cp>\"California repeatedly has been the leader on innovation on tobacco control,\" said Myers. \"And what California does almost always spreads not only across the country, but globally.\"\u003c/p>\n\u003cp>San Francisco especially has a history of taking on Big Tobacco. In 1983, the city passed a \u003ca href=\"https://publishing.cdlib.org/ucpressebooks/view?docId=ft167nb0vq&chunk.id=d0e845&toc.depth=1&toc.id=d0e447&brand=ucpress\" target=\"_blank\" rel=\"noopener\">workplace smoking restriction\u003c/a>. Several tobacco companies tried to stop the ordinance by forcing a referendum. But their expensive campaigning efforts failed, as voters upheld the restrictions. The industry lost many similar fights across the country as communities successfully removed smoking from offices.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"San Francisco's ban is really going to be a trendsetter for all over the country,\" said Stanton Glantz, who heads the \u003ca href=\"https://tobacco.ucsf.edu/\">Center for Tobacco Control Research and Education\u003c/a> at UC San Francisco. \"I just came back from an international meeting in South Africa and people were talking about the San Francisco ordinance.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"tagline": "The flip side of gentrification, told through one town",
"info": "Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?",
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},
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"tagline": "Exploring the Bay Area, one question at a time",
"info": "KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.",
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},
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"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
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"order": 8
},
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},
"link": "https://www.cityarts.net",
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"order": 1
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"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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}
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"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"source": "kqed",
"order": 9
},
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"id": "fresh-air",
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"hidden-brain": {
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"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
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"source": "NPR"
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"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
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"airtime": "SUN 7:30pm-8pm",
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"jerrybrown": {
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"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"order": 18
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},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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},
"link": "/radio/program/latino-usa",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
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},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
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},
"masters-of-scale": {
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"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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