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"content": "\u003cp>\u003cem>Zoë Quinn is a video game developer who was one of several women in the industry targeted by online harassment campaigns using the hashtag \u003ca href=\"https://en.wikipedia.org/wiki/Gamergate_controversy\" target=\"_blank\" rel=\"noopener\">#Gamergate\u003c/a>. The harassment started after an ex-boyfriend published a disparaging blog post about Quinn, and as it spread online, her detractors multiplied, leading to the public posting of her address, the hacking of her internet accounts, and numerous rape and death threats. \u003c/em>\u003c/p>\n\u003cp>\u003cem>This edited excerpt is from Quinn’s book “CRASH OVERRIDE: How Gamergate (Nearly) Destroyed My Life, and How We Can Win the Fight Against Online Hate,” published in September 2017 by PublicAffairs, an imprint of the Hachette Book Group. \u003c/em>\u003c/p>\n\u003caside class=\"pullquote alignright\">‘They were highly organized, discussing how to divide their ranks into specialized groups: one dedicated to getting me in legal trouble, one dedicated to turning all of my friends against me, and another dedicated to pushing me to kill myself.’\u003c/aside>\n\u003cp>As anyone who has ever expressed an opinion on the internet knows, it’s not all sunshine and rainbows. Every rose has its thorn, and every news story has its comments section. As the internet has graduated out of nerds’ basements and into the mainstream, its formerly separate communities have come in closer and closer contact. For years, the people who preferred hanging out in small subcultural message boards and interest-based communities stayed pretty isolated, but with the advent of social media, the people who wind up on “\u003ca href=\"https://en.wikipedia.org/wiki/To_Catch_a_Predator\" target=\"_blank\" rel=\"noopener\">To Catch a Predator\u003c/a>” now have accounts on Twitter, Facebook et al., alongside your sweet grandma — assuming your grandmother hasn’t been caught trying to lure kids into a van.\u003c/p>\n\u003cp>Even if you stick mainly to mainstream sites, you’ve probably seen glimpses of the internet’s underbelly in the notorious comments sections at the bottom of news articles. The article could be about a local man saving a box of kittens from a burning building, but no matter: The comments will accuse him of hating dogs, setting the building on fire in the first place, and secretly being Barack Obama’s Kenyan uncle.\u003c/p>\n\u003cp>You’ve probably wondered two things: Who are these people, and what the hell is going on here?\u003c/p>\n\u003caside class=\"alignright\">\n\u003cul>\n\u003cli>\u003ca href=\"http://www.crashoverridenetwork.com/\" target=\"_blank\" rel=\"noopener\">Crash Override Network\u003c/a> — organization dedicated to fighting online abuse and providing assistance to victims, co-founded by Zoë Quinn. Includes automated \u003ca href=\"http://www.crashoverridenetwork.com/coach.html\" target=\"_blank\" rel=\"noopener\">cybersecurity helper\u003c/a>.\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>My teenaged obsession with shock sites like \u003ca href=\"https://theoutline.com/post/2549/rotten-com-is-offline\" target=\"_blank\" rel=\"noopener\">Rotten.com\u003c/a> started a lifelong hobby of spelunking through the weird pockets of the internet. This exploration taught me a lot (and, uh . . . showed me a lot) and exposed the fact that internet culture is essentially a magnificent patchwork of specific subcultures — good, bad and strange as hell. For every harmless community of users into really specific sexual kinks, there is a place like Bareback Exchange, a forum for people who get off on transmitting STDs to as many people as possible, often without consent. For every community of angsty kids who pretend they are secretly vampires, there are seven different forums of white nationalists who sincerely believe that Jewish people are secretly vampires. For every geeky and silly toy collector’s community, there are forums full of dudes collecting upskirt photos of random women and girls who had no idea they were about to become porn.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/12/crashcover.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-438546\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/12/crashcover.png\" alt=\"\" width=\"352\" height=\"535\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/13/2019/12/crashcover.png 750w, https://cdn.kqed.org/wp-content/uploads/sites/13/2019/12/crashcover-160x243.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/13/2019/12/crashcover-240x365.png 240w, https://cdn.kqed.org/wp-content/uploads/sites/13/2019/12/crashcover-375x570.png 375w, https://cdn.kqed.org/wp-content/uploads/sites/13/2019/12/crashcover-520x790.png 520w\" sizes=\"(max-width: 352px) 100vw, 352px\">\u003c/a>Attempting to explain anonymous message-board culture to the uninitiated is a lot like trying to explain an inside joke — you can lay out the particulars, but it won’t carry the same weight or meaning. It’s complicated and difficult to parse, like most things about internet culture, but here’s a brief overview. Opened in 1999, a Japanese site called 2channel was the first board in this genre. An anonymous board where admins are virtually nonexistent, this site has enabled corporate whistleblowing as well as frank, open exchanges about taboo subjects like mental health and sexuality. Alongside these generally positive discussions, the boards are teeming with slander, hate speech, porn, nationalism, and general unchecked terribleness.\u003c/p>\n\u003cp>2channel’s American counterpart is 4chan, an image board launched by a 15-year-old boy in 2003. Fourteen years later, 4chan is a hugely influential force on the internet: “the ground zero of Western web culture,” as one journalist put it. Most of the memes you see on social media were invented there — everything from \u003ca href=\"http://knowyourmeme.com/memes/lolcats\" target=\"_blank\" rel=\"noopener\">LOLCats\u003c/a> to \u003ca href=\"http://knowyourmeme.com/memes/rickroll\" target=\"_blank\" rel=\"noopener\">rickrolling\u003c/a>. It’s also a breeding ground for not-so-cute things, including a hoax hashtag with the goal of getting young girls to #CutForBieber, campaigns to troll the social media of dead teenagers, and murderers occasionally posting pictures of their victims.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘Pretty much everything we’ve been told about dealing with online abuse is wrong, but the misconception that “trolls” will just go away if they’re ignored is possibly the most damaging.’\u003c/aside>\n\u003cp>Reddit has an even larger version of this problem, in both size and scope. Calling itself the “front page of the internet” and clocking in at 36 million user accounts, Reddit allows anyone to create a “subreddit,” a discussion area dedicated to any subculture or interest on its site. This model has allowed mentally ill people to find community without stigma, locals to exchange highly specific information about what’s good in their neighborhoods, and even President Obama to hop online and answer readers’ questions. But, like 4chan, it’s also been a hotbed for communities founded on hatred.\u003c/p>\n\u003cp>Reddit isn’t as anonymous as 4chan — users must create accounts and can be banned — but the site was created with a sort of free-speech absolutism in mind. Before it was shut down, the subreddit /r/Jailbait was a board for sharing sexualized pictures of underaged girls, and “jailbait” was the second-most-popular search term leading people to Reddit. Reddit users voted Jailbait the Best Subreddit of 2008, with double the number of votes received by the runner-up. It took six years and multiple public scandals to finally \u003ca href=\"https://www.dailydot.com/society/reddit-r-jailbait-shutdown-controversy/\" target=\"_blank\" rel=\"noopener\">close it\u003c/a>. Reddit has only recently started banning other repugnant subreddits, including hateful and blatantly racist forums, though many of them live on and new ones spring up constantly.\u003c/p>\n\u003caside class=\"alignright\">\u003ca href=\"https://ww2.kqed.org/forum/2017/10/04/zoe-quinn-on-gamergate-fighting-online-harassment/\" target=\"_blank\" rel=\"noopener\">Zoë Quinn on KQED Forum\u003c/a>\u003c/aside>\n\u003cp>Poorly moderated anonymous communities can have the capricious morality of any mob. In 2009, when two videos featuring the physical abuse of a domestic cat named Dusty by a person calling himself “Timmy” were posted on YouTube, the 4chan community tracked down the originator of the videos and passed his details on to the local police department. The suspect was arrested, and the cat was treated by a veterinarian and taken to a safe place. This kind of “internet detectivery” has been banned from many traditional online forums outside 4chan. It’s invasive, it’s sometimes used simply to intimidate or harass people, and the mob is often wrong, with very real consequences.\u003c/p>\n\u003cp>When you consider how a tendency for vigilante action might manifest itself in a community founded on hating people together, you can see how the results might turn scary. Stormfront, a message board for white supremacists, was founded by former Ku Klux Klan leader Don Black in 1995 and had more than 300,000 users as of May 2015. Calling it “the Web’s first and best-known hate site,” the Southern Poverty Law Center’s March 2014 intelligence report stated, “Stormfront users have been disproportionately responsible for some of the most lethal hate crimes and mass killings since the site was put up in 1995. In the past five years alone, Stormfront members have murdered close to 100 people.”\u003c/p>\n\u003cp>This escalation from hate speech to real action isn’t unique to Stormfront’s user base. Before embarking on a \u003ca href=\"https://ww2.kqed.org/news/2014/05/26/amid-multiple-warning-signs-alleged-isla-vista-killer-slipped-through-system/\" target=\"_blank\" rel=\"noopener\">shooting spree\u003c/a> that killed six and injured 14, Elliot Rodger posted a video on several internet forums dedicated to hating women, discussing the deeply misogynist and racist motives for his rampage. He namechecked one of these sites in his manifesto, saying he had discovered “a forum full of men who are starved of sex, just like me.” The forum had “confirmed many of the theories I had about how wicked and degenerate women really are.”\u003c/p>\n\u003cfigure id=\"attachment_438515\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/12/zoequinn-e1516148809366.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-438515\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/12/zoequinn-1020x680.jpg\" alt=\"\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Zoe Quinn (right), with Anita Sarkeesian, also a #Gamergate target, were guest speakers at the introduction of a UN report called ‘\u003ca href=\"http://www.unwomen.org/~/media/headquarters/attachments/sections/library/publications/2015/cyber_violence_gender%20report.pdf?v=1&d=20150924T154259\">Cyber Violence Against Women and Girls: A World-Wide Wake-Up Call\u003c/a>.’ \u003ccite>(UN Women/Ryan Brown)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Bad Advice\u003c/strong>\u003c/p>\n\u003cp>There’s one piece of advice that most often gets passed around to anyone who experiences harassment or abuse on the internet: “Don’t feed the trolls.” This maxim is passed off as gospel and is applied across the board, whether you’re a kid getting into your very first Facebook argument or an experienced developer dealing with death threats.\u003c/p>\n\u003cp>This advice is wrong. Pretty much everything we’ve been told about dealing with online abuse is wrong, but the misconception that “trolls” will just go away if they’re ignored is possibly the most damaging.\u003c/p>\n\u003cp>This kind of behavior is not just about terrorizing you; it’s about control. It’s about making you want to disappear, instilling fear and limiting your possibilities. It’s about punishing you for stepping out of line. It’s about isolating and hurting you in specific ways to provoke a reaction.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘Anyone to whom I had public ties began to receive nude photos of me and pressure to publicly denounce me or become their next target.’\u003c/aside>\n\u003cp>In my case, it became obvious that my attackers’ dream was to get me to stop “feeding the trolls” and shut up. They didn’t want to tease me; they wanted me gone. There were countless forms of harassment — the same channels that I had used to talk with friends, grow my business, and share weird videos were now full of threats, slurs, and all manner of nastiness. It escalated to include sexual or violent images with my face Photoshopped into them. My inbox started to fill up with pictures of women being raped. As strangers stalked through everything I had said or done online since I was 12, looking for more ammo, lies and conspiracy theories about me snowballed into weirder and more extreme accusations. These would then be blasted out widely, and also directly to my colleagues in games. Anyone to whom I had public ties began to receive nude photos of me and pressure to publicly denounce me or become their next target.\u003c/p>\n\u003cp>\u003cstrong>Tools of Abuse\u003c/strong>\u003c/p>\n\u003cp>It’s one thing to have a single person going after you with all of the above tactics; it’s something else entirely when a community forms around doing so. The networked nature of the internet doesn’t just make it easier for stalkers to find you; it also makes it easier for them to find each other. These tools of abuse serve both as an attack in and of themselves and as a rallying cry. They’re meant to be shared.\u003c/p>\n\u003cp>When you’re the target of abuse like this, you’re basically screwed. Not only does the scope of abuse that you face increase exponentially with every single signal boost from a new member of the mob, but all of the good things about the web’s ability to bring people together are turned against you. The same techniques that people have used to organize important grassroots movements can be used by people trying to destroy someone.\u003c/p>\n\u003cp>[contextly_sidebar id=”mlpZZdvOLAdS7bEg7MHbtPNH4WgpVTAX”]Attacking you becomes a participatory game in which people try to one-up each other in terms of who can get to you the most. In my case, I was struck by how many of the threats or disgusting remarks sent my way were made so publicly, usually while tagging other people. The ones that were especially vicious were rewarded with likes, shares, and people joining in on the abuse.\u003c/p>\n\u003cp>This phenomenon is often referred to as “dogpiling.” The cool remix culture that facilitates the spread of fanart and memes suddenly becomes a powerful tool to hurt someone. Photos and videos of you are Photoshopped to label you a whore or to make you look uglier or fatter and then shared the same way cute pictures of cats are. Memes are easily co-opted by other people, who made reams of almost propaganda-like images with my face Photoshopped onto them. It wasn’t really about me anymore. The mob was engaging in a performative group activity.\u003c/p>\n\u003cp>This type of community building is quite deliberate and direct. As the 4chan threads kept growing in size and the mob gained momentum, I noticed that a chatroom had sprung up in the original posts. The chatroom participants worked as a team to try to discover personal information about everyone connected to me, referring to it as “digging” and sharing form letters and tactics on how to best alert anyone in my life that I was a horrible slut. They were highly organized, discussing how to divide their ranks into specialized groups: one dedicated to getting me in legal trouble, one dedicated to turning all of my friends against me, and another dedicated to pushing me to kill myself.\u003c/p>\n\u003cp>They shared elaborate fantasies about raping and murdering me, discussing the pros and cons of each. They talked about how to break into all of my accounts to try to find more ways to invade my privacy. They bragged about victories like flooding my game’s page with hatred and nude photos of me and went so far as to create guides to share tactics on how best to ruin my life. They even orchestrated plans to donate to various charities specifically to make themselves look like concerned citizens and not a mob of people trying to get me killed. They built friendships and bonded with each other by reinforcing their dedication to the righteous cause of taking me down, reminding themselves at every turn that they were the good guys.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘For every harmless community of users into really specific sexual kinks, there is a place like Bareback Exchange, a forum for people who get off on transmitting STDs to as many people as possible.’\u003c/aside>\n\u003cp>A mob has more tools at its disposal than individual actors do. Popularity — the quantity of clicks or views on any given page — is tracked and exploited by algorithms online, and a mob is a critical mass. If thousands of people are linking to something about you, that will quickly become the first thing people see when they Google your name, regardless of whether it’s a fact-checked news article or a video about what a bitch you are. Many sites allow their user base to vote on what is good content and what’s garbage, and mobs manipulate these systems to their targets’ detriment. There are also services that direct people away from sketchy websites that contain viruses, and the mob had flooded such services with false reports to make my websites and social media accounts inaccessible. My cohorts and I call this “brigading” — when people manipulate online systems to force their target into silence or hurt the person. Mass false reporting is a common tool to try to make the legitimate sites belonging to targets of online abuse vanish, as many systems are automated to react to a large volume of reports. Law enforcement agencies and government bodies like the IRS have online reporting systems that can also be manipulated this way by a mob.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>As a game designer, I can spot a game being played. And the more people who join in on the “fun,” the faster you become an abstract concept for your aggressors to hate. This might sound sort of comforting or like a way to defang the attacks, but in reality, it’s the opposite — this “game” is another way that you are dehumanized, and it makes it easier for a mob to grow its ranks and escalate its attacks. You’re just data, and data doesn’t bleed. You’re a symbol, and hating you can become part of someone’s identity, just as any other hobby might. Just as they would in a game, they are always trying to make their numbers go up. And plenty of the witch hunters advance from amateur to professional.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Zoë Quinn is a video game developer who was one of several women in the industry targeted by online harassment campaigns using the hashtag \u003ca href=\"https://en.wikipedia.org/wiki/Gamergate_controversy\" target=\"_blank\" rel=\"noopener\">#Gamergate\u003c/a>. The harassment started after an ex-boyfriend published a disparaging blog post about Quinn, and as it spread online, her detractors multiplied, leading to the public posting of her address, the hacking of her internet accounts, and numerous rape and death threats. \u003c/em>\u003c/p>\n\u003cp>\u003cem>This edited excerpt is from Quinn’s book “CRASH OVERRIDE: How Gamergate (Nearly) Destroyed My Life, and How We Can Win the Fight Against Online Hate,” published in September 2017 by PublicAffairs, an imprint of the Hachette Book Group. \u003c/em>\u003c/p>\n\u003caside class=\"pullquote alignright\">‘They were highly organized, discussing how to divide their ranks into specialized groups: one dedicated to getting me in legal trouble, one dedicated to turning all of my friends against me, and another dedicated to pushing me to kill myself.’\u003c/aside>\n\u003cp>As anyone who has ever expressed an opinion on the internet knows, it’s not all sunshine and rainbows. Every rose has its thorn, and every news story has its comments section. As the internet has graduated out of nerds’ basements and into the mainstream, its formerly separate communities have come in closer and closer contact. For years, the people who preferred hanging out in small subcultural message boards and interest-based communities stayed pretty isolated, but with the advent of social media, the people who wind up on “\u003ca href=\"https://en.wikipedia.org/wiki/To_Catch_a_Predator\" target=\"_blank\" rel=\"noopener\">To Catch a Predator\u003c/a>” now have accounts on Twitter, Facebook et al., alongside your sweet grandma — assuming your grandmother hasn’t been caught trying to lure kids into a van.\u003c/p>\n\u003cp>Even if you stick mainly to mainstream sites, you’ve probably seen glimpses of the internet’s underbelly in the notorious comments sections at the bottom of news articles. The article could be about a local man saving a box of kittens from a burning building, but no matter: The comments will accuse him of hating dogs, setting the building on fire in the first place, and secretly being Barack Obama’s Kenyan uncle.\u003c/p>\n\u003cp>You’ve probably wondered two things: Who are these people, and what the hell is going on here?\u003c/p>\n\u003caside class=\"alignright\">\n\u003cul>\n\u003cli>\u003ca href=\"http://www.crashoverridenetwork.com/\" target=\"_blank\" rel=\"noopener\">Crash Override Network\u003c/a> — organization dedicated to fighting online abuse and providing assistance to victims, co-founded by Zoë Quinn. Includes automated \u003ca href=\"http://www.crashoverridenetwork.com/coach.html\" target=\"_blank\" rel=\"noopener\">cybersecurity helper\u003c/a>.\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>My teenaged obsession with shock sites like \u003ca href=\"https://theoutline.com/post/2549/rotten-com-is-offline\" target=\"_blank\" rel=\"noopener\">Rotten.com\u003c/a> started a lifelong hobby of spelunking through the weird pockets of the internet. This exploration taught me a lot (and, uh . . . showed me a lot) and exposed the fact that internet culture is essentially a magnificent patchwork of specific subcultures — good, bad and strange as hell. For every harmless community of users into really specific sexual kinks, there is a place like Bareback Exchange, a forum for people who get off on transmitting STDs to as many people as possible, often without consent. For every community of angsty kids who pretend they are secretly vampires, there are seven different forums of white nationalists who sincerely believe that Jewish people are secretly vampires. For every geeky and silly toy collector’s community, there are forums full of dudes collecting upskirt photos of random women and girls who had no idea they were about to become porn.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/12/crashcover.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-438546\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/12/crashcover.png\" alt=\"\" width=\"352\" height=\"535\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/13/2019/12/crashcover.png 750w, https://cdn.kqed.org/wp-content/uploads/sites/13/2019/12/crashcover-160x243.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/13/2019/12/crashcover-240x365.png 240w, https://cdn.kqed.org/wp-content/uploads/sites/13/2019/12/crashcover-375x570.png 375w, https://cdn.kqed.org/wp-content/uploads/sites/13/2019/12/crashcover-520x790.png 520w\" sizes=\"(max-width: 352px) 100vw, 352px\">\u003c/a>Attempting to explain anonymous message-board culture to the uninitiated is a lot like trying to explain an inside joke — you can lay out the particulars, but it won’t carry the same weight or meaning. It’s complicated and difficult to parse, like most things about internet culture, but here’s a brief overview. Opened in 1999, a Japanese site called 2channel was the first board in this genre. An anonymous board where admins are virtually nonexistent, this site has enabled corporate whistleblowing as well as frank, open exchanges about taboo subjects like mental health and sexuality. Alongside these generally positive discussions, the boards are teeming with slander, hate speech, porn, nationalism, and general unchecked terribleness.\u003c/p>\n\u003cp>2channel’s American counterpart is 4chan, an image board launched by a 15-year-old boy in 2003. Fourteen years later, 4chan is a hugely influential force on the internet: “the ground zero of Western web culture,” as one journalist put it. Most of the memes you see on social media were invented there — everything from \u003ca href=\"http://knowyourmeme.com/memes/lolcats\" target=\"_blank\" rel=\"noopener\">LOLCats\u003c/a> to \u003ca href=\"http://knowyourmeme.com/memes/rickroll\" target=\"_blank\" rel=\"noopener\">rickrolling\u003c/a>. It’s also a breeding ground for not-so-cute things, including a hoax hashtag with the goal of getting young girls to #CutForBieber, campaigns to troll the social media of dead teenagers, and murderers occasionally posting pictures of their victims.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘Pretty much everything we’ve been told about dealing with online abuse is wrong, but the misconception that “trolls” will just go away if they’re ignored is possibly the most damaging.’\u003c/aside>\n\u003cp>Reddit has an even larger version of this problem, in both size and scope. Calling itself the “front page of the internet” and clocking in at 36 million user accounts, Reddit allows anyone to create a “subreddit,” a discussion area dedicated to any subculture or interest on its site. This model has allowed mentally ill people to find community without stigma, locals to exchange highly specific information about what’s good in their neighborhoods, and even President Obama to hop online and answer readers’ questions. But, like 4chan, it’s also been a hotbed for communities founded on hatred.\u003c/p>\n\u003cp>Reddit isn’t as anonymous as 4chan — users must create accounts and can be banned — but the site was created with a sort of free-speech absolutism in mind. Before it was shut down, the subreddit /r/Jailbait was a board for sharing sexualized pictures of underaged girls, and “jailbait” was the second-most-popular search term leading people to Reddit. Reddit users voted Jailbait the Best Subreddit of 2008, with double the number of votes received by the runner-up. It took six years and multiple public scandals to finally \u003ca href=\"https://www.dailydot.com/society/reddit-r-jailbait-shutdown-controversy/\" target=\"_blank\" rel=\"noopener\">close it\u003c/a>. Reddit has only recently started banning other repugnant subreddits, including hateful and blatantly racist forums, though many of them live on and new ones spring up constantly.\u003c/p>\n\u003caside class=\"alignright\">\u003ca href=\"https://ww2.kqed.org/forum/2017/10/04/zoe-quinn-on-gamergate-fighting-online-harassment/\" target=\"_blank\" rel=\"noopener\">Zoë Quinn on KQED Forum\u003c/a>\u003c/aside>\n\u003cp>Poorly moderated anonymous communities can have the capricious morality of any mob. In 2009, when two videos featuring the physical abuse of a domestic cat named Dusty by a person calling himself “Timmy” were posted on YouTube, the 4chan community tracked down the originator of the videos and passed his details on to the local police department. The suspect was arrested, and the cat was treated by a veterinarian and taken to a safe place. This kind of “internet detectivery” has been banned from many traditional online forums outside 4chan. It’s invasive, it’s sometimes used simply to intimidate or harass people, and the mob is often wrong, with very real consequences.\u003c/p>\n\u003cp>When you consider how a tendency for vigilante action might manifest itself in a community founded on hating people together, you can see how the results might turn scary. Stormfront, a message board for white supremacists, was founded by former Ku Klux Klan leader Don Black in 1995 and had more than 300,000 users as of May 2015. Calling it “the Web’s first and best-known hate site,” the Southern Poverty Law Center’s March 2014 intelligence report stated, “Stormfront users have been disproportionately responsible for some of the most lethal hate crimes and mass killings since the site was put up in 1995. In the past five years alone, Stormfront members have murdered close to 100 people.”\u003c/p>\n\u003cp>This escalation from hate speech to real action isn’t unique to Stormfront’s user base. Before embarking on a \u003ca href=\"https://ww2.kqed.org/news/2014/05/26/amid-multiple-warning-signs-alleged-isla-vista-killer-slipped-through-system/\" target=\"_blank\" rel=\"noopener\">shooting spree\u003c/a> that killed six and injured 14, Elliot Rodger posted a video on several internet forums dedicated to hating women, discussing the deeply misogynist and racist motives for his rampage. He namechecked one of these sites in his manifesto, saying he had discovered “a forum full of men who are starved of sex, just like me.” The forum had “confirmed many of the theories I had about how wicked and degenerate women really are.”\u003c/p>\n\u003cfigure id=\"attachment_438515\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/12/zoequinn-e1516148809366.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-438515\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/12/zoequinn-1020x680.jpg\" alt=\"\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Zoe Quinn (right), with Anita Sarkeesian, also a #Gamergate target, were guest speakers at the introduction of a UN report called ‘\u003ca href=\"http://www.unwomen.org/~/media/headquarters/attachments/sections/library/publications/2015/cyber_violence_gender%20report.pdf?v=1&d=20150924T154259\">Cyber Violence Against Women and Girls: A World-Wide Wake-Up Call\u003c/a>.’ \u003ccite>(UN Women/Ryan Brown)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Bad Advice\u003c/strong>\u003c/p>\n\u003cp>There’s one piece of advice that most often gets passed around to anyone who experiences harassment or abuse on the internet: “Don’t feed the trolls.” This maxim is passed off as gospel and is applied across the board, whether you’re a kid getting into your very first Facebook argument or an experienced developer dealing with death threats.\u003c/p>\n\u003cp>This advice is wrong. Pretty much everything we’ve been told about dealing with online abuse is wrong, but the misconception that “trolls” will just go away if they’re ignored is possibly the most damaging.\u003c/p>\n\u003cp>This kind of behavior is not just about terrorizing you; it’s about control. It’s about making you want to disappear, instilling fear and limiting your possibilities. It’s about punishing you for stepping out of line. It’s about isolating and hurting you in specific ways to provoke a reaction.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘Anyone to whom I had public ties began to receive nude photos of me and pressure to publicly denounce me or become their next target.’\u003c/aside>\n\u003cp>In my case, it became obvious that my attackers’ dream was to get me to stop “feeding the trolls” and shut up. They didn’t want to tease me; they wanted me gone. There were countless forms of harassment — the same channels that I had used to talk with friends, grow my business, and share weird videos were now full of threats, slurs, and all manner of nastiness. It escalated to include sexual or violent images with my face Photoshopped into them. My inbox started to fill up with pictures of women being raped. As strangers stalked through everything I had said or done online since I was 12, looking for more ammo, lies and conspiracy theories about me snowballed into weirder and more extreme accusations. These would then be blasted out widely, and also directly to my colleagues in games. Anyone to whom I had public ties began to receive nude photos of me and pressure to publicly denounce me or become their next target.\u003c/p>\n\u003cp>\u003cstrong>Tools of Abuse\u003c/strong>\u003c/p>\n\u003cp>It’s one thing to have a single person going after you with all of the above tactics; it’s something else entirely when a community forms around doing so. The networked nature of the internet doesn’t just make it easier for stalkers to find you; it also makes it easier for them to find each other. These tools of abuse serve both as an attack in and of themselves and as a rallying cry. They’re meant to be shared.\u003c/p>\n\u003cp>When you’re the target of abuse like this, you’re basically screwed. Not only does the scope of abuse that you face increase exponentially with every single signal boost from a new member of the mob, but all of the good things about the web’s ability to bring people together are turned against you. The same techniques that people have used to organize important grassroots movements can be used by people trying to destroy someone.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Attacking you becomes a participatory game in which people try to one-up each other in terms of who can get to you the most. In my case, I was struck by how many of the threats or disgusting remarks sent my way were made so publicly, usually while tagging other people. The ones that were especially vicious were rewarded with likes, shares, and people joining in on the abuse.\u003c/p>\n\u003cp>This phenomenon is often referred to as “dogpiling.” The cool remix culture that facilitates the spread of fanart and memes suddenly becomes a powerful tool to hurt someone. Photos and videos of you are Photoshopped to label you a whore or to make you look uglier or fatter and then shared the same way cute pictures of cats are. Memes are easily co-opted by other people, who made reams of almost propaganda-like images with my face Photoshopped onto them. It wasn’t really about me anymore. The mob was engaging in a performative group activity.\u003c/p>\n\u003cp>This type of community building is quite deliberate and direct. As the 4chan threads kept growing in size and the mob gained momentum, I noticed that a chatroom had sprung up in the original posts. The chatroom participants worked as a team to try to discover personal information about everyone connected to me, referring to it as “digging” and sharing form letters and tactics on how to best alert anyone in my life that I was a horrible slut. They were highly organized, discussing how to divide their ranks into specialized groups: one dedicated to getting me in legal trouble, one dedicated to turning all of my friends against me, and another dedicated to pushing me to kill myself.\u003c/p>\n\u003cp>They shared elaborate fantasies about raping and murdering me, discussing the pros and cons of each. They talked about how to break into all of my accounts to try to find more ways to invade my privacy. They bragged about victories like flooding my game’s page with hatred and nude photos of me and went so far as to create guides to share tactics on how best to ruin my life. They even orchestrated plans to donate to various charities specifically to make themselves look like concerned citizens and not a mob of people trying to get me killed. They built friendships and bonded with each other by reinforcing their dedication to the righteous cause of taking me down, reminding themselves at every turn that they were the good guys.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘For every harmless community of users into really specific sexual kinks, there is a place like Bareback Exchange, a forum for people who get off on transmitting STDs to as many people as possible.’\u003c/aside>\n\u003cp>A mob has more tools at its disposal than individual actors do. Popularity — the quantity of clicks or views on any given page — is tracked and exploited by algorithms online, and a mob is a critical mass. If thousands of people are linking to something about you, that will quickly become the first thing people see when they Google your name, regardless of whether it’s a fact-checked news article or a video about what a bitch you are. Many sites allow their user base to vote on what is good content and what’s garbage, and mobs manipulate these systems to their targets’ detriment. There are also services that direct people away from sketchy websites that contain viruses, and the mob had flooded such services with false reports to make my websites and social media accounts inaccessible. My cohorts and I call this “brigading” — when people manipulate online systems to force their target into silence or hurt the person. Mass false reporting is a common tool to try to make the legitimate sites belonging to targets of online abuse vanish, as many systems are automated to react to a large volume of reports. Law enforcement agencies and government bodies like the IRS have online reporting systems that can also be manipulated this way by a mob.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As a game designer, I can spot a game being played. And the more people who join in on the “fun,” the faster you become an abstract concept for your aggressors to hate. This might sound sort of comforting or like a way to defang the attacks, but in reality, it’s the opposite — this “game” is another way that you are dehumanized, and it makes it easier for a mob to grow its ranks and escalate its attacks. You’re just data, and data doesn’t bleed. You’re a symbol, and hating you can become part of someone’s identity, just as any other hobby might. Just as they would in a game, they are always trying to make their numbers go up. And plenty of the witch hunters advance from amateur to professional.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Seconds Matter When Treating Stroke. This San Francisco Hospital Got a Lot Faster",
"title": "Seconds Matter When Treating Stroke. This San Francisco Hospital Got a Lot Faster",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>\u003cspan style=\"font-weight: 400\">The last thing Donna Taylor remembers about the night of July 21, 2017, is her intense headache and flickering vision. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When her husband, Joseph, found her lying on the floor of their San Francisco home, she couldn’t get up, so he called 911. \u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'There’s an old adage that time is brain.'\u003ccite>Debbie Madhok, physician\u003c/cite>\u003c/aside>\n\u003cp>“I realized this was not something we can handle here at home,” Joseph says. “This was awfully scary.”\u003c/p>\n\u003cp>The ambulance took Taylor, 55, to Zuckerberg San Francisco General Hospital and Trauma Center, where she was rushed to get a CT scan. The doctors found a large clot blocking one of the major arteries to her brain -- a stroke. Within 28 minutes of her arrival, Donna was given medication to break up the clot. Within 108 minutes, surgeons were removing it. By the next day, she was mobile again.\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>Signs You're Having a Stroke:\u003c/h3>\n\u003cul>\n\u003cli>Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body\u003c/li>\n\u003cli>Sudden confusion or trouble speaking\u003c/li>\n\u003cli>Sudden trouble seeing\u003c/li>\n\u003cli>Sudden trouble walking or dizziness\u003c/li>\n\u003cli>Sudden severe headache with no cause\u003c/li>\n\u003c/ul>\n\u003ch4>What to do if you — or someone near you — is experiencing even one of these symptoms:\u003c/h4>\n\u003cul>\n\u003cli>Call 911 immediately; never wait more than 5 minutes.\u003c/li>\n\u003cli>Take note of the time symptoms started.\u003c/li>\n\u003cli>Stay put until help arrives.\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>This protocol was new. It was developed by emergency and neurocritical care physician Debbie Madhok.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"There’s an old adage that ‘time is brain,’” says Madhok. “It’s been shown that if you occlude a big blood vessel in the brain, about 2 million brain cells die per minute. Depending on where these cells die, the impact can be quite devastating.”\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">People who suffer massive strokes can permanently lose the ability to speak or move parts of their bodies. For every hour that treatment is delayed, a stroke patient loses 3.6 years of functional life, says J. Claude Hemphill III, one of San Francisco General's neurosurgeons. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The American Heart Association recommends stroke patients receive the clot-busting medicine known as \u003ca href=\"http://www.strokeassociation.org/idc/groups/stroke-public/@wcm/@hcm/@gwtg/documents/downloadable/ucm_430859.pdf\" target=\"_blank\" rel=\"noopener\">tPA\u003c/a> within \u003ca href=\"http://www.strokeassociation.org/STROKEORG/Professionals/TargetStroke/About-Target-Stroke_UCM_432409_Article.jsp#.Wi7hQxOPIWo\" target=\"_blank\" rel=\"noopener\">45-60 minutes\u003c/a> of arriving at a hospital. But under Madhok’s plan, treatment comes faster.\u003c/span>\u003c/p>\n\u003cp>It starts with the paramedics calling ahead when transporting a potential stroke patient. They are met at the emergency room doors by a stroke specialist who moves the patient just a few yards, to be weighed and given a CT scan. If the scan reveals that a large clot is cutting off blood supply to the brain, the patient immediately receives a weight-appropriate dose of tPA while still in the scanner. Soon after, a surgical team removes the clot.\u003c/p>\n\u003cfigure id=\"attachment_438615\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"wp-image-438615 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/brainscan-1020x299.jpg\" alt=\"Brain scans show where a stroke patient's blood flow is blocked (left), the clot being removed (middle) and blood flow restored (right).\" width=\"640\" height=\"188\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/01/brainscan-1020x299.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/brainscan-160x47.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/brainscan-800x235.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/brainscan-768x225.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/brainscan-960x281.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/brainscan-240x70.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/brainscan-375x110.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/brainscan-520x152.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/brainscan.jpg 1129w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">X-ray scans of the brain (\u003cspan class=\"s1\">a cerebral angiogram)\u003c/span> show where a stroke patient's blood flow is blocked (left), the clot being removed (middle) and blood flow restored (right). \u003ccite>(San Francisco General Hospital)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">Madhok calls it the Mission Protocol, both because it’s her mission to streamline emergency stroke treatment and because the hospital sits on the border of San Francisco’s Mission district, providing care for many of its residents.\u003c/span>\u003c/p>\n\u003cp>Under the protocol, the median time for patients to get a CT scan is 10 minutes , which is 13 minutes faster than before. The median from \"door-to-needle,” the time it takes to administer tPA, is 20 minutes, less than half the 45 minutes it used to take.\u003c/p>\n\u003cp>Several studies have shown that \u003ca href=\"http://share.upmc.com/2015/08/mechanical-thrombectomy-stroke-mm02/\" target=\"_blank\" rel=\"noopener\">\u003cspan style=\"font-weight: 400\">mechanical thrombectomy\u003c/span>\u003c/a>, \u003cspan style=\"font-weight: 400\">in which doctors snake tiny tools into a patient’s artery to remove clots, is a key step in emergency stroke care. While the Committee of the Society of Vascular and Interventional Neurology \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4817382/\" target=\"_blank\" rel=\"noopener\">recommends clot removal in less than 90 minutes, \u003c/a>under the Mission Protocol, the hospital’s median time to remove clots is 76 minutes.\u003c/span>\u003c/p>\n\u003cp>In response to those studies, more hospitals are adding mechanical thrombectomy to their emergency stroke care, says Dr. Jose Biller, neurology chair at the Loyola University Chicago Stritch School of Medicine.\u003c/p>\n\u003cp>“Everyone I know of is very cognizant of the fact that early stroke treatment is essential,” Biller says. “You see variations on this theme in many institutions.”\u003c/p>\n\u003cp>\u003cb>Shaving Time to Treatment\u003c/b>\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s become a competitive thing, seeing who can go for the quickest stroke treatment time possible.'\u003ccite>David Tong, California Pacific Medical Center neurologist\u003c/cite>\u003c/aside>\n\u003cp>\u003cspan style=\"font-weight: 400\">Two initiatives in the past decade began to affect how hospitals treat stroke patients. In 2010, the American Heart Association launched \u003c/span>\u003ca href=\"http://www.strokeassociation.org/STROKEORG/Professionals/TargetStroke/About-Target-Stroke_UCM_432409_Article.jsp#.Wi7fIROPIWo\" target=\"_blank\" rel=\"noopener\">\u003cspan style=\"font-weight: 400\">Target: Stroke\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, an initiative aimed at encouraging hospitals to reduce their door-to-needle time to less than 60 minutes. Two years later, research out of Helsinki showed how to shave off minutes from that time, and many hospitals began adopting the method.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It’s become a competitive thing, seeing who can go for the quickest time possible,” says David Tong, a neurologist with California Pacific Medical Center and a member of the American Neurological Association's Advisory Committee. “Over the past 10 to 15 years, that has dramatically improved. But it takes a lot of coordination.”\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_438620\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-438620\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/iStock-475593228-1020x1020.jpg\" alt=\"Top view of a brain showing a red blotch amid blue brain tissue\" width=\"640\" height=\"640\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-1020x1020.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-160x160.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-800x800.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-768x768.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-960x960.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-240x240.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-375x375.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-520x520.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-50x50.jpg 50w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-150x150.jpg 150w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228.jpg 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">CT scan of a brain showing a stroke \u003ccite>(iStockphoto)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">One \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/1861802?resultClick=3\" target=\"_blank\" rel=\"noopener\">study\u003c/a> found that hospitals participating in the AHA initiative from 2009-2013 improved their average door-to-needle time from 74 down to 59 minutes. Patients’ in-hospital deaths dropped close to 2 percent, and more patients were able to recover at home instead of a rehab facility, according to the AHA.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Tong says no regulation requires hospitals to follow the AHA’s recommendations for door-to-needle times, so there’s no way to know how many hospitals have made these changes. But the nationwide statistics aren’t encouraging; in 2017, \u003c/span>\u003ca href=\"http://www.strokeassociation.org/STROKEORG/Professionals/TargetStroke/About-Target-Stroke_UCM_432409_Article.jsp#.Wi7i_BOPIWo\" target=\"_blank\" rel=\"noopener\">\u003cspan style=\"font-weight: 400\">according to the American Stroke Association\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, fewer than 30 percent of stroke patients received tPA within an hour of arrival. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">And even an hour is still too long, say stroke experts.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Some hospitals say a 60-minute door-to-needle time is good,” says Hemphill. “Now, when we treat someone in 60 or 45 minutes, we ask, ‘What went wrong?’ We regularly treat patients within 20 minutes.”\u003c/span>\u003c/p>\n\u003cp>\u003cb>Closing the Gender and Race Gaps\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">[contextly_sidebar id=\"B3Ey7pC4m5a9R8T6qLl2KnJcgiMSblm7\"]Madhok reached out to San Francisco General to develop her protocol because the hospital provides emergency medicine to underserved populations, as well as doing neurocritical care research. The hospital wasn’t hiring, but once doctors heard what she wanted to do, they found space. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">As a \u003c/span>\u003ca href=\"https://www.aan.com/PressRoom/Home/PressRelease/1493\" target=\"_blank\" rel=\"noopener\">\u003cspan style=\"font-weight: 400\">handful of studies\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> show, people of color and women tend to receive inferior care when they’re having a stroke, and they are less likely to receive tPA or have their clots removed. \u003c/span>\u003cspan style=\"font-weight: 400\">Loyola’s Dr. Biller says that lack of awareness about stroke symptoms, or the fact that high blood pressure is a precursor to stroke, may explain some of the disparities in treatment. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Not surprisingly, these patients also have worse short- and long-term outcomes after stroke,” Madhok says. “Organized stroke care has the potential to reduce these disparities. Mission Protocol was my way to put this to the test.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Among the roughly 80 patients who have been subject to the protocol since July, three-quarters are Latino, Asian or black. Madhok is still gathering data for publication on long-term outcomes. \u003c/span>\u003cspan style=\"font-weight: 400\">Already, though, she has some idea what the results will look like. \u003c/span>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“If a 20-minute delay in care can cost a patient 1.2 years of functioning brain health, then you can imagine what getting a patient to tPA in less than 20 minutes, as opposed to 45 to 60 minutes, and getting a clot open in less than 90 minutes, as opposed to two hours, means for a patient.”\u003c/span>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-weight: 400\">The last thing Donna Taylor remembers about the night of July 21, 2017, is her intense headache and flickering vision. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When her husband, Joseph, found her lying on the floor of their San Francisco home, she couldn’t get up, so he called 911. \u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'There’s an old adage that time is brain.'\u003ccite>Debbie Madhok, physician\u003c/cite>\u003c/aside>\n\u003cp>“I realized this was not something we can handle here at home,” Joseph says. “This was awfully scary.”\u003c/p>\n\u003cp>The ambulance took Taylor, 55, to Zuckerberg San Francisco General Hospital and Trauma Center, where she was rushed to get a CT scan. The doctors found a large clot blocking one of the major arteries to her brain -- a stroke. Within 28 minutes of her arrival, Donna was given medication to break up the clot. Within 108 minutes, surgeons were removing it. By the next day, she was mobile again.\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>Signs You're Having a Stroke:\u003c/h3>\n\u003cul>\n\u003cli>Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body\u003c/li>\n\u003cli>Sudden confusion or trouble speaking\u003c/li>\n\u003cli>Sudden trouble seeing\u003c/li>\n\u003cli>Sudden trouble walking or dizziness\u003c/li>\n\u003cli>Sudden severe headache with no cause\u003c/li>\n\u003c/ul>\n\u003ch4>What to do if you — or someone near you — is experiencing even one of these symptoms:\u003c/h4>\n\u003cul>\n\u003cli>Call 911 immediately; never wait more than 5 minutes.\u003c/li>\n\u003cli>Take note of the time symptoms started.\u003c/li>\n\u003cli>Stay put until help arrives.\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>This protocol was new. It was developed by emergency and neurocritical care physician Debbie Madhok.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"There’s an old adage that ‘time is brain,’” says Madhok. “It’s been shown that if you occlude a big blood vessel in the brain, about 2 million brain cells die per minute. Depending on where these cells die, the impact can be quite devastating.”\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">People who suffer massive strokes can permanently lose the ability to speak or move parts of their bodies. For every hour that treatment is delayed, a stroke patient loses 3.6 years of functional life, says J. Claude Hemphill III, one of San Francisco General's neurosurgeons. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The American Heart Association recommends stroke patients receive the clot-busting medicine known as \u003ca href=\"http://www.strokeassociation.org/idc/groups/stroke-public/@wcm/@hcm/@gwtg/documents/downloadable/ucm_430859.pdf\" target=\"_blank\" rel=\"noopener\">tPA\u003c/a> within \u003ca href=\"http://www.strokeassociation.org/STROKEORG/Professionals/TargetStroke/About-Target-Stroke_UCM_432409_Article.jsp#.Wi7hQxOPIWo\" target=\"_blank\" rel=\"noopener\">45-60 minutes\u003c/a> of arriving at a hospital. But under Madhok’s plan, treatment comes faster.\u003c/span>\u003c/p>\n\u003cp>It starts with the paramedics calling ahead when transporting a potential stroke patient. They are met at the emergency room doors by a stroke specialist who moves the patient just a few yards, to be weighed and given a CT scan. If the scan reveals that a large clot is cutting off blood supply to the brain, the patient immediately receives a weight-appropriate dose of tPA while still in the scanner. Soon after, a surgical team removes the clot.\u003c/p>\n\u003cfigure id=\"attachment_438615\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"wp-image-438615 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/brainscan-1020x299.jpg\" alt=\"Brain scans show where a stroke patient's blood flow is blocked (left), the clot being removed (middle) and blood flow restored (right).\" width=\"640\" height=\"188\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/01/brainscan-1020x299.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/brainscan-160x47.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/brainscan-800x235.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/brainscan-768x225.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/brainscan-960x281.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/brainscan-240x70.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/brainscan-375x110.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/brainscan-520x152.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/brainscan.jpg 1129w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">X-ray scans of the brain (\u003cspan class=\"s1\">a cerebral angiogram)\u003c/span> show where a stroke patient's blood flow is blocked (left), the clot being removed (middle) and blood flow restored (right). \u003ccite>(San Francisco General Hospital)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">Madhok calls it the Mission Protocol, both because it’s her mission to streamline emergency stroke treatment and because the hospital sits on the border of San Francisco’s Mission district, providing care for many of its residents.\u003c/span>\u003c/p>\n\u003cp>Under the protocol, the median time for patients to get a CT scan is 10 minutes , which is 13 minutes faster than before. The median from \"door-to-needle,” the time it takes to administer tPA, is 20 minutes, less than half the 45 minutes it used to take.\u003c/p>\n\u003cp>Several studies have shown that \u003ca href=\"http://share.upmc.com/2015/08/mechanical-thrombectomy-stroke-mm02/\" target=\"_blank\" rel=\"noopener\">\u003cspan style=\"font-weight: 400\">mechanical thrombectomy\u003c/span>\u003c/a>, \u003cspan style=\"font-weight: 400\">in which doctors snake tiny tools into a patient’s artery to remove clots, is a key step in emergency stroke care. While the Committee of the Society of Vascular and Interventional Neurology \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4817382/\" target=\"_blank\" rel=\"noopener\">recommends clot removal in less than 90 minutes, \u003c/a>under the Mission Protocol, the hospital’s median time to remove clots is 76 minutes.\u003c/span>\u003c/p>\n\u003cp>In response to those studies, more hospitals are adding mechanical thrombectomy to their emergency stroke care, says Dr. Jose Biller, neurology chair at the Loyola University Chicago Stritch School of Medicine.\u003c/p>\n\u003cp>“Everyone I know of is very cognizant of the fact that early stroke treatment is essential,” Biller says. “You see variations on this theme in many institutions.”\u003c/p>\n\u003cp>\u003cb>Shaving Time to Treatment\u003c/b>\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s become a competitive thing, seeing who can go for the quickest stroke treatment time possible.'\u003ccite>David Tong, California Pacific Medical Center neurologist\u003c/cite>\u003c/aside>\n\u003cp>\u003cspan style=\"font-weight: 400\">Two initiatives in the past decade began to affect how hospitals treat stroke patients. In 2010, the American Heart Association launched \u003c/span>\u003ca href=\"http://www.strokeassociation.org/STROKEORG/Professionals/TargetStroke/About-Target-Stroke_UCM_432409_Article.jsp#.Wi7fIROPIWo\" target=\"_blank\" rel=\"noopener\">\u003cspan style=\"font-weight: 400\">Target: Stroke\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, an initiative aimed at encouraging hospitals to reduce their door-to-needle time to less than 60 minutes. Two years later, research out of Helsinki showed how to shave off minutes from that time, and many hospitals began adopting the method.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“It’s become a competitive thing, seeing who can go for the quickest time possible,” says David Tong, a neurologist with California Pacific Medical Center and a member of the American Neurological Association's Advisory Committee. “Over the past 10 to 15 years, that has dramatically improved. But it takes a lot of coordination.”\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_438620\" class=\"wp-caption alignleft\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-438620\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/iStock-475593228-1020x1020.jpg\" alt=\"Top view of a brain showing a red blotch amid blue brain tissue\" width=\"640\" height=\"640\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-1020x1020.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-160x160.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-800x800.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-768x768.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-960x960.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-240x240.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-375x375.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-520x520.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-50x50.jpg 50w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228-150x150.jpg 150w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/iStock-475593228.jpg 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">CT scan of a brain showing a stroke \u003ccite>(iStockphoto)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">One \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/1861802?resultClick=3\" target=\"_blank\" rel=\"noopener\">study\u003c/a> found that hospitals participating in the AHA initiative from 2009-2013 improved their average door-to-needle time from 74 down to 59 minutes. Patients’ in-hospital deaths dropped close to 2 percent, and more patients were able to recover at home instead of a rehab facility, according to the AHA.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Tong says no regulation requires hospitals to follow the AHA’s recommendations for door-to-needle times, so there’s no way to know how many hospitals have made these changes. But the nationwide statistics aren’t encouraging; in 2017, \u003c/span>\u003ca href=\"http://www.strokeassociation.org/STROKEORG/Professionals/TargetStroke/About-Target-Stroke_UCM_432409_Article.jsp#.Wi7i_BOPIWo\" target=\"_blank\" rel=\"noopener\">\u003cspan style=\"font-weight: 400\">according to the American Stroke Association\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">, fewer than 30 percent of stroke patients received tPA within an hour of arrival. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">And even an hour is still too long, say stroke experts.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Some hospitals say a 60-minute door-to-needle time is good,” says Hemphill. “Now, when we treat someone in 60 or 45 minutes, we ask, ‘What went wrong?’ We regularly treat patients within 20 minutes.”\u003c/span>\u003c/p>\n\u003cp>\u003cb>Closing the Gender and Race Gaps\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003c/p>\u003cp>\u003c/p>\u003cp>Madhok reached out to San Francisco General to develop her protocol because the hospital provides emergency medicine to underserved populations, as well as doing neurocritical care research. The hospital wasn’t hiring, but once doctors heard what she wanted to do, they found space. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">As a \u003c/span>\u003ca href=\"https://www.aan.com/PressRoom/Home/PressRelease/1493\" target=\"_blank\" rel=\"noopener\">\u003cspan style=\"font-weight: 400\">handful of studies\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> show, people of color and women tend to receive inferior care when they’re having a stroke, and they are less likely to receive tPA or have their clots removed. \u003c/span>\u003cspan style=\"font-weight: 400\">Loyola’s Dr. Biller says that lack of awareness about stroke symptoms, or the fact that high blood pressure is a precursor to stroke, may explain some of the disparities in treatment. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Not surprisingly, these patients also have worse short- and long-term outcomes after stroke,” Madhok says. “Organized stroke care has the potential to reduce these disparities. Mission Protocol was my way to put this to the test.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Among the roughly 80 patients who have been subject to the protocol since July, three-quarters are Latino, Asian or black. Madhok is still gathering data for publication on long-term outcomes. \u003c/span>\u003cspan style=\"font-weight: 400\">Already, though, she has some idea what the results will look like. \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "What Happens When #MeToo Stories Reignite Old Trauma",
"title": "What Happens When #MeToo Stories Reignite Old Trauma",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>For victims of sexual violence, the flood of #MeToo sexual harassment stories may stir a mix of emotions. In many ways it can be validating to know you’re not alone. But the stories can also spark old memories and uncomfortable physical reactions.\u003c/p>\n\u003caside class=\"pullquote alignright\">During flashbacks, people with PTSD 'will see exactly what they saw at the time of the trauma.'\u003ccite>Dr Ruth Lanius, University of Western Ontario\u003c/cite>\u003c/aside>\n\u003cp>“What’s happening right now has been a big trigger,\" says San Francisco resident Jane Johnstone.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The many tales of male sexual misconduct have ended careers in numerous workplaces, \u003ca href=\"https://www.npr.org/2017/11/05/562188679/nprs-sexual-harassment-scandal\" target=\"_blank\" rel=\"noopener\">including NPR\u003c/a>. Initially Johnstone was relieved to see a national conversation unfolding about a subject painfully close to her heart, but it wasn't long before all the headlines sent her into a tailspin.\u003c/p>\n\u003cp>\"I just felt all of the things that I hadn't felt in so long,\" Johnstone, says. She's also been hit by waves of pain and sadness.\u003c/p>\n\u003cp>\"There's still so much shame.\"\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>[contextly_sidebar id=\"JehcYJDbzFhpUhsCW7dMIPhpciO3cWkD\"]The Body Stores the Memories \u003c/strong>\u003c/p>\n\u003cp>So much shame, for something that happened nearly 50 years in the past. When Johnstone was about eight years old, she was sexually abused by her best friend’s father. At first she was too young to fully understand his actions as wrong. But experts say her brain instinctively knew.\u003c/p>\n\u003cp>“When a child is abused, the innate alarm system may be activated. And this can cause distress under the level of conscious awareness,\" says Ruth Lanius, a psychiatrist at the University of Western Ontario who specializes in \u003ca href=\"https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml\" target=\"_blank\" rel=\"noopener\">post-traumatic stress disorder\u003c/a>.\u003c/p>\n\u003cp>That alarm system, located deep in the brain stem, will activate a region that helps a person detach, Lanius says.\u003c/p>\n\u003cp>[contextly_sidebar id=\"oaEBLSzYfTzn0W8fF2puK5d5ivPgevbF\"]“People can go into an emotional shutdown response where they actually don't perceive sensory information anymore,\" Lanius says. \"They essentially become very disconnected from their own body.”\u003c/p>\n\u003cp>\u003cstrong>Trauma Can Rewire the Nervous System\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Johnstone endured the abuse silently for several years. As an adult, she remained emotionally withdrawn.\u003c/p>\n\u003cp>“I couldn’t get close to people,\" she says. \"I was afraid to open up and have really intimate relationships.”\u003c/p>\n\u003cp>That response makes complete sense to Laurie Richer, a psychiatrist at UC San Francisco and the director of the \u003ca href=\"http://traumarecoverycenter.org/about-us/mental-health-team/\" target=\"_blank\" rel=\"noopener\">Trauma Recovery Center.\u003c/a>\u003c/p>\n\u003cp>“So right away she developed a sense that not everybody's safe,\" Richer says. \"In general, especially when we're talking about sexual harassment, sexual assault, or sexual abuse, individuals tend to feel less safe in all relationships and especially in intimate relationships.\"\u003c/p>\n\u003cp>Women are more than \u003ca href=\"https://www.ptsd.va.gov/public/PTSD-overview/women/women-trauma-and-ptsd.asp\" target=\"_blank\" rel=\"noopener\">twice\u003c/a> as likely as men to develop PTSD, and survivors of sexual violence are particularly at risk. Richer says a traumatic experience can literally rewire the nervous system and alter the body’s coping mechanisms. Victims who develop PTSD may struggle with \u003ca href=\"https://www.ptsd.va.gov/public/PTSD-overview/women/women-trauma-and-ptsd.asp\" target=\"_blank\" rel=\"noopener\">symptoms\u003c/a>, such as hyperarousal, for their entire lives.\u003c/p>\n\u003cp>The visceral nature of flashbacks is a unique symptom. In most people, a memory lights up the thinking part of the brain. In people with PTSD, a memory lights up the sensory area, so that the past is not just recalled, but rather relived.\u003c/p>\n\u003cp>“So people will see exactly what they saw at the time of the trauma. They may hear what they heard at the time of the trauma,\" Lanius says.\u003c/p>\n\u003cp>\u003cstrong>It All Comes Rushing Back\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">'You can say to yourself, \"It’s 2018. I’m in the present. I’m safe.\"' \u003ccite>Dr Ruth Lanius, University of Western Ontario\u003c/cite>\u003c/aside>\n\u003cp>In her mid-40s, Johnstone finally sought therapy. Eventually she told her family what had happened to her, and she pressed charges against her abuser. He wasn’t arrested, but she says the\u003cstrong> \u003c/strong>fact that he was confronted by authorities was enough to help put the past behind her.\u003c/p>\n\u003cp>Nearly a decade passed, and Johnstone thought she had successfully overcome her childhood trauma. But the steady drumbeat of #MeToo stories reignited her PTSD symptoms. Suddenly she was anxious and irritable. She couldn't sleep. She feared another slide into depression.\u003c/p>\n\u003cp>\u003cstrong>What to Do\u003c/strong>\u003c/p>\n\u003cp>[contextly_sidebar id=\"z1T7EpABPy2XSlX8o4fEv4UZYZN3Ncjt\"]Psychiatrists recommend self-talk during these episodes, to calm the nervous system. “You can say to yourself, 'It’s 2018,' says Lanius. 'I’m in the present. I’m safe.' ”\u003c/p>\n\u003cp>Johnstone called her therapist for a check-in. She says talking to someone in a safe space has been very helpful in quieting her emotions. The night after our interview, she cried hard, she says. For Johnstone, getting dragged back to the past is painful. Yet, she's also hopeful that a lot of healing is taking place.\u003c/p>\n\u003cp>“I think it’s very empowering to see all these women come forward and tell their stories and stand up,\" Johnstone says. She says the #MeToo voices are softening the internalized shame that kept both herself and so many women silent for too long. \u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>If you’re experiencing sexual harassment or assault, you can call the \u003ca href=\"https://www.rainn.org/about-national-sexual-assault-telephone-hotline\" target=\"_blank\" rel=\"noopener\">National Sexual Assault Hotline\u003c/a> at 1-800-656-HOPE (4673). The call is free and anything you share is confidential. A trained staff member will help you find local resources like counseling and support groups, and will answer questions about medical concerns. You can also get information about local harassment laws.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>For victims of sexual violence, the flood of #MeToo sexual harassment stories may stir a mix of emotions. In many ways it can be validating to know you’re not alone. But the stories can also spark old memories and uncomfortable physical reactions.\u003c/p>\n\u003caside class=\"pullquote alignright\">During flashbacks, people with PTSD 'will see exactly what they saw at the time of the trauma.'\u003ccite>Dr Ruth Lanius, University of Western Ontario\u003c/cite>\u003c/aside>\n\u003cp>“What’s happening right now has been a big trigger,\" says San Francisco resident Jane Johnstone.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The many tales of male sexual misconduct have ended careers in numerous workplaces, \u003ca href=\"https://www.npr.org/2017/11/05/562188679/nprs-sexual-harassment-scandal\" target=\"_blank\" rel=\"noopener\">including NPR\u003c/a>. Initially Johnstone was relieved to see a national conversation unfolding about a subject painfully close to her heart, but it wasn't long before all the headlines sent her into a tailspin.\u003c/p>\n\u003cp>\"I just felt all of the things that I hadn't felt in so long,\" Johnstone, says. She's also been hit by waves of pain and sadness.\u003c/p>\n\u003cp>\"There's still so much shame.\"\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>\u003c/p>\u003cp>\u003c/p>\u003cp>The Body Stores the Memories \u003c/strong>\u003c/p>\n\u003cp>So much shame, for something that happened nearly 50 years in the past. When Johnstone was about eight years old, she was sexually abused by her best friend’s father. At first she was too young to fully understand his actions as wrong. But experts say her brain instinctively knew.\u003c/p>\n\u003cp>“When a child is abused, the innate alarm system may be activated. And this can cause distress under the level of conscious awareness,\" says Ruth Lanius, a psychiatrist at the University of Western Ontario who specializes in \u003ca href=\"https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml\" target=\"_blank\" rel=\"noopener\">post-traumatic stress disorder\u003c/a>.\u003c/p>\n\u003cp>That alarm system, located deep in the brain stem, will activate a region that helps a person detach, Lanius says.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>“People can go into an emotional shutdown response where they actually don't perceive sensory information anymore,\" Lanius says. \"They essentially become very disconnected from their own body.”\u003c/p>\n\u003cp>\u003cstrong>Trauma Can Rewire the Nervous System\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Johnstone endured the abuse silently for several years. As an adult, she remained emotionally withdrawn.\u003c/p>\n\u003cp>“I couldn’t get close to people,\" she says. \"I was afraid to open up and have really intimate relationships.”\u003c/p>\n\u003cp>That response makes complete sense to Laurie Richer, a psychiatrist at UC San Francisco and the director of the \u003ca href=\"http://traumarecoverycenter.org/about-us/mental-health-team/\" target=\"_blank\" rel=\"noopener\">Trauma Recovery Center.\u003c/a>\u003c/p>\n\u003cp>“So right away she developed a sense that not everybody's safe,\" Richer says. \"In general, especially when we're talking about sexual harassment, sexual assault, or sexual abuse, individuals tend to feel less safe in all relationships and especially in intimate relationships.\"\u003c/p>\n\u003cp>Women are more than \u003ca href=\"https://www.ptsd.va.gov/public/PTSD-overview/women/women-trauma-and-ptsd.asp\" target=\"_blank\" rel=\"noopener\">twice\u003c/a> as likely as men to develop PTSD, and survivors of sexual violence are particularly at risk. Richer says a traumatic experience can literally rewire the nervous system and alter the body’s coping mechanisms. Victims who develop PTSD may struggle with \u003ca href=\"https://www.ptsd.va.gov/public/PTSD-overview/women/women-trauma-and-ptsd.asp\" target=\"_blank\" rel=\"noopener\">symptoms\u003c/a>, such as hyperarousal, for their entire lives.\u003c/p>\n\u003cp>The visceral nature of flashbacks is a unique symptom. In most people, a memory lights up the thinking part of the brain. In people with PTSD, a memory lights up the sensory area, so that the past is not just recalled, but rather relived.\u003c/p>\n\u003cp>“So people will see exactly what they saw at the time of the trauma. They may hear what they heard at the time of the trauma,\" Lanius says.\u003c/p>\n\u003cp>\u003cstrong>It All Comes Rushing Back\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">'You can say to yourself, \"It’s 2018. I’m in the present. I’m safe.\"' \u003ccite>Dr Ruth Lanius, University of Western Ontario\u003c/cite>\u003c/aside>\n\u003cp>In her mid-40s, Johnstone finally sought therapy. Eventually she told her family what had happened to her, and she pressed charges against her abuser. He wasn’t arrested, but she says the\u003cstrong> \u003c/strong>fact that he was confronted by authorities was enough to help put the past behind her.\u003c/p>\n\u003cp>Nearly a decade passed, and Johnstone thought she had successfully overcome her childhood trauma. But the steady drumbeat of #MeToo stories reignited her PTSD symptoms. Suddenly she was anxious and irritable. She couldn't sleep. She feared another slide into depression.\u003c/p>\n\u003cp>\u003cstrong>What to Do\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Psychiatrists recommend self-talk during these episodes, to calm the nervous system. “You can say to yourself, 'It’s 2018,' says Lanius. 'I’m in the present. I’m safe.' ”\u003c/p>\n\u003cp>Johnstone called her therapist for a check-in. She says talking to someone in a safe space has been very helpful in quieting her emotions. The night after our interview, she cried hard, she says. For Johnstone, getting dragged back to the past is painful. Yet, she's also hopeful that a lot of healing is taking place.\u003c/p>\n\u003cp>“I think it’s very empowering to see all these women come forward and tell their stories and stand up,\" Johnstone says. She says the #MeToo voices are softening the internalized shame that kept both herself and so many women silent for too long. \u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>If you’re experiencing sexual harassment or assault, you can call the \u003ca href=\"https://www.rainn.org/about-national-sexual-assault-telephone-hotline\" target=\"_blank\" rel=\"noopener\">National Sexual Assault Hotline\u003c/a> at 1-800-656-HOPE (4673). The call is free and anything you share is confidential. A trained staff member will help you find local resources like counseling and support groups, and will answer questions about medical concerns. You can also get information about local harassment laws.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Since October, when \u003ca href=\"https://www.usatoday.com/story/life/people/2017/10/27/weinstein-scandal-complete-list-accusers/804663001/\" target=\"_blank\" rel=\"noopener\">dozens \u003c/a>of women accused Hollywood producer Harvey Weinstein of sexual harassment, a torrent of stories about male sexual misconduct has roiled workplaces in entertainment, journalism, government and the restaurant industry. Even \u003ca href=\"https://www.yogajournal.com/lifestyle/yoga-girl-rachel-brathen-collects-more-than-300-metoo-yoga-stories-the-community-responds\" target=\"_blank\" rel=\"noopener\">yoga teachers\u003c/a> now face a day of reckoning.\u003c/p>\n\u003caside class=\"pullquote alignright\">'If they wanted to shut me up, they’d touch me under the table.'\u003c/aside>\n\u003cp>Many women have talked about the negative impact these experiences have had on their lives, but the distress isn't just anecdotal. A growing body of \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3884002/\" target=\"_blank\" rel=\"noopener\">research\u003c/a> links workplace sexual harassment to negative psychological and physical effects, and these can have consequences years after the events occurred.\u003c/p>\n\u003cp>For Cindy Patterson, workplace sexual harassment isn't just something that happened to her 25 years ago; she says it's something that still has an impact on her life today.\u003c/p>\n\u003cp>\u003cstrong>'We Were Going to Break That Glass Ceiling'\u003c/strong>\u003c/p>\n\u003cp>In her mid-20s, Patterson landed her dream job at a financial institution in the southwest, setting her sights high.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I was one of the only women, and we were going to break that glass ceiling,\" says Patterson.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The office becomes a place you can’t assume your safety and go about your work; instead you’re also worrying about the potential for psychological or physical assault ... It exhausts you.'\u003ccite>David Spiegel, Stanford University\u003c/cite>\u003c/aside>\n\u003cp>She quickly rose through the ranks. But when a new vice president laid off many of the women and brought in his own team, Patterson says, things changed.\u003c/p>\n\u003cp>“Little comments like, 'Oh, I see you’ve got some assets there, Cindy,' \" she recounts. \"This one guy would just stare at my breasts, and it was just -- it's bullying.\"\u003c/p>\n\u003cp>Her male executive colleagues scheduled meetings at topless bars, where they'd slide their hands under her dress. And it wasn't just over cocktails -- it happened at work, too.\u003c/p>\n\u003cp>\"If they wanted to shut me up, they’d touch me under the table,\" she says. \"And it did shut me up. It would throw me off my game.”\u003c/p>\n\u003cp>The human resources department \u003ca href=\"http://dynamic.uoregon.edu/jjf/institutionalbetrayal/\" target=\"_blank\" rel=\"noopener\">shrugged off\u003c/a> her complaints. The daily incidents left her feeling “as if my skin was being ripped off.\" She lost sleep and developed stomachaches, migraines, acne and facial hair. She put on weight, then more weight. The stress, she says, contributed to an eventual divorce.\u003c/p>\n\u003cp>\"And I haven't worked for something like that, where it's very competitive, again,\" she says.\u003c/p>\n\u003cp>\u003cstrong>The Body Reacts\u003c/strong>\u003c/p>\n\u003cp>Experts in sexual harassment say they frequently hear victims report similar health consequences to those that Cindy Patterson describes. Even seemingly innocuous or occasional harassment can lead to a myriad of \u003ca href=\"http://scholar.google.com/scholar_url?url=https://ww2.cas.sc.edu/psyc/sites/default/files/directory_files/Schneider,%2520Swan,%2520Fitzgerald%25201997%2520JAP.pdf&hl=en&sa=X&scisig=AAGBfm05LK0EMFmG75BeKNvztw-G5qb76A&nossl=1&oi=scholarr\" target=\"_blank\" rel=\"noopener\">health effects\u003c/a>, such as anxiety, headaches, sleep disorders, weight loss or gain, nausea, lowered self-esteem and sexual dysfunction. Victims also tend to have higher rates of absenteeism and decreased job satisfaction.\u003c/p>\n\u003cp>[contextly_sidebar id=\"FOa5ozgC4Gzm2fPJBl7cvueZdFRgH7yF\"]There's \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227029/\" target=\"_blank\" rel=\"noopener\">evidence\u003c/a> that sexual harassment early in one's career can lead to depression down the road. Some experts have argued that sexual harassment can lead to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/11936724\" target=\"_blank\" rel=\"noopener\">post-traumatic stress disorder\u003c/a>.\u003c/p>\n\u003cp>“Uncontrollable and unpredictable stressful experiences have very negative effects on people’s brains and bodies,\" says \u003ca href=\"https://www.jimhopper.com/about/\" target=\"_blank\" rel=\"noopener\">Jim Hopper\u003c/a>, who teaches in the psychiatry department at Harvard Medical School and is an expert on the neurobiology of trauma and sexual assault. “These are things that affect our identity, our sense of who we are.”\u003c/p>\n\u003cp>\u003cstrong>It's in Our DNA\u003c/strong>\u003c/p>\n\u003cp>Humans are wired to respond to threatening behavior, and even a lewd comment can kick our defense circuitry into gear, says\u003ca href=\"https://profiles.stanford.edu/david-spiegel\" target=\"_blank\" rel=\"noopener\"> David Spiegel\u003c/a>, a psychiatrist and stress expert at Stanford University. The moment an ostensibly safe space like an office becomes sexualized, he says, it can set off an internal alarm.\u003c/p>\n\u003cp>He wasn't surprised that Patterson suffered extreme stress from comments and groping.\u003c/p>\n\u003cp>“From that moment, she's beginning to think that she's not just uncomfortable but potentially in danger,\" he says. \"Even if the harassment is primarily psychological, it's suggesting unwelcome sexual activity, which arouses a physical response to a physical threat. That stirs up your fight-or-flight reaction.\"\u003c/p>\n\u003cp>As in any potentially dangerous situation, sexual harassment triggers the release of adrenaline and cortisol, which quickens heart rate and raises blood pressure, muscle tension and blood glucose levels. The response is evolutionary: The extra energy fuels our ability to flee or do combat.\u003c/p>\n\u003cp>An occasional spike in stress hormones isn't harmful, Spiegel says, but if a victim starts living in a chronic state of high alert, it can be toxic to the nervous system. \u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>\"The office becomes a place you can't assume your safety and go about your work; instead you're also worrying about the potential for psychological or physical assault,\" Spiegel says. \"This chronic activation of the nervous system can lead to a kind of burnout, where your body is overreacting much of the time, and it exhausts you.\"\u003c/p>\n\u003cp>\u003cstrong>Shutting Down\u003c/strong>\u003c/p>\n\u003cp>Patterson wasn't only living on high alert. When groped, she would freeze up. Spiegel calls this response speechless terror. He says the emotional center, the limbic system, kicks the analytical part of the brain, the prefrontal cortex, into overdrive.\u003c/p>\n\u003cp>\"The emotional part of the brain is hijacking the rest of the brain for a while because you’re having such a strong reaction,\" he says.\u003c/p>\n\u003cp>In Patterson's case, she stopped talking at meetings altogether to avoid the possibility of getting silenced involuntarily.\u003c/p>\n\u003cp>\u003cstrong>Long-Term Consequences\u003c/strong>\u003c/p>\n\u003cp>\"I used to think that although [it was] unpleasant, I was above it, stronger than the harassment,\" says Patterson. \"But later I realized how it had impacted how I acted at work and the choices I made in my career and in my personal life.\"\u003c/p>\n\u003cp>Nearly 25 years later, Patterson believes she is still paying for what happened those two excruciating years. Since then, she has struggled with weight gain, and she was recently diagnosed with heart disease, which she believes may be related to the extreme stress she was under.\u003c/p>\n\u003cp>\"It becomes this sort of non-reversing cycle of feeling worse about yourself, doing things that make you physically worse and restrict your other options in life,\" Spiegel says.\u003c/p>\n\u003cp>Patterson does, however, find all the current attention on sexual harassment to be healing. She hopes the glass ceiling -- the one she planned to break in the 80s -- may be shattered by the #MeToo voices that are finally getting their say.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>If you’re experiencing sexual harassment or assault, you can call the \u003ca href=\"https://www.rainn.org/about-national-sexual-assault-telephone-hotline\" target=\"_blank\" rel=\"noopener\">National Sexual Assault Hotline\u003c/a> at 1-800-656-HOPE (4673). The call is free and anything you share is confidential. A trained staff member will help you find local resources like counseling and support groups, and will answer questions about medical concerns. You can also get information about local harassment laws.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Since October, when \u003ca href=\"https://www.usatoday.com/story/life/people/2017/10/27/weinstein-scandal-complete-list-accusers/804663001/\" target=\"_blank\" rel=\"noopener\">dozens \u003c/a>of women accused Hollywood producer Harvey Weinstein of sexual harassment, a torrent of stories about male sexual misconduct has roiled workplaces in entertainment, journalism, government and the restaurant industry. Even \u003ca href=\"https://www.yogajournal.com/lifestyle/yoga-girl-rachel-brathen-collects-more-than-300-metoo-yoga-stories-the-community-responds\" target=\"_blank\" rel=\"noopener\">yoga teachers\u003c/a> now face a day of reckoning.\u003c/p>\n\u003caside class=\"pullquote alignright\">'If they wanted to shut me up, they’d touch me under the table.'\u003c/aside>\n\u003cp>Many women have talked about the negative impact these experiences have had on their lives, but the distress isn't just anecdotal. A growing body of \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3884002/\" target=\"_blank\" rel=\"noopener\">research\u003c/a> links workplace sexual harassment to negative psychological and physical effects, and these can have consequences years after the events occurred.\u003c/p>\n\u003cp>For Cindy Patterson, workplace sexual harassment isn't just something that happened to her 25 years ago; she says it's something that still has an impact on her life today.\u003c/p>\n\u003cp>\u003cstrong>'We Were Going to Break That Glass Ceiling'\u003c/strong>\u003c/p>\n\u003cp>In her mid-20s, Patterson landed her dream job at a financial institution in the southwest, setting her sights high.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I was one of the only women, and we were going to break that glass ceiling,\" says Patterson.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The office becomes a place you can’t assume your safety and go about your work; instead you’re also worrying about the potential for psychological or physical assault ... It exhausts you.'\u003ccite>David Spiegel, Stanford University\u003c/cite>\u003c/aside>\n\u003cp>She quickly rose through the ranks. But when a new vice president laid off many of the women and brought in his own team, Patterson says, things changed.\u003c/p>\n\u003cp>“Little comments like, 'Oh, I see you’ve got some assets there, Cindy,' \" she recounts. \"This one guy would just stare at my breasts, and it was just -- it's bullying.\"\u003c/p>\n\u003cp>Her male executive colleagues scheduled meetings at topless bars, where they'd slide their hands under her dress. And it wasn't just over cocktails -- it happened at work, too.\u003c/p>\n\u003cp>\"If they wanted to shut me up, they’d touch me under the table,\" she says. \"And it did shut me up. It would throw me off my game.”\u003c/p>\n\u003cp>The human resources department \u003ca href=\"http://dynamic.uoregon.edu/jjf/institutionalbetrayal/\" target=\"_blank\" rel=\"noopener\">shrugged off\u003c/a> her complaints. The daily incidents left her feeling “as if my skin was being ripped off.\" She lost sleep and developed stomachaches, migraines, acne and facial hair. She put on weight, then more weight. The stress, she says, contributed to an eventual divorce.\u003c/p>\n\u003cp>\"And I haven't worked for something like that, where it's very competitive, again,\" she says.\u003c/p>\n\u003cp>\u003cstrong>The Body Reacts\u003c/strong>\u003c/p>\n\u003cp>Experts in sexual harassment say they frequently hear victims report similar health consequences to those that Cindy Patterson describes. Even seemingly innocuous or occasional harassment can lead to a myriad of \u003ca href=\"http://scholar.google.com/scholar_url?url=https://ww2.cas.sc.edu/psyc/sites/default/files/directory_files/Schneider,%2520Swan,%2520Fitzgerald%25201997%2520JAP.pdf&hl=en&sa=X&scisig=AAGBfm05LK0EMFmG75BeKNvztw-G5qb76A&nossl=1&oi=scholarr\" target=\"_blank\" rel=\"noopener\">health effects\u003c/a>, such as anxiety, headaches, sleep disorders, weight loss or gain, nausea, lowered self-esteem and sexual dysfunction. Victims also tend to have higher rates of absenteeism and decreased job satisfaction.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>There's \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227029/\" target=\"_blank\" rel=\"noopener\">evidence\u003c/a> that sexual harassment early in one's career can lead to depression down the road. Some experts have argued that sexual harassment can lead to \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/11936724\" target=\"_blank\" rel=\"noopener\">post-traumatic stress disorder\u003c/a>.\u003c/p>\n\u003cp>“Uncontrollable and unpredictable stressful experiences have very negative effects on people’s brains and bodies,\" says \u003ca href=\"https://www.jimhopper.com/about/\" target=\"_blank\" rel=\"noopener\">Jim Hopper\u003c/a>, who teaches in the psychiatry department at Harvard Medical School and is an expert on the neurobiology of trauma and sexual assault. “These are things that affect our identity, our sense of who we are.”\u003c/p>\n\u003cp>\u003cstrong>It's in Our DNA\u003c/strong>\u003c/p>\n\u003cp>Humans are wired to respond to threatening behavior, and even a lewd comment can kick our defense circuitry into gear, says\u003ca href=\"https://profiles.stanford.edu/david-spiegel\" target=\"_blank\" rel=\"noopener\"> David Spiegel\u003c/a>, a psychiatrist and stress expert at Stanford University. The moment an ostensibly safe space like an office becomes sexualized, he says, it can set off an internal alarm.\u003c/p>\n\u003cp>He wasn't surprised that Patterson suffered extreme stress from comments and groping.\u003c/p>\n\u003cp>“From that moment, she's beginning to think that she's not just uncomfortable but potentially in danger,\" he says. \"Even if the harassment is primarily psychological, it's suggesting unwelcome sexual activity, which arouses a physical response to a physical threat. That stirs up your fight-or-flight reaction.\"\u003c/p>\n\u003cp>As in any potentially dangerous situation, sexual harassment triggers the release of adrenaline and cortisol, which quickens heart rate and raises blood pressure, muscle tension and blood glucose levels. The response is evolutionary: The extra energy fuels our ability to flee or do combat.\u003c/p>\n\u003cp>An occasional spike in stress hormones isn't harmful, Spiegel says, but if a victim starts living in a chronic state of high alert, it can be toxic to the nervous system. \u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>\"The office becomes a place you can't assume your safety and go about your work; instead you're also worrying about the potential for psychological or physical assault,\" Spiegel says. \"This chronic activation of the nervous system can lead to a kind of burnout, where your body is overreacting much of the time, and it exhausts you.\"\u003c/p>\n\u003cp>\u003cstrong>Shutting Down\u003c/strong>\u003c/p>\n\u003cp>Patterson wasn't only living on high alert. When groped, she would freeze up. Spiegel calls this response speechless terror. He says the emotional center, the limbic system, kicks the analytical part of the brain, the prefrontal cortex, into overdrive.\u003c/p>\n\u003cp>\"The emotional part of the brain is hijacking the rest of the brain for a while because you’re having such a strong reaction,\" he says.\u003c/p>\n\u003cp>In Patterson's case, she stopped talking at meetings altogether to avoid the possibility of getting silenced involuntarily.\u003c/p>\n\u003cp>\u003cstrong>Long-Term Consequences\u003c/strong>\u003c/p>\n\u003cp>\"I used to think that although [it was] unpleasant, I was above it, stronger than the harassment,\" says Patterson. \"But later I realized how it had impacted how I acted at work and the choices I made in my career and in my personal life.\"\u003c/p>\n\u003cp>Nearly 25 years later, Patterson believes she is still paying for what happened those two excruciating years. Since then, she has struggled with weight gain, and she was recently diagnosed with heart disease, which she believes may be related to the extreme stress she was under.\u003c/p>\n\u003cp>\"It becomes this sort of non-reversing cycle of feeling worse about yourself, doing things that make you physically worse and restrict your other options in life,\" Spiegel says.\u003c/p>\n\u003cp>Patterson does, however, find all the current attention on sexual harassment to be healing. She hopes the glass ceiling -- the one she planned to break in the 80s -- may be shattered by the #MeToo voices that are finally getting their say.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>If you’re experiencing sexual harassment or assault, you can call the \u003ca href=\"https://www.rainn.org/about-national-sexual-assault-telephone-hotline\" target=\"_blank\" rel=\"noopener\">National Sexual Assault Hotline\u003c/a> at 1-800-656-HOPE (4673). The call is free and anything you share is confidential. A trained staff member will help you find local resources like counseling and support groups, and will answer questions about medical concerns. You can also get information about local harassment laws.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Another Reason Why You Still Need a Flu Shot This Year",
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"content": "\u003cp>\u003cspan style=\"font-weight: 400\">It could be a whole lot easier to get the flu than you thought: A new study finds it doesn't take someone coughing or sneezing near you -- just breathing may be enough.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The study from San Jose State University, UC Berkeley and others looked for infectious virus in coughs, sneezes and exhaled air from people with the flu, and found 35 percent of samples of exhaled air contained it.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"So when someone is coming down with influenza, they should go home,\" says Dr. Donald Milton of the University of Maryland School of Public Health, \"and not remain in the workplace and infect others.\"\u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'We're not sure we've seen the peak of flu season yet.'\u003ccite>Dr. Richard Webby,\u003cbr>\nSt. Jude Children's Research Hospital and WHO\u003c/cite>\u003c/aside>\n\u003cp>This is a particularly bad year for influenza. Flu cases are continuing to rise in California, and are\u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/Immunization/Week2017-1801_FINALReport.pdf\">\u003cspan style=\"font-weight: 400\"> higher for this time of year\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> than in the previous five years. During the first week of 2018, the California Department of Public Health reported 15 deaths of people under the age of 65, bringing the state’s total deaths this flu season to 42.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“With the increase in influenza impacting many communities across the entire state, it is important to get a flu shot now if you have not done so already,” CDPH Director Karen Smith said in a\u003c/span>\u003ca href=\"https://www.cdph.ca.gov/Programs/OPA/Pages/NR18-003.aspx\"> \u003cspan style=\"font-weight: 400\">statement\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Adults ages 18 through 49 get a flu shot at much lower rates than others. If you're thinking that a flu shot won't really help you, because you've heard it's only 30 percent effective, think again. There are many strains of flu, and the shot can protect you against three or four of them. The 30 percent figure applies only to the dominant strain this year -- your shot might protect you from completely different strains.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/ww2.kqed_.orgflu-1-d94c6f6333c37ebdfc7-2a73434118befd5f08e2e6b0395e6ae543930c27.jpg\">\u003cimg class=\"alignright wp-image-438276\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/ww2.kqed_.orgflu-1-d94c6f6333c37ebdfc7-2a73434118befd5f08e2e6b0395e6ae543930c27.jpg\" alt=\"\" width=\"390\" height=\"292\">\u003c/a>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">It’s possible, for example, that later in the flu season influenza B could become active -- that's a strain that the current vaccine is effective against, says Dr. Richard Webby, a member of the Department of Infectious diseases at St. Jude Children’s Research Hospital, and of the World Health Organization team that formulates the flu vaccine. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Also, it isn't just about you, points out Aaron E. Carroll, a professor of pediatrics at Indiana School of Medicine, in a recent\u003c/span>\u003ca href=\"https://www.nytimes.com/2018/01/15/upshot/flu-shot-deaths-herd-immunity.html\"> \u003cspan style=\"font-weight: 400\">New York Times\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> post.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"You don’t get immunized just to protect yourself,\" Carroll writes. \"You also get immunized to protect those who can’t protect themselves.\"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">That means people like babies who are too young to get the shots and people with compromised immune systems.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Carroll says in the 2015 to 2016 season, flu shots prevented an estimated 3,000 deaths. Yet, in that same season:\u003c/span>\u003c/p>\n\u003cblockquote>\u003cp>\u003cspan style=\"font-weight: 400\">\"If just 5 percent more people had been immunized, we could have probably avoided 500,000 illnesses, 230,000 medical visits and 6,000 hospitalizations … Less than 50 percent of children are immunized against the flu. About two-thirds of people 65 and older are. But only a third of adults 18 to 49 are.\"\u003c/span>\u003c/p>\u003c/blockquote>\n\u003cp>\u003cb>Why the Vaccine Isn't Perfect\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Currently, flu cases are dominated by a strain of influenza A called H3N2. And the problem this year is not that the WHO scientists got the strains wrong in the vaccine -- H3N2 is covered by the flu shot.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">[contextly_sidebar id=\"be2kMFKFzFOLuQbbG0h32DXxbUQVd8FH\"]The problem is that the virus changes during the production of the vaccine.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Twice a year, WHO scientists meet to develop a flu vaccine: once for the world’s northern hemisphere and once for the southern. They do this about six months before the flu hits a given hemisphere, and they choose which viruses to include based on disease trends identified from laboratories worldwide.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Next, the viruses\u003c/span> \u003cspan style=\"font-weight: 400\">get injected into chicken eggs. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Sometimes the flu virus doesn’t like to grow in eggs that much,” Webby says. So it mutates to adapt to its new home.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The result is that the lab-grown H3N2 used in this season’s flu shot doesn’t quite match the H3N2 currently being spread in people. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We're really having a few difficulties getting the perfect match between these H3N2 viruses and the vaccine,” Webby says.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">He adds that in the future, there are some ways scientists could improve the vaccine. It could be grown in a different medium instead of eggs, for example, to prevent the virus from mutating as much. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Meanwhile, Webby says flu activity this year could continue to increase. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We’re not sure we’ve seen the peak of flu season yet.”\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-weight: 400\">It could be a whole lot easier to get the flu than you thought: A new study finds it doesn't take someone coughing or sneezing near you -- just breathing may be enough.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The study from San Jose State University, UC Berkeley and others looked for infectious virus in coughs, sneezes and exhaled air from people with the flu, and found 35 percent of samples of exhaled air contained it.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"So when someone is coming down with influenza, they should go home,\" says Dr. Donald Milton of the University of Maryland School of Public Health, \"and not remain in the workplace and infect others.\"\u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'We're not sure we've seen the peak of flu season yet.'\u003ccite>Dr. Richard Webby,\u003cbr>\nSt. Jude Children's Research Hospital and WHO\u003c/cite>\u003c/aside>\n\u003cp>This is a particularly bad year for influenza. Flu cases are continuing to rise in California, and are\u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/Immunization/Week2017-1801_FINALReport.pdf\">\u003cspan style=\"font-weight: 400\"> higher for this time of year\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> than in the previous five years. During the first week of 2018, the California Department of Public Health reported 15 deaths of people under the age of 65, bringing the state’s total deaths this flu season to 42.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“With the increase in influenza impacting many communities across the entire state, it is important to get a flu shot now if you have not done so already,” CDPH Director Karen Smith said in a\u003c/span>\u003ca href=\"https://www.cdph.ca.gov/Programs/OPA/Pages/NR18-003.aspx\"> \u003cspan style=\"font-weight: 400\">statement\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Adults ages 18 through 49 get a flu shot at much lower rates than others. If you're thinking that a flu shot won't really help you, because you've heard it's only 30 percent effective, think again. There are many strains of flu, and the shot can protect you against three or four of them. The 30 percent figure applies only to the dominant strain this year -- your shot might protect you from completely different strains.\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/ww2.kqed_.orgflu-1-d94c6f6333c37ebdfc7-2a73434118befd5f08e2e6b0395e6ae543930c27.jpg\">\u003cimg class=\"alignright wp-image-438276\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/ww2.kqed_.orgflu-1-d94c6f6333c37ebdfc7-2a73434118befd5f08e2e6b0395e6ae543930c27.jpg\" alt=\"\" width=\"390\" height=\"292\">\u003c/a>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">It’s possible, for example, that later in the flu season influenza B could become active -- that's a strain that the current vaccine is effective against, says Dr. Richard Webby, a member of the Department of Infectious diseases at St. Jude Children’s Research Hospital, and of the World Health Organization team that formulates the flu vaccine. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Also, it isn't just about you, points out Aaron E. Carroll, a professor of pediatrics at Indiana School of Medicine, in a recent\u003c/span>\u003ca href=\"https://www.nytimes.com/2018/01/15/upshot/flu-shot-deaths-herd-immunity.html\"> \u003cspan style=\"font-weight: 400\">New York Times\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> post.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"You don’t get immunized just to protect yourself,\" Carroll writes. \"You also get immunized to protect those who can’t protect themselves.\"\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">That means people like babies who are too young to get the shots and people with compromised immune systems.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Carroll says in the 2015 to 2016 season, flu shots prevented an estimated 3,000 deaths. Yet, in that same season:\u003c/span>\u003c/p>\n\u003cblockquote>\u003cp>\u003cspan style=\"font-weight: 400\">\"If just 5 percent more people had been immunized, we could have probably avoided 500,000 illnesses, 230,000 medical visits and 6,000 hospitalizations … Less than 50 percent of children are immunized against the flu. About two-thirds of people 65 and older are. But only a third of adults 18 to 49 are.\"\u003c/span>\u003c/p>\u003c/blockquote>\n\u003cp>\u003cb>Why the Vaccine Isn't Perfect\u003c/b>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Currently, flu cases are dominated by a strain of influenza A called H3N2. And the problem this year is not that the WHO scientists got the strains wrong in the vaccine -- H3N2 is covered by the flu shot.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\u003c/p>\u003cp>\u003c/p>\u003cp>The problem is that the virus changes during the production of the vaccine.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Twice a year, WHO scientists meet to develop a flu vaccine: once for the world’s northern hemisphere and once for the southern. They do this about six months before the flu hits a given hemisphere, and they choose which viruses to include based on disease trends identified from laboratories worldwide.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Next, the viruses\u003c/span> \u003cspan style=\"font-weight: 400\">get injected into chicken eggs. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Sometimes the flu virus doesn’t like to grow in eggs that much,” Webby says. So it mutates to adapt to its new home.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">The result is that the lab-grown H3N2 used in this season’s flu shot doesn’t quite match the H3N2 currently being spread in people. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We're really having a few difficulties getting the perfect match between these H3N2 viruses and the vaccine,” Webby says.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">He adds that in the future, there are some ways scientists could improve the vaccine. It could be grown in a different medium instead of eggs, for example, to prevent the virus from mutating as much. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Meanwhile, Webby says flu activity this year could continue to increase. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“We’re not sure we’ve seen the peak of flu season yet.”\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Precision Medicine in Cancer Treatment Has Yet to Show Much Benefit for Patients",
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"content": "\u003cp>People diagnosed with cancer understandably reach for the very best that medical science has to offer. That motivation is increasingly driving people to ask to have the DNA of their tumors sequenced. And while that's useful for some malignancies, the hype of precision medicine for cancer is getting far ahead of the facts.\u003c/p>\n\u003cp>It's easy to understand why that's the case. When you hear stories about the use of DNA sequencing to create individualized cancer treatment, chances are they are uplifting stories. Like that of Ben Stern.\u003c/p>\n\u003cp>In the spring of 2016, Stern was diagnosed with a deadly brain cancer, \u003ca href=\"http://www.abta.org/brain-tumor-information/types-of-tumors/glioblastoma.html\">glioblastoma\u003c/a>. His doctors at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins promptly treated him with surgery, then over the months, chemotherapy and radiation. He even got on a clinical trial to see if a leading edge drug called a checkpoint inhibitor would work.\u003c/p>\n\u003cp>Ben Stern found out abruptly that wasn't doing the trick either, when he was struck with a seizure. \"My whole right side clenched up and [my wife] Tara had called 911 in the middle of it.\"\u003c/p>\n\u003cp>The tumor had grown back, so surgeons went in again to remove what they could. Tara said the next month's appointment showed the surgery hadn't worked, either.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"The tumor had already grown back and it was already bigger than the original size tumor that we had found the previous May,\" Tara Stern says. This staggering regrowth took only five weeks.\u003c/p>\n\u003cp>Stern's doctor got a sample of the tumor and sent a genetic analysis of it to what Hopkins calls its \"molecular tumor board.\" It's a small group of doctors who meet Mondays to review these genetic tests. They found an overactive gene in his tumor that's only rarely associated with brain cancer. But that mutation in other cancers sometimes responds to a particular drug. So Ben went on it as part of his ongoing treatment.\u003c/p>\n\u003cp>\"He started his next round of chemotherapy that Monday but he didn't seem to get weaker,\" Tara says, \"He was getting stronger almost every day. It was almost miraculous.\"\u003c/p>\n\u003cp>Ben says the drug even reversed his deteriorating mental state brought on by the brain tumor. At the next monthly appointment, following a brain scan, Ben and Tara got more good news.\u003c/p>\n\u003cp>\"The tumor was immeasurable on that next MRI,\" Tara says. \"It wasn't there, to put it bluntly.\"\u003c/p>\n\u003cp>Ben's eyes well up as he hears his wife telling the story. \"I was basically as I am now, which is in tears.\"\u003c/p>\n\u003cp>Eight months later, Ben was thinking ahead about his future, rather than wondering whether his life is ending.\u003c/p>\n\u003cp>\"We have to use this result with caution because we don't know how long this effect might wear on, but for the time being this is a clinically very meaningful benefit,\" says his doctor at Hopkins, medical oncologist \u003ca href=\"https://www.hopkinsmedicine.org/profiles/results/directory/profile/5037896/matthias-holdhoff\">Matthias Holdhoff\u003c/a>.\u003c/p>\n\u003cp>And while it's a good-news story for the field of precision medicine, it is also not the way most of these stories end.\u003c/p>\n\u003cp>\"We're getting better, but like many things in life, there's hope and hype. And that's also the reality with precision medicine right now,\" says \u003ca href=\"https://www.hopkinsmedicine.org/kimmel_cancer_center/centers/breast_cancer_program/our_breast_cancer_experts/ben_parks.html\">Ben Park\u003c/a>, an oncology professor at the Sidney Kimmel Comprehensive Cancer Center at Hopkins. After noticing how much confusing genetic information was flooding doctors at Hopkins, he founded the molecular tumor board there.\u003c/p>\n\u003cp>\"The reason I started this tumor board [in 2013]... was simply because there was a patient, a young woman who had metastatic breast cancer who had a mutation on one of these reports and decided to forego standard-of-care therapies, which have been proven to actually prolong life in this setting,\" Park says. Instead, the woman enrolled in a clinical trial that didn't really make sense for her particular type of cancer and \"she almost died. She had really bad toxicity from the experimental drug.\"\u003c/p>\n\u003cp>She was drawn, Park says, by the allure of precision medicine. Patients and doctors alike are clamoring for these tests. But interpreting the results isn't easy because different companies offer these tests \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5323161/\">and interpret the DNA signatures differently\u003c/a>, \"and that can make a huge difference,\" Park says.\u003c/p>\n\u003cp>\"That's where we're having difficulty right now as a field,\" he says, harmonizing test results that often disagree with each other.\u003c/p>\n\u003cp>At Hopkins, the genomic tests usually don't offer any suggestion for treatment. Only \u003ca href=\"http://ascopubs.org/doi/abs/10.1200/PO.16.00046\">about one quarter\u003c/a> of patients at Hopkins are steered toward particular drugs or toward ongoing clinical trials. Other top medical centers find they can identify potential treatments only about 10 percent of the time.\u003c/p>\n\u003cp>So far there's only been one randomized study of this approach to precision cancer care — and it \u003ca href=\"http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(15)00188-6/abstract\">did not show a survival advantage\u003c/a> for people who went through all this genetic testing.\u003c/p>\n\u003cp>\"If you have this knowledge, it's not enough,\" Park says. \"You have to prove that acting on that knowledge — some medical intervention — will actually afford benefit for patients. That's the trickiest, toughest part about looking at all these types of genomic tests, to really prove that this is making a difference in the lives of our patients.\"\u003c/p>\n\u003cp>Park has since passed on leadership of the molecular tumor board to his colleague, oncologist \u003ca href=\"https://www.hopkinsmedicine.org/awomansjourney/baltimore/2017_conference/lauring.html\">Josh Lauring\u003c/a>. Lauring says there are a few cancers where DNA analysis does make a clear difference, say in melanoma and certain types of lung cancer.\u003c/p>\n\u003cp>\"In other cancers, it's really kind of an open question. At the same time, this testing is available commercially as well as at academic medical centers, and is being done. Patients want it, providers want it.\"\u003c/p>\n\u003cp>So what's happening, in effect, is a huge, unorganized experiment, involving real patients, treated differently in all sorts of settings. Lauring and colleagues at Hopkins are trying to keep track of all their patients: what treatment they got, how long it was successful, and how long the patients lived.\u003c/p>\n\u003cp>\"We think it's really important to capture that information as well, to try to learn from it,\" Lauring says, \"because in many cases it's not going to be effective, but in some it is, and it's important for us to figure that out.\"\u003c/p>\n\u003cp>Therapies that target specific genetic patterns are appealing because medical scientists have some sense of the biology underlying their drugs — they aren't just killing fast-growing cells, as conventional chemotherapy does.\u003c/p>\n\u003cp>\"Unfortunately in many cases these responses, if they occur, are relatively brief.\"\u003c/p>\n\u003cp>That unfortunately turned out to be the case for Ben Stern as well. Five months after his remarkable response, Ben started feeling weaker again. An MRI suggested the cancer might be on the move. So he went back to the hospital for another round of chemotherapy and radiation.\u003c/p>\n\u003cp>They're hoping for the best.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Contact Richard Harris at \u003ca href=\"mailto:rharris@npr.org\">rharris@npr.org\u003c/a>.\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=For+Now%2C+Sequencing+Cancer+Tumors+Holds+More+Promise+Than+Proof&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>People diagnosed with cancer understandably reach for the very best that medical science has to offer. That motivation is increasingly driving people to ask to have the DNA of their tumors sequenced. And while that's useful for some malignancies, the hype of precision medicine for cancer is getting far ahead of the facts.\u003c/p>\n\u003cp>It's easy to understand why that's the case. When you hear stories about the use of DNA sequencing to create individualized cancer treatment, chances are they are uplifting stories. Like that of Ben Stern.\u003c/p>\n\u003cp>In the spring of 2016, Stern was diagnosed with a deadly brain cancer, \u003ca href=\"http://www.abta.org/brain-tumor-information/types-of-tumors/glioblastoma.html\">glioblastoma\u003c/a>. His doctors at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins promptly treated him with surgery, then over the months, chemotherapy and radiation. He even got on a clinical trial to see if a leading edge drug called a checkpoint inhibitor would work.\u003c/p>\n\u003cp>Ben Stern found out abruptly that wasn't doing the trick either, when he was struck with a seizure. \"My whole right side clenched up and [my wife] Tara had called 911 in the middle of it.\"\u003c/p>\n\u003cp>The tumor had grown back, so surgeons went in again to remove what they could. Tara said the next month's appointment showed the surgery hadn't worked, either.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"The tumor had already grown back and it was already bigger than the original size tumor that we had found the previous May,\" Tara Stern says. This staggering regrowth took only five weeks.\u003c/p>\n\u003cp>Stern's doctor got a sample of the tumor and sent a genetic analysis of it to what Hopkins calls its \"molecular tumor board.\" It's a small group of doctors who meet Mondays to review these genetic tests. They found an overactive gene in his tumor that's only rarely associated with brain cancer. But that mutation in other cancers sometimes responds to a particular drug. So Ben went on it as part of his ongoing treatment.\u003c/p>\n\u003cp>\"He started his next round of chemotherapy that Monday but he didn't seem to get weaker,\" Tara says, \"He was getting stronger almost every day. It was almost miraculous.\"\u003c/p>\n\u003cp>Ben says the drug even reversed his deteriorating mental state brought on by the brain tumor. At the next monthly appointment, following a brain scan, Ben and Tara got more good news.\u003c/p>\n\u003cp>\"The tumor was immeasurable on that next MRI,\" Tara says. \"It wasn't there, to put it bluntly.\"\u003c/p>\n\u003cp>Ben's eyes well up as he hears his wife telling the story. \"I was basically as I am now, which is in tears.\"\u003c/p>\n\u003cp>Eight months later, Ben was thinking ahead about his future, rather than wondering whether his life is ending.\u003c/p>\n\u003cp>\"We have to use this result with caution because we don't know how long this effect might wear on, but for the time being this is a clinically very meaningful benefit,\" says his doctor at Hopkins, medical oncologist \u003ca href=\"https://www.hopkinsmedicine.org/profiles/results/directory/profile/5037896/matthias-holdhoff\">Matthias Holdhoff\u003c/a>.\u003c/p>\n\u003cp>And while it's a good-news story for the field of precision medicine, it is also not the way most of these stories end.\u003c/p>\n\u003cp>\"We're getting better, but like many things in life, there's hope and hype. And that's also the reality with precision medicine right now,\" says \u003ca href=\"https://www.hopkinsmedicine.org/kimmel_cancer_center/centers/breast_cancer_program/our_breast_cancer_experts/ben_parks.html\">Ben Park\u003c/a>, an oncology professor at the Sidney Kimmel Comprehensive Cancer Center at Hopkins. After noticing how much confusing genetic information was flooding doctors at Hopkins, he founded the molecular tumor board there.\u003c/p>\n\u003cp>\"The reason I started this tumor board [in 2013]... was simply because there was a patient, a young woman who had metastatic breast cancer who had a mutation on one of these reports and decided to forego standard-of-care therapies, which have been proven to actually prolong life in this setting,\" Park says. Instead, the woman enrolled in a clinical trial that didn't really make sense for her particular type of cancer and \"she almost died. She had really bad toxicity from the experimental drug.\"\u003c/p>\n\u003cp>She was drawn, Park says, by the allure of precision medicine. Patients and doctors alike are clamoring for these tests. But interpreting the results isn't easy because different companies offer these tests \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5323161/\">and interpret the DNA signatures differently\u003c/a>, \"and that can make a huge difference,\" Park says.\u003c/p>\n\u003cp>\"That's where we're having difficulty right now as a field,\" he says, harmonizing test results that often disagree with each other.\u003c/p>\n\u003cp>At Hopkins, the genomic tests usually don't offer any suggestion for treatment. Only \u003ca href=\"http://ascopubs.org/doi/abs/10.1200/PO.16.00046\">about one quarter\u003c/a> of patients at Hopkins are steered toward particular drugs or toward ongoing clinical trials. Other top medical centers find they can identify potential treatments only about 10 percent of the time.\u003c/p>\n\u003cp>So far there's only been one randomized study of this approach to precision cancer care — and it \u003ca href=\"http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(15)00188-6/abstract\">did not show a survival advantage\u003c/a> for people who went through all this genetic testing.\u003c/p>\n\u003cp>\"If you have this knowledge, it's not enough,\" Park says. \"You have to prove that acting on that knowledge — some medical intervention — will actually afford benefit for patients. That's the trickiest, toughest part about looking at all these types of genomic tests, to really prove that this is making a difference in the lives of our patients.\"\u003c/p>\n\u003cp>Park has since passed on leadership of the molecular tumor board to his colleague, oncologist \u003ca href=\"https://www.hopkinsmedicine.org/awomansjourney/baltimore/2017_conference/lauring.html\">Josh Lauring\u003c/a>. Lauring says there are a few cancers where DNA analysis does make a clear difference, say in melanoma and certain types of lung cancer.\u003c/p>\n\u003cp>\"In other cancers, it's really kind of an open question. At the same time, this testing is available commercially as well as at academic medical centers, and is being done. Patients want it, providers want it.\"\u003c/p>\n\u003cp>So what's happening, in effect, is a huge, unorganized experiment, involving real patients, treated differently in all sorts of settings. Lauring and colleagues at Hopkins are trying to keep track of all their patients: what treatment they got, how long it was successful, and how long the patients lived.\u003c/p>\n\u003cp>\"We think it's really important to capture that information as well, to try to learn from it,\" Lauring says, \"because in many cases it's not going to be effective, but in some it is, and it's important for us to figure that out.\"\u003c/p>\n\u003cp>Therapies that target specific genetic patterns are appealing because medical scientists have some sense of the biology underlying their drugs — they aren't just killing fast-growing cells, as conventional chemotherapy does.\u003c/p>\n\u003cp>\"Unfortunately in many cases these responses, if they occur, are relatively brief.\"\u003c/p>\n\u003cp>That unfortunately turned out to be the case for Ben Stern as well. Five months after his remarkable response, Ben started feeling weaker again. An MRI suggested the cancer might be on the move. So he went back to the hospital for another round of chemotherapy and radiation.\u003c/p>\n\u003cp>They're hoping for the best.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Contact Richard Harris at \u003ca href=\"mailto:rharris@npr.org\">rharris@npr.org\u003c/a>.\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=For+Now%2C+Sequencing+Cancer+Tumors+Holds+More+Promise+Than+Proof&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Should You Get a More Expensive, 3‑D Mammogram?",
"title": "Should You Get a More Expensive, 3‑D Mammogram?",
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"content": "\u003cp>When I went to the imaging center for my regular mammogram last year, the woman behind the desk asked me if I'd like to get a \"3-D\" mammogram instead of the standard test I'd had in the past.\u003c/p>\n\u003cp>\"It's more accurate,\" she said.\u003c/p>\n\u003cp>What do you say to that? \"No, thanks, I'd rather have the test that gets it wrong?\" Of course, I agreed.\u003c/p>\n\u003cp>A growing number of women are likely to face a similar choice in coming years as imaging centers across the country add three-dimensional mammography, also called \u003ca href=\"http://www.breastcancer.org/symptoms/testing/types/dig_tomosynth\">digital breast tomosynthesis\u003c/a>, to the two-dimensional, or 2-D, screening women customarily receive.\u003c/p>\n\u003cp>What's not yet clear is whether this newer, more expensive technology is better at catching cancers that are likely to kill. So should it be widely recommended? And who should pick up the extra cost involved?\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>According to the Food and Drug Administration, there were \u003ca href=\"https://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityScorecard/ucm113858.htm\">3,915 certified mammography imaging facilities\u003c/a> that offered digital breast tomosynthesis in January. That's a 30 percent increase over the previous January, when the total was 3,011.\u003c/p>\n\u003cp>Some facilities have switched over entirely to 3-D imaging, but many practices have both.\u003c/p>\n\u003cp>\"There's a lot of marketing pressure to offer these new machines,\" says \u003ca href=\"https://www.sph.emory.edu/faculty/profile/#!RASMIT3\">Robert Smith\u003c/a>, vice president of cancer screening at the American Cancer Society.\u003c/p>\n\u003cp>Both types of tests use X-ray technology to create images of the breast. The 2-D digital mammograms that most women receive typically provide front and side images. For the 3-D test, the X-ray arcs across the breast, creating multiple images of breast tissue. The experience is the same for women, though, because both scans involve compressing the breast between two plates extending from the machine.\u003c/p>\n\u003cp>Studies have generally shown that the 3-D test is \u003ca href=\"https://www.ncbi.nlm.nih.gov/books/NBK343784/\">slightly better at detecting cancers\u003c/a> than the 2-D test, and women typically have to return less often to have additional images taken. But the jury is still out on whether the newer technology is any better at identifying the advanced cancers that will become lethal.\u003c/p>\n\u003cp>\"Cancers don't always progress and kill people,\" says Dr. Etta Pisano, chief science officer at the American College of Radiology's Center for Research and Innovation and a faculty member at Harvard Medical School. Pisano is leading a \u003ca href=\"https://www.cancer.gov/news-events/press-releases/2017/tmist-mammography-trial\">five-year clinical trial of 165,000 women\u003c/a> that will compare the two types of mammography to evaluate whether the new technology reduces the risk that women will develop life-threatening cancers.\u003c/p>\n\u003cp>\"If tomosynthesis is improving the likelihood of women to survive their breast cancers, they should have fewer cancers that are more likely to kill women over the 4.5 years of screening. Since tomosynthesis caught them early, they'll never grow up to be bad cancers,\" Pisano says.\u003c/p>\n\u003cp>Overdiagnosis is one of the potential downsides of this technology, says Dr. David Grossman, chair of the U.S. Preventive Services Task Force. The more sensitive test picks up more breast lesions for which the clinical significance is unclear, potentially resulting in women receiving more testing and treatment they don't need. Some \u003ca href=\"https://www.ncbi.nlm.nih.gov/books/NBK343784/\">research suggests\u003c/a> the biopsy rate is slightly higher with 3-D mammograms.\u003c/p>\n\u003cp>In addition, some of the mammography systems require both 2-D and 3-D X-rays, which can expose women to twice as much radiation. Other systems are able to generate a 2-D image from the 3-D version with software, eliminating the extra exposure. The 2-D image is important because clusters of calcifications, which may signal breast cancer, might be easier to see on the 2-D image, says Pisano.\u003c/p>\n\u003cp>Under the Affordable Care Act, most health plans are required to cover preventive services that are recommended by the task force without charging patients anything out-of-pocket. The task force \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening1?ds=1&s=breast%20cancer%20screening\">recommends mammograms every other year for women ages 50 to 74\u003c/a>, but it says that there's not enough evidence to recommend 3-D mammograms at this time.\u003c/p>\n\u003cp>Insurance coverage of 3-D testing has improved in recent years, but it's not assured. The 3-D test typically \u003ca href=\"http://truvenhealth.com/Portals/0/Assets/studies/hologic/f_ceor-76167.pdf\">costs about $50 more\u003c/a> than a 2-D test, according to a 2015 study by Truven Health Analytics that was funded by Hologic, a manufacturer of 3-D mammography systems. Medicare also covers 3-D tests.\u003c/p>\n\u003cp>A growing number of states require commercial insurers to cover 3-D mammograms, including Arkansas, Texas, Connecticut, Maryland, Illinois and Pennsylvania.\u003c/p>\n\u003cp>My state of \u003ca href=\"http://www.dfs.ny.gov/insurance/circltr/2017/cl2017_s1_cl02_2016.htm\">New York also requires coverage\u003c/a>, without any out-of-pocket payments. Though I didn't have to pay it, the explanation of benefits form I got from my insurer says the 3-D portion of the test added $51 to the $157 cost of the mammogram.\u003c/p>\n\u003cp>\"Costs are high for new technologies,\" Pisano says. \"Maybe they are better, but we need to have evidence before we recommend it for the entire population.\"\u003c/p>\n\u003cp>So if you're offered a 3-D test, should you get it?\u003c/p>\n\u003cp>\"If the examination is available at no extra cost, the data we have now tells us it has some advantages,\" says Smith. On the other hand, \"any woman who's feeling stressed about the extra cost ... should feel comfortable getting a regular mammogram,\" he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Kaiser Health News is an editorially independent news service that is part of the nonpartisan Henry J. Kaiser Family Foundation. Michelle Andrews is on Twitter \u003c/em>\u003ca href=\"https://twitter.com/mandrews110\">@mandrews110\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=When+You+Need+A+Mammogram%2C+Should+You+Get+One+In+%273-D%27%3F+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When I went to the imaging center for my regular mammogram last year, the woman behind the desk asked me if I'd like to get a \"3-D\" mammogram instead of the standard test I'd had in the past.\u003c/p>\n\u003cp>\"It's more accurate,\" she said.\u003c/p>\n\u003cp>What do you say to that? \"No, thanks, I'd rather have the test that gets it wrong?\" Of course, I agreed.\u003c/p>\n\u003cp>A growing number of women are likely to face a similar choice in coming years as imaging centers across the country add three-dimensional mammography, also called \u003ca href=\"http://www.breastcancer.org/symptoms/testing/types/dig_tomosynth\">digital breast tomosynthesis\u003c/a>, to the two-dimensional, or 2-D, screening women customarily receive.\u003c/p>\n\u003cp>What's not yet clear is whether this newer, more expensive technology is better at catching cancers that are likely to kill. So should it be widely recommended? And who should pick up the extra cost involved?\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>According to the Food and Drug Administration, there were \u003ca href=\"https://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/FacilityScorecard/ucm113858.htm\">3,915 certified mammography imaging facilities\u003c/a> that offered digital breast tomosynthesis in January. That's a 30 percent increase over the previous January, when the total was 3,011.\u003c/p>\n\u003cp>Some facilities have switched over entirely to 3-D imaging, but many practices have both.\u003c/p>\n\u003cp>\"There's a lot of marketing pressure to offer these new machines,\" says \u003ca href=\"https://www.sph.emory.edu/faculty/profile/#!RASMIT3\">Robert Smith\u003c/a>, vice president of cancer screening at the American Cancer Society.\u003c/p>\n\u003cp>Both types of tests use X-ray technology to create images of the breast. The 2-D digital mammograms that most women receive typically provide front and side images. For the 3-D test, the X-ray arcs across the breast, creating multiple images of breast tissue. The experience is the same for women, though, because both scans involve compressing the breast between two plates extending from the machine.\u003c/p>\n\u003cp>Studies have generally shown that the 3-D test is \u003ca href=\"https://www.ncbi.nlm.nih.gov/books/NBK343784/\">slightly better at detecting cancers\u003c/a> than the 2-D test, and women typically have to return less often to have additional images taken. But the jury is still out on whether the newer technology is any better at identifying the advanced cancers that will become lethal.\u003c/p>\n\u003cp>\"Cancers don't always progress and kill people,\" says Dr. Etta Pisano, chief science officer at the American College of Radiology's Center for Research and Innovation and a faculty member at Harvard Medical School. Pisano is leading a \u003ca href=\"https://www.cancer.gov/news-events/press-releases/2017/tmist-mammography-trial\">five-year clinical trial of 165,000 women\u003c/a> that will compare the two types of mammography to evaluate whether the new technology reduces the risk that women will develop life-threatening cancers.\u003c/p>\n\u003cp>\"If tomosynthesis is improving the likelihood of women to survive their breast cancers, they should have fewer cancers that are more likely to kill women over the 4.5 years of screening. Since tomosynthesis caught them early, they'll never grow up to be bad cancers,\" Pisano says.\u003c/p>\n\u003cp>Overdiagnosis is one of the potential downsides of this technology, says Dr. David Grossman, chair of the U.S. Preventive Services Task Force. The more sensitive test picks up more breast lesions for which the clinical significance is unclear, potentially resulting in women receiving more testing and treatment they don't need. Some \u003ca href=\"https://www.ncbi.nlm.nih.gov/books/NBK343784/\">research suggests\u003c/a> the biopsy rate is slightly higher with 3-D mammograms.\u003c/p>\n\u003cp>In addition, some of the mammography systems require both 2-D and 3-D X-rays, which can expose women to twice as much radiation. Other systems are able to generate a 2-D image from the 3-D version with software, eliminating the extra exposure. The 2-D image is important because clusters of calcifications, which may signal breast cancer, might be easier to see on the 2-D image, says Pisano.\u003c/p>\n\u003cp>Under the Affordable Care Act, most health plans are required to cover preventive services that are recommended by the task force without charging patients anything out-of-pocket. The task force \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening1?ds=1&s=breast%20cancer%20screening\">recommends mammograms every other year for women ages 50 to 74\u003c/a>, but it says that there's not enough evidence to recommend 3-D mammograms at this time.\u003c/p>\n\u003cp>Insurance coverage of 3-D testing has improved in recent years, but it's not assured. The 3-D test typically \u003ca href=\"http://truvenhealth.com/Portals/0/Assets/studies/hologic/f_ceor-76167.pdf\">costs about $50 more\u003c/a> than a 2-D test, according to a 2015 study by Truven Health Analytics that was funded by Hologic, a manufacturer of 3-D mammography systems. Medicare also covers 3-D tests.\u003c/p>\n\u003cp>A growing number of states require commercial insurers to cover 3-D mammograms, including Arkansas, Texas, Connecticut, Maryland, Illinois and Pennsylvania.\u003c/p>\n\u003cp>My state of \u003ca href=\"http://www.dfs.ny.gov/insurance/circltr/2017/cl2017_s1_cl02_2016.htm\">New York also requires coverage\u003c/a>, without any out-of-pocket payments. Though I didn't have to pay it, the explanation of benefits form I got from my insurer says the 3-D portion of the test added $51 to the $157 cost of the mammogram.\u003c/p>\n\u003cp>\"Costs are high for new technologies,\" Pisano says. \"Maybe they are better, but we need to have evidence before we recommend it for the entire population.\"\u003c/p>\n\u003cp>So if you're offered a 3-D test, should you get it?\u003c/p>\n\u003cp>\"If the examination is available at no extra cost, the data we have now tells us it has some advantages,\" says Smith. On the other hand, \"any woman who's feeling stressed about the extra cost ... should feel comfortable getting a regular mammogram,\" he says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Kaiser Health News is an editorially independent news service that is part of the nonpartisan Henry J. Kaiser Family Foundation. Michelle Andrews is on Twitter \u003c/em>\u003ca href=\"https://twitter.com/mandrews110\">@mandrews110\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=When+You+Need+A+Mammogram%2C+Should+You+Get+One+In+%273-D%27%3F+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Calif. Stem Cell Agency Has Yet to Fund an FDA-Approved Cure. Will Voters Give It $5 Billion More?",
"title": "Calif. Stem Cell Agency Has Yet to Fund an FDA-Approved Cure. Will Voters Give It $5 Billion More?",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>The year was 2004, and great medical breakthroughs were supposedly right around the corner.\u003c/p>\n\u003cp>In TV advertisements, celebrities\u003ca href=\"https://www.youtube.com/watch?v=fK9Eg0GVl7Q\" target=\"_blank\" rel=\"noopener\"> Michael J. Fox\u003c/a> and \u003ca href=\"https://preview-archives.nbclearn.com/portal/site/k-12/browse/?cuecard=4336\" target=\"_blank\" rel=\"noopener\">Christopher Reeve, \u003c/a>both suffering from incurable conditions, touted the promise of stem cell research, which could lead to a plethora of cures for life-threatening diseases.\u003c/p>\n\u003caside class=\"pullquote alignright\">Will California's appetite for funding stem cell research last?\u003c/aside>\n\u003cp>The ads ran in support of \u003ca href=\"https://ballotpedia.org/California_Proposition_71,_Stem_Cell_Research_(2004)\" target=\"_blank\" rel=\"noopener\">Proposition 71\u003c/a>, a $3 billion California bond measure that would create the first state-funded stem cell agency in the nation. Three years earlier, the George W. Bush administration had \u003ca href=\"http://www.presidency.ucsb.edu/ws/?pid=79025\" target=\"_blank\" rel=\"noopener\">issued\u003c/a> rules to limit use of stem cells obtained from human embryos. But California voters easily passed Proposition 71, 59-41 percent. The California Institute for Regenerative Medicine, or \u003ca href=\"https://www.cirm.ca.gov/\" target=\"_blank\" rel=\"noopener\">CIRM\u003c/a>, was born. Its mission: to fund and accelerate stem-cell-related treatments.\u003c/p>\n\u003cp>Fourteen years and billions of dollars later, the agency is running out of money, and backers of stem cell research \u003ca href=\"http://capitolweekly.net/stem-cell-agency-nears-5-billion-ballot-plan/\" target=\"_blank\" rel=\"noopener\">plan\u003c/a> on asking California voters to pony up for round two.\u003c/p>\n\u003cp>And those stem cell breakthroughs?\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Still right around the corner. Or, if you're an optimist, perhaps rounding it, now.\u003c/p>\n\u003caside class=\"alignright\">Promising but as yet unapproved therapies funded by CIRM\n\u003cul>\n\u003cli>Slowing or reversing \u003ca href=\"https://newswise.com/articles/jcyte-presents-results-of-clinical-testing-in-retinitis-pigmentosa2\" target=\"_blank\" rel=\"noopener\">retinitis pigmentosa\u003c/a>\u003c/li>\n\u003cli>New shunt for \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/10/12/new-stem-cell-technology-could-make-life-easier-for-kidney-disease-patients/\" target=\"_blank\" rel=\"noopener\">kidney dialysis patients\u003c/a>\u003c/li>\n\u003cli>Gene therapy for children with no \u003ca href=\"https://blog.cirm.ca.gov/tag/evangelina-padilla-vaccaro/\" target=\"_blank\" rel=\"noopener\">functioning immune system\u003c/a>\u003c/li>\n\u003cli>Help for \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/10/04/spinal-patients-continue-remarkable-recovery-after-stem-cell-injections-company-says/\" target=\"_blank\" rel=\"noopener\">spinal-injury victims\u003c/a>\u003c/li>\n\u003cli>Lab-modified cells to treat \u003ca href=\"https://blog.cirm.ca.gov/2017/07/20/stem-cell-agency-funds-phase-3-clinical-trial-for-lou-gehrigs-disease/\" target=\"_blank\" rel=\"noopener\">ALS patients\u003c/a>\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>\u003cstrong>The Pitch\u003c/strong>\u003c/p>\n\u003cp>Stem cell research proponents — including the same advocacy group that backed Proposition 71 — want to ask voters in the November 2020 election for $5 billion in bond money to continue the work of CIRM.\u003c/p>\n\u003cp>For voters, there will be one major question, according to Zev Yaroslavsky, an expert on state politics and government at UCLA.\u003c/p>\n\u003cp>“The public will want to know what they’ve gotten for their money.”\u003c/p>\n\u003cfigure id=\"attachment_188656\" class=\"wp-caption alignleft\" style=\"max-width: 351px\">\u003cimg class=\" wp-image-188656\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/06/StemCells-800x534.jpg\" alt=\"Buttons with the slogan 'Save Lives With Stem Cells,' in support of Prop. 71 at the Stem Cell Research Proposition Party at the Biltmore Hotel Nov. 2, 2004 in Los Angeles, California.\" width=\"351\" height=\"234\">\u003cfigcaption class=\"wp-caption-text\">Buttons with the slogan 'Save Lives With Stem Cells,' in support of Prop. 71 in 2004. \u003ccite>(Frazer Harrison/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Yaroslavsky expects to see plenty of funding measures on the 2020 ballot, including a parks bond and money for open space and schools, not to mention repeal of the gas tax.\u003c/p>\n\u003cp>“At what point do people start to vote no on everything?\" Yaroslavsky said. \"Or prioritize which of those many good causes they want to spend their money on?”\u003c/p>\n\u003cfigure id=\"attachment_262540\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-full wp-image-262540\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/10/HumanEScellsintoneurons.jpg\" alt=\"\" width=\"640\" height=\"588\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/10/HumanEScellsintoneurons.jpg 640w, https://ww2.kqed.org/app/uploads/sites/13/2016/10/HumanEScellsintoneurons-400x368.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Human embryonic stem cells differentiating into neurons \u003ccite>(Guoping Fan/UCLA/CIRM)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Robert Klein, who spearheaded the original 2004 ballot measure and served as the CIRM board's first chairman, still heads the advocacy group, \u003ca href=\"https://americansforcures.org/\" target=\"_blank\" rel=\"noopener\">Americans for Cures\u003c/a>, that pushed Proposition 71. Medical science isn't exactly his field — he's president of a Palo Alto-based real estate development firm — but he got involved in stem cell funding because of his son's Type 1 diabetes, which is incurable.\u003c/p>\n\u003cp>Klein said re-funding the stem cell agency is not just a good cause, but good business.\u003c/p>\n\u003cp>“It has been a creator of jobs, and the state benefits from taxes by attracting research centers here,” he said.\u003c/p>\n\u003cp>[contextly_sidebar id=\"Bv07QyLXQ031CUEZCQOytRKusurX2p1i\"]A 2012 \u003ca href=\"https://www.cirm.ca.gov/sites/default/files/files/about_cirm/Econ_Impact_REPORT_updated_2012.pdf\" target=\"_blank\" rel=\"noopener\">independent review\u003c/a> commissioned by CIRM and looking forward through 2014 estimated that its grants plus matching funds would result in an average of over 4,000 jobs created per year, and $205 million in state tax revenue.\u003c/p>\n\u003cp>As for the proposed new funding, Klein said the $5 billion bond cost would be amortized over 40 years, so it’s not a huge cost compared to other government projects.\u003c/p>\n\u003cp>“Look, we paid \u003ca href=\"https://www.citylab.com/equity/2015/10/from-250-million-to-65-billion-the-bay-bridge-cost-overrun/410254/\">$6.5 billion\u003c/a> just to fix the eastern span of the Bay Bridge,” Klein said. “That’s road infrastructure — this is more like [funding] the intellectual infrastructure of California.”\u003c/p>\n\u003cp>\u003cstrong>Where Are the Cures?\u003c/strong>\u003c/p>\n\u003cp>Stem cells are undifferentiated cells that can be transformed into specific tissue and organ cells. The 2004 ballot initiative struck an emotional chord, in part because of the high-profile cases of actors Reeve and Fox, who personified the hope that the cells could play a role in new therapies for incurable medical conditions. Reeve, who died in 2004, became a quadriplegic after injuring his spine in a horse-riding accident; Fox has Parkinson’s, a neurodegenerative disease.\u003c/p>\n\u003cp>In Fox's \u003ca href=\"https://www.youtube.com/watch?v=fK9Eg0GVl7Q\" target=\"_blank\" rel=\"noopener\">30-second spot\u003c/a>, he used the word “cures” three times.\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=fK9Eg0GVl7Q\u003c/p>\n\u003cp>So has CIRM produced any cures?\u003c/p>\n\u003cp>The family of 5-year-old \u003ca href=\"https://blog.cirm.ca.gov/tag/evangelina-padilla-vaccaro/\" target=\"_blank\" rel=\"noopener\">Evangelina Padilla-Vaccaro\u003c/a> would say yes.\u003c/p>\n\u003cp>Evangelina was born with a rare genetic condition called Severe Combined Immunodeficiency, or\u003ca href=\"https://www.genome.gov/13014325/learning-about-severe-combined-immunodeficiency-scid/\" target=\"_blank\" rel=\"noopener\"> SCID\u003c/a>, also known as “bubble baby” disease. The ailment renders a patient's immune system nonfunctioning. The National Institutes of Health \u003ca href=\"https://www.genome.gov/13014325/learning-about-severe-combined-immunodeficiency-scid/#al-3\" target=\"_blank\" rel=\"noopener\">estimates\u003c/a> approximately 40 to 100 children in the U.S. each year are diagnosed with the malady.\u003c/p>\n\u003cp>A team of UCLA clinical researchers, partially funded by CIRM, genetically modified Evangelina’s own blood stem cells to correct the SCID mutation.\u003c/p>\n\u003cp>She was cured.\u003c/p>\n\u003cp>Evangelina was the first to undergo the treatment, back when she was just a few months old. And now, CIRM says, at least 40 other children have been cured with the same procedure.\u003c/p>\n\u003cfigure id=\"attachment_438299\" class=\"wp-caption alignright\" style=\"max-width: 576px\">\u003cimg class=\"size-full wp-image-438299\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/evangelina_treatment.jpg\" alt=\"Baby in a hospital bed\" width=\"576\" height=\"768\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/01/evangelina_treatment.jpg 576w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/evangelina_treatment-160x213.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/evangelina_treatment-240x320.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/evangelina_treatment-375x500.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/evangelina_treatment-520x693.jpg 520w\" sizes=\"(max-width: 576px) 100vw, 576px\">\u003cfigcaption class=\"wp-caption-text\">Evangelina being treated by Don Kohn and his team in 2012. \u003ccite>(UCLA)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Despite this success, the SCID trial is only in Phase 2. CIRM has only two trials in Phase 3, a necessary step before FDA approval: one testing a \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/10/12/new-stem-cell-technology-could-make-life-easier-for-kidney-disease-patients/\" target=\"_blank\" rel=\"noopener\">new port\u003c/a> for kidney dialysis patients that is made out of human tissue and would not have to be replaced; and one that aims to\u003ca href=\"http://www.cirm.ca.gov/about-cirm/newsroom/press-releases/07202017/phase-3-clinical-trial-targeting-lou-gehrigs-disease\" target=\"_blank\" rel=\"noopener\"> slow down\u003c/a> the progression of Lou Gehrig's disease.\u003c/p>\n\u003cp>Other promising CIRM-funded therapies include slowing or \u003ca href=\"https://newswise.com/articles/jcyte-presents-results-of-clinical-testing-in-retinitis-pigmentosa2\" target=\"_blank\" rel=\"noopener\">reversing\u003c/a> retinitis pigmentosa, a genetic abnormality that destroys a person’s sight; and \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/10/26/paralyzed-patients-regain-movement-in-stem-cell-trial-is-it-too-early-to-celebrate/\" target=\"_blank\" rel=\"noopener\">injecting stem cells\u003c/a> into patients with severe spinal injuries.\u003c/p>\n\u003cp>The FDA has made several of these therapies eligible for priority review by granting them Regenerative Medicine Advanced Therapy, or \u003ca href=\"https://www.fda.gov/BiologicsBloodVaccines/CellularGeneTherapyProducts/ucm537670.htm\" target=\"_blank\" rel=\"noopener\">RMAT\u003c/a>, status.\u003c/p>\n\u003cp>Clinical trials and research in less-advanced stages are ongoing for many other \u003ca href=\"https://www.cirm.ca.gov/grants\" target=\"_blank\" rel=\"noopener\">diseases and conditions\u003c/a>, including brain cancer, diabetes and HIV.\u003c/p>\n\u003cp>But the fact remains: Although this could change in the run-up to the election, no CIRM-funded stem cell treatment has yet to be approved by the FDA.\u003c/p>\n\u003cp>\u003cstrong>Miracles Capture the Imagination\u003c/strong>\u003c/p>\n\u003cp>Even outside of CIRM, only a handful of stem cell-related therapies have been approved for general use. Yet, stem cell research has captured the public's imagination with flashes of the miraculous.\u003c/p>\n\u003cfigure id=\"attachment_438300\" class=\"wp-caption alignright\" style=\"max-width: 594px\">\u003cimg class=\"size-full wp-image-438300\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/GettyImages-149183631.jpg\" alt=\"Middle aged man looks at camera.\" width=\"594\" height=\"396\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/01/GettyImages-149183631.jpg 594w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/GettyImages-149183631-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/GettyImages-149183631-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/GettyImages-149183631-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/GettyImages-149183631-520x347.jpg 520w\" sizes=\"(max-width: 594px) 100vw, 594px\">\u003cfigcaption class=\"wp-caption-text\">Timothy Ray Brown, known as the 'Berlin patient' and the only person to have been cured of AIDS, at a press conference in 2012. \u003ccite>(T.J. Kirkpatrick/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Timothy Ray Brown, the famous \"\u003ca href=\"http://defeathiv.org/berlin/\" target=\"_blank\" rel=\"noopener\">Berlin patient\u003c/a>,\" for example, is an HIV patient who received a bone marrow transplant from a donor with a genetic mutation that endowed resistance to HIV. The transplant effectively cured Brown of the disease. However, there are currently a dearth of potential donors with the correct mutation, so researchers hope to create them, for use in patients' blood systems.\u003c/p>\n\u003cp>The bubble baby breakthrough and positive initial results in other CIRM-funded trials are strong selling points, said David Jensen, a journalist who covers stem cell research and writes a blog called \u003ca href=\"http://californiastemcellreport.blogspot.com/\" target=\"_blank\" rel=\"noopener\">California Stem Cell Report.\u003c/a>\u003c/p>\n\u003cp>\"There are some things CIRM can point to that are really impressive,\" Jensen said. \"It’s a pretty big deal in the world of science. It's the largest single source of funding for embryonic stem cell research in the world, and that’s no small thing.\"\u003c/p>\n\u003cp>[contextly_sidebar id=\"jHMWEkOPxg4IYTLSL83TfP2I7GjhjcyI\"]That doesn't necessarily mean voters will agree to re-fund it, he said.\u003c/p>\n\u003cp>Kevin McCormack, CIRM’s director of public communications and patient advocate outreach, said there's still time for CIRM to make a bigger splash.\u003c/p>\n\u003cp>“We’ve still got two more years,” McCormack said. “By 2020 I think people will see that CIRM-funded therapies are not just changing lives but saving lives.”\u003c/p>\n\u003cp>\u003cstrong>Overpromising: Something CIRM Has 'Had to Live With'\u003c/strong>\u003c/p>\n\u003cp>Klein, the backer of Proposition 71, said the 2004 campaign never promised cures during the lifetime of the stem cell agency, only progress toward attaining them.\u003c/p>\n\u003cp>“What we put in the ballot arguments is that we had to make major progress in mitigating disease, and moving toward cures,” Klein said. He feels that certainly has been achieved— and more. “In terms of progress toward the ultimate goal of cures, it’s remarkable what progress has been made.\u003c/p>\n\u003cp>\"When I look back, I think we have out-achieved the representations we put on the ballot.”\u003c/p>\n\u003cp>But even CIRM's McCormack has said, in an \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/06/22/stem-cells-where-science-hope-and-hype-meet/\" target=\"_blank\" rel=\"noopener\">interview with KQED\u003c/a> in 2016, that overpromising by the Proposition 71 campaign is \"something [CIRM] has had to live with.\"\u003c/p>\n\u003cp>Opposition during the \u003ca href=\"https://ballotpedia.org/California_Proposition_71,_Stem_Cell_Research_(2004)\">first ballot measure\u003c/a> was based mostly on religious concerns about using embryonic stem cells, on the large amount of money (the $3 billion price tag actually costs taxpayers $6 billion when interest is included) and on the lack of any guarantees of specific achievements.\u003c/p>\n\u003cp>Jensen expects religious objections to resurface when the election campaigns ramp up — but that those might not gain traction, because the field has expanded into adult and \u003ca href=\"https://stemcell.ucla.edu/induced-pluripotent-stem-cells\" target=\"_blank\" rel=\"noopener\">induced pluripotent stem cells\u003c/a> in addition to embryonic cells.\u003c/p>\n\u003cfigure id=\"attachment_438301\" class=\"wp-caption alignleft\" style=\"max-width: 570px\">\u003cimg class=\"size-full wp-image-438301\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/cured_ar_2016_cover.png\" alt=\"\" width=\"570\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/01/cured_ar_2016_cover.png 570w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/cured_ar_2016_cover-160x168.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/cured_ar_2016_cover-240x253.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/cured_ar_2016_cover-375x395.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/cured_ar_2016_cover-520x547.png 520w\" sizes=\"(max-width: 570px) 100vw, 570px\">\u003cfigcaption class=\"wp-caption-text\">Evangelina Padilla-Vaccaro on the cover of CIRM's \u003ca href=\"https://www.cirm.ca.gov/about-cirm/cirm-annual-reports\">2016 Annual Report\u003c/a>. \u003ccite>(CIRM)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>And since the poster child for stem cell success could very well be the pint-sized and happy-faced Evangelina Padilla-Vaccaro, it may be hard to argue that these concerns outweigh not having to live in a bubble.\u003c/p>\n\u003cp>\"I mean, how can you be against that?\" Jensen said.\u003c/p>\n\u003cp>But some opposition has sprung up even inside the medical community. Barbara Koenig, head of the bioethics program at UCSF, pointed to ongoing concerns about conflict of interest at the agency — 90 percent of all spending benefited organizations that have been represented on the \u003ca href=\"https://www.cirm.ca.gov/board-and-meetings/list-icoc-members\" target=\"_blank\" rel=\"noopener\">governing board\u003c/a>, Jensen has been \u003ca href=\"http://capitolweekly.net/californias-stem-cell-agency-future-uncertain/\" target=\"_blank\" rel=\"noopener\">reporting\u003c/a>— and the public governance that she said has been lacking. (McCormack said the expansion of companies involved in stem cell research has resulted in broader distribution of funds. He also pointed to CIRM's adoption of more stringent\u003ca href=\"https://govt.westlaw.com/calregs/Document/ICD886A9181574C3BADD5946217E13F00?viewType=FullText&originationContext=documenttoc&transitionType=CategoryPageItem&contextData=(sc.Default)&bhcp=1\" target=\"_blank\" rel=\"noopener\"> conflict-of-interest policies \u003c/a>in 2013.)\u003c/p>\n\u003caside class=\"pullquote alignright\">'I didn’t like the over-hyping of the immediate idea that [in 2004] there were cures around the corner. I think we need to be honest about how we’re investing in research.'\u003ccite>Barbara Koenig, UCSF bioethics program\u003cbr>\n\u003c/cite>\u003c/aside>\n\u003cp>Koenig supports stem cell research, but voted against the measure in 2004. And she has serious concerns about its possible renewal.\u003c/p>\n\u003cp>“I didn’t like the overhyping of the immediate idea that there were cures around the corner,” Koenig said. “I think we need to be honest about how we’re investing in research.”\u003c/p>\n\u003cp>Ask Koenig how she might use that proposed $5 billion differently, and she responds with a moment of stunned silence.\u003c/p>\n\u003cp>“Oh my, so many things,” she said. “I would try to figure out how to make sure every child in California has access to basic health services, nutrition, clean water . . . not just make high-priced products, but to improve public health.”\u003c/p>\n\u003cp>She said stem cell research \"privileges these quick-fix biotech approaches, which may make a lot of money but may not benefit the general public.”\u003c/p>\n\u003cp>Another bioethicist, Jodi Halpern of UC Berkeley, said the ballot initiative process is no place for a basic state spending decision.\u003c/p>\n\u003cp>“Why isn’t this a legislative issue?” Halpern asked. “We elect the Legislature to decide where California is going to spend its money. Putting this on the ballot, making it an emotional issue rather than just a financial one, that doesn’t sit right with me.\"\u003c/p>\n\u003cp>https://www.youtube.com/watch?time_continue=59&v=FjXiRx7DvzQ\u003c/p>\n\u003cp>\u003cstrong>Concerns vs. Cures\u003c/strong>\u003c/p>\n\u003cp>CIRM’s McCormack said he understands the concerns about state funding, but he said he's seen too much good come from the agency to see it wither on the budget-bickering vine.\u003c/p>\n\u003cp>“We are helping change the face of medicine,” he said. “We have so many clinical trials in the pipeline . . . that will pay off with therapies to help people who right now don’t have much of a chance for help, people with unmet medical needs.”\u003c/p>\n\u003cp>At its current spending pace, CIRM will run out of money by the \u003ca href=\"https://www.cirm.ca.gov/sites/default/files/files/agenda/171214_Agedna_Item_%234_FINAL%20Dec%202017%20President%20Report%5B7%5D.pdf\" target=\"_blank\" rel=\"noopener\">end of 2019\u003c/a> — roughly a year before the proposed ballot measure vote. At its December 2017 board meeting, one of the \u003ca href=\"https://www.cirm.ca.gov/sites/default/files/files/agenda/171214_Agenda_Item_%236_Presentation_Draft_1%5B2%5D_0.pdf\" target=\"_blank\" rel=\"noopener\">topics\u003c/a> for discussion was how to slow that spending and extend the agency’s grant-making till the end of 2020.\u003c/p>\n\u003cp>Board members and staffers aren’t involved in the proposed ballot measure, but they’re obviously keen on it, McCormack said.\u003c/p>\n\u003cp>Klein said he commissioned a survey to gauge interest and attitudes toward re-funding the agency. He said the numbers are strongly positive, but he has not released those results. There have been no other California polls on the topic since 2004, according to Jensen.\u003c/p>\n\u003cp>Even if voter attitudes are overwhelmingly favorable toward stem cell research, proponents may find that goodwill might wilt when it comes to passing a ballot measure, UCLA’s Yaroslavsky said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“People do see stem cell research as something they have a stake in, but you’re going to have to explain what we got with the first $3 billion. I suspect their case with the voters will be that we need to keep momentum going. But the question is, 'Will they buy it?' ”\u003c/p>\n\n",
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"excerpt": "Fourteen years after Calif. voters approved $3 billion in funding to create a state stem cell agency, backers are planning to ask the public to pony up again. What achievements will they be able to point to?",
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"description": "Fourteen years after Calif. voters approved $3 billion in funding to create a state stem cell agency, backers are planning to ask the public to pony up again. What achievements will they be able to point to?",
"title": "Calif. Stem Cell Agency Has Yet to Fund an FDA-Approved Cure. Will Voters Give It $5 Billion More? | KQED",
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"headline": "Calif. Stem Cell Agency Has Yet to Fund an FDA-Approved Cure. Will Voters Give It $5 Billion More?",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The year was 2004, and great medical breakthroughs were supposedly right around the corner.\u003c/p>\n\u003cp>In TV advertisements, celebrities\u003ca href=\"https://www.youtube.com/watch?v=fK9Eg0GVl7Q\" target=\"_blank\" rel=\"noopener\"> Michael J. Fox\u003c/a> and \u003ca href=\"https://preview-archives.nbclearn.com/portal/site/k-12/browse/?cuecard=4336\" target=\"_blank\" rel=\"noopener\">Christopher Reeve, \u003c/a>both suffering from incurable conditions, touted the promise of stem cell research, which could lead to a plethora of cures for life-threatening diseases.\u003c/p>\n\u003caside class=\"pullquote alignright\">Will California's appetite for funding stem cell research last?\u003c/aside>\n\u003cp>The ads ran in support of \u003ca href=\"https://ballotpedia.org/California_Proposition_71,_Stem_Cell_Research_(2004)\" target=\"_blank\" rel=\"noopener\">Proposition 71\u003c/a>, a $3 billion California bond measure that would create the first state-funded stem cell agency in the nation. Three years earlier, the George W. Bush administration had \u003ca href=\"http://www.presidency.ucsb.edu/ws/?pid=79025\" target=\"_blank\" rel=\"noopener\">issued\u003c/a> rules to limit use of stem cells obtained from human embryos. But California voters easily passed Proposition 71, 59-41 percent. The California Institute for Regenerative Medicine, or \u003ca href=\"https://www.cirm.ca.gov/\" target=\"_blank\" rel=\"noopener\">CIRM\u003c/a>, was born. Its mission: to fund and accelerate stem-cell-related treatments.\u003c/p>\n\u003cp>Fourteen years and billions of dollars later, the agency is running out of money, and backers of stem cell research \u003ca href=\"http://capitolweekly.net/stem-cell-agency-nears-5-billion-ballot-plan/\" target=\"_blank\" rel=\"noopener\">plan\u003c/a> on asking California voters to pony up for round two.\u003c/p>\n\u003cp>And those stem cell breakthroughs?\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Still right around the corner. Or, if you're an optimist, perhaps rounding it, now.\u003c/p>\n\u003caside class=\"alignright\">Promising but as yet unapproved therapies funded by CIRM\n\u003cul>\n\u003cli>Slowing or reversing \u003ca href=\"https://newswise.com/articles/jcyte-presents-results-of-clinical-testing-in-retinitis-pigmentosa2\" target=\"_blank\" rel=\"noopener\">retinitis pigmentosa\u003c/a>\u003c/li>\n\u003cli>New shunt for \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/10/12/new-stem-cell-technology-could-make-life-easier-for-kidney-disease-patients/\" target=\"_blank\" rel=\"noopener\">kidney dialysis patients\u003c/a>\u003c/li>\n\u003cli>Gene therapy for children with no \u003ca href=\"https://blog.cirm.ca.gov/tag/evangelina-padilla-vaccaro/\" target=\"_blank\" rel=\"noopener\">functioning immune system\u003c/a>\u003c/li>\n\u003cli>Help for \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/10/04/spinal-patients-continue-remarkable-recovery-after-stem-cell-injections-company-says/\" target=\"_blank\" rel=\"noopener\">spinal-injury victims\u003c/a>\u003c/li>\n\u003cli>Lab-modified cells to treat \u003ca href=\"https://blog.cirm.ca.gov/2017/07/20/stem-cell-agency-funds-phase-3-clinical-trial-for-lou-gehrigs-disease/\" target=\"_blank\" rel=\"noopener\">ALS patients\u003c/a>\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>\u003cstrong>The Pitch\u003c/strong>\u003c/p>\n\u003cp>Stem cell research proponents — including the same advocacy group that backed Proposition 71 — want to ask voters in the November 2020 election for $5 billion in bond money to continue the work of CIRM.\u003c/p>\n\u003cp>For voters, there will be one major question, according to Zev Yaroslavsky, an expert on state politics and government at UCLA.\u003c/p>\n\u003cp>“The public will want to know what they’ve gotten for their money.”\u003c/p>\n\u003cfigure id=\"attachment_188656\" class=\"wp-caption alignleft\" style=\"max-width: 351px\">\u003cimg class=\" wp-image-188656\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/06/StemCells-800x534.jpg\" alt=\"Buttons with the slogan 'Save Lives With Stem Cells,' in support of Prop. 71 at the Stem Cell Research Proposition Party at the Biltmore Hotel Nov. 2, 2004 in Los Angeles, California.\" width=\"351\" height=\"234\">\u003cfigcaption class=\"wp-caption-text\">Buttons with the slogan 'Save Lives With Stem Cells,' in support of Prop. 71 in 2004. \u003ccite>(Frazer Harrison/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Yaroslavsky expects to see plenty of funding measures on the 2020 ballot, including a parks bond and money for open space and schools, not to mention repeal of the gas tax.\u003c/p>\n\u003cp>“At what point do people start to vote no on everything?\" Yaroslavsky said. \"Or prioritize which of those many good causes they want to spend their money on?”\u003c/p>\n\u003cfigure id=\"attachment_262540\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-full wp-image-262540\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/10/HumanEScellsintoneurons.jpg\" alt=\"\" width=\"640\" height=\"588\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/10/HumanEScellsintoneurons.jpg 640w, https://ww2.kqed.org/app/uploads/sites/13/2016/10/HumanEScellsintoneurons-400x368.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Human embryonic stem cells differentiating into neurons \u003ccite>(Guoping Fan/UCLA/CIRM)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Robert Klein, who spearheaded the original 2004 ballot measure and served as the CIRM board's first chairman, still heads the advocacy group, \u003ca href=\"https://americansforcures.org/\" target=\"_blank\" rel=\"noopener\">Americans for Cures\u003c/a>, that pushed Proposition 71. Medical science isn't exactly his field — he's president of a Palo Alto-based real estate development firm — but he got involved in stem cell funding because of his son's Type 1 diabetes, which is incurable.\u003c/p>\n\u003cp>Klein said re-funding the stem cell agency is not just a good cause, but good business.\u003c/p>\n\u003cp>“It has been a creator of jobs, and the state benefits from taxes by attracting research centers here,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>A 2012 \u003ca href=\"https://www.cirm.ca.gov/sites/default/files/files/about_cirm/Econ_Impact_REPORT_updated_2012.pdf\" target=\"_blank\" rel=\"noopener\">independent review\u003c/a> commissioned by CIRM and looking forward through 2014 estimated that its grants plus matching funds would result in an average of over 4,000 jobs created per year, and $205 million in state tax revenue.\u003c/p>\n\u003cp>As for the proposed new funding, Klein said the $5 billion bond cost would be amortized over 40 years, so it’s not a huge cost compared to other government projects.\u003c/p>\n\u003cp>“Look, we paid \u003ca href=\"https://www.citylab.com/equity/2015/10/from-250-million-to-65-billion-the-bay-bridge-cost-overrun/410254/\">$6.5 billion\u003c/a> just to fix the eastern span of the Bay Bridge,” Klein said. “That’s road infrastructure — this is more like [funding] the intellectual infrastructure of California.”\u003c/p>\n\u003cp>\u003cstrong>Where Are the Cures?\u003c/strong>\u003c/p>\n\u003cp>Stem cells are undifferentiated cells that can be transformed into specific tissue and organ cells. The 2004 ballot initiative struck an emotional chord, in part because of the high-profile cases of actors Reeve and Fox, who personified the hope that the cells could play a role in new therapies for incurable medical conditions. Reeve, who died in 2004, became a quadriplegic after injuring his spine in a horse-riding accident; Fox has Parkinson’s, a neurodegenerative disease.\u003c/p>\n\u003cp>In Fox's \u003ca href=\"https://www.youtube.com/watch?v=fK9Eg0GVl7Q\" target=\"_blank\" rel=\"noopener\">30-second spot\u003c/a>, he used the word “cures” three times.\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/fK9Eg0GVl7Q'\n title='//www.youtube.com/embed/fK9Eg0GVl7Q'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>So has CIRM produced any cures?\u003c/p>\n\u003cp>The family of 5-year-old \u003ca href=\"https://blog.cirm.ca.gov/tag/evangelina-padilla-vaccaro/\" target=\"_blank\" rel=\"noopener\">Evangelina Padilla-Vaccaro\u003c/a> would say yes.\u003c/p>\n\u003cp>Evangelina was born with a rare genetic condition called Severe Combined Immunodeficiency, or\u003ca href=\"https://www.genome.gov/13014325/learning-about-severe-combined-immunodeficiency-scid/\" target=\"_blank\" rel=\"noopener\"> SCID\u003c/a>, also known as “bubble baby” disease. The ailment renders a patient's immune system nonfunctioning. The National Institutes of Health \u003ca href=\"https://www.genome.gov/13014325/learning-about-severe-combined-immunodeficiency-scid/#al-3\" target=\"_blank\" rel=\"noopener\">estimates\u003c/a> approximately 40 to 100 children in the U.S. each year are diagnosed with the malady.\u003c/p>\n\u003cp>A team of UCLA clinical researchers, partially funded by CIRM, genetically modified Evangelina’s own blood stem cells to correct the SCID mutation.\u003c/p>\n\u003cp>She was cured.\u003c/p>\n\u003cp>Evangelina was the first to undergo the treatment, back when she was just a few months old. And now, CIRM says, at least 40 other children have been cured with the same procedure.\u003c/p>\n\u003cfigure id=\"attachment_438299\" class=\"wp-caption alignright\" style=\"max-width: 576px\">\u003cimg class=\"size-full wp-image-438299\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/evangelina_treatment.jpg\" alt=\"Baby in a hospital bed\" width=\"576\" height=\"768\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/01/evangelina_treatment.jpg 576w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/evangelina_treatment-160x213.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/evangelina_treatment-240x320.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/evangelina_treatment-375x500.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/evangelina_treatment-520x693.jpg 520w\" sizes=\"(max-width: 576px) 100vw, 576px\">\u003cfigcaption class=\"wp-caption-text\">Evangelina being treated by Don Kohn and his team in 2012. \u003ccite>(UCLA)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Despite this success, the SCID trial is only in Phase 2. CIRM has only two trials in Phase 3, a necessary step before FDA approval: one testing a \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/10/12/new-stem-cell-technology-could-make-life-easier-for-kidney-disease-patients/\" target=\"_blank\" rel=\"noopener\">new port\u003c/a> for kidney dialysis patients that is made out of human tissue and would not have to be replaced; and one that aims to\u003ca href=\"http://www.cirm.ca.gov/about-cirm/newsroom/press-releases/07202017/phase-3-clinical-trial-targeting-lou-gehrigs-disease\" target=\"_blank\" rel=\"noopener\"> slow down\u003c/a> the progression of Lou Gehrig's disease.\u003c/p>\n\u003cp>Other promising CIRM-funded therapies include slowing or \u003ca href=\"https://newswise.com/articles/jcyte-presents-results-of-clinical-testing-in-retinitis-pigmentosa2\" target=\"_blank\" rel=\"noopener\">reversing\u003c/a> retinitis pigmentosa, a genetic abnormality that destroys a person’s sight; and \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/10/26/paralyzed-patients-regain-movement-in-stem-cell-trial-is-it-too-early-to-celebrate/\" target=\"_blank\" rel=\"noopener\">injecting stem cells\u003c/a> into patients with severe spinal injuries.\u003c/p>\n\u003cp>The FDA has made several of these therapies eligible for priority review by granting them Regenerative Medicine Advanced Therapy, or \u003ca href=\"https://www.fda.gov/BiologicsBloodVaccines/CellularGeneTherapyProducts/ucm537670.htm\" target=\"_blank\" rel=\"noopener\">RMAT\u003c/a>, status.\u003c/p>\n\u003cp>Clinical trials and research in less-advanced stages are ongoing for many other \u003ca href=\"https://www.cirm.ca.gov/grants\" target=\"_blank\" rel=\"noopener\">diseases and conditions\u003c/a>, including brain cancer, diabetes and HIV.\u003c/p>\n\u003cp>But the fact remains: Although this could change in the run-up to the election, no CIRM-funded stem cell treatment has yet to be approved by the FDA.\u003c/p>\n\u003cp>\u003cstrong>Miracles Capture the Imagination\u003c/strong>\u003c/p>\n\u003cp>Even outside of CIRM, only a handful of stem cell-related therapies have been approved for general use. Yet, stem cell research has captured the public's imagination with flashes of the miraculous.\u003c/p>\n\u003cfigure id=\"attachment_438300\" class=\"wp-caption alignright\" style=\"max-width: 594px\">\u003cimg class=\"size-full wp-image-438300\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/GettyImages-149183631.jpg\" alt=\"Middle aged man looks at camera.\" width=\"594\" height=\"396\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/01/GettyImages-149183631.jpg 594w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/GettyImages-149183631-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/GettyImages-149183631-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/GettyImages-149183631-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/GettyImages-149183631-520x347.jpg 520w\" sizes=\"(max-width: 594px) 100vw, 594px\">\u003cfigcaption class=\"wp-caption-text\">Timothy Ray Brown, known as the 'Berlin patient' and the only person to have been cured of AIDS, at a press conference in 2012. \u003ccite>(T.J. Kirkpatrick/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Timothy Ray Brown, the famous \"\u003ca href=\"http://defeathiv.org/berlin/\" target=\"_blank\" rel=\"noopener\">Berlin patient\u003c/a>,\" for example, is an HIV patient who received a bone marrow transplant from a donor with a genetic mutation that endowed resistance to HIV. The transplant effectively cured Brown of the disease. However, there are currently a dearth of potential donors with the correct mutation, so researchers hope to create them, for use in patients' blood systems.\u003c/p>\n\u003cp>The bubble baby breakthrough and positive initial results in other CIRM-funded trials are strong selling points, said David Jensen, a journalist who covers stem cell research and writes a blog called \u003ca href=\"http://californiastemcellreport.blogspot.com/\" target=\"_blank\" rel=\"noopener\">California Stem Cell Report.\u003c/a>\u003c/p>\n\u003cp>\"There are some things CIRM can point to that are really impressive,\" Jensen said. \"It’s a pretty big deal in the world of science. It's the largest single source of funding for embryonic stem cell research in the world, and that’s no small thing.\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>That doesn't necessarily mean voters will agree to re-fund it, he said.\u003c/p>\n\u003cp>Kevin McCormack, CIRM’s director of public communications and patient advocate outreach, said there's still time for CIRM to make a bigger splash.\u003c/p>\n\u003cp>“We’ve still got two more years,” McCormack said. “By 2020 I think people will see that CIRM-funded therapies are not just changing lives but saving lives.”\u003c/p>\n\u003cp>\u003cstrong>Overpromising: Something CIRM Has 'Had to Live With'\u003c/strong>\u003c/p>\n\u003cp>Klein, the backer of Proposition 71, said the 2004 campaign never promised cures during the lifetime of the stem cell agency, only progress toward attaining them.\u003c/p>\n\u003cp>“What we put in the ballot arguments is that we had to make major progress in mitigating disease, and moving toward cures,” Klein said. He feels that certainly has been achieved— and more. “In terms of progress toward the ultimate goal of cures, it’s remarkable what progress has been made.\u003c/p>\n\u003cp>\"When I look back, I think we have out-achieved the representations we put on the ballot.”\u003c/p>\n\u003cp>But even CIRM's McCormack has said, in an \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/06/22/stem-cells-where-science-hope-and-hype-meet/\" target=\"_blank\" rel=\"noopener\">interview with KQED\u003c/a> in 2016, that overpromising by the Proposition 71 campaign is \"something [CIRM] has had to live with.\"\u003c/p>\n\u003cp>Opposition during the \u003ca href=\"https://ballotpedia.org/California_Proposition_71,_Stem_Cell_Research_(2004)\">first ballot measure\u003c/a> was based mostly on religious concerns about using embryonic stem cells, on the large amount of money (the $3 billion price tag actually costs taxpayers $6 billion when interest is included) and on the lack of any guarantees of specific achievements.\u003c/p>\n\u003cp>Jensen expects religious objections to resurface when the election campaigns ramp up — but that those might not gain traction, because the field has expanded into adult and \u003ca href=\"https://stemcell.ucla.edu/induced-pluripotent-stem-cells\" target=\"_blank\" rel=\"noopener\">induced pluripotent stem cells\u003c/a> in addition to embryonic cells.\u003c/p>\n\u003cfigure id=\"attachment_438301\" class=\"wp-caption alignleft\" style=\"max-width: 570px\">\u003cimg class=\"size-full wp-image-438301\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/cured_ar_2016_cover.png\" alt=\"\" width=\"570\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/01/cured_ar_2016_cover.png 570w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/cured_ar_2016_cover-160x168.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/cured_ar_2016_cover-240x253.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/cured_ar_2016_cover-375x395.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/cured_ar_2016_cover-520x547.png 520w\" sizes=\"(max-width: 570px) 100vw, 570px\">\u003cfigcaption class=\"wp-caption-text\">Evangelina Padilla-Vaccaro on the cover of CIRM's \u003ca href=\"https://www.cirm.ca.gov/about-cirm/cirm-annual-reports\">2016 Annual Report\u003c/a>. \u003ccite>(CIRM)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>And since the poster child for stem cell success could very well be the pint-sized and happy-faced Evangelina Padilla-Vaccaro, it may be hard to argue that these concerns outweigh not having to live in a bubble.\u003c/p>\n\u003cp>\"I mean, how can you be against that?\" Jensen said.\u003c/p>\n\u003cp>But some opposition has sprung up even inside the medical community. Barbara Koenig, head of the bioethics program at UCSF, pointed to ongoing concerns about conflict of interest at the agency — 90 percent of all spending benefited organizations that have been represented on the \u003ca href=\"https://www.cirm.ca.gov/board-and-meetings/list-icoc-members\" target=\"_blank\" rel=\"noopener\">governing board\u003c/a>, Jensen has been \u003ca href=\"http://capitolweekly.net/californias-stem-cell-agency-future-uncertain/\" target=\"_blank\" rel=\"noopener\">reporting\u003c/a>— and the public governance that she said has been lacking. (McCormack said the expansion of companies involved in stem cell research has resulted in broader distribution of funds. He also pointed to CIRM's adoption of more stringent\u003ca href=\"https://govt.westlaw.com/calregs/Document/ICD886A9181574C3BADD5946217E13F00?viewType=FullText&originationContext=documenttoc&transitionType=CategoryPageItem&contextData=(sc.Default)&bhcp=1\" target=\"_blank\" rel=\"noopener\"> conflict-of-interest policies \u003c/a>in 2013.)\u003c/p>\n\u003caside class=\"pullquote alignright\">'I didn’t like the over-hyping of the immediate idea that [in 2004] there were cures around the corner. I think we need to be honest about how we’re investing in research.'\u003ccite>Barbara Koenig, UCSF bioethics program\u003cbr>\n\u003c/cite>\u003c/aside>\n\u003cp>Koenig supports stem cell research, but voted against the measure in 2004. And she has serious concerns about its possible renewal.\u003c/p>\n\u003cp>“I didn’t like the overhyping of the immediate idea that there were cures around the corner,” Koenig said. “I think we need to be honest about how we’re investing in research.”\u003c/p>\n\u003cp>Ask Koenig how she might use that proposed $5 billion differently, and she responds with a moment of stunned silence.\u003c/p>\n\u003cp>“Oh my, so many things,” she said. “I would try to figure out how to make sure every child in California has access to basic health services, nutrition, clean water . . . not just make high-priced products, but to improve public health.”\u003c/p>\n\u003cp>She said stem cell research \"privileges these quick-fix biotech approaches, which may make a lot of money but may not benefit the general public.”\u003c/p>\n\u003cp>Another bioethicist, Jodi Halpern of UC Berkeley, said the ballot initiative process is no place for a basic state spending decision.\u003c/p>\n\u003cp>“Why isn’t this a legislative issue?” Halpern asked. “We elect the Legislature to decide where California is going to spend its money. Putting this on the ballot, making it an emotional issue rather than just a financial one, that doesn’t sit right with me.\"\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/FjXiRx7DvzQ'\n title='//www.youtube.com/embed/FjXiRx7DvzQ'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>\u003cstrong>Concerns vs. Cures\u003c/strong>\u003c/p>\n\u003cp>CIRM’s McCormack said he understands the concerns about state funding, but he said he's seen too much good come from the agency to see it wither on the budget-bickering vine.\u003c/p>\n\u003cp>“We are helping change the face of medicine,” he said. “We have so many clinical trials in the pipeline . . . that will pay off with therapies to help people who right now don’t have much of a chance for help, people with unmet medical needs.”\u003c/p>\n\u003cp>At its current spending pace, CIRM will run out of money by the \u003ca href=\"https://www.cirm.ca.gov/sites/default/files/files/agenda/171214_Agedna_Item_%234_FINAL%20Dec%202017%20President%20Report%5B7%5D.pdf\" target=\"_blank\" rel=\"noopener\">end of 2019\u003c/a> — roughly a year before the proposed ballot measure vote. At its December 2017 board meeting, one of the \u003ca href=\"https://www.cirm.ca.gov/sites/default/files/files/agenda/171214_Agenda_Item_%236_Presentation_Draft_1%5B2%5D_0.pdf\" target=\"_blank\" rel=\"noopener\">topics\u003c/a> for discussion was how to slow that spending and extend the agency’s grant-making till the end of 2020.\u003c/p>\n\u003cp>Board members and staffers aren’t involved in the proposed ballot measure, but they’re obviously keen on it, McCormack said.\u003c/p>\n\u003cp>Klein said he commissioned a survey to gauge interest and attitudes toward re-funding the agency. He said the numbers are strongly positive, but he has not released those results. There have been no other California polls on the topic since 2004, according to Jensen.\u003c/p>\n\u003cp>Even if voter attitudes are overwhelmingly favorable toward stem cell research, proponents may find that goodwill might wilt when it comes to passing a ballot measure, UCLA’s Yaroslavsky said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“People do see stem cell research as something they have a stake in, but you’re going to have to explain what we got with the first $3 billion. I suspect their case with the voters will be that we need to keep momentum going. But the question is, 'Will they buy it?' ”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "What the Fitbit Saw During That 4.4 Quake",
"title": "What the Fitbit Saw During That 4.4 Quake",
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"content": "\u003cp>Some of the most useful new research on earthquakes might be coming from -- well, you, via your smartphone and wearable activity tracker.\u003c/p>\n\u003caside class=\"pullquote alignright\">Berkeley users, near the epicenter, got the biggest wake-up call, according to Fitbit.\u003c/aside>\n\u003cp>As a magnitude 4.4 quake \u003ca href=\"https://ww2.kqed.org/news/2018/01/04/rude-awakening-moderate-quake-rattles-east-bay-overnight/\" target=\"_blank\" rel=\"noopener\">jolted people out of their beds\u003c/a> around the Bay Area last week, some of those folks had smartphones that were already at work sending data to scientists via the \u003ca href=\"http://myshake.berkeley.edu/\" target=\"_blank\" rel=\"noopener\">MyShake app\u003c/a> developed at the \u003ca href=\"http://seismo.berkeley.edu/\" target=\"_blank\" rel=\"noopener\">UC Berkeley Seismological Lab\u003c/a>.\u003c/p>\n\u003cp>According to Richard Allen, who heads the lab, instantaneous data came in from 59 phones armed with the app, which uses built-in motion sensors to detect the strength of the shaking and transmit the data to scientists. They can use that data to produce useful maps of the temblor's reach and impact. The app responds so quickly to a quake's first vibrations, that at some point in the next few years, plans are to make it part of a phone-based warning system that can alert users to quakes seconds before the shaking starts where they are.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>[youtube https://www.youtube.com/watch?v=i-UH6oEx5JI&w=560&h=315]Allen was impressed that readings came in from phones farther than 60 miles from the epicenter.\u003c/p>\n\u003cp>\"The data is really clean for this event,\" wrote Allen in an email, \"which encourages us that we can use this for research purposes, and eventually earthquake early warning.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The MyShake app is currently available only for Android phones. But potentially useful data is beginning to come in from other sources that weren't developed with earthquakes in mind.\u003c/p>\n\u003cp>\u003cstrong>Of Fitbits and Fitfulness\u003c/strong>\u003c/p>\n\u003cp>Developers of the \u003ca href=\"https://www.fitbit.com/home\" target=\"_blank\" rel=\"noopener\">Fitbit\u003c/a> series of wearable activity trackers say that when the quake struck, they also got a burst of data. Since the devices also track sleep patterns, they inferred from that data that about 4-in-10 of their Bay Area users were awakened by the quake, which struck at 2:39 a.m. Thursday near the historic Claremont Hotel in Berkeley.\u003c/p>\n\u003cp>The company declined to say how many Bay Area users it has, but a Fitbit spokeswoman told KQED that the numbers are based on \"a representative sample of tens of thousands of aggregated and anonymous Fitbit user data.\"\u003c/p>\n\u003cfigure id=\"attachment_438281\" class=\"wp-caption aligncenter\" style=\"max-width: 858px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/FitbitWakes_180104.png\">\u003cimg class=\"wp-image-438281 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/FitbitWakes_180104.png\" alt=\"Fitbit quake graph\" width=\"858\" height=\"439\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/01/FitbitWakes_180104.png 858w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/FitbitWakes_180104-160x82.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/FitbitWakes_180104-800x409.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/FitbitWakes_180104-768x393.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/FitbitWakes_180104-240x123.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/FitbitWakes_180104-375x192.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/FitbitWakes_180104-520x266.png 520w\" sizes=\"(max-width: 858px) 100vw, 858px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Spike in graph shows people waking up as the Jan. 4 M4.4 quake shook the Bay Area, as registered by Fitbit devices. Click to enlarge. \u003ccite>(Fitbit)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Analysts at the San Francisco-based company could virtually map the epicenter of the quake by looking at the proportion of Fitbit users awakened in various locations. As one would expect, Berkeley users had the biggest wake-up call, with the percentage of wakeful customers leaping from 8 percent to 52 percent as soon as the Hayward Fault started slipping. (The fact that even 8 percent were already awake might imply that Fitbit has a loyal following among insomniacs.) The farther from the epicenter, the fewer Fitbit users were jarred awake -- just 18 percent in San Jose, for example.\u003c/p>\n\u003cp>It's still unclear what value this kind of data might have for seismic research.\u003c/p>\n\u003cp>\"Smartphone data has been quite useful for us at the [lab] so far, and other techniques such as using fiber optic cables are showing promise as well for seismology,\" notes Jennifer Strauss, who is in charge of outreach at the Berkeley lab. \"So, it would be very interesting to explore how other crowdsourced data can be used for earthquake science.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Fitbit analysts also noted that even relatively benign earthquakes can be night-wreckers, as it took an hour for most awakened users to return to \"normal sleep,\" and 90 minutes before those rocked out of bed achieved the REM stage of sleep.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Some of the most useful new research on earthquakes might be coming from -- well, you, via your smartphone and wearable activity tracker.\u003c/p>\n\u003caside class=\"pullquote alignright\">Berkeley users, near the epicenter, got the biggest wake-up call, according to Fitbit.\u003c/aside>\n\u003cp>As a magnitude 4.4 quake \u003ca href=\"https://ww2.kqed.org/news/2018/01/04/rude-awakening-moderate-quake-rattles-east-bay-overnight/\" target=\"_blank\" rel=\"noopener\">jolted people out of their beds\u003c/a> around the Bay Area last week, some of those folks had smartphones that were already at work sending data to scientists via the \u003ca href=\"http://myshake.berkeley.edu/\" target=\"_blank\" rel=\"noopener\">MyShake app\u003c/a> developed at the \u003ca href=\"http://seismo.berkeley.edu/\" target=\"_blank\" rel=\"noopener\">UC Berkeley Seismological Lab\u003c/a>.\u003c/p>\n\u003cp>According to Richard Allen, who heads the lab, instantaneous data came in from 59 phones armed with the app, which uses built-in motion sensors to detect the strength of the shaking and transmit the data to scientists. They can use that data to produce useful maps of the temblor's reach and impact. The app responds so quickly to a quake's first vibrations, that at some point in the next few years, plans are to make it part of a phone-based warning system that can alert users to quakes seconds before the shaking starts where they are.\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/i-UH6oEx5JI'\n title='//www.youtube.com/embed/i-UH6oEx5JI'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>Allen was impressed that readings came in from phones farther than 60 miles from the epicenter.\u003c/p>\n\u003cp>\"The data is really clean for this event,\" wrote Allen in an email, \"which encourages us that we can use this for research purposes, and eventually earthquake early warning.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The MyShake app is currently available only for Android phones. But potentially useful data is beginning to come in from other sources that weren't developed with earthquakes in mind.\u003c/p>\n\u003cp>\u003cstrong>Of Fitbits and Fitfulness\u003c/strong>\u003c/p>\n\u003cp>Developers of the \u003ca href=\"https://www.fitbit.com/home\" target=\"_blank\" rel=\"noopener\">Fitbit\u003c/a> series of wearable activity trackers say that when the quake struck, they also got a burst of data. Since the devices also track sleep patterns, they inferred from that data that about 4-in-10 of their Bay Area users were awakened by the quake, which struck at 2:39 a.m. Thursday near the historic Claremont Hotel in Berkeley.\u003c/p>\n\u003cp>The company declined to say how many Bay Area users it has, but a Fitbit spokeswoman told KQED that the numbers are based on \"a representative sample of tens of thousands of aggregated and anonymous Fitbit user data.\"\u003c/p>\n\u003cfigure id=\"attachment_438281\" class=\"wp-caption aligncenter\" style=\"max-width: 858px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/FitbitWakes_180104.png\">\u003cimg class=\"wp-image-438281 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/01/FitbitWakes_180104.png\" alt=\"Fitbit quake graph\" width=\"858\" height=\"439\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/01/FitbitWakes_180104.png 858w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/FitbitWakes_180104-160x82.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/FitbitWakes_180104-800x409.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/FitbitWakes_180104-768x393.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/FitbitWakes_180104-240x123.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/FitbitWakes_180104-375x192.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/01/FitbitWakes_180104-520x266.png 520w\" sizes=\"(max-width: 858px) 100vw, 858px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Spike in graph shows people waking up as the Jan. 4 M4.4 quake shook the Bay Area, as registered by Fitbit devices. Click to enlarge. \u003ccite>(Fitbit)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Analysts at the San Francisco-based company could virtually map the epicenter of the quake by looking at the proportion of Fitbit users awakened in various locations. As one would expect, Berkeley users had the biggest wake-up call, with the percentage of wakeful customers leaping from 8 percent to 52 percent as soon as the Hayward Fault started slipping. (The fact that even 8 percent were already awake might imply that Fitbit has a loyal following among insomniacs.) The farther from the epicenter, the fewer Fitbit users were jarred awake -- just 18 percent in San Jose, for example.\u003c/p>\n\u003cp>It's still unclear what value this kind of data might have for seismic research.\u003c/p>\n\u003cp>\"Smartphone data has been quite useful for us at the [lab] so far, and other techniques such as using fiber optic cables are showing promise as well for seismology,\" notes Jennifer Strauss, who is in charge of outreach at the Berkeley lab. \"So, it would be very interesting to explore how other crowdsourced data can be used for earthquake science.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Fitbit analysts also noted that even relatively benign earthquakes can be night-wreckers, as it took an hour for most awakened users to return to \"normal sleep,\" and 90 minutes before those rocked out of bed achieved the REM stage of sleep.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp class=\"big-cap-wrap danger-zone\">\u003cspan class=\"big-cap\">W\u003c/span>ith this week’s bellicose boasting about who has the bigger red button on his desk, an alert Thursday from the Centers for Disease Control and Prevention felt more than a bit on the nose.\u003c/p>\n\u003cp class=\"m_-3376017972562176062gmail-danger-zone danger-zone\">With the prospect of actual nuclear war breaking out between North Korea and the United States seeming ever more real, the CDC is moving to prepare health professionals and others on what the public health response would be to a nuclear detonation.\u003c/p>\n\u003cp class=\"m_-3376017972562176062gmail-danger-zone danger-zone\">The CDC announced it is staging a grand rounds — a teaching session — on the topic. The target audience: doctors, nurses, epidemiologists, pharmacists, veterinarians, certified health education specialists, laboratory scientists, and others. The event will be held \u003cspan class=\"aBn\">\u003cspan class=\"aQJ\">Jan. 16\u003c/span>\u003c/span>.\u003c/p>\n\u003cp class=\"danger-zone\">A spokesperson for the agency said planning for the event has been underway for months — in fact, since CDC officials took part in a\u003cb> \u003c/b>“radiation/nuclear incident exercise” led by the Federal Emergency Management Agency last April, Kathy Harben said in an email.\u003c/p>\n\u003cp class=\"danger-zone\">“CDC participants felt it would be a good way to discuss public health preparedness and share resources with states and other partners. State and local partners also have expressed interest in this topic over time,” she said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp class=\"danger-zone\">Still, the timing of the announcement was eerie, coming on the heels of back-to-back threats exchanged between North Korean leader Kim Jong Un and President Donald Trump.\u003c/p>\n\u003cp>“Join us for this session of Grand Rounds to learn what public health programs have done on a federal, state, and local level to prepare for a nuclear detonation,” urges the CDC email advising people on one of the agency’s mailing lists about the session. “Learn how planning and preparation efforts for a nuclear detonation are similar and different from other emergency response planning efforts.”\u003c/p>\n\u003cp>The CDC \u003ca href=\"https://www.cdc.gov/cdcgrandrounds/archives/index.htm\" target=\"_blank\" rel=\"noopener\">holds grand rounds\u003c/a> virtually monthly on topics such as birth defects prevention, diseases spread by ticks, and sodium reduction. A previous grand rounds on \u003ca href=\"https://www.cdc.gov/cdcgrandrounds/archives/2010/03-March.htm\" target=\"_blank\" rel=\"noopener\">radiological and nuclear disaster preparedness\u003c/a> was offered in March 2010.\u003c/p>\n\u003cp>The titles of several of the talks that will make up the session are enough to give one pause, including “Preparing for the Unthinkable,” and “Roadmap to Radiation Preparedness.” Equally unsettling is the image of a nuclear mushroom cloud on the \u003ca href=\"https://www.cdc.gov/cdcgrandrounds/archives/2018/January2018.htm\" target=\"_blank\" rel=\"noopener\">webpage\u003c/a> advertising the event.\u003c/p>\n\u003cp>“While a nuclear detonation is unlikely, it would have devastating results and there would be a limited time to take critical protection steps,” the agency said. “Despite the fear surrounding such an event, planning and preparation can lessen deaths and illness.”\u003c/p>\n\u003cp>“For instance, most people don’t realize that sheltering in place for at least 24 hours is crucial to saving lives and reducing exposure to radiation. While federal, state and local agencies will lead the immediate response efforts, public health will play a key role in responding.”\u003c/p>\n\u003cp>The event will be \u003ca href=\"https://www.cdc.gov/cdcgrandrounds/archives/2018/January2018.htm\" target=\"_blank\" rel=\"noopener\">webcast live\u003c/a> from the CDC headquarters in Atlanta, and the will be posted on the grand rounds archive page a few days later that week.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cspan style=\"font-weight: 400\">This \u003ca href=\"https://www.statnews.com/2018/01/04/cdc-nuclear-war-grand-rounds/\" 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/span>\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"danger-zone\">Still, the timing of the announcement was eerie, coming on the heels of back-to-back threats exchanged between North Korean leader Kim Jong Un and President Donald Trump.\u003c/p>\n\u003cp>“Join us for this session of Grand Rounds to learn what public health programs have done on a federal, state, and local level to prepare for a nuclear detonation,” urges the CDC email advising people on one of the agency’s mailing lists about the session. “Learn how planning and preparation efforts for a nuclear detonation are similar and different from other emergency response planning efforts.”\u003c/p>\n\u003cp>The CDC \u003ca href=\"https://www.cdc.gov/cdcgrandrounds/archives/index.htm\" target=\"_blank\" rel=\"noopener\">holds grand rounds\u003c/a> virtually monthly on topics such as birth defects prevention, diseases spread by ticks, and sodium reduction. A previous grand rounds on \u003ca href=\"https://www.cdc.gov/cdcgrandrounds/archives/2010/03-March.htm\" target=\"_blank\" rel=\"noopener\">radiological and nuclear disaster preparedness\u003c/a> was offered in March 2010.\u003c/p>\n\u003cp>The titles of several of the talks that will make up the session are enough to give one pause, including “Preparing for the Unthinkable,” and “Roadmap to Radiation Preparedness.” Equally unsettling is the image of a nuclear mushroom cloud on the \u003ca href=\"https://www.cdc.gov/cdcgrandrounds/archives/2018/January2018.htm\" target=\"_blank\" rel=\"noopener\">webpage\u003c/a> advertising the event.\u003c/p>\n\u003cp>“While a nuclear detonation is unlikely, it would have devastating results and there would be a limited time to take critical protection steps,” the agency said. “Despite the fear surrounding such an event, planning and preparation can lessen deaths and illness.”\u003c/p>\n\u003cp>“For instance, most people don’t realize that sheltering in place for at least 24 hours is crucial to saving lives and reducing exposure to radiation. While federal, state and local agencies will lead the immediate response efforts, public health will play a key role in responding.”\u003c/p>\n\u003cp>The event will be \u003ca href=\"https://www.cdc.gov/cdcgrandrounds/archives/2018/January2018.htm\" target=\"_blank\" rel=\"noopener\">webcast live\u003c/a> from the CDC headquarters in Atlanta, and the will be posted on the grand rounds archive page a few days later that week.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cspan style=\"font-weight: 400\">This \u003ca href=\"https://www.statnews.com/2018/01/04/cdc-nuclear-war-grand-rounds/\" 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/span>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "The Crippling Ransomware Attack on a San Francisco NPR Member Station",
"title": "The Crippling Ransomware Attack on a San Francisco NPR Member Station",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>\u003cem>Originally published Oct. 31, 2017\u003c/em>\u003c/p>\n\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">L\u003c/span>esley McClurg is trudging through the KQED newsroom, oozing distress.\u003c/p>\n\u003cp>McClurg, who in the course of her career as a radio reporter has conducted interviews amid raging fires and torrential floods, has finally met her match: an office printer. She has just spent an entire hour trying to get her radio script to print, a task that took the cumulative analytical skills of three nearby co-workers plus a guy from IT.\u003c/p>\n\u003cp>“And now I need to go on the radio and sound like I’m calm and relaxed and NPR-friendly,” McClurg tells me. “But, really, I need to scream.”\u003c/p>\n\u003cp>And so went Day 33 of the Great KQED Ransomware Attack.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>This summer, criminals somewhere in Russia, Ukraine or maybe down the block, hacked into KQED’s computer system, installed malicious code that encrypted the station’s files, software and servers, and demanded money for their safe return. The perpetrators, as is routine in ransomware attacks, demanded payment in the form of the cryptocurrency bitcoin—if the victims ever wanted to see their data alive again. The message, rife with grammatical and spelling errors (cold comfort to no one but the copy editors), included directions on how to recover the data in “3 Easy Step” (sic), with step one being the transfer of funds.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'It's not some teenager sitting in his garage. These are effectively organized crime.'\u003ccite>Elizabeth Weise, USA Today\u003c/cite>\u003c/aside>\n\u003cp>The chaos commenced on June 15, as KQED’s employees began suddenly reporting computer crashes en masse. The IT department at the San Francisco-based NPR and PBS station decided to play it safe—they shut down the entire network to stop the malware’s spread.\u003c/p>\n\u003cp>The results were difficult to face: Phones went dead; the internet vanished; reporters’ audio interviews disappeared. And it meant the only way the head of IT, John Reilly, could get a message out to each of the 503 full- and part-time employees to keep their hands off their computers was to post handwritten signs at every entrance and on every desk.\u003c/p>\n\u003cp>KQED, one of the largest public media companies in America, has been hobbling its way to recovery ever since. What was it like? Think of a really boring episode of “The Twilight Zone”—or better yet, “Black Mirror.” Or getting stuck in an absurdist satire about human dependence on technology. Everyone had their particular breaking point, triggered by one Rube Goldbergian workaround or another.\u003c/p>\n\u003cp>One afternoon, a KQED marketing employee attempted to send out a meeting agenda in a single email to some 60 people. Our temporary email system wouldn’t allow grouping of multiple addresses into one alias, so each destination had to be entered one at a time. Any tiny problem with the syntax—an extra period here, an omitted semicolon there—grounded the message until you could figure it out. Four hours, that job took.\u003c/p>\n\u003cfigure id=\"attachment_436762\" class=\"wp-caption aligncenter\" style=\"max-width: 1436px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/OnQComp_02-e1509482625551.png\">\u003cimg class=\"size-full wp-image-436762\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/OnQComp_02-e1509482625551.png\" alt=\"\" width=\"1436\" height=\"1445\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551.png 1436w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-160x161.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-800x805.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-768x773.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-1020x1026.png 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-1180x1187.png 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-960x966.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-240x242.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-375x377.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-520x523.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-32x32.png 32w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-50x50.png 50w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-64x64.png 64w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-96x96.png 96w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-128x128.png 128w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-150x150.png 150w\" sizes=\"(max-width: 1436px) 100vw, 1436px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Managing editor Ethan Lindsey (R) leads the morning story meeting on Sept. 25, 2017. Pictured (L-R) are: politics and government reporter Marisa Lagos, photo/video intern Serginho Roosblad, cartoonist Mark Fiore, producer Sam Harnett, editor Erika Kelly. \u003ccite>(Alison Yin Photography)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>It’s a Problem\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">R\u003c/span>ansomware—it’s a growth industry. Last week, a new strain called \"Bad Rabbit\"\u003ca href=\"http://www.zdnet.com/article/bad-rabbit-ransomware-spread-using-leaked-nsa-eternalromance-exploit-researchers-confirm/\" target=\"_blank\" rel=\"noopener noreferrer\"> hit computer systems\u003c/a> in Russia, Eastern Europe and beyond. This year, a posse of federal agencies, including the Justice Department and the CIA, issued a report describing ransomware as the “fastest growing malware threat, targeting users of all types—from the home user to the corporate network.”\u003c/p>\n\u003cp>And in another study, anti-virus software maker Symantec estimated 463,000 ransomware attacks worldwide in 2016, a 36 percent increase from the previous year.\u003c/p>\n\u003cp>Entrepreneurial hackers also have innovated “ransomware as a service,” in which they peddle kits to criminals who are less technically adept.\u003c/p>\n\u003cp>“It’s not some teenager sitting in his garage,” USA Today tech reporter Elizabeth Weise told KQED. “These are effectively organized crime; they have offices, they have office workers who come in.”\u003c/p>\n\u003caside class=\"alignleft\">\u003cem>Ransomware Survival Tip: Triage\u003c/em> \n\u003cp>You can't fix everything at once, so think like a triage doctor and prioritize essential functions. KQED priorities: Check and secure critical information (membership data was off-site, so was not breached), pay staff, pay bills, and keep daily radio news on the air. What had to wait: Networked printing, high-speed internet and access to stored documents and audio.\u003c/p>\n\u003c/aside>\n\u003cp>Over the last two years, researchers from New York University and Google tracked about $25 million in victim payments. Not bad, but not the global drug trade either. Estimates of monetary gain for perpetrators of the WannaCry ransomware scourge, a worldwide attack last May on computers running the Microsoft Windows operating system, were remarkably low, even though the virus disabled more than 200,000 computers, including those of FedEx and England’s National Health Service.\u003c/p>\n\u003cp>That does not, however, take into account the cost in lost sales and business interruptions, which can be considerably higher. The U.K. company Reckitt Benckiser, maker of Clearasil, Lysol and Airborne, estimated a $117 million loss resulting from the Petya ransomware attack in June.\u003c/p>\n\u003cp>In KQED’s case, the attackers demanded 1.7 bitcoins per computer (roughly $2,500 at the exchange rate of the time) or—act now!—just $27,000 for the lot.\u003c/p>\n\u003cp>KQED briefly considered paying up, said Chief Technology Officer Dan Mansergh, but abandoned the idea after the FBI laid out the risks. They were: being seen as an easy mark; inclusion of code in the decryption key that would set the stage for future intrusions; and failure of the perps to keep their part of the bargain to set your data free.\u003c/p>\n\u003cp>KQED has yet to fully calculate the attack’s cost, but much of it will be in IT. In fiscal year 2018, the company is allocating $475,000 for new network protections. Those funds will pay for four new IT employees, plus more sophisticated anti-virus software.\u003c/p>\n\u003cp>As for the cost in employee productivity and stress? A lot.\u003c/p>\n\u003cp>\u003cstrong>‘Worst Stress of My Life’\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">T\u003c/span>he attack took place on a Thursday. The next day, news reporters and editors at KQED, the most-listened-to radio station in the Bay Area, could access the internet only through personal hot spots on their cellphones. Reporters read stories into their recording decks to get on the air and didn’t use sound bites; no one crumpled cellophane to emulate the sound of a fire, but it was still old school.\u003c/p>\n\u003caside class=\"alignright\">\u003ca href=\"https://ww2.kqed.org/futureofyou/how-to-make-it-harder-for-malware-to-shut-you-down/\">How to Make It Harder for Malware to Shut You Down\u003c/a>\u003cbr>\nFor 18 days before the ransomware attack actually commenced, the implanted malware sat dormant in KQED’s computer system, probably sniffing out usernames and passwords. When the malware got hold of an account with the ability to enter anywhere and do anything, it propagated throughout the network, infecting machines and locking up files. \u003ca href=\"https://ww2.kqed.org/futureofyou/how-to-make-it-harder-for-malware-to-shut-you-down/\" target=\"_blank\" rel=\"noopener noreferrer\">Read more...\u003c/a>\n\u003c/aside>\n\u003cp>The station's weekly current affairs television program, \u003cem>KQED Newsroom,\u003c/em> had to abandon its original production plans and run a previously aired special show. And when the television studios were still out the following week, the staff took production out of the building, to a makeshift studio at UC Hastings College of the Law and another at the \u003ca href=\"https://www.eff.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Electronic Frontier Foundation\u003c/a> for \u003ca href=\"https://ww2.kqed.org/news/2017/06/23/kqed-newsroom-on-the-road/\" target=\"_blank\" rel=\"noopener noreferrer\">a segment\u003c/a> on ransomware.\u003c/p>\n\u003cp>Meanwhile, IT collected and wiped clean every computer that the malware, called Samas, had so much as breathed on. But that was nowhere near the end of it. To stop the infection from spreading, IT had taken the network down. No phones, one rickety internet router, no access to documents or audio, and the only way to print was to walk your laptop to a printer and plug in the cable. And after the malware was eradicated, the network did not come back up.\u003c/p>\n\u003cp>“We could not just put it back the way it was, because there were all kinds of security holes,” said Michael Kadel, KQED’s network systems engineer.\u003c/p>\n\u003cp>So the staff went to work creating temporary systems to keep things functioning until a more secure infrastructure could be built. They worked long hours, long being a euphemism for 12-, 16- and 20-hour shifts at a time.\u003c/p>\n\u003cp>“Worst stress of my life,” said IT director Reilly.\u003c/p>\n\u003cp>Kadel agreed. “A solid two months of just terrible, terrible stress.”\u003c/p>\n\u003cfigure id=\"attachment_436503\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/10/MinaKim.jpg\">\u003cimg class=\"size-full wp-image-436503\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/10/MinaKim.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim-520x347.jpg 520w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Mina Kim, afternoon drive-time news anchor and Forum host. 'Initially, we all had this attitude, the show must go on. After that surge of adrenaline and can-do attitude subsides, you’re just exhausted. It’s workaround fatigue.' \u003ccite>(Arash Malekzadeh/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kadel said he’d once suffered through cancer. “This was way worse.”\u003c/p>\n\u003cp>Those views are not necessarily unheard of in these types of situations, said Jonah Silas Sheridan, a Bay Area computer security consultant for nonprofits.\u003c/p>\n\u003cp>“It’s a big deal for security practitioners,” Sheridan said. “How can you secure someone’s systems when you are in a place of sleeplessness and arrhythmia yourself?”\u003c/p>\n\u003cp>Meanwhile, the radio news team and their engineers went full-on \u003ca href=\"https://www.youtube.com/watch?v=fF6FUVxAVzI&index=6&list=PL6OtFuSjxy8q59zJ86r4akeO8pGjVf5D8\" target=\"_blank\" rel=\"noopener noreferrer\">MacGyver\u003c/a> to rig a system that kept the news on the air. In normal times, reporters and editors were fully networked, with universal real-time access to every story, revision and audio clip. Now, every story had to pass through three or four computers. Audio had to be uploaded to one site, then downloaded somewhere else. Cellphones and the instant messaging app Slack were conscripted into the workflow. The motto: Whatever works.\u003c/p>\n\u003cp>As weeks turned into months, the newsfolk reported on the congressional health care debate, the move to end DACA, the total solar eclipse and the eruption of far-right rallies in Charlottesville and other cities, all using a system that took three to four times the usual amount of time.\u003c/p>\n\u003caside class=\"alignleft\">\u003cem>Ransomware Survival Tip: Ease Work Rules\u003c/em>Do what you can to ease stress and tech difficulties by relaxing work rules. KQED staff often found it more productive to work in neighborhood cafes or at home, where they had high-speed internet. And be clear with staff about how long it will take to resume normal operations.\u003c/aside>\n\u003cp>The audience most likely didn’t notice. But the staff found the relentless workarounds, jury-rigging and duct-taping exhausting.\u003c/p>\n\u003cp>“Initially, we all had this attitude, ‘The show must go on,’ ” said Mina Kim, the afternoon drive-time news anchor. “After that surge of adrenaline and can-do attitude subsides, you’re just exhausted. It’s workaround fatigue.”\u003c/p>\n\u003cp>I asked John Reilly, who’s done a lot of consulting in his career, if he’d ever seen an organization experience the level of disruption KQED had. “No, not through an attack,” he said.\u003c/p>\n\u003cp>How could it have happened? And how much at risk are other companies?\u003c/p>\n\u003cp>\u003cstrong>Convenience vs. Security\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">S\u003c/span>ecurity experts like to recite an aphorism to describe the basic dilemma of their profession.\u003c/p>\n\u003cp>The safest computer, they say, is one sitting in a metal box in a locked room, switched off and unconnected to anything. Such a computer, goeth the Parable of the Completely Safe Workstation, is impenetrable.\u003c/p>\n\u003cp>And utterly useless.\u003c/p>\n\u003cp>“You do have to make trade-offs of usability and convenience for security,” said Paul Guthrie, a vice president for PSC, the security firm hired by KQED after the attack. “And sometimes the pendulum swings too far.”\u003c/p>\n\u003cfigure id=\"attachment_436589\" class=\"wp-caption alignright\" style=\"max-width: 491px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/10/KadelReilly3.jpg\">\u003cimg class=\" wp-image-436589\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/10/KadelReilly3-1020x766.jpg\" alt=\"\" width=\"491\" height=\"369\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3-1020x766.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3-800x601.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3-768x577.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3-1180x886.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3-960x721.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3-375x282.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3-520x391.jpg 520w\" sizes=\"(max-width: 491px) 100vw, 491px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">KQED Director of IT John Reilly and Network Systems Engineer Michael Kadel. Much of the burden for rebuilding the network in a safer way fell on them. \u003ccite>(Arash Malekzadeh/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Guthrie is one of the tech and security people both inside and outside KQED who agree the company’s pendulum over the years had strayed quite a way over into convenience territory.\u003c/p>\n\u003cp>Kadel and Reilly, who had been the head of IT for a year and a half when the attack hit, were frank about the vulnerabilities the ransomware exposed.\u003c/p>\n\u003cp>“Honestly, I’m surprised this didn’t happen long ago,” Reilly said.\u003c/p>\n\u003cp>Kadel put it this way: The culture of KQED, a multifaceted media organization that produces a huge amount of radio, TV, educational materials and websites, tilted toward easier collaboration. If someone wanted to put the video from a news interview into the video editing system, for instance, and then share the audio with radio reporters, they could. And they could do that from the same computer they used for daily email.\u003c/p>\n\u003cp>But security people know this type of one-big-network-for-all is risky. Their job, after all, is to keep malicious hackers from turning the place into “The Day the Earth Stood Still.” And when systems connect to each other like they could at KQED, malicious actors can more easily infect the entire infrastructure.\u003c/p>\n\u003cp>Another problem: The station’s IT department allowed employees to download and install free software from the web. IT folks call this the “granting of local admin rights.” Many in the industry also call it “A Catastrophe Waiting to Happen.” Free software is often laden with viruses, worms and other nasty extras.\u003c/p>\n\u003caside class=\"alignleft\">\u003cem>Ransomware Survival Tip: Establish a Walk-Up IT Help Desk\u003c/em>Shield your IT staff from the deluge of help requests, while providing a clear avenue for employees to get help. At KQED, IT set up long tables in an open area and staffed a walk-up help desk all day. KQED Chief of Staff Jason Black laid down the law in a companywide memo: 'Individual requests, side doors, hallway nudges, note passing, private Slacking, hand and/or smoke signals to IT or Systems Engineering are not helpful right now.'\u003c/aside>\n\u003cp>Kadel said one reason IT gave the staff free rein was due to a lack of IT employees to oversee the process.\u003c/p>\n\u003cp>“You can’t visit 600 people to do a Flash update,” he said. “You have to let people do their own Flash update.”\u003c/p>\n\u003cp>Lots of consultants say companies routinely shortchange IT. But Kadel may have a point. At the time of the attack, KQED employed nine IT employees to service roughly 503 workers. That means IT represented less than 2 percent of the organization’s workforce.\u003c/p>\n\u003cp>A 2016 survey of media and entertainment companies by the research firm Gartner found that IT workers made up an average of 6.5 percent of employees, more than three times the level at KQED. Across all industries, the number is 5 percent.\u003c/p>\n\u003cp>Finally, KQED used standard anti-virus programs to protect its system. But hackers know how to get around these by altering their code. In a test run by KQED’s security consultant, just 10 out of 60 off-the-shelf anti-virus programs recognized the variant of Samas that hit the company.\u003c/p>\n\u003cp>[contextly_sidebar id=\"3n0wfcXpPVXE3R3ShFbLhAMSkRo0pfNf\"]“If somebody wishes to put out a new variant, it takes a little bit for the anti-virus vendors to catch up,” said Guthrie.\u003c/p>\n\u003cp>KQED is now plugging all these holes, redesigning its network and all of its media systems. It’s also deploying much more sophisticated anti-virus software that looks for processes that are outside the normal behavior, shutting them down. Among the new IT employees coming on board: a full-time security pro.\u003c/p>\n\u003cp>\u003cstrong>What Kept Working\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">W\u003c/span>hen everything went down, the safest place for data turned out to be the cloud. KQED lost no member or donor information, because it wasn’t stored in the network. And as the attack short-circuited system after system, KQED’s network of websites kept on keeping on. How so?\u003c/p>\n\u003cp>“We’ve moved most of KQED.org to be hosted in the cloud, so it’s sitting on [Amazon] servers,” said Tim Olson, KQED’s chief digital officer. “It’s more disaster recovery, more efficient for everybody.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'In some ways I view this as a dress rehearsal. Because we’re in an earthquake zone.'\u003ccite>John Reilly, KQED\u003c/cite>\u003c/aside>\n\u003cp>The cloud is “certainly a strategy that a lot of smaller organizations employ, because it’s a lot of work to keep your systems patched,” said IT consultant Sheridan. And big cloud services like those of Amazon, Microsoft and Google spend tons of money to pay for cybersecurity. “That being said, you’re now in a very deep trust relationship with someone else, Sheridan said.\u003c/p>\n\u003cp>But in terms of maintaining access to data after the attack, the cloud was the silver lining. When everything went down and all of KQED’s storage systems became inaccessible, there sat my audio interviews, my budget numbers, my everything, safe and snug on Google Drive.\u003c/p>\n\u003cp>\u003cstrong>Talking About It\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">B\u003c/span>elow the hard truths about security vs. convenience now adorning whiteboards at KQED are a few about survival, too.\u003c/p>\n\u003cp>“We've learned a lot,” said Reilly. “People have realized that we weren't prepared in a lot of ways. But then again, in some ways I view this as a dress rehearsal. Because we’re in an earthquake zone.”\u003c/p>\n\u003cp>What’s being done to fight back against the spreading threat of ransomware across the world?\u003c/p>\n\u003cp>Companies and individuals dealing with a ransomware attack may find help at NoMoreRansom.org, an initiative of the Netherlands’ police, Europol and the computer security companies Kaspersky Lab and McAfee. The website includes decryption tools for dozens of known ransomware infections, as well as advice on how to prevent an attack in the first place. (Update Nov. 15: The U.S. Dept. of Homeland Security has \u003ca href=\"https://www.washingtonpost.com/world/national-security/us-official-15-percent-of-agencies-used-kaspersky-software/2017/11/14/32019dec-c994-11e7-b506-8a10ed11ecf5_story.html?utm_term=.7f5c8ad59b58/\" target=\"_blank\" rel=\"noopener noreferrer\">banned\u003c/a> federal agencies from using Kaspersky products due to alleged ties to the Russian government and intelligence services.)\u003c/p>\n\u003caside class=\"alignleft\">\u003cem>Ransomware Survival Tip: Use the Cloud and Your Cell Network\u003c/em>Slack, Google Drive, Dropbox and cellphones can substitute for networked communications and make transferring files easy.\u003c/aside>\n\u003cp>One thing every expert recommends: Back up like crazy.\u003c/p>\n\u003cp>“The number one thing to do is back up your data,” said Alexander Garcia-Tobar, co-founder of ValiMail, a San Francisco company that authenticates email in order to prevent intrusions like ransomware.\u003c/p>\n\u003cp>“If you’re backing up on a daily basis or even on a weekly basis, you back up to before the known infection and you cross your fingers.”\u003c/p>\n\u003cp>Guthrie said high-end tools designed to keep things running in the event of a catastrophe can be a lifesaver. But they are expensive.\u003c/p>\n\u003cp>“There’s network backup and restore systems that are very good and very fast and very expensive,” said Guthrie. “Smaller companies tend to do what they can with the resources they’re given.”\u003c/p>\n\u003cp>KQED decided to go public with our tale as a kind of public service, so that other organizations can learn not only from our mistakes but also from the way we kept functioning with minimal disruption to the public, despite maximum disruption internally.\u003c/p>\n\u003cp>Sheridan said opening up can only help.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“You might be surprised at how many different kinds of breaches, how many kinds of incidents, have happened in other organizations, and continue to happen,” he said. “We would be well-advised as a community to figure out a way to talk about these things without shame. We need to learn from them collectively.”\u003c/p>\n\n",
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"excerpt": "On June 15, a ransomware attack took down the computer network of KQED, one of the largest public media companies in America. Here's how we survived and what we learned.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Originally published Oct. 31, 2017\u003c/em>\u003c/p>\n\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">L\u003c/span>esley McClurg is trudging through the KQED newsroom, oozing distress.\u003c/p>\n\u003cp>McClurg, who in the course of her career as a radio reporter has conducted interviews amid raging fires and torrential floods, has finally met her match: an office printer. She has just spent an entire hour trying to get her radio script to print, a task that took the cumulative analytical skills of three nearby co-workers plus a guy from IT.\u003c/p>\n\u003cp>“And now I need to go on the radio and sound like I’m calm and relaxed and NPR-friendly,” McClurg tells me. “But, really, I need to scream.”\u003c/p>\n\u003cp>And so went Day 33 of the Great KQED Ransomware Attack.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This summer, criminals somewhere in Russia, Ukraine or maybe down the block, hacked into KQED’s computer system, installed malicious code that encrypted the station’s files, software and servers, and demanded money for their safe return. The perpetrators, as is routine in ransomware attacks, demanded payment in the form of the cryptocurrency bitcoin—if the victims ever wanted to see their data alive again. The message, rife with grammatical and spelling errors (cold comfort to no one but the copy editors), included directions on how to recover the data in “3 Easy Step” (sic), with step one being the transfer of funds.\u003c/p>\n\u003caside class=\"pullquote alignleft\">'It's not some teenager sitting in his garage. These are effectively organized crime.'\u003ccite>Elizabeth Weise, USA Today\u003c/cite>\u003c/aside>\n\u003cp>The chaos commenced on June 15, as KQED’s employees began suddenly reporting computer crashes en masse. The IT department at the San Francisco-based NPR and PBS station decided to play it safe—they shut down the entire network to stop the malware’s spread.\u003c/p>\n\u003cp>The results were difficult to face: Phones went dead; the internet vanished; reporters’ audio interviews disappeared. And it meant the only way the head of IT, John Reilly, could get a message out to each of the 503 full- and part-time employees to keep their hands off their computers was to post handwritten signs at every entrance and on every desk.\u003c/p>\n\u003cp>KQED, one of the largest public media companies in America, has been hobbling its way to recovery ever since. What was it like? Think of a really boring episode of “The Twilight Zone”—or better yet, “Black Mirror.” Or getting stuck in an absurdist satire about human dependence on technology. Everyone had their particular breaking point, triggered by one Rube Goldbergian workaround or another.\u003c/p>\n\u003cp>One afternoon, a KQED marketing employee attempted to send out a meeting agenda in a single email to some 60 people. Our temporary email system wouldn’t allow grouping of multiple addresses into one alias, so each destination had to be entered one at a time. Any tiny problem with the syntax—an extra period here, an omitted semicolon there—grounded the message until you could figure it out. Four hours, that job took.\u003c/p>\n\u003cfigure id=\"attachment_436762\" class=\"wp-caption aligncenter\" style=\"max-width: 1436px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/OnQComp_02-e1509482625551.png\">\u003cimg class=\"size-full wp-image-436762\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/OnQComp_02-e1509482625551.png\" alt=\"\" width=\"1436\" height=\"1445\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551.png 1436w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-160x161.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-800x805.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-768x773.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-1020x1026.png 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-1180x1187.png 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-960x966.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-240x242.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-375x377.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-520x523.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-32x32.png 32w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-50x50.png 50w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-64x64.png 64w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-96x96.png 96w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-128x128.png 128w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/OnQComp_02-e1509482625551-150x150.png 150w\" sizes=\"(max-width: 1436px) 100vw, 1436px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Managing editor Ethan Lindsey (R) leads the morning story meeting on Sept. 25, 2017. Pictured (L-R) are: politics and government reporter Marisa Lagos, photo/video intern Serginho Roosblad, cartoonist Mark Fiore, producer Sam Harnett, editor Erika Kelly. \u003ccite>(Alison Yin Photography)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>It’s a Problem\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">R\u003c/span>ansomware—it’s a growth industry. Last week, a new strain called \"Bad Rabbit\"\u003ca href=\"http://www.zdnet.com/article/bad-rabbit-ransomware-spread-using-leaked-nsa-eternalromance-exploit-researchers-confirm/\" target=\"_blank\" rel=\"noopener noreferrer\"> hit computer systems\u003c/a> in Russia, Eastern Europe and beyond. This year, a posse of federal agencies, including the Justice Department and the CIA, issued a report describing ransomware as the “fastest growing malware threat, targeting users of all types—from the home user to the corporate network.”\u003c/p>\n\u003cp>And in another study, anti-virus software maker Symantec estimated 463,000 ransomware attacks worldwide in 2016, a 36 percent increase from the previous year.\u003c/p>\n\u003cp>Entrepreneurial hackers also have innovated “ransomware as a service,” in which they peddle kits to criminals who are less technically adept.\u003c/p>\n\u003cp>“It’s not some teenager sitting in his garage,” USA Today tech reporter Elizabeth Weise told KQED. “These are effectively organized crime; they have offices, they have office workers who come in.”\u003c/p>\n\u003caside class=\"alignleft\">\u003cem>Ransomware Survival Tip: Triage\u003c/em> \n\u003cp>You can't fix everything at once, so think like a triage doctor and prioritize essential functions. KQED priorities: Check and secure critical information (membership data was off-site, so was not breached), pay staff, pay bills, and keep daily radio news on the air. What had to wait: Networked printing, high-speed internet and access to stored documents and audio.\u003c/p>\n\u003c/aside>\n\u003cp>Over the last two years, researchers from New York University and Google tracked about $25 million in victim payments. Not bad, but not the global drug trade either. Estimates of monetary gain for perpetrators of the WannaCry ransomware scourge, a worldwide attack last May on computers running the Microsoft Windows operating system, were remarkably low, even though the virus disabled more than 200,000 computers, including those of FedEx and England’s National Health Service.\u003c/p>\n\u003cp>That does not, however, take into account the cost in lost sales and business interruptions, which can be considerably higher. The U.K. company Reckitt Benckiser, maker of Clearasil, Lysol and Airborne, estimated a $117 million loss resulting from the Petya ransomware attack in June.\u003c/p>\n\u003cp>In KQED’s case, the attackers demanded 1.7 bitcoins per computer (roughly $2,500 at the exchange rate of the time) or—act now!—just $27,000 for the lot.\u003c/p>\n\u003cp>KQED briefly considered paying up, said Chief Technology Officer Dan Mansergh, but abandoned the idea after the FBI laid out the risks. They were: being seen as an easy mark; inclusion of code in the decryption key that would set the stage for future intrusions; and failure of the perps to keep their part of the bargain to set your data free.\u003c/p>\n\u003cp>KQED has yet to fully calculate the attack’s cost, but much of it will be in IT. In fiscal year 2018, the company is allocating $475,000 for new network protections. Those funds will pay for four new IT employees, plus more sophisticated anti-virus software.\u003c/p>\n\u003cp>As for the cost in employee productivity and stress? A lot.\u003c/p>\n\u003cp>\u003cstrong>‘Worst Stress of My Life’\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">T\u003c/span>he attack took place on a Thursday. The next day, news reporters and editors at KQED, the most-listened-to radio station in the Bay Area, could access the internet only through personal hot spots on their cellphones. Reporters read stories into their recording decks to get on the air and didn’t use sound bites; no one crumpled cellophane to emulate the sound of a fire, but it was still old school.\u003c/p>\n\u003caside class=\"alignright\">\u003ca href=\"https://ww2.kqed.org/futureofyou/how-to-make-it-harder-for-malware-to-shut-you-down/\">How to Make It Harder for Malware to Shut You Down\u003c/a>\u003cbr>\nFor 18 days before the ransomware attack actually commenced, the implanted malware sat dormant in KQED’s computer system, probably sniffing out usernames and passwords. When the malware got hold of an account with the ability to enter anywhere and do anything, it propagated throughout the network, infecting machines and locking up files. \u003ca href=\"https://ww2.kqed.org/futureofyou/how-to-make-it-harder-for-malware-to-shut-you-down/\" target=\"_blank\" rel=\"noopener noreferrer\">Read more...\u003c/a>\n\u003c/aside>\n\u003cp>The station's weekly current affairs television program, \u003cem>KQED Newsroom,\u003c/em> had to abandon its original production plans and run a previously aired special show. And when the television studios were still out the following week, the staff took production out of the building, to a makeshift studio at UC Hastings College of the Law and another at the \u003ca href=\"https://www.eff.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Electronic Frontier Foundation\u003c/a> for \u003ca href=\"https://ww2.kqed.org/news/2017/06/23/kqed-newsroom-on-the-road/\" target=\"_blank\" rel=\"noopener noreferrer\">a segment\u003c/a> on ransomware.\u003c/p>\n\u003cp>Meanwhile, IT collected and wiped clean every computer that the malware, called Samas, had so much as breathed on. But that was nowhere near the end of it. To stop the infection from spreading, IT had taken the network down. No phones, one rickety internet router, no access to documents or audio, and the only way to print was to walk your laptop to a printer and plug in the cable. And after the malware was eradicated, the network did not come back up.\u003c/p>\n\u003cp>“We could not just put it back the way it was, because there were all kinds of security holes,” said Michael Kadel, KQED’s network systems engineer.\u003c/p>\n\u003cp>So the staff went to work creating temporary systems to keep things functioning until a more secure infrastructure could be built. They worked long hours, long being a euphemism for 12-, 16- and 20-hour shifts at a time.\u003c/p>\n\u003cp>“Worst stress of my life,” said IT director Reilly.\u003c/p>\n\u003cp>Kadel agreed. “A solid two months of just terrible, terrible stress.”\u003c/p>\n\u003cfigure id=\"attachment_436503\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/10/MinaKim.jpg\">\u003cimg class=\"size-full wp-image-436503\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/10/MinaKim.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/MinaKim-520x347.jpg 520w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Mina Kim, afternoon drive-time news anchor and Forum host. 'Initially, we all had this attitude, the show must go on. After that surge of adrenaline and can-do attitude subsides, you’re just exhausted. It’s workaround fatigue.' \u003ccite>(Arash Malekzadeh/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Kadel said he’d once suffered through cancer. “This was way worse.”\u003c/p>\n\u003cp>Those views are not necessarily unheard of in these types of situations, said Jonah Silas Sheridan, a Bay Area computer security consultant for nonprofits.\u003c/p>\n\u003cp>“It’s a big deal for security practitioners,” Sheridan said. “How can you secure someone’s systems when you are in a place of sleeplessness and arrhythmia yourself?”\u003c/p>\n\u003cp>Meanwhile, the radio news team and their engineers went full-on \u003ca href=\"https://www.youtube.com/watch?v=fF6FUVxAVzI&index=6&list=PL6OtFuSjxy8q59zJ86r4akeO8pGjVf5D8\" target=\"_blank\" rel=\"noopener noreferrer\">MacGyver\u003c/a> to rig a system that kept the news on the air. In normal times, reporters and editors were fully networked, with universal real-time access to every story, revision and audio clip. Now, every story had to pass through three or four computers. Audio had to be uploaded to one site, then downloaded somewhere else. Cellphones and the instant messaging app Slack were conscripted into the workflow. The motto: Whatever works.\u003c/p>\n\u003cp>As weeks turned into months, the newsfolk reported on the congressional health care debate, the move to end DACA, the total solar eclipse and the eruption of far-right rallies in Charlottesville and other cities, all using a system that took three to four times the usual amount of time.\u003c/p>\n\u003caside class=\"alignleft\">\u003cem>Ransomware Survival Tip: Ease Work Rules\u003c/em>Do what you can to ease stress and tech difficulties by relaxing work rules. KQED staff often found it more productive to work in neighborhood cafes or at home, where they had high-speed internet. And be clear with staff about how long it will take to resume normal operations.\u003c/aside>\n\u003cp>The audience most likely didn’t notice. But the staff found the relentless workarounds, jury-rigging and duct-taping exhausting.\u003c/p>\n\u003cp>“Initially, we all had this attitude, ‘The show must go on,’ ” said Mina Kim, the afternoon drive-time news anchor. “After that surge of adrenaline and can-do attitude subsides, you’re just exhausted. It’s workaround fatigue.”\u003c/p>\n\u003cp>I asked John Reilly, who’s done a lot of consulting in his career, if he’d ever seen an organization experience the level of disruption KQED had. “No, not through an attack,” he said.\u003c/p>\n\u003cp>How could it have happened? And how much at risk are other companies?\u003c/p>\n\u003cp>\u003cstrong>Convenience vs. Security\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">S\u003c/span>ecurity experts like to recite an aphorism to describe the basic dilemma of their profession.\u003c/p>\n\u003cp>The safest computer, they say, is one sitting in a metal box in a locked room, switched off and unconnected to anything. Such a computer, goeth the Parable of the Completely Safe Workstation, is impenetrable.\u003c/p>\n\u003cp>And utterly useless.\u003c/p>\n\u003cp>“You do have to make trade-offs of usability and convenience for security,” said Paul Guthrie, a vice president for PSC, the security firm hired by KQED after the attack. “And sometimes the pendulum swings too far.”\u003c/p>\n\u003cfigure id=\"attachment_436589\" class=\"wp-caption alignright\" style=\"max-width: 491px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/10/KadelReilly3.jpg\">\u003cimg class=\" wp-image-436589\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2019/10/KadelReilly3-1020x766.jpg\" alt=\"\" width=\"491\" height=\"369\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3-1020x766.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3-800x601.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3-768x577.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3-1180x886.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3-960x721.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3-375x282.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2019/10/KadelReilly3-520x391.jpg 520w\" sizes=\"(max-width: 491px) 100vw, 491px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">KQED Director of IT John Reilly and Network Systems Engineer Michael Kadel. Much of the burden for rebuilding the network in a safer way fell on them. \u003ccite>(Arash Malekzadeh/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Guthrie is one of the tech and security people both inside and outside KQED who agree the company’s pendulum over the years had strayed quite a way over into convenience territory.\u003c/p>\n\u003cp>Kadel and Reilly, who had been the head of IT for a year and a half when the attack hit, were frank about the vulnerabilities the ransomware exposed.\u003c/p>\n\u003cp>“Honestly, I’m surprised this didn’t happen long ago,” Reilly said.\u003c/p>\n\u003cp>Kadel put it this way: The culture of KQED, a multifaceted media organization that produces a huge amount of radio, TV, educational materials and websites, tilted toward easier collaboration. If someone wanted to put the video from a news interview into the video editing system, for instance, and then share the audio with radio reporters, they could. And they could do that from the same computer they used for daily email.\u003c/p>\n\u003cp>But security people know this type of one-big-network-for-all is risky. Their job, after all, is to keep malicious hackers from turning the place into “The Day the Earth Stood Still.” And when systems connect to each other like they could at KQED, malicious actors can more easily infect the entire infrastructure.\u003c/p>\n\u003cp>Another problem: The station’s IT department allowed employees to download and install free software from the web. IT folks call this the “granting of local admin rights.” Many in the industry also call it “A Catastrophe Waiting to Happen.” Free software is often laden with viruses, worms and other nasty extras.\u003c/p>\n\u003caside class=\"alignleft\">\u003cem>Ransomware Survival Tip: Establish a Walk-Up IT Help Desk\u003c/em>Shield your IT staff from the deluge of help requests, while providing a clear avenue for employees to get help. At KQED, IT set up long tables in an open area and staffed a walk-up help desk all day. KQED Chief of Staff Jason Black laid down the law in a companywide memo: 'Individual requests, side doors, hallway nudges, note passing, private Slacking, hand and/or smoke signals to IT or Systems Engineering are not helpful right now.'\u003c/aside>\n\u003cp>Kadel said one reason IT gave the staff free rein was due to a lack of IT employees to oversee the process.\u003c/p>\n\u003cp>“You can’t visit 600 people to do a Flash update,” he said. “You have to let people do their own Flash update.”\u003c/p>\n\u003cp>Lots of consultants say companies routinely shortchange IT. But Kadel may have a point. At the time of the attack, KQED employed nine IT employees to service roughly 503 workers. That means IT represented less than 2 percent of the organization’s workforce.\u003c/p>\n\u003cp>A 2016 survey of media and entertainment companies by the research firm Gartner found that IT workers made up an average of 6.5 percent of employees, more than three times the level at KQED. Across all industries, the number is 5 percent.\u003c/p>\n\u003cp>Finally, KQED used standard anti-virus programs to protect its system. But hackers know how to get around these by altering their code. In a test run by KQED’s security consultant, just 10 out of 60 off-the-shelf anti-virus programs recognized the variant of Samas that hit the company.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>“If somebody wishes to put out a new variant, it takes a little bit for the anti-virus vendors to catch up,” said Guthrie.\u003c/p>\n\u003cp>KQED is now plugging all these holes, redesigning its network and all of its media systems. It’s also deploying much more sophisticated anti-virus software that looks for processes that are outside the normal behavior, shutting them down. Among the new IT employees coming on board: a full-time security pro.\u003c/p>\n\u003cp>\u003cstrong>What Kept Working\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">W\u003c/span>hen everything went down, the safest place for data turned out to be the cloud. KQED lost no member or donor information, because it wasn’t stored in the network. And as the attack short-circuited system after system, KQED’s network of websites kept on keeping on. How so?\u003c/p>\n\u003cp>“We’ve moved most of KQED.org to be hosted in the cloud, so it’s sitting on [Amazon] servers,” said Tim Olson, KQED’s chief digital officer. “It’s more disaster recovery, more efficient for everybody.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'In some ways I view this as a dress rehearsal. Because we’re in an earthquake zone.'\u003ccite>John Reilly, KQED\u003c/cite>\u003c/aside>\n\u003cp>The cloud is “certainly a strategy that a lot of smaller organizations employ, because it’s a lot of work to keep your systems patched,” said IT consultant Sheridan. And big cloud services like those of Amazon, Microsoft and Google spend tons of money to pay for cybersecurity. “That being said, you’re now in a very deep trust relationship with someone else, Sheridan said.\u003c/p>\n\u003cp>But in terms of maintaining access to data after the attack, the cloud was the silver lining. When everything went down and all of KQED’s storage systems became inaccessible, there sat my audio interviews, my budget numbers, my everything, safe and snug on Google Drive.\u003c/p>\n\u003cp>\u003cstrong>Talking About It\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">B\u003c/span>elow the hard truths about security vs. convenience now adorning whiteboards at KQED are a few about survival, too.\u003c/p>\n\u003cp>“We've learned a lot,” said Reilly. “People have realized that we weren't prepared in a lot of ways. But then again, in some ways I view this as a dress rehearsal. Because we’re in an earthquake zone.”\u003c/p>\n\u003cp>What’s being done to fight back against the spreading threat of ransomware across the world?\u003c/p>\n\u003cp>Companies and individuals dealing with a ransomware attack may find help at NoMoreRansom.org, an initiative of the Netherlands’ police, Europol and the computer security companies Kaspersky Lab and McAfee. The website includes decryption tools for dozens of known ransomware infections, as well as advice on how to prevent an attack in the first place. (Update Nov. 15: The U.S. Dept. of Homeland Security has \u003ca href=\"https://www.washingtonpost.com/world/national-security/us-official-15-percent-of-agencies-used-kaspersky-software/2017/11/14/32019dec-c994-11e7-b506-8a10ed11ecf5_story.html?utm_term=.7f5c8ad59b58/\" target=\"_blank\" rel=\"noopener noreferrer\">banned\u003c/a> federal agencies from using Kaspersky products due to alleged ties to the Russian government and intelligence services.)\u003c/p>\n\u003caside class=\"alignleft\">\u003cem>Ransomware Survival Tip: Use the Cloud and Your Cell Network\u003c/em>Slack, Google Drive, Dropbox and cellphones can substitute for networked communications and make transferring files easy.\u003c/aside>\n\u003cp>One thing every expert recommends: Back up like crazy.\u003c/p>\n\u003cp>“The number one thing to do is back up your data,” said Alexander Garcia-Tobar, co-founder of ValiMail, a San Francisco company that authenticates email in order to prevent intrusions like ransomware.\u003c/p>\n\u003cp>“If you’re backing up on a daily basis or even on a weekly basis, you back up to before the known infection and you cross your fingers.”\u003c/p>\n\u003cp>Guthrie said high-end tools designed to keep things running in the event of a catastrophe can be a lifesaver. But they are expensive.\u003c/p>\n\u003cp>“There’s network backup and restore systems that are very good and very fast and very expensive,” said Guthrie. “Smaller companies tend to do what they can with the resources they’re given.”\u003c/p>\n\u003cp>KQED decided to go public with our tale as a kind of public service, so that other organizations can learn not only from our mistakes but also from the way we kept functioning with minimal disruption to the public, despite maximum disruption internally.\u003c/p>\n\u003cp>Sheridan said opening up can only help.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"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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"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.",
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"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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"order": 12
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
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