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"content": "\u003cp>Researchers at UC San Francisco have unveiled the largest \u003ca href=\"http://10kimmunomes.org/\" target=\"_blank\" rel=\"noopener\">searchable database\u003c/a> of immunology data, gathered from 10,000 people of various ages, ethnicity, and backgrounds. It could lead to more effective treatments for a wide range of immune disorders.[contextly_sidebar id=”lms9rSPdk5pG72xqgRdVMiGv0hv7IpdH”]\u003c/p>\n\u003cp>The new data pool represents the \u003ca href=\"https://www.cell.com/cell-reports/fulltext/S2211-1247(18)31451-7\" target=\"_blank\" rel=\"noopener\">largest control group\u003c/a> ever compiled on the human immune system, according to the study published on Tuesday in the journal, \u003cem>Cell Reports\u003c/em>.\u003c/p>\n\u003cp>Called the \u003ca href=\"http://10kimmunomes.org/\" target=\"_blank\" rel=\"noopener\">10,000 Immunomes Project\u003c/a> (10KIP), it’s the culmination of four years of work and provides an instant comparison group for researchers studying the immune system and immune dysfunction.\u003c/p>\n\u003cp>UCSF researchers created the tool using immunology data from 83 studies representing 10,000 healthy subjects, according to senior author Atul Butte, director of the \u003ca href=\"http://bakarinstitute.ucsf.edu/\" target=\"_blank\" rel=\"noopener\">Bakar Computational Health Sciences Institute\u003c/a> at UCSF.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘If the field of genetics is able to compile large collections consisting of millions of people, why does immunology lag behind?’\u003ccite>Atul Butte, UCSF\u003c/cite>\u003c/aside>\n\u003cp>The data comes from studies on organ transplants, autoimmune disease trials, vaccine studies and other research funded by the National Institute of Allergy and Infectious Diseases (NIAID).\u003c/p>\n\u003cdiv>\n\u003cp>“We have sub-populations in the U.S. that don’t really participate in studies so why not just gather all this massive data on the immune system in one central place,” says Butte. “We can turn to this data to see what is going on in a healthy immune system spanning different populations in the U.S.”\u003c/p>\n\u003cp>Butte says the ability to manipulate immune system activity will benefit a wide range of patients, including transplant recipients, cancer and AIDS patients, and those suffering from some form of immune dysfunction.\u003c/p>\n\u003cp>Autoimmune Disease (AD) in particular, an historically underfunded field, could benefit greatly from the availability of a large and diverse control group, according to Butte.\u003c/p>\n\u003cp>\u003cstrong>Rise of Autoimmine Disease\u003c/strong>\u003c/p>\n\u003cp>AD is one of the fastest growing illnesses in the U.S., with 20 percent of the population or one in five people, suffering from the disorder.[contextly_sidebar id=”KPqEb6LD9ky4mDsIDJAEnoEvgzkEna45″]\u003c/p>\n\u003cp>Despite AD being \u003ca href=\"https://www.aarda.org/who-we-are/our-mission/\" target=\"_blank\" rel=\"noopener\">one of the top 10 leading causes\u003c/a> of death in females up to 64 years of age, research has continued to lag behind, according to Butte.\u003c/p>\n\u003cp>The National Institutes of Health\u003ca href=\"https://ww2.kqed.org/science/2018/10/09/voting-on-daylight-saving-time-animal-confinement-and-water-propositions-3-7-and-12-explained/\" target=\"_blank\" rel=\"noopener\"> has spent\u003c/a> $591 million dollars on AD research compared to the $6.1 billion spent on cancer. Current treatments consist of risky immunosuppressants that can lead to devastating long-term side effects.[contextly_sidebar id=”ZbtYikLAiggPmeNWkxr4kKECzkkjZf4Z”]\u003c/p>\n\u003cp>UCSF researchers developed the new searchable database in part to boost AD research. Typically, studies done on immune systems are smaller and it’s rare to get 10,000 participants, according to Butte.\u003c/p>\n\u003cp>Plus, the human immune system is a moving target.\u003c/p>\n\u003cp>“It’s a difficult field to study because unlike DNA for example, your immune system changes from morning to night. So which aspect of the immune system scientists focus on, and \u003cem>when\u003c/em> they study it, these are all problems we are getting better at. We just need more studies.”\u003c/p>\n\u003cp>To test their new tool, researchers created a custom control group comprised of women between 18 and 40 years of age and compared it to 56 pregnant women who participated in a prior study tracking immune changes during pregnancy.\u003c/p>\n\u003cp>Using this control group, researchers were able to detect how various immune cells and cell signaling proteins, called cytokines, changed from pre-pregnancy levels— measurements that the original study failed to pick up.\u003c/p>\n\u003cp>Researchers also used the new tool to compare immunity in people from different racial and ethnic backgrounds. The findings showed both known differences as well as new information that could only be seen by combining data from dozens of different studies.\u003c/p>\n\u003cp>For instance, researchers found that regulatory T cells, which suppress the immune response, are present at higher levels in African Americans, compared to all other groups.\u003c/p>\n\u003cp>\u003cstrong>Shareable Science\u003c/strong>\u003c/p>\n\u003cp>Butte sees the searchable database as part of a broader trend in science, promoting open access where more scientists are willing to share their raw data with others.\u003c/p>\n\u003cp>“It’s really hundreds of people who have essentially contributed to this work,” he notes.\u003c/p>\n\u003cp>Butte says he hopes his work will bring immunology to the forefront and inspire others to rethink their approach to the field.\u003c/p>\n\u003cp>“If the field of genetics is able to compile large collections consisting of millions of people,” he wonders, “why does immunology lag behind? I want to get people in the field thinking about larger collections of samples that cut across race, age and gender.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003c/div>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Researchers at UC San Francisco have unveiled the largest \u003ca href=\"http://10kimmunomes.org/\" target=\"_blank\" rel=\"noopener\">searchable database\u003c/a> of immunology data, gathered from 10,000 people of various ages, ethnicity, and backgrounds. It could lead to more effective treatments for a wide range of immune disorders.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The new data pool represents the \u003ca href=\"https://www.cell.com/cell-reports/fulltext/S2211-1247(18)31451-7\" target=\"_blank\" rel=\"noopener\">largest control group\u003c/a> ever compiled on the human immune system, according to the study published on Tuesday in the journal, \u003cem>Cell Reports\u003c/em>.\u003c/p>\n\u003cp>Called the \u003ca href=\"http://10kimmunomes.org/\" target=\"_blank\" rel=\"noopener\">10,000 Immunomes Project\u003c/a> (10KIP), it’s the culmination of four years of work and provides an instant comparison group for researchers studying the immune system and immune dysfunction.\u003c/p>\n\u003cp>UCSF researchers created the tool using immunology data from 83 studies representing 10,000 healthy subjects, according to senior author Atul Butte, director of the \u003ca href=\"http://bakarinstitute.ucsf.edu/\" target=\"_blank\" rel=\"noopener\">Bakar Computational Health Sciences Institute\u003c/a> at UCSF.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘If the field of genetics is able to compile large collections consisting of millions of people, why does immunology lag behind?’\u003ccite>Atul Butte, UCSF\u003c/cite>\u003c/aside>\n\u003cp>The data comes from studies on organ transplants, autoimmune disease trials, vaccine studies and other research funded by the National Institute of Allergy and Infectious Diseases (NIAID).\u003c/p>\n\u003cdiv>\n\u003cp>“We have sub-populations in the U.S. that don’t really participate in studies so why not just gather all this massive data on the immune system in one central place,” says Butte. “We can turn to this data to see what is going on in a healthy immune system spanning different populations in the U.S.”\u003c/p>\n\u003cp>Butte says the ability to manipulate immune system activity will benefit a wide range of patients, including transplant recipients, cancer and AIDS patients, and those suffering from some form of immune dysfunction.\u003c/p>\n\u003cp>Autoimmune Disease (AD) in particular, an historically underfunded field, could benefit greatly from the availability of a large and diverse control group, according to Butte.\u003c/p>\n\u003cp>\u003cstrong>Rise of Autoimmine Disease\u003c/strong>\u003c/p>\n\u003cp>AD is one of the fastest growing illnesses in the U.S., with 20 percent of the population or one in five people, suffering from the disorder.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Despite AD being \u003ca href=\"https://www.aarda.org/who-we-are/our-mission/\" target=\"_blank\" rel=\"noopener\">one of the top 10 leading causes\u003c/a> of death in females up to 64 years of age, research has continued to lag behind, according to Butte.\u003c/p>\n\u003cp>The National Institutes of Health\u003ca href=\"https://ww2.kqed.org/science/2018/10/09/voting-on-daylight-saving-time-animal-confinement-and-water-propositions-3-7-and-12-explained/\" target=\"_blank\" rel=\"noopener\"> has spent\u003c/a> $591 million dollars on AD research compared to the $6.1 billion spent on cancer. Current treatments consist of risky immunosuppressants that can lead to devastating long-term side effects.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>UCSF researchers developed the new searchable database in part to boost AD research. Typically, studies done on immune systems are smaller and it’s rare to get 10,000 participants, according to Butte.\u003c/p>\n\u003cp>Plus, the human immune system is a moving target.\u003c/p>\n\u003cp>“It’s a difficult field to study because unlike DNA for example, your immune system changes from morning to night. So which aspect of the immune system scientists focus on, and \u003cem>when\u003c/em> they study it, these are all problems we are getting better at. We just need more studies.”\u003c/p>\n\u003cp>To test their new tool, researchers created a custom control group comprised of women between 18 and 40 years of age and compared it to 56 pregnant women who participated in a prior study tracking immune changes during pregnancy.\u003c/p>\n\u003cp>Using this control group, researchers were able to detect how various immune cells and cell signaling proteins, called cytokines, changed from pre-pregnancy levels— measurements that the original study failed to pick up.\u003c/p>\n\u003cp>Researchers also used the new tool to compare immunity in people from different racial and ethnic backgrounds. The findings showed both known differences as well as new information that could only be seen by combining data from dozens of different studies.\u003c/p>\n\u003cp>For instance, researchers found that regulatory T cells, which suppress the immune response, are present at higher levels in African Americans, compared to all other groups.\u003c/p>\n\u003cp>\u003cstrong>Shareable Science\u003c/strong>\u003c/p>\n\u003cp>Butte sees the searchable database as part of a broader trend in science, promoting open access where more scientists are willing to share their raw data with others.\u003c/p>\n\u003cp>“It’s really hundreds of people who have essentially contributed to this work,” he notes.\u003c/p>\n\u003cp>Butte says he hopes his work will bring immunology to the forefront and inspire others to rethink their approach to the field.\u003c/p>\n\u003cp>“If the field of genetics is able to compile large collections consisting of millions of people,” he wonders, “why does immunology lag behind? I want to get people in the field thinking about larger collections of samples that cut across race, age and gender.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "CRISPR Cures Inherited Disorder in Mice, Paving Way for Genetic Therapy Before Birth",
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"content": "\u003cp class=\"danger-zone\">Nearly 40 years after surgeons first \u003ca href=\"https://www.ucsf.edu/news/2011/02/9366/ucsf-surgeon-reflects-performing-worlds-first-fetal-surgery-30-years-ago\" target=\"_blank\" rel=\"noopener\">operated on fetuses\u003c/a> to cure devastating abnormalities, researchers have taken the first step toward curing genetic disease before birth via genome editing: scientists reported on Monday that they used the genome editing technique CRISPR to alter the DNA of laboratory mice in the womb, eliminating an often-fatal liver disease before the animals had even been born.[contextly_sidebar id=\"kLt87B75fzdQ6XiJiVHbmy8S3RDMp2KF\"]\u003c/p>\n\u003cp class=\"danger-zone\">The research, by a team at the University of Pennsylvania and the Children’s Hospital of Philadelphia (CHOP), is a very early proof of concept. But while CRISPRing human fetuses is years away, at best, the success in mice bolsters what Dr. William Peranteau, who co-led the study, calls his dream of curing genetic diseases before birth.\u003c/p>\n\u003cp class=\"danger-zone\">“A lot more animal work needs to be done before we can even think about applying this [fetal genome editing] clinically,” said Peranteau, a pediatric and fetal surgeon at CHOP. “But I think fetal genome editing may be where fetal surgery [which is now routine] once was, and that one day we’ll use it to treat diseases that cause significant morbidity and mortality.”\u003c/p>\n\u003cp>Simon Waddington of University College London, a leader in research to develop fetal gene therapy who was not involved in the new study, called the CRISPR approach “an elegant refinement of the brute-force technology” that’s been the focus of \u003ca href=\"https://www.nature.com/articles/s41591-018-0106-7\" target=\"_blank\" rel=\"noopener\">animal studies\u003c/a> of fetal genetic therapy.\u003c/p>\n\u003cp>The success in mouse fetuses raises the possibility that, even before \u003ca href=\"https://www.statnews.com/2018/07/25/can-gene-therapy-halt-diseases-in-babies-before-theyre-even-born/\">traditional gene therapy\u003c/a> is ready to treat inherited disorders in utero, genome editing might emerge as a safer, more effective approach. In traditional gene therapy, an entire healthy gene is ferried, typically by a virus, into cells containing a disease-causing gene. With CRISPR, only the mutated bit of a defective gene is changed. It’s the difference between retyping a whole 5,000 word document and using Word’s “find and replace” to correct a typo.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We think this represents a safer and more precise way to make changes in the genome,” said Dr. Kiran Musunuru of Penn and a co-leader of the study. “It’s is the better way forward if you want to take CRISPR into the clinic.”[contextly_sidebar id=\"WspKwnRfkmuJ8Ui6Pu5mBgKtCSqZqfJ5\"]\u003c/p>\n\u003cp>The rationale for fetal genetic therapy is simple: it could halt a disease before it causes irreversible and even fatal damage. In people, the inherited liver disease that the scientists targeted in mice, called hereditary tyrosinemia type 1, starts damaging the liver months before birth. Another rationale: because a fetus’s immune system is immature, it is less likely than even a newborn’s to attack the alien CRISPR molecules.\u003c/p>\n\u003cp>For their study, \u003ca href=\"https://www.nature.com/articles/s41591-018-0184-6\" target=\"_blank\" rel=\"noopener\">published in Nature Medicine\u003c/a>, Musunuru and his colleagues gently opened the uterus of a pregnant mouse, removed the fetus from the amniotic sac, and injected CRISPR into the vitelline vein, which is near the surface of the sac and connects to the liver. “We wanted to make sure we got the genome editor into the liver rather than everywhere else,” Musunuru said. The fetus was then replaced in the uterus and was born normally.\u003c/p>\n\u003cp>Instead of using the original form of CRISPR, which cuts DNA where a gene is mutated and inserts a replacement string of A’s, T’s, C’s, and G’s, the scientists used the form of CRISPR called base editing. \u003ca href=\"https://www.statnews.com/2016/04/20/clever-crispr-advance-unveiled/%5D\">Invented\u003c/a> just two years ago, base editing changes an incorrect DNA letter, or base, to the correct one, such as a C to a T or a G to an A. Its advantage is that it doesn’t need to cut DNA to do this, as CRISPR 1.0 does; those cuts can wreak \u003ca href=\"https://www.statnews.com/2018/07/16/crispr-potential-dna-damage-underestimated/\">genetic havoc\u003c/a>, with unknown consequences for CRISPR’d cells.\u003c/p>\n\u003cp>For a dry run, the scientists first made a CRISPR base editor that changes a \u003ca href=\"https://ghr.nlm.nih.gov/gene/PCSK9\" target=\"_blank\" rel=\"noopener\">gene called PCSK9\u003c/a>, which makes a protein that helps regulate the amount of cholesterol in the bloodstream, into a super-cholesterol-lowering form. When injected into mouse fetuses, the base editor changed liver cells as intended and left other organs alone. Crucially, the mouse mother showed no effects of the CRISPR treatment. After birth, the baby mice had ultra-low cholesterol levels, showing that the CRISPR base editor had worked. Only about 15 percent of the liver cells of the baby mice had been edited, but that fraction remained stable through the animals’ adulthood.[contextly_sidebar id=\"7RKromVt2cYnSDdz2L7SJg04iooF89dn\"]\u003c/p>\n\u003cp>The amount of genetic havoc from the base editing was low: about 2 percent, compared to 40 percent for many uses of traditional CRISPR. And none of the likely spots for “off target” effects — DNA sites that resemble the target and so might be inadvertently edited — showed any sign of being altered.\u003c/p>\n\u003cp>The Philadelphia scientists then tried their technique on hereditary tyrosinemia type 1. HT1, which strikes 1 in 100,000 newborns worldwide, is \u003ca href=\"https://rarediseases.info.nih.gov/diseases/2658/tyrosinemia-type-1\" target=\"_blank\" rel=\"noopener\">caused by\u003c/a> any of several mutations in a \u003ca href=\"https://ghr.nlm.nih.gov/gene/FAH\" target=\"_blank\" rel=\"noopener\">gene called FAH\u003c/a>. All the mutations cause the build-up of toxic breakdown products of the amino acid tyrosine, a component of protein, and ultimately destroy the liver. Treatment with the drug nitisinone and a strict tyrosine-free diet is not always effective, with the result that children sometimes develop fatal liver failure or liver cancer.\u003c/p>\n\u003cp>The scientists used their base editor on a gene related to the disease-causing one. If this gene, \u003ca href=\"https://ghr.nlm.nih.gov/gene/HPD\" target=\"_blank\" rel=\"noopener\">called HPD\u003c/a>, is disabled, then no toxic metabolites of tyrosine ever get to where FAH is unable to handle them.\u003c/p>\n\u003cp>Changing a C to a T in the HPD gene disabled it. No toxic molecules built up in the livers of the fetal mice. No other organs showed signs of editing, no off-target effects were detected, and having only 15 percent of their liver cells edited was enough to cure the mice and keep them cured into adulthood. “We weren’t expecting it, but the genome-edited mice did much better” than mice treated with nitisinone, Musunuru said. “They survived longer and gained more weight.”\u003c/p>\n\u003cp>The scientists hope to study fetal base editing for other severe congenital diseases. It remains to be seen whether this technique or conventional gene therapy, which provides an entire replacement gene, will work better.\u003c/p>\n\u003cp>“I’d consider that CRISPR isn’t a replacement” for the latter, Waddington said, “but will be an additional tool” for curing genetic diseases in the womb.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/08/crispr-cures-inherited-disorder-in-mice-paving-way-for-genetic-therapy-before-birth/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\">\u003cbr>\n\u003c/span>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"danger-zone\">Nearly 40 years after surgeons first \u003ca href=\"https://www.ucsf.edu/news/2011/02/9366/ucsf-surgeon-reflects-performing-worlds-first-fetal-surgery-30-years-ago\" target=\"_blank\" rel=\"noopener\">operated on fetuses\u003c/a> to cure devastating abnormalities, researchers have taken the first step toward curing genetic disease before birth via genome editing: scientists reported on Monday that they used the genome editing technique CRISPR to alter the DNA of laboratory mice in the womb, eliminating an often-fatal liver disease before the animals had even been born.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp class=\"danger-zone\">The research, by a team at the University of Pennsylvania and the Children’s Hospital of Philadelphia (CHOP), is a very early proof of concept. But while CRISPRing human fetuses is years away, at best, the success in mice bolsters what Dr. William Peranteau, who co-led the study, calls his dream of curing genetic diseases before birth.\u003c/p>\n\u003cp class=\"danger-zone\">“A lot more animal work needs to be done before we can even think about applying this [fetal genome editing] clinically,” said Peranteau, a pediatric and fetal surgeon at CHOP. “But I think fetal genome editing may be where fetal surgery [which is now routine] once was, and that one day we’ll use it to treat diseases that cause significant morbidity and mortality.”\u003c/p>\n\u003cp>Simon Waddington of University College London, a leader in research to develop fetal gene therapy who was not involved in the new study, called the CRISPR approach “an elegant refinement of the brute-force technology” that’s been the focus of \u003ca href=\"https://www.nature.com/articles/s41591-018-0106-7\" target=\"_blank\" rel=\"noopener\">animal studies\u003c/a> of fetal genetic therapy.\u003c/p>\n\u003cp>The success in mouse fetuses raises the possibility that, even before \u003ca href=\"https://www.statnews.com/2018/07/25/can-gene-therapy-halt-diseases-in-babies-before-theyre-even-born/\">traditional gene therapy\u003c/a> is ready to treat inherited disorders in utero, genome editing might emerge as a safer, more effective approach. In traditional gene therapy, an entire healthy gene is ferried, typically by a virus, into cells containing a disease-causing gene. With CRISPR, only the mutated bit of a defective gene is changed. It’s the difference between retyping a whole 5,000 word document and using Word’s “find and replace” to correct a typo.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We think this represents a safer and more precise way to make changes in the genome,” said Dr. Kiran Musunuru of Penn and a co-leader of the study. “It’s is the better way forward if you want to take CRISPR into the clinic.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The rationale for fetal genetic therapy is simple: it could halt a disease before it causes irreversible and even fatal damage. In people, the inherited liver disease that the scientists targeted in mice, called hereditary tyrosinemia type 1, starts damaging the liver months before birth. Another rationale: because a fetus’s immune system is immature, it is less likely than even a newborn’s to attack the alien CRISPR molecules.\u003c/p>\n\u003cp>For their study, \u003ca href=\"https://www.nature.com/articles/s41591-018-0184-6\" target=\"_blank\" rel=\"noopener\">published in Nature Medicine\u003c/a>, Musunuru and his colleagues gently opened the uterus of a pregnant mouse, removed the fetus from the amniotic sac, and injected CRISPR into the vitelline vein, which is near the surface of the sac and connects to the liver. “We wanted to make sure we got the genome editor into the liver rather than everywhere else,” Musunuru said. The fetus was then replaced in the uterus and was born normally.\u003c/p>\n\u003cp>Instead of using the original form of CRISPR, which cuts DNA where a gene is mutated and inserts a replacement string of A’s, T’s, C’s, and G’s, the scientists used the form of CRISPR called base editing. \u003ca href=\"https://www.statnews.com/2016/04/20/clever-crispr-advance-unveiled/%5D\">Invented\u003c/a> just two years ago, base editing changes an incorrect DNA letter, or base, to the correct one, such as a C to a T or a G to an A. Its advantage is that it doesn’t need to cut DNA to do this, as CRISPR 1.0 does; those cuts can wreak \u003ca href=\"https://www.statnews.com/2018/07/16/crispr-potential-dna-damage-underestimated/\">genetic havoc\u003c/a>, with unknown consequences for CRISPR’d cells.\u003c/p>\n\u003cp>For a dry run, the scientists first made a CRISPR base editor that changes a \u003ca href=\"https://ghr.nlm.nih.gov/gene/PCSK9\" target=\"_blank\" rel=\"noopener\">gene called PCSK9\u003c/a>, which makes a protein that helps regulate the amount of cholesterol in the bloodstream, into a super-cholesterol-lowering form. When injected into mouse fetuses, the base editor changed liver cells as intended and left other organs alone. Crucially, the mouse mother showed no effects of the CRISPR treatment. After birth, the baby mice had ultra-low cholesterol levels, showing that the CRISPR base editor had worked. Only about 15 percent of the liver cells of the baby mice had been edited, but that fraction remained stable through the animals’ adulthood.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The amount of genetic havoc from the base editing was low: about 2 percent, compared to 40 percent for many uses of traditional CRISPR. And none of the likely spots for “off target” effects — DNA sites that resemble the target and so might be inadvertently edited — showed any sign of being altered.\u003c/p>\n\u003cp>The Philadelphia scientists then tried their technique on hereditary tyrosinemia type 1. HT1, which strikes 1 in 100,000 newborns worldwide, is \u003ca href=\"https://rarediseases.info.nih.gov/diseases/2658/tyrosinemia-type-1\" target=\"_blank\" rel=\"noopener\">caused by\u003c/a> any of several mutations in a \u003ca href=\"https://ghr.nlm.nih.gov/gene/FAH\" target=\"_blank\" rel=\"noopener\">gene called FAH\u003c/a>. All the mutations cause the build-up of toxic breakdown products of the amino acid tyrosine, a component of protein, and ultimately destroy the liver. Treatment with the drug nitisinone and a strict tyrosine-free diet is not always effective, with the result that children sometimes develop fatal liver failure or liver cancer.\u003c/p>\n\u003cp>The scientists used their base editor on a gene related to the disease-causing one. If this gene, \u003ca href=\"https://ghr.nlm.nih.gov/gene/HPD\" target=\"_blank\" rel=\"noopener\">called HPD\u003c/a>, is disabled, then no toxic metabolites of tyrosine ever get to where FAH is unable to handle them.\u003c/p>\n\u003cp>Changing a C to a T in the HPD gene disabled it. No toxic molecules built up in the livers of the fetal mice. No other organs showed signs of editing, no off-target effects were detected, and having only 15 percent of their liver cells edited was enough to cure the mice and keep them cured into adulthood. “We weren’t expecting it, but the genome-edited mice did much better” than mice treated with nitisinone, Musunuru said. “They survived longer and gained more weight.”\u003c/p>\n\u003cp>The scientists hope to study fetal base editing for other severe congenital diseases. It remains to be seen whether this technique or conventional gene therapy, which provides an entire replacement gene, will work better.\u003c/p>\n\u003cp>“I’d consider that CRISPR isn’t a replacement” for the latter, Waddington said, “but will be an additional tool” for curing genetic diseases in the womb.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>https://www.youtube.com/watch?v=lyu7v7nWzfo\u003c/p>\n\u003cp>\u003cem>Part 4 of the \u003c/em>TED Radio Hour \u003cem>episode \u003c/em>\u003ca href=\"http://www.npr.org/programs/ted-radio-hour/485704159/what-makes-us-us\" target=\"_blank\" rel=\"noopener\">What Makes Us ... Us\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>About Anil Seth's TED Talk\u003c/strong>\u003c/p>\n\u003cp>When we look around, it feels like we're seeing an objective reality. But neuroscientist Anil Seth says everything we perceive, from objects to emotions, is an act of informed guesswork by the brain.\u003c/p>\n\u003cp>\u003cstrong>About Anil Seth\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://www.anilseth.com/\">Anil Seth\u003c/a> is a professor of cognitive and computational neuroscience at the University of Sussex, where he studies consciousness and its role in health and disease.\u003c/p>\n\u003cp>He co-directs the \u003ca href=\"http://www.sussex.ac.uk/sackler/\" target=\"_blank\" rel=\"noopener\">Sackler Centre for Consciousness Science\u003c/a> and is the Editor-in-Chief of the academic journal \u003cem>Neuroscience of Consciousness\u003c/em>. Seth was also the 2017 President of the British Science Association (Psychology Section). He is the co-author of \u003ca href=\"http://www.anilseth.com/books\" target=\"_blank\" rel=\"noopener\">\u003cem>30-Second Brain\u003c/em>,\u003c/a> a best-seller that explores how the brain works.\u003c/p>\n\u003cp>Seth is a regular contributor to the \u003cem>New Scientist, The Guardian\u003c/em>, and the BBC.\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=Anil+Seth%3A+How+Does+Your+Brain+Construct+Your+Conscious+Reality%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cp>Paige Thesing has struggled with insomnia since high school. “It takes me a really long time to fall asleep — about four hours,” she says. For years, her mornings were groggy and involved a “lot of coffee.”[contextly_sidebar id=”SWkBBNCnUWhPf7KOuvUyV7If0Ca3ug47”]\u003c/p>\n\u003cp>After a year of trying sleep medication prescribed by her doctor, she turned to the internet for alternate solutions. About four months ago, she settled on a mobile phone meditation app called \u003ca href=\"https://www.inscape.life/\" target=\"_blank\" rel=\"noopener\">INSCAPE\u003c/a>.\u003c/p>\n\u003cp>“It’s about a 30-minute soundtrack, and it starts with a woman kind of telling you to relax and instructing your breathing,” explains Thesing. “Then it goes into sounds — relaxing noises. There’s wind chimes, some atmospheric music playing…”\u003c/p>\n\u003cp>She uses the app every night and falls asleep within 15 or 20 minutes. “So, definitely a big improvement from four hours,” she says.\u003c/p>\n\u003cp>Thesing is not alone. Chronic insomnia affects an estimated \u003ca href=\"https://www.ajmc.com/journals/supplement/2006/2006-05-vol12-n8suppl/may06-2307ps214-s220\" target=\"_blank\" rel=\"noopener\">10-15 percent of adults\u003c/a>, and another 25-35 percent struggle with sleep issues occasionally. And like Thesing, a growing number of insomniacs are turning to mobile phone apps to lull them to sleep.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>On \u003ca href=\"https://twitter.com/NPRHealth/status/1046884648167624711\" target=\"_blank\" rel=\"noopener\">Twitter\u003c/a> and Facebook, NPR asked its audience if they have used a mobile phone app to help manage insomnia. Nearly 100 people wrote back suggesting a range of apps, including podcasts created to put a listener to sleep.\u003c/p>\n\u003cp>“These are usually relaxation strategies, white noise, meditation,” \u003ca href=\"https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=35378\" target=\"_blank\" rel=\"noopener\">Jason Ong\u003c/a>, an associate professor of neurology specializing in sleep at Northwestern University’s Feinberg School of Medicine. He studies non-pharmacological treatments for various sleep disorders and treats patients at the university’s Sleep Medicine clinic. “It’s not that there’s something wrong with those apps. It’s a reasonable first thing to try.”[contextly_sidebar id=”ljN7S8LuvqENw8QrvBPFbhASn6EIv1oE”]\u003c/p>\n\u003cp>But, he adds, these kinds of apps aren’t based on scientifically-proven solutions, and they don’t really fix the problem of why someone is not sleeping.\u003c/p>\n\u003cp>Ong wanted to do something about that, so a few years ago, he consulted for a team that developed an app that uses a science-based approach to address insomnia called \u003ca href=\"https://www.sleepio.com/cbt-for-insomnia/\" target=\"_blank\" rel=\"noopener\">Sleepio\u003c/a>. (However, he doesn’t have any ongoing financial interest in the product, he says.)\u003c/p>\n\u003cp>Sleepio and a few other apps like \u003ca href=\"http://www.myshuti.com/\" target=\"_blank\" rel=\"noopener\">SHUT-i\u003c/a> and a free one developed by the Veterans Administration use the most sustainable and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/15451764\" target=\"_blank\" rel=\"noopener\">evidence-based\u003c/a> solution for insomnia. It’s a kind of therapy called Cognitive Behavioral Therapy for Insomnia — \u003ca href=\"https://www.sleepfoundation.org/sleep-news/cognitive-behavioral-therapy-insomnia\" target=\"_blank\" rel=\"noopener\">CBT-I\u003c/a> for short, he says. It helps the patient understand the biology of sleep and gives them a bag of tools and tricks to change their own thought patterns and behaviors to treat their underlying sleep issues.\u003c/p>\n\u003cp>“CBT for insomnia is a specific package … [that] includes different techniques like spending less time in bed [and] what to do if you are in bed and can’t sleep,” says Ong. “It’s teaching you how to change your behavior to better work with your brain to give you confidence that you’re going to be able to sleep on a regular basis.”\u003c/p>\n\u003cp>It may be surprising to us, but our own thought patterns and sleep habits \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3621793/\" target=\"_blank\" rel=\"noopener\">affect our biology\u003c/a>, in this case how our brains regulate sleep. “If you modify some of your behaviors, you can work better with how your brain regulates sleep and wake,” he says.\u003c/p>\n\u003cp>The American College of Physicians \u003ca href=\"https://www.acponline.org/acp-newsroom/acp-recommends-cognitive-behavioral-therapy-as-initial-treatment-for-chronic-insomnia\" target=\"_blank\" rel=\"noopener\">first recommended\u003c/a> Cognitive Behavioral Therapy for Insomnia as the first-line treatment for insomnia in 2016. “The evidence is quite strong to support the effectiveness of CBT-I treatment and there really aren’t a lot of side effects,” says Ong. And, because it changes behavior, “in the long run CBT-I tends to perform quite well in maintaining the benefits.”\u003c/p>\n\u003cp>In the past the only way for people to get Cognitive Behavioral Therapy for Insomnia was to see a therapist, now they can access the therapy on their mobile phones.\u003c/p>\n\u003cp>“In Sleepio, it’s like an avatar of a real therapist that’s walking the patient through that process,” explains Ong. Sleepio also allows users to keep a sleep diary so the app can use its algorithm to suggest a better bedtime schedule. It also reminds people to get up when they’ve spent too much time in bed trying to fall asleep, for example.[contextly_sidebar id=”wEwpbDeWifEPnKULBpzGtSdpZ0ZUBzcu”]\u003c/p>\n\u003cp>Like a real therapist, the apps that use Cognitive Behavior Therapy for Insomnia also provide practical tools to help the user worry less about their sleep and over time, be less anxious and more confident about their ability get a good night’s rest. “It’s very similar to what we do face-to-face with patients,” adds Ong.\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427093/\" target=\"_blank\" rel=\"noopener\">Studies show\u003c/a> that CBT-I delivered digitally through mobile phone apps is effective in treating insomnia. And a \u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2704019\" target=\"_blank\" rel=\"noopener\">recent study\u003c/a> of Sleepio by Ong and the team that developed the product found that participants who used the product reported an improvement in insomnia symptoms and overall wellbeing.\u003c/p>\n\u003cp>“It’s an impressive study in size and scope,” says \u003ca href=\"http://www.johntorousmd.com/\" target=\"_blank\" rel=\"noopener\">John Torous\u003c/a>, the director of digital psychiatry at Beth Israel Deaconess Medical Center. “But like any study, we have to interpret it within reason.”\u003c/p>\n\u003cp>The participants in the study were mostly white and female, he notes, and so it’s hard to generalize the findings to the larger population. And, he adds that the study was designed and funded by Big Health, the company that created the app and is now marketing it.\u003c/p>\n\u003cp>Also, Sleepio is only available on a limited basis. You can get it through employers, health insurance and national health systems at the moment, says Mike Radocchia, the marketing and business development lead at Big Health. Although the company does give it to researchers and charities for free.\u003c/p>\n\u003cp>And while apps that use Cognitive Behavior Therapy for Insomnia cost less than in-person therapy, they can be pricey. A 26-week subscription of SHUTi \u003ca href=\"http://www.myshuti.com/shuti-pricing/\" target=\"_blank\" rel=\"noopener\">costs $149\u003c/a>.\u003c/p>\n\u003cp>That’s why Torous often directs his patients with insomnia to a free app developed by the Veterans Administration called \u003ca href=\"https://mobile.va.gov/app/cbt-i-coach\" target=\"_blank\" rel=\"noopener\">CBT-I Coach\u003c/a>.\u003c/p>\n\u003cp>“Anyone can access it. You don’t have to be a veteran,” Torous says.\u003c/p>\n\u003cp>\u003ca href=\"http://www.nextbreathcounseling.com/credentials/\" target=\"_blank\" rel=\"noopener\">Jake Hanks\u003c/a>, a mental health counselor based in Glenwood Springs, Colorado, agrees. “CBT-I Coach would be my absolute favorite,” he says. “It includes a lot of the cognitive restructuring, the true things about sleep that we want patients to keep in mind.” And so, he too, recommends the free app to his patients.\u003c/p>\n\u003cp>However, Torous notes that these apps don’t work for everyone. The recent study by Ong and his colleagues hints at why.\u003c/p>\n\u003cp>“Even in this clinical study, less than 50 percent [of people who were assigned to use the app in a randomized controlled trial] are able to make it through the entire course of CBT delivered through digital platforms,” he notes. “For some people it may be hard to make it through all the sessions of CBT.”\u003c/p>\n\u003cp>This is true of most health and wellness apps, he says. Torous \u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2616170\" target=\"_blank\" rel=\"noopener\">has studied\u003c/a> this and found that of the 10,000 mental health apps out there, very few are actually being used. “I don’t think we really understand how people are using technology towards their health and recovery,” he notes.[contextly_sidebar id=”LqkvTN1dfENdC3n50jRUdIl6PSPHOHGb”]\u003c/p>\n\u003cp>But in some ways, he says, people with insomnia may be ahead of scientists in figuring out what works well for them.\u003c/p>\n\u003cp>“If you find something that works [for you], I think that’s always a good first step,” he says. “Quick fixes or simple solutions may get you feeling better right away.”\u003c/p>\n\u003cp>But, he notes, insomnia is a complex disorder with many underlying causes. Sometimes it can be caused by a medical condition that’s easily treatable, like a thyroid problem, he adds.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>So, no matter what app you are considering, always talk to your doctor about your sleep issues, he advises. “Until you know the diagnosis or what you’re working with, you don’t want to start treating something that’s not what you think it is.”\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Some+Apps+May+Help+Curb+Insomnia%2C+Others+Just+Put+You+To+Sleep&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "People struggling with insomnia often turn to apps to help them fall asleep. But scientists say only some apps use proven methods that can help address the underlying causes of sleeplessness.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Paige Thesing has struggled with insomnia since high school. “It takes me a really long time to fall asleep — about four hours,” she says. For years, her mornings were groggy and involved a “lot of coffee.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>After a year of trying sleep medication prescribed by her doctor, she turned to the internet for alternate solutions. About four months ago, she settled on a mobile phone meditation app called \u003ca href=\"https://www.inscape.life/\" target=\"_blank\" rel=\"noopener\">INSCAPE\u003c/a>.\u003c/p>\n\u003cp>“It’s about a 30-minute soundtrack, and it starts with a woman kind of telling you to relax and instructing your breathing,” explains Thesing. “Then it goes into sounds — relaxing noises. There’s wind chimes, some atmospheric music playing…”\u003c/p>\n\u003cp>She uses the app every night and falls asleep within 15 or 20 minutes. “So, definitely a big improvement from four hours,” she says.\u003c/p>\n\u003cp>Thesing is not alone. Chronic insomnia affects an estimated \u003ca href=\"https://www.ajmc.com/journals/supplement/2006/2006-05-vol12-n8suppl/may06-2307ps214-s220\" target=\"_blank\" rel=\"noopener\">10-15 percent of adults\u003c/a>, and another 25-35 percent struggle with sleep issues occasionally. And like Thesing, a growing number of insomniacs are turning to mobile phone apps to lull them to sleep.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>On \u003ca href=\"https://twitter.com/NPRHealth/status/1046884648167624711\" target=\"_blank\" rel=\"noopener\">Twitter\u003c/a> and Facebook, NPR asked its audience if they have used a mobile phone app to help manage insomnia. Nearly 100 people wrote back suggesting a range of apps, including podcasts created to put a listener to sleep.\u003c/p>\n\u003cp>“These are usually relaxation strategies, white noise, meditation,” \u003ca href=\"https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=35378\" target=\"_blank\" rel=\"noopener\">Jason Ong\u003c/a>, an associate professor of neurology specializing in sleep at Northwestern University’s Feinberg School of Medicine. He studies non-pharmacological treatments for various sleep disorders and treats patients at the university’s Sleep Medicine clinic. “It’s not that there’s something wrong with those apps. It’s a reasonable first thing to try.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But, he adds, these kinds of apps aren’t based on scientifically-proven solutions, and they don’t really fix the problem of why someone is not sleeping.\u003c/p>\n\u003cp>Ong wanted to do something about that, so a few years ago, he consulted for a team that developed an app that uses a science-based approach to address insomnia called \u003ca href=\"https://www.sleepio.com/cbt-for-insomnia/\" target=\"_blank\" rel=\"noopener\">Sleepio\u003c/a>. (However, he doesn’t have any ongoing financial interest in the product, he says.)\u003c/p>\n\u003cp>Sleepio and a few other apps like \u003ca href=\"http://www.myshuti.com/\" target=\"_blank\" rel=\"noopener\">SHUT-i\u003c/a> and a free one developed by the Veterans Administration use the most sustainable and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/15451764\" target=\"_blank\" rel=\"noopener\">evidence-based\u003c/a> solution for insomnia. It’s a kind of therapy called Cognitive Behavioral Therapy for Insomnia — \u003ca href=\"https://www.sleepfoundation.org/sleep-news/cognitive-behavioral-therapy-insomnia\" target=\"_blank\" rel=\"noopener\">CBT-I\u003c/a> for short, he says. It helps the patient understand the biology of sleep and gives them a bag of tools and tricks to change their own thought patterns and behaviors to treat their underlying sleep issues.\u003c/p>\n\u003cp>“CBT for insomnia is a specific package … [that] includes different techniques like spending less time in bed [and] what to do if you are in bed and can’t sleep,” says Ong. “It’s teaching you how to change your behavior to better work with your brain to give you confidence that you’re going to be able to sleep on a regular basis.”\u003c/p>\n\u003cp>It may be surprising to us, but our own thought patterns and sleep habits \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3621793/\" target=\"_blank\" rel=\"noopener\">affect our biology\u003c/a>, in this case how our brains regulate sleep. “If you modify some of your behaviors, you can work better with how your brain regulates sleep and wake,” he says.\u003c/p>\n\u003cp>The American College of Physicians \u003ca href=\"https://www.acponline.org/acp-newsroom/acp-recommends-cognitive-behavioral-therapy-as-initial-treatment-for-chronic-insomnia\" target=\"_blank\" rel=\"noopener\">first recommended\u003c/a> Cognitive Behavioral Therapy for Insomnia as the first-line treatment for insomnia in 2016. “The evidence is quite strong to support the effectiveness of CBT-I treatment and there really aren’t a lot of side effects,” says Ong. And, because it changes behavior, “in the long run CBT-I tends to perform quite well in maintaining the benefits.”\u003c/p>\n\u003cp>In the past the only way for people to get Cognitive Behavioral Therapy for Insomnia was to see a therapist, now they can access the therapy on their mobile phones.\u003c/p>\n\u003cp>“In Sleepio, it’s like an avatar of a real therapist that’s walking the patient through that process,” explains Ong. Sleepio also allows users to keep a sleep diary so the app can use its algorithm to suggest a better bedtime schedule. It also reminds people to get up when they’ve spent too much time in bed trying to fall asleep, for example.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Like a real therapist, the apps that use Cognitive Behavior Therapy for Insomnia also provide practical tools to help the user worry less about their sleep and over time, be less anxious and more confident about their ability get a good night’s rest. “It’s very similar to what we do face-to-face with patients,” adds Ong.\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427093/\" target=\"_blank\" rel=\"noopener\">Studies show\u003c/a> that CBT-I delivered digitally through mobile phone apps is effective in treating insomnia. And a \u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2704019\" target=\"_blank\" rel=\"noopener\">recent study\u003c/a> of Sleepio by Ong and the team that developed the product found that participants who used the product reported an improvement in insomnia symptoms and overall wellbeing.\u003c/p>\n\u003cp>“It’s an impressive study in size and scope,” says \u003ca href=\"http://www.johntorousmd.com/\" target=\"_blank\" rel=\"noopener\">John Torous\u003c/a>, the director of digital psychiatry at Beth Israel Deaconess Medical Center. “But like any study, we have to interpret it within reason.”\u003c/p>\n\u003cp>The participants in the study were mostly white and female, he notes, and so it’s hard to generalize the findings to the larger population. And, he adds that the study was designed and funded by Big Health, the company that created the app and is now marketing it.\u003c/p>\n\u003cp>Also, Sleepio is only available on a limited basis. You can get it through employers, health insurance and national health systems at the moment, says Mike Radocchia, the marketing and business development lead at Big Health. Although the company does give it to researchers and charities for free.\u003c/p>\n\u003cp>And while apps that use Cognitive Behavior Therapy for Insomnia cost less than in-person therapy, they can be pricey. A 26-week subscription of SHUTi \u003ca href=\"http://www.myshuti.com/shuti-pricing/\" target=\"_blank\" rel=\"noopener\">costs $149\u003c/a>.\u003c/p>\n\u003cp>That’s why Torous often directs his patients with insomnia to a free app developed by the Veterans Administration called \u003ca href=\"https://mobile.va.gov/app/cbt-i-coach\" target=\"_blank\" rel=\"noopener\">CBT-I Coach\u003c/a>.\u003c/p>\n\u003cp>“Anyone can access it. You don’t have to be a veteran,” Torous says.\u003c/p>\n\u003cp>\u003ca href=\"http://www.nextbreathcounseling.com/credentials/\" target=\"_blank\" rel=\"noopener\">Jake Hanks\u003c/a>, a mental health counselor based in Glenwood Springs, Colorado, agrees. “CBT-I Coach would be my absolute favorite,” he says. “It includes a lot of the cognitive restructuring, the true things about sleep that we want patients to keep in mind.” And so, he too, recommends the free app to his patients.\u003c/p>\n\u003cp>However, Torous notes that these apps don’t work for everyone. The recent study by Ong and his colleagues hints at why.\u003c/p>\n\u003cp>“Even in this clinical study, less than 50 percent [of people who were assigned to use the app in a randomized controlled trial] are able to make it through the entire course of CBT delivered through digital platforms,” he notes. “For some people it may be hard to make it through all the sessions of CBT.”\u003c/p>\n\u003cp>This is true of most health and wellness apps, he says. Torous \u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2616170\" target=\"_blank\" rel=\"noopener\">has studied\u003c/a> this and found that of the 10,000 mental health apps out there, very few are actually being used. “I don’t think we really understand how people are using technology towards their health and recovery,” he notes.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But in some ways, he says, people with insomnia may be ahead of scientists in figuring out what works well for them.\u003c/p>\n\u003cp>“If you find something that works [for you], I think that’s always a good first step,” he says. “Quick fixes or simple solutions may get you feeling better right away.”\u003c/p>\n\u003cp>But, he notes, insomnia is a complex disorder with many underlying causes. Sometimes it can be caused by a medical condition that’s easily treatable, like a thyroid problem, he adds.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So, no matter what app you are considering, always talk to your doctor about your sleep issues, he advises. “Until you know the diagnosis or what you’re working with, you don’t want to start treating something that’s not what you think it is.”\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Some+Apps+May+Help+Curb+Insomnia%2C+Others+Just+Put+You+To+Sleep&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "You Don't Have To Pass Out To Be Blackout Drunk",
"title": "You Don't Have To Pass Out To Be Blackout Drunk",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Unless you've been blissfully unplugged, you must have come across the term \"blackout\" lately. And you may have thought it means inebriated to the point of unconsciousness. Falling-down drunk. Blotto.[contextly_sidebar id=\"UNiHL8eB1QjUnbIxSw8VWUrjWiq8mQov\"]\u003c/p>\n\u003cp>Supreme Court nominee Brett Kavanaugh appears to think so, based on \u003ca href=\"https://www.washingtonpost.com/news/national/wp/2018/09/27/kavanaugh-hearing-transcript/?utm_term=.953b6f43eb3c\" target=\"_blank\" rel=\"noopener\">this exchange\u003c/a> last Thursday during his fiery self-defense before the Senate Judiciary Committee:\u003c/p>\n\u003cblockquote>\u003cp>\"Have you ever passed out from drinking?\" queried Rachel Mitchell, a sex crimes prosecutor from Phoenix retained by Republicans to ask question at the hearing.\u003c/p>\n\u003cp>\"Passed out would be — no. But I've gone to sleep. But — but I've never blacked out,\" Kavanaugh replied. \"That's the — allegation, and that — that's wrong.\"\u003c/p>\u003c/blockquote>\n\u003cp>But that notion of an alcohol-induced blackout is wrong.\u003c/p>\n\u003cp>A less confusing term might be \"alcohol-induced amnesia.\" It can be total. Hours of experience and events can be totally missing from memory. Or it can be spotty. Either way, it can be hard to impossible for a bystander, or even the inebriated person, to know when it has happened.\u003c/p>\n\u003cp>Misunderstanding blackouts has big implications. The phenomenon could reconcile the disconnect between what psychologist Christine Blasey Ford says she remembers so indelibly about an alleged sexual assault by Kavanaugh one summer evening 36 years ago and Kavanaugh's categorical denial that it ever happened.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>To understand the phenomenon, I talked with Dr. \u003ca href=\"https://www.bu.edu/sph/profile/richard-saitz/\" target=\"_blank\" rel=\"noopener\">Richard Saitz\u003c/a>, chair of Boston University School of Public Health's Department of Community Health Sciences, a veteran researcher of alcohol abuse and an addiction medicine specialist. Our conversation, edited:\u003c/p>\n\u003cp>\u003cstrong>There's been recent confusion about alcohol-related blackouts — what they are and what they aren't. What's been your reaction to the use of the term lately?\u003c/strong>\u003c/p>\n\u003cp>Many people confuse the idea of a blackout with someone who's had so much to drink that they are unarousable — they're not awake and they don't know what's going on. That's not at all the case. A blackout is when you don't remember what happened. You can appear to be completely awake. An observer can't tell when someone is in the midst of not forming a memory.\u003c/p>\n\u003cp>The second common misconception is that having a blackout is characteristic of an alcohol use disorder more commonly called alcoholism — that you only have blackouts if you have an alcohol use disorder. And that's just not true.\u003c/p>\n\u003cp>\u003cstrong>It's a curious phenomenon — a very selective kind of temporary memory impairment. What's going on in there?\u003c/strong>\u003c/p>\n\u003cp>It involves those parts of the brain that are required to take in what's happening and allow you to remember it later. You might remember it two or three minutes later but not 10 hours later or two days later or ever again, because it didn't get permanently encoded by the brain. It probably happens in the hippocampus and it involves the frontal lobes of the brain as well.[contextly_sidebar id=\"nWd7zNE3xlJLE0K0o8Op2Mrh7FV5jCXX\"]\u003c/p>\n\u003cp>\u003cstrong>What touches it off?\u003c/strong>\u003c/p>\n\u003cp>If you drink a substantial amount quickly, you might experience a blackout. Drinking games would be an example of that because that's the point of the game.\u003c/p>\n\u003cp>\u003cstrong>How common are blackouts?\u003c/strong>\u003c/p>\n\u003cp>We don't have great epidemiologic data about this. I've seen the prevalence of blackouts ranging anywhere from 10 percent to up to 50 percent of young people who drink. It's fair to say it's not rare.\u003c/p>\n\u003cp>\u003cstrong>Does blackout seem to explain, at least potentially, the great divergence we heard last week in the testimony of Ford and Kavanaugh?\u003c/strong>\u003c/p>\n\u003cp>It's plausible that if he were drinking heavily and rapidly that he might have a blackout. So it's possible he might have no recollection of what happened.\u003c/p>\n\u003cp>\u003cstrong>What do you think when you hear Kavanaugh say, in response to a question about whether he's ever \"passed out from drinking,\" that he's \"gone to sleep, but ... never blacked out\"?\u003c/strong>\u003c/p>\n\u003cp>I have no knowledge of what Judge Kavanaugh knows about the definition of \"blackout\" versus \"passing out\" versus \"falling asleep after drinking.\" Passed out is not a clinical term and usually people use it to mean that they drank so much that they ended up falling asleep. I'm not sure if he could say that he had a blackout or not. The only way he would know is if somebody later told him that something happened while he was intoxicated and he didn't remember it, and then he believed they were telling the truth. So it's not a particularly easy question to answer unless you know the definition of blackout and your memory has been questioned, or somebody told you about it.[contextly_sidebar id=\"cOFlriGvdakmZZ3kgLOVmpocMiXNOj0A\"]\u003c/p>\n\u003cp>\u003cstrong>Ford placed Kavanaugh's companion, Mark Judge, in the room where the alleged assault occurred. If he also was drinking heavily and also had a blackout, neither of them would remember and nobody else would be in a position to call their attention to it.\u003c/strong>\u003c/p>\n\u003cp>Sure. It's conceivable they both could have had a blackout about the same event, although that begins to get a little bit less likely. If there was someone there to say that something happened, that's the only way you could come close to knowing.\u003c/p>\n\u003cp>\u003cstrong>If you were consulted by the FBI, which is trying to unravel all this, what would you advise them to consider in light of the blackout phenomenon? What should they be alert to?\u003c/strong>\u003c/p>\n\u003cp>They need to be aware that it's certainly possible there could have been something that happened that [Kavanaugh] might have no memory of. So if he says something didn't happen and it was supposed to have happened during a heavy drinking episode, then it's possible he has no memory of it. And so therefore they need to find other evidence or ask someone else, because his denial is questionable.\u003c/p>\n\u003cp>I would also tell them that it's unlikely, at that age and in that context, that this would have happened only once. It's likely he'd have had a blackout on some other occasion. And so there might be evidence of that.\u003c/p>\n\u003cp>\u003cstrong>It seems as though this whole phenomenon of blackouts is a really big public health issue. Because people may do things in that state, such as committing sexual assault, that they don't feel personally responsible for later.\u003c/strong>\u003c/p>\n\u003cp>The real problem with blackouts is that you don't remember. And so you can't learn from your behavior unless someone tells you that you did something terrible.\u003c/p>\n\u003cp>\u003cstrong>Shouldn't public health educators and message-makers address blackouts? Don't teens and young adults need to understand more about this phenomenon? That it's not simply a question of moral failure but it's the way the brain acts in some people, in certain situations?\u003c/strong>\u003c/p>\n\u003cp>You're absolutely right. This is not a moral judgment about whether people are drinking too much or not. This is a toxic biological effect of something that you're taking in that affects your brain in this way and makes it so that you can't remember what happened.\u003c/p>\n\u003cp>This afternoon our school of public health is having a conversation with students and faculty about sexual assault. So it's a teaching opportunity for that. And more broadly, it's a teaching opportunity around alcohol use and heavy drinking.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>A version of this story originally ran on WBUR's \u003c/em>\u003ca href=\"http://www.wbur.org/commonhealth\">CommonHealth\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 WBUR. To see more, visit \u003ca href=\"http://www.wbur.org\">WBUR\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=You+Don%27t+Have+To+Pass+Out+To+Be+Blackout+Drunk&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Unless you've been blissfully unplugged, you must have come across the term \"blackout\" lately. And you may have thought it means inebriated to the point of unconsciousness. Falling-down drunk. Blotto.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Supreme Court nominee Brett Kavanaugh appears to think so, based on \u003ca href=\"https://www.washingtonpost.com/news/national/wp/2018/09/27/kavanaugh-hearing-transcript/?utm_term=.953b6f43eb3c\" target=\"_blank\" rel=\"noopener\">this exchange\u003c/a> last Thursday during his fiery self-defense before the Senate Judiciary Committee:\u003c/p>\n\u003cblockquote>\u003cp>\"Have you ever passed out from drinking?\" queried Rachel Mitchell, a sex crimes prosecutor from Phoenix retained by Republicans to ask question at the hearing.\u003c/p>\n\u003cp>\"Passed out would be — no. But I've gone to sleep. But — but I've never blacked out,\" Kavanaugh replied. \"That's the — allegation, and that — that's wrong.\"\u003c/p>\u003c/blockquote>\n\u003cp>But that notion of an alcohol-induced blackout is wrong.\u003c/p>\n\u003cp>A less confusing term might be \"alcohol-induced amnesia.\" It can be total. Hours of experience and events can be totally missing from memory. Or it can be spotty. Either way, it can be hard to impossible for a bystander, or even the inebriated person, to know when it has happened.\u003c/p>\n\u003cp>Misunderstanding blackouts has big implications. The phenomenon could reconcile the disconnect between what psychologist Christine Blasey Ford says she remembers so indelibly about an alleged sexual assault by Kavanaugh one summer evening 36 years ago and Kavanaugh's categorical denial that it ever happened.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>To understand the phenomenon, I talked with Dr. \u003ca href=\"https://www.bu.edu/sph/profile/richard-saitz/\" target=\"_blank\" rel=\"noopener\">Richard Saitz\u003c/a>, chair of Boston University School of Public Health's Department of Community Health Sciences, a veteran researcher of alcohol abuse and an addiction medicine specialist. Our conversation, edited:\u003c/p>\n\u003cp>\u003cstrong>There's been recent confusion about alcohol-related blackouts — what they are and what they aren't. What's been your reaction to the use of the term lately?\u003c/strong>\u003c/p>\n\u003cp>Many people confuse the idea of a blackout with someone who's had so much to drink that they are unarousable — they're not awake and they don't know what's going on. That's not at all the case. A blackout is when you don't remember what happened. You can appear to be completely awake. An observer can't tell when someone is in the midst of not forming a memory.\u003c/p>\n\u003cp>The second common misconception is that having a blackout is characteristic of an alcohol use disorder more commonly called alcoholism — that you only have blackouts if you have an alcohol use disorder. And that's just not true.\u003c/p>\n\u003cp>\u003cstrong>It's a curious phenomenon — a very selective kind of temporary memory impairment. What's going on in there?\u003c/strong>\u003c/p>\n\u003cp>It involves those parts of the brain that are required to take in what's happening and allow you to remember it later. You might remember it two or three minutes later but not 10 hours later or two days later or ever again, because it didn't get permanently encoded by the brain. It probably happens in the hippocampus and it involves the frontal lobes of the brain as well.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>What touches it off?\u003c/strong>\u003c/p>\n\u003cp>If you drink a substantial amount quickly, you might experience a blackout. Drinking games would be an example of that because that's the point of the game.\u003c/p>\n\u003cp>\u003cstrong>How common are blackouts?\u003c/strong>\u003c/p>\n\u003cp>We don't have great epidemiologic data about this. I've seen the prevalence of blackouts ranging anywhere from 10 percent to up to 50 percent of young people who drink. It's fair to say it's not rare.\u003c/p>\n\u003cp>\u003cstrong>Does blackout seem to explain, at least potentially, the great divergence we heard last week in the testimony of Ford and Kavanaugh?\u003c/strong>\u003c/p>\n\u003cp>It's plausible that if he were drinking heavily and rapidly that he might have a blackout. So it's possible he might have no recollection of what happened.\u003c/p>\n\u003cp>\u003cstrong>What do you think when you hear Kavanaugh say, in response to a question about whether he's ever \"passed out from drinking,\" that he's \"gone to sleep, but ... never blacked out\"?\u003c/strong>\u003c/p>\n\u003cp>I have no knowledge of what Judge Kavanaugh knows about the definition of \"blackout\" versus \"passing out\" versus \"falling asleep after drinking.\" Passed out is not a clinical term and usually people use it to mean that they drank so much that they ended up falling asleep. I'm not sure if he could say that he had a blackout or not. The only way he would know is if somebody later told him that something happened while he was intoxicated and he didn't remember it, and then he believed they were telling the truth. So it's not a particularly easy question to answer unless you know the definition of blackout and your memory has been questioned, or somebody told you about it.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Ford placed Kavanaugh's companion, Mark Judge, in the room where the alleged assault occurred. If he also was drinking heavily and also had a blackout, neither of them would remember and nobody else would be in a position to call their attention to it.\u003c/strong>\u003c/p>\n\u003cp>Sure. It's conceivable they both could have had a blackout about the same event, although that begins to get a little bit less likely. If there was someone there to say that something happened, that's the only way you could come close to knowing.\u003c/p>\n\u003cp>\u003cstrong>If you were consulted by the FBI, which is trying to unravel all this, what would you advise them to consider in light of the blackout phenomenon? What should they be alert to?\u003c/strong>\u003c/p>\n\u003cp>They need to be aware that it's certainly possible there could have been something that happened that [Kavanaugh] might have no memory of. So if he says something didn't happen and it was supposed to have happened during a heavy drinking episode, then it's possible he has no memory of it. And so therefore they need to find other evidence or ask someone else, because his denial is questionable.\u003c/p>\n\u003cp>I would also tell them that it's unlikely, at that age and in that context, that this would have happened only once. It's likely he'd have had a blackout on some other occasion. And so there might be evidence of that.\u003c/p>\n\u003cp>\u003cstrong>It seems as though this whole phenomenon of blackouts is a really big public health issue. Because people may do things in that state, such as committing sexual assault, that they don't feel personally responsible for later.\u003c/strong>\u003c/p>\n\u003cp>The real problem with blackouts is that you don't remember. And so you can't learn from your behavior unless someone tells you that you did something terrible.\u003c/p>\n\u003cp>\u003cstrong>Shouldn't public health educators and message-makers address blackouts? Don't teens and young adults need to understand more about this phenomenon? That it's not simply a question of moral failure but it's the way the brain acts in some people, in certain situations?\u003c/strong>\u003c/p>\n\u003cp>You're absolutely right. This is not a moral judgment about whether people are drinking too much or not. This is a toxic biological effect of something that you're taking in that affects your brain in this way and makes it so that you can't remember what happened.\u003c/p>\n\u003cp>This afternoon our school of public health is having a conversation with students and faculty about sexual assault. So it's a teaching opportunity for that. And more broadly, it's a teaching opportunity around alcohol use and heavy drinking.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>The U.S. Food and Drug Administration announced on Friday that it has \u003ca href=\"https://www.fda.gov/Food/NewsEvents/ConstituentUpdates/ucm622475.htm\" target=\"_blank\" rel=\"noopener\">removed seven artificial flavors\u003c/a> from its list of approved food additives after animal studies showed that they cause cancer.\u003c/p>\n\u003cp>The banned chemicals— benzophenone, ethyl acrylate, eugenyl methyl ether, myrcene, pulegone, and pyridine— can be found as flavors and flavor enhancers in common products such as baked goods, desserts, beverages, candy, beer and ice cream.\u003c/p>\n\u003cp>The FDA also delisted styrene without ruling on its status as a carcinogen, according to the Natural Resources Defense Council, which, along with several other health and consumer organizations, filed a petition in 2015 asking the FDA to ban the chemicals on safety grounds.\u003c/p>\n\u003cdiv>\n\u003cp>“Carcinogens\u003ca href=\"https://www.nrdc.org/media/2018/181005-0\" target=\"_blank\" rel=\"noopener\"> have no place\u003c/a> in the food we feed our families,\" Erik Olson, senior director of health and food at NRDC, said in a statement. \"This is welcome news for millions of Americans who have been unknowingly snacking on cancer-causing chemicals for far too long.\"\u003c/p>\n\u003c/div>\n\u003cp>Since the FDA first approved the artificial flavors in 1964, government toxicology reports \u003ca href=\"http://blogs.edf.org/health/2018/05/17/fda-carcinogenic-flavors-petition/\" target=\"_blank\" rel=\"noopener\">have shown t\u003c/a>hat six of them cause cancer in two species of animals, and that styrene is also “reasonably anticipated\" to be carcinogenic, according to the petition.\u003c/p>\n\u003cp>A law passed in 1958 \u003ca href=\"https://www.gao.gov/products/HRD-82-3\" target=\"_blank\" rel=\"noopener\">requires the FDA\u003c/a> to ban the use of any food additive found to cause cancer in animals or humans.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The chemicals are hard to pin down \u003ca href=\"https://www.ceh.org/news-events/press-coverage/content/advocacy-groups-sue-fda-ban-seven-synthetic-food-flavors/\" target=\"_blank\" rel=\"noopener\">on food labels\u003c/a> because they are listed as \"artificial flavors,\" according to the Center for Environmental Health.\u003c/p>\n\u003cp>The FDA says the substances are used \"in very small amounts\" and carry \"very low levels of exposures\" \u003ca href=\"https://www.fda.gov/Food/NewsEvents/ConstituentUpdates/ucm622475.htm\" target=\"_blank\" rel=\"noopener\">that do not pose\u003c/a> a risk to public health when used as intended.\u003c/p>\n\u003cp>Following FDA inaction on the petition, which was revised in 2016, a broad coalition of consumer and health groups \u003ca href=\"https://www.ceh.org/news-events/press-coverage/content/advocacy-groups-sue-fda-ban-seven-synthetic-food-flavors/\" target=\"_blank\" rel=\"noopener\">sued the FDA\u003c/a> in May of this year. In response to the court filing, the FDA agreed to make a decision.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The decision goes into effect immediately following publication in the Federal Register unless companies object. Food manufacturers will then have two years to comply with the ban.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The U.S. Food and Drug Administration announced on Friday that it has \u003ca href=\"https://www.fda.gov/Food/NewsEvents/ConstituentUpdates/ucm622475.htm\" target=\"_blank\" rel=\"noopener\">removed seven artificial flavors\u003c/a> from its list of approved food additives after animal studies showed that they cause cancer.\u003c/p>\n\u003cp>The banned chemicals— benzophenone, ethyl acrylate, eugenyl methyl ether, myrcene, pulegone, and pyridine— can be found as flavors and flavor enhancers in common products such as baked goods, desserts, beverages, candy, beer and ice cream.\u003c/p>\n\u003cp>The FDA also delisted styrene without ruling on its status as a carcinogen, according to the Natural Resources Defense Council, which, along with several other health and consumer organizations, filed a petition in 2015 asking the FDA to ban the chemicals on safety grounds.\u003c/p>\n\u003cdiv>\n\u003cp>“Carcinogens\u003ca href=\"https://www.nrdc.org/media/2018/181005-0\" target=\"_blank\" rel=\"noopener\"> have no place\u003c/a> in the food we feed our families,\" Erik Olson, senior director of health and food at NRDC, said in a statement. \"This is welcome news for millions of Americans who have been unknowingly snacking on cancer-causing chemicals for far too long.\"\u003c/p>\n\u003c/div>\n\u003cp>Since the FDA first approved the artificial flavors in 1964, government toxicology reports \u003ca href=\"http://blogs.edf.org/health/2018/05/17/fda-carcinogenic-flavors-petition/\" target=\"_blank\" rel=\"noopener\">have shown t\u003c/a>hat six of them cause cancer in two species of animals, and that styrene is also “reasonably anticipated\" to be carcinogenic, according to the petition.\u003c/p>\n\u003cp>A law passed in 1958 \u003ca href=\"https://www.gao.gov/products/HRD-82-3\" target=\"_blank\" rel=\"noopener\">requires the FDA\u003c/a> to ban the use of any food additive found to cause cancer in animals or humans.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The chemicals are hard to pin down \u003ca href=\"https://www.ceh.org/news-events/press-coverage/content/advocacy-groups-sue-fda-ban-seven-synthetic-food-flavors/\" target=\"_blank\" rel=\"noopener\">on food labels\u003c/a> because they are listed as \"artificial flavors,\" according to the Center for Environmental Health.\u003c/p>\n\u003cp>The FDA says the substances are used \"in very small amounts\" and carry \"very low levels of exposures\" \u003ca href=\"https://www.fda.gov/Food/NewsEvents/ConstituentUpdates/ucm622475.htm\" target=\"_blank\" rel=\"noopener\">that do not pose\u003c/a> a risk to public health when used as intended.\u003c/p>\n\u003cp>Following FDA inaction on the petition, which was revised in 2016, a broad coalition of consumer and health groups \u003ca href=\"https://www.ceh.org/news-events/press-coverage/content/advocacy-groups-sue-fda-ban-seven-synthetic-food-flavors/\" target=\"_blank\" rel=\"noopener\">sued the FDA\u003c/a> in May of this year. In response to the court filing, the FDA agreed to make a decision.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The decision goes into effect immediately following publication in the Federal Register unless companies object. Food manufacturers will then have two years to comply with the ban.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>Updated 6:45 a.m. ET\u003c/strong>\u003c/p>\n\u003cp>The 2018 Nobel Peace Prize has been awarded to Dr. Denis Mukwege, a Congolese gynecologist, and Nadia Murad, a Yazidi survivor of rape and captivity by ISIS, for their contributions toward combating wartime sexual assault.[contextly_sidebar id=\"NXJQbyDb7jC8ES9o3yGFx6gEvwbaL22U\"]\u003c/p>\n\u003cp>The prize was announced by the Norwegian Nobel Committee in Oslo, Norway, on Friday morning. The committee praised the winners for being symbols in the fight to end the use of sexual violence as a weapon of war and armed conflict.\u003c/p>\n\u003cp>Mukwege has treated victims of sexual violence in the Democratic Republic of the Congo for most of his adult life. He founded the \u003ca href=\"http://www.panzifoundation.org/panzi-hospital/\" target=\"_blank\" rel=\"noopener\">Panzi Hospital\u003c/a>, which supports survivors of sexual assault.\u003c/p>\n\u003cp>He practices medicine in eastern Congo, which has been called the \u003ca href=\"https://news.un.org/en/story/2010/04/336662#.WWS7OGXqquc\" target=\"_blank\" rel=\"noopener\">\"rape capital of the world\"\u003c/a> by U.N. officials. Nearly 50 women are raped there every hour, experts say. Mukwege has treated tens of thousands of women for rape since opening Panzi Hospital in the eastern Congo in 1999.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The hospital's original mission was to curb maternal mortality rates. \"But our first patient did not come to deliver a baby,\" he \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2016/10/06/496893413/doctor-who-helps-rape-survivors-is-shortlisted-for-nobel-peace-prize\" target=\"_blank\" rel=\"noopener\">said in a 2016 speech\u003c/a>. \"She had been raped with extreme violence.\"\u003c/p>\n\u003cp>Mukwege developed a model of treatment that emphasizes both physical care and justice. The Panzi model's five pillars are medical treatment, psychosocial therapy, socioeconomic support and training, community reintegration and legal assistance — a healing process that allows survivors to process physical, emotional and spiritual trauma.\u003c/p>\n\u003cp>Mukwege has received multiple threats for carrying out his work. As \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2016/10/06/496893413/doctor-who-helps-rape-survivors-is-shortlisted-for-nobel-peace-prize\" target=\"_blank\" rel=\"noopener\">NPR reported\u003c/a> in a 2016 profile of the doctor:\u003c/p>\n\u003cblockquote>\u003cp>\"In September 2012 he gave a speech decrying the horror of mass rape in Congo to the U.N. A month later, gunmen invaded his home and attempted to kill him, his wife and their two daughters. His guard intervened. During the ensuing shootout, the doctor and his family played dead. He left Congo shortly thereafter but the women of Eastern Congo sold their harvest to pay for his plane ticket home.\"\u003c/p>\u003c/blockquote>\n\u003cp>\"His basic principle is that justice is everyone's business,\" the committee said.\u003c/p>\n\u003cp>Murad herself is a victim of sexual war crimes.\u003c/p>\n\u003cp>She is a member of the Yazidi minority in northern Iraq and was taken captive by ISIS members who had launched an attack on her small village. She was held as a sex slave for three months before escaping from her captors. In 2016, she was named the U.N.'s first Goodwill Ambassador for the Dignity of Survivors of Human Trafficking.[contextly_sidebar id=\"tdvC6ca5g96PXhw4ZN6RW1SOjMwwwESF\"]\u003c/p>\n\u003cp>It is believed that \u003ca href=\"https://www.npr.org/2018/08/22/640956251/once-held-captive-by-isis-nadia-murad-is-now-engaged\" target=\"_blank\" rel=\"noopener\">some 3,000 Yazidi women and girls\u003c/a> remain enslaved.\u003c/p>\n\u003cp>Murad, who is in her mid-20s, has spoken extensively about her experience, despite \u003ca href=\"https://www.npr.org/sections/parallels/2014/12/10/369636434/for-yazidi-women-escaping-isis-doesnt-mean-the-ordeal-is-over\" target=\"_blank\" rel=\"noopener\">the immense shame\u003c/a> her culture associates with rape — many Yazidi survivors refuse to be named. As NPR has reported, health authorities administer so-called virginity tests to some Yazidi women who return from captivity. Officials say they're voluntary and are done at the request of a victim or by the court, but some health groups call them traumatic and medically useless.\u003c/p>\n\u003cp>\"She refused to accept the social codes that require women to remain silent and ashamed of the abuses to which they have been subjected,\" the committee said.\u003c/p>\n\u003cp>This year, the committee wanted to send \"a message of awareness that women who constitute half the population in most communities actually are used as a weapon of war,\" said Berit Reiss-Andersen, chair of the Norwegian Nobel Committee, during a news conference.\u003c/p>\n\u003cp>Reiss-Andersen said that while wartime sexual assault and the #MeToo movement in general are significantly different, their goals share key elements: They both aim to acknowledge the abuses of women, eliminate the victim shaming and support women who speak out about their sexual assaults.\u003c/p>\n\u003cp>There were 331 candidates for the 2018 Nobel Peace Prize, the second-highest number of candidates ever. The peace prize is the only Nobel Prize awarded by the Norwegian Nobel Committee.[contextly_sidebar id=\"pD6V5igb9NHYIEQ8EuhBT53l6Qlg4c0W\"]\u003c/p>\n\u003cp>Last year's prize \u003ca href=\"https://www.npr.org/sections/thetwo-way/2017/10/06/556047073/2017-nobel-peace-prize\" target=\"_blank\" rel=\"noopener\">was awarded\u003c/a> to the International Campaign to Abolish Nuclear Weapons, or ICAN, a global organization seeking to \"outlaw and eliminate all nuclear weapons\" under international law.\u003c/p>\n\u003cp>The committee praised ICAN for drawing attention to \"the catastrophic humanitarian consequences of any use of nuclear weapons.\" The world's nuclear powers have not committed to their treaty.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>This year's Nobel Prizes in\u003ca href=\"https://www.npr.org/sections/health-shots/2018/10/01/653251667/james-p-allison-and-tasuku-honjo-win-2018-nobel-prize-in-physiology-or-medicine\" target=\"_blank\" rel=\"noopener\"> medicine\u003c/a>, \u003ca href=\"https://www.npr.org/2018/10/02/653576926/scientists-from-u-s-canada-france-split-nobel-prize-in-physics-for-laser-work\" target=\"_blank\" rel=\"noopener\">physics\u003c/a> and \u003ca href=\"https://www.npr.org/2018/10/03/653915709/nobel-prize-in-chemistry-honors-the-power-of-evolution\" target=\"_blank\" rel=\"noopener\">chemistry\u003c/a> were announced by the Royal Swedish Academy of Sciences earlier this week. The Nobel Memorial Prize in Economic Sciences will be awarded on Monday.\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=Nobel+Peace+Prize+Goes+To+Denis+Mukwege+And+Nadia+Murad+For+Fighting+Sexual+Violence&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Updated 6:45 a.m. ET\u003c/strong>\u003c/p>\n\u003cp>The 2018 Nobel Peace Prize has been awarded to Dr. Denis Mukwege, a Congolese gynecologist, and Nadia Murad, a Yazidi survivor of rape and captivity by ISIS, for their contributions toward combating wartime sexual assault.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The prize was announced by the Norwegian Nobel Committee in Oslo, Norway, on Friday morning. The committee praised the winners for being symbols in the fight to end the use of sexual violence as a weapon of war and armed conflict.\u003c/p>\n\u003cp>Mukwege has treated victims of sexual violence in the Democratic Republic of the Congo for most of his adult life. He founded the \u003ca href=\"http://www.panzifoundation.org/panzi-hospital/\" target=\"_blank\" rel=\"noopener\">Panzi Hospital\u003c/a>, which supports survivors of sexual assault.\u003c/p>\n\u003cp>He practices medicine in eastern Congo, which has been called the \u003ca href=\"https://news.un.org/en/story/2010/04/336662#.WWS7OGXqquc\" target=\"_blank\" rel=\"noopener\">\"rape capital of the world\"\u003c/a> by U.N. officials. Nearly 50 women are raped there every hour, experts say. Mukwege has treated tens of thousands of women for rape since opening Panzi Hospital in the eastern Congo in 1999.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The hospital's original mission was to curb maternal mortality rates. \"But our first patient did not come to deliver a baby,\" he \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2016/10/06/496893413/doctor-who-helps-rape-survivors-is-shortlisted-for-nobel-peace-prize\" target=\"_blank\" rel=\"noopener\">said in a 2016 speech\u003c/a>. \"She had been raped with extreme violence.\"\u003c/p>\n\u003cp>Mukwege developed a model of treatment that emphasizes both physical care and justice. The Panzi model's five pillars are medical treatment, psychosocial therapy, socioeconomic support and training, community reintegration and legal assistance — a healing process that allows survivors to process physical, emotional and spiritual trauma.\u003c/p>\n\u003cp>Mukwege has received multiple threats for carrying out his work. As \u003ca href=\"https://www.npr.org/sections/goatsandsoda/2016/10/06/496893413/doctor-who-helps-rape-survivors-is-shortlisted-for-nobel-peace-prize\" target=\"_blank\" rel=\"noopener\">NPR reported\u003c/a> in a 2016 profile of the doctor:\u003c/p>\n\u003cblockquote>\u003cp>\"In September 2012 he gave a speech decrying the horror of mass rape in Congo to the U.N. A month later, gunmen invaded his home and attempted to kill him, his wife and their two daughters. His guard intervened. During the ensuing shootout, the doctor and his family played dead. He left Congo shortly thereafter but the women of Eastern Congo sold their harvest to pay for his plane ticket home.\"\u003c/p>\u003c/blockquote>\n\u003cp>\"His basic principle is that justice is everyone's business,\" the committee said.\u003c/p>\n\u003cp>Murad herself is a victim of sexual war crimes.\u003c/p>\n\u003cp>She is a member of the Yazidi minority in northern Iraq and was taken captive by ISIS members who had launched an attack on her small village. She was held as a sex slave for three months before escaping from her captors. In 2016, she was named the U.N.'s first Goodwill Ambassador for the Dignity of Survivors of Human Trafficking.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>It is believed that \u003ca href=\"https://www.npr.org/2018/08/22/640956251/once-held-captive-by-isis-nadia-murad-is-now-engaged\" target=\"_blank\" rel=\"noopener\">some 3,000 Yazidi women and girls\u003c/a> remain enslaved.\u003c/p>\n\u003cp>Murad, who is in her mid-20s, has spoken extensively about her experience, despite \u003ca href=\"https://www.npr.org/sections/parallels/2014/12/10/369636434/for-yazidi-women-escaping-isis-doesnt-mean-the-ordeal-is-over\" target=\"_blank\" rel=\"noopener\">the immense shame\u003c/a> her culture associates with rape — many Yazidi survivors refuse to be named. As NPR has reported, health authorities administer so-called virginity tests to some Yazidi women who return from captivity. Officials say they're voluntary and are done at the request of a victim or by the court, but some health groups call them traumatic and medically useless.\u003c/p>\n\u003cp>\"She refused to accept the social codes that require women to remain silent and ashamed of the abuses to which they have been subjected,\" the committee said.\u003c/p>\n\u003cp>This year, the committee wanted to send \"a message of awareness that women who constitute half the population in most communities actually are used as a weapon of war,\" said Berit Reiss-Andersen, chair of the Norwegian Nobel Committee, during a news conference.\u003c/p>\n\u003cp>Reiss-Andersen said that while wartime sexual assault and the #MeToo movement in general are significantly different, their goals share key elements: They both aim to acknowledge the abuses of women, eliminate the victim shaming and support women who speak out about their sexual assaults.\u003c/p>\n\u003cp>There were 331 candidates for the 2018 Nobel Peace Prize, the second-highest number of candidates ever. The peace prize is the only Nobel Prize awarded by the Norwegian Nobel Committee.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Last year's prize \u003ca href=\"https://www.npr.org/sections/thetwo-way/2017/10/06/556047073/2017-nobel-peace-prize\" target=\"_blank\" rel=\"noopener\">was awarded\u003c/a> to the International Campaign to Abolish Nuclear Weapons, or ICAN, a global organization seeking to \"outlaw and eliminate all nuclear weapons\" under international law.\u003c/p>\n\u003cp>The committee praised ICAN for drawing attention to \"the catastrophic humanitarian consequences of any use of nuclear weapons.\" The world's nuclear powers have not committed to their treaty.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>This year's Nobel Prizes in\u003ca href=\"https://www.npr.org/sections/health-shots/2018/10/01/653251667/james-p-allison-and-tasuku-honjo-win-2018-nobel-prize-in-physiology-or-medicine\" target=\"_blank\" rel=\"noopener\"> medicine\u003c/a>, \u003ca href=\"https://www.npr.org/2018/10/02/653576926/scientists-from-u-s-canada-france-split-nobel-prize-in-physics-for-laser-work\" target=\"_blank\" rel=\"noopener\">physics\u003c/a> and \u003ca href=\"https://www.npr.org/2018/10/03/653915709/nobel-prize-in-chemistry-honors-the-power-of-evolution\" target=\"_blank\" rel=\"noopener\">chemistry\u003c/a> were announced by the Royal Swedish Academy of Sciences earlier this week. The Nobel Memorial Prize in Economic Sciences will be awarded on Monday.\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=Nobel+Peace+Prize+Goes+To+Denis+Mukwege+And+Nadia+Murad+For+Fighting+Sexual+Violence&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Sexual Assault And Harassment May Have Lasting Health Repercussions For Women",
"title": "Sexual Assault And Harassment May Have Lasting Health Repercussions For Women",
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"content": "\u003cp>The trauma of sexual assault or harassment is not only hard to forget; it may also leave lasting effects on a woman's health. This finding of a study \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.4886\" target=\"_blank\" rel=\"noopener\">published Wednesday\u003c/a> adds support to a growing body of evidence suggesting the link.[contextly_sidebar id=\"HEpAUbCt2g19YW7Y7Rht6rrTaYElddh0\"]\u003c/p>\n\u003cp>In the study of roughly 300 middle-aged women, an experience of sexual assault was associated with anxiety, depression and poor sleep. A history of workplace sexual harassment was also associated with poor sleep and with an increased risk of developing high blood pressure.\u003c/p>\n\u003cp>\"These are experiences that [a woman] could have had long ago ... and it can have this long arm of influence throughout a woman's life,\" says \u003ca href=\"https://www.publichealth.pitt.edu/home/directory/rebecca-thurston\">Rebecca Thurston\u003c/a>, lead author of the study, and a research psychologist and director of the Women's Behavioral Health Laboratory at the University of Pittsburgh.\u003c/p>\n\u003cp>The study data come from a survey of healthy women between ages 40 and 60 who had been recruited for a study on menopause and cardiovascular disease — not sexual harassment or assault. They all had their blood pressure checked at study visits, as well as height and weight.\u003c/p>\n\u003cp>Among other questions, the survey asked the women if they had ever experienced sexual harassment at work. Participants were also asked if they had ever \"been made or pressured into having some type of unwanted sexual contact.\" The women were not asked when those events occurred.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Twenty-two percent reported a history of sexual assault, and 19 percent said they'd experienced workplace sexual harassment.\u003c/p>\n\u003cp>Though the sample size was small, the results are statistically significant. Women who had experienced sexual assault had on average an almost threefold increased risk of developing depressive symptoms, compared to women who hadn't. They also had a greater incidence of clinically significant anxiety.[contextly_sidebar id=\"IsNCC9ByhjKnhi0QhEGUW78GbGlaWQIA\"]\u003c/p>\n\u003cp>About 1 in 4 women who had been sexually assaulted met criteria for depression, while approximately 1 in 10 who had not were depressed.\u003c/p>\n\u003cp>Those who experienced sexual harassment at work had a twofold increased risk compared to women who hadn't of developing high blood pressure. Poor sleep was more common, too.\u003c/p>\n\u003cp>\"These [traumatic experiences] are clearly critical things that happen to people early on, that have these really long-lasting effects,\" says \u003ca href=\"https://directory.sph.umn.edu/bio/sph-a-z/susan-mason\" target=\"_blank\" rel=\"noopener\">Susan Mason\u003c/a>, an assistant professor of epidemiology at the University of Minnesota who studies the effects of trauma. \"These really shape people's life trajectories.\"\u003c/p>\n\u003cp>Mason was not involved in this study, but says the findings dovetail with other research on the relationship between trauma and physical or mental health later in life. Intimate partner violence, for example, has been associated with the development of \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23248189\" target=\"_blank\" rel=\"noopener\">diabetes\u003c/a> and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22717307\" target=\"_blank\" rel=\"noopener\">high blood pressure\u003c/a>.\u003c/p>\n\u003cp>Wednesday's study is particularly noteworthy, Mason says, because it includes clinical data — in-office blood pressure checks, for example, and validated diagnostic tools for depression and anxiety — rather than depending exclusively on self-reported diagnoses.\u003c/p>\n\u003cp>Clinicians don't have the ability to corroborate women's memories of sexual assault or harassment, however. Thurston points to literature on the way traumatic memories are processed that demonstrates that discrete events like a sexual assault often remain vivid in a way other memories don't. This is why, she says, she trusts the study participants who say they've been through these experiences.[contextly_sidebar id=\"aop33xdUj0MLT7LwmTHbeoNCW1mJ7lyp\"]\u003c/p>\n\u003cp>\"If the patient thinks it's important, it's important,\" says Dr. Valerie Gilchrist, chair of the department of family medicine at the University of Wisconsin who has written about screening for sexual violence in primary care.\u003c/p>\n\u003cp>She recommends that clinicians ask patients if they've experienced sexual assault, particularly patients who are experiencing significant stress or have difficulty with pelvic exams. Authors note that sexual assault and harassment seemed to be less common in this group of women than in national estimates.\u003c/p>\n\u003cp>The prevalence in their cohort was significantly lower than a \u003ca href=\"https://www.cdc.gov/mmwr/preview/mmwrhtml/ss6308a1.htm\" target=\"_blank\" rel=\"noopener\">2014 estimate from the Centers for Disease Control and Prevention\u003c/a>, which found that 19 percent of American women had been raped, and almost 44 percent had experienced another form of sexual violence.\u003c/p>\n\u003cp>Thurston thinks this is because the study excluded a fair number of women for reasons related to its original intent of researching menopause and cardiovascular disease. Women taking medications for depression were not included, for example, as well as those with serious medical problems.\u003c/p>\n\u003cp>\"Sexual assault and sexual abuse are much more common than people think,\" Thurston says. These are \"key toxic stressors for women.\"\u003c/p>\n\u003cp>While researchers weren't surprised that sexual assault and harassment seemed to be related to the development of mood disorders and poor sleep, they were impressed by the strength of the association.\u003c/p>\n\u003cp>\"These should be urgent public health priorities,\" Mason says. \"How do we address the fundamental ways that our social structure affects health?\"\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Mara Gordon is a family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine.\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=Sexual+Assault+And+Harassment+May+Have+Lasting+Health+Repercussions+For+Women&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The trauma of sexual assault or harassment is not only hard to forget; it may also leave lasting effects on a woman's health. This finding of a study \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2018.4886\" target=\"_blank\" rel=\"noopener\">published Wednesday\u003c/a> adds support to a growing body of evidence suggesting the link.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In the study of roughly 300 middle-aged women, an experience of sexual assault was associated with anxiety, depression and poor sleep. A history of workplace sexual harassment was also associated with poor sleep and with an increased risk of developing high blood pressure.\u003c/p>\n\u003cp>\"These are experiences that [a woman] could have had long ago ... and it can have this long arm of influence throughout a woman's life,\" says \u003ca href=\"https://www.publichealth.pitt.edu/home/directory/rebecca-thurston\">Rebecca Thurston\u003c/a>, lead author of the study, and a research psychologist and director of the Women's Behavioral Health Laboratory at the University of Pittsburgh.\u003c/p>\n\u003cp>The study data come from a survey of healthy women between ages 40 and 60 who had been recruited for a study on menopause and cardiovascular disease — not sexual harassment or assault. They all had their blood pressure checked at study visits, as well as height and weight.\u003c/p>\n\u003cp>Among other questions, the survey asked the women if they had ever experienced sexual harassment at work. Participants were also asked if they had ever \"been made or pressured into having some type of unwanted sexual contact.\" The women were not asked when those events occurred.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Twenty-two percent reported a history of sexual assault, and 19 percent said they'd experienced workplace sexual harassment.\u003c/p>\n\u003cp>Though the sample size was small, the results are statistically significant. Women who had experienced sexual assault had on average an almost threefold increased risk of developing depressive symptoms, compared to women who hadn't. They also had a greater incidence of clinically significant anxiety.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>About 1 in 4 women who had been sexually assaulted met criteria for depression, while approximately 1 in 10 who had not were depressed.\u003c/p>\n\u003cp>Those who experienced sexual harassment at work had a twofold increased risk compared to women who hadn't of developing high blood pressure. Poor sleep was more common, too.\u003c/p>\n\u003cp>\"These [traumatic experiences] are clearly critical things that happen to people early on, that have these really long-lasting effects,\" says \u003ca href=\"https://directory.sph.umn.edu/bio/sph-a-z/susan-mason\" target=\"_blank\" rel=\"noopener\">Susan Mason\u003c/a>, an assistant professor of epidemiology at the University of Minnesota who studies the effects of trauma. \"These really shape people's life trajectories.\"\u003c/p>\n\u003cp>Mason was not involved in this study, but says the findings dovetail with other research on the relationship between trauma and physical or mental health later in life. Intimate partner violence, for example, has been associated with the development of \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23248189\" target=\"_blank\" rel=\"noopener\">diabetes\u003c/a> and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22717307\" target=\"_blank\" rel=\"noopener\">high blood pressure\u003c/a>.\u003c/p>\n\u003cp>Wednesday's study is particularly noteworthy, Mason says, because it includes clinical data — in-office blood pressure checks, for example, and validated diagnostic tools for depression and anxiety — rather than depending exclusively on self-reported diagnoses.\u003c/p>\n\u003cp>Clinicians don't have the ability to corroborate women's memories of sexual assault or harassment, however. Thurston points to literature on the way traumatic memories are processed that demonstrates that discrete events like a sexual assault often remain vivid in a way other memories don't. This is why, she says, she trusts the study participants who say they've been through these experiences.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"If the patient thinks it's important, it's important,\" says Dr. Valerie Gilchrist, chair of the department of family medicine at the University of Wisconsin who has written about screening for sexual violence in primary care.\u003c/p>\n\u003cp>She recommends that clinicians ask patients if they've experienced sexual assault, particularly patients who are experiencing significant stress or have difficulty with pelvic exams. Authors note that sexual assault and harassment seemed to be less common in this group of women than in national estimates.\u003c/p>\n\u003cp>The prevalence in their cohort was significantly lower than a \u003ca href=\"https://www.cdc.gov/mmwr/preview/mmwrhtml/ss6308a1.htm\" target=\"_blank\" rel=\"noopener\">2014 estimate from the Centers for Disease Control and Prevention\u003c/a>, which found that 19 percent of American women had been raped, and almost 44 percent had experienced another form of sexual violence.\u003c/p>\n\u003cp>Thurston thinks this is because the study excluded a fair number of women for reasons related to its original intent of researching menopause and cardiovascular disease. Women taking medications for depression were not included, for example, as well as those with serious medical problems.\u003c/p>\n\u003cp>\"Sexual assault and sexual abuse are much more common than people think,\" Thurston says. These are \"key toxic stressors for women.\"\u003c/p>\n\u003cp>While researchers weren't surprised that sexual assault and harassment seemed to be related to the development of mood disorders and poor sleep, they were impressed by the strength of the association.\u003c/p>\n\u003cp>\"These should be urgent public health priorities,\" Mason says. \"How do we address the fundamental ways that our social structure affects health?\"\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Mara Gordon is a family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine.\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=Sexual+Assault+And+Harassment+May+Have+Lasting+Health+Repercussions+For+Women&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp class=\"danger-zone\">In the world of digital health, Silicon Valley-based \u003ca href=\"https://www.statnews.com/2017/08/07/mindstrong-insel-mental-illness/\" target=\"_blank\" rel=\"noopener\">Mindstrong\u003c/a> stands out. It has a star-studded team and tens of millions in venture capital funding, including from Jeff Bezos’ VC firm.[contextly_sidebar id=\"KMLJnak6yPOdRS3TfVoiDTc6a7Cm51Xf\"]\u003c/p>\n\u003cp class=\"danger-zone\">It also has a captivating idea: that its app, based on cognitive functioning research, can help detect troubling mental health patterns by collecting data on a person’s smartphone usage — how quickly they type or scroll, for instance.\u003c/p>\n\u003cp class=\"danger-zone\">The promise of that technology has helped Mindstrong build incredible momentum since it launched last year; already more than a dozen counties in California have agreed to deploy the company’s app to patients.\u003c/p>\n\u003cp class=\"\">Does the app live up to its promise? There’s no way to tell. Almost no one outside the company has any idea whether it works. Most of the company’s key promises or claims aren’t yet backed up by published, peer-reviewed data — leading some experts to wonder if the technology is ready for the real world.\u003c/p>\n\u003cp class=\"\">“I wouldn’t waste all that time and money in the wild until they get sure that some of those things are as specific as they hope they are,” said Rosalind Picard, a researcher at MIT Media Lab who is familiar with Mindstrong’s work and tries to use data from smartphones and wearables to detect a person’s mood.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Even as one of the company’s executives, Dr. Tom Insel, acknowledged to STAT that the app isn’t perfect, the company’s CEO emphasized that Mindstrong could provide unprecedented insight into conditions like depression.[contextly_sidebar id=\"Kw9tNYwAAP3TxDDlzs24FDdim0qufSVP\"]\u003c/p>\n\u003cp>Mindstrong is not alone in pushing the frontiers of smartphone-based digital health. Many companies use so-called digital phenotyping, collecting scientific data on a person’s digital life, to gain insights into his or her physical or mental health.\u003c/p>\n\u003cp>The company’s app collects information about how people are typing and runs it through a machine learning algorithm to determine which data can predict their emotional state. Mindstrong has already used it in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a \u003ca href=\"https://www.statnews.com/2018/09/24/ketamine-clinics-severe-depression-treatment/\" target=\"_blank\" rel=\"noopener\">ketamine clinic\u003c/a>. The app is available in Apple’s app store, but requires a participant code to access it.\u003c/p>\n\u003cp>“We’ve done the validation work against the gold-standard clinical tests for depression, for anxiety, for cognitive decline, whether it’s memory or executive function,” said Dr. Paul Dagum, the company’s founder. “We’re confident, we’re already seeing some really exciting results.”\u003c/p>\n\u003cp>In the last year, Mindstrong’s footprint and reach have already grown exponentially. The Palo Alto-based company’s workforce has doubled to 42 employees and it made \u003ca href=\"https://www.hsph.harvard.edu/magazine/magazine_article/philanthropic-impact-digital-phenotyping/\" target=\"_blank\" rel=\"noopener\">a sizable gift\u003c/a> to Harvard’s school of public health. In February, it launched a partnership with Takeda to develop new biomarkers that will be able to aid the pharmaceutical giant’s clinical trials for depression treatments.\u003c/p>\n\u003cp>The idea is to use that data to establish a “normal” pattern — so it can be compared against someone’s typing habits on any given day. If the habits look off, slower or more agitated than normal, the app can alert a health care provider.\u003c/p>\n\u003cp>Abnormal patterns, Mindstrong says, might show up if a person is more depressed or anxious, or if just about anything else about their mental health changes. When asked which disorders Mindstrong might be able to detect, Dagum replied, “all of them.” (Dagum, a data scientist and physician, founded the company in 2017 with Rick Klausner, the founder and director of CAR-T pioneer Juno Therapeutics and \u003ca href=\"https://www.statnews.com/2018/06/02/grail-cancer-blood-test-asco/\" target=\"_blank\" rel=\"noopener\">Grail\u003c/a>, a liquid biopsy company.)[contextly_sidebar id=\"XHhLlvPBCoPTlN54jyme2G0wpse1GITN\"]\u003c/p>\n\u003cp>Mindstrong officials told STAT that among their most encouraging results is that its app can even predict how a person will feel next week, or at least how a person will perform on the Hamilton Rating Scale for depression — kind of like a weather app for your mood.\u003c/p>\n\u003cp>The data behind this claim is being published soon, said Insel, who is the former head of the National Institute of Mental Health and came to the company in 2017 after a short stint at \u003ca href=\"https://www.statnews.com/2016/03/28/google-life-sciences-exodus/\" target=\"_blank\" rel=\"noopener\">Verily\u003c/a>.\u003c/p>\n\u003cp>The app can detect a seven-point change on the Hamilton scale, Insel said. That kind of difference could indicate a patient who is not normally depressed now shows signs of mild or moderate depression, or that a person with moderate depression is now showing signs of a very severe condition.\u003c/p>\n\u003cp>“For a clinician and for someone taking care of a patient, knowing that, it could be very, very powerful,” Dagum said.\u003c/p>\n\u003cp>The company’s momentum has taken it to the cusp of a real-world deployment in California. About 15 counties — including the most populous county in the United States, Los Angeles County — will be spending about $60 million over the next four years to bring companies like Mindstrong and other apps into their health care system.\u003c/p>\n\u003cp>These counties hope apps will help them get better services to people with mental illnesses like depression, schizophrenia, bipolar disorder, and post-traumatic stress disorder.\u003c/p>\n\u003cp>The Mindstrong program itself is limited: Patients can choose voluntarily whether to use the app, which will be free to them, and that decision won’t affect the rest of the mental health services they can access.\u003c/p>\n\u003cp>\u003cstrong>Lack of Public Data\u003c/strong>\u003c/p>\n\u003cp>So far, the Mindstrong app has only been used in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a ketamine clinic. The company has also claimed that a “\u003ca href=\"https://mindstronghealth.com/clinical-programs/\" target=\"_blank\" rel=\"noopener\">nationwide employer\u003c/a>” and private substance abuse clinics in D.C. are using the app.[contextly_sidebar id=\"KGoxoWR6m8MUKnLishPvyacpod0HWpt7\"]\u003c/p>\n\u003cp>But other than the change on the Hamilton scale — which hasn’t yet gone through peer review and was disclosed to STAT in an interview — almost no data about how well Mindstrong’s technology works is available to independent observers.\u003c/p>\n\u003cp>The company’s website describes five completed clinical trials, but it has not yet published the results of any. Only a handful of other published works — all from the last year — have hinted at how well it works or its scope with data to back up the claims.\u003c/p>\n\u003cp>The company \u003ca href=\"https://www.nature.com/articles/s41746-018-0018-4\" target=\"_blank\" rel=\"noopener\">published\u003c/a> a 27-person pilot study in the journal npj Digital Medicine earlier this year. Dagum is also an author on a poster \u003ca href=\"https://www.nature.com/articles/npp2017265#t122-assessing-anhedonia-with-quantitative-tasks-digital-and-patient-reported-measures-in-a-multicenter-doubleblind-trial-with-btrx246040-for-the-treatment-of-major-depressive-disorder\" target=\"_blank\" rel=\"noopener\">presentation\u003c/a> given at the American College of Neuropsychopharmacology’s 2017 conference, another \u003ca href=\"https://isctm.org/public_access/Feb2018/PDFs/Smith-poster.pdf\" target=\"_blank\" rel=\"noopener\">poster\u003c/a> that reported results from a very wide variety of digital phenotyping techniques — not just typing — and a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29074231\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> describing a clinical trial protocol — not results.\u003c/p>\n\u003cp>As Mindstrong steps toward a wider rollout, the scientific studies behind its claims will matter. Federal regulators, for one, have \u003ca href=\"https://www.ftc.gov/news-events/blogs/business-blog/2016/01/mind-gap-what-lumosity-promised-vs-what-it-could-prove\" target=\"_blank\" rel=\"noopener\">cracked down\u003c/a> on \u003ca href=\"https://www.ftc.gov/news-events/press-releases/2016/12/marketers-blood-pressure-app-settle-ftc-charges-regarding\" target=\"_blank\" rel=\"noopener\">commercial apps\u003c/a>that misleadingly reference a study’s conclusions to market their app.\u003c/p>\n\u003cp>Based on her own research, at least one expert in digital health and mood said she’s skeptical that Mindstrong can, in a general population, work as well as the company claims. MIT’s Picard said that while there are ways to predict or detect mood changes, you usually need more than just a single type of data to do so.\u003c/p>\n\u003cp>“I’m suspicious that a single modality like typing is going to be sufficient. It would be like saying there’s a single question [on a screening questionnaire] that a doctor could be using,” said Picard, who is also CEO of a company that works on digital phenotyping, like Mindstrong does.\u003c/p>\n\u003cp>“My guess is that their specificity to depression is going to be relatively low,” Picard said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Her \u003ca href=\"https://www.jmir.org/2018/6/e210/\" target=\"_blank\" rel=\"noopener\">own\u003c/a> \u003ca href=\"https://ieeexplore.ieee.org/abstract/document/954607\" target=\"_blank\" rel=\"noopener\">research\u003c/a>, for example, relies on temperature and skin conductivity as well as calls and the amount of time spent on a phone to predict mood changes. It is about 80 percent accurate.\u003c/p>\n\u003cdiv class=\"quote-inner\">\n\u003cp>Especially in the field of digital mental health, “we need more peer review,” said Dr. Steven Steinhubl, the director of digital medicine at Scripps Research Translational Institute. (Steinhubl is also the co-editor-in-chief of npj Digital Medicine.) Though he said he strongly believes in the potential of apps like Mindstrong, Steinhubl cautioned that peer review has a purpose.[contextly_sidebar id=\"8bFNH4xsL9O8lTSDRHnxnqtYwxOF2Z5k\"]\u003c/p>\n\u003cp>“[Peer review] is a very imperfect system, but there’s really nothing in the peer-reviewed literature. That means that other experts aren’t able to weigh in,” he said. “If you have committees and other people reviewing something who maybe don’t have the same level of expertise, you’ll have people saying, ‘Yeah, that sounds good.’”\u003c/p>\n\u003cp>Other researchers have also found that neuropsychological tests, more broadly, have relatively low accuracy rates.\u003c/p>\n\u003cp>In a study that examined people who were already being treated for depression, one computerized test could only accurately predict their condition in about 40 percent of cases. Another showed a 44 percent accuracy rate for a similar computerized test used to examine people with major depression.\u003c/p>\n\u003cp>A neuropsychological test — if it’s used as a screening test — is “going to miss a lot of people who are depressed,” said Richard Porter, a psychology researcher based at the University of Otago in New Zealand who conducted one of the studies.\u003c/p>\n\u003cp>And even if depressed people do show some kind of cognitive impairment, it’s impossible to tell what caused it.\u003c/p>\n\u003cp>Many things other than mental illness might cause a person to perform poorly on cognitive tests — like living with another disorder, having a lower baseline performance on cognitive tests, having a drink or taking prescription, over-the-counter, or illegal drugs.\u003c/p>\n\u003cp>Mindstrong’s leaders aren’t worried about that kind of noise in their data. Some of those factors are important to note, both for patients and the health care professionals working with them.\u003c/p>\n\u003cp>“You’re hungover, you didn’t sleep well, you didn’t take your medication, you have a medication side effects, you’re having stress and challenges at work and at home. Those are things that we want to measure,” Dagum said.\u003c/p>\n\u003cp>But even Insel admitted that there are plenty of issues that could affect typing speed — and which Mindstrong hasn’t figured out how to sort out yet. Sticky fingers after lunch, full hands at an airport, wearing gloves during winter, or a broken hand might also plausible affect a person’s typing speed — and, therefore, the app’s performance.\u003c/p>\n\u003cp>“One thing we’ve thought about is how we factor in those unusual environmental issues,” Insel said. “We’re working on that. But I can’t say that we’ve solved all of those possible issues.”\u003c/p>\n\u003cp>\u003cstrong>A Looming Launch in the Golden State\u003c/strong>\u003c/p>\n\u003cp>Insel and others linked with the company are fond of comparing their app to a smoke detector — something that’s intended to enhance humans’ senses to detect danger.\u003c/p>\n\u003cp>But part of the value of a smoke detector is that if it’s functioning properly, we know it isn’t going off at random. It only goes off in certain conditions and carries a specific message: Your house is on fire or about to be. Do something.\u003c/p>\n\u003cp>At least for now, that’s where Mindstrong differs from a smoke detector. There’s no way to tell, yet, how specific it is or how sensitive its algorithm is.\u003c/p>\n\u003cp>Insel said that information is coming. He said the company has the data about the app’s accuracy — but he declined to provide those figures, citing papers pending publication. “[They] square very well with clinically used biomarkers,” he said.\u003c/p>\n\u003cp>California authorities suggest they have been shown some of that data. But they’re nevertheless cautious about how the app will work in their new, different setting.\u003c/p>\n\u003cp>One official said there will be “clear writing” included with the state’s version of the app about what it can do, what it cannot do, and what goals the counties hope it will help them achieve.\u003c/p>\n\u003cp>Those goals are pretty lofty. At least some counties eventually plan to use it not only to supplement the existing system, but potentially to bring more people into its fold.\u003c/p>\n\u003cp>“We might be able to go to colleges, emergency departments, other places,” said Debbie Innes-Gomberg, a deputy director at the Los Angeles County Department of Mental Health. “There’s a process of identifying that they’re symptomatic, but [our target population is] people that are in our system and people who maybe need to be.”\u003c/p>\n\u003cp>And even before the app launched in the original five counties that had signed on, the pilot has expanded. Another 11 counties have recently decided to join.\u003c/p>\n\u003cp>Still, Innes-Gomberg said, it’s going to be rolled out with caution. “We’re not going to oversell this.”\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/04/mindstrong-questions-over-evidence/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"danger-zone\">In the world of digital health, Silicon Valley-based \u003ca href=\"https://www.statnews.com/2017/08/07/mindstrong-insel-mental-illness/\" target=\"_blank\" rel=\"noopener\">Mindstrong\u003c/a> stands out. It has a star-studded team and tens of millions in venture capital funding, including from Jeff Bezos’ VC firm.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp class=\"danger-zone\">It also has a captivating idea: that its app, based on cognitive functioning research, can help detect troubling mental health patterns by collecting data on a person’s smartphone usage — how quickly they type or scroll, for instance.\u003c/p>\n\u003cp class=\"danger-zone\">The promise of that technology has helped Mindstrong build incredible momentum since it launched last year; already more than a dozen counties in California have agreed to deploy the company’s app to patients.\u003c/p>\n\u003cp class=\"\">Does the app live up to its promise? There’s no way to tell. Almost no one outside the company has any idea whether it works. Most of the company’s key promises or claims aren’t yet backed up by published, peer-reviewed data — leading some experts to wonder if the technology is ready for the real world.\u003c/p>\n\u003cp class=\"\">“I wouldn’t waste all that time and money in the wild until they get sure that some of those things are as specific as they hope they are,” said Rosalind Picard, a researcher at MIT Media Lab who is familiar with Mindstrong’s work and tries to use data from smartphones and wearables to detect a person’s mood.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Even as one of the company’s executives, Dr. Tom Insel, acknowledged to STAT that the app isn’t perfect, the company’s CEO emphasized that Mindstrong could provide unprecedented insight into conditions like depression.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Mindstrong is not alone in pushing the frontiers of smartphone-based digital health. Many companies use so-called digital phenotyping, collecting scientific data on a person’s digital life, to gain insights into his or her physical or mental health.\u003c/p>\n\u003cp>The company’s app collects information about how people are typing and runs it through a machine learning algorithm to determine which data can predict their emotional state. Mindstrong has already used it in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a \u003ca href=\"https://www.statnews.com/2018/09/24/ketamine-clinics-severe-depression-treatment/\" target=\"_blank\" rel=\"noopener\">ketamine clinic\u003c/a>. The app is available in Apple’s app store, but requires a participant code to access it.\u003c/p>\n\u003cp>“We’ve done the validation work against the gold-standard clinical tests for depression, for anxiety, for cognitive decline, whether it’s memory or executive function,” said Dr. Paul Dagum, the company’s founder. “We’re confident, we’re already seeing some really exciting results.”\u003c/p>\n\u003cp>In the last year, Mindstrong’s footprint and reach have already grown exponentially. The Palo Alto-based company’s workforce has doubled to 42 employees and it made \u003ca href=\"https://www.hsph.harvard.edu/magazine/magazine_article/philanthropic-impact-digital-phenotyping/\" target=\"_blank\" rel=\"noopener\">a sizable gift\u003c/a> to Harvard’s school of public health. In February, it launched a partnership with Takeda to develop new biomarkers that will be able to aid the pharmaceutical giant’s clinical trials for depression treatments.\u003c/p>\n\u003cp>The idea is to use that data to establish a “normal” pattern — so it can be compared against someone’s typing habits on any given day. If the habits look off, slower or more agitated than normal, the app can alert a health care provider.\u003c/p>\n\u003cp>Abnormal patterns, Mindstrong says, might show up if a person is more depressed or anxious, or if just about anything else about their mental health changes. When asked which disorders Mindstrong might be able to detect, Dagum replied, “all of them.” (Dagum, a data scientist and physician, founded the company in 2017 with Rick Klausner, the founder and director of CAR-T pioneer Juno Therapeutics and \u003ca href=\"https://www.statnews.com/2018/06/02/grail-cancer-blood-test-asco/\" target=\"_blank\" rel=\"noopener\">Grail\u003c/a>, a liquid biopsy company.)\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Mindstrong officials told STAT that among their most encouraging results is that its app can even predict how a person will feel next week, or at least how a person will perform on the Hamilton Rating Scale for depression — kind of like a weather app for your mood.\u003c/p>\n\u003cp>The data behind this claim is being published soon, said Insel, who is the former head of the National Institute of Mental Health and came to the company in 2017 after a short stint at \u003ca href=\"https://www.statnews.com/2016/03/28/google-life-sciences-exodus/\" target=\"_blank\" rel=\"noopener\">Verily\u003c/a>.\u003c/p>\n\u003cp>The app can detect a seven-point change on the Hamilton scale, Insel said. That kind of difference could indicate a patient who is not normally depressed now shows signs of mild or moderate depression, or that a person with moderate depression is now showing signs of a very severe condition.\u003c/p>\n\u003cp>“For a clinician and for someone taking care of a patient, knowing that, it could be very, very powerful,” Dagum said.\u003c/p>\n\u003cp>The company’s momentum has taken it to the cusp of a real-world deployment in California. About 15 counties — including the most populous county in the United States, Los Angeles County — will be spending about $60 million over the next four years to bring companies like Mindstrong and other apps into their health care system.\u003c/p>\n\u003cp>These counties hope apps will help them get better services to people with mental illnesses like depression, schizophrenia, bipolar disorder, and post-traumatic stress disorder.\u003c/p>\n\u003cp>The Mindstrong program itself is limited: Patients can choose voluntarily whether to use the app, which will be free to them, and that decision won’t affect the rest of the mental health services they can access.\u003c/p>\n\u003cp>\u003cstrong>Lack of Public Data\u003c/strong>\u003c/p>\n\u003cp>So far, the Mindstrong app has only been used in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a ketamine clinic. The company has also claimed that a “\u003ca href=\"https://mindstronghealth.com/clinical-programs/\" target=\"_blank\" rel=\"noopener\">nationwide employer\u003c/a>” and private substance abuse clinics in D.C. are using the app.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But other than the change on the Hamilton scale — which hasn’t yet gone through peer review and was disclosed to STAT in an interview — almost no data about how well Mindstrong’s technology works is available to independent observers.\u003c/p>\n\u003cp>The company’s website describes five completed clinical trials, but it has not yet published the results of any. Only a handful of other published works — all from the last year — have hinted at how well it works or its scope with data to back up the claims.\u003c/p>\n\u003cp>The company \u003ca href=\"https://www.nature.com/articles/s41746-018-0018-4\" target=\"_blank\" rel=\"noopener\">published\u003c/a> a 27-person pilot study in the journal npj Digital Medicine earlier this year. Dagum is also an author on a poster \u003ca href=\"https://www.nature.com/articles/npp2017265#t122-assessing-anhedonia-with-quantitative-tasks-digital-and-patient-reported-measures-in-a-multicenter-doubleblind-trial-with-btrx246040-for-the-treatment-of-major-depressive-disorder\" target=\"_blank\" rel=\"noopener\">presentation\u003c/a> given at the American College of Neuropsychopharmacology’s 2017 conference, another \u003ca href=\"https://isctm.org/public_access/Feb2018/PDFs/Smith-poster.pdf\" target=\"_blank\" rel=\"noopener\">poster\u003c/a> that reported results from a very wide variety of digital phenotyping techniques — not just typing — and a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29074231\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> describing a clinical trial protocol — not results.\u003c/p>\n\u003cp>As Mindstrong steps toward a wider rollout, the scientific studies behind its claims will matter. Federal regulators, for one, have \u003ca href=\"https://www.ftc.gov/news-events/blogs/business-blog/2016/01/mind-gap-what-lumosity-promised-vs-what-it-could-prove\" target=\"_blank\" rel=\"noopener\">cracked down\u003c/a> on \u003ca href=\"https://www.ftc.gov/news-events/press-releases/2016/12/marketers-blood-pressure-app-settle-ftc-charges-regarding\" target=\"_blank\" rel=\"noopener\">commercial apps\u003c/a>that misleadingly reference a study’s conclusions to market their app.\u003c/p>\n\u003cp>Based on her own research, at least one expert in digital health and mood said she’s skeptical that Mindstrong can, in a general population, work as well as the company claims. MIT’s Picard said that while there are ways to predict or detect mood changes, you usually need more than just a single type of data to do so.\u003c/p>\n\u003cp>“I’m suspicious that a single modality like typing is going to be sufficient. It would be like saying there’s a single question [on a screening questionnaire] that a doctor could be using,” said Picard, who is also CEO of a company that works on digital phenotyping, like Mindstrong does.\u003c/p>\n\u003cp>“My guess is that their specificity to depression is going to be relatively low,” Picard said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Her \u003ca href=\"https://www.jmir.org/2018/6/e210/\" target=\"_blank\" rel=\"noopener\">own\u003c/a> \u003ca href=\"https://ieeexplore.ieee.org/abstract/document/954607\" target=\"_blank\" rel=\"noopener\">research\u003c/a>, for example, relies on temperature and skin conductivity as well as calls and the amount of time spent on a phone to predict mood changes. It is about 80 percent accurate.\u003c/p>\n\u003cdiv class=\"quote-inner\">\n\u003cp>Especially in the field of digital mental health, “we need more peer review,” said Dr. Steven Steinhubl, the director of digital medicine at Scripps Research Translational Institute. (Steinhubl is also the co-editor-in-chief of npj Digital Medicine.) Though he said he strongly believes in the potential of apps like Mindstrong, Steinhubl cautioned that peer review has a purpose.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“[Peer review] is a very imperfect system, but there’s really nothing in the peer-reviewed literature. That means that other experts aren’t able to weigh in,” he said. “If you have committees and other people reviewing something who maybe don’t have the same level of expertise, you’ll have people saying, ‘Yeah, that sounds good.’”\u003c/p>\n\u003cp>Other researchers have also found that neuropsychological tests, more broadly, have relatively low accuracy rates.\u003c/p>\n\u003cp>In a study that examined people who were already being treated for depression, one computerized test could only accurately predict their condition in about 40 percent of cases. Another showed a 44 percent accuracy rate for a similar computerized test used to examine people with major depression.\u003c/p>\n\u003cp>A neuropsychological test — if it’s used as a screening test — is “going to miss a lot of people who are depressed,” said Richard Porter, a psychology researcher based at the University of Otago in New Zealand who conducted one of the studies.\u003c/p>\n\u003cp>And even if depressed people do show some kind of cognitive impairment, it’s impossible to tell what caused it.\u003c/p>\n\u003cp>Many things other than mental illness might cause a person to perform poorly on cognitive tests — like living with another disorder, having a lower baseline performance on cognitive tests, having a drink or taking prescription, over-the-counter, or illegal drugs.\u003c/p>\n\u003cp>Mindstrong’s leaders aren’t worried about that kind of noise in their data. Some of those factors are important to note, both for patients and the health care professionals working with them.\u003c/p>\n\u003cp>“You’re hungover, you didn’t sleep well, you didn’t take your medication, you have a medication side effects, you’re having stress and challenges at work and at home. Those are things that we want to measure,” Dagum said.\u003c/p>\n\u003cp>But even Insel admitted that there are plenty of issues that could affect typing speed — and which Mindstrong hasn’t figured out how to sort out yet. Sticky fingers after lunch, full hands at an airport, wearing gloves during winter, or a broken hand might also plausible affect a person’s typing speed — and, therefore, the app’s performance.\u003c/p>\n\u003cp>“One thing we’ve thought about is how we factor in those unusual environmental issues,” Insel said. “We’re working on that. But I can’t say that we’ve solved all of those possible issues.”\u003c/p>\n\u003cp>\u003cstrong>A Looming Launch in the Golden State\u003c/strong>\u003c/p>\n\u003cp>Insel and others linked with the company are fond of comparing their app to a smoke detector — something that’s intended to enhance humans’ senses to detect danger.\u003c/p>\n\u003cp>But part of the value of a smoke detector is that if it’s functioning properly, we know it isn’t going off at random. It only goes off in certain conditions and carries a specific message: Your house is on fire or about to be. Do something.\u003c/p>\n\u003cp>At least for now, that’s where Mindstrong differs from a smoke detector. There’s no way to tell, yet, how specific it is or how sensitive its algorithm is.\u003c/p>\n\u003cp>Insel said that information is coming. He said the company has the data about the app’s accuracy — but he declined to provide those figures, citing papers pending publication. “[They] square very well with clinically used biomarkers,” he said.\u003c/p>\n\u003cp>California authorities suggest they have been shown some of that data. But they’re nevertheless cautious about how the app will work in their new, different setting.\u003c/p>\n\u003cp>One official said there will be “clear writing” included with the state’s version of the app about what it can do, what it cannot do, and what goals the counties hope it will help them achieve.\u003c/p>\n\u003cp>Those goals are pretty lofty. At least some counties eventually plan to use it not only to supplement the existing system, but potentially to bring more people into its fold.\u003c/p>\n\u003cp>“We might be able to go to colleges, emergency departments, other places,” said Debbie Innes-Gomberg, a deputy director at the Los Angeles County Department of Mental Health. “There’s a process of identifying that they’re symptomatic, but [our target population is] people that are in our system and people who maybe need to be.”\u003c/p>\n\u003cp>And even before the app launched in the original five counties that had signed on, the pilot has expanded. Another 11 counties have recently decided to join.\u003c/p>\n\u003cp>Still, Innes-Gomberg said, it’s going to be rolled out with caution. “We’re not going to oversell this.”\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/04/mindstrong-questions-over-evidence/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Think You Don't Need A Flu Shot? Here Are 5 Reasons To Change Your Mind",
"title": "Think You Don't Need A Flu Shot? Here Are 5 Reasons To Change Your Mind",
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"content": "\u003cp>There are a lot of misconceptions out there about the flu shot.\u003c/p>\n\u003cp>But following a winter in which more than 80,000 people died from flu-related illnesses in the U.S. — the highest death toll in more than 40 years — infectious disease experts are ramping up efforts to get the word out.[contextly_sidebar id=\"d8sAsPjwUq9P6K71Bm4vRaAmUWmUHYSs\"]\u003c/p>\n\u003cp>\"Flu vaccinations save lives,\" Surgeon General Jerome Adams told the crowd at an event to kick off flu vaccine awareness last week at the National Press Club in Washington, D.C. \"That's why it's so important for everyone 6 months and older to get a flu vaccine every year.\"\u003c/p>\n\u003cp>But many Americans ignore this advice. The U.S. \u003ca href=\"https://www.cdc.gov/flu/fluvaxview/reportshtml/trends/index.html\">vaccination rate\u003c/a> hovers at about 47 percent a year. This is far below the \u003ca href=\"https://www.healthypeople.gov/sites/default/files/HP2020_IID_and_GH_Progress_Review_Slides.pdf\">70 percent target\u003c/a>. And college students are among the least vaccinated.\u003c/p>\n\u003cp>\"We have long known that college students are at a particularly high risk of getting and spreading flu viruses,\" says \u003ca href=\"https://weillcornell.org/lisaipp\">Lisa Ipp\u003c/a>, an adolescent medicine specialist at Weill Cornell Medicine. \"Yet, on U.S. college campuses, flu vaccination rates remain strikingly low,\" \u003ca href=\"https://nfid.wordpress.com/2017/12/06/why-arent-college-students-getting-flu-shots/\">she writes in a 2017 post\u003c/a> published by the National Foundation for Infectious Disease. The group sponsored a \u003ca href=\"http://www.nfid.org/publications/reports/college-flu-summit-report.pdf\">survey\u003c/a> of college students and found that only between 8 and 39 percent of students get the vaccine.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>So why aren't people getting the vaccine? The college survey data point to a mix of misperception and fear.[contextly_sidebar id=\"1GYhiWSWE3AU14flVCzzeer5d84YkhaR\"]\u003c/p>\n\u003cp>For instance, among students who don't get the vaccine, 36 percent say that they are healthy and don't need it, and 30 percent say they don't think the vaccine is effective. Then, there's the fear: 31 percent say they don't like needles.\u003c/p>\n\u003cp>So, let's do a reality check. If you're on the fence about a flu shot, here are five arguments to twist your arm.\u003c/p>\n\u003cp>\u003cstrong>1. You are vulnerable.\u003c/strong>\u003c/p>\n\u003cp>People 65 and older are at higher risk of flu-related complications, but the flu can knock young, healthy people off their feet, too. It does every year.\u003c/p>\n\u003cp>\"The flu can, on occasion, take a young, healthy person and put them in the intensive care unit,\" says \u003ca href=\"http://www.nfid.org/newsroom/press-releases/2015-press-releases/nfid-selects-william-schaffner-as-new-medical-director.pdf\">William Schaffner\u003c/a>, medical director at the NFID.\u003c/p>\n\u003cp>And, even when it's not that severe, it's still bad. \"If you get the flu, you're [down] for the count for about a week,\" Ipp tells her college-age patients.\u003c/p>\n\u003cp>Here's a sobering thought: Healthy children die from flu, too. According to the CDC, \u003ca href=\"https://www.cdc.gov/flu/spotlights/reported-flu-children-deaths.htm\">172 American children and teens\u003c/a> (under the age of 18) died from the flu last winter. Eighty percent of them had not received a flu vaccine. And about half had no underlying illnesses before getting the flu. In other words, they'd been healthy children.[contextly_sidebar id=\"uR6a8xg4qkSfioEgDzzDZvzsgwhTq8sS\"]\u003c/p>\n\u003cp>And there's this: The flu doesn't just make you feel lousy. It can \u003ca href=\"https://www.npr.org/sections/health-shots/2018/01/24/579997381/aw-seriously-the-flu-can-trigger-a-heart-attack-too\">increase the risk of having a heart attack\u003c/a>, according to a study published this year.\u003c/p>\n\u003cp>\u003cstrong>2. Getting a flu shot is your civic duty.\u003c/strong>\u003c/p>\n\u003cp>\"Nobody wants to be the dreaded spreader,\" says Schaffner. But everybody gets the flu from somebody else. According to the Centers for Disease Control and Prevention, people who have caught the flu virus are contagious one day before they start to feel sick and for up to seven days after. (Check out our \u003ca href=\"https://www.npr.org/sections/health-shots/2018/02/20/585143079/how-long-are-you-contagious-with-the-flu\">video on flu contagion \u003c/a>if you really need to be convinced!)\u003c/p>\n\u003cp>So getting the flu shot will help protect your family, friends and co-workers. \"It's the socially correct thing to do,\" Schaffner says.\u003c/p>\n\u003cp>\u003cstrong>3. You can still get the flu, but you won't be as sick.\u003c/strong>\u003c/p>\n\u003cp>After last winter's severe season, some people are skeptical. They say: \"I got the flu shot, but I still caught the flu.\"\u003c/p>\n\u003cp>In fact, the 2017-18 season was the deadliest in more than 40 years. \"We had a very vicious virus, the so-called H3N2 influenza strain,\" says Schaffner.[contextly_sidebar id=\"TFcjOHNAbBl7nUaIFKyNSb1xwI4w06NI\"]\u003c/p>\n\u003cp>And yes, it's true that the vaccine does not offer complete protection. The CDC estimates that flu vaccination \u003ca href=\"https://www.cdc.gov/flu/about/qa/vaccineeffect.htm\">reduces the risk of the virus\u003c/a> by about 40 to 60 percent. Think of it this way: If you catch the flu, the vaccine does still offer some protection. It cushions the blow. \"Your illness is likely to be milder\" if you've had a flu shot, says Schaffner. You're less likely to get pneumonia, which is a major complication of the flu, and less likely to be hospitalized.\u003c/p>\n\u003cp>\u003cstrong>4. Pregnant women who get the flu shot protect their babies from flu.\u003c/strong>\u003c/p>\n\u003cp>Women who are pregnant should be vaccinated to protect themselves. The vaccine also offers protection after babies are born. \"[Women] can pass the protection on, across the placenta,\" Schaffner explains. And this will protect their baby during the first six months of life, until the baby is old enough to be vaccinated.\u003c/p>\n\u003cp>\u003cstrong>5. You\u003c/strong>\u003cem>\u003cstrong> cannot\u003c/strong>\u003c/em>\u003cstrong> get flu from the flu vaccine.\u003c/strong>\u003c/p>\n\u003cp>It's still a common misperception: the idea that you can get the flu from the flu shot.\u003c/p>\n\u003cp>The NFID-sponsored survey of college students found that close to 60 percent of students seem to think that the flu vaccine can cause flu. \"That's, of course, incorrect,\" says Schaffner.\u003c/p>\n\u003cp>The most common side effects are a sore arm, and perhaps a little swelling. \"A very small proportion of people, 1 to 2 percent, get a degree of fever,\" Schaffner says. That's not the flu, he explains. \"That's the body reacting to the vaccine.\"\u003c/p>\n\u003cp>Because the flu is unpredictable, it's too soon to know what to expect this winter. But Schaffner has this advice: Don't wait. \"The time to get vaccinated is right now,\" he says.\u003c/p>\n\u003cp>If that doesn't move you, maybe a little reward will. The survey data of college students found that incentives are a good idea. Think: free food, free entertainment or a gift card for a free coffee. Ipp found about 60 percent of students said these types of incentives would increase the likelihood of their getting the flu vaccine.\u003c/p>\n\u003cp>Another way to nudge people? Make it super convenient. On the campus of George Washington University, the medical director of the student health center has organized flu-clinic pop-ups in venues where students hang out, such as the library. \"We don't wait for them to come to us,\" \u003ca href=\"https://healthcenter.gwu.edu/isabel-goldenberg-md\">Isabel Goldenberg\u003c/a> told us\u003cem>.\u003c/em>\u003c/p>\n\u003cp>For workers in offices, flu clinics at the workplace can be an effective way to encourage vaccination, too.\u003c/p>\n\u003cp>What about the use of social media to motivate people? \"I've had the flu, which was horrible,\" Max Webb, a student at George Washington University, told me. He thinks if people shared their flu stories, it could help nudge people in their social networks to get the flu shot.\u003c/p>\n\u003cp>And what would you name this campaign, I asked Webb? \"Say boo to the flu,\" Web replied. Or simply, #boo2flu.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Kinda catchy.\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=Think+You+Don%27t+Need+A+Flu+Shot%3F+Here+Are+5+Reasons+To+Change+Your+Mind&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "College students are among the least likely to get vaccinated against the flu, which killed more than 80,000 people last winter. Experts say the reasons are a combination of fear and misperception.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>There are a lot of misconceptions out there about the flu shot.\u003c/p>\n\u003cp>But following a winter in which more than 80,000 people died from flu-related illnesses in the U.S. — the highest death toll in more than 40 years — infectious disease experts are ramping up efforts to get the word out.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"Flu vaccinations save lives,\" Surgeon General Jerome Adams told the crowd at an event to kick off flu vaccine awareness last week at the National Press Club in Washington, D.C. \"That's why it's so important for everyone 6 months and older to get a flu vaccine every year.\"\u003c/p>\n\u003cp>But many Americans ignore this advice. The U.S. \u003ca href=\"https://www.cdc.gov/flu/fluvaxview/reportshtml/trends/index.html\">vaccination rate\u003c/a> hovers at about 47 percent a year. This is far below the \u003ca href=\"https://www.healthypeople.gov/sites/default/files/HP2020_IID_and_GH_Progress_Review_Slides.pdf\">70 percent target\u003c/a>. And college students are among the least vaccinated.\u003c/p>\n\u003cp>\"We have long known that college students are at a particularly high risk of getting and spreading flu viruses,\" says \u003ca href=\"https://weillcornell.org/lisaipp\">Lisa Ipp\u003c/a>, an adolescent medicine specialist at Weill Cornell Medicine. \"Yet, on U.S. college campuses, flu vaccination rates remain strikingly low,\" \u003ca href=\"https://nfid.wordpress.com/2017/12/06/why-arent-college-students-getting-flu-shots/\">she writes in a 2017 post\u003c/a> published by the National Foundation for Infectious Disease. The group sponsored a \u003ca href=\"http://www.nfid.org/publications/reports/college-flu-summit-report.pdf\">survey\u003c/a> of college students and found that only between 8 and 39 percent of students get the vaccine.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So why aren't people getting the vaccine? The college survey data point to a mix of misperception and fear.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>For instance, among students who don't get the vaccine, 36 percent say that they are healthy and don't need it, and 30 percent say they don't think the vaccine is effective. Then, there's the fear: 31 percent say they don't like needles.\u003c/p>\n\u003cp>So, let's do a reality check. If you're on the fence about a flu shot, here are five arguments to twist your arm.\u003c/p>\n\u003cp>\u003cstrong>1. You are vulnerable.\u003c/strong>\u003c/p>\n\u003cp>People 65 and older are at higher risk of flu-related complications, but the flu can knock young, healthy people off their feet, too. It does every year.\u003c/p>\n\u003cp>\"The flu can, on occasion, take a young, healthy person and put them in the intensive care unit,\" says \u003ca href=\"http://www.nfid.org/newsroom/press-releases/2015-press-releases/nfid-selects-william-schaffner-as-new-medical-director.pdf\">William Schaffner\u003c/a>, medical director at the NFID.\u003c/p>\n\u003cp>And, even when it's not that severe, it's still bad. \"If you get the flu, you're [down] for the count for about a week,\" Ipp tells her college-age patients.\u003c/p>\n\u003cp>Here's a sobering thought: Healthy children die from flu, too. According to the CDC, \u003ca href=\"https://www.cdc.gov/flu/spotlights/reported-flu-children-deaths.htm\">172 American children and teens\u003c/a> (under the age of 18) died from the flu last winter. Eighty percent of them had not received a flu vaccine. And about half had no underlying illnesses before getting the flu. In other words, they'd been healthy children.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>And there's this: The flu doesn't just make you feel lousy. It can \u003ca href=\"https://www.npr.org/sections/health-shots/2018/01/24/579997381/aw-seriously-the-flu-can-trigger-a-heart-attack-too\">increase the risk of having a heart attack\u003c/a>, according to a study published this year.\u003c/p>\n\u003cp>\u003cstrong>2. Getting a flu shot is your civic duty.\u003c/strong>\u003c/p>\n\u003cp>\"Nobody wants to be the dreaded spreader,\" says Schaffner. But everybody gets the flu from somebody else. According to the Centers for Disease Control and Prevention, people who have caught the flu virus are contagious one day before they start to feel sick and for up to seven days after. (Check out our \u003ca href=\"https://www.npr.org/sections/health-shots/2018/02/20/585143079/how-long-are-you-contagious-with-the-flu\">video on flu contagion \u003c/a>if you really need to be convinced!)\u003c/p>\n\u003cp>So getting the flu shot will help protect your family, friends and co-workers. \"It's the socially correct thing to do,\" Schaffner says.\u003c/p>\n\u003cp>\u003cstrong>3. You can still get the flu, but you won't be as sick.\u003c/strong>\u003c/p>\n\u003cp>After last winter's severe season, some people are skeptical. They say: \"I got the flu shot, but I still caught the flu.\"\u003c/p>\n\u003cp>In fact, the 2017-18 season was the deadliest in more than 40 years. \"We had a very vicious virus, the so-called H3N2 influenza strain,\" says Schaffner.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>And yes, it's true that the vaccine does not offer complete protection. The CDC estimates that flu vaccination \u003ca href=\"https://www.cdc.gov/flu/about/qa/vaccineeffect.htm\">reduces the risk of the virus\u003c/a> by about 40 to 60 percent. Think of it this way: If you catch the flu, the vaccine does still offer some protection. It cushions the blow. \"Your illness is likely to be milder\" if you've had a flu shot, says Schaffner. You're less likely to get pneumonia, which is a major complication of the flu, and less likely to be hospitalized.\u003c/p>\n\u003cp>\u003cstrong>4. Pregnant women who get the flu shot protect their babies from flu.\u003c/strong>\u003c/p>\n\u003cp>Women who are pregnant should be vaccinated to protect themselves. The vaccine also offers protection after babies are born. \"[Women] can pass the protection on, across the placenta,\" Schaffner explains. And this will protect their baby during the first six months of life, until the baby is old enough to be vaccinated.\u003c/p>\n\u003cp>\u003cstrong>5. You\u003c/strong>\u003cem>\u003cstrong> cannot\u003c/strong>\u003c/em>\u003cstrong> get flu from the flu vaccine.\u003c/strong>\u003c/p>\n\u003cp>It's still a common misperception: the idea that you can get the flu from the flu shot.\u003c/p>\n\u003cp>The NFID-sponsored survey of college students found that close to 60 percent of students seem to think that the flu vaccine can cause flu. \"That's, of course, incorrect,\" says Schaffner.\u003c/p>\n\u003cp>The most common side effects are a sore arm, and perhaps a little swelling. \"A very small proportion of people, 1 to 2 percent, get a degree of fever,\" Schaffner says. That's not the flu, he explains. \"That's the body reacting to the vaccine.\"\u003c/p>\n\u003cp>Because the flu is unpredictable, it's too soon to know what to expect this winter. But Schaffner has this advice: Don't wait. \"The time to get vaccinated is right now,\" he says.\u003c/p>\n\u003cp>If that doesn't move you, maybe a little reward will. The survey data of college students found that incentives are a good idea. Think: free food, free entertainment or a gift card for a free coffee. Ipp found about 60 percent of students said these types of incentives would increase the likelihood of their getting the flu vaccine.\u003c/p>\n\u003cp>Another way to nudge people? Make it super convenient. On the campus of George Washington University, the medical director of the student health center has organized flu-clinic pop-ups in venues where students hang out, such as the library. \"We don't wait for them to come to us,\" \u003ca href=\"https://healthcenter.gwu.edu/isabel-goldenberg-md\">Isabel Goldenberg\u003c/a> told us\u003cem>.\u003c/em>\u003c/p>\n\u003cp>For workers in offices, flu clinics at the workplace can be an effective way to encourage vaccination, too.\u003c/p>\n\u003cp>What about the use of social media to motivate people? \"I've had the flu, which was horrible,\" Max Webb, a student at George Washington University, told me. He thinks if people shared their flu stories, it could help nudge people in their social networks to get the flu shot.\u003c/p>\n\u003cp>And what would you name this campaign, I asked Webb? \"Say boo to the flu,\" Web replied. Or simply, #boo2flu.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Kinda catchy.\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=Think+You+Don%27t+Need+A+Flu+Shot%3F+Here+Are+5+Reasons+To+Change+Your+Mind&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Artificial Sweeteners Could be Sabotaging Your Microbiome, Says Study",
"title": "Artificial Sweeteners Could be Sabotaging Your Microbiome, Says Study",
"headTitle": "Diabetes Management | KQED Future of You | KQED Science",
"content": "\u003cp>Artificial sweeteners, widely regarded as a healthy alternative to sugar, may be sabotaging your gut biome.[contextly_sidebar id=\"yjhBwHasobhXnJ18NYXbIYtjXOq70PwF\"]\u003c/p>\n\u003cp>A new study published \u003ca href=\"https://www.mdpi.com/1420-3049/23/10/2454\" target=\"_blank\" rel=\"noopener\">in the journal\u003c/a> \u003cem>Molecule\u003c/em> found that \u003cem>E. coli\u003c/em> bacteria in the intestinal tract became damaged when exposed to several different kinds of artificial sweeteners.\u003c/p>\n\u003cp>The study zeroed in on six artificial sweeteners to determine their toxicity to the healthy bacteria present: aspartame, sucralose, saccharine, neotame, advantame, and acesulfame potassium-k.\u003c/p>\n\u003cp>The researchers used as markers special light-producing bacteria known as bioluminescent \u003cem>E. coli\u003c/em> that light up when toxicity is detected, according to the collaborative study by researchers at Israel’s Ben-Gurion University of the Negev and Singapore’s Nanyang Technological University.\u003c/p>\n\u003cp>Sucralose displayed the most significant effects, with as little as 1 milligram affecting a strain of the \u003cem>E. coli.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"This is further evidence that consumption of artificial sweeteners adversely affects gut \u003ca href=\"https://www.sciencedaily.com/releases/2018/10/181001101932.htm\" target=\"_blank\" rel=\"noopener\">microbial activity\u003c/a> which can cause a wide range of health issues,\" co-author Ariel Kushmaro, a professor of biotechnology engineering at Ben-Gurion, said in a statement.[contextly_sidebar id=\"zlhu2orfRNf238Xnhya1R1LkDBb9jMGv\"]\u003c/p>\n\u003cp>Disturbances in the gut ecosystem can seriously harm human health with previous studies showing that pathogenic\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425030/\"> bacteria\u003c/a> can cause many chronic diseases, including inflammatory bowel disease, obesity, diabetes, and cancer.\u003c/p>\n\u003cp>The presence of these chemicals is not always obvious, with many popular foods, such as microwave popcorn and fruit juice, labeling the ingredient as a \"natural sweetener.\" That's because the Food and Drug Administration has \u003ca href=\"https://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm456090.htm\" target=\"_blank\" rel=\"noopener\">yet to define\u003c/a> the term “natural” for use in food labeling.\u003c/p>\n\u003cp>Along with possible adverse health effects, the study warns that artificial sweeteners have become so ubiquitous that they're increasingly turning up in drinking water and groundwater basins.\u003c/p>\n\u003cp>\"They are resistant to wastewater treatment processes, therefore they are continuously introduced into the water environments,\" write the authors. \"Such concentrations [of artificial sweeteners] are among the highest known for anthropogenic trace pollutants.\"\u003c/p>\n\u003cp>\u003ca href=\"https://caloriecontrol.org/\" target=\"_blank\" rel=\"noopener\">Calorie Control Council\u003c/a>, the trade group for the artificial sweetener industry, criticized the study for relying solely on \u003cem>E. coli \u003c/em>bacterium, which they argue is not directly comparable to the human microbiome.\u003c/p>\n\u003cp style=\"font-weight: 400\">\"More specifically, it is unknown whether the changes to the bacterium noted in the study, or any changes in microbiome bacteria, are indicative of negative health outcomes in humans,\" the \u003ca href=\"https://caloriecontrol.org/\" target=\"_blank\" rel=\"noopener\">group \u003c/a>said in a statement emailed to KQED.\u003c/p>\n\u003cp style=\"font-weight: 400\">Moreover, the group says that all the sweeteners included in the study have been approved for use by several scientific and regulatory authorities, including the FDA.\u003c/p>\n\u003cp>To determine toxicity, researchers modified different types of \u003ci>E.coli \u003c/i>bacteria to emit light when experiencing distress. Researchers then could see what type of damage occurred, depending on which type of modified \u003cem>E. coli\u003c/em> glowed. Researchers found that each sweetener produced a specific fingerprint using three stripes of bacteria, with each stripe representing a different type of damage. From \u003ca href=\"https://www.livescience.com/63743-artificial-sweeteners-gut-health.html\" target=\"_blank\" rel=\"noopener\">Live Science\u003c/a>, quoting senior author Evgeni Eltzov:\u003c/p>\n\u003cblockquote>\n\u003cp class=\"p1\">The pattern of colors was unique for each sweetener; one might've caused more DNA damage than protein damage, for example. However, all sweeteners damaged the bacteria in some way, Eltzov said. But Eltzov noted that these findings don't mean the chemicals are \"toxic\" to humans. More research is needed to make that determination.\u003c/p>\n\u003c/blockquote>\n\u003cp class=\"p1\">One cited shortcoming of the study is that the concentrations of artificial sweetener used were higher than what's typically consumed in a can of diet soda. The \u003ca href=\"https://www.livescience.com/63743-artificial-sweeteners-gut-health.html\" target=\"_blank\" rel=\"noopener\">findings do\u003c/a> not\u003cspan class=\"Apple-converted-space\"> \u003c/span>\"tell us what happens in real life. It tells us what happens in a test tube,\" Dr. Kristina Rother, a senior research physician at the National Institutes of Health, told Live Science.\u003c/p>\n\u003cp class=\"p1\">\"Real life is just more complicated,\" Rother, who was not involved in the study, told Live Science.\u003c/p>\n\u003cp class=\"p1\">Still, she recommends avoiding artificial sweeteners.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp class=\"p1\">\"I haven't seen a study that says any of these six FDA-approved sweeteners make the gut microbiome better,” she says. \"So, my recommendation is very simple and very difficult to achieve: Live a healthy life, eat little processed food.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Artificial sweeteners, widely regarded as a healthy alternative to sugar, may be sabotaging your gut biome.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>A new study published \u003ca href=\"https://www.mdpi.com/1420-3049/23/10/2454\" target=\"_blank\" rel=\"noopener\">in the journal\u003c/a> \u003cem>Molecule\u003c/em> found that \u003cem>E. coli\u003c/em> bacteria in the intestinal tract became damaged when exposed to several different kinds of artificial sweeteners.\u003c/p>\n\u003cp>The study zeroed in on six artificial sweeteners to determine their toxicity to the healthy bacteria present: aspartame, sucralose, saccharine, neotame, advantame, and acesulfame potassium-k.\u003c/p>\n\u003cp>The researchers used as markers special light-producing bacteria known as bioluminescent \u003cem>E. coli\u003c/em> that light up when toxicity is detected, according to the collaborative study by researchers at Israel’s Ben-Gurion University of the Negev and Singapore’s Nanyang Technological University.\u003c/p>\n\u003cp>Sucralose displayed the most significant effects, with as little as 1 milligram affecting a strain of the \u003cem>E. coli.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"This is further evidence that consumption of artificial sweeteners adversely affects gut \u003ca href=\"https://www.sciencedaily.com/releases/2018/10/181001101932.htm\" target=\"_blank\" rel=\"noopener\">microbial activity\u003c/a> which can cause a wide range of health issues,\" co-author Ariel Kushmaro, a professor of biotechnology engineering at Ben-Gurion, said in a statement.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Disturbances in the gut ecosystem can seriously harm human health with previous studies showing that pathogenic\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425030/\"> bacteria\u003c/a> can cause many chronic diseases, including inflammatory bowel disease, obesity, diabetes, and cancer.\u003c/p>\n\u003cp>The presence of these chemicals is not always obvious, with many popular foods, such as microwave popcorn and fruit juice, labeling the ingredient as a \"natural sweetener.\" That's because the Food and Drug Administration has \u003ca href=\"https://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm456090.htm\" target=\"_blank\" rel=\"noopener\">yet to define\u003c/a> the term “natural” for use in food labeling.\u003c/p>\n\u003cp>Along with possible adverse health effects, the study warns that artificial sweeteners have become so ubiquitous that they're increasingly turning up in drinking water and groundwater basins.\u003c/p>\n\u003cp>\"They are resistant to wastewater treatment processes, therefore they are continuously introduced into the water environments,\" write the authors. \"Such concentrations [of artificial sweeteners] are among the highest known for anthropogenic trace pollutants.\"\u003c/p>\n\u003cp>\u003ca href=\"https://caloriecontrol.org/\" target=\"_blank\" rel=\"noopener\">Calorie Control Council\u003c/a>, the trade group for the artificial sweetener industry, criticized the study for relying solely on \u003cem>E. coli \u003c/em>bacterium, which they argue is not directly comparable to the human microbiome.\u003c/p>\n\u003cp style=\"font-weight: 400\">\"More specifically, it is unknown whether the changes to the bacterium noted in the study, or any changes in microbiome bacteria, are indicative of negative health outcomes in humans,\" the \u003ca href=\"https://caloriecontrol.org/\" target=\"_blank\" rel=\"noopener\">group \u003c/a>said in a statement emailed to KQED.\u003c/p>\n\u003cp style=\"font-weight: 400\">Moreover, the group says that all the sweeteners included in the study have been approved for use by several scientific and regulatory authorities, including the FDA.\u003c/p>\n\u003cp>To determine toxicity, researchers modified different types of \u003ci>E.coli \u003c/i>bacteria to emit light when experiencing distress. Researchers then could see what type of damage occurred, depending on which type of modified \u003cem>E. coli\u003c/em> glowed. Researchers found that each sweetener produced a specific fingerprint using three stripes of bacteria, with each stripe representing a different type of damage. From \u003ca href=\"https://www.livescience.com/63743-artificial-sweeteners-gut-health.html\" target=\"_blank\" rel=\"noopener\">Live Science\u003c/a>, quoting senior author Evgeni Eltzov:\u003c/p>\n\u003cblockquote>\n\u003cp class=\"p1\">The pattern of colors was unique for each sweetener; one might've caused more DNA damage than protein damage, for example. However, all sweeteners damaged the bacteria in some way, Eltzov said. But Eltzov noted that these findings don't mean the chemicals are \"toxic\" to humans. More research is needed to make that determination.\u003c/p>\n\u003c/blockquote>\n\u003cp class=\"p1\">One cited shortcoming of the study is that the concentrations of artificial sweetener used were higher than what's typically consumed in a can of diet soda. The \u003ca href=\"https://www.livescience.com/63743-artificial-sweeteners-gut-health.html\" target=\"_blank\" rel=\"noopener\">findings do\u003c/a> not\u003cspan class=\"Apple-converted-space\"> \u003c/span>\"tell us what happens in real life. It tells us what happens in a test tube,\" Dr. Kristina Rother, a senior research physician at the National Institutes of Health, told Live Science.\u003c/p>\n\u003cp class=\"p1\">\"Real life is just more complicated,\" Rother, who was not involved in the study, told Live Science.\u003c/p>\n\u003cp class=\"p1\">Still, she recommends avoiding artificial sweeteners.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp class=\"p1\">\"I haven't seen a study that says any of these six FDA-approved sweeteners make the gut microbiome better,” she says. \"So, my recommendation is very simple and very difficult to achieve: Live a healthy life, eat little processed food.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "A Rush Against Time: Decades Old Chemicals, New Angst Over Drinking Water",
"title": "A Rush Against Time: Decades Old Chemicals, New Angst Over Drinking Water",
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"content": "\u003cp>In some parts of the country people are learning their drinking water contains pollution from a group of chemicals called \u003ca href=\"https://www.epa.gov/pfas\" target=\"_blank\" rel=\"noopener\">Per- and Polyfluoroalkyl Substances\u003c/a> (PFAS). These chemicals have been linked to illnesses, including cancer. But a lot of questions remain including how exactly they affect people's health and in what doses.[contextly_sidebar id=\"6zIBNiaB7i0Hof1u8JCSiwQIZioEoqoi\"]\u003c/p>\n\u003cp>These chemicals have been around for decades but the issue gained urgency in recent years as water suppliers tested for and found PFAS pollution as part of an Environmental Protection Agency program.\u003c/p>\n\u003cp>The EPA is working on a plan to manage PFAS but members of Congress are \u003ca href=\"https://apnews.com/9f387f98e705432e9278001687fe99aa\" target=\"_blank\" rel=\"noopener\">pushing the EPA to move faster\u003c/a>. A few states already have established strict new standards to limit the compounds in drinking water. And in some places, \u003ca href=\"http://www.wbur.org/hereandnow/2018/09/25/water-pollution-pennsylvania-gop-midterms\" target=\"_blank\" rel=\"noopener\">such as the Philadelphia suburbs\u003c/a>, PFAS pollution has become an issue in mid-term election races.\u003c/p>\n\u003cp>As scientists and policy-makers work to limit human exposure to the compounds here are a few key points that are worth knowing.\u003c/p>\n\u003cp>\u003cstrong>1. PFAS Chemicals Useful But May Be Dangerous \u003c/strong>\u003c/p>\n\u003cp>PFAS chemicals are good at repelling oil and water. That makes them useful in a lot of products including non-stick cookware, fast food wrappers, pizza boxes, water-repellent fabrics and fire-fighting foam.\u003c/p>\n\u003cp>It's difficult to pin down exactly how harmful these chemicals are because research is limited. There was a \u003ca href=\"http://www.c8sciencepanel.org/\" target=\"_blank\" rel=\"noopener\">big health study\u003c/a> involving one form of PFAS in the Mid-Ohio Valley. From that and other studies scientists are comfortable saying certain diseases are linked to PFAS exposure but they won't be more definitive than that.[contextly_sidebar id=\"q4qiZYcFYSHVK4Y9xGlLpSQ7zRpqCqtg\"]\u003c/p>\n\u003cp>\"PFAS chemicals have been linked to a wide range of health effects, including cancer, low birth weight, thyroid disease, elevated cholesterol and effects on the immune system,\" says Laurel Schaider, research scientist at \u003ca href=\"https://www.silentspring.org/research-area/highly-fluorinated-chemicals-pfass\" target=\"_blank\" rel=\"noopener\">Silent Spring Institute\u003c/a>.\u003c/p>\n\u003cp>Manufacturers have agreed to stop using two forms of PFAS in the U.S. These chemicals take a long time to break down in the environment, which is why they remain a problem now. And Schaider says newer forms of PFAS chemicals are still being used, though some people believe they are safer because they remain in the environment and in our bodies for shorter periods.\u003c/p>\n\u003cp>\u003cstrong>2. PFAS Pollution Affects Communities Around the Country\u003c/strong>\u003c/p>\n\u003cp>In some communities PFAS pollution may be known by another name if a specific compound is to blame for problems there. Some of the most common are PFOS, PFOA and Gen-X. PFAS is the overall name for this group of several thousand chemicals.\u003c/p>\n\u003cp>Among the places with PFAS pollution is \u003ca href=\"http://www.michiganradio.org/post/parchment-residents-can-drink-their-tap-water-again\" target=\"_blank\" rel=\"noopener\">Michigan\u003c/a> where the some residents were warned not to drink the water for a month. In \u003ca href=\"http://www.nhpr.org/post/coakley-landfill-site-government-assurances-meet-public-fear\" target=\"_blank\" rel=\"noopener\">New Hampshire\u003c/a> there are concerns a landfill may be polluting water. A case in \u003ca href=\"https://www.npr.org/2016/03/31/472501029/elevated-levels-of-suspected-carcinogen-found-in-states-drinking-water\" target=\"_blank\" rel=\"noopener\">New York\u003c/a> came to regulators' attention after a resident tested his own water. And in \u003ca href=\"http://www.starnewsonline.com/news/20180608/whats-happened-since-we-first-learned-of-genx-year-ago-lot\" target=\"_blank\" rel=\"noopener\">North Carolina\u003c/a> high levels of a PFAS chemical were found in drinking water downstream from a manufacturing plant.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.ewg.org/interactive-maps/2017_pfa\">map\u003c/a> of contaminated sites and communities where PFAS has been detected in drinking water has been compiled by Northeastern University and Environmental Working Group.\u003c/p>\n\u003cp>Lawsuits have been filed against companies believed to be responsible for the pollution. For example, Minnesota sued 3M over PFAS pollution and \u003ca href=\"https://www.mprnews.org/story/2018/02/20/3m-pfc-groundwater-pollution-trial-announcement\" target=\"_blank\" rel=\"noopener\">settled for $850 million\u003c/a> in February 2018\u003c/p>\n\u003cp>\u003cstrong>3. State and Federal Agencies Not Responding Fast Enough \u003c/strong>\u003c/p>\n\u003cp>The EPA requires most water utilities to test for a list of PFAS chemicals. In 2016 the agency lowered a \u003ca href=\"https://www.epa.gov/sites/production/files/2016-06/documents/drinkingwaterhealthadvisories_pfoa_pfos_updated_5.31.16.pdf\" target=\"_blank\" rel=\"noopener\">non-binding health advisory limit\u003c/a> for some PFAS compounds to 70 parts per trillion (ppt). That's about 70 grains of sand in an Olympic-size swimming pool, says Christopher Crockett, chief environmental officer for the water utility Aqua America.[contextly_sidebar id=\"K3FQ2vxkI9zPMDIwttZqKDOlOkz9sSst\"]\u003c/p>\n\u003cp>But environmentalists argue that a \u003ca href=\"https://www.propublica.org/article/suppressed-study-the-epa-underestimated-dangers-of-widespread-chemicals\" target=\"_blank\" rel=\"noopener\">Centers for Disease Control and Prevention study\u003c/a> indicates the numbers should be much lower. \u003ca href=\"https://news.bloombergenvironment.com/environment-and-energy/glass-half-full-on-state-solutions-to-chemicals-in-water/\">A few states\u003c/a> have set lower standards on their own.\u003c/p>\n\u003cp>The EPA is working on a plan to manage PFAS chemicals and expects to release it by the end of this year.\u003c/p>\n\u003cp>\"We need actions to come out of those plans that lead to clear direction for water suppliers,\" says Crockett. He wants to know what level of PFAS chemicals in water is safe and when should his company install filters to remove the chemicals.\u003c/p>\n\u003cp>The Department of Defense also has a big role to play in cleaning up PFAS pollution. The agency uses fire-fighting foam for training at air bases around the country. In places like \u003ca href=\"https://whyy.org/segments/pfas-chemicals-showing-up-in-montco-water-beyond-military-bases/\">Pennsylvania\u003c/a> PFAS chemicals from that foam have made their way into local drinking water.\u003c/p>\n\u003cp>\u003cstrong>4. Steps to Protect Yourself \u003c/strong>\u003c/p>\n\u003cp>When utility company Aqua America learns it needs to treat water polluted with PFAS it installs big carbon filters. If you're worried about this issue and want to be extra cautious, you can essentially do the same in your home.\u003c/p>\n\u003cp>Christopher Crockett with Aqua says filters on refrigerators that dispense water or pitchers with carbon filters work pretty well—just make sure you change the filters regularly as manufacturers recommend.\u003c/p>\n\u003cp>If you want to also limit exposure from taking showers or brushing your teeth then a whole-house filtration system might be necessary. When asked if he filters his water, Crockett says he does not. He's comfortable that water under the current EPA health advisory level of 70 ppt is safe to drink.[contextly_sidebar id=\"Q6TlIH5KCT6cF2EoLBgJP95hLDZvlPwV\"]\u003c/p>\n\u003cp>Water is not the only concern though. Laurel Schaider with Silent Spring Institute says it could make sense to avoid things like fast food wrappers and microwave popcorn bags that can have PFAS chemicals in them. The problem is you never know which ones to avoid because there are no labeling requirements.\u003c/p>\n\u003cp>The state of Washington will eventually \u003ca href=\"https://www.opb.org/news/article/food-packaging-chemical-perfluorinated-ban-washington/\" target=\"_blank\" rel=\"noopener\">ban PFAS use for food packaging\u003c/a> and \u003ca href=\"http://www.spokesman.com/stories/2018/mar/27/washington-bans-fire-fighting-chemicals-that-may-c/\">fire-fighting foam\u003c/a>.\u003c/p>\n\u003cp>Finally, eating a lot of fish also can be a concern in some places. New Jersey is among states that have warned people to \u003ca href=\"https://stateimpact.npr.org/pennsylvania/2018/07/20/new-jersey-issues-first-advisories-for-consumption-of-fish-containing-pfas-chemicals/\" target=\"_blank\" rel=\"noopener\">limit how much fish they eat\u003c/a> from certain bodies of water\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=Decades+Old+Chemicals%2C+New+Angst+Over+Drinking+Water&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" />\u003c/div>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In some parts of the country people are learning their drinking water contains pollution from a group of chemicals called \u003ca href=\"https://www.epa.gov/pfas\" target=\"_blank\" rel=\"noopener\">Per- and Polyfluoroalkyl Substances\u003c/a> (PFAS). These chemicals have been linked to illnesses, including cancer. But a lot of questions remain including how exactly they affect people's health and in what doses.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>These chemicals have been around for decades but the issue gained urgency in recent years as water suppliers tested for and found PFAS pollution as part of an Environmental Protection Agency program.\u003c/p>\n\u003cp>The EPA is working on a plan to manage PFAS but members of Congress are \u003ca href=\"https://apnews.com/9f387f98e705432e9278001687fe99aa\" target=\"_blank\" rel=\"noopener\">pushing the EPA to move faster\u003c/a>. A few states already have established strict new standards to limit the compounds in drinking water. And in some places, \u003ca href=\"http://www.wbur.org/hereandnow/2018/09/25/water-pollution-pennsylvania-gop-midterms\" target=\"_blank\" rel=\"noopener\">such as the Philadelphia suburbs\u003c/a>, PFAS pollution has become an issue in mid-term election races.\u003c/p>\n\u003cp>As scientists and policy-makers work to limit human exposure to the compounds here are a few key points that are worth knowing.\u003c/p>\n\u003cp>\u003cstrong>1. PFAS Chemicals Useful But May Be Dangerous \u003c/strong>\u003c/p>\n\u003cp>PFAS chemicals are good at repelling oil and water. That makes them useful in a lot of products including non-stick cookware, fast food wrappers, pizza boxes, water-repellent fabrics and fire-fighting foam.\u003c/p>\n\u003cp>It's difficult to pin down exactly how harmful these chemicals are because research is limited. There was a \u003ca href=\"http://www.c8sciencepanel.org/\" target=\"_blank\" rel=\"noopener\">big health study\u003c/a> involving one form of PFAS in the Mid-Ohio Valley. From that and other studies scientists are comfortable saying certain diseases are linked to PFAS exposure but they won't be more definitive than that.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"PFAS chemicals have been linked to a wide range of health effects, including cancer, low birth weight, thyroid disease, elevated cholesterol and effects on the immune system,\" says Laurel Schaider, research scientist at \u003ca href=\"https://www.silentspring.org/research-area/highly-fluorinated-chemicals-pfass\" target=\"_blank\" rel=\"noopener\">Silent Spring Institute\u003c/a>.\u003c/p>\n\u003cp>Manufacturers have agreed to stop using two forms of PFAS in the U.S. These chemicals take a long time to break down in the environment, which is why they remain a problem now. And Schaider says newer forms of PFAS chemicals are still being used, though some people believe they are safer because they remain in the environment and in our bodies for shorter periods.\u003c/p>\n\u003cp>\u003cstrong>2. PFAS Pollution Affects Communities Around the Country\u003c/strong>\u003c/p>\n\u003cp>In some communities PFAS pollution may be known by another name if a specific compound is to blame for problems there. Some of the most common are PFOS, PFOA and Gen-X. PFAS is the overall name for this group of several thousand chemicals.\u003c/p>\n\u003cp>Among the places with PFAS pollution is \u003ca href=\"http://www.michiganradio.org/post/parchment-residents-can-drink-their-tap-water-again\" target=\"_blank\" rel=\"noopener\">Michigan\u003c/a> where the some residents were warned not to drink the water for a month. In \u003ca href=\"http://www.nhpr.org/post/coakley-landfill-site-government-assurances-meet-public-fear\" target=\"_blank\" rel=\"noopener\">New Hampshire\u003c/a> there are concerns a landfill may be polluting water. A case in \u003ca href=\"https://www.npr.org/2016/03/31/472501029/elevated-levels-of-suspected-carcinogen-found-in-states-drinking-water\" target=\"_blank\" rel=\"noopener\">New York\u003c/a> came to regulators' attention after a resident tested his own water. And in \u003ca href=\"http://www.starnewsonline.com/news/20180608/whats-happened-since-we-first-learned-of-genx-year-ago-lot\" target=\"_blank\" rel=\"noopener\">North Carolina\u003c/a> high levels of a PFAS chemical were found in drinking water downstream from a manufacturing plant.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.ewg.org/interactive-maps/2017_pfa\">map\u003c/a> of contaminated sites and communities where PFAS has been detected in drinking water has been compiled by Northeastern University and Environmental Working Group.\u003c/p>\n\u003cp>Lawsuits have been filed against companies believed to be responsible for the pollution. For example, Minnesota sued 3M over PFAS pollution and \u003ca href=\"https://www.mprnews.org/story/2018/02/20/3m-pfc-groundwater-pollution-trial-announcement\" target=\"_blank\" rel=\"noopener\">settled for $850 million\u003c/a> in February 2018\u003c/p>\n\u003cp>\u003cstrong>3. State and Federal Agencies Not Responding Fast Enough \u003c/strong>\u003c/p>\n\u003cp>The EPA requires most water utilities to test for a list of PFAS chemicals. In 2016 the agency lowered a \u003ca href=\"https://www.epa.gov/sites/production/files/2016-06/documents/drinkingwaterhealthadvisories_pfoa_pfos_updated_5.31.16.pdf\" target=\"_blank\" rel=\"noopener\">non-binding health advisory limit\u003c/a> for some PFAS compounds to 70 parts per trillion (ppt). That's about 70 grains of sand in an Olympic-size swimming pool, says Christopher Crockett, chief environmental officer for the water utility Aqua America.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But environmentalists argue that a \u003ca href=\"https://www.propublica.org/article/suppressed-study-the-epa-underestimated-dangers-of-widespread-chemicals\" target=\"_blank\" rel=\"noopener\">Centers for Disease Control and Prevention study\u003c/a> indicates the numbers should be much lower. \u003ca href=\"https://news.bloombergenvironment.com/environment-and-energy/glass-half-full-on-state-solutions-to-chemicals-in-water/\">A few states\u003c/a> have set lower standards on their own.\u003c/p>\n\u003cp>The EPA is working on a plan to manage PFAS chemicals and expects to release it by the end of this year.\u003c/p>\n\u003cp>\"We need actions to come out of those plans that lead to clear direction for water suppliers,\" says Crockett. He wants to know what level of PFAS chemicals in water is safe and when should his company install filters to remove the chemicals.\u003c/p>\n\u003cp>The Department of Defense also has a big role to play in cleaning up PFAS pollution. The agency uses fire-fighting foam for training at air bases around the country. In places like \u003ca href=\"https://whyy.org/segments/pfas-chemicals-showing-up-in-montco-water-beyond-military-bases/\">Pennsylvania\u003c/a> PFAS chemicals from that foam have made their way into local drinking water.\u003c/p>\n\u003cp>\u003cstrong>4. Steps to Protect Yourself \u003c/strong>\u003c/p>\n\u003cp>When utility company Aqua America learns it needs to treat water polluted with PFAS it installs big carbon filters. If you're worried about this issue and want to be extra cautious, you can essentially do the same in your home.\u003c/p>\n\u003cp>Christopher Crockett with Aqua says filters on refrigerators that dispense water or pitchers with carbon filters work pretty well—just make sure you change the filters regularly as manufacturers recommend.\u003c/p>\n\u003cp>If you want to also limit exposure from taking showers or brushing your teeth then a whole-house filtration system might be necessary. When asked if he filters his water, Crockett says he does not. He's comfortable that water under the current EPA health advisory level of 70 ppt is safe to drink.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Water is not the only concern though. Laurel Schaider with Silent Spring Institute says it could make sense to avoid things like fast food wrappers and microwave popcorn bags that can have PFAS chemicals in them. The problem is you never know which ones to avoid because there are no labeling requirements.\u003c/p>\n\u003cp>The state of Washington will eventually \u003ca href=\"https://www.opb.org/news/article/food-packaging-chemical-perfluorinated-ban-washington/\" target=\"_blank\" rel=\"noopener\">ban PFAS use for food packaging\u003c/a> and \u003ca href=\"http://www.spokesman.com/stories/2018/mar/27/washington-bans-fire-fighting-chemicals-that-may-c/\">fire-fighting foam\u003c/a>.\u003c/p>\n\u003cp>Finally, eating a lot of fish also can be a concern in some places. New Jersey is among states that have warned people to \u003ca href=\"https://stateimpact.npr.org/pennsylvania/2018/07/20/new-jersey-issues-first-advisories-for-consumption-of-fish-containing-pfas-chemicals/\" target=\"_blank\" rel=\"noopener\">limit how much fish they eat\u003c/a> from certain bodies of water\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=Decades+Old+Chemicals%2C+New+Angst+Over+Drinking+Water&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" />\u003c/div>\n\u003c/div>\u003c/p>",
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"soldout": {
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