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"disqusTitle": "Theranos CEO Holmes' Net Worth Is Now Zero, Says Forbes",
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"content": "\u003cp>\u003cstrong>Update Wednesday, June 1:\u003c/strong> Forbes Slashes Estimates of Elizabeth Holmes' Net Worth\u003c/p>\n\u003cp>Forbes \u003ca href=\"http://www.forbes.com/sites/matthewherper/2016/06/01/from-4-5-billion-to-nothing-forbes-revises-estimated-net-worth-of-theranos-founder-elizabeth-holmes/#610806f12f29\" target=\"_blank\">announced today\u003c/a> it has revised its estimate of the net worth of Theranos founder Elizabeth Holmes, from last year's $4.5 billion to: absolutely nothing. Analysts cut the estimate of the company's net worth to $800 million, a fraction of its previous estimated value of $9 billion. The magazine reports Theranos had no comment. From the Forbes story:\u003c/p>\n\u003cblockquote>\u003cp>Our estimate of Holmes’ wealth is based entirely on her 50% stake in Theranos, the blood-testing company she founded in 2003 with plans of revolutionizing the diagnostic test market. Theranos shares are not traded on any stock market; private investors purchased stakes in 2014 at a price that implied a $9 billion valuation for the company.\u003c/p>\n\u003cp>Since then, Theranos has been hit with allegations that its tests are inaccurate and is being investigated by an alphabet soup of federal agencies. That, plus new information indicating Theranos’ annual revenues are less than $100 million, has led FORBES to come up with a new, lower estimate of Theranos’ value.\u003c/p>\n\u003cp>FORBES spoke to a dozen venture capitalists, analysts and industry experts and concluded that a more realistic value for Theranos is $800 million, rather than $9 billion.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong>Update Thursday, May 26: \u003c/strong> And now, the lawsuits.\u003c/p>\n\u003cp>On the heels of Theranos \u003ca href=\"http://ww2.kqed.org/futureofyou/2016/05/19/theranos-corrects-tens-of-thousands-of-blood-tests/\">voiding or correcting\u003c/a> tens of thousands of blood tests it performed at its California lab, two suits seeking class action status have been filed in Northern California. The \u003ca href=\"http://fortune.com/2016/05/26/theranos-class-action-lawsuit/\">first suit\u003c/a> was filed Wednesday on behalf of an unidentified Arizona man. The suit accuses the blood-testing company of fraud.\u003c/p>\n\u003cp>Today, a \u003ca href=\"https://cdn2.vox-cdn.com/uploads/chorus_asset/file/6552851/jones-theranos.0.pdf\">second class-action suit\u003c/a> was filed on behalf of a man named Casey Jones. Jones visited a Theranos Wellness Center inside a Phoenix Walgreens in September 2015 to obtain a routine blood panel as well as a test marked \"reproductive health,\" as he was concerned about his ability to impregnate his wife, the suit says. His doctor had spoken highly of Theranos' finger-prick test as being minimally invasive, and Jones was also influenced by heavy media coverage.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Upon arriving at Walgreens, Mr. Jones' experience differed greatly from what was promoted,\" the lawsuit claims. \"He had several large vials of blood drawn ... the same as what he would have had drawn at any other lab. There was no disclaimer made to Mr. Jones about this apparent change in the blood draw procedure.\"\u003c/p>\n\u003cp>The suit claims Theranos breached its contract with the plaintiff by not drawing blood in the advertised, minimally invasive way. It also recaps the history of Theranos' disastrous government inspection of its lab and claims Theranos failed to maintain its equipment to industry or government standards. The suit also accuses Theranos of deceptive advertising and fraudulent business practices.\u003c/p>\n\u003cp>\"Because of the reported issues with Theranos, Mr. Jones has serious concerns about the lab results he received, including concerns regarding the reliability and accuracy of the tests,\" the suit says.\u003c/p>\n\u003cp>\u003ca href=\"http://www.vanityfair.com/news/2016/05/elizabeth-holmes-theranos-class-action-lawsuit\">The Verge\u003c/a> says Theranos spokeswoman Brooke Buchanan issued the same response to today's lawsuit as she did to yesterday's: “The lawsuit filed today against Theranos is without merit. The company will vigorously defend itself against these claims.”\u003c/p>\n\u003cp>Whether any patients have been truly harmed by decisions they or their doctors made based on inaccurate Theranos results is not yet known. The Wall Street Journal has\u003ca href=\"http://www.wsj.com/articles/theranos-voids-two-years-of-edison-blood-test-results-1463616976\"> reported\u003c/a> that one physician who received a corrected report said she'd unnecessarily sent a patient to the ER based on abnormally high test results.\u003c/p>\n\u003cp>Also of note for Theranos watchers: The Wall Street Journal Wednesday \u003ca href=\"http://www.wsj.com/articles/craving-growth-walgreens-dismissed-its-doubts-about-theranos-1464207285\">recounted the history\u003c/a> of the company's partnership with Walgreens, which allowed for the opening of dozens of Theranos centers inside the drugstore chain's Arizona stores. The story suggests Walgreens, in its eagerness to expand into next-wave health care, did less than due diligence in vetting Theranos.\u003c/p>\n\u003cp>\u003cstrong>Original post: Theranos, From All Angles\u003c/strong>\u003c/p>\n\u003cp>Think fast:\u003c/p>\n\u003cp>Charlize Theron or Scarlett Johannson as Elizabeth Holmes in \"Theranos: The Movie\"?\u003c/p>\n\u003cp>There's a lot of drama here, as business stories go. Is the company going to be definitively exposed as the Enron of biotech startups? Or will it be vindicated as a misunderstood and unfairly persecuted innovator that, well, made a few mistakes.\u003c/p>\n\u003cp>If the former, you get the sense only a talent on a par with \u003ca href=\"http://www.theatlantic.com/magazine/archive/2008/01/the-angriest-man-in-television/306581/\">David Simon's\u003c/a> could coherently dramatize the shortcomings of the multiple institutions implicated in this mess. The story is compelling even without the appearance to date of the most important characters -- real-life patients who may have been harmed by Theranos' \u003ca href=\"http://ww2.kqed.org/futureofyou/2016/05/19/theranos-corrects-tens-of-thousands-of-blood-tests/\">faulty blood tests\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"#articles\">\u003cstrong>See below for Theranos analysis from around the Web.\u003c/strong>\u003c/a>\u003c/aside>\n\u003cp>That may not be the case much longer. Last week, we saw the first report of an actual patient impacted by erroneous results issued by Theranos' California lab. The Wall Street Journal, in a \u003ca href=\"http://www.wsj.com/articles/theranos-voids-two-years-of-edison-blood-test-results-1463616976\">story\u003c/a> about thousands of blood tests Theranos now says were incorrect, reported that a physician in the Phoenix area recently received a revised report for a Theranos patient whom the doctor unnecessarily sent to the ER based on abnormally high results.\u003c/p>\n\u003cp>Nick Stockton, who in \u003ca href=\"http://www.wired.com/2016/05/theranos-inching-towards-legal-bull-issh/\">Wired\u003c/a>, Friday, wrote that Theranos \"is really testing the old adage that all press is good press,\" reported the company has left itself vulnerable to all manner of lawsuits:\u003c/p>\n\u003cblockquote>\u003cp>Many people probably made medical decisions based on those two years of voided tests. Or perhaps they wrongfully decided to forgo medical treatment for a misdiagnosed condition. “If Theranos negligently did blood tests, then someone has a right to sue,” says [UC Berkeley law professor Steven] Davidoff-Soloman. “And it looks like it might be a good case.” But so far, he says he has not seen any examples where a person has popped up and said they were adversely affected by the results from a Theranos test. So again, wait and see.\u003c/p>\n\u003cp>As an accredited lab, Theranos was available to patients through Medicare and Medicaid. “Here you have a situation where they were not just deceiving patients, but also the federal government, who is paying for those tests,” says [University of Michigan law professor Adam] Pritchard. “That is something the Department of Justice is going to be very interested in.” The DOJ itself could bring suit. And depending on what that suit entails, class action lawyers could come calling with cases of mass consumer fraud. Nightmare.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong>'Whatever They're Up To, I Can't Figure It Out'\u003c/strong>\u003c/p>\n\u003cp>Dr. Norman Paradis, a professor of medicine at Dartmouth who has consulted for both diagnostic startups and biomed investors, told me recently that several years ago he looked into Theranos at the request of some potential investors. He found nothing that could be assessed.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Their patents — there’s nothing there. There’s nothing you look at and say, ‘Oh, I can build that.''\u003ccite>Dr. Norman Paradis, Geisel School of Medicine, Dartmouth College\u003c/cite>\u003c/aside>\n\u003cp>\"I said whatever they're up to, I can't figure it out. I didn't see it in their patents or regulatory filings. Their patents -- there's nothing there. There's nothing you look at and say, 'Oh I can build that.'\"\u003c/p>\n\u003cp>Paradis says the molecular diagnostics space is not exactly fertile ground for startups to begin with, because of the royalties due companies that have developed the antibodies indicating a particular illness or condition. Because of this, he says, it is unlikely the low-cost tests Theranos offers are breaking even.\u003c/p>\n\u003cp>\"I have seen smart business types look at this model, and they’ve said I can’t see how you make money here.\"\u003c/p>\n\u003cp>Christina Farr, in \u003ca href=\"http://www.fastcompany.com/3059230/the-theranos-scandal-is-just-the-beginning\">Fast Company\u003c/a>, writes that whatever the company's business plan, it seemed to be a nonstarter with the most prestigious biotech investing firms. \"None of the top biotech investors invested in Theranos,\" Farr wrote. \"Five of the best-regarded biotech firms—Venrock, Third Rock Ventures, Polaris, Deerfield, Versant—either didn't meet with Theranos at all or passed on the pitch. The Silicon Valley firms with health care practices, like Google Ventures and Bessemer Venture Partners, weren't swayed, either.\"\u003c/p>\n\u003cp>Dartmouth's Paradis does give the company credit for submitting over 100 tests for FDA approval, even though a \u003ca href=\"http://www.theverge.com/2015/11/17/9750048/ldt-loophole-fda-hearing-theranos-lab-tests\">legal loophole\u003c/a> regarding \"\u003ca href=\"http://www.fda.gov/medicaldevices/productsandmedicalprocedures/invitrodiagnostics/ucm407296.htm\">Laboratory Developed Tests\u003c/a>\" allows it and \u003ca href=\"http://www.theverge.com/science/2015/11/11/9706356/fda-theranos-health-diagnostics-cancer-tests-regulation-loophole-ldt\">other diagnostic startups\u003c/a> to bring these tests to market without doing so. (The FDA plans on issuing its final version of a \u003ca href=\"http://www.fda.gov/downloads/medicaldevices/deviceregulationandguidance/guidancedocuments/ucm416685.pdf\">draft plan\u003c/a> to phase in \u003ca href=\"https://www.genomeweb.com/molecular-diagnostics/fda-finalize-ldt-guidance-amid-uncertainty-number-genetic-tests-impacted\">oversight of LDTS\u003c/a> sometime this year.)\u003c/p>\n\u003cp>\"For Theranos to decide to go the FDA route does show considerable rigor on Theranos’ part,\" Paradis says. \"When they made that decision, people were not doing it that way.\"\u003c/p>\n\u003cp>Soon, we may get another key development in the story, courtesy of the U.S. government. The Centers for Medicare & Medicaid Services is still mulling whether to revoke the license of Theranos' California lab, and whether to suspend Elizabeth Holmes from involvement in the blood-testing industry for two years. If things go that way, the company still has a couple of administrative appeals available to it. And beyond that, there's always the courts.\u003c/p>\n\u003cp>Meanwhile, Theranos is \u003ca href=\"https://www.statnews.com/2016/05/19/theranos-expansion-plans/\">still hiring\u003c/a>, and Holmes is scheduled to give a presentation at a plenary session of the American Association for Clinical Chemistry's annual meeting in Philadelphia on Aug. 1. \"For the first time, Holmes will present data at a scientific conference that describes Theranos’ technologies, including small sample volume testing and finger-stick collection,\" said the press release.\u003c/p>\n\u003cp>That one should be put on pay-per-view.\u003c/p>\n\u003chr>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ca id=\"articles\">\u003c/a>Below are some of the most interesting recent takes on the Theranos saga:\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"http://www.vanityfair.com/news/2016/05/theranos-silicon-valley-media\">The Secret Culprit in the Theranos Mess\u003c/a> (Nick Bilton, Vanity Fair)\u003cbr>\n\u003cblockquote>\u003cp>(I)f you peel back all of the layers of this tale, at the center you will find one of the more insidious culprits: the Silicon Valley tech press. They embraced Holmes and her start-up with a surprising paucity of questions about the technology she had supposedly developed. They praised her as “the next Steve Jobs,” over and over (the black turtleneck didn’t hurt), until it was no longer a question, but seemingly a fact. At TechCrunch Disrupt, blogger Jon Shieber had his blood drawn onstage as he interviewed her. There were no tough questions about whether Theranos’s technology actually worked; just praise. When it seemed that the tech press had vetted Holmes, she subsequently went mainstream. She got her New Yorker profile, and her face appeared on the cover of T: The New York Times Style Magazine, among others.\u003c/p>\u003c/blockquote>\n\u003c/li>\n\u003cli>\u003ca href=\"http://www.businessinsider.com/why-investor-tim-draper-still-loves-theranos-2016-5\">Blood-testing 'vampires' want to take down Theranos, says investor Tim Draper\u003c/a> (Julie Bort, Business Insider)\u003cbr>\n\u003cblockquote>\u003cp>Troubled blood-testing startup Theranos still has one big, vocal fan: the guy that invested the seed money to get the company started, famed investor Tim Draper. Draper tells Business Insider that of all the startups out there, Theranos is among those he's most excited about. ... Although Draper is not listed as a board member, his take is that all of the questions about Theranos is smoke and mirrors from the established blood-testing industry that doesn't want to see itself overthrown by a one-drop-of-blood-alternative. He says he's seen this struggle many times in his investing career, how telecom companies fought Skype, taxis fought Uber, car companies fought Tesla and so on.\u003c/p>\u003c/blockquote>\n\u003c/li>\n\u003cli>\u003ca href=\"http://www.fastcompany.com/3059230/the-theranos-scandal-is-just-the-beginning\">The Theranos Scandal Is Just The Beginning\u003c/a> (Christina Farr, Fast Company)\u003cbr>\n\u003cblockquote>\u003cp>(A)fter we find our scapegoats, the problem will not be solved. Until we address all the factors that led to Theranos' rise and its downfall, this will happen again. Launch, hype-cycle, demise. Launch, hype-cycle, demise. Again and again. One the biggest catalysts for this cycle? Dumb money. ...The biotech funding process might be flawed, but it works well enough to smell a very large rat.\u003c/p>\u003c/blockquote>\n\u003c/li>\n\u003cli>\u003ca href=\"http://time.com/4299943/the-theranos-downfall-was-inevitable/\">The Theranos Downfall Was Inevitable\u003c/a> (Alice Park, Time)\u003cbr>\n\u003cblockquote>\u003cp>At issue is the secrecy with which Theranos developed and brought to market the technology and its proprietary blood-testing process from day one. Theranos did not share with outside scientists which machines the company used to perform its tests, and they wouldn’t then reveal how its technology differed from the microfluidics that other companies were using to perform similar—though less extensive—assays as Theranos’. Nor did they publish in any peer-reviewed journal any research that proved the effectiveness of their product. To do so, Holmes said, would make them lose their competitive advantage of being the first to offer such tests. When Dr. Eric Topol, director of the Scripps Translational Science Institute, had his blood drawn and tested using the system, he says, “I wasn’t allowed to see the equipment, wasn’t allowed to go near it.”\u003c/p>\u003c/blockquote>\n\u003c/li>\n\u003cli>\u003ca href=\"http://www.wsj.com/articles/from-lending-club-to-theranos-the-limits-of-disruption-1463161745\">From LendingClub to Theranos, the Limits of Disruption\u003c/a> (Justin Lahart, The Wall Street Journal)\u003cbr>\n\u003cblockquote>\u003cp>(E)arly critics of Theranos complained the company had published little data in peer-reviewed journals that would have helped provide insight into the quality of its tests. But innovators often see ignoring criticism as a feature, says University of Toronto economist Joshua Gans, author of a recent book on disruption. That is particularly true when the criticism comes from incumbents who, as ousted Zenefits chief Parker Conrad once complained, often cry foul and look to regulators for protection. The problem is that while critics may be protecting turf, there also may be some truth to what they say. Indeed, the norms incumbents adhere to, and the rules they play by, are often there for reasons that go beyond protecting their moats. That’s particularly true of many old-line industries, such as banking, insurance brokers and medicine, that seem ripe for new entrants.\u003c/p>\u003c/blockquote>\n\u003c/li>\n\u003cli>\u003ca href=\"http://ww2.kqed.org/futureofyou/2016/04/25/analysis-why-medical-lab-experts-were-always-skeptical-of-theranos/\">Analysis: Why Medical Lab Experts Were Always Skeptical of Theranos\u003c/a> (Norman A. Paradis, The Conversation)\u003cbr>\n\u003cblockquote>\u003cp>The vast majority of FDA-approved medically important laboratory tests are based on blood taken from a vein, not from the finger. ... To understand why that matters, let’s start with some simple physiology. The human body can be considered a series of compartments; the concentration of any given molecule in blood or tissue fluid may vary from one compartment to the next. A small molecule, such as glucose, can move easily between these compartments, and any bodily fluid can generally be used to test its concentration. This is why testing blood sugar with a finger prick works. But large, medically important molecules like proteins and lipids are not always found in uniform concentrations throughout the body. The composition of blood from finger pricks from the same person can vary, a problem that doesn’t happen in blood taken from a vein. When you lance a fingertip, you get both blood and tissue fluid, and this means that the concentration of molecules may be different than if the blood sample comes from a vein.\u003c/p>\u003c/blockquote>\n\u003c/li>\n\u003cli>\u003ca href=\"http://fivethirtyeight.com/features/theranos-is-wrong-we-dont-need-more-blood-tests/\">Theranos is Wrong: We Don't Need More Blood Tests\u003c/a> (Katherine Hobson, FiveThirtyEight)\u003cbr>\n\u003cblockquote>\u003cp>Much of the debate over the last few months has been about whether Theranos’s technology can actually do what the company has said it can. But there’s a dubious assumption at the heart of Theranos, arguably just as damning as the questions about its technology. Theranos wants us to believe that ostensibly healthy people can get healthier by having more tests. But the science suggests that is far from true.\u003c/p>\u003c/blockquote>\n\u003c/li>\n\u003cli>\u003ca href=\"http://www.natlawreview.com/article/theranos-sec-s-pursuit-unicorns-and-taking-reins-internal-controls\">Theranos, the SEC’s Pursuit of Unicorns, and Taking the Reins of Internal Controls\u003c/a> (The National Law Review)\u003cbr>\n\u003cblockquote>\u003cp>Even beyond potential misrepresentation issues, we believe the SEC may also be focused on the adequacy of internal controls at privately-held companies, potentially viewing governance and control problems as contributing factors to other issues. ...(I)n a recent speech addressing issues relating to pre-IPO companies, SEC Chair Mary Jo White noted that the SEC was looking closely at privately-held “unicorns”, even where the investors appeared to be venture capital and private equity funds. She stated that control issues were a major risk factor that could lead to opportunities to misstate financial results: “The risk of distortion and inaccuracy is amplified because start-up companies, even quite mature ones, often have far less robust internal controls and governance procedures than most public companies.”\u003c/p>\u003c/blockquote>\n\u003c/li>\n\u003c/ul>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Update Wednesday, June 1:\u003c/strong> Forbes Slashes Estimates of Elizabeth Holmes' Net Worth\u003c/p>\n\u003cp>Forbes \u003ca href=\"http://www.forbes.com/sites/matthewherper/2016/06/01/from-4-5-billion-to-nothing-forbes-revises-estimated-net-worth-of-theranos-founder-elizabeth-holmes/#610806f12f29\" target=\"_blank\">announced today\u003c/a> it has revised its estimate of the net worth of Theranos founder Elizabeth Holmes, from last year's $4.5 billion to: absolutely nothing. Analysts cut the estimate of the company's net worth to $800 million, a fraction of its previous estimated value of $9 billion. The magazine reports Theranos had no comment. From the Forbes story:\u003c/p>\n\u003cblockquote>\u003cp>Our estimate of Holmes’ wealth is based entirely on her 50% stake in Theranos, the blood-testing company she founded in 2003 with plans of revolutionizing the diagnostic test market. Theranos shares are not traded on any stock market; private investors purchased stakes in 2014 at a price that implied a $9 billion valuation for the company.\u003c/p>\n\u003cp>Since then, Theranos has been hit with allegations that its tests are inaccurate and is being investigated by an alphabet soup of federal agencies. That, plus new information indicating Theranos’ annual revenues are less than $100 million, has led FORBES to come up with a new, lower estimate of Theranos’ value.\u003c/p>\n\u003cp>FORBES spoke to a dozen venture capitalists, analysts and industry experts and concluded that a more realistic value for Theranos is $800 million, rather than $9 billion.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong>Update Thursday, May 26: \u003c/strong> And now, the lawsuits.\u003c/p>\n\u003cp>On the heels of Theranos \u003ca href=\"http://ww2.kqed.org/futureofyou/2016/05/19/theranos-corrects-tens-of-thousands-of-blood-tests/\">voiding or correcting\u003c/a> tens of thousands of blood tests it performed at its California lab, two suits seeking class action status have been filed in Northern California. The \u003ca href=\"http://fortune.com/2016/05/26/theranos-class-action-lawsuit/\">first suit\u003c/a> was filed Wednesday on behalf of an unidentified Arizona man. The suit accuses the blood-testing company of fraud.\u003c/p>\n\u003cp>Today, a \u003ca href=\"https://cdn2.vox-cdn.com/uploads/chorus_asset/file/6552851/jones-theranos.0.pdf\">second class-action suit\u003c/a> was filed on behalf of a man named Casey Jones. Jones visited a Theranos Wellness Center inside a Phoenix Walgreens in September 2015 to obtain a routine blood panel as well as a test marked \"reproductive health,\" as he was concerned about his ability to impregnate his wife, the suit says. His doctor had spoken highly of Theranos' finger-prick test as being minimally invasive, and Jones was also influenced by heavy media coverage.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Upon arriving at Walgreens, Mr. Jones' experience differed greatly from what was promoted,\" the lawsuit claims. \"He had several large vials of blood drawn ... the same as what he would have had drawn at any other lab. There was no disclaimer made to Mr. Jones about this apparent change in the blood draw procedure.\"\u003c/p>\n\u003cp>The suit claims Theranos breached its contract with the plaintiff by not drawing blood in the advertised, minimally invasive way. It also recaps the history of Theranos' disastrous government inspection of its lab and claims Theranos failed to maintain its equipment to industry or government standards. The suit also accuses Theranos of deceptive advertising and fraudulent business practices.\u003c/p>\n\u003cp>\"Because of the reported issues with Theranos, Mr. Jones has serious concerns about the lab results he received, including concerns regarding the reliability and accuracy of the tests,\" the suit says.\u003c/p>\n\u003cp>\u003ca href=\"http://www.vanityfair.com/news/2016/05/elizabeth-holmes-theranos-class-action-lawsuit\">The Verge\u003c/a> says Theranos spokeswoman Brooke Buchanan issued the same response to today's lawsuit as she did to yesterday's: “The lawsuit filed today against Theranos is without merit. The company will vigorously defend itself against these claims.”\u003c/p>\n\u003cp>Whether any patients have been truly harmed by decisions they or their doctors made based on inaccurate Theranos results is not yet known. The Wall Street Journal has\u003ca href=\"http://www.wsj.com/articles/theranos-voids-two-years-of-edison-blood-test-results-1463616976\"> reported\u003c/a> that one physician who received a corrected report said she'd unnecessarily sent a patient to the ER based on abnormally high test results.\u003c/p>\n\u003cp>Also of note for Theranos watchers: The Wall Street Journal Wednesday \u003ca href=\"http://www.wsj.com/articles/craving-growth-walgreens-dismissed-its-doubts-about-theranos-1464207285\">recounted the history\u003c/a> of the company's partnership with Walgreens, which allowed for the opening of dozens of Theranos centers inside the drugstore chain's Arizona stores. The story suggests Walgreens, in its eagerness to expand into next-wave health care, did less than due diligence in vetting Theranos.\u003c/p>\n\u003cp>\u003cstrong>Original post: Theranos, From All Angles\u003c/strong>\u003c/p>\n\u003cp>Think fast:\u003c/p>\n\u003cp>Charlize Theron or Scarlett Johannson as Elizabeth Holmes in \"Theranos: The Movie\"?\u003c/p>\n\u003cp>There's a lot of drama here, as business stories go. Is the company going to be definitively exposed as the Enron of biotech startups? Or will it be vindicated as a misunderstood and unfairly persecuted innovator that, well, made a few mistakes.\u003c/p>\n\u003cp>If the former, you get the sense only a talent on a par with \u003ca href=\"http://www.theatlantic.com/magazine/archive/2008/01/the-angriest-man-in-television/306581/\">David Simon's\u003c/a> could coherently dramatize the shortcomings of the multiple institutions implicated in this mess. The story is compelling even without the appearance to date of the most important characters -- real-life patients who may have been harmed by Theranos' \u003ca href=\"http://ww2.kqed.org/futureofyou/2016/05/19/theranos-corrects-tens-of-thousands-of-blood-tests/\">faulty blood tests\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"#articles\">\u003cstrong>See below for Theranos analysis from around the Web.\u003c/strong>\u003c/a>\u003c/aside>\n\u003cp>That may not be the case much longer. Last week, we saw the first report of an actual patient impacted by erroneous results issued by Theranos' California lab. The Wall Street Journal, in a \u003ca href=\"http://www.wsj.com/articles/theranos-voids-two-years-of-edison-blood-test-results-1463616976\">story\u003c/a> about thousands of blood tests Theranos now says were incorrect, reported that a physician in the Phoenix area recently received a revised report for a Theranos patient whom the doctor unnecessarily sent to the ER based on abnormally high results.\u003c/p>\n\u003cp>Nick Stockton, who in \u003ca href=\"http://www.wired.com/2016/05/theranos-inching-towards-legal-bull-issh/\">Wired\u003c/a>, Friday, wrote that Theranos \"is really testing the old adage that all press is good press,\" reported the company has left itself vulnerable to all manner of lawsuits:\u003c/p>\n\u003cblockquote>\u003cp>Many people probably made medical decisions based on those two years of voided tests. Or perhaps they wrongfully decided to forgo medical treatment for a misdiagnosed condition. “If Theranos negligently did blood tests, then someone has a right to sue,” says [UC Berkeley law professor Steven] Davidoff-Soloman. “And it looks like it might be a good case.” But so far, he says he has not seen any examples where a person has popped up and said they were adversely affected by the results from a Theranos test. So again, wait and see.\u003c/p>\n\u003cp>As an accredited lab, Theranos was available to patients through Medicare and Medicaid. “Here you have a situation where they were not just deceiving patients, but also the federal government, who is paying for those tests,” says [University of Michigan law professor Adam] Pritchard. “That is something the Department of Justice is going to be very interested in.” The DOJ itself could bring suit. And depending on what that suit entails, class action lawyers could come calling with cases of mass consumer fraud. Nightmare.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong>'Whatever They're Up To, I Can't Figure It Out'\u003c/strong>\u003c/p>\n\u003cp>Dr. Norman Paradis, a professor of medicine at Dartmouth who has consulted for both diagnostic startups and biomed investors, told me recently that several years ago he looked into Theranos at the request of some potential investors. He found nothing that could be assessed.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Their patents — there’s nothing there. There’s nothing you look at and say, ‘Oh, I can build that.''\u003ccite>Dr. Norman Paradis, Geisel School of Medicine, Dartmouth College\u003c/cite>\u003c/aside>\n\u003cp>\"I said whatever they're up to, I can't figure it out. I didn't see it in their patents or regulatory filings. Their patents -- there's nothing there. There's nothing you look at and say, 'Oh I can build that.'\"\u003c/p>\n\u003cp>Paradis says the molecular diagnostics space is not exactly fertile ground for startups to begin with, because of the royalties due companies that have developed the antibodies indicating a particular illness or condition. Because of this, he says, it is unlikely the low-cost tests Theranos offers are breaking even.\u003c/p>\n\u003cp>\"I have seen smart business types look at this model, and they’ve said I can’t see how you make money here.\"\u003c/p>\n\u003cp>Christina Farr, in \u003ca href=\"http://www.fastcompany.com/3059230/the-theranos-scandal-is-just-the-beginning\">Fast Company\u003c/a>, writes that whatever the company's business plan, it seemed to be a nonstarter with the most prestigious biotech investing firms. \"None of the top biotech investors invested in Theranos,\" Farr wrote. \"Five of the best-regarded biotech firms—Venrock, Third Rock Ventures, Polaris, Deerfield, Versant—either didn't meet with Theranos at all or passed on the pitch. The Silicon Valley firms with health care practices, like Google Ventures and Bessemer Venture Partners, weren't swayed, either.\"\u003c/p>\n\u003cp>Dartmouth's Paradis does give the company credit for submitting over 100 tests for FDA approval, even though a \u003ca href=\"http://www.theverge.com/2015/11/17/9750048/ldt-loophole-fda-hearing-theranos-lab-tests\">legal loophole\u003c/a> regarding \"\u003ca href=\"http://www.fda.gov/medicaldevices/productsandmedicalprocedures/invitrodiagnostics/ucm407296.htm\">Laboratory Developed Tests\u003c/a>\" allows it and \u003ca href=\"http://www.theverge.com/science/2015/11/11/9706356/fda-theranos-health-diagnostics-cancer-tests-regulation-loophole-ldt\">other diagnostic startups\u003c/a> to bring these tests to market without doing so. (The FDA plans on issuing its final version of a \u003ca href=\"http://www.fda.gov/downloads/medicaldevices/deviceregulationandguidance/guidancedocuments/ucm416685.pdf\">draft plan\u003c/a> to phase in \u003ca href=\"https://www.genomeweb.com/molecular-diagnostics/fda-finalize-ldt-guidance-amid-uncertainty-number-genetic-tests-impacted\">oversight of LDTS\u003c/a> sometime this year.)\u003c/p>\n\u003cp>\"For Theranos to decide to go the FDA route does show considerable rigor on Theranos’ part,\" Paradis says. \"When they made that decision, people were not doing it that way.\"\u003c/p>\n\u003cp>Soon, we may get another key development in the story, courtesy of the U.S. government. The Centers for Medicare & Medicaid Services is still mulling whether to revoke the license of Theranos' California lab, and whether to suspend Elizabeth Holmes from involvement in the blood-testing industry for two years. If things go that way, the company still has a couple of administrative appeals available to it. And beyond that, there's always the courts.\u003c/p>\n\u003cp>Meanwhile, Theranos is \u003ca href=\"https://www.statnews.com/2016/05/19/theranos-expansion-plans/\">still hiring\u003c/a>, and Holmes is scheduled to give a presentation at a plenary session of the American Association for Clinical Chemistry's annual meeting in Philadelphia on Aug. 1. \"For the first time, Holmes will present data at a scientific conference that describes Theranos’ technologies, including small sample volume testing and finger-stick collection,\" said the press release.\u003c/p>\n\u003cp>That one should be put on pay-per-view.\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca id=\"articles\">\u003c/a>Below are some of the most interesting recent takes on the Theranos saga:\u003c/p>\n\u003cul>\n\u003cli>\u003ca href=\"http://www.vanityfair.com/news/2016/05/theranos-silicon-valley-media\">The Secret Culprit in the Theranos Mess\u003c/a> (Nick Bilton, Vanity Fair)\u003cbr>\n\u003cblockquote>\u003cp>(I)f you peel back all of the layers of this tale, at the center you will find one of the more insidious culprits: the Silicon Valley tech press. They embraced Holmes and her start-up with a surprising paucity of questions about the technology she had supposedly developed. They praised her as “the next Steve Jobs,” over and over (the black turtleneck didn’t hurt), until it was no longer a question, but seemingly a fact. At TechCrunch Disrupt, blogger Jon Shieber had his blood drawn onstage as he interviewed her. There were no tough questions about whether Theranos’s technology actually worked; just praise. When it seemed that the tech press had vetted Holmes, she subsequently went mainstream. She got her New Yorker profile, and her face appeared on the cover of T: The New York Times Style Magazine, among others.\u003c/p>\u003c/blockquote>\n\u003c/li>\n\u003cli>\u003ca href=\"http://www.businessinsider.com/why-investor-tim-draper-still-loves-theranos-2016-5\">Blood-testing 'vampires' want to take down Theranos, says investor Tim Draper\u003c/a> (Julie Bort, Business Insider)\u003cbr>\n\u003cblockquote>\u003cp>Troubled blood-testing startup Theranos still has one big, vocal fan: the guy that invested the seed money to get the company started, famed investor Tim Draper. Draper tells Business Insider that of all the startups out there, Theranos is among those he's most excited about. ... Although Draper is not listed as a board member, his take is that all of the questions about Theranos is smoke and mirrors from the established blood-testing industry that doesn't want to see itself overthrown by a one-drop-of-blood-alternative. He says he's seen this struggle many times in his investing career, how telecom companies fought Skype, taxis fought Uber, car companies fought Tesla and so on.\u003c/p>\u003c/blockquote>\n\u003c/li>\n\u003cli>\u003ca href=\"http://www.fastcompany.com/3059230/the-theranos-scandal-is-just-the-beginning\">The Theranos Scandal Is Just The Beginning\u003c/a> (Christina Farr, Fast Company)\u003cbr>\n\u003cblockquote>\u003cp>(A)fter we find our scapegoats, the problem will not be solved. Until we address all the factors that led to Theranos' rise and its downfall, this will happen again. Launch, hype-cycle, demise. Launch, hype-cycle, demise. Again and again. One the biggest catalysts for this cycle? Dumb money. ...The biotech funding process might be flawed, but it works well enough to smell a very large rat.\u003c/p>\u003c/blockquote>\n\u003c/li>\n\u003cli>\u003ca href=\"http://time.com/4299943/the-theranos-downfall-was-inevitable/\">The Theranos Downfall Was Inevitable\u003c/a> (Alice Park, Time)\u003cbr>\n\u003cblockquote>\u003cp>At issue is the secrecy with which Theranos developed and brought to market the technology and its proprietary blood-testing process from day one. Theranos did not share with outside scientists which machines the company used to perform its tests, and they wouldn’t then reveal how its technology differed from the microfluidics that other companies were using to perform similar—though less extensive—assays as Theranos’. Nor did they publish in any peer-reviewed journal any research that proved the effectiveness of their product. To do so, Holmes said, would make them lose their competitive advantage of being the first to offer such tests. When Dr. Eric Topol, director of the Scripps Translational Science Institute, had his blood drawn and tested using the system, he says, “I wasn’t allowed to see the equipment, wasn’t allowed to go near it.”\u003c/p>\u003c/blockquote>\n\u003c/li>\n\u003cli>\u003ca href=\"http://www.wsj.com/articles/from-lending-club-to-theranos-the-limits-of-disruption-1463161745\">From LendingClub to Theranos, the Limits of Disruption\u003c/a> (Justin Lahart, The Wall Street Journal)\u003cbr>\n\u003cblockquote>\u003cp>(E)arly critics of Theranos complained the company had published little data in peer-reviewed journals that would have helped provide insight into the quality of its tests. But innovators often see ignoring criticism as a feature, says University of Toronto economist Joshua Gans, author of a recent book on disruption. That is particularly true when the criticism comes from incumbents who, as ousted Zenefits chief Parker Conrad once complained, often cry foul and look to regulators for protection. The problem is that while critics may be protecting turf, there also may be some truth to what they say. Indeed, the norms incumbents adhere to, and the rules they play by, are often there for reasons that go beyond protecting their moats. That’s particularly true of many old-line industries, such as banking, insurance brokers and medicine, that seem ripe for new entrants.\u003c/p>\u003c/blockquote>\n\u003c/li>\n\u003cli>\u003ca href=\"http://ww2.kqed.org/futureofyou/2016/04/25/analysis-why-medical-lab-experts-were-always-skeptical-of-theranos/\">Analysis: Why Medical Lab Experts Were Always Skeptical of Theranos\u003c/a> (Norman A. Paradis, The Conversation)\u003cbr>\n\u003cblockquote>\u003cp>The vast majority of FDA-approved medically important laboratory tests are based on blood taken from a vein, not from the finger. ... To understand why that matters, let’s start with some simple physiology. The human body can be considered a series of compartments; the concentration of any given molecule in blood or tissue fluid may vary from one compartment to the next. A small molecule, such as glucose, can move easily between these compartments, and any bodily fluid can generally be used to test its concentration. This is why testing blood sugar with a finger prick works. But large, medically important molecules like proteins and lipids are not always found in uniform concentrations throughout the body. The composition of blood from finger pricks from the same person can vary, a problem that doesn’t happen in blood taken from a vein. When you lance a fingertip, you get both blood and tissue fluid, and this means that the concentration of molecules may be different than if the blood sample comes from a vein.\u003c/p>\u003c/blockquote>\n\u003c/li>\n\u003cli>\u003ca href=\"http://fivethirtyeight.com/features/theranos-is-wrong-we-dont-need-more-blood-tests/\">Theranos is Wrong: We Don't Need More Blood Tests\u003c/a> (Katherine Hobson, FiveThirtyEight)\u003cbr>\n\u003cblockquote>\u003cp>Much of the debate over the last few months has been about whether Theranos’s technology can actually do what the company has said it can. But there’s a dubious assumption at the heart of Theranos, arguably just as damning as the questions about its technology. Theranos wants us to believe that ostensibly healthy people can get healthier by having more tests. But the science suggests that is far from true.\u003c/p>\u003c/blockquote>\n\u003c/li>\n\u003cli>\u003ca href=\"http://www.natlawreview.com/article/theranos-sec-s-pursuit-unicorns-and-taking-reins-internal-controls\">Theranos, the SEC’s Pursuit of Unicorns, and Taking the Reins of Internal Controls\u003c/a> (The National Law Review)\u003cbr>\n\u003cblockquote>\u003cp>Even beyond potential misrepresentation issues, we believe the SEC may also be focused on the adequacy of internal controls at privately-held companies, potentially viewing governance and control problems as contributing factors to other issues. ...(I)n a recent speech addressing issues relating to pre-IPO companies, SEC Chair Mary Jo White noted that the SEC was looking closely at privately-held “unicorns”, even where the investors appeared to be venture capital and private equity funds. She stated that control issues were a major risk factor that could lead to opportunities to misstate financial results: “The risk of distortion and inaccuracy is amplified because start-up companies, even quite mature ones, often have far less robust internal controls and governance procedures than most public companies.”\u003c/p>\u003c/blockquote>\n\u003c/li>\n\u003c/ul>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Stung by Yelp Reviews, Health Providers Divulge Patient Secrets",
"title": "Stung by Yelp Reviews, Health Providers Divulge Patient Secrets",
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"content": "\u003cp>Burned by negative reviews, some health providers are casting their patients’ privacy aside and sharing intimate details online as they try to rebut criticism.\u003c/p>\n\u003caside class=\"pullquote alignright\">One California dentist scolded a patient who accused him of misdiagnosing her. 'You can live in a world of denial and simply believe what you want to hear from your other dentist or make an educated and informed decision.'\u003c/aside>\n\u003cp>In the course of these arguments — which have spilled out publicly on ratings sites like \u003ca href=\"https://www.yelp.com/\" target=\"_blank\">Yelp\u003c/a> — doctors, dentists, chiropractors and massage therapists, among others, have divulged details of patients’ diagnoses, treatments and idiosyncrasies.\u003c/p>\n\u003cp>One Washington state dentist turned the tables on a patient who blamed him for the loss of a molar: “Due to your clenching and grinding habit, this is not the first molar tooth you have lost due to a fractured root,” he wrote. “This tooth is no different.”\u003c/p>\n\u003cp>In California, a chiropractor pushed back against a mother’s claims that he misdiagnosed her daughter with scoliosis. “You brought your daughter in for the exam in early March 2014,” he wrote. “The exam identified one or more of the signs I mentioned above for scoliosis. I absolutely recommended an x-ray to determine if this condition existed; this x-ray was at no additional cost to you.”\u003c/p>\n\u003cp>And a California dentist scolded a patient who accused him of misdiagnosing her. “I looked very closely at your radiographs and it was obvious that you have cavities and gum disease that your other dentist has overlooked. … You can live in a world of denial and simply believe what you want to hear from your other dentist or make an educated and informed decision.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Health professionals are adapting to a harsh reality in which consumers rate them on sites like Yelp, Vitals and RateMDs much as they do restaurants, hotels and spas. The vast majority of reviews are positive. But in trying to respond to negative ones, some providers appear to be violating the Health Insurance Portability and Accountability Act, the federal patient privacy law known as \u003ca href=\"http://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html\" target=\"_blank\">HIPAA\u003c/a>. The law forbids them from disclosing any patient health information without permission.\u003c/p>\n\u003cp>[contextly_sidebar id=\"d6pxF3w1yvSQqhLKwa6WBniDhTQV1yf5\"]Yelp has given ProPublica \u003ca href=\"https://www.propublica.org/article/stay-far-far-away-and-other-things-gleaned-from-yelp-health-reviews\" target=\"_blank\">unprecedented access\u003c/a> to its trove of public reviews — more than 1.7 million in all — allowing us to search them by keyword. Using \u003ca href=\"http://enrico.bertini.io/revex\" target=\"_blank\">a tool developed\u003c/a> by the Department of Computer Science and Engineering at the NYU Tandon School of Engineering, we identified more than 3,500 one-star reviews (the lowest) in which patients mention privacy or HIPAA. In dozens of instances, responses to complaints about medical care turned into disputes over patient privacy.\u003c/p>\n\u003cp>The patients affected say they’ve been doubly injured — first by poor service or care and then by the disclosure of information they considered private.\u003c/p>\n\u003cp>The shock of exposure can be effective, prompting patients to back off.\u003c/p>\n\u003cp>“I posted a negative review” on Yelp, a client of a California dentist wrote in 2013. “After that, she posted a response with details that included my personal dental information. … I removed my review to protect my medical privacy.”\u003c/p>\n\u003cp>The consumer complained to the Office for Civil Rights within the U.S. Department of Health and Human Services, which enforces HIPAA. The office warned the dentist about posting personal information in response to Yelp reviews. It is currently investigating a New York dentist for divulging personal information about a patient who complained about her care, according to a letter reviewed by ProPublica.\u003c/p>\n\u003cp>The office couldn’t say how many complaints it has received in this area because it doesn’t track complaints this way. ProPublica has \u003ca href=\"https://www.propublica.org/article/few-consequences-for-health-privacy-law-repeat-offenders\" target=\"_blank\">previously reported\u003c/a> about the agency’s historic inability to analyze its complaints and identify repeat HIPAA violators.\u003c/p>\n\u003cp>Deven McGraw, the office’s deputy director of health information privacy, said health professionals responding to online reviews can speak generally about the way they treat patients but must have permission to discuss individual cases. Just because patients have rated their health provider publicly doesn’t give their health provider permission to rate them in return.\u003c/p>\n\u003cp>“If the complaint is about poor patient care, they can come back and say, ‘I provide all of my patients with good patient care’ and ‘I’ve been reviewed in other contexts and have good reviews,’ ” McGraw said. But they can’t “take those accusations on individually by the patient.”\u003c/p>\n\u003cp>[contextly_sidebar id=\"6uBq1ebppHdyoTZuJufJQP8Oyv5kL0C8\"]McGraw pointed to a 2013 \u003ca href=\"http://www.hhs.gov/hipaa/for-professionals/compliance-enforcement/agreements/SRMC/press-release/index.html\" target=\"_blank\">case in California\u003c/a> in which a hospital was fined $275,000 for disclosing information about a patient to the media without permission, allegedly in retaliation for the patient complaining to the media about the hospital.\u003c/p>\n\u003cp>Yelp’s senior director of litigation, Aaron Schur, said most reviews of doctors and dentists aren’t about the actual health care delivered but rather their office wait, the front office staff, billing procedures or bedside manner. Many health providers are careful and appropriate in responding to online reviews, encouraging patients to contact them offline or apologizing for any perceived slights. Some don’t respond at all.\u003c/p>\n\u003cp>“There’s certainly ways to respond to reviews that don’t implicate HIPAA,” Schur said.\u003c/p>\n\u003cp>In 2012, University of Utah Health Care in Salt Lake City was the \u003ca href=\"http://healthcare.utah.edu/publicaffairs/news/archive/2012/12-10-2012_physician_reviews%20.php\" target=\"_blank\">first hospital system in the country\u003c/a> to post patient reviews and comments online. The system, which had to overcome doctors’ resistance to being rated, found positive comments far outnumbered negative ones.\u003c/p>\n\u003cp>“If you whitewash comments, if you only put those that are highly positive, the public is very savvy and will consider that to be only advertising,” said Thomas Miller, chief medical officer for the University of Utah Hospitals and Clinics.\u003c/p>\n\u003cp>Unlike Yelp, the University of Utah does not allow comments about a doctor’s medical competency and it does not allow physicians to respond to comments.\u003c/p>\n\u003cp>In discussing their battles over online reviews, patients said they’d turned to ratings sites for closure and in the hope that their experiences would help others seeking care. Their providers’ responses, however, left them with a lingering sense of lost trust.\u003c/p>\n\u003cp>Angela Grijalva brought her then-12-year-old daughter to Maximize Chiropractic in Sacramento a couple years ago for an exam. In a one-star \u003ca href=\"https://www.yelp.com/biz/maximize-chiropractic-west-sacramento-3\" target=\"_blank\">review on Yelp\u003c/a>, Grijalva alleged that chiropractor Tim Nicholl led her daughter to “believe she had scoliosis and urgently needed x-rays, which could be performed at her next appointment. … My daughter cried all night and had a tough time concentrating at school.”\u003c/p>\n\u003cp>But it turned out her daughter did not have scoliosis, Grijalva wrote. She encouraged parents to stay away from the office.\u003c/p>\n\u003cp>Nicholl replied on Yelp, acknowledging that Grijalva’s daughter was a patient (a disclosure that is not allowed under HIPAA) and discussing the procedures he performed on her and her condition, though he said he could not disclose specifics of the diagnosis “due to privacy and patient confidentiality.”\u003c/p>\n\u003cp>“The next day you brought your daughter back in for a verbal review of the x-rays and I informed you that the x-rays had identified some issues, but the good news was that your daughter did not have scoliosis, great news!” he recounted. “I proceeded to adjust your daughter and the adjustment went very well, as did the entire appointment; you made no mention of a ‘misdiagnosis’ or any other concern.”\u003c/p>\n\u003cp>In an interview, Grijalva said Nicholl’s response “violated my daughter and her privacy.”\u003c/p>\n\u003cp>“I wouldn’t want another parent, another child to go through what my daughter went through: the panic, the stress, the fear,” she added.\u003c/p>\n\u003cp>Nicholl declined a request for comment. “It just doesn’t seem like this is worth my time,” he said. His practice has mixed reviews on Yelp, but more positive than negative.\u003c/p>\n\u003cp>A few years ago, Marisa Speed posted a review of \u003ca href=\"https://www.yelp.com/biz/north-valley-plastic-surgery-phoenix\" target=\"_blank\">North Valley Plastic Surgery\u003c/a> in Phoenix after her then–3-year-old son received stitches there for a gash on his chin. “Half-way through the procedure, the doctor seemed flustered with my crying child. …,” she wrote. “At this point the doctor was more upset and he ended up throwing the instruments to the floor. I understand that dealing with kids requires extra effort, but if you don’t like to do it, don’t even welcome them.”\u003c/p>\n\u003cp>An employee named Chase replied on the business’s behalf: “This patient presented in an agitated and uncontrollable state. Despite our best efforts, this patient was screaming, crying, inconsolable, and a danger to both himself and to our staff. As any parent that has raised a young boy knows, they have the strength to cause harm.”\u003c/p>\n\u003cp>Speed and her husband complained to the Office for Civil Rights. “You may wish to remove any specific information about current or former patients from your Web-blog,” the Office for Civil Rights wrote in an \u003ca href=\"https://www.propublica.org/documents/item/2843212-North-Valley-Plastic-Surgery.html\" target=\"_blank\">October 2013 letter to the surgery center.\u003c/a>\u003c/p>\n\u003cp>In an email, a representative of the surgery center declined to comment. “Everyone that was directly involved in the incident no longer works here. The nurse on this case left a year ago, the surgeon in the case retired last month, and the administrator left a few years ago,” he wrote.\u003c/p>\n\u003cp>Reviews of North Valley Plastic Surgery are mixed on Yelp.\u003c/p>\n\u003cp>Health providers have tried a host of ways to try to combat negative reviews. Some have sued their patients, attracting a torrent of attention but scoring few, if any, legal successes. Others have begged patients to remove their complaints.\u003c/p>\n\u003cp>Jeffrey Segal, a onetime critic of review sites, now says doctors need to embrace them. Beginning in 2007, Segal’s company, Medical Justice, crafted contracts that health providers could give to patients asking them to sign over the copyright to any reviews, which allowed providers to demand that negative ones be removed. But \u003ca href=\"http://www.citizen.org/pressroom/pressroomredirect.cfm?ID=3464\" target=\"_blank\">after a lawsuit\u003c/a>, Medical Justice stopped recommending the contracts in 2011.\u003c/p>\n\u003cp>Segal said he has come to believe reviews are valuable and that providers should encourage patients who are satisfied to post positive reviews and should respond — carefully — to negative ones.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“For doctors who get bent out of shape to get rid of negative reviews, it’s a denominator problem,” he said. “If they only have three reviews and two are negative, the denominator is the problem. … If you can figure out a way to cultivate reviews from hundreds of patients rather than a few patients, the problem is solved.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Burned by negative reviews, some health providers are casting their patients’ privacy aside and sharing intimate details online as they try to rebut criticism.\u003c/p>\n\u003caside class=\"pullquote alignright\">One California dentist scolded a patient who accused him of misdiagnosing her. 'You can live in a world of denial and simply believe what you want to hear from your other dentist or make an educated and informed decision.'\u003c/aside>\n\u003cp>In the course of these arguments — which have spilled out publicly on ratings sites like \u003ca href=\"https://www.yelp.com/\" target=\"_blank\">Yelp\u003c/a> — doctors, dentists, chiropractors and massage therapists, among others, have divulged details of patients’ diagnoses, treatments and idiosyncrasies.\u003c/p>\n\u003cp>One Washington state dentist turned the tables on a patient who blamed him for the loss of a molar: “Due to your clenching and grinding habit, this is not the first molar tooth you have lost due to a fractured root,” he wrote. “This tooth is no different.”\u003c/p>\n\u003cp>In California, a chiropractor pushed back against a mother’s claims that he misdiagnosed her daughter with scoliosis. “You brought your daughter in for the exam in early March 2014,” he wrote. “The exam identified one or more of the signs I mentioned above for scoliosis. I absolutely recommended an x-ray to determine if this condition existed; this x-ray was at no additional cost to you.”\u003c/p>\n\u003cp>And a California dentist scolded a patient who accused him of misdiagnosing her. “I looked very closely at your radiographs and it was obvious that you have cavities and gum disease that your other dentist has overlooked. … You can live in a world of denial and simply believe what you want to hear from your other dentist or make an educated and informed decision.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Health professionals are adapting to a harsh reality in which consumers rate them on sites like Yelp, Vitals and RateMDs much as they do restaurants, hotels and spas. The vast majority of reviews are positive. But in trying to respond to negative ones, some providers appear to be violating the Health Insurance Portability and Accountability Act, the federal patient privacy law known as \u003ca href=\"http://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html\" target=\"_blank\">HIPAA\u003c/a>. The law forbids them from disclosing any patient health information without permission.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Yelp has given ProPublica \u003ca href=\"https://www.propublica.org/article/stay-far-far-away-and-other-things-gleaned-from-yelp-health-reviews\" target=\"_blank\">unprecedented access\u003c/a> to its trove of public reviews — more than 1.7 million in all — allowing us to search them by keyword. Using \u003ca href=\"http://enrico.bertini.io/revex\" target=\"_blank\">a tool developed\u003c/a> by the Department of Computer Science and Engineering at the NYU Tandon School of Engineering, we identified more than 3,500 one-star reviews (the lowest) in which patients mention privacy or HIPAA. In dozens of instances, responses to complaints about medical care turned into disputes over patient privacy.\u003c/p>\n\u003cp>The patients affected say they’ve been doubly injured — first by poor service or care and then by the disclosure of information they considered private.\u003c/p>\n\u003cp>The shock of exposure can be effective, prompting patients to back off.\u003c/p>\n\u003cp>“I posted a negative review” on Yelp, a client of a California dentist wrote in 2013. “After that, she posted a response with details that included my personal dental information. … I removed my review to protect my medical privacy.”\u003c/p>\n\u003cp>The consumer complained to the Office for Civil Rights within the U.S. Department of Health and Human Services, which enforces HIPAA. The office warned the dentist about posting personal information in response to Yelp reviews. It is currently investigating a New York dentist for divulging personal information about a patient who complained about her care, according to a letter reviewed by ProPublica.\u003c/p>\n\u003cp>The office couldn’t say how many complaints it has received in this area because it doesn’t track complaints this way. ProPublica has \u003ca href=\"https://www.propublica.org/article/few-consequences-for-health-privacy-law-repeat-offenders\" target=\"_blank\">previously reported\u003c/a> about the agency’s historic inability to analyze its complaints and identify repeat HIPAA violators.\u003c/p>\n\u003cp>Deven McGraw, the office’s deputy director of health information privacy, said health professionals responding to online reviews can speak generally about the way they treat patients but must have permission to discuss individual cases. Just because patients have rated their health provider publicly doesn’t give their health provider permission to rate them in return.\u003c/p>\n\u003cp>“If the complaint is about poor patient care, they can come back and say, ‘I provide all of my patients with good patient care’ and ‘I’ve been reviewed in other contexts and have good reviews,’ ” McGraw said. But they can’t “take those accusations on individually by the patient.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>McGraw pointed to a 2013 \u003ca href=\"http://www.hhs.gov/hipaa/for-professionals/compliance-enforcement/agreements/SRMC/press-release/index.html\" target=\"_blank\">case in California\u003c/a> in which a hospital was fined $275,000 for disclosing information about a patient to the media without permission, allegedly in retaliation for the patient complaining to the media about the hospital.\u003c/p>\n\u003cp>Yelp’s senior director of litigation, Aaron Schur, said most reviews of doctors and dentists aren’t about the actual health care delivered but rather their office wait, the front office staff, billing procedures or bedside manner. Many health providers are careful and appropriate in responding to online reviews, encouraging patients to contact them offline or apologizing for any perceived slights. Some don’t respond at all.\u003c/p>\n\u003cp>“There’s certainly ways to respond to reviews that don’t implicate HIPAA,” Schur said.\u003c/p>\n\u003cp>In 2012, University of Utah Health Care in Salt Lake City was the \u003ca href=\"http://healthcare.utah.edu/publicaffairs/news/archive/2012/12-10-2012_physician_reviews%20.php\" target=\"_blank\">first hospital system in the country\u003c/a> to post patient reviews and comments online. The system, which had to overcome doctors’ resistance to being rated, found positive comments far outnumbered negative ones.\u003c/p>\n\u003cp>“If you whitewash comments, if you only put those that are highly positive, the public is very savvy and will consider that to be only advertising,” said Thomas Miller, chief medical officer for the University of Utah Hospitals and Clinics.\u003c/p>\n\u003cp>Unlike Yelp, the University of Utah does not allow comments about a doctor’s medical competency and it does not allow physicians to respond to comments.\u003c/p>\n\u003cp>In discussing their battles over online reviews, patients said they’d turned to ratings sites for closure and in the hope that their experiences would help others seeking care. Their providers’ responses, however, left them with a lingering sense of lost trust.\u003c/p>\n\u003cp>Angela Grijalva brought her then-12-year-old daughter to Maximize Chiropractic in Sacramento a couple years ago for an exam. In a one-star \u003ca href=\"https://www.yelp.com/biz/maximize-chiropractic-west-sacramento-3\" target=\"_blank\">review on Yelp\u003c/a>, Grijalva alleged that chiropractor Tim Nicholl led her daughter to “believe she had scoliosis and urgently needed x-rays, which could be performed at her next appointment. … My daughter cried all night and had a tough time concentrating at school.”\u003c/p>\n\u003cp>But it turned out her daughter did not have scoliosis, Grijalva wrote. She encouraged parents to stay away from the office.\u003c/p>\n\u003cp>Nicholl replied on Yelp, acknowledging that Grijalva’s daughter was a patient (a disclosure that is not allowed under HIPAA) and discussing the procedures he performed on her and her condition, though he said he could not disclose specifics of the diagnosis “due to privacy and patient confidentiality.”\u003c/p>\n\u003cp>“The next day you brought your daughter back in for a verbal review of the x-rays and I informed you that the x-rays had identified some issues, but the good news was that your daughter did not have scoliosis, great news!” he recounted. “I proceeded to adjust your daughter and the adjustment went very well, as did the entire appointment; you made no mention of a ‘misdiagnosis’ or any other concern.”\u003c/p>\n\u003cp>In an interview, Grijalva said Nicholl’s response “violated my daughter and her privacy.”\u003c/p>\n\u003cp>“I wouldn’t want another parent, another child to go through what my daughter went through: the panic, the stress, the fear,” she added.\u003c/p>\n\u003cp>Nicholl declined a request for comment. “It just doesn’t seem like this is worth my time,” he said. His practice has mixed reviews on Yelp, but more positive than negative.\u003c/p>\n\u003cp>A few years ago, Marisa Speed posted a review of \u003ca href=\"https://www.yelp.com/biz/north-valley-plastic-surgery-phoenix\" target=\"_blank\">North Valley Plastic Surgery\u003c/a> in Phoenix after her then–3-year-old son received stitches there for a gash on his chin. “Half-way through the procedure, the doctor seemed flustered with my crying child. …,” she wrote. “At this point the doctor was more upset and he ended up throwing the instruments to the floor. I understand that dealing with kids requires extra effort, but if you don’t like to do it, don’t even welcome them.”\u003c/p>\n\u003cp>An employee named Chase replied on the business’s behalf: “This patient presented in an agitated and uncontrollable state. Despite our best efforts, this patient was screaming, crying, inconsolable, and a danger to both himself and to our staff. As any parent that has raised a young boy knows, they have the strength to cause harm.”\u003c/p>\n\u003cp>Speed and her husband complained to the Office for Civil Rights. “You may wish to remove any specific information about current or former patients from your Web-blog,” the Office for Civil Rights wrote in an \u003ca href=\"https://www.propublica.org/documents/item/2843212-North-Valley-Plastic-Surgery.html\" target=\"_blank\">October 2013 letter to the surgery center.\u003c/a>\u003c/p>\n\u003cp>In an email, a representative of the surgery center declined to comment. “Everyone that was directly involved in the incident no longer works here. The nurse on this case left a year ago, the surgeon in the case retired last month, and the administrator left a few years ago,” he wrote.\u003c/p>\n\u003cp>Reviews of North Valley Plastic Surgery are mixed on Yelp.\u003c/p>\n\u003cp>Health providers have tried a host of ways to try to combat negative reviews. Some have sued their patients, attracting a torrent of attention but scoring few, if any, legal successes. Others have begged patients to remove their complaints.\u003c/p>\n\u003cp>Jeffrey Segal, a onetime critic of review sites, now says doctors need to embrace them. Beginning in 2007, Segal’s company, Medical Justice, crafted contracts that health providers could give to patients asking them to sign over the copyright to any reviews, which allowed providers to demand that negative ones be removed. But \u003ca href=\"http://www.citizen.org/pressroom/pressroomredirect.cfm?ID=3464\" target=\"_blank\">after a lawsuit\u003c/a>, Medical Justice stopped recommending the contracts in 2011.\u003c/p>\n\u003cp>Segal said he has come to believe reviews are valuable and that providers should encourage patients who are satisfied to post positive reviews and should respond — carefully — to negative ones.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Stanford Medicine is holding its fourth Big Data in Biomedicine Conference today and Thursday. From the website: \"Now in its fourth year, the event provides a forum for experts to discuss ways to use large-scale data analysis and technology to improve human health. This year’s event will include a focus on Stanford Medicine’s work in precision health\"\u003c/p>\n\u003cp>Here's the \u003ca href=\"http://scopeblog.stanford.edu/2016/05/25/stanfords-big-data-in-biomedicine-conference-begins-today/\" target=\"_blank\">schedule of speakers\u003c/a>. Dr. Robert Califf, head of the FDA, will speak at 4:15 p.m. today. Tomorrow's schedule includes a panel discussion on digital health and technology featuring a partner with Google Ventures, among others.\u003c/p>\n\u003cp>Click on the photo and scroll down to watch live.\u003c/p>\n\u003cp>\u003ca href=\"http://bigdata.stanford.edu/\">\u003cimg class=\"aligncenter size-full wp-image-170418\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/05/Screen-shot-2016-05-25-at-11.06.17-AM.png\" alt=\"Screen shot 2016-05-25 at 11.06.17 AM\" width=\"780\" height=\"574\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/05/Screen-shot-2016-05-25-at-11.06.17-AM.png 780w, https://ww2.kqed.org/app/uploads/sites/13/2016/05/Screen-shot-2016-05-25-at-11.06.17-AM-400x294.png 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/05/Screen-shot-2016-05-25-at-11.06.17-AM-768x565.png 768w\" sizes=\"(max-width: 780px) 100vw, 780px\">\u003c/a>\u003c/p>\n\u003cp>You can also follow on Twitter:\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[twitter-timeline id=735537076590936064 username=jbrooksfoy]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[twitter-timeline id=735537076590936064 username=jbrooksfoy]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n[twitter-timeline id=735537076590936064]\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Stanford Medicine is holding its fourth Big Data in Biomedicine Conference today and Thursday. From the website: \"Now in its fourth year, the event provides a forum for experts to discuss ways to use large-scale data analysis and technology to improve human health. This year’s event will include a focus on Stanford Medicine’s work in precision health\"\u003c/p>\n\u003cp>Here's the \u003ca href=\"http://scopeblog.stanford.edu/2016/05/25/stanfords-big-data-in-biomedicine-conference-begins-today/\" target=\"_blank\">schedule of speakers\u003c/a>. Dr. Robert Califf, head of the FDA, will speak at 4:15 p.m. today. Tomorrow's schedule includes a panel discussion on digital health and technology featuring a partner with Google Ventures, among others.\u003c/p>\n\u003cp>Click on the photo and scroll down to watch live.\u003c/p>\n\u003cp>\u003ca href=\"http://bigdata.stanford.edu/\">\u003cimg class=\"aligncenter size-full wp-image-170418\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/05/Screen-shot-2016-05-25-at-11.06.17-AM.png\" alt=\"Screen shot 2016-05-25 at 11.06.17 AM\" width=\"780\" height=\"574\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/05/Screen-shot-2016-05-25-at-11.06.17-AM.png 780w, https://ww2.kqed.org/app/uploads/sites/13/2016/05/Screen-shot-2016-05-25-at-11.06.17-AM-400x294.png 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/05/Screen-shot-2016-05-25-at-11.06.17-AM-768x565.png 768w\" sizes=\"(max-width: 780px) 100vw, 780px\">\u003c/a>\u003c/p>\n\u003cp>You can also follow on Twitter:\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>The Wall Street Journal reported last night that the company has told its regulator, the Centers for Medicare & Medicaid Services, that it has \u003ca href=\"http://www.wsj.com/articles/theranos-voids-two-years-of-edison-blood-test-results-1463616976\" target=\"_blank\">voided tens of thousands\u003c/a> -- two years worth -- of patient blood test results. The tests were run on both the company's proprietary Edison machines and conventional testing equipment, the paper said. Some results were thrown out and some revised.\u003c/p>\n\u003cp>The Journal, which owns this story in a big way, cited its usual source: \"a person familiar with the matter.\" Forcing Theranos to issue its usual confirmation, plus this statement:\u003c/p>\n\u003caside class=\"pullquote alignright\">One physician received a corrected report for a patient who was unnecessarily sent to the ER based on erroneous test results, The Wall Street Journal said.\u003c/aside>\n\u003cp>\"Excellence in quality and patient safety is our top priority and we’ve taken comprehensive corrective measures to address the issues CMS raised in their observations,\" Theranos spokesperson Brooke Buchanan said in an email to KQED. \"As these matters are currently under review, we have no further comment at this time.\"\u003c/p>\n\u003cp>If you've been following this story -- which has unfolded like some sort of Silicon Valley morality tale -- you know that Theranos made a splash with investors and the media by claiming it was going to remake the diagnostic testing industry with more efficient and cheaper blood tests. The company said it could sample just a finger-prick's worth of blood, collected in a device it called a \"nanotainer;\" that small amount of blood, the company claimed, was enough to run a host of tests. The FDA, however, approved the process for just one of those tests, and the company collects samples for all others the traditional way -- from a patient's vein.\u003c/p>\n\u003cp>In March, The Wall Street Journal reported Theranos had run tests measuring blood-clotting time on 81 patients despite erratic results from quality-control checks. Around the time the story came out, Theranos released a statement saying it had contacted any patients potentially affected by inaccurate tests.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We have conducted assessments to identify any patients affected or having the potential to be affected by the issues identified by CMS, and we have no reason to believe that these issues have affected patients’ health,\" said Theranos’ Newark, California lab director, Dr. Kingshuk Das, in a \u003ca href=\"https://www.theranos.com/news/posts/statement-regarding-newark-california-lab-survey\">statement\u003c/a>.\u003c/p>\n\u003cp>Apparently, Theranos has expanded that group of patients. From the Journal:\u003c/p>\n\u003cblockquote>\u003cp>[The corrections mean] some patients received erroneous results that might have thrown off health decisions made with their doctors. ...\u003c/p>\n\u003cp>Several physician practices in the Phoenix area confirmed receiving corrected test reports from Theranos in recent weeks. ...\u003c/p>\n\u003cp>There have been massive recalls of single tests in the past, but I’m not aware of one where a company recalled the entirety of the results from its testing platform,” said Geoffrey Baird, associate professor in the department of laboratory medicine at the University of Washington in Seattle. “I believe that’s unprecedented.”\u003c/p>\u003c/blockquote>\n\u003cp>One Phoenix-area physician received a corrected report for a patient who was unnecessarily sent to the ER based on the original test results, the paper said.\u003c/p>\n\u003cp>These revised or voided tests may or may not satisfy CMS, which has been weighing whether to drop the hammer on Theranos since March, when the agency informed the company it had not submitted credible evidence of correcting serious deficiencies at its Newark, California lab. Those deficiencies, which CMS had uncovered during an inspection, were potentially life-threatening to patients, CMS said.\u003c/p>\n\u003cp>Among the penalties CMS threatened: revoking the lab's federal license to operate and suspending Theranos founder and CEO Elizabeth Holmes from involvement in the blood-testing industry for two years. CMS also named president and COO Sunny Balwani as subject to suspension, but Balwani last week announced his departure from the company.\u003c/p>\n\u003cp>At the same time it informed Theranos of potential penalties, CMS gave the company one last chance to submit additional proof of its compliance with regulations. Theranos responsed to CMS with additional information, and there's been no word from CMS since that story broke in April.\u003c/p>\n\u003cp>If CMS declines to accept Theranos' filing as valid proof of compliance, the company will still have options for administrative appeal. So it's possible the final resolution of the case may not come for months.\u003c/p>\n\u003cp>But even if Theranos manages to avoid sanctions from CMS, it still faces investigations by both the SEC and the U.S. Attorney’s Office for the Northern District of California. It also faces what many assume will be the end of its \u003ca href=\"http://www.nytimes.com/2016/04/22/business/a-once-avid-ally-walgreens-is-struggling-to-shake-off-theranos.html?_r=0\">high-profile deal\u003c/a> with the Walgreens Boots Alliance, which put dozens of Theranos \"Wellness Centers\" in Walgreens stores in Arizona, giving the secretive company and its unproven technology a needed dose of credibility.\u003c/p>\n\u003cp>That has now been wiped out by the one-two punch of the Journal's investigative reports and the failed federal inspection. Last October, the Journal reported allegations by Theranos employees that the company may have violated reporting rules related to proficiency tests run on Edison.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Theranos' Buchanan says federal regulators have issued no findings related to allegations of cheating on proficiency testing or manipulating data. The struggling company recently added a group of doctors and medical scientists to its advisory board to comb through data and help Theranos publish its results publicly.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Wall Street Journal reported last night that the company has told its regulator, the Centers for Medicare & Medicaid Services, that it has \u003ca href=\"http://www.wsj.com/articles/theranos-voids-two-years-of-edison-blood-test-results-1463616976\" target=\"_blank\">voided tens of thousands\u003c/a> -- two years worth -- of patient blood test results. The tests were run on both the company's proprietary Edison machines and conventional testing equipment, the paper said. Some results were thrown out and some revised.\u003c/p>\n\u003cp>The Journal, which owns this story in a big way, cited its usual source: \"a person familiar with the matter.\" Forcing Theranos to issue its usual confirmation, plus this statement:\u003c/p>\n\u003caside class=\"pullquote alignright\">One physician received a corrected report for a patient who was unnecessarily sent to the ER based on erroneous test results, The Wall Street Journal said.\u003c/aside>\n\u003cp>\"Excellence in quality and patient safety is our top priority and we’ve taken comprehensive corrective measures to address the issues CMS raised in their observations,\" Theranos spokesperson Brooke Buchanan said in an email to KQED. \"As these matters are currently under review, we have no further comment at this time.\"\u003c/p>\n\u003cp>If you've been following this story -- which has unfolded like some sort of Silicon Valley morality tale -- you know that Theranos made a splash with investors and the media by claiming it was going to remake the diagnostic testing industry with more efficient and cheaper blood tests. The company said it could sample just a finger-prick's worth of blood, collected in a device it called a \"nanotainer;\" that small amount of blood, the company claimed, was enough to run a host of tests. The FDA, however, approved the process for just one of those tests, and the company collects samples for all others the traditional way -- from a patient's vein.\u003c/p>\n\u003cp>In March, The Wall Street Journal reported Theranos had run tests measuring blood-clotting time on 81 patients despite erratic results from quality-control checks. Around the time the story came out, Theranos released a statement saying it had contacted any patients potentially affected by inaccurate tests.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We have conducted assessments to identify any patients affected or having the potential to be affected by the issues identified by CMS, and we have no reason to believe that these issues have affected patients’ health,\" said Theranos’ Newark, California lab director, Dr. Kingshuk Das, in a \u003ca href=\"https://www.theranos.com/news/posts/statement-regarding-newark-california-lab-survey\">statement\u003c/a>.\u003c/p>\n\u003cp>Apparently, Theranos has expanded that group of patients. From the Journal:\u003c/p>\n\u003cblockquote>\u003cp>[The corrections mean] some patients received erroneous results that might have thrown off health decisions made with their doctors. ...\u003c/p>\n\u003cp>Several physician practices in the Phoenix area confirmed receiving corrected test reports from Theranos in recent weeks. ...\u003c/p>\n\u003cp>There have been massive recalls of single tests in the past, but I’m not aware of one where a company recalled the entirety of the results from its testing platform,” said Geoffrey Baird, associate professor in the department of laboratory medicine at the University of Washington in Seattle. “I believe that’s unprecedented.”\u003c/p>\u003c/blockquote>\n\u003cp>One Phoenix-area physician received a corrected report for a patient who was unnecessarily sent to the ER based on the original test results, the paper said.\u003c/p>\n\u003cp>These revised or voided tests may or may not satisfy CMS, which has been weighing whether to drop the hammer on Theranos since March, when the agency informed the company it had not submitted credible evidence of correcting serious deficiencies at its Newark, California lab. Those deficiencies, which CMS had uncovered during an inspection, were potentially life-threatening to patients, CMS said.\u003c/p>\n\u003cp>Among the penalties CMS threatened: revoking the lab's federal license to operate and suspending Theranos founder and CEO Elizabeth Holmes from involvement in the blood-testing industry for two years. CMS also named president and COO Sunny Balwani as subject to suspension, but Balwani last week announced his departure from the company.\u003c/p>\n\u003cp>At the same time it informed Theranos of potential penalties, CMS gave the company one last chance to submit additional proof of its compliance with regulations. Theranos responsed to CMS with additional information, and there's been no word from CMS since that story broke in April.\u003c/p>\n\u003cp>If CMS declines to accept Theranos' filing as valid proof of compliance, the company will still have options for administrative appeal. So it's possible the final resolution of the case may not come for months.\u003c/p>\n\u003cp>But even if Theranos manages to avoid sanctions from CMS, it still faces investigations by both the SEC and the U.S. Attorney’s Office for the Northern District of California. It also faces what many assume will be the end of its \u003ca href=\"http://www.nytimes.com/2016/04/22/business/a-once-avid-ally-walgreens-is-struggling-to-shake-off-theranos.html?_r=0\">high-profile deal\u003c/a> with the Walgreens Boots Alliance, which put dozens of Theranos \"Wellness Centers\" in Walgreens stores in Arizona, giving the secretive company and its unproven technology a needed dose of credibility.\u003c/p>\n\u003cp>That has now been wiped out by the one-two punch of the Journal's investigative reports and the failed federal inspection. Last October, the Journal reported allegations by Theranos employees that the company may have violated reporting rules related to proficiency tests run on Edison.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Theranos' Buchanan says federal regulators have issued no findings related to allegations of cheating on proficiency testing or manipulating data. The struggling company recently added a group of doctors and medical scientists to its advisory board to comb through data and help Theranos publish its results publicly.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Scientists Create Part-Human, Part-Animal Embryos",
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"content": "\u003cp>A handful of scientists around the United States are trying to do something that some people find disturbing: make embryos that are part human, part animal.\u003c/p>\n\u003cp>The researchers hope these embryos, known as chimeras, could eventually help save the lives of people with a wide range of diseases.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"You're getting into unsettling ground that I think is damaging to our sense of humanity.\"\u003ccite>Stuart Newman, a professor of cell biology and anatomy at the New York Medical College.\u003c/cite>\u003c/aside>\n\u003cp>One way would be to use chimera embryos to create better animal models to study how human diseases happen and how they progress.\u003c/p>\n\u003cp>Perhaps the boldest hope is to create farm animals that have human organs that could be transplanted into terminally ill patients.\u003c/p>\n\u003cp>But some scientists and bioethicists worry the creation of these interspecies embryos crosses the line. \"You're getting into unsettling ground that I think is damaging to our sense of humanity,\" says \u003ca href=\"http://www.nymc.edu/faculty/directory/by-name/newman-stuart/\">Stuart Newman\u003c/a>, a professor of cell biology and anatomy at the New York Medical College.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The experiments are so sensitive that the National Institutes of Health has imposed a \u003ca href=\"http://www.npr.org/sections/health-shots/2015/11/06/454693391/should-human-stem-cells-be-used-to-make-partly-human-chimeras\">moratorium\u003c/a> on funding them while officials explore the ethical issues they raise.\u003c/p>\n\u003cp>Nevertheless, a small number of researchers are pursuing the work with private funding. They hope the results will convince the NIH to lift the moratorium.\u003c/p>\n\u003cp>\"We're not trying to make a chimera just because we want to see some kind of monstrous creature,\" says \u003ca href=\"http://animalscience.ucdavis.edu/faculty/ross/\">Pablo Ross\u003c/a>, a reproductive biologist at the University of California, Davis. \"We're doing this for a biomedical purpose.\"\u003c/p>\n\u003cp>The NIH is expected to announce soon how it plans to handle requests for funding.\u003c/p>\n\u003cp>Recently, Ross agreed to let me visit his lab for an unusual look at his research. During the visit, Ross demonstrated how he's trying to create a pancreas that theoretically could be transplanted into a patient with diabetes.\u003c/p>\n\u003cp>The first step involves using new \u003ca href=\"http://www.npr.org/sections/health-shots/2015/12/28/460705645/gene-editing-tool-hailed-as-a-breakthrough-and-it-really-is-one\">gene-editing\u003c/a> techniques to remove the gene pig embryos need to make a pancreas.\u003c/p>\n\u003cp>Working under an elaborate microscope, Ross makes a small hole in the embryo's outer membrane with a laser. Next, he injects a molecule synthesized in the laboratory to home in and delete the pancreas gene inside. (In separate experiments, he's done this to sheep embryos, too.)\u003c/p>\n\u003cp>After the embryos have had their DNA edited this way, Ross creates another hole in the membrane so he can inject \u003ca href=\"http://stemcells.nih.gov/info/basics/pages/basics10.aspx\">human induced pluripotent stem cells\u003c/a>, or \u003ca href=\"http://stemcells.nih.gov/info/basics/pages/basics10.aspx\">iPS\u003c/a> for short, into the pig embryos.\u003c/p>\n\u003cp>Like human embryonic stem cells, iPS cells can turn into any kind of cell or tissue in the body. The researchers' hope is that the human stem cells will take advantage of the void in the embryo to start forming a human pancreas.\u003c/p>\n\u003cp>Because iPS cells can be made from any adult's skin cells, any organs they form would match the patient who needs the transplant, vastly reducing the risk that the body would reject the new organ.\u003c/p>\n\u003cp>But for the embryo to develop and produce an organ, Ross has to put the chimera embryos into the wombs of adult pigs. That involves a surgical procedure, which is performed in a large operating room across the street from Ross's lab.\u003c/p>\n\u003cfigure id=\"attachment_166039\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/05/chimeras-1a-7ce31e2e2827205b2edcbe1cbc21e0c171e77a46-800x600.jpg\" alt=\"Pablo Ross of UC Davis inserts human stem cells into a pig embryo as part of experiments to create chimeric embryos.\" width=\"800\" height=\"600\" class=\"size-medium wp-image-166039\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/05/chimeras-1a-7ce31e2e2827205b2edcbe1cbc21e0c171e77a46-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/05/chimeras-1a-7ce31e2e2827205b2edcbe1cbc21e0c171e77a46-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/05/chimeras-1a-7ce31e2e2827205b2edcbe1cbc21e0c171e77a46-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/05/chimeras-1a-7ce31e2e2827205b2edcbe1cbc21e0c171e77a46-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/05/chimeras-1a-7ce31e2e2827205b2edcbe1cbc21e0c171e77a46-1920x1440.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/05/chimeras-1a-7ce31e2e2827205b2edcbe1cbc21e0c171e77a46-960x720.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Pablo Ross of UC Davis inserts human stem cells into a pig embryo as part of experiments to create chimeric embryos. \u003ccite>(Rob Stein/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The day Ross opened his lab to me, a surgical team was anesthetizing an adult female pig so surgeons could make an incision to get access to its uterus.\u003c/p>\n\u003cp>Ross then rushed over with a special syringe filled with chimera embryos. He injected 25 embryos into each side of the animal's uterus. The procedure took about an hour. He repeated the process on a second pig.\u003c/p>\n\u003cp>Every time Ross does this, he then waits a few weeks to allow the embryos to develop to their 28th day — a time when primitive structures such as organs start to form.\u003c/p>\n\u003cp>Ross then retrieves the chimeric embryos to dissect them so he can see what the human stem cells are doing inside. He examines whether the human stem cells have started to form a pancreas, and whether they have begun making any other types of tissues.\u003c/p>\n\u003cp>The uncertainty is part of what makes the work so controversial. Ross and other scientists conducting these experiments can't know exactly where the human stem cells will go. Ross hopes they'll only grow a human pancreas. But they could go elsewhere, such as to the brain.\u003c/p>\n\u003cp>\"If you have pigs with partly human brains you would have animals that might actually have consciousness like a human,\" Newman says. \"It might have human-type needs. We don't really know.\"\u003c/p>\n\u003cp>That possibility raises new questions about the morality of using the animals for experimentation. Another concern is that the stem cells could form human sperm and human eggs in the chimeras.\u003c/p>\n\u003cp>\"If a male chimeric pig mated with a female chimeric pig, the result could be a human fetus developing in the uterus of that female chimera,\" Newman says. Another possibility is the animals could give birth to some kind of part-human, part-pig creature.\u003c/p>\n\u003cp>\"One of the concerns that a lot of people have is that there's something sacrosanct about what it means to be human expressed in our DNA,\" says \u003ca href=\"https://sols.asu.edu/people/jason-robert\">Jason Robert\u003c/a>, a bioethicist at Arizona State University. \"And that by inserting that into other animals and giving those other animals potentially some of the capacities of humans that this could be a kind of violation — a kind of, maybe, even a playing God.\"\u003c/p>\n\u003cp>Ross defends what his work. \"I don't consider that we're playing God or even close to that,\" Ross says. \"We're just trying to use the technologies that we have developed to improve peoples' life.\"\u003c/p>\n\u003cp>Still, Ross acknowledges the concerns. So he's moving very carefully, he says. For example, he's only letting the chimera embryos develop for 28 days. At that point, he removes the embryos and dissects them.\u003c/p>\n\u003cp>If he discovers the stem cells are going to the wrong places in the embryos, he says he can take steps to stop that from happening. In addition, he'd make sure adult chimeras are never allowed to mate, he says.\u003c/p>\n\u003cp>\"We're very aware and sensitive to the ethical concerns,\" he says. \"One of the reasons we're doing this research the way we're doing it is because we want to provide scientific information to inform those concerns.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Ross is working with \u003ca href=\"http://www.salk.edu/scientist/juan-carlos-izpisua-belmonte/\">Juan Carlos Izpisua Belmonte\u003c/a> from the Salk Intitute for Biological Studies in La Jolla, Calif., and \u003ca href=\"https://med.stanford.edu/profiles/hiromitsu-nakauchi\">Hiromitsu Nakauchi \u003c/a>at Stanford University. \u003ca href=\"http://www.stemcell.umn.edu/bio/stem-cell-ins-faculty-staff/daniel-garry\">Daniel Garry\u003c/a> of the University of Minnesota and colleagues are conducting similar work.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=In+Search+For+Cures%2C+Scientists+Create+Embryos+That+Are+Both+Animal+And+Human&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A handful of scientists around the United States are trying to do something that some people find disturbing: make embryos that are part human, part animal.\u003c/p>\n\u003cp>The researchers hope these embryos, known as chimeras, could eventually help save the lives of people with a wide range of diseases.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"You're getting into unsettling ground that I think is damaging to our sense of humanity.\"\u003ccite>Stuart Newman, a professor of cell biology and anatomy at the New York Medical College.\u003c/cite>\u003c/aside>\n\u003cp>One way would be to use chimera embryos to create better animal models to study how human diseases happen and how they progress.\u003c/p>\n\u003cp>Perhaps the boldest hope is to create farm animals that have human organs that could be transplanted into terminally ill patients.\u003c/p>\n\u003cp>But some scientists and bioethicists worry the creation of these interspecies embryos crosses the line. \"You're getting into unsettling ground that I think is damaging to our sense of humanity,\" says \u003ca href=\"http://www.nymc.edu/faculty/directory/by-name/newman-stuart/\">Stuart Newman\u003c/a>, a professor of cell biology and anatomy at the New York Medical College.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The experiments are so sensitive that the National Institutes of Health has imposed a \u003ca href=\"http://www.npr.org/sections/health-shots/2015/11/06/454693391/should-human-stem-cells-be-used-to-make-partly-human-chimeras\">moratorium\u003c/a> on funding them while officials explore the ethical issues they raise.\u003c/p>\n\u003cp>Nevertheless, a small number of researchers are pursuing the work with private funding. They hope the results will convince the NIH to lift the moratorium.\u003c/p>\n\u003cp>\"We're not trying to make a chimera just because we want to see some kind of monstrous creature,\" says \u003ca href=\"http://animalscience.ucdavis.edu/faculty/ross/\">Pablo Ross\u003c/a>, a reproductive biologist at the University of California, Davis. \"We're doing this for a biomedical purpose.\"\u003c/p>\n\u003cp>The NIH is expected to announce soon how it plans to handle requests for funding.\u003c/p>\n\u003cp>Recently, Ross agreed to let me visit his lab for an unusual look at his research. During the visit, Ross demonstrated how he's trying to create a pancreas that theoretically could be transplanted into a patient with diabetes.\u003c/p>\n\u003cp>The first step involves using new \u003ca href=\"http://www.npr.org/sections/health-shots/2015/12/28/460705645/gene-editing-tool-hailed-as-a-breakthrough-and-it-really-is-one\">gene-editing\u003c/a> techniques to remove the gene pig embryos need to make a pancreas.\u003c/p>\n\u003cp>Working under an elaborate microscope, Ross makes a small hole in the embryo's outer membrane with a laser. Next, he injects a molecule synthesized in the laboratory to home in and delete the pancreas gene inside. (In separate experiments, he's done this to sheep embryos, too.)\u003c/p>\n\u003cp>After the embryos have had their DNA edited this way, Ross creates another hole in the membrane so he can inject \u003ca href=\"http://stemcells.nih.gov/info/basics/pages/basics10.aspx\">human induced pluripotent stem cells\u003c/a>, or \u003ca href=\"http://stemcells.nih.gov/info/basics/pages/basics10.aspx\">iPS\u003c/a> for short, into the pig embryos.\u003c/p>\n\u003cp>Like human embryonic stem cells, iPS cells can turn into any kind of cell or tissue in the body. The researchers' hope is that the human stem cells will take advantage of the void in the embryo to start forming a human pancreas.\u003c/p>\n\u003cp>Because iPS cells can be made from any adult's skin cells, any organs they form would match the patient who needs the transplant, vastly reducing the risk that the body would reject the new organ.\u003c/p>\n\u003cp>But for the embryo to develop and produce an organ, Ross has to put the chimera embryos into the wombs of adult pigs. That involves a surgical procedure, which is performed in a large operating room across the street from Ross's lab.\u003c/p>\n\u003cfigure id=\"attachment_166039\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/05/chimeras-1a-7ce31e2e2827205b2edcbe1cbc21e0c171e77a46-800x600.jpg\" alt=\"Pablo Ross of UC Davis inserts human stem cells into a pig embryo as part of experiments to create chimeric embryos.\" width=\"800\" height=\"600\" class=\"size-medium wp-image-166039\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/05/chimeras-1a-7ce31e2e2827205b2edcbe1cbc21e0c171e77a46-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/05/chimeras-1a-7ce31e2e2827205b2edcbe1cbc21e0c171e77a46-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/05/chimeras-1a-7ce31e2e2827205b2edcbe1cbc21e0c171e77a46-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/05/chimeras-1a-7ce31e2e2827205b2edcbe1cbc21e0c171e77a46-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/05/chimeras-1a-7ce31e2e2827205b2edcbe1cbc21e0c171e77a46-1920x1440.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/05/chimeras-1a-7ce31e2e2827205b2edcbe1cbc21e0c171e77a46-960x720.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Pablo Ross of UC Davis inserts human stem cells into a pig embryo as part of experiments to create chimeric embryos. \u003ccite>(Rob Stein/NPR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The day Ross opened his lab to me, a surgical team was anesthetizing an adult female pig so surgeons could make an incision to get access to its uterus.\u003c/p>\n\u003cp>Ross then rushed over with a special syringe filled with chimera embryos. He injected 25 embryos into each side of the animal's uterus. The procedure took about an hour. He repeated the process on a second pig.\u003c/p>\n\u003cp>Every time Ross does this, he then waits a few weeks to allow the embryos to develop to their 28th day — a time when primitive structures such as organs start to form.\u003c/p>\n\u003cp>Ross then retrieves the chimeric embryos to dissect them so he can see what the human stem cells are doing inside. He examines whether the human stem cells have started to form a pancreas, and whether they have begun making any other types of tissues.\u003c/p>\n\u003cp>The uncertainty is part of what makes the work so controversial. Ross and other scientists conducting these experiments can't know exactly where the human stem cells will go. Ross hopes they'll only grow a human pancreas. But they could go elsewhere, such as to the brain.\u003c/p>\n\u003cp>\"If you have pigs with partly human brains you would have animals that might actually have consciousness like a human,\" Newman says. \"It might have human-type needs. We don't really know.\"\u003c/p>\n\u003cp>That possibility raises new questions about the morality of using the animals for experimentation. Another concern is that the stem cells could form human sperm and human eggs in the chimeras.\u003c/p>\n\u003cp>\"If a male chimeric pig mated with a female chimeric pig, the result could be a human fetus developing in the uterus of that female chimera,\" Newman says. Another possibility is the animals could give birth to some kind of part-human, part-pig creature.\u003c/p>\n\u003cp>\"One of the concerns that a lot of people have is that there's something sacrosanct about what it means to be human expressed in our DNA,\" says \u003ca href=\"https://sols.asu.edu/people/jason-robert\">Jason Robert\u003c/a>, a bioethicist at Arizona State University. \"And that by inserting that into other animals and giving those other animals potentially some of the capacities of humans that this could be a kind of violation — a kind of, maybe, even a playing God.\"\u003c/p>\n\u003cp>Ross defends what his work. \"I don't consider that we're playing God or even close to that,\" Ross says. \"We're just trying to use the technologies that we have developed to improve peoples' life.\"\u003c/p>\n\u003cp>Still, Ross acknowledges the concerns. So he's moving very carefully, he says. For example, he's only letting the chimera embryos develop for 28 days. At that point, he removes the embryos and dissects them.\u003c/p>\n\u003cp>If he discovers the stem cells are going to the wrong places in the embryos, he says he can take steps to stop that from happening. In addition, he'd make sure adult chimeras are never allowed to mate, he says.\u003c/p>\n\u003cp>\"We're very aware and sensitive to the ethical concerns,\" he says. \"One of the reasons we're doing this research the way we're doing it is because we want to provide scientific information to inform those concerns.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Ross is working with \u003ca href=\"http://www.salk.edu/scientist/juan-carlos-izpisua-belmonte/\">Juan Carlos Izpisua Belmonte\u003c/a> from the Salk Intitute for Biological Studies in La Jolla, Calif., and \u003ca href=\"https://med.stanford.edu/profiles/hiromitsu-nakauchi\">Hiromitsu Nakauchi \u003c/a>at Stanford University. \u003ca href=\"http://www.stemcell.umn.edu/bio/stem-cell-ins-faculty-staff/daniel-garry\">Daniel Garry\u003c/a> of the University of Minnesota and colleagues are conducting similar work.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=In+Search+For+Cures%2C+Scientists+Create+Embryos+That+Are+Both+Animal+And+Human&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>A 64-year-old cancer patient has received the nation's first penis transplant, a groundbreaking operation that may also help some of the U.S. veterans maimed by roadside bombs.\u003c/p>\n\u003cp>In a case that represents the latest frontier in the growing field of reconstructive transplants, Thomas Manning of Halifax, Massachusetts, is faring well after the 15-hour operation last week, Massachusetts General Hospital said Monday.\u003c/p>\n\u003cp>His doctors said they are cautiously optimistic that Manning eventually will be able to urinate normally and function sexually again for the first time since aggressive penile cancer led to the amputation of his genitals in 2012. They said his psychological state will play a big role in his recovery.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"//players.brightcove.net/245991542/344c319b-6d23-4cbc-975e-c8530534af8a_default/index.html?videoId=4895992613001\" frameborder=\"0\" width=\"100%\" height=\"500\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>\"Emotionally he's doing amazing. I'm really impressed with how he's handling things. He's just a positive person,\" Dr. Curtis Cetrulo, who was among the lead surgeons on a team of more than 50, said at a news conference. \"He wants to be whole again. He does not want to be in the shadows.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Manning, who is single, did not appear at the news conference but said in a statement: \"Today I begin a new chapter filled with personal hope and hope for others who have suffered genital injuries. In sharing this success with all of you, it is my hope we can usher in a bright future for this type of transplantation.\"\u003c/p>\n\u003cp>The identity of the deceased donor was not released.\u003c/p>\n\u003cp>The operation is highly experimental — only one other patient, in South Africa, has a transplanted penis. But four additional hospitals around the country have permission from the United Network for Organ Sharing, which oversees the nation's transplant system, to attempt the delicate surgery.\u003c/p>\n\u003cp>The loss of a penis, whether from cancer, accident or war injury, is emotionally traumatic, affecting urination, sexual intimacy and the ability to conceive a child. Many patients suffer in silence because of the stigma their injuries sometimes carry; Cetrulo said many become isolated and despondent.\u003c/p>\n\u003cp>Unlike traditional life-saving transplants of hearts, kidneys or livers, reconstructive transplants are done to improve quality of life. And while a penis transplant may sound radical, it follows transplants of faces, hands and even the uterus.\u003c/p>\n\u003cp>\"This is a logical next step,\" said Dr. W. P. Andrew Lee, chairman of plastic and reconstructive surgery at Johns Hopkins University School of Medicine.\u003c/p>\n\u003cp>His hospital is preparing for a penis transplant in a wounded veteran soon, and Lee said this new field is important for \"people who want to feel whole again after the loss of important body parts.\"\u003c/p>\n\u003cp>Still, candidates face some serious risks: rejection of the tissue, and side effects from the anti-rejection drugs that must be taken for life. Doctors are working to reduce the medication needed.\u003c/p>\n\u003cp>Penis transplants have generated intense interest among veterans from Iraq and Afghanistan, but they will require more extensive surgery since their injuries, often from roadside bombs, tend to be more extensive, with damage to blood vessels, nerves and pelvic tissue that also will need repair, Lee noted.\u003c/p>\n\u003cp>The Department of Defense Trauma Registry has recorded 1,367 male service members who survived with genitourinary injuries between 2001 and 2013. It's not clear how many victims lost all or part of the penis.\u003c/p>\n\u003cp>A man in China received a penis transplant in 2005. But doctors said he asked them to remove his new organ two weeks later because he and his wife were having psychological problems.\u003c/p>\n\u003cp>In December 2014, a 21-year-old man in South Africa whose penis had been amputated following complications from circumcision in his late teens received a transplant.\u003c/p>\n\u003cp>Dr. Andre van der Merwe of the University of Stellenbosch told The Associated Press that the man is healthy, has normal sexual function and was able to conceive, although the baby was stillborn. But his recovery was difficult, with blood clots and infections, the doctor said.\u003c/p>\n\u003cp>For congenital abnormalities or transgender surgery, doctors can fashion the form of a penis from a patient's own skin, using implants to achieve erection. But transplanting a functional penis requires connecting tiny blood vessels and nerves.\u003c/p>\n\u003cp>A bigger challenge than the surgery itself is finding donor organs.\u003c/p>\n\u003cp>\"People are still reluctant to donate,\" van der Merwe said. \"There are huge psychological issues about donating your relative's penis.\"\u003c/p>\n\u003cp>In the U.S., people or their families who agree to donate organs such as the heart or lung must be asked separately about also donating a penis, hand or other body part, said Dr. Scott Levin, a hand transplant surgeon at the University of Pennsylvania and vice chairman of UNOS' committee on reconstructive transplants.\u003c/p>\n\u003cp>In Boston, Cetrulo said the transplanted penis has good blood flow and so far shows no signs of rejection. He said that Manning should be released from the hospital soon, and that the surgery had three aims: ensuring the transplanted penis looks natural, is capable of normal urination — which he hopes will resume in a few weeks — and eventually normal sexual function.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Reproduction won't be possible, he said, since Manning did not receive new testes.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A 64-year-old cancer patient has received the nation's first penis transplant, a groundbreaking operation that may also help some of the U.S. veterans maimed by roadside bombs.\u003c/p>\n\u003cp>In a case that represents the latest frontier in the growing field of reconstructive transplants, Thomas Manning of Halifax, Massachusetts, is faring well after the 15-hour operation last week, Massachusetts General Hospital said Monday.\u003c/p>\n\u003cp>His doctors said they are cautiously optimistic that Manning eventually will be able to urinate normally and function sexually again for the first time since aggressive penile cancer led to the amputation of his genitals in 2012. They said his psychological state will play a big role in his recovery.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"//players.brightcove.net/245991542/344c319b-6d23-4cbc-975e-c8530534af8a_default/index.html?videoId=4895992613001\" frameborder=\"0\" width=\"100%\" height=\"500\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>\"Emotionally he's doing amazing. I'm really impressed with how he's handling things. He's just a positive person,\" Dr. Curtis Cetrulo, who was among the lead surgeons on a team of more than 50, said at a news conference. \"He wants to be whole again. He does not want to be in the shadows.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Manning, who is single, did not appear at the news conference but said in a statement: \"Today I begin a new chapter filled with personal hope and hope for others who have suffered genital injuries. In sharing this success with all of you, it is my hope we can usher in a bright future for this type of transplantation.\"\u003c/p>\n\u003cp>The identity of the deceased donor was not released.\u003c/p>\n\u003cp>The operation is highly experimental — only one other patient, in South Africa, has a transplanted penis. But four additional hospitals around the country have permission from the United Network for Organ Sharing, which oversees the nation's transplant system, to attempt the delicate surgery.\u003c/p>\n\u003cp>The loss of a penis, whether from cancer, accident or war injury, is emotionally traumatic, affecting urination, sexual intimacy and the ability to conceive a child. Many patients suffer in silence because of the stigma their injuries sometimes carry; Cetrulo said many become isolated and despondent.\u003c/p>\n\u003cp>Unlike traditional life-saving transplants of hearts, kidneys or livers, reconstructive transplants are done to improve quality of life. And while a penis transplant may sound radical, it follows transplants of faces, hands and even the uterus.\u003c/p>\n\u003cp>\"This is a logical next step,\" said Dr. W. P. Andrew Lee, chairman of plastic and reconstructive surgery at Johns Hopkins University School of Medicine.\u003c/p>\n\u003cp>His hospital is preparing for a penis transplant in a wounded veteran soon, and Lee said this new field is important for \"people who want to feel whole again after the loss of important body parts.\"\u003c/p>\n\u003cp>Still, candidates face some serious risks: rejection of the tissue, and side effects from the anti-rejection drugs that must be taken for life. Doctors are working to reduce the medication needed.\u003c/p>\n\u003cp>Penis transplants have generated intense interest among veterans from Iraq and Afghanistan, but they will require more extensive surgery since their injuries, often from roadside bombs, tend to be more extensive, with damage to blood vessels, nerves and pelvic tissue that also will need repair, Lee noted.\u003c/p>\n\u003cp>The Department of Defense Trauma Registry has recorded 1,367 male service members who survived with genitourinary injuries between 2001 and 2013. It's not clear how many victims lost all or part of the penis.\u003c/p>\n\u003cp>A man in China received a penis transplant in 2005. But doctors said he asked them to remove his new organ two weeks later because he and his wife were having psychological problems.\u003c/p>\n\u003cp>In December 2014, a 21-year-old man in South Africa whose penis had been amputated following complications from circumcision in his late teens received a transplant.\u003c/p>\n\u003cp>Dr. Andre van der Merwe of the University of Stellenbosch told The Associated Press that the man is healthy, has normal sexual function and was able to conceive, although the baby was stillborn. But his recovery was difficult, with blood clots and infections, the doctor said.\u003c/p>\n\u003cp>For congenital abnormalities or transgender surgery, doctors can fashion the form of a penis from a patient's own skin, using implants to achieve erection. But transplanting a functional penis requires connecting tiny blood vessels and nerves.\u003c/p>\n\u003cp>A bigger challenge than the surgery itself is finding donor organs.\u003c/p>\n\u003cp>\"People are still reluctant to donate,\" van der Merwe said. \"There are huge psychological issues about donating your relative's penis.\"\u003c/p>\n\u003cp>In the U.S., people or their families who agree to donate organs such as the heart or lung must be asked separately about also donating a penis, hand or other body part, said Dr. Scott Levin, a hand transplant surgeon at the University of Pennsylvania and vice chairman of UNOS' committee on reconstructive transplants.\u003c/p>\n\u003cp>In Boston, Cetrulo said the transplanted penis has good blood flow and so far shows no signs of rejection. He said that Manning should be released from the hospital soon, and that the surgery had three aims: ensuring the transplanted penis looks natural, is capable of normal urination — which he hopes will resume in a few weeks — and eventually normal sexual function.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Reproduction won't be possible, he said, since Manning did not receive new testes.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "How Your Bicycling Data Can Help San Francisco (and Other Cities) Build Safer Streets",
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"content": "\u003cp>Cyclists often find themselves pedaling between huge trucks and speeding cars or stranded when protected bike lanes abruptly end at busy intersections.\u003c/p>\n\u003cp>Chris Cassidy moved to San Francisco in 2005. He used to cycle through Market Street, a busy downtown thoroughfare.\u003c/p>\n\u003cp>\"It was definitely the kind of biking experience that was really only for some of the more courageous among us,\" he says. \"You would be sharing a lane with much larger vehicles going faster than you when people were not as used to sharing the lane.\"\u003c/p>\n\u003cp>Before San Francisco, Cassidy was in Washington, D.C., where he said he was hit by taxi doors twice when he was cycling in the protected lanes.\u003c/p>\n\u003cp>\"They just stopped, and the passenger opened the door to the bike lane,\" he says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Cyclists and pedestrians often pass on knowledge about which roads or intersections to avoid through word of mouth or social media.\u003c/p>\n\u003cp>Now some cities and companies are experimenting with technology to record that information — which can be crucial in helping design or improve bike and pedestrian paths. And transportation planners are turning to data from apps that cyclists and runners use to track themselves.\u003c/p>\n\u003cp>With the exploding popularity in bikes and many millennials' \u003ca href=\"http://www.npr.org/2016/02/11/466178523/like-millennials-more-older-americans-steering-away-from-driving\" target=\"_blank\">distaste for driving\u003c/a>, the need for better streets is gaining attention.\u003c/p>\n\u003cp>\u003cstrong>What Does It Take To Build A Bike \u003c/strong>\u003cstrong>Lane?\u003c/strong>\u003c/p>\n\u003cp>San Francisco has a goal to eliminate traffic deaths by 2024. According to the \u003ca href=\"https://www.sfmta.com/sites/default/files/projects/2015/vision-zero-san-francisco.pdf\">city's \"Vision Zero\" report\u003c/a>, more than half of traffic deaths in the city are pedestrians, compared to 14 percent nationally.\u003c/p>\n\u003cp>Cassidy, now the spokesperson for the San Francisco Biking Coalition, says enforcement and smart engineering based on data are key to reaching that goal.\u003c/p>\n\u003cp>\"The first piece of data is where are injuries happening — where people are using streets currently and where they are doing so that is proving unsafe,\" he says.\u003c/p>\n\u003cp>Technology plays a big role in how that information is collected, says Jamie Parks, a manager with the city's Municipal Transportation Agency.\u003c/p>\n\u003cp>\"Whether it's data analysis to look at where crashes have occurred so we can improve safety, or analyzing bicycle counts to understand where demand is, or getting feedback from the public,\" Parks says.\u003c/p>\n\u003cp>The agency has issued an \u003ca href=\"https://www.sfmta.com/sites/default/files/reports/2016/Annual%20Bicycle%20Count%20Report%202015_04152016.pdf\" target=\"_blank\">annual bicycle count report\u003c/a> for over a decade now. Initially, it had to rely on sending people to count bicycles on the streets for a two-hour period.\u003c/p>\n\u003cp>Last year, the department added several automated bike counters that consist of a wire loop embedded in the pavement, allowing round-the-clock data collection with more accuracy.\u003c/p>\n\u003cp>Alex Dodds and Emiko Atherton from Smart Growth America are championing a new way of designing streets.\u003c/p>\n\u003cp>\"Historically roads have been built to facilitate the most number of cars as possible, and usually that means wide lanes, lots of space for cars to go faster,\" Dodds says. \"Often planners will add a bike lane. They'll just plop it on ... it's very unsafe for everyone.\"\u003c/p>\n\u003cp>The \u003ca href=\"http://www.smartgrowthamerica.org/complete-streets/complete-streets-fundamentals/complete-streets-faq\" target=\"_blank\">\"Complete Streets Approach\"\u003c/a> means building streets that accommodate the needs of a variety of users — drivers, cyclists, children and wheelchair users.\u003c/p>\n\u003cp>\"It doesn't mean every roadway is outfitted with a sidewalk or a bike lane, but there is a network that allows people to travel,\" Atherton says. \"So we start to look at patterns of how people are using roadways or what streets are bikers using.\"\u003c/p>\n\u003cp>The Department of Transportation does have national data from surveys \u003ca href=\"http://www.pedbikeinfo.org/data/factsheet_general.cfm\" target=\"_blank\">about who walks or bikes\u003c/a> and \u003ca href=\"http://www.pedbikeinfo.org/data/factsheet_crash.cfm\" target=\"_blank\">crash statistics\u003c/a>, but it may not be as helpful in determining which streets are used or in measuring effectiveness of street designs.\u003c/p>\n\u003cp>Dodds says Smart Growth America \u003ca href=\"http://www.smartgrowthamerica.org/best-complete-streets-policies-of-2015\" target=\"_blank\">published a report\u003c/a> last year that examined the outcome of the Complete Streets programs.\u003c/p>\n\u003cp>\"It was really hard for us to get answers because so few transportation agencies collect information about what happens after you added a bike lane,\" Dodds says. \"There is just not enough data out there about who is biking, and where they are biking, and where they walk.\"\u003c/p>\n\u003cp>\u003cstrong>Technology Taking A Crack At Data Collection\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_183727\" class=\"wp-caption aligncenter\" style=\"max-width: 1200px\">\u003cimg class=\"wp-image-183727 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/sf-traffic.gif\" alt=\"A screenshot from Strava Metro, showcasing street-by-street visualizations of biking and commuting data.\" width=\"1200\" height=\"646\">\u003cfigcaption class=\"wp-caption-text\">A compilation of screenshots from Strava Metro, showcasing street-by-street visualizations of biking and commuting data. \u003ccite>(Courtesy: Strava)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Strava developed \u003ca href=\"https://www.strava.com/features\">software and an app\u003c/a> that allows cyclers and runners to track their journey and compare their achievements with others. It left the company with a huge database of how people move — and it decided to launch \u003ca href=\"http://metro.strava.com/\" target=\"_blank\">Strava Metro\u003c/a>, a service that shows movement street by street. Data from users is anonymized and aggregated.\u003c/p>\n\u003cp>The idea started, co-founder Michael Horvath says, when an employee in the Oregon Department of Transportation, who was also a Strava user, reached out to the company. She asked if the \u003ca href=\"http://bikeportland.org/2014/05/01/odot-embarks-on-big-data-project-with-purchase-of-strava-dataset-105375\" target=\"_blank\">department could use the data\u003c/a> that Strava collected. Six months later, Horvath launched Strava Metro.\u003c/p>\n\u003cp>\"Before you can make changes, you have to know what is going on,\" he says.\u003c/p>\n\u003cp>For example, Horvath says, Strava used the data to find out how pedestrians and cyclists get to the \u003ca href=\"http://www.travelportland.com/article/tilikum-crossing/\" target=\"_blank\">Tilikum Crossing\u003c/a>, a bridge that recently opened in Portland, Ore. It helped the city figure out where it should build pathways leading to the bridge.\u003c/p>\n\u003cfigure id=\"attachment_183723\" class=\"wp-caption aligncenter\" style=\"max-width: 1281px\">\u003cimg class=\"size-full wp-image-183723\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/strava-2_custom-2f6758590b92dea22b66d9a4ff01d8ca61522930.png\" alt=\"A screenshot from the Strava Labs website shows the visualization of biking activity data around the world. The Strava Global Heatmap is free of charge for advocacy organizations and the general public to access online.\" width=\"1281\" height=\"899\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/strava-2_custom-2f6758590b92dea22b66d9a4ff01d8ca61522930.png 1281w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/strava-2_custom-2f6758590b92dea22b66d9a4ff01d8ca61522930-400x281.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/strava-2_custom-2f6758590b92dea22b66d9a4ff01d8ca61522930-800x561.png 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/strava-2_custom-2f6758590b92dea22b66d9a4ff01d8ca61522930-768x539.png 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/strava-2_custom-2f6758590b92dea22b66d9a4ff01d8ca61522930-1180x828.png 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/strava-2_custom-2f6758590b92dea22b66d9a4ff01d8ca61522930-960x674.png 960w\" sizes=\"(max-width: 1281px) 100vw, 1281px\">\u003cfigcaption class=\"wp-caption-text\">A screenshot from the Strava Labs website shows the visualization of biking activity data around the world. The Strava Global Heatmap is free of charge for advocacy organizations and the general public to access online. \u003ccite>(Courtesy: Strava)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Strava Metro is not the only database collecting such information. The San Francisco County Transportation Authority created a \u003ca href=\"http://www.sfcta.org/modeling-and-travel-forecasting/cycletracks-iphone-and-android\" target=\"_blank\">CycleTracks app\u003c/a> in 2009 to track biking route choices in the city and other cities from Austin to Toronto are using it to collect data.\u003c/p>\n\u003cp>\u003ca href=\"http://metro.strava.com/faq/\" target=\"_blank\">According to Strava\u003c/a>, over 6 million GPS-tracked activities are uploaded to its database every week from around the globe. The cost to its clients — which include state and local governments — depends on the number of Strava members in a particular area. The company charges the clients 80 cents per member for a year.\u003c/p>\n\u003cp>While Parks says he would love to have the data — especially about cross-platform transportation choices, he still has concerns.\u003c/p>\n\u003cp>\"People who use the Strava app may not be representative of the average cyclist in SF,\" Parks says. \"It might be for recreational routes.\"\u003c/p>\n\u003cp>But using technology to track demand for pedestrian or bike paths is already a leap from how engineers used to detect demand for sidewalks or pathways, Dodds says.\u003c/p>\n\u003cp>\"Sometimes if they build a new neighborhood but they don't put in enough sidewalks, people just walk where they wish to walk ... they cut the corner and kill all the grass,\" she says. \"That is one very straightforward way for engineers to say obviously people want a sidewalk here.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Zhai Yun Tan is a digital news intern.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Your+Workout+Data+Might+Be+Helping+Cities+Build+Safer+Streets&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Cyclists often find themselves pedaling between huge trucks and speeding cars or stranded when protected bike lanes abruptly end at busy intersections.\u003c/p>\n\u003cp>Chris Cassidy moved to San Francisco in 2005. He used to cycle through Market Street, a busy downtown thoroughfare.\u003c/p>\n\u003cp>\"It was definitely the kind of biking experience that was really only for some of the more courageous among us,\" he says. \"You would be sharing a lane with much larger vehicles going faster than you when people were not as used to sharing the lane.\"\u003c/p>\n\u003cp>Before San Francisco, Cassidy was in Washington, D.C., where he said he was hit by taxi doors twice when he was cycling in the protected lanes.\u003c/p>\n\u003cp>\"They just stopped, and the passenger opened the door to the bike lane,\" he says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Cyclists and pedestrians often pass on knowledge about which roads or intersections to avoid through word of mouth or social media.\u003c/p>\n\u003cp>Now some cities and companies are experimenting with technology to record that information — which can be crucial in helping design or improve bike and pedestrian paths. And transportation planners are turning to data from apps that cyclists and runners use to track themselves.\u003c/p>\n\u003cp>With the exploding popularity in bikes and many millennials' \u003ca href=\"http://www.npr.org/2016/02/11/466178523/like-millennials-more-older-americans-steering-away-from-driving\" target=\"_blank\">distaste for driving\u003c/a>, the need for better streets is gaining attention.\u003c/p>\n\u003cp>\u003cstrong>What Does It Take To Build A Bike \u003c/strong>\u003cstrong>Lane?\u003c/strong>\u003c/p>\n\u003cp>San Francisco has a goal to eliminate traffic deaths by 2024. According to the \u003ca href=\"https://www.sfmta.com/sites/default/files/projects/2015/vision-zero-san-francisco.pdf\">city's \"Vision Zero\" report\u003c/a>, more than half of traffic deaths in the city are pedestrians, compared to 14 percent nationally.\u003c/p>\n\u003cp>Cassidy, now the spokesperson for the San Francisco Biking Coalition, says enforcement and smart engineering based on data are key to reaching that goal.\u003c/p>\n\u003cp>\"The first piece of data is where are injuries happening — where people are using streets currently and where they are doing so that is proving unsafe,\" he says.\u003c/p>\n\u003cp>Technology plays a big role in how that information is collected, says Jamie Parks, a manager with the city's Municipal Transportation Agency.\u003c/p>\n\u003cp>\"Whether it's data analysis to look at where crashes have occurred so we can improve safety, or analyzing bicycle counts to understand where demand is, or getting feedback from the public,\" Parks says.\u003c/p>\n\u003cp>The agency has issued an \u003ca href=\"https://www.sfmta.com/sites/default/files/reports/2016/Annual%20Bicycle%20Count%20Report%202015_04152016.pdf\" target=\"_blank\">annual bicycle count report\u003c/a> for over a decade now. Initially, it had to rely on sending people to count bicycles on the streets for a two-hour period.\u003c/p>\n\u003cp>Last year, the department added several automated bike counters that consist of a wire loop embedded in the pavement, allowing round-the-clock data collection with more accuracy.\u003c/p>\n\u003cp>Alex Dodds and Emiko Atherton from Smart Growth America are championing a new way of designing streets.\u003c/p>\n\u003cp>\"Historically roads have been built to facilitate the most number of cars as possible, and usually that means wide lanes, lots of space for cars to go faster,\" Dodds says. \"Often planners will add a bike lane. They'll just plop it on ... it's very unsafe for everyone.\"\u003c/p>\n\u003cp>The \u003ca href=\"http://www.smartgrowthamerica.org/complete-streets/complete-streets-fundamentals/complete-streets-faq\" target=\"_blank\">\"Complete Streets Approach\"\u003c/a> means building streets that accommodate the needs of a variety of users — drivers, cyclists, children and wheelchair users.\u003c/p>\n\u003cp>\"It doesn't mean every roadway is outfitted with a sidewalk or a bike lane, but there is a network that allows people to travel,\" Atherton says. \"So we start to look at patterns of how people are using roadways or what streets are bikers using.\"\u003c/p>\n\u003cp>The Department of Transportation does have national data from surveys \u003ca href=\"http://www.pedbikeinfo.org/data/factsheet_general.cfm\" target=\"_blank\">about who walks or bikes\u003c/a> and \u003ca href=\"http://www.pedbikeinfo.org/data/factsheet_crash.cfm\" target=\"_blank\">crash statistics\u003c/a>, but it may not be as helpful in determining which streets are used or in measuring effectiveness of street designs.\u003c/p>\n\u003cp>Dodds says Smart Growth America \u003ca href=\"http://www.smartgrowthamerica.org/best-complete-streets-policies-of-2015\" target=\"_blank\">published a report\u003c/a> last year that examined the outcome of the Complete Streets programs.\u003c/p>\n\u003cp>\"It was really hard for us to get answers because so few transportation agencies collect information about what happens after you added a bike lane,\" Dodds says. \"There is just not enough data out there about who is biking, and where they are biking, and where they walk.\"\u003c/p>\n\u003cp>\u003cstrong>Technology Taking A Crack At Data Collection\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_183727\" class=\"wp-caption aligncenter\" style=\"max-width: 1200px\">\u003cimg class=\"wp-image-183727 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/sf-traffic.gif\" alt=\"A screenshot from Strava Metro, showcasing street-by-street visualizations of biking and commuting data.\" width=\"1200\" height=\"646\">\u003cfigcaption class=\"wp-caption-text\">A compilation of screenshots from Strava Metro, showcasing street-by-street visualizations of biking and commuting data. \u003ccite>(Courtesy: Strava)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Strava developed \u003ca href=\"https://www.strava.com/features\">software and an app\u003c/a> that allows cyclers and runners to track their journey and compare their achievements with others. It left the company with a huge database of how people move — and it decided to launch \u003ca href=\"http://metro.strava.com/\" target=\"_blank\">Strava Metro\u003c/a>, a service that shows movement street by street. Data from users is anonymized and aggregated.\u003c/p>\n\u003cp>The idea started, co-founder Michael Horvath says, when an employee in the Oregon Department of Transportation, who was also a Strava user, reached out to the company. She asked if the \u003ca href=\"http://bikeportland.org/2014/05/01/odot-embarks-on-big-data-project-with-purchase-of-strava-dataset-105375\" target=\"_blank\">department could use the data\u003c/a> that Strava collected. Six months later, Horvath launched Strava Metro.\u003c/p>\n\u003cp>\"Before you can make changes, you have to know what is going on,\" he says.\u003c/p>\n\u003cp>For example, Horvath says, Strava used the data to find out how pedestrians and cyclists get to the \u003ca href=\"http://www.travelportland.com/article/tilikum-crossing/\" target=\"_blank\">Tilikum Crossing\u003c/a>, a bridge that recently opened in Portland, Ore. It helped the city figure out where it should build pathways leading to the bridge.\u003c/p>\n\u003cfigure id=\"attachment_183723\" class=\"wp-caption aligncenter\" style=\"max-width: 1281px\">\u003cimg class=\"size-full wp-image-183723\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2016/05/strava-2_custom-2f6758590b92dea22b66d9a4ff01d8ca61522930.png\" alt=\"A screenshot from the Strava Labs website shows the visualization of biking activity data around the world. The Strava Global Heatmap is free of charge for advocacy organizations and the general public to access online.\" width=\"1281\" height=\"899\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2016/05/strava-2_custom-2f6758590b92dea22b66d9a4ff01d8ca61522930.png 1281w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/strava-2_custom-2f6758590b92dea22b66d9a4ff01d8ca61522930-400x281.png 400w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/strava-2_custom-2f6758590b92dea22b66d9a4ff01d8ca61522930-800x561.png 800w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/strava-2_custom-2f6758590b92dea22b66d9a4ff01d8ca61522930-768x539.png 768w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/strava-2_custom-2f6758590b92dea22b66d9a4ff01d8ca61522930-1180x828.png 1180w, https://ww2.kqed.org/app/uploads/sites/27/2016/05/strava-2_custom-2f6758590b92dea22b66d9a4ff01d8ca61522930-960x674.png 960w\" sizes=\"(max-width: 1281px) 100vw, 1281px\">\u003cfigcaption class=\"wp-caption-text\">A screenshot from the Strava Labs website shows the visualization of biking activity data around the world. The Strava Global Heatmap is free of charge for advocacy organizations and the general public to access online. \u003ccite>(Courtesy: Strava)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Strava Metro is not the only database collecting such information. The San Francisco County Transportation Authority created a \u003ca href=\"http://www.sfcta.org/modeling-and-travel-forecasting/cycletracks-iphone-and-android\" target=\"_blank\">CycleTracks app\u003c/a> in 2009 to track biking route choices in the city and other cities from Austin to Toronto are using it to collect data.\u003c/p>\n\u003cp>\u003ca href=\"http://metro.strava.com/faq/\" target=\"_blank\">According to Strava\u003c/a>, over 6 million GPS-tracked activities are uploaded to its database every week from around the globe. The cost to its clients — which include state and local governments — depends on the number of Strava members in a particular area. The company charges the clients 80 cents per member for a year.\u003c/p>\n\u003cp>While Parks says he would love to have the data — especially about cross-platform transportation choices, he still has concerns.\u003c/p>\n\u003cp>\"People who use the Strava app may not be representative of the average cyclist in SF,\" Parks says. \"It might be for recreational routes.\"\u003c/p>\n\u003cp>But using technology to track demand for pedestrian or bike paths is already a leap from how engineers used to detect demand for sidewalks or pathways, Dodds says.\u003c/p>\n\u003cp>\"Sometimes if they build a new neighborhood but they don't put in enough sidewalks, people just walk where they wish to walk ... they cut the corner and kill all the grass,\" she says. \"That is one very straightforward way for engineers to say obviously people want a sidewalk here.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\"A new study shows that drinking a glass of red wine is just as good as spending an hour at the gym.\"\u003c/p>\n\u003cp>If you're thinking, \"HUH?\" then you'll want to watch the latest from \u003ca href=\"https://www.youtube.com/watch?v=0Rnq1NpHdmw\" target=\"_blank\">Last Week Tonight \u003c/a>host John Oliver. His show Sunday night was devoted to science -- and how scientific studies are poorly reported by the mainstream press.\u003c/p>\n\u003cp>You'll recognize plenty of the headlines he cites. Does coffee cure everything or kill you? Numerous studies have either trumpeted its benefits or gravely warns of its risks.\u003c/p>\n\u003cp>\"Coffee today is like God in the Old Testament,\" Oliver says. \"It will either save you or kill you depending in how much you believe in its magical powers.\"\u003c/p>\n\u003cp>Oliver expounds on the dual problems of scientists under pressure to publish something new (\"There is no reward for being the second person to discover something; no Nobel Prize for fact checking\") and news programs/websites' desire to feed the public shareable headlines.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Remember this one: \"Scientists say smelling farts might prevent cancer\"?\u003c/p>\n\u003cp>It was based on a group of papers, \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24755204\" target=\"_blank\">one of which was titled this way\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>AP39, a novel mitochondria-targeted hydrogen sulfide donor, stimulates cellular bioenergetics, exerts cytoprotective effects and protects against the loss of mitochondrial DNA integrity in oxidatively stressed endothelial cells in vitro.\u003c/p>\u003c/blockquote>\n\u003cp>Hmmmm, that's not so eye-catching any more.\u003c/p>\n\u003cp>Gary Schwitzer publishes the nonprofit \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24755204\" target=\"_blank\">HealthNewsReview,\u003c/a> which is exactly what it sounds like -- a site where knowledgeable people analyze claims both about health care interventions and the accuracy and completeness of health news stories. (Like many of my health/science reporter colleagues, I worry about stories I write showing up on the site.)\u003c/p>\n\u003cp>The massive attention these \"smelling farts\" studies received appear to have been sparked by a university press release, Schwitzer says, \"which used the word flatulence (five) words in.\"\u003c/p>\n\u003cp>Not so surprisingly, the word \"flatulence\" caught reporters' eyes. The day after the study was published, Schwitzer did a Google search and got 330,000 returns. That's a lot of coverage.\u003c/p>\n\u003cp>The press release ultimately \"increased click rates,\" Schwitzer said, \"and that's the coin of the realm.\"\u003c/p>\n\u003cp>It's worth noting that the scientists have added a disclaimer at the end of the \"flatulence\" \u003ca href=\"http://www.exeter.ac.uk/news/research/title_393168_en.html\" target=\"_blank\">press release\u003c/a> saying that the studies do not \"make any reference at all to cancer or to any health benefits from inhaling (sniffing) hydrogen sulfide.\" It was simply an early stage drug development project, they said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Oliver clearly explains that science is \"hugely important,\" but needs to be accurately reported, not \"twisted out of proportion and turned into morning show gossip.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\"A new study shows that drinking a glass of red wine is just as good as spending an hour at the gym.\"\u003c/p>\n\u003cp>If you're thinking, \"HUH?\" then you'll want to watch the latest from \u003ca href=\"https://www.youtube.com/watch?v=0Rnq1NpHdmw\" target=\"_blank\">Last Week Tonight \u003c/a>host John Oliver. His show Sunday night was devoted to science -- and how scientific studies are poorly reported by the mainstream press.\u003c/p>\n\u003cp>You'll recognize plenty of the headlines he cites. Does coffee cure everything or kill you? Numerous studies have either trumpeted its benefits or gravely warns of its risks.\u003c/p>\n\u003cp>\"Coffee today is like God in the Old Testament,\" Oliver says. \"It will either save you or kill you depending in how much you believe in its magical powers.\"\u003c/p>\n\u003cp>Oliver expounds on the dual problems of scientists under pressure to publish something new (\"There is no reward for being the second person to discover something; no Nobel Prize for fact checking\") and news programs/websites' desire to feed the public shareable headlines.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Remember this one: \"Scientists say smelling farts might prevent cancer\"?\u003c/p>\n\u003cp>It was based on a group of papers, \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24755204\" target=\"_blank\">one of which was titled this way\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>AP39, a novel mitochondria-targeted hydrogen sulfide donor, stimulates cellular bioenergetics, exerts cytoprotective effects and protects against the loss of mitochondrial DNA integrity in oxidatively stressed endothelial cells in vitro.\u003c/p>\u003c/blockquote>\n\u003cp>Hmmmm, that's not so eye-catching any more.\u003c/p>\n\u003cp>Gary Schwitzer publishes the nonprofit \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24755204\" target=\"_blank\">HealthNewsReview,\u003c/a> which is exactly what it sounds like -- a site where knowledgeable people analyze claims both about health care interventions and the accuracy and completeness of health news stories. (Like many of my health/science reporter colleagues, I worry about stories I write showing up on the site.)\u003c/p>\n\u003cp>The massive attention these \"smelling farts\" studies received appear to have been sparked by a university press release, Schwitzer says, \"which used the word flatulence (five) words in.\"\u003c/p>\n\u003cp>Not so surprisingly, the word \"flatulence\" caught reporters' eyes. The day after the study was published, Schwitzer did a Google search and got 330,000 returns. That's a lot of coverage.\u003c/p>\n\u003cp>The press release ultimately \"increased click rates,\" Schwitzer said, \"and that's the coin of the realm.\"\u003c/p>\n\u003cp>It's worth noting that the scientists have added a disclaimer at the end of the \"flatulence\" \u003ca href=\"http://www.exeter.ac.uk/news/research/title_393168_en.html\" target=\"_blank\">press release\u003c/a> saying that the studies do not \"make any reference at all to cancer or to any health benefits from inhaling (sniffing) hydrogen sulfide.\" It was simply an early stage drug development project, they said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Oliver clearly explains that science is \"hugely important,\" but needs to be accurately reported, not \"twisted out of proportion and turned into morning show gossip.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>There are lots of ways to make a buck, but becoming a human guinea pig for drug research has to be one of the oddest.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"The vast majority of participants are under-represented minorities.\"\u003ccite>Jill Fisher, sociologist, University of North Carolina's Center for Bioethics\u003c/cite>\u003c/aside>\n\u003cp>\"We are selling our bodies, most definitely,\" says Paul Clough, who has taken part in more than 80 drug tests in the past 11 years. \"Well, renting,\" might be more accurate, he concedes. Clough, who's 37, also runs a \u003ca href=\"http://www.jalr.org/\">website\u003c/a> that helps people find trials to sign up for.\u003c/p>\n\u003cp>Some are like the one he's doing right now, which stretches over three months and involves multiple stints living in a clinic with other volunteers, eating cafeteria food and showing up on time to get his vitals checked or to pop another pill.\u003c/p>\n\u003cp>\"It's like summer camp,\" he says, then reconsiders, since in this trial he can't leave. \"It's kind of like being in jail, except you don't get shanked in the shower.\"\u003c/p>\n\u003cp>Clough first heard about this line of work from a homeless man in Kansas City. Since then, he moved to Austin, Texas, to be closer to some of the big clinics that pay well. He says he can make thousands of dollars in just a few weeks. \"Generally, the more procedures, the more perceived risk in a study, the more it's going to pay,\" he says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The early tests, though usually safe, can carry unexpected hazards. In January, the test of an experimental pain drug in France \u003ca href=\"http://www.npr.org/sections/health-shots/2016/05/03/475867184/botched-french-drug-trial-followed-rules-but-lacked-common-sense\">was halted\u003c/a> after several participants developed serious neurological problems. One man died.\u003c/p>\n\u003cp>\"Every time you see a TV commercial for a drug and they rattle off all the reasons why you shouldn't take the drug — that's all information that they got from people like me,\" says Clough.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"It's kind of like being in jail, except you don't get shanked in the shower.\"\u003ccite>Professional human test-subject Paul Clough\u003c/cite>\u003c/aside>\n\u003cp>He may be overstating the case a bit. Larger trials of the potential new medicines in people with illnesses the drugs aim to treat are more likely to uncover a wide range of side effects, but there's no question that these early tests in humans help reveal the potential hazards of experimental medicines.\u003c/p>\n\u003cp>Those so-called \u003ca href=\"https://www.nlm.nih.gov/services/ctphases.html\">phase 1 studies\u003c/a> involve a small group of healthy people to determine the right dosage and to get a first look at what the side effects in humans might be. A drug that passes the first test will then move on to larger human studies where it is typically compared with a placebo or other treatment in patients suffering from the condition it's meant to help.\u003c/p>\n\u003cp>Clough says he'll do about eight or nine trials a year. It's enough to fund day-to-day life, plus travel. He's planning a trip to Alaska to photograph bears.\u003c/p>\n\u003cp>Like other serial participants in clinical trials, Clough knows that what he's doing could potentially help others down the line. But that's not the main drive for volunteers. \"We need money,\" says Clough.\u003c/p>\n\u003cp>\u003cstrong>For Some, a Rare Opportunity\u003c/strong>\u003c/p>\n\u003cp>And for some people, especially those with a history of incarceration, clinical trials are a rare opportunity. \"I can't get a regular job because I have a couple of legal problems in my background,\" he says. But when he signs up for a clinical trial, he says, \"They're only looking at what your body does, not what you did.\"\u003c/p>\n\u003cp>Sociologist \u003ca href=\"https://www.med.unc.edu/socialmed/people/jill-fisher\">Jill Fisher\u003c/a>, at the Center for Bioethics at University of North Carolina in Chapel Hill, says that's a perspective she's come across frequently in her research. She \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408988/\">studies\u003c/a> people who participate repeatedly in phase 1 clinical trials, including self-proclaimed professionals like Clough. \"I think that says a lot about our system overall and what kind of opportunities we have for people in a period of post-incarceration,\" she says.\u003c/p>\n\u003cp>Until the 1970s, experimental medications were often tested in prisoners. Now, clinics rely on healthy volunteers, who get paid for taking the risk, typically around $200 a night spent in a facility.\u003c/p>\n\u003cp>For a lot of people, it's good money. But Fisher says there are a few things about phase 1 clinical research that are concerning.\u003c/p>\n\u003cp>For one, medical research trials in the later stages of drug development — usually involving patients who could gain something more than money from taking the experimental medication — \u003ca href=\"http://www.npr.org/sections/health-shots/2015/12/16/459666750/clinical-trials-still-dont-reflect-the-diversity-of-america\">tend not\u003c/a> to involve enough minority participants. By contrast, in phase 1 research, she says, \"The vast majority of participants are under-represented minorities.\" In the Northeast they're typically black men, and in the Southwest they're typically Hispanic men.\u003c/p>\n\u003cp>The drugs they're testing may go on to make billions of dollars for pharmaceutical companies, though the vast majority that manage pass phase 1 never make it to market.\u003c/p>\n\u003cp>\"I am very concerned about the fact that we're using a segment of our population who might not ever be able to afford the drugs that they're part of testing, and not compensating them perhaps to the degree that we really should,\" she says.\u003c/p>\n\u003cp>Robert Biafore doesn't see it that way. He's a former car salesman who lost his job when the economy went sour in 2008. Biafore says he's participated in at least 50 trials in the last six years.\u003c/p>\n\u003cp>\"My time will come to an end ... and I will go back to selling cars. But in the meantime, this is easy. And I'm getting full medical checks,\" says Biafore, who's uninsured. \"Where else am I going to go and get labs done, physicals done, ECGs done, MRIs looked at and people are going to look at my body and tell me what is wrong with me before something's even wrong?\"\u003c/p>\n\u003cp>He acknowledges that his line of work has risks. But Biafore says the worst that's happened to him was that he got a rash and vomited.\u003c/p>\n\u003cp>\"It's all part of the game,\" he says. \"You're letting scientists use your body to get data for clinical results, so they can get it approved by the [Food and Drug Administration]. It is what it is. You can't be afraid of it.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Every time someone picks up medicine from a pharmacy, or gets a prescription, they owe a debt to the human guinea pigs. \"If it wasn't for people like us you wouldn't get that medication,\" Biafore says.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Professional+%27Guinea+Pigs%27+Can+Make+A+Living+Testing+Drugs+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>There are lots of ways to make a buck, but becoming a human guinea pig for drug research has to be one of the oddest.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"The vast majority of participants are under-represented minorities.\"\u003ccite>Jill Fisher, sociologist, University of North Carolina's Center for Bioethics\u003c/cite>\u003c/aside>\n\u003cp>\"We are selling our bodies, most definitely,\" says Paul Clough, who has taken part in more than 80 drug tests in the past 11 years. \"Well, renting,\" might be more accurate, he concedes. Clough, who's 37, also runs a \u003ca href=\"http://www.jalr.org/\">website\u003c/a> that helps people find trials to sign up for.\u003c/p>\n\u003cp>Some are like the one he's doing right now, which stretches over three months and involves multiple stints living in a clinic with other volunteers, eating cafeteria food and showing up on time to get his vitals checked or to pop another pill.\u003c/p>\n\u003cp>\"It's like summer camp,\" he says, then reconsiders, since in this trial he can't leave. \"It's kind of like being in jail, except you don't get shanked in the shower.\"\u003c/p>\n\u003cp>Clough first heard about this line of work from a homeless man in Kansas City. Since then, he moved to Austin, Texas, to be closer to some of the big clinics that pay well. He says he can make thousands of dollars in just a few weeks. \"Generally, the more procedures, the more perceived risk in a study, the more it's going to pay,\" he says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The early tests, though usually safe, can carry unexpected hazards. In January, the test of an experimental pain drug in France \u003ca href=\"http://www.npr.org/sections/health-shots/2016/05/03/475867184/botched-french-drug-trial-followed-rules-but-lacked-common-sense\">was halted\u003c/a> after several participants developed serious neurological problems. One man died.\u003c/p>\n\u003cp>\"Every time you see a TV commercial for a drug and they rattle off all the reasons why you shouldn't take the drug — that's all information that they got from people like me,\" says Clough.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"It's kind of like being in jail, except you don't get shanked in the shower.\"\u003ccite>Professional human test-subject Paul Clough\u003c/cite>\u003c/aside>\n\u003cp>He may be overstating the case a bit. Larger trials of the potential new medicines in people with illnesses the drugs aim to treat are more likely to uncover a wide range of side effects, but there's no question that these early tests in humans help reveal the potential hazards of experimental medicines.\u003c/p>\n\u003cp>Those so-called \u003ca href=\"https://www.nlm.nih.gov/services/ctphases.html\">phase 1 studies\u003c/a> involve a small group of healthy people to determine the right dosage and to get a first look at what the side effects in humans might be. A drug that passes the first test will then move on to larger human studies where it is typically compared with a placebo or other treatment in patients suffering from the condition it's meant to help.\u003c/p>\n\u003cp>Clough says he'll do about eight or nine trials a year. It's enough to fund day-to-day life, plus travel. He's planning a trip to Alaska to photograph bears.\u003c/p>\n\u003cp>Like other serial participants in clinical trials, Clough knows that what he's doing could potentially help others down the line. But that's not the main drive for volunteers. \"We need money,\" says Clough.\u003c/p>\n\u003cp>\u003cstrong>For Some, a Rare Opportunity\u003c/strong>\u003c/p>\n\u003cp>And for some people, especially those with a history of incarceration, clinical trials are a rare opportunity. \"I can't get a regular job because I have a couple of legal problems in my background,\" he says. But when he signs up for a clinical trial, he says, \"They're only looking at what your body does, not what you did.\"\u003c/p>\n\u003cp>Sociologist \u003ca href=\"https://www.med.unc.edu/socialmed/people/jill-fisher\">Jill Fisher\u003c/a>, at the Center for Bioethics at University of North Carolina in Chapel Hill, says that's a perspective she's come across frequently in her research. She \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408988/\">studies\u003c/a> people who participate repeatedly in phase 1 clinical trials, including self-proclaimed professionals like Clough. \"I think that says a lot about our system overall and what kind of opportunities we have for people in a period of post-incarceration,\" she says.\u003c/p>\n\u003cp>Until the 1970s, experimental medications were often tested in prisoners. Now, clinics rely on healthy volunteers, who get paid for taking the risk, typically around $200 a night spent in a facility.\u003c/p>\n\u003cp>For a lot of people, it's good money. But Fisher says there are a few things about phase 1 clinical research that are concerning.\u003c/p>\n\u003cp>For one, medical research trials in the later stages of drug development — usually involving patients who could gain something more than money from taking the experimental medication — \u003ca href=\"http://www.npr.org/sections/health-shots/2015/12/16/459666750/clinical-trials-still-dont-reflect-the-diversity-of-america\">tend not\u003c/a> to involve enough minority participants. By contrast, in phase 1 research, she says, \"The vast majority of participants are under-represented minorities.\" In the Northeast they're typically black men, and in the Southwest they're typically Hispanic men.\u003c/p>\n\u003cp>The drugs they're testing may go on to make billions of dollars for pharmaceutical companies, though the vast majority that manage pass phase 1 never make it to market.\u003c/p>\n\u003cp>\"I am very concerned about the fact that we're using a segment of our population who might not ever be able to afford the drugs that they're part of testing, and not compensating them perhaps to the degree that we really should,\" she says.\u003c/p>\n\u003cp>Robert Biafore doesn't see it that way. He's a former car salesman who lost his job when the economy went sour in 2008. Biafore says he's participated in at least 50 trials in the last six years.\u003c/p>\n\u003cp>\"My time will come to an end ... and I will go back to selling cars. But in the meantime, this is easy. And I'm getting full medical checks,\" says Biafore, who's uninsured. \"Where else am I going to go and get labs done, physicals done, ECGs done, MRIs looked at and people are going to look at my body and tell me what is wrong with me before something's even wrong?\"\u003c/p>\n\u003cp>He acknowledges that his line of work has risks. But Biafore says the worst that's happened to him was that he got a rash and vomited.\u003c/p>\n\u003cp>\"It's all part of the game,\" he says. \"You're letting scientists use your body to get data for clinical results, so they can get it approved by the [Food and Drug Administration]. It is what it is. You can't be afraid of it.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Every time someone picks up medicine from a pharmacy, or gets a prescription, they owe a debt to the human guinea pigs. \"If it wasn't for people like us you wouldn't get that medication,\" Biafore says.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Professional+%27Guinea+Pigs%27+Can+Make+A+Living+Testing+Drugs+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "How Bad For You is Staring at a Computer All Day?",
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"content": "\u003cp>It's 2:00 p.m. and you have a few more hours until the end of your workday.\u003c/p>\n\u003caside class=\"pullquote alignright\">The evidence doesn’t suggest symptoms are permanent. They can be alleviated by changing workplace habits.\u003c/aside>\n\u003cp>Your eyes sting, your vision is getting blurry and your head hurts. The computer screen that you've been staring at for the past six hours seems so bright that you want to shut your eyes.\u003c/p>\n\u003cp>Sound familiar? We'd bet yes.\u003c/p>\n\u003cp>Piotr Le, a Georgetown University grad student, thinks so, too. He used to work in consulting — and that meant staring at a computer screen for 12 or more hours every workday.\u003c/p>\n\u003cp>\"Partially I left because of the physical deterioration of my body,\" Le says. \"A lot of eye rubbing. That's why my prescription got worse. I would wake up with neck pain and back pain.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Depending on whether you consult an optometrist or an ophthalmologist, you might get different answers on what ails you. Is it computer vision syndrome? Is it digital eyestrain? Is it just dry eyes and some eyestrain?\u003c/p>\n\u003cp>[contextly_sidebar id=\"QNoGq8UBrCbujTBCY73WRgfrXV78zHln\"]The most common definition is given by the American Optometric Association, which coined \u003ca href=\"http://www.aoa.org/patients-and-public/caring-for-your-vision/protecting-your-vision/computer-vision-syndrome?sso=y\">computer vision syndrome\u003c/a> and digital eyestrain as a group of vision-related problems from viewing digital screens for a long time.\u003c/p>\n\u003cp>The American Academy of Ophthalmology labels it \u003ca href=\"http://www.aao.org/eye-health/tips-prevention/computer-usage\">digital-related eyestrain\u003c/a>. The group emphasizes that extended reading and writing can also strain the eyes.\u003c/p>\n\u003cp>Neither computer vision syndrome nor digital eyestrain is an official medical condition. They are more of a collection of symptoms that sometimes include headache, neck and shoulder pain.\u003c/p>\n\u003cp>\"Classification schemes do take time to develop, and so it may not have crept into medical coding,\" says Dr. Michael X. Repka, a Johns Hopkins ophthalmologist and clinical spokesman for the American Academy of Ophthalmology.\u003c/p>\n\u003cp>Repka says in the past these symptoms would be lumped under \u003ca href=\"http://eyewiki.aao.org/Asthenopia\">asthenopia\u003c/a>, a condition that encompasses eye fatigue, ache around the eyes, blurred vision and headache. Computer vision syndrome, he says, is considered to be under asthenopia in the \u003ca href=\"http://icdlist.com/icd-10/H53.149\">ICD-10 medical coding system\u003c/a>.\u003c/p>\n\u003cp>\"Computer vision syndrome ... is not a recognized medical entity,\" says James Sheedy, a professor of optometry at Pacific University and head of the Vision Ergonomics Research Laboratory. \"A medical diagnosis is a condition where the anatomy or physiology isn't functioning properly. There are several different medical diagnoses that could be the cause of what is commonly called computer vision syndrome. There are different names put on it. Those are really names to create a black box where you put everything into ... but it's really the same thing.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">Follow the 20-20-20 rule: Every 20 minutes, look at something at least 20 feet away for 20 seconds.\u003c/aside>\n\u003cp>The fact that these symptoms are common is self-evident. Optometrists and ophthalmologists agree that many patients walk into their offices with these complaints. But is there enough evidence to upgrade their diagnostic status?\u003c/p>\n\u003cp>\"I think research is coming out now that this really is a different condition,\" says Mark Rosenfield, a professor at SUNY College of Optometry. \"There is something about these screens that is different from paper and so we're trying to figure out what aspects of screens is it that is causing problems. People didn't look at paper for that length of time [that] people are looking at screens, so I think that could be a factor too — the fact that people are looking at these things for such long periods of time.\"\u003c/p>\n\u003cp>So why do our digital screens cause us so much trouble?\u003c/p>\n\u003cp>\"We're not really designed to do full-time near work; we're designed to do part-time near work, and so to the extent that we have to do so much near work our eyes are in tension virtually all the time,\" says Steve Loomis, president of the American Optometric Association. \"The average worker spends seven hours a day on some digital device. ... I'm among them and so what we know is that that means that the muscles in the eye are in a state of tension.\"\u003c/p>\n\u003cp>In a \u003ca href=\"http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=64714113&site=ehost-live\">review of studies\u003c/a> for the journal \u003cem>Ophthalmic & Physiological Optics,\u003c/em> Rosenfield found that we have more incomplete blinks during computer operations, which reduces the volume of tears in our eyes. Too few tears causes irritation and a burning sensation in the eyes.\u003c/p>\n\u003cp>A \u003ca href=\"http://content.iospress.com/articles/work/wor2162\">more recent review\u003c/a> of the syndrome in \u003cem>IOS Press\u003c/em> lists other factors: glare from windows, overhead lights and the computer. Also, the particulars of how your computer or digital devices are arranged, including the height and viewing distance of the device from our eyes. We also tend to hold hand-held devices closer to our eyes than we should.\u003c/p>\n\u003cp>\"The eyes work best we know by looking down about 15 degrees in most desktop computer situations. This means that the top of the computer screen displays should be level with the eyes,\" Sheedy says. \"If it's higher or lower than that the person tends to tilt the head back or forward and now they have an imbalance and this creates muscular tension and it can give them a neck ache.\"\u003c/p>\n\u003cp>The evidence doesn't suggest these symptoms are permanent. They can be alleviated by changing our workplace habits. Anti-glare screen filters and eyedrops may help some. Optometrists say that some people who use reading glasses may benefit from trying glasses with a different focal length for computer work.\u003c/p>\n\u003cp>One of the most commonly cited — and cheapest — things to do is just to give your eyes a rest. Follow the 20-20-20 rule: Every 20 minutes, look at something at least 20 feet away for 20 seconds.\u003c/p>\n\u003cp>Grad student Le now stares at his computer only four to six hours a day. He says he still gets occasional neck pain from looking down at his laptop. And the white backgrounds of PDFs and Word documents still bother his eyes some. He's also trying software to make the tone of his screen warmer.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>But his go-to move is taking a break. \"I close my eyes and look at the skyline,\" he says, \"or something that is not bright.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=After+A+Long+Day+At+The+Computer+Do+You+Have+A+Medical+Problem%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It's 2:00 p.m. and you have a few more hours until the end of your workday.\u003c/p>\n\u003caside class=\"pullquote alignright\">The evidence doesn’t suggest symptoms are permanent. They can be alleviated by changing workplace habits.\u003c/aside>\n\u003cp>Your eyes sting, your vision is getting blurry and your head hurts. The computer screen that you've been staring at for the past six hours seems so bright that you want to shut your eyes.\u003c/p>\n\u003cp>Sound familiar? We'd bet yes.\u003c/p>\n\u003cp>Piotr Le, a Georgetown University grad student, thinks so, too. He used to work in consulting — and that meant staring at a computer screen for 12 or more hours every workday.\u003c/p>\n\u003cp>\"Partially I left because of the physical deterioration of my body,\" Le says. \"A lot of eye rubbing. That's why my prescription got worse. I would wake up with neck pain and back pain.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Depending on whether you consult an optometrist or an ophthalmologist, you might get different answers on what ails you. Is it computer vision syndrome? Is it digital eyestrain? Is it just dry eyes and some eyestrain?\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The most common definition is given by the American Optometric Association, which coined \u003ca href=\"http://www.aoa.org/patients-and-public/caring-for-your-vision/protecting-your-vision/computer-vision-syndrome?sso=y\">computer vision syndrome\u003c/a> and digital eyestrain as a group of vision-related problems from viewing digital screens for a long time.\u003c/p>\n\u003cp>The American Academy of Ophthalmology labels it \u003ca href=\"http://www.aao.org/eye-health/tips-prevention/computer-usage\">digital-related eyestrain\u003c/a>. The group emphasizes that extended reading and writing can also strain the eyes.\u003c/p>\n\u003cp>Neither computer vision syndrome nor digital eyestrain is an official medical condition. They are more of a collection of symptoms that sometimes include headache, neck and shoulder pain.\u003c/p>\n\u003cp>\"Classification schemes do take time to develop, and so it may not have crept into medical coding,\" says Dr. Michael X. Repka, a Johns Hopkins ophthalmologist and clinical spokesman for the American Academy of Ophthalmology.\u003c/p>\n\u003cp>Repka says in the past these symptoms would be lumped under \u003ca href=\"http://eyewiki.aao.org/Asthenopia\">asthenopia\u003c/a>, a condition that encompasses eye fatigue, ache around the eyes, blurred vision and headache. Computer vision syndrome, he says, is considered to be under asthenopia in the \u003ca href=\"http://icdlist.com/icd-10/H53.149\">ICD-10 medical coding system\u003c/a>.\u003c/p>\n\u003cp>\"Computer vision syndrome ... is not a recognized medical entity,\" says James Sheedy, a professor of optometry at Pacific University and head of the Vision Ergonomics Research Laboratory. \"A medical diagnosis is a condition where the anatomy or physiology isn't functioning properly. There are several different medical diagnoses that could be the cause of what is commonly called computer vision syndrome. There are different names put on it. Those are really names to create a black box where you put everything into ... but it's really the same thing.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">Follow the 20-20-20 rule: Every 20 minutes, look at something at least 20 feet away for 20 seconds.\u003c/aside>\n\u003cp>The fact that these symptoms are common is self-evident. Optometrists and ophthalmologists agree that many patients walk into their offices with these complaints. But is there enough evidence to upgrade their diagnostic status?\u003c/p>\n\u003cp>\"I think research is coming out now that this really is a different condition,\" says Mark Rosenfield, a professor at SUNY College of Optometry. \"There is something about these screens that is different from paper and so we're trying to figure out what aspects of screens is it that is causing problems. People didn't look at paper for that length of time [that] people are looking at screens, so I think that could be a factor too — the fact that people are looking at these things for such long periods of time.\"\u003c/p>\n\u003cp>So why do our digital screens cause us so much trouble?\u003c/p>\n\u003cp>\"We're not really designed to do full-time near work; we're designed to do part-time near work, and so to the extent that we have to do so much near work our eyes are in tension virtually all the time,\" says Steve Loomis, president of the American Optometric Association. \"The average worker spends seven hours a day on some digital device. ... I'm among them and so what we know is that that means that the muscles in the eye are in a state of tension.\"\u003c/p>\n\u003cp>In a \u003ca href=\"http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=64714113&site=ehost-live\">review of studies\u003c/a> for the journal \u003cem>Ophthalmic & Physiological Optics,\u003c/em> Rosenfield found that we have more incomplete blinks during computer operations, which reduces the volume of tears in our eyes. Too few tears causes irritation and a burning sensation in the eyes.\u003c/p>\n\u003cp>A \u003ca href=\"http://content.iospress.com/articles/work/wor2162\">more recent review\u003c/a> of the syndrome in \u003cem>IOS Press\u003c/em> lists other factors: glare from windows, overhead lights and the computer. Also, the particulars of how your computer or digital devices are arranged, including the height and viewing distance of the device from our eyes. We also tend to hold hand-held devices closer to our eyes than we should.\u003c/p>\n\u003cp>\"The eyes work best we know by looking down about 15 degrees in most desktop computer situations. This means that the top of the computer screen displays should be level with the eyes,\" Sheedy says. \"If it's higher or lower than that the person tends to tilt the head back or forward and now they have an imbalance and this creates muscular tension and it can give them a neck ache.\"\u003c/p>\n\u003cp>The evidence doesn't suggest these symptoms are permanent. They can be alleviated by changing our workplace habits. Anti-glare screen filters and eyedrops may help some. Optometrists say that some people who use reading glasses may benefit from trying glasses with a different focal length for computer work.\u003c/p>\n\u003cp>One of the most commonly cited — and cheapest — things to do is just to give your eyes a rest. Follow the 20-20-20 rule: Every 20 minutes, look at something at least 20 feet away for 20 seconds.\u003c/p>\n\u003cp>Grad student Le now stares at his computer only four to six hours a day. He says he still gets occasional neck pain from looking down at his laptop. And the white backgrounds of PDFs and Word documents still bother his eyes some. He's also trying software to make the tone of his screen warmer.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But his go-to move is taking a break. \"I close my eyes and look at the skyline,\" he says, \"or something that is not bright.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=After+A+Long+Day+At+The+Computer+Do+You+Have+A+Medical+Problem%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Elizabeth Holmes fit into the Silicon Valley success mold. A young Stanford dropout who left school to pursue her entrepreneurial vision, she founded Theranos and said she would disrupt the world of medicine with easy and inexpensive blood tests.\u003c/p>\n\u003caside class=\"pullquote alignright\">In Silicon Valley, secrecy and raising big money before achieving results are par for the course. Not so in the world of biomed.\u003c/aside>\n\u003cp>But now her company is \u003ca href=\"http://www.npr.org/2016/04/19/474868428/innovative-blood-testing-company-theranos-under-criminal-investigation\">under federal investigation\u003c/a> and extra scrutiny \u003ca href=\"http://www.latimes.com/business/la-fi-theranos-investigations-20160419-story.html\">by federal regulators\u003c/a>. And questions are being raised about whether applying hardware and software business culture to biotechnology is dangerous.\u003c/p>\n\u003cp>Holmes was an alluring figure; young and intense in the kind of way Apple founder Steve Jobs was. Like Jobs, she wore \u003ca href=\"http://www.glamour.com/story/theranos-founder-elizabeth-holmes-career-advice\">only black turtlenecks\u003c/a> because she didn't have time to think about her wardrobe.\u003c/p>\n\u003cp>And of course, there was \u003ca href=\"http://www.tedmed.com/talks/show?id=309114\">the TED talk\u003c/a> in which Holmes painted a picture of a world in which too many people avoided blood tests because of the cost, inconvenience and discomfort of giving so much blood. Sometimes they learned too late about a serious health condition. But, her company — \u003ca href=\"https://www.theranos.com/\">Theranos\u003c/a> — had the solution.\u003c/p>\n\u003cp>\"We've made it possible to run comprehensive laboratory tests from a tiny sample or a few drops of blood that could be taken from a finger,\" she told the audience.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Holmes had a beautiful vision, backed by hundreds of millions of dollars in investment, and \u003ca href=\"https://www.theranos.com/leadership\">a board of big names\u003c/a> like Henry Kissinger and George P. Schulz. The media had a love fest. \u003cem>Time\u003c/em> magazine called Holmes \u003ca href=\"http://time.com/3822734/elizabeth-holmes-2015-time-100/\">one of the 100 most influential people\u003c/a> in the world. She was profiled in \u003ca href=\"http://fortune.com/2014/06/12/theranos-blood-holmes/\">Fortune\u003c/a> and \u003ca href=\"http://www.newyorker.com/magazine/2014/12/15/blood-simpler\">The New Yorker\u003c/a>. Even medical professionals like \u003ca href=\"http://www.businessinsider.com/scientist-skeptical-thranos-blood-test-elizabeth-holmes-2015-6\">Dr. John Ioannidis\u003c/a>, a professor at Stanford University Medical School were intrigued.\u003c/p>\n\u003caside class=\"pullquote alignright\">“This is equivalent to me, being a biomedical researcher, trying to become an architect and build a skyscraper. Would you give me a few billion dollars please?”\u003ccite> Dr. John Ioannidis, Stanford Medical School professor\u003c/cite>\u003c/aside>\n\u003cp>\"My first reaction was, it sounds really brilliant,\" Ioannides says. \"I would like to collaborate with these people and maybe even use their technology in my own studies.\" Studies — that's what medicine and science is built upon.\u003c/p>\n\u003cp>\"So the first thing that I did as a researcher, as a scientist is check the scientific literature,\" says Ioannidis. \"How much do we know about what they do? And I couldn't find even a single paper.\"\u003c/p>\n\u003cp>Then there was the advisory board: big names in politics, not science. And Holmes had no background in medicine. \"This is equivalent to me, being a biomedical researcher, trying to become an architect and build a skyscraper. Would you give me a few billion dollars please?\"\u003c/p>\n\u003cp>Of course, no one would give him a few billion dollars.\u003c/p>\n\u003cp>But in the tech world, maybe they would. Jo-Ellen Pozner, a professor at the University of California, Berkeley Haas School of Business, says some of the greatest companies were built on hype and a big idea.\u003c/p>\n\u003cp>\"Often the product comes after the money, and so the first job is to get the investors to give you the money and that requires that you really sell them on this big idea before it's actually in hand,\" Pozner says.\u003c/p>\n\u003cp>Pozner points to \u003ca href=\"http://www.npr.org/sections/theprotojournalist/2014/01/08/260457752/can-jeff-bezos-save-planet-earth\">Jeff Bezos\u003c/a> and his company Amazon, which started as an online bookseller. \"He called the company Amazon because he wanted it to be the biggest retailer in the world, so he named it after the biggest river in the world,\" she says. \"That projects a certain kind of optimism about where we're going and what we have in mind and what we're able to accomplish.\"\u003c/p>\n\u003cp>Despite many years when Amazon made no profit, Bezos drew investors and in turn he expanded and got more customers.\u003c/p>\n\u003cp>Secrecy is also part of the tech world playbook — no studies needed. Google keeps its search algorithms secret — as a way to keep them out of the hands of competitors.\u003c/p>\n\u003cp>\"So there are so many things going on in our firm and we're not telling you about them and that's part of the allure and the mystique of the organization,\" says Pozner. \"That keeps people excited about what's coming next.\"\u003c/p>\n\u003cp>This is totally contrary to how the medical and biotech fields work — studies are published in journals and reviewed by peers and products require government approval. This may gum up the works of Silicon Valley's fast-paced innovation economy, but it's for a good reason, says Stanford's Ioannidis.\u003c/p>\n\u003cp>\"It's not such a horrible thing if your mobile phone battery dies an hour earlier than it's supposed to,\" he says. \"But if a patient gets given the wrong results and then going down the path of making wrong decisions, that's serious. People can lose their lives.\"\u003c/p>\n\u003cp>As for Theranos and Elizabeth Holmes — the company is \u003ca href=\"http://www.bloomberg.com/news/articles/2016-04-18/theranos-is-under-investigation-by-sec-u-s-attorney-s-office\">facing scrutiny\u003c/a> from the Securities and Exchange Commission and the U.S. Attorney's Office for the Northern District of California. Some Theranos supporters believe in the end Holmes will turn out to be right.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Meanwhile, venture capital dollars going into biotech rose nearly 20 percent between 2014 and 2015. Perhaps this round of funding will come with less hype and more scrutiny.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Biotech%27s+Theranos+Offers+A+Cautionary+Tale+For+Silicon+Valley&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Elizabeth Holmes fit into the Silicon Valley success mold. A young Stanford dropout who left school to pursue her entrepreneurial vision, she founded Theranos and said she would disrupt the world of medicine with easy and inexpensive blood tests.\u003c/p>\n\u003caside class=\"pullquote alignright\">In Silicon Valley, secrecy and raising big money before achieving results are par for the course. Not so in the world of biomed.\u003c/aside>\n\u003cp>But now her company is \u003ca href=\"http://www.npr.org/2016/04/19/474868428/innovative-blood-testing-company-theranos-under-criminal-investigation\">under federal investigation\u003c/a> and extra scrutiny \u003ca href=\"http://www.latimes.com/business/la-fi-theranos-investigations-20160419-story.html\">by federal regulators\u003c/a>. And questions are being raised about whether applying hardware and software business culture to biotechnology is dangerous.\u003c/p>\n\u003cp>Holmes was an alluring figure; young and intense in the kind of way Apple founder Steve Jobs was. Like Jobs, she wore \u003ca href=\"http://www.glamour.com/story/theranos-founder-elizabeth-holmes-career-advice\">only black turtlenecks\u003c/a> because she didn't have time to think about her wardrobe.\u003c/p>\n\u003cp>And of course, there was \u003ca href=\"http://www.tedmed.com/talks/show?id=309114\">the TED talk\u003c/a> in which Holmes painted a picture of a world in which too many people avoided blood tests because of the cost, inconvenience and discomfort of giving so much blood. Sometimes they learned too late about a serious health condition. But, her company — \u003ca href=\"https://www.theranos.com/\">Theranos\u003c/a> — had the solution.\u003c/p>\n\u003cp>\"We've made it possible to run comprehensive laboratory tests from a tiny sample or a few drops of blood that could be taken from a finger,\" she told the audience.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Holmes had a beautiful vision, backed by hundreds of millions of dollars in investment, and \u003ca href=\"https://www.theranos.com/leadership\">a board of big names\u003c/a> like Henry Kissinger and George P. Schulz. The media had a love fest. \u003cem>Time\u003c/em> magazine called Holmes \u003ca href=\"http://time.com/3822734/elizabeth-holmes-2015-time-100/\">one of the 100 most influential people\u003c/a> in the world. She was profiled in \u003ca href=\"http://fortune.com/2014/06/12/theranos-blood-holmes/\">Fortune\u003c/a> and \u003ca href=\"http://www.newyorker.com/magazine/2014/12/15/blood-simpler\">The New Yorker\u003c/a>. Even medical professionals like \u003ca href=\"http://www.businessinsider.com/scientist-skeptical-thranos-blood-test-elizabeth-holmes-2015-6\">Dr. John Ioannidis\u003c/a>, a professor at Stanford University Medical School were intrigued.\u003c/p>\n\u003caside class=\"pullquote alignright\">“This is equivalent to me, being a biomedical researcher, trying to become an architect and build a skyscraper. Would you give me a few billion dollars please?”\u003ccite> Dr. John Ioannidis, Stanford Medical School professor\u003c/cite>\u003c/aside>\n\u003cp>\"My first reaction was, it sounds really brilliant,\" Ioannides says. \"I would like to collaborate with these people and maybe even use their technology in my own studies.\" Studies — that's what medicine and science is built upon.\u003c/p>\n\u003cp>\"So the first thing that I did as a researcher, as a scientist is check the scientific literature,\" says Ioannidis. \"How much do we know about what they do? And I couldn't find even a single paper.\"\u003c/p>\n\u003cp>Then there was the advisory board: big names in politics, not science. And Holmes had no background in medicine. \"This is equivalent to me, being a biomedical researcher, trying to become an architect and build a skyscraper. Would you give me a few billion dollars please?\"\u003c/p>\n\u003cp>Of course, no one would give him a few billion dollars.\u003c/p>\n\u003cp>But in the tech world, maybe they would. Jo-Ellen Pozner, a professor at the University of California, Berkeley Haas School of Business, says some of the greatest companies were built on hype and a big idea.\u003c/p>\n\u003cp>\"Often the product comes after the money, and so the first job is to get the investors to give you the money and that requires that you really sell them on this big idea before it's actually in hand,\" Pozner says.\u003c/p>\n\u003cp>Pozner points to \u003ca href=\"http://www.npr.org/sections/theprotojournalist/2014/01/08/260457752/can-jeff-bezos-save-planet-earth\">Jeff Bezos\u003c/a> and his company Amazon, which started as an online bookseller. \"He called the company Amazon because he wanted it to be the biggest retailer in the world, so he named it after the biggest river in the world,\" she says. \"That projects a certain kind of optimism about where we're going and what we have in mind and what we're able to accomplish.\"\u003c/p>\n\u003cp>Despite many years when Amazon made no profit, Bezos drew investors and in turn he expanded and got more customers.\u003c/p>\n\u003cp>Secrecy is also part of the tech world playbook — no studies needed. Google keeps its search algorithms secret — as a way to keep them out of the hands of competitors.\u003c/p>\n\u003cp>\"So there are so many things going on in our firm and we're not telling you about them and that's part of the allure and the mystique of the organization,\" says Pozner. \"That keeps people excited about what's coming next.\"\u003c/p>\n\u003cp>This is totally contrary to how the medical and biotech fields work — studies are published in journals and reviewed by peers and products require government approval. This may gum up the works of Silicon Valley's fast-paced innovation economy, but it's for a good reason, says Stanford's Ioannidis.\u003c/p>\n\u003cp>\"It's not such a horrible thing if your mobile phone battery dies an hour earlier than it's supposed to,\" he says. \"But if a patient gets given the wrong results and then going down the path of making wrong decisions, that's serious. People can lose their lives.\"\u003c/p>\n\u003cp>As for Theranos and Elizabeth Holmes — the company is \u003ca href=\"http://www.bloomberg.com/news/articles/2016-04-18/theranos-is-under-investigation-by-sec-u-s-attorney-s-office\">facing scrutiny\u003c/a> from the Securities and Exchange Commission and the U.S. Attorney's Office for the Northern District of California. Some Theranos supporters believe in the end Holmes will turn out to be right.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Meanwhile, venture capital dollars going into biotech rose nearly 20 percent between 2014 and 2015. Perhaps this round of funding will come with less hype and more scrutiny.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Biotech%27s+Theranos+Offers+A+Cautionary+Tale+For+Silicon+Valley&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Robots Are Now Handling Pills. Will Pharmacists Be Liberated or Out of Work?",
"title": "Robots Are Now Handling Pills. Will Pharmacists Be Liberated or Out of Work?",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>One of the most important things a pharmacist does after five or six years of training is make sure you get the correct number of pills in the correct dosage.\u003c/p>\n\u003cp>Now, it seems, robots are better at doing that than people. Even trained pharmacist people. Actually, it's a perfect job for a robot: a repetitive and mundane task.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Automation has led to the ability for us to reinvent ourselves as a profession, and we need to take the challenge.'\u003ccite>Dr. Marilyn Stebbins, UCSF\u003c/cite>\u003c/aside>\n\u003cp>And artificial intelligence has finally matured to the point where doctors trust robots (with human supervision) to do it. For five years now, the UCSF Medical Center has relied on an automated “robot pharmacy” to fill prescriptions, and a fleet of thousands of autonomous bots to deliver them.\u003c/p>\n\u003cp>Rita Jew, director of the UCSF program, says the robots have worked for five years with 100% accuracy.\u003c/p>\n\u003cp>Humans are involved only to stock the medications in the canisters that the robots pluck off a rack, and to grab the packaged and labeled medications the robot spits out and send it on its way.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And if the meds are going to a patient in the hospital, a human might hand them off to a \u003ca href=\"http://ww2.kqed.org/futureofyou/2016/03/01/hospital-uses-robots-instead-of-people-to-cart-things-around/\" target=\"_blank\">Tug robot\u003c/a> that rolls around the hospital from floor to floor, dropping off prescriptions at each nurse’s station.\u003c/p>\n\u003cp>The job of finding medications and dispensing the right amount for the right patient, is called “pulling” drugs. There used to be seven pharmacy technicians pulling drugs, with three to four pharmacists supervising them. Now, Jew says she needs at most two technicians to interface with the bots, and the other techs were reassigned to work such as collecting medication history\u003c/p>\n\u003cfigure id=\"attachment_121044\" class=\"wp-caption aligncenter\" style=\"max-width: 770px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/03/tug.jpg\">\u003cimg class=\"size-full wp-image-121044\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/03/tug.jpg\" alt=\"A tug enters the kitchen of the UCSF Benioff Children’s Hospital in San Francisco. \" width=\"770\" height=\"514\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/03/tug.jpg 770w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/tug-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/tug-768x513.jpg 768w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A tug enters the kitchen of the UCSF Benioff Children’s Hospital in San Francisco. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Robots are faster and more accurate than people—a recent \u003ca href=\"http://www.ajhp.org/content/72/17/1471.abstract\">study\u003c/a> from a medical center in Houston found that in one year their pharmacists made an average of almost five medication errors for every 100,000 prescriptions. That’s not a lot, but it’s a lot more than zero.\u003c/p>\n\u003cp>\u003cstrong>Will Robots Replace Pharmacists?\u003c/strong>\u003c/p>\n\u003cp>This bionic competition has some pharmacists worried about whether humans have a role in the future of their profession. A paper published in the American Journal of Pharmacy Education last year warned of a potential glut of more than 40,000 pharmacy school grads by 2022.\u003c/p>\n\u003cp>“Technology and automation are going to do a whole lot of things that the traditional pharmacist has done,” says Dr. Marilyn Stebbins, a pharmacy professor and vice-chair of clinical innovation at UCSF. “If the pharmacists don’t prove their value outside of their existing roles, automation will win because ultimately it will be cheaper.”\u003c/p>\n\u003cp>That means pharmacists need to carve out new niches robots can’t fill.\u003c/p>\n\u003cp>California lawmakers recently \u003ca href=\"http://www.leginfo.ca.gov/pub/13-14/bill/sen/sb_0451-0500/sb_493_bill_20131001_chaptered.html\" target=\"_blank\">authorized pharmacists\u003c/a> who have certain levels of training and experience to prescribe medications, including nicotine replacements and hormonal birth control, and take a more active role in primary care.\u003c/p>\n\u003cp>[contextly_sidebar id=\"bM52RWQkoiFSagHpIhxBjL4WpsA39bOf\"]This means the person behind the counter at Walgreens would be able to help patients quit smoking, or review their full medical record to make sure they’re getting the best medication for their condition.\u003c/p>\n\u003cp>“It’s kind of a pivot in the role of the pharmacist but it’s up to us to take this opportunity,” says Dr. Lisa Kroon, a clinical pharmacy professor at UCSF.\u003c/p>\n\u003cp>But so far this new role doesn’t come with any extra pay for extra services. The new law doesn’t include regulations to allow pharmacists to be paid for their services. Pharmacists are still reimbursed just for the products they provide. So Stebbins says pharmacists' potential to fill gaps in the healthcare system may remain untapped until there's some way to pay them for it.\u003c/p>\n\u003cp>\u003cstrong>Facing a New Future\u003c/strong>\u003c/p>\n\u003cp>Kroon has been practicing for 20 years, and she says pharmacists have been talking about the “threat” of automation for as long as she can remember. But she says this is the wrong way to think about technology.\u003c/p>\n\u003cp>“Our stand here at our school is if [dispensing medication] is all you want to do, don’t come to this school,” Kroon says.\u003c/p>\n\u003cp>One innovation Stebbins is working on is an app that allows patients to track their blood pressure and other vital signs.\u003c/p>\n\u003cp>The data are then shared with both their doctor and pharmacist—but it’s the pharmacist who would be responsible for checking in with patients, tracking their data, making sure they’re taking their medication and monitoring whether the medication is working.\u003c/p>\n\u003cfigure id=\"attachment_153717\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/04/robotic-pharmacy-main_0.jpg\">\u003cimg class=\"size-medium wp-image-153717\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/04/robotic-pharmacy-main_0-800x533.jpg\" alt=\"Pharmacy resident Oliver Hsu photographs medication expiration dates.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/04/robotic-pharmacy-main_0-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/robotic-pharmacy-main_0-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/robotic-pharmacy-main_0-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/robotic-pharmacy-main_0-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/robotic-pharmacy-main_0-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/robotic-pharmacy-main_0-960x640.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Pharmacy resident Oliver Hsu photographs medication expiration dates. \u003ccite>(Susan Merrell/UCSF)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“The pharmacist is the ultimate medication manager,” Stebbins says. “That’s what our training is all about.”\u003c/p>\n\u003cp>Stebbins has also helped develop a new automated call service, in which patients get a phone call within the first two days after they leave the hospital, asking if they have questions about their medication. If they do, Stebbins gets a text or email and she or one of her team of pharmacy students can respond to the patient’s concerns.\u003c/p>\n\u003cp>Getting the pharmacist involved sooner through services like this call service, frees up more time for the physician to focus on other aspects of the patient’s recovery.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“People have to embrace technology, and not fear it,” she says. “The ultimate thing is that automation has led to the ability for us to reinvent ourselves as a profession, and we need to take the challenge.”\u003c/p>\n\n",
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"excerpt": "Robots can fill prescriptions with more accuracy than humans, leaving pharmacists to reimagine their role.\r\n",
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"description": "Robots can fill prescriptions with more accuracy than humans, leaving pharmacists to reimagine their role.\r\n",
"title": "Robots Are Now Handling Pills. Will Pharmacists Be Liberated or Out of Work? | KQED",
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"headline": "Robots Are Now Handling Pills. Will Pharmacists Be Liberated or Out of Work?",
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"slug": "when-a-robot-counts-out-your-pills-what-will-your-pharmacist-do",
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"source": "Big Ideas",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>One of the most important things a pharmacist does after five or six years of training is make sure you get the correct number of pills in the correct dosage.\u003c/p>\n\u003cp>Now, it seems, robots are better at doing that than people. Even trained pharmacist people. Actually, it's a perfect job for a robot: a repetitive and mundane task.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Automation has led to the ability for us to reinvent ourselves as a profession, and we need to take the challenge.'\u003ccite>Dr. Marilyn Stebbins, UCSF\u003c/cite>\u003c/aside>\n\u003cp>And artificial intelligence has finally matured to the point where doctors trust robots (with human supervision) to do it. For five years now, the UCSF Medical Center has relied on an automated “robot pharmacy” to fill prescriptions, and a fleet of thousands of autonomous bots to deliver them.\u003c/p>\n\u003cp>Rita Jew, director of the UCSF program, says the robots have worked for five years with 100% accuracy.\u003c/p>\n\u003cp>Humans are involved only to stock the medications in the canisters that the robots pluck off a rack, and to grab the packaged and labeled medications the robot spits out and send it on its way.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And if the meds are going to a patient in the hospital, a human might hand them off to a \u003ca href=\"http://ww2.kqed.org/futureofyou/2016/03/01/hospital-uses-robots-instead-of-people-to-cart-things-around/\" target=\"_blank\">Tug robot\u003c/a> that rolls around the hospital from floor to floor, dropping off prescriptions at each nurse’s station.\u003c/p>\n\u003cp>The job of finding medications and dispensing the right amount for the right patient, is called “pulling” drugs. There used to be seven pharmacy technicians pulling drugs, with three to four pharmacists supervising them. Now, Jew says she needs at most two technicians to interface with the bots, and the other techs were reassigned to work such as collecting medication history\u003c/p>\n\u003cfigure id=\"attachment_121044\" class=\"wp-caption aligncenter\" style=\"max-width: 770px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/03/tug.jpg\">\u003cimg class=\"size-full wp-image-121044\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/03/tug.jpg\" alt=\"A tug enters the kitchen of the UCSF Benioff Children’s Hospital in San Francisco. \" width=\"770\" height=\"514\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/03/tug.jpg 770w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/tug-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/tug-768x513.jpg 768w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A tug enters the kitchen of the UCSF Benioff Children’s Hospital in San Francisco. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Robots are faster and more accurate than people—a recent \u003ca href=\"http://www.ajhp.org/content/72/17/1471.abstract\">study\u003c/a> from a medical center in Houston found that in one year their pharmacists made an average of almost five medication errors for every 100,000 prescriptions. That’s not a lot, but it’s a lot more than zero.\u003c/p>\n\u003cp>\u003cstrong>Will Robots Replace Pharmacists?\u003c/strong>\u003c/p>\n\u003cp>This bionic competition has some pharmacists worried about whether humans have a role in the future of their profession. A paper published in the American Journal of Pharmacy Education last year warned of a potential glut of more than 40,000 pharmacy school grads by 2022.\u003c/p>\n\u003cp>“Technology and automation are going to do a whole lot of things that the traditional pharmacist has done,” says Dr. Marilyn Stebbins, a pharmacy professor and vice-chair of clinical innovation at UCSF. “If the pharmacists don’t prove their value outside of their existing roles, automation will win because ultimately it will be cheaper.”\u003c/p>\n\u003cp>That means pharmacists need to carve out new niches robots can’t fill.\u003c/p>\n\u003cp>California lawmakers recently \u003ca href=\"http://www.leginfo.ca.gov/pub/13-14/bill/sen/sb_0451-0500/sb_493_bill_20131001_chaptered.html\" target=\"_blank\">authorized pharmacists\u003c/a> who have certain levels of training and experience to prescribe medications, including nicotine replacements and hormonal birth control, and take a more active role in primary care.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>This means the person behind the counter at Walgreens would be able to help patients quit smoking, or review their full medical record to make sure they’re getting the best medication for their condition.\u003c/p>\n\u003cp>“It’s kind of a pivot in the role of the pharmacist but it’s up to us to take this opportunity,” says Dr. Lisa Kroon, a clinical pharmacy professor at UCSF.\u003c/p>\n\u003cp>But so far this new role doesn’t come with any extra pay for extra services. The new law doesn’t include regulations to allow pharmacists to be paid for their services. Pharmacists are still reimbursed just for the products they provide. So Stebbins says pharmacists' potential to fill gaps in the healthcare system may remain untapped until there's some way to pay them for it.\u003c/p>\n\u003cp>\u003cstrong>Facing a New Future\u003c/strong>\u003c/p>\n\u003cp>Kroon has been practicing for 20 years, and she says pharmacists have been talking about the “threat” of automation for as long as she can remember. But she says this is the wrong way to think about technology.\u003c/p>\n\u003cp>“Our stand here at our school is if [dispensing medication] is all you want to do, don’t come to this school,” Kroon says.\u003c/p>\n\u003cp>One innovation Stebbins is working on is an app that allows patients to track their blood pressure and other vital signs.\u003c/p>\n\u003cp>The data are then shared with both their doctor and pharmacist—but it’s the pharmacist who would be responsible for checking in with patients, tracking their data, making sure they’re taking their medication and monitoring whether the medication is working.\u003c/p>\n\u003cfigure id=\"attachment_153717\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/04/robotic-pharmacy-main_0.jpg\">\u003cimg class=\"size-medium wp-image-153717\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/04/robotic-pharmacy-main_0-800x533.jpg\" alt=\"Pharmacy resident Oliver Hsu photographs medication expiration dates.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/04/robotic-pharmacy-main_0-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/robotic-pharmacy-main_0-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/robotic-pharmacy-main_0-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/robotic-pharmacy-main_0-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/robotic-pharmacy-main_0-1920x1280.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/04/robotic-pharmacy-main_0-960x640.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Pharmacy resident Oliver Hsu photographs medication expiration dates. \u003ccite>(Susan Merrell/UCSF)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“The pharmacist is the ultimate medication manager,” Stebbins says. “That’s what our training is all about.”\u003c/p>\n\u003cp>Stebbins has also helped develop a new automated call service, in which patients get a phone call within the first two days after they leave the hospital, asking if they have questions about their medication. If they do, Stebbins gets a text or email and she or one of her team of pharmacy students can respond to the patient’s concerns.\u003c/p>\n\u003cp>Getting the pharmacist involved sooner through services like this call service, frees up more time for the physician to focus on other aspects of the patient’s recovery.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“People have to embrace technology, and not fear it,” she says. “The ultimate thing is that automation has led to the ability for us to reinvent ourselves as a profession, and we need to take the challenge.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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},
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
"airtime": "SAT 4pm-5pm",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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"link": "/radio/program/reveal",
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"rss": "http://feeds.revealradio.org/revealpodcast"
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
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