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"content": "\u003cp>Let's say you're a pregnant woman who recently traveled to Latin America or the Caribbean. You got a little sick shortly after the trip, with some combination of mild fever, rash, joint pain and conjunctivitis. The big question now is: Did you have Zika virus? And, if so, is your fetus still healthy?\u003c/p>\n\u003caside class=\"pullquote alignright\">One test has a particularly nasty drawback: It sometimes tells people they have the Zika virus when they don't.\u003c/aside>\n\u003cp>Probably every day, patients come in questioning whether or not they would qualify for testing,\" says \u003ca href=\"http://www.umiamihospital.com/doctors/profile/137788\">Dr. Christine Curry\u003c/a>, an obstetrician-gynecologist at the University of Miami, and Jackson Memorial Hospital.\u003c/p>\n\u003cp>A \u003ca href=\"http://www.npr.org/sections/health-shots/2016/03/04/469179452/study-finds-multiple-problems-in-fetuses-exposed-to-zika-virus\">preliminary study\u003c/a> in Brazil makes a strong case for the link between Zika virus infection during pregnancy and a number of birth defects, including microcephaly. The infection has been \u003ca href=\"http://www.cdc.gov/mmwr/volumes/65/wr/mm6508e1.htm\">associated\u003c/a> with a range of outcomes in another study of nine U.S. women who caught the virus while traveling to regions where Zika is prevalent.\u003c/p>\n\u003cp>If a patient has a particular \u003ca href=\"http://www.cdc.gov/zika/hc-providers/qa-pregnant-women.html\">travel history\u003c/a>, Curry sends a sample of the woman's blood to a lab for analysis. But it can take awhile for test results to come back, Curry says, and the waiting can be really stressful, especially for patients in the middle of a pregnancy.\u003c/p>\n\u003cp>\"They're trying to decide what to do with the pregnancy, given so many unknowns,\" she says. \"The difference between two and four weeks can be the difference between being able to end a pregnancy and not.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There's another problem: Some tests aren't very reliable, so patients sometimes have to go through \u003ca href=\"http://www.cdc.gov/zika/hc-providers/diagnostic.html\">multiple rounds\u003c/a> to confirm whether they had Zika. That puts Curry in a tricky situation when she's counseling patients.\u003c/p>\n\u003cp>\"It involves saying 'I don't know' and 'no one knows' over and over again,\" she says.\u003c/p>\n\u003cp>Until recently, most samples of fluids from patients had to be sent to Atlanta for testing by the Centers for Disease Control and Prevention. Now, about 30 local \u003ca href=\"http://dfs.dc.gov/page/public-health-laboratory-division-phl\">public health labs\u003c/a> are gearing up to do the analysis themselves, including the District of Columbia's department of forensic sciences, where Cleveland Weeden works as a medical technologist.\u003c/p>\n\u003cp>Most days, Weeden says, he feels like an athlete stuck on the bench. Outbreaks are exciting, in a way, because he finally gets to put his expertise and skills to work.\u003c/p>\n\u003cp>\"We're the bench,\" Weeden says. \"We get called into action when something goes on in the city.\"\u003c/p>\n\u003cp>A refrigerator behind Weeden holds plastic baggies with tubes of blood and urine from patients in the area. As of this week, his job is to test all these samples for Zika virus.\u003c/p>\n\u003cp>Weeden expects to get the results to patients within three days, rather than four weeks. He's running a procedure called \u003ca href=\"http://www.bio.davidson.edu/people/kabernd/seminar/2002/method/lowry/rtpcr.htm\">RT-PCR\u003c/a> – or Reverse Transcription-Polymerase Chain Reaction. The CDC has produced about 375,000 kits that can perform this test. It looks for pieces of the virus' genetic material and answers \"yes\" or \"no\" to the question: \"Is there virus in this person's blood?\"\u003c/p>\n\u003cp>Weeden says the test is pretty straightforward — except for one thing.\u003c/p>\n\u003cp>\"From the time the person is bitten [by an infected mosquito] to the time they get to the doctor, no more than five to seven days can pass for us to [be able to] pick it up on PCR,\" he says.\u003c/p>\n\u003cp>That means that if PCR is to work, doctors have to collect patients' blood within a week of the first signs of a fever and rash. The virus hangs around a little longer in urine, so doctors would have a slightly longer window of time — about two weeks — to collect those samples. But there's an extra complication, Curry says: Most patients don't rush to the doctor when their illness is mild.\u003c/p>\n\u003cp>\"If someone had virus in their blood three weeks ago and they're now cleared, the PCR's not going to tell you that,\" she says. In that case, a negative result could mean either that the person never had Zika, or that their body had already cleared it from their system by the time they got tested.\u003c/p>\n\u003cp>That's why labs like Weeden's are trying to get hold of another kind of test that the CDC developed, which goes by yet another bulky acronym — the \u003ca href=\"http://www.cdc.gov/zika/state-labs/\">Zika MAC-ELISA\u003c/a>. This test looks for a protein in a person's blood — a specific type of antibody — that shows what foreign things the body has fought off recently.\u003c/p>\n\u003cp>The Zika MAC-ELISA is widely seen as the best test available, right now, because it works over a longer time span than the first option. It's also faster and cheaper than another more definitive test, and requires less specialized training to perform. According to the CDC, Zika antibodies appear in the blood \"starting 4 to 5 days after the start of illness and last for up to 12 weeks,\" \u003ca href=\"http://www.cdc.gov/zika/pdfs/zika-mac-elisa-fact-sheet-for-patients.pdf\">or even longer\u003c/a> in some people.\u003c/p>\n\u003cp>The CDC has produced about 100,000 of these test kits, and is offering them free to \u003ca href=\"http://emergency.cdc.gov/lrn/\">qualified labs\u003c/a>. But there's one drawback: The test sometimes tells people they had Zika when they didn't.\u003c/p>\n\u003cp>An ideal test, all agree, would be specific to this particular virus and give a faster turnaround time — eliminating the need for the manpower, money and time required to go through the current layers of testing.\u003c/p>\n\u003cp>It's not just pregnant women who would benefit from a better test — so would patients who need blood transfusions in places like Puerto Rico, where health officials have been worried that patients might accidentally get Zika during transfusions with infected blood. So the officials have stopped accepting local donations and, instead, are now getting blood \u003ca href=\"http://www.hhs.gov/about/news/2016/03/07/hhs-ships-blood-products-puerto-rico-response-zika-outbreak.html\">shipped in\u003c/a> from the continental U.S.\u003c/p>\n\u003cp>The third, more definitive, test is called \u003ca href=\"http://www.cdc.gov/zika/pdfs/denvchikvzikv-testing-algorithm.pdf\">PRNT\u003c/a>, or the plaque-reduction neutralization test. Because PRNT is expensive and takes at least a week longer to do than the Zika MAC-ELISA, the ELISA test is widely considered the more practical option in many cases.\u003c/p>\n\u003cp>\"And herein lies where science needs to innovate a bit,\" says \u003ca href=\"http://www.niaid.nih.gov/labsandresources/labs/aboutlabs/lvd/viralpathogenesissection/Pages/default.aspx\">Ted Pierson\u003c/a>, a virologist and senior investigator at the National Institute of Allergy and Infectious Diseases.\u003c/p>\n\u003cp>Sometime in December, Pierson and colleagues in his molecular virology lab dropped their work on dengue virus so they could press the pedal to the metal on Zika. Pierson's work doesn't focus on pregnant women or blood transfusions.\u003c/p>\n\u003cp>\"I am focused on amino acids, hydroxyls and phosphates,\" he explains. His team is trying to figure out how to make a better version of the antibody test — the Zika MAC-ELISA test the CDC is distributing to labs.\u003c/p>\n\u003cp>\"The problem here is actually quite simple,\" Pierson explains. Viruses in the same family — in Zika's case, the \u003ca href=\"http://www.cdc.gov/vhf/virus-families/flaviviridae.html\">flaviviruses\u003c/a>\u003cem> — \u003c/em>can look similar on the outside, and the antibodies the human immune system uses to fight them can also be similar.\u003c/p>\n\u003cp>So, if a person had been infected sometime along the way with another mosquito-borne virus in that family, like dengue or West Nile — or even if they simply had been vaccinated against yellow fever — they could test positive in a Zika antibody test.\u003c/p>\n\u003cp>\"It's a good example of where the devil is in the details,\" Pierson says, and those details are what he and his colleagues are delving into now.\u003c/p>\n\u003cp>\"What we, as a field, need to do is develop antigens that allow us to distinguish between the antibodies specific to Zika, versus those for other flaviviruses,\" he says.\u003c/p>\n\u003cp>The group is essentially stripping down the virus to figure out what is unique to Zika — what distinguishes it from related viruses. The researchers are particularly interested in proteins, like the \"fusion loop,\" that lie on top of the virus and help it enter a human cell. Once those unique parts are identified, it might be possible to create a more specific test that has much lower odds of triggering false positives.\u003c/p>\n\u003cp>That could take days to figure out — or months, Pierson says.\u003c/p>\n\u003cp>\"You just can't predict,\" he says. \"This is science. We just have to do the experiments.\"\u003c/p>\n\u003cp>In the meantime, people across the country who have jobs like Cleveland Weeden's will be working long days.\u003c/p>\n\u003cp>\"You get physically tired,\" Weeden admits. \"We're not robots. Your hands cramp up after you pipette so much. But that's what we're here for. We're public health scientists.\"\u003c/p>\n\u003cp>As the weather warms and mosquitoes start flying around, these scientists will keep on testing with — they hope — better and better tools.\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=How+Best+To+Test+For+Zika+Virus%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Let's say you're a pregnant woman who recently traveled to Latin America or the Caribbean. You got a little sick shortly after the trip, with some combination of mild fever, rash, joint pain and conjunctivitis. The big question now is: Did you have Zika virus? And, if so, is your fetus still healthy?\u003c/p>\n\u003caside class=\"pullquote alignright\">One test has a particularly nasty drawback: It sometimes tells people they have the Zika virus when they don't.\u003c/aside>\n\u003cp>Probably every day, patients come in questioning whether or not they would qualify for testing,\" says \u003ca href=\"http://www.umiamihospital.com/doctors/profile/137788\">Dr. Christine Curry\u003c/a>, an obstetrician-gynecologist at the University of Miami, and Jackson Memorial Hospital.\u003c/p>\n\u003cp>A \u003ca href=\"http://www.npr.org/sections/health-shots/2016/03/04/469179452/study-finds-multiple-problems-in-fetuses-exposed-to-zika-virus\">preliminary study\u003c/a> in Brazil makes a strong case for the link between Zika virus infection during pregnancy and a number of birth defects, including microcephaly. The infection has been \u003ca href=\"http://www.cdc.gov/mmwr/volumes/65/wr/mm6508e1.htm\">associated\u003c/a> with a range of outcomes in another study of nine U.S. women who caught the virus while traveling to regions where Zika is prevalent.\u003c/p>\n\u003cp>If a patient has a particular \u003ca href=\"http://www.cdc.gov/zika/hc-providers/qa-pregnant-women.html\">travel history\u003c/a>, Curry sends a sample of the woman's blood to a lab for analysis. But it can take awhile for test results to come back, Curry says, and the waiting can be really stressful, especially for patients in the middle of a pregnancy.\u003c/p>\n\u003cp>\"They're trying to decide what to do with the pregnancy, given so many unknowns,\" she says. \"The difference between two and four weeks can be the difference between being able to end a pregnancy and not.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There's another problem: Some tests aren't very reliable, so patients sometimes have to go through \u003ca href=\"http://www.cdc.gov/zika/hc-providers/diagnostic.html\">multiple rounds\u003c/a> to confirm whether they had Zika. That puts Curry in a tricky situation when she's counseling patients.\u003c/p>\n\u003cp>\"It involves saying 'I don't know' and 'no one knows' over and over again,\" she says.\u003c/p>\n\u003cp>Until recently, most samples of fluids from patients had to be sent to Atlanta for testing by the Centers for Disease Control and Prevention. Now, about 30 local \u003ca href=\"http://dfs.dc.gov/page/public-health-laboratory-division-phl\">public health labs\u003c/a> are gearing up to do the analysis themselves, including the District of Columbia's department of forensic sciences, where Cleveland Weeden works as a medical technologist.\u003c/p>\n\u003cp>Most days, Weeden says, he feels like an athlete stuck on the bench. Outbreaks are exciting, in a way, because he finally gets to put his expertise and skills to work.\u003c/p>\n\u003cp>\"We're the bench,\" Weeden says. \"We get called into action when something goes on in the city.\"\u003c/p>\n\u003cp>A refrigerator behind Weeden holds plastic baggies with tubes of blood and urine from patients in the area. As of this week, his job is to test all these samples for Zika virus.\u003c/p>\n\u003cp>Weeden expects to get the results to patients within three days, rather than four weeks. He's running a procedure called \u003ca href=\"http://www.bio.davidson.edu/people/kabernd/seminar/2002/method/lowry/rtpcr.htm\">RT-PCR\u003c/a> – or Reverse Transcription-Polymerase Chain Reaction. The CDC has produced about 375,000 kits that can perform this test. It looks for pieces of the virus' genetic material and answers \"yes\" or \"no\" to the question: \"Is there virus in this person's blood?\"\u003c/p>\n\u003cp>Weeden says the test is pretty straightforward — except for one thing.\u003c/p>\n\u003cp>\"From the time the person is bitten [by an infected mosquito] to the time they get to the doctor, no more than five to seven days can pass for us to [be able to] pick it up on PCR,\" he says.\u003c/p>\n\u003cp>That means that if PCR is to work, doctors have to collect patients' blood within a week of the first signs of a fever and rash. The virus hangs around a little longer in urine, so doctors would have a slightly longer window of time — about two weeks — to collect those samples. But there's an extra complication, Curry says: Most patients don't rush to the doctor when their illness is mild.\u003c/p>\n\u003cp>\"If someone had virus in their blood three weeks ago and they're now cleared, the PCR's not going to tell you that,\" she says. In that case, a negative result could mean either that the person never had Zika, or that their body had already cleared it from their system by the time they got tested.\u003c/p>\n\u003cp>That's why labs like Weeden's are trying to get hold of another kind of test that the CDC developed, which goes by yet another bulky acronym — the \u003ca href=\"http://www.cdc.gov/zika/state-labs/\">Zika MAC-ELISA\u003c/a>. This test looks for a protein in a person's blood — a specific type of antibody — that shows what foreign things the body has fought off recently.\u003c/p>\n\u003cp>The Zika MAC-ELISA is widely seen as the best test available, right now, because it works over a longer time span than the first option. It's also faster and cheaper than another more definitive test, and requires less specialized training to perform. According to the CDC, Zika antibodies appear in the blood \"starting 4 to 5 days after the start of illness and last for up to 12 weeks,\" \u003ca href=\"http://www.cdc.gov/zika/pdfs/zika-mac-elisa-fact-sheet-for-patients.pdf\">or even longer\u003c/a> in some people.\u003c/p>\n\u003cp>The CDC has produced about 100,000 of these test kits, and is offering them free to \u003ca href=\"http://emergency.cdc.gov/lrn/\">qualified labs\u003c/a>. But there's one drawback: The test sometimes tells people they had Zika when they didn't.\u003c/p>\n\u003cp>An ideal test, all agree, would be specific to this particular virus and give a faster turnaround time — eliminating the need for the manpower, money and time required to go through the current layers of testing.\u003c/p>\n\u003cp>It's not just pregnant women who would benefit from a better test — so would patients who need blood transfusions in places like Puerto Rico, where health officials have been worried that patients might accidentally get Zika during transfusions with infected blood. So the officials have stopped accepting local donations and, instead, are now getting blood \u003ca href=\"http://www.hhs.gov/about/news/2016/03/07/hhs-ships-blood-products-puerto-rico-response-zika-outbreak.html\">shipped in\u003c/a> from the continental U.S.\u003c/p>\n\u003cp>The third, more definitive, test is called \u003ca href=\"http://www.cdc.gov/zika/pdfs/denvchikvzikv-testing-algorithm.pdf\">PRNT\u003c/a>, or the plaque-reduction neutralization test. Because PRNT is expensive and takes at least a week longer to do than the Zika MAC-ELISA, the ELISA test is widely considered the more practical option in many cases.\u003c/p>\n\u003cp>\"And herein lies where science needs to innovate a bit,\" says \u003ca href=\"http://www.niaid.nih.gov/labsandresources/labs/aboutlabs/lvd/viralpathogenesissection/Pages/default.aspx\">Ted Pierson\u003c/a>, a virologist and senior investigator at the National Institute of Allergy and Infectious Diseases.\u003c/p>\n\u003cp>Sometime in December, Pierson and colleagues in his molecular virology lab dropped their work on dengue virus so they could press the pedal to the metal on Zika. Pierson's work doesn't focus on pregnant women or blood transfusions.\u003c/p>\n\u003cp>\"I am focused on amino acids, hydroxyls and phosphates,\" he explains. His team is trying to figure out how to make a better version of the antibody test — the Zika MAC-ELISA test the CDC is distributing to labs.\u003c/p>\n\u003cp>\"The problem here is actually quite simple,\" Pierson explains. Viruses in the same family — in Zika's case, the \u003ca href=\"http://www.cdc.gov/vhf/virus-families/flaviviridae.html\">flaviviruses\u003c/a>\u003cem> — \u003c/em>can look similar on the outside, and the antibodies the human immune system uses to fight them can also be similar.\u003c/p>\n\u003cp>So, if a person had been infected sometime along the way with another mosquito-borne virus in that family, like dengue or West Nile — or even if they simply had been vaccinated against yellow fever — they could test positive in a Zika antibody test.\u003c/p>\n\u003cp>\"It's a good example of where the devil is in the details,\" Pierson says, and those details are what he and his colleagues are delving into now.\u003c/p>\n\u003cp>\"What we, as a field, need to do is develop antigens that allow us to distinguish between the antibodies specific to Zika, versus those for other flaviviruses,\" he says.\u003c/p>\n\u003cp>The group is essentially stripping down the virus to figure out what is unique to Zika — what distinguishes it from related viruses. The researchers are particularly interested in proteins, like the \"fusion loop,\" that lie on top of the virus and help it enter a human cell. Once those unique parts are identified, it might be possible to create a more specific test that has much lower odds of triggering false positives.\u003c/p>\n\u003cp>That could take days to figure out — or months, Pierson says.\u003c/p>\n\u003cp>\"You just can't predict,\" he says. \"This is science. We just have to do the experiments.\"\u003c/p>\n\u003cp>In the meantime, people across the country who have jobs like Cleveland Weeden's will be working long days.\u003c/p>\n\u003cp>\"You get physically tired,\" Weeden admits. \"We're not robots. Your hands cramp up after you pipette so much. But that's what we're here for. We're public health scientists.\"\u003c/p>\n\u003cp>As the weather warms and mosquitoes start flying around, these scientists will keep on testing with — they hope — better and better tools.\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=How+Best+To+Test+For+Zika+Virus%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>BALTIMORE — There is little in Ruby’s life that is easy. Nearly blind and unable to walk more than a step or two, the 39-year-old struggles to raise three sons while dealing with a daunting array of health conditions, from diabetes that recently landed her in the hospital to pain from bulging spinal disks.\u003c/p>\n\u003cp>Without support, odds are she’ll end up back in a hospital. But Ruby, who asked that her last name not be used to protect her family’s privacy, is part of a growing effort to reduce those odds by arming home care aides and other non-medical workers with the power of data.\u003c/p>\n\u003caside class=\"pullquote alignright\">Companies are targeting non-medical caregivers in touting software designed to help spot potential medical problems and avoid hospitalization.\u003c/aside>\n\u003cp>On a recent Monday, health coach Nhaomie Douyon visited Ruby in the small, rented two-story row house where she lives with her children. Douyon works for the Coordinating Center, a Maryland-based nonprofit that helps organize medical and social needs for clients like Ruby, who live in designated medically underserved areas.\u003c/p>\n\u003cp>The two chatted in the living room, where a couch and chairs share the space with a bed. White curtains obscure the view outside, where small groups of young people cluster on front steps and some homes have boarded-up windows. Douyon, 28, came equipped with a tablet loaded with a software program that uses predictive analytics to generate patient-specific questions.\u003c/p>\n\u003cp>The software was developed by Care at Hand, a privately held firm that is among a small but growing number of companies touting products they say can help spot potential medical problems before they require hospitalization. The software was created for use by non-medical workers like Douyon and home care aides who care for millions of elderly, ill or disabled people.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Skeptics note that there are few studies confirming whether the technology accurately predicts problems, prevents hospitalizations or saves money. Still, the business has attracted the attention of venture capitalists and may lead to more health care applications for consumers.\u003c/p>\n\u003cp>Was Ruby having trouble paying for her medications? Did she feel nauseous? Were her ankles more swollen today? Those were some of the 15 questions the program Douyon’s agency uses generated for Ruby.\u003c/p>\n\u003cp>When she typed in Ruby’s answer that her ankles and legs were definitely more swollen, it triggered an alert to the nurse manager back at her office. Within a few minutes, nurse Chris Parsons called from the Coordinating Center’s headquarters, asked more questions and directed the pair to contact Ruby’s doctor’s office for medicine that might help. Try to elevate your feet, she told Ruby, and go to the emergency room if the swelling gets worse.\u003c/p>\n\u003cp>“It’s like bringing a pocket nurse Chris with you,” said Douyon, who is also studying for a master’s degree in public health and has previously worked for groups doing health outreach in Ghana and Haiti.\u003c/p>\n\u003cp>“It doesn’t just go through medical questions but asks about resources they might need and helps us pick up on certain red flags or the barriers they face,” she said of the tablet.\u003c/p>\n\u003cp>Another firm, eCaring, is aimed more squarely at home care aides and their agencies. The company’s software allows aides to note a patient’s well-being hour by hour, using colorful icons, such as a toothbrush for recording personal care activities and a happy or sad face for documenting their mental state. It, too, uses the information to predict which patients might be at high risk and send an alert back to a care manager.\u003c/p>\n\u003cp>“It’s a portrait of what is going on in the home,” said Robert Herzog, CEO and founder of eCaring, a privately held firm that has contracted with home care agencies in New York to use its software programs. “It transforms the home from a black box into a data-rich environment.”\u003c/p>\n\u003cp>Other firms, such as Honor in California and Hometeam in New York, offer more consumer-directed services, such as apps that home care aides use to log their daily observations. The companies have each drawn low, double-digit million dollar funding from well-known venture capitalists, including Marc Andreessen, a cofounder of the Silicon Valley venture firm Andreesen Horowitz, Yelp cofounder and CEO Jeremy Stoppelman, and emerging technology investor Lux Capital. The apps help families hire and schedule home care aides, and then keep the family informed about how mom is doing with texts, pictures and updates on daily activities.\u003c/p>\n\u003cp>One big question is who will pay for the technology? Agencies using programs aimed at consumers can build the cost into their home care services, charging consumers more than agencies that didn’t use the technology. Herzog at eCaring says his firm pays for the tablets and gets a low-cost data package for internet use — which the tablets require — from Verizon. It then builds those costs into its contracts with hospitals or insurers. The Coordinating Center, which uses Care at Hand in Baltimore and other locations in Maryland, similarly builds those costs into its contracts. It also receives grant money from the state and other agencies for its care coordination efforts.\u003c/p>\n\u003cp>Thomas Scully, the former top administrator at the Centers for Medicare & Medicaid Services and now an attorney who advises clients on health care issues and a general partner in a private investment firm, said the idea behind these firms is good. But, he added, their growth potential may be limited because the expense of the tablets and software will make the home care services more expensive. “All of this is part of the answer, but it has to show economic savings,” said Scully.\u003c/p>\n\u003cp>\u003cstrong>Watching For Evidence Of Success\u003c/strong>\u003c/p>\n\u003cp>Billions are spent nationally each year on avoidable hospital admissions, prompting measures to prevent more of them. The federal health law, for example, created financial incentives for hospitals to reduce readmissions.\u003c/p>\n\u003cp>The new software fits into this focus. But obstacles remain, including the big question of whether they actually work better than other efforts aimed at this goal.\u003c/p>\n\u003cp>The companies themselves — mainly small, privately held ventures — say they have data showing significant reduction in hospitalizations and costs.\u003c/p>\n\u003cp>“Non-medical workers are able to make some guided observations that predict if a patient will be at risk of going to a hospital,” said Andrey Ostrovsky, a doctor who is CEO and founder of Care at Hand.\u003c/p>\n\u003cp>For example, a study done by consulting firm Avalere, with Ostrovsky co-authoring, reviewed the records of more than 2,200 patients using the technology. It concluded that hospital admissions dropped 29 percent for patients who had three or more hospital visits the prior year. It showed an overall 14 percent decrease in admissions among all those studied.\u003c/p>\n\u003cp>But not everyone is convinced that arming home care workers with software programs will prove to be an effective strategy.\u003c/p>\n\u003cp>“It’s more theory than reality,” said Bob Kocher, a partner at Venrock, a venture capital firm in California. After reviewing the firms out there, Kocher said his firm decided not to invest yet, although “I have no doubt that 10 years from now, we will improve the training of home care workers and have much better diagnostic tools in the home — and it will work.”\u003c/p>\n\u003cp>Still, the ranks of elderly Americans are growing rapidly and most want to avoid nursing homes. “The industry is placing a big bet that technology will be the missing variable … to allow us to care for a large elderly population at home,” said Jared Landis, practice manager at the Advisory Board, a firm that consults with hospitals.\u003c/p>\n\u003cp>’Just One Tool’ In A Larger Effort\u003c/p>\n\u003cp>For Ruby, the tablet is just one piece of a much larger effort by the Coordinating Center, which has also enrolled her in the practice of a local primary care doctor, signed her up for an appointment at an eye clinic and is seeking an alternative to a medication she was prescribed that wasn’t included on her insurance plan.\u003c/p>\n\u003cp>She is motivated: “I want to be here to see my kids walk across the stage at high school graduation, to see when they have kids.”\u003c/p>\n\u003cp>That combination — a motivated patient and a broad effort to coordinate her care — may help prevent Ruby from returning to the hospital with high blood sugar levels or other problems.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“The tablet is just one tool. We were reducing readmissions without it, but when we implemented it, we were able to squeeze out a little more,” said Carol Marsiglia, senior vice president of strategic initiatives at the center.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>BALTIMORE — There is little in Ruby’s life that is easy. Nearly blind and unable to walk more than a step or two, the 39-year-old struggles to raise three sons while dealing with a daunting array of health conditions, from diabetes that recently landed her in the hospital to pain from bulging spinal disks.\u003c/p>\n\u003cp>Without support, odds are she’ll end up back in a hospital. But Ruby, who asked that her last name not be used to protect her family’s privacy, is part of a growing effort to reduce those odds by arming home care aides and other non-medical workers with the power of data.\u003c/p>\n\u003caside class=\"pullquote alignright\">Companies are targeting non-medical caregivers in touting software designed to help spot potential medical problems and avoid hospitalization.\u003c/aside>\n\u003cp>On a recent Monday, health coach Nhaomie Douyon visited Ruby in the small, rented two-story row house where she lives with her children. Douyon works for the Coordinating Center, a Maryland-based nonprofit that helps organize medical and social needs for clients like Ruby, who live in designated medically underserved areas.\u003c/p>\n\u003cp>The two chatted in the living room, where a couch and chairs share the space with a bed. White curtains obscure the view outside, where small groups of young people cluster on front steps and some homes have boarded-up windows. Douyon, 28, came equipped with a tablet loaded with a software program that uses predictive analytics to generate patient-specific questions.\u003c/p>\n\u003cp>The software was developed by Care at Hand, a privately held firm that is among a small but growing number of companies touting products they say can help spot potential medical problems before they require hospitalization. The software was created for use by non-medical workers like Douyon and home care aides who care for millions of elderly, ill or disabled people.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Skeptics note that there are few studies confirming whether the technology accurately predicts problems, prevents hospitalizations or saves money. Still, the business has attracted the attention of venture capitalists and may lead to more health care applications for consumers.\u003c/p>\n\u003cp>Was Ruby having trouble paying for her medications? Did she feel nauseous? Were her ankles more swollen today? Those were some of the 15 questions the program Douyon’s agency uses generated for Ruby.\u003c/p>\n\u003cp>When she typed in Ruby’s answer that her ankles and legs were definitely more swollen, it triggered an alert to the nurse manager back at her office. Within a few minutes, nurse Chris Parsons called from the Coordinating Center’s headquarters, asked more questions and directed the pair to contact Ruby’s doctor’s office for medicine that might help. Try to elevate your feet, she told Ruby, and go to the emergency room if the swelling gets worse.\u003c/p>\n\u003cp>“It’s like bringing a pocket nurse Chris with you,” said Douyon, who is also studying for a master’s degree in public health and has previously worked for groups doing health outreach in Ghana and Haiti.\u003c/p>\n\u003cp>“It doesn’t just go through medical questions but asks about resources they might need and helps us pick up on certain red flags or the barriers they face,” she said of the tablet.\u003c/p>\n\u003cp>Another firm, eCaring, is aimed more squarely at home care aides and their agencies. The company’s software allows aides to note a patient’s well-being hour by hour, using colorful icons, such as a toothbrush for recording personal care activities and a happy or sad face for documenting their mental state. It, too, uses the information to predict which patients might be at high risk and send an alert back to a care manager.\u003c/p>\n\u003cp>“It’s a portrait of what is going on in the home,” said Robert Herzog, CEO and founder of eCaring, a privately held firm that has contracted with home care agencies in New York to use its software programs. “It transforms the home from a black box into a data-rich environment.”\u003c/p>\n\u003cp>Other firms, such as Honor in California and Hometeam in New York, offer more consumer-directed services, such as apps that home care aides use to log their daily observations. The companies have each drawn low, double-digit million dollar funding from well-known venture capitalists, including Marc Andreessen, a cofounder of the Silicon Valley venture firm Andreesen Horowitz, Yelp cofounder and CEO Jeremy Stoppelman, and emerging technology investor Lux Capital. The apps help families hire and schedule home care aides, and then keep the family informed about how mom is doing with texts, pictures and updates on daily activities.\u003c/p>\n\u003cp>One big question is who will pay for the technology? Agencies using programs aimed at consumers can build the cost into their home care services, charging consumers more than agencies that didn’t use the technology. Herzog at eCaring says his firm pays for the tablets and gets a low-cost data package for internet use — which the tablets require — from Verizon. It then builds those costs into its contracts with hospitals or insurers. The Coordinating Center, which uses Care at Hand in Baltimore and other locations in Maryland, similarly builds those costs into its contracts. It also receives grant money from the state and other agencies for its care coordination efforts.\u003c/p>\n\u003cp>Thomas Scully, the former top administrator at the Centers for Medicare & Medicaid Services and now an attorney who advises clients on health care issues and a general partner in a private investment firm, said the idea behind these firms is good. But, he added, their growth potential may be limited because the expense of the tablets and software will make the home care services more expensive. “All of this is part of the answer, but it has to show economic savings,” said Scully.\u003c/p>\n\u003cp>\u003cstrong>Watching For Evidence Of Success\u003c/strong>\u003c/p>\n\u003cp>Billions are spent nationally each year on avoidable hospital admissions, prompting measures to prevent more of them. The federal health law, for example, created financial incentives for hospitals to reduce readmissions.\u003c/p>\n\u003cp>The new software fits into this focus. But obstacles remain, including the big question of whether they actually work better than other efforts aimed at this goal.\u003c/p>\n\u003cp>The companies themselves — mainly small, privately held ventures — say they have data showing significant reduction in hospitalizations and costs.\u003c/p>\n\u003cp>“Non-medical workers are able to make some guided observations that predict if a patient will be at risk of going to a hospital,” said Andrey Ostrovsky, a doctor who is CEO and founder of Care at Hand.\u003c/p>\n\u003cp>For example, a study done by consulting firm Avalere, with Ostrovsky co-authoring, reviewed the records of more than 2,200 patients using the technology. It concluded that hospital admissions dropped 29 percent for patients who had three or more hospital visits the prior year. It showed an overall 14 percent decrease in admissions among all those studied.\u003c/p>\n\u003cp>But not everyone is convinced that arming home care workers with software programs will prove to be an effective strategy.\u003c/p>\n\u003cp>“It’s more theory than reality,” said Bob Kocher, a partner at Venrock, a venture capital firm in California. After reviewing the firms out there, Kocher said his firm decided not to invest yet, although “I have no doubt that 10 years from now, we will improve the training of home care workers and have much better diagnostic tools in the home — and it will work.”\u003c/p>\n\u003cp>Still, the ranks of elderly Americans are growing rapidly and most want to avoid nursing homes. “The industry is placing a big bet that technology will be the missing variable … to allow us to care for a large elderly population at home,” said Jared Landis, practice manager at the Advisory Board, a firm that consults with hospitals.\u003c/p>\n\u003cp>’Just One Tool’ In A Larger Effort\u003c/p>\n\u003cp>For Ruby, the tablet is just one piece of a much larger effort by the Coordinating Center, which has also enrolled her in the practice of a local primary care doctor, signed her up for an appointment at an eye clinic and is seeking an alternative to a medication she was prescribed that wasn’t included on her insurance plan.\u003c/p>\n\u003cp>She is motivated: “I want to be here to see my kids walk across the stage at high school graduation, to see when they have kids.”\u003c/p>\n\u003cp>That combination — a motivated patient and a broad effort to coordinate her care — may help prevent Ruby from returning to the hospital with high blood sugar levels or other problems.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Defying Norm, Scientist Reports Zika Research in Real Time",
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"content": "\u003cp>Anyone can follow the pregnancy of a monkey infected with Zika virus in real time, thanks to an experiment in data sharing that's unusual for biology.\u003c/p>\n\u003cp>Researchers in Wisconsin injected Zika virus into a pregnant rhesus macaque monkey on Monday, to start exploring how this virus can affect the brain of a developing fetus. Over the course of the coming weeks, the team will be \u003ca href=\"https://dholk.primate.wisc.edu/project/dho/public/Zika/public/ZIKV-003/begin.view\">posting\u003c/a> the infected monkey's ultrasounds and blood tests, as well as other data such as the amount of virus in the amniotic fluid.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"I haven't seen a researcher before essentially publishing all the raw data from experiments.\"\u003c/aside>\n\u003cp>The study is being led by \u003ca href=\"http://labs.pathology.wisc.edu/oconnor/staff/index_files/page7-1000-full.html\">Dave O'Connor\u003c/a>, a professor at the University of Wisconsin-Madison who is also writing a \u003ca href=\"https://dholk.primate.wisc.edu/project/dho/public/Zika/public/ZIKV-003/begin.view\">running commentary\u003c/a> on the laboratory's website that frankly discusses things like the emotional impact of looking at this primate's ultrasounds.\u003c/p>\n\u003cp>O'Connor says that he can feel a moral need to do this kind of animal research and at the same time feel \"sad and heartbroken\" at what the work entails. \"I don't think those two are mutually exclusive,\" he says.\u003c/p>\n\u003cp>He and his colleagues have been planning these monkey experiments for months. A couple of weeks ago, when he was in Rio de Janeiro, he kept seeing pregnant women on the street. It really hit him that all of them were potentially at risk of Zika, which is suspected of causing microcephaly and other devastating birth defects.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"I've come to the conclusion that there is an ethical and a moral imperative to study the most relevant animal model to get the most impactful and valuable data,\" says O'Connor.\u003c/p>\n\u003cp>And making sure that the data has the biggest impact is why he's releasing it right away, letting strangers follow the experiment as it happens.\u003c/p>\n\u003cp>This kind of openness is not the norm in biology. Usually researchers would collect data, analyze it, maybe present it at a conference, and eventually submit a manuscript to a scientific journal. The findings might not get published for more than a year.\u003c/p>\n\u003cp>\"In the case of a public health emergency like Zika virus, the journals are \u003ca href=\"http://science.sciencemag.org/content/early/2016/02/10/science.aaf4545\">aware\u003c/a> that there is certain urgency to communicating the results,\" says O'Connor, \"but that process can still take weeks to months.\"\u003c/p>\n\u003cp>He didn't want to wait. Doing the experiment publicly means that other experts can contact him and suggest changes or offer help. Plus the early results could maybe help other groups better plan their own Zika studies, so they could get results faster and use fewer animals.\u003c/p>\n\u003cp>\"I haven't seen a researcher before essentially publishing all the raw data from experiments. I think that's great. That's certainly new to me,\" says \u003ca href=\"http://andersen-lab.com/people/\">Kristian Andersen\u003c/a>, a biologist at The Scripps Research Institute.\u003c/p>\n\u003cp>During the Ebola outbreak in West Africa, Andersen and his colleagues sequenced Ebola viruses taken from patients and made that genetic information public unusually fast — within 48 hours of generating it.\u003c/p>\n\u003cp>\"My take on it is that for public health emergencies like Ebola, like Zika, it's really a no-brainer,\" says Andersen. \"The data has to be made publicly available as soon as possible.\"\u003c/p>\n\u003cp>Still, this kind of rapid data sharing is so new, there's a lot that isn't yet sorted out — like how to make sure scientists get proper credit for their work, even if it's not formally published.\u003c/p>\n\u003cp>\"You're seeing a shift, as you are in many other aspects of culture, where information can be shared much more broadly and much more quickly than it ever could before,\" says \u003ca href=\"http://www.vetmed.wisc.edu/friedrichlab/\">Thomas Friedrich\u003c/a>, a researcher at the University of Wisconsin, Madison who is collaborating with O'Connor on the Zika experiments in monkeys. \"Part of what we're testing here is the viability of real-time public data sharing.\"\u003c/p>\n\u003cp>He notes that one recent \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1600651\">paper\u003c/a> in the \u003cem>New England Journal of Medicine\u003c/em> used unpublished data on Zika virus genetic sequences that had been deposited in a publicly available database. Some felt that the group in Brazil that originally obtained those sequences was not given enough credit in that publication.\u003c/p>\n\u003cp>\"That's caused a bit of controversy within the field, partially because there are no rules about how to do that,\" Friedrich says. \"By the kind of standard rules, the researchers who wrote the paper didn't do anything wrong in taking publicly available data and doing their own analysis with it.\"\u003c/p>\n\u003cp>On the other hand, he says, there's a growing appreciation for how researchers in developing countries may not get enough credit for their contributions, and there's an obvious need to make sure that these scientists can contribute to rapidly moving science without the fear of being shortchanged.\u003c/p>\n\u003cp>Friedrich says he wouldn't want to rush into recommending that everyone go public with their experiments, but doing this monkey study out in the open seemed right to him — at least in the urgent context of the Zika outbreak.\u003c/p>\n\u003cp>\"I understand that not everyone in science is going to feel the same way,\" says Friedrich, \"and because we don't have codified rules and because we don't have established norms, the level of data sharing that each individual scientist thinks is appropriate is going to vary widely.\"\u003c/p>\n\u003cp>But O'Connor hopes that if this experiment in transparency goes well, it might embolden others to follow their lead. \"We don't know how it's going to be received,\" says O'Connor, \"but trying new things and seeing what happens is important in its own right.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Copyright NPR.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Anyone can follow the pregnancy of a monkey infected with Zika virus in real time, thanks to an experiment in data sharing that's unusual for biology.\u003c/p>\n\u003cp>Researchers in Wisconsin injected Zika virus into a pregnant rhesus macaque monkey on Monday, to start exploring how this virus can affect the brain of a developing fetus. Over the course of the coming weeks, the team will be \u003ca href=\"https://dholk.primate.wisc.edu/project/dho/public/Zika/public/ZIKV-003/begin.view\">posting\u003c/a> the infected monkey's ultrasounds and blood tests, as well as other data such as the amount of virus in the amniotic fluid.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"I haven't seen a researcher before essentially publishing all the raw data from experiments.\"\u003c/aside>\n\u003cp>The study is being led by \u003ca href=\"http://labs.pathology.wisc.edu/oconnor/staff/index_files/page7-1000-full.html\">Dave O'Connor\u003c/a>, a professor at the University of Wisconsin-Madison who is also writing a \u003ca href=\"https://dholk.primate.wisc.edu/project/dho/public/Zika/public/ZIKV-003/begin.view\">running commentary\u003c/a> on the laboratory's website that frankly discusses things like the emotional impact of looking at this primate's ultrasounds.\u003c/p>\n\u003cp>O'Connor says that he can feel a moral need to do this kind of animal research and at the same time feel \"sad and heartbroken\" at what the work entails. \"I don't think those two are mutually exclusive,\" he says.\u003c/p>\n\u003cp>He and his colleagues have been planning these monkey experiments for months. A couple of weeks ago, when he was in Rio de Janeiro, he kept seeing pregnant women on the street. It really hit him that all of them were potentially at risk of Zika, which is suspected of causing microcephaly and other devastating birth defects.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"I've come to the conclusion that there is an ethical and a moral imperative to study the most relevant animal model to get the most impactful and valuable data,\" says O'Connor.\u003c/p>\n\u003cp>And making sure that the data has the biggest impact is why he's releasing it right away, letting strangers follow the experiment as it happens.\u003c/p>\n\u003cp>This kind of openness is not the norm in biology. Usually researchers would collect data, analyze it, maybe present it at a conference, and eventually submit a manuscript to a scientific journal. The findings might not get published for more than a year.\u003c/p>\n\u003cp>\"In the case of a public health emergency like Zika virus, the journals are \u003ca href=\"http://science.sciencemag.org/content/early/2016/02/10/science.aaf4545\">aware\u003c/a> that there is certain urgency to communicating the results,\" says O'Connor, \"but that process can still take weeks to months.\"\u003c/p>\n\u003cp>He didn't want to wait. Doing the experiment publicly means that other experts can contact him and suggest changes or offer help. Plus the early results could maybe help other groups better plan their own Zika studies, so they could get results faster and use fewer animals.\u003c/p>\n\u003cp>\"I haven't seen a researcher before essentially publishing all the raw data from experiments. I think that's great. That's certainly new to me,\" says \u003ca href=\"http://andersen-lab.com/people/\">Kristian Andersen\u003c/a>, a biologist at The Scripps Research Institute.\u003c/p>\n\u003cp>During the Ebola outbreak in West Africa, Andersen and his colleagues sequenced Ebola viruses taken from patients and made that genetic information public unusually fast — within 48 hours of generating it.\u003c/p>\n\u003cp>\"My take on it is that for public health emergencies like Ebola, like Zika, it's really a no-brainer,\" says Andersen. \"The data has to be made publicly available as soon as possible.\"\u003c/p>\n\u003cp>Still, this kind of rapid data sharing is so new, there's a lot that isn't yet sorted out — like how to make sure scientists get proper credit for their work, even if it's not formally published.\u003c/p>\n\u003cp>\"You're seeing a shift, as you are in many other aspects of culture, where information can be shared much more broadly and much more quickly than it ever could before,\" says \u003ca href=\"http://www.vetmed.wisc.edu/friedrichlab/\">Thomas Friedrich\u003c/a>, a researcher at the University of Wisconsin, Madison who is collaborating with O'Connor on the Zika experiments in monkeys. \"Part of what we're testing here is the viability of real-time public data sharing.\"\u003c/p>\n\u003cp>He notes that one recent \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1600651\">paper\u003c/a> in the \u003cem>New England Journal of Medicine\u003c/em> used unpublished data on Zika virus genetic sequences that had been deposited in a publicly available database. Some felt that the group in Brazil that originally obtained those sequences was not given enough credit in that publication.\u003c/p>\n\u003cp>\"That's caused a bit of controversy within the field, partially because there are no rules about how to do that,\" Friedrich says. \"By the kind of standard rules, the researchers who wrote the paper didn't do anything wrong in taking publicly available data and doing their own analysis with it.\"\u003c/p>\n\u003cp>On the other hand, he says, there's a growing appreciation for how researchers in developing countries may not get enough credit for their contributions, and there's an obvious need to make sure that these scientists can contribute to rapidly moving science without the fear of being shortchanged.\u003c/p>\n\u003cp>Friedrich says he wouldn't want to rush into recommending that everyone go public with their experiments, but doing this monkey study out in the open seemed right to him — at least in the urgent context of the Zika outbreak.\u003c/p>\n\u003cp>\"I understand that not everyone in science is going to feel the same way,\" says Friedrich, \"and because we don't have codified rules and because we don't have established norms, the level of data sharing that each individual scientist thinks is appropriate is going to vary widely.\"\u003c/p>\n\u003cp>But O'Connor hopes that if this experiment in transparency goes well, it might embolden others to follow their lead. \"We don't know how it's going to be received,\" says O'Connor, \"but trying new things and seeing what happens is important in its own right.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Copyright NPR.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>One of the best ways to understand Zika virus might be to deliberately inject it into volunteers.\u003c/p>\n\u003caside class=\"pullquote alignright\">Scientists are trying to decide whether it's ethical to ask volunteers to take a shot of Zika virus to help search for a vaccine.\u003c/aside>\n\u003cp>That idea may sound a little crazy, but it's not unprecedented. And some researchers are hoping the approach could help speed up the search for an effective Zika vaccine.\u003c/p>\n\u003cp>Right now, a bunch of labs are pursuing different ways of making a vaccine against Zika, mostly because of the concern that the virus might be linked to the birth defect called \u003ca href=\"http://www.cdc.gov/ncbddd/birthdefects/microcephaly.html\">microcephaly\u003c/a>.\u003c/p>\n\u003cp>At the \u003ca href=\"http://www.niaid.nih.gov/about/organization/vrc/pages/default.aspx/Pages/default.aspx\">Vaccine Research Center\u003c/a> at the National Institute of Allergy and Infectious Diseases in Maryland, scientists are creating different versions of a DNA-based vaccine. \"Which one is the best one? We are testing it in animals, using that to select our top candidate,\" says \u003ca href=\"http://www.niaid.nih.gov/labsandresources/labs/aboutlabs/vrc/virology/pages/virologycore.aspx\">Wing-Pui Kong\u003c/a>, a virologist at the center.\u003c/p>\n\u003cp>If any vaccine candidate looks good in animal tests, it could then go for initial safety testing in people. After that, scientists somehow have to show that the immune response elicited by the vaccine will actually protect people from getting infected with Zika.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That's no easy task, and no one can say for sure how long it will take.\u003c/p>\n\u003cp>\"Most vaccine development efforts are measured in decades,\" says \u003ca href=\"http://www.niaid.nih.gov/labsandresources/labs/aboutlabs/vrc/viralpathogenesislaboratory/pages/graham.aspx\">Dr. Barney Graham\u003c/a>, deputy director of the NIAID vaccine research center. \"Almost every vaccine we have for a viral disease has come several decades after the discovery of the virus.\"\u003c/p>\n\u003cp>New technology does make it much easier to quickly develop a vaccine concept and test it in animals, he notes, \"but you can't really have it for public use and distribution until you're able to prove efficacy. Proving that a vaccine works often takes very large organized field trials.\"\u003c/p>\n\u003cp>Those kinds of field trials are difficult, time-consuming, and sometimes just impossible. By the time an Ebola vaccine was ready to go into a large study, for example, the outbreak in West Africa was winding down. Not enough people were being exposed to Ebola to prove that a vaccine would protect them.\u003c/p>\n\u003cp>What's more, when researchers do manage to do a big clinical trial, it frequently reveals that their vaccine is a dud.\u003c/p>\n\u003cp>So, to see if a potential Zika vaccine really can protect people, scientists would like to do this: Give volunteers a candidate vaccine, and then later inject Zika virus into them, to see what happens. That could produce real answers fast.\u003c/p>\n\u003cp>\"The limitations would be you'd have to do this in young people who were volunteering to do this and who were not going to get pregnant,\" says Graham.\u003c/p>\n\u003cp>In some ways, this is a blast from the past. In the 1950s, soon after Zika was discovered, one intrepid scientist injected it into his arm, to see if it could make people sick. He just got a slight fever.\u003c/p>\n\u003cp>After all, if you're not pregnant, \"Zika itself is a pretty mild illness,\" says \u003ca href=\"http://www.jhsph.edu/faculty/directory/profile/1358/anna-durbin\">Dr. Anna Durbin\u003c/a>, an expert on vaccine clinical trials at the Johns Hopkins Bloomberg School of Public Health.\u003c/p>\n\u003cp>This fall, we'll likely see safety tests of a potential Zika vaccine in about 20 to 50 people here in the United States. \"And then the big question is, what is our next step?\" says Durbin.\u003c/p>\n\u003cp>Ideally, she says, you could ask for volunteers to be exposed to Zika in a controlled setting. Researchers could compare two groups: people who get the virus alone compared to people who get a candidate vaccine and then the virus later on.\u003c/p>\n\u003cp>\"We would admit them to our inpatient unit, where they have 24-hour care,\" says Durbin. And they'd use a low dose of the virus.\u003c/p>\n\u003cp>Her group has already done this kind of \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/26424605\">study\u003c/a> to evaluate a potential vaccine for dengue, a closely related virus. Dengue can cause serious illness, but one particular dengue virus just causes a rash. And people did agree to be injected with it.\u003c/p>\n\u003cp>That let Durbin and her colleagues show that the dengue vaccine really seemed to protect people from infection, making them feel more confident about moving forward with larger trials.\u003c/p>\n\u003cp>\"We would like to develop a similar model for Zika,\" Durbin says.\u003c/p>\n\u003cp>But the situation with Zika is a little more complicated. That's because, in addition to the possible connection with microcephaly in fetuses, Zika infection in adults may be linked to \u003ca href=\"http://www.ninds.nih.gov/disorders/gbs/detail_gbs.htm#3139_1\">Guillain-Barre syndrome\u003c/a> — a disorder in which the immune system attacks the nervous system.\u003c/p>\n\u003cp>\"We do not want to put people at risk for that,\" says Durbin, \"because these are normal, healthy people.\"\u003c/p>\n\u003cp>Still, people already face a small risk of getting Guillain-Barre from more mundane infections, like diarrheal diseases or the flu. And it's still unclear how often this actually happens with Zika.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>That's something scientists are trying to understand now, to help them figure out whether it would be ethical to ask people to take a shot of Zika virus to help search for a vaccine.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. 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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>One of the best ways to understand Zika virus might be to deliberately inject it into volunteers.\u003c/p>\n\u003caside class=\"pullquote alignright\">Scientists are trying to decide whether it's ethical to ask volunteers to take a shot of Zika virus to help search for a vaccine.\u003c/aside>\n\u003cp>That idea may sound a little crazy, but it's not unprecedented. And some researchers are hoping the approach could help speed up the search for an effective Zika vaccine.\u003c/p>\n\u003cp>Right now, a bunch of labs are pursuing different ways of making a vaccine against Zika, mostly because of the concern that the virus might be linked to the birth defect called \u003ca href=\"http://www.cdc.gov/ncbddd/birthdefects/microcephaly.html\">microcephaly\u003c/a>.\u003c/p>\n\u003cp>At the \u003ca href=\"http://www.niaid.nih.gov/about/organization/vrc/pages/default.aspx/Pages/default.aspx\">Vaccine Research Center\u003c/a> at the National Institute of Allergy and Infectious Diseases in Maryland, scientists are creating different versions of a DNA-based vaccine. \"Which one is the best one? We are testing it in animals, using that to select our top candidate,\" says \u003ca href=\"http://www.niaid.nih.gov/labsandresources/labs/aboutlabs/vrc/virology/pages/virologycore.aspx\">Wing-Pui Kong\u003c/a>, a virologist at the center.\u003c/p>\n\u003cp>If any vaccine candidate looks good in animal tests, it could then go for initial safety testing in people. After that, scientists somehow have to show that the immune response elicited by the vaccine will actually protect people from getting infected with Zika.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That's no easy task, and no one can say for sure how long it will take.\u003c/p>\n\u003cp>\"Most vaccine development efforts are measured in decades,\" says \u003ca href=\"http://www.niaid.nih.gov/labsandresources/labs/aboutlabs/vrc/viralpathogenesislaboratory/pages/graham.aspx\">Dr. Barney Graham\u003c/a>, deputy director of the NIAID vaccine research center. \"Almost every vaccine we have for a viral disease has come several decades after the discovery of the virus.\"\u003c/p>\n\u003cp>New technology does make it much easier to quickly develop a vaccine concept and test it in animals, he notes, \"but you can't really have it for public use and distribution until you're able to prove efficacy. Proving that a vaccine works often takes very large organized field trials.\"\u003c/p>\n\u003cp>Those kinds of field trials are difficult, time-consuming, and sometimes just impossible. By the time an Ebola vaccine was ready to go into a large study, for example, the outbreak in West Africa was winding down. Not enough people were being exposed to Ebola to prove that a vaccine would protect them.\u003c/p>\n\u003cp>What's more, when researchers do manage to do a big clinical trial, it frequently reveals that their vaccine is a dud.\u003c/p>\n\u003cp>So, to see if a potential Zika vaccine really can protect people, scientists would like to do this: Give volunteers a candidate vaccine, and then later inject Zika virus into them, to see what happens. That could produce real answers fast.\u003c/p>\n\u003cp>\"The limitations would be you'd have to do this in young people who were volunteering to do this and who were not going to get pregnant,\" says Graham.\u003c/p>\n\u003cp>In some ways, this is a blast from the past. In the 1950s, soon after Zika was discovered, one intrepid scientist injected it into his arm, to see if it could make people sick. He just got a slight fever.\u003c/p>\n\u003cp>After all, if you're not pregnant, \"Zika itself is a pretty mild illness,\" says \u003ca href=\"http://www.jhsph.edu/faculty/directory/profile/1358/anna-durbin\">Dr. Anna Durbin\u003c/a>, an expert on vaccine clinical trials at the Johns Hopkins Bloomberg School of Public Health.\u003c/p>\n\u003cp>This fall, we'll likely see safety tests of a potential Zika vaccine in about 20 to 50 people here in the United States. \"And then the big question is, what is our next step?\" says Durbin.\u003c/p>\n\u003cp>Ideally, she says, you could ask for volunteers to be exposed to Zika in a controlled setting. Researchers could compare two groups: people who get the virus alone compared to people who get a candidate vaccine and then the virus later on.\u003c/p>\n\u003cp>\"We would admit them to our inpatient unit, where they have 24-hour care,\" says Durbin. And they'd use a low dose of the virus.\u003c/p>\n\u003cp>Her group has already done this kind of \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/26424605\">study\u003c/a> to evaluate a potential vaccine for dengue, a closely related virus. Dengue can cause serious illness, but one particular dengue virus just causes a rash. And people did agree to be injected with it.\u003c/p>\n\u003cp>That let Durbin and her colleagues show that the dengue vaccine really seemed to protect people from infection, making them feel more confident about moving forward with larger trials.\u003c/p>\n\u003cp>\"We would like to develop a similar model for Zika,\" Durbin says.\u003c/p>\n\u003cp>But the situation with Zika is a little more complicated. That's because, in addition to the possible connection with microcephaly in fetuses, Zika infection in adults may be linked to \u003ca href=\"http://www.ninds.nih.gov/disorders/gbs/detail_gbs.htm#3139_1\">Guillain-Barre syndrome\u003c/a> — a disorder in which the immune system attacks the nervous system.\u003c/p>\n\u003cp>\"We do not want to put people at risk for that,\" says Durbin, \"because these are normal, healthy people.\"\u003c/p>\n\u003cp>Still, people already face a small risk of getting Guillain-Barre from more mundane infections, like diarrheal diseases or the flu. And it's still unclear how often this actually happens with Zika.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>That's something scientists are trying to understand now, to help them figure out whether it would be ethical to ask people to take a shot of Zika virus to help search for a vaccine.\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=Why+Scientists+Hope+To+Inject+Some+People+With+Zika+Virus&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Scientists suspect an outbreak of the Zika virus is behind a surge in a rare birth defect in Brazil. But how are they going to prove it?\u003c/p>\n\u003caside class=\"“pullquote alignright\">\n\"The simple presence of the virus doesn't mean it caused the birth defect. It means there's a probability.\"\u003cbr>\n\u003c/aside>\n\u003cp>Authorities in the South American country were quick to make the link last fall. The health minister last week said he was \"absolutely sure\" that the mosquito-borne virus is a cause.\u003c/p>\n\u003cp>But others aren't so certain. While the evidence has been mounting, so far it is circumstantial.\u003c/p>\n\u003cp>\"The simple presence of the virus doesn't mean it caused the birth defect. It means there's a probability,\" said Dr. Arnold Monto, a University of Michigan epidemiologist.\u003c/p>\n\u003cp>The investigation is still in its early stages. It began after Brazilian doctors noticed an increase last fall in babies with a birth defect called microcephaly, which has a number of causes. The cases closely followed the country's first outbreak of the tropical virus Zika, which was thought to cause no more than a mild illness that clears up in a week.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Microcephaly hadn't been seen in past Zika outbreaks. Babies with the condition have a smaller than normal head and often have a smaller brain that hasn't developed properly. Lab tests have detected the virus in the brain tissue of a few babies with microcephaly.\u003c/p>\n\u003cp>Proving the cause is a bit like prosecuting a murder investigation, with Zika as the apparent killer but a lot of unanswered questions, said Dr. Ernesto Marques, a University of Pittsburgh microbiologist who is collaborating with Brazilian researchers.\u003c/p>\n\u003cp>\"What you have so far, the victim is there, and you find a person right there that has a smoking gun in his hand,\" Marques said. \"But you still need to close the deal.\"\u003c/p>\n\u003cp>The investigation poses special challenges. There's currently no good animal substitute for humans to study the virus. And it's not considered ethical to infect people, especially pregnant women, in an experiment to see what happens — not when there seems to be a real chance that a volunteer could be seriously harmed.\u003c/p>\n\u003cp>So researchers are turning to other kinds of studies to try to establish whether Zika or some other factor is causing the birth defect or, also, a paralyzing condition called Guillain-Barre. Five Latin America countries with Zika outbreaks are reporting an uptick in that condition in adults.\u003c/p>\n\u003cp>One method is quick-and-dirty research called a case-control study, which looks back in time after an illness or condition has occurred. For the birth defect research, that means recruiting a group of women with babies born with microcephaly and trying to sort out what may have happened during their pregnancy to spark the condition. For comparison, they will query women whose infants don't have the birth defect.\u003c/p>\n\u003cp>The U.S. Centers for Disease Control and Prevention is involved in one such a study set to start next week in the Brazilian state of Paraiba. It will focus on 100 babies with microcephaly and at least 100 more without.\u003c/p>\n\u003cp>Investigators will take blood samples from the mothers to check for signs of an earlier Zika infection. They also will ask not only about Zika infections but other possible factors, like other germs or poisons in the environment. Some experts suggest that perhaps Zika needs an accomplice — like malnutrition or an infection with another tropical illness like dengue — to cause serious problems.\u003c/p>\n\u003cp>A similar study, led by Brazil, is investigating 200 babies with microcephaly and 400 without. Results are due in April.\u003c/p>\n\u003cp>\"That will be the first one to tell us if there's strong evidence,\" Dr. Marcos Espinal of the Pan American Health Organization told reporters Thursday.\u003c/p>\n\u003cp>The CDC was in the coastal city of Salvador last month to help health officials with another look-back study, this one targeting Guillain-Barre. They tested 40 people who had the condition, and 80 people who didn't, said Dr. James Sejvar, who led the CDC team.\u003c/p>\n\u003cp>Such studies are hardly perfect. People often have trouble remembering every detail from six months ago — for example, when they might have been bitten by mosquitoes, the primary source of Zika infections.\u003c/p>\n\u003cp>While these studies can sort out potential causes, experts say they need to be confirmed with research that follows people forward. Colombia, for example, will be following 2,000 Zika-infected pregnant women to see what happens with them and their pregnancies, Espinal said.\u003c/p>\n\u003cp>In Brazil, Zika's possible link to microcephaly emerged in September, when a spike in babies born with the condition got the attention of Dr. Vanessa van der Linden, a pediatric neurologist at a hospital in northeast Recife that works with disabled children.\u003c/p>\n\u003cp>Initially, Van der Linden and other doctors looked for the usual causes of microcephaly, such as toxoplasmosis, rubella, HIV, and cytomegalovirus. None were found.\u003c/p>\n\u003cp>But most of the mothers had something in common: blotches and skin rashes early in their pregnancies that seemed consistent with Zika. That was the genesis of the link.\u003c/p>\n\u003cp>It's all been difficult to sort out, though, because Brazil wasn't keeping good track of microcephaly cases before Zika arrived. They're still determining how many of the reported cases are really microcephaly and involve a Zika infection.\u003c/p>\n\u003cp>One of the puzzling questions facing researchers: Why have so many severe health problems been reported in Brazil, but comparatively few in other Latin America or Caribbean countries with Zika? Will we soon see similar spikes elsewhere, or is the Brazilian setting somehow unique?\u003c/p>\n\u003cp>Health officials are closely watching Colombia, which had a Zika outbreak after Brazil and so far has not seen a spike in microcephaly cases. If there is, it would be apparent by June and would help finger Zika as the culprit, Espinal said.\u003c/p>\n\u003cp>It will take a combination of studies and laboratory evidence to finally determine if Zika is the villain it appears to be, experts say.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"This is going to be solved,\" said Dr. Farrah Mateen, a Harvard researcher. \"It's just a matter of doing the research in the right way.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Scientists suspect an outbreak of the Zika virus is behind a surge in a rare birth defect in Brazil. But how are they going to prove it?\u003c/p>\n\u003caside class=\"“pullquote alignright\">\n\"The simple presence of the virus doesn't mean it caused the birth defect. It means there's a probability.\"\u003cbr>\n\u003c/aside>\n\u003cp>Authorities in the South American country were quick to make the link last fall. The health minister last week said he was \"absolutely sure\" that the mosquito-borne virus is a cause.\u003c/p>\n\u003cp>But others aren't so certain. While the evidence has been mounting, so far it is circumstantial.\u003c/p>\n\u003cp>\"The simple presence of the virus doesn't mean it caused the birth defect. It means there's a probability,\" said Dr. Arnold Monto, a University of Michigan epidemiologist.\u003c/p>\n\u003cp>The investigation is still in its early stages. It began after Brazilian doctors noticed an increase last fall in babies with a birth defect called microcephaly, which has a number of causes. The cases closely followed the country's first outbreak of the tropical virus Zika, which was thought to cause no more than a mild illness that clears up in a week.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Microcephaly hadn't been seen in past Zika outbreaks. Babies with the condition have a smaller than normal head and often have a smaller brain that hasn't developed properly. Lab tests have detected the virus in the brain tissue of a few babies with microcephaly.\u003c/p>\n\u003cp>Proving the cause is a bit like prosecuting a murder investigation, with Zika as the apparent killer but a lot of unanswered questions, said Dr. Ernesto Marques, a University of Pittsburgh microbiologist who is collaborating with Brazilian researchers.\u003c/p>\n\u003cp>\"What you have so far, the victim is there, and you find a person right there that has a smoking gun in his hand,\" Marques said. \"But you still need to close the deal.\"\u003c/p>\n\u003cp>The investigation poses special challenges. There's currently no good animal substitute for humans to study the virus. And it's not considered ethical to infect people, especially pregnant women, in an experiment to see what happens — not when there seems to be a real chance that a volunteer could be seriously harmed.\u003c/p>\n\u003cp>So researchers are turning to other kinds of studies to try to establish whether Zika or some other factor is causing the birth defect or, also, a paralyzing condition called Guillain-Barre. Five Latin America countries with Zika outbreaks are reporting an uptick in that condition in adults.\u003c/p>\n\u003cp>One method is quick-and-dirty research called a case-control study, which looks back in time after an illness or condition has occurred. For the birth defect research, that means recruiting a group of women with babies born with microcephaly and trying to sort out what may have happened during their pregnancy to spark the condition. For comparison, they will query women whose infants don't have the birth defect.\u003c/p>\n\u003cp>The U.S. Centers for Disease Control and Prevention is involved in one such a study set to start next week in the Brazilian state of Paraiba. It will focus on 100 babies with microcephaly and at least 100 more without.\u003c/p>\n\u003cp>Investigators will take blood samples from the mothers to check for signs of an earlier Zika infection. They also will ask not only about Zika infections but other possible factors, like other germs or poisons in the environment. Some experts suggest that perhaps Zika needs an accomplice — like malnutrition or an infection with another tropical illness like dengue — to cause serious problems.\u003c/p>\n\u003cp>A similar study, led by Brazil, is investigating 200 babies with microcephaly and 400 without. Results are due in April.\u003c/p>\n\u003cp>\"That will be the first one to tell us if there's strong evidence,\" Dr. Marcos Espinal of the Pan American Health Organization told reporters Thursday.\u003c/p>\n\u003cp>The CDC was in the coastal city of Salvador last month to help health officials with another look-back study, this one targeting Guillain-Barre. They tested 40 people who had the condition, and 80 people who didn't, said Dr. James Sejvar, who led the CDC team.\u003c/p>\n\u003cp>Such studies are hardly perfect. People often have trouble remembering every detail from six months ago — for example, when they might have been bitten by mosquitoes, the primary source of Zika infections.\u003c/p>\n\u003cp>While these studies can sort out potential causes, experts say they need to be confirmed with research that follows people forward. Colombia, for example, will be following 2,000 Zika-infected pregnant women to see what happens with them and their pregnancies, Espinal said.\u003c/p>\n\u003cp>In Brazil, Zika's possible link to microcephaly emerged in September, when a spike in babies born with the condition got the attention of Dr. Vanessa van der Linden, a pediatric neurologist at a hospital in northeast Recife that works with disabled children.\u003c/p>\n\u003cp>Initially, Van der Linden and other doctors looked for the usual causes of microcephaly, such as toxoplasmosis, rubella, HIV, and cytomegalovirus. None were found.\u003c/p>\n\u003cp>But most of the mothers had something in common: blotches and skin rashes early in their pregnancies that seemed consistent with Zika. That was the genesis of the link.\u003c/p>\n\u003cp>It's all been difficult to sort out, though, because Brazil wasn't keeping good track of microcephaly cases before Zika arrived. They're still determining how many of the reported cases are really microcephaly and involve a Zika infection.\u003c/p>\n\u003cp>One of the puzzling questions facing researchers: Why have so many severe health problems been reported in Brazil, but comparatively few in other Latin America or Caribbean countries with Zika? Will we soon see similar spikes elsewhere, or is the Brazilian setting somehow unique?\u003c/p>\n\u003cp>Health officials are closely watching Colombia, which had a Zika outbreak after Brazil and so far has not seen a spike in microcephaly cases. If there is, it would be apparent by June and would help finger Zika as the culprit, Espinal said.\u003c/p>\n\u003cp>It will take a combination of studies and laboratory evidence to finally determine if Zika is the villain it appears to be, experts say.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"This is going to be solved,\" said Dr. Farrah Mateen, a Harvard researcher. \"It's just a matter of doing the research in the right way.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Extra Testosterone Helped Sex Lives of Elderly Men, Study Shows",
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"content": "\u003cp>As men age, they lose testosterone — which some say affects their sense of well-being and sexual function. But for healthy older men, using supplemental testosterone as a remedy has been controversial. Past studies of the supplement's use have been relatively small, and the evidence about benefits and risks has been mixed.\u003c/p>\n\u003caside class=\"“pullquote alignright\">\"Testosterone improved sexual activity, sexual desire and improved erectile function.\"\u003c/aside>\n\u003cp>Now a well-designed study \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1506119?query=TOC\">published \u003c/a>online Wednesday, in the \u003cem>New England Journal of Medicine,\u003c/em> confirms certain benefits in sexual function and mood for some men 65 and over, at least in the first year. Though the gains were modest, and some tended to wane in the latter months of treatment, researchers say the findings are encouraging, and merit further research.\u003c/p>\n\u003cp>Dave Bostick, a retired vocational counselor in Pittsburgh, took part in the study. Bostick loves his wife, but when he got to his 60s, he says, he'd noticed some changes in himself — a decline in his sexual drive, and a drop in his enthusiasm for trying new things at work.\u003c/p>\n\u003cp>[contextly_sidebar id=\"Zx40QCllMb3bZaOUDpRHJQvphvmh63SV\"]His lack of ambition was so noticeable, he tells Shots, that he decided it was time to retire. But he still wasn't really happy. And one day, while taking a course at the University of Pittsburgh, he was drawn to a posted notice about a new study.\u003c/p>\n\u003cp>\"I looked at the announcement,\" he says. \"I said, 'Yes, I'm 65, and yes, I feel low-energy/low-libido.' \"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The University of Pittsburgh was one of 12 sites nationwide that collaborated to look at the possible benefits of testosterone in older men whose levels of the hormone were below 275 ng per deciliter of blood — that's just below the wide range that many doctors consider \"normal\" for healthy, younger men.\u003c/p>\n\u003cp>The scientists screened more than 51,000 men who were 65 or older for their study, and from that group found 790 with low testosterone, as measured by \u003ca href=\"http://www.npr.org/sections/health-shots/2014/04/28/306830577/test-first-before-going-for-those-testosterone-supplements\">a blood test\u003c/a>. The researchers say the study wasn't designed to get at whether the men had lost the hormone more rapidly than others, or whether they produced less testosterone to begin with.\u003c/p>\n\u003cp>About half the participants were given testosterone gel, and the other half a placebo gel. Until the first year of the study was over, neither the participants nor the researchers knew which men were getting the placebo.\u003c/p>\n\u003cp>\"The testosterone concentrations in the men in this trial [who got the active treatment] were increased, on average, to just the middle of the normal range for young men,\" says endocrinologist \u003ca href=\"http://www.med.upenn.edu/apps/faculty/index.php/g275/p18180\">Dr. Peter Snyder\u003c/a>, of the University of Pennsylvania, who led the study.\u003c/p>\n\u003cp>After a year, Snyder says, though the benefits were only moderate, it was clear that mood and physical activity had improved among the group that had been getting a boost of testosterone. And the biggest improvement, he says, was in sexual function.\u003c/p>\n\u003cp>\"Testosterone improved sexual activity, sexual desire and improved erectile function,\" Snyder says.\u003c/p>\n\u003cp>Dave Bostick, it turned out, was in the group assigned testosterone. He did develop a more robust libido, he says. But even more important, he adds, he felt happier. He had more energy, and his enthusiasm for trying new things — new classes, new interests — was restored. His part of the study ended two years ago, but Bostick is still taking testosterone.\u003c/p>\n\u003cp>Past research has suggested that increasing testosterone levels might also \u003ca href=\"http://www.npr.org/sections/health-shots/2014/01/29/268427675/popular-testosterone-therapy-may-raise-risk-of-heart-attack\">increase the risk for of heart attack\u003c/a> and stroke, or lead to prostate issues. But Snyder says, so far, his team of scientists has found no increase in adverse events among those taking the hormone.\u003c/p>\n\u003cp>Still, that doesn't mean testosterone supplements are safe to take long-term, he says. To get those answers, he says, far more research is needed — larger studies that last longer periods of time.\u003c/p>\n\u003cp>Even so, endocrinologist \u003ca href=\"https://www.linkedin.com/in/eric-orwoll-b9283519\">Dr. Eric Orwoll\u003c/a>, with the Oregon Health And Science University, says the findings offer a bit more guidance for doctors and some patients.\u003c/p>\n\u003cp>\"I think we can be confident that there is some benefit for some men,\" Orwoll says. \"This is the first really well-designed and scientifically rigorous trial to get at the question of whether testosterone supplements provide benefit; we didn't have that information before.\"\u003c/p>\n\u003cp>Researchers still don't know exactly which men might benefit.\u003c/p>\n\u003cp>\"The average participant was 72 years of age,\" Orwoll notes in \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMe1600196?query=TOC\">an editorial\u003c/a> that accompanied the journal study. \"Almost 90 percent of participants were white, most were obese, most had hypertension, more than one third had diabetes, and almost 20 percent had sleep apnea.\"\u003c/p>\n\u003cp>Most testosterone prescriptions these days are written for middle-aged men, Orwoll adds — not the demographic included in Snyder's study.\u003c/p>\n\u003cp>\"We should not assume that the benefits, lack of benefits, or adverse-event profile observed in these studies would be similar in younger men, men with higher testosterone levels, or those with different demographic or clinical characteristics,\" Orwoll writes.\u003c/p>\n\u003cp>The supplement was given only to men with abnormally low testosterone — as measured by a blood test. Those men, Orwoll says, now have more information to inform their treatment choices.\u003c/p>\n\u003cp>\"Some men would say, 'Yes! I want to take any chance that there might be that my sexual function will improve, even if it's modest,' \" Orwoll says. \"Other men will say, 'Geez, that doesn't sound very encouraging — I don't want to go to the trouble of using testosterone, particularly when we don't know about long-term risks.' \"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The study, which cost $50 million, is ongoing; researchers will soon analyze supplemental testosterone's effect, if any, on cognitive function, bone health and the cardiovascular system.\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=Study+Shows+Extra+Testosterone+Might+Help+Some+Older+Men&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As men age, they lose testosterone — which some say affects their sense of well-being and sexual function. But for healthy older men, using supplemental testosterone as a remedy has been controversial. Past studies of the supplement's use have been relatively small, and the evidence about benefits and risks has been mixed.\u003c/p>\n\u003caside class=\"“pullquote alignright\">\"Testosterone improved sexual activity, sexual desire and improved erectile function.\"\u003c/aside>\n\u003cp>Now a well-designed study \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1506119?query=TOC\">published \u003c/a>online Wednesday, in the \u003cem>New England Journal of Medicine,\u003c/em> confirms certain benefits in sexual function and mood for some men 65 and over, at least in the first year. Though the gains were modest, and some tended to wane in the latter months of treatment, researchers say the findings are encouraging, and merit further research.\u003c/p>\n\u003cp>Dave Bostick, a retired vocational counselor in Pittsburgh, took part in the study. Bostick loves his wife, but when he got to his 60s, he says, he'd noticed some changes in himself — a decline in his sexual drive, and a drop in his enthusiasm for trying new things at work.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>His lack of ambition was so noticeable, he tells Shots, that he decided it was time to retire. But he still wasn't really happy. And one day, while taking a course at the University of Pittsburgh, he was drawn to a posted notice about a new study.\u003c/p>\n\u003cp>\"I looked at the announcement,\" he says. \"I said, 'Yes, I'm 65, and yes, I feel low-energy/low-libido.' \"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The University of Pittsburgh was one of 12 sites nationwide that collaborated to look at the possible benefits of testosterone in older men whose levels of the hormone were below 275 ng per deciliter of blood — that's just below the wide range that many doctors consider \"normal\" for healthy, younger men.\u003c/p>\n\u003cp>The scientists screened more than 51,000 men who were 65 or older for their study, and from that group found 790 with low testosterone, as measured by \u003ca href=\"http://www.npr.org/sections/health-shots/2014/04/28/306830577/test-first-before-going-for-those-testosterone-supplements\">a blood test\u003c/a>. The researchers say the study wasn't designed to get at whether the men had lost the hormone more rapidly than others, or whether they produced less testosterone to begin with.\u003c/p>\n\u003cp>About half the participants were given testosterone gel, and the other half a placebo gel. Until the first year of the study was over, neither the participants nor the researchers knew which men were getting the placebo.\u003c/p>\n\u003cp>\"The testosterone concentrations in the men in this trial [who got the active treatment] were increased, on average, to just the middle of the normal range for young men,\" says endocrinologist \u003ca href=\"http://www.med.upenn.edu/apps/faculty/index.php/g275/p18180\">Dr. Peter Snyder\u003c/a>, of the University of Pennsylvania, who led the study.\u003c/p>\n\u003cp>After a year, Snyder says, though the benefits were only moderate, it was clear that mood and physical activity had improved among the group that had been getting a boost of testosterone. And the biggest improvement, he says, was in sexual function.\u003c/p>\n\u003cp>\"Testosterone improved sexual activity, sexual desire and improved erectile function,\" Snyder says.\u003c/p>\n\u003cp>Dave Bostick, it turned out, was in the group assigned testosterone. He did develop a more robust libido, he says. But even more important, he adds, he felt happier. He had more energy, and his enthusiasm for trying new things — new classes, new interests — was restored. His part of the study ended two years ago, but Bostick is still taking testosterone.\u003c/p>\n\u003cp>Past research has suggested that increasing testosterone levels might also \u003ca href=\"http://www.npr.org/sections/health-shots/2014/01/29/268427675/popular-testosterone-therapy-may-raise-risk-of-heart-attack\">increase the risk for of heart attack\u003c/a> and stroke, or lead to prostate issues. But Snyder says, so far, his team of scientists has found no increase in adverse events among those taking the hormone.\u003c/p>\n\u003cp>Still, that doesn't mean testosterone supplements are safe to take long-term, he says. To get those answers, he says, far more research is needed — larger studies that last longer periods of time.\u003c/p>\n\u003cp>Even so, endocrinologist \u003ca href=\"https://www.linkedin.com/in/eric-orwoll-b9283519\">Dr. Eric Orwoll\u003c/a>, with the Oregon Health And Science University, says the findings offer a bit more guidance for doctors and some patients.\u003c/p>\n\u003cp>\"I think we can be confident that there is some benefit for some men,\" Orwoll says. \"This is the first really well-designed and scientifically rigorous trial to get at the question of whether testosterone supplements provide benefit; we didn't have that information before.\"\u003c/p>\n\u003cp>Researchers still don't know exactly which men might benefit.\u003c/p>\n\u003cp>\"The average participant was 72 years of age,\" Orwoll notes in \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMe1600196?query=TOC\">an editorial\u003c/a> that accompanied the journal study. \"Almost 90 percent of participants were white, most were obese, most had hypertension, more than one third had diabetes, and almost 20 percent had sleep apnea.\"\u003c/p>\n\u003cp>Most testosterone prescriptions these days are written for middle-aged men, Orwoll adds — not the demographic included in Snyder's study.\u003c/p>\n\u003cp>\"We should not assume that the benefits, lack of benefits, or adverse-event profile observed in these studies would be similar in younger men, men with higher testosterone levels, or those with different demographic or clinical characteristics,\" Orwoll writes.\u003c/p>\n\u003cp>The supplement was given only to men with abnormally low testosterone — as measured by a blood test. Those men, Orwoll says, now have more information to inform their treatment choices.\u003c/p>\n\u003cp>\"Some men would say, 'Yes! I want to take any chance that there might be that my sexual function will improve, even if it's modest,' \" Orwoll says. \"Other men will say, 'Geez, that doesn't sound very encouraging — I don't want to go to the trouble of using testosterone, particularly when we don't know about long-term risks.' \"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The study, which cost $50 million, is ongoing; researchers will soon analyze supplemental testosterone's effect, if any, on cognitive function, bone health and the cardiovascular system.\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=Study+Shows+Extra+Testosterone+Might+Help+Some+Older+Men&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Mice were much healthier and lived about 25 percent longer when scientists killed off a certain kind of cell that accumulates in the body with age.\u003c/p>\n\u003cp>What's more, the mice didn't seem to suffer any ill effects from losing their so-called senescent cells.\u003c/p>\n\u003caside class=\"pullquote alignright\">Not only did the mice live 25 percent longer, but they had fewer cataracts, hearts with better stress tolerance and improved kidney function.\u003c/aside>\n\u003cp>These are cells that have stopped dividing, though not necessarily because the cells themselves are old. \"It's a normal cell that experienced an unusual amount of stress, and it decided to stop dividing,\" says \u003ca href=\"http://www.mayo.edu/research/faculty/van-deursen-jan-ph-d/bio-00027650\">Jan van Deursen\u003c/a>, who studies senescent cells at the Mayo Clinic College of Medicine in Rochester, Minnesota.\u003c/p>\n\u003cp>Older creatures have a lot more of these cells than young 'uns. And even though the cells aren't dividing, they do keep busy — they secrete a mixture of chemicals that can trigger inflammation, which seems to be involved in just about every major age-related disease.\u003c/p>\n\u003cp>So van Deursen and his colleagues wanted to know: What would happen if you simply got rid of senescent cells? That's tough to do in humans, but possible in mice.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The researchers created mice that were genetically altered so that giving them a drug would trigger senescent cells to kill themselves. Then they waited until the mice reached middle age, and gave some of them the drug.\u003c/p>\n\u003cp>At first, wiping out the senescent cells didn't seem to make much difference. But as the mice got older, the research team could see that the treated mice looked healthier.\u003c/p>\n\u003cp>\"And then when we started to record the life span of the animals, we saw that there was about a 25 percent extension in life span of animals that had their senescent cells removed from 1 year of age on,\" says van Deursen.\u003c/p>\n\u003cp>What's more, the treated mice had fewer cataracts, hearts with better stress tolerance, and improved kidney function. And losing the cells didn't seem to cause them any problems, the researchers \u003ca href=\"http://www.nature.com/nature/journal/vaop/ncurrent/full/nature16932.html\">report\u003c/a> Wednesday in the journal \u003cem>Nature.\u003c/em>\u003c/p>\n\u003cp>The bottom line, says van Deursen, is that \"it seems like we're accumulating a cell type that we really don't need for anything and that makes us more unhealthy and reduces the length of our healthy lives.\"\u003c/p>\n\u003cp>Needless to say, the hunt is already on for drugs that could eliminate these cells in people. That's not going to happen tomorrow, of course, and useful drugs might never materialize. But the findings in mice provide researchers with a new place to look.\u003c/p>\n\u003cp>Van Deursen himself is working with a new company, \u003ca href=\"http://unitybiotechnology.com/\">Unity Biotechnology\u003c/a> in San Francisco, that has some promising candidates.\u003c/p>\n\u003cp>A scientist named \u003ca href=\"http://www.buckinstitute.org/campisiLab\">Judith Campisi\u003c/a>, who studies senescent cells at the independent Buck Institute for Research on Aging, also works with Unity. She thinks the findings of the latest study are significant. \"The impressive thing is those mice not only lived longer but they lived healthier,\" says Campisi.\u003c/p>\n\u003cp>But she cautions that removing these cells isn't going to be a magic bullet against aging.\u003c/p>\n\u003cp>\"Obviously, even in the \u003cem>Nature\u003c/em> paper, those mice got old and died,\" she points out.\u003c/p>\n\u003cp>And some research shows that these cells may have a useful role to play in our bodies. For example, there's evidence that senescent cells aid wound healing and that cellular senescence helps protect against cancer.\u003c/p>\n\u003cp>\"One needs to move forward with care about trying to just kill off senescent cells with the anticipation that things will be wholly beneficial,\" says \u003ca href=\"http://www.imperial.ac.uk/people/d.withers\">Dominic Withers\u003c/a>, a researcher at the MRC Clinical Sciences Centre, Imperial College London.\u003c/p>\n\u003cp>He says it looks like these cells do contribute to aging, but it's too soon to say what to do with them.\u003c/p>\n\u003cp>\"I think it's early days at the moment,\" Withers says. \"There's still quite a lot to learn about whether you would want to try and kill senescent cells or do something to the senescent cells that exist, such as stop them secreting this cocktail of potentially bad molecules.\"\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=Boosting+Life+Span+By+Clearing+Out+Cellular+Clutter&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Mice were much healthier and lived about 25 percent longer when scientists killed off a certain kind of cell that accumulates in the body with age.\u003c/p>\n\u003cp>What's more, the mice didn't seem to suffer any ill effects from losing their so-called senescent cells.\u003c/p>\n\u003caside class=\"pullquote alignright\">Not only did the mice live 25 percent longer, but they had fewer cataracts, hearts with better stress tolerance and improved kidney function.\u003c/aside>\n\u003cp>These are cells that have stopped dividing, though not necessarily because the cells themselves are old. \"It's a normal cell that experienced an unusual amount of stress, and it decided to stop dividing,\" says \u003ca href=\"http://www.mayo.edu/research/faculty/van-deursen-jan-ph-d/bio-00027650\">Jan van Deursen\u003c/a>, who studies senescent cells at the Mayo Clinic College of Medicine in Rochester, Minnesota.\u003c/p>\n\u003cp>Older creatures have a lot more of these cells than young 'uns. And even though the cells aren't dividing, they do keep busy — they secrete a mixture of chemicals that can trigger inflammation, which seems to be involved in just about every major age-related disease.\u003c/p>\n\u003cp>So van Deursen and his colleagues wanted to know: What would happen if you simply got rid of senescent cells? That's tough to do in humans, but possible in mice.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The researchers created mice that were genetically altered so that giving them a drug would trigger senescent cells to kill themselves. Then they waited until the mice reached middle age, and gave some of them the drug.\u003c/p>\n\u003cp>At first, wiping out the senescent cells didn't seem to make much difference. But as the mice got older, the research team could see that the treated mice looked healthier.\u003c/p>\n\u003cp>\"And then when we started to record the life span of the animals, we saw that there was about a 25 percent extension in life span of animals that had their senescent cells removed from 1 year of age on,\" says van Deursen.\u003c/p>\n\u003cp>What's more, the treated mice had fewer cataracts, hearts with better stress tolerance, and improved kidney function. And losing the cells didn't seem to cause them any problems, the researchers \u003ca href=\"http://www.nature.com/nature/journal/vaop/ncurrent/full/nature16932.html\">report\u003c/a> Wednesday in the journal \u003cem>Nature.\u003c/em>\u003c/p>\n\u003cp>The bottom line, says van Deursen, is that \"it seems like we're accumulating a cell type that we really don't need for anything and that makes us more unhealthy and reduces the length of our healthy lives.\"\u003c/p>\n\u003cp>Needless to say, the hunt is already on for drugs that could eliminate these cells in people. That's not going to happen tomorrow, of course, and useful drugs might never materialize. But the findings in mice provide researchers with a new place to look.\u003c/p>\n\u003cp>Van Deursen himself is working with a new company, \u003ca href=\"http://unitybiotechnology.com/\">Unity Biotechnology\u003c/a> in San Francisco, that has some promising candidates.\u003c/p>\n\u003cp>A scientist named \u003ca href=\"http://www.buckinstitute.org/campisiLab\">Judith Campisi\u003c/a>, who studies senescent cells at the independent Buck Institute for Research on Aging, also works with Unity. She thinks the findings of the latest study are significant. \"The impressive thing is those mice not only lived longer but they lived healthier,\" says Campisi.\u003c/p>\n\u003cp>But she cautions that removing these cells isn't going to be a magic bullet against aging.\u003c/p>\n\u003cp>\"Obviously, even in the \u003cem>Nature\u003c/em> paper, those mice got old and died,\" she points out.\u003c/p>\n\u003cp>And some research shows that these cells may have a useful role to play in our bodies. For example, there's evidence that senescent cells aid wound healing and that cellular senescence helps protect against cancer.\u003c/p>\n\u003cp>\"One needs to move forward with care about trying to just kill off senescent cells with the anticipation that things will be wholly beneficial,\" says \u003ca href=\"http://www.imperial.ac.uk/people/d.withers\">Dominic Withers\u003c/a>, a researcher at the MRC Clinical Sciences Centre, Imperial College London.\u003c/p>\n\u003cp>He says it looks like these cells do contribute to aging, but it's too soon to say what to do with them.\u003c/p>\n\u003cp>\"I think it's early days at the moment,\" Withers says. \"There's still quite a lot to learn about whether you would want to try and kill senescent cells or do something to the senescent cells that exist, such as stop them secreting this cocktail of potentially bad molecules.\"\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=Boosting+Life+Span+By+Clearing+Out+Cellular+Clutter&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New Low-Cost Test For Cystic Fibrosis",
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"headTitle": "Future of You | KQED Future of You | KQED Science",
"content": "\u003cp>The bad news came on Kirsten McGowan's birthday. She was pregnant with her first child Patrick, and discovered she was a carrier for cystic fibrosis.\u003c/p>\n\u003cp>A child can only inherit the disease if both parents are carriers, and McGowan's husband also tested positive.\u003c/p>\n\u003cp>\"It hit us out of the blue,\" McGowan says.\u003c/p>\n\u003cp>The genetic disease causes mucus to build up in the lungs and digestive system. Digestive enzymes are blocked, which inhibits the absorption of food nutrients. It's a chronic illness that can't be cured, but can be treated.\u003c/p>\n\u003cp>When Patrick was born with the illness, doctors put him on a diet high in protein, fat and salt so he'd maintain a healthy weight. And they outlined a daily breathing regime of two to three hours to prevent mucus build-up in his lungs.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cimg class=\"alignright wp-image-104549\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/01/cystic-fibrosis-image.jpg\" alt=\"cystic fibrosis image\" width=\"336\" height=\"240\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/01/cystic-fibrosis-image.jpg 493w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/cystic-fibrosis-image-400x286.jpg 400w\" sizes=\"(max-width: 336px) 100vw, 336px\">Mucus builds up because CF makes it more thick and viscous.\u003c/p>\n\u003cp>The CF gene controls the movement of chloride ions in and out of cells, which regulates the salt and water balances in the lungs and pancreas. Mutations in this gene rob mucus of water and it builds up in the lungs it can inhibit breathing.\u003c/p>\n\u003cp>McGowan says detecting the illness early in Patrick meant he could get treatment right away.\u003c/p>\n\u003cp>\"Getting a diagnosis early is key,\" says McGowan. \"Knowing sooner helps you process that emotion--to be angry, to be sad--and then say, 'OK, now h\u003cspan style=\"font-weight: 400\">ow do I help my son or daughter stay healthy.\"\u003c/span>\u003c/p>\n\u003cp>CF is the most common fatal genetic disease in the United States. It takes just two CF gene mutation to cause cystic fibrosis and more than 2,000 changes are known.\u003c/p>\n\u003cp>\u003cstrong>A Rapid and Affordable New Test\u003c/strong>\u003c/p>\n\u003cp>Forty different genetic mutations account for most types of cystic fibrosis in California. The state tests for these common mutations but there are more than 2,000 possible changes, and more are discovered each year.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"Current tests are not comprehensive,\" says Stanford geneticist Curt Scharfe. \u003c/span>\"They can miss newborns with two rare mutations.\"\u003c/p>\n\u003cp>Scharfe compares the CF gene mutations to typos in a novel. But imagine a really big novel, like \"War and Peace,\" with really unusual typos.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"Imagine changes in a letter in a word somewhere in a book,\" says Scharfe. \"It doesn't help if you read one page very well, you need to read all these pages--or genetic changes--well. We're talking about rare typos and they happen once, not many times.\"\u003c/span>\u003c/p>\n\u003cp>Currently, the state has a tiered testing method for CF; it\u003cstrong> \u003c/strong>tests once for common mutations and send all positive results to Stanford for further testing. Stanford does about 9,000 tests a year.\u003c/p>\n\u003cp>Now, researchers at Stanford have figured out how to do \u003ca href=\"http://jmd.amjpathol.org/article/S1525-1578(15)00275-5/abstract\" target=\"_blank\">one test for CF \u003c/a>using genome sequencing. The scientists were able to sequence the entire CF gene which means they can spot any and all abnormalities.\u003c/p>\n\u003cfigure id=\"attachment_104686\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-104686\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/01/Dried-blood-testing-800x443.jpg\" alt=\"Stanford researchers were able to take enough DNA from dried blood spots to test newborns for cystic fibrosis.\" width=\"800\" height=\"443\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/01/Dried-blood-testing-800x443.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/Dried-blood-testing-400x221.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/Dried-blood-testing-768x425.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/Dried-blood-testing-960x532.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/Dried-blood-testing-672x372.jpg 672w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/Dried-blood-testing.jpg 1024w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Stanford researchers were able to take enough DNA from dried blood to sequence the CF gene for cystic fibrosis. \u003ccite>(Eric T. Sheler/US Air Force)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At birth, all infants get a heel pin-prick to test their blood for a range of diseases. Stanford researchers used blood from the test to map\u003cstrong> \u003c/strong>the CF gene. Now when they test babies, the results show whether or not a baby has a mutation on that gene.\u003c/p>\n\u003cp>The other benefit of Stanford's new test is that researchers can sequence DNA from nearly 100 babies at once in an \u003ca href=\"http://www.illumina.com/systems/miseq.html\">Illumina genome sequencing machine\u003c/a>.\u003c/p>\n\u003cp>This process takes only a few days and Scharfe hopes eventually it will only take a few hours. Current tests take longer than a week.\u003c/p>\n\u003cp>And because the process sequences the entire CF genome it won't miss mutations, even if they are extremely rare.\u003c/p>\n\u003cp>\u003cstrong>The Future for Stanford's CF Test\u003c/strong>\u003c/p>\n\u003cp>Stanford's new test is about one-fifth the cost of current CF tests. That's partially because genome sequencing has become much less expensive. Analyzing the CF gene is possible in a way that it wasn't fifty years ago.\u003c/p>\n\u003cfigure id=\"attachment_105112\" class=\"wp-caption alignright\" style=\"max-width: 338px\">\u003cimg class=\"size-medium wp-image-105112\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/01/IMG_7115-338x600.png\" alt=\"At age six, Patrick McGowan is extremely active and shows few outward signs of cystic fibrosis.\" width=\"338\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">At age six, Patrick McGowan is extremely active and shows few outward signs of cystic fibrosis. \u003ccite>(Kirsten McGowan)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So Scharfe hopes that, eventually, the test will be used throughout the country.\u003c/p>\n\u003cp>\"California has the most comprehensive cystic fibrosis testing program and it would be very beneficial to have this new test available in many states.\"\u003c/p>\n\u003cp>Before California's statewide newborn screening program started in 1966, many kids with genetic disorders would go undiagnosed and symptoms would show up later.\u003cstrong>\u003cbr>\n\u003c/strong>\u003cbr>\nBut this hasn't been a problem for Kirsten's son Patrick.\u003c/p>\n\u003cp>\"Outwardly he looks like any other kid walking down the sidewalk,\" says McGowan.\u003c/p>\n\u003cp>She said early detection of genetic diseases is crucial.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The sooner you get that news, the sooner you stop thinking ‘what if’. And then can get to that good place of living with the disease.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The bad news came on Kirsten McGowan's birthday. She was pregnant with her first child Patrick, and discovered she was a carrier for cystic fibrosis.\u003c/p>\n\u003cp>A child can only inherit the disease if both parents are carriers, and McGowan's husband also tested positive.\u003c/p>\n\u003cp>\"It hit us out of the blue,\" McGowan says.\u003c/p>\n\u003cp>The genetic disease causes mucus to build up in the lungs and digestive system. Digestive enzymes are blocked, which inhibits the absorption of food nutrients. It's a chronic illness that can't be cured, but can be treated.\u003c/p>\n\u003cp>When Patrick was born with the illness, doctors put him on a diet high in protein, fat and salt so he'd maintain a healthy weight. And they outlined a daily breathing regime of two to three hours to prevent mucus build-up in his lungs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cimg class=\"alignright wp-image-104549\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/01/cystic-fibrosis-image.jpg\" alt=\"cystic fibrosis image\" width=\"336\" height=\"240\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/01/cystic-fibrosis-image.jpg 493w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/cystic-fibrosis-image-400x286.jpg 400w\" sizes=\"(max-width: 336px) 100vw, 336px\">Mucus builds up because CF makes it more thick and viscous.\u003c/p>\n\u003cp>The CF gene controls the movement of chloride ions in and out of cells, which regulates the salt and water balances in the lungs and pancreas. Mutations in this gene rob mucus of water and it builds up in the lungs it can inhibit breathing.\u003c/p>\n\u003cp>McGowan says detecting the illness early in Patrick meant he could get treatment right away.\u003c/p>\n\u003cp>\"Getting a diagnosis early is key,\" says McGowan. \"Knowing sooner helps you process that emotion--to be angry, to be sad--and then say, 'OK, now h\u003cspan style=\"font-weight: 400\">ow do I help my son or daughter stay healthy.\"\u003c/span>\u003c/p>\n\u003cp>CF is the most common fatal genetic disease in the United States. It takes just two CF gene mutation to cause cystic fibrosis and more than 2,000 changes are known.\u003c/p>\n\u003cp>\u003cstrong>A Rapid and Affordable New Test\u003c/strong>\u003c/p>\n\u003cp>Forty different genetic mutations account for most types of cystic fibrosis in California. The state tests for these common mutations but there are more than 2,000 possible changes, and more are discovered each year.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"Current tests are not comprehensive,\" says Stanford geneticist Curt Scharfe. \u003c/span>\"They can miss newborns with two rare mutations.\"\u003c/p>\n\u003cp>Scharfe compares the CF gene mutations to typos in a novel. But imagine a really big novel, like \"War and Peace,\" with really unusual typos.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">\"Imagine changes in a letter in a word somewhere in a book,\" says Scharfe. \"It doesn't help if you read one page very well, you need to read all these pages--or genetic changes--well. We're talking about rare typos and they happen once, not many times.\"\u003c/span>\u003c/p>\n\u003cp>Currently, the state has a tiered testing method for CF; it\u003cstrong> \u003c/strong>tests once for common mutations and send all positive results to Stanford for further testing. Stanford does about 9,000 tests a year.\u003c/p>\n\u003cp>Now, researchers at Stanford have figured out how to do \u003ca href=\"http://jmd.amjpathol.org/article/S1525-1578(15)00275-5/abstract\" target=\"_blank\">one test for CF \u003c/a>using genome sequencing. The scientists were able to sequence the entire CF gene which means they can spot any and all abnormalities.\u003c/p>\n\u003cfigure id=\"attachment_104686\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-104686\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/01/Dried-blood-testing-800x443.jpg\" alt=\"Stanford researchers were able to take enough DNA from dried blood spots to test newborns for cystic fibrosis.\" width=\"800\" height=\"443\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/01/Dried-blood-testing-800x443.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/Dried-blood-testing-400x221.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/Dried-blood-testing-768x425.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/Dried-blood-testing-960x532.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/Dried-blood-testing-672x372.jpg 672w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/Dried-blood-testing.jpg 1024w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Stanford researchers were able to take enough DNA from dried blood to sequence the CF gene for cystic fibrosis. \u003ccite>(Eric T. Sheler/US Air Force)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At birth, all infants get a heel pin-prick to test their blood for a range of diseases. Stanford researchers used blood from the test to map\u003cstrong> \u003c/strong>the CF gene. Now when they test babies, the results show whether or not a baby has a mutation on that gene.\u003c/p>\n\u003cp>The other benefit of Stanford's new test is that researchers can sequence DNA from nearly 100 babies at once in an \u003ca href=\"http://www.illumina.com/systems/miseq.html\">Illumina genome sequencing machine\u003c/a>.\u003c/p>\n\u003cp>This process takes only a few days and Scharfe hopes eventually it will only take a few hours. Current tests take longer than a week.\u003c/p>\n\u003cp>And because the process sequences the entire CF genome it won't miss mutations, even if they are extremely rare.\u003c/p>\n\u003cp>\u003cstrong>The Future for Stanford's CF Test\u003c/strong>\u003c/p>\n\u003cp>Stanford's new test is about one-fifth the cost of current CF tests. That's partially because genome sequencing has become much less expensive. Analyzing the CF gene is possible in a way that it wasn't fifty years ago.\u003c/p>\n\u003cfigure id=\"attachment_105112\" class=\"wp-caption alignright\" style=\"max-width: 338px\">\u003cimg class=\"size-medium wp-image-105112\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/01/IMG_7115-338x600.png\" alt=\"At age six, Patrick McGowan is extremely active and shows few outward signs of cystic fibrosis.\" width=\"338\" height=\"600\">\u003cfigcaption class=\"wp-caption-text\">At age six, Patrick McGowan is extremely active and shows few outward signs of cystic fibrosis. \u003ccite>(Kirsten McGowan)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So Scharfe hopes that, eventually, the test will be used throughout the country.\u003c/p>\n\u003cp>\"California has the most comprehensive cystic fibrosis testing program and it would be very beneficial to have this new test available in many states.\"\u003c/p>\n\u003cp>Before California's statewide newborn screening program started in 1966, many kids with genetic disorders would go undiagnosed and symptoms would show up later.\u003cstrong>\u003cbr>\n\u003c/strong>\u003cbr>\nBut this hasn't been a problem for Kirsten's son Patrick.\u003c/p>\n\u003cp>\"Outwardly he looks like any other kid walking down the sidewalk,\" says McGowan.\u003c/p>\n\u003cp>She said early detection of genetic diseases is crucial.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The sooner you get that news, the sooner you stop thinking ‘what if’. 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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>STAT's \"Signal\" podcast has put up its latest episode, called \"\u003ca href=\"http://www.statnews.com/2016/01/28/podcast-alzheimers-amyloid-science/\" target=\"_blank\">Choosing scientific sides in the fight against Alzheimer's\u003c/a>.\"\u003c/p>\n\u003cp>The segment takes a look at the \u003ca href=\"https://www.google.com/webhp?sourceid=chrome-instant&ion=1&espv=2&ie=UTF-8#q=amyloid%20hypothesis%20controversy\" target=\"_blank\">controversy\u003c/a> around the theory that the buildup in the brain of a protein called beta amyloid is a key cause of Alzheimer's. This is called \"the amyloid hypothesis.\" For almost 30 years, STAT says, researchers have targeted the protein in trying to fight the disease.\u003c/p>\n\u003cp>But \"the industry as a whole has so far struck out,\" STAT says. \"Out of 244 drugs tested between 2002 and 2012, only one successfully got to market.\"\u003c/p>\n\u003cp>And not all scientists agree the amyloid hypothesis is even correct. Listen below ...\u003c/p>\n\u003cp>https://soundcloud.com/stat-signal-podcast/episode-6-choosing-scientific-sides-in-the-fight-against-alzheimers\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Scientists pursuing the biological roots of schizophrenia have zeroed in on a potential factor — a normal brain process that gets kicked into overdrive. The finding could someday lead to ways to treat the disease or even prevent it.\u003c/p>\n\u003cp>The result — accomplished by analysis of genetics, autopsy brain tissue and laboratory mice — is \"going to be a game-changer\" in terms of understanding schizophrenia and offering routes for treatment and potential for prevention, said Bruce Cuthbert, acting deputy director of the National Institute of Mental Health, which helped fund the research.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"100%\" height=\"124\" scrolling=\"no\" frameborder=\"no\" src=\"//embed.wbur.org/player/hereandnow/2016/01/27/schizophrenia-gene\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>An expert unconnected to the research said the study's conclusion was not yet proven, but plausible.\u003c/p>\n\u003cp>Almost 1 percent of the general population will have schizophrenia at some point in their lives. They may hear voices or hallucinate, talk about strange ideas, and believe others are reading their minds or plotting against them.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Nobody knows what causes the disorder, so the new result offers a possible peek into a black box. The work is reported in a \u003ca href=\"http://www.nature.com/nature/journal/vaop/ncurrent/full/nature16549.html\" target=\"_blank\">paper\u003c/a> released Wednesday by the journal Nature.\u003c/p>\n\u003cp>The finding might pertain to \"a very substantial fraction of cases, maybe most cases, even,\" said senior author Steven McCarroll, of Harvard Medical School and the Broad Institute in Cambridge, Massachusetts.\u003c/p>\n\u003cp>https://vimeo.com/106122585\u003c/p>\n\u003cp>The result links schizophrenia risk to a problem with a normal process that happens in adolescence and early adulthood, when disease symptoms often appear. That age range is when the brain trims back the number of specialized places on brain cells where the cells signal each other, called synapses. The new work suggests a connection to schizophrenia when this process gets out of hand, deleting too many synapses.\u003c/p>\n\u003cp>\"It's like you have a gardener who was supposed to prune the bushes and just got overactive,\" Cuthbert observed. \"You end up with bushes that are pruned way too much.\"\u003c/p>\n\u003cp>The result doesn't mean over-pruning causes schizophrenia on its own. It could promote the disease in combination with other factors in the brain, McCarroll said.\u003c/p>\n\u003cp>[contextly_sidebar id=\"uuZTjFjJXl20JTX7E1Sm3O0Vq2hq0aGz\"]The work began with a genetic investigation. Previous analysis of the human DNA indicates over 100 places that influence the risk of getting schizophrenia, but detailed biological explanations for those influences are very rare. The new work identified a risk gene and found evidence for the over-pruning idea.\u003c/p>\n\u003cp>Drawing on DNA data from 28,799 people with schizophrenia and 35,986 people without it, the researchers found that a gene called C4 can raise a person's risk by about 30 percent over that of the general population.\u003c/p>\n\u003cp>The gene comes in several forms, and researchers examining brain tissue found evidence that the forms that pose the most risk of schizophrenia were also the most active in the brain. In lab mice, they found that the gene plays a key role in pruning synapses.\u003c/p>\n\u003cp>The study doesn't directly demonstrate that excessive pruning of synapses plays a role in schizophrenia, but the idea makes sense, McCarroll said. It ties together previous observations, among them that schizophrenia most often develops during youth and that patients' brains show unusually few synapses, he said.\u003c/p>\n\u003cp>[contextly_sidebar id=\"602z5KFzIF50tC5NzfumWiNV260SBmeO\"]Dr. Kenneth Kendler, a schizophrenia genetics expert at Virginia Commonwealth University in Richmond who didn't participate in the project, said the work presents an impressive array of results. The evidence that C4 can raise schizophrenia risk is strong, he said. The proposal that it does so through excessive pruning of synapses is \"plausible and interesting, but not yet fully convincing,\" he said.\u003c/p>\n\u003cp>\"We don't yet know (whether) their hypothesis is completely true,\" Kendler said, but the work is still \"a pretty big deal.\"\u003c/p>\n\u003cp>If it's true, scientists can think about finding drugs that would intervene, McCarroll said. They might be useful to give when young people show symptoms that suggest they may be on the road to developing schizophrenia, he said. And even after the diagnosis, such drugs might keep the disease from getting worse, he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But any such treatments are years away, he cautioned.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Scientists pursuing the biological roots of schizophrenia have zeroed in on a potential factor — a normal brain process that gets kicked into overdrive. The finding could someday lead to ways to treat the disease or even prevent it.\u003c/p>\n\u003cp>The result — accomplished by analysis of genetics, autopsy brain tissue and laboratory mice — is \"going to be a game-changer\" in terms of understanding schizophrenia and offering routes for treatment and potential for prevention, said Bruce Cuthbert, acting deputy director of the National Institute of Mental Health, which helped fund the research.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"100%\" height=\"124\" scrolling=\"no\" frameborder=\"no\" src=\"//embed.wbur.org/player/hereandnow/2016/01/27/schizophrenia-gene\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>An expert unconnected to the research said the study's conclusion was not yet proven, but plausible.\u003c/p>\n\u003cp>Almost 1 percent of the general population will have schizophrenia at some point in their lives. They may hear voices or hallucinate, talk about strange ideas, and believe others are reading their minds or plotting against them.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Nobody knows what causes the disorder, so the new result offers a possible peek into a black box. The work is reported in a \u003ca href=\"http://www.nature.com/nature/journal/vaop/ncurrent/full/nature16549.html\" target=\"_blank\">paper\u003c/a> released Wednesday by the journal Nature.\u003c/p>\n\u003cp>The finding might pertain to \"a very substantial fraction of cases, maybe most cases, even,\" said senior author Steven McCarroll, of Harvard Medical School and the Broad Institute in Cambridge, Massachusetts.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The result links schizophrenia risk to a problem with a normal process that happens in adolescence and early adulthood, when disease symptoms often appear. That age range is when the brain trims back the number of specialized places on brain cells where the cells signal each other, called synapses. The new work suggests a connection to schizophrenia when this process gets out of hand, deleting too many synapses.\u003c/p>\n\u003cp>\"It's like you have a gardener who was supposed to prune the bushes and just got overactive,\" Cuthbert observed. \"You end up with bushes that are pruned way too much.\"\u003c/p>\n\u003cp>The result doesn't mean over-pruning causes schizophrenia on its own. It could promote the disease in combination with other factors in the brain, McCarroll said.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The work began with a genetic investigation. Previous analysis of the human DNA indicates over 100 places that influence the risk of getting schizophrenia, but detailed biological explanations for those influences are very rare. The new work identified a risk gene and found evidence for the over-pruning idea.\u003c/p>\n\u003cp>Drawing on DNA data from 28,799 people with schizophrenia and 35,986 people without it, the researchers found that a gene called C4 can raise a person's risk by about 30 percent over that of the general population.\u003c/p>\n\u003cp>The gene comes in several forms, and researchers examining brain tissue found evidence that the forms that pose the most risk of schizophrenia were also the most active in the brain. In lab mice, they found that the gene plays a key role in pruning synapses.\u003c/p>\n\u003cp>The study doesn't directly demonstrate that excessive pruning of synapses plays a role in schizophrenia, but the idea makes sense, McCarroll said. It ties together previous observations, among them that schizophrenia most often develops during youth and that patients' brains show unusually few synapses, he said.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Dr. Kenneth Kendler, a schizophrenia genetics expert at Virginia Commonwealth University in Richmond who didn't participate in the project, said the work presents an impressive array of results. The evidence that C4 can raise schizophrenia risk is strong, he said. The proposal that it does so through excessive pruning of synapses is \"plausible and interesting, but not yet fully convincing,\" he said.\u003c/p>\n\u003cp>\"We don't yet know (whether) their hypothesis is completely true,\" Kendler said, but the work is still \"a pretty big deal.\"\u003c/p>\n\u003cp>If it's true, scientists can think about finding drugs that would intervene, McCarroll said. They might be useful to give when young people show symptoms that suggest they may be on the road to developing schizophrenia, he said. And even after the diagnosis, such drugs might keep the disease from getting worse, he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But any such treatments are years away, he cautioned.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Medical editors don't usually attract much attention. They perform their daily duties evaluating submissions and producing articles that, on good days, influence practice and policy.\u003c/p>\n\u003cp>But last Wednesday, the editors of the leading medical journals around the world made \u003ca href=\"http://www.icmje.org/news-and-editorials/M15-2928-PAP.pdf\">a proposal\u003c/a> that could change medical science forever. They said that researchers would have to publicly share the data gathered in their clinical studies as a condition of publishing the results in the journals. This idea is now out for public comment.\u003c/p>\n\u003cp>As it stands now, medical scientists can publish their findings without ever making available the data upon which their conclusions were based.\u003c/p>\n\u003caside class=\"alignright\">Leading medical journals are proposing as a condition of publication of research a commitment to share data on individual patients within six months.\u003c/aside>\n\u003cp>Only some of the top journals, such as \u003cem>The BMJ,\u003c/em> have tried to make data sharing a condition of publication. But authors who didn't want to comply could just go elsewhere.\u003c/p>\n\u003cp>Think about it. The scientists who generate the data, with the participation of the people being studied and often with public funding, control it and most often don't share. By holding the data tight, researchers who ran a study are the only ones who can conduct additional analysis and studies.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>If the proposed change is adopted, as I hope it will be, it would make sharing more compelling.\u003c/p>\n\u003cp>Inaccessible data is a problem rife throughout medical science. Industry traditionally held its data close — but so did academics.\u003c/p>\n\u003cp>These researchers have felt that they deserved the right to future papers for all their hard work gathering the original data. And maybe they didn't want others examining their work.\u003c/p>\n\u003cp>But this practice shields data from scrutiny. It forgoes an opportunity to crowdsource knowledge from scientists who weren't associated with the original study. It also violates the sensible practice of showing your work, not just the presumed answer.\u003c/p>\n\u003cp>Some skeptics contend that those who pore over data generated elsewhere are nothing more than \"\u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMe1516564\">research parasites\u003c/a>.\" But that disparaging term neglects the key role that independent scientists can play in bringing new insights and also in validating the quality of the data that were collected. Access is also central to the scientific method and the idea of replication to establish the truth.\u003c/p>\n\u003cp>The editors who made the proposal sought to be sensitive to the rights of researchers, funders and participants. But their intent is clear: It's time to share.\u003c/p>\n\u003cp>The past culture has impeded science. For example, many times in my career as a heart disease researcher, I respectfully requested access to clinical trial data held by others. The response was no — regardless of the merit of the request — and most often from other academics. It is a behavior that would be hard to imagine in other fields, like physics or astronomy.\u003c/p>\n\u003cp>The data from clinical trials have the potential to provide additional knowledge that often goes untapped.\u003c/p>\n\u003cp>There were times my research group was able to gain access to data through the National Heart, Lung and Blood Institute, which promotes sharing of trials it funds, or through litigation. We uncovered insights that weren't in the original articles. Our work produced papers that found their way into the \u003cem>New England Journal of Medicine\u003c/em> and \u003cem>JAMA,\u003c/em> the Journal of the American Medical Association. The findings have since been cited by thousands of other papers, incorporated in treatment guidelines for doctors and patients. In several cases our results upended the original conclusions.\u003c/p>\n\u003cp>Others have also used trial data to replicate and extend findings from the initial studies and made critically important contributions.\u003c/p>\n\u003cp>In recent years the momentum for open science has grown rapidly. This action by the editors follows directly from \u003ca href=\"http://iom.nationalacademies.org/Activities/Research/SharingClinicalTrialData/2015-JAN-14.aspx\">guidance\u003c/a> in 2015 from the National Academy of Medicine (formerly the Institute of Medicine), a body of the nation's top medical experts, that said clearly it is time for the culture of medical research to change.\u003c/p>\n\u003cp>Companies such as GlaxoSmithKline, Johnson & Johnson and Medtronic have led the way in sharing their trial data. Our group at the Yale Center for Outcomes Research and Evaluation started the \u003ca href=\"http://yoda.yale.edu/\">Yale Open Data Access Project\u003c/a> to promote data sharing and was an early advocate for open science. We are showing the feasibility of establishing partnerships with industry and acting as a trusted intermediary. Visit the site, and you can see a variety of trials from Johnson & Johnson that are available to scientists around the world.\u003c/p>\n\u003cp>With sharing, the sky hasn't fallen and worthwhile independent projects that could not have been done otherwise are proceeding. Many academics and companies are lagging, however. As a result, the data from a large number of trials remain off-limits.\u003c/p>\n\u003cp>Amid the progress, there has been a lack of consequences for not sharing. Even as the benefits from sharing are manifold, to be honest, it's easier not to share. Why expose your data to others? Why compromise your ability to publish more at your own pace? Why risk the possibility that someone could find an error? Why let others benefit from your hard work? Why spend the money to do it?\u003c/p>\n\u003cp>The absence of an incentive to share seems about to change. The proposal by the medical editors outlines an approach that would require: a data-sharing policy when the study is started; a commitment to share within six months of publication; and that those who use the data acknowledge those who produced it. The data should be down to the level of the individual patient (identifying information will be removed) rather than just summary data, an important detail that will allow rigorous science to proceed.\u003c/p>\n\u003cp>Among the first things we learn in school are to share and to show our work. This lesson has been lost on medicine for many years. The medical editors are reminding us that we scientists have a principal responsibility to society and to those who agreed to participate in our studies.\u003c/p>\n\u003cp>There are many details to resolve. How will sharing work? Who will pay for it? How will the researchers who produced the work get credit in the subsequent analyses? All good and difficult questions, but it is high time to find solutions.\u003c/p>\n\u003cp>For now, this proposal is out for public comment. It is likely that mostly scientists will weigh in on how the change would affect their work. It would be great, in my view, if the general public participated too. Do people want to see scientific data exposed to the light, available to advance knowledge for generations? The public stands to benefit the most. I hope that voices other than those of my colleagues will be heard.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Harlan Krumholz is a cardiologist and the Harold H. Hines Jr. Professor of Medicine at Yale School of Medicine. He directs the Yale-New Haven Hospital Center for Outcomes Research and Evaluation and is a co-director of the Robert Wood Johnson Foundation Clinical Scholars Program. To comment on the proposal described above, you can go to\u003c/em> \u003ca href=\"http://www.icmje.org/\">www.icmje.org\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>If the proposed change is adopted, as I hope it will be, it would make sharing more compelling.\u003c/p>\n\u003cp>Inaccessible data is a problem rife throughout medical science. Industry traditionally held its data close — but so did academics.\u003c/p>\n\u003cp>These researchers have felt that they deserved the right to future papers for all their hard work gathering the original data. And maybe they didn't want others examining their work.\u003c/p>\n\u003cp>But this practice shields data from scrutiny. It forgoes an opportunity to crowdsource knowledge from scientists who weren't associated with the original study. It also violates the sensible practice of showing your work, not just the presumed answer.\u003c/p>\n\u003cp>Some skeptics contend that those who pore over data generated elsewhere are nothing more than \"\u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMe1516564\">research parasites\u003c/a>.\" But that disparaging term neglects the key role that independent scientists can play in bringing new insights and also in validating the quality of the data that were collected. Access is also central to the scientific method and the idea of replication to establish the truth.\u003c/p>\n\u003cp>The editors who made the proposal sought to be sensitive to the rights of researchers, funders and participants. But their intent is clear: It's time to share.\u003c/p>\n\u003cp>The past culture has impeded science. For example, many times in my career as a heart disease researcher, I respectfully requested access to clinical trial data held by others. 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In several cases our results upended the original conclusions.\u003c/p>\n\u003cp>Others have also used trial data to replicate and extend findings from the initial studies and made critically important contributions.\u003c/p>\n\u003cp>In recent years the momentum for open science has grown rapidly. This action by the editors follows directly from \u003ca href=\"http://iom.nationalacademies.org/Activities/Research/SharingClinicalTrialData/2015-JAN-14.aspx\">guidance\u003c/a> in 2015 from the National Academy of Medicine (formerly the Institute of Medicine), a body of the nation's top medical experts, that said clearly it is time for the culture of medical research to change.\u003c/p>\n\u003cp>Companies such as GlaxoSmithKline, Johnson & Johnson and Medtronic have led the way in sharing their trial data. Our group at the Yale Center for Outcomes Research and Evaluation started the \u003ca href=\"http://yoda.yale.edu/\">Yale Open Data Access Project\u003c/a> to promote data sharing and was an early advocate for open science. We are showing the feasibility of establishing partnerships with industry and acting as a trusted intermediary. Visit the site, and you can see a variety of trials from Johnson & Johnson that are available to scientists around the world.\u003c/p>\n\u003cp>With sharing, the sky hasn't fallen and worthwhile independent projects that could not have been done otherwise are proceeding. Many academics and companies are lagging, however. As a result, the data from a large number of trials remain off-limits.\u003c/p>\n\u003cp>Amid the progress, there has been a lack of consequences for not sharing. Even as the benefits from sharing are manifold, to be honest, it's easier not to share. Why expose your data to others? Why compromise your ability to publish more at your own pace? Why risk the possibility that someone could find an error? Why let others benefit from your hard work? Why spend the money to do it?\u003c/p>\n\u003cp>The absence of an incentive to share seems about to change. The proposal by the medical editors outlines an approach that would require: a data-sharing policy when the study is started; a commitment to share within six months of publication; and that those who use the data acknowledge those who produced it. The data should be down to the level of the individual patient (identifying information will be removed) rather than just summary data, an important detail that will allow rigorous science to proceed.\u003c/p>\n\u003cp>Among the first things we learn in school are to share and to show our work. This lesson has been lost on medicine for many years. The medical editors are reminding us that we scientists have a principal responsibility to society and to those who agreed to participate in our studies.\u003c/p>\n\u003cp>There are many details to resolve. How will sharing work? Who will pay for it? How will the researchers who produced the work get credit in the subsequent analyses? All good and difficult questions, but it is high time to find solutions.\u003c/p>\n\u003cp>For now, this proposal is out for public comment. It is likely that mostly scientists will weigh in on how the change would affect their work. It would be great, in my view, if the general public participated too. Do people want to see scientific data exposed to the light, available to advance knowledge for generations? The public stands to benefit the most. I hope that voices other than those of my colleagues will be heard.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Harlan Krumholz is a cardiologist and the Harold H. Hines Jr. Professor of Medicine at Yale School of Medicine. He directs the Yale-New Haven Hospital Center for Outcomes Research and Evaluation and is a co-director of the Robert Wood Johnson Foundation Clinical Scholars Program. To comment on the proposal described above, you can go to\u003c/em> \u003ca href=\"http://www.icmje.org/\">www.icmje.org\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>In a \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2480485\">new study\u003c/a>, scientists have shown just how hard it will be to one day use your DNA to predict your risk for illnesses.\u003c/p>\n\u003cp>As expected, it wasn’t the reading of the DNA that was the tricky part -- that gets cheaper and easier all the time.\u003c/p>\n\u003cp>Instead, the difficulty was figuring out which DNA differences mattered and which didn’t. Four groups of scientists couldn’t agree on which differences predicted an increased risk for an irregular heartbeat and which didn’t. And even the differences they compared didn’t turn out to predict much of anything.\u003c/p>\n\u003cp>Until scientists work this out, the dream of truly personalized medicine will remain a distant one.\u003c/p>\n\u003cp>\u003cstrong>Harder Than We Thought\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_97653\" class=\"wp-caption aligncenter\" style=\"max-width: 750px\">\u003cimg class=\"size-full wp-image-97653\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/01/DoctorPatient01142016.jpg\" alt=\"It may be awhile before you are discussing with your doctor what your DNA tells you about your health risks. (NHGRI)\" width=\"750\" height=\"569\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/01/DoctorPatient01142016.jpg 750w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/DoctorPatient01142016-400x303.jpg 400w\" sizes=\"(max-width: 750px) 100vw, 750px\">\u003cfigcaption class=\"wp-caption-text\">It may be awhile before you are discussing with your doctor what your DNA tells you about your health risks. (\u003ca href=\"http://www.genome.gov/dmd/img.cfm?node=Photos/Graphics&id=85342\">NHGRI\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>Listening to the news, you can be forgiven for thinking that sooner rather than later doctors will be able to predict most anything about your health from a look at your DNA.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In fact, right now, they can’t tell you a whole lot.\u003c/p>\n\u003cp>Now this isn’t to say doctors can’t get some very important information from your DNA. There are definitely some differences (or “\u003ca href=\"https://en.wikipedia.org/wiki/Human_genetic_variation\">variants\u003c/a>”) that can be used to help \u003ca href=\"http://ghr.nlm.nih.gov/handbook/genomicresearch/pharmacogenomics\">determine just the right amount of medicine\u003c/a> you should be prescribed. And some real progress is being made in helping to find more targeted \u003ca href=\"http://cancergenome.nih.gov/cancergenomics/whatisgenomics/whatis\">treatments for a patient’s particular cancer\u003c/a>.\u003c/p>\n\u003cp>But the day when you can go to your doctor and she can correctly tell you only from your DNA which ailment you are at a higher risk for is a long way off. This becomes clear in a \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2480485\">new study\u003c/a> in the Journal of the American Medical Association (JAMA).\u003c/p>\n\u003cp>In this study researchers couldn’t use DNA to reliably predict who, from a group of 2,202 patients, was at a higher risk for \u003ca href=\"http://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_300290.pdf\">arrhythmia\u003c/a>, an irregular heartbeat. This is surprising because the two genes they looked at are supposedly \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23788249\">two out there that are better understood\u003c/a>.\u003c/p>\n\u003cp>If we can’t make good predictions on the few genes we understand really well, then odds are we will do even worse with the ones that are still more of a mystery. And these are the genes people will be most interested in, involved in heart disease, type 2 diabetes and so on.\u003c/p>\n\u003cp>This was a small study and it may be that with a larger group of patients, scientists will be able to make better predictions. But regardless it does give us an inkling of what we are up against in the upcoming genomics revolution.\u003c/p>\n\u003cp>It is going to be a hard slog. But in the end, the hope is that it will be worth it because it will make us all healthier.\u003c/p>\n\u003cp>\u003cstrong>The Pitfalls of Personalized Medicine\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_97681\" class=\"wp-caption aligncenter\" style=\"max-width: 750px\">\u003cimg class=\"size-full wp-image-97681\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/01/CrowdDNA.jpg\" alt=\"Figuring out which DNA differences matter is a tricky business. (NHGRI)\" width=\"750\" height=\"664\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/01/CrowdDNA.jpg 750w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/CrowdDNA-400x354.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/CrowdDNA-678x600.jpg 678w\" sizes=\"(max-width: 750px) 100vw, 750px\">\u003cfigcaption class=\"wp-caption-text\">Figuring out which DNA differences matter is a tricky business. (\u003ca href=\"https://www.genome.gov/dmd/img.cfm?node=Photos/Graphics&id=86913\">NHGRI\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>The key to predicting people’s health risks based on their DNA is knowing what to look for. This is even harder to do than you might think because everyone’s genetic make up is so unique.\u003c/p>\n\u003cp>The first step in finding disease-causing DNA differences is to gather up two groups of people and compare their DNA. One group will have the disease and the second, the control group, will not.\u003c/p>\n\u003cp>Any DNA differences more common in the disease group could be implicated in that disease. Lots of follow-up work is done until scientists are left with what they think are the really important variants.\u003c/p>\n\u003cp>Surprisingly, it often isn’t the variants themselves that are important for personalized medicine. Instead, it is the genes they affect that are the real prizes.\u003c/p>\n\u003cp>This is because many of the variants they find in the original study will be rare—not many people will have them. So just looking for them would not be that useful.\u003c/p>\n\u003cp>What they will look for are DNA differences in these genes that no one has seen before. Turns out that there are a lot of these.\u003c/p>\n\u003cp>The final step is to predict which of these other variants will be important for the disease. (These are called “\u003ca href=\"https://www.invitae.com/en/vus-resolution/\">variants of uncertain significance\u003c/a>” or VUS.) This is what this study could not do very well.\u003c/p>\n\u003cp>\u003cstrong>Genes and an Irregular Heartbeat\u003c/strong>\u003c/p>\n\u003cp>A number of previous studies have shown that certain DNA differences in two genes, SCN5A and KCNH2, increase a person’s risk for having an irregular heartbeat. These are the two genes the researchers focused on.\u003c/p>\n\u003cp>Not surprisingly, the researchers didn’t find these DNA variants in any of the 2,202 patients they looked at. Remember these kinds of variants are usually pretty rare.\u003c/p>\n\u003cp>But they did find lots of other differences. They were prepared for this and had lined up four different groups to help them predict which variants might increase a patient’s risk for arrhythmia.\u003c/p>\n\u003cp>They came up with 42 DNA variants in 63 patients that looked like they fit the bill. Unfortunately, none of these DNA differences predicted anything about a patient’s risk for arrhythmia. There was no significant difference in cases of arrhythmia between the group that had these variants and the group that didn’t.\u003c/p>\n\u003cp>In some ways this wasn’t surprising. After all, 63 people is a pretty small group.\u003c/p>\n\u003cp>What is more troubling for personalized medicine is that the four groups making the predictions agreed on very few of the 42 variants. Making accurate predictions is an incredibly important step, and it failed in this study.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>To get to a future where genetics can help the maximum number of people, we are going to need to be able to use a patient’s DNA to figure out his or her health risks. We’ll get there, but it may take longer than we thought.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In a \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2480485\">new study\u003c/a>, scientists have shown just how hard it will be to one day use your DNA to predict your risk for illnesses.\u003c/p>\n\u003cp>As expected, it wasn’t the reading of the DNA that was the tricky part -- that gets cheaper and easier all the time.\u003c/p>\n\u003cp>Instead, the difficulty was figuring out which DNA differences mattered and which didn’t. Four groups of scientists couldn’t agree on which differences predicted an increased risk for an irregular heartbeat and which didn’t. And even the differences they compared didn’t turn out to predict much of anything.\u003c/p>\n\u003cp>Until scientists work this out, the dream of truly personalized medicine will remain a distant one.\u003c/p>\n\u003cp>\u003cstrong>Harder Than We Thought\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_97653\" class=\"wp-caption aligncenter\" style=\"max-width: 750px\">\u003cimg class=\"size-full wp-image-97653\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/01/DoctorPatient01142016.jpg\" alt=\"It may be awhile before you are discussing with your doctor what your DNA tells you about your health risks. (NHGRI)\" width=\"750\" height=\"569\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/01/DoctorPatient01142016.jpg 750w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/DoctorPatient01142016-400x303.jpg 400w\" sizes=\"(max-width: 750px) 100vw, 750px\">\u003cfigcaption class=\"wp-caption-text\">It may be awhile before you are discussing with your doctor what your DNA tells you about your health risks. (\u003ca href=\"http://www.genome.gov/dmd/img.cfm?node=Photos/Graphics&id=85342\">NHGRI\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>Listening to the news, you can be forgiven for thinking that sooner rather than later doctors will be able to predict most anything about your health from a look at your DNA.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In fact, right now, they can’t tell you a whole lot.\u003c/p>\n\u003cp>Now this isn’t to say doctors can’t get some very important information from your DNA. There are definitely some differences (or “\u003ca href=\"https://en.wikipedia.org/wiki/Human_genetic_variation\">variants\u003c/a>”) that can be used to help \u003ca href=\"http://ghr.nlm.nih.gov/handbook/genomicresearch/pharmacogenomics\">determine just the right amount of medicine\u003c/a> you should be prescribed. And some real progress is being made in helping to find more targeted \u003ca href=\"http://cancergenome.nih.gov/cancergenomics/whatisgenomics/whatis\">treatments for a patient’s particular cancer\u003c/a>.\u003c/p>\n\u003cp>But the day when you can go to your doctor and she can correctly tell you only from your DNA which ailment you are at a higher risk for is a long way off. This becomes clear in a \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2480485\">new study\u003c/a> in the Journal of the American Medical Association (JAMA).\u003c/p>\n\u003cp>In this study researchers couldn’t use DNA to reliably predict who, from a group of 2,202 patients, was at a higher risk for \u003ca href=\"http://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_300290.pdf\">arrhythmia\u003c/a>, an irregular heartbeat. This is surprising because the two genes they looked at are supposedly \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/23788249\">two out there that are better understood\u003c/a>.\u003c/p>\n\u003cp>If we can’t make good predictions on the few genes we understand really well, then odds are we will do even worse with the ones that are still more of a mystery. And these are the genes people will be most interested in, involved in heart disease, type 2 diabetes and so on.\u003c/p>\n\u003cp>This was a small study and it may be that with a larger group of patients, scientists will be able to make better predictions. But regardless it does give us an inkling of what we are up against in the upcoming genomics revolution.\u003c/p>\n\u003cp>It is going to be a hard slog. But in the end, the hope is that it will be worth it because it will make us all healthier.\u003c/p>\n\u003cp>\u003cstrong>The Pitfalls of Personalized Medicine\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_97681\" class=\"wp-caption aligncenter\" style=\"max-width: 750px\">\u003cimg class=\"size-full wp-image-97681\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/01/CrowdDNA.jpg\" alt=\"Figuring out which DNA differences matter is a tricky business. (NHGRI)\" width=\"750\" height=\"664\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/01/CrowdDNA.jpg 750w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/CrowdDNA-400x354.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/01/CrowdDNA-678x600.jpg 678w\" sizes=\"(max-width: 750px) 100vw, 750px\">\u003cfigcaption class=\"wp-caption-text\">Figuring out which DNA differences matter is a tricky business. (\u003ca href=\"https://www.genome.gov/dmd/img.cfm?node=Photos/Graphics&id=86913\">NHGRI\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>The key to predicting people’s health risks based on their DNA is knowing what to look for. This is even harder to do than you might think because everyone’s genetic make up is so unique.\u003c/p>\n\u003cp>The first step in finding disease-causing DNA differences is to gather up two groups of people and compare their DNA. One group will have the disease and the second, the control group, will not.\u003c/p>\n\u003cp>Any DNA differences more common in the disease group could be implicated in that disease. Lots of follow-up work is done until scientists are left with what they think are the really important variants.\u003c/p>\n\u003cp>Surprisingly, it often isn’t the variants themselves that are important for personalized medicine. Instead, it is the genes they affect that are the real prizes.\u003c/p>\n\u003cp>This is because many of the variants they find in the original study will be rare—not many people will have them. So just looking for them would not be that useful.\u003c/p>\n\u003cp>What they will look for are DNA differences in these genes that no one has seen before. Turns out that there are a lot of these.\u003c/p>\n\u003cp>The final step is to predict which of these other variants will be important for the disease. (These are called “\u003ca href=\"https://www.invitae.com/en/vus-resolution/\">variants of uncertain significance\u003c/a>” or VUS.) This is what this study could not do very well.\u003c/p>\n\u003cp>\u003cstrong>Genes and an Irregular Heartbeat\u003c/strong>\u003c/p>\n\u003cp>A number of previous studies have shown that certain DNA differences in two genes, SCN5A and KCNH2, increase a person’s risk for having an irregular heartbeat. These are the two genes the researchers focused on.\u003c/p>\n\u003cp>Not surprisingly, the researchers didn’t find these DNA variants in any of the 2,202 patients they looked at. Remember these kinds of variants are usually pretty rare.\u003c/p>\n\u003cp>But they did find lots of other differences. They were prepared for this and had lined up four different groups to help them predict which variants might increase a patient’s risk for arrhythmia.\u003c/p>\n\u003cp>They came up with 42 DNA variants in 63 patients that looked like they fit the bill. Unfortunately, none of these DNA differences predicted anything about a patient’s risk for arrhythmia. There was no significant difference in cases of arrhythmia between the group that had these variants and the group that didn’t.\u003c/p>\n\u003cp>In some ways this wasn’t surprising. After all, 63 people is a pretty small group.\u003c/p>\n\u003cp>What is more troubling for personalized medicine is that the four groups making the predictions agreed on very few of the 42 variants. Making accurate predictions is an incredibly important step, and it failed in this study.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>To get to a future where genetics can help the maximum number of people, we are going to need to be able to use a patient’s DNA to figure out his or her health risks. We’ll get there, but it may take longer than we thought.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
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"order": 8
},
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"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
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"order": 1
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"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"source": "Commonwealth Club of California"
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"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
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"source": "kqed",
"order": 9
},
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"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
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"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
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"id": "fresh-air",
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"hidden-brain": {
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"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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"how-i-built-this": {
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"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
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"airtime": "SUN 7:30pm-8pm",
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"link": "/radio/program/how-i-built-this",
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"hyphenacion": {
"id": "hyphenacion",
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"order": 15
},
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"order": 18
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},
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"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
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},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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},
"masters-of-scale": {
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"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"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>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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"stitcher": "https://www.stitcher.com/podcast/kqed/stories-teachers-share",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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},
"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
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