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"content": "\u003cp>When people think of particle accelerators, they tend to think of giant structures: tunnels many miles long that electrons and protons race through at tremendous speeds, packing enormous energy.\u003c/p>\n\u003cp>But scientists in California think small is beautiful. They want to build an accelerator on semiconductor chips. An accelerator built that way won't achieve the energy of its much larger cousins, but it could accelerate material research and revolutionize medical therapy.\u003c/p>\n\u003cp>First of all, what is an accelerator?\u003c/p>\n\u003cp>\"An accelerator is a way to add energy to particles,\" says \u003ca href=\"https://web.stanford.edu/~rlbyer/\" target=\"_blank\" rel=\"noopener\">Robert Byer\u003c/a>, a physicist at Stanford University. Once you have those energetic particles, you can do things with them, like irradiate tumors or generate X-rays that scientists use to investigate new materials. 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Byer took me on a tour there.\u003c/p>\n\u003cp>We put on glasses to protect our eyes from the powerful laser light used in the pint-sized accelerator.\u003c/p>\n\u003cp>A big red emergency shut-off button attached to a shelf suggests this is not equipment to trifle with.\u003c/p>\n\u003cp>\u003ca href=\"https://www.laserphysics.nat.fau.eu/person/peter-hommelhoff/\" target=\"_blank\" rel=\"noopener\">Peter Hommelhoff\u003c/a> of the Friedrich-Alexander-Universität Erlangen-Nürnberg in Germany says one of the big challenges is to keep the electrons in the accelerator traveling where you want them to.\u003c/p>\n\u003cp>\"The acceleration channel is very narrow, so you have to generate a very, very narrow electron beam that you can send through the channel,\" Hommelhoff says.\u003c/p>\n\u003cp>\"It's a little like threading an invisible needle,\" says Dylan Black, a Stanford graduate student in physics.\u003c/p>\n\u003cp>Testing their accelerator requires lasers and lenses and pumps scattered around benches in the lab, it takes up a fair amount of space. 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"disqusTitle": "Insurers And Government Are Slow To Cover Expensive CAR-T Cancer Therapy",
"title": "Insurers And Government Are Slow To Cover Expensive CAR-T Cancer Therapy",
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"content": "\u003cp>Patients whose blood cancers have failed to respond to repeated rounds of chemotherapy may be candidates for a new type of gene therapy that could send their cancers into remission for years. But the two approved therapies, with price tags of hundreds of thousands of dollars, have roiled the insurance approval process, leading to delays and, in some cases, denials of coverage, clinicians and analysts say.[contextly_sidebar id=\"ReV9Gv0J6j7ADmv2dqbEuegAVdiLN5dE\"]\u003c/p>\n\u003cp>The therapy involves collecting patients' own T cells, a type of white blood cell, genetically modifying them, and then infusing them back into patients, where they hunt down and kill cancer cells. Known as \u003ca href=\"https://www.cancer.gov/about-cancer/treatment/research/car-t-cells\" target=\"_blank\" rel=\"noopener\">CAR-T cell therapy\u003c/a>, it's been characterized as a \"living drug\" by some researchers.\u003c/p>\n\u003cp>Two different CAR-T drugs — \u003ca href=\"https://www.us.kymriah.com/diffuse-large-b-cell-lymphoma-adults/?site=KYDDAY0DTCBR0040&source=01030&gclid=CNDIg4PMpNwCFRj1swod-MwKyw&gclsrc=ds\" target=\"_blank\" rel=\"noopener\">Kymriah\u003c/a> and \u003ca href=\"https://www.yescarta.com/therapy#how-yescarta-is-different\" target=\"_blank\" rel=\"noopener\">Yescarta\u003c/a> — were approved by the FDA last year to treat patients whose blood cancers haven't responded to at least two other rounds of treatment.\u003c/p>\n\u003cp>Kymriah is \u003ca href=\"https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm574154.htm\">approved\u003c/a> for people up to age 25 with a form of acute lymphoblastic leukemia, the most common cancer in children. Kymriah and Yescarta are \u003ca href=\"https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm606540.htm\" target=\"_blank\" rel=\"noopener\">both\u003c/a> \u003ca href=\"https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm581296.htm\" target=\"_blank\" rel=\"noopener\">approved\u003c/a> for adults with advanced lymphomas.\u003c/p>\n\u003cp>Researchers report that some critically ill patients who received the therapy have remained cancer-free for as long as five years.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"This is what patients need,\" says \u003ca href=\"https://www.mayo.edu/research/faculty/lin-yi-m-d-ph-d/bio-00092684\" target=\"_blank\" rel=\"noopener\">Dr. Yi Lin\u003c/a>, a hematologist who oversees the CAR-T cell practice and research for the Mayo Clinic. \"With the likelihood of getting patients into durable survival, we don't want to deny them the therapy.\" She says she receives no personal financial support from the drugs' makers.[contextly_sidebar id=\"nsB5Luqi8Mrdsb9vLceD3T77zYYY4sKK\"]\u003c/p>\n\u003cp>But the treatment comes at a cost — the drug treatments are hugely expensive. Kymriah and Yescarta cost $373,000 for a one-time infusion to treat adults with advanced lymphomas, while Kymriah costs $475,000 to treat acute lymphoblastic leukemia in children and young adults. That's the cost of the drug itself; in addition, many patients experience serious side effects that can land them in a hospital intensive care unit for weeks, \u003ca href=\"https://khn.org/news/cascade-of-costs-could-push-new-gene-therapy-above-1-million-per-patient/\" target=\"_blank\" rel=\"noopener\">pushing treatment costs to more than $1 million\u003c/a>.\u003c/p>\n\u003cp>All of this gives government and private insurers pause.\u003c/p>\n\u003cp>Most commercial insurers are covering CAR-T cell therapies now, but they do so on an individual basis, writing single-patient agreements each time, say cancer specialists. Large insurers that are already familiar with complicated therapies like stem-cell transplants are getting speedier at handling requests for CAR-T cell treatment, they say. But that's not always the case at smaller or regional plans, where delays can add weeks to the approval process.\u003c/p>\n\u003cp>\"A request for CAR-T may end up with somebody on the payer authorization team who doesn't understand the technology or the urgency of the request, when somebody has only weeks or months to live,\" says \u003ca href=\"https://www.asbmt.org/about/contact-us\" target=\"_blank\" rel=\"noopener\">Stephanie Farnia\u003c/a>, director of health policy and strategic relations at the American Society for Blood and Marrow Transplantation.\u003c/p>\n\u003cp>Farnia is in contact with many of the more than 50 medical centers that are authorized to provide treatment. The process of getting to a treatment center and evaluated for therapy is involved, she says. \"To then be substantially delayed due to paperwork is incredibly frustrating\" for patients.[contextly_sidebar id=\"mCjXSziNW7nkG4M52QmA48lgOAVmv3eg\"]\u003c/p>\n\u003cp>Medicare and Medicaid often pose greater coverage challenges than do private insurers, according to insurance experts.\u003c/p>\n\u003cp>Some Medicaid programs don't cover the treatment, says \u003ca href=\"AndrewsCAR-TandInsuranceDFedit.docx\" target=\"_blank\" rel=\"noopener\">Dr. Michael Bishop\u003c/a>, director of the cellular therapy program in the hematology/oncology section at the University of Chicago. Medicaid, the state-federal health program, covers children in low-income households and some adults.\u003c/p>\n\u003cp>\"Medicaid has been very tough,\" he says. \"Certain states just deny coverage — even states with balanced budgets.\"\u003c/p>\n\u003cp>States \u003ca href=\"https://icer-review.org/wp-content/uploads/2017/07/ICER_CAR_T_Final_Evidence_Report_032318.pdf\" target=\"_blank\" rel=\"noopener\">have to evaluate the cost as well as the drugs' effectiveness\u003c/a>, says \u003ca href=\"http://medicaiddirectors.org/about/staff/\" target=\"_blank\" rel=\"noopener\">Matt Salo\u003c/a>, executive director of the National Association of Medicaid Directors.\u003c/p>\n\u003cp>\"Medicaid is a finite pot of money, and it's stretched threadbare even on a good day,\" he says.\u003c/p>\n\u003cp>People who are on Medicare, the health insurance program for people age 65 and older and some people with disabilities, typically haven't faced coverage denials to date, clinicians say. But the government's reimbursement rates are raising concerns for providers.\u003c/p>\n\u003cp>Last spring, Medicare announced payment rates for providers who administer Yescarta and Kymriah on an outpatient basis. The payments would more than cover the costs of the drugs. Medicare beneficiaries' out-of-pocket costs would be capped at $1,340 plus the beneficiaries' Part B deductible (if that hasn't already been met), the agency says.[contextly_sidebar id=\"zRKGtFwAO4CBGEIycv3lNE5oWVwoZuVf\"]\u003c/p>\n\u003cp>The problem with this plan? Facilities typically provide treatment on an inpatient basis, not outpatient, because of the potential for severe, systemic side effects.\u003c/p>\n\u003cp>\"There's a lot of toxicity and questions about whether it can even be provided in an outpatient setting,\" says Gary Goldstein, the business manager at the blood and marrow transplant program at Stanford Health Care in Stanford, Calif.\u003c/p>\n\u003cp>For inpatient care, \"CAR-T cell therapy ... would be paid at a much lower amount compared to outpatient hospital use,\" according to officials at the Centers for Medicare & Medicaid Services.\u003c/p>\n\u003cp>The agency is considering how to handle payment for inpatient CAR-T care for the fiscal year that starts in October. For now, some medical centers are absorbing whatever Medicare doesn't pay.\u003c/p>\n\u003cp>\"How can you tell a patient who's 66, 'If only you'd gotten lymphoma when you were 64'?\" Goldstein asks.\u003c/p>\n\u003cp>But the current approach can't continue indefinitely, he says.\u003c/p>\n\u003cp>\"Even if there aren't any centers that are making that decision today, if coverage doesn't change for Medicare, it absolutely is going to be a problem tomorrow,\" says Goldstein.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://khn.org/\" target=\"_blank\" rel=\"noopener\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>, a nonprofit news service, is an editorially independent program of the Kaiser Family Foundation, and is not affiliated with Kaiser Permanente. Michelle Andrews is on Twitter \u003c/em>\u003ca href=\"https://twitter.com/mandrews110\" target=\"_blank\" rel=\"noopener\">\u003cem>@mandrews110\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Insurers+And+Government+Are+Slow+To+Cover+Expensive+CAR-T+Cancer+Therapy&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "Treatment costs for the immunotherapy can run to more than $1 million. Some state Medicaid programs aren't paying for the treatment, and Medicare's complicated payment rates have hospitals worried.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Patients whose blood cancers have failed to respond to repeated rounds of chemotherapy may be candidates for a new type of gene therapy that could send their cancers into remission for years. But the two approved therapies, with price tags of hundreds of thousands of dollars, have roiled the insurance approval process, leading to delays and, in some cases, denials of coverage, clinicians and analysts say.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The therapy involves collecting patients' own T cells, a type of white blood cell, genetically modifying them, and then infusing them back into patients, where they hunt down and kill cancer cells. Known as \u003ca href=\"https://www.cancer.gov/about-cancer/treatment/research/car-t-cells\" target=\"_blank\" rel=\"noopener\">CAR-T cell therapy\u003c/a>, it's been characterized as a \"living drug\" by some researchers.\u003c/p>\n\u003cp>Two different CAR-T drugs — \u003ca href=\"https://www.us.kymriah.com/diffuse-large-b-cell-lymphoma-adults/?site=KYDDAY0DTCBR0040&source=01030&gclid=CNDIg4PMpNwCFRj1swod-MwKyw&gclsrc=ds\" target=\"_blank\" rel=\"noopener\">Kymriah\u003c/a> and \u003ca href=\"https://www.yescarta.com/therapy#how-yescarta-is-different\" target=\"_blank\" rel=\"noopener\">Yescarta\u003c/a> — were approved by the FDA last year to treat patients whose blood cancers haven't responded to at least two other rounds of treatment.\u003c/p>\n\u003cp>Kymriah is \u003ca href=\"https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm574154.htm\">approved\u003c/a> for people up to age 25 with a form of acute lymphoblastic leukemia, the most common cancer in children. Kymriah and Yescarta are \u003ca href=\"https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm606540.htm\" target=\"_blank\" rel=\"noopener\">both\u003c/a> \u003ca href=\"https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm581296.htm\" target=\"_blank\" rel=\"noopener\">approved\u003c/a> for adults with advanced lymphomas.\u003c/p>\n\u003cp>Researchers report that some critically ill patients who received the therapy have remained cancer-free for as long as five years.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"This is what patients need,\" says \u003ca href=\"https://www.mayo.edu/research/faculty/lin-yi-m-d-ph-d/bio-00092684\" target=\"_blank\" rel=\"noopener\">Dr. Yi Lin\u003c/a>, a hematologist who oversees the CAR-T cell practice and research for the Mayo Clinic. \"With the likelihood of getting patients into durable survival, we don't want to deny them the therapy.\" She says she receives no personal financial support from the drugs' makers.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But the treatment comes at a cost — the drug treatments are hugely expensive. Kymriah and Yescarta cost $373,000 for a one-time infusion to treat adults with advanced lymphomas, while Kymriah costs $475,000 to treat acute lymphoblastic leukemia in children and young adults. That's the cost of the drug itself; in addition, many patients experience serious side effects that can land them in a hospital intensive care unit for weeks, \u003ca href=\"https://khn.org/news/cascade-of-costs-could-push-new-gene-therapy-above-1-million-per-patient/\" target=\"_blank\" rel=\"noopener\">pushing treatment costs to more than $1 million\u003c/a>.\u003c/p>\n\u003cp>All of this gives government and private insurers pause.\u003c/p>\n\u003cp>Most commercial insurers are covering CAR-T cell therapies now, but they do so on an individual basis, writing single-patient agreements each time, say cancer specialists. Large insurers that are already familiar with complicated therapies like stem-cell transplants are getting speedier at handling requests for CAR-T cell treatment, they say. But that's not always the case at smaller or regional plans, where delays can add weeks to the approval process.\u003c/p>\n\u003cp>\"A request for CAR-T may end up with somebody on the payer authorization team who doesn't understand the technology or the urgency of the request, when somebody has only weeks or months to live,\" says \u003ca href=\"https://www.asbmt.org/about/contact-us\" target=\"_blank\" rel=\"noopener\">Stephanie Farnia\u003c/a>, director of health policy and strategic relations at the American Society for Blood and Marrow Transplantation.\u003c/p>\n\u003cp>Farnia is in contact with many of the more than 50 medical centers that are authorized to provide treatment. The process of getting to a treatment center and evaluated for therapy is involved, she says. \"To then be substantially delayed due to paperwork is incredibly frustrating\" for patients.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Medicare and Medicaid often pose greater coverage challenges than do private insurers, according to insurance experts.\u003c/p>\n\u003cp>Some Medicaid programs don't cover the treatment, says \u003ca href=\"AndrewsCAR-TandInsuranceDFedit.docx\" target=\"_blank\" rel=\"noopener\">Dr. Michael Bishop\u003c/a>, director of the cellular therapy program in the hematology/oncology section at the University of Chicago. Medicaid, the state-federal health program, covers children in low-income households and some adults.\u003c/p>\n\u003cp>\"Medicaid has been very tough,\" he says. \"Certain states just deny coverage — even states with balanced budgets.\"\u003c/p>\n\u003cp>States \u003ca href=\"https://icer-review.org/wp-content/uploads/2017/07/ICER_CAR_T_Final_Evidence_Report_032318.pdf\" target=\"_blank\" rel=\"noopener\">have to evaluate the cost as well as the drugs' effectiveness\u003c/a>, says \u003ca href=\"http://medicaiddirectors.org/about/staff/\" target=\"_blank\" rel=\"noopener\">Matt Salo\u003c/a>, executive director of the National Association of Medicaid Directors.\u003c/p>\n\u003cp>\"Medicaid is a finite pot of money, and it's stretched threadbare even on a good day,\" he says.\u003c/p>\n\u003cp>People who are on Medicare, the health insurance program for people age 65 and older and some people with disabilities, typically haven't faced coverage denials to date, clinicians say. But the government's reimbursement rates are raising concerns for providers.\u003c/p>\n\u003cp>Last spring, Medicare announced payment rates for providers who administer Yescarta and Kymriah on an outpatient basis. The payments would more than cover the costs of the drugs. Medicare beneficiaries' out-of-pocket costs would be capped at $1,340 plus the beneficiaries' Part B deductible (if that hasn't already been met), the agency says.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The problem with this plan? Facilities typically provide treatment on an inpatient basis, not outpatient, because of the potential for severe, systemic side effects.\u003c/p>\n\u003cp>\"There's a lot of toxicity and questions about whether it can even be provided in an outpatient setting,\" says Gary Goldstein, the business manager at the blood and marrow transplant program at Stanford Health Care in Stanford, Calif.\u003c/p>\n\u003cp>For inpatient care, \"CAR-T cell therapy ... would be paid at a much lower amount compared to outpatient hospital use,\" according to officials at the Centers for Medicare & Medicaid Services.\u003c/p>\n\u003cp>The agency is considering how to handle payment for inpatient CAR-T care for the fiscal year that starts in October. For now, some medical centers are absorbing whatever Medicare doesn't pay.\u003c/p>\n\u003cp>\"How can you tell a patient who's 66, 'If only you'd gotten lymphoma when you were 64'?\" Goldstein asks.\u003c/p>\n\u003cp>But the current approach can't continue indefinitely, he says.\u003c/p>\n\u003cp>\"Even if there aren't any centers that are making that decision today, if coverage doesn't change for Medicare, it absolutely is going to be a problem tomorrow,\" says Goldstein.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://khn.org/\" target=\"_blank\" rel=\"noopener\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>, a nonprofit news service, is an editorially independent program of the Kaiser Family Foundation, and is not affiliated with Kaiser Permanente. Michelle Andrews is on Twitter \u003c/em>\u003ca href=\"https://twitter.com/mandrews110\" target=\"_blank\" rel=\"noopener\">\u003cem>@mandrews110\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Insurers+And+Government+Are+Slow+To+Cover+Expensive+CAR-T+Cancer+Therapy&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Potential DNA Damage From CRISPR ‘Seriously Underestimated,’ Study Finds",
"title": "Potential DNA Damage From CRISPR ‘Seriously Underestimated,’ Study Finds",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>From the earliest days of the CRISPR-Cas9 era, scientists have known that the first step in how it \u003ca href=\"https://www.statnews.com/2018/04/04/how-crispr-works-visualized/\">edits genomes\u003c/a> — snipping DNA — creates an unholy mess: Cellular repairmen frantically try to fix the cuts by throwing random chunks of DNA into the breach and deleting other random bits. \u003ca href=\"https://www.nature.com/articles/Nbt.4192\" target=\"_blank\" rel=\"noopener\">Research\u003c/a> published on Monday suggests that’s only the tip of a Titanic-sized iceberg: CRISPR-Cas9 can cause significantly greater genetic havoc than experts thought, the study concludes, perhaps enough to threaten the health of patients who would one day receive \u003ca href=\"https://www.statnews.com/2018/02/21/crispr-sickle-cell-clinical-trials/\">CRISPR-based therapy\u003c/a>.[contextly_sidebar id=\"y9TqAZzR84fJHw52DmhRAZZb04jkzjxD\"]\u003c/p>\n\u003cp>The results come hard on the heels of two \u003ca href=\"https://www.statnews.com/2018/06/11/crispr-hurdle-edited-cells-might-cause-cancer/\">studies\u003c/a> that identified a related issue: Some CRISPR’d cells might be missing a key anti-cancer mechanism and therefore be able to initiate tumors.\u003c/p>\n\u003cp>The DNA damage found in the new study included deletions of thousands of DNA bases, including at spots far from the edit. Some of the deletions can silence genes that should be active and activate genes that should be silent, including cancer-causing genes.\u003c/p>\n\u003cp>The DNA chaos that CRISPR unleashes has been “seriously underestimated,” said geneticist Allan Bradley of England’s Wellcome Sanger Institute, who led the study. “This should be a wake-up call.”\u003c/p>\n\u003cp>Leading CRISPR companies scrambled to play down the latest threat to what they hope will be a multibillion-dollar business \u003cstrong>— \u003c/strong>and to their stock prices, but investors reacted with alarm. Within the first 20 minutes of when the study was released, the three publicly traded CRISPR companies lost more than $300 million in value, and it was downhill from there: CRISPR Therapeutics ended down 8.6 percent, Editas Medicine fell 7 percent, and Intellia Therapeutics lost nearly 10 percent.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The companies questioned whether the CRISPR-caused DNA damage reported in the new study applied to the kind of cells they’re planning to CRISPR. They emphasized that if genomic scrambling is at all common then it should also be seen in earlier forms of genome-editing such as \u003ca href=\"https://www.statnews.com/2017/11/30/crispr-talens-gene-editing/\">zinc fingers and TALENs\u003c/a> (but apparently isn’t). And they insisted they’re on the case.\u003c/p>\n\u003cp>“We’re not Pollyannaish about this,” said geneticist Tom Barnes, chief innovation officer at Intellia. For its mouse experiments, Intellia analyzes edited genomes for collateral damage both near the editing target and tens of thousands of DNA letters away, he said, but “we have not seen any [cancer-causing] transformation of these cells, even with all the edits we’ve introduced.”[contextly_sidebar id=\"X3REPdHlQY5Hjsf4rQxCF5iuUbyNXJ8K\"]\u003c/p>\n\u003cp>In a statement, Editas spokeswoman Cristi Barnett said the possibility of genetic chaos from CRISPR is “an interesting topic” that the company “actively examine[s].” The reported DNA havoc, she said, is not “specifically problematic in our work to make CRISPR-based medicines.” CRISPR Therapeutics did not respond to requests for comment.\u003c/p>\n\u003cp>Academic scientists were less dismissive of the new study, in Nature Biotechnology. One leading CRISPR developer called it “well-done and credible,” “a cautionary note to the [genome-editing] community,” and consistent with other research showing that the DNA cuts that CRISPR makes, called double-stranded breaks, “can induce the types of genomic DNA rearrangements and deletions they report.” He asked not to be identified so as not to jeopardize business relationships with genome-editing companies.\u003c/p>\n\u003cp>But just as critics of last month’s studies asked why, if CRISPR’d cells can initiate cancer, no CRISPR’d mice had turned up with tumors, so scientists raised similar questions about the new genomic havoc finding: Why don’t scientists see it when they analyze the DNA of CRISPR’d cells?\u003c/p>\n\u003cp>“You find what you look for,” said Bradley. “No one is looking at the impact [of these DNA changes] on downstream genes.”\u003c/p>\n\u003cp>And few studies conduct full-out genome sequencing of CRISPR’d cells. Moreover, scientists typically search for one form of the collateral damage the Sanger study found — deletions of thousands of DNA bases (the double helix’s famous A’s, T’s, C’s, and G’s) — using a standard technique called PCR, which makes millions of DNA copies. But to work, PCR must attach to a “binding site” on DNA; CRISPR sometimes deletes that binding site, said Bradley, whose team used a different technique to analyze the double helix for collateral damage from CRISPR.\u003c/p>\n\u003cp>The Sanger scientists didn’t set out to find collateral DNA damage from CRISPR. As they investigated how CRISPR might change gene expression, a “weird thing” showed up, Bradley said: The target DNA was accurately changed, but that set off a chain reaction that engulfed genes far from the target. The scientists therefore changed course.[contextly_sidebar id=\"dkt97iGOrAQULIvrxP1t89Dkl2rYRsky\"]\u003c/p>\n\u003cp>When they aimed CRISPR at different targets in mouse embryonic stem cells, mouse blood-making cells, and human retinal cells, “extensive on-target genomic damage [was] a common outcome,” they wrote in their paper. In one case, genomes in about two-thirds of the CRISPR’d cells showed the expected small-scale inadvertent havoc, but 21 percent had DNA deletions of more than 250 bases and up to 6,000 bases long.\u003c/p>\n\u003cp>Since therapeutic uses of CRISPR would edit the genomes of billions of cells in, say, a patient’s liver, even rare DNA damage “makes it likely that one or more edited cells … would be endowed with an important [disease-causing] lesion,” the scientists wrote.\u003c/p>\n\u003cp>Nature Biotechnology took a year to publish the paper, after asking Bradley numerous variations of “are you sure?” and “did you consider this?” and asking him to run additional experiments, Bradley said. The results all held up.\u003c/p>\n\u003cp>The one U.S. \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03399448\" target=\"_blank\" rel=\"noopener\">clinical trial\u003c/a> using CRISPR’d cells began recruiting patients this year. It will use CRISPR to make immune cells, removed from patients with any of four types of cancer, attack telltale molecules on the tumor cells’ surface. Asked what genome analysis he plans to do, lead investigator Dr. Edward Stadtmauer of the University of Pennsylvania said, “We are doing extensive testing of the final cellular product as well as the cells within the patient.”\u003c/p>\n\u003cp>The possibility of adverse consequences from CRISPR’d cells has caused some company officials to argue that if, say, their therapy cures a child of a devastating disease, but increases her risk of cancer, that might be an acceptable trade-off.\u003c/p>\n\u003cp>That argument may well prevail. In 2003, however, when a boy in a gene therapy trial in France \u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJM200301163480314\" target=\"_blank\" rel=\"noopener\">developed leukemia\u003c/a> because the repair gene landed in the wrong place in his genome and activated a cancer-causing gene, it shut down gene therapy development on both sides of the Atlantic for years.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This\u003ca href=\"https://www.statnews.com/2018/07/16/crispr-potential-dna-damage-underestimated/\" target=\"_blank\" rel=\"noopener\"> story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>From the earliest days of the CRISPR-Cas9 era, scientists have known that the first step in how it \u003ca href=\"https://www.statnews.com/2018/04/04/how-crispr-works-visualized/\">edits genomes\u003c/a> — snipping DNA — creates an unholy mess: Cellular repairmen frantically try to fix the cuts by throwing random chunks of DNA into the breach and deleting other random bits. \u003ca href=\"https://www.nature.com/articles/Nbt.4192\" target=\"_blank\" rel=\"noopener\">Research\u003c/a> published on Monday suggests that’s only the tip of a Titanic-sized iceberg: CRISPR-Cas9 can cause significantly greater genetic havoc than experts thought, the study concludes, perhaps enough to threaten the health of patients who would one day receive \u003ca href=\"https://www.statnews.com/2018/02/21/crispr-sickle-cell-clinical-trials/\">CRISPR-based therapy\u003c/a>.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The results come hard on the heels of two \u003ca href=\"https://www.statnews.com/2018/06/11/crispr-hurdle-edited-cells-might-cause-cancer/\">studies\u003c/a> that identified a related issue: Some CRISPR’d cells might be missing a key anti-cancer mechanism and therefore be able to initiate tumors.\u003c/p>\n\u003cp>The DNA damage found in the new study included deletions of thousands of DNA bases, including at spots far from the edit. Some of the deletions can silence genes that should be active and activate genes that should be silent, including cancer-causing genes.\u003c/p>\n\u003cp>The DNA chaos that CRISPR unleashes has been “seriously underestimated,” said geneticist Allan Bradley of England’s Wellcome Sanger Institute, who led the study. “This should be a wake-up call.”\u003c/p>\n\u003cp>Leading CRISPR companies scrambled to play down the latest threat to what they hope will be a multibillion-dollar business \u003cstrong>— \u003c/strong>and to their stock prices, but investors reacted with alarm. Within the first 20 minutes of when the study was released, the three publicly traded CRISPR companies lost more than $300 million in value, and it was downhill from there: CRISPR Therapeutics ended down 8.6 percent, Editas Medicine fell 7 percent, and Intellia Therapeutics lost nearly 10 percent.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The companies questioned whether the CRISPR-caused DNA damage reported in the new study applied to the kind of cells they’re planning to CRISPR. They emphasized that if genomic scrambling is at all common then it should also be seen in earlier forms of genome-editing such as \u003ca href=\"https://www.statnews.com/2017/11/30/crispr-talens-gene-editing/\">zinc fingers and TALENs\u003c/a> (but apparently isn’t). And they insisted they’re on the case.\u003c/p>\n\u003cp>“We’re not Pollyannaish about this,” said geneticist Tom Barnes, chief innovation officer at Intellia. For its mouse experiments, Intellia analyzes edited genomes for collateral damage both near the editing target and tens of thousands of DNA letters away, he said, but “we have not seen any [cancer-causing] transformation of these cells, even with all the edits we’ve introduced.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In a statement, Editas spokeswoman Cristi Barnett said the possibility of genetic chaos from CRISPR is “an interesting topic” that the company “actively examine[s].” The reported DNA havoc, she said, is not “specifically problematic in our work to make CRISPR-based medicines.” CRISPR Therapeutics did not respond to requests for comment.\u003c/p>\n\u003cp>Academic scientists were less dismissive of the new study, in Nature Biotechnology. One leading CRISPR developer called it “well-done and credible,” “a cautionary note to the [genome-editing] community,” and consistent with other research showing that the DNA cuts that CRISPR makes, called double-stranded breaks, “can induce the types of genomic DNA rearrangements and deletions they report.” He asked not to be identified so as not to jeopardize business relationships with genome-editing companies.\u003c/p>\n\u003cp>But just as critics of last month’s studies asked why, if CRISPR’d cells can initiate cancer, no CRISPR’d mice had turned up with tumors, so scientists raised similar questions about the new genomic havoc finding: Why don’t scientists see it when they analyze the DNA of CRISPR’d cells?\u003c/p>\n\u003cp>“You find what you look for,” said Bradley. “No one is looking at the impact [of these DNA changes] on downstream genes.”\u003c/p>\n\u003cp>And few studies conduct full-out genome sequencing of CRISPR’d cells. Moreover, scientists typically search for one form of the collateral damage the Sanger study found — deletions of thousands of DNA bases (the double helix’s famous A’s, T’s, C’s, and G’s) — using a standard technique called PCR, which makes millions of DNA copies. But to work, PCR must attach to a “binding site” on DNA; CRISPR sometimes deletes that binding site, said Bradley, whose team used a different technique to analyze the double helix for collateral damage from CRISPR.\u003c/p>\n\u003cp>The Sanger scientists didn’t set out to find collateral DNA damage from CRISPR. As they investigated how CRISPR might change gene expression, a “weird thing” showed up, Bradley said: The target DNA was accurately changed, but that set off a chain reaction that engulfed genes far from the target. The scientists therefore changed course.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>When they aimed CRISPR at different targets in mouse embryonic stem cells, mouse blood-making cells, and human retinal cells, “extensive on-target genomic damage [was] a common outcome,” they wrote in their paper. In one case, genomes in about two-thirds of the CRISPR’d cells showed the expected small-scale inadvertent havoc, but 21 percent had DNA deletions of more than 250 bases and up to 6,000 bases long.\u003c/p>\n\u003cp>Since therapeutic uses of CRISPR would edit the genomes of billions of cells in, say, a patient’s liver, even rare DNA damage “makes it likely that one or more edited cells … would be endowed with an important [disease-causing] lesion,” the scientists wrote.\u003c/p>\n\u003cp>Nature Biotechnology took a year to publish the paper, after asking Bradley numerous variations of “are you sure?” and “did you consider this?” and asking him to run additional experiments, Bradley said. The results all held up.\u003c/p>\n\u003cp>The one U.S. \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03399448\" target=\"_blank\" rel=\"noopener\">clinical trial\u003c/a> using CRISPR’d cells began recruiting patients this year. It will use CRISPR to make immune cells, removed from patients with any of four types of cancer, attack telltale molecules on the tumor cells’ surface. Asked what genome analysis he plans to do, lead investigator Dr. Edward Stadtmauer of the University of Pennsylvania said, “We are doing extensive testing of the final cellular product as well as the cells within the patient.”\u003c/p>\n\u003cp>The possibility of adverse consequences from CRISPR’d cells has caused some company officials to argue that if, say, their therapy cures a child of a devastating disease, but increases her risk of cancer, that might be an acceptable trade-off.\u003c/p>\n\u003cp>That argument may well prevail. In 2003, however, when a boy in a gene therapy trial in France \u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJM200301163480314\" target=\"_blank\" rel=\"noopener\">developed leukemia\u003c/a> because the repair gene landed in the wrong place in his genome and activated a cancer-causing gene, it shut down gene therapy development on both sides of the Atlantic for years.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Pulses of Light Restored Hearing in Gerbils. Could that Lead to Better Implants?",
"title": "Pulses of Light Restored Hearing in Gerbils. Could that Lead to Better Implants?",
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"content": "\u003cp>Could light one day be used to restore hearing loss?\u003c/p>\n\u003cp>To try to answer that question, a team of German bioengineers surgically installed coiled strips of optical fibers in the ears of deaf gerbils.\u003c/p>\n\u003cp>While they still had their hearing, the gerbils had learned to hurdle a small barrier upon hearing an alarm. Now researchers sent a pulse of blue laser light deep into the animals’ ears. They jumped.\u003c/p>\n\u003cp>The experiment was part of a \u003ca href=\"http://stm.sciencemag.org/content/10/449/eaaq1564\" target=\"_blank\" rel=\"noopener\">study\u003c/a> published Wednesday seeking to improve upon cochlear implants — electronic devices that stimulate auditory neurons to partially restore hearing. Instead of using electrical currents, scientists are trying to determine whether optogenetics, a new field that uses light to control living cells, could one day help improve someone’s sense of hearing.\u003c/p>\n\u003cp>Although it could take decades to use optogenetics-based technologies in humans, researchers are beginning to demonstrate that light, not electricity, may be the best way to convey the rich information contained in sound.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Through my experience with patients, I’ve recognized the huge potential of cochlear implants,” said Tobias Moser, director of the Institute for Auditory Neuroscience at the University Medical Center Göttingen and lead author of the new study. “At the same time I’ve also witnessed the shortcomings.”\u003c/p>\n\u003cp>Patients with cochlear implants often describe the sound quality through the devices as harsh and tinny. Listening to music or picking out one voice from several others is often impossible. The goal of the new research, said Moser, is to improve the technology and create “a more natural hearing so that patients can recognize the melody in music and speech.”\u003c/p>\n\u003cp>At the most basic level, the act of hearing is transforming sound into electrochemical signals, the language of neurons, that the brain can then interpret.\u003c/p>\n\u003cp>Much of this process occurs in the cochlea, a snail-shaped organ within the inner ear lined with specialized sensory cells called hair cells. When hair cells detect vibration through thin protrusions on their surface, they generate electrical current in neighboring nerve cells that travel to the brain.\u003c/p>\n\u003cp>In people who have dysfunctional or dead hair cells, cochlear implants work by electrically stimulating auditory nerve cells directly.\u003c/p>\n\u003cp>According to Dan Polley, an associate professor at Harvard Medical School and director of the Lauer Tinnitus Research Center who was not involved in the study, the successes and limitations of the cochlear implant are determined by the anatomy of the inner ear.\u003c/p>\n\u003cp>Within the cochlea, hair cells rest on an organic platform known as the basilar membrane that is floppy and wide on one end and narrow and taut on the other. This biomechanical organization causes hair cells to wiggle in response to specific sound frequencies or pitches that are mapped out smoothly from low to high, like keys on a piano.\u003c/p>\n\u003cp>When implanting cochlear implants, Polley explained, surgeons thread electrodes into specific locations along the basilar membrane to target nerves that are sensitive to particular frequencies.\u003c/p>\n\u003cp>With cochlear implants, however, electrical current spreads itself over a large area and activates not only the targeted nerves but also neighboring cells as well. This impercision distorts and muffles sound.\u003c/p>\n\u003cp>Moser and other scientists believe that using light, which can be more finely targeted, will improve the performance of implants.\u003c/p>\n\u003cp>“Using electricity to control neurons is like playing the piano with your elbow,” said Polley. “Whereas light is better. It is more like playing the piano while wearing mittens.”\u003c/p>\n\u003cp>Auditory neurons normally don’t respond to light. However, the rapidly growing field of optogenetics has made this possible. The key is to genetically engineer neurons so that they contain light-sensitive proteins that are found elsewhere in nature including bacteria, algae, and the human eye.\u003c/p>\n\u003cp>Moser and his team of scientists performed this technique in adult Mongolian gerbils instead of mice or rats, which were used in previous studies. Gerbils, in contrast to other rodents, are a better proxy for humans because they hear low frequencies used by the human ear and have relatively large cochleas that are only two-and-a-half times smaller than those of humans.\u003c/p>\n\u003cp>The researchers also used a new version of light-sensitive proteins, called CatCh, to increase how quickly nerve cells could respond to light stimulation. Previous versions of the protein worked sluggishly to move ions in and out of neurons — a critical step in generating electrical signals to the brain conveying the rapidly changing characteristics of sound like loudness and pitch.\u003c/p>\n\u003cp>This really hampers our ability to “capture the dynamics of speech,” said Polley. “If you have to deliver pulses [of light] more slowly, you can’t keep up.”\u003c/p>\n\u003cp>To test how quickly neurons equipped with CatCh could process information, researchers exposed neurons to rapid bursts of laser light, up to 300 flashes per second. They observed that individual neurons and groups of neurons were able to keep pace with the flashes by releasing their own corresponding surges of electrical energy.\u003c/p>\n\u003cp>“This is a big improvement over our previous work, “ said Moser. The response “is quick and approaches physiological performance of normal neurons.”\u003c/p>\n\u003cp>Aside from faster processing, the neurons also showed a graded response to different intensities of light. This suggests that the gerbils could experience an accurate representation of loudness that is proportional to how strongly neurons are activated by light.\u003c/p>\n\u003cp>But how could researchers be sure that all this promising electrical activity was actually creating a sense of hearing in gerbils?\u003c/p>\n\u003cp>Scientists first surgically implanted a loop of optical fibers — a primitive prototype of high-tech cochlear implants that could one day be used in humans — into the gerbils’ inner ear. They then trained the animals to jump over a fence-like obstacle dividing two halves of a box. Once the gerbils learned this behavior, scientists deafened the animals, causing them to become unresponsive to the loudspeaker. However, when researchers pulsed blue laser light through the optic fiber, the gerbils leapt into the air again.\u003c/p>\n\u003cp>“It’s not hearing until you measure behavior,” said Polley. “Because hearing is a psychological property. [This experiment] shows that the animals generalize light stimulation to sound, they treat it as if it were sound.”\u003c/p>\n\u003cp>Despite these dramatic results, Moser is quick to point out that light-based cochlear implants are not ready for human use.\u003c/p>\n\u003cp>The most obvious hurdle is that installing light-sensitive proteins into cells requires genetic engineering. In the case of gerbils, scientists accomplished the feat by injecting viruses carrying specially designed DNA into the animals’ ears. While gene therapy is being used to treat certain diseases in clinical trials — and has been approved for a \u003ca href=\"https://www.statnews.com/2018/03/21/gene-therapy-luxturna-launch/\">rare form of blindness\u003c/a> — it remains a long way from reality for most conditions.\u003c/p>\n\u003cp>“Right now,” said Polley, “ I doubt anyone would suggest that you get this gene therapy instead of cochlear implants.”\u003c/p>\n\u003cp>Even if gene therapy was a proven technology, light-based implants have other restrictions. In humans, bioengineers imagine using tiny light-emitting diodes (LEDs) to stimulate genetically engineered auditory neurons. However these machines consume a lot of power and dissipate heat, making it unclear how patients would wear or operate such a device.\u003c/p>\n\u003cp>“Optogenetics is the most sophisticated way we have to stimulate nerves in the cochlea,” said Adrien Eshraghi, a professor at the Miller School of Medicine and director of the Hearing Research Laboratory at the University of Miami who was not involved with the study. “It is still [in] the early basics of science research, but I think optogenetics has a good future.”\u003c/p>\n\u003cp>Another source of optimism is the power of the brain to adapt to new signaling inputs.\u003c/p>\n\u003cp>In the case of cochlear implants, patients initially experience the human voice as high-pitched and scratchy (think Mickey Mouse) but adapt over time. Although researchers don’t know what light will sound like, they expect a similar adjustment process.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“At the end of the day for engineers,” said Polley, “the brain is the hero … it is one of the best players on their team because they don’t have to perfect the signal, they just have to make it reasonably good, and then the brain can take it the rest of the way.”\u003c/p>\n\u003cdiv> \u003cem>This\u003ca href=\"https://www.statnews.com/2018/07/11/optogenetics-hearing-gerbils-cochlear-implants/\" target=\"_blank\" rel=\"noopener\"> story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Could light one day be used to restore hearing loss?\u003c/p>\n\u003cp>To try to answer that question, a team of German bioengineers surgically installed coiled strips of optical fibers in the ears of deaf gerbils.\u003c/p>\n\u003cp>While they still had their hearing, the gerbils had learned to hurdle a small barrier upon hearing an alarm. Now researchers sent a pulse of blue laser light deep into the animals’ ears. They jumped.\u003c/p>\n\u003cp>The experiment was part of a \u003ca href=\"http://stm.sciencemag.org/content/10/449/eaaq1564\" target=\"_blank\" rel=\"noopener\">study\u003c/a> published Wednesday seeking to improve upon cochlear implants — electronic devices that stimulate auditory neurons to partially restore hearing. Instead of using electrical currents, scientists are trying to determine whether optogenetics, a new field that uses light to control living cells, could one day help improve someone’s sense of hearing.\u003c/p>\n\u003cp>Although it could take decades to use optogenetics-based technologies in humans, researchers are beginning to demonstrate that light, not electricity, may be the best way to convey the rich information contained in sound.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Through my experience with patients, I’ve recognized the huge potential of cochlear implants,” said Tobias Moser, director of the Institute for Auditory Neuroscience at the University Medical Center Göttingen and lead author of the new study. “At the same time I’ve also witnessed the shortcomings.”\u003c/p>\n\u003cp>Patients with cochlear implants often describe the sound quality through the devices as harsh and tinny. Listening to music or picking out one voice from several others is often impossible. The goal of the new research, said Moser, is to improve the technology and create “a more natural hearing so that patients can recognize the melody in music and speech.”\u003c/p>\n\u003cp>At the most basic level, the act of hearing is transforming sound into electrochemical signals, the language of neurons, that the brain can then interpret.\u003c/p>\n\u003cp>Much of this process occurs in the cochlea, a snail-shaped organ within the inner ear lined with specialized sensory cells called hair cells. When hair cells detect vibration through thin protrusions on their surface, they generate electrical current in neighboring nerve cells that travel to the brain.\u003c/p>\n\u003cp>In people who have dysfunctional or dead hair cells, cochlear implants work by electrically stimulating auditory nerve cells directly.\u003c/p>\n\u003cp>According to Dan Polley, an associate professor at Harvard Medical School and director of the Lauer Tinnitus Research Center who was not involved in the study, the successes and limitations of the cochlear implant are determined by the anatomy of the inner ear.\u003c/p>\n\u003cp>Within the cochlea, hair cells rest on an organic platform known as the basilar membrane that is floppy and wide on one end and narrow and taut on the other. This biomechanical organization causes hair cells to wiggle in response to specific sound frequencies or pitches that are mapped out smoothly from low to high, like keys on a piano.\u003c/p>\n\u003cp>When implanting cochlear implants, Polley explained, surgeons thread electrodes into specific locations along the basilar membrane to target nerves that are sensitive to particular frequencies.\u003c/p>\n\u003cp>With cochlear implants, however, electrical current spreads itself over a large area and activates not only the targeted nerves but also neighboring cells as well. This impercision distorts and muffles sound.\u003c/p>\n\u003cp>Moser and other scientists believe that using light, which can be more finely targeted, will improve the performance of implants.\u003c/p>\n\u003cp>“Using electricity to control neurons is like playing the piano with your elbow,” said Polley. “Whereas light is better. It is more like playing the piano while wearing mittens.”\u003c/p>\n\u003cp>Auditory neurons normally don’t respond to light. However, the rapidly growing field of optogenetics has made this possible. The key is to genetically engineer neurons so that they contain light-sensitive proteins that are found elsewhere in nature including bacteria, algae, and the human eye.\u003c/p>\n\u003cp>Moser and his team of scientists performed this technique in adult Mongolian gerbils instead of mice or rats, which were used in previous studies. Gerbils, in contrast to other rodents, are a better proxy for humans because they hear low frequencies used by the human ear and have relatively large cochleas that are only two-and-a-half times smaller than those of humans.\u003c/p>\n\u003cp>The researchers also used a new version of light-sensitive proteins, called CatCh, to increase how quickly nerve cells could respond to light stimulation. Previous versions of the protein worked sluggishly to move ions in and out of neurons — a critical step in generating electrical signals to the brain conveying the rapidly changing characteristics of sound like loudness and pitch.\u003c/p>\n\u003cp>This really hampers our ability to “capture the dynamics of speech,” said Polley. “If you have to deliver pulses [of light] more slowly, you can’t keep up.”\u003c/p>\n\u003cp>To test how quickly neurons equipped with CatCh could process information, researchers exposed neurons to rapid bursts of laser light, up to 300 flashes per second. They observed that individual neurons and groups of neurons were able to keep pace with the flashes by releasing their own corresponding surges of electrical energy.\u003c/p>\n\u003cp>“This is a big improvement over our previous work, “ said Moser. The response “is quick and approaches physiological performance of normal neurons.”\u003c/p>\n\u003cp>Aside from faster processing, the neurons also showed a graded response to different intensities of light. This suggests that the gerbils could experience an accurate representation of loudness that is proportional to how strongly neurons are activated by light.\u003c/p>\n\u003cp>But how could researchers be sure that all this promising electrical activity was actually creating a sense of hearing in gerbils?\u003c/p>\n\u003cp>Scientists first surgically implanted a loop of optical fibers — a primitive prototype of high-tech cochlear implants that could one day be used in humans — into the gerbils’ inner ear. They then trained the animals to jump over a fence-like obstacle dividing two halves of a box. Once the gerbils learned this behavior, scientists deafened the animals, causing them to become unresponsive to the loudspeaker. However, when researchers pulsed blue laser light through the optic fiber, the gerbils leapt into the air again.\u003c/p>\n\u003cp>“It’s not hearing until you measure behavior,” said Polley. “Because hearing is a psychological property. [This experiment] shows that the animals generalize light stimulation to sound, they treat it as if it were sound.”\u003c/p>\n\u003cp>Despite these dramatic results, Moser is quick to point out that light-based cochlear implants are not ready for human use.\u003c/p>\n\u003cp>The most obvious hurdle is that installing light-sensitive proteins into cells requires genetic engineering. In the case of gerbils, scientists accomplished the feat by injecting viruses carrying specially designed DNA into the animals’ ears. While gene therapy is being used to treat certain diseases in clinical trials — and has been approved for a \u003ca href=\"https://www.statnews.com/2018/03/21/gene-therapy-luxturna-launch/\">rare form of blindness\u003c/a> — it remains a long way from reality for most conditions.\u003c/p>\n\u003cp>“Right now,” said Polley, “ I doubt anyone would suggest that you get this gene therapy instead of cochlear implants.”\u003c/p>\n\u003cp>Even if gene therapy was a proven technology, light-based implants have other restrictions. In humans, bioengineers imagine using tiny light-emitting diodes (LEDs) to stimulate genetically engineered auditory neurons. However these machines consume a lot of power and dissipate heat, making it unclear how patients would wear or operate such a device.\u003c/p>\n\u003cp>“Optogenetics is the most sophisticated way we have to stimulate nerves in the cochlea,” said Adrien Eshraghi, a professor at the Miller School of Medicine and director of the Hearing Research Laboratory at the University of Miami who was not involved with the study. “It is still [in] the early basics of science research, but I think optogenetics has a good future.”\u003c/p>\n\u003cp>Another source of optimism is the power of the brain to adapt to new signaling inputs.\u003c/p>\n\u003cp>In the case of cochlear implants, patients initially experience the human voice as high-pitched and scratchy (think Mickey Mouse) but adapt over time. Although researchers don’t know what light will sound like, they expect a similar adjustment process.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“At the end of the day for engineers,” said Polley, “the brain is the hero … it is one of the best players on their team because they don’t have to perfect the signal, they just have to make it reasonably good, and then the brain can take it the rest of the way.”\u003c/p>\n\u003cdiv> \u003cem>This\u003ca href=\"https://www.statnews.com/2018/07/11/optogenetics-hearing-gerbils-cochlear-implants/\" target=\"_blank\" rel=\"noopener\"> story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The mother of a girl at the center of a medical and religious debate over brain death said she does not regret moving from California to New Jersey so her daughter could receive care after being declared dead.[contextly_sidebar id=\"23Ay0lmvAahQPeVvigzIETSKtEkm43UJ\"]\u003c/p>\n\u003cp>Nailah Winkfield told reporters Tuesday that she gave up everything for daughter Jahi McMath.\u003c/p>\n\u003cp>“Everything that I did, from selling my house, to quitting my job, to moving across the country and taking all that time away from my family, it was all worth it,” Winkfield said.\u003c/p>\n\u003cp>She has said doctors declared Jahi dead on June 22 from excessive bleeding and liver failure after an operation to treat an intestinal issue.\u003c/p>\n\u003cp>Jahi had been declared dead in December 2013 at age 13 after suffering irreversible brain damage during surgery in California to remove her tonsils. A coroner signed a death certificate.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Winkfield refused to accept the conclusion and took Jahi to New Jersey, which accommodates religions that don’t recognize brain death.\u003c/p>\n\u003cp>Winkfield said Tuesday that her daughter grew and went through puberty — evidence she was not dead.\u003c/p>\n\u003cp>“There’s no way in the world that I would be holding onto a corpse for 4½ years,” she said.\u003c/p>\n\u003cp>She also described her final moments with Jahi. Winkfield said she gave her daughter permission to “go” if she was tired, telling her not to worry about her mom.[contextly_sidebar id=\"aYsDGYXXZXPDLEprrXkMdRXaPOQCyavj\"]\u003c/p>\n\u003cp>“I said, ‘You have my permission. You can go,’” she said. “I said, ‘My husband will see about me, your siblings will see about me. Don’t worry.’”\u003c/p>\n\u003cp>She said Jahi died hours later.\u003c/p>\n\u003cp>“It’s going to be hard without her,” she said. “She was a sweet girl.”\u003c/p>\n\u003cp>Jahi will be buried Friday in Hayward, California, the San Francisco Chronicle \u003ca href=\"https://www.sfgate.com/bayarea/article/Family-of-Jahi-McMath-gets-approval-to-bury-their-13047928.php\">reported\u003c/a> .\u003c/p>\n\u003cp>Conservative religious groups rallied behind Winkfield and helped raise money for Jahi’s continued care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Winkfield and her lawyers have been trying to rescind the California death certificate as part of a medical malpractice lawsuit against the hospital where Jahi had her tonsillectomy.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Winkfield refused to accept the conclusion and took Jahi to New Jersey, which accommodates religions that don’t recognize brain death.\u003c/p>\n\u003cp>Winkfield said Tuesday that her daughter grew and went through puberty — evidence she was not dead.\u003c/p>\n\u003cp>“There’s no way in the world that I would be holding onto a corpse for 4½ years,” she said.\u003c/p>\n\u003cp>She also described her final moments with Jahi. Winkfield said she gave her daughter permission to “go” if she was tired, telling her not to worry about her mom.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“I said, ‘You have my permission. You can go,’” she said. “I said, ‘My husband will see about me, your siblings will see about me. Don’t worry.’”\u003c/p>\n\u003cp>She said Jahi died hours later.\u003c/p>\n\u003cp>“It’s going to be hard without her,” she said. “She was a sweet girl.”\u003c/p>\n\u003cp>Jahi will be buried Friday in Hayward, California, the San Francisco Chronicle \u003ca href=\"https://www.sfgate.com/bayarea/article/Family-of-Jahi-McMath-gets-approval-to-bury-their-13047928.php\">reported\u003c/a> .\u003c/p>\n\u003cp>Conservative religious groups rallied behind Winkfield and helped raise money for Jahi’s continued care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Winkfield and her lawyers have been trying to rescind the California death certificate as part of a medical malpractice lawsuit against the hospital where Jahi had her tonsillectomy.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Now that the world’s leading public health group says too much Minecraft can be an addiction, could overindulging in chocolate, exercise, even sex, be next?[contextly_sidebar id=”01ODny8j1QsQF9gorizQRnBzsbgXPKRY”]\u003c/p>\n\u003cp>The short answer is probably not.\u003c/p>\n\u003cp>The new “gaming disorder” classification from the World Health Organization revives a debate in the medical community about whether behaviors can cause the same kind of addictive illness as drugs.\u003c/p>\n\u003cp>The strictest definition of addiction refers to a disease resulting from changes in brain chemistry caused by compulsive use of drugs or alcohol. The definition includes excessive use that damages health, relationships, jobs and other parts of normal life. Brain research supports that definition, and some imaging studies have suggested that excessive gaming might affect the brain in similar ways.\u003c/p>\n\u003cp>Under a looser definition, addiction is considered “a disease of extreme behavior. Any behavior carried to extreme that consumes you and keeps you from doing what you should be doing becomes an addiction as far as life is concerned,” said Dr. Walter Ling, a UCLA psychiatrist.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In its widely used manual for diagnosing mental illness, the American Psychiatric Association calls excessive video gaming a “condition” but not a formal diagnosis or disease, and says more research is needed to determine if it qualifies as an addiction.[contextly_sidebar id=”Wl5OAMpArUdB6zi7q3hdM5GrzcPwa5h3″]\u003c/p>\n\u003cp>\u003cstrong>Drugs and the Brain\u003c/strong>\u003c/p>\n\u003cp>Certain drugs including opioids and alcohol can over-activate the brain’s reward circuit. That’s the system that under normal circumstances is activated when people engage in “behaviors conducive to survival” including eating and drinking water when thirsty, explained Dr. Andrew Saxon, chairman of the association’s addiction psychiatry council. The brain chemical dopamine regulates these behaviors, but narcotic drugs can flood the brain with dopamine, encouraging repeated use and making drug use more rewarding that healthy behaviors, Saxon said. Eventually increasing amounts are needed to get the same effect, and brain changes lead to an inability to control use.\u003c/p>\n\u003cp>\u003cstrong>What About Other Substances\u003c/strong>\u003c/p>\n\u003cp>Caffeine is a stimulant and also activates the brain’s reward system, but to a much lesser degree than addictive drugs. The “reward” can make people feel more alert, and frequent users can develop mild withdrawal symptoms when they stop, including headaches and tiredness. Caffeine-containing chocolate may produce similar effects. Neither substance causes the kinds of life problems found in drug addiction, although some coffee drinkers develop a tolerance to caffeine and need to drink more to get the same “buzz” or sense of alertness.[contextly_sidebar id=”mhQtfvihYwLCtDzX98xiu7QDvAtMJa4g”]\u003c/p>\n\u003cp>The World Health Organization recognizes caffeine “dependence” as a disorder; the American Psychiatric Association does not and says more research is needed.\u003c/p>\n\u003cp>“The term ‘addiction’ is tossed around pretty commonly, like ‘chocoholic’ or saying you’re addicted to reality TV,” said Dr. Ellen Selkie, a University of Michigan physician who studies teens’ use of digital technology. But addiction means an inability to control use “to the point where you’re failing at life,” she said.\u003c/p>\n\u003cp>\u003cstrong>What About Behavior\u003c/strong>\u003c/p>\n\u003cp>The only behavior classified as an addiction in the American Psychiatric Association’s diagnostic manual is compulsive gambling. To be diagnosed, gamblers must have several symptoms including repeatedly gambling increasing amounts of money, lying to hide gambling activity, feeling irritable or restless when trying to stop, and losing jobs or relationships because of gambling. Research suggests excessive gambling can affect the brain in ways similar to addictive drugs. Since the diagnostic manual was last updated, in 2013, studies have bolstered evidence that excessive video gaming may do the same thing, and some experts speculate that it may be added to the next update.\u003c/p>\n\u003cp>The manual doesn’t include sex addiction because there’s little evidence that compulsive sexual behavior has similar effects on the brain.[contextly_sidebar id=”WREHBIaI0tAVtsrRyKdECjzCVCBZe8oy”]\u003c/p>\n\u003cp>Many excessive gamblers, gamers and sex “addicts” have other psychiatric conditions, including anxiety, attention deficit disorder and depression, and some mental health specialists believe their compulsive behaviors are merely symptoms of those diseases rather than separate addictions.\u003c/p>\n\u003cp>Excessive use of the internet and smartphones is also absent from the psychiatric manual and World Health Organization’s update. Psychiatrists disagree on whether that is a true addiction — partly because overuse is hard to measure when so many people need to use their smartphones and the internet for their jobs.\u003c/p>\n\u003cp>\u003cstrong>Does the Term Matter?\u003c/strong>\u003c/p>\n\u003cp>The World Health Organization’s decision to classify excessive video gaming as an addiction means “gaming disorder” will be added to this year’s update to the organization’s International Classification of Diseases. Doctors worldwide use that document to diagnose physical and mental illnesses. Insurers, including Medicaid and Medicare, use billing codes listed there to make coverage decisions. The American Psychiatric Association’s manual is widely used for defining and diagnosing mental disorders. If conditions aren’t listed in these documents, insurance coverage for treatment is unlikely.\u003c/p>\n\u003cp>___\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>This Associated Press \u003ca href=\"https://apnews.com/tag/ScienceSays\" target=\"_blank\" rel=\"noopener\">series\u003c/a> was produced in \u003ca href=\"http://bit.ly/2ptoKnW\" target=\"_blank\" rel=\"noopener\">partnership\u003c/a> with the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Now that the world’s leading public health group says too much Minecraft can be an addiction, could overindulging in chocolate, exercise, even sex, be next?\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The short answer is probably not.\u003c/p>\n\u003cp>The new “gaming disorder” classification from the World Health Organization revives a debate in the medical community about whether behaviors can cause the same kind of addictive illness as drugs.\u003c/p>\n\u003cp>The strictest definition of addiction refers to a disease resulting from changes in brain chemistry caused by compulsive use of drugs or alcohol. The definition includes excessive use that damages health, relationships, jobs and other parts of normal life. Brain research supports that definition, and some imaging studies have suggested that excessive gaming might affect the brain in similar ways.\u003c/p>\n\u003cp>Under a looser definition, addiction is considered “a disease of extreme behavior. Any behavior carried to extreme that consumes you and keeps you from doing what you should be doing becomes an addiction as far as life is concerned,” said Dr. Walter Ling, a UCLA psychiatrist.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In its widely used manual for diagnosing mental illness, the American Psychiatric Association calls excessive video gaming a “condition” but not a formal diagnosis or disease, and says more research is needed to determine if it qualifies as an addiction.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Drugs and the Brain\u003c/strong>\u003c/p>\n\u003cp>Certain drugs including opioids and alcohol can over-activate the brain’s reward circuit. That’s the system that under normal circumstances is activated when people engage in “behaviors conducive to survival” including eating and drinking water when thirsty, explained Dr. Andrew Saxon, chairman of the association’s addiction psychiatry council. The brain chemical dopamine regulates these behaviors, but narcotic drugs can flood the brain with dopamine, encouraging repeated use and making drug use more rewarding that healthy behaviors, Saxon said. Eventually increasing amounts are needed to get the same effect, and brain changes lead to an inability to control use.\u003c/p>\n\u003cp>\u003cstrong>What About Other Substances\u003c/strong>\u003c/p>\n\u003cp>Caffeine is a stimulant and also activates the brain’s reward system, but to a much lesser degree than addictive drugs. The “reward” can make people feel more alert, and frequent users can develop mild withdrawal symptoms when they stop, including headaches and tiredness. Caffeine-containing chocolate may produce similar effects. Neither substance causes the kinds of life problems found in drug addiction, although some coffee drinkers develop a tolerance to caffeine and need to drink more to get the same “buzz” or sense of alertness.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The World Health Organization recognizes caffeine “dependence” as a disorder; the American Psychiatric Association does not and says more research is needed.\u003c/p>\n\u003cp>“The term ‘addiction’ is tossed around pretty commonly, like ‘chocoholic’ or saying you’re addicted to reality TV,” said Dr. Ellen Selkie, a University of Michigan physician who studies teens’ use of digital technology. But addiction means an inability to control use “to the point where you’re failing at life,” she said.\u003c/p>\n\u003cp>\u003cstrong>What About Behavior\u003c/strong>\u003c/p>\n\u003cp>The only behavior classified as an addiction in the American Psychiatric Association’s diagnostic manual is compulsive gambling. To be diagnosed, gamblers must have several symptoms including repeatedly gambling increasing amounts of money, lying to hide gambling activity, feeling irritable or restless when trying to stop, and losing jobs or relationships because of gambling. Research suggests excessive gambling can affect the brain in ways similar to addictive drugs. Since the diagnostic manual was last updated, in 2013, studies have bolstered evidence that excessive video gaming may do the same thing, and some experts speculate that it may be added to the next update.\u003c/p>\n\u003cp>The manual doesn’t include sex addiction because there’s little evidence that compulsive sexual behavior has similar effects on the brain.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Many excessive gamblers, gamers and sex “addicts” have other psychiatric conditions, including anxiety, attention deficit disorder and depression, and some mental health specialists believe their compulsive behaviors are merely symptoms of those diseases rather than separate addictions.\u003c/p>\n\u003cp>Excessive use of the internet and smartphones is also absent from the psychiatric manual and World Health Organization’s update. Psychiatrists disagree on whether that is a true addiction — partly because overuse is hard to measure when so many people need to use their smartphones and the internet for their jobs.\u003c/p>\n\u003cp>\u003cstrong>Does the Term Matter?\u003c/strong>\u003c/p>\n\u003cp>The World Health Organization’s decision to classify excessive video gaming as an addiction means “gaming disorder” will be added to this year’s update to the organization’s International Classification of Diseases. Doctors worldwide use that document to diagnose physical and mental illnesses. Insurers, including Medicaid and Medicare, use billing codes listed there to make coverage decisions. The American Psychiatric Association’s manual is widely used for defining and diagnosing mental disorders. If conditions aren’t listed in these documents, insurance coverage for treatment is unlikely.\u003c/p>\n\u003cp>___\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>This Associated Press \u003ca href=\"https://apnews.com/tag/ScienceSays\" target=\"_blank\" rel=\"noopener\">series\u003c/a> was produced in \u003ca href=\"http://bit.ly/2ptoKnW\" target=\"_blank\" rel=\"noopener\">partnership\u003c/a> with the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "First Phage Center In The U.S. Signals Growing Acceptance",
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"content": "\u003cp>When her husband was dying of a drug-resistant infection, Steffanie Strathdee had a last-ditch idea. They could try treating him with a virus that would kill the bacteria colonizing his insides. The method, called \u003ca href=\"https://www.statnews.com/2017/11/28/phage-therapy-mallory-smith/\" target=\"_blank\" rel=\"noopener\">phage therapy\u003c/a>, was popular in former Soviet republics, but had mostly been abandoned in the U.S. Researchers had to \u003ca href=\"https://www.motherjones.com/environment/2018/05/the-best-viral-news-youll-ever-read-antibiotic-resistance-phage-therapy-bacteriophage-virus/\" target=\"_blank\" rel=\"noopener\">hunt\u003c/a> for the right virus in Texas pigsties and sewage treatment plants.[contextly_sidebar id=\"arHYIuUonCY76BgMGAom8CdlRJtFsuZL\"]\u003c/p>\n\u003cp>That was 2016. Phage therapy is still very much experimental — but it’s come a long way since then. New companies have popped up, hoping to get approval to sell these viruses as drugs. A \u003ca href=\"https://phage.directory/\" target=\"_blank\" rel=\"noopener\">phage directory\u003c/a> has come together, lab by lab, helping doctors figure out who has which virus.\u003c/p>\n\u003cp>Now, the U.S. is getting its first \u003ca href=\"https://medschool.ucsd.edu/som/medicine/divisions/infectious-diseases/research/center-innovative-phage-applications-and-therapeutics/Pages/default.aspx\" target=\"_blank\" rel=\"noopener\">phage therapy center\u003c/a>, at the University of California, San Diego. Its mission is to run clinical trials, but also to streamline the mad dash to secure the right phage before a patient dies.\u003c/p>\n\u003cp>In some ways, the Center for Innovative Phage Applications and Therapeutics simply gives a name — and $1.2 million — to an institute that already exists. After word got out that Strathdee and her husband’s doctors had managed to save his life with a bacteriophage — literally, a bacteria-eater — her inbox filled with pleas for a repeat performance. They came from all over: the U.S., the U.K., Australia, India, China, Albania. In almost every case, there was someone dying because of antibiotic-resistant bacteria. Viruses that had specifically evolved to kill those microbes might be able to help.\u003c/p>\n\u003cp>Sometimes, Strathdee and her network couldn’t act fast enough, and the patient died. But occasionally, it worked out. “I’ve had a second job as a phage-wrangler,” said Strathdee, who is the associate dean of global health sciences at UCSD, and who has been named a co-director of the new center. “When we started to treat patients, each one was like reinventing the wheel all over again: The phone calls at the 11th hour, the paperwork.”[contextly_sidebar id=\"HWlHiwtZ3b4aS5iux0NZv3CbgJWJOIOp\"]\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Getting phage therapy to a patient can be a bit a puzzle. These viruses are picky about the microbes they feast on, so you often need to take a swab of the patient’s bacteria, nurture it in a dish, and then test which phages are able to kill it off. You need to make sure that the phages in question will explode a bacterial cell, rather than settling comfortably in its nucleus like lice on a kindergartener’s scalp. And then you need to purify it before delivery, so there aren’t any bacterial leftovers that might poison the person instead of saving them.\u003c/p>\n\u003cp>There’s also plenty of bureaucracy, because phages have not been approved by the Food and Drug Administration.\u003c/p>\n\u003cp>It’s often a crazy rush to find the right phage with emails and calls and tweets, then getting emergency experimental approval — and that was largely what happened for the five other patients who’ve been treated with phages at UCSD since Strathdee’s husband was revived.\u003c/p>\n\u003cp>“We wanted to make it so it isn’t such a scramble,” said Dr. Robert “Chip” Schooley, an infectious disease \u003ca href=\"https://www.tuftsmedicalcenter.org/PhysicianDirectory/Helen-Boucher.aspx\" target=\"_blank\" rel=\"noopener\">specialist\u003c/a> at UCSD, who administered the phage to Strathdee’s husband, and who is also co-director of the new center.\u003c/p>\n\u003cp>The announcement is also symbolic of a wider shift. With the rise of antibiotics in the 1930s and ’40s, phages went out of fashion in the U.S. But the person who had named them, a Canadian microbiologist named Felix d’Herelle, moved to Tbilisi, in the republic of Georgia, continuing his research at an institute that attracted the admiration of Joseph Stalin himself. Even after d’Herelle’s death, the \u003ca href=\"http://www.eliava-institute.org/\" target=\"_blank\" rel=\"noopener\">Eliava Institute\u003c/a> kept the flame of phage therapy alive.[contextly_sidebar id=\"HGcjrnDFzg80OPCbEp1ow35PtAMePTXI\"]\u003c/p>\n\u003cp>That hardly helped the viruses’ reputation in America during the Cold War. “It was commie science; there was a taint to it,” explained Dr. William Summers, a phage biologist, historian, and professor emeritus at Yale University.\u003c/p>\n\u003cp>Even though phages continued to be an important part of lab science, the researchers who used them thought they were good for just that: research. The idea of using them for therapy was almost a joke.\u003c/p>\n\u003cp>Then, as antibiotic resistance grew into a worldwide crisis — one that \u003ca href=\"https://www.cdc.gov/drugresistance/threat-report-2013/index.html\" target=\"_blank\" rel=\"noopener\">kills\u003c/a> some 23,000 Americans a year — that joke started sounding more and more appealing. The funding of a center to administer and collect data on phage therapy is a reversal, of sorts: An admission that this long-disparaged idea is worth a million-dollar second glance.\u003c/p>\n\u003cp>“Trust me, at the Eliava, we have tried to convince people that phages are a safe and good alternative to antibiotics for many years,” said Mzia Kutateladze, the director of the Eliava Institute. “Finally the people agreed to use it, and we are very happy, of course.” She estimated that Eliava’s phage therapy center gets around 15 to 20 Americans every year.\u003c/p>\n\u003cp>“There really is, thankfully, some momentum building … around these non-traditional therapies,” said Dr. Helen Boucher, an infectious disease specialist at Tufts Medical Center in Boston, who is not involved with the UCSD project. “I would think of this more in a high-risk, high-reward category. This is largely uncharted territory. … At the end of the day, if you have a product that can work against antibiotic-resistant organisms that isn’t antibiotics, that would be huge.”[contextly_sidebar id=\"oZXWClXhDyGosKyti4BoRnGzhEfmXr3I\"]\u003c/p>\n\u003cp>The news that her brainchild had been funded took Strathdee by surprise in late May. She was at a ceremony for UCSD professors with endowed chairs, at which all of them received medals. “The chancellor’s literally putting the medal around my neck, and he said, ‘Hey, I just sent you some money today,’” she recalled.\u003c/p>\n\u003cp>The new center will collaborate with companies such as \u003ca href=\"http://www.ampliphibio.com/\" target=\"_blank\" rel=\"noopener\">AmpliPhi Biosciences\u003c/a> and \u003ca href=\"http://www.aphage.com/\" target=\"_blank\" rel=\"noopener\">Adaptive Phage Therapeutics\u003c/a> to treat future patients. Some of them will have cystic fibrosis, which causes mucus in the lungs to be overly sticky, often allowing drug-resistant microbes to proliferate. Others might have long-term infections that are preventing them from getting organ transplants. Yet others will have implanted devices, which sometimes provide the nooks and crannies where bacteria can grow into a slimy film.\u003c/p>\n\u003cp>“The sad thing is that there is going to be no shortage of patients,” said Strathdee.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This\u003ca href=\"https://www.statnews.com/2018/06/21/first-phage-therapy-center-in-us/\" target=\"_blank\" rel=\"noopener\"> story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\u003cdiv class=\"ctx-subscribe-container ctx-personalization-container ctx_default_placement ctx-clearfix\">\u003c/div>\n\u003cdiv class=\"ctx-social-container ctx_default_placement ctx-clearfix\">\u003c/div>\n\u003cdiv class=\"ctx-module-container ctx_default_placement ctx-clearfix\">\n\u003cdiv class=\"ctx-module ctx-nodefs ctx-content-block2 ctx-module-default\">\n\u003cdiv class=\"ctx-sections-container ctx-nomar\">\n\u003cdiv class=\"ctx-section ctx-clearfix ctx-section-previous\">\n\u003cdiv class=\"ctx-links-header\">\u003c/div>\n\u003c/div>\n\u003c/div>\n\u003c/div>\n\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When her husband was dying of a drug-resistant infection, Steffanie Strathdee had a last-ditch idea. They could try treating him with a virus that would kill the bacteria colonizing his insides. The method, called \u003ca href=\"https://www.statnews.com/2017/11/28/phage-therapy-mallory-smith/\" target=\"_blank\" rel=\"noopener\">phage therapy\u003c/a>, was popular in former Soviet republics, but had mostly been abandoned in the U.S. Researchers had to \u003ca href=\"https://www.motherjones.com/environment/2018/05/the-best-viral-news-youll-ever-read-antibiotic-resistance-phage-therapy-bacteriophage-virus/\" target=\"_blank\" rel=\"noopener\">hunt\u003c/a> for the right virus in Texas pigsties and sewage treatment plants.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>That was 2016. Phage therapy is still very much experimental — but it’s come a long way since then. New companies have popped up, hoping to get approval to sell these viruses as drugs. A \u003ca href=\"https://phage.directory/\" target=\"_blank\" rel=\"noopener\">phage directory\u003c/a> has come together, lab by lab, helping doctors figure out who has which virus.\u003c/p>\n\u003cp>Now, the U.S. is getting its first \u003ca href=\"https://medschool.ucsd.edu/som/medicine/divisions/infectious-diseases/research/center-innovative-phage-applications-and-therapeutics/Pages/default.aspx\" target=\"_blank\" rel=\"noopener\">phage therapy center\u003c/a>, at the University of California, San Diego. Its mission is to run clinical trials, but also to streamline the mad dash to secure the right phage before a patient dies.\u003c/p>\n\u003cp>In some ways, the Center for Innovative Phage Applications and Therapeutics simply gives a name — and $1.2 million — to an institute that already exists. After word got out that Strathdee and her husband’s doctors had managed to save his life with a bacteriophage — literally, a bacteria-eater — her inbox filled with pleas for a repeat performance. They came from all over: the U.S., the U.K., Australia, India, China, Albania. In almost every case, there was someone dying because of antibiotic-resistant bacteria. Viruses that had specifically evolved to kill those microbes might be able to help.\u003c/p>\n\u003cp>Sometimes, Strathdee and her network couldn’t act fast enough, and the patient died. But occasionally, it worked out. “I’ve had a second job as a phage-wrangler,” said Strathdee, who is the associate dean of global health sciences at UCSD, and who has been named a co-director of the new center. “When we started to treat patients, each one was like reinventing the wheel all over again: The phone calls at the 11th hour, the paperwork.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Getting phage therapy to a patient can be a bit a puzzle. These viruses are picky about the microbes they feast on, so you often need to take a swab of the patient’s bacteria, nurture it in a dish, and then test which phages are able to kill it off. You need to make sure that the phages in question will explode a bacterial cell, rather than settling comfortably in its nucleus like lice on a kindergartener’s scalp. And then you need to purify it before delivery, so there aren’t any bacterial leftovers that might poison the person instead of saving them.\u003c/p>\n\u003cp>There’s also plenty of bureaucracy, because phages have not been approved by the Food and Drug Administration.\u003c/p>\n\u003cp>It’s often a crazy rush to find the right phage with emails and calls and tweets, then getting emergency experimental approval — and that was largely what happened for the five other patients who’ve been treated with phages at UCSD since Strathdee’s husband was revived.\u003c/p>\n\u003cp>“We wanted to make it so it isn’t such a scramble,” said Dr. Robert “Chip” Schooley, an infectious disease \u003ca href=\"https://www.tuftsmedicalcenter.org/PhysicianDirectory/Helen-Boucher.aspx\" target=\"_blank\" rel=\"noopener\">specialist\u003c/a> at UCSD, who administered the phage to Strathdee’s husband, and who is also co-director of the new center.\u003c/p>\n\u003cp>The announcement is also symbolic of a wider shift. With the rise of antibiotics in the 1930s and ’40s, phages went out of fashion in the U.S. But the person who had named them, a Canadian microbiologist named Felix d’Herelle, moved to Tbilisi, in the republic of Georgia, continuing his research at an institute that attracted the admiration of Joseph Stalin himself. Even after d’Herelle’s death, the \u003ca href=\"http://www.eliava-institute.org/\" target=\"_blank\" rel=\"noopener\">Eliava Institute\u003c/a> kept the flame of phage therapy alive.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>That hardly helped the viruses’ reputation in America during the Cold War. “It was commie science; there was a taint to it,” explained Dr. William Summers, a phage biologist, historian, and professor emeritus at Yale University.\u003c/p>\n\u003cp>Even though phages continued to be an important part of lab science, the researchers who used them thought they were good for just that: research. The idea of using them for therapy was almost a joke.\u003c/p>\n\u003cp>Then, as antibiotic resistance grew into a worldwide crisis — one that \u003ca href=\"https://www.cdc.gov/drugresistance/threat-report-2013/index.html\" target=\"_blank\" rel=\"noopener\">kills\u003c/a> some 23,000 Americans a year — that joke started sounding more and more appealing. The funding of a center to administer and collect data on phage therapy is a reversal, of sorts: An admission that this long-disparaged idea is worth a million-dollar second glance.\u003c/p>\n\u003cp>“Trust me, at the Eliava, we have tried to convince people that phages are a safe and good alternative to antibiotics for many years,” said Mzia Kutateladze, the director of the Eliava Institute. “Finally the people agreed to use it, and we are very happy, of course.” She estimated that Eliava’s phage therapy center gets around 15 to 20 Americans every year.\u003c/p>\n\u003cp>“There really is, thankfully, some momentum building … around these non-traditional therapies,” said Dr. Helen Boucher, an infectious disease specialist at Tufts Medical Center in Boston, who is not involved with the UCSD project. “I would think of this more in a high-risk, high-reward category. This is largely uncharted territory. … At the end of the day, if you have a product that can work against antibiotic-resistant organisms that isn’t antibiotics, that would be huge.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The news that her brainchild had been funded took Strathdee by surprise in late May. She was at a ceremony for UCSD professors with endowed chairs, at which all of them received medals. “The chancellor’s literally putting the medal around my neck, and he said, ‘Hey, I just sent you some money today,’” she recalled.\u003c/p>\n\u003cp>The new center will collaborate with companies such as \u003ca href=\"http://www.ampliphibio.com/\" target=\"_blank\" rel=\"noopener\">AmpliPhi Biosciences\u003c/a> and \u003ca href=\"http://www.aphage.com/\" target=\"_blank\" rel=\"noopener\">Adaptive Phage Therapeutics\u003c/a> to treat future patients. Some of them will have cystic fibrosis, which causes mucus in the lungs to be overly sticky, often allowing drug-resistant microbes to proliferate. Others might have long-term infections that are preventing them from getting organ transplants. Yet others will have implanted devices, which sometimes provide the nooks and crannies where bacteria can grow into a slimy film.\u003c/p>\n\u003cp>“The sad thing is that there is going to be no shortage of patients,” said Strathdee.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Little Evidence for Alternative Autism Treatment Sold by 'Brain Balance' Franchise",
"title": "Little Evidence for Alternative Autism Treatment Sold by 'Brain Balance' Franchise",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Some parents see it coming. Natalie was not that kind of parent.[contextly_sidebar id=\"uOHnnzKYOmBeTGoKuvAQzedxhPZkeU99\"]\u003c/p>\n\u003cp>Even after the director and a teacher at her older son's day care sat her down one afternoon in 2011 to detail the 3-year-old's difficulty socializing and his tendency to chatter endlessly about topics his peers showed no interest in, she still didn't get the message.\u003c/p>\n\u003cp>Her son, the two educators eventually spelled out, might be on the autism spectrum.\u003c/p>\n\u003cp>\"I was in tears at the end,\" she says. \"When I got home, I was just devastated.\"\u003c/p>\n\u003cp>Natalie broke the news to her wife, Stephanie, whose mind fast-forwarded to a distressing future. Would her son — a squat, cheerful boy who, despite his affectionate nature, didn't have any playmates — ever be able to make friends?\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>When a doctor eventually confirmed he had an autism spectrum disorder, the diagnosis came with a suggestion: Perhaps the boy would benefit from Prozac when he turned 7.\u003c/p>\n\u003cp>\"That was when both of us fell apart in that meeting,\" Natalie says. For both parents, medication wasn't an option.\u003c/p>\n\u003cp>\"Prozac is a very powerful drug for adults. Why would you give it to a 7-year-old?\" Stephanie wondered after the doctor's visit. \"I welled up with all of this emotion. And I said I will not let that happen.\"[contextly_sidebar id=\"4sXIngF1woiIEbdfxhHX6lYzTUKP5vdD\"]\u003c/p>\n\u003cp>(To protect their privacy, we are only using Natalie's and Stephanie's first names. We are not naming their children.)\u003c/p>\n\u003cp>The fear of psychotropic drugs led the family to pursue alternative treatments for autism.\u003c/p>\n\u003cp>To start, they dropped gluten.\u003c/p>\n\u003cp>Then one day, as Natalie roamed the aisles of a gluten-free expo in a Chicago suburb not far from where the family lives, she came across a booth for a Brain Balance Achievement Center.\u003c/p>\n\u003cp>Natalie says the program claimed to help with disorders ranging from dyslexia to ADHD and autism. Best of all, it didn't involve prescription drugs.\u003c/p>\n\u003cp>\"We were very excited,\" Stephanie says. \"Maybe we found a solution that wasn't going to be about medicine. I was very, very hopeful.\"\u003c/p>\n\u003cp>\"\u003cstrong>It will completely, absolutely, 100 percent change your life\"\u003c/strong>\u003c/p>\n\u003cp>Natalie had stumbled upon one of 113 Brain Balance franchises across the country. Seventeen more are in the works. In the dozen years since its inception, Brain Balance says, it has helped roughly 25,000 children. The company says it is currently taking in over $50 million in annual revenue.\u003c/p>\n\u003cp>Although Brain Balance isn't the only purveyor of alternative approaches for developmental disorders in the U.S., the scale of the enterprise sets it apart. The company's approach is still relatively new and not widely known, meaning many experts in the field of childhood development have not vetted its effectiveness.\u003c/p>\n\u003cp>Brain Balance says its nonmedical and drug-free program helps children who struggle with ADHD, autism spectrum disorders and learning and processing disorders. The company says it addresses a child's challenges with a combination of physical exercises, nutritional guidance and academic training.\u003c/p>\n\u003cp>An NPR investigation of Brain Balance reveals a company whose promises have resonated with parents averse to medication. But Brain Balance also appears to have overstated the scientific evidence in its messaging to families, who can easily spend over $10,000 in six months, a common length of enrollment.\u003c/p>\n\u003cp>Brain Balance's metrics for consumer satisfaction are impressive. Customers rate the program, on average, an 8.5 on a 10-point scale in surveys, according to the company.\u003c/p>\n\u003cp>The ratings square with comments in online forums and in interviews NPR conducted with 18 parents who enrolled their children. Across the country, about three dozen centers are run by parents who began as happy customers.\u003c/p>\n\u003cp>\u003ca href=\"https://www.brainbalancecenters.com/\" target=\"_blank\" rel=\"noopener\">Brain Balance's website\u003c/a> is where caretakers encounter the company's strongest pitch: dozens upon dozens of \u003ca href=\"https://www.brainbalancecenters.com/our-stories/\" target=\"_blank\" rel=\"noopener\">parent testimonials\u003c/a>.\u003c/p>\n\u003cp>One of the company's \u003ca href=\"https://www.youtube.com/watch?v=OAaow0Kk0g8\" target=\"_blank\" rel=\"noopener\">television commercials\u003c/a> begins with a montage of formerly frustrated mothers. But, they all agree, Brain Balance put an end to their kids' challenges. One woman insists \"it will completely, absolutely, 100 percent change your life.\"\u003c/p>\n\u003cp>\u003cstrong>Autism \"can become a thing of the past\"\u003c/strong>\u003c/p>\n\u003cp>The man who created Brain Balance, Robert Melillo, is often introduced as \"Dr. Melillo\" in media appearances. He has a doctorate and an active license in chiropractic. He is also acknowledged as an expert in the field of \u003ca href=\"https://www.youtube.com/watch?v=3tQtAs3d05E\" target=\"_blank\" rel=\"noopener\">functional neurology\u003c/a>, chiropractic's \u003ca href=\"https://chiromt.biomedcentral.com/articles/10.1186/s12998-017-0151-1\" target=\"_blank\" rel=\"noopener\">controversial alternative\u003c/a> to mainstream neurology.\u003c/p>\n\u003cp>Melillo's \u003ca href=\"http://drrobertmelillo.com/about/\">biography\u003c/a> states he has master's degrees in neuroscience and clinical rehabilitation neuropsychology, though it does not say from where. A \u003ca href=\"http://members.fclb.org/staff_online/staff/uploads/individual/0_34022299_Melillo%20CV.pdf\" target=\"_blank\" rel=\"noopener\">curriculum vitae for Melillo\u003c/a> that NPR found on a website for chiropractic licensing boards says the master's in neuroscience came from the Carrick Institute for Graduate Studies, a chiropractic academy in Florida that isn't accredited by any of the agencies recognized by the Department of Education. His second master's degree is from a now-defunct program at Touro College, a private educational organization based in New York.[contextly_sidebar id=\"qHKhvNx0WtImHmg2ZAaY7Wq5YHOgE9Ba\"]\u003c/p>\n\u003cp>Melillo says it was during an intense period of research in the 1990s, while his own son struggled with attention issues, that he conceived of a single disorder to explain everything from autism to ADHD to dyslexia. He called it functional disconnection syndrome.\u003c/p>\n\u003cp>As he writes in his book, \u003cem>Disconnected Kids,\u003c/em> the syndrome occurs when \"areas in the brain, especially the two hemispheres of the brain, are not electrically balanced, or synchronized.\" The particulars of this imbalance are not clearly defined in the book, but numerous metaphors — some involving concert orchestras with bad timing or tuning — paint a picture of a child's brain unable to communicate with itself.\u003c/p>\n\u003cp>According to Melillo, a weak right hemisphere (the emotional half) can lead to autism and ADHD; a weak left hemisphere (the logical half) often causes learning disorders like dyslexia.\u003c/p>\n\u003cp>And he argues in the book that for people who follow his program, \"ADHD, dyslexia, and even autism, among others, can become a thing of the past.\"\u003c/p>\n\u003cp>He even appears to see his program as the answer to societal problems.\u003c/p>\n\u003cp>In February, one day after the mass shooting at Marjory Stoneman Douglas High School in Parkland, Fla., Melillo used his public Facebook page to envision a world where Brain Balance had reached the shooter.\u003c/p>\n\u003cp>\"I can't help but wonder if Brain Balance and Brain Integration could have prevented this tragedy,\" Melillo \u003ca href=\"https://www.facebook.com/DrRobertMelillo/photos/a.262064050637436.1073741828.262055963971578/902197553290746/?type=3&theater\" target=\"_blank\" rel=\"noopener\">wrote in the post\u003c/a> alongside a news report in which the shooter's relatives said the teenager had been diagnosed with autism and took medication.\u003c/p>\n\u003cp>\"We have to make the whole world more aware of Brain Imbalances and how they can be helped especially in kids,\" he added. \"This is my mission now.\"\u003c/p>\n\u003cp>\u003cstrong>What happens at Brain Balance\u003c/strong>\u003c/p>\n\u003cp>Stephanie and Natalie say they watched their older son from the other side of a two-way mirror as a Brain Balance staff member ran him through a series of tests during his baseline assessment. Later, they received his results: eight pages of ratings in unfamiliar categories.[contextly_sidebar id=\"AjksKQkvNBCw7ARjvhMRqANHG340k0k4\"]\u003c/p>\n\u003cp>\"I have two master's [degrees] and a Ph.D., and I needed them explained to me,\" Natalie says. Their son had a weak right hemisphere. Additionally, his \"frontal lobe acquisition\" was lacking. His primitive reflexes were also in bad shape, according to the assessment, portions of which were shared with NPR.\u003c/p>\n\u003cp>The center recommended six months of one-hour sessions three times a week, a common course of intervention.\u003c/p>\n\u003cp>Brain Balance's approach breaks down into three broad categories: academic, nutrition and sensory-motor.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.brainbalancecenters.com/our-program/integrated-approach/academic/\" target=\"_blank\" rel=\"noopener\">academic exercises\u003c/a> focus on the same areas targeted by many after-school tutoring programs. The \u003ca href=\"https://www.brainbalancecenters.com/our-program/integrated-approach/nutrition/\" target=\"_blank\" rel=\"noopener\">nutritional component\u003c/a> recommends decreasing a child's intake of gluten, dairy and refined sugar.\u003c/p>\n\u003cp>The third, and most complex, prong of Brain Balance's intervention is its \u003ca href=\"https://www.brainbalancecenters.com/our-program/integrated-approach/sensory-motor/\" target=\"_blank\" rel=\"noopener\">sensory-motor training\u003c/a>, a diverse set of physical exercises. Parents and former employees describe activities like walking across balance beams, syncing actions with a computerized metronome and being spun in swivel chairs.[contextly_sidebar id=\"X9IS4CBjwH4LHwMmOzWNlEgWq0OztSoK\"]\u003c/p>\n\u003cp>Consistent with Melillo's theory, Brain Balance focuses much of its sensory-motor training on one-half of the child's body to send strengthening signals up and across to the supposedly weak, opposite hemisphere of the brain. (Much of the human brain indeed \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23931149\">maps to the opposite\u003c/a> half of the human body.)\u003c/p>\n\u003cp>For instance, with a \"right brain weak\" child like Stephanie and Natalie's son, Brain Balance may have him wear a vibrating armband on his left biceps or eyeglasses that allow light only onto the left visual field. Or they may simply have him stand on his left leg.\u003c/p>\n\u003cp>It has not been uncommon for parents to enroll their children for at least six months, costing roughly $12,000. The company recently said its average enrollment is now about four months. Assessments and optional nutritional supplements and blood tests can add hundreds of dollars.\u003c/p>\n\u003cp>The program isn't covered by insurance. Brain Balance offers payment plans to parents who can't cover the cost immediately. As of publication, close to 200 families have solicited money from relatives and friends with \u003ca href=\"https://www.gofundme.com/mvc.php?route=category&term=%22brain%20balance%22\" target=\"_blank\" rel=\"noopener\">GoFundMe.com\u003c/a> campaigns.\u003c/p>\n\u003cp>Natalie and Stephanie were quoted $5,000 for their first three months, with the option to re-up for more after.\u003c/p>\n\u003cp>\"When you're talking about your child's self-esteem and knowing it's the most important thing, what are you going to do?\" Stephanie says. \"Maybe work a few more years and take a little bit out of your retirement so that maybe — if you nip this thing in the bud — he's able to have a better life going forward?\"\u003c/p>\n\u003cp>They dipped into their retirement savings and enrolled both their sons at a total cost of more than $15,000.\u003c/p>\n\u003cp>\"\u003cstrong>Cutting edge\" science\u003c/strong>\u003c/p>\n\u003cp>In numerous media appearances, Melillo hasn't been shy about publicizing the strength of his program's scientific evidence.\u003c/p>\n\u003cp>\"This isn't smoke and mirrors. This is real stuff. ... [Parents] are going to get real answers,\" Melillo \u003ca href=\"https://youtu.be/uaMbTtcFhvU?t=5m16s\" target=\"_blank\" rel=\"noopener\">told a radio host in 2010\u003c/a>. \"We've shown in our centers that we can correct these problems completely. We've proved that in research,\" he \u003ca href=\"https://youtu.be/7XJ8ouQgmtA?t=1m56s\" target=\"_blank\" rel=\"noopener\">said on TV in 2014\u003c/a>. \"We use really cutting-edge brain science to address the issue,\" he \u003ca href=\"https://youtu.be/KhmgeWUrkwo?t=49s\" target=\"_blank\" rel=\"noopener\">said in 2016\u003c/a>.\u003c/p>\n\u003cp>Yet a dozen experts in autism spectrum disorder, ADHD, dyslexia and childhood psychiatry interviewed by NPR all identified flaws in Brain Balance's approach.\u003c/p>\n\u003cp>They said the company's idea of imbalanced hemispheres was too simplistic and built upon the popular, discredited myth of the logical left brain and the intuitive right brain.[contextly_sidebar id=\"cWTrlOd6AlGxpGOvjVNIxgehcBIwY6uh\"]\u003c/p>\n\u003cp>\"It doesn't make sense,\" says \u003ca href=\"https://www.kennedykrieger.org/professional-training/training-disciplines/special-education-fellowship/leadership/mark-mahone-phd\" target=\"_blank\" rel=\"noopener\">Mark Mahone\u003c/a>, a pediatric neuropsychologist at the Kennedy Krieger Institute in Baltimore. \"In virtually every activity that one does ... both hemispheres of the brain are very, very active. ... It's not as simple as just being a left- or a right-hemisphere problem. Nothing is that simple.\"\u003c/p>\n\u003cp>As for the three-pronged Brain Balance regimen, experts NPR spoke with said there is no solid evidence suggesting gluten, dairy or sugar consumption affects ADHD, autism or dyslexia. And although physical exercise may have modest impacts on inattention and tutoring can help in school, these interventions can be found elsewhere for much less money. No expert suggested either as a front-line remedy for ADHD or autism.\u003c/p>\n\u003cp>Doctors and researchers NPR interviewed also questioned the diagnostic metrics Brain Balance uses.\u003c/p>\n\u003cp>For example, the company tests children for the primitive reflexes that drive infants to instinctively suckle or grab a finger. Natalie and Stephanie were told their son's lingering primitive reflexes were connected to his behavioral issues.\u003c/p>\n\u003cp>But multiple pediatricians said it is exceptionally rare for children older than 4 to retain any primitive reflexes.\u003c/p>\n\u003cp>\"Typically by 1 year of age these primitive reflexes have disappeared,\" says Dr. Andrew Adesman, a developmental pediatrician at Cohen Children's Medical Center of New York. \"The major exception is children who have cerebral palsy.\"\u003c/p>\n\u003cp>Melillo disagreed with the experts' opinions. \"I think they're completely wrong,\" he says.\u003c/p>\n\u003cp>\"Pediatricians rarely look at primitive reflexes after infancy, but if they did, they will find that, in many cases, they are still there,\" he wrote in an email.\u003c/p>\n\u003cp>Melillo also pushed back against the medical consensus that autism, ADHD and dyslexia aren't caused by hemispheric differences and that gluten doesn't affect such disorders.\u003c/p>\n\u003cp>\"I can show you a lot of papers that actually say that there is a relationship between food sensitivities, gluten sensitivity and different types of issues and conditions,\" he says. \"So again, it depends on the expert.\"\u003c/p>\n\u003cp>\"\u003cstrong>Evidence based\"?\u003c/strong>\u003c/p>\n\u003cp>There are two published studies of Brain Balance, which the company has said show that 81 percent of children with ADHD no longer displayed symptoms after three months in the program.\u003c/p>\n\u003cp>\"We have two studies now,\" Melillo said \u003ca href=\"https://youtu.be/AVp295htBVI?t=4m52s\" target=\"_blank\" rel=\"noopener\">on local TV\u003c/a> in 2013. \"So that means that we qualify as what we call 'evidence based' at this point.\"\u003c/p>\n\u003cp>Brain Balance \u003ca href=\"https://blog.brainbalancecenters.com/2013/07/control-study-shows-brain-balance-eliminates-adhd-symptoms\" target=\"_blank\" rel=\"noopener\">touted one of the studies on its blog\u003c/a> with the headline, \"Control Study Shows Brain Balance Eliminates ADHD Symptoms.\"\u003c/p>\n\u003cp>The studies, however, have serious scientific shortcomings.\u003c/p>\n\u003cp>Melillo, someone with a clear financial interest in the outcome, co-authored \u003ca href=\"http://www.carolinabraincenter.com/wp-content/uploads/2014/03/The_effect_of_hemisphere_specific_remediation_strategies_on_the_academic_performance_outcome_of_children_with_ADD_ADHD_.pdf\" target=\"_blank\" rel=\"noopener\">the first one\u003c/a>.\u003c/p>\n\u003cp>He also had parents rate their own children's improvement in ADHD symptoms but \u003ca href=\"https://www.documentcloud.org/documents/4420809-2010-BB-Study.html#document/p5/a415343\" target=\"_blank\" rel=\"noopener\">didn't compare\u003c/a> them with other kids who weren't in Brain Balance.[contextly_sidebar id=\"40It7ERz2X1PbU5Xz4PrJhqRCedRiEbu\"]\u003c/p>\n\u003cp>Without a control group, a study cannot definitively determine whether an intervention — a pill or procedure or program — is the reason for improvement or whether any change is simply the placebo effect.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.feingold.org/Research/PDFstudies/Leisman2013.pdf\" target=\"_blank\" rel=\"noopener\">second study\u003c/a> did feature a control group of children with ADHD who didn't do Brain Balance. But it compared them with the same children from the first study published years earlier instead of randomly assigning children into simultaneous treatment and control groups.\u003c/p>\n\u003cp>\"My issue with these data is that there's no legitimate comparison for the treatment group, so we really don't know if [Brain Balance] helps,\" says Dr. Paul Wang, deputy director for clinical research at the Simons Foundation.\u003c/p>\n\u003cp>The experts NPR consulted took issue with other aspects of the studies as well.\u003c/p>\n\u003cp>The kids in the treatment and control groups \u003ca href=\"https://www.documentcloud.org/documents/4420810-2013-BB-Study.html#document/p3/a415322\" target=\"_blank\" rel=\"noopener\">differed in important ways\u003c/a>, the experts said, rendering comparisons between them less meaningful. The two groups weren't drawn from the same centers; all of the treatment group was medicated while only 60 percent of the controls were; and at baseline the controls scored more severe on an ADHD rating scale.\u003c/p>\n\u003cp>Curiously, even though the \u003ca href=\"https://www.documentcloud.org/documents/4420810-2013-BB-Study.html#document/p5/a429871\" target=\"_blank\" rel=\"noopener\">second\u003c/a> study reused the treatment group data from the \u003ca href=\"https://www.documentcloud.org/documents/4420809-2010-BB-Study.html#document/p6/a415327\" target=\"_blank\" rel=\"noopener\">first\u003c/a> study published years earlier, it reported different improvements on those same kids' test scores. The lead author on both studies, Gerry Leisman, a professor of neuro and rehabilitation sciences at the University of Haifa in Israel, explained one of the test score differences as a \"reviewer correction\" but did not provide explanations for any of the six remaining discrepancies.\u003c/p>\n\u003cp>Dr. James McGough, a professor of clinical psychiatry at UCLA's David Geffen Medical School, wasn't convinced by Brain Balance's published research. \"It means absolutely nothing. ... What we have here, in my view, is a marketing piece.\"[contextly_sidebar id=\"ul2FBC3owyMkUEM8UijiLxV0mmmsmz4s\"]\u003c/p>\n\u003cp>At least one state remains similarly unconvinced.\u003c/p>\n\u003cp>In 2015, Wisconsin's Department of Health Services determined Brain Balance had \"\u003ca href=\"https://www.dhs.wisconsin.gov/tiac/brain-balance-january-2015.pdf\" target=\"_blank\" rel=\"noopener\">insufficient evidence\u003c/a>\" to show it was a \"proven and effective treatment for individuals with autism spectrum disorder and/or other developmental disabilities,\" as the \u003cem>Milwaukee Journal-Sentinel \u003c/em>\u003ca href=\"http://archive.jsonline.com/business/company-pushes-brain-balancing-program-for-learning-disabilities-evidence-lacking-b99551698z1-324854621.html\">reported\u003c/a>. The state assigned Brain Balance to the second-lowest ranking on its five-tier system. The only lower ranking is for \"potentially harmful\" treatments.\u003c/p>\n\u003cp>\u003cstrong>Brain Balance defends its approach\u003c/strong>\u003c/p>\n\u003cp>Asked by NPR why Brain Balance hadn't been tested more thoroughly before its nationwide expansion began a decade ago, Melillo says the company was \"faced with a dilemma.\" While he did feel an obligation to validate his approach, he says he knew Brain Balance worked and didn't want to deprive his clients of its benefits while waiting for clinical trials. \"All these 25,000 families that we've helped, are they left suffering for years on end?\"\u003c/p>\n\u003cp>\"What was done to date was commensurate to the resources that we had,\" says Aleem Choudhry, the chairman of Brain Balance and a managing member at Crane Street Capital, which invested in the franchise in 2013.\u003c/p>\n\u003cp>The company says ADHD was the only disorder to be studied thus far because — contrary to the opinion of all the experts contacted by NPR — it is neurologically equivalent to others like autism, dyslexia and OCD. If Brain Balance improves ADHD symptoms, Melillo says, \"then we believe that we're going to get the same results in the other types of issues, because they're really the same problem.\"\u003c/p>\n\u003cp>Melillo also says the company's proprietary records from about 80,000 before-and-after client assessments qualify as corroboration. Melillo disputed the idea that his company's own data may require third-party review. \"Data is data,\" he says. \"There's no bias in the way we collect this.\"\u003c/p>\n\u003cp>A new study of a \u003ca href=\"https://drteicher.wordpress.com/2015/11/20/non-pharmacological-treatment-for-adhd/\" target=\"_blank\" rel=\"noopener\">computerized version of Brain Balance\u003c/a> is underway at a Harvard-affiliated hospital and features a concurrent control group of children.\u003c/p>\n\u003cp>But Melillo says that questions about the research behind Brain Balance ultimately miss a larger, more important point.\u003c/p>\n\u003cp>\"Families are out there struggling and suffering, and they don't really give a crap about the data or the research, to be quite honest,\" he says. \"When they go through it and they see the difference in their child ... that's what matters to them.\"\u003c/p>\n\u003cp>Choudhry, the company's chairman, later clarified that \"we very much do care about the data.\"\u003c/p>\n\u003cp>\u003cstrong>No easy answer\u003c/strong>\u003c/p>\n\u003cp>With both their boys enrolled in Brain Balance, the routine for Stephanie and Natalie's family was frantic.\u003c/p>\n\u003cp>Three times a week, Stephanie would ferry their sons against traffic to and from their sessions. Family dinners became more rushed. Soccer and swimming were abandoned.\u003c/p>\n\u003cp>Lost time is often a hidden cost of any form of treatment.\u003c/p>\n\u003cp>The mothers began observing changes in their older son. They say his previously weak sense of smell suddenly blossomed, first for brownies and then other foods. And he became less obsessed with characters he had repetitively sketched in his notebooks and imbued with rich inner lives. (His parents are torn as to whether this was a positive development.) He also advanced in certain Brain Balance measures, including his primitive reflexes.\u003c/p>\n\u003cp>\"It's not that the needle didn't move on some of those dimensions,\" says Natalie. \"But if you step back at the 10,000- or 100,000-foot view and say, 'Is this kid different in a way that his life is going to be better or altered?' the answer is 'No.' OK, so now he can smell brownies that he couldn't smell before but is his life different?\"\u003c/p>\n\u003cp>She says she and her wife began to feel discouraged, thinking about the \"aura around this program that says your child's going to be different and better-adjusted.\"\u003c/p>\n\u003cp>Eric Rossen of the National Association of School Psychologists isn't surprised by Brain Balance's popularity as an option beyond what schools and insurance will cover.\u003c/p>\n\u003cp>He says many parents are frustrated by mainstream medicine's limits when it comes to complex disorders like autism. And schools are sometimes too strapped for resources to provide students with learning disorders all the help their parents may want.\u003c/p>\n\u003cp>\"Most parents will say they would die for their children,\" Rossen says. \"So to say, 'I want to provide some therapy and pay a few thousand dollars' is quite short of dying for them and it's totally reasonable.\"[contextly_sidebar id=\"trKt9lVGGL2hYvUb63mGVzd7zTqN7BTZ\"]\u003c/p>\n\u003cp>But he says \"the problem is they are easy prey for certain providers that can make promises that cannot necessarily be kept or are not necessarily backed by scientific data.\"\u003c/p>\n\u003cp>For parents looking to find evidence-based third-party interventions, experts suggest the \u003ca href=\"https://ies.ed.gov/ncee/wwc/\" target=\"_blank\" rel=\"noopener\">What Works Clearinghouse\u003c/a>, which is backed by the Department of Education, or the Substance Abuse and Mental Health Services Administration's \u003ca href=\"https://www.samhsa.gov/nrepp\" target=\"_blank\" rel=\"noopener\">own resource\u003c/a>.\u003c/p>\n\u003cp>Brain Balance's protocol doesn't appear to pose any physical or developmental harms to children. Instead, the program's costs may come in other ways: siphoning away time and money, and prolonging the hope in some parents that their child may one day shed his or her disorder.\u003c/p>\n\u003cp>Dr. Susan Hyman, a professor of pediatrics at the University of Rochester who has studied autism treatments for decades, says many alternative providers do this by offering an unrealistically simple solution.\u003c/p>\n\u003cp>\"If you were to come to a traditional provider who said, 'You know I'm going to have you work really, really, really hard. ... I might have some drugs. Drugs have side effects. And 90 percent of the time, as an adult, he is still going to have autism,' that's a far less attractive message than 'I can help you.' \"\u003c/p>\n\u003cp>\u003cstrong>Beyond Brain Balance\u003c/strong>\u003c/p>\n\u003cp>By the end of their older son's second three-month session at Brain Balance, Stephanie and Natalie had completely soured on it. They stopped believing that vibrating armbands and spinning in swivel chairs would translate to social success.\u003c/p>\n\u003cp>They decided to not continue.\u003c/p>\n\u003cp>Later, in second grade, their older son began to work with a social worker at school who taught him how to have socially acceptable conversation with his peers.\u003c/p>\n\u003cp>And Stephanie and Natalie did something else — the unthinkable.\u003c/p>\n\u003cp>They put their son on a medication called Strattera. Calibrating the proper dosage with tolerable side effects was a drawn-out process, but eventually they reached an equilibrium. Their older son ended up with a new diagnosis that has some overlap with autism but is more consistent with ADHD, which the medication treats.[contextly_sidebar id=\"Mk0Q9RIDdUaNoWDya3YvMRUEK35nUdWD\"]\u003c/p>\n\u003cp>Today, he seems to be navigating the world more successfully than before.\u003c/p>\n\u003cp>On a Saturday last August, their older son — who once plaintively asked his parents, \"Why aren't I invited to birthday parties?\" — had just wrapped up a party to celebrate turning 10 years old.\u003c/p>\n\u003cp>Natalie and Stephanie had pizzas delivered and rented a truck lined with pleather sofas on one side and video game systems along the other. The children sat in pairs and used their greasy fingers to dispatch their avatars against each other in virtual battle.\u003c/p>\n\u003cp>\"They were yelling my son's name and saying 'Come play with me! Come play with me!' \" recalls Natalie.\u003c/p>\n\u003cp>The birthday boy says he invited almost all of his friends, from school and camp, and all but one showed up, which was more than he could have ever imagined before.\u003c/p>\n\u003cp>\"Because,\" he says before pausing. \"I haven't had friends for a bit. Until I got my medicine. I got some treatment. I got help. Now, I have tons of friends.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>The reporter, Chris Benderev, can be contacted at cbenderev@npr.org.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=%27Cutting+Edge%27+Program+For+Children+With+Autism+And+ADHD+Rests+On+Razor-Thin+Evidence&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "With 113 locations in the U.S., Brain Balance says its drug-free approach has helped tens of thousands of children. But experts say there's insufficient proof of its effectiveness.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Some parents see it coming. Natalie was not that kind of parent.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Even after the director and a teacher at her older son's day care sat her down one afternoon in 2011 to detail the 3-year-old's difficulty socializing and his tendency to chatter endlessly about topics his peers showed no interest in, she still didn't get the message.\u003c/p>\n\u003cp>Her son, the two educators eventually spelled out, might be on the autism spectrum.\u003c/p>\n\u003cp>\"I was in tears at the end,\" she says. \"When I got home, I was just devastated.\"\u003c/p>\n\u003cp>Natalie broke the news to her wife, Stephanie, whose mind fast-forwarded to a distressing future. Would her son — a squat, cheerful boy who, despite his affectionate nature, didn't have any playmates — ever be able to make friends?\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>When a doctor eventually confirmed he had an autism spectrum disorder, the diagnosis came with a suggestion: Perhaps the boy would benefit from Prozac when he turned 7.\u003c/p>\n\u003cp>\"That was when both of us fell apart in that meeting,\" Natalie says. For both parents, medication wasn't an option.\u003c/p>\n\u003cp>\"Prozac is a very powerful drug for adults. Why would you give it to a 7-year-old?\" Stephanie wondered after the doctor's visit. \"I welled up with all of this emotion. And I said I will not let that happen.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>(To protect their privacy, we are only using Natalie's and Stephanie's first names. We are not naming their children.)\u003c/p>\n\u003cp>The fear of psychotropic drugs led the family to pursue alternative treatments for autism.\u003c/p>\n\u003cp>To start, they dropped gluten.\u003c/p>\n\u003cp>Then one day, as Natalie roamed the aisles of a gluten-free expo in a Chicago suburb not far from where the family lives, she came across a booth for a Brain Balance Achievement Center.\u003c/p>\n\u003cp>Natalie says the program claimed to help with disorders ranging from dyslexia to ADHD and autism. Best of all, it didn't involve prescription drugs.\u003c/p>\n\u003cp>\"We were very excited,\" Stephanie says. \"Maybe we found a solution that wasn't going to be about medicine. I was very, very hopeful.\"\u003c/p>\n\u003cp>\"\u003cstrong>It will completely, absolutely, 100 percent change your life\"\u003c/strong>\u003c/p>\n\u003cp>Natalie had stumbled upon one of 113 Brain Balance franchises across the country. Seventeen more are in the works. In the dozen years since its inception, Brain Balance says, it has helped roughly 25,000 children. The company says it is currently taking in over $50 million in annual revenue.\u003c/p>\n\u003cp>Although Brain Balance isn't the only purveyor of alternative approaches for developmental disorders in the U.S., the scale of the enterprise sets it apart. The company's approach is still relatively new and not widely known, meaning many experts in the field of childhood development have not vetted its effectiveness.\u003c/p>\n\u003cp>Brain Balance says its nonmedical and drug-free program helps children who struggle with ADHD, autism spectrum disorders and learning and processing disorders. The company says it addresses a child's challenges with a combination of physical exercises, nutritional guidance and academic training.\u003c/p>\n\u003cp>An NPR investigation of Brain Balance reveals a company whose promises have resonated with parents averse to medication. But Brain Balance also appears to have overstated the scientific evidence in its messaging to families, who can easily spend over $10,000 in six months, a common length of enrollment.\u003c/p>\n\u003cp>Brain Balance's metrics for consumer satisfaction are impressive. Customers rate the program, on average, an 8.5 on a 10-point scale in surveys, according to the company.\u003c/p>\n\u003cp>The ratings square with comments in online forums and in interviews NPR conducted with 18 parents who enrolled their children. Across the country, about three dozen centers are run by parents who began as happy customers.\u003c/p>\n\u003cp>\u003ca href=\"https://www.brainbalancecenters.com/\" target=\"_blank\" rel=\"noopener\">Brain Balance's website\u003c/a> is where caretakers encounter the company's strongest pitch: dozens upon dozens of \u003ca href=\"https://www.brainbalancecenters.com/our-stories/\" target=\"_blank\" rel=\"noopener\">parent testimonials\u003c/a>.\u003c/p>\n\u003cp>One of the company's \u003ca href=\"https://www.youtube.com/watch?v=OAaow0Kk0g8\" target=\"_blank\" rel=\"noopener\">television commercials\u003c/a> begins with a montage of formerly frustrated mothers. But, they all agree, Brain Balance put an end to their kids' challenges. One woman insists \"it will completely, absolutely, 100 percent change your life.\"\u003c/p>\n\u003cp>\u003cstrong>Autism \"can become a thing of the past\"\u003c/strong>\u003c/p>\n\u003cp>The man who created Brain Balance, Robert Melillo, is often introduced as \"Dr. Melillo\" in media appearances. He has a doctorate and an active license in chiropractic. He is also acknowledged as an expert in the field of \u003ca href=\"https://www.youtube.com/watch?v=3tQtAs3d05E\" target=\"_blank\" rel=\"noopener\">functional neurology\u003c/a>, chiropractic's \u003ca href=\"https://chiromt.biomedcentral.com/articles/10.1186/s12998-017-0151-1\" target=\"_blank\" rel=\"noopener\">controversial alternative\u003c/a> to mainstream neurology.\u003c/p>\n\u003cp>Melillo's \u003ca href=\"http://drrobertmelillo.com/about/\">biography\u003c/a> states he has master's degrees in neuroscience and clinical rehabilitation neuropsychology, though it does not say from where. A \u003ca href=\"http://members.fclb.org/staff_online/staff/uploads/individual/0_34022299_Melillo%20CV.pdf\" target=\"_blank\" rel=\"noopener\">curriculum vitae for Melillo\u003c/a> that NPR found on a website for chiropractic licensing boards says the master's in neuroscience came from the Carrick Institute for Graduate Studies, a chiropractic academy in Florida that isn't accredited by any of the agencies recognized by the Department of Education. His second master's degree is from a now-defunct program at Touro College, a private educational organization based in New York.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Melillo says it was during an intense period of research in the 1990s, while his own son struggled with attention issues, that he conceived of a single disorder to explain everything from autism to ADHD to dyslexia. He called it functional disconnection syndrome.\u003c/p>\n\u003cp>As he writes in his book, \u003cem>Disconnected Kids,\u003c/em> the syndrome occurs when \"areas in the brain, especially the two hemispheres of the brain, are not electrically balanced, or synchronized.\" The particulars of this imbalance are not clearly defined in the book, but numerous metaphors — some involving concert orchestras with bad timing or tuning — paint a picture of a child's brain unable to communicate with itself.\u003c/p>\n\u003cp>According to Melillo, a weak right hemisphere (the emotional half) can lead to autism and ADHD; a weak left hemisphere (the logical half) often causes learning disorders like dyslexia.\u003c/p>\n\u003cp>And he argues in the book that for people who follow his program, \"ADHD, dyslexia, and even autism, among others, can become a thing of the past.\"\u003c/p>\n\u003cp>He even appears to see his program as the answer to societal problems.\u003c/p>\n\u003cp>In February, one day after the mass shooting at Marjory Stoneman Douglas High School in Parkland, Fla., Melillo used his public Facebook page to envision a world where Brain Balance had reached the shooter.\u003c/p>\n\u003cp>\"I can't help but wonder if Brain Balance and Brain Integration could have prevented this tragedy,\" Melillo \u003ca href=\"https://www.facebook.com/DrRobertMelillo/photos/a.262064050637436.1073741828.262055963971578/902197553290746/?type=3&theater\" target=\"_blank\" rel=\"noopener\">wrote in the post\u003c/a> alongside a news report in which the shooter's relatives said the teenager had been diagnosed with autism and took medication.\u003c/p>\n\u003cp>\"We have to make the whole world more aware of Brain Imbalances and how they can be helped especially in kids,\" he added. \"This is my mission now.\"\u003c/p>\n\u003cp>\u003cstrong>What happens at Brain Balance\u003c/strong>\u003c/p>\n\u003cp>Stephanie and Natalie say they watched their older son from the other side of a two-way mirror as a Brain Balance staff member ran him through a series of tests during his baseline assessment. Later, they received his results: eight pages of ratings in unfamiliar categories.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"I have two master's [degrees] and a Ph.D., and I needed them explained to me,\" Natalie says. Their son had a weak right hemisphere. Additionally, his \"frontal lobe acquisition\" was lacking. His primitive reflexes were also in bad shape, according to the assessment, portions of which were shared with NPR.\u003c/p>\n\u003cp>The center recommended six months of one-hour sessions three times a week, a common course of intervention.\u003c/p>\n\u003cp>Brain Balance's approach breaks down into three broad categories: academic, nutrition and sensory-motor.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.brainbalancecenters.com/our-program/integrated-approach/academic/\" target=\"_blank\" rel=\"noopener\">academic exercises\u003c/a> focus on the same areas targeted by many after-school tutoring programs. The \u003ca href=\"https://www.brainbalancecenters.com/our-program/integrated-approach/nutrition/\" target=\"_blank\" rel=\"noopener\">nutritional component\u003c/a> recommends decreasing a child's intake of gluten, dairy and refined sugar.\u003c/p>\n\u003cp>The third, and most complex, prong of Brain Balance's intervention is its \u003ca href=\"https://www.brainbalancecenters.com/our-program/integrated-approach/sensory-motor/\" target=\"_blank\" rel=\"noopener\">sensory-motor training\u003c/a>, a diverse set of physical exercises. Parents and former employees describe activities like walking across balance beams, syncing actions with a computerized metronome and being spun in swivel chairs.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Consistent with Melillo's theory, Brain Balance focuses much of its sensory-motor training on one-half of the child's body to send strengthening signals up and across to the supposedly weak, opposite hemisphere of the brain. (Much of the human brain indeed \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23931149\">maps to the opposite\u003c/a> half of the human body.)\u003c/p>\n\u003cp>For instance, with a \"right brain weak\" child like Stephanie and Natalie's son, Brain Balance may have him wear a vibrating armband on his left biceps or eyeglasses that allow light only onto the left visual field. Or they may simply have him stand on his left leg.\u003c/p>\n\u003cp>It has not been uncommon for parents to enroll their children for at least six months, costing roughly $12,000. The company recently said its average enrollment is now about four months. Assessments and optional nutritional supplements and blood tests can add hundreds of dollars.\u003c/p>\n\u003cp>The program isn't covered by insurance. Brain Balance offers payment plans to parents who can't cover the cost immediately. As of publication, close to 200 families have solicited money from relatives and friends with \u003ca href=\"https://www.gofundme.com/mvc.php?route=category&term=%22brain%20balance%22\" target=\"_blank\" rel=\"noopener\">GoFundMe.com\u003c/a> campaigns.\u003c/p>\n\u003cp>Natalie and Stephanie were quoted $5,000 for their first three months, with the option to re-up for more after.\u003c/p>\n\u003cp>\"When you're talking about your child's self-esteem and knowing it's the most important thing, what are you going to do?\" Stephanie says. \"Maybe work a few more years and take a little bit out of your retirement so that maybe — if you nip this thing in the bud — he's able to have a better life going forward?\"\u003c/p>\n\u003cp>They dipped into their retirement savings and enrolled both their sons at a total cost of more than $15,000.\u003c/p>\n\u003cp>\"\u003cstrong>Cutting edge\" science\u003c/strong>\u003c/p>\n\u003cp>In numerous media appearances, Melillo hasn't been shy about publicizing the strength of his program's scientific evidence.\u003c/p>\n\u003cp>\"This isn't smoke and mirrors. This is real stuff. ... [Parents] are going to get real answers,\" Melillo \u003ca href=\"https://youtu.be/uaMbTtcFhvU?t=5m16s\" target=\"_blank\" rel=\"noopener\">told a radio host in 2010\u003c/a>. \"We've shown in our centers that we can correct these problems completely. We've proved that in research,\" he \u003ca href=\"https://youtu.be/7XJ8ouQgmtA?t=1m56s\" target=\"_blank\" rel=\"noopener\">said on TV in 2014\u003c/a>. \"We use really cutting-edge brain science to address the issue,\" he \u003ca href=\"https://youtu.be/KhmgeWUrkwo?t=49s\" target=\"_blank\" rel=\"noopener\">said in 2016\u003c/a>.\u003c/p>\n\u003cp>Yet a dozen experts in autism spectrum disorder, ADHD, dyslexia and childhood psychiatry interviewed by NPR all identified flaws in Brain Balance's approach.\u003c/p>\n\u003cp>They said the company's idea of imbalanced hemispheres was too simplistic and built upon the popular, discredited myth of the logical left brain and the intuitive right brain.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"It doesn't make sense,\" says \u003ca href=\"https://www.kennedykrieger.org/professional-training/training-disciplines/special-education-fellowship/leadership/mark-mahone-phd\" target=\"_blank\" rel=\"noopener\">Mark Mahone\u003c/a>, a pediatric neuropsychologist at the Kennedy Krieger Institute in Baltimore. \"In virtually every activity that one does ... both hemispheres of the brain are very, very active. ... It's not as simple as just being a left- or a right-hemisphere problem. Nothing is that simple.\"\u003c/p>\n\u003cp>As for the three-pronged Brain Balance regimen, experts NPR spoke with said there is no solid evidence suggesting gluten, dairy or sugar consumption affects ADHD, autism or dyslexia. And although physical exercise may have modest impacts on inattention and tutoring can help in school, these interventions can be found elsewhere for much less money. No expert suggested either as a front-line remedy for ADHD or autism.\u003c/p>\n\u003cp>Doctors and researchers NPR interviewed also questioned the diagnostic metrics Brain Balance uses.\u003c/p>\n\u003cp>For example, the company tests children for the primitive reflexes that drive infants to instinctively suckle or grab a finger. Natalie and Stephanie were told their son's lingering primitive reflexes were connected to his behavioral issues.\u003c/p>\n\u003cp>But multiple pediatricians said it is exceptionally rare for children older than 4 to retain any primitive reflexes.\u003c/p>\n\u003cp>\"Typically by 1 year of age these primitive reflexes have disappeared,\" says Dr. Andrew Adesman, a developmental pediatrician at Cohen Children's Medical Center of New York. \"The major exception is children who have cerebral palsy.\"\u003c/p>\n\u003cp>Melillo disagreed with the experts' opinions. \"I think they're completely wrong,\" he says.\u003c/p>\n\u003cp>\"Pediatricians rarely look at primitive reflexes after infancy, but if they did, they will find that, in many cases, they are still there,\" he wrote in an email.\u003c/p>\n\u003cp>Melillo also pushed back against the medical consensus that autism, ADHD and dyslexia aren't caused by hemispheric differences and that gluten doesn't affect such disorders.\u003c/p>\n\u003cp>\"I can show you a lot of papers that actually say that there is a relationship between food sensitivities, gluten sensitivity and different types of issues and conditions,\" he says. \"So again, it depends on the expert.\"\u003c/p>\n\u003cp>\"\u003cstrong>Evidence based\"?\u003c/strong>\u003c/p>\n\u003cp>There are two published studies of Brain Balance, which the company has said show that 81 percent of children with ADHD no longer displayed symptoms after three months in the program.\u003c/p>\n\u003cp>\"We have two studies now,\" Melillo said \u003ca href=\"https://youtu.be/AVp295htBVI?t=4m52s\" target=\"_blank\" rel=\"noopener\">on local TV\u003c/a> in 2013. \"So that means that we qualify as what we call 'evidence based' at this point.\"\u003c/p>\n\u003cp>Brain Balance \u003ca href=\"https://blog.brainbalancecenters.com/2013/07/control-study-shows-brain-balance-eliminates-adhd-symptoms\" target=\"_blank\" rel=\"noopener\">touted one of the studies on its blog\u003c/a> with the headline, \"Control Study Shows Brain Balance Eliminates ADHD Symptoms.\"\u003c/p>\n\u003cp>The studies, however, have serious scientific shortcomings.\u003c/p>\n\u003cp>Melillo, someone with a clear financial interest in the outcome, co-authored \u003ca href=\"http://www.carolinabraincenter.com/wp-content/uploads/2014/03/The_effect_of_hemisphere_specific_remediation_strategies_on_the_academic_performance_outcome_of_children_with_ADD_ADHD_.pdf\" target=\"_blank\" rel=\"noopener\">the first one\u003c/a>.\u003c/p>\n\u003cp>He also had parents rate their own children's improvement in ADHD symptoms but \u003ca href=\"https://www.documentcloud.org/documents/4420809-2010-BB-Study.html#document/p5/a415343\" target=\"_blank\" rel=\"noopener\">didn't compare\u003c/a> them with other kids who weren't in Brain Balance.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Without a control group, a study cannot definitively determine whether an intervention — a pill or procedure or program — is the reason for improvement or whether any change is simply the placebo effect.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.feingold.org/Research/PDFstudies/Leisman2013.pdf\" target=\"_blank\" rel=\"noopener\">second study\u003c/a> did feature a control group of children with ADHD who didn't do Brain Balance. But it compared them with the same children from the first study published years earlier instead of randomly assigning children into simultaneous treatment and control groups.\u003c/p>\n\u003cp>\"My issue with these data is that there's no legitimate comparison for the treatment group, so we really don't know if [Brain Balance] helps,\" says Dr. Paul Wang, deputy director for clinical research at the Simons Foundation.\u003c/p>\n\u003cp>The experts NPR consulted took issue with other aspects of the studies as well.\u003c/p>\n\u003cp>The kids in the treatment and control groups \u003ca href=\"https://www.documentcloud.org/documents/4420810-2013-BB-Study.html#document/p3/a415322\" target=\"_blank\" rel=\"noopener\">differed in important ways\u003c/a>, the experts said, rendering comparisons between them less meaningful. The two groups weren't drawn from the same centers; all of the treatment group was medicated while only 60 percent of the controls were; and at baseline the controls scored more severe on an ADHD rating scale.\u003c/p>\n\u003cp>Curiously, even though the \u003ca href=\"https://www.documentcloud.org/documents/4420810-2013-BB-Study.html#document/p5/a429871\" target=\"_blank\" rel=\"noopener\">second\u003c/a> study reused the treatment group data from the \u003ca href=\"https://www.documentcloud.org/documents/4420809-2010-BB-Study.html#document/p6/a415327\" target=\"_blank\" rel=\"noopener\">first\u003c/a> study published years earlier, it reported different improvements on those same kids' test scores. The lead author on both studies, Gerry Leisman, a professor of neuro and rehabilitation sciences at the University of Haifa in Israel, explained one of the test score differences as a \"reviewer correction\" but did not provide explanations for any of the six remaining discrepancies.\u003c/p>\n\u003cp>Dr. James McGough, a professor of clinical psychiatry at UCLA's David Geffen Medical School, wasn't convinced by Brain Balance's published research. \"It means absolutely nothing. ... What we have here, in my view, is a marketing piece.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>At least one state remains similarly unconvinced.\u003c/p>\n\u003cp>In 2015, Wisconsin's Department of Health Services determined Brain Balance had \"\u003ca href=\"https://www.dhs.wisconsin.gov/tiac/brain-balance-january-2015.pdf\" target=\"_blank\" rel=\"noopener\">insufficient evidence\u003c/a>\" to show it was a \"proven and effective treatment for individuals with autism spectrum disorder and/or other developmental disabilities,\" as the \u003cem>Milwaukee Journal-Sentinel \u003c/em>\u003ca href=\"http://archive.jsonline.com/business/company-pushes-brain-balancing-program-for-learning-disabilities-evidence-lacking-b99551698z1-324854621.html\">reported\u003c/a>. The state assigned Brain Balance to the second-lowest ranking on its five-tier system. The only lower ranking is for \"potentially harmful\" treatments.\u003c/p>\n\u003cp>\u003cstrong>Brain Balance defends its approach\u003c/strong>\u003c/p>\n\u003cp>Asked by NPR why Brain Balance hadn't been tested more thoroughly before its nationwide expansion began a decade ago, Melillo says the company was \"faced with a dilemma.\" While he did feel an obligation to validate his approach, he says he knew Brain Balance worked and didn't want to deprive his clients of its benefits while waiting for clinical trials. \"All these 25,000 families that we've helped, are they left suffering for years on end?\"\u003c/p>\n\u003cp>\"What was done to date was commensurate to the resources that we had,\" says Aleem Choudhry, the chairman of Brain Balance and a managing member at Crane Street Capital, which invested in the franchise in 2013.\u003c/p>\n\u003cp>The company says ADHD was the only disorder to be studied thus far because — contrary to the opinion of all the experts contacted by NPR — it is neurologically equivalent to others like autism, dyslexia and OCD. If Brain Balance improves ADHD symptoms, Melillo says, \"then we believe that we're going to get the same results in the other types of issues, because they're really the same problem.\"\u003c/p>\n\u003cp>Melillo also says the company's proprietary records from about 80,000 before-and-after client assessments qualify as corroboration. Melillo disputed the idea that his company's own data may require third-party review. \"Data is data,\" he says. \"There's no bias in the way we collect this.\"\u003c/p>\n\u003cp>A new study of a \u003ca href=\"https://drteicher.wordpress.com/2015/11/20/non-pharmacological-treatment-for-adhd/\" target=\"_blank\" rel=\"noopener\">computerized version of Brain Balance\u003c/a> is underway at a Harvard-affiliated hospital and features a concurrent control group of children.\u003c/p>\n\u003cp>But Melillo says that questions about the research behind Brain Balance ultimately miss a larger, more important point.\u003c/p>\n\u003cp>\"Families are out there struggling and suffering, and they don't really give a crap about the data or the research, to be quite honest,\" he says. \"When they go through it and they see the difference in their child ... that's what matters to them.\"\u003c/p>\n\u003cp>Choudhry, the company's chairman, later clarified that \"we very much do care about the data.\"\u003c/p>\n\u003cp>\u003cstrong>No easy answer\u003c/strong>\u003c/p>\n\u003cp>With both their boys enrolled in Brain Balance, the routine for Stephanie and Natalie's family was frantic.\u003c/p>\n\u003cp>Three times a week, Stephanie would ferry their sons against traffic to and from their sessions. Family dinners became more rushed. Soccer and swimming were abandoned.\u003c/p>\n\u003cp>Lost time is often a hidden cost of any form of treatment.\u003c/p>\n\u003cp>The mothers began observing changes in their older son. They say his previously weak sense of smell suddenly blossomed, first for brownies and then other foods. And he became less obsessed with characters he had repetitively sketched in his notebooks and imbued with rich inner lives. (His parents are torn as to whether this was a positive development.) He also advanced in certain Brain Balance measures, including his primitive reflexes.\u003c/p>\n\u003cp>\"It's not that the needle didn't move on some of those dimensions,\" says Natalie. \"But if you step back at the 10,000- or 100,000-foot view and say, 'Is this kid different in a way that his life is going to be better or altered?' the answer is 'No.' OK, so now he can smell brownies that he couldn't smell before but is his life different?\"\u003c/p>\n\u003cp>She says she and her wife began to feel discouraged, thinking about the \"aura around this program that says your child's going to be different and better-adjusted.\"\u003c/p>\n\u003cp>Eric Rossen of the National Association of School Psychologists isn't surprised by Brain Balance's popularity as an option beyond what schools and insurance will cover.\u003c/p>\n\u003cp>He says many parents are frustrated by mainstream medicine's limits when it comes to complex disorders like autism. And schools are sometimes too strapped for resources to provide students with learning disorders all the help their parents may want.\u003c/p>\n\u003cp>\"Most parents will say they would die for their children,\" Rossen says. \"So to say, 'I want to provide some therapy and pay a few thousand dollars' is quite short of dying for them and it's totally reasonable.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But he says \"the problem is they are easy prey for certain providers that can make promises that cannot necessarily be kept or are not necessarily backed by scientific data.\"\u003c/p>\n\u003cp>For parents looking to find evidence-based third-party interventions, experts suggest the \u003ca href=\"https://ies.ed.gov/ncee/wwc/\" target=\"_blank\" rel=\"noopener\">What Works Clearinghouse\u003c/a>, which is backed by the Department of Education, or the Substance Abuse and Mental Health Services Administration's \u003ca href=\"https://www.samhsa.gov/nrepp\" target=\"_blank\" rel=\"noopener\">own resource\u003c/a>.\u003c/p>\n\u003cp>Brain Balance's protocol doesn't appear to pose any physical or developmental harms to children. Instead, the program's costs may come in other ways: siphoning away time and money, and prolonging the hope in some parents that their child may one day shed his or her disorder.\u003c/p>\n\u003cp>Dr. Susan Hyman, a professor of pediatrics at the University of Rochester who has studied autism treatments for decades, says many alternative providers do this by offering an unrealistically simple solution.\u003c/p>\n\u003cp>\"If you were to come to a traditional provider who said, 'You know I'm going to have you work really, really, really hard. ... I might have some drugs. Drugs have side effects. And 90 percent of the time, as an adult, he is still going to have autism,' that's a far less attractive message than 'I can help you.' \"\u003c/p>\n\u003cp>\u003cstrong>Beyond Brain Balance\u003c/strong>\u003c/p>\n\u003cp>By the end of their older son's second three-month session at Brain Balance, Stephanie and Natalie had completely soured on it. They stopped believing that vibrating armbands and spinning in swivel chairs would translate to social success.\u003c/p>\n\u003cp>They decided to not continue.\u003c/p>\n\u003cp>Later, in second grade, their older son began to work with a social worker at school who taught him how to have socially acceptable conversation with his peers.\u003c/p>\n\u003cp>And Stephanie and Natalie did something else — the unthinkable.\u003c/p>\n\u003cp>They put their son on a medication called Strattera. Calibrating the proper dosage with tolerable side effects was a drawn-out process, but eventually they reached an equilibrium. Their older son ended up with a new diagnosis that has some overlap with autism but is more consistent with ADHD, which the medication treats.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Today, he seems to be navigating the world more successfully than before.\u003c/p>\n\u003cp>On a Saturday last August, their older son — who once plaintively asked his parents, \"Why aren't I invited to birthday parties?\" — had just wrapped up a party to celebrate turning 10 years old.\u003c/p>\n\u003cp>Natalie and Stephanie had pizzas delivered and rented a truck lined with pleather sofas on one side and video game systems along the other. The children sat in pairs and used their greasy fingers to dispatch their avatars against each other in virtual battle.\u003c/p>\n\u003cp>\"They were yelling my son's name and saying 'Come play with me! Come play with me!' \" recalls Natalie.\u003c/p>\n\u003cp>The birthday boy says he invited almost all of his friends, from school and camp, and all but one showed up, which was more than he could have ever imagined before.\u003c/p>\n\u003cp>\"Because,\" he says before pausing. \"I haven't had friends for a bit. Until I got my medicine. I got some treatment. I got help. Now, I have tons of friends.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>The reporter, Chris Benderev, can be contacted at cbenderev@npr.org.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=%27Cutting+Edge%27+Program+For+Children+With+Autism+And+ADHD+Rests+On+Razor-Thin+Evidence&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Results Of At-Home Genetic Tests For Health Can Be Hard To Interpret",
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"content": "\u003cp>Rita Adele Steyn's mother had a double mastectomy in her 40s because she had so many lumps in her breasts. Her first cousin died of breast cancer. And Steyn's sister is going through chemotherapy for the disease now. Steyn worries she might be next.[contextly_sidebar id=\"2jv7QCmynDbyHW9qUVcm6pRU4NOR220R\"]\u003c/p>\n\u003cp>\"Sometimes you feel like you beat the odds. And sometimes you feel like the odds are against you,\" said Steyn, 42, who lives in Tampa, Fla. \"And right now I feel like the odds are against me.\"\u003c/p>\n\u003cp>So Steyn jumped at the chance when she heard about a company offering an inexpensive and easy new way to get her DNA tested for genetic mutations that sharply increase the risk for \u003ca href=\"https://www.cancer.org/cancer/breast-cancer.html\" target=\"_blank\" rel=\"noopener\">breast cancer\u003c/a>.\u003c/p>\n\u003cp>\"I thought it would be good to get tested,\" says Steyn. \"I thought this is something I should know.\"\u003c/p>\n\u003cp>She ordered a $200 testing kit from the company, 23andme, spit into a small plastic tube, sent it back and waited for the results.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Genetic testing used to be uncommon and ordered only by doctors. They used it mainly to diagnose rare conditions, to find out whether prospective parents are carrying genetic diseases, or to determine whether patients are at risk for diseases in the future.\u003c/p>\n\u003cp>Now, more people are getting their DNA analyzed for health reasons, in the comfort of their own homes. As genetic testing has gotten easier, faster and more affordable, it has become a multimillion-dollar industry, with many companies aggressively marketing convenient, inexpensive tests directly to consumers. About one-third of Americans say they or a family member have considered getting a genetic test, \u003ca href=\"https://www.npr.org/sections/health-shots/2018/06/01/616126056/poll-genealogical-curiosity-is-a-top-reason-for-dna-tests-privacy-a-concern\" target=\"_blank\" rel=\"noopener\">according to a recent NPR-IBM Watson Health Poll\u003c/a>. And millions of people have gotten them, for a variety of reasons.[contextly_sidebar id=\"5sGM4fbYVp0AOmgc16BrIla2iYM1tjtz\"]\u003c/p>\n\u003cp>\"This health-related testing is probably the next big step in using genomic information in our lives,\" says \u003ca href=\"https://isearch.asu.edu/profile/2783639\" target=\"_blank\" rel=\"noopener\">Robert Cook-Deegan\u003c/a>, who studies health policy at Arizona State University.\u003c/p>\n\u003cp>But others find the trend troubling. The tests have limitations and can be hard to interpret without a doctor or genetic counselor to weigh in.\u003c/p>\n\u003cp>\u003cstrong>Pros and Cons\u003c/strong>\u003c/p>\n\u003cp>The company Steyn used, \u003ca href=\"https://www.23andme.com/\" target=\"_blank\" rel=\"noopener\">23andMe\u003c/a>, recently \u003ca href=\"https://www.npr.org/2018/03/07/591423146/test-for-breast-cancer-gene-will-be-available-in-weeks\" target=\"_blank\" rel=\"noopener\">became the first to win approval\u003c/a> from the Food and Drug Administration to market a genetic test for cancer directly to consumers without a doctor's order. It spent $27.9 million on advertising in the first quarter of 2018, according to the tracking firm Kantar Media. (NPR receives financial support from 23andMe.)\u003c/p>\n\u003cp>The industry is set to grow even more as restrictions on the medical uses of these tests are eased. The Food and Drug Administration recently \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm583885.htm\">announced\u003c/a> plans to make it easier for these kinds of tests to win approval.[contextly_sidebar id=\"6BR65Pmc5xtQQjBssPMWnhSlrwXrhHIz\"]\u003c/p>\n\u003cp>Many physicians welcome the trend, saying it's giving people valuable information. Consumers can find out early whether they are at increased risk for cancer, Alzheimer's and other diseases — and take steps to protect themselves. The testing can also sometimes help identify the safest and most effective medications to use.\u003c/p>\n\u003cp>\"Direct-to-consumer genetics companies are leading the way toward democratizing genetics and making it available to more and more people to learn about their risks and intervene in ways to keep themselves healthy,\" says \u003ca href=\"http://personalizedmedicine.partners.org/About/Leadership-Team/Robert%20Green.aspx\" target=\"_blank\" rel=\"noopener\">Robert Green\u003c/a>, a medical geneticist at Harvard.\u003c/p>\n\u003cp>But other genetic specialists, including \u003ca href=\"https://www.med.unc.edu/im/patients/general-medicine-internal-medicine-clinic/james-evans-md-phd\" target=\"_blank\" rel=\"noopener\">James Evans\u003c/a>, a professor of genetics and medicine at the University of North Carolina, Chapel Hill, argue genetic testing is still in its infancy and that the results are often inconclusive and confusing.\u003c/p>\n\u003cp>\"I think that it's an unfortunate development that will likely cause considerable mischief,\" Evans says.\u003c/p>\n\u003cp>One problem is that patients can be easily overwhelmed when results are misleading or murky. Genetic testing is still best done through doctors, he says, working with specially trained genetic counselors who can guide patients every step of the way.[contextly_sidebar id=\"xJAmUsouQpJLM7V2Qt8t7fJx04FgVQwG\"]\u003c/p>\n\u003cp>\"What people deserve is well-thought-out information,\" Evans says. \"The only people who will really benefit are the investors in these companies that market these incomplete and misleading tests.\"\u003c/p>\n\u003cp>Some companies are offering newer forms of genetic testing that decipher and analyze every gene known to carry instructions for producing proteins that might reveal mutations — a process called \u003ca href=\"https://ghr.nlm.nih.gov/primer/testing/sequencing\" target=\"_blank\" rel=\"noopener\">whole exome sequencing\u003c/a>. Still others analyze the entire genetic code, which is called \u003ca href=\"https://www.fda.gov/Food/FoodScienceResearch/WholeGenomeSequencingProgramWGS/\" target=\"_blank\" rel=\"noopener\">whole genome sequencing\u003c/a>, which may find additional clues to disease. They will then analyze customers' genomes for any variations known to be associated with diseases.\u003c/p>\n\u003cp>The approach 23andMe takes is a rapid, but older, process. It analyzes short pieces of DNA for genetic variations known as \u003ca href=\"https://ghr.nlm.nih.gov/primer/genomicresearch/snp\" target=\"_blank\" rel=\"noopener\">single nucleotide variations (SNPs)\u003c/a> associated with specific diseases.\u003c/p>\n\u003cp>Except for 23andMe, all of the companies still require a doctor's order to get this testing. But an increasing number of these companies will find a physician to sign off on that for customers.\u003c/p>\n\u003cp>\"We're all about empowering consumers and making it as easy as possible for people to get these insights,\" says \u003ca href=\"https://www.helix.com/blog/author/elissa-levin/\" target=\"_blank\" rel=\"noopener\">Elissa Levin\u003c/a>, director of policy and clinical services at \u003ca href=\"https://www.helix.com/\">Helix\u003c/a>, a genetic testing company.\u003c/p>\n\u003cp>Dr. \u003ca href=\"https://profiles.stanford.edu/louanne-hudgins\" target=\"_blank\" rel=\"noopener\">Louanne Hudgins\u003c/a>, president of the \u003ca href=\"https://www.acmg.net/\" target=\"_blank\" rel=\"noopener\">American College of Medical Genetics and Genomics\u003c/a>, says she's \"very concerned\" about this.\u003c/p>\n\u003cp>\"Individuals should be evaluated by medical professionals who are not conflicted, meaning they do not somehow work for a company,\" Hudgins says. \"Doctors who are contracted by companies are going to say, 'Do the test' no matter what, even if the test may not be indicated.\"\u003c/p>\n\u003cp>The companies defend the practice, saying the doctors they find for customers may be better suited than the average physician.\u003c/p>\n\u003cp>\"The majority of doctors have had maybe one class in genetics,\" says \u003ca href=\"https://www.color.com/team\" target=\"_blank\" rel=\"noopener\">Othman Laraki\u003c/a>, CEO of Color Genomics, another genetic testing company. \"I think it's much more important to have someone who has a background in genetics than just simply have someone who you can physically meet with.\"[contextly_sidebar id=\"z5IAPc8KdOy51FSsfsI8mbgyU8TgOGr0\"]\u003c/p>\n\u003cp>Privacy is another concern. Genetic testing companies say they have strict policies and procedures to protect customers' information. But some firms provide access to the genetic information they collect on an anonymous basis to drug companies and others to use for research.\u003c/p>\n\u003cp>Recent breaches of privacy by companies that collect information about people, such as Facebook, have underscored the risks of electronic data.\u003c/p>\n\u003cp>\"I'm really hoping that the security practices associated with genetic information are quite strong,\" says Cook-Deegan. \"The companies say they're strong. Time will tell if that's true.\"\u003c/p>\n\u003cp>A \u003ca href=\"https://www.eeoc.gov/laws/statutes/gina.cfm\">federal law\u003c/a> prohibits the use of genetic information to discriminate against the people for health insurance or jobs. But that law does not protect against the use of genetic information in making decisions about other things, such as life and long-term care insurance.\u003c/p>\n\u003cp>\"These are the types of things you really ought to consider when thinking about doing this kind of genetic testing — not whether there's a special on the testing this week,\" says \u003ca href=\"https://louisville.edu/bioethics/directory/mark-a.-rothstein\" target=\"_blank\" rel=\"noopener\">Mark Rothstein\u003c/a>, a professor of medicine and a bioethicist at the University of Louisville School of Medicine.\u003c/p>\n\u003cp>\u003cstrong>Results — With Limitations\u003c/strong>\u003c/p>\n\u003cp>About a month after sending in her sample, Steyn got a notice that the results of her breast cancer test were ready.\u003c/p>\n\u003cp>\"I'm really nervous,\" she said as she read through the company's explanation of what her results do and do not mean.\u003c/p>\n\u003cp>She paused in silence after she clicked to get the results.\u003c/p>\n\u003cp>\"It says zero variants detected,\" Steyn finally said, meaning the test had not found any mutations that would increase her risk.\u003c/p>\n\u003cp>\"I guess I do feel really relieved. It does make me feel better,\" she said, her voice cracking. \"I guess I just feel my chances are better now, you know?\"\u003c/p>\n\u003cp>Critics worry the testing is misleading — and relying on it could be dangerous. It tests for only three mutations in two genes known as \u003ca href=\"https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet\" target=\"_blank\" rel=\"noopener\">BRCA1 and BRCA2\u003c/a> that can increase the risk for breast and \u003ca href=\"https://www.cancer.org/cancer/ovarian-cancer.html\" target=\"_blank\" rel=\"noopener\">ovarian cancer\u003c/a>. Women could still have one of the thousands of other mutations that increase the risk, or be at risk for other, nongenetic reasons.[contextly_sidebar id=\"yoPuviqWfqVzH92JGqeNFv9hvL3T9Qlf\"]\u003c/p>\n\u003cp>The concern is that if a woman's 23andMe test shows she's free of the risky mutations, she may think she's in the clear and not do things she should do, such as get regular mammograms or undergo more thorough genetic testing.\u003c/p>\n\u003cp>\"To be very blunt, I worry that women who undertake testing from 23andMe could believe that they do not carry a mutation when in fact they do, and as a consequence could die of breast or ovarian cancer,\" says \u003ca href=\"http://www.gs.washington.edu/faculty/king.htm\" target=\"_blank\" rel=\"noopener\">Mary-Claire King\u003c/a>, a University of Washington geneticist who helped identify the breast cancer genes. \"I do not want to see that happen.\"\u003c/p>\n\u003cp>The company argues that it makes the test's limitations very clear and encourages women to talk to their doctor about the results and possibly seek more extensive genetic testing.\u003c/p>\n\u003cp>For women who discover they have one of the risky gene variants, the information could be crucial, according to \u003ca href=\"https://medical.23andme.com/medical-team/\" target=\"_blank\" rel=\"noopener\">Stacey Detweiller\u003c/a>, a medical affairs associate and genetic counselor at 23andMe.\u003c/p>\n\u003cp>\"Our mission is helping people access, understand and benefit from the human genome,\" Detweiller says. \"There's steps that can be taken from knowing this information that could be life-saving.\"\u003c/p>\n\u003cp>Steyn and the two other women NPR followed through the process of taking the test seemed to understand the test's limitations. They said they knew they couldn't rely on it, but they were curious to see the results.\u003c/p>\n\u003cp>But Steyn admits that she felt somewhat less urgency to get a mammogram or additional testing because of the 23andMe test results, especially since she doesn't have health insurance at the moment.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"I'm glad I did it, especially in light of the fact that I find myself in a position where I do have to wait to see a doctor now because of the insurance situation I find myself in,\" Steyn says. \"Now I feel a little bit better about waiting. Beforehand, I probably would have not waited and figure out a way to afford this.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Results+Of+At-Home+Genetic+Tests+For+Health+Can+Be+Hard+To+Interpret+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Rita Adele Steyn's mother had a double mastectomy in her 40s because she had so many lumps in her breasts. Her first cousin died of breast cancer. And Steyn's sister is going through chemotherapy for the disease now. Steyn worries she might be next.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"Sometimes you feel like you beat the odds. And sometimes you feel like the odds are against you,\" said Steyn, 42, who lives in Tampa, Fla. \"And right now I feel like the odds are against me.\"\u003c/p>\n\u003cp>So Steyn jumped at the chance when she heard about a company offering an inexpensive and easy new way to get her DNA tested for genetic mutations that sharply increase the risk for \u003ca href=\"https://www.cancer.org/cancer/breast-cancer.html\" target=\"_blank\" rel=\"noopener\">breast cancer\u003c/a>.\u003c/p>\n\u003cp>\"I thought it would be good to get tested,\" says Steyn. \"I thought this is something I should know.\"\u003c/p>\n\u003cp>She ordered a $200 testing kit from the company, 23andme, spit into a small plastic tube, sent it back and waited for the results.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Genetic testing used to be uncommon and ordered only by doctors. They used it mainly to diagnose rare conditions, to find out whether prospective parents are carrying genetic diseases, or to determine whether patients are at risk for diseases in the future.\u003c/p>\n\u003cp>Now, more people are getting their DNA analyzed for health reasons, in the comfort of their own homes. As genetic testing has gotten easier, faster and more affordable, it has become a multimillion-dollar industry, with many companies aggressively marketing convenient, inexpensive tests directly to consumers. About one-third of Americans say they or a family member have considered getting a genetic test, \u003ca href=\"https://www.npr.org/sections/health-shots/2018/06/01/616126056/poll-genealogical-curiosity-is-a-top-reason-for-dna-tests-privacy-a-concern\" target=\"_blank\" rel=\"noopener\">according to a recent NPR-IBM Watson Health Poll\u003c/a>. And millions of people have gotten them, for a variety of reasons.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"This health-related testing is probably the next big step in using genomic information in our lives,\" says \u003ca href=\"https://isearch.asu.edu/profile/2783639\" target=\"_blank\" rel=\"noopener\">Robert Cook-Deegan\u003c/a>, who studies health policy at Arizona State University.\u003c/p>\n\u003cp>But others find the trend troubling. The tests have limitations and can be hard to interpret without a doctor or genetic counselor to weigh in.\u003c/p>\n\u003cp>\u003cstrong>Pros and Cons\u003c/strong>\u003c/p>\n\u003cp>The company Steyn used, \u003ca href=\"https://www.23andme.com/\" target=\"_blank\" rel=\"noopener\">23andMe\u003c/a>, recently \u003ca href=\"https://www.npr.org/2018/03/07/591423146/test-for-breast-cancer-gene-will-be-available-in-weeks\" target=\"_blank\" rel=\"noopener\">became the first to win approval\u003c/a> from the Food and Drug Administration to market a genetic test for cancer directly to consumers without a doctor's order. It spent $27.9 million on advertising in the first quarter of 2018, according to the tracking firm Kantar Media. (NPR receives financial support from 23andMe.)\u003c/p>\n\u003cp>The industry is set to grow even more as restrictions on the medical uses of these tests are eased. The Food and Drug Administration recently \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm583885.htm\">announced\u003c/a> plans to make it easier for these kinds of tests to win approval.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Many physicians welcome the trend, saying it's giving people valuable information. Consumers can find out early whether they are at increased risk for cancer, Alzheimer's and other diseases — and take steps to protect themselves. The testing can also sometimes help identify the safest and most effective medications to use.\u003c/p>\n\u003cp>\"Direct-to-consumer genetics companies are leading the way toward democratizing genetics and making it available to more and more people to learn about their risks and intervene in ways to keep themselves healthy,\" says \u003ca href=\"http://personalizedmedicine.partners.org/About/Leadership-Team/Robert%20Green.aspx\" target=\"_blank\" rel=\"noopener\">Robert Green\u003c/a>, a medical geneticist at Harvard.\u003c/p>\n\u003cp>But other genetic specialists, including \u003ca href=\"https://www.med.unc.edu/im/patients/general-medicine-internal-medicine-clinic/james-evans-md-phd\" target=\"_blank\" rel=\"noopener\">James Evans\u003c/a>, a professor of genetics and medicine at the University of North Carolina, Chapel Hill, argue genetic testing is still in its infancy and that the results are often inconclusive and confusing.\u003c/p>\n\u003cp>\"I think that it's an unfortunate development that will likely cause considerable mischief,\" Evans says.\u003c/p>\n\u003cp>One problem is that patients can be easily overwhelmed when results are misleading or murky. Genetic testing is still best done through doctors, he says, working with specially trained genetic counselors who can guide patients every step of the way.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"What people deserve is well-thought-out information,\" Evans says. \"The only people who will really benefit are the investors in these companies that market these incomplete and misleading tests.\"\u003c/p>\n\u003cp>Some companies are offering newer forms of genetic testing that decipher and analyze every gene known to carry instructions for producing proteins that might reveal mutations — a process called \u003ca href=\"https://ghr.nlm.nih.gov/primer/testing/sequencing\" target=\"_blank\" rel=\"noopener\">whole exome sequencing\u003c/a>. Still others analyze the entire genetic code, which is called \u003ca href=\"https://www.fda.gov/Food/FoodScienceResearch/WholeGenomeSequencingProgramWGS/\" target=\"_blank\" rel=\"noopener\">whole genome sequencing\u003c/a>, which may find additional clues to disease. They will then analyze customers' genomes for any variations known to be associated with diseases.\u003c/p>\n\u003cp>The approach 23andMe takes is a rapid, but older, process. It analyzes short pieces of DNA for genetic variations known as \u003ca href=\"https://ghr.nlm.nih.gov/primer/genomicresearch/snp\" target=\"_blank\" rel=\"noopener\">single nucleotide variations (SNPs)\u003c/a> associated with specific diseases.\u003c/p>\n\u003cp>Except for 23andMe, all of the companies still require a doctor's order to get this testing. But an increasing number of these companies will find a physician to sign off on that for customers.\u003c/p>\n\u003cp>\"We're all about empowering consumers and making it as easy as possible for people to get these insights,\" says \u003ca href=\"https://www.helix.com/blog/author/elissa-levin/\" target=\"_blank\" rel=\"noopener\">Elissa Levin\u003c/a>, director of policy and clinical services at \u003ca href=\"https://www.helix.com/\">Helix\u003c/a>, a genetic testing company.\u003c/p>\n\u003cp>Dr. \u003ca href=\"https://profiles.stanford.edu/louanne-hudgins\" target=\"_blank\" rel=\"noopener\">Louanne Hudgins\u003c/a>, president of the \u003ca href=\"https://www.acmg.net/\" target=\"_blank\" rel=\"noopener\">American College of Medical Genetics and Genomics\u003c/a>, says she's \"very concerned\" about this.\u003c/p>\n\u003cp>\"Individuals should be evaluated by medical professionals who are not conflicted, meaning they do not somehow work for a company,\" Hudgins says. \"Doctors who are contracted by companies are going to say, 'Do the test' no matter what, even if the test may not be indicated.\"\u003c/p>\n\u003cp>The companies defend the practice, saying the doctors they find for customers may be better suited than the average physician.\u003c/p>\n\u003cp>\"The majority of doctors have had maybe one class in genetics,\" says \u003ca href=\"https://www.color.com/team\" target=\"_blank\" rel=\"noopener\">Othman Laraki\u003c/a>, CEO of Color Genomics, another genetic testing company. \"I think it's much more important to have someone who has a background in genetics than just simply have someone who you can physically meet with.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Privacy is another concern. Genetic testing companies say they have strict policies and procedures to protect customers' information. But some firms provide access to the genetic information they collect on an anonymous basis to drug companies and others to use for research.\u003c/p>\n\u003cp>Recent breaches of privacy by companies that collect information about people, such as Facebook, have underscored the risks of electronic data.\u003c/p>\n\u003cp>\"I'm really hoping that the security practices associated with genetic information are quite strong,\" says Cook-Deegan. \"The companies say they're strong. Time will tell if that's true.\"\u003c/p>\n\u003cp>A \u003ca href=\"https://www.eeoc.gov/laws/statutes/gina.cfm\">federal law\u003c/a> prohibits the use of genetic information to discriminate against the people for health insurance or jobs. But that law does not protect against the use of genetic information in making decisions about other things, such as life and long-term care insurance.\u003c/p>\n\u003cp>\"These are the types of things you really ought to consider when thinking about doing this kind of genetic testing — not whether there's a special on the testing this week,\" says \u003ca href=\"https://louisville.edu/bioethics/directory/mark-a.-rothstein\" target=\"_blank\" rel=\"noopener\">Mark Rothstein\u003c/a>, a professor of medicine and a bioethicist at the University of Louisville School of Medicine.\u003c/p>\n\u003cp>\u003cstrong>Results — With Limitations\u003c/strong>\u003c/p>\n\u003cp>About a month after sending in her sample, Steyn got a notice that the results of her breast cancer test were ready.\u003c/p>\n\u003cp>\"I'm really nervous,\" she said as she read through the company's explanation of what her results do and do not mean.\u003c/p>\n\u003cp>She paused in silence after she clicked to get the results.\u003c/p>\n\u003cp>\"It says zero variants detected,\" Steyn finally said, meaning the test had not found any mutations that would increase her risk.\u003c/p>\n\u003cp>\"I guess I do feel really relieved. It does make me feel better,\" she said, her voice cracking. \"I guess I just feel my chances are better now, you know?\"\u003c/p>\n\u003cp>Critics worry the testing is misleading — and relying on it could be dangerous. It tests for only three mutations in two genes known as \u003ca href=\"https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet\" target=\"_blank\" rel=\"noopener\">BRCA1 and BRCA2\u003c/a> that can increase the risk for breast and \u003ca href=\"https://www.cancer.org/cancer/ovarian-cancer.html\" target=\"_blank\" rel=\"noopener\">ovarian cancer\u003c/a>. Women could still have one of the thousands of other mutations that increase the risk, or be at risk for other, nongenetic reasons.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The concern is that if a woman's 23andMe test shows she's free of the risky mutations, she may think she's in the clear and not do things she should do, such as get regular mammograms or undergo more thorough genetic testing.\u003c/p>\n\u003cp>\"To be very blunt, I worry that women who undertake testing from 23andMe could believe that they do not carry a mutation when in fact they do, and as a consequence could die of breast or ovarian cancer,\" says \u003ca href=\"http://www.gs.washington.edu/faculty/king.htm\" target=\"_blank\" rel=\"noopener\">Mary-Claire King\u003c/a>, a University of Washington geneticist who helped identify the breast cancer genes. \"I do not want to see that happen.\"\u003c/p>\n\u003cp>The company argues that it makes the test's limitations very clear and encourages women to talk to their doctor about the results and possibly seek more extensive genetic testing.\u003c/p>\n\u003cp>For women who discover they have one of the risky gene variants, the information could be crucial, according to \u003ca href=\"https://medical.23andme.com/medical-team/\" target=\"_blank\" rel=\"noopener\">Stacey Detweiller\u003c/a>, a medical affairs associate and genetic counselor at 23andMe.\u003c/p>\n\u003cp>\"Our mission is helping people access, understand and benefit from the human genome,\" Detweiller says. \"There's steps that can be taken from knowing this information that could be life-saving.\"\u003c/p>\n\u003cp>Steyn and the two other women NPR followed through the process of taking the test seemed to understand the test's limitations. They said they knew they couldn't rely on it, but they were curious to see the results.\u003c/p>\n\u003cp>But Steyn admits that she felt somewhat less urgency to get a mammogram or additional testing because of the 23andMe test results, especially since she doesn't have health insurance at the moment.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"I'm glad I did it, especially in light of the fact that I find myself in a position where I do have to wait to see a doctor now because of the insurance situation I find myself in,\" Steyn says. \"Now I feel a little bit better about waiting. Beforehand, I probably would have not waited and figure out a way to afford this.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Results+Of+At-Home+Genetic+Tests+For+Health+Can+Be+Hard+To+Interpret+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Does Vitamin D Really Protect Against Colorectal Cancer?",
"title": "Does Vitamin D Really Protect Against Colorectal Cancer?",
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"content": "\u003cp>It's been clear for many years that vitamin D helps keep bones strong, but studies have been inconclusive and conflicting about the vitamin's value in protecting against certain cancers, including \u003ca href=\"https://www.cancer.gov/types/colorectal\" target=\"_blank\" rel=\"noopener\">colorectal cancer\u003c/a>.[contextly_sidebar id=\"9k4uFVtwqiLPQYTYxUgc0nIsJORbVOWp\"]\u003c/p>\n\u003cp>Now a large international \u003ca href=\"https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djy087\" target=\"_blank\" rel=\"noopener\">study\u003c/a> provides the strongest evidence yet that vitamin D may indeed be protective against colorectal cancer and that a deficiency may increase the risk of this cancer. The findings appear Thursday in the \u003cem>Journal of the National Cancer Institute\u003c/em>.\u003c/p>\n\u003cp>\"For both men and women, deficient levels of vitamin D were associated with a 30 percent increased risk of colorectal cancer,\" says \u003ca href=\"https://www.cancer.org/research/acs-researchers/marjorie-mccullough-bio.html\" target=\"_blank\" rel=\"noopener\">Marji McCullough\u003c/a>, a nutritional epidemiologist with the American Cancer Society and study co-author. People who had higher circulating blood levels of vitamin D\u003cstrong>, \u003c/strong>above the range deemed \"sufficient,\" had a 22 percent lower risk, she says.\u003c/p>\n\u003cp>The study pooled findings from 17 previous studies that included 12,813 adults in the U.S., Europe and Asia. Those studies collectively looked at 5,706 people with colorectal cancer and 7,107 people of a similar age and race who didn't have cancer. Women's menopausal status was also taken into account.\u003c/p>\n\u003cp>To determine what role vitamin D might be playing, researchers looked at participants' blood samples collected in the years before their cancer diagnosis. They also considered the established risk factors for colorectal cancer, including smoking, low physical activity and high body mass index.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Our findings suggest what's optimal for bone health may not be optimal for colorectal risk reduction,\" McCullough says, which could mean higher doses are needed to prevent cancer. Current recommendations for vitamin D supplementation are based solely on studies showing conclusively that it does preserve bone health.\u003c/p>\n\u003cp>A particularly provocative finding of the study, McCullough says, is the relatively strong correlation between higher blood levels of vitamin D and lower risk of colorectal cancer in women.\u003c/p>\n\u003cp>\"We don't know why,\" she says. One hypothesis is that there is some interaction between vitamin D and female hormones. Or it's possible vitamin D prevents cancer by reducing the proliferation of tumor cells or by stopping their growth and \"actually killing those cells,\" she says.\u003c/p>\n\u003cp>Studies like this do not prove cause and effect but rather show only that there may be a connection between the levels of vitamin D circulating through the body and cancer. Still, the authors of the paper write that the results \"substantially strengthen the evidence, previously considered inconclusive, for a causal relationship\" between low vitamin D levels and colorectal cancer.[contextly_sidebar id=\"MAqLylPcwu1QCC3r4WiQXhzaSDOZfRPb\"]\u003c/p>\n\u003cp>Another interesting observation in the study, McCullough says, was that beyond a certain level, increasingly higher amounts of vitamin D in the blood had no additional benefit. At the highest levels above what is considered \"adequate,\" there was no further reduction in risk. In other words, she says, \"more is not necessarily better.\"\u003c/p>\n\u003cp>Her take-home message: Don't race out and buy high doses of vitamin D \"just in case.\" Overdoing it can be toxic. Taking too much vitamin D can cause kidney stones and, in very rare cases, death.\u003c/p>\n\u003cp>The issue of whether vitamin D supplements should be used at all to prevent colorectal cancer is still up in the air. \"The key question now is whether intervening with people who have low levels of vitamin D can make a difference,\" says \u003ca href=\"http://www.dana-farber.org/find-a-doctor/jeffrey-a-meyerhardt/\" target=\"_blank\" rel=\"noopener\">Dr. Jeffrey Meyerhardt\u003c/a>, director of the Gastrointestinal Cancer Center at Dana-Farber Cancer Institute in Boston, who was not involved in the study.\u003c/p>\n\u003cp>The study didn't evaluate whether adding vitamin D through food, sunlight or supplements made a difference in cancer risk. It was limited to looking at the level of vitamin D in people's blood.\u003c/p>\n\u003cp>Currently, a large \u003ca href=\"https://www.vitalstudy.org/\" target=\"_blank\" rel=\"noopener\">study\u003c/a> involving more than 25,000 patients is underway at Brigham and Women's Hospital in Boston to find out whether taking vitamin D supplements might reduce the risk of numerous cancers as well as heart disease and stroke. Meyerhardt says answers may be available in the coming year.\u003c/p>\n\u003cp>In the meantime, he suggests people talk with their health care provider about having a blood test to measure vitamin D levels. If you're starting in the deficient range, he says, some doctors might prescribe high doses, to be taken each week for a month or two, and then prescribe lower, maintenance levels.[contextly_sidebar id=\"x4oXchtt2cZV7lIWDVrGT7XXeJne7cWq\"]\u003c/p>\n\u003cp>The cancer society's McCullough says it is generally \u003ca href=\"https://www.bones.nih.gov/health-info/bone/bone-health/nutrition/calcium-and-vitamin-d-important-every-age\" target=\"_blank\" rel=\"noopener\">recommended\u003c/a> that adults have a daily intake of 600 international units of vitamin D up to age 70. Men and women over age 70 should increase their uptake to 800 IUs daily, she says.\u003c/p>\n\u003cp>People should talk with their doctor because different individuals have different needs, she says.\u003c/p>\n\u003cp>\"It depends on where you live and what race you are, because darker skin tends to absorb less vitamin D.\" Sun, age, genetics and weight also play a role in how the body processes vitamin D.\u003c/p>\n\u003cp>Vitamin D can be obtained from vitamin D-rich foods such as egg yolks, salmon, trout, swordfish, tuna and sardines. Numerous foods are fortified with vitamin D including cow's milk, almond milk, soy milk, some cereals and some orange juices.\u003c/p>\n\u003cp>\"If you have a serving of salmon, that's about 500 IUs, and a cup of milk would give you 100 IUs,\" McCullough says, which adds up to the daily recommended dose of 600 IUs.\u003c/p>\n\u003cp>But Meyerhardt says most people don't eat enough fatty fish to reach the recommended vitamin D intake.\u003c/p>\n\u003cp>\"Most vitamin D doesn't really come from your diet\" in most cases, he says. And he says multivitamins contain relatively low levels of vitamin D. \"So you really have to take a supplement\" to meet recommended doses.\u003c/p>\n\u003cp>Vitamin D is often called the \"sunshine\" vitamin, because exposure to sunlight can stimulate production of the vitamin. But exposure to sun is generally not recommended as a way to boost vitamin D, McCullough says, since at excessive levels it can raise the risk of melanoma and other skin cancers.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>More than 20 medical centers and organizations participated in the study, including Harvard, the American Cancer Society and the National Cancer Institute.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Does+Vitamin+D+Really+Protect+Against+Colorectal+Cancer%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "The jury's been out on whether low blood levels of vitamin D increase the risk of colorectal cancer. Researchers say a new review involving more than 12,000 people strongly suggests the answer is yes.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It's been clear for many years that vitamin D helps keep bones strong, but studies have been inconclusive and conflicting about the vitamin's value in protecting against certain cancers, including \u003ca href=\"https://www.cancer.gov/types/colorectal\" target=\"_blank\" rel=\"noopener\">colorectal cancer\u003c/a>.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Now a large international \u003ca href=\"https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djy087\" target=\"_blank\" rel=\"noopener\">study\u003c/a> provides the strongest evidence yet that vitamin D may indeed be protective against colorectal cancer and that a deficiency may increase the risk of this cancer. The findings appear Thursday in the \u003cem>Journal of the National Cancer Institute\u003c/em>.\u003c/p>\n\u003cp>\"For both men and women, deficient levels of vitamin D were associated with a 30 percent increased risk of colorectal cancer,\" says \u003ca href=\"https://www.cancer.org/research/acs-researchers/marjorie-mccullough-bio.html\" target=\"_blank\" rel=\"noopener\">Marji McCullough\u003c/a>, a nutritional epidemiologist with the American Cancer Society and study co-author. People who had higher circulating blood levels of vitamin D\u003cstrong>, \u003c/strong>above the range deemed \"sufficient,\" had a 22 percent lower risk, she says.\u003c/p>\n\u003cp>The study pooled findings from 17 previous studies that included 12,813 adults in the U.S., Europe and Asia. Those studies collectively looked at 5,706 people with colorectal cancer and 7,107 people of a similar age and race who didn't have cancer. Women's menopausal status was also taken into account.\u003c/p>\n\u003cp>To determine what role vitamin D might be playing, researchers looked at participants' blood samples collected in the years before their cancer diagnosis. They also considered the established risk factors for colorectal cancer, including smoking, low physical activity and high body mass index.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Our findings suggest what's optimal for bone health may not be optimal for colorectal risk reduction,\" McCullough says, which could mean higher doses are needed to prevent cancer. Current recommendations for vitamin D supplementation are based solely on studies showing conclusively that it does preserve bone health.\u003c/p>\n\u003cp>A particularly provocative finding of the study, McCullough says, is the relatively strong correlation between higher blood levels of vitamin D and lower risk of colorectal cancer in women.\u003c/p>\n\u003cp>\"We don't know why,\" she says. One hypothesis is that there is some interaction between vitamin D and female hormones. Or it's possible vitamin D prevents cancer by reducing the proliferation of tumor cells or by stopping their growth and \"actually killing those cells,\" she says.\u003c/p>\n\u003cp>Studies like this do not prove cause and effect but rather show only that there may be a connection between the levels of vitamin D circulating through the body and cancer. Still, the authors of the paper write that the results \"substantially strengthen the evidence, previously considered inconclusive, for a causal relationship\" between low vitamin D levels and colorectal cancer.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Another interesting observation in the study, McCullough says, was that beyond a certain level, increasingly higher amounts of vitamin D in the blood had no additional benefit. At the highest levels above what is considered \"adequate,\" there was no further reduction in risk. In other words, she says, \"more is not necessarily better.\"\u003c/p>\n\u003cp>Her take-home message: Don't race out and buy high doses of vitamin D \"just in case.\" Overdoing it can be toxic. Taking too much vitamin D can cause kidney stones and, in very rare cases, death.\u003c/p>\n\u003cp>The issue of whether vitamin D supplements should be used at all to prevent colorectal cancer is still up in the air. \"The key question now is whether intervening with people who have low levels of vitamin D can make a difference,\" says \u003ca href=\"http://www.dana-farber.org/find-a-doctor/jeffrey-a-meyerhardt/\" target=\"_blank\" rel=\"noopener\">Dr. Jeffrey Meyerhardt\u003c/a>, director of the Gastrointestinal Cancer Center at Dana-Farber Cancer Institute in Boston, who was not involved in the study.\u003c/p>\n\u003cp>The study didn't evaluate whether adding vitamin D through food, sunlight or supplements made a difference in cancer risk. It was limited to looking at the level of vitamin D in people's blood.\u003c/p>\n\u003cp>Currently, a large \u003ca href=\"https://www.vitalstudy.org/\" target=\"_blank\" rel=\"noopener\">study\u003c/a> involving more than 25,000 patients is underway at Brigham and Women's Hospital in Boston to find out whether taking vitamin D supplements might reduce the risk of numerous cancers as well as heart disease and stroke. Meyerhardt says answers may be available in the coming year.\u003c/p>\n\u003cp>In the meantime, he suggests people talk with their health care provider about having a blood test to measure vitamin D levels. If you're starting in the deficient range, he says, some doctors might prescribe high doses, to be taken each week for a month or two, and then prescribe lower, maintenance levels.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The cancer society's McCullough says it is generally \u003ca href=\"https://www.bones.nih.gov/health-info/bone/bone-health/nutrition/calcium-and-vitamin-d-important-every-age\" target=\"_blank\" rel=\"noopener\">recommended\u003c/a> that adults have a daily intake of 600 international units of vitamin D up to age 70. Men and women over age 70 should increase their uptake to 800 IUs daily, she says.\u003c/p>\n\u003cp>People should talk with their doctor because different individuals have different needs, she says.\u003c/p>\n\u003cp>\"It depends on where you live and what race you are, because darker skin tends to absorb less vitamin D.\" Sun, age, genetics and weight also play a role in how the body processes vitamin D.\u003c/p>\n\u003cp>Vitamin D can be obtained from vitamin D-rich foods such as egg yolks, salmon, trout, swordfish, tuna and sardines. Numerous foods are fortified with vitamin D including cow's milk, almond milk, soy milk, some cereals and some orange juices.\u003c/p>\n\u003cp>\"If you have a serving of salmon, that's about 500 IUs, and a cup of milk would give you 100 IUs,\" McCullough says, which adds up to the daily recommended dose of 600 IUs.\u003c/p>\n\u003cp>But Meyerhardt says most people don't eat enough fatty fish to reach the recommended vitamin D intake.\u003c/p>\n\u003cp>\"Most vitamin D doesn't really come from your diet\" in most cases, he says. And he says multivitamins contain relatively low levels of vitamin D. \"So you really have to take a supplement\" to meet recommended doses.\u003c/p>\n\u003cp>Vitamin D is often called the \"sunshine\" vitamin, because exposure to sunlight can stimulate production of the vitamin. But exposure to sun is generally not recommended as a way to boost vitamin D, McCullough says, since at excessive levels it can raise the risk of melanoma and other skin cancers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>More than 20 medical centers and organizations participated in the study, including Harvard, the American Cancer Society and the National Cancer Institute.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Does+Vitamin+D+Really+Protect+Against+Colorectal+Cancer%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Stanford Pioneer in Brain Research Wins Prestigious Kyoto Prize",
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"content": "\u003cp>Karl Deisseroth, a Stanford University professor of bioengineering and psychiatry, has been awarded an international prize worth more than $900,000 for his work in illuminating brain activity with light. The exact amount of the prize was 100 million yen.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Karl has created a revolutionary technology that has broadened our understanding of brain disorders and may one day yield treatments to the millions with these disorders.'\u003ccite>Lloyd Minor, Stanford School of Medicine\u003c/cite>\u003c/aside>\n\u003cp>Deisseroth is receiving the 2018 \u003ca href=\"https://www.kyotoprize.org/en/\" target=\"_blank\" rel=\"noopener\">Kyoto Prize\u003c/a> for advanced technology. Awards are also granted for basic sciences, and arts and philosophy. Some of its recipients have gone on to win the Nobel Prize.\u003c/p>\n\u003cp>\u003ca href=\"https://web.stanford.edu/group/dlab/about_pi.html\" target=\"_blank\" rel=\"noopener\">Deisseroth,\u003c/a> the youngest person to ever receive the prize, is being honored for developing \u003ca href=\"http://web.stanford.edu/group/dlab/optogenetics/\">optogenetics\u003c/a>, a technology that uses light-sensitive proteins to manipulate brain cell activity. The method allows scientists to glean more information about brain disorders and to probe how the nervous system works.\u003c/p>\n\u003cp>\"It is humbling to see all the distinguished people who have won the Kyoto Prize, and to be listed with them. It is wonderful to see pure basic science discoveries recognized in this way,\" said Deisseroth.\u003c/p>\n\u003cp>The technique developed by Deisseroth and his team manipulates cellular activity by delivering a pulse of light to a particular cell through an optical fiber that has been implanted in the animal’s brain. The method yields information on how brain cells give rise to sensations, memories and actions.\u003c/p>\n\u003cfigure id=\"attachment_442697\" class=\"wp-caption alignright\" style=\"max-width: 480px\">\u003cimg class=\"size-full wp-image-442697\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/06/image01.jpg\" alt=\"\" width=\"480\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/06/image01.jpg 480w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image01-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image01-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image01-375x281.jpg 375w\" sizes=\"(max-width: 480px) 100vw, 480px\">\u003cfigcaption class=\"wp-caption-text\">The Kyoto prize medal. \u003ccite>(Inamori Foundation)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“A brilliant and innovative investigator, Karl has created a revolutionary technology that has broadened our understanding of brain disorders and may one day yield treatments to the millions with these disorders,” said Dr. Lloyd Minor, dean of the \u003ca href=\"http://med.stanford.edu/\" target=\"_blank\" rel=\"noopener\">Stanford School of Medicine\u003c/a>, in a statement. “His receipt of the Kyoto Prize is inordinately well-deserved and the product of his unmatched scientific vision.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Deisseroth has said his research\u003ca href=\"https://www.scientificamerican.com/article/optogenetics-controlling/\" target=\"_blank\" rel=\"noopener\"> was motivated by\u003c/a> a desire to better understand psychiatric disorders, the leading cause of years of life lost to death or disability.\u003c/p>\n\u003cp>Deisseroth’s research, developed between 2004 and 2009, is used by laboratories around the world.\u003c/p>\n\u003cp>\"Thousands of laboratories around the world have used optogenetics to satisfy their own curiosity about the natural world, and to test ideas in a broad range of systems and species,\" he said. \"Many people are also studying brain diseases, and optogenetics-guided clinical trials have already started with some success, bringing a new kind of hope to people affected by these diseases such as substance dependence and depression.\"\u003c/p>\n\u003cp>\u003ciframe width=\"640\" height=\"360\" src=\"https://www.youtube.com/embed/CE6uNFFZ0qc?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen>\u003c/iframe>\u003c/p>\n\u003cp>What makes optogenetics so groundbreaking is its level of precision in controlling defined activity within specific cells, according to I-Han Chou, senior editor at the journal \"Nature\".[contextly_sidebar id=\"08EVHeybNXS0fTuglKI55A1KVy7EFUpl\"]\u003c/p>\n\u003cp>\"If you imagine the brain as this city, up until now we have been looking at it as if from space,\" Chou\u003ca href=\"https://www.weforum.org/agenda/2016/10/what-is-optogenetics/\" target=\"_blank\" rel=\"noopener\"> told the\u003c/a> World Economic Forum site. \"We haven't had the tools to do anything beyond seeing what the whole city block is doing. What you actually want to know is what the individual components of the city are, what the people are doing, and what's the information being transported from one part of the city to another.\"\u003c/p>\n\u003cp>The technique could transform how neurological disorders such as Parkinson's disease are treated.\u003c/p>\n\u003cp>\"When things go wrong with the brain it is just so devastating. One of the hopes for optogenetics is that if it can work in humans, it might be used as a tool for restoring brain function,\" Chou added.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "Karl Deisseroth, the Stanford University professor who developed a groundbreaking method for probing how brain cells behave and communicate, is the recipient of the 2018 Kyoto Prize for advanced technology. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Karl Deisseroth, a Stanford University professor of bioengineering and psychiatry, has been awarded an international prize worth more than $900,000 for his work in illuminating brain activity with light. The exact amount of the prize was 100 million yen.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Karl has created a revolutionary technology that has broadened our understanding of brain disorders and may one day yield treatments to the millions with these disorders.'\u003ccite>Lloyd Minor, Stanford School of Medicine\u003c/cite>\u003c/aside>\n\u003cp>Deisseroth is receiving the 2018 \u003ca href=\"https://www.kyotoprize.org/en/\" target=\"_blank\" rel=\"noopener\">Kyoto Prize\u003c/a> for advanced technology. Awards are also granted for basic sciences, and arts and philosophy. Some of its recipients have gone on to win the Nobel Prize.\u003c/p>\n\u003cp>\u003ca href=\"https://web.stanford.edu/group/dlab/about_pi.html\" target=\"_blank\" rel=\"noopener\">Deisseroth,\u003c/a> the youngest person to ever receive the prize, is being honored for developing \u003ca href=\"http://web.stanford.edu/group/dlab/optogenetics/\">optogenetics\u003c/a>, a technology that uses light-sensitive proteins to manipulate brain cell activity. The method allows scientists to glean more information about brain disorders and to probe how the nervous system works.\u003c/p>\n\u003cp>\"It is humbling to see all the distinguished people who have won the Kyoto Prize, and to be listed with them. It is wonderful to see pure basic science discoveries recognized in this way,\" said Deisseroth.\u003c/p>\n\u003cp>The technique developed by Deisseroth and his team manipulates cellular activity by delivering a pulse of light to a particular cell through an optical fiber that has been implanted in the animal’s brain. The method yields information on how brain cells give rise to sensations, memories and actions.\u003c/p>\n\u003cfigure id=\"attachment_442697\" class=\"wp-caption alignright\" style=\"max-width: 480px\">\u003cimg class=\"size-full wp-image-442697\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/06/image01.jpg\" alt=\"\" width=\"480\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/06/image01.jpg 480w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image01-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image01-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/06/image01-375x281.jpg 375w\" sizes=\"(max-width: 480px) 100vw, 480px\">\u003cfigcaption class=\"wp-caption-text\">The Kyoto prize medal. \u003ccite>(Inamori Foundation)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“A brilliant and innovative investigator, Karl has created a revolutionary technology that has broadened our understanding of brain disorders and may one day yield treatments to the millions with these disorders,” said Dr. Lloyd Minor, dean of the \u003ca href=\"http://med.stanford.edu/\" target=\"_blank\" rel=\"noopener\">Stanford School of Medicine\u003c/a>, in a statement. “His receipt of the Kyoto Prize is inordinately well-deserved and the product of his unmatched scientific vision.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Deisseroth has said his research\u003ca href=\"https://www.scientificamerican.com/article/optogenetics-controlling/\" target=\"_blank\" rel=\"noopener\"> was motivated by\u003c/a> a desire to better understand psychiatric disorders, the leading cause of years of life lost to death or disability.\u003c/p>\n\u003cp>Deisseroth’s research, developed between 2004 and 2009, is used by laboratories around the world.\u003c/p>\n\u003cp>\"Thousands of laboratories around the world have used optogenetics to satisfy their own curiosity about the natural world, and to test ideas in a broad range of systems and species,\" he said. \"Many people are also studying brain diseases, and optogenetics-guided clinical trials have already started with some success, bringing a new kind of hope to people affected by these diseases such as substance dependence and depression.\"\u003c/p>\n\u003cp>\u003ciframe width=\"640\" height=\"360\" src=\"https://www.youtube.com/embed/CE6uNFFZ0qc?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen>\u003c/iframe>\u003c/p>\n\u003cp>What makes optogenetics so groundbreaking is its level of precision in controlling defined activity within specific cells, according to I-Han Chou, senior editor at the journal \"Nature\".\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"If you imagine the brain as this city, up until now we have been looking at it as if from space,\" Chou\u003ca href=\"https://www.weforum.org/agenda/2016/10/what-is-optogenetics/\" target=\"_blank\" rel=\"noopener\"> told the\u003c/a> World Economic Forum site. \"We haven't had the tools to do anything beyond seeing what the whole city block is doing. What you actually want to know is what the individual components of the city are, what the people are doing, and what's the information being transported from one part of the city to another.\"\u003c/p>\n\u003cp>The technique could transform how neurological disorders such as Parkinson's disease are treated.\u003c/p>\n\u003cp>\"When things go wrong with the brain it is just so devastating. One of the hopes for optogenetics is that if it can work in humans, it might be used as a tool for restoring brain function,\" Chou added.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "A Science Writer Explores The 'Perversions And Potential' Of Genetic Tests",
"title": "A Science Writer Explores The 'Perversions And Potential' Of Genetic Tests",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://www.npr.org/player/embed/618870881/618969757\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\" title=\"NPR embedded audio player\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>As a science columnist for\u003cem> The New York Times, \u003c/em>Carl Zimmer had reported extensively about genetics and the role gene mutations play in various ailments. After a while, he got to wondering about what secrets his own genetic code holds.[contextly_sidebar id=\"AyWMyOjcCCjd9Wr45bM9omzK5fGeueow\"]\u003c/p>\n\u003cp>\"I wanted to know if there was anything I needed to worry about,\" Zimmer says. \"We all think back to our relatives who got sick and then wonder, 'Is that in me?'\"\u003c/p>\n\u003cp>So Zimmer worked with a genetics counselor to get his entire genome sequenced — an experience he describes as \"very nerve-wracking.\" He worried that he would discover a mutation that would put him on the path for a particular disease.\u003c/p>\n\u003cp>As it turned out, the counselor told Zimmer he has a \"boring genome.\" Though Zimmer initially hoped for a more \"exciting and exotic\" assessment, the counselor reminded him \"A boring genome is a really good genome.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Zimmer writes about the broader implications of genetic research and testing in his new book, \u003cem>She Has Her Mother's Laugh: The Powers, Perversions and Potential of Heredity\u003c/em>.[contextly_sidebar id=\"YtqF4uhyPE2pCelB55bttG0XpqJfRSq3\"]\u003c/p>\n\u003chr>\n\u003cp>\u003cstrong>Interview Highlights\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>On how the new genetic editing technology known as \u003ca href=\"https://www.npr.org/tags/419142387/crispr\" target=\"_blank\" rel=\"noopener\">CRISPR\u003c/a> works\u003c/strong>\u003c/p>\n\u003cp>What happens with CRISPR is that scientists will design a molecule — think of it as a probe — and it will search around in the DNA in a cell until if finds a very specific short sequence. And it will grab onto it, and it brings on with it basically molecular scissors, which will then cut the DNA at that spot — kind of like cutting tape. And you can cut out a segment of DNA. And if you just do that, DNA will heal itself. Basically the two loose ends will stitch themselves together, and now that piece is just missing. Or you can add in a little piece of different DNA, and you can actually get the cell to put in that new piece of DNA where you just cut out the old one.\u003c/p>\n\u003cp>\u003cstrong>On whether CRISPR technology could be used to treat diseases in humans\u003c/strong>\u003c/p>\n\u003cp>We're just on the verge of human trials. They will be starting, hopefully very soon, for diseases like sickle-cell anemia. There's actually a lot of research on muscular dystrophy as well. There are a few key diseases where scientists think these would be the best places to start. To basically inject CRISPR molecules into people's bodies; these CRISPR molecules would then go to certain kinds of cells and repair one particular spot in their DNA. And that treats the disease.\u003c/p>\n\u003cp>We shouldn't look at this as a panacea. ... There have been earlier kinds of treatments known as gene therapy, where you basically try to add an extra gene into someone's cells. And that [seemed] like it was just a slam dunk, but then it turned out to not work very well for years and years. ... So CRISPR could be even more exciting and truly revolutionary. We just have to wait and see what this first generation of human clinical trials show us.\u003c/p>\n\u003cp>\u003cstrong>On his visit to an insectarium where a scientist is breeding genetically modified mosquitoes that are resistant to malaria\u003c/strong>\u003c/p>\n\u003cp>First of all, you have to gown up before you go in there. ... And then you go through an air lock, and then you're in this room where there are mosquitoes living in all their different life cycles.\u003c/p>\n\u003cp>So there's a dark room where the female mosquitoes are laying their eggs, because they like to do it in the dark. And then the scientists pull the eggs out from these rooms and they inject DNA into them and then they put them in water, because that's where mosquito larvae like to develop.\u003c/p>\n\u003cp>And so you go into this other room where there are these tubs of water, and these snake-like things are slithering around in there and then they develop into adults. And the females need to drink blood; so [researchers] found that the containers for movie popcorn work really well. What they do is, they basically clamp a warm container of calves' blood on top of them, and then the mosquitoes are underneath — on the underside of the plastic lid — basically poking through and drinking the blood and fattening themselves up. ...\u003c/p>\n\u003cp>You can tell that they've been genetically altered because they have red eyes, which is kind of spooky. But you look at that and you say, well, that means that these could be the cure for malaria. It really could happen. And hundreds of thousands of people die every year of malaria. We've thrown everything we can at it and this parasite is still knocking us down worldwide. So, maybe this could be it – so, that's actually quite exciting.\u003c/p>\n\u003cp>\u003cstrong>On how genetic testing was used in the Golden State Killer case\u003c/strong>\u003c/p>\n\u003cp>For the \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/04/27/606624218/in-hunt-for-golden-state-killer-investigators-uploaded-his-dna-to-genealogy-site\" target=\"_blank\" rel=\"noopener\">Golden State Killer case\u003c/a>, what somebody decided to do was take the DNA that they had from these crime scenes, and upload it to one of these open-access sites — not a commercial site — and then see if they could find any close matches. And they found that there were some people that looked like they were distant cousins of this person. And they went and did the genealogical research to figure out \"Well, how would they be related?\" And then said \"OK, who are the possible relatives that this person could be, and where do they live?\" And that actually helped narrow down their search until they made an arrest.\u003c/p>\n\u003cp>\u003cstrong>On whether genetic testing companies will protect user privacy\u003c/strong>\u003c/p>\n\u003cp>You can choose different levels of privacy with a lot of these services. So, for example, some people will say \"I want you to look at my DNA. I want you to tell me about my ancestry.\" ... For 23 and Me they'll give you a few bits of information about your medical conditions, and that's it. But they will try to get you to opt in to sharing your data for their own basic research. At 23 and Me, for example, there's a whole team of researchers who are studying all sorts of ... diseases, sleep patterns and so on. And then they will also go into partnerships with drug development companies who will take their data, looking at, say, 50,000 people with lupus and 50,000 people who don't have lupus, and try to look for the genetic differences. Those could point the way toward possible drugs.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Phyllis Myers and Seth Kelley produced and edited the audio of this interview. Bridget Bentz and Seth Kelley adapted it for the Web.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Fresh Air. To see more, visit \u003ca href=\"http://www.npr.org/programs/fresh-air/\">Fresh Air\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+Science+Writer+Explores+The+%27Perversions+And+Potential%27+Of+Genetic+Tests&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "Carl Zimmer wondered what secrets lurked in his genetic code — so he decided to have his genome sequenced. He writes about the implications of the study of genetics in \u003cem>She Has Her Mother's Laugh.\u003c/em>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://www.npr.org/player/embed/618870881/618969757\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\" title=\"NPR embedded audio player\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>As a science columnist for\u003cem> The New York Times, \u003c/em>Carl Zimmer had reported extensively about genetics and the role gene mutations play in various ailments. After a while, he got to wondering about what secrets his own genetic code holds.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"I wanted to know if there was anything I needed to worry about,\" Zimmer says. \"We all think back to our relatives who got sick and then wonder, 'Is that in me?'\"\u003c/p>\n\u003cp>So Zimmer worked with a genetics counselor to get his entire genome sequenced — an experience he describes as \"very nerve-wracking.\" He worried that he would discover a mutation that would put him on the path for a particular disease.\u003c/p>\n\u003cp>As it turned out, the counselor told Zimmer he has a \"boring genome.\" Though Zimmer initially hoped for a more \"exciting and exotic\" assessment, the counselor reminded him \"A boring genome is a really good genome.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Zimmer writes about the broader implications of genetic research and testing in his new book, \u003cem>She Has Her Mother's Laugh: The Powers, Perversions and Potential of Heredity\u003c/em>.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003chr>\n\u003cp>\u003cstrong>Interview Highlights\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>On how the new genetic editing technology known as \u003ca href=\"https://www.npr.org/tags/419142387/crispr\" target=\"_blank\" rel=\"noopener\">CRISPR\u003c/a> works\u003c/strong>\u003c/p>\n\u003cp>What happens with CRISPR is that scientists will design a molecule — think of it as a probe — and it will search around in the DNA in a cell until if finds a very specific short sequence. And it will grab onto it, and it brings on with it basically molecular scissors, which will then cut the DNA at that spot — kind of like cutting tape. And you can cut out a segment of DNA. And if you just do that, DNA will heal itself. Basically the two loose ends will stitch themselves together, and now that piece is just missing. Or you can add in a little piece of different DNA, and you can actually get the cell to put in that new piece of DNA where you just cut out the old one.\u003c/p>\n\u003cp>\u003cstrong>On whether CRISPR technology could be used to treat diseases in humans\u003c/strong>\u003c/p>\n\u003cp>We're just on the verge of human trials. They will be starting, hopefully very soon, for diseases like sickle-cell anemia. There's actually a lot of research on muscular dystrophy as well. There are a few key diseases where scientists think these would be the best places to start. To basically inject CRISPR molecules into people's bodies; these CRISPR molecules would then go to certain kinds of cells and repair one particular spot in their DNA. And that treats the disease.\u003c/p>\n\u003cp>We shouldn't look at this as a panacea. ... There have been earlier kinds of treatments known as gene therapy, where you basically try to add an extra gene into someone's cells. And that [seemed] like it was just a slam dunk, but then it turned out to not work very well for years and years. ... So CRISPR could be even more exciting and truly revolutionary. We just have to wait and see what this first generation of human clinical trials show us.\u003c/p>\n\u003cp>\u003cstrong>On his visit to an insectarium where a scientist is breeding genetically modified mosquitoes that are resistant to malaria\u003c/strong>\u003c/p>\n\u003cp>First of all, you have to gown up before you go in there. ... And then you go through an air lock, and then you're in this room where there are mosquitoes living in all their different life cycles.\u003c/p>\n\u003cp>So there's a dark room where the female mosquitoes are laying their eggs, because they like to do it in the dark. And then the scientists pull the eggs out from these rooms and they inject DNA into them and then they put them in water, because that's where mosquito larvae like to develop.\u003c/p>\n\u003cp>And so you go into this other room where there are these tubs of water, and these snake-like things are slithering around in there and then they develop into adults. And the females need to drink blood; so [researchers] found that the containers for movie popcorn work really well. What they do is, they basically clamp a warm container of calves' blood on top of them, and then the mosquitoes are underneath — on the underside of the plastic lid — basically poking through and drinking the blood and fattening themselves up. ...\u003c/p>\n\u003cp>You can tell that they've been genetically altered because they have red eyes, which is kind of spooky. But you look at that and you say, well, that means that these could be the cure for malaria. It really could happen. And hundreds of thousands of people die every year of malaria. We've thrown everything we can at it and this parasite is still knocking us down worldwide. So, maybe this could be it – so, that's actually quite exciting.\u003c/p>\n\u003cp>\u003cstrong>On how genetic testing was used in the Golden State Killer case\u003c/strong>\u003c/p>\n\u003cp>For the \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/04/27/606624218/in-hunt-for-golden-state-killer-investigators-uploaded-his-dna-to-genealogy-site\" target=\"_blank\" rel=\"noopener\">Golden State Killer case\u003c/a>, what somebody decided to do was take the DNA that they had from these crime scenes, and upload it to one of these open-access sites — not a commercial site — and then see if they could find any close matches. And they found that there were some people that looked like they were distant cousins of this person. And they went and did the genealogical research to figure out \"Well, how would they be related?\" And then said \"OK, who are the possible relatives that this person could be, and where do they live?\" And that actually helped narrow down their search until they made an arrest.\u003c/p>\n\u003cp>\u003cstrong>On whether genetic testing companies will protect user privacy\u003c/strong>\u003c/p>\n\u003cp>You can choose different levels of privacy with a lot of these services. So, for example, some people will say \"I want you to look at my DNA. I want you to tell me about my ancestry.\" ... For 23 and Me they'll give you a few bits of information about your medical conditions, and that's it. But they will try to get you to opt in to sharing your data for their own basic research. At 23 and Me, for example, there's a whole team of researchers who are studying all sorts of ... diseases, sleep patterns and so on. 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"airtime": "FRI 4:30pm-5pm, 6:30pm-7pm, 11pm-11:30pm",
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"officialWebsiteLink": "/californiareportmagazine",
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"order": 10
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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},
"city-arts": {
"id": "city-arts",
"title": "City Arts & Lectures",
"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
"officialWebsiteLink": "https://www.cityarts.net/",
"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
"site": "news",
"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
"subscribe": {
"tuneIn": "https://tunein.com/radio/City-Arts-and-Lectures-p692/",
"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
"id": "closealltabs",
"title": "Close All Tabs",
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"info": "Close All Tabs breaks down how digital culture shapes our world through thoughtful insights and irreverent humor.",
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"officialWebsiteLink": "/podcasts/closealltabs",
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"order": 1
},
"link": "/podcasts/closealltabs",
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"title": "Code Switch / Life Kit",
"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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"meta": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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}
},
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"id": "forum",
"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.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"id": "freakonomics-radio",
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"info": "Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. It is produced in partnership with WNYC.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/4s8b",
"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
"rss": "https://feeds.feedburner.com/freakonomicsradio"
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},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
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"link": "/radio/program/fresh-air",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/381444908/podcast.xml"
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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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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"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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"officialWebsiteLink": "https://www.npr.org/series/423302056/hidden-brain",
"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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"title": "How I Built This with Guy Raz",
"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.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png",
"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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"source": "npr"
},
"link": "/radio/program/how-i-built-this",
"subscribe": {
"npr": "https://rpb3r.app.goo.gl/3zxy",
"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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"rss": "https://feeds.npr.org/510313/podcast.xml"
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},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"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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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
"link": "/podcasts/hyphenacion",
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"spotify": "https://open.spotify.com/show/2p3Fifq96nw9BPcmFdIq0o?si=39209f7b25774f38",
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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. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
"meta": {
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"source": "kqed",
"order": 18
},
"link": "/podcasts/jerrybrown",
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
"meta": {
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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"
}
},
"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": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"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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"apple": "http://mastersofscale.app.link/",
"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",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
"apple": "https://podcasts.apple.com/podcast/id1567098962",
"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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"rss": "https://feeds.npr.org/510360/podcast.xml"
}
},
"on-the-media": {
"id": "on-the-media",
"title": "On The Media",
"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
"airtime": "SUN 2pm-3pm, MON 12am-1am",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/onTheMedia.png",
"officialWebsiteLink": "https://www.wnycstudios.org/shows/otm",
"meta": {
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"source": "wnyc"
},
"link": "/radio/program/on-the-media",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/on-the-media/id73330715?mt=2",
"tuneIn": "https://tunein.com/radio/On-the-Media-p69/",
"rss": "http://feeds.wnyc.org/onthemedia"
}
},
"pbs-newshour": {
"id": "pbs-newshour",
"title": "PBS NewsHour",
"info": "Analysis, background reports and updates from the PBS NewsHour putting today's news in context.",
"airtime": "MON-FRI 3pm-4pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/PBS-News-Hour-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.pbs.org/newshour/",
"meta": {
"site": "news",
"source": "pbs"
},
"link": "/radio/program/pbs-newshour",
"subscribe": {
"apple": "https://itunes.apple.com/us/podcast/pbs-newshour-full-show/id394432287?mt=2",
"tuneIn": "https://tunein.com/radio/PBS-NewsHour---Full-Show-p425698/",
"rss": "https://www.pbs.org/newshour/feeds/rss/podcasts/show"
}
},
"perspectives": {
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