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"content": "\u003cp>Danielle Vukadinovich is sitting up in a hospital bed at the Inova Women's Hospital in Falls Church, Va., waiting to give birth.\u003c/p>\n\u003cp>\"I feel good, I'm excited!\" says Vukadinovich, 35, of Annandale, Va., \"Nervous, but good!\"[contextly_sidebar id=\"FEjJfJVXw64VNWTIkBjmTrT87lKdBgJO\"]\u003c/p>\n\u003cp>Vukadinovich is getting a \u003ca href=\"https://medlineplus.gov/cesareansection.html\" target=\"_blank\" rel=\"noopener\">cesarean section\u003c/a> today. It's the second time for her — she underwent the surgical procedure 19 months ago when her twins were born.\u003c/p>\n\u003cp>This time Danielle wants to try something different, something that might sound strange. As soon as her daughter is born, a doctor will wipe bacteria fluid from Danielle's birth canal all over her baby's body.\u003c/p>\n\u003cp>\"I haven't told many people about this yet,\" Vukadinovich says, laughing. \"I understand why people would be like, 'Oh my gosh. That's so weird.' But I don't think it's yucky. It's normal. It's natural really.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The procedure, known as \"\u003ca href=\"https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/expert-answers/vaginal-seeding/faq-20380881\" target=\"_blank\" rel=\"noopener\">vaginal seeding\u003c/a>,\" is designed to help babies develop healthy microbiomes — the collection of friendly bacteria that inhabit every person's body. Some people call it a \"bacterial baptism.\"\u003c/p>\n\u003cp>\"It's a little bit like that baby's first dunk,\" says \u003ca href=\"https://www.inova.org/indirectory/clinicaltrials.aspx?design=true&dirId=1&LoadCategory=ITMI&LoadSubCategory=Microbiome&memberID=280\" target=\"_blank\" rel=\"noopener\">Shira Levy\u003c/a>, the microbiome research manager at the Inova hospital. \"That's their first religious experience. You know, they get the water and that changes their spirituality.\u003c/p>\n\u003cp>\"In this case, they get the bacteria and that changes their microbiome,\" Levy says. \"This is their first microbiome experience.\"\u003c/p>\n\u003cp>The procedure was developed in response to the sharp rise in C-section births in recent years. That increase has been accompanied by \u003ca href=\"https://www.npr.org/sections/health-shots/2015/09/30/444746094/missing-microbes-provide-clues-about-asthma-risk\" target=\"_blank\" rel=\"noopener\">more cases of asthma\u003c/a>, allergies, eczema, obesity, and other diseases.\u003c/p>\n\u003cp>The theory is that the rise in these diseases might be happening, in part, because babies aren't getting exposed to their mother's microbes the way they would if they were passing naturally through the birth canal.[contextly_sidebar id=\"0AllfLEduBOKAavkhBROexZnBFbtKljt\"]\u003c/p>\n\u003cp>\"We think that one of the reasons that babies born by C-section are at increased risk for these diseases is because they don't receive that first beneficial exposure to their mother's vaginal microbiome,\" says \u003ca href=\"https://www.inova.org/Physician_Directory/Suchitra-K-Hourigan-MD/824530\" target=\"_blank\" rel=\"noopener\">Suchitra Hourigan\u003c/a>, a pediatric gastroenterologist at Inova.\u003c/p>\n\u003cp>One very small study \u003ca href=\"https://www.npr.org/sections/health-shots/2016/02/01/464905786/researchers-test-microbe-wipe-to-promote-babies-health-after-c-sections\" target=\"_blank\" rel=\"noopener\">indicated \u003c/a>that swabbing C-section babies with their mother's microbes immediately after birth could make their microbiomes develop more like those of babies born vaginally.\u003c/p>\n\u003cp>But the appeal of vaginal seeding has outpaced evidence that it is safe and effective.\u003c/p>\n\u003cp>Some couples have started trying vaginal seeding on their own. Vukadinovich jokes that she considered doing it herself. After all, she says, she's a nurse and her husband is a high school biology teacher.\u003c/p>\n\u003cp>\"I even told my mom: 'Nobody has to know. My husband would help me out,' \" she says, laughing. \"But I try not to take unnecessary risks.\"\u003c/p>\n\u003cp>Vukadinovich knows the procedure could be risky. Babies could be inadvertently exposed to disease-causing microbes, such as herpes virus or streptococcus bacteria.\u003c/p>\n\u003cp>In fact, medical groups such as the American College of Obstetrics and Gynecology \u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Vaginal-Seeding\" target=\"_blank\" rel=\"noopener\">warn\u003c/a> women against doing this. \"While there are data to suggest that there may be some scientific plausibility to the concept, it is not without significant risks,\" says \u003ca href=\"http://newsroom.ucla.edu/experts/preview/578561302cfac209100154a4/\" target=\"_blank\" rel=\"noopener\">Neil Silverman\u003c/a>, a clinical professor of obstetrics and gynecology at the UCLA School of Medicine, who represents ACOG. The group notes that mothers also transfer microbes to their newborns through skin-to-skin contact and breastfeeding.\u003c/p>\n\u003cp>So Vukadinovich was thrilled when she found out she could be part of the first \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03298334?term=vaginal+seeding&rank=1\" target=\"_blank\" rel=\"noopener\">study\u003c/a> the Food and Drug Administration is allowing to rigorously test whether the procedure is safe and helps improve babies' health.[contextly_sidebar id=\"kMHzgUs0dutTuVHV7G0EJpefrLt2hB8h\"]\u003c/p>\n\u003cp>\"Who knows what's going to happen with the results? But if it does show something positive, I just think that would be great for kids and parents,\" she says.\u003c/p>\n\u003cp>Hourigan, who's helping lead the study, agrees. \"Just to be able to reduce one risk factor for obesity, especially when there are such high [C-section rates] in the U.S., would be huge,\" she says.\u003c/p>\n\u003cp>In the study, half of the babies will get swabbed with their mother's microbes; half will get swabbed with a sterile solution. All of the mothers will be carefully screened for dangerous infections.\u003c/p>\n\u003cp>All of the babies will then be followed for three years to see if they become obese or develop other health problems. A \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03567707?term=vaginal+seeding&rank=2\" target=\"_blank\" rel=\"noopener\">similar study\u003c/a> is starting at the Icahn School of Medicine at Mount Sinai in New York City.\u003c/p>\n\u003cp>Vukadinovich agreed to let an NPR reporter and photographer observe her baby's birth and the swabbing. It's the first time journalists have been allowed to watch a baby go through the study.\u003c/p>\n\u003cp>\u003cstrong>Evelyn Marie is Born\u003c/strong>\u003c/p>\n\u003cp>As the nurses wheel Vukadinovich into the operating room, Hourigan, Levy and Dr. Varsha Deopujari follow. Deopujari, the study's clinical manager, will do the actual swabbing.\u003c/p>\n\u003cp>Inside the OR, everyone quickly takes their places. As the surgeon starts, Hourigan explains what's happening. It goes very fast.\u003c/p>\n\u003cp>\"An incision is being made into mom, and they are getting ready to take out the baby,\" Hourigan says. \"They can see the head. And the head is now coming out of the C-section incision. Baby's head is out.\"\u003c/p>\n\u003cp>In less than a minute after the surgery starts, the baby girl is completely out. A nurse rushes the newborn to a nearby table to clear her breathing. After the baby is breathing smoothly, Deopujari starts swabbing with a gauze pad.\u003c/p>\n\u003cp>First, she swabs the baby's mouth, cheeks and face. After turning the gauze over to expose more bacteria, Deopujari wipes the baby's hands and arms. Next, she wipes down her chest, goes over her abdomen, up the other arm and then over her back.[contextly_sidebar id=\"umm131VoK2OKqBWygztDrKkMjOgsaGeH\"]\u003c/p>\n\u003cp>\"And the swabbing is now over,\" Hourigan says.\u003c/p>\n\u003cp>Deopujari hands the baby back to a nurse. Hourigan and her team quickly head out of the OR.\u003c/p>\n\u003cp>\"That went perfectly,\" she says. \"Baby came out and was crying. We waited until baby was stable, and the swabbing went just as planned.\"\u003c/p>\n\u003cp>Hourigan and her colleagues will swab 50 babies to make sure their procedure is safe. If it is, they plan to expand the study to 800 babies, who would randomly receive either the bacterial swab or a placebo, throughout the Inova hospital system.\u003c/p>\n\u003cp>The results could prove important. \"We need more data and we need better data,\" says Silverman, of ACOG. \"If it shows that there is a clear benefit, then this process can be re-evaluated.\"\u003c/p>\n\u003cp>The next morning, Vukadinovich, her husband, Nick, 41, and their new daughter are together in a hospital room.\u003c/p>\n\u003cp>\"I'm good — feeling good today,\" she says, cradling her baby.\u003c/p>\n\u003cp>The couple doesn't know if their new daughter, who they would later name Evelyn Marie, was exposed to her mother's microbes or a sterile placebo solution. But they have their fingers crossed she was swabbed with bacteria.\u003c/p>\n\u003cp>\"I really hope that she was,\" Vukadinovich says. \"If there's a decreased chance of her having any health issues, that would be awesome.\"\u003c/p>\n\u003cp>Her husband, Nick, agrees.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"We're not terribly religious so we won't baptize with water — holy water,\" Nick says. \"But since we're scientists, we like the idea of a bacterial baptism instead of a holy baptism — because now she's been initiated with bacteria, friendly bacteria, that should protect her down the road.\"\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=Doctors+Test+Bacterial+Smear+After+Cesarean+Sections+To+Bolster+Babies%27+Microbiomes&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Danielle Vukadinovich is sitting up in a hospital bed at the Inova Women's Hospital in Falls Church, Va., waiting to give birth.\u003c/p>\n\u003cp>\"I feel good, I'm excited!\" says Vukadinovich, 35, of Annandale, Va., \"Nervous, but good!\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Vukadinovich is getting a \u003ca href=\"https://medlineplus.gov/cesareansection.html\" target=\"_blank\" rel=\"noopener\">cesarean section\u003c/a> today. It's the second time for her — she underwent the surgical procedure 19 months ago when her twins were born.\u003c/p>\n\u003cp>This time Danielle wants to try something different, something that might sound strange. As soon as her daughter is born, a doctor will wipe bacteria fluid from Danielle's birth canal all over her baby's body.\u003c/p>\n\u003cp>\"I haven't told many people about this yet,\" Vukadinovich says, laughing. \"I understand why people would be like, 'Oh my gosh. That's so weird.' But I don't think it's yucky. It's normal. It's natural really.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The procedure, known as \"\u003ca href=\"https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/expert-answers/vaginal-seeding/faq-20380881\" target=\"_blank\" rel=\"noopener\">vaginal seeding\u003c/a>,\" is designed to help babies develop healthy microbiomes — the collection of friendly bacteria that inhabit every person's body. Some people call it a \"bacterial baptism.\"\u003c/p>\n\u003cp>\"It's a little bit like that baby's first dunk,\" says \u003ca href=\"https://www.inova.org/indirectory/clinicaltrials.aspx?design=true&dirId=1&LoadCategory=ITMI&LoadSubCategory=Microbiome&memberID=280\" target=\"_blank\" rel=\"noopener\">Shira Levy\u003c/a>, the microbiome research manager at the Inova hospital. \"That's their first religious experience. You know, they get the water and that changes their spirituality.\u003c/p>\n\u003cp>\"In this case, they get the bacteria and that changes their microbiome,\" Levy says. \"This is their first microbiome experience.\"\u003c/p>\n\u003cp>The procedure was developed in response to the sharp rise in C-section births in recent years. That increase has been accompanied by \u003ca href=\"https://www.npr.org/sections/health-shots/2015/09/30/444746094/missing-microbes-provide-clues-about-asthma-risk\" target=\"_blank\" rel=\"noopener\">more cases of asthma\u003c/a>, allergies, eczema, obesity, and other diseases.\u003c/p>\n\u003cp>The theory is that the rise in these diseases might be happening, in part, because babies aren't getting exposed to their mother's microbes the way they would if they were passing naturally through the birth canal.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"We think that one of the reasons that babies born by C-section are at increased risk for these diseases is because they don't receive that first beneficial exposure to their mother's vaginal microbiome,\" says \u003ca href=\"https://www.inova.org/Physician_Directory/Suchitra-K-Hourigan-MD/824530\" target=\"_blank\" rel=\"noopener\">Suchitra Hourigan\u003c/a>, a pediatric gastroenterologist at Inova.\u003c/p>\n\u003cp>One very small study \u003ca href=\"https://www.npr.org/sections/health-shots/2016/02/01/464905786/researchers-test-microbe-wipe-to-promote-babies-health-after-c-sections\" target=\"_blank\" rel=\"noopener\">indicated \u003c/a>that swabbing C-section babies with their mother's microbes immediately after birth could make their microbiomes develop more like those of babies born vaginally.\u003c/p>\n\u003cp>But the appeal of vaginal seeding has outpaced evidence that it is safe and effective.\u003c/p>\n\u003cp>Some couples have started trying vaginal seeding on their own. Vukadinovich jokes that she considered doing it herself. After all, she says, she's a nurse and her husband is a high school biology teacher.\u003c/p>\n\u003cp>\"I even told my mom: 'Nobody has to know. My husband would help me out,' \" she says, laughing. \"But I try not to take unnecessary risks.\"\u003c/p>\n\u003cp>Vukadinovich knows the procedure could be risky. Babies could be inadvertently exposed to disease-causing microbes, such as herpes virus or streptococcus bacteria.\u003c/p>\n\u003cp>In fact, medical groups such as the American College of Obstetrics and Gynecology \u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Vaginal-Seeding\" target=\"_blank\" rel=\"noopener\">warn\u003c/a> women against doing this. \"While there are data to suggest that there may be some scientific plausibility to the concept, it is not without significant risks,\" says \u003ca href=\"http://newsroom.ucla.edu/experts/preview/578561302cfac209100154a4/\" target=\"_blank\" rel=\"noopener\">Neil Silverman\u003c/a>, a clinical professor of obstetrics and gynecology at the UCLA School of Medicine, who represents ACOG. The group notes that mothers also transfer microbes to their newborns through skin-to-skin contact and breastfeeding.\u003c/p>\n\u003cp>So Vukadinovich was thrilled when she found out she could be part of the first \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03298334?term=vaginal+seeding&rank=1\" target=\"_blank\" rel=\"noopener\">study\u003c/a> the Food and Drug Administration is allowing to rigorously test whether the procedure is safe and helps improve babies' health.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"Who knows what's going to happen with the results? But if it does show something positive, I just think that would be great for kids and parents,\" she says.\u003c/p>\n\u003cp>Hourigan, who's helping lead the study, agrees. \"Just to be able to reduce one risk factor for obesity, especially when there are such high [C-section rates] in the U.S., would be huge,\" she says.\u003c/p>\n\u003cp>In the study, half of the babies will get swabbed with their mother's microbes; half will get swabbed with a sterile solution. All of the mothers will be carefully screened for dangerous infections.\u003c/p>\n\u003cp>All of the babies will then be followed for three years to see if they become obese or develop other health problems. A \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03567707?term=vaginal+seeding&rank=2\" target=\"_blank\" rel=\"noopener\">similar study\u003c/a> is starting at the Icahn School of Medicine at Mount Sinai in New York City.\u003c/p>\n\u003cp>Vukadinovich agreed to let an NPR reporter and photographer observe her baby's birth and the swabbing. It's the first time journalists have been allowed to watch a baby go through the study.\u003c/p>\n\u003cp>\u003cstrong>Evelyn Marie is Born\u003c/strong>\u003c/p>\n\u003cp>As the nurses wheel Vukadinovich into the operating room, Hourigan, Levy and Dr. Varsha Deopujari follow. Deopujari, the study's clinical manager, will do the actual swabbing.\u003c/p>\n\u003cp>Inside the OR, everyone quickly takes their places. As the surgeon starts, Hourigan explains what's happening. It goes very fast.\u003c/p>\n\u003cp>\"An incision is being made into mom, and they are getting ready to take out the baby,\" Hourigan says. \"They can see the head. And the head is now coming out of the C-section incision. Baby's head is out.\"\u003c/p>\n\u003cp>In less than a minute after the surgery starts, the baby girl is completely out. A nurse rushes the newborn to a nearby table to clear her breathing. After the baby is breathing smoothly, Deopujari starts swabbing with a gauze pad.\u003c/p>\n\u003cp>First, she swabs the baby's mouth, cheeks and face. After turning the gauze over to expose more bacteria, Deopujari wipes the baby's hands and arms. Next, she wipes down her chest, goes over her abdomen, up the other arm and then over her back.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"And the swabbing is now over,\" Hourigan says.\u003c/p>\n\u003cp>Deopujari hands the baby back to a nurse. Hourigan and her team quickly head out of the OR.\u003c/p>\n\u003cp>\"That went perfectly,\" she says. \"Baby came out and was crying. We waited until baby was stable, and the swabbing went just as planned.\"\u003c/p>\n\u003cp>Hourigan and her colleagues will swab 50 babies to make sure their procedure is safe. If it is, they plan to expand the study to 800 babies, who would randomly receive either the bacterial swab or a placebo, throughout the Inova hospital system.\u003c/p>\n\u003cp>The results could prove important. \"We need more data and we need better data,\" says Silverman, of ACOG. \"If it shows that there is a clear benefit, then this process can be re-evaluated.\"\u003c/p>\n\u003cp>The next morning, Vukadinovich, her husband, Nick, 41, and their new daughter are together in a hospital room.\u003c/p>\n\u003cp>\"I'm good — feeling good today,\" she says, cradling her baby.\u003c/p>\n\u003cp>The couple doesn't know if their new daughter, who they would later name Evelyn Marie, was exposed to her mother's microbes or a sterile placebo solution. But they have their fingers crossed she was swabbed with bacteria.\u003c/p>\n\u003cp>\"I really hope that she was,\" Vukadinovich says. \"If there's a decreased chance of her having any health issues, that would be awesome.\"\u003c/p>\n\u003cp>Her husband, Nick, agrees.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We're not terribly religious so we won't baptize with water — holy water,\" Nick says. \"But since we're scientists, we like the idea of a bacterial baptism instead of a holy baptism — because now she's been initiated with bacteria, friendly bacteria, that should protect her down the road.\"\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=Doctors+Test+Bacterial+Smear+After+Cesarean+Sections+To+Bolster+Babies%27+Microbiomes&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Government Intervenes in Heart Study Following Concerns About Underlying Research",
"title": "Government Intervenes in Heart Study Following Concerns About Underlying Research",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp class=\"danger-zone\">A government agency has paused a clinical trial testing an experimental stem cell therapy in heart failure patients, a move made public on Monday and sparked by recommendations to retract 31 journal articles from the lab of a controversial cardiac stem cell researcher.[contextly_sidebar id=\"I7izVP7XTjOkvUPxO6DOfpUiStgsOB7A\"]\u003c/p>\n\u003cp class=\"danger-zone\">“Recent calls for the retraction of journal articles in related fields of cell therapy research have raised concerns about the scientific foundations of this trial,” the \u003ca href=\"https://www.nih.gov/news-events/news-releases/statement-nhlbi-decision-pause-concert-hf-trial\" target=\"_blank\" rel=\"noopener\">National Heart, Lung, and Blood Institute\u003c/a> said in a statement posted Monday.\u003c/p>\n\u003cp class=\"danger-zone\">On Oct. 17, the \u003ca href=\"https://www.statnews.com/2018/10/17/nejm-retract-stem-cell-anversa/\">New England Journal of Medicine retracted\u003c/a> one paper and published an “expression of concern” about two others from the lab of Dr. Piero Anversa, a controversial stem cell researcher. The journal’s move came three days after Harvard Medical School and Brigham and Women’s Hospital told \u003ca href=\"https://www.statnews.com/2018/10/14/harvard-brigham-retractions-stem-cell/\">STAT and Retraction Watch\u003c/a> they had recommended that 31 papers from Anversa be retracted by medical journals.\u003c/p>\n\u003cp>Dr. David Goff, director of the Division of Cardiovascular Sciences at NHLBI, confirmed Monday that news about the 31 journal articles from the Anversa lab prompted the pause in the trial known as \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02501811\" target=\"_blank\" rel=\"noopener\">CONCERT-HF\u003c/a>. None of the retracted or disputed papers specifically relate to the trial\u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02501811\" target=\"_blank\" rel=\"noopener\">,\u003c/a> he said, but the trial’s Data and Safety Monitoring Board, convened last week at the institute’s request, on Friday recommended a “pause” in the trial so the board could complete its review.\u003c/p>\n\u003cp>Anversa’s research focused on advancing the idea that the heart contains stem cells, called c-kit cells, that could regenerate cardiac muscle after a heart attack. But when various research teams tried to reproduce results reported in his papers, they failed. Anversa left Harvard and the Brigham in 2015. Lawyers for Anversa and his colleague Dr. Annarosa Leri said earlier this month the doctors “stand by the scientific findings in their papers, including the existence and potential therapeutic benefits of cardiac stem cells.” In an Oct. 3 letter that Anversa provided to \u003ca href=\"https://www.nytimes.com/2018/10/29/health/dr-piero-anversa-harvard-retraction.html?action=click&module=Top%20Stories&pgtype=Homepage\" target=\"_blank\" rel=\"noopener\">The New York Times\u003c/a>, Harvard and the Brigham said he had “committed research misconduct” in eight papers and in a grant application.[contextly_sidebar id=\"J93WJNRRTNR70mMyZTyFDOqE9SKlEyHq\"]\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The CONCERT-HF study set out to determine whether c-kit+ cells, either alone or in combination with stem cells derived from the bone marrow, are safe and could help patients with chronic heart failure. There are limited treatment options for people with heart failure; half of them will die within five years of receiving a diagnosis.\u003c/p>\n\u003cp>Goff said that the study’s approval to launch in 2015 was based on 11 reports from eight different labs — all independent of Anversa’s — showing benefits from c-kit+ cells in animal experiments. At the time, reviewers of the study protocols were aware that other labs were unable to duplicate findings reported by Anversa and his colleagues.\u003c/p>\n\u003cp>The University of Texas and NHLBI are sponsors of the trial, which sought to enroll 141 patients at seven locations since it was launched in 2015. The trial has recruited 125 patients, Goff said. Of those 125 people, 117 have undergone tissue collection from bone marrow or heart muscle and 90 have been treated.\u003c/p>\n\u003cp>Dr. Lem Moye of the University of Texas said participants are being notified about the trial’s pause and being told that recent media coverage about cell therapy research is not directly related to CONCERT-HF.\u003c/p>\n\u003cp>“Although we do not follow the protocols of Dr. Anversa (we have our own lab at the University of Miami which uses GMP procedures, as is FDA approved). … NHLBI would like to assure itself that our lab is in fact generating c-kit+ cells,” Moye wrote in response to questions. “We hope that this will not take long.”\u003c/p>\n\u003cp>Goff said NHLBI has asked the board to conduct an “expeditious review in keeping with appropriate rigor.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We have a responsibility to our participants and to generating knowledge to improve the health of people with heart failure.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"danger-zone\">A government agency has paused a clinical trial testing an experimental stem cell therapy in heart failure patients, a move made public on Monday and sparked by recommendations to retract 31 journal articles from the lab of a controversial cardiac stem cell researcher.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp class=\"danger-zone\">“Recent calls for the retraction of journal articles in related fields of cell therapy research have raised concerns about the scientific foundations of this trial,” the \u003ca href=\"https://www.nih.gov/news-events/news-releases/statement-nhlbi-decision-pause-concert-hf-trial\" target=\"_blank\" rel=\"noopener\">National Heart, Lung, and Blood Institute\u003c/a> said in a statement posted Monday.\u003c/p>\n\u003cp class=\"danger-zone\">On Oct. 17, the \u003ca href=\"https://www.statnews.com/2018/10/17/nejm-retract-stem-cell-anversa/\">New England Journal of Medicine retracted\u003c/a> one paper and published an “expression of concern” about two others from the lab of Dr. Piero Anversa, a controversial stem cell researcher. The journal’s move came three days after Harvard Medical School and Brigham and Women’s Hospital told \u003ca href=\"https://www.statnews.com/2018/10/14/harvard-brigham-retractions-stem-cell/\">STAT and Retraction Watch\u003c/a> they had recommended that 31 papers from Anversa be retracted by medical journals.\u003c/p>\n\u003cp>Dr. David Goff, director of the Division of Cardiovascular Sciences at NHLBI, confirmed Monday that news about the 31 journal articles from the Anversa lab prompted the pause in the trial known as \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02501811\" target=\"_blank\" rel=\"noopener\">CONCERT-HF\u003c/a>. None of the retracted or disputed papers specifically relate to the trial\u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02501811\" target=\"_blank\" rel=\"noopener\">,\u003c/a> he said, but the trial’s Data and Safety Monitoring Board, convened last week at the institute’s request, on Friday recommended a “pause” in the trial so the board could complete its review.\u003c/p>\n\u003cp>Anversa’s research focused on advancing the idea that the heart contains stem cells, called c-kit cells, that could regenerate cardiac muscle after a heart attack. But when various research teams tried to reproduce results reported in his papers, they failed. Anversa left Harvard and the Brigham in 2015. Lawyers for Anversa and his colleague Dr. Annarosa Leri said earlier this month the doctors “stand by the scientific findings in their papers, including the existence and potential therapeutic benefits of cardiac stem cells.” In an Oct. 3 letter that Anversa provided to \u003ca href=\"https://www.nytimes.com/2018/10/29/health/dr-piero-anversa-harvard-retraction.html?action=click&module=Top%20Stories&pgtype=Homepage\" target=\"_blank\" rel=\"noopener\">The New York Times\u003c/a>, Harvard and the Brigham said he had “committed research misconduct” in eight papers and in a grant application.\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>The CONCERT-HF study set out to determine whether c-kit+ cells, either alone or in combination with stem cells derived from the bone marrow, are safe and could help patients with chronic heart failure. There are limited treatment options for people with heart failure; half of them will die within five years of receiving a diagnosis.\u003c/p>\n\u003cp>Goff said that the study’s approval to launch in 2015 was based on 11 reports from eight different labs — all independent of Anversa’s — showing benefits from c-kit+ cells in animal experiments. At the time, reviewers of the study protocols were aware that other labs were unable to duplicate findings reported by Anversa and his colleagues.\u003c/p>\n\u003cp>The University of Texas and NHLBI are sponsors of the trial, which sought to enroll 141 patients at seven locations since it was launched in 2015. The trial has recruited 125 patients, Goff said. Of those 125 people, 117 have undergone tissue collection from bone marrow or heart muscle and 90 have been treated.\u003c/p>\n\u003cp>Dr. Lem Moye of the University of Texas said participants are being notified about the trial’s pause and being told that recent media coverage about cell therapy research is not directly related to CONCERT-HF.\u003c/p>\n\u003cp>“Although we do not follow the protocols of Dr. Anversa (we have our own lab at the University of Miami which uses GMP procedures, as is FDA approved). … NHLBI would like to assure itself that our lab is in fact generating c-kit+ cells,” Moye wrote in response to questions. “We hope that this will not take long.”\u003c/p>\n\u003cp>Goff said NHLBI has asked the board to conduct an “expeditious review in keeping with appropriate rigor.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“We have a responsibility to our participants and to generating knowledge to improve the health of people with heart failure.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Advanced Skin Cancer Was Once a Death Sentence. Immunotherapy Is Changing That",
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"content": "\u003cp>Most cancer patients are haunted by the same two questions:\u003c/p>\n\u003cp>\"Why me?\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'If I had been diagnosed five years prior, who knows if I would be here.'\u003c/aside>\n\u003cp>\"Why now?\"\u003c/p>\n\u003cp>Not Ashley Walton.\u003c/p>\n\u003cp>Walton, 34, actually feels lucky advanced melanoma struck when it did.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“If I had been diagnosed five years prior, who knows if I would be here,\" she says.\u003c/p>\n\u003cp>Stage 4 melanoma used to be a death sentence. The disease doesn’t respond to radiation or chemotherapy, and patients survived, on average, less than a year.\u003c/p>\n\u003cp>But over the last decade, doctors are successfully using a new approach, one significantly different than the treatment options available for the last 150 years.\u003c/p>\n\u003cp>Instead of burning or poisoning cancer cells, new medicines unleash the body's natural defenses to fight them.\u003c/p>\n\u003cp>This treatment is called immunotherapy.\u003c/p>\n\u003cfigure id=\"attachment_444546\" class=\"wp-caption aligncenter\" style=\"max-width: 1857px\">\u003cimg class=\"size-full wp-image-444546\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/09/IMG_6200-e1537470859372.jpg\" alt=\"\" width=\"1857\" height=\"1209\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372.jpg 1857w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-160x104.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-800x521.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-768x500.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-1020x664.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-1200x781.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-1180x768.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-960x625.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-240x156.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-375x244.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-520x339.jpg 520w\" sizes=\"(max-width: 1857px) 100vw, 1857px\">\u003cfigcaption class=\"wp-caption-text\">Ashley Walton drinks fluid to prepare for magnetic resonance imaging (MRI) scan to check on the progress of her melanoma. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Beating the Odds\u003c/strong>\u003c/p>\n\u003cp>When Walton was 26, she found a mole on the back of her hip.\u003c/p>\n\u003cp>\"It started morphing into this ugly, dark, bleeding thing,\" she says, grimacing. \"I just knew something was wrong.\"\u003c/p>\n\u003cp>Doctors surgically removed her tumor. But a couple of years later, she discovered a tiny lump in her abdomen. It felt like a popcorn kernel, and within a few weeks grew to the size of a walnut.\u003c/p>\n\u003cp>A biopsy revealed she had stage 4 melanoma.\u003c/p>\n\u003cp>Walton searched online for information about the disease. She recalls the moment she discovered the average survival rate: six to nine months.\u003c/p>\n\u003cp>\"I remember sort of losing my hearing, almost losing my vision to where I felt like I was in a tunnel,\" she says.\u003c/p>\n\u003cp>But when she consulted with her oncologist, Dr. Adil Daud of UC San Francisco, he had consoling news.\u003c/p>\n\u003cp>“He told me if there's any time to have a melanoma -- right now is a pretty good time to have it -- because there's a lot of stuff opening up to you,\" she says.\u003c/p>\n\u003cp>Dr. Daud was referring to immune checkpoint inhibitors, which he says are increasing survival rates by at least threefold. These cancer drugs help the immune system do what it’s supposed to -- fight pathogens.\u003c/p>\n\u003cp>Normally the immune system recognizes disease-causing organisms. But cancer cells are unusual because they go undetected as harmful. Immune checkpoint inhibitors make them visible for attack.\u003c/p>\n\u003cfigure id=\"attachment_444547\" class=\"wp-caption aligncenter\" style=\"max-width: 1728px\">\u003cimg class=\"size-full wp-image-444547\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/09/IMG_6291-e1537471184446.jpg\" alt=\"\" width=\"1728\" height=\"1166\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446.jpg 1728w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-160x108.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-800x540.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-768x518.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-1020x688.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-1200x810.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-1180x796.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-960x648.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-240x162.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-375x253.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-520x351.jpg 520w\" sizes=\"(max-width: 1728px) 100vw, 1728px\">\u003cfigcaption class=\"wp-caption-text\">Ashley Walton and her mother in a quarterly doctor appointment at UCSF Medical Center. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cb>Treatment Earns Nobel Prize\u003c/b>\u003c/p>\n\u003cp>The Food and Drug Administration’s approval of the first immune checkpoint inhibitor in 2011 marked a breakthrough in the field.\u003c/p>\n\u003cp>The technology behind Ipilimumab, which is branded as Yervoy, was developed in a UC Berkeley lab in the 1990s, by a student named Matthew Krummel, now an immunotherapy researcher at \u003ca href=\"http://krummellab.com/\" target=\"_blank\" rel=\"noopener\">UCSF\u003c/a>.\u003c/p>\n\u003cp>“I was a very frustrated graduate student for a few years, trying to develop an antibody that would do something,\" Krummel says.\u003c/p>\n\u003cp>He wanted to influence how cells behave. After many long nights, Krummel noticed one antibody successfully manipulating the movement of immune cells.\u003c/p>\n\u003cp>“You can drive them like a car; you can accelerate them; or you can brake them,\" Krummel says. \"And then it was really like playtime.”\u003c/p>\n\u003cp>He injected the antibodies into mice with cancer. In the very first set of experiments, their tumors shrunk.\u003c/p>\n\u003cp>Earlier this month, Krummel’s thesis advisor, James Allison, won the Nobel Prize for Medicine for their lab's work on immune checkpoint inhibitors.\u003c/p>\n\u003cp>\u003cstrong>Years of Harrowing Treatments\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">'Across different tumor types, only about 20 percent of patients with cancer respond to today's immunotherapy.'\u003ccite>Dr. Adil Daud, UCSF\u003c/cite>\u003c/aside>\n\u003cp>When Walton started immunotherapy treatment, including Ipilimumab, the 90-minute drips were followed by side effects like fever, diarrhea, rash, vomiting and gastritis. This is not uncommon in immunotherapy, as the drugs can put a patient’s immune system into overdrive provoking an attack on healthy cells, tissues and organs.\u003c/p>\n\u003cp>Walton’s tumors initially shrunk, but within six months, new tumors cropped up, in her abdomen. Her oncologist then ran through the list of available drugs, moving on as each one, sometimes tried in combination, in turn failed to deliver the knockout blow.\u003c/p>\n\u003cp>“It's absolutely exhausting emotionally and physically to know that there's no option for you,” says Walton. “Those were the days when I felt like I will probably die from this, and I’ll die young.”\u003c/p>\n\u003cp>Finally, eight years later, she heard the magic word: remission. Dr. Daud isn't sure if it was the buildup of multiple immunotherapy drugs or some new combination that did the trick.\u003c/p>\n\u003cp>“There are so many advancements being made in the field of immunotherapy that even if [one] doesn't cure you, it gets you to the next big thing,” says Walton.\u003c/p>\n\u003cp>Now that she has been off immunotherapy for 10 months, Walton tentatively asked Dr. Daud something that had been her mind for a long time.\u003c/p>\n\u003cp>\"So, what do you think about pregnancy or trying to start a family?\" asked Walton.\u003c/p>\n\u003cp>\"I think this is a good time to get pregnant, actually,\" responded Dr. Daud.\u003c/p>\n\u003cp>Both doctor and patient could barely contain their glee, punctuating the question-and-answer session with happy giggles. Walton \u003cspan style=\"font-weight: 400\">crosses her fingers and smiles. \u003c/span>Throughout her treatment, doctors warned that getting pregnant would be too dangerous. But Daud now trusts her body's ability to support a child.\u003c/p>\n\u003cp>\u003cstrong>A Hopeful Future\u003c/strong>\u003c/p>\n\u003cp>Stories like Walton's are sparking a lot of excitement among oncologists.\u003c/p>\n\u003cp>\"So imagine when we’ve gone from a time when we had nothing to offer, to today, and they are talking about a cure for some patients with advanced melanoma,\" says Dr. Leonard Lichtenfeld, deputy chief medical officer for the American Cancer Society.\u003c/p>\n\u003cp>Scientists and major pharmaceutical companies are waging huge bets on immunotherapy. There are currently about 1,000 active trials to develop the next miracle drug. Lichtenfeld is optimistic, but he is also cautious about adding to the hype.\u003c/p>\n\u003cp>“We don’t know in how many cancers they are going to be effective,” he says. “And we still don’t know how to harness the maximum benefit from these drugs by, say, using them in combination with other drugs.”\u003c/p>\n\u003cp>Currently, 40 percent of advanced melanoma patients still do not respond to immunotherapy. The statistics are even worse for other cancers.\u003c/p>\n\u003cp>“It is still very common to not have immune treatment work at all,” says Dr. Daud. “Across different tumor types, only about 20 percent of patients with cancer respond to today's immunotherapy, so the numbers are much more sobering.\"\u003c/p>\n\u003cp>He hypothesizes that age, gender, concurring autoimmune diseases, or even gut bacteria may influence patient responsiveness, but he says we know very little about these factors.\u003c/p>\n\u003cp>“I think there's a lot of fundamental questions about the immune system that we just simply don't know the answer to,” says Daud.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“And yet I do foresee a day when we use other types of treatment infrequently to treat cancer, and most cancers will be treated with immunotherapy. But we still have a long ways to go.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Most cancer patients are haunted by the same two questions:\u003c/p>\n\u003cp>\"Why me?\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'If I had been diagnosed five years prior, who knows if I would be here.'\u003c/aside>\n\u003cp>\"Why now?\"\u003c/p>\n\u003cp>Not Ashley Walton.\u003c/p>\n\u003cp>Walton, 34, actually feels lucky advanced melanoma struck when it did.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“If I had been diagnosed five years prior, who knows if I would be here,\" she says.\u003c/p>\n\u003cp>Stage 4 melanoma used to be a death sentence. The disease doesn’t respond to radiation or chemotherapy, and patients survived, on average, less than a year.\u003c/p>\n\u003cp>But over the last decade, doctors are successfully using a new approach, one significantly different than the treatment options available for the last 150 years.\u003c/p>\n\u003cp>Instead of burning or poisoning cancer cells, new medicines unleash the body's natural defenses to fight them.\u003c/p>\n\u003cp>This treatment is called immunotherapy.\u003c/p>\n\u003cfigure id=\"attachment_444546\" class=\"wp-caption aligncenter\" style=\"max-width: 1857px\">\u003cimg class=\"size-full wp-image-444546\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/09/IMG_6200-e1537470859372.jpg\" alt=\"\" width=\"1857\" height=\"1209\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372.jpg 1857w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-160x104.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-800x521.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-768x500.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-1020x664.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-1200x781.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-1180x768.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-960x625.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-240x156.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-375x244.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6200-e1537470859372-520x339.jpg 520w\" sizes=\"(max-width: 1857px) 100vw, 1857px\">\u003cfigcaption class=\"wp-caption-text\">Ashley Walton drinks fluid to prepare for magnetic resonance imaging (MRI) scan to check on the progress of her melanoma. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Beating the Odds\u003c/strong>\u003c/p>\n\u003cp>When Walton was 26, she found a mole on the back of her hip.\u003c/p>\n\u003cp>\"It started morphing into this ugly, dark, bleeding thing,\" she says, grimacing. \"I just knew something was wrong.\"\u003c/p>\n\u003cp>Doctors surgically removed her tumor. But a couple of years later, she discovered a tiny lump in her abdomen. It felt like a popcorn kernel, and within a few weeks grew to the size of a walnut.\u003c/p>\n\u003cp>A biopsy revealed she had stage 4 melanoma.\u003c/p>\n\u003cp>Walton searched online for information about the disease. She recalls the moment she discovered the average survival rate: six to nine months.\u003c/p>\n\u003cp>\"I remember sort of losing my hearing, almost losing my vision to where I felt like I was in a tunnel,\" she says.\u003c/p>\n\u003cp>But when she consulted with her oncologist, Dr. Adil Daud of UC San Francisco, he had consoling news.\u003c/p>\n\u003cp>“He told me if there's any time to have a melanoma -- right now is a pretty good time to have it -- because there's a lot of stuff opening up to you,\" she says.\u003c/p>\n\u003cp>Dr. Daud was referring to immune checkpoint inhibitors, which he says are increasing survival rates by at least threefold. These cancer drugs help the immune system do what it’s supposed to -- fight pathogens.\u003c/p>\n\u003cp>Normally the immune system recognizes disease-causing organisms. But cancer cells are unusual because they go undetected as harmful. Immune checkpoint inhibitors make them visible for attack.\u003c/p>\n\u003cfigure id=\"attachment_444547\" class=\"wp-caption aligncenter\" style=\"max-width: 1728px\">\u003cimg class=\"size-full wp-image-444547\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/09/IMG_6291-e1537471184446.jpg\" alt=\"\" width=\"1728\" height=\"1166\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446.jpg 1728w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-160x108.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-800x540.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-768x518.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-1020x688.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-1200x810.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-1180x796.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-960x648.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-240x162.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-375x253.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/09/IMG_6291-e1537471184446-520x351.jpg 520w\" sizes=\"(max-width: 1728px) 100vw, 1728px\">\u003cfigcaption class=\"wp-caption-text\">Ashley Walton and her mother in a quarterly doctor appointment at UCSF Medical Center. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cb>Treatment Earns Nobel Prize\u003c/b>\u003c/p>\n\u003cp>The Food and Drug Administration’s approval of the first immune checkpoint inhibitor in 2011 marked a breakthrough in the field.\u003c/p>\n\u003cp>The technology behind Ipilimumab, which is branded as Yervoy, was developed in a UC Berkeley lab in the 1990s, by a student named Matthew Krummel, now an immunotherapy researcher at \u003ca href=\"http://krummellab.com/\" target=\"_blank\" rel=\"noopener\">UCSF\u003c/a>.\u003c/p>\n\u003cp>“I was a very frustrated graduate student for a few years, trying to develop an antibody that would do something,\" Krummel says.\u003c/p>\n\u003cp>He wanted to influence how cells behave. After many long nights, Krummel noticed one antibody successfully manipulating the movement of immune cells.\u003c/p>\n\u003cp>“You can drive them like a car; you can accelerate them; or you can brake them,\" Krummel says. \"And then it was really like playtime.”\u003c/p>\n\u003cp>He injected the antibodies into mice with cancer. In the very first set of experiments, their tumors shrunk.\u003c/p>\n\u003cp>Earlier this month, Krummel’s thesis advisor, James Allison, won the Nobel Prize for Medicine for their lab's work on immune checkpoint inhibitors.\u003c/p>\n\u003cp>\u003cstrong>Years of Harrowing Treatments\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">'Across different tumor types, only about 20 percent of patients with cancer respond to today's immunotherapy.'\u003ccite>Dr. Adil Daud, UCSF\u003c/cite>\u003c/aside>\n\u003cp>When Walton started immunotherapy treatment, including Ipilimumab, the 90-minute drips were followed by side effects like fever, diarrhea, rash, vomiting and gastritis. This is not uncommon in immunotherapy, as the drugs can put a patient’s immune system into overdrive provoking an attack on healthy cells, tissues and organs.\u003c/p>\n\u003cp>Walton’s tumors initially shrunk, but within six months, new tumors cropped up, in her abdomen. Her oncologist then ran through the list of available drugs, moving on as each one, sometimes tried in combination, in turn failed to deliver the knockout blow.\u003c/p>\n\u003cp>“It's absolutely exhausting emotionally and physically to know that there's no option for you,” says Walton. “Those were the days when I felt like I will probably die from this, and I’ll die young.”\u003c/p>\n\u003cp>Finally, eight years later, she heard the magic word: remission. Dr. Daud isn't sure if it was the buildup of multiple immunotherapy drugs or some new combination that did the trick.\u003c/p>\n\u003cp>“There are so many advancements being made in the field of immunotherapy that even if [one] doesn't cure you, it gets you to the next big thing,” says Walton.\u003c/p>\n\u003cp>Now that she has been off immunotherapy for 10 months, Walton tentatively asked Dr. Daud something that had been her mind for a long time.\u003c/p>\n\u003cp>\"So, what do you think about pregnancy or trying to start a family?\" asked Walton.\u003c/p>\n\u003cp>\"I think this is a good time to get pregnant, actually,\" responded Dr. Daud.\u003c/p>\n\u003cp>Both doctor and patient could barely contain their glee, punctuating the question-and-answer session with happy giggles. Walton \u003cspan style=\"font-weight: 400\">crosses her fingers and smiles. \u003c/span>Throughout her treatment, doctors warned that getting pregnant would be too dangerous. But Daud now trusts her body's ability to support a child.\u003c/p>\n\u003cp>\u003cstrong>A Hopeful Future\u003c/strong>\u003c/p>\n\u003cp>Stories like Walton's are sparking a lot of excitement among oncologists.\u003c/p>\n\u003cp>\"So imagine when we’ve gone from a time when we had nothing to offer, to today, and they are talking about a cure for some patients with advanced melanoma,\" says Dr. Leonard Lichtenfeld, deputy chief medical officer for the American Cancer Society.\u003c/p>\n\u003cp>Scientists and major pharmaceutical companies are waging huge bets on immunotherapy. There are currently about 1,000 active trials to develop the next miracle drug. Lichtenfeld is optimistic, but he is also cautious about adding to the hype.\u003c/p>\n\u003cp>“We don’t know in how many cancers they are going to be effective,” he says. “And we still don’t know how to harness the maximum benefit from these drugs by, say, using them in combination with other drugs.”\u003c/p>\n\u003cp>Currently, 40 percent of advanced melanoma patients still do not respond to immunotherapy. The statistics are even worse for other cancers.\u003c/p>\n\u003cp>“It is still very common to not have immune treatment work at all,” says Dr. Daud. “Across different tumor types, only about 20 percent of patients with cancer respond to today's immunotherapy, so the numbers are much more sobering.\"\u003c/p>\n\u003cp>He hypothesizes that age, gender, concurring autoimmune diseases, or even gut bacteria may influence patient responsiveness, but he says we know very little about these factors.\u003c/p>\n\u003cp>“I think there's a lot of fundamental questions about the immune system that we just simply don't know the answer to,” says Daud.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“And yet I do foresee a day when we use other types of treatment infrequently to treat cancer, and most cancers will be treated with immunotherapy. But we still have a long ways to go.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "A Rural Community Decided To Treat Its Opioid Problem Like A Natural Disaster",
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"content": "\u003cp>When he was police chief of Stanwood, Wash., population 7,000, Ty Trenary thought rural communities like his were immune from the opioid crisis.\u003c/p>\n\u003cp>Then, one day, a mother walked through his door and said, \"Chief, you have a heroin problem in your community.\"[contextly_sidebar id=\"snF1nVDNKWV8zjCpOVtbCXhNa21X1NeR\"]\u003c/p>\n\u003cp>\"And I remember thinking, 'Well that's not possible,' \" Trenary recalls. \"This is Stanwood and heroin is in big cities with homeless populations. It's not in rural America.\"\u003c/p>\n\u003cp>But heroin addiction and abuse are not just a big city problem, as Trenary had thought. While the bulk of fatal overdoses still happen in urban areas, \u003ca href=\"https://www.cdc.gov/mmwr/volumes/66/ss/ss6619a1.htm?s_cid=ss6619a1_w\" target=\"_blank\" rel=\"noopener\">the rural overdose rate has increased \u003c/a>to slightly surpass that of cities.\u003c/p>\n\u003cp>Rural Americans say drug addiction and abuse are the most urgent health problems facing their local community, according to\u003ca href=\"https://www.npr.org/HARVARD-POLL/rural-health-poll-10-15-18-updated.pdf\" target=\"_blank\" rel=\"noopener\"> a new poll\u003c/a> by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. In the poll, 48 percent of people said opioid addiction has gotten worse in their community in the past five years.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Trenary now agrees. A few years ago, he was elected sheriff of Snohomish County and got a rude awakening. He toured the jail and found it had become a de facto detox center, full of \"very, very sick, very, very sick people,\" he says.\u003c/p>\n\u003cp>\"Detoxing from heroin is like having the worst possible stomach virus you can have. People are proned out, just suffering.\"\u003c/p>\n\u003cp>At any given time, about half the inmates were withdrawing from heroin, making for a \u003ca href=\"https://www.heraldnet.com/news/lawsuit-against-snohomish-county-focuses-on-inmates-death/\" target=\"_blank\" rel=\"noopener\">dangerous\u003c/a> and \u003ca href=\"https://komonews.com/news/local/13m-settlement-in-snohomish-county-jail-death-claim\" target=\"_blank\" rel=\"noopener\">expensive\u003c/a> situation.\u003c/p>\n\u003cp>\"It took becoming the sheriff to see the impacts inside the jail with heroin abuse, to see the impacts in the community across the entire county for me to realize that we had to change a lot about what we were doing,\" Trenary says.\u003c/p>\n\u003cp>\u003cstrong>A Disaster Response Approach\u003c/strong>\u003c/p>\n\u003cp>So they did. Snohomish County in Western Washington is taking a unique approach to tackle the problem.\u003c/p>\n\u003cp>Last year, leaders declared the opioid epidemic a life-threatening emergency. The county is now responding to the drug crisis as if it were a natural disaster, the same way it would mobilize to respond to a landslide or flu pandemic.\u003c/p>\n\u003cfigure id=\"attachment_445267\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-full wp-image-445267\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85.jpg\" alt=\"\" width=\"800\" height=\"532\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-160x106.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-768x511.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-375x249.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-520x346.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Snohomish County Sheriff Ty Trenary. He wasn't aware of the extent of the opioid epidemic in his county until he became sheriff and realized the jail had become a defacto detox center. \u003ccite>(Leah Nash/Finding Fixes podcast)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Snohomish County is the first county in the country to treat it this way.\u003c/p>\n\u003cp>The idea grew out of their experience with another tremendous disaster in the county: the massive 2014 landslide in Oso, Wash., which killed 43 people.\u003c/p>\n\u003cp>Back then, the director of communications for the sheriff's office, Shari Ireton, took reporters to see the landslide, and she ended up learning something, too.\u003c/p>\n\u003cp>\"It was amazing to see Black Hawk helicopters flying with our helicopter and a fixed wing over the top of that,\" she says. \"All in coordination with each other, all with the same objective, which is life safety.\"[contextly_sidebar id=\"EkK9yT8ARJNlHsaGPy5VTEvcCBTT8MS7\"]\u003c/p>\n\u003cp>Ireton thought, what if they used that same coordinated system, of everyone working together across government agencies, to tackle the opioid epidemic?\u003c/p>\n\u003cp>County leaders took the idea and ran with it.\u003c/p>\n\u003cp>Now, the response to the opioid epidemic is run out of a special emergency operations center, a lot like during the Oso landslide, where representatives from across local government meet every two weeks, including people in charge of everything from firetrucks to the dump.\u003c/p>\n\u003cp>The technical name for this group is the Multi-Agency Coordination group, or MAC group. It comes straight out of FEMA's emergency response playbook.\u003c/p>\n\u003cp>They talk through PowerPoint slides and rattle off numbers like 7.5 and 6.1, which refer to items on their to-do list. Seven big, overarching goals, which include reducing opioid misuse and reducing damage to the community, are broken down into manageable steps, like distributing needle cleanup kits and a project to train schoolteachers to recognize trauma and addiction.\u003c/p>\n\u003cp>This to-do list is over 100 items long.\u003c/p>\n\u003cp>\"Some of these goals are really long term,\" Ireton says. \"I mean they're going to take years, decades.\"[contextly_sidebar id=\"4DNOyEVwXKrhJsxImwngLjd8ofHh3LVo\"]\u003c/p>\n\u003cp>The key is to be realistic, says Ireton, who is also the spokesperson for this group. You are never going to be successful if your goal is just \"end the opioid epidemic,\" she says.\u003c/p>\n\u003cp>\"By breaking it down, it's like eating an elephant. You just can eat one piece at a time. Breaking it down into a piece that you can actually digest.\" Ireton says.\u003c/p>\n\u003cp>The county's program includes small steps, like making transportation easier for people in drug treatment. They train family members and others in the community on steps to reverse overdoses with medicine, and they send teams of police officers and social workers to help addicted homeless people.[contextly_sidebar id=\"tgGunyxLm8dgF9b7x7IdKyEh7K66M6ez\"]\u003c/p>\n\u003cp>In Marysville, Wash., the woods are full of homeless encampments surrounded by piles of spent syringes and trash. On a recent visit, rain drips through a cedar forest next to a strip mall. Officer Mike Buell is visiting the camp along with social worker Lauren Rainbow. Buell cracks jokes with some illegal campers and introduces himself using his first name.\u003c/p>\n\u003cp>Buell's job isn't to arrest the campers, but to help them get drug treatment and housing. He crouches next to the opening of one tent and explains that he and his colleagues will help the campers with food, coffee and transportation to and from appointments.\u003c/p>\n\u003cp>\"We're basically your Uber,\" Buell says.\u003c/p>\n\u003cp>The new approach is paying off. The teams have helped hundreds of people find housing and drug treatment.\u003c/p>\n\u003cp>That's just one item in the county's plan, and problems with opioids are far from solved here.\u003c/p>\n\u003cp>Snohomish County will keep working on its large and small goals, one bite at a time.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was reported by \u003c/em>\u003ca href=\"https://www.findingfixes.com/\" target=\"_blank\" rel=\"noopener\">\u003cem>Finding Fixes\u003c/em>\u003c/a>\u003cem>, a podcast about solutions to the opioid epidemic, which is a project of \u003c/em>\u003ca href=\"http://www.invw.org/\" target=\"_blank\" rel=\"noopener\">\u003cem>InvestigateWest\u003c/em>\u003c/a>\u003cem>. \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=A+Rural+Community+Decided+To+Treat+Its+Opioid+Problem+Like+A+Natural+Disaster&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When he was police chief of Stanwood, Wash., population 7,000, Ty Trenary thought rural communities like his were immune from the opioid crisis.\u003c/p>\n\u003cp>Then, one day, a mother walked through his door and said, \"Chief, you have a heroin problem in your community.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"And I remember thinking, 'Well that's not possible,' \" Trenary recalls. \"This is Stanwood and heroin is in big cities with homeless populations. It's not in rural America.\"\u003c/p>\n\u003cp>But heroin addiction and abuse are not just a big city problem, as Trenary had thought. While the bulk of fatal overdoses still happen in urban areas, \u003ca href=\"https://www.cdc.gov/mmwr/volumes/66/ss/ss6619a1.htm?s_cid=ss6619a1_w\" target=\"_blank\" rel=\"noopener\">the rural overdose rate has increased \u003c/a>to slightly surpass that of cities.\u003c/p>\n\u003cp>Rural Americans say drug addiction and abuse are the most urgent health problems facing their local community, according to\u003ca href=\"https://www.npr.org/HARVARD-POLL/rural-health-poll-10-15-18-updated.pdf\" target=\"_blank\" rel=\"noopener\"> a new poll\u003c/a> by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. In the poll, 48 percent of people said opioid addiction has gotten worse in their community in the past five years.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Trenary now agrees. A few years ago, he was elected sheriff of Snohomish County and got a rude awakening. He toured the jail and found it had become a de facto detox center, full of \"very, very sick, very, very sick people,\" he says.\u003c/p>\n\u003cp>\"Detoxing from heroin is like having the worst possible stomach virus you can have. People are proned out, just suffering.\"\u003c/p>\n\u003cp>At any given time, about half the inmates were withdrawing from heroin, making for a \u003ca href=\"https://www.heraldnet.com/news/lawsuit-against-snohomish-county-focuses-on-inmates-death/\" target=\"_blank\" rel=\"noopener\">dangerous\u003c/a> and \u003ca href=\"https://komonews.com/news/local/13m-settlement-in-snohomish-county-jail-death-claim\" target=\"_blank\" rel=\"noopener\">expensive\u003c/a> situation.\u003c/p>\n\u003cp>\"It took becoming the sheriff to see the impacts inside the jail with heroin abuse, to see the impacts in the community across the entire county for me to realize that we had to change a lot about what we were doing,\" Trenary says.\u003c/p>\n\u003cp>\u003cstrong>A Disaster Response Approach\u003c/strong>\u003c/p>\n\u003cp>So they did. Snohomish County in Western Washington is taking a unique approach to tackle the problem.\u003c/p>\n\u003cp>Last year, leaders declared the opioid epidemic a life-threatening emergency. The county is now responding to the drug crisis as if it were a natural disaster, the same way it would mobilize to respond to a landslide or flu pandemic.\u003c/p>\n\u003cfigure id=\"attachment_445267\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-full wp-image-445267\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85.jpg\" alt=\"\" width=\"800\" height=\"532\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-160x106.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-768x511.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-375x249.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/10/20180823_ff_105_custom-37d326f563ec4055bd7d38d350065ee12644fc95-s800-c85-520x346.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Snohomish County Sheriff Ty Trenary. He wasn't aware of the extent of the opioid epidemic in his county until he became sheriff and realized the jail had become a defacto detox center. \u003ccite>(Leah Nash/Finding Fixes podcast)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Snohomish County is the first county in the country to treat it this way.\u003c/p>\n\u003cp>The idea grew out of their experience with another tremendous disaster in the county: the massive 2014 landslide in Oso, Wash., which killed 43 people.\u003c/p>\n\u003cp>Back then, the director of communications for the sheriff's office, Shari Ireton, took reporters to see the landslide, and she ended up learning something, too.\u003c/p>\n\u003cp>\"It was amazing to see Black Hawk helicopters flying with our helicopter and a fixed wing over the top of that,\" she says. \"All in coordination with each other, all with the same objective, which is life safety.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Ireton thought, what if they used that same coordinated system, of everyone working together across government agencies, to tackle the opioid epidemic?\u003c/p>\n\u003cp>County leaders took the idea and ran with it.\u003c/p>\n\u003cp>Now, the response to the opioid epidemic is run out of a special emergency operations center, a lot like during the Oso landslide, where representatives from across local government meet every two weeks, including people in charge of everything from firetrucks to the dump.\u003c/p>\n\u003cp>The technical name for this group is the Multi-Agency Coordination group, or MAC group. It comes straight out of FEMA's emergency response playbook.\u003c/p>\n\u003cp>They talk through PowerPoint slides and rattle off numbers like 7.5 and 6.1, which refer to items on their to-do list. Seven big, overarching goals, which include reducing opioid misuse and reducing damage to the community, are broken down into manageable steps, like distributing needle cleanup kits and a project to train schoolteachers to recognize trauma and addiction.\u003c/p>\n\u003cp>This to-do list is over 100 items long.\u003c/p>\n\u003cp>\"Some of these goals are really long term,\" Ireton says. \"I mean they're going to take years, decades.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The key is to be realistic, says Ireton, who is also the spokesperson for this group. You are never going to be successful if your goal is just \"end the opioid epidemic,\" she says.\u003c/p>\n\u003cp>\"By breaking it down, it's like eating an elephant. You just can eat one piece at a time. Breaking it down into a piece that you can actually digest.\" Ireton says.\u003c/p>\n\u003cp>The county's program includes small steps, like making transportation easier for people in drug treatment. They train family members and others in the community on steps to reverse overdoses with medicine, and they send teams of police officers and social workers to help addicted homeless people.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In Marysville, Wash., the woods are full of homeless encampments surrounded by piles of spent syringes and trash. On a recent visit, rain drips through a cedar forest next to a strip mall. Officer Mike Buell is visiting the camp along with social worker Lauren Rainbow. Buell cracks jokes with some illegal campers and introduces himself using his first name.\u003c/p>\n\u003cp>Buell's job isn't to arrest the campers, but to help them get drug treatment and housing. He crouches next to the opening of one tent and explains that he and his colleagues will help the campers with food, coffee and transportation to and from appointments.\u003c/p>\n\u003cp>\"We're basically your Uber,\" Buell says.\u003c/p>\n\u003cp>The new approach is paying off. The teams have helped hundreds of people find housing and drug treatment.\u003c/p>\n\u003cp>That's just one item in the county's plan, and problems with opioids are far from solved here.\u003c/p>\n\u003cp>Snohomish County will keep working on its large and small goals, one bite at a time.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was reported by \u003c/em>\u003ca href=\"https://www.findingfixes.com/\" target=\"_blank\" rel=\"noopener\">\u003cem>Finding Fixes\u003c/em>\u003c/a>\u003cem>, a podcast about solutions to the opioid epidemic, which is a project of \u003c/em>\u003ca href=\"http://www.invw.org/\" target=\"_blank\" rel=\"noopener\">\u003cem>InvestigateWest\u003c/em>\u003c/a>\u003cem>. \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=A+Rural+Community+Decided+To+Treat+Its+Opioid+Problem+Like+A+Natural+Disaster&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp class=\"danger-zone\">Minneapolis hospital tested powerful antipsychotics and the potent anesthetic \u003ca href=\"https://www.statnews.com/2018/09/24/ketamine-clinics-severe-depression-treatment/\">ketamine\u003c/a> on emergency room patients without their knowledge or consent, violating regulations on human research, federal inspectors have determined.\u003c/p>\n\u003cp class=\"danger-zone\">Based on those findings\u003cstrong>,\u003c/strong> a health watchdog group on Monday urged federal regulators to suspend all clinical trials at the hospital. In a \u003ca href=\"https://www.citizen.org/our-work/health-and-safety/second-follow-letter-fda-and-ohrp-regarding-unethical-high-risk-clinical-trials-tested-ketamine-management\" target=\"_blank\" rel=\"noopener\">letter\u003c/a> to the Food and Drug Administration and the Department of Health and Human Services office that protects human research subjects, Public Citizen also called for regulators to immediately launch an investigation into the conduct and oversight of the studies and “impose severe sanctions for the serious ethical and regulatory lapses that have occurred in the ketamine clinical trials and other studies” at Minneapolis’s Hennepin County Medical Center.[contextly_sidebar id=\"VBSQOWNGkwEDBdz8APDok0lptMEsHZ3N\"]\u003c/p>\n\u003cp class=\"danger-zone\">The hospital committee that green-lighted the studies, called an institutional review board (IRB), “appears incapable of doing its job,” said Dr. Michael Carome, director of Public Citizen’s Health Research Group, who organized the letter. It acted unethically and placed patients in danger, he said, “including by waiving the requirement for informed consent in situations where that is not allowed.”\u003c/p>\n\u003cp>A hospital spokesperson said the findings by inspectors from the FDA “are neither formal nor conclusory.” Hennepin “has provided formal written responses to each” of the inspectors’ findings, she said, adding that the hospital “has undertaken several reviews by independent experts to evaluate its research and emergency medical practices with the intent to improve our processes. …We understand our mission includes providing the highest standards of medical care, and also conducting studies that help to continuously improve the health and wellness of our patients.”\u003c/p>\n\u003cp>Among other violations identified by FDA inspectors, the IRB ruled that researchers did not need consent to make patients part of a clinical trial in which they were given antipsychotic drugs that they might not receive as part of usual care. The Public Citizen letter said the IRB, which is legally obligated to protect research participants, “appears to lack even a basic understanding of federal regulations for the protection of human subjects and is clearly incapable of fulfilling its obligation” to do so.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In July, Public Citizen and 64 bioethicists, physicians, and other scholars submitted a complaint about two of Hennepin’s ketamine studies to the FDA and HHS’s Office of Human Research Protections. In August, FDA sent inspectors to the hospital.\u003c/p>\n\u003cp>Their report, obtained by Public Citizen through a public records request and shared with STAT, examined additional clinical trials beyond those initially flagged. It found that in four, the hospital IRB “did not determine that informed consent would be sought from each prospective subject” as required by law, while in another five, the IRB granted fast-track review to studies that didn’t qualify for it.\u003c/p>\n\u003cp>At least three of the studies cited by the FDA inspectors involved people brought to the emergency room with “severe” agitation, as assessed by emergency technicians using criteria developed by the researchers. The study leaders apparently persuaded the IRB that such patients could not provide informed consent, and so could be swept into the trial unknowingly.[contextly_sidebar id=\"OXR63kbgFz9mq4tqZdVi1Hy2Rk2yuUa7\"]\u003c/p>\n\u003cp>In fact, such patients are considered “vulnerable,” said bioethicist Leigh Turner of the University of Minnesota, who signed the Public Citizen letter. According to federal law, they are supposed to receive special safeguards, such as having a family member or other representative give or decline consent. That did not happen.\u003c/p>\n\u003cp>Just as concerning, Turner said, it’s not clear that the patients were in fact too agitated to be asked for their consent, as the scientists argued to the IRB. According to the evaluation form’s scoring, “it’s not like they had acute psychosis,” Turner said. “These investigators were basically drugging up individuals with a degree of agitation many of us could experience, like after being pulled over for speeding.”\u003c/p>\n\u003cp>In the first study cited by the FDA inspectors, researchers injected either ketamine or haloperidol into people taken to the ER, to reduce their “agitation.” Ketamine is not approved by the FDA for that use. The unwitting participants were treated not according to clinicians’ best judgment but according to the study’s protocol: Those arriving during certain months got ketamine and those arriving in other months got haloperidol.\u003c/p>\n\u003cp>Among the trial’s \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/27102743\" target=\"_blank\" rel=\"noopener\">results\u003c/a> was that some patients given ketamine suffered breathing problems; 39 percent required intubation, compared to 4 percent given haloperidol. Before the trial began, its leaders had warned in a 2013 \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23231451\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> that ketamine can impair breathing and so should be reserved for only the most severely agitated patients.\u003c/p>\n\u003cp>The identities of five of the seven studies the FDA report flagged are redacted, but one corresponds to the second ketamine \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03554915\" target=\"_blank\" rel=\"noopener\">clinical trial\u003c/a> questioned in Public Citizen’s letter. It compared ketamine to midazolam, also in “agitated” ER patients given one or the other drug essentially randomly, not according to which — if any — might help them. The study was suspended by the medical center in June, for unclear reasons, but it also failed to obtain informed consent from participants, the FDA inspectors found.[contextly_sidebar id=\"VDuCmh6PY0M6Ga88zjfyN4sUMUCXdtg4\"]\u003c/p>\n\u003cp>A third clinical \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03211897?term=hennepin+AND+agitation&rank=1\" target=\"_blank\" rel=\"noopener\">trial\u003c/a> compared the safety and efficacy of four drugs (the antipsychotics olanzapine, haloperidol, and ziprasidone and the sedative midazolam) in agitated patients. The hospital scientists had initially requested an FDA waiver from the informed consent requirement. FDA denied the request. The scientists then requested IRB approval, calling their study observational (meaning patients would be treated according to their doctors’ best judgment rather than receiving drugs as per the trial protocol) and therefore entitled to “expedited review.” The IRB agreed, including giving the okay to forgo consent.\u003c/p>\n\u003cp>In fact the study was not observational: Patients received one of the four drugs based on when they arrived in the ER. They were not informed of this, and so were unwitting participants, the FDA inspectors found.\u003c/p>\n\u003cp>“When the investigators didn’t get FDA clearance, they did an end-run around the agency,” Turner said. “They claimed it was no longer the randomized controlled trial they’d planned, and then pushed it through the IRB as a waiver-of-consent study,” a strategy he called “dodgy.”\u003c/p>\n\u003cp>The FDA inspectors found that “some or all of the subjects [in four studies] were likely to be vulnerable to coercion or undue influence,” yet the IRB did not require the researchers to do anything to safeguard the participants’ safety.\u003c/p>\n\u003cp>In addition to asking HHS to suspend all clinical trials at Hennepin unless doing so would harm participants, Public Citizen called it “imperative” that the hospital disband its current IRB and train a new one, retrain researchers involved in human research, and inform the unwitting participants in past trials of steps “to redress these violations.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/29/er-patients-given-ketamine-powerful-drugs-without-consent/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"danger-zone\">Minneapolis hospital tested powerful antipsychotics and the potent anesthetic \u003ca href=\"https://www.statnews.com/2018/09/24/ketamine-clinics-severe-depression-treatment/\">ketamine\u003c/a> on emergency room patients without their knowledge or consent, violating regulations on human research, federal inspectors have determined.\u003c/p>\n\u003cp class=\"danger-zone\">Based on those findings\u003cstrong>,\u003c/strong> a health watchdog group on Monday urged federal regulators to suspend all clinical trials at the hospital. In a \u003ca href=\"https://www.citizen.org/our-work/health-and-safety/second-follow-letter-fda-and-ohrp-regarding-unethical-high-risk-clinical-trials-tested-ketamine-management\" target=\"_blank\" rel=\"noopener\">letter\u003c/a> to the Food and Drug Administration and the Department of Health and Human Services office that protects human research subjects, Public Citizen also called for regulators to immediately launch an investigation into the conduct and oversight of the studies and “impose severe sanctions for the serious ethical and regulatory lapses that have occurred in the ketamine clinical trials and other studies” at Minneapolis’s Hennepin County Medical Center.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp class=\"danger-zone\">The hospital committee that green-lighted the studies, called an institutional review board (IRB), “appears incapable of doing its job,” said Dr. Michael Carome, director of Public Citizen’s Health Research Group, who organized the letter. It acted unethically and placed patients in danger, he said, “including by waiving the requirement for informed consent in situations where that is not allowed.”\u003c/p>\n\u003cp>A hospital spokesperson said the findings by inspectors from the FDA “are neither formal nor conclusory.” Hennepin “has provided formal written responses to each” of the inspectors’ findings, she said, adding that the hospital “has undertaken several reviews by independent experts to evaluate its research and emergency medical practices with the intent to improve our processes. …We understand our mission includes providing the highest standards of medical care, and also conducting studies that help to continuously improve the health and wellness of our patients.”\u003c/p>\n\u003cp>Among other violations identified by FDA inspectors, the IRB ruled that researchers did not need consent to make patients part of a clinical trial in which they were given antipsychotic drugs that they might not receive as part of usual care. The Public Citizen letter said the IRB, which is legally obligated to protect research participants, “appears to lack even a basic understanding of federal regulations for the protection of human subjects and is clearly incapable of fulfilling its obligation” to do so.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In July, Public Citizen and 64 bioethicists, physicians, and other scholars submitted a complaint about two of Hennepin’s ketamine studies to the FDA and HHS’s Office of Human Research Protections. In August, FDA sent inspectors to the hospital.\u003c/p>\n\u003cp>Their report, obtained by Public Citizen through a public records request and shared with STAT, examined additional clinical trials beyond those initially flagged. It found that in four, the hospital IRB “did not determine that informed consent would be sought from each prospective subject” as required by law, while in another five, the IRB granted fast-track review to studies that didn’t qualify for it.\u003c/p>\n\u003cp>At least three of the studies cited by the FDA inspectors involved people brought to the emergency room with “severe” agitation, as assessed by emergency technicians using criteria developed by the researchers. The study leaders apparently persuaded the IRB that such patients could not provide informed consent, and so could be swept into the trial unknowingly.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In fact, such patients are considered “vulnerable,” said bioethicist Leigh Turner of the University of Minnesota, who signed the Public Citizen letter. According to federal law, they are supposed to receive special safeguards, such as having a family member or other representative give or decline consent. That did not happen.\u003c/p>\n\u003cp>Just as concerning, Turner said, it’s not clear that the patients were in fact too agitated to be asked for their consent, as the scientists argued to the IRB. According to the evaluation form’s scoring, “it’s not like they had acute psychosis,” Turner said. “These investigators were basically drugging up individuals with a degree of agitation many of us could experience, like after being pulled over for speeding.”\u003c/p>\n\u003cp>In the first study cited by the FDA inspectors, researchers injected either ketamine or haloperidol into people taken to the ER, to reduce their “agitation.” Ketamine is not approved by the FDA for that use. The unwitting participants were treated not according to clinicians’ best judgment but according to the study’s protocol: Those arriving during certain months got ketamine and those arriving in other months got haloperidol.\u003c/p>\n\u003cp>Among the trial’s \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/27102743\" target=\"_blank\" rel=\"noopener\">results\u003c/a> was that some patients given ketamine suffered breathing problems; 39 percent required intubation, compared to 4 percent given haloperidol. Before the trial began, its leaders had warned in a 2013 \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23231451\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> that ketamine can impair breathing and so should be reserved for only the most severely agitated patients.\u003c/p>\n\u003cp>The identities of five of the seven studies the FDA report flagged are redacted, but one corresponds to the second ketamine \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03554915\" target=\"_blank\" rel=\"noopener\">clinical trial\u003c/a> questioned in Public Citizen’s letter. It compared ketamine to midazolam, also in “agitated” ER patients given one or the other drug essentially randomly, not according to which — if any — might help them. The study was suspended by the medical center in June, for unclear reasons, but it also failed to obtain informed consent from participants, the FDA inspectors found.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>A third clinical \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03211897?term=hennepin+AND+agitation&rank=1\" target=\"_blank\" rel=\"noopener\">trial\u003c/a> compared the safety and efficacy of four drugs (the antipsychotics olanzapine, haloperidol, and ziprasidone and the sedative midazolam) in agitated patients. The hospital scientists had initially requested an FDA waiver from the informed consent requirement. FDA denied the request. The scientists then requested IRB approval, calling their study observational (meaning patients would be treated according to their doctors’ best judgment rather than receiving drugs as per the trial protocol) and therefore entitled to “expedited review.” The IRB agreed, including giving the okay to forgo consent.\u003c/p>\n\u003cp>In fact the study was not observational: Patients received one of the four drugs based on when they arrived in the ER. They were not informed of this, and so were unwitting participants, the FDA inspectors found.\u003c/p>\n\u003cp>“When the investigators didn’t get FDA clearance, they did an end-run around the agency,” Turner said. “They claimed it was no longer the randomized controlled trial they’d planned, and then pushed it through the IRB as a waiver-of-consent study,” a strategy he called “dodgy.”\u003c/p>\n\u003cp>The FDA inspectors found that “some or all of the subjects [in four studies] were likely to be vulnerable to coercion or undue influence,” yet the IRB did not require the researchers to do anything to safeguard the participants’ safety.\u003c/p>\n\u003cp>In addition to asking HHS to suspend all clinical trials at Hennepin unless doing so would harm participants, Public Citizen called it “imperative” that the hospital disband its current IRB and train a new one, retrain researchers involved in human research, and inform the unwitting participants in past trials of steps “to redress these violations.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/29/er-patients-given-ketamine-powerful-drugs-without-consent/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Sex and Gender Memo by Trump Administration Is Wrong on All Counts, Say Experts",
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"content": "\u003cp>Lately we've been noting the reality-bending statements made by President Trump and those in his administration on matters of the environment. \u003ca href=\"https://www.kqed.org/science/1929060/trumps-confusing-tweets-on-california-fires-now-appear-to-be-actual-policy\" target=\"_blank\" rel=\"noopener\">Fire\u003c/a>, \u003ca href=\"https://www.kqed.org/science/1928770/no-president-trump-calif-isnt-diverting-its-water-supply-away-from-wildfires\" target=\"_blank\" rel=\"noopener\">water\u003c/a>, \u003ca href=\"https://www.kqed.org/science/1929627/interior-secretary-ryan-zinke-says-california-fires-have-nothing-to-do-with-climate-change-hes-wrong\" target=\"_blank\" rel=\"noopener\">earth\u003c/a>, \u003ca href=\"http://www.sciencemag.org/news/2018/08/trump-s-effort-roll-back-auto-efficiency-rules-could-hinge-debate-over-safety\" target=\"_blank\" rel=\"noopener\">air\u003c/a> — you might say that for science journalists, fact-checking this presidency is now elemental.\u003c/p>\n\u003caside class=\"pullquote alignright\">'For decades, researchers have recognized that gender is not necessarily determined by a person’s biological sex assigned at birth, which can be physiologically uncertain in some cases.'\u003ccite>American Psychological Association\u003c/cite>\u003c/aside>\n\u003cp>Now comes a \u003ca href=\"https://www.nytimes.com/2018/10/21/us/politics/transgender-trump-administration-sex-definition.html\" target=\"_blank\" rel=\"noopener\">New York Times report\u003c/a> that the administration is wading into a new area: the complex interplay between biology and gender. On Sunday the paper said that the Dept. of Health and Human Services wants to establish a definition of a person's gender, one that is determined “on a biological basis that is clear, grounded in science, objective and administrable,” as the paper quoted an HHS memo.\u003c/p>\n\u003cp>“Sex means a person’s status as male or female based on immutable biological traits identifiable by or before birth,” the memo said. “The sex listed on a person’s birth certificate, as originally issued, shall constitute definitive proof of a person’s sex unless rebutted by reliable genetic evidence.”\u003c/p>\n\u003cp>In other words, your genitals at birth determine your gender. End of discussion.\u003c/p>\n\u003cp>The move aims to reverse civil rights protections granted to transgender people under the Obama administration, the Times said.\u003c/p>\n\u003cp>But it would also appear to create an official position by the United States government that transgender people simply don't, well, exist.\u003c/p>\n\u003cp>And that is going to be news to the roughly \u003ca href=\"http://williamsinstitute.law.ucla.edu/wp-content/uploads/How-Many-Adults-Identify-as-Transgender-in-the-United-States.pdf\" target=\"_blank\" rel=\"noopener\">1.4 million transgender individuals\u003c/a> in the country.\u003c/p>\n\u003cp>The American Psychological Association wasted no time in issuing a response to the report. On Monday, it said in a \u003ca href=\"https://www.apa.org/news/press/releases/2018/10/erase-transgender-definition.aspx\" target=\"_blank\" rel=\"noopener\">statement\u003c/a>:\u003c/p>\n\u003cp>“For decades, researchers have recognized that gender is not necessarily determined by a person’s biological sex assigned at birth, which can be physiologically uncertain in some cases. Purposely ignoring this body of evidence is indefensible and certain to add to the stress and discrimination already experienced by transgender people.”\u003c/p>\n\u003cp>Dr. Stephen Rosenthal, a pediatric endocrinologist and the medical director of UCSF's Child and Adolescent Gender Center, agrees.\u003c/p>\n\u003cp class=\"p1\">\"A\u003cspan class=\"s1\"> typical transgender person has genitalia that are not in any way obviously abnormal,\" he said. \"And not in any way a clue that that person is going to end up transgender.\"\u003c/span>\u003c/p>\n\u003cp>Genitalia, he said, does not always predict gender identity, and other physical characteristics most likely contribute to people's fundamental sense of whether they are male, female or some variant. Rosenthal cited a number of studies showing \u003cspan class=\"s1\">certain parts of the brain, shaped differently in men and women, that are more closely aligned with the gender identity of transgender individuals than with their natal sex. \u003c/span>\u003c/p>\n\u003cp>Other research suggests that \u003ca href=\"https://www.kqed.org/futureofyou/the-biological-roots-of-gender-identity\" target=\"_blank\" rel=\"noopener\">genetic and endocrinological differences \u003c/a>in transgender people play a role in forming a gender identity that is different than their external sexual characteristics might indicate.\u003c/p>\n\u003cp>The HHS memo's proposition that genetic testing would clear up any dispute around a person's gender is also wrongheaded, said Rosenthal.\u003c/p>\n\u003cp>\"A\u003cspan class=\"s1\">nyone, even high school students, know that there are plenty of examples of women with female bodies, female genitalia, let's say, and an unequivocal female gender identity, who happen to have XY chromosomes,\" he said, referring to the chromosomal pair typically found in males.\u003c/span>\u003c/p>\n\u003cp>The HHS memo would also seem to ignore intersex people — those individuals born with a mix of physical characteristics typically found in only males or females. A \u003ca href=\"http://www.academia.edu/21132481/How_sexually_dimorphic_are_we_Review_and_synthesis\" target=\"_blank\" rel=\"noopener\">2000 review\u003c/a> of the scientific literature by Brown University researchers looked at these deviations from the norm in people born from 1955 on. The survey took into account \u003cspan class=\"a\">chromosomes, gonadal structure, hormone lev\u003c/span>\u003cspan class=\"a\">els, internal genital structure and external geni\u003c/span>\u003cspan class=\"a\">tal\u003cspan class=\"l6\">ia, finding that as many as 2 percent of newborns contain some biological trait normally associated with the opposite sex. \u003c/span>\u003c/span>\u003c/p>\n\u003cp>One of the researchers, the biologist Ann Fausto Sterling, put it this way in a seminal 1993 \u003ca href=\"https://www.researchgate.net/profile/Anne_Fausto-Sterling/publication/239657377_The_Five_Sexes_Why_Male_and_Female_are_not_Enough/links/00b7d525802a725b6b000000/The-Five-Sexes-Why-Male-and-Female-are-not-Enough.pdf\" target=\"_blank\" rel=\"noopener\">essay\u003c/a>:\u003c/p>\n\u003cp>\u003cstrong>\"\u003c/strong>If the state and the legal system have an interest in maintaining a two-party sexual system, they are in defiance of nature. For biologically speaking, there are many gradations running from female to male; and depending on how one calls the shots, one can argue that along that spectrum lie at least five sexes — and perhaps even more.\"\u003c/p>\n\u003cp>Last year, \u003ca href=\"https://www.scientificamerican.com/article/the-new-science-of-sex-and-gender/?fbclid=IwAR01v8tv0iW4E7ve5UEXi-9SrR2ltvAzQBS9PoREKCXREKChBMp-62KoKDU\" target=\"_blank\" rel=\"noopener\">Scientific American\u003c/a> took note of the mounting evidence of a male-female biological spectrum. \"To varying extents, many of us are biological hybrids on a male-female continuum,\" wrote the editors. \"As science looks more closely ... it becomes increasingly clear that a pair of chromosomes do not always suffice to distinguish girl/boy — either from the standpoint of sex (biological traits) or of gender (social identity).\"\u003c/p>\n\u003cp>\u003cstrong>Gender Identity: Biopsychosocial\u003c/strong>\u003c/p>\n\u003cp>California, of course, has moved beyond tying individuals' biological sexual characteristics to their gender identity. Last year, the state made it easier to officially change genders and \u003ca href=\"https://www.kqed.org/futureofyou/436110/california-third-gender-nonbinary\" target=\"_blank\" rel=\"noopener\">added a new category\u003c/a> called \"\u003ca href=\"https://www.kqed.org/futureofyou/335790/boy-girl-both-neither-a-new-generation-overthrows-gender\" target=\"_blank\" rel=\"noopener\">nonbinary\u003c/a>\" to the \"male\" and \"female\" options.\u003c/p>\n\u003cp>Researchers often describe the roots of gender identity as a complex mix of factors that are \"biopsychosocial.\" Surveys in recent years have revealed younger generations as accepting of more customizable views of gender, with some individuals even eschewing the pronouns \"he\" and \"she\" in favor of \"they\" to indicate the duality or fluidity of their identity.\u003c/p>\n\u003cp>Charlotte Tate, a gender researcher at San Francisco State University, said it's time to move on from debates like the one the Trump administration is trying to foster.\u003c/p>\n\u003cp>\"Historically, science about gender has contained lots of errors that needed to be corrected or discarded,\" she wrote in an email. \"Pretending that gender identity can be reduced to a person’s genitals is one of those errors that we needed to discard in order to move forward in a way that is scientifically productive.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Lately we've been noting the reality-bending statements made by President Trump and those in his administration on matters of the environment. \u003ca href=\"https://www.kqed.org/science/1929060/trumps-confusing-tweets-on-california-fires-now-appear-to-be-actual-policy\" target=\"_blank\" rel=\"noopener\">Fire\u003c/a>, \u003ca href=\"https://www.kqed.org/science/1928770/no-president-trump-calif-isnt-diverting-its-water-supply-away-from-wildfires\" target=\"_blank\" rel=\"noopener\">water\u003c/a>, \u003ca href=\"https://www.kqed.org/science/1929627/interior-secretary-ryan-zinke-says-california-fires-have-nothing-to-do-with-climate-change-hes-wrong\" target=\"_blank\" rel=\"noopener\">earth\u003c/a>, \u003ca href=\"http://www.sciencemag.org/news/2018/08/trump-s-effort-roll-back-auto-efficiency-rules-could-hinge-debate-over-safety\" target=\"_blank\" rel=\"noopener\">air\u003c/a> — you might say that for science journalists, fact-checking this presidency is now elemental.\u003c/p>\n\u003caside class=\"pullquote alignright\">'For decades, researchers have recognized that gender is not necessarily determined by a person’s biological sex assigned at birth, which can be physiologically uncertain in some cases.'\u003ccite>American Psychological Association\u003c/cite>\u003c/aside>\n\u003cp>Now comes a \u003ca href=\"https://www.nytimes.com/2018/10/21/us/politics/transgender-trump-administration-sex-definition.html\" target=\"_blank\" rel=\"noopener\">New York Times report\u003c/a> that the administration is wading into a new area: the complex interplay between biology and gender. On Sunday the paper said that the Dept. of Health and Human Services wants to establish a definition of a person's gender, one that is determined “on a biological basis that is clear, grounded in science, objective and administrable,” as the paper quoted an HHS memo.\u003c/p>\n\u003cp>“Sex means a person’s status as male or female based on immutable biological traits identifiable by or before birth,” the memo said. “The sex listed on a person’s birth certificate, as originally issued, shall constitute definitive proof of a person’s sex unless rebutted by reliable genetic evidence.”\u003c/p>\n\u003cp>In other words, your genitals at birth determine your gender. End of discussion.\u003c/p>\n\u003cp>The move aims to reverse civil rights protections granted to transgender people under the Obama administration, the Times said.\u003c/p>\n\u003cp>But it would also appear to create an official position by the United States government that transgender people simply don't, well, exist.\u003c/p>\n\u003cp>And that is going to be news to the roughly \u003ca href=\"http://williamsinstitute.law.ucla.edu/wp-content/uploads/How-Many-Adults-Identify-as-Transgender-in-the-United-States.pdf\" target=\"_blank\" rel=\"noopener\">1.4 million transgender individuals\u003c/a> in the country.\u003c/p>\n\u003cp>The American Psychological Association wasted no time in issuing a response to the report. On Monday, it said in a \u003ca href=\"https://www.apa.org/news/press/releases/2018/10/erase-transgender-definition.aspx\" target=\"_blank\" rel=\"noopener\">statement\u003c/a>:\u003c/p>\n\u003cp>“For decades, researchers have recognized that gender is not necessarily determined by a person’s biological sex assigned at birth, which can be physiologically uncertain in some cases. Purposely ignoring this body of evidence is indefensible and certain to add to the stress and discrimination already experienced by transgender people.”\u003c/p>\n\u003cp>Dr. Stephen Rosenthal, a pediatric endocrinologist and the medical director of UCSF's Child and Adolescent Gender Center, agrees.\u003c/p>\n\u003cp class=\"p1\">\"A\u003cspan class=\"s1\"> typical transgender person has genitalia that are not in any way obviously abnormal,\" he said. \"And not in any way a clue that that person is going to end up transgender.\"\u003c/span>\u003c/p>\n\u003cp>Genitalia, he said, does not always predict gender identity, and other physical characteristics most likely contribute to people's fundamental sense of whether they are male, female or some variant. Rosenthal cited a number of studies showing \u003cspan class=\"s1\">certain parts of the brain, shaped differently in men and women, that are more closely aligned with the gender identity of transgender individuals than with their natal sex. \u003c/span>\u003c/p>\n\u003cp>Other research suggests that \u003ca href=\"https://www.kqed.org/futureofyou/the-biological-roots-of-gender-identity\" target=\"_blank\" rel=\"noopener\">genetic and endocrinological differences \u003c/a>in transgender people play a role in forming a gender identity that is different than their external sexual characteristics might indicate.\u003c/p>\n\u003cp>The HHS memo's proposition that genetic testing would clear up any dispute around a person's gender is also wrongheaded, said Rosenthal.\u003c/p>\n\u003cp>\"A\u003cspan class=\"s1\">nyone, even high school students, know that there are plenty of examples of women with female bodies, female genitalia, let's say, and an unequivocal female gender identity, who happen to have XY chromosomes,\" he said, referring to the chromosomal pair typically found in males.\u003c/span>\u003c/p>\n\u003cp>The HHS memo would also seem to ignore intersex people — those individuals born with a mix of physical characteristics typically found in only males or females. A \u003ca href=\"http://www.academia.edu/21132481/How_sexually_dimorphic_are_we_Review_and_synthesis\" target=\"_blank\" rel=\"noopener\">2000 review\u003c/a> of the scientific literature by Brown University researchers looked at these deviations from the norm in people born from 1955 on. The survey took into account \u003cspan class=\"a\">chromosomes, gonadal structure, hormone lev\u003c/span>\u003cspan class=\"a\">els, internal genital structure and external geni\u003c/span>\u003cspan class=\"a\">tal\u003cspan class=\"l6\">ia, finding that as many as 2 percent of newborns contain some biological trait normally associated with the opposite sex. \u003c/span>\u003c/span>\u003c/p>\n\u003cp>One of the researchers, the biologist Ann Fausto Sterling, put it this way in a seminal 1993 \u003ca href=\"https://www.researchgate.net/profile/Anne_Fausto-Sterling/publication/239657377_The_Five_Sexes_Why_Male_and_Female_are_not_Enough/links/00b7d525802a725b6b000000/The-Five-Sexes-Why-Male-and-Female-are-not-Enough.pdf\" target=\"_blank\" rel=\"noopener\">essay\u003c/a>:\u003c/p>\n\u003cp>\u003cstrong>\"\u003c/strong>If the state and the legal system have an interest in maintaining a two-party sexual system, they are in defiance of nature. For biologically speaking, there are many gradations running from female to male; and depending on how one calls the shots, one can argue that along that spectrum lie at least five sexes — and perhaps even more.\"\u003c/p>\n\u003cp>Last year, \u003ca href=\"https://www.scientificamerican.com/article/the-new-science-of-sex-and-gender/?fbclid=IwAR01v8tv0iW4E7ve5UEXi-9SrR2ltvAzQBS9PoREKCXREKChBMp-62KoKDU\" target=\"_blank\" rel=\"noopener\">Scientific American\u003c/a> took note of the mounting evidence of a male-female biological spectrum. \"To varying extents, many of us are biological hybrids on a male-female continuum,\" wrote the editors. \"As science looks more closely ... it becomes increasingly clear that a pair of chromosomes do not always suffice to distinguish girl/boy — either from the standpoint of sex (biological traits) or of gender (social identity).\"\u003c/p>\n\u003cp>\u003cstrong>Gender Identity: Biopsychosocial\u003c/strong>\u003c/p>\n\u003cp>California, of course, has moved beyond tying individuals' biological sexual characteristics to their gender identity. Last year, the state made it easier to officially change genders and \u003ca href=\"https://www.kqed.org/futureofyou/436110/california-third-gender-nonbinary\" target=\"_blank\" rel=\"noopener\">added a new category\u003c/a> called \"\u003ca href=\"https://www.kqed.org/futureofyou/335790/boy-girl-both-neither-a-new-generation-overthrows-gender\" target=\"_blank\" rel=\"noopener\">nonbinary\u003c/a>\" to the \"male\" and \"female\" options.\u003c/p>\n\u003cp>Researchers often describe the roots of gender identity as a complex mix of factors that are \"biopsychosocial.\" Surveys in recent years have revealed younger generations as accepting of more customizable views of gender, with some individuals even eschewing the pronouns \"he\" and \"she\" in favor of \"they\" to indicate the duality or fluidity of their identity.\u003c/p>\n\u003cp>Charlotte Tate, a gender researcher at San Francisco State University, said it's time to move on from debates like the one the Trump administration is trying to foster.\u003c/p>\n\u003cp>\"Historically, science about gender has contained lots of errors that needed to be corrected or discarded,\" she wrote in an email. \"Pretending that gender identity can be reduced to a person’s genitals is one of those errors that we needed to discard in order to move forward in a way that is scientifically productive.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "CDC Chair on Trump’s Transgender Proposal: Stigma is ‘Not in The Interest of Public Health’",
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"content": "\u003cp>The director of the Centers for Disease Control and Prevention on Tuesday suggested a \u003ca href=\"https://www.kqed.org/news/11700270/trump-move-to-redefine-gender-could-lead-to-david-and-goliath-battle-with-transgender-californians\" rel=\"noopener\" target=\"_blank\">Trump administration proposal\u003c/a> that would define someone’s sex at birth risked heightening stigma around transgender people.\u003c/p>\n\u003cp>The director, Robert Redfield, did not directly criticize the proposal. But when asked whether any such effort might hamper efforts to treat HIV, especially among transgender women, he replied: “We need to understand that stigmatizing illness, stigmatizing individuals is not in the interest of public health.”[contextly_sidebar id=\"mVeGOCjwCxD05uYuQsgkbTz0xWyggdvD\"]\u003c/p>\n\u003cp>He made the remarks in an interview with STAT Executive Editor Rick Berke at the opening session of the Milken Institute’s Future of Health Summit.\u003c/p>\n\u003cp class=\"\">Redfield said he was not involved in developing \u003ca href=\"https://www.nytimes.com/2018/10/21/us/politics/transgender-trump-administration-sex-definition.html\" target=\"_blank\" rel=\"noopener\">the policy\u003c/a>, which was first reported by the New York Times.\u003c/p>\n\u003cp class=\"\">The proposal was criticized by scientists, who pointed out that it \u003ca href=\"https://www.statnews.com/2018/10/22/scientists-see-a-problem-with-trump-plan-on-defining-sex-biology/\">stands in contradiction to basic biology\u003c/a>, which recognizes that many individuals are born with sex chromosomes or genitalia that don’t conform to the social definitions of “male” and “female.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Trump addressed the issue Monday, telling reporters that the administration is “looking at it.”\u003c/p>\n\u003cp>“We have a lot of different concepts right now,” Trump said. “They have a lot of different things happening with respect to transgender right now. You know that as well as I do and we’re looking at it very seriously.”\u003c/p>\n\u003cp>The Department of Health and Human Services, which oversees the CDC, has declined to comment on the substance of the proposal directly. On Monday, the Washington Post reported that, while \u003ca href=\"https://www.washingtonpost.com/national/trump-administration-considering-different-concepts-regarding-transgender-rights-with-some-pushing-back-internally/2018/10/22/0668f4da-d624-11e8-83a2-d1c3da28d6b6_story.html?utm_term=.5da392e86f59\" target=\"_blank\" rel=\"noopener\">HHS is backing the proposal\u003c/a>, the Department of Education is pushing back.\u003c/p>\n\u003cp>Redfield also argued that stigma is harmful more broadly, saying that it interferes with actually treating a disease, such as addiction to opioids.\u003c/p>\n\u003cp>He said that the stigma around opioid use now is greater than the stigma around AIDS.\u003c/p>\n\u003cp>“It’s nothing compared to what we’re confronting with drug use,” Redfield said.\u003c/p>\n\u003cp>For him, the issue is personal — his son has been in recovery for drug use for three years.[contextly_sidebar id=\"SSyvhjTE85ossB5jaH387kntcvQgQVWT\"]\u003c/p>\n\u003cp>“I pray for him every day,” Redfield said. “People don’t realize that addiction is a medical condition, it’s not a moral failing. People don’t realize it’s a chronic medical condition.”\u003c/p>\n\u003cp>Redfield compared it to another disease, like cancer. We don’t stigmatize people whose cancer goes into remission and then flares back up, he said, so why do we stigmatize people who relapse after treatment for drug use?\u003c/p>\n\u003cp>He said that treatment for addiction should be integrated into primary care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/23/cdc-director-on-trump-transgender-proposal/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The director of the Centers for Disease Control and Prevention on Tuesday suggested a \u003ca href=\"https://www.kqed.org/news/11700270/trump-move-to-redefine-gender-could-lead-to-david-and-goliath-battle-with-transgender-californians\" rel=\"noopener\" target=\"_blank\">Trump administration proposal\u003c/a> that would define someone’s sex at birth risked heightening stigma around transgender people.\u003c/p>\n\u003cp>The director, Robert Redfield, did not directly criticize the proposal. But when asked whether any such effort might hamper efforts to treat HIV, especially among transgender women, he replied: “We need to understand that stigmatizing illness, stigmatizing individuals is not in the interest of public health.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>He made the remarks in an interview with STAT Executive Editor Rick Berke at the opening session of the Milken Institute’s Future of Health Summit.\u003c/p>\n\u003cp class=\"\">Redfield said he was not involved in developing \u003ca href=\"https://www.nytimes.com/2018/10/21/us/politics/transgender-trump-administration-sex-definition.html\" target=\"_blank\" rel=\"noopener\">the policy\u003c/a>, which was first reported by the New York Times.\u003c/p>\n\u003cp class=\"\">The proposal was criticized by scientists, who pointed out that it \u003ca href=\"https://www.statnews.com/2018/10/22/scientists-see-a-problem-with-trump-plan-on-defining-sex-biology/\">stands in contradiction to basic biology\u003c/a>, which recognizes that many individuals are born with sex chromosomes or genitalia that don’t conform to the social definitions of “male” and “female.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Trump addressed the issue Monday, telling reporters that the administration is “looking at it.”\u003c/p>\n\u003cp>“We have a lot of different concepts right now,” Trump said. “They have a lot of different things happening with respect to transgender right now. You know that as well as I do and we’re looking at it very seriously.”\u003c/p>\n\u003cp>The Department of Health and Human Services, which oversees the CDC, has declined to comment on the substance of the proposal directly. On Monday, the Washington Post reported that, while \u003ca href=\"https://www.washingtonpost.com/national/trump-administration-considering-different-concepts-regarding-transgender-rights-with-some-pushing-back-internally/2018/10/22/0668f4da-d624-11e8-83a2-d1c3da28d6b6_story.html?utm_term=.5da392e86f59\" target=\"_blank\" rel=\"noopener\">HHS is backing the proposal\u003c/a>, the Department of Education is pushing back.\u003c/p>\n\u003cp>Redfield also argued that stigma is harmful more broadly, saying that it interferes with actually treating a disease, such as addiction to opioids.\u003c/p>\n\u003cp>He said that the stigma around opioid use now is greater than the stigma around AIDS.\u003c/p>\n\u003cp>“It’s nothing compared to what we’re confronting with drug use,” Redfield said.\u003c/p>\n\u003cp>For him, the issue is personal — his son has been in recovery for drug use for three years.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“I pray for him every day,” Redfield said. “People don’t realize that addiction is a medical condition, it’s not a moral failing. People don’t realize it’s a chronic medical condition.”\u003c/p>\n\u003cp>Redfield compared it to another disease, like cancer. We don’t stigmatize people whose cancer goes into remission and then flares back up, he said, so why do we stigmatize people who relapse after treatment for drug use?\u003c/p>\n\u003cp>He said that treatment for addiction should be integrated into primary care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/23/cdc-director-on-trump-transgender-proposal/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Youth Are Failing to Recognize Dangers of Juul E-Cigarettes",
"title": "California Youth Are Failing to Recognize Dangers of Juul E-Cigarettes",
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"content": "\u003cp>Young adults and teens who smoke Juul brand e-cigarettes are blissfully unaware of the health risks associated with the popular vape kit, according to a new study out of Stanford.\u003c/p>\n\u003cp>Younger users fail to recognize the addictive potential of Juul e-cigarettes, according to the\u003ca href=\"https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2707425\" target=\"_blank\" rel=\"noopener\"> study published Friday\u003c/a> in the journal \u003cem>JAMA Network Open.[contextly_sidebar id=\"EK9hFqM2yZUTzSOgfHFT52apU2Vgh1xK\"]\u003c/em>\u003c/p>\n\u003cp>Researchers said they found a \"worrisome disconnect\" between teens’ perceptions of their Juul use and actual addiction.\u003c/p>\n\u003cp>That's troubling since adolescents who use Juul e-cigarettes do so on a more regular basis than adolescents who use other forms of e-cigarettes, according to the study’s senior author and Stanford \u003ca href=\"http://med.stanford.edu/adolescent/research/Research.html\" target=\"_blank\" rel=\"noopener\">professor Bonnie Halpern-Felsher\u003c/a>.\u003c/p>\n\u003cp>In a statement Juul said, \"We agree that underage use of JUUL is completely unacceptable and it is directly opposed to our mission of eliminating cigarettes by offering existing adult smokers a true alternative to combustible cigarettes. We stand committed to working with those who want to keep nicotine products out of the hands of young people.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Growing Up With E-Cigs\u003c/strong>\u003c/p>\n\u003cp>For the first phase of the study, researchers interviewed more than 700 students in ninth and 12th grade in 2014 and 2015. Follow-up questionnaires were completed by 445 of the participants, who were by then in the 12th grade or a few years out of high school.\u003c/p>\n\u003cp>Participants who used e-cigarettes also completed a separate questionnaire assessing their degree of nicotine dependence.\u003c/p>\n\u003cp>About half of all participants said they had heard of Juul, while about 16 percent said they had used it. Other e-cigarette brands were used by about 30 percent of participants, while conventional cigarettes were smoked by about 24 percent of participants.\u003c/p>\n\u003cp>About two-thirds of users reported using more than one type of product. Among those who had tried Juul, nearly 60 percent reported that they had used the product within the last 30 days.\u003c/p>\n\u003cp>By contrast, participants who had tried other e-cigarette brands or conventional cigarettes, about 30 percent and 28 percent respectively, reported use within the last 30 days — a striking difference between Juul users and users of other tobacco products.[contextly_sidebar id=\"o8Fym2tNlF7cBkD0KG2bbPnUmKXrgLdI\"]\u003c/p>\n\u003cp>Researchers also found that younger users were showing signs of addiction but not reporting it. In other words, there was a disconnect between what they were actually experiencing and their perception of the product's addiction potential.\u003c/p>\n\u003cp>Halpern-Felsher says the findings raise serious concerns about higher rates of addiction among Juul users. Especially since users expressed the view that Juul e-cigarettes are less harmful or addictive than the other products mentioned in the survey.\u003c/p>\n\u003cp>Juul e-cigarettes account for two-thirds of the nation's e-cigarette market. They contain more nicotine than competing brands of e-cigarettes, according to the study. Nicotine \u003ca href=\"https://www.cdc.gov/cancer/tobacco/index.htm\" target=\"_blank\" rel=\"noopener\">has been\u003c/a> linked to cancer.\u003c/p>\n\u003cp>\"It's not clear on the package how much nicotine is in there and how harmful nicotine can be,\" says Halpern-Felsher.\u003c/p>\n\u003cp>The label says it contains five percent nicotine, but to a young person that may not seem like much, according to Halpern-Felsher.\u003c/p>\n\u003cp>She says that Juul products contain 59 mg of nicotine per milliliter, which is comparable to about a pack-and-a-half to two packs of cigarettes.\u003c/p>\n\u003cp>Other forms of e-cigarettes have anywhere between 0 to around 36 mg per milliliter.[contextly_sidebar id=\"yBQAN1uArOrCWBWhXStG5szdMxIJkw7D\"]\u003c/p>\n\u003cp>E-cigarette use in adolescents is particularly alarming since nicotine can change the brain of an adolescent, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4560573/\" target=\"_blank\" rel=\"noopener\">making it easier\u003c/a> for the user to be calm while addicted to that substance.\u003c/p>\n\u003cp>As a result, Halpern-Felsher says there's a higher possibility of addiction during adolescence than if the user had started using the product as an adult.\u003c/p>\n\u003cp>\u003cstrong>Public Perception\u003c/strong>\u003c/p>\n\u003cp>Researchers blame marketing and advertisements for the gap between reality and public perception among younger users.\u003c/p>\n\u003cp>Juul has come under sharp criticism for designing e-cigarettes that appeal to the youth market. Their products use flavored nicotine-containing liquids, such as cool mint and dessert flavors, that are inhaled from colorful pods resembling USB flash drives.\u003c/p>\n\u003cp>The Food and Drug Administration \u003ca href=\"https://www.fda.gov/TobaccoProducts/PublicHealthEducation/PublicEducationCampaigns/TheRealCostCampaign/ucm620783.htm\" target=\"_blank\" rel=\"noopener\">recently launched a\u003c/a> campaign to warn youths about the health risks and to stop Juul sales to young people.\u003c/p>\n\u003cp>Halpern-Felsher says that youth are more likely to use tobacco products that come in flavors. She notes that only one of the participants in the study used the plain tobacco flavor.\u003c/p>\n\u003cp>The study emphasizes the need for better public-health campaigns highlighting the health risks of e-cigarettes.\u003c/p>\n\u003cp>\"Juul users aren't aware of the amount of nicotine in the product,\" says Halpern-Felsher. \"We really need to have a discussion about the amount of nicotine in these products. \"\u003c/p>\n\u003cp>She also recommends increased regulation of e-cigarette flavors and how they are advertised.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Juul needs to report more accurately and in plain English,\" she says. \"And in a way that everybody understands how much nicotine is in there.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Young adults and teens who smoke Juul brand e-cigarettes are blissfully unaware of the health risks associated with the popular vape kit, according to a new study out of Stanford.\u003c/p>\n\u003cp>Younger users fail to recognize the addictive potential of Juul e-cigarettes, according to the\u003ca href=\"https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2707425\" target=\"_blank\" rel=\"noopener\"> study published Friday\u003c/a> in the journal \u003cem>JAMA Network Open.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/em>\u003c/p>\n\u003cp>Researchers said they found a \"worrisome disconnect\" between teens’ perceptions of their Juul use and actual addiction.\u003c/p>\n\u003cp>That's troubling since adolescents who use Juul e-cigarettes do so on a more regular basis than adolescents who use other forms of e-cigarettes, according to the study’s senior author and Stanford \u003ca href=\"http://med.stanford.edu/adolescent/research/Research.html\" target=\"_blank\" rel=\"noopener\">professor Bonnie Halpern-Felsher\u003c/a>.\u003c/p>\n\u003cp>In a statement Juul said, \"We agree that underage use of JUUL is completely unacceptable and it is directly opposed to our mission of eliminating cigarettes by offering existing adult smokers a true alternative to combustible cigarettes. We stand committed to working with those who want to keep nicotine products out of the hands of young people.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Growing Up With E-Cigs\u003c/strong>\u003c/p>\n\u003cp>For the first phase of the study, researchers interviewed more than 700 students in ninth and 12th grade in 2014 and 2015. Follow-up questionnaires were completed by 445 of the participants, who were by then in the 12th grade or a few years out of high school.\u003c/p>\n\u003cp>Participants who used e-cigarettes also completed a separate questionnaire assessing their degree of nicotine dependence.\u003c/p>\n\u003cp>About half of all participants said they had heard of Juul, while about 16 percent said they had used it. Other e-cigarette brands were used by about 30 percent of participants, while conventional cigarettes were smoked by about 24 percent of participants.\u003c/p>\n\u003cp>About two-thirds of users reported using more than one type of product. Among those who had tried Juul, nearly 60 percent reported that they had used the product within the last 30 days.\u003c/p>\n\u003cp>By contrast, participants who had tried other e-cigarette brands or conventional cigarettes, about 30 percent and 28 percent respectively, reported use within the last 30 days — a striking difference between Juul users and users of other tobacco products.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Researchers also found that younger users were showing signs of addiction but not reporting it. In other words, there was a disconnect between what they were actually experiencing and their perception of the product's addiction potential.\u003c/p>\n\u003cp>Halpern-Felsher says the findings raise serious concerns about higher rates of addiction among Juul users. Especially since users expressed the view that Juul e-cigarettes are less harmful or addictive than the other products mentioned in the survey.\u003c/p>\n\u003cp>Juul e-cigarettes account for two-thirds of the nation's e-cigarette market. They contain more nicotine than competing brands of e-cigarettes, according to the study. Nicotine \u003ca href=\"https://www.cdc.gov/cancer/tobacco/index.htm\" target=\"_blank\" rel=\"noopener\">has been\u003c/a> linked to cancer.\u003c/p>\n\u003cp>\"It's not clear on the package how much nicotine is in there and how harmful nicotine can be,\" says Halpern-Felsher.\u003c/p>\n\u003cp>The label says it contains five percent nicotine, but to a young person that may not seem like much, according to Halpern-Felsher.\u003c/p>\n\u003cp>She says that Juul products contain 59 mg of nicotine per milliliter, which is comparable to about a pack-and-a-half to two packs of cigarettes.\u003c/p>\n\u003cp>Other forms of e-cigarettes have anywhere between 0 to around 36 mg per milliliter.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>E-cigarette use in adolescents is particularly alarming since nicotine can change the brain of an adolescent, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4560573/\" target=\"_blank\" rel=\"noopener\">making it easier\u003c/a> for the user to be calm while addicted to that substance.\u003c/p>\n\u003cp>As a result, Halpern-Felsher says there's a higher possibility of addiction during adolescence than if the user had started using the product as an adult.\u003c/p>\n\u003cp>\u003cstrong>Public Perception\u003c/strong>\u003c/p>\n\u003cp>Researchers blame marketing and advertisements for the gap between reality and public perception among younger users.\u003c/p>\n\u003cp>Juul has come under sharp criticism for designing e-cigarettes that appeal to the youth market. Their products use flavored nicotine-containing liquids, such as cool mint and dessert flavors, that are inhaled from colorful pods resembling USB flash drives.\u003c/p>\n\u003cp>The Food and Drug Administration \u003ca href=\"https://www.fda.gov/TobaccoProducts/PublicHealthEducation/PublicEducationCampaigns/TheRealCostCampaign/ucm620783.htm\" target=\"_blank\" rel=\"noopener\">recently launched a\u003c/a> campaign to warn youths about the health risks and to stop Juul sales to young people.\u003c/p>\n\u003cp>Halpern-Felsher says that youth are more likely to use tobacco products that come in flavors. She notes that only one of the participants in the study used the plain tobacco flavor.\u003c/p>\n\u003cp>The study emphasizes the need for better public-health campaigns highlighting the health risks of e-cigarettes.\u003c/p>\n\u003cp>\"Juul users aren't aware of the amount of nicotine in the product,\" says Halpern-Felsher. \"We really need to have a discussion about the amount of nicotine in these products. \"\u003c/p>\n\u003cp>She also recommends increased regulation of e-cigarette flavors and how they are advertised.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Juul needs to report more accurately and in plain English,\" she says. \"And in a way that everybody understands how much nicotine is in there.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>U.S. health officials on Tuesday reported a jump in cases of a rare paralyzing illness in children, and said it seems to be following an every-other-year pattern.\u003c/p>\n\u003cp>At least 62 cases have been confirmed in 22 states this year, and at least 65 additional illnesses in those states are being investigated, according to the Centers for Disease Control and Prevention. Similar waves of the same illness occurred in 2014 and 2016.[contextly_sidebar id=\"zKNDHyK9wsqxBIHxC5WNrDdt7TULEM32\"]\u003c/p>\n\u003cp>CDC officials say they haven’t found the cause. Some possible suspects, such as polio and West Nile virus, have been ruled out. Another kind of virus is suspected, but it’s been found in only some of the cases.\u003c/p>\n\u003cp>“This is a mystery so far,” the CDC’s Dr. Nancy Messonnier said in a call Tuesday with reporters.\u003c/p>\n\u003cp>About 90 percent of the cases are children who have suffered muscle weakness or paralysis, including in the face, neck, back or limbs. The symptoms tend to occur about a week after they had a fever and respiratory illness.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It is “a pretty dramatic disease,” but fortunately most kids recover, Messonnier said.\u003c/p>\n\u003cp>Health officials call the condition acute flaccid myelitis. The CDC would not release a list of the states reporting probable or confirmed cases. But some states have previously announced clusters, including Minnesota, Illinois, Colorado, New York and Washington.\u003c/p>\n\u003cp>The cases in 2014 and 2016 were partly attributed to particular strains of respiratory germs called enteroviruses, which spread the most in the summer and fall.\u003c/p>\n\u003cp>Most people infected with enteroviruses suffer only minor symptoms like cough and runny nose. And though enteroviruses have been detected in some paralysis cases, it hasn’t been found in others, CDC officials say.[contextly_sidebar id=\"Xxex6MzIUJU6pTMyIeSK4oyCi80okhvw\"]\u003c/p>\n\u003cp>Lacking an established cause, health officials confirm cases through a review of brain scans and symptoms.\u003c/p>\n\u003cp>About 120 confirmed cases were reported in 2014. Another 149 were reported in 2016. In 2015 and 2017, the counts of reported illnesses were far lower.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The cases this year seem to be spread across much of the country, as were the earlier two waves. But mysteriously no other country has reported the emerging every-two-years pattern seen in the U.S., Messonnier said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It is “a pretty dramatic disease,” but fortunately most kids recover, Messonnier said.\u003c/p>\n\u003cp>Health officials call the condition acute flaccid myelitis. The CDC would not release a list of the states reporting probable or confirmed cases. But some states have previously announced clusters, including Minnesota, Illinois, Colorado, New York and Washington.\u003c/p>\n\u003cp>The cases in 2014 and 2016 were partly attributed to particular strains of respiratory germs called enteroviruses, which spread the most in the summer and fall.\u003c/p>\n\u003cp>Most people infected with enteroviruses suffer only minor symptoms like cough and runny nose. And though enteroviruses have been detected in some paralysis cases, it hasn’t been found in others, CDC officials say.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Lacking an established cause, health officials confirm cases through a review of brain scans and symptoms.\u003c/p>\n\u003cp>About 120 confirmed cases were reported in 2014. Another 149 were reported in 2016. In 2015 and 2017, the counts of reported illnesses were far lower.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The cases this year seem to be spread across much of the country, as were the earlier two waves. But mysteriously no other country has reported the emerging every-two-years pattern seen in the U.S., Messonnier said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Jurors To San Francisco Judge: Don’t Throw Out Our Monsanto Verdict",
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"content": "\u003cp>Jurors who found that agribusiness giant Monsanto’s Roundup weed killer contributed to a school groundskeeper’s cancer are urging a San Francisco judge not to throw out the bulk of their $289 million award in his favor, a newspaper reported Monday.[contextly_sidebar id=\"7YRBS461v724TaAmMJpo9JmrwQ2KCKb2\"]\u003c/p>\n\u003cp>Juror Gary Kitahata told Judge Suzanne Bolanos in a letter that the jury was convinced by the evidence, the \u003ca href=\"https://www.sfchronicle.com/bayarea/article/Monsanto-case-Jurors-urge-judge-not-to-overturn-13309317.php?src=hp_totn\" target=\"_blank\" rel=\"noopener\">San Francisco Chronicle\u003c/a> said.\u003c/p>\n\u003cp>“I urge you to respect and honor our verdict and the six weeks of our lives that we dedicated to this trial,” he said.\u003c/p>\n\u003cp>Juror Robert Howard wrote to the judge that the jury had paid “studious attention” to the evidence and any decision to overturn its verdict would shake his confidence in the judicial system.\u003c/p>\n\u003cp>Bolanos said last week she is inclined to throw out $250 million in punitive damages in favor of DeWayne Johnson. She is also considering dramatically reducing the remaining award. Her final decision is due by Oct. 22.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Monsanto, which was acquired by Bayer AG in June, has asked the judge to override the jury’s decision and enter judgment in its favor or order a new trial.\u003c/p>\n\u003cp>Bayer AG in a statement on Monday thanked the jury for its “important public service,” but said the “post-trial motions in the Johnson case raise issues of law that are properly addressed by Judge Bolanos.”[contextly_sidebar id=\"3g1bwuV7xkZGzNrqExl6CbowYVDrYjR6\"]\u003c/p>\n\u003cp>Johnson sprayed Roundup and a similar product, Ranger Pro, at his job as a pest control manager at a San Francisco Bay Area school district, according to his attorneys. He was diagnosed with non-Hodgkin’s lymphoma in 2014 at age 42.\u003c/p>\n\u003cp>His lawsuit is among hundreds alleging Roundup caused cancer, but it was the first one to go to trial.\u003c/p>\n\u003cp>Many government regulators have rejected a link between glyphosate — the active ingredient in Roundup — and cancer. Monsanto has vehemently denied such a connection, saying hundreds of studies have established that glyphosate is safe.\u003c/p>\n\u003cp>The jury in August determined that Monsanto should have provided a label warning of a potential health hazard.\u003c/p>\n\u003cp>\u003ca href=\"https://chicago.suntimes.com/news/dewayne-johnson-jury-289m-roundup-cancer-suit-court/\" target=\"_blank\" rel=\"noopener\">In a tentative order last week\u003c/a>, Bolanos said Johnson’s attorneys had failed to show Monsanto acted with “malice or oppression” — a prerequisite for punitive damages.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Howard told the Chronicle testimony at trial showed there were “serious questions” about the safety of Roundup when the company gave it to Johnson’s employer.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Jurors who found that agribusiness giant Monsanto’s Roundup weed killer contributed to a school groundskeeper’s cancer are urging a San Francisco judge not to throw out the bulk of their $289 million award in his favor, a newspaper reported Monday.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Juror Gary Kitahata told Judge Suzanne Bolanos in a letter that the jury was convinced by the evidence, the \u003ca href=\"https://www.sfchronicle.com/bayarea/article/Monsanto-case-Jurors-urge-judge-not-to-overturn-13309317.php?src=hp_totn\" target=\"_blank\" rel=\"noopener\">San Francisco Chronicle\u003c/a> said.\u003c/p>\n\u003cp>“I urge you to respect and honor our verdict and the six weeks of our lives that we dedicated to this trial,” he said.\u003c/p>\n\u003cp>Juror Robert Howard wrote to the judge that the jury had paid “studious attention” to the evidence and any decision to overturn its verdict would shake his confidence in the judicial system.\u003c/p>\n\u003cp>Bolanos said last week she is inclined to throw out $250 million in punitive damages in favor of DeWayne Johnson. She is also considering dramatically reducing the remaining award. Her final decision is due by Oct. 22.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Monsanto, which was acquired by Bayer AG in June, has asked the judge to override the jury’s decision and enter judgment in its favor or order a new trial.\u003c/p>\n\u003cp>Bayer AG in a statement on Monday thanked the jury for its “important public service,” but said the “post-trial motions in the Johnson case raise issues of law that are properly addressed by Judge Bolanos.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Johnson sprayed Roundup and a similar product, Ranger Pro, at his job as a pest control manager at a San Francisco Bay Area school district, according to his attorneys. He was diagnosed with non-Hodgkin’s lymphoma in 2014 at age 42.\u003c/p>\n\u003cp>His lawsuit is among hundreds alleging Roundup caused cancer, but it was the first one to go to trial.\u003c/p>\n\u003cp>Many government regulators have rejected a link between glyphosate — the active ingredient in Roundup — and cancer. Monsanto has vehemently denied such a connection, saying hundreds of studies have established that glyphosate is safe.\u003c/p>\n\u003cp>The jury in August determined that Monsanto should have provided a label warning of a potential health hazard.\u003c/p>\n\u003cp>\u003ca href=\"https://chicago.suntimes.com/news/dewayne-johnson-jury-289m-roundup-cancer-suit-court/\" target=\"_blank\" rel=\"noopener\">In a tentative order last week\u003c/a>, Bolanos said Johnson’s attorneys had failed to show Monsanto acted with “malice or oppression” — a prerequisite for punitive damages.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Howard told the Chronicle testimony at trial showed there were “serious questions” about the safety of Roundup when the company gave it to Johnson’s employer.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Human Retinas Grown In a Dish Reveal Origin Of Color Vision",
"title": "Human Retinas Grown In a Dish Reveal Origin Of Color Vision",
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"content": "\u003cp>In order to see the red of a sunset or the green of spring leaves, developing human eyes need to get the right hormone at the right time.\u003c/p>\n\u003cp>That's the finding of a team of scientists who studied how color vision develops using hundreds of human retinas grown in the lab.\u003c/p>\n\u003cp>The discovery, \u003ca href=\"http://science.sciencemag.org/cgi/doi/10.1126/science.aau6348\" target=\"_blank\" rel=\"noopener\">published\u003c/a> Thursday in the journal \u003cem>Science\u003c/em>, could help accelerate current efforts to cure colorblindness. It could also lead to new treatments for diseases including macular degeneration, the leading cause of vision loss.\u003c/p>\n\u003cp>\"It's important that we understand how nature controls the development of the retina so we can understand better why things go wrong in disease and how we can treat them,\" says \u003ca href=\"https://www.linkedin.com/in/smbeck2000/\" target=\"_blank\" rel=\"noopener\">Steven Becker\u003c/a>, a scientist at the National Eye Institute. The newly published findings are a step in that direction, says Becker, who has no connection to the research.\u003c/p>\n\u003cp>The development of color vision in people has been difficult to study because it usually occurs in the womb — and out of sight. But two scientists at Johns Hopkins University thought they might find some answers using retinas grown in the lab.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>These \"\u003ca href=\"https://www.youtube.com/watch?v=4CHvLNjg6nI\" target=\"_blank\" rel=\"noopener\">retinal organoids\u003c/a>\" have been around for a few years but are difficult and tedious to grow, says \u003ca href=\"https://www.linkedin.com/in/kiara-eldred-984b1513/\" target=\"_blank\" rel=\"noopener\">Kiara Eldred\u003c/a>, a graduate student at Hopkins who is the paper's first author.\u003c/p>\n\u003cp>It takes up to a year to turn a batch of immature retinal cells into a functioning organoid.\u003c/p>\n\u003cp>\"For the first week of their life, I take care of them every day,\" Eldred says. After a couple of weeks, she says, the cells become \"a little bit more independent.\"\u003c/p>\n\u003cp>And with luck, these clusters of immature cells develop into a 3D structure that \"looks and acts like a developing retina that you would see in a baby,\" says \u003ca href=\"http://sites.krieger.jhu.edu/johnstonlab/people/\" target=\"_blank\" rel=\"noopener\">Bob Johnston\u003c/a>, Eldred's boss and an assistant professor in the biology department.\u003c/p>\n\u003cp>Johnston's lab had been studying vision in flies. But he and Eldred saw a chance to try something much more ambitious.\u003c/p>\n\u003cp>\"We discussed this crazy idea of: Could we use these human retinal organoids to study how we get the different color-sensing cells in our eyes?\" Johnston says.\u003c/p>\n\u003cp>Using human cells was key because you can't study how humans see color in a fly, or even a mouse.\u003c/p>\n\u003cp>\"Mice don't sense red,\" Johnston says. \"They don't have these red-detecting cells. So we really have to study this in human tissue to get any insight into how it works.\"\u003c/p>\n\u003cp>Johnston and Eldred knew that in a human fetus, cells that detect blue light appear first. Then come cells that respond to red and green light.\u003c/p>\n\u003cp>And research on animals suggested that the thyroid hormone was involved in the development of these color-sensing cells, called cones. So Johnston had Eldred conduct an experiment with immature retinal cells.\u003c/p>\n\u003cp>\"I added thyroid hormone to the dish during their development, and we got more red-green cones developing in those organoids,\" she says. \"We got really excited because we were on to something.\"\u003c/p>\n\u003cp>It would take years and many more experiments to confirm that the thyroid hormone was actually triggering the emergence of color vision. And the team still hasn't figured out what causes some cones to go on to become even more specialized by detecting only red or only green.\u003c/p>\n\u003cp>But Johnston says his lab is now preparing to take on two new goals.\u003c/p>\n\u003cp>\"One is to restore color vision to people that are colorblind,\" he says. What his lab is learning, he says, could help speed an \u003ca href=\"https://www.npr.org/sections/health-shots/2015/03/25/395303785/university-and-biotech-firm-team-up-on-colorblindness-therapy\" target=\"_blank\" rel=\"noopener\">existing effort\u003c/a> to use gene therapy to cure colorblindness.\u003c/p>\n\u003cp>The lab's second goal is to use retinal organoids to better understand diseases including glaucoma and \u003ca href=\"https://medlineplus.gov/maculardegeneration.html\" target=\"_blank\" rel=\"noopener\">macular degeneration\u003c/a>, a leading cause of vision loss.\u003c/p>\n\u003cp>Macular degeneration affects the macula, an area of the retina that provides high-resolution vision. The condition has been hard to study, though, because mice don't have a macula.\u003c/p>\n\u003cp>So Johnston hopes to learn more by having his lab create macular organoids.\u003c/p>\n\u003cp>There's growing optimism among scientists that new treatments for retinal diseases will emerge from such efforts, Becker says. Initially, he says, researchers had doubts about whether a retina grown in a dish could mimic the real thing.\u003c/p>\n\u003cp>But studies like this one on color vision, he says, \"show that the similarity is quite high.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>To encourage scientists to develop more retinal organoids, the National Eye Institute is sponsoring a \u003ca href=\"https://nei.nih.gov/content/nih-solicits-next-generation-retina-organoids-prize-competition\" target=\"_blank\" rel=\"noopener\">scientific competition\u003c/a> with $1 million in prizes.\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=Human+Retinas+Grown+In+A+Dish+Reveal+Origin+Of+Color+Vision&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In order to see the red of a sunset or the green of spring leaves, developing human eyes need to get the right hormone at the right time.\u003c/p>\n\u003cp>That's the finding of a team of scientists who studied how color vision develops using hundreds of human retinas grown in the lab.\u003c/p>\n\u003cp>The discovery, \u003ca href=\"http://science.sciencemag.org/cgi/doi/10.1126/science.aau6348\" target=\"_blank\" rel=\"noopener\">published\u003c/a> Thursday in the journal \u003cem>Science\u003c/em>, could help accelerate current efforts to cure colorblindness. It could also lead to new treatments for diseases including macular degeneration, the leading cause of vision loss.\u003c/p>\n\u003cp>\"It's important that we understand how nature controls the development of the retina so we can understand better why things go wrong in disease and how we can treat them,\" says \u003ca href=\"https://www.linkedin.com/in/smbeck2000/\" target=\"_blank\" rel=\"noopener\">Steven Becker\u003c/a>, a scientist at the National Eye Institute. The newly published findings are a step in that direction, says Becker, who has no connection to the research.\u003c/p>\n\u003cp>The development of color vision in people has been difficult to study because it usually occurs in the womb — and out of sight. But two scientists at Johns Hopkins University thought they might find some answers using retinas grown in the lab.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>These \"\u003ca href=\"https://www.youtube.com/watch?v=4CHvLNjg6nI\" target=\"_blank\" rel=\"noopener\">retinal organoids\u003c/a>\" have been around for a few years but are difficult and tedious to grow, says \u003ca href=\"https://www.linkedin.com/in/kiara-eldred-984b1513/\" target=\"_blank\" rel=\"noopener\">Kiara Eldred\u003c/a>, a graduate student at Hopkins who is the paper's first author.\u003c/p>\n\u003cp>It takes up to a year to turn a batch of immature retinal cells into a functioning organoid.\u003c/p>\n\u003cp>\"For the first week of their life, I take care of them every day,\" Eldred says. After a couple of weeks, she says, the cells become \"a little bit more independent.\"\u003c/p>\n\u003cp>And with luck, these clusters of immature cells develop into a 3D structure that \"looks and acts like a developing retina that you would see in a baby,\" says \u003ca href=\"http://sites.krieger.jhu.edu/johnstonlab/people/\" target=\"_blank\" rel=\"noopener\">Bob Johnston\u003c/a>, Eldred's boss and an assistant professor in the biology department.\u003c/p>\n\u003cp>Johnston's lab had been studying vision in flies. But he and Eldred saw a chance to try something much more ambitious.\u003c/p>\n\u003cp>\"We discussed this crazy idea of: Could we use these human retinal organoids to study how we get the different color-sensing cells in our eyes?\" Johnston says.\u003c/p>\n\u003cp>Using human cells was key because you can't study how humans see color in a fly, or even a mouse.\u003c/p>\n\u003cp>\"Mice don't sense red,\" Johnston says. \"They don't have these red-detecting cells. So we really have to study this in human tissue to get any insight into how it works.\"\u003c/p>\n\u003cp>Johnston and Eldred knew that in a human fetus, cells that detect blue light appear first. Then come cells that respond to red and green light.\u003c/p>\n\u003cp>And research on animals suggested that the thyroid hormone was involved in the development of these color-sensing cells, called cones. So Johnston had Eldred conduct an experiment with immature retinal cells.\u003c/p>\n\u003cp>\"I added thyroid hormone to the dish during their development, and we got more red-green cones developing in those organoids,\" she says. \"We got really excited because we were on to something.\"\u003c/p>\n\u003cp>It would take years and many more experiments to confirm that the thyroid hormone was actually triggering the emergence of color vision. And the team still hasn't figured out what causes some cones to go on to become even more specialized by detecting only red or only green.\u003c/p>\n\u003cp>But Johnston says his lab is now preparing to take on two new goals.\u003c/p>\n\u003cp>\"One is to restore color vision to people that are colorblind,\" he says. What his lab is learning, he says, could help speed an \u003ca href=\"https://www.npr.org/sections/health-shots/2015/03/25/395303785/university-and-biotech-firm-team-up-on-colorblindness-therapy\" target=\"_blank\" rel=\"noopener\">existing effort\u003c/a> to use gene therapy to cure colorblindness.\u003c/p>\n\u003cp>The lab's second goal is to use retinal organoids to better understand diseases including glaucoma and \u003ca href=\"https://medlineplus.gov/maculardegeneration.html\" target=\"_blank\" rel=\"noopener\">macular degeneration\u003c/a>, a leading cause of vision loss.\u003c/p>\n\u003cp>Macular degeneration affects the macula, an area of the retina that provides high-resolution vision. The condition has been hard to study, though, because mice don't have a macula.\u003c/p>\n\u003cp>So Johnston hopes to learn more by having his lab create macular organoids.\u003c/p>\n\u003cp>There's growing optimism among scientists that new treatments for retinal diseases will emerge from such efforts, Becker says. Initially, he says, researchers had doubts about whether a retina grown in a dish could mimic the real thing.\u003c/p>\n\u003cp>But studies like this one on color vision, he says, \"show that the similarity is quite high.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>To encourage scientists to develop more retinal organoids, the National Eye Institute is sponsoring a \u003ca href=\"https://nei.nih.gov/content/nih-solicits-next-generation-retina-organoids-prize-competition\" target=\"_blank\" rel=\"noopener\">scientific competition\u003c/a> with $1 million in prizes.\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=Human+Retinas+Grown+In+A+Dish+Reveal+Origin+Of+Color+Vision&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Easy DNA Identifications With Genealogy Databases Raise Privacy Concerns",
"title": "Easy DNA Identifications With Genealogy Databases Raise Privacy Concerns",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Police in California \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\">made headlines\u003c/a> this spring when they charged a former police officer with being the Golden State Killer, a man who allegedly committed a series of notorious rapes and murders in the 1970s and '80s.[contextly_sidebar id=\"wnxqjWPunPnkNxirmoKmxB8OyxTBzMuy\"]\u003c/p>\n\u003cp>Authorities revealed they used DNA from a publicly available genealogy website to crack the case.\u003c/p>\n\u003cp>Since then, police around the country have started doing the same sort of thing to solve other cold cases.\u003c/p>\n\u003cp>That prompted \u003ca href=\"https://www.myheritage.com/management/yaniv_erlich\" target=\"_blank\" rel=\"noopener\">Yaniv Erlich, \u003c/a>the chief science officer at the Israeli company \u003ca href=\"https://www.myheritage.com/\" target=\"_blank\" rel=\"noopener\">MyHeritage\u003c/a>, to investigate just how easy it is to use public genealogy databases to track down people.\u003c/p>\n\u003cp>\"We wanted to quantify how powerful this technique is to identify individuals,\" Erlich says. So he and his colleagues analyzed the genomes of 1.28 million people in the company's database.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In a \u003ca href=\"http://science.sciencemag.org/lookup/doi/10.1126/science.aau4832\" target=\"_blank\" rel=\"noopener\">paper \u003c/a>published Thursday in the journal \u003cem>Science\u003c/em>, the researchers projected that they could identify third cousins and more closely related relatives in more than 60 percent of people of European descent. (They chose this group because most people in their database have that ancestry.)\u003c/p>\n\u003cp>\"It's kind of like each person in this database is a beacon that illuminates hundreds of distant relatives,\" Erlich says. \"So it's enough to have your third cousin or your second cousin once-removed in these databases to actually identify you.\"[contextly_sidebar id=\"B44UUm4fmJ0qJhwetu8JjvUYBxbNVQtq\"]\u003c/p>\n\u003cp>And when the researchers combined their strategy with other information, such a specific geographic area or the approximate age of a person, they could quickly reduce a list of possibilities to just a few people.\u003c/p>\n\u003cp>\"Of course, you need the genealogical records. You need to do the work. But you have enough power to to get very close,\" Erlich says.\u003c/p>\n\u003cp>And that's not all. Erlich estimates that as his and other databases grow, investigators will essentially be able to identify anyone in the United States within that ethnic background within a few years.\u003c/p>\n\u003cp>\"It seems that very quickly we can get virtually to nearly everyone,\" Erlich says.\u003c/p>\n\u003cp>In another part of the study, the researchers went even further to see if they could do the same thing with other DNA databases. They were able to use their techniques to identify a supposedly anonymous woman whose DNA was stored in the \u003ca href=\"https://www.genome.gov/27528684/1000-genomes-project/\" target=\"_blank\" rel=\"noopener\">1,000 Genomes Project\u003c/a>, a National Institutes of Health research database.\u003c/p>\n\u003cp>\"This technique doesn't only get you criminals,\" Erlich says. \"You can also use this technique for other purposes — maybe purposes that could be illegitimate.\"\u003c/p>\n\u003cp>And that, he says, raises serious questions about privacy.\u003c/p>\n\u003cp>\"The police currently [are] using these techniques to find ... [murderers] and bad people,\" Erlich says. \"But are we OK with using this technique to identify people in a political demonstration who left their DNA behind? There are many scenarios that you can think about misuse.\"[contextly_sidebar id=\"EdtIiFNqDOAH81r6zsse3iX6ZCM6PiDN\"]\u003c/p>\n\u003cp>But some people involved in genealogical forensics defend the use of the techniques to help solves serious crimes.\u003c/p>\n\u003cp>\"I was excited to see this demonstration that genetic genealogy is so powerful,\" says \u003ca href=\"https://www.parabon-nanolabs.com/nanolabs/news-events/2015/10/snapshot-ishi-presentation.html\" target=\"_blank\" rel=\"noopener\">Ellen Greytak\u003c/a>, director of bioinformatics at \u003ca href=\"https://parabon-nanolabs.com/\" target=\"_blank\" rel=\"noopener\">Parabon Nanolabs, Inc.\u003c/a>, which helps police solve crimes this way.\u003c/p>\n\u003cp>\"We're working on these cases that haven't been able to be solved for decades. They are all either homicide or sexual assault. And some of these are horrific,\" she says.\u003c/p>\n\u003cp>But Greytak and her colleagues caution that this study suggests the process is easier than it seems.\u003c/p>\n\u003cp>\"There are a number of problematic assumptions made in the study that do not reflect the reality of the work I am doing,\" writes \u003ca href=\"http://www.yourgeneticgenealogist.com/p/about-me.html\" target=\"_blank\" rel=\"noopener\">CeCe Moore\u003c/a>, who works with Parabon, in an e-mail. \"The study demonstrates the power of genetic genealogy in a theoretical way, but does not fully capture the challenges of the work in practice.\"\u003c/p>\n\u003cp>But others argue that the findings underscore the need to make sure people know what they're getting into when they provide their genetic information to genealogy services and other databases.\u003c/p>\n\u003cp>\"When you make those decisions to put the genome out in the world it's really hard to dial it back,\" \u003ca href=\"https://its.law.nyu.edu/facultyprofiles/index.cfm?fuseaction=profile.overview&personid=31567\" target=\"_blank\" rel=\"noopener\">Erin Murphy\u003c/a>, a professor at the New York University School of Law.\u003c/p>\n\u003cp>\"And more importantly,\" she says, \"you've made a decision not just for yourself but for your siblings, for your distant cousins, people you don't even know you're related to, for your children, for your children's children.\"\u003c/p>\n\u003cp>A second \u003ca href=\"http://www.cell.com/cell/fulltext/S0092-8674(18)31180-2\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> published Thursday in the journal \u003cem>Cell\u003c/em> found that it could be possible to link ancestry databases to older law enforcement DNA databases, giving police yet another potential tool.\u003c/p>\n\u003cp>\"We were trying to pose the question of whether a newer, more modern system of genetic markers could be tested against the old system and still get matches and find relatives,\" says \u003ca href=\"https://profiles.stanford.edu/noah-rosenberg\" target=\"_blank\" rel=\"noopener\">Noah Rosenberg\u003c/a>, a biology professor at Stanford University.\u003c/p>\n\u003cp>Taking these studies together, some bioethicists and legal experts say they show that it's important to take steps to protect genetic information and make sure people providing DNA samples are aware of the risks.\u003c/p>\n\u003cp>\"We can tell people that we can de-identify their data,\" says \u003ca href=\"https://www.bioethics.nih.gov/people/berkman-bio.shtml\" target=\"_blank\" rel=\"noopener\">Benjamin Berkman\u003c/a>, a bioethicist at the National Institutes of Health, who was speaking for himself, not NIH. \"We can tell them about all the procedural and technical safeguards that we've put in place to protect the confidentiality of their data. But I don't think we can promise people anonymity.\"\u003c/p>\n\u003cp>As a result, Berkman says, \"it's incumbent on anyone collecting and aggregating and sharing genomic data to be clear exactly how the data will be treated and whether there are any risks to genomic privacy.\"\u003c/p>\n\u003cp>For his part, Erlich proposes that all genetic information be encrypted to protect the information and enable people to explicitly provide consent for using their data.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It sounds geeky and complicated, but it's very simple in practice,\" Erlich says.\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=Easy+DNA+Identifications+With+Genealogy+Databases+Raise+Privacy+Concerns&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "A majority of Americans of European descent could be linked to third cousins, or closer relatives, using genealogy databases, a study finds. Soon it may be possible to identify nearly everyone by DNA.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Police in California \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\">made headlines\u003c/a> this spring when they charged a former police officer with being the Golden State Killer, a man who allegedly committed a series of notorious rapes and murders in the 1970s and '80s.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Authorities revealed they used DNA from a publicly available genealogy website to crack the case.\u003c/p>\n\u003cp>Since then, police around the country have started doing the same sort of thing to solve other cold cases.\u003c/p>\n\u003cp>That prompted \u003ca href=\"https://www.myheritage.com/management/yaniv_erlich\" target=\"_blank\" rel=\"noopener\">Yaniv Erlich, \u003c/a>the chief science officer at the Israeli company \u003ca href=\"https://www.myheritage.com/\" target=\"_blank\" rel=\"noopener\">MyHeritage\u003c/a>, to investigate just how easy it is to use public genealogy databases to track down people.\u003c/p>\n\u003cp>\"We wanted to quantify how powerful this technique is to identify individuals,\" Erlich says. So he and his colleagues analyzed the genomes of 1.28 million people in the company's database.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In a \u003ca href=\"http://science.sciencemag.org/lookup/doi/10.1126/science.aau4832\" target=\"_blank\" rel=\"noopener\">paper \u003c/a>published Thursday in the journal \u003cem>Science\u003c/em>, the researchers projected that they could identify third cousins and more closely related relatives in more than 60 percent of people of European descent. (They chose this group because most people in their database have that ancestry.)\u003c/p>\n\u003cp>\"It's kind of like each person in this database is a beacon that illuminates hundreds of distant relatives,\" Erlich says. \"So it's enough to have your third cousin or your second cousin once-removed in these databases to actually identify you.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>And when the researchers combined their strategy with other information, such a specific geographic area or the approximate age of a person, they could quickly reduce a list of possibilities to just a few people.\u003c/p>\n\u003cp>\"Of course, you need the genealogical records. You need to do the work. But you have enough power to to get very close,\" Erlich says.\u003c/p>\n\u003cp>And that's not all. Erlich estimates that as his and other databases grow, investigators will essentially be able to identify anyone in the United States within that ethnic background within a few years.\u003c/p>\n\u003cp>\"It seems that very quickly we can get virtually to nearly everyone,\" Erlich says.\u003c/p>\n\u003cp>In another part of the study, the researchers went even further to see if they could do the same thing with other DNA databases. They were able to use their techniques to identify a supposedly anonymous woman whose DNA was stored in the \u003ca href=\"https://www.genome.gov/27528684/1000-genomes-project/\" target=\"_blank\" rel=\"noopener\">1,000 Genomes Project\u003c/a>, a National Institutes of Health research database.\u003c/p>\n\u003cp>\"This technique doesn't only get you criminals,\" Erlich says. \"You can also use this technique for other purposes — maybe purposes that could be illegitimate.\"\u003c/p>\n\u003cp>And that, he says, raises serious questions about privacy.\u003c/p>\n\u003cp>\"The police currently [are] using these techniques to find ... [murderers] and bad people,\" Erlich says. \"But are we OK with using this technique to identify people in a political demonstration who left their DNA behind? There are many scenarios that you can think about misuse.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But some people involved in genealogical forensics defend the use of the techniques to help solves serious crimes.\u003c/p>\n\u003cp>\"I was excited to see this demonstration that genetic genealogy is so powerful,\" says \u003ca href=\"https://www.parabon-nanolabs.com/nanolabs/news-events/2015/10/snapshot-ishi-presentation.html\" target=\"_blank\" rel=\"noopener\">Ellen Greytak\u003c/a>, director of bioinformatics at \u003ca href=\"https://parabon-nanolabs.com/\" target=\"_blank\" rel=\"noopener\">Parabon Nanolabs, Inc.\u003c/a>, which helps police solve crimes this way.\u003c/p>\n\u003cp>\"We're working on these cases that haven't been able to be solved for decades. They are all either homicide or sexual assault. And some of these are horrific,\" she says.\u003c/p>\n\u003cp>But Greytak and her colleagues caution that this study suggests the process is easier than it seems.\u003c/p>\n\u003cp>\"There are a number of problematic assumptions made in the study that do not reflect the reality of the work I am doing,\" writes \u003ca href=\"http://www.yourgeneticgenealogist.com/p/about-me.html\" target=\"_blank\" rel=\"noopener\">CeCe Moore\u003c/a>, who works with Parabon, in an e-mail. \"The study demonstrates the power of genetic genealogy in a theoretical way, but does not fully capture the challenges of the work in practice.\"\u003c/p>\n\u003cp>But others argue that the findings underscore the need to make sure people know what they're getting into when they provide their genetic information to genealogy services and other databases.\u003c/p>\n\u003cp>\"When you make those decisions to put the genome out in the world it's really hard to dial it back,\" \u003ca href=\"https://its.law.nyu.edu/facultyprofiles/index.cfm?fuseaction=profile.overview&personid=31567\" target=\"_blank\" rel=\"noopener\">Erin Murphy\u003c/a>, a professor at the New York University School of Law.\u003c/p>\n\u003cp>\"And more importantly,\" she says, \"you've made a decision not just for yourself but for your siblings, for your distant cousins, people you don't even know you're related to, for your children, for your children's children.\"\u003c/p>\n\u003cp>A second \u003ca href=\"http://www.cell.com/cell/fulltext/S0092-8674(18)31180-2\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> published Thursday in the journal \u003cem>Cell\u003c/em> found that it could be possible to link ancestry databases to older law enforcement DNA databases, giving police yet another potential tool.\u003c/p>\n\u003cp>\"We were trying to pose the question of whether a newer, more modern system of genetic markers could be tested against the old system and still get matches and find relatives,\" says \u003ca href=\"https://profiles.stanford.edu/noah-rosenberg\" target=\"_blank\" rel=\"noopener\">Noah Rosenberg\u003c/a>, a biology professor at Stanford University.\u003c/p>\n\u003cp>Taking these studies together, some bioethicists and legal experts say they show that it's important to take steps to protect genetic information and make sure people providing DNA samples are aware of the risks.\u003c/p>\n\u003cp>\"We can tell people that we can de-identify their data,\" says \u003ca href=\"https://www.bioethics.nih.gov/people/berkman-bio.shtml\" target=\"_blank\" rel=\"noopener\">Benjamin Berkman\u003c/a>, a bioethicist at the National Institutes of Health, who was speaking for himself, not NIH. \"We can tell them about all the procedural and technical safeguards that we've put in place to protect the confidentiality of their data. But I don't think we can promise people anonymity.\"\u003c/p>\n\u003cp>As a result, Berkman says, \"it's incumbent on anyone collecting and aggregating and sharing genomic data to be clear exactly how the data will be treated and whether there are any risks to genomic privacy.\"\u003c/p>\n\u003cp>For his part, Erlich proposes that all genetic information be encrypted to protect the information and enable people to explicitly provide consent for using their data.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It sounds geeky and complicated, but it's very simple in practice,\" Erlich says.\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=Easy+DNA+Identifications+With+Genealogy+Databases+Raise+Privacy+Concerns&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"mindshift": {
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
"rightnowish": {
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