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"content": "\u003cp>Neuroscientist Paul Aisen has seen a lot of brains in patients afflicted with Alzheimer’s disease. In the tie-dye pattern characteristic of brain-imaging PET scans, researchers like Aisen are able to spot one of Alzheimer’s hallmarks: clumps of a certain type of protein that can be detected years before memory loss sets in.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The amyloid story needs to be finished, and either it works or it doesn’t in the current trials.'\u003ccite>Dr. David Knopman, Mayo Clinic\u003c/cite>\u003c/aside>\n\u003cp>Long-term studies indicate this protein — known as amyloid beta — starts building up excessively in the brain 15 or 20 years \u003ca href=\"https://www.mayoclinic.org/medical-professionals/clinical-updates/neurosciences/preclinical-alzheimers-disease\" target=\"_blank\" rel=\"noopener\">before any signs \u003c/a>of memory loss or cognitive difficulties. Healthy brains are \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24493463\" target=\"_blank\" rel=\"noopener\">generally free \u003c/a>from these fibers of accumulated amyloid that have been linked to brain cell damage seen in Alzheimer's patients.\u003c/p>\n\u003cp>About\u003ca href=\"https://www.alz.org/facts/\" target=\"_blank\" rel=\"noopener\"> 5.5 million Americans\u003c/a> currently have the disease, according to the Alzheimer's Association.\u003c/p>\n\u003cp>Researchers like Aisen, who teaches at the University of Southern California's Keck School of Medicine, are betting that the early targeting and destruction of amyloid proteins will stop the disease before it can wreak havoc on a patient’s mind, and even long before overt symptoms appear. It's a novel idea for tackling Alzheimer's, based on tools like brain-imaging PET scans and long-term studies that have tracked amyloid buildup along with declines in memory.\u003c/p>\n\u003cp>A group of clinical trials just underway or currently recruiting subjects will test this approach. If they fail, it could prove to be the nail in the coffin for treatment based on the \u003ca href=\"https://www.google.com/search?q=amyloid+hypothesis\" target=\"_blank\" rel=\"noopener\">amyloid hypothesis\u003c/a> -- the idea that eradicating amyloid plaque will prevent or cure the disease. Multiple trials targeting the protein after symptoms have already begun have shown \u003ca href=\"https://www.theatlantic.com/health/archive/2017/02/alzheimers-amyloid-hypothesis/517185/\" target=\"_blank\" rel=\"noopener\">disappointing results\u003c/a>, including Eli Lilly’s high-profile \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/01/11/failure-of-experimental-alzheimers-drug-the-latest-blow-to-amyloid-hypothesis/\" target=\"_blank\" rel=\"noopener\">flop\u003c/a> last year with the drug solanezumab.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Dr. David Knopman, a clinician and researcher in cognitive disorders at the Mayo Clinic, thinks looking for drugs outside of amyloid targets “is critically important for the field.\" He mentions targeting the\u003ca href=\"http://blogs.sciencemag.org/pipeline/archives/2017/05/26/a-movement-towards-tau-in-alzheimers\" target=\"_blank\" rel=\"noopener\"> tau protein \u003c/a>as an approach researchers are excited about.\u003c/p>\n\u003cp>\"Even if an anti-amyloid agent did work,\" he says, \"there must be other processes downstream that could be more easily targeted or effective than amyloid.”\u003c/p>\n\u003cp>\u003cstrong>Amyloid, But Early\u003c/strong>\u003cbr>\n[contextly_sidebar id=\"cahpe4dxxqEqzeVeXObMxbAPDdMuyzx3\"]But according to Aisen, solanezumab is not dead yet. The problem with past trials, he believes, is they did not get to patients early enough.\u003c/p>\n\u003cp>“We strongly believe the effect will be greater in prevention trials that are underway, probably about 15 years earlier in the course of Alzheimer’s than the studies that were completed,\" he says.\u003c/p>\n\u003cp>This new crop of trials — five in total — have either recently begun or will soon get underway. Each trial is aiming to treat and prevent Alzheimer’s by targeting amyloid before cognitive symptoms ever develop.\u003c/p>\n\u003cp>Aisen is one of the lead scientists for the Anti-Amyloid Treatment in Asymptomatic Alzheimer’s (or A4) trial. As part of the trial, solanezumab will be given to seniors ages 65 to 85 who have elevated levels of amyloid plaque but no outward symptoms. Some of the 1,150 participants will receive the drug, an antibody that cleans up free-floating amyloid, over the course of four-and-a-half years, while others will get a placebo.\u003c/p>\n\u003cp>The participants will be monitored throughout for changes in memory and cognition, along with lab tests and brain imaging to detect physiological changes.\u003c/p>\n\u003cp>Another study known as the EARLY trial is still recruiting participants, ages 60 to 85, also healthy but at risk for Alzheimer's due to an elevated amyloid level or other factors. The treatment period lasts for four-and-a-half years with a drug that hampers the production of the protein. Both the A4 and the EARLY trials are coordinated by the \u003ca href=\"http://keck.usc.edu/atri/research/studies/\" target=\"_blank\" rel=\"noopener\">Alzheimer’s Therapeutic Research Institute\u003c/a>, which Aisen directs.\u003c/p>\n\u003cp>The \u003ca href=\"http://banneralz.org/research-clinical-trials/studies-currently-enrolling.aspx\" target=\"_blank\" rel=\"noopener\">Banner Alzheimer’s Institute\u003c/a> is conducting a trial on a different drug that also blocks the production of amyloid. Its Alzheimer’s Prevention Initiative program is still recruiting 1,300 participants worldwide for the trial, which will last 5 to 8 years. Known as the API Generation study, individuals ages 60 to 75 who are healthy but have a genetic profile that increases their risk for Alzheimer’s will be treated with one of two drugs. One targets amyloid in the brain for removal, and the other acts in a unique way that’s analogous to “the body being able to create its own vaccine,” says principal scientist Jessica Langbaum at Banner Alzheimer’s Institute.\u003c/p>\n\u003cp>Participants are selected based on a genetic risk factor known as APOE4, though they will not be made aware of this if they choose not to, says Langbaum. The study will also provide genetic counseling so that risk profiles aren’t misunderstood as prophecies of disease.\u003c/p>\n\u003cp>The Banner institute has created a registry called \u003ca href=\"http://banneralz.org/research-clinical-trials/genematch.aspx\" target=\"_blank\" rel=\"noopener\">GeneMatch\u003c/a> for Alzheimer's \u003ca href=\"http://banneralz.org/research-clinical-trials/studies-currently-enrolling.aspx\" target=\"_blank\" rel=\"noopener\">studies\u003c/a> currently enrolling people. These studies call for subjects as young as 40.\u003c/p>\n\u003cp>\u003cstrong>'Either It Works or It Doesn't'\u003c/strong>\u003c/p>\n\u003cp>In these three trials, even though the subjects have biochemical markers linked to the disease, the participants will not necessarily wind up with Alzheimer's.\u003c/p>\n\u003cp>Not so with two other two trials that are looking at a form of \u003ca href=\"https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers/art-20048356\" target=\"_blank\" rel=\"noopener\">early onset Alzheimer’s. \u003c/a>These individuals all have one of a few rare genes in which the disease manifests before age 65, usually when people are in their 40s or 50s. About 5 percent of people with Alzheimer's fall into this category.\u003c/p>\n\u003cp>Will targeting amyloid in the asymptomatic stage keep dementia at bay? That’s the billion-dollar question. But it's going to take several years for the results to trickle in.\u003c/p>\n\u003cp>Says Knopman: \"The amyloid story needs to be finished, and either it works or it doesn't in the current trials.\"\u003c/p>\n\u003cp>\u003cem>Dr. Paul Aisen discusses early targeting of amyloid in 2014.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=99ysY7LOajQ\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Neuroscientist Paul Aisen has seen a lot of brains in patients afflicted with Alzheimer’s disease. In the tie-dye pattern characteristic of brain-imaging PET scans, researchers like Aisen are able to spot one of Alzheimer’s hallmarks: clumps of a certain type of protein that can be detected years before memory loss sets in.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The amyloid story needs to be finished, and either it works or it doesn’t in the current trials.'\u003ccite>Dr. David Knopman, Mayo Clinic\u003c/cite>\u003c/aside>\n\u003cp>Long-term studies indicate this protein — known as amyloid beta — starts building up excessively in the brain 15 or 20 years \u003ca href=\"https://www.mayoclinic.org/medical-professionals/clinical-updates/neurosciences/preclinical-alzheimers-disease\" target=\"_blank\" rel=\"noopener\">before any signs \u003c/a>of memory loss or cognitive difficulties. Healthy brains are \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24493463\" target=\"_blank\" rel=\"noopener\">generally free \u003c/a>from these fibers of accumulated amyloid that have been linked to brain cell damage seen in Alzheimer's patients.\u003c/p>\n\u003cp>About\u003ca href=\"https://www.alz.org/facts/\" target=\"_blank\" rel=\"noopener\"> 5.5 million Americans\u003c/a> currently have the disease, according to the Alzheimer's Association.\u003c/p>\n\u003cp>Researchers like Aisen, who teaches at the University of Southern California's Keck School of Medicine, are betting that the early targeting and destruction of amyloid proteins will stop the disease before it can wreak havoc on a patient’s mind, and even long before overt symptoms appear. It's a novel idea for tackling Alzheimer's, based on tools like brain-imaging PET scans and long-term studies that have tracked amyloid buildup along with declines in memory.\u003c/p>\n\u003cp>A group of clinical trials just underway or currently recruiting subjects will test this approach. If they fail, it could prove to be the nail in the coffin for treatment based on the \u003ca href=\"https://www.google.com/search?q=amyloid+hypothesis\" target=\"_blank\" rel=\"noopener\">amyloid hypothesis\u003c/a> -- the idea that eradicating amyloid plaque will prevent or cure the disease. Multiple trials targeting the protein after symptoms have already begun have shown \u003ca href=\"https://www.theatlantic.com/health/archive/2017/02/alzheimers-amyloid-hypothesis/517185/\" target=\"_blank\" rel=\"noopener\">disappointing results\u003c/a>, including Eli Lilly’s high-profile \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/01/11/failure-of-experimental-alzheimers-drug-the-latest-blow-to-amyloid-hypothesis/\" target=\"_blank\" rel=\"noopener\">flop\u003c/a> last year with the drug solanezumab.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Dr. David Knopman, a clinician and researcher in cognitive disorders at the Mayo Clinic, thinks looking for drugs outside of amyloid targets “is critically important for the field.\" He mentions targeting the\u003ca href=\"http://blogs.sciencemag.org/pipeline/archives/2017/05/26/a-movement-towards-tau-in-alzheimers\" target=\"_blank\" rel=\"noopener\"> tau protein \u003c/a>as an approach researchers are excited about.\u003c/p>\n\u003cp>\"Even if an anti-amyloid agent did work,\" he says, \"there must be other processes downstream that could be more easily targeted or effective than amyloid.”\u003c/p>\n\u003cp>\u003cstrong>Amyloid, But Early\u003c/strong>\u003cbr>\n\u003c/p>\u003cp>\u003c/p>\u003cp>But according to Aisen, solanezumab is not dead yet. The problem with past trials, he believes, is they did not get to patients early enough.\u003c/p>\n\u003cp>“We strongly believe the effect will be greater in prevention trials that are underway, probably about 15 years earlier in the course of Alzheimer’s than the studies that were completed,\" he says.\u003c/p>\n\u003cp>This new crop of trials — five in total — have either recently begun or will soon get underway. Each trial is aiming to treat and prevent Alzheimer’s by targeting amyloid before cognitive symptoms ever develop.\u003c/p>\n\u003cp>Aisen is one of the lead scientists for the Anti-Amyloid Treatment in Asymptomatic Alzheimer’s (or A4) trial. As part of the trial, solanezumab will be given to seniors ages 65 to 85 who have elevated levels of amyloid plaque but no outward symptoms. Some of the 1,150 participants will receive the drug, an antibody that cleans up free-floating amyloid, over the course of four-and-a-half years, while others will get a placebo.\u003c/p>\n\u003cp>The participants will be monitored throughout for changes in memory and cognition, along with lab tests and brain imaging to detect physiological changes.\u003c/p>\n\u003cp>Another study known as the EARLY trial is still recruiting participants, ages 60 to 85, also healthy but at risk for Alzheimer's due to an elevated amyloid level or other factors. The treatment period lasts for four-and-a-half years with a drug that hampers the production of the protein. Both the A4 and the EARLY trials are coordinated by the \u003ca href=\"http://keck.usc.edu/atri/research/studies/\" target=\"_blank\" rel=\"noopener\">Alzheimer’s Therapeutic Research Institute\u003c/a>, which Aisen directs.\u003c/p>\n\u003cp>The \u003ca href=\"http://banneralz.org/research-clinical-trials/studies-currently-enrolling.aspx\" target=\"_blank\" rel=\"noopener\">Banner Alzheimer’s Institute\u003c/a> is conducting a trial on a different drug that also blocks the production of amyloid. Its Alzheimer’s Prevention Initiative program is still recruiting 1,300 participants worldwide for the trial, which will last 5 to 8 years. Known as the API Generation study, individuals ages 60 to 75 who are healthy but have a genetic profile that increases their risk for Alzheimer’s will be treated with one of two drugs. One targets amyloid in the brain for removal, and the other acts in a unique way that’s analogous to “the body being able to create its own vaccine,” says principal scientist Jessica Langbaum at Banner Alzheimer’s Institute.\u003c/p>\n\u003cp>Participants are selected based on a genetic risk factor known as APOE4, though they will not be made aware of this if they choose not to, says Langbaum. The study will also provide genetic counseling so that risk profiles aren’t misunderstood as prophecies of disease.\u003c/p>\n\u003cp>The Banner institute has created a registry called \u003ca href=\"http://banneralz.org/research-clinical-trials/genematch.aspx\" target=\"_blank\" rel=\"noopener\">GeneMatch\u003c/a> for Alzheimer's \u003ca href=\"http://banneralz.org/research-clinical-trials/studies-currently-enrolling.aspx\" target=\"_blank\" rel=\"noopener\">studies\u003c/a> currently enrolling people. These studies call for subjects as young as 40.\u003c/p>\n\u003cp>\u003cstrong>'Either It Works or It Doesn't'\u003c/strong>\u003c/p>\n\u003cp>In these three trials, even though the subjects have biochemical markers linked to the disease, the participants will not necessarily wind up with Alzheimer's.\u003c/p>\n\u003cp>Not so with two other two trials that are looking at a form of \u003ca href=\"https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers/art-20048356\" target=\"_blank\" rel=\"noopener\">early onset Alzheimer’s. \u003c/a>These individuals all have one of a few rare genes in which the disease manifests before age 65, usually when people are in their 40s or 50s. About 5 percent of people with Alzheimer's fall into this category.\u003c/p>\n\u003cp>Will targeting amyloid in the asymptomatic stage keep dementia at bay? That’s the billion-dollar question. 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"content": "\u003cp>Depending on whom you ask, finding out whether your genes make you a better athlete or give you healthier skin may be as easy as swabbing your cheeks for a DNA test on your way into a football game. But others say these “wellness” tests marketed directly to consumers are modern snake oil — worthless, or even misleading.\u003c/p>\n\u003cp>On Monday, the Food and Drug Administration gave a boost to direct-to-consumer genetic testing when it announced plans to streamline its approval process.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘Giving out DNA kits at a football game screams out for regulation.’\u003ccite>Peter Pitts, Center for Medicine in the Public Interest\u003c/cite>\u003c/aside>\n\u003cp>“These tests can prompt consumers to be more engaged in pursuing the benefits of healthy lifestyle choices and more aware of their health risks,” FDA Commissioner Scott Gottlieb said in a \u003ca href=\"https://www.prnewswire.com/news-releases/statement-from-fda-commissioner-scott-gottlieb-md-on-implementation-of-agencys-streamlined-development-and-review-pathway-for-consumer-tests-that-evaluate-genetic-health-risks-300549992.html\" target=\"_blank\" rel=\"noopener\">statement\u003c/a>. However, he continued, “They’re not without their own risks — especially if they provide consumers with incorrect or misleading information that may be used to make health choices without considering the advice of a medical professional.”\u003c/p>\n\u003cp>The FDA intends to let sellers of direct-to-consumer DNA test kits seek a one-time FDA review, which would allow subsequent tests to be sold without going first to the FDA for approval. Under present rules, each new health test must be submitted and reviewed. The FDA’s jurisdiction applies to tests used to assess or diagnose health.\u003c/p>\n\u003cp>But a company in Boston is finding out that mass marketing of DNA tests attracts not just customers and fans, but skeptics and regulators. \u003ca href=\"http://orig3n.com/\" target=\"_blank\" rel=\"noopener\">Orig3n\u003c/a>, which sells genetic test kits with catchy names like “Fitcode,” “Fuel” and “Bliss” at festivals and sporting events, now finds itself under scrutiny by state and federal officials.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“The California Department of Public Health is investigating the nature and distribution of these test kits by Orig3n at Levi’s Stadium in Santa Clara,” a department representative said in an email.\u003c/p>\n\u003cp>At every 49ers home game during the current season, the company has a booth where it offers free introductory DNA test kits to the 68,000 fans entering the stadium. Fans can also purchase other tests at prices ranging from $29 to $149 each. It has a similar relationship with the Baltimore Ravens, but a plan to give test kits to every fan entering a September game was called off after Maryland regulators had some questions.\u003c/p>\n\u003cp>“I want people to learn more about themselves, and what they choose to do with that information is really up to them,” says Orig3n co-founder and chief operating officer Kate Blanchard. “But some of the information can really impact the way they live their life.”\u003c/p>\n\u003cp>That is precisely the problem, and it’s why state and federal regulators have said that “information” tests like Orig3n’s should be regulated as medical tests, because they’re assessing a person’s health. It’s a complex question, as the FDA’s Gottlieb notes. “Consider the consequences of a person who is told they’re not at risk for coronary heart disease and incorrectly opts to forgo dietary changes or drugs that reduce their risk of heart attack and death,” he says.\u003c/p>\n\u003cp>As much as genetic science has advanced, scientists do not fully understand how the more than 50 million known genetic variations interact with each other or with lifestyle and other factors to affect someone’s health, wellness or behavior. Very few genes are as closely associated with a specific outcome as the breast cancer genes BRCA1 and BRCA2, and even a positive test for these cancer-associated genes is insufficient for doctors to advise patients to have surgery or other major treatments.\u003c/p>\n\u003cp>In other words, you can get a test that tells you what variations you have, but that test alone cannot predict your future or dictate specific health or lifestyle decisions. Skeptics worry that people will read too much into genetic test results, especially if they are done without the help of a medical professional.\u003c/p>\n\u003cp>Blanchard says she stepped up her personal training regimen after her DNA test indicated that she might perform well in endurance sports. She says it was a change she might not have made without this information.\u003c/p>\n\u003cp>Distributing DNA tests to tens of thousands of people at NFL football games “is not good clinical practice,” says Peter Pitts, president of the advocacy group \u003ca href=\"http://cmpi.org/\">Center for Medicine in the Public Interest\u003c/a>. Unlike tests done in clinical laboratories, like tests for diabetes or cholesterol, there is less control over the quality of the test process, so the resulting data may be “highly questionable,” says Pitts, who is a former associate commissioner of the Food and Drug Administration.\u003c/p>\n\u003cp>Now you can get a nutrition plan and ready-to-eat meals based on “your body’s unique make-up” from Campbell’s Soup-funded \u003ca href=\"http://habit.com/\">Habit\u003c/a>. \u003ca href=\"http://ancestry.com/\">Ancestry\u003c/a> sells a test that “tells a more complete story of you,” and \u003ca href=\"https://www.helix.com/shop/\">Helix\u003c/a> promotes more than a dozen of its partners who sell genetic tests ranging from National Geographic (your ancestor’s migration paths) to companies that offer targeted fitness routines based on the DNA results, and several health companies. There is even a \u003ca href=\"https://www.helix.com/shop/vinome-wine-explorer/\">wine club\u003c/a> with wines “scientifically selected based on your DNA.”\u003c/p>\n\u003cp>“We don’t begrudge the excitement and the desire to help people based on genetics,” says Shirley Wu, director of product science for 23andMe, a direct-to-consumer genetic testing company that started in 2006. However, she questions companies that may be overpromising on what the tests can tell you. The science behind some consumer-oriented tests is lacking, says Wu. “We are still at the beginning of our understanding.”\u003c/p>\n\u003cp>The FDA \u003ca href=\"https://www.npr.org/sections/health-shots/2013/12/06/249231236/23andme-bows-to-fdas-demands-drops-health-claims\">halted 23andMe’s sales\u003c/a> of medical-risk tests in 2013, saying that it couldn’t prove those tests were accurate. In April, 23andMe obtained federal \u003ca href=\"https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm551185.htm\">clearance\u003c/a> to resume selling direct-to-consumer DNA tests for certain health risks. Now, consumers can get reports on their ancestry as well as genes associated with sleep quality, lactose sensitivity, weight and other wellness factors and risks for several dozen inherited conditions for about $200.\u003c/p>\n\u003cp>And companies can offer very different information on the same finding. That’s evident in two reports on the CC variant of the ACTN3 gene:\u003c/p>\n\u003cul>\n\u003cli>23andMe tells you that you have a trait “common among elite power athletes … but its role for non-elite athletes isn’t completely understood.” The report also says that lifestyle and training are the driver of athletic performance for most people.\u003c/li>\n\u003cli>Orig3n also tells you that this trait is common in elite athletes and “is found in 45 percent of the general population.” And it “contributes to your ability to perform better in sports requiring power such as sprinting.” The Orig3n report recommends the types of sports that someone with this biomarker might want to pursue.\u003c/li>\n\u003c/ul>\n\u003cp>A \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4278350/\">2015 review\u003c/a> of genetic testing for sports concluded that there is little value to knowing the ACTN3 or other variants in recreational athletes. However, genetic testing of professional athletes may be useful for training and injury prevention, the review authors concluded.\u003c/p>\n\u003cp>“For the most part, data on personal genomic testing have revealed little or no harms but also little or no health benefits,” writes Dr. Muin Khoury, director of the Office of Public Health Genomics at the Centers for Disease Control and Prevention in a \u003ca href=\"https://blogs.cdc.gov/genomics/2017/04/18/direct-to-consumer-2/\">recent article\u003c/a>. “Also, evidence on the ability of genetic information to change health behavior has been lacking.”\u003c/p>\n\u003cp>Blanchard says that Orig3n got the idea for its fitness DNA test after it solicited blood samples for research at marathons and other sporting events. “People started asking, ‘What can you tell me about me?’ ” she says.\u003c/p>\n\u003cp>The business model for 23andMe, Helix and some of the other direct-to-consumer DNA testing companies doesn’t rely solely on sales of test kits. They want to aggregate massive amounts of human genetic data that can be mined for research and commercial uses. Consumers are asked to “opt-in” to this when getting tested — and most do, according to 23andMe.\u003c/p>\n\u003cp>Orig3n is an exception: It says it would contact people separately if it ever wanted to use the DNA for anything other than the person’s own tests. But those test kits create a pool of people who would be more likely to give blood samples for Orig3n’s stem cell research. Its business banks on amassing tens of thousands of human blood samples so that it can create many stem cell lines.\u003c/p>\n\u003cp>Orig3n has sponsorship arrangements with the Baltimore Ravens and the San Francisco 49ers football teams. Fans at home games can get a free test that reports on three genes — ACTN3 for muscle force, FOXP2 for language-learning ability and AGER for skin aging. For $149, Orig3n reports back on 27 genes related to strength, metabolism, endurance and power. The company’s other tests are to provide information about genes associated with skin, child development, and how you think, feel and react.\u003c/p>\n\u003cp>Orig3n says its tests are “not diagnostic” and “for informational purposes only.” The federal agency that oversees medical labs disagrees. That distinction is critical because it is the boundary between regulated medical services and ones that avoid that level of scrutiny.\u003c/p>\n\u003cp>After reviewing Orig3n’s materials, the Centers for Medicare and Medicaid Services told the company on Oct. 30 that it must follow the rules for medical laboratories because its services include “genetic testing for the assessment of health.”\u003c/p>\n\u003cp>The decision was based on 18 of the 140 genes included in Orig3n’s tests, according to a \u003ca href=\"https://www.documentcloud.org/documents/4176983-CMS-Letter.html\">letter\u003c/a> from CMS to Orig3n.\u003c/p>\n\u003cp>Orig3n’s Blanchard says the company will continue selling its tests without those 18 genes until Orig3n receives approval from regulators to resume. In addition to CMS, Orig3n must satisfy state regulators in Massachusetts, Maryland and California – or any other states where it operates. “Going forward, we will continue to work with CMS, California, Massachusetts and the other states to ensure that we are meeting all federal and state regulatory requirements regarding our products,” Blanchard said in an email.\u003c/p>\n\u003cp>That may not be enough to satisfy all the critics. Says Pitts: “Giving out DNA kits at a football game screams out for regulation.”\u003c/p>\n\u003chr>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Doug Levy is a freelance writer based in Sausalito, Calif. \u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=You+Can+Get+Your+DNA+Tested+At+An+NFL+Game.+Should+You%3F+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Depending on whom you ask, finding out whether your genes make you a better athlete or give you healthier skin may be as easy as swabbing your cheeks for a DNA test on your way into a football game. But others say these “wellness” tests marketed directly to consumers are modern snake oil — worthless, or even misleading.\u003c/p>\n\u003cp>On Monday, the Food and Drug Administration gave a boost to direct-to-consumer genetic testing when it announced plans to streamline its approval process.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘Giving out DNA kits at a football game screams out for regulation.’\u003ccite>Peter Pitts, Center for Medicine in the Public Interest\u003c/cite>\u003c/aside>\n\u003cp>“These tests can prompt consumers to be more engaged in pursuing the benefits of healthy lifestyle choices and more aware of their health risks,” FDA Commissioner Scott Gottlieb said in a \u003ca href=\"https://www.prnewswire.com/news-releases/statement-from-fda-commissioner-scott-gottlieb-md-on-implementation-of-agencys-streamlined-development-and-review-pathway-for-consumer-tests-that-evaluate-genetic-health-risks-300549992.html\" target=\"_blank\" rel=\"noopener\">statement\u003c/a>. However, he continued, “They’re not without their own risks — especially if they provide consumers with incorrect or misleading information that may be used to make health choices without considering the advice of a medical professional.”\u003c/p>\n\u003cp>The FDA intends to let sellers of direct-to-consumer DNA test kits seek a one-time FDA review, which would allow subsequent tests to be sold without going first to the FDA for approval. Under present rules, each new health test must be submitted and reviewed. The FDA’s jurisdiction applies to tests used to assess or diagnose health.\u003c/p>\n\u003cp>But a company in Boston is finding out that mass marketing of DNA tests attracts not just customers and fans, but skeptics and regulators. \u003ca href=\"http://orig3n.com/\" target=\"_blank\" rel=\"noopener\">Orig3n\u003c/a>, which sells genetic test kits with catchy names like “Fitcode,” “Fuel” and “Bliss” at festivals and sporting events, now finds itself under scrutiny by state and federal officials.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The California Department of Public Health is investigating the nature and distribution of these test kits by Orig3n at Levi’s Stadium in Santa Clara,” a department representative said in an email.\u003c/p>\n\u003cp>At every 49ers home game during the current season, the company has a booth where it offers free introductory DNA test kits to the 68,000 fans entering the stadium. Fans can also purchase other tests at prices ranging from $29 to $149 each. It has a similar relationship with the Baltimore Ravens, but a plan to give test kits to every fan entering a September game was called off after Maryland regulators had some questions.\u003c/p>\n\u003cp>“I want people to learn more about themselves, and what they choose to do with that information is really up to them,” says Orig3n co-founder and chief operating officer Kate Blanchard. “But some of the information can really impact the way they live their life.”\u003c/p>\n\u003cp>That is precisely the problem, and it’s why state and federal regulators have said that “information” tests like Orig3n’s should be regulated as medical tests, because they’re assessing a person’s health. It’s a complex question, as the FDA’s Gottlieb notes. “Consider the consequences of a person who is told they’re not at risk for coronary heart disease and incorrectly opts to forgo dietary changes or drugs that reduce their risk of heart attack and death,” he says.\u003c/p>\n\u003cp>As much as genetic science has advanced, scientists do not fully understand how the more than 50 million known genetic variations interact with each other or with lifestyle and other factors to affect someone’s health, wellness or behavior. Very few genes are as closely associated with a specific outcome as the breast cancer genes BRCA1 and BRCA2, and even a positive test for these cancer-associated genes is insufficient for doctors to advise patients to have surgery or other major treatments.\u003c/p>\n\u003cp>In other words, you can get a test that tells you what variations you have, but that test alone cannot predict your future or dictate specific health or lifestyle decisions. Skeptics worry that people will read too much into genetic test results, especially if they are done without the help of a medical professional.\u003c/p>\n\u003cp>Blanchard says she stepped up her personal training regimen after her DNA test indicated that she might perform well in endurance sports. She says it was a change she might not have made without this information.\u003c/p>\n\u003cp>Distributing DNA tests to tens of thousands of people at NFL football games “is not good clinical practice,” says Peter Pitts, president of the advocacy group \u003ca href=\"http://cmpi.org/\">Center for Medicine in the Public Interest\u003c/a>. Unlike tests done in clinical laboratories, like tests for diabetes or cholesterol, there is less control over the quality of the test process, so the resulting data may be “highly questionable,” says Pitts, who is a former associate commissioner of the Food and Drug Administration.\u003c/p>\n\u003cp>Now you can get a nutrition plan and ready-to-eat meals based on “your body’s unique make-up” from Campbell’s Soup-funded \u003ca href=\"http://habit.com/\">Habit\u003c/a>. \u003ca href=\"http://ancestry.com/\">Ancestry\u003c/a> sells a test that “tells a more complete story of you,” and \u003ca href=\"https://www.helix.com/shop/\">Helix\u003c/a> promotes more than a dozen of its partners who sell genetic tests ranging from National Geographic (your ancestor’s migration paths) to companies that offer targeted fitness routines based on the DNA results, and several health companies. There is even a \u003ca href=\"https://www.helix.com/shop/vinome-wine-explorer/\">wine club\u003c/a> with wines “scientifically selected based on your DNA.”\u003c/p>\n\u003cp>“We don’t begrudge the excitement and the desire to help people based on genetics,” says Shirley Wu, director of product science for 23andMe, a direct-to-consumer genetic testing company that started in 2006. However, she questions companies that may be overpromising on what the tests can tell you. The science behind some consumer-oriented tests is lacking, says Wu. “We are still at the beginning of our understanding.”\u003c/p>\n\u003cp>The FDA \u003ca href=\"https://www.npr.org/sections/health-shots/2013/12/06/249231236/23andme-bows-to-fdas-demands-drops-health-claims\">halted 23andMe’s sales\u003c/a> of medical-risk tests in 2013, saying that it couldn’t prove those tests were accurate. In April, 23andMe obtained federal \u003ca href=\"https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm551185.htm\">clearance\u003c/a> to resume selling direct-to-consumer DNA tests for certain health risks. Now, consumers can get reports on their ancestry as well as genes associated with sleep quality, lactose sensitivity, weight and other wellness factors and risks for several dozen inherited conditions for about $200.\u003c/p>\n\u003cp>And companies can offer very different information on the same finding. That’s evident in two reports on the CC variant of the ACTN3 gene:\u003c/p>\n\u003cul>\n\u003cli>23andMe tells you that you have a trait “common among elite power athletes … but its role for non-elite athletes isn’t completely understood.” The report also says that lifestyle and training are the driver of athletic performance for most people.\u003c/li>\n\u003cli>Orig3n also tells you that this trait is common in elite athletes and “is found in 45 percent of the general population.” And it “contributes to your ability to perform better in sports requiring power such as sprinting.” The Orig3n report recommends the types of sports that someone with this biomarker might want to pursue.\u003c/li>\n\u003c/ul>\n\u003cp>A \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4278350/\">2015 review\u003c/a> of genetic testing for sports concluded that there is little value to knowing the ACTN3 or other variants in recreational athletes. However, genetic testing of professional athletes may be useful for training and injury prevention, the review authors concluded.\u003c/p>\n\u003cp>“For the most part, data on personal genomic testing have revealed little or no harms but also little or no health benefits,” writes Dr. Muin Khoury, director of the Office of Public Health Genomics at the Centers for Disease Control and Prevention in a \u003ca href=\"https://blogs.cdc.gov/genomics/2017/04/18/direct-to-consumer-2/\">recent article\u003c/a>. “Also, evidence on the ability of genetic information to change health behavior has been lacking.”\u003c/p>\n\u003cp>Blanchard says that Orig3n got the idea for its fitness DNA test after it solicited blood samples for research at marathons and other sporting events. “People started asking, ‘What can you tell me about me?’ ” she says.\u003c/p>\n\u003cp>The business model for 23andMe, Helix and some of the other direct-to-consumer DNA testing companies doesn’t rely solely on sales of test kits. They want to aggregate massive amounts of human genetic data that can be mined for research and commercial uses. Consumers are asked to “opt-in” to this when getting tested — and most do, according to 23andMe.\u003c/p>\n\u003cp>Orig3n is an exception: It says it would contact people separately if it ever wanted to use the DNA for anything other than the person’s own tests. But those test kits create a pool of people who would be more likely to give blood samples for Orig3n’s stem cell research. Its business banks on amassing tens of thousands of human blood samples so that it can create many stem cell lines.\u003c/p>\n\u003cp>Orig3n has sponsorship arrangements with the Baltimore Ravens and the San Francisco 49ers football teams. Fans at home games can get a free test that reports on three genes — ACTN3 for muscle force, FOXP2 for language-learning ability and AGER for skin aging. For $149, Orig3n reports back on 27 genes related to strength, metabolism, endurance and power. The company’s other tests are to provide information about genes associated with skin, child development, and how you think, feel and react.\u003c/p>\n\u003cp>Orig3n says its tests are “not diagnostic” and “for informational purposes only.” The federal agency that oversees medical labs disagrees. That distinction is critical because it is the boundary between regulated medical services and ones that avoid that level of scrutiny.\u003c/p>\n\u003cp>After reviewing Orig3n’s materials, the Centers for Medicare and Medicaid Services told the company on Oct. 30 that it must follow the rules for medical laboratories because its services include “genetic testing for the assessment of health.”\u003c/p>\n\u003cp>The decision was based on 18 of the 140 genes included in Orig3n’s tests, according to a \u003ca href=\"https://www.documentcloud.org/documents/4176983-CMS-Letter.html\">letter\u003c/a> from CMS to Orig3n.\u003c/p>\n\u003cp>Orig3n’s Blanchard says the company will continue selling its tests without those 18 genes until Orig3n receives approval from regulators to resume. In addition to CMS, Orig3n must satisfy state regulators in Massachusetts, Maryland and California – or any other states where it operates. “Going forward, we will continue to work with CMS, California, Massachusetts and the other states to ensure that we are meeting all federal and state regulatory requirements regarding our products,” Blanchard said in an email.\u003c/p>\n\u003cp>That may not be enough to satisfy all the critics. Says Pitts: “Giving out DNA kits at a football game screams out for regulation.”\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Doug Levy is a freelance writer based in Sausalito, Calif. \u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=You+Can+Get+Your+DNA+Tested+At+An+NFL+Game.+Should+You%3F+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>If you've been reading about the\u003ca href=\"https://www.scistar-study.com/\" target=\"_blank\" rel=\"noopener\"> SCiStar\u003c/a> stem cell trial, you know the company's \u003ca href=\"http://asteriasbiotherapeutics.com/inv_news_releases_text.php?releaseid=2303887&date=October+02%2C+2017&title=Asterias+Announces+Two+Significant+Developments+for+Spinal+Cord+Injury+Program%3Chttp://asteriasbiotherapeutics.com/inv_news_releases_text.php?releaseid=2303887&date=October+02%2C+2017&title=Asterias+Announces+Two+Significant+Developments+for+Spinal+Cord+Injury+Program%3E\" target=\"_blank\" rel=\"noopener\">reports\u003c/a> of its initial results sound truly remarkable.\u003c/p>\n\u003caside class=\"alignright\">All six paralyzed patients in Phase II of the SCiStar trial have regained some movement, and 4 out of 6 have made significant gains.\u003c/aside>\n\u003cp>The trial is injecting \u003ca href=\"https://en.wikipedia.org/wiki/Oligodendrocyte_progenitor_cell\" target=\"_blank\" rel=\"noopener\">oligodendrocyte progenitor cells\u003c/a>, produced from human embryonic stem cells, into patients ages 18-69. These trial subjects have suffered recent spinal cord injuries in the neck, resulting in the loss of nearly all sensation and movement below the injury, as well as some paralysis of the arms and legs.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The results so far: One year after six people with severe spinal cord injuries received a dose of more than 10 million stem cells, all six patients have progressed at least one motor level on both sides of their bodies, based on a widely used \u003c/span>\u003cspan class=\"s1\">\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3232636/\" target=\"_blank\" rel=\"noopener\">scale \u003c/a>\u003c/span>that measures the range of movement in various muscles.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">In addition, four of the patients jumped two levels on at least one side, and one patient advanced three. And two patients progressed two motor levels on both sides. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">This is all according to Asterias Biotherapeutics, the company conducting the trial. Asterias also says\u003c/span> patients in this cohort showed improvement between the six-month and 12-month marks from the time they received the infusion of stem cells.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The take-home message is that we can only hope to truly demonstrate efficacy in a randomized control trial.'\u003ccite>Dr. Edward Wirth, Asterias Biotherapeutics\u003c/cite>\u003c/aside>\n\u003cp>“Usually what you see is a plateau, and that’s not what we’re seeing here. They continued to improve,” said Dr. Charles Liu, an investigator on the study and director of the USC Neurorestoration Center. “It was a durable effect. And that’s incredibly exciting.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan class=\"s1\">The trial is legitimate. It’s partially funded by the\u003ca href=\"https://www.cirm.ca.gov/\" target=\"_blank\" rel=\"noopener\"> California Institute for Regenerative Medicine,\u003c/a> the state's stem cell agency; well-known spinal experts are participating; and the FDA has certified the treatment as one that preliminary clinical evidence indicates has the “potential to address unmet medical needs” related to a “serious or life-threatening disease or condition.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan class=\"s1\">There have also been a steady stream of media reports about the possibility of a breakthrough, including our own \u003ca href=\"https://ww2.kqed.org/futureofyou/tag/spinal-injuries/\" target=\"_blank\" rel=\"noopener\">coverage \u003c/a>and a recent \u003ca href=\"http://discovermagazine.com/2017/oct/what-once--was-lost\" target=\"_blank\" rel=\"noopener\">feature\u003c/a> by Discover magazine and front-page\u003ca href=\"http://www.sfchronicle.com/health/article/Super-exciting-results-in-stem-cell-therapy-12245199.php\" target=\"_blank\" rel=\"noopener\"> story \u003c/a>from the San Francisco Chronicle.\u003c/span>\u003c/p>\n\u003cp>\u003cspan class=\"s1\">\"'Super exciting' results in stem cell therapy trial,\" was the headline, quoting Dr. Edward Wirth, the chief medical officer at Asterias.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>It's Still Early\u003c/strong>\u003c/p>\n\u003cp>Regaining two motor levels in spinocervical patients is significant. That level of improvement could mean the difference between full paralysis from the neck down, requiring a ventilator to breathe, versus regaining some arm, hand and finger movement, enabling patients to take care of many of life’s daily tasks unassisted.\u003c/p>\n\u003cp>Below is video of Kris Boesen, a patient in the trial who at the age of 20 was paralyzed from the neck down.\u003c/p>\n\u003cp>\"I couldn't drink, I couldn't feed myself, I couldn't text or pretty much do anything,\" he says. \"I was basically just existing.\"\u003c/p>\n\u003cp>But after the stem cell treatment, he says, \"I'm able to live my life.\"\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=N0ZWqBWDoQI&ab_channel=AmericansforCures\u003c/p>\n\u003cp>Another trial patient, Lucas Lindner, was in a car accident that left him a quadriplegic, with no use of his hands or legs. After receiving the stem cells, he recovered to the point of being able to throw a ball, type and use a soldering gun.\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=1DerDpM_FO4&ab_channel=AsteriasBiotherapeutics\u003c/p>\n\u003cp>These are compelling stories. And if the treatment really does work, it could provide hope to traumatic-injury patients who might otherwise show little progress or improvement in their paralysis.\u003c/p>\n\u003cp>But of course, the sample size we've seen so far is small — really small — just six patients. And it's true that some patients have been known to spontaneously recover some movement after spinal injuries without having received a cutting-edge stem cell treatment. Also, in this second phase of the trial, there is no control group. A double-blind, control-group study is planned in Phase III next year.\u003c/p>\n\u003caside class=\"pullquote alignright\">'As a scientist I think it’s very exciting.'\u003ccite>Oswald Steward, UC Irvine School of Medicine\u003c/cite>\u003c/aside>\n\u003cp>So we wondered, how can the people running the trial know, right now, that the level of improvement in their subjects is favorable to patients who haven't received the treatment, prompting such optimistic press releases? And how much excitement should anyone allow themselves over these early results?\u003c/p>\n\u003cp>\u003cstrong>Using Historical Data to Compare\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">The likelihood of all six patients recovering to the degree they have on their own is unlikely, researchers say.\u003c/p>\n\u003cp class=\"p1\">“This is as good as you could hope at this point,” said USC's Liu, in March. “So far all the evidence is pointing in the right direction.\"\u003c/p>\n\u003cp>Asterias, based in Fremont, Calif., has tried to assess these early results by comparing the improvement in its cohort of patients to historical data from an estimated pool of 3,300 spinal injury victims in the \u003ca href=\"https://www.emsci.org/\" target=\"_blank\" rel=\"noopener\">European Multicenter Study about Spinal Cord Injury\u003c/a>. Asterias says the level of progress for its six subjects is about twice the rate of recovery patients saw in the European data, dating back to 2001.\u003c/p>\n\u003cp>\"The 12-month data showed 67% (4/6) of Cohort 2 (subjects) have recovered 2 or more motor levels on at least one side through 12 months, which is more than double the rates of recovery seen in both matched historical controls and published data in a similar population,\" the company wrote in an October \u003ca href=\"http://www.asteriasbiotherapeutics.com/inv_news_releases_text.php?releaseid=2303887&date=October+02%2C+2017&title=Asterias+Announces+Two+Significant+Developments+for+Spinal+Cord+Injury+Program\" target=\"_blank\" rel=\"noopener\">press release\u003c/a>.\u003c/p>\n\u003cp>But according to Oswald Steward, director of the Reeve-Irvine spinal cord research center at the UC Irvine School of Medicine, there are so many variables to be considered when you look at historical data, you really have to take any conclusions with a few grains of salt.\u003c/p>\n\u003cp>“It sounds good, but it’s not a control group, there’s no real data here,\" Steward says. \"It’s nice to give some background, to give you a sense of [comparative recovery rates], but that’s definitely the way I would put it.\"\u003c/p>\n\u003cp>Getting background information to give a rough framework of comparison is exactly what the company wanted to accomplish, according to \u003cspan class=\"s1\">Wirth, Asterias' chief medical officer.\u003c/span>\u003c/p>\n\u003cp>\u003cspan class=\"s1\">\"The take-home message is that we can only hope to truly demonstrate efficacy in a randomized control trial,\" he says. \u003c/span>\u003c/p>\n\u003cp>\u003cspan class=\"s1\">That's the plan in Phase\u003cstrong> \u003c/strong>III of the trial. \u003c/span>\u003cspan class=\"s1\">\"The historical controls are merely a temporary comparator to help us determine whether the ... program should move forward.\"\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cstrong>An Unusual Step\u003c/strong>\u003c/span>\u003c/p>\n\u003cp>Historical data is often used in cancer studies because of the fixed nature of outcomes in some cancer types, but it's unusual to see early-stage clinical trials in other areas use it as a comparison, says Karen Messer, chief of the Biostatistics and Bioinformatics division at the Moores Cancer Center at UC San Diego Health.\u003c/p>\n\u003cp>“Use of historical controls is common in early-phase cancer studies because they usually have small sample sizes and the end points are really well-defined,\" she says.\u003c/p>\n\u003cp>But spinal cord injury outcomes may be more varied, Messer says, so the results of an intervention wouldn't be as reliable.\u003c/p>\n\u003cp>“(T)here are a few things to watch for: Are the patients comparable? Has treatment changed? You want to make sure the response assessment is not subject to any judgment calls.”\u003c/p>\n\u003cp>Asterias mined the European historical data because it was the only large spinal-injury database with current information that could be licensed, Wirth said in an internal memo on the rationale and methods for compiling historical data.\u003c/p>\n\u003cp>In that memo, Wirth wrote that some variables are not included in the European database. These include MRI data on spinal cord lesions and the timing or quality of decompression, a bone-trimming surgery that makes more room for nerves. These differences in the data make direct comparisons harder.\u003c/p>\n\u003cp>Diana Miglioretti is a biostatistics professor at UC Davis. She says historical data is an interesting approach to frame a comparison.\u003c/p>\n\u003cp>“Obviously it isn’t as strong as a control group,” she says, “but if there aren’t major time trends, it can be a reasonable alternative.”\u003c/p>\n\u003cp>In other words, Miglioretti says, if outcomes haven't changed over time — due to improvements in treatment, for example — it's not out of the question that historical data can serve as a control.\u003c/p>\n\u003cp>But according to spinal cord researcher Steward, that’s the main concern about taking historical data on spinal injuries at face value .\u003c/p>\n\u003cp>“In the past we treated spinal injury differently,” Steward says. “For instance the amount of time people spend in rehab is a lot less than it was 10 years ago.”\u003c/p>\n\u003cp>\u003cstrong>Strong Anecdotal Statements\u003c/strong>\u003c/p>\n\u003cp>From Steward’s point of view, the real reason to get excited about the phenomenal initial results of this stem cell therapy is not the supporting historical data, but rather the anecdotal statements by the clinical researchers.\u003c/p>\n\u003cp>For instance, he points to the statements by Richard Fessler, the lead investigator of the Asterias trial and a professor of neurosurgery at Rush University Medical Center in Chicago. “I’ve been treating these kinds of patients for 30 years,” Fessler said in the San Francisco Chronicle story, “and I’ve never seen anything like this before.” (Fessler has no financial stake in Asterias, company officials say.)\u003c/p>\n\u003cp>“When someone like Fessler says 'I’ve never seen anything like that,' ” Steward says, “I spend more time listening to that than to historical data.”\u003c/p>\n\u003cp>Steward also points out that this stem cell therapy won’t help those with chronic spinal injuries, but says it could be a game-changer for newly injured patients.\u003c/p>\n\u003cp>“Still, this is huge,” he says. “Things are progressing in a positive way. No bad outcomes, and people seem to be improving in a way that may be unprecedented. As a scientist I think it’s very exciting.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Jon Brooks contributed to this report.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you've been reading about the\u003ca href=\"https://www.scistar-study.com/\" target=\"_blank\" rel=\"noopener\"> SCiStar\u003c/a> stem cell trial, you know the company's \u003ca href=\"http://asteriasbiotherapeutics.com/inv_news_releases_text.php?releaseid=2303887&date=October+02%2C+2017&title=Asterias+Announces+Two+Significant+Developments+for+Spinal+Cord+Injury+Program%3Chttp://asteriasbiotherapeutics.com/inv_news_releases_text.php?releaseid=2303887&date=October+02%2C+2017&title=Asterias+Announces+Two+Significant+Developments+for+Spinal+Cord+Injury+Program%3E\" target=\"_blank\" rel=\"noopener\">reports\u003c/a> of its initial results sound truly remarkable.\u003c/p>\n\u003caside class=\"alignright\">All six paralyzed patients in Phase II of the SCiStar trial have regained some movement, and 4 out of 6 have made significant gains.\u003c/aside>\n\u003cp>The trial is injecting \u003ca href=\"https://en.wikipedia.org/wiki/Oligodendrocyte_progenitor_cell\" target=\"_blank\" rel=\"noopener\">oligodendrocyte progenitor cells\u003c/a>, produced from human embryonic stem cells, into patients ages 18-69. These trial subjects have suffered recent spinal cord injuries in the neck, resulting in the loss of nearly all sensation and movement below the injury, as well as some paralysis of the arms and legs.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The results so far: One year after six people with severe spinal cord injuries received a dose of more than 10 million stem cells, all six patients have progressed at least one motor level on both sides of their bodies, based on a widely used \u003c/span>\u003cspan class=\"s1\">\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3232636/\" target=\"_blank\" rel=\"noopener\">scale \u003c/a>\u003c/span>that measures the range of movement in various muscles.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">In addition, four of the patients jumped two levels on at least one side, and one patient advanced three. And two patients progressed two motor levels on both sides. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">This is all according to Asterias Biotherapeutics, the company conducting the trial. Asterias also says\u003c/span> patients in this cohort showed improvement between the six-month and 12-month marks from the time they received the infusion of stem cells.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The take-home message is that we can only hope to truly demonstrate efficacy in a randomized control trial.'\u003ccite>Dr. Edward Wirth, Asterias Biotherapeutics\u003c/cite>\u003c/aside>\n\u003cp>“Usually what you see is a plateau, and that’s not what we’re seeing here. They continued to improve,” said Dr. Charles Liu, an investigator on the study and director of the USC Neurorestoration Center. “It was a durable effect. And that’s incredibly exciting.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan class=\"s1\">The trial is legitimate. It’s partially funded by the\u003ca href=\"https://www.cirm.ca.gov/\" target=\"_blank\" rel=\"noopener\"> California Institute for Regenerative Medicine,\u003c/a> the state's stem cell agency; well-known spinal experts are participating; and the FDA has certified the treatment as one that preliminary clinical evidence indicates has the “potential to address unmet medical needs” related to a “serious or life-threatening disease or condition.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan class=\"s1\">There have also been a steady stream of media reports about the possibility of a breakthrough, including our own \u003ca href=\"https://ww2.kqed.org/futureofyou/tag/spinal-injuries/\" target=\"_blank\" rel=\"noopener\">coverage \u003c/a>and a recent \u003ca href=\"http://discovermagazine.com/2017/oct/what-once--was-lost\" target=\"_blank\" rel=\"noopener\">feature\u003c/a> by Discover magazine and front-page\u003ca href=\"http://www.sfchronicle.com/health/article/Super-exciting-results-in-stem-cell-therapy-12245199.php\" target=\"_blank\" rel=\"noopener\"> story \u003c/a>from the San Francisco Chronicle.\u003c/span>\u003c/p>\n\u003cp>\u003cspan class=\"s1\">\"'Super exciting' results in stem cell therapy trial,\" was the headline, quoting Dr. Edward Wirth, the chief medical officer at Asterias.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>It's Still Early\u003c/strong>\u003c/p>\n\u003cp>Regaining two motor levels in spinocervical patients is significant. That level of improvement could mean the difference between full paralysis from the neck down, requiring a ventilator to breathe, versus regaining some arm, hand and finger movement, enabling patients to take care of many of life’s daily tasks unassisted.\u003c/p>\n\u003cp>Below is video of Kris Boesen, a patient in the trial who at the age of 20 was paralyzed from the neck down.\u003c/p>\n\u003cp>\"I couldn't drink, I couldn't feed myself, I couldn't text or pretty much do anything,\" he says. \"I was basically just existing.\"\u003c/p>\n\u003cp>But after the stem cell treatment, he says, \"I'm able to live my life.\"\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/N0ZWqBWDoQI'\n title='//www.youtube.com/embed/N0ZWqBWDoQI'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>Another trial patient, Lucas Lindner, was in a car accident that left him a quadriplegic, with no use of his hands or legs. After receiving the stem cells, he recovered to the point of being able to throw a ball, type and use a soldering gun.\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/1DerDpM_FO4'\n title='//www.youtube.com/embed/1DerDpM_FO4'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>These are compelling stories. And if the treatment really does work, it could provide hope to traumatic-injury patients who might otherwise show little progress or improvement in their paralysis.\u003c/p>\n\u003cp>But of course, the sample size we've seen so far is small — really small — just six patients. And it's true that some patients have been known to spontaneously recover some movement after spinal injuries without having received a cutting-edge stem cell treatment. Also, in this second phase of the trial, there is no control group. A double-blind, control-group study is planned in Phase III next year.\u003c/p>\n\u003caside class=\"pullquote alignright\">'As a scientist I think it’s very exciting.'\u003ccite>Oswald Steward, UC Irvine School of Medicine\u003c/cite>\u003c/aside>\n\u003cp>So we wondered, how can the people running the trial know, right now, that the level of improvement in their subjects is favorable to patients who haven't received the treatment, prompting such optimistic press releases? And how much excitement should anyone allow themselves over these early results?\u003c/p>\n\u003cp>\u003cstrong>Using Historical Data to Compare\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">The likelihood of all six patients recovering to the degree they have on their own is unlikely, researchers say.\u003c/p>\n\u003cp class=\"p1\">“This is as good as you could hope at this point,” said USC's Liu, in March. “So far all the evidence is pointing in the right direction.\"\u003c/p>\n\u003cp>Asterias, based in Fremont, Calif., has tried to assess these early results by comparing the improvement in its cohort of patients to historical data from an estimated pool of 3,300 spinal injury victims in the \u003ca href=\"https://www.emsci.org/\" target=\"_blank\" rel=\"noopener\">European Multicenter Study about Spinal Cord Injury\u003c/a>. Asterias says the level of progress for its six subjects is about twice the rate of recovery patients saw in the European data, dating back to 2001.\u003c/p>\n\u003cp>\"The 12-month data showed 67% (4/6) of Cohort 2 (subjects) have recovered 2 or more motor levels on at least one side through 12 months, which is more than double the rates of recovery seen in both matched historical controls and published data in a similar population,\" the company wrote in an October \u003ca href=\"http://www.asteriasbiotherapeutics.com/inv_news_releases_text.php?releaseid=2303887&date=October+02%2C+2017&title=Asterias+Announces+Two+Significant+Developments+for+Spinal+Cord+Injury+Program\" target=\"_blank\" rel=\"noopener\">press release\u003c/a>.\u003c/p>\n\u003cp>But according to Oswald Steward, director of the Reeve-Irvine spinal cord research center at the UC Irvine School of Medicine, there are so many variables to be considered when you look at historical data, you really have to take any conclusions with a few grains of salt.\u003c/p>\n\u003cp>“It sounds good, but it’s not a control group, there’s no real data here,\" Steward says. \"It’s nice to give some background, to give you a sense of [comparative recovery rates], but that’s definitely the way I would put it.\"\u003c/p>\n\u003cp>Getting background information to give a rough framework of comparison is exactly what the company wanted to accomplish, according to \u003cspan class=\"s1\">Wirth, Asterias' chief medical officer.\u003c/span>\u003c/p>\n\u003cp>\u003cspan class=\"s1\">\"The take-home message is that we can only hope to truly demonstrate efficacy in a randomized control trial,\" he says. \u003c/span>\u003c/p>\n\u003cp>\u003cspan class=\"s1\">That's the plan in Phase\u003cstrong> \u003c/strong>III of the trial. \u003c/span>\u003cspan class=\"s1\">\"The historical controls are merely a temporary comparator to help us determine whether the ... program should move forward.\"\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cstrong>An Unusual Step\u003c/strong>\u003c/span>\u003c/p>\n\u003cp>Historical data is often used in cancer studies because of the fixed nature of outcomes in some cancer types, but it's unusual to see early-stage clinical trials in other areas use it as a comparison, says Karen Messer, chief of the Biostatistics and Bioinformatics division at the Moores Cancer Center at UC San Diego Health.\u003c/p>\n\u003cp>“Use of historical controls is common in early-phase cancer studies because they usually have small sample sizes and the end points are really well-defined,\" she says.\u003c/p>\n\u003cp>But spinal cord injury outcomes may be more varied, Messer says, so the results of an intervention wouldn't be as reliable.\u003c/p>\n\u003cp>“(T)here are a few things to watch for: Are the patients comparable? Has treatment changed? You want to make sure the response assessment is not subject to any judgment calls.”\u003c/p>\n\u003cp>Asterias mined the European historical data because it was the only large spinal-injury database with current information that could be licensed, Wirth said in an internal memo on the rationale and methods for compiling historical data.\u003c/p>\n\u003cp>In that memo, Wirth wrote that some variables are not included in the European database. These include MRI data on spinal cord lesions and the timing or quality of decompression, a bone-trimming surgery that makes more room for nerves. These differences in the data make direct comparisons harder.\u003c/p>\n\u003cp>Diana Miglioretti is a biostatistics professor at UC Davis. She says historical data is an interesting approach to frame a comparison.\u003c/p>\n\u003cp>“Obviously it isn’t as strong as a control group,” she says, “but if there aren’t major time trends, it can be a reasonable alternative.”\u003c/p>\n\u003cp>In other words, Miglioretti says, if outcomes haven't changed over time — due to improvements in treatment, for example — it's not out of the question that historical data can serve as a control.\u003c/p>\n\u003cp>But according to spinal cord researcher Steward, that’s the main concern about taking historical data on spinal injuries at face value .\u003c/p>\n\u003cp>“In the past we treated spinal injury differently,” Steward says. “For instance the amount of time people spend in rehab is a lot less than it was 10 years ago.”\u003c/p>\n\u003cp>\u003cstrong>Strong Anecdotal Statements\u003c/strong>\u003c/p>\n\u003cp>From Steward’s point of view, the real reason to get excited about the phenomenal initial results of this stem cell therapy is not the supporting historical data, but rather the anecdotal statements by the clinical researchers.\u003c/p>\n\u003cp>For instance, he points to the statements by Richard Fessler, the lead investigator of the Asterias trial and a professor of neurosurgery at Rush University Medical Center in Chicago. “I’ve been treating these kinds of patients for 30 years,” Fessler said in the San Francisco Chronicle story, “and I’ve never seen anything like this before.” (Fessler has no financial stake in Asterias, company officials say.)\u003c/p>\n\u003cp>“When someone like Fessler says 'I’ve never seen anything like that,' ” Steward says, “I spend more time listening to that than to historical data.”\u003c/p>\n\u003cp>Steward also points out that this stem cell therapy won’t help those with chronic spinal injuries, but says it could be a game-changer for newly injured patients.\u003c/p>\n\u003cp>“Still, this is huge,” he says. “Things are progressing in a positive way. No bad outcomes, and people seem to be improving in a way that may be unprecedented. As a scientist I think it’s very exciting.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "North Bay Fires: Yes, Californians Can Now Buy Air Purifiers on Amazon",
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"content": "\u003cp>During\u003cb> \u003c/b>the deadly North Bay wildfires, air quality in the Bay Area has suffered -- a lot. In fact, air monitors have recorded the \u003ca href=\"https://ww2.kqed.org/science/2017/10/11/bay-area-air-quality-worst-on-record-check-out-your-city/\" target=\"_blank\" rel=\"noopener\">worst pollution \u003c/a>since the state started keeping records for small particulates, in 1999. That goes even for areas as far removed from the disaster's epicenter as the South Bay.\u003c/p>\n\u003caside class=\"pullquote alignright\">The California Air Resources Board says HEPA air purifiers can remove almost all of the harmful particles in the air caused by fire.\u003c/aside>\n\u003cp>Naturally, this has left people all over the region worried about pollutant-related health hazards. And not without reason.\u003c/p>\n\u003cp>\"When we breath particulates they bypass the lung system and get into our bloodstream,” Lisa Fasano of the Bay Area Air Quality Management District told KQED's Lesley McClurg last week. \"They exacerbate respiratory conditions like asthma, COPD [Chronic Obstructive Pulmonary Disease], emphysema and other conditions because they are very harmful.”\u003c/p>\n\u003cp>Air quality \u003ca href=\"https://airnow.gov/index.cfm?action=airnow.local_city&cityid=317\" target=\"_blank\" rel=\"noopener\">has improved\u003c/a> this week, and the good news is that as it gets better outside, it will improve indoors as well.\u003c/p>\n\u003caside class=\"alignright\">\n\u003cul>California Consumer Information on Air Cleaners\n\u003cli>\u003ca href=\"https://www.arb.ca.gov/research/indoor/aircleaners/certified.htm\">List of air-cleaning devices that can be sold in California\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.arb.ca.gov/research/indoor/acdsumm.pdf\">FAQ: Air cleaning devices for the home\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.arb.ca.gov/research/indoor/aircleaners/consumers.htm?_ga=2.103214725.400296666.1508192585-1430501393.1496685106\" target=\"_blank\" rel=\"noopener\">More air-cleaner information for consumers\u003c/a>\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>\"Fine particle pollution essentially acts like a gas, so if there is an exchange between outside and indoor air, the indoor pollution will dissipate,\" said CARB Communications Director Stanley Young in an email.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Provided the air outside is clean, the indoor air will clear \"in a matter of hours or days,\" not weeks, Young said.\u003c/p>\n\u003cp>Still, the air resources board definitely recommends purifiers -- portable devices that will clean the air, not just for fire-related pollutants, but for everyday use as well.\u003c/p>\n\u003cp>Peggy Jenkins, who manages the agency's Indoor Air Quality and Personal Exposure Assessment Program, says those air-cleaning devices that use filters designated as high-efficiency particulate air, or HEPA, work best, as they remove very small particles.\u003c/p>\n\u003cp>\"The high-efficiency filters typically are deeper or more dense,\" Jenkins says, \"and they can remove really almost 100 percent of the particles in the air. So we've seen very dramatic reductions in our air quality studies.\"\u003c/p>\n\u003cp>\u003cstrong>High Demand\u003c/strong>\u003c/p>\n\u003cp>But due to the fires, local stores have been selling out of the devices. Eliza Hersh of San Francisco, who recently hosted a Santa Rosa family forced to evacuate their home, has been on the hunt. Before her guests were okayed to go back home, they wanted to buy a purifier to clean the air in both their house and business.\u003c/p>\n\u003cp>[contextly_sidebar id=\"uNJzQt7aM6CcDNCU8aao9oGDi0lPEpNJ\"]\"Every local place was sold out,\" Hersh said. \"[They] were about to drive to Tracy.\"\u003c/p>\n\u003cp>With local stores depleted, Hersh and others naturally turned to an online source. And that usually means Amazon. Except there was a problem: Would-be buyers kept running into this message:\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2027/10/Amazon-message-2.png\">\u003cimg class=\"aligncenter size-full wp-image-436287\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2027/10/Amazon-message-2.png\" alt=\"\" width=\"536\" height=\"83\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2027/10/Amazon-message-2.png 536w, https://ww2.kqed.org/app/uploads/sites/13/2027/10/Amazon-message-2-160x25.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2027/10/Amazon-message-2-240x37.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2027/10/Amazon-message-2-375x58.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2027/10/Amazon-message-2-520x81.png 520w\" sizes=\"(max-width: 536px) 100vw, 536px\">\u003c/a>\u003c/p>\n\u003cp>Many went on Twitter to vent ... . Here's just one of the many tweets:\u003c/p>\n\u003cp>https://twitter.com/wildwestpie/status/918733350994448384\u003c/p>\n\u003cp>\u003cstrong>Ozone Regulation\u003c/strong>\u003c/p>\n\u003cp>Here's the answer to that WTF: Selling air purifiers in California is a little complicated, because of a state \u003ca href=\"https://www.arb.ca.gov/research/indoor/aircleaners/air-cleaner-regulation.pdf\" target=\"_blank\" rel=\"noopener\">regulation\u003c/a> banning certain models that emit ozone. The California Air Resources Board \u003ca href=\"https://www.arb.ca.gov/research/indoor/ozone.htm\" target=\"_blank\" rel=\"noopener\">calls ozone\u003c/a> \"a highly reactive, unstable, toxic gas\" that can irritate and inflame the respiratory system and even cause permanent lung damage. CARB says ozone-generating air purifiers can produce several times the state's allowable levels.\u003c/p>\n\u003cp>Thus, the board maintains a list of potentially hazardous ozone-generating air cleaners that\u003ca href=\"https://www.arb.ca.gov/research/indoor/o3g-list.htm\" target=\"_blank\" rel=\"noopener\"> cannot be sold\u003c/a> in the state, as well as a list of \u003ca href=\"https://www.arb.ca.gov/research/indoor/aircleaners/certified.htm\" target=\"_blank\" rel=\"noopener\">those that can\u003c/a>. CARB updates the lists as frequently as each week.\u003c/p>\n\u003cp>The problem is would-be buyers were stymied even ordering models specifically certified as legal. On Tuesday, SFGate \u003ca href=\"http://www.sfgate.com/bayarea/article/cant-buy-air-purifier-ozone-ca-12276943.php\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> on the issue and got this statement from CARB:\u003c/p>\n\u003cp>\"Amazon, unfortunately, has had problems shipping some CARB-approved air purifiers ... so until Amazon addresses this error, consumers may opt for another company to purchase from.\"\u003c/p>\n\u003cp>So on Wednesday, we asked Amazon: What gives?\u003c/p>\n\u003cp class=\"x_MsoNormal\">“Air filters must meet the California Air Resources Board’s unique restrictions before they can be legally sold into the state,\" Erik Fairleigh, an Amazon spokesman wrote in an email. \"As a result, we require suppliers to provide confirmation that air filters comply with the restrictions in order to be sold into California.”\u003c/p>\n\u003cp>\u003cstrong>Problem (Mostly) Solved\u003c/strong>\u003c/p>\n\u003cp>Well, in light of all this, we decided to run a little test. On Thursday, we selected a sample of 10 top-rated, CARB-approved air purifiers, each with at least 400 reviews from Amazon customers. (Here's the Amazon \u003ca href=\"https://www.amazon.com/s/ref=sr_st_undefined?keywords=hepa+air+purifier&rh=i%3Aaps%2Ck%3Ahepa+air+purifier&qid=1508537823&sort=review-rank\" target=\"_blank\" rel=\"noopener\">search we did\u003c/a> to find our 10.) Then we went through the ordering process for each. Of those 10, Amazon allowed seven to be shipped to a San Francisco address, and only three, all made by Honeywell, evoked the dreaded \"can't ship\" message. Amazon's Fairleigh also sent us a list of about 40 models he said Californians could successfully buy.\u003c/p>\n\u003cp>Meanwhile, Hersh provided us with the links to four Honeywell models she had sent to Amazon last Friday as examples of state-approved models that California customers couldn't get shipped to them. On Thursday -- yesterday -- 2 of the 4 that had been previously unshippable were now good to go. So that is progress.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If you still can't find an air purifier locally, give it another try online. Even as late as yesterday, purifiers remained a hot item in the region. On the Best Buy website, a small sampling of air purifiers we looked at were listed as available in each and every Bay Area store no sooner than Oct. 28.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>During\u003cb> \u003c/b>the deadly North Bay wildfires, air quality in the Bay Area has suffered -- a lot. In fact, air monitors have recorded the \u003ca href=\"https://ww2.kqed.org/science/2017/10/11/bay-area-air-quality-worst-on-record-check-out-your-city/\" target=\"_blank\" rel=\"noopener\">worst pollution \u003c/a>since the state started keeping records for small particulates, in 1999. That goes even for areas as far removed from the disaster's epicenter as the South Bay.\u003c/p>\n\u003caside class=\"pullquote alignright\">The California Air Resources Board says HEPA air purifiers can remove almost all of the harmful particles in the air caused by fire.\u003c/aside>\n\u003cp>Naturally, this has left people all over the region worried about pollutant-related health hazards. And not without reason.\u003c/p>\n\u003cp>\"When we breath particulates they bypass the lung system and get into our bloodstream,” Lisa Fasano of the Bay Area Air Quality Management District told KQED's Lesley McClurg last week. \"They exacerbate respiratory conditions like asthma, COPD [Chronic Obstructive Pulmonary Disease], emphysema and other conditions because they are very harmful.”\u003c/p>\n\u003cp>Air quality \u003ca href=\"https://airnow.gov/index.cfm?action=airnow.local_city&cityid=317\" target=\"_blank\" rel=\"noopener\">has improved\u003c/a> this week, and the good news is that as it gets better outside, it will improve indoors as well.\u003c/p>\n\u003caside class=\"alignright\">\n\u003cul>California Consumer Information on Air Cleaners\n\u003cli>\u003ca href=\"https://www.arb.ca.gov/research/indoor/aircleaners/certified.htm\">List of air-cleaning devices that can be sold in California\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.arb.ca.gov/research/indoor/acdsumm.pdf\">FAQ: Air cleaning devices for the home\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.arb.ca.gov/research/indoor/aircleaners/consumers.htm?_ga=2.103214725.400296666.1508192585-1430501393.1496685106\" target=\"_blank\" rel=\"noopener\">More air-cleaner information for consumers\u003c/a>\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>\"Fine particle pollution essentially acts like a gas, so if there is an exchange between outside and indoor air, the indoor pollution will dissipate,\" said CARB Communications Director Stanley Young in an email.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Provided the air outside is clean, the indoor air will clear \"in a matter of hours or days,\" not weeks, Young said.\u003c/p>\n\u003cp>Still, the air resources board definitely recommends purifiers -- portable devices that will clean the air, not just for fire-related pollutants, but for everyday use as well.\u003c/p>\n\u003cp>Peggy Jenkins, who manages the agency's Indoor Air Quality and Personal Exposure Assessment Program, says those air-cleaning devices that use filters designated as high-efficiency particulate air, or HEPA, work best, as they remove very small particles.\u003c/p>\n\u003cp>\"The high-efficiency filters typically are deeper or more dense,\" Jenkins says, \"and they can remove really almost 100 percent of the particles in the air. So we've seen very dramatic reductions in our air quality studies.\"\u003c/p>\n\u003cp>\u003cstrong>High Demand\u003c/strong>\u003c/p>\n\u003cp>But due to the fires, local stores have been selling out of the devices. Eliza Hersh of San Francisco, who recently hosted a Santa Rosa family forced to evacuate their home, has been on the hunt. Before her guests were okayed to go back home, they wanted to buy a purifier to clean the air in both their house and business.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\"Every local place was sold out,\" Hersh said. \"[They] were about to drive to Tracy.\"\u003c/p>\n\u003cp>With local stores depleted, Hersh and others naturally turned to an online source. And that usually means Amazon. Except there was a problem: Would-be buyers kept running into this message:\u003c/p>\n\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2027/10/Amazon-message-2.png\">\u003cimg class=\"aligncenter size-full wp-image-436287\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2027/10/Amazon-message-2.png\" alt=\"\" width=\"536\" height=\"83\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2027/10/Amazon-message-2.png 536w, https://ww2.kqed.org/app/uploads/sites/13/2027/10/Amazon-message-2-160x25.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2027/10/Amazon-message-2-240x37.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2027/10/Amazon-message-2-375x58.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2027/10/Amazon-message-2-520x81.png 520w\" sizes=\"(max-width: 536px) 100vw, 536px\">\u003c/a>\u003c/p>\n\u003cp>Many went on Twitter to vent ... . Here's just one of the many tweets:\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>\u003cstrong>Ozone Regulation\u003c/strong>\u003c/p>\n\u003cp>Here's the answer to that WTF: Selling air purifiers in California is a little complicated, because of a state \u003ca href=\"https://www.arb.ca.gov/research/indoor/aircleaners/air-cleaner-regulation.pdf\" target=\"_blank\" rel=\"noopener\">regulation\u003c/a> banning certain models that emit ozone. The California Air Resources Board \u003ca href=\"https://www.arb.ca.gov/research/indoor/ozone.htm\" target=\"_blank\" rel=\"noopener\">calls ozone\u003c/a> \"a highly reactive, unstable, toxic gas\" that can irritate and inflame the respiratory system and even cause permanent lung damage. CARB says ozone-generating air purifiers can produce several times the state's allowable levels.\u003c/p>\n\u003cp>Thus, the board maintains a list of potentially hazardous ozone-generating air cleaners that\u003ca href=\"https://www.arb.ca.gov/research/indoor/o3g-list.htm\" target=\"_blank\" rel=\"noopener\"> cannot be sold\u003c/a> in the state, as well as a list of \u003ca href=\"https://www.arb.ca.gov/research/indoor/aircleaners/certified.htm\" target=\"_blank\" rel=\"noopener\">those that can\u003c/a>. CARB updates the lists as frequently as each week.\u003c/p>\n\u003cp>The problem is would-be buyers were stymied even ordering models specifically certified as legal. On Tuesday, SFGate \u003ca href=\"http://www.sfgate.com/bayarea/article/cant-buy-air-purifier-ozone-ca-12276943.php\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> on the issue and got this statement from CARB:\u003c/p>\n\u003cp>\"Amazon, unfortunately, has had problems shipping some CARB-approved air purifiers ... so until Amazon addresses this error, consumers may opt for another company to purchase from.\"\u003c/p>\n\u003cp>So on Wednesday, we asked Amazon: What gives?\u003c/p>\n\u003cp class=\"x_MsoNormal\">“Air filters must meet the California Air Resources Board’s unique restrictions before they can be legally sold into the state,\" Erik Fairleigh, an Amazon spokesman wrote in an email. \"As a result, we require suppliers to provide confirmation that air filters comply with the restrictions in order to be sold into California.”\u003c/p>\n\u003cp>\u003cstrong>Problem (Mostly) Solved\u003c/strong>\u003c/p>\n\u003cp>Well, in light of all this, we decided to run a little test. On Thursday, we selected a sample of 10 top-rated, CARB-approved air purifiers, each with at least 400 reviews from Amazon customers. (Here's the Amazon \u003ca href=\"https://www.amazon.com/s/ref=sr_st_undefined?keywords=hepa+air+purifier&rh=i%3Aaps%2Ck%3Ahepa+air+purifier&qid=1508537823&sort=review-rank\" target=\"_blank\" rel=\"noopener\">search we did\u003c/a> to find our 10.) Then we went through the ordering process for each. Of those 10, Amazon allowed seven to be shipped to a San Francisco address, and only three, all made by Honeywell, evoked the dreaded \"can't ship\" message. Amazon's Fairleigh also sent us a list of about 40 models he said Californians could successfully buy.\u003c/p>\n\u003cp>Meanwhile, Hersh provided us with the links to four Honeywell models she had sent to Amazon last Friday as examples of state-approved models that California customers couldn't get shipped to them. On Thursday -- yesterday -- 2 of the 4 that had been previously unshippable were now good to go. So that is progress.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If you still can't find an air purifier locally, give it another try online. Even as late as yesterday, purifiers remained a hot item in the region. On the Best Buy website, a small sampling of air purifiers we looked at were listed as available in each and every Bay Area store no sooner than Oct. 28.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Now Recognizes a Third Gender",
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"content": "\u003cp>Gender is no longer either male or female, according to the state of California.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It means that when somebody looks at my license, it's not going to be as confusing to them.'\u003c/aside>\n\u003cp>Gov. Jerry Brown on Sunday signed into law \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB179\" target=\"_blank\" rel=\"noopener\">legislation\u003c/a> that recognizes a third gender option. Starting Jan. 1, Californians will be able to apply to change their birth certificates from male or female to \"nonbinary.\" In 2019, Californians will be able to identify themselves as nonbinary on driver's licenses.\u003c/p>\n\u003cp>The bill was one of \u003ca href=\"https://www.gov.ca.gov/news.php?id=20027\" target=\"_blank\" rel=\"noopener\">many\u003c/a> Brown left to the last day of the Oct. 15 deadline to either sign or veto.\u003c/p>\n\u003cp>California joins Oregon and Washington D.C. in creating the third gender option on driver's licenses. New York state may \u003ca href=\"https://www.nbcnews.com/feature/nbc-out/lawmakers-new-york-d-c-propose-third-sex-driver-s-n774741\" target=\"_blank\" rel=\"noopener\">follow suit\u003c/a>. Unlike California, Oregon and Washington have not passed an actual law enacting the change, and neither accommodates a revision on birth certificates. \u003ca href=\"https://en.wikipedia.org/wiki/Legal_recognition_of_non-binary_gender\" target=\"_blank\" rel=\"noopener\">Countries\u003c/a> that recognize a third gender include Australia, Germany and India.\u003c/p>\n\u003cp>[contextly_sidebar id=\"KjrmGaNfPZB7ShxMWOYSoqqYzOWGS4B2\"]The legislation, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB179\" target=\"_blank\" rel=\"noopener\">SB 179\u003c/a>, from state Sen. Toni Atkins (D-San Diego) and Scott Wiener (D-San Francisco), also rescinds the requirement that individuals who want to change their gender must submit a sworn statement from a physician declaring they have undergone clinical treatment. That change takes effect Sept. 1, 2018.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"With Governor Brown’s signature on this bill, transgender and non-binary people will now be able to identify themselves as they are, not as who society tells them they should be,\" said Wiener, in a statement.\u003c/p>\n\u003cp>The new law not only addresses the experience of inter-sex people — those individuals born with ambiguous sexual characteristics — but also codifies a \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/04/24/boy-girl-both-neither-a-new-generation-overthrows-gender/\" target=\"_blank\" rel=\"noopener\">growing trend\u003c/a> among transgender youth who eschew a traditional gender identity, decoupling it from not only their innate physiology, but from the notion that only males and females exist.\u003c/p>\n\u003cp>A 2015 \u003ca href=\"http://www.ustranssurvey.org/report\" target=\"_blank\" rel=\"noopener\">survey\u003c/a> by the National Center for Transgender Equality found a third of the almost 28,000 respondents chose \"nonbinary/genderqueer” when given a choice of terms to best describe themselves.\u003c/p>\n\u003cp>\"The binary gender designations of female and male fail to adequately represent the diversity of human experience,\" SB 179 states. \"Nonbinary is an umbrella term for people with gender identities that fall somewhere outside of the traditional conceptions of strictly either female or male. \"\u003c/p>\n\u003cp>Courts in Oregon and California have already granted requests by residents to change their gender to a third type. In California, dozens of people have petitioned courts to make the change.\u003c/p>\n\u003cp>One person who will benefit from the law is Jak Kazmarek, a KQED employee who has identified as nonbinary for 17 years. Kazmarek uses the pronoun \"they\" instead of \"he\" or \"she,\" something many nonbinary people do to reflect a gender identification outside the traditional male or female.\u003c/p>\n\u003cp>Kazmarek says they were the 25th person in California to petition a court for a gender change to nonbinary, a request the court granted in May. But the change had no practical effect -- there is currently no option to list your gender as anything other than male or female on a driver's license.\u003c/p>\n\u003cp>\"Right now, when somebody looks at an ID and they look at me, they don't see female,\" Kazmarek said. \"They also don't see male, though. That exposes me to a lot of questions. It's a really vulnerable place to be.\"\u003c/p>\n\u003cp>Kazmarek said that the state's sanction of nonbinary identity is \"huge.\"\u003c/p>\n\u003cp>\"It means that when somebody looks at my license, it's not going to be as confusing to them.\"\u003c/p>\n\u003cp>Ending the requirement that a physician sign off on someone's change of gender will also have a big effect, Kazmarek said.\u003c/p>\n\u003cp>\"I've been very privileged because I live in an area where people support me. There's a lot of people that live in other areas where it's difficult to find a doctor that's willing to write that note.\"\u003c/p>\n\u003cp>Opposition to the bill has come mostly from \u003ca href=\"http://www.californiafamily.org/2017/gender-change-anti-religious-liberty-bills-nearing-final-approval-2/\" target=\"_blank\" rel=\"noopener\">Christian groups\u003c/a>. It did not appear to have much effect: The bill passed the Senate 26-12 and the Assembly 57-21.\u003c/p>\n\u003cp>The issue of whether or not to recognize a third gender is headed for a day of reckoning on the federal level, too. Last November, Colorado U.S. District Court Judge R. Brooke Jackson remanded the case of Dana Zzyym back to the U.S. State Department after Lambda Legal, on behalf of Zzyym, \u003ca href=\"https://www.lambdalegal.org/news/us_20151026_zzyym-intersex-denied-passport\" target=\"_blank\" rel=\"noopener\">sued\u003c/a> the department for denying Zzyym's application for a passport. The agency rejected the request because Zzyym did not choose male or female on the application.\u003c/p>\n\u003cp>“I find that the administrative record contains no evidence that the Department followed a rational decision-making process in deciding to implement its binary-only gender passport policy,\" Jackson wrote in his decision. \"Therefore, the proper next step is to remand the case to the Department to give it an opportunity either to shore up the record, if it can, or reconsider its policy.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But the State Department declined Zzyym's application again, in May. The court then granted a motion to \u003ca href=\"https://www.washingtonpost.com/news/post-nation/wp/2017/06/28/a-navy-veteran-who-identifies-as-neither-male-nor-female-cant-get-a-passport-that-could-change/?utm_term=.26879130b6c5\" target=\"_blank\" rel=\"noopener\">reopen\u003c/a> the case.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Gender is no longer either male or female, according to the state of California.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It means that when somebody looks at my license, it's not going to be as confusing to them.'\u003c/aside>\n\u003cp>Gov. Jerry Brown on Sunday signed into law \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB179\" target=\"_blank\" rel=\"noopener\">legislation\u003c/a> that recognizes a third gender option. Starting Jan. 1, Californians will be able to apply to change their birth certificates from male or female to \"nonbinary.\" In 2019, Californians will be able to identify themselves as nonbinary on driver's licenses.\u003c/p>\n\u003cp>The bill was one of \u003ca href=\"https://www.gov.ca.gov/news.php?id=20027\" target=\"_blank\" rel=\"noopener\">many\u003c/a> Brown left to the last day of the Oct. 15 deadline to either sign or veto.\u003c/p>\n\u003cp>California joins Oregon and Washington D.C. in creating the third gender option on driver's licenses. New York state may \u003ca href=\"https://www.nbcnews.com/feature/nbc-out/lawmakers-new-york-d-c-propose-third-sex-driver-s-n774741\" target=\"_blank\" rel=\"noopener\">follow suit\u003c/a>. Unlike California, Oregon and Washington have not passed an actual law enacting the change, and neither accommodates a revision on birth certificates. \u003ca href=\"https://en.wikipedia.org/wiki/Legal_recognition_of_non-binary_gender\" target=\"_blank\" rel=\"noopener\">Countries\u003c/a> that recognize a third gender include Australia, Germany and India.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The legislation, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB179\" target=\"_blank\" rel=\"noopener\">SB 179\u003c/a>, from state Sen. Toni Atkins (D-San Diego) and Scott Wiener (D-San Francisco), also rescinds the requirement that individuals who want to change their gender must submit a sworn statement from a physician declaring they have undergone clinical treatment. That change takes effect Sept. 1, 2018.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"With Governor Brown’s signature on this bill, transgender and non-binary people will now be able to identify themselves as they are, not as who society tells them they should be,\" said Wiener, in a statement.\u003c/p>\n\u003cp>The new law not only addresses the experience of inter-sex people — those individuals born with ambiguous sexual characteristics — but also codifies a \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/04/24/boy-girl-both-neither-a-new-generation-overthrows-gender/\" target=\"_blank\" rel=\"noopener\">growing trend\u003c/a> among transgender youth who eschew a traditional gender identity, decoupling it from not only their innate physiology, but from the notion that only males and females exist.\u003c/p>\n\u003cp>A 2015 \u003ca href=\"http://www.ustranssurvey.org/report\" target=\"_blank\" rel=\"noopener\">survey\u003c/a> by the National Center for Transgender Equality found a third of the almost 28,000 respondents chose \"nonbinary/genderqueer” when given a choice of terms to best describe themselves.\u003c/p>\n\u003cp>\"The binary gender designations of female and male fail to adequately represent the diversity of human experience,\" SB 179 states. \"Nonbinary is an umbrella term for people with gender identities that fall somewhere outside of the traditional conceptions of strictly either female or male. \"\u003c/p>\n\u003cp>Courts in Oregon and California have already granted requests by residents to change their gender to a third type. In California, dozens of people have petitioned courts to make the change.\u003c/p>\n\u003cp>One person who will benefit from the law is Jak Kazmarek, a KQED employee who has identified as nonbinary for 17 years. Kazmarek uses the pronoun \"they\" instead of \"he\" or \"she,\" something many nonbinary people do to reflect a gender identification outside the traditional male or female.\u003c/p>\n\u003cp>Kazmarek says they were the 25th person in California to petition a court for a gender change to nonbinary, a request the court granted in May. But the change had no practical effect -- there is currently no option to list your gender as anything other than male or female on a driver's license.\u003c/p>\n\u003cp>\"Right now, when somebody looks at an ID and they look at me, they don't see female,\" Kazmarek said. \"They also don't see male, though. That exposes me to a lot of questions. It's a really vulnerable place to be.\"\u003c/p>\n\u003cp>Kazmarek said that the state's sanction of nonbinary identity is \"huge.\"\u003c/p>\n\u003cp>\"It means that when somebody looks at my license, it's not going to be as confusing to them.\"\u003c/p>\n\u003cp>Ending the requirement that a physician sign off on someone's change of gender will also have a big effect, Kazmarek said.\u003c/p>\n\u003cp>\"I've been very privileged because I live in an area where people support me. There's a lot of people that live in other areas where it's difficult to find a doctor that's willing to write that note.\"\u003c/p>\n\u003cp>Opposition to the bill has come mostly from \u003ca href=\"http://www.californiafamily.org/2017/gender-change-anti-religious-liberty-bills-nearing-final-approval-2/\" target=\"_blank\" rel=\"noopener\">Christian groups\u003c/a>. It did not appear to have much effect: The bill passed the Senate 26-12 and the Assembly 57-21.\u003c/p>\n\u003cp>The issue of whether or not to recognize a third gender is headed for a day of reckoning on the federal level, too. Last November, Colorado U.S. District Court Judge R. Brooke Jackson remanded the case of Dana Zzyym back to the U.S. State Department after Lambda Legal, on behalf of Zzyym, \u003ca href=\"https://www.lambdalegal.org/news/us_20151026_zzyym-intersex-denied-passport\" target=\"_blank\" rel=\"noopener\">sued\u003c/a> the department for denying Zzyym's application for a passport. The agency rejected the request because Zzyym did not choose male or female on the application.\u003c/p>\n\u003cp>“I find that the administrative record contains no evidence that the Department followed a rational decision-making process in deciding to implement its binary-only gender passport policy,\" Jackson wrote in his decision. \"Therefore, the proper next step is to remand the case to the Department to give it an opportunity either to shore up the record, if it can, or reconsider its policy.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But the State Department declined Zzyym's application again, in May. The court then granted a motion to \u003ca href=\"https://www.washingtonpost.com/news/post-nation/wp/2017/06/28/a-navy-veteran-who-identifies-as-neither-male-nor-female-cant-get-a-passport-that-could-change/?utm_term=.26879130b6c5\" target=\"_blank\" rel=\"noopener\">reopen\u003c/a> the case.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Capturing the Sound of Depression in the Human Voice",
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"content": "\u003cp>In any given year, nearly 1 in 5 adults in the U.S. suffer from a mental illness, yet fewer than half of those suffering receive treatment.\u003c/p>\n\u003caside class=\"alignright\">Signs of depression in the human voice might help to diagnose mental health problems\n\u003cul>\n\u003cli>Speaking lower, flatter and softer\u003c/li>\n\u003cli>Sounding labored, with more pauses, starts and stops\u003c/li>\n\u003cli>Sounding strained or breathy\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>In an attempt to fill that gap, companies are developing digital technology to help doctors diagnose, monitor and treat psychiatric disorders.\u003c/p>\n\u003cp>The behavioral health startup Ellipsis Health, based in San Francisco, uses machine learning to analyze audio recordings of conversations between doctors and patients during exams. The software works as a screening tool to flag patients whose speech matches the voice patterns of depressed individuals, alerting clinicians to follow up with a full diagnostic interview.\u003c/p>\n\u003cp>Meanwhile, Boston's \u003ca href=\"http://www.cogitocorp.com/\" target=\"_blank\" rel=\"noopener\">Cogito\u003c/a> has developed an app to use metadata from patients' phones to alert health care providers about sudden changes in behavior that might be linked to mental health.\u003c/p>\n\u003cp>\u003cstrong>Difficulty of Diagnosis\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>One reason for the lack of treatment for mental illness is that conditions like depression, anxiety and post‐traumatic stress disorder are difficult to diagnose.\u003c/p>\n\u003cp>There are no biological markers of mental illness that can be picked up in a blood test or a brain scan, so physicians must rely on patients’ self‐reports of their symptoms and on mental health questionnaires.\u003c/p>\n\u003cp>But self‐reporting and doctor observations can be highly subjective. Low energy, for example, can be a sign of depression, a normal response to a busy schedule, or an indicator of hypothyroidism. Subsequently, many physicians miss or misdiagnose psychiatric disorders; one \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60879-5/abstract\" target=\"_blank\" rel=\"noopener\">study \u003c/a>found that primary care doctors correctly identify depression in patients only 50 percent of the time.\u003c/p>\n\u003cp>However, there are a few consistent physiological changes that take place in the body when something is off in your brain. Some researchers think these types of changes could be used as objective flags for mental illness.\u003c/p>\n\u003cp>\u003cstrong>It’s Not What You Say, But How You Say It\u003c/strong>\u003c/p>\n\u003cp>When someone is depressed, their range of pitch and volume drop, so they tend to speak \u003ca href=\"http://ieeexplore.ieee.org/document/7117386/?reload=true\" target=\"_blank\" rel=\"noopener\">lower, flatter and softer\u003c/a>. Speech also sounds labored, with more pauses, starts and stops. Another key indicator is the tension or relaxation of the vocal cords, which can make speech sound strained or breathy. Too much tension or relaxation has been linked to depression and \u003ca href=\"http://ieeexplore.ieee.org/document/7384418/\" target=\"_blank\" rel=\"noopener\">suicide risk\u003c/a>. Depressed patients’ tongues and breath may also become uncoordinated, resulting in a slight slurring of speech.\u003c/p>\n\u003cp>These types of vocal traits — called paraverbal features — are detectable in other mental illnesses too, including bipolar and post‐traumatic stress disorder.\u003c/p>\n\u003cp>Researchers have been studying these different paraverbal patterns for over a decade, but they’ve only recently been able to make use of them with the rise of advanced computer analytics. Some of the qualities are noticeable to a trained ear, but others are more subtle.\u003c/p>\n\u003cp>Computer algorithms can pick up on differences in tone that a human might miss, and they can also quantify them. This technology helps clinicians track patients over time by comparing individuals to their own baselines, particularly important if a person has a naturally deep or breathy voice that is not indicative of depression.\u003c/p>\n\u003cp>“There’s no doubt that paraverbal features can be helpful in making clinical diagnoses,” says Danielle Ramo, an assistant professor of psychiatry at UCSF who is not affiliated with either company. “To the extent that machines are able to take advantage of paraverbal features in communication, that is a step forward in using machines to inform clinical diagnoses or treatment planning.”\u003c/p>\n\u003cp>Ellipsis used these vocal traits to create its tool. The program was initially trained by taking millions of conversations between nondepressed individuals and mining them for key features in speech patterns, such as pitch, cadence and enunciation. Data scientists then added conversations, data from mental health questionnaires and clinical information, all from depressed patients. That trained the software to identify vocal features indicative of depression.\u003c/p>\n\u003cp>One potential benefit of the Ellipsis program is that it could alert physicians if their patients may be depressed, even if that’s not the reason they went to the doctor in the first place.\u003c/p>\n\u003cp>“There are a lot of problems in the process of screening for mental health disorders,\" says Mark Richman, medical director of the Disease Management Program at Northwell Health, a health network in Long Island and New York City that is in talks with Ellipsis to use its program. \"Some of that has to do with limited sensitivity of the tools that are used to do that, some of it has to do with limited time to address and identify mental health disorders.”\u003c/p>\n\u003cp>Richman says he hopes a tool like the one from Ellipsis will help doctors catch patients who might otherwise fall through the cracks, but without taking up valuable face time in the exam room.\u003c/p>\n\u003cp>Ellipsis founder and CEO Mainul Mondal says that making doctor appointments more efficient was a key focus for the company.\u003c/p>\n\u003cp>“People like talking to their health teams. They feel loyalty\u003cbr>\nand the trust is there, and they’re already having the conversations,” he says.\u003c/p>\n\u003cp>By capturing and utilizing the conversation — with the patient’s consent — clinicians could screen every patient for depression without taking up extra time, following up with only those who are flagged as high risk.\u003c/p>\n\u003cp>Integrating the software into the normal flow of a doctor’s visit is the next step, says Elizabeth Shriberg, the Ellipsis chief scientific officer. Including Northwell, Ellipsis is now in talks with other large health care providers around the country to introduce the program into exam rooms, the company says.\u003c/p>\n\u003cp>\u003cstrong>Monitoring From Afar\u003c/strong>\u003c/p>\n\u003cp>Other physicians want to use voice and behavior analysis technology to learn more about what happens to patients when they’re \u003cem>outside\u003c/em> the exam room.\u003c/p>\n\u003cfigure id=\"attachment_436000\" class=\"wp-caption alignright\" style=\"max-width: 248px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/companion-2-0-android-Home-1.png\">\u003cimg class=\"wp-image-436000 \" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/companion-2-0-android-Home-1-800x1422.png\" alt=\"\" width=\"248\" height=\"441\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-800x1422.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-160x284.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-768x1365.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-1020x1813.png 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-1180x2098.png 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-960x1707.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-240x427.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-375x667.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-520x924.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1.png 1440w\" sizes=\"(max-width: 248px) 100vw, 248px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Image from the dashboard of Cogito's Companion app, meant to diagnose depression and other mental health conditions. \u003ccite>(Cogito)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We often get data only when people come into a clinic … and we know that there's a lot that goes on, obviously, outside of the clinic walls,” says David Ahern, director of the program in Behavioral Informatics and eHealth at Brigham and Women’s Hospital in Boston. “It's this huge unmet need of both understanding the nature of a … mental health disorder as it evolves over time and the experience of patients over time.”\u003c/p>\n\u003cp>Ahern leads a \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02167373?term=cogito&rank=1\" target=\"_blank\" rel=\"noopener\">clinical trial\u003c/a> testing the efficacy of Cogito's Companion app. Cogito was founded eight years ago as a spin-off from the MIT Media Lab in Boston. In addition to Companion, it makes software that gives real‐time feedback to customer call centers.\u003c/p>\n\u003cp>With patients' consent, the Companion app mines background metadata from their phone, including text frequency, call logs and geolocation. Using this data, the program creates a daily score for each patient, which is sent to their care team, alerting them if sudden changes in behavior might be linked to a decline in mental health. For example, if a patient starts to text less and has fewer or shorter calls, it may signal that they’re isolating themselves. Their caregiver can then reach out immediately to see if they are all right rather than having to wait until the next visit.\u003c/p>\n\u003cp>Patients also record a short audio diary a few times a week, which the app analyzes for nonverbal markers of depression, such as tenseness or breathiness, low pitch, volume or range. These results are also included in the patient’s daily score, giving the care team several objective measures of their mental state. In addition to depression, the app is also being \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02742064?term=cogito&rank=2\" target=\"_blank\" rel=\"noopener\">tested\u003c/a> on patients with bipolar disorder and post‐traumatic disorder, with the goal of predicting the onset of acute psychiatric episodes and suicide risk.\u003c/p>\n\u003cp>Skyler Place, vice president of behavioral science at Cogito, says he hopes doctors will use the system to be more proactive, not just in patients’ mental health care, but in their overall quality of life. In another trial for veterans at risk for post‐traumatic stress disorder and suicide, clinicians were able to detect major lifestyle changes through the app, as when one person lost his job and another became homeless.\u003c/p>\n\u003cp>“While the original goal was suicide prevention, in addition to being able to capture that risk, it’s really able to provide an overall risk score for the veteran population, and the clinicians are able to then provide the right service to these veterans in the moment when they need them.”\u003c/p>\n\u003cp>\u003cstrong>Replacing Clinicians? Not so Fast\u003c/strong>\u003c/p>\n\u003cp>As with the adoption of many new technologies, users may be reasonably concerned about privacy. Both Cogito and Ellipsis say that all the proper precautions are taken to store and protect the data, and in many cases the content of the conversations or voice recordings is irrelevant and even discarded.\u003c/p>\n\u003cp>The voice screening software is also not perfect; Cogito’s is currently about 75 percent accurate at flagging mental illness\u003cstrong> \u003c/strong>as compared to clinical interviews with mental health professionals. Ellipsis declined to state how accurate its software is.\u003c/p>\n\u003cp>Adam Miner, a clinical psychologist and instructor at\u003cbr>\nStanford University, says that, “Clinicians regularly take into account patient's tone and vocal patterns when making diagnostic decisions. If a new technology can help measure, or compare patterns over time, there is the potential to add value.” However, he cautions, there are “risks in oversimplifying the complexity of medical diagnoses.”\u003c/p>\n\u003cp>The two companies were quick to emphasize that the technology is not a replacement for human clinicians, but simply an aid or tool, akin to a blood test or an electrocardiogram.\u003c/p>\n\u003cp>“It's a buddy for health teams,” says Mondal. “It is an adviser for behavioral health; you flag patients so health systems can intervene.” After a patient is flagged as needing additional attention, either before or after diagnosis, it is still up to the clinician to administer care, an interaction that hasn’t been disrupted by artificial intelligence.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Yet.\u003c/p>\n\n",
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"excerpt": "One company aims to use data from patients' voices to diagnose depression, and another wants to look at patients' use of their smartphones to alert providers to possible changes in mental health.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In any given year, nearly 1 in 5 adults in the U.S. suffer from a mental illness, yet fewer than half of those suffering receive treatment.\u003c/p>\n\u003caside class=\"alignright\">Signs of depression in the human voice might help to diagnose mental health problems\n\u003cul>\n\u003cli>Speaking lower, flatter and softer\u003c/li>\n\u003cli>Sounding labored, with more pauses, starts and stops\u003c/li>\n\u003cli>Sounding strained or breathy\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>In an attempt to fill that gap, companies are developing digital technology to help doctors diagnose, monitor and treat psychiatric disorders.\u003c/p>\n\u003cp>The behavioral health startup Ellipsis Health, based in San Francisco, uses machine learning to analyze audio recordings of conversations between doctors and patients during exams. The software works as a screening tool to flag patients whose speech matches the voice patterns of depressed individuals, alerting clinicians to follow up with a full diagnostic interview.\u003c/p>\n\u003cp>Meanwhile, Boston's \u003ca href=\"http://www.cogitocorp.com/\" target=\"_blank\" rel=\"noopener\">Cogito\u003c/a> has developed an app to use metadata from patients' phones to alert health care providers about sudden changes in behavior that might be linked to mental health.\u003c/p>\n\u003cp>\u003cstrong>Difficulty of Diagnosis\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>One reason for the lack of treatment for mental illness is that conditions like depression, anxiety and post‐traumatic stress disorder are difficult to diagnose.\u003c/p>\n\u003cp>There are no biological markers of mental illness that can be picked up in a blood test or a brain scan, so physicians must rely on patients’ self‐reports of their symptoms and on mental health questionnaires.\u003c/p>\n\u003cp>But self‐reporting and doctor observations can be highly subjective. Low energy, for example, can be a sign of depression, a normal response to a busy schedule, or an indicator of hypothyroidism. Subsequently, many physicians miss or misdiagnose psychiatric disorders; one \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60879-5/abstract\" target=\"_blank\" rel=\"noopener\">study \u003c/a>found that primary care doctors correctly identify depression in patients only 50 percent of the time.\u003c/p>\n\u003cp>However, there are a few consistent physiological changes that take place in the body when something is off in your brain. Some researchers think these types of changes could be used as objective flags for mental illness.\u003c/p>\n\u003cp>\u003cstrong>It’s Not What You Say, But How You Say It\u003c/strong>\u003c/p>\n\u003cp>When someone is depressed, their range of pitch and volume drop, so they tend to speak \u003ca href=\"http://ieeexplore.ieee.org/document/7117386/?reload=true\" target=\"_blank\" rel=\"noopener\">lower, flatter and softer\u003c/a>. Speech also sounds labored, with more pauses, starts and stops. Another key indicator is the tension or relaxation of the vocal cords, which can make speech sound strained or breathy. Too much tension or relaxation has been linked to depression and \u003ca href=\"http://ieeexplore.ieee.org/document/7384418/\" target=\"_blank\" rel=\"noopener\">suicide risk\u003c/a>. Depressed patients’ tongues and breath may also become uncoordinated, resulting in a slight slurring of speech.\u003c/p>\n\u003cp>These types of vocal traits — called paraverbal features — are detectable in other mental illnesses too, including bipolar and post‐traumatic stress disorder.\u003c/p>\n\u003cp>Researchers have been studying these different paraverbal patterns for over a decade, but they’ve only recently been able to make use of them with the rise of advanced computer analytics. Some of the qualities are noticeable to a trained ear, but others are more subtle.\u003c/p>\n\u003cp>Computer algorithms can pick up on differences in tone that a human might miss, and they can also quantify them. This technology helps clinicians track patients over time by comparing individuals to their own baselines, particularly important if a person has a naturally deep or breathy voice that is not indicative of depression.\u003c/p>\n\u003cp>“There’s no doubt that paraverbal features can be helpful in making clinical diagnoses,” says Danielle Ramo, an assistant professor of psychiatry at UCSF who is not affiliated with either company. “To the extent that machines are able to take advantage of paraverbal features in communication, that is a step forward in using machines to inform clinical diagnoses or treatment planning.”\u003c/p>\n\u003cp>Ellipsis used these vocal traits to create its tool. The program was initially trained by taking millions of conversations between nondepressed individuals and mining them for key features in speech patterns, such as pitch, cadence and enunciation. Data scientists then added conversations, data from mental health questionnaires and clinical information, all from depressed patients. That trained the software to identify vocal features indicative of depression.\u003c/p>\n\u003cp>One potential benefit of the Ellipsis program is that it could alert physicians if their patients may be depressed, even if that’s not the reason they went to the doctor in the first place.\u003c/p>\n\u003cp>“There are a lot of problems in the process of screening for mental health disorders,\" says Mark Richman, medical director of the Disease Management Program at Northwell Health, a health network in Long Island and New York City that is in talks with Ellipsis to use its program. \"Some of that has to do with limited sensitivity of the tools that are used to do that, some of it has to do with limited time to address and identify mental health disorders.”\u003c/p>\n\u003cp>Richman says he hopes a tool like the one from Ellipsis will help doctors catch patients who might otherwise fall through the cracks, but without taking up valuable face time in the exam room.\u003c/p>\n\u003cp>Ellipsis founder and CEO Mainul Mondal says that making doctor appointments more efficient was a key focus for the company.\u003c/p>\n\u003cp>“People like talking to their health teams. They feel loyalty\u003cbr>\nand the trust is there, and they’re already having the conversations,” he says.\u003c/p>\n\u003cp>By capturing and utilizing the conversation — with the patient’s consent — clinicians could screen every patient for depression without taking up extra time, following up with only those who are flagged as high risk.\u003c/p>\n\u003cp>Integrating the software into the normal flow of a doctor’s visit is the next step, says Elizabeth Shriberg, the Ellipsis chief scientific officer. Including Northwell, Ellipsis is now in talks with other large health care providers around the country to introduce the program into exam rooms, the company says.\u003c/p>\n\u003cp>\u003cstrong>Monitoring From Afar\u003c/strong>\u003c/p>\n\u003cp>Other physicians want to use voice and behavior analysis technology to learn more about what happens to patients when they’re \u003cem>outside\u003c/em> the exam room.\u003c/p>\n\u003cfigure id=\"attachment_436000\" class=\"wp-caption alignright\" style=\"max-width: 248px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/companion-2-0-android-Home-1.png\">\u003cimg class=\"wp-image-436000 \" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/companion-2-0-android-Home-1-800x1422.png\" alt=\"\" width=\"248\" height=\"441\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-800x1422.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-160x284.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-768x1365.png 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-1020x1813.png 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-1180x2098.png 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-960x1707.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-240x427.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-375x667.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1-520x924.png 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/companion-2-0-android-Home-1.png 1440w\" sizes=\"(max-width: 248px) 100vw, 248px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Image from the dashboard of Cogito's Companion app, meant to diagnose depression and other mental health conditions. \u003ccite>(Cogito)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We often get data only when people come into a clinic … and we know that there's a lot that goes on, obviously, outside of the clinic walls,” says David Ahern, director of the program in Behavioral Informatics and eHealth at Brigham and Women’s Hospital in Boston. “It's this huge unmet need of both understanding the nature of a … mental health disorder as it evolves over time and the experience of patients over time.”\u003c/p>\n\u003cp>Ahern leads a \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02167373?term=cogito&rank=1\" target=\"_blank\" rel=\"noopener\">clinical trial\u003c/a> testing the efficacy of Cogito's Companion app. Cogito was founded eight years ago as a spin-off from the MIT Media Lab in Boston. In addition to Companion, it makes software that gives real‐time feedback to customer call centers.\u003c/p>\n\u003cp>With patients' consent, the Companion app mines background metadata from their phone, including text frequency, call logs and geolocation. Using this data, the program creates a daily score for each patient, which is sent to their care team, alerting them if sudden changes in behavior might be linked to a decline in mental health. For example, if a patient starts to text less and has fewer or shorter calls, it may signal that they’re isolating themselves. Their caregiver can then reach out immediately to see if they are all right rather than having to wait until the next visit.\u003c/p>\n\u003cp>Patients also record a short audio diary a few times a week, which the app analyzes for nonverbal markers of depression, such as tenseness or breathiness, low pitch, volume or range. These results are also included in the patient’s daily score, giving the care team several objective measures of their mental state. In addition to depression, the app is also being \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02742064?term=cogito&rank=2\" target=\"_blank\" rel=\"noopener\">tested\u003c/a> on patients with bipolar disorder and post‐traumatic disorder, with the goal of predicting the onset of acute psychiatric episodes and suicide risk.\u003c/p>\n\u003cp>Skyler Place, vice president of behavioral science at Cogito, says he hopes doctors will use the system to be more proactive, not just in patients’ mental health care, but in their overall quality of life. In another trial for veterans at risk for post‐traumatic stress disorder and suicide, clinicians were able to detect major lifestyle changes through the app, as when one person lost his job and another became homeless.\u003c/p>\n\u003cp>“While the original goal was suicide prevention, in addition to being able to capture that risk, it’s really able to provide an overall risk score for the veteran population, and the clinicians are able to then provide the right service to these veterans in the moment when they need them.”\u003c/p>\n\u003cp>\u003cstrong>Replacing Clinicians? Not so Fast\u003c/strong>\u003c/p>\n\u003cp>As with the adoption of many new technologies, users may be reasonably concerned about privacy. Both Cogito and Ellipsis say that all the proper precautions are taken to store and protect the data, and in many cases the content of the conversations or voice recordings is irrelevant and even discarded.\u003c/p>\n\u003cp>The voice screening software is also not perfect; Cogito’s is currently about 75 percent accurate at flagging mental illness\u003cstrong> \u003c/strong>as compared to clinical interviews with mental health professionals. Ellipsis declined to state how accurate its software is.\u003c/p>\n\u003cp>Adam Miner, a clinical psychologist and instructor at\u003cbr>\nStanford University, says that, “Clinicians regularly take into account patient's tone and vocal patterns when making diagnostic decisions. If a new technology can help measure, or compare patterns over time, there is the potential to add value.” However, he cautions, there are “risks in oversimplifying the complexity of medical diagnoses.”\u003c/p>\n\u003cp>The two companies were quick to emphasize that the technology is not a replacement for human clinicians, but simply an aid or tool, akin to a blood test or an electrocardiogram.\u003c/p>\n\u003cp>“It's a buddy for health teams,” says Mondal. “It is an adviser for behavioral health; you flag patients so health systems can intervene.” After a patient is flagged as needing additional attention, either before or after diagnosis, it is still up to the clinician to administer care, an interaction that hasn’t been disrupted by artificial intelligence.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Fatal Genetic Disease Treatable if Caught Early, But Only Handful of States Test for It",
"title": "Fatal Genetic Disease Treatable if Caught Early, But Only Handful of States Test for It",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>SAN DIEGO — Kerri De Nies received the news this spring from her son’s pediatrician: Her chubby-cheeked toddler had a rare brain disorder.\u003c/p>\n\u003cp>She’d never heard of the disease — adrenoleukodystrophy, or ALD — and she soon felt devastated and overwhelmed.\u003c/p>\n\u003caside class=\"pullquote alignright\">'If you pick it up in the early stages … you are at a much better place in terms of treating it effectively.'\u003ccite>Dr. Florian Eichler, Massachusetts General Hospital\u003c/cite>\u003c/aside>\n\u003cp>“I probably read everything you could possibly read online — every single website,” De Nies said as she cradled her son, Gregory Mac Phee. “It’s definitely hard to think about what could potentially happen. You think about the worst-case scenario.”\u003c/p>\n\u003cp>ALD is a \u003ca href=\"http://myelin.org/ald-adrenoleukodystrophy/\">brain disorder\u003c/a> depicted in the 1992 movie “Lorenzo’s Oil,” about a couple whose son became debilitated by the disease. The most serious form of the illness typically strikes boys between ages 4 and 10. Most are diagnosed too late for treatment to be successful, and they often die before their 10th birthday.\u003c/p>\n\u003cp>The more De Nies learned about ALD, the more she realized how fortunate she and Gregory were to have discovered it so early. Her son’s blood was tested when he was about 10 months old.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>California is one of only a handful of states nationwide that screens babies for the gene mutation that causes the disease — a test that dramatically increases Gregory’s chances of survival.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s mind-boggling that not every state is testing.'\u003ccite>Kerri De Nies, mother of child with ALD\u003c/cite>\u003c/aside>\n\u003cp>The state began testing newborns for ALD in September 2016, seven months after the federal government added it to the list of recommended screenings. The testing included all babies born after February of that year.\u003c/p>\n\u003cp>“If you pick it up in the early stages … you are at a much better place in terms of treating it effectively,” said Florian Eichler, a neurologist at Massachusetts General Hospital. “That’s where the newborn screening is so important. It really helps you detect these boys at risk.”\u003c/p>\n\u003cp>Eichler said he has seen many families whose boys were diagnosed late. “Listening to families and their ordeal gives you a real sense of what this has done over generations and how much suffering could be prevented through the screening program,” he said.\u003c/p>\n\u003cp>New York was the first to begin screening, in 2013, followed last year by Connecticut and California. A few other states, including Pennsylvania and Minnesota, have since followed.\u003c/p>\n\u003cp>“It’s mind-boggling that not every state is testing,” said De Nies, who teaches children’s ballet in San Diego. “Families will not know until it could be too late for them.”\u003c/p>\n\u003cp>Advocates, including several moms who lost their sons to the disease, were instrumental in getting the \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1559\">screening law\u003c/a> passed in California. Now they are continuing to lobby legislators and pushing health officials to add ALD to screening panels across the nation.\u003c/p>\n\u003cp>Janis Sherwood said that since her son Sawyer’s death from ALD, she has felt an urgency to educate doctors, families and others about the disease. In the past few years, she turned her attention to newborn screening. She believes that as California collects data on how the boys do in treatment, other states will follow. “I think that we are going to see a domino effect as we get more states on board,” she said.\u003c/p>\n\u003cp>About 1 in every 18,000 people have ALD. Of boys with the genetic defect, about 30 to 40 percent will develop the life-threatening form of the disease, which leads to vision, gait and memory problems — and eventually death. It destroys myelin, the protective surface that surrounds some nerve cells.\u003c/p>\n\u003cp>Technicians draw the blood of newborns in the hospital soon after they are born. In California, state law requires that the blood be tested for about 80 diseases, including cystic fibrosis, severe combined immunodeficiency and primary congenital hypothyroidism.\u003c/p>\n\u003cp>Around the nation, testing kits cost a hospital or birthing facility about $120, said Jeff Botkin, who heads the medical ethics division at the University of Utah. “This is an extraordinarily low cost for this number of tests,” he said in an email. The tests are typically covered by insurers or Medicaid.\u003c/p>\n\u003cp>Some conditions on the screening list are relatively common, but ALD is among the rare disorders the tests ferret out that can lead to serious health issues or even death if not detected and treated, Botkin said.\u003c/p>\n\u003cp>There is no answer to the question of how common a condition should be to merit spending health care dollars to test for it, Botkin said. But many of the conditions for which the federal government recommends screening are rare, which means they could affect 1 in 50,000 babies or fewer. “The major question is whether the condition is treatable,” Botkin said.\u003c/p>\n\u003cp>Both boys and girls get tested for ALD because they can both be carriers of the genetic defect and develop the less serious adult form of the disease. Only boys, however, develop the more serious, ultimately fatal, childhood disease.\u003c/p>\n\u003cp>When doctors know that boys have the mutation, they perform brain MRIs beginning when the boys are toddlers. If an MRI starts to show telltale changes in the brain, doctors can intervene to halt the progression of the disease.\u003c/p>\n\u003cp>The common treatment, a bone marrow transplant, is risky and complicated, but it is often successful if the donor is a good match and the procedure is performed before the children have visible symptoms, UCLA neurologist Raman Sankar said. Doctors are also having some success with gene therapy, in which the children undergo a transplant with their own stem cells rather than a donor’s, Sankar said.\u003c/p>\n\u003cp>The earlier the transplant, the better a child’s chance of survival, he said. “The delay may make the difference between whether he can have a lifesaving treatment or not.”\u003c/p>\n\u003cp>Before newborn screening, boys in the early stages of ALD frequently were incorrectly diagnosed with hyperactivity and other conditions, said Richard Olney, who heads the genetic disease screening program for the California public health department. “Many families had to go through a sort of diagnostic odyssey,” he said. “It only became clear as they developed progressively worse problems that they had a serious genetic condition.”\u003c/p>\n\u003cp>By the time a brain MRI was performed, there was often too much damage to save the child. That’s part of the challenge for clinicians who may not be familiar with ALD: “How do you know when this is a critical brain disease versus just a normal part of development?” Eichler said.\u003c/p>\n\u003cp>Those with the genetic mutation who do not develop the disease in childhood may still have a milder form as adults. People with the mutation also need to be monitored by an endocrinologist, because many will suffer from a condition in which their adrenal glands fail to produce enough of a stress hormone that is needed to fight infections.\u003c/p>\n\u003cp>Gina Cousineau’s 8-year-old son, Evan, was diagnosed with ALD in May 2007 after he came home from swim practice and had a seizure. Though he underwent a bone marrow transplant, Evan died from a secondary infection before he turned 9.\u003c/p>\n\u003cp>Cousineau lives in the southern Orange County city of San Clemente and helped lobby for the California law that requires ALD screening. She said newborn testing benefits infants with ALD and can help families discover that siblings or other relatives have the gene mutation.\u003c/p>\n\u003cp>“Thank God this newborn screening came into effect,” Cousineau said. “Knowledge is power. Had I had the knowledge with my son, Evan, he would be alive today.”\u003c/p>\n\u003cp>De Nies said she worries about Gregory’s future, but she’s confident her son will live a long life. And she credits Cousineau and other mothers whose sons didn’t have the same chance.\u003c/p>\n\u003cp>“Without them, we would never know about the gene mutation,” she said. “I just feel like they are our fairy godmothers.”\u003c/p>\n\u003cp>This story was produced by \u003ca href=\"http://khn.org/\">Kaiser Health News\u003c/a>, an editorially independent program of the \u003ca href=\"http://kff.org/\">Kaiser Family Foundation\u003c/a>.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\">Henry J. Kaiser Family Foundation\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>SAN DIEGO — Kerri De Nies received the news this spring from her son’s pediatrician: Her chubby-cheeked toddler had a rare brain disorder.\u003c/p>\n\u003cp>She’d never heard of the disease — adrenoleukodystrophy, or ALD — and she soon felt devastated and overwhelmed.\u003c/p>\n\u003caside class=\"pullquote alignright\">'If you pick it up in the early stages … you are at a much better place in terms of treating it effectively.'\u003ccite>Dr. Florian Eichler, Massachusetts General Hospital\u003c/cite>\u003c/aside>\n\u003cp>“I probably read everything you could possibly read online — every single website,” De Nies said as she cradled her son, Gregory Mac Phee. “It’s definitely hard to think about what could potentially happen. You think about the worst-case scenario.”\u003c/p>\n\u003cp>ALD is a \u003ca href=\"http://myelin.org/ald-adrenoleukodystrophy/\">brain disorder\u003c/a> depicted in the 1992 movie “Lorenzo’s Oil,” about a couple whose son became debilitated by the disease. The most serious form of the illness typically strikes boys between ages 4 and 10. Most are diagnosed too late for treatment to be successful, and they often die before their 10th birthday.\u003c/p>\n\u003cp>The more De Nies learned about ALD, the more she realized how fortunate she and Gregory were to have discovered it so early. Her son’s blood was tested when he was about 10 months old.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>California is one of only a handful of states nationwide that screens babies for the gene mutation that causes the disease — a test that dramatically increases Gregory’s chances of survival.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s mind-boggling that not every state is testing.'\u003ccite>Kerri De Nies, mother of child with ALD\u003c/cite>\u003c/aside>\n\u003cp>The state began testing newborns for ALD in September 2016, seven months after the federal government added it to the list of recommended screenings. The testing included all babies born after February of that year.\u003c/p>\n\u003cp>“If you pick it up in the early stages … you are at a much better place in terms of treating it effectively,” said Florian Eichler, a neurologist at Massachusetts General Hospital. “That’s where the newborn screening is so important. It really helps you detect these boys at risk.”\u003c/p>\n\u003cp>Eichler said he has seen many families whose boys were diagnosed late. “Listening to families and their ordeal gives you a real sense of what this has done over generations and how much suffering could be prevented through the screening program,” he said.\u003c/p>\n\u003cp>New York was the first to begin screening, in 2013, followed last year by Connecticut and California. A few other states, including Pennsylvania and Minnesota, have since followed.\u003c/p>\n\u003cp>“It’s mind-boggling that not every state is testing,” said De Nies, who teaches children’s ballet in San Diego. “Families will not know until it could be too late for them.”\u003c/p>\n\u003cp>Advocates, including several moms who lost their sons to the disease, were instrumental in getting the \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140AB1559\">screening law\u003c/a> passed in California. Now they are continuing to lobby legislators and pushing health officials to add ALD to screening panels across the nation.\u003c/p>\n\u003cp>Janis Sherwood said that since her son Sawyer’s death from ALD, she has felt an urgency to educate doctors, families and others about the disease. In the past few years, she turned her attention to newborn screening. She believes that as California collects data on how the boys do in treatment, other states will follow. “I think that we are going to see a domino effect as we get more states on board,” she said.\u003c/p>\n\u003cp>About 1 in every 18,000 people have ALD. Of boys with the genetic defect, about 30 to 40 percent will develop the life-threatening form of the disease, which leads to vision, gait and memory problems — and eventually death. It destroys myelin, the protective surface that surrounds some nerve cells.\u003c/p>\n\u003cp>Technicians draw the blood of newborns in the hospital soon after they are born. In California, state law requires that the blood be tested for about 80 diseases, including cystic fibrosis, severe combined immunodeficiency and primary congenital hypothyroidism.\u003c/p>\n\u003cp>Around the nation, testing kits cost a hospital or birthing facility about $120, said Jeff Botkin, who heads the medical ethics division at the University of Utah. “This is an extraordinarily low cost for this number of tests,” he said in an email. The tests are typically covered by insurers or Medicaid.\u003c/p>\n\u003cp>Some conditions on the screening list are relatively common, but ALD is among the rare disorders the tests ferret out that can lead to serious health issues or even death if not detected and treated, Botkin said.\u003c/p>\n\u003cp>There is no answer to the question of how common a condition should be to merit spending health care dollars to test for it, Botkin said. But many of the conditions for which the federal government recommends screening are rare, which means they could affect 1 in 50,000 babies or fewer. “The major question is whether the condition is treatable,” Botkin said.\u003c/p>\n\u003cp>Both boys and girls get tested for ALD because they can both be carriers of the genetic defect and develop the less serious adult form of the disease. Only boys, however, develop the more serious, ultimately fatal, childhood disease.\u003c/p>\n\u003cp>When doctors know that boys have the mutation, they perform brain MRIs beginning when the boys are toddlers. If an MRI starts to show telltale changes in the brain, doctors can intervene to halt the progression of the disease.\u003c/p>\n\u003cp>The common treatment, a bone marrow transplant, is risky and complicated, but it is often successful if the donor is a good match and the procedure is performed before the children have visible symptoms, UCLA neurologist Raman Sankar said. Doctors are also having some success with gene therapy, in which the children undergo a transplant with their own stem cells rather than a donor’s, Sankar said.\u003c/p>\n\u003cp>The earlier the transplant, the better a child’s chance of survival, he said. “The delay may make the difference between whether he can have a lifesaving treatment or not.”\u003c/p>\n\u003cp>Before newborn screening, boys in the early stages of ALD frequently were incorrectly diagnosed with hyperactivity and other conditions, said Richard Olney, who heads the genetic disease screening program for the California public health department. “Many families had to go through a sort of diagnostic odyssey,” he said. “It only became clear as they developed progressively worse problems that they had a serious genetic condition.”\u003c/p>\n\u003cp>By the time a brain MRI was performed, there was often too much damage to save the child. That’s part of the challenge for clinicians who may not be familiar with ALD: “How do you know when this is a critical brain disease versus just a normal part of development?” Eichler said.\u003c/p>\n\u003cp>Those with the genetic mutation who do not develop the disease in childhood may still have a milder form as adults. People with the mutation also need to be monitored by an endocrinologist, because many will suffer from a condition in which their adrenal glands fail to produce enough of a stress hormone that is needed to fight infections.\u003c/p>\n\u003cp>Gina Cousineau’s 8-year-old son, Evan, was diagnosed with ALD in May 2007 after he came home from swim practice and had a seizure. Though he underwent a bone marrow transplant, Evan died from a secondary infection before he turned 9.\u003c/p>\n\u003cp>Cousineau lives in the southern Orange County city of San Clemente and helped lobby for the California law that requires ALD screening. She said newborn testing benefits infants with ALD and can help families discover that siblings or other relatives have the gene mutation.\u003c/p>\n\u003cp>“Thank God this newborn screening came into effect,” Cousineau said. “Knowledge is power. Had I had the knowledge with my son, Evan, he would be alive today.”\u003c/p>\n\u003cp>De Nies said she worries about Gregory’s future, but she’s confident her son will live a long life. And she credits Cousineau and other mothers whose sons didn’t have the same chance.\u003c/p>\n\u003cp>“Without them, we would never know about the gene mutation,” she said. “I just feel like they are our fairy godmothers.”\u003c/p>\n\u003cp>This story was produced by \u003ca href=\"http://khn.org/\">Kaiser Health News\u003c/a>, an editorially independent program of the \u003ca href=\"http://kff.org/\">Kaiser Family Foundation\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Farmworkers Want Pesticide Banned in California After EPA Refuses",
"title": "Farmworkers Want Pesticide Banned in California After EPA Refuses",
"headTitle": "Future of You | KQED Future of You | KQED Science",
"content": "\u003cp>Environmentalists and farmworkers are pushing California regulators to ban the \u003ca href=\"https://www.epa.gov/sites/production/files/2016-05/documents/session-2-chlorpyrifos-human-health-risk-assessment-approach.pdf\" target=\"_blank\" rel=\"noopener\">most commonly\u003c/a> used conventional insecticide in the country. The Environmental Protection Agency under President Obama proposed \u003ca href=\"https://www.gpo.gov/fdsys/pkg/FR-2015-11-06/pdf/2015-28083.pdf\" target=\"_blank\" rel=\"noopener\">banning\u003c/a> chlorpyrifos in 2015 because studies suggest it threatens human health, but the Trump administration \u003ca href=\"https://www.epa.gov/newsreleases/epa-administrator-pruitt-denies-petition-ban-widely-used-pesticide-0\" target=\"_blank\" rel=\"noopener\">reversed\u003c/a> that decision this spring. Now activists are pushing for a statewide ban.\u003c/p>\n\u003cp>\u003cstrong>Clorpyrifos: What Is it? \u003c/strong>\u003c/p>\n\u003cp>Dow Chemical registered chlorpyrifos in 1965. Around 6 million pounds are used nationally every year, and about a million pounds are used annually in California. Farmers use it to kill pests like ants, moths, larvae and worms on about 60 crops, including oranges, alfalfa and almonds.\u003c/p>\n\u003cp>Chlorpyrifos is part of a class of chemicals called organophosphates, which can poison the nervous systems of insects and mammals. \u003ca href=\"https://www.osha.gov/SLTC/emergencypreparedness/guides/nerve.html\" target=\"_blank\" rel=\"noopener\">Sarin gas, \u003c/a>the nerve agent used in chemical warfare, is also an organophosphate, though chlorpyrifos is much less toxic.\u003c/p>\n\u003caside class=\"pullquote alignright\">'They know it impacts children's brains — the question is about what levels.'\u003ccite>Paul Towers, Pesticide Action Network\u003c/cite>\u003c/aside>\n\u003cp>At high doses, nerve agents like chlorpyrifos cause symptoms like headaches, nausea, dizziness and disorientation. If larger doses are ingested, it can lead to vomiting, stomachaches, diarrhea and even death.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The EPA banned chlorpyrifos for the majority of home and garden uses in 2000 due to toxic effects on the nervous system. The agency has also restricted its use on a few commercial crops like apples and tomatoes. A few years ago the U.K. banned the chemical on nearly all crops.\u003c/p>\n\u003cp>\u003cstrong>Trump EPA Revokes Ban\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>In March, the new chief of the EPA, Scott Pruitt, rejected the proposed ban, which had been recommended by EPA scientists. In a \u003ca href=\"https://www.epa.gov/newsreleases/epa-administrator-pruitt-denies-petition-ban-widely-used-pesticide-0\">press release\u003c/a> Pruitt said, \"By reversing the previous administration’s steps to ban one of the most widely used pesticides in the world, we are returning to using sound science in decision-making — rather than predetermined results.\" He said the EPA would not make any final decisions on chlorpyrifos until 2022, pending the agency's further scientific review.\u003c/p>\n\u003cp>Pruitt's actions outraged environmentalists and many scientists who have studied the chemical for decades. Activists were further angered this spring when the widely used pesticide Vulcan (whose active ingredient is chlorpyrifos) drifted from a field in Kern County over to a group of farmworkers picking cabbage. Five of them sought medical treatment.\u003c/p>\n\u003cfigure id=\"attachment_435787\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"wp-image-435787 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/chlorpyrifos-pics-1020x680.jpg\" alt=\"\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-1180x786.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics.jpg 1280w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Protesters near the state Capitol in Sacramento calling for a ban on chlorpyrifos in September 2017. \u003ccite>(Joan Cusick)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>California Tightens Restrictions, But No Ban\u003c/strong>\u003c/p>\n\u003cp>The California Department of Pesticide Regulation is in the midst of reviewing the science on chlorpyrifos to analyze whether a statewide ban is justified. California already had stricter rules related to its application than most states. For example, farmers must have a permit to apply the chemical; they must post a warning after they spray a field; and the state requires buffer zones between sprayed fields and human dwellings.\u003c/p>\n\u003cp>Last week CDPR implemented even stricter rules while it completes its lengthy scientific review. The interim guidelines require greater distances between fields sprayed with chlorpyrifos and \"sensitive areas\" like homes. The distances are now up to 500 feet, about three times longer than previous requirements.\u003c/p>\n\u003cp>“Our scientists have figured out a way that we can use this pesticide with protections and restrictions in place safely in California,\" said CDPR spokeswoman Charlotte Fadipe. \"And we are saying we want more scientific eyes on this to see if those restrictions are robust enough or whether we need to do more.”\u003c/p>\n\u003cp>But the enhanced mitigation does not satisfy activists.\u003c/p>\n\u003cp>\"We are calling on DPR to hit the pause button on continued use of this chemical based on what they know, \" said Paul Towers of Pesticide Action Network. \"They know it impacts children's brains -- the question is about what levels. So while we determine that through two different lengthy scientific bodies we should suspend the use of chlorpyrifos in California.\"\u003c/p>\n\u003cp>When EPA scientists proposed banning chlorpyrifos in November 2015, their recommendation was based on the \u003ca href=\"http://unesdoc.unesco.org/images/0013/001395/139578e.pdf\">precautionary \u003c/a>principle: better to err on the side of caution rather than putting anyone at risk. Towers is calling on state regulators to take the same stance to protect agricultural communities.\u003c/p>\n\u003cfigure id=\"attachment_435850\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-435850 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/JCP_2026-X2-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-1180x786.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2.jpg 1280w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">California farmworker protests use of chlorpyrifos at the state capitol in July 2017. \u003ccite>(Joan Cusick)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Does the Science Justify a Ban?\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The majority of research available has looked at how exposure to chlorpyrifos influences the developing fetus rather than workers in the field. Research shows that prenatal exposure can lead to preterm births, abnormal reflexes in newborns, pervasive attention problems, motor control deficiencies and lower IQ. Scientists have also noted that some young children who have been exposed to the chemical have conditions related to compromised lung function, like asthma.\u003c/p>\n\u003cp>Brenda Eskenazi is an epidemiologist and neuropsychologist at UC Berkeley who has studied organophosphates for many years. She says the EPA under the Obama administration made a sound scientific decision when the agency recommended a ban. “A weight of evidence strongly suggests that chlorpyrifos has sufficient evidence in animals — limited evidence in humans — to restrict or even ban it’s use.”\u003c/p>\n\u003cp>Eskenazi also says chlorpyrifos is not the worst organophosphate used in agriculture; there are other chemicals that may be more toxic to human health. But environmentalists are targeting chlorpyrifos because it is one of the most widely studied chemicals in the world, even though there is still little research on whether residue in produce could impact consumer health.\u003c/p>\n\u003cp>Dow Agrosciences says it remains confident that authorized uses of its product offer wide margins of protection for human health and safety. In a statement the company said, \"Overall, more than 4,000 studies and reports have examined chlorpyrifos in terms of health, safety and the environment. No pest-control product has been or continues to be more thoroughly evaluated.\"\u003c/p>\n\u003cp>Towers draws a different conclusion from the abundance of research.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"If we can't act on this pesticide,\" he say, \"what pesticide can we act on?\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Environmentalists and farmworkers are pushing California regulators to ban the \u003ca href=\"https://www.epa.gov/sites/production/files/2016-05/documents/session-2-chlorpyrifos-human-health-risk-assessment-approach.pdf\" target=\"_blank\" rel=\"noopener\">most commonly\u003c/a> used conventional insecticide in the country. The Environmental Protection Agency under President Obama proposed \u003ca href=\"https://www.gpo.gov/fdsys/pkg/FR-2015-11-06/pdf/2015-28083.pdf\" target=\"_blank\" rel=\"noopener\">banning\u003c/a> chlorpyrifos in 2015 because studies suggest it threatens human health, but the Trump administration \u003ca href=\"https://www.epa.gov/newsreleases/epa-administrator-pruitt-denies-petition-ban-widely-used-pesticide-0\" target=\"_blank\" rel=\"noopener\">reversed\u003c/a> that decision this spring. Now activists are pushing for a statewide ban.\u003c/p>\n\u003cp>\u003cstrong>Clorpyrifos: What Is it? \u003c/strong>\u003c/p>\n\u003cp>Dow Chemical registered chlorpyrifos in 1965. Around 6 million pounds are used nationally every year, and about a million pounds are used annually in California. Farmers use it to kill pests like ants, moths, larvae and worms on about 60 crops, including oranges, alfalfa and almonds.\u003c/p>\n\u003cp>Chlorpyrifos is part of a class of chemicals called organophosphates, which can poison the nervous systems of insects and mammals. \u003ca href=\"https://www.osha.gov/SLTC/emergencypreparedness/guides/nerve.html\" target=\"_blank\" rel=\"noopener\">Sarin gas, \u003c/a>the nerve agent used in chemical warfare, is also an organophosphate, though chlorpyrifos is much less toxic.\u003c/p>\n\u003caside class=\"pullquote alignright\">'They know it impacts children's brains — the question is about what levels.'\u003ccite>Paul Towers, Pesticide Action Network\u003c/cite>\u003c/aside>\n\u003cp>At high doses, nerve agents like chlorpyrifos cause symptoms like headaches, nausea, dizziness and disorientation. If larger doses are ingested, it can lead to vomiting, stomachaches, diarrhea and even death.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The EPA banned chlorpyrifos for the majority of home and garden uses in 2000 due to toxic effects on the nervous system. The agency has also restricted its use on a few commercial crops like apples and tomatoes. A few years ago the U.K. banned the chemical on nearly all crops.\u003c/p>\n\u003cp>\u003cstrong>Trump EPA Revokes Ban\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>In March, the new chief of the EPA, Scott Pruitt, rejected the proposed ban, which had been recommended by EPA scientists. In a \u003ca href=\"https://www.epa.gov/newsreleases/epa-administrator-pruitt-denies-petition-ban-widely-used-pesticide-0\">press release\u003c/a> Pruitt said, \"By reversing the previous administration’s steps to ban one of the most widely used pesticides in the world, we are returning to using sound science in decision-making — rather than predetermined results.\" He said the EPA would not make any final decisions on chlorpyrifos until 2022, pending the agency's further scientific review.\u003c/p>\n\u003cp>Pruitt's actions outraged environmentalists and many scientists who have studied the chemical for decades. Activists were further angered this spring when the widely used pesticide Vulcan (whose active ingredient is chlorpyrifos) drifted from a field in Kern County over to a group of farmworkers picking cabbage. Five of them sought medical treatment.\u003c/p>\n\u003cfigure id=\"attachment_435787\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"wp-image-435787 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/chlorpyrifos-pics-1020x680.jpg\" alt=\"\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-1180x786.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/chlorpyrifos-pics.jpg 1280w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Protesters near the state Capitol in Sacramento calling for a ban on chlorpyrifos in September 2017. \u003ccite>(Joan Cusick)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>California Tightens Restrictions, But No Ban\u003c/strong>\u003c/p>\n\u003cp>The California Department of Pesticide Regulation is in the midst of reviewing the science on chlorpyrifos to analyze whether a statewide ban is justified. California already had stricter rules related to its application than most states. For example, farmers must have a permit to apply the chemical; they must post a warning after they spray a field; and the state requires buffer zones between sprayed fields and human dwellings.\u003c/p>\n\u003cp>Last week CDPR implemented even stricter rules while it completes its lengthy scientific review. The interim guidelines require greater distances between fields sprayed with chlorpyrifos and \"sensitive areas\" like homes. The distances are now up to 500 feet, about three times longer than previous requirements.\u003c/p>\n\u003cp>“Our scientists have figured out a way that we can use this pesticide with protections and restrictions in place safely in California,\" said CDPR spokeswoman Charlotte Fadipe. \"And we are saying we want more scientific eyes on this to see if those restrictions are robust enough or whether we need to do more.”\u003c/p>\n\u003cp>But the enhanced mitigation does not satisfy activists.\u003c/p>\n\u003cp>\"We are calling on DPR to hit the pause button on continued use of this chemical based on what they know, \" said Paul Towers of Pesticide Action Network. \"They know it impacts children's brains -- the question is about what levels. So while we determine that through two different lengthy scientific bodies we should suspend the use of chlorpyrifos in California.\"\u003c/p>\n\u003cp>When EPA scientists proposed banning chlorpyrifos in November 2015, their recommendation was based on the \u003ca href=\"http://unesdoc.unesco.org/images/0013/001395/139578e.pdf\">precautionary \u003c/a>principle: better to err on the side of caution rather than putting anyone at risk. Towers is calling on state regulators to take the same stance to protect agricultural communities.\u003c/p>\n\u003cfigure id=\"attachment_435850\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-435850 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/10/JCP_2026-X2-800x533.jpg\" alt=\"\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-1180x786.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/10/JCP_2026-X2.jpg 1280w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">California farmworker protests use of chlorpyrifos at the state capitol in July 2017. \u003ccite>(Joan Cusick)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Does the Science Justify a Ban?\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>The majority of research available has looked at how exposure to chlorpyrifos influences the developing fetus rather than workers in the field. Research shows that prenatal exposure can lead to preterm births, abnormal reflexes in newborns, pervasive attention problems, motor control deficiencies and lower IQ. Scientists have also noted that some young children who have been exposed to the chemical have conditions related to compromised lung function, like asthma.\u003c/p>\n\u003cp>Brenda Eskenazi is an epidemiologist and neuropsychologist at UC Berkeley who has studied organophosphates for many years. She says the EPA under the Obama administration made a sound scientific decision when the agency recommended a ban. “A weight of evidence strongly suggests that chlorpyrifos has sufficient evidence in animals — limited evidence in humans — to restrict or even ban it’s use.”\u003c/p>\n\u003cp>Eskenazi also says chlorpyrifos is not the worst organophosphate used in agriculture; there are other chemicals that may be more toxic to human health. But environmentalists are targeting chlorpyrifos because it is one of the most widely studied chemicals in the world, even though there is still little research on whether residue in produce could impact consumer health.\u003c/p>\n\u003cp>Dow Agrosciences says it remains confident that authorized uses of its product offer wide margins of protection for human health and safety. In a statement the company said, \"Overall, more than 4,000 studies and reports have examined chlorpyrifos in terms of health, safety and the environment. No pest-control product has been or continues to be more thoroughly evaluated.\"\u003c/p>\n\u003cp>Towers draws a different conclusion from the abundance of research.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"If we can't act on this pesticide,\" he say, \"what pesticide can we act on?\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Isolation is Big Health Risk for Seniors. But There's Community Online",
"title": "Isolation is Big Health Risk for Seniors. But There's Community Online",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp class=\"p1\">\u003cem>Originally published June 26, 2017\u003c/em>\u003c/p>\n\u003cp class=\"p1\">Orazgul Tachmuradova, age 71, emigrated to the United States alone, about a decade ago. Learning to get around San Francisco wasn't easy.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“My eyes are not good, my hearing’s not good, my English is not good,” is how she puts it. Having grown up in a rural area, surrounded by family, she was “slowly dying of disconnection.” \u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'The iPad is like a genie -- Hello, Siri? Tell me this one!' \u003ccite>Orazgul Tachmuradova, 71\u003c/cite>\u003c/aside>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“This world does not belong to me; I do not belong to this world,” she recalls feeling.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">But recently, things have been looking up, thanks to a new high-tech relationship.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“The iPad is like a \u003cem>genie\u003c/em>,” she says. She mimes pressing a button: “Hello, Siri? Tell me this one!”\u003c/p>\n\u003cp class=\"p1\">Tachmuradova and Siri started conversing during a year-long pilot project, now coming to an end, at San Francisco’s \u003cspan class=\"s2\">\u003ca href=\"http://curryseniorcenter.org\">Curry Senior Center\u003c/a>. Seventeen s\u003c/span>eniors were given iPads, FitBits and digital scales to monitor their health, and to reduce isolation by teaching them how to socialize, learn and enjoy themselves online.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\"> “When I started this program, I was reborn,” says Tachmuradova. “I am becoming alive! More and more now, we are busy. I don’t feel I am alone. I live alone without \u003ci>being\u003c/i> alone.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">All of the program’s seniors live alone, and most are very low-income.\u003cb> \u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“Some people felt isolated, technologically-wise, because they didn't know what other people were doing on the internet,” says Angela Di Martino, who teaches the weekly class on how to use the devices. “Now I think they feel a lot more comfortable because they have that knowledge.”\u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'I live alone without \u003ci>being\u003c/i> alone.'\u003c/aside>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Di Martino devoted early lessons to finding trustworthy medical information on the web, emailing your doctor and checking lab results online. Her students have also been introduced to an array of social tech tools; some of the group’s favorite are FaceTime and Skype for video chatting and Messenger for sharing photos. Many in the group use their iPads to tune in the radio or podcasts, and one has \u003ca href=\"https://www.youtube.com/user/MJofSanFran\">\u003cspan class=\"s2\">her own YouTube channel\u003c/span>\u003c/a>.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The last few classes have been devoted to iPad photography, so today everyone is editing their best shots. In one corner, Marilyn Chan and Shirley Smith keep leaning over to see what’s happening on each other’s screens. Chan is polishing up a selfie of the two of them making the most of Ben & Jerry’s Free Cone Day. Across the room, Linda Rospendowski, 68, is contemplating a photo of herself in a hot pink dress. But she has a problem: The photographer has chopped off the top of her head, and she's wondering if you can digitally repair hair. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“The bouffant—it has to be there,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>America: Getting Old\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">As baby boomers head into their 60s and 70s, advocacy groups are now exploring the benefits of this kind of tech education for seniors. Prime candidates are elderly people who live in rural areas, are estranged or live far from family, or have health or mobility problems that make it difficult to get around.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_414753\" class=\"wp-caption alignleft\" style=\"max-width: 386px\">\u003cimg class=\"wp-image-414753 \" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/06/SENIORS1_Platoni-1-1020x680.jpg\" alt=\"\" width=\"386\" height=\"257\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1.jpg 1600w\" sizes=\"(max-width: 386px) 100vw, 386px\">\u003cfigcaption class=\"wp-caption-text\">Linda Rospendowski, 68, and Orazgul Tachmuradova, 71, work on editing their photos. \u003ccite>(Kara Platoni/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Lisa Marsh Ryerson, president of the AARP Foundation, a charitable affiliate of the advocacy group for seniors, points out that 10,000 Americans turn 65 every day. But despite their numbers, baby boomers don’t always feel like they’re aging together. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“As many as 40 percent of adults who are 65 or older say that they experience significant loneliness,” says Ryerson.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">Loneliness isn’t quite the same thing as being alone, but both can influence health. “Loneliness is something that is subjective. It’s our own perception of our experiences,” says Ryerson. It is also one measure of distress. Isolation, on the other hand, is an objective metric, “based on the size of someone’s social network, the frequency of contact with their social network and their access to services.”\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">[contextly_sidebar id=\"pJzqgRcGnSSnAs2omLf83MRF0ZoTRCKk\"]Isolation can cause health problems even for a person who feels perfectly satisfied with a small or distant network. (Imagine not knowing anyone nearby who can check on you when you’re ill.) Ryerson says isolation is often triggered by loss of hearing or mobility, a move to a new community or a partner’s death, and it’s especially common among those who are low-income or identify as a member of a marginalized group.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">To address the problem, the AARP Foundation recently launched \u003ca href=\"https://connect2affect.org/\">\u003cspan class=\"s2\">Connect2Affect\u003c/span>\u003c/a>, a resource portal for older adults and caregivers that encourages online engagement, and includes a \u003ca href=\"https://connect2affect.org/wp-content/uploads/2017/03/A-Profile-of-Social-Connectedness.pdf\">\u003cspan class=\"s2\">study of social connectedness among people over age 62\u003c/span>\u003c/a>. The \u003ca href=\"https://aarptek.aarp.org/\">\u003cspan class=\"s2\">AARP Academy\u003c/span>\u003c/a> also offers free online tutorials for using smartphones, tablets or social media, and for conducting job searches on the internet. \u003c/span>\u003c/p>\n\u003cp class=\"p3\">\u003cspan class=\"s1\">Meanwhile, the National Council on Aging completed its own \u003ca href=\"https://www.ncoa.org/healthy-aging/aging-mastery-program/\">\u003cspan class=\"s3\">two-year tablet program\u003c/span>\u003c/a>, similar to Curry’s. The result? “The more time [participants] were spending on the tablets, the stronger their social interactions, their emotional support, self-esteem,” says \u003c/span>\u003cspan class=\"s4\">Susan Stiles, senior director of product development and strategy for the group. \u003c/span>\u003c/p>\n\u003cp class=\"p5\">\u003cstrong>\u003cspan class=\"s1\">Getting Seniors Connected\u003c/span>\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Yet enticing people online isn’t always easy. According to a \u003ca href=\"http://www.pewinternet.org/2017/05/17/technology-use-among-seniors/\">\u003cspan class=\"s2\">study \u003c/span>\u003c/a>\u003cspan class=\"s2\">released in May by the Pew Research Center\u003c/span>, while mobile device use is climbing among seniors, still only about a third own a tablet, 42 percent own smartphones, and just over half have broadband at home. Only about a third use social media.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“There were some fears going into the project,” says Stiles of the NCOA program. “People did not necessarily think that a tablet computer had any relevancy for their lives. They had privacy concerns and were afraid of potentially being exposed to scams.” (Ditto the Curry class, where people asked pointed questions about putting credit card information on their iPad and worried about being unfairly charged when ordering photo prints online.)\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">For the NCOA program, the trick was helping users find their personal killer app. For a former taxi driver now in his 90s, it was Google Maps. Stiles recalls a colleague asking the man to name some streets on his old route. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“She zoomed in on these streets and his eyes just lit up, \" Stiles says. \"And then he wanted to go everywhere in New York City.” \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">For a former B-movie actress, the most alluring app was YouTube, where she found her old film clips.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Tablets seem to be a nice middle ground for those who are skeptical of full-sized computers. You can use voice commands instead of struggling with a mouse or keyboard; they fit neatly into a small living space like a senior apartment; and you can use them while sitting in your favorite comfy chair. “It doesn't feel like this weighty technology object,” says Stiles. “It really feels like a book.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>Designing for Seniors\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Pittsburgh-based Breezie, which sells tech solutions for seniors and \u003ca href=\"https://www.breezie.com/breezie-in-action/breezie-brings-online-benefits-to-seniors-in-florida/\">\u003cspan class=\"s2\">partnered with the NCOA on its program\u003c/span>\u003c/a>, is trying to make Android-based devices even easier for new users by offering a service that simplifies a tablet’s interface. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“If you went right now to a Best Buy and if you bought a tablet to give to a senior, there are 43 different settings you would want to change before you make it senior-friendly,”\u003cb> \u003c/b>says CEO and founder Jeh Kazimi. He means things that Breezie can pre-adjust, like brightness and volume, consolidating logins, and making the screen more forgiving if you accidentally put your thumb on it. The company is also trying to develop a way to cancel out hand tremor for people with Parkinson's disease, because uneven pressure can make the tablet think a user is swiping when they mean to click.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_415056\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/06/SENIORS15_Platoni.jpg\">\u003cimg class=\"size-large wp-image-415056\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/06/SENIORS15_Platoni-1020x804.jpg\" alt=\"\" width=\"640\" height=\"504\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-1020x804.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-160x126.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-800x631.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-768x605.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-1180x930.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-960x757.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-240x189.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-375x296.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-520x410.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni.jpg 1600w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaycee Springer, 65, polishes up her photo of the sun setting over San Francisco. \u003ccite>(Kara Platoni/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Caregivers or Breezie staff can also curate each person’s desktop, like providing ready-made YouTube playlists for fans of jazz music or Muhammad Ali’s boxing matches. For an avid gardener, Kazimi says, they might install a few outdoorsy apps “that don’t show you ads every two minutes or ask you to upgrade every three minutes.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">But tablets aren’t a foolproof platform. Kazimi has seen seniors who need stickers to label the camera, volume and charging socket, because the devices can suddenly flip screen orientation, leaving confused people holding them upside down and wondering where the buttons are. Di Martino encountered some unexpected hurdles, too, “like a couple of the men in the class didn't know how to type.” She helped get people comfortable with the touchscreen by offering styluses, which are more accurate pointing tools than fingers. And she encouraged her students to feel OK about making mistakes. “Sometimes I tell them, ‘I don’t know what that button does. Let’s hit it,’” she says.\u003c/span>\u003c/p>\n\u003cp class=\"p2\">\u003cstrong>\u003cspan class=\"s1\">Dip in Loneliness\u003c/span>\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The seniors in the Curry program report different feelings about living alone—for example, Kaycee Springer enjoys it and is content using video chat to keep in touch with her daughters long-distance. But she does feel a bit socially crimped in the Tenderloin, where it doesn't always seem safe to walk around, especially at night. And she knows some of her elderly neighbors are extremely withdrawn. “There are people in my building, they just lay around and do absolutely nothing,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Di Martino has put together some preliminary stats from surveying participants at the program’s 6-month point. Almost all of the seniors said they used their iPad daily. As with the NCOA program, she noted a slight dip in reported loneliness. But the leaders of both projects say it’s hard to know if that stems from people making friends in class or becoming more social online. The AARP’s Ryerson says you might as well encourage both, so that technological and real-world connections reinforce each other. For example, she says, “FitBits are about taking steps. So let’s walk together.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">At the Curry Center, one other result is very clear: Now that the class is ending, nobody wants to give up their iPads. \"We just started!” exclaims Tachmuradova.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Springer still finds her tablet hard to put down: “I will put it on my bed—and then I will go, ‘\u003ci>It’s calling me\u003c/i>.’”\u003c/span>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Di Martino says not to worry—they’re looking into a second phase that will allow everyone to keep their tablets, perhaps in exchange for peer mentoring the next round of students. Now that she’s taught them every iPad trick she knows, their new challenge will be teaching each other. \u003c/span>\u003c/p>\n\n",
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"excerpt": "As baby boomers head into their golden years, senior advocates and organizations look for ways to use social technology tools to keep them connected to the world, and avoiding isolation and loneliness. ",
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"description": "As baby boomers head into their golden years, senior advocates and organizations look for ways to use social technology tools to keep them connected to the world, and avoiding isolation and loneliness. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"p1\">\u003cem>Originally published June 26, 2017\u003c/em>\u003c/p>\n\u003cp class=\"p1\">Orazgul Tachmuradova, age 71, emigrated to the United States alone, about a decade ago. Learning to get around San Francisco wasn't easy.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“My eyes are not good, my hearing’s not good, my English is not good,” is how she puts it. Having grown up in a rural area, surrounded by family, she was “slowly dying of disconnection.” \u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'The iPad is like a genie -- Hello, Siri? Tell me this one!' \u003ccite>Orazgul Tachmuradova, 71\u003c/cite>\u003c/aside>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“This world does not belong to me; I do not belong to this world,” she recalls feeling.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">But recently, things have been looking up, thanks to a new high-tech relationship.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The iPad is like a \u003cem>genie\u003c/em>,” she says. She mimes pressing a button: “Hello, Siri? Tell me this one!”\u003c/p>\n\u003cp class=\"p1\">Tachmuradova and Siri started conversing during a year-long pilot project, now coming to an end, at San Francisco’s \u003cspan class=\"s2\">\u003ca href=\"http://curryseniorcenter.org\">Curry Senior Center\u003c/a>. Seventeen s\u003c/span>eniors were given iPads, FitBits and digital scales to monitor their health, and to reduce isolation by teaching them how to socialize, learn and enjoy themselves online.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\"> “When I started this program, I was reborn,” says Tachmuradova. “I am becoming alive! More and more now, we are busy. I don’t feel I am alone. I live alone without \u003ci>being\u003c/i> alone.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">All of the program’s seniors live alone, and most are very low-income.\u003cb> \u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“Some people felt isolated, technologically-wise, because they didn't know what other people were doing on the internet,” says Angela Di Martino, who teaches the weekly class on how to use the devices. “Now I think they feel a lot more comfortable because they have that knowledge.”\u003c/span>\u003c/p>\n\u003caside class=\"pullquote alignright\">'I live alone without \u003ci>being\u003c/i> alone.'\u003c/aside>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Di Martino devoted early lessons to finding trustworthy medical information on the web, emailing your doctor and checking lab results online. Her students have also been introduced to an array of social tech tools; some of the group’s favorite are FaceTime and Skype for video chatting and Messenger for sharing photos. Many in the group use their iPads to tune in the radio or podcasts, and one has \u003ca href=\"https://www.youtube.com/user/MJofSanFran\">\u003cspan class=\"s2\">her own YouTube channel\u003c/span>\u003c/a>.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The last few classes have been devoted to iPad photography, so today everyone is editing their best shots. In one corner, Marilyn Chan and Shirley Smith keep leaning over to see what’s happening on each other’s screens. Chan is polishing up a selfie of the two of them making the most of Ben & Jerry’s Free Cone Day. Across the room, Linda Rospendowski, 68, is contemplating a photo of herself in a hot pink dress. But she has a problem: The photographer has chopped off the top of her head, and she's wondering if you can digitally repair hair. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“The bouffant—it has to be there,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>America: Getting Old\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">As baby boomers head into their 60s and 70s, advocacy groups are now exploring the benefits of this kind of tech education for seniors. Prime candidates are elderly people who live in rural areas, are estranged or live far from family, or have health or mobility problems that make it difficult to get around.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_414753\" class=\"wp-caption alignleft\" style=\"max-width: 386px\">\u003cimg class=\"wp-image-414753 \" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/06/SENIORS1_Platoni-1-1020x680.jpg\" alt=\"\" width=\"386\" height=\"257\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS1_Platoni-1.jpg 1600w\" sizes=\"(max-width: 386px) 100vw, 386px\">\u003cfigcaption class=\"wp-caption-text\">Linda Rospendowski, 68, and Orazgul Tachmuradova, 71, work on editing their photos. \u003ccite>(Kara Platoni/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Lisa Marsh Ryerson, president of the AARP Foundation, a charitable affiliate of the advocacy group for seniors, points out that 10,000 Americans turn 65 every day. But despite their numbers, baby boomers don’t always feel like they’re aging together. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“As many as 40 percent of adults who are 65 or older say that they experience significant loneliness,” says Ryerson.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">Loneliness isn’t quite the same thing as being alone, but both can influence health. “Loneliness is something that is subjective. It’s our own perception of our experiences,” says Ryerson. It is also one measure of distress. Isolation, on the other hand, is an objective metric, “based on the size of someone’s social network, the frequency of contact with their social network and their access to services.”\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003c/p>\u003cp>\u003c/p>\u003cp>Isolation can cause health problems even for a person who feels perfectly satisfied with a small or distant network. (Imagine not knowing anyone nearby who can check on you when you’re ill.) Ryerson says isolation is often triggered by loss of hearing or mobility, a move to a new community or a partner’s death, and it’s especially common among those who are low-income or identify as a member of a marginalized group.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">To address the problem, the AARP Foundation recently launched \u003ca href=\"https://connect2affect.org/\">\u003cspan class=\"s2\">Connect2Affect\u003c/span>\u003c/a>, a resource portal for older adults and caregivers that encourages online engagement, and includes a \u003ca href=\"https://connect2affect.org/wp-content/uploads/2017/03/A-Profile-of-Social-Connectedness.pdf\">\u003cspan class=\"s2\">study of social connectedness among people over age 62\u003c/span>\u003c/a>. The \u003ca href=\"https://aarptek.aarp.org/\">\u003cspan class=\"s2\">AARP Academy\u003c/span>\u003c/a> also offers free online tutorials for using smartphones, tablets or social media, and for conducting job searches on the internet. \u003c/span>\u003c/p>\n\u003cp class=\"p3\">\u003cspan class=\"s1\">Meanwhile, the National Council on Aging completed its own \u003ca href=\"https://www.ncoa.org/healthy-aging/aging-mastery-program/\">\u003cspan class=\"s3\">two-year tablet program\u003c/span>\u003c/a>, similar to Curry’s. The result? “The more time [participants] were spending on the tablets, the stronger their social interactions, their emotional support, self-esteem,” says \u003c/span>\u003cspan class=\"s4\">Susan Stiles, senior director of product development and strategy for the group. \u003c/span>\u003c/p>\n\u003cp class=\"p5\">\u003cstrong>\u003cspan class=\"s1\">Getting Seniors Connected\u003c/span>\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Yet enticing people online isn’t always easy. According to a \u003ca href=\"http://www.pewinternet.org/2017/05/17/technology-use-among-seniors/\">\u003cspan class=\"s2\">study \u003c/span>\u003c/a>\u003cspan class=\"s2\">released in May by the Pew Research Center\u003c/span>, while mobile device use is climbing among seniors, still only about a third own a tablet, 42 percent own smartphones, and just over half have broadband at home. Only about a third use social media.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“There were some fears going into the project,” says Stiles of the NCOA program. “People did not necessarily think that a tablet computer had any relevancy for their lives. They had privacy concerns and were afraid of potentially being exposed to scams.” (Ditto the Curry class, where people asked pointed questions about putting credit card information on their iPad and worried about being unfairly charged when ordering photo prints online.)\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">For the NCOA program, the trick was helping users find their personal killer app. For a former taxi driver now in his 90s, it was Google Maps. Stiles recalls a colleague asking the man to name some streets on his old route. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“She zoomed in on these streets and his eyes just lit up, \" Stiles says. \"And then he wanted to go everywhere in New York City.” \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">For a former B-movie actress, the most alluring app was YouTube, where she found her old film clips.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Tablets seem to be a nice middle ground for those who are skeptical of full-sized computers. You can use voice commands instead of struggling with a mouse or keyboard; they fit neatly into a small living space like a senior apartment; and you can use them while sitting in your favorite comfy chair. “It doesn't feel like this weighty technology object,” says Stiles. “It really feels like a book.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>Designing for Seniors\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Pittsburgh-based Breezie, which sells tech solutions for seniors and \u003ca href=\"https://www.breezie.com/breezie-in-action/breezie-brings-online-benefits-to-seniors-in-florida/\">\u003cspan class=\"s2\">partnered with the NCOA on its program\u003c/span>\u003c/a>, is trying to make Android-based devices even easier for new users by offering a service that simplifies a tablet’s interface. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“If you went right now to a Best Buy and if you bought a tablet to give to a senior, there are 43 different settings you would want to change before you make it senior-friendly,”\u003cb> \u003c/b>says CEO and founder Jeh Kazimi. He means things that Breezie can pre-adjust, like brightness and volume, consolidating logins, and making the screen more forgiving if you accidentally put your thumb on it. The company is also trying to develop a way to cancel out hand tremor for people with Parkinson's disease, because uneven pressure can make the tablet think a user is swiping when they mean to click.\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_415056\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/06/SENIORS15_Platoni.jpg\">\u003cimg class=\"size-large wp-image-415056\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/06/SENIORS15_Platoni-1020x804.jpg\" alt=\"\" width=\"640\" height=\"504\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-1020x804.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-160x126.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-800x631.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-768x605.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-1180x930.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-960x757.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-240x189.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-375x296.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni-520x410.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/SENIORS15_Platoni.jpg 1600w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Kaycee Springer, 65, polishes up her photo of the sun setting over San Francisco. \u003ccite>(Kara Platoni/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Caregivers or Breezie staff can also curate each person’s desktop, like providing ready-made YouTube playlists for fans of jazz music or Muhammad Ali’s boxing matches. For an avid gardener, Kazimi says, they might install a few outdoorsy apps “that don’t show you ads every two minutes or ask you to upgrade every three minutes.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">But tablets aren’t a foolproof platform. Kazimi has seen seniors who need stickers to label the camera, volume and charging socket, because the devices can suddenly flip screen orientation, leaving confused people holding them upside down and wondering where the buttons are. Di Martino encountered some unexpected hurdles, too, “like a couple of the men in the class didn't know how to type.” She helped get people comfortable with the touchscreen by offering styluses, which are more accurate pointing tools than fingers. And she encouraged her students to feel OK about making mistakes. “Sometimes I tell them, ‘I don’t know what that button does. Let’s hit it,’” she says.\u003c/span>\u003c/p>\n\u003cp class=\"p2\">\u003cstrong>\u003cspan class=\"s1\">Dip in Loneliness\u003c/span>\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The seniors in the Curry program report different feelings about living alone—for example, Kaycee Springer enjoys it and is content using video chat to keep in touch with her daughters long-distance. But she does feel a bit socially crimped in the Tenderloin, where it doesn't always seem safe to walk around, especially at night. And she knows some of her elderly neighbors are extremely withdrawn. “There are people in my building, they just lay around and do absolutely nothing,” she says.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Di Martino has put together some preliminary stats from surveying participants at the program’s 6-month point. Almost all of the seniors said they used their iPad daily. As with the NCOA program, she noted a slight dip in reported loneliness. But the leaders of both projects say it’s hard to know if that stems from people making friends in class or becoming more social online. The AARP’s Ryerson says you might as well encourage both, so that technological and real-world connections reinforce each other. For example, she says, “FitBits are about taking steps. So let’s walk together.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">At the Curry Center, one other result is very clear: Now that the class is ending, nobody wants to give up their iPads. \"We just started!” exclaims Tachmuradova.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Springer still finds her tablet hard to put down: “I will put it on my bed—and then I will go, ‘\u003ci>It’s calling me\u003c/i>.’”\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Di Martino says not to worry—they’re looking into a second phase that will allow everyone to keep their tablets, perhaps in exchange for peer mentoring the next round of students. Now that she’s taught them every iPad trick she knows, their new challenge will be teaching each other. \u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Spinal Patients Continue Remarkable Recovery After Stem Cell Injections, Company Says",
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"content": "\u003cp>Patients with spinal injuries have continued to heal long after they’ve received an initial injection of stem cells, \u003ca href=\"http://asteriasbiotherapeutics.com/inv_news_releases_text.php?releaseid=2303887&date=October+02%2C+2017&title=Asterias+Announces+Two+Significant+Developments+for+Spinal+Cord+Injury+Program%3Chttp://asteriasbiotherapeutics.com/inv_news_releases_text.php?releaseid=2303887&date=October+02%2C+2017&title=Asterias+Announces+Two+Significant+Developments+for+Spinal+Cord+Injury+Program%3E\">according to data\u003c/a> released Oct. 2 by the biotech company conducting a clinical trial on the treatment.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The rate of recovery at 12 months is more than double the rates of recovery seen at 12 months in both matched historical controls (29%) and published data in a similar patient population (26%).'\u003ccite>Asterias Biotherapeutics\u003c/cite>\u003c/aside>\n\u003cp>One year after six patients with severe spinal injuries were dosed with 10 million stem cells, four in the group have recovered at least two full motor levels of movement on at least one side of their bodies. That degree of improvement, based on the International Standards for Neurological Classification of Spinal Cord Injury \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3232636/\" target=\"_blank\" rel=\"noopener\">scale\u003c/a>, is about twice the rate of recovery patients historically see, according to the company, Asterias Biotherapeutics of Fremont, California.\u003c/p>\n\u003cp>\"The rate of recovery at 12 months is more than double the rates of recovery seen at 12 months in both matched historical controls (29%) and published data in a similar patient population (26%),\" the company wrote in a press release.\u003c/p>\n\u003cp>According to Edward Wirth III, chief medical officer at Asterias, all six patients in the second cohort of the study progressed at least one motor level on one side; three patients improved two levels on one side; and one patient advanced three motor levels on one side. In addition, Wirth said, almost all the patients showed improvement on both sides of their bodies, and two of them jumped two motor levels on both sides.\u003c/p>\n\u003cp>Regaining two motor levels in spinocervical patients is significant. That could make the difference between full paralysis from the neck down, a condition that would require a ventilator to breathe, versus regaining some arm, hand and finger movement, allowing patients to take care of many of life’s daily tasks unassisted.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>We reported \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/09/23/stem-cells-may-have-restored-use-of-hands-and-arms-in-paralyzed-man/\">last year\u003c/a> on the striking initial results of this experimental phase 2 clinical trial, called \u003ca href=\"http://www.scistar-study.com/\">SCiStar.\u003c/a> The updated information suggests patients in this second cohort of the study not only received strong early benefit from the large single dose of stem cells, but that they have continued to improve over time.\u003c/p>\n\u003cp>Dr. Charles Liu, an investigator on the study and director of the USC Neurorestoration Center, has a patient in the second cohort of the trial, 21-year-old Kris Boesen of Fresno, whose substantial progress we first \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/03/23/strong-stem-cell-therapy-results-for-paralyzed-patients-company-says/\">reported\u003c/a> in September 2016.\u003c/p>\n\u003cp>Liu says most spinal-injury patients, once they’ve gone through initial recovery, tend to remain at the same level of movement.\u003c/p>\n\u003cp>“They can get a little bit better, but there’s definitely a point of plateau,\" Liu says.\u003c/p>\n\u003cp>But the new data from the trial shows continued progress. At the \u003ca href=\"http://www.globenewswire.com/NewsRoom/AttachmentNg/5f3b3123-31c5-48ec-be59-dd0b842a21ca\">six-month mark\u003c/a>, for instance, only two of the patients attained two-motor-level-improvement. After 12 months, two more had attained the milestone.\u003c/p>\n\u003cp>“Usually what you see is a plateau and that’s not what we’re seeing here. They continued to improve,” Liu says. “It was a durable effect. And that’s incredibly exciting.”\u003c/p>\n\u003cp>The six people in the second cohort obviously represent a small sample size, and some patients do spontaneously recover from spinal injuries. But Liu believes now that the replication of Boesen's progress has occurred in multiple patients, it’s more difficult to write them off as outliers.\u003c/p>\n\u003cp>There are five cohorts of patients in the study. The first received 2 million stem cells, the second 10 million, and the third is still in the process of receiving 20 million. The patients who received 2 million stem cells showed some benefit from the treatment, but not nearly as much as the 10-million-cell cohort.\u003cb> \u003c/b>The fourth and fifth cohorts target a different level of spinal injury, using dosages of 10 million and 20 million cells.\u003c/p>\n\u003cp>Enrollment is completed for the first four rounds of the trial; the fifth cohort's enrollment has begun and is expected to be completed by the end of this year, Asterias officials said.\u003c/p>\n\u003cp>The San Francisco Chronicle also \u003ca href=\"http://www.sfgate.com/health/article/Super-exciting-results-in-stem-cell-therapy-12245199.php\" target=\"_blank\" rel=\"noopener\">wrote about the trial\u003c/a> this week, in a front-page article. Reporter Erin Allday spoke with Christopher Block, a 31-year-old patient in the SCiStar trial who had virtually no movement in his arms after he injured his spinal cord in a biking accident.\u003c/p>\n\u003cp>“About a month after my stem cells, I was able to begin feeding myself,” Block told the Chronicle. He can now raise himself out of his wheelchair and change his shirt, he said.\u003c/p>\n\u003cp>On Monday, Asterias announced that the FDA had granted its request for designation of its stem cell treatment as a regenerative medicine advanced therapy, or \u003ca href=\"https://www.fda.gov/BiologicsBloodVaccines/CellularGeneTherapyProducts/ucm537670.htm\" target=\"_blank\" rel=\"noopener\">RMAT\u003c/a>. One of the conditions of that designation is that preliminary clinical evidence indicates the treatment has \"potential to address unmet medical needs\" related to a \"serious or life-threatening disease or condition.\" The designation, which was created under the 21st Century Cures Act last year, was designed to accelerate review and approval by the FDA.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>SCiStar is partially funded by the California Institute for Regenerative Medicine, or CIRM, the publicly funded stem cell agency created by a state initiative in 2004.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Patients with spinal injuries have continued to heal long after they’ve received an initial injection of stem cells, \u003ca href=\"http://asteriasbiotherapeutics.com/inv_news_releases_text.php?releaseid=2303887&date=October+02%2C+2017&title=Asterias+Announces+Two+Significant+Developments+for+Spinal+Cord+Injury+Program%3Chttp://asteriasbiotherapeutics.com/inv_news_releases_text.php?releaseid=2303887&date=October+02%2C+2017&title=Asterias+Announces+Two+Significant+Developments+for+Spinal+Cord+Injury+Program%3E\">according to data\u003c/a> released Oct. 2 by the biotech company conducting a clinical trial on the treatment.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The rate of recovery at 12 months is more than double the rates of recovery seen at 12 months in both matched historical controls (29%) and published data in a similar patient population (26%).'\u003ccite>Asterias Biotherapeutics\u003c/cite>\u003c/aside>\n\u003cp>One year after six patients with severe spinal injuries were dosed with 10 million stem cells, four in the group have recovered at least two full motor levels of movement on at least one side of their bodies. That degree of improvement, based on the International Standards for Neurological Classification of Spinal Cord Injury \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3232636/\" target=\"_blank\" rel=\"noopener\">scale\u003c/a>, is about twice the rate of recovery patients historically see, according to the company, Asterias Biotherapeutics of Fremont, California.\u003c/p>\n\u003cp>\"The rate of recovery at 12 months is more than double the rates of recovery seen at 12 months in both matched historical controls (29%) and published data in a similar patient population (26%),\" the company wrote in a press release.\u003c/p>\n\u003cp>According to Edward Wirth III, chief medical officer at Asterias, all six patients in the second cohort of the study progressed at least one motor level on one side; three patients improved two levels on one side; and one patient advanced three motor levels on one side. In addition, Wirth said, almost all the patients showed improvement on both sides of their bodies, and two of them jumped two motor levels on both sides.\u003c/p>\n\u003cp>Regaining two motor levels in spinocervical patients is significant. That could make the difference between full paralysis from the neck down, a condition that would require a ventilator to breathe, versus regaining some arm, hand and finger movement, allowing patients to take care of many of life’s daily tasks unassisted.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>We reported \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/09/23/stem-cells-may-have-restored-use-of-hands-and-arms-in-paralyzed-man/\">last year\u003c/a> on the striking initial results of this experimental phase 2 clinical trial, called \u003ca href=\"http://www.scistar-study.com/\">SCiStar.\u003c/a> The updated information suggests patients in this second cohort of the study not only received strong early benefit from the large single dose of stem cells, but that they have continued to improve over time.\u003c/p>\n\u003cp>Dr. Charles Liu, an investigator on the study and director of the USC Neurorestoration Center, has a patient in the second cohort of the trial, 21-year-old Kris Boesen of Fresno, whose substantial progress we first \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/03/23/strong-stem-cell-therapy-results-for-paralyzed-patients-company-says/\">reported\u003c/a> in September 2016.\u003c/p>\n\u003cp>Liu says most spinal-injury patients, once they’ve gone through initial recovery, tend to remain at the same level of movement.\u003c/p>\n\u003cp>“They can get a little bit better, but there’s definitely a point of plateau,\" Liu says.\u003c/p>\n\u003cp>But the new data from the trial shows continued progress. At the \u003ca href=\"http://www.globenewswire.com/NewsRoom/AttachmentNg/5f3b3123-31c5-48ec-be59-dd0b842a21ca\">six-month mark\u003c/a>, for instance, only two of the patients attained two-motor-level-improvement. After 12 months, two more had attained the milestone.\u003c/p>\n\u003cp>“Usually what you see is a plateau and that’s not what we’re seeing here. They continued to improve,” Liu says. “It was a durable effect. And that’s incredibly exciting.”\u003c/p>\n\u003cp>The six people in the second cohort obviously represent a small sample size, and some patients do spontaneously recover from spinal injuries. But Liu believes now that the replication of Boesen's progress has occurred in multiple patients, it’s more difficult to write them off as outliers.\u003c/p>\n\u003cp>There are five cohorts of patients in the study. The first received 2 million stem cells, the second 10 million, and the third is still in the process of receiving 20 million. The patients who received 2 million stem cells showed some benefit from the treatment, but not nearly as much as the 10-million-cell cohort.\u003cb> \u003c/b>The fourth and fifth cohorts target a different level of spinal injury, using dosages of 10 million and 20 million cells.\u003c/p>\n\u003cp>Enrollment is completed for the first four rounds of the trial; the fifth cohort's enrollment has begun and is expected to be completed by the end of this year, Asterias officials said.\u003c/p>\n\u003cp>The San Francisco Chronicle also \u003ca href=\"http://www.sfgate.com/health/article/Super-exciting-results-in-stem-cell-therapy-12245199.php\" target=\"_blank\" rel=\"noopener\">wrote about the trial\u003c/a> this week, in a front-page article. Reporter Erin Allday spoke with Christopher Block, a 31-year-old patient in the SCiStar trial who had virtually no movement in his arms after he injured his spinal cord in a biking accident.\u003c/p>\n\u003cp>“About a month after my stem cells, I was able to begin feeding myself,” Block told the Chronicle. He can now raise himself out of his wheelchair and change his shirt, he said.\u003c/p>\n\u003cp>On Monday, Asterias announced that the FDA had granted its request for designation of its stem cell treatment as a regenerative medicine advanced therapy, or \u003ca href=\"https://www.fda.gov/BiologicsBloodVaccines/CellularGeneTherapyProducts/ucm537670.htm\" target=\"_blank\" rel=\"noopener\">RMAT\u003c/a>. One of the conditions of that designation is that preliminary clinical evidence indicates the treatment has \"potential to address unmet medical needs\" related to a \"serious or life-threatening disease or condition.\" The designation, which was created under the 21st Century Cures Act last year, was designed to accelerate review and approval by the FDA.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>SCiStar is partially funded by the California Institute for Regenerative Medicine, or CIRM, the publicly funded stem cell agency created by a state initiative in 2004.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Editing Embryo DNA Yields Clues About Early Human Development",
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"content": "\u003cp>For the first time, scientists have edited the DNA in human embryos to make a fundamental discovery about the earliest days of human development.\u003c/p>\n\u003cp>By modifying a key gene in very early-stage embryos, the researchers demonstrated that a gene plays a crucial role in making sure embryos develop normally, the scientists say.\u003c/p>\n\u003cp>The finding might someday lead to new ways for doctors to help \u003ca href=\"Understanding%20early%20human%20embryonic%20development%20is%20of%20great%20importance,%20and%20gene%20editing%20is%20a%20powerful%20tool%20to%20answer%20questions%20that%20will%20ultimately%20improve%20human%20health\">infertile couples\u003c/a> have children, and could aid future efforts to use embryonic \u003ca href=\"https://stemcells.nih.gov/info/basics/1.htm\">stem cells\u003c/a> to treat incurable diseases, the researchers say.\u003c/p>\n\u003cp>[contextly_sidebar id=\"DxiouDx6uOtnloxxAdrx1bpm338DaD5e\"]The work also provides the first direct evidence that manipulating DNA in human embryos can yield insights into how a single cell becomes a complex human. That has been the major justification for allowing scientists to change human DNA in ways that could be passed town to future generations, a step that had long been considered off limits because of fears about safety and opening the door to \"designer babies.\"\u003c/p>\n\u003cp>\"This proof of principle lays out a framework for future investigations that could transform our understanding of human biology,\" the researchers write in \u003ca href=\"http://nature.com/articles/doi:10.1038/nature24033\">reporting\u003c/a> their findings in the journal \u003cem>Nature \u003c/em>on Wednesday.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>That statement was seconded by other scientists.\u003c/p>\n\u003cp>\"It opens up a new area of research,\" says \u003ca href=\"http://vesta.cumc.columbia.edu/stemcell/facdb/profile/profile.php?id=de2220\">Dietrich Egli\u003c/a>, a Columbia University biologist who studies stem cells and was not involved in the study. \"Understanding early human embryonic development is of great importance, and gene-editing is a powerful tool to answer questions that will ultimately improve human health.\"\u003c/p>\n\u003cp>[contextly_sidebar id=\"eUKe54zdnORrdRfzHHEn5FhZ3YPM6Geu\"]But the research is renewing a long, intense debate about whether it's ethical to make changes in the genes in eggs, sperm or very early embryos that would be passed down to succeeding generations. While using gene editing for basic research about human development may be useful, critics worry it could lead to attempts to create genetically modified babies.\u003c/p>\n\u003cp>\"The concerns are that we would be opening the door to fertility clinics vying to offer gene-editing to make future children taller or stronger or whatever they wanted to market,\" says \u003ca href=\"https://www.geneticsandsociety.org/user/25\">Marcy Darnovsky\u003c/a>, who heads the Center for Genetics and Society, a genetics watchdog group. \"That could put us into a situation where some children were perceived to be biologically superior to other children.\u003c/p>\n\u003cp>The study comes just weeks after \u003ca href=\"http://www.npr.org/sections/health-shots/2017/08/18/543769759/a-first-look-inside-the-lab-where-scientists-are-editing-dna-in-human-embryos\">another team\u003c/a> of scientists \u003ca href=\"http://www.npr.org/sections/health-shots/2017/08/02/540975224/scientists-precisely-edit-dna-in-human-embryos-to-fix-a-disease-gene\">reported\u003c/a> the group had for the first time edited the DNA in human embryos to correct a genetic defect that causes a heart disorder.\u003c/p>\n\u003cp>The new research was led by \u003ca href=\"https://www.crick.ac.uk/kathy-niakan\">Kathy Niakan, \u003c/a>a developmental biologist at the Francis Crick Institute in London. Niakan's team used a powerful gene-editing technique known as \u003ca href=\"http://www.npr.org/tags/419142387/crispr\">CRISPR\u003c/a> to disable a gene that produces a protein known as OCT4. The procedure was performed in 41 embryos donated by women undergoing treatment for infertility.\u003c/p>\n\u003cp>In the study, more than 80 percent of the embryos with the disabled gene failed to develop into a blastocyst, a ball of 200 cells that is the stage when embryos are usually implanted into the womb during in vitro fertilization (\u003ca href=\"https://medlineplus.gov/ency/article/007279.htm\">IVF\u003c/a>). Many cases of infertility occur because embryos fail to reach this stage.\u003c/p>\n\u003cp>\"That tells us that OCT4 is really important for the development of a human blastocyst,\" Niakan told reporters during a briefing.\u003c/p>\n\u003cp>\"By understanding the key genes that are involved in the development of the blastocyst, this can really inform our understanding of this important, critical window of human development,\" Niakan says.\u003c/p>\n\u003cp>The experiments also show that the gene is involved in forming the cells that eventually become the placenta, the organ that nourishes a developing embryo in the womb, the researchers reported.\u003c/p>\n\u003cp>In addition, OCT4 helps embryonic stem cells specialize into various tissues, which could help scientists figure out how to turn stem cells into replacement cells, tissues and perhaps entire organs to treat diseases, Niakan says.\u003c/p>\n\u003cp>In an unexpected finding, the researchers discovered the gene functions differently in human embryos than in mouse embryos. That shows the need for experiments on human embryos and not just animal embryos, the scientists say.\u003c/p>\n\u003cp>\"This is opening up the possibility of using a really powerful, precise genetics tool to understand gene function,\" Niakan says. \"We would have never gained this insight had we not really studied the function of this gene in human embryos.\"\u003c/p>\n\u003cp>Jennifer Doudna, a biologist at the University of California, Berkeley, who led efforts to develop CRISPR, agrees.\u003c/p>\n\u003cp>\"One of the most fundamental aspects of becoming human is, how do egg and sperm cells combine to form embryos that develop into a person?\" \u003ca href=\"http://rna.berkeley.edu/\">Doudna \u003c/a>says. \"So understanding the genetic basis for that is, in my view, one of the fundamental aspects of developmental biology — or all of biology in a way.\"\u003c/p>\n\u003cp>In 2015, Chinese scientists sparked an \u003ca href=\"http://www.npr.org/templates/transcript/transcript.php?storyId=401655818\">uproar\u003c/a> when they reported attempts to use CRISPR to edit human embryos. And in 2016, the British government approved editing of human embryos for research purposes.\u003c/p>\n\u003cp>With the British government's \u003ca href=\"http://www.npr.org/2016/02/01/465180953/british-scientists-gain-approval-to-edit-dna-in-human-embryos\">approval\u003c/a>, Niakan began her experiments. Scientists in Sweden have begun \u003ca href=\"http://www.npr.org/about-npr/494863809/npr-exclusive-report-stockholm-lab-first-to-try-to-edit-dna-of-healthy-human-emb\">similar research\u003c/a>.\u003c/p>\n\u003cp>In February, the U.S. National Academy of Sciences and the National Academy of Medicine \u003ca href=\"http://www.npr.org/sections/health-shots/2017/02/14/514580162/scientific-panel-says-editing-heritable-human-genes-could-be-ok-in-the-future\">concluded \u003c/a>that editing DNA in humans could be permissible in certain circumstances. That has critics like Darnovsky worried.\u003c/p>\n\u003cp>\"In a world already plagued by distressing levels of inequality, that seems like a very bad idea,\" Darnovsky says. \"We don't want to add ideas that some people are biologically better and some people are biologically inferior to others. That is an idea that has led to horrific abuses throughout history.\"\u003c/p>\n\u003cp>But Niakan defends the work, saying she is only interested in making fundamental discoveries about basic human biology.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"As with any technology, as with any tool, it can be used for a variety of different purposes,\" Niakan says. \"We're choosing to use it to uncover critical roles of genes in development that can increase our knowledge about how human embryos develop.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Editing+Embryo+DNA+Yields+Clues+About+Early+Human+Development&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "Researchers disabled a gene that they think helps determine which human embryos will develop normally. The technique they used is controversial because it could be used to change babies' DNA.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>For the first time, scientists have edited the DNA in human embryos to make a fundamental discovery about the earliest days of human development.\u003c/p>\n\u003cp>By modifying a key gene in very early-stage embryos, the researchers demonstrated that a gene plays a crucial role in making sure embryos develop normally, the scientists say.\u003c/p>\n\u003cp>The finding might someday lead to new ways for doctors to help \u003ca href=\"Understanding%20early%20human%20embryonic%20development%20is%20of%20great%20importance,%20and%20gene%20editing%20is%20a%20powerful%20tool%20to%20answer%20questions%20that%20will%20ultimately%20improve%20human%20health\">infertile couples\u003c/a> have children, and could aid future efforts to use embryonic \u003ca href=\"https://stemcells.nih.gov/info/basics/1.htm\">stem cells\u003c/a> to treat incurable diseases, the researchers say.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The work also provides the first direct evidence that manipulating DNA in human embryos can yield insights into how a single cell becomes a complex human. That has been the major justification for allowing scientists to change human DNA in ways that could be passed town to future generations, a step that had long been considered off limits because of fears about safety and opening the door to \"designer babies.\"\u003c/p>\n\u003cp>\"This proof of principle lays out a framework for future investigations that could transform our understanding of human biology,\" the researchers write in \u003ca href=\"http://nature.com/articles/doi:10.1038/nature24033\">reporting\u003c/a> their findings in the journal \u003cem>Nature \u003c/em>on Wednesday.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That statement was seconded by other scientists.\u003c/p>\n\u003cp>\"It opens up a new area of research,\" says \u003ca href=\"http://vesta.cumc.columbia.edu/stemcell/facdb/profile/profile.php?id=de2220\">Dietrich Egli\u003c/a>, a Columbia University biologist who studies stem cells and was not involved in the study. \"Understanding early human embryonic development is of great importance, and gene-editing is a powerful tool to answer questions that will ultimately improve human health.\"\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>But the research is renewing a long, intense debate about whether it's ethical to make changes in the genes in eggs, sperm or very early embryos that would be passed down to succeeding generations. While using gene editing for basic research about human development may be useful, critics worry it could lead to attempts to create genetically modified babies.\u003c/p>\n\u003cp>\"The concerns are that we would be opening the door to fertility clinics vying to offer gene-editing to make future children taller or stronger or whatever they wanted to market,\" says \u003ca href=\"https://www.geneticsandsociety.org/user/25\">Marcy Darnovsky\u003c/a>, who heads the Center for Genetics and Society, a genetics watchdog group. \"That could put us into a situation where some children were perceived to be biologically superior to other children.\u003c/p>\n\u003cp>The study comes just weeks after \u003ca href=\"http://www.npr.org/sections/health-shots/2017/08/18/543769759/a-first-look-inside-the-lab-where-scientists-are-editing-dna-in-human-embryos\">another team\u003c/a> of scientists \u003ca href=\"http://www.npr.org/sections/health-shots/2017/08/02/540975224/scientists-precisely-edit-dna-in-human-embryos-to-fix-a-disease-gene\">reported\u003c/a> the group had for the first time edited the DNA in human embryos to correct a genetic defect that causes a heart disorder.\u003c/p>\n\u003cp>The new research was led by \u003ca href=\"https://www.crick.ac.uk/kathy-niakan\">Kathy Niakan, \u003c/a>a developmental biologist at the Francis Crick Institute in London. Niakan's team used a powerful gene-editing technique known as \u003ca href=\"http://www.npr.org/tags/419142387/crispr\">CRISPR\u003c/a> to disable a gene that produces a protein known as OCT4. The procedure was performed in 41 embryos donated by women undergoing treatment for infertility.\u003c/p>\n\u003cp>In the study, more than 80 percent of the embryos with the disabled gene failed to develop into a blastocyst, a ball of 200 cells that is the stage when embryos are usually implanted into the womb during in vitro fertilization (\u003ca href=\"https://medlineplus.gov/ency/article/007279.htm\">IVF\u003c/a>). Many cases of infertility occur because embryos fail to reach this stage.\u003c/p>\n\u003cp>\"That tells us that OCT4 is really important for the development of a human blastocyst,\" Niakan told reporters during a briefing.\u003c/p>\n\u003cp>\"By understanding the key genes that are involved in the development of the blastocyst, this can really inform our understanding of this important, critical window of human development,\" Niakan says.\u003c/p>\n\u003cp>The experiments also show that the gene is involved in forming the cells that eventually become the placenta, the organ that nourishes a developing embryo in the womb, the researchers reported.\u003c/p>\n\u003cp>In addition, OCT4 helps embryonic stem cells specialize into various tissues, which could help scientists figure out how to turn stem cells into replacement cells, tissues and perhaps entire organs to treat diseases, Niakan says.\u003c/p>\n\u003cp>In an unexpected finding, the researchers discovered the gene functions differently in human embryos than in mouse embryos. That shows the need for experiments on human embryos and not just animal embryos, the scientists say.\u003c/p>\n\u003cp>\"This is opening up the possibility of using a really powerful, precise genetics tool to understand gene function,\" Niakan says. \"We would have never gained this insight had we not really studied the function of this gene in human embryos.\"\u003c/p>\n\u003cp>Jennifer Doudna, a biologist at the University of California, Berkeley, who led efforts to develop CRISPR, agrees.\u003c/p>\n\u003cp>\"One of the most fundamental aspects of becoming human is, how do egg and sperm cells combine to form embryos that develop into a person?\" \u003ca href=\"http://rna.berkeley.edu/\">Doudna \u003c/a>says. \"So understanding the genetic basis for that is, in my view, one of the fundamental aspects of developmental biology — or all of biology in a way.\"\u003c/p>\n\u003cp>In 2015, Chinese scientists sparked an \u003ca href=\"http://www.npr.org/templates/transcript/transcript.php?storyId=401655818\">uproar\u003c/a> when they reported attempts to use CRISPR to edit human embryos. And in 2016, the British government approved editing of human embryos for research purposes.\u003c/p>\n\u003cp>With the British government's \u003ca href=\"http://www.npr.org/2016/02/01/465180953/british-scientists-gain-approval-to-edit-dna-in-human-embryos\">approval\u003c/a>, Niakan began her experiments. Scientists in Sweden have begun \u003ca href=\"http://www.npr.org/about-npr/494863809/npr-exclusive-report-stockholm-lab-first-to-try-to-edit-dna-of-healthy-human-emb\">similar research\u003c/a>.\u003c/p>\n\u003cp>In February, the U.S. National Academy of Sciences and the National Academy of Medicine \u003ca href=\"http://www.npr.org/sections/health-shots/2017/02/14/514580162/scientific-panel-says-editing-heritable-human-genes-could-be-ok-in-the-future\">concluded \u003c/a>that editing DNA in humans could be permissible in certain circumstances. That has critics like Darnovsky worried.\u003c/p>\n\u003cp>\"In a world already plagued by distressing levels of inequality, that seems like a very bad idea,\" Darnovsky says. \"We don't want to add ideas that some people are biologically better and some people are biologically inferior to others. That is an idea that has led to horrific abuses throughout history.\"\u003c/p>\n\u003cp>But Niakan defends the work, saying she is only interested in making fundamental discoveries about basic human biology.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"As with any technology, as with any tool, it can be used for a variety of different purposes,\" Niakan says. \"We're choosing to use it to uncover critical roles of genes in development that can increase our knowledge about how human embryos develop.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Editing+Embryo+DNA+Yields+Clues+About+Early+Human+Development&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Governor Signs Law Allowing Californians to Choose to Liquefy Their Remains",
"title": "Governor Signs Law Allowing Californians to Choose to Liquefy Their Remains",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>Update, October 16, 2017:\u003c/b>\u003c/span>\u003c/p>\n\u003cp>\u003cspan class=\"s1\">Gov. Jerry Brown last night signed into law the \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB967\" target=\"_blank\" rel=\"noopener noreferrer\">bill\u003c/a> that legalizes a method of disposing of human remains commonly called 'water cremation.' \u003c/span>\u003c/p>\n\u003cp>The method doesn't actually use water, but uses a chemical that speeds up decomposition of bodies and leaves behind only sterile water, bones, and medical implants or devices.\u003c/p>\n\u003cp>\u003cspan class=\"s1\">The new law establishes procedures for licensing and regulating mortuaries or other companies that aim to adopt the method, to be overseen by the Cemetery and Funeral Bureau within the state Department of Consumer Affairs. \u003c/span>\u003cem>\u003cspan class=\"s1\">\u003cbr>\n\u003c/span>\u003c/em>\u003c/p>\n\u003cp>Supporters say water cremation offers a green alternative to traditional cremation or burial.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Original Story, July 24, 2017:\u003c/strong>\u003c/p>\n\u003cp>You may not equate death with climate change, but disposing of human remains leaves a fairly hefty \u003ca href=\"https://www3.epa.gov/carbon-footprint-calculator/\" target=\"_blank\" rel=\"noopener noreferrer\">carbon footprint\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignright\">Supporters of a California bill allowing dead bodies to be dissolved in a hot chemical bath are hoping to overcome the 'ick factor.'\u003c/aside>\n\u003cp>“Cremation is really what people hold up as the environmentally friendly option,” says \u003ca href=\"http://www.caitlindoughty.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Caitlin Doughty\u003c/a>, a mortician in Los Angeles. “It’s better than the whole rigmarole of formaldehyde and chemicals and big caskets that go into the more traditional funeral industry, but it still releases mercury into the air, and it uses a whole ton of natural gas.”\u003c/p>\n\u003cp>Plus, Doughty says, cemeteries monopolize land, an increasingly precious resource as the population grows.\u003c/p>\n\u003cp>Hence the growing popularity of a green alternative, known as water cremation, bio-cremation or flameless cremation. Basically, the body is dissolved in a hot chemical bath, leaving a sterile solution that can be flushed down the drain. The carbon footprint of this process is just a quarter of traditional fire cremation because it uses so much less energy; and only a sixth of a burial because it doesn't require the materials for concrete headstones, mahogany caskets or the chemicals used in embalming.\u003c/p>\n\u003cp>State lawmakers are considering a \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB967\" target=\"_blank\" rel=\"noopener noreferrer\">bill\u003c/a> that would legalize water cremation. In the last decade, two previous efforts have failed, although the process has been approved in 14 other states, including neighboring Nevada. This year, a third attempt is gaining momentum in California, progressing further in the Legislature than the previous bills.\u003c/p>\n\u003cp>\u003cstrong>Not an Acid Bath\u003c/strong>\u003c/p>\n\u003cp>There’s only one place in California where bodies are currently dissolved — legally, at least. That would be a chilly lab at UCLA, where cadavers that have outlived their usefulness at the medical school end up. The room smells a little like shellfish, which I think might be the smell of melted flesh. But the guy in charge, Dean Fisher, laughs at that notion.\u003c/p>\n\u003caside class=\"pullquote alignright\">'This just leaves us questioning. Why did part of grandma go to the waste treatment plant?'\u003ccite>Ned Dolejsi, Catholic Church spokesman\u003c/cite>\u003c/aside>\n\u003cp>Fisher, the head of the university's \u003ca href=\"https://www.uclahealth.org/donatedbody/default.cfm\" target=\"_blank\" rel=\"noopener noreferrer\">Donated Body Program,\u003c/a> explains that I'm sniffing potassium hydroxide\u003cb>,\u003c/b> a base, and the chemical of choice for liquefying bodies, because it catalyzes the hydrogen in water to more rapidly attack the chemical bonds between molecules in the body. (The process is technically called\u003cem> alkaline hydrolysis.)\u003c/em>\u003c/p>\n\u003cp>“So, it's not an acid at all,\" said Fisher. \"Some people say this is an acid bath, and they're wrong.”\u003c/p>\n\u003cp>Potassium hydroxide is found in the Earth's crust — and in many household cleaning products. It's the same chemical that breaks down or composts organic matter in dirt.\u003c/p>\n\u003cp>“So, like, if you were to bury a body in soil, all we're doing is we're speeding that up,\" says Fisher. \"We're adding heat to that.”\u003c/p>\n\u003cfigure id=\"attachment_428986\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-428986 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/07/Fisher-machine-800x599.jpg\" alt=\"\" width=\"800\" height=\"599\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-800x599.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-768x575.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-1020x764.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-1180x883.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-960x719.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-520x389.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine.jpg 1893w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">UCLA's Dean Fisher opens an alkaline hydrolysis machine that can dissolve bodies. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>A Whirlpool for the Dead\u003c/strong>\u003c/p>\n\u003cp>That heat is applied inside a shiny stainless-steel chamber, about the size of a large van. The front of the machine has a circular hatch, modeled after a submarine door. The hatch leads to a dark tunnel where cadavers are heated to 302 degrees and then bathed in 270 gallons of liquid for three to four hours. That's about twice as long as the time required for a fire cremation.\u003c/p>\n\u003cp>The cost varies widely in the U.S., depending on location, but typically, funeral homes charge $150-$500 more for a water cremation than for one done with flames.\u003c/p>\n\u003cp>What's usually left at the end of the process is a tray scattered with clean white bones, and maybe some items of medical hardware. Fisher shows me an example when he opens the door, revealing the remains of a dissolved male body.\u003c/p>\n\u003cp>“There’s a pacemaker in there,\" says Fisher. \"There’s a couple of prosthetics. It looks like he’s had a hip replacement, and it looks like he’s had a knee replacement, also.”\u003c/p>\n\u003cp>Some of the metal in these parts can be recycled, and everything left over is sterile. Nothing organic survives during a water cremation. No bacteria — not even a strand of DNA.\u003c/p>\n\u003cp>The bones will be pulverized into a white powder that can be placed in an urn, just like the ashes in a traditional cremation.\u003c/p>\n\u003cfigure id=\"attachment_429008\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-429008\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/07/IMG_33511-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-1920x1440.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The pulverized bones from a water cremation ready to be placed inside an urn. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>From a cupboard nearby, Fisher holds up a tooth with a mercury filling. The silver molar demonstrates part of why water is more eco-friendly than flame. When you burn a body, the toxic mercury in dental fillings vaporizes and escapes into the air.\u003c/p>\n\u003cp>\u003cstrong>Ick Factor\u003c/strong>\u003c/p>\n\u003cp>But water cremation proved a tough sell the last two times legalization was tried in California. There's an inherent ick factor: You’re reducing loved ones to a chemical broth that swirls down the drain.\u003c/p>\n\u003cp>“This just leaves us questioning,\" said Ned Dolejsi, the executive director of the \u003ca href=\"http://www.cacatholic.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Catholic Conference\u003c/a>. \"Why did part of grandma go to the waste treatment plant?”\u003cb> \u003c/b>He says water cremation isn't inherently wrong, but it also doesn’t treat life — or death — with dignity and respect.\u003c/p>\n\u003cp>The proposed bill sailed through the Assembly in June. Now it's before the Senate.\u003c/p>\n\u003cp>If the bill is made law, water cremation will be available in California starting in 2020.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been edited.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Gov. Jerry Brown signed into law an eco-friendly option for disposing of cadavers.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>Update, October 16, 2017:\u003c/b>\u003c/span>\u003c/p>\n\u003cp>\u003cspan class=\"s1\">Gov. Jerry Brown last night signed into law the \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB967\" target=\"_blank\" rel=\"noopener noreferrer\">bill\u003c/a> that legalizes a method of disposing of human remains commonly called 'water cremation.' \u003c/span>\u003c/p>\n\u003cp>The method doesn't actually use water, but uses a chemical that speeds up decomposition of bodies and leaves behind only sterile water, bones, and medical implants or devices.\u003c/p>\n\u003cp>\u003cspan class=\"s1\">The new law establishes procedures for licensing and regulating mortuaries or other companies that aim to adopt the method, to be overseen by the Cemetery and Funeral Bureau within the state Department of Consumer Affairs. \u003c/span>\u003cem>\u003cspan class=\"s1\">\u003cbr>\n\u003c/span>\u003c/em>\u003c/p>\n\u003cp>Supporters say water cremation offers a green alternative to traditional cremation or burial.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Original Story, July 24, 2017:\u003c/strong>\u003c/p>\n\u003cp>You may not equate death with climate change, but disposing of human remains leaves a fairly hefty \u003ca href=\"https://www3.epa.gov/carbon-footprint-calculator/\" target=\"_blank\" rel=\"noopener noreferrer\">carbon footprint\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignright\">Supporters of a California bill allowing dead bodies to be dissolved in a hot chemical bath are hoping to overcome the 'ick factor.'\u003c/aside>\n\u003cp>“Cremation is really what people hold up as the environmentally friendly option,” says \u003ca href=\"http://www.caitlindoughty.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Caitlin Doughty\u003c/a>, a mortician in Los Angeles. “It’s better than the whole rigmarole of formaldehyde and chemicals and big caskets that go into the more traditional funeral industry, but it still releases mercury into the air, and it uses a whole ton of natural gas.”\u003c/p>\n\u003cp>Plus, Doughty says, cemeteries monopolize land, an increasingly precious resource as the population grows.\u003c/p>\n\u003cp>Hence the growing popularity of a green alternative, known as water cremation, bio-cremation or flameless cremation. Basically, the body is dissolved in a hot chemical bath, leaving a sterile solution that can be flushed down the drain. The carbon footprint of this process is just a quarter of traditional fire cremation because it uses so much less energy; and only a sixth of a burial because it doesn't require the materials for concrete headstones, mahogany caskets or the chemicals used in embalming.\u003c/p>\n\u003cp>State lawmakers are considering a \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB967\" target=\"_blank\" rel=\"noopener noreferrer\">bill\u003c/a> that would legalize water cremation. In the last decade, two previous efforts have failed, although the process has been approved in 14 other states, including neighboring Nevada. This year, a third attempt is gaining momentum in California, progressing further in the Legislature than the previous bills.\u003c/p>\n\u003cp>\u003cstrong>Not an Acid Bath\u003c/strong>\u003c/p>\n\u003cp>There’s only one place in California where bodies are currently dissolved — legally, at least. That would be a chilly lab at UCLA, where cadavers that have outlived their usefulness at the medical school end up. The room smells a little like shellfish, which I think might be the smell of melted flesh. But the guy in charge, Dean Fisher, laughs at that notion.\u003c/p>\n\u003caside class=\"pullquote alignright\">'This just leaves us questioning. Why did part of grandma go to the waste treatment plant?'\u003ccite>Ned Dolejsi, Catholic Church spokesman\u003c/cite>\u003c/aside>\n\u003cp>Fisher, the head of the university's \u003ca href=\"https://www.uclahealth.org/donatedbody/default.cfm\" target=\"_blank\" rel=\"noopener noreferrer\">Donated Body Program,\u003c/a> explains that I'm sniffing potassium hydroxide\u003cb>,\u003c/b> a base, and the chemical of choice for liquefying bodies, because it catalyzes the hydrogen in water to more rapidly attack the chemical bonds between molecules in the body. (The process is technically called\u003cem> alkaline hydrolysis.)\u003c/em>\u003c/p>\n\u003cp>“So, it's not an acid at all,\" said Fisher. \"Some people say this is an acid bath, and they're wrong.”\u003c/p>\n\u003cp>Potassium hydroxide is found in the Earth's crust — and in many household cleaning products. It's the same chemical that breaks down or composts organic matter in dirt.\u003c/p>\n\u003cp>“So, like, if you were to bury a body in soil, all we're doing is we're speeding that up,\" says Fisher. \"We're adding heat to that.”\u003c/p>\n\u003cfigure id=\"attachment_428986\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-428986 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/07/Fisher-machine-800x599.jpg\" alt=\"\" width=\"800\" height=\"599\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-800x599.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-768x575.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-1020x764.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-1180x883.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-960x719.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine-520x389.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/Fisher-machine.jpg 1893w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">UCLA's Dean Fisher opens an alkaline hydrolysis machine that can dissolve bodies. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>A Whirlpool for the Dead\u003c/strong>\u003c/p>\n\u003cp>That heat is applied inside a shiny stainless-steel chamber, about the size of a large van. The front of the machine has a circular hatch, modeled after a submarine door. The hatch leads to a dark tunnel where cadavers are heated to 302 degrees and then bathed in 270 gallons of liquid for three to four hours. That's about twice as long as the time required for a fire cremation.\u003c/p>\n\u003cp>The cost varies widely in the U.S., depending on location, but typically, funeral homes charge $150-$500 more for a water cremation than for one done with flames.\u003c/p>\n\u003cp>What's usually left at the end of the process is a tray scattered with clean white bones, and maybe some items of medical hardware. Fisher shows me an example when he opens the door, revealing the remains of a dissolved male body.\u003c/p>\n\u003cp>“There’s a pacemaker in there,\" says Fisher. \"There’s a couple of prosthetics. It looks like he’s had a hip replacement, and it looks like he’s had a knee replacement, also.”\u003c/p>\n\u003cp>Some of the metal in these parts can be recycled, and everything left over is sterile. Nothing organic survives during a water cremation. No bacteria — not even a strand of DNA.\u003c/p>\n\u003cp>The bones will be pulverized into a white powder that can be placed in an urn, just like the ashes in a traditional cremation.\u003c/p>\n\u003cfigure id=\"attachment_429008\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-429008\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/07/IMG_33511-800x600.jpg\" alt=\"\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-1020x765.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-1920x1440.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/07/IMG_33511-520x390.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">The pulverized bones from a water cremation ready to be placed inside an urn. \u003ccite>(Lesley McClurg/ KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>From a cupboard nearby, Fisher holds up a tooth with a mercury filling. The silver molar demonstrates part of why water is more eco-friendly than flame. When you burn a body, the toxic mercury in dental fillings vaporizes and escapes into the air.\u003c/p>\n\u003cp>\u003cstrong>Ick Factor\u003c/strong>\u003c/p>\n\u003cp>But water cremation proved a tough sell the last two times legalization was tried in California. There's an inherent ick factor: You’re reducing loved ones to a chemical broth that swirls down the drain.\u003c/p>\n\u003cp>“This just leaves us questioning,\" said Ned Dolejsi, the executive director of the \u003ca href=\"http://www.cacatholic.org/\" target=\"_blank\" rel=\"noopener noreferrer\">California Catholic Conference\u003c/a>. \"Why did part of grandma go to the waste treatment plant?”\u003cb> \u003c/b>He says water cremation isn't inherently wrong, but it also doesn’t treat life — or death — with dignity and respect.\u003c/p>\n\u003cp>The proposed bill sailed through the Assembly in June. Now it's before the Senate.\u003c/p>\n\u003cp>If the bill is made law, water cremation will be available in California starting in 2020.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post has been edited.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg",
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},
"link": "/radio/program/bbc-world-service",
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"rss": "https://podcasts.files.bbci.co.uk/p02nq0gn.rss"
}
},
"californiareport": {
"id": "californiareport",
"title": "The California Report",
"tagline": "California, day by day",
"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-California-Report-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/californiareport",
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"source": "kqed",
"order": 8
},
"link": "/californiareport",
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}
},
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"title": "The California Report Magazine",
"tagline": "Your state, your stories",
"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
"airtime": "FRI 4:30pm-5pm, 6:30pm-7pm, 11pm-11:30pm",
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"order": 10
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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},
"city-arts": {
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"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
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"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
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"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
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"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
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"order": 1
},
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"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"meta": {
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"freakonomics-radio": {
"id": "freakonomics-radio",
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"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
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},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"here-and-now": {
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
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"airtime": "SUN 7:30pm-8pm",
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},
"link": "/radio/program/how-i-built-this",
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"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"order": 15
},
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
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"order": 18
},
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
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},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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