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"content": "\u003cp>Ariana Marciano is adding to her collection of about 75 tattoos at Body Electric, a tattoo and piercing studio on trendy Melrose Avenue in Hollywood. \"I think they're so cool and I think they're visually really nice to look at,\" she says. There's a ram's head, an elk, a green-and-peach praying mantis, a love bug and a moth. Today she's getting a ladybug.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Ann%22\">Recommendations on tattoos from American Academy of Pediatrics\u003c/a>\u003c/aside>\n\u003cp>\"I love bugs,\" Marciano, 23, says. \"I think they're kind of overlooked.\" In about 20 minutes, a small ladybug with dots on its back and a bit of rusty orange takes its place on her elbow.Marciano is part of a trend; 38 percent of millennials have at least one tattoo, \u003ca href=\"http://www.pewsocialtrends.org/2010/02/24/millennials-confident-connected-open-to-change/\">according\u003c/a> to the Pew Research Center, and 23 percent have a piercing somewhere other than an earlobe. That compares to just 6 percent of boomers with tattoos, and 1 percent with other piercings.\u003c/p>\n\u003cp>The nation's pediatricians, who want teenagers and young adults to be aware of potential health issues with tattoos and piercings, released their first-ever recommendations on health and safety on Monday.\u003c/p>\n\u003cp>The report finds that most people who have a tattoo (86 percent) have never regretted getting one, and 30 percent says it makes them feel sexier.\u003c/p>\n\u003cp>But despite the popularity of body art, \"Most of my medical colleagues don't know regulations in the states, complication rates or later impact on young people when looking for a job,\" says \u003ca href=\"http://www.seattlechildrens.org/medical-staff/cora-collette-breuner/\">Dr. Cora Breuner\u003c/a>. She's a member of the division of adolescent medicine at Seattle Children's Hospital who chaired the AAP Committee on Adolescence that wrote the recommendations.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Breuner says she wants doctors and other health care professionals to be able to appropriately guide patients and their parents when a tattoo or body piercing is being considered. That includes being aware of regulations in their state. The federal government does not regulate the industry and rules \u003ca href=\"http://www.ncsl.org/research/health/tattooing-and-body-piercing.aspx\">vary from state to state\u003c/a>. In some states, minors as young as 14 can get tattoos if they have parental permission. And when it comes to sanitary conditions, there is wide variation in state regulations.\u003c/p>\n\u003cp>The AAP recommends that pediatricians talk with adolescent patients about the importance of hygienic practices in piercing and tattoo parlors, including making sure practitioners use new disposable gloves; needles from a sealed, sterile container; and fresh unused ink poured into a new disposable container with each client. This means infection control \"just like in a doctor's office,\" says Breuner.\u003c/p>\n\u003cp>At Body Electric, owner Brian Keith Thompson says, \"I want to leave the studio today the same way I came in — disease-free.\" He sets employees to work every morning cleaning floors and equipment. \"I'm a former Marine, so I am the commanding general inspecting it,\" he says.\u003c/p>\n\u003cp>His state, California, sets standards for sterilization, sanitation and safety for both tattooing and body piercing. Practitioners have to register with the state health department and are required to submit proof of hepatitis vaccination as well as take a yearly course in bloodborne diseases and infection control. While infection is rare, concern about infectious diseases such as HIV, hepatitis and skin infections caused by \u003cem>Staphylococcus aureus\u003c/em> (staph) bacteria remain.\u003c/p>\n\u003cp>People on medications that inhibit the immune system and can affect the healing process, such as steroids or Accutane, should avoid both tattoos and piercings, the pediatricians say. And everyone should be up to date on immunizations, especially tetanus.\u003c/p>\n\u003cp>After the procedure, the doctors say patients should watch for signs of infection, such as redness that spreads beyond the tattoo or piercing, increasing pain, or fever. If this happens, Breuner says, \"go to the doctor.\"\u003c/p>\n\u003cp>And doctors and patients should understand that healing times differ depending on the piercing. For example, an ear piercing may take just a few weeks to heal, but a piercing in the tongue can take up to six weeks, and a belly button piercing up to nine months, Breuner says.\u003c/p>\n\u003cp>And there's the key point that tattoos are permanent.\u003c/p>\n\u003cp>Even though he owns a tattoo parlor, Thompson says he often counsels teenage clients against tattoos that are easily visible on the hands, neck and fingers. \"I'll tell them no, you're 19, you should wait,\" he says, adding that many professions are still conservative when it comes to tattoos.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Definitely stay away from the face,\" says Thompson. \"We call that the job stopper; if you don't want to get employed, tattoo your face.\" And understand that tattoo removal by laser is painful, difficult, expensive and only partially effective.\u003c/p>\n\u003chr>\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=Teen+Wants+A+Tattoo%3F+Pediatricians+Say+Here%27s+How+To+Do+It+Safely&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Ariana Marciano is adding to her collection of about 75 tattoos at Body Electric, a tattoo and piercing studio on trendy Melrose Avenue in Hollywood. \"I think they're so cool and I think they're visually really nice to look at,\" she says. There's a ram's head, an elk, a green-and-peach praying mantis, a love bug and a moth. Today she's getting a ladybug.\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"https://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Ann%22\">Recommendations on tattoos from American Academy of Pediatrics\u003c/a>\u003c/aside>\n\u003cp>\"I love bugs,\" Marciano, 23, says. \"I think they're kind of overlooked.\" In about 20 minutes, a small ladybug with dots on its back and a bit of rusty orange takes its place on her elbow.Marciano is part of a trend; 38 percent of millennials have at least one tattoo, \u003ca href=\"http://www.pewsocialtrends.org/2010/02/24/millennials-confident-connected-open-to-change/\">according\u003c/a> to the Pew Research Center, and 23 percent have a piercing somewhere other than an earlobe. That compares to just 6 percent of boomers with tattoos, and 1 percent with other piercings.\u003c/p>\n\u003cp>The nation's pediatricians, who want teenagers and young adults to be aware of potential health issues with tattoos and piercings, released their first-ever recommendations on health and safety on Monday.\u003c/p>\n\u003cp>The report finds that most people who have a tattoo (86 percent) have never regretted getting one, and 30 percent says it makes them feel sexier.\u003c/p>\n\u003cp>But despite the popularity of body art, \"Most of my medical colleagues don't know regulations in the states, complication rates or later impact on young people when looking for a job,\" says \u003ca href=\"http://www.seattlechildrens.org/medical-staff/cora-collette-breuner/\">Dr. Cora Breuner\u003c/a>. She's a member of the division of adolescent medicine at Seattle Children's Hospital who chaired the AAP Committee on Adolescence that wrote the recommendations.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Breuner says she wants doctors and other health care professionals to be able to appropriately guide patients and their parents when a tattoo or body piercing is being considered. That includes being aware of regulations in their state. The federal government does not regulate the industry and rules \u003ca href=\"http://www.ncsl.org/research/health/tattooing-and-body-piercing.aspx\">vary from state to state\u003c/a>. In some states, minors as young as 14 can get tattoos if they have parental permission. And when it comes to sanitary conditions, there is wide variation in state regulations.\u003c/p>\n\u003cp>The AAP recommends that pediatricians talk with adolescent patients about the importance of hygienic practices in piercing and tattoo parlors, including making sure practitioners use new disposable gloves; needles from a sealed, sterile container; and fresh unused ink poured into a new disposable container with each client. This means infection control \"just like in a doctor's office,\" says Breuner.\u003c/p>\n\u003cp>At Body Electric, owner Brian Keith Thompson says, \"I want to leave the studio today the same way I came in — disease-free.\" He sets employees to work every morning cleaning floors and equipment. \"I'm a former Marine, so I am the commanding general inspecting it,\" he says.\u003c/p>\n\u003cp>His state, California, sets standards for sterilization, sanitation and safety for both tattooing and body piercing. Practitioners have to register with the state health department and are required to submit proof of hepatitis vaccination as well as take a yearly course in bloodborne diseases and infection control. While infection is rare, concern about infectious diseases such as HIV, hepatitis and skin infections caused by \u003cem>Staphylococcus aureus\u003c/em> (staph) bacteria remain.\u003c/p>\n\u003cp>People on medications that inhibit the immune system and can affect the healing process, such as steroids or Accutane, should avoid both tattoos and piercings, the pediatricians say. And everyone should be up to date on immunizations, especially tetanus.\u003c/p>\n\u003cp>After the procedure, the doctors say patients should watch for signs of infection, such as redness that spreads beyond the tattoo or piercing, increasing pain, or fever. If this happens, Breuner says, \"go to the doctor.\"\u003c/p>\n\u003cp>And doctors and patients should understand that healing times differ depending on the piercing. For example, an ear piercing may take just a few weeks to heal, but a piercing in the tongue can take up to six weeks, and a belly button piercing up to nine months, Breuner says.\u003c/p>\n\u003cp>And there's the key point that tattoos are permanent.\u003c/p>\n\u003cp>Even though he owns a tattoo parlor, Thompson says he often counsels teenage clients against tattoos that are easily visible on the hands, neck and fingers. \"I'll tell them no, you're 19, you should wait,\" he says, adding that many professions are still conservative when it comes to tattoos.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Definitely stay away from the face,\" says Thompson. \"We call that the job stopper; if you don't want to get employed, tattoo your face.\" And understand that tattoo removal by laser is painful, difficult, expensive and only partially effective.\u003c/p>\n\u003chr>\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=Teen+Wants+A+Tattoo%3F+Pediatricians+Say+Here%27s+How+To+Do+It+Safely&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>Update, Sept. 19:\u003c/strong> The American Psychological Association says that a controversial research paper that applied computer facial recognition to successfully guess people’s sexual orientation has passed a review of documentation submitted by the researchers. The paper is set to be published in the association’s peer-reviewed \u003cem>Journal of Personality and Social Psychology\u003c/em>.\u003c/p>\n\u003cp>A spokesperson for the association said it completed the review last week. The association undertook the review to substantiate an institutional review board's vetting of the study, which ensured that the study met ethical guidelines.\u003c/p>\n\u003cp>\"Given the sensitive nature of photo-images used in the current study, we are currently taking this additional step with this as yet unpublished manuscript,\" a spokesperson for the APA wrote to KQED last week, before the review was completed.\u003c/p>\n\u003cp>The research, by Michal Kosinski and Yilun Wang of Stanford University, claims that a computer algorithm bested humans in distinguishing between a gay person and a straight person when analyzing images from public profiles on a dating website. (Here is a \u003ca href=\"https://osf.io/zn79k/\" target=\"_blank\" rel=\"noopener noreferrer\">preprint\u003c/a> of the study; it's not necessarily the final version of the paper.)Researchers claim AI can be taught to predict sexual orientation from analyzing photographs. LGBTQ advocates are outraged.\u003c/p>\n\u003cp>The research had led to a firestorm of criticism from LGBTQ advocates and academics since it was \u003ca href=\"https://www.economist.com/news/science-and-technology/21728614-machines-read-faces-are-coming-advances-ai-are-used-spot-signs?fsrc=scn/tw/te/bl/ed/advancesinaiareusedtospotsignsofsexuality\" target=\"_blank\" rel=\"noopener noreferrer\">first reported\u003c/a> Sept. 9 by The Economist. Two gay rights groups, Human Rights Campaign and GLAAD, \u003ca href=\"https://www.glaad.org/blog/glaad-and-hrc-call-stanford-university-responsible-media-debunk-dangerous-flawed-report\" target=\"_blank\" rel=\"noopener noreferrer\">called the research,\u003c/a> in a joint press release, \"junk science.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Analyzing Faces\u003c/strong>\u003c/p>\n\u003cp>Using basic facial-recognition technology, the researchers weeded through 130,741 public photos of men and women posted on a U.S. dating website, selecting for images that showed a single face large and clear enough to analyze. This left a pool of 35,326 pictures of 14,776 individuals. Gay and straight people, male and female, were represented evenly.\u003c/p>\n\u003cp>Software called VGG-Face analyzed the faces and looked for correlations between a person's face (nose length, jaw width, etc.) and their self-declared sexual identity on the website. Using a resulting model made up of these distinguishing characteristics, the program, when shown one photo of a gay man and one of a straight man, was able to identify their sexual orientation 81 percent of the time. For women, the success rate was 71 percent. (Accuracy increased when the model was shown more than one image of a person.) Human guessers correctly identified straight faces and gay faces just 61 percent of the time for men and 54 percent for women.\u003c/p>\n\u003cp>The researchers say in the paper that these results \"provide strong support\" for the prenatal hormone theory of gay and lesbian sexual orientation. The theory holds that under or overexposure to prenatal androgens are a key determinant of sexual orientation.\u003c/p>\n\u003cp>In an \u003ca href=\"https://docs.google.com/document/d/11oGZ1Ke3wK9E3BtOFfGfUQuuaSMR8AO2WfWH3aVke6U/preview#\" target=\"_blank\" rel=\"noopener noreferrer\">authors' note\u003c/a> (last updated Sept. 13), the researchers discuss the study's limitations at some length, including the narrow demographic characteristics of the individuals analyzed -- white people who self-reported to be gay or straight. They also expressed concerns about the implications of the study:\u003c/p>\n\u003cblockquote>\u003cp>\u003cspan style=\"font-weight: 400\">We were really disturbed by these results and spent much time considering whether they should be made public at all. We did not want to enable the very risks that we are warning against. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Recent press reports,\u003c/span>\u003cspan style=\"font-weight: 400\"> however, suggest that governments and corporations are already using tools aimed at revealing intimate traits from faces. Facial images of billions of people are stockpiled in digital and traditional archives, including dating platforms, photo-sharing websites, and government databases. Profile pictures on Facebook, LinkedIn, and Google Plus are public by default. CCTV cameras and smartphones can be used to take pictures of others’ faces without their permission.\u003c/span>\u003c/p>\u003c/blockquote>\n\u003cp>Critics of the research expressed concerns that it will lead to the very invasion of privacy the authors seek to warn against. HRC/GLAAD also criticized the limited demographic pool used by the researchers, the \"superficial\" nature of the characteristics analyzed in the model, and the way media have represented the study.\u003c/p>\n\u003cp>The \u003ca href=\"https://docs.google.com/document/d/1UuEcSNFMduIaf0cOWdWbOV3NORLoKWdz3big4xuk7Z4/edit#\" target=\"_blank\" rel=\"noopener noreferrer\">authors responded\u003c/a> angrily, calling the HRC/GLAAD press release premature and misleading. \"\u003cspan style=\"font-weight: 400\">They do a great disservice to the LGBTQ community by dismissing our results outright without properly assessing the science behind it, and hurt the mission of the great organizations that they represent,\" they wrote. \u003c/span>\u003c/p>\n\u003cp>The researchers also stressed, in their authors' note, that they did not invent the tools used. Rather, they applied internet-available software to internet-available data, with the goal of demonstrating the privacy risks inherent in artificially intelligent technologies.\u003c/p>\n\u003cp>\"We studied existing technologies,\" wrote Kosinski and Wang, already widely used by companies and governments, to see whether they present a risk to the privacy of LGBTQ individuals.\"\u003c/p>\n\u003cp>They added, \"We were terrified to find that they do.\"\u003c/p>\n\u003cp>Such tools present a special threat, said the authors, to the privacy and safety of gay men and women living under repressive regimes where homosexuality is illegal.\u003c/p>\n\u003cp>But other LGBT academics and writers did not accept this line of reasoning. Oberlin sociology professor Greggor Mattson wrote a \u003ca href=\"https://greggormattson.com/2017/09/09/artificial-intelligence-discovers-gayface/\" target=\"_blank\" rel=\"noopener noreferrer\">takedown,\u003c/a> published on his website, describing the study as \"much less insightful than the researchers claim.\" The authors' discussion of their ethical concerns suffered from \"stunning tone-deafness,\" Mattson wrote.\u003c/p>\n\u003cp>At least one LGBT blogger, though, came to the researchers' defense.\u003c/p>\n\u003cp>Alex Bollinger, writing at LGBTQ Nation, wrote a \u003ca href=\"https://www.lgbtqnation.com/2017/09/hrc-glaad-release-silly-statement-gay-face-study/\" target=\"_blank\" rel=\"noopener noreferrer\">post \u003c/a>titled \"HRC and GLAAD release a silly statement about the ‘gay face’ study.\"\u003c/p>\n\u003cblockquote>\u003cp>\"We should take a stance of curiosity instead of judgment.\u003c/p>\n\u003cp>\"This is just one study that looked at one sample and said a few things. There will be more studies later on that will say other things. Let’s see how that all unfolds before deciding what the correct answer is.\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post was edited Oct. 9 to specify the nature of the American Psychological Association's review of the study.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Update, Sept. 19:\u003c/strong> The American Psychological Association says that a controversial research paper that applied computer facial recognition to successfully guess people’s sexual orientation has passed a review of documentation submitted by the researchers. The paper is set to be published in the association’s peer-reviewed \u003cem>Journal of Personality and Social Psychology\u003c/em>.\u003c/p>\n\u003cp>A spokesperson for the association said it completed the review last week. The association undertook the review to substantiate an institutional review board's vetting of the study, which ensured that the study met ethical guidelines.\u003c/p>\n\u003cp>\"Given the sensitive nature of photo-images used in the current study, we are currently taking this additional step with this as yet unpublished manuscript,\" a spokesperson for the APA wrote to KQED last week, before the review was completed.\u003c/p>\n\u003cp>The research, by Michal Kosinski and Yilun Wang of Stanford University, claims that a computer algorithm bested humans in distinguishing between a gay person and a straight person when analyzing images from public profiles on a dating website. (Here is a \u003ca href=\"https://osf.io/zn79k/\" target=\"_blank\" rel=\"noopener noreferrer\">preprint\u003c/a> of the study; it's not necessarily the final version of the paper.)Researchers claim AI can be taught to predict sexual orientation from analyzing photographs. LGBTQ advocates are outraged.\u003c/p>\n\u003cp>The research had led to a firestorm of criticism from LGBTQ advocates and academics since it was \u003ca href=\"https://www.economist.com/news/science-and-technology/21728614-machines-read-faces-are-coming-advances-ai-are-used-spot-signs?fsrc=scn/tw/te/bl/ed/advancesinaiareusedtospotsignsofsexuality\" target=\"_blank\" rel=\"noopener noreferrer\">first reported\u003c/a> Sept. 9 by The Economist. Two gay rights groups, Human Rights Campaign and GLAAD, \u003ca href=\"https://www.glaad.org/blog/glaad-and-hrc-call-stanford-university-responsible-media-debunk-dangerous-flawed-report\" target=\"_blank\" rel=\"noopener noreferrer\">called the research,\u003c/a> in a joint press release, \"junk science.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Analyzing Faces\u003c/strong>\u003c/p>\n\u003cp>Using basic facial-recognition technology, the researchers weeded through 130,741 public photos of men and women posted on a U.S. dating website, selecting for images that showed a single face large and clear enough to analyze. This left a pool of 35,326 pictures of 14,776 individuals. Gay and straight people, male and female, were represented evenly.\u003c/p>\n\u003cp>Software called VGG-Face analyzed the faces and looked for correlations between a person's face (nose length, jaw width, etc.) and their self-declared sexual identity on the website. Using a resulting model made up of these distinguishing characteristics, the program, when shown one photo of a gay man and one of a straight man, was able to identify their sexual orientation 81 percent of the time. For women, the success rate was 71 percent. (Accuracy increased when the model was shown more than one image of a person.) Human guessers correctly identified straight faces and gay faces just 61 percent of the time for men and 54 percent for women.\u003c/p>\n\u003cp>The researchers say in the paper that these results \"provide strong support\" for the prenatal hormone theory of gay and lesbian sexual orientation. The theory holds that under or overexposure to prenatal androgens are a key determinant of sexual orientation.\u003c/p>\n\u003cp>In an \u003ca href=\"https://docs.google.com/document/d/11oGZ1Ke3wK9E3BtOFfGfUQuuaSMR8AO2WfWH3aVke6U/preview#\" target=\"_blank\" rel=\"noopener noreferrer\">authors' note\u003c/a> (last updated Sept. 13), the researchers discuss the study's limitations at some length, including the narrow demographic characteristics of the individuals analyzed -- white people who self-reported to be gay or straight. They also expressed concerns about the implications of the study:\u003c/p>\n\u003cblockquote>\u003cp>\u003cspan style=\"font-weight: 400\">We were really disturbed by these results and spent much time considering whether they should be made public at all. We did not want to enable the very risks that we are warning against. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Recent press reports,\u003c/span>\u003cspan style=\"font-weight: 400\"> however, suggest that governments and corporations are already using tools aimed at revealing intimate traits from faces. Facial images of billions of people are stockpiled in digital and traditional archives, including dating platforms, photo-sharing websites, and government databases. Profile pictures on Facebook, LinkedIn, and Google Plus are public by default. CCTV cameras and smartphones can be used to take pictures of others’ faces without their permission.\u003c/span>\u003c/p>\u003c/blockquote>\n\u003cp>Critics of the research expressed concerns that it will lead to the very invasion of privacy the authors seek to warn against. HRC/GLAAD also criticized the limited demographic pool used by the researchers, the \"superficial\" nature of the characteristics analyzed in the model, and the way media have represented the study.\u003c/p>\n\u003cp>The \u003ca href=\"https://docs.google.com/document/d/1UuEcSNFMduIaf0cOWdWbOV3NORLoKWdz3big4xuk7Z4/edit#\" target=\"_blank\" rel=\"noopener noreferrer\">authors responded\u003c/a> angrily, calling the HRC/GLAAD press release premature and misleading. \"\u003cspan style=\"font-weight: 400\">They do a great disservice to the LGBTQ community by dismissing our results outright without properly assessing the science behind it, and hurt the mission of the great organizations that they represent,\" they wrote. \u003c/span>\u003c/p>\n\u003cp>The researchers also stressed, in their authors' note, that they did not invent the tools used. Rather, they applied internet-available software to internet-available data, with the goal of demonstrating the privacy risks inherent in artificially intelligent technologies.\u003c/p>\n\u003cp>\"We studied existing technologies,\" wrote Kosinski and Wang, already widely used by companies and governments, to see whether they present a risk to the privacy of LGBTQ individuals.\"\u003c/p>\n\u003cp>They added, \"We were terrified to find that they do.\"\u003c/p>\n\u003cp>Such tools present a special threat, said the authors, to the privacy and safety of gay men and women living under repressive regimes where homosexuality is illegal.\u003c/p>\n\u003cp>But other LGBT academics and writers did not accept this line of reasoning. Oberlin sociology professor Greggor Mattson wrote a \u003ca href=\"https://greggormattson.com/2017/09/09/artificial-intelligence-discovers-gayface/\" target=\"_blank\" rel=\"noopener noreferrer\">takedown,\u003c/a> published on his website, describing the study as \"much less insightful than the researchers claim.\" The authors' discussion of their ethical concerns suffered from \"stunning tone-deafness,\" Mattson wrote.\u003c/p>\n\u003cp>At least one LGBT blogger, though, came to the researchers' defense.\u003c/p>\n\u003cp>Alex Bollinger, writing at LGBTQ Nation, wrote a \u003ca href=\"https://www.lgbtqnation.com/2017/09/hrc-glaad-release-silly-statement-gay-face-study/\" target=\"_blank\" rel=\"noopener noreferrer\">post \u003c/a>titled \"HRC and GLAAD release a silly statement about the ‘gay face’ study.\"\u003c/p>\n\u003cblockquote>\u003cp>\"We should take a stance of curiosity instead of judgment.\u003c/p>\n\u003cp>\"This is just one study that looked at one sample and said a few things. There will be more studies later on that will say other things. Let’s see how that all unfolds before deciding what the correct answer is.\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This post was edited Oct. 9 to specify the nature of the American Psychological Association's review of the study.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Intravenous Hydrogen Peroxide: Unproven Treatment Offered by Naturopaths",
"title": "Intravenous Hydrogen Peroxide: Unproven Treatment Offered by Naturopaths",
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"content": "\u003cp>Many a parent has applied hydrogen peroxide to a child's cut or scrape to prevent infections. But a number of Southern California naturopathic doctors are using the mild antiseptic in an unconventional way: They intravenously infuse a saline solution with 3 percent hydrogen peroxide straight into a patient's bloodstream.\u003c/p>\n\u003caside class=\"pullquote alignright\">'When you have something that has never been shown to be of value and has the potential to do a lot of harm, it shouldn’t be used.'\u003ccite>Dr. Paul Offit, University of Pennsylvania medical school\u003c/cite>\u003c/aside>\n\u003cp>Montrose osteopath Dr. Yoshi Rahm says this treatment, called IV hydrogen peroxide, does the same thing inside your body as it does on the outside. It's \"killing things,\" such as \"the infection that you currently have, or those unhealthy cancer cells you currently have,\" he says.There's no proof this treatment works. On top of that, IV hydrogen peroxide can be expensive and potentially dangerous. Yet it's not hard to find naturopaths in Southern California who offer it.\u003c/p>\n\u003cp>Some naturopaths promote it online. In this YouTube video, a doctor in Georgia says there are \"30 to 50 maladies\" that IV hydrogen peroxide can help fight, including colds, flus and bacterial and viral infections.\u003c/p>\n\u003cp>\"When you have one compound that someone's telling you can treat a wide variety of unrelated conditions, that's a red flag,\" says Dr. David Gorski, a professor at Wayne State University's medical school and editor of the website Science-Based Medicine.\u003c/p>\n\u003cp>\u003cstrong>Unproven and Untracked\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_435349\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/09/hydrogperoxdoc.jpg\">\u003cimg class=\"size-large wp-image-435349\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/09/hydrogperoxdoc-1020x851.jpg\" alt=\"\" width=\"640\" height=\"534\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-1020x851.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-160x133.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-800x667.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-768x641.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-960x801.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-240x200.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-375x313.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-520x434.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc.jpg 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Yoshi Rahm estimates he's provided about 100 IV hydrogen peroxide treatments over the past four years. He acknowledges there's no scientific proof that it works. \u003ccite>(Rebecca Plevin/KPCC)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>IV hydrogen peroxide has never been studied in a clinical trial, and the U.S. Food and Drug Administration hasn't approved any IV drugs that contain hydrogen peroxide as an active ingredient.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"When you have something that has never been shown to be of value and has the potential to do a lot of harm, it shouldn't be used,\" says Dr. Paul Offit, a professor at the University of Pennsylvania medical school and author of a book about alternative medicine.\u003c/p>\n\u003cp>The U.S. Centers for Disease Control and Prevention doesn't track adverse events from IV hydrogen peroxide. But according to news reports, one woman died in South Carolina in 2004 after a doctor administered it as a treatment for multiple sclerosis.\u003c/p>\n\u003cp>The coroner concluded the hydrogen peroxide produced bubbles in the woman's blood, which led to multiple organ failure and cardiac arrest.\u003c/p>\n\u003cp>IV hydrogen peroxide has a lot of risk and no proven benefits, Offit says.\u003c/p>\n\u003cp>\"If you're going to do placebo medicine, which is what I think this is, then use a placebo, because hydrogen peroxide can kill you,\" he says.\u003c/p>\n\u003cp>It's also expensive: In Southern California, treatments often cost more than a $100 per session.\u003c/p>\n\u003cp>\u003cstrong>No 'Solid Medical Evidence'\u003c/strong>\u003c/p>\n\u003cp>The California Naturopathic Doctors Association says it doesn't track how many people have gotten IV hydrogen peroxide or how many providers offer it, but the group referred KPCC to a naturopath in Grass Valley who says she's trained thousands on how to administer the treatment.\u003c/p>\n\u003cp>Dr. Rahm estimates he's provided about 100 treatments of IV hydrogen peroxide over the past four years. He says he's mainly used it on sinus infections and on cancer, as long as patients are also getting standard treatments like chemotherapy.\u003c/p>\n\u003cp>Rahm acknowledges there's no scientific proof that it works.\u003c/p>\n\u003cp>\"Honestly, I would say no, there's not like solid medical evidence behind it,\" Rahm says. \"Those studies haven't been done.\"\u003c/p>\n\u003cp>He defends the treatment by pointing to one patient's story as proof that it works.\u003c/p>\n\u003cp>Mercedes Curran, a 28-year-old from Beverly Glen Canyon, has MS, an unpredictable, degenerative disease of the central nervous system.\u003c/p>\n\u003cp>At one point, she couldn't control the right side of her body.\u003c/p>\n\u003cp>\"It felt like the right side of my body had 30 extra pounds on all of it,\" Curran recalls. \"Essentially, it would feel like that part of my body was dead.\"\u003c/p>\n\u003cp>Her neurologist recommended five rounds of steroids and physical therapy. Alongside that treatment, Rahm recommended 10 IV hydrogen peroxide sessions over two weeks.\u003c/p>\n\u003cp>Curran says she was skeptical, but willing to try it.\u003c/p>\n\u003cp>\"I wouldn't say I was desperate, but at the same time, of course I wanted to walk without having to drag my leg and I love to travel and all those other things,\" she says.\u003c/p>\n\u003cp>Dr. Offit says he has \"enormous sympathy\" for Curran's situation. He says she, like many others, turned to alternative medicine after coming up against the limits of Western medicine.\u003c/p>\n\u003cp>Still, \"there's just no reason to put people at this kind of risk,\" he says. \"I think these are very vulnerable people and it's just disheartening to see that there are clinicians who are willing to step into the breach and take advantage of these patients.\"\u003c/p>\n\u003cp>Curran estimates she’s spent about $2,000 altogether on her treatments. Each time, she would relax in a lounge chair in Rahm's office, as a saline solution with 3 percent hydrogen peroxide was infused into her bloodstream.\u003c/p>\n\u003cp>\"I felt better after the first session,\" Curran recalls. \"I just felt like I had more energy and my body wasn't as heavy. It could've been even after two or three sessions was the first time I could flex my foot.\"\u003c/p>\n\u003cp>\u003cstrong>Anecdotes Not Scientific Evidence\u003c/strong>\u003c/p>\n\u003cp>Experts say it's impossible to know why Curran started feeling better.\u003c/p>\n\u003cp>MS symptoms sometimes improve on their own. It could've been the steroids Curran's neurologist prescribed, which can take a few weeks to kick in. Or it could've been the placebo effect.\u003c/p>\n\u003cp>\"With one single case, we should be very careful and definitely not jump to the conclusions, especially when it comes to intravenous administration of a substance that can be toxic,\" says Dr. Regina Berkovich, a neurologist who specializes in MS at USC.\u003c/p>\n\u003cp>If naturopathic doctors like Rahm think IV hydrogen peroxide can help treat MS and other conditions, they should prove it, says Dr. Robert Califf, who served as FDA commissioner until January.\u003c/p>\n\u003cp>\"If the treatment works, he would be doing the world a favor to show it using good scientific principles,\" he says, while predicting that it wouldn't be proven to work.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"Even in the mainstream drug industry, over 90 percent of drugs that get into human clinical trials end up not being safe and effective,\" says Califf.\u003c/p>\n\n",
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"excerpt": "Naturopaths in Southern California are treating patients intravenously with the antiseptic hydrogen peroxide. But this treatment can be expensive and possibly dangerous, and there's no evidence that it actually works.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Many a parent has applied hydrogen peroxide to a child's cut or scrape to prevent infections. But a number of Southern California naturopathic doctors are using the mild antiseptic in an unconventional way: They intravenously infuse a saline solution with 3 percent hydrogen peroxide straight into a patient's bloodstream.\u003c/p>\n\u003caside class=\"pullquote alignright\">'When you have something that has never been shown to be of value and has the potential to do a lot of harm, it shouldn’t be used.'\u003ccite>Dr. Paul Offit, University of Pennsylvania medical school\u003c/cite>\u003c/aside>\n\u003cp>Montrose osteopath Dr. Yoshi Rahm says this treatment, called IV hydrogen peroxide, does the same thing inside your body as it does on the outside. It's \"killing things,\" such as \"the infection that you currently have, or those unhealthy cancer cells you currently have,\" he says.There's no proof this treatment works. On top of that, IV hydrogen peroxide can be expensive and potentially dangerous. Yet it's not hard to find naturopaths in Southern California who offer it.\u003c/p>\n\u003cp>Some naturopaths promote it online. In this YouTube video, a doctor in Georgia says there are \"30 to 50 maladies\" that IV hydrogen peroxide can help fight, including colds, flus and bacterial and viral infections.\u003c/p>\n\u003cp>\"When you have one compound that someone's telling you can treat a wide variety of unrelated conditions, that's a red flag,\" says Dr. David Gorski, a professor at Wayne State University's medical school and editor of the website Science-Based Medicine.\u003c/p>\n\u003cp>\u003cstrong>Unproven and Untracked\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_435349\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/09/hydrogperoxdoc.jpg\">\u003cimg class=\"size-large wp-image-435349\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/09/hydrogperoxdoc-1020x851.jpg\" alt=\"\" width=\"640\" height=\"534\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-1020x851.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-160x133.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-800x667.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-768x641.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-960x801.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-240x200.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-375x313.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc-520x434.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/09/hydrogperoxdoc.jpg 1024w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Yoshi Rahm estimates he's provided about 100 IV hydrogen peroxide treatments over the past four years. He acknowledges there's no scientific proof that it works. \u003ccite>(Rebecca Plevin/KPCC)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>IV hydrogen peroxide has never been studied in a clinical trial, and the U.S. Food and Drug Administration hasn't approved any IV drugs that contain hydrogen peroxide as an active ingredient.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"When you have something that has never been shown to be of value and has the potential to do a lot of harm, it shouldn't be used,\" says Dr. Paul Offit, a professor at the University of Pennsylvania medical school and author of a book about alternative medicine.\u003c/p>\n\u003cp>The U.S. Centers for Disease Control and Prevention doesn't track adverse events from IV hydrogen peroxide. But according to news reports, one woman died in South Carolina in 2004 after a doctor administered it as a treatment for multiple sclerosis.\u003c/p>\n\u003cp>The coroner concluded the hydrogen peroxide produced bubbles in the woman's blood, which led to multiple organ failure and cardiac arrest.\u003c/p>\n\u003cp>IV hydrogen peroxide has a lot of risk and no proven benefits, Offit says.\u003c/p>\n\u003cp>\"If you're going to do placebo medicine, which is what I think this is, then use a placebo, because hydrogen peroxide can kill you,\" he says.\u003c/p>\n\u003cp>It's also expensive: In Southern California, treatments often cost more than a $100 per session.\u003c/p>\n\u003cp>\u003cstrong>No 'Solid Medical Evidence'\u003c/strong>\u003c/p>\n\u003cp>The California Naturopathic Doctors Association says it doesn't track how many people have gotten IV hydrogen peroxide or how many providers offer it, but the group referred KPCC to a naturopath in Grass Valley who says she's trained thousands on how to administer the treatment.\u003c/p>\n\u003cp>Dr. Rahm estimates he's provided about 100 treatments of IV hydrogen peroxide over the past four years. He says he's mainly used it on sinus infections and on cancer, as long as patients are also getting standard treatments like chemotherapy.\u003c/p>\n\u003cp>Rahm acknowledges there's no scientific proof that it works.\u003c/p>\n\u003cp>\"Honestly, I would say no, there's not like solid medical evidence behind it,\" Rahm says. \"Those studies haven't been done.\"\u003c/p>\n\u003cp>He defends the treatment by pointing to one patient's story as proof that it works.\u003c/p>\n\u003cp>Mercedes Curran, a 28-year-old from Beverly Glen Canyon, has MS, an unpredictable, degenerative disease of the central nervous system.\u003c/p>\n\u003cp>At one point, she couldn't control the right side of her body.\u003c/p>\n\u003cp>\"It felt like the right side of my body had 30 extra pounds on all of it,\" Curran recalls. \"Essentially, it would feel like that part of my body was dead.\"\u003c/p>\n\u003cp>Her neurologist recommended five rounds of steroids and physical therapy. Alongside that treatment, Rahm recommended 10 IV hydrogen peroxide sessions over two weeks.\u003c/p>\n\u003cp>Curran says she was skeptical, but willing to try it.\u003c/p>\n\u003cp>\"I wouldn't say I was desperate, but at the same time, of course I wanted to walk without having to drag my leg and I love to travel and all those other things,\" she says.\u003c/p>\n\u003cp>Dr. Offit says he has \"enormous sympathy\" for Curran's situation. He says she, like many others, turned to alternative medicine after coming up against the limits of Western medicine.\u003c/p>\n\u003cp>Still, \"there's just no reason to put people at this kind of risk,\" he says. \"I think these are very vulnerable people and it's just disheartening to see that there are clinicians who are willing to step into the breach and take advantage of these patients.\"\u003c/p>\n\u003cp>Curran estimates she’s spent about $2,000 altogether on her treatments. Each time, she would relax in a lounge chair in Rahm's office, as a saline solution with 3 percent hydrogen peroxide was infused into her bloodstream.\u003c/p>\n\u003cp>\"I felt better after the first session,\" Curran recalls. \"I just felt like I had more energy and my body wasn't as heavy. It could've been even after two or three sessions was the first time I could flex my foot.\"\u003c/p>\n\u003cp>\u003cstrong>Anecdotes Not Scientific Evidence\u003c/strong>\u003c/p>\n\u003cp>Experts say it's impossible to know why Curran started feeling better.\u003c/p>\n\u003cp>MS symptoms sometimes improve on their own. It could've been the steroids Curran's neurologist prescribed, which can take a few weeks to kick in. Or it could've been the placebo effect.\u003c/p>\n\u003cp>\"With one single case, we should be very careful and definitely not jump to the conclusions, especially when it comes to intravenous administration of a substance that can be toxic,\" says Dr. Regina Berkovich, a neurologist who specializes in MS at USC.\u003c/p>\n\u003cp>If naturopathic doctors like Rahm think IV hydrogen peroxide can help treat MS and other conditions, they should prove it, says Dr. Robert Califf, who served as FDA commissioner until January.\u003c/p>\n\u003cp>\"If the treatment works, he would be doing the world a favor to show it using good scientific principles,\" he says, while predicting that it wouldn't be proven to work.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"slug": "as-human-gene-editing-advances-doudna-says-ethical-discussions-cant-wait",
"title": "As Human Gene-Editing Advances, Doudna Says Ethical Discussions Can't Wait",
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"headTitle": "As Human Gene-Editing Advances, Doudna Says Ethical Discussions Can’t Wait | KQED",
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"content": "\u003cp>If you want to have a role in shaping the near and coming future of biotechnology, the time is now. A science degree is not required, but a sense of urgency is.\u003c/p>\n\u003cp>This was the primary takeaway from Jennifer Doudna’s recent public remarks at\u003ca href=\"http://crisprcon.org/\" target=\"_blank\" rel=\"noopener noreferrer\"> CRISPRcon\u003c/a>, a two day event at UC Berkeley, intended to get nonspecialists talking about the promise and potential peril of the fast-moving biotech landscape.\u003c/p>\n\u003cp>“Decisions about gene editing have an impact on all of us,” said Michael Krasney, host of KQED’s “Forum” radio program and the CRISPRcon emcee. “That’s why there are no outsiders in discussing this topic.” (For a primer on how CRISPR gene editing works, check out our story “\u003ca href=\"https://ww2.kqed.org/futureofyou/2015/12/30/a-crispr-solution-to-bubble-boy-disease/\" target=\"_blank\" rel=\"noopener noreferrer\">CRISPR: What You Need to Know About the Medical Science ‘Breakthrough of the Year\u003c/a>.”)\u003c/p>\n\u003caside class=\"pullquote alignright\">“We can no longer say, well there’s a lot of technology development to be done before we have to worry about that application, it’s now a question of ‘We know this can work, are we willing to go there or not?'” \u003ccite>Jennifer Doudna, one of the inventors of CRISPR/Cas9 gene-editing technology\u003c/cite>\u003c/aside>\n\u003cp>The National Academies of Sciences, Engineering and Medicine wants public input, as well. The rationale is, if it affects the public, the public should have a say.\u003c/p>\n\u003cp>\u003cstrong>What’s at Stake\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In her new book, “\u003ca href=\"http://www.acrackincreation.com/\" target=\"_blank\" rel=\"noopener noreferrer\">A Crack in Creation: Gene Editing and the Unthinkable Power to Control Evolution\u003c/a>,” Doudna (who co-authored the book with former student Samuel Sternberg) writes humans are “on the cusp of a new age in genetic engineering and biological mastery.”\u003c/p>\n\u003cp>“It won’t be long before CRISPR allows us to bend nature to our will.”\u003c/p>\n\u003cp>CRISPR applications could bring us \u003ca href=\"https://www.sciencedaily.com/releases/2017/05/170518140335.htm\" target=\"_blank\" rel=\"noopener noreferrer\">higher tomato yields\u003c/a> or cattle \u003ca href=\"https://geneticliteracyproject.org/2016/05/11/gene-edited-hornless-cow-improve-animal-welfare-regulatory-fate-unclear/\" target=\"_blank\" rel=\"noopener noreferrer\">born without horns\u003c/a> (allowing livestock to avoid the potentially painful procedure of having them removed). Ongoing medical research using CRISPR includes \u003ca href=\"https://www.nature.com/news/first-crispr-clinical-trial-gets-green-light-from-us-panel-1.20137\" target=\"_blank\" rel=\"noopener noreferrer\">gene editing to target immune response\u003c/a> in cancer patients and to \u003ca href=\"https://www.nature.com/news/crispr-deployed-to-combat-sickle-cell-anaemia-1.20782\" target=\"_blank\" rel=\"noopener noreferrer\">correct sickle-cell anemia\u003c/a>, a painful blood disorder.\u003c/p>\n\u003cp>But the $10 million question at CRISPRcon loomed large:\u003c/p>\n\u003cp>“How do you decide which genes are appropriate for germline editing?” asked a woman in the audience, during a question and answer session with Doudna. Germline editing means that the changes made affect sperm or egg cells, and therefore can be inherited.\u003c/p>\n\u003cp>[contextly_sidebar id=”HfCYio1aAJwJdg2Ip7LwMBF1sWeN5NFY”]”That’s a question that could be debated and discussed for the entire time of the conference,” said Doudna. But her short answer, referencing a \u003ca href=\"http://www.nationalacademies.org/gene-editing/consensus-study/index.htm\" target=\"_blank\" rel=\"noopener noreferrer\">recent report with recommendations\u003c/a> from the National Academies, was, “We look for situations where there would be no other reasonable way to deal with a genetic disease other than gene editing. And when you think about it that way, those situations are rather rare.”\u003c/p>\n\u003cp>Preimplantation genetic diagnosis (for parents using in vitro fertilization) and genetic counseling can offer routes to avoid serious genetic mutations without gene editing. This latter technique would, however, require parents to decide if they are willing to terminate a pregnancy.\u003c/p>\n\u003cp>Doudna believes that in most cases genetic counseling and preimplantation genetic diagnosis are sufficient to deal with disorders caused by a single gene. But some couples might not have any other option to conceive a healthy embryo outside of editing their genes. For example, if both parents both have the same disease-causing gene, “That’s an issue where gene editing could be relevant in the future.”\u003c/p>\n\u003cp>For any parents who want to select for green-eyed, athletic geniuses, their best bet is still a random roll of the dice, not gene-editing, if the National Academies has anything to do with it. “Do not proceed at this time with human genome editing for purposes other than treatment or prevention of disease and disability,” the study recommends.\u003c/p>\n\u003cp>But the question of whether embryos should be edited to avoid disease and disability has reached new urgency, says Doudna, with the publication several weeks ago of the first \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/07/27/scientists-in-us-edit-human-embryos-with-crispr-for-first-time-reports-suggest/\" target=\"_blank\" rel=\"noopener noreferrer\">paper\u003c/a> that lays out a good protocol (a written procedure) for targeting a gene linked to disease. It has the potential of being useful in clinical applications.\u003c/p>\n\u003cp>“What they showed, importantly,” said Doudna, “was that there was very few off-target effects [unintended changes] and also they could avoid something called ‘mosaicism’. ” That arises when the desired edit occurs in only some of the cells in the developing embryo. Both edited and non-editing cells replicate, resulting in an organism with a genetic patchwork, which may or may not be harmful.\u003c/p>\n\u003cp>“We now understand that, when applied in certain ways this technology can be very robust, in viable human embryos. We can no longer say, ‘Well, there’s a lot of technology development to be done before we have to worry about that application.’ It’s now a question of, ‘We know this can work, are we willing to go there or not?’ ”\u003c/p>\n\u003cp>Since CRISPRcon, the paper in question has come in for some \u003ca href=\"https://ipscell.com/2017/08/doubts-raised-on-key-points-of-nature-paper-on-crispr-gene-editing-of-human-embryos/\" target=\"_blank\" rel=\"noopener noreferrer\">recent criticism from scientists\u003c/a> not involved in the research. They call into question the main conclusions of the paper and say more definitive studies are needed. That said, most scientists believe precise editing in embryos will be possible someday, and likely someday soon.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>For members of the public eager to be part of the debate, events like CRISPRcon provide a rare forum with scientists like Doudna who have \u003ca href=\"https://ipscell.com/2015/06/doudnacongress/\" target=\"_blank\" rel=\"noopener noreferrer\">testified before Congress\u003c/a> regarding the science and ethics of gene editing. But for the average person on the street, the most direct route to voicing opinions and concerns may be \u003ca href=\"http://www.nationalacademies.org/gene-editing/consensus-study/index.htm\" target=\"_blank\" rel=\"noopener noreferrer\">submitting comments\u003c/a> on the homepage of the National Academies’ Human Gene-Editing Initiative. Of course, there is also the tried and true method of \u003ca href=\"https://callyourrep.co/\" target=\"_blank\" rel=\"noopener noreferrer\">calling your representatives\u003c/a>.\u003c/p>\n\n",
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"excerpt": "Will debating the ethics of gene editing lead to more agreement? Some scientists and policy makers are hoping so. \r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you want to have a role in shaping the near and coming future of biotechnology, the time is now. A science degree is not required, but a sense of urgency is.\u003c/p>\n\u003cp>This was the primary takeaway from Jennifer Doudna’s recent public remarks at\u003ca href=\"http://crisprcon.org/\" target=\"_blank\" rel=\"noopener noreferrer\"> CRISPRcon\u003c/a>, a two day event at UC Berkeley, intended to get nonspecialists talking about the promise and potential peril of the fast-moving biotech landscape.\u003c/p>\n\u003cp>“Decisions about gene editing have an impact on all of us,” said Michael Krasney, host of KQED’s “Forum” radio program and the CRISPRcon emcee. “That’s why there are no outsiders in discussing this topic.” (For a primer on how CRISPR gene editing works, check out our story “\u003ca href=\"https://ww2.kqed.org/futureofyou/2015/12/30/a-crispr-solution-to-bubble-boy-disease/\" target=\"_blank\" rel=\"noopener noreferrer\">CRISPR: What You Need to Know About the Medical Science ‘Breakthrough of the Year\u003c/a>.”)\u003c/p>\n\u003caside class=\"pullquote alignright\">“We can no longer say, well there’s a lot of technology development to be done before we have to worry about that application, it’s now a question of ‘We know this can work, are we willing to go there or not?'” \u003ccite>Jennifer Doudna, one of the inventors of CRISPR/Cas9 gene-editing technology\u003c/cite>\u003c/aside>\n\u003cp>The National Academies of Sciences, Engineering and Medicine wants public input, as well. The rationale is, if it affects the public, the public should have a say.\u003c/p>\n\u003cp>\u003cstrong>What’s at Stake\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In her new book, “\u003ca href=\"http://www.acrackincreation.com/\" target=\"_blank\" rel=\"noopener noreferrer\">A Crack in Creation: Gene Editing and the Unthinkable Power to Control Evolution\u003c/a>,” Doudna (who co-authored the book with former student Samuel Sternberg) writes humans are “on the cusp of a new age in genetic engineering and biological mastery.”\u003c/p>\n\u003cp>“It won’t be long before CRISPR allows us to bend nature to our will.”\u003c/p>\n\u003cp>CRISPR applications could bring us \u003ca href=\"https://www.sciencedaily.com/releases/2017/05/170518140335.htm\" target=\"_blank\" rel=\"noopener noreferrer\">higher tomato yields\u003c/a> or cattle \u003ca href=\"https://geneticliteracyproject.org/2016/05/11/gene-edited-hornless-cow-improve-animal-welfare-regulatory-fate-unclear/\" target=\"_blank\" rel=\"noopener noreferrer\">born without horns\u003c/a> (allowing livestock to avoid the potentially painful procedure of having them removed). Ongoing medical research using CRISPR includes \u003ca href=\"https://www.nature.com/news/first-crispr-clinical-trial-gets-green-light-from-us-panel-1.20137\" target=\"_blank\" rel=\"noopener noreferrer\">gene editing to target immune response\u003c/a> in cancer patients and to \u003ca href=\"https://www.nature.com/news/crispr-deployed-to-combat-sickle-cell-anaemia-1.20782\" target=\"_blank\" rel=\"noopener noreferrer\">correct sickle-cell anemia\u003c/a>, a painful blood disorder.\u003c/p>\n\u003cp>But the $10 million question at CRISPRcon loomed large:\u003c/p>\n\u003cp>“How do you decide which genes are appropriate for germline editing?” asked a woman in the audience, during a question and answer session with Doudna. Germline editing means that the changes made affect sperm or egg cells, and therefore can be inherited.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>”That’s a question that could be debated and discussed for the entire time of the conference,” said Doudna. But her short answer, referencing a \u003ca href=\"http://www.nationalacademies.org/gene-editing/consensus-study/index.htm\" target=\"_blank\" rel=\"noopener noreferrer\">recent report with recommendations\u003c/a> from the National Academies, was, “We look for situations where there would be no other reasonable way to deal with a genetic disease other than gene editing. And when you think about it that way, those situations are rather rare.”\u003c/p>\n\u003cp>Preimplantation genetic diagnosis (for parents using in vitro fertilization) and genetic counseling can offer routes to avoid serious genetic mutations without gene editing. This latter technique would, however, require parents to decide if they are willing to terminate a pregnancy.\u003c/p>\n\u003cp>Doudna believes that in most cases genetic counseling and preimplantation genetic diagnosis are sufficient to deal with disorders caused by a single gene. But some couples might not have any other option to conceive a healthy embryo outside of editing their genes. For example, if both parents both have the same disease-causing gene, “That’s an issue where gene editing could be relevant in the future.”\u003c/p>\n\u003cp>For any parents who want to select for green-eyed, athletic geniuses, their best bet is still a random roll of the dice, not gene-editing, if the National Academies has anything to do with it. “Do not proceed at this time with human genome editing for purposes other than treatment or prevention of disease and disability,” the study recommends.\u003c/p>\n\u003cp>But the question of whether embryos should be edited to avoid disease and disability has reached new urgency, says Doudna, with the publication several weeks ago of the first \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/07/27/scientists-in-us-edit-human-embryos-with-crispr-for-first-time-reports-suggest/\" target=\"_blank\" rel=\"noopener noreferrer\">paper\u003c/a> that lays out a good protocol (a written procedure) for targeting a gene linked to disease. It has the potential of being useful in clinical applications.\u003c/p>\n\u003cp>“What they showed, importantly,” said Doudna, “was that there was very few off-target effects [unintended changes] and also they could avoid something called ‘mosaicism’. ” That arises when the desired edit occurs in only some of the cells in the developing embryo. Both edited and non-editing cells replicate, resulting in an organism with a genetic patchwork, which may or may not be harmful.\u003c/p>\n\u003cp>“We now understand that, when applied in certain ways this technology can be very robust, in viable human embryos. We can no longer say, ‘Well, there’s a lot of technology development to be done before we have to worry about that application.’ It’s now a question of, ‘We know this can work, are we willing to go there or not?’ ”\u003c/p>\n\u003cp>Since CRISPRcon, the paper in question has come in for some \u003ca href=\"https://ipscell.com/2017/08/doubts-raised-on-key-points-of-nature-paper-on-crispr-gene-editing-of-human-embryos/\" target=\"_blank\" rel=\"noopener noreferrer\">recent criticism from scientists\u003c/a> not involved in the research. They call into question the main conclusions of the paper and say more definitive studies are needed. That said, most scientists believe precise editing in embryos will be possible someday, and likely someday soon.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>For members of the public eager to be part of the debate, events like CRISPRcon provide a rare forum with scientists like Doudna who have \u003ca href=\"https://ipscell.com/2015/06/doudnacongress/\" target=\"_blank\" rel=\"noopener noreferrer\">testified before Congress\u003c/a> regarding the science and ethics of gene editing. But for the average person on the street, the most direct route to voicing opinions and concerns may be \u003ca href=\"http://www.nationalacademies.org/gene-editing/consensus-study/index.htm\" target=\"_blank\" rel=\"noopener noreferrer\">submitting comments\u003c/a> on the homepage of the National Academies’ Human Gene-Editing Initiative. Of course, there is also the tried and true method of \u003ca href=\"https://callyourrep.co/\" target=\"_blank\" rel=\"noopener noreferrer\">calling your representatives\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Feds Seize Smallpox Vaccine as FDA Targets 'Deceitful' Stem Cell Clinics",
"title": "Feds Seize Smallpox Vaccine as FDA Targets 'Deceitful' Stem Cell Clinics",
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"content": "\u003cp>Federal authorities raided a California stem cell clinic and seized a smallpox vaccine that is reserved only for the military and high-risk populations, as the Food and Drug Administration expressed “serious concerns” about how the clinic obtained access to the vaccine at all.\u003c/p>\n\u003cp class=\"danger-zone\">The U.S. Marshals Service seized five vials of the smallpox vaccine, which is not commercially available, the FDA \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm573427.htm\" target=\"_blank\" rel=\"noopener noreferrer\">announced\u003c/a> Monday. Four of the vials — which each hold 100 vaccine doses — were unused, but a portion of the fifth vial had been used.\u003c/p>\n\u003caside class=\"pullquote alignright\">'I especially won’t allow cases such as this one to go unchallenged, where we have good medical reasons to believe these purported treatments can actually harm patients and make their conditions worse.'\u003ccite> FDA Commissioner Scott Gottlieb\u003c/cite>\u003c/aside>\n\u003cp>The treatment mixed some of the vaccine with stem cells taken from a patient to create an injectable — and unproven and unregulated — cancer treatment that was targeted directly at the patient’s tumors, the FDA said. The FDA, which learned of the treatment after inspections, said the injection could have caused inflammation and swelling of the heart.\u003c/p>\n\u003cp>The treatment belonged to San Diego-based company StemImmune Inc., and was given at California Stem Cell Treatment Centers in Rancho Mirage and Beverly Hills. U.S. marshals seized the product on Friday.\u003c/p>\n\u003cp>“The FDA will not allow deceitful actors to take advantage of vulnerable patients by purporting to have treatments or cures for serious diseases without any proof that they actually work,” FDA Commissioner Scott Gottlieb said in a statement. “I especially won’t allow cases such as this one to go unchallenged, where we have good medical reasons to believe these purported treatments can actually harm patients and make their conditions worse.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>A complaint filed in federal court indicates the vials were shipped from outside California but does not provide more detail on the origin. StemImmune also filed \u003ca href=\"http://appft.uspto.gov/netacgi/nph-Parser?Sect1=PTO2&Sect2=HITOFF&u=%2Fnetahtml%2FPTO%2Fsearch-adv.html&r=2&p=1&f=G&l=50&d=PG01&S1=Stemimmune.AANM.&OS=AANM/Stemimmune&RS=AANM/Stemimmune\" target=\"_blank\" rel=\"noopener noreferrer\">a patent application\u003c/a> in February describing “the use of smallpox vaccine to induce an effective anti-tumor immune response.”\u003c/p>\n\u003cp>The type of vaccine that was seized \u003ca href=\"https://www.cdc.gov/smallpox/vaccine-basics/index.html\" target=\"_blank\" rel=\"noopener noreferrer\">is made \u003c/a>from a virus similar to smallpox, but it does not contain smallpox virus and cannot give anyone smallpox, according to the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Also Monday, the FDA announced it had sent \u003ca href=\"https://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2017/ucm573187.htm\" target=\"_blank\" rel=\"noopener noreferrer\">a warning letter\u003c/a> to a Florida stem cell clinic where a 2015 procedure led three women to go legally blind, according \u003ca href=\"https://www.statnews.com/2017/03/15/stem-cell-patients-blind-macular-degeneration/\">to a March study\u003c/a> in the New England Journal of Medicine. The letter to U.S. Stem Cell Clinic said that the company was offering unapproved stem cell treatments and that an agency inspection uncovered violations of manufacturing standards, including potential sterility issues. The company also tried to stop FDA inspectors from talking with employees, the letter says.\u003c/p>\n\u003cp>“You should take prompt action to correct these deviations,” says the letter, which was sent Thursday. “Failure to promptly correct these deviations may result in regulatory action without further notice. Such actions include seizure and/or injunction.”\u003c/p>\n\u003cp>StemImmune did not respond immediately to a request for comment. In a statement, U.S. Stem Cell Clinic said it had given the FDA “unrestricted access” since 2014 and that it followed the agency’s rules. But it also suggested that regulations could prevent patients from getting treatments.\u003c/p>\n\u003cp>“The safety and health of our patients are our number one priority and the strict standards that we have in place follow the laws of the [FDA],” it said, adding: “We have helped thousands of patients harness their own healing potential. It would be a mistake to limit these therapies from patients who need them when we are adhering to top industry standards.”\u003c/p>\n\u003cp>The actions announced Monday are the latest salvo in a back-and-forth between regulators and the clinics that claim to be able to treat everything from paralysis to neurodegenerative diseases to erectile dysfunction. The clinics, \u003ca href=\"https://www.statnews.com/2016/06/30/stem-cell-clinics-proliferate/\">which have proliferated\u003c/a> around the country in recent years, have largely evaded regulation enforcement because they typically take a person’s own stem cells and inject them back into the same person, meaning the cells are considered “minimally manipulated.”\u003c/p>\n\u003cp>The \u003ca href=\"https://www.statnews.com/2016/02/08/fda-crackdown-stem-cell-clinics/\">FDA has tried\u003c/a> at various times to regulate clinics offering unproven stem cell treatments more tightly and close down clinics that put patients at risk, but overall, their efforts have not amounted to much.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.statnews.com/2016/09/09/stem-cell-fda-hearing/\">FDA has held meetings\u003c/a> about possibly regulating the therapies more like drugs, a move that has been backed by many academic stem cell experts who say that stem cell therapies, while holding great potential, are not ready to be used widely or outside regulated clinical trials. But clinic owners warn that the FDA could stamp out progress in the field and keep desperate patients from getting treatments.\u003c/p>\n\u003cp>“The government should not regulate our bodies. … I will always stand up for patient rights,” Kristin Comella, U.S. Stem Cell’s chief scientific officer, said at an FDA hearing months ago. (The FDA’s warning letter this month was addressed to Comella.)\u003c/p>\n\u003cp>Some experts have wondered whether the regulation-averse Trump administration would take further action against stem cell clinics. But in a statement Monday, Gottlieb said the FDA would be bolstering its enforcement as a way of “separating the promise from the unscrupulous hype” and that the agency would roll out a new “comprehensive policy framework” this fall to delineate the rules for stem cell treatments.\u003c/p>\n\u003cp>“There are a small number of unscrupulous actors who have seized on the clinical promise of regenerative medicine, while exploiting the uncertainty, in order to make deceptive, and sometimes corrupt, assurances to patients based on unproven and, in some cases, dangerously dubious products,” Gottlieb said. “These dishonest actors exploit the sincere reports of the significant clinical potential of properly developed products as a way of deceiving patients and preying on the optimism of patients facing bad illnesses. This put the entire field at risk.”\u003c/p>\n\u003cp>Experts who study stem cell clinics and the regulatory landscape generally praised the FDA’s moves, but said that it was unclear what the enforcement actions and \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm573443.htm\" target=\"_blank\" rel=\"noopener noreferrer\">Gottlieb’s statement\u003c/a> meant for the field going forward.\u003c/p>\n\u003cp>“The most important thing is that the FDA is now publicly making a commitment to discipline what has become an out-of-control area of fraudulent medicine,” said R. Alta Charo, a bioethicist at the University of Wisconsin Law School.\u003c/p>\n\u003cp>One part of Gottlieb’s statement that stuck out to Charo, she said, was when he signaled some flexibility in terms of the areas that are subject to FDA regulation, with the commissioner writing that “the FDA must advance an efficient and least burdensome framework” and establish “a regulatory structure that does not become a barrier to beneficial new innovation.”\u003c/p>\n\u003cp>“It’s about a tone being set,” Charo said.\u003c/p>\n\u003cp>Leigh Turner, a University of Minnesota bioethicist, said that from one standpoint, the FDA’s enforcement actions targeted the low-hanging fruit of the bad actors in the industry. Presumably any administration would want to seize unauthorized smallpox vaccine supplies, and the Florida clinic was the subject of lawsuits and media coverage in addition to the high-profile academic paper.\u003c/p>\n\u003cp>“The larger question is going to be, what about the stem cell clinics … that are out there marketing therapies and charging people but don’t have a New England Journal of Medicine piece or lawsuits?” Turner asked. “Is it just going to be that after harm occurs that the FDA is going to do something? Or are we going to see a more systemic approach to this marketplace?”\u003c/p>\n\u003cp>The action against the California clinics was solely based on the vaccine, noted Turner, who \u003ca href=\"http://www.cell.com/cell-stem-cell/abstract/S1934-5909(16)30157-6\" target=\"_blank\" rel=\"noopener noreferrer\">has tracked\u003c/a> the growth of clinics around the country. It did not mention all the other diseases and conditions that the clinics have been marketing their unapproved stem cell therapies for.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>\u003cspan style=\"font-weight: 400\">This \u003ca href=\"https://www.statnews.com/2017/08/28/smallpox-stem-cell-clinic/\" target=\"_blank\" rel=\"noopener noreferrer\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery. \u003c/span>\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Federal authorities raided a California stem cell clinic and seized a smallpox vaccine that is reserved only for the military and high-risk populations, as the Food and Drug Administration expressed “serious concerns” about how the clinic obtained access to the vaccine at all.\u003c/p>\n\u003cp class=\"danger-zone\">The U.S. Marshals Service seized five vials of the smallpox vaccine, which is not commercially available, the FDA \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm573427.htm\" target=\"_blank\" rel=\"noopener noreferrer\">announced\u003c/a> Monday. Four of the vials — which each hold 100 vaccine doses — were unused, but a portion of the fifth vial had been used.\u003c/p>\n\u003caside class=\"pullquote alignright\">'I especially won’t allow cases such as this one to go unchallenged, where we have good medical reasons to believe these purported treatments can actually harm patients and make their conditions worse.'\u003ccite> FDA Commissioner Scott Gottlieb\u003c/cite>\u003c/aside>\n\u003cp>The treatment mixed some of the vaccine with stem cells taken from a patient to create an injectable — and unproven and unregulated — cancer treatment that was targeted directly at the patient’s tumors, the FDA said. The FDA, which learned of the treatment after inspections, said the injection could have caused inflammation and swelling of the heart.\u003c/p>\n\u003cp>The treatment belonged to San Diego-based company StemImmune Inc., and was given at California Stem Cell Treatment Centers in Rancho Mirage and Beverly Hills. U.S. marshals seized the product on Friday.\u003c/p>\n\u003cp>“The FDA will not allow deceitful actors to take advantage of vulnerable patients by purporting to have treatments or cures for serious diseases without any proof that they actually work,” FDA Commissioner Scott Gottlieb said in a statement. “I especially won’t allow cases such as this one to go unchallenged, where we have good medical reasons to believe these purported treatments can actually harm patients and make their conditions worse.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>A complaint filed in federal court indicates the vials were shipped from outside California but does not provide more detail on the origin. StemImmune also filed \u003ca href=\"http://appft.uspto.gov/netacgi/nph-Parser?Sect1=PTO2&Sect2=HITOFF&u=%2Fnetahtml%2FPTO%2Fsearch-adv.html&r=2&p=1&f=G&l=50&d=PG01&S1=Stemimmune.AANM.&OS=AANM/Stemimmune&RS=AANM/Stemimmune\" target=\"_blank\" rel=\"noopener noreferrer\">a patent application\u003c/a> in February describing “the use of smallpox vaccine to induce an effective anti-tumor immune response.”\u003c/p>\n\u003cp>The type of vaccine that was seized \u003ca href=\"https://www.cdc.gov/smallpox/vaccine-basics/index.html\" target=\"_blank\" rel=\"noopener noreferrer\">is made \u003c/a>from a virus similar to smallpox, but it does not contain smallpox virus and cannot give anyone smallpox, according to the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Also Monday, the FDA announced it had sent \u003ca href=\"https://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2017/ucm573187.htm\" target=\"_blank\" rel=\"noopener noreferrer\">a warning letter\u003c/a> to a Florida stem cell clinic where a 2015 procedure led three women to go legally blind, according \u003ca href=\"https://www.statnews.com/2017/03/15/stem-cell-patients-blind-macular-degeneration/\">to a March study\u003c/a> in the New England Journal of Medicine. The letter to U.S. Stem Cell Clinic said that the company was offering unapproved stem cell treatments and that an agency inspection uncovered violations of manufacturing standards, including potential sterility issues. The company also tried to stop FDA inspectors from talking with employees, the letter says.\u003c/p>\n\u003cp>“You should take prompt action to correct these deviations,” says the letter, which was sent Thursday. “Failure to promptly correct these deviations may result in regulatory action without further notice. Such actions include seizure and/or injunction.”\u003c/p>\n\u003cp>StemImmune did not respond immediately to a request for comment. In a statement, U.S. Stem Cell Clinic said it had given the FDA “unrestricted access” since 2014 and that it followed the agency’s rules. But it also suggested that regulations could prevent patients from getting treatments.\u003c/p>\n\u003cp>“The safety and health of our patients are our number one priority and the strict standards that we have in place follow the laws of the [FDA],” it said, adding: “We have helped thousands of patients harness their own healing potential. It would be a mistake to limit these therapies from patients who need them when we are adhering to top industry standards.”\u003c/p>\n\u003cp>The actions announced Monday are the latest salvo in a back-and-forth between regulators and the clinics that claim to be able to treat everything from paralysis to neurodegenerative diseases to erectile dysfunction. The clinics, \u003ca href=\"https://www.statnews.com/2016/06/30/stem-cell-clinics-proliferate/\">which have proliferated\u003c/a> around the country in recent years, have largely evaded regulation enforcement because they typically take a person’s own stem cells and inject them back into the same person, meaning the cells are considered “minimally manipulated.”\u003c/p>\n\u003cp>The \u003ca href=\"https://www.statnews.com/2016/02/08/fda-crackdown-stem-cell-clinics/\">FDA has tried\u003c/a> at various times to regulate clinics offering unproven stem cell treatments more tightly and close down clinics that put patients at risk, but overall, their efforts have not amounted to much.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.statnews.com/2016/09/09/stem-cell-fda-hearing/\">FDA has held meetings\u003c/a> about possibly regulating the therapies more like drugs, a move that has been backed by many academic stem cell experts who say that stem cell therapies, while holding great potential, are not ready to be used widely or outside regulated clinical trials. But clinic owners warn that the FDA could stamp out progress in the field and keep desperate patients from getting treatments.\u003c/p>\n\u003cp>“The government should not regulate our bodies. … I will always stand up for patient rights,” Kristin Comella, U.S. Stem Cell’s chief scientific officer, said at an FDA hearing months ago. (The FDA’s warning letter this month was addressed to Comella.)\u003c/p>\n\u003cp>Some experts have wondered whether the regulation-averse Trump administration would take further action against stem cell clinics. But in a statement Monday, Gottlieb said the FDA would be bolstering its enforcement as a way of “separating the promise from the unscrupulous hype” and that the agency would roll out a new “comprehensive policy framework” this fall to delineate the rules for stem cell treatments.\u003c/p>\n\u003cp>“There are a small number of unscrupulous actors who have seized on the clinical promise of regenerative medicine, while exploiting the uncertainty, in order to make deceptive, and sometimes corrupt, assurances to patients based on unproven and, in some cases, dangerously dubious products,” Gottlieb said. “These dishonest actors exploit the sincere reports of the significant clinical potential of properly developed products as a way of deceiving patients and preying on the optimism of patients facing bad illnesses. This put the entire field at risk.”\u003c/p>\n\u003cp>Experts who study stem cell clinics and the regulatory landscape generally praised the FDA’s moves, but said that it was unclear what the enforcement actions and \u003ca href=\"https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm573443.htm\" target=\"_blank\" rel=\"noopener noreferrer\">Gottlieb’s statement\u003c/a> meant for the field going forward.\u003c/p>\n\u003cp>“The most important thing is that the FDA is now publicly making a commitment to discipline what has become an out-of-control area of fraudulent medicine,” said R. Alta Charo, a bioethicist at the University of Wisconsin Law School.\u003c/p>\n\u003cp>One part of Gottlieb’s statement that stuck out to Charo, she said, was when he signaled some flexibility in terms of the areas that are subject to FDA regulation, with the commissioner writing that “the FDA must advance an efficient and least burdensome framework” and establish “a regulatory structure that does not become a barrier to beneficial new innovation.”\u003c/p>\n\u003cp>“It’s about a tone being set,” Charo said.\u003c/p>\n\u003cp>Leigh Turner, a University of Minnesota bioethicist, said that from one standpoint, the FDA’s enforcement actions targeted the low-hanging fruit of the bad actors in the industry. Presumably any administration would want to seize unauthorized smallpox vaccine supplies, and the Florida clinic was the subject of lawsuits and media coverage in addition to the high-profile academic paper.\u003c/p>\n\u003cp>“The larger question is going to be, what about the stem cell clinics … that are out there marketing therapies and charging people but don’t have a New England Journal of Medicine piece or lawsuits?” Turner asked. “Is it just going to be that after harm occurs that the FDA is going to do something? Or are we going to see a more systemic approach to this marketplace?”\u003c/p>\n\u003cp>The action against the California clinics was solely based on the vaccine, noted Turner, who \u003ca href=\"http://www.cell.com/cell-stem-cell/abstract/S1934-5909(16)30157-6\" target=\"_blank\" rel=\"noopener noreferrer\">has tracked\u003c/a> the growth of clinics around the country. It did not mention all the other diseases and conditions that the clinics have been marketing their unapproved stem cell therapies for.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cspan style=\"font-weight: 400\">This \u003ca href=\"https://www.statnews.com/2017/08/28/smallpox-stem-cell-clinic/\" target=\"_blank\" rel=\"noopener noreferrer\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery. \u003c/span>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The familiar phrase, “The doctor will see you now,” is not what it used to be.\u003c/p>\n\u003cp>That's because during most exams, physicians are spending a good chunk of time not looking at the patient, but at the patient's electronic health record on a computer screen.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We have invested a lot of time to train physicians, so why not have them use their expertise in the most efficient way possible?'\u003c/aside>\n\u003cp>A 2016 \u003ca href=\"http://annals.org/aim/article/2546704/allocation-physician-time-ambulatory-practice-time-motion-study-4-specialties\" target=\"_blank\" rel=\"noopener noreferrer\"> study\u003c/a> in the \u003cem>Annals of Internal Medicine\u003c/em> found that physicians spent 37 percent of their time on\u003cstrong> \u003c/strong>a computer during exams.\u003c/p>\n\u003cp>The situation can be frustrating for patients, who don't think they are getting the doctor's full attention.\u003c/p>\n\u003cp>\"That most fundamental aspect of human communication, which is eye contact, now is being robbed from the medical encounter because of the electronic health record,\" says Dr. Lloyd Minor, dean of Stanford's medical school.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>While acknowledging the benefits of EHRs, which are meant to improve patient care by providing an easily accessible health history, physicians have also railed against the heavy amount of data entry they require. Physicians spend an estimated one to two hours after work completing EHRs and other \"desktop medicine\" requirements, according to the study in \u003cem>Annals of Internal Medicine.\u003c/em>\u003c/p>\n\u003cp>But now Dr. Albert Chan, the chief of digital patient experience for the Sutter Health Network, thinks he has a solution for the burden of EHRs. Chan uses \u003ca href=\"https://www.x.company/glass/\" target=\"_blank\" rel=\"noopener noreferrer\">Google Glass\u003c/a>, with its tiny camera mounted on a device worn like eyeglasses, to stream audio and video of the patient to an offsite medical scribe. The scribe sees and hears what the doctor does, writing the notes that go into the electronic health record. This frees up the physician to give the patient her full attention. Doctors can communicate with their note-takers through a headset, asking them to retrieve test results and other data. The scribe responds via text message, which the physician sees in the Glass lens.\u003c/p>\n\u003caside class=\"pullquote alignright\">'You’re just adding more layers of cost and people to assist in the exam room.'\u003c/aside>\n\u003cp>“For patients, it’s better care because the doctors focus on them, and the doctors spend more time with them,\" Chan says. He says that because the doctor’s attention is not divided between the computer and the patient, records of the visit are more accurate.\u003c/p>\n\u003cp>The system is provided by a company called Augmedix, of which Sutter Health is an investor.\u003c/p>\n\u003cp>Currently about 100 Sutter doctors are using the system. After first deploying it among physicians in internal medicine, Sutter is now expanding it for use by specialists like dermatologists, podiatrists and orthopedists across its Northern California network.\u003c/p>\n\u003cp>“I mean, we have invested a lot of time to train physicians, so why not have them use their expertise in the most efficient way possible?” says Chan.\u003c/p>\n\u003cp>\u003cstrong>Encounter at Dolores Park\u003c/strong>\u003c/p>\n\u003cp>Augmedix was founded in 2012, by Ian Shakil and Pelu Tran. Shakil, who is the CEO, says he got the idea after a chance encounter at San Francisco's Dolores Park with some Google employees who were working on Glass. \"They had Glass in their backpacks. And they let us try it on,\" he says.\u003c/p>\n\u003cp>[contextly_sidebar id=\"TXibesbDeLMGc9JYIC8IybWNpNcdvmaW\"]After the Google crew explained the product was intended for consumers, \"I got into a big argument with the group that this was really meant for doctors.\" (Glass was a notorious bust with the public, but is \u003ca href=\"https://www.wired.com/story/google-glass-2-is-here/\" target=\"_blank\" rel=\"noopener noreferrer\">now hitting its stride as a workplace tool.\u003c/a>)\u003c/p>\n\u003cp>Shakil, who knew from media reports and his own encounters with physicians that they were beleaguered with documentation requirements, says he became obsessed with the idea of using Glass as a solution. \"I couldn't sleep; I couldn't stop talking about it. I literally quit my job.\"\u003c/p>\n\u003cp>He then reeled in his friend Tran, who dropped out of his fourth year at medical school, and the two formed the company. Shakil says more than 1,000 doctors are currently using Augmedix across the U.S. , with the largest deployment by Sutter.\u003c/p>\n\u003cp>Besides Sutter, investors include health services company McKesson and Dignity Health network.\u003c/p>\n\u003cp>Sutter's Dr. Chan says the scribes provide a number of benefits, including reminding physicians to address issues they might otherwise miss.\u003c/p>\n\u003cp>“If you have shoulder pain and chest pain, for instance, well, if I forget to address the shoulder pain during the exam, I can get a subtle hint from the transcriptionist -- ‘Hey, you may want to address the shoulder pain, too.’ ”\u003c/p>\n\u003cp>Because doctors use shorthand when entering information in an EHR, Chan says, they often have to go back hours later and fill in the gaps; that isn't necessary when a third party is taking the notes in real-time.\u003c/p>\n\u003cp>\u003cstrong>'Oh, I Can See My Kid's Soccer Game'\u003c/strong>\u003c/p>\n\u003cp>About two-thirds of Augmedix's note-takers are located overseas, in India, the Dominican Republic and Sri Lanka, says CEO Shakil. But Adeeba Hasan, a full-time scribe for the company, works out of headquarters in San Francisco. Hasan says she's able to take 80 percent of the EHR workload off a doctor's hands. \"My doctors are able to leave and get home about two or three hours early,\" Hasan says. \"They definitely thank for me for little things like, 'Oh, I can see my kids' soccer game.' \"\u003c/p>\n\u003cp>She has scribed for 20 doctors, whose predominant perspective, she says, is that while EHRs are important, they don't require a medical degree to complete. She herself is applying to medical school and finds the experience valuable. \"I'm learning all about different medications and illnesses and how you talk to patients,\" she says.\u003c/p>\n\u003cp>\u003cstrong>A Doubter\u003c/strong>\u003c/p>\n\u003cp>So is this the future of medicine as we know it?\u003c/p>\n\u003cp>“Oh my God, I hope not,” says David Lansky, executive director of the Pacific Business Group on Health, a nonprofit consortium of private companies and public agencies working toward greater health care affordability and quality.\u003c/p>\n\u003cp>The Augmedix service generally ranges from $1,500 to $3,500 per physician, per month, according to Shakil. Lansky says fixing the dysfunctional health care system requires putting the brakes on runaway costs, and using expensive scribes does just the opposite.\u003c/p>\n\u003cp>“You’re just adding more layers of cost and people to assist in the exam room,” Lansky says.\u003c/p>\n\u003cp>He thinks the solution to the burden of EHRs is to lessen reporting requirements, from quality measures to insurance coding to language intended to fend off lawsuits\u003cb>.\u003c/b>\u003c/p>\n\u003cp>“The real problem is that administrative requirements are uncoordinated and useless,\" Lansky says. \"I mean, no one’s even looking at the quality measures physicians are required to key in.\"\u003c/p>\n\u003cp>“The two paths we want to pursue are to reduce reporting and improve EHR function. If everything’s in front of you, you can use your face time [with the patient] to really \u003cem>do\u003c/em> face time.”\u003c/p>\n\u003cp>\u003cstrong>What About the Creepiness Factor?\u003c/strong>\u003c/p>\n\u003cp>Might some patients, especially women, not take too kindly to having something as intimate as a medical exam observed by someone they don't know and can't see?\u003c/p>\n\u003cp>\"To be honest\u003cstrong>, \u003c/strong>\u003cspan class=\"s1\">when we first founded the business, we had no idea if this issue was going to be a show-stopper or not a big deal,\" says Shakil. \"We’ve since grown and we’ve learned that it’ s not actually a big deal.\" \u003c/span>\u003c/p>\n\u003cp>He says only 2 percent of patients have opted out so far, a rate that remains steady across all demographics, including sex.\u003c/p>\n\u003cp>Shakil says the audio-video stream is encrypted, so hacking is not an issue. \"We've penetration-tested it, and it's Fort Knox, basically.\" The scribes sit in what he calls an \"ultra-secure environment,\" with nothing in their pockets, video monitoring, and computers that can only run the company's application.\u003c/p>\n\u003cp>The doctor can also temporarily switch off the Glass feed by swiping or verbal command if there's something occurring the patient doesn't want transmitted. The light on the device changes color to indicate its no longer active, which the patient can see.\u003c/p>\n\u003cp>Interestingly enough, there is one small sub-group of patients who are opting out at a slightly greater rate.\u003c/p>\n\u003cp>\"It's a little bit higher around the Google campus than anywhere in the country,\" Shakil says.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Make of that what you will.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The familiar phrase, “The doctor will see you now,” is not what it used to be.\u003c/p>\n\u003cp>That's because during most exams, physicians are spending a good chunk of time not looking at the patient, but at the patient's electronic health record on a computer screen.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We have invested a lot of time to train physicians, so why not have them use their expertise in the most efficient way possible?'\u003c/aside>\n\u003cp>A 2016 \u003ca href=\"http://annals.org/aim/article/2546704/allocation-physician-time-ambulatory-practice-time-motion-study-4-specialties\" target=\"_blank\" rel=\"noopener noreferrer\"> study\u003c/a> in the \u003cem>Annals of Internal Medicine\u003c/em> found that physicians spent 37 percent of their time on\u003cstrong> \u003c/strong>a computer during exams.\u003c/p>\n\u003cp>The situation can be frustrating for patients, who don't think they are getting the doctor's full attention.\u003c/p>\n\u003cp>\"That most fundamental aspect of human communication, which is eye contact, now is being robbed from the medical encounter because of the electronic health record,\" says Dr. Lloyd Minor, dean of Stanford's medical school.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>While acknowledging the benefits of EHRs, which are meant to improve patient care by providing an easily accessible health history, physicians have also railed against the heavy amount of data entry they require. Physicians spend an estimated one to two hours after work completing EHRs and other \"desktop medicine\" requirements, according to the study in \u003cem>Annals of Internal Medicine.\u003c/em>\u003c/p>\n\u003cp>But now Dr. Albert Chan, the chief of digital patient experience for the Sutter Health Network, thinks he has a solution for the burden of EHRs. Chan uses \u003ca href=\"https://www.x.company/glass/\" target=\"_blank\" rel=\"noopener noreferrer\">Google Glass\u003c/a>, with its tiny camera mounted on a device worn like eyeglasses, to stream audio and video of the patient to an offsite medical scribe. The scribe sees and hears what the doctor does, writing the notes that go into the electronic health record. This frees up the physician to give the patient her full attention. Doctors can communicate with their note-takers through a headset, asking them to retrieve test results and other data. The scribe responds via text message, which the physician sees in the Glass lens.\u003c/p>\n\u003caside class=\"pullquote alignright\">'You’re just adding more layers of cost and people to assist in the exam room.'\u003c/aside>\n\u003cp>“For patients, it’s better care because the doctors focus on them, and the doctors spend more time with them,\" Chan says. He says that because the doctor’s attention is not divided between the computer and the patient, records of the visit are more accurate.\u003c/p>\n\u003cp>The system is provided by a company called Augmedix, of which Sutter Health is an investor.\u003c/p>\n\u003cp>Currently about 100 Sutter doctors are using the system. After first deploying it among physicians in internal medicine, Sutter is now expanding it for use by specialists like dermatologists, podiatrists and orthopedists across its Northern California network.\u003c/p>\n\u003cp>“I mean, we have invested a lot of time to train physicians, so why not have them use their expertise in the most efficient way possible?” says Chan.\u003c/p>\n\u003cp>\u003cstrong>Encounter at Dolores Park\u003c/strong>\u003c/p>\n\u003cp>Augmedix was founded in 2012, by Ian Shakil and Pelu Tran. Shakil, who is the CEO, says he got the idea after a chance encounter at San Francisco's Dolores Park with some Google employees who were working on Glass. \"They had Glass in their backpacks. And they let us try it on,\" he says.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>After the Google crew explained the product was intended for consumers, \"I got into a big argument with the group that this was really meant for doctors.\" (Glass was a notorious bust with the public, but is \u003ca href=\"https://www.wired.com/story/google-glass-2-is-here/\" target=\"_blank\" rel=\"noopener noreferrer\">now hitting its stride as a workplace tool.\u003c/a>)\u003c/p>\n\u003cp>Shakil, who knew from media reports and his own encounters with physicians that they were beleaguered with documentation requirements, says he became obsessed with the idea of using Glass as a solution. \"I couldn't sleep; I couldn't stop talking about it. I literally quit my job.\"\u003c/p>\n\u003cp>He then reeled in his friend Tran, who dropped out of his fourth year at medical school, and the two formed the company. Shakil says more than 1,000 doctors are currently using Augmedix across the U.S. , with the largest deployment by Sutter.\u003c/p>\n\u003cp>Besides Sutter, investors include health services company McKesson and Dignity Health network.\u003c/p>\n\u003cp>Sutter's Dr. Chan says the scribes provide a number of benefits, including reminding physicians to address issues they might otherwise miss.\u003c/p>\n\u003cp>“If you have shoulder pain and chest pain, for instance, well, if I forget to address the shoulder pain during the exam, I can get a subtle hint from the transcriptionist -- ‘Hey, you may want to address the shoulder pain, too.’ ”\u003c/p>\n\u003cp>Because doctors use shorthand when entering information in an EHR, Chan says, they often have to go back hours later and fill in the gaps; that isn't necessary when a third party is taking the notes in real-time.\u003c/p>\n\u003cp>\u003cstrong>'Oh, I Can See My Kid's Soccer Game'\u003c/strong>\u003c/p>\n\u003cp>About two-thirds of Augmedix's note-takers are located overseas, in India, the Dominican Republic and Sri Lanka, says CEO Shakil. But Adeeba Hasan, a full-time scribe for the company, works out of headquarters in San Francisco. Hasan says she's able to take 80 percent of the EHR workload off a doctor's hands. \"My doctors are able to leave and get home about two or three hours early,\" Hasan says. \"They definitely thank for me for little things like, 'Oh, I can see my kids' soccer game.' \"\u003c/p>\n\u003cp>She has scribed for 20 doctors, whose predominant perspective, she says, is that while EHRs are important, they don't require a medical degree to complete. She herself is applying to medical school and finds the experience valuable. \"I'm learning all about different medications and illnesses and how you talk to patients,\" she says.\u003c/p>\n\u003cp>\u003cstrong>A Doubter\u003c/strong>\u003c/p>\n\u003cp>So is this the future of medicine as we know it?\u003c/p>\n\u003cp>“Oh my God, I hope not,” says David Lansky, executive director of the Pacific Business Group on Health, a nonprofit consortium of private companies and public agencies working toward greater health care affordability and quality.\u003c/p>\n\u003cp>The Augmedix service generally ranges from $1,500 to $3,500 per physician, per month, according to Shakil. Lansky says fixing the dysfunctional health care system requires putting the brakes on runaway costs, and using expensive scribes does just the opposite.\u003c/p>\n\u003cp>“You’re just adding more layers of cost and people to assist in the exam room,” Lansky says.\u003c/p>\n\u003cp>He thinks the solution to the burden of EHRs is to lessen reporting requirements, from quality measures to insurance coding to language intended to fend off lawsuits\u003cb>.\u003c/b>\u003c/p>\n\u003cp>“The real problem is that administrative requirements are uncoordinated and useless,\" Lansky says. \"I mean, no one’s even looking at the quality measures physicians are required to key in.\"\u003c/p>\n\u003cp>“The two paths we want to pursue are to reduce reporting and improve EHR function. If everything’s in front of you, you can use your face time [with the patient] to really \u003cem>do\u003c/em> face time.”\u003c/p>\n\u003cp>\u003cstrong>What About the Creepiness Factor?\u003c/strong>\u003c/p>\n\u003cp>Might some patients, especially women, not take too kindly to having something as intimate as a medical exam observed by someone they don't know and can't see?\u003c/p>\n\u003cp>\"To be honest\u003cstrong>, \u003c/strong>\u003cspan class=\"s1\">when we first founded the business, we had no idea if this issue was going to be a show-stopper or not a big deal,\" says Shakil. \"We’ve since grown and we’ve learned that it’ s not actually a big deal.\" \u003c/span>\u003c/p>\n\u003cp>He says only 2 percent of patients have opted out so far, a rate that remains steady across all demographics, including sex.\u003c/p>\n\u003cp>Shakil says the audio-video stream is encrypted, so hacking is not an issue. \"We've penetration-tested it, and it's Fort Knox, basically.\" The scribes sit in what he calls an \"ultra-secure environment,\" with nothing in their pockets, video monitoring, and computers that can only run the company's application.\u003c/p>\n\u003cp>The doctor can also temporarily switch off the Glass feed by swiping or verbal command if there's something occurring the patient doesn't want transmitted. The light on the device changes color to indicate its no longer active, which the patient can see.\u003c/p>\n\u003cp>Interestingly enough, there is one small sub-group of patients who are opting out at a slightly greater rate.\u003c/p>\n\u003cp>\"It's a little bit higher around the Google campus than anywhere in the country,\" Shakil says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>https://www.youtube.com/watch?v=IS5Yankf1GY&feature=youtu.be\u003c/p>\n\u003cp>The idea was a simple one: Create a summer camp where \u003ca href=\"https://ww2.kqed.org/stateofhealth/2016/06/09/day-camp-for-transgender-youth-allows-kids-to-be-themselves/\" target=\"_blank\" rel=\"noopener noreferrer\">transgender kids can go to feel safe\u003c/a>, welcome and empowered.\u003c/p>\n\u003cp>The \u003ca href=\"http://rainbowdaycamp.org\" target=\"_blank\" rel=\"noopener noreferrer\">Bay Area Rainbow Day Camp\u003c/a> has now wrapped up its third summer. The camp was the brainchild of Sandra Collins, who got the idea after her daughter, Scarlett, had a run-in at her previous camp. Scarlett's friend, in anger, had revealed to other kids that Scarlett had been born a biological boy.\u003c/p>\n\u003cp>Now, Rainbow Camp, run out of a school in El Cerrito, is a place \"where gender-diverse youth can come together, have fun, and feel a sense of gender-identity pride and resilience, and feel safe and belonging in a community,\" Collins says.\u003c/p>\n\u003cp>“To be in this space where there are lots and lots of [transgender] kids is actually really unique,” says Sara Kaplan, whose son, James, attended the camp this summer. \"Because most of the time they’re in experiences where they’re the only child who is transgender.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>James says being surrounded by other transgender kids has definitely been a positive.\u003c/p>\n\u003cp>“It’s very amazing to be with people that are also transgender,” James says. “The camp has helped me in life experience and being less shy about who I am.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Watch the video, above.\u003c/p>\n\n",
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"content": "\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"600\" height=\"338\" src=\"//content.jwplatform.com/players/Dg4gz7oc-jEuQjxp9.html\" frameborder=\"0\" scrolling=\"no\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Forget iTunes or your old zipper case of DVDs. How about storing movies in a Petri dish of E. coli?\u003c/p>\n\u003cp>Researchers at Harvard Medical School and the Wyss Institute for Biologically Inspired Engineering have stored a short video in the DNA of bacteria and then retrieved it. It’s the first time a video has been recorded into living cells, and the development could have environmental applications.\u003c/p>\n\u003cp>“DNA is a great place to store information. Biology uses it quite effectively,” said Seth Shipman, a postdoctoral fellow at Harvard Medical School and first author of the study. “It’s compact, and it’s incredibly stable.”\u003c/p>\n\u003cp>Shipman and his colleagues encoded Eadweard Muybridge’s “Sallie Gardner at a Gallop,” otherwise known as “The Horse in Motion,” one of the earliest series of moving images ever created.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Their \u003ca href=\"https://www.nature.com/articles/doi:10.1038/nature23017\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> was published in \u003cem>Nature\u003c/em> on Wednesday.\u003c/p>\n\u003cp>To get the DNA stored into the bacterial genome, researchers used the CRISPR-Cas system, a powerful gene-editing tool. The researchers chopped up each frame into single-colored pixels. They then created DNA codes that corresponded to each color and strung several codes together.\u003c/p>\n\u003cp>Each bacterium took in snippets of the video and stored it in their DNA. Taken together, the researchers were able to put the pieces back and play the video.\u003c/p>\n\u003cp>With this work, Shipman said they eventually want to create “molecular recorders,” which are living cells that could sense things in the environment, like toxins or heavy metals, and record and store that information within their DNA.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2017/07/12/crispr-bacteria-video-harvard-wyss/\" target=\"_blank\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"600\" height=\"338\" src=\"//content.jwplatform.com/players/Dg4gz7oc-jEuQjxp9.html\" frameborder=\"0\" scrolling=\"no\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Forget iTunes or your old zipper case of DVDs. How about storing movies in a Petri dish of E. coli?\u003c/p>\n\u003cp>Researchers at Harvard Medical School and the Wyss Institute for Biologically Inspired Engineering have stored a short video in the DNA of bacteria and then retrieved it. It’s the first time a video has been recorded into living cells, and the development could have environmental applications.\u003c/p>\n\u003cp>“DNA is a great place to store information. Biology uses it quite effectively,” said Seth Shipman, a postdoctoral fellow at Harvard Medical School and first author of the study. “It’s compact, and it’s incredibly stable.”\u003c/p>\n\u003cp>Shipman and his colleagues encoded Eadweard Muybridge’s “Sallie Gardner at a Gallop,” otherwise known as “The Horse in Motion,” one of the earliest series of moving images ever created.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Dr. Lloyd Minor is frustrated. As dean of Stanford University Medical School, he says he can handle the constant cascade of large-scale challenges that come with his job. But what flummoxes him — drives him crazy, in fact — is something that occurs on a much smaller scale every time he examines someone in his clinical practice.\u003c/p>\n\u003cp>Minor cannot get the electronic health record, which provides a medical history of each patient, to work the way he wants. So he spends too much time wrestling with the computer and not enough directly communicating with his patient.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There is nothing more frustrating to a patient than talking to their doctor, wanting advice, and that provider is typing away and looking at a computer screen instead of the patient.' \u003ccite>Stanford medical school Dean Lloyd Minor\u003c/cite>\u003c/aside>\n\u003cp>“There is nothing more frustrating to a patient than talking to their doctor, wanting advice, and that provider is typing away and looking at a computer screen instead of the patient,\" Minor says. \"That most fundamental aspect of human communication, which is eye contact, now is being robbed from the medical encounter because of the electronic health record.”\u003c/p>\n\u003cp>He says EHRs now function primarily as documentation for billing and quality reporting rather than as an aid to doctors. Given their cumbersome nature, the EHR, long touted as a way to dramatically improve patient care, often does just the opposite, Minor believes.\u003c/p>\n\u003cp>“As a provider, you’re thinking about what do I need to document, or how do I navigate the EHR system, not how do I assimilate this information to provide the best care advice to the patient,\" he says. \"You’re thinking about the mechanics of the documentation, rather than the implications of the symptoms and findings.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Data Entry or Medicine?\u003c/strong>\u003c/p>\n\u003cp>Many physicians are fed up with the amount of documentation required in EHRs. Many feel they spend more time as data-entry clerks than as doctors.\u003c/p>\n\u003cp>[contextly_sidebar id=\"iCL76xAqQztIVtwiKb3Jdka9M3FawwGC\"]Studies bear that out. Only 27 percent of a doctor’s time is spent with patients — and nearly half is spent on EHR and desk work, according to a \u003ca href=\"http://annals.org/aim/article/2546704/allocation-physician-time-ambulatory-practice-time-motion-study-4-specialties\">2016 study\u003c/a> published in \u003cem>Annals of Internal Medicine\u003c/em>. The study looked at physicians in family practice, internal medicine, cardiology and orthopedics. A smaller\u003ca href=\"http://content.healthaffairs.org/content/36/4/655.abstract\" target=\"_blank\" rel=\"noopener noreferrer\"> study\u003c/a> published in April by \u003cem>Health Affairs, \u003c/em>focusing on primary care physicians, also found about a 50-50 split in direct patient care time versus desktop medicine.\u003c/p>\n\u003cp>When doctors do spend time in the exam room with patients, they spent 37 percent of that time looking at the computer, the 2016 study estimated.\u003c/p>\n\u003cp>It's not just recording the patient's medical information that takes up time, according to Dr. Albert Chan, a family practice physician and the chief of digital patient experience for the Sutter Health Network. Doctors now need to report a series of quality measurements, provide proper insurance coding, and introduce more legalistic wording into the EHR to prevent lawsuits, he says.\u003c/p>\n\u003cp>There’s so much required paperwork and documentation now that primary care physicians spend an estimated one to two hours every night after work finishing up their data entry on EHRs, the study in \u003cem>Annals of Internal Medicine\u003c/em> found.\u003c/p>\n\u003cp>In the business, that’s called \"pajama time.\" In the real world, it's called one reason for burnout. Fifty-four \u003ca href=\"http://www.mayoclinicproceedings.org/article/S0025-6196(15)00716-8/abstract\">percent of physicians\u003c/a> reported at least one symptom of burnout, according to a recent Mayo Clinic study. A separate Mayo study found that a higher risk of burnout was \u003ca href=\"http://www.mayoclinicproceedings.org/article/S0025-6196(16)30215-4/abstract\">linked\u003c/a> to frustrations with the data-entry workload of EHRs.\u003c/p>\n\u003cp>\u003cstrong>A Powerful Tool\u003c/strong>\u003c/p>\n\u003cp>When the Affordable Care Act and the 2009 \u003ca href=\"https://www.hhs.gov/hipaa/for-professionals/special-topics/HITECH-act-enforcement-interim-final-rule/index.html\">HITECH Act\u003c/a> required electronic health records to be incorporated into medical practices, Dr. Chan says, many medical groups and physicians rushed to install EHR systems. That means the search function may not work well, or the system may require multiple keystrokes and screens to accomplish common tasks.\u003c/p>\n\u003cp>(Eric Helsher, vice president of client success at Epic, one of the leading EHR providers, responded that customer feedback \"drives our continuous development, with the aim of making the software a joy to use, helping them get value from their data, and facilitating collaboration across the Epic community.\")\u003c/p>\n\u003caside class=\"pullquote alignright\">'I remember back in the old days of paper medical records … not being able to find a patient’s chart was just maddening. We don’t have that anymore.'\u003ccite>Dr. Albert Chan\u003c/cite>\u003c/aside>\n\u003cp>But, Chan says, as flawed as the EHR is, it would be wise not to throw the baby out with the bathwater.\u003c/p>\n\u003cp>“It’s important to note that the EHR is an incredibly powerful tool,” he says. “There are tremendous things you can do with the EHR. You can automatically alert patients about their conditions, for example; you can personalize their care. The lesson I’ve learned is that the EHR requires work to make it work.”\u003c/p>\n\u003cp>Chan says he would never want to go back to the paper-only era.\u003c/p>\n\u003cp>“I remember back in the old days of paper medical records ... not being able to find a patient’s chart was just maddening. We don’t have that anymore.\"\u003c/p>\n\u003cp>\u003cstrong>The Interoperability Problem\u003c/strong>\u003c/p>\n\u003cp>Current design problems can be corrected over time by EHR system vendors, Chan says, and he expects the furor over EHRs to dissipate as annoying and time-consuming glitches are altered.\u003c/p>\n\u003cp>One of the big complaints doctors have had is the lack of interoperability between EHR systems, so that hospitals, medical groups, insurers and physicians can't easily share patient data with each other. In the San Francisco Bay Area, some sharing is now starting to occur among institutions like Sutter Health, Kaiser, UCSF and Stanford that all that use the EHR system Epic.\u003c/p>\n\u003cp>“We’re starting to see fruits of our labor to connect data,” Chan says.\u003c/p>\n\u003cp>But that may be a glass-half-full view, according to Will Ross, a project manager at Redwood MedNet, a nonprofit health information exchange based in Ukiah. Ross has been working on trying to improve the interoperability of EHRs for two decades, and says the progress has been plodding, to say the least.\u003c/p>\n\u003cp>Ross says EHRs took a turn for the worse after Congress tried to get physicians to prove they were meaningfully using them in the HITECH Act of 2009. Those rules, which he calls arbitrary, made the whole process much more complex and time-consuming.\u003c/p>\n\u003cp>\u003cspan style=\"color: #2b2b2b\">“That transformed all of this into busy work and nonsense,” Ross says. \u003c/span>\u003c/p>\n\u003cp>The obvious solution is for vendors to improve their products, he says. But that’s easier proposed than accomplished.\u003c/p>\n\u003cp>“A lot of the EHRs are cash cows to their owners,” Ross says. “They make their money on installing them, not changing them.”\u003c/p>\n\u003cp>Even if the complex problems of interoperability and ease of use were magically solved today, physicians would still be overloaded by reporting requirements, Ross says.\u003c/p>\n\u003cp>“Documentation is still there, so blaming the computer for what insurers and the government are requiring you to do is misplacing the blame.\"\u003c/p>\n\u003cp>Large organizations such as Kaiser and Sutter Health have tackled some of the ease-of-use problems of the EHR, according to David Lansky, executive director of the Pacific Business Group on Health, a nonprofit consortium of private businesses and public agencies. That’s not so easy for smaller practices to do.\u003c/p>\n\u003cp>“In big medical groups, the burden on the individual doctor using EHR is lower already, it’s easier,” Lansky says. “But small-group practices and individuals have the same administrative burden as the large-group practices.\"\u003c/p>\n\u003cp>Lansky’s organization is encouraging smaller groups to join provider contracting networks — niche companies that will help them track patients, install reminder systems, streamline quality reporting and connect with health information exchanges — so smaller practices are not trying to solve the problem themselves.\u003c/p>\n\u003cp class=\"p1\">He says the idea is to get doctors to use their skills and training properly. “We have this cult of the physician, and we pay a lot of money to train them,” Lansky says, “yet they’re being asked to do work others can do very well.”\u003c/p>\n\u003cp>That rings true for Stanford medical school's Dean Minor. He’s sick of scrolling down page by page; sick of checking off a million little boxes. All the time spent on medical documentation cuts down on physician efficiency, he says.\u003c/p>\n\u003cp>If doctors are working so many extra hours entering data, they’re likely to cut down on their patient load to make up for it. That means they make less money, and the quality of patient visits continues to decline.\u003c/p>\n\u003cp>“It negatively impacts patient care, that’s the main thing,” he says.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This post had been edited.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dr. Lloyd Minor is frustrated. As dean of Stanford University Medical School, he says he can handle the constant cascade of large-scale challenges that come with his job. But what flummoxes him — drives him crazy, in fact — is something that occurs on a much smaller scale every time he examines someone in his clinical practice.\u003c/p>\n\u003cp>Minor cannot get the electronic health record, which provides a medical history of each patient, to work the way he wants. So he spends too much time wrestling with the computer and not enough directly communicating with his patient.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There is nothing more frustrating to a patient than talking to their doctor, wanting advice, and that provider is typing away and looking at a computer screen instead of the patient.' \u003ccite>Stanford medical school Dean Lloyd Minor\u003c/cite>\u003c/aside>\n\u003cp>“There is nothing more frustrating to a patient than talking to their doctor, wanting advice, and that provider is typing away and looking at a computer screen instead of the patient,\" Minor says. \"That most fundamental aspect of human communication, which is eye contact, now is being robbed from the medical encounter because of the electronic health record.”\u003c/p>\n\u003cp>He says EHRs now function primarily as documentation for billing and quality reporting rather than as an aid to doctors. Given their cumbersome nature, the EHR, long touted as a way to dramatically improve patient care, often does just the opposite, Minor believes.\u003c/p>\n\u003cp>“As a provider, you’re thinking about what do I need to document, or how do I navigate the EHR system, not how do I assimilate this information to provide the best care advice to the patient,\" he says. \"You’re thinking about the mechanics of the documentation, rather than the implications of the symptoms and findings.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Data Entry or Medicine?\u003c/strong>\u003c/p>\n\u003cp>Many physicians are fed up with the amount of documentation required in EHRs. Many feel they spend more time as data-entry clerks than as doctors.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Studies bear that out. Only 27 percent of a doctor’s time is spent with patients — and nearly half is spent on EHR and desk work, according to a \u003ca href=\"http://annals.org/aim/article/2546704/allocation-physician-time-ambulatory-practice-time-motion-study-4-specialties\">2016 study\u003c/a> published in \u003cem>Annals of Internal Medicine\u003c/em>. The study looked at physicians in family practice, internal medicine, cardiology and orthopedics. A smaller\u003ca href=\"http://content.healthaffairs.org/content/36/4/655.abstract\" target=\"_blank\" rel=\"noopener noreferrer\"> study\u003c/a> published in April by \u003cem>Health Affairs, \u003c/em>focusing on primary care physicians, also found about a 50-50 split in direct patient care time versus desktop medicine.\u003c/p>\n\u003cp>When doctors do spend time in the exam room with patients, they spent 37 percent of that time looking at the computer, the 2016 study estimated.\u003c/p>\n\u003cp>It's not just recording the patient's medical information that takes up time, according to Dr. Albert Chan, a family practice physician and the chief of digital patient experience for the Sutter Health Network. Doctors now need to report a series of quality measurements, provide proper insurance coding, and introduce more legalistic wording into the EHR to prevent lawsuits, he says.\u003c/p>\n\u003cp>There’s so much required paperwork and documentation now that primary care physicians spend an estimated one to two hours every night after work finishing up their data entry on EHRs, the study in \u003cem>Annals of Internal Medicine\u003c/em> found.\u003c/p>\n\u003cp>In the business, that’s called \"pajama time.\" In the real world, it's called one reason for burnout. Fifty-four \u003ca href=\"http://www.mayoclinicproceedings.org/article/S0025-6196(15)00716-8/abstract\">percent of physicians\u003c/a> reported at least one symptom of burnout, according to a recent Mayo Clinic study. A separate Mayo study found that a higher risk of burnout was \u003ca href=\"http://www.mayoclinicproceedings.org/article/S0025-6196(16)30215-4/abstract\">linked\u003c/a> to frustrations with the data-entry workload of EHRs.\u003c/p>\n\u003cp>\u003cstrong>A Powerful Tool\u003c/strong>\u003c/p>\n\u003cp>When the Affordable Care Act and the 2009 \u003ca href=\"https://www.hhs.gov/hipaa/for-professionals/special-topics/HITECH-act-enforcement-interim-final-rule/index.html\">HITECH Act\u003c/a> required electronic health records to be incorporated into medical practices, Dr. Chan says, many medical groups and physicians rushed to install EHR systems. That means the search function may not work well, or the system may require multiple keystrokes and screens to accomplish common tasks.\u003c/p>\n\u003cp>(Eric Helsher, vice president of client success at Epic, one of the leading EHR providers, responded that customer feedback \"drives our continuous development, with the aim of making the software a joy to use, helping them get value from their data, and facilitating collaboration across the Epic community.\")\u003c/p>\n\u003caside class=\"pullquote alignright\">'I remember back in the old days of paper medical records … not being able to find a patient’s chart was just maddening. We don’t have that anymore.'\u003ccite>Dr. Albert Chan\u003c/cite>\u003c/aside>\n\u003cp>But, Chan says, as flawed as the EHR is, it would be wise not to throw the baby out with the bathwater.\u003c/p>\n\u003cp>“It’s important to note that the EHR is an incredibly powerful tool,” he says. “There are tremendous things you can do with the EHR. You can automatically alert patients about their conditions, for example; you can personalize their care. The lesson I’ve learned is that the EHR requires work to make it work.”\u003c/p>\n\u003cp>Chan says he would never want to go back to the paper-only era.\u003c/p>\n\u003cp>“I remember back in the old days of paper medical records ... not being able to find a patient’s chart was just maddening. We don’t have that anymore.\"\u003c/p>\n\u003cp>\u003cstrong>The Interoperability Problem\u003c/strong>\u003c/p>\n\u003cp>Current design problems can be corrected over time by EHR system vendors, Chan says, and he expects the furor over EHRs to dissipate as annoying and time-consuming glitches are altered.\u003c/p>\n\u003cp>One of the big complaints doctors have had is the lack of interoperability between EHR systems, so that hospitals, medical groups, insurers and physicians can't easily share patient data with each other. In the San Francisco Bay Area, some sharing is now starting to occur among institutions like Sutter Health, Kaiser, UCSF and Stanford that all that use the EHR system Epic.\u003c/p>\n\u003cp>“We’re starting to see fruits of our labor to connect data,” Chan says.\u003c/p>\n\u003cp>But that may be a glass-half-full view, according to Will Ross, a project manager at Redwood MedNet, a nonprofit health information exchange based in Ukiah. Ross has been working on trying to improve the interoperability of EHRs for two decades, and says the progress has been plodding, to say the least.\u003c/p>\n\u003cp>Ross says EHRs took a turn for the worse after Congress tried to get physicians to prove they were meaningfully using them in the HITECH Act of 2009. Those rules, which he calls arbitrary, made the whole process much more complex and time-consuming.\u003c/p>\n\u003cp>\u003cspan style=\"color: #2b2b2b\">“That transformed all of this into busy work and nonsense,” Ross says. \u003c/span>\u003c/p>\n\u003cp>The obvious solution is for vendors to improve their products, he says. But that’s easier proposed than accomplished.\u003c/p>\n\u003cp>“A lot of the EHRs are cash cows to their owners,” Ross says. “They make their money on installing them, not changing them.”\u003c/p>\n\u003cp>Even if the complex problems of interoperability and ease of use were magically solved today, physicians would still be overloaded by reporting requirements, Ross says.\u003c/p>\n\u003cp>“Documentation is still there, so blaming the computer for what insurers and the government are requiring you to do is misplacing the blame.\"\u003c/p>\n\u003cp>Large organizations such as Kaiser and Sutter Health have tackled some of the ease-of-use problems of the EHR, according to David Lansky, executive director of the Pacific Business Group on Health, a nonprofit consortium of private businesses and public agencies. That’s not so easy for smaller practices to do.\u003c/p>\n\u003cp>“In big medical groups, the burden on the individual doctor using EHR is lower already, it’s easier,” Lansky says. “But small-group practices and individuals have the same administrative burden as the large-group practices.\"\u003c/p>\n\u003cp>Lansky’s organization is encouraging smaller groups to join provider contracting networks — niche companies that will help them track patients, install reminder systems, streamline quality reporting and connect with health information exchanges — so smaller practices are not trying to solve the problem themselves.\u003c/p>\n\u003cp class=\"p1\">He says the idea is to get doctors to use their skills and training properly. “We have this cult of the physician, and we pay a lot of money to train them,” Lansky says, “yet they’re being asked to do work others can do very well.”\u003c/p>\n\u003cp>That rings true for Stanford medical school's Dean Minor. He’s sick of scrolling down page by page; sick of checking off a million little boxes. All the time spent on medical documentation cuts down on physician efficiency, he says.\u003c/p>\n\u003cp>If doctors are working so many extra hours entering data, they’re likely to cut down on their patient load to make up for it. That means they make less money, and the quality of patient visits continues to decline.\u003c/p>\n\u003cp>“It negatively impacts patient care, that’s the main thing,” he says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Hard Times May Contribute to High Dementia Rate in Blacks",
"title": "Hard Times May Contribute to High Dementia Rate in Blacks",
"headTitle": "Future of You | KQED Future of You | KQED Science",
"content": "\u003cp>Harsh life experiences appear to leave African-Americans vulnerable to Alzheimer's and other forms of dementia, researchers \u003ca href=\"https://www.alz.org/aaic/2017_news_releases.asp\">reported\u003c/a> Sunday at the Alzheimer's Association International Conference in London.\u003c/p>\n\u003cp>Several teams presented evidence that poverty, disadvantage and stressful life events are strongly associated with cognitive problems in middle age and dementia later in life among African-Americans.\u003c/p>\n\u003cp>The findings could help explain why African-Americans are twice as likely as white Americans to develop dementia. And the research suggests genetic factors are not a major contributor.\u003c/p>\n\u003cp>\"The increased risk seems to be a matter of experience rather than ancestry,\" says \u003ca href=\"http://obgyn.wisc.edu/directory/detail.aspx?id=321\">Megan Zuelsdorff\u003c/a>, a postdoctoral fellow in the Health Disparities Research Scholars Program at the University of Wisconsin-Madison.\u003c/p>\n\u003cp>Scientists have struggled to understand why African-Americans are so likely to develop dementia. They are more likely to have conditions like high blood pressure and diabetes, which can affect the brain. And \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4084964/\">previous research\u003c/a> has found some evidence that African-Americans are more likely to carry genes that raise the risk.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But more recent studies suggest those explanations are incomplete, says \u003ca href=\"https://divisionofresearch.kaiserpermanente.org/researchers/whitmer-rachel\">Rachel Whitmer\u003c/a>, an epidemiologist with Kaiser Permanente's Division of Research in Northern California.\u003c/p>\n\u003cp>Whitmer has been involved in several studies that accounted for genetic and disease risks when comparing dementia in white and black Americans. \"And we still saw these [racial] differences,\" she says. \"So there is still something there that we are trying to get at.\"\u003c/p>\n\u003cp>The research presented at the Alzheimer's conference suggests the missing factors involve adverse life experiences beginning in childhood. These experiences have already been \u003ca href=\"http://www.ajpmonline.org/article/S0749-3797(98)00017-8/abstract\">linked\u003c/a> to a range of diseases, including heart disease and cancer.\u003c/p>\n\u003cp>\"We're starting to understand how early life stress and early life deprivation can increase your risk of a number of health outcomes in late life,\" Whitmer says. \"And the latest thing is understanding how and why that might affect the brain.\"\u003c/p>\n\u003cp>Whitmer was part of a team that presented results of a study of more than 6,000 Kaiser Permanente health plan members, most born in the 1920s.\u003c/p>\n\u003cp>The team wanted to know whether people who grew up in harsher conditions were more likely to develop dementia. So they looked at people who'd been born in states with high infant mortality rates — an indicator of social problems like poverty and limited access to medical care.\u003c/p>\n\u003cp>White people's risk of dementia wasn't affected by their place of birth. But black people were 40 percent more likely to develop dementia if they'd been born in a state with high infant mortality.\u003c/p>\n\u003cp>\"These people left the state and subsequently moved to northern California, yet there was still this very robust association between being born in a state with high infant mortality and increased risk of dementia,\" Whitmer says.\u003c/p>\n\u003cp>Scientists from the University of Wisconsin presented results of a study of the link between stressful life events and mental function in middle age. They studied more than 1,300 people in their 50s and 60s, including 82 African-Americans.\u003c/p>\n\u003cp>Stressful experiences included having a parent with a drinking problem, financial insecurity, legal issues, divorce, being fired from a job, and the death of a child.\u003c/p>\n\u003cp>African-Americans reported 60 percent more of these stressful events than white Americans. But that was only part of the difference, Zuelsdorff says.\u003c/p>\n\u003cp>\"The impact of these stressful events was stronger in African-Americans than it was in non-Hispanic white participants,\" she says.\u003c/p>\n\u003cp>The researchers discovered this by administering tests that reveal the brain's speed and flexibility in doing certain tasks. These abilities normally decline with age. So the team looked for evidence that stressful events were accelerating this decline.\u003c/p>\n\u003cp>And they found that in white participants, each stressful event added about a year and a half to normal brain aging. But in African-Americans, each event aged the brain an extra four years.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The next challenge for researchers is to figure out precisely how adverse life experiences are changing the brain, Zuelsdorff says. That will mean looking at the effects of stress hormones and seeing whether stress leads to inflammation in the brain, something that has been associated with Alzheimer's.\u003c/p>\n\u003chr>\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=Stress+And+Poverty+May+Explain+High+Rates+Of+Dementia+In+African-Americans&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Harsh life experiences appear to leave African-Americans vulnerable to Alzheimer's and other forms of dementia, researchers \u003ca href=\"https://www.alz.org/aaic/2017_news_releases.asp\">reported\u003c/a> Sunday at the Alzheimer's Association International Conference in London.\u003c/p>\n\u003cp>Several teams presented evidence that poverty, disadvantage and stressful life events are strongly associated with cognitive problems in middle age and dementia later in life among African-Americans.\u003c/p>\n\u003cp>The findings could help explain why African-Americans are twice as likely as white Americans to develop dementia. And the research suggests genetic factors are not a major contributor.\u003c/p>\n\u003cp>\"The increased risk seems to be a matter of experience rather than ancestry,\" says \u003ca href=\"http://obgyn.wisc.edu/directory/detail.aspx?id=321\">Megan Zuelsdorff\u003c/a>, a postdoctoral fellow in the Health Disparities Research Scholars Program at the University of Wisconsin-Madison.\u003c/p>\n\u003cp>Scientists have struggled to understand why African-Americans are so likely to develop dementia. They are more likely to have conditions like high blood pressure and diabetes, which can affect the brain. And \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4084964/\">previous research\u003c/a> has found some evidence that African-Americans are more likely to carry genes that raise the risk.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But more recent studies suggest those explanations are incomplete, says \u003ca href=\"https://divisionofresearch.kaiserpermanente.org/researchers/whitmer-rachel\">Rachel Whitmer\u003c/a>, an epidemiologist with Kaiser Permanente's Division of Research in Northern California.\u003c/p>\n\u003cp>Whitmer has been involved in several studies that accounted for genetic and disease risks when comparing dementia in white and black Americans. \"And we still saw these [racial] differences,\" she says. \"So there is still something there that we are trying to get at.\"\u003c/p>\n\u003cp>The research presented at the Alzheimer's conference suggests the missing factors involve adverse life experiences beginning in childhood. These experiences have already been \u003ca href=\"http://www.ajpmonline.org/article/S0749-3797(98)00017-8/abstract\">linked\u003c/a> to a range of diseases, including heart disease and cancer.\u003c/p>\n\u003cp>\"We're starting to understand how early life stress and early life deprivation can increase your risk of a number of health outcomes in late life,\" Whitmer says. \"And the latest thing is understanding how and why that might affect the brain.\"\u003c/p>\n\u003cp>Whitmer was part of a team that presented results of a study of more than 6,000 Kaiser Permanente health plan members, most born in the 1920s.\u003c/p>\n\u003cp>The team wanted to know whether people who grew up in harsher conditions were more likely to develop dementia. So they looked at people who'd been born in states with high infant mortality rates — an indicator of social problems like poverty and limited access to medical care.\u003c/p>\n\u003cp>White people's risk of dementia wasn't affected by their place of birth. But black people were 40 percent more likely to develop dementia if they'd been born in a state with high infant mortality.\u003c/p>\n\u003cp>\"These people left the state and subsequently moved to northern California, yet there was still this very robust association between being born in a state with high infant mortality and increased risk of dementia,\" Whitmer says.\u003c/p>\n\u003cp>Scientists from the University of Wisconsin presented results of a study of the link between stressful life events and mental function in middle age. They studied more than 1,300 people in their 50s and 60s, including 82 African-Americans.\u003c/p>\n\u003cp>Stressful experiences included having a parent with a drinking problem, financial insecurity, legal issues, divorce, being fired from a job, and the death of a child.\u003c/p>\n\u003cp>African-Americans reported 60 percent more of these stressful events than white Americans. But that was only part of the difference, Zuelsdorff says.\u003c/p>\n\u003cp>\"The impact of these stressful events was stronger in African-Americans than it was in non-Hispanic white participants,\" she says.\u003c/p>\n\u003cp>The researchers discovered this by administering tests that reveal the brain's speed and flexibility in doing certain tasks. These abilities normally decline with age. So the team looked for evidence that stressful events were accelerating this decline.\u003c/p>\n\u003cp>And they found that in white participants, each stressful event added about a year and a half to normal brain aging. But in African-Americans, each event aged the brain an extra four years.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The next challenge for researchers is to figure out precisely how adverse life experiences are changing the brain, Zuelsdorff says. That will mean looking at the effects of stress hormones and seeing whether stress leads to inflammation in the brain, something that has been associated with Alzheimer's.\u003c/p>\n\u003chr>\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=Stress+And+Poverty+May+Explain+High+Rates+Of+Dementia+In+African-Americans&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The first thing I do is put on Google Glass, its tiny camera situated over my right eye.\u003c/p>\n\u003cp>A MiFi — a personal wireless hotspot — goes into my pocket. I pop in earbuds connected to a smartphone. Then I close my eyes. I am trying to simulate, for this demonstration, what it's like to navigate without being able to see.\u003c/p>\n\u003caside class=\"alignright\">Finding a cafe, describing a museum exhibit, or helping someone fold origami -- a new service guides blind people by connecting them with live agents who view their surroundings through smartglasses like Google Glass.\u003c/aside>\n\u003cp>All geared up, I am now ready for my test run. \u003ca href=\"https://aira.io/#service\" target=\"_blank\" rel=\"noopener noreferrer\">Aira\u003c/a>, based in San Diego, is a paid service that offers \"visual interpretation\" for the blind and visually impaired. With a smartphone app, Aira users connect with a remote agent who sees through any one of four types of smartglasses and describes the client's environment to her. Employees say the service, which became available in March, is like \u003ca href=\"https://www.theatlantic.com/business/archive/2016/04/onstar/480471/\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan style=\"color: #24890d\">OnStar\u003c/span>\u003c/a>\u003cspan class=\"m-6819587429447741435apple-converted-space\"> \u003c/span>for the blind — or maybe like having your own personal “\u003ca href=\"http://24.wikia.com/wiki/Chloe_O%27Brian\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan style=\"color: #24890d\">Chloe\u003c/span>\u003c/a>,” the intelligence analyst on the TV show \"24\" who often remotely assists hero Jack Bauer.\u003c/p>\n\u003cp>I summon \u003cem>my\u003c/em> Chloe using the Aira interface, which consists of a giant blue button. All I have to do is tap anywhere on the phone's display.\u003c/p>\n\u003cp>“Thank you for calling Aira,” a friendly voice says. “How can I help you?”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>This is Andy Del Valle, my agent, and, for as long as I need him, my long-distance eyes. Del Valle — sitting in front of his laptop — can now see through my Google Glass feed. As I scan my surroundings, he sees Amy Bernal, the company’s vice president of customer experience, who has helped get me outfitted; then I lower my head so he can see the path before my feet.\u003c/p>\n\u003cp>Thanks to my GPS connection, Del Valle is also able to locate me using Google Maps. We’re on the campus of San Francisco State University, for me unfamiliar turf. I ask him to direct me to the nearest cafe.\u003c/p>\n\u003cp>Within seconds, he's produced a route.\u003c/p>\n\u003cp>Granted, we’re approximating the Aira experience; I’m a sighted person with no orientation and mobility training, and I'm not using a dog or cane, as regular users do. I am, to put it gently, perhaps not the most graceful mover Del Valle has ever assisted. But he is cheerful as he offers me directions, like to turn left toward 11 o’clock. As I walk, he offers environmental cues, telling me to turn when I feel the slope of the sidewalk level out, or when I can feel the sun as I emerge from a nearby building’s shadow.\u003c/p>\n\u003cp>I quickly grow to trust his voice in my ear.\u003c/p>\n\u003cp>After a short walk, I hear music and a cash register — we’ve arrived at our destination. I want to order an iced coffee; Del Valle asks me to turn so he can scan a posted menu.\u003c/p>\n\u003cfigure id=\"attachment_424306\" class=\"wp-caption alignleft\" style=\"max-width: 292px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/07/AiraPhoto1-e1499819013990.jpg\">\u003cimg class=\"wp-image-424306\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/07/AiraPhoto1-1020x1360.jpg\" alt=\"\" width=\"292\" height=\"390\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Orientation and mobility specialist using Aira at the International Mobility Conference in 2016. (Courtesy Aira)\u003c/figcaption>\u003c/figure>\n\u003cp>“Taking picture,” an automated voice intones as Del Valle grabs a shot from the camera feed and zooms in. He also pulls up a more detailed menu online and gives me a rundown of options — espresso? Blended java drink? — and a headcount of how many people are in line.\u003c/p>\n\u003cp>Del Valle is among the 33 agents working that day, covering customers across the United States. The service runs from 4 a.m. to 10 p.m., Pacific time or 7 a.m.to 1 a.m. Eastern, and clients subscribe to a monthly plan or a package of minutes. (The monthly plans go from $89 to $329, depending on \u003ca href=\"https://aira.io/plans\" target=\"_blank\" rel=\"noopener noreferrer\">level of service\u003c/a>.\u003cstrong>) \u003c/strong>Each user gets a personal profile that lists details like allergies, so an agent can warn someone allergic to shellfish, for example, that there’s shrimp salad on the potluck table. The company says it has \"hundreds\" of clients.\u003c/p>\n\u003cp>Bernal, the customer experience VP, is also an agent, and she's set up shop for the afternoon in the campus’ special education department. The calls she fields run from the mundane (a man looking for a trash can while cleaning up after his guide dog) to the complicated (a lost woman with bad directions from a passerby can't find her bus stop.) “You'll never know until you pick up the call,” Bernal says.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There are hundreds of thousands of very clever and efficient solutions that don’t involve sight.'\u003ccite>Bryan Bashin, LightHouse for the Blind and Visually Impaired\u003c/cite>\u003c/aside>\n\u003cp>Sometimes they get a strange one — Bernal recalls an agent being asked to help a user do origami, having to hastily grab some paper and fold along. But most are the stuff of ordinary life: setting up the cable box, checking the expiration date on the milk, matching a shirt and tie.\u003c/p>\n\u003cp>Tiffany Manosh, president of the River City Chapter of the National Federation of the Blind, in Sacramento, has been using Aira for about a year. She likes it for tasks that involve browsing, like shopping. Sure, she could ask a clerk for help, but “they go directly to whatever item we’ve asked for,” she says. “Well, what if I want to see maybe what’s on sale?”\u003c/p>\n\u003cp>At a natural history museum, she once had an agent describe the exhibits. A docent could have done that — if she’d booked one a month in advance. “Sighted people don’t have to do that, so why should we?” she asks. “Aira gives us the freedom to be able to really integrate and do things at our own time — when we want to, and where we want to go.” An agent even helped her find her father’s gravesite at Arlington National Cemetery. “It was a very emotional and just phenomenal feeling to be able to do it on my own time,” says Manosh.\u003c/p>\n\u003cp>Aira, based in San Diego, test-launched three years ago with 200 beta users. Among them was Victorville resident Michael Hingson, who has been blind since birth and recently became the company’s director of strategic sales. “Aira is not helping a blind person see,” Hingson says. “Aira is giving me information that the sighted world has not learned to provide to us.”\u003c/p>\n\u003cp>For example, on emails or websites, those who are visually impaired might use a screen reader that speaks the text aloud. For printed materials, they might try a phone app like the \u003ca href=\"http://www.knfbreader.com/\" target=\"_blank\" rel=\"noopener noreferrer\">KNFB Reader\u003c/a>, which translates text using optical character recognition. But those don’t cover everything. Hingson recalls trying to assemble a laundry cart and discovering the instructions were in pictures, which his reader couldn’t decipher. So he called Aira. The agent zoomed in on the cart’s bar code and found assembly instructions on the internet. In a half-hour, Hingson said, “I had a working laundry cart.”\u003c/p>\n\u003cp>Aira agents are trained to give factual information without offering advice, deferring to the user’s orientation and mobility training. “What I don’t want is an agent telling me it’s safe to cross the street — because the agent doesn't \u003cem>know\u003c/em> it’s safe to cross the street,” says Hingson. “That should be my choice.”\u003c/p>\n\u003cp>Learning to give the right information is a balancing act, says Bernal. “When agents first start, they feel like they have to say every little thing that is in any remote path of a user,” she says. But a person’s dog or cane will help them avoid obstacles. Instead, it might be more useful to offer social information, like where the empty seat in the room is, or whether the driver greeting you at the airport is smiling and waving you over.\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=Jxkq-Ta0tv4&ab_channel=KansasCityStarVideo\u003c/p>\n\u003cp>\u003cstrong>Free Services\u003c/strong>\u003c/p>\n\u003cp>Bryan Bashin, CEO of the training and advocacy group \u003ca href=\"http://lighthouse-sf.org/\">LightHouse for the Blind and Visually Impaired\u003c/a>, in San Francisco, has tried Aira, and points out that while it’s the first such for-profit service, it’s not the first visual interpretation app.\u003c/p>\n\u003cp>Once the iPhone debuted, he says, “a lot of people had the same idea at the same time.” He sometimes uses \u003ca href=\"http://bemyeyes.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Be My Eyes\u003c/a>, a free worldwide service powered by volunteers who assist by cellphone video chat. The free app \u003ca href=\"http://taptapseeapp.com/\" target=\"_blank\" rel=\"noopener noreferrer\">TapTapSee\u003c/a> identifies the content of still photos and speaks it aloud. And people can also improvise by simply Facetiming with friends or relatives. Bashin says these solutions are more accessible to low-income people than Aira’s paid service, although they lack some of the features — smartglasses, GPS mapping, agents trained to work with the blind. But what they all have in common, Bashin says, “is the world is still not 100 percent accessible for blind people.”\u003c/p>\n\u003cp>Bashin says that dialing a sighted person can be especially helpful when optical character readers fail, noting they are often thwarted by glare (think thermostat screens) or fancy script (think wine bottle labels or handwritten mail). But Bashin cautions against over-reliance on visual interpreters.\u003c/p>\n\u003cp>“When somebody first becomes blind, they think that the answers to the obstacles of blindness are to have someone see for you,” he says. Yet a person can skillfully use other senses, like touch and hearing, and low-tech solutions, like Braille. “There are hundreds of thousands of very clever and efficient solutions that don’t involve sight,” Bashin continues. “That’s what we teach at the LightHouse, and that’s what will get us through the day with a little bit of grace, so that we can reserve these technologies for when they really count. I'm a little bit afraid that new students will avoid learning what they need to learn to be competent blind people.”\u003c/p>\n\u003cp>While some Aira users prefer a paid agent — often for fear of imposing on others’ time — Bashin doesn't mind asking a stranger to steer him toward the check-in desk or describe what’s on the buffet, because that’s a social activity. “Yes, I’ll learn where the strawberries are, but I’ll also learn about \u003cem>them\u003c/em>. Now I’ve made a bridge to another person instead of isolating myself talking into a headset and some goggles,” he says.\u003c/p>\n\u003cp>But Manosh, from the Sacramento National Federation of the Blind chapter, disagrees that the service will encourage isolation or over-reliance. She calls Aira “a tool in my toolbox” that also includes her cane and her mobility training. “You don’t have to rely \u003cem>just\u003c/em> on it, and that’s the beauty of it,” she says.\u003c/p>\n\u003cfigure id=\"attachment_418103\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/06/Aira5.jpg\">\u003cimg class=\"wp-image-418103 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/06/Aira5-1020x680.jpg\" alt=\"\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5.jpg 1600w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Amy Bernal, Aira's vice president of customer experience, demonstrates what agents connected to the company's clients see on their screen -- a Google Map of the user's location with an inset of the video stream coming from their glasses or phone. (Kara Platoni/KQED)\u003c/figcaption>\u003c/figure>\n\u003caside class=\"pullquote alignright\">'I’ve had this experience where I’ve actually gone to an airport and thought ‘How do I know this airport? I’ve never been here before. You realize that you’ve been an agent for a user in an airport. You are like, ‘Oh, I’ve been in this terminal, but I haven’t \u003cem>been in this terminal\u003c/em>.’ It’s very déjà vu.'\u003ccite>Amy Bernal, Aira’s vice president of customer experience\u003c/cite>\u003c/aside>\n\u003cp>The next phase of Aira’s development will be to turn some tasks over to a machine. At first, Bernal says, the AI will likely assist the agent. Later, it might guide people through routine tasks, like daily commutes. Or it might replace agents in sensitive situations, while users are in restrooms or dealing with finances, for instance. (Currently, users can go into “privacy mode” with no video or audio, or hang up and call back.)\u003c/p>\n\u003cp>Hingson imagines sending a shopping list to Aira, and having the AI map his path through the store and check barcodes to confirm that he's grabbed the right items. He’d also like Aira integration with Facebook, so the system could use facial recognition to let him know if his friends are nearby.\u003c/p>\n\u003cp>For now, employees like Bernal are happy to assist with just about everything, although she notes that there’s one oddly sci-fi effect of seeing the world through someone else’s lenses.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“I’ve had this experience where I’ve actually gone to an airport and thought ‘How do I know this airport? I’ve never been here before,’ ” she says. “But you realize that you’ve been an agent for a user in an airport. You are like, ‘Oh, I’ve been in this terminal, but I haven’t \u003cem>been in this terminal\u003c/em>.’ It’s very déjà vu.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The first thing I do is put on Google Glass, its tiny camera situated over my right eye.\u003c/p>\n\u003cp>A MiFi — a personal wireless hotspot — goes into my pocket. I pop in earbuds connected to a smartphone. Then I close my eyes. I am trying to simulate, for this demonstration, what it's like to navigate without being able to see.\u003c/p>\n\u003caside class=\"alignright\">Finding a cafe, describing a museum exhibit, or helping someone fold origami -- a new service guides blind people by connecting them with live agents who view their surroundings through smartglasses like Google Glass.\u003c/aside>\n\u003cp>All geared up, I am now ready for my test run. \u003ca href=\"https://aira.io/#service\" target=\"_blank\" rel=\"noopener noreferrer\">Aira\u003c/a>, based in San Diego, is a paid service that offers \"visual interpretation\" for the blind and visually impaired. With a smartphone app, Aira users connect with a remote agent who sees through any one of four types of smartglasses and describes the client's environment to her. Employees say the service, which became available in March, is like \u003ca href=\"https://www.theatlantic.com/business/archive/2016/04/onstar/480471/\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan style=\"color: #24890d\">OnStar\u003c/span>\u003c/a>\u003cspan class=\"m-6819587429447741435apple-converted-space\"> \u003c/span>for the blind — or maybe like having your own personal “\u003ca href=\"http://24.wikia.com/wiki/Chloe_O%27Brian\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cspan style=\"color: #24890d\">Chloe\u003c/span>\u003c/a>,” the intelligence analyst on the TV show \"24\" who often remotely assists hero Jack Bauer.\u003c/p>\n\u003cp>I summon \u003cem>my\u003c/em> Chloe using the Aira interface, which consists of a giant blue button. All I have to do is tap anywhere on the phone's display.\u003c/p>\n\u003cp>“Thank you for calling Aira,” a friendly voice says. “How can I help you?”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This is Andy Del Valle, my agent, and, for as long as I need him, my long-distance eyes. Del Valle — sitting in front of his laptop — can now see through my Google Glass feed. As I scan my surroundings, he sees Amy Bernal, the company’s vice president of customer experience, who has helped get me outfitted; then I lower my head so he can see the path before my feet.\u003c/p>\n\u003cp>Thanks to my GPS connection, Del Valle is also able to locate me using Google Maps. We’re on the campus of San Francisco State University, for me unfamiliar turf. I ask him to direct me to the nearest cafe.\u003c/p>\n\u003cp>Within seconds, he's produced a route.\u003c/p>\n\u003cp>Granted, we’re approximating the Aira experience; I’m a sighted person with no orientation and mobility training, and I'm not using a dog or cane, as regular users do. I am, to put it gently, perhaps not the most graceful mover Del Valle has ever assisted. But he is cheerful as he offers me directions, like to turn left toward 11 o’clock. As I walk, he offers environmental cues, telling me to turn when I feel the slope of the sidewalk level out, or when I can feel the sun as I emerge from a nearby building’s shadow.\u003c/p>\n\u003cp>I quickly grow to trust his voice in my ear.\u003c/p>\n\u003cp>After a short walk, I hear music and a cash register — we’ve arrived at our destination. I want to order an iced coffee; Del Valle asks me to turn so he can scan a posted menu.\u003c/p>\n\u003cfigure id=\"attachment_424306\" class=\"wp-caption alignleft\" style=\"max-width: 292px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/07/AiraPhoto1-e1499819013990.jpg\">\u003cimg class=\"wp-image-424306\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/07/AiraPhoto1-1020x1360.jpg\" alt=\"\" width=\"292\" height=\"390\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Orientation and mobility specialist using Aira at the International Mobility Conference in 2016. (Courtesy Aira)\u003c/figcaption>\u003c/figure>\n\u003cp>“Taking picture,” an automated voice intones as Del Valle grabs a shot from the camera feed and zooms in. He also pulls up a more detailed menu online and gives me a rundown of options — espresso? Blended java drink? — and a headcount of how many people are in line.\u003c/p>\n\u003cp>Del Valle is among the 33 agents working that day, covering customers across the United States. The service runs from 4 a.m. to 10 p.m., Pacific time or 7 a.m.to 1 a.m. Eastern, and clients subscribe to a monthly plan or a package of minutes. (The monthly plans go from $89 to $329, depending on \u003ca href=\"https://aira.io/plans\" target=\"_blank\" rel=\"noopener noreferrer\">level of service\u003c/a>.\u003cstrong>) \u003c/strong>Each user gets a personal profile that lists details like allergies, so an agent can warn someone allergic to shellfish, for example, that there’s shrimp salad on the potluck table. The company says it has \"hundreds\" of clients.\u003c/p>\n\u003cp>Bernal, the customer experience VP, is also an agent, and she's set up shop for the afternoon in the campus’ special education department. The calls she fields run from the mundane (a man looking for a trash can while cleaning up after his guide dog) to the complicated (a lost woman with bad directions from a passerby can't find her bus stop.) “You'll never know until you pick up the call,” Bernal says.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There are hundreds of thousands of very clever and efficient solutions that don’t involve sight.'\u003ccite>Bryan Bashin, LightHouse for the Blind and Visually Impaired\u003c/cite>\u003c/aside>\n\u003cp>Sometimes they get a strange one — Bernal recalls an agent being asked to help a user do origami, having to hastily grab some paper and fold along. But most are the stuff of ordinary life: setting up the cable box, checking the expiration date on the milk, matching a shirt and tie.\u003c/p>\n\u003cp>Tiffany Manosh, president of the River City Chapter of the National Federation of the Blind, in Sacramento, has been using Aira for about a year. She likes it for tasks that involve browsing, like shopping. Sure, she could ask a clerk for help, but “they go directly to whatever item we’ve asked for,” she says. “Well, what if I want to see maybe what’s on sale?”\u003c/p>\n\u003cp>At a natural history museum, she once had an agent describe the exhibits. A docent could have done that — if she’d booked one a month in advance. “Sighted people don’t have to do that, so why should we?” she asks. “Aira gives us the freedom to be able to really integrate and do things at our own time — when we want to, and where we want to go.” An agent even helped her find her father’s gravesite at Arlington National Cemetery. “It was a very emotional and just phenomenal feeling to be able to do it on my own time,” says Manosh.\u003c/p>\n\u003cp>Aira, based in San Diego, test-launched three years ago with 200 beta users. Among them was Victorville resident Michael Hingson, who has been blind since birth and recently became the company’s director of strategic sales. “Aira is not helping a blind person see,” Hingson says. “Aira is giving me information that the sighted world has not learned to provide to us.”\u003c/p>\n\u003cp>For example, on emails or websites, those who are visually impaired might use a screen reader that speaks the text aloud. For printed materials, they might try a phone app like the \u003ca href=\"http://www.knfbreader.com/\" target=\"_blank\" rel=\"noopener noreferrer\">KNFB Reader\u003c/a>, which translates text using optical character recognition. But those don’t cover everything. Hingson recalls trying to assemble a laundry cart and discovering the instructions were in pictures, which his reader couldn’t decipher. So he called Aira. The agent zoomed in on the cart’s bar code and found assembly instructions on the internet. In a half-hour, Hingson said, “I had a working laundry cart.”\u003c/p>\n\u003cp>Aira agents are trained to give factual information without offering advice, deferring to the user’s orientation and mobility training. “What I don’t want is an agent telling me it’s safe to cross the street — because the agent doesn't \u003cem>know\u003c/em> it’s safe to cross the street,” says Hingson. “That should be my choice.”\u003c/p>\n\u003cp>Learning to give the right information is a balancing act, says Bernal. “When agents first start, they feel like they have to say every little thing that is in any remote path of a user,” she says. But a person’s dog or cane will help them avoid obstacles. Instead, it might be more useful to offer social information, like where the empty seat in the room is, or whether the driver greeting you at the airport is smiling and waving you over.\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/Jxkq-Ta0tv4'\n title='//www.youtube.com/embed/Jxkq-Ta0tv4'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>\u003cstrong>Free Services\u003c/strong>\u003c/p>\n\u003cp>Bryan Bashin, CEO of the training and advocacy group \u003ca href=\"http://lighthouse-sf.org/\">LightHouse for the Blind and Visually Impaired\u003c/a>, in San Francisco, has tried Aira, and points out that while it’s the first such for-profit service, it’s not the first visual interpretation app.\u003c/p>\n\u003cp>Once the iPhone debuted, he says, “a lot of people had the same idea at the same time.” He sometimes uses \u003ca href=\"http://bemyeyes.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Be My Eyes\u003c/a>, a free worldwide service powered by volunteers who assist by cellphone video chat. The free app \u003ca href=\"http://taptapseeapp.com/\" target=\"_blank\" rel=\"noopener noreferrer\">TapTapSee\u003c/a> identifies the content of still photos and speaks it aloud. And people can also improvise by simply Facetiming with friends or relatives. Bashin says these solutions are more accessible to low-income people than Aira’s paid service, although they lack some of the features — smartglasses, GPS mapping, agents trained to work with the blind. But what they all have in common, Bashin says, “is the world is still not 100 percent accessible for blind people.”\u003c/p>\n\u003cp>Bashin says that dialing a sighted person can be especially helpful when optical character readers fail, noting they are often thwarted by glare (think thermostat screens) or fancy script (think wine bottle labels or handwritten mail). But Bashin cautions against over-reliance on visual interpreters.\u003c/p>\n\u003cp>“When somebody first becomes blind, they think that the answers to the obstacles of blindness are to have someone see for you,” he says. Yet a person can skillfully use other senses, like touch and hearing, and low-tech solutions, like Braille. “There are hundreds of thousands of very clever and efficient solutions that don’t involve sight,” Bashin continues. “That’s what we teach at the LightHouse, and that’s what will get us through the day with a little bit of grace, so that we can reserve these technologies for when they really count. I'm a little bit afraid that new students will avoid learning what they need to learn to be competent blind people.”\u003c/p>\n\u003cp>While some Aira users prefer a paid agent — often for fear of imposing on others’ time — Bashin doesn't mind asking a stranger to steer him toward the check-in desk or describe what’s on the buffet, because that’s a social activity. “Yes, I’ll learn where the strawberries are, but I’ll also learn about \u003cem>them\u003c/em>. Now I’ve made a bridge to another person instead of isolating myself talking into a headset and some goggles,” he says.\u003c/p>\n\u003cp>But Manosh, from the Sacramento National Federation of the Blind chapter, disagrees that the service will encourage isolation or over-reliance. She calls Aira “a tool in my toolbox” that also includes her cane and her mobility training. “You don’t have to rely \u003cem>just\u003c/em> on it, and that’s the beauty of it,” she says.\u003c/p>\n\u003cfigure id=\"attachment_418103\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/06/Aira5.jpg\">\u003cimg class=\"wp-image-418103 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/06/Aira5-1020x680.jpg\" alt=\"\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5-768x512.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5-960x640.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5-520x347.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/06/Aira5.jpg 1600w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Amy Bernal, Aira's vice president of customer experience, demonstrates what agents connected to the company's clients see on their screen -- a Google Map of the user's location with an inset of the video stream coming from their glasses or phone. (Kara Platoni/KQED)\u003c/figcaption>\u003c/figure>\n\u003caside class=\"pullquote alignright\">'I’ve had this experience where I’ve actually gone to an airport and thought ‘How do I know this airport? I’ve never been here before. You realize that you’ve been an agent for a user in an airport. You are like, ‘Oh, I’ve been in this terminal, but I haven’t \u003cem>been in this terminal\u003c/em>.’ It’s very déjà vu.'\u003ccite>Amy Bernal, Aira’s vice president of customer experience\u003c/cite>\u003c/aside>\n\u003cp>The next phase of Aira’s development will be to turn some tasks over to a machine. At first, Bernal says, the AI will likely assist the agent. Later, it might guide people through routine tasks, like daily commutes. Or it might replace agents in sensitive situations, while users are in restrooms or dealing with finances, for instance. (Currently, users can go into “privacy mode” with no video or audio, or hang up and call back.)\u003c/p>\n\u003cp>Hingson imagines sending a shopping list to Aira, and having the AI map his path through the store and check barcodes to confirm that he's grabbed the right items. He’d also like Aira integration with Facebook, so the system could use facial recognition to let him know if his friends are nearby.\u003c/p>\n\u003cp>For now, employees like Bernal are happy to assist with just about everything, although she notes that there’s one oddly sci-fi effect of seeing the world through someone else’s lenses.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Taking Ibuprofen Could Be Dangerous for Endurance Runners",
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"content": "\u003cp>Marathoners have reason to think twice before they nurse aches and pains with ibuprofen. \u003ca href=\"https://www.nytimes.com/2017/07/05/well/move/bring-on-the-exercise-hold-the-painkillers.html\" target=\"_blank\" rel=\"noopener noreferrer\">New research\u003c/a> shows taking pain pills may be harming the body, more than helping it. Stanford University researchers found ultramarathoners who took ibuprofen during races doubled their rate of kidney injury.\u003c/p>\n\u003caside class=\"pullquote alignright\">“If you're hurting after your big event, I say take an ice bath. If you're running and you're hurting, consider \u003ca href=\"https://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm165107.htm\" target=\"_blank\" rel=\"noopener noreferrer\">acetaminophen\u003c/a>.\" \u003ccite>Dr. Grant Lipman, Stanford University\u003c/cite>\u003c/aside>\n\u003cp>It is not uncommon for people who exercise zealously to stress their kidneys because they are so dehydrated, but adding nonsteroidal anti-inflammatory drugs, or NSAIDs like ibuprofen, to the mix may make things worse.\u003c/p>\n\u003cp>NSAIDs are the popular choice for athletes because they reduce pain \u003cem>and swelling\u003c/em>. As many as 75 percent of athletes turn to NSAIDs before, during and after races, according to Dr. Grant Lipman. Lipman is a Stanford University emergency medical doctor and lead author of a new double-blind \u003ca href=\"http://emj.bmj.com/content/early/2017/06/28/emermed-2016-206353\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> published online this week in \u003cem>Emergency Medical Journal.\u003c/em>\u003c/p>\n\u003cp>Lipman randomly selected 89 runners who were participating in a seven-day, 155-mile ultramarathon. He divided them into two groups. One group took 400 milligrams of ibuprofen every four hours during a 50-mile section of the race; the other group took a sugar pill. Those racers who took ibuprofen had an 18 percent higher rate of kidney injury at the end of the race.\u003c/p>\n\u003cp>[contextly_sidebar id=\"fgteb9CbbBtu2Apjxog4S9jQ9xvJx2U0\"]Basically, one out of every five runners who took ibuprofen suffered an acute kidney injury, said Lipman. \"That’s a pretty high rate,\" he added.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>When athletes push their limits they're already stressing their kidneys through both dehydration and muscle tissue break down.\u003c/p>\n\u003cp>That's why, says UCSF nephrologist Dr. Kristen Johansen, those results are not surprising. \"We tell all our kidney patient to avoid NSAIDs. The kidney is a big filter and we know non-steroidals interfere with the system.\"\u003c/p>\n\u003cp>Lipman advises hard-core athletes to use alternative ways to nurse the body.\u003c/p>\n\u003cp>“If you're hurting after your big event I say take an ice bath,\" Lipman says. \"If you're running and you're hurting consider \u003ca href=\"https://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm165107.htm\" target=\"_blank\" rel=\"noopener noreferrer\">acetaminophen\u003c/a>.\"\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Data show that most athletes with acute kidney injuries recover quickly but there are cautionary \u003ca href=\"http://www.thedenverchannel.com/news/front-range/boulder/dehydration-excessive-exercise-killed-brian-godlove-at-boulder-ironman-coroner-says\" target=\"_blank\" rel=\"noopener noreferrer\">tales\u003c/a>, like the 40-year-old Boulder triathlete who died from renal failure a few days after competing in an Ironman.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lipman stresses that the results of his study do not apply to everyday athletes like those of us who go for a trail run.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Marathoners have reason to think twice before they nurse aches and pains with ibuprofen. \u003ca href=\"https://www.nytimes.com/2017/07/05/well/move/bring-on-the-exercise-hold-the-painkillers.html\" target=\"_blank\" rel=\"noopener noreferrer\">New research\u003c/a> shows taking pain pills may be harming the body, more than helping it. Stanford University researchers found ultramarathoners who took ibuprofen during races doubled their rate of kidney injury.\u003c/p>\n\u003caside class=\"pullquote alignright\">“If you're hurting after your big event, I say take an ice bath. If you're running and you're hurting, consider \u003ca href=\"https://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm165107.htm\" target=\"_blank\" rel=\"noopener noreferrer\">acetaminophen\u003c/a>.\" \u003ccite>Dr. Grant Lipman, Stanford University\u003c/cite>\u003c/aside>\n\u003cp>It is not uncommon for people who exercise zealously to stress their kidneys because they are so dehydrated, but adding nonsteroidal anti-inflammatory drugs, or NSAIDs like ibuprofen, to the mix may make things worse.\u003c/p>\n\u003cp>NSAIDs are the popular choice for athletes because they reduce pain \u003cem>and swelling\u003c/em>. As many as 75 percent of athletes turn to NSAIDs before, during and after races, according to Dr. Grant Lipman. Lipman is a Stanford University emergency medical doctor and lead author of a new double-blind \u003ca href=\"http://emj.bmj.com/content/early/2017/06/28/emermed-2016-206353\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> published online this week in \u003cem>Emergency Medical Journal.\u003c/em>\u003c/p>\n\u003cp>Lipman randomly selected 89 runners who were participating in a seven-day, 155-mile ultramarathon. He divided them into two groups. One group took 400 milligrams of ibuprofen every four hours during a 50-mile section of the race; the other group took a sugar pill. Those racers who took ibuprofen had an 18 percent higher rate of kidney injury at the end of the race.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Basically, one out of every five runners who took ibuprofen suffered an acute kidney injury, said Lipman. \"That’s a pretty high rate,\" he added.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>When athletes push their limits they're already stressing their kidneys through both dehydration and muscle tissue break down.\u003c/p>\n\u003cp>That's why, says UCSF nephrologist Dr. Kristen Johansen, those results are not surprising. \"We tell all our kidney patient to avoid NSAIDs. The kidney is a big filter and we know non-steroidals interfere with the system.\"\u003c/p>\n\u003cp>Lipman advises hard-core athletes to use alternative ways to nurse the body.\u003c/p>\n\u003cp>“If you're hurting after your big event I say take an ice bath,\" Lipman says. \"If you're running and you're hurting consider \u003ca href=\"https://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm165107.htm\" target=\"_blank\" rel=\"noopener noreferrer\">acetaminophen\u003c/a>.\"\u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Data show that most athletes with acute kidney injuries recover quickly but there are cautionary \u003ca href=\"http://www.thedenverchannel.com/news/front-range/boulder/dehydration-excessive-exercise-killed-brian-godlove-at-boulder-ironman-coroner-says\" target=\"_blank\" rel=\"noopener noreferrer\">tales\u003c/a>, like the 40-year-old Boulder triathlete who died from renal failure a few days after competing in an Ironman.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Lipman stresses that the results of his study do not apply to everyday athletes like those of us who go for a trail run.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"soldout": {
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