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"content": "\u003cp>Algorithms are embedded into our technological lives, helping accomplish a variety of tasks like making sure that email makes it to your aunt or that you're matched to someone on a dating website who likes the same bands as you.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Unless we tune our algorithms for self-actualization, it will be simply too convenient for people to follow the advice of an algorithm ... turning these algorithms into self-fulfilling prophecies and users into zombies ... .'\u003c/aside>\n\u003cp>Sure, such computer code aims to make our lives easier, but experts cited in \u003ca href=\"http://www.pewinternet.org/2017/02/08/code-dependent-pros-and-cons-of-the-algorithm-age/\">a new report\u003c/a> by Pew Research Center and Elon University's Imagining the Internet Center are worried that algorithms may also make us lose our ability to make decisions. After all, if the software can do it for us, why should we bother?\u003c/p>\n\u003cp>\"Algorithms are the new arbiters of human decision-making in almost any area we can imagine, from watching a movie (Affectiva emotion recognition) to buying a house (Zillow.com) to self-driving cars (Google),\" Barry Chudakov, founder and principal at Sertain Research and StreamFuzion Corp., says in the report.\u003c/p>\n\u003cp>But despite advances, algorithms may lead to a loss in human judgment as people become reliant on the software to think for them.\u003c/p>\n\u003cp>That's one of the conclusions made in the report. It included responses from 1,300 technology experts, scholars, businesspeople and government leaders about what the next decades hold for the future of algorithms.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>One of the themes that emerged was \"humanity and human judgment are lost when data and predictive modeling become paramount.\" Many respondents worried that humans were considered \"inputs\" in the process and not real beings.\u003c/p>\n\u003cp>Additionally, they say that as algorithms take on human responsibilities, and essentially begin to create themselves, \"humans may get left out of the loop.\"\u003c/p>\n\u003cp>And although some experts expressed concern, others gave reasons algorithms were a positive solution and should expand their role in society.\u003c/p>\n\u003cp>Here's a sampling of opinions about the benefits and drawbacks of algorithms from the report:\u003c/p>\n\u003cp>Bart Knijnenburg, an assistant professor in human-centered computing at Clemson University: \"My biggest fear is that, unless we tune our algorithms for \u003cem>self-actualization,\u003c/em> it will be simply too convenient for people to follow the advice of an algorithm (or, too difficult to go beyond such advice), turning these algorithms into self-fulfilling prophecies and users into zombies who exclusively consume easy-to-consume items.\"\u003c/p>\n\u003cp>Rebecca MacKinnon, director of the Ranking Digital Rights project at New America: \"Algorithms driven by machine learning quickly become opaque even to their creators who no longer understand the logic being followed to make certain decisions or produce certain results. The lack of accountability and complete opacity is frightening. On the other hand, algorithms have revolutionized humans' relationship with information in ways that have been life-saving and empowering and will continue to do so.\"\u003c/p>\n\u003cp>Jason Hong, an associate professor at Carnegie Mellon University: \"The old adage of garbage in, garbage out still applies, but the sheer quantity of data and the speed of computers might give the false impression of correctness. As a trivial example, there are stories of people following GPS too closely and ending up driving into a river.\"\u003c/p>\n\u003cp>Amali De Silva-Mitchell, a futurist and consultant: \"Predictive modeling will limit individual self-expression hence innovation and development. It will cultivate a spoon-fed population with those in the elite being the innovators. There will be a loss in complex decision-making skills of the masses.\"\u003c/p>\n\u003cp>Marina Gorbis, executive director at the Institute for the Future: \"Imagine instead of typing search words and getting a list of articles, pushing a button and getting a narrative paper on a specific topic of interest. It's the equivalent of each one of us having many research and other assistants. ... Algorithms also have the potential to uncover current biases in hiring, job descriptions and other text information.\"\u003c/p>\n\u003cp>Ryan Hayes, owner of Fit to Tweet: \"Technology is going to start helping us not just maximize our productivity but shift toward doing those things in ways that make us happier, healthier, less distracted, safer, more peaceful, etc., and that will be a very positive trend. Technology, in other words, will start helping us enjoy being human again rather than burdening us with more abstraction.\"\u003c/p>\n\u003cp>David Karger, a professor of computer science at MIT: \"The question of algorithmic fairness and discrimination is an important one but it is already being considered. If we want algorithms that don't discriminate, we will be able to design algorithms that do not discriminate.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Daniel Berleant, author of \u003cem>The Human Race to the Future:\u003c/em> \"Algorithms are less subject to hidden agendas than human advisors and managers. Hence the output of these algorithms will be more socially and economically efficient, in the sense that they will be better aligned with their intended goals. Humans are a lot more suspect in their advice and decisions than computers are.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Will+Algorithms+Erode+Our+Decision-Making+Skills%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>One of the themes that emerged was \"humanity and human judgment are lost when data and predictive modeling become paramount.\" Many respondents worried that humans were considered \"inputs\" in the process and not real beings.\u003c/p>\n\u003cp>Additionally, they say that as algorithms take on human responsibilities, and essentially begin to create themselves, \"humans may get left out of the loop.\"\u003c/p>\n\u003cp>And although some experts expressed concern, others gave reasons algorithms were a positive solution and should expand their role in society.\u003c/p>\n\u003cp>Here's a sampling of opinions about the benefits and drawbacks of algorithms from the report:\u003c/p>\n\u003cp>Bart Knijnenburg, an assistant professor in human-centered computing at Clemson University: \"My biggest fear is that, unless we tune our algorithms for \u003cem>self-actualization,\u003c/em> it will be simply too convenient for people to follow the advice of an algorithm (or, too difficult to go beyond such advice), turning these algorithms into self-fulfilling prophecies and users into zombies who exclusively consume easy-to-consume items.\"\u003c/p>\n\u003cp>Rebecca MacKinnon, director of the Ranking Digital Rights project at New America: \"Algorithms driven by machine learning quickly become opaque even to their creators who no longer understand the logic being followed to make certain decisions or produce certain results. The lack of accountability and complete opacity is frightening. On the other hand, algorithms have revolutionized humans' relationship with information in ways that have been life-saving and empowering and will continue to do so.\"\u003c/p>\n\u003cp>Jason Hong, an associate professor at Carnegie Mellon University: \"The old adage of garbage in, garbage out still applies, but the sheer quantity of data and the speed of computers might give the false impression of correctness. As a trivial example, there are stories of people following GPS too closely and ending up driving into a river.\"\u003c/p>\n\u003cp>Amali De Silva-Mitchell, a futurist and consultant: \"Predictive modeling will limit individual self-expression hence innovation and development. It will cultivate a spoon-fed population with those in the elite being the innovators. There will be a loss in complex decision-making skills of the masses.\"\u003c/p>\n\u003cp>Marina Gorbis, executive director at the Institute for the Future: \"Imagine instead of typing search words and getting a list of articles, pushing a button and getting a narrative paper on a specific topic of interest. It's the equivalent of each one of us having many research and other assistants. ... Algorithms also have the potential to uncover current biases in hiring, job descriptions and other text information.\"\u003c/p>\n\u003cp>Ryan Hayes, owner of Fit to Tweet: \"Technology is going to start helping us not just maximize our productivity but shift toward doing those things in ways that make us happier, healthier, less distracted, safer, more peaceful, etc., and that will be a very positive trend. Technology, in other words, will start helping us enjoy being human again rather than burdening us with more abstraction.\"\u003c/p>\n\u003cp>David Karger, a professor of computer science at MIT: \"The question of algorithmic fairness and discrimination is an important one but it is already being considered. If we want algorithms that don't discriminate, we will be able to design algorithms that do not discriminate.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Daniel Berleant, author of \u003cem>The Human Race to the Future:\u003c/em> \"Algorithms are less subject to hidden agendas than human advisors and managers. Hence the output of these algorithms will be more socially and economically efficient, in the sense that they will be better aligned with their intended goals. Humans are a lot more suspect in their advice and decisions than computers are.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Will+Algorithms+Erode+Our+Decision-Making+Skills%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Squinting while texting? Always losing your reading glasses? An eye implant that takes about 10 minutes to put in place is the newest in a list of surgical repairs for the blurry close-up vision that is a bane of middle age. But who's really a good candidate to toss their specs?\u003c/p>\n\u003cp>\"It's not bringing anybody back to being 20 again,\" cautioned Dr. Shilpa Rose, a Washington ophthalmologist who tests whether patients' eyes are healthy enough to qualify. \"But it decreases the need to rush to get that pair of reading glasses every time you want to send a text or read an email.\"\u003c/p>\n\u003cp>Nearly everybody will experience presbyopia at some point, usually starting in the mid-40s. At first you may notice yourself holding restaurant menus at arm's length. Eventually, even in good light, reading becomes a blur.\u003c/p>\n\u003cp>How well you see has to do with how light is directed through the natural lens to the back of the eye. That lens stiffens with age, losing its ability to shift and bend light so that it becomes more difficult to focus close-up.\u003c/p>\n\u003cp>The usual options are magnifying drugstore reading glasses or, for people with other vision problems, bifocals, multifocal contact lenses or what's called monovision, correcting for distance vision in one eye and near vision in the other.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"I have glasses everywhere — the bedroom, the office, the kitchen,\" said Christianne Krupinsky, 51, of Marriottsville, Maryland, who'd never needed them until presbyopia struck. \"Getting ready in the morning, even to put on jewelry I can't see the clasp. It's so frustrating.\"\u003c/p>\n\u003cp>And while surgery always carries some risk, corneal inlays that are implanted into the eye's clear front surface are getting attention because they're removable if necessary.\u003c/p>\n\u003cp>\"It's not magic. It's surgery. People have to remember this is not one and done,\" but requires post-surgical exams and care, said Dr. Deepinder K. Dhaliwal of the University of Pittsburgh Medical Center, a corneal specialist who is watching studies of the inlays.\u003c/p>\n\u003cp>Krupinsky was a little nervous while lying on the operating table to receive the new Raindrop near vision inlay.\u003c/p>\n\u003cp>\"The most you're going to feel is pressure,\" promised Washington refractive surgeon Dr. Mark Whitten, applying numbing drops to her left eye.\u003c/p>\n\u003cp>A gel-like device that looks like a miniature contact lens, the Raindrop is smaller than the eye of a needle. It's the first implant to treat presbyopia by changing the cornea's shape, making it steeper to alter how light passes through.\u003c/p>\n\u003cp>It's placed in only one eye; both eyes still see at a distance. Patients can test-wear a single contact lens to be sure they'll like the effect before choosing surgery.\u003c/p>\n\u003cp>Rose, the ophthalmologist, checked for dry eye, underlying diseases like glaucoma, and whether the corneas were thick and healthy enough to implant before turning Krupinsky over to her surgical partner.\u003c/p>\n\u003cp>\"Just look straight up,\" Whitten said as he used a laser to slice a flap in Krupinsky's cornea. He centered the Raindrop inlay over her pupil and lowered the flap to seal it in place.\u003c/p>\n\u003cp>Minutes later, Krupinsky read lines on an eye chart she previously couldn't make out without glasses, albeit still a little blurry. She'll need eye drops for several months as her cornea heals so vision can sharpen.\u003c/p>\n\u003cp>Maker ReVision Optics Inc. is gradually training eye surgeons to use the Raindrop properly, after the Food and Drug Administration approved it last summer based on a study of 373 people whose only vision problem was moderate presbyopia. Two years later, 92 percent had good near vision, 20/40 or better without glasses, in the implanted eye.\u003c/p>\n\u003cp>Potential side effects include infection, dry eye, glare, or corneal problems such as scarring. About 7 percent of study participants had the implant removed, mostly because they weren't satisfied with their vision or experienced a haze or clouding of the cornea. Most returned to their pre-surgical vision, although one had lingering haze.\u003c/p>\n\u003cp>Other surgical options:\u003c/p>\n\u003cp>—Another FDA-approved corneal inlay, the Kamra, is a doughnut-shaped device, also used in one eye and removable. It works like a pinhole camera, improving vision by focusing light through the center of the pupil.\u003cbr>\n—A more invasive operation replaces the natural lens in each eye with an artificial one, named Symfony, that can focus both near and far. Approved for cataract surgery, it also is being offered as a presbyopia fix for the middle-aged who don't yet have cataracts.\u003c/p>\n\u003cp>Unlike inlays, artificial lenses can't simply be removed.\u003c/p>\n\u003cp>Insurance doesn't cover elective presbyopia surgery. Rose said the inlays average about $4,000 to $5,000, while the artificial lens in both eyes can cost twice as much.\u003c/p>\n\u003cp>Patients should consult a surgeon experienced with all the options who can determine which best suits their eyes, advised Pittsburgh's Dhaliwal.\u003c/p>\n\u003cp>Each has pros, cons and unknowns. For example, elective lens replacement isn't for the very nearsighted because they're at higher risk for a vision-threatening complication, Dhaliwal said.\u003c/p>\n\u003cp>And the Raindrop hasn't been studied in people who years ago underwent LASIK surgery to correct nearsightedness. That didn't deter Mike Gray, 52, of Haymarket, Virginia, who lost his reading glasses so often that he bought bulk packs. To implant the inlay, Whitten had to avoid cutting the cornea in the same place as Gray's long-ago LASIK, and advises such patients to pick a surgeon experienced in both procedures.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Everything is very clear and getting better every day,\" Gray said about a month later.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Squinting while texting? Always losing your reading glasses? An eye implant that takes about 10 minutes to put in place is the newest in a list of surgical repairs for the blurry close-up vision that is a bane of middle age. But who's really a good candidate to toss their specs?\u003c/p>\n\u003cp>\"It's not bringing anybody back to being 20 again,\" cautioned Dr. Shilpa Rose, a Washington ophthalmologist who tests whether patients' eyes are healthy enough to qualify. \"But it decreases the need to rush to get that pair of reading glasses every time you want to send a text or read an email.\"\u003c/p>\n\u003cp>Nearly everybody will experience presbyopia at some point, usually starting in the mid-40s. At first you may notice yourself holding restaurant menus at arm's length. Eventually, even in good light, reading becomes a blur.\u003c/p>\n\u003cp>How well you see has to do with how light is directed through the natural lens to the back of the eye. That lens stiffens with age, losing its ability to shift and bend light so that it becomes more difficult to focus close-up.\u003c/p>\n\u003cp>The usual options are magnifying drugstore reading glasses or, for people with other vision problems, bifocals, multifocal contact lenses or what's called monovision, correcting for distance vision in one eye and near vision in the other.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"I have glasses everywhere — the bedroom, the office, the kitchen,\" said Christianne Krupinsky, 51, of Marriottsville, Maryland, who'd never needed them until presbyopia struck. \"Getting ready in the morning, even to put on jewelry I can't see the clasp. It's so frustrating.\"\u003c/p>\n\u003cp>And while surgery always carries some risk, corneal inlays that are implanted into the eye's clear front surface are getting attention because they're removable if necessary.\u003c/p>\n\u003cp>\"It's not magic. It's surgery. People have to remember this is not one and done,\" but requires post-surgical exams and care, said Dr. Deepinder K. Dhaliwal of the University of Pittsburgh Medical Center, a corneal specialist who is watching studies of the inlays.\u003c/p>\n\u003cp>Krupinsky was a little nervous while lying on the operating table to receive the new Raindrop near vision inlay.\u003c/p>\n\u003cp>\"The most you're going to feel is pressure,\" promised Washington refractive surgeon Dr. Mark Whitten, applying numbing drops to her left eye.\u003c/p>\n\u003cp>A gel-like device that looks like a miniature contact lens, the Raindrop is smaller than the eye of a needle. It's the first implant to treat presbyopia by changing the cornea's shape, making it steeper to alter how light passes through.\u003c/p>\n\u003cp>It's placed in only one eye; both eyes still see at a distance. Patients can test-wear a single contact lens to be sure they'll like the effect before choosing surgery.\u003c/p>\n\u003cp>Rose, the ophthalmologist, checked for dry eye, underlying diseases like glaucoma, and whether the corneas were thick and healthy enough to implant before turning Krupinsky over to her surgical partner.\u003c/p>\n\u003cp>\"Just look straight up,\" Whitten said as he used a laser to slice a flap in Krupinsky's cornea. He centered the Raindrop inlay over her pupil and lowered the flap to seal it in place.\u003c/p>\n\u003cp>Minutes later, Krupinsky read lines on an eye chart she previously couldn't make out without glasses, albeit still a little blurry. She'll need eye drops for several months as her cornea heals so vision can sharpen.\u003c/p>\n\u003cp>Maker ReVision Optics Inc. is gradually training eye surgeons to use the Raindrop properly, after the Food and Drug Administration approved it last summer based on a study of 373 people whose only vision problem was moderate presbyopia. Two years later, 92 percent had good near vision, 20/40 or better without glasses, in the implanted eye.\u003c/p>\n\u003cp>Potential side effects include infection, dry eye, glare, or corneal problems such as scarring. About 7 percent of study participants had the implant removed, mostly because they weren't satisfied with their vision or experienced a haze or clouding of the cornea. Most returned to their pre-surgical vision, although one had lingering haze.\u003c/p>\n\u003cp>Other surgical options:\u003c/p>\n\u003cp>—Another FDA-approved corneal inlay, the Kamra, is a doughnut-shaped device, also used in one eye and removable. It works like a pinhole camera, improving vision by focusing light through the center of the pupil.\u003cbr>\n—A more invasive operation replaces the natural lens in each eye with an artificial one, named Symfony, that can focus both near and far. Approved for cataract surgery, it also is being offered as a presbyopia fix for the middle-aged who don't yet have cataracts.\u003c/p>\n\u003cp>Unlike inlays, artificial lenses can't simply be removed.\u003c/p>\n\u003cp>Insurance doesn't cover elective presbyopia surgery. Rose said the inlays average about $4,000 to $5,000, while the artificial lens in both eyes can cost twice as much.\u003c/p>\n\u003cp>Patients should consult a surgeon experienced with all the options who can determine which best suits their eyes, advised Pittsburgh's Dhaliwal.\u003c/p>\n\u003cp>Each has pros, cons and unknowns. For example, elective lens replacement isn't for the very nearsighted because they're at higher risk for a vision-threatening complication, Dhaliwal said.\u003c/p>\n\u003cp>And the Raindrop hasn't been studied in people who years ago underwent LASIK surgery to correct nearsightedness. That didn't deter Mike Gray, 52, of Haymarket, Virginia, who lost his reading glasses so often that he bought bulk packs. To implant the inlay, Whitten had to avoid cutting the cornea in the same place as Gray's long-ago LASIK, and advises such patients to pick a surgeon experienced in both procedures.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Everything is very clear and getting better every day,\" Gray said about a month later.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Don't Get EKG-Happy, Say Docs, as Heart Screening For Teens Questioned",
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"content": "\u003cp>Dozens of not-for-profit organizations have formed in the past decade to promote free or low-cost heart screenings for teens. The groups often claim such tests save lives by finding abnormalities that might pose a risk of sudden cardiac death.\u003c/p>\n\u003cp>But the efforts are raising concerns. There's no evidence that screening adolescents with \u003ca href=\"http://www.heart.org/HEARTORG/Conditions/HeartAttack/DiagnosingaHeartAttack/Electrocardiogram-ECG-or-EKG_UCM_309050_Article.jsp#.WKc4HTsrKUk\" target=\"_blank\">electrocardiograms\u003c/a> prevents deaths. Sudden cardiac death is rare in young people, and some physicians worry screening kids with no symptoms or family history of disease could do more harm than good. The tests can set off false alarms that can lead to follow-up tests and risky interventions or force some kids to quit sports unnecessarily.\u003c/p>\n\u003cp>\"There are harms that I don't think a lot of people realize,\" said Dr. Kristin Burns, who oversees a two-year-old \u003ca href=\"https://www.nhlbi.nih.gov/news/spotlight/fact-sheet/frequently-asked-questions-about-sudden-death-young-case-registry\">registry\u003c/a> at the National Institute of Health of sudden deaths in people under 20. It's one of several efforts aimed at gathering better data about cardiac abnormalities in kids.\u003c/p>\n\u003cp>Studies using limited data have found between \u003ca href=\"http://heartsmartekg.org/sites/ekgyourteen/files/SCD%20in%20the%20Young%20article.pdf\" target=\"_blank\">one and four sudden cardiac deaths\u003c/a> occur annually per 100,000 kids between ages 1 and 18. By comparison, 22 in 100,000 U.S. teens are killed each year in accidents, including those involving motor vehicles; 9 in 100,000 commit suicide, according to the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Some screening advocates believe sudden cardiac deaths are underreported and that not enough is being done to spare families from the fate of losing a child. \"We have to acknowledge that every kid who drops dead, they've been failed by the current system,\" said Darren Sudman, who founded \u003ca href=\"http://www.simonsfund.org/\" target=\"_blank\">Simon's Fund\u003c/a>, a screening effort in greater Philadelphia in memory of his infant son, who died of an arrhythmia.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Screening programs say they're educating parents about the risks. \"What we want to emphasize is, make sure your kid is heart-safe,\" said Dr. Jonathan Drezner, a sports and family medicine specialist at \u003ca href=\"http://www.uwmedicine.org/bios/jonathan-drezner\">UW Medicine\u003c/a> and medical director of the Seattle-area \u003ca href=\"http://nickoftimefoundation.org/\">Nick of Time Foundation\u003c/a>.\u003c/p>\n\u003cp>Enthusiasm for EKGs, which measure the electrical activity in the heart to detect abnormalities, grew after a 2006 \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/17018804\">study\u003c/a> showed they lowered death rates among athletes in Italy. But research in other countries hasn't yielded similar results, and the Italian researchers recently \u003ca href=\"http://www.bmj.com/content/353/bmj.i2208\" target=\"_blank\">were accused of\u003c/a> refusing to share their data so it could be evaluated independently.\u003c/p>\n\u003cp>Some 60,000 to 70,000 U.S. teens were screened with EKGs in 2016, most by foundations created by families who lost a child to sudden cardiac death, said Sudman, who runs the online directory \u003ca href=\"http://www.screenacrossamerica.org/\" target=\"_blank\">Screen Across America\u003c/a>. It's unclear whether high school athletes face higher risk than nonathletes, so screening programs usually invite everybody.\u003c/p>\n\u003cp>Screenings typically are held in high schools and overseen by volunteer cardiologists, with funding from individuals and businesses including hospitals. A handful of hospitals and for-profit companies also run screenings.\u003c/p>\n\u003cp>It may be presumptuous to claim EKGs save lives, but parents often believe they do, said Sudman. \"If I find a heart condition, I promise you there are parents who are thanking me for savings their kid's life,\" he said.\u003c/p>\n\u003cp>That perception is stoked by tragic stories in the media of children who died suddenly after never reporting a symptom.\u003c/p>\n\u003cp>Meanwhile, the drawbacks of EKGs are seldom depicted. As many as 1 in 10 EKGs detects a potential abnormality, and the emotional and financial toll of such a finding can be significant — especially when they turn out to be wrong.\u003c/p>\n\u003cp>Following a screening EKG and echocardiogram last fall, Daniel Garza, 16, a talented sophomore basketball player in San Antonio, was told he had \u003ca href=\"https://medlineplus.gov/ency/article/000192.htm\">hypertrophic cardiomyopathy\u003c/a>, a thickening of the heart muscle and the most common cause of sudden cardiac death in young people. He was advised to quit all exercise, at least temporarily.\u003c/p>\n\u003cp>\"We were shocked, just shocked,\" said his mother, Denise. She said her son became depressed when he couldn't play the sport he enjoyed and excelled at. \"He came home and cried himself to sleep. He said, 'Mom, why did God give me this gift to take it away?' \"\u003c/p>\n\u003cp>The Garzas traveled to the Mayo Clinic in Rochester, Minn., where further tests indicated his enlarged heart was a benign condition known as athletic heart, a result of intense training. His mother estimates that correcting the misdiagnosis cost more than $20,000, including medical costs, travel and lost work.\u003c/p>\n\u003cp>Daniel has returned to the basketball court. Still, Denise Garza said the emotional toll was rough: \"It was one of the hardest things my family has ever endured.\"\u003c/p>\n\u003cp>Several cardiologists said they often see cases like this — or worse. Even after follow-up testing, it can be unclear which cases are life-threatening, so kids with low risk could be restricted from exercise or given life-altering interventions such as implantable defibrillators, surgery or anti-arrhythmic medications.\u003c/p>\n\u003cp>Medical groups have wrestled with the issue. The American Heart Association and the American College of Cardiology \u003ca href=\"http://circ.ahajournals.org/content/130/15/1303\" target=\"_blank\">recommended\u003c/a> in 2014 against mass ECG screening, noting that sudden cardiac death is rare in teens and false positives generate \"excessive and costly second-tier testing.\" ECGs also miss at least 1 in 10 cases of hypertrophic cardiomyopathy and more than 9 in 10 cases of congenital anomalies, the second-most-common cause.\u003c/p>\n\u003cp>But the medical panel accepted voluntary screening \"in relatively small cohorts,\" if there's physician involvement, quality control and a recognition of unreliable results and ancillary costs.\u003c/p>\n\u003cp>Efforts are underway to improve the accuracy of the screening programs. Some are adding \u003ca href=\"http://www.heart.org/HEARTORG/Conditions/HeartAttack/DiagnosingaHeartAttack/Echocardiogram%E2%80%94-Echo_UCM_451485_Article.jsp#.WKc5rjsrKUk\" target=\"_blank\">echocardiograms\u003c/a>, which use ultrasound to produce images of the heart, to assess potential abnormalities. Advocates say false positives have dropped as a result of better interpretation guidelines, known as the \u003ca href=\"https://www.amssm.org/BMJ_ECGModules.php\" target=\"_blank\">Seattle Criteria\u003c/a>, which are expected to soon be endorsed by cardiology societies in revised form.\u003c/p>\n\u003cp>But the criteria aren't perfect, and there's a \"giant gap\" in training cardiologists to use them, said Drezner, one of the developers. He's also a medical adviser for \u003ca href=\"https://parentheartwatch.org/\" target=\"_blank\">Parent Heart Watch\u003c/a>, a consortium of foundations. \"If I was a parent, I'd want to know about the experience of the (cardiologists) and what they're going to do to help my kid if they have a positive screen.\"\u003c/p>\n\u003cp>One problem with EKGs is a lack of good data.\u003c/p>\n\u003cp>\"There's no evidence we have that [EKG] screening saves lives,\" said Dr. Jonathan Kaltman of the National Heart, Lung, and Blood Institute. \"There's never been a controlled clinical trial, which is the only way to answer that question.\"\u003c/p>\n\u003cp>At the urging of screening advocates, the NIH partnered with the Centers for Disease Control and Prevention to rigorously track cardiac deaths as part of a Sudden Death in the Young Case Registry. So far a handful of states and counties have joined the effort, which helps local health departments collect better data. The goal is to standardize death investigations and get a firm handle on how often kids die from heart abnormalities as well as the role of factors such as genetics. Initial findings are expected to be available in about two years. The NIH is also funding three university-based research groups to answer key questions about sudden cardiac death in the young.\u003c/p>\n\u003cp>Some screening organizations are getting behind a nascent initiative with the \u003ca href=\"http://cardiac-safety.org/\" target=\"_blank\">Cardiac Safety Research Consortium\u003c/a> to harness their own screening data for research. It would require standardizing their practices and tracking outcomes, which organizations aren't now equipped to do.\u003c/p>\n\u003cp>\"Screening is happening. We can't avoid that,\" said Dr. Salim Idriss, director of pediatric electrophysiology at Duke University and co-chair of the initiative. \"We have a really good opportunity to get the data we need to make it better.\"\u003c/p>\n\u003cp>Separately, the UT Southwestern Medical Center in Dallas recently began a \u003ca href=\"http://www.utsouthwestern.edu/newsroom/news-releases/year-2016/september/ecg-athletes-levine.html\" target=\"_blank\">four-year pilot study \u003c/a>involving athletes and band members at eight high schools to determine the feasibility of a full-scale randomized controlled trial.\u003c/p>\n\u003cp>A valid finding on the overarching question of whether EKG screening saves lives could require at least 800,000 participants and a cost of $15 million, said Dr. Benjamin Levine, a cardiologist and the lead researcher.\u003c/p>\n\u003cp>The pilot is partly a response to legislation that would mandate EKGs for student athletes in Texas. A similar bill was also introduced in South Carolina. Both bills failed, but it's expected there will be more attempts to mandate EKGs, leaving state legislators looking for better guidance.\u003c/p>\n\u003cp>\"We're not going to solve this by having more debates, but by having more data,\" Levine said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Kaiser Health News is an editorially independent news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.\u003c/em> \u003cem>Mary Chris Jaklevic is a freelance health and environment writer based in Chicago. She's on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/mcjaklevic\">@mcjaklevic\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Heart+Screening+For+Teens+May+Cause+More+Problems+Than+It+Solves&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dozens of not-for-profit organizations have formed in the past decade to promote free or low-cost heart screenings for teens. The groups often claim such tests save lives by finding abnormalities that might pose a risk of sudden cardiac death.\u003c/p>\n\u003cp>But the efforts are raising concerns. There's no evidence that screening adolescents with \u003ca href=\"http://www.heart.org/HEARTORG/Conditions/HeartAttack/DiagnosingaHeartAttack/Electrocardiogram-ECG-or-EKG_UCM_309050_Article.jsp#.WKc4HTsrKUk\" target=\"_blank\">electrocardiograms\u003c/a> prevents deaths. Sudden cardiac death is rare in young people, and some physicians worry screening kids with no symptoms or family history of disease could do more harm than good. The tests can set off false alarms that can lead to follow-up tests and risky interventions or force some kids to quit sports unnecessarily.\u003c/p>\n\u003cp>\"There are harms that I don't think a lot of people realize,\" said Dr. Kristin Burns, who oversees a two-year-old \u003ca href=\"https://www.nhlbi.nih.gov/news/spotlight/fact-sheet/frequently-asked-questions-about-sudden-death-young-case-registry\">registry\u003c/a> at the National Institute of Health of sudden deaths in people under 20. It's one of several efforts aimed at gathering better data about cardiac abnormalities in kids.\u003c/p>\n\u003cp>Studies using limited data have found between \u003ca href=\"http://heartsmartekg.org/sites/ekgyourteen/files/SCD%20in%20the%20Young%20article.pdf\" target=\"_blank\">one and four sudden cardiac deaths\u003c/a> occur annually per 100,000 kids between ages 1 and 18. By comparison, 22 in 100,000 U.S. teens are killed each year in accidents, including those involving motor vehicles; 9 in 100,000 commit suicide, according to the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Some screening advocates believe sudden cardiac deaths are underreported and that not enough is being done to spare families from the fate of losing a child. \"We have to acknowledge that every kid who drops dead, they've been failed by the current system,\" said Darren Sudman, who founded \u003ca href=\"http://www.simonsfund.org/\" target=\"_blank\">Simon's Fund\u003c/a>, a screening effort in greater Philadelphia in memory of his infant son, who died of an arrhythmia.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Screening programs say they're educating parents about the risks. \"What we want to emphasize is, make sure your kid is heart-safe,\" said Dr. Jonathan Drezner, a sports and family medicine specialist at \u003ca href=\"http://www.uwmedicine.org/bios/jonathan-drezner\">UW Medicine\u003c/a> and medical director of the Seattle-area \u003ca href=\"http://nickoftimefoundation.org/\">Nick of Time Foundation\u003c/a>.\u003c/p>\n\u003cp>Enthusiasm for EKGs, which measure the electrical activity in the heart to detect abnormalities, grew after a 2006 \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/17018804\">study\u003c/a> showed they lowered death rates among athletes in Italy. But research in other countries hasn't yielded similar results, and the Italian researchers recently \u003ca href=\"http://www.bmj.com/content/353/bmj.i2208\" target=\"_blank\">were accused of\u003c/a> refusing to share their data so it could be evaluated independently.\u003c/p>\n\u003cp>Some 60,000 to 70,000 U.S. teens were screened with EKGs in 2016, most by foundations created by families who lost a child to sudden cardiac death, said Sudman, who runs the online directory \u003ca href=\"http://www.screenacrossamerica.org/\" target=\"_blank\">Screen Across America\u003c/a>. It's unclear whether high school athletes face higher risk than nonathletes, so screening programs usually invite everybody.\u003c/p>\n\u003cp>Screenings typically are held in high schools and overseen by volunteer cardiologists, with funding from individuals and businesses including hospitals. A handful of hospitals and for-profit companies also run screenings.\u003c/p>\n\u003cp>It may be presumptuous to claim EKGs save lives, but parents often believe they do, said Sudman. \"If I find a heart condition, I promise you there are parents who are thanking me for savings their kid's life,\" he said.\u003c/p>\n\u003cp>That perception is stoked by tragic stories in the media of children who died suddenly after never reporting a symptom.\u003c/p>\n\u003cp>Meanwhile, the drawbacks of EKGs are seldom depicted. As many as 1 in 10 EKGs detects a potential abnormality, and the emotional and financial toll of such a finding can be significant — especially when they turn out to be wrong.\u003c/p>\n\u003cp>Following a screening EKG and echocardiogram last fall, Daniel Garza, 16, a talented sophomore basketball player in San Antonio, was told he had \u003ca href=\"https://medlineplus.gov/ency/article/000192.htm\">hypertrophic cardiomyopathy\u003c/a>, a thickening of the heart muscle and the most common cause of sudden cardiac death in young people. He was advised to quit all exercise, at least temporarily.\u003c/p>\n\u003cp>\"We were shocked, just shocked,\" said his mother, Denise. She said her son became depressed when he couldn't play the sport he enjoyed and excelled at. \"He came home and cried himself to sleep. He said, 'Mom, why did God give me this gift to take it away?' \"\u003c/p>\n\u003cp>The Garzas traveled to the Mayo Clinic in Rochester, Minn., where further tests indicated his enlarged heart was a benign condition known as athletic heart, a result of intense training. His mother estimates that correcting the misdiagnosis cost more than $20,000, including medical costs, travel and lost work.\u003c/p>\n\u003cp>Daniel has returned to the basketball court. Still, Denise Garza said the emotional toll was rough: \"It was one of the hardest things my family has ever endured.\"\u003c/p>\n\u003cp>Several cardiologists said they often see cases like this — or worse. Even after follow-up testing, it can be unclear which cases are life-threatening, so kids with low risk could be restricted from exercise or given life-altering interventions such as implantable defibrillators, surgery or anti-arrhythmic medications.\u003c/p>\n\u003cp>Medical groups have wrestled with the issue. The American Heart Association and the American College of Cardiology \u003ca href=\"http://circ.ahajournals.org/content/130/15/1303\" target=\"_blank\">recommended\u003c/a> in 2014 against mass ECG screening, noting that sudden cardiac death is rare in teens and false positives generate \"excessive and costly second-tier testing.\" ECGs also miss at least 1 in 10 cases of hypertrophic cardiomyopathy and more than 9 in 10 cases of congenital anomalies, the second-most-common cause.\u003c/p>\n\u003cp>But the medical panel accepted voluntary screening \"in relatively small cohorts,\" if there's physician involvement, quality control and a recognition of unreliable results and ancillary costs.\u003c/p>\n\u003cp>Efforts are underway to improve the accuracy of the screening programs. Some are adding \u003ca href=\"http://www.heart.org/HEARTORG/Conditions/HeartAttack/DiagnosingaHeartAttack/Echocardiogram%E2%80%94-Echo_UCM_451485_Article.jsp#.WKc5rjsrKUk\" target=\"_blank\">echocardiograms\u003c/a>, which use ultrasound to produce images of the heart, to assess potential abnormalities. Advocates say false positives have dropped as a result of better interpretation guidelines, known as the \u003ca href=\"https://www.amssm.org/BMJ_ECGModules.php\" target=\"_blank\">Seattle Criteria\u003c/a>, which are expected to soon be endorsed by cardiology societies in revised form.\u003c/p>\n\u003cp>But the criteria aren't perfect, and there's a \"giant gap\" in training cardiologists to use them, said Drezner, one of the developers. He's also a medical adviser for \u003ca href=\"https://parentheartwatch.org/\" target=\"_blank\">Parent Heart Watch\u003c/a>, a consortium of foundations. \"If I was a parent, I'd want to know about the experience of the (cardiologists) and what they're going to do to help my kid if they have a positive screen.\"\u003c/p>\n\u003cp>One problem with EKGs is a lack of good data.\u003c/p>\n\u003cp>\"There's no evidence we have that [EKG] screening saves lives,\" said Dr. Jonathan Kaltman of the National Heart, Lung, and Blood Institute. \"There's never been a controlled clinical trial, which is the only way to answer that question.\"\u003c/p>\n\u003cp>At the urging of screening advocates, the NIH partnered with the Centers for Disease Control and Prevention to rigorously track cardiac deaths as part of a Sudden Death in the Young Case Registry. So far a handful of states and counties have joined the effort, which helps local health departments collect better data. The goal is to standardize death investigations and get a firm handle on how often kids die from heart abnormalities as well as the role of factors such as genetics. Initial findings are expected to be available in about two years. The NIH is also funding three university-based research groups to answer key questions about sudden cardiac death in the young.\u003c/p>\n\u003cp>Some screening organizations are getting behind a nascent initiative with the \u003ca href=\"http://cardiac-safety.org/\" target=\"_blank\">Cardiac Safety Research Consortium\u003c/a> to harness their own screening data for research. It would require standardizing their practices and tracking outcomes, which organizations aren't now equipped to do.\u003c/p>\n\u003cp>\"Screening is happening. We can't avoid that,\" said Dr. Salim Idriss, director of pediatric electrophysiology at Duke University and co-chair of the initiative. \"We have a really good opportunity to get the data we need to make it better.\"\u003c/p>\n\u003cp>Separately, the UT Southwestern Medical Center in Dallas recently began a \u003ca href=\"http://www.utsouthwestern.edu/newsroom/news-releases/year-2016/september/ecg-athletes-levine.html\" target=\"_blank\">four-year pilot study \u003c/a>involving athletes and band members at eight high schools to determine the feasibility of a full-scale randomized controlled trial.\u003c/p>\n\u003cp>A valid finding on the overarching question of whether EKG screening saves lives could require at least 800,000 participants and a cost of $15 million, said Dr. Benjamin Levine, a cardiologist and the lead researcher.\u003c/p>\n\u003cp>The pilot is partly a response to legislation that would mandate EKGs for student athletes in Texas. A similar bill was also introduced in South Carolina. Both bills failed, but it's expected there will be more attempts to mandate EKGs, leaving state legislators looking for better guidance.\u003c/p>\n\u003cp>\"We're not going to solve this by having more debates, but by having more data,\" Levine said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Kaiser Health News is an editorially independent news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.\u003c/em> \u003cem>Mary Chris Jaklevic is a freelance health and environment writer based in Chicago. She's on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/mcjaklevic\">@mcjaklevic\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Heart+Screening+For+Teens+May+Cause+More+Problems+Than+It+Solves&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>https://www.youtube.com/watch?v=i6GHhqPMVZ4\u003c/p>\n\u003cp>Can your social status make you sick?\u003c/p>\n\u003cp>And can what you \u003cem>think\u003c/em> is your social status make you sick?\u003c/p>\n\u003cp>Researchers have long known that your social class, or where you are on the social ladder in terms of income, education and employment, is one of the most powerful predictors of health, more powerful, even, than genetics and smoking.\u003c/p>\n\u003cp>But research has shown there is another important social factor that affects health, though it doesn't get as much attention: your \u003ci>perception \u003c/i>of your social status, regardless of what it actually is.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>This 2016 \u003ca href=\"http://journals.sagepub.com/doi/abs/10.1177/0044118X16646028\" target=\"_blank\">study,\u003c/a> for example, looked at the health of adolescents in relation to both their parents' social class and the teens' \u003cem>subjective\u003c/em> social class. The researchers discovered that the actual social class of the parents did not predict certain health outcomes among their children as much as the teens' \u003cem>perceived\u003c/em> social class compared to classmates.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>For more on social status and its relation to health, watch the video above, from \"\u003ca href=\"https://www.youtube.com/abovethenoise\" target=\"_blank\">Above the Noise\u003c/a>,\" KQED's new YouTube series for teens.\u003c/p>\n\n",
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"excerpt": "Researchers have long known that social class is a powerful predictor of health. But there is another important factor that doesn’t get as much attention: your \u003ci>perception\u003c/i> of your social status, regardless of what it actually is. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\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/i6GHhqPMVZ4'\n title='//www.youtube.com/embed/i6GHhqPMVZ4'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>Can your social status make you sick?\u003c/p>\n\u003cp>And can what you \u003cem>think\u003c/em> is your social status make you sick?\u003c/p>\n\u003cp>Researchers have long known that your social class, or where you are on the social ladder in terms of income, education and employment, is one of the most powerful predictors of health, more powerful, even, than genetics and smoking.\u003c/p>\n\u003cp>But research has shown there is another important social factor that affects health, though it doesn't get as much attention: your \u003ci>perception \u003c/i>of your social status, regardless of what it actually is.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This 2016 \u003ca href=\"http://journals.sagepub.com/doi/abs/10.1177/0044118X16646028\" target=\"_blank\">study,\u003c/a> for example, looked at the health of adolescents in relation to both their parents' social class and the teens' \u003cem>subjective\u003c/em> social class. The researchers discovered that the actual social class of the parents did not predict certain health outcomes among their children as much as the teens' \u003cem>perceived\u003c/em> social class compared to classmates.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>For more on social status and its relation to health, watch the video above, from \"\u003ca href=\"https://www.youtube.com/abovethenoise\" target=\"_blank\">Above the Noise\u003c/a>,\" KQED's new YouTube series for teens.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "3 Analyses: The Best Places for STEM Professionals",
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"content": "\u003cp>Last week the personal finance website SmartAsset released an \u003ca href=\"https://smartasset.com/mortgage/best-places-stem-jobs-pay-2017\" target=\"_blank\">analysis\u003c/a> on the best-paying geographical areas for STEM jobs. STEM, in case you haven't been paying attention, stands for Science, Technology, Engineering and \u003cdel>Martial Arts\u003c/del>.\u003c/p>\n\u003cp>Ha, just kidding, man. Math!\u003c/p>\n\u003cp>Using the latest Bureau of Labor Statistics data, from 2014, SmartAsset crunched the numbers for 53 U.S. metro areas that have at least 30,000 workers in the sciences, computers, mathematics, architecture and engineering. Comparing each area's average pay and increase in average pay to the corresponding national average, they came up with their list.\u003c/p>\n\u003cp>\"In short, our analysis looks at the metro areas that are the furthest above the national median for both STEM pay and income growth,\" SmartAsset wrote. As you can see, and as you may have suspected, paywise it's California-here-we-come for STEM workers, with three of the top five regions, including Silicon Valley, located in and around the San Francisco Bay Area.\u003c/p>\n\u003cfigure id=\"attachment_347185\" class=\"wp-caption aligncenter\" style=\"max-width: 600px\">\u003ca href=\"https://dr5dymrsxhdzh.cloudfront.net/blog/images/a14008/2017/02/stem_1_table.png\">\u003cimg class=\"wp-image-347185 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/03/stem_1_table.png\" alt=\"stem_1_table\" width=\"600\" height=\"1076\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/03/stem_1_table.png 600w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/stem_1_table-160x287.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/stem_1_table-240x430.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/stem_1_table-375x673.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/stem_1_table-520x933.png 520w\" sizes=\"(max-width: 600px) 100vw, 600px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">From SmartAsset. \u003ca href=\"https://smartasset.com/mortgage/best-places-stem-jobs-pay-2017\">See full post here\u003c/a>. \u003ccite>(SmartAsset)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But wait, there's more. This \u003ca href=\"https://wallethub.com/edu/best-worst-metro-areas-for-stem-professionals/9200/\" target=\"_blank\">post\u003c/a> by WalletHub in January ranked the best and worst areas for STEM professionals inclusive of not just pay, but quality of life and professional factors like job openings, R&D budgets, and transit and housing.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The results? Sorry Silicon Valley/San Francisco--the Seattle area edges you out for the top spot. Rounding out the top five: Boston-Cambridge-Newton and Springfield, in Massachusetts. See the \u003ca href=\"https://wallethub.com/edu/best-worst-metro-areas-for-stem-professionals/9200/#main-findings\" target=\"_blank\">full list here\u003c/a>. Or click on the circles to see the rankings of the different areas:\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"600\" height=\"338\" src=\"//d2e70e9yced57e.cloudfront.net/wallethub/embed/9200/geochart-stem.html\" frameborder=\"0\" scrolling=\"no\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>But wait, there's more of the more. Finally, we have \u003ca href=\"https://www.nerdwallet.com/blog/studies/best-places-stem-grads-2016/\" target=\"_blank\">Best Places for STEM Graduates\u003c/a>, posted last year by NerdWallet. While NerdWallet may or may not have the most incisive equation for tabulating STEMie heaven, they at least sport the best name for this type of website. In ranking 330 metro areas, the Nerds took into account the number of STEM employees per 1,000 jobs, annual average wage, median monthly rent and unemployment rate. That formula produced a sleeper of a No. 1 -- Huntsville, Alabama.\u003c/p>\n\u003cp>\"A STEM worker in Huntsville, Alabama will pay about 9% of his or her income on rent, compared with a peer in [No. 2] San Jose, California, who can expect housing to claim at least 17% of his or her salary,\" NerdWallet wrote.\u003c/p>\n\u003cp>Here are \u003ca href=\"http://www.bls.gov/oes/stem_list.xlsx\" target=\"_blank\">all the jobs\u003c/a> that BLS categorizes as STEM. While medical scientists are on the list, doctors and other health care professionals are not.\u003c/p>\n\u003cp>But something to take note of: While it's true that we are living in the digital age, the biggest job growth in terms of sheer numbers from 2014-24 will not occur among computer programmers or big data analysts, according to BLS, but rather \u003ca href=\"https://www.bls.gov/oes/current/oes399021.htm\" target=\"_blank\">personal care\u003c/a> and \u003ca href=\"https://www.bls.gov/ooh/healthcare/home-health-aides.htm\" target=\"_blank\">home health aides\u003c/a>. So welcome to the aging baby boomer economy. You can check out median salaries for dozens of other \u003ca href=\"https://www.bls.gov/ooh/healthcare/home.htm\" target=\"_blank\">health care occupations here--\u003c/a>click on the individual links to find job growth projections for each.\u003c/p>\n\u003cp>One of the interesting things WalletHub did was to ask a \u003ca href=\"https://wallethub.com/edu/best-worst-metro-areas-for-stem-professionals/9200/#\" target=\"_blank\">panel of academics\u003c/a> in STEM education questions related to the STEM job market. One query: Why do so many STEM graduates \u003ca href=\"https://www.usnews.com/news/stem-solutions/articles/2015/09/02/not-everyone-with-a-stem-degree-chooses-a-stem-job\" target=\"_blank\">end up not working in STEM\u003c/a> occupations, as \u003ca href=\"https://www.census.gov/newsroom/press-releases/2014/cb14-130.html\" target=\"_blank\">reported\u003c/a> by the U.S. Census Bureau in 2014.\u003c/p>\n\u003cp>That appears to be due at least in part to the exclusion of many otherwise related professions from the government's list of STEM jobs. Peter R. Turner, director of the Institute for STEM Education at Clarkson University, told WalletHub \"most STEM graduates do work in STEM fields but often in areas where they are using those skills for other applications.\"\u003c/p>\n\u003cp>That was echoed by several of the other experts. But not Carolyn Parker, assistant professor of STEM education at Johns Hopkins University. She said: \"We have an unwelcoming STEM culture, which supports a lack of interest in STEM courses and careers, particularly among females, people of color, and people with disabilities, because of entrenched cultural attitudes and beliefs about innate abilities.\"\u003c/p>\n\u003cp>The Census Bureau wrote back in 2014 that \"men continue to be overrepresented in STEM, especially in computer and engineering occupations. About 86 percent of engineers and 74 percent of computer professionals are men.\"\u003c/p>\n\u003cp>Click on the link for the government's \u003ca href=\"https://www.bls.gov/careeroutlook/subject/stem.htm\" target=\"_blank\">career outlooks\u003c/a> for STEM jobs, from \u003ca href=\"https://www.bls.gov/careeroutlook/2016/youre-a-what/quantum-computer-research-scientist.htm\" target=\"_blank\">quantum computer research scientist\u003c/a> to \u003ca href=\"https://www.bls.gov/careeroutlook/2015/interview/sports-statistical-analyst.htm\" target=\"_blank\">sports statistical analyst\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And next week, maybe we'll do Best Areas for Journalists, where every region comes in \u003ca href=\"https://www.bls.gov/ooh/media-and-communication/reporters-correspondents-and-broadcast-news-analysts.htm\" target=\"_blank\">last\u003c/a>.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Last week the personal finance website SmartAsset released an \u003ca href=\"https://smartasset.com/mortgage/best-places-stem-jobs-pay-2017\" target=\"_blank\">analysis\u003c/a> on the best-paying geographical areas for STEM jobs. STEM, in case you haven't been paying attention, stands for Science, Technology, Engineering and \u003cdel>Martial Arts\u003c/del>.\u003c/p>\n\u003cp>Ha, just kidding, man. Math!\u003c/p>\n\u003cp>Using the latest Bureau of Labor Statistics data, from 2014, SmartAsset crunched the numbers for 53 U.S. metro areas that have at least 30,000 workers in the sciences, computers, mathematics, architecture and engineering. Comparing each area's average pay and increase in average pay to the corresponding national average, they came up with their list.\u003c/p>\n\u003cp>\"In short, our analysis looks at the metro areas that are the furthest above the national median for both STEM pay and income growth,\" SmartAsset wrote. As you can see, and as you may have suspected, paywise it's California-here-we-come for STEM workers, with three of the top five regions, including Silicon Valley, located in and around the San Francisco Bay Area.\u003c/p>\n\u003cfigure id=\"attachment_347185\" class=\"wp-caption aligncenter\" style=\"max-width: 600px\">\u003ca href=\"https://dr5dymrsxhdzh.cloudfront.net/blog/images/a14008/2017/02/stem_1_table.png\">\u003cimg class=\"wp-image-347185 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/03/stem_1_table.png\" alt=\"stem_1_table\" width=\"600\" height=\"1076\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/03/stem_1_table.png 600w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/stem_1_table-160x287.png 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/stem_1_table-240x430.png 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/stem_1_table-375x673.png 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/03/stem_1_table-520x933.png 520w\" sizes=\"(max-width: 600px) 100vw, 600px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">From SmartAsset. \u003ca href=\"https://smartasset.com/mortgage/best-places-stem-jobs-pay-2017\">See full post here\u003c/a>. \u003ccite>(SmartAsset)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But wait, there's more. This \u003ca href=\"https://wallethub.com/edu/best-worst-metro-areas-for-stem-professionals/9200/\" target=\"_blank\">post\u003c/a> by WalletHub in January ranked the best and worst areas for STEM professionals inclusive of not just pay, but quality of life and professional factors like job openings, R&D budgets, and transit and housing.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The results? Sorry Silicon Valley/San Francisco--the Seattle area edges you out for the top spot. Rounding out the top five: Boston-Cambridge-Newton and Springfield, in Massachusetts. See the \u003ca href=\"https://wallethub.com/edu/best-worst-metro-areas-for-stem-professionals/9200/#main-findings\" target=\"_blank\">full list here\u003c/a>. Or click on the circles to see the rankings of the different areas:\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"600\" height=\"338\" src=\"//d2e70e9yced57e.cloudfront.net/wallethub/embed/9200/geochart-stem.html\" frameborder=\"0\" scrolling=\"no\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>But wait, there's more of the more. Finally, we have \u003ca href=\"https://www.nerdwallet.com/blog/studies/best-places-stem-grads-2016/\" target=\"_blank\">Best Places for STEM Graduates\u003c/a>, posted last year by NerdWallet. While NerdWallet may or may not have the most incisive equation for tabulating STEMie heaven, they at least sport the best name for this type of website. In ranking 330 metro areas, the Nerds took into account the number of STEM employees per 1,000 jobs, annual average wage, median monthly rent and unemployment rate. That formula produced a sleeper of a No. 1 -- Huntsville, Alabama.\u003c/p>\n\u003cp>\"A STEM worker in Huntsville, Alabama will pay about 9% of his or her income on rent, compared with a peer in [No. 2] San Jose, California, who can expect housing to claim at least 17% of his or her salary,\" NerdWallet wrote.\u003c/p>\n\u003cp>Here are \u003ca href=\"http://www.bls.gov/oes/stem_list.xlsx\" target=\"_blank\">all the jobs\u003c/a> that BLS categorizes as STEM. While medical scientists are on the list, doctors and other health care professionals are not.\u003c/p>\n\u003cp>But something to take note of: While it's true that we are living in the digital age, the biggest job growth in terms of sheer numbers from 2014-24 will not occur among computer programmers or big data analysts, according to BLS, but rather \u003ca href=\"https://www.bls.gov/oes/current/oes399021.htm\" target=\"_blank\">personal care\u003c/a> and \u003ca href=\"https://www.bls.gov/ooh/healthcare/home-health-aides.htm\" target=\"_blank\">home health aides\u003c/a>. So welcome to the aging baby boomer economy. You can check out median salaries for dozens of other \u003ca href=\"https://www.bls.gov/ooh/healthcare/home.htm\" target=\"_blank\">health care occupations here--\u003c/a>click on the individual links to find job growth projections for each.\u003c/p>\n\u003cp>One of the interesting things WalletHub did was to ask a \u003ca href=\"https://wallethub.com/edu/best-worst-metro-areas-for-stem-professionals/9200/#\" target=\"_blank\">panel of academics\u003c/a> in STEM education questions related to the STEM job market. One query: Why do so many STEM graduates \u003ca href=\"https://www.usnews.com/news/stem-solutions/articles/2015/09/02/not-everyone-with-a-stem-degree-chooses-a-stem-job\" target=\"_blank\">end up not working in STEM\u003c/a> occupations, as \u003ca href=\"https://www.census.gov/newsroom/press-releases/2014/cb14-130.html\" target=\"_blank\">reported\u003c/a> by the U.S. Census Bureau in 2014.\u003c/p>\n\u003cp>That appears to be due at least in part to the exclusion of many otherwise related professions from the government's list of STEM jobs. Peter R. Turner, director of the Institute for STEM Education at Clarkson University, told WalletHub \"most STEM graduates do work in STEM fields but often in areas where they are using those skills for other applications.\"\u003c/p>\n\u003cp>That was echoed by several of the other experts. But not Carolyn Parker, assistant professor of STEM education at Johns Hopkins University. She said: \"We have an unwelcoming STEM culture, which supports a lack of interest in STEM courses and careers, particularly among females, people of color, and people with disabilities, because of entrenched cultural attitudes and beliefs about innate abilities.\"\u003c/p>\n\u003cp>The Census Bureau wrote back in 2014 that \"men continue to be overrepresented in STEM, especially in computer and engineering occupations. About 86 percent of engineers and 74 percent of computer professionals are men.\"\u003c/p>\n\u003cp>Click on the link for the government's \u003ca href=\"https://www.bls.gov/careeroutlook/subject/stem.htm\" target=\"_blank\">career outlooks\u003c/a> for STEM jobs, from \u003ca href=\"https://www.bls.gov/careeroutlook/2016/youre-a-what/quantum-computer-research-scientist.htm\" target=\"_blank\">quantum computer research scientist\u003c/a> to \u003ca href=\"https://www.bls.gov/careeroutlook/2015/interview/sports-statistical-analyst.htm\" target=\"_blank\">sports statistical analyst\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And next week, maybe we'll do Best Areas for Journalists, where every region comes in \u003ca href=\"https://www.bls.gov/ooh/media-and-communication/reporters-correspondents-and-broadcast-news-analysts.htm\" target=\"_blank\">last\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>People born in 2030 will have longer lives than scientists once thought possible, but American babies born in 2030 will continue to have one of the lowest life expectancies of any developed country, according to a \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)32381-9/abstract\" target=\"_blank\">new study\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignright\">'I can imagine that there is a limit, but we are still very far from it.'\u003c/aside>\n\u003cp>Scientists once thought an average life expectancy beyond 90 was impossible but medical advances combined with improved social programs are continuing to break barriers, including in countries where many people already live well into old age, according to the study's lead researcher, Majid Ezzati of Imperial College London.\u003c/p>\n\u003cp>\"I can imagine that there is a limit,\" he said, \"but we are still very far from it.\"\u003c/p>\n\u003cp>Ezzati estimated that someday people could survive on average to at least 110 or 120 years.\u003c/p>\n\u003cp>The study shows South Korean girls born in 2030 are likely to have the greatest lifespan. They'll have a more than 50 percent chance of living past 90 --that's roughly 7 years longer than South Korean girls born in 2010. The longevity of South Korean women estimated in 2030 is due largely to investments in universal health care, he said. South Korea also led the list for men.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"It's basically the opposite of what we're doing in the West, where there's a lot of austerity and inequality,\" he said.\u003c/p>\n\u003cp>Ezzati and his co-authors used death and longevity trends to estimate life expectancy in 35 developed countries for a baby born in 2030. The study was published online Tuesday in \u003ca href=\"http://www.thelancet.com/journals/lancet/issue/current\" target=\"_blank\">The Lancet\u003c/a>.\u003c/p>\n\u003cp>Women were ahead of men in all countries. Behind South Korea, women in France, Japan, Spain and Switzerland were projected to live until 88. For South Korea men, life expectancy is expected to reach 84. Next were Australia, Switzerland, Canada and the Netherlands at nearly 84.\u003c/p>\n\u003cp>At the bottom of the list: Macedonia for women at nearly 78, and Serbia for men at about 73.\u003c/p>\n\u003cp>While some genetic factors might explain the longevity in certain countries, Ezzati said, social and environmental factors were probably more important.\u003c/p>\n\u003cp>The study estimated that the U.S., which already lags behind other developed countries, will fall even further behind by 2030, when men and women are projected to live to 80 and 83. American women will fall to 27th out of 35 countries, from their current ranking of 25, and men will fall from 23rd to 26th.\u003c/p>\n\u003cp>The researchers note that, among rich countries, the U.S. has the highest maternal and child death rates, homicide rate and body-mass index. It's the only country in the Organisation for Economic Co-operation and Development (OECD) without universal health care. \"The poor recent and projected U.S. performance is at least partly due to high and inequitable mortality from chronic diseases and violence, and insufficient and inequitable health care,\" the study notes.\u003c/p>\n\u003cp>In an accompanying commentary, Ailiana Santosa of Umea University in Sweden wrote that the projections raise \"crucial issues\" about which strategies are needed to tackle worsening inequality problems.\u003c/p>\n\u003cp>\"Achieving universal health coverage is worthy, plausible and needs to be continued,\" she said.\u003c/p>\n\u003cp>The study was paid for by the U.K. Medical Research Council and the U.S. Environmental Protection Agency.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Editor's Note: This article has been edited for clarity.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>People born in 2030 will have longer lives than scientists once thought possible, but American babies born in 2030 will continue to have one of the lowest life expectancies of any developed country, according to a \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)32381-9/abstract\" target=\"_blank\">new study\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignright\">'I can imagine that there is a limit, but we are still very far from it.'\u003c/aside>\n\u003cp>Scientists once thought an average life expectancy beyond 90 was impossible but medical advances combined with improved social programs are continuing to break barriers, including in countries where many people already live well into old age, according to the study's lead researcher, Majid Ezzati of Imperial College London.\u003c/p>\n\u003cp>\"I can imagine that there is a limit,\" he said, \"but we are still very far from it.\"\u003c/p>\n\u003cp>Ezzati estimated that someday people could survive on average to at least 110 or 120 years.\u003c/p>\n\u003cp>The study shows South Korean girls born in 2030 are likely to have the greatest lifespan. They'll have a more than 50 percent chance of living past 90 --that's roughly 7 years longer than South Korean girls born in 2010. The longevity of South Korean women estimated in 2030 is due largely to investments in universal health care, he said. South Korea also led the list for men.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It's basically the opposite of what we're doing in the West, where there's a lot of austerity and inequality,\" he said.\u003c/p>\n\u003cp>Ezzati and his co-authors used death and longevity trends to estimate life expectancy in 35 developed countries for a baby born in 2030. The study was published online Tuesday in \u003ca href=\"http://www.thelancet.com/journals/lancet/issue/current\" target=\"_blank\">The Lancet\u003c/a>.\u003c/p>\n\u003cp>Women were ahead of men in all countries. Behind South Korea, women in France, Japan, Spain and Switzerland were projected to live until 88. For South Korea men, life expectancy is expected to reach 84. Next were Australia, Switzerland, Canada and the Netherlands at nearly 84.\u003c/p>\n\u003cp>At the bottom of the list: Macedonia for women at nearly 78, and Serbia for men at about 73.\u003c/p>\n\u003cp>While some genetic factors might explain the longevity in certain countries, Ezzati said, social and environmental factors were probably more important.\u003c/p>\n\u003cp>The study estimated that the U.S., which already lags behind other developed countries, will fall even further behind by 2030, when men and women are projected to live to 80 and 83. American women will fall to 27th out of 35 countries, from their current ranking of 25, and men will fall from 23rd to 26th.\u003c/p>\n\u003cp>The researchers note that, among rich countries, the U.S. has the highest maternal and child death rates, homicide rate and body-mass index. It's the only country in the Organisation for Economic Co-operation and Development (OECD) without universal health care. \"The poor recent and projected U.S. performance is at least partly due to high and inequitable mortality from chronic diseases and violence, and insufficient and inequitable health care,\" the study notes.\u003c/p>\n\u003cp>In an accompanying commentary, Ailiana Santosa of Umea University in Sweden wrote that the projections raise \"crucial issues\" about which strategies are needed to tackle worsening inequality problems.\u003c/p>\n\u003cp>\"Achieving universal health coverage is worthy, plausible and needs to be continued,\" she said.\u003c/p>\n\u003cp>The study was paid for by the U.K. Medical Research Council and the U.S. Environmental Protection Agency.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Editor's Note: This article has been edited for clarity.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>It’s been 20 years since scientists in Scotland told the world about \u003ca href=\"http://dolly.roslin.ed.ac.uk/facts/the-life-of-dolly/\">Dolly the sheep\u003c/a>, the first mammal successfully \u003ca href=\"http://dx.doi.org/10.1038/385810a0\">cloned from an adult body cell\u003c/a>. What was special about Dolly is that her “parents” were actually a single cell originating from mammary tissue of an adult ewe. Dolly was an exact genetic copy of that sheep – a clone.\u003c/p>\n\u003cp>Dolly captured people’s imaginations, but those of us in the field had seen her coming through \u003ca href=\"http://doi.org/10.1038/380064a0\">previous research\u003c/a>. I’ve been working with \u003ca href=\"http://doi.org/10.1002/jez.1402280217\">mammalian embryos for over 40 years\u003c/a>, with some work in my lab specifically focusing on various methods of cloning cattle and other livestock species. In fact, one of the coauthors of the paper announcing Dolly worked in our laboratory for three years prior to going to Scotland to help create the famous clone.\u003c/p>\n\u003caside class=\"pullquote alignright\">The endgame was never meant to be armies of genetically identical livestock.\u003c/aside>\n\u003cp>Dolly was an important milestone, inspiring scientists to continue improving cloning technology as well as to pursue new concepts in stem cell research. The endgame was never meant to be armies of genetically identical livestock: Rather, researchers continue to refine the techniques and combine them with other methods to turbocharge traditional animal breeding methods as well as gain insights into aging and disease.\u003c/p>\n\u003cp>\u003cstrong>Not the Usual Sperm + Egg\u003c/strong>\u003c/p>\n\u003cp>Dolly was a perfectly normal sheep who became the mother of numerous normal lambs. She lived to six and a half years, when she \u003ca href=\"http://www.nature.com/news/1998/030217/full/news030217-6.html\">was eventually put down\u003c/a> after a contagious disease spread through her flock, infecting cloned and normally reproduced sheep alike. Her life wasn’t unusual; it’s her origin that made her unique.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Before the decades of experiments that led to Dolly, it was thought that normal animals could be produced only by fertilization of an egg by a sperm. That’s how things naturally work. These germ cells are the only ones in the body that have their genetic material all jumbled up and in half the quantity of every other kind of cell. That way when these so-called haploid cells come together at fertilization, they produce one cell with the full complement of DNA. Joined together, the cell is termed diploid, for twice, or double. Two halves make a whole.\u003c/p>\n\u003cp>From that moment forward, nearly all cells in that body have the same genetic makeup. When the one-cell embryo duplicates its genetic material, both cells of the now two-cell embryo are genetically identical. When they in turn duplicate their genetic material, each cell at the four-cell stage is genetically identical. This pattern goes on so that each of the trillions of cells in an adult is genetically exactly the same – whether it’s in a lung or a bone or the blood.\u003c/p>\n\u003cfigure id=\"attachment_345327\" class=\"wp-caption aligncenter\" style=\"max-width: 760px\">\u003cimg class=\"wp-image-345327 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/02/scnt.gif\" alt=\"Somatic cell nuclear transfer\" width=\"760\" height=\"420\">\u003cfigcaption class=\"wp-caption-text\">Somatic cell nuclear transfer uses genetic material from a body cell. \u003ccite>(Australian Department of Industry)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In contrast, Dolly was produced by what’s called \u003ca href=\"http://doi.org/10.1146/annurev-animal-031412-103709\">somatic cell nuclear transfer\u003c/a>. In this process, researchers remove the genetic material from an egg and replace it with the nucleus of some other body cell. The resulting egg becomes a factory to produce an embryo that develops into an offspring. No sperm is in the picture; instead of half the genetic material coming from a sperm and half from an egg, it all comes from a single cell. It’s diploid from the start.\u003c/p>\n\u003cp>\u003cstrong>Long Research Path Led to Dolly\u003c/strong>\u003c/p>\n\u003cp>Dolly was the culmination of hundreds of cloning experiments that, for example, showed diploid embryonic and fetal cells could be parents of offspring. But there was no way to easily know all the characteristics of the animal that would result from a cloned embryo or fetus. Researchers could freeze a few of the cells of a 16-cell embryo, while going on to produce clones from the other cells; if a desirable animal was produced, they could thaw the frozen cells and make more copies. But this was impractical because of low success rates.\u003c/p>\n\u003cp>Dolly demonstrated that adult somatic cells also could be used as parents. Thus, one could know the characteristics of the animal being cloned.\u003c/p>\n\u003cp>By my calculations, Dolly was the single success from 277 tries at somatic cell nuclear transfer. Sometimes the process of cloning by somatic cell nuclear transfer still produces abnormal embryos, most of which die. But the process has greatly improved so success rates \u003ca href=\"http://www.fda.gov/AnimalVeterinary/SafetyHealth/AnimalCloning/ucm124840.htm\">now are more like 10 percent\u003c/a>; it’s highly variable, though, depending on the cell type used and the species.\u003c/p>\n\u003cp>More than 10 different cell types have been used successfully as “parents” for cloning. These days most cloning is done using cells obtained by \u003ca href=\"http://assets.redangus.org/media/Documents/ARA_Magazine/Archived_Issues/2006/11-November/An_Update_On_The_Science_And_Commercialization_Of_Cloning_Cattle.pdf\">biopsying skin\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>More Than Genes Can Affect a Clone\u003c/strong>\u003c/p>\n\u003cp>Genetics is only part of the story. Even while clones are genetically identical, their phenotypes – the characteristics they express – will be different. It’s like naturally occurring identical twins: They share all their genes \u003ca href=\"http://doi.org/10.1016/b978-012174597-4.50012-0\">but they’re not really exactly alike\u003c/a>, especially if reared in different settings.\u003c/p>\n\u003cp>Environment plays a huge role for some characteristics. Food availability can influence weight. Diseases can stunt growth. These kinds of lifestyle, nutrition or disease effects can influence which genes are turned on or off in an individual; these are called \u003ca href=\"http://learn.genetics.utah.edu/content/epigenetics/\">epigenetic effects\u003c/a>. Even though all the genetic material may be the same in two identical clones, they might not be expressing all the same genes.\u003c/p>\n\u003caside class=\"pullquote alignright\">In racehorses, good genes don't guarantee a winner.\u003c/aside>\n\u003cp>Consider the \u003ca href=\"http://doi.org/10.1530/REP-07-0069\">practice of cloning winning racehorses\u003c/a>. Clones of winners sometimes also will be winners – but most of the time they’re not. This is because winners are outliers; they need to have the right genetics, but also the right epigenetics and the right environment to reach that winning potential. For example, one can never exactly duplicate the uterine conditions a winning racehorse experienced when it was a developing fetus. Thus, cloning champions usually leads to disappointment. On the other hand, \u003ca href=\"http://www.wiley.com/WileyCDA/WileyTitle/productCd-0813819717.html\">cloning a stallion\u003c/a> that sires a high proportion of race-winning horses will result very reliably in a clone that similarly sires winners. This is a genetic rather than a phenotypic situation.\u003c/p>\n\u003cfigure id=\"attachment_345354\" class=\"wp-caption alignleft\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-345354\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/02/horses-430439_960_720-800x626.jpg\" alt=\"Racehorses\" width=\"800\" height=\"626\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/02/horses-430439_960_720-800x626.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/horses-430439_960_720-160x125.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/horses-430439_960_720-768x601.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/horses-430439_960_720-240x188.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/horses-430439_960_720-375x293.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/horses-430439_960_720-520x407.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/horses-430439_960_720.jpg 920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Cloning a winning racehorse is usually leads to disappointment. There is much more than genetics at work. \u003ccite>(Pixabay user Bhakti2)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Even though the genetics are reliable, there are aspects of the cloning procedure that mean the epigenetics and environment are suboptimal. For example, sperm have \u003ca href=\"http://doi.org/10.1016/j.rbmo.2010.02.015\">elegant ways of activating the eggs they fertilize\u003c/a>, which will die unless activated properly; with cloning, activation usually is accomplished by a strong electric shock. Many of the steps of cloning and subsequent embryonic development are done in test tubes in incubators. These conditions are not perfect substitutes for the female reproductive tract where fertilization and early embryonic development normally occur.\u003c/p>\n\u003cp>\u003ca href=\"http://doi.org/10.1038/nbt0102-13\">Sometimes abnormal fetuses develop to term\u003c/a>, resulting in \u003ca href=\"http://doi.org/10.1530/REP-07-0069\">abnormalities at birth\u003c/a>. The most striking abnormal phenotype of some clones is termed “\u003ca href=\"http://doi.org/10.1530/ror.0.0030155\">large offspring syndrome\u003c/a>,” in which calves or lambs are 30 or 40 percent larger than normal, resulting in difficult birth. The problems stem from \u003ca href=\"http://dx.doi.org/10.1016/j.theriogenology.2016.05.017\">an abnormal placenta\u003c/a>. At birth, these clones are genetically normal, but are overly large, and tend to be hyperinsulinemic and hypoglycemic. (The conditions normalize over time once the offspring is no longer influenced by the abnormal placenta.)\u003c/p>\n\u003cp>Recent improvements in cloning procedures have greatly reduced these abnormalities, which also occur with natural reproduction, but at a much lower incidence.\u003c/p>\n\u003cp>\u003cstrong>Continuing Onward With Cloning\u003c/strong>\u003c/p>\n\u003cp>Many thousands of cloned mammals have been produced in nearly two dozen species. Very few of these concern practical applications, such as cloning a famous Angus bull named Final Answer (who recently died at an old age) in order to produce more high-quality cattle via his clone’s sperm.\u003c/p>\n\u003cp>But the cloning research landscape is changing fast. The driving force for producing Dolly was not to \u003ca href=\"http://doi.org/10.1126/science.280.5368.1400\">produce genetically identical animals\u003c/a>. Rather researchers want to combine cloning techniques with other methods in order to efficiently change animals genetically – much quicker than traditional animal breeding methods that take decades to make changes in populations of species such as cattle.\u003c/p>\n\u003cp>One recent example is \u003ca href=\"http://doi.org/10.1038/nbt.3560\">introducing the polled (no horns) gene into dairy cattle\u003c/a>, thus eliminating the need for the painful process of dehorning. An even more striking application has been to produce a strain of pigs that is \u003ca href=\"http://doi.org/10.1038/nbt.3434\">incapable of being infected\u003c/a> by the very contagious and debilitating PRRS virus. Researchers have even made cattle that \u003ca href=\"http://doi.org/10.1038/nbt1271\">cannot develop Mad Cow Disease\u003c/a>. For each of these procedures, somatic cell nuclear transplantation is an essential part of the process.\u003c/p>\n\u003cp>To date, the most valuable contribution of these somatic cell nuclear transplantation experiments has been the scientific information and insights gained. They’ve enhanced our understanding of normal and abnormal embryonic development, including aspects of aging, and more. \u003ca href=\"http://doi.org/10.17226/24623\">This information is already helping\u003c/a> reduce birth defects, improve methods of circumventing infertility, develop tools to fight certain cancers and even decrease some of the negative consequences of aging – in livestock and even in people. Two decades since Dolly, important applications are still evolving.\u003cimg src=\"https://counter.theconversation.edu.au/content/72655/count.gif?distributor=republish-lightbox-basic\" alt=\"The Conversation\" width=\"1\" height=\"1\">\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://theconversation.com/profiles/george-seidel-336737\">George Seidel\u003c/a> is a professor of biomedical science at \u003ca href=\"http://theconversation.com/institutions/colorado-state-university-1267\">Colorado State University\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This article was originally published on \u003ca href=\"http://theconversation.com\">The Conversation\u003c/a>. Read the \u003ca href=\"https://theconversation.com/20-years-after-dolly-everything-you-always-wanted-to-know-about-the-cloned-sheep-and-what-came-next-72655\">original article\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"excerpt": "In 1997, Scottish scientists captured the world's attention by announcing the first successful cloning of a mammal, Dolly the sheep. Here, a look back at the insights Dolly gave researchers.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It’s been 20 years since scientists in Scotland told the world about \u003ca href=\"http://dolly.roslin.ed.ac.uk/facts/the-life-of-dolly/\">Dolly the sheep\u003c/a>, the first mammal successfully \u003ca href=\"http://dx.doi.org/10.1038/385810a0\">cloned from an adult body cell\u003c/a>. What was special about Dolly is that her “parents” were actually a single cell originating from mammary tissue of an adult ewe. Dolly was an exact genetic copy of that sheep – a clone.\u003c/p>\n\u003cp>Dolly captured people’s imaginations, but those of us in the field had seen her coming through \u003ca href=\"http://doi.org/10.1038/380064a0\">previous research\u003c/a>. I’ve been working with \u003ca href=\"http://doi.org/10.1002/jez.1402280217\">mammalian embryos for over 40 years\u003c/a>, with some work in my lab specifically focusing on various methods of cloning cattle and other livestock species. In fact, one of the coauthors of the paper announcing Dolly worked in our laboratory for three years prior to going to Scotland to help create the famous clone.\u003c/p>\n\u003caside class=\"pullquote alignright\">The endgame was never meant to be armies of genetically identical livestock.\u003c/aside>\n\u003cp>Dolly was an important milestone, inspiring scientists to continue improving cloning technology as well as to pursue new concepts in stem cell research. The endgame was never meant to be armies of genetically identical livestock: Rather, researchers continue to refine the techniques and combine them with other methods to turbocharge traditional animal breeding methods as well as gain insights into aging and disease.\u003c/p>\n\u003cp>\u003cstrong>Not the Usual Sperm + Egg\u003c/strong>\u003c/p>\n\u003cp>Dolly was a perfectly normal sheep who became the mother of numerous normal lambs. She lived to six and a half years, when she \u003ca href=\"http://www.nature.com/news/1998/030217/full/news030217-6.html\">was eventually put down\u003c/a> after a contagious disease spread through her flock, infecting cloned and normally reproduced sheep alike. Her life wasn’t unusual; it’s her origin that made her unique.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Before the decades of experiments that led to Dolly, it was thought that normal animals could be produced only by fertilization of an egg by a sperm. That’s how things naturally work. These germ cells are the only ones in the body that have their genetic material all jumbled up and in half the quantity of every other kind of cell. That way when these so-called haploid cells come together at fertilization, they produce one cell with the full complement of DNA. Joined together, the cell is termed diploid, for twice, or double. Two halves make a whole.\u003c/p>\n\u003cp>From that moment forward, nearly all cells in that body have the same genetic makeup. When the one-cell embryo duplicates its genetic material, both cells of the now two-cell embryo are genetically identical. When they in turn duplicate their genetic material, each cell at the four-cell stage is genetically identical. This pattern goes on so that each of the trillions of cells in an adult is genetically exactly the same – whether it’s in a lung or a bone or the blood.\u003c/p>\n\u003cfigure id=\"attachment_345327\" class=\"wp-caption aligncenter\" style=\"max-width: 760px\">\u003cimg class=\"wp-image-345327 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/02/scnt.gif\" alt=\"Somatic cell nuclear transfer\" width=\"760\" height=\"420\">\u003cfigcaption class=\"wp-caption-text\">Somatic cell nuclear transfer uses genetic material from a body cell. \u003ccite>(Australian Department of Industry)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In contrast, Dolly was produced by what’s called \u003ca href=\"http://doi.org/10.1146/annurev-animal-031412-103709\">somatic cell nuclear transfer\u003c/a>. In this process, researchers remove the genetic material from an egg and replace it with the nucleus of some other body cell. The resulting egg becomes a factory to produce an embryo that develops into an offspring. No sperm is in the picture; instead of half the genetic material coming from a sperm and half from an egg, it all comes from a single cell. It’s diploid from the start.\u003c/p>\n\u003cp>\u003cstrong>Long Research Path Led to Dolly\u003c/strong>\u003c/p>\n\u003cp>Dolly was the culmination of hundreds of cloning experiments that, for example, showed diploid embryonic and fetal cells could be parents of offspring. But there was no way to easily know all the characteristics of the animal that would result from a cloned embryo or fetus. Researchers could freeze a few of the cells of a 16-cell embryo, while going on to produce clones from the other cells; if a desirable animal was produced, they could thaw the frozen cells and make more copies. But this was impractical because of low success rates.\u003c/p>\n\u003cp>Dolly demonstrated that adult somatic cells also could be used as parents. Thus, one could know the characteristics of the animal being cloned.\u003c/p>\n\u003cp>By my calculations, Dolly was the single success from 277 tries at somatic cell nuclear transfer. Sometimes the process of cloning by somatic cell nuclear transfer still produces abnormal embryos, most of which die. But the process has greatly improved so success rates \u003ca href=\"http://www.fda.gov/AnimalVeterinary/SafetyHealth/AnimalCloning/ucm124840.htm\">now are more like 10 percent\u003c/a>; it’s highly variable, though, depending on the cell type used and the species.\u003c/p>\n\u003cp>More than 10 different cell types have been used successfully as “parents” for cloning. These days most cloning is done using cells obtained by \u003ca href=\"http://assets.redangus.org/media/Documents/ARA_Magazine/Archived_Issues/2006/11-November/An_Update_On_The_Science_And_Commercialization_Of_Cloning_Cattle.pdf\">biopsying skin\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>More Than Genes Can Affect a Clone\u003c/strong>\u003c/p>\n\u003cp>Genetics is only part of the story. Even while clones are genetically identical, their phenotypes – the characteristics they express – will be different. It’s like naturally occurring identical twins: They share all their genes \u003ca href=\"http://doi.org/10.1016/b978-012174597-4.50012-0\">but they’re not really exactly alike\u003c/a>, especially if reared in different settings.\u003c/p>\n\u003cp>Environment plays a huge role for some characteristics. Food availability can influence weight. Diseases can stunt growth. These kinds of lifestyle, nutrition or disease effects can influence which genes are turned on or off in an individual; these are called \u003ca href=\"http://learn.genetics.utah.edu/content/epigenetics/\">epigenetic effects\u003c/a>. Even though all the genetic material may be the same in two identical clones, they might not be expressing all the same genes.\u003c/p>\n\u003caside class=\"pullquote alignright\">In racehorses, good genes don't guarantee a winner.\u003c/aside>\n\u003cp>Consider the \u003ca href=\"http://doi.org/10.1530/REP-07-0069\">practice of cloning winning racehorses\u003c/a>. Clones of winners sometimes also will be winners – but most of the time they’re not. This is because winners are outliers; they need to have the right genetics, but also the right epigenetics and the right environment to reach that winning potential. For example, one can never exactly duplicate the uterine conditions a winning racehorse experienced when it was a developing fetus. Thus, cloning champions usually leads to disappointment. On the other hand, \u003ca href=\"http://www.wiley.com/WileyCDA/WileyTitle/productCd-0813819717.html\">cloning a stallion\u003c/a> that sires a high proportion of race-winning horses will result very reliably in a clone that similarly sires winners. This is a genetic rather than a phenotypic situation.\u003c/p>\n\u003cfigure id=\"attachment_345354\" class=\"wp-caption alignleft\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-345354\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/02/horses-430439_960_720-800x626.jpg\" alt=\"Racehorses\" width=\"800\" height=\"626\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/02/horses-430439_960_720-800x626.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/horses-430439_960_720-160x125.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/horses-430439_960_720-768x601.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/horses-430439_960_720-240x188.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/horses-430439_960_720-375x293.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/horses-430439_960_720-520x407.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/horses-430439_960_720.jpg 920w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Cloning a winning racehorse is usually leads to disappointment. There is much more than genetics at work. \u003ccite>(Pixabay user Bhakti2)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Even though the genetics are reliable, there are aspects of the cloning procedure that mean the epigenetics and environment are suboptimal. For example, sperm have \u003ca href=\"http://doi.org/10.1016/j.rbmo.2010.02.015\">elegant ways of activating the eggs they fertilize\u003c/a>, which will die unless activated properly; with cloning, activation usually is accomplished by a strong electric shock. Many of the steps of cloning and subsequent embryonic development are done in test tubes in incubators. These conditions are not perfect substitutes for the female reproductive tract where fertilization and early embryonic development normally occur.\u003c/p>\n\u003cp>\u003ca href=\"http://doi.org/10.1038/nbt0102-13\">Sometimes abnormal fetuses develop to term\u003c/a>, resulting in \u003ca href=\"http://doi.org/10.1530/REP-07-0069\">abnormalities at birth\u003c/a>. The most striking abnormal phenotype of some clones is termed “\u003ca href=\"http://doi.org/10.1530/ror.0.0030155\">large offspring syndrome\u003c/a>,” in which calves or lambs are 30 or 40 percent larger than normal, resulting in difficult birth. The problems stem from \u003ca href=\"http://dx.doi.org/10.1016/j.theriogenology.2016.05.017\">an abnormal placenta\u003c/a>. At birth, these clones are genetically normal, but are overly large, and tend to be hyperinsulinemic and hypoglycemic. (The conditions normalize over time once the offspring is no longer influenced by the abnormal placenta.)\u003c/p>\n\u003cp>Recent improvements in cloning procedures have greatly reduced these abnormalities, which also occur with natural reproduction, but at a much lower incidence.\u003c/p>\n\u003cp>\u003cstrong>Continuing Onward With Cloning\u003c/strong>\u003c/p>\n\u003cp>Many thousands of cloned mammals have been produced in nearly two dozen species. Very few of these concern practical applications, such as cloning a famous Angus bull named Final Answer (who recently died at an old age) in order to produce more high-quality cattle via his clone’s sperm.\u003c/p>\n\u003cp>But the cloning research landscape is changing fast. The driving force for producing Dolly was not to \u003ca href=\"http://doi.org/10.1126/science.280.5368.1400\">produce genetically identical animals\u003c/a>. Rather researchers want to combine cloning techniques with other methods in order to efficiently change animals genetically – much quicker than traditional animal breeding methods that take decades to make changes in populations of species such as cattle.\u003c/p>\n\u003cp>One recent example is \u003ca href=\"http://doi.org/10.1038/nbt.3560\">introducing the polled (no horns) gene into dairy cattle\u003c/a>, thus eliminating the need for the painful process of dehorning. An even more striking application has been to produce a strain of pigs that is \u003ca href=\"http://doi.org/10.1038/nbt.3434\">incapable of being infected\u003c/a> by the very contagious and debilitating PRRS virus. Researchers have even made cattle that \u003ca href=\"http://doi.org/10.1038/nbt1271\">cannot develop Mad Cow Disease\u003c/a>. For each of these procedures, somatic cell nuclear transplantation is an essential part of the process.\u003c/p>\n\u003cp>To date, the most valuable contribution of these somatic cell nuclear transplantation experiments has been the scientific information and insights gained. They’ve enhanced our understanding of normal and abnormal embryonic development, including aspects of aging, and more. \u003ca href=\"http://doi.org/10.17226/24623\">This information is already helping\u003c/a> reduce birth defects, improve methods of circumventing infertility, develop tools to fight certain cancers and even decrease some of the negative consequences of aging – in livestock and even in people. Two decades since Dolly, important applications are still evolving.\u003cimg src=\"https://counter.theconversation.edu.au/content/72655/count.gif?distributor=republish-lightbox-basic\" alt=\"The Conversation\" width=\"1\" height=\"1\">\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://theconversation.com/profiles/george-seidel-336737\">George Seidel\u003c/a> is a professor of biomedical science at \u003ca href=\"http://theconversation.com/institutions/colorado-state-university-1267\">Colorado State University\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This article was originally published on \u003ca href=\"http://theconversation.com\">The Conversation\u003c/a>. Read the \u003ca href=\"https://theconversation.com/20-years-after-dolly-everything-you-always-wanted-to-know-about-the-cloned-sheep-and-what-came-next-72655\">original article\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "On Opioid Prescriptions, Doctors 'All Over the Map'",
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"content": "\u003cp>Which doctor a person happens to see at a local emergency room can have long-term consequences when it comes to opioid use.\u003c/p>\n\u003cp>Within the same hospital, some doctors are three times more likely to prescribe an opioid than other doctors, and patients treated by high-prescribing doctors are more likely to become long-term opioid users, according to a study published recently in the \u003cem>New England Journal of Medicine\u003c/em>.\u003c/p>\n\u003cp>“Physicians are just doing things all over the map,” says Dr. Michael Barnett, an assistant professor at the Harvard T. H. Chan School of Public Health and one of the study’s authors. “This is a call to arms for people to start paying a lot more attention to having a unified approach.”\u003c/p>\n\u003cp>The study looked at how many opioid prescriptions emergency physicians gave to about 377,000 Medicare beneficiaries from 2008 through 2011. The lowest-prescribing quartile of doctors prescribed opioids to just 7 percent of patients, while the highest prescribed opioids to 24 percent — more than three times as often.\u003c/p>\n\u003cp>Patients who saw a high-intensity prescriber were about 30 percent more likely to end up with a long-term opioid prescription of at least six months within the year following their hospital visit. They were also more likely to return to the hospital in the next 12 months with an opioid-related fall or fracture, a risk factor for seniors who take the powerful painkillers.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Overall, about one in every 48 Medicare patients prescribed an opioid in the study were likely to become a long-term opioid user.\u003c/p>\n\u003cp>There is a growing consensus among doctors that opioids have long been overprescribed. In 2010, there were enough prescriptions written to supply every American adult with hydrocodone for a month, according to the \u003ca href=\"https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm\" target=\"_blank\">Centers for Disease Control and Prevention\u003c/a>.\u003c/p>\n\u003cp>Part of the problem, Barnett believes, is that there isn’t enough guidance for doctors on when it’s appropriate to prescribe an opioid. Much of the evidence for when they are appropriate comes from small studies sponsored by drug companies.\u003c/p>\n\u003cp>“It’s kind of a grey area and there’s not very clear evidence around what you should do, so we use our own judgement. And there’s a huge gulf between what one doctor thinks and another,” Barnett explains.\u003c/p>\n\u003cp>Take, for example, a patient who comes to the emergency room complaining of back pain. There’s evidence that opioids are not necessary in that situation, but many doctors prescribe them anyway, said Barnett. “The world of pain treatment outside of opioids is limited and can take time to figure out. Opioids are an easy fix.”\u003c/p>\n\u003cp>The problem, he said, is that “even one prescription for opioids carries risks with it, that from my own experience as a provider, we tend to underestimate and under-explain to patients.”\u003c/p>\n\u003cp>“It is very, very plausible that well-intentioned but perhaps overly aggressive prescribing of opioids makes it likely that a patient will continue a medication long-term even if they don’t truly need it,” said Dr. \u003ca href=\"http://ihpme.utoronto.ca/faculty/david-juurlink/\" target=\"_blank\">David Juurlink\u003c/a>, a professor of medicine at the University of Toronto. He was not involved in the study. “The doctors in the lowest quartile are the ones whose prescribing we should seek to be emulating.”\u003c/p>\n\u003cp>The study did not look at whether the opioids were correctly prescribed in each incidence. Dr. \u003ca href=\"http://californiahealthline.org/news/prescribing-opioids-to-seniors-its-a-balancing-act/\">Carla Perissinotto\u003c/a>, a geriatrician at the University of California San Francisco, worries that some of the doctors in the lowest quartile might be under-prescribing. “We have to be careful to not make assumptions too quickly and assume they’re bad prescribers, because it could be the opposite,” said Perissinotto, who also was not involved in the study.\u003c/p>\n\u003cp>Usually, a patient is prescribed just a handful of pills by a doctor at the emergency department to tide them over until the patient can visit his or her primary care physician.\u003c/p>\n\u003cp>But many primary care doctors simply refill the opioid prescription for another 30 days or longer, a phenomenon Barnett calls clinical inertia. “There’s this cognitive bias to keep going with the flow especially if the patient still feels they’re in pain.”\u003c/p>\n\u003cp>That can have long-term implications: One-third of people who have taken prescription opioids for at least two months say they became addicted to or physically dependent on them, a recent \u003ca href=\"https://www.washingtonpost.com/page/2010-2019/WashingtonPost/2016/12/09/National-Politics/Polling/release_455.xml\" target=\"_blank\">Washington Post-Kaiser Family Foundation survey found.\u003c/a>\u003c/p>\n\u003cp>“We know there is a population of people who will potentially get addicted if they’re exposed to an opioid,” said Dr. \u003ca href=\"http://njms.rutgers.edu/departments/emergency_medicine/\">Lewis Nelson\u003c/a>, chair of the department of emergency medicine at Rutgers New Jersey Medical School, who was not involved with the study. “It’s a numbers game. The more people you expose, the more people you are likely to hit in that population likely to get addicted.”\u003c/p>\n\u003cp>Some hospitals are starting to help doctors prescribe opioids more judiciously. Many of those efforts have taken place after 2011, and therefore any changes would not be seen in the New England Journal of Medicine study.\u003c/p>\n\u003cp>For the past year, St. Joseph’s Regional Medical Center in New Jersey has been instructing doctors to prescribe opioids only as a last resort, said Dr. \u003ca href=\"https://www.acep.org/About-Us/Mark-S--Rosenberg,-DO,-MBA,-FACEP/\" target=\"_blank\">Mark Rosenberg\u003c/a>, who runs the hospital’s emergency department and is on the board of the American College of Emergency Physicians. Rosenberg helped institute protocols that have doctors try other methods of pain relief first, such as a Novocain injection. In just over a year, the hospital has managed to reduce the number of opioid prescriptions written in the emergency room by 50 percent.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>New York City and Washington state have also tried to introduce opioid prescribing guidelines into hospitals, and the ACEP expects to release new nationwide guidelines for emergency physicians in 2018.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Which doctor a person happens to see at a local emergency room can have long-term consequences when it comes to opioid use.\u003c/p>\n\u003cp>Within the same hospital, some doctors are three times more likely to prescribe an opioid than other doctors, and patients treated by high-prescribing doctors are more likely to become long-term opioid users, according to a study published recently in the \u003cem>New England Journal of Medicine\u003c/em>.\u003c/p>\n\u003cp>“Physicians are just doing things all over the map,” says Dr. Michael Barnett, an assistant professor at the Harvard T. H. Chan School of Public Health and one of the study’s authors. “This is a call to arms for people to start paying a lot more attention to having a unified approach.”\u003c/p>\n\u003cp>The study looked at how many opioid prescriptions emergency physicians gave to about 377,000 Medicare beneficiaries from 2008 through 2011. The lowest-prescribing quartile of doctors prescribed opioids to just 7 percent of patients, while the highest prescribed opioids to 24 percent — more than three times as often.\u003c/p>\n\u003cp>Patients who saw a high-intensity prescriber were about 30 percent more likely to end up with a long-term opioid prescription of at least six months within the year following their hospital visit. They were also more likely to return to the hospital in the next 12 months with an opioid-related fall or fracture, a risk factor for seniors who take the powerful painkillers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Overall, about one in every 48 Medicare patients prescribed an opioid in the study were likely to become a long-term opioid user.\u003c/p>\n\u003cp>There is a growing consensus among doctors that opioids have long been overprescribed. In 2010, there were enough prescriptions written to supply every American adult with hydrocodone for a month, according to the \u003ca href=\"https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm\" target=\"_blank\">Centers for Disease Control and Prevention\u003c/a>.\u003c/p>\n\u003cp>Part of the problem, Barnett believes, is that there isn’t enough guidance for doctors on when it’s appropriate to prescribe an opioid. Much of the evidence for when they are appropriate comes from small studies sponsored by drug companies.\u003c/p>\n\u003cp>“It’s kind of a grey area and there’s not very clear evidence around what you should do, so we use our own judgement. And there’s a huge gulf between what one doctor thinks and another,” Barnett explains.\u003c/p>\n\u003cp>Take, for example, a patient who comes to the emergency room complaining of back pain. There’s evidence that opioids are not necessary in that situation, but many doctors prescribe them anyway, said Barnett. “The world of pain treatment outside of opioids is limited and can take time to figure out. Opioids are an easy fix.”\u003c/p>\n\u003cp>The problem, he said, is that “even one prescription for opioids carries risks with it, that from my own experience as a provider, we tend to underestimate and under-explain to patients.”\u003c/p>\n\u003cp>“It is very, very plausible that well-intentioned but perhaps overly aggressive prescribing of opioids makes it likely that a patient will continue a medication long-term even if they don’t truly need it,” said Dr. \u003ca href=\"http://ihpme.utoronto.ca/faculty/david-juurlink/\" target=\"_blank\">David Juurlink\u003c/a>, a professor of medicine at the University of Toronto. He was not involved in the study. “The doctors in the lowest quartile are the ones whose prescribing we should seek to be emulating.”\u003c/p>\n\u003cp>The study did not look at whether the opioids were correctly prescribed in each incidence. Dr. \u003ca href=\"http://californiahealthline.org/news/prescribing-opioids-to-seniors-its-a-balancing-act/\">Carla Perissinotto\u003c/a>, a geriatrician at the University of California San Francisco, worries that some of the doctors in the lowest quartile might be under-prescribing. “We have to be careful to not make assumptions too quickly and assume they’re bad prescribers, because it could be the opposite,” said Perissinotto, who also was not involved in the study.\u003c/p>\n\u003cp>Usually, a patient is prescribed just a handful of pills by a doctor at the emergency department to tide them over until the patient can visit his or her primary care physician.\u003c/p>\n\u003cp>But many primary care doctors simply refill the opioid prescription for another 30 days or longer, a phenomenon Barnett calls clinical inertia. “There’s this cognitive bias to keep going with the flow especially if the patient still feels they’re in pain.”\u003c/p>\n\u003cp>That can have long-term implications: One-third of people who have taken prescription opioids for at least two months say they became addicted to or physically dependent on them, a recent \u003ca href=\"https://www.washingtonpost.com/page/2010-2019/WashingtonPost/2016/12/09/National-Politics/Polling/release_455.xml\" target=\"_blank\">Washington Post-Kaiser Family Foundation survey found.\u003c/a>\u003c/p>\n\u003cp>“We know there is a population of people who will potentially get addicted if they’re exposed to an opioid,” said Dr. \u003ca href=\"http://njms.rutgers.edu/departments/emergency_medicine/\">Lewis Nelson\u003c/a>, chair of the department of emergency medicine at Rutgers New Jersey Medical School, who was not involved with the study. “It’s a numbers game. The more people you expose, the more people you are likely to hit in that population likely to get addicted.”\u003c/p>\n\u003cp>Some hospitals are starting to help doctors prescribe opioids more judiciously. Many of those efforts have taken place after 2011, and therefore any changes would not be seen in the New England Journal of Medicine study.\u003c/p>\n\u003cp>For the past year, St. Joseph’s Regional Medical Center in New Jersey has been instructing doctors to prescribe opioids only as a last resort, said Dr. \u003ca href=\"https://www.acep.org/About-Us/Mark-S--Rosenberg,-DO,-MBA,-FACEP/\" target=\"_blank\">Mark Rosenberg\u003c/a>, who runs the hospital’s emergency department and is on the board of the American College of Emergency Physicians. Rosenberg helped institute protocols that have doctors try other methods of pain relief first, such as a Novocain injection. In just over a year, the hospital has managed to reduce the number of opioid prescriptions written in the emergency room by 50 percent.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>New York City and Washington state have also tried to introduce opioid prescribing guidelines into hospitals, and the ACEP expects to release new nationwide guidelines for emergency physicians in 2018.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Hundreds of Babies Reported Harmed by Homeopathic Product",
"title": "Hundreds of Babies Reported Harmed by Homeopathic Product",
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"content": "\u003cp>Case 7682299: Aug. 1, 2010. A mother gives her toddler three homeopathic pills to relieve her teething pain. Within minutes, the baby stops breathing.\u003c/p>\n\u003cp>“My daughter had a seizure, lost consciousness, and stopped breathing about 30 minutes after I gave her three Hyland’s Teething Tablets,” the mother later told the Food and Drug Administration. “She had to receive mouth-to-mouth CPR to resume breathing and was brought to the hospital.”\u003c/p>\n\u003cp>The company, \u003ca href=\"https://www.hylands.com/\" target=\"_blank\">Hyland’s\u003c/a>, promotes “safe, effective, and natural health solutions” that appeal to parents seeking alternative treatments. But the agency would soon hear much more about Hyland’s teething products. Staff at the FDA would come to consider Case 7682299 one of the luckier outcomes.\u003c/p>\n\u003cfigure id=\"attachment_341968\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-341968 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/02/homeopathic-800x800.jpg\" alt=\"A review of FDA records shows that some babies who were given Hyland’s teething products had repeated seizures, became delirious or turned blue and died. \" width=\"800\" height=\"800\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-800x800.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-160x160.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-768x768.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-1020x1020.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-1180x1180.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-960x960.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-240x240.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-375x375.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-520x520.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-50x50.jpg 50w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-150x150.jpg 150w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic.jpg 1600w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A review of FDA records shows that some babies who were given Hyland’s teething products had repeated seizures, became delirious or turned blue and died. \u003ccite>(Photo from FDA)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A review of FDA records obtained by STAT under the Freedom of Information Act paints a far grimmer picture: Babies who were given Hyland’s teething products turned blue and died. Babies had repeated seizures. Babies became delirious. Babies were airlifted to the hospital, where emergency room staff tried to figure out what had caused their legs and arms to start twitching.\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>Over a 10-year period, from 2006 to 2016, the FDA collected reports of “adverse events” in more than 370 children who had used Hyland’s homeopathic teething tablets or gel, a similar product that is applied directly to a baby’s gums. Agency records show eight cases in which babies were reported to have died after taking Hyland’s products, though the FDA says the question of whether those products caused the deaths is still under review.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>(The agency is also investigating two other deaths tied to teething remedies but declined to confirm the manufacturer of the products or provide the case reports.)\u003c/p>\n\u003cp>Following an \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm523468.htm\" target=\"_blank\">FDA warning in September\u003c/a>, Hyland’s said that it \u003ca href=\"https://www.hylands.com/hylands-discontinues-teething-tablets-and-gels\" target=\"_blank\">would no longer manufacture\u003c/a> the teething products. But they remained on some store shelves for months, and are still available on the internet. They likely continue to be used in homes nationwide.\u003c/p>\n\u003cp>Hyland’s, a 114-year-old private company based in Los Angeles, is the nation’s largest homeopathic business. It insists its products are safe and says the FDA has failed to show there is a scientific link between them and infant seizures or other complications.\u003c/p>\n\u003cp>“That doesn’t mean that children don’t have a sensitivity to a product. There is a lot of sensitivity on kids’ parts and we have to watch carefully,” said a spokeswoman, Mary Borneman. “It’s not something that condemns the entire product line.”\u003c/p>\n\u003cp>Behind each of the FDA case numbers are angry and, in some cases, heartbroken parents. But a STAT examination — and the first detailed look at the case reports — also raises questions over the response of regulators.\u003c/p>\n\u003cp>It took four years until the FDA pushed Hyland’s to reformulate its remedies, in 2010. In the seven years since then, there has been a steady stream of reports of adverse events tied to Hyland’s homeopathic teething products.\u003c/p>\n\u003cp>“The FDA could bring the hammer down on them,” said Sarah Sorscher, an attorney for the nonprofit Public Citizen Health Research Group. “But it doesn’t. At the point where you have infants being hospitalized and deaths reported, it’s simply not acceptable for the agency to delay in taking action.”\u003c/p>\n\u003cp>An FDA spokeswoman defended the agency’s handling of the matter.\u003c/p>\n\u003cp>“It is important to note that while adverse event reports give us some information about a product and serious injuries or deaths related to use of a particular product, they often indicate situations that require additional analysis and do not constitute conclusive evidence of a problem with the product,” the spokeswoman, Lyndsay Meyer, said in a statement.\u003c/p>\n\u003cp>Despite the FDA’s difficulty in proving Hyland’s products harmed children, some doctors had no doubt.\u003c/p>\n\u003cp>In case 462749, dated Sept. 15, 2011, a physician sent Hyland’s a handwritten note, stating his patient, a 5-month-old girl, was unresponsive for 45 minutes after taking its teething tablets.\u003c/p>\n\u003cp>“I am sure this was not an allergic reaction,” he wrote. “I would like you to report it, find a contact at the FDA, so we can start an investigation and pull this dangerous, unregulated product from the shelves.”\u003c/p>\n\u003cp>One mother wrote the company to say her son’s pupils dilated “like marbles with big black eyes.” Another described seizures her daughter continued to have after taking the tablets and told the company, “I hate hate hate u for this.”\u003c/p>\n\u003cfigure id=\"attachment_342003\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-342003 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/02/homeophathadverse-800x450.jpg\" alt=\"homeophathadverse\" width=\"800\" height=\"450\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse-800x450.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse-160x90.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse-768x432.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse-1020x574.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse-1180x664.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse-960x540.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse-240x135.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse-375x211.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse-520x293.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Adverse event report on Hyland' teething tablets, sent to FDA. \u003ccite>(Photo by STAT)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>An Industry Giant in a Giant Industry\u003c/strong>\u003c/p>\n\u003cp>Hyland’s and its parent company, Standard Homeopathy Co., are considered major players in the homeopathic market. CEO \u003ca href=\"https://www.hylands.com/meet-the-team/jay-borneman\" target=\"_blank\">John P. Borneman\u003c/a> comes from a family that has been in the business for generations, and is president of the industry group that publishes the Homeopathic Pharmacopeia, a compendium that serves as the bible of the industry.\u003c/p>\n\u003cp>The company sells dozens of products for pain relief, stress, sleep problems, allergies, flu, and other maladies.\u003c/p>\n\u003cp>As with all homeopathic treatments, Hyland’s products are based on a theory that patients can benefit from highly diluted natural substances that, in their original form, might make people sick.\u003c/p>\n\u003cp>Despite a lack of scientific evidence that homeopathic remedies work, they are ubiquitous.\u003c/p>\n\u003cp>Homeopathy has become a multibillion-dollar industry. Its products are big sellers around the world, and popular with adherents from Cher to Prince Charles. The industry also has political clout: It has been able to exempt itself from many rules proposed by Congress and the FDA over the years.\u003c/p>\n\u003cp>Unlike pharmaceutical company-produced drugs, homeopathic products don’t have to prove that they are effective at treating anything in particular before going on the market. It is left to the FDA’s drug division to determine whether they are unsafe after they are on the market — a difficult task since the adverse event reports are generally considered to represent only a fraction of the actual incidents and may lack sufficient information to allow for thorough investigations.\u003c/p>\n\u003cp>“If I’m working in the emergency room and I have a family that comes in with a seizing infant, I may not have the wherewithal to get the history of homeopathic use,” said Dr. Edward W. Boyer, a toxicologist in Harvard Medical School’s emergency medicine department.\u003c/p>\n\u003cp>In some cases, parents assume that products described as natural remedies, as is the case with Hyland’s tablets and gels, could not possibly result in complications, and never mention their use to a doctor. Without sufficient evidence of a problem, the FDA lacks what it needs to use the enforcement tools it does have.\u003c/p>\n\u003cp>For Karinna Talbott, a 26-year-old mother in Colorado Springs, the fact that Hyland’s teething products were labeled “natural” made her lower her guard.\u003c/p>\n\u003cp>“When our fourth kiddo comes around and starts teething at three months, we were like, ‘OK, what can we do to give him some relief?’” Talbott said. “Someone told us about the teething tablets and we thought, ‘give them a try.' ’’\u003c/p>\n\u003cp>Shortly after her son began taking the tablets, she said, his hands began twitching.\u003c/p>\n\u003cp>“We didn’t correlate it to the teething tablets,” Talbott said. “And his symptoms got worse, went to his arms and his feet. Sometimes they all happened together.”\u003c/p>\n\u003cp>Talbott said her doctor was at first uncertain as to the cause. But when they stopped giving him the tablets, the seizures also stopped.\u003c/p>\n\u003cp>“The neurologist said, maybe he was a little sensitive to the products in the teething tablet.”\u003c/p>\n\u003cp>\u003cstrong>‘Deadly nightshade’\u003c/strong>\u003c/p>\n\u003cp>In investigating Hyland’s teething products, the FDA focused on an ingredient known as atropa belladonna, an herb known colloquially as “deadly nightshade.”\u003c/p>\n\u003cp>In diluted form, the substance is not expected to pose any health risk. In 2010, however, FDA inspectors who examined Hyland’s facilities criticized the company for substandard manufacturing practices and found inconsistent levels of atropa belladonna in its products.\u003c/p>\n\u003cp>The agency issued a public warning, noting “reports of serious adverse events in children taking this product that are consistent with belladonna toxicity.”\u003c/p>\n\u003cp>It also noted that “infants are very susceptible to the neurotoxicity of drugs” because of how the body distributes and responds to drugs, and noted that “absorption of belladonna from the skin and mouth was fairly rapid.”\u003c/p>\n\u003cp>The company voluntarily took the products off shelves and agreed to reformulate them, although it insisted they were safe.\u003c/p>\n\u003cp>“We felt it was the right thing to do so that parents didn’t have to be concerned about the product,” said Borneman, the spokeswoman.\u003c/p>\n\u003cp>But the number of serious adverse events tied by the FDA to the products kept climbing. Some pediatricians and neurologists concluded the tablets and gels were the cause. Many parents wrote to the FDA, accusingly, asking why the pills were still on the market.\u003c/p>\n\u003cp>“My son had 3 of Hyland’s Teething Tablets,” a mother told FDA on Feb. 13, 2012, noting that the product appeared to have caused several seizures. “I am shocked at the popularity of this product, which is growing, and the lack of knowledge among parents, as well as the lack of warnings on the labels. Parents desperately need to be warned about this product if it is going to stay on the shelves!!!! Please do something!”\u003c/p>\n\u003cp>In September 2016, the \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm523468.htm\" target=\"_blank\">FDA announced\u003c/a> that it was investigating more adverse events reports and recommended that consumers stop using Hyland’s and other homeopathic teething products and dispose of any in their possession. Some stores, including Target and CVS, which sold Hyland’s and other homeopathic teething products, pulled them in response.\u003c/p>\n\u003cp>The FDA also asked Hyland’s to recall its products again. But this time Hyland’s stood its ground, and the agency has no authority to enforce a recall of homeopathic products.\u003c/p>\n\u003cp>Borneman said the company’s “pharmacovigilance program,” a product safety review system launched after 2010, offers proof that the treatments are safe.\u003c/p>\n\u003cp>“Homeopathic medicine has a very large margin of safety,” she said. “Our testing ensures there’s not too much belladonna in any bottle” of tablets.\u003c/p>\n\u003cp>At the same time, the company decided to stop manufacturing the teething tablets. In an \u003ca href=\"https://www.hylands.com/hylands-discontinues-teething-tablets-and-gels\" target=\"_blank\">open letter to customers\u003c/a>, Hyland’s said the FDA warning had “created confusion among parents.”\u003c/p>\n\u003cp>“Putting you in a position of having to choose who to trust in the face of contradictory information is burdensome and undermines the FDA,” the company said, while insisting Hyland’s products, “including those you already have, are safe for use.”\u003c/p>\n\u003cp>Several weeks ago, on Jan. 27, the FDA \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm538684.htm\" target=\"_blank\">issued another warning\u003c/a>, saying that laboratory analysis of Hyland’s teething tablets found levels of belladonna “sometimes far exceeding the amount claimed on the label.” The agency warned consumers not to use the products and to seek medical care immediately if their child has seizures, difficulty breathing, lethargy, muscle weakness, or other problems after using homeopathic teething products.\u003c/p>\n\u003cp>The FDA also said there was no evidence that they actually worked.\u003c/p>\n\u003cfigure id=\"attachment_342006\" class=\"wp-caption aligncenter\" style=\"max-width: 768px\">\u003cimg class=\"wp-image-342006 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/02/homeopathicevent.jpg\" alt=\"homeopathicevent\" width=\"768\" height=\"432\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathicevent.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathicevent-160x90.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathicevent-240x135.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathicevent-375x211.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathicevent-520x293.jpg 520w\" sizes=\"(max-width: 768px) 100vw, 768px\">\u003cfigcaption class=\"wp-caption-text\">Report sent to FDA by a physician. \u003ccite>(Photo by STAT)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Cracks in the FDA’s Authority\u003c/strong>\u003c/p>\n\u003cp>With concerns about toxic levels of belladonna, and the sheer number of cases of adverse events, some critics — and parents — say the FDA should have moved faster in the case of Hyland’s.\u003c/p>\n\u003cp>But they also acknowledge that the episode underlines the cracks in the agency’s regulatory power when it comes to homeopathic products. There is no set mathematical formula or official standard that spells out how many sick or deceased children must be reported before the FDA seizes a company’s inventory or levies fines or shuts it down.\u003c/p>\n\u003cp>Critics say the fact that homeopathic products are generally highly diluted has kept them on the FDA’s back burner.\u003c/p>\n\u003cp>“It’s low on their priority list,” said Dr. Aaron S. Kesselheim, who \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1513393#t=article\" target=\"_blank\">coauthored a paper\u003c/a> in the New England Journal of Medicine last year on the subject. “FDA for a long time just kind of deferred on homeopathic products because they are mostly inert and so diluted. The harm comes from people wasting their money, or diverting them from things that do work.”\u003c/p>\n\u003cp>In the case of some of Hyland’s products, however, Kesselheim believes that the toxic levels of belladonna show a substantial safety problem, putting a responsibility on FDA to respond.\u003c/p>\n\u003cp>One problem the FDA has in doing so is a matter of staffing: The agency has a medical officer review each report from manufacturers, but it doesn’t have someone who can routinely follow up with the patient, the patient’s family, or physician for missing records necessary to take a serious enforcement action.\u003c/p>\n\u003cp>“Is it fair to criticize FDA for the time lag between 2010 and now?” says Patricia Zettler, a former FDA counsel and associate law professor at Georgia State University. “I think the agency is in a tough position, with these kinds of products and with adverse event reports in general. They are not necessarily a perfect indication of something happening with a drug.”\u003c/p>\n\u003cp>“That said,” Zettler added, “it does sound like this is a product the agency was concerned about. It’s tough to parse out whether two reports of seizures should have been enough, or three or 10. There’s a balance the agency has to strike between acting quickly on safety information and not overreacting to something that may not actually be caused by the product.”\u003c/p>\n\u003cp>Public Citizen’s Sorscher said criminal cases take years to pursue, so the FDA would much prefer voluntary compliance.\u003c/p>\n\u003cp>“They don’t have a mechanism to say, ‘this ingredient is unsafe, nobody should sell it,’” she said. “It might be time for Congress to give FDA a standard and say, you can issue a regulation saying no one can make it anymore.”\u003c/p>\n\u003cp>Outraged by the standoff between FDA and Hyland’s, Connecticut Democratic Representative Rosa DeLauro \u003ca href=\"https://delauro.house.gov/media-center/press-releases/delauro-introduces-bill-give-fda-mandatory-recall-authority-over-drugs\" target=\"_blank\">introduced a bill last week\u003c/a> called the Recall Unsafe Drugs Act. The proposal would give the FDA mandatory recall authority over homeopathic products and drugs.\u003c/p>\n\u003cp>“Hyland’s refusal to recall its teething tablets, despite numerous health and safety warnings from the FDA, is downright shameful,” DeLauro said, adding that the company “is choosing instead to prioritize the company’s profits and reputation before the safety of our children.”\u003c/p>\n\u003cp>“As it stands the FDA would have to go through an arduous legal process to take action against manufacturers such as Hyland’s. This is unacceptable and threatens the health and safety of American families.’’\u003c/p>\n\u003cp>For the parents of Case 10723317, any action would come too late. A mother reported that on July 9, 2014, her 9-month-old daughter died after being given two teething tablets, crushed, for the first time. She gave her infant the tablets, then a bottle, and then left her to sleep. When she checked on her 45 minutes later, she was dead in her crib, beside a puddle of vomit.\u003c/p>\n\u003cp>Five months later, after reading online reports suggesting babies may experience seizures after taking belladonna, she contacted Hyland’s.\u003c/p>\n\u003cp>“Customer did not request a refund or replacement,” noted the Hyland’s staffer who filed the report with the FDA. Hyland’s also noted that it was not able to test the bottle, because the customer threw it away.\u003c/p>\n\u003cp>“Due to the limited information provided by the reporter no further investigation is possible at this time of this incident,” the company concluded.\u003c/p>\n\u003cp>\u003cem>Ike Swetlitz contributed reporting.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2017/02/21/hylands-homeopathic-teething-fda/\" 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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"excerpt": "The FDA has collected reports of 'adverse events' in over 370 children who used Hyland’s homeopathic teething products, and the agency is investigating whether the products caused the deaths of eight babies. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Case 7682299: Aug. 1, 2010. A mother gives her toddler three homeopathic pills to relieve her teething pain. Within minutes, the baby stops breathing.\u003c/p>\n\u003cp>“My daughter had a seizure, lost consciousness, and stopped breathing about 30 minutes after I gave her three Hyland’s Teething Tablets,” the mother later told the Food and Drug Administration. “She had to receive mouth-to-mouth CPR to resume breathing and was brought to the hospital.”\u003c/p>\n\u003cp>The company, \u003ca href=\"https://www.hylands.com/\" target=\"_blank\">Hyland’s\u003c/a>, promotes “safe, effective, and natural health solutions” that appeal to parents seeking alternative treatments. But the agency would soon hear much more about Hyland’s teething products. Staff at the FDA would come to consider Case 7682299 one of the luckier outcomes.\u003c/p>\n\u003cfigure id=\"attachment_341968\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-341968 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/02/homeopathic-800x800.jpg\" alt=\"A review of FDA records shows that some babies who were given Hyland’s teething products had repeated seizures, became delirious or turned blue and died. \" width=\"800\" height=\"800\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-800x800.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-160x160.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-768x768.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-1020x1020.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-1180x1180.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-960x960.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-240x240.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-375x375.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-520x520.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-50x50.jpg 50w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic-150x150.jpg 150w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathic.jpg 1600w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A review of FDA records shows that some babies who were given Hyland’s teething products had repeated seizures, became delirious or turned blue and died. \u003ccite>(Photo from FDA)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A review of FDA records obtained by STAT under the Freedom of Information Act paints a far grimmer picture: Babies who were given Hyland’s teething products turned blue and died. Babies had repeated seizures. Babies became delirious. Babies were airlifted to the hospital, where emergency room staff tried to figure out what had caused their legs and arms to start twitching.\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>Over a 10-year period, from 2006 to 2016, the FDA collected reports of “adverse events” in more than 370 children who had used Hyland’s homeopathic teething tablets or gel, a similar product that is applied directly to a baby’s gums. Agency records show eight cases in which babies were reported to have died after taking Hyland’s products, though the FDA says the question of whether those products caused the deaths is still under review.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>(The agency is also investigating two other deaths tied to teething remedies but declined to confirm the manufacturer of the products or provide the case reports.)\u003c/p>\n\u003cp>Following an \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm523468.htm\" target=\"_blank\">FDA warning in September\u003c/a>, Hyland’s said that it \u003ca href=\"https://www.hylands.com/hylands-discontinues-teething-tablets-and-gels\" target=\"_blank\">would no longer manufacture\u003c/a> the teething products. But they remained on some store shelves for months, and are still available on the internet. They likely continue to be used in homes nationwide.\u003c/p>\n\u003cp>Hyland’s, a 114-year-old private company based in Los Angeles, is the nation’s largest homeopathic business. It insists its products are safe and says the FDA has failed to show there is a scientific link between them and infant seizures or other complications.\u003c/p>\n\u003cp>“That doesn’t mean that children don’t have a sensitivity to a product. There is a lot of sensitivity on kids’ parts and we have to watch carefully,” said a spokeswoman, Mary Borneman. “It’s not something that condemns the entire product line.”\u003c/p>\n\u003cp>Behind each of the FDA case numbers are angry and, in some cases, heartbroken parents. But a STAT examination — and the first detailed look at the case reports — also raises questions over the response of regulators.\u003c/p>\n\u003cp>It took four years until the FDA pushed Hyland’s to reformulate its remedies, in 2010. In the seven years since then, there has been a steady stream of reports of adverse events tied to Hyland’s homeopathic teething products.\u003c/p>\n\u003cp>“The FDA could bring the hammer down on them,” said Sarah Sorscher, an attorney for the nonprofit Public Citizen Health Research Group. “But it doesn’t. At the point where you have infants being hospitalized and deaths reported, it’s simply not acceptable for the agency to delay in taking action.”\u003c/p>\n\u003cp>An FDA spokeswoman defended the agency’s handling of the matter.\u003c/p>\n\u003cp>“It is important to note that while adverse event reports give us some information about a product and serious injuries or deaths related to use of a particular product, they often indicate situations that require additional analysis and do not constitute conclusive evidence of a problem with the product,” the spokeswoman, Lyndsay Meyer, said in a statement.\u003c/p>\n\u003cp>Despite the FDA’s difficulty in proving Hyland’s products harmed children, some doctors had no doubt.\u003c/p>\n\u003cp>In case 462749, dated Sept. 15, 2011, a physician sent Hyland’s a handwritten note, stating his patient, a 5-month-old girl, was unresponsive for 45 minutes after taking its teething tablets.\u003c/p>\n\u003cp>“I am sure this was not an allergic reaction,” he wrote. “I would like you to report it, find a contact at the FDA, so we can start an investigation and pull this dangerous, unregulated product from the shelves.”\u003c/p>\n\u003cp>One mother wrote the company to say her son’s pupils dilated “like marbles with big black eyes.” Another described seizures her daughter continued to have after taking the tablets and told the company, “I hate hate hate u for this.”\u003c/p>\n\u003cfigure id=\"attachment_342003\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"wp-image-342003 size-medium\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/02/homeophathadverse-800x450.jpg\" alt=\"homeophathadverse\" width=\"800\" height=\"450\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse-800x450.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse-160x90.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse-768x432.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse-1020x574.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse-1180x664.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse-960x540.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse-240x135.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse-375x211.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeophathadverse-520x293.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Adverse event report on Hyland' teething tablets, sent to FDA. \u003ccite>(Photo by STAT)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>An Industry Giant in a Giant Industry\u003c/strong>\u003c/p>\n\u003cp>Hyland’s and its parent company, Standard Homeopathy Co., are considered major players in the homeopathic market. CEO \u003ca href=\"https://www.hylands.com/meet-the-team/jay-borneman\" target=\"_blank\">John P. Borneman\u003c/a> comes from a family that has been in the business for generations, and is president of the industry group that publishes the Homeopathic Pharmacopeia, a compendium that serves as the bible of the industry.\u003c/p>\n\u003cp>The company sells dozens of products for pain relief, stress, sleep problems, allergies, flu, and other maladies.\u003c/p>\n\u003cp>As with all homeopathic treatments, Hyland’s products are based on a theory that patients can benefit from highly diluted natural substances that, in their original form, might make people sick.\u003c/p>\n\u003cp>Despite a lack of scientific evidence that homeopathic remedies work, they are ubiquitous.\u003c/p>\n\u003cp>Homeopathy has become a multibillion-dollar industry. Its products are big sellers around the world, and popular with adherents from Cher to Prince Charles. The industry also has political clout: It has been able to exempt itself from many rules proposed by Congress and the FDA over the years.\u003c/p>\n\u003cp>Unlike pharmaceutical company-produced drugs, homeopathic products don’t have to prove that they are effective at treating anything in particular before going on the market. It is left to the FDA’s drug division to determine whether they are unsafe after they are on the market — a difficult task since the adverse event reports are generally considered to represent only a fraction of the actual incidents and may lack sufficient information to allow for thorough investigations.\u003c/p>\n\u003cp>“If I’m working in the emergency room and I have a family that comes in with a seizing infant, I may not have the wherewithal to get the history of homeopathic use,” said Dr. Edward W. Boyer, a toxicologist in Harvard Medical School’s emergency medicine department.\u003c/p>\n\u003cp>In some cases, parents assume that products described as natural remedies, as is the case with Hyland’s tablets and gels, could not possibly result in complications, and never mention their use to a doctor. Without sufficient evidence of a problem, the FDA lacks what it needs to use the enforcement tools it does have.\u003c/p>\n\u003cp>For Karinna Talbott, a 26-year-old mother in Colorado Springs, the fact that Hyland’s teething products were labeled “natural” made her lower her guard.\u003c/p>\n\u003cp>“When our fourth kiddo comes around and starts teething at three months, we were like, ‘OK, what can we do to give him some relief?’” Talbott said. “Someone told us about the teething tablets and we thought, ‘give them a try.' ’’\u003c/p>\n\u003cp>Shortly after her son began taking the tablets, she said, his hands began twitching.\u003c/p>\n\u003cp>“We didn’t correlate it to the teething tablets,” Talbott said. “And his symptoms got worse, went to his arms and his feet. Sometimes they all happened together.”\u003c/p>\n\u003cp>Talbott said her doctor was at first uncertain as to the cause. But when they stopped giving him the tablets, the seizures also stopped.\u003c/p>\n\u003cp>“The neurologist said, maybe he was a little sensitive to the products in the teething tablet.”\u003c/p>\n\u003cp>\u003cstrong>‘Deadly nightshade’\u003c/strong>\u003c/p>\n\u003cp>In investigating Hyland’s teething products, the FDA focused on an ingredient known as atropa belladonna, an herb known colloquially as “deadly nightshade.”\u003c/p>\n\u003cp>In diluted form, the substance is not expected to pose any health risk. In 2010, however, FDA inspectors who examined Hyland’s facilities criticized the company for substandard manufacturing practices and found inconsistent levels of atropa belladonna in its products.\u003c/p>\n\u003cp>The agency issued a public warning, noting “reports of serious adverse events in children taking this product that are consistent with belladonna toxicity.”\u003c/p>\n\u003cp>It also noted that “infants are very susceptible to the neurotoxicity of drugs” because of how the body distributes and responds to drugs, and noted that “absorption of belladonna from the skin and mouth was fairly rapid.”\u003c/p>\n\u003cp>The company voluntarily took the products off shelves and agreed to reformulate them, although it insisted they were safe.\u003c/p>\n\u003cp>“We felt it was the right thing to do so that parents didn’t have to be concerned about the product,” said Borneman, the spokeswoman.\u003c/p>\n\u003cp>But the number of serious adverse events tied by the FDA to the products kept climbing. Some pediatricians and neurologists concluded the tablets and gels were the cause. Many parents wrote to the FDA, accusingly, asking why the pills were still on the market.\u003c/p>\n\u003cp>“My son had 3 of Hyland’s Teething Tablets,” a mother told FDA on Feb. 13, 2012, noting that the product appeared to have caused several seizures. “I am shocked at the popularity of this product, which is growing, and the lack of knowledge among parents, as well as the lack of warnings on the labels. Parents desperately need to be warned about this product if it is going to stay on the shelves!!!! Please do something!”\u003c/p>\n\u003cp>In September 2016, the \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm523468.htm\" target=\"_blank\">FDA announced\u003c/a> that it was investigating more adverse events reports and recommended that consumers stop using Hyland’s and other homeopathic teething products and dispose of any in their possession. Some stores, including Target and CVS, which sold Hyland’s and other homeopathic teething products, pulled them in response.\u003c/p>\n\u003cp>The FDA also asked Hyland’s to recall its products again. But this time Hyland’s stood its ground, and the agency has no authority to enforce a recall of homeopathic products.\u003c/p>\n\u003cp>Borneman said the company’s “pharmacovigilance program,” a product safety review system launched after 2010, offers proof that the treatments are safe.\u003c/p>\n\u003cp>“Homeopathic medicine has a very large margin of safety,” she said. “Our testing ensures there’s not too much belladonna in any bottle” of tablets.\u003c/p>\n\u003cp>At the same time, the company decided to stop manufacturing the teething tablets. In an \u003ca href=\"https://www.hylands.com/hylands-discontinues-teething-tablets-and-gels\" target=\"_blank\">open letter to customers\u003c/a>, Hyland’s said the FDA warning had “created confusion among parents.”\u003c/p>\n\u003cp>“Putting you in a position of having to choose who to trust in the face of contradictory information is burdensome and undermines the FDA,” the company said, while insisting Hyland’s products, “including those you already have, are safe for use.”\u003c/p>\n\u003cp>Several weeks ago, on Jan. 27, the FDA \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm538684.htm\" target=\"_blank\">issued another warning\u003c/a>, saying that laboratory analysis of Hyland’s teething tablets found levels of belladonna “sometimes far exceeding the amount claimed on the label.” The agency warned consumers not to use the products and to seek medical care immediately if their child has seizures, difficulty breathing, lethargy, muscle weakness, or other problems after using homeopathic teething products.\u003c/p>\n\u003cp>The FDA also said there was no evidence that they actually worked.\u003c/p>\n\u003cfigure id=\"attachment_342006\" class=\"wp-caption aligncenter\" style=\"max-width: 768px\">\u003cimg class=\"wp-image-342006 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/02/homeopathicevent.jpg\" alt=\"homeopathicevent\" width=\"768\" height=\"432\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathicevent.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathicevent-160x90.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathicevent-240x135.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathicevent-375x211.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/homeopathicevent-520x293.jpg 520w\" sizes=\"(max-width: 768px) 100vw, 768px\">\u003cfigcaption class=\"wp-caption-text\">Report sent to FDA by a physician. \u003ccite>(Photo by STAT)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Cracks in the FDA’s Authority\u003c/strong>\u003c/p>\n\u003cp>With concerns about toxic levels of belladonna, and the sheer number of cases of adverse events, some critics — and parents — say the FDA should have moved faster in the case of Hyland’s.\u003c/p>\n\u003cp>But they also acknowledge that the episode underlines the cracks in the agency’s regulatory power when it comes to homeopathic products. There is no set mathematical formula or official standard that spells out how many sick or deceased children must be reported before the FDA seizes a company’s inventory or levies fines or shuts it down.\u003c/p>\n\u003cp>Critics say the fact that homeopathic products are generally highly diluted has kept them on the FDA’s back burner.\u003c/p>\n\u003cp>“It’s low on their priority list,” said Dr. Aaron S. Kesselheim, who \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp1513393#t=article\" target=\"_blank\">coauthored a paper\u003c/a> in the New England Journal of Medicine last year on the subject. “FDA for a long time just kind of deferred on homeopathic products because they are mostly inert and so diluted. The harm comes from people wasting their money, or diverting them from things that do work.”\u003c/p>\n\u003cp>In the case of some of Hyland’s products, however, Kesselheim believes that the toxic levels of belladonna show a substantial safety problem, putting a responsibility on FDA to respond.\u003c/p>\n\u003cp>One problem the FDA has in doing so is a matter of staffing: The agency has a medical officer review each report from manufacturers, but it doesn’t have someone who can routinely follow up with the patient, the patient’s family, or physician for missing records necessary to take a serious enforcement action.\u003c/p>\n\u003cp>“Is it fair to criticize FDA for the time lag between 2010 and now?” says Patricia Zettler, a former FDA counsel and associate law professor at Georgia State University. “I think the agency is in a tough position, with these kinds of products and with adverse event reports in general. They are not necessarily a perfect indication of something happening with a drug.”\u003c/p>\n\u003cp>“That said,” Zettler added, “it does sound like this is a product the agency was concerned about. It’s tough to parse out whether two reports of seizures should have been enough, or three or 10. There’s a balance the agency has to strike between acting quickly on safety information and not overreacting to something that may not actually be caused by the product.”\u003c/p>\n\u003cp>Public Citizen’s Sorscher said criminal cases take years to pursue, so the FDA would much prefer voluntary compliance.\u003c/p>\n\u003cp>“They don’t have a mechanism to say, ‘this ingredient is unsafe, nobody should sell it,’” she said. “It might be time for Congress to give FDA a standard and say, you can issue a regulation saying no one can make it anymore.”\u003c/p>\n\u003cp>Outraged by the standoff between FDA and Hyland’s, Connecticut Democratic Representative Rosa DeLauro \u003ca href=\"https://delauro.house.gov/media-center/press-releases/delauro-introduces-bill-give-fda-mandatory-recall-authority-over-drugs\" target=\"_blank\">introduced a bill last week\u003c/a> called the Recall Unsafe Drugs Act. The proposal would give the FDA mandatory recall authority over homeopathic products and drugs.\u003c/p>\n\u003cp>“Hyland’s refusal to recall its teething tablets, despite numerous health and safety warnings from the FDA, is downright shameful,” DeLauro said, adding that the company “is choosing instead to prioritize the company’s profits and reputation before the safety of our children.”\u003c/p>\n\u003cp>“As it stands the FDA would have to go through an arduous legal process to take action against manufacturers such as Hyland’s. This is unacceptable and threatens the health and safety of American families.’’\u003c/p>\n\u003cp>For the parents of Case 10723317, any action would come too late. A mother reported that on July 9, 2014, her 9-month-old daughter died after being given two teething tablets, crushed, for the first time. She gave her infant the tablets, then a bottle, and then left her to sleep. When she checked on her 45 minutes later, she was dead in her crib, beside a puddle of vomit.\u003c/p>\n\u003cp>Five months later, after reading online reports suggesting babies may experience seizures after taking belladonna, she contacted Hyland’s.\u003c/p>\n\u003cp>“Customer did not request a refund or replacement,” noted the Hyland’s staffer who filed the report with the FDA. Hyland’s also noted that it was not able to test the bottle, because the customer threw it away.\u003c/p>\n\u003cp>“Due to the limited information provided by the reporter no further investigation is possible at this time of this incident,” the company concluded.\u003c/p>\n\u003cp>\u003cem>Ike Swetlitz contributed reporting.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2017/02/21/hylands-homeopathic-teething-fda/\" 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\u003c/div>\u003c/p>",
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"disqusTitle": "CRISPR Patent Ruling: 3 Different Takes",
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"content": "\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/02/16/broad-institute-wins-decision-over-uc-berkeley-in-crispr-patent-battle/\" target=\"_blank\">Last week\u003c/a> the feds may have dashed \u003ca href=\"http://www.berkeley.edu/\" target=\"_blank\">UC Berkeley's\u003c/a> billion-dollar dreams when it decided not to give the university patent rights over CRISPR-Cas9, a revolutionary gene-editing technology.\u003c/p>\n\u003cp>The Feb. 15 ruling from the U.S. Patent and Trademark Office let Berkeley's rival--the \u003ca href=\"https://www.broadinstitute.org/\" target=\"_blank\">Broad Institute\u003c/a> jointly owned by Harvard and MIT--keep its existing patents issued in 2014. UC Berkeley has yet to say whether or not it will appeal.\u003c/p>\n\u003cp>[contextly_sidebar id=\"6PeUNVfkMeIqGUVoQhOEw9qi7r38vVhJ\"] Berkeley was seeking to have some of those patents repealed because the university says they conflict with its pending patent application for CRISPR.\u003c/p>\n\u003cp>The judges reasoned that Berkeley's patent request doesn't affect Broad's existing patents because the two are based on different gene editing techniques.\u003c/p>\n\u003cp>Berkeley's patent request is for editing genes in bacteria, whereas Broad's existing patents are for editing genes in eukaryotic cells, i.e. cells found in plants and animals, including humans.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But Berkeley argues that its research tool can easily be extended to use in non-bacterial cells.\u003c/p>\n\u003cp>That distinction is key since potentially lucrative applications of gene editing in medicine and health will involve eukaryotic cells found in humans.\u003c/p>\n\u003cp>UC Berkeley biologist Jennifer Doudna, who is credited with co-inventing CRISPR-Cas9 now has two options:\u003c/p>\n\u003cp>1) Appeal to the \u003ca href=\"http://www.cafc.uscourts.gov/\" target=\"_blank\">U.S. Court of Appeals for the Federal Circuit\u003c/a>\u003cbr>\n2) Go back to the \u003ca href=\"https://www.uspto.gov/\" target=\"_blank\">U.S. Patent and Trademark Office\u003c/a>\u003c/p>\n\u003cp>If Berkeley appeals, the court could overrule the patent office decision in favor of Berkeley.\u003c/p>\n\u003cp>If Berkeley loses, it could go back to the patent office, where it could be required to narrow its claims, i.e., specifying that its technique is only intended to be used in bacteria.\u003c/p>\n\u003cp>Or it could get a broad patent that still doesn't specify how to use CRISPR in eukaryotic cells. But according to \u003ca href=\"http://www.nyls.edu/faculty/faculty-profiles/faculty_profiles/jacob-s-sherkow/\" target=\"_blank\">Jacob Sherkow\u003c/a>, a law professor at \u003ca href=\"http://www.nyls.edu/\" target=\"_blank\">New York Law School\u003c/a>, that could lead to future legal challenges.\u003c/p>\n\u003cp>\"It’s not going to be that strong because anyone who wants to challenge it later can say, 'that patent doesn't disclose how to use the tool in eukaryotic cells,'\" says Sherkow.\u003c/p>\n\u003cp>And the money is in altering those specific cells.\u003c/p>\n\u003cp>So what's next? Only Berkeley knows; the university has said it will \"\u003ca href=\"http://news.berkeley.edu/2017/02/15/berkeley-statement-regarding-patent-boards-decision-on-crispr-cas9-gene-editing-technology/\" target=\"_blank\">carefully consider all options\u003c/a>.\"\u003c/p>\n\u003cp>Science journalists are abuzz about what this means for biotech. Here's a sampling of what they're saying:\u003c/p>\n\u003cp>\u003cstrong>1. \u003c/strong>\u003cstrong>Berkeley + Broad = Virtual Monopoly on CRISPR-Cas9\u003c/strong> (\u003ca href=\"http://gizmodo.com/should-anyone-really-control-who-gets-to-use-crispr-1792659635\" target=\"_blank\">Gizmodo\u003c/a>)\u003c/p>\n\u003cblockquote>\u003cp>Why does this matter? While academic researchers can still use CRISPR for free, companies hoping to harness the gene editing tool to fight disease, solve agricultural problems, or for myriad other potential applications, may have to pay not one, but both institutions, a hefty fee. It’s a decision that has caused some to wonder whether the rights to such revolutionary technology don’t really belong to a third party: the people.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong>2. Could the Case Encourage Scientists to Be Less Honest?\u003c/strong> (\u003ca href=\"https://www.statnews.com/2017/02/16/crispr-patent-decision-six-takeaways/\" target=\"_blank\">STAT\u003c/a>)\u003c/p>\n\u003cblockquote>\u003cp>The patent judges concluded that “the inventors themselves were uncertain” about making CRISPR work in human cells.\u003c/p>\n\u003cp>That could send a terrible message to scientists, said \u003ca href=\"https://isearch.asu.edu/profile/2783639\" target=\"_blank\">Dr. Robert Cook-Deegan\u003c/a> of \u003ca href=\"https://www.asu.edu/\" target=\"_blank\">Arizona State University\u003c/a>, an expert on legal and ethical issues surrounding biotechnology. “I hope this does not become the poster child that patent offices use to coach scientists not to be honest about uncertainties about their discoveries,” he said. “The fact that Doudna’s quotes were used by the judges mainly tells me Doudna was being honest. I hope scientists will continue to be honest and not succumb to being told they can’t say things that might undermine a broad patenting strategy.”\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong>3. Fogettaboutit, Companies Can Sidestep Berkeley and Broad\u003c/strong> (\u003ca href=\"http://www.nature.com/news/why-the-crispr-patent-verdict-isn-t-the-end-of-the-story-1.21510\" target=\"_blank\">Nature\u003c/a>)\u003c/p>\n\u003cblockquote>\u003cp>Researchers in academia and industry have been pushing CRISPR gene editing beyond the scope of the Broad and Berkeley patents.\u003c/p>\n\u003cp>Both patent families cover the use of CRISPR–Cas9, which relies on the Cas9 enzyme to cut DNA. But there are alternatives to Cas9 that provide other functions, and a way to sidestep the Berkeley–Broad patent fight.\u003c/p>\n\u003cp>One attractive alternative is Cpf1, an enzyme that \u003ca href=\"http://www.nature.com/news/alternative-crispr-system-could-improve-genome-editing-1.18432\" target=\"_blank\">may be simpler to use\u003c/a> and more accurate than Cas9 in some cases. The Broad has already filed patents on applications of Cpf1 in gene editing, and has licensed them to biotech company Editas Medicine in Cambridge, Massachusetts.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>Remember, my friends, if UC Berkeley appeals, this whole process could last through 2020. Or longer.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"https://ww2.kqed.org/futureofyou/2017/02/16/broad-institute-wins-decision-over-uc-berkeley-in-crispr-patent-battle/\" target=\"_blank\">Last week\u003c/a> the feds may have dashed \u003ca href=\"http://www.berkeley.edu/\" target=\"_blank\">UC Berkeley's\u003c/a> billion-dollar dreams when it decided not to give the university patent rights over CRISPR-Cas9, a revolutionary gene-editing technology.\u003c/p>\n\u003cp>The Feb. 15 ruling from the U.S. Patent and Trademark Office let Berkeley's rival--the \u003ca href=\"https://www.broadinstitute.org/\" target=\"_blank\">Broad Institute\u003c/a> jointly owned by Harvard and MIT--keep its existing patents issued in 2014. UC Berkeley has yet to say whether or not it will appeal.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp> Berkeley was seeking to have some of those patents repealed because the university says they conflict with its pending patent application for CRISPR.\u003c/p>\n\u003cp>The judges reasoned that Berkeley's patent request doesn't affect Broad's existing patents because the two are based on different gene editing techniques.\u003c/p>\n\u003cp>Berkeley's patent request is for editing genes in bacteria, whereas Broad's existing patents are for editing genes in eukaryotic cells, i.e. cells found in plants and animals, including humans.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But Berkeley argues that its research tool can easily be extended to use in non-bacterial cells.\u003c/p>\n\u003cp>That distinction is key since potentially lucrative applications of gene editing in medicine and health will involve eukaryotic cells found in humans.\u003c/p>\n\u003cp>UC Berkeley biologist Jennifer Doudna, who is credited with co-inventing CRISPR-Cas9 now has two options:\u003c/p>\n\u003cp>1) Appeal to the \u003ca href=\"http://www.cafc.uscourts.gov/\" target=\"_blank\">U.S. Court of Appeals for the Federal Circuit\u003c/a>\u003cbr>\n2) Go back to the \u003ca href=\"https://www.uspto.gov/\" target=\"_blank\">U.S. Patent and Trademark Office\u003c/a>\u003c/p>\n\u003cp>If Berkeley appeals, the court could overrule the patent office decision in favor of Berkeley.\u003c/p>\n\u003cp>If Berkeley loses, it could go back to the patent office, where it could be required to narrow its claims, i.e., specifying that its technique is only intended to be used in bacteria.\u003c/p>\n\u003cp>Or it could get a broad patent that still doesn't specify how to use CRISPR in eukaryotic cells. But according to \u003ca href=\"http://www.nyls.edu/faculty/faculty-profiles/faculty_profiles/jacob-s-sherkow/\" target=\"_blank\">Jacob Sherkow\u003c/a>, a law professor at \u003ca href=\"http://www.nyls.edu/\" target=\"_blank\">New York Law School\u003c/a>, that could lead to future legal challenges.\u003c/p>\n\u003cp>\"It’s not going to be that strong because anyone who wants to challenge it later can say, 'that patent doesn't disclose how to use the tool in eukaryotic cells,'\" says Sherkow.\u003c/p>\n\u003cp>And the money is in altering those specific cells.\u003c/p>\n\u003cp>So what's next? Only Berkeley knows; the university has said it will \"\u003ca href=\"http://news.berkeley.edu/2017/02/15/berkeley-statement-regarding-patent-boards-decision-on-crispr-cas9-gene-editing-technology/\" target=\"_blank\">carefully consider all options\u003c/a>.\"\u003c/p>\n\u003cp>Science journalists are abuzz about what this means for biotech. Here's a sampling of what they're saying:\u003c/p>\n\u003cp>\u003cstrong>1. \u003c/strong>\u003cstrong>Berkeley + Broad = Virtual Monopoly on CRISPR-Cas9\u003c/strong> (\u003ca href=\"http://gizmodo.com/should-anyone-really-control-who-gets-to-use-crispr-1792659635\" target=\"_blank\">Gizmodo\u003c/a>)\u003c/p>\n\u003cblockquote>\u003cp>Why does this matter? While academic researchers can still use CRISPR for free, companies hoping to harness the gene editing tool to fight disease, solve agricultural problems, or for myriad other potential applications, may have to pay not one, but both institutions, a hefty fee. It’s a decision that has caused some to wonder whether the rights to such revolutionary technology don’t really belong to a third party: the people.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong>2. Could the Case Encourage Scientists to Be Less Honest?\u003c/strong> (\u003ca href=\"https://www.statnews.com/2017/02/16/crispr-patent-decision-six-takeaways/\" target=\"_blank\">STAT\u003c/a>)\u003c/p>\n\u003cblockquote>\u003cp>The patent judges concluded that “the inventors themselves were uncertain” about making CRISPR work in human cells.\u003c/p>\n\u003cp>That could send a terrible message to scientists, said \u003ca href=\"https://isearch.asu.edu/profile/2783639\" target=\"_blank\">Dr. Robert Cook-Deegan\u003c/a> of \u003ca href=\"https://www.asu.edu/\" target=\"_blank\">Arizona State University\u003c/a>, an expert on legal and ethical issues surrounding biotechnology. “I hope this does not become the poster child that patent offices use to coach scientists not to be honest about uncertainties about their discoveries,” he said. “The fact that Doudna’s quotes were used by the judges mainly tells me Doudna was being honest. I hope scientists will continue to be honest and not succumb to being told they can’t say things that might undermine a broad patenting strategy.”\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong>3. Fogettaboutit, Companies Can Sidestep Berkeley and Broad\u003c/strong> (\u003ca href=\"http://www.nature.com/news/why-the-crispr-patent-verdict-isn-t-the-end-of-the-story-1.21510\" target=\"_blank\">Nature\u003c/a>)\u003c/p>\n\u003cblockquote>\u003cp>Researchers in academia and industry have been pushing CRISPR gene editing beyond the scope of the Broad and Berkeley patents.\u003c/p>\n\u003cp>Both patent families cover the use of CRISPR–Cas9, which relies on the Cas9 enzyme to cut DNA. But there are alternatives to Cas9 that provide other functions, and a way to sidestep the Berkeley–Broad patent fight.\u003c/p>\n\u003cp>One attractive alternative is Cpf1, an enzyme that \u003ca href=\"http://www.nature.com/news/alternative-crispr-system-could-improve-genome-editing-1.18432\" target=\"_blank\">may be simpler to use\u003c/a> and more accurate than Cas9 in some cases. The Broad has already filed patents on applications of Cpf1 in gene editing, and has licensed them to biotech company Editas Medicine in Cambridge, Massachusetts.\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>Remember, my friends, if UC Berkeley appeals, this whole process could last through 2020. Or longer.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Testosterone Anti-Aging Studies: Some Benefits, But None to Mental Function",
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"content": "\u003cp>Testosterone treatment did not improve older men's memory or mental function in the latest results from landmark government research that challenges the anti-aging claims of popular supplements.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"I don't think anybody would interpret these results as saying, 'Wow, this is a fountain of youth, this is a magical anti-aging potion.'\"\u003c/aside>\n\u003cp>While testosterone use for one year appeared to strengthen bones and reduce anemia, it also showed signs of worsening artery disease. Questions also remain about other potential risks. The researchers said more studies are needed to determine long-term effects — the kind of research the U.S. Food and Drug Administration has already asked supplement makers to conduct.\u003c/p>\n\u003cp>\"I don't think anybody would interpret these results as saying, 'Wow, this is a fountain of youth, this is a magical anti-aging potion,'\" said study co-author Susan Ellenberg, a University of Pennsylvania researcher.\u003c/p>\n\u003cp>[contextly_sidebar id=\"vGIx3CEh4RE10Omd9HBu0aZMjktQ5IJ6\"]The results are from the final four studies in a seven-part project mostly funded by the National Institute on Aging, involving nearly 800 U.S. men aged 65 and older with low testosterone levels. The goal was to see if rubbing testosterone gel on the skin daily for a year could treat problems linked with low levels of the male hormone, which declines with age. Half the men in each group used the real thing and half used fake gel.\u003c/p>\n\u003cp>Results published a year ago from the same research linked testosterone with mostly modest improvement in sexual performance, walking strength and mood.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The key new findings:\u003c/p>\n\u003cul>\n\u003cli>Testosterone had no effect on memory or mental function, based on tests given before, halfway and at the end of treatment to nearly 500 men with age-related memory decline.\u003c/li>\n\u003cli>Among almost 140 men who underwent heart artery imaging tests to see if the hormone slowed progression of plaque, those who used testosterone had more plaque buildup and narrower arteries after a year than the fake gel group. Those changes could signal increased chances for heart attacks although none occurred in the study. Men in this sub-study were already more vulnerable for heart problems because of conditions including artery disease, obesity and high blood pressure.\u003c/li>\n\u003cli>Among about 200 men given bone imaging tests before and at the end of treatment, those on testosterone showed increases in bone density and strength, especially in the spine, while minimal changes were found in the group that used fake gel. The improvement was similar to bone changes seen with treatment for osteoporosis, although most men studied did not have that bone-thinning condition, which can lead to fractures.\u003c/li>\n\u003cli>Among 126 men with anemia — a fatigue-linked condition involving inadequate red blood cells — those on testosterone showed substantial improvement. By the study's end, anemia had vanished in almost 60 percent of men on testosterone compared with 22 percent of the fake gel group. The hormone group also reported having more energy.\u003c/li>\n\u003c/ul>\n\u003cp>\"The overall health benefits, however, remain to be determined,\" the researchers said.\u003c/p>\n\u003cp>The studies were published Tuesday in the Journal of the American Medical Association and JAMA Internal Medicine. AbbVie Pharmaceuticals provided its gel for the study and helped pay for the research but had no other role in the study.\u003c/p>\n\u003cp>The research was not designed to look at risks and does not apply to younger men or those with normal levels of testosterone, said study leader Dr. Peter Snyder, a University of Pennsylvania hormone specialist. It's also not known if other forms of testosterone supplements would have similar effects in older men with low levels.\u003c/p>\n\u003cp>Prescription testosterone products, including gel, are approved only for men with low levels of the hormones caused by various medical conditions. Benefits and risks are unknown in men whose levels are low due only to aging, the FDA says. The agency requires testosterone labels to include possible risks for heart attacks and strokes, based on some previous studies.\u003c/p>\n\u003cp>A separate study published Tuesday in JAMA Internal Medicine found that men using prescription testosterone gel, patches or injections had fewer heart attacks and strokes than non-users during about three years of follow-up. But this was only observational data in men aged 40 and up, not rigorous research testing the hormone against a placebo.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Clarifying testosterone's effects on heart problems, fractures and age-related disability will require larger, longer studies, said Dr. Evan Hadley of the National Institute on Aging. He said decisions about whether to use testosterone should take into account men's individual risks for conditions the hormone could affect.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Testosterone treatment did not improve older men's memory or mental function in the latest results from landmark government research that challenges the anti-aging claims of popular supplements.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"I don't think anybody would interpret these results as saying, 'Wow, this is a fountain of youth, this is a magical anti-aging potion.'\"\u003c/aside>\n\u003cp>While testosterone use for one year appeared to strengthen bones and reduce anemia, it also showed signs of worsening artery disease. Questions also remain about other potential risks. The researchers said more studies are needed to determine long-term effects — the kind of research the U.S. Food and Drug Administration has already asked supplement makers to conduct.\u003c/p>\n\u003cp>\"I don't think anybody would interpret these results as saying, 'Wow, this is a fountain of youth, this is a magical anti-aging potion,'\" said study co-author Susan Ellenberg, a University of Pennsylvania researcher.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The results are from the final four studies in a seven-part project mostly funded by the National Institute on Aging, involving nearly 800 U.S. men aged 65 and older with low testosterone levels. The goal was to see if rubbing testosterone gel on the skin daily for a year could treat problems linked with low levels of the male hormone, which declines with age. Half the men in each group used the real thing and half used fake gel.\u003c/p>\n\u003cp>Results published a year ago from the same research linked testosterone with mostly modest improvement in sexual performance, walking strength and mood.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The key new findings:\u003c/p>\n\u003cul>\n\u003cli>Testosterone had no effect on memory or mental function, based on tests given before, halfway and at the end of treatment to nearly 500 men with age-related memory decline.\u003c/li>\n\u003cli>Among almost 140 men who underwent heart artery imaging tests to see if the hormone slowed progression of plaque, those who used testosterone had more plaque buildup and narrower arteries after a year than the fake gel group. Those changes could signal increased chances for heart attacks although none occurred in the study. Men in this sub-study were already more vulnerable for heart problems because of conditions including artery disease, obesity and high blood pressure.\u003c/li>\n\u003cli>Among about 200 men given bone imaging tests before and at the end of treatment, those on testosterone showed increases in bone density and strength, especially in the spine, while minimal changes were found in the group that used fake gel. The improvement was similar to bone changes seen with treatment for osteoporosis, although most men studied did not have that bone-thinning condition, which can lead to fractures.\u003c/li>\n\u003cli>Among 126 men with anemia — a fatigue-linked condition involving inadequate red blood cells — those on testosterone showed substantial improvement. By the study's end, anemia had vanished in almost 60 percent of men on testosterone compared with 22 percent of the fake gel group. The hormone group also reported having more energy.\u003c/li>\n\u003c/ul>\n\u003cp>\"The overall health benefits, however, remain to be determined,\" the researchers said.\u003c/p>\n\u003cp>The studies were published Tuesday in the Journal of the American Medical Association and JAMA Internal Medicine. AbbVie Pharmaceuticals provided its gel for the study and helped pay for the research but had no other role in the study.\u003c/p>\n\u003cp>The research was not designed to look at risks and does not apply to younger men or those with normal levels of testosterone, said study leader Dr. Peter Snyder, a University of Pennsylvania hormone specialist. It's also not known if other forms of testosterone supplements would have similar effects in older men with low levels.\u003c/p>\n\u003cp>Prescription testosterone products, including gel, are approved only for men with low levels of the hormones caused by various medical conditions. Benefits and risks are unknown in men whose levels are low due only to aging, the FDA says. The agency requires testosterone labels to include possible risks for heart attacks and strokes, based on some previous studies.\u003c/p>\n\u003cp>A separate study published Tuesday in JAMA Internal Medicine found that men using prescription testosterone gel, patches or injections had fewer heart attacks and strokes than non-users during about three years of follow-up. But this was only observational data in men aged 40 and up, not rigorous research testing the hormone against a placebo.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Clarifying testosterone's effects on heart problems, fractures and age-related disability will require larger, longer studies, said Dr. Evan Hadley of the National Institute on Aging. He said decisions about whether to use testosterone should take into account men's individual risks for conditions the hormone could affect.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Theranos' Arizona Lab Also Had License Revoked: WSJ",
"title": "Theranos' Arizona Lab Also Had License Revoked: WSJ",
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"content": "\u003cp>\u003cstrong>Update Wednesday, Feb. 22\u003c/strong> Remember how during the presidential election Donald Trump managed to lurch from campaign-ending misstep to campaign-ending misstep without those missteps actually ending his campaign?\u003c/p>\n\u003cp>Well, Theranos ain't no Donald Trump.\u003c/p>\n\u003cp>You hate to beat a dead unicorn, but The Wall Street Journal keeps stomping on this one's lifeless head.\u003c/p>\n\u003cp>It would take, say, a\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/07/14/the-rise-and-fall-of-theranos-a-cartoon-history/\" target=\"_blank\"> graphic cartoon history\u003c/a> to lay out every wrong turn Theranos has taken the last year-and-a-half or so. But today's bad news emanates from a Journal \u003ca href=\"https://www.wsj.com/articles/second-theranos-lab-has-blood-testing-license-revoked-1487775664\" target=\"_blank\">report\u003c/a> that the Centers for Medicare & Medicaid Services (CMS) has levied harsh penalties on Theranos' now-shuttered Arizona lab, sanctions similar to those earlier imposed by CMS on the company's California facility (also shut down).\u003c/p>\n\u003cp>The penalties in the more recent case stem from a government inspection of the Arizona lab in September. They include pulling the lab's license to operate, according to the Journal.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Theranos announced it was exiting the consumer blood testing business last October. But the government, which had warned the company that closing the lab would not stop the penalty process, informed Theranos of the Arizona-related sanctions in a Jan. 27 \u003ca href=\"http://online.wsj.com/public/resources/documents/theranos_az.pdf\" target=\"_blank\">letter\u003c/a>. That was obtained by the Journal in a public records request.\u003c/p>\n\u003cp>Theranos can still appeal the ruling, as it has appealed the CMS penalties related to its California lab. But whatever happens with these cases may be moot as far as the company's ultimate fate is concerned. Last week, the Journal reported Theranos had just $200 million left at the end of 2016, with no money set aside for potential liability in the many lawsuits that have been filed against it. Those suits are all related in one form or another to Theranos' inability to accurately perform the blood tests it said it could.\u003c/p>\n\u003cp>Theranos and its founder and CEO, Elizabeth Holmes, have pinned hopes for a comeback on a portable blood-testing device called the miniLab. But there's no telling when and if the machine will gain FDA approval.\u003c/p>\n\u003cp>\u003cstrong>Update Thursday, Feb. 16\u003c/strong> Citing \"people familiar with the matter,\" The Wall Street Journal is \u003ca href=\"https://www.wsj.com/articles/theranos-had-200-million-in-cash-left-at-year-end-1487277878\" target=\"_blank\">reporting\u003c/a> Theranos had $200 million left at the end of 2016, less than a quarter of what it raised from investors.\u003c/p>\n\u003cblockquote>\u003cp>The number was disclosed in a conference call with investors last month. Investors also were told the firm didn’t generate any material revenue in 2015 and 2016 and hasn’t set aside funds for any potential liability that could arise from its pending legal challenges.\u003c/p>\u003c/blockquote>\n\u003cp>Theranos, once a high-flying blood-testing startup, is being sued by a \u003cem>lot\u003c/em> of different parties--patients, investors and its former business partner Walgreens--for hundreds of millions of dollars.\u003c/p>\n\u003cp>The company's never-ending woes began with a Wall Street Journal investigation published in October 2015. The paper found, among other improprieties, that Theranos failed to report data showing its vaunted technology, supposedly capable of performing dozens of tests from a few drops of blood, may not be accurate.\u003c/p>\n\u003cp>Penalties stemming from a disastrous federal inspection report of Theranos' California lab eventually forced the company to withdraw from the consumer blood-testing business and to lay off hundreds of workers.\u003c/p>\n\u003cp>More recently Theranos and its founder and CEO, Elizabeth Holmes, had pinned hopes for a comeback on a portable blood-testing device called the miniLab. But there's no telling when and if the machine will gain the FDA's approval.\u003c/p>\n\u003cp>\u003cem>Original post\u003c/em>\u003c/p>\n\u003cp>Yesterday ...\u003c/p>\n\u003cp>https://twitter.com/JohnCarreyrou/status/829506893156642816\u003c/p>\n\u003cp>Carreyrou, who first broke the news that Theranos was better at press releases and TED Talks than implementing the cutting-edge blood tests it said it could perform, was referring to \u003ca href=\"https://www.wsj.com/articles/report-cites-deficiencies-at-theranos-lab-1486604062\" target=\"_blank\">this article\u003c/a> by his Wall Street Journal colleague John Weaver. The Journal, through a public records request, got a hold of a \u003ca href=\"http://online.wsj.com/public/resources/documents/theranos_arizona.pdf\" target=\"_blank\">federal inspection report\u003c/a> documenting a number of deficiencies at the company's now-shuttered Scottsdale, Arizona lab.\u003c/p>\n\u003cp>The Sepember 2016 inspection, by the Centers for Medicare & Medicaid Services, found a lack of quality control and incorrect use of equipment for several common tests. Furthermore, CMS found no evidence that Theranos notified doctors or patients that patients' blood glucose results from February-June 2015 may be inaccurate. Theranos also failed to ensure that doctors and patients received corrected reports of incorrect blood coagulation tests from Feb. 17, 2015 through Jan. 20, 2016.\u003c/p>\n\u003cp>Theranos told the Journal \"that notifications to patients and their doctors were part of the company’s efforts to address the problems, but it didn’t immediately respond to an inquiry about how many patients it believed were affected.\"\u003c/p>\n\u003cp>Last year, Theranos \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/05/19/theranos-corrects-tens-of-thousands-of-blood-tests/\" target=\"_blank\">voided\u003c/a> tens of thousands of blood tests performed at its Newark, California lab, which has also been shut down.\u003c/p>\n\u003cp>Theranos exited the consumer blood testing business in October, saying it would focus on developing a portable blood-testing machine called the miniLab.\u003c/p>\n\u003cp>One lab expert the Journal talked to, speaking about the Arizona lab inspection, said that the government report shows \"failures in nearly every aspect of laboratory operation.”\u003c/p>\n\u003cp>The company faces an uncertain future, to say the least. It's reputation is in tatters as it faces multiple lawsuits by patients and investors, as well as government investigations.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>https://www.wsj.com/articles/report-cites-deficiencies-at-theranos-lab-1486604062\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Update Wednesday, Feb. 22\u003c/strong> Remember how during the presidential election Donald Trump managed to lurch from campaign-ending misstep to campaign-ending misstep without those missteps actually ending his campaign?\u003c/p>\n\u003cp>Well, Theranos ain't no Donald Trump.\u003c/p>\n\u003cp>You hate to beat a dead unicorn, but The Wall Street Journal keeps stomping on this one's lifeless head.\u003c/p>\n\u003cp>It would take, say, a\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/07/14/the-rise-and-fall-of-theranos-a-cartoon-history/\" target=\"_blank\"> graphic cartoon history\u003c/a> to lay out every wrong turn Theranos has taken the last year-and-a-half or so. But today's bad news emanates from a Journal \u003ca href=\"https://www.wsj.com/articles/second-theranos-lab-has-blood-testing-license-revoked-1487775664\" target=\"_blank\">report\u003c/a> that the Centers for Medicare & Medicaid Services (CMS) has levied harsh penalties on Theranos' now-shuttered Arizona lab, sanctions similar to those earlier imposed by CMS on the company's California facility (also shut down).\u003c/p>\n\u003cp>The penalties in the more recent case stem from a government inspection of the Arizona lab in September. They include pulling the lab's license to operate, according to the Journal.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Theranos announced it was exiting the consumer blood testing business last October. But the government, which had warned the company that closing the lab would not stop the penalty process, informed Theranos of the Arizona-related sanctions in a Jan. 27 \u003ca href=\"http://online.wsj.com/public/resources/documents/theranos_az.pdf\" target=\"_blank\">letter\u003c/a>. That was obtained by the Journal in a public records request.\u003c/p>\n\u003cp>Theranos can still appeal the ruling, as it has appealed the CMS penalties related to its California lab. But whatever happens with these cases may be moot as far as the company's ultimate fate is concerned. Last week, the Journal reported Theranos had just $200 million left at the end of 2016, with no money set aside for potential liability in the many lawsuits that have been filed against it. Those suits are all related in one form or another to Theranos' inability to accurately perform the blood tests it said it could.\u003c/p>\n\u003cp>Theranos and its founder and CEO, Elizabeth Holmes, have pinned hopes for a comeback on a portable blood-testing device called the miniLab. But there's no telling when and if the machine will gain FDA approval.\u003c/p>\n\u003cp>\u003cstrong>Update Thursday, Feb. 16\u003c/strong> Citing \"people familiar with the matter,\" The Wall Street Journal is \u003ca href=\"https://www.wsj.com/articles/theranos-had-200-million-in-cash-left-at-year-end-1487277878\" target=\"_blank\">reporting\u003c/a> Theranos had $200 million left at the end of 2016, less than a quarter of what it raised from investors.\u003c/p>\n\u003cblockquote>\u003cp>The number was disclosed in a conference call with investors last month. Investors also were told the firm didn’t generate any material revenue in 2015 and 2016 and hasn’t set aside funds for any potential liability that could arise from its pending legal challenges.\u003c/p>\u003c/blockquote>\n\u003cp>Theranos, once a high-flying blood-testing startup, is being sued by a \u003cem>lot\u003c/em> of different parties--patients, investors and its former business partner Walgreens--for hundreds of millions of dollars.\u003c/p>\n\u003cp>The company's never-ending woes began with a Wall Street Journal investigation published in October 2015. The paper found, among other improprieties, that Theranos failed to report data showing its vaunted technology, supposedly capable of performing dozens of tests from a few drops of blood, may not be accurate.\u003c/p>\n\u003cp>Penalties stemming from a disastrous federal inspection report of Theranos' California lab eventually forced the company to withdraw from the consumer blood-testing business and to lay off hundreds of workers.\u003c/p>\n\u003cp>More recently Theranos and its founder and CEO, Elizabeth Holmes, had pinned hopes for a comeback on a portable blood-testing device called the miniLab. But there's no telling when and if the machine will gain the FDA's approval.\u003c/p>\n\u003cp>\u003cem>Original post\u003c/em>\u003c/p>\n\u003cp>Yesterday ...\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>Carreyrou, who first broke the news that Theranos was better at press releases and TED Talks than implementing the cutting-edge blood tests it said it could perform, was referring to \u003ca href=\"https://www.wsj.com/articles/report-cites-deficiencies-at-theranos-lab-1486604062\" target=\"_blank\">this article\u003c/a> by his Wall Street Journal colleague John Weaver. The Journal, through a public records request, got a hold of a \u003ca href=\"http://online.wsj.com/public/resources/documents/theranos_arizona.pdf\" target=\"_blank\">federal inspection report\u003c/a> documenting a number of deficiencies at the company's now-shuttered Scottsdale, Arizona lab.\u003c/p>\n\u003cp>The Sepember 2016 inspection, by the Centers for Medicare & Medicaid Services, found a lack of quality control and incorrect use of equipment for several common tests. Furthermore, CMS found no evidence that Theranos notified doctors or patients that patients' blood glucose results from February-June 2015 may be inaccurate. Theranos also failed to ensure that doctors and patients received corrected reports of incorrect blood coagulation tests from Feb. 17, 2015 through Jan. 20, 2016.\u003c/p>\n\u003cp>Theranos told the Journal \"that notifications to patients and their doctors were part of the company’s efforts to address the problems, but it didn’t immediately respond to an inquiry about how many patients it believed were affected.\"\u003c/p>\n\u003cp>Last year, Theranos \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/05/19/theranos-corrects-tens-of-thousands-of-blood-tests/\" target=\"_blank\">voided\u003c/a> tens of thousands of blood tests performed at its Newark, California lab, which has also been shut down.\u003c/p>\n\u003cp>Theranos exited the consumer blood testing business in October, saying it would focus on developing a portable blood-testing machine called the miniLab.\u003c/p>\n\u003cp>One lab expert the Journal talked to, speaking about the Arizona lab inspection, said that the government report shows \"failures in nearly every aspect of laboratory operation.”\u003c/p>\n\u003cp>The company faces an uncertain future, to say the least. It's reputation is in tatters as it faces multiple lawsuits by patients and investors, as well as government investigations.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>https://www.wsj.com/articles/report-cites-deficiencies-at-theranos-lab-1486604062\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
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"possible": {
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"radiolab": {
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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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"reveal": {
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"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"order": 16
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},
"science-friday": {
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"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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