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"content": "\u003cp>It’s been more than a decade since California launched an unprecedented experiment in medical research by direct democracy, when voters created a $3 billion fund to kick-start the hunt for stem cell therapies.\u003c/p>\n\u003cp>The bold plan, a response to federal funding limits for embryonic stem cell research, was sold with a simple pitch: The money would rapidly yield cures for devastating human diseases such as Parkinson’s and ALS.\u003c/p>\n\u003cp>That hasn’t happened.\u003c/p>\n\u003cp>[contextly_sidebar id=\"wiA2OMIATARmkALimTVF9L5bJoRR3eQd\"]A major reason, a STAT examination found, is that the \u003ca href=\"https://www.cirm.ca.gov/\" target=\"_blank\">California Institute for Regenerative Medicine\u003c/a> has been slow to move promising experimental therapies into clinical trials. The National Institutes of Health has supported three and a half times as many human trials of stem cell therapies, dollar for dollar, as the California agency has funded since it started making grants in 2006. Just two of its clinical trials have been completed.\u003c/p>\n\u003cp>“I am floored by the disparity,” said Jim Lott, a health care consultant and member of the state board that monitors the agency, known as CIRM. If the numbers are correct, he told STAT, “that doesn’t settle well with me as a voter. That doesn’t settle well with me as a taxpayer. That doesn’t settle well with me as a member of the oversight committee.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>CIRM has used most of the $2.2 billion in grants it has distributed so far to build labs and pay for basic research at public and private universities, such as Stanford and the University of Southern California, and private companies.\u003c/p>\n\u003cp>It has given more than $300 million to 27 projects that include clinical trials — though much of that funding also supported preclinical work. Meanwhile, the agency has committed about $540 million to new labs and buildings.\u003c/p>\n\u003cp>In part, that’s because its directors chose to focus on infrastructure early on, as well as bench experiments and animal studies given that the biology of embryonic stem cells was not well-understood and there are formidable roadblocks to moving into human studies. Much more is known about the bone marrow stem cells that are the focus of many NIH-funded clinical trials.\u003c/p>\n\u003cp>But critics have noted that many top grantees come from institutions that hold seats on CIRM’s governing board. The respected Institute of Medicine, in a 2013 \u003ca href=\"https://www.nap.edu/catalog/13523/the-california-institute-for-regenerative-medicine-science-governance-and-the\" target=\"_blank\">review\u003c/a>, said institutionalized conflicts of interest have raised questions about “the integrity and independence of some of CIRM’s decisions.” CIRM later enacted reforms that barred board members from voting directly on grants for their institutions. But the changes didn’t prevent other financial \u003ca href=\"http://www.latimes.com/business/hiltzik/la-fi-hiltzik-20140720-column.html\" target=\"_blank\">conflicts\u003c/a> involving \u003ca href=\"http://californiastemcellreport.blogspot.com/2016/09/alan-trounson-former-ceo-of-california.html\" target=\"_blank\">CIRM officers and grantees\u003c/a>, and the flow of funds to board members’ institutions continued unabated.\u003c/p>\n\u003cfigure id=\"attachment_322983\" class=\"wp-caption aligncenter\" style=\"max-width: 979px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/CIRM.jpg\">\u003cimg class=\"wp-image-322983 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/CIRM.jpg\" alt=\"CIRM\" width=\"979\" height=\"462\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM.jpg 979w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-160x76.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-800x378.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-768x362.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-960x453.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-240x113.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-375x177.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-520x245.jpg 520w\" sizes=\"(max-width: 979px) 100vw, 979px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sources: California Institute for Regenerative Medicine, National Institutes of Health. \u003cspan class=\"media-source\">*Several CIRM trials included here were announced shortly after Sept. 30, 2016, the cut-off for the NIH data. **NIH spending for 2006 and 2007 is estimated because exact figures were unavailable.\u003c/span>NATALIA BRONSHTEIN/STAT\u003c/figcaption>\u003c/figure>\n\u003cp>“You could make an argument that California taxpayer money should go to build new facilities on state university campuses,” said Marcy Darnovsky, who directs the Berkeley-based Center for Genetics and Society, a public affairs nonprofit. “But I don’t see an argument for Stanford getting fancy new buildings from California taxpayer money.”\u003c/p>\n\u003cp>Stanford, whose endowment is among the top five nationally, and USC have received more than $70\u003cstrong> \u003c/strong>million for major building projects, and hundreds of millions more for labs and research. Stanford alone has been favored with $1 out of every $7 CIRM has approved.\u003c/p>\n\u003cp>But scientists outside California said CIRM’s record is a strong one. CIRM-funded researchers have published nearly 2,000 scholarly papers. That output has helped vault California into the top ranks of stem cell science, said Dr. George Daley, the new dean of Harvard Medical School and a leading stem cell scientist who describes himself as an informal adviser and cheerleader for CIRM. “When I look at the progress my colleagues have made in California, I am duly awed,” he said.\u003c/p>\n\u003cp>The institute announced a year ago that it would reinvent itself to emphasize clinical research until it runs out of money in 2020 — unless voters grant a new infusion of cash. CIRM plans to fund 50 new trials with its remaining $692 million, of which 10 were announced in 2016. Just 17 trials were funded in its first decade of grants.\u003c/p>\n\u003cp>C. Randal Mills, CIRM’s CEO since 2014 and architect of its new strategy, said he welcomed comparisons that help benchmark CIRM’s progress. Mills, former head of Osiris Therapeutics, the first company to commercialize an approved stem cell treatment, declined to comment on STAT’s specific findings, but defended the initial emphasis on labs and basic science as underpinning future clinical work.\u003c/p>\n\u003cp>“We’re running our own race. … What we have to do is just continually get better” to benefit patients, Mills said in an interview. “If we’re behind [NIH], we’re going to get better.”\u003c/p>\n\u003cp>Lott’s teenage daughter was paralyzed in an automobile crash and he hopes for a stem cell cure. He supports the goals of CIRM and applauds much of its work, but he now has second thoughts about the governance structure, which allows board members’ institutions to benefit from CIRM grants, as well as its financing. The ballot question that created CIRM, Proposition 71, authorized bond sales to pay for the agency’s budget, raising the total cost for taxpayers to $6 billion including interest. Financial experts, however, said that relatively low interest rates paid on long-term bonds can offer advantages over funding so large a venture directly from state coffers.\u003c/p>\n\u003cp>Asked whether he would support a similar ballot measure today, Lott said, “We were all caught up in the time, and the events were different when we first looked at this. But not today. Not at all.”\u003c/p>\n\u003cp>\u003cstrong>'Lives Will Be Saved'\u003c/strong>\u003c/p>\n\u003cp>Californians emphatically supported CIRM, creating the stem cell colossus with 59 percent of the vote in 2004. Many were upset that President George W. Bush had sharply limited federal funding for work with embryonic stem cells, which are derived from early human embryos and able to develop into any type of tissue or organ.\u003c/p>\n\u003cp>But Proposition 71 also won because it was shamelessly oversold, consumer advocates and science policy experts said. Desperate patients, Nobel laureates, and A-list celebrities such as \u003ca href=\"https://www.statnews.com/2016/08/30/parkinsons-study-fox-foundation-feud/\" target=\"_blank\">Michael J. Fox\u003c/a> — the Hollywood star and Parkinson’s sufferer — predicted “cures” that would “save millions of lives.”\u003c/p>\n\u003cp>“There are more Americans than … we can count who are sick now, or are going to be sick in the future, whose lives will be saved by Prop 71,” patient advocate Joan Samuelson said in another ad. The sponsors of the measure also predicted that CIRM-generated cures would drastically reduce health care spending. No one made specific promises for the 10-year timeframe initially planned for CIRM’s work, but miracles seemed just around the corner.\u003c/p>\n\u003cp>“You can support embryonic stem cell research, which we do and did, and still be pretty appalled by what was going down,” said Darnovsky. “The airwaves were swamped with guys in white coats who were identified with their academic affiliation even though they were principals of private companies (some of which later got CIRM grants), and basically saying, ‘We’re going to have cures by Christmas.’”\u003c/p>\n\u003cp>Mills, who was not involved at the agency’s genesis, called the idea sold to voters — impending, sweeping breakthroughs — “naïve.” Radical medical change usually takes decades from idea to cure.\u003c/p>\n\u003cp>“But here we are,” he said. “My sole mission is to create as much value for the resources we have left, for the people of California, that I can.”\u003c/p>\n\u003cp>\u003cstrong>California vs. NIH\u003c/strong>\u003c/p>\n\u003cp>Even under Bush-era restrictions — rescinded after President Barack Obama took office — the NIH continued to support substantial stem cell research.\u003c/p>\n\u003cp>Since 2006, it has spent $13.4 billion on stem cell science, six times CIRM’s budget during that period. But NIH fully or partly funded 571 clinical trials, according to STAT’s review — more than 20 times the number backed by California.\u003c/p>\n\u003cp>While NIH in that period funded 50 Phase 3 clinical trials of stem cell therapies — generally the last step before seeking approval to market a product — CIRM has supported just three.\u003c/p>\n\u003cp>One, the study of a treatment for skin cancer involving immune system cells, was terminated by Caladrius Biosciences, the grantee, when it determined that existing treatments had overtaken its approach. The others — testing altered immune cells to treat brain cancer and bioengineered veins to manage vascular problems — show promise, but are still recruiting patients and will not be completed for several years, according to the NIH website, ClinicalTrials.gov.\u003c/p>\n\u003cp>Daley called the NIH comparison “a little unfair,” because that agency emphasized hematopoietic stem cells — blood-forming cells from bone marrow, which had been studied for decades — unlike CIRM’s sharper focus on cutting-edge embryonic stem cells. A little more than half of CIRM’s awards have gone to support research on embryonic or induced pluripotent stem cells, which are created by modifying adult stem cells to act like embryonic ones. It gave about a quarter of its awards to support adult stem cell work, and the rest for other research areas.\u003c/p>\n\u003cp>“In the early days of CIRM, the feeling was that the field needed deep and direct investments in the … fundamental foundation of stem cell biology, because the translational opportunities were not yet mature, certainly not using embryonic or induced pluripotent stem cells,” Daley said.\u003c/p>\n\u003cp>\u003ca href=\"https://www.statnews.com/2016/01/30/paul-knoepfler/\" target=\"_blank\">Paul Knoepfler\u003c/a>, a University of California, Davis, researcher and CIRM grantee who writes a popular \u003ca href=\"http://www.ipscell.com/\" target=\"_blank\">stem cell blog\u003c/a>, agreed. “One almost had to invent a system for figuring out what would be a safe way to proceed with embryonic stem cell clinical trials because those cells are really much more powerful and also have different kinds of risks,” he said.\u003c/p>\n\u003cp>Knoepfler said he expected the basic science to spark clinical breakthroughs in time, citing, for example, promising early work on reversing paralysis from Asterias Biotherapeutics, located in Fremont, southeast of San Francisco. Jake Javier, a patient in a CIRM-supported Asterias trial, lost almost all use of his limbs in an accident diving into a swimming pool. He recently received an injection of a type of cell derived from embryonic stem cells that can help protect nerve cells damaged in spinal cord injuries. Javier has since regained some\u003cstrong> \u003c/strong>use of his arms — one of five patients in early trials who have shown improvement that CIRM and the researchers attribute to the treatment. The results have not yet been published in a peer-reviewed journal.\u003c/p>\n\u003cp>In addition, Mills noted that grants for new labs included provisions that required grantees to raise other funds — to “leverage” economic benefits to taxpayers — and to assist future trials. The institute, for example, gave $30 million to the contract research firm Quintiles to create facilities that will conduct preclinical research, manage regulatory issues, and provide clinical support for CIRM-supported stem cell trials, all at a steep discount.\u003c/p>\n\u003cp>“There is no iPhone 4 without an iPhone 3 or a 2 or a 1,” Mills said. But in a world where technology advances rapidly — Apple is already selling the iPhone 7, after all — voters are still waiting for the promised cures.\u003c/p>\n\u003cfigure id=\"attachment_322991\" class=\"wp-caption alignright\" style=\"max-width: 384px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/evangelina.jpg\">\u003cimg class=\"size-full wp-image-322991\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/evangelina.jpg\" alt=\"Evangelina Padilla Vaccaro in November 2016.\" width=\"384\" height=\"576\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/01/evangelina.jpg 384w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/evangelina-160x240.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/evangelina-240x360.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/evangelina-375x563.jpg 375w\" sizes=\"(max-width: 384px) 100vw, 384px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Evangelina Padilla Vaccaro in November 2016. \u003ccite>(Nancy Ramos)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So far, CIRM has one literal poster child to show it can deliver. Four-year-old Evangelina Padilla Vaccaro, featured on the cover of CIRM’s recent \u003ca href=\"https://www.cirm.ca.gov/about-cirm/2016-annual-report\" target=\"_blank\">annual report\u003c/a>, was born with severe combined immunodeficiency. She had no operating immune system. Some such children have been kept alive in sterile isolation tents for a time — hence the term, “bubble baby” — but most have died from infections within a few years. A lucky few who received matching bone-marrow transplants survived.\u003c/p>\n\u003cp>UCLA’s Dr. Donald Kohn, supported by CIRM, cured Evangelina by extracting some of her blood stem cells, altering them to correct the genetic defect, and returning them to her body. She’s now thriving with a robust immune system.\u003c/p>\n\u003cp>That little girl, and 29 children like her, “are getting immunizations, they’re going to school, they’re swimming in public swimming pools, they’re eating dirt, they’re doing all the things that little kids are supposed to do,” said Steven Peckman, associate director of UCLA’s Broad Center of Regenerative Medicine and Stem Cell Research. “They get sick and their own bodies attack those viruses and bacteria. And they survive. If there’s going to be something that’s called a cure, this is it.”\u003c/p>\n\u003cp>That inspiring triumph was partly funded by CIRM, but Kohn’s work took three decades, was well underway long before CIRM existed, and didn’t involve embryonic stem cells — the key gap CIRM was founded to fill. Evangelina was saved by hematopoietic stem cells, the type that NIH has been more focused on.\u003c/p>\n\u003cp>\u003cstrong>Racing the Clock\u003c/strong>\u003c/p>\n\u003cp>As much as Mills defends the old CIRM, last year he announced “CIRM 2.0” — a drastic shift to speed up clinical trials before the organization’s clock runs out.\u003c/p>\n\u003cp>Asked whether Californians are getting good value for their money from CIRM, Mills cited economic gains to the state, then added: “I focus a lot more on the return in relief of human suffering. We’re just starting to lift off the ground on that. I hope in history, in time, the record shows CIRM was a great deal.”\u003c/p>\n\u003cp>To that end, CIRM has said it will focus in 2017 primarily on clinical trials and work it hopes will lay the foundation for such studies.\u003c/p>\n\u003cp>If the studies show clear results, Mills said, “I think it will be self-evident that CIRM should be continued” with new funding.\u003c/p>\n\u003cp>Lott, the state overseer, called CIRM 2.0 long overdue. “They needed to at least create something a little more tangible, more specifically measurable, for the billions of dollars that they’ve allocated,” he said. “But it may be a little too late,” he added, to convince taxpayers that CIRM should get a new infusion of funds, given its governance structure.\u003c/p>\n\u003cp>Even Daley — unbridled in his enthusiasm for CIRM’s work — hesitated when asked if it was a model to emulate, though for a different reason. “I reluctantly endorse it,” he said, “in part because I think it’s another argument that allows the federal government and the NIH to abdicate its responsibility for investments in biomedical research, which benefits us all.”\u003c/p>\n\u003cp>Yet, just as President Bush’s policy on stem cells led to CIRM’s creation, the incoming Trump administration might bail out the institute just in time. The president-elect has not weighed in on federal funding, but Representative Tom Price, his nominee for Health and Human Services secretary, has long opposed federal funding of embryonic stem cell research — a view shared by Vice President-elect Mike Pence.\u003c/p>\n\u003cp>“If the Trump administration takes a hostile mind toward embryonic stem cell research, and perhaps some kinds of important fetal research are restricted as well, it may give another source of energy to CIRM,” said Knoepfler. “I don’t think Californians like to be told what we can or cannot do, research-wise.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2017/01/19/california-stem-cell-agency-cirm/\" 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": "California's $3 billion stem cell initiative was sold to voters with the pitch that the investment would rapidly yield cures for devastating diseases like Parkinson’s and ALS. That hasn’t happened.",
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"description": "California's $3 billion stem cell initiative was sold to voters with the pitch that the investment would rapidly yield cures for devastating diseases like Parkinson’s and ALS. That hasn’t happened.",
"title": "Time Running Out, California Stem Cell Agency Yet to Produce Big Results | KQED",
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"headline": "Time Running Out, California Stem Cell Agency Yet to Produce Big Results",
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"source": "\u003ca href=\"https://www.statnews.com/2017/01/19/california-stem-cell-agency-cirm/\">STAT\u003c/a>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It’s been more than a decade since California launched an unprecedented experiment in medical research by direct democracy, when voters created a $3 billion fund to kick-start the hunt for stem cell therapies.\u003c/p>\n\u003cp>The bold plan, a response to federal funding limits for embryonic stem cell research, was sold with a simple pitch: The money would rapidly yield cures for devastating human diseases such as Parkinson’s and ALS.\u003c/p>\n\u003cp>That hasn’t happened.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>A major reason, a STAT examination found, is that the \u003ca href=\"https://www.cirm.ca.gov/\" target=\"_blank\">California Institute for Regenerative Medicine\u003c/a> has been slow to move promising experimental therapies into clinical trials. The National Institutes of Health has supported three and a half times as many human trials of stem cell therapies, dollar for dollar, as the California agency has funded since it started making grants in 2006. Just two of its clinical trials have been completed.\u003c/p>\n\u003cp>“I am floored by the disparity,” said Jim Lott, a health care consultant and member of the state board that monitors the agency, known as CIRM. If the numbers are correct, he told STAT, “that doesn’t settle well with me as a voter. That doesn’t settle well with me as a taxpayer. That doesn’t settle well with me as a member of the oversight committee.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>CIRM has used most of the $2.2 billion in grants it has distributed so far to build labs and pay for basic research at public and private universities, such as Stanford and the University of Southern California, and private companies.\u003c/p>\n\u003cp>It has given more than $300 million to 27 projects that include clinical trials — though much of that funding also supported preclinical work. Meanwhile, the agency has committed about $540 million to new labs and buildings.\u003c/p>\n\u003cp>In part, that’s because its directors chose to focus on infrastructure early on, as well as bench experiments and animal studies given that the biology of embryonic stem cells was not well-understood and there are formidable roadblocks to moving into human studies. Much more is known about the bone marrow stem cells that are the focus of many NIH-funded clinical trials.\u003c/p>\n\u003cp>But critics have noted that many top grantees come from institutions that hold seats on CIRM’s governing board. The respected Institute of Medicine, in a 2013 \u003ca href=\"https://www.nap.edu/catalog/13523/the-california-institute-for-regenerative-medicine-science-governance-and-the\" target=\"_blank\">review\u003c/a>, said institutionalized conflicts of interest have raised questions about “the integrity and independence of some of CIRM’s decisions.” CIRM later enacted reforms that barred board members from voting directly on grants for their institutions. But the changes didn’t prevent other financial \u003ca href=\"http://www.latimes.com/business/hiltzik/la-fi-hiltzik-20140720-column.html\" target=\"_blank\">conflicts\u003c/a> involving \u003ca href=\"http://californiastemcellreport.blogspot.com/2016/09/alan-trounson-former-ceo-of-california.html\" target=\"_blank\">CIRM officers and grantees\u003c/a>, and the flow of funds to board members’ institutions continued unabated.\u003c/p>\n\u003cfigure id=\"attachment_322983\" class=\"wp-caption aligncenter\" style=\"max-width: 979px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/CIRM.jpg\">\u003cimg class=\"wp-image-322983 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/CIRM.jpg\" alt=\"CIRM\" width=\"979\" height=\"462\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM.jpg 979w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-160x76.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-800x378.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-768x362.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-960x453.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-240x113.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-375x177.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-520x245.jpg 520w\" sizes=\"(max-width: 979px) 100vw, 979px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sources: California Institute for Regenerative Medicine, National Institutes of Health. \u003cspan class=\"media-source\">*Several CIRM trials included here were announced shortly after Sept. 30, 2016, the cut-off for the NIH data. **NIH spending for 2006 and 2007 is estimated because exact figures were unavailable.\u003c/span>NATALIA BRONSHTEIN/STAT\u003c/figcaption>\u003c/figure>\n\u003cp>“You could make an argument that California taxpayer money should go to build new facilities on state university campuses,” said Marcy Darnovsky, who directs the Berkeley-based Center for Genetics and Society, a public affairs nonprofit. “But I don’t see an argument for Stanford getting fancy new buildings from California taxpayer money.”\u003c/p>\n\u003cp>Stanford, whose endowment is among the top five nationally, and USC have received more than $70\u003cstrong> \u003c/strong>million for major building projects, and hundreds of millions more for labs and research. Stanford alone has been favored with $1 out of every $7 CIRM has approved.\u003c/p>\n\u003cp>But scientists outside California said CIRM’s record is a strong one. CIRM-funded researchers have published nearly 2,000 scholarly papers. That output has helped vault California into the top ranks of stem cell science, said Dr. George Daley, the new dean of Harvard Medical School and a leading stem cell scientist who describes himself as an informal adviser and cheerleader for CIRM. “When I look at the progress my colleagues have made in California, I am duly awed,” he said.\u003c/p>\n\u003cp>The institute announced a year ago that it would reinvent itself to emphasize clinical research until it runs out of money in 2020 — unless voters grant a new infusion of cash. CIRM plans to fund 50 new trials with its remaining $692 million, of which 10 were announced in 2016. Just 17 trials were funded in its first decade of grants.\u003c/p>\n\u003cp>C. Randal Mills, CIRM’s CEO since 2014 and architect of its new strategy, said he welcomed comparisons that help benchmark CIRM’s progress. Mills, former head of Osiris Therapeutics, the first company to commercialize an approved stem cell treatment, declined to comment on STAT’s specific findings, but defended the initial emphasis on labs and basic science as underpinning future clinical work.\u003c/p>\n\u003cp>“We’re running our own race. … What we have to do is just continually get better” to benefit patients, Mills said in an interview. “If we’re behind [NIH], we’re going to get better.”\u003c/p>\n\u003cp>Lott’s teenage daughter was paralyzed in an automobile crash and he hopes for a stem cell cure. He supports the goals of CIRM and applauds much of its work, but he now has second thoughts about the governance structure, which allows board members’ institutions to benefit from CIRM grants, as well as its financing. The ballot question that created CIRM, Proposition 71, authorized bond sales to pay for the agency’s budget, raising the total cost for taxpayers to $6 billion including interest. Financial experts, however, said that relatively low interest rates paid on long-term bonds can offer advantages over funding so large a venture directly from state coffers.\u003c/p>\n\u003cp>Asked whether he would support a similar ballot measure today, Lott said, “We were all caught up in the time, and the events were different when we first looked at this. But not today. Not at all.”\u003c/p>\n\u003cp>\u003cstrong>'Lives Will Be Saved'\u003c/strong>\u003c/p>\n\u003cp>Californians emphatically supported CIRM, creating the stem cell colossus with 59 percent of the vote in 2004. Many were upset that President George W. Bush had sharply limited federal funding for work with embryonic stem cells, which are derived from early human embryos and able to develop into any type of tissue or organ.\u003c/p>\n\u003cp>But Proposition 71 also won because it was shamelessly oversold, consumer advocates and science policy experts said. Desperate patients, Nobel laureates, and A-list celebrities such as \u003ca href=\"https://www.statnews.com/2016/08/30/parkinsons-study-fox-foundation-feud/\" target=\"_blank\">Michael J. Fox\u003c/a> — the Hollywood star and Parkinson’s sufferer — predicted “cures” that would “save millions of lives.”\u003c/p>\n\u003cp>“There are more Americans than … we can count who are sick now, or are going to be sick in the future, whose lives will be saved by Prop 71,” patient advocate Joan Samuelson said in another ad. The sponsors of the measure also predicted that CIRM-generated cures would drastically reduce health care spending. No one made specific promises for the 10-year timeframe initially planned for CIRM’s work, but miracles seemed just around the corner.\u003c/p>\n\u003cp>“You can support embryonic stem cell research, which we do and did, and still be pretty appalled by what was going down,” said Darnovsky. “The airwaves were swamped with guys in white coats who were identified with their academic affiliation even though they were principals of private companies (some of which later got CIRM grants), and basically saying, ‘We’re going to have cures by Christmas.’”\u003c/p>\n\u003cp>Mills, who was not involved at the agency’s genesis, called the idea sold to voters — impending, sweeping breakthroughs — “naïve.” Radical medical change usually takes decades from idea to cure.\u003c/p>\n\u003cp>“But here we are,” he said. “My sole mission is to create as much value for the resources we have left, for the people of California, that I can.”\u003c/p>\n\u003cp>\u003cstrong>California vs. NIH\u003c/strong>\u003c/p>\n\u003cp>Even under Bush-era restrictions — rescinded after President Barack Obama took office — the NIH continued to support substantial stem cell research.\u003c/p>\n\u003cp>Since 2006, it has spent $13.4 billion on stem cell science, six times CIRM’s budget during that period. But NIH fully or partly funded 571 clinical trials, according to STAT’s review — more than 20 times the number backed by California.\u003c/p>\n\u003cp>While NIH in that period funded 50 Phase 3 clinical trials of stem cell therapies — generally the last step before seeking approval to market a product — CIRM has supported just three.\u003c/p>\n\u003cp>One, the study of a treatment for skin cancer involving immune system cells, was terminated by Caladrius Biosciences, the grantee, when it determined that existing treatments had overtaken its approach. The others — testing altered immune cells to treat brain cancer and bioengineered veins to manage vascular problems — show promise, but are still recruiting patients and will not be completed for several years, according to the NIH website, ClinicalTrials.gov.\u003c/p>\n\u003cp>Daley called the NIH comparison “a little unfair,” because that agency emphasized hematopoietic stem cells — blood-forming cells from bone marrow, which had been studied for decades — unlike CIRM’s sharper focus on cutting-edge embryonic stem cells. A little more than half of CIRM’s awards have gone to support research on embryonic or induced pluripotent stem cells, which are created by modifying adult stem cells to act like embryonic ones. It gave about a quarter of its awards to support adult stem cell work, and the rest for other research areas.\u003c/p>\n\u003cp>“In the early days of CIRM, the feeling was that the field needed deep and direct investments in the … fundamental foundation of stem cell biology, because the translational opportunities were not yet mature, certainly not using embryonic or induced pluripotent stem cells,” Daley said.\u003c/p>\n\u003cp>\u003ca href=\"https://www.statnews.com/2016/01/30/paul-knoepfler/\" target=\"_blank\">Paul Knoepfler\u003c/a>, a University of California, Davis, researcher and CIRM grantee who writes a popular \u003ca href=\"http://www.ipscell.com/\" target=\"_blank\">stem cell blog\u003c/a>, agreed. “One almost had to invent a system for figuring out what would be a safe way to proceed with embryonic stem cell clinical trials because those cells are really much more powerful and also have different kinds of risks,” he said.\u003c/p>\n\u003cp>Knoepfler said he expected the basic science to spark clinical breakthroughs in time, citing, for example, promising early work on reversing paralysis from Asterias Biotherapeutics, located in Fremont, southeast of San Francisco. Jake Javier, a patient in a CIRM-supported Asterias trial, lost almost all use of his limbs in an accident diving into a swimming pool. He recently received an injection of a type of cell derived from embryonic stem cells that can help protect nerve cells damaged in spinal cord injuries. Javier has since regained some\u003cstrong> \u003c/strong>use of his arms — one of five patients in early trials who have shown improvement that CIRM and the researchers attribute to the treatment. The results have not yet been published in a peer-reviewed journal.\u003c/p>\n\u003cp>In addition, Mills noted that grants for new labs included provisions that required grantees to raise other funds — to “leverage” economic benefits to taxpayers — and to assist future trials. The institute, for example, gave $30 million to the contract research firm Quintiles to create facilities that will conduct preclinical research, manage regulatory issues, and provide clinical support for CIRM-supported stem cell trials, all at a steep discount.\u003c/p>\n\u003cp>“There is no iPhone 4 without an iPhone 3 or a 2 or a 1,” Mills said. But in a world where technology advances rapidly — Apple is already selling the iPhone 7, after all — voters are still waiting for the promised cures.\u003c/p>\n\u003cfigure id=\"attachment_322991\" class=\"wp-caption alignright\" style=\"max-width: 384px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/evangelina.jpg\">\u003cimg class=\"size-full wp-image-322991\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/evangelina.jpg\" alt=\"Evangelina Padilla Vaccaro in November 2016.\" width=\"384\" height=\"576\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/01/evangelina.jpg 384w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/evangelina-160x240.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/evangelina-240x360.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/evangelina-375x563.jpg 375w\" sizes=\"(max-width: 384px) 100vw, 384px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Evangelina Padilla Vaccaro in November 2016. \u003ccite>(Nancy Ramos)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So far, CIRM has one literal poster child to show it can deliver. Four-year-old Evangelina Padilla Vaccaro, featured on the cover of CIRM’s recent \u003ca href=\"https://www.cirm.ca.gov/about-cirm/2016-annual-report\" target=\"_blank\">annual report\u003c/a>, was born with severe combined immunodeficiency. She had no operating immune system. Some such children have been kept alive in sterile isolation tents for a time — hence the term, “bubble baby” — but most have died from infections within a few years. A lucky few who received matching bone-marrow transplants survived.\u003c/p>\n\u003cp>UCLA’s Dr. Donald Kohn, supported by CIRM, cured Evangelina by extracting some of her blood stem cells, altering them to correct the genetic defect, and returning them to her body. She’s now thriving with a robust immune system.\u003c/p>\n\u003cp>That little girl, and 29 children like her, “are getting immunizations, they’re going to school, they’re swimming in public swimming pools, they’re eating dirt, they’re doing all the things that little kids are supposed to do,” said Steven Peckman, associate director of UCLA’s Broad Center of Regenerative Medicine and Stem Cell Research. “They get sick and their own bodies attack those viruses and bacteria. And they survive. If there’s going to be something that’s called a cure, this is it.”\u003c/p>\n\u003cp>That inspiring triumph was partly funded by CIRM, but Kohn’s work took three decades, was well underway long before CIRM existed, and didn’t involve embryonic stem cells — the key gap CIRM was founded to fill. Evangelina was saved by hematopoietic stem cells, the type that NIH has been more focused on.\u003c/p>\n\u003cp>\u003cstrong>Racing the Clock\u003c/strong>\u003c/p>\n\u003cp>As much as Mills defends the old CIRM, last year he announced “CIRM 2.0” — a drastic shift to speed up clinical trials before the organization’s clock runs out.\u003c/p>\n\u003cp>Asked whether Californians are getting good value for their money from CIRM, Mills cited economic gains to the state, then added: “I focus a lot more on the return in relief of human suffering. We’re just starting to lift off the ground on that. I hope in history, in time, the record shows CIRM was a great deal.”\u003c/p>\n\u003cp>To that end, CIRM has said it will focus in 2017 primarily on clinical trials and work it hopes will lay the foundation for such studies.\u003c/p>\n\u003cp>If the studies show clear results, Mills said, “I think it will be self-evident that CIRM should be continued” with new funding.\u003c/p>\n\u003cp>Lott, the state overseer, called CIRM 2.0 long overdue. “They needed to at least create something a little more tangible, more specifically measurable, for the billions of dollars that they’ve allocated,” he said. “But it may be a little too late,” he added, to convince taxpayers that CIRM should get a new infusion of funds, given its governance structure.\u003c/p>\n\u003cp>Even Daley — unbridled in his enthusiasm for CIRM’s work — hesitated when asked if it was a model to emulate, though for a different reason. “I reluctantly endorse it,” he said, “in part because I think it’s another argument that allows the federal government and the NIH to abdicate its responsibility for investments in biomedical research, which benefits us all.”\u003c/p>\n\u003cp>Yet, just as President Bush’s policy on stem cells led to CIRM’s creation, the incoming Trump administration might bail out the institute just in time. The president-elect has not weighed in on federal funding, but Representative Tom Price, his nominee for Health and Human Services secretary, has long opposed federal funding of embryonic stem cell research — a view shared by Vice President-elect Mike Pence.\u003c/p>\n\u003cp>“If the Trump administration takes a hostile mind toward embryonic stem cell research, and perhaps some kinds of important fetal research are restricted as well, it may give another source of energy to CIRM,” said Knoepfler. “I don’t think Californians like to be told what we can or cannot do, research-wise.”\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/2017/01/19/california-stem-cell-agency-cirm/\" 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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"content": "\u003cp>Last October, Matt Herich was listening to the news while he drove door to door delivering pizzas. A story came on the radio about a technology that sends an electric current through your brain to possibly make you better at some things — moving, remembering, learning. He was fascinated.\u003c/p>\n\u003cp>The neurotechnology is called transcranial direct current stimulation, or tDCS for short. At its simplest, the method involves a device that uses little more than a 9-volt battery and some electrodes to send a low-intensity electrical current to a targeted area of the brain, \u003ca href=\"http://www.jove.com/video/2744/electrode-positioning-montage-transcranial-direct-current\">typically via a headset\u003c/a>.\u003c/p>\n\u003cp>More than a 1,000 studies have been published in peer-reviewed journals over the last decade suggesting benefits of the technique — maybe \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S0014488609001290\">regulating mood\u003c/a>, possibly \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S0166432809006536\">improving language skills\u003c/a> — but its effects, good \u003cem>or\u003c/em> bad, are far from clear.\u003c/p>\n\u003cp>Although researchers see possibilities for tDCS in treating diseases and boosting performance, it's still an exploratory technology, says Mark George, editor-in-chief of \u003cem>Brain Stimulation\u003c/em>, a leading journal on neuromodulation. And leading experts have \u003ca href=\"http://www.tandfonline.com/doi/pdf/10.3109/10601333.2015.980944?needAccess=true\">warned against at-home use\u003c/a> of such devices.\u003c/p>\n\u003cp>\"If we can figure out safe long-term applications, it's so inexpensive we might be able to use it to boost tons of things,\" says George, a professor at the Medical University of South Carolina. \"But I have to underline \u003cem>might \u003c/em>-- we don't know yet.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>When Herich finished his shift delivering pizzas, he raced home and began googling. He found a thriving \u003ca href=\"https://www.reddit.com/r/tDCS/\">community on Reddit\u003c/a> and other online forums dedicated to discussing ways to self-administer tDCS.\u003c/p>\n\u003cp>After reading some scientific studies on neurostimulation, Herich decided to give it a try. He eventually got his hands on a rudimentary tDCS device made by a student at Northern Arizona University.\u003c/p>\n\u003cp>\"I did my research before I put the device on my head,\" Herich says. \"So it was a mix between me being confident it would be safe and me taking a leap of faith.\"\u003c/p>\n\u003cp>In his opinion, the leap of faith paid off. Herich takes online courses on machine learning, and he says that one 20-minute session of tDCS puts him in a state of intense focus that increases his productivity and helps him learn abstract math much faster than before.\u003c/p>\n\u003cp>Herich is not alone — beyond the DIY neurostimulation community, companies are cashing in on the phenomenon, offering brain stimulation kits and ready-to-wear headsets, like \u003ca href=\"http://www.wsj.com/articles/this-gadget-gives-you-a-low-voltage-pick-me-up-1437503825\">Thync\u003c/a> and \u003ca href=\"https://techcrunch.com/2016/11/16/halo-neuroscience/\">Halo\u003c/a>. While the simplest devices can be made with items found in a hardware store, the best-selling versions like \u003ca href=\"http://www.caputron.com/transcutaneous-electrical-stimulation/54-activadose-ii.html?search_query=activadose&results=3\">ActivaDose\u003c/a> or the \u003ca href=\"https://foc.us/\">Foc.us\u003c/a> can cost more than $300.\u003c/p>\n\u003cp>And sales of the devices spike at fairly regular times, says Robin Azzam, CEO of a leading tDCS retailer \u003ca href=\"http://www.caputron.com/content/11-tdcs-device-comaparison\">Caputron\u003c/a>: around college midterms and finals. Caputron also helps point customers to academic studies about tDCS. And Azzam says articles on cognitive enhancement are in particularly high demand during exam times.\u003c/p>\n\u003cp>George says he's also heard students are using tDCS to study for exams, but he doesn't recommend it: There isn't enough data to back up claims that it is effective or safe.\u003c/p>\n\u003cp>He says an updated article will be published soon detailing the experts' concerns about liberal use of tDCS by the DIY community. The main worries include the risks of mistakes in administration by amateurs and the uncertainty of long-term harmful effects of the technique.\u003c/p>\n\u003cp>Besides, George says, at-home users that attempt to study with the device may actually be doing themselves a disservice.\u003c/p>\n\u003cp>\"When we learn something, we're more likely to remember it in the same environment as when we learned it,\" he says. \"So if you study with one of these devices on and then you take your test without the device, you've violated that rule. You may be very good with it on, but unless they allow you to do that in the exam you're actually hurting yourself.\"\u003c/p>\n\u003cp>Plus, the safety of devices can vary — given that most tDCS devices aren't marketed with specific medical claims, they are not reviewed by the Food and Drug Administration.\u003c/p>\n\u003cp>\"A lot of the people that buy these think that they're safe because a company is allowed to sell them,\" says Vince Clark, director of the Psychology Clinical Neuroscience Center at the University of New Mexico. \"What they don't know is that a lot of those devices are never evaluated by the FDA. They go to market without safety studies that everybody expects must have happened. They haven't.\"\u003c/p>\n\u003cp>But like Herich, many users read the literature that supports and condemns tDCS use outside of clinical settings and choose to move forward anyway. And according to \u003ca href=\"http://jme.bmj.com/content/early/2015/08/30/medethics-2015-102704.short\">one academic review of the do-it-yourself brain stimulation community\u003c/a>, most DIYers do draw heavily on existing scientific knowledge, circulate academic journal articles and adopt the standard electrode placement used by scientists.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I do understand the risks,\" Herich says. \"I know ... the nature of what it is that I'm doing, connecting a 9-volt to the forehead.\" He acknowledges that to many people it may sound crazy. \"I don't know,\" he says, \"I think I just accept that risk.\"\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=Students+Zap+Their+Brains+For+a+Boost%2C+For+Better+Or+Worse&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Last October, Matt Herich was listening to the news while he drove door to door delivering pizzas. A story came on the radio about a technology that sends an electric current through your brain to possibly make you better at some things — moving, remembering, learning. He was fascinated.\u003c/p>\n\u003cp>The neurotechnology is called transcranial direct current stimulation, or tDCS for short. At its simplest, the method involves a device that uses little more than a 9-volt battery and some electrodes to send a low-intensity electrical current to a targeted area of the brain, \u003ca href=\"http://www.jove.com/video/2744/electrode-positioning-montage-transcranial-direct-current\">typically via a headset\u003c/a>.\u003c/p>\n\u003cp>More than a 1,000 studies have been published in peer-reviewed journals over the last decade suggesting benefits of the technique — maybe \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S0014488609001290\">regulating mood\u003c/a>, possibly \u003ca href=\"http://www.sciencedirect.com/science/article/pii/S0166432809006536\">improving language skills\u003c/a> — but its effects, good \u003cem>or\u003c/em> bad, are far from clear.\u003c/p>\n\u003cp>Although researchers see possibilities for tDCS in treating diseases and boosting performance, it's still an exploratory technology, says Mark George, editor-in-chief of \u003cem>Brain Stimulation\u003c/em>, a leading journal on neuromodulation. And leading experts have \u003ca href=\"http://www.tandfonline.com/doi/pdf/10.3109/10601333.2015.980944?needAccess=true\">warned against at-home use\u003c/a> of such devices.\u003c/p>\n\u003cp>\"If we can figure out safe long-term applications, it's so inexpensive we might be able to use it to boost tons of things,\" says George, a professor at the Medical University of South Carolina. \"But I have to underline \u003cem>might \u003c/em>-- we don't know yet.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>When Herich finished his shift delivering pizzas, he raced home and began googling. He found a thriving \u003ca href=\"https://www.reddit.com/r/tDCS/\">community on Reddit\u003c/a> and other online forums dedicated to discussing ways to self-administer tDCS.\u003c/p>\n\u003cp>After reading some scientific studies on neurostimulation, Herich decided to give it a try. He eventually got his hands on a rudimentary tDCS device made by a student at Northern Arizona University.\u003c/p>\n\u003cp>\"I did my research before I put the device on my head,\" Herich says. \"So it was a mix between me being confident it would be safe and me taking a leap of faith.\"\u003c/p>\n\u003cp>In his opinion, the leap of faith paid off. Herich takes online courses on machine learning, and he says that one 20-minute session of tDCS puts him in a state of intense focus that increases his productivity and helps him learn abstract math much faster than before.\u003c/p>\n\u003cp>Herich is not alone — beyond the DIY neurostimulation community, companies are cashing in on the phenomenon, offering brain stimulation kits and ready-to-wear headsets, like \u003ca href=\"http://www.wsj.com/articles/this-gadget-gives-you-a-low-voltage-pick-me-up-1437503825\">Thync\u003c/a> and \u003ca href=\"https://techcrunch.com/2016/11/16/halo-neuroscience/\">Halo\u003c/a>. While the simplest devices can be made with items found in a hardware store, the best-selling versions like \u003ca href=\"http://www.caputron.com/transcutaneous-electrical-stimulation/54-activadose-ii.html?search_query=activadose&results=3\">ActivaDose\u003c/a> or the \u003ca href=\"https://foc.us/\">Foc.us\u003c/a> can cost more than $300.\u003c/p>\n\u003cp>And sales of the devices spike at fairly regular times, says Robin Azzam, CEO of a leading tDCS retailer \u003ca href=\"http://www.caputron.com/content/11-tdcs-device-comaparison\">Caputron\u003c/a>: around college midterms and finals. Caputron also helps point customers to academic studies about tDCS. And Azzam says articles on cognitive enhancement are in particularly high demand during exam times.\u003c/p>\n\u003cp>George says he's also heard students are using tDCS to study for exams, but he doesn't recommend it: There isn't enough data to back up claims that it is effective or safe.\u003c/p>\n\u003cp>He says an updated article will be published soon detailing the experts' concerns about liberal use of tDCS by the DIY community. The main worries include the risks of mistakes in administration by amateurs and the uncertainty of long-term harmful effects of the technique.\u003c/p>\n\u003cp>Besides, George says, at-home users that attempt to study with the device may actually be doing themselves a disservice.\u003c/p>\n\u003cp>\"When we learn something, we're more likely to remember it in the same environment as when we learned it,\" he says. \"So if you study with one of these devices on and then you take your test without the device, you've violated that rule. You may be very good with it on, but unless they allow you to do that in the exam you're actually hurting yourself.\"\u003c/p>\n\u003cp>Plus, the safety of devices can vary — given that most tDCS devices aren't marketed with specific medical claims, they are not reviewed by the Food and Drug Administration.\u003c/p>\n\u003cp>\"A lot of the people that buy these think that they're safe because a company is allowed to sell them,\" says Vince Clark, director of the Psychology Clinical Neuroscience Center at the University of New Mexico. \"What they don't know is that a lot of those devices are never evaluated by the FDA. They go to market without safety studies that everybody expects must have happened. They haven't.\"\u003c/p>\n\u003cp>But like Herich, many users read the literature that supports and condemns tDCS use outside of clinical settings and choose to move forward anyway. And according to \u003ca href=\"http://jme.bmj.com/content/early/2015/08/30/medethics-2015-102704.short\">one academic review of the do-it-yourself brain stimulation community\u003c/a>, most DIYers do draw heavily on existing scientific knowledge, circulate academic journal articles and adopt the standard electrode placement used by scientists.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I do understand the risks,\" Herich says. \"I know ... the nature of what it is that I'm doing, connecting a 9-volt to the forehead.\" He acknowledges that to many people it may sound crazy. \"I don't know,\" he says, \"I think I just accept that risk.\"\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=Students+Zap+Their+Brains+For+a+Boost%2C+For+Better+Or+Worse&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>A next step for smart watches and fitness trackers? Wearable gadgets gave a Stanford University professor an early warning that he was getting sick before he ever felt any symptoms of Lyme disease.\u003c/p>\n\u003cp>Geneticist Michael Snyder never had Lyme's characteristic bulls-eye rash. But a smart watch and other sensors charted changes in Snyder's heart rate and oxygen levels during a family vacation. Eventually a fever struck that led to his diagnosis.\u003c/p>\n\u003cp>Say \"wearables,\" and step-counting fitness trackers spring to mind. It's not clear if they really make a difference in users' health. Now Snyder's team at Stanford is starting to find out, tracking the everyday lives of several dozen volunteers wearing devices that monitor more than mere activity.\u003c/p>\n\u003cp>He envisions one day having wearables that act as a sort of \"check engine\" light indicating it's time to see the doctor.\u003c/p>\n\u003cp>\"One way to look at this is, these are the equivalent of oral thermometers but you're measuring yourself all the time,\" said Snyder, senior author of a report released Thursday on the project.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Among the earliest hints: Changes in people's day-to-day physiology may flag when certain ailments are brewing, from colds to Lyme to Type 2 diabetes, researchers reported in the journal PLOS Biology.\u003c/p>\n\u003cp>Interest in wearable sensors is growing along with efforts to personalize medicine, as scientists learn how to tailor treatments and preventive care to people's genes, environment and lifestyle. The sensors are expected to be a part of the National Institutes of Health's huge \"precision medicine\" study, planned to begin later this year.\u003c/p>\n\u003cp>But a first step is learning what's normal for different people under different conditions.\u003c/p>\n\u003cp>The Stanford team is collecting reams of data — as many as 250,000 daily measurements — from volunteers who wear up to eight activity monitors or other sensors of varying sizes that measure heart rate, blood oxygen, skin temperature, sleep, calories expended, exercise and even exposure to radiation. That's paired with occasional laboratory tests to measure blood chemistry and some genetic information.\u003c/p>\n\u003cp>An initial finding: Blood oxygen levels decrease with rising altitudes during plane flights, in turn triggering fatigue. But toward the end of long flights, oxygen begins rising again, possibly as bodies adapt, the researchers reported.\u003c/p>\n\u003cp>It was that phenomenon that alerted Snyder, the longest-tested participant, \"that something wasn't quite right\" on one of his frequent long flights.\u003c/p>\n\u003cp>Landing in Norway for a family vacation, Snyder noticed his oxygen levels didn't return to normal like they always had before. Plus his heart rate was much higher than normal, which sometimes signals infection.\u003c/p>\n\u003cp>Sure enough, soon a low-grade fever left him dragging. He feared Lyme because two weeks before going abroad, Snyder had helped his brother build a fence in a tick-infested rural area in Massachusetts. He persuaded a Norwegian doctor to prescribe the appropriate antibiotic, and post-vacation testing back home confirmed the diagnosis.\u003c/p>\n\u003cp>Also during the study's first two years, Snyder and several other volunteers had minor cold-like illnesses that began with higher-than-normal readings for heart rate and skin temperature — and correlated with blood tests showing inflammation was on the rise before any sniffling.\u003c/p>\n\u003cp>In addition, the Stanford team detected variations in heart rate patterns that could tell the difference between study participants with what's called insulin resistance — a risk factor for Type 2 diabetes — and healthy people.\u003c/p>\n\u003cp>No, don't try to self-diagnose with your fitness tracker any time soon. The findings in Thursday's report are intriguing but the study is highly experimental, cautioned medical technology specialist Dr. Atul Butte of the University of California, San Francisco, who wasn't involved with the research.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"This kind of approach is going to help science more than the general public\" until there's better data about what's normal or not, Butte said. \"Remember, the baseline is always in motion. We're always getting older. We're always exposed to things. Just because there's a deviation doesn't mean it's abnormal.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A next step for smart watches and fitness trackers? Wearable gadgets gave a Stanford University professor an early warning that he was getting sick before he ever felt any symptoms of Lyme disease.\u003c/p>\n\u003cp>Geneticist Michael Snyder never had Lyme's characteristic bulls-eye rash. But a smart watch and other sensors charted changes in Snyder's heart rate and oxygen levels during a family vacation. Eventually a fever struck that led to his diagnosis.\u003c/p>\n\u003cp>Say \"wearables,\" and step-counting fitness trackers spring to mind. It's not clear if they really make a difference in users' health. Now Snyder's team at Stanford is starting to find out, tracking the everyday lives of several dozen volunteers wearing devices that monitor more than mere activity.\u003c/p>\n\u003cp>He envisions one day having wearables that act as a sort of \"check engine\" light indicating it's time to see the doctor.\u003c/p>\n\u003cp>\"One way to look at this is, these are the equivalent of oral thermometers but you're measuring yourself all the time,\" said Snyder, senior author of a report released Thursday on the project.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Among the earliest hints: Changes in people's day-to-day physiology may flag when certain ailments are brewing, from colds to Lyme to Type 2 diabetes, researchers reported in the journal PLOS Biology.\u003c/p>\n\u003cp>Interest in wearable sensors is growing along with efforts to personalize medicine, as scientists learn how to tailor treatments and preventive care to people's genes, environment and lifestyle. The sensors are expected to be a part of the National Institutes of Health's huge \"precision medicine\" study, planned to begin later this year.\u003c/p>\n\u003cp>But a first step is learning what's normal for different people under different conditions.\u003c/p>\n\u003cp>The Stanford team is collecting reams of data — as many as 250,000 daily measurements — from volunteers who wear up to eight activity monitors or other sensors of varying sizes that measure heart rate, blood oxygen, skin temperature, sleep, calories expended, exercise and even exposure to radiation. That's paired with occasional laboratory tests to measure blood chemistry and some genetic information.\u003c/p>\n\u003cp>An initial finding: Blood oxygen levels decrease with rising altitudes during plane flights, in turn triggering fatigue. But toward the end of long flights, oxygen begins rising again, possibly as bodies adapt, the researchers reported.\u003c/p>\n\u003cp>It was that phenomenon that alerted Snyder, the longest-tested participant, \"that something wasn't quite right\" on one of his frequent long flights.\u003c/p>\n\u003cp>Landing in Norway for a family vacation, Snyder noticed his oxygen levels didn't return to normal like they always had before. Plus his heart rate was much higher than normal, which sometimes signals infection.\u003c/p>\n\u003cp>Sure enough, soon a low-grade fever left him dragging. He feared Lyme because two weeks before going abroad, Snyder had helped his brother build a fence in a tick-infested rural area in Massachusetts. He persuaded a Norwegian doctor to prescribe the appropriate antibiotic, and post-vacation testing back home confirmed the diagnosis.\u003c/p>\n\u003cp>Also during the study's first two years, Snyder and several other volunteers had minor cold-like illnesses that began with higher-than-normal readings for heart rate and skin temperature — and correlated with blood tests showing inflammation was on the rise before any sniffling.\u003c/p>\n\u003cp>In addition, the Stanford team detected variations in heart rate patterns that could tell the difference between study participants with what's called insulin resistance — a risk factor for Type 2 diabetes — and healthy people.\u003c/p>\n\u003cp>No, don't try to self-diagnose with your fitness tracker any time soon. The findings in Thursday's report are intriguing but the study is highly experimental, cautioned medical technology specialist Dr. Atul Butte of the University of California, San Francisco, who wasn't involved with the research.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"This kind of approach is going to help science more than the general public\" until there's better data about what's normal or not, Butte said. \"Remember, the baseline is always in motion. We're always getting older. We're always exposed to things. Just because there's a deviation doesn't mean it's abnormal.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Most Important Genetics Stories 2016",
"title": "Most Important Genetics Stories 2016",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp class=\"p1\">\u003cspan class=\"s1\">Two thousand and sixteen was a big year for genetics, and there was no bigger story than everyone’s favorite gene-editing tool, \u003ca href=\"http://genetics.thetech.org/ask-a-geneticist/why-crispr-revolutionary-and-how-it-works\">CRISPR-Cas9\u003c/a>. But that wasn’t the only story: A “three-parent baby” was born in Mexico, the minimum number of genes needed for bacterial life was determined, gene drives were tentatively approved for dealing with the Zika virus, and four species of giraffes were identified based on DNA alone. And there were many more.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Here's the rundown of our top stories.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>The Many Tales of CRISPR-Cas9\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">For the last couple of years, there's been a lot of news about tweaking genes using the CRISPR-Cas9 system. In 2016, scientists began to use this cutting-edge gene-editing tool in earnest.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Last year was the first time that CRISPR-Cas9 was \u003ca href=\"http://www.nature.com/news/crispr-gene-editing-tested-in-a-person-for-the-first-time-1.20988\">\u003cspan class=\"s2\">directly used to treat a disease\u003c/span>\u003c/a> in a patient. In late October, Dr. Lu You of Sichuan University in Chengdu, China used CRISPR-Cas9 to change the DNA in a patient’s immune cells so that these cells would attack the patient’s cancer. This approach is called immunotherapy--a \u003ca href=\"http://www.cnn.com/2016/10/26/health/immunotherapy-cancer-treatments/\">\u003cspan class=\"s2\">big story all on its own\u003c/span>\u003c/a>.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp class=\"p1\">What these researchers did was to remove immune cells from the patient and knock out their PD-1 gene, which can incorrectly determine that cancer cells are not a threat. Removing the gene should theoretically help the immune cells recognize and destroy cancer cells. The researchers grew the modified cells in the lab and then injected them back into the patient. While it is too soon to know if the treatment is effective, we do know that -- so far at least-- the patient hasn't experienced any negative effects.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Last year, for only the second time, \u003ca href=\"http://www.nature.com/news/second-chinese-team-reports-gene-editing-in-human-embryos-1.19718\">\u003cspan class=\"s2\">researchers “successfully” changed DNA in human embryos\u003c/span>\u003c/a> using CRISPR-Cas9. (The first time was way back in 2015.) The researchers purposely used nonviable embryos, which were not transferred into a womb.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The reason I included the quotation marks is that gene editing human embryos is still very much a work in progress. Only four of the 26 embryos were successfully edited. And the results were not identical even in these four; some had additional mutations in the targeted gene. \u003c/span>\u003cspan class=\"s1\">These mixed results emphasize how much more work needs to be done before editing human embryos can become routine.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">And of course, the \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/01/15/crispr-patent-war-billions-at-stake-for-uc-berkeley/\">\u003cspan class=\"s2\">CRISPR-Cas9 patent war\u003c/span>\u003c/a> between UC Berkeley and the Broad Institute of Harvard and MIT continued to rage on. Whoever wins stands to make a whole lot of money, which makes this a very nasty, ongoing battle unlikely to end soon. \u003c/span>\u003c/p>\n\u003cp>CRISPR-Cas9 even became a player in the GMO field. The \u003ca href=\"https://www.washingtonpost.com/news/speaking-of-science/wp/2016/04/18/why-this-genetically-modified-mushroom-is-bypassing-usda-regulation/?utm_term=.1af905912360\">\u003cspan class=\"s2\">FDA ruled\u003c/span>\u003c/a> that a mushroom with a gene that had been modified with CRISPR-Cas9 didn’t need to jump through the usual regulatory hoops that a genetically modified organism has to.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Another big story last year, gene drives, owes its existence to CRISPR-Cas9:\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>Gene Drives, Mosquitoes and Zika\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Last year, the Zika virus spread like wildfire across South and Central America, leaving over 1,000 babies with the birth defect microcephaly.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Scientists are working on a number of ways to prevent Zika infections. The most controversial is to wipe out the mosquito that carries the virus using \u003ca href=\"http://genetics.thetech.org/driving-genes-wild\">gene drives\u003c/a>. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Gene drives use CRISPR-Cas9 to quickly and easily spread a harmful gene through a population. In this case the idea would be to destroy the population of mosquitoes that carry the Zika virus. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">This method was given \u003ca href=\"http://www.forbes.com/sites/robertglatter/2016/03/14/fda-grants-tentative-approval-for-gmo-mosquito-trial-in-florida-keys/\">\u003cspan class=\"s2\">tentative approval by the FDA\u003c/span>\u003c/a> back in March 2016, but it has not yet been used, as\u003ca href=\"http://blogs.plos.org/scicomm/2016/11/09/as-florida-voters-are-asked-to-weigh-in-on-a-gm-mosquito-field-trial-where-is-and-isnt-the-science-of-zika-virus-control/\"> many Florida residents strongly oppose it\u003c/a>.\u003c/p>\n\u003cp class=\"p1\">Gene drives were mostly theoretical until CRISPR-Cas9 came along to make them a relatively simple thing to make. In fact, so simple that a group of undergraduate students \u003ca href=\"http://gizmodo.com/college-students-show-how-easy-it-is-to-use-terrifying-1790526457\">\u003cspan class=\"s2\">nearly pulled it off\u003c/span>\u003c/a> at the end of 2016.\u003c/p>\n\u003cp class=\"p1\">\u003cb>Child With Three Parents\u003c/b>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">In 2015, a big controversy swirled around whether to \u003ca href=\"http://genetics.thetech.org/ask/ask70\">\u003cspan class=\"s2\">restart\u003c/span>\u003c/a> a genetic technique that allows some women who carry mitochondrial diseases to have children without passing them on to their kids. In 2016 \u003ca href=\"https://www.newscientist.com/article/2107219-exclusive-worlds-first-baby-born-with-new-3-parent-technique/\">\u003cspan class=\"s2\">a healthy baby boy was born\u003c/span>\u003c/a> in Mexico using this technique.\u003c/span>\u003c/p>\n\u003cp>The technique is controversial for a couple of reasons. First, any girls born will pass their genetically engineered DNA down to their children. This has always been an ethics no-fly zone, as the feeling is that whatever genetic modification we make in a person should stay in that person. Because the woman in Mexico had a son, the issue was sidestepped.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The other controversy is that this boy has DNA from three people instead of the usual two. \u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_316963\" class=\"wp-caption aligncenter\" style=\"max-width: 500px\">\u003cimg class=\"wp-image-316963 size-full\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/3parent.jpg\" alt=\"This egg is now fertilized with dad's sperm.\" width=\"500\" height=\"335\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/01/3parent.jpg 500w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/3parent-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/3parent-240x161.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/3parent-375x251.jpg 375w\" sizes=\"(max-width: 500px) 100vw, 500px\">\u003cfigcaption class=\"wp-caption-text\">This egg is now fertilized with dad's sperm. (Image by Barry Starr)\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">The child has mitochondria, and thus mitochondrial DNA, from the donor, along with DNA from his mom and dad. (Mitochondria are the organelles that supply our cells with energy; they have a bit of DNA all their own.) Although this is referred to as having three parents, that might be a bit of an overstatement. After all, s\u003cspan class=\"s1\">omething like 1/300,000\u003c/span>\u003cspan class=\"s3\">\u003csup>th\u003c/sup>\u003c/span>\u003cspan class=\"s1\"> of the child's DNA comes from the donor, with the rest coming from the mother and father. If the donor is a parent, she is a very minor one indeed.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cb>The Edge of Life\u003c/b>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">With the exception of viruses, most life has evolved with a thousand or more genes.Humans have somewhere around 22,000 genes; the humble yeast that gives beer and wine its alcohol has around 6,000; and the bacterium with the fewest known number of genes has 901.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">In 2016 a group of researchers was able to show that this last bacterium could get by \u003ca href=\"https://www.sciencenews.org/article/scientists-build-minimum-genome-bacterium\">\u003cspan class=\"s2\">with only 473 genes\u003c/span>\u003c/a>. This is the bare bones machinery needed to keep a bacterium going.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">What is cool is that we would not have been able to predict that these were the 473 a bacterium would need. We don’t even know what 143 of them do... .\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp class=\"p1\">Genetics is bound to be a hot topic in 2017 as well. Stay tuned.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"p1\">\u003cspan class=\"s1\">Two thousand and sixteen was a big year for genetics, and there was no bigger story than everyone’s favorite gene-editing tool, \u003ca href=\"http://genetics.thetech.org/ask-a-geneticist/why-crispr-revolutionary-and-how-it-works\">CRISPR-Cas9\u003c/a>. But that wasn’t the only story: A “three-parent baby” was born in Mexico, the minimum number of genes needed for bacterial life was determined, gene drives were tentatively approved for dealing with the Zika virus, and four species of giraffes were identified based on DNA alone. And there were many more.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Here's the rundown of our top stories.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>The Many Tales of CRISPR-Cas9\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">For the last couple of years, there's been a lot of news about tweaking genes using the CRISPR-Cas9 system. In 2016, scientists began to use this cutting-edge gene-editing tool in earnest.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Last year was the first time that CRISPR-Cas9 was \u003ca href=\"http://www.nature.com/news/crispr-gene-editing-tested-in-a-person-for-the-first-time-1.20988\">\u003cspan class=\"s2\">directly used to treat a disease\u003c/span>\u003c/a> in a patient. In late October, Dr. Lu You of Sichuan University in Chengdu, China used CRISPR-Cas9 to change the DNA in a patient’s immune cells so that these cells would attack the patient’s cancer. This approach is called immunotherapy--a \u003ca href=\"http://www.cnn.com/2016/10/26/health/immunotherapy-cancer-treatments/\">\u003cspan class=\"s2\">big story all on its own\u003c/span>\u003c/a>.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"p1\">What these researchers did was to remove immune cells from the patient and knock out their PD-1 gene, which can incorrectly determine that cancer cells are not a threat. Removing the gene should theoretically help the immune cells recognize and destroy cancer cells. The researchers grew the modified cells in the lab and then injected them back into the patient. While it is too soon to know if the treatment is effective, we do know that -- so far at least-- the patient hasn't experienced any negative effects.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Last year, for only the second time, \u003ca href=\"http://www.nature.com/news/second-chinese-team-reports-gene-editing-in-human-embryos-1.19718\">\u003cspan class=\"s2\">researchers “successfully” changed DNA in human embryos\u003c/span>\u003c/a> using CRISPR-Cas9. (The first time was way back in 2015.) The researchers purposely used nonviable embryos, which were not transferred into a womb.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The reason I included the quotation marks is that gene editing human embryos is still very much a work in progress. Only four of the 26 embryos were successfully edited. And the results were not identical even in these four; some had additional mutations in the targeted gene. \u003c/span>\u003cspan class=\"s1\">These mixed results emphasize how much more work needs to be done before editing human embryos can become routine.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">And of course, the \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/01/15/crispr-patent-war-billions-at-stake-for-uc-berkeley/\">\u003cspan class=\"s2\">CRISPR-Cas9 patent war\u003c/span>\u003c/a> between UC Berkeley and the Broad Institute of Harvard and MIT continued to rage on. Whoever wins stands to make a whole lot of money, which makes this a very nasty, ongoing battle unlikely to end soon. \u003c/span>\u003c/p>\n\u003cp>CRISPR-Cas9 even became a player in the GMO field. The \u003ca href=\"https://www.washingtonpost.com/news/speaking-of-science/wp/2016/04/18/why-this-genetically-modified-mushroom-is-bypassing-usda-regulation/?utm_term=.1af905912360\">\u003cspan class=\"s2\">FDA ruled\u003c/span>\u003c/a> that a mushroom with a gene that had been modified with CRISPR-Cas9 didn’t need to jump through the usual regulatory hoops that a genetically modified organism has to.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Another big story last year, gene drives, owes its existence to CRISPR-Cas9:\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>Gene Drives, Mosquitoes and Zika\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Last year, the Zika virus spread like wildfire across South and Central America, leaving over 1,000 babies with the birth defect microcephaly.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Scientists are working on a number of ways to prevent Zika infections. The most controversial is to wipe out the mosquito that carries the virus using \u003ca href=\"http://genetics.thetech.org/driving-genes-wild\">gene drives\u003c/a>. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Gene drives use CRISPR-Cas9 to quickly and easily spread a harmful gene through a population. In this case the idea would be to destroy the population of mosquitoes that carry the Zika virus. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">This method was given \u003ca href=\"http://www.forbes.com/sites/robertglatter/2016/03/14/fda-grants-tentative-approval-for-gmo-mosquito-trial-in-florida-keys/\">\u003cspan class=\"s2\">tentative approval by the FDA\u003c/span>\u003c/a> back in March 2016, but it has not yet been used, as\u003ca href=\"http://blogs.plos.org/scicomm/2016/11/09/as-florida-voters-are-asked-to-weigh-in-on-a-gm-mosquito-field-trial-where-is-and-isnt-the-science-of-zika-virus-control/\"> many Florida residents strongly oppose it\u003c/a>.\u003c/p>\n\u003cp class=\"p1\">Gene drives were mostly theoretical until CRISPR-Cas9 came along to make them a relatively simple thing to make. In fact, so simple that a group of undergraduate students \u003ca href=\"http://gizmodo.com/college-students-show-how-easy-it-is-to-use-terrifying-1790526457\">\u003cspan class=\"s2\">nearly pulled it off\u003c/span>\u003c/a> at the end of 2016.\u003c/p>\n\u003cp class=\"p1\">\u003cb>Child With Three Parents\u003c/b>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">In 2015, a big controversy swirled around whether to \u003ca href=\"http://genetics.thetech.org/ask/ask70\">\u003cspan class=\"s2\">restart\u003c/span>\u003c/a> a genetic technique that allows some women who carry mitochondrial diseases to have children without passing them on to their kids. In 2016 \u003ca href=\"https://www.newscientist.com/article/2107219-exclusive-worlds-first-baby-born-with-new-3-parent-technique/\">\u003cspan class=\"s2\">a healthy baby boy was born\u003c/span>\u003c/a> in Mexico using this technique.\u003c/span>\u003c/p>\n\u003cp>The technique is controversial for a couple of reasons. First, any girls born will pass their genetically engineered DNA down to their children. This has always been an ethics no-fly zone, as the feeling is that whatever genetic modification we make in a person should stay in that person. Because the woman in Mexico had a son, the issue was sidestepped.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The other controversy is that this boy has DNA from three people instead of the usual two. \u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_316963\" class=\"wp-caption aligncenter\" style=\"max-width: 500px\">\u003cimg class=\"wp-image-316963 size-full\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/3parent.jpg\" alt=\"This egg is now fertilized with dad's sperm.\" width=\"500\" height=\"335\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/01/3parent.jpg 500w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/3parent-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/3parent-240x161.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/3parent-375x251.jpg 375w\" sizes=\"(max-width: 500px) 100vw, 500px\">\u003cfigcaption class=\"wp-caption-text\">This egg is now fertilized with dad's sperm. (Image by Barry Starr)\u003c/figcaption>\u003c/figure>\n\u003cp class=\"p1\">The child has mitochondria, and thus mitochondrial DNA, from the donor, along with DNA from his mom and dad. (Mitochondria are the organelles that supply our cells with energy; they have a bit of DNA all their own.) Although this is referred to as having three parents, that might be a bit of an overstatement. After all, s\u003cspan class=\"s1\">omething like 1/300,000\u003c/span>\u003cspan class=\"s3\">\u003csup>th\u003c/sup>\u003c/span>\u003cspan class=\"s1\"> of the child's DNA comes from the donor, with the rest coming from the mother and father. If the donor is a parent, she is a very minor one indeed.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cb>The Edge of Life\u003c/b>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">With the exception of viruses, most life has evolved with a thousand or more genes.Humans have somewhere around 22,000 genes; the humble yeast that gives beer and wine its alcohol has around 6,000; and the bacterium with the fewest known number of genes has 901.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">In 2016 a group of researchers was able to show that this last bacterium could get by \u003ca href=\"https://www.sciencenews.org/article/scientists-build-minimum-genome-bacterium\">\u003cspan class=\"s2\">with only 473 genes\u003c/span>\u003c/a>. This is the bare bones machinery needed to keep a bacterium going.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">What is cool is that we would not have been able to predict that these were the 473 a bacterium would need. We don’t even know what 143 of them do... .\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp class=\"p1\">Genetics is bound to be a hot topic in 2017 as well. Stay tuned.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Vice President Joe Biden is outlining how he intends to pursue his \"cancer moonshot\" agenda after he leaves office next week.\u003c/p>\n\u003cp>[contextly_sidebar id=\"fXg9Yi3NNbgCtbEglpi4NJfWUuSjRQHo\"]The vice president, speaking at the J.P. Morgan Healthcare Conference in San Francisco, Monday, said cancer is a bipartisan issue, and he offered to help the next administration carry on his mission to end the deadly disease. But he said he will also create an organization called the Biden Cancer Initiative; the primary focus will be collaboration between scientists so that research will be widely shared across specialties.\u003c/p>\n\u003cp>“Virologists, geneticists, chemical and biological engineers -- they weren’t all working in unison, but today we’ve reached an inflection point ... and the promise is enormous,\" Biden said.\u003c/p>\n\u003cp>Biden said the initiative will also concentrate on improving data standards to help researchers, work with community care organizations to improve access, and push pharmaceutical companies, insurance providers and biotech companies to make sure patients can afford treatments.\u003c/p>\n\u003cp>The subject hits home for the vice president, whose son, former Delaware Attorney General Beau Biden, died of brain cancer in May 2015.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Vice President Joe Biden is outlining how he intends to pursue his \"cancer moonshot\" agenda after he leaves office next week.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The vice president, speaking at the J.P. Morgan Healthcare Conference in San Francisco, Monday, said cancer is a bipartisan issue, and he offered to help the next administration carry on his mission to end the deadly disease. But he said he will also create an organization called the Biden Cancer Initiative; the primary focus will be collaboration between scientists so that research will be widely shared across specialties.\u003c/p>\n\u003cp>“Virologists, geneticists, chemical and biological engineers -- they weren’t all working in unison, but today we’ve reached an inflection point ... and the promise is enormous,\" Biden said.\u003c/p>\n\u003cp>Biden said the initiative will also concentrate on improving data standards to help researchers, work with community care organizations to improve access, and push pharmaceutical companies, insurance providers and biotech companies to make sure patients can afford treatments.\u003c/p>\n\u003cp>The subject hits home for the vice president, whose son, former Delaware Attorney General Beau Biden, died of brain cancer in May 2015.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>In a \u003ca href=\"https://news.theranos.com/2017/01/06/company-re-engineers-operations/\" target=\"_blank\">press release\u003c/a> titled \"Company Re-engineers Operations,\" Theranos announced it has re-engineered 155 workers right out the door.\u003c/p>\n\u003cp>The layoff leaves the reeling blood-testing company, once heralded as a major innovator on the basis of its claimed ability to conduct dozens of tests from just a few drops of blood, with just 220 employees. That's down from about 850 last October, when Theranos let go of about 340 people in conjunction with shuttering its disastrous consumer blood-testing business.\u003c/p>\n\u003cp>That business, which once included dozens of blood-draw locations in Walgreen's stores, collapsed in the wake of a series of events not exactly conducive to business. Among the company's misfortunes were a Wall Street Journal investigation alleging a bevy of improprieties and inaccuracies related to the company’s secret technology; unprecedented government sanctions due to uncovered deficiencies at its main lab; and a multiplicity of lawsuits.\u003c/p>\n\u003cp>Theranos has said for months now that its main focus is on its miniLab, a printer-sized device that integrates already available technologies into one machine.\u003c/p>\n\u003cp>But some scientists who attended the unveiling of the device at a scientific conference last August were \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/07/29/theranos-elizabeth-holmes-will-face-1000-scientists-monday-can-she-say-anything-to-gain-their-trust/\" target=\"_blank\">less than impressed\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>'“It’s not as if there’s something here we haven’t fundamentally seen before,\" said Dr. Stephen R. Master, one of the event’s moderators,\u003c/p>\n\u003cp>Getting FDA approval for the miniLab could also take years. How much of the $900 million that Theranos once raised from investors might be left at that point ... well, the math doesn't look good.\u003c/p>\n\u003cp>\u003cstrong>More Bad Test Results\u003c/strong>\u003c/p>\n\u003cp>Also today, The Wall Street Journal reported Theranos sent out more notices of bad test results. Last April, the company said it had voided tens of thousands of tests that may have been inaccurate.\u003c/p>\n\u003cp>From the \u003ca href=\"http://www.wsj.com/articles/theranos-cuts-40-of-remaining-workforce-1483731874\" target=\"_blank\">Journal\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>As recently as last week the company sent out newly corrected results saying some tests done in 2015 and 2016 for hemoglobin A1c, a protein doctors measure to help diagnose diabetes, shouldn’t be relied upon, according to copies of the corrected reports.\u003c/p>\n\u003cp>In a letter sent last week, Theranos said a patient who previously had gotten a “normal to prediabetic” result should have received a result in the “prediabetic to diabetic” range.\u003c/p>\n\u003cp>Kim Toy, a house cleaner in Phoenix, also learned last week that a past Theranos lab-test result had been voided, according to her lawyer.\u003c/p>\n\u003cp>Ms. Toy had the diabetes test at a Theranos location at a Walgreens in February 2016, indicating she may be on the brink of becoming diabetic. She doubted the result then, but hadn’t received any corrected information until now.\u003c/p>\u003c/blockquote>\n\u003cp>Then, to top it all off, there's this:\u003c/p>\n\u003cp>https://twitter.com/JohnCarreyrou/status/817516317754408960\u003c/p>\n\u003cp>John Carreyrou, of course, is The Wall Street Journal reporter who started the company on its long road to ruin with his investigative reports.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.vanityfair.com/news/2016/09/elizabeth-holmes-theranos-exclusive\" target=\"_blank\">Vanity Fair\u003c/a> reported last October that Theranos employees had chanted \"Fuck you, Carreyrou!\" during a company meeting at which founder and CEO Elizabeth Holmes had claimed the Journal's investigation was inaccurate.\u003c/p>\n\n",
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"excerpt": "One hundred and fifty-five workers will lose their jobs with the company that was once a high-flying startup but is now a shell of its former self. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In a \u003ca href=\"https://news.theranos.com/2017/01/06/company-re-engineers-operations/\" target=\"_blank\">press release\u003c/a> titled \"Company Re-engineers Operations,\" Theranos announced it has re-engineered 155 workers right out the door.\u003c/p>\n\u003cp>The layoff leaves the reeling blood-testing company, once heralded as a major innovator on the basis of its claimed ability to conduct dozens of tests from just a few drops of blood, with just 220 employees. That's down from about 850 last October, when Theranos let go of about 340 people in conjunction with shuttering its disastrous consumer blood-testing business.\u003c/p>\n\u003cp>That business, which once included dozens of blood-draw locations in Walgreen's stores, collapsed in the wake of a series of events not exactly conducive to business. Among the company's misfortunes were a Wall Street Journal investigation alleging a bevy of improprieties and inaccuracies related to the company’s secret technology; unprecedented government sanctions due to uncovered deficiencies at its main lab; and a multiplicity of lawsuits.\u003c/p>\n\u003cp>Theranos has said for months now that its main focus is on its miniLab, a printer-sized device that integrates already available technologies into one machine.\u003c/p>\n\u003cp>But some scientists who attended the unveiling of the device at a scientific conference last August were \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/07/29/theranos-elizabeth-holmes-will-face-1000-scientists-monday-can-she-say-anything-to-gain-their-trust/\" target=\"_blank\">less than impressed\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>'“It’s not as if there’s something here we haven’t fundamentally seen before,\" said Dr. Stephen R. Master, one of the event’s moderators,\u003c/p>\n\u003cp>Getting FDA approval for the miniLab could also take years. How much of the $900 million that Theranos once raised from investors might be left at that point ... well, the math doesn't look good.\u003c/p>\n\u003cp>\u003cstrong>More Bad Test Results\u003c/strong>\u003c/p>\n\u003cp>Also today, The Wall Street Journal reported Theranos sent out more notices of bad test results. Last April, the company said it had voided tens of thousands of tests that may have been inaccurate.\u003c/p>\n\u003cp>From the \u003ca href=\"http://www.wsj.com/articles/theranos-cuts-40-of-remaining-workforce-1483731874\" target=\"_blank\">Journal\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>As recently as last week the company sent out newly corrected results saying some tests done in 2015 and 2016 for hemoglobin A1c, a protein doctors measure to help diagnose diabetes, shouldn’t be relied upon, according to copies of the corrected reports.\u003c/p>\n\u003cp>In a letter sent last week, Theranos said a patient who previously had gotten a “normal to prediabetic” result should have received a result in the “prediabetic to diabetic” range.\u003c/p>\n\u003cp>Kim Toy, a house cleaner in Phoenix, also learned last week that a past Theranos lab-test result had been voided, according to her lawyer.\u003c/p>\n\u003cp>Ms. Toy had the diabetes test at a Theranos location at a Walgreens in February 2016, indicating she may be on the brink of becoming diabetic. She doubted the result then, but hadn’t received any corrected information until now.\u003c/p>\u003c/blockquote>\n\u003cp>Then, to top it all off, there's this:\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>John Carreyrou, of course, is The Wall Street Journal reporter who started the company on its long road to ruin with his investigative reports.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.vanityfair.com/news/2016/09/elizabeth-holmes-theranos-exclusive\" target=\"_blank\">Vanity Fair\u003c/a> reported last October that Theranos employees had chanted \"Fuck you, Carreyrou!\" during a company meeting at which founder and CEO Elizabeth Holmes had claimed the Journal's investigation was inaccurate.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Crowdfunding is a now a popular way to raise money for everything from birthday bashes to political protests. But on some of the big online fund raising sites, you'll find public pleas for something far more personal — infertility treatments.\u003c/p>\n\u003cp>Greg and Julia Fry of Ithaca, N.Y., were in their early 30s when they got married three years ago and set out to start a family. But a year passed and they didn't get pregnant. Six more months went by and, still, no baby.\u003c/p>\n\u003cp>So they consulted a medical specialist, Greg says. \"And we wound up realizing that fertility treatments were what we would need.\"\u003c/p>\n\u003cp>They began with a less costly and less invasive option: \u003ca href=\"http://www.cdc.gov/reproductivehealth/Infertility/index.htm\">IUI\u003c/a> or intrauterine insemination. That's where sperm is inserted with a catheter directly into the woman's uterus at the time of ovulation. The procedure costs, on average, just under $1,000 a try. The Frys have tried four times in the past year — with no luck.\u003c/p>\n\u003cp>\"This, by far, is the hardest thing that we've ever been through together,\" says Greg. \"There is always hope going into every cycle. And that hope, sort of, gets dashed at the end of the cycle, and then we start again.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The next step they took was to try \u003ca href=\"http://www.npr.org/sections/health-shots/2014/02/18/279035110/ivf-baby-boom-births-from-fertility-procedure-hit-new-high\">in vitro fertilization\u003c/a>, or IVF. This involves fertilizing eggs with sperm in a laboratory dish, then transferring the embryo into the woman's uterus. It can cost $15,000 to $20,000 each try.\u003c/p>\n\u003cp>At first, Greg says, they thought about traveling overseas for more affordable treatments, but travel costs would have gobbled up any savings. So, they went online instead, to the crowdfunding site GiveForward. They \u003ca href=\"https://pages.giveforward.com/medical/page-bwg4ty5/activity/595921\">posted\u003c/a> a video in which they talk about their decision to ask for financial help.\u003c/p>\n\u003cp>\"You know us as Julia and Greg,\" Greg begins. \"The couple with so much love to give,\" Julia continues, and they alternate telling their story.\u003c/p>\n\u003cp>Asking for IVF assistance like this is one of the fastest growing crowdfunding categories, according to \u003ca href=\"https://www.linkedin.com/in/joshuacchapman\">Josh Chapman\u003c/a>, CEO of \u003ca href=\"https://pages.giveforward.com/homepage/\">GiveForward\u003c/a>. It's outpaced all categories except adoption at his firm in 2016, Chapman says, adding, \"we believe this trend will continue into 2017.\"\u003c/p>\n\u003cp>Most health insurance doesn't cover treatments for infertility. That was the case for Janet Carter and her wife Jackie. They live in Charleston, S.C., and both have job-based health insurance.\u003c/p>\n\u003cp>Janet says their insurance was helpful for the diagnostic part of the process, but that was the extent of the reimbursement. \"[The insurance] will cover anything that is testing beforehand, like any underlying issues that are leading to the need for fertility treatment. They do not cover any of the actual procedures at all,\" she says.\u003c/p>\n\u003cp>As their August, 2015 wedding approached, the couple asked their guests to consider giving them cash for fertility treatments.\u003c/p>\n\u003cp>\"We not only had a regular registry for Target, but we also decided to have it be an option for our friends and family that wanted to be a part of us starting our little new family,\" Janet says.\u003c/p>\n\u003cp>The wedding guests gave them about $3,000, which they used to help pay for nine failed IUI attempts. Janet wanted to try asking friends again for money, this time for help with IVF. But, initially, Jackie wasn't so sure.\u003c/p>\n\u003cp>\"Does it seem like we're begging, or asking people for money,\" she recalls wondering. \"Am I ready to do that? Am I ready for people to be that involved?\"\u003c/p>\n\u003cp>They asked friends for their opinions about crowdfunding, and the support was resounding, the women say, save for a wee bit of hesitation from Janet's mom.\u003c/p>\n\u003cp>\"I think that's just a generational difference in opinion,\" Janet says.\u003c/p>\n\u003cp>But, Jackie became convinced.\u003c/p>\n\u003cp>\"I realized, 'Hey, you know what? There are thousands of people out there using these crowdfunding sources for honeymoons and, you know, maybe things that aren't as impactful as having a child,' \" she says.\u003c/p>\n\u003cp>The couple went forward with a site called, \u003ca href=\"https://www.youcaring.com/janet-carter-and-jackie-regan-368536\">YouCaring.com\u003c/a>, that's helped them raise about $5,000 so far.\u003c/p>\n\u003cp>Still, crowdfunding \u003cem>is\u003c/em> hard for a lot of people, says \u003ca href=\"http://www.rachelgurevich.com/\">Rachel Gurevich\u003c/a>, who writes about fertility issues.\u003c/p>\n\u003cp>\"I wouldn't do it unless you have a lot of social connections,\" she says. \"A lot of people think that it's automatic — they're going to put it up and raise a bunch of money. And they're not — and that can be really disappointing.\"\u003c/p>\n\u003cp>Indeed, dozens of IVF campaigns on these sites show $0 raised. Both the Frys and the Carters received money from friends, family and some acquaintances, which is more typical for these crowdfunds, Gurevich says. Most donations range from $20 to $100.\u003c/p>\n\u003cp>Greg and Julia Fry's crowdfunding page has earned about $1,200.\u003c/p>\n\u003cp>\"It's been very positive — everybody that I've worked with,\" says Julia. \"People come up to me. And they've come into my office and they hand me $20,\" she says. \"They say, 'We love you guys. We think you will be such great parents — please take it.' \"\u003c/p>\n\u003cp>Their friend Jordanna Larish gave $50, even though she's unemployed right now. \"Julia and Greg are incredibly generous people, always helping others,\" she writes in an email to NPR. \"They've been trying for so long to have a baby, and they'll be excellent parents.\"\u003c/p>\n\u003cp>Jessie Simpson, who is friends with Jackie and Janet Carter, says she gave them $500 — \"and a whole lot of prayers.\" Simpson was moved by how easy it was for her to have her son and how difficult it has been for her friends.\u003c/p>\n\u003cp>\"Watching their struggle for over a year, all while the medical bills rack up each month, it was heartbreaking,\" Simpson writes to NPR. \"That is the power of crowdfunding though — connect their story to your experiences and you want to melt in a puddle of tears and give them the shirt off your back.\"\u003c/p>\n\u003cp>The Carters are using their fundraising to pay down a credit card bill for their IVF. And Janet is now pregnant — their baby is due in June, 2017.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of NPR's reporting partnership with \u003ca href=\"http://www.kaiserhealthnews.org\">Kaiser Health News\u003c/a>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 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=Please%2C+Baby%2C+Please%3A+Some+Couples+Turn+To+Crowdfunding+For+IVF&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Crowdfunding is a now a popular way to raise money for everything from birthday bashes to political protests. But on some of the big online fund raising sites, you'll find public pleas for something far more personal — infertility treatments.\u003c/p>\n\u003cp>Greg and Julia Fry of Ithaca, N.Y., were in their early 30s when they got married three years ago and set out to start a family. But a year passed and they didn't get pregnant. Six more months went by and, still, no baby.\u003c/p>\n\u003cp>So they consulted a medical specialist, Greg says. \"And we wound up realizing that fertility treatments were what we would need.\"\u003c/p>\n\u003cp>They began with a less costly and less invasive option: \u003ca href=\"http://www.cdc.gov/reproductivehealth/Infertility/index.htm\">IUI\u003c/a> or intrauterine insemination. That's where sperm is inserted with a catheter directly into the woman's uterus at the time of ovulation. The procedure costs, on average, just under $1,000 a try. The Frys have tried four times in the past year — with no luck.\u003c/p>\n\u003cp>\"This, by far, is the hardest thing that we've ever been through together,\" says Greg. \"There is always hope going into every cycle. And that hope, sort of, gets dashed at the end of the cycle, and then we start again.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The next step they took was to try \u003ca href=\"http://www.npr.org/sections/health-shots/2014/02/18/279035110/ivf-baby-boom-births-from-fertility-procedure-hit-new-high\">in vitro fertilization\u003c/a>, or IVF. This involves fertilizing eggs with sperm in a laboratory dish, then transferring the embryo into the woman's uterus. It can cost $15,000 to $20,000 each try.\u003c/p>\n\u003cp>At first, Greg says, they thought about traveling overseas for more affordable treatments, but travel costs would have gobbled up any savings. So, they went online instead, to the crowdfunding site GiveForward. They \u003ca href=\"https://pages.giveforward.com/medical/page-bwg4ty5/activity/595921\">posted\u003c/a> a video in which they talk about their decision to ask for financial help.\u003c/p>\n\u003cp>\"You know us as Julia and Greg,\" Greg begins. \"The couple with so much love to give,\" Julia continues, and they alternate telling their story.\u003c/p>\n\u003cp>Asking for IVF assistance like this is one of the fastest growing crowdfunding categories, according to \u003ca href=\"https://www.linkedin.com/in/joshuacchapman\">Josh Chapman\u003c/a>, CEO of \u003ca href=\"https://pages.giveforward.com/homepage/\">GiveForward\u003c/a>. It's outpaced all categories except adoption at his firm in 2016, Chapman says, adding, \"we believe this trend will continue into 2017.\"\u003c/p>\n\u003cp>Most health insurance doesn't cover treatments for infertility. That was the case for Janet Carter and her wife Jackie. They live in Charleston, S.C., and both have job-based health insurance.\u003c/p>\n\u003cp>Janet says their insurance was helpful for the diagnostic part of the process, but that was the extent of the reimbursement. \"[The insurance] will cover anything that is testing beforehand, like any underlying issues that are leading to the need for fertility treatment. They do not cover any of the actual procedures at all,\" she says.\u003c/p>\n\u003cp>As their August, 2015 wedding approached, the couple asked their guests to consider giving them cash for fertility treatments.\u003c/p>\n\u003cp>\"We not only had a regular registry for Target, but we also decided to have it be an option for our friends and family that wanted to be a part of us starting our little new family,\" Janet says.\u003c/p>\n\u003cp>The wedding guests gave them about $3,000, which they used to help pay for nine failed IUI attempts. Janet wanted to try asking friends again for money, this time for help with IVF. But, initially, Jackie wasn't so sure.\u003c/p>\n\u003cp>\"Does it seem like we're begging, or asking people for money,\" she recalls wondering. \"Am I ready to do that? Am I ready for people to be that involved?\"\u003c/p>\n\u003cp>They asked friends for their opinions about crowdfunding, and the support was resounding, the women say, save for a wee bit of hesitation from Janet's mom.\u003c/p>\n\u003cp>\"I think that's just a generational difference in opinion,\" Janet says.\u003c/p>\n\u003cp>But, Jackie became convinced.\u003c/p>\n\u003cp>\"I realized, 'Hey, you know what? There are thousands of people out there using these crowdfunding sources for honeymoons and, you know, maybe things that aren't as impactful as having a child,' \" she says.\u003c/p>\n\u003cp>The couple went forward with a site called, \u003ca href=\"https://www.youcaring.com/janet-carter-and-jackie-regan-368536\">YouCaring.com\u003c/a>, that's helped them raise about $5,000 so far.\u003c/p>\n\u003cp>Still, crowdfunding \u003cem>is\u003c/em> hard for a lot of people, says \u003ca href=\"http://www.rachelgurevich.com/\">Rachel Gurevich\u003c/a>, who writes about fertility issues.\u003c/p>\n\u003cp>\"I wouldn't do it unless you have a lot of social connections,\" she says. \"A lot of people think that it's automatic — they're going to put it up and raise a bunch of money. And they're not — and that can be really disappointing.\"\u003c/p>\n\u003cp>Indeed, dozens of IVF campaigns on these sites show $0 raised. Both the Frys and the Carters received money from friends, family and some acquaintances, which is more typical for these crowdfunds, Gurevich says. Most donations range from $20 to $100.\u003c/p>\n\u003cp>Greg and Julia Fry's crowdfunding page has earned about $1,200.\u003c/p>\n\u003cp>\"It's been very positive — everybody that I've worked with,\" says Julia. \"People come up to me. And they've come into my office and they hand me $20,\" she says. \"They say, 'We love you guys. We think you will be such great parents — please take it.' \"\u003c/p>\n\u003cp>Their friend Jordanna Larish gave $50, even though she's unemployed right now. \"Julia and Greg are incredibly generous people, always helping others,\" she writes in an email to NPR. \"They've been trying for so long to have a baby, and they'll be excellent parents.\"\u003c/p>\n\u003cp>Jessie Simpson, who is friends with Jackie and Janet Carter, says she gave them $500 — \"and a whole lot of prayers.\" Simpson was moved by how easy it was for her to have her son and how difficult it has been for her friends.\u003c/p>\n\u003cp>\"Watching their struggle for over a year, all while the medical bills rack up each month, it was heartbreaking,\" Simpson writes to NPR. \"That is the power of crowdfunding though — connect their story to your experiences and you want to melt in a puddle of tears and give them the shirt off your back.\"\u003c/p>\n\u003cp>The Carters are using their fundraising to pay down a credit card bill for their IVF. And Janet is now pregnant — their baby is due in June, 2017.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of NPR's reporting partnership with \u003ca href=\"http://www.kaiserhealthnews.org\">Kaiser Health News\u003c/a>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 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=Please%2C+Baby%2C+Please%3A+Some+Couples+Turn+To+Crowdfunding+For+IVF&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "One of the Problems With E-Cigarettes: They Can Explode",
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"content": "\u003cp>Katrina Williams wanted a safer alternative to smoking, and e-cigarettes seemed to be the answer until the day one exploded in her pocket as she drove home from a beauty salon.\u003c/p>\n\u003cp>\"It was like a firecracker\" as it seared third-degree burns in her leg, blasted through her charred pants and stuck in the dashboard, the New Yorker said. That was in April. Williams, a freight manager, said she still hasn't returned to work. \"It was very disturbing.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'It was like a firecracker.'\u003c/aside>\n\u003cp>Similar painful accidents have been recorded with increasing frequency over the past year as use of e-cigarettes has climbed, with faulty batteries seen as the suspected culprit. The industry maintains e-cigarettes are safe when used properly.\u003c/p>\n\u003cp>The U.S. Food and Drug Administration, which started regulating e-cigarettes in May, identified about 66 explosions in 2015 and early 2016, after recording 92 explosions from 2009 to September 2015.\u003c/p>\n\u003cp>In late November, a clerk at a liquor store in New York's Grand Central Station was casually leaning against a counter when the e-cigarette in his pocket erupted. A security camera captured him frantically trying to snuff out a fountain of white-hot sparks.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Surveillance video also captured an e-cigarette explosion in September at a New Jersey mall that left a woman's Louis Vuitton bag smoking as she stood at a checkout counter.\u003c/p>\n\u003cp>Police say a teenage girl on a train at the Universal Orlando amusement park suffered burns in October when an electronic cigarette belonging to another visitor exploded and shot a fireball at her.\u003c/p>\n\u003cp>The numbers kept by the FDA may be an undercount. One hospital, the UW Medicine Regional Burn Center at Harborview Medical Center in Seattle, says it has seen about 23 patients with e-cigarette burns since it started tracking them informally in October 2015.\u003c/p>\n\u003cp>\"They are extremely dangerous and need to be revamped or revised,\" said Marc Freund, a New York attorney who represents both Williams and a 14-year-old boy who was partially blinded when an e-cigarette device exploded at a kiosk selling e-cigarettes at a Brooklyn mall.\u003c/p>\n\u003cp>The problems with the devices are linked to their lithium-ion batteries, which help vaporize liquid nicotine into a mist that distributors and some health experts say is far less harmful than traditional tobacco cigarettes.\u003c/p>\n\u003cp>The same types of batteries are used safely in many consumer electronics, but they've also been behind fires in hover boards and smartphones. Last year, the federal Department of Transportation issued a rule prohibiting passengers from packing e-cigarettes in checked luggage to protect against in-flight fires.\u003c/p>\n\u003cp>Thomas Kiklas, co-founder of the Tobacco Vapor Electronic Cigarette Association, argues the devices are safe when used properly. He said the TVECA encourages proper recharging of the batteries as a way to prevent possible injuries.\u003c/p>\n\u003cp>Euromonitor International, a market research company, noted there were 10.8 million regular e-cigarette users in the U.S. in 2015, generating $3.5 billion in sales.\u003c/p>\n\u003cp>Gregory L. Bentley, an Irvine attorney, won a nearly $2 million judgment in a product liability lawsuit for a woman burned by an e-cigarette last year. He said he has a growing list of similar cases, most of which involve batteries and other components manufactured in China that have been subject to little safety oversight.\u003c/p>\n\u003cp>\"The problem is defectively manufactured batteries,\" he said. \"Consumers need to know it's next to impossible to sue a Chinese company. If people want to seek compensation they have to target distributors, wholesalers and retailers.\"\u003c/p>\n\u003cp>Last week, the U.S. surgeon general called e-cigarettes an emerging public health threat to the nation's youth, although he highlighted the risk of nicotine addiction, not explosions.\u003c/p>\n\u003cp>New York Sen. Charles Schumer said the FDA should consider a recall.\u003c/p>\n\u003cp>\"It's bad enough that e-cigarettes cause nicotine addiction and may be dangerous to a person's health, but now it seems they're doubling as a ticking time bomb,\" he said.\u003c/p>\n\u003cp>FDA spokesman Michael Felberbaum said the agency is reviewing the health impacts of all tobacco products, including e-cigarettes. He said the review will include an evaluation of the use of e-cigarette batteries, including \"amperage, voltage, wattage, battery type\" and other issues.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Associated Press researcher Jennifer Farrar contributed to this report. Follow Eltman on Twitter at @feltman41.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Katrina Williams wanted a safer alternative to smoking, and e-cigarettes seemed to be the answer until the day one exploded in her pocket as she drove home from a beauty salon.\u003c/p>\n\u003cp>\"It was like a firecracker\" as it seared third-degree burns in her leg, blasted through her charred pants and stuck in the dashboard, the New Yorker said. That was in April. Williams, a freight manager, said she still hasn't returned to work. \"It was very disturbing.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'It was like a firecracker.'\u003c/aside>\n\u003cp>Similar painful accidents have been recorded with increasing frequency over the past year as use of e-cigarettes has climbed, with faulty batteries seen as the suspected culprit. The industry maintains e-cigarettes are safe when used properly.\u003c/p>\n\u003cp>The U.S. Food and Drug Administration, which started regulating e-cigarettes in May, identified about 66 explosions in 2015 and early 2016, after recording 92 explosions from 2009 to September 2015.\u003c/p>\n\u003cp>In late November, a clerk at a liquor store in New York's Grand Central Station was casually leaning against a counter when the e-cigarette in his pocket erupted. A security camera captured him frantically trying to snuff out a fountain of white-hot sparks.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Surveillance video also captured an e-cigarette explosion in September at a New Jersey mall that left a woman's Louis Vuitton bag smoking as she stood at a checkout counter.\u003c/p>\n\u003cp>Police say a teenage girl on a train at the Universal Orlando amusement park suffered burns in October when an electronic cigarette belonging to another visitor exploded and shot a fireball at her.\u003c/p>\n\u003cp>The numbers kept by the FDA may be an undercount. One hospital, the UW Medicine Regional Burn Center at Harborview Medical Center in Seattle, says it has seen about 23 patients with e-cigarette burns since it started tracking them informally in October 2015.\u003c/p>\n\u003cp>\"They are extremely dangerous and need to be revamped or revised,\" said Marc Freund, a New York attorney who represents both Williams and a 14-year-old boy who was partially blinded when an e-cigarette device exploded at a kiosk selling e-cigarettes at a Brooklyn mall.\u003c/p>\n\u003cp>The problems with the devices are linked to their lithium-ion batteries, which help vaporize liquid nicotine into a mist that distributors and some health experts say is far less harmful than traditional tobacco cigarettes.\u003c/p>\n\u003cp>The same types of batteries are used safely in many consumer electronics, but they've also been behind fires in hover boards and smartphones. Last year, the federal Department of Transportation issued a rule prohibiting passengers from packing e-cigarettes in checked luggage to protect against in-flight fires.\u003c/p>\n\u003cp>Thomas Kiklas, co-founder of the Tobacco Vapor Electronic Cigarette Association, argues the devices are safe when used properly. He said the TVECA encourages proper recharging of the batteries as a way to prevent possible injuries.\u003c/p>\n\u003cp>Euromonitor International, a market research company, noted there were 10.8 million regular e-cigarette users in the U.S. in 2015, generating $3.5 billion in sales.\u003c/p>\n\u003cp>Gregory L. Bentley, an Irvine attorney, won a nearly $2 million judgment in a product liability lawsuit for a woman burned by an e-cigarette last year. He said he has a growing list of similar cases, most of which involve batteries and other components manufactured in China that have been subject to little safety oversight.\u003c/p>\n\u003cp>\"The problem is defectively manufactured batteries,\" he said. \"Consumers need to know it's next to impossible to sue a Chinese company. If people want to seek compensation they have to target distributors, wholesalers and retailers.\"\u003c/p>\n\u003cp>Last week, the U.S. surgeon general called e-cigarettes an emerging public health threat to the nation's youth, although he highlighted the risk of nicotine addiction, not explosions.\u003c/p>\n\u003cp>New York Sen. Charles Schumer said the FDA should consider a recall.\u003c/p>\n\u003cp>\"It's bad enough that e-cigarettes cause nicotine addiction and may be dangerous to a person's health, but now it seems they're doubling as a ticking time bomb,\" he said.\u003c/p>\n\u003cp>FDA spokesman Michael Felberbaum said the agency is reviewing the health impacts of all tobacco products, including e-cigarettes. He said the review will include an evaluation of the use of e-cigarette batteries, including \"amperage, voltage, wattage, battery type\" and other issues.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Associated Press researcher Jennifer Farrar contributed to this report. Follow Eltman on Twitter at @feltman41.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Wikipedia Handles Fake News With Humans, Not Algorithms",
"title": "Wikipedia Handles Fake News With Humans, Not Algorithms",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>“We have solved the fake news problem on Wikipedia.”\u003c/p>\n\u003cp>That was the bold assertion from Canadian ER doc and university professor James Heilman, speaking to KQED News last week. Heilman puts in roughly 60 hours weekly editing medical entries on the colossal online encyclopedia. He's the founder of \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:WikiProject_Medicine\" target=\"_blank\">WikiProject Medicine\u003c/a>, a group of several hundred editors who have taken on the mission of making the site's medical pages more thorough and \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/11/28/how-accurate-is-wikipedias-medical-information/\" target=\"_blank\">accurate\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignright\">'People who are involved in generating fake news -- that's a higher level of vandalism than a computer program can take care of.'\u003ccite>James Heilman, WikiProject Medicine\u003c/cite>\u003c/aside>\n\u003cp>Fake news—fabricated reports related to current events—has received a lot of attention in the wake of President-elect Donald Trump’s unexpected victory over non-President-elect Hillary Clinton.\u003c/p>\n\u003cp>Pundits and polls had assured the country that Clinton would be busy polishing her inaugural address by now. Was \u003ca href=\"https://www.google.com/search?q=fake+news&oq=fake+news\" target=\"_blank\">fake news\u003c/a> a factor in Trump's victory? We may never know, but a \u003ca href=\"https://www.buzzfeed.com/craigsilverman/viral-fake-election-news-outperformed-real-news-on-facebook?utm_term=.wkgkYg5z7#.kdEDER4l2\" target=\"_blank\">\u003cspan style=\"font-weight: 400\">Buzzfeed analysis\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> found that the top-20 fake news stories received more Facebook shares, reactions and comments in the three months leading up to the election than the top-20 real news reports. A large majority of the phony stories overtly favored Trump.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>A New Age\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Not too long ago, the barriers to entry for disseminating written information on a mass scale included financial resources enough to pay for millions of dollars worth of reporters, editors, layout designers, press operators, printing equipment, delivery trucks and \u003ca href=\"http://wtvr.com/2016/11/18/when-was-the-last-time-you-saw-a-kid-with-a-paper-route/\" target=\"_blank\">tweens on bikes\u003c/a> with poor aim. Short of that, you're handing out pamphlets on a street corner.\u003c/p>\n\u003cp>But today, you can run your own mass communications operation with little more than computer, a WordPress account and a little savvy about Facebook algorithms. Whether it's done for clicks, tricks or kicks, fake news has become a \u003ca href=\"http://www.npr.org/sections/alltechconsidered/2016/11/23/503146770/npr-finds-the-head-of-a-covert-fake-news-operation-in-the-suburbs\" target=\"_blank\">profitable\u003c/a> cottage industry.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2050/12/FioreFakeNews.jpg\">\u003cimg class=\"aligncenter size-large wp-image-295313\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2050/12/FioreFakeNews-1020x1020.jpg\" alt=\"fiorefakenews\" width=\"640\" height=\"640\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-1020x1020.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-160x160.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-800x800.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-768x768.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-1180x1180.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-960x960.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-240x240.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-375x375.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-520x520.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-50x50.jpg 50w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-150x150.jpg 150w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Wikipedia, being a site that actually \u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\">invites\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\"> members of the public to write their own content with no vetting of their qualifications to do so, would seem to be ripe for an onslaught of material laden with inaccuracy and bias.\u003c/span>\u003c/p>\n\u003cp>“We see people attempting to promote alternative medicine, we see people attempting to promote conventional medicine beyond the level of evidence that's available,” said Heilman, the medical editor.\u003c/p>\n\u003cp>But Wikipedia polices the creation of new entries and changes to existing pages with both machine and human interventions.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Pages are \"analyzed by smart bots that deal with a large majority of low-level vandalism and many copyright issues,” Heilman wrote in an email. The \u003c/span>\u003cspan style=\"font-weight: 400\">\u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:New_pages_patrol\" target=\"_blank\">New Pages Patrol, \u003c/a>consisting of seasoned human editors who have made at least 500 uncontested edits to Wikipedia pages, reviews every freshly created page. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Wikipedia requires contributors to justify every assertion of fact in an article, and it has blacklisted \u003ca href=\"https://en.wikipedia.org/wiki/MediaWiki_talk:Spam-blacklist#abcnews.com.co\" target=\"_blank\">certain sites\u003c/a> from being used as verification this way. Wikipedians can also put individual pages on watch lists, which will trigger notifications any time an edit is made. For example, the \u003c/span>\u003ca href=\"https://en.wikipedia.org/wiki/HIV/AIDS\" target=\"_blank\">\u003cspan style=\"font-weight: 400\">HIV/AIDS page \u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">is currently monitored by almost a thousand editors, any of whom can jump in and quickly challenge changes they deem to be unreliable.\u003c/span>\u003c/p>\n\u003cp>Finally, some administrators can “protect” articles, so that only established editors can make changes. Editors who create consistently problematic content can be kicked off the site.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When Heilman emailed me, he had just finished \u003ca href=\"https://en.wikipedia.org/w/index.php?title=Vaccine&type=revision&diff=752549754&oldid=752547510%5D\" target=\"_blank\">reverting\u003c/a> an edit to the Wikipedia \"\u003ca href=\"https://en.wikipedia.org/wiki/Vaccine\" target=\"_blank\">Vaccine\u003c/a>\" page back to its former state, due to a change made in the \"\u003ca href=\"https://en.wikipedia.org/wiki/Vaccine#Adverse_effects\" target=\"_blank\">Adverse effects\u003c/a>\" section. The topic of vaccinations has spawned a lot of misinformation on exaggerated or even nonexistent risks, driving down inoculation rates in some communities. Below is the short-lived edit, followed by the original version that Heilman restored:\u003c/span>\u003c/p>\n\u003cp>\u003cem>There is growing evidence that vaccines trigger autoimmune disease. A mass Hepatitis B vaccination program was halted in France in 1994 following a significant increase in incidence of multiple sclerosis 1-2 years following vaccination. In 2009, GSK's Pandemrix influenza vaccine was proven to trigger narcolepsy in multiple cases across Europe leading to multiple legal claims. Despite this growing evidence the medical establishment maintain that vaccinations given during childhood are generally safe.\u003c/em>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Reversion to previous entry:\u003c/span>\u003c/p>\n\u003cblockquote>\u003cp>Vaccination given during childhood is generally safe. The rate of side effects depends on the vaccine in question. Some common side effects include: fever, pain around the injection site, and muscle aches. Additionally, some individuals may be allergic to ingredients in the vaccine. MMR vaccine is rarely associated with febrile seizures.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong>The Election on Wikipedia\u003c/strong>\u003c/p>\n\u003cp>On Sunday, a 28-year-old North Carolina man \u003ca href=\"http://www.usatoday.com/story/news/politics/2016/12/05/pizzagate-shooter-washington-court/94995926/\" target=\"_blank\">shot off his assault weapon\u003c/a> in a Washington D.C. pizza restaurant. Afterward he reportedly told police he wanted to find the truth about a viral fake news story claiming the eatery was involved in a Democratic child prostitution ring. Contrast the rapid \u003ca href=\"https://www.buzzfeed.com/craigsilverman/fever-swamp-election?utm_term=.mmWdD3M53#.qqw71XQ3X\" target=\"_blank\">metastasizing\u003c/a> of the hoax with the \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:Miscellany_for_deletion/Draft:Pizzagate_(conspiracy_theory)\" target=\"_blank\">ongoing Wikipedia discussion\u003c/a> on whether to publish a \u003ca href=\"https://en.wikipedia.org/wiki/Draft:Pizzagate_(conspiracy_theory)\" target=\"_blank\">draft\u003c/a> page on the topic, and you can gain a little appreciation of the deliberate way Wikipedia contributors make decisions.\u003c/p>\n\u003cp>Another election article Wikipedians had to grapple with was “The Impeachment of Donald Trump,” created on Nov. 11. Just three hours after it went live, editors deleted it. The article, based on the opinions of two academics, said Trump's impeachment was “expected to occur sometime after inauguration.\" A handful of editors quickly \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:Articles_for_deletion/Impeachment_of_Donald_Trump\" target=\"_blank\">came to the conclusion\u003c/a> that speculation by two people did not a valid Wikipedia entry make.\u003c/p>\n\u003cp>\u003cstrong>Humans vs. Algorithms\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Facebook, where most of the fake news spread this election season, is now reportedly \u003c/span>\u003ca href=\"http://www.wsj.com/articles/facebook-could-develop-artificial-intelligence-to-weed-out-fake-news-1480608004\">\u003cspan style=\"font-weight: 400\">developing artificial intelligence \u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">to cope with the problem. Heilman doesn’t think that will be enough. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“People who are involved in generating fake news -- that's a higher level of vandalism than a computer program can take care of,\" he said. \"The only people who can manage to deal with that in my opinion is human beings.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">One reason, he said, is that spotting errors requires layers of knowledge and understanding of the context in which a statement is made.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“You need good faith people who have looked at the whole breadth of literature out there, who have researched the topic in question.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Katherine Maher, executive director of the Wikimedia Foundation, thinks\u003c/span> \u003cspan style=\"font-weight: 400\">the main problem with Facebook’s newsfeed is that the reasons it serves up certain stories are opaque.\u003c/span>\u003c/p>\n\u003cp>\"Are you receiving the information because it’s accurate, timely or important?\" she says. \"Or just because a lot of other people have been sharing it, regardless of its validity?\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When people have that information, she believes, they're smart enough to make an informed decision as to whether that which has been placed before them is relevant or meaningless. \u003c/span>\u003c/p>\n\u003cp>Heilman, too, thinks \"Facebook and Twitter could learn a lot from the mechanisms Wikipedia has put into place.\"\u003c/p>\n\u003cp>But even Wikipedians acknowledge that they, too, have a lot of work to do when it comes to halting the spread of unvetted information. For example, just a small fraction of Wikipedia's health articles—\u003ca href=\"https://tools.wmflabs.org/enwp10/cgi-bin/list2.fcgi?run=yes&projecta=Medicine&quality=FA-Class%20featured%20health%20articles\" target=\"_blank\">63\u003c/a>—have received the highest quality grade by section editors. A page called \u003ca href=\"https://en.wikipedia.org/wiki/Reliability_of_Wikipedia\" target=\"_blank\">Reliability of Wikipedia\u003c/a> points out the good and the bad. And the site keeps a \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:List_of_hoaxes_on_Wikipedia\" target=\"_blank\">list of hoaxes\u003c/a> that have appeared on its pages, a number of which stayed visible for many years.\u003c/p>\n\u003cp>In the months and maybe years ahead, Wikipedians -- and anyone involved in the gathering and dissemination of fact-based information, actually -- could have their work cut out for them. If the president-elect's own proclivity for \u003ca href=\"http://www.politifact.com/truth-o-meter/statements/2016/nov/28/donald-trump/donald-trumps-pants-fire-claim-millions-illegal-vo/\" target=\"_blank\">creating news out of whole cloth\u003c/a> is any indication, this problem is not going away.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=4hHL_6s5eR8\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>“We have solved the fake news problem on Wikipedia.”\u003c/p>\n\u003cp>That was the bold assertion from Canadian ER doc and university professor James Heilman, speaking to KQED News last week. Heilman puts in roughly 60 hours weekly editing medical entries on the colossal online encyclopedia. He's the founder of \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:WikiProject_Medicine\" target=\"_blank\">WikiProject Medicine\u003c/a>, a group of several hundred editors who have taken on the mission of making the site's medical pages more thorough and \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/11/28/how-accurate-is-wikipedias-medical-information/\" target=\"_blank\">accurate\u003c/a>.\u003c/p>\n\u003caside class=\"pullquote alignright\">'People who are involved in generating fake news -- that's a higher level of vandalism than a computer program can take care of.'\u003ccite>James Heilman, WikiProject Medicine\u003c/cite>\u003c/aside>\n\u003cp>Fake news—fabricated reports related to current events—has received a lot of attention in the wake of President-elect Donald Trump’s unexpected victory over non-President-elect Hillary Clinton.\u003c/p>\n\u003cp>Pundits and polls had assured the country that Clinton would be busy polishing her inaugural address by now. Was \u003ca href=\"https://www.google.com/search?q=fake+news&oq=fake+news\" target=\"_blank\">fake news\u003c/a> a factor in Trump's victory? We may never know, but a \u003ca href=\"https://www.buzzfeed.com/craigsilverman/viral-fake-election-news-outperformed-real-news-on-facebook?utm_term=.wkgkYg5z7#.kdEDER4l2\" target=\"_blank\">\u003cspan style=\"font-weight: 400\">Buzzfeed analysis\u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\"> found that the top-20 fake news stories received more Facebook shares, reactions and comments in the three months leading up to the election than the top-20 real news reports. A large majority of the phony stories overtly favored Trump.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>A New Age\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Not too long ago, the barriers to entry for disseminating written information on a mass scale included financial resources enough to pay for millions of dollars worth of reporters, editors, layout designers, press operators, printing equipment, delivery trucks and \u003ca href=\"http://wtvr.com/2016/11/18/when-was-the-last-time-you-saw-a-kid-with-a-paper-route/\" target=\"_blank\">tweens on bikes\u003c/a> with poor aim. Short of that, you're handing out pamphlets on a street corner.\u003c/p>\n\u003cp>But today, you can run your own mass communications operation with little more than computer, a WordPress account and a little savvy about Facebook algorithms. Whether it's done for clicks, tricks or kicks, fake news has become a \u003ca href=\"http://www.npr.org/sections/alltechconsidered/2016/11/23/503146770/npr-finds-the-head-of-a-covert-fake-news-operation-in-the-suburbs\" target=\"_blank\">profitable\u003c/a> cottage industry.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2050/12/FioreFakeNews.jpg\">\u003cimg class=\"aligncenter size-large wp-image-295313\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2050/12/FioreFakeNews-1020x1020.jpg\" alt=\"fiorefakenews\" width=\"640\" height=\"640\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-1020x1020.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-160x160.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-800x800.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-768x768.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-1180x1180.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-960x960.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-240x240.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-375x375.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-520x520.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-32x32.jpg 32w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-50x50.jpg 50w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-64x64.jpg 64w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-96x96.jpg 96w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-128x128.jpg 128w, https://ww2.kqed.org/app/uploads/sites/13/2050/12/FioreFakeNews-150x150.jpg 150w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Wikipedia, being a site that actually \u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\">invites\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\"> members of the public to write their own content with no vetting of their qualifications to do so, would seem to be ripe for an onslaught of material laden with inaccuracy and bias.\u003c/span>\u003c/p>\n\u003cp>“We see people attempting to promote alternative medicine, we see people attempting to promote conventional medicine beyond the level of evidence that's available,” said Heilman, the medical editor.\u003c/p>\n\u003cp>But Wikipedia polices the creation of new entries and changes to existing pages with both machine and human interventions.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Pages are \"analyzed by smart bots that deal with a large majority of low-level vandalism and many copyright issues,” Heilman wrote in an email. The \u003c/span>\u003cspan style=\"font-weight: 400\">\u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:New_pages_patrol\" target=\"_blank\">New Pages Patrol, \u003c/a>consisting of seasoned human editors who have made at least 500 uncontested edits to Wikipedia pages, reviews every freshly created page. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Wikipedia requires contributors to justify every assertion of fact in an article, and it has blacklisted \u003ca href=\"https://en.wikipedia.org/wiki/MediaWiki_talk:Spam-blacklist#abcnews.com.co\" target=\"_blank\">certain sites\u003c/a> from being used as verification this way. Wikipedians can also put individual pages on watch lists, which will trigger notifications any time an edit is made. For example, the \u003c/span>\u003ca href=\"https://en.wikipedia.org/wiki/HIV/AIDS\" target=\"_blank\">\u003cspan style=\"font-weight: 400\">HIV/AIDS page \u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">is currently monitored by almost a thousand editors, any of whom can jump in and quickly challenge changes they deem to be unreliable.\u003c/span>\u003c/p>\n\u003cp>Finally, some administrators can “protect” articles, so that only established editors can make changes. Editors who create consistently problematic content can be kicked off the site.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When Heilman emailed me, he had just finished \u003ca href=\"https://en.wikipedia.org/w/index.php?title=Vaccine&type=revision&diff=752549754&oldid=752547510%5D\" target=\"_blank\">reverting\u003c/a> an edit to the Wikipedia \"\u003ca href=\"https://en.wikipedia.org/wiki/Vaccine\" target=\"_blank\">Vaccine\u003c/a>\" page back to its former state, due to a change made in the \"\u003ca href=\"https://en.wikipedia.org/wiki/Vaccine#Adverse_effects\" target=\"_blank\">Adverse effects\u003c/a>\" section. The topic of vaccinations has spawned a lot of misinformation on exaggerated or even nonexistent risks, driving down inoculation rates in some communities. Below is the short-lived edit, followed by the original version that Heilman restored:\u003c/span>\u003c/p>\n\u003cp>\u003cem>There is growing evidence that vaccines trigger autoimmune disease. A mass Hepatitis B vaccination program was halted in France in 1994 following a significant increase in incidence of multiple sclerosis 1-2 years following vaccination. In 2009, GSK's Pandemrix influenza vaccine was proven to trigger narcolepsy in multiple cases across Europe leading to multiple legal claims. Despite this growing evidence the medical establishment maintain that vaccinations given during childhood are generally safe.\u003c/em>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Reversion to previous entry:\u003c/span>\u003c/p>\n\u003cblockquote>\u003cp>Vaccination given during childhood is generally safe. The rate of side effects depends on the vaccine in question. Some common side effects include: fever, pain around the injection site, and muscle aches. Additionally, some individuals may be allergic to ingredients in the vaccine. MMR vaccine is rarely associated with febrile seizures.\u003c/p>\u003c/blockquote>\n\u003cp>\u003cstrong>The Election on Wikipedia\u003c/strong>\u003c/p>\n\u003cp>On Sunday, a 28-year-old North Carolina man \u003ca href=\"http://www.usatoday.com/story/news/politics/2016/12/05/pizzagate-shooter-washington-court/94995926/\" target=\"_blank\">shot off his assault weapon\u003c/a> in a Washington D.C. pizza restaurant. Afterward he reportedly told police he wanted to find the truth about a viral fake news story claiming the eatery was involved in a Democratic child prostitution ring. Contrast the rapid \u003ca href=\"https://www.buzzfeed.com/craigsilverman/fever-swamp-election?utm_term=.mmWdD3M53#.qqw71XQ3X\" target=\"_blank\">metastasizing\u003c/a> of the hoax with the \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:Miscellany_for_deletion/Draft:Pizzagate_(conspiracy_theory)\" target=\"_blank\">ongoing Wikipedia discussion\u003c/a> on whether to publish a \u003ca href=\"https://en.wikipedia.org/wiki/Draft:Pizzagate_(conspiracy_theory)\" target=\"_blank\">draft\u003c/a> page on the topic, and you can gain a little appreciation of the deliberate way Wikipedia contributors make decisions.\u003c/p>\n\u003cp>Another election article Wikipedians had to grapple with was “The Impeachment of Donald Trump,” created on Nov. 11. Just three hours after it went live, editors deleted it. The article, based on the opinions of two academics, said Trump's impeachment was “expected to occur sometime after inauguration.\" A handful of editors quickly \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:Articles_for_deletion/Impeachment_of_Donald_Trump\" target=\"_blank\">came to the conclusion\u003c/a> that speculation by two people did not a valid Wikipedia entry make.\u003c/p>\n\u003cp>\u003cstrong>Humans vs. Algorithms\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Facebook, where most of the fake news spread this election season, is now reportedly \u003c/span>\u003ca href=\"http://www.wsj.com/articles/facebook-could-develop-artificial-intelligence-to-weed-out-fake-news-1480608004\">\u003cspan style=\"font-weight: 400\">developing artificial intelligence \u003c/span>\u003c/a>\u003cspan style=\"font-weight: 400\">to cope with the problem. Heilman doesn’t think that will be enough. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“People who are involved in generating fake news -- that's a higher level of vandalism than a computer program can take care of,\" he said. \"The only people who can manage to deal with that in my opinion is human beings.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">One reason, he said, is that spotting errors requires layers of knowledge and understanding of the context in which a statement is made.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“You need good faith people who have looked at the whole breadth of literature out there, who have researched the topic in question.” \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Katherine Maher, executive director of the Wikimedia Foundation, thinks\u003c/span> \u003cspan style=\"font-weight: 400\">the main problem with Facebook’s newsfeed is that the reasons it serves up certain stories are opaque.\u003c/span>\u003c/p>\n\u003cp>\"Are you receiving the information because it’s accurate, timely or important?\" she says. \"Or just because a lot of other people have been sharing it, regardless of its validity?\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">When people have that information, she believes, they're smart enough to make an informed decision as to whether that which has been placed before them is relevant or meaningless. \u003c/span>\u003c/p>\n\u003cp>Heilman, too, thinks \"Facebook and Twitter could learn a lot from the mechanisms Wikipedia has put into place.\"\u003c/p>\n\u003cp>But even Wikipedians acknowledge that they, too, have a lot of work to do when it comes to halting the spread of unvetted information. For example, just a small fraction of Wikipedia's health articles—\u003ca href=\"https://tools.wmflabs.org/enwp10/cgi-bin/list2.fcgi?run=yes&projecta=Medicine&quality=FA-Class%20featured%20health%20articles\" target=\"_blank\">63\u003c/a>—have received the highest quality grade by section editors. A page called \u003ca href=\"https://en.wikipedia.org/wiki/Reliability_of_Wikipedia\" target=\"_blank\">Reliability of Wikipedia\u003c/a> points out the good and the bad. And the site keeps a \u003ca href=\"https://en.wikipedia.org/wiki/Wikipedia:List_of_hoaxes_on_Wikipedia\" target=\"_blank\">list of hoaxes\u003c/a> that have appeared on its pages, a number of which stayed visible for many years.\u003c/p>\n\u003cp>In the months and maybe years ahead, Wikipedians -- and anyone involved in the gathering and dissemination of fact-based information, actually -- could have their work cut out for them. If the president-elect's own proclivity for \u003ca href=\"http://www.politifact.com/truth-o-meter/statements/2016/nov/28/donald-trump/donald-trumps-pants-fire-claim-millions-illegal-vo/\" target=\"_blank\">creating news out of whole cloth\u003c/a> is any indication, this problem is not going away.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "$250 Disposable Scopes Used to Combat Drug-Resistant Infection",
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"content": "\u003cp>In response to a series of superbug outbreaks around the country, some doctors and hospitals are trying out disposable scopes to combat the spread of antibiotic-resistant bacteria.\u003c/p>\n\u003cp>U.S. regulators recently approved two new colonoscopes designed to be used just once and thrown away. They will sell for $250 or less apiece — compared to roughly $40,000 or more for a conventional scope that lasts several years but must be disinfected after each use. Other companies are promoting such devices — flexible, lighted tubes used to peer deep inside the body — for use in the lungs and kidneys.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s almost too good to be true with it being so cheap.'\u003c/aside>\n\u003cp>The new scopes are coming primarily from smaller companies looking to challenge a handful of dominant device makers. The upstarts are seizing on growing evidence that many reusable instruments cannot be cleaned reliably, even when manufacturer’s instructions are followed.\u003c/p>\n\u003cp>“If you can tell patients we have a disposable device so there’s really no chance of infection, that has to be very appealing,” said Chris Lavanchy, engineering director at the ECRI Institute, a nonprofit organization that tests medical devices. “This could allay public fears.”\u003c/p>\n\u003cp>Scopes include a wide array of devices used on millions of patients annually. As they snake through a patient’s throat, intestines and other cavities, they pick up mucus, blood and thousands of microbes. But the delicate devices can’t be sterilized like a scalpel because intense heat would destroy crucial components.\u003c/p>\n\u003cfigure id=\"attachment_305327\" class=\"wp-caption alignright\" style=\"max-width: 270px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/disposable-scope-270.jpg\">\u003cimg class=\"size-full wp-image-305327\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/disposable-scope-270.jpg\" alt=\"A disposable colonoscope from German device maker Invendo Medical secured clearance from the FDA in August. \" width=\"270\" height=\"405\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/12/disposable-scope-270.jpg 270w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/disposable-scope-270-160x240.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/disposable-scope-270-240x360.jpg 240w\" sizes=\"(max-width: 270px) 100vw, 270px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A disposable colonoscope from German device maker Invendo Medical secured clearance from the FDA in August. \u003ccite>(Courtesy of Invendo)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Instead, the scopes are brushed and washed with disinfectants in preparation for the next patient. Despite those efforts, contamination can persist and drug-resistant bacteria can result in patient infections that are difficult or even impossible to treat.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The threat has led to safety alerts from the Food and Drug Administration and a recent U.S. Senate investigation into repeated failures by manufacturers and hospitals to report outbreaks.\u003c/p>\n\u003cp>Overall, as many as 350 patients at 41 medical facilities worldwide were exposed to or infected by contaminated gastrointestinal scopes from 2010 to 2015, according to the FDA. And at least 35 patients at U.S. hospitals have died since 2013 after developing infections tied to tainted scopes, according to hospitals and public health officials.\u003c/p>\n\u003cp>For now, just a handful of medical centers are experimenting with the disposable colonoscopes. Some doctors remain skeptical about whether a cheaper scope will provide the high-quality images and versatility they need to diagnose and treat patients effectively. Many doctors count on the sophisticated cameras on existing scopes as well as multiple channels inside the device to accommodate surgical instruments.\u003c/p>\n\u003cp>Dr. Simon Lo, a nationally known gastroenterologist at Cedars-Sinai Medical Center in Los Angeles, said he shares those concerns. Nonetheless, he said he’s eager to try the disposable colonoscope from German device maker Invendo Medical in the coming months. The scope secured clearance from the U.S. Food and Drug Administration in August.\u003c/p>\n\u003cp>“I’m not totally sold this will be comparable to the [conventional] scopes other companies have spent decades perfecting. It’s almost too good to be true with it being so cheap,” Lo said. “But this is a fantastic possibility and at least gives us an alternative to the current scopes.”\u003c/p>\n\u003cp>Physician groups such as the American Society for Gastrointestinal Endoscopy maintain that the overall risk of infection is very low from these reusable devices. They say the benefits of screenings and many other procedures far outweigh any potential danger.\u003c/p>\n\u003cp>But some doctors say a simpler, single-use scope could be sufficient for many routine examinations. It could also be preferred for immunosuppressed patients who are more susceptible to infection and for patients who have already tested positive for antibiotic-resistant bacteria and would be likely to spread it.\u003c/p>\n\u003cp>“For those patients, it would be great to use this and throw it away,” Lo said.\u003c/p>\n\u003cp>His hospital, Cedars-Sinai, reported four infections last year from contaminated duodenoscopes, which are inserted down a patient’s throat and used to treat problems in the digestive tract such as cancers and blockages in the bile duct.\u003c/p>\n\u003cp>Colonoscopes, which look at the inner lining of the large intestine, haven’t been linked to the recent outbreaks, but concerns about cleaning and the spread of bacteria apply to all types of reusable scopes. Last year, the FDA warned about the risk to patients posed by bronchoscopes, used to examine problems in the airway and lungs.\u003c/p>\n\u003cp>In one study, researchers found that more than 75 percent of colonoscopes and gastroscopes were still contaminated after cleaning and disinfection in accordance with manufacturer guidelines.\u003c/p>\n\u003cp>Hospitals have experimented with a wide variety of new safety measures over the past two years. Some facilities started testing scopes for contamination after cleaning and holding them in quarantine for 48 hours to check them again for bacterial growth.\u003c/p>\n\u003cp>Those steps added layers to what was already a labor-intensive process. It costs about $75 or more to clean a scope each time.\u003c/p>\n\u003cp>“There is a lot of time and money tied up in that,” said John Cifarelli, chief commercial officer for Invendo. “The best solution is a device that doesn’t have to be cleaned.”\u003c/p>\n\u003cp>The leading scope makers haven’t shown much interest thus far in single-use devices, which could affect their longstanding dominance in the business.\u003c/p>\n\u003cp>Olympus Corp., which controls 85 percent of the U.S. market for gastrointestinal scopes, didn’t respond to a request for comment. The Tokyo-based company, linked to numerous infections in the U.S. and Europe, conducted a voluntary recall of its duodenoscopes this year and made repairs designed to reduce the contamination risk.\u003c/p>\n\u003cp>In a statement, another big manufacturer, Fujifilm, said it “has no plans at this time to market single-use disposable scopes, and cannot speak to the benefits or risks associated with such products.”\u003c/p>\n\u003cp>Israeli company GI-View received FDA clearance in August for its single-use colonoscope, called Aer-O-Scope, priced at about $200. The company’s chief executive, Tal Simchony, acknowledges that his smaller company faces an uphill battle against the industry giants. But he said he’s optimistic it can address the “ick” factor some patients feel with a reusable scope.\u003c/p>\n\u003cp>Other companies see opportunity, too. Boston Scientific, a bigger device maker, promotes a disposable ureteroscope to aid in treatment of kidney stones and other procedures. Ambu A/S, based in Denmark, has sold a single-use bronchoscope for about $300 in the U.S. for the past few years.\u003c/p>\n\u003cp>In Europe, two biomedical engineers are raising money to build a prototype and manufacture what could become a full line of disposable endoscopes. Francisco Soriano, one of the engineers in Barcelona, said he learned the business from repairing scopes with his father, who was a longtime Olympus technician.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“We must reinvent the endoscope as we know it,” Soriano said. “Our vision is to eliminate cross-infection completely.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In response to a series of superbug outbreaks around the country, some doctors and hospitals are trying out disposable scopes to combat the spread of antibiotic-resistant bacteria.\u003c/p>\n\u003cp>U.S. regulators recently approved two new colonoscopes designed to be used just once and thrown away. They will sell for $250 or less apiece — compared to roughly $40,000 or more for a conventional scope that lasts several years but must be disinfected after each use. Other companies are promoting such devices — flexible, lighted tubes used to peer deep inside the body — for use in the lungs and kidneys.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It’s almost too good to be true with it being so cheap.'\u003c/aside>\n\u003cp>The new scopes are coming primarily from smaller companies looking to challenge a handful of dominant device makers. The upstarts are seizing on growing evidence that many reusable instruments cannot be cleaned reliably, even when manufacturer’s instructions are followed.\u003c/p>\n\u003cp>“If you can tell patients we have a disposable device so there’s really no chance of infection, that has to be very appealing,” said Chris Lavanchy, engineering director at the ECRI Institute, a nonprofit organization that tests medical devices. “This could allay public fears.”\u003c/p>\n\u003cp>Scopes include a wide array of devices used on millions of patients annually. As they snake through a patient’s throat, intestines and other cavities, they pick up mucus, blood and thousands of microbes. But the delicate devices can’t be sterilized like a scalpel because intense heat would destroy crucial components.\u003c/p>\n\u003cfigure id=\"attachment_305327\" class=\"wp-caption alignright\" style=\"max-width: 270px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/disposable-scope-270.jpg\">\u003cimg class=\"size-full wp-image-305327\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/12/disposable-scope-270.jpg\" alt=\"A disposable colonoscope from German device maker Invendo Medical secured clearance from the FDA in August. \" width=\"270\" height=\"405\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/12/disposable-scope-270.jpg 270w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/disposable-scope-270-160x240.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/12/disposable-scope-270-240x360.jpg 240w\" sizes=\"(max-width: 270px) 100vw, 270px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A disposable colonoscope from German device maker Invendo Medical secured clearance from the FDA in August. \u003ccite>(Courtesy of Invendo)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Instead, the scopes are brushed and washed with disinfectants in preparation for the next patient. Despite those efforts, contamination can persist and drug-resistant bacteria can result in patient infections that are difficult or even impossible to treat.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The threat has led to safety alerts from the Food and Drug Administration and a recent U.S. Senate investigation into repeated failures by manufacturers and hospitals to report outbreaks.\u003c/p>\n\u003cp>Overall, as many as 350 patients at 41 medical facilities worldwide were exposed to or infected by contaminated gastrointestinal scopes from 2010 to 2015, according to the FDA. And at least 35 patients at U.S. hospitals have died since 2013 after developing infections tied to tainted scopes, according to hospitals and public health officials.\u003c/p>\n\u003cp>For now, just a handful of medical centers are experimenting with the disposable colonoscopes. Some doctors remain skeptical about whether a cheaper scope will provide the high-quality images and versatility they need to diagnose and treat patients effectively. Many doctors count on the sophisticated cameras on existing scopes as well as multiple channels inside the device to accommodate surgical instruments.\u003c/p>\n\u003cp>Dr. Simon Lo, a nationally known gastroenterologist at Cedars-Sinai Medical Center in Los Angeles, said he shares those concerns. Nonetheless, he said he’s eager to try the disposable colonoscope from German device maker Invendo Medical in the coming months. The scope secured clearance from the U.S. Food and Drug Administration in August.\u003c/p>\n\u003cp>“I’m not totally sold this will be comparable to the [conventional] scopes other companies have spent decades perfecting. It’s almost too good to be true with it being so cheap,” Lo said. “But this is a fantastic possibility and at least gives us an alternative to the current scopes.”\u003c/p>\n\u003cp>Physician groups such as the American Society for Gastrointestinal Endoscopy maintain that the overall risk of infection is very low from these reusable devices. 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Last year, the FDA warned about the risk to patients posed by bronchoscopes, used to examine problems in the airway and lungs.\u003c/p>\n\u003cp>In one study, researchers found that more than 75 percent of colonoscopes and gastroscopes were still contaminated after cleaning and disinfection in accordance with manufacturer guidelines.\u003c/p>\n\u003cp>Hospitals have experimented with a wide variety of new safety measures over the past two years. Some facilities started testing scopes for contamination after cleaning and holding them in quarantine for 48 hours to check them again for bacterial growth.\u003c/p>\n\u003cp>Those steps added layers to what was already a labor-intensive process. It costs about $75 or more to clean a scope each time.\u003c/p>\n\u003cp>“There is a lot of time and money tied up in that,” said John Cifarelli, chief commercial officer for Invendo. “The best solution is a device that doesn’t have to be cleaned.”\u003c/p>\n\u003cp>The leading scope makers haven’t shown much interest thus far in single-use devices, which could affect their longstanding dominance in the business.\u003c/p>\n\u003cp>Olympus Corp., which controls 85 percent of the U.S. market for gastrointestinal scopes, didn’t respond to a request for comment. The Tokyo-based company, linked to numerous infections in the U.S. and Europe, conducted a voluntary recall of its duodenoscopes this year and made repairs designed to reduce the contamination risk.\u003c/p>\n\u003cp>In a statement, another big manufacturer, Fujifilm, said it “has no plans at this time to market single-use disposable scopes, and cannot speak to the benefits or risks associated with such products.”\u003c/p>\n\u003cp>Israeli company GI-View received FDA clearance in August for its single-use colonoscope, called Aer-O-Scope, priced at about $200. The company’s chief executive, Tal Simchony, acknowledges that his smaller company faces an uphill battle against the industry giants. But he said he’s optimistic it can address the “ick” factor some patients feel with a reusable scope.\u003c/p>\n\u003cp>Other companies see opportunity, too. Boston Scientific, a bigger device maker, promotes a disposable ureteroscope to aid in treatment of kidney stones and other procedures. 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"content": "\u003cp>Pilloried for their role in the epidemic of prescription painkiller abuse, drugmakers are aggressively pushing their remedy to the problem: a new generation of harder-to-manipulate opioids that have racked up billions in sales, even though there's little proof they reduce rates of overdoses or deaths.\u003c/p>\n\u003caside class=\"pullquote alignright\">Harder-to-manipulate opioids have racked up billions in sales, despite a lack of proof that they reduce overdoses.\u003c/aside>\n\u003cp>More than prescriptions are at stake. Critics worry the drugmakers' nationwide lobbying campaign is distracting from more productive solutions and delaying crucial efforts to steer physicians away from prescription opioids — addictive pain medications involved in the deaths of more than 165,000 Americans since 2000.\u003c/p>\n\u003cp>\"If we've learned one lesson from the last 20 years on opioids it's that these products have very, very high inherent risks,\" said Dr. Caleb Alexander, co-director of Johns Hopkins University's Center for Drug Safety and Effectiveness. \"My concern is that they'll contribute to a perception that there is a safe opioid, and there's no such thing as a fully safe opioid.\"\u003c/p>\n\u003cp>The latest drugs — known as abuse-deterrent formulations, or ADFs — are generally harder to crush or dissolve, which the drugmakers tout as making them difficult to snort or inject. But they still are vulnerable to manipulation and potentially addictive when simply swallowed. National data from an industry-sponsored tracking system also show drug abusers quickly drop the reformulated drugs in favor of older painkillers or heroin.\u003c/p>\n\u003cp>In the last two years, pharmaceutical companies have made a concerted under-the-radar push for bills benefiting the anti-abuse opioids in statehouses and in Congress, where proposed legislation would require the Food and Drug Administration to replace older opioids with the new drugs.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The lobbying push features industry-funded advocacy groups and physicians, along with grieving family members, who rarely disclosed the drugmakers' ties during their testimony in support of the drugs.\u003c/p>\n\u003cp>Besides the tamper-resistant pills, ADF opioids are being rolled out in other forms, including injectable drugs and pills that irritate users when they're snorted or contain substances that counteract highs.\u003c/p>\n\u003cp>\u003cstrong>Sales Opportunity\u003c/strong>\u003c/p>\n\u003cp>Making painkillers harder to abuse is a common-sense step. But it's also a multibillion-dollar sales opportunity, offering drugmakers the potential to wipe out lower-cost generic competitors and lock in sales of their higher-priced versions, which cost many times more than conventional pills. The big companies hold multiple patents on the reformulated drugs, shielding them from competition for years — in some cases decades.\u003c/p>\n\u003cp>Though abuse-deterrent painkillers represented less than 5 percent of all opioids prescribed last year, they generated more than $2.4 billion in sales, or roughly a quarter of the nearly $10 billion U.S. market for the drugs, according to IMS Health. The field is dominated by Purdue Pharma's OxyContin, patent-protected until 2030.\u003c/p>\n\u003cp>\"We at Purdue make certain that prescribers and other stakeholders understand that opioids with abuse-deterrent properties won't stop all prescription drug abuse, but they are an important part of the comprehensive approach needed to address this public health issue,\" Purdue spokesman Robert Josephson said in a statement.\u003c/p>\n\u003cp>Like a spokeswoman for Pfizer Inc., Josephson also noted that some public health officials, including the Food and Drug Administration, have endorsed using ADFs.\u003c/p>\n\u003cp>\"We need every tool that we can have in our toolbox,\" said Kentucky state Rep. Addia Wuchner, a Republican who has worked on several bills to benefit reformulated opioids. \"The extra steps are worth the effort in order to prevent this escalation of more addiction.\"\u003c/p>\n\u003cp>\u003cstrong>Massive Lobbying Effort\u003c/strong>\u003c/p>\n\u003cp>The current industry campaign draws on the same 50-state strategy that painkiller manufacturers successfully deployed to help kill or weaken measures aimed at stemming the tide of prescription opioids, a playbook The Associated Press and Center for Public Integrity exposed in September.\u003c/p>\n\u003cp>The \u003ca href=\"https://ww2.kqed.org/stateofhealth/2016/09/19/how-drugmakers-used-money-and-influence-to-shape-the-national-response-to-opioid-abuse/\" target=\"_blank\">reporting \u003c/a>detailed how opioid drugmakers and the nonprofits they help fund spent more than $880 million on lobbying and political contributions at the state and federal level over the past decade, eight times what the gun lobby reported for the same period. The money represents the drugmakers' spending on all their legislative interests, including opioids.\u003c/p>\n\u003cp>The FDA has approved a handful of the reformulated drugs but has not yet concluded that any reduce rates of addiction, abuse or death, and the evidence gap has led to diverging views among health authorities.\u003c/p>\n\u003cp>\u003cstrong>'No less addictive'\u003c/strong>\u003c/p>\n\u003cp>Whereas FDA regulators emphasize the potential promise of reformulated painkillers, other government officials stress that they contain the same heroin-like ingredients as traditional opioids. An estimated 78 Americans die from heroin and prescription opioid overdoses every day.\u003c/p>\n\u003cp>\"'Abuse-deterrent' sounds to people sometimes like 'Oh, maybe it's not addictive.' But it's no less addictive,\" said Dr. Tom Frieden, head of the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Survey results published this year in the Clinical Journal of Pain showed nearly half of U.S. physicians incorrectly believed that reformulated opioids are less addictive than their predecessors.\u003c/p>\n\u003cp>Many experts see a key role for ADFs in reducing the number of people who first begin abusing opioids, and some say the abuse-deterrent formulations should be the default painkiller for patients with histories of drug use, anxiety or depression. But even they worry that some drugmakers are overselling the technology. They stress that separate measures are needed for the majority of opioid abusers who ingest the pills orally.\u003c/p>\n\u003cp>\"The way they're handling the ADF is that this is the answer. And it's not the answer — it's part of the bigger puzzle,\" said Theodore Cicero, a psychiatry professor at Washington University in St. Louis, who has authored several studies on the drugs.\u003c/p>\n\u003cp>\u003cstrong>'You can't put a price tag on anybody's life'\u003c/strong>\u003c/p>\n\u003cp>Two years after the overdose that killed her 21-year-old son, Terri Bartlett traveled to Illinois' state capital to champion an unlikely cause: revamped painkillers.\u003c/p>\n\u003cp>Bartlett's son Michael became hooked on Vicodin and later graduated to heroin. In emotional testimony last year, she urged lawmakers to support a bill that would prioritize the new harder-to-crush pills, saying she believed her son would still be alive if abuse-deterrent formulations had been on the market then.\u003c/p>\n\u003cp>\"You can't put a price tag on anybody's life,\" she said.\u003c/p>\n\u003cp>Bartlett didn't know then that she had been recruited into a wide-ranging lobbying campaign. A public relations firm hired by OxyContin-maker Purdue had helped recruit her to support the bill, along with local sheriffs and fire chiefs.\u003c/p>\n\u003cp>Her words, and similar testimony from parents of drug abusers elsewhere, reflect a tactic used by the drugmakers across the country. For instance, Purdue paid nearly $95,000 for similar lobbying efforts in New York, state records show.\u003c/p>\n\u003cp>And the industry's fingerprints are easy to spot in other areas. Of more than 100 bills dealing with the drugs introduced in 35 states in 2015 and 2016, at least 49 featured nearly identical language requiring insurers to cover abuse-deterrent drugs, according to an analysis of data from Quorum, a legislative tracking service. Several of the bill sponsors said they received the wording from pharmaceutical lobbyists.\u003c/p>\n\u003cp>Since 2012, at least 21 bills related to the drugs have become law, including five that require insurers to pay for the more expensive drugs in Maine, Maryland, Massachusetts, Florida and West Virginia.\u003c/p>\n\u003cp>Wins in such states will give drugmakers momentum to successfully push for copycat laws elsewhere, noted Paul Kelly, a federal lobbyist who has worked on multistate lobbying campaigns for drugstores and major retailers.\u003c/p>\n\u003cp>\"It's like a foot in the door,\" he said.\u003c/p>\n\u003cp>\u003cstrong>Fierce Opposition\u003c/strong>\u003c/p>\n\u003cp>Drugmakers have found fierce opposition to their ADF legislation from insurers and employers who would be on the hook for the far pricier opioid variations.\u003c/p>\n\u003cp>The Illinois bill — and the 48 strikingly similar measures in other states — would require insurers to cover the drugs in the same way as other opioids, which the insurance companies argue would allow drugmakers to charge whatever they want for them.\u003c/p>\n\u003cp>\"That is not the best use of our medical care resources,\" Vernon Rowen, vice president of state government affairs for the insurance company Aetna, told Illinois lawmakers after Bartlett testified. \"It totally eliminates our ability to negotiate discounts with manufacturers.\"\u003c/p>\n\u003cp>New York Gov. Andrew Cuomo and New Jersey Gov. Chris Christie both vetoed such insurance mandates in the past year, citing the high costs and lack of evidence that the drugs help.\u003c/p>\n\u003cp>Federal health officials also have pushed back against requirements to cover the drugs, citing the \"staggering\" costs. For example, a 30-day supply of Pfizer's abuse-deterrent Embeda, a combination drug containing morphine, costs $268, while a 30-day supply of a generic morphine costs roughly $38, according to data compiled by Truven Health Analytics, a company that tracks drug prices set by manufacturers.\u003c/p>\n\u003cp>The Department of Veterans Affairs' Dr. Bernie Good estimated that converting the 8.8 million patient system exclusively to the new reformulations would increase opioid spending more than tenfold, to over $1.6 billion annually. Good, who co-directs the VA's program for medication safety, said the vast majority of veterans are not at risk for snorting or injecting their medications.\u003c/p>\n\u003cp>\"Would the excess money to pay for abuse-deterrent products — mostly to pay for it in cases where it wouldn't be necessary — be better spent for drug treatment centers?\" he asked at a recent federal meeting on the drugs.\u003c/p>\n\u003cp>Federal estimates say at least 2.2 million Americans are addicted to prescription opioids or heroin, yet only one in five actually receives treatment, according to a Surgeon General's report published last month. That's despite some $35 billion already spent annually on substance abuse programs by private and public health providers.\u003c/p>\n\u003cp>State lawmakers who support the abuse-deterrent bills often defend them as an important piece of solving the opioid puzzle, preventing more costly overdoses and hospitalizations.\u003c/p>\n\u003cp>And Fred Brason, executive director of Project Lazarus, a North Carolina-based group that promotes anti-addiction policies in several states, called the focus on the drugs' cost too narrow.\u003c/p>\n\u003cp>\"You're already spending that money at the back end,\" he said. \"You're spending it at the emergency department.\" He also noted the costs of addiction treatment.\u003c/p>\n\u003cp>\u003cstrong>Industry-Supported Groups and Physicians\u003c/strong>\u003c/p>\n\u003cp>When critics raise alarms about higher costs and limited evidence, drugmakers can rely on groups they support financially to argue their side, including the National Association of Drug Diversion Investigators, the Academy of Integrative Pain Management and the Partnership for Drug-Free Kids. Representatives from those groups have testified in favor of abuse-deterrent legislation in at least seven states.\u003c/p>\n\u003cp>NADDI president Charlie Cichon acknowledged his group receives funds from several ADF-makers, but said it views the drugs as a proven part of the solution to the opioid crisis. \"We're not testifying for Purdue Pharma's product or Endo's product,\" he said.\u003c/p>\n\u003cp>And Bob Twillman, executive director of the Academy, said, \"Increased use of abuse-deterrent opioids makes it more likely that those patients who need opiates to treat their pain will be able to get them.\"\u003c/p>\n\u003cp>The Partnership for Drug-Free Kids did not respond to multiple requests for comment.\u003c/p>\n\u003cp>Physicians with financial ties to drugmakers play similar roles. Dr. Gareth Shemesh, a pain specialist, testified in support of a Colorado bill last year brought to the sponsoring legislator by Pfizer. Shemesh had received more than $13,500 from Pfizer that year in speaking fees, travel and meals, and more than $5,000 from Purdue the year before. He did not respond to repeated calls for comment, but Pfizer said he was not paid to testify and did not speak on behalf of any specific product.\u003c/p>\n\u003cp>\u003cstrong>Political Contributions Ramped Up\u003c/strong>\u003c/p>\n\u003cp>Purdue and Pfizer also have ramped up contributions to the Republican and Democratic attorneys general associations, which raise unlimited funds to help elect AGs across the country. In 2015 and 2016, they gave a total of $950,000 — more than in the previous four years combined.\u003c/p>\n\u003cp>To date, 51 attorneys general from U.S. states and territories have signed at least one of two National Association of Attorneys General letters to the FDA, urging the agency to favor abuse-deterrent drugs.\u003c/p>\n\u003cp>The pro-ADF playbook even includes a bit of political theater. In at least seven states, lawmakers or advocates have pounded the reformulated pills with hammers to demonstrate how difficult they are to smash.\u003c/p>\n\u003cp>In Illinois, it was Democratic Rep. Sara Feigenholtz wielding the hammer on the same committee that heard Terri Bartlett's testimony. The main sponsor of the bill prioritizing ADFs, Feigenholtz ranked second-highest among legislative recipients of money from Pfizer since the start of 2010, according to an analysis of data from the National Institute on Money in State Politics. The $6,200 she received during that period was more than she had received in the 14 previous years combined. Her bill passed the committee but later stalled in the Legislature and remains pending.\u003c/p>\n\u003cp>She did not return multiple requests for comment. Pfizer said its contributions to Feigenholtz go back 20 years and it would be \"inaccurate and misleading\" to suggest a tie to any one piece of legislation.\u003c/p>\n\u003cp>Bartlett said she doesn't mind that Purdue was ultimately responsible for her invitation to testify, even though she didn't know that at the time. She still supports the bill.\u003c/p>\n\u003cp>\"I want to believe that in every pharmaceutical company there still remains some sort of humanity,\" she said. \"Saving life is expensive.\"\u003c/p>\n\u003cp>\u003cstrong>'An addict can find a way'\u003c/strong>\u003c/p>\n\u003cp>The FDA has walked a careful line on the new drugs, promoting them as a promising approach to discouraging abuse while acknowledging their real-world benefits remain largely theoretical.\u003c/p>\n\u003cp>Earlier this year, the agency highlighted the drugs in its \"opioids action plan,\" issued after scathing criticism from some members of Congress that the FDA wasn't doing enough to combat the epidemic.\u003c/p>\n\u003cp>Thus far, the agency has approved seven drugs with labeling suggesting they are \"expected to\" discourage abuse, based on studies conducted by pharmaceutical companies.\u003c/p>\n\u003cp>But the FDA has not yet concluded that any of the products have a \"real-world impact\" on measures like overdose or death, according to Dr. Douglas Throckmorton, an agency deputy director. He and other regulators predict, however, that the reformulations will eventually translate into public health results.\u003c/p>\n\u003cp>\"We stand by those predictions,\" Throckmorton said at a recent public meeting on the drugs. \"We're confident in the science, we're confident in the assessments we conducted.\"\u003c/p>\n\u003cp>Even some former FDA advisers who support expanded use of the drugs say they are only part of the solution. Dr. Lewis Nelson, who previously chaired an FDA panel on drug safety, notes that the drugs don't deter the most common form of abuse: swallowing pills whole.\u003c/p>\n\u003cp>\"Certainly, you might not eat one and get high,\" he said. \"You eat three and get high.\"\u003c/p>\n\u003cp>At least one study found that while OxyContin's reformulation coincided with many abusers switching to other drugs, other users still were able to defeat the pills' technology and snort or inject the contents.\u003c/p>\n\u003cp>David Rook, a 40-year-old Henrico, Virginia, resident who now operates a recovery facility, was among them. Before entering treatment, he said, he would break down abuse-deterrent OxyContins and crush-resistant Opanas using water, lemon juice and a microwave.\u003c/p>\n\u003cp>\"The truth is an addict can find a way to abuse a medication one way or the other,\" he said.\u003c/p>\n\u003cp>\u003cstrong>Unpredictable Effects\u003c/strong>\u003c/p>\n\u003cp>A recent HIV outbreak in rural Indiana illustrates the sometimes unpredictable effect of ADFs on abusers' behavior.\u003c/p>\n\u003cp>Approximately 210 people have tested positive for the virus in Scott County since 2014, a public health crisis linked to needle-sharing among abusers of Opana. Endo Pharmaceuticals received approval for a reformulated version of the drug in 2011, making it harder to crush. As a result, many abusers switched from snorting the drug to injecting it with syringes, leading to the spread of the blood-borne HIV virus, according to the state health commissioner and other officials.\u003c/p>\n\u003cp>Endo spokeswoman Heather Zoumas Lubeski declined to comment on the outbreak, but issued a statement saying, \"Patient safety has always been a top priority for Endo and we are committed to providing patients with approved products that are safe and effective when used as prescribed.\"\u003c/p>\n\u003cp>The FDA declined to approve labeling claims for Opana's anti-abuse features, noting that the drug still can easily be cooked and injected.\u003c/p>\n\u003cp>Pfizer, Purdue, Endo and Teva Pharmaceuticals Industries Ltd. spent more than $20 million between 2012 and 2015 on federal lobbying efforts that included support of a bill that would require the FDA to gradually replace current opioids with harder-to-abuse versions that become available. Teva declined comment.\u003c/p>\n\u003cp>Rep. William Keating, D-Mass., first introduced the bill in 2012 and tried again in 2013 and 2015. Like his colleagues at the state level, he employed the hammer-smashing routine to illustrate the medications' crush-resistant properties.\u003c/p>\n\u003cp>Keating said the industry played no part in spurring the bill, even though the head of a nonprofit association funded by abuse-deterrent drugmakers spoke at the press conference introducing his legislation. He also received $2,500 in political contributions from makers of reformulated opioids in 2011 and 2012, a small fraction of his overall fundraising haul.\u003c/p>\n\u003cp>\"My interest in this stems from when I was a district attorney and I got to see the lives that were lost,\" Keating said in an interview.\u003c/p>\n\u003cp>While Keating's bill has not received a vote in Congress, the FDA already has begun moving in the direction suggested by companies, mapping out a process for removing older opioids from the market when newer versions are shown to be more effective at thwarting abuse.\u003c/p>\n\u003cp>\"You don't have to pass a bill, necessarily, to change policy,\" said Dan Cohen of the Abuse Deterrent Coalition, which represents smaller abuse-deterrent manufacturers.\u003c/p>\n\u003cp>The lack of real-world data on reformulated opioids is the main reason some federal officials haven't embraced them.\u003c/p>\n\u003cp>The CDC did not recommend ADFs in its landmark opioid guidelines this year, the first-ever federal recommendations for doctors prescribing the drugs. Why? Frieden, the agency's director, said his staff could not find any evidence showing the updated opioids actually reduce rates of addiction, overdoses or deaths.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Center for Public Integrity data reporter Ben Wieder contributed to this article.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Drugmakers aggressively push new generation of harder-to-manipulate opioids that have racked up billions in sales, even though there's little proof they reduce rates of overdoses or deaths.",
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"title": "Drugmakers Push Unproven Solution to Opioid Epidemic They Helped Create | KQED",
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"headline": "Drugmakers Push Unproven Solution to Opioid Epidemic They Helped Create",
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"nprByline": "Matthew Perrone\u003cbr />Geoff Mulvihill\u003cbr />Liz Essley Whyte\u003cbr />Associated Press and Center for Public Integrity",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Pilloried for their role in the epidemic of prescription painkiller abuse, drugmakers are aggressively pushing their remedy to the problem: a new generation of harder-to-manipulate opioids that have racked up billions in sales, even though there's little proof they reduce rates of overdoses or deaths.\u003c/p>\n\u003caside class=\"pullquote alignright\">Harder-to-manipulate opioids have racked up billions in sales, despite a lack of proof that they reduce overdoses.\u003c/aside>\n\u003cp>More than prescriptions are at stake. Critics worry the drugmakers' nationwide lobbying campaign is distracting from more productive solutions and delaying crucial efforts to steer physicians away from prescription opioids — addictive pain medications involved in the deaths of more than 165,000 Americans since 2000.\u003c/p>\n\u003cp>\"If we've learned one lesson from the last 20 years on opioids it's that these products have very, very high inherent risks,\" said Dr. Caleb Alexander, co-director of Johns Hopkins University's Center for Drug Safety and Effectiveness. \"My concern is that they'll contribute to a perception that there is a safe opioid, and there's no such thing as a fully safe opioid.\"\u003c/p>\n\u003cp>The latest drugs — known as abuse-deterrent formulations, or ADFs — are generally harder to crush or dissolve, which the drugmakers tout as making them difficult to snort or inject. But they still are vulnerable to manipulation and potentially addictive when simply swallowed. National data from an industry-sponsored tracking system also show drug abusers quickly drop the reformulated drugs in favor of older painkillers or heroin.\u003c/p>\n\u003cp>In the last two years, pharmaceutical companies have made a concerted under-the-radar push for bills benefiting the anti-abuse opioids in statehouses and in Congress, where proposed legislation would require the Food and Drug Administration to replace older opioids with the new drugs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The lobbying push features industry-funded advocacy groups and physicians, along with grieving family members, who rarely disclosed the drugmakers' ties during their testimony in support of the drugs.\u003c/p>\n\u003cp>Besides the tamper-resistant pills, ADF opioids are being rolled out in other forms, including injectable drugs and pills that irritate users when they're snorted or contain substances that counteract highs.\u003c/p>\n\u003cp>\u003cstrong>Sales Opportunity\u003c/strong>\u003c/p>\n\u003cp>Making painkillers harder to abuse is a common-sense step. But it's also a multibillion-dollar sales opportunity, offering drugmakers the potential to wipe out lower-cost generic competitors and lock in sales of their higher-priced versions, which cost many times more than conventional pills. The big companies hold multiple patents on the reformulated drugs, shielding them from competition for years — in some cases decades.\u003c/p>\n\u003cp>Though abuse-deterrent painkillers represented less than 5 percent of all opioids prescribed last year, they generated more than $2.4 billion in sales, or roughly a quarter of the nearly $10 billion U.S. market for the drugs, according to IMS Health. The field is dominated by Purdue Pharma's OxyContin, patent-protected until 2030.\u003c/p>\n\u003cp>\"We at Purdue make certain that prescribers and other stakeholders understand that opioids with abuse-deterrent properties won't stop all prescription drug abuse, but they are an important part of the comprehensive approach needed to address this public health issue,\" Purdue spokesman Robert Josephson said in a statement.\u003c/p>\n\u003cp>Like a spokeswoman for Pfizer Inc., Josephson also noted that some public health officials, including the Food and Drug Administration, have endorsed using ADFs.\u003c/p>\n\u003cp>\"We need every tool that we can have in our toolbox,\" said Kentucky state Rep. Addia Wuchner, a Republican who has worked on several bills to benefit reformulated opioids. \"The extra steps are worth the effort in order to prevent this escalation of more addiction.\"\u003c/p>\n\u003cp>\u003cstrong>Massive Lobbying Effort\u003c/strong>\u003c/p>\n\u003cp>The current industry campaign draws on the same 50-state strategy that painkiller manufacturers successfully deployed to help kill or weaken measures aimed at stemming the tide of prescription opioids, a playbook The Associated Press and Center for Public Integrity exposed in September.\u003c/p>\n\u003cp>The \u003ca href=\"https://ww2.kqed.org/stateofhealth/2016/09/19/how-drugmakers-used-money-and-influence-to-shape-the-national-response-to-opioid-abuse/\" target=\"_blank\">reporting \u003c/a>detailed how opioid drugmakers and the nonprofits they help fund spent more than $880 million on lobbying and political contributions at the state and federal level over the past decade, eight times what the gun lobby reported for the same period. The money represents the drugmakers' spending on all their legislative interests, including opioids.\u003c/p>\n\u003cp>The FDA has approved a handful of the reformulated drugs but has not yet concluded that any reduce rates of addiction, abuse or death, and the evidence gap has led to diverging views among health authorities.\u003c/p>\n\u003cp>\u003cstrong>'No less addictive'\u003c/strong>\u003c/p>\n\u003cp>Whereas FDA regulators emphasize the potential promise of reformulated painkillers, other government officials stress that they contain the same heroin-like ingredients as traditional opioids. An estimated 78 Americans die from heroin and prescription opioid overdoses every day.\u003c/p>\n\u003cp>\"'Abuse-deterrent' sounds to people sometimes like 'Oh, maybe it's not addictive.' But it's no less addictive,\" said Dr. Tom Frieden, head of the Centers for Disease Control and Prevention.\u003c/p>\n\u003cp>Survey results published this year in the Clinical Journal of Pain showed nearly half of U.S. physicians incorrectly believed that reformulated opioids are less addictive than their predecessors.\u003c/p>\n\u003cp>Many experts see a key role for ADFs in reducing the number of people who first begin abusing opioids, and some say the abuse-deterrent formulations should be the default painkiller for patients with histories of drug use, anxiety or depression. But even they worry that some drugmakers are overselling the technology. They stress that separate measures are needed for the majority of opioid abusers who ingest the pills orally.\u003c/p>\n\u003cp>\"The way they're handling the ADF is that this is the answer. And it's not the answer — it's part of the bigger puzzle,\" said Theodore Cicero, a psychiatry professor at Washington University in St. Louis, who has authored several studies on the drugs.\u003c/p>\n\u003cp>\u003cstrong>'You can't put a price tag on anybody's life'\u003c/strong>\u003c/p>\n\u003cp>Two years after the overdose that killed her 21-year-old son, Terri Bartlett traveled to Illinois' state capital to champion an unlikely cause: revamped painkillers.\u003c/p>\n\u003cp>Bartlett's son Michael became hooked on Vicodin and later graduated to heroin. In emotional testimony last year, she urged lawmakers to support a bill that would prioritize the new harder-to-crush pills, saying she believed her son would still be alive if abuse-deterrent formulations had been on the market then.\u003c/p>\n\u003cp>\"You can't put a price tag on anybody's life,\" she said.\u003c/p>\n\u003cp>Bartlett didn't know then that she had been recruited into a wide-ranging lobbying campaign. A public relations firm hired by OxyContin-maker Purdue had helped recruit her to support the bill, along with local sheriffs and fire chiefs.\u003c/p>\n\u003cp>Her words, and similar testimony from parents of drug abusers elsewhere, reflect a tactic used by the drugmakers across the country. For instance, Purdue paid nearly $95,000 for similar lobbying efforts in New York, state records show.\u003c/p>\n\u003cp>And the industry's fingerprints are easy to spot in other areas. Of more than 100 bills dealing with the drugs introduced in 35 states in 2015 and 2016, at least 49 featured nearly identical language requiring insurers to cover abuse-deterrent drugs, according to an analysis of data from Quorum, a legislative tracking service. Several of the bill sponsors said they received the wording from pharmaceutical lobbyists.\u003c/p>\n\u003cp>Since 2012, at least 21 bills related to the drugs have become law, including five that require insurers to pay for the more expensive drugs in Maine, Maryland, Massachusetts, Florida and West Virginia.\u003c/p>\n\u003cp>Wins in such states will give drugmakers momentum to successfully push for copycat laws elsewhere, noted Paul Kelly, a federal lobbyist who has worked on multistate lobbying campaigns for drugstores and major retailers.\u003c/p>\n\u003cp>\"It's like a foot in the door,\" he said.\u003c/p>\n\u003cp>\u003cstrong>Fierce Opposition\u003c/strong>\u003c/p>\n\u003cp>Drugmakers have found fierce opposition to their ADF legislation from insurers and employers who would be on the hook for the far pricier opioid variations.\u003c/p>\n\u003cp>The Illinois bill — and the 48 strikingly similar measures in other states — would require insurers to cover the drugs in the same way as other opioids, which the insurance companies argue would allow drugmakers to charge whatever they want for them.\u003c/p>\n\u003cp>\"That is not the best use of our medical care resources,\" Vernon Rowen, vice president of state government affairs for the insurance company Aetna, told Illinois lawmakers after Bartlett testified. \"It totally eliminates our ability to negotiate discounts with manufacturers.\"\u003c/p>\n\u003cp>New York Gov. Andrew Cuomo and New Jersey Gov. Chris Christie both vetoed such insurance mandates in the past year, citing the high costs and lack of evidence that the drugs help.\u003c/p>\n\u003cp>Federal health officials also have pushed back against requirements to cover the drugs, citing the \"staggering\" costs. For example, a 30-day supply of Pfizer's abuse-deterrent Embeda, a combination drug containing morphine, costs $268, while a 30-day supply of a generic morphine costs roughly $38, according to data compiled by Truven Health Analytics, a company that tracks drug prices set by manufacturers.\u003c/p>\n\u003cp>The Department of Veterans Affairs' Dr. Bernie Good estimated that converting the 8.8 million patient system exclusively to the new reformulations would increase opioid spending more than tenfold, to over $1.6 billion annually. Good, who co-directs the VA's program for medication safety, said the vast majority of veterans are not at risk for snorting or injecting their medications.\u003c/p>\n\u003cp>\"Would the excess money to pay for abuse-deterrent products — mostly to pay for it in cases where it wouldn't be necessary — be better spent for drug treatment centers?\" he asked at a recent federal meeting on the drugs.\u003c/p>\n\u003cp>Federal estimates say at least 2.2 million Americans are addicted to prescription opioids or heroin, yet only one in five actually receives treatment, according to a Surgeon General's report published last month. That's despite some $35 billion already spent annually on substance abuse programs by private and public health providers.\u003c/p>\n\u003cp>State lawmakers who support the abuse-deterrent bills often defend them as an important piece of solving the opioid puzzle, preventing more costly overdoses and hospitalizations.\u003c/p>\n\u003cp>And Fred Brason, executive director of Project Lazarus, a North Carolina-based group that promotes anti-addiction policies in several states, called the focus on the drugs' cost too narrow.\u003c/p>\n\u003cp>\"You're already spending that money at the back end,\" he said. \"You're spending it at the emergency department.\" He also noted the costs of addiction treatment.\u003c/p>\n\u003cp>\u003cstrong>Industry-Supported Groups and Physicians\u003c/strong>\u003c/p>\n\u003cp>When critics raise alarms about higher costs and limited evidence, drugmakers can rely on groups they support financially to argue their side, including the National Association of Drug Diversion Investigators, the Academy of Integrative Pain Management and the Partnership for Drug-Free Kids. Representatives from those groups have testified in favor of abuse-deterrent legislation in at least seven states.\u003c/p>\n\u003cp>NADDI president Charlie Cichon acknowledged his group receives funds from several ADF-makers, but said it views the drugs as a proven part of the solution to the opioid crisis. \"We're not testifying for Purdue Pharma's product or Endo's product,\" he said.\u003c/p>\n\u003cp>And Bob Twillman, executive director of the Academy, said, \"Increased use of abuse-deterrent opioids makes it more likely that those patients who need opiates to treat their pain will be able to get them.\"\u003c/p>\n\u003cp>The Partnership for Drug-Free Kids did not respond to multiple requests for comment.\u003c/p>\n\u003cp>Physicians with financial ties to drugmakers play similar roles. Dr. Gareth Shemesh, a pain specialist, testified in support of a Colorado bill last year brought to the sponsoring legislator by Pfizer. Shemesh had received more than $13,500 from Pfizer that year in speaking fees, travel and meals, and more than $5,000 from Purdue the year before. He did not respond to repeated calls for comment, but Pfizer said he was not paid to testify and did not speak on behalf of any specific product.\u003c/p>\n\u003cp>\u003cstrong>Political Contributions Ramped Up\u003c/strong>\u003c/p>\n\u003cp>Purdue and Pfizer also have ramped up contributions to the Republican and Democratic attorneys general associations, which raise unlimited funds to help elect AGs across the country. In 2015 and 2016, they gave a total of $950,000 — more than in the previous four years combined.\u003c/p>\n\u003cp>To date, 51 attorneys general from U.S. states and territories have signed at least one of two National Association of Attorneys General letters to the FDA, urging the agency to favor abuse-deterrent drugs.\u003c/p>\n\u003cp>The pro-ADF playbook even includes a bit of political theater. In at least seven states, lawmakers or advocates have pounded the reformulated pills with hammers to demonstrate how difficult they are to smash.\u003c/p>\n\u003cp>In Illinois, it was Democratic Rep. Sara Feigenholtz wielding the hammer on the same committee that heard Terri Bartlett's testimony. The main sponsor of the bill prioritizing ADFs, Feigenholtz ranked second-highest among legislative recipients of money from Pfizer since the start of 2010, according to an analysis of data from the National Institute on Money in State Politics. The $6,200 she received during that period was more than she had received in the 14 previous years combined. Her bill passed the committee but later stalled in the Legislature and remains pending.\u003c/p>\n\u003cp>She did not return multiple requests for comment. Pfizer said its contributions to Feigenholtz go back 20 years and it would be \"inaccurate and misleading\" to suggest a tie to any one piece of legislation.\u003c/p>\n\u003cp>Bartlett said she doesn't mind that Purdue was ultimately responsible for her invitation to testify, even though she didn't know that at the time. She still supports the bill.\u003c/p>\n\u003cp>\"I want to believe that in every pharmaceutical company there still remains some sort of humanity,\" she said. \"Saving life is expensive.\"\u003c/p>\n\u003cp>\u003cstrong>'An addict can find a way'\u003c/strong>\u003c/p>\n\u003cp>The FDA has walked a careful line on the new drugs, promoting them as a promising approach to discouraging abuse while acknowledging their real-world benefits remain largely theoretical.\u003c/p>\n\u003cp>Earlier this year, the agency highlighted the drugs in its \"opioids action plan,\" issued after scathing criticism from some members of Congress that the FDA wasn't doing enough to combat the epidemic.\u003c/p>\n\u003cp>Thus far, the agency has approved seven drugs with labeling suggesting they are \"expected to\" discourage abuse, based on studies conducted by pharmaceutical companies.\u003c/p>\n\u003cp>But the FDA has not yet concluded that any of the products have a \"real-world impact\" on measures like overdose or death, according to Dr. Douglas Throckmorton, an agency deputy director. He and other regulators predict, however, that the reformulations will eventually translate into public health results.\u003c/p>\n\u003cp>\"We stand by those predictions,\" Throckmorton said at a recent public meeting on the drugs. \"We're confident in the science, we're confident in the assessments we conducted.\"\u003c/p>\n\u003cp>Even some former FDA advisers who support expanded use of the drugs say they are only part of the solution. Dr. Lewis Nelson, who previously chaired an FDA panel on drug safety, notes that the drugs don't deter the most common form of abuse: swallowing pills whole.\u003c/p>\n\u003cp>\"Certainly, you might not eat one and get high,\" he said. \"You eat three and get high.\"\u003c/p>\n\u003cp>At least one study found that while OxyContin's reformulation coincided with many abusers switching to other drugs, other users still were able to defeat the pills' technology and snort or inject the contents.\u003c/p>\n\u003cp>David Rook, a 40-year-old Henrico, Virginia, resident who now operates a recovery facility, was among them. Before entering treatment, he said, he would break down abuse-deterrent OxyContins and crush-resistant Opanas using water, lemon juice and a microwave.\u003c/p>\n\u003cp>\"The truth is an addict can find a way to abuse a medication one way or the other,\" he said.\u003c/p>\n\u003cp>\u003cstrong>Unpredictable Effects\u003c/strong>\u003c/p>\n\u003cp>A recent HIV outbreak in rural Indiana illustrates the sometimes unpredictable effect of ADFs on abusers' behavior.\u003c/p>\n\u003cp>Approximately 210 people have tested positive for the virus in Scott County since 2014, a public health crisis linked to needle-sharing among abusers of Opana. Endo Pharmaceuticals received approval for a reformulated version of the drug in 2011, making it harder to crush. As a result, many abusers switched from snorting the drug to injecting it with syringes, leading to the spread of the blood-borne HIV virus, according to the state health commissioner and other officials.\u003c/p>\n\u003cp>Endo spokeswoman Heather Zoumas Lubeski declined to comment on the outbreak, but issued a statement saying, \"Patient safety has always been a top priority for Endo and we are committed to providing patients with approved products that are safe and effective when used as prescribed.\"\u003c/p>\n\u003cp>The FDA declined to approve labeling claims for Opana's anti-abuse features, noting that the drug still can easily be cooked and injected.\u003c/p>\n\u003cp>Pfizer, Purdue, Endo and Teva Pharmaceuticals Industries Ltd. spent more than $20 million between 2012 and 2015 on federal lobbying efforts that included support of a bill that would require the FDA to gradually replace current opioids with harder-to-abuse versions that become available. Teva declined comment.\u003c/p>\n\u003cp>Rep. William Keating, D-Mass., first introduced the bill in 2012 and tried again in 2013 and 2015. Like his colleagues at the state level, he employed the hammer-smashing routine to illustrate the medications' crush-resistant properties.\u003c/p>\n\u003cp>Keating said the industry played no part in spurring the bill, even though the head of a nonprofit association funded by abuse-deterrent drugmakers spoke at the press conference introducing his legislation. He also received $2,500 in political contributions from makers of reformulated opioids in 2011 and 2012, a small fraction of his overall fundraising haul.\u003c/p>\n\u003cp>\"My interest in this stems from when I was a district attorney and I got to see the lives that were lost,\" Keating said in an interview.\u003c/p>\n\u003cp>While Keating's bill has not received a vote in Congress, the FDA already has begun moving in the direction suggested by companies, mapping out a process for removing older opioids from the market when newer versions are shown to be more effective at thwarting abuse.\u003c/p>\n\u003cp>\"You don't have to pass a bill, necessarily, to change policy,\" said Dan Cohen of the Abuse Deterrent Coalition, which represents smaller abuse-deterrent manufacturers.\u003c/p>\n\u003cp>The lack of real-world data on reformulated opioids is the main reason some federal officials haven't embraced them.\u003c/p>\n\u003cp>The CDC did not recommend ADFs in its landmark opioid guidelines this year, the first-ever federal recommendations for doctors prescribing the drugs. Why? Frieden, the agency's director, said his staff could not find any evidence showing the updated opioids actually reduce rates of addiction, overdoses or deaths.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Center for Public Integrity data reporter Ben Wieder contributed to this article.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Hospitalized Elderly Have Lower Death Rate When Cared for by Female Doc: Study",
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"content": "\u003cp>In a study that is sure to rile male doctors, Harvard researchers have found that female doctors who care for elderly hospitalized patients get better results. Patients cared for by women were less likely to die or return to the hospital after discharge.\u003c/p>\n\u003cp>Previous research has shown that female doctors are \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/8769910\">more likely to follow\u003c/a> recommendations about prevention counseling and to order \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJM199308123290707#t=article\">preventive tests\u003c/a> like Pap smears and mammograms.\u003c/p>\n\u003cp>But the \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2593255\">latest work\u003c/a>, published Monday in \u003cem>JAMA Internal Medicine\u003c/em>, is the first to show a big difference in the result that matters most to patients: life or death.\u003c/p>\n\u003cp>The study's authors estimate \"that approximately 32,000 fewer patients would die if male physicians could achieve the same outcomes as female physicians every year.\"\u003c/p>\n\u003cp>\"Of course! What did you expect?\" replied the wife of Dr. Ashish Jha, the study's senior author, when he shared his team's findings with her. Jha said he expects a backlash on the study results. But his team's methodology, successfully put through multiple analyses, makes this work noteworthy, he added.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But tens of thousands of fewer deaths per year if we just went with female doctors?\u003c/p>\n\u003cp>Whoa! To us, a man and woman who met as we were getting our start in medicine, them's fightin' words.\u003c/p>\n\u003cp>An \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2593252\">editorial\u003c/a> about the study urges doctors to remedy the gender disparities in care and the pay gap that favors male physicians over women.\u003c/p>\n\u003cp>Since half the patients we treat are women and girls, it makes sense that at least half the physician corps should reflect the population. We've achieved that in \u003ca href=\"https://www.aamc.org/members/gwims/statistics/\">medical school\u003c/a> rolls, but overall only a third of practicing doctors are female. And many specialties, including orthopedics, cardiology and neurosurgery, are still dominated by men.\u003c/p>\n\u003cp>So why is there a gender-based difference in physicians' care? The authors admit that they are \"unable to identify exactly why female physicians have better outcomes than male physicians.\"\u003c/p>\n\u003cp>We don't pretend to know for sure, but as married doctors, we have our hunches. We talked it over and here are our thoughts about the research.\u003c/p>\n\u003cp>\u003cstrong>Dr. Sarah-Anne Henning Schumann:\u003c/strong> The actual effect reported in the study is small, but multiplied over a huge population it does add up to something significant.\u003c/p>\n\u003cp>\u003cstrong>Dr. John Henning Schumann:\u003c/strong> I like the Big Data aspect of it. The authors said, \"Let's look at more than a million Medicare patients over several years and see how they fared based on the gender of their doctor.\" While many people may want to tear this study apart, I think the findings make intuitive sense.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> I'm assuming the difference is because of the way that women, in general, communicate. It's about being better listeners, more nurturing and having emotional intelligence.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> There are plenty of men who are good communicators.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Yes, just as there are plenty of women who don't really have those qualities. For female doctors, having worked their way through pre-med, med school, and residency, they can have some of that nurturing communication skill beaten out of them.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> That happens to men, too!\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> That's true. But this study shows us — just possibly — that if female doctors, on average, communicate better, their style might be more effective in treating disease and preventing death.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> It's interesting to me because I think about some of my older patients, who much prefer that I tell them what to do rather than to discuss options and share decision-making.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> I think that traditionally men were the doctors. People often assume men are more intelligent and so would be more likely to take their advice.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> That has to change, as we get closer to parity with women in the profession.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> My mother has had many experiences with male doctors, where she feels they haven't listened to her. They aren't warm or kind, but she feels reassured anyway. She thinks they're smart, and what's most important to her is their knowledge and technical skill, not their bedside manner.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> Mom always knows best, if that's what she values.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Even in our family, we're both doctors. I'm a family doctor, trained to see adults and kids. You're an internist, trained to only see adults. And in both of our families, most of the time, our family members will reach out to you with their questions — even about kids. And my family, who attended my Harvard Medical School graduation, I'll remind you, seems to value your opinion more. They seem to be looking for opinions more from men. That's kind of an interesting thing.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> I never really thought about that. I can see how that's totally male privilege. It has to be frustrating to be taken less seriously.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> I'm in a Facebook group of physicians who are moms. While it's not every doctor-mom in the country, there are over 60,000 of us in it. So many tell stories of being mistaken for nurses—and taking great offense at that. We have worked so hard to get where we are and want to be treated as equals to our male colleagues.\u003c/p>\n\u003cp>But I see the mix-up as a compliment rather than an insult. To be compared with a nurse says that patients are seeing me as someone who is caring for them and nurturing.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> That's a smart way to reframe it. Our colleague Jill used to get angry when people assumed she was a nurse. Instead, she decided to embrace it and use it as a call to service. Now she asks patients if they need an extra blanket or something to drink. And she believes that she provides better, more empathic care.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Everyone is going to want to know what is it about women that leads to these better outcomes. I think it's going to be hard to figure out exactly.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> Do you think people that read or hear about this study will take home the message that they need to choose female doctors?\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Some will no doubt oversimplify it to that. What I take away is that if communication is the key, as I suspect, then we need to better select and train medical students and residents to exhibit these qualities.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> Amen to that. What about equal pay for equal (or better!) outcomes? Paging, \u003ca href=\"https://www.eeoc.gov/eeoc/publications/brochure-equal_pay_and_ledbetter_act.cfm\">Lilly Ledbetter\u003c/a>!\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> You're not really asking me that, are you?\u003c/p>\n\u003cp>\u003cem>Sarah-Anne Henning Schumann is a family doctor and serves as medical director of \u003c/em>\u003ca href=\"http://communityhealthconnection.org/\">Community Health Connection\u003c/a>,\u003cem> a federally qualified community health center in Tulsa, Okla.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>John Henning Schumann is an internal medicine doctor and serves as President of the University of Oklahoma's Tulsa campus. He also hosts \u003c/em>\u003ca href=\"http://publicradiotulsa.org/term/john-henning-schumann\">Studio Tulsa: Medical Monday\u003c/a>\u003cem> on KWGS Public Radio Tulsa. He's on Twitter: @\u003c/em>\u003ca href=\"https://twitter.com/glasshospital?lang=en\">\u003cem>GlassHospital\u003c/em>\u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 KWGS-FM. To see more, visit \u003ca href=\"http://publicradiotulsa.org/\">KWGS-FM\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Patients+Cared+For+By+Female+Doctors+Fare+Better+Than+Those+Treated+By+Men&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In a study that is sure to rile male doctors, Harvard researchers have found that female doctors who care for elderly hospitalized patients get better results. Patients cared for by women were less likely to die or return to the hospital after discharge.\u003c/p>\n\u003cp>Previous research has shown that female doctors are \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/8769910\">more likely to follow\u003c/a> recommendations about prevention counseling and to order \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJM199308123290707#t=article\">preventive tests\u003c/a> like Pap smears and mammograms.\u003c/p>\n\u003cp>But the \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2593255\">latest work\u003c/a>, published Monday in \u003cem>JAMA Internal Medicine\u003c/em>, is the first to show a big difference in the result that matters most to patients: life or death.\u003c/p>\n\u003cp>The study's authors estimate \"that approximately 32,000 fewer patients would die if male physicians could achieve the same outcomes as female physicians every year.\"\u003c/p>\n\u003cp>\"Of course! What did you expect?\" replied the wife of Dr. Ashish Jha, the study's senior author, when he shared his team's findings with her. Jha said he expects a backlash on the study results. But his team's methodology, successfully put through multiple analyses, makes this work noteworthy, he added.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But tens of thousands of fewer deaths per year if we just went with female doctors?\u003c/p>\n\u003cp>Whoa! To us, a man and woman who met as we were getting our start in medicine, them's fightin' words.\u003c/p>\n\u003cp>An \u003ca href=\"http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2593252\">editorial\u003c/a> about the study urges doctors to remedy the gender disparities in care and the pay gap that favors male physicians over women.\u003c/p>\n\u003cp>Since half the patients we treat are women and girls, it makes sense that at least half the physician corps should reflect the population. We've achieved that in \u003ca href=\"https://www.aamc.org/members/gwims/statistics/\">medical school\u003c/a> rolls, but overall only a third of practicing doctors are female. And many specialties, including orthopedics, cardiology and neurosurgery, are still dominated by men.\u003c/p>\n\u003cp>So why is there a gender-based difference in physicians' care? The authors admit that they are \"unable to identify exactly why female physicians have better outcomes than male physicians.\"\u003c/p>\n\u003cp>We don't pretend to know for sure, but as married doctors, we have our hunches. We talked it over and here are our thoughts about the research.\u003c/p>\n\u003cp>\u003cstrong>Dr. Sarah-Anne Henning Schumann:\u003c/strong> The actual effect reported in the study is small, but multiplied over a huge population it does add up to something significant.\u003c/p>\n\u003cp>\u003cstrong>Dr. John Henning Schumann:\u003c/strong> I like the Big Data aspect of it. The authors said, \"Let's look at more than a million Medicare patients over several years and see how they fared based on the gender of their doctor.\" While many people may want to tear this study apart, I think the findings make intuitive sense.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> I'm assuming the difference is because of the way that women, in general, communicate. It's about being better listeners, more nurturing and having emotional intelligence.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> There are plenty of men who are good communicators.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Yes, just as there are plenty of women who don't really have those qualities. For female doctors, having worked their way through pre-med, med school, and residency, they can have some of that nurturing communication skill beaten out of them.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> That happens to men, too!\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> That's true. But this study shows us — just possibly — that if female doctors, on average, communicate better, their style might be more effective in treating disease and preventing death.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> It's interesting to me because I think about some of my older patients, who much prefer that I tell them what to do rather than to discuss options and share decision-making.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> I think that traditionally men were the doctors. People often assume men are more intelligent and so would be more likely to take their advice.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> That has to change, as we get closer to parity with women in the profession.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> My mother has had many experiences with male doctors, where she feels they haven't listened to her. They aren't warm or kind, but she feels reassured anyway. She thinks they're smart, and what's most important to her is their knowledge and technical skill, not their bedside manner.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> Mom always knows best, if that's what she values.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Even in our family, we're both doctors. I'm a family doctor, trained to see adults and kids. You're an internist, trained to only see adults. And in both of our families, most of the time, our family members will reach out to you with their questions — even about kids. And my family, who attended my Harvard Medical School graduation, I'll remind you, seems to value your opinion more. They seem to be looking for opinions more from men. That's kind of an interesting thing.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> I never really thought about that. I can see how that's totally male privilege. It has to be frustrating to be taken less seriously.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> I'm in a Facebook group of physicians who are moms. While it's not every doctor-mom in the country, there are over 60,000 of us in it. So many tell stories of being mistaken for nurses—and taking great offense at that. We have worked so hard to get where we are and want to be treated as equals to our male colleagues.\u003c/p>\n\u003cp>But I see the mix-up as a compliment rather than an insult. To be compared with a nurse says that patients are seeing me as someone who is caring for them and nurturing.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> That's a smart way to reframe it. Our colleague Jill used to get angry when people assumed she was a nurse. Instead, she decided to embrace it and use it as a call to service. Now she asks patients if they need an extra blanket or something to drink. And she believes that she provides better, more empathic care.\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Everyone is going to want to know what is it about women that leads to these better outcomes. I think it's going to be hard to figure out exactly.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> Do you think people that read or hear about this study will take home the message that they need to choose female doctors?\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> Some will no doubt oversimplify it to that. What I take away is that if communication is the key, as I suspect, then we need to better select and train medical students and residents to exhibit these qualities.\u003c/p>\n\u003cp>\u003cstrong>John:\u003c/strong> Amen to that. What about equal pay for equal (or better!) outcomes? Paging, \u003ca href=\"https://www.eeoc.gov/eeoc/publications/brochure-equal_pay_and_ledbetter_act.cfm\">Lilly Ledbetter\u003c/a>!\u003c/p>\n\u003cp>\u003cstrong>Sarah-Anne:\u003c/strong> You're not really asking me that, are you?\u003c/p>\n\u003cp>\u003cem>Sarah-Anne Henning Schumann is a family doctor and serves as medical director of \u003c/em>\u003ca href=\"http://communityhealthconnection.org/\">Community Health Connection\u003c/a>,\u003cem> a federally qualified community health center in Tulsa, Okla.\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>John Henning Schumann is an internal medicine doctor and serves as President of the University of Oklahoma's Tulsa campus. He also hosts \u003c/em>\u003ca href=\"http://publicradiotulsa.org/term/john-henning-schumann\">Studio Tulsa: Medical Monday\u003c/a>\u003cem> on KWGS Public Radio Tulsa. He's on Twitter: @\u003c/em>\u003ca href=\"https://twitter.com/glasshospital?lang=en\">\u003cem>GlassHospital\u003c/em>\u003c/a>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 KWGS-FM. To see more, visit \u003ca href=\"http://publicradiotulsa.org/\">KWGS-FM\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Patients+Cared+For+By+Female+Doctors+Fare+Better+Than+Those+Treated+By+Men&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\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": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game and Brown has some lessons he'd like to share. ",
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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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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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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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"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
"airtime": "SAT 4pm-5pm",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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"link": "/radio/program/reveal",
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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
},
"link": "/podcasts/rightnowish",
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