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"content": "\u003cp>When patients come to Dr. Molly Quinn for infertility treatments, they usually aren't too interested in hearing about the possible downsides, she says. They just want to get pregnant.[contextly_sidebar id=\"ey0hWotixUsdyo0wQnYUMCoyOptxLTRK\"]\u003c/p>\n\u003cp>Still, she always discusses the risks. For example, there's an increased likelihood of twins or triplets — which increases the chances of \u003ca href=\"https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=85&ContentID=P08021\" target=\"_blank\" rel=\"noopener\">medical complications\u003c/a> for both moms and babies. And stimulating the ovaries to ripen extra eggs can, in a small number of cases, cause the ovaries to rupture.\u003c/p>\n\u003cp>\u003ca href=\"https://www.uclahealth.org/molly-quinn\" target=\"_blank\" rel=\"noopener\">Quinn\u003c/a>, an infertility specialist and assistant professor of obstetrics and gynecology at the University of California, Los Angeles, now has a new hazard to consider. According to \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0735109718354809?via%3Dihub\" target=\"_blank\" rel=\"noopener\">research\u003c/a> published this month in the \u003cem>Journal of the American College of Cardiology\u003c/em>, children conceived through certain infertility treatments may be at a higher risk for cardiovascular disease.\u003c/p>\n\u003cp>Parents shouldn't panic, the study's authors say: The findings are preliminary, and the study cohort was fairly small. Still, they say, it means that families who used infertility treatments should be particularly vigilant about screening for high blood pressure in their children and help them avoid other cardiovascular risk factors, such as smoking, obesity and a sedentary lifestyle.\u003c/p>\n\u003cp>\"Fertility clinics should really ... counsel about potential risks for their kids,\" says \u003ca href=\"http://www.dbmr.unibe.ch/research/research_groups/personenpool/cardiology/prof_dr_med_scherrer_urs/index_eng.html\" target=\"_blank\" rel=\"noopener\">Dr. Urs Scherrer\u003c/a>, a visiting professor at the University of Bern in Switzerland and a senior author of the study.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Scherrer and his colleagues followed the health of children conceived through assisted reproductive technology for more than a decade. \u003ca href=\"https://medlineplus.gov/assistedreproductivetechnology.html\" target=\"_blank\" rel=\"noopener\">ART\u003c/a> is an umbrella term that covers a number of different types of procedures, including in vitro fertilization, in which sperm and eggs are mixed in a lab dish, and intracytoplasmic sperm injection, in which sperm are inserted directly into eggs. Today, roughly 2 percent of all births in the U.S are conceived via ART.[contextly_sidebar id=\"QmmfxSiEfwbF2B1GB9guL21XilL52eqX\"]\u003c/p>\n\u003cp>In 2012, the same team of scientists published a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22434595\" target=\"_blank\" rel=\"noopener\">major paper\u003c/a> showing that 65 healthy kids born with the help of ART were more likely than their peers to have early signs of problematic blood vessels. The current study, comparing 54 of those original children with 43 age- and sex-matched peers, shows those early irregularities — signs of \"premature vascular aging\", the scientists say — persist into adolescence and young adulthood.\u003c/p>\n\u003cp>Kids in the study who were conceived via ART are now 16 years old, on average, but have blood vessels resembling those of middle-aged adults, the scientists found.\u003c/p>\n\u003cp>And those differences seemed to be enough to boost the teens' blood pressure. Everyone in the study underwent round-the-clock blood pressure monitoring for 24 hours, and the differences between a group conceived by ART and teens in the control group were significant. The ART group had markedly higher blood pressure; about 15 percent met the criteria for hypertension.\u003c/p>\n\u003cp>The study adds to a small but \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24270419\" target=\"_blank\" rel=\"noopener\">growing\u003c/a> \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/27420642\">body\u003c/a> of research suggesting that children conceived this way may have an elevated risk of hypertension and its health complications.\u003c/p>\n\u003cp>Scientists say they don't yet know why that would be true, but they hypothesize that \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1392256/\" target=\"_blank\" rel=\"noopener\">epigenetics\u003c/a> — the interplay of environment and genes — plays a role. Something about the manipulation of the eggs and sperm in the lab might affect which genes are turned on or off as embryos develop.\u003c/p>\n\u003cp>Medical specialists who study high blood pressure in kids called the research striking.\u003c/p>\n\u003cp>\"The fact that these kids already have abnormal vasculature is quite concerning,\" says \u003ca href=\"http://www.seattlechildrens.org/medical-staff/joseph-t-flynn/\" target=\"_blank\" rel=\"noopener\">Dr. Joseph Flynn\u003c/a>, a pediatrician who helped write the American Academy of Pediatrics' guidelines about blood pressure management. \"I think the fact that they saw these changes at an early age and that they're still persisting into adolescence is worrisome for these kids.\"[contextly_sidebar id=\"85O7WjzrUHwoOFYBW2OgPx9FMGcZx2CI\"]\u003c/p>\n\u003cp>Still, he says, it's unclear what the long-term effects on their cardiovascular health will be. Conception through ART, Flynn says, may confer the same amount of risk as, say, teenage smoking or alcohol use.\u003c/p>\n\u003cp>Quinn says she would like to see more longitudinal research that tracks long-term consequences of infertility treatments.\u003c/p>\n\u003cp>\"We need to connect these kinds of studies,\" she says. Such research can be more difficult to do in the United States, she notes, because there is no unified medical record, so it's hard to track the babies who are conceived through ART.\u003c/p>\n\u003cp>Still, she says, it's important for all doctors working in the infertility field to acknowledge that the techniques they use are still evolving.\u003c/p>\n\u003cp>\"We appreciate that there is quite a bit unknown about we do on a day-to-day basis,\" says Quinn. \"We have to be humble.\"\u003c/p>\n\u003cp>For now, \u003ca href=\"http://pediatrics.aappublications.org/content/early/2017/08/21/peds.2017-1904\" target=\"_blank\" rel=\"noopener\">the American Academy of Pediatrics recommends\u003c/a> that every child over the age of 3 get a yearly blood pressure test at the doctor's office — whether or not their parents underwent infertility treatments.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Mara Gordon is a family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Do+IVF+And+Other+Infertility+Tech+Lead+To+Health+Risks+For+The+Baby%3F+Maybe&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When patients come to Dr. Molly Quinn for infertility treatments, they usually aren't too interested in hearing about the possible downsides, she says. They just want to get pregnant.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Still, she always discusses the risks. For example, there's an increased likelihood of twins or triplets — which increases the chances of \u003ca href=\"https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=85&ContentID=P08021\" target=\"_blank\" rel=\"noopener\">medical complications\u003c/a> for both moms and babies. And stimulating the ovaries to ripen extra eggs can, in a small number of cases, cause the ovaries to rupture.\u003c/p>\n\u003cp>\u003ca href=\"https://www.uclahealth.org/molly-quinn\" target=\"_blank\" rel=\"noopener\">Quinn\u003c/a>, an infertility specialist and assistant professor of obstetrics and gynecology at the University of California, Los Angeles, now has a new hazard to consider. According to \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0735109718354809?via%3Dihub\" target=\"_blank\" rel=\"noopener\">research\u003c/a> published this month in the \u003cem>Journal of the American College of Cardiology\u003c/em>, children conceived through certain infertility treatments may be at a higher risk for cardiovascular disease.\u003c/p>\n\u003cp>Parents shouldn't panic, the study's authors say: The findings are preliminary, and the study cohort was fairly small. Still, they say, it means that families who used infertility treatments should be particularly vigilant about screening for high blood pressure in their children and help them avoid other cardiovascular risk factors, such as smoking, obesity and a sedentary lifestyle.\u003c/p>\n\u003cp>\"Fertility clinics should really ... counsel about potential risks for their kids,\" says \u003ca href=\"http://www.dbmr.unibe.ch/research/research_groups/personenpool/cardiology/prof_dr_med_scherrer_urs/index_eng.html\" target=\"_blank\" rel=\"noopener\">Dr. Urs Scherrer\u003c/a>, a visiting professor at the University of Bern in Switzerland and a senior author of the study.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Scherrer and his colleagues followed the health of children conceived through assisted reproductive technology for more than a decade. \u003ca href=\"https://medlineplus.gov/assistedreproductivetechnology.html\" target=\"_blank\" rel=\"noopener\">ART\u003c/a> is an umbrella term that covers a number of different types of procedures, including in vitro fertilization, in which sperm and eggs are mixed in a lab dish, and intracytoplasmic sperm injection, in which sperm are inserted directly into eggs. Today, roughly 2 percent of all births in the U.S are conceived via ART.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In 2012, the same team of scientists published a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22434595\" target=\"_blank\" rel=\"noopener\">major paper\u003c/a> showing that 65 healthy kids born with the help of ART were more likely than their peers to have early signs of problematic blood vessels. The current study, comparing 54 of those original children with 43 age- and sex-matched peers, shows those early irregularities — signs of \"premature vascular aging\", the scientists say — persist into adolescence and young adulthood.\u003c/p>\n\u003cp>Kids in the study who were conceived via ART are now 16 years old, on average, but have blood vessels resembling those of middle-aged adults, the scientists found.\u003c/p>\n\u003cp>And those differences seemed to be enough to boost the teens' blood pressure. Everyone in the study underwent round-the-clock blood pressure monitoring for 24 hours, and the differences between a group conceived by ART and teens in the control group were significant. The ART group had markedly higher blood pressure; about 15 percent met the criteria for hypertension.\u003c/p>\n\u003cp>The study adds to a small but \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/24270419\" target=\"_blank\" rel=\"noopener\">growing\u003c/a> \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/27420642\">body\u003c/a> of research suggesting that children conceived this way may have an elevated risk of hypertension and its health complications.\u003c/p>\n\u003cp>Scientists say they don't yet know why that would be true, but they hypothesize that \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1392256/\" target=\"_blank\" rel=\"noopener\">epigenetics\u003c/a> — the interplay of environment and genes — plays a role. Something about the manipulation of the eggs and sperm in the lab might affect which genes are turned on or off as embryos develop.\u003c/p>\n\u003cp>Medical specialists who study high blood pressure in kids called the research striking.\u003c/p>\n\u003cp>\"The fact that these kids already have abnormal vasculature is quite concerning,\" says \u003ca href=\"http://www.seattlechildrens.org/medical-staff/joseph-t-flynn/\" target=\"_blank\" rel=\"noopener\">Dr. Joseph Flynn\u003c/a>, a pediatrician who helped write the American Academy of Pediatrics' guidelines about blood pressure management. \"I think the fact that they saw these changes at an early age and that they're still persisting into adolescence is worrisome for these kids.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Still, he says, it's unclear what the long-term effects on their cardiovascular health will be. Conception through ART, Flynn says, may confer the same amount of risk as, say, teenage smoking or alcohol use.\u003c/p>\n\u003cp>Quinn says she would like to see more longitudinal research that tracks long-term consequences of infertility treatments.\u003c/p>\n\u003cp>\"We need to connect these kinds of studies,\" she says. Such research can be more difficult to do in the United States, she notes, because there is no unified medical record, so it's hard to track the babies who are conceived through ART.\u003c/p>\n\u003cp>Still, she says, it's important for all doctors working in the infertility field to acknowledge that the techniques they use are still evolving.\u003c/p>\n\u003cp>\"We appreciate that there is quite a bit unknown about we do on a day-to-day basis,\" says Quinn. \"We have to be humble.\"\u003c/p>\n\u003cp>For now, \u003ca href=\"http://pediatrics.aappublications.org/content/early/2017/08/21/peds.2017-1904\" target=\"_blank\" rel=\"noopener\">the American Academy of Pediatrics recommends\u003c/a> that every child over the age of 3 get a yearly blood pressure test at the doctor's office — whether or not their parents underwent infertility treatments.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Mara Gordon is a family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Do+IVF+And+Other+Infertility+Tech+Lead+To+Health+Risks+For+The+Baby%3F+Maybe&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>https://youtu.be/_zptWlAxYk0\u003c/p>\n\u003cp>When a relationship ends but love remains, it can be both frustrating and embarrassing.\u003c/p>\n\u003cp>Dessa, \u003ca href=\"http://www.doomtree.net/dessa/\" target=\"_blank\" rel=\"noopener\">a well-known rapper, singer and writer from Minneapolis,\u003c/a> knows the feeling well. She'd spent years trying to get over an ex-boyfriend, but she was still stuck on him.[contextly_sidebar id=\"mlbMdLIlSsXEMYXBPWlqFIXoZNq8obvy\"]\u003c/p>\n\u003cp>\"You're not only suffering,\" she says, \"you're just sort of ridiculous. Discipline and dedication are my strong suits — it really bothered me that, no matter how much effort I tried to expend in trying to solve this problem, I was stuck.\"\u003c/p>\n\u003cp>But things changed when Dessa turned to the frontiers of neuroscience for help. She came across a \u003ca href=\"https://www.ted.com/talks/helen_fisher_studies_the_brain_in_love\" target=\"_blank\" rel=\"noopener\">TED Talk by Helen Fisher\u003c/a>, a biological anthropologist and visiting research associate at Rutgers University. Using a type of brain scan called functional MRI, or fMRI, Fisher had looked into the brains of love-struck people and noticed that certain parts of their brains were unusually active.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"That you could objectively measure and observe 'love' — that had never occurred to me before,\" Dessa says.\u003c/p>\n\u003cp>She wondered: If science could map the sources of love in her brain, could it somehow make that love go away?\u003c/p>\n\u003cp>The question led her to a controversial therapy technique called \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4892319/\" target=\"_blank\" rel=\"noopener\">neurofeedback\u003c/a>.\u003c/p>\n\u003cp>The idea is simple: If you want to learn to lower your heart rate, it helps to be able to hear your pulse. And if you want to change patterns of brain activity, it might be helpful to be able to see what your brain is up to.\u003c/p>\n\u003cp>One flavor of neurofeedback therapy uses a technology called electroencephalography (EEG). A cap full of electrical leads picks up brain waves and translates them into visual or audio cues — like shifting colors on a screen or a series of dings.[contextly_sidebar id=\"1fHutBtcW68QYfMP3EG9cUp4qyVAiRXb\"]\u003c/p>\n\u003cp>The idea is that people can use this feedback to retrain those brain waves, changing underlying patterns in the process — turning down unwanted brain activity or turning up regions that are too quiet.\u003c/p>\n\u003cp>Clinicians have used neurofeedback to try and treat all kinds of mental health issues: anxiety, depression, autism, and ADHD. And they say they've \u003ca href=\"https://www.isnr.org/in-defense-of-neurofeedback\" target=\"_blank\" rel=\"noopener\">seen some positive results\u003c/a>. Patients say they feel better.\u003c/p>\n\u003cp>The growing popularity of EEG-neurofeedback has been met with skepticism. Some scientists say the power of this therapy \u003ca href=\"https://s3.ca-central-1.amazonaws.com/razlab.org/publications/NF_AMP_2017.pdf\" target=\"_blank\" rel=\"noopener\">may stem from the placebo effect\u003c/a>. (They also point out that a lot of neurofeedback research is done by \u003ca href=\"https://s3.ca-central-1.amazonaws.com/razlab.org/publications/NF_Brain_Climate_2018.pdf\" target=\"_blank\" rel=\"noopener\">people who have a financial stake in the industry\u003c/a>.)\u003c/p>\n\u003cp>But more rigorous research from the past couple of years supports the idea that, at least in some cases, neurofeedback can be used to train the brain. Most of this research uses fMRI brain scans — not EEG — to peek inside the skull.\u003c/p>\n\u003cp>In \u003ca href=\"https://www.cell.com/neuron/abstract/S0896-6273(16)00095-7\" target=\"_blank\" rel=\"noopener\">one study\u003c/a>, participants learned to turn up a brain region linked to motivation and focus. In \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28407727\" target=\"_blank\" rel=\"noopener\">another\u003c/a>, patients with depression were able to alleviate some of their symptoms. But scientists doing this research say there's a lot of work to be done before it can be applied clinically.[contextly_sidebar id=\"ZTOJcPBkTbqiXR1MSox5O57wZuSuzU4T\"]\u003c/p>\n\u003cp>Could neurofeedback provide a balm for broken hearts? No research has been done in this area. But that didn't stop Dessa from trying a sort of experiment on herself: nine EEG-neurofeedback sessions aimed at helping her brain escape the rut of romantic obsession.\u003c/p>\n\u003cp>She says she felt different when she was done.\u003c/p>\n\u003cp>\"Before, I felt that I was really under the thumb of a fixation and a compulsion,\" she says. \"And now it feels like those feelings have been scaled down.\"\u003c/p>\n\u003cp>Now, maybe the neurofeedback had worked as practitioners suggest it does. Or maybe, alternatively, Dessa got the therapy she wanted in other ways — by talking through her experiment, by writing about it, by composing songs for her new album.\u003c/p>\n\u003cp>Or maybe, her neurofeedback sessions helped her via the placebo effect. They suggested that her emotions are grounded in a physical organ \u003cem> — \u003c/em>one that she might be able to influence. Maybe simply believing that she wasn't helpless helped her change her mind and heal her heartbreak.\u003c/p>\n\u003cp>Whatever the reason, Dessa is happy to begin to move on and to start a new chapter with her music.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I've written a bunch of sad rap bangers — I'd like to write other kinds of songs,\" she says.\u003c/p>\n\u003cdiv>\u003c/div>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=This+Rapper+Tried+To+Use+Neuroscience+To+Get+Over+Her+Ex&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"That you could objectively measure and observe 'love' — that had never occurred to me before,\" Dessa says.\u003c/p>\n\u003cp>She wondered: If science could map the sources of love in her brain, could it somehow make that love go away?\u003c/p>\n\u003cp>The question led her to a controversial therapy technique called \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4892319/\" target=\"_blank\" rel=\"noopener\">neurofeedback\u003c/a>.\u003c/p>\n\u003cp>The idea is simple: If you want to learn to lower your heart rate, it helps to be able to hear your pulse. And if you want to change patterns of brain activity, it might be helpful to be able to see what your brain is up to.\u003c/p>\n\u003cp>One flavor of neurofeedback therapy uses a technology called electroencephalography (EEG). A cap full of electrical leads picks up brain waves and translates them into visual or audio cues — like shifting colors on a screen or a series of dings.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The idea is that people can use this feedback to retrain those brain waves, changing underlying patterns in the process — turning down unwanted brain activity or turning up regions that are too quiet.\u003c/p>\n\u003cp>Clinicians have used neurofeedback to try and treat all kinds of mental health issues: anxiety, depression, autism, and ADHD. And they say they've \u003ca href=\"https://www.isnr.org/in-defense-of-neurofeedback\" target=\"_blank\" rel=\"noopener\">seen some positive results\u003c/a>. Patients say they feel better.\u003c/p>\n\u003cp>The growing popularity of EEG-neurofeedback has been met with skepticism. Some scientists say the power of this therapy \u003ca href=\"https://s3.ca-central-1.amazonaws.com/razlab.org/publications/NF_AMP_2017.pdf\" target=\"_blank\" rel=\"noopener\">may stem from the placebo effect\u003c/a>. (They also point out that a lot of neurofeedback research is done by \u003ca href=\"https://s3.ca-central-1.amazonaws.com/razlab.org/publications/NF_Brain_Climate_2018.pdf\" target=\"_blank\" rel=\"noopener\">people who have a financial stake in the industry\u003c/a>.)\u003c/p>\n\u003cp>But more rigorous research from the past couple of years supports the idea that, at least in some cases, neurofeedback can be used to train the brain. Most of this research uses fMRI brain scans — not EEG — to peek inside the skull.\u003c/p>\n\u003cp>In \u003ca href=\"https://www.cell.com/neuron/abstract/S0896-6273(16)00095-7\" target=\"_blank\" rel=\"noopener\">one study\u003c/a>, participants learned to turn up a brain region linked to motivation and focus. In \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28407727\" target=\"_blank\" rel=\"noopener\">another\u003c/a>, patients with depression were able to alleviate some of their symptoms. But scientists doing this research say there's a lot of work to be done before it can be applied clinically.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Could neurofeedback provide a balm for broken hearts? No research has been done in this area. But that didn't stop Dessa from trying a sort of experiment on herself: nine EEG-neurofeedback sessions aimed at helping her brain escape the rut of romantic obsession.\u003c/p>\n\u003cp>She says she felt different when she was done.\u003c/p>\n\u003cp>\"Before, I felt that I was really under the thumb of a fixation and a compulsion,\" she says. \"And now it feels like those feelings have been scaled down.\"\u003c/p>\n\u003cp>Now, maybe the neurofeedback had worked as practitioners suggest it does. Or maybe, alternatively, Dessa got the therapy she wanted in other ways — by talking through her experiment, by writing about it, by composing songs for her new album.\u003c/p>\n\u003cp>Or maybe, her neurofeedback sessions helped her via the placebo effect. They suggested that her emotions are grounded in a physical organ \u003cem> — \u003c/em>one that she might be able to influence. Maybe simply believing that she wasn't helpless helped her change her mind and heal her heartbreak.\u003c/p>\n\u003cp>Whatever the reason, Dessa is happy to begin to move on and to start a new chapter with her music.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I've written a bunch of sad rap bangers — I'd like to write other kinds of songs,\" she says.\u003c/p>\n\u003cdiv>\u003c/div>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=This+Rapper+Tried+To+Use+Neuroscience+To+Get+Over+Her+Ex&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Turmoil Erupts Over Expulsion of Vaccine Critic from Leading Medical Group",
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"content": "\u003cp>One of the medical world’s most respected expert bodies is in turmoil as its annual meeting gets underway in Edinburgh, Scotland, after its governing board voted to expel a member.[contextly_sidebar id=\"Kn64ul6ElC5kMYHks5hc2dO2RuxcXwvM\"]\u003c/p>\n\u003cp>The Cochrane Collaboration, which reviews the scientific literature in areas of clinical research and produces widely cited analyses that help guide clinical practice, kicked out a member who has been an outspoken critic of certain vaccines and has blasted the profession of psychiatry for pushing unsafe drugs on unsuspecting patients.\u003c/p>\n\u003cp>The expulsion of Peter Gøtzsche sparked accusations that the Collaboration is too friendly toward the drug industry. Four other members of the organization’s governing board resigned in response, citing concerns that the action “goes against Cochrane ethos.”\u003c/p>\n\u003cp class=\"\">The vote appears to have been 6 of 13 in favor of the move, according to statements from the board members who resigned and Gøtzsche — short of a majority but enough to pass because only 11 voted.\u003c/p>\n\u003cp class=\"\">“This unprecedented action taken by a minority of the Governing Board is disproportionate and damaging to Cochrane, as well as to public health interests,” Gøtzsche said in a \u003ca href=\"https://nordic.cochrane.org/sites/nordic.cochrane.org/files/public/uploads/moral_crisis_in_cochrane.pdf\" target=\"_blank\" rel=\"noopener\">letter he circulated on Friday\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Collaboration \u003ca href=\"https://www.cochrane.org/news/message-governing-board\" target=\"_blank\" rel=\"noopener\">posted a statement\u003c/a> on its website Saturday, saying, “Cochrane’s Governing Board considered, as planned, the findings of an independent review and additional complaints related to the conduct of a Member.” The complaints were not specified, but the statement said the board’s co-chairs will provide more details “once this process is complete.”[contextly_sidebar id=\"ynjsrFwcYBXkogb3iv2lea34bcxV6tJK\"]\u003c/p>\n\u003cp>In a longer \u003ca href=\"https://www.cochrane.org/news/statement-cochranes-governing-board\" target=\"_blank\" rel=\"noopener\">response posted Monday\u003c/a>, Cochrane’s governing board said that it finds itself in “an extraordinary situation” and that the four board members who resigned “actively disseminated an incomplete and misleading account of events.”\u003c/p>\n\u003cp>The decision, the board said, “is not about freedom of speech. It is not about scientific debate. It is not about tolerance of dissent. It is not about someone being unable to criticize a Cochrane Review.”\u003c/p>\n\u003cp>Instead, the board said, “It is about a long-term pattern of behaviour that we say is totally, and utterly, at variance with the principles and governance of the Cochrane Collaboration.” Although the board did not describe the behavior, the pattern, it claimed, dated back to complaints since 2003, and included three new complaints in March of this year. “All our staff, and our members, have the right to do their work without harassment and personal attacks,” the statement said.\u003c/p>\n\u003cp>Gøtzsche, the director of the \u003ca href=\"https://nordic.cochrane.org/\" target=\"_blank\" rel=\"noopener\">Nordic Cochrane Center\u003c/a>, in Copenhagen, Denmark, has cast doubts about the safety of a vaccine against human papillomavirus (HPV), a cause of cervical cancer, and \u003ca href=\"https://www.youtube.com/watch?v=DiJcSoo3C4Q\" target=\"_blank\" rel=\"noopener\">says\u003c/a> psychiatry has “gone astray” by coercing patients into taking medication, such as antidepressants, they don’t want to use and that cause “brain damage” over the long run. “The way these drugs are used today cause[s] more harm than good. So it would be better for us if the drugs didn’t exist.”\u003c/p>\n\u003cp>Gøtzsche, Cochrane member Tom Jefferson, and another colleague ruffled feathers at Cochrane with a \u003ca href=\"https://ebm.bmj.com/content/early/2018/07/27/bmjebm-2018-111012\" target=\"_blank\" rel=\"noopener\">July 2018 article\u003c/a> that criticized a recent paper from the Collaboration on the safety of the HPV vaccine. The paper prompted a \u003ca href=\"https://www.cochrane.org/news/cochranes-editor-chief-responds-bmj-ebm-article-criticizing-hpv-review\" target=\"_blank\" rel=\"noopener\">rebuttal\u003c/a> from Cochrane that dismissed the concerns and stood behind the original findings.\u003c/p>\n\u003cp>Hilda Bastian, a founding member of the Cochrane Collaboration and an influential writer about science, \u003ca href=\"https://hildabastian.net/index.php/67-the-hpv-vaccine\" target=\"_blank\" rel=\"noopener\">called the review\u003c/a> “a manufactured controversy — a hatchet job by people with such strong intellectual and ideological biases, that they didn’t even pick up that some of their most implausible allegations were based on their own analytical and investigative slip-ups.”[contextly_sidebar id=\"lCLNW34bypWghzUhqKu6Xt2EeSW06udI\"]\u003c/p>\n\u003cp>Complaints about the review that Gotzsche co-authored came late in the process, according to the \u003ca href=\"https://www.cochrane.org/news/statement-cochranes-governing-board\" target=\"_blank\" rel=\"noopener\">board’s Monday statement\u003c/a>, and were not the initial trigger of the investigation.\u003c/p>\n\u003cp>As of now, the board said, Gotzsche remains a member of the organization. He was given seven days to respond to the board’s vote. He did not immediately respond to a request for comment from STAT and Retraction Watch.\u003c/p>\n\u003cp>Gøtzsche, who was \u003ca href=\"https://nordic.cochrane.org/news/prof-peter-c-g%C3%B8tzsche-becomes-member-cochrane-governing-board\" target=\"_blank\" rel=\"noopener\">elected to the group’s board of governors in 2017\u003c/a>, blamed the vote on his stance on the drug industry. “As most people know, much of my work is not very favourable to the financial interests of the pharmaceutical industry. Because of this Cochrane has faced pressure, criticism and complaints. My expulsion is one of the results of these campaigns.”\u003c/p>\n\u003cp>Jefferson, speaking from a reception at the Edinburgh meeting, told Retraction Watch and STAT that people he’s spoken to are outraged. “I’ve been in Cochrane 25 years, this is not how we do things,” he said. “Peter Gotzsche was a democratically elected member of the board. It’s really unheard of.”\u003c/p>\n\u003cp>At least one prominent scientist expressed alarm that the move to jettison Gøtzsche was an assault on free speech. \u003ca href=\"https://profiles.stanford.edu/john-ioannidis\" target=\"_blank\" rel=\"noopener\">John Ioannidis\u003c/a>, of Stanford University, said he is “disturbed” by Gøtzsche’s expulsion and stressed the importance of heterodox views in science.\u003c/p>\n\u003cp>“I adore Peter for his courage and I highly value his major contributions to evidence-based medicine … even if I don’t agree with all of Peter’s views and inferences,” Ioannidis wrote Sunday in an email to a group of more than 100 experts in evidence-based medicine. “I think it is important to make sure that people who disagree with us will get the most opportunity to express and support their views with arguments and evidence and, of course, not get expelled.”[contextly_sidebar id=\"odd8SE7t4b9S7rToLgrBZZS25O72EdXO\"]\u003c/p>\n\u003cp>But at least one other expert defended Cochrane. Allen Frances, chair of the Department of Psychiatry at Duke University, in Durham, N.C., dismissed the notion that Gøtzsche was being unfairly muzzled.\u003c/p>\n\u003cp>“This has nothing to do with freedom of speech,” Frances wrote in the thread that included Ioannidis. Rather, he said, Cochrane is justifiably concerned about remaining an “impartial evaluator of evidence” and providing reliable information to doctors and their patients.\u003c/p>\n\u003cp>“At least in psychiatry, Peter is anything but impartial,” Frances wrote. “He consistently expresses the most extreme views in the most dramatic and misleading way. His role at Cochrane lends its legitimacy to opinions that are dangerous to patients with severe mental illness. As an individual, Peter has total freedom to express extreme opinions, but he has no inherent right to cloak them with Cochrane’s hard won mantle of neutrality.”\u003c/p>\n\u003cp>The four board members who resigned in the wake of the vote said in a statement Saturday that “the expulsion of inconvenient members from the Collaboration goes against Cochrane ethos and neither reflects its founding spirit nor promotes the Collaboration’s best interests. We are concerned that these actions might cause great damage to the reputation of the Collaboration.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.cochrane.org/news/message-governing-board\" target=\"_blank\" rel=\"noopener\">In its own statement\u003c/a>, the governing board said that two other members had resigned because the “situation required further changes in the composition of the Board in order to comply with \u003ca href=\"https://www.cochrane.org/sites/default/files/public/uploads/cochrane_-_articles_of_association_-_final_and_approved_-_october_2016.pdf\" target=\"_blank\" rel=\"noopener\">Cochrane’s Articles of Association\u003c/a>.” Neither of the board’s co-chairs immediately responded to requests for comment.\u003c/p>\n\u003cp>“There appears to be no confidence in the management board at this point,” Jefferson said. “I think the only honorable thing for the rest of the board to do is resign.”\u003c/p>\n\u003cp>\u003cem>This story has been updated with a statement from Cochrane’s governing board. The story is a collaboration between STAT and \u003c/em>\u003ca href=\"https://retractionwatch.com/\" target=\"_blank\" rel=\"noopener\">\u003cem>Retraction Watch\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/09/16/expulsion-cochrane-peter-gotzsche-medicine/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\n",
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"excerpt": "One of the medical world’s most respected body of experts is in turmoil after its governing board voted to expel an outspoken critic of certain vaccines and the psychiatry profession for pushing unsafe drugs. The move has sparked accusations that the group is too friendly with drugmakers.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>One of the medical world’s most respected expert bodies is in turmoil as its annual meeting gets underway in Edinburgh, Scotland, after its governing board voted to expel a member.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The Cochrane Collaboration, which reviews the scientific literature in areas of clinical research and produces widely cited analyses that help guide clinical practice, kicked out a member who has been an outspoken critic of certain vaccines and has blasted the profession of psychiatry for pushing unsafe drugs on unsuspecting patients.\u003c/p>\n\u003cp>The expulsion of Peter Gøtzsche sparked accusations that the Collaboration is too friendly toward the drug industry. Four other members of the organization’s governing board resigned in response, citing concerns that the action “goes against Cochrane ethos.”\u003c/p>\n\u003cp class=\"\">The vote appears to have been 6 of 13 in favor of the move, according to statements from the board members who resigned and Gøtzsche — short of a majority but enough to pass because only 11 voted.\u003c/p>\n\u003cp class=\"\">“This unprecedented action taken by a minority of the Governing Board is disproportionate and damaging to Cochrane, as well as to public health interests,” Gøtzsche said in a \u003ca href=\"https://nordic.cochrane.org/sites/nordic.cochrane.org/files/public/uploads/moral_crisis_in_cochrane.pdf\" target=\"_blank\" rel=\"noopener\">letter he circulated on Friday\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Collaboration \u003ca href=\"https://www.cochrane.org/news/message-governing-board\" target=\"_blank\" rel=\"noopener\">posted a statement\u003c/a> on its website Saturday, saying, “Cochrane’s Governing Board considered, as planned, the findings of an independent review and additional complaints related to the conduct of a Member.” The complaints were not specified, but the statement said the board’s co-chairs will provide more details “once this process is complete.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In a longer \u003ca href=\"https://www.cochrane.org/news/statement-cochranes-governing-board\" target=\"_blank\" rel=\"noopener\">response posted Monday\u003c/a>, Cochrane’s governing board said that it finds itself in “an extraordinary situation” and that the four board members who resigned “actively disseminated an incomplete and misleading account of events.”\u003c/p>\n\u003cp>The decision, the board said, “is not about freedom of speech. It is not about scientific debate. It is not about tolerance of dissent. It is not about someone being unable to criticize a Cochrane Review.”\u003c/p>\n\u003cp>Instead, the board said, “It is about a long-term pattern of behaviour that we say is totally, and utterly, at variance with the principles and governance of the Cochrane Collaboration.” Although the board did not describe the behavior, the pattern, it claimed, dated back to complaints since 2003, and included three new complaints in March of this year. “All our staff, and our members, have the right to do their work without harassment and personal attacks,” the statement said.\u003c/p>\n\u003cp>Gøtzsche, the director of the \u003ca href=\"https://nordic.cochrane.org/\" target=\"_blank\" rel=\"noopener\">Nordic Cochrane Center\u003c/a>, in Copenhagen, Denmark, has cast doubts about the safety of a vaccine against human papillomavirus (HPV), a cause of cervical cancer, and \u003ca href=\"https://www.youtube.com/watch?v=DiJcSoo3C4Q\" target=\"_blank\" rel=\"noopener\">says\u003c/a> psychiatry has “gone astray” by coercing patients into taking medication, such as antidepressants, they don’t want to use and that cause “brain damage” over the long run. “The way these drugs are used today cause[s] more harm than good. So it would be better for us if the drugs didn’t exist.”\u003c/p>\n\u003cp>Gøtzsche, Cochrane member Tom Jefferson, and another colleague ruffled feathers at Cochrane with a \u003ca href=\"https://ebm.bmj.com/content/early/2018/07/27/bmjebm-2018-111012\" target=\"_blank\" rel=\"noopener\">July 2018 article\u003c/a> that criticized a recent paper from the Collaboration on the safety of the HPV vaccine. The paper prompted a \u003ca href=\"https://www.cochrane.org/news/cochranes-editor-chief-responds-bmj-ebm-article-criticizing-hpv-review\" target=\"_blank\" rel=\"noopener\">rebuttal\u003c/a> from Cochrane that dismissed the concerns and stood behind the original findings.\u003c/p>\n\u003cp>Hilda Bastian, a founding member of the Cochrane Collaboration and an influential writer about science, \u003ca href=\"https://hildabastian.net/index.php/67-the-hpv-vaccine\" target=\"_blank\" rel=\"noopener\">called the review\u003c/a> “a manufactured controversy — a hatchet job by people with such strong intellectual and ideological biases, that they didn’t even pick up that some of their most implausible allegations were based on their own analytical and investigative slip-ups.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Complaints about the review that Gotzsche co-authored came late in the process, according to the \u003ca href=\"https://www.cochrane.org/news/statement-cochranes-governing-board\" target=\"_blank\" rel=\"noopener\">board’s Monday statement\u003c/a>, and were not the initial trigger of the investigation.\u003c/p>\n\u003cp>As of now, the board said, Gotzsche remains a member of the organization. He was given seven days to respond to the board’s vote. He did not immediately respond to a request for comment from STAT and Retraction Watch.\u003c/p>\n\u003cp>Gøtzsche, who was \u003ca href=\"https://nordic.cochrane.org/news/prof-peter-c-g%C3%B8tzsche-becomes-member-cochrane-governing-board\" target=\"_blank\" rel=\"noopener\">elected to the group’s board of governors in 2017\u003c/a>, blamed the vote on his stance on the drug industry. “As most people know, much of my work is not very favourable to the financial interests of the pharmaceutical industry. Because of this Cochrane has faced pressure, criticism and complaints. My expulsion is one of the results of these campaigns.”\u003c/p>\n\u003cp>Jefferson, speaking from a reception at the Edinburgh meeting, told Retraction Watch and STAT that people he’s spoken to are outraged. “I’ve been in Cochrane 25 years, this is not how we do things,” he said. “Peter Gotzsche was a democratically elected member of the board. It’s really unheard of.”\u003c/p>\n\u003cp>At least one prominent scientist expressed alarm that the move to jettison Gøtzsche was an assault on free speech. \u003ca href=\"https://profiles.stanford.edu/john-ioannidis\" target=\"_blank\" rel=\"noopener\">John Ioannidis\u003c/a>, of Stanford University, said he is “disturbed” by Gøtzsche’s expulsion and stressed the importance of heterodox views in science.\u003c/p>\n\u003cp>“I adore Peter for his courage and I highly value his major contributions to evidence-based medicine … even if I don’t agree with all of Peter’s views and inferences,” Ioannidis wrote Sunday in an email to a group of more than 100 experts in evidence-based medicine. “I think it is important to make sure that people who disagree with us will get the most opportunity to express and support their views with arguments and evidence and, of course, not get expelled.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But at least one other expert defended Cochrane. Allen Frances, chair of the Department of Psychiatry at Duke University, in Durham, N.C., dismissed the notion that Gøtzsche was being unfairly muzzled.\u003c/p>\n\u003cp>“This has nothing to do with freedom of speech,” Frances wrote in the thread that included Ioannidis. Rather, he said, Cochrane is justifiably concerned about remaining an “impartial evaluator of evidence” and providing reliable information to doctors and their patients.\u003c/p>\n\u003cp>“At least in psychiatry, Peter is anything but impartial,” Frances wrote. “He consistently expresses the most extreme views in the most dramatic and misleading way. His role at Cochrane lends its legitimacy to opinions that are dangerous to patients with severe mental illness. As an individual, Peter has total freedom to express extreme opinions, but he has no inherent right to cloak them with Cochrane’s hard won mantle of neutrality.”\u003c/p>\n\u003cp>The four board members who resigned in the wake of the vote said in a statement Saturday that “the expulsion of inconvenient members from the Collaboration goes against Cochrane ethos and neither reflects its founding spirit nor promotes the Collaboration’s best interests. We are concerned that these actions might cause great damage to the reputation of the Collaboration.”\u003c/p>\n\u003cp>\u003ca href=\"https://www.cochrane.org/news/message-governing-board\" target=\"_blank\" rel=\"noopener\">In its own statement\u003c/a>, the governing board said that two other members had resigned because the “situation required further changes in the composition of the Board in order to comply with \u003ca href=\"https://www.cochrane.org/sites/default/files/public/uploads/cochrane_-_articles_of_association_-_final_and_approved_-_october_2016.pdf\" target=\"_blank\" rel=\"noopener\">Cochrane’s Articles of Association\u003c/a>.” Neither of the board’s co-chairs immediately responded to requests for comment.\u003c/p>\n\u003cp>“There appears to be no confidence in the management board at this point,” Jefferson said. “I think the only honorable thing for the rest of the board to do is resign.”\u003c/p>\n\u003cp>\u003cem>This story has been updated with a statement from Cochrane’s governing board. The story is a collaboration between STAT and \u003c/em>\u003ca href=\"https://retractionwatch.com/\" target=\"_blank\" rel=\"noopener\">\u003cem>Retraction Watch\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "For Older, Healthy People, Taking a Daily Aspirin Has No Benefit",
"title": "For Older, Healthy People, Taking a Daily Aspirin Has No Benefit",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Many healthy Americans take a baby aspirin every day to reduce their risk of having a heart attack, getting cancer and even possibly dementia. But is it really a good idea?[contextly_sidebar id=\"TeVgffLo8LYnxiLIJLovHnm2siFYHMFR\"]\u003c/p>\n\u003cp>Results released Sunday from a major \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1800722\" target=\"_blank\" rel=\"noopener\">study\u003c/a> of low-dose aspirin contain a disappointing answer for older, otherwise healthy people.\u003c/p>\n\u003cp>\"We found there was no discernible benefit of aspirin on prolonging independent, healthy life for the elderly,\" says \u003ca href=\"https://www.hennepinhealthcare.org/provider/anne-m-murray-md/\" target=\"_blank\" rel=\"noopener\">Anne Murray\u003c/a>, a geriatrician and epidemiologist at Hennepin Healthcare in Minneapolis, who helped lead the study.\u003c/p>\n\u003cp>The study involved more than 19,000 people ages 65 and older in the United States and Australia. The results were published in three papers in the \u003cem>New England Journal of Medicine.\u003c/em>\u003c/p>\n\u003cp>There is still strong evidence that a daily baby aspirin can \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/aspirin-to-prevent-cardiovascular-disease-and-cancer\" target=\"_blank\" rel=\"noopener\">reduce the risk\u003c/a> that many people who have already suffered a heart attack or stroke will suffer another attack.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>And there is some evidence that daily low-dose aspirin may help people younger than 70 who have at least a 10 percent risk of having a heart attack avoid a heart attack or stroke, according to the latest \u003ca href=\"https://www.npr.org/sections/health-shots/2015/09/15/440337151/panel-says-aspirin-lowers-heart-attack-risk-for-some-but-not-all\" target=\"_blank\" rel=\"noopener\">recommendations\u003c/a> from the U.S. Preventive Services Task Force.\u003c/p>\n\u003cp>But for older, healthy people, \"the risks outweigh the benefits for taking low-dose aspirin,\" Murray says.[contextly_sidebar id=\"06i7Zbzq5DlgqfooOTFa4lgjt6Ui9wr1\"]\u003c/p>\n\u003cp>The primary risk is bleeding. The study \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1805819\" target=\"_blank\" rel=\"noopener\">confirmed\u003c/a> that a daily baby aspirin increases the risk for serious, potentially life-threatening bleeding.\u003c/p>\n\u003cp>Surprisingly, those who took daily aspirin also appeared to be \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1803955\" target=\"_blank\" rel=\"noopener\">more likely\u003c/a> to die overall, apparently from an increased risk of succumbing to cancer. That was especially unexpected given previous evidence that aspirin might reduce the risk for colorectal cancer.\u003c/p>\n\u003cp>The researchers stressed, however, that the cancer finding might have been a fluke. There's also a possibility that any colorectal cancer benefit wasn't seen because the subjects had only been followed for about five years.\u003c/p>\n\u003cp>Regardless, the findings raise serious questions as to whether otherwise healthy older people should routinely take low-dose aspirin.\u003c/p>\n\u003cp>\"A lot of people read, 'Well, aspirin is good for people who have heart problems. Maybe I should take it, even if they haven't really had a heart attack,' \" Murray says. But \"for a long time there's been a need to establish appropriate criteria for when healthy people — elderly people — need aspirin.\"\u003c/p>\n\u003cp>That's why the researchers launched their study, called \u003ca href=\"https://www.aspree.org/\" target=\"_blank\" rel=\"noopener\">ASPREE\u003c/a>, in 2010. It involved 19,114 older people, with 16,703 in Australia and 2,411 in the United States. The U.S. portion included white volunteers ages 70 and older, and African-Americans and Hispanics subjects ages 65 and older.[contextly_sidebar id=\"lMIuMVSFXI9eLmCGzVINxi5SI7xGl6IV\"]\u003c/p>\n\u003cp>Participants took either 100 milligrams of aspirin every day or a placebo. People in the study were followed for an average of 4.7 years.\u003c/p>\n\u003cp>\"We were hoping that an inexpensive, very accessible medication might be something that we could recommend to elderly to maintain their independence but also decrease their risk of cardiovascular disease,\" Murray says.\u003c/p>\n\u003cp>But based on the findings, \u003ca href=\"https://www.nia.nih.gov/about/staff/hadley-evan\" target=\"_blank\" rel=\"noopener\">Dr. Evan Hadley\u003c/a> of the National Institute on Aging, which helped fund the study, says any elderly people taking aspirin or thinking about it should think twice.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"This gives pause and a reason for older people and their physician to think carefully about the decision whether to take low-dose aspirin regularly or not,\" Hadley says. \"And in many cases the right answer may be: Not.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Study%3A+A+Daily+Baby+Aspirin+Has+No+Benefit+For+Healthy+Older+People&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Many healthy Americans take a baby aspirin every day to reduce their risk of having a heart attack, getting cancer and even possibly dementia. But is it really a good idea?\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Results released Sunday from a major \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1800722\" target=\"_blank\" rel=\"noopener\">study\u003c/a> of low-dose aspirin contain a disappointing answer for older, otherwise healthy people.\u003c/p>\n\u003cp>\"We found there was no discernible benefit of aspirin on prolonging independent, healthy life for the elderly,\" says \u003ca href=\"https://www.hennepinhealthcare.org/provider/anne-m-murray-md/\" target=\"_blank\" rel=\"noopener\">Anne Murray\u003c/a>, a geriatrician and epidemiologist at Hennepin Healthcare in Minneapolis, who helped lead the study.\u003c/p>\n\u003cp>The study involved more than 19,000 people ages 65 and older in the United States and Australia. The results were published in three papers in the \u003cem>New England Journal of Medicine.\u003c/em>\u003c/p>\n\u003cp>There is still strong evidence that a daily baby aspirin can \u003ca href=\"https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/aspirin-to-prevent-cardiovascular-disease-and-cancer\" target=\"_blank\" rel=\"noopener\">reduce the risk\u003c/a> that many people who have already suffered a heart attack or stroke will suffer another attack.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And there is some evidence that daily low-dose aspirin may help people younger than 70 who have at least a 10 percent risk of having a heart attack avoid a heart attack or stroke, according to the latest \u003ca href=\"https://www.npr.org/sections/health-shots/2015/09/15/440337151/panel-says-aspirin-lowers-heart-attack-risk-for-some-but-not-all\" target=\"_blank\" rel=\"noopener\">recommendations\u003c/a> from the U.S. Preventive Services Task Force.\u003c/p>\n\u003cp>But for older, healthy people, \"the risks outweigh the benefits for taking low-dose aspirin,\" Murray says.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The primary risk is bleeding. The study \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1805819\" target=\"_blank\" rel=\"noopener\">confirmed\u003c/a> that a daily baby aspirin increases the risk for serious, potentially life-threatening bleeding.\u003c/p>\n\u003cp>Surprisingly, those who took daily aspirin also appeared to be \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1803955\" target=\"_blank\" rel=\"noopener\">more likely\u003c/a> to die overall, apparently from an increased risk of succumbing to cancer. That was especially unexpected given previous evidence that aspirin might reduce the risk for colorectal cancer.\u003c/p>\n\u003cp>The researchers stressed, however, that the cancer finding might have been a fluke. There's also a possibility that any colorectal cancer benefit wasn't seen because the subjects had only been followed for about five years.\u003c/p>\n\u003cp>Regardless, the findings raise serious questions as to whether otherwise healthy older people should routinely take low-dose aspirin.\u003c/p>\n\u003cp>\"A lot of people read, 'Well, aspirin is good for people who have heart problems. Maybe I should take it, even if they haven't really had a heart attack,' \" Murray says. But \"for a long time there's been a need to establish appropriate criteria for when healthy people — elderly people — need aspirin.\"\u003c/p>\n\u003cp>That's why the researchers launched their study, called \u003ca href=\"https://www.aspree.org/\" target=\"_blank\" rel=\"noopener\">ASPREE\u003c/a>, in 2010. It involved 19,114 older people, with 16,703 in Australia and 2,411 in the United States. The U.S. portion included white volunteers ages 70 and older, and African-Americans and Hispanics subjects ages 65 and older.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Participants took either 100 milligrams of aspirin every day or a placebo. People in the study were followed for an average of 4.7 years.\u003c/p>\n\u003cp>\"We were hoping that an inexpensive, very accessible medication might be something that we could recommend to elderly to maintain their independence but also decrease their risk of cardiovascular disease,\" Murray says.\u003c/p>\n\u003cp>But based on the findings, \u003ca href=\"https://www.nia.nih.gov/about/staff/hadley-evan\" target=\"_blank\" rel=\"noopener\">Dr. Evan Hadley\u003c/a> of the National Institute on Aging, which helped fund the study, says any elderly people taking aspirin or thinking about it should think twice.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"This gives pause and a reason for older people and their physician to think carefully about the decision whether to take low-dose aspirin regularly or not,\" Hadley says. \"And in many cases the right answer may be: Not.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Study%3A+A+Daily+Baby+Aspirin+Has+No+Benefit+For+Healthy+Older+People&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "'Germ Theory' of Alzheimer's May Trigger a Seismic Shift in Treatment",
"title": "'Germ Theory' of Alzheimer's May Trigger a Seismic Shift in Treatment",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Dr. Leslie Norins is willing to hand over $1 million of his own money to anyone who can clarify something: Is Alzheimer's disease, the most common form of dementia worldwide, caused by a germ?[contextly_sidebar id=\"MVU0oAlLJAOY5cRLFm8SgRXzH5ufmBIa\"]\u003c/p>\n\u003cp>By \"germ\" he means microbes like bacteria, viruses, fungi and parasites. In other words, Norins, a physician turned publisher, wants to know if Alzheimer's is infectious.\u003c/p>\n\u003cp>It's an idea that just a few years ago would've seemed to many an easy way to drain your research budget on bunk science. Money has poured into Alzheimer's research for years, but until very recently not much of it went toward investigating infection in causing dementia.\u003c/p>\n\u003cp>But this \"germ theory\" of Alzheimer's, as Norins calls it, has been fermenting in the literature for decades. Even early 20th century Czech physician Oskar Fischer — who, along with his German contemporary Dr. Alois Alzheimer, was integral in first describing the condition — noted a possible connection between the newly identified dementia and tuberculosis.\u003c/p>\n\u003cp>If the germ theory gets traction, even in some Alzheimer's patients, it could trigger a seismic shift in how doctors understand and treat the disease.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For instance, would we see a day when dementia is prevented with a vaccine, or treated with antibiotics and antiviral medications? Norins thinks it's worth looking into.\u003c/p>\n\u003cp>Norins received his medical degree from Duke in the early 1960s, and after a stint at the Centers for Disease Control and Prevention he fell into a lucrative career in medical publishing. He eventually settled in an admittedly aged community in Naples, Fla., where he took an interest in dementia and began reading up on the condition.[contextly_sidebar id=\"Xrb4XR0KXYySlI7ldjHh45GWXuqxKcIS\"]\u003c/p>\n\u003cp>After scouring the medical literature he noticed a pattern.\u003c/p>\n\u003cp>\"It appeared that many of the reported characteristics of Alzheimer's disease were compatible with an infectious process,\" Norins tells NPR. \"I thought for sure this must have already been investigated, because \u003ca href=\"http://act.alz.org/site/DocServer/2015_Appropriations_Fact_Sheet__FY16_.pdf?docID=3641\" target=\"_blank\" rel=\"noopener\">millions and millions of dollars\u003c/a> have been spent on Alzheimer's research.\"\u003c/p>\n\u003cp>But aside from scattered interest through the decades, this wasn't the case.\u003c/p>\n\u003cp>In 2017, Norins launched \u003ca href=\"https://alzgerm.org/about/\" target=\"_blank\" rel=\"noopener\">Alzheimer's Germ Quest Inc.\u003c/a>, a public benefit corporation he hopes will drive interest into the germ theory of Alzheimer's, and through which his prize will be distributed. A white paper he penned for the site reads: \"From a two-year review of the scientific literature, I believe it's now clear that just one germ — identity not yet specified, and possibly not yet discovered — causes most AD. I'm calling it the 'Alzheimer's Germ.' \"\u003c/p>\n\u003cp>Norins is quick to cite sources and studies supporting his claim, among them a 2010 study published in the \u003cem>Journal of Neurosurgery\u003c/em> showing that \u003ca href=\"http://thejns.org/doi/pdf/10.3171/2010.1.JNS091740\" target=\"_blank\" rel=\"noopener\">neurosurgeons die from Alzheimer's at a seven-fold higher rate\u003c/a> than they do from other disorders.\u003c/p>\n\u003cp>Another study from that same year, published in The \u003cem>Journal of the American Geriatric Society,\u003c/em> found that people whose \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/20722820/\" target=\"_blank\" rel=\"noopener\">spouses have dementia are at a six-times greater risk\u003c/a> for the condition themselves.\u003c/p>\n\u003cp>Contagion does come to mind. And Norins isn't alone in his thinking.\u003c/p>\n\u003cp>In 2016, 32 researchers from universities around the world signed an editorial in the \u003cem>Journal of Alzheimer's Disease\u003c/em> calling for \"further research on the role of infectious agents in [Alzheimer's] causation.\" Based on much of the same evidence Norins encountered, the authors concluded that clinical trials with antimicrobial drugs in Alzheimer's are now justified.[contextly_sidebar id=\"TlULmPwfIfLNT30W6fAdCGOQeBCymn7e\"]\u003c/p>\n\u003cp>NPR reported on an intriguing \u003ca href=\"https://www.npr.org/sections/health-shots/2018/06/21/621908340/researchers-find-herpes-viruses-in-brains-marked-by-alzheimers-disease\" target=\"_blank\" rel=\"noopener\">study\u003c/a> published in \u003cem>Neuron\u003c/em> in June that suggested that viral infection can influence the progression of Alzheimer's. Led by Mount Sinai genetics professor Joel Dudley, the work was intended to compare the genomes of healthy brain tissue with that affected by dementia.\u003c/p>\n\u003cp>But something kept getting in the way: herpes.\u003c/p>\n\u003cp>Dudley's team noticed an unexpectedly high level of viral DNA from two human herpes viruses, HHV-6 and HHV-7. The viruses are common and cause a rash called roseola in young children (not the sexually transmitted disease caused by other strains).\u003c/p>\n\u003cp>Some viruses have the ability to lie dormant in our neurons for decades by incorporating their genomes into our own. The classic example is chickenpox: A childhood viral infection resolves and lurks silently, returning years later as \u003ca href=\"https://www.cdc.gov/shingles/about/symptoms.html\" target=\"_blank\" rel=\"noopener\">shingles\u003c/a>, an excruciating rash. Like it or not, nearly all of us are chimeras with viral DNA speckling our genomes.\u003c/p>\n\u003cp>But having the herpes viruses alone doesn't mean inevitable brain decline. After all, up to 75 percent of us may \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/11285567\" target=\"_blank\" rel=\"noopener\">harbor HHV-6\u003c/a> .\u003c/p>\n\u003cp>But Dudley also noticed that herpes appeared to interact with human genes known to increase Alzheimer's risk. Perhaps, he says, there is some toxic combination of genetic and infectious influence that results in the disease; a combination that sparks what some feel is the main contributor to the disease, an overactive immune system.\u003c/p>\n\u003cp>The hallmark pathology of Alzheimer's is accumulation of a protein called amyloid in the brain. Many researchers have assumed these aggregates, or plaques, are simply a byproduct of some other process at the core of the disease. Other scientists posit that the protein itself contributes to the condition in some way.\u003c/p>\n\u003cp>The theory that amyloid is the root cause of Alzheimer's is losing steam. But the protein may still contribute to the disease, even if it winds up being deemed infectious.[contextly_sidebar id=\"reNe9dG45Jm18II65oxyuE0ETmculfjN\"]\u003c/p>\n\u003cp>Work by Harvard neuroscientist Rudolph Tanzi suggests it might be a bit of both. Along with colleague Robert Moir, Tanzi has shown that amyloid is lethal to viruses and bacteria in the test tube, and also in mice. He now believes the protein is part of our ancient immune system that like antibodies, ramps up its activity to help fend off unwanted bugs.\u003c/p>\n\u003cp>So does that mean that the microbe is the cause of Alzheimer's, and amyloid a harmless reaction to it? According to Tanzi it's not that simple.\u003c/p>\n\u003cp>Tanzi believes that in many cases of Alzheimer's, microbes are probably the initial seed that sets off a toxic tumble of molecular dominoes. Early in the disease amyloid protein builds up to fight infection, yet too much of the protein begins to impair function of neurons in the brain. The excess amyloid then causes another protein, called tau, to form tangles, which further harm brain cells.\u003c/p>\n\u003cp>But as Tanzi explains, the ultimate neurological insult in Alzheimer's is the body's reaction to this neurotoxic mess. All the excess protein revs up the immune system, causing inflammation — and it's this inflammation that does the most damage to the Alzheimer's-afflicted brain.\u003c/p>\n\u003cp>So what does this say about the future of treatment? Possibly a lot. Tanzi envisions a day when people are screened at, say, 50 years old. \"If their brains are riddled with too much amyloid,\" he says, \"we knock it down a bit with antiviral medications. It's just like how you are prescribed preventative drugs if your cholesterol is too high.\"\u003c/p>\n\u003cp>Tanzi feels that microbes are just one possible seed for the complex pathology behind Alzheimer's. Genetics may also play a role, as certain genes produce a type of amyloid more prone to clumping up. He also feels environmental factors like pollution might contribute.\u003c/p>\n\u003cp>Dr. James Burke, professor of medicine and psychiatry at Duke University's Alzheimer's Disease Research Center, isn't willing to abandon the amyloid theory altogether, but agrees it's time for the field to move on. \"There may be many roads to developing Alzheimer's disease and it would be shortsighted to focus just on amyloid and tau,\" he says. \"A million-dollar prize is attention- getting, but the reward for identifying a treatable target to delay or prevent Alzheimer's disease is invaluable.\"[contextly_sidebar id=\"VDtvU3haNd1M74SuCUvVZuAz4hFEV5iO\"]\u003c/p>\n\u003cp>Any treatment that disrupts the cascade leading to amyloid, tau and inflammation could theoretically benefit an at-risk brain. The vast majority of Alzheimer's treatment trials have failed, including many targeting amyloid. But it could be that the patients included were too far along in their disease to reap any therapeutic benefit.\u003c/p>\n\u003cp>If a microbe is responsible for all or some cases of Alzheimer's, perhaps future treatments or preventive approaches will prevent toxin protein buildup in the first place. Both Tanzi and Norins believe Alzheimer's vaccines against viruses like herpes might one day become common practice.\u003c/p>\n\u003cp>In July of this year, in collaboration with Norins, the Infectious Diseases Society of America announced that they plan to offer two $50,000 grants supporting research into a microbial association with Alzheimer's. According to Norins, this is the first acknowledgement by a leading infectious disease group that Alzheimer's may be microbial in nature – or at least that it's worth exploring.\u003c/p>\n\u003cp>\"The important thing is not the amount of the money, which is a pittance compared with the $2 billion NIH spends on amyloid and tau research,\" says Norins, \"but rather the respectability and more mainstream status the grants confer on investigating of the infectious possibility. Remember when we thought ulcers were caused by stress?\"\u003c/p>\n\u003cp>Ulcers, we now know, are \u003ca href=\"https://www.nobelprize.org/prizes/medicine/2005/press-release/\" target=\"_blank\" rel=\"noopener\">caused by a germ\u003c/a>.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Bret Stetka is a writer based in New York and an editorial director at \u003c/em>\u003ca href=\"http://www.medscape.com/public/bios/bio-bretstetka\">Medscape\u003c/a>.\u003cem> His work has appeared in \u003c/em>Wired, Scientific American\u003cem> and on The Atlantic.com. He graduated from the University of Virginia School of Medicine. He's also on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/BretStetka\" target=\"_blank\" rel=\"noopener\">@BretStetka\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Infectious+Theory+Of+Alzheimer%27s+Disease+Draws+Fresh+Interest&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dr. Leslie Norins is willing to hand over $1 million of his own money to anyone who can clarify something: Is Alzheimer's disease, the most common form of dementia worldwide, caused by a germ?\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>By \"germ\" he means microbes like bacteria, viruses, fungi and parasites. In other words, Norins, a physician turned publisher, wants to know if Alzheimer's is infectious.\u003c/p>\n\u003cp>It's an idea that just a few years ago would've seemed to many an easy way to drain your research budget on bunk science. Money has poured into Alzheimer's research for years, but until very recently not much of it went toward investigating infection in causing dementia.\u003c/p>\n\u003cp>But this \"germ theory\" of Alzheimer's, as Norins calls it, has been fermenting in the literature for decades. Even early 20th century Czech physician Oskar Fischer — who, along with his German contemporary Dr. Alois Alzheimer, was integral in first describing the condition — noted a possible connection between the newly identified dementia and tuberculosis.\u003c/p>\n\u003cp>If the germ theory gets traction, even in some Alzheimer's patients, it could trigger a seismic shift in how doctors understand and treat the disease.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For instance, would we see a day when dementia is prevented with a vaccine, or treated with antibiotics and antiviral medications? Norins thinks it's worth looking into.\u003c/p>\n\u003cp>Norins received his medical degree from Duke in the early 1960s, and after a stint at the Centers for Disease Control and Prevention he fell into a lucrative career in medical publishing. He eventually settled in an admittedly aged community in Naples, Fla., where he took an interest in dementia and began reading up on the condition.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>After scouring the medical literature he noticed a pattern.\u003c/p>\n\u003cp>\"It appeared that many of the reported characteristics of Alzheimer's disease were compatible with an infectious process,\" Norins tells NPR. \"I thought for sure this must have already been investigated, because \u003ca href=\"http://act.alz.org/site/DocServer/2015_Appropriations_Fact_Sheet__FY16_.pdf?docID=3641\" target=\"_blank\" rel=\"noopener\">millions and millions of dollars\u003c/a> have been spent on Alzheimer's research.\"\u003c/p>\n\u003cp>But aside from scattered interest through the decades, this wasn't the case.\u003c/p>\n\u003cp>In 2017, Norins launched \u003ca href=\"https://alzgerm.org/about/\" target=\"_blank\" rel=\"noopener\">Alzheimer's Germ Quest Inc.\u003c/a>, a public benefit corporation he hopes will drive interest into the germ theory of Alzheimer's, and through which his prize will be distributed. A white paper he penned for the site reads: \"From a two-year review of the scientific literature, I believe it's now clear that just one germ — identity not yet specified, and possibly not yet discovered — causes most AD. I'm calling it the 'Alzheimer's Germ.' \"\u003c/p>\n\u003cp>Norins is quick to cite sources and studies supporting his claim, among them a 2010 study published in the \u003cem>Journal of Neurosurgery\u003c/em> showing that \u003ca href=\"http://thejns.org/doi/pdf/10.3171/2010.1.JNS091740\" target=\"_blank\" rel=\"noopener\">neurosurgeons die from Alzheimer's at a seven-fold higher rate\u003c/a> than they do from other disorders.\u003c/p>\n\u003cp>Another study from that same year, published in The \u003cem>Journal of the American Geriatric Society,\u003c/em> found that people whose \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/20722820/\" target=\"_blank\" rel=\"noopener\">spouses have dementia are at a six-times greater risk\u003c/a> for the condition themselves.\u003c/p>\n\u003cp>Contagion does come to mind. And Norins isn't alone in his thinking.\u003c/p>\n\u003cp>In 2016, 32 researchers from universities around the world signed an editorial in the \u003cem>Journal of Alzheimer's Disease\u003c/em> calling for \"further research on the role of infectious agents in [Alzheimer's] causation.\" Based on much of the same evidence Norins encountered, the authors concluded that clinical trials with antimicrobial drugs in Alzheimer's are now justified.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>NPR reported on an intriguing \u003ca href=\"https://www.npr.org/sections/health-shots/2018/06/21/621908340/researchers-find-herpes-viruses-in-brains-marked-by-alzheimers-disease\" target=\"_blank\" rel=\"noopener\">study\u003c/a> published in \u003cem>Neuron\u003c/em> in June that suggested that viral infection can influence the progression of Alzheimer's. Led by Mount Sinai genetics professor Joel Dudley, the work was intended to compare the genomes of healthy brain tissue with that affected by dementia.\u003c/p>\n\u003cp>But something kept getting in the way: herpes.\u003c/p>\n\u003cp>Dudley's team noticed an unexpectedly high level of viral DNA from two human herpes viruses, HHV-6 and HHV-7. The viruses are common and cause a rash called roseola in young children (not the sexually transmitted disease caused by other strains).\u003c/p>\n\u003cp>Some viruses have the ability to lie dormant in our neurons for decades by incorporating their genomes into our own. The classic example is chickenpox: A childhood viral infection resolves and lurks silently, returning years later as \u003ca href=\"https://www.cdc.gov/shingles/about/symptoms.html\" target=\"_blank\" rel=\"noopener\">shingles\u003c/a>, an excruciating rash. Like it or not, nearly all of us are chimeras with viral DNA speckling our genomes.\u003c/p>\n\u003cp>But having the herpes viruses alone doesn't mean inevitable brain decline. After all, up to 75 percent of us may \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/11285567\" target=\"_blank\" rel=\"noopener\">harbor HHV-6\u003c/a> .\u003c/p>\n\u003cp>But Dudley also noticed that herpes appeared to interact with human genes known to increase Alzheimer's risk. Perhaps, he says, there is some toxic combination of genetic and infectious influence that results in the disease; a combination that sparks what some feel is the main contributor to the disease, an overactive immune system.\u003c/p>\n\u003cp>The hallmark pathology of Alzheimer's is accumulation of a protein called amyloid in the brain. Many researchers have assumed these aggregates, or plaques, are simply a byproduct of some other process at the core of the disease. Other scientists posit that the protein itself contributes to the condition in some way.\u003c/p>\n\u003cp>The theory that amyloid is the root cause of Alzheimer's is losing steam. But the protein may still contribute to the disease, even if it winds up being deemed infectious.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Work by Harvard neuroscientist Rudolph Tanzi suggests it might be a bit of both. Along with colleague Robert Moir, Tanzi has shown that amyloid is lethal to viruses and bacteria in the test tube, and also in mice. He now believes the protein is part of our ancient immune system that like antibodies, ramps up its activity to help fend off unwanted bugs.\u003c/p>\n\u003cp>So does that mean that the microbe is the cause of Alzheimer's, and amyloid a harmless reaction to it? According to Tanzi it's not that simple.\u003c/p>\n\u003cp>Tanzi believes that in many cases of Alzheimer's, microbes are probably the initial seed that sets off a toxic tumble of molecular dominoes. Early in the disease amyloid protein builds up to fight infection, yet too much of the protein begins to impair function of neurons in the brain. The excess amyloid then causes another protein, called tau, to form tangles, which further harm brain cells.\u003c/p>\n\u003cp>But as Tanzi explains, the ultimate neurological insult in Alzheimer's is the body's reaction to this neurotoxic mess. All the excess protein revs up the immune system, causing inflammation — and it's this inflammation that does the most damage to the Alzheimer's-afflicted brain.\u003c/p>\n\u003cp>So what does this say about the future of treatment? Possibly a lot. Tanzi envisions a day when people are screened at, say, 50 years old. \"If their brains are riddled with too much amyloid,\" he says, \"we knock it down a bit with antiviral medications. It's just like how you are prescribed preventative drugs if your cholesterol is too high.\"\u003c/p>\n\u003cp>Tanzi feels that microbes are just one possible seed for the complex pathology behind Alzheimer's. Genetics may also play a role, as certain genes produce a type of amyloid more prone to clumping up. He also feels environmental factors like pollution might contribute.\u003c/p>\n\u003cp>Dr. James Burke, professor of medicine and psychiatry at Duke University's Alzheimer's Disease Research Center, isn't willing to abandon the amyloid theory altogether, but agrees it's time for the field to move on. \"There may be many roads to developing Alzheimer's disease and it would be shortsighted to focus just on amyloid and tau,\" he says. \"A million-dollar prize is attention- getting, but the reward for identifying a treatable target to delay or prevent Alzheimer's disease is invaluable.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Any treatment that disrupts the cascade leading to amyloid, tau and inflammation could theoretically benefit an at-risk brain. The vast majority of Alzheimer's treatment trials have failed, including many targeting amyloid. But it could be that the patients included were too far along in their disease to reap any therapeutic benefit.\u003c/p>\n\u003cp>If a microbe is responsible for all or some cases of Alzheimer's, perhaps future treatments or preventive approaches will prevent toxin protein buildup in the first place. Both Tanzi and Norins believe Alzheimer's vaccines against viruses like herpes might one day become common practice.\u003c/p>\n\u003cp>In July of this year, in collaboration with Norins, the Infectious Diseases Society of America announced that they plan to offer two $50,000 grants supporting research into a microbial association with Alzheimer's. According to Norins, this is the first acknowledgement by a leading infectious disease group that Alzheimer's may be microbial in nature – or at least that it's worth exploring.\u003c/p>\n\u003cp>\"The important thing is not the amount of the money, which is a pittance compared with the $2 billion NIH spends on amyloid and tau research,\" says Norins, \"but rather the respectability and more mainstream status the grants confer on investigating of the infectious possibility. Remember when we thought ulcers were caused by stress?\"\u003c/p>\n\u003cp>Ulcers, we now know, are \u003ca href=\"https://www.nobelprize.org/prizes/medicine/2005/press-release/\" target=\"_blank\" rel=\"noopener\">caused by a germ\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Bret Stetka is a writer based in New York and an editorial director at \u003c/em>\u003ca href=\"http://www.medscape.com/public/bios/bio-bretstetka\">Medscape\u003c/a>.\u003cem> His work has appeared in \u003c/em>Wired, Scientific American\u003cem> and on The Atlantic.com. He graduated from the University of Virginia School of Medicine. He's also on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/BretStetka\" target=\"_blank\" rel=\"noopener\">@BretStetka\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Infectious+Theory+Of+Alzheimer%27s+Disease+Draws+Fresh+Interest&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Historic Gene Editing Attempt in First Human Off to a Positive Start",
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"content": "\u003cp>Early, partial results from a historic gene editing study give encouraging signs that the treatment may be safe and having at least some of its hoped-for effect, but it’s too soon to know whether it ultimately will succeed.[contextly_sidebar id=\"nLB0LaskunDkFSzX8O5LVSxfj3Ayt7CZ\"]\u003c/p>\n\u003cp>The results announced Wednesday are from the first human \u003ca href=\"//mps2study.com/study-overview/?pn=\">test\u003c/a> of gene editing in the body, an attempt to permanently change someone’s DNA to cure a disease — in this case, a genetic disorder called \u003ca href=\"https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Mucopolysaccharidoses-Fact-Sheet\">Hunter syndrome\u003c/a> that often kills people in their teens.\u003c/p>\n\u003cp>In two patients who got a medium dose of the treatment, urine levels of large sugar compounds that are hallmarks of Hunter syndrome had fallen by half, on average, four months later — a possible sign the treatment is working. Two others who got a low dose have seen little change in these sugars so far.\u003c/p>\n\u003cp>There’s no way to know yet whether the change in the middle-dose patients is due to the gene editing or something else, but the fact their sugars have declined consistently since treatment suggests it might be.\u003c/p>\n\u003cp>“I cannot absolutely say it’s a treatment effect” but the drop is “really encouraging,” said the study leader, Dr. Joseph Muenzer of the University of North Carolina, Chapel Hill. The main goal of early treatment studies is to test safety, though researchers also look for hints that the therapy is working. Muenzer gave the results at a conference in Greece and consults for the treatment’s maker, California-based Sangamo Therapeutics.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The company’s president, Dr. Sandy Macrae, said tests in about five months will reveal more, but the change in the middle-dose group so far “looks really good.”[contextly_sidebar id=\"FMPymRVSamCP4f8RpmzlwSdu0yioj0rt\"]\u003c/p>\n\u003cp>“The most rational explanation for this is that what we hoped was going to happen has happened,” he said.\u003c/p>\n\u003cp>Several independent experts agreed.\u003c/p>\n\u003cp>“The results are exciting” and suggest that the gene editing is working to some degree, without safety concerns so far, said Dr. Howard Kaufman, a Boston scientist and member of a National Institutes of Health panel that reviewed the study before it began.\u003c/p>\n\u003cp>Dr. Matthew Porteus, a genetics expert at Stanford University who consults for two other companies developing gene therapies, said more time is needed to see how the patients’ immune system continues to react to the treatment and whether the effects last, but added, “I would be excited about continuing to push along” based on these results.\u003c/p>\n\u003cp>\u003cstrong>How It Works\u003c/strong>\u003c/p>\n\u003cp>Gene editing is intended as a more precise way to do gene therapy, to knock out a bad gene or supply a good one that’s missing. Doctors hope it will give a way to address a host of diseases that can’t be treated well now.\u003c/p>\n\u003cp>In November, a Phoenix-area man with Hunter syndrome, Brian Madeux, became the first person to test this inside the body. He lacks a gene that makes an enzyme that breaks down certain large sugar compounds called GAGs. These build up in cells and cause havoc throughout the body.\u003c/p>\n\u003cp>Through an IV, Madeux received many copies of a corrective gene and a gene-editing tool called zinc finger nucleases to help put it in a precise spot in his DNA. He was one of the two patients given a very low dose of the treatment, because this first-in-human testing called for extreme caution.\u003c/p>\n\u003cp>\u003cstrong>Early Results\u003c/strong>\u003c/p>\n\u003cp>In Madeux and the other low-dose patient, levels of the tell-tale sugar compounds in urine rose 9 percent on average after four months. Muenzer said it’s hard to know whether this is a significant change; little is known about the biology of these compounds, including whether they fluctuate during the day or before or after meals.[contextly_sidebar id=\"g6IAb2xjtv0z0Te9cBhCwQAn8pi68Yxx\"]\u003c/p>\n\u003cp>A liver biopsy on one patient given a low dose of the therapy found no evidence that the gene editing had occurred, but Sangamo scientists said this dose is far below the level at which such signs had been detected in research on primates.\u003c/p>\n\u003cp>Two other patients were given a middle dose that was twice what the first two patients received. Their GAG levels declined by 51 percent after four months, on average. Two of the main types of these sugars that accumulate in tissues declined 32 percent and 61 percent, respectively.\u003c/p>\n\u003cp>It is not yet known if declines like these can improve patients’ health or slow the progression of the disease.\u003c/p>\n\u003cp>“This is not proof that this is a successful therapy yet, that these patients had enough gene editing to now supply them with the enzyme they need for the rest of their life,” Muenzer said.\u003c/p>\n\u003cp>But he said an important goal was met: the treatment seems safe. There were two serious side effects — one patient was hospitalized for bronchitis and another for an irregular heartbeat — but those were deemed due to their disease and pre-existing conditions, not the gene treatment.\u003c/p>\n\u003cp>Blood tests did not detect the missing enzyme. Company scientists said this could be because any that was being made was rapidly used by cells rather than getting into the bloodstream — an explanation some outside experts agreed with. What counts, they said, was seeing the result of enzyme activity, the drop in sugars.\u003c/p>\n\u003cp>\u003cstrong>Next Steps\u003c/strong>\u003c/p>\n\u003cp>Two more patients have been given the highest dose being tested — 10 times the starting dose — for a total of six patients in the study. The next step is to start taking patients off the weekly enzyme treatments they’ve been receiving to see if the gene therapy has changed their bodies so they make enough of the enzyme themselves.\u003c/p>\n\u003cp>More results are expected at a medical meeting in February.\u003c/p>\n\u003cp>“We need to see sustained levels for this to be practical. If this only works for six months, that’s not very beneficial,” Muenzer said. “Time’s going to tell.”\u003c/p>\n\u003cp>In an interview at his home in Arizona last month, Madeux, 45, told The Associated Press he volunteered for the study in hope of being able to stop the weekly, three-hour enzyme infusions, but also to help find a treatment for future generations with the disease.\u003c/p>\n\u003cp>“I’m old and having Hunter’s has done a lot of damage to my body,” Madeux said. “I’m actually pretty lucky I’ve lived this long.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The company’s president, Dr. Sandy Macrae, said tests in about five months will reveal more, but the change in the middle-dose group so far “looks really good.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“The most rational explanation for this is that what we hoped was going to happen has happened,” he said.\u003c/p>\n\u003cp>Several independent experts agreed.\u003c/p>\n\u003cp>“The results are exciting” and suggest that the gene editing is working to some degree, without safety concerns so far, said Dr. Howard Kaufman, a Boston scientist and member of a National Institutes of Health panel that reviewed the study before it began.\u003c/p>\n\u003cp>Dr. Matthew Porteus, a genetics expert at Stanford University who consults for two other companies developing gene therapies, said more time is needed to see how the patients’ immune system continues to react to the treatment and whether the effects last, but added, “I would be excited about continuing to push along” based on these results.\u003c/p>\n\u003cp>\u003cstrong>How It Works\u003c/strong>\u003c/p>\n\u003cp>Gene editing is intended as a more precise way to do gene therapy, to knock out a bad gene or supply a good one that’s missing. 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Muenzer said it’s hard to know whether this is a significant change; little is known about the biology of these compounds, including whether they fluctuate during the day or before or after meals.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>A liver biopsy on one patient given a low dose of the therapy found no evidence that the gene editing had occurred, but Sangamo scientists said this dose is far below the level at which such signs had been detected in research on primates.\u003c/p>\n\u003cp>Two other patients were given a middle dose that was twice what the first two patients received. Their GAG levels declined by 51 percent after four months, on average. Two of the main types of these sugars that accumulate in tissues declined 32 percent and 61 percent, respectively.\u003c/p>\n\u003cp>It is not yet known if declines like these can improve patients’ health or slow the progression of the disease.\u003c/p>\n\u003cp>“This is not proof that this is a successful therapy yet, that these patients had enough gene editing to now supply them with the enzyme they need for the rest of their life,” Muenzer said.\u003c/p>\n\u003cp>But he said an important goal was met: the treatment seems safe. There were two serious side effects — one patient was hospitalized for bronchitis and another for an irregular heartbeat — but those were deemed due to their disease and pre-existing conditions, not the gene treatment.\u003c/p>\n\u003cp>Blood tests did not detect the missing enzyme. Company scientists said this could be because any that was being made was rapidly used by cells rather than getting into the bloodstream — an explanation some outside experts agreed with. What counts, they said, was seeing the result of enzyme activity, the drop in sugars.\u003c/p>\n\u003cp>\u003cstrong>Next Steps\u003c/strong>\u003c/p>\n\u003cp>Two more patients have been given the highest dose being tested — 10 times the starting dose — for a total of six patients in the study. The next step is to start taking patients off the weekly enzyme treatments they’ve been receiving to see if the gene therapy has changed their bodies so they make enough of the enzyme themselves.\u003c/p>\n\u003cp>More results are expected at a medical meeting in February.\u003c/p>\n\u003cp>“We need to see sustained levels for this to be practical. If this only works for six months, that’s not very beneficial,” Muenzer said. “Time’s going to tell.”\u003c/p>\n\u003cp>In an interview at his home in Arizona last month, Madeux, 45, told The Associated Press he volunteered for the study in hope of being able to stop the weekly, three-hour enzyme infusions, but also to help find a treatment for future generations with the disease.\u003c/p>\n\u003cp>“I’m old and having Hunter’s has done a lot of damage to my body,” Madeux said. “I’m actually pretty lucky I’ve lived this long.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Why is a Consumer Group Fighting to Stop a Nationwide Study Of Sepsis?",
"title": "Why is a Consumer Group Fighting to Stop a Nationwide Study Of Sepsis?",
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"content": "\u003cp>A consumer advocacy organization is asking federal health officials Tuesday to halt a large medical study being conducted at major universities nationwide.\u003c/p>\n\u003cp>Public Citizen says that the study, involving treatment for \u003ca href=\"https://www.cdc.gov/sepsis/\" target=\"_blank\" rel=\"noopener\">sepsis,\u003c/a> puts patients at risk and will at best produce confusing results.\u003c/p>\n\u003cp>The \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03434028?term=NCT03434028&rank=1\" target=\"_blank\" rel=\"noopener\">CLOVERS study\u003c/a> seeks to answer a key question about sepsis, which is a common and life-threatening response to infection. Sepsis kills more than 250,000 Americans a year, often by triggering the failure of multiple organs. As patients' blood vessels get leaky as a result of sepsis, it becomes difficult to maintain safe fluid balance and blood pressure.\u003c/p>\n\u003cp>Doctors use a combination of IV fluids and blood-pressure medicines called vasopressors, such as epinephrine and norepinephrine, to manage this life-threatening complication. But there is no consensus about the best strategy. Some doctors prefer to give lots of fluids and use drugs sparingly; others take the opposite approach.\u003c/p>\n\u003cp>\"So, trying to find the sweet spot — or the 'Goldilocks place' — is important,\" says \u003ca href=\"http://www.surgery.emory.edu/about-us/faculty_directory/faculty_profile_craig_coopersmith.html\" target=\"_blank\" rel=\"noopener\">Dr. Craig Coopersmith\u003c/a>, director of the surgical transplant intensive care unit at Emory University Hospital and an expert on sepsis.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The CLOVERS trial is an attempt to find that sweet spot. Patients who volunteer for the study are put into one of two groups: One gets plentiful fluids; the other gets limited fluids and more medication. Unlike most research, this study lacks a control group — people who receive the typically given amounts of IV fluids and drugs — as a comparison.\u003c/p>\n\u003cp>\"The problem is, both of those experimental ways for treating sepsis may do worse,\" says \u003ca href=\"https://www.citizen.org/about/michael-carome-md\" target=\"_blank\" rel=\"noopener\">Dr. Michael Carome,\u003c/a> head of the Public Citizen Health Research Group, which has lodged a complaint with federal health officials.\u003c/p>\n\u003cp>\"There may be higher mortality rates for both groups compared to usual care,\" Carome says, and without a comparison group there's no way to tell.\u003c/p>\n\u003cp>And if people on one of these experimental treatments do better than those on the other, that doesn't mean it would be better than usual care, he says. This study can't answer that question.\u003c/p>\n\u003cp>Carome is also alarmed that, in certain unusual circumstances, the protocol calls for holding off on treating dangerously low blood pressure for several hours.\u003c/p>\n\u003cp>\"No one caring for a sepsis patient would normally do that as part of usual care,\" he says.\u003c/p>\n\u003cp>The study, designed at Harvard and funded by the National Institutes of Health, went through multiple reviews by people who concluded that it didn't pose an undue risk to patients.\u003c/p>\n\u003cp>\"But the fact that it got through these layers of review with these serious design flaws signals that our system for protecting human subjects is broken,\" Carome says.\u003c/p>\n\u003cp>Coopersmith, who is not involved with the CLOVERS study, reviewed Public Citizen's complaint at NPR's request. He doesn't share Carome's sense of alarm.\u003c/p>\n\u003cp>Coopersmith agrees that including a comparison group that received the standard of care would be a better study design.\u003c/p>\n\u003cp>But, \"there's no clear standard of care for the first 24 hours,\" he says. Standard protocols for sepsis treatment dictate what doctors should do during the first six hours of treatment only, whereas the CLOVERS study is guiding treatment over a longer time period.\u003c/p>\n\u003cp>He says he agrees with Carome that the study won't clearly show that one of these experimental treatments is better than a more middle-of-the road approach to fluids and blood pressure medication; so sepsis doctors won't get clear guidance from the results. But the findings might help nudge doctors in one direction or another, he says, if it helps resolve the question of what's better — limited fluids or a lot?\u003c/p>\n\u003cp>As for the concerns about how to deal with a patient with very low blood pressure, Coopersmith says, \"in a very narrow patient population for a narrow period of time, there is a theoretical chance that someone could have what I would consider to be too low a blood pressure.\"\u003c/p>\n\u003cp>If he were a doctor involved in this trial and encountered that, he says, he would deviate from the protocol and treat that patient with standard care. He expects his colleagues would do that as well.\u003c/p>\n\u003cp>The study isn't designed the way he would have done it, Coopersmith says, but, he \"would be comfortable enrolling patients in this trial.\"\u003c/p>\n\u003cp>\u003ca href=\"http://cvbr.hms.harvard.edu/researchers/shapiro.html\" target=\"_blank\" rel=\"noopener\">Dr. Nathan Shapiro\u003c/a>, a professor of Emergency Medicine at Harvard's Beth Israel Deaconess Medical Center and one of the principal investigators for the CLOVERS study, stands by it. He declined a request for an interview, but sent a written response to NPR.\u003c/p>\n\u003cp>\"The study protocol was designed by expert clinicians in emergency and critical care medicine representing nearly 50 hospitals in the United States and follows a well-accepted design,\" he writes.\u003c/p>\n\u003cp>A spokesperson for the federal \u003ca href=\"https://www.hhs.gov/ohrp/\" target=\"_blank\" rel=\"noopener\">Office for Human Research Protections\u003c/a> says the office has not yet seen the Public Citizen complaint, but will review the allegations.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Richard Harris can be reached at \u003c/em>\u003ca href=\"mailto:rharris@npr.org\" target=\"_blank\" rel=\"noopener\">\u003cem>rharris@npr.org\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Critics+Trying+To+Stop+A+Big+Study+Of+Sepsis+Say+The+Research+Puts+Patients+At+Risk&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "The consumer advocacy group Public Citizen also says the multicenter study of life-threatening sepsis will at best produce confusing results. A Harvard doctor and designer of the research disagrees.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A consumer advocacy organization is asking federal health officials Tuesday to halt a large medical study being conducted at major universities nationwide.\u003c/p>\n\u003cp>Public Citizen says that the study, involving treatment for \u003ca href=\"https://www.cdc.gov/sepsis/\" target=\"_blank\" rel=\"noopener\">sepsis,\u003c/a> puts patients at risk and will at best produce confusing results.\u003c/p>\n\u003cp>The \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03434028?term=NCT03434028&rank=1\" target=\"_blank\" rel=\"noopener\">CLOVERS study\u003c/a> seeks to answer a key question about sepsis, which is a common and life-threatening response to infection. Sepsis kills more than 250,000 Americans a year, often by triggering the failure of multiple organs. As patients' blood vessels get leaky as a result of sepsis, it becomes difficult to maintain safe fluid balance and blood pressure.\u003c/p>\n\u003cp>Doctors use a combination of IV fluids and blood-pressure medicines called vasopressors, such as epinephrine and norepinephrine, to manage this life-threatening complication. But there is no consensus about the best strategy. Some doctors prefer to give lots of fluids and use drugs sparingly; others take the opposite approach.\u003c/p>\n\u003cp>\"So, trying to find the sweet spot — or the 'Goldilocks place' — is important,\" says \u003ca href=\"http://www.surgery.emory.edu/about-us/faculty_directory/faculty_profile_craig_coopersmith.html\" target=\"_blank\" rel=\"noopener\">Dr. Craig Coopersmith\u003c/a>, director of the surgical transplant intensive care unit at Emory University Hospital and an expert on sepsis.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The CLOVERS trial is an attempt to find that sweet spot. Patients who volunteer for the study are put into one of two groups: One gets plentiful fluids; the other gets limited fluids and more medication. Unlike most research, this study lacks a control group — people who receive the typically given amounts of IV fluids and drugs — as a comparison.\u003c/p>\n\u003cp>\"The problem is, both of those experimental ways for treating sepsis may do worse,\" says \u003ca href=\"https://www.citizen.org/about/michael-carome-md\" target=\"_blank\" rel=\"noopener\">Dr. Michael Carome,\u003c/a> head of the Public Citizen Health Research Group, which has lodged a complaint with federal health officials.\u003c/p>\n\u003cp>\"There may be higher mortality rates for both groups compared to usual care,\" Carome says, and without a comparison group there's no way to tell.\u003c/p>\n\u003cp>And if people on one of these experimental treatments do better than those on the other, that doesn't mean it would be better than usual care, he says. This study can't answer that question.\u003c/p>\n\u003cp>Carome is also alarmed that, in certain unusual circumstances, the protocol calls for holding off on treating dangerously low blood pressure for several hours.\u003c/p>\n\u003cp>\"No one caring for a sepsis patient would normally do that as part of usual care,\" he says.\u003c/p>\n\u003cp>The study, designed at Harvard and funded by the National Institutes of Health, went through multiple reviews by people who concluded that it didn't pose an undue risk to patients.\u003c/p>\n\u003cp>\"But the fact that it got through these layers of review with these serious design flaws signals that our system for protecting human subjects is broken,\" Carome says.\u003c/p>\n\u003cp>Coopersmith, who is not involved with the CLOVERS study, reviewed Public Citizen's complaint at NPR's request. He doesn't share Carome's sense of alarm.\u003c/p>\n\u003cp>Coopersmith agrees that including a comparison group that received the standard of care would be a better study design.\u003c/p>\n\u003cp>But, \"there's no clear standard of care for the first 24 hours,\" he says. Standard protocols for sepsis treatment dictate what doctors should do during the first six hours of treatment only, whereas the CLOVERS study is guiding treatment over a longer time period.\u003c/p>\n\u003cp>He says he agrees with Carome that the study won't clearly show that one of these experimental treatments is better than a more middle-of-the road approach to fluids and blood pressure medication; so sepsis doctors won't get clear guidance from the results. But the findings might help nudge doctors in one direction or another, he says, if it helps resolve the question of what's better — limited fluids or a lot?\u003c/p>\n\u003cp>As for the concerns about how to deal with a patient with very low blood pressure, Coopersmith says, \"in a very narrow patient population for a narrow period of time, there is a theoretical chance that someone could have what I would consider to be too low a blood pressure.\"\u003c/p>\n\u003cp>If he were a doctor involved in this trial and encountered that, he says, he would deviate from the protocol and treat that patient with standard care. He expects his colleagues would do that as well.\u003c/p>\n\u003cp>The study isn't designed the way he would have done it, Coopersmith says, but, he \"would be comfortable enrolling patients in this trial.\"\u003c/p>\n\u003cp>\u003ca href=\"http://cvbr.hms.harvard.edu/researchers/shapiro.html\" target=\"_blank\" rel=\"noopener\">Dr. Nathan Shapiro\u003c/a>, a professor of Emergency Medicine at Harvard's Beth Israel Deaconess Medical Center and one of the principal investigators for the CLOVERS study, stands by it. He declined a request for an interview, but sent a written response to NPR.\u003c/p>\n\u003cp>\"The study protocol was designed by expert clinicians in emergency and critical care medicine representing nearly 50 hospitals in the United States and follows a well-accepted design,\" he writes.\u003c/p>\n\u003cp>A spokesperson for the federal \u003ca href=\"https://www.hhs.gov/ohrp/\" target=\"_blank\" rel=\"noopener\">Office for Human Research Protections\u003c/a> says the office has not yet seen the Public Citizen complaint, but will review the allegations.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Richard Harris can be reached at \u003c/em>\u003ca href=\"mailto:rharris@npr.org\" target=\"_blank\" rel=\"noopener\">\u003cem>rharris@npr.org\u003c/em>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Critics+Trying+To+Stop+A+Big+Study+Of+Sepsis+Say+The+Research+Puts+Patients+At+Risk&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Science is Finding Some Truth in ‘Microdosing’ Claims Touted by ’Shroomers and Reddit Users",
"title": "Science is Finding Some Truth in ‘Microdosing’ Claims Touted by ’Shroomers and Reddit Users",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Dennis van der Meijden isn’t aiming to see the face of God, feel one with the cosmos, grasp the hidden reality of time and space, or embark on a \u003ca href=\"https://www.amazon.com/Psychedelic-Explorers-Guide-Therapeutic-Journeys/dp/1594774021\" target=\"_blank\" rel=\"noopener\">sacred journey\u003c/a>. What the Dutch graphic designer, producer, and rapper (under the professional name Terilekst) wants — and gets — from his twice-weekly “microdoses” of psilocybin is more modest.[contextly_sidebar id=\"2u046KLqIpjlWqt95jSvMRrGksdXK55L\"]\u003c/p>\n\u003cp>“It sharpens all the senses, as if the frequencies of all of your atoms and energy field are raised a little bit and are being slightly more conscious,” said van der Meijden, 39, who told STAT he first microdosed psilocybin — the active ingredient in “magic mushrooms” — three years ago. It makes him energetic enough to skip coffee, “as if I’m kicked in some sort of orbit for that day.” If he becomes distracted, “I’m very much aware of that, as if seeing myself from a bird’s eye view, so I can correct myself very fast.” But van der Meijden says he’s careful not to exceed about 0.4 grams, because 0.5 made him “a bit too joyful and a bit too philosophical,” which wasn’t always appropriate.\u003c/p>\n\u003cp>Microdosing involves taking roughly one-tenth the “trip” dose of a psychedelic drug, an amount too little to trigger hallucinations but enough, its proponents say, to sharpen the mind. Psilocybin microdosers (including hundreds on Reddit) report that the mushrooms can increase creativity, calm anxiety, decrease the need for caffeine, and reduce depression. There is enough evidence that trip doses might have the latter effect that, on Wednesday, London-based Compass Pathways received Food and Drug Administration \u003ca href=\"https://markets.businessinsider.com/news/stocks/compass-pathways-receives-fda-approval-for-psilocybin-therapy-clinical-trial-for-treatment-resistant-depression-1027477289\" target=\"_blank\" rel=\"noopener\">approval\u003c/a> for a Phase 2B clinical trial of psilocybin (in larger-than-microdoses) for treatment-resistant depression. But research into microdosing is minimal.\u003c/p>\n\u003cp>In the nearly 10 years since psychologist and psychedelics researcher James Fadiman introduced the notion of microdosing and devised a widely followed \u003ca href=\"https://sites.google.com/view/microdosingpsychedelics/home\" target=\"_blank\" rel=\"noopener\">protocol\u003c/a> for it, and three years after microdosing psychedelics became the latest Silicon Valley “\u003ca href=\"https://www.forbes.com/sites/robertglatter/2015/11/27/lsd-microdosing-the-new-job-enhancer-in-silicon-valley-and-beyond/#8ece3fe188a8\" target=\"_blank\" rel=\"noopener\">productivity hack\u003c/a>,” all the evidence about its effects has been anecdotal. Psilocybin is illegal almost everywhere, so it’s been nearly impossible to study scientifically. That is changing, however, as the Netherlands and other countries effectively decriminalize it and scientists in places where it remains illegal obtain government permission to study it.[contextly_sidebar id=\"uhfAqZqMFWRdicHoQZb7cSTv52omgvqK\"]\u003c/p>\n\u003cp>The scientific interest is driven, in part, by numerous reports over the years that psilocybin might have antidepressant or anti-anxiety effects that might guide the development of better psychiatric drugs. But it also reflects an itch to see whether there is any basis for the anecdotal accounts. Now, in the first \u003ca href=\"https://www.biorxiv.org/content/early/2018/08/11/384412\" target=\"_blank\" rel=\"noopener\">study\u003c/a> of its kind, scientists in the Netherlands found that psilocybin microdoses have no noticeable effect on the problem-solving, rational-thinking, and abstract-reasoning ability called fluid intelligence. But they do seem to improve two forms of thinking that underlie creativity.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Performance was significantly higher” on tests of convergent and divergent thinking, said psychologist Bernhard Hommel of Leiden University in the Netherlands, who led the study. Convergent thinking is the ability to focus on abstract concepts to identify a single solution to a well-defined problem. Divergent thinking requires meandering mental forays and mental flexibility. Psychologists consider both to be ingredients of creativity.\u003c/p>\n\u003cp>Whatever the dose, psilocybin (O-phosphoryl-4-hydroxy-N, N-dimethyltryptamine) binds to receptors for the neurotransmitter serotonin. The cortex is packed with these 5-HT2A receptors, especially in areas that control reflection, imagination, and introspection, but “whether there is a minimum dose [of psilocybin that’s required to activate them] is an empirical question that we try to tackle,” Hommel said.\u003c/p>\n\u003cp>To do so, he and his colleagues zeroed in on the effects that many users report: creativity, problem-solving, and the “cognitive flexibility” deemed crucial to both. Leiden’s Luisa Prochazkova took the lead in inviting members of the Psychedelic Society of the Netherlands to participate in the study; she got 38 takers.\u003c/p>\n\u003cp>Before their microdose, the volunteers took three standard psychological tests, two related to creative problem-solving and one an assessment of fluid intelligence. The scientists ran chemical analyses of the mushroom samples to determine how much psilocybin they contained. Since a trip dose is about 3 grams of dried ’shrooms, a microdose is around 0.33 grams. Participants averaged 0.37 grams of the dried preparation, which can be taken with food or packed into gelcaps for easy swallowing.\u003c/p>\n\u003cp>About 90 minutes after the microdose, the participants took the three tests again.\u003c/p>\n\u003cp>In the Picture Concept Task, they saw three rows of three pictures, and had to choose three — one from each row — that were related. That requires converging on the correct solution, like noticing that a bathtub, a sink, and a hose all have something to do with water. The brain must focus, weigh alternatives, and reject wrong ones.\u003c/p>\n\u003cp>In the Alternate Uses Task, the microdosers had five minutes to think of ways to use a pen (tracheotomy? finger splint?) or towel. That measures divergent thinking, to move thoughts away from writing, for example, in the case of the pen.\u003c/p>\n\u003cp>The microdosers also took a “progressive matrices” test: In blocks of two-by-two or three-by-three patterns, with the bottom right one missing, they had to choose which of six possibilities belonged in the blank square — a task that requires fluid intelligence.\u003c/p>\n\u003cp>The scientists found no post-microdose difference on the fluid intelligence test. But after microdosing, performance on the picture concept test was significantly higher (an average score of 7.6) than before (6.6). That suggested an improvement in the convergent thinking element of creativity.\u003c/p>\n\u003cp>The microdosers also came up with significantly more uses for pens and towels, 16.7 vs. 14.7. That suggests a microdose of psilocybin “allowed participants to create more out-of-the-box alternative solutions for a problem,” the scientists wrote. Taken together, the three findings suggest a specific effect of psilocybin microdoses on creativity but not on fluid intelligence.\u003c/p>\n\u003cp>For van der Meijden, a microdose of psilocybin makes his musical brainstorm sessions yield “more concepts, ideas, and solutions,” he said, partly because it lets him “better understand and visualize other people’s concepts.” In his design and illustration work, it produces a “more natural flow of line drawing” and lets him “see more possibilities in how things can be or look.” In his music, it lets him “analyze all the different instruments better” and know, for instance, whether to turn up or down the reverberation effect.\u003c/p>\n\u003cp>The Dutch study, which was published on a preprint site and has not undergone peer review at a journal, has several caveats. For one thing, having seen a test before might make people better at it. More problematic, the study didn’t have a control group of people who took something other than psilocybin. That leaves open the possibility that it wasn’t the compound that improved some forms of thinking, but the expectation that it would do so. Maybe people who microdose believe in its benefits enough to make those expectations reality.\u003c/p>\n\u003cp>On the other hand, the results fit with another new \u003ca href=\"https://www.biorxiv.org/content/early/2018/07/25/376491\" target=\"_blank\" rel=\"noopener\">study\u003c/a> of psilocybin. In this one, scientists led by computational neuroscientist Joana Cabral of the University of Oxford used fMRI scans to study the brain activity of nine people who volunteered to be injected with 2 milligram (trip-inducing) doses. The chemical changed the functional connectivity of various brain regions, so that activity in one became synced with that in another. In particular, the rational, logical, well-behaved frontoparietal regions became “strongly destabilized,” the scientists reported, melding with activity in emotional and other regions to produce “unconstrained consciousness,” “mind wandering,” and a sense that everything is connected to everything else. Seeing connections that elude other people is almost the definition of creativity.\u003c/p>\n\u003cp>The findings in the microdosing study also fit with many anecdotal reports. One college student who is a member of the Portland, Ore., microdosing community said that although he doesn’t microdose psilocybin with the express purpose of boosting creativity or focus, he has found that “things seem to have quieted down, in terms of racing thoughts.” He can still be distracted, said Alex, 38, who asked not to be further identified because the drug is illegal in the U.S. But “if I want to go about doing something, then I have an easier time with it because I’m not being bogged down by my thoughts,” he added.\u003c/p>\n\u003cp>Jakobien van der Weijden takes one psilocybin microdose every three days, with bimonthly breaks, “to work more focused, more efficiently and be more creative” at his marketing job in the Netherlands, he said. “On the downside, I would often feel that the inspiration was still there at night and I would keep working on projects until late. So it was somewhat more difficult to maintain a healthy biorhythm.”\u003c/p>\n\u003cp>As legal strictures loosen, there will likely be more rigorous studies of microdosing psilocybin. “Scientific studies could legitimize the claimed benefits,” said Will Burns, CEO of Wenham, Mass.-based \u003ca href=\"http://www.ideasicle.com/\" target=\"_blank\" rel=\"noopener\">Ideasicle\u003c/a>, which develops branding and marketing ideas. He does not microdose, Burns said, but has \u003ca href=\"https://www.forbes.com/sites/willburns/2015/11/29/lsd-microdosing-deserves-more-serious-research/#6824b00d656d\" target=\"_blank\" rel=\"noopener\">called for\u003c/a> research into its purported effects, including improving productivity and creativity. “Right now, we’re swimming in a world of anecdotes and almost no one has taken this seriously,” he said. “We need scientific studies.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2018/08/23/science-testing-claimed-benefits-of-psilocybin-microdosing/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dennis van der Meijden isn’t aiming to see the face of God, feel one with the cosmos, grasp the hidden reality of time and space, or embark on a \u003ca href=\"https://www.amazon.com/Psychedelic-Explorers-Guide-Therapeutic-Journeys/dp/1594774021\" target=\"_blank\" rel=\"noopener\">sacred journey\u003c/a>. What the Dutch graphic designer, producer, and rapper (under the professional name Terilekst) wants — and gets — from his twice-weekly “microdoses” of psilocybin is more modest.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“It sharpens all the senses, as if the frequencies of all of your atoms and energy field are raised a little bit and are being slightly more conscious,” said van der Meijden, 39, who told STAT he first microdosed psilocybin — the active ingredient in “magic mushrooms” — three years ago. It makes him energetic enough to skip coffee, “as if I’m kicked in some sort of orbit for that day.” If he becomes distracted, “I’m very much aware of that, as if seeing myself from a bird’s eye view, so I can correct myself very fast.” But van der Meijden says he’s careful not to exceed about 0.4 grams, because 0.5 made him “a bit too joyful and a bit too philosophical,” which wasn’t always appropriate.\u003c/p>\n\u003cp>Microdosing involves taking roughly one-tenth the “trip” dose of a psychedelic drug, an amount too little to trigger hallucinations but enough, its proponents say, to sharpen the mind. Psilocybin microdosers (including hundreds on Reddit) report that the mushrooms can increase creativity, calm anxiety, decrease the need for caffeine, and reduce depression. There is enough evidence that trip doses might have the latter effect that, on Wednesday, London-based Compass Pathways received Food and Drug Administration \u003ca href=\"https://markets.businessinsider.com/news/stocks/compass-pathways-receives-fda-approval-for-psilocybin-therapy-clinical-trial-for-treatment-resistant-depression-1027477289\" target=\"_blank\" rel=\"noopener\">approval\u003c/a> for a Phase 2B clinical trial of psilocybin (in larger-than-microdoses) for treatment-resistant depression. But research into microdosing is minimal.\u003c/p>\n\u003cp>In the nearly 10 years since psychologist and psychedelics researcher James Fadiman introduced the notion of microdosing and devised a widely followed \u003ca href=\"https://sites.google.com/view/microdosingpsychedelics/home\" target=\"_blank\" rel=\"noopener\">protocol\u003c/a> for it, and three years after microdosing psychedelics became the latest Silicon Valley “\u003ca href=\"https://www.forbes.com/sites/robertglatter/2015/11/27/lsd-microdosing-the-new-job-enhancer-in-silicon-valley-and-beyond/#8ece3fe188a8\" target=\"_blank\" rel=\"noopener\">productivity hack\u003c/a>,” all the evidence about its effects has been anecdotal. Psilocybin is illegal almost everywhere, so it’s been nearly impossible to study scientifically. That is changing, however, as the Netherlands and other countries effectively decriminalize it and scientists in places where it remains illegal obtain government permission to study it.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The scientific interest is driven, in part, by numerous reports over the years that psilocybin might have antidepressant or anti-anxiety effects that might guide the development of better psychiatric drugs. But it also reflects an itch to see whether there is any basis for the anecdotal accounts. Now, in the first \u003ca href=\"https://www.biorxiv.org/content/early/2018/08/11/384412\" target=\"_blank\" rel=\"noopener\">study\u003c/a> of its kind, scientists in the Netherlands found that psilocybin microdoses have no noticeable effect on the problem-solving, rational-thinking, and abstract-reasoning ability called fluid intelligence. But they do seem to improve two forms of thinking that underlie creativity.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Performance was significantly higher” on tests of convergent and divergent thinking, said psychologist Bernhard Hommel of Leiden University in the Netherlands, who led the study. Convergent thinking is the ability to focus on abstract concepts to identify a single solution to a well-defined problem. Divergent thinking requires meandering mental forays and mental flexibility. Psychologists consider both to be ingredients of creativity.\u003c/p>\n\u003cp>Whatever the dose, psilocybin (O-phosphoryl-4-hydroxy-N, N-dimethyltryptamine) binds to receptors for the neurotransmitter serotonin. The cortex is packed with these 5-HT2A receptors, especially in areas that control reflection, imagination, and introspection, but “whether there is a minimum dose [of psilocybin that’s required to activate them] is an empirical question that we try to tackle,” Hommel said.\u003c/p>\n\u003cp>To do so, he and his colleagues zeroed in on the effects that many users report: creativity, problem-solving, and the “cognitive flexibility” deemed crucial to both. Leiden’s Luisa Prochazkova took the lead in inviting members of the Psychedelic Society of the Netherlands to participate in the study; she got 38 takers.\u003c/p>\n\u003cp>Before their microdose, the volunteers took three standard psychological tests, two related to creative problem-solving and one an assessment of fluid intelligence. The scientists ran chemical analyses of the mushroom samples to determine how much psilocybin they contained. Since a trip dose is about 3 grams of dried ’shrooms, a microdose is around 0.33 grams. Participants averaged 0.37 grams of the dried preparation, which can be taken with food or packed into gelcaps for easy swallowing.\u003c/p>\n\u003cp>About 90 minutes after the microdose, the participants took the three tests again.\u003c/p>\n\u003cp>In the Picture Concept Task, they saw three rows of three pictures, and had to choose three — one from each row — that were related. That requires converging on the correct solution, like noticing that a bathtub, a sink, and a hose all have something to do with water. The brain must focus, weigh alternatives, and reject wrong ones.\u003c/p>\n\u003cp>In the Alternate Uses Task, the microdosers had five minutes to think of ways to use a pen (tracheotomy? finger splint?) or towel. That measures divergent thinking, to move thoughts away from writing, for example, in the case of the pen.\u003c/p>\n\u003cp>The microdosers also took a “progressive matrices” test: In blocks of two-by-two or three-by-three patterns, with the bottom right one missing, they had to choose which of six possibilities belonged in the blank square — a task that requires fluid intelligence.\u003c/p>\n\u003cp>The scientists found no post-microdose difference on the fluid intelligence test. But after microdosing, performance on the picture concept test was significantly higher (an average score of 7.6) than before (6.6). That suggested an improvement in the convergent thinking element of creativity.\u003c/p>\n\u003cp>The microdosers also came up with significantly more uses for pens and towels, 16.7 vs. 14.7. That suggests a microdose of psilocybin “allowed participants to create more out-of-the-box alternative solutions for a problem,” the scientists wrote. Taken together, the three findings suggest a specific effect of psilocybin microdoses on creativity but not on fluid intelligence.\u003c/p>\n\u003cp>For van der Meijden, a microdose of psilocybin makes his musical brainstorm sessions yield “more concepts, ideas, and solutions,” he said, partly because it lets him “better understand and visualize other people’s concepts.” In his design and illustration work, it produces a “more natural flow of line drawing” and lets him “see more possibilities in how things can be or look.” In his music, it lets him “analyze all the different instruments better” and know, for instance, whether to turn up or down the reverberation effect.\u003c/p>\n\u003cp>The Dutch study, which was published on a preprint site and has not undergone peer review at a journal, has several caveats. For one thing, having seen a test before might make people better at it. More problematic, the study didn’t have a control group of people who took something other than psilocybin. That leaves open the possibility that it wasn’t the compound that improved some forms of thinking, but the expectation that it would do so. Maybe people who microdose believe in its benefits enough to make those expectations reality.\u003c/p>\n\u003cp>On the other hand, the results fit with another new \u003ca href=\"https://www.biorxiv.org/content/early/2018/07/25/376491\" target=\"_blank\" rel=\"noopener\">study\u003c/a> of psilocybin. In this one, scientists led by computational neuroscientist Joana Cabral of the University of Oxford used fMRI scans to study the brain activity of nine people who volunteered to be injected with 2 milligram (trip-inducing) doses. The chemical changed the functional connectivity of various brain regions, so that activity in one became synced with that in another. In particular, the rational, logical, well-behaved frontoparietal regions became “strongly destabilized,” the scientists reported, melding with activity in emotional and other regions to produce “unconstrained consciousness,” “mind wandering,” and a sense that everything is connected to everything else. Seeing connections that elude other people is almost the definition of creativity.\u003c/p>\n\u003cp>The findings in the microdosing study also fit with many anecdotal reports. One college student who is a member of the Portland, Ore., microdosing community said that although he doesn’t microdose psilocybin with the express purpose of boosting creativity or focus, he has found that “things seem to have quieted down, in terms of racing thoughts.” He can still be distracted, said Alex, 38, who asked not to be further identified because the drug is illegal in the U.S. But “if I want to go about doing something, then I have an easier time with it because I’m not being bogged down by my thoughts,” he added.\u003c/p>\n\u003cp>Jakobien van der Weijden takes one psilocybin microdose every three days, with bimonthly breaks, “to work more focused, more efficiently and be more creative” at his marketing job in the Netherlands, he said. “On the downside, I would often feel that the inspiration was still there at night and I would keep working on projects until late. So it was somewhat more difficult to maintain a healthy biorhythm.”\u003c/p>\n\u003cp>As legal strictures loosen, there will likely be more rigorous studies of microdosing psilocybin. “Scientific studies could legitimize the claimed benefits,” said Will Burns, CEO of Wenham, Mass.-based \u003ca href=\"http://www.ideasicle.com/\" target=\"_blank\" rel=\"noopener\">Ideasicle\u003c/a>, which develops branding and marketing ideas. He does not microdose, Burns said, but has \u003ca href=\"https://www.forbes.com/sites/willburns/2015/11/29/lsd-microdosing-deserves-more-serious-research/#6824b00d656d\" target=\"_blank\" rel=\"noopener\">called for\u003c/a> research into its purported effects, including improving productivity and creativity. “Right now, we’re swimming in a world of anecdotes and almost no one has taken this seriously,” he said. “We need scientific studies.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "America's Vaccine Wars Stoked By Russian Bots and Troll Armies",
"title": "America's Vaccine Wars Stoked By Russian Bots and Troll Armies",
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"content": "\u003cp class=\"danger-zone\">In the lead-up to the 2016 U.S. election, Russian bots and trolls took to Twitter and other social media platforms to try to turn Americans against one another. But in addition to spreading false information and interfering in the election, a new study reports, a significant number of these malevolent actors tried to sow discord over vaccines.[contextly_sidebar id=\"U9m2Xosa038xtsfDSwPz5O7TUvqWe42O\"]\u003c/p>\n\u003cp class=\"danger-zone\">An \u003ca href=\"https://ajph.aphapublications.org/doi/10.2105/AJPH.2018.304567\" target=\"_blank\" rel=\"noopener\">analysis of Twitter accounts\u003c/a> previously identified as having been operated by Russian bots and trolls found they dove into the vaccine debate as early as January 2015, the researchers reported. They did not take one side or the other, but seemed to tweet pro-vaccine and anti-vaccine messages in roughly equal measure.\u003c/p>\n\u003cp class=\"danger-zone\">On a variety of issues, the overall aim of the Russian campaign appeared to be to erode social cohesion and generate confusion by amplifying the number of voices taking part in these debates on social media. But in the case of vaccines, that could have increased the misperception that the science on their safety and effectiveness isn’t settled — as is the case — but rather that it is still subject to debate.\u003c/p>\n\u003cp class=\"\">“We do have a very strong suspicion that these accounts were attempting to generate discord,” said David Broniatowski, assistant professor in George Washington University’s department of engineering management and systems engineering and lead author of the study.\u003c/p>\n\u003cp>In the study, published Thursday in the American Journal of Public Health, Broniatowski and his co-authors focused on Twitter, analyzing tweets from accounts that had been identified as having been operated by Russian trolls, bots, and so-called content polluters whose aim is to disseminate spam and malware. The article is titled “Weaponized Health Communications: Twitter Bots and Russian Trolls Amplify the Vaccine Debate.”[contextly_sidebar id=\"9QtW5fawtVoxY4YEBFmA2GatrjvQlfvd\"]\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The researchers compared tweets from the accounts to a selection of tweets from other users to see if the trolls and bots commented on vaccines more frequently than average Twitter accounts. They did.\u003c/p>\n\u003cp>“We found that, yeah, indeed, this was something that does seem to be part of the lexicon of what some of these bots and trolls use,” Broniatowski told STAT.\u003c/p>\n\u003cp>Even though the division of pro- and anti-vacccine tweets was roughly equal, that still skewed the picture of views on vaccines on Twitter, he noted, pointing to \u003ca href=\"http://www.pewinternet.org/2017/02/02/vast-majority-of-americans-say-benefits-of-childhood-vaccines-outweigh-risks/\" target=\"_blank\" rel=\"noopener\">data from the Pew Trust\u003c/a> that shows the vast majority of Americans support vaccination.\u003c/p>\n\u003cp>“We’ve always been a little puzzled why social media looks like there are so many anti-vaxxers,” said Broniatowski. “So even if somebody’s posting 50-50, compared to the Pew data, there are going to be more anti-vaxxers.”\u003c/p>\n\u003cp>Dr. Amesh Adalja, an infectious diseases physician and senior scholar at the Center for Health Security at Johns Hopkins Bloomberg School of Public Health, said any skepticism about the safety of vaccines risks feeding the concerns of parents who are worried about having their children vaccinated.\u003c/p>\n\u003cp>“The more the vaccine ‘debate’… is amplified it gains an undeserved sense of legitimacy and gives vaccine-hesitant individuals a pretense to forgo vaccination for themselves and their children,” said Adalja, who was harshly critical of the use of vaccinations in efforts to turn people against each other, calling it “overtly nihilistic.”\u003c/p>\n\u003cp>A spokesman for Twitter said that malicious accounts “are likely to target virtually any high profile conversation, since that’s where the views are.”[contextly_sidebar id=\"Q4N5GXoIo4iApYaASdjmnyeqp8POWr3L\"]\u003c/p>\n\u003cp>The spokesman, Ian Plunkett, told STAT that Twitter has aggressively ramped up preventive measures to try to keep such content from general users. In May, he noted, the platform identified and challenged nearly 10 million potentially automated accounts. “We put preemptive measures in place to ensure automated content is filtered from discoverable areas of the services — like trends and search. It’s possible that may users did not see this content before it was suspended,” Plunkett said.\u003c/p>\n\u003cp>Other experts, too, were unsurprised that Russian trolls and bots would delve into vaccines discussions, given the heat the topic can generate.\u003c/p>\n\u003cp>“Vaccination links to deep values around protection, health, harm, and the social contract,” said Julie Leask, an associate professor at the University of Sydney’s Susan Wakil School of Nursing and Midwifery who researches vaccine refusal. “People become highly invested in the discussion, and highly reactive to the notion that people refuse vaccines. The expression of sentiment at the margins — very pro- and very anti-vaccine — generates emotional energy and clicks.”\u003c/p>\n\u003cp>Adam Dunn, an associate professor in the Center for Health Informatics at Australia’s Macquarie University, said responding to this type of activity by internet bots and trolls would be challenging for public health authorities and may rely on the rooting out of the malicious accounts.\u003c/p>\n\u003cp>“The responsibility of managing the health of online conversations may … fall to Twitter itself, and work like this demonstrating the potential for real harm to human health provides a strong impetus for Twitter to act more often and more quickly to identify, isolate, or remove bots and trolls,” Dunn said.\u003c/p>\n\u003cp>Many of the accounts Broniatowski’s group studied have since been shut down, he said. But freeing the Twitter platform of bots and trolls is like playing whack-a-mole, he suggested.\u003c/p>\n\u003cp>For her part, Leask wasn’t certain how Twitter would have an outsized impact on vaccination decisions.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“When parents decide not to vaccinate, the decision isn’t usually taken lightly and a few tweets from bots are unlikely to change this trajectory,” she said. “The decision process is much more complex and centered on beliefs, experience and notions of what it means to be a ‘good parent’ held within that community. What we still need to establish is the relative role of social media independent of the influence of peer networks.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"danger-zone\">In the lead-up to the 2016 U.S. election, Russian bots and trolls took to Twitter and other social media platforms to try to turn Americans against one another. But in addition to spreading false information and interfering in the election, a new study reports, a significant number of these malevolent actors tried to sow discord over vaccines.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp class=\"danger-zone\">An \u003ca href=\"https://ajph.aphapublications.org/doi/10.2105/AJPH.2018.304567\" target=\"_blank\" rel=\"noopener\">analysis of Twitter accounts\u003c/a> previously identified as having been operated by Russian bots and trolls found they dove into the vaccine debate as early as January 2015, the researchers reported. They did not take one side or the other, but seemed to tweet pro-vaccine and anti-vaccine messages in roughly equal measure.\u003c/p>\n\u003cp class=\"danger-zone\">On a variety of issues, the overall aim of the Russian campaign appeared to be to erode social cohesion and generate confusion by amplifying the number of voices taking part in these debates on social media. But in the case of vaccines, that could have increased the misperception that the science on their safety and effectiveness isn’t settled — as is the case — but rather that it is still subject to debate.\u003c/p>\n\u003cp class=\"\">“We do have a very strong suspicion that these accounts were attempting to generate discord,” said David Broniatowski, assistant professor in George Washington University’s department of engineering management and systems engineering and lead author of the study.\u003c/p>\n\u003cp>In the study, published Thursday in the American Journal of Public Health, Broniatowski and his co-authors focused on Twitter, analyzing tweets from accounts that had been identified as having been operated by Russian trolls, bots, and so-called content polluters whose aim is to disseminate spam and malware. The article is titled “Weaponized Health Communications: Twitter Bots and Russian Trolls Amplify the Vaccine Debate.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The researchers compared tweets from the accounts to a selection of tweets from other users to see if the trolls and bots commented on vaccines more frequently than average Twitter accounts. They did.\u003c/p>\n\u003cp>“We found that, yeah, indeed, this was something that does seem to be part of the lexicon of what some of these bots and trolls use,” Broniatowski told STAT.\u003c/p>\n\u003cp>Even though the division of pro- and anti-vacccine tweets was roughly equal, that still skewed the picture of views on vaccines on Twitter, he noted, pointing to \u003ca href=\"http://www.pewinternet.org/2017/02/02/vast-majority-of-americans-say-benefits-of-childhood-vaccines-outweigh-risks/\" target=\"_blank\" rel=\"noopener\">data from the Pew Trust\u003c/a> that shows the vast majority of Americans support vaccination.\u003c/p>\n\u003cp>“We’ve always been a little puzzled why social media looks like there are so many anti-vaxxers,” said Broniatowski. “So even if somebody’s posting 50-50, compared to the Pew data, there are going to be more anti-vaxxers.”\u003c/p>\n\u003cp>Dr. Amesh Adalja, an infectious diseases physician and senior scholar at the Center for Health Security at Johns Hopkins Bloomberg School of Public Health, said any skepticism about the safety of vaccines risks feeding the concerns of parents who are worried about having their children vaccinated.\u003c/p>\n\u003cp>“The more the vaccine ‘debate’… is amplified it gains an undeserved sense of legitimacy and gives vaccine-hesitant individuals a pretense to forgo vaccination for themselves and their children,” said Adalja, who was harshly critical of the use of vaccinations in efforts to turn people against each other, calling it “overtly nihilistic.”\u003c/p>\n\u003cp>A spokesman for Twitter said that malicious accounts “are likely to target virtually any high profile conversation, since that’s where the views are.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The spokesman, Ian Plunkett, told STAT that Twitter has aggressively ramped up preventive measures to try to keep such content from general users. In May, he noted, the platform identified and challenged nearly 10 million potentially automated accounts. “We put preemptive measures in place to ensure automated content is filtered from discoverable areas of the services — like trends and search. It’s possible that may users did not see this content before it was suspended,” Plunkett said.\u003c/p>\n\u003cp>Other experts, too, were unsurprised that Russian trolls and bots would delve into vaccines discussions, given the heat the topic can generate.\u003c/p>\n\u003cp>“Vaccination links to deep values around protection, health, harm, and the social contract,” said Julie Leask, an associate professor at the University of Sydney’s Susan Wakil School of Nursing and Midwifery who researches vaccine refusal. “People become highly invested in the discussion, and highly reactive to the notion that people refuse vaccines. The expression of sentiment at the margins — very pro- and very anti-vaccine — generates emotional energy and clicks.”\u003c/p>\n\u003cp>Adam Dunn, an associate professor in the Center for Health Informatics at Australia’s Macquarie University, said responding to this type of activity by internet bots and trolls would be challenging for public health authorities and may rely on the rooting out of the malicious accounts.\u003c/p>\n\u003cp>“The responsibility of managing the health of online conversations may … fall to Twitter itself, and work like this demonstrating the potential for real harm to human health provides a strong impetus for Twitter to act more often and more quickly to identify, isolate, or remove bots and trolls,” Dunn said.\u003c/p>\n\u003cp>Many of the accounts Broniatowski’s group studied have since been shut down, he said. But freeing the Twitter platform of bots and trolls is like playing whack-a-mole, he suggested.\u003c/p>\n\u003cp>For her part, Leask wasn’t certain how Twitter would have an outsized impact on vaccination decisions.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“When parents decide not to vaccinate, the decision isn’t usually taken lightly and a few tweets from bots are unlikely to change this trajectory,” she said. “The decision process is much more complex and centered on beliefs, experience and notions of what it means to be a ‘good parent’ held within that community. What we still need to establish is the relative role of social media independent of the influence of peer networks.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Teens are no more sexually promiscuous in states that have passed legislation promoting the HPV vaccine than those living in states that have not, according to a newly published study.\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The study, released in the journal Pediatrics, compared the District of Columbia and 23 U.S. states that passed legislation to promote the vaccine for human papillomavirus (HPV) with states with no such policies. Researchers then analyzed the results of a \u003ca style=\"color: #000000\" href=\"https://www.cdc.gov/healthyyouth/data/yrbs/pdf/2017/ss6708.pdf\" target=\"_blank\" rel=\"noopener\">multi-year survey\u003c/a> conducted by the Centers for Disease Control and Prevention to determine whether teens living in states with pro-HPV vaccine policies had more sex. They didn’t, the study concluded.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“Concern that legislation will increase risky adolescent sexual behaviors should not be used when deciding to pass HPV legislation,” the study said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">In states that promoted vaccines, these policies ranged from in-school awareness programs to incentivizing insurance companies to cover the vaccine’s cost, said Erin Cook, the study’s primary author who led this research as part of her doctoral dissertation in epidemiology at the Harvard T.H. Chan School of Public Health.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“The big takeaway is that passage of legislation regarding HPV didn’t seem to be associated with any changes in adolescent sexual behaviors in the sample of states we were able to look at,” Cook said.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The study did not examine how well these policies were implemented but simply used the mere presence or absence of such legislation as an indicator of a state’s political will to act on HPV vaccine, cancer prevention and public health, she cautioned.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">According to the CDC, some 79 million Americans have HPV; it’s the most common sexually transmitted infection in the U.S., this latest study says. Another 14 million people are infected with HPV each year, the CDC says, many of them in their teens and early 20s. Cervical cancer cases \u003ca style=\"color: #000000\" href=\"https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31206-5/fulltext\" target=\"_blank\" rel=\"noopener\">almost always link\u003c/a> back to the human papillomavirus, according to the Lancet.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The U.S. approved use of the three-dose HPV vaccine for girls in 2006 and for boys in 2011. By 2014, just a third of U.S. girls — 37 percent — and 13 percent of American boys had completed the vaccination course. By 2016, nearly half of U.S. girls were vaccinated.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">Still, half of U.S. states have not implemented policies to promote the vaccine, which scientific research shows can effectively \u003ca style=\"color: #000000\" href=\"https://www.cdc.gov/vaccines/parents/diseases/teen/hpv.html\" target=\"_blank\" rel=\"noopener\">prevent cancers caused by HPV infection\u003c/a>, according to the CDC.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">These findings are not new, despite persistent attitudes that the HPV vaccine could encourage sexual promiscuity. In 2015, JAMA published a Harvard Medical School study that showed \u003ca style=\"color: #000000\" href=\"https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2109856\" target=\"_blank\" rel=\"noopener\">no link between the vaccine\u003c/a>and a change in teen sexual behavior.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">In 2007, Gary Freed, a pediatrician and professor at the University of Michigan, chaired the National Vaccine Advisory Council, and told \u003ca style=\"color: #000000\" href=\"http://www.pbs.org/now/shows/308/hpv-vaccine.html\" target=\"_blank\" rel=\"noopener\">Now on PBS\u003c/a>: “If we have the ability to prevent any cancer deaths, much less a significant number of cancer deaths that affect a segment of our population that historically have not been necessarily as well served as they could have been, then I think it’s incumbent upon society to make sure that we’re able to prevent these cancers.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">Freed said this latest study reinforces the idea that teens are not deciding whether to have sex based on the threat of receiving an HPV infection. This is partly because so few people have heard of HPV, and because “adolescents think in the here and now, not 40 years from now.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“We as a society need to decide how much we want to prevent cervical cancer for the children of today,” Freed said. “That’s really what this is all about. We can make pap smears a thing of the past.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The U.S. is not alone in its sluggish implementation of a vaccine that can prevent illness and death as a result of cervical cancer. In 2016, \u003ca style=\"color: #000000\" href=\"https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30099-7/fulltext?code=lancet-site\" target=\"_blank\" rel=\"noopener\">a study published in the Lancet\u003c/a> reported that out of 64 nations and 12 territories, only 47 million women finished the three-dose HPV vaccine course. Most of those women lived in high-income or upper middle income countries, the study said.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“Access to HPV vaccination in low-income and lower-middle-income countries is almost non-existent, despite these countries carrying most of the burden of cervical cancer cases worldwide,” the report said.\u003c/span>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Teens are no more sexually promiscuous in states that have passed legislation promoting the HPV vaccine than those living in states that have not, according to a newly published study.\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The study, released in the journal Pediatrics, compared the District of Columbia and 23 U.S. states that passed legislation to promote the vaccine for human papillomavirus (HPV) with states with no such policies. Researchers then analyzed the results of a \u003ca style=\"color: #000000\" href=\"https://www.cdc.gov/healthyyouth/data/yrbs/pdf/2017/ss6708.pdf\" target=\"_blank\" rel=\"noopener\">multi-year survey\u003c/a> conducted by the Centers for Disease Control and Prevention to determine whether teens living in states with pro-HPV vaccine policies had more sex. They didn’t, the study concluded.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“Concern that legislation will increase risky adolescent sexual behaviors should not be used when deciding to pass HPV legislation,” the study said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">In states that promoted vaccines, these policies ranged from in-school awareness programs to incentivizing insurance companies to cover the vaccine’s cost, said Erin Cook, the study’s primary author who led this research as part of her doctoral dissertation in epidemiology at the Harvard T.H. Chan School of Public Health.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“The big takeaway is that passage of legislation regarding HPV didn’t seem to be associated with any changes in adolescent sexual behaviors in the sample of states we were able to look at,” Cook said.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The study did not examine how well these policies were implemented but simply used the mere presence or absence of such legislation as an indicator of a state’s political will to act on HPV vaccine, cancer prevention and public health, she cautioned.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">According to the CDC, some 79 million Americans have HPV; it’s the most common sexually transmitted infection in the U.S., this latest study says. Another 14 million people are infected with HPV each year, the CDC says, many of them in their teens and early 20s. Cervical cancer cases \u003ca style=\"color: #000000\" href=\"https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31206-5/fulltext\" target=\"_blank\" rel=\"noopener\">almost always link\u003c/a> back to the human papillomavirus, according to the Lancet.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The U.S. approved use of the three-dose HPV vaccine for girls in 2006 and for boys in 2011. By 2014, just a third of U.S. girls — 37 percent — and 13 percent of American boys had completed the vaccination course. By 2016, nearly half of U.S. girls were vaccinated.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">Still, half of U.S. states have not implemented policies to promote the vaccine, which scientific research shows can effectively \u003ca style=\"color: #000000\" href=\"https://www.cdc.gov/vaccines/parents/diseases/teen/hpv.html\" target=\"_blank\" rel=\"noopener\">prevent cancers caused by HPV infection\u003c/a>, according to the CDC.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">These findings are not new, despite persistent attitudes that the HPV vaccine could encourage sexual promiscuity. In 2015, JAMA published a Harvard Medical School study that showed \u003ca style=\"color: #000000\" href=\"https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2109856\" target=\"_blank\" rel=\"noopener\">no link between the vaccine\u003c/a>and a change in teen sexual behavior.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">In 2007, Gary Freed, a pediatrician and professor at the University of Michigan, chaired the National Vaccine Advisory Council, and told \u003ca style=\"color: #000000\" href=\"http://www.pbs.org/now/shows/308/hpv-vaccine.html\" target=\"_blank\" rel=\"noopener\">Now on PBS\u003c/a>: “If we have the ability to prevent any cancer deaths, much less a significant number of cancer deaths that affect a segment of our population that historically have not been necessarily as well served as they could have been, then I think it’s incumbent upon society to make sure that we’re able to prevent these cancers.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">Freed said this latest study reinforces the idea that teens are not deciding whether to have sex based on the threat of receiving an HPV infection. This is partly because so few people have heard of HPV, and because “adolescents think in the here and now, not 40 years from now.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“We as a society need to decide how much we want to prevent cervical cancer for the children of today,” Freed said. “That’s really what this is all about. We can make pap smears a thing of the past.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">The U.S. is not alone in its sluggish implementation of a vaccine that can prevent illness and death as a result of cervical cancer. In 2016, \u003ca style=\"color: #000000\" href=\"https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(16)30099-7/fulltext?code=lancet-site\" target=\"_blank\" rel=\"noopener\">a study published in the Lancet\u003c/a> reported that out of 64 nations and 12 territories, only 47 million women finished the three-dose HPV vaccine course. Most of those women lived in high-income or upper middle income countries, the study said.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"color: #000000\">“Access to HPV vaccination in low-income and lower-middle-income countries is almost non-existent, despite these countries carrying most of the burden of cervical cancer cases worldwide,” the report said.\u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"source": "BBC World Service"
},
"link": "/radio/program/bbc-world-service",
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"rss": "https://podcasts.files.bbci.co.uk/p02nq0gn.rss"
}
},
"californiareport": {
"id": "californiareport",
"title": "The California Report",
"tagline": "California, day by day",
"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-California-Report-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/californiareport",
"meta": {
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"source": "kqed",
"order": 8
},
"link": "/californiareport",
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}
},
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"id": "californiareportmagazine",
"title": "The California Report Magazine",
"tagline": "Your state, your stories",
"info": "Every week, The California Report Magazine takes you on a road trip for the ears: to visit the places and meet the people who make California unique. The in-depth storytelling podcast from the California Report.",
"airtime": "FRI 4:30pm-5pm, 6:30pm-7pm, 11pm-11:30pm",
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"officialWebsiteLink": "/californiareportmagazine",
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"order": 10
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM3NjkwNjk1OTAz",
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},
"city-arts": {
"id": "city-arts",
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"info": "A one-hour radio program to hear celebrated writers, artists and thinkers address contemporary ideas and values, often discussing the creative process. Please note: tapes or transcripts are not available",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/05/cityartsandlecture-300x300.jpg",
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"airtime": "SUN 1pm-2pm, TUE 10pm, WED 1am",
"meta": {
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"source": "City Arts & Lectures"
},
"link": "https://www.cityarts.net",
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"rss": "https://www.cityarts.net/feed/"
}
},
"closealltabs": {
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"info": "Close All Tabs breaks down how digital culture shapes our world through thoughtful insights and irreverent humor.",
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"order": 1
},
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"title": "Code Switch / Life Kit",
"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"meta": {
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
"airtime": "THU 10pm, FRI 1am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"meta": {
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"source": "Commonwealth Club of California"
},
"link": "/radio/program/commonwealth-club",
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"google": "https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw",
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"id": "forum",
"title": "Forum",
"tagline": "The conversation starts here",
"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
"airtime": "MON-FRI 9am-11am, 10pm-11pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED Forum with Mina Kim and Alexis Madrigal",
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"source": "kqed",
"order": 9
},
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz",
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"freakonomics-radio": {
"id": "freakonomics-radio",
"title": "Freakonomics Radio",
"info": "Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. It is produced in partnership with WNYC.",
"imageSrc": "https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png",
"officialWebsiteLink": "http://freakonomics.com/",
"airtime": "SUN 1am-2am, SAT 3pm-4pm",
"meta": {
"site": "radio",
"source": "WNYC"
},
"link": "/radio/program/freakonomics-radio",
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"apple": "https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519",
"tuneIn": "https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/",
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},
"fresh-air": {
"id": "fresh-air",
"title": "Fresh Air",
"info": "Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory",
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"here-and-now": {
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"info": "A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.",
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"rss": "https://feeds.npr.org/510051/podcast.xml"
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},
"hidden-brain": {
"id": "hidden-brain",
"title": "Hidden Brain",
"info": "Shankar Vedantam uses science and storytelling to reveal the unconscious patterns that drive human behavior, shape our choices and direct our relationships.",
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"airtime": "SUN 7pm-8pm",
"meta": {
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"source": "NPR"
},
"link": "/radio/program/hidden-brain",
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},
"how-i-built-this": {
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"title": "How I Built This with Guy Raz",
"info": "Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.",
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"officialWebsiteLink": "https://www.npr.org/podcasts/510313/how-i-built-this",
"airtime": "SUN 7:30pm-8pm",
"meta": {
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},
"link": "/radio/program/how-i-built-this",
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"apple": "https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2",
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},
"hyphenacion": {
"id": "hyphenacion",
"title": "Hyphenación",
"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2025/03/Hyphenacion_FinalAssets_PodcastTile.png",
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"officialWebsiteLink": "/podcasts/hyphenacion",
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"order": 15
},
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},
"jerrybrown": {
"id": "jerrybrown",
"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-Political-Mind-of-Jerry-Brown-Podcast-Tile-703x703-1.jpg",
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"officialWebsiteLink": "/podcasts/jerrybrown",
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"order": 18
},
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}
},
"latino-usa": {
"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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"source": "npr"
},
"link": "/radio/program/latino-usa",
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"apple": "https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory",
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"rss": "https://feeds.npr.org/510016/podcast.xml"
}
},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
"site": "news",
"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
}
},
"masters-of-scale": {
"id": "masters-of-scale",
"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Masters-of-Scale-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
"link": "/radio/program/masters-of-scale",
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
"tagline": "A podcast about the future of learning and how we raise our kids",
"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg",
"imageAlt": "KQED MindShift: How We Will Learn",
"officialWebsiteLink": "/mindshift/",
"meta": {
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"source": "kqed",
"order": 12
},
"link": "/podcasts/mindshift",
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5",
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}
},
"morning-edition": {
"id": "morning-edition",
"title": "Morning Edition",
"info": "\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. Hosts Steve Inskeep, David Greene and Rachel Martin bring you the latest breaking news and features to prepare you for the day.",
"airtime": "MON-FRI 3am-9am",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Morning-Edition-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.npr.org/programs/morning-edition/",
"meta": {
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"link": "/radio/program/morning-edition"
},
"onourwatch": {
"id": "onourwatch",
"title": "On Our Watch",
"tagline": "Deeply-reported investigative journalism",
"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg",
"imageAlt": "On Our Watch from NPR and KQED",
"officialWebsiteLink": "/podcasts/onourwatch",
"meta": {
"site": "news",
"source": "kqed",
"order": 11
},
"link": "/podcasts/onourwatch",
"subscribe": {
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"google": "https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw",
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