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"content": "\u003cp>https://www.youtube.com/watch?v=t30taY9a3ZM\u003c/p>\n\u003cp>Drone delivery might be years away in the U.S., but it's becoming a reality in Rwanda this summer.\u003c/p>\n\u003cp>A San Francisco-based drone delivery company says it'll start making its first deliveries of blood and medicine in Rwanda in July.\u003c/p>\n\u003cp>Zipline International Inc., backed by tech heavyweights like Sequoia Capital and Google Ventures, demonstrated its technology for journalists last week in an open field in the San Francisco Bay area.\u003c/p>\n\u003cp>In a demo broadcast on Periscope on Friday, a staffer launched a fixed-wing plane weighing just 22 pounds off a launcher that used compressed air.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Electric-powered propellers took it the rest of the way, on a flight that could extend to 75 miles round trip, using military-grade GPS and software to navigate.\u003c/p>\n\u003cp>As it dipped low before the drop-off area, the bottom popped open, and a cardboard box with a parachute made of butcher paper and biodegradable tape burst out, plopping to the ground a few steps away from CEO Keller Rinaudo, who walked over to retrieve it.\u003c/p>\n\u003cp>\"You have a database of people. You know their lives are in danger,\" he said. \"Can you get them what they need fast enough? That's been the mission from the start.\"\u003c/p>\n\u003cp>Company executives said the cost of each flight was about the same as a motorcycle trip, but far more reliable.\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=KP-3xjB8Hd8\u003c/p>\n\u003cp>And because deliveries of packages up to 3.5 pounds could be completed in 15-30 minutes, modest packaging eliminated the need for refrigeration along the way, which saves on wasted supplies such as blood.\u003c/p>\n\u003cp>\"We leapfrog broken refrigerators, we leapfrog the lack of roads,\" said Keenan Wyrobek, Zipline's head of product and engineering.\u003c/p>\n\u003cp>Two hubs contained in modified shipping containers with 10 to 15 planes each are all that's required to serve all of Rwanda, the company says. The Rwandan government announced its deal with Zipline in February.\u003c/p>\n\u003cp>It plans to operate in other countries later this year if it proves it can operate successfully in Rwanda.\u003c/p>\n\u003cp>Rinaudo says the company for now is focused on medical supply delivery in emerging economies where there is less air traffic and regulations are easier to deal with than in the U.S. or Europe.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The U.S. has one of the most complicated airspaces in the world and for that reason the (Federal Aviation Administration) is even more risk-averse than most regulators,\" he said. \"So I think where this will start is in environments where the need is incredibly high and the airspace is relatively empty.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Electric-powered propellers took it the rest of the way, on a flight that could extend to 75 miles round trip, using military-grade GPS and software to navigate.\u003c/p>\n\u003cp>As it dipped low before the drop-off area, the bottom popped open, and a cardboard box with a parachute made of butcher paper and biodegradable tape burst out, plopping to the ground a few steps away from CEO Keller Rinaudo, who walked over to retrieve it.\u003c/p>\n\u003cp>\"You have a database of people. You know their lives are in danger,\" he said. \"Can you get them what they need fast enough? That's been the mission from the start.\"\u003c/p>\n\u003cp>Company executives said the cost of each flight was about the same as a motorcycle trip, but far more reliable.\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/KP-3xjB8Hd8'\n title='//www.youtube.com/embed/KP-3xjB8Hd8'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>And because deliveries of packages up to 3.5 pounds could be completed in 15-30 minutes, modest packaging eliminated the need for refrigeration along the way, which saves on wasted supplies such as blood.\u003c/p>\n\u003cp>\"We leapfrog broken refrigerators, we leapfrog the lack of roads,\" said Keenan Wyrobek, Zipline's head of product and engineering.\u003c/p>\n\u003cp>Two hubs contained in modified shipping containers with 10 to 15 planes each are all that's required to serve all of Rwanda, the company says. The Rwandan government announced its deal with Zipline in February.\u003c/p>\n\u003cp>It plans to operate in other countries later this year if it proves it can operate successfully in Rwanda.\u003c/p>\n\u003cp>Rinaudo says the company for now is focused on medical supply delivery in emerging economies where there is less air traffic and regulations are easier to deal with than in the U.S. or Europe.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The U.S. has one of the most complicated airspaces in the world and for that reason the (Federal Aviation Administration) is even more risk-averse than most regulators,\" he said. \"So I think where this will start is in environments where the need is incredibly high and the airspace is relatively empty.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Prosthetic limbs for people who have lost an arm or a leg have come a long way in the last decade. They are now lighter and more comfortable and flexible. You can change out a prosthetic foot for a ski, an ice skate, or a \"cheetah foot\" for high-performance running.\u003c/p>\n\u003cp>\u003ca href=\"http://espn.go.com/nba/story/_/page/VeteranNBA151111/how-advanced-prosthetics-impact-future-sports\">Athletes\u003c/a> and a new generation of wounded warriors from Iraq and Afghanistan are also changing the way wearers feel about the prosthetic — pride is replacing stigma.\u003c/p>\n\u003cp>Skin tone is out; \u003ca href=\"http://www.summitid.com/#/fairings-1/\">custom designs\u003c/a> are in, like tattoos for an artificial limb. 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Young veterans today say they want their prosthetics — and the reality of their sacrifice — right out in the open.\u003c/p>\n\u003cp>The underlying prosthetic device (the socket that fits the body, the pipe that replaces bone, and the foot) is a medical product. Anyone in need of a prosthetic must see a specialist like Erenstone in person for that.\u003c/p>\n\u003cp>But another part is its cover — the flexible plastic that protects the prosthetic and gives it a leg-like shape. Create's covers aren't just for veterans. They're $500 apiece. You can buy more than one and swap 'em out if you want. Some clients order car imprints on their covers, or a marijuana leaf. Sports teams. Butterflies. 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"disqusTitle": "Truvada, the Miracle HIV Drug Few People Take, Suffers Another Setback",
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"content": "\u003cp>The first documented case of HIV infection by someone adhering to the prescribed regimen for the preventive HIV drug Truvada was reported at a medical conference last month.\u003c/p>\n\u003cp>Dr. David Knox, an HIV primary care physician at Toronto's Maple Leaf Medical Clinic, reported the case at the \u003ca href=\"http://www.croiconference.org/sessions/hiv-1-infection-multiclass-resistance-despite-preexposure-prophylaxis-prep\" target=\"_blank\" rel=\"nofollow\">Conference on Retroviruses and Opportunistic Infections in Boston\u003c/a>. (You can listen to his full presentation \u003ca href=\"http://streamst3.capitalreach.com/c/croi/2016croi/29737.mp3?isMobileView=false&detectedMobile=false\" target=\"_blank\">here\u003c/a>.)\u003c/p>\n\u003cp>Truvada, called PrEP for \"pre-exposure prophylaxis\" when used as a prophylactic, is an FDA-approved combination of two drugs that is also used to treat HIV. Since 2012, it's also been prescribed to HIV-negative individuals in high-risk populations who want to prevent infection.\u003c/p>\n\u003cp>The patient who represents the first PrEP failure was a 43-year-old man who had taken Truvada for approximately two years, Knox said in an email. Before his infection, the man had multiple encounters in which he engaged in high-risk sexual behavior.\u003c/p>\n\u003cp>Knox said his patient had \"a very resistant strain of virus\" and that the failure of PrEP was probably rare.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Just last September, an analysis by researchers at Kaiser San Francisco \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/09/02/no-new-infections-in-hundreds-taking-pill-to-prevent-hiv/\" target=\"_blank\">found no new HIV infections \u003c/a>in over a two-and-a-half-year period among patients who took PrEP.\u003c/p>\n\u003cp>Ryan McKeel, a spokesman for Gilead Sciences, Truvada's manufacturer, said in an email that \"no single intervention is 100 percent effective in preventing HIV. In this case, the individual contracted HIV while taking PrEP due to exposure to a rare strain of HIV that is resistant to both of the drugs included in Truvada.\"\u003c/p>\n\u003cp>\u003cb>Truvada: The Miracle Drug No One's Taking\u003c/b>\u003c/p>\n\u003cp>Before the FDA approval of PrEP, in 2011, I \u003ca href=\"http://ww2.kqed.org/news/2011/07/15/interview-new-studies-show-anti-hiv-drug-prevents-transmission\" target=\"_blank\">interviewed the seminal AIDS researcher Dr. Paul Volberding\u003c/a> about studies showing Truvada's effectiveness in preventing HIV transmission. He was tremendously excited about the possibilities of a prophylactic drug. \"This is the kind of effect we might expect from a very good vaccine,\" he said.\u003c/p>\n\u003cp>That enthusiasm has spread to both the Centers for Disease Control and the World Health Organization. CDC now says\u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2015/11/24/cdc-on-hiv-prevention-pill-how-to-tell-whether-you-should-be-taking-the-medication/\" target=\"_blank\"> about 1.2 million people \u003c/a>should at least consider PrEP, and four months ago the World Health Organization broadened its recommendation of who should take the medication, from men who have sex with men to \"all population groups at substantial risk of HIV infection.\"\u003c/p>\n\u003cp>Yet, what some have called a \"\u003ca href=\"https://www.washingtonpost.com/opinions/the-miracle-aids-drug-that-people-refust-to-take/2016/01/29/ba2b9460-b88a-11e5-b682-4bb4dd403c7d_story.html\" target=\"_blank\">miracle drug\u003c/a>\" that \u003ca href=\"http://www.nytimes.com/2014/07/17/upshot/is-truvada-the-pill-to-prevent-hiv-99-percent-effective-dont-be-so-sure.html?_r=0\" target=\"_blank\">works better\u003c/a> than \u003ca href=\"http://www.aidsmap.com/Consistent-condom-use-in-anal-sex-stops-70-of-HIV-infections-study-finds-but-intermittent-use-has-no-effect/page/2586976/\" target=\"_blank\">condoms\u003c/a> has been a bust in terms of adoption by the public.\u003c/p>\n\u003cp>\"\u003ca href=\"http://www.newyorker.com/tech/elements/why-is-no-one-on-the-first-treatment-to-prevent-h-i-v\" target=\"_blank\">Why Is No One On the First Treatment To Prevent H.I.V.?\u003c/a>\" The New Yorker asked in 2013.\u003c/p>\n\u003cp>\"Why have \u003ca href=\"http://www.natap.org/2013/ICAAC/ICAAC_04.htm\" target=\"_blank\">only 1,774 people\u003c/a>—half of whom are women—filled Truvada prescriptions over the last two years?\" \u003ca href=\"http://www.slate.com/blogs/outward/2014/01/06/truvada_prep_hiv_gay_men_should_take_pre_exposure_prophylaxis.html\" target=\"_blank\">Slate\u003c/a> asked in 2014.\u003c/p>\n\u003cp>\"Gilead’s Pill Can Stop HIV. So Why Does Almost Nobody Take It?\" \u003ca href=\"http://www.bloomberg.com/news/articles/2015-02-18/gilead-s-pill-can-stop-hiv-so-why-does-almost-nobody-take-it-\" target=\"_blank\">Bloomberg asked\u003c/a> in 2015.\u003c/p>\n\u003cp>\"\u003ca href=\"https://www.washingtonpost.com/opinions/the-miracle-aids-drug-that-people-refust-to-take/2016/01/29/ba2b9460-b88a-11e5-b682-4bb4dd403c7d_story.html\" target=\"_blank\">The miracle AIDS drug that people refuse to take,\u003c/a>\" an op-ed headline in The Washington Post read just two months ago.\u003c/p>\n\u003cp>\"Truvada’s been a financial success, bringing Gilead $1.79 billion in the U.S last year,\" Bloomberg reported in July. But that is due to its use by HIV-positive patients, not in those taking it for prevention. The report cited a \u003ca href=\"http://www.jiasociety.org/index.php/jias/article/view/19730/html\" target=\"_blank\">study\u003c/a> published in the November 2014 Journal of the International AIDS Society that found an unbelievably low 3,253 people, in the U.S., had used Truvada for PrEP between January 2012 and March 2014 -- only about 1,900 of those men.\u003c/p>\n\u003cp>The CDC says that figure is now about 21,000. According to an October 2015 \u003ca href=\"http://www.iapac.org/tasp_prep/presentations/TPSparis15-Panel-Grant.pdf\" target=\"_blank\">presentation\u003c/a> by Dr. Robert Grant, the protocol chair for a \u003ca href=\"https://www.google.com/search?q=iprex+study\" target=\"_blank\">multinational study on PrEP\u003c/a>, the number of U.S. users is about 22,000, and use of the drug \"has reached a tipping point.\"\u003c/p>\n\u003cp>Not according to Michael Weinstein, president of AIDS Healthcare Foundation, a global HIV/AIDS organization. Weinstein has been \u003ca href=\"https://www.frontiersmedia.com/frontiers-blog/2016/01/07/aids-healthcare-foundation-continues-to-wage-war-against-prep-reignites-party-drug-rhetoric/\" target=\"_blank\">outspoken\u003c/a> against mass adoption of Truvada, arguing it's a poor public health solution and drawing the wrath of some in the HIV health community. (The New York Times' Upshot \u003ca href=\"http://www.nytimes.com/2014/11/17/upshot/aids-group-wages-lonely-fight-against-pill-to-prevent-hiv.html\" target=\"_blank\">column\u003c/a> called him \"the most hated man in the AIDS business\" in 2014.)\u003c/p>\n\u003cp>Weinstein is well aware that the number of people taking Truvada is trivial.\u003c/p>\n\u003cp>\"The bottom line is we are now almost four years since the approval of this, and the last report from the CDC was that 21,000 people were taking it. Really, it's an insignificant number.\"\u003c/p>\n\u003cp>He said he thought the recent report about the Truvada failure out of Toronto \"will give some people pause\" about the drug. And he thinks the focus on Truvada is wrongheaded:\u003c/p>\n\u003cp>\"The messaging coming out is all about Truvada and PrEP, and not about condoms,\" he said. \"So we're seeing this huge s\u003ca href=\"http://www.cdc.gov/nchhstp/newsroom/2015/std-surveillance-report-press-release.html\" target=\"_blank\">pike in STDs\u003c/a> across the country. And I think it's because the CDC has really taken their foot off the gas and they're not saying anything about safer sex.\"\u003c/p>\n\u003cp>Dana Van Gorder is the executive director of Project Inform, which advocates for new HIV and hepatitis C treatments. He agrees that reduced condom use is a big factor in the rise of STDs. But he says PrEP use is so minimal, it can't be the culprit. Plus PrEP is better.\u003c/p>\n\u003cp>\"Condoms have been a great device, but on a statistical level, they're not as effective as PrEP can be in preventing infections, and the reality is just that not everyone is going to use them, for a variety of different reasons. So it feels unethical to us to not provide people with another option.\u003c/p>\n\u003cp>\"We can't just wish that people are going to use condoms more than they are.\"\u003c/p>\n\u003cp>Van Gorder said those who support Truvada were \"disappointed\" over the news it had failed for someone. But, he said, \"We'll continue to encourage PrEP use and stress it is highly effective but not necessarily 100 percent effective.\"\u003c/p>\n\u003cp>\u003cstrong>What, Exactly, is the Problem?\u003c/strong>\u003c/p>\n\u003cp>The reasons for PrEP's failure to catch on are manifold, Van Gorder said: Lack of effective education campaigns among \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/08/01/why-latinos-arent-taking-the-anti-hiv-pill-and-why-they-should-consider-it/\" target=\"_blank\">people of color\u003c/a> and injection drug users, for one; the need for follow-up appontments and testing, for another.\u003c/p>\n\u003cp>Also, he said, health care providers are not talking enough about PrEP to their patients. Some \"are actually hostile to it,\" he said.\u003c/p>\n\u003cp>Finally, Van Gorder said, PrEP is expensive. \"Covering its cost is not a small matter. While many insurers if not most are covering it, people often have high cost of sharing with deductibles and copays. Not everyone is in a position to [use] it.\"\u003c/p>\n\u003cp>But as Lisa Aliferis reported in KQED's \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/09/02/no-new-infections-in-hundreds-taking-pill-to-prevent-hiv/\" target=\"_blank\">State of Health blog\u003c/a> last September, there's another reason PrEP has failed to take off:\u003c/p>\n\u003cp>\"Despite the success of PrEP as a preventive, stigma remains,\" Aliferis wrote. \"People who take PrEP are sometimes viewed as promiscuous, [A PrEP patient] told me. “People say, ‘Why are you not just using condoms?’ … Sometimes people say, ‘You must be a slut.’\u003c/p>\n\u003cp>In fact, the term \"\u003ca href=\"http://www.advocate.com/health/2014/08/11/truvada-whore-stigma-endures-among-doctors-and-lgbts\" target=\"_blank\">Truvada whore\u003c/a>\" has often been used to describe PrEP users ... and not in a nice way, either. (The term has been\u003ca href=\"http://www.out.com/entertainment/popnography/2014/05/20/why-i-am-truvada-whore\" target=\"_blank\"> co-opted\u003c/a> by some Truvada fans.)\u003c/p>\n\u003cp>\u003cstrong>The Patient Speaks\u003c/strong>\u003c/p>\n\u003cp>Earlier this month, POZ, a magazine for people who are HIV-positive, published an \u003ca href=\"https://www.poz.com/article/meet-man-got-hiv-daily-prep\" target=\"_blank\">anonymous-yet-candid interview\u003c/a> with the Canadian PrEP user who still became infected.\u003c/p>\n\u003cp>When asked if PrEP altered his sexual behavior or attitudes, he answered:\u003c/p>\n\u003cp>\"Yes. I became more sexually liberated. It took away the fear. I mean, that’s really one of the reasons why people behave themselves [sexually]. It’s not because of morals or religion or society; it’s just the fear of getting sick—especially the fear of HIV. But once you’re on PrEP you’re more comfortable. You feel safer.\"\u003c/p>\n\u003cp>\u003cspan style=\"line-height: 1.5\">He said he's still a fan of the drug, despite its failure.\u003c/span>\u003c/p>\n\u003cp>\"PrEP’s a calculated risk,\" he said. \"It’s important for people to know that there is the possibility as opposed to the fantasy that there have been no recorded infections on PrEP. At least now there is one, so it makes it more real.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"excerpt": "Truvada, or PrEP, prevents HIV infection in healthy people. It's been foolproof, until now. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The first documented case of HIV infection by someone adhering to the prescribed regimen for the preventive HIV drug Truvada was reported at a medical conference last month.\u003c/p>\n\u003cp>Dr. David Knox, an HIV primary care physician at Toronto's Maple Leaf Medical Clinic, reported the case at the \u003ca href=\"http://www.croiconference.org/sessions/hiv-1-infection-multiclass-resistance-despite-preexposure-prophylaxis-prep\" target=\"_blank\" rel=\"nofollow\">Conference on Retroviruses and Opportunistic Infections in Boston\u003c/a>. (You can listen to his full presentation \u003ca href=\"http://streamst3.capitalreach.com/c/croi/2016croi/29737.mp3?isMobileView=false&detectedMobile=false\" target=\"_blank\">here\u003c/a>.)\u003c/p>\n\u003cp>Truvada, called PrEP for \"pre-exposure prophylaxis\" when used as a prophylactic, is an FDA-approved combination of two drugs that is also used to treat HIV. Since 2012, it's also been prescribed to HIV-negative individuals in high-risk populations who want to prevent infection.\u003c/p>\n\u003cp>The patient who represents the first PrEP failure was a 43-year-old man who had taken Truvada for approximately two years, Knox said in an email. Before his infection, the man had multiple encounters in which he engaged in high-risk sexual behavior.\u003c/p>\n\u003cp>Knox said his patient had \"a very resistant strain of virus\" and that the failure of PrEP was probably rare.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Just last September, an analysis by researchers at Kaiser San Francisco \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/09/02/no-new-infections-in-hundreds-taking-pill-to-prevent-hiv/\" target=\"_blank\">found no new HIV infections \u003c/a>in over a two-and-a-half-year period among patients who took PrEP.\u003c/p>\n\u003cp>Ryan McKeel, a spokesman for Gilead Sciences, Truvada's manufacturer, said in an email that \"no single intervention is 100 percent effective in preventing HIV. In this case, the individual contracted HIV while taking PrEP due to exposure to a rare strain of HIV that is resistant to both of the drugs included in Truvada.\"\u003c/p>\n\u003cp>\u003cb>Truvada: The Miracle Drug No One's Taking\u003c/b>\u003c/p>\n\u003cp>Before the FDA approval of PrEP, in 2011, I \u003ca href=\"http://ww2.kqed.org/news/2011/07/15/interview-new-studies-show-anti-hiv-drug-prevents-transmission\" target=\"_blank\">interviewed the seminal AIDS researcher Dr. Paul Volberding\u003c/a> about studies showing Truvada's effectiveness in preventing HIV transmission. He was tremendously excited about the possibilities of a prophylactic drug. \"This is the kind of effect we might expect from a very good vaccine,\" he said.\u003c/p>\n\u003cp>That enthusiasm has spread to both the Centers for Disease Control and the World Health Organization. CDC now says\u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2015/11/24/cdc-on-hiv-prevention-pill-how-to-tell-whether-you-should-be-taking-the-medication/\" target=\"_blank\"> about 1.2 million people \u003c/a>should at least consider PrEP, and four months ago the World Health Organization broadened its recommendation of who should take the medication, from men who have sex with men to \"all population groups at substantial risk of HIV infection.\"\u003c/p>\n\u003cp>Yet, what some have called a \"\u003ca href=\"https://www.washingtonpost.com/opinions/the-miracle-aids-drug-that-people-refust-to-take/2016/01/29/ba2b9460-b88a-11e5-b682-4bb4dd403c7d_story.html\" target=\"_blank\">miracle drug\u003c/a>\" that \u003ca href=\"http://www.nytimes.com/2014/07/17/upshot/is-truvada-the-pill-to-prevent-hiv-99-percent-effective-dont-be-so-sure.html?_r=0\" target=\"_blank\">works better\u003c/a> than \u003ca href=\"http://www.aidsmap.com/Consistent-condom-use-in-anal-sex-stops-70-of-HIV-infections-study-finds-but-intermittent-use-has-no-effect/page/2586976/\" target=\"_blank\">condoms\u003c/a> has been a bust in terms of adoption by the public.\u003c/p>\n\u003cp>\"\u003ca href=\"http://www.newyorker.com/tech/elements/why-is-no-one-on-the-first-treatment-to-prevent-h-i-v\" target=\"_blank\">Why Is No One On the First Treatment To Prevent H.I.V.?\u003c/a>\" The New Yorker asked in 2013.\u003c/p>\n\u003cp>\"Why have \u003ca href=\"http://www.natap.org/2013/ICAAC/ICAAC_04.htm\" target=\"_blank\">only 1,774 people\u003c/a>—half of whom are women—filled Truvada prescriptions over the last two years?\" \u003ca href=\"http://www.slate.com/blogs/outward/2014/01/06/truvada_prep_hiv_gay_men_should_take_pre_exposure_prophylaxis.html\" target=\"_blank\">Slate\u003c/a> asked in 2014.\u003c/p>\n\u003cp>\"Gilead’s Pill Can Stop HIV. So Why Does Almost Nobody Take It?\" \u003ca href=\"http://www.bloomberg.com/news/articles/2015-02-18/gilead-s-pill-can-stop-hiv-so-why-does-almost-nobody-take-it-\" target=\"_blank\">Bloomberg asked\u003c/a> in 2015.\u003c/p>\n\u003cp>\"\u003ca href=\"https://www.washingtonpost.com/opinions/the-miracle-aids-drug-that-people-refust-to-take/2016/01/29/ba2b9460-b88a-11e5-b682-4bb4dd403c7d_story.html\" target=\"_blank\">The miracle AIDS drug that people refuse to take,\u003c/a>\" an op-ed headline in The Washington Post read just two months ago.\u003c/p>\n\u003cp>\"Truvada’s been a financial success, bringing Gilead $1.79 billion in the U.S last year,\" Bloomberg reported in July. But that is due to its use by HIV-positive patients, not in those taking it for prevention. The report cited a \u003ca href=\"http://www.jiasociety.org/index.php/jias/article/view/19730/html\" target=\"_blank\">study\u003c/a> published in the November 2014 Journal of the International AIDS Society that found an unbelievably low 3,253 people, in the U.S., had used Truvada for PrEP between January 2012 and March 2014 -- only about 1,900 of those men.\u003c/p>\n\u003cp>The CDC says that figure is now about 21,000. According to an October 2015 \u003ca href=\"http://www.iapac.org/tasp_prep/presentations/TPSparis15-Panel-Grant.pdf\" target=\"_blank\">presentation\u003c/a> by Dr. Robert Grant, the protocol chair for a \u003ca href=\"https://www.google.com/search?q=iprex+study\" target=\"_blank\">multinational study on PrEP\u003c/a>, the number of U.S. users is about 22,000, and use of the drug \"has reached a tipping point.\"\u003c/p>\n\u003cp>Not according to Michael Weinstein, president of AIDS Healthcare Foundation, a global HIV/AIDS organization. Weinstein has been \u003ca href=\"https://www.frontiersmedia.com/frontiers-blog/2016/01/07/aids-healthcare-foundation-continues-to-wage-war-against-prep-reignites-party-drug-rhetoric/\" target=\"_blank\">outspoken\u003c/a> against mass adoption of Truvada, arguing it's a poor public health solution and drawing the wrath of some in the HIV health community. (The New York Times' Upshot \u003ca href=\"http://www.nytimes.com/2014/11/17/upshot/aids-group-wages-lonely-fight-against-pill-to-prevent-hiv.html\" target=\"_blank\">column\u003c/a> called him \"the most hated man in the AIDS business\" in 2014.)\u003c/p>\n\u003cp>Weinstein is well aware that the number of people taking Truvada is trivial.\u003c/p>\n\u003cp>\"The bottom line is we are now almost four years since the approval of this, and the last report from the CDC was that 21,000 people were taking it. Really, it's an insignificant number.\"\u003c/p>\n\u003cp>He said he thought the recent report about the Truvada failure out of Toronto \"will give some people pause\" about the drug. And he thinks the focus on Truvada is wrongheaded:\u003c/p>\n\u003cp>\"The messaging coming out is all about Truvada and PrEP, and not about condoms,\" he said. \"So we're seeing this huge s\u003ca href=\"http://www.cdc.gov/nchhstp/newsroom/2015/std-surveillance-report-press-release.html\" target=\"_blank\">pike in STDs\u003c/a> across the country. And I think it's because the CDC has really taken their foot off the gas and they're not saying anything about safer sex.\"\u003c/p>\n\u003cp>Dana Van Gorder is the executive director of Project Inform, which advocates for new HIV and hepatitis C treatments. He agrees that reduced condom use is a big factor in the rise of STDs. But he says PrEP use is so minimal, it can't be the culprit. Plus PrEP is better.\u003c/p>\n\u003cp>\"Condoms have been a great device, but on a statistical level, they're not as effective as PrEP can be in preventing infections, and the reality is just that not everyone is going to use them, for a variety of different reasons. So it feels unethical to us to not provide people with another option.\u003c/p>\n\u003cp>\"We can't just wish that people are going to use condoms more than they are.\"\u003c/p>\n\u003cp>Van Gorder said those who support Truvada were \"disappointed\" over the news it had failed for someone. But, he said, \"We'll continue to encourage PrEP use and stress it is highly effective but not necessarily 100 percent effective.\"\u003c/p>\n\u003cp>\u003cstrong>What, Exactly, is the Problem?\u003c/strong>\u003c/p>\n\u003cp>The reasons for PrEP's failure to catch on are manifold, Van Gorder said: Lack of effective education campaigns among \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/08/01/why-latinos-arent-taking-the-anti-hiv-pill-and-why-they-should-consider-it/\" target=\"_blank\">people of color\u003c/a> and injection drug users, for one; the need for follow-up appontments and testing, for another.\u003c/p>\n\u003cp>Also, he said, health care providers are not talking enough about PrEP to their patients. Some \"are actually hostile to it,\" he said.\u003c/p>\n\u003cp>Finally, Van Gorder said, PrEP is expensive. \"Covering its cost is not a small matter. While many insurers if not most are covering it, people often have high cost of sharing with deductibles and copays. Not everyone is in a position to [use] it.\"\u003c/p>\n\u003cp>But as Lisa Aliferis reported in KQED's \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/09/02/no-new-infections-in-hundreds-taking-pill-to-prevent-hiv/\" target=\"_blank\">State of Health blog\u003c/a> last September, there's another reason PrEP has failed to take off:\u003c/p>\n\u003cp>\"Despite the success of PrEP as a preventive, stigma remains,\" Aliferis wrote. \"People who take PrEP are sometimes viewed as promiscuous, [A PrEP patient] told me. “People say, ‘Why are you not just using condoms?’ … Sometimes people say, ‘You must be a slut.’\u003c/p>\n\u003cp>In fact, the term \"\u003ca href=\"http://www.advocate.com/health/2014/08/11/truvada-whore-stigma-endures-among-doctors-and-lgbts\" target=\"_blank\">Truvada whore\u003c/a>\" has often been used to describe PrEP users ... and not in a nice way, either. (The term has been\u003ca href=\"http://www.out.com/entertainment/popnography/2014/05/20/why-i-am-truvada-whore\" target=\"_blank\"> co-opted\u003c/a> by some Truvada fans.)\u003c/p>\n\u003cp>\u003cstrong>The Patient Speaks\u003c/strong>\u003c/p>\n\u003cp>Earlier this month, POZ, a magazine for people who are HIV-positive, published an \u003ca href=\"https://www.poz.com/article/meet-man-got-hiv-daily-prep\" target=\"_blank\">anonymous-yet-candid interview\u003c/a> with the Canadian PrEP user who still became infected.\u003c/p>\n\u003cp>When asked if PrEP altered his sexual behavior or attitudes, he answered:\u003c/p>\n\u003cp>\"Yes. I became more sexually liberated. It took away the fear. I mean, that’s really one of the reasons why people behave themselves [sexually]. It’s not because of morals or religion or society; it’s just the fear of getting sick—especially the fear of HIV. But once you’re on PrEP you’re more comfortable. You feel safer.\"\u003c/p>\n\u003cp>\u003cspan style=\"line-height: 1.5\">He said he's still a fan of the drug, despite its failure.\u003c/span>\u003c/p>\n\u003cp>\"PrEP’s a calculated risk,\" he said. \"It’s important for people to know that there is the possibility as opposed to the fantasy that there have been no recorded infections on PrEP. At least now there is one, so it makes it more real.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Poison comes in many forms for addicts: Alcohol and drugs usually come first to mind, but gambling — often overlooked — is of increasing concern to state officials and rehab centers.\u003c/p>\n\u003caside class=\"alignright\">“We’re seeing a monumental shift. What started as a pastime to relax and have a few beers with friends … has become full hardcore gambling.”\u003c/aside>\n\u003cp>The number of problem gamblers has grown in recent years with an explosion of betting opportunities available at the touch of a smartphone screen. That is particularly true during this month’s annual “March Madness” college basketball tournament.\u003c/p>\n\u003cp>The state’s Office of Problem Gambling, part of the Department of Public Health, recorded 36,000 calls to its hotline last year — the highest number since it began public awareness efforts in 2003, said Terri Sue Canale-Dalman, who heads the agency. The number of problem gamblers in California is estimated to have reached 1 million.\u003c/p>\n\u003cp>The average gambler loses about $38,000 a year and is $20,000 in debt, Canale-Dalman said. And the damage is not only monetary: Relationships are often lost and some gamblers suffer a decline in mental and physical health.\u003c/p>\n\u003cp>Jason, a resident of Culver City, knows what it’s like to be seduced by high stakes. To his family and friends, Jason was a winner. He frequently reaped thousands of dollars through various forms of gambling: blackjack and sports betting were his favorites. Those who heard his stories thought him a lucky man.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_sidebar id=\"n8D5nsqB1EOjXRm5c7lBHHFW23WDwjh6\"]TIt was a facade he maintained for more than 10 years. Jason did win quite a bit, but he lost even more – a sum, he said, that many people earn over an entire lifetime.\u003c/p>\n\u003cp>“Gamblers are very good at not showing their cards,” said Jason, who requested his last name not be used because of the sensitivity of the subject. “I didn’t share my losses or horror stories. Most gamblers won’t.”\u003c/p>\n\u003cp>He also lost time — valuable time he now realizes would have been better spent with his wife and children.\u003c/p>\n\u003cp>For state health officials, stories like Jason’s aren’t new — but they’re hearing them more often now.\u003c/p>\n\u003cp>One reason: there are more ways to gamble than ever before.\u003c/p>\n\u003cp>\u003cstrong>Growth of Online Gambling, Fantasy Sports\u003c/strong>\u003c/p>\n\u003cp>In the digital age, table poker and slot machines are beginning to take the back seat. Instead, online gambling and fantasy sports are becoming more popular. With easy access from a computer, tablet or phone, daily fantasy sites such as New York’s FanDuel and Boston-based DraftKings have become the newer, hipper go-to platforms for people seeking the adrenaline rush that comes with sports betting.\u003c/p>\n\u003cp>While considered a harmless form of entertainment for many people, experts say it can be a dangerous activity for the vulnerable.\u003c/p>\n\u003cp>Mostly unregulated for the nearly 10 years they have been in existence, daily fantasy sports has become a controversial topic. The California legislature is considering legislation to clarify its legal standing and help address the problem behavior surrounding it.\u003c/p>\n\u003cp>Traditionally, participating in fantasy sports meant drafting athletes to create a team that would last an entire season. Now, daily fantasy sports contests are more immediate, offering leagues that last a weekend or a day. With that, opportunities to wager — and problem gamblers — have multiplied.\u003c/p>\n\u003cp>“We’re seeing a monumental shift,” said Dr. Eric Geffner, who has treated gambling addiction in Los Angeles since 1998. “What started as a pastime to relax and have a few beers with friends … has become full hardcore gambling.”\u003c/p>\n\u003cp>Many people are attracted to daily fantasy sports sites because they believe their sports knowledge can help them win, Geffner said.\u003c/p>\n\u003cp>Over the years, Geffner has seen hundreds of problem gamblers walk through his Westwood office. This time of year is particularly busy because March Madness offers a big pool of games to bet on, he said.\u003c/p>\n\u003cp>Daily fantasy sports, now a billion-dollar industry, was exempted from a federal law that outlawed Internet gambling in 2006. But state regulators are starting to scrutinize it. In the past few months, fantasy sports companies have been fighting in some states to remain in operation.\u003c/p>\n\u003cp>On March 21, DraftKings and FanDuel suspended their operations in New York pending a legal battle with the state’s attorney general. In California, a bill working its way through the state legislature would authorize and regulate daily fantasy sports sites.\u003c/p>\n\u003cp>The legislation, authored by Assemblyman Adam Gray (D-Merced), would allow these companies to operate in California after obtaining a license and paying an annual fee. The purpose of the legislation is to protect consumers, who currently assume all the risk.\u003c/p>\n\u003cp>The bill would prohibit an operator from allowing players to establish more than one account and would ban any advertising aimed at people under 21.\u003c/p>\n\u003cp>It would also require the state’s Department of Justice to develop an online self-exclusion form for problem gamblers who ask to be banned from gambling activities. The operators would have to make these forms available on their sites by July 2017.\u003c/p>\n\u003cp>Gray’s bill cleared the state Assembly in January and is now awaiting Senate action.\u003c/p>\n\u003cp>The daily sports fantasy industry does not consider itself to be in the gambling business. Industry representatives argue that unlike gambling, which is largely a matter of chance, daily fantasy sports require research and an ability to evaluate players and matchups.\u003c/p>\n\u003cp>But they are cognizant of problem behavior and willing to cooperate, said Peter Schoenke, chairman of the Fantasy Sports Trade Association. He said the industry is working with 20 states to help pass legislation that will clarify the legal status of daily fantasy sports.\u003c/p>\n\u003cp>“It’s not good for the industry to have those (problem) behaviors go unchecked,” Schoenke said. “We are being proactive and working to get bills passed that work for everyone.”\u003c/p>\n\u003cp>A spokeswoman for FanDuel said the site has trained staff in place to look for compulsive behavior by players. The number of contests a player can enter in a given time period is also limited, according to the site.\u003c/p>\n\u003cp>Jason, now in his mid-40s, never used DraftKings or FanDuel, but he has heard plenty about the sites from younger gambling addicts who, like him, are currently in treatment at Beit T’Shuvah, a rehabilitation center in Los Angeles whose name means “house of return” in Hebrew.\u003c/p>\n\u003cp>Yael Landa, the center’s gambling treatment program director, said Beit T’Shuvah treats a variety of addictions through residential and outpatient services. At any given time, about 120 people are enrolled in the center, 15 percent of whom are gamblers. Quite a few are in their early to mid-20s.\u003c/p>\n\u003cp>“We hear all kinds of stories from people of all ages,” Landa said. “People who owe a lot of money, people who’ve lived a double life. Some face severe financial wreckage.”\u003c/p>\n\u003cp>I. Nelson Rose, a law professor and gambling expert at Whittier Law School, said young adults’ attraction to gambling is not surprising: temptation is all around them. When gambling becomes convenient, common sense dictates that the number of problem gamblers grows, Rose said.\u003c/p>\n\u003cp>“Why in the world would you play a slot machine if you are carrying the world’s greatest games on your smartphone?” he said.\u003c/p>\n\u003cp>To address the growing number of people addicted to gambling, the Office of Problem Gambling has invested in training for medical providers, public service announcements, prevention for high school youth and is consulting with nonprofit community organizations to expand education on the dangers of gambling, said Canale-Dalman.\u003c/p>\n\u003cp>“Warning signs vary,” she said. “This isn’t like alcohol. You can’t smell or see something right away.”\u003c/p>\n\u003cp>Michael Barbosa, 57, of Pleasant Hill, believes the lack of obvious physical symptoms might be a reason why gambling addictions are too often disregarded as a disease. He lost four marriages because of his addiction to card games and poker. He stole money from his mother and at one point ended up on the street.\u003c/p>\n\u003cp>In 2013, he started a rehabilitation program at HealthRight 360, a residential treatment facility in San Francisco. That’s where he learned that being addicted to gambling is not much different than being addicted to a drug. When he attempted to stop cold turkey, he’d get fevers.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“It made me physically sick,” Barbosa said. He also fell victim to depression, which he still struggles with today. “It all goes hand in hand,” he said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Poison comes in many forms for addicts: Alcohol and drugs usually come first to mind, but gambling — often overlooked — is of increasing concern to state officials and rehab centers.\u003c/p>\n\u003caside class=\"alignright\">“We’re seeing a monumental shift. What started as a pastime to relax and have a few beers with friends … has become full hardcore gambling.”\u003c/aside>\n\u003cp>The number of problem gamblers has grown in recent years with an explosion of betting opportunities available at the touch of a smartphone screen. That is particularly true during this month’s annual “March Madness” college basketball tournament.\u003c/p>\n\u003cp>The state’s Office of Problem Gambling, part of the Department of Public Health, recorded 36,000 calls to its hotline last year — the highest number since it began public awareness efforts in 2003, said Terri Sue Canale-Dalman, who heads the agency. The number of problem gamblers in California is estimated to have reached 1 million.\u003c/p>\n\u003cp>The average gambler loses about $38,000 a year and is $20,000 in debt, Canale-Dalman said. And the damage is not only monetary: Relationships are often lost and some gamblers suffer a decline in mental and physical health.\u003c/p>\n\u003cp>Jason, a resident of Culver City, knows what it’s like to be seduced by high stakes. To his family and friends, Jason was a winner. He frequently reaped thousands of dollars through various forms of gambling: blackjack and sports betting were his favorites. Those who heard his stories thought him a lucky man.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>TIt was a facade he maintained for more than 10 years. Jason did win quite a bit, but he lost even more – a sum, he said, that many people earn over an entire lifetime.\u003c/p>\n\u003cp>“Gamblers are very good at not showing their cards,” said Jason, who requested his last name not be used because of the sensitivity of the subject. “I didn’t share my losses or horror stories. Most gamblers won’t.”\u003c/p>\n\u003cp>He also lost time — valuable time he now realizes would have been better spent with his wife and children.\u003c/p>\n\u003cp>For state health officials, stories like Jason’s aren’t new — but they’re hearing them more often now.\u003c/p>\n\u003cp>One reason: there are more ways to gamble than ever before.\u003c/p>\n\u003cp>\u003cstrong>Growth of Online Gambling, Fantasy Sports\u003c/strong>\u003c/p>\n\u003cp>In the digital age, table poker and slot machines are beginning to take the back seat. Instead, online gambling and fantasy sports are becoming more popular. With easy access from a computer, tablet or phone, daily fantasy sites such as New York’s FanDuel and Boston-based DraftKings have become the newer, hipper go-to platforms for people seeking the adrenaline rush that comes with sports betting.\u003c/p>\n\u003cp>While considered a harmless form of entertainment for many people, experts say it can be a dangerous activity for the vulnerable.\u003c/p>\n\u003cp>Mostly unregulated for the nearly 10 years they have been in existence, daily fantasy sports has become a controversial topic. The California legislature is considering legislation to clarify its legal standing and help address the problem behavior surrounding it.\u003c/p>\n\u003cp>Traditionally, participating in fantasy sports meant drafting athletes to create a team that would last an entire season. Now, daily fantasy sports contests are more immediate, offering leagues that last a weekend or a day. With that, opportunities to wager — and problem gamblers — have multiplied.\u003c/p>\n\u003cp>“We’re seeing a monumental shift,” said Dr. Eric Geffner, who has treated gambling addiction in Los Angeles since 1998. “What started as a pastime to relax and have a few beers with friends … has become full hardcore gambling.”\u003c/p>\n\u003cp>Many people are attracted to daily fantasy sports sites because they believe their sports knowledge can help them win, Geffner said.\u003c/p>\n\u003cp>Over the years, Geffner has seen hundreds of problem gamblers walk through his Westwood office. This time of year is particularly busy because March Madness offers a big pool of games to bet on, he said.\u003c/p>\n\u003cp>Daily fantasy sports, now a billion-dollar industry, was exempted from a federal law that outlawed Internet gambling in 2006. But state regulators are starting to scrutinize it. In the past few months, fantasy sports companies have been fighting in some states to remain in operation.\u003c/p>\n\u003cp>On March 21, DraftKings and FanDuel suspended their operations in New York pending a legal battle with the state’s attorney general. In California, a bill working its way through the state legislature would authorize and regulate daily fantasy sports sites.\u003c/p>\n\u003cp>The legislation, authored by Assemblyman Adam Gray (D-Merced), would allow these companies to operate in California after obtaining a license and paying an annual fee. The purpose of the legislation is to protect consumers, who currently assume all the risk.\u003c/p>\n\u003cp>The bill would prohibit an operator from allowing players to establish more than one account and would ban any advertising aimed at people under 21.\u003c/p>\n\u003cp>It would also require the state’s Department of Justice to develop an online self-exclusion form for problem gamblers who ask to be banned from gambling activities. The operators would have to make these forms available on their sites by July 2017.\u003c/p>\n\u003cp>Gray’s bill cleared the state Assembly in January and is now awaiting Senate action.\u003c/p>\n\u003cp>The daily sports fantasy industry does not consider itself to be in the gambling business. Industry representatives argue that unlike gambling, which is largely a matter of chance, daily fantasy sports require research and an ability to evaluate players and matchups.\u003c/p>\n\u003cp>But they are cognizant of problem behavior and willing to cooperate, said Peter Schoenke, chairman of the Fantasy Sports Trade Association. He said the industry is working with 20 states to help pass legislation that will clarify the legal status of daily fantasy sports.\u003c/p>\n\u003cp>“It’s not good for the industry to have those (problem) behaviors go unchecked,” Schoenke said. “We are being proactive and working to get bills passed that work for everyone.”\u003c/p>\n\u003cp>A spokeswoman for FanDuel said the site has trained staff in place to look for compulsive behavior by players. The number of contests a player can enter in a given time period is also limited, according to the site.\u003c/p>\n\u003cp>Jason, now in his mid-40s, never used DraftKings or FanDuel, but he has heard plenty about the sites from younger gambling addicts who, like him, are currently in treatment at Beit T’Shuvah, a rehabilitation center in Los Angeles whose name means “house of return” in Hebrew.\u003c/p>\n\u003cp>Yael Landa, the center’s gambling treatment program director, said Beit T’Shuvah treats a variety of addictions through residential and outpatient services. At any given time, about 120 people are enrolled in the center, 15 percent of whom are gamblers. Quite a few are in their early to mid-20s.\u003c/p>\n\u003cp>“We hear all kinds of stories from people of all ages,” Landa said. “People who owe a lot of money, people who’ve lived a double life. Some face severe financial wreckage.”\u003c/p>\n\u003cp>I. Nelson Rose, a law professor and gambling expert at Whittier Law School, said young adults’ attraction to gambling is not surprising: temptation is all around them. When gambling becomes convenient, common sense dictates that the number of problem gamblers grows, Rose said.\u003c/p>\n\u003cp>“Why in the world would you play a slot machine if you are carrying the world’s greatest games on your smartphone?” he said.\u003c/p>\n\u003cp>To address the growing number of people addicted to gambling, the Office of Problem Gambling has invested in training for medical providers, public service announcements, prevention for high school youth and is consulting with nonprofit community organizations to expand education on the dangers of gambling, said Canale-Dalman.\u003c/p>\n\u003cp>“Warning signs vary,” she said. “This isn’t like alcohol. You can’t smell or see something right away.”\u003c/p>\n\u003cp>Michael Barbosa, 57, of Pleasant Hill, believes the lack of obvious physical symptoms might be a reason why gambling addictions are too often disregarded as a disease. He lost four marriages because of his addiction to card games and poker. He stole money from his mother and at one point ended up on the street.\u003c/p>\n\u003cp>In 2013, he started a rehabilitation program at HealthRight 360, a residential treatment facility in San Francisco. That’s where he learned that being addicted to gambling is not much different than being addicted to a drug. When he attempted to stop cold turkey, he’d get fevers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Scientists announced Thursday that they have built a single-celled organism that has just 473 genes — likely close to the minimum number of genes necessary to sustain its life. The development, they say, could eventually lead to new manufacturing methods.\u003c/p>\n\u003cp>Around 1995, a few top geneticists set out on a quest: to make an organism that had only the genes that were absolutely essential for its survival. A zero-frills life.\u003c/p>\n\u003cp>It was a heady time.\u003c/p>\n\u003cp>\"That was the first time anybody had seen the complete genome of anything,\" says \u003ca href=\"http://www.jcvi.org/cms/about/bios/jcventer/\">J. Craig Venter\u003c/a>, a genome scientist and founder and CEO of the J. Craig Venter Institute. Back then, he and his colleagues had just sequenced the complete genomes of two types of bacteria and were shocked to see how different they were from each other, in terms of their DNA.\u003c/p>\n\u003cp>\"We were amazed at the lack of similarity of the two, even at the most fundamental level,\" he says, and it got them thinking philosophically. \"We were asking basic fundamental questions of life. What did we think might comprise the most primitive cell? What would be the gene content of this thing?\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Two decades later, in this week's issue of the journal \u003cem>Science\u003c/em>, Venter's team \u003ca href=\"http://science.sciencemag.org/cgi/doi/10.1126/science.aad6253\"> published\u003c/a> one possible answer. Their research report describes a new organism they've put together, using only 473 genes. That gives it the smallest genome of any known living thing that is able to reproduce on its own. (For comparison, humans each have about 20,000 genes).\u003c/p>\n\u003cp>\"You cannot live without all but one or two of the genes in this genome,\" says Venter.\u003c/p>\n\u003cp>The little cell marks one incremental step in a larger, two-pronged scheme: to understand what genes are essential for life, and eventually to design what could be a process of mass production — armies of cells that could spit out pretty much any molecule that's desired.\u003c/p>\n\u003cp>To make the simplified bacterium, which the scientists are calling \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3026460/\">JCVI - syn3.0\u003c/a> for now, they started with a bacterium that's already very simple -- \u003cem>Mycoplasma mycoides\u003c/em>. In its natural state, \u003cem>M. mycoides\u003c/em> is a parasite found in cattle and goats. Next, the scientists fashioned a little bacterial heaven — a material that the bacterium could live on that would provide all the food it could ever want. Then, they started tossing out genes.\u003c/p>\n\u003cp>(Ever heard of the Japanese organizer, \u003ca href=\"http://www.npr.org/2016/01/07/462230434/japanese-organizing-consultant-marie-kondo-takes-america-by-storm\">Marie Kondo\u003c/a>, who gives tips on how to declutter homes by taking each object in it and asking if it's worth keeping around? These biologists took that same approach to the \u003cem>M. mycoides\u003c/em> genome.)\u003c/p>\n\u003cp>If a gene could be removed without disrupting the cell's ability to live, grow and reproduce, it was deemed nonessential. Out it went. They chucked out a bunch of genes involved in transporting and metabolizing different kinds of food, since the cell they were working with had plenty of sugars to keep it going. They kept in almost all of the genes responsible for reading genetic material and creating more. They also kept a few that would allow the cell to reproduce quickly enough for them to observe that growth in the lab. And they added some specific DNA that could serve as a \"watermark,\" indicating the lab that had assembled it — the \u003ca href=\"http://www.jcvi.org/cms/home/\">J. Craig Venter Institute\u003c/a>.\u003c/p>\n\u003cp>Based on \u003ca href=\"http://www.ncbi.nlm.nih.gov/books/NBK2227/\">estimates\u003c/a> that biologists have been making for decades, Venter's team thought the modified bacterium would only need about 250 genes to eke out a bare existence. But, says Venter, it ended up requiring a lot more genes than that.\u003c/p>\n\u003cp>For example, the researchers also had to leave in 149 genes that are apparently essential for the cell's survival — though they don't know what that genetic material actually does. \"Many of these genes probably encode universal proteins whose functions are yet to be characterized,\" the scientists report. And there are versions of these genes in a lot of different organisms, they say.\u003c/p>\n\u003cp>\"It's remarkable that there are still so many genes in their minimal genome that we don't know anything about other than that they are needed,\" \u003ca href=\"https://profiles.stanford.edu/drew-endy\">Drew Endy\u003c/a>, a bioengineer at Stanford University who was not involved in this research, tells Shots. \"Only when you try to build something do you find out what's truly required,\" he says.\u003c/p>\n\u003cp>A lot of organisms, including humans, have swaths of genes with unknown functions. That, says Venter, is the next step: figuring out what the heck all those essential genes actually do.\u003c/p>\n\u003cp>\"If we can't understand what happens in a cell with less than 500 genes, imagine how complicated it's going to be to understand our 20,000-some genes in the human genome,\" Venter says. \"So, it's essential for understanding all of life to understand the basic components.\"\u003c/p>\n\u003cp>The group also has a long-range goal: engineering tailored cells that could mass-produce chemicals that are hard to make now.\u003c/p>\n\u003cp>\"Our long-term vision has been to design and build synthetic organisms on demand,\" says \u003ca href=\"http://jcvi.org/cms/about/bios/dgibson\">Dan Gibson\u003c/a>, a synthetic biologist with the Venter Institute and an author on the paper. \"We believe that these cells would be a very useful chassis for many industrial applications, from medicine to biochemicals, biofuels, nutrition and agriculture,\" he says.\u003c/p>\n\u003cp>He and his colleagues view their \"minimal cell\" as a useful starting point. Venter describes the cell as sort of like the frame of a car.\u003c/p>\n\u003cp>\"Early on, for example, Rolls Royce or Bugati, they made a car frame with an engine and provided those to a lot of different body makers that would style and make cars that look different from one another, but they were all based on the same chassis,\" he says.\u003c/p>\n\u003cp>Similarly, he says, minimal cells of various varieties could serve as starting points for engineering cells that digest or produce certain chemicals. \"It's a basic component that we can add things to,\" says Venter, like a gene from a deep-sea creature that would allow a cell to eat carbon dioxide and spit out methane — a fuel.\u003c/p>\n\u003cp>\"You could design cells and choose the type of metabolism you want,\" says Venter. \"If you just have a cassette of those genes that you can just plug in, that will enable design to go much faster,\" he says.\u003c/p>\n\u003cp>Because the cells wouldn't have any extra genes, the researchers explain, they would be easier to engineer. And organizing genes by their function would be helpful.\u003c/p>\n\u003cp>That sort of genetic engineering could be considered intelligent design for the purpose of mass production — of anything from pharmaceutical chemicals to fuel, which is why this kind of work by the Venter Institute has, over the years, been funded in part by the U.S. Department of Energy and the Defense Advanced Research Projects Agency. (Most of these scientists' funding comes from Venter's ventures, the endowment of the non-profit institute, and a for-profit company he started called Synthetic Genomics, Inc.)\u003c/p>\n\u003cp>Synthetic Genomics, Inc. has already \u003ca href=\"https://www.google.com/patents/US20150344837\">applied for a patent\u003c/a> on the process of making this minimal genome.\u003c/p>\n\u003cp>\u003ca href=\"http://arep.med.harvard.edu/gmc/\">George Church\u003c/a>, another pioneer in the field of genomics and a professor of genetics at Harvard Medical School, says the process Venter's team describes in this week's study is nowhere near those applications yet.\u003c/p>\n\u003cp>\"I think the main reason it should be celebrated is that it is an achievement of a 20-year goal,\" says Church. Making a minimal bacterial genome is not easy, and contributes to basic science. \"That's a labor of love on a pretty out-of-the-way pure science project for 20 years,\" he says.\u003c/p>\n\u003cp>Still, that accomplishment is a long way from revolutionizing genetic manipulation, Church says, noting that scientists have manipulated genomes before, and made minimal genomes in the past. They've also put new DNA into existing organisms using methods like \u003ca href=\"http://www.npr.org/sections/health-shots/2015/12/28/460705645/gene-editing-tool-hailed-as-a-breakthrough-and-it-really-is-one\">CRISPR.\u003c/a> That method, for example, has allowed scientists to edit out parts of the pig genome so that it can \u003ca href=\"http://www.nature.com/news/new-life-for-pig-to-human-transplants-1.18768\">make organs\u003c/a> that a human body would not reject during transplantation.\u003c/p>\n\u003cp>The method described in the research published Thursday — for designing an entire genome and plopping it into a cell — \"hasn't been proven to work in any organism outside of \u003cem>Mycoplasma mycoides,\" \u003c/em>Church says. \"It doesn't even work in \u003cem>Mycoplasma genitalium\u003c/em>, last time I checked.\" That's a very close relative of \u003cem>M. mycoides.\u003c/em>\u003c/p>\n\u003cp>And to get to the point where people can design whole genomes to produce chemicals or biofuel, the whole process would have to be shown to be speedy, cost-effective and widely applicable, Church adds.\u003c/p>\n\u003cp>In the meantime, he says, let's not forget that this entire field brings up some tricky what-ifs. For example, what if an engineered organism accidentally got out of the lab?\u003c/p>\n\u003cp>\"Most of the organisms we manipulate in the laboratory are so weak they wouldn't survive outside the laboratory,\" Church says, \"so, from a safety standpoint, it's probably a solved problem for these very weak strains.\"\u003c/p>\n\u003cp>But, he says, \"Anything that has a chance — even a remote chance — of spreading through the wild should be something we're very cautious [with], and have mechanisms in place to limit it and/or reverse it.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Scientists+Build+A+Live%2C+No-Frills+Cell+That+Could+Have+A+Big+Future&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\u003cp>\u003cstrong>Transcript :\u003c/strong>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Scientists announced Thursday that they have built a single-celled organism that has just 473 genes — likely close to the minimum number of genes necessary to sustain its life. The development, they say, could eventually lead to new manufacturing methods.\u003c/p>\n\u003cp>Around 1995, a few top geneticists set out on a quest: to make an organism that had only the genes that were absolutely essential for its survival. A zero-frills life.\u003c/p>\n\u003cp>It was a heady time.\u003c/p>\n\u003cp>\"That was the first time anybody had seen the complete genome of anything,\" says \u003ca href=\"http://www.jcvi.org/cms/about/bios/jcventer/\">J. Craig Venter\u003c/a>, a genome scientist and founder and CEO of the J. Craig Venter Institute. Back then, he and his colleagues had just sequenced the complete genomes of two types of bacteria and were shocked to see how different they were from each other, in terms of their DNA.\u003c/p>\n\u003cp>\"We were amazed at the lack of similarity of the two, even at the most fundamental level,\" he says, and it got them thinking philosophically. \"We were asking basic fundamental questions of life. What did we think might comprise the most primitive cell? What would be the gene content of this thing?\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Two decades later, in this week's issue of the journal \u003cem>Science\u003c/em>, Venter's team \u003ca href=\"http://science.sciencemag.org/cgi/doi/10.1126/science.aad6253\"> published\u003c/a> one possible answer. Their research report describes a new organism they've put together, using only 473 genes. That gives it the smallest genome of any known living thing that is able to reproduce on its own. (For comparison, humans each have about 20,000 genes).\u003c/p>\n\u003cp>\"You cannot live without all but one or two of the genes in this genome,\" says Venter.\u003c/p>\n\u003cp>The little cell marks one incremental step in a larger, two-pronged scheme: to understand what genes are essential for life, and eventually to design what could be a process of mass production — armies of cells that could spit out pretty much any molecule that's desired.\u003c/p>\n\u003cp>To make the simplified bacterium, which the scientists are calling \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3026460/\">JCVI - syn3.0\u003c/a> for now, they started with a bacterium that's already very simple -- \u003cem>Mycoplasma mycoides\u003c/em>. In its natural state, \u003cem>M. mycoides\u003c/em> is a parasite found in cattle and goats. Next, the scientists fashioned a little bacterial heaven — a material that the bacterium could live on that would provide all the food it could ever want. Then, they started tossing out genes.\u003c/p>\n\u003cp>(Ever heard of the Japanese organizer, \u003ca href=\"http://www.npr.org/2016/01/07/462230434/japanese-organizing-consultant-marie-kondo-takes-america-by-storm\">Marie Kondo\u003c/a>, who gives tips on how to declutter homes by taking each object in it and asking if it's worth keeping around? These biologists took that same approach to the \u003cem>M. mycoides\u003c/em> genome.)\u003c/p>\n\u003cp>If a gene could be removed without disrupting the cell's ability to live, grow and reproduce, it was deemed nonessential. Out it went. They chucked out a bunch of genes involved in transporting and metabolizing different kinds of food, since the cell they were working with had plenty of sugars to keep it going. They kept in almost all of the genes responsible for reading genetic material and creating more. They also kept a few that would allow the cell to reproduce quickly enough for them to observe that growth in the lab. And they added some specific DNA that could serve as a \"watermark,\" indicating the lab that had assembled it — the \u003ca href=\"http://www.jcvi.org/cms/home/\">J. Craig Venter Institute\u003c/a>.\u003c/p>\n\u003cp>Based on \u003ca href=\"http://www.ncbi.nlm.nih.gov/books/NBK2227/\">estimates\u003c/a> that biologists have been making for decades, Venter's team thought the modified bacterium would only need about 250 genes to eke out a bare existence. But, says Venter, it ended up requiring a lot more genes than that.\u003c/p>\n\u003cp>For example, the researchers also had to leave in 149 genes that are apparently essential for the cell's survival — though they don't know what that genetic material actually does. \"Many of these genes probably encode universal proteins whose functions are yet to be characterized,\" the scientists report. And there are versions of these genes in a lot of different organisms, they say.\u003c/p>\n\u003cp>\"It's remarkable that there are still so many genes in their minimal genome that we don't know anything about other than that they are needed,\" \u003ca href=\"https://profiles.stanford.edu/drew-endy\">Drew Endy\u003c/a>, a bioengineer at Stanford University who was not involved in this research, tells Shots. \"Only when you try to build something do you find out what's truly required,\" he says.\u003c/p>\n\u003cp>A lot of organisms, including humans, have swaths of genes with unknown functions. That, says Venter, is the next step: figuring out what the heck all those essential genes actually do.\u003c/p>\n\u003cp>\"If we can't understand what happens in a cell with less than 500 genes, imagine how complicated it's going to be to understand our 20,000-some genes in the human genome,\" Venter says. \"So, it's essential for understanding all of life to understand the basic components.\"\u003c/p>\n\u003cp>The group also has a long-range goal: engineering tailored cells that could mass-produce chemicals that are hard to make now.\u003c/p>\n\u003cp>\"Our long-term vision has been to design and build synthetic organisms on demand,\" says \u003ca href=\"http://jcvi.org/cms/about/bios/dgibson\">Dan Gibson\u003c/a>, a synthetic biologist with the Venter Institute and an author on the paper. \"We believe that these cells would be a very useful chassis for many industrial applications, from medicine to biochemicals, biofuels, nutrition and agriculture,\" he says.\u003c/p>\n\u003cp>He and his colleagues view their \"minimal cell\" as a useful starting point. Venter describes the cell as sort of like the frame of a car.\u003c/p>\n\u003cp>\"Early on, for example, Rolls Royce or Bugati, they made a car frame with an engine and provided those to a lot of different body makers that would style and make cars that look different from one another, but they were all based on the same chassis,\" he says.\u003c/p>\n\u003cp>Similarly, he says, minimal cells of various varieties could serve as starting points for engineering cells that digest or produce certain chemicals. \"It's a basic component that we can add things to,\" says Venter, like a gene from a deep-sea creature that would allow a cell to eat carbon dioxide and spit out methane — a fuel.\u003c/p>\n\u003cp>\"You could design cells and choose the type of metabolism you want,\" says Venter. \"If you just have a cassette of those genes that you can just plug in, that will enable design to go much faster,\" he says.\u003c/p>\n\u003cp>Because the cells wouldn't have any extra genes, the researchers explain, they would be easier to engineer. And organizing genes by their function would be helpful.\u003c/p>\n\u003cp>That sort of genetic engineering could be considered intelligent design for the purpose of mass production — of anything from pharmaceutical chemicals to fuel, which is why this kind of work by the Venter Institute has, over the years, been funded in part by the U.S. Department of Energy and the Defense Advanced Research Projects Agency. (Most of these scientists' funding comes from Venter's ventures, the endowment of the non-profit institute, and a for-profit company he started called Synthetic Genomics, Inc.)\u003c/p>\n\u003cp>Synthetic Genomics, Inc. has already \u003ca href=\"https://www.google.com/patents/US20150344837\">applied for a patent\u003c/a> on the process of making this minimal genome.\u003c/p>\n\u003cp>\u003ca href=\"http://arep.med.harvard.edu/gmc/\">George Church\u003c/a>, another pioneer in the field of genomics and a professor of genetics at Harvard Medical School, says the process Venter's team describes in this week's study is nowhere near those applications yet.\u003c/p>\n\u003cp>\"I think the main reason it should be celebrated is that it is an achievement of a 20-year goal,\" says Church. Making a minimal bacterial genome is not easy, and contributes to basic science. \"That's a labor of love on a pretty out-of-the-way pure science project for 20 years,\" he says.\u003c/p>\n\u003cp>Still, that accomplishment is a long way from revolutionizing genetic manipulation, Church says, noting that scientists have manipulated genomes before, and made minimal genomes in the past. They've also put new DNA into existing organisms using methods like \u003ca href=\"http://www.npr.org/sections/health-shots/2015/12/28/460705645/gene-editing-tool-hailed-as-a-breakthrough-and-it-really-is-one\">CRISPR.\u003c/a> That method, for example, has allowed scientists to edit out parts of the pig genome so that it can \u003ca href=\"http://www.nature.com/news/new-life-for-pig-to-human-transplants-1.18768\">make organs\u003c/a> that a human body would not reject during transplantation.\u003c/p>\n\u003cp>The method described in the research published Thursday — for designing an entire genome and plopping it into a cell — \"hasn't been proven to work in any organism outside of \u003cem>Mycoplasma mycoides,\" \u003c/em>Church says. \"It doesn't even work in \u003cem>Mycoplasma genitalium\u003c/em>, last time I checked.\" That's a very close relative of \u003cem>M. mycoides.\u003c/em>\u003c/p>\n\u003cp>And to get to the point where people can design whole genomes to produce chemicals or biofuel, the whole process would have to be shown to be speedy, cost-effective and widely applicable, Church adds.\u003c/p>\n\u003cp>In the meantime, he says, let's not forget that this entire field brings up some tricky what-ifs. For example, what if an engineered organism accidentally got out of the lab?\u003c/p>\n\u003cp>\"Most of the organisms we manipulate in the laboratory are so weak they wouldn't survive outside the laboratory,\" Church says, \"so, from a safety standpoint, it's probably a solved problem for these very weak strains.\"\u003c/p>\n\u003cp>But, he says, \"Anything that has a chance — even a remote chance — of spreading through the wild should be something we're very cautious [with], and have mechanisms in place to limit it and/or reverse it.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Scientists+Build+A+Live%2C+No-Frills+Cell+That+Could+Have+A+Big+Future&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\u003cp>\u003cstrong>Transcript :\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "New Research Sheds Light on Gambling Addiction ... At Least in Rats",
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"content": "\u003cp>Some people walk into a casino and head to the nickel slots; others march straight to the roulette table with their life savings.\u003c/p>\n\u003cp>Why? What makes us more prone to take risks?\u003c/p>\n\u003cp>The answer, according to \u003ca href=\"http://www.nature.com/articles/nature17400.epdf?referrer_access_token=QwrzFIr2jKrPWYNlHtA6-tRgN0jAjWel9jnR3ZoTv0MAMAaL7Wsp_Ll2m98B2kO3GoXldSLV2BdmMcu9-RqTpAlSldZDCtsGdHel7FWnOTMa7SpwaF00k29RCTRZRksssuFfWhVyK27fTovDozEYVIWY5Y4UMG8rLaxlAFIe5VADoWtHYtMraG_2lflq1PX7Ff2rF1UHH70MegF35XLQOMqtkPE2EXMSiIZ27oYu8RFrsViLmOtv26SpWjCGPhRLF2wbHznMiBFsvp9H5i6NYg%3D%3D&tracking_referrer=www.nytimes.com\">research\u003c/a> out Wednesday from Stanford University, is the failure of specific nerve cells in the brain to send out a signal that inhibits gambling behavior.\u003c/p>\n\u003cp>The discovery was made in an experiment aimed at studying brain chemistry in rats as they made decisions about whether to get a steady, regular reward or a rare, much larger reward.\u003c/p>\n\u003cp>“Humans and rats have similar brain structures involved,” says senior author and practicing psychiatrist \u003ca href=\"http://web.stanford.edu/group/dlab/\">Karl Deisseroth\u003c/a>. “So every indication is that these findings are relevant to humans.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>High-Rolling Rodents\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Researchers reached their conclusions after devising a task where rats poke their nose in a hole, at which point two levers pop out. When the rats pulled one lever, they received a dependable dose of sugar water. Pulling the other lever most of the time yielded a much smaller amount of sugar water, but a big rush of sugar water every once in a while.\u003c/p>\n\u003cp>Once they had learned the system, about two-thirds of the rats consistently chose the steady-paying dose. The other third preferred the occasional windfall. Like some people, a high-rolling rat doesn't seem to be fazed by a losing streak.\u003c/p>\n\u003cp>\u003cstrong>The Brain and Risk\u003c/strong>\u003c/p>\n\u003cp>Heading into the study, researchers were fairly certain that a specific region of the brain called the \u003ca href=\"http://thebrain.mcgill.ca/flash/i/i_03/i_03_cr/i_03_cr_par/i_03_cr_par.html\">nucleus accumbens\u003c/a> was implicated in gambling behavior.\u003c/p>\n\u003cp>To test this, they gave the rats a drug called pramipexole; it's prescribed for Parkinson’s disease, restless leg syndrome and other brain or nervous system disorders, and it can cause gambling problems.\u003c/p>\n\u003cp>The drug turned rats that chose the steady lever into rats looking for a big reward.\u003c/p>\n\u003cp>\"We found that a drug known to increase risk preference in people had the same effect on the rats,\" Deisseroth says.\u003c/p>\n\u003cp>Zeroing in on nucleus accumbens, scientists then discovered that a small group of nerve cells in the region lit up in the risk-averse rats, but not in those who were risk-prone.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Having this knowledge, knowing which chemicals, which receptors in the brain are responsible means that we can make better predictions about which drugs would increase risk taking and won’t.'\u003ccite>Brian Knutson,\u003cbr>\nStanford University\u003c/cite>\u003c/aside>\n\u003cp>That meant a rat was really bummed out after getting the smaller dose, and was more likely to choose the steadier payout the next time. But the risk taking rodents didn't seem to care if they were disappointed most of the time as long as a big sugar rush arrived occasionally. In other words, the risk-prone rats were less sensitive to loss signals -- they care less when they lose so they're more likely to keep going for the win.\u003c/p>\n\u003cp>“It looks as though we have found a brain signal that, in most individuals, corresponds to a memory of a failed risky choice,” Deisseroth says. “It seems to represent the memory of that recent unfavorable outcome, manifested later at just the right time when it can -- and does -- modify an upcoming decision.”\u003c/p>\n\u003cp>Through a couple of different techniques, the researchers then manipulated the rats' brains and found they could influence their choices, turning risk avoiders into risk seekers.\u003c/p>\n\u003cp>\u003cb>Could the Same Be True for People?\u003cbr>\n\u003c/b>\u003c/p>\n\u003cp>The researchers say the findings could inform human therapy down the road.\u003c/p>\n\u003cp>Brian Knutson, a professor of psychology at Stanford and a study co-author, says the research offers insight into both pharmacotherapy or even environmental cues that influence gambling addicts.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Having this knowledge,” says Knutson, \"knowing which chemicals, which receptors in the brain are responsible means that we can make better predictions about which drugs would increase risk-taking and which won’t.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Some people walk into a casino and head to the nickel slots; others march straight to the roulette table with their life savings.\u003c/p>\n\u003cp>Why? What makes us more prone to take risks?\u003c/p>\n\u003cp>The answer, according to \u003ca href=\"http://www.nature.com/articles/nature17400.epdf?referrer_access_token=QwrzFIr2jKrPWYNlHtA6-tRgN0jAjWel9jnR3ZoTv0MAMAaL7Wsp_Ll2m98B2kO3GoXldSLV2BdmMcu9-RqTpAlSldZDCtsGdHel7FWnOTMa7SpwaF00k29RCTRZRksssuFfWhVyK27fTovDozEYVIWY5Y4UMG8rLaxlAFIe5VADoWtHYtMraG_2lflq1PX7Ff2rF1UHH70MegF35XLQOMqtkPE2EXMSiIZ27oYu8RFrsViLmOtv26SpWjCGPhRLF2wbHznMiBFsvp9H5i6NYg%3D%3D&tracking_referrer=www.nytimes.com\">research\u003c/a> out Wednesday from Stanford University, is the failure of specific nerve cells in the brain to send out a signal that inhibits gambling behavior.\u003c/p>\n\u003cp>The discovery was made in an experiment aimed at studying brain chemistry in rats as they made decisions about whether to get a steady, regular reward or a rare, much larger reward.\u003c/p>\n\u003cp>“Humans and rats have similar brain structures involved,” says senior author and practicing psychiatrist \u003ca href=\"http://web.stanford.edu/group/dlab/\">Karl Deisseroth\u003c/a>. “So every indication is that these findings are relevant to humans.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>High-Rolling Rodents\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>Researchers reached their conclusions after devising a task where rats poke their nose in a hole, at which point two levers pop out. When the rats pulled one lever, they received a dependable dose of sugar water. Pulling the other lever most of the time yielded a much smaller amount of sugar water, but a big rush of sugar water every once in a while.\u003c/p>\n\u003cp>Once they had learned the system, about two-thirds of the rats consistently chose the steady-paying dose. The other third preferred the occasional windfall. Like some people, a high-rolling rat doesn't seem to be fazed by a losing streak.\u003c/p>\n\u003cp>\u003cstrong>The Brain and Risk\u003c/strong>\u003c/p>\n\u003cp>Heading into the study, researchers were fairly certain that a specific region of the brain called the \u003ca href=\"http://thebrain.mcgill.ca/flash/i/i_03/i_03_cr/i_03_cr_par/i_03_cr_par.html\">nucleus accumbens\u003c/a> was implicated in gambling behavior.\u003c/p>\n\u003cp>To test this, they gave the rats a drug called pramipexole; it's prescribed for Parkinson’s disease, restless leg syndrome and other brain or nervous system disorders, and it can cause gambling problems.\u003c/p>\n\u003cp>The drug turned rats that chose the steady lever into rats looking for a big reward.\u003c/p>\n\u003cp>\"We found that a drug known to increase risk preference in people had the same effect on the rats,\" Deisseroth says.\u003c/p>\n\u003cp>Zeroing in on nucleus accumbens, scientists then discovered that a small group of nerve cells in the region lit up in the risk-averse rats, but not in those who were risk-prone.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Having this knowledge, knowing which chemicals, which receptors in the brain are responsible means that we can make better predictions about which drugs would increase risk taking and won’t.'\u003ccite>Brian Knutson,\u003cbr>\nStanford University\u003c/cite>\u003c/aside>\n\u003cp>That meant a rat was really bummed out after getting the smaller dose, and was more likely to choose the steadier payout the next time. But the risk taking rodents didn't seem to care if they were disappointed most of the time as long as a big sugar rush arrived occasionally. In other words, the risk-prone rats were less sensitive to loss signals -- they care less when they lose so they're more likely to keep going for the win.\u003c/p>\n\u003cp>“It looks as though we have found a brain signal that, in most individuals, corresponds to a memory of a failed risky choice,” Deisseroth says. “It seems to represent the memory of that recent unfavorable outcome, manifested later at just the right time when it can -- and does -- modify an upcoming decision.”\u003c/p>\n\u003cp>Through a couple of different techniques, the researchers then manipulated the rats' brains and found they could influence their choices, turning risk avoiders into risk seekers.\u003c/p>\n\u003cp>\u003cb>Could the Same Be True for People?\u003cbr>\n\u003c/b>\u003c/p>\n\u003cp>The researchers say the findings could inform human therapy down the road.\u003c/p>\n\u003cp>Brian Knutson, a professor of psychology at Stanford and a study co-author, says the research offers insight into both pharmacotherapy or even environmental cues that influence gambling addicts.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Having this knowledge,” says Knutson, \"knowing which chemicals, which receptors in the brain are responsible means that we can make better predictions about which drugs would increase risk-taking and which won’t.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Electronic Records Mismatch Can Stymie End-Of-Life Plans",
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"content": "\u003cp>In a perfect world, patients with advance directives would be confident that their doctors and nurses — no matter where they receive care — could know in a split second their end-of-life wishes.\u003c/p>\n\u003cp>But this ideal is still in the distance. Patients’ documents often go missing in maze-like files or are rendered unreadable by incompatible software. And this risk continues even as health systems and physician practices adopt new electronic health records. So advocates and policymakers are pushing for a fix.\u003c/p>\n\u003cp>The problem isn’t new, experts noted. Advance directives were lost during the era of paper records, too. But, so far, digital efforts have fallen short.\u003c/p>\n\u003cp>“When these systems don’t work — and currently, they don’t work well enough — then that has a huge negative feedback on doctors and patients and families,” said Dr. Lachlan Forrow, director of the ethics and palliative care program at Boston’s Beth Israel Deaconess Medical Center. “Like, why even bother?” Thinking through and writing down end-of-life preferences can be grueling, he added.\u003c/p>\n\u003cp>Still, end-of-life planning has been encouraged by ethicists and experts in recent years, who say it communicates patient choices about medical interventions like being connected to a ventilator or feeding tube, or being resuscitated after heart failure — especially when patients can’t speak for themselves. This January, Medicare began paying doctors to discuss end-of-life wishes with patients, a policy almost 90 percent of Americans support. Meanwhile, according to 2015 figures from the Kaiser Family Foundation, 60 percent of adults older than 65 have such directives. (KHN is an editorially independent program of the foundation.)\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Here’s how difficulties arise. Maybe a patient’s doctor uses one record system and the emergency room another. If the software doesn’t match up, the ER doctors may be unable to tell if the patient has a preference like a “do-not-resuscitate” order.\u003c/p>\n\u003cp>“An individual will fill out an advance directive, but unless they bring a copy with them, the provider will likely not know or see it exists,” said Kim Callinan, chief program officer at Compassion & Choices, a Colorado-based group that advocates for end-of-life care options.\u003c/p>\n\u003cp>Also, older patients, who are increasingly likely to have a directive, often get treatment from varied sources — surgeons, hospitals, nursing homes, primary physicians. That increases the odds of unaligned systems, said Dr. Irene Hamrick, who directs geriatric services in family medicine at the University of Wisconsin-Madison.\u003c/p>\n\u003cp>An additional complication stems from system design. Many systems don’t have a dedicated tab to mark where such information — if it exists — is stored. After doctors and nurses click through various pages, they still don’t know whether they looked in the right place. Time doesn’t always allow this kind of search.\u003c/p>\n\u003cp>“If they’re not able to access the advance directive quickly and easily, they’re honestly likely not to use it,” said Torrie Fields, senior program manager for palliative care at Blue Shield of California. “They’ll end up erring on the side of the most treatment possible.”\u003c/p>\n\u003cp>No one has researched how often this flaw yields unwanted treatment for dying patients. Based on anecdote, it’s “really common,” said Judy Thomas, CEO of the Coalition for Compassionate Care of California, an end-of-life care advocacy group.\u003c/p>\n\u003cp>\u003cstrong>Fixes Proposed\u003c/strong>\u003c/p>\n\u003cp>Changes may lie ahead. Developers of record systems are introducing functions that could make it easier to find and read an advance directive, said Harriet Warshaw, executive director of the Boston-based Conversation Project, which encourages families to discuss end-of-life options. Epic Systems, a Madison, Wisconsin-based company that is among the dominant sellers for electronic health records, has added a tab intended to indicate clearly whether a patient has an advance directive on file. Cerner, based in Missouri, has partnered with a website, MyDirectives. Patients can upload their forms to that website, and doctors can reach it through Cerner.\u003c/p>\n\u003cp>“Advance care planning is an important issue we’re tackling,” said Bob Robke, Cerner’s vice president of interoperability. “To that end, we’ve made recent improvements … that address advance directive documentation.”\u003c/p>\n\u003cp>Cerner, Robke added, is dedicated to helping “overcome [the] barriers to data exchange” between different software systems that can currently block doctors from seeing advance directives.\u003c/p>\n\u003cp>Additional efforts are underway.\u003c/p>\n\u003cp>In Congress, lawmakers have expressed interest in making directives “portable” — that is, easily accessible. Legislation introduced in the Senate by Sen. Mark Warner, D-Virginia, includes provisions that could push health facilities to ensure compatibility across different health records for advance directives. Rep. Earl Blumenauer, D-Oregon, is also working on legislation, he said in an interview.\u003c/p>\n\u003cp>Hospitals and health systems are also making adjustments. The hospital at Oregon Health & Science University, California-based Sharp Hospice and Gunderson Health in Wisconsin are among those that have made in-house software revisions to make advance directives easy to find in electronic health records — for instance having IT teams add tabs on the record’s main page to indicate if a patient has end-of-life planning documents. Representatives of those hospitals said such efforts aren’t the norm, though.\u003c/p>\n\u003cp>Meanwhile, a number of states, including Virginia, Vermont, North Carolina and Arizona, have created online databases for residents to upload and store their advance directives. Recent figures are hard to come by, but in 2007, nine states were counted to have these in place. In these instances, doctors can go online to find a patient’s advance directive on those websites. They’re secured websites, and directives are password protected, requiring special logins from both patients and doctors, but specifics vary from state to state.\u003c/p>\n\u003cp>But there’s debate over how to finance state websites — in North Carolina, for instance, patients pay a $10 one-time fee to upload their advance directive. That can be an easy, low-cost way to maintain a site’s upkeep, but it can also discourage people from doing something they already find unappealing, said Marian Grant, director of policy and professional engagement at the Coalition to Transform Advanced Care and an associate professor at the University of Maryland School of Nursing.\u003c/p>\n\u003cp>These fixes lead to other complications, too. Directories specific to a particular state don’t necessarily accommodate patients who travel regularly between states — for example, a patient who sees one doctor in New Jersey and another in New York. And doctors navigating a cumbersome health record system may not take the additional time to check multiple websites.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“If you are sick enough and worried about finding your advance directives, it’s a critical situation. We are moving very fast,” said Grant. “We don’t have extra staff to say, ‘She might have an advance directive somewhere — check the top five directories and let me know.’ A busy resident is going to look in one place, and if they don’t find it, move on.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In a perfect world, patients with advance directives would be confident that their doctors and nurses — no matter where they receive care — could know in a split second their end-of-life wishes.\u003c/p>\n\u003cp>But this ideal is still in the distance. Patients’ documents often go missing in maze-like files or are rendered unreadable by incompatible software. And this risk continues even as health systems and physician practices adopt new electronic health records. So advocates and policymakers are pushing for a fix.\u003c/p>\n\u003cp>The problem isn’t new, experts noted. Advance directives were lost during the era of paper records, too. But, so far, digital efforts have fallen short.\u003c/p>\n\u003cp>“When these systems don’t work — and currently, they don’t work well enough — then that has a huge negative feedback on doctors and patients and families,” said Dr. Lachlan Forrow, director of the ethics and palliative care program at Boston’s Beth Israel Deaconess Medical Center. “Like, why even bother?” Thinking through and writing down end-of-life preferences can be grueling, he added.\u003c/p>\n\u003cp>Still, end-of-life planning has been encouraged by ethicists and experts in recent years, who say it communicates patient choices about medical interventions like being connected to a ventilator or feeding tube, or being resuscitated after heart failure — especially when patients can’t speak for themselves. This January, Medicare began paying doctors to discuss end-of-life wishes with patients, a policy almost 90 percent of Americans support. Meanwhile, according to 2015 figures from the Kaiser Family Foundation, 60 percent of adults older than 65 have such directives. (KHN is an editorially independent program of the foundation.)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Here’s how difficulties arise. Maybe a patient’s doctor uses one record system and the emergency room another. If the software doesn’t match up, the ER doctors may be unable to tell if the patient has a preference like a “do-not-resuscitate” order.\u003c/p>\n\u003cp>“An individual will fill out an advance directive, but unless they bring a copy with them, the provider will likely not know or see it exists,” said Kim Callinan, chief program officer at Compassion & Choices, a Colorado-based group that advocates for end-of-life care options.\u003c/p>\n\u003cp>Also, older patients, who are increasingly likely to have a directive, often get treatment from varied sources — surgeons, hospitals, nursing homes, primary physicians. That increases the odds of unaligned systems, said Dr. Irene Hamrick, who directs geriatric services in family medicine at the University of Wisconsin-Madison.\u003c/p>\n\u003cp>An additional complication stems from system design. Many systems don’t have a dedicated tab to mark where such information — if it exists — is stored. After doctors and nurses click through various pages, they still don’t know whether they looked in the right place. Time doesn’t always allow this kind of search.\u003c/p>\n\u003cp>“If they’re not able to access the advance directive quickly and easily, they’re honestly likely not to use it,” said Torrie Fields, senior program manager for palliative care at Blue Shield of California. “They’ll end up erring on the side of the most treatment possible.”\u003c/p>\n\u003cp>No one has researched how often this flaw yields unwanted treatment for dying patients. Based on anecdote, it’s “really common,” said Judy Thomas, CEO of the Coalition for Compassionate Care of California, an end-of-life care advocacy group.\u003c/p>\n\u003cp>\u003cstrong>Fixes Proposed\u003c/strong>\u003c/p>\n\u003cp>Changes may lie ahead. Developers of record systems are introducing functions that could make it easier to find and read an advance directive, said Harriet Warshaw, executive director of the Boston-based Conversation Project, which encourages families to discuss end-of-life options. Epic Systems, a Madison, Wisconsin-based company that is among the dominant sellers for electronic health records, has added a tab intended to indicate clearly whether a patient has an advance directive on file. Cerner, based in Missouri, has partnered with a website, MyDirectives. Patients can upload their forms to that website, and doctors can reach it through Cerner.\u003c/p>\n\u003cp>“Advance care planning is an important issue we’re tackling,” said Bob Robke, Cerner’s vice president of interoperability. “To that end, we’ve made recent improvements … that address advance directive documentation.”\u003c/p>\n\u003cp>Cerner, Robke added, is dedicated to helping “overcome [the] barriers to data exchange” between different software systems that can currently block doctors from seeing advance directives.\u003c/p>\n\u003cp>Additional efforts are underway.\u003c/p>\n\u003cp>In Congress, lawmakers have expressed interest in making directives “portable” — that is, easily accessible. Legislation introduced in the Senate by Sen. Mark Warner, D-Virginia, includes provisions that could push health facilities to ensure compatibility across different health records for advance directives. Rep. Earl Blumenauer, D-Oregon, is also working on legislation, he said in an interview.\u003c/p>\n\u003cp>Hospitals and health systems are also making adjustments. The hospital at Oregon Health & Science University, California-based Sharp Hospice and Gunderson Health in Wisconsin are among those that have made in-house software revisions to make advance directives easy to find in electronic health records — for instance having IT teams add tabs on the record’s main page to indicate if a patient has end-of-life planning documents. Representatives of those hospitals said such efforts aren’t the norm, though.\u003c/p>\n\u003cp>Meanwhile, a number of states, including Virginia, Vermont, North Carolina and Arizona, have created online databases for residents to upload and store their advance directives. Recent figures are hard to come by, but in 2007, nine states were counted to have these in place. In these instances, doctors can go online to find a patient’s advance directive on those websites. They’re secured websites, and directives are password protected, requiring special logins from both patients and doctors, but specifics vary from state to state.\u003c/p>\n\u003cp>But there’s debate over how to finance state websites — in North Carolina, for instance, patients pay a $10 one-time fee to upload their advance directive. That can be an easy, low-cost way to maintain a site’s upkeep, but it can also discourage people from doing something they already find unappealing, said Marian Grant, director of policy and professional engagement at the Coalition to Transform Advanced Care and an associate professor at the University of Maryland School of Nursing.\u003c/p>\n\u003cp>These fixes lead to other complications, too. Directories specific to a particular state don’t necessarily accommodate patients who travel regularly between states — for example, a patient who sees one doctor in New Jersey and another in New York. And doctors navigating a cumbersome health record system may not take the additional time to check multiple websites.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“If you are sick enough and worried about finding your advance directives, it’s a critical situation. We are moving very fast,” said Grant. “We don’t have extra staff to say, ‘She might have an advance directive somewhere — check the top five directories and let me know.’ A busy resident is going to look in one place, and if they don’t find it, move on.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "After Infecting Pregnant Monkey With Zika, Scientists Wait for Backlash",
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"content": "\u003cp>We've all seen the \u003ca href=\"https://www.google.com/search?q=zika+microcephaly\" target=\"_blank\">media coverage\u003c/a> about the Zika virus' potentially \u003ca href=\"http://news.yahoo.com/brazil-says-confirmed-suspected-microcephaly-cases-rise-5-135759702.html\" target=\"_blank\">destructive effect\u003c/a> on newborns. The virus has sowed fear and loathing in parts of Latin America and the Caribbean, and now Puerto Rico is \u003ca href=\"http://www.nytimes.com/2016/03/20/health/zika-virus-puerto-rico.html?_r=0\" target=\"_blank\">preparing for a nasty epidemic\u003c/a> that may result in hundreds of thousands of infections. The CDC has \u003ca href=\"http://wwwnc.cdc.gov/travel/notices/alert/zika-virus-puerto-rico\" target=\"_blank\">advised pregnant women\u003c/a> to avoid traveling to the island.\u003c/p>\n\u003cp>Two researchers who are working diligently to learn more about Zika are Dave O'Connor and Tom Friedrich. They are currently studying the virus' transmission from mother to fetus, in hopes of informing the public health response.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"The idea of making data from nonhuman primates available to the public is basically an invitation to disaster.\"\u003ccite>Researcher Dave O'Connor\u003c/cite>\u003c/aside>\n\u003cp>And yet, O'Connor and Friedrich have prepared themselves for the possibility, if not the probability, that some will not exactly view them as doing God’s own work.\u003c/p>\n\u003cp>Why? Because they are using rhesus monkeys in their research. Two weeks ago, they deliberately infected a pregnant mother with the virus in order to observe its effect on the fetus.\u003c/p>\n\u003cp>\u003cstrong>Posting Data in Real Time\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>O'Connor and Friedrich hope to answer important unknowns about the virus, including how long it's present after infection, where in the body besides the blood it exists, and what the likelihood is that an infected mother will pass it on to her offspring. They are also deviating from the ordinary method for disseminating research — publishing in a peer-reviewed journal — by \u003ca href=\"https://zika.labkey.com/project/OConnor/ZIKV-003/begin.view\" target=\"_blank\">posting their data\u003c/a> for both their colleagues and the public to see as soon as it comes in.\u003c/p>\n\u003cp>That could be a problem.\u003c/p>\n\u003cp>\"I am aware that sharing \u003ca href=\"https://dholk.primate.wisc.edu/_webdav/dho/public/Zika/public/%40files/ultrasounds/827577/Placenta%20disk%202%20d0.jpg\" target=\"_blank\">ultrasound imagery\u003c/a> of developing macaques can elicit stronger emotions than looking at relatively sterile charts and tables. It certainly did for me and our staff who saw the first ultrasound today,\" \u003ca href=\"https://zika.labkey.com/announcements/OConnor/ZIKV-003/thread.view?rowId=32\" target=\"_blank\">O'Connor logged\u003c/a> on the lab's website.\u003c/p>\n\u003cp>\"I want to thank those who have viewed our data so far and have chosen not to use it out of context to further arguments against using animals in research.\"\u003c/p>\n\u003cfigure id=\"attachment_133119\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/03/Monkey-ultrasound.jpg\" rel=\"attachment wp-att-133119\">\u003cimg class=\"size-medium wp-image-133119\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/03/Monkey-ultrasound-800x598.jpg\" alt=\"This ultrasound shows the rhesus monkey fetus before the mother was injected with Zika two weeks ago. Researchers say ultrasounds show the fetus still appears healthy.\" width=\"800\" height=\"598\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/03/Monkey-ultrasound-800x598.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/Monkey-ultrasound-400x299.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/Monkey-ultrasound-768x574.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/Monkey-ultrasound-960x718.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/Monkey-ultrasound.jpg 1158w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">This ultrasound shows the rhesus monkey fetus before the mother was injected with Zika two weeks ago. Researchers say ultrasounds show the fetus still appears healthy. \u003ccite>(University of Wisconsin, Madison)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Last Thursday I asked him what he meant by \"taking data out of context.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">‘The sad reality is that most of the research we conduct on animals never gets into the biomedical literature … That kind of retention of data fails to redeem the suffering and the sacrifice of animals in experiments.’\u003ccite>Biomedical ethicist Jonathan Kimmelman\u003c/cite>\u003c/aside>\n\u003cp>\"The idea of making data from nonhuman primates available to the public is basically an invitation to disaster,\" he said, referring to the possibility that those who oppose animal research will use it in a propagandistic way. \"Just like if you were to take patient data out of the hospital and show images of surgeries or ultrasounds ... without the full context of how you ended up in that position. It can be visceral, it can be grotesque.\"\u003c/p>\n\u003cp>O'Connor said that both he and Friedrich have had run-ins over the years with animal welfare activists.\u003c/p>\n\u003cp>\"Madison is a very progressive city,\" he said. \"We have a lot of people here who have very strong viewpoints, including a community of people who are pretty strongly against research on nonhuman primates in most contexts.\"\u003c/p>\n\u003cp>The issue of animal welfare has been a \u003ca href=\"https://www.google.com/search?q=animal+rights+university+of+wisconsin\" target=\"_blank\">flashpoint\u003c/a> at the university because of its status as a hub for animal research, and because it operates \u003ca href=\"https://www.primate.wisc.edu/\" target=\"_blank\">one \u003c/a>of seven \u003ca href=\"http://nprcresearch.org/primate/contact.php\" target=\"_blank\">national primate research centers\u003c/a>. In 2014, the school was \u003ca href=\"http://host.madison.com/wsj/news/local/education/on_campus/on-campus-uw-madison-fined-for-violations-of-animals-in/article_e6a3b4f5-31eb-5049-a105-4a97bc17ee4a.html\" target=\"_blank\">fined $35,000\u003c/a> by the U.S. Department of Agriculture for violations of the federal Animal Research Act.\u003c/p>\n\u003cp>The two scientists' experiences researching AIDS/HIV have colored their opinions about using animals.\u003c/p>\n\u003caside class=\"pullquote alignright\">'While we support effective and humane research in the search for vaccines and treatments for Zika virus, we have serious concerns regarding the use of monkeys and other animals for this purpose.'\u003ccite>Katy Taylor, Cruelty Free International\u003c/cite>\u003c/aside>\n\u003cp>\"I like to remind people that, even though you don't hear about it as much today, there’s still about 6,000 people who get HIV every day around the world,\" O'Connor says. \"In the entire history of my lab and Tom’s lab and probably every other lab at this university ... we’re not going to use 6,000 monkeys in our entire scientific careers. So the idea that a small number of animals could have a profound effect on the health of a lot of people with HIV is something we came to terms with a long time ago.\"\u003c/p>\n\u003cp>Still, he said, injecting a pregnant monkey with the Zika virus was \"profound.\"\u003c/p>\n\u003cp>\"As parents ourselves we are sensitive to the implications of studying mothers during pregnancy,\" he says.\u003c/p>\n\u003cp>Friedrich said his first experiment as a Ph.D. student involved injecting monkeys with the simian immune deficiency virus, a retrovirus similar to HIV. \"I went back with the veterinarians to assist with the process. I wanted to take ownership of it and see what it was going to mean for those animals, and it was a hard thing to do.\"\u003c/p>\n\u003cp>\u003cstrong>Animal Welfare Group Opposed\u003c/strong>\u003c/p>\n\u003cp>Last month, Cruelty Free International, a London-based, anti-animal experimentation organization with roots going back to 1898, \u003ca href=\"https://www.crueltyfreeinternational.org/blog/pregnant-monkeys-be-infected-zika-virus-cruel-research\" target=\"_blank\">came out against\u003c/a> the experiments.\u003c/p>\n\u003caside class=\"pullquote alignright\">'While we support effective and humane research in the search for vaccines and treatments for Zika virus, we have serious concerns regarding the use of monkeys and other animals for this purpose.'\u003ccite>Katy Taylor, Cruelty Free International\u003c/cite>\u003c/aside>\n\u003cp>“While we support effective and humane research in the search for vaccines and treatments for Zika virus, we have serious concerns regarding the use of monkeys and other animals for this purpose,\" said Katy Taylor, the organization's director of science. \"The poor relevance of using monkeys to study human disease and the greater relevance of human-based approaches, means that it is scientifically and morally indefensible to deliberately infect monkeys with Zika virus and/or to test therapies and vaccines on them.”\u003c/p>\n\u003cp>Friedrich said using animals is the best way to get the most relevant data quickly, and that human trials would cause significant delay.\u003c/p>\n\u003cp>\"It will take a long time to enroll the number of people that would be required ... to conclude that it was statistically sound data that allows us to draw conclusions applicable to most infected people,\" he says.\u003c/p>\n\u003cp>He says taking the necessary samples from a monkey wouldn't be feasible or ethical in humans. \"We might sample amniotic fluid from the infected [monkey] on a frequent basis and ask whether the virus gets into the amniotic fluid, and that’s just not something you can do in pregnant humans.\"\u003c/p>\n\u003cp>Jonathan Kimmelman, an associate professor in the biomedical ethics unit of McGill University, says it's \"silly\" to dismiss research results gleaned from animals as irrelevant to humans.\u003c/p>\n\u003cp>\"There are some animal experiments that are reasonably predictive of scenarios that will play out in human beings and some [that] aren’t.\"\u003c/p>\n\u003cp>Friedrich points to trials in monkeys that found pre-exposure prophylaxis drugs (PrEP) are effective in preventing infection in people who are later exposed to HIV.\u003c/p>\n\u003cp>\"This result paved the way for clinical trials of PrEP in humans that were also extremely effective,\" he said in an email. The result: \u003ca href=\"http://cid.oxfordjournals.org/content/61/10/1604.full\" target=\"_blank\">Truvada\u003c/a>, approved by the FDA in 2012 as the first drug to prevent people from acquiring HIV.\u003c/p>\n\u003cp>\u003cstrong>No Backlash -- Yet\u003c/strong>\u003c/p>\n\u003cp>As of last week, the lab had yet to experience a significant backlash for their experiment.\u003c/p>\n\u003cp>But, O'Connor said, \"I’m under no illusion that's going to continue indefinitely.\"\u003c/p>\n\u003cp>In the meantime, at least one online criticism has emerged, on a website called \"\u003ca href=\"http://primateresearch.blogspot.com/2016/03/dave-oconnor-sad-and-heartbroken.html\" target=\"_blank\">Primate Freedom\u003c/a>,\" which attacks O'Connor for \"using and killing monkeys.\"\u003c/p>\n\u003cp>\"His career rests squarely on their corpses,\" the post says.\u003c/p>\n\u003cp>Kimmelman, the bioethicist, says the researchers' public dissemination of their data is a strong mitigating factor in justifying these experiments.\u003c/p>\n\u003cp>\"The sad reality is that most of the research we conduct on animals never gets into the biomedical literature. The results are almost completely inaccessible,\" he says. \"That kind of retention of data fails to redeem the suffering and the sacrifice of animals in experiments.\"\u003c/p>\n\u003cp>The real-time data-sharing aspect of their research has so far been a big success, says Friedrich, with other scientists using their posted data and replicating the results, or collaborating on certain tests.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"We aren’t the only ones who have good ideas,\" he says. \"The more people who are thinking about this, especially in the context of an emergent public health crisis, the better.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>We've all seen the \u003ca href=\"https://www.google.com/search?q=zika+microcephaly\" target=\"_blank\">media coverage\u003c/a> about the Zika virus' potentially \u003ca href=\"http://news.yahoo.com/brazil-says-confirmed-suspected-microcephaly-cases-rise-5-135759702.html\" target=\"_blank\">destructive effect\u003c/a> on newborns. The virus has sowed fear and loathing in parts of Latin America and the Caribbean, and now Puerto Rico is \u003ca href=\"http://www.nytimes.com/2016/03/20/health/zika-virus-puerto-rico.html?_r=0\" target=\"_blank\">preparing for a nasty epidemic\u003c/a> that may result in hundreds of thousands of infections. The CDC has \u003ca href=\"http://wwwnc.cdc.gov/travel/notices/alert/zika-virus-puerto-rico\" target=\"_blank\">advised pregnant women\u003c/a> to avoid traveling to the island.\u003c/p>\n\u003cp>Two researchers who are working diligently to learn more about Zika are Dave O'Connor and Tom Friedrich. They are currently studying the virus' transmission from mother to fetus, in hopes of informing the public health response.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"The idea of making data from nonhuman primates available to the public is basically an invitation to disaster.\"\u003ccite>Researcher Dave O'Connor\u003c/cite>\u003c/aside>\n\u003cp>And yet, O'Connor and Friedrich have prepared themselves for the possibility, if not the probability, that some will not exactly view them as doing God’s own work.\u003c/p>\n\u003cp>Why? Because they are using rhesus monkeys in their research. Two weeks ago, they deliberately infected a pregnant mother with the virus in order to observe its effect on the fetus.\u003c/p>\n\u003cp>\u003cstrong>Posting Data in Real Time\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>O'Connor and Friedrich hope to answer important unknowns about the virus, including how long it's present after infection, where in the body besides the blood it exists, and what the likelihood is that an infected mother will pass it on to her offspring. They are also deviating from the ordinary method for disseminating research — publishing in a peer-reviewed journal — by \u003ca href=\"https://zika.labkey.com/project/OConnor/ZIKV-003/begin.view\" target=\"_blank\">posting their data\u003c/a> for both their colleagues and the public to see as soon as it comes in.\u003c/p>\n\u003cp>That could be a problem.\u003c/p>\n\u003cp>\"I am aware that sharing \u003ca href=\"https://dholk.primate.wisc.edu/_webdav/dho/public/Zika/public/%40files/ultrasounds/827577/Placenta%20disk%202%20d0.jpg\" target=\"_blank\">ultrasound imagery\u003c/a> of developing macaques can elicit stronger emotions than looking at relatively sterile charts and tables. It certainly did for me and our staff who saw the first ultrasound today,\" \u003ca href=\"https://zika.labkey.com/announcements/OConnor/ZIKV-003/thread.view?rowId=32\" target=\"_blank\">O'Connor logged\u003c/a> on the lab's website.\u003c/p>\n\u003cp>\"I want to thank those who have viewed our data so far and have chosen not to use it out of context to further arguments against using animals in research.\"\u003c/p>\n\u003cfigure id=\"attachment_133119\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/03/Monkey-ultrasound.jpg\" rel=\"attachment wp-att-133119\">\u003cimg class=\"size-medium wp-image-133119\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/03/Monkey-ultrasound-800x598.jpg\" alt=\"This ultrasound shows the rhesus monkey fetus before the mother was injected with Zika two weeks ago. Researchers say ultrasounds show the fetus still appears healthy.\" width=\"800\" height=\"598\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/03/Monkey-ultrasound-800x598.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/Monkey-ultrasound-400x299.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/Monkey-ultrasound-768x574.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/Monkey-ultrasound-960x718.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/03/Monkey-ultrasound.jpg 1158w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">This ultrasound shows the rhesus monkey fetus before the mother was injected with Zika two weeks ago. Researchers say ultrasounds show the fetus still appears healthy. \u003ccite>(University of Wisconsin, Madison)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Last Thursday I asked him what he meant by \"taking data out of context.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">‘The sad reality is that most of the research we conduct on animals never gets into the biomedical literature … That kind of retention of data fails to redeem the suffering and the sacrifice of animals in experiments.’\u003ccite>Biomedical ethicist Jonathan Kimmelman\u003c/cite>\u003c/aside>\n\u003cp>\"The idea of making data from nonhuman primates available to the public is basically an invitation to disaster,\" he said, referring to the possibility that those who oppose animal research will use it in a propagandistic way. \"Just like if you were to take patient data out of the hospital and show images of surgeries or ultrasounds ... without the full context of how you ended up in that position. It can be visceral, it can be grotesque.\"\u003c/p>\n\u003cp>O'Connor said that both he and Friedrich have had run-ins over the years with animal welfare activists.\u003c/p>\n\u003cp>\"Madison is a very progressive city,\" he said. \"We have a lot of people here who have very strong viewpoints, including a community of people who are pretty strongly against research on nonhuman primates in most contexts.\"\u003c/p>\n\u003cp>The issue of animal welfare has been a \u003ca href=\"https://www.google.com/search?q=animal+rights+university+of+wisconsin\" target=\"_blank\">flashpoint\u003c/a> at the university because of its status as a hub for animal research, and because it operates \u003ca href=\"https://www.primate.wisc.edu/\" target=\"_blank\">one \u003c/a>of seven \u003ca href=\"http://nprcresearch.org/primate/contact.php\" target=\"_blank\">national primate research centers\u003c/a>. In 2014, the school was \u003ca href=\"http://host.madison.com/wsj/news/local/education/on_campus/on-campus-uw-madison-fined-for-violations-of-animals-in/article_e6a3b4f5-31eb-5049-a105-4a97bc17ee4a.html\" target=\"_blank\">fined $35,000\u003c/a> by the U.S. Department of Agriculture for violations of the federal Animal Research Act.\u003c/p>\n\u003cp>The two scientists' experiences researching AIDS/HIV have colored their opinions about using animals.\u003c/p>\n\u003caside class=\"pullquote alignright\">'While we support effective and humane research in the search for vaccines and treatments for Zika virus, we have serious concerns regarding the use of monkeys and other animals for this purpose.'\u003ccite>Katy Taylor, Cruelty Free International\u003c/cite>\u003c/aside>\n\u003cp>\"I like to remind people that, even though you don't hear about it as much today, there’s still about 6,000 people who get HIV every day around the world,\" O'Connor says. \"In the entire history of my lab and Tom’s lab and probably every other lab at this university ... we’re not going to use 6,000 monkeys in our entire scientific careers. So the idea that a small number of animals could have a profound effect on the health of a lot of people with HIV is something we came to terms with a long time ago.\"\u003c/p>\n\u003cp>Still, he said, injecting a pregnant monkey with the Zika virus was \"profound.\"\u003c/p>\n\u003cp>\"As parents ourselves we are sensitive to the implications of studying mothers during pregnancy,\" he says.\u003c/p>\n\u003cp>Friedrich said his first experiment as a Ph.D. student involved injecting monkeys with the simian immune deficiency virus, a retrovirus similar to HIV. \"I went back with the veterinarians to assist with the process. I wanted to take ownership of it and see what it was going to mean for those animals, and it was a hard thing to do.\"\u003c/p>\n\u003cp>\u003cstrong>Animal Welfare Group Opposed\u003c/strong>\u003c/p>\n\u003cp>Last month, Cruelty Free International, a London-based, anti-animal experimentation organization with roots going back to 1898, \u003ca href=\"https://www.crueltyfreeinternational.org/blog/pregnant-monkeys-be-infected-zika-virus-cruel-research\" target=\"_blank\">came out against\u003c/a> the experiments.\u003c/p>\n\u003caside class=\"pullquote alignright\">'While we support effective and humane research in the search for vaccines and treatments for Zika virus, we have serious concerns regarding the use of monkeys and other animals for this purpose.'\u003ccite>Katy Taylor, Cruelty Free International\u003c/cite>\u003c/aside>\n\u003cp>“While we support effective and humane research in the search for vaccines and treatments for Zika virus, we have serious concerns regarding the use of monkeys and other animals for this purpose,\" said Katy Taylor, the organization's director of science. \"The poor relevance of using monkeys to study human disease and the greater relevance of human-based approaches, means that it is scientifically and morally indefensible to deliberately infect monkeys with Zika virus and/or to test therapies and vaccines on them.”\u003c/p>\n\u003cp>Friedrich said using animals is the best way to get the most relevant data quickly, and that human trials would cause significant delay.\u003c/p>\n\u003cp>\"It will take a long time to enroll the number of people that would be required ... to conclude that it was statistically sound data that allows us to draw conclusions applicable to most infected people,\" he says.\u003c/p>\n\u003cp>He says taking the necessary samples from a monkey wouldn't be feasible or ethical in humans. \"We might sample amniotic fluid from the infected [monkey] on a frequent basis and ask whether the virus gets into the amniotic fluid, and that’s just not something you can do in pregnant humans.\"\u003c/p>\n\u003cp>Jonathan Kimmelman, an associate professor in the biomedical ethics unit of McGill University, says it's \"silly\" to dismiss research results gleaned from animals as irrelevant to humans.\u003c/p>\n\u003cp>\"There are some animal experiments that are reasonably predictive of scenarios that will play out in human beings and some [that] aren’t.\"\u003c/p>\n\u003cp>Friedrich points to trials in monkeys that found pre-exposure prophylaxis drugs (PrEP) are effective in preventing infection in people who are later exposed to HIV.\u003c/p>\n\u003cp>\"This result paved the way for clinical trials of PrEP in humans that were also extremely effective,\" he said in an email. The result: \u003ca href=\"http://cid.oxfordjournals.org/content/61/10/1604.full\" target=\"_blank\">Truvada\u003c/a>, approved by the FDA in 2012 as the first drug to prevent people from acquiring HIV.\u003c/p>\n\u003cp>\u003cstrong>No Backlash -- Yet\u003c/strong>\u003c/p>\n\u003cp>As of last week, the lab had yet to experience a significant backlash for their experiment.\u003c/p>\n\u003cp>But, O'Connor said, \"I’m under no illusion that's going to continue indefinitely.\"\u003c/p>\n\u003cp>In the meantime, at least one online criticism has emerged, on a website called \"\u003ca href=\"http://primateresearch.blogspot.com/2016/03/dave-oconnor-sad-and-heartbroken.html\" target=\"_blank\">Primate Freedom\u003c/a>,\" which attacks O'Connor for \"using and killing monkeys.\"\u003c/p>\n\u003cp>\"His career rests squarely on their corpses,\" the post says.\u003c/p>\n\u003cp>Kimmelman, the bioethicist, says the researchers' public dissemination of their data is a strong mitigating factor in justifying these experiments.\u003c/p>\n\u003cp>\"The sad reality is that most of the research we conduct on animals never gets into the biomedical literature. The results are almost completely inaccessible,\" he says. \"That kind of retention of data fails to redeem the suffering and the sacrifice of animals in experiments.\"\u003c/p>\n\u003cp>The real-time data-sharing aspect of their research has so far been a big success, says Friedrich, with other scientists using their posted data and replicating the results, or collaborating on certain tests.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We aren’t the only ones who have good ideas,\" he says. \"The more people who are thinking about this, especially in the context of an emergent public health crisis, the better.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Last week the Centers for Disease Control and Prevention told doctors they should really, really think twice before prescribing opioids for chronic pain.\u003c/p>\n\u003cp>And now the doctors are telling us that meditation and cognitive behavioral therapy often works better than pain meds and other medical treatments for chronic back pain.\u003c/p>\n\u003caside class=\"alignright\">It's pretty striking to see a journal like JAMA endorsing meditation as an effective treatment, considering that not so very long ago it would have been dismissed as woo woo.\u003c/aside>\n\u003cp>It's the latest in a series of studies saying that low-tech interventions like \u003ca href=\"http://www.npr.org/sections/health-shots/2016/01/11/462366361/forget-the-gizmos-exercise-works-best-for-lower-back-pain\">exercise\u003c/a>, \u003ca href=\"http://www.npr.org/sections/goatsandsoda/2015/06/08/412314701/lost-posture-why-indigenous-cultures-dont-have-back-pain\">posture training\u003c/a>, \u003ca href=\"http://www.npr.org/sections/health-shots/2015/10/13/448299723/physical-therapy-may-help-for-back-pain-but-time-works-best\">physical therapy\u003c/a> and just the passage of time work better than opioids, imaging or surgery for the vast majority of people with chronic back pain.\u003c/p>\n\u003cp>And it's part of a push to move treatment for chronic back pain, which affects about 8 percent of Americans and is a major cause of disability, away from being \"medicalized\" to something that people can manage by choosing from an array of nonmedical alternatives.\u003c/p>\n\u003cp>This latest \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2504811\">study\u003c/a>, published Tuesday in \u003cem>JAMA\u003c/em>, the journal of the American Medical Association, assessed the value of \u003ca href=\"http://www.mindfullivingprograms.com/whatMBSR.php\">mindfulness-based stress reduction\u003c/a>, a program developed at the University of Massachusetts Medical Center in the 1970s, and \u003ca href=\"https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000415.htm\">cognitive behavioral therapy\u003c/a>, a form of psychotherapy that helps reframe negative thoughts and is considered an evidence-based treatment for chronic pain.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The 342 participants, most of whom had suffered back pain weekly for at least the past year, were offered either eight weekly sessions of mindfulness training; eight sessions of cognitive behavioral therapy; or to keep doing what they'd been doing.\u003c/p>\n\u003cp>Of those who did the mindfulness training, which included meditation and yoga instruction and CDs they could use at home, 43.6 percent reported a meaningful reduction in pain 26 weeks later. In the cognitive behavioral therapy group, 44.9 percent reported significant improvements. That's compared to 26.6 percent in the usual care group. And despite the fact that most people didn't attend all eight sessions of the programs.\u003c/p>\n\u003cp>\"I've been doing research on back pain for 30 years,\" says Daniel Cherkin, a senior investigator at the Group Health Research Institute in Seattle and lead author of the study. \"The biggest revolution has been the understanding that it's not just a physical problem with physical solutions. It's a biopsychosocial problem.\"\u003c/p>\n\u003cp>And some of those problems come about because there's often no medical \"cure\" for chronic back pain. \"It puts people in a situation where they get afraid, they get stressed, they're tired, they're irritable,\" Cherkin says. \"Unfortunately, these people have not found health care providers to be very helpful. They feel alone; they feel that their pain is not being validated.\"\u003c/p>\n\u003cp>The lack of effective medical treatments frustrates doctors, too, and has helped fuel the explosion of opioid prescribing for chronic pain, Cherkin says, \"Patients and docs were really kind of desperate to find things that worked.\"\u003c/p>\n\u003cp>It's pretty striking to see a journal like \u003cem>JAMA\u003c/em> endorsing meditation as an effective treatment, considering that not so very long ago it would have been dismissed as woo woo.\u003c/p>\n\u003cp>But that doesn't mean it's easy to find mindfulness training for stress reduction, or cognitive behavioral therapy for pain, or to get insurers to pay for it.\u003c/p>\n\u003cp>\"A lot of treatments that are recommended by high-quality guidelines are not covered by insurance or even licensed in some states,\" Cherkin says. \"Some of the least effective and sometimes harmful and expensive treatments are readily available and are covered by insurance.\"\u003c/p>\n\u003cp>But if your back is making you miserable, insurance reimbursement may not be at the top of your must-haves. So let's talk retail.\u003c/p>\n\u003cp>A \u003ca href=\"http://www.umassmed.edu/cfm/stress-reduction/mbsr-8-week/tuition--payment-plans/\">31-hour on-site course \u003c/a>at the University of Massachusetts Medical School's Center for Mindfulness, which developed mindfulness-based stress reduction, costs $545 to $725; tuition assistance is available. An \u003ca href=\"http://www.soundstrue.com/store/the-mbsr-online-course-3226.html\">online video course\u003c/a> costs $197.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Cognitive behavioral therapy sessions can run $120 to $200 each; people typically don't need more than 16 sessions, and might need much less. It's a very particular technique, so it's important to ask a practitioner about \u003ca href=\"http://www.abct.org/Information/?fa=_HowToChooseTherapist&m=mInformation\">training and qualifications\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=For+Chronic+Low+Back+Pain%2C+Mindfulness+Can+Beat+Painkillers&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Last week the Centers for Disease Control and Prevention told doctors they should really, really think twice before prescribing opioids for chronic pain.\u003c/p>\n\u003cp>And now the doctors are telling us that meditation and cognitive behavioral therapy often works better than pain meds and other medical treatments for chronic back pain.\u003c/p>\n\u003caside class=\"alignright\">It's pretty striking to see a journal like JAMA endorsing meditation as an effective treatment, considering that not so very long ago it would have been dismissed as woo woo.\u003c/aside>\n\u003cp>It's the latest in a series of studies saying that low-tech interventions like \u003ca href=\"http://www.npr.org/sections/health-shots/2016/01/11/462366361/forget-the-gizmos-exercise-works-best-for-lower-back-pain\">exercise\u003c/a>, \u003ca href=\"http://www.npr.org/sections/goatsandsoda/2015/06/08/412314701/lost-posture-why-indigenous-cultures-dont-have-back-pain\">posture training\u003c/a>, \u003ca href=\"http://www.npr.org/sections/health-shots/2015/10/13/448299723/physical-therapy-may-help-for-back-pain-but-time-works-best\">physical therapy\u003c/a> and just the passage of time work better than opioids, imaging or surgery for the vast majority of people with chronic back pain.\u003c/p>\n\u003cp>And it's part of a push to move treatment for chronic back pain, which affects about 8 percent of Americans and is a major cause of disability, away from being \"medicalized\" to something that people can manage by choosing from an array of nonmedical alternatives.\u003c/p>\n\u003cp>This latest \u003ca href=\"http://jama.jamanetwork.com/article.aspx?articleid=2504811\">study\u003c/a>, published Tuesday in \u003cem>JAMA\u003c/em>, the journal of the American Medical Association, assessed the value of \u003ca href=\"http://www.mindfullivingprograms.com/whatMBSR.php\">mindfulness-based stress reduction\u003c/a>, a program developed at the University of Massachusetts Medical Center in the 1970s, and \u003ca href=\"https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000415.htm\">cognitive behavioral therapy\u003c/a>, a form of psychotherapy that helps reframe negative thoughts and is considered an evidence-based treatment for chronic pain.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The 342 participants, most of whom had suffered back pain weekly for at least the past year, were offered either eight weekly sessions of mindfulness training; eight sessions of cognitive behavioral therapy; or to keep doing what they'd been doing.\u003c/p>\n\u003cp>Of those who did the mindfulness training, which included meditation and yoga instruction and CDs they could use at home, 43.6 percent reported a meaningful reduction in pain 26 weeks later. In the cognitive behavioral therapy group, 44.9 percent reported significant improvements. That's compared to 26.6 percent in the usual care group. And despite the fact that most people didn't attend all eight sessions of the programs.\u003c/p>\n\u003cp>\"I've been doing research on back pain for 30 years,\" says Daniel Cherkin, a senior investigator at the Group Health Research Institute in Seattle and lead author of the study. \"The biggest revolution has been the understanding that it's not just a physical problem with physical solutions. It's a biopsychosocial problem.\"\u003c/p>\n\u003cp>And some of those problems come about because there's often no medical \"cure\" for chronic back pain. \"It puts people in a situation where they get afraid, they get stressed, they're tired, they're irritable,\" Cherkin says. \"Unfortunately, these people have not found health care providers to be very helpful. They feel alone; they feel that their pain is not being validated.\"\u003c/p>\n\u003cp>The lack of effective medical treatments frustrates doctors, too, and has helped fuel the explosion of opioid prescribing for chronic pain, Cherkin says, \"Patients and docs were really kind of desperate to find things that worked.\"\u003c/p>\n\u003cp>It's pretty striking to see a journal like \u003cem>JAMA\u003c/em> endorsing meditation as an effective treatment, considering that not so very long ago it would have been dismissed as woo woo.\u003c/p>\n\u003cp>But that doesn't mean it's easy to find mindfulness training for stress reduction, or cognitive behavioral therapy for pain, or to get insurers to pay for it.\u003c/p>\n\u003cp>\"A lot of treatments that are recommended by high-quality guidelines are not covered by insurance or even licensed in some states,\" Cherkin says. \"Some of the least effective and sometimes harmful and expensive treatments are readily available and are covered by insurance.\"\u003c/p>\n\u003cp>But if your back is making you miserable, insurance reimbursement may not be at the top of your must-haves. So let's talk retail.\u003c/p>\n\u003cp>A \u003ca href=\"http://www.umassmed.edu/cfm/stress-reduction/mbsr-8-week/tuition--payment-plans/\">31-hour on-site course \u003c/a>at the University of Massachusetts Medical School's Center for Mindfulness, which developed mindfulness-based stress reduction, costs $545 to $725; tuition assistance is available. An \u003ca href=\"http://www.soundstrue.com/store/the-mbsr-online-course-3226.html\">online video course\u003c/a> costs $197.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Cognitive behavioral therapy sessions can run $120 to $200 each; people typically don't need more than 16 sessions, and might need much less. It's a very particular technique, so it's important to ask a practitioner about \u003ca href=\"http://www.abct.org/Information/?fa=_HowToChooseTherapist&m=mInformation\">training and qualifications\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=For+Chronic+Low+Back+Pain%2C+Mindfulness+Can+Beat+Painkillers&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Plant Extracts May Slow Aging Process, Study Says",
"title": "Plant Extracts May Slow Aging Process, Study Says",
"headTitle": "Future of You | KQED Future of You | KQED Science",
"content": "\u003cp>It's embarrassing to admit (given that I'm a reporter covering science and health), but my bathroom drawers are bulging with products promising to turn back the clock by removing fine lines around my eyes or creases on my forehead.\u003c/p>\n\u003cp>Nostalgia for my teenage skin helps me ignore the evidence -- or \u003ca href=\"https://www.researchgate.net/publication/47814245_Botanical_Extracts_as_Anti-Aging_Preparations_for_the_Skin\" target=\"_blank\">lack of it\u003c/a> -- surrounding anti-aging products, containing ingredients like green tea extract or maca root.\u003c/p>\n\u003caside class=\"alignright\">Celery root, valerian root, passionflower, ginkgo biloba, black cohosh and white willow bark were all found to slow aging in yeast. But don't run out and by these yet.\u003c/aside>\n\u003cp>That's why when a \u003ca href=\"http://www.impactjournals.com/oncotarget/index.php?journal=oncotarget&page=article&op=view&path%5B%5D=7665&author-preview=5wx\">study \u003c/a>gets published in the journal \u003ca href=\"http://www.impactjournals.com/oncotarget/index.php?journal=oncotarget\">\u003ci>Oncotarget\u003c/i>\u003c/a> claiming researchers have discovered revolutionary anti-aging molecules, well, color me interested.\u003c/p>\n\u003cp>The research team, from Concordia and the Quebec-based biotech company\u003ca href=\"http://idunntechnologies.com/\"> Idunn Technologies\u003c/a>, conducted more than 10,000 trials to screen for plant extracts with anti-aging properties. What they found is that six groups of molecules in specific doses successfully slowed down aging in yeast. The plant extracts included celery root, valerian root, passionflower, ginkgo biloba, black cohosh and white willow bark.\u003c/p>\n\u003cp>Okay, great. But \u003cem>yeast?\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Cellularly speaking, aging progresses similarly in both yeast and humans,” says \u003ca href=\"http://www.concordia.ca/artsci/biology/faculty.html.html?fpid=vladimir-titorenko\">Vladimir Titorenko\u003c/a>, the study’s senior author and a biologist at Concordia. “It’s the best cellular model to understand how the anti-aging process takes place.”\u003c/p>\n\u003cp>For the initial trials, yeast was also attractive because the researchers could get results much faster than by using a small animal, Titorenko says. For example, a mouse’s lifespan is two to three years, so testing whether the chemicals slowed aging would take at least that long to know if they were effective.\u003c/p>\n\u003cp>Titorenko says trials on worms and then mice are next. What about humans? He hesitated to predict when those might begin.\u003c/p>\n\u003cp>The most successful anti-aging molecule cited by the study was willow bark, which dates back to the \u003ca href=\"http://umm.edu/health/medical/altmed/herb/willow-bark\" target=\"_blank\">time of Hippocrates\u003c/a> in 400 B.C., when it was used for its medicinal properties. (It has a high concentration of salicin, a chemical that mimics the effects of aspirin.)\u003c/p>\n\u003cp>The study showed that willow bark extract increased the average and maximum chronological lifespan of yeast by 475 percent and 369 percent, respectively. Titorenko says that’s at least five times better than \u003ca href=\"https://www.sciencedaily.com/releases/2013/07/130725141715.htm\" target=\"_blank\">rapamycin \u003c/a>or \u003ca href=\"http://www.telegraph.co.uk/news/science/science-news/12017112/Worlds-first-anti-ageing-drug-could-see-humans-live-to-120.html\" target=\"_blank\">metformin\u003c/a>, two drugs known for extending lifespan.\u003c/p>\n\u003cp>Idunn Technologies plans to create commercial products based on the study.\u003c/p>\n\u003cp>“The goal is to a have a healthy life, and increasing the quality of life can happen by reducing the rate of disease and aging,” says Éric Simard, the company’s founder.\u003c/p>\n\u003cp>\u003cstrong>Negative Effects Possible\u003c/strong>\u003c/p>\n\u003cp>But before you race to your nearest natural foods store and stock up on willow bark (yes, I’m tempted), it's best to wait for more data.\u003c/p>\n\u003cp>“Exceeding a specific beneficial dose of willow bark can cause negative effects and even be dangerous,\" Simard says. \"The concentrations are very delicate and I would not recommend rushing out and taking the plant extracts until more research has been done.”\u003c/p>\n\u003cp>Dena Dubal, a neuroscientist at University of California San Francisco who studies aging, strongly agrees.\u003c/p>\n\u003cp>“It’s an intriguing start, but the research needs to be replicated in other labs,” says Dubal. “One thing I would caution is that these are very specific doses in very specific conditions on a very simple organism. Right now it’s an isolated finding. This is in no way ready for testing on ourselves.”\u003c/p>\n\u003cp>Dubal says human trials are likely at least a decade away. She emphasizes that plant extracts are not regulated by the FDA, and they can be unsafe.\u003c/p>\n\u003cp>\"Remember some of the most toxic compounds come from plants, like cyanide,\" she says. \"We don’t know what we are buying off the shelf. It may be that these compounds have a future in healthy aging, but we are not at the point of knowing that yet.”\u003c/p>\n\u003cp>In the meantime, Dubal offers some simple advice.\u003c/p>\n\u003cp>“When it comes to the science of longevity, we should stick with the science that has matured to the human level, like diet, brain stimulation, and socializing,” she says. “Take a walk, learn a new language, share a good meal with friends. And, then stay tuned for what’s being done in laboratories.”\u003c/p>\n\u003cp>As I was interviewing Dubal, I started feeling guilty about my bloated bathroom drawers.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Maybe it's time for a spring cleaning.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It's embarrassing to admit (given that I'm a reporter covering science and health), but my bathroom drawers are bulging with products promising to turn back the clock by removing fine lines around my eyes or creases on my forehead.\u003c/p>\n\u003cp>Nostalgia for my teenage skin helps me ignore the evidence -- or \u003ca href=\"https://www.researchgate.net/publication/47814245_Botanical_Extracts_as_Anti-Aging_Preparations_for_the_Skin\" target=\"_blank\">lack of it\u003c/a> -- surrounding anti-aging products, containing ingredients like green tea extract or maca root.\u003c/p>\n\u003caside class=\"alignright\">Celery root, valerian root, passionflower, ginkgo biloba, black cohosh and white willow bark were all found to slow aging in yeast. But don't run out and by these yet.\u003c/aside>\n\u003cp>That's why when a \u003ca href=\"http://www.impactjournals.com/oncotarget/index.php?journal=oncotarget&page=article&op=view&path%5B%5D=7665&author-preview=5wx\">study \u003c/a>gets published in the journal \u003ca href=\"http://www.impactjournals.com/oncotarget/index.php?journal=oncotarget\">\u003ci>Oncotarget\u003c/i>\u003c/a> claiming researchers have discovered revolutionary anti-aging molecules, well, color me interested.\u003c/p>\n\u003cp>The research team, from Concordia and the Quebec-based biotech company\u003ca href=\"http://idunntechnologies.com/\"> Idunn Technologies\u003c/a>, conducted more than 10,000 trials to screen for plant extracts with anti-aging properties. What they found is that six groups of molecules in specific doses successfully slowed down aging in yeast. The plant extracts included celery root, valerian root, passionflower, ginkgo biloba, black cohosh and white willow bark.\u003c/p>\n\u003cp>Okay, great. But \u003cem>yeast?\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Cellularly speaking, aging progresses similarly in both yeast and humans,” says \u003ca href=\"http://www.concordia.ca/artsci/biology/faculty.html.html?fpid=vladimir-titorenko\">Vladimir Titorenko\u003c/a>, the study’s senior author and a biologist at Concordia. “It’s the best cellular model to understand how the anti-aging process takes place.”\u003c/p>\n\u003cp>For the initial trials, yeast was also attractive because the researchers could get results much faster than by using a small animal, Titorenko says. For example, a mouse’s lifespan is two to three years, so testing whether the chemicals slowed aging would take at least that long to know if they were effective.\u003c/p>\n\u003cp>Titorenko says trials on worms and then mice are next. What about humans? He hesitated to predict when those might begin.\u003c/p>\n\u003cp>The most successful anti-aging molecule cited by the study was willow bark, which dates back to the \u003ca href=\"http://umm.edu/health/medical/altmed/herb/willow-bark\" target=\"_blank\">time of Hippocrates\u003c/a> in 400 B.C., when it was used for its medicinal properties. (It has a high concentration of salicin, a chemical that mimics the effects of aspirin.)\u003c/p>\n\u003cp>The study showed that willow bark extract increased the average and maximum chronological lifespan of yeast by 475 percent and 369 percent, respectively. Titorenko says that’s at least five times better than \u003ca href=\"https://www.sciencedaily.com/releases/2013/07/130725141715.htm\" target=\"_blank\">rapamycin \u003c/a>or \u003ca href=\"http://www.telegraph.co.uk/news/science/science-news/12017112/Worlds-first-anti-ageing-drug-could-see-humans-live-to-120.html\" target=\"_blank\">metformin\u003c/a>, two drugs known for extending lifespan.\u003c/p>\n\u003cp>Idunn Technologies plans to create commercial products based on the study.\u003c/p>\n\u003cp>“The goal is to a have a healthy life, and increasing the quality of life can happen by reducing the rate of disease and aging,” says Éric Simard, the company’s founder.\u003c/p>\n\u003cp>\u003cstrong>Negative Effects Possible\u003c/strong>\u003c/p>\n\u003cp>But before you race to your nearest natural foods store and stock up on willow bark (yes, I’m tempted), it's best to wait for more data.\u003c/p>\n\u003cp>“Exceeding a specific beneficial dose of willow bark can cause negative effects and even be dangerous,\" Simard says. \"The concentrations are very delicate and I would not recommend rushing out and taking the plant extracts until more research has been done.”\u003c/p>\n\u003cp>Dena Dubal, a neuroscientist at University of California San Francisco who studies aging, strongly agrees.\u003c/p>\n\u003cp>“It’s an intriguing start, but the research needs to be replicated in other labs,” says Dubal. “One thing I would caution is that these are very specific doses in very specific conditions on a very simple organism. Right now it’s an isolated finding. This is in no way ready for testing on ourselves.”\u003c/p>\n\u003cp>Dubal says human trials are likely at least a decade away. She emphasizes that plant extracts are not regulated by the FDA, and they can be unsafe.\u003c/p>\n\u003cp>\"Remember some of the most toxic compounds come from plants, like cyanide,\" she says. \"We don’t know what we are buying off the shelf. It may be that these compounds have a future in healthy aging, but we are not at the point of knowing that yet.”\u003c/p>\n\u003cp>In the meantime, Dubal offers some simple advice.\u003c/p>\n\u003cp>“When it comes to the science of longevity, we should stick with the science that has matured to the human level, like diet, brain stimulation, and socializing,” she says. “Take a walk, learn a new language, share a good meal with friends. And, then stay tuned for what’s being done in laboratories.”\u003c/p>\n\u003cp>As I was interviewing Dubal, I started feeling guilty about my bloated bathroom drawers.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Maybe it's time for a spring cleaning.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>When Allison Fite was 16, she couldn't stop falling asleep in class. Doctors told her it was from a severe sinus infection, but it never really went away. For the next decade she struggled with infection after infection, taking antibiotics and decongestants. \"Having these sinus problems and not being able to breathe was debilitating,\" she says.\u003c/p>\n\u003caside class=\"pullquote alignright\">Aspirin-exacerbated respiratory disease, or AERD, is often missed by clinicians.\u003c/aside>\n\u003cp>Fite, now 27, couldn't figure out why this kept happening. Neither could any of her doctors. They told her she had allergies, but \"then the tests would come back and they'd be like, 'Huh. You don't have allergies,' \" she says.\u003c/p>\n\u003cp>But a few unusual symptoms helped Fite eventually figure out that she had a little-known disease shared by 1 million to 1.5 million Americans. She has asthma, a loss of smell and taste, and a strong, adverse reaction to alcohol. \"Before I could finish [a drink], I started to get these really bad headaches,\" she says. \"I really am allergic to fun.\"\u003c/p>\n\u003cp>And she had \u003ca href=\"https://www.nlm.nih.gov/medlineplus/ency/article/001641.htm\">nasal polyps\u003c/a>, which are benign growths in the sinus cavities. When she was 20, she had them surgically removed for the first time. At age 25, she flew back from where she was living in Thailand to the U.S. for a second operation. But this time the polyps reappeared even faster, a mere eight weeks after the surgery.\u003c/p>\n\u003cp>\"I was seeing a doctor in Bangkok at this point,\" she says. \"He was like, 'This is not normal.' \" But the doctor mentioned that aspirin can cause nasal polyps. This was Fite's first real clue about her illness. It's called aspirin-exacerbated respiratory disease, or \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3005316/\">AERD\u003c/a>.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It was first described in the early 1900s, says \u003ca href=\"http://physiciandirectory.brighamandwomens.org/details/1894\">Dr. Tanya Laidlaw\u003c/a>, an immunologist at Brigham and Women's Hospital in Boston who studies the disease. It's seen in \"patients who had this triad of asthma, nasal polyps and these rather idiosyncratic reactions to medications like aspirin,\" Laidlaw says.\u003c/p>\n\u003cp>Things started clicking into place. Fite's mother found one of Laidlaw's presentations on the illness online and sent it to her daughter. Fite knew she had nasal polyps and asthma, but she didn't know if she had the third symptom — a potentially life-threatening reaction to painkillers like aspirin or ibuprofen. So her doctor in Thailand decided to test her. He gave her a fifth of a pill of aspirin, just to see what would happen.\u003c/p>\n\u003cp>\"Forty-five minutes later,\" Fite says, \"I'm sitting in this hospital waiting room coughing, sweating, and my blood pressure spiked. And they're like 'OK, stop. Give her medicine; she has the disease.' \"\u003c/p>\n\u003cp>After years of seeing doctor after doctor, trying to understand why she was always sick, she finally knew the reason. \"It felt so good\" to have the diagnosis, Fite says. \"I started tearing up in this doctor's office, mid-horrible reaction,\" Fite says.\u003c/p>\n\u003cp>But there was one problem. Fite needed a treatment called \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0058767/\">aspirin desensitization\u003c/a>. That's when a doctor overloads a patient with a large dose of aspirin. And Fite's doctor had never done it before.\u003c/p>\n\u003cp>\"He was like, 'I don't feel comfortable doing it, and I don't think you'll find a doctor in Asia that is,' \" Fite says.\u003c/p>\n\u003cp>So Fite left Thailand again and went to Tanya Laidlaw's clinic in Boston to get the procedure. Laidlaw says nobody knows why the treatment works, but it desensitizes the patient to aspirin and helps alleviate the symptoms.\u003c/p>\n\u003cp>Laidlaw says she's frustrated by the lack of awareness of AERD. She estimates at least 20 percent of people who have it go undiagnosed. \"It's really frustrating,\" she says.\u003c/p>\n\u003cp>It probably gets missed a lot by clinicians, particularly primary care providers who don't specialize in immunology or ear, nose and throat medicine, says \u003ca href=\"http://www.childrenshospital.org/doctors/ana-broyles\">Dr. Ana Broyles\u003c/a>, an immunologist at Boston Children's Hospital.\u003c/p>\n\u003cp>And there's a severe lack of science around the illness. When Laidlaw began studying it 10 years ago, she says, barely any basic research had been done in the last century.\u003c/p>\n\u003cp>It's not an allergy. There's no geographic pattern to suggest an environmental link like a toxin. Family history doesn't seem to factor, either, so it doesn't seem to be genetic. One theory suggests that AERD might begin with an infection, Laidlaw says. The body turns on an immune response to fight the illness, but then somehow never turns it back off. The person is left with an army of misplaced white blood cells that can inflame the airway and cut off smell receptors.\u003c/p>\n\u003cp>Also, AERD patients overproduce inflammatory molecules called leukotrienes, and Laidlaw thinks that causes many of the symptoms. That has led to some useful advice for patients — like avoiding certain substances, such as alcohol, that make the symptoms worse.\u003c/p>\n\u003cp>Fite has been doing a lot better since her desensitization procedure. Over the past year, she's only had one sinus infection. \"It's amazing,\" she says. \"Prior to that, I had one once a month.\"\u003c/p>\n\u003cp>Fite still has her worries, though. She has to be on aspirin for the rest of her life to maintain the desensitization. \"Say I get in an accident, and I bleed too much because of the aspirin,\" she says. The symptoms aren't totally gone, and she still can't drink alcohol without becoming really ill. Plus, she says, it's just unnerving taking aspirin every day when she knows it should kill her.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But there aren't many alternatives, so until there's a better solution, she'll stay on the aspirin.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Aspirin+Both+Triggers+And+Treats+An+Often-Missed+Disease&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When Allison Fite was 16, she couldn't stop falling asleep in class. Doctors told her it was from a severe sinus infection, but it never really went away. For the next decade she struggled with infection after infection, taking antibiotics and decongestants. \"Having these sinus problems and not being able to breathe was debilitating,\" she says.\u003c/p>\n\u003caside class=\"pullquote alignright\">Aspirin-exacerbated respiratory disease, or AERD, is often missed by clinicians.\u003c/aside>\n\u003cp>Fite, now 27, couldn't figure out why this kept happening. Neither could any of her doctors. They told her she had allergies, but \"then the tests would come back and they'd be like, 'Huh. You don't have allergies,' \" she says.\u003c/p>\n\u003cp>But a few unusual symptoms helped Fite eventually figure out that she had a little-known disease shared by 1 million to 1.5 million Americans. She has asthma, a loss of smell and taste, and a strong, adverse reaction to alcohol. \"Before I could finish [a drink], I started to get these really bad headaches,\" she says. \"I really am allergic to fun.\"\u003c/p>\n\u003cp>And she had \u003ca href=\"https://www.nlm.nih.gov/medlineplus/ency/article/001641.htm\">nasal polyps\u003c/a>, which are benign growths in the sinus cavities. When she was 20, she had them surgically removed for the first time. At age 25, she flew back from where she was living in Thailand to the U.S. for a second operation. But this time the polyps reappeared even faster, a mere eight weeks after the surgery.\u003c/p>\n\u003cp>\"I was seeing a doctor in Bangkok at this point,\" she says. \"He was like, 'This is not normal.' \" But the doctor mentioned that aspirin can cause nasal polyps. This was Fite's first real clue about her illness. It's called aspirin-exacerbated respiratory disease, or \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3005316/\">AERD\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It was first described in the early 1900s, says \u003ca href=\"http://physiciandirectory.brighamandwomens.org/details/1894\">Dr. Tanya Laidlaw\u003c/a>, an immunologist at Brigham and Women's Hospital in Boston who studies the disease. It's seen in \"patients who had this triad of asthma, nasal polyps and these rather idiosyncratic reactions to medications like aspirin,\" Laidlaw says.\u003c/p>\n\u003cp>Things started clicking into place. Fite's mother found one of Laidlaw's presentations on the illness online and sent it to her daughter. Fite knew she had nasal polyps and asthma, but she didn't know if she had the third symptom — a potentially life-threatening reaction to painkillers like aspirin or ibuprofen. So her doctor in Thailand decided to test her. He gave her a fifth of a pill of aspirin, just to see what would happen.\u003c/p>\n\u003cp>\"Forty-five minutes later,\" Fite says, \"I'm sitting in this hospital waiting room coughing, sweating, and my blood pressure spiked. And they're like 'OK, stop. Give her medicine; she has the disease.' \"\u003c/p>\n\u003cp>After years of seeing doctor after doctor, trying to understand why she was always sick, she finally knew the reason. \"It felt so good\" to have the diagnosis, Fite says. \"I started tearing up in this doctor's office, mid-horrible reaction,\" Fite says.\u003c/p>\n\u003cp>But there was one problem. Fite needed a treatment called \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0058767/\">aspirin desensitization\u003c/a>. That's when a doctor overloads a patient with a large dose of aspirin. And Fite's doctor had never done it before.\u003c/p>\n\u003cp>\"He was like, 'I don't feel comfortable doing it, and I don't think you'll find a doctor in Asia that is,' \" Fite says.\u003c/p>\n\u003cp>So Fite left Thailand again and went to Tanya Laidlaw's clinic in Boston to get the procedure. Laidlaw says nobody knows why the treatment works, but it desensitizes the patient to aspirin and helps alleviate the symptoms.\u003c/p>\n\u003cp>Laidlaw says she's frustrated by the lack of awareness of AERD. She estimates at least 20 percent of people who have it go undiagnosed. \"It's really frustrating,\" she says.\u003c/p>\n\u003cp>It probably gets missed a lot by clinicians, particularly primary care providers who don't specialize in immunology or ear, nose and throat medicine, says \u003ca href=\"http://www.childrenshospital.org/doctors/ana-broyles\">Dr. Ana Broyles\u003c/a>, an immunologist at Boston Children's Hospital.\u003c/p>\n\u003cp>And there's a severe lack of science around the illness. When Laidlaw began studying it 10 years ago, she says, barely any basic research had been done in the last century.\u003c/p>\n\u003cp>It's not an allergy. There's no geographic pattern to suggest an environmental link like a toxin. Family history doesn't seem to factor, either, so it doesn't seem to be genetic. One theory suggests that AERD might begin with an infection, Laidlaw says. The body turns on an immune response to fight the illness, but then somehow never turns it back off. The person is left with an army of misplaced white blood cells that can inflame the airway and cut off smell receptors.\u003c/p>\n\u003cp>Also, AERD patients overproduce inflammatory molecules called leukotrienes, and Laidlaw thinks that causes many of the symptoms. That has led to some useful advice for patients — like avoiding certain substances, such as alcohol, that make the symptoms worse.\u003c/p>\n\u003cp>Fite has been doing a lot better since her desensitization procedure. Over the past year, she's only had one sinus infection. \"It's amazing,\" she says. \"Prior to that, I had one once a month.\"\u003c/p>\n\u003cp>Fite still has her worries, though. She has to be on aspirin for the rest of her life to maintain the desensitization. \"Say I get in an accident, and I bleed too much because of the aspirin,\" she says. The symptoms aren't totally gone, and she still can't drink alcohol without becoming really ill. Plus, she says, it's just unnerving taking aspirin every day when she knows it should kill her.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But there aren't many alternatives, so until there's a better solution, she'll stay on the aspirin.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Aspirin+Both+Triggers+And+Treats+An+Often-Missed+Disease&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"soldout": {
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"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
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