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"content": "\u003cp>When scientists first read out the human genome 15 years ago, there were high hopes that we'd soon understand how traits like height are inherited. It hasn't been easy. A huge effort to find height-related genes so far only explains a fraction of this trait.\u003c/p>\n\u003cp>Now scientists say they've made some more headway. And the effort is not just useful for understanding how genes determine height, but how they're involved in driving many other human traits.\u003c/p>\n\u003cp>At first, these problems didn't seem to be so complicated. The 19\u003csup>th\u003c/sup>-century monk Gregor Mendel discovered that traits in his garden peas, like smoothness and color, could be passed predictably from one generation to the next.\u003c/p>\n\u003cp>But \u003ca href=\"https://www.broadinstitute.org/bios/joel-hirschhorn\">Joel Hirschhorn\u003c/a>, a geneticist at Boston Children's Hospital and the Broad Institute, says it became evident that most stories of inheritance were not so simple. Height turns out to be a prime example.\u003c/p>\n\u003cp>\"People's height didn't behave like Mendel's peas,\" Hirschhorn says. \"It wasn't like they you had two tall people and they'd either have a tall [child] or a short [child]. Often the child was partway between the parents.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Scientists explained this 100 years ago, when they realized that height was influenced by many genes, and each makes a small contribution.\u003c/p>\n\u003cp>So when the human genome was sequenced, scientists like Hirschhorn thought they could plumb that data to track all the height genes, and finally understand how height — and in fact most other human traits — are shaped by our genes.\u003c/p>\n\u003cp>That effort started slowly. But now, Hirschhorn says, \"For height there are about 700 variants known to affect height, each of them usually with a pretty small effect on height, usually like a millimeter or less.\"\u003c/p>\n\u003cp>That massive global effort has involved studying the genes of more than 700,000 volunteer subjects. Even so, the traits they've found only explain about a quarter of the inherited height factors.\u003c/p>\n\u003cp>And, frustratingly, for most of those variants scientists have no idea what they actually do.\u003c/p>\n\u003cp>Mostly the variants crop up in mysterious bits of DNA between genes on our chromosomes. That makes it hard to figure out their roles.\u003c/p>\n\u003cp>So Hirschhorn and his army of colleagues, who \u003ca href=\"http://nature.com/articles/doi:10.1038/nature21039\">reported\u003c/a> on the effort last week in the journal \u003cem>Nature\u003c/em>, tried a new tack.\u003c/p>\n\u003cp>Their study focused only on variants that are directly in the genes themselves. By knowing that the genes do, they can understand better how variants might influence height. For example, one is in a gene that influences hormones that regulate growth.\u003c/p>\n\u003cp>The variants within genes are uncommon, but some have a remarkably large influence on height.\u003c/p>\n\u003cp>\"We found some that, if you carry them, you might actually be an inch taller or an inch shorter, as opposed to just a millimeter difference that we found with the previous variants,\" Hirschhorn says.\u003c/p>\n\u003cp>Scientists are still very far from identifying all the genes involved with stature, but these new findings do help them better understand the natural biochemistry that influences height.\u003c/p>\n\u003cp>So far most of our understanding of height has come from scientists who study children who have abnormal growth patterns, according to \u003ca href=\"https://www.nichd.nih.gov/about/staff/Pages/bio.aspx?nih_id=0010126245\">Constantine Stratakis\u003c/a>, a pediatrician and scientific director of the National Institute of Child Health and Human Development.\u003c/p>\n\u003cp>\"There are rare experiments of nature that have told us these genes are involved in the regulation of growth,\" he says. In fact, he discovered one of those rare genes, linked to a trait called \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1408028#t=article\">gigantism\u003c/a>.\u003c/p>\n\u003cp>\"It leads to babies that double or triple their length in the first year of life,\" he says.\u003c/p>\n\u003cp>These natural experiments have been most useful for treating height disorders, but Stratakis hopes that eventually the genome-search methods will provide leads for future treatments.\u003c/p>\n\u003cp>The bigger lesson here is figuring out how the biology of a complex trait like height really works.\u003c/p>\n\u003cp>Rare variants can sometimes make a big difference, \"but most of the time it's all about systems that interact that define how an organism behaves, or grows, or has a disease, develops a trait and so on,\" Stratakis says. \"And although it's humbling to see the complexity, at this point it's not unexpected.\"\u003c/p>\n\u003cp>Hirschhorn and his colleagues are expanding their already massive study of 700,000 subjects. That approach has \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp0806284\">drawn skepticism\u003c/a> from some scientists, who think it's a waste of effort.\u003c/p>\n\u003cp>David Goldstein, a professor of genetics at Columbia University, says an expanded effort could ultimately implicate every gene in existence, and that hardly helps scientists narrow down the biological factors that contribute to height.\u003c/p>\n\u003cp>It's likely scientists will never be able to figure out what these hundreds of common variants do to influence height, \u003ca href=\"http://www.igm.columbia.edu/profile/dbgoldstein\">Goldstein \u003c/a>says. Instead, a much better strategy is what Hirschhorn used in this latest study: looking for rare variants that pack a big punch.\u003c/p>\n\u003cp>Hirschhorn is undeterred.\u003c/p>\n\u003chr>\n\u003cp>\"We probably won't get all of the way to explaining 100 percent of the genetic factors, but in some sense that's not really our goal,\" Hirschhorn says. \"Our goal is to use the genetics to do our best at understanding the biology.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>To that end, Hirschhorn and his colleagues are not just looking at height; they're digging into traits that make people susceptible to diabetes and obesity.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Which+Genes+Make+You+Taller%3F+A+Whole+Bunch+Of+Them%2C+It+Turns+Out&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>When scientists first read out the human genome 15 years ago, there were high hopes that we'd soon understand how traits like height are inherited. It hasn't been easy. A huge effort to find height-related genes so far only explains a fraction of this trait.\u003c/p>\n\u003cp>Now scientists say they've made some more headway. And the effort is not just useful for understanding how genes determine height, but how they're involved in driving many other human traits.\u003c/p>\n\u003cp>At first, these problems didn't seem to be so complicated. The 19\u003csup>th\u003c/sup>-century monk Gregor Mendel discovered that traits in his garden peas, like smoothness and color, could be passed predictably from one generation to the next.\u003c/p>\n\u003cp>But \u003ca href=\"https://www.broadinstitute.org/bios/joel-hirschhorn\">Joel Hirschhorn\u003c/a>, a geneticist at Boston Children's Hospital and the Broad Institute, says it became evident that most stories of inheritance were not so simple. Height turns out to be a prime example.\u003c/p>\n\u003cp>\"People's height didn't behave like Mendel's peas,\" Hirschhorn says. \"It wasn't like they you had two tall people and they'd either have a tall [child] or a short [child]. Often the child was partway between the parents.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Scientists explained this 100 years ago, when they realized that height was influenced by many genes, and each makes a small contribution.\u003c/p>\n\u003cp>So when the human genome was sequenced, scientists like Hirschhorn thought they could plumb that data to track all the height genes, and finally understand how height — and in fact most other human traits — are shaped by our genes.\u003c/p>\n\u003cp>That effort started slowly. But now, Hirschhorn says, \"For height there are about 700 variants known to affect height, each of them usually with a pretty small effect on height, usually like a millimeter or less.\"\u003c/p>\n\u003cp>That massive global effort has involved studying the genes of more than 700,000 volunteer subjects. Even so, the traits they've found only explain about a quarter of the inherited height factors.\u003c/p>\n\u003cp>And, frustratingly, for most of those variants scientists have no idea what they actually do.\u003c/p>\n\u003cp>Mostly the variants crop up in mysterious bits of DNA between genes on our chromosomes. That makes it hard to figure out their roles.\u003c/p>\n\u003cp>So Hirschhorn and his army of colleagues, who \u003ca href=\"http://nature.com/articles/doi:10.1038/nature21039\">reported\u003c/a> on the effort last week in the journal \u003cem>Nature\u003c/em>, tried a new tack.\u003c/p>\n\u003cp>Their study focused only on variants that are directly in the genes themselves. By knowing that the genes do, they can understand better how variants might influence height. For example, one is in a gene that influences hormones that regulate growth.\u003c/p>\n\u003cp>The variants within genes are uncommon, but some have a remarkably large influence on height.\u003c/p>\n\u003cp>\"We found some that, if you carry them, you might actually be an inch taller or an inch shorter, as opposed to just a millimeter difference that we found with the previous variants,\" Hirschhorn says.\u003c/p>\n\u003cp>Scientists are still very far from identifying all the genes involved with stature, but these new findings do help them better understand the natural biochemistry that influences height.\u003c/p>\n\u003cp>So far most of our understanding of height has come from scientists who study children who have abnormal growth patterns, according to \u003ca href=\"https://www.nichd.nih.gov/about/staff/Pages/bio.aspx?nih_id=0010126245\">Constantine Stratakis\u003c/a>, a pediatrician and scientific director of the National Institute of Child Health and Human Development.\u003c/p>\n\u003cp>\"There are rare experiments of nature that have told us these genes are involved in the regulation of growth,\" he says. In fact, he discovered one of those rare genes, linked to a trait called \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1408028#t=article\">gigantism\u003c/a>.\u003c/p>\n\u003cp>\"It leads to babies that double or triple their length in the first year of life,\" he says.\u003c/p>\n\u003cp>These natural experiments have been most useful for treating height disorders, but Stratakis hopes that eventually the genome-search methods will provide leads for future treatments.\u003c/p>\n\u003cp>The bigger lesson here is figuring out how the biology of a complex trait like height really works.\u003c/p>\n\u003cp>Rare variants can sometimes make a big difference, \"but most of the time it's all about systems that interact that define how an organism behaves, or grows, or has a disease, develops a trait and so on,\" Stratakis says. \"And although it's humbling to see the complexity, at this point it's not unexpected.\"\u003c/p>\n\u003cp>Hirschhorn and his colleagues are expanding their already massive study of 700,000 subjects. That approach has \u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMp0806284\">drawn skepticism\u003c/a> from some scientists, who think it's a waste of effort.\u003c/p>\n\u003cp>David Goldstein, a professor of genetics at Columbia University, says an expanded effort could ultimately implicate every gene in existence, and that hardly helps scientists narrow down the biological factors that contribute to height.\u003c/p>\n\u003cp>It's likely scientists will never be able to figure out what these hundreds of common variants do to influence height, \u003ca href=\"http://www.igm.columbia.edu/profile/dbgoldstein\">Goldstein \u003c/a>says. Instead, a much better strategy is what Hirschhorn used in this latest study: looking for rare variants that pack a big punch.\u003c/p>\n\u003cp>Hirschhorn is undeterred.\u003c/p>\n\u003chr>\n\u003cp>\"We probably won't get all of the way to explaining 100 percent of the genetic factors, but in some sense that's not really our goal,\" Hirschhorn says. \"Our goal is to use the genetics to do our best at understanding the biology.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>To that end, Hirschhorn and his colleagues are not just looking at height; they're digging into traits that make people susceptible to diabetes and obesity.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Which+Genes+Make+You+Taller%3F+A+Whole+Bunch+Of+Them%2C+It+Turns+Out&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Much has been written about the \u003ca href=\"https://aspe.hhs.gov/sites/default/files/pdf/187551/ACA2010-2016.pdf\">20 million people\u003c/a> who gained health insurance under the Affordable Care Act, and \u003ca href=\"http://www.npr.org/sections/health-shots/2017/01/24/511413971/arizona-children-could-lose-health-coverage-under-obamacare-repeal\">what could happen\u003c/a> to these patients if the ACA is repealed without a replacement. But some people don’t realize that hospitals nationwide could take a big financial hit on several fronts, too.\u003c/p>\n\u003cp>First, it’s likely that fewer patients would be able to pay their hospital bills, health policy analysts say, so the institutions would be stuck with that bad debt, as they were before Obamacare.\u003c/p>\n\u003cp>“If the Medicaid expansion goes away wholesale, and things go back to the way they were before this expansion was in place, a lot of those hospitals would see an increase in their uncompensated care costs,” says \u003ca href=\"http://kff.org/person/rachel-garfield/\">Rachel Garfield\u003c/a>, an analyst with the Kaiser Family Foundation. The American Hospital Association estimates that hospitals across the U.S. could \u003ca href=\"http://www.aha.org/content/16/impact-repeal-aca-exec-summary.pdf\">lose\u003c/a> more than $160 billion from the reduction in Medicaid revenue and the increase in unpaid medical bills.\u003c/p>\n\u003cp>Then there’s this: The ACA has used financial incentives to encourage hospitals to experiment with ways to improve their care of patients, while reducing health care’s cost. That sort of experimentation has included a sizable upfront investment by many hospitals.\u003c/p>\n\u003cp>Massachusetts General Hospital in Boston, for example, signed \u003ca href=\"http://www.partners.org/For-Patients/ACO/\">agreements\u003c/a> with physicians and insurers to create \u003ca href=\"http://www.npr.org/2011/04/01/132937232/accountable-care-organizations-explained\">accountable care organizations\u003c/a>, in hopes of saving money in the long run. With an ACO, insurers pay doctors for making sure the patient is getting the best and most appropriate care, instead of paying for every test and procedure a doctor does.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We have now more than 20 different programs,” says \u003ca href=\"http://www.massgeneral.org/children/doctors/doctor.aspx?id=16933\">Dr. Timothy Ferris\u003c/a>, an internist and medical director of the Mass General Physicians Organization. “Video visits, electronic consultation with specialists, home hospitalization, [and] programs for patients with diabetes and heart disease. I would be worried that a repeal of the ACA would undermine our ability to invest in services for our patients.”\u003c/p>\n\u003cp>Ferris acknowledges that most of those experiments \u003ca href=\"http://www.npr.org/sections/health-shots/2015/09/14/440240225/medicare-fails-to-save-money-so-far-on-cooperative-care-experiment\">haven’t yet\u003c/a> saved money. But they need more time to work out the kinks safely, he says.\u003c/p>\n\u003cp>“One of the things that it’s difficult for people outside of health care to appreciate — particularly politicians — is how long it takes to make significant improvements in the delivery of care,” Ferris says. “You have to be very careful when you make changes.”\u003c/p>\n\u003cp>Ferris says the threatened repeal of the ACA makes him worry “that the progress we’ve made over the past five years would be threatened.”\u003c/p>\n\u003cp>Many other \u003ca href=\"http://healthaffairs.org/blog/2016/04/21/accountable-care-organizations-in-2016-private-and-public-sector-growth-and-dispersion/\">hospitals across the country\u003c/a> have invested in accountable care organizations — often overhauling their medical records systems, hiring staff and creating new services. \u003ca href=\"http://www.carenewengland.org/about/board-of-directors/dennis-keefe.cfm\">Dennis Keefe\u003c/a>, head of a large hospital chain called \u003ca href=\"http://www.carenewengland.org/\">Care New England\u003c/a> in Rhode Island, says he, too, worries about the future of his ACO, \u003ca href=\"http://www.integracare.org/\">Integra\u003c/a>.\u003c/p>\n\u003cp>“I think, if there’s a real change in direction away from these alternative payment models, we will be assuming risk to care for a population,” Keefe says.”We have invested enormously to be successful in this area.”\u003c/p>\n\u003cp>But these seismic changes in the way hospitals do business were predicated, he adds, on long-term support from the federal government — support that might disappear if the ACA is repealed.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of NPR’s reporting partnership with NPR, Rhode Island Public Radio and Kaiser Health News. The Kaiser Family Foundation supports Kaiser Health News, an editorially independent program that produces news reports heard on NPR and published on \u003c/em>\u003ca href=\"http://NPR.org\">NPR.org\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 Rhode Island Public Radio. To see more, visit \u003ca href=\"http://www.ripr.org/\">Rhode Island Public Radio\u003c/a>.\u003cimg decoding=\"async\" src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Hospitals+Worry+Repeal+Of+Obamacare+Would+Jeopardize+Innovations+In+Care&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Much has been written about the \u003ca href=\"https://aspe.hhs.gov/sites/default/files/pdf/187551/ACA2010-2016.pdf\">20 million people\u003c/a> who gained health insurance under the Affordable Care Act, and \u003ca href=\"http://www.npr.org/sections/health-shots/2017/01/24/511413971/arizona-children-could-lose-health-coverage-under-obamacare-repeal\">what could happen\u003c/a> to these patients if the ACA is repealed without a replacement. But some people don’t realize that hospitals nationwide could take a big financial hit on several fronts, too.\u003c/p>\n\u003cp>First, it’s likely that fewer patients would be able to pay their hospital bills, health policy analysts say, so the institutions would be stuck with that bad debt, as they were before Obamacare.\u003c/p>\n\u003cp>“If the Medicaid expansion goes away wholesale, and things go back to the way they were before this expansion was in place, a lot of those hospitals would see an increase in their uncompensated care costs,” says \u003ca href=\"http://kff.org/person/rachel-garfield/\">Rachel Garfield\u003c/a>, an analyst with the Kaiser Family Foundation. The American Hospital Association estimates that hospitals across the U.S. could \u003ca href=\"http://www.aha.org/content/16/impact-repeal-aca-exec-summary.pdf\">lose\u003c/a> more than $160 billion from the reduction in Medicaid revenue and the increase in unpaid medical bills.\u003c/p>\n\u003cp>Then there’s this: The ACA has used financial incentives to encourage hospitals to experiment with ways to improve their care of patients, while reducing health care’s cost. That sort of experimentation has included a sizable upfront investment by many hospitals.\u003c/p>\n\u003cp>Massachusetts General Hospital in Boston, for example, signed \u003ca href=\"http://www.partners.org/For-Patients/ACO/\">agreements\u003c/a> with physicians and insurers to create \u003ca href=\"http://www.npr.org/2011/04/01/132937232/accountable-care-organizations-explained\">accountable care organizations\u003c/a>, in hopes of saving money in the long run. With an ACO, insurers pay doctors for making sure the patient is getting the best and most appropriate care, instead of paying for every test and procedure a doctor does.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We have now more than 20 different programs,” says \u003ca href=\"http://www.massgeneral.org/children/doctors/doctor.aspx?id=16933\">Dr. Timothy Ferris\u003c/a>, an internist and medical director of the Mass General Physicians Organization. “Video visits, electronic consultation with specialists, home hospitalization, [and] programs for patients with diabetes and heart disease. I would be worried that a repeal of the ACA would undermine our ability to invest in services for our patients.”\u003c/p>\n\u003cp>Ferris acknowledges that most of those experiments \u003ca href=\"http://www.npr.org/sections/health-shots/2015/09/14/440240225/medicare-fails-to-save-money-so-far-on-cooperative-care-experiment\">haven’t yet\u003c/a> saved money. But they need more time to work out the kinks safely, he says.\u003c/p>\n\u003cp>“One of the things that it’s difficult for people outside of health care to appreciate — particularly politicians — is how long it takes to make significant improvements in the delivery of care,” Ferris says. “You have to be very careful when you make changes.”\u003c/p>\n\u003cp>Ferris says the threatened repeal of the ACA makes him worry “that the progress we’ve made over the past five years would be threatened.”\u003c/p>\n\u003cp>Many other \u003ca href=\"http://healthaffairs.org/blog/2016/04/21/accountable-care-organizations-in-2016-private-and-public-sector-growth-and-dispersion/\">hospitals across the country\u003c/a> have invested in accountable care organizations — often overhauling their medical records systems, hiring staff and creating new services. \u003ca href=\"http://www.carenewengland.org/about/board-of-directors/dennis-keefe.cfm\">Dennis Keefe\u003c/a>, head of a large hospital chain called \u003ca href=\"http://www.carenewengland.org/\">Care New England\u003c/a> in Rhode Island, says he, too, worries about the future of his ACO, \u003ca href=\"http://www.integracare.org/\">Integra\u003c/a>.\u003c/p>\n\u003cp>“I think, if there’s a real change in direction away from these alternative payment models, we will be assuming risk to care for a population,” Keefe says.”We have invested enormously to be successful in this area.”\u003c/p>\n\u003cp>But these seismic changes in the way hospitals do business were predicated, he adds, on long-term support from the federal government — support that might disappear if the ACA is repealed.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of NPR’s reporting partnership with NPR, Rhode Island Public Radio and Kaiser Health News. The Kaiser Family Foundation supports Kaiser Health News, an editorially independent program that produces news reports heard on NPR and published on \u003c/em>\u003ca href=\"http://NPR.org\">NPR.org\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 Rhode Island Public Radio. To see more, visit \u003ca href=\"http://www.ripr.org/\">Rhode Island Public Radio\u003c/a>.\u003cimg decoding=\"async\" src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Hospitals+Worry+Repeal+Of+Obamacare+Would+Jeopardize+Innovations+In+Care&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong>Silicon Valley Response on Immigration\u003c/strong>\u003cbr>\nSeveral Silicon Valley companies, including Alphabet, Apple, Facebook and Microsoft, drafted a joint letter opposing President Donald Trump’s executive order limiting immigration and travel to the U.S. Recode Executive Editor Kara Swisher and KQED Silicon Valley Desk Senior Editor Queena Kim join Thuy Vu.\u003c/p>\n\u003cp>\u003cstrong>Congressman Ro Khanna\u003c/strong>\u003cbr>\nCongressman Ro Khanna (D-Silicon Valley) weighs in on immigration policy, job creation and federal funding for California. He joins Scott Shafer, senior editor of KQED’s California Politics and Government Desk.\u003c/p>\n\u003cp>\u003cstrong>Border Report\u003c/strong>\u003cbr>\nKQED host and reporter John Sepulvado spent the week in San Diego, where he talked with residents about President Trump’s proposed new wall and the executive order limiting travel from seven predominantly Muslim countries. He joins Thuy Vu.\u003c/p>\n\u003cp>\u003cstrong>Sports and Politics\u003c/strong>\u003cbr>\nThis Sunday, an iconic American beer brewer will debut a Super Bowl ad that weighs in on immigration policy. But political commentary is not always welcome in athletics. Monica Lam talks with prominent athletes and activists, including Jim Brown, Tommie Smith, Danielle Slaton and Harry Edwards, about the intersection of sports and politics.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Silicon Valley Response on Immigration\u003c/strong>\u003cbr>\nSeveral Silicon Valley companies, including Alphabet, Apple, Facebook and Microsoft, drafted a joint letter opposing President Donald Trump’s executive order limiting immigration and travel to the U.S. Recode Executive Editor Kara Swisher and KQED Silicon Valley Desk Senior Editor Queena Kim join Thuy Vu.\u003c/p>\n\u003cp>\u003cstrong>Congressman Ro Khanna\u003c/strong>\u003cbr>\nCongressman Ro Khanna (D-Silicon Valley) weighs in on immigration policy, job creation and federal funding for California. He joins Scott Shafer, senior editor of KQED’s California Politics and Government Desk.\u003c/p>\n\u003cp>\u003cstrong>Border Report\u003c/strong>\u003cbr>\nKQED host and reporter John Sepulvado spent the week in San Diego, where he talked with residents about President Trump’s proposed new wall and the executive order limiting travel from seven predominantly Muslim countries. He joins Thuy Vu.\u003c/p>\n\u003cp>\u003cstrong>Sports and Politics\u003c/strong>\u003cbr>\nThis Sunday, an iconic American beer brewer will debut a Super Bowl ad that weighs in on immigration policy. But political commentary is not always welcome in athletics. Monica Lam talks with prominent athletes and activists, including Jim Brown, Tommie Smith, Danielle Slaton and Harry Edwards, about the intersection of sports and politics.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>In an unusual sign of protest at an iconic Silicon Valley name, Google employees worldwide took to the streets to denounce Trump’s new immigration policies that are directly impacting workers at the global giant.\u003c/p>\n\u003cfigure id=\"attachment_11294847\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11294847\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-800x806.jpg\" alt=\"A Google worker walks to a protest against President Trump's executive order banning immigrants from seven majority-Muslim countries.\" width=\"800\" height=\"806\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-800x806.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-160x161.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-1020x1027.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-1920x1934.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-1180x1188.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-960x967.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-240x242.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-375x378.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-520x524.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-32x32.jpg 32w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-50x50.jpg 50w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-64x64.jpg 64w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-96x96.jpg 96w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-128x128.jpg 128w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-150x150.jpg 150w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A Google worker walks to a protest against President Trump’s executive order banning immigrants from seven majority-Muslim countries. \u003ccite>(Queena Sook Kim)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At Google’s headquarters in Mountain View on Monday, a quad was packed with Googlers toting signs reading “Nation of immigrants,” “Even introverts are here” and “No ban, no wall.”\u003c/p>\n\u003cp>Google CEO Sundar Pichai, who joined the rally, has been highly critical of Trump’s order and warned that it could prevent at least 187 foreign-born Google employees from entering the United States.\u003c/p>\n\u003cp>“There are some values that are foundational and you should never compromise on,” said Pichai, a U.S. citizen born in India. “It is core to the founding of this company.”\u003c/p>\n\u003cp>Silicon Valley relies heavily on a foreign and immigrant workforce. That’s apparent at Google, where visitors can see large groups of Indians, Chinese, Iranians, Europeans and more — both foreign nationals and hyphenated Americans.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>One of them — Soufi Esmaeilzdeh, an Iranian-born Canadian Google product manager — addressed the crowd. She was in Switzerland when news of the Trump policies broke, learning that the immigration freeze included people from Iran (the others are Iraq, Yemen, Syria, Libya, Somalia and Sudan).\u003c/p>\n\u003cfigure id=\"attachment_11294850\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11294850\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-800x600.jpg\" alt=\"Soufi Esmaeilzdeh, a product manager at Google, speaks about her experience dealing with Trump's executive action banning people from seven majority Muslim states entry into the U.S. Esmaeilzdeh is an Iranian-born Canadian citizen and was in Switzerland when the executive action was announced.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-1920x1440.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-1180x885.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-960x720.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-240x180.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-375x281.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-520x390.jpg 520w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Soufi Esmaeilzdeh, a product manager at Google, speaks about her experience dealing with Trump’s executive action banning people from seven majority Muslim states entry into the U.S. Esmaeilzdeh is an Iranian-born Canadian citizen and was in Switzerland when the executive action was announced. \u003ccite>(Queena Sook Kim)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">When Esmaeilzdeh asked Google’s immigration and security team if she should come home to the U.S., they advised her to stay put. It was unclear what the consequences would be and the Google team needed to figure it out. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She asked, what would happen if she tried to return?\u003c/span>\u003c/p>\n\u003cp>They told her, “The likelihood was very high that I would either be deported, turned away and put on the next flight back to Canada or back to Europe.” She was also told that if any of those immigration actions was taken, it could become a part of her record and pose a problem in the future.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">And so, like an untold number of travelers, Esmaeilzdeh was stuck in limbo until the courts intervened.\u003c/span>\u003c/p>\n\u003cp>The protest was capped off by an appearance from Google co-founder Sergey Brin, who joined the large protests at San Francisco International Airport against the Trump policies over the weekend.\u003c/p>\n\u003cfigure id=\"attachment_11294923\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11294923\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-800x472.jpg\" alt=\"Google co-founder Sergey Brin speaking at a protest on the company's headquarters in Mountain View. The protest was against President Trump's executive order banning people from seven majority Muslim states from entering the U.S.\" width=\"800\" height=\"472\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-800x472.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-160x94.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-1020x602.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-1920x1133.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-1180x696.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-960x567.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-240x142.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-375x221.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-520x307.jpg 520w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Google co-founder Sergey Brin speaking at a protest on the company’s headquarters in Mountain View. The protest was against President Trump’s executive order banning people from seven majority Muslim states from entering the U.S. \u003ccite>(Queena Sook Kim)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">Brin, whose family immigrated from the Soviet Union at the height of the Cold War, reminded the crowd that tensions between the two nations were fierce and the relationship was full of mistrust. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Nevertheless, this country was brave and welcoming,” said Brin, who was six years old when his family moved to the U.S. “I wouldn’t be where I am here today, if it was not for this great country that stood up for liberty.”\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of our ongoing series on Techquity: Diversity, Inclusion and Equity in Silicon Valley. \u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In an unusual sign of protest at an iconic Silicon Valley name, Google employees worldwide took to the streets to denounce Trump’s new immigration policies that are directly impacting workers at the global giant.\u003c/p>\n\u003cfigure id=\"attachment_11294847\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11294847\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-800x806.jpg\" alt=\"A Google worker walks to a protest against President Trump's executive order banning immigrants from seven majority-Muslim countries.\" width=\"800\" height=\"806\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-800x806.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-160x161.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-1020x1027.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-1920x1934.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-1180x1188.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-960x967.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-240x242.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-375x378.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-520x524.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-32x32.jpg 32w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-50x50.jpg 50w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-64x64.jpg 64w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-96x96.jpg 96w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-128x128.jpg 128w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/GOOG-PIC-1-150x150.jpg 150w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A Google worker walks to a protest against President Trump’s executive order banning immigrants from seven majority-Muslim countries. \u003ccite>(Queena Sook Kim)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>At Google’s headquarters in Mountain View on Monday, a quad was packed with Googlers toting signs reading “Nation of immigrants,” “Even introverts are here” and “No ban, no wall.”\u003c/p>\n\u003cp>Google CEO Sundar Pichai, who joined the rally, has been highly critical of Trump’s order and warned that it could prevent at least 187 foreign-born Google employees from entering the United States.\u003c/p>\n\u003cp>“There are some values that are foundational and you should never compromise on,” said Pichai, a U.S. citizen born in India. “It is core to the founding of this company.”\u003c/p>\n\u003cp>Silicon Valley relies heavily on a foreign and immigrant workforce. That’s apparent at Google, where visitors can see large groups of Indians, Chinese, Iranians, Europeans and more — both foreign nationals and hyphenated Americans.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>One of them — Soufi Esmaeilzdeh, an Iranian-born Canadian Google product manager — addressed the crowd. She was in Switzerland when news of the Trump policies broke, learning that the immigration freeze included people from Iran (the others are Iraq, Yemen, Syria, Libya, Somalia and Sudan).\u003c/p>\n\u003cfigure id=\"attachment_11294850\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11294850\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-800x600.jpg\" alt=\"Soufi Esmaeilzdeh, a product manager at Google, speaks about her experience dealing with Trump's executive action banning people from seven majority Muslim states entry into the U.S. Esmaeilzdeh is an Iranian-born Canadian citizen and was in Switzerland when the executive action was announced.\" width=\"800\" height=\"600\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-800x600.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-160x120.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-1020x765.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-1920x1440.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-1180x885.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-960x720.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-240x180.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-375x281.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Soufi-Esmaeilzdeh-520x390.jpg 520w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Soufi Esmaeilzdeh, a product manager at Google, speaks about her experience dealing with Trump’s executive action banning people from seven majority Muslim states entry into the U.S. Esmaeilzdeh is an Iranian-born Canadian citizen and was in Switzerland when the executive action was announced. \u003ccite>(Queena Sook Kim)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">When Esmaeilzdeh asked Google’s immigration and security team if she should come home to the U.S., they advised her to stay put. It was unclear what the consequences would be and the Google team needed to figure it out. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">She asked, what would happen if she tried to return?\u003c/span>\u003c/p>\n\u003cp>They told her, “The likelihood was very high that I would either be deported, turned away and put on the next flight back to Canada or back to Europe.” She was also told that if any of those immigration actions was taken, it could become a part of her record and pose a problem in the future.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">And so, like an untold number of travelers, Esmaeilzdeh was stuck in limbo until the courts intervened.\u003c/span>\u003c/p>\n\u003cp>The protest was capped off by an appearance from Google co-founder Sergey Brin, who joined the large protests at San Francisco International Airport against the Trump policies over the weekend.\u003c/p>\n\u003cfigure id=\"attachment_11294923\" class=\"wp-caption alignnone\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-11294923\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-800x472.jpg\" alt=\"Google co-founder Sergey Brin speaking at a protest on the company's headquarters in Mountain View. The protest was against President Trump's executive order banning people from seven majority Muslim states from entering the U.S.\" width=\"800\" height=\"472\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-800x472.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-160x94.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-1020x602.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-1920x1133.jpg 1920w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-1180x696.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-960x567.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-240x142.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-375x221.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/sundar-and-sergy-520x307.jpg 520w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Google co-founder Sergey Brin speaking at a protest on the company’s headquarters in Mountain View. The protest was against President Trump’s executive order banning people from seven majority Muslim states from entering the U.S. \u003ccite>(Queena Sook Kim)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cspan style=\"font-weight: 400\">Brin, whose family immigrated from the Soviet Union at the height of the Cold War, reminded the crowd that tensions between the two nations were fierce and the relationship was full of mistrust. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“Nevertheless, this country was brave and welcoming,” said Brin, who was six years old when his family moved to the U.S. “I wouldn’t be where I am here today, if it was not for this great country that stood up for liberty.”\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of our ongoing series on Techquity: Diversity, Inclusion and Equity in Silicon Valley. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cem>Updated 10:35 a.m. Sunday\u003c/em>\u003c/p>\n\u003cp>Google, Apple and other tech giants expressed dismay over Friday’s executive order on immigration from President Trump that bars nationals of seven Muslim-majority countries from entering the United States\u003c/p>\n\u003cp>The U.S tech industry relies on foreign engineers and other technical experts for a sizable percentage of its workforce. The order bars entry to the U.S. for anyone from Iran, Iraq, Libya, Somalia, Sudan, Syria and Yemen for 90 days.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘Trump’s actions are hurting Netflix employees around the world, and are so un-American it pains us all. Worse, these actions will make America less safe (through hatred and loss of allies) rather than more safe.’\u003ccite>Reed Hastings,\u003cbr>Netflix CEO\u003c/cite>\u003c/aside>\n\u003cp>The move, ostensibly intended to prevent extremists from carrying out attacks in the U.S., could now also heighten tensions between the Trump administration and one of the nation’s most economically and culturally important industries. That’s especially true if Trump goes on to revamp the industry’s temporary worker permits known as H-1B visas, as some fear.\u003c/p>\n\u003cp>“I share your concerns” about Trump’s immigration order, Apple CEO Tim Cook wrote in a memo to employees obtained by The Associated Press. “It is not a policy we support.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“We have reached out to the White House to explain the negative effect on our coworkers and our company,” he added.\u003c/p>\n\u003cp>Cook didn’t say how many Apple employees are directly affected by the order, but said the company’s HR, legal and security teams are in contact to support them. \u003c/p>\n\u003cp>“Apple would not exist without immigration, let alone thrive and innovate the way we do,” Cook wrote — an apparent reference not only to the company’s foreign-born employees, but to Apple co-founder Steve Jobs, the son of a Syrian immigrant.\u003c/p>\n\u003cp>Netflix CEO Reed Hastings was forcefully blunt.\u003c/p>\n\u003cp>“Trump’s actions are hurting Netflix employees around the world, and are so un-American it pains us all,” he wrote on Facebook . “Worse, these actions will make America less safe (through hatred and loss of allies) rather than more safe.”\u003c/p>\n\u003cp>“It is time to link arms together to protect American values of freedom and opportunity,” he continued.\u003c/p>\n\u003cp>Facebook founder Mark Zuckerberg criticized the order in similar, though more carefully couched, terms on Friday.\u003c/p>\n\u003cp>On Sunday, Lyft cofounders John Zimmer and Logan Green announced they would donate $1 million to the American Civil Liberties Union over the next four years “to defend our Constitution.”\u003c/p>\n\u003cp>“Banning people of a particular faith or creed, race or identity, sexuality or ethnicity, from entering the U.S. is antithetical to both Lyft’s and our nation’s core values,” Zimmer and Green said in a statement. “We stand firmly against these actions, and will not be silent on issues that threaten the values of our community.”\u003c/p>\n\u003cp>Uber CEO Travis Kalanick, one of 19 corporate leaders chosen to serve as business advisors to Trump, stopped short of criticizing the president’s order. But he noted in \u003ca href=\"https://newsroom.uber.com/standing-up-for-whats-right/\" target=\"_blank\" rel=\"noopener\">a blog post published Saturday\u003c/a> that the travel ban will affect thousands of Uber drivers.\u003c/p>\n\u003cp>“This ban will impact many innocent people,” Kalanick said, “an issue that I will raise this coming Friday when I go to Washington for President Trump’s first business advisory group meeting.” \u003c/p>\n\u003cp>Technology investor Chris Sacca, an early backer of Uber and Instagram, said on Twitter that he would match ACLU donations up to $75,000 after the organization sued over the ban — and then decided to donate another $75,000 , for a total of $150,000. \u003c/p>\n\u003cp>EBay founder Pierre Omidyar, the child of Iranians, complained that the order was “simple bigotry .”\u003c/p>\n\u003cp>Tesla Motors and SpaceX founder Elon Musk, who has recently appeared to be cultivating a relationship with Trump, tweeted that “many people negatively affected by this policy are strong supporters of the U.S.” who don’t “deserve to be rejected.” Musk is an immigrant from South Africa.\u003c/p>\n\u003cp>Google told its employees from those countries to cancel any travel plans outside the U.S. and to consult with the company’s human resources department if they’re not currently in the U.S., according to a companywide note described to The Associated Press. That memo was first reported by Bloomberg and the Wall Street Journal.\u003c/p>\n\u003cp>Google CEO Sundar Pichai told employees in the note that at least 187 Google workers could be affected by Trump’s order. It is not clear how many of those workers are currently traveling outside the U.S. “We’ve always made our views on immigration known publicly and will continue to do so,” Pichai said in the memo.\u003c/p>\n\u003cp>Company representatives declined to discuss the memo or to answer questions about the affected employees. In an official statement, Google said: “We’re concerned about the impact of this order and any proposals that could impose restrictions on Googlers and their families, or that could create barriers to bringing great talent to the U.S.”\u003c/p>\n\u003cp>Microsoft also said it is providing legal advice and assistance to its employees from the banned countries, noting they are all working in the U.S. lawfully.\u003c/p>\n\u003cp>The tech industry may be bracing for further immigration-related hits. Leaks of draft executive orders, still unverified, suggest that Trump might also revamp the H1-B program that lets Silicon Valley bring foreigners with technical skills to the U.S. for three to six years.\u003c/p>\n\u003cp>While the tech industry insists the H1-B program is vital, it has drawn fire for allegedly disadvantaging American programmers and engineers, especially given that the visas are widely used by outsourcing firms. Trump’s attorney general nominee, Sen. Jeff Sessions, is a long-time critic of the program.\u003c/p>\n\u003cp>Venky Ganesan, a managing director at venture capitalist firm Menlo Ventures, acknowledged that the program is “not perfect” and subject to some abuse, but noted that it provides an invaluable source of skilled workers and plays a “pivotal” role in the tech industry.\u003c/p>\n\u003cp>“If we want to buy American and hire American, we do that best by creating companies in America,” he said. :Having the best and brightest from all over the world come and create companies in America is better than them creating companies in India, Israel or China.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>AP Auto Writer Dee-Ann Durbin contributed to this article from Detroit. AP Technology Editor David Hamilton contributed from San Francisco.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Updated 10:35 a.m. Sunday\u003c/em>\u003c/p>\n\u003cp>Google, Apple and other tech giants expressed dismay over Friday’s executive order on immigration from President Trump that bars nationals of seven Muslim-majority countries from entering the United States\u003c/p>\n\u003cp>The U.S tech industry relies on foreign engineers and other technical experts for a sizable percentage of its workforce. The order bars entry to the U.S. for anyone from Iran, Iraq, Libya, Somalia, Sudan, Syria and Yemen for 90 days.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘Trump’s actions are hurting Netflix employees around the world, and are so un-American it pains us all. Worse, these actions will make America less safe (through hatred and loss of allies) rather than more safe.’\u003ccite>Reed Hastings,\u003cbr>Netflix CEO\u003c/cite>\u003c/aside>\n\u003cp>The move, ostensibly intended to prevent extremists from carrying out attacks in the U.S., could now also heighten tensions between the Trump administration and one of the nation’s most economically and culturally important industries. That’s especially true if Trump goes on to revamp the industry’s temporary worker permits known as H-1B visas, as some fear.\u003c/p>\n\u003cp>“I share your concerns” about Trump’s immigration order, Apple CEO Tim Cook wrote in a memo to employees obtained by The Associated Press. “It is not a policy we support.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“We have reached out to the White House to explain the negative effect on our coworkers and our company,” he added.\u003c/p>\n\u003cp>Cook didn’t say how many Apple employees are directly affected by the order, but said the company’s HR, legal and security teams are in contact to support them. \u003c/p>\n\u003cp>“Apple would not exist without immigration, let alone thrive and innovate the way we do,” Cook wrote — an apparent reference not only to the company’s foreign-born employees, but to Apple co-founder Steve Jobs, the son of a Syrian immigrant.\u003c/p>\n\u003cp>Netflix CEO Reed Hastings was forcefully blunt.\u003c/p>\n\u003cp>“Trump’s actions are hurting Netflix employees around the world, and are so un-American it pains us all,” he wrote on Facebook . “Worse, these actions will make America less safe (through hatred and loss of allies) rather than more safe.”\u003c/p>\n\u003cp>“It is time to link arms together to protect American values of freedom and opportunity,” he continued.\u003c/p>\n\u003cp>Facebook founder Mark Zuckerberg criticized the order in similar, though more carefully couched, terms on Friday.\u003c/p>\n\u003cp>On Sunday, Lyft cofounders John Zimmer and Logan Green announced they would donate $1 million to the American Civil Liberties Union over the next four years “to defend our Constitution.”\u003c/p>\n\u003cp>“Banning people of a particular faith or creed, race or identity, sexuality or ethnicity, from entering the U.S. is antithetical to both Lyft’s and our nation’s core values,” Zimmer and Green said in a statement. “We stand firmly against these actions, and will not be silent on issues that threaten the values of our community.”\u003c/p>\n\u003cp>Uber CEO Travis Kalanick, one of 19 corporate leaders chosen to serve as business advisors to Trump, stopped short of criticizing the president’s order. But he noted in \u003ca href=\"https://newsroom.uber.com/standing-up-for-whats-right/\" target=\"_blank\" rel=\"noopener\">a blog post published Saturday\u003c/a> that the travel ban will affect thousands of Uber drivers.\u003c/p>\n\u003cp>“This ban will impact many innocent people,” Kalanick said, “an issue that I will raise this coming Friday when I go to Washington for President Trump’s first business advisory group meeting.” \u003c/p>\n\u003cp>Technology investor Chris Sacca, an early backer of Uber and Instagram, said on Twitter that he would match ACLU donations up to $75,000 after the organization sued over the ban — and then decided to donate another $75,000 , for a total of $150,000. \u003c/p>\n\u003cp>EBay founder Pierre Omidyar, the child of Iranians, complained that the order was “simple bigotry .”\u003c/p>\n\u003cp>Tesla Motors and SpaceX founder Elon Musk, who has recently appeared to be cultivating a relationship with Trump, tweeted that “many people negatively affected by this policy are strong supporters of the U.S.” who don’t “deserve to be rejected.” Musk is an immigrant from South Africa.\u003c/p>\n\u003cp>Google told its employees from those countries to cancel any travel plans outside the U.S. and to consult with the company’s human resources department if they’re not currently in the U.S., according to a companywide note described to The Associated Press. That memo was first reported by Bloomberg and the Wall Street Journal.\u003c/p>\n\u003cp>Google CEO Sundar Pichai told employees in the note that at least 187 Google workers could be affected by Trump’s order. It is not clear how many of those workers are currently traveling outside the U.S. “We’ve always made our views on immigration known publicly and will continue to do so,” Pichai said in the memo.\u003c/p>\n\u003cp>Company representatives declined to discuss the memo or to answer questions about the affected employees. In an official statement, Google said: “We’re concerned about the impact of this order and any proposals that could impose restrictions on Googlers and their families, or that could create barriers to bringing great talent to the U.S.”\u003c/p>\n\u003cp>Microsoft also said it is providing legal advice and assistance to its employees from the banned countries, noting they are all working in the U.S. lawfully.\u003c/p>\n\u003cp>The tech industry may be bracing for further immigration-related hits. Leaks of draft executive orders, still unverified, suggest that Trump might also revamp the H1-B program that lets Silicon Valley bring foreigners with technical skills to the U.S. for three to six years.\u003c/p>\n\u003cp>While the tech industry insists the H1-B program is vital, it has drawn fire for allegedly disadvantaging American programmers and engineers, especially given that the visas are widely used by outsourcing firms. Trump’s attorney general nominee, Sen. Jeff Sessions, is a long-time critic of the program.\u003c/p>\n\u003cp>Venky Ganesan, a managing director at venture capitalist firm Menlo Ventures, acknowledged that the program is “not perfect” and subject to some abuse, but noted that it provides an invaluable source of skilled workers and plays a “pivotal” role in the tech industry.\u003c/p>\n\u003cp>“If we want to buy American and hire American, we do that best by creating companies in America,” he said. :Having the best and brightest from all over the world come and create companies in America is better than them creating companies in India, Israel or China.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"title": "Another Lawmaker Asks UC President to Halt UCSF Layoffs",
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"content": "\u003cp>This time the letter came from Democratic Rep. Jared Huffman.\u003c/p>\n\u003cp>In his letter to UC President Janet Napolitano on Wednesday, Huffman of San Rafael denounced UCSF’s decision to send nearly 100 IT jobs to a multinational contractor overseas. IT employees at UCSF began training their replacements in October, and if Napolitano does not step in, several dozen of the IT workers will lose their jobs by the end of February. The employees had received layoff notices in July 2016.\u003c/p>\n\u003cp>[contextly_sidebar id=”6jOiXgMFR0BFdRWWv2H0418FHZcizQ2g”]\u003c/p>\n\u003cp>Lawmakers, academics and unions have sent almost a dozen letters to Napolitano criticizing the outsourcing. At the UC Regents meeting Thursday, UCSF employee Keith Pavlik read off the names of all the letter writers to board members, hoping to get their attention.\u003c/p>\n\u003cp>Those who have sent letters include UCSF’s Faculty Association, Sen. Dianne Feinstein and House Minority Leader Nancy Pelosi. But Napolitano has not budged on the issue. Her office has not yet responded to a request for comment.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Here are some of the letters sent to her office so far.\u003c/p>\n\u003cp>[scribd id=337641404 key=key-9WdX8YAx4bxyzaCchYzc mode=scroll]\u003c/p>\n\u003cp>[scribd id=337642212 key=key-nNkCG2ZX13sINYIHuY8m mode=scroll]\u003c/p>\n\u003cp>[scribd id=337642315 key=key-1a4MoVGdMuBNoPly3DpD mode=scroll]\u003c/p>\n\u003cp>[scribd id=337642429 key=key-pzmzi9OVBZVg77ab3J3K mode=scroll]\u003c/p>\n\u003cp>[scribd id=337642508 key=key-zpFByUwKOe410vPQEIhL mode=scroll]\u003c/p>\n\u003cp>[scribd id=337642611 key=key-Pp2tQBr5BTe2C7lJPNXx mode=scroll]\u003c/p>\n\u003cp>[scribd id=337646119 key=key-0kc5eZyJw9v91LWhKmw7 mode=scroll]\u003c/p>\n\u003cp>[scribd id=337646397 key=key-gFH5a5USrMEeHwLBICQg mode=scroll]\u003c/p>\n\u003cp>[scribd id=337642810 key=key-yT4wEUl8div9ItsTUAbt mode=scroll]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[scribd id=337642941 key=key-AtrcVpvzOnmuRHoEqQWb mode=scroll]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>This time the letter came from Democratic Rep. Jared Huffman.\u003c/p>\n\u003cp>In his letter to UC President Janet Napolitano on Wednesday, Huffman of San Rafael denounced UCSF’s decision to send nearly 100 IT jobs to a multinational contractor overseas. IT employees at UCSF began training their replacements in October, and if Napolitano does not step in, several dozen of the IT workers will lose their jobs by the end of February. The employees had received layoff notices in July 2016.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Lawmakers, academics and unions have sent almost a dozen letters to Napolitano criticizing the outsourcing. At the UC Regents meeting Thursday, UCSF employee Keith Pavlik read off the names of all the letter writers to board members, hoping to get their attention.\u003c/p>\n\u003cp>Those who have sent letters include UCSF’s Faculty Association, Sen. Dianne Feinstein and House Minority Leader Nancy Pelosi. But Napolitano has not budged on the issue. Her office has not yet responded to a request for comment.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Here are some of the letters sent to her office so far.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003ciframe\n class=\"scribd_iframe_embed\"\n src=\"//www.scribd.com/embeds/337641404/content?start_page=1&view_mode=&access_key=key-9WdX8YAx4bxyzaCchYzc\"\n title=\"http://www.scribd.com/doc/337641404\"\n data-auto-height=\"true\" scrolling=\"no\" id=\"scribd_337641404\"\n width=\"100%\" height=\"500\" frameborder=\"0\">\u003c/iframe>\n \u003ca class=\"utils-parseShortcode-shortcodes-__scribdShortcode__scribd_footer\"\n href=\"http://www.scribd.com/doc/337641404\"\n target=\"_blank\" rel=\"noopener noreferrer\">View this document on Scribd\u003c/a>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003ciframe\n class=\"scribd_iframe_embed\"\n src=\"//www.scribd.com/embeds/337642212/content?start_page=1&view_mode=&access_key=key-nNkCG2ZX13sINYIHuY8m\"\n title=\"http://www.scribd.com/doc/337642212\"\n data-auto-height=\"true\" scrolling=\"no\" id=\"scribd_337642212\"\n width=\"100%\" height=\"500\" frameborder=\"0\">\u003c/iframe>\n \u003ca class=\"utils-parseShortcode-shortcodes-__scribdShortcode__scribd_footer\"\n href=\"http://www.scribd.com/doc/337642212\"\n target=\"_blank\" rel=\"noopener noreferrer\">View this document on Scribd\u003c/a>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003ciframe\n class=\"scribd_iframe_embed\"\n src=\"//www.scribd.com/embeds/337642315/content?start_page=1&view_mode=&access_key=key-1a4MoVGdMuBNoPly3DpD\"\n title=\"http://www.scribd.com/doc/337642315\"\n data-auto-height=\"true\" scrolling=\"no\" id=\"scribd_337642315\"\n width=\"100%\" height=\"500\" frameborder=\"0\">\u003c/iframe>\n \u003ca class=\"utils-parseShortcode-shortcodes-__scribdShortcode__scribd_footer\"\n href=\"http://www.scribd.com/doc/337642315\"\n target=\"_blank\" rel=\"noopener noreferrer\">View this document on Scribd\u003c/a>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003ciframe\n class=\"scribd_iframe_embed\"\n src=\"//www.scribd.com/embeds/337642429/content?start_page=1&view_mode=&access_key=key-pzmzi9OVBZVg77ab3J3K\"\n title=\"http://www.scribd.com/doc/337642429\"\n data-auto-height=\"true\" scrolling=\"no\" id=\"scribd_337642429\"\n width=\"100%\" height=\"500\" frameborder=\"0\">\u003c/iframe>\n \u003ca class=\"utils-parseShortcode-shortcodes-__scribdShortcode__scribd_footer\"\n href=\"http://www.scribd.com/doc/337642429\"\n target=\"_blank\" rel=\"noopener noreferrer\">View this document on Scribd\u003c/a>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003ciframe\n class=\"scribd_iframe_embed\"\n src=\"//www.scribd.com/embeds/337642508/content?start_page=1&view_mode=&access_key=key-zpFByUwKOe410vPQEIhL\"\n title=\"http://www.scribd.com/doc/337642508\"\n data-auto-height=\"true\" scrolling=\"no\" id=\"scribd_337642508\"\n width=\"100%\" height=\"500\" frameborder=\"0\">\u003c/iframe>\n \u003ca class=\"utils-parseShortcode-shortcodes-__scribdShortcode__scribd_footer\"\n href=\"http://www.scribd.com/doc/337642508\"\n target=\"_blank\" rel=\"noopener noreferrer\">View this document on Scribd\u003c/a>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003ciframe\n class=\"scribd_iframe_embed\"\n src=\"//www.scribd.com/embeds/337642611/content?start_page=1&view_mode=&access_key=key-Pp2tQBr5BTe2C7lJPNXx\"\n title=\"http://www.scribd.com/doc/337642611\"\n data-auto-height=\"true\" scrolling=\"no\" id=\"scribd_337642611\"\n width=\"100%\" height=\"500\" frameborder=\"0\">\u003c/iframe>\n \u003ca class=\"utils-parseShortcode-shortcodes-__scribdShortcode__scribd_footer\"\n href=\"http://www.scribd.com/doc/337642611\"\n target=\"_blank\" rel=\"noopener noreferrer\">View this document on Scribd\u003c/a>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003ciframe\n class=\"scribd_iframe_embed\"\n 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"disqusTitle": "Obamacare Architect Says Silicon Valley Tech Won't Steer Health Care",
"title": "Obamacare Architect Says Silicon Valley Tech Won't Steer Health Care",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Ezekiel Emanuel is one of the architects of the Affordable Care Act, aka Obamacare, aka \u003ca href=\"http://www.npr.org/sections/thetwo-way/2017/01/17/510281627/18-million-people-could-lose-insurance-in-first-year-after-partial-obamacare-rep\" target=\"_blank\" rel=\"noopener\">dead-plan-walking\u003c/a>.\u003c/p>\n\u003cp>He's also a \"techno-skeptic,\" as he called himself the other day during an \u003ca href=\"http://audio.californiareport.org/archive/R201701170850/b\" target=\"_blank\" rel=\"noopener\">interview\u003c/a> with KQED health editor Carrie Feibel. When Feibel asked him if there should be any role to play for the \"data gurus of Silicon Valley\" in whatever comes after the ACA, he literally laughed.\u003c/p>\n\u003caside class=\"pullquote alignright\">'I do think there is an important role for tech, but I think the role is probably not what many of the startup companies around here are thinking of.'\u003ccite>Ezekiel Emanuel\u003c/cite>\u003c/aside>\n\u003cp>\"I do think there is an important role for tech, but I think the role is probably not what many of the startup companies around here are thinking of,\" he said, \"around here\" meaning San Francisco and Silicon Valley. Emanuel said tech should play a support role that \"augments\" what health care providers do, providing better data about the patient and where health care funds are spent.\u003c/p>\n\u003cp>\"I am much more skeptical that the computer is going to replace a doctor,\" he said. \"That a computer is going to interface with the patient and take care of them. Not gonna happen.\" (See our posts \"\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/11/07/AI-computers-diagnosis-watson/\" target=\"_blank\" rel=\"noopener\">Will Computers Ever Be as Good as Physicians at Diagnosing Patients\u003c/a>\" and \"\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/02/03/virtual_care_clinic_usc/\" target=\"_blank\" rel=\"noopener\">Would You See a Holographic Doctor?\" \u003c/a>for high hopes surrounding digital docs.)\u003c/p>\n\u003cp>Emanuel said he's also not big on efforts to achieve continuous patient monitoring for health indicators like glucose level and blood pressure. He cited the \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/10/10/fitbit-study/\" target=\"_blank\" rel=\"noopener\">failure of Fitbits and other wearable tech\u003c/a> to improve health outcomes in research studies.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"It’s not that we don’t have information,\" he said. \"The problem is what do you do once you have the information. And there, tech is not going to be the key thing. Medicine fundamentally is about human interaction. That is really the most important challenge, and I don’t think the tech sector has locked onto that part of it.\"\u003c/p>\n\u003cp>This sort of digital contrarianism is not unheard of in the health care biz, even at events and panels where tech-oriented medicine is the focus. Last September, for instance, at the Stanford Medicine X conference, Stephen Downs, the chief technical officer at the Robert Wood Johnson Foundation, said digital health companies\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/09/29/analysis-digital-health-companies-arent-solving-the-right-problems/\" target=\"_blank\" rel=\"noopener\"> weren't focused on solving the right problems\u003c/a>. From a report by KQED's Lesley McClurg:\u003c/p>\n\u003cblockquote>\u003cp>In this age of the Fitbit, Downs said, digital health companies are focused on monitoring the consequences of our \u003ca href=\"http://stateofobesity.org/physical-inactivity/\" target=\"_blank\" rel=\"noopener\">notoriously sedentary lifestyles. \u003c/a>But what is really called for from innovators is to stop treating symptoms and start remedying the roots of the problem.\u003c/p>\n\u003cp>“The system needs to be re-engineered,” said Downs. ... “We don’t need an app that counts steps, because that really just tells you that your day doesn’t naturally incorporate the time and space to walk.”\u003c/p>\u003c/blockquote>\n\u003cp>Instead of a focus on monitoring, he said, engineers and designers need to incorporate solutions --such as enabling urban farming --to core health problems like obesity and heart disease. \u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Policy Versus Scientific Advances\u003c/strong>\u003c/p>\n\u003cp>Several times now at conferences I've witnessed one expert or another--in the midst of a coterie of big data boosters and monitoring mavens, no less--offer up a kind of indirect scolding by cautioning that the best way to improve health is not via smartphones, but smart policy.\u003c/p>\n\u003cp>That dichotomy to some degree echoes a conversation I once had with a longtime health journalist who thought even something as institutionally sanctioned and evidence-based as \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/01/20/time-running-out-california-stem-cell-agency-yet-to-produce-big-results/\" target=\"_blank\" rel=\"noopener\">California's stem cell initiative\u003c/a> was a waste of money, because the funds would have been better directed toward policy prescriptions that address basic health needs.\u003c/p>\n\u003cp>I asked Emanuel to comment on this point, specifically mentioning stem cells.\u003c/p>\n\u003cp>\"Here's a thought experiment,\" he said. \"You know how many lives stem cells have saved? A tiny number compared to the 2.7 million people [in the U.S.] who die each year.\u003c/p>\n\u003cp>\"Now, how many lives have been saved by the ACA?\" he said. \"I don’t know, but it ain’t zero. I intersect with people all the time who happen to recognize me on the street and say I or a family friend got diagnosed with cancer and got therapy or got a heart transplant or something like that.\u003c/p>\n\u003cp>\"In the future, even under a rosy projection, stem cells will not save tons of people,\" he said. \"If you were to cure every single cancer in the U.S.-- no one in America ever dies again of cancer--we add three years to the average life expectancy. It’s a big improvement but it is not anything close to [gains achieved by] doing the basics.\"\u003c/p>\n\u003cp>The two most effective goals for increasing longevity, he said, would be to reduce smoking even further and to control blood pressure.\u003c/p>\n\u003cp>\"We’re not talking high tech,\" he said. \"There is nothing you can do that is going to come close to those two interventions.\"\u003c/p>\n\u003cp>Of course, medical value depends on your perspective, and Emanuel's is a public health view. Someone suffering from any number of horrendous diseases that stem cell research is targeting is not going to be thinking: \"Boy, what a waste to be chasing stem cell cures. I sure wish they'd divert that money to anti-smoking programs.\"\u003c/p>\n\u003cp>And even on the health tech front, some doctors have come around to viewing digital monitoring devices like \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/03/17/mobile-ekg-on-a-watchband-is-useful-for-some-say-docs/\" target=\"_blank\" rel=\"noopener\">mobile EKGs\u003c/a> as useful.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>As for computers versus doctors, physician and author Bob Wachter, has written that radiology may be the \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/10/25/technology-radiology/\" target=\"_blank\" rel=\"noopener\">canary in the coal mine\u003c/a> in terms of algorithms replacing humans.\u003c/p>\n\n",
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"excerpt": "In interviews, Ezekiel Emanuel, a former adviser on health care to President Obama, disses digital health monitoring and even stem cell research. ",
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"description": "In interviews, Ezekiel Emanuel, a former adviser on health care to President Obama, disses digital health monitoring and even stem cell research. ",
"title": "Obamacare Architect Says Silicon Valley Tech Won't Steer Health Care | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Ezekiel Emanuel is one of the architects of the Affordable Care Act, aka Obamacare, aka \u003ca href=\"http://www.npr.org/sections/thetwo-way/2017/01/17/510281627/18-million-people-could-lose-insurance-in-first-year-after-partial-obamacare-rep\" target=\"_blank\" rel=\"noopener\">dead-plan-walking\u003c/a>.\u003c/p>\n\u003cp>He's also a \"techno-skeptic,\" as he called himself the other day during an \u003ca href=\"http://audio.californiareport.org/archive/R201701170850/b\" target=\"_blank\" rel=\"noopener\">interview\u003c/a> with KQED health editor Carrie Feibel. When Feibel asked him if there should be any role to play for the \"data gurus of Silicon Valley\" in whatever comes after the ACA, he literally laughed.\u003c/p>\n\u003caside class=\"pullquote alignright\">'I do think there is an important role for tech, but I think the role is probably not what many of the startup companies around here are thinking of.'\u003ccite>Ezekiel Emanuel\u003c/cite>\u003c/aside>\n\u003cp>\"I do think there is an important role for tech, but I think the role is probably not what many of the startup companies around here are thinking of,\" he said, \"around here\" meaning San Francisco and Silicon Valley. Emanuel said tech should play a support role that \"augments\" what health care providers do, providing better data about the patient and where health care funds are spent.\u003c/p>\n\u003cp>\"I am much more skeptical that the computer is going to replace a doctor,\" he said. \"That a computer is going to interface with the patient and take care of them. Not gonna happen.\" (See our posts \"\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/11/07/AI-computers-diagnosis-watson/\" target=\"_blank\" rel=\"noopener\">Will Computers Ever Be as Good as Physicians at Diagnosing Patients\u003c/a>\" and \"\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/02/03/virtual_care_clinic_usc/\" target=\"_blank\" rel=\"noopener\">Would You See a Holographic Doctor?\" \u003c/a>for high hopes surrounding digital docs.)\u003c/p>\n\u003cp>Emanuel said he's also not big on efforts to achieve continuous patient monitoring for health indicators like glucose level and blood pressure. He cited the \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/10/10/fitbit-study/\" target=\"_blank\" rel=\"noopener\">failure of Fitbits and other wearable tech\u003c/a> to improve health outcomes in research studies.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It’s not that we don’t have information,\" he said. \"The problem is what do you do once you have the information. And there, tech is not going to be the key thing. Medicine fundamentally is about human interaction. That is really the most important challenge, and I don’t think the tech sector has locked onto that part of it.\"\u003c/p>\n\u003cp>This sort of digital contrarianism is not unheard of in the health care biz, even at events and panels where tech-oriented medicine is the focus. Last September, for instance, at the Stanford Medicine X conference, Stephen Downs, the chief technical officer at the Robert Wood Johnson Foundation, said digital health companies\u003ca href=\"https://ww2.kqed.org/futureofyou/2016/09/29/analysis-digital-health-companies-arent-solving-the-right-problems/\" target=\"_blank\" rel=\"noopener\"> weren't focused on solving the right problems\u003c/a>. From a report by KQED's Lesley McClurg:\u003c/p>\n\u003cblockquote>\u003cp>In this age of the Fitbit, Downs said, digital health companies are focused on monitoring the consequences of our \u003ca href=\"http://stateofobesity.org/physical-inactivity/\" target=\"_blank\" rel=\"noopener\">notoriously sedentary lifestyles. \u003c/a>But what is really called for from innovators is to stop treating symptoms and start remedying the roots of the problem.\u003c/p>\n\u003cp>“The system needs to be re-engineered,” said Downs. ... “We don’t need an app that counts steps, because that really just tells you that your day doesn’t naturally incorporate the time and space to walk.”\u003c/p>\u003c/blockquote>\n\u003cp>Instead of a focus on monitoring, he said, engineers and designers need to incorporate solutions --such as enabling urban farming --to core health problems like obesity and heart disease. \u003cstrong>\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>Policy Versus Scientific Advances\u003c/strong>\u003c/p>\n\u003cp>Several times now at conferences I've witnessed one expert or another--in the midst of a coterie of big data boosters and monitoring mavens, no less--offer up a kind of indirect scolding by cautioning that the best way to improve health is not via smartphones, but smart policy.\u003c/p>\n\u003cp>That dichotomy to some degree echoes a conversation I once had with a longtime health journalist who thought even something as institutionally sanctioned and evidence-based as \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/01/20/time-running-out-california-stem-cell-agency-yet-to-produce-big-results/\" target=\"_blank\" rel=\"noopener\">California's stem cell initiative\u003c/a> was a waste of money, because the funds would have been better directed toward policy prescriptions that address basic health needs.\u003c/p>\n\u003cp>I asked Emanuel to comment on this point, specifically mentioning stem cells.\u003c/p>\n\u003cp>\"Here's a thought experiment,\" he said. \"You know how many lives stem cells have saved? A tiny number compared to the 2.7 million people [in the U.S.] who die each year.\u003c/p>\n\u003cp>\"Now, how many lives have been saved by the ACA?\" he said. \"I don’t know, but it ain’t zero. I intersect with people all the time who happen to recognize me on the street and say I or a family friend got diagnosed with cancer and got therapy or got a heart transplant or something like that.\u003c/p>\n\u003cp>\"In the future, even under a rosy projection, stem cells will not save tons of people,\" he said. \"If you were to cure every single cancer in the U.S.-- no one in America ever dies again of cancer--we add three years to the average life expectancy. It’s a big improvement but it is not anything close to [gains achieved by] doing the basics.\"\u003c/p>\n\u003cp>The two most effective goals for increasing longevity, he said, would be to reduce smoking even further and to control blood pressure.\u003c/p>\n\u003cp>\"We’re not talking high tech,\" he said. \"There is nothing you can do that is going to come close to those two interventions.\"\u003c/p>\n\u003cp>Of course, medical value depends on your perspective, and Emanuel's is a public health view. Someone suffering from any number of horrendous diseases that stem cell research is targeting is not going to be thinking: \"Boy, what a waste to be chasing stem cell cures. I sure wish they'd divert that money to anti-smoking programs.\"\u003c/p>\n\u003cp>And even on the health tech front, some doctors have come around to viewing digital monitoring devices like \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/03/17/mobile-ekg-on-a-watchband-is-useful-for-some-say-docs/\" target=\"_blank\" rel=\"noopener\">mobile EKGs\u003c/a> as useful.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>As for computers versus doctors, physician and author Bob Wachter, has written that radiology may be the \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/10/25/technology-radiology/\" target=\"_blank\" rel=\"noopener\">canary in the coal mine\u003c/a> in terms of algorithms replacing humans.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Was the EpiPen Hack Ethical?",
"title": "Was the EpiPen Hack Ethical?",
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"content": "\u003cp>\u003cstrong>Update June 5, 2017 \u003c/strong>\u003c/p>\n\u003cp>From The New York Times Sunday: Charles Duhigg \u003ca href=\"https://www.nytimes.com/2017/06/04/business/angry-about-epipen-prices-executive-dont-care-much.html\" target=\"_blank\" rel=\"noopener noreferrer\">writes\u003c/a> that last year's outrage over Mylan ratcheting up the price of the EpiPen, so that patients\u003ca href=\"http://www.reuters.com/article/us-health-epipen-costs-idUSKBN16Y24O\" target=\"_blank\" rel=\"noopener noreferrer\"> out-of-pocket costs\u003c/a> increased by over 500 percent in a few years, has not resulted in the company lowering the price of the product. Duhigg writes:\u003c/p>\n\u003cblockquote>\u003cp>Mylan has been called out again and again over the years — by the company’s own employees, regulators, patients, politicians and the press — and hasn’t changed, even as revenue has skyrocketed, hitting $11 billion last year. The firm is a case study in the limits of what consumer and employee activism, as well as government oversight, can achieve.\u003c/p>\u003c/blockquote>\n\u003cp>Meanwhile last week, Iowa Republican Sen. Charles Grassley\u003ca href=\"https://www.grassley.senate.gov/news/news-releases/grassley-latest-estimate-taxpayers-overpaid-127-billion-epipen\" target=\"_blank\" rel=\"noopener noreferrer\"> announced\u003c/a> that the government has estimated Mylan may have overcharged Medicaid by as much as $1.27 billion for the EpiPen under the agency's drug rebate program.\u003c/p>\n\u003cp>\u003cstrong>Original post from Jan. 23, 2017\u003c/strong>\u003c/p>\n\u003cp>Should we be free, as individuals, to make and take our own medicine at home? Who’s responsible if we get hurt or die? Do we have to right to do what we wish with our bodies in the interests of survival, healing and self-care? For years, such questions have been at the heart of public health debates over euthanasia – the right to die – and even drug addiction.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>They also lie at the center of the infamous Mylan EpiPen pricing scandal. Last fall, Mylan CEO Heather Bresch appeared before the House Oversight Committee to explain the company’s 548 percent price hike for a simple device that injects a lifesaving anti-allergy hormone, FDA-approved epinephrine.\u003c/p>\n\u003cp>The cost drove desperate allergy patients to seek alternatives, including \u003ca href=\"http://www.thedailybeast.com/articles/2016/09/22/please-do-not-hack-your-own-epipen.html\">the dangerous practice\u003c/a> of shooting epinephrine straight from a vial into a muscle.\u003c/p>\n\u003cp>Enter a new challenger: the pharmaceutical hacking collective \u003ca href=\"https://fourthievesvinegar.org/\">Four Thieves Vinegar.\u003c/a> The group is led by Michael Laufer, a math professor by day at Menlo College in Atherton, California, who shot to internet fame overnight last August when he uploaded a DIY instructional video that went viral, showcasing his homemade version of a copycat EpiPen he called the EpiPencil. \u003ca href=\"https://www.the-parallax.com/2016/09/19/epipencil-hack-costs-fraction-epipen-exclusive/\">His device costs around $35 to construct\u003c/a>– a fraction of Mylan’s $600 brand name dual-pack EpiPen. Anyone can make it at home for personal use, he claims.\u003c/p>\n\u003cp>Laufer isn’t a medical doctor and doesn’t pretend to be. But he’s a numbers guy, well versed in computer science, and has dipped into biology and chemistry. It took him two weeks to research and assemble the plastic components of the EpiPen, an auto injector created by a NASA researcher and marketed in 1980 for $20. Mylan later picked up the patent and has benefited from a monopoly.\u003c/p>\n\u003cfigure id=\"attachment_323237\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-323237\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-800x1013.jpg\" alt=\"Close-up of packaging used in the Epi-Pencil. \" width=\"800\" height=\"1013\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-800x1013.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-160x203.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-768x973.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-1020x1292.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-1920x2432.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-1180x1495.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-960x1216.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-240x304.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-375x475.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-520x659.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Close-up of packaging used in the EpiPencil. \u003ccite>(Four Thieves Vinegar Collective)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Four Thieves Vinegar is named after a folk remedy made from vinegar and spices to ward off bubonic plague. The collective is part of the fast-growing DIY Biology movement, a subculture in which tech meets pharma--a Maker Faire for bio-geeks. In the video, Laufer carefully demonstrates how anyone can do what he did: combine a cheap off-the-shelf needle injector made for diabetics that is easy to buy on the internet, and combine it with a syringe that can be preloaded with a $1 dose of epinephrine.\u003c/p>\n\u003cp>Under fire, Mylan soon released\u003ca href=\"http://newsroom.mylan.com/2016-12-16-Mylan-Launches-the-First-Generic-for-EpiPen-epinephrine-injection-USP-Auto-Injector-as-an-Authorized-Generic\"> a $300 generic of its EpiPen\u003c/a>, but that did little to quiet critics. Georgia Congressman Buddy Carter accused the company of failing to disclose the truth about its profiteering. “There is no transparency, that's the problem here,\" he declared.\u003c/p>\n\u003cp>Leaders also criticized the FDA for its slow-paced approval of generic rivals. Teva Pharmaceutical Industries failed to get approval \u003ca href=\"https://consumerist.com/2016/09/12/teva-will-try-again-to-get-fda-approval-on-epipen-competitor-by-2018/\">for its generic EpiPen\u003c/a> in late 2016, but expects approval by 2018. Meanwhile, CVS Pharmacy has just released a $109.99 generic \u003ca href=\"http://www.pharmacytimes.com/sap-news/cvs-offers-2pack-adrenaclick-for-fraction-of-epipen-price\">two-pack EpiPen called Adrenaclick\u003c/a>. At $55 a pen, it’s close to Laufer’s DIY price -- and provides consumers with a safe, FDA-approved product.\u003c/p>\n\u003cp>That’s exactly what Laufer hoped might happen. As he sees it, his EpiPencil hack was a classic example of The Emperor Has No Clothes: It revealed the actual cost of the plastic auto injector – and showed others how they could make such a device cheaply.\u003c/p>\n\u003cp>It’s a mixed victory, though. The media spotlight gained supporters for Laufer's collective, but also opened him up to criticism. “I get a lot more fan mail then hate mail,” he says, including from parents. But others sharply condemn his actions, and his hacking group’s broader mission: making medicine at home.\u003c/p>\n\u003cp>\u003cstrong>Home Pharma Hacks Raise Safety Questions\u003c/strong>\u003c/p>\n\u003cp>Shortly after Laufer’s hack, the FDA issued a strongly worded warning against its use: “Using unapproved prescription drugs for personal use is a potentially dangerous practice,” an FDA spokesperson \u003ca href=\"http://www.in-pharmatechnologist.com/Regulatory-Safety/US-FDA-warns-against-30-alternative-to-Mylan-s-EpiPen\">told\u003c/a> the website in-PharmaTechnologist. “Unapproved drugs may be contaminated, sub-potent, super-potent or counterfeit.”\u003c/p>\n\u003cp>Critics agree. Yvette d’Entremont, known as SciBabe, is a former chemist-cum-blogger who quickly labeled the EpiPen hack a potential major fail if misused. “It seems like such a bad idea,” she told the Daily Beast. “It’s all fun and games until your product gets contaminated and you get a giant abscess in your muscle.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'I believe in empowering people, in sharing information. We need to talk about alternatives to expensive medication regimens.’\u003ccite>Michael Laufer\u003c/cite>\u003c/aside>\n\u003cp>Contamination and improper dosing can happen with approved drugs too. Epinephrine is a serious drug, used to shock the heart. Laufer defends his device as safe. “In most ways it is equivalent” to Mylan’s EpiPen, he argues, pointing out that it features a safety cap like approved EpiPens, and only carries a single dose.\u003c/p>\n\u003cp>But it’s still untested. And as the father of toxicology himself, Paracelsus, famously warned: all medicine is poison at a certain dose.\u003c/p>\n\u003cp>Oncologist Ezekiel Emanuel, a bioethicist and senior fellow at the Center for American Progress, adds to the chorus of concern, cautioning strongly against using the device.\u003c/p>\n\u003cp>“We have the FDA for a reason. We want to protect the American public from dangerous drugs, which they have no ability to evaluate independently,” he says. “So now we’re going to have some guy who’s going to make a drug and a drug delivery device, put it out there -- no testing, no evaluation of whether it’s safe or effective -- and who the hell knows how many people are going to be hurt -- or not.”\u003c/p>\n\u003cfigure id=\"attachment_323239\" class=\"wp-caption aligncenter\" style=\"max-width: 678px\">\u003cimg class=\"size-full wp-image-323239\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown.jpg\" alt=\"Michael Laufer demonstrates how to lead the Epi-Pencil in a DIY video posted to YouTube.\" width=\"678\" height=\"487\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown.jpg 678w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown-160x115.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown-240x172.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown-375x269.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown-520x374.jpg 520w\" sizes=\"(max-width: 678px) 100vw, 678px\">\u003cfigcaption class=\"wp-caption-text\">Michael Laufer demonstrates the EpiPencil in a DIY video posted to YouTube. \u003ccite>(Anne-christine d'Adesky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Adds Emanuel: “In this case he may turn out to be lucky and no one’s hurt. But we don’t want that regime.”\u003c/p>\n\u003cp>He said the solution to high pharmaceutical prices was \"not this cockamamie 'let people throw drugs out there untested,'\" but to reduce the market power that drug companies rely on to set prices.\u003c/p>\n\u003cp>\"We give drug companies monopolies through the patent law, and marketing exclusivity,\" he said. \"No other country gives a monopoly and then expects good behavior on pricing.\u003c/p>\n\u003cp>\"So what we’ve done is say, 'Oh we’re giving drug companies monopoly pricing power and then we’re like shocked, shocked they're raising prices.\"\u003c/p>\n\u003cp>Margaret McLean, director of bioethics at the\u003ca href=\"https://www.scu.edu/ethics/focus-areas/bioethics/\"> Markkula Center for Applied Ethics\u003c/a> in Santa Clara, also agrees using Laufer's device could be dangerous. She herself, carries an EpiPen. It carries a higher copay than her other medicines, so she sympathizes with parents who can’t afford even generic versions. But the safety risks remain serious.\u003c/p>\n\u003cp>“There is always user error,” says McLean, citing incorrect dosing as a concern. “That is true with FDA-approved drugs too. But the error is less if I don’t have to draw up the right amount of epinephrine myself. I’m grateful for the standardization and check on the injector itself, and that the dose in there is appropriate for me.” She doesn’t want to worry about bubbles in the syringe, which are very dangerous. “There are a lot of steps here,” she says of Laufer’s DIY epinephrine device, “where sitting at home in your kitchen, never having done this before, it puts you in a higher risk category then buying it from the pharmacy.”\u003c/p>\n\u003cp>Still, she understands the urgent unmet need for affordable EpiPens. “The FDA is not able to move things through in an expeditious way, so people rightly get antsy.”\u003c/p>\n\u003cp>Perhaps surprisingly, Laufer agrees about the warnings on safety. “Chemistry is science. So, yes, it’s a concern. You have to think immediately, ‘What if it’s misused?’ But that’s a first-order reaction,” he says. “Ideologically, I believe that more access to more information is inherently better for everyone.” He supports FDA safety reviews and clinical trial tests for new drugs and devices that are marketed to consumers. But he stresses, he’s not marketing anything.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We have the FDA for a reason. We want to protect the American public from dangerous drugs which they have no ability to evaluate independently.'\u003ccite>Ezekiel Emanuel, Center for American Progress\u003c/cite>\u003c/aside>\n\u003cp>Where Laufer draws a hard line – and marks his battleground -- is the domain of the private individual. “What I’m saying is, here is something you can think about... If you decide you’d like to adopt it, then that’s the whole ethic: Here is an idea, play with it, if you like -- no strings attached.”\u003c/p>\n\u003cp>\u003cstrong>More Drug Hacks On the Horizon\u003c/strong>\u003c/p>\n\u003cp>In his cramped faculty office, Laufer greets visitors with a warm smile, eager to share his mission and rebut critics who, he feels, have misperceptions about the true goals and the impact of his hacking action. Online, he looks like a steampunk rebel hero in a metal-studded leather jacket, rimless glasses shoved high on his forehead. Offline, he’s natty in a dark suit, purple tie and tie pin, and fancy abacus-shaped cuff links befitting a math geek.\u003c/p>\n\u003cp>“I believe in empowering people, in sharing information,” Laufer says, citing his hacker creed. “We need to talk about alternatives to expensive medication regimens.” He compares the need for a cheap drug delivery device like his EpiPencil to IKEA furniture: something that should be easy to make, with simple instructions for the average consumer.\u003c/p>\n\u003cp>What people do with that information is not his business, he declares. “I don’t know if anyone has built it besides me,” he says of the EpiPencil. “I don’t want to know. I believe in giving people information they can use to make important decisions about their self-care. That’s what I can offer.”[contextly_sidebar id=\"ucdOGkeG5JNKwxC6hhmw4jS3XUbH2VRU\"]\u003c/p>\n\u003cp>Anyone who copies a patented device risks running afoul of patent law. It's a form of civil disobedience with life-or-death stakes. That make it easy to justify, according to Laufer's group, whose \u003ca href=\"https://fourthievesvinegar.org/faq\">website asks\u003c/a>, \"If the choices presented to you are to die, because you cannot afford medication, or violate a copyright, which would you choose?\"\u003c/p>\n\u003cp>Four Thieves Vinegar is presently focused on “small batch” chemistry--medicines that are easy to make with at-home equipment. Laufer’s first successful hack was pyrimethamine (brand name Daraprim), a decades-old drug used to treat toxoplasmosis in AIDS, cancer and malaria patients. Turing Pharmaceuticals purchased the patent in August 2015 and, a month later, \u003ca href=\"http://www.cbsnews.com/news/generic-drug-price-increases-5000-percent-overnight/\">hiked the price for a single Daraprim pill overnight\u003c/a> by 5,000 percent, from $13.50 to $750. Turing CEO Martin Shkreli became a Big Pharma pariah. In response, Laufer made a batch of DIY Daraprim for $2 a pill. So did a group of \u003ca href=\"https://qz.com/851416/why-martin-shkreli-and-turings-daraprim-still-costs-750-in-the-us-when-australian-schoolkids-can-make-it-for-2/\">Australian high school students\u003c/a>.\u003c/p>\n\u003cp>Laufer has now set his sights on several drugs he feels urgently merit greater public access, including the\u003ca href=\"http://www.rawstory.com/2016/05/american-women-increasingly-turn-to-diy-abortion-drugs-after-gop-laws-shut-down-health-clinics/\"> abortion drugs RU-486 (Mifepristone) and Misoprostol\u003c/a>; Solvadi, a hepatitis C drug; and Glaxo’s HIV prevention pill, GSK-744. He’s keenly aware his choices remain controversial and politically charged.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Looking ahead, Laufer foresees a future of medicine more like Socrates, less like Big Pharma: “Maybe in not too long, the idea of doing chemistry on a personal and individual level and applying it to medicine will be more commonplace. I like dreaming about that.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Update June 5, 2017 \u003c/strong>\u003c/p>\n\u003cp>From The New York Times Sunday: Charles Duhigg \u003ca href=\"https://www.nytimes.com/2017/06/04/business/angry-about-epipen-prices-executive-dont-care-much.html\" target=\"_blank\" rel=\"noopener noreferrer\">writes\u003c/a> that last year's outrage over Mylan ratcheting up the price of the EpiPen, so that patients\u003ca href=\"http://www.reuters.com/article/us-health-epipen-costs-idUSKBN16Y24O\" target=\"_blank\" rel=\"noopener noreferrer\"> out-of-pocket costs\u003c/a> increased by over 500 percent in a few years, has not resulted in the company lowering the price of the product. Duhigg writes:\u003c/p>\n\u003cblockquote>\u003cp>Mylan has been called out again and again over the years — by the company’s own employees, regulators, patients, politicians and the press — and hasn’t changed, even as revenue has skyrocketed, hitting $11 billion last year. The firm is a case study in the limits of what consumer and employee activism, as well as government oversight, can achieve.\u003c/p>\u003c/blockquote>\n\u003cp>Meanwhile last week, Iowa Republican Sen. Charles Grassley\u003ca href=\"https://www.grassley.senate.gov/news/news-releases/grassley-latest-estimate-taxpayers-overpaid-127-billion-epipen\" target=\"_blank\" rel=\"noopener noreferrer\"> announced\u003c/a> that the government has estimated Mylan may have overcharged Medicaid by as much as $1.27 billion for the EpiPen under the agency's drug rebate program.\u003c/p>\n\u003cp>\u003cstrong>Original post from Jan. 23, 2017\u003c/strong>\u003c/p>\n\u003cp>Should we be free, as individuals, to make and take our own medicine at home? Who’s responsible if we get hurt or die? Do we have to right to do what we wish with our bodies in the interests of survival, healing and self-care? For years, such questions have been at the heart of public health debates over euthanasia – the right to die – and even drug addiction.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>They also lie at the center of the infamous Mylan EpiPen pricing scandal. Last fall, Mylan CEO Heather Bresch appeared before the House Oversight Committee to explain the company’s 548 percent price hike for a simple device that injects a lifesaving anti-allergy hormone, FDA-approved epinephrine.\u003c/p>\n\u003cp>The cost drove desperate allergy patients to seek alternatives, including \u003ca href=\"http://www.thedailybeast.com/articles/2016/09/22/please-do-not-hack-your-own-epipen.html\">the dangerous practice\u003c/a> of shooting epinephrine straight from a vial into a muscle.\u003c/p>\n\u003cp>Enter a new challenger: the pharmaceutical hacking collective \u003ca href=\"https://fourthievesvinegar.org/\">Four Thieves Vinegar.\u003c/a> The group is led by Michael Laufer, a math professor by day at Menlo College in Atherton, California, who shot to internet fame overnight last August when he uploaded a DIY instructional video that went viral, showcasing his homemade version of a copycat EpiPen he called the EpiPencil. \u003ca href=\"https://www.the-parallax.com/2016/09/19/epipencil-hack-costs-fraction-epipen-exclusive/\">His device costs around $35 to construct\u003c/a>– a fraction of Mylan’s $600 brand name dual-pack EpiPen. Anyone can make it at home for personal use, he claims.\u003c/p>\n\u003cp>Laufer isn’t a medical doctor and doesn’t pretend to be. But he’s a numbers guy, well versed in computer science, and has dipped into biology and chemistry. It took him two weeks to research and assemble the plastic components of the EpiPen, an auto injector created by a NASA researcher and marketed in 1980 for $20. Mylan later picked up the patent and has benefited from a monopoly.\u003c/p>\n\u003cfigure id=\"attachment_323237\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-323237\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-800x1013.jpg\" alt=\"Close-up of packaging used in the Epi-Pencil. \" width=\"800\" height=\"1013\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-800x1013.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-160x203.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-768x973.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-1020x1292.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-1920x2432.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-1180x1495.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-960x1216.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-240x304.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-375x475.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/Epi-Pencil-packaging-sent-by-Laufer-520x659.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Close-up of packaging used in the EpiPencil. \u003ccite>(Four Thieves Vinegar Collective)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Four Thieves Vinegar is named after a folk remedy made from vinegar and spices to ward off bubonic plague. The collective is part of the fast-growing DIY Biology movement, a subculture in which tech meets pharma--a Maker Faire for bio-geeks. In the video, Laufer carefully demonstrates how anyone can do what he did: combine a cheap off-the-shelf needle injector made for diabetics that is easy to buy on the internet, and combine it with a syringe that can be preloaded with a $1 dose of epinephrine.\u003c/p>\n\u003cp>Under fire, Mylan soon released\u003ca href=\"http://newsroom.mylan.com/2016-12-16-Mylan-Launches-the-First-Generic-for-EpiPen-epinephrine-injection-USP-Auto-Injector-as-an-Authorized-Generic\"> a $300 generic of its EpiPen\u003c/a>, but that did little to quiet critics. Georgia Congressman Buddy Carter accused the company of failing to disclose the truth about its profiteering. “There is no transparency, that's the problem here,\" he declared.\u003c/p>\n\u003cp>Leaders also criticized the FDA for its slow-paced approval of generic rivals. Teva Pharmaceutical Industries failed to get approval \u003ca href=\"https://consumerist.com/2016/09/12/teva-will-try-again-to-get-fda-approval-on-epipen-competitor-by-2018/\">for its generic EpiPen\u003c/a> in late 2016, but expects approval by 2018. Meanwhile, CVS Pharmacy has just released a $109.99 generic \u003ca href=\"http://www.pharmacytimes.com/sap-news/cvs-offers-2pack-adrenaclick-for-fraction-of-epipen-price\">two-pack EpiPen called Adrenaclick\u003c/a>. At $55 a pen, it’s close to Laufer’s DIY price -- and provides consumers with a safe, FDA-approved product.\u003c/p>\n\u003cp>That’s exactly what Laufer hoped might happen. As he sees it, his EpiPencil hack was a classic example of The Emperor Has No Clothes: It revealed the actual cost of the plastic auto injector – and showed others how they could make such a device cheaply.\u003c/p>\n\u003cp>It’s a mixed victory, though. The media spotlight gained supporters for Laufer's collective, but also opened him up to criticism. “I get a lot more fan mail then hate mail,” he says, including from parents. But others sharply condemn his actions, and his hacking group’s broader mission: making medicine at home.\u003c/p>\n\u003cp>\u003cstrong>Home Pharma Hacks Raise Safety Questions\u003c/strong>\u003c/p>\n\u003cp>Shortly after Laufer’s hack, the FDA issued a strongly worded warning against its use: “Using unapproved prescription drugs for personal use is a potentially dangerous practice,” an FDA spokesperson \u003ca href=\"http://www.in-pharmatechnologist.com/Regulatory-Safety/US-FDA-warns-against-30-alternative-to-Mylan-s-EpiPen\">told\u003c/a> the website in-PharmaTechnologist. “Unapproved drugs may be contaminated, sub-potent, super-potent or counterfeit.”\u003c/p>\n\u003cp>Critics agree. Yvette d’Entremont, known as SciBabe, is a former chemist-cum-blogger who quickly labeled the EpiPen hack a potential major fail if misused. “It seems like such a bad idea,” she told the Daily Beast. “It’s all fun and games until your product gets contaminated and you get a giant abscess in your muscle.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'I believe in empowering people, in sharing information. We need to talk about alternatives to expensive medication regimens.’\u003ccite>Michael Laufer\u003c/cite>\u003c/aside>\n\u003cp>Contamination and improper dosing can happen with approved drugs too. Epinephrine is a serious drug, used to shock the heart. Laufer defends his device as safe. “In most ways it is equivalent” to Mylan’s EpiPen, he argues, pointing out that it features a safety cap like approved EpiPens, and only carries a single dose.\u003c/p>\n\u003cp>But it’s still untested. And as the father of toxicology himself, Paracelsus, famously warned: all medicine is poison at a certain dose.\u003c/p>\n\u003cp>Oncologist Ezekiel Emanuel, a bioethicist and senior fellow at the Center for American Progress, adds to the chorus of concern, cautioning strongly against using the device.\u003c/p>\n\u003cp>“We have the FDA for a reason. We want to protect the American public from dangerous drugs, which they have no ability to evaluate independently,” he says. “So now we’re going to have some guy who’s going to make a drug and a drug delivery device, put it out there -- no testing, no evaluation of whether it’s safe or effective -- and who the hell knows how many people are going to be hurt -- or not.”\u003c/p>\n\u003cfigure id=\"attachment_323239\" class=\"wp-caption aligncenter\" style=\"max-width: 678px\">\u003cimg class=\"size-full wp-image-323239\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown.jpg\" alt=\"Michael Laufer demonstrates how to lead the Epi-Pencil in a DIY video posted to YouTube.\" width=\"678\" height=\"487\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown.jpg 678w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown-160x115.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown-240x172.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown-375x269.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/RESEND-capture-of-screenshot-of-Daraprim-chemical-breakdown-520x374.jpg 520w\" sizes=\"(max-width: 678px) 100vw, 678px\">\u003cfigcaption class=\"wp-caption-text\">Michael Laufer demonstrates the EpiPencil in a DIY video posted to YouTube. \u003ccite>(Anne-christine d'Adesky/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Adds Emanuel: “In this case he may turn out to be lucky and no one’s hurt. But we don’t want that regime.”\u003c/p>\n\u003cp>He said the solution to high pharmaceutical prices was \"not this cockamamie 'let people throw drugs out there untested,'\" but to reduce the market power that drug companies rely on to set prices.\u003c/p>\n\u003cp>\"We give drug companies monopolies through the patent law, and marketing exclusivity,\" he said. \"No other country gives a monopoly and then expects good behavior on pricing.\u003c/p>\n\u003cp>\"So what we’ve done is say, 'Oh we’re giving drug companies monopoly pricing power and then we’re like shocked, shocked they're raising prices.\"\u003c/p>\n\u003cp>Margaret McLean, director of bioethics at the\u003ca href=\"https://www.scu.edu/ethics/focus-areas/bioethics/\"> Markkula Center for Applied Ethics\u003c/a> in Santa Clara, also agrees using Laufer's device could be dangerous. She herself, carries an EpiPen. It carries a higher copay than her other medicines, so she sympathizes with parents who can’t afford even generic versions. But the safety risks remain serious.\u003c/p>\n\u003cp>“There is always user error,” says McLean, citing incorrect dosing as a concern. “That is true with FDA-approved drugs too. But the error is less if I don’t have to draw up the right amount of epinephrine myself. I’m grateful for the standardization and check on the injector itself, and that the dose in there is appropriate for me.” She doesn’t want to worry about bubbles in the syringe, which are very dangerous. “There are a lot of steps here,” she says of Laufer’s DIY epinephrine device, “where sitting at home in your kitchen, never having done this before, it puts you in a higher risk category then buying it from the pharmacy.”\u003c/p>\n\u003cp>Still, she understands the urgent unmet need for affordable EpiPens. “The FDA is not able to move things through in an expeditious way, so people rightly get antsy.”\u003c/p>\n\u003cp>Perhaps surprisingly, Laufer agrees about the warnings on safety. “Chemistry is science. So, yes, it’s a concern. You have to think immediately, ‘What if it’s misused?’ But that’s a first-order reaction,” he says. “Ideologically, I believe that more access to more information is inherently better for everyone.” He supports FDA safety reviews and clinical trial tests for new drugs and devices that are marketed to consumers. But he stresses, he’s not marketing anything.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We have the FDA for a reason. We want to protect the American public from dangerous drugs which they have no ability to evaluate independently.'\u003ccite>Ezekiel Emanuel, Center for American Progress\u003c/cite>\u003c/aside>\n\u003cp>Where Laufer draws a hard line – and marks his battleground -- is the domain of the private individual. “What I’m saying is, here is something you can think about... If you decide you’d like to adopt it, then that’s the whole ethic: Here is an idea, play with it, if you like -- no strings attached.”\u003c/p>\n\u003cp>\u003cstrong>More Drug Hacks On the Horizon\u003c/strong>\u003c/p>\n\u003cp>In his cramped faculty office, Laufer greets visitors with a warm smile, eager to share his mission and rebut critics who, he feels, have misperceptions about the true goals and the impact of his hacking action. Online, he looks like a steampunk rebel hero in a metal-studded leather jacket, rimless glasses shoved high on his forehead. Offline, he’s natty in a dark suit, purple tie and tie pin, and fancy abacus-shaped cuff links befitting a math geek.\u003c/p>\n\u003cp>“I believe in empowering people, in sharing information,” Laufer says, citing his hacker creed. “We need to talk about alternatives to expensive medication regimens.” He compares the need for a cheap drug delivery device like his EpiPencil to IKEA furniture: something that should be easy to make, with simple instructions for the average consumer.\u003c/p>\n\u003cp>What people do with that information is not his business, he declares. “I don’t know if anyone has built it besides me,” he says of the EpiPencil. “I don’t want to know. I believe in giving people information they can use to make important decisions about their self-care. That’s what I can offer.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Anyone who copies a patented device risks running afoul of patent law. It's a form of civil disobedience with life-or-death stakes. That make it easy to justify, according to Laufer's group, whose \u003ca href=\"https://fourthievesvinegar.org/faq\">website asks\u003c/a>, \"If the choices presented to you are to die, because you cannot afford medication, or violate a copyright, which would you choose?\"\u003c/p>\n\u003cp>Four Thieves Vinegar is presently focused on “small batch” chemistry--medicines that are easy to make with at-home equipment. Laufer’s first successful hack was pyrimethamine (brand name Daraprim), a decades-old drug used to treat toxoplasmosis in AIDS, cancer and malaria patients. Turing Pharmaceuticals purchased the patent in August 2015 and, a month later, \u003ca href=\"http://www.cbsnews.com/news/generic-drug-price-increases-5000-percent-overnight/\">hiked the price for a single Daraprim pill overnight\u003c/a> by 5,000 percent, from $13.50 to $750. Turing CEO Martin Shkreli became a Big Pharma pariah. In response, Laufer made a batch of DIY Daraprim for $2 a pill. So did a group of \u003ca href=\"https://qz.com/851416/why-martin-shkreli-and-turings-daraprim-still-costs-750-in-the-us-when-australian-schoolkids-can-make-it-for-2/\">Australian high school students\u003c/a>.\u003c/p>\n\u003cp>Laufer has now set his sights on several drugs he feels urgently merit greater public access, including the\u003ca href=\"http://www.rawstory.com/2016/05/american-women-increasingly-turn-to-diy-abortion-drugs-after-gop-laws-shut-down-health-clinics/\"> abortion drugs RU-486 (Mifepristone) and Misoprostol\u003c/a>; Solvadi, a hepatitis C drug; and Glaxo’s HIV prevention pill, GSK-744. He’s keenly aware his choices remain controversial and politically charged.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Looking ahead, Laufer foresees a future of medicine more like Socrates, less like Big Pharma: “Maybe in not too long, the idea of doing chemistry on a personal and individual level and applying it to medicine will be more commonplace. I like dreaming about that.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Time Running Out, California Stem Cell Agency Yet to Produce Big Results",
"title": "Time Running Out, California Stem Cell Agency Yet to Produce Big Results",
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"content": "\u003cp>It’s been more than a decade since California launched an unprecedented experiment in medical research by direct democracy, when voters created a $3 billion fund to kick-start the hunt for stem cell therapies.\u003c/p>\n\u003cp>The bold plan, a response to federal funding limits for embryonic stem cell research, was sold with a simple pitch: The money would rapidly yield cures for devastating human diseases such as Parkinson’s and ALS.\u003c/p>\n\u003cp>That hasn’t happened.\u003c/p>\n\u003cp>[contextly_sidebar id=\"wiA2OMIATARmkALimTVF9L5bJoRR3eQd\"]A major reason, a STAT examination found, is that the \u003ca href=\"https://www.cirm.ca.gov/\" target=\"_blank\">California Institute for Regenerative Medicine\u003c/a> has been slow to move promising experimental therapies into clinical trials. The National Institutes of Health has supported three and a half times as many human trials of stem cell therapies, dollar for dollar, as the California agency has funded since it started making grants in 2006. Just two of its clinical trials have been completed.\u003c/p>\n\u003cp>“I am floored by the disparity,” said Jim Lott, a health care consultant and member of the state board that monitors the agency, known as CIRM. If the numbers are correct, he told STAT, “that doesn’t settle well with me as a voter. That doesn’t settle well with me as a taxpayer. That doesn’t settle well with me as a member of the oversight committee.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>CIRM has used most of the $2.2 billion in grants it has distributed so far to build labs and pay for basic research at public and private universities, such as Stanford and the University of Southern California, and private companies.\u003c/p>\n\u003cp>It has given more than $300 million to 27 projects that include clinical trials — though much of that funding also supported preclinical work. Meanwhile, the agency has committed about $540 million to new labs and buildings.\u003c/p>\n\u003cp>In part, that’s because its directors chose to focus on infrastructure early on, as well as bench experiments and animal studies given that the biology of embryonic stem cells was not well-understood and there are formidable roadblocks to moving into human studies. Much more is known about the bone marrow stem cells that are the focus of many NIH-funded clinical trials.\u003c/p>\n\u003cp>But critics have noted that many top grantees come from institutions that hold seats on CIRM’s governing board. The respected Institute of Medicine, in a 2013 \u003ca href=\"https://www.nap.edu/catalog/13523/the-california-institute-for-regenerative-medicine-science-governance-and-the\" target=\"_blank\">review\u003c/a>, said institutionalized conflicts of interest have raised questions about “the integrity and independence of some of CIRM’s decisions.” CIRM later enacted reforms that barred board members from voting directly on grants for their institutions. But the changes didn’t prevent other financial \u003ca href=\"http://www.latimes.com/business/hiltzik/la-fi-hiltzik-20140720-column.html\" target=\"_blank\">conflicts\u003c/a> involving \u003ca href=\"http://californiastemcellreport.blogspot.com/2016/09/alan-trounson-former-ceo-of-california.html\" target=\"_blank\">CIRM officers and grantees\u003c/a>, and the flow of funds to board members’ institutions continued unabated.\u003c/p>\n\u003cfigure id=\"attachment_322983\" class=\"wp-caption aligncenter\" style=\"max-width: 979px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/CIRM.jpg\">\u003cimg class=\"wp-image-322983 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/CIRM.jpg\" alt=\"CIRM\" width=\"979\" height=\"462\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM.jpg 979w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-160x76.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-800x378.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-768x362.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-960x453.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-240x113.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-375x177.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-520x245.jpg 520w\" sizes=\"(max-width: 979px) 100vw, 979px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sources: California Institute for Regenerative Medicine, National Institutes of Health. \u003cspan class=\"media-source\">*Several CIRM trials included here were announced shortly after Sept. 30, 2016, the cut-off for the NIH data. **NIH spending for 2006 and 2007 is estimated because exact figures were unavailable.\u003c/span>NATALIA BRONSHTEIN/STAT\u003c/figcaption>\u003c/figure>\n\u003cp>“You could make an argument that California taxpayer money should go to build new facilities on state university campuses,” said Marcy Darnovsky, who directs the Berkeley-based Center for Genetics and Society, a public affairs nonprofit. “But I don’t see an argument for Stanford getting fancy new buildings from California taxpayer money.”\u003c/p>\n\u003cp>Stanford, whose endowment is among the top five nationally, and USC have received more than $70\u003cstrong> \u003c/strong>million for major building projects, and hundreds of millions more for labs and research. Stanford alone has been favored with $1 out of every $7 CIRM has approved.\u003c/p>\n\u003cp>But scientists outside California said CIRM’s record is a strong one. CIRM-funded researchers have published nearly 2,000 scholarly papers. That output has helped vault California into the top ranks of stem cell science, said Dr. George Daley, the new dean of Harvard Medical School and a leading stem cell scientist who describes himself as an informal adviser and cheerleader for CIRM. “When I look at the progress my colleagues have made in California, I am duly awed,” he said.\u003c/p>\n\u003cp>The institute announced a year ago that it would reinvent itself to emphasize clinical research until it runs out of money in 2020 — unless voters grant a new infusion of cash. CIRM plans to fund 50 new trials with its remaining $692 million, of which 10 were announced in 2016. Just 17 trials were funded in its first decade of grants.\u003c/p>\n\u003cp>C. Randal Mills, CIRM’s CEO since 2014 and architect of its new strategy, said he welcomed comparisons that help benchmark CIRM’s progress. Mills, former head of Osiris Therapeutics, the first company to commercialize an approved stem cell treatment, declined to comment on STAT’s specific findings, but defended the initial emphasis on labs and basic science as underpinning future clinical work.\u003c/p>\n\u003cp>“We’re running our own race. … What we have to do is just continually get better” to benefit patients, Mills said in an interview. “If we’re behind [NIH], we’re going to get better.”\u003c/p>\n\u003cp>Lott’s teenage daughter was paralyzed in an automobile crash and he hopes for a stem cell cure. He supports the goals of CIRM and applauds much of its work, but he now has second thoughts about the governance structure, which allows board members’ institutions to benefit from CIRM grants, as well as its financing. The ballot question that created CIRM, Proposition 71, authorized bond sales to pay for the agency’s budget, raising the total cost for taxpayers to $6 billion including interest. Financial experts, however, said that relatively low interest rates paid on long-term bonds can offer advantages over funding so large a venture directly from state coffers.\u003c/p>\n\u003cp>Asked whether he would support a similar ballot measure today, Lott said, “We were all caught up in the time, and the events were different when we first looked at this. But not today. Not at all.”\u003c/p>\n\u003cp>\u003cstrong>'Lives Will Be Saved'\u003c/strong>\u003c/p>\n\u003cp>Californians emphatically supported CIRM, creating the stem cell colossus with 59 percent of the vote in 2004. Many were upset that President George W. Bush had sharply limited federal funding for work with embryonic stem cells, which are derived from early human embryos and able to develop into any type of tissue or organ.\u003c/p>\n\u003cp>But Proposition 71 also won because it was shamelessly oversold, consumer advocates and science policy experts said. Desperate patients, Nobel laureates, and A-list celebrities such as \u003ca href=\"https://www.statnews.com/2016/08/30/parkinsons-study-fox-foundation-feud/\" target=\"_blank\">Michael J. Fox\u003c/a> — the Hollywood star and Parkinson’s sufferer — predicted “cures” that would “save millions of lives.”\u003c/p>\n\u003cp>“There are more Americans than … we can count who are sick now, or are going to be sick in the future, whose lives will be saved by Prop 71,” patient advocate Joan Samuelson said in another ad. The sponsors of the measure also predicted that CIRM-generated cures would drastically reduce health care spending. No one made specific promises for the 10-year timeframe initially planned for CIRM’s work, but miracles seemed just around the corner.\u003c/p>\n\u003cp>“You can support embryonic stem cell research, which we do and did, and still be pretty appalled by what was going down,” said Darnovsky. “The airwaves were swamped with guys in white coats who were identified with their academic affiliation even though they were principals of private companies (some of which later got CIRM grants), and basically saying, ‘We’re going to have cures by Christmas.’”\u003c/p>\n\u003cp>Mills, who was not involved at the agency’s genesis, called the idea sold to voters — impending, sweeping breakthroughs — “naïve.” Radical medical change usually takes decades from idea to cure.\u003c/p>\n\u003cp>“But here we are,” he said. “My sole mission is to create as much value for the resources we have left, for the people of California, that I can.”\u003c/p>\n\u003cp>\u003cstrong>California vs. NIH\u003c/strong>\u003c/p>\n\u003cp>Even under Bush-era restrictions — rescinded after President Barack Obama took office — the NIH continued to support substantial stem cell research.\u003c/p>\n\u003cp>Since 2006, it has spent $13.4 billion on stem cell science, six times CIRM’s budget during that period. But NIH fully or partly funded 571 clinical trials, according to STAT’s review — more than 20 times the number backed by California.\u003c/p>\n\u003cp>While NIH in that period funded 50 Phase 3 clinical trials of stem cell therapies — generally the last step before seeking approval to market a product — CIRM has supported just three.\u003c/p>\n\u003cp>One, the study of a treatment for skin cancer involving immune system cells, was terminated by Caladrius Biosciences, the grantee, when it determined that existing treatments had overtaken its approach. The others — testing altered immune cells to treat brain cancer and bioengineered veins to manage vascular problems — show promise, but are still recruiting patients and will not be completed for several years, according to the NIH website, ClinicalTrials.gov.\u003c/p>\n\u003cp>Daley called the NIH comparison “a little unfair,” because that agency emphasized hematopoietic stem cells — blood-forming cells from bone marrow, which had been studied for decades — unlike CIRM’s sharper focus on cutting-edge embryonic stem cells. A little more than half of CIRM’s awards have gone to support research on embryonic or induced pluripotent stem cells, which are created by modifying adult stem cells to act like embryonic ones. It gave about a quarter of its awards to support adult stem cell work, and the rest for other research areas.\u003c/p>\n\u003cp>“In the early days of CIRM, the feeling was that the field needed deep and direct investments in the … fundamental foundation of stem cell biology, because the translational opportunities were not yet mature, certainly not using embryonic or induced pluripotent stem cells,” Daley said.\u003c/p>\n\u003cp>\u003ca href=\"https://www.statnews.com/2016/01/30/paul-knoepfler/\" target=\"_blank\">Paul Knoepfler\u003c/a>, a University of California, Davis, researcher and CIRM grantee who writes a popular \u003ca href=\"http://www.ipscell.com/\" target=\"_blank\">stem cell blog\u003c/a>, agreed. “One almost had to invent a system for figuring out what would be a safe way to proceed with embryonic stem cell clinical trials because those cells are really much more powerful and also have different kinds of risks,” he said.\u003c/p>\n\u003cp>Knoepfler said he expected the basic science to spark clinical breakthroughs in time, citing, for example, promising early work on reversing paralysis from Asterias Biotherapeutics, located in Fremont, southeast of San Francisco. Jake Javier, a patient in a CIRM-supported Asterias trial, lost almost all use of his limbs in an accident diving into a swimming pool. He recently received an injection of a type of cell derived from embryonic stem cells that can help protect nerve cells damaged in spinal cord injuries. Javier has since regained some\u003cstrong> \u003c/strong>use of his arms — one of five patients in early trials who have shown improvement that CIRM and the researchers attribute to the treatment. The results have not yet been published in a peer-reviewed journal.\u003c/p>\n\u003cp>In addition, Mills noted that grants for new labs included provisions that required grantees to raise other funds — to “leverage” economic benefits to taxpayers — and to assist future trials. The institute, for example, gave $30 million to the contract research firm Quintiles to create facilities that will conduct preclinical research, manage regulatory issues, and provide clinical support for CIRM-supported stem cell trials, all at a steep discount.\u003c/p>\n\u003cp>“There is no iPhone 4 without an iPhone 3 or a 2 or a 1,” Mills said. But in a world where technology advances rapidly — Apple is already selling the iPhone 7, after all — voters are still waiting for the promised cures.\u003c/p>\n\u003cfigure id=\"attachment_322991\" class=\"wp-caption alignright\" style=\"max-width: 384px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/evangelina.jpg\">\u003cimg class=\"size-full wp-image-322991\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/evangelina.jpg\" alt=\"Evangelina Padilla Vaccaro in November 2016.\" width=\"384\" height=\"576\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/01/evangelina.jpg 384w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/evangelina-160x240.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/evangelina-240x360.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/evangelina-375x563.jpg 375w\" sizes=\"(max-width: 384px) 100vw, 384px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Evangelina Padilla Vaccaro in November 2016. \u003ccite>(Nancy Ramos)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So far, CIRM has one literal poster child to show it can deliver. Four-year-old Evangelina Padilla Vaccaro, featured on the cover of CIRM’s recent \u003ca href=\"https://www.cirm.ca.gov/about-cirm/2016-annual-report\" target=\"_blank\">annual report\u003c/a>, was born with severe combined immunodeficiency. She had no operating immune system. Some such children have been kept alive in sterile isolation tents for a time — hence the term, “bubble baby” — but most have died from infections within a few years. A lucky few who received matching bone-marrow transplants survived.\u003c/p>\n\u003cp>UCLA’s Dr. Donald Kohn, supported by CIRM, cured Evangelina by extracting some of her blood stem cells, altering them to correct the genetic defect, and returning them to her body. She’s now thriving with a robust immune system.\u003c/p>\n\u003cp>That little girl, and 29 children like her, “are getting immunizations, they’re going to school, they’re swimming in public swimming pools, they’re eating dirt, they’re doing all the things that little kids are supposed to do,” said Steven Peckman, associate director of UCLA’s Broad Center of Regenerative Medicine and Stem Cell Research. “They get sick and their own bodies attack those viruses and bacteria. And they survive. If there’s going to be something that’s called a cure, this is it.”\u003c/p>\n\u003cp>That inspiring triumph was partly funded by CIRM, but Kohn’s work took three decades, was well underway long before CIRM existed, and didn’t involve embryonic stem cells — the key gap CIRM was founded to fill. Evangelina was saved by hematopoietic stem cells, the type that NIH has been more focused on.\u003c/p>\n\u003cp>\u003cstrong>Racing the Clock\u003c/strong>\u003c/p>\n\u003cp>As much as Mills defends the old CIRM, last year he announced “CIRM 2.0” — a drastic shift to speed up clinical trials before the organization’s clock runs out.\u003c/p>\n\u003cp>Asked whether Californians are getting good value for their money from CIRM, Mills cited economic gains to the state, then added: “I focus a lot more on the return in relief of human suffering. We’re just starting to lift off the ground on that. I hope in history, in time, the record shows CIRM was a great deal.”\u003c/p>\n\u003cp>To that end, CIRM has said it will focus in 2017 primarily on clinical trials and work it hopes will lay the foundation for such studies.\u003c/p>\n\u003cp>If the studies show clear results, Mills said, “I think it will be self-evident that CIRM should be continued” with new funding.\u003c/p>\n\u003cp>Lott, the state overseer, called CIRM 2.0 long overdue. “They needed to at least create something a little more tangible, more specifically measurable, for the billions of dollars that they’ve allocated,” he said. “But it may be a little too late,” he added, to convince taxpayers that CIRM should get a new infusion of funds, given its governance structure.\u003c/p>\n\u003cp>Even Daley — unbridled in his enthusiasm for CIRM’s work — hesitated when asked if it was a model to emulate, though for a different reason. “I reluctantly endorse it,” he said, “in part because I think it’s another argument that allows the federal government and the NIH to abdicate its responsibility for investments in biomedical research, which benefits us all.”\u003c/p>\n\u003cp>Yet, just as President Bush’s policy on stem cells led to CIRM’s creation, the incoming Trump administration might bail out the institute just in time. The president-elect has not weighed in on federal funding, but Representative Tom Price, his nominee for Health and Human Services secretary, has long opposed federal funding of embryonic stem cell research — a view shared by Vice President-elect Mike Pence.\u003c/p>\n\u003cp>“If the Trump administration takes a hostile mind toward embryonic stem cell research, and perhaps some kinds of important fetal research are restricted as well, it may give another source of energy to CIRM,” said Knoepfler. “I don’t think Californians like to be told what we can or cannot do, research-wise.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2017/01/19/california-stem-cell-agency-cirm/\" target=\"_blank\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"excerpt": "California's $3 billion stem cell initiative was sold to voters with the pitch that the investment would rapidly yield cures for devastating diseases like Parkinson’s and ALS. That hasn’t happened.",
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"description": "California's $3 billion stem cell initiative was sold to voters with the pitch that the investment would rapidly yield cures for devastating diseases like Parkinson’s and ALS. That hasn’t happened.",
"title": "Time Running Out, California Stem Cell Agency Yet to Produce Big Results | KQED",
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"headline": "Time Running Out, California Stem Cell Agency Yet to Produce Big Results",
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"nprByline": "Charles Piller\u003cbr />\u003cA HREF=\"https://www.statnews.com/\">STAT\u003c/A>",
"source": "\u003ca href=\"https://www.statnews.com/2017/01/19/california-stem-cell-agency-cirm/\">STAT\u003c/a>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It’s been more than a decade since California launched an unprecedented experiment in medical research by direct democracy, when voters created a $3 billion fund to kick-start the hunt for stem cell therapies.\u003c/p>\n\u003cp>The bold plan, a response to federal funding limits for embryonic stem cell research, was sold with a simple pitch: The money would rapidly yield cures for devastating human diseases such as Parkinson’s and ALS.\u003c/p>\n\u003cp>That hasn’t happened.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>A major reason, a STAT examination found, is that the \u003ca href=\"https://www.cirm.ca.gov/\" target=\"_blank\">California Institute for Regenerative Medicine\u003c/a> has been slow to move promising experimental therapies into clinical trials. The National Institutes of Health has supported three and a half times as many human trials of stem cell therapies, dollar for dollar, as the California agency has funded since it started making grants in 2006. Just two of its clinical trials have been completed.\u003c/p>\n\u003cp>“I am floored by the disparity,” said Jim Lott, a health care consultant and member of the state board that monitors the agency, known as CIRM. If the numbers are correct, he told STAT, “that doesn’t settle well with me as a voter. That doesn’t settle well with me as a taxpayer. That doesn’t settle well with me as a member of the oversight committee.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>CIRM has used most of the $2.2 billion in grants it has distributed so far to build labs and pay for basic research at public and private universities, such as Stanford and the University of Southern California, and private companies.\u003c/p>\n\u003cp>It has given more than $300 million to 27 projects that include clinical trials — though much of that funding also supported preclinical work. Meanwhile, the agency has committed about $540 million to new labs and buildings.\u003c/p>\n\u003cp>In part, that’s because its directors chose to focus on infrastructure early on, as well as bench experiments and animal studies given that the biology of embryonic stem cells was not well-understood and there are formidable roadblocks to moving into human studies. Much more is known about the bone marrow stem cells that are the focus of many NIH-funded clinical trials.\u003c/p>\n\u003cp>But critics have noted that many top grantees come from institutions that hold seats on CIRM’s governing board. The respected Institute of Medicine, in a 2013 \u003ca href=\"https://www.nap.edu/catalog/13523/the-california-institute-for-regenerative-medicine-science-governance-and-the\" target=\"_blank\">review\u003c/a>, said institutionalized conflicts of interest have raised questions about “the integrity and independence of some of CIRM’s decisions.” CIRM later enacted reforms that barred board members from voting directly on grants for their institutions. But the changes didn’t prevent other financial \u003ca href=\"http://www.latimes.com/business/hiltzik/la-fi-hiltzik-20140720-column.html\" target=\"_blank\">conflicts\u003c/a> involving \u003ca href=\"http://californiastemcellreport.blogspot.com/2016/09/alan-trounson-former-ceo-of-california.html\" target=\"_blank\">CIRM officers and grantees\u003c/a>, and the flow of funds to board members’ institutions continued unabated.\u003c/p>\n\u003cfigure id=\"attachment_322983\" class=\"wp-caption aligncenter\" style=\"max-width: 979px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/CIRM.jpg\">\u003cimg class=\"wp-image-322983 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/CIRM.jpg\" alt=\"CIRM\" width=\"979\" height=\"462\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM.jpg 979w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-160x76.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-800x378.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-768x362.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-960x453.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-240x113.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-375x177.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/CIRM-520x245.jpg 520w\" sizes=\"(max-width: 979px) 100vw, 979px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sources: California Institute for Regenerative Medicine, National Institutes of Health. \u003cspan class=\"media-source\">*Several CIRM trials included here were announced shortly after Sept. 30, 2016, the cut-off for the NIH data. **NIH spending for 2006 and 2007 is estimated because exact figures were unavailable.\u003c/span>NATALIA BRONSHTEIN/STAT\u003c/figcaption>\u003c/figure>\n\u003cp>“You could make an argument that California taxpayer money should go to build new facilities on state university campuses,” said Marcy Darnovsky, who directs the Berkeley-based Center for Genetics and Society, a public affairs nonprofit. “But I don’t see an argument for Stanford getting fancy new buildings from California taxpayer money.”\u003c/p>\n\u003cp>Stanford, whose endowment is among the top five nationally, and USC have received more than $70\u003cstrong> \u003c/strong>million for major building projects, and hundreds of millions more for labs and research. Stanford alone has been favored with $1 out of every $7 CIRM has approved.\u003c/p>\n\u003cp>But scientists outside California said CIRM’s record is a strong one. CIRM-funded researchers have published nearly 2,000 scholarly papers. That output has helped vault California into the top ranks of stem cell science, said Dr. George Daley, the new dean of Harvard Medical School and a leading stem cell scientist who describes himself as an informal adviser and cheerleader for CIRM. “When I look at the progress my colleagues have made in California, I am duly awed,” he said.\u003c/p>\n\u003cp>The institute announced a year ago that it would reinvent itself to emphasize clinical research until it runs out of money in 2020 — unless voters grant a new infusion of cash. CIRM plans to fund 50 new trials with its remaining $692 million, of which 10 were announced in 2016. Just 17 trials were funded in its first decade of grants.\u003c/p>\n\u003cp>C. Randal Mills, CIRM’s CEO since 2014 and architect of its new strategy, said he welcomed comparisons that help benchmark CIRM’s progress. Mills, former head of Osiris Therapeutics, the first company to commercialize an approved stem cell treatment, declined to comment on STAT’s specific findings, but defended the initial emphasis on labs and basic science as underpinning future clinical work.\u003c/p>\n\u003cp>“We’re running our own race. … What we have to do is just continually get better” to benefit patients, Mills said in an interview. “If we’re behind [NIH], we’re going to get better.”\u003c/p>\n\u003cp>Lott’s teenage daughter was paralyzed in an automobile crash and he hopes for a stem cell cure. He supports the goals of CIRM and applauds much of its work, but he now has second thoughts about the governance structure, which allows board members’ institutions to benefit from CIRM grants, as well as its financing. The ballot question that created CIRM, Proposition 71, authorized bond sales to pay for the agency’s budget, raising the total cost for taxpayers to $6 billion including interest. Financial experts, however, said that relatively low interest rates paid on long-term bonds can offer advantages over funding so large a venture directly from state coffers.\u003c/p>\n\u003cp>Asked whether he would support a similar ballot measure today, Lott said, “We were all caught up in the time, and the events were different when we first looked at this. But not today. Not at all.”\u003c/p>\n\u003cp>\u003cstrong>'Lives Will Be Saved'\u003c/strong>\u003c/p>\n\u003cp>Californians emphatically supported CIRM, creating the stem cell colossus with 59 percent of the vote in 2004. Many were upset that President George W. Bush had sharply limited federal funding for work with embryonic stem cells, which are derived from early human embryos and able to develop into any type of tissue or organ.\u003c/p>\n\u003cp>But Proposition 71 also won because it was shamelessly oversold, consumer advocates and science policy experts said. Desperate patients, Nobel laureates, and A-list celebrities such as \u003ca href=\"https://www.statnews.com/2016/08/30/parkinsons-study-fox-foundation-feud/\" target=\"_blank\">Michael J. Fox\u003c/a> — the Hollywood star and Parkinson’s sufferer — predicted “cures” that would “save millions of lives.”\u003c/p>\n\u003cp>“There are more Americans than … we can count who are sick now, or are going to be sick in the future, whose lives will be saved by Prop 71,” patient advocate Joan Samuelson said in another ad. The sponsors of the measure also predicted that CIRM-generated cures would drastically reduce health care spending. No one made specific promises for the 10-year timeframe initially planned for CIRM’s work, but miracles seemed just around the corner.\u003c/p>\n\u003cp>“You can support embryonic stem cell research, which we do and did, and still be pretty appalled by what was going down,” said Darnovsky. “The airwaves were swamped with guys in white coats who were identified with their academic affiliation even though they were principals of private companies (some of which later got CIRM grants), and basically saying, ‘We’re going to have cures by Christmas.’”\u003c/p>\n\u003cp>Mills, who was not involved at the agency’s genesis, called the idea sold to voters — impending, sweeping breakthroughs — “naïve.” Radical medical change usually takes decades from idea to cure.\u003c/p>\n\u003cp>“But here we are,” he said. “My sole mission is to create as much value for the resources we have left, for the people of California, that I can.”\u003c/p>\n\u003cp>\u003cstrong>California vs. NIH\u003c/strong>\u003c/p>\n\u003cp>Even under Bush-era restrictions — rescinded after President Barack Obama took office — the NIH continued to support substantial stem cell research.\u003c/p>\n\u003cp>Since 2006, it has spent $13.4 billion on stem cell science, six times CIRM’s budget during that period. But NIH fully or partly funded 571 clinical trials, according to STAT’s review — more than 20 times the number backed by California.\u003c/p>\n\u003cp>While NIH in that period funded 50 Phase 3 clinical trials of stem cell therapies — generally the last step before seeking approval to market a product — CIRM has supported just three.\u003c/p>\n\u003cp>One, the study of a treatment for skin cancer involving immune system cells, was terminated by Caladrius Biosciences, the grantee, when it determined that existing treatments had overtaken its approach. The others — testing altered immune cells to treat brain cancer and bioengineered veins to manage vascular problems — show promise, but are still recruiting patients and will not be completed for several years, according to the NIH website, ClinicalTrials.gov.\u003c/p>\n\u003cp>Daley called the NIH comparison “a little unfair,” because that agency emphasized hematopoietic stem cells — blood-forming cells from bone marrow, which had been studied for decades — unlike CIRM’s sharper focus on cutting-edge embryonic stem cells. A little more than half of CIRM’s awards have gone to support research on embryonic or induced pluripotent stem cells, which are created by modifying adult stem cells to act like embryonic ones. It gave about a quarter of its awards to support adult stem cell work, and the rest for other research areas.\u003c/p>\n\u003cp>“In the early days of CIRM, the feeling was that the field needed deep and direct investments in the … fundamental foundation of stem cell biology, because the translational opportunities were not yet mature, certainly not using embryonic or induced pluripotent stem cells,” Daley said.\u003c/p>\n\u003cp>\u003ca href=\"https://www.statnews.com/2016/01/30/paul-knoepfler/\" target=\"_blank\">Paul Knoepfler\u003c/a>, a University of California, Davis, researcher and CIRM grantee who writes a popular \u003ca href=\"http://www.ipscell.com/\" target=\"_blank\">stem cell blog\u003c/a>, agreed. “One almost had to invent a system for figuring out what would be a safe way to proceed with embryonic stem cell clinical trials because those cells are really much more powerful and also have different kinds of risks,” he said.\u003c/p>\n\u003cp>Knoepfler said he expected the basic science to spark clinical breakthroughs in time, citing, for example, promising early work on reversing paralysis from Asterias Biotherapeutics, located in Fremont, southeast of San Francisco. Jake Javier, a patient in a CIRM-supported Asterias trial, lost almost all use of his limbs in an accident diving into a swimming pool. He recently received an injection of a type of cell derived from embryonic stem cells that can help protect nerve cells damaged in spinal cord injuries. Javier has since regained some\u003cstrong> \u003c/strong>use of his arms — one of five patients in early trials who have shown improvement that CIRM and the researchers attribute to the treatment. The results have not yet been published in a peer-reviewed journal.\u003c/p>\n\u003cp>In addition, Mills noted that grants for new labs included provisions that required grantees to raise other funds — to “leverage” economic benefits to taxpayers — and to assist future trials. The institute, for example, gave $30 million to the contract research firm Quintiles to create facilities that will conduct preclinical research, manage regulatory issues, and provide clinical support for CIRM-supported stem cell trials, all at a steep discount.\u003c/p>\n\u003cp>“There is no iPhone 4 without an iPhone 3 or a 2 or a 1,” Mills said. But in a world where technology advances rapidly — Apple is already selling the iPhone 7, after all — voters are still waiting for the promised cures.\u003c/p>\n\u003cfigure id=\"attachment_322991\" class=\"wp-caption alignright\" style=\"max-width: 384px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/evangelina.jpg\">\u003cimg class=\"size-full wp-image-322991\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/01/evangelina.jpg\" alt=\"Evangelina Padilla Vaccaro in November 2016.\" width=\"384\" height=\"576\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/01/evangelina.jpg 384w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/evangelina-160x240.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/evangelina-240x360.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/01/evangelina-375x563.jpg 375w\" sizes=\"(max-width: 384px) 100vw, 384px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Evangelina Padilla Vaccaro in November 2016. \u003ccite>(Nancy Ramos)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>So far, CIRM has one literal poster child to show it can deliver. Four-year-old Evangelina Padilla Vaccaro, featured on the cover of CIRM’s recent \u003ca href=\"https://www.cirm.ca.gov/about-cirm/2016-annual-report\" target=\"_blank\">annual report\u003c/a>, was born with severe combined immunodeficiency. She had no operating immune system. Some such children have been kept alive in sterile isolation tents for a time — hence the term, “bubble baby” — but most have died from infections within a few years. A lucky few who received matching bone-marrow transplants survived.\u003c/p>\n\u003cp>UCLA’s Dr. Donald Kohn, supported by CIRM, cured Evangelina by extracting some of her blood stem cells, altering them to correct the genetic defect, and returning them to her body. She’s now thriving with a robust immune system.\u003c/p>\n\u003cp>That little girl, and 29 children like her, “are getting immunizations, they’re going to school, they’re swimming in public swimming pools, they’re eating dirt, they’re doing all the things that little kids are supposed to do,” said Steven Peckman, associate director of UCLA’s Broad Center of Regenerative Medicine and Stem Cell Research. “They get sick and their own bodies attack those viruses and bacteria. And they survive. If there’s going to be something that’s called a cure, this is it.”\u003c/p>\n\u003cp>That inspiring triumph was partly funded by CIRM, but Kohn’s work took three decades, was well underway long before CIRM existed, and didn’t involve embryonic stem cells — the key gap CIRM was founded to fill. Evangelina was saved by hematopoietic stem cells, the type that NIH has been more focused on.\u003c/p>\n\u003cp>\u003cstrong>Racing the Clock\u003c/strong>\u003c/p>\n\u003cp>As much as Mills defends the old CIRM, last year he announced “CIRM 2.0” — a drastic shift to speed up clinical trials before the organization’s clock runs out.\u003c/p>\n\u003cp>Asked whether Californians are getting good value for their money from CIRM, Mills cited economic gains to the state, then added: “I focus a lot more on the return in relief of human suffering. We’re just starting to lift off the ground on that. I hope in history, in time, the record shows CIRM was a great deal.”\u003c/p>\n\u003cp>To that end, CIRM has said it will focus in 2017 primarily on clinical trials and work it hopes will lay the foundation for such studies.\u003c/p>\n\u003cp>If the studies show clear results, Mills said, “I think it will be self-evident that CIRM should be continued” with new funding.\u003c/p>\n\u003cp>Lott, the state overseer, called CIRM 2.0 long overdue. “They needed to at least create something a little more tangible, more specifically measurable, for the billions of dollars that they’ve allocated,” he said. “But it may be a little too late,” he added, to convince taxpayers that CIRM should get a new infusion of funds, given its governance structure.\u003c/p>\n\u003cp>Even Daley — unbridled in his enthusiasm for CIRM’s work — hesitated when asked if it was a model to emulate, though for a different reason. “I reluctantly endorse it,” he said, “in part because I think it’s another argument that allows the federal government and the NIH to abdicate its responsibility for investments in biomedical research, which benefits us all.”\u003c/p>\n\u003cp>Yet, just as President Bush’s policy on stem cells led to CIRM’s creation, the incoming Trump administration might bail out the institute just in time. The president-elect has not weighed in on federal funding, but Representative Tom Price, his nominee for Health and Human Services secretary, has long opposed federal funding of embryonic stem cell research — a view shared by Vice President-elect Mike Pence.\u003c/p>\n\u003cp>“If the Trump administration takes a hostile mind toward embryonic stem cell research, and perhaps some kinds of important fetal research are restricted as well, it may give another source of energy to CIRM,” said Knoepfler. “I don’t think Californians like to be told what we can or cannot do, research-wise.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2017/01/19/california-stem-cell-agency-cirm/\" target=\"_blank\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "White House Removes Climate Change Webpage After Trump's Inauguration",
"headTitle": "White House Removes Climate Change Webpage After Trump’s Inauguration | KQED",
"content": "\u003cp>Well, that didn’t take long.\u003c/p>\n\u003cp>The morning of President Trump’s inauguration, several \u003ca href=\"https://www.whitehouse.gov/\">webpages outlining official policy and priorities on the White House website \u003c/a>were removed or replaced with new text. Those pages include information about LGBT rights, civil rights, law enforcement and climate change.\u003c/p>\n\u003cp>It’s not unusual for an incoming administration to change material on the whitehouse.gov site. But it’s also a window into the new president’s priorities and how he might frame various solutions to the nation’s problems.\u003c/p>\n\u003cp>According to a javascript program run by KQED, the climate change page on the White House website kicked the bucket at 11:52 a.m. EST.\u003c/p>\n\u003cfigure id=\"attachment_1338617\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/01/whitehousechange.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1338617\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/01/whitehousechange-800x608.jpg\" alt=\"Websites accessed at 12:40 p.m. PST, Jan. 20, 2017.\" width=\"800\" height=\"608\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/whitehousechange.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/whitehousechange-160x122.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/whitehousechange-768x584.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/whitehousechange-240x182.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/whitehousechange-375x285.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/whitehousechange-520x395.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Websites accessed at 12:40 p.m. PST, Jan. 20, 2017.\u003c/figcaption>\u003c/figure>\n\u003cp>Following the page’s removal, a new energy website appeared with the title “\u003ca href=\"https://www.whitehouse.gov/america-first-energy\" target=\"_blank\" rel=\"noopener\">An America First Energy Plan\u003c/a>.” It outlines the administration’s goals to exploit oil and gas reserves and to revive the coal industry.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Ironically — or not — the page change comes during the same week \u003ca href=\"https://www.nasa.gov/\" target=\"_blank\" rel=\"noopener\">NASA\u003c/a> and \u003ca href=\"http://www.noaa.gov/\" target=\"_blank\" rel=\"noopener\">NOAA\u003c/a> reported that global warming contributed to 2016 being \u003ca href=\"https://ww2.kqed.org/science/2017/01/18/global-warming-drives-record-heat-for-third-straight-year/\" target=\"_blank\" rel=\"noopener\">the hottest year since modern record keeping began\u003c/a> in 1880. (The main contributor to global warming is the burning of fossil fuels.) Scientists have been fearful that the Trump administration would destroy climate change data, and have begun \u003ca href=\"http://www.npr.org/2016/12/14/505592206/scientists-race-to-preserve-climate-change-data-before-trump-takes-office\" target=\"_blank\" rel=\"noopener\">archiving and saving historical climate records\u003c/a>.\u003c/p>\n\u003cp>On Twitter many reacted to removal of the White House climate change site. The Wall Street Journal’s energy policy reporter, Amy Harder, for instance eulogized:\u003c/p>\n\u003cp>https://twitter.com/AmyAHarder/status/822495092367884290\u003c/p>\n\u003cp>You can find the old Obama administration\u003ca href=\"https://obamawhitehouse.archives.gov/\"> whitehouse.gov page here. \u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Trump administration website accessed at 12:40 p.m.:\u003c/strong>\u003cbr>\n\u003ca href=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.42.15-PM.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-medium wp-image-1338616\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.42.15-PM-800x1106.png\" alt=\"Screen Shot 2017-01-20 at 12.42.15 PM\" width=\"800\" height=\"1106\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.42.15-PM-800x1106.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.42.15-PM-160x221.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.42.15-PM-768x1062.png 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.42.15-PM-240x332.png 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.42.15-PM-375x518.png 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.42.15-PM-520x719.png 520w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.42.15-PM.png 847w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Obama administration website accessed at 12:40 p.m.:\u003c/strong>\u003cbr>\n\u003ca href=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.41.47-PM.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-medium wp-image-1338615\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.41.47-PM-800x1156.png\" alt=\"Screen Shot 2017-01-20 at 12.41.47 PM\" width=\"800\" height=\"1156\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.41.47-PM-800x1156.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.41.47-PM-160x231.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.41.47-PM-768x1109.png 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.41.47-PM-240x347.png 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.41.47-PM-375x542.png 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.41.47-PM-520x751.png 520w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.41.47-PM.png 846w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Well, that didn’t take long.\u003c/p>\n\u003cp>The morning of President Trump’s inauguration, several \u003ca href=\"https://www.whitehouse.gov/\">webpages outlining official policy and priorities on the White House website \u003c/a>were removed or replaced with new text. Those pages include information about LGBT rights, civil rights, law enforcement and climate change.\u003c/p>\n\u003cp>It’s not unusual for an incoming administration to change material on the whitehouse.gov site. But it’s also a window into the new president’s priorities and how he might frame various solutions to the nation’s problems.\u003c/p>\n\u003cp>According to a javascript program run by KQED, the climate change page on the White House website kicked the bucket at 11:52 a.m. EST.\u003c/p>\n\u003cfigure id=\"attachment_1338617\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/01/whitehousechange.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1338617\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/01/whitehousechange-800x608.jpg\" alt=\"Websites accessed at 12:40 p.m. PST, Jan. 20, 2017.\" width=\"800\" height=\"608\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/whitehousechange.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/whitehousechange-160x122.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/whitehousechange-768x584.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/whitehousechange-240x182.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/whitehousechange-375x285.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/whitehousechange-520x395.jpg 520w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Websites accessed at 12:40 p.m. PST, Jan. 20, 2017.\u003c/figcaption>\u003c/figure>\n\u003cp>Following the page’s removal, a new energy website appeared with the title “\u003ca href=\"https://www.whitehouse.gov/america-first-energy\" target=\"_blank\" rel=\"noopener\">An America First Energy Plan\u003c/a>.” It outlines the administration’s goals to exploit oil and gas reserves and to revive the coal industry.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Ironically — or not — the page change comes during the same week \u003ca href=\"https://www.nasa.gov/\" target=\"_blank\" rel=\"noopener\">NASA\u003c/a> and \u003ca href=\"http://www.noaa.gov/\" target=\"_blank\" rel=\"noopener\">NOAA\u003c/a> reported that global warming contributed to 2016 being \u003ca href=\"https://ww2.kqed.org/science/2017/01/18/global-warming-drives-record-heat-for-third-straight-year/\" target=\"_blank\" rel=\"noopener\">the hottest year since modern record keeping began\u003c/a> in 1880. (The main contributor to global warming is the burning of fossil fuels.) Scientists have been fearful that the Trump administration would destroy climate change data, and have begun \u003ca href=\"http://www.npr.org/2016/12/14/505592206/scientists-race-to-preserve-climate-change-data-before-trump-takes-office\" target=\"_blank\" rel=\"noopener\">archiving and saving historical climate records\u003c/a>.\u003c/p>\n\u003cp>On Twitter many reacted to removal of the White House climate change site. The Wall Street Journal’s energy policy reporter, Amy Harder, for instance eulogized:\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>You can find the old Obama administration\u003ca href=\"https://obamawhitehouse.archives.gov/\"> whitehouse.gov page here. \u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Trump administration website accessed at 12:40 p.m.:\u003c/strong>\u003cbr>\n\u003ca href=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.42.15-PM.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-medium wp-image-1338616\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.42.15-PM-800x1106.png\" alt=\"Screen Shot 2017-01-20 at 12.42.15 PM\" width=\"800\" height=\"1106\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.42.15-PM-800x1106.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.42.15-PM-160x221.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.42.15-PM-768x1062.png 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.42.15-PM-240x332.png 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.42.15-PM-375x518.png 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.42.15-PM-520x719.png 520w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.42.15-PM.png 847w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Obama administration website accessed at 12:40 p.m.:\u003c/strong>\u003cbr>\n\u003ca href=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.41.47-PM.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-medium wp-image-1338615\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.41.47-PM-800x1156.png\" alt=\"Screen Shot 2017-01-20 at 12.41.47 PM\" width=\"800\" height=\"1156\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.41.47-PM-800x1156.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.41.47-PM-160x231.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.41.47-PM-768x1109.png 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.41.47-PM-240x347.png 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.41.47-PM-375x542.png 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.41.47-PM-520x751.png 520w, https://cdn.kqed.org/wp-content/uploads/sites/35/2017/01/Screen-Shot-2017-01-20-at-12.41.47-PM.png 846w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "In Trump Era, Where Are Diversity Efforts in Silicon Valley Headed?",
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"content": "\u003cp>With high-profile companies from \u003ca href=\"https://www.wired.com/2014/10/maxine-williams/\" target=\"_blank\" rel=\"noopener noreferrer\">Facebook\u003c/a> to Airbnb making pronouncements in support of diversity, you’d think that the very people hired to address the problems inside tech companies would feel comfortable talking about the challenges of their job. Not necessarily.\u003c/p>\n\u003cp>“I don’t feel comfortable speaking freely,” said “Elizabeth” with a nervous laugh.\u003c/p>\n\u003cp>Elizabeth is African-American and works at a tech company in Silicon Valley. We’re not using her real name because she’s concerned her job could be in jeopardy if she’s identified.\u003c/p>\n\u003cp>“One of the things I consistently feel is that I’m not taken seriously because of my race,” Elizabeth said.\u003c/p>\n\u003cp>What she means is that whenever she brings up issues about diversity or raises concerns that people might be treated unfairly, the response she senses from colleagues and management is: Of course she’s gonna bring that up, she’s African-American. Then, the eye roll.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Elizabeth’s company makes software for industries ranging from retail to banking. As a diversity and inclusion specialist, she pushes to make sure product focus groups are diverse.\u003c/p>\n\u003cp>“Even that gets an eye roll,” she said. “Just asking for an audience that is representative of the population as opposed to who we can get now, who are the easiest people to access.”\u003c/p>\n\u003cp>[soundcloud url=”https://api.soundcloud.com/tracks/303519185″ params=”auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false&visual=true” width=”100%” height=”250″ iframe=”true” /]\u003c/p>\n\u003cp>Tech companies have acknowledged the need to diversify their workforce, but despite these high-profile commitments, the road has been slow going. Diversity numbers at many tech companies have barely \u003ca href=\"http://time.com/4391031/google-diversity-statistics-2016/\" target=\"_blank\" rel=\"noopener noreferrer\">budged\u003c/a>. And people of color say while the industry talks a lot about diversity, in general it’s not a top priority and initiatives to bring about change are met with \u003ca href=\"https://www.bloomberg.com/news/articles/2017-01-09/facebook-s-hiring-process-hinders-its-effort-to-create-a-diverse-workforce\" target=\"_blank\" rel=\"noopener noreferrer\">resistance\u003c/a>.\u003c/p>\n\u003cp>Elizabeth says one important ally has been President Obama. For one thing, she says, Obama was beloved by many in Silicon Valley and so had influence. Another reason?\u003c/p>\n\u003cp>“These companies do government work, and so to be on the good side of the administration there was pressure to really commit to diversity and inclusion,” Elizabeth said.\u003c/p>\n\u003cp>Obama urged tech executives to be more inclusive of women and people of color. And in response, the CEOs of Airbnb, Lyft and Intel, among others, initiated an “\u003ca href=\"https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&uact=8&ved=0ahUKEwi-x_755s7RAhVhqlQKHQUnAxoQFggjMAE&url=https%3A%2F%2Fwww.whitehouse.gov%2Fsites%2Fwhitehouse.gov%2Ffiles%2Fimages%2FBlog%2FTech-Inclusion-Pledge-Letter-6-22-16.pdf&usg=AFQjCNEwUvITCJY6FglWsP-sW5dMYd2L8w&sig2=-QwLrC2wa_BSs1cY_XRvcw\" target=\"_blank\" rel=\"noopener noreferrer\">Inclusion Pledge\u003c/a>.”\u003c/p>\n\u003cp>To date, some \u003ca href=\"https://www.tech-inclusion.org/participants\" target=\"_blank\" rel=\"noopener noreferrer\">80\u003c/a> companies have pledged to publish annual reports on the makeup of their workforce and to put in place policies and resources to train, recruit and retain more women, blacks and Latinos.\u003c/p>\n\u003cp>Elizabeth said the pledge created a tiny bit of leverage.\u003c/p>\n\u003cp>“Signing a pledge isn’t the thing that makes companies change,” she said. “But for the people doing diversity and inclusion work, you can say, ‘Hey, this is what you stated to do and your actions better line up.’ ”\u003c/p>\n\u003cp>If Obama played good cop by cajoling and flattering tech leaders to change, the Department of Labor has been bad cop.\u003c/p>\n\u003cp>\u003ca href=\"https://www.orrick.com/People/8/F/3/Erin-M-Connell\" target=\"_blank\" rel=\"noopener noreferrer\">Erin Connell\u003c/a> practices employment law at Orrick in San Francisco and represents companies that do business with the federal government.\u003c/p>\n\u003cp>“There definitely has been a focus on the technology sector within the Department of Labor,” Connell said.\u003c/p>\n\u003cp>She says federal compliance officers have taken a tougher, more adversarial tone with tech companies. And for the first time in recent memory, the Department of Labor sued three Silicon Valley companies — \u003ca href=\"http://www.reuters.com/article/us-palantir-tech-discrimination-lawsuit-idUSKCN11W2DA\" target=\"_blank\" rel=\"noopener noreferrer\">Palantir\u003c/a>, Google and Oracle — for alleged violations of equal employment opportunity laws.\u003c/p>\n\u003cp>The companies deny wrongdoing.\u003c/p>\n\u003cp>Connell speculates that the lawsuits are the Obama administration’s last-ditch effort to try to shore up its legacy.\u003c/p>\n\u003cp>“With the inauguration right around the corner, I think they’re running out of runway,” Connell said.\u003c/p>\n\u003cp>She believes the lawsuits will continue under a Trump administration but said “hypothetically, at any time the Department of Labor could choose to no longer pursue these lawsuits.”\u003c/p>\n\u003cp>Advocates believe that’s exactly what will happen under a Trump administration and fear they’ll lose another pressure point.\u003c/p>\n\u003cp>But \u003ca href=\"http://www.kaporcapital.com/who-we-are/ellen-pao/\" target=\"_blank\" rel=\"noopener noreferrer\">Ellen Pao\u003c/a>, the chief diversity and inclusion officer at \u003ca href=\"http://www.kaporcapital.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Kapor Capital\u003c/a>, is more optimistic. Pao emerged as a vocal advocate for diversity after losing a high-profile gender discrimination lawsuit against the venture capital firm Kleiner Perkins Caufield & Byers in 2015.\u003c/p>\n\u003cp>Pao says that in reaction to the election, she’s seen some tech leaders, especially at up-and-coming companies, become even more committed to diversity.\u003c/p>\n\u003cp>“I’m excited because I think these startups are going to be the next wave of successful startups,” Pao said.\u003c/p>\n\u003cp>As a co-founder of \u003ca href=\"http://projectinclude.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Project Include\u003c/a>, Pao works with CEOs of early-stage startups to try to build a culture of diversity from the start.\u003c/p>\n\u003cp>“You know in tech there is still very much a herd mentality,” Pao said.\u003c/p>\n\u003cp>When these new companies become successful with a diverse and inclusive workforce, she said, Trump or no Trump, it will be that success that paves the way for real change in Silicon Valley.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of our ongoing series on Techquity: Diversity, Inclusion and Equity in Silicon Valley. \u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>With high-profile companies from \u003ca href=\"https://www.wired.com/2014/10/maxine-williams/\" target=\"_blank\" rel=\"noopener noreferrer\">Facebook\u003c/a> to Airbnb making pronouncements in support of diversity, you’d think that the very people hired to address the problems inside tech companies would feel comfortable talking about the challenges of their job. Not necessarily.\u003c/p>\n\u003cp>“I don’t feel comfortable speaking freely,” said “Elizabeth” with a nervous laugh.\u003c/p>\n\u003cp>Elizabeth is African-American and works at a tech company in Silicon Valley. We’re not using her real name because she’s concerned her job could be in jeopardy if she’s identified.\u003c/p>\n\u003cp>“One of the things I consistently feel is that I’m not taken seriously because of my race,” Elizabeth said.\u003c/p>\n\u003cp>What she means is that whenever she brings up issues about diversity or raises concerns that people might be treated unfairly, the response she senses from colleagues and management is: Of course she’s gonna bring that up, she’s African-American. Then, the eye roll.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Elizabeth’s company makes software for industries ranging from retail to banking. As a diversity and inclusion specialist, she pushes to make sure product focus groups are diverse.\u003c/p>\n\u003cp>“Even that gets an eye roll,” she said. “Just asking for an audience that is representative of the population as opposed to who we can get now, who are the easiest people to access.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='”100%”' height='”250″'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=”https://api.soundcloud.com/tracks/303519185″&visual=true&”auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false&visual=true”'\n title='”https://api.soundcloud.com/tracks/303519185″'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Tech companies have acknowledged the need to diversify their workforce, but despite these high-profile commitments, the road has been slow going. Diversity numbers at many tech companies have barely \u003ca href=\"http://time.com/4391031/google-diversity-statistics-2016/\" target=\"_blank\" rel=\"noopener noreferrer\">budged\u003c/a>. And people of color say while the industry talks a lot about diversity, in general it’s not a top priority and initiatives to bring about change are met with \u003ca href=\"https://www.bloomberg.com/news/articles/2017-01-09/facebook-s-hiring-process-hinders-its-effort-to-create-a-diverse-workforce\" target=\"_blank\" rel=\"noopener noreferrer\">resistance\u003c/a>.\u003c/p>\n\u003cp>Elizabeth says one important ally has been President Obama. For one thing, she says, Obama was beloved by many in Silicon Valley and so had influence. Another reason?\u003c/p>\n\u003cp>“These companies do government work, and so to be on the good side of the administration there was pressure to really commit to diversity and inclusion,” Elizabeth said.\u003c/p>\n\u003cp>Obama urged tech executives to be more inclusive of women and people of color. And in response, the CEOs of Airbnb, Lyft and Intel, among others, initiated an “\u003ca href=\"https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&uact=8&ved=0ahUKEwi-x_755s7RAhVhqlQKHQUnAxoQFggjMAE&url=https%3A%2F%2Fwww.whitehouse.gov%2Fsites%2Fwhitehouse.gov%2Ffiles%2Fimages%2FBlog%2FTech-Inclusion-Pledge-Letter-6-22-16.pdf&usg=AFQjCNEwUvITCJY6FglWsP-sW5dMYd2L8w&sig2=-QwLrC2wa_BSs1cY_XRvcw\" target=\"_blank\" rel=\"noopener noreferrer\">Inclusion Pledge\u003c/a>.”\u003c/p>\n\u003cp>To date, some \u003ca href=\"https://www.tech-inclusion.org/participants\" target=\"_blank\" rel=\"noopener noreferrer\">80\u003c/a> companies have pledged to publish annual reports on the makeup of their workforce and to put in place policies and resources to train, recruit and retain more women, blacks and Latinos.\u003c/p>\n\u003cp>Elizabeth said the pledge created a tiny bit of leverage.\u003c/p>\n\u003cp>“Signing a pledge isn’t the thing that makes companies change,” she said. “But for the people doing diversity and inclusion work, you can say, ‘Hey, this is what you stated to do and your actions better line up.’ ”\u003c/p>\n\u003cp>If Obama played good cop by cajoling and flattering tech leaders to change, the Department of Labor has been bad cop.\u003c/p>\n\u003cp>\u003ca href=\"https://www.orrick.com/People/8/F/3/Erin-M-Connell\" target=\"_blank\" rel=\"noopener noreferrer\">Erin Connell\u003c/a> practices employment law at Orrick in San Francisco and represents companies that do business with the federal government.\u003c/p>\n\u003cp>“There definitely has been a focus on the technology sector within the Department of Labor,” Connell said.\u003c/p>\n\u003cp>She says federal compliance officers have taken a tougher, more adversarial tone with tech companies. And for the first time in recent memory, the Department of Labor sued three Silicon Valley companies — \u003ca href=\"http://www.reuters.com/article/us-palantir-tech-discrimination-lawsuit-idUSKCN11W2DA\" target=\"_blank\" rel=\"noopener noreferrer\">Palantir\u003c/a>, Google and Oracle — for alleged violations of equal employment opportunity laws.\u003c/p>\n\u003cp>The companies deny wrongdoing.\u003c/p>\n\u003cp>Connell speculates that the lawsuits are the Obama administration’s last-ditch effort to try to shore up its legacy.\u003c/p>\n\u003cp>“With the inauguration right around the corner, I think they’re running out of runway,” Connell said.\u003c/p>\n\u003cp>She believes the lawsuits will continue under a Trump administration but said “hypothetically, at any time the Department of Labor could choose to no longer pursue these lawsuits.”\u003c/p>\n\u003cp>Advocates believe that’s exactly what will happen under a Trump administration and fear they’ll lose another pressure point.\u003c/p>\n\u003cp>But \u003ca href=\"http://www.kaporcapital.com/who-we-are/ellen-pao/\" target=\"_blank\" rel=\"noopener noreferrer\">Ellen Pao\u003c/a>, the chief diversity and inclusion officer at \u003ca href=\"http://www.kaporcapital.com/\" target=\"_blank\" rel=\"noopener noreferrer\">Kapor Capital\u003c/a>, is more optimistic. Pao emerged as a vocal advocate for diversity after losing a high-profile gender discrimination lawsuit against the venture capital firm Kleiner Perkins Caufield & Byers in 2015.\u003c/p>\n\u003cp>Pao says that in reaction to the election, she’s seen some tech leaders, especially at up-and-coming companies, become even more committed to diversity.\u003c/p>\n\u003cp>“I’m excited because I think these startups are going to be the next wave of successful startups,” Pao said.\u003c/p>\n\u003cp>As a co-founder of \u003ca href=\"http://projectinclude.org/\" target=\"_blank\" rel=\"noopener noreferrer\">Project Include\u003c/a>, Pao works with CEOs of early-stage startups to try to build a culture of diversity from the start.\u003c/p>\n\u003cp>“You know in tech there is still very much a herd mentality,” Pao said.\u003c/p>\n\u003cp>When these new companies become successful with a diverse and inclusive workforce, she said, Trump or no Trump, it will be that success that paves the way for real change in Silicon Valley.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story is part of our ongoing series on Techquity: Diversity, Inclusion and Equity in Silicon Valley. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>What could go wrong with a tech company’s plan to place hundreds or perhaps thousands of shared bikes around San Francisco, the nation’s \u003ca href=\"http://www.bicycling.com/culture/news/the-50-best-bike-cities-of-2016/slide/2\">second-most-bike-friendly city\u003c/a>?\u003c/p>\n\u003cp>China-based \u003ca href=\"https://www.bluegogo.com/us/\" target=\"_blank\" rel=\"noopener\">Bluegogo\u003c/a>, which \u003ca href=\"http://www.bizjournals.com/sanfrancisco/news/2017/01/18/sf-supervisors-bluegogo-bike-sharing.html\">has reportedly\u003c/a> scooped up $34 million in startup funds, appears ready to begin deploying its blue aluminum bikes in popular neighborhoods around San Francisco.\u003c/p>\n\u003cp>Unlike the Bay Area’s public bike-share system — which \u003ca href=\"http://www.bizjournals.com/sanfrancisco/news/2017/01/18/sf-supervisors-bluegogo-bike-sharing.html\" target=\"_blank\" rel=\"noopener\">plans to begin expanding this year\u003c/a> from 700 to 7,000 bikes — Bluegogo’s bikes don’t need docking stations. Bluegogo says it will place its bikes only where bicycles may be legally parked and that users will be instructed to do the same.\u003c/p>\n\u003cp>But San Francisco city officials, led by Supervisor Aaron Peskin, have painted a scenario in which abandoned Bluegogo bikes could wind up piled on city sidewalks and other public spaces. At a \u003ca href=\"https://twitter.com/akrazia/status/821793340861489152\">City Hall press conference on Wednesday\u003c/a>, blow-up photos showing \u003ca href=\"https://www.theguardian.com/world/2017/jan/17/chinese-discard-hundreds-of-cycles-for-hire-in-giant-pile\">a mess of abandoned shared bikes\u003c/a> in China were displayed.\u003c/p>\n\u003cp>“Bluegogo is just another example of the tech arrogance that has gotten everybody from Airbnb to Uber in trouble,” said Peskin. “San Francisco has historically been known for its welcome mat, but in recent years we’ve let ourselves become a doormat. It’s time to put the public’s interests first, even if that means disrupting the disrupters.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Peskin, joined by Supervisor Mark Farrell and Brian Wiedenmeier, the executive director of the San Francisco Bicycle Coalition, vowed to introduce legislation “prohibiting the unpermitted use of the public realm as a distribution platform for private bike-share corporations and other unregulated ‘sharing economy’ schemes.”\u003c/p>\n\u003cp>A Jan. 16 letter to Bluegogo from Ed Reiskin, head of the Municipal Transportation Agency, and Mohammed Nuru, director of Public Works, asked the company to provide its business plan, show it has obtained a city business license, and confirm that its operations would not interfere with the city’s exclusive contract with Bay Area Motivate LLC, which operates Bay Area BikeShare, soon to become Ford GoBike.\u003c/p>\n\u003cp>The exclusive bike-share contract contains just three exceptions: traditional bike-rental operations, electric scooter sharing, and automated round-trip bike sharing — systems that require users to return bicycles to the site where they’re rented.\u003c/p>\n\u003cp>The city letter warns that if Bluegogo’s business violated that contract provision, the city may withhold permits and could take legal action against the company.\u003c/p>\n\u003cp>Of equal concern, the letter said, was the company’s use of public sidewalks and streets.\u003c/p>\n\u003cp>“To the extent that your shared bicycles will occupy the public right of way, we require they do so in compliance with local law and in a manner that does not constitute a public nuisance or public safety hazard,” the letter said.\u003c/p>\n\u003cp>Rachel Gordon, a spokeswoman for San Francisco Public Works, said the department has the authority to remove the bikes if they become a hazard.\u003c/p>\n\u003cfigure id=\"attachment_11276996\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-11276996\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM-1020x532.png\" alt=\"Bluegogo insists its bikes will be placed only where its legal to park a bicycle, and that its users will be instructed to do the same.\" width=\"640\" height=\"334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM-1020x532.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM-160x83.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM-800x417.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM-1180x616.png 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM-960x501.png 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM-240x125.png 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM-375x196.png 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM-520x271.png 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM.png 1221w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Bluegogo’s bikes have locking clamps on the back wheels, and an alarm sounds when the bikes move without being unlocked. \u003ccite>(Photo courtesy of Bluegogo)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In an interview, Ilya Movshovich, Bluegogo’s vice president of U.S. operations, said considering that San Francisco is “a bike city,” Bluegogo was shocked to see the pushback from city officials.\u003c/p>\n\u003cp>“We’re still happy to be cooperative and collaborative,” he said.\u003c/p>\n\u003cp>In an email to SFMTA officials dated Jan. 2 and provided by Bluegogo, Movshovich wrote to Luis Montoya, the head of the SFMTA’s livable streets program. He inquired about what permits the company might need and shared some general information about the company’s planned operation.\u003c/p>\n\u003cp>“I understand that according to California law, we can’t drop our bikes in positions that would disrupt an adequate path for pedestrian traffic. We don’t intend to do that. We also have a system in place to monitor, review and reward/penalize users for bicycle placement behavior.”\u003c/p>\n\u003cp>Movshovich wrote that the company would charge a $99 deposit that “would hedge against damaged bikes or if the user is irresponsible with bike placement or any actions that would jeopardize the safety of others — they would get assessed a warning, and possibly a fine.”\u003c/p>\n\u003cp>Bluegogo says it plans to charge 99 cents for every 30 minutes, along with the $99 deposit. The cheapest Bay Area BikeShare membership is $9 for 24 hours, a charge that provides unlimited rides up to 30 minutes each; rides of 30 to 60 minutes incur a $4 overage fee; rides over 60 minutes cost $7 for each additional half-hour.\u003c/p>\n\u003cp>Users can locate a bike with the Bluegogo app, reserve it and have about 15 minutes to pick it up before the reservation expires. The bikes weigh 33 pounds and come equipped with airless tires, so users don’t have to worry about flats.\u003c/p>\n\u003cp>“The beauty is the fact that we don’t have docking stations, which makes us special and unique in this market,” said Movshovich, who is also co-founder of the shared-parking startup \u003ca href=\"https://www.carmanation.com/\" target=\"_blank\" rel=\"noopener\">CARMAnation\u003c/a>. “It’s more likely that people are going to be using the bikes when it’s a couple of steps from them as opposed to a couple of blocks. We bring easier access.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Movshovich wouldn’t talk numbers, neither confirming the amount of funding the company has raised nor the number of bikes the company plans to deploy around the city. But he said it’s nowhere near 10,000 to 20,000, as some have speculated. The company can scale up or down depending on the demand, he said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>What could go wrong with a tech company’s plan to place hundreds or perhaps thousands of shared bikes around San Francisco, the nation’s \u003ca href=\"http://www.bicycling.com/culture/news/the-50-best-bike-cities-of-2016/slide/2\">second-most-bike-friendly city\u003c/a>?\u003c/p>\n\u003cp>China-based \u003ca href=\"https://www.bluegogo.com/us/\" target=\"_blank\" rel=\"noopener\">Bluegogo\u003c/a>, which \u003ca href=\"http://www.bizjournals.com/sanfrancisco/news/2017/01/18/sf-supervisors-bluegogo-bike-sharing.html\">has reportedly\u003c/a> scooped up $34 million in startup funds, appears ready to begin deploying its blue aluminum bikes in popular neighborhoods around San Francisco.\u003c/p>\n\u003cp>Unlike the Bay Area’s public bike-share system — which \u003ca href=\"http://www.bizjournals.com/sanfrancisco/news/2017/01/18/sf-supervisors-bluegogo-bike-sharing.html\" target=\"_blank\" rel=\"noopener\">plans to begin expanding this year\u003c/a> from 700 to 7,000 bikes — Bluegogo’s bikes don’t need docking stations. Bluegogo says it will place its bikes only where bicycles may be legally parked and that users will be instructed to do the same.\u003c/p>\n\u003cp>But San Francisco city officials, led by Supervisor Aaron Peskin, have painted a scenario in which abandoned Bluegogo bikes could wind up piled on city sidewalks and other public spaces. At a \u003ca href=\"https://twitter.com/akrazia/status/821793340861489152\">City Hall press conference on Wednesday\u003c/a>, blow-up photos showing \u003ca href=\"https://www.theguardian.com/world/2017/jan/17/chinese-discard-hundreds-of-cycles-for-hire-in-giant-pile\">a mess of abandoned shared bikes\u003c/a> in China were displayed.\u003c/p>\n\u003cp>“Bluegogo is just another example of the tech arrogance that has gotten everybody from Airbnb to Uber in trouble,” said Peskin. “San Francisco has historically been known for its welcome mat, but in recent years we’ve let ourselves become a doormat. It’s time to put the public’s interests first, even if that means disrupting the disrupters.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Peskin, joined by Supervisor Mark Farrell and Brian Wiedenmeier, the executive director of the San Francisco Bicycle Coalition, vowed to introduce legislation “prohibiting the unpermitted use of the public realm as a distribution platform for private bike-share corporations and other unregulated ‘sharing economy’ schemes.”\u003c/p>\n\u003cp>A Jan. 16 letter to Bluegogo from Ed Reiskin, head of the Municipal Transportation Agency, and Mohammed Nuru, director of Public Works, asked the company to provide its business plan, show it has obtained a city business license, and confirm that its operations would not interfere with the city’s exclusive contract with Bay Area Motivate LLC, which operates Bay Area BikeShare, soon to become Ford GoBike.\u003c/p>\n\u003cp>The exclusive bike-share contract contains just three exceptions: traditional bike-rental operations, electric scooter sharing, and automated round-trip bike sharing — systems that require users to return bicycles to the site where they’re rented.\u003c/p>\n\u003cp>The city letter warns that if Bluegogo’s business violated that contract provision, the city may withhold permits and could take legal action against the company.\u003c/p>\n\u003cp>Of equal concern, the letter said, was the company’s use of public sidewalks and streets.\u003c/p>\n\u003cp>“To the extent that your shared bicycles will occupy the public right of way, we require they do so in compliance with local law and in a manner that does not constitute a public nuisance or public safety hazard,” the letter said.\u003c/p>\n\u003cp>Rachel Gordon, a spokeswoman for San Francisco Public Works, said the department has the authority to remove the bikes if they become a hazard.\u003c/p>\n\u003cfigure id=\"attachment_11276996\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-11276996\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM-1020x532.png\" alt=\"Bluegogo insists its bikes will be placed only where its legal to park a bicycle, and that its users will be instructed to do the same.\" width=\"640\" height=\"334\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM-1020x532.png 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM-160x83.png 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM-800x417.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM-1180x616.png 1180w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM-960x501.png 960w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM-240x125.png 240w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM-375x196.png 375w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM-520x271.png 520w, https://cdn.kqed.org/wp-content/uploads/sites/10/2017/01/Screen-Shot-2017-01-19-at-10.24.04-AM.png 1221w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Bluegogo’s bikes have locking clamps on the back wheels, and an alarm sounds when the bikes move without being unlocked. \u003ccite>(Photo courtesy of Bluegogo)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In an interview, Ilya Movshovich, Bluegogo’s vice president of U.S. operations, said considering that San Francisco is “a bike city,” Bluegogo was shocked to see the pushback from city officials.\u003c/p>\n\u003cp>“We’re still happy to be cooperative and collaborative,” he said.\u003c/p>\n\u003cp>In an email to SFMTA officials dated Jan. 2 and provided by Bluegogo, Movshovich wrote to Luis Montoya, the head of the SFMTA’s livable streets program. He inquired about what permits the company might need and shared some general information about the company’s planned operation.\u003c/p>\n\u003cp>“I understand that according to California law, we can’t drop our bikes in positions that would disrupt an adequate path for pedestrian traffic. We don’t intend to do that. We also have a system in place to monitor, review and reward/penalize users for bicycle placement behavior.”\u003c/p>\n\u003cp>Movshovich wrote that the company would charge a $99 deposit that “would hedge against damaged bikes or if the user is irresponsible with bike placement or any actions that would jeopardize the safety of others — they would get assessed a warning, and possibly a fine.”\u003c/p>\n\u003cp>Bluegogo says it plans to charge 99 cents for every 30 minutes, along with the $99 deposit. The cheapest Bay Area BikeShare membership is $9 for 24 hours, a charge that provides unlimited rides up to 30 minutes each; rides of 30 to 60 minutes incur a $4 overage fee; rides over 60 minutes cost $7 for each additional half-hour.\u003c/p>\n\u003cp>Users can locate a bike with the Bluegogo app, reserve it and have about 15 minutes to pick it up before the reservation expires. The bikes weigh 33 pounds and come equipped with airless tires, so users don’t have to worry about flats.\u003c/p>\n\u003cp>“The beauty is the fact that we don’t have docking stations, which makes us special and unique in this market,” said Movshovich, who is also co-founder of the shared-parking startup \u003ca href=\"https://www.carmanation.com/\" target=\"_blank\" rel=\"noopener\">CARMAnation\u003c/a>. “It’s more likely that people are going to be using the bikes when it’s a couple of steps from them as opposed to a couple of blocks. We bring easier access.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Movshovich wouldn’t talk numbers, neither confirming the amount of funding the company has raised nor the number of bikes the company plans to deploy around the city. But he said it’s nowhere near 10,000 to 20,000, as some have speculated. The company can scale up or down depending on the demand, he said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"tagline": "The flip side of gentrification, told through one town",
"info": "Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?",
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"tagline": "Exploring the Bay Area, one question at a time",
"info": "KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.",
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"info": "KQED’s statewide radio news program providing daily coverage of issues, trends and public policy decisions.",
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"order": 8
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},
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"order": 1
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"info": "\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />",
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"id": "commonwealth-club",
"title": "Commonwealth Club of California Podcast",
"info": "The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg",
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"source": "Commonwealth Club of California"
},
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"info": "KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg",
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"order": 9
},
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"id": "fresh-air",
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"hidden-brain": {
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"airtime": "SUN 7pm-8pm",
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"airtime": "SUN 7:30pm-8pm",
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"title": "The Political Mind of Jerry Brown",
"tagline": "Lessons from a lifetime in politics",
"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"order": 18
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},
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"id": "latino-usa",
"title": "Latino USA",
"airtime": "MON 1am-2am, SUN 6pm-7pm",
"info": "Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.",
"imageSrc": "https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg",
"officialWebsiteLink": "http://latinousa.org/",
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},
"marketplace": {
"id": "marketplace",
"title": "Marketplace",
"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Marketplace-Podcast-Tile-360x360-1.jpg",
"officialWebsiteLink": "https://www.marketplace.org/",
"meta": {
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"source": "American Public Media"
},
"link": "/radio/program/marketplace",
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"rss": "https://feeds.publicradio.org/public_feeds/marketplace-pm/rss/rss"
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},
"masters-of-scale": {
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"title": "Masters of Scale",
"info": "Masters of Scale is an original podcast in which LinkedIn co-founder and Greylock Partner Reid Hoffman sets out to describe and prove theories that explain how great entrepreneurs take their companies from zero to a gazillion in ingenious fashion.",
"airtime": "Every other Wednesday June 12 through October 16 at 8pm (repeats Thursdays at 2am)",
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"officialWebsiteLink": "https://mastersofscale.com/",
"meta": {
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"source": "WaitWhat"
},
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"rss": "https://rss.art19.com/masters-of-scale"
}
},
"mindshift": {
"id": "mindshift",
"title": "MindShift",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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