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"bio": "\u003ca href=\"http://www.MarkFiore.com\">MarkFiore.com\u003c/a> | \u003ca href=\"https://twitter.com/markfiore\">Follow on Twitter\u003c/a> | \u003ca href=\"https://www.facebook.com/pages/Mark-Fiore-Animated-Political-Cartoons/94451707396?ref=bookmarks\">Facebook\u003c/a> | \u003ca href=\"mailto:mark@markfiore.com\">email\u003c/a>\r\n\r\nPulitzer Prize-winner, Mark Fiore, who the Wall Street Journal has called “the undisputed guru of the form,” creates animated political cartoons in San Francisco, where his work has been featured regularly on the San Francisco Chronicle’s web site, SFGate.com. His work has appeared on Newsweek.com, Slate.com, CBSNews.com, MotherJones.com, DailyKos.com and NPR’s web site. Fiore’s political animation has appeared on CNN, Frontline, Bill Moyers Journal, Salon.com and cable and broadcast outlets across the globe.\r\n\r\nBeginning his professional life by drawing traditional political cartoons for newspapers, Fiore’s work appeared in publications ranging from the Washington Post to the Los Angeles Times. In the late 1990s, he began to experiment with animating political cartoons and, after a short stint at the San Jose Mercury News as their staff cartoonist, Fiore devoted all his energies to animation.\r\nGrowing up in California, Fiore also spent a good portion of his life in the backwoods of Idaho. It was this combination that shaped him politically. Mark majored in political science at Colorado College, where, in a perfect send-off for a cartoonist, he received his diploma in 1991 as commencement speaker Dick Cheney smiled approvingly.\r\nMark Fiore was awarded the Pulitzer Prize for political cartooning in 2010, a Robert F. Kennedy Journalism Award in 2004 and has twice received an Online Journalism Award for commentary from the Online News Association (2002, 2008). Fiore has received two awards for his work in new media from the National Cartoonists Society (2001, 2002), and in 2006 received The James Madison Freedom of Information Award from The Society of Professional Journalists.",
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"content": "\u003cp>Researchers at UC San Francisco have unveiled the largest \u003ca href=\"http://10kimmunomes.org/\" target=\"_blank\" rel=\"noopener\">searchable database\u003c/a> of immunology data, gathered from 10,000 people of various ages, ethnicity, and backgrounds. It could lead to more effective treatments for a wide range of immune disorders.[contextly_sidebar id=”lms9rSPdk5pG72xqgRdVMiGv0hv7IpdH”]\u003c/p>\n\u003cp>The new data pool represents the \u003ca href=\"https://www.cell.com/cell-reports/fulltext/S2211-1247(18)31451-7\" target=\"_blank\" rel=\"noopener\">largest control group\u003c/a> ever compiled on the human immune system, according to the study published on Tuesday in the journal, \u003cem>Cell Reports\u003c/em>.\u003c/p>\n\u003cp>Called the \u003ca href=\"http://10kimmunomes.org/\" target=\"_blank\" rel=\"noopener\">10,000 Immunomes Project\u003c/a> (10KIP), it’s the culmination of four years of work and provides an instant comparison group for researchers studying the immune system and immune dysfunction.\u003c/p>\n\u003cp>UCSF researchers created the tool using immunology data from 83 studies representing 10,000 healthy subjects, according to senior author Atul Butte, director of the \u003ca href=\"http://bakarinstitute.ucsf.edu/\" target=\"_blank\" rel=\"noopener\">Bakar Computational Health Sciences Institute\u003c/a> at UCSF.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘If the field of genetics is able to compile large collections consisting of millions of people, why does immunology lag behind?’\u003ccite>Atul Butte, UCSF\u003c/cite>\u003c/aside>\n\u003cp>The data comes from studies on organ transplants, autoimmune disease trials, vaccine studies and other research funded by the National Institute of Allergy and Infectious Diseases (NIAID).\u003c/p>\n\u003cdiv>\n\u003cp>“We have sub-populations in the U.S. that don’t really participate in studies so why not just gather all this massive data on the immune system in one central place,” says Butte. “We can turn to this data to see what is going on in a healthy immune system spanning different populations in the U.S.”\u003c/p>\n\u003cp>Butte says the ability to manipulate immune system activity will benefit a wide range of patients, including transplant recipients, cancer and AIDS patients, and those suffering from some form of immune dysfunction.\u003c/p>\n\u003cp>Autoimmune Disease (AD) in particular, an historically underfunded field, could benefit greatly from the availability of a large and diverse control group, according to Butte.\u003c/p>\n\u003cp>\u003cstrong>Rise of Autoimmine Disease\u003c/strong>\u003c/p>\n\u003cp>AD is one of the fastest growing illnesses in the U.S., with 20 percent of the population or one in five people, suffering from the disorder.[contextly_sidebar id=”KPqEb6LD9ky4mDsIDJAEnoEvgzkEna45″]\u003c/p>\n\u003cp>Despite AD being \u003ca href=\"https://www.aarda.org/who-we-are/our-mission/\" target=\"_blank\" rel=\"noopener\">one of the top 10 leading causes\u003c/a> of death in females up to 64 years of age, research has continued to lag behind, according to Butte.\u003c/p>\n\u003cp>The National Institutes of Health\u003ca href=\"https://ww2.kqed.org/science/2018/10/09/voting-on-daylight-saving-time-animal-confinement-and-water-propositions-3-7-and-12-explained/\" target=\"_blank\" rel=\"noopener\"> has spent\u003c/a> $591 million dollars on AD research compared to the $6.1 billion spent on cancer. Current treatments consist of risky immunosuppressants that can lead to devastating long-term side effects.[contextly_sidebar id=”ZbtYikLAiggPmeNWkxr4kKECzkkjZf4Z”]\u003c/p>\n\u003cp>UCSF researchers developed the new searchable database in part to boost AD research. Typically, studies done on immune systems are smaller and it’s rare to get 10,000 participants, according to Butte.\u003c/p>\n\u003cp>Plus, the human immune system is a moving target.\u003c/p>\n\u003cp>“It’s a difficult field to study because unlike DNA for example, your immune system changes from morning to night. So which aspect of the immune system scientists focus on, and \u003cem>when\u003c/em> they study it, these are all problems we are getting better at. We just need more studies.”\u003c/p>\n\u003cp>To test their new tool, researchers created a custom control group comprised of women between 18 and 40 years of age and compared it to 56 pregnant women who participated in a prior study tracking immune changes during pregnancy.\u003c/p>\n\u003cp>Using this control group, researchers were able to detect how various immune cells and cell signaling proteins, called cytokines, changed from pre-pregnancy levels— measurements that the original study failed to pick up.\u003c/p>\n\u003cp>Researchers also used the new tool to compare immunity in people from different racial and ethnic backgrounds. The findings showed both known differences as well as new information that could only be seen by combining data from dozens of different studies.\u003c/p>\n\u003cp>For instance, researchers found that regulatory T cells, which suppress the immune response, are present at higher levels in African Americans, compared to all other groups.\u003c/p>\n\u003cp>\u003cstrong>Shareable Science\u003c/strong>\u003c/p>\n\u003cp>Butte sees the searchable database as part of a broader trend in science, promoting open access where more scientists are willing to share their raw data with others.\u003c/p>\n\u003cp>“It’s really hundreds of people who have essentially contributed to this work,” he notes.\u003c/p>\n\u003cp>Butte says he hopes his work will bring immunology to the forefront and inspire others to rethink their approach to the field.\u003c/p>\n\u003cp>“If the field of genetics is able to compile large collections consisting of millions of people,” he wonders, “why does immunology lag behind? I want to get people in the field thinking about larger collections of samples that cut across race, age and gender.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003c/div>\n\u003cp>\u003c/p>\n",
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"content": "\u003cp>Paige Thesing has struggled with insomnia since high school. “It takes me a really long time to fall asleep — about four hours,” she says. For years, her mornings were groggy and involved a “lot of coffee.”[contextly_sidebar id=”SWkBBNCnUWhPf7KOuvUyV7If0Ca3ug47”]\u003c/p>\n\u003cp>After a year of trying sleep medication prescribed by her doctor, she turned to the internet for alternate solutions. About four months ago, she settled on a mobile phone meditation app called \u003ca href=\"https://www.inscape.life/\" target=\"_blank\" rel=\"noopener\">INSCAPE\u003c/a>.\u003c/p>\n\u003cp>“It’s about a 30-minute soundtrack, and it starts with a woman kind of telling you to relax and instructing your breathing,” explains Thesing. “Then it goes into sounds — relaxing noises. There’s wind chimes, some atmospheric music playing…”\u003c/p>\n\u003cp>She uses the app every night and falls asleep within 15 or 20 minutes. “So, definitely a big improvement from four hours,” she says.\u003c/p>\n\u003cp>Thesing is not alone. Chronic insomnia affects an estimated \u003ca href=\"https://www.ajmc.com/journals/supplement/2006/2006-05-vol12-n8suppl/may06-2307ps214-s220\" target=\"_blank\" rel=\"noopener\">10-15 percent of adults\u003c/a>, and another 25-35 percent struggle with sleep issues occasionally. And like Thesing, a growing number of insomniacs are turning to mobile phone apps to lull them to sleep.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>On \u003ca href=\"https://twitter.com/NPRHealth/status/1046884648167624711\" target=\"_blank\" rel=\"noopener\">Twitter\u003c/a> and Facebook, NPR asked its audience if they have used a mobile phone app to help manage insomnia. Nearly 100 people wrote back suggesting a range of apps, including podcasts created to put a listener to sleep.\u003c/p>\n\u003cp>“These are usually relaxation strategies, white noise, meditation,” \u003ca href=\"https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=35378\" target=\"_blank\" rel=\"noopener\">Jason Ong\u003c/a>, an associate professor of neurology specializing in sleep at Northwestern University’s Feinberg School of Medicine. He studies non-pharmacological treatments for various sleep disorders and treats patients at the university’s Sleep Medicine clinic. “It’s not that there’s something wrong with those apps. It’s a reasonable first thing to try.”[contextly_sidebar id=”ljN7S8LuvqENw8QrvBPFbhASn6EIv1oE”]\u003c/p>\n\u003cp>But, he adds, these kinds of apps aren’t based on scientifically-proven solutions, and they don’t really fix the problem of why someone is not sleeping.\u003c/p>\n\u003cp>Ong wanted to do something about that, so a few years ago, he consulted for a team that developed an app that uses a science-based approach to address insomnia called \u003ca href=\"https://www.sleepio.com/cbt-for-insomnia/\" target=\"_blank\" rel=\"noopener\">Sleepio\u003c/a>. (However, he doesn’t have any ongoing financial interest in the product, he says.)\u003c/p>\n\u003cp>Sleepio and a few other apps like \u003ca href=\"http://www.myshuti.com/\" target=\"_blank\" rel=\"noopener\">SHUT-i\u003c/a> and a free one developed by the Veterans Administration use the most sustainable and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/15451764\" target=\"_blank\" rel=\"noopener\">evidence-based\u003c/a> solution for insomnia. It’s a kind of therapy called Cognitive Behavioral Therapy for Insomnia — \u003ca href=\"https://www.sleepfoundation.org/sleep-news/cognitive-behavioral-therapy-insomnia\" target=\"_blank\" rel=\"noopener\">CBT-I\u003c/a> for short, he says. It helps the patient understand the biology of sleep and gives them a bag of tools and tricks to change their own thought patterns and behaviors to treat their underlying sleep issues.\u003c/p>\n\u003cp>“CBT for insomnia is a specific package … [that] includes different techniques like spending less time in bed [and] what to do if you are in bed and can’t sleep,” says Ong. “It’s teaching you how to change your behavior to better work with your brain to give you confidence that you’re going to be able to sleep on a regular basis.”\u003c/p>\n\u003cp>It may be surprising to us, but our own thought patterns and sleep habits \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3621793/\" target=\"_blank\" rel=\"noopener\">affect our biology\u003c/a>, in this case how our brains regulate sleep. “If you modify some of your behaviors, you can work better with how your brain regulates sleep and wake,” he says.\u003c/p>\n\u003cp>The American College of Physicians \u003ca href=\"https://www.acponline.org/acp-newsroom/acp-recommends-cognitive-behavioral-therapy-as-initial-treatment-for-chronic-insomnia\" target=\"_blank\" rel=\"noopener\">first recommended\u003c/a> Cognitive Behavioral Therapy for Insomnia as the first-line treatment for insomnia in 2016. “The evidence is quite strong to support the effectiveness of CBT-I treatment and there really aren’t a lot of side effects,” says Ong. And, because it changes behavior, “in the long run CBT-I tends to perform quite well in maintaining the benefits.”\u003c/p>\n\u003cp>In the past the only way for people to get Cognitive Behavioral Therapy for Insomnia was to see a therapist, now they can access the therapy on their mobile phones.\u003c/p>\n\u003cp>“In Sleepio, it’s like an avatar of a real therapist that’s walking the patient through that process,” explains Ong. Sleepio also allows users to keep a sleep diary so the app can use its algorithm to suggest a better bedtime schedule. It also reminds people to get up when they’ve spent too much time in bed trying to fall asleep, for example.[contextly_sidebar id=”wEwpbDeWifEPnKULBpzGtSdpZ0ZUBzcu”]\u003c/p>\n\u003cp>Like a real therapist, the apps that use Cognitive Behavior Therapy for Insomnia also provide practical tools to help the user worry less about their sleep and over time, be less anxious and more confident about their ability get a good night’s rest. “It’s very similar to what we do face-to-face with patients,” adds Ong.\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427093/\" target=\"_blank\" rel=\"noopener\">Studies show\u003c/a> that CBT-I delivered digitally through mobile phone apps is effective in treating insomnia. And a \u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2704019\" target=\"_blank\" rel=\"noopener\">recent study\u003c/a> of Sleepio by Ong and the team that developed the product found that participants who used the product reported an improvement in insomnia symptoms and overall wellbeing.\u003c/p>\n\u003cp>“It’s an impressive study in size and scope,” says \u003ca href=\"http://www.johntorousmd.com/\" target=\"_blank\" rel=\"noopener\">John Torous\u003c/a>, the director of digital psychiatry at Beth Israel Deaconess Medical Center. “But like any study, we have to interpret it within reason.”\u003c/p>\n\u003cp>The participants in the study were mostly white and female, he notes, and so it’s hard to generalize the findings to the larger population. And, he adds that the study was designed and funded by Big Health, the company that created the app and is now marketing it.\u003c/p>\n\u003cp>Also, Sleepio is only available on a limited basis. You can get it through employers, health insurance and national health systems at the moment, says Mike Radocchia, the marketing and business development lead at Big Health. Although the company does give it to researchers and charities for free.\u003c/p>\n\u003cp>And while apps that use Cognitive Behavior Therapy for Insomnia cost less than in-person therapy, they can be pricey. A 26-week subscription of SHUTi \u003ca href=\"http://www.myshuti.com/shuti-pricing/\" target=\"_blank\" rel=\"noopener\">costs $149\u003c/a>.\u003c/p>\n\u003cp>That’s why Torous often directs his patients with insomnia to a free app developed by the Veterans Administration called \u003ca href=\"https://mobile.va.gov/app/cbt-i-coach\" target=\"_blank\" rel=\"noopener\">CBT-I Coach\u003c/a>.\u003c/p>\n\u003cp>“Anyone can access it. You don’t have to be a veteran,” Torous says.\u003c/p>\n\u003cp>\u003ca href=\"http://www.nextbreathcounseling.com/credentials/\" target=\"_blank\" rel=\"noopener\">Jake Hanks\u003c/a>, a mental health counselor based in Glenwood Springs, Colorado, agrees. “CBT-I Coach would be my absolute favorite,” he says. “It includes a lot of the cognitive restructuring, the true things about sleep that we want patients to keep in mind.” And so, he too, recommends the free app to his patients.\u003c/p>\n\u003cp>However, Torous notes that these apps don’t work for everyone. The recent study by Ong and his colleagues hints at why.\u003c/p>\n\u003cp>“Even in this clinical study, less than 50 percent [of people who were assigned to use the app in a randomized controlled trial] are able to make it through the entire course of CBT delivered through digital platforms,” he notes. “For some people it may be hard to make it through all the sessions of CBT.”\u003c/p>\n\u003cp>This is true of most health and wellness apps, he says. Torous \u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2616170\" target=\"_blank\" rel=\"noopener\">has studied\u003c/a> this and found that of the 10,000 mental health apps out there, very few are actually being used. “I don’t think we really understand how people are using technology towards their health and recovery,” he notes.[contextly_sidebar id=”LqkvTN1dfENdC3n50jRUdIl6PSPHOHGb”]\u003c/p>\n\u003cp>But in some ways, he says, people with insomnia may be ahead of scientists in figuring out what works well for them.\u003c/p>\n\u003cp>“If you find something that works [for you], I think that’s always a good first step,” he says. “Quick fixes or simple solutions may get you feeling better right away.”\u003c/p>\n\u003cp>But, he notes, insomnia is a complex disorder with many underlying causes. Sometimes it can be caused by a medical condition that’s easily treatable, like a thyroid problem, he adds.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>So, no matter what app you are considering, always talk to your doctor about your sleep issues, he advises. “Until you know the diagnosis or what you’re working with, you don’t want to start treating something that’s not what you think it is.”\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Some+Apps+May+Help+Curb+Insomnia%2C+Others+Just+Put+You+To+Sleep&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Paige Thesing has struggled with insomnia since high school. “It takes me a really long time to fall asleep — about four hours,” she says. For years, her mornings were groggy and involved a “lot of coffee.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>After a year of trying sleep medication prescribed by her doctor, she turned to the internet for alternate solutions. About four months ago, she settled on a mobile phone meditation app called \u003ca href=\"https://www.inscape.life/\" target=\"_blank\" rel=\"noopener\">INSCAPE\u003c/a>.\u003c/p>\n\u003cp>“It’s about a 30-minute soundtrack, and it starts with a woman kind of telling you to relax and instructing your breathing,” explains Thesing. “Then it goes into sounds — relaxing noises. There’s wind chimes, some atmospheric music playing…”\u003c/p>\n\u003cp>She uses the app every night and falls asleep within 15 or 20 minutes. “So, definitely a big improvement from four hours,” she says.\u003c/p>\n\u003cp>Thesing is not alone. Chronic insomnia affects an estimated \u003ca href=\"https://www.ajmc.com/journals/supplement/2006/2006-05-vol12-n8suppl/may06-2307ps214-s220\" target=\"_blank\" rel=\"noopener\">10-15 percent of adults\u003c/a>, and another 25-35 percent struggle with sleep issues occasionally. And like Thesing, a growing number of insomniacs are turning to mobile phone apps to lull them to sleep.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>On \u003ca href=\"https://twitter.com/NPRHealth/status/1046884648167624711\" target=\"_blank\" rel=\"noopener\">Twitter\u003c/a> and Facebook, NPR asked its audience if they have used a mobile phone app to help manage insomnia. Nearly 100 people wrote back suggesting a range of apps, including podcasts created to put a listener to sleep.\u003c/p>\n\u003cp>“These are usually relaxation strategies, white noise, meditation,” \u003ca href=\"https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=35378\" target=\"_blank\" rel=\"noopener\">Jason Ong\u003c/a>, an associate professor of neurology specializing in sleep at Northwestern University’s Feinberg School of Medicine. He studies non-pharmacological treatments for various sleep disorders and treats patients at the university’s Sleep Medicine clinic. “It’s not that there’s something wrong with those apps. It’s a reasonable first thing to try.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But, he adds, these kinds of apps aren’t based on scientifically-proven solutions, and they don’t really fix the problem of why someone is not sleeping.\u003c/p>\n\u003cp>Ong wanted to do something about that, so a few years ago, he consulted for a team that developed an app that uses a science-based approach to address insomnia called \u003ca href=\"https://www.sleepio.com/cbt-for-insomnia/\" target=\"_blank\" rel=\"noopener\">Sleepio\u003c/a>. (However, he doesn’t have any ongoing financial interest in the product, he says.)\u003c/p>\n\u003cp>Sleepio and a few other apps like \u003ca href=\"http://www.myshuti.com/\" target=\"_blank\" rel=\"noopener\">SHUT-i\u003c/a> and a free one developed by the Veterans Administration use the most sustainable and \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/15451764\" target=\"_blank\" rel=\"noopener\">evidence-based\u003c/a> solution for insomnia. It’s a kind of therapy called Cognitive Behavioral Therapy for Insomnia — \u003ca href=\"https://www.sleepfoundation.org/sleep-news/cognitive-behavioral-therapy-insomnia\" target=\"_blank\" rel=\"noopener\">CBT-I\u003c/a> for short, he says. It helps the patient understand the biology of sleep and gives them a bag of tools and tricks to change their own thought patterns and behaviors to treat their underlying sleep issues.\u003c/p>\n\u003cp>“CBT for insomnia is a specific package … [that] includes different techniques like spending less time in bed [and] what to do if you are in bed and can’t sleep,” says Ong. “It’s teaching you how to change your behavior to better work with your brain to give you confidence that you’re going to be able to sleep on a regular basis.”\u003c/p>\n\u003cp>It may be surprising to us, but our own thought patterns and sleep habits \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3621793/\" target=\"_blank\" rel=\"noopener\">affect our biology\u003c/a>, in this case how our brains regulate sleep. “If you modify some of your behaviors, you can work better with how your brain regulates sleep and wake,” he says.\u003c/p>\n\u003cp>The American College of Physicians \u003ca href=\"https://www.acponline.org/acp-newsroom/acp-recommends-cognitive-behavioral-therapy-as-initial-treatment-for-chronic-insomnia\" target=\"_blank\" rel=\"noopener\">first recommended\u003c/a> Cognitive Behavioral Therapy for Insomnia as the first-line treatment for insomnia in 2016. “The evidence is quite strong to support the effectiveness of CBT-I treatment and there really aren’t a lot of side effects,” says Ong. And, because it changes behavior, “in the long run CBT-I tends to perform quite well in maintaining the benefits.”\u003c/p>\n\u003cp>In the past the only way for people to get Cognitive Behavioral Therapy for Insomnia was to see a therapist, now they can access the therapy on their mobile phones.\u003c/p>\n\u003cp>“In Sleepio, it’s like an avatar of a real therapist that’s walking the patient through that process,” explains Ong. Sleepio also allows users to keep a sleep diary so the app can use its algorithm to suggest a better bedtime schedule. It also reminds people to get up when they’ve spent too much time in bed trying to fall asleep, for example.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Like a real therapist, the apps that use Cognitive Behavior Therapy for Insomnia also provide practical tools to help the user worry less about their sleep and over time, be less anxious and more confident about their ability get a good night’s rest. “It’s very similar to what we do face-to-face with patients,” adds Ong.\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427093/\" target=\"_blank\" rel=\"noopener\">Studies show\u003c/a> that CBT-I delivered digitally through mobile phone apps is effective in treating insomnia. And a \u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2704019\" target=\"_blank\" rel=\"noopener\">recent study\u003c/a> of Sleepio by Ong and the team that developed the product found that participants who used the product reported an improvement in insomnia symptoms and overall wellbeing.\u003c/p>\n\u003cp>“It’s an impressive study in size and scope,” says \u003ca href=\"http://www.johntorousmd.com/\" target=\"_blank\" rel=\"noopener\">John Torous\u003c/a>, the director of digital psychiatry at Beth Israel Deaconess Medical Center. “But like any study, we have to interpret it within reason.”\u003c/p>\n\u003cp>The participants in the study were mostly white and female, he notes, and so it’s hard to generalize the findings to the larger population. And, he adds that the study was designed and funded by Big Health, the company that created the app and is now marketing it.\u003c/p>\n\u003cp>Also, Sleepio is only available on a limited basis. You can get it through employers, health insurance and national health systems at the moment, says Mike Radocchia, the marketing and business development lead at Big Health. Although the company does give it to researchers and charities for free.\u003c/p>\n\u003cp>And while apps that use Cognitive Behavior Therapy for Insomnia cost less than in-person therapy, they can be pricey. A 26-week subscription of SHUTi \u003ca href=\"http://www.myshuti.com/shuti-pricing/\" target=\"_blank\" rel=\"noopener\">costs $149\u003c/a>.\u003c/p>\n\u003cp>That’s why Torous often directs his patients with insomnia to a free app developed by the Veterans Administration called \u003ca href=\"https://mobile.va.gov/app/cbt-i-coach\" target=\"_blank\" rel=\"noopener\">CBT-I Coach\u003c/a>.\u003c/p>\n\u003cp>“Anyone can access it. You don’t have to be a veteran,” Torous says.\u003c/p>\n\u003cp>\u003ca href=\"http://www.nextbreathcounseling.com/credentials/\" target=\"_blank\" rel=\"noopener\">Jake Hanks\u003c/a>, a mental health counselor based in Glenwood Springs, Colorado, agrees. “CBT-I Coach would be my absolute favorite,” he says. “It includes a lot of the cognitive restructuring, the true things about sleep that we want patients to keep in mind.” And so, he too, recommends the free app to his patients.\u003c/p>\n\u003cp>However, Torous notes that these apps don’t work for everyone. The recent study by Ong and his colleagues hints at why.\u003c/p>\n\u003cp>“Even in this clinical study, less than 50 percent [of people who were assigned to use the app in a randomized controlled trial] are able to make it through the entire course of CBT delivered through digital platforms,” he notes. “For some people it may be hard to make it through all the sessions of CBT.”\u003c/p>\n\u003cp>This is true of most health and wellness apps, he says. Torous \u003ca href=\"https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2616170\" target=\"_blank\" rel=\"noopener\">has studied\u003c/a> this and found that of the 10,000 mental health apps out there, very few are actually being used. “I don’t think we really understand how people are using technology towards their health and recovery,” he notes.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But in some ways, he says, people with insomnia may be ahead of scientists in figuring out what works well for them.\u003c/p>\n\u003cp>“If you find something that works [for you], I think that’s always a good first step,” he says. “Quick fixes or simple solutions may get you feeling better right away.”\u003c/p>\n\u003cp>But, he notes, insomnia is a complex disorder with many underlying causes. Sometimes it can be caused by a medical condition that’s easily treatable, like a thyroid problem, he adds.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So, no matter what app you are considering, always talk to your doctor about your sleep issues, he advises. “Until you know the diagnosis or what you’re working with, you don’t want to start treating something that’s not what you think it is.”\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Some+Apps+May+Help+Curb+Insomnia%2C+Others+Just+Put+You+To+Sleep&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Love it or hate it, it's Fleet Week in San Francisco again. \u003ca href=\"http://bit.ly/fiorefleetflying\" target=\"_blank\" rel=\"noopener\">Find out what you can see (or avoid) here\u003c/a>.\u003c/p>\n\u003cp>The main action will be along the north side of San Francisco, from Crissy Field to the Bay Bridge.\u003c/p>\n\u003cp>If you want to avoid the Fleet Week crowds, you can find an entirely different crowd in Golden Gate Park at \u003ca href=\"http://www.hardlystrictlybluegrass.com/2018/\" target=\"_blank\" rel=\"noopener\">Hardly Strictly Bluegrass\u003c/a>.\u003c/p>\n\u003cp>As the cartoon below shows, I'm a little torn.\u003c/p>\n\u003cp>\u003cimg class=\"alignnone size-medium wp-image-11696861\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/10/fleetweek_100915_final-800x800.png\" alt=\"Fleet Week by Mark Fiore\" width=\"800\" height=\"800\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2018/10/fleetweek_100915_final-800x800.png 800w, https://ww2.kqed.org/app/uploads/sites/10/2018/10/fleetweek_100915_final-160x160.png 160w, https://ww2.kqed.org/app/uploads/sites/10/2018/10/fleetweek_100915_final-1020x1020.png 1020w, https://ww2.kqed.org/app/uploads/sites/10/2018/10/fleetweek_100915_final-1200x1200.png 1200w, https://ww2.kqed.org/app/uploads/sites/10/2018/10/fleetweek_100915_final-1920x1920.png 1920w, https://ww2.kqed.org/app/uploads/sites/10/2018/10/fleetweek_100915_final-1180x1180.png 1180w, https://ww2.kqed.org/app/uploads/sites/10/2018/10/fleetweek_100915_final-960x960.png 960w, https://ww2.kqed.org/app/uploads/sites/10/2018/10/fleetweek_100915_final-240x240.png 240w, https://ww2.kqed.org/app/uploads/sites/10/2018/10/fleetweek_100915_final-375x375.png 375w, https://ww2.kqed.org/app/uploads/sites/10/2018/10/fleetweek_100915_final-520x520.png 520w, https://ww2.kqed.org/app/uploads/sites/10/2018/10/fleetweek_100915_final-32x32.png 32w, https://ww2.kqed.org/app/uploads/sites/10/2018/10/fleetweek_100915_final-50x50.png 50w, https://ww2.kqed.org/app/uploads/sites/10/2018/10/fleetweek_100915_final-64x64.png 64w, https://ww2.kqed.org/app/uploads/sites/10/2018/10/fleetweek_100915_final-96x96.png 96w, https://ww2.kqed.org/app/uploads/sites/10/2018/10/fleetweek_100915_final-128x128.png 128w, https://ww2.kqed.org/app/uploads/sites/10/2018/10/fleetweek_100915_final-150x150.png 150w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp class=\"danger-zone\">In the world of digital health, Silicon Valley-based \u003ca href=\"https://www.statnews.com/2017/08/07/mindstrong-insel-mental-illness/\" target=\"_blank\" rel=\"noopener\">Mindstrong\u003c/a> stands out. It has a star-studded team and tens of millions in venture capital funding, including from Jeff Bezos’ VC firm.[contextly_sidebar id=\"KMLJnak6yPOdRS3TfVoiDTc6a7Cm51Xf\"]\u003c/p>\n\u003cp class=\"danger-zone\">It also has a captivating idea: that its app, based on cognitive functioning research, can help detect troubling mental health patterns by collecting data on a person’s smartphone usage — how quickly they type or scroll, for instance.\u003c/p>\n\u003cp class=\"danger-zone\">The promise of that technology has helped Mindstrong build incredible momentum since it launched last year; already more than a dozen counties in California have agreed to deploy the company’s app to patients.\u003c/p>\n\u003cp class=\"\">Does the app live up to its promise? There’s no way to tell. Almost no one outside the company has any idea whether it works. Most of the company’s key promises or claims aren’t yet backed up by published, peer-reviewed data — leading some experts to wonder if the technology is ready for the real world.\u003c/p>\n\u003cp class=\"\">“I wouldn’t waste all that time and money in the wild until they get sure that some of those things are as specific as they hope they are,” said Rosalind Picard, a researcher at MIT Media Lab who is familiar with Mindstrong’s work and tries to use data from smartphones and wearables to detect a person’s mood.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Even as one of the company’s executives, Dr. Tom Insel, acknowledged to STAT that the app isn’t perfect, the company’s CEO emphasized that Mindstrong could provide unprecedented insight into conditions like depression.[contextly_sidebar id=\"Kw9tNYwAAP3TxDDlzs24FDdim0qufSVP\"]\u003c/p>\n\u003cp>Mindstrong is not alone in pushing the frontiers of smartphone-based digital health. Many companies use so-called digital phenotyping, collecting scientific data on a person’s digital life, to gain insights into his or her physical or mental health.\u003c/p>\n\u003cp>The company’s app collects information about how people are typing and runs it through a machine learning algorithm to determine which data can predict their emotional state. Mindstrong has already used it in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a \u003ca href=\"https://www.statnews.com/2018/09/24/ketamine-clinics-severe-depression-treatment/\" target=\"_blank\" rel=\"noopener\">ketamine clinic\u003c/a>. The app is available in Apple’s app store, but requires a participant code to access it.\u003c/p>\n\u003cp>“We’ve done the validation work against the gold-standard clinical tests for depression, for anxiety, for cognitive decline, whether it’s memory or executive function,” said Dr. Paul Dagum, the company’s founder. “We’re confident, we’re already seeing some really exciting results.”\u003c/p>\n\u003cp>In the last year, Mindstrong’s footprint and reach have already grown exponentially. The Palo Alto-based company’s workforce has doubled to 42 employees and it made \u003ca href=\"https://www.hsph.harvard.edu/magazine/magazine_article/philanthropic-impact-digital-phenotyping/\" target=\"_blank\" rel=\"noopener\">a sizable gift\u003c/a> to Harvard’s school of public health. In February, it launched a partnership with Takeda to develop new biomarkers that will be able to aid the pharmaceutical giant’s clinical trials for depression treatments.\u003c/p>\n\u003cp>The idea is to use that data to establish a “normal” pattern — so it can be compared against someone’s typing habits on any given day. If the habits look off, slower or more agitated than normal, the app can alert a health care provider.\u003c/p>\n\u003cp>Abnormal patterns, Mindstrong says, might show up if a person is more depressed or anxious, or if just about anything else about their mental health changes. When asked which disorders Mindstrong might be able to detect, Dagum replied, “all of them.” (Dagum, a data scientist and physician, founded the company in 2017 with Rick Klausner, the founder and director of CAR-T pioneer Juno Therapeutics and \u003ca href=\"https://www.statnews.com/2018/06/02/grail-cancer-blood-test-asco/\" target=\"_blank\" rel=\"noopener\">Grail\u003c/a>, a liquid biopsy company.)[contextly_sidebar id=\"XHhLlvPBCoPTlN54jyme2G0wpse1GITN\"]\u003c/p>\n\u003cp>Mindstrong officials told STAT that among their most encouraging results is that its app can even predict how a person will feel next week, or at least how a person will perform on the Hamilton Rating Scale for depression — kind of like a weather app for your mood.\u003c/p>\n\u003cp>The data behind this claim is being published soon, said Insel, who is the former head of the National Institute of Mental Health and came to the company in 2017 after a short stint at \u003ca href=\"https://www.statnews.com/2016/03/28/google-life-sciences-exodus/\" target=\"_blank\" rel=\"noopener\">Verily\u003c/a>.\u003c/p>\n\u003cp>The app can detect a seven-point change on the Hamilton scale, Insel said. That kind of difference could indicate a patient who is not normally depressed now shows signs of mild or moderate depression, or that a person with moderate depression is now showing signs of a very severe condition.\u003c/p>\n\u003cp>“For a clinician and for someone taking care of a patient, knowing that, it could be very, very powerful,” Dagum said.\u003c/p>\n\u003cp>The company’s momentum has taken it to the cusp of a real-world deployment in California. About 15 counties — including the most populous county in the United States, Los Angeles County — will be spending about $60 million over the next four years to bring companies like Mindstrong and other apps into their health care system.\u003c/p>\n\u003cp>These counties hope apps will help them get better services to people with mental illnesses like depression, schizophrenia, bipolar disorder, and post-traumatic stress disorder.\u003c/p>\n\u003cp>The Mindstrong program itself is limited: Patients can choose voluntarily whether to use the app, which will be free to them, and that decision won’t affect the rest of the mental health services they can access.\u003c/p>\n\u003cp>\u003cstrong>Lack of Public Data\u003c/strong>\u003c/p>\n\u003cp>So far, the Mindstrong app has only been used in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a ketamine clinic. The company has also claimed that a “\u003ca href=\"https://mindstronghealth.com/clinical-programs/\" target=\"_blank\" rel=\"noopener\">nationwide employer\u003c/a>” and private substance abuse clinics in D.C. are using the app.[contextly_sidebar id=\"KGoxoWR6m8MUKnLishPvyacpod0HWpt7\"]\u003c/p>\n\u003cp>But other than the change on the Hamilton scale — which hasn’t yet gone through peer review and was disclosed to STAT in an interview — almost no data about how well Mindstrong’s technology works is available to independent observers.\u003c/p>\n\u003cp>The company’s website describes five completed clinical trials, but it has not yet published the results of any. Only a handful of other published works — all from the last year — have hinted at how well it works or its scope with data to back up the claims.\u003c/p>\n\u003cp>The company \u003ca href=\"https://www.nature.com/articles/s41746-018-0018-4\" target=\"_blank\" rel=\"noopener\">published\u003c/a> a 27-person pilot study in the journal npj Digital Medicine earlier this year. Dagum is also an author on a poster \u003ca href=\"https://www.nature.com/articles/npp2017265#t122-assessing-anhedonia-with-quantitative-tasks-digital-and-patient-reported-measures-in-a-multicenter-doubleblind-trial-with-btrx246040-for-the-treatment-of-major-depressive-disorder\" target=\"_blank\" rel=\"noopener\">presentation\u003c/a> given at the American College of Neuropsychopharmacology’s 2017 conference, another \u003ca href=\"https://isctm.org/public_access/Feb2018/PDFs/Smith-poster.pdf\" target=\"_blank\" rel=\"noopener\">poster\u003c/a> that reported results from a very wide variety of digital phenotyping techniques — not just typing — and a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29074231\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> describing a clinical trial protocol — not results.\u003c/p>\n\u003cp>As Mindstrong steps toward a wider rollout, the scientific studies behind its claims will matter. Federal regulators, for one, have \u003ca href=\"https://www.ftc.gov/news-events/blogs/business-blog/2016/01/mind-gap-what-lumosity-promised-vs-what-it-could-prove\" target=\"_blank\" rel=\"noopener\">cracked down\u003c/a> on \u003ca href=\"https://www.ftc.gov/news-events/press-releases/2016/12/marketers-blood-pressure-app-settle-ftc-charges-regarding\" target=\"_blank\" rel=\"noopener\">commercial apps\u003c/a>that misleadingly reference a study’s conclusions to market their app.\u003c/p>\n\u003cp>Based on her own research, at least one expert in digital health and mood said she’s skeptical that Mindstrong can, in a general population, work as well as the company claims. MIT’s Picard said that while there are ways to predict or detect mood changes, you usually need more than just a single type of data to do so.\u003c/p>\n\u003cp>“I’m suspicious that a single modality like typing is going to be sufficient. It would be like saying there’s a single question [on a screening questionnaire] that a doctor could be using,” said Picard, who is also CEO of a company that works on digital phenotyping, like Mindstrong does.\u003c/p>\n\u003cp>“My guess is that their specificity to depression is going to be relatively low,” Picard said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Her \u003ca href=\"https://www.jmir.org/2018/6/e210/\" target=\"_blank\" rel=\"noopener\">own\u003c/a> \u003ca href=\"https://ieeexplore.ieee.org/abstract/document/954607\" target=\"_blank\" rel=\"noopener\">research\u003c/a>, for example, relies on temperature and skin conductivity as well as calls and the amount of time spent on a phone to predict mood changes. It is about 80 percent accurate.\u003c/p>\n\u003cdiv class=\"quote-inner\">\n\u003cp>Especially in the field of digital mental health, “we need more peer review,” said Dr. Steven Steinhubl, the director of digital medicine at Scripps Research Translational Institute. (Steinhubl is also the co-editor-in-chief of npj Digital Medicine.) Though he said he strongly believes in the potential of apps like Mindstrong, Steinhubl cautioned that peer review has a purpose.[contextly_sidebar id=\"8bFNH4xsL9O8lTSDRHnxnqtYwxOF2Z5k\"]\u003c/p>\n\u003cp>“[Peer review] is a very imperfect system, but there’s really nothing in the peer-reviewed literature. That means that other experts aren’t able to weigh in,” he said. “If you have committees and other people reviewing something who maybe don’t have the same level of expertise, you’ll have people saying, ‘Yeah, that sounds good.’”\u003c/p>\n\u003cp>Other researchers have also found that neuropsychological tests, more broadly, have relatively low accuracy rates.\u003c/p>\n\u003cp>In a study that examined people who were already being treated for depression, one computerized test could only accurately predict their condition in about 40 percent of cases. Another showed a 44 percent accuracy rate for a similar computerized test used to examine people with major depression.\u003c/p>\n\u003cp>A neuropsychological test — if it’s used as a screening test — is “going to miss a lot of people who are depressed,” said Richard Porter, a psychology researcher based at the University of Otago in New Zealand who conducted one of the studies.\u003c/p>\n\u003cp>And even if depressed people do show some kind of cognitive impairment, it’s impossible to tell what caused it.\u003c/p>\n\u003cp>Many things other than mental illness might cause a person to perform poorly on cognitive tests — like living with another disorder, having a lower baseline performance on cognitive tests, having a drink or taking prescription, over-the-counter, or illegal drugs.\u003c/p>\n\u003cp>Mindstrong’s leaders aren’t worried about that kind of noise in their data. Some of those factors are important to note, both for patients and the health care professionals working with them.\u003c/p>\n\u003cp>“You’re hungover, you didn’t sleep well, you didn’t take your medication, you have a medication side effects, you’re having stress and challenges at work and at home. Those are things that we want to measure,” Dagum said.\u003c/p>\n\u003cp>But even Insel admitted that there are plenty of issues that could affect typing speed — and which Mindstrong hasn’t figured out how to sort out yet. Sticky fingers after lunch, full hands at an airport, wearing gloves during winter, or a broken hand might also plausible affect a person’s typing speed — and, therefore, the app’s performance.\u003c/p>\n\u003cp>“One thing we’ve thought about is how we factor in those unusual environmental issues,” Insel said. “We’re working on that. But I can’t say that we’ve solved all of those possible issues.”\u003c/p>\n\u003cp>\u003cstrong>A Looming Launch in the Golden State\u003c/strong>\u003c/p>\n\u003cp>Insel and others linked with the company are fond of comparing their app to a smoke detector — something that’s intended to enhance humans’ senses to detect danger.\u003c/p>\n\u003cp>But part of the value of a smoke detector is that if it’s functioning properly, we know it isn’t going off at random. It only goes off in certain conditions and carries a specific message: Your house is on fire or about to be. Do something.\u003c/p>\n\u003cp>At least for now, that’s where Mindstrong differs from a smoke detector. There’s no way to tell, yet, how specific it is or how sensitive its algorithm is.\u003c/p>\n\u003cp>Insel said that information is coming. He said the company has the data about the app’s accuracy — but he declined to provide those figures, citing papers pending publication. “[They] square very well with clinically used biomarkers,” he said.\u003c/p>\n\u003cp>California authorities suggest they have been shown some of that data. But they’re nevertheless cautious about how the app will work in their new, different setting.\u003c/p>\n\u003cp>One official said there will be “clear writing” included with the state’s version of the app about what it can do, what it cannot do, and what goals the counties hope it will help them achieve.\u003c/p>\n\u003cp>Those goals are pretty lofty. At least some counties eventually plan to use it not only to supplement the existing system, but potentially to bring more people into its fold.\u003c/p>\n\u003cp>“We might be able to go to colleges, emergency departments, other places,” said Debbie Innes-Gomberg, a deputy director at the Los Angeles County Department of Mental Health. “There’s a process of identifying that they’re symptomatic, but [our target population is] people that are in our system and people who maybe need to be.”\u003c/p>\n\u003cp>And even before the app launched in the original five counties that had signed on, the pilot has expanded. Another 11 counties have recently decided to join.\u003c/p>\n\u003cp>Still, Innes-Gomberg said, it’s going to be rolled out with caution. “We’re not going to oversell this.”\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/04/mindstrong-questions-over-evidence/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"danger-zone\">In the world of digital health, Silicon Valley-based \u003ca href=\"https://www.statnews.com/2017/08/07/mindstrong-insel-mental-illness/\" target=\"_blank\" rel=\"noopener\">Mindstrong\u003c/a> stands out. It has a star-studded team and tens of millions in venture capital funding, including from Jeff Bezos’ VC firm.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp class=\"danger-zone\">It also has a captivating idea: that its app, based on cognitive functioning research, can help detect troubling mental health patterns by collecting data on a person’s smartphone usage — how quickly they type or scroll, for instance.\u003c/p>\n\u003cp class=\"danger-zone\">The promise of that technology has helped Mindstrong build incredible momentum since it launched last year; already more than a dozen counties in California have agreed to deploy the company’s app to patients.\u003c/p>\n\u003cp class=\"\">Does the app live up to its promise? There’s no way to tell. Almost no one outside the company has any idea whether it works. Most of the company’s key promises or claims aren’t yet backed up by published, peer-reviewed data — leading some experts to wonder if the technology is ready for the real world.\u003c/p>\n\u003cp class=\"\">“I wouldn’t waste all that time and money in the wild until they get sure that some of those things are as specific as they hope they are,” said Rosalind Picard, a researcher at MIT Media Lab who is familiar with Mindstrong’s work and tries to use data from smartphones and wearables to detect a person’s mood.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Even as one of the company’s executives, Dr. Tom Insel, acknowledged to STAT that the app isn’t perfect, the company’s CEO emphasized that Mindstrong could provide unprecedented insight into conditions like depression.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Mindstrong is not alone in pushing the frontiers of smartphone-based digital health. Many companies use so-called digital phenotyping, collecting scientific data on a person’s digital life, to gain insights into his or her physical or mental health.\u003c/p>\n\u003cp>The company’s app collects information about how people are typing and runs it through a machine learning algorithm to determine which data can predict their emotional state. Mindstrong has already used it in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a \u003ca href=\"https://www.statnews.com/2018/09/24/ketamine-clinics-severe-depression-treatment/\" target=\"_blank\" rel=\"noopener\">ketamine clinic\u003c/a>. The app is available in Apple’s app store, but requires a participant code to access it.\u003c/p>\n\u003cp>“We’ve done the validation work against the gold-standard clinical tests for depression, for anxiety, for cognitive decline, whether it’s memory or executive function,” said Dr. Paul Dagum, the company’s founder. “We’re confident, we’re already seeing some really exciting results.”\u003c/p>\n\u003cp>In the last year, Mindstrong’s footprint and reach have already grown exponentially. The Palo Alto-based company’s workforce has doubled to 42 employees and it made \u003ca href=\"https://www.hsph.harvard.edu/magazine/magazine_article/philanthropic-impact-digital-phenotyping/\" target=\"_blank\" rel=\"noopener\">a sizable gift\u003c/a> to Harvard’s school of public health. In February, it launched a partnership with Takeda to develop new biomarkers that will be able to aid the pharmaceutical giant’s clinical trials for depression treatments.\u003c/p>\n\u003cp>The idea is to use that data to establish a “normal” pattern — so it can be compared against someone’s typing habits on any given day. If the habits look off, slower or more agitated than normal, the app can alert a health care provider.\u003c/p>\n\u003cp>Abnormal patterns, Mindstrong says, might show up if a person is more depressed or anxious, or if just about anything else about their mental health changes. When asked which disorders Mindstrong might be able to detect, Dagum replied, “all of them.” (Dagum, a data scientist and physician, founded the company in 2017 with Rick Klausner, the founder and director of CAR-T pioneer Juno Therapeutics and \u003ca href=\"https://www.statnews.com/2018/06/02/grail-cancer-blood-test-asco/\" target=\"_blank\" rel=\"noopener\">Grail\u003c/a>, a liquid biopsy company.)\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Mindstrong officials told STAT that among their most encouraging results is that its app can even predict how a person will feel next week, or at least how a person will perform on the Hamilton Rating Scale for depression — kind of like a weather app for your mood.\u003c/p>\n\u003cp>The data behind this claim is being published soon, said Insel, who is the former head of the National Institute of Mental Health and came to the company in 2017 after a short stint at \u003ca href=\"https://www.statnews.com/2016/03/28/google-life-sciences-exodus/\" target=\"_blank\" rel=\"noopener\">Verily\u003c/a>.\u003c/p>\n\u003cp>The app can detect a seven-point change on the Hamilton scale, Insel said. That kind of difference could indicate a patient who is not normally depressed now shows signs of mild or moderate depression, or that a person with moderate depression is now showing signs of a very severe condition.\u003c/p>\n\u003cp>“For a clinician and for someone taking care of a patient, knowing that, it could be very, very powerful,” Dagum said.\u003c/p>\n\u003cp>The company’s momentum has taken it to the cusp of a real-world deployment in California. About 15 counties — including the most populous county in the United States, Los Angeles County — will be spending about $60 million over the next four years to bring companies like Mindstrong and other apps into their health care system.\u003c/p>\n\u003cp>These counties hope apps will help them get better services to people with mental illnesses like depression, schizophrenia, bipolar disorder, and post-traumatic stress disorder.\u003c/p>\n\u003cp>The Mindstrong program itself is limited: Patients can choose voluntarily whether to use the app, which will be free to them, and that decision won’t affect the rest of the mental health services they can access.\u003c/p>\n\u003cp>\u003cstrong>Lack of Public Data\u003c/strong>\u003c/p>\n\u003cp>So far, the Mindstrong app has only been used in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a ketamine clinic. The company has also claimed that a “\u003ca href=\"https://mindstronghealth.com/clinical-programs/\" target=\"_blank\" rel=\"noopener\">nationwide employer\u003c/a>” and private substance abuse clinics in D.C. are using the app.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But other than the change on the Hamilton scale — which hasn’t yet gone through peer review and was disclosed to STAT in an interview — almost no data about how well Mindstrong’s technology works is available to independent observers.\u003c/p>\n\u003cp>The company’s website describes five completed clinical trials, but it has not yet published the results of any. Only a handful of other published works — all from the last year — have hinted at how well it works or its scope with data to back up the claims.\u003c/p>\n\u003cp>The company \u003ca href=\"https://www.nature.com/articles/s41746-018-0018-4\" target=\"_blank\" rel=\"noopener\">published\u003c/a> a 27-person pilot study in the journal npj Digital Medicine earlier this year. Dagum is also an author on a poster \u003ca href=\"https://www.nature.com/articles/npp2017265#t122-assessing-anhedonia-with-quantitative-tasks-digital-and-patient-reported-measures-in-a-multicenter-doubleblind-trial-with-btrx246040-for-the-treatment-of-major-depressive-disorder\" target=\"_blank\" rel=\"noopener\">presentation\u003c/a> given at the American College of Neuropsychopharmacology’s 2017 conference, another \u003ca href=\"https://isctm.org/public_access/Feb2018/PDFs/Smith-poster.pdf\" target=\"_blank\" rel=\"noopener\">poster\u003c/a> that reported results from a very wide variety of digital phenotyping techniques — not just typing — and a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29074231\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> describing a clinical trial protocol — not results.\u003c/p>\n\u003cp>As Mindstrong steps toward a wider rollout, the scientific studies behind its claims will matter. Federal regulators, for one, have \u003ca href=\"https://www.ftc.gov/news-events/blogs/business-blog/2016/01/mind-gap-what-lumosity-promised-vs-what-it-could-prove\" target=\"_blank\" rel=\"noopener\">cracked down\u003c/a> on \u003ca href=\"https://www.ftc.gov/news-events/press-releases/2016/12/marketers-blood-pressure-app-settle-ftc-charges-regarding\" target=\"_blank\" rel=\"noopener\">commercial apps\u003c/a>that misleadingly reference a study’s conclusions to market their app.\u003c/p>\n\u003cp>Based on her own research, at least one expert in digital health and mood said she’s skeptical that Mindstrong can, in a general population, work as well as the company claims. MIT’s Picard said that while there are ways to predict or detect mood changes, you usually need more than just a single type of data to do so.\u003c/p>\n\u003cp>“I’m suspicious that a single modality like typing is going to be sufficient. It would be like saying there’s a single question [on a screening questionnaire] that a doctor could be using,” said Picard, who is also CEO of a company that works on digital phenotyping, like Mindstrong does.\u003c/p>\n\u003cp>“My guess is that their specificity to depression is going to be relatively low,” Picard said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Her \u003ca href=\"https://www.jmir.org/2018/6/e210/\" target=\"_blank\" rel=\"noopener\">own\u003c/a> \u003ca href=\"https://ieeexplore.ieee.org/abstract/document/954607\" target=\"_blank\" rel=\"noopener\">research\u003c/a>, for example, relies on temperature and skin conductivity as well as calls and the amount of time spent on a phone to predict mood changes. It is about 80 percent accurate.\u003c/p>\n\u003cdiv class=\"quote-inner\">\n\u003cp>Especially in the field of digital mental health, “we need more peer review,” said Dr. Steven Steinhubl, the director of digital medicine at Scripps Research Translational Institute. (Steinhubl is also the co-editor-in-chief of npj Digital Medicine.) Though he said he strongly believes in the potential of apps like Mindstrong, Steinhubl cautioned that peer review has a purpose.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“[Peer review] is a very imperfect system, but there’s really nothing in the peer-reviewed literature. That means that other experts aren’t able to weigh in,” he said. “If you have committees and other people reviewing something who maybe don’t have the same level of expertise, you’ll have people saying, ‘Yeah, that sounds good.’”\u003c/p>\n\u003cp>Other researchers have also found that neuropsychological tests, more broadly, have relatively low accuracy rates.\u003c/p>\n\u003cp>In a study that examined people who were already being treated for depression, one computerized test could only accurately predict their condition in about 40 percent of cases. Another showed a 44 percent accuracy rate for a similar computerized test used to examine people with major depression.\u003c/p>\n\u003cp>A neuropsychological test — if it’s used as a screening test — is “going to miss a lot of people who are depressed,” said Richard Porter, a psychology researcher based at the University of Otago in New Zealand who conducted one of the studies.\u003c/p>\n\u003cp>And even if depressed people do show some kind of cognitive impairment, it’s impossible to tell what caused it.\u003c/p>\n\u003cp>Many things other than mental illness might cause a person to perform poorly on cognitive tests — like living with another disorder, having a lower baseline performance on cognitive tests, having a drink or taking prescription, over-the-counter, or illegal drugs.\u003c/p>\n\u003cp>Mindstrong’s leaders aren’t worried about that kind of noise in their data. Some of those factors are important to note, both for patients and the health care professionals working with them.\u003c/p>\n\u003cp>“You’re hungover, you didn’t sleep well, you didn’t take your medication, you have a medication side effects, you’re having stress and challenges at work and at home. Those are things that we want to measure,” Dagum said.\u003c/p>\n\u003cp>But even Insel admitted that there are plenty of issues that could affect typing speed — and which Mindstrong hasn’t figured out how to sort out yet. Sticky fingers after lunch, full hands at an airport, wearing gloves during winter, or a broken hand might also plausible affect a person’s typing speed — and, therefore, the app’s performance.\u003c/p>\n\u003cp>“One thing we’ve thought about is how we factor in those unusual environmental issues,” Insel said. “We’re working on that. But I can’t say that we’ve solved all of those possible issues.”\u003c/p>\n\u003cp>\u003cstrong>A Looming Launch in the Golden State\u003c/strong>\u003c/p>\n\u003cp>Insel and others linked with the company are fond of comparing their app to a smoke detector — something that’s intended to enhance humans’ senses to detect danger.\u003c/p>\n\u003cp>But part of the value of a smoke detector is that if it’s functioning properly, we know it isn’t going off at random. It only goes off in certain conditions and carries a specific message: Your house is on fire or about to be. Do something.\u003c/p>\n\u003cp>At least for now, that’s where Mindstrong differs from a smoke detector. There’s no way to tell, yet, how specific it is or how sensitive its algorithm is.\u003c/p>\n\u003cp>Insel said that information is coming. He said the company has the data about the app’s accuracy — but he declined to provide those figures, citing papers pending publication. “[They] square very well with clinically used biomarkers,” he said.\u003c/p>\n\u003cp>California authorities suggest they have been shown some of that data. But they’re nevertheless cautious about how the app will work in their new, different setting.\u003c/p>\n\u003cp>One official said there will be “clear writing” included with the state’s version of the app about what it can do, what it cannot do, and what goals the counties hope it will help them achieve.\u003c/p>\n\u003cp>Those goals are pretty lofty. At least some counties eventually plan to use it not only to supplement the existing system, but potentially to bring more people into its fold.\u003c/p>\n\u003cp>“We might be able to go to colleges, emergency departments, other places,” said Debbie Innes-Gomberg, a deputy director at the Los Angeles County Department of Mental Health. “There’s a process of identifying that they’re symptomatic, but [our target population is] people that are in our system and people who maybe need to be.”\u003c/p>\n\u003cp>And even before the app launched in the original five counties that had signed on, the pilot has expanded. Another 11 counties have recently decided to join.\u003c/p>\n\u003cp>Still, Innes-Gomberg said, it’s going to be rolled out with caution. “We’re not going to oversell this.”\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/04/mindstrong-questions-over-evidence/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003ch2>Safety Violations Uncovered in Southern California Detention Center\u003c/h2>\n\u003cp>Inspectors for the Department of Homeland Security have found serious violations at an immigration detention center in Southern California. The violations include nooses in detainee cells and substandard medical care.\u003cbr>\n\u003cem>Reporter: Farida Jhabvala Romero\u003c/em>\u003c/p>\n\u003ch2>\u003ca href=\"https://www.kqed.org/news/11696031/4-california-white-supremacists-arrested-in-connection-with-violent-charlottesville-rally\" rel=\"noopener\" target=\"_blank\">4 California White Supremacists Arrested in Connection With Violent Charlottesville Rally\u003c/a>\u003c/h2>\n\u003cp>Four Californians were arrested Tuesday in connection to the 2017 Charlottesville white nationalist rally. The men are allegedly part of a supremacy group called the Rise Above Movement. Joanna Mendleson of the Anti-Defamation League speaks to host John Sepulvado about the charges.\u003cbr>\n\u003cem>Guest: Joanna Mendleson\u003c/em>\u003c/p>\n\u003ch2>Lawsuit Filed for Catholic Church to Release Names of Priests Accused of Abusing Children\u003c/h2>\n\u003cp>Lawyers for a Southern California man filed a civil suit in Los Angeles Superior Court yesterday against nearly all of the state's Catholic Dioceses.\u003cbr>\n\u003cem>Reporter: Polly Stryker\u003c/em>\u003c/p>\n\u003ch2>California Doctors Are Now Requited to Use Database When Prescribing Opioids\u003c/h2>\n\u003cp>Starting this week, California doctors must check a state database before writing a new prescription for opioids. But some doctors worry the change is misguided.\u003cbr>\n\u003cem>Reporter: April Dembosky\u003c/em>\u003c/p>\n\u003ch2>Truck Drivers, Warehouse Workers Go On Strike in Southern California\u003c/h2>\n\u003cp>Truck drivers are on strike today outside the Ports of Los Angeles and Long Beach. This is their sixteenth labor strike in the past five years.\u003cbr>\n\u003cem>Reporter: Michelle Wiley\u003c/em>\u003c/p>\n\u003ch2>Santa Clara Law Professor Questions Feds' Case Against Net Neutrality\u003c/h2>\n\u003cp>Earlier this week California passed the toughest state-level net neutrality law in the nation. Hours later, the Department of Justice sued. But one legal expert says the feds are on shaky ground because of what’s called “police power of the state.”\u003cbr>\n\u003cem>Reporter: Tonya Mosley\u003c/em>\u003c/p>\n\u003ch2>Congressman Nunes's California Farm is in...Iowa\u003c/h2>\n\u003cp>Host John Sepulvado speaks with Ryan Lizza of Esquire about his article revealing that Congressman Devin Nunes’s family farm is not in California’s Central Valley, it’s in Iowa.\u003cbr>\n\u003cem>Guest: Ryan Lizza\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cp>Gov. Jerry Brown signed the nation's toughest net neutrality measure Sunday, requiring internet providers to maintain a level playing field online. The move prompted an immediate lawsuit by the Trump administration.\u003c/p>\n\u003cp>Advocates of net neutrality hope the new law in the home of the global technology industry will have national implications by pushing Congress to enact national net neutrality rules or encouraging other states to follow suit.\u003c/p>\n\u003cp>But the U.S. Department of Justice wants to stop the law in its tracks, arguing that it creates burdensome, anti-consumer requirements that go against the federal government's approach of deregulating the Internet.\u003c/p>\n\u003cp>\"Once again the California Legislature has enacted an extreme and illegal state law attempting to frustrate federal policy,\" U.S. Attorney General Jeff Sessions said in a statement.\u003c/p>\n\u003cp>The law is the latest example of the nation's most populous state seeking to drive public policy outside its borders and rebuff President Donald Trump's agenda. Brown did not explain his reasons for signing the bill when the decision was announced, but supporters cheered it as a win for internet freedom.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"This is a historic day for California. A free and open internet is a cornerstone of 21st century life: our democracy, our economy, our health care and public safety systems, and day-to-day activities,\" said Sen. Scott Wiener (D-San Francisco), the law's author.\u003c/p>\n\u003cp>The legislation is based on Obama-era rules that the Federal Communications Commission repealed last year that prevented internet companies from exercising more control over what people watch and see on the internet.\u003c/p>\n\u003cp>Telecommunications companies lobbied hard to kill the California law or water it down, saying it would lead to higher internet and cellphone bills and discourage investments in faster internet. They say it's unrealistic to expect them to comply with internet regulations that differ from state to state.\u003c/p>\n\u003cp>USTelecom, a telecommunications trade group, said California writing its own rules will create problems.\u003c/p>\n\u003cp>\"Rather than 50 states stepping in with their own conflicting open internet solutions, we need Congress to step up with a national framework for the whole internet ecosystem and resolve this issue once and for all,\" the group said in a Sunday statement.\u003c/p>\n\u003cp>Net neutrality advocates worry that without rules, internet providers could create fast lanes and slow lanes that favor their own sites and apps or make it harder for consumers to see content from competitors.\u003c/p>\n\u003cp>That could limit consumer choice or shut out upstart companies that can't afford to buy access to the fast lane, critics say.\u003c/p>\n\u003cp>The new law prohibits internet providers from blocking or slowing data based on content or from favoring websites or video streams from companies that pay extra. It also bans \"zero rating,\" in which internet providers don't count certain content against a monthly data cap — generally video streams produced by the company's own subsidiaries and partners.\u003c/p>\n\u003cp>Oregon, Washington and Vermont have approved legislation related to net neutrality, but California's measure is seen as the most comprehensive attempt to codify the principle in a way that might survive a likely court challenge. An identical bill was introduced in New York.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Associated Press writers Eric Tucker and Mike Balsamo in Washington and Kathleen Ronayne in Sacramento contributed to this report.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cp>Tesla CEO Elon Musk has agreed to pay $20 million and make a series of concessions to settle a government lawsuit alleging he duped investors with misleading statements about a proposed buyout of the company.\u003c/p>\n\u003cp>The Securities and Exchange Commission announced the agreement Saturday, just two days after filing a case seeking to \u003ca href=\"https://www.kqed.org/news/11695040/sec-sues-tesla-ceo-elon-musk-for-securities-fraud\" rel=\"noopener\" target=\"_blank\">oust Musk as CEO\u003c/a>.\u003c/p>\n\u003cp>Musk has agreed to pay a $20 million fine and resign as chairman of Tesla's Board of Directors within 45 days, \u003ca href=\"https://www.documentcloud.org/documents/4951959-Musk.html\" rel=\"noopener\" target=\"_blank\">according to the settlement\u003c/a>, which is subject to court approval. Musk will be required to relinquish his role as chairman for at least three years, but he will be able to remain as CEO.\u003c/p>\n\u003cp>The suit by the SEC stemmed from an Aug. 7, 2018 \u003ca href=\"https://twitter.com/elonmusk/status/1026872652290379776\" rel=\"noopener\" target=\"_blank\">tweet\u003c/a> by Musk saying that he was considering taking the publicly-held Tesla private at $420 per share. The SEC said the tweet was not based in fact and led to \"significant market disruption.\"\u003c/p>\n\u003cp>The SEC also announced a \u003ca href=\"https://www.sec.gov/news/press-release/2018-226\" rel=\"noopener\" target=\"_blank\">settlement with Tesla\u003c/a> over its failure to have procedures in place to determine whether Musk's tweets included information that would need to be disclosed in SEC filings \"despite notifying the market in 2013 that it intended to use Musk’s Twitter account as a means of announcing material information about Tesla and encouraging investors to review Musk’s tweets.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>As part of the settlement, Tesla will replace Musk with an \"independent Chairman,\" appoint two new independent directors to its board and establish additional controls and procedures to oversee Musk’s communications — including his tweets. The company will also pay its own $20 million fine, which combined with Musk's $20 million, will be \"distributed to harmed investors under a court-approved process.\"\u003c/p>\n\u003cp>“The total package of remedies and relief announced today are specifically designed to address the misconduct at issue by strengthening Tesla’s corporate governance and oversight in order to protect investors,” said Stephanie Avakian, Co-Director of the SEC’s Enforcement Division in a statement.\u003c/p>\n\u003cp>As part of his settlement, Musk agreed to comply with the new oversight of his personal communications related to the company, including receiving pre-approval of any communications that could contain information related to Tesla or its shareholders.\u003c/p>\n\u003cp>Musk reportedly \u003ca href=\"https://www.cnbc.com/2018/09/28/teslas-musk-pulled-plug-on-settlement-with-sec-at-last-minute.html\" rel=\"noopener\" target=\"_blank\">turned down an offer\u003c/a> from the SEC on Thursday that would've kept him from being chairman for two years and forced him to pay a fine. Tesla's stock plummeted 14 percent Friday after the SEC filed its lawsuit, erasing more than $7 billion in shareholder wealth.\u003c/p>\n\u003cp>Representatives from Tesla declined to comment on the settlement.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Reporting from the Associated Press was used in this post.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Tesla CEO Elon Musk has agreed to pay $20 million and make a series of concessions to settle a government lawsuit alleging he duped investors with misleading statements about a proposed buyout of the company.\u003c/p>\n\u003cp>The Securities and Exchange Commission announced the agreement Saturday, just two days after filing a case seeking to \u003ca href=\"https://www.kqed.org/news/11695040/sec-sues-tesla-ceo-elon-musk-for-securities-fraud\" rel=\"noopener\" target=\"_blank\">oust Musk as CEO\u003c/a>.\u003c/p>\n\u003cp>Musk has agreed to pay a $20 million fine and resign as chairman of Tesla's Board of Directors within 45 days, \u003ca href=\"https://www.documentcloud.org/documents/4951959-Musk.html\" rel=\"noopener\" target=\"_blank\">according to the settlement\u003c/a>, which is subject to court approval. Musk will be required to relinquish his role as chairman for at least three years, but he will be able to remain as CEO.\u003c/p>\n\u003cp>The suit by the SEC stemmed from an Aug. 7, 2018 \u003ca href=\"https://twitter.com/elonmusk/status/1026872652290379776\" rel=\"noopener\" target=\"_blank\">tweet\u003c/a> by Musk saying that he was considering taking the publicly-held Tesla private at $420 per share. The SEC said the tweet was not based in fact and led to \"significant market disruption.\"\u003c/p>\n\u003cp>The SEC also announced a \u003ca href=\"https://www.sec.gov/news/press-release/2018-226\" rel=\"noopener\" target=\"_blank\">settlement with Tesla\u003c/a> over its failure to have procedures in place to determine whether Musk's tweets included information that would need to be disclosed in SEC filings \"despite notifying the market in 2013 that it intended to use Musk’s Twitter account as a means of announcing material information about Tesla and encouraging investors to review Musk’s tweets.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As part of the settlement, Tesla will replace Musk with an \"independent Chairman,\" appoint two new independent directors to its board and establish additional controls and procedures to oversee Musk’s communications — including his tweets. The company will also pay its own $20 million fine, which combined with Musk's $20 million, will be \"distributed to harmed investors under a court-approved process.\"\u003c/p>\n\u003cp>“The total package of remedies and relief announced today are specifically designed to address the misconduct at issue by strengthening Tesla’s corporate governance and oversight in order to protect investors,” said Stephanie Avakian, Co-Director of the SEC’s Enforcement Division in a statement.\u003c/p>\n\u003cp>As part of his settlement, Musk agreed to comply with the new oversight of his personal communications related to the company, including receiving pre-approval of any communications that could contain information related to Tesla or its shareholders.\u003c/p>\n\u003cp>Musk reportedly \u003ca href=\"https://www.cnbc.com/2018/09/28/teslas-musk-pulled-plug-on-settlement-with-sec-at-last-minute.html\" rel=\"noopener\" target=\"_blank\">turned down an offer\u003c/a> from the SEC on Thursday that would've kept him from being chairman for two years and forced him to pay a fine. Tesla's stock plummeted 14 percent Friday after the SEC filed its lawsuit, erasing more than $7 billion in shareholder wealth.\u003c/p>\n\u003cp>Representatives from Tesla declined to comment on the settlement.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Reporting from the Associated Press was used in this post.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cb>Congressman Adam Schiff Weighs in on Kavanaugh Nomination Process\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Today the Senate Judiciary Committee voted along party lines to advance Brett Kavanaugh’s Supreme Court nomination to the full Senate floor. In a dramatic move, Republican Arizona Sen. Jeff Flake voted yes, but said the FBI should have a week to investigate allegations brought by Dr. Christine Blasey Ford against Judge Kavanaugh. This comes just one day after a riveting hearing in which Ford and Kavanaugh both testified about an alleged sexual assault when they were in high school. We get reaction from Southern California congressman\u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\"> Adam Schiff (D-Burbank)\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\">.\u003c/span>\u003c/p>\n\u003cp>\u003cb>2018 Election Coverage: Lt. Gov. Gavin Newsom\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">With about five weeks to go until Election Day, a new poll from the Public Policy Institute of California shows the race for governor is tightening. Among likely voters, Democrat Gavin Newsom’s lead is shrinking, but he still leads Republican John Cox by 12 points. The two candidates differ over a host of issues, including immigration and whether to repeal the gas tax. As part of our election coverage, KQED Politics and Government Senior Editor Scott Shafer sat down with gubernatorial candidate \u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\">Lt. Gov. Gavin Newsom\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\">.\u003c/span>\u003c/p>\n\u003cp>\u003cb>The Markup\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">A new nonprofit news organization is taking aim at the power of tech companies and their impact on our lives. Launching next year, The Markup will be led by journalists previously with ProPublica, who pioneered the use of data to reveal the discriminatory effects of software. The organization aims to examine discrimination in advertising, the workplace and within our court system.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guests:\u003c/span>\u003c/p>\n\u003cp> \u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003ci>\u003cspan style=\"font-weight: 400\">Julia Angwin\u003c/span>\u003cspan style=\"font-weight: 400\">, The Markup editor-in-chief\u003c/span>\u003c/i>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003ci>Jeff Larson\u003c/i>, The Markup managing editor\u003c/li>\n\u003c/ul>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>Congressman Adam Schiff Weighs in on Kavanaugh Nomination Process\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Today the Senate Judiciary Committee voted along party lines to advance Brett Kavanaugh’s Supreme Court nomination to the full Senate floor. In a dramatic move, Republican Arizona Sen. Jeff Flake voted yes, but said the FBI should have a week to investigate allegations brought by Dr. Christine Blasey Ford against Judge Kavanaugh. This comes just one day after a riveting hearing in which Ford and Kavanaugh both testified about an alleged sexual assault when they were in high school. We get reaction from Southern California congressman\u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\"> Adam Schiff (D-Burbank)\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\">.\u003c/span>\u003c/p>\n\u003cp>\u003cb>2018 Election Coverage: Lt. Gov. Gavin Newsom\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">With about five weeks to go until Election Day, a new poll from the Public Policy Institute of California shows the race for governor is tightening. Among likely voters, Democrat Gavin Newsom’s lead is shrinking, but he still leads Republican John Cox by 12 points. The two candidates differ over a host of issues, including immigration and whether to repeal the gas tax. As part of our election coverage, KQED Politics and Government Senior Editor Scott Shafer sat down with gubernatorial candidate \u003c/span>\u003ci>\u003cspan style=\"font-weight: 400\">Lt. Gov. Gavin Newsom\u003c/span>\u003c/i>\u003cspan style=\"font-weight: 400\">.\u003c/span>\u003c/p>\n\u003cp>\u003cb>The Markup\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">A new nonprofit news organization is taking aim at the power of tech companies and their impact on our lives. Launching next year, The Markup will be led by journalists previously with ProPublica, who pioneered the use of data to reveal the discriminatory effects of software. The organization aims to examine discrimination in advertising, the workplace and within our court system.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Guests:\u003c/span>\u003c/p>\n\u003cp> \u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003ci>\u003cspan style=\"font-weight: 400\">Julia Angwin\u003c/span>\u003cspan style=\"font-weight: 400\">, The Markup editor-in-chief\u003c/span>\u003c/i>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003ci>Jeff Larson\u003c/i>, The Markup managing editor\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Facebook \u003ca href=\"https://newsroom.fb.com/news/2018/09/security-update/\" rel=\"noopener\" target=\"_blank\">disclosed Friday a widespread security flaw\u003c/a> that allowed hackers to access user accounts. The breach has impacted around 50 million people. As a security measure, Facebook says about 90 million users have been required to log back into their accounts which effectively “resets” their digital key.\u003c/p>\n\u003cp>“This a serious issue, and we’re very focused on addressing it and it’s why we’ve patched the vulnerability,” Facebook CEO Mark Zuckerberg said during a conference call with reporters.\u003c/p>\n\u003cp>Engineers discovered the attack on Tuesday. According to Zuckerberg, the hackers found a vulnerability in the code of what’s called the “View As” feature, which is a privacy function that allows users to see what their Facebook profile looks like to another person. This breach allowed the hackers to access a digital key, which the hackers could have used to take over users accounts. The “View As” feature has temporarily been shut off while Facebook conducts a security review.\u003c/p>\n\u003cp>Guy Rosen, Facebook’s vice president of product management, said during the conference call that it is not clear who might have been behind the attack. Rosen says the company is still assessing the scope of the attack and is in the beginning stages of its investigation. Rosen says they’ve called on the help of the FBI and in light of General Data Protection Regulation laws, notified the Irish Data Commission of the breach.\u003c/p>\n\u003cp>“The timing is bad, it’s really the worst time for Facebook,” cybersecurity expert and San Jose State University professor Ahmed Banafa said. “They’re under the microscope.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Over the last year, the Securities and Exchange Commission and the FBI joined the Justice Department and Federal Trade Commission to investigate how the political analytics firm Cambridge Analytica, purchased data on 87 million users of Facebook without their consent. There is also mounting pressure from politicians to regulate companies like Facebook. \u003c/p>\n\u003cp>Banafa says Facebook's transparency about this breach is a good sign, but it can only go so far, and privacy is what users want. \u003c/p>\n\u003cp>“Privacy gives me the assurance that my data will not be used without my permission because of your fault or somebody else's,” Banafa said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>News of this security breach came hours after Taiwanese hacker Chang Chi-yuan pledged to delete Zuckerberg’s personal page on Sunday as a way to demonstrate Facebook security flaws. Rosen says Facebook is aware of the threat, but they have no indication it is related to the latest security breach.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Facebook \u003ca href=\"https://newsroom.fb.com/news/2018/09/security-update/\" rel=\"noopener\" target=\"_blank\">disclosed Friday a widespread security flaw\u003c/a> that allowed hackers to access user accounts. The breach has impacted around 50 million people. As a security measure, Facebook says about 90 million users have been required to log back into their accounts which effectively “resets” their digital key.\u003c/p>\n\u003cp>“This a serious issue, and we’re very focused on addressing it and it’s why we’ve patched the vulnerability,” Facebook CEO Mark Zuckerberg said during a conference call with reporters.\u003c/p>\n\u003cp>Engineers discovered the attack on Tuesday. According to Zuckerberg, the hackers found a vulnerability in the code of what’s called the “View As” feature, which is a privacy function that allows users to see what their Facebook profile looks like to another person. This breach allowed the hackers to access a digital key, which the hackers could have used to take over users accounts. The “View As” feature has temporarily been shut off while Facebook conducts a security review.\u003c/p>\n\u003cp>Guy Rosen, Facebook’s vice president of product management, said during the conference call that it is not clear who might have been behind the attack. Rosen says the company is still assessing the scope of the attack and is in the beginning stages of its investigation. Rosen says they’ve called on the help of the FBI and in light of General Data Protection Regulation laws, notified the Irish Data Commission of the breach.\u003c/p>\n\u003cp>“The timing is bad, it’s really the worst time for Facebook,” cybersecurity expert and San Jose State University professor Ahmed Banafa said. “They’re under the microscope.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>\u003cstrong>Updated at 6:03 p.m. ET\u003c/strong>\u003c/p>\n\u003cp>The U.S. Securities and Exchange Commission is suing Tesla CEO Elon Musk, alleging securities fraud a month after he announced that he planned to take the publicly traded electric car company private.\u003c/p>\n\u003cp>\"Musk's false and misleading public statements and omissions caused significant confusion and disruption in the market for Tesla's stock and resulting harm to investors,\" the \u003ca href=\"https://www.scribd.com/document/389617063/United-States-Securities-and-Exchange-Commission-v-Musk#fullscreen&from_embed\">lawsuit \u003c/a>says.\u003c/p>\n\u003cp>The SEC is asking the court to ban Musk from acting as an officer or director of any publicly traded company. In addition to being at the helm of Tesla, he's also the CEO and founder of SpaceX.\u003c/p>\n\u003cp>Musk denies the allegations of wrongdoing and insists he did not mislead investors.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"This unjustified action by the SEC leaves me deeply saddened and disappointed. I have always taken action in the best interests of truth, transparency and investors,\" Musk told NPR in an emailed statement.\u003c/p>\n\u003cp>\"Integrity is the most important value in my life and the facts will show I never compromised this in any way,\" he added.\u003c/p>\n\u003cp>The case stems from an Aug. 7 tweet in which Musk \u003ca href=\"https://twitter.com/elonmusk/status/1026872652290379776\">boasted \u003c/a>that he could take Tesla private at $420 a share — a significant premium over its price at the time — and that funding for the switch was \"secured.\"\u003c/p>\n\u003cp>https://twitter.com/elonmusk/status/1026872652290379776\u003c/p>\n\u003cp>Those eight words were enough to send the stock soaring — up by nearly \u003ca href=\"https://www.npr.org/2018/08/07/636412162/8-years-after-going-public-elon-musk-wants-to-take-tesla-private\">11 percent\u003c/a> by the end of the day.\u003c/p>\n\u003cp>Musk later posted that the only thing he needed to take Tesla private was a shareholder vote.\u003c/p>\n\u003cp>The SEC complaint says that \"Musk had not even discussed, much less confirmed, key deal terms, including price with any potential funding source.\"\u003c/p>\n\u003cp>It alleges the 47-year-old \"knew or was reckless in not knowing that each of these statements was false and/or misleading because he did not have an adequate basis in fact for his assertions.\"\u003c/p>\n\u003cp>As NPR's Sasha Ingber \u003ca href=\"https://www.npr.org/2018/09/18/649313979/tesla-is-under-investigation-by-the-justice-department\">reported\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\"Musk said [later] his tweet was prompted by \u003ca href=\"https://www.npr.org/2018/08/13/638176030/elon-musk-says-saudi-investment-fund-could-help-him-take-tesla-private\">Saudi Arabia's sovereign wealth fund\u003c/a>, which brought up the possibility of taking the company private. Tesla later admitted that it did not have the funding for the deal, and less than three weeks after his tweet, Musk walked back the prospect of going private.\u003c/p>\n\u003cp>\"Short-sellers who had anticipated that Tesla's stock would fall said Musk's tweet was meant to manipulate the shares, according to the Associated Press.\"\u003c/p>\u003c/blockquote>\n\u003cp>In a \u003ca href=\"https://www.tesla.com/blog/taking-tesla-private?redirect=no\">statement\u003c/a> on Tesla's website following the initial tweet, Musk provided an explanation for setting the stock price at $420, writing that he had calculated the price per share based on a \"20% premium over the stock price following our Q2 earnings call (which had already increased by 16%). \"\u003c/p>\n\u003cp>The court documents note the calculation resulted in a price of $419, but that Musk later admitted he had added the extra dollar — $420 — \"because he had recently learned about the number's significance in marijuana culture and thought his girlfriend 'would find it funny, which admittedly is not a great reason to pick a price.' \"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Tesla stock was down nearly 10 percent in after-hours trading.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=SEC+Sues+Tesla+CEO+Elon+Musk+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>Those eight words were enough to send the stock soaring — up by nearly \u003ca href=\"https://www.npr.org/2018/08/07/636412162/8-years-after-going-public-elon-musk-wants-to-take-tesla-private\">11 percent\u003c/a> by the end of the day.\u003c/p>\n\u003cp>Musk later posted that the only thing he needed to take Tesla private was a shareholder vote.\u003c/p>\n\u003cp>The SEC complaint says that \"Musk had not even discussed, much less confirmed, key deal terms, including price with any potential funding source.\"\u003c/p>\n\u003cp>It alleges the 47-year-old \"knew or was reckless in not knowing that each of these statements was false and/or misleading because he did not have an adequate basis in fact for his assertions.\"\u003c/p>\n\u003cp>As NPR's Sasha Ingber \u003ca href=\"https://www.npr.org/2018/09/18/649313979/tesla-is-under-investigation-by-the-justice-department\">reported\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\"Musk said [later] his tweet was prompted by \u003ca href=\"https://www.npr.org/2018/08/13/638176030/elon-musk-says-saudi-investment-fund-could-help-him-take-tesla-private\">Saudi Arabia's sovereign wealth fund\u003c/a>, which brought up the possibility of taking the company private. Tesla later admitted that it did not have the funding for the deal, and less than three weeks after his tweet, Musk walked back the prospect of going private.\u003c/p>\n\u003cp>\"Short-sellers who had anticipated that Tesla's stock would fall said Musk's tweet was meant to manipulate the shares, according to the Associated Press.\"\u003c/p>\u003c/blockquote>\n\u003cp>In a \u003ca href=\"https://www.tesla.com/blog/taking-tesla-private?redirect=no\">statement\u003c/a> on Tesla's website following the initial tweet, Musk provided an explanation for setting the stock price at $420, writing that he had calculated the price per share based on a \"20% premium over the stock price following our Q2 earnings call (which had already increased by 16%). \"\u003c/p>\n\u003cp>The court documents note the calculation resulted in a price of $419, but that Musk later admitted he had added the extra dollar — $420 — \"because he had recently learned about the number's significance in marijuana culture and thought his girlfriend 'would find it funny, which admittedly is not a great reason to pick a price.' \"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Tesla stock was down nearly 10 percent in after-hours trading.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=SEC+Sues+Tesla+CEO+Elon+Musk+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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