Telehealth Is Having a Huge Moment During Coronavirus Crisis
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FDA Says It Will Overhaul Long-Criticized System for Approving Medical Devices
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Video visits and conversations are the closest doctors can get to patients who are sheltering in place and avoiding potential exposure from doctor visits.\u003c/p>\n\u003cp>[pullquote citation=\"Dr. Mark Henderson, UC Davis School of Medicine\"]‘Because of COVID-19…it has accelerated all of these ideas and it’s totally exploded our thinking around what we can do with telemedicine in primary care.’[/pullquote]COVID-19 has catapulted telehealth — those virtual visits — into the mainstream more effectively than years of advocacy and policy-making. Experts and physicians are calling it a rare “silver lining” of the current crisis: An overnight availability of video and phone appointments for medical needs, especially in areas where doctors have been in short supply.\u003c/p>\n\u003cp>“COVID-19 has changed everything,” said Dr. Mark Henderson, professor of internal medicine and associate dean for admissions and outreach at UC Davis School of Medicine. “Because of COVID-19 we have all of this distance and it has accelerated all of these ideas and it’s totally exploded our thinking around what we can do with telemedicine in primary care.”\u003c/p>\n\u003cp>Telehealth has been in use for decades, long before smartphones or tablets, and California already was poised to expand options under several new laws passed last year. Initially, though, it was seen as a tool for rural communities and inner-city areas with a shortage of providers.\u003c/p>\n\u003cp>It took a change in regulations affecting billing during the pandemic to allow a dramatic pivot to telehealth, as much as 40% to 80% of patient visits in some health systems in recent weeks. The Department of Managed Health Care announced March 18 that all health plans must reimburse telehealth medical care at \u003ca href=\"http://www.dmhc.ca.gov/Portals/0/Docs/OPL/APL%2020-009%20(OPL)%20-%20Reimbursement%20for%20Telehealth%20Services%20(3_18_20).pdf?ver=2020-03-18-105612-547\" target=\"_blank\" rel=\"noopener noreferrer\">the same rate\u003c/a> as face-to-face appointments, and California’s Department of Health Care Services \u003ca href=\"https://www.dhcs.ca.gov/Documents/COVID-19/CA-1135-Waiver-COVID-19-031620.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">obtained a federal waiver\u003c/a> to allow similar Medi-Cal reimbursement. The federal government \u003ca href=\"https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet\" target=\"_blank\" rel=\"noopener noreferrer\">eased regulations on March 17\u003c/a> affecting Medicare payments to allow the same flexibility.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Medical providers say telehealth is especially important during the pandemic, allowing doctors to keep tabs on fragile patients, especially those with chronic conditions who are most vulnerable to falling ill from the coronavirus.\u003c/p>\n\u003cp>\u003cstrong>From Convenience to Necessity\u003c/strong>\u003c/p>\n\u003cp>Health systems that serve rural and inner-city areas already were investing in telehealth infrastructure to try to bridge the doctor shortage gap. Riverside County in the Inland Empire has only half the physicians it needs, for instance, so telehealth was one way to provide medical care in far-flung corners of the county.\u003c/p>\n\u003cp>Riverside University Health System, the county’s public health network, had offered limited primary care telehealth for patients facing transportation, childcare and work schedule problems. But telehealth mostly was used by behavioral health teams and those caring for incarcerated patients.\u003c/p>\n\u003cp>That’s changed. In the past week, the system’s medical center and 13 community health centers have handled 5,600 virtual visits by phone or video, accounting for two-thirds of all patient visits.\u003c/p>\n\u003cp>“This challenging situation right now has shown how telehealth can help us provide the right care in the right setting at the right time for people,” said Dr. Geoffrey Leung, chair of the family medicine department and ambulatory medical director at Riverside University Health System. He called the ingenuity behind telehealth “one of those silver linings during this difficult time for all of us.”\u003c/p>\n\u003cp>While Kaiser Permanente has had a telehealth program in place for years, under pandemic restrictions about 80% of the system’s appointments nationally are for video or phone calls.\u003c/p>\n\u003cp>\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1963157 alignright\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2020/04/RS42937_VIRTUAL-MEDICAL-VISITS-graphic-.jpg\" alt=\"\" width=\"550\" height=\"836\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2020/04/RS42937_VIRTUAL-MEDICAL-VISITS-graphic-.jpg 550w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/04/RS42937_VIRTUAL-MEDICAL-VISITS-graphic--160x243.jpg 160w\" sizes=\"(max-width: 550px) 100vw, 550px\">\u003c/p>\n\u003cp>“In the past, a lot of what we thought of in respect to telehealth was offering our patients choice and convenience,” said Dr. Edward Lee, the physician leader for telehealth at Kaiser Permanente. “Nowadays, because of COVID-19 and the shelter-in-place order, a lot of patients are seeing this as a necessity.”\u003c/p>\n\u003cp>Similarly, at UC San Diego Health, about half of all outpatient visits in recent weeks were through video, said Dr. Christopher Longhurst, chief information officer for the health system. Prior to the coronavirus outbreak, UCSD Health already had a well-established telehealth system in place, but still only about 1% of their outpatient visits were handled virtually.\u003c/p>\n\u003cp>“We did more video visits in the first three days of rolling it out broadly (during pandemic) than we had done in the previous three years,” Longhurst said.\u003c/p>\n\u003cp>Not all providers, however, were as experienced in the world of telehealth as Kaiser or the UC medical centers. Many didn’t have the infrastructure set up, administrators said, and others didn’t get reimbursed for telehealth visits prior to the pandemic. In underserved communities, some health clinics were not allowed to charge Medi-Cal for telehealth appointments until the requirement was waived because of the coronavirus.\u003c/p>\n\u003cp>AltaMed, a health center with sites in Los Angeles and Orange counties, began video and telephone visits on March 16, just days before the state issued its stay-at-home order. AltaMed had to spread the word quickly to let patients know they could keep their appointments, they would just look different.\u003c/p>\n\u003cp>Dr. Efrain Talamantes, medical director for the AltaMed’s Institute for Health Equity, said that for patients who didn’t have this option in the past, telehealth is a big deal.\u003c/p>\n\u003cp>“It’s allowed us to care for people in their own homes, so they can stay safe, they don’t have to take time away from their family or work and we can still make sure they have the care and medication they need,” Talamantes said.\u003c/p>\n\u003cp>A California law starting next year ensures at least some telehealth appointments will continue to be reimbursed at the same rate as in-person visits after the pandemic. Talamantes doesn’t yet know the impact on his clinic, he said, but thinks the coronavirus shows how useful remote services can be in communities with strapped resources and high poverty. Still, it doesn’t work for every type of visit — you can’t really do a physical exam over the phone, you can’t feel a bump or administer vaccines.\u003c/p>\n\u003cp>Henderson, of UC Davis, who described himself as a telehealth skeptic before the coronavirus, has been pleasantly surprised by how much can be done via video, such as examining a skin rash or a healing wound and assessing breathing or the color of a patient’s skin.\u003c/p>\n\u003cp>“I believe strongly in the power of putting your hands on a patient, the connection you form with patients when you lay your hands on them, that to me is something very fundamental and sacred in some ways,” he said. “But that doesn’t mean there isn’t a bigger role for telehealth.”\u003c/p>\n\u003cp>Being able to see the patient via video makes a huge difference, he said.\u003c/p>\n\u003cp>“It’s a whole new world when you can see them and they can see you. There are nonverbal clues that are visible and you can use to make a connection,” he said. “The video visit adds life to it.”\u003c/p>\n\u003cp>Telehealth also helps to screen patients for the coronavirus. UC Davis Health expanded its telehealth capacity as a way to check in with those who might be infected, Henderson said.\u003c/p>\n\u003cp>Medical providers across California have been screening patients suspected of possible COVID-19 infection using video and the phone and, if they meet testing criteria, directing patients to urgent care centers, emergency rooms or testing facilities such as the temporary tents set up in some clinic parking lots.\u003c/p>\n\u003cp>“We didn’t want them to come in, we wanted to figure out what they looked like and if they had symptoms,” Henderson said.\u003c/p>\n\u003cp>\u003cstrong>Keeping Offices Afloat\u003c/strong>\u003c/p>\n\u003cp>Even with the new payment rules for telehealth, medical visits are down across California. Health centers and private practices are struggling to stay open; for them, a drop in appointments means a drop in revenue. The California Primary Care Association, which oversees nearly 1,400 health centers in the state, has said that clinics are \u003ca href=\"https://calmatters.org/california-divide/2020/04/not-enough-patients-community-clinics-california/\" target=\"_blank\" rel=\"noopener noreferrer\">losing about $90 million a week collectively during the pandemic.\u003c/a>\u003c/p>\n\u003cp>Dr. Sumana Reddy runs Acacia Family Medical Group, a private practice with offices in Salinas and Prunedale in Monterey County. She said she’s scrambling to apply for every option to keep her business afloat, from loans for small businesses to advances from insurance providers.\u003c/p>\n\u003cp>“We’re working really hard to do what’s right by our patients and community and yet of course the irony is that it can lead to cash flow challenges,” Reddy said. “We were struggling to meet our payroll this last time.”\u003c/p>\n\u003cp>Full payment for telehealth patient care is a big help, she said.\u003c/p>\n\u003cp>“Without that I’m not sure what we would do,” Reddy said. “We made such a rapid pivot that we went within two weeks of never having even thought of telehealth to doing over 75% of our patients’ visits by telehealth.”\u003c/p>\n\u003cp>But video visits aren’t always the most efficient. Technology can be a barrier, especially with frail patients. Helping patients conduct a video visit is time and labor intensive.\u003c/p>\n\u003cp>“Imagine someone who is 80 years old, with pain, he has to look for an assistant to hold the phone, and we’re asking can you move the phone around to see the area. The entire process is so much slower,” she said. “It sounds like you could just replace a regular visit with a telehealth visit but actually there are many barriers there.”\u003c/p>\n\u003cp>While telehealth is necessary during these times, it can’t solve all of the issues, she said,\u003c/p>\n\u003cp>\u003cstrong>Rural California Still Needs Broadband\u003c/strong>\u003c/p>\n\u003cp>Medical providers in rural California are familiar with the technological barriers. Madera Community Hospital serves a region of California’s San Joaquin Valley with a 106-bed hospital and several community clinics. Telehealth there is mostly in the form of phone calls because many patients don’t have access to a smart phone or computer.\u003c/p>\n\u003cp>“We’re finding many patients don’t have fast enough internet to even do a telehealth visit,” said Karen Paolinelli, CEO of Madera Community Hospital. “When you take care of patients from all walks of life and different age groups, not everyone has the technology.”\u003c/p>\n\u003cp>But for those who can participate in a video visit, it helps with another big issue in rural areas, and that is transportation.\u003c/p>\n\u003cp>Paolinelli said she believes COVID-19 will forever change how they provide care.\u003c/p>\n\u003cp>“I don’t know that we can go back,” she said. “To have different ways to see patients — that’s access to care.”\u003c/p>\n\u003cp>Mei Kwong, executive director of the Center for Connected Health Policy, The National Telehealth Policy Resource Center, said the data from this period about how to use telehealth, when it is best and for whom, will be invaluable in creating a roadmap for the future.\u003c/p>\n\u003cp>“The genie is out of the bottle and you can’t let it back in, people have experienced this,” she said. “Not everybody is going to like it and people are going to want to see their providers but the option should be there.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://calmatters.org/\" target=\"_blank\" rel=\"noopener noreferrer\">CalMatters.org\u003c/a> is a nonprofit, nonpartisan media venture explaining California policies and politics.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Virtual medical visits are the new normal during the coronavirus pandemic.","status":"publish","parent":0,"modified":1704847512,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":48,"wordCount":1976},"headData":{"title":"Telehealth Is Having a Huge Moment During Coronavirus Crisis | KQED","description":"Virtual medical visits are the new normal during the coronavirus pandemic.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Telehealth Is Having a Huge Moment During Coronavirus Crisis","datePublished":"2020-04-28T18:50:45.000Z","dateModified":"2024-01-10T00:45:12.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"source":"Calmatters","sticky":false,"nprByline":"Ana B. Ibarra and Elizabeth Aguilera \u003cbr />Calmatters\u003cbr>","path":"/science/1963133/telehealth-is-having-a-huge-moment-during-coronavirus-crisis","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>California doctors are diagnosing anything from appendicitis to strep throat with only a phone during the coronavirus pandemic. Video visits and conversations are the closest doctors can get to patients who are sheltering in place and avoiding potential exposure from doctor visits.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘Because of COVID-19…it has accelerated all of these ideas and it’s totally exploded our thinking around what we can do with telemedicine in primary care.’","name":"pullquote","attributes":{"named":{"citation":"Dr. Mark Henderson, UC Davis School of Medicine","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>COVID-19 has catapulted telehealth — those virtual visits — into the mainstream more effectively than years of advocacy and policy-making. Experts and physicians are calling it a rare “silver lining” of the current crisis: An overnight availability of video and phone appointments for medical needs, especially in areas where doctors have been in short supply.\u003c/p>\n\u003cp>“COVID-19 has changed everything,” said Dr. Mark Henderson, professor of internal medicine and associate dean for admissions and outreach at UC Davis School of Medicine. “Because of COVID-19 we have all of this distance and it has accelerated all of these ideas and it’s totally exploded our thinking around what we can do with telemedicine in primary care.”\u003c/p>\n\u003cp>Telehealth has been in use for decades, long before smartphones or tablets, and California already was poised to expand options under several new laws passed last year. Initially, though, it was seen as a tool for rural communities and inner-city areas with a shortage of providers.\u003c/p>\n\u003cp>It took a change in regulations affecting billing during the pandemic to allow a dramatic pivot to telehealth, as much as 40% to 80% of patient visits in some health systems in recent weeks. The Department of Managed Health Care announced March 18 that all health plans must reimburse telehealth medical care at \u003ca href=\"http://www.dmhc.ca.gov/Portals/0/Docs/OPL/APL%2020-009%20(OPL)%20-%20Reimbursement%20for%20Telehealth%20Services%20(3_18_20).pdf?ver=2020-03-18-105612-547\" target=\"_blank\" rel=\"noopener noreferrer\">the same rate\u003c/a> as face-to-face appointments, and California’s Department of Health Care Services \u003ca href=\"https://www.dhcs.ca.gov/Documents/COVID-19/CA-1135-Waiver-COVID-19-031620.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">obtained a federal waiver\u003c/a> to allow similar Medi-Cal reimbursement. The federal government \u003ca href=\"https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet\" target=\"_blank\" rel=\"noopener noreferrer\">eased regulations on March 17\u003c/a> affecting Medicare payments to allow the same flexibility.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Medical providers say telehealth is especially important during the pandemic, allowing doctors to keep tabs on fragile patients, especially those with chronic conditions who are most vulnerable to falling ill from the coronavirus.\u003c/p>\n\u003cp>\u003cstrong>From Convenience to Necessity\u003c/strong>\u003c/p>\n\u003cp>Health systems that serve rural and inner-city areas already were investing in telehealth infrastructure to try to bridge the doctor shortage gap. Riverside County in the Inland Empire has only half the physicians it needs, for instance, so telehealth was one way to provide medical care in far-flung corners of the county.\u003c/p>\n\u003cp>Riverside University Health System, the county’s public health network, had offered limited primary care telehealth for patients facing transportation, childcare and work schedule problems. But telehealth mostly was used by behavioral health teams and those caring for incarcerated patients.\u003c/p>\n\u003cp>That’s changed. In the past week, the system’s medical center and 13 community health centers have handled 5,600 virtual visits by phone or video, accounting for two-thirds of all patient visits.\u003c/p>\n\u003cp>“This challenging situation right now has shown how telehealth can help us provide the right care in the right setting at the right time for people,” said Dr. Geoffrey Leung, chair of the family medicine department and ambulatory medical director at Riverside University Health System. He called the ingenuity behind telehealth “one of those silver linings during this difficult time for all of us.”\u003c/p>\n\u003cp>While Kaiser Permanente has had a telehealth program in place for years, under pandemic restrictions about 80% of the system’s appointments nationally are for video or phone calls.\u003c/p>\n\u003cp>\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1963157 alignright\" src=\"https://ww2.kqed.org/app/uploads/sites/35/2020/04/RS42937_VIRTUAL-MEDICAL-VISITS-graphic-.jpg\" alt=\"\" width=\"550\" height=\"836\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2020/04/RS42937_VIRTUAL-MEDICAL-VISITS-graphic-.jpg 550w, https://cdn.kqed.org/wp-content/uploads/sites/35/2020/04/RS42937_VIRTUAL-MEDICAL-VISITS-graphic--160x243.jpg 160w\" sizes=\"(max-width: 550px) 100vw, 550px\">\u003c/p>\n\u003cp>“In the past, a lot of what we thought of in respect to telehealth was offering our patients choice and convenience,” said Dr. Edward Lee, the physician leader for telehealth at Kaiser Permanente. “Nowadays, because of COVID-19 and the shelter-in-place order, a lot of patients are seeing this as a necessity.”\u003c/p>\n\u003cp>Similarly, at UC San Diego Health, about half of all outpatient visits in recent weeks were through video, said Dr. Christopher Longhurst, chief information officer for the health system. Prior to the coronavirus outbreak, UCSD Health already had a well-established telehealth system in place, but still only about 1% of their outpatient visits were handled virtually.\u003c/p>\n\u003cp>“We did more video visits in the first three days of rolling it out broadly (during pandemic) than we had done in the previous three years,” Longhurst said.\u003c/p>\n\u003cp>Not all providers, however, were as experienced in the world of telehealth as Kaiser or the UC medical centers. Many didn’t have the infrastructure set up, administrators said, and others didn’t get reimbursed for telehealth visits prior to the pandemic. In underserved communities, some health clinics were not allowed to charge Medi-Cal for telehealth appointments until the requirement was waived because of the coronavirus.\u003c/p>\n\u003cp>AltaMed, a health center with sites in Los Angeles and Orange counties, began video and telephone visits on March 16, just days before the state issued its stay-at-home order. AltaMed had to spread the word quickly to let patients know they could keep their appointments, they would just look different.\u003c/p>\n\u003cp>Dr. Efrain Talamantes, medical director for the AltaMed’s Institute for Health Equity, said that for patients who didn’t have this option in the past, telehealth is a big deal.\u003c/p>\n\u003cp>“It’s allowed us to care for people in their own homes, so they can stay safe, they don’t have to take time away from their family or work and we can still make sure they have the care and medication they need,” Talamantes said.\u003c/p>\n\u003cp>A California law starting next year ensures at least some telehealth appointments will continue to be reimbursed at the same rate as in-person visits after the pandemic. Talamantes doesn’t yet know the impact on his clinic, he said, but thinks the coronavirus shows how useful remote services can be in communities with strapped resources and high poverty. Still, it doesn’t work for every type of visit — you can’t really do a physical exam over the phone, you can’t feel a bump or administer vaccines.\u003c/p>\n\u003cp>Henderson, of UC Davis, who described himself as a telehealth skeptic before the coronavirus, has been pleasantly surprised by how much can be done via video, such as examining a skin rash or a healing wound and assessing breathing or the color of a patient’s skin.\u003c/p>\n\u003cp>“I believe strongly in the power of putting your hands on a patient, the connection you form with patients when you lay your hands on them, that to me is something very fundamental and sacred in some ways,” he said. “But that doesn’t mean there isn’t a bigger role for telehealth.”\u003c/p>\n\u003cp>Being able to see the patient via video makes a huge difference, he said.\u003c/p>\n\u003cp>“It’s a whole new world when you can see them and they can see you. There are nonverbal clues that are visible and you can use to make a connection,” he said. “The video visit adds life to it.”\u003c/p>\n\u003cp>Telehealth also helps to screen patients for the coronavirus. UC Davis Health expanded its telehealth capacity as a way to check in with those who might be infected, Henderson said.\u003c/p>\n\u003cp>Medical providers across California have been screening patients suspected of possible COVID-19 infection using video and the phone and, if they meet testing criteria, directing patients to urgent care centers, emergency rooms or testing facilities such as the temporary tents set up in some clinic parking lots.\u003c/p>\n\u003cp>“We didn’t want them to come in, we wanted to figure out what they looked like and if they had symptoms,” Henderson said.\u003c/p>\n\u003cp>\u003cstrong>Keeping Offices Afloat\u003c/strong>\u003c/p>\n\u003cp>Even with the new payment rules for telehealth, medical visits are down across California. Health centers and private practices are struggling to stay open; for them, a drop in appointments means a drop in revenue. The California Primary Care Association, which oversees nearly 1,400 health centers in the state, has said that clinics are \u003ca href=\"https://calmatters.org/california-divide/2020/04/not-enough-patients-community-clinics-california/\" target=\"_blank\" rel=\"noopener noreferrer\">losing about $90 million a week collectively during the pandemic.\u003c/a>\u003c/p>\n\u003cp>Dr. Sumana Reddy runs Acacia Family Medical Group, a private practice with offices in Salinas and Prunedale in Monterey County. She said she’s scrambling to apply for every option to keep her business afloat, from loans for small businesses to advances from insurance providers.\u003c/p>\n\u003cp>“We’re working really hard to do what’s right by our patients and community and yet of course the irony is that it can lead to cash flow challenges,” Reddy said. “We were struggling to meet our payroll this last time.”\u003c/p>\n\u003cp>Full payment for telehealth patient care is a big help, she said.\u003c/p>\n\u003cp>“Without that I’m not sure what we would do,” Reddy said. “We made such a rapid pivot that we went within two weeks of never having even thought of telehealth to doing over 75% of our patients’ visits by telehealth.”\u003c/p>\n\u003cp>But video visits aren’t always the most efficient. Technology can be a barrier, especially with frail patients. Helping patients conduct a video visit is time and labor intensive.\u003c/p>\n\u003cp>“Imagine someone who is 80 years old, with pain, he has to look for an assistant to hold the phone, and we’re asking can you move the phone around to see the area. The entire process is so much slower,” she said. “It sounds like you could just replace a regular visit with a telehealth visit but actually there are many barriers there.”\u003c/p>\n\u003cp>While telehealth is necessary during these times, it can’t solve all of the issues, she said,\u003c/p>\n\u003cp>\u003cstrong>Rural California Still Needs Broadband\u003c/strong>\u003c/p>\n\u003cp>Medical providers in rural California are familiar with the technological barriers. Madera Community Hospital serves a region of California’s San Joaquin Valley with a 106-bed hospital and several community clinics. Telehealth there is mostly in the form of phone calls because many patients don’t have access to a smart phone or computer.\u003c/p>\n\u003cp>“We’re finding many patients don’t have fast enough internet to even do a telehealth visit,” said Karen Paolinelli, CEO of Madera Community Hospital. “When you take care of patients from all walks of life and different age groups, not everyone has the technology.”\u003c/p>\n\u003cp>But for those who can participate in a video visit, it helps with another big issue in rural areas, and that is transportation.\u003c/p>\n\u003cp>Paolinelli said she believes COVID-19 will forever change how they provide care.\u003c/p>\n\u003cp>“I don’t know that we can go back,” she said. “To have different ways to see patients — that’s access to care.”\u003c/p>\n\u003cp>Mei Kwong, executive director of the Center for Connected Health Policy, The National Telehealth Policy Resource Center, said the data from this period about how to use telehealth, when it is best and for whom, will be invaluable in creating a roadmap for the future.\u003c/p>\n\u003cp>“The genie is out of the bottle and you can’t let it back in, people have experienced this,” she said. “Not everybody is going to like it and people are going to want to see their providers but the option should be there.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://calmatters.org/\" target=\"_blank\" rel=\"noopener noreferrer\">CalMatters.org\u003c/a> is a nonprofit, nonpartisan media venture explaining California policies and politics.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1963133/telehealth-is-having-a-huge-moment-during-coronavirus-crisis","authors":["byline_science_1963133"],"categories":["science_3151","science_39","science_3890","science_40","science_4450"],"tags":["science_3969","science_4329","science_4414","science_5181","science_3838"],"featImg":"science_1963160","label":"source_science_1963133"},"science_1938819":{"type":"posts","id":"science_1938819","meta":{"index":"posts_1591205157","site":"science","id":"1938819","score":null,"sort":[1551980825000]},"guestAuthors":[],"slug":"some-kids-are-just-more-sensitive-and-heres-the-science-to-show-it","title":"Some Kids Are Just More Sensitive, and Here's the Science to Show It","publishDate":1551980825,"format":"standard","headTitle":"Some Kids Are Just More Sensitive, and Here’s the Science to Show It | KQED","labelTerm":{},"content":"\u003cp>Dr. Thomas Boyce, an emeritus professor of pediatrics and psychiatry at the University of California, San Francisco, has treated children who seem to be completely unflappable and unfazed by their surroundings — as well as those who are extremely sensitive to their environments. Over the years, he began to liken these two types of children to two very different flowers: dandelions and orchids.\u003c/p>\n\u003cp>Broadly speaking, says \u003ca href=\"https://profiles.ucsf.edu/tom.boyce\" target=\"_blank\" rel=\"noopener\">Boyce\u003c/a> — who also has spent nearly 40 years studying the human stress response, especially in children — most kids tend to be like dandelions, fairly resilient and able to cope with stress and adversity in their lives. But a minority of kids, those he calls “orchid children,” are more sensitive and biologically reactive to their circumstances, which makes it harder for them to deal with stressful situations.[contextly_sidebar id=”IvCr36i4S1EYhLjR3xMTzjOHrdmBka5u”]\u003c/p>\n\u003cp>Like the flower, Boyce says, “the orchid child is the child who shows great sensitivity and susceptibility to both bad and good environments in which he or she finds herself or himself.”\u003c/p>\n\u003cp>Given supportive, nurturing conditions, orchid children can thrive — especially, Boyce says, if they have the comfort of a regular routine.\u003c/p>\n\u003cp>“Orchid children seem to thrive on having things like dinner every night in the same place at the same time with the same people, having certain kinds of rituals that the family goes through week to week, month to month,” he says. “This kind of routine and sameness of life from day to day, week to week, seems to be something that is helpful to kids with these great susceptibilities.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Boyce’s new book is \u003cem>The Orchid and the Dandelion: Why Some Children Struggle and How All Can Thri\u003c/em>ve\u003cem>. \u003c/em>He appeared this week on \u003ca href=\"https://www.npr.org/programs/fresh-air/2019/03/04/699939149\" target=\"_blank\" rel=\"noopener\">Fresh Air\u003c/a> with host Dave Davies to discuss it.\u003cem>\u003cbr>\n\u003c/em>\u003c/p>\n\u003chr>\n\u003cp>\u003cstrong>Interview highlights:\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>On the lab test he did to determine if a child is an orchid or a dandelion\u003c/strong>\u003c/p>\n\u003cp>We made an effort to try to understand these individual differences between children in how they respond biologically to mild, common kinds of challenges and stressors, and the way we did that was we brought them into a laboratory setting. We sat them down in front of an examiner — a research assistant that they had not previously met — and we asked them to go through a series of mildly challenging tasks. These were things like recounting a series of digits that the examiner asked them to say and increasing that from first three to four to five digits; having them just engage in a conversation with this examiner, who might ask them about their birthday or presents or something about their family. That, in itself, is a challenge for a young child. Putting a drop of lemon juice on the tongue was another kind of challenge that was evocative of these changes in biological response. …\u003c/p>\n\u003cp>We measured their stress response using the two primary stress response systems in the human brain. [One was] the \u003ca href=\"http://www.yourhormones.info/hormones/cortisol/\" target=\"_blank\" rel=\"noopener\">cortisol system\u003c/a>, which is centered in the hypothalamus of the brain. This is the system that releases the stress hormone cortisol, which has profound effects on both immune function and cardiovascular functioning.\u003c/p>\n\u003cp>And then the second stress response system is the \u003ca href=\"https://faculty.washington.edu/chudler/auto.html\" target=\"_blank\" rel=\"noopener\">autonomic nervous system\u003c/a>, or the “fight-or-flight” system. This is the one that is responsible for the sweaty palms and a little bit of tremulousness, the dilation of the pupils, all of these things that we associate with the fight-or-flight response. So we were monitoring responsivity and both of those systems as the children went through these mildly challenging tasks. …\u003c/p>\n\u003cp>We found that there were huge differences [among] children. There were some children at the high end of the spectrum, who had dramatic reactivity in both the cortisol system and the fight-or-flight system, and there were other children who had almost no biological response to the challenges that we presented to them.\u003c/p>\n\u003cp>\u003cstrong>On how a child’s responsivity to stressors can be connected to physical and emotional behavioral outcomes\u003c/strong>\u003c/p>\n\u003cp>We find in our research that the same kinds of patterns of response are found for both physical illnesses, like severe respiratory disease, pneumonia, asthma and so on, as well as or more [in] emotional behavioral outcomes, like anxiety and depression and externalizing kinds of symptoms. So we believe that the same patterns of susceptibility that we find in the orchid child versus the dandelion child work themselves out not only for physical ailments but also for psychosocial and emotional problems. And we believe that the same kinds of underlying biological processes work for both. …\u003c/p>\n\u003cp>We do know, for example, that these two stress response systems … the cortisol system and the fight-or-flight system, the autonomic nervous system, both of those have powerful effects on the immune system, so they can alter the child’s ability to build an immune defense against viruses and bacteria that he or she may be exposed to. And they have also powerful effects on the cardiovascular system, so [they] could eventually, in adult life, predispose to developing hypertension, high blood pressure or other kinds of cardiovascular risk.\u003c/p>\n\u003cp>\u003cstrong>On how children’s experiences can vary, even within the same family\u003c/strong>\u003c/p>\n\u003cp>The experience of children within a given family, the siblings within a family — although they are being reared with the same parents in the same house in the same neighborhood — they actually have quite different kinds of experiences that depend upon the birth order of the child, the gender of the child, to some extent differences in genetic sequence. It is a way of talking about these dramatic differences that kids from different birth orders and different genders have within a given family.\u003c/p>\n\u003cp>\u003cstrong>On pushing orchid kids to stretch to do new or difficult things\u003c/strong>\u003c/p>\n\u003cp>I think that this is probably the most difficult parenting task in raising an orchid child. The parent of an orchid child needs to walk this very fine line between, on the one hand, not pushing them into circumstances that are really going to overwhelm them and make them greatly fearful, but, on the other hand, not protecting them so much that they don’t have experiences of mastery of these kinds of fearful situations.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Sam Briger and Seth Kelley produced and edited the \u003ca href=\"https://www.npr.org/sections/health-shots/2019/03/04/699979387/is-your-child-an-orchid-or-a-dandelion-unlocking-the-science-of-sensitive-kids\" target=\"_blank\" rel=\"noopener\">audio version\u003c/a> of this interview, which aired on Fresh Air. Bridget Bentz and Molly Seavy-Nesper adapted it for the Web.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2019 \u003ca href=\"https://www.npr.org/programs/fresh-air/\" target=\"_blank\" rel=\"noopener\">Fresh Air\u003c/a>.\u003c/em>\u003c/div>\n\n","blocks":[],"excerpt":"Some kids seem resilient from the start — readily able to cope with stress and adversity. But pediatrician Thomas Boyce says biologically reactive kids need more support to thrive.","status":"publish","parent":0,"modified":1704848815,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":1090},"headData":{"title":"Some Kids Are Just More Sensitive, and Here's the Science to Show It | KQED","description":"Some kids seem resilient from the start — readily able to cope with stress and adversity. But pediatrician Thomas Boyce says biologically reactive kids need more support to thrive.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Some Kids Are Just More Sensitive, and Here's the Science to Show It","datePublished":"2019-03-07T17:47:05.000Z","dateModified":"2024-01-10T01:06:55.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"source":"NPR","sticky":false,"nprImageCredit":"Michael H","nprByline":"Dave Davies\u003c/br>NPR","nprImageAgency":"Getty Images","nprStoryId":"699979387","nprApiLink":"http://api.npr.org/query?id=699979387&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2019/03/04/699979387/is-your-child-an-orchid-or-a-dandelion-unlocking-the-science-of-sensitive-kids?ft=nprml&f=699979387","nprRetrievedStory":"1","nprPubDate":"Wed, 06 Mar 2019 11:23:00 -0500","nprStoryDate":"Mon, 04 Mar 2019 15:38:00 -0500","nprLastModifiedDate":"Mon, 04 Mar 2019 19:34:15 -0500","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/fa/2019/03/20190304_fa_01.mp3?orgId=427869011&topicId=1030&d=2191&p=13&story=699979387&ft=nprml&f=699979387","nprAudioM3u":"http://api.npr.org/m3u/1700126425-86883c.m3u?orgId=427869011&topicId=1030&d=2191&p=13&story=699979387&ft=nprml&f=699979387","audioTrackLength":2192,"path":"/science/1938819/some-kids-are-just-more-sensitive-and-heres-the-science-to-show-it","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/fa/2019/03/20190304_fa_01.mp3?orgId=427869011&topicId=1030&d=2191&p=13&story=699979387&ft=nprml&f=699979387","parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Dr. Thomas Boyce, an emeritus professor of pediatrics and psychiatry at the University of California, San Francisco, has treated children who seem to be completely unflappable and unfazed by their surroundings — as well as those who are extremely sensitive to their environments. Over the years, he began to liken these two types of children to two very different flowers: dandelions and orchids.\u003c/p>\n\u003cp>Broadly speaking, says \u003ca href=\"https://profiles.ucsf.edu/tom.boyce\" target=\"_blank\" rel=\"noopener\">Boyce\u003c/a> — who also has spent nearly 40 years studying the human stress response, especially in children — most kids tend to be like dandelions, fairly resilient and able to cope with stress and adversity in their lives. But a minority of kids, those he calls “orchid children,” are more sensitive and biologically reactive to their circumstances, which makes it harder for them to deal with stressful situations.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Like the flower, Boyce says, “the orchid child is the child who shows great sensitivity and susceptibility to both bad and good environments in which he or she finds herself or himself.”\u003c/p>\n\u003cp>Given supportive, nurturing conditions, orchid children can thrive — especially, Boyce says, if they have the comfort of a regular routine.\u003c/p>\n\u003cp>“Orchid children seem to thrive on having things like dinner every night in the same place at the same time with the same people, having certain kinds of rituals that the family goes through week to week, month to month,” he says. “This kind of routine and sameness of life from day to day, week to week, seems to be something that is helpful to kids with these great susceptibilities.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Boyce’s new book is \u003cem>The Orchid and the Dandelion: Why Some Children Struggle and How All Can Thri\u003c/em>ve\u003cem>. \u003c/em>He appeared this week on \u003ca href=\"https://www.npr.org/programs/fresh-air/2019/03/04/699939149\" target=\"_blank\" rel=\"noopener\">Fresh Air\u003c/a> with host Dave Davies to discuss it.\u003cem>\u003cbr>\n\u003c/em>\u003c/p>\n\u003chr>\n\u003cp>\u003cstrong>Interview highlights:\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>On the lab test he did to determine if a child is an orchid or a dandelion\u003c/strong>\u003c/p>\n\u003cp>We made an effort to try to understand these individual differences between children in how they respond biologically to mild, common kinds of challenges and stressors, and the way we did that was we brought them into a laboratory setting. We sat them down in front of an examiner — a research assistant that they had not previously met — and we asked them to go through a series of mildly challenging tasks. These were things like recounting a series of digits that the examiner asked them to say and increasing that from first three to four to five digits; having them just engage in a conversation with this examiner, who might ask them about their birthday or presents or something about their family. That, in itself, is a challenge for a young child. Putting a drop of lemon juice on the tongue was another kind of challenge that was evocative of these changes in biological response. …\u003c/p>\n\u003cp>We measured their stress response using the two primary stress response systems in the human brain. [One was] the \u003ca href=\"http://www.yourhormones.info/hormones/cortisol/\" target=\"_blank\" rel=\"noopener\">cortisol system\u003c/a>, which is centered in the hypothalamus of the brain. This is the system that releases the stress hormone cortisol, which has profound effects on both immune function and cardiovascular functioning.\u003c/p>\n\u003cp>And then the second stress response system is the \u003ca href=\"https://faculty.washington.edu/chudler/auto.html\" target=\"_blank\" rel=\"noopener\">autonomic nervous system\u003c/a>, or the “fight-or-flight” system. This is the one that is responsible for the sweaty palms and a little bit of tremulousness, the dilation of the pupils, all of these things that we associate with the fight-or-flight response. So we were monitoring responsivity and both of those systems as the children went through these mildly challenging tasks. …\u003c/p>\n\u003cp>We found that there were huge differences [among] children. There were some children at the high end of the spectrum, who had dramatic reactivity in both the cortisol system and the fight-or-flight system, and there were other children who had almost no biological response to the challenges that we presented to them.\u003c/p>\n\u003cp>\u003cstrong>On how a child’s responsivity to stressors can be connected to physical and emotional behavioral outcomes\u003c/strong>\u003c/p>\n\u003cp>We find in our research that the same kinds of patterns of response are found for both physical illnesses, like severe respiratory disease, pneumonia, asthma and so on, as well as or more [in] emotional behavioral outcomes, like anxiety and depression and externalizing kinds of symptoms. So we believe that the same patterns of susceptibility that we find in the orchid child versus the dandelion child work themselves out not only for physical ailments but also for psychosocial and emotional problems. And we believe that the same kinds of underlying biological processes work for both. …\u003c/p>\n\u003cp>We do know, for example, that these two stress response systems … the cortisol system and the fight-or-flight system, the autonomic nervous system, both of those have powerful effects on the immune system, so they can alter the child’s ability to build an immune defense against viruses and bacteria that he or she may be exposed to. And they have also powerful effects on the cardiovascular system, so [they] could eventually, in adult life, predispose to developing hypertension, high blood pressure or other kinds of cardiovascular risk.\u003c/p>\n\u003cp>\u003cstrong>On how children’s experiences can vary, even within the same family\u003c/strong>\u003c/p>\n\u003cp>The experience of children within a given family, the siblings within a family — although they are being reared with the same parents in the same house in the same neighborhood — they actually have quite different kinds of experiences that depend upon the birth order of the child, the gender of the child, to some extent differences in genetic sequence. It is a way of talking about these dramatic differences that kids from different birth orders and different genders have within a given family.\u003c/p>\n\u003cp>\u003cstrong>On pushing orchid kids to stretch to do new or difficult things\u003c/strong>\u003c/p>\n\u003cp>I think that this is probably the most difficult parenting task in raising an orchid child. The parent of an orchid child needs to walk this very fine line between, on the one hand, not pushing them into circumstances that are really going to overwhelm them and make them greatly fearful, but, on the other hand, not protecting them so much that they don’t have experiences of mastery of these kinds of fearful situations.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Sam Briger and Seth Kelley produced and edited the \u003ca href=\"https://www.npr.org/sections/health-shots/2019/03/04/699979387/is-your-child-an-orchid-or-a-dandelion-unlocking-the-science-of-sensitive-kids\" target=\"_blank\" rel=\"noopener\">audio version\u003c/a> of this interview, which aired on Fresh Air. Bridget Bentz and Molly Seavy-Nesper adapted it for the Web.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2019 \u003ca href=\"https://www.npr.org/programs/fresh-air/\" target=\"_blank\" rel=\"noopener\">Fresh Air\u003c/a>.\u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1938819/some-kids-are-just-more-sensitive-and-heres-the-science-to-show-it","authors":["byline_science_1938819"],"categories":["science_32","science_3151","science_39","science_16","science_3890","science_40"],"tags":["science_5181","science_3838","science_807","science_1342","science_5155"],"featImg":"science_1938820","label":"source_science_1938819"},"science_1938496":{"type":"posts","id":"science_1938496","meta":{"index":"posts_1591205157","site":"science","id":"1938496","score":null,"sort":[1551304821000]},"guestAuthors":[],"slug":"grandmothers-may-be-key-to-understanding-human-longevity","title":"Grandmothers May Be Key to Understanding Human Longevity","publishDate":1551304821,"format":"standard","headTitle":"Grandmothers May Be Key to Understanding Human Longevity | KQED","labelTerm":{},"content":"\u003cp>Killer whales, Japanese aphids and \u003cem>Homo sapiens\u003c/em> \u003cem>—\u003c/em> they’re among the few organisms whose females live on long past the age of reproduction.\u003c/p>\n\u003cp>Since the name of the evolutionary game is survival and reproduction, the phenomenon begs explanation — why live longer than you can reproduce? In the 1960s, researchers came up with the “grandmother hypothesis” to explain the human side of things. The hypothesis is that the help of grandmothers enables mothers to have more children. So women who had the genetic makeup for longer living would ultimately have more grandchildren carrying their longevity genes. (Sorry, grandfathers, you’re not included in this picture.)\u003c/p>\n\u003cp>\u003ca href=\"https://www.cell.com/current-biology/fulltext/S0960-9822(19)30008-9\" target=\"_blank\" rel=\"noopener\">Two studies\u003c/a> published Thursday in \u003cem>Current Biology\u003c/em> take another look at this hypothesis and add new insights into the role grandmothers play.\u003c/p>\n\u003cp>The first hard evidence for the grandmother hypothesis was gathered by \u003ca href=\"https://faculty.utah.edu/u0030555-KRISTEN_HAWKES/research/index.hml\" target=\"_blank\" rel=\"noopener\">Kristen Hawkes\u003c/a>, an anthropologist at the University of Utah who was studying the Hadza people, a group of hunter-gatherers in northern Tanzania. Hawkes was struck by “how productive these old ladies were” at foraging for food, and she later documented how their help allowed mothers to have more children.\u003c/p>\n\u003cp>If our long post-reproductive lives evolved because of grandmothers, we should be able to find fingerprints of the benefits of grandmothering in many cultures. But the circumstances of modern life differ drastically from those we faced at the beginning of our evolutionary story.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The studies in \u003cem>Current Biology\u003c/em> turned to the detailed records of two preindustrial populations, one in what is now Quebec and the other in Finland. The researchers mined these rich databases to quantify the reproductive boost that grandmothers provide and to help us better understand the limits of their help.\u003c/p>\n\u003cp>In 1608, French Catholic priests in what is present-day Quebec began recording every birth, death and marriage in their parish. As settlers continued to arrive, multiply and fill the St. Lawrence Valley, parish records ballooned. “We had the data set of the first French settlers coming off the first boat,” says \u003ca href=\"https://www.ubishops.ca/academic-programs/faculty-of-arts-and-science/natural-sciences-and-mathematics/biological-sciences/faculty/name/patrick-bergeron/\" target=\"_blank\" rel=\"noopener\">Patrick Bergeron\u003c/a>, an evolutionary biologist at Bishop’s University, who co-authored the study.\u003c/p>\n\u003cp>The population was mostly French and mostly farmers and was fairly mobile. That homogeneity helped the researchers isolate the effect of grandmothers and see if it mattered how close, geographically, a daughter was to her mother.\u003c/p>\n\u003cp>Hawkes explains that this approach adds nuance to previous studies of the grandmother hypothesis, which didn’t directly measure proximity. “After all, if you’re in Quebec but your grandma’s in Cleveland, she may not be much help,” she says.\u003c/p>\n\u003cp>\u003ca href=\"http://www.iee.unibe.ch/about_us/team/index_eng.html\" target=\"_blank\" rel=\"noopener\">Sacha Engelhardt\u003c/a>, a postdoctoral researcher at the University of Bern who conducted research for this study at Université de Sherbrooke, looked for groups of sisters in which some left home and others stayed put. If being close to grandma helps, the homebodies should have had more kids than their adventurous sisters.\u003c/p>\n\u003cp>It turned out that staying close to grandma paid off in family size. Women who lived 200 miles from mom had, on average, 1.75 fewer children than their sisters who lived in the same parish as their mother. “Women in those days had a lot of kids, on average almost eight,” says Engelhardt. But times were tough, and about half of a woman’s offspring died before age 15. Such harsh conditions led to a range of reproductive success; the number of grandkids per grandmother in this database ranged from one to 195.\u003c/p>\n\u003cp>Being geographically close to grandma curbed child mortality too and allowed mothers to start having kids at a younger age.\u003c/p>\n\u003cp>Altogether, these results are what you’d expect if the grandmother hypothesis is true. “These results are really interesting,” says Hawkes. “They took a much more fine-grained approach, and it gives us a clearer picture of the effect of grandmothers.”\u003c/p>\n\u003cp>But if grandmas are so beneficial, why don’t they live even longer — long enough to help their great-grandchildren grow up and have kids of their own?\u003c/p>\n\u003cp>To answer that question, you need to consider not only how much help a grandmother can give but also how the opportunity for a grandmother to help changes over time. If a grandmother’s abilities deteriorate with age or if there just aren’t as many grandkids around to help, the evolutionary benefits of living longer might disappear.\u003c/p>\n\u003cp>The second study, conducted by Simon Chapman, a Ph.D. student at the University of Turku in Finland, looked at a database of preindustrial Finns to answer this question. From 1731 to 1895, all births, deaths and marriages were recorded by the state. Finns moved around much less than the French settlers of the previous study, so most grandchildren lived close to their grandparents.\u003c/p>\n\u003cp>In Finland too, the presence of a grandmother boosted a daughter’s total number of offspring. But closer inspection revealed some caveats.\u003c/p>\n\u003cp>The study shows that the opportunity for grandmas to help was not constant over the years. On average, a woman became a grandmother in her 40s, and the number of grandkids she cared for steadily rose, peaking in her early 60s and then diminishing into her mid-70s.\u003c/p>\n\u003cp>Having a grandmother age 50 to 75 increased a toddler’s chance of surviving from age 2 to 5 by 30 percent. But the researchers found that the benefits of having a grandmother petered out after she passed age 75. In fact, the presence of an older paternal grandmother reduced a newborn’s probability of surviving to age 2 by 37 percent.\u003c/p>\n\u003cp>Why? Too many mouths to feed, according to Chapman. “At this time, paternal grandmothers often lived in the same home as their son and may have required extra care,” he says. That may have shifted resources away from younger grandchildren.\u003c/p>\n\u003cp>Chapman says that together, these results help explain why selection has extended human lives past our reproductive prime, but only up to a point. Grandma can help when her grandchildren are growing up and she is likely in her 50s, 60s and early 70s. As both these studies demonstrate, grandmas can make a big difference in these years, and that reproductive boost helps push human life past the normal finish line of old age.\u003c/p>\n\u003cp>But as grandkids grow older, grandma’s help doesn’t have the same impact, and the evolutionary value of living much longer decreases. Chapman found that grandmothers’ mortality rates shoot up just when this dip in opportunity for helping arrives.\u003c/p>\n\u003cp>\u003ca href=\"https://www.rosalynlapier.com/\" target=\"_blank\" rel=\"noopener\">Rosalyn LaPier\u003c/a> is intrigued by the results of these new studies. She examines the benefits of grandmothers on a societal and cultural level. Currently a professor at the University of Montana who studies how indigenous cultures transmit knowledge, LaPier grew up on the Blackfeet reservation in Montana and spent countless afternoons with her grandmother learning about the land and plants that sustain their culture.\u003c/p>\n\u003cp>For most of human history, this kind of knowledge was transmitted orally. “In North American indigenous communities, you see the transmission of agricultural knowledge across generations,” she says. “In many cases from grandmother to grandchild.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>\u003cem>Jonathan Lambert is an intern on NPR’s Science Desk.\u003c/em> \u003cem>You can follow him on Twitter:\u003c/em> \u003ca href=\"https://twitter.com/evolambert\" target=\"_blank\" rel=\"noopener\">@evolambert\u003c/a>\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2019 \u003ca href=\"https://www.npr.org\" target=\"_blank\" rel=\"noopener\">NPR\u003c/a>.\u003c/em>\u003c/div>\n\n","blocks":[],"excerpt":"Humans are evolutionary oddballs for living long past our reproductive prime. New research explains how grandmothers might be the reason why.","status":"publish","parent":0,"modified":1704848829,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":1231},"headData":{"title":"Grandmothers May Be Key to Understanding Human Longevity | KQED","description":"Humans are evolutionary oddballs for living long past our reproductive prime. New research explains how grandmothers might be the reason why.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Grandmothers May Be Key to Understanding Human Longevity","datePublished":"2019-02-27T22:00:21.000Z","dateModified":"2024-01-10T01:07:09.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"source":"Evolution","sticky":false,"nprByline":"Jonathan Lambert\u003c/br>NPR","nprImageAgency":"Nicole Xu for NPR","nprStoryId":"692088371","nprApiLink":"http://api.npr.org/query?id=692088371&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/goatsandsoda/2019/02/07/692088371/living-near-your-grandmother-has-evolutionary-benefits?ft=nprml&f=692088371","nprRetrievedStory":"1","nprPubDate":"Fri, 08 Feb 2019 14:53:00 -0500","nprStoryDate":"Thu, 07 Feb 2019 14:41:00 -0500","nprLastModifiedDate":"Fri, 08 Feb 2019 14:53:03 -0500","path":"/science/1938496/grandmothers-may-be-key-to-understanding-human-longevity","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Killer whales, Japanese aphids and \u003cem>Homo sapiens\u003c/em> \u003cem>—\u003c/em> they’re among the few organisms whose females live on long past the age of reproduction.\u003c/p>\n\u003cp>Since the name of the evolutionary game is survival and reproduction, the phenomenon begs explanation — why live longer than you can reproduce? In the 1960s, researchers came up with the “grandmother hypothesis” to explain the human side of things. The hypothesis is that the help of grandmothers enables mothers to have more children. So women who had the genetic makeup for longer living would ultimately have more grandchildren carrying their longevity genes. (Sorry, grandfathers, you’re not included in this picture.)\u003c/p>\n\u003cp>\u003ca href=\"https://www.cell.com/current-biology/fulltext/S0960-9822(19)30008-9\" target=\"_blank\" rel=\"noopener\">Two studies\u003c/a> published Thursday in \u003cem>Current Biology\u003c/em> take another look at this hypothesis and add new insights into the role grandmothers play.\u003c/p>\n\u003cp>The first hard evidence for the grandmother hypothesis was gathered by \u003ca href=\"https://faculty.utah.edu/u0030555-KRISTEN_HAWKES/research/index.hml\" target=\"_blank\" rel=\"noopener\">Kristen Hawkes\u003c/a>, an anthropologist at the University of Utah who was studying the Hadza people, a group of hunter-gatherers in northern Tanzania. Hawkes was struck by “how productive these old ladies were” at foraging for food, and she later documented how their help allowed mothers to have more children.\u003c/p>\n\u003cp>If our long post-reproductive lives evolved because of grandmothers, we should be able to find fingerprints of the benefits of grandmothering in many cultures. But the circumstances of modern life differ drastically from those we faced at the beginning of our evolutionary story.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The studies in \u003cem>Current Biology\u003c/em> turned to the detailed records of two preindustrial populations, one in what is now Quebec and the other in Finland. The researchers mined these rich databases to quantify the reproductive boost that grandmothers provide and to help us better understand the limits of their help.\u003c/p>\n\u003cp>In 1608, French Catholic priests in what is present-day Quebec began recording every birth, death and marriage in their parish. As settlers continued to arrive, multiply and fill the St. Lawrence Valley, parish records ballooned. “We had the data set of the first French settlers coming off the first boat,” says \u003ca href=\"https://www.ubishops.ca/academic-programs/faculty-of-arts-and-science/natural-sciences-and-mathematics/biological-sciences/faculty/name/patrick-bergeron/\" target=\"_blank\" rel=\"noopener\">Patrick Bergeron\u003c/a>, an evolutionary biologist at Bishop’s University, who co-authored the study.\u003c/p>\n\u003cp>The population was mostly French and mostly farmers and was fairly mobile. That homogeneity helped the researchers isolate the effect of grandmothers and see if it mattered how close, geographically, a daughter was to her mother.\u003c/p>\n\u003cp>Hawkes explains that this approach adds nuance to previous studies of the grandmother hypothesis, which didn’t directly measure proximity. “After all, if you’re in Quebec but your grandma’s in Cleveland, she may not be much help,” she says.\u003c/p>\n\u003cp>\u003ca href=\"http://www.iee.unibe.ch/about_us/team/index_eng.html\" target=\"_blank\" rel=\"noopener\">Sacha Engelhardt\u003c/a>, a postdoctoral researcher at the University of Bern who conducted research for this study at Université de Sherbrooke, looked for groups of sisters in which some left home and others stayed put. If being close to grandma helps, the homebodies should have had more kids than their adventurous sisters.\u003c/p>\n\u003cp>It turned out that staying close to grandma paid off in family size. Women who lived 200 miles from mom had, on average, 1.75 fewer children than their sisters who lived in the same parish as their mother. “Women in those days had a lot of kids, on average almost eight,” says Engelhardt. But times were tough, and about half of a woman’s offspring died before age 15. Such harsh conditions led to a range of reproductive success; the number of grandkids per grandmother in this database ranged from one to 195.\u003c/p>\n\u003cp>Being geographically close to grandma curbed child mortality too and allowed mothers to start having kids at a younger age.\u003c/p>\n\u003cp>Altogether, these results are what you’d expect if the grandmother hypothesis is true. “These results are really interesting,” says Hawkes. “They took a much more fine-grained approach, and it gives us a clearer picture of the effect of grandmothers.”\u003c/p>\n\u003cp>But if grandmas are so beneficial, why don’t they live even longer — long enough to help their great-grandchildren grow up and have kids of their own?\u003c/p>\n\u003cp>To answer that question, you need to consider not only how much help a grandmother can give but also how the opportunity for a grandmother to help changes over time. If a grandmother’s abilities deteriorate with age or if there just aren’t as many grandkids around to help, the evolutionary benefits of living longer might disappear.\u003c/p>\n\u003cp>The second study, conducted by Simon Chapman, a Ph.D. student at the University of Turku in Finland, looked at a database of preindustrial Finns to answer this question. From 1731 to 1895, all births, deaths and marriages were recorded by the state. Finns moved around much less than the French settlers of the previous study, so most grandchildren lived close to their grandparents.\u003c/p>\n\u003cp>In Finland too, the presence of a grandmother boosted a daughter’s total number of offspring. But closer inspection revealed some caveats.\u003c/p>\n\u003cp>The study shows that the opportunity for grandmas to help was not constant over the years. On average, a woman became a grandmother in her 40s, and the number of grandkids she cared for steadily rose, peaking in her early 60s and then diminishing into her mid-70s.\u003c/p>\n\u003cp>Having a grandmother age 50 to 75 increased a toddler’s chance of surviving from age 2 to 5 by 30 percent. But the researchers found that the benefits of having a grandmother petered out after she passed age 75. In fact, the presence of an older paternal grandmother reduced a newborn’s probability of surviving to age 2 by 37 percent.\u003c/p>\n\u003cp>Why? Too many mouths to feed, according to Chapman. “At this time, paternal grandmothers often lived in the same home as their son and may have required extra care,” he says. That may have shifted resources away from younger grandchildren.\u003c/p>\n\u003cp>Chapman says that together, these results help explain why selection has extended human lives past our reproductive prime, but only up to a point. Grandma can help when her grandchildren are growing up and she is likely in her 50s, 60s and early 70s. As both these studies demonstrate, grandmas can make a big difference in these years, and that reproductive boost helps push human life past the normal finish line of old age.\u003c/p>\n\u003cp>But as grandkids grow older, grandma’s help doesn’t have the same impact, and the evolutionary value of living much longer decreases. Chapman found that grandmothers’ mortality rates shoot up just when this dip in opportunity for helping arrives.\u003c/p>\n\u003cp>\u003ca href=\"https://www.rosalynlapier.com/\" target=\"_blank\" rel=\"noopener\">Rosalyn LaPier\u003c/a> is intrigued by the results of these new studies. She examines the benefits of grandmothers on a societal and cultural level. Currently a professor at the University of Montana who studies how indigenous cultures transmit knowledge, LaPier grew up on the Blackfeet reservation in Montana and spent countless afternoons with her grandmother learning about the land and plants that sustain their culture.\u003c/p>\n\u003cp>For most of human history, this kind of knowledge was transmitted orally. “In North American indigenous communities, you see the transmission of agricultural knowledge across generations,” she says. “In many cases from grandmother to grandchild.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cem>Jonathan Lambert is an intern on NPR’s Science Desk.\u003c/em> \u003cem>You can follow him on Twitter:\u003c/em> \u003ca href=\"https://twitter.com/evolambert\" target=\"_blank\" rel=\"noopener\">@evolambert\u003c/a>\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2019 \u003ca href=\"https://www.npr.org\" target=\"_blank\" rel=\"noopener\">NPR\u003c/a>.\u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1938496/grandmothers-may-be-key-to-understanding-human-longevity","authors":["byline_science_1938496"],"categories":["science_30","science_3151","science_39","science_16","science_3890","science_40"],"tags":["science_116","science_3838"],"featImg":"science_1938497","label":"source_science_1938496"},"science_1937243":{"type":"posts","id":"science_1937243","meta":{"index":"posts_1591205157","site":"science","id":"1937243","score":null,"sort":[1548696271000]},"guestAuthors":[],"slug":"digital-pill-can-track-if-patients-are-taking-their-meds","title":"‘Digital Pill’ Can Track When Patients Take Their Meds","publishDate":1548696271,"format":"standard","headTitle":"‘Digital Pill’ Can Track When Patients Take Their Meds | KQED","labelTerm":{},"content":"\u003cp class=\"danger-zone\">A Silicon Valley company \u003ca href=\"https://www.proteus.com/\" target=\"_blank\" rel=\"noopener\">announced\u003c/a> this month what it described as the first “digital pill” program of its kind, one in which the chemotherapy pills taken by cancer patients are packaged with a sensor that can alert a physician, pharmacist, or caregiver after it has been swallowed.\u003c/p>\n\u003cp class=\"danger-zone\">Seven patients — all of whom have colorectal cancer in stage 3 or stage 4 and are being treated in Minnesota — have been provided with the treatment since September, according to Proteus Digital Health. The idea is that, by tracking when patients take their drugs, health care providers will be better able to ensure medication adherence and to provide treatment guidance, with the goal of improving health outcomes.\u003c/p>\n\u003cp class=\"danger-zone\">After patients swallow a capsule, the sensor activates when it gets wet in the stomach and then pings a signal to a patch that patients wear on their torso. That transmits data on the time of day, the size of the dose, and the type of medication taken to an online portal that the patient can view. If patients choose to allow it, their support team can access the portal, too.\u003c/p>\n\u003cp class=\"\">Proteus previously developed the technology behind Abilify MyCite, which in November 2017 became \u003ca href=\"https://www.statnews.com/2017/11/13/pill-sensor-fda-approval/\" target=\"_blank\" rel=\"noopener\">the first digital pill approved\u003c/a> by the Food and Drug Administration. That drug is meant for patients with schizophrenia and bipolar disorder, and it needed FDA review because it involves a sensor embedded within the active medication in the pill.\u003c/p>\n\u003cp>By contrast, the digital chemotherapy pills did not have to undergo a new round of regulatory approval because of the way they’re loosely packaged within a capsule. The program in Minnesota appears to be the first one in which a digital pill has been used in oncology.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Neither patients nor insurers are paying anything beyond the typical cost of the medication for Proteus’s high-tech upgrade. With the new digital chemotherapy pills, Proteus is only making money from the Minnesota health system, Fairview Health Services, where the patients receiving the medication are being treated.\u003c/p>\n\u003cp>Fairview, which like other health systems invests in phone calls and other reminders to patients to help them stay on track with their medications, is paying Proteus in the hope that it can save money if the technology can help its cancer patients do better.\u003c/p>\n\u003cp>Under the contract, Fairview will generally only pay Proteus if indicated cancer patients take their digital chemotherapy as prescribed 80 percent of the time, Proteus executives told reporters. For those patients who don’t meet that threshold, Proteus won’t get paid. With the unusual arrangement, Proteus joins a growing number of medical companies \u003ca href=\"https://www.statnews.com/2018/11/14/a-startup-for-diabetes-patients-will-only-get-paid-if-the-service-works/\" target=\"_blank\" rel=\"noopener\">experimenting with payment structures\u003c/a> tied to how well patients fare.\u003c/p>\n\u003cp>The commercial rollout of Abilify MyCite has gotten off to a slow start. It has yet to be prescribed outside of a clinical trial to a single patient, according to a spokesman for Otuska, the drug’s manufacturer. Otsuka late last summer \u003ca href=\"https://www.statnews.com/2018/08/30/abilify-digital-medicaid-mental-illness/\" target=\"_blank\" rel=\"noopener\">announced plans to initially roll out the pill\u003c/a> to certain patients covered by Medicaid.\u003c/p>\n\u003cp>The holdup: The managed care company that struck a deal with Otuska to roll out Abilify MyCite is still working with a health plan to get final approval so that physicians in its network can start offering the pills to patients, said the spokesman, Robert Murphy.\u003c/p>\n\u003cp>Proteus’s new digital chemotherapy offering combines two parts into a single capsule: The first is a medication known to scientists as capecitabine; it’s sold under the brand name Xeloda and generic equivalents. The second is the sensor, which Proteus manufactures and embeds into a placebo pill for easy handling; Proteus won FDA approval for the product in 2012. Proteus ships its sensor to a specialty pharmacy, where a pharmacist does the physical handiwork of putting the active medication and the sensor-within-a-placebo into one capsule.\u003c/p>\n\u003cp>Proteus picked capecitabine for its high-tech upgrade for a few reasons. For one, it’s a commonly prescribed chemotherapy pill used in a number of different cancers. It’s also a medication that doesn’t look likely to be threatened by any direct competitors or new entrants. And, crucially, it’s a challenging regimen for patients to stay adherent to; patients have to take six to eight pills each day, with two weeks on and one week off, to complete one of eight cycles of chemotherapy.\u003c/p>\n\u003cp>Abilify MyCite’s approval \u003ca href=\"https://www.statnews.com/2017/12/05/smart-pill-abilify-ethics/\" target=\"_blank\" rel=\"noopener\">sparked concerns\u003c/a> that vulnerable patients might be coerced into taking the drug, maybe through a court order or a deal offered in exchange for freedom, child custody, or a more lenient sentence. Critics also saw a risk to patient privacy, if a patient’s insurer or other companies peered in on a patient’s daily medication intake patterns and other data.\u003c/p>\n\u003cp>Dr. George Savage, Proteus’ chief medical officer, told reporters that the company is trying to preempt those concerns by working with bioethicists and keeping patients “in the driver’s seat.”\u003c/p>\n\u003cp>\u003cstrong>An experiment starting in Minnesota\u003c/strong>\u003c/p>\n\u003cp>Dr. Edward Greeno, an oncologist at the University of Minnesota who treats patients in the Fairview system, has led the rollout of the digital chemotherapy pills there. He said he’s been surprised by how enthusiastic patients have been so far.\u003c/p>\n\u003cp>Every time he and other clinicians have offered the treatment to appropriate patients, they’ve wanted to try it, he said. The only patients who haven’t gone through with it were those whose insurers wouldn’t allow them to fill their capecitabine prescriptions at Fairview’s specialty pharmacies, the only ones that can dispense the digital chemotherapy pills, Greeno said.\u003c/p>\n\u003cp>When patients have returned to the clinic after a few months of trying the digital chemotherapy pills, none has voiced complaints or worries, Greeno said. (Proteus has paid for some of Greeno’s travel.)\u003c/p>\n\u003cp>Greeno will be one of the researchers running a clinical trial that Proteus plans to launch to gauge whether patients taking digital chemotherapy see better clinical outcomes than those in the general population — and whether it saves money. The company plans to enroll 750 patients with different cancers at sites across the country, with the goal of launching eight trial sites this year.\u003c/p>\n\u003cp>The digital chemotherapy program is just one of about 40 approved medications that Proteus has packaged with a sensor in a capsule. The company has tried the technology with drugs for diabetes, hepatitis C, and tuberculosis, among others. Collectively, they’ve been used to treat thousands of patients, either commercially or in clinical trials, the company’s executives told reporters. In an unusual business model, none of Proteus’s revenue has come from insurers; instead, it’s made money from health systems and a development deal with Otuska.\u003c/p>\n\u003cp>Proteus also has big plans to turn itself into something of a high-tech generic drug manufacturer. It intends in the coming years to try to develop a generic version of capecitabine embedded with its sensor, like Abilify MyCite, and then seek FDA approval, the company’s executives said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2019/01/17/a-digital-pill-for-cancer-patients-is-rolled-out-for-the-first-time-in-hopes-of-improving-outcomes/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"A Silicon Valley company announced the creation of a “digital pill\" that can track if patients are taking their medication.","status":"publish","parent":0,"modified":1704927178,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":20,"wordCount":1219},"headData":{"title":"‘Digital Pill’ Can Track When Patients Take Their Meds | KQED","description":"A Silicon Valley company announced the creation of a “digital pill" that can track if patients are taking their medication.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"‘Digital Pill’ Can Track When Patients Take Their Meds","datePublished":"2019-01-28T17:24:31.000Z","dateModified":"2024-01-10T22:52:58.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"source":"Health","sticky":false,"nprByline":"Rebecca Robbins\u003c/br>STAT","path":"/science/1937243/digital-pill-can-track-if-patients-are-taking-their-meds","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"danger-zone\">A Silicon Valley company \u003ca href=\"https://www.proteus.com/\" target=\"_blank\" rel=\"noopener\">announced\u003c/a> this month what it described as the first “digital pill” program of its kind, one in which the chemotherapy pills taken by cancer patients are packaged with a sensor that can alert a physician, pharmacist, or caregiver after it has been swallowed.\u003c/p>\n\u003cp class=\"danger-zone\">Seven patients — all of whom have colorectal cancer in stage 3 or stage 4 and are being treated in Minnesota — have been provided with the treatment since September, according to Proteus Digital Health. The idea is that, by tracking when patients take their drugs, health care providers will be better able to ensure medication adherence and to provide treatment guidance, with the goal of improving health outcomes.\u003c/p>\n\u003cp class=\"danger-zone\">After patients swallow a capsule, the sensor activates when it gets wet in the stomach and then pings a signal to a patch that patients wear on their torso. That transmits data on the time of day, the size of the dose, and the type of medication taken to an online portal that the patient can view. If patients choose to allow it, their support team can access the portal, too.\u003c/p>\n\u003cp class=\"\">Proteus previously developed the technology behind Abilify MyCite, which in November 2017 became \u003ca href=\"https://www.statnews.com/2017/11/13/pill-sensor-fda-approval/\" target=\"_blank\" rel=\"noopener\">the first digital pill approved\u003c/a> by the Food and Drug Administration. That drug is meant for patients with schizophrenia and bipolar disorder, and it needed FDA review because it involves a sensor embedded within the active medication in the pill.\u003c/p>\n\u003cp>By contrast, the digital chemotherapy pills did not have to undergo a new round of regulatory approval because of the way they’re loosely packaged within a capsule. The program in Minnesota appears to be the first one in which a digital pill has been used in oncology.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Neither patients nor insurers are paying anything beyond the typical cost of the medication for Proteus’s high-tech upgrade. With the new digital chemotherapy pills, Proteus is only making money from the Minnesota health system, Fairview Health Services, where the patients receiving the medication are being treated.\u003c/p>\n\u003cp>Fairview, which like other health systems invests in phone calls and other reminders to patients to help them stay on track with their medications, is paying Proteus in the hope that it can save money if the technology can help its cancer patients do better.\u003c/p>\n\u003cp>Under the contract, Fairview will generally only pay Proteus if indicated cancer patients take their digital chemotherapy as prescribed 80 percent of the time, Proteus executives told reporters. For those patients who don’t meet that threshold, Proteus won’t get paid. With the unusual arrangement, Proteus joins a growing number of medical companies \u003ca href=\"https://www.statnews.com/2018/11/14/a-startup-for-diabetes-patients-will-only-get-paid-if-the-service-works/\" target=\"_blank\" rel=\"noopener\">experimenting with payment structures\u003c/a> tied to how well patients fare.\u003c/p>\n\u003cp>The commercial rollout of Abilify MyCite has gotten off to a slow start. It has yet to be prescribed outside of a clinical trial to a single patient, according to a spokesman for Otuska, the drug’s manufacturer. Otsuka late last summer \u003ca href=\"https://www.statnews.com/2018/08/30/abilify-digital-medicaid-mental-illness/\" target=\"_blank\" rel=\"noopener\">announced plans to initially roll out the pill\u003c/a> to certain patients covered by Medicaid.\u003c/p>\n\u003cp>The holdup: The managed care company that struck a deal with Otuska to roll out Abilify MyCite is still working with a health plan to get final approval so that physicians in its network can start offering the pills to patients, said the spokesman, Robert Murphy.\u003c/p>\n\u003cp>Proteus’s new digital chemotherapy offering combines two parts into a single capsule: The first is a medication known to scientists as capecitabine; it’s sold under the brand name Xeloda and generic equivalents. The second is the sensor, which Proteus manufactures and embeds into a placebo pill for easy handling; Proteus won FDA approval for the product in 2012. Proteus ships its sensor to a specialty pharmacy, where a pharmacist does the physical handiwork of putting the active medication and the sensor-within-a-placebo into one capsule.\u003c/p>\n\u003cp>Proteus picked capecitabine for its high-tech upgrade for a few reasons. For one, it’s a commonly prescribed chemotherapy pill used in a number of different cancers. It’s also a medication that doesn’t look likely to be threatened by any direct competitors or new entrants. And, crucially, it’s a challenging regimen for patients to stay adherent to; patients have to take six to eight pills each day, with two weeks on and one week off, to complete one of eight cycles of chemotherapy.\u003c/p>\n\u003cp>Abilify MyCite’s approval \u003ca href=\"https://www.statnews.com/2017/12/05/smart-pill-abilify-ethics/\" target=\"_blank\" rel=\"noopener\">sparked concerns\u003c/a> that vulnerable patients might be coerced into taking the drug, maybe through a court order or a deal offered in exchange for freedom, child custody, or a more lenient sentence. Critics also saw a risk to patient privacy, if a patient’s insurer or other companies peered in on a patient’s daily medication intake patterns and other data.\u003c/p>\n\u003cp>Dr. George Savage, Proteus’ chief medical officer, told reporters that the company is trying to preempt those concerns by working with bioethicists and keeping patients “in the driver’s seat.”\u003c/p>\n\u003cp>\u003cstrong>An experiment starting in Minnesota\u003c/strong>\u003c/p>\n\u003cp>Dr. Edward Greeno, an oncologist at the University of Minnesota who treats patients in the Fairview system, has led the rollout of the digital chemotherapy pills there. He said he’s been surprised by how enthusiastic patients have been so far.\u003c/p>\n\u003cp>Every time he and other clinicians have offered the treatment to appropriate patients, they’ve wanted to try it, he said. The only patients who haven’t gone through with it were those whose insurers wouldn’t allow them to fill their capecitabine prescriptions at Fairview’s specialty pharmacies, the only ones that can dispense the digital chemotherapy pills, Greeno said.\u003c/p>\n\u003cp>When patients have returned to the clinic after a few months of trying the digital chemotherapy pills, none has voiced complaints or worries, Greeno said. (Proteus has paid for some of Greeno’s travel.)\u003c/p>\n\u003cp>Greeno will be one of the researchers running a clinical trial that Proteus plans to launch to gauge whether patients taking digital chemotherapy see better clinical outcomes than those in the general population — and whether it saves money. The company plans to enroll 750 patients with different cancers at sites across the country, with the goal of launching eight trial sites this year.\u003c/p>\n\u003cp>The digital chemotherapy program is just one of about 40 approved medications that Proteus has packaged with a sensor in a capsule. The company has tried the technology with drugs for diabetes, hepatitis C, and tuberculosis, among others. Collectively, they’ve been used to treat thousands of patients, either commercially or in clinical trials, the company’s executives told reporters. In an unusual business model, none of Proteus’s revenue has come from insurers; instead, it’s made money from health systems and a development deal with Otuska.\u003c/p>\n\u003cp>Proteus also has big plans to turn itself into something of a high-tech generic drug manufacturer. It intends in the coming years to try to develop a generic version of capecitabine embedded with its sensor, like Abilify MyCite, and then seek FDA approval, the company’s executives said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2019/01/17/a-digital-pill-for-cancer-patients-is-rolled-out-for-the-first-time-in-hopes-of-improving-outcomes/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1937243/digital-pill-can-track-if-patients-are-taking-their-meds","authors":["byline_science_1937243"],"categories":["science_3151","science_39","science_16","science_40"],"tags":["science_1513","science_5181","science_3838"],"featImg":"science_1937272","label":"source_science_1937243"},"science_1936787":{"type":"posts","id":"science_1936787","meta":{"index":"posts_1591205157","site":"science","id":"1936787","score":null,"sort":[1547582438000]},"guestAuthors":[],"slug":"the-quiet-threat-inside-internet-of-things-devices","title":"The Quiet Threat Inside ‘Internet of Things’ Devices","publishDate":1547582438,"format":"image","headTitle":"The Quiet Threat Inside ‘Internet of Things’ Devices | KQED","labelTerm":{},"content":"\u003cp>[dropcap]A[/dropcap]s Americans increasingly \u003ca href=\"https://www.nielsen.com/us/en/insights/news/2018/smart-speaking-my-language-despite-their-vast-capabilities-smart-speakers-all-about-the-music.html\" target=\"_blank\" rel=\"noopener\">buy and install smart devices\u003c/a> in their homes, all those cheap interconnected devices create new security problems for individuals and society as a whole. The problem is compounded by businesses radically expanding the \u003ca href=\"https://en.wikipedia.org/wiki/SCADA\" target=\"_blank\" rel=\"noopener\">number of sensors and remote monitors\u003c/a> it uses to manage overhead lights in corporate offices and detailed manufacturing processes in factories. Governments, too, are getting into the act – cities, especially, want to use new technologies to improve energy efficiency, reduce traffic congestion and improve water quality.\u003c/p>\n\u003cp>The number of these “internet of things” devices is \u003ca href=\"https://iot-analytics.com/state-of-the-iot-update-q1-q2-2018-number-of-iot-devices-now-7b/\" target=\"_blank\" rel=\"noopener\">climbing into the tens of billions\u003c/a>. They’re creating an interconnected world with the potential to make people’s lives more enjoyable, productive, secure and efficient. But those very same devices, many of which have no real security protections, are also becoming part of what are called “botnets,” vast networks of tiny computers vulnerable to hijacking by hackers.\u003c/p>\n\u003cp>Botnets have caused problems on the internet, from sending vast amounts of spam mail to disrupting websites around the world. While traditionally most botnets are comprised of laptop and desktop computers, the growth of unsecured devices such as industrial sensors, webcams, televisions and other smart home devices is leading to a growing disruptive capability.\u003c/p>\n\u003ch2>Tiny computers everywhere\u003c/h2>\n\u003cp>The “internet of things” includes countless types of devices – \u003ca href=\"https://theconversation.com/security-risks-in-the-age-of-smart-homes-58756\" target=\"_blank\" rel=\"noopener\">webcams, pressure sensors\u003c/a>, thermometers, \u003ca href=\"https://theconversation.com/do-i-want-an-always-on-digital-assistant-listening-in-all-the-time-92571\" target=\"_blank\" rel=\"noopener\">microphones, speakers\u003c/a>, \u003ca href=\"https://theconversation.com/4-ways-internet-of-things-toys-endanger-children-94092\" target=\"_blank\" rel=\"noopener\">stuffed animals\u003c/a> and many more – made by a vast array of companies. Many of these manufacturers are \u003ca href=\"https://theconversation.com/using-blockchain-to-secure-the-internet-of-things-90002\" target=\"_blank\" rel=\"noopener\">small and unknown\u003c/a>, and don’t have popular brands or public reputations to protect. Their goals are to produce lots of devices to sell as cheaply as possible. Customers’ cybersecurity \u003ca href=\"https://theconversation.com/using-blockchain-to-secure-the-internet-of-things-90002\" target=\"_blank\" rel=\"noopener\">isn’t a real concern\u003c/a> for them.\u003c/p>\n\u003cfigure id=\"attachment_1936794\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1936794\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2019/01/file-20190108-32148-3qo844-800x530.jpg\" alt=\"\" width=\"800\" height=\"530\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/file-20190108-32148-3qo844-800x530.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/file-20190108-32148-3qo844-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/file-20190108-32148-3qo844-768x508.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/file-20190108-32148-3qo844-960x636.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/file-20190108-32148-3qo844-240x159.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/file-20190108-32148-3qo844-375x248.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/file-20190108-32148-3qo844-520x344.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/file-20190108-32148-3qo844.jpg 1000w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A tiny computer on a desk. \u003ccite>(Mehaniq/Shutterstock.com)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>These devices’ variety means they’re useful for lots of things, but also means they have a \u003ca href=\"https://resources.infosecinstitute.com/the-top-ten-iot-vulnerabilities/\" target=\"_blank\" rel=\"noopener\">wide range of vulnerabilities\u003c/a>. They include weak passwords, unencrypted communications and insecure web interfaces. With thousands, or hundreds of thousands, of identically insecure devices scattered all over the world, they’re a wealth of targets ripe for the hacking.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>If, for instance, a manufacturer has set an \u003ca href=\"https://arstechnica.com/information-technology/2017/06/internet-cameras-expose-private-video-feeds-and-remote-controls/\" target=\"_blank\" rel=\"noopener\">unchangeable administrative password\u003c/a> on a particular type of device – it \u003ca href=\"https://www.csoonline.com/article/3038302/application-development/hard-coded-passwords-remain-a-key-security-flaw.html\" target=\"_blank\" rel=\"noopener\">happens more often\u003c/a> than you might think – a \u003ca href=\"https://blog.avast.com/hacker-creates-seven-new-variants-of-the-mirai-botnet\" target=\"_blank\" rel=\"noopener\">hacker can run a program\u003c/a> searching the internet for those devices, and then logging in, taking control and installing their own malicious software, \u003ca href=\"https://krebsonsecurity.com/2016/10/source-code-for-iot-botnet-mirai-released/\" target=\"_blank\" rel=\"noopener\">recruiting the device into a botnet army\u003c/a>. The devices run normally until the hackers issue instructions, after which they can do more or less anything a computer might do – such as sending meaningless internet traffic to clog up data connections.\u003c/p>\n\u003ch2>Blocking internet access\u003c/h2>\n\u003cp>That type of attack when emanating from thousands of devices at once, called a “distributed denial of service,” can shut down companies’ servers or even block wide swaths of the internet from being publicly accessible. A major DDoS attack in 2016 \u003ca href=\"https://www.wired.com/story/mirai-botnet-minecraft-scam-brought-down-the-internet/\" target=\"_blank\" rel=\"noopener\">interrupted connections to Amazon, Netflix and Paypal\u003c/a> from customers on the east coast of the U.S.\u003c/p>\n\u003cfigure class=\"align-center zoomable\">\u003ca href=\"https://images.theconversation.com/files/252901/original/file-20190108-32148-jrvq1r.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip\">\u003cimg decoding=\"async\" src=\"https://images.theconversation.com/files/252901/original/file-20190108-32148-jrvq1r.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip\" alt=\"\">\u003c/a>\u003cfigcaption>\u003cspan class=\"caption\">A botnet took down connections through a major internet company in October 2016.\u003c/span>\u003cbr>\n\u003cspan class=\"attribution\">\u003ca class=\"source\" href=\"https://commons.wikimedia.org/wiki/File:Level3_Outage_Map_(US)_-_21_October_2016.png\" target=\"_blank\" rel=\"noopener\">DownDetector/Wikimedia Commons\u003c/a>, \u003ca class=\"license\" href=\"http://creativecommons.org/licenses/by-sa/4.0/\" target=\"_blank\" rel=\"noopener\">CC BY-SA\u003c/a>\u003c/span>\u003c/figcaption>\u003c/figure>\n\u003cp>That attack was linked to a botnet-control software program \u003ca href=\"https://www.justice.gov/opa/pr/justice-department-announces-charges-and-guilty-pleas-three-computer-crime-cases-involving\" target=\"_blank\" rel=\"noopener\">created by three teenagers\u003c/a> seeking to use more than 100,000 hijacked webcams and other internet-connected devices from around the world to \u003ca href=\"https://www.wired.com/story/mirai-botnet-minecraft-scam-brought-down-the-internet/\" target=\"_blank\" rel=\"noopener\">gain an advantage\u003c/a> over other players of the “Minecraft” online video game.\u003c/p>\n\u003cp>The size and scale of these attacks – and the broad range of devices that can contribute to them – make this both a private problem and a public one. People want to secure the devices in their homes and pockets, of course. Yet the same networks that stream television shows and music also link burglar alarms to police, manage traffic lights in congested areas and let \u003ca href=\"https://theconversation.com/saving-lives-by-letting-cars-talk-to-each-other-59221\" target=\"_blank\" rel=\"noopener\">self-driving cars talk to each other\u003c/a>.\u003c/p>\n\u003cp>All that activity can be drowned out if hackers flood the internet, or sections of it, with meaningless messages. Traffic would stall across towns, even counties, and police officers would have a hard time communicating with each other to try to straighten everything out. Even small devices, in their hundreds of thousands, all around the world, can work together to have huge repercussions both online and in the physical world.\u003c!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. -->\u003cimg loading=\"lazy\" decoding=\"async\" style=\"border: none !important;margin: 0 !important;max-height: 1px !important;max-width: 1px !important;min-height: 1px !important;min-width: 1px !important;padding: 0 !important\" src=\"https://counter.theconversation.com/content/109391/count.gif?distributor=republish-lightbox-basic\" alt=\"The Conversation\" width=\"1\" height=\"1\">\u003c!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines -->\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://theconversation.com/profiles/charles-t-harry-660658\" target=\"_blank\" rel=\"noopener\">Charles T. Harry\u003c/a>, Associate Research Professor of Public Policy; Director of Operations, Maryland Global Initiative in Cybersecurity; Senior Research Associate, Center for International and Security Studies, \u003ca href=\"http://theconversation.com/institutions/university-of-maryland-1347\" target=\"_blank\" rel=\"noopener\">\u003cem>University of Maryland\u003c/em>\u003c/a>\u003c/em>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This article is republished from \u003ca href=\"http://theconversation.com\" target=\"_blank\" rel=\"noopener\">The Conversation\u003c/a> under a Creative Commons license. Read the \u003ca href=\"https://theconversation.com/the-quiet-threat-inside-internet-of-things-devices-109391\" target=\"_blank\" rel=\"noopener\">original article\u003c/a>.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"As Americans increasingly buy and install smart devices in their homes, all those cheap interconnected devices increase security vulnerabilities to homes, businesses, governments and the internet as as whole.","status":"publish","parent":0,"modified":1704927197,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":14,"wordCount":773},"headData":{"title":"The Quiet Threat Inside ‘Internet of Things’ Devices | KQED","description":"As Americans increasingly buy and install smart devices in their homes, all those cheap interconnected devices increase security vulnerabilities to homes, businesses, governments and the internet as as whole.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"The Quiet Threat Inside ‘Internet of Things’ Devices","datePublished":"2019-01-15T20:00:38.000Z","dateModified":"2024-01-10T22:53:17.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"source":"Commentary","sticky":false,"nprByline":"Charles T. Harry\u003c/br>The Conversation","path":"/science/1936787/the-quiet-threat-inside-internet-of-things-devices","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">A\u003c/span>\u003c/p>\u003cp>s Americans increasingly \u003ca href=\"https://www.nielsen.com/us/en/insights/news/2018/smart-speaking-my-language-despite-their-vast-capabilities-smart-speakers-all-about-the-music.html\" target=\"_blank\" rel=\"noopener\">buy and install smart devices\u003c/a> in their homes, all those cheap interconnected devices create new security problems for individuals and society as a whole. The problem is compounded by businesses radically expanding the \u003ca href=\"https://en.wikipedia.org/wiki/SCADA\" target=\"_blank\" rel=\"noopener\">number of sensors and remote monitors\u003c/a> it uses to manage overhead lights in corporate offices and detailed manufacturing processes in factories. Governments, too, are getting into the act – cities, especially, want to use new technologies to improve energy efficiency, reduce traffic congestion and improve water quality.\u003c/p>\n\u003cp>The number of these “internet of things” devices is \u003ca href=\"https://iot-analytics.com/state-of-the-iot-update-q1-q2-2018-number-of-iot-devices-now-7b/\" target=\"_blank\" rel=\"noopener\">climbing into the tens of billions\u003c/a>. They’re creating an interconnected world with the potential to make people’s lives more enjoyable, productive, secure and efficient. But those very same devices, many of which have no real security protections, are also becoming part of what are called “botnets,” vast networks of tiny computers vulnerable to hijacking by hackers.\u003c/p>\n\u003cp>Botnets have caused problems on the internet, from sending vast amounts of spam mail to disrupting websites around the world. While traditionally most botnets are comprised of laptop and desktop computers, the growth of unsecured devices such as industrial sensors, webcams, televisions and other smart home devices is leading to a growing disruptive capability.\u003c/p>\n\u003ch2>Tiny computers everywhere\u003c/h2>\n\u003cp>The “internet of things” includes countless types of devices – \u003ca href=\"https://theconversation.com/security-risks-in-the-age-of-smart-homes-58756\" target=\"_blank\" rel=\"noopener\">webcams, pressure sensors\u003c/a>, thermometers, \u003ca href=\"https://theconversation.com/do-i-want-an-always-on-digital-assistant-listening-in-all-the-time-92571\" target=\"_blank\" rel=\"noopener\">microphones, speakers\u003c/a>, \u003ca href=\"https://theconversation.com/4-ways-internet-of-things-toys-endanger-children-94092\" target=\"_blank\" rel=\"noopener\">stuffed animals\u003c/a> and many more – made by a vast array of companies. Many of these manufacturers are \u003ca href=\"https://theconversation.com/using-blockchain-to-secure-the-internet-of-things-90002\" target=\"_blank\" rel=\"noopener\">small and unknown\u003c/a>, and don’t have popular brands or public reputations to protect. Their goals are to produce lots of devices to sell as cheaply as possible. Customers’ cybersecurity \u003ca href=\"https://theconversation.com/using-blockchain-to-secure-the-internet-of-things-90002\" target=\"_blank\" rel=\"noopener\">isn’t a real concern\u003c/a> for them.\u003c/p>\n\u003cfigure id=\"attachment_1936794\" class=\"wp-caption alignright\" style=\"max-width: 800px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-1936794\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2019/01/file-20190108-32148-3qo844-800x530.jpg\" alt=\"\" width=\"800\" height=\"530\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/file-20190108-32148-3qo844-800x530.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/file-20190108-32148-3qo844-160x106.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/file-20190108-32148-3qo844-768x508.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/file-20190108-32148-3qo844-960x636.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/file-20190108-32148-3qo844-240x159.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/file-20190108-32148-3qo844-375x248.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/file-20190108-32148-3qo844-520x344.jpg 520w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/file-20190108-32148-3qo844.jpg 1000w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A tiny computer on a desk. \u003ccite>(Mehaniq/Shutterstock.com)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>These devices’ variety means they’re useful for lots of things, but also means they have a \u003ca href=\"https://resources.infosecinstitute.com/the-top-ten-iot-vulnerabilities/\" target=\"_blank\" rel=\"noopener\">wide range of vulnerabilities\u003c/a>. They include weak passwords, unencrypted communications and insecure web interfaces. With thousands, or hundreds of thousands, of identically insecure devices scattered all over the world, they’re a wealth of targets ripe for the hacking.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>If, for instance, a manufacturer has set an \u003ca href=\"https://arstechnica.com/information-technology/2017/06/internet-cameras-expose-private-video-feeds-and-remote-controls/\" target=\"_blank\" rel=\"noopener\">unchangeable administrative password\u003c/a> on a particular type of device – it \u003ca href=\"https://www.csoonline.com/article/3038302/application-development/hard-coded-passwords-remain-a-key-security-flaw.html\" target=\"_blank\" rel=\"noopener\">happens more often\u003c/a> than you might think – a \u003ca href=\"https://blog.avast.com/hacker-creates-seven-new-variants-of-the-mirai-botnet\" target=\"_blank\" rel=\"noopener\">hacker can run a program\u003c/a> searching the internet for those devices, and then logging in, taking control and installing their own malicious software, \u003ca href=\"https://krebsonsecurity.com/2016/10/source-code-for-iot-botnet-mirai-released/\" target=\"_blank\" rel=\"noopener\">recruiting the device into a botnet army\u003c/a>. The devices run normally until the hackers issue instructions, after which they can do more or less anything a computer might do – such as sending meaningless internet traffic to clog up data connections.\u003c/p>\n\u003ch2>Blocking internet access\u003c/h2>\n\u003cp>That type of attack when emanating from thousands of devices at once, called a “distributed denial of service,” can shut down companies’ servers or even block wide swaths of the internet from being publicly accessible. A major DDoS attack in 2016 \u003ca href=\"https://www.wired.com/story/mirai-botnet-minecraft-scam-brought-down-the-internet/\" target=\"_blank\" rel=\"noopener\">interrupted connections to Amazon, Netflix and Paypal\u003c/a> from customers on the east coast of the U.S.\u003c/p>\n\u003cfigure class=\"align-center zoomable\">\u003ca href=\"https://images.theconversation.com/files/252901/original/file-20190108-32148-jrvq1r.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip\">\u003cimg decoding=\"async\" src=\"https://images.theconversation.com/files/252901/original/file-20190108-32148-jrvq1r.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip\" alt=\"\">\u003c/a>\u003cfigcaption>\u003cspan class=\"caption\">A botnet took down connections through a major internet company in October 2016.\u003c/span>\u003cbr>\n\u003cspan class=\"attribution\">\u003ca class=\"source\" href=\"https://commons.wikimedia.org/wiki/File:Level3_Outage_Map_(US)_-_21_October_2016.png\" target=\"_blank\" rel=\"noopener\">DownDetector/Wikimedia Commons\u003c/a>, \u003ca class=\"license\" href=\"http://creativecommons.org/licenses/by-sa/4.0/\" target=\"_blank\" rel=\"noopener\">CC BY-SA\u003c/a>\u003c/span>\u003c/figcaption>\u003c/figure>\n\u003cp>That attack was linked to a botnet-control software program \u003ca href=\"https://www.justice.gov/opa/pr/justice-department-announces-charges-and-guilty-pleas-three-computer-crime-cases-involving\" target=\"_blank\" rel=\"noopener\">created by three teenagers\u003c/a> seeking to use more than 100,000 hijacked webcams and other internet-connected devices from around the world to \u003ca href=\"https://www.wired.com/story/mirai-botnet-minecraft-scam-brought-down-the-internet/\" target=\"_blank\" rel=\"noopener\">gain an advantage\u003c/a> over other players of the “Minecraft” online video game.\u003c/p>\n\u003cp>The size and scale of these attacks – and the broad range of devices that can contribute to them – make this both a private problem and a public one. People want to secure the devices in their homes and pockets, of course. Yet the same networks that stream television shows and music also link burglar alarms to police, manage traffic lights in congested areas and let \u003ca href=\"https://theconversation.com/saving-lives-by-letting-cars-talk-to-each-other-59221\" target=\"_blank\" rel=\"noopener\">self-driving cars talk to each other\u003c/a>.\u003c/p>\n\u003cp>All that activity can be drowned out if hackers flood the internet, or sections of it, with meaningless messages. Traffic would stall across towns, even counties, and police officers would have a hard time communicating with each other to try to straighten everything out. Even small devices, in their hundreds of thousands, all around the world, can work together to have huge repercussions both online and in the physical world.\u003c!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. -->\u003cimg loading=\"lazy\" decoding=\"async\" style=\"border: none !important;margin: 0 !important;max-height: 1px !important;max-width: 1px !important;min-height: 1px !important;min-width: 1px !important;padding: 0 !important\" src=\"https://counter.theconversation.com/content/109391/count.gif?distributor=republish-lightbox-basic\" alt=\"The Conversation\" width=\"1\" height=\"1\">\u003c!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: http://theconversation.com/republishing-guidelines -->\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://theconversation.com/profiles/charles-t-harry-660658\" target=\"_blank\" rel=\"noopener\">Charles T. Harry\u003c/a>, Associate Research Professor of Public Policy; Director of Operations, Maryland Global Initiative in Cybersecurity; Senior Research Associate, Center for International and Security Studies, \u003ca href=\"http://theconversation.com/institutions/university-of-maryland-1347\" target=\"_blank\" rel=\"noopener\">\u003cem>University of Maryland\u003c/em>\u003c/a>\u003c/em>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This article is republished from \u003ca href=\"http://theconversation.com\" target=\"_blank\" rel=\"noopener\">The Conversation\u003c/a> under a Creative Commons license. Read the \u003ca href=\"https://theconversation.com/the-quiet-threat-inside-internet-of-things-devices-109391\" target=\"_blank\" rel=\"noopener\">original article\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1936787/the-quiet-threat-inside-internet-of-things-devices","authors":["byline_science_1936787"],"categories":["science_3151","science_16","science_40"],"tags":["science_3838"],"featImg":"science_1936789","label":"source_science_1936787"},"science_1936758":{"type":"posts","id":"science_1936758","meta":{"index":"posts_1591205157","site":"science","id":"1936758","score":null,"sort":[1547575227000]},"guestAuthors":[],"slug":"report-americans-are-now-more-likely-to-die-of-an-opioid-overdose-than-on-the-road","title":"Opioid Overdoses Surpass Vehicle Crashes on Leading Causes of Death List","publishDate":1547575227,"format":"standard","headTitle":"Opioid Overdoses Surpass Vehicle Crashes on Leading Causes of Death List | KQED","labelTerm":{},"content":"\u003cp>For the first time in U.S. history, a leading cause of deaths — vehicle crashes — has been surpassed in likelihood by opioid overdoses, according to a \u003ca href=\"https://injuryfacts.nsc.org/all-injuries/preventable-death-overview/odds-of-dying/\" target=\"_blank\" rel=\"noopener\">new report \u003c/a>on preventable deaths from the National Safety Council.\u003c/p>\n\u003cp>Americans now have a 1 in 96 chance of dying from an opioid overdose, according to the council’s analysis of 2017 data on accidental death. The probability of dying in a motor vehicle crash is 1 in 103.\u003c/p>\n\u003cp>“The nation’s opioid crisis is fueling the Council’s grim probabilities, and that crisis is worsening with an influx of illicit fentanyl,” the council said in a statement released Monday.\u003c/p>\n\u003cp>Fentanyl is now the drug most often responsible for drug overdose deaths, the Centers for Disease Control and Prevention \u003ca href=\"https://www.npr.org/sections/health-shots/2018/12/12/676214086/fentanyl-surpasses-heroin-as-drug-most-often-involved-in-deadly-overdoses\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> in December. And that may only be a partial view of the problem: Opioid-related overdoses also have been\u003ca href=\"https://www.npr.org/sections/health-shots/2018/03/22/595787272/omissions-on-death-certificates-lead-to-undercounting-of-opioid-overdoses\" target=\"_blank\" rel=\"noopener\"> undercounted\u003c/a> by as much as 35 percent, according to a study published last year in the journal \u003cem>Addiction\u003c/em>.\u003c/p>\n\u003cp>The council has \u003ca href=\"https://www.nsc.org/home-safety/safety-topics/opioids/whats-working\" target=\"_blank\" rel=\"noopener\">recommended\u003c/a> tackling the epidemic by increasing pain management training for opioid prescribers, making the potentially lifesaving drug \u003ca href=\"https://whyy.org/segments/the-overdose-antidote-how-narcan-works/\" target=\"_blank\" rel=\"noopener\">naloxone\u003c/a> more widely available and expanding access to addiction treatment.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>While the leading causes of death in the U.S. are heart disease (1 in 6 chance) and cancer (1 in 7), the rising overdose numbers are part of a distressing trend the nonprofit has tracked: The lifetime odds of an American dying from a preventable, unintentional injury have gone up over the past 15 years.\u003c/p>\n\u003cp>“It is impacting our workforce, it is impacting our fathers and mothers who are still raising their children,” said Ken Kolosh, manager of statistics at the National Safety Council. Kolosh said that those accidental deaths usually affect people in the “core of their life,” with greater financial and emotional ramifications than deaths of those in their later years.\u003c/p>\n\u003cp>https://www.youtube.com/watch?time_continue=59&v=_vNYQi6ZXss\u003c/p>\n\u003cp>Vehicle crashes remain a leading danger as well. Kolosh said half of people who died in crashes they analyzed were not wearing seat belts. Meanwhile, the frequency of pedestrian deaths has increased, led by a jump in fatalities in urban areas.\u003c/p>\n\u003cp>Pedestrian deaths have been at a \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/02/28/589453431/pedestrian-fatalities-remain-at-25-year-high-for-second-year-in-a-row\" target=\"_blank\" rel=\"noopener\">25-year high\u003c/a>, according to the Governors Highway Safety Association. A 2017 study found that an average of \u003ca href=\"https://www.npr.org/sections/thetwo-way/2017/01/10/509206453/walking-in-america-remains-dangerous-especially-in-florida\" target=\"_blank\" rel=\"noopener\">13 people a day\u003c/a> were killed by cars between 2005 and 2014, and that people of color and the elderly are disproportionately at risk.\u003c/p>\n\u003cp>“Historically, roadways have been designed to make it as efficient as possible for the vehicle,” Kolosh said, noting that bicyclists and pedestrians have been shortchanged. “We now have to do a far better job of building our infrastructure to accommodate all road users.”\u003c/p>\n\u003cp>Kolosh said he hopes the council’s analysis will allay unfounded fears, and remind people of more common dangers.\u003c/p>\n\u003cp>“As human beings, we’re terrible at assessing our own risk,” Kolosh said. “We typically focus on the unusual or scary events … and assume that those are the riskiest.”\u003c/p>\n\u003cp>He said data show the opposite is true.\u003c/p>\n\u003cp>For example, an American’s likelihood of dying in a “cataclysmic storm” is just 1 in 31,394.\u003c/p>\n\u003cp>Dying as an airplane passenger? 1 in 188,364.\u003c/p>\n\u003cp>In a train wreck? 1 in 243,765.\u003c/p>\n\u003cp>Falling? 1 in 114.\u003c/p>\n\u003cp>Kolosh said the probability of dying in a fall has increased (it was 1 in 119 last year), driven by more recorded falls among older adults as the \u003ca href=\"https://www.npr.org/2018/03/14/593398944/projections-show-an-aging-u-s-population\" target=\"_blank\" rel=\"noopener\">U.S. population ages\u003c/a>. Experts say the best way to prevent that risk is \u003ca href=\"https://www.npr.org/sections/health-shots/2018/04/17/603186213/to-prevent-falls-in-older-age-try-regular-exercise\" target=\"_blank\" rel=\"noopener\">exercise\u003c/a>. It’s a reminder, Kolosh said, that each of the 169,936 preventable deaths recorded in 2017 were preventable.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Your odds of dying are 1 in 1,” Kolosh quipped. “But that doesn’t mean we can’t do something. If, as a society, we put the appropriate rules and regulations in place we can prevent all accidental deaths in the future.”\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2019 NPR. To see more, visit \u003ca href=\"http://www.npr.org\" target=\"_blank\" rel=\"noopener\">www.npr.org\u003c/a>.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Report%3A+Americans+Are+Now+More+Likely+To+Die+Of+An+Opioid+Overdose+Than+On+The+Road&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\n","blocks":[],"excerpt":"Americans now have a 1 in 96 chance of dying from an opioid overdose, according to new analysis from the National Safety Council.","status":"publish","parent":0,"modified":1704927198,"stats":{"hasAudio":false,"hasVideo":true,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":21,"wordCount":692},"headData":{"title":"Opioid Overdoses Surpass Vehicle Crashes on Leading Causes of Death List | KQED","description":"Americans now have a 1 in 96 chance of dying from an opioid overdose, according to new analysis from the National Safety Council.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Opioid Overdoses Surpass Vehicle Crashes on Leading Causes of Death List","datePublished":"2019-01-15T18:00:27.000Z","dateModified":"2024-01-10T22:53:18.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"source":"Report","sticky":false,"nprImageCredit":"Spencer Platt","nprByline":"Ian Stewart\u003c/br>NPR","nprImageAgency":"Getty Images","nprStoryId":"684695273","nprApiLink":"http://api.npr.org/query?id=684695273&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/2019/01/14/684695273/report-americans-are-now-more-likely-to-die-of-an-opioid-overdose-than-on-the-ro?ft=nprml&f=684695273","nprRetrievedStory":"1","nprPubDate":"Mon, 14 Jan 2019 14:28:00 -0500","nprStoryDate":"Mon, 14 Jan 2019 00:01:00 -0500","nprLastModifiedDate":"Mon, 14 Jan 2019 14:28:39 -0500","path":"/science/1936758/report-americans-are-now-more-likely-to-die-of-an-opioid-overdose-than-on-the-road","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>For the first time in U.S. history, a leading cause of deaths — vehicle crashes — has been surpassed in likelihood by opioid overdoses, according to a \u003ca href=\"https://injuryfacts.nsc.org/all-injuries/preventable-death-overview/odds-of-dying/\" target=\"_blank\" rel=\"noopener\">new report \u003c/a>on preventable deaths from the National Safety Council.\u003c/p>\n\u003cp>Americans now have a 1 in 96 chance of dying from an opioid overdose, according to the council’s analysis of 2017 data on accidental death. The probability of dying in a motor vehicle crash is 1 in 103.\u003c/p>\n\u003cp>“The nation’s opioid crisis is fueling the Council’s grim probabilities, and that crisis is worsening with an influx of illicit fentanyl,” the council said in a statement released Monday.\u003c/p>\n\u003cp>Fentanyl is now the drug most often responsible for drug overdose deaths, the Centers for Disease Control and Prevention \u003ca href=\"https://www.npr.org/sections/health-shots/2018/12/12/676214086/fentanyl-surpasses-heroin-as-drug-most-often-involved-in-deadly-overdoses\" target=\"_blank\" rel=\"noopener\">reported\u003c/a> in December. And that may only be a partial view of the problem: Opioid-related overdoses also have been\u003ca href=\"https://www.npr.org/sections/health-shots/2018/03/22/595787272/omissions-on-death-certificates-lead-to-undercounting-of-opioid-overdoses\" target=\"_blank\" rel=\"noopener\"> undercounted\u003c/a> by as much as 35 percent, according to a study published last year in the journal \u003cem>Addiction\u003c/em>.\u003c/p>\n\u003cp>The council has \u003ca href=\"https://www.nsc.org/home-safety/safety-topics/opioids/whats-working\" target=\"_blank\" rel=\"noopener\">recommended\u003c/a> tackling the epidemic by increasing pain management training for opioid prescribers, making the potentially lifesaving drug \u003ca href=\"https://whyy.org/segments/the-overdose-antidote-how-narcan-works/\" target=\"_blank\" rel=\"noopener\">naloxone\u003c/a> more widely available and expanding access to addiction treatment.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>While the leading causes of death in the U.S. are heart disease (1 in 6 chance) and cancer (1 in 7), the rising overdose numbers are part of a distressing trend the nonprofit has tracked: The lifetime odds of an American dying from a preventable, unintentional injury have gone up over the past 15 years.\u003c/p>\n\u003cp>“It is impacting our workforce, it is impacting our fathers and mothers who are still raising their children,” said Ken Kolosh, manager of statistics at the National Safety Council. Kolosh said that those accidental deaths usually affect people in the “core of their life,” with greater financial and emotional ramifications than deaths of those in their later years.\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/_vNYQi6ZXss'\n title='//www.youtube.com/embed/_vNYQi6ZXss'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>Vehicle crashes remain a leading danger as well. Kolosh said half of people who died in crashes they analyzed were not wearing seat belts. Meanwhile, the frequency of pedestrian deaths has increased, led by a jump in fatalities in urban areas.\u003c/p>\n\u003cp>Pedestrian deaths have been at a \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/02/28/589453431/pedestrian-fatalities-remain-at-25-year-high-for-second-year-in-a-row\" target=\"_blank\" rel=\"noopener\">25-year high\u003c/a>, according to the Governors Highway Safety Association. A 2017 study found that an average of \u003ca href=\"https://www.npr.org/sections/thetwo-way/2017/01/10/509206453/walking-in-america-remains-dangerous-especially-in-florida\" target=\"_blank\" rel=\"noopener\">13 people a day\u003c/a> were killed by cars between 2005 and 2014, and that people of color and the elderly are disproportionately at risk.\u003c/p>\n\u003cp>“Historically, roadways have been designed to make it as efficient as possible for the vehicle,” Kolosh said, noting that bicyclists and pedestrians have been shortchanged. “We now have to do a far better job of building our infrastructure to accommodate all road users.”\u003c/p>\n\u003cp>Kolosh said he hopes the council’s analysis will allay unfounded fears, and remind people of more common dangers.\u003c/p>\n\u003cp>“As human beings, we’re terrible at assessing our own risk,” Kolosh said. “We typically focus on the unusual or scary events … and assume that those are the riskiest.”\u003c/p>\n\u003cp>He said data show the opposite is true.\u003c/p>\n\u003cp>For example, an American’s likelihood of dying in a “cataclysmic storm” is just 1 in 31,394.\u003c/p>\n\u003cp>Dying as an airplane passenger? 1 in 188,364.\u003c/p>\n\u003cp>In a train wreck? 1 in 243,765.\u003c/p>\n\u003cp>Falling? 1 in 114.\u003c/p>\n\u003cp>Kolosh said the probability of dying in a fall has increased (it was 1 in 119 last year), driven by more recorded falls among older adults as the \u003ca href=\"https://www.npr.org/2018/03/14/593398944/projections-show-an-aging-u-s-population\" target=\"_blank\" rel=\"noopener\">U.S. population ages\u003c/a>. Experts say the best way to prevent that risk is \u003ca href=\"https://www.npr.org/sections/health-shots/2018/04/17/603186213/to-prevent-falls-in-older-age-try-regular-exercise\" target=\"_blank\" rel=\"noopener\">exercise\u003c/a>. It’s a reminder, Kolosh said, that each of the 169,936 preventable deaths recorded in 2017 were preventable.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“Your odds of dying are 1 in 1,” Kolosh quipped. “But that doesn’t mean we can’t do something. If, as a society, we put the appropriate rules and regulations in place we can prevent all accidental deaths in the future.”\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2019 NPR. To see more, visit \u003ca href=\"http://www.npr.org\" target=\"_blank\" rel=\"noopener\">www.npr.org\u003c/a>.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Report%3A+Americans+Are+Now+More+Likely+To+Die+Of+An+Opioid+Overdose+Than+On+The+Road&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1936758/report-americans-are-now-more-likely-to-die-of-an-opioid-overdose-than-on-the-road","authors":["byline_science_1936758"],"categories":["science_3151","science_39","science_16","science_40"],"tags":["science_5181","science_3838","science_3072"],"featImg":"science_1936759","label":"source_science_1936758"},"science_1936659":{"type":"posts","id":"science_1936659","meta":{"index":"posts_1591205157","site":"science","id":"1936659","score":null,"sort":[1547494714000]},"guestAuthors":[],"slug":"tech-firms-look-to-robotic-pets-music-and-vr-to-help-treat-alzheimers","title":"Tech Firms Look to Robotic Pets, Music and VR to Help Treat Alzheimer’s","publishDate":1547494714,"format":"standard","headTitle":"Tech Firms Look to Robotic Pets, Music and VR to Help Treat Alzheimer’s | KQED","labelTerm":{},"content":"\u003cp>[dropcap]L[/dropcap]AS VEGAS — The drug industry’s\u003ca href=\"https://www.statnews.com/2018/08/10/alzheimers-pipeline-clinical-trials/\" target=\"_blank\" rel=\"noopener\"> foundering search for an Alzheimer’s cure\u003c/a> is fueling a parallel quest by technology companies to help patients and family caregivers cope with the disease by using virtual reality software, robotics and novel communication tools.\u003c/p>\n\u003cp>Several companies engaged in the effort \u003ca href=\"https://digitalhealthsummit.com/Sessions/who-will-rescue-alzheimers-if-pharma-cant/\" target=\"_blank\" rel=\"noopener\">gathered here on Wednesday\u003c/a> to deliver a unified message: Waiting for pharma to deliver a miracle is a recipe for financial Armageddon, as the cost of treating Alzheimer’s is expected to quadruple, to more than $1 trillion in the U.S. by 2030, if no breakthrough treatments reach the market.\u003c/p>\n\u003cp>The solution is not simply developing tools to manage patient symptoms, but to deliver better support to family caregivers who are collectively spending more than $500 billion annually to care for elderly relatives.\u003c/p>\n\u003cp>“If we do not support the role of family caregivers and value them in this process, there is nothing we can do to bend the cost curve beyond what we’re doing,” said Thomas Riley, chief executive of Seniorlink, which developed a digital communication platform to help coordinate care for Alzheimer’s patients.\u003c/p>\n\u003cp>Technology firms are also selling digital products to help patients: A company called Dthera Sciences has built a therapy that uses music and images to help patients recover memories. The product analyzes facial expressions to monitor the emotional impact on patients and discover the sounds and visuals that provide the greatest relief. Earlier this year, Dthera received breakthrough device designation from the Food and Drug Administration, which provides an expedited pathway for the product’s approval.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Another firm, Ageless Innovation, has developed robotic cats and dogs that help to treat the depression and social isolation that so often afflicts people with Alzheimer’s. Ted Fischer, the company’s CEO, said Wednesday that research conducted by Pace University showed the products resulted in better patient outcomes across several measures, including a reduction in hospitalizations. “And it produces joy and meaningful connections for these patients,” Fischer said.\u003c/p>\n\u003cp>The pharmaceutical industry has racked up a long list of failures in recent years, with many drug candidates following a similar narrative. A promising treatment in early-stage research turns out to be a flop in late-stage trials, putting investors, patients, and caregivers on a roller coaster that always ends in disappointment and a return to the drawing board.\u003c/p>\n\u003cp>Fischer and other technology executives gathered here said their products are neither panaceas nor substitutes for a hoped-for pharmaceutical breakthrough that could reverse or prevent the symptoms of the disease. But they also urged public and private funders to step up investments in technology solutions that, in the short term, represent the best option for patients and families.\u003c/p>\n\u003cp>Carrie Shaw, chief executive of Embodied Labs, said the fear and stigma of Alzheimer’s has undermined the development of tools to help families, clinicians, and payers confront the disease in a meaningful way. “We’re afraid of it, so we’re not addressing it,” she said, adding that more investment is needed to diagnose the onset of the disease at an earlier stage, to ensure more effective treatment.\u003c/p>\n\u003cp>Her company developed a virtual reality program to educate caregivers about the disease and help them understand its impact on their relatives. The product immerses users in various scenarios Alzheimer’s patients and caregivers commonly face — from the loss of cognitive function, to changes in family relationships, to caregiver burnout.\u003c/p>\n\u003cp>“We not only go inside their lives, but inside their bodies, so they actually know what it’s like to have this disease,” Shaw said.\u003c/p>\n\u003cp>Effective training and education for caregivers is especially important as the population ages, dramatically increasing the need for Alzheimer’s treatment as government investment in nursing home beds continues to decline.\u003c/p>\n\u003cp>Riley, the CEO of Seniorlink, said that means care will be increasingly delivered in home settings, where technology can help facilitate access to timely information and care. Seniorlink’s communication platform, called Vela, is a digital messaging service that can be used by all the family members, clinicians, and service providers involved in a patient’s care. Similar to workplace platforms like Slack, it lets the parties communicate in real time to address emergent problems and share information about changes in a patient’s condition and level of need.\u003c/p>\n\u003cp>Riley said the company is using analytics to help recognize patterns in patients’ symptoms, in an effort to flag optimal interventions for caregivers. He cautioned, however, that such technology should be used only to augment human care — not replace it.\u003c/p>\n\u003cp>“Money always rushes to technology,” he said. “But what technology gives you is data that humans still have to act on. And to act on it, they have to be able to trust it.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2019/01/10/alzheimers-tech-firms-solutions/\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"The drug industry’s faltering search for an Alzheimer’s cure is fueling a parallel quest by technology companies to help patients and family caregivers cope with the disease by using virtual reality software, robotics and novel communication tools.","status":"publish","parent":0,"modified":1704927203,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":845},"headData":{"title":"Tech Firms Look to Robotic Pets, Music and VR to Help Treat Alzheimer’s | KQED","description":"The drug industry’s faltering search for an Alzheimer’s cure is fueling a parallel quest by technology companies to help patients and family caregivers cope with the disease by using virtual reality software, robotics and novel communication tools.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Tech Firms Look to Robotic Pets, Music and VR to Help Treat Alzheimer’s","datePublished":"2019-01-14T19:38:34.000Z","dateModified":"2024-01-10T22:53:23.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"source":"Health","sticky":false,"nprByline":"Casey Ross\u003c/br>STAT","path":"/science/1936659/tech-firms-look-to-robotic-pets-music-and-vr-to-help-treat-alzheimers","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">L\u003c/span>\u003c/p>\u003cp>AS VEGAS — The drug industry’s\u003ca href=\"https://www.statnews.com/2018/08/10/alzheimers-pipeline-clinical-trials/\" target=\"_blank\" rel=\"noopener\"> foundering search for an Alzheimer’s cure\u003c/a> is fueling a parallel quest by technology companies to help patients and family caregivers cope with the disease by using virtual reality software, robotics and novel communication tools.\u003c/p>\n\u003cp>Several companies engaged in the effort \u003ca href=\"https://digitalhealthsummit.com/Sessions/who-will-rescue-alzheimers-if-pharma-cant/\" target=\"_blank\" rel=\"noopener\">gathered here on Wednesday\u003c/a> to deliver a unified message: Waiting for pharma to deliver a miracle is a recipe for financial Armageddon, as the cost of treating Alzheimer’s is expected to quadruple, to more than $1 trillion in the U.S. by 2030, if no breakthrough treatments reach the market.\u003c/p>\n\u003cp>The solution is not simply developing tools to manage patient symptoms, but to deliver better support to family caregivers who are collectively spending more than $500 billion annually to care for elderly relatives.\u003c/p>\n\u003cp>“If we do not support the role of family caregivers and value them in this process, there is nothing we can do to bend the cost curve beyond what we’re doing,” said Thomas Riley, chief executive of Seniorlink, which developed a digital communication platform to help coordinate care for Alzheimer’s patients.\u003c/p>\n\u003cp>Technology firms are also selling digital products to help patients: A company called Dthera Sciences has built a therapy that uses music and images to help patients recover memories. The product analyzes facial expressions to monitor the emotional impact on patients and discover the sounds and visuals that provide the greatest relief. Earlier this year, Dthera received breakthrough device designation from the Food and Drug Administration, which provides an expedited pathway for the product’s approval.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Another firm, Ageless Innovation, has developed robotic cats and dogs that help to treat the depression and social isolation that so often afflicts people with Alzheimer’s. Ted Fischer, the company’s CEO, said Wednesday that research conducted by Pace University showed the products resulted in better patient outcomes across several measures, including a reduction in hospitalizations. “And it produces joy and meaningful connections for these patients,” Fischer said.\u003c/p>\n\u003cp>The pharmaceutical industry has racked up a long list of failures in recent years, with many drug candidates following a similar narrative. A promising treatment in early-stage research turns out to be a flop in late-stage trials, putting investors, patients, and caregivers on a roller coaster that always ends in disappointment and a return to the drawing board.\u003c/p>\n\u003cp>Fischer and other technology executives gathered here said their products are neither panaceas nor substitutes for a hoped-for pharmaceutical breakthrough that could reverse or prevent the symptoms of the disease. But they also urged public and private funders to step up investments in technology solutions that, in the short term, represent the best option for patients and families.\u003c/p>\n\u003cp>Carrie Shaw, chief executive of Embodied Labs, said the fear and stigma of Alzheimer’s has undermined the development of tools to help families, clinicians, and payers confront the disease in a meaningful way. “We’re afraid of it, so we’re not addressing it,” she said, adding that more investment is needed to diagnose the onset of the disease at an earlier stage, to ensure more effective treatment.\u003c/p>\n\u003cp>Her company developed a virtual reality program to educate caregivers about the disease and help them understand its impact on their relatives. The product immerses users in various scenarios Alzheimer’s patients and caregivers commonly face — from the loss of cognitive function, to changes in family relationships, to caregiver burnout.\u003c/p>\n\u003cp>“We not only go inside their lives, but inside their bodies, so they actually know what it’s like to have this disease,” Shaw said.\u003c/p>\n\u003cp>Effective training and education for caregivers is especially important as the population ages, dramatically increasing the need for Alzheimer’s treatment as government investment in nursing home beds continues to decline.\u003c/p>\n\u003cp>Riley, the CEO of Seniorlink, said that means care will be increasingly delivered in home settings, where technology can help facilitate access to timely information and care. Seniorlink’s communication platform, called Vela, is a digital messaging service that can be used by all the family members, clinicians, and service providers involved in a patient’s care. Similar to workplace platforms like Slack, it lets the parties communicate in real time to address emergent problems and share information about changes in a patient’s condition and level of need.\u003c/p>\n\u003cp>Riley said the company is using analytics to help recognize patterns in patients’ symptoms, in an effort to flag optimal interventions for caregivers. He cautioned, however, that such technology should be used only to augment human care — not replace it.\u003c/p>\n\u003cp>“Money always rushes to technology,” he said. “But what technology gives you is data that humans still have to act on. And to act on it, they have to be able to trust it.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2019/01/10/alzheimers-tech-firms-solutions/\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1936659/tech-firms-look-to-robotic-pets-music-and-vr-to-help-treat-alzheimers","authors":["byline_science_1936659"],"categories":["science_3151","science_39","science_16","science_40"],"tags":["science_235","science_1785","science_5181","science_3838"],"featImg":"science_1936726","label":"source_science_1936659"},"science_1936401":{"type":"posts","id":"science_1936401","meta":{"index":"posts_1591205157","site":"science","id":"1936401","score":null,"sort":[1546890876000]},"guestAuthors":[],"slug":"new-software-can-spot-genetic-mutations-using-photos","title":"New Software Can Spot Genetic Mutations Using Photos","publishDate":1546890876,"format":"standard","headTitle":"New Software Can Spot Genetic Mutations Using Photos | KQED","labelTerm":{},"content":"\u003cp>[dropcap]S[/dropcap]ome people’s faces — or even just a photo of them — hint at the genes they carry. And now, an algorithm can predict not only whether they carry a genetic mutation, but which genes were mutated.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.nature.com/articles/s41591-018-0279-0\">study\u003c/a>, published Monday in Nature Medicine, is the latest from a Boston-based company called FDNA, one of a \u003ca href=\"https://www.statnews.com/2017/04/10/facial-recognition-genetic-disorders/\">few organizations creating software\u003c/a> that can help physicians diagnose genetic syndromes based just on a face — and may serve an important validation of the company’s technology, said Yaron Gurovich, the company’s chief technology officer.\u003c/p>\n\u003cp>“We went for this high-impact journal to prove beyond any doubt that this technology is good, it performs as we say, we can stand behind it, and now it opens a lot of doors to publish more,” he said.\u003c/p>\n\u003cp>The study itself is a collection of experiments testing how the results of algorithms — FDNA refers to them as DeepGestalt — stack up against clinicians’ diagnoses. In one of the experiments, DeepGestalt’s performance was better than random chance when picking which of five genetic mutations might be causing a condition called Noonan syndrome. It was correct 64 percent of the time, far more than the 20 percent success rate that would be expected from guesswork.\u003c/p>\n\u003cp>“This is new — we’ve never published something like this before,” Gurovich said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Gurovich is quick to say that the tool isn’t specifically or only for Noonan syndrome. His team chose the condition because there are already published studies about how well humans can distinguish between the various faces associated with it. FDNA is already working on another paper Gurovich said will show that the tool can be used more broadly. It’s going through the peer review process, he said, but a \u003ca href=\"https://www.biorxiv.org/content/early/2018/11/21/473306\">preprint version\u003c/a> is available.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘This is new — we’ve never published something like this before.’\u003ccite>Yaron Gurovich, FDNA\u003c/cite>\u003c/aside>\n\u003cp>One expert on Noonan syndrome, Dr. Bruce Gelb, the director of the Mindich Child Health and Development Institute and a professor at the Icahn School of Medicine at Mount Sinai, cautioned that being able to pick apart a person’s genotype based on facial features is not generally going to be useful for people with the condition.\u003c/p>\n\u003cp>Noonan syndrome comes with a variety of symptoms, including difficulty learning, facial appearance, short stature, and heart issues — including issues with valves or the muscles of the heart itself. A few have a very high risk of leukemia.\u003c/p>\n\u003cp>Some children with Noonan syndrome attend special education classes; others develop typically and can attend mainstream classes. Many can live independently when they’re adults. “It varies a lot,” Gelb said.\u003c/p>\n\u003cp>The genetic cause of Noonan syndrome can vary, too. Mutations in a few different genes can lead to the condition; some mutations cause more serious problems than others. All of the genes, however, are linked to one vital biochemical pathway. Gelb and his research group \u003ca href=\"https://www.nature.com/articles/ng772.epdf?referrer_access_token=pyqbUoC1N6pu4ONrbf7p-dRgN0jAjWel9jnR3ZoTv0N_aEXfBZJ5UdikqtmfwCNXtbaW16rct1gXy0ybOILq30HDNTADZng2FuE6EIQ5rZUCeTxb0IcHHWK4FYeWQUzl1RC37x8AUQ5VhWgJ_gCtuexxd6Hbv9Jdi_kTnCSJ58A%3D&tracking_referrer=www.statnews.com\">have discovered\u003c/a> \u003ca href=\"https://www.nature.com/articles/ng1939.epdf?referrer_access_token=YGvl4Y4X_QshFYTfu2YjQ9RgN0jAjWel9jnR3ZoTv0Mrh-TZl36dLirUZe-74nzZOxlFsdIHF50ddu1dNrJfeaq9wkfjaVZoRTGs8sbI39nA6vpr1CpXKLQdwf7hvAQbSEiKx9tRYNbP-HvhG0GxWgTtRX2Ai6LzUREdlZecehg%3D&tracking_referrer=www.statnews.com\">some of them\u003c/a>.\u003c/p>\n\u003cp>For example, children whose RAS1 gene is mutated almost always get hypertrophic cardiomyopathy, a condition in which the muscles of the heart get thick, making it difficult for the heart to pump normally. Children with mutations in a gene called KRAS have some of the most severe forms of the syndrome and some of the worst neurological and heart outcomes.\u003c/p>\n\u003cp>There aren’t any drugs to treat Noonan syndrome, or many other developmental syndromes like it.\u003c/p>\n\u003cp>Understanding how a child with Noonan syndrome will develop can help health care providers figure out what medical problems they may face, Gelb said. But the algorithm isn’t likely to replace a genetic test, he said — which doctors can undertake easily if they notice something off in a particular region of a fetus’ neck.\u003c/p>\n\u003cp>“I don’t know why they undertook this, exactly,” he said of FDNA’s work. “It’s inconceivable to me that one wouldn’t send off the panel testing and figure out which one it actually is.” Even in low-resource countries — at least in those with a medical geneticist — such genetic testing is becoming more widely available, he said.\u003c/p>\n\u003cp>Gelb also pointed out that the paper only used a set of images of young children — a choice that may have set the algorithm up for success. “The facial features are most obvious in a toddler or young child, and it can kind of melt away in adolescence by the time they hit adulthood,” he said.\u003c/p>\n\u003cp>He acknowledged that the algorithm’s success rate, however, is “impressive” and could be especially useful for clinicians who don’t have hyper-specialized knowledge about a given genetic condition.\u003c/p>\n\u003cp>And using a tool like FDNA’s could show clinicians what genes they should ask labs to test, Gurovich suggested. “If you consider the phenotype properly, you are able to increase your odds of a diagnosis,” he said — something that he said humans can’t quite do.\u003c/p>\n\u003cp>“There are geneticists that have tried to do this. They couldn’t. We can.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2019/01/07/algorithm-spot-genetic-mutation-photo/\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Some people’s faces, or even just a photo of them, hint at the genes they carry. According to a study out today, a new algorithm can predict not only whether they carry a genetic mutation, but which genes were mutated.\r\n\r\nThe study, published Monday in Nature Medicin","status":"publish","parent":0,"modified":1704927220,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":21,"wordCount":905},"headData":{"title":"New Software Can Spot Genetic Mutations Using Photos | KQED","description":"Some people’s faces, or even just a photo of them, hint at the genes they carry. According to a study out today, a new algorithm can predict not only whether they carry a genetic mutation, but which genes were mutated.\r\n\r\nThe study, published Monday in Nature Medicin","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"New Software Can Spot Genetic Mutations Using Photos","datePublished":"2019-01-07T19:54:36.000Z","dateModified":"2024-01-10T22:53:40.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"source":"Science","sticky":false,"nprByline":"Kate Sheridan\u003cbr />STAT","path":"/science/1936401/new-software-can-spot-genetic-mutations-using-photos","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c/p>\u003cp>\u003cspan class=\"utils-parseShortcode-shortcodes-__dropcapShortcode__dropcap\">S\u003c/span>\u003c/p>\u003cp>ome people’s faces — or even just a photo of them — hint at the genes they carry. And now, an algorithm can predict not only whether they carry a genetic mutation, but which genes were mutated.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.nature.com/articles/s41591-018-0279-0\">study\u003c/a>, published Monday in Nature Medicine, is the latest from a Boston-based company called FDNA, one of a \u003ca href=\"https://www.statnews.com/2017/04/10/facial-recognition-genetic-disorders/\">few organizations creating software\u003c/a> that can help physicians diagnose genetic syndromes based just on a face — and may serve an important validation of the company’s technology, said Yaron Gurovich, the company’s chief technology officer.\u003c/p>\n\u003cp>“We went for this high-impact journal to prove beyond any doubt that this technology is good, it performs as we say, we can stand behind it, and now it opens a lot of doors to publish more,” he said.\u003c/p>\n\u003cp>The study itself is a collection of experiments testing how the results of algorithms — FDNA refers to them as DeepGestalt — stack up against clinicians’ diagnoses. In one of the experiments, DeepGestalt’s performance was better than random chance when picking which of five genetic mutations might be causing a condition called Noonan syndrome. It was correct 64 percent of the time, far more than the 20 percent success rate that would be expected from guesswork.\u003c/p>\n\u003cp>“This is new — we’ve never published something like this before,” Gurovich said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Gurovich is quick to say that the tool isn’t specifically or only for Noonan syndrome. His team chose the condition because there are already published studies about how well humans can distinguish between the various faces associated with it. FDNA is already working on another paper Gurovich said will show that the tool can be used more broadly. It’s going through the peer review process, he said, but a \u003ca href=\"https://www.biorxiv.org/content/early/2018/11/21/473306\">preprint version\u003c/a> is available.\u003c/p>\n\u003caside class=\"pullquote alignright\">‘This is new — we’ve never published something like this before.’\u003ccite>Yaron Gurovich, FDNA\u003c/cite>\u003c/aside>\n\u003cp>One expert on Noonan syndrome, Dr. Bruce Gelb, the director of the Mindich Child Health and Development Institute and a professor at the Icahn School of Medicine at Mount Sinai, cautioned that being able to pick apart a person’s genotype based on facial features is not generally going to be useful for people with the condition.\u003c/p>\n\u003cp>Noonan syndrome comes with a variety of symptoms, including difficulty learning, facial appearance, short stature, and heart issues — including issues with valves or the muscles of the heart itself. A few have a very high risk of leukemia.\u003c/p>\n\u003cp>Some children with Noonan syndrome attend special education classes; others develop typically and can attend mainstream classes. Many can live independently when they’re adults. “It varies a lot,” Gelb said.\u003c/p>\n\u003cp>The genetic cause of Noonan syndrome can vary, too. Mutations in a few different genes can lead to the condition; some mutations cause more serious problems than others. All of the genes, however, are linked to one vital biochemical pathway. Gelb and his research group \u003ca href=\"https://www.nature.com/articles/ng772.epdf?referrer_access_token=pyqbUoC1N6pu4ONrbf7p-dRgN0jAjWel9jnR3ZoTv0N_aEXfBZJ5UdikqtmfwCNXtbaW16rct1gXy0ybOILq30HDNTADZng2FuE6EIQ5rZUCeTxb0IcHHWK4FYeWQUzl1RC37x8AUQ5VhWgJ_gCtuexxd6Hbv9Jdi_kTnCSJ58A%3D&tracking_referrer=www.statnews.com\">have discovered\u003c/a> \u003ca href=\"https://www.nature.com/articles/ng1939.epdf?referrer_access_token=YGvl4Y4X_QshFYTfu2YjQ9RgN0jAjWel9jnR3ZoTv0Mrh-TZl36dLirUZe-74nzZOxlFsdIHF50ddu1dNrJfeaq9wkfjaVZoRTGs8sbI39nA6vpr1CpXKLQdwf7hvAQbSEiKx9tRYNbP-HvhG0GxWgTtRX2Ai6LzUREdlZecehg%3D&tracking_referrer=www.statnews.com\">some of them\u003c/a>.\u003c/p>\n\u003cp>For example, children whose RAS1 gene is mutated almost always get hypertrophic cardiomyopathy, a condition in which the muscles of the heart get thick, making it difficult for the heart to pump normally. Children with mutations in a gene called KRAS have some of the most severe forms of the syndrome and some of the worst neurological and heart outcomes.\u003c/p>\n\u003cp>There aren’t any drugs to treat Noonan syndrome, or many other developmental syndromes like it.\u003c/p>\n\u003cp>Understanding how a child with Noonan syndrome will develop can help health care providers figure out what medical problems they may face, Gelb said. But the algorithm isn’t likely to replace a genetic test, he said — which doctors can undertake easily if they notice something off in a particular region of a fetus’ neck.\u003c/p>\n\u003cp>“I don’t know why they undertook this, exactly,” he said of FDNA’s work. “It’s inconceivable to me that one wouldn’t send off the panel testing and figure out which one it actually is.” Even in low-resource countries — at least in those with a medical geneticist — such genetic testing is becoming more widely available, he said.\u003c/p>\n\u003cp>Gelb also pointed out that the paper only used a set of images of young children — a choice that may have set the algorithm up for success. “The facial features are most obvious in a toddler or young child, and it can kind of melt away in adolescence by the time they hit adulthood,” he said.\u003c/p>\n\u003cp>He acknowledged that the algorithm’s success rate, however, is “impressive” and could be especially useful for clinicians who don’t have hyper-specialized knowledge about a given genetic condition.\u003c/p>\n\u003cp>And using a tool like FDNA’s could show clinicians what genes they should ask labs to test, Gurovich suggested. “If you consider the phenotype properly, you are able to increase your odds of a diagnosis,” he said — something that he said humans can’t quite do.\u003c/p>\n\u003cp>“There are geneticists that have tried to do this. They couldn’t. We can.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2019/01/07/algorithm-spot-genetic-mutation-photo/\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1936401/new-software-can-spot-genetic-mutations-using-photos","authors":["byline_science_1936401"],"categories":["science_30","science_3151","science_39","science_16","science_3424","science_40"],"tags":["science_3663","science_5196","science_5181","science_3838"],"featImg":"science_1936411","label":"source_science_1936401"},"science_1934940":{"type":"posts","id":"science_1934940","meta":{"index":"posts_1591205157","site":"science","id":"1934940","score":null,"sort":[1543413606000]},"guestAuthors":[],"slug":"fda-says-it-will-overhaul-long-criticized-system-for-approving-medical-devices","title":"FDA Says It Will Overhaul Long-Criticized System for Approving Medical Devices","publishDate":1543413606,"format":"standard","headTitle":"FDA Says It Will Overhaul Long-Criticized System for Approving Medical Devices | KQED","labelTerm":{},"content":"\u003cp>U.S. health officials said earlier this week they plan to overhaul the nation’s decades-old system for approving most medical devices, which has long been criticized by experts for failing to catch problems with risky implants and related products.\u003c/p>\n\u003cp>The Food and Drug Administration (FDA) announced plans aimed at making sure new medical devices reflect up-to-date safety and effectiveness features. The system targeted by the actions generally allows manufacturers to launch new products based on similarities to decades-old products, not new clinical testing in patients.\u003c/p>\n\u003cp>The FDA’s move came one day after \u003ca href=\"https://www.icij.org/investigations/implant-files/medical-devices-harm-patients-worldwide-as-governments-fail-on-safety/\" target=\"_blank\" rel=\"noopener\">the publication of a global investigation into medical device safety by more than 50 media organizations\u003c/a>. Led by the International Consortium of Investigative Journalists, the group found that more than 1.7 million injuries and nearly 83,000 deaths suspected of being linked to medical devices had been reported to the FDA over a 10-year period.\u003c/p>\n\u003cp>“We believe that it’s time to fundamentally modernize an approach first adopted in 1976,” said FDA Commissioner Scott Gottlieb in a statement, noting that the changes under consideration would push companies to compare their devices to more up-to-date technology.\u003c/p>\n\u003cp>On Twitter, he described the proposal as “the most significant modernization” of the medical device review process in a generation.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>https://twitter.com/SGottliebFDA/status/1067374433231360000\u003c/p>\n\u003cp>Some of the reforms proposed by the FDA could take years to implement and potentially include new guidelines and regulations for manufacturers, and the most substantive changes could require action by Congress.\u003c/p>\n\u003cp>Dr. David Challoner, a leading expert on the FDA’s review system, said the changes would likely improve device safety, but he worried manufacturers could scuttle the reform effort.\u003c/p>\n\u003cp>“If the device industry comes back at this full bore with their lobbying efforts, this could all die a slow and painful death,” he said.\u003c/p>\n\u003cp>In 2011, Challoner led a government advisory panel that recommended the FDA’s “flawed” review system be replaced. At the time, the FDA said it disagreed with the group’s recommendations.\u003c/p>\n\u003cp>The FDA’s framework for clearing more than 95 percent of devices on the U.S. market has long been criticized in reports from government watchdogs and independent medical experts. Unlike new pharmaceuticals — which are tested in patient studies — most medical devices only have to show that they are similar to devices already on the market. Only a handful of truly new devices must undergo extensive clinical testing to verify they are safe and effective.\u003c/p>\n\u003cp>Challoner’s review panel had concluded that Congress originally intended for the streamlined pathway to be a temporary way to “grandfather” in thousands of low-to-moderate risk devices then on the market. But instead of being phased out it became the principal approval path.\u003c/p>\n\u003cp>Defective devices cleared through the streamlined system have included hip replacements that failed prematurely, surgical mesh linked to pain and bleeding, and a surgical instrument that inadvertently spread uterine cancer.\u003c/p>\n\u003cp>As generations of devices have been cleared via the FDA’s main review process, medical products have become increasingly complex and often barely resemble the decades-old “predicates” they claim to reference. Devices cleared through this system, known as the 510(k), include imaging scanners, computerized drug pumps, artificial joints and spinal implants.\u003c/p>\n\u003cp>The FDA said it would consider phasing out some older devices so that new products could no longer reference them to enter the market. The agency noted that nearly 20 percent of devices cleared through its main review process are predicated on devices that are more than 10 years old.\u003c/p>\n\u003cp>The Advanced Medical Technology Association, the industry’s chief lobbying group, said in a statement that it looked forward to learning more about the FDA’s plans.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“While we believe the 510(k) pathway has proven its effectiveness over the years, we have always maintained that any process can be improved,” the group said.\u003c/p>\n\n","blocks":[],"excerpt":"Unlike new pharmaceuticals, most new medical devices only have to show that they are similar to devices already on the market. The system has long been criticized in reports from government watchdogs and medical experts.","status":"publish","parent":0,"modified":1704927284,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":676},"headData":{"title":"FDA Says It Will Overhaul Long-Criticized System for Approving Medical Devices | KQED","description":"Unlike new pharmaceuticals, most new medical devices only have to show that they are similar to devices already on the market. The system has long been criticized in reports from government watchdogs and medical experts.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"FDA Says It Will Overhaul Long-Criticized System for Approving Medical Devices","datePublished":"2018-11-28T14:00:06.000Z","dateModified":"2024-01-10T22:54:44.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"source":"Associated Press","sticky":false,"nprByline":"Matthew Perrone\u003cbr>\u003cstrong>Associated Press\u003c/strong>","path":"/science/1934940/fda-says-it-will-overhaul-long-criticized-system-for-approving-medical-devices","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>U.S. health officials said earlier this week they plan to overhaul the nation’s decades-old system for approving most medical devices, which has long been criticized by experts for failing to catch problems with risky implants and related products.\u003c/p>\n\u003cp>The Food and Drug Administration (FDA) announced plans aimed at making sure new medical devices reflect up-to-date safety and effectiveness features. The system targeted by the actions generally allows manufacturers to launch new products based on similarities to decades-old products, not new clinical testing in patients.\u003c/p>\n\u003cp>The FDA’s move came one day after \u003ca href=\"https://www.icij.org/investigations/implant-files/medical-devices-harm-patients-worldwide-as-governments-fail-on-safety/\" target=\"_blank\" rel=\"noopener\">the publication of a global investigation into medical device safety by more than 50 media organizations\u003c/a>. Led by the International Consortium of Investigative Journalists, the group found that more than 1.7 million injuries and nearly 83,000 deaths suspected of being linked to medical devices had been reported to the FDA over a 10-year period.\u003c/p>\n\u003cp>“We believe that it’s time to fundamentally modernize an approach first adopted in 1976,” said FDA Commissioner Scott Gottlieb in a statement, noting that the changes under consideration would push companies to compare their devices to more up-to-date technology.\u003c/p>\n\u003cp>On Twitter, he described the proposal as “the most significant modernization” of the medical device review process in a generation.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"singleTwitterStatus","attributes":{"named":{"id":"1067374433231360000"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>Some of the reforms proposed by the FDA could take years to implement and potentially include new guidelines and regulations for manufacturers, and the most substantive changes could require action by Congress.\u003c/p>\n\u003cp>Dr. David Challoner, a leading expert on the FDA’s review system, said the changes would likely improve device safety, but he worried manufacturers could scuttle the reform effort.\u003c/p>\n\u003cp>“If the device industry comes back at this full bore with their lobbying efforts, this could all die a slow and painful death,” he said.\u003c/p>\n\u003cp>In 2011, Challoner led a government advisory panel that recommended the FDA’s “flawed” review system be replaced. At the time, the FDA said it disagreed with the group’s recommendations.\u003c/p>\n\u003cp>The FDA’s framework for clearing more than 95 percent of devices on the U.S. market has long been criticized in reports from government watchdogs and independent medical experts. Unlike new pharmaceuticals — which are tested in patient studies — most medical devices only have to show that they are similar to devices already on the market. Only a handful of truly new devices must undergo extensive clinical testing to verify they are safe and effective.\u003c/p>\n\u003cp>Challoner’s review panel had concluded that Congress originally intended for the streamlined pathway to be a temporary way to “grandfather” in thousands of low-to-moderate risk devices then on the market. But instead of being phased out it became the principal approval path.\u003c/p>\n\u003cp>Defective devices cleared through the streamlined system have included hip replacements that failed prematurely, surgical mesh linked to pain and bleeding, and a surgical instrument that inadvertently spread uterine cancer.\u003c/p>\n\u003cp>As generations of devices have been cleared via the FDA’s main review process, medical products have become increasingly complex and often barely resemble the decades-old “predicates” they claim to reference. Devices cleared through this system, known as the 510(k), include imaging scanners, computerized drug pumps, artificial joints and spinal implants.\u003c/p>\n\u003cp>The FDA said it would consider phasing out some older devices so that new products could no longer reference them to enter the market. The agency noted that nearly 20 percent of devices cleared through its main review process are predicated on devices that are more than 10 years old.\u003c/p>\n\u003cp>The Advanced Medical Technology Association, the industry’s chief lobbying group, said in a statement that it looked forward to learning more about the FDA’s plans.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“While we believe the 510(k) pathway has proven its effectiveness over the years, we have always maintained that any process can be improved,” the group said.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/science/1934940/fda-says-it-will-overhaul-long-criticized-system-for-approving-medical-devices","authors":["byline_science_1934940"],"categories":["science_3151","science_39","science_40"],"tags":["science_1050"],"featImg":"science_1934943","label":"source_science_1934940"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! 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Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. 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