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"content": "\u003cp>As the story goes, nearly 80 years ago on the Faroe Islands — a stark North Atlantic archipelago 200 miles off the coast of Scotland — a neurologic epidemic may have washed, or rather convoyed, ashore.\u003c/p>\n\u003cp>Before 1940 the incidence of multiple sclerosis on the Faroes was near, if not actually, zero, according to the \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/11165464\" target=\"_blank\" rel=\"noopener\">tantalizing lore\u003c/a> I recall from medical school. Yet in the years following British occupation of the islands during World War II, the rate of MS rose dramatically, leading many researchers to assume the outbreak was caused by some unknown germ transmitted by the foreign soldiers.\u003c/p>\n\u003cp>We now know that MS is not infectious in the true sense of the word. It is not contagious in the way, say, the flu is.\u003c/p>\n\u003cp>But infection does likely play a role in MS.\u003c/p>\n\u003cp>As may be the case in \u003ca href=\"https://www.npr.org/sections/health-shots/2018/09/09/645629133/infectious-theory-of-alzheimers-disease-draws-fresh-interest\" target=\"_blank\" rel=\"noopener\">Alzheimer’s disease\u003c/a>, it’s looking more and more as though MS strikes when infectious, genetic and immune factors gang up to eventually impair the function of neurons in the brain and spinal cord. Researchers are hoping to better understand this network of influences to develop more effective ways to treat MS and perhaps prevent it in the first place.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In the MS-free brain, electrical impulses zip down \u003ca href=\"https://en.wikipedia.org/wiki/Axon\" target=\"_blank\" rel=\"noopener\">nerve fibers called axons\u003c/a> causing the release of neurotransmitters. The wiring allows neurons to communicate with each other and generate biologic wonders like thought, sensation and movement.\u003c/p>\n\u003cp>In many regions of the brain those axons are encased in an insulating jacket of protein and fat called myelin, which increases the speed that electrical nerve impulses travel.\u003c/p>\n\u003cp>In MS, myelin breaks down and scars – it becomes “sclerotic” and degrades nerve function. A pickle for researchers has been figuring out how this process starts.\u003c/p>\n\u003cp>There is certainly a genetic component at work: The risk of developing MS is 1 in 1,000 in the general population; it rises to about 1 in 4 in identical twins in which one twin is affected.\u003c/p>\n\u003cp>Even so, genes don’t explain it all. MS occurs more frequently at higher latitudes, suggesting that vitamin D deficiency might play a role in disease risk (the vitamin’s production in the body is dependent on sun exposure). Smoking also increases risk for the disease, as does obesity.\u003c/p>\n\u003cp>And while the tale of the Faroe Islands is disputed – large scale retroactive epidemiological studies are notoriously hard to pull off – it is for the most part accepted that microbes play some role in MS given that dozens of microbes, including the Epstein-Barr virus, have been tied to MS.\u003c/p>\n\u003cp>Yet more than 30 years of research suggests that risk factors in MS ultimately converge on the crux of its pathology: a misguided immune attack on myelin. Research in animals and humans supports the idea that MS develops when a type of white blood cell called a T-cell attacks specific proteins in myelin, making the axons less able to conduct electrical impulses efficiently.\u003c/p>\n\u003cp>The immune siege appears to be a result of something called “molecular mimicry.” Normally the body’s immune system attacks foreign invaders like viruses and bacteria. If a molecule that’s part of the body happens to closely resemble a portion of an intruding microbe, then both molecules can be targeted.\u003c/p>\n\u003cp>Put another way, say a particular protein on the surface of a virus is similar in structure to a protein found in myelin. The immune system ramps up to clear the virus but also attacks the myelin. It’s a case of mistaken identity, of collateral damage.\u003c/p>\n\u003cp>\u003ca href=\"http://www.en.neurologie.usz.ch/about-us/Pages/team.aspx\" target=\"_blank\" rel=\"noopener\">Dr. Roland Martin from the University Hospital of Zurich\u003c/a> in Switzerland is among the researchers who over the years helped identify which myelin proteins and peptides – biologic building blocks made of amino acids — come under attack in MS and which cells and immune molecules do the attacking.\u003c/p>\n\u003cp>“The idea of molecular mimicry is one of the most important ones in MS,” Martin says. “We and others have shown that mimicry between myelin peptides and viral and bacterial peptides indeed exists.”\u003c/p>\n\u003cp>And a number of proteins that make up myelin have been identified as helping spark the immune activity behind MS, possibly in response to similar microbial cousins.\u003c/p>\n\u003cp>Now, a \u003ca href=\"https://www.zora.uzh.ch/id/eprint/158835/1/2018_Planas_GDP_L-Fucose_Sci_Transl._Med._in_press.pdf\" target=\"_blank\" rel=\"noopener\">paper co-authored by Martin\u003c/a>, and published in October in \u003cem>Science and Translational Medicine\u003c/em>, reports on an additional nonmyelin-related protein that also may be involved.\u003c/p>\n\u003cp>Martin and his colleagues examined protein samples from the brains of 31 people who had died from suspected or confirmed MS. T-cells from 12 people reacted to the clunkily named enzyme, guanosine diphosphate-L-fucose synthase – or GDP-L-fucose synthase. The enzyme is normally involved in processing sugars essential to cellular function and communication, including that of neurons.\u003c/p>\n\u003cp>Paper co-author \u003ca href=\"https://www.multiplesclerosis.uzh.ch/en/coretopics/psospedra.html\" target=\"_blank\" rel=\"noopener\">Mireia Sospedra\u003c/a>, also of the University Hospital of Zurich, likens the enzyme to the iceberg’s ominous tip. “Yes, [myelin proteins] make sense but we think they might be not the only ones involved,” she speculates. “We think is that other auto-antigens might be involved in initiating the disease.”\u003c/p>\n\u003cp>She believes that the attack on this newly identified auto-antigen triggers tissue damage that exposes other proteins in myelin that are subsequently attacked themselves.\u003c/p>\n\u003cp>Sospedra also makes the point that culprit antigens might be different in everyone. The structure of our molecular machinery is genetically determined. Certain variants in, say, myelin protein structure might be more prone to immune attack; also genetic variation in immune cells themselves could influence how the body responds to a particular infection.\u003c/p>\n\u003cp>Northwestern University \u003ca href=\"https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=14949\" target=\"_blank\" rel=\"noopener\">immunology professor Stephen Miller\u003c/a> – who was not involved in the new research but who has collaborated with Martin in the past — sees the findings as revealing another piece in the MS puzzle.\u003c/p>\n\u003cp>“I don’t think there’s one particular virus or bacteria or environmental factor that triggers MS in every patient. There are probably many things that can trigger an autoimmune reaction against a particular infection,” he says. “But the more antigens we identify that can contribute to the disease the better.”\u003c/p>\n\u003cp>Regardless of the particular “cause” in a given patient, Martin, Miller and a number of other researchers are hard at work trying to thwart the MS immune attack in the first place using by coaxing the body into building up a familiarity and tolerance to suspected antigens, something called immunotolerance therapy. It’s a similar concept to how certain allergies can be thwarted by exposure to small amounts of a particular allergen.\u003c/p>\n\u003cp>“Think of it as a sort of negative vaccine,” says Miller. “We want less immune activity, not more.”\u003c/p>\n\u003cp>The sizable batch of approved MS medications for the most part work by broadly suppressing the immune system. They help control symptoms but also leave patients vulnerable to side effects like common infections.\u003c/p>\n\u003cp>Antigen-specific therapy only tames the immune response to specific antigens of interest. In theory it should come with fewer risks.\u003c/p>\n\u003cp>Miller recently co-founded a startup called \u003ca href=\"https://www.courpharma.com/about/\" target=\"_blank\" rel=\"noopener\">Cour Pharmaceuticals\u003c/a> through which he and his colleagues are studying the potential for immunotolerance therapy for MS and a number of other conditions, including celiac disease and Type I diabetes. The experimental therapy they plan to test involves attaching known MS-inducing antigens to biodegradable nanoparticles which they will then inject into trial patients. But for now they’ve just completed a phase I study testing their approach in celiac disease, with a phase II trial about to begin.\u003c/p>\n\u003cp>Martin’s group is pursuing a similar approach in which they chemically combine red or white blood cells with MS antigens and infuse them back into patients to induce tolerance.\u003c/p>\n\u003cp>This research is at a very early stage, but both groups are optimistic.\u003c/p>\n\u003cp>“Several of us in academia — and also the pharmaceutical industry — are pursing the long-standing dream of many immunologists: inducing tolerance against specific target antigens in autoimmune diseases like MS,” says Martin. “I am confident that sooner or later, we will be successful.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Bret Stetka is a writer based in New York and an editorial director at \u003c/em>\u003ca href=\"http://www.medscape.com/public/bios/bio-bretstetka\" target=\"_blank\" rel=\"noopener\">Medscape\u003c/a>.\u003cem> A graduate of the University of Virginia School of Medicine, Stetka has had his work published by \u003c/em>Wired, Scientific American\u003cem> and The Atlantic.com. He’s also on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/BretStetka\" target=\"_blank\" rel=\"noopener\">@BretStetka\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2019 \u003ca href=\"http://www.npr.org\" target=\"_blank\" rel=\"noopener\">NPR\u003c/a>.\u003c/em>\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In the MS-free brain, electrical impulses zip down \u003ca href=\"https://en.wikipedia.org/wiki/Axon\" target=\"_blank\" rel=\"noopener\">nerve fibers called axons\u003c/a> causing the release of neurotransmitters. The wiring allows neurons to communicate with each other and generate biologic wonders like thought, sensation and movement.\u003c/p>\n\u003cp>In many regions of the brain those axons are encased in an insulating jacket of protein and fat called myelin, which increases the speed that electrical nerve impulses travel.\u003c/p>\n\u003cp>In MS, myelin breaks down and scars – it becomes “sclerotic” and degrades nerve function. A pickle for researchers has been figuring out how this process starts.\u003c/p>\n\u003cp>There is certainly a genetic component at work: The risk of developing MS is 1 in 1,000 in the general population; it rises to about 1 in 4 in identical twins in which one twin is affected.\u003c/p>\n\u003cp>Even so, genes don’t explain it all. MS occurs more frequently at higher latitudes, suggesting that vitamin D deficiency might play a role in disease risk (the vitamin’s production in the body is dependent on sun exposure). Smoking also increases risk for the disease, as does obesity.\u003c/p>\n\u003cp>And while the tale of the Faroe Islands is disputed – large scale retroactive epidemiological studies are notoriously hard to pull off – it is for the most part accepted that microbes play some role in MS given that dozens of microbes, including the Epstein-Barr virus, have been tied to MS.\u003c/p>\n\u003cp>Yet more than 30 years of research suggests that risk factors in MS ultimately converge on the crux of its pathology: a misguided immune attack on myelin. Research in animals and humans supports the idea that MS develops when a type of white blood cell called a T-cell attacks specific proteins in myelin, making the axons less able to conduct electrical impulses efficiently.\u003c/p>\n\u003cp>The immune siege appears to be a result of something called “molecular mimicry.” Normally the body’s immune system attacks foreign invaders like viruses and bacteria. If a molecule that’s part of the body happens to closely resemble a portion of an intruding microbe, then both molecules can be targeted.\u003c/p>\n\u003cp>Put another way, say a particular protein on the surface of a virus is similar in structure to a protein found in myelin. The immune system ramps up to clear the virus but also attacks the myelin. It’s a case of mistaken identity, of collateral damage.\u003c/p>\n\u003cp>\u003ca href=\"http://www.en.neurologie.usz.ch/about-us/Pages/team.aspx\" target=\"_blank\" rel=\"noopener\">Dr. Roland Martin from the University Hospital of Zurich\u003c/a> in Switzerland is among the researchers who over the years helped identify which myelin proteins and peptides – biologic building blocks made of amino acids — come under attack in MS and which cells and immune molecules do the attacking.\u003c/p>\n\u003cp>“The idea of molecular mimicry is one of the most important ones in MS,” Martin says. “We and others have shown that mimicry between myelin peptides and viral and bacterial peptides indeed exists.”\u003c/p>\n\u003cp>And a number of proteins that make up myelin have been identified as helping spark the immune activity behind MS, possibly in response to similar microbial cousins.\u003c/p>\n\u003cp>Now, a \u003ca href=\"https://www.zora.uzh.ch/id/eprint/158835/1/2018_Planas_GDP_L-Fucose_Sci_Transl._Med._in_press.pdf\" target=\"_blank\" rel=\"noopener\">paper co-authored by Martin\u003c/a>, and published in October in \u003cem>Science and Translational Medicine\u003c/em>, reports on an additional nonmyelin-related protein that also may be involved.\u003c/p>\n\u003cp>Martin and his colleagues examined protein samples from the brains of 31 people who had died from suspected or confirmed MS. T-cells from 12 people reacted to the clunkily named enzyme, guanosine diphosphate-L-fucose synthase – or GDP-L-fucose synthase. The enzyme is normally involved in processing sugars essential to cellular function and communication, including that of neurons.\u003c/p>\n\u003cp>Paper co-author \u003ca href=\"https://www.multiplesclerosis.uzh.ch/en/coretopics/psospedra.html\" target=\"_blank\" rel=\"noopener\">Mireia Sospedra\u003c/a>, also of the University Hospital of Zurich, likens the enzyme to the iceberg’s ominous tip. “Yes, [myelin proteins] make sense but we think they might be not the only ones involved,” she speculates. “We think is that other auto-antigens might be involved in initiating the disease.”\u003c/p>\n\u003cp>She believes that the attack on this newly identified auto-antigen triggers tissue damage that exposes other proteins in myelin that are subsequently attacked themselves.\u003c/p>\n\u003cp>Sospedra also makes the point that culprit antigens might be different in everyone. The structure of our molecular machinery is genetically determined. Certain variants in, say, myelin protein structure might be more prone to immune attack; also genetic variation in immune cells themselves could influence how the body responds to a particular infection.\u003c/p>\n\u003cp>Northwestern University \u003ca href=\"https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=14949\" target=\"_blank\" rel=\"noopener\">immunology professor Stephen Miller\u003c/a> – who was not involved in the new research but who has collaborated with Martin in the past — sees the findings as revealing another piece in the MS puzzle.\u003c/p>\n\u003cp>“I don’t think there’s one particular virus or bacteria or environmental factor that triggers MS in every patient. There are probably many things that can trigger an autoimmune reaction against a particular infection,” he says. “But the more antigens we identify that can contribute to the disease the better.”\u003c/p>\n\u003cp>Regardless of the particular “cause” in a given patient, Martin, Miller and a number of other researchers are hard at work trying to thwart the MS immune attack in the first place using by coaxing the body into building up a familiarity and tolerance to suspected antigens, something called immunotolerance therapy. It’s a similar concept to how certain allergies can be thwarted by exposure to small amounts of a particular allergen.\u003c/p>\n\u003cp>“Think of it as a sort of negative vaccine,” says Miller. “We want less immune activity, not more.”\u003c/p>\n\u003cp>The sizable batch of approved MS medications for the most part work by broadly suppressing the immune system. They help control symptoms but also leave patients vulnerable to side effects like common infections.\u003c/p>\n\u003cp>Antigen-specific therapy only tames the immune response to specific antigens of interest. In theory it should come with fewer risks.\u003c/p>\n\u003cp>Miller recently co-founded a startup called \u003ca href=\"https://www.courpharma.com/about/\" target=\"_blank\" rel=\"noopener\">Cour Pharmaceuticals\u003c/a> through which he and his colleagues are studying the potential for immunotolerance therapy for MS and a number of other conditions, including celiac disease and Type I diabetes. The experimental therapy they plan to test involves attaching known MS-inducing antigens to biodegradable nanoparticles which they will then inject into trial patients. But for now they’ve just completed a phase I study testing their approach in celiac disease, with a phase II trial about to begin.\u003c/p>\n\u003cp>Martin’s group is pursuing a similar approach in which they chemically combine red or white blood cells with MS antigens and infuse them back into patients to induce tolerance.\u003c/p>\n\u003cp>This research is at a very early stage, but both groups are optimistic.\u003c/p>\n\u003cp>“Several of us in academia — and also the pharmaceutical industry — are pursing the long-standing dream of many immunologists: inducing tolerance against specific target antigens in autoimmune diseases like MS,” says Martin. “I am confident that sooner or later, we will be successful.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Bret Stetka is a writer based in New York and an editorial director at \u003c/em>\u003ca href=\"http://www.medscape.com/public/bios/bio-bretstetka\" target=\"_blank\" rel=\"noopener\">Medscape\u003c/a>.\u003cem> A graduate of the University of Virginia School of Medicine, Stetka has had his work published by \u003c/em>Wired, Scientific American\u003cem> and The Atlantic.com. He’s also on Twitter: \u003c/em>\u003ca href=\"https://twitter.com/BretStetka\" target=\"_blank\" rel=\"noopener\">@BretStetka\u003c/a>.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2019 \u003ca href=\"http://www.npr.org\" target=\"_blank\" rel=\"noopener\">NPR\u003c/a>.\u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>",
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"title": "Considering a No Carb Diet? Instead, Think 'Slow Carb'",
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"content": "\u003cp>It’s trendy to go low-carb these days, even no carb. And, yes, this can lead to quick weight loss.\u003c/p>\n\u003cp>But ditching carbs is tough to do over the long haul. For starters, you’re swimming upstream. On average, adults in the U.S. get about \u003ca href=\"https://watermark.silverchair.com/836.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAkAwggI8BgkqhkiG9w0BBwagggItMIICKQIBADCCAiIGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMgJ56isTW1zGKv3U7AgEQgIIB8yJXZ0KWIGgk-gkY7JiJ6HOwRiZaHApv9DRFiZhhQSh2e-BPFrLSZPK5GLiu6YIn9D8yWOb_PJ_zOiu77CuZyPsjVdgmWTe7mm1GAiksxBjGRKPsID488Bmv13src3e-GzRQbzNvVN6-b8cXEF6O82hQjNIwZ_JRDZAKq894DZ9kaRM0WfZ8fq5EzFlcEyGL1P5v4gvV1Tw90f_Hl9XIDQ7gzSZmxqKLRY59jP0kVJsK2qr8h7Al9blXGoQQIy4OfrEWYMPTnbhU4280B3tXL4z93_rRAqFwcl35iHCs4Uac1n22HILWxYIEiYHvD1elXGxcuimydRrLQGMgyrvrvh2n-2FenREPw1jtbY3twm6WQoHJpmC96mwwhr7XMDoiDMTyaADcwivWJ-A4XMBzlBGtDbY6W3d0MDKY3q57T0Us7i6M7g6VF6gTqqAzraMjLSWjYpBChzhIl0_kRtRQgDjXMUk4ZZgrAz95BbAHm9agQ0jBCVop0D46wN_wTPzD5ztSBMcfmpx-QbbQ8pVs5Wa9WijFg_RitfNoOeNEqMCatLD1SCebDEAeqKmiS6pj0j-z01PexCBOx2FO9Asdl7gFjYnV7Gzc7DqGevlpOdUeEgGaNgb_4d4ByVX13g18Z6t2D3v7QGvu20R64PwWY2O1mA4\" target=\"_blank\" rel=\"noopener\">50 percent \u003c/a>of their daily calories from carbohydrates. And, if you truly cut out all carbs, you’ll have to give up fruits, vegetables, whole grains and beans — which are the building blocks of a healthy diet.\u003c/p>\n\u003cp>So, why do carbs get such a bad rap? Well, as we discuss in our new \u003ca href=\"https://www.npr.org/podcasts/510328/eat-your-way-to-a-healthier-life\" target=\"_blank\" rel=\"noopener\">Life Kit podcast\u003c/a>, a lot of us are choosing the wrong kind of carbs.\u003c/p>\n\u003cp>“We’ve known for decades that different foods affect the body differently,” says Dr. \u003ca href=\"http://www.childrenshospital.org/research/researchers/l/david-ludwig\" target=\"_blank\" rel=\"noopener\">David Ludwig\u003c/a>. He’s a professor of nutrition at the Harvard School of Public Health and the co-director of the New Balance Foundation Obesity Prevention Center Boston Children’s Hospital.\u003c/p>\n\u003cp>So, let’s compare two carbohydrate-rich foods. If you’re shopping in the bread aisle, you can pick white bread or a whole-grain bread, maybe pumpernickel or rye. They may have about the same number of calories, but the whole grain has a lot more going for it.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“When you eat a whole-kernel, minimally processed grain … they take a while to digest. Blood sugar rises relatively more gently. You produce less insulin calorie for calorie,” Ludwig explains. Think of whole grains as slow carbs because of this slow digestion. (Other slow carbs include fruits, vegetables, beans and grains.)\u003c/p>\n\u003cp>Whole grains — which include everything from whole wheat to brown rice to steel-cut oats and \u003ca href=\"http://www.npr.org/2013/10/02/227838385/farro-an-ancient-if-complicated-grain-worth-figuring-out\" target=\"_blank\" rel=\"noopener\">farro\u003c/a> — are also rich in fiber. A\u003ca href=\"https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31809-9/fulltext\" target=\"_blank\" rel=\"noopener\"> new study published in The Lancet\u003c/a> finds that people who eat a diet rich in fiber and whole grains have a reduced risk of Type 2 diabetes, stroke, coronary heart disease and colorectal cancer. (For more, we have this \u003ca href=\"https://www.npr.org/sections/thesalt/2014/04/15/301473319/wheres-the-whole-grain-in-most-of-our-wheat-bread\" target=\"_blank\" rel=\"noopener\">primer on whole grains\u003c/a>.)\u003c/p>\n\u003caside class=\"pullquote alignright\">I know if I eat a scone or chocolate croissant for breakfast, I’m hungry an hour later. But, if I eat an egg and a piece of whole grain toast, I’m set until lunch.\u003c/aside>\n\u003cp>Here’s what to visualize: When you eat whole grain wheat bread, you’re getting everything that comes in the wheat kernel. This includes the fiber-rich bran. It also includes the germ, which is the embryo of the seed, so it contains everything that’s needed to nurture new life. Think of wheat germ as a little packet of nutrients, including zinc, magnesium and Vitamin E.\u003c/p>\n\u003cp>But with white bread, all this good stuff has been stripped out during processing. All that’s left is starch, which is one step away from turning to sugar in your body. “Refined starch is the hidden sugar,” says Dr. \u003ca href=\"https://nutrition.tufts.edu/profile/faculty/dariush-mozaffarian\" target=\"_blank\" rel=\"noopener\">Dariush Mozaffarian\u003c/a>, dean of the nutrition school at Tufts University.\u003c/p>\n\u003cp>And it’s not just white bread. Many of the packaged snacks we eat, such as pretzels and crackers, are often made from refined starch. So when you eat these foods, that starch can “slam into your bloodstream, raising blood sugar and insulin,” Ludwig says. And this can send a signal to the body to store fat and leave you feeling hungry.\u003c/p>\n\u003cp>I’ve experienced this. I know if I eat a scone or chocolate croissant for breakfast, I’m hungry an hour later. But, if I eat an egg and a piece of whole grain toast, I’m set until lunch. That’s because I’m getting plenty of fiber — which slows down digestion — as well as fat and protein that leave me feeling sated.\u003c/p>\n\u003cp>So I’ve cut back on refined carbs. And the science suggests this is the way to go. The authors of the latest\u003cem> Lancet\u003c/em> study say their findings “provide convincing evidence for nutrition guidelines to focus on increasing dietary fiber and on replacing refined grains with whole grains.” \u003ca href=\"https://health.gov/dietaryguidelines/2015/guidelines/chapter-2/a-closer-look-at-current-intakes-and-recommended-shifts/\" target=\"_blank\" rel=\"noopener\">U.S. Dietary Guidelines recommend\u003c/a> that at least half of your daily grain consumption should come from whole grains. But currently, most Americans under-consume whole grains and exceed the recommended limits on refined grains.\u003c/p>\n\u003cp>David Ludwig says it’s time we “just get off the roller-coaster” — the cycle of spiking blood sugar and hunger that refined carbs can cause. He says aim to replace refined carbs with whole fruits (the fiber in them slows digestion), beans, nuts, a variety of healthy fats and plenty of protein.\u003c/p>\n\u003cp>So, what does that look like on our dinner plates? David Ludwig has teamed up with his wife, Dawn Ludwig, a professional chef. They’ve collaborated on cookbooks designed to help people eat smarter.\u003c/p>\n\u003cp>“I don’t want anyone to feel deprived … or that they have to give up anything,” Dawn Ludwig says. “I want to meet people where they are.”\u003c/p>\n\u003cp>Here’s how she thinks about building a quick and easy dinner meal. Pick a protein, whether it’s plant-based — such as tofu — or meat. Include some healthy fats, such as olive oil. Chop up some vegetables. “Then, have the wholegrain be the side dish,” she says. To tie the meal together, try one of her sauce recipes below. (For an example of a complete meal, check out \u003ca href=\"https://www.drdavidludwig.com/buddha-bowl/\" target=\"_blank\" rel=\"noopener\">this recipe for Dawn Ludwig’s Japanese Buddha Bowl\u003c/a>.)\u003c/p>\n\u003cp>“I do a lot of really simple five-minute sauces that I have in my fridge that I can pull out” for dinner, Ludwig says. She tosses all the ingredients for the sauces in Mason jars and mixes them in the jar with one of those stick-like immersion blender, so there’s not much clean-up involved and they store well in the refrigerator.\u003c/p>\n\u003cp>And, here’s one final tip for all of you who have a hard time turning down a baguette, croissant or warm basket of rolls: Eat them at the end of a meal.\u003c/p>\n\u003cp>Why? A small study published a few years back found that, compared with eating bread at the beginning of a meal, people who saved the rolls for the end had a \u003ca href=\"https://www.npr.org/sections/thesalt/2015/06/29/417500957/curb-your-appetite-save-bread-for-the-end-of-the-meal\" target=\"_blank\" rel=\"noopener\">30 percent lower peak in blood sugar\u003c/a>. Now, this may not have the same effect on everyone, but it suggests that timing matters.\u003c/p>\n\u003cp>\u003cem>NPR’s Maria Godoy contributed to this report.\u003c/em>\u003c/p>\n\u003chr>\n\u003ch3>\u003cstrong>Dawn Ludwig’s 5-Minute Sauces\u003c/strong>\u003c/h3>\n\u003cp>\u003cstrong>Cashew Balsamic Dressing \u003c/strong>\u003c/p>\n\u003cp>Prep time: 5 minutes. Makes about 1 cup.\u003c/p>\n\u003cp>2 1/2 tablespoons soy sauce\u003cbr>\n1 1/2 tablespoons balsamic vinegar\u003cbr>\n2 tablespoons water\u003cbr>\n1/2 cup neutral-tasting oil, such as high-oleic safflower or avocado oil\u003cbr>\n1/4 cup cashews\u003c/p>\n\u003cp>Place all the ingredients in a wide-mouthed mason jar or cup that will fit an immersion blender without splashing. Pulse a few times to blend until the cashews are in small pieces but still chunky. Place a lid on the jar. For best results, set aside for at least one hour to allow the flavors to develop. The dressing will keep in the refrigerator for one to two weeks.\u003c/p>\n\u003cp>\u003cstrong>Ginger Tahini Dressing\u003c/strong>\u003c/p>\n\u003cp>Prep time: 5 minutes. Makes about 1 cup.\u003c/p>\n\u003cp>1/4 cup tahini\u003cbr>\n2 tablespoons white miso paste\u003cbr>\n1 2-inch piece ginger, peeled and thinly sliced\u003cbr>\n2 teaspoons rice vinegar\u003cbr>\n1 teaspoon soy sauce\u003cbr>\n1/2 cup warm water\u003c/p>\n\u003cp>Place all the ingredients in a wide-mouth mason jar or cup that will fit an immersion blender without splashing. Blend, working the blender into the pieces of ginger until smooth. Add additional water as needed to reach the desired consistency. Place a lid on the jar. For best results, set aside for at least one hour to allow the flavors to develop. The dressing will keep in the refrigerator for one to two weeks.\u003c/p>\n\u003cp>\u003cstrong>Moroccan Sauce\u003c/strong>\u003c/p>\n\u003cp>Prep time: 7 minutes. Makes 2/3 to 3/4 cup.\u003c/p>\n\u003cp>1 2-inch piece fresh ginger, peeled and sliced into thin rounds\u003cbr>\n3 medium cloves garlic\u003cbr>\n1 3- to 4-inch piece fresh turmeric, peeled, or 1 teaspoon ground turmeric\u003cbr>\n(optional) 2 teaspoons paprika\u003cbr>\n1 teaspoon ground cumin\u003cbr>\n1 teaspoon ground coriander\u003cbr>\n1/2 teaspoon ground cinnamon\u003cbr>\n1/4 teaspoon ground cloves\u003cbr>\nDash of freshly grated nutmeg\u003cbr>\n1/4 teaspoon ground white or black pepper\u003cbr>\n9 or 10 sprigs cilantro, stems and leaves coarsely chopped\u003cbr>\n1/4 cup extra-virgin olive oil\u003cbr>\n1/4 cup water\u003cbr>\n1/2 teaspoon salt\u003cbr>\nDash of cayenne pepper, or to taste (optional)\u003c/p>\n\u003cp>Place all the ingredients in a wide-mouth mason jar or cup that will fit an immersion blender without splashing. Blend, working the blender in the jar until the garlic, ginger and turmeric are smooth. Place a lid on the jar. For best results, set aside for at least one hour to allow the flavors to develop. The dressing will keep in the refrigerator for up to two weeks.\u003c/p>\n\u003cp>\u003cstrong>Thai Peanut Sauce\u003c/strong>\u003c/p>\n\u003cp>Prep time: 5 minutes. Makes about 1 3/4 cups.\u003c/p>\n\u003cp>1 large orange, 4 small clementines or 2 large tangerines, peeled, seeded and cut into 1-inch pieces\u003cbr>\n1 1/2-inch piece fresh ginger, peeled\u003cbr>\n1 teaspoon fresh lime juice\u003cbr>\n1/2 cup peanut butter (no sugar added)\u003cbr>\n1 teaspoons unseasoned rice vinegar\u003cbr>\n2 tablespoons water\u003cbr>\n1 tablespoon soy sauce\u003cbr>\n1/4 teaspoon salt\u003cbr>\n1/4 to 1/2 teaspoon cayenne pepper, or to taste\u003c/p>\n\u003cp>Place all the ingredients in a wide-mouth mason jar or cup that will fit an immersion blender without splashing. Blend until the orange is fully blended and the sauce is thick and creamy. Adjust seasoning to taste. Place a lid on the jar. Allow the flavors to develop for one hour or more in the refrigerator. The dressing will keep for about a week.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>These recipes are excerpted from \u003c/em>\u003ca href=\"https://www.drdavidludwig.com/\" target=\"_blank\" rel=\"noopener\">Always Delicious\u003cem>, by David and Dawn Ludwig, and \u003c/em>Always Hungry? \u003c/a>\u003ca href=\"https://www.drdavidludwig.com/\" target=\"_blank\" rel=\"noopener\">\u003cem>by David Ludwig\u003c/em>\u003c/a>\u003cem> and are used with permission.\u003c/em>\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=You+Don%27t+Have+To+Go+No-Carb%3A+Instead%2C+Think+Slow+Carb&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It’s trendy to go low-carb these days, even no carb. And, yes, this can lead to quick weight loss.\u003c/p>\n\u003cp>But ditching carbs is tough to do over the long haul. For starters, you’re swimming upstream. On average, adults in the U.S. get about \u003ca href=\"https://watermark.silverchair.com/836.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAkAwggI8BgkqhkiG9w0BBwagggItMIICKQIBADCCAiIGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMgJ56isTW1zGKv3U7AgEQgIIB8yJXZ0KWIGgk-gkY7JiJ6HOwRiZaHApv9DRFiZhhQSh2e-BPFrLSZPK5GLiu6YIn9D8yWOb_PJ_zOiu77CuZyPsjVdgmWTe7mm1GAiksxBjGRKPsID488Bmv13src3e-GzRQbzNvVN6-b8cXEF6O82hQjNIwZ_JRDZAKq894DZ9kaRM0WfZ8fq5EzFlcEyGL1P5v4gvV1Tw90f_Hl9XIDQ7gzSZmxqKLRY59jP0kVJsK2qr8h7Al9blXGoQQIy4OfrEWYMPTnbhU4280B3tXL4z93_rRAqFwcl35iHCs4Uac1n22HILWxYIEiYHvD1elXGxcuimydRrLQGMgyrvrvh2n-2FenREPw1jtbY3twm6WQoHJpmC96mwwhr7XMDoiDMTyaADcwivWJ-A4XMBzlBGtDbY6W3d0MDKY3q57T0Us7i6M7g6VF6gTqqAzraMjLSWjYpBChzhIl0_kRtRQgDjXMUk4ZZgrAz95BbAHm9agQ0jBCVop0D46wN_wTPzD5ztSBMcfmpx-QbbQ8pVs5Wa9WijFg_RitfNoOeNEqMCatLD1SCebDEAeqKmiS6pj0j-z01PexCBOx2FO9Asdl7gFjYnV7Gzc7DqGevlpOdUeEgGaNgb_4d4ByVX13g18Z6t2D3v7QGvu20R64PwWY2O1mA4\" target=\"_blank\" rel=\"noopener\">50 percent \u003c/a>of their daily calories from carbohydrates. And, if you truly cut out all carbs, you’ll have to give up fruits, vegetables, whole grains and beans — which are the building blocks of a healthy diet.\u003c/p>\n\u003cp>So, why do carbs get such a bad rap? Well, as we discuss in our new \u003ca href=\"https://www.npr.org/podcasts/510328/eat-your-way-to-a-healthier-life\" target=\"_blank\" rel=\"noopener\">Life Kit podcast\u003c/a>, a lot of us are choosing the wrong kind of carbs.\u003c/p>\n\u003cp>“We’ve known for decades that different foods affect the body differently,” says Dr. \u003ca href=\"http://www.childrenshospital.org/research/researchers/l/david-ludwig\" target=\"_blank\" rel=\"noopener\">David Ludwig\u003c/a>. He’s a professor of nutrition at the Harvard School of Public Health and the co-director of the New Balance Foundation Obesity Prevention Center Boston Children’s Hospital.\u003c/p>\n\u003cp>So, let’s compare two carbohydrate-rich foods. If you’re shopping in the bread aisle, you can pick white bread or a whole-grain bread, maybe pumpernickel or rye. They may have about the same number of calories, but the whole grain has a lot more going for it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“When you eat a whole-kernel, minimally processed grain … they take a while to digest. Blood sugar rises relatively more gently. You produce less insulin calorie for calorie,” Ludwig explains. Think of whole grains as slow carbs because of this slow digestion. (Other slow carbs include fruits, vegetables, beans and grains.)\u003c/p>\n\u003cp>Whole grains — which include everything from whole wheat to brown rice to steel-cut oats and \u003ca href=\"http://www.npr.org/2013/10/02/227838385/farro-an-ancient-if-complicated-grain-worth-figuring-out\" target=\"_blank\" rel=\"noopener\">farro\u003c/a> — are also rich in fiber. A\u003ca href=\"https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31809-9/fulltext\" target=\"_blank\" rel=\"noopener\"> new study published in The Lancet\u003c/a> finds that people who eat a diet rich in fiber and whole grains have a reduced risk of Type 2 diabetes, stroke, coronary heart disease and colorectal cancer. (For more, we have this \u003ca href=\"https://www.npr.org/sections/thesalt/2014/04/15/301473319/wheres-the-whole-grain-in-most-of-our-wheat-bread\" target=\"_blank\" rel=\"noopener\">primer on whole grains\u003c/a>.)\u003c/p>\n\u003caside class=\"pullquote alignright\">I know if I eat a scone or chocolate croissant for breakfast, I’m hungry an hour later. But, if I eat an egg and a piece of whole grain toast, I’m set until lunch.\u003c/aside>\n\u003cp>Here’s what to visualize: When you eat whole grain wheat bread, you’re getting everything that comes in the wheat kernel. This includes the fiber-rich bran. It also includes the germ, which is the embryo of the seed, so it contains everything that’s needed to nurture new life. Think of wheat germ as a little packet of nutrients, including zinc, magnesium and Vitamin E.\u003c/p>\n\u003cp>But with white bread, all this good stuff has been stripped out during processing. All that’s left is starch, which is one step away from turning to sugar in your body. “Refined starch is the hidden sugar,” says Dr. \u003ca href=\"https://nutrition.tufts.edu/profile/faculty/dariush-mozaffarian\" target=\"_blank\" rel=\"noopener\">Dariush Mozaffarian\u003c/a>, dean of the nutrition school at Tufts University.\u003c/p>\n\u003cp>And it’s not just white bread. Many of the packaged snacks we eat, such as pretzels and crackers, are often made from refined starch. So when you eat these foods, that starch can “slam into your bloodstream, raising blood sugar and insulin,” Ludwig says. And this can send a signal to the body to store fat and leave you feeling hungry.\u003c/p>\n\u003cp>I’ve experienced this. I know if I eat a scone or chocolate croissant for breakfast, I’m hungry an hour later. But, if I eat an egg and a piece of whole grain toast, I’m set until lunch. That’s because I’m getting plenty of fiber — which slows down digestion — as well as fat and protein that leave me feeling sated.\u003c/p>\n\u003cp>So I’ve cut back on refined carbs. And the science suggests this is the way to go. The authors of the latest\u003cem> Lancet\u003c/em> study say their findings “provide convincing evidence for nutrition guidelines to focus on increasing dietary fiber and on replacing refined grains with whole grains.” \u003ca href=\"https://health.gov/dietaryguidelines/2015/guidelines/chapter-2/a-closer-look-at-current-intakes-and-recommended-shifts/\" target=\"_blank\" rel=\"noopener\">U.S. Dietary Guidelines recommend\u003c/a> that at least half of your daily grain consumption should come from whole grains. But currently, most Americans under-consume whole grains and exceed the recommended limits on refined grains.\u003c/p>\n\u003cp>David Ludwig says it’s time we “just get off the roller-coaster” — the cycle of spiking blood sugar and hunger that refined carbs can cause. He says aim to replace refined carbs with whole fruits (the fiber in them slows digestion), beans, nuts, a variety of healthy fats and plenty of protein.\u003c/p>\n\u003cp>So, what does that look like on our dinner plates? David Ludwig has teamed up with his wife, Dawn Ludwig, a professional chef. They’ve collaborated on cookbooks designed to help people eat smarter.\u003c/p>\n\u003cp>“I don’t want anyone to feel deprived … or that they have to give up anything,” Dawn Ludwig says. “I want to meet people where they are.”\u003c/p>\n\u003cp>Here’s how she thinks about building a quick and easy dinner meal. Pick a protein, whether it’s plant-based — such as tofu — or meat. Include some healthy fats, such as olive oil. Chop up some vegetables. “Then, have the wholegrain be the side dish,” she says. To tie the meal together, try one of her sauce recipes below. (For an example of a complete meal, check out \u003ca href=\"https://www.drdavidludwig.com/buddha-bowl/\" target=\"_blank\" rel=\"noopener\">this recipe for Dawn Ludwig’s Japanese Buddha Bowl\u003c/a>.)\u003c/p>\n\u003cp>“I do a lot of really simple five-minute sauces that I have in my fridge that I can pull out” for dinner, Ludwig says. She tosses all the ingredients for the sauces in Mason jars and mixes them in the jar with one of those stick-like immersion blender, so there’s not much clean-up involved and they store well in the refrigerator.\u003c/p>\n\u003cp>And, here’s one final tip for all of you who have a hard time turning down a baguette, croissant or warm basket of rolls: Eat them at the end of a meal.\u003c/p>\n\u003cp>Why? A small study published a few years back found that, compared with eating bread at the beginning of a meal, people who saved the rolls for the end had a \u003ca href=\"https://www.npr.org/sections/thesalt/2015/06/29/417500957/curb-your-appetite-save-bread-for-the-end-of-the-meal\" target=\"_blank\" rel=\"noopener\">30 percent lower peak in blood sugar\u003c/a>. Now, this may not have the same effect on everyone, but it suggests that timing matters.\u003c/p>\n\u003cp>\u003cem>NPR’s Maria Godoy contributed to this report.\u003c/em>\u003c/p>\n\u003chr>\n\u003ch3>\u003cstrong>Dawn Ludwig’s 5-Minute Sauces\u003c/strong>\u003c/h3>\n\u003cp>\u003cstrong>Cashew Balsamic Dressing \u003c/strong>\u003c/p>\n\u003cp>Prep time: 5 minutes. Makes about 1 cup.\u003c/p>\n\u003cp>2 1/2 tablespoons soy sauce\u003cbr>\n1 1/2 tablespoons balsamic vinegar\u003cbr>\n2 tablespoons water\u003cbr>\n1/2 cup neutral-tasting oil, such as high-oleic safflower or avocado oil\u003cbr>\n1/4 cup cashews\u003c/p>\n\u003cp>Place all the ingredients in a wide-mouthed mason jar or cup that will fit an immersion blender without splashing. Pulse a few times to blend until the cashews are in small pieces but still chunky. Place a lid on the jar. For best results, set aside for at least one hour to allow the flavors to develop. The dressing will keep in the refrigerator for one to two weeks.\u003c/p>\n\u003cp>\u003cstrong>Ginger Tahini Dressing\u003c/strong>\u003c/p>\n\u003cp>Prep time: 5 minutes. Makes about 1 cup.\u003c/p>\n\u003cp>1/4 cup tahini\u003cbr>\n2 tablespoons white miso paste\u003cbr>\n1 2-inch piece ginger, peeled and thinly sliced\u003cbr>\n2 teaspoons rice vinegar\u003cbr>\n1 teaspoon soy sauce\u003cbr>\n1/2 cup warm water\u003c/p>\n\u003cp>Place all the ingredients in a wide-mouth mason jar or cup that will fit an immersion blender without splashing. Blend, working the blender into the pieces of ginger until smooth. Add additional water as needed to reach the desired consistency. Place a lid on the jar. For best results, set aside for at least one hour to allow the flavors to develop. The dressing will keep in the refrigerator for one to two weeks.\u003c/p>\n\u003cp>\u003cstrong>Moroccan Sauce\u003c/strong>\u003c/p>\n\u003cp>Prep time: 7 minutes. Makes 2/3 to 3/4 cup.\u003c/p>\n\u003cp>1 2-inch piece fresh ginger, peeled and sliced into thin rounds\u003cbr>\n3 medium cloves garlic\u003cbr>\n1 3- to 4-inch piece fresh turmeric, peeled, or 1 teaspoon ground turmeric\u003cbr>\n(optional) 2 teaspoons paprika\u003cbr>\n1 teaspoon ground cumin\u003cbr>\n1 teaspoon ground coriander\u003cbr>\n1/2 teaspoon ground cinnamon\u003cbr>\n1/4 teaspoon ground cloves\u003cbr>\nDash of freshly grated nutmeg\u003cbr>\n1/4 teaspoon ground white or black pepper\u003cbr>\n9 or 10 sprigs cilantro, stems and leaves coarsely chopped\u003cbr>\n1/4 cup extra-virgin olive oil\u003cbr>\n1/4 cup water\u003cbr>\n1/2 teaspoon salt\u003cbr>\nDash of cayenne pepper, or to taste (optional)\u003c/p>\n\u003cp>Place all the ingredients in a wide-mouth mason jar or cup that will fit an immersion blender without splashing. Blend, working the blender in the jar until the garlic, ginger and turmeric are smooth. Place a lid on the jar. For best results, set aside for at least one hour to allow the flavors to develop. The dressing will keep in the refrigerator for up to two weeks.\u003c/p>\n\u003cp>\u003cstrong>Thai Peanut Sauce\u003c/strong>\u003c/p>\n\u003cp>Prep time: 5 minutes. Makes about 1 3/4 cups.\u003c/p>\n\u003cp>1 large orange, 4 small clementines or 2 large tangerines, peeled, seeded and cut into 1-inch pieces\u003cbr>\n1 1/2-inch piece fresh ginger, peeled\u003cbr>\n1 teaspoon fresh lime juice\u003cbr>\n1/2 cup peanut butter (no sugar added)\u003cbr>\n1 teaspoons unseasoned rice vinegar\u003cbr>\n2 tablespoons water\u003cbr>\n1 tablespoon soy sauce\u003cbr>\n1/4 teaspoon salt\u003cbr>\n1/4 to 1/2 teaspoon cayenne pepper, or to taste\u003c/p>\n\u003cp>Place all the ingredients in a wide-mouth mason jar or cup that will fit an immersion blender without splashing. Blend until the orange is fully blended and the sauce is thick and creamy. Adjust seasoning to taste. Place a lid on the jar. Allow the flavors to develop for one hour or more in the refrigerator. The dressing will keep for about a week.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>These recipes are excerpted from \u003c/em>\u003ca href=\"https://www.drdavidludwig.com/\" target=\"_blank\" rel=\"noopener\">Always Delicious\u003cem>, by David and Dawn Ludwig, and \u003c/em>Always Hungry? \u003c/a>\u003ca href=\"https://www.drdavidludwig.com/\" target=\"_blank\" rel=\"noopener\">\u003cem>by David Ludwig\u003c/em>\u003c/a>\u003cem> and are used with permission.\u003c/em>\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=You+Don%27t+Have+To+Go+No-Carb%3A+Instead%2C+Think+Slow+Carb&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>",
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"title": "‘Digital Pill’ Can Track When Patients Take Their Meds",
"headTitle": "‘Digital Pill’ Can Track When Patients Take Their Meds | KQED",
"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",
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"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>",
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"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>",
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"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>",
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"content": "\u003cp>Want to reduce your risk of dementia in older age? Move as much as you can.\u003c/p>\n\u003cp>We’ve all heard about techniques to get us more physically active — take the stairs, park the car a bit further from your destination, get up and march in place for a minute or two when standing or sitting at a desk.\u003c/p>\n\u003cp>Now a study finds even simple housework like cooking or cleaning may make a difference in brain health in our 70s and 80s.\u003c/p>\n\u003cp>“Exercise is an inexpensive way to improve health and our study shows it may have a protective effect on the brain,” says \u003ca href=\"https://www.rushu.rush.edu/faculty/aron-buchman-md\">Dr. Aron S. Buchman\u003c/a> with Rush University Medical Center in Chicago, who led the study.\u003c/p>\n\u003cp>Previous \u003ca href=\"https://www.pnas.org/content/108/7/3017?sid=68cb95f7-9654-4717-a9c5-14a0d7338c70\">research\u003c/a> found just 45 minutes of walking three days a week actually increased brain volume among individuals 65 and older.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The new \u003ca href=\"http://n.neurology.org/lookup/doi/10.1212/WNL.0000000000006954\">study\u003c/a>, published Wednesday in the online issue of \u003cem>Neurology\u003c/em>, is unique because Buchman was able to analyze the actual brains of study participants. The findings are a “great thank you” to the participants who agreed to donate their brains for research after death, he says.\u003c/p>\n\u003cp>The study looked at 454 older adults who were 70 or older when the research began. Of those adults, 191 had behavioral signs of dementia and 263 did not. All were given thinking and memory tests every year for 20 years.\u003c/p>\n\u003cp>In the last years of research before death, each participant wore an activity monitor called an \u003ca href=\"https://www.tandfonline.com/doi/abs/10.1080/02701367.2006.10599333\">accelerometer\u003c/a>, similar to a Fitbit, which measured physical activity around the clock — everything from small movements such as walking around the house to more vigorous movements like exercise routines. Researchers collected and evaluated 10 days of movement data for each participant and calculated an average daily activity score.\u003c/p>\n\u003cp>The findings show that higher levels of daily movement were linked to better thinking and memory skills, as measured by the yearly cognitive tests. And when Buchman analyzed brain tissue under a microscope, this finding turned out to be the case even for individuals with at least three signs of \u003ca href=\"https://www.nia.nih.gov/health/what-happens-brain-alzheimers-disease\">Alzheimer’s disease\u003c/a>, such as amyloid plaques and neurofibrillary tangles. Even though these individuals might have been diagnosed with Alzheimer’s, 30 percent of them had “normal” cognition at death, says Buchman.\u003c/p>\n\u003cp>Why one person shows signs of dementia and another, who has similar degenerative changes in the brain, does not, is a mystery. But Buchman says the new findings suggest that physical activity may be protective, even amidst developing Alzheimer’s. It sort of masks the symptoms, he says, and is an “empowering finding” suggesting you can have some control over your brain health even if you don’t have control over developing Alzheimer’s.\u003c/p>\n\u003cp>“It’s almost as if the physical activity was helping the brain to bypass the physical damage,” says \u003ca href=\"http://www.timchurchmd.com/bio/\">Dr. Tim Church\u003c/a>, a preventive medicine specialist with Pennington Biomedical Research Center at Louisiana State University who was not involved in the research. “It appears that physical activity was critical to creating a reserve that protects against those physical damages.”\u003c/p>\n\u003cp>And, while intense activity and exercise is highly beneficial, even light activity can make a difference, says Buchman. “As long as you have some activity and you’re moving, whether you’re chopping onions, typing, sweeping the floor or even running,” you can reduce your risk of cognitive decline.\u003c/p>\n\u003cp>The findings are impressive, says research scientist \u003ca href=\"https://www.faculty.uci.edu/profile.cfm?faculty_id=2273\">Carl Cotman\u003c/a>, director of the Institute for Brain Aging and Dementia at the University of California, Irvine, showing that physical activity may “offset the ill effects of brain degeneration.” He adds that lifestyle interventions such as an increase in physical activity and movement can be powerful even in the presence of disease. Cotman was not involved in the research.\u003c/p>\n\u003cp>But exactly how the protective effect may work is unclear. Buchman says the current findings are a “great start” but he hopes to look more closely at participant’s brains to measure different proteins and try to identify which ones might link physical activity to better cognition.\u003c/p>\n\u003cp>There are some caveats to the study. The findings do not show clear cause and effect. Study participants with dementia had significantly lower indications of movement compared to those without dementia. It may be possible that as people lose memory and thinking skills, they also reduce their physical activity.\u003c/p>\n\u003cp>And the study did not have data on how active participants were over the course of their lives. It could be that older adults who moved more were also lifelong exercisers so it’s not known if physical activity in early life may have played a role.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>While previous research suggests that people may be able to \u003ca href=\"https://www.npr.org/sections/health-shots/2013/04/15/176920391/how-exercise-and-other-activities-beat-back-dementia\">beat back dementia\u003c/a> with exercise, Buchman acknowledges that “more studies are needed to determine if moving more is truly beneficial to the brain.”\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Daily+Movement+%E2%80%94+Even+Household+Chores+%E2%80%94+May+Boost+Brain+Health+In+Elderly&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "Whether it's exercise or housework, older Americans who move their bodies regularly may preserve more of their memory and thinking skills, even if they have brain lesions and other signs of dementia.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Want to reduce your risk of dementia in older age? Move as much as you can.\u003c/p>\n\u003cp>We’ve all heard about techniques to get us more physically active — take the stairs, park the car a bit further from your destination, get up and march in place for a minute or two when standing or sitting at a desk.\u003c/p>\n\u003cp>Now a study finds even simple housework like cooking or cleaning may make a difference in brain health in our 70s and 80s.\u003c/p>\n\u003cp>“Exercise is an inexpensive way to improve health and our study shows it may have a protective effect on the brain,” says \u003ca href=\"https://www.rushu.rush.edu/faculty/aron-buchman-md\">Dr. Aron S. Buchman\u003c/a> with Rush University Medical Center in Chicago, who led the study.\u003c/p>\n\u003cp>Previous \u003ca href=\"https://www.pnas.org/content/108/7/3017?sid=68cb95f7-9654-4717-a9c5-14a0d7338c70\">research\u003c/a> found just 45 minutes of walking three days a week actually increased brain volume among individuals 65 and older.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The new \u003ca href=\"http://n.neurology.org/lookup/doi/10.1212/WNL.0000000000006954\">study\u003c/a>, published Wednesday in the online issue of \u003cem>Neurology\u003c/em>, is unique because Buchman was able to analyze the actual brains of study participants. The findings are a “great thank you” to the participants who agreed to donate their brains for research after death, he says.\u003c/p>\n\u003cp>The study looked at 454 older adults who were 70 or older when the research began. Of those adults, 191 had behavioral signs of dementia and 263 did not. All were given thinking and memory tests every year for 20 years.\u003c/p>\n\u003cp>In the last years of research before death, each participant wore an activity monitor called an \u003ca href=\"https://www.tandfonline.com/doi/abs/10.1080/02701367.2006.10599333\">accelerometer\u003c/a>, similar to a Fitbit, which measured physical activity around the clock — everything from small movements such as walking around the house to more vigorous movements like exercise routines. Researchers collected and evaluated 10 days of movement data for each participant and calculated an average daily activity score.\u003c/p>\n\u003cp>The findings show that higher levels of daily movement were linked to better thinking and memory skills, as measured by the yearly cognitive tests. And when Buchman analyzed brain tissue under a microscope, this finding turned out to be the case even for individuals with at least three signs of \u003ca href=\"https://www.nia.nih.gov/health/what-happens-brain-alzheimers-disease\">Alzheimer’s disease\u003c/a>, such as amyloid plaques and neurofibrillary tangles. Even though these individuals might have been diagnosed with Alzheimer’s, 30 percent of them had “normal” cognition at death, says Buchman.\u003c/p>\n\u003cp>Why one person shows signs of dementia and another, who has similar degenerative changes in the brain, does not, is a mystery. But Buchman says the new findings suggest that physical activity may be protective, even amidst developing Alzheimer’s. It sort of masks the symptoms, he says, and is an “empowering finding” suggesting you can have some control over your brain health even if you don’t have control over developing Alzheimer’s.\u003c/p>\n\u003cp>“It’s almost as if the physical activity was helping the brain to bypass the physical damage,” says \u003ca href=\"http://www.timchurchmd.com/bio/\">Dr. Tim Church\u003c/a>, a preventive medicine specialist with Pennington Biomedical Research Center at Louisiana State University who was not involved in the research. “It appears that physical activity was critical to creating a reserve that protects against those physical damages.”\u003c/p>\n\u003cp>And, while intense activity and exercise is highly beneficial, even light activity can make a difference, says Buchman. “As long as you have some activity and you’re moving, whether you’re chopping onions, typing, sweeping the floor or even running,” you can reduce your risk of cognitive decline.\u003c/p>\n\u003cp>The findings are impressive, says research scientist \u003ca href=\"https://www.faculty.uci.edu/profile.cfm?faculty_id=2273\">Carl Cotman\u003c/a>, director of the Institute for Brain Aging and Dementia at the University of California, Irvine, showing that physical activity may “offset the ill effects of brain degeneration.” He adds that lifestyle interventions such as an increase in physical activity and movement can be powerful even in the presence of disease. Cotman was not involved in the research.\u003c/p>\n\u003cp>But exactly how the protective effect may work is unclear. Buchman says the current findings are a “great start” but he hopes to look more closely at participant’s brains to measure different proteins and try to identify which ones might link physical activity to better cognition.\u003c/p>\n\u003cp>There are some caveats to the study. The findings do not show clear cause and effect. Study participants with dementia had significantly lower indications of movement compared to those without dementia. It may be possible that as people lose memory and thinking skills, they also reduce their physical activity.\u003c/p>\n\u003cp>And the study did not have data on how active participants were over the course of their lives. It could be that older adults who moved more were also lifelong exercisers so it’s not known if physical activity in early life may have played a role.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>While previous research suggests that people may be able to \u003ca href=\"https://www.npr.org/sections/health-shots/2013/04/15/176920391/how-exercise-and-other-activities-beat-back-dementia\">beat back dementia\u003c/a> with exercise, Buchman acknowledges that “more studies are needed to determine if moving more is truly beneficial to the brain.”\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2019 NPR. To see more, visit https://www.npr.org.\u003cimg decoding=\"async\" src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Daily+Movement+%E2%80%94+Even+Household+Chores+%E2%80%94+May+Boost+Brain+Health+In+Elderly&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"title": "Commentary: For Minority Students, the Pipeline to Become a Doctor is Leaky",
"headTitle": "Commentary: For Minority Students, the Pipeline to Become a Doctor is Leaky | KQED",
"content": "\u003cp class=\"danger-zone\">\u003cspan class=\"big-cap-wrap\">\u003cspan class=\"big-cap\">T\u003c/span>\u003c/span>he population of physicians in the U.S. should look like the population as a whole. But it doesn’t. African-Americans and Hispanics now make up about \u003ca href=\"https://www.census.gov/quickfacts/fact/table/US/PST045217\" target=\"_blank\" rel=\"noopener\">31 percent\u003c/a> of the U.S. population, but comprise just \u003ca href=\"https://www.aamc.org/download/321472/data/factstablea8.pdf\" target=\"_blank\" rel=\"noopener\">15 percent\u003c/a> of this year’s first-year medical students. That number would be higher if we could figure out how to keep potential medical students from falling through the leaks in the pipeline from grammar school to medical school and beyond.\u003c/p>\n\u003cp class=\"danger-zone\">The leaks are everywhere. Lack of family support: drip. Low-functioning schools: drip. Little guidance or support from teachers: drip. No role models or mentors: drip.\u003c/p>\n\u003cp class=\"danger-zone\">As an African-American girl growing up in a lower-middle-class neighborhood in North Carolina, one of those “drips” should have derailed my journey. Yet I managed to traverse the pipeline and become a physician. Here’s how.\u003c/p>\n\u003cp>\u003cstrong>My Mother’s Support\u003c/strong>\u003c/p>\n\u003cp class=\"\">My mother gave me permission as a young girl to dream big: “You can be whatever you want to be,” she told me time and time again. It wasn’t until I was older that I realized how her empowerment would be tested by external limits.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp class=\"\">My mom valued education and prioritized it for my sister and me. She understood how important it was to go to college, even though she didn’t complete college until we were adults. We were latchkey kids, but felt her presence even when she wasn’t home. Our homework had to be completed and on the coffee table by the time she got home from work. She took time to review our schoolwork with us. She built a structure that required us to do well academically. This initial foundation helped me develop habits that would later become important. She created the pipeline for me and sealed its beginning section.\u003c/p>\n\u003cp>\u003cstrong>Help From My Community\u003c/strong>\u003c/p>\n\u003cp>The median income of a school’s neighborhood serves as a proxy for the quality of education the school provides. Stanford researchers have shown that in 100 of the largest U.S. cities, 75 percent of African-American and Hispanic students \u003ca href=\"https://www.theatlantic.com/education/archive/2016/02/concentration-poverty-american-schools/471414/\" target=\"_blank\" rel=\"noopener\">were segregated to schools\u003c/a> with peers of low socioeconomic status, compared to just 33 percent of white students. This disparity was shown to contribute to diminished educational achievement due to poor access to resources and increased difficulty attracting higher-quality teachers.\u003c/p>\n\u003cp>I was destined to go to a low-income school lacking in strong classroom leadership. Yet that leak closed for me when I was afforded the opportunity to attend a newly opened and highly resourced secondary school. Families in my neighborhood attended city council meetings and fought for our inclusion in the prized school district, which had initially been built to serve the surrounding upper middle-class neighborhood. Over time, the school became known for having the best resources and the highest test scores in the city.\u003c/p>\n\u003cp>The opportunity to enroll in this school let me escape the achievement gap that frequently eliminates minority students from consideration well before their opportunity to apply to college or medical school. Neighborhood parents fighting for equitable zoning policies kept me from slipping through the cracks and nudged me forward.\u003c/p>\n\u003cp>\u003cstrong>Teachers and Counselors Plugged Important Leaks\u003c/strong>\u003c/p>\n\u003cp>Teachers pulled me back into the pipeline when they noticed I was beginning to lose interest. I enjoyed science and math in elementary school. By the end of middle school, though, I began to follow the pattern of many black girls in my circle. We became interested in science at a young age but later succumbed to the \u003ca href=\"https://money.cnn.com/2017/02/28/technology/girls-math-science-engineering/index.html\" target=\"_blank\" rel=\"noopener\">“loss of interest”\u003c/a> leak in the pipeline. I was fortunate that my high school biology teacher, Michelle Chadwick, pulled me back in by reinvigorating my interest and teaching me how to be successful.\u003c/p>\n\u003cp>She was an amazing teacher. She innovated in the classroom by making us write songs corresponding to different biological processes. We read fictional books about biological agents. We dissected cats and bred fruit flies. She did everything possible to keep our interest by making science fun. I continued to use many of her innovative techniques in medical school to help me learn information.\u003c/p>\n\u003cp>My high school guidance counselor, Janice Barbee, further fortified the pipeline. She told me about scholarships and signed me up for leadership programs. She was specific and direct. She told me exactly where to go and when. Her consistent but necessary investment kept me in the pipeline and pushed me forward.\u003c/p>\n\u003cp>\u003cstrong>The Strong Influence of Peers\u003c/strong>\u003c/p>\n\u003cp>When I started at Winston-Salem State University, one of the country’s small, historically black colleges and universities, I hadn’t selected a major, and becoming a doctor was far from my mind. That career un-choice was due in part to my limited interactions with physicians, especially black ones.\u003c/p>\n\u003cp>My roommate, though, knew she wanted to become a doctor and was ready to make her dream a reality. Hearing her story was a shock to me. Cynthia invited me to meetings with black physicians and medical students at a neighboring institution. She introduced me to her friends, who were also interested in medicine. After a year of delving into her interest, it slowly became my interest, too. I chose to major in chemistry.\u003c/p>\n\u003cp>My roommate’s infectious enthusiasm for a career in medicine and her exposing me to other black women pursuing medicine captured me before I fell through the college leak. Her encouragement and dedication to her goals kept me in the pipeline.\u003c/p>\n\u003cp>\u003cstrong>Unlikely Mentors\u003c/strong>\u003c/p>\n\u003cp>Winston-Salem State did not have dedicated medical school advisers or connections to a medical school, so its students didn’t have many on-campus black mentors in medicine. Teachers and mentors from outside the college who were willing to help were often overwhelmed by the number of students seeking their help. (This is something I continue to experience, as I connect with mentors and act as a mentor for others.)\u003c/p>\n\u003cp>My roommate created her own path to medical mentors through networking and Google. We formed our own group and relied heavily on each other for information about the process of applying to medical school. Our biology and chemistry department chairs tried to serve as proxies for black physician mentorship. Without their guidance, medical school would have remained a pipe dream.\u003c/p>\n\u003cp>\u003cstrong>Help Beyond Medical School\u003c/strong>\u003c/p>\n\u003cp>Once I got into Morehouse School of Medicine, I was surrounded by minority students and faculty with the same goal: increasing the number of minority physicians. Leaks in the pipeline still loomed, but they were plugged by my friends and mentors. I struggled to stay focused because of personal issues during my first year in medical school. When I admitted that I didn’t want to finish medical school, my friend Deanna held me accountable and kept me organized. She remained my study partner throughout all four years. Other friends became part of that circle. We challenged each other in our courses and encouraged each other to follow our specialty goals.\u003c/p>\n\u003cp>During my residency, this same circle of friends offered emotional support and helped me navigate \u003ca href=\"https://opmed.doximity.com/articles/i-am-not-an-imposter-02f50b07-087f-44a5-a93c-c1f36fbf4463\" target=\"_blank\" rel=\"noopener\">imposter syndrome\u003c/a>. They continue to support me as a fledgling attending physician.\u003c/p>\n\u003cp>\u003cstrong>Now It’s My Turn\u003c/strong>\u003c/p>\n\u003cp>Many medical school students grew up knowing that they wanted to become doctors. Some had parents, siblings, or friends of the family who were physicians. Many had mentors or friends who encouraged them to consider careers in medicine. For minority students like me, the path to medicine is far more uncertain and uncharted. We need to find ways to build stronger, less-leaky pipelines for them.\u003c/p>\n\u003cp>I was fortunate that someone always stepped in at moments when I was at risk of dripping out of the pipeline. Now it’s my turn to pay my experiences forward.\u003c/p>\n\u003cp>\u003cem>Paula Magee, M.D., is a hospitalist in the pediatric intensive care unit at Children’s National Health System in Washington, D.C.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2019/01/14/minority-students-physician-leaky-pipeline/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"danger-zone\">\u003cspan class=\"big-cap-wrap\">\u003cspan class=\"big-cap\">T\u003c/span>\u003c/span>he population of physicians in the U.S. should look like the population as a whole. But it doesn’t. African-Americans and Hispanics now make up about \u003ca href=\"https://www.census.gov/quickfacts/fact/table/US/PST045217\" target=\"_blank\" rel=\"noopener\">31 percent\u003c/a> of the U.S. population, but comprise just \u003ca href=\"https://www.aamc.org/download/321472/data/factstablea8.pdf\" target=\"_blank\" rel=\"noopener\">15 percent\u003c/a> of this year’s first-year medical students. That number would be higher if we could figure out how to keep potential medical students from falling through the leaks in the pipeline from grammar school to medical school and beyond.\u003c/p>\n\u003cp class=\"danger-zone\">The leaks are everywhere. Lack of family support: drip. Low-functioning schools: drip. Little guidance or support from teachers: drip. No role models or mentors: drip.\u003c/p>\n\u003cp class=\"danger-zone\">As an African-American girl growing up in a lower-middle-class neighborhood in North Carolina, one of those “drips” should have derailed my journey. Yet I managed to traverse the pipeline and become a physician. Here’s how.\u003c/p>\n\u003cp>\u003cstrong>My Mother’s Support\u003c/strong>\u003c/p>\n\u003cp class=\"\">My mother gave me permission as a young girl to dream big: “You can be whatever you want to be,” she told me time and time again. It wasn’t until I was older that I realized how her empowerment would be tested by external limits.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"\">My mom valued education and prioritized it for my sister and me. She understood how important it was to go to college, even though she didn’t complete college until we were adults. We were latchkey kids, but felt her presence even when she wasn’t home. Our homework had to be completed and on the coffee table by the time she got home from work. She took time to review our schoolwork with us. She built a structure that required us to do well academically. This initial foundation helped me develop habits that would later become important. She created the pipeline for me and sealed its beginning section.\u003c/p>\n\u003cp>\u003cstrong>Help From My Community\u003c/strong>\u003c/p>\n\u003cp>The median income of a school’s neighborhood serves as a proxy for the quality of education the school provides. Stanford researchers have shown that in 100 of the largest U.S. cities, 75 percent of African-American and Hispanic students \u003ca href=\"https://www.theatlantic.com/education/archive/2016/02/concentration-poverty-american-schools/471414/\" target=\"_blank\" rel=\"noopener\">were segregated to schools\u003c/a> with peers of low socioeconomic status, compared to just 33 percent of white students. This disparity was shown to contribute to diminished educational achievement due to poor access to resources and increased difficulty attracting higher-quality teachers.\u003c/p>\n\u003cp>I was destined to go to a low-income school lacking in strong classroom leadership. Yet that leak closed for me when I was afforded the opportunity to attend a newly opened and highly resourced secondary school. Families in my neighborhood attended city council meetings and fought for our inclusion in the prized school district, which had initially been built to serve the surrounding upper middle-class neighborhood. Over time, the school became known for having the best resources and the highest test scores in the city.\u003c/p>\n\u003cp>The opportunity to enroll in this school let me escape the achievement gap that frequently eliminates minority students from consideration well before their opportunity to apply to college or medical school. Neighborhood parents fighting for equitable zoning policies kept me from slipping through the cracks and nudged me forward.\u003c/p>\n\u003cp>\u003cstrong>Teachers and Counselors Plugged Important Leaks\u003c/strong>\u003c/p>\n\u003cp>Teachers pulled me back into the pipeline when they noticed I was beginning to lose interest. I enjoyed science and math in elementary school. By the end of middle school, though, I began to follow the pattern of many black girls in my circle. We became interested in science at a young age but later succumbed to the \u003ca href=\"https://money.cnn.com/2017/02/28/technology/girls-math-science-engineering/index.html\" target=\"_blank\" rel=\"noopener\">“loss of interest”\u003c/a> leak in the pipeline. I was fortunate that my high school biology teacher, Michelle Chadwick, pulled me back in by reinvigorating my interest and teaching me how to be successful.\u003c/p>\n\u003cp>She was an amazing teacher. She innovated in the classroom by making us write songs corresponding to different biological processes. We read fictional books about biological agents. We dissected cats and bred fruit flies. She did everything possible to keep our interest by making science fun. I continued to use many of her innovative techniques in medical school to help me learn information.\u003c/p>\n\u003cp>My high school guidance counselor, Janice Barbee, further fortified the pipeline. She told me about scholarships and signed me up for leadership programs. She was specific and direct. She told me exactly where to go and when. Her consistent but necessary investment kept me in the pipeline and pushed me forward.\u003c/p>\n\u003cp>\u003cstrong>The Strong Influence of Peers\u003c/strong>\u003c/p>\n\u003cp>When I started at Winston-Salem State University, one of the country’s small, historically black colleges and universities, I hadn’t selected a major, and becoming a doctor was far from my mind. That career un-choice was due in part to my limited interactions with physicians, especially black ones.\u003c/p>\n\u003cp>My roommate, though, knew she wanted to become a doctor and was ready to make her dream a reality. Hearing her story was a shock to me. Cynthia invited me to meetings with black physicians and medical students at a neighboring institution. She introduced me to her friends, who were also interested in medicine. After a year of delving into her interest, it slowly became my interest, too. I chose to major in chemistry.\u003c/p>\n\u003cp>My roommate’s infectious enthusiasm for a career in medicine and her exposing me to other black women pursuing medicine captured me before I fell through the college leak. Her encouragement and dedication to her goals kept me in the pipeline.\u003c/p>\n\u003cp>\u003cstrong>Unlikely Mentors\u003c/strong>\u003c/p>\n\u003cp>Winston-Salem State did not have dedicated medical school advisers or connections to a medical school, so its students didn’t have many on-campus black mentors in medicine. Teachers and mentors from outside the college who were willing to help were often overwhelmed by the number of students seeking their help. (This is something I continue to experience, as I connect with mentors and act as a mentor for others.)\u003c/p>\n\u003cp>My roommate created her own path to medical mentors through networking and Google. We formed our own group and relied heavily on each other for information about the process of applying to medical school. Our biology and chemistry department chairs tried to serve as proxies for black physician mentorship. Without their guidance, medical school would have remained a pipe dream.\u003c/p>\n\u003cp>\u003cstrong>Help Beyond Medical School\u003c/strong>\u003c/p>\n\u003cp>Once I got into Morehouse School of Medicine, I was surrounded by minority students and faculty with the same goal: increasing the number of minority physicians. Leaks in the pipeline still loomed, but they were plugged by my friends and mentors. I struggled to stay focused because of personal issues during my first year in medical school. When I admitted that I didn’t want to finish medical school, my friend Deanna held me accountable and kept me organized. She remained my study partner throughout all four years. Other friends became part of that circle. We challenged each other in our courses and encouraged each other to follow our specialty goals.\u003c/p>\n\u003cp>During my residency, this same circle of friends offered emotional support and helped me navigate \u003ca href=\"https://opmed.doximity.com/articles/i-am-not-an-imposter-02f50b07-087f-44a5-a93c-c1f36fbf4463\" target=\"_blank\" rel=\"noopener\">imposter syndrome\u003c/a>. They continue to support me as a fledgling attending physician.\u003c/p>\n\u003cp>\u003cstrong>Now It’s My Turn\u003c/strong>\u003c/p>\n\u003cp>Many medical school students grew up knowing that they wanted to become doctors. Some had parents, siblings, or friends of the family who were physicians. Many had mentors or friends who encouraged them to consider careers in medicine. For minority students like me, the path to medicine is far more uncertain and uncharted. We need to find ways to build stronger, less-leaky pipelines for them.\u003c/p>\n\u003cp>I was fortunate that someone always stepped in at moments when I was at risk of dripping out of the pipeline. Now it’s my turn to pay my experiences forward.\u003c/p>\n\u003cp>\u003cem>Paula Magee, M.D., is a hospitalist in the pediatric intensive care unit at Children’s National Health System in Washington, D.C.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2019/01/14/minority-students-physician-leaky-pipeline/\" 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>",
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"title": "Opioid Overdoses Surpass Vehicle Crashes on Leading Causes of Death List",
"headTitle": "Opioid Overdoses Surpass Vehicle Crashes on Leading Causes of Death List | KQED",
"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",
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"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>",
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"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>",
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"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",
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"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>",
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"content": "\u003cp>NEW YORK (AP) — The U.S. cancer death rate has hit a milestone: It’s been falling for at least 25 years, according to a new report.\u003c/p>\n\u003cp>Lower smoking rates are translating into fewer deaths. Advances in early detection and treatment also are having a positive impact, experts say.\u003c/p>\n\u003cp>But it’s not all good news. Obesity-related cancer deaths are rising, and prostate cancer deaths are no longer dropping, said Rebecca Siegel, lead author of the American Cancer Society report published Tuesday.\u003c/p>\n\u003cp>Cancer also remains the nation’s No. 2 killer. The society predicts there will be more than 1.7 million new cancer cases, and more than 600,000 cancer deaths, in the U.S. this year.\u003c/p>\n\u003cp>Here’s a breakdown of the report:\u003c/p>\n\u003ch2>\u003cstrong>Decline\u003c/strong>\u003c/h2>\n\u003cp>There’s been a lot of bad news recently regarding U.S. death rates. In 2017, increases were seen in fatalities from seven of the 10 leading causes of death, according to recently released government data. But cancer has been something of a bright spot.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The nation’s cancer death rate was increasing until the early 1990s. It has been dropping since, falling 27 percent between 1991 and 2016, the Cancer Society reported.\u003c/p>\n\u003cp>Lung cancer is the main reason. Among cancers, it has long killed the most people, especially men. But the lung cancer death rate dropped by nearly 50 percent among men since 1991. It was a delayed effect from a decline in smoking that began in the 1960s, Siegel said.\u003c/p>\n\u003ch2>Prostate Cancer\u003c/h2>\n\u003cp>The report has some mixed news about prostate cancer, the second leading cause of cancer death in men.\u003c/p>\n\u003cp>The prostate cancer death rate fell by half over two decades, but experts have been wondering whether the trend changed after a 2011 decision by the U.S. Preventive Services Task Force to stop recommending routine testing of men using the PSA blood test. That decision was prompted by concerns the test was leading to over-diagnosis and over-treatment.\u003c/p>\n\u003cp>The prostate cancer death rate flattened from 2013 to 2016. So while the PSA testing may have surfaced cases that didn’t actually need treatment, it may also have prevented some cancer deaths, the report suggests.\u003c/p>\n\u003ch2>Obesity\u003c/h2>\n\u003cp>Of the most common types of cancer in the U.S., all the ones with increasing death rates are linked to obesity, including cancers of the pancreas and uterus.\u003c/p>\n\u003cp>Another is liver cancer. Liver cancer deaths have been increasing since the 1970s, and initially most of the increase was tied to hepatitis C infections spread among people who abuse drugs. But now obesity accounts for a third of liver cancer deaths, and is more of a factor than hepatitis, Siegel said.\u003c/p>\n\u003cp>The nation’s growing obesity epidemic was first identified as a problem in the 1990s. It can take decades to see how a risk factor influences cancer rates, “so we may just be seeing the tip of the iceberg in terms of the effect of the obesity epidemic on cancer,” Siegel said.\u003c/p>\n\u003ch2>Disparity\u003c/h2>\n\u003cp>There’s been a decline in the historic racial gap in cancer death rates, but an economic gap is growing — especially when it comes to deaths that could be prevented by early screening and treatment, better eating and less smoking.\u003c/p>\n\u003cp>In the early 1970s, colon cancer death rates in the poorest counties were 20 percent lower than those in affluent counties; now they’re 30 percent higher. Cervical cancer deaths are twice as high for women in poor counties now, compared with women in affluent counties. And lung and liver cancer death rates are 40 percent higher for men in poor counties.\u003c/p>\n\u003cp>Dr. Darrell Gray, deputy director of Ohio State University’s Center for Cancer Health Equity, called the findings “important but not surprising.”\u003c/p>\n\u003cp>“We’ve known for some time that race is a surrogate” for other factors, like poverty and difficulty getting to — or paying for — doctor’s appointments, he said.\u003c/p>\n\u003cp>\u003cem>The Associated Press Health & Science Department receives \u003ca href=\"https://www.ap.org/press-releases/2018/ap-hhmi-expand-collaboration-to-bolster-health-science-coverage\">support\u003c/a> from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Copyright 2019 \u003ca href=\"https://www.apnews.com/b5589e095abb4a0e9022bcffe9ed38b3\">Associated Press\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>NEW YORK (AP) — The U.S. cancer death rate has hit a milestone: It’s been falling for at least 25 years, according to a new report.\u003c/p>\n\u003cp>Lower smoking rates are translating into fewer deaths. Advances in early detection and treatment also are having a positive impact, experts say.\u003c/p>\n\u003cp>But it’s not all good news. Obesity-related cancer deaths are rising, and prostate cancer deaths are no longer dropping, said Rebecca Siegel, lead author of the American Cancer Society report published Tuesday.\u003c/p>\n\u003cp>Cancer also remains the nation’s No. 2 killer. The society predicts there will be more than 1.7 million new cancer cases, and more than 600,000 cancer deaths, in the U.S. this year.\u003c/p>\n\u003cp>Here’s a breakdown of the report:\u003c/p>\n\u003ch2>\u003cstrong>Decline\u003c/strong>\u003c/h2>\n\u003cp>There’s been a lot of bad news recently regarding U.S. death rates. In 2017, increases were seen in fatalities from seven of the 10 leading causes of death, according to recently released government data. But cancer has been something of a bright spot.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The nation’s cancer death rate was increasing until the early 1990s. It has been dropping since, falling 27 percent between 1991 and 2016, the Cancer Society reported.\u003c/p>\n\u003cp>Lung cancer is the main reason. Among cancers, it has long killed the most people, especially men. But the lung cancer death rate dropped by nearly 50 percent among men since 1991. It was a delayed effect from a decline in smoking that began in the 1960s, Siegel said.\u003c/p>\n\u003ch2>Prostate Cancer\u003c/h2>\n\u003cp>The report has some mixed news about prostate cancer, the second leading cause of cancer death in men.\u003c/p>\n\u003cp>The prostate cancer death rate fell by half over two decades, but experts have been wondering whether the trend changed after a 2011 decision by the U.S. Preventive Services Task Force to stop recommending routine testing of men using the PSA blood test. That decision was prompted by concerns the test was leading to over-diagnosis and over-treatment.\u003c/p>\n\u003cp>The prostate cancer death rate flattened from 2013 to 2016. So while the PSA testing may have surfaced cases that didn’t actually need treatment, it may also have prevented some cancer deaths, the report suggests.\u003c/p>\n\u003ch2>Obesity\u003c/h2>\n\u003cp>Of the most common types of cancer in the U.S., all the ones with increasing death rates are linked to obesity, including cancers of the pancreas and uterus.\u003c/p>\n\u003cp>Another is liver cancer. Liver cancer deaths have been increasing since the 1970s, and initially most of the increase was tied to hepatitis C infections spread among people who abuse drugs. But now obesity accounts for a third of liver cancer deaths, and is more of a factor than hepatitis, Siegel said.\u003c/p>\n\u003cp>The nation’s growing obesity epidemic was first identified as a problem in the 1990s. It can take decades to see how a risk factor influences cancer rates, “so we may just be seeing the tip of the iceberg in terms of the effect of the obesity epidemic on cancer,” Siegel said.\u003c/p>\n\u003ch2>Disparity\u003c/h2>\n\u003cp>There’s been a decline in the historic racial gap in cancer death rates, but an economic gap is growing — especially when it comes to deaths that could be prevented by early screening and treatment, better eating and less smoking.\u003c/p>\n\u003cp>In the early 1970s, colon cancer death rates in the poorest counties were 20 percent lower than those in affluent counties; now they’re 30 percent higher. Cervical cancer deaths are twice as high for women in poor counties now, compared with women in affluent counties. And lung and liver cancer death rates are 40 percent higher for men in poor counties.\u003c/p>\n\u003cp>Dr. Darrell Gray, deputy director of Ohio State University’s Center for Cancer Health Equity, called the findings “important but not surprising.”\u003c/p>\n\u003cp>“We’ve known for some time that race is a surrogate” for other factors, like poverty and difficulty getting to — or paying for — doctor’s appointments, he said.\u003c/p>\n\u003cp>\u003cem>The Associated Press Health & Science Department receives \u003ca href=\"https://www.ap.org/press-releases/2018/ap-hhmi-expand-collaboration-to-bolster-health-science-coverage\">support\u003c/a> from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Copyright 2019 \u003ca href=\"https://www.apnews.com/b5589e095abb4a0e9022bcffe9ed38b3\">Associated Press\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "For Peanut Allergy Sufferers, A Look at the Latest Treatment Research",
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"content": "\u003cp>Whenever I see a report touting possible new peanut allergy treatments, I devour it. I can’t help it. It’s an occupational hazard for any health journalist whose reporting specialty and medical history intertwine.\u003c/p>\n\u003cp>I write about the business of health care, focusing on how consumers interact with the system — what we pay, what we get and why American care costs so much. But in this particular instance, I have another kind of authority: 26 years of life-threatening allergies to nuts and peanuts.\u003c/p>\n\u003cp>So last month, when California-based Aimmune Therapeutics sparked optimistic headlines after releasing clinical trial results that its allergy product, AR101, would reduce the risks linked to an accidental exposure to peanuts, I received the usual wave of questions from friends, co-workers and my parents: Would you try it? Could this help?\u003c/p>\n\u003cp>Aimmune is just one company eyeing the prize. Childhood peanut allergy diagnoses increased \u003ca href=\"https://www.sciencedaily.com/releases/2017/10/171027085541.htm\">more than 20 percent\u003c/a> in the United States from 2010 to 2017. The global market for relief is worth as much as $2 billion. The French drugmaker DBV Technologies is also working to commercialize a peanut allergy patch. \u003ca href=\"http://www.camallergy.com/about/\">Other companies\u003c/a>, including industry giant \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03463135\">Sanofi\u003c/a>, are following their \u003ca href=\"http://www.intrommune.com/oral-mucosal-therapy-omit/\">lead\u003c/a>.\u003c/p>\n\u003cp>If any one of them succeeds, it could change my life.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>My friends call nuts “Shefali poison.” My allergies first surfaced when, as a 15-month-old, I picked Thai noodles off an aunt’s plate and developed hives on my face, and then a few months later when I tasted my mom’s kaju barfi – an Indian dessert with cashews – and ended up in the hospital. Nobody in my family had ever heard of peanut allergies.\u003c/p>\n\u003cp>I’ve carried epinephrine since I was 7 years old. My friends are trained to inject it in my leg, the standard procedure for an emergency allergen exposure. Though I luckily haven’t had to take a shot of it since I was 4. (Another child in my Montessori class had a peanut butter sandwich for lunch.)\u003c/p>\n\u003cp>My mom also recalls another incident when she had to pick me up early from day care because the class was making peanut butter bird feeders. And I spent too many years of pre-adolescence eating lunch at the designated “peanut-free table.” Now, I can only dream of flying to visit my parents for Christmas without worrying about whether my seatmate’s snacks might induce anaphylaxis. And yes, \u003ca href=\"https://www.teenvogue.com/story/deathly-peanut-butter-kiss\">kissing someone\u003c/a> who has just eaten peanut butter would put my life in danger.\u003c/p>\n\u003cp>But are these pills and patches a true breakthrough for people like me?\u003c/p>\n\u003cp>I approached the question as I would any other assignment. I read the research, called immunologists, and spoke with economists and drug pricing experts about whether these treatments offer meaningful benefit.\u003c/p>\n\u003cp>One of the first things I heard: “We are still in the infancy of these treatments,” said Dr. Corinne Keet, a pediatric allergist at Johns Hopkins University.\u003c/p>\n\u003cfigure id=\"attachment_1936503\" class=\"wp-caption alignnone\" style=\"max-width: 770px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1936503\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2019/01/Shefali.jpg\" alt=\"\" width=\"770\" height=\"513\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/Shefali.jpg 770w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/Shefali-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/Shefali-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/Shefali-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/Shefali-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/Shefali-520x346.jpg 520w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003cfigcaption class=\"wp-caption-text\">Shefali Luthra (second from right), pictured in the seventh grade with her school math team, carried epinephrine in a fanny pack as a child, in case she had an allergic reaction. \u003ccite>(Courtesy of the Luthra family)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Medically, there’s a lot we don’t know about the risks, how much these drugs could help and how long any effects would last.\u003c/p>\n\u003cp>“None of these treatments have been shown to prevent fatal reaction,” Keet emphasized.\u003c/p>\n\u003cp>The idea behind them is to desensitize people. Aimmune’s “peanut pill” is modeled on the oral therapies some specialists use to wean allergic kids back on to nuts. This approach has gained popularity in recent years, especially for children with multiple allergies, or when it’s a substance particularly hard to avoid.\u003c/p>\n\u003cp>A colleague’s young daughter, who was born with multiple allergies, used that very treatment, as did a younger cousin of mine who, for the first several years of her life, was allergic to — not joking — almost everything but fruits and vegetables. In my case, this therapy came into vogue after I was too old to have a good chance of it weakening my sensitivities.\u003c/p>\n\u003cp>How it works: Kids ingest tiny, escalating doses of peanut protein. They then stay on peanut protein — Aimmune recommends the pill, though other doctors I spoke to suggested a little bit of peanut — as a maintenance drug.\u003c/p>\n\u003cp>But it’s unclear how much the new therapies would improve upon that ad hoc oral immunotherapy allergists are already offering. Instead of drugs, they use store-bought peanut protein, usually de-fatted peanut flour available online for as little as $1 a pound. This method isn’t approved by the Food and Drug Administration, and often isn’t covered by insurance — though doctors’ visits can be billed as “food challenges” or other visits that are typically covered.\u003c/p>\n\u003cp>In contrast, Aimmune’s product \u003ca href=\"https://www.latimes.com/business/la-fi-peanut-allergy-treatment-20180220-story.html\">is expected\u003c/a> to cost between $5,000 and $10,000 for the first six months of use, and $300 to $400 per month after. \u003ca href=\"https://www.reuters.com/article/us-biotech-peanuts/biotech-companies-chase-elusive-peanut-allergy-treatment-idUSKCN0SL2LK20151027\">Analysts predict\u003c/a> DBV’s will cost more than $6,000 for a year’s supply, though the company says it has not yet determined a price. DBV, Aimmune’s chief rival, has come up with a wearable skin patch that would transmit tiny, desensitizing protein doses. It declined to estimate a price, but it does not view oral immunotherapy as a competitor, said Joseph Becker, a company spokesman.\u003c/p>\n\u003cp>“There’s excitement, there’s caution and a lot of unanswered questions,” warned Dr. Erwin Gelfand, a pediatrics and immunology professor at the University of Colorado.\u003c/p>\n\u003caside class=\"pullquote alignright\">For an allergic kid, even the possibility [of a reaction] is maybe one of the most terrifying things you can imagine.\u003c/aside>\n\u003cp>According to Aimmune’s results, published in the prestigious \u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJMoa1812856\">New England Journal of Medicine\u003c/a>, two-thirds of allergic children could ingest 600 milligrams of peanut without harm after going through treatment.\u003c/p>\n\u003cp>To be clear, even with Aimmune’s help, someone like me still couldn’t safely eat PB&J. But it would desensitize me enough that I could taste a friend’s wine even if he recently ate pad thai.\u003c/p>\n\u003cp>Still, the treatment comes with caveats.\u003c/p>\n\u003cp>While 496 children started the trial, only 372 completed it. Of the 20 percent who backed out, half did so because of adverse events. About 14 percent of kids getting treatment still had to take epinephrine, and one experienced anaphylaxis, a severe reaction that can involve rashes, vomiting, a tightening throat and difficulty breathing. (For an allergic kid, even the possibility is maybe one of the most terrifying things you can imagine.)\u003c/p>\n\u003cp>Children who completed the regimen still had to take small doses of peanut protein daily, either the Aimmune drug or a controlled peanut serving. Statistically significant benefits were clear only in patients through age 17, though Dr. Daniel Adelman, the company’s chief medical officer, said Aimmune plans to do a follow-up trial for adults.\u003c/p>\n\u003cp>And the results don’t indicate who is likely to benefit, or how long improvements would last. That’s impossible to know, Adelman said, though he suggested accidental peanut exposure is scary enough — and pure avoidance ineffective enough — that the treatment is still worth it.\u003c/p>\n\u003cp>But all this means that anyone who has gone through Aimmune’s regimen would still want to carry epinephrine, and try to avoid peanuts.\u003c/p>\n\u003cp>“Not everybody responds well,” Gelfand said. When you factor in those details, the results are “not all that impressive,” he argued.\u003c/p>\n\u003cp>Dr. Tina Sindher, a pediatric allergist at Stanford University, pointed out that the Aimmune pill is a repackaged, clinically tested version of that homegrown oral therapy many allergists have already been using. DBV’s peanut patch, Viaskin, to a lesser extent, is the same — more convenient, perhaps, and more regulated, but still a variation on the existing medical approach.\u003c/p>\n\u003cp>“This concept has been around for a long time,” she said.\u003c/p>\n\u003cp>What’s new is the addition of labor, standardization and federal oversight — which companies then say demonstrates increased value.\u003c/p>\n\u003cp>It highlights a pattern \u003ca href=\"https://khn.org/news/fish-oil-drug-looks-heart-healthy-just-dont-swallow-it-hook-line-and-sinker/\">I’ve noticed\u003c/a> from my reporting: Drugmakers develop medication that refines a low-tech remedy, run a clinical trial to secure FDA approval, and then sell it at a higher price. For pharma, it’s a logical way to profit. But it puts patients in a bind.\u003c/p>\n\u003cp>“The hard outcome is we have these new products and they’re just about as good or slightly better than what we have,” said Nicholson Price, an assistant professor at the University of Michigan Law School, who studies drug pricing. “And they’re a lot more expensive.” He noted: “That’s when the choices get hard, and we’re not good at making hard choices.”\u003c/p>\n\u003cp>Also skeptical? The closest authority I know: my mother, who raised me with peanut allergies when they were more or less unheard of, and is now doing it all over again for my 10-year-old brother. (My other brother, my twin, was allergy-free until about a year ago.)\u003c/p>\n\u003cp>“It’s not worth it,” my mom told me. Her concern? Getting any of us to maintain a peanut dose — without knowing how long that reduced sensitivity would last — could induce what she called “a false sense of security.”\u003c/p>\n\u003cp>This thinking isn’t out of line, Sindher suggested. The way these studies are touted, she said, often “gloss over the fact that there’s a lot we don’t know.”\u003c/p>\n\u003cp>So for now, I’ll have to maintain my distance from the newsroom stash of Reese’s Pieces. My epinephrine and I aren’t parting ways anytime soon.\u003c/p>\n\u003cp>\u003cem>KHN’s coverage of children’s health care issues is supported in part by the \u003ca href=\"https://www.hsfoundation.org/\">Heising-Simons Foundation\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://khn.org/\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"https://www.kff.org/\">Henry J. Kaiser Family Foundation\u003c/a> which is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Whenever I see a report touting possible new peanut allergy treatments, I devour it. I can’t help it. It’s an occupational hazard for any health journalist whose reporting specialty and medical history intertwine.\u003c/p>\n\u003cp>I write about the business of health care, focusing on how consumers interact with the system — what we pay, what we get and why American care costs so much. But in this particular instance, I have another kind of authority: 26 years of life-threatening allergies to nuts and peanuts.\u003c/p>\n\u003cp>So last month, when California-based Aimmune Therapeutics sparked optimistic headlines after releasing clinical trial results that its allergy product, AR101, would reduce the risks linked to an accidental exposure to peanuts, I received the usual wave of questions from friends, co-workers and my parents: Would you try it? Could this help?\u003c/p>\n\u003cp>Aimmune is just one company eyeing the prize. Childhood peanut allergy diagnoses increased \u003ca href=\"https://www.sciencedaily.com/releases/2017/10/171027085541.htm\">more than 20 percent\u003c/a> in the United States from 2010 to 2017. The global market for relief is worth as much as $2 billion. The French drugmaker DBV Technologies is also working to commercialize a peanut allergy patch. \u003ca href=\"http://www.camallergy.com/about/\">Other companies\u003c/a>, including industry giant \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03463135\">Sanofi\u003c/a>, are following their \u003ca href=\"http://www.intrommune.com/oral-mucosal-therapy-omit/\">lead\u003c/a>.\u003c/p>\n\u003cp>If any one of them succeeds, it could change my life.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>My friends call nuts “Shefali poison.” My allergies first surfaced when, as a 15-month-old, I picked Thai noodles off an aunt’s plate and developed hives on my face, and then a few months later when I tasted my mom’s kaju barfi – an Indian dessert with cashews – and ended up in the hospital. Nobody in my family had ever heard of peanut allergies.\u003c/p>\n\u003cp>I’ve carried epinephrine since I was 7 years old. My friends are trained to inject it in my leg, the standard procedure for an emergency allergen exposure. Though I luckily haven’t had to take a shot of it since I was 4. (Another child in my Montessori class had a peanut butter sandwich for lunch.)\u003c/p>\n\u003cp>My mom also recalls another incident when she had to pick me up early from day care because the class was making peanut butter bird feeders. And I spent too many years of pre-adolescence eating lunch at the designated “peanut-free table.” Now, I can only dream of flying to visit my parents for Christmas without worrying about whether my seatmate’s snacks might induce anaphylaxis. And yes, \u003ca href=\"https://www.teenvogue.com/story/deathly-peanut-butter-kiss\">kissing someone\u003c/a> who has just eaten peanut butter would put my life in danger.\u003c/p>\n\u003cp>But are these pills and patches a true breakthrough for people like me?\u003c/p>\n\u003cp>I approached the question as I would any other assignment. I read the research, called immunologists, and spoke with economists and drug pricing experts about whether these treatments offer meaningful benefit.\u003c/p>\n\u003cp>One of the first things I heard: “We are still in the infancy of these treatments,” said Dr. Corinne Keet, a pediatric allergist at Johns Hopkins University.\u003c/p>\n\u003cfigure id=\"attachment_1936503\" class=\"wp-caption alignnone\" style=\"max-width: 770px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-1936503\" src=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2019/01/Shefali.jpg\" alt=\"\" width=\"770\" height=\"513\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/Shefali.jpg 770w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/Shefali-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/Shefali-768x512.jpg 768w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/Shefali-240x160.jpg 240w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/Shefali-375x250.jpg 375w, https://cdn.kqed.org/wp-content/uploads/sites/35/2019/01/Shefali-520x346.jpg 520w\" sizes=\"(max-width: 770px) 100vw, 770px\">\u003cfigcaption class=\"wp-caption-text\">Shefali Luthra (second from right), pictured in the seventh grade with her school math team, carried epinephrine in a fanny pack as a child, in case she had an allergic reaction. \u003ccite>(Courtesy of the Luthra family)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Medically, there’s a lot we don’t know about the risks, how much these drugs could help and how long any effects would last.\u003c/p>\n\u003cp>“None of these treatments have been shown to prevent fatal reaction,” Keet emphasized.\u003c/p>\n\u003cp>The idea behind them is to desensitize people. Aimmune’s “peanut pill” is modeled on the oral therapies some specialists use to wean allergic kids back on to nuts. This approach has gained popularity in recent years, especially for children with multiple allergies, or when it’s a substance particularly hard to avoid.\u003c/p>\n\u003cp>A colleague’s young daughter, who was born with multiple allergies, used that very treatment, as did a younger cousin of mine who, for the first several years of her life, was allergic to — not joking — almost everything but fruits and vegetables. In my case, this therapy came into vogue after I was too old to have a good chance of it weakening my sensitivities.\u003c/p>\n\u003cp>How it works: Kids ingest tiny, escalating doses of peanut protein. They then stay on peanut protein — Aimmune recommends the pill, though other doctors I spoke to suggested a little bit of peanut — as a maintenance drug.\u003c/p>\n\u003cp>But it’s unclear how much the new therapies would improve upon that ad hoc oral immunotherapy allergists are already offering. Instead of drugs, they use store-bought peanut protein, usually de-fatted peanut flour available online for as little as $1 a pound. This method isn’t approved by the Food and Drug Administration, and often isn’t covered by insurance — though doctors’ visits can be billed as “food challenges” or other visits that are typically covered.\u003c/p>\n\u003cp>In contrast, Aimmune’s product \u003ca href=\"https://www.latimes.com/business/la-fi-peanut-allergy-treatment-20180220-story.html\">is expected\u003c/a> to cost between $5,000 and $10,000 for the first six months of use, and $300 to $400 per month after. \u003ca href=\"https://www.reuters.com/article/us-biotech-peanuts/biotech-companies-chase-elusive-peanut-allergy-treatment-idUSKCN0SL2LK20151027\">Analysts predict\u003c/a> DBV’s will cost more than $6,000 for a year’s supply, though the company says it has not yet determined a price. DBV, Aimmune’s chief rival, has come up with a wearable skin patch that would transmit tiny, desensitizing protein doses. It declined to estimate a price, but it does not view oral immunotherapy as a competitor, said Joseph Becker, a company spokesman.\u003c/p>\n\u003cp>“There’s excitement, there’s caution and a lot of unanswered questions,” warned Dr. Erwin Gelfand, a pediatrics and immunology professor at the University of Colorado.\u003c/p>\n\u003caside class=\"pullquote alignright\">For an allergic kid, even the possibility [of a reaction] is maybe one of the most terrifying things you can imagine.\u003c/aside>\n\u003cp>According to Aimmune’s results, published in the prestigious \u003ca href=\"https://www.nejm.org/doi/full/10.1056/NEJMoa1812856\">New England Journal of Medicine\u003c/a>, two-thirds of allergic children could ingest 600 milligrams of peanut without harm after going through treatment.\u003c/p>\n\u003cp>To be clear, even with Aimmune’s help, someone like me still couldn’t safely eat PB&J. But it would desensitize me enough that I could taste a friend’s wine even if he recently ate pad thai.\u003c/p>\n\u003cp>Still, the treatment comes with caveats.\u003c/p>\n\u003cp>While 496 children started the trial, only 372 completed it. Of the 20 percent who backed out, half did so because of adverse events. About 14 percent of kids getting treatment still had to take epinephrine, and one experienced anaphylaxis, a severe reaction that can involve rashes, vomiting, a tightening throat and difficulty breathing. (For an allergic kid, even the possibility is maybe one of the most terrifying things you can imagine.)\u003c/p>\n\u003cp>Children who completed the regimen still had to take small doses of peanut protein daily, either the Aimmune drug or a controlled peanut serving. Statistically significant benefits were clear only in patients through age 17, though Dr. Daniel Adelman, the company’s chief medical officer, said Aimmune plans to do a follow-up trial for adults.\u003c/p>\n\u003cp>And the results don’t indicate who is likely to benefit, or how long improvements would last. That’s impossible to know, Adelman said, though he suggested accidental peanut exposure is scary enough — and pure avoidance ineffective enough — that the treatment is still worth it.\u003c/p>\n\u003cp>But all this means that anyone who has gone through Aimmune’s regimen would still want to carry epinephrine, and try to avoid peanuts.\u003c/p>\n\u003cp>“Not everybody responds well,” Gelfand said. When you factor in those details, the results are “not all that impressive,” he argued.\u003c/p>\n\u003cp>Dr. Tina Sindher, a pediatric allergist at Stanford University, pointed out that the Aimmune pill is a repackaged, clinically tested version of that homegrown oral therapy many allergists have already been using. DBV’s peanut patch, Viaskin, to a lesser extent, is the same — more convenient, perhaps, and more regulated, but still a variation on the existing medical approach.\u003c/p>\n\u003cp>“This concept has been around for a long time,” she said.\u003c/p>\n\u003cp>What’s new is the addition of labor, standardization and federal oversight — which companies then say demonstrates increased value.\u003c/p>\n\u003cp>It highlights a pattern \u003ca href=\"https://khn.org/news/fish-oil-drug-looks-heart-healthy-just-dont-swallow-it-hook-line-and-sinker/\">I’ve noticed\u003c/a> from my reporting: Drugmakers develop medication that refines a low-tech remedy, run a clinical trial to secure FDA approval, and then sell it at a higher price. For pharma, it’s a logical way to profit. But it puts patients in a bind.\u003c/p>\n\u003cp>“The hard outcome is we have these new products and they’re just about as good or slightly better than what we have,” said Nicholson Price, an assistant professor at the University of Michigan Law School, who studies drug pricing. “And they’re a lot more expensive.” He noted: “That’s when the choices get hard, and we’re not good at making hard choices.”\u003c/p>\n\u003cp>Also skeptical? The closest authority I know: my mother, who raised me with peanut allergies when they were more or less unheard of, and is now doing it all over again for my 10-year-old brother. (My other brother, my twin, was allergy-free until about a year ago.)\u003c/p>\n\u003cp>“It’s not worth it,” my mom told me. Her concern? Getting any of us to maintain a peanut dose — without knowing how long that reduced sensitivity would last — could induce what she called “a false sense of security.”\u003c/p>\n\u003cp>This thinking isn’t out of line, Sindher suggested. The way these studies are touted, she said, often “gloss over the fact that there’s a lot we don’t know.”\u003c/p>\n\u003cp>So for now, I’ll have to maintain my distance from the newsroom stash of Reese’s Pieces. My epinephrine and I aren’t parting ways anytime soon.\u003c/p>\n\u003cp>\u003cem>KHN’s coverage of children’s health care issues is supported in part by the \u003ca href=\"https://www.hsfoundation.org/\">Heising-Simons Foundation\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"https://khn.org/\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"https://www.kff.org/\">Henry J. Kaiser Family Foundation\u003c/a> which is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Government Shutdown Threatens Funding for Public Health Programs",
"headTitle": "Government Shutdown Threatens Funding for Public Health Programs | KQED",
"content": "\u003cp>There seems to be no end in sight for the \u003ca href=\"https://www.npr.org/2019/01/02/681658834/congressional-leaders-get-briefing-on-border-as-impacts-of-partial-shutdown-grow\">current partial government shutdown\u003c/a>, the third since the beginning of the Trump administration.\u003c/p>\n\u003cp>For the vast majority of the federal government’s public health efforts, though, it’s business as usual.\u003c/p>\n\u003cp>That’s because Congress has already passed five of its major appropriations bills, funding about three-fourths of the federal government, including the Department of Health and Human Services and the Department of Veterans Affairs.\u003c/p>\n\u003cp>But \u003ca href=\"https://www.congress.gov/resources/display/content/Appropriations+for+Fiscal+Year+2019\">seven bills\u003c/a> are outstanding — including those that fund the Interior, Agriculture and Justice departments — and that puts the squeeze on some important health-related initiatives.\u003c/p>\n\u003cp>The shutdown itself is not about health policies. It’s the result of differences of opinion between the administration and congressional Democrats regarding Trump’s so-called border wall. But it’s far-reaching, nonetheless. Here’s where things stand:\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Funding for “big-ticket” health programs is already in place, alleviating much of the shutdown’s immediate potential impact.\u003c/strong>\u003c/p>\n\u003cp>Since HHS funding is set through September, the flagship government health care programs — think Obamacare, Medicare and Medicaid — are insulated.\u003c/p>\n\u003cp>That’s also true of public health surveillance, like tracking the flu virus, a responsibility of the Centers for Disease Control and Prevention. The National Institutes of Health, which oversees major biomedical research, is also fine. It’s a stark contrast to \u003ca href=\"https://khn.org/news/in-the-event-of-a-shutdown/\">last January’s shutdown\u003c/a>, which sent home about half of HHS’ staff.\u003c/p>\n\u003cp>\u003cstrong>But some other public health operations are vulnerable because of complicated funding streams.\u003c/strong>\u003c/p>\n\u003cp>Although the Food and Drug Administration falls under the HHS umbrella, it receives significant funding for its food safety operations through the spending bill for the Department of Agriculture, which is entirely caught up in the shutdown.\u003c/p>\n\u003cp>Last year, that tallied an estimated \u003ca href=\"https://appropriations.house.gov/uploadedfiles/03.21.18_fy18_omnibus_-_agriculture_-_summary.pdf\">$2.9 billion\u003c/a> to support among other things these FDA oversight efforts, which involve everything from food recalls to routine facility inspections and cosmetics regulation. Not having those dollars now means, according to the FDA \u003ca href=\"https://www.hhs.gov/sites/default/files/fy-2019-hhs-lapse-contingency-plan-narrative-december-ag-interior.pdf\">contingency plan\u003c/a>, that about 40 percent of the agency — thousands of government workers — is furloughed.\u003c/p>\n\u003cp>The FDA’s responsibilities for drug approval and oversight are funded by user fees and are generally not affected. Regulation of tobacco products is also continuing.\u003c/p>\n\u003cp>\u003cstrong>Health services for Native Americans are also on hold.\u003c/strong>\u003c/p>\n\u003cp>Because Congress has yet to approve funding for the Indian Health Service, which is run by HHS but gets its money through the Department of the Interior, IHS feels the full weight of the shutdown. The only services that can continue are those that meet “immediate needs of the patients, medical staff, and medical facilities,” according to the shutdown contingency plan.\u003c/p>\n\u003cp>That includes IHS-run clinics, which provide direct health care to tribes \u003ca href=\"https://www.ihs.gov/locations/\">around the country\u003c/a>. These facilities are open, and many staffers are reporting to work because they are deemed “excepted,” said Jennifer Buschik, an agency spokeswoman. But they will not be paid until Congress and the administration reach a deal.\u003c/p>\n\u003cp>Other IHS programs are taking a more direct hit. For example, the agency has suspended grants that support tribal health programs, as well as preventive health clinics run by the \u003ca href=\"https://www.ihs.gov/urban/\">Office of Urban Indian Health Programs\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Public health efforts by Homeland Security and the EPA face serious constraints.\u003c/strong>\u003c/p>\n\u003cp>The Department of Homeland Security’s Office of Health Affairs assesses threats posed by infectious diseases, pandemics and biological and chemical attacks. It is supposed to be scaling back, according to the department’s \u003ca href=\"https://www.dhs.gov/sites/default/files/publications/DHS%20Procedure%20Related%20to%20a%20Lapse%20in%20Appropriations%20%2812-20-2018%29%20-%20FINAL%20..._0.pdf\">shutdown contingency plan\u003c/a>. This office is just one component of the 204-person Countering Weapons of Mass Destruction Office, which is retaining about 65 employees during the funding gap.\u003c/p>\n\u003cp>Other DHS health workers are likely to work without pay — for instance, health inspectors at the border, said Peter Boogaard, who was an agency spokesman under the Obama administration. According to \u003ca href=\"https://www.dhs.gov/sites/default/files/publications/DHS%20Procedure%20Related%20to%20a%20Lapse%20in%20Appropriations%20%2812-20-2018%29%20-%20FINAL%20..._0.pdf\">DHS’ plan\u003c/a>, the vast majority of border patrol employees will continue working through the shutdown.\u003c/p>\n\u003cp>The Environmental Protection Agency has also run \u003ca href=\"https://www.epa.gov/tsca-peer-review\">out of funding\u003c/a>. According to its \u003ca href=\"https://www.epa.gov/sites/production/files/2018-12/documents/epa_contingency_plan_december_18_2018_508.pdf\">contingency plan\u003c/a>, it’s keeping on more than 700 employees without pay, including those who work on Superfund sites or other activities where the “threat to life or property is imminent.” (More than 13,000 EPA workers have been furloughed.)\u003c/p>\n\u003cp>That limits the agency’s capacity for activities including inspecting water that people drink and regulating pesticides.\u003c/p>\n\u003cp>But it’s not just regulation. The public health stakes are visceral — and sometimes, frankly, pretty gross.\u003c/p>\n\u003cp>Just look at the \u003ca href=\"https://www.doi.gov/sites/doi.gov/files/2018_01_nps_contingency_plan.pdf\">National Park Service\u003c/a>, which has halted restroom maintenance and trash service for lack of funding. On Sunday, Yosemite National Park in California closed its campgrounds. On Wednesday, Joshua Tree National Park, also in California, did the same.\u003c/p>\n\u003cp>Why? Per a park service \u003ca href=\"https://www.nps.gov/jotr/learn/news/park-campgrounds-closed-during-government-shutdown.htm\">press release\u003c/a>: “The park is being forced to take this action for health and safety concerns as vault toilets reach capacity.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\">Henry J. Kaiser Family Foundation\u003c/a> which is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\n",
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"excerpt": "With the partial government shutdown continuing for a third straight week, several bills remain tied up in Congress — including those that fund the Interior, Agriculture and Justice departments. The standstill has limited funding going to agencies like the EPA, FDA and National Park Service. Here's how the shutdown is impacting some important health-related initiatives.",
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"description": "With the partial government shutdown continuing for a third straight week, several bills remain tied up in Congress — including those that fund the Interior, Agriculture and Justice departments. The standstill has limited funding going to agencies like the EPA, FDA and National Park Service. Here's how the shutdown is impacting some important health-related initiatives.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>There seems to be no end in sight for the \u003ca href=\"https://www.npr.org/2019/01/02/681658834/congressional-leaders-get-briefing-on-border-as-impacts-of-partial-shutdown-grow\">current partial government shutdown\u003c/a>, the third since the beginning of the Trump administration.\u003c/p>\n\u003cp>For the vast majority of the federal government’s public health efforts, though, it’s business as usual.\u003c/p>\n\u003cp>That’s because Congress has already passed five of its major appropriations bills, funding about three-fourths of the federal government, including the Department of Health and Human Services and the Department of Veterans Affairs.\u003c/p>\n\u003cp>But \u003ca href=\"https://www.congress.gov/resources/display/content/Appropriations+for+Fiscal+Year+2019\">seven bills\u003c/a> are outstanding — including those that fund the Interior, Agriculture and Justice departments — and that puts the squeeze on some important health-related initiatives.\u003c/p>\n\u003cp>The shutdown itself is not about health policies. It’s the result of differences of opinion between the administration and congressional Democrats regarding Trump’s so-called border wall. But it’s far-reaching, nonetheless. Here’s where things stand:\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Funding for “big-ticket” health programs is already in place, alleviating much of the shutdown’s immediate potential impact.\u003c/strong>\u003c/p>\n\u003cp>Since HHS funding is set through September, the flagship government health care programs — think Obamacare, Medicare and Medicaid — are insulated.\u003c/p>\n\u003cp>That’s also true of public health surveillance, like tracking the flu virus, a responsibility of the Centers for Disease Control and Prevention. The National Institutes of Health, which oversees major biomedical research, is also fine. It’s a stark contrast to \u003ca href=\"https://khn.org/news/in-the-event-of-a-shutdown/\">last January’s shutdown\u003c/a>, which sent home about half of HHS’ staff.\u003c/p>\n\u003cp>\u003cstrong>But some other public health operations are vulnerable because of complicated funding streams.\u003c/strong>\u003c/p>\n\u003cp>Although the Food and Drug Administration falls under the HHS umbrella, it receives significant funding for its food safety operations through the spending bill for the Department of Agriculture, which is entirely caught up in the shutdown.\u003c/p>\n\u003cp>Last year, that tallied an estimated \u003ca href=\"https://appropriations.house.gov/uploadedfiles/03.21.18_fy18_omnibus_-_agriculture_-_summary.pdf\">$2.9 billion\u003c/a> to support among other things these FDA oversight efforts, which involve everything from food recalls to routine facility inspections and cosmetics regulation. Not having those dollars now means, according to the FDA \u003ca href=\"https://www.hhs.gov/sites/default/files/fy-2019-hhs-lapse-contingency-plan-narrative-december-ag-interior.pdf\">contingency plan\u003c/a>, that about 40 percent of the agency — thousands of government workers — is furloughed.\u003c/p>\n\u003cp>The FDA’s responsibilities for drug approval and oversight are funded by user fees and are generally not affected. Regulation of tobacco products is also continuing.\u003c/p>\n\u003cp>\u003cstrong>Health services for Native Americans are also on hold.\u003c/strong>\u003c/p>\n\u003cp>Because Congress has yet to approve funding for the Indian Health Service, which is run by HHS but gets its money through the Department of the Interior, IHS feels the full weight of the shutdown. The only services that can continue are those that meet “immediate needs of the patients, medical staff, and medical facilities,” according to the shutdown contingency plan.\u003c/p>\n\u003cp>That includes IHS-run clinics, which provide direct health care to tribes \u003ca href=\"https://www.ihs.gov/locations/\">around the country\u003c/a>. These facilities are open, and many staffers are reporting to work because they are deemed “excepted,” said Jennifer Buschik, an agency spokeswoman. But they will not be paid until Congress and the administration reach a deal.\u003c/p>\n\u003cp>Other IHS programs are taking a more direct hit. For example, the agency has suspended grants that support tribal health programs, as well as preventive health clinics run by the \u003ca href=\"https://www.ihs.gov/urban/\">Office of Urban Indian Health Programs\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Public health efforts by Homeland Security and the EPA face serious constraints.\u003c/strong>\u003c/p>\n\u003cp>The Department of Homeland Security’s Office of Health Affairs assesses threats posed by infectious diseases, pandemics and biological and chemical attacks. It is supposed to be scaling back, according to the department’s \u003ca href=\"https://www.dhs.gov/sites/default/files/publications/DHS%20Procedure%20Related%20to%20a%20Lapse%20in%20Appropriations%20%2812-20-2018%29%20-%20FINAL%20..._0.pdf\">shutdown contingency plan\u003c/a>. This office is just one component of the 204-person Countering Weapons of Mass Destruction Office, which is retaining about 65 employees during the funding gap.\u003c/p>\n\u003cp>Other DHS health workers are likely to work without pay — for instance, health inspectors at the border, said Peter Boogaard, who was an agency spokesman under the Obama administration. According to \u003ca href=\"https://www.dhs.gov/sites/default/files/publications/DHS%20Procedure%20Related%20to%20a%20Lapse%20in%20Appropriations%20%2812-20-2018%29%20-%20FINAL%20..._0.pdf\">DHS’ plan\u003c/a>, the vast majority of border patrol employees will continue working through the shutdown.\u003c/p>\n\u003cp>The Environmental Protection Agency has also run \u003ca href=\"https://www.epa.gov/tsca-peer-review\">out of funding\u003c/a>. According to its \u003ca href=\"https://www.epa.gov/sites/production/files/2018-12/documents/epa_contingency_plan_december_18_2018_508.pdf\">contingency plan\u003c/a>, it’s keeping on more than 700 employees without pay, including those who work on Superfund sites or other activities where the “threat to life or property is imminent.” (More than 13,000 EPA workers have been furloughed.)\u003c/p>\n\u003cp>That limits the agency’s capacity for activities including inspecting water that people drink and regulating pesticides.\u003c/p>\n\u003cp>But it’s not just regulation. The public health stakes are visceral — and sometimes, frankly, pretty gross.\u003c/p>\n\u003cp>Just look at the \u003ca href=\"https://www.doi.gov/sites/doi.gov/files/2018_01_nps_contingency_plan.pdf\">National Park Service\u003c/a>, which has halted restroom maintenance and trash service for lack of funding. On Sunday, Yosemite National Park in California closed its campgrounds. On Wednesday, Joshua Tree National Park, also in California, did the same.\u003c/p>\n\u003cp>Why? Per a park service \u003ca href=\"https://www.nps.gov/jotr/learn/news/park-campgrounds-closed-during-government-shutdown.htm\">press release\u003c/a>: “The park is being forced to take this action for health and safety concerns as vault toilets reach capacity.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a> (KHN) is a national health policy news service. It is an editorially independent program of the \u003ca href=\"http://www.kff.org/\">Henry J. Kaiser Family Foundation\u003c/a> which is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"headTitle": "New Software Can Spot Genetic Mutations Using Photos | KQED",
"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",
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"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",
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"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>",
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"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>",
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"title": "The Most Important New California Environmental and Health Laws of 2019",
"headTitle": "The Most Important New California Environmental and Health Laws of 2019 | KQED",
"content": "\u003cp>The California Legislature in 2018 cranked out \u003ca href=\"http://www.counties.org/csac-bulletin-article/governor-brown-takes-final-action-2018-legislation\" target=\"_blank\" rel=\"noopener\">1,016 pieces of legislation\u003c/a> that Gov. Brown \u003ca href=\"https://twitter.com/GovPressOffice/status/1046601496702332928/photo/1\" target=\"_blank\" rel=\"noopener\">signed\u003c/a> into law. Number of bills \u003ca href=\"https://www.kqed.org/news/11624605/revealing-rejections-jerry-browns-vetoes-are-a-window-into-his-mind\" target=\"_blank\" rel=\"noopener\">vetoed\u003c/a>? 201. (For those keeping track, note that Brown rejected bills at a \u003ca href=\"https://sor.senate.ca.gov/sites/sor.senate.ca.gov/files/Governors%20Vetoes%202017_Senate%20Office%20of%20Research.pdf\" target=\"_blank\" rel=\"noopener\">much higher clip\u003c/a> his second time around as governor.)\u003c/p>\n\u003cp>Here are some of the most important environmental and health changes coming in 2019:\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB100\" target=\"_blank\" rel=\"noopener\">SB 100\u003c/a>: The long road to 100 percent clean energy\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>It was, in many ways,\u003ca href=\"https://www.kqed.org/science/1915384/can-california-really-go-100-percent-renewable-energy\" target=\"_blank\" rel=\"noopener\"> the defining environmental law of the year\u003c/a>: a groundbreaking mandate for generating 100 percent of the state’s electricity from solar, wind and other non-fossil sources by 2045. Now comes the hard part: \u003ca href=\"https://www.kqed.org/science/1930972/why-100-percent-clean-energy-in-california-is-gonna-be-tricky\" target=\"_blank\" rel=\"noopener\">actually doing it\u003c/a>. Legislators have already passed a rash of environmental legislation to begin meeting these goals, including an increase in incentives for solar panels, more \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB1013\" target=\"_blank\" rel=\"noopener\">restrictions\u003c/a> on hydrofluorocarbons, and an\u003ca href=\"https://www.kqed.org/news/11560541/heres-whats-in-the-deal-to-extend-californias-cap-and-trade-system\" target=\"_blank\" rel=\"noopener\"> extension of the state’s cap-and-trade system\u003c/a> to 2030.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB901\" target=\"_blank\" rel=\"noopener\">SB 901\u003c/a>, et al: Wildfire mitigation\u003c/strong>\u003c/p>\n\u003cp>In September, Brown signed a \u003ca href=\"https://www.kqed.org/news/11694129/gov-brown-signs-major-wildfire-reforms-utility-protections-into-law\" target=\"_blank\" rel=\"noopener\">package of bills\u003c/a> in response to the massive wildfires of the last few years. The main bill, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB901\" target=\"_blank\" rel=\"noopener\">SB 901\u003c/a>, requires utilities to implement fire prevention plans and upgrade equipment. It also creates incentives for landowners to reduce excess fuel and remove dead trees, and sets aside $1 billion for forest management over the next five years. Controversially, the negotiated deal \u003ca href=\"https://www.kqed.org/news/11689138/last-minute-deal-allows-utilities-to-pass-along-costs-of-2017-fires\" target=\"_blank\" rel=\"noopener\">allows PG&E\u003c/a> to pass on to consumers some of the cost it may incur if it’s found liable for the 2017 fires. The two- dozen or so fire prevention bills Brown signed include rules making it easier for private landowners to conduct controlled burns, rules requiring garage door openers to have backup batteries in case of electrical outages, and a clarification that insurers \u003ca href=\"https://www.latimes.com/business/lazarus/la-fi-lazarus-mudslides-homeowners-insurance-20180130-story.html\" target=\"_blank\" rel=\"noopener\">must cover\u003c/a> losses due to landslides and mudslides if those calamities resulted mainly from a separate, insured catastrophe like fire.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB1775\" target=\"_blank\" rel=\"noopener\">AB 1775\u003c/a>\u003c/strong>and \u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB834\" target=\"_blank\" rel=\"noopener\">SB 834\u003c/a>: No offshore drilling\u003c/strong>\u003c/p>\n\u003cp>Gov. Brown signed \u003ca href=\"https://www.kqed.org/news/11691228/brown-signs-bills-to-make-new-offshore-drilling-in-california-more-difficult\" target=\"_blank\" rel=\"noopener\">two bills\u003c/a> to stem offshore drilling, in response to the Trump administration’s \u003ca href=\"https://www.kqed.org/science/1919605/offshore-drilling-showdown-in-sacramento-thursday\" target=\"_blank\" rel=\"noopener\">push\u003c/a> to open nearly the entire U.S. coastline to offshore oil leasing in federal waters. The companion bills prevent any new leases for construction of oil or gas infrastructure like pipelines or piers in state waters or tidal lands as of Jan. 1, which would ostensibly prevent any oil from coming ashore.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB1274\" target=\"_blank\" rel=\"noopener\">AB 1274\u003c/a>: Smog check exemption \u003c/strong>\u003c/p>\n\u003cp>Previously, cars six \u003ca href=\"https://www.autoblog.com/2016/04/15/determine-car-model-year-vin/\">model-years\u003c/a> old or newer could forego a smog-check. The new law extends that exemption to cars eight years old or newer. During the last two of those eight years, the smog abatement fee will jump to $25 from $20.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB544\" target=\"_blank\" rel=\"noopener\">AB 544\u003c/a>: HOV stickers for zero-emission cars\u003c/strong>\u003c/p>\n\u003cp>This law \u003ca href=\"https://www.kqed.org/science/1915616/ca-legislature-clean-cars-can-keep-carpool-lane-access\" target=\"_blank\" rel=\"noopener\">extends\u003c/a> the program that allows \u003ca href=\"https://www.arb.ca.gov/msprog/carpool/carpool.htm\" target=\"_blank\" rel=\"noopener noreferrer\">zero-emission cars\u003c/a> to drive in carpool lanes. Here are the new rules:\u003c/p>\n\u003cul>\n\u003cli>Stickers issued before Jan. 1, 2017 expire on Jan. 1, 2019.\u003c/li>\n\u003cli>Stickers issued to new cars after Jan. 1, 2019 are valid for three full years and then until Jan. 1 of their fourth year.\u003c/li>\n\u003cli>Drivers issued stickers in 2017 and 2018 will be able to apply for a new sticker in 2019 that is valid until Jan. 1, 2022.\u003c/li>\n\u003c/ul>\n\u003cp>In addition, drivers that receive the state’s \u003ca href=\"https://cleanvehiclerebate.org/eng\" target=\"_blank\" rel=\"noopener noreferrer\">Clean Vehicle Rebate\u003c/a>, which can be several thousand dollars, won’t be eligible for HOV lane stickers unless their gross annual income falls below $150,000 for a single tax filer, $204,000 for a head of household and $300,000 for joint filers.\u003c/p>\n\u003cp>Here is the California Air Resources Board \u003ca href=\"https://ww2.arb.ca.gov/eligible-carpool-sticker-list\" target=\"_blank\" rel=\"noopener\">list of vehicles\u003c/a>, going back to 1997, that are eligible for carpool stickers.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB606\" target=\"_blank\" rel=\"noopener\">SB 606\u003c/a> and \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB1668\" target=\"_blank\" rel=\"noopener\">AB 1668\u003c/a>: More efficient water use\u003c/strong>\u003c/p>\n\u003cp>These laws don’t go into effect in 2019, but their passage in 2018 was an important part of Gov. Brown’s push to make water conservation “\u003ca href=\"https://www.kqed.org/science/1235760/california-drought-six-years-in-how-will-the-state-keep-saving-water\" target=\"_blank\" rel=\"noopener\">a way of life\u003c/a>.” SB 606 and AB 1668 collectively require the state to establish new efficiency standards for water use by 2022 and mandate that local agencies devise drought and water-shortage plans. The bills also set indoor residential use at 55 gallons per person per day, incrementally reducing that number after Jan. 1, 2025. Basically, this year, you might want to start getting used to using less water and more water- efficient appliances.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB1884\" target=\"_blank\" rel=\"noopener\">AB 1884\u003c/a>: No more plastic straws … unless you really want one\u003c/strong>\u003c/p>\n\u003cp>It was a tough year for plastic straws. \u003ca href=\"https://www.kqed.org/science/1927896/san-francisco-to-consider-outlawing-plastic-straws-stirrers\" target=\"_blank\" rel=\"noopener\">San Francisco banned them, \u003c/a> Starbucks announced a \u003ca href=\"https://www.kqed.org/science/1927062/starbucks-goodbye-plastic-straws\" target=\"_blank\" rel=\"noopener\">phaseout\u003c/a>, and California passed a law removing them from full-service restaurants starting Jan. 1. However, dining establishments can still give you a plastic straw if you ask for one. (This is similar to the new rule that restaurants are not supposed to serve water unless you ask for it.) Businesses that don’t comply will get two warnings and then can be fined $25 per day, up to $300 annually.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB1192\" target=\"_blank\" rel=\"noopener\">SB 1192\u003c/a>: No soda or juice with kid meals\u003c/strong>\u003c/p>\n\u003cp>Restaurants will now have to remove soda and juice from kids’ menus. The default options starting in 2019 will be water with no added sweetners or milk or a dairy-free milk substitute. If kids or their parents want juice or soda, they’ll have to ask. (If you want to go full gadfly, ask for a plastic straw with that soda.) After a warning, restaurant violators can be fined $250, or $500 for a repeat offense.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB1976\" target=\"_blank\" rel=\"noopener\">AB 1976\u003c/a>: Breastfeeding at work\u003c/strong>\u003c/p>\n\u003cp>California already requires employers to provide a reasonable amount of time to breastfeed and a place for lactation that isn’t a toilet stall. AB 1976 now requires that area be outside the bathroom itself. Temporary locations are acceptable, as long as they’re private. Another bill, which would have legislated more specific requirements, was vetoed by Gov. Brown.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB179\" target=\"_blank\" rel=\"noopener\">SB 179\u003c/a>: Nonbinary gender option on official forms\u003c/strong>\u003c/p>\n\u003cp>The \u003ca href=\"https://www.kqed.org/futureofyou/436110/california-third-gender-nonbinary\" target=\"_blank\" rel=\"noopener\">Gender Recognition Act \u003c/a>was passed in 2017, allowing Caifornians to change the gender on their birth certificates to “\u003ca href=\"https://www.kqed.org/futureofyou/335790/boy-girl-both-neither-a-new-generation-overthrows-gender\" target=\"_blank\" rel=\"noopener\">nonbinary\u003c/a>” instead of male or female. Now the rest of the law goes into effect. Starting Jan. 1, individuals can choose the nonbinary gender designation on \u003ca href=\"https://www.dmv.ca.gov/portal/dmv/detail/dl/gender_id\" target=\"_blank\" rel=\"noopener\">driver’s licenses or state IDs\u003c/a>. People wanting to change their gender on those forms will also no longer have to provide a doctor’s authorization. The law, of course, does not apply to federal forms, such as passports, or documents issued by other states. (For more on the law, check out the Transgender Law Center \u003ca href=\"https://transgenderlawcenter.org/resources/id/ca-sb179\" target=\"_blank\" rel=\"noopener\">fact sheet\u003c/a>.)\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB1448\" target=\"_blank\" rel=\"noopener\">SB 1448\u003c/a>: Informing patients about physician misconduct\u003c/strong>\u003c/p>\n\u003cp>After a number of \u003ca href=\"https://www.kqed.org/stateofhealth/209413/nationwide-doctors-who-sexually-abuse-their-patients-continue-to-practice\" target=\"_blank\" rel=\"noopener\">instances\u003c/a> in which doctors were allowed to continue practicing following sexual assault or misconduct, a movement ensued to arm the public with information about which physicians have been found culpable. Previously, patients could search an online database to see if their doctors were on probation, but that put the onus on the public. SB 1448 requires doctors to actively inform their patients if they’ve been disciplined by the regulatory board for the following: sexual misconduct involving a patient, drug abuse, criminal convictions involving harm to a patient, and inappropriate prescribing that resulted in patient harm. In July, the list of medical professionals required to proactively inform the public will expand to include surgeons, osteopaths, naturopathic doctors, chiropractors, podiatrists and acupuncturists.\u003c/p>\n\u003cp>\u003cstrong>Also of interest …\u003c/strong>\u003c/p>\n\u003cp>We note: A \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB1138\" target=\"_blank\" rel=\"noopener\">law\u003c/a> requiring vegan meals to be offered in prisons and hospitals; \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB1017\" target=\"_blank\" rel=\"noopener\">one\u003c/a> phasing out drift gill-net fishing, which unintentionally snares marine mammals; and \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB2998\" target=\"_blank\" rel=\"noopener\">another\u003c/a> that phases out certain flame retardants by 2020.\u003c/p>\n\u003cp>\u003cem>Jon Brooks contributed to this report.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "From an ambitious clean-energy goal to officially recognizing a third gender, California continued to break new legislative ground last year. ",
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"description": "From an ambitious clean-energy goal to officially recognizing a third gender, California continued to break new legislative ground last year. ",
"title": "The Most Important New California Environmental and Health Laws of 2019 | KQED",
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"headline": "The Most Important New California Environmental and Health Laws of 2019",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The California Legislature in 2018 cranked out \u003ca href=\"http://www.counties.org/csac-bulletin-article/governor-brown-takes-final-action-2018-legislation\" target=\"_blank\" rel=\"noopener\">1,016 pieces of legislation\u003c/a> that Gov. Brown \u003ca href=\"https://twitter.com/GovPressOffice/status/1046601496702332928/photo/1\" target=\"_blank\" rel=\"noopener\">signed\u003c/a> into law. Number of bills \u003ca href=\"https://www.kqed.org/news/11624605/revealing-rejections-jerry-browns-vetoes-are-a-window-into-his-mind\" target=\"_blank\" rel=\"noopener\">vetoed\u003c/a>? 201. (For those keeping track, note that Brown rejected bills at a \u003ca href=\"https://sor.senate.ca.gov/sites/sor.senate.ca.gov/files/Governors%20Vetoes%202017_Senate%20Office%20of%20Research.pdf\" target=\"_blank\" rel=\"noopener\">much higher clip\u003c/a> his second time around as governor.)\u003c/p>\n\u003cp>Here are some of the most important environmental and health changes coming in 2019:\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB100\" target=\"_blank\" rel=\"noopener\">SB 100\u003c/a>: The long road to 100 percent clean energy\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>It was, in many ways,\u003ca href=\"https://www.kqed.org/science/1915384/can-california-really-go-100-percent-renewable-energy\" target=\"_blank\" rel=\"noopener\"> the defining environmental law of the year\u003c/a>: a groundbreaking mandate for generating 100 percent of the state’s electricity from solar, wind and other non-fossil sources by 2045. Now comes the hard part: \u003ca href=\"https://www.kqed.org/science/1930972/why-100-percent-clean-energy-in-california-is-gonna-be-tricky\" target=\"_blank\" rel=\"noopener\">actually doing it\u003c/a>. Legislators have already passed a rash of environmental legislation to begin meeting these goals, including an increase in incentives for solar panels, more \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB1013\" target=\"_blank\" rel=\"noopener\">restrictions\u003c/a> on hydrofluorocarbons, and an\u003ca href=\"https://www.kqed.org/news/11560541/heres-whats-in-the-deal-to-extend-californias-cap-and-trade-system\" target=\"_blank\" rel=\"noopener\"> extension of the state’s cap-and-trade system\u003c/a> to 2030.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB901\" target=\"_blank\" rel=\"noopener\">SB 901\u003c/a>, et al: Wildfire mitigation\u003c/strong>\u003c/p>\n\u003cp>In September, Brown signed a \u003ca href=\"https://www.kqed.org/news/11694129/gov-brown-signs-major-wildfire-reforms-utility-protections-into-law\" target=\"_blank\" rel=\"noopener\">package of bills\u003c/a> in response to the massive wildfires of the last few years. The main bill, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB901\" target=\"_blank\" rel=\"noopener\">SB 901\u003c/a>, requires utilities to implement fire prevention plans and upgrade equipment. It also creates incentives for landowners to reduce excess fuel and remove dead trees, and sets aside $1 billion for forest management over the next five years. Controversially, the negotiated deal \u003ca href=\"https://www.kqed.org/news/11689138/last-minute-deal-allows-utilities-to-pass-along-costs-of-2017-fires\" target=\"_blank\" rel=\"noopener\">allows PG&E\u003c/a> to pass on to consumers some of the cost it may incur if it’s found liable for the 2017 fires. The two- dozen or so fire prevention bills Brown signed include rules making it easier for private landowners to conduct controlled burns, rules requiring garage door openers to have backup batteries in case of electrical outages, and a clarification that insurers \u003ca href=\"https://www.latimes.com/business/lazarus/la-fi-lazarus-mudslides-homeowners-insurance-20180130-story.html\" target=\"_blank\" rel=\"noopener\">must cover\u003c/a> losses due to landslides and mudslides if those calamities resulted mainly from a separate, insured catastrophe like fire.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB1775\" target=\"_blank\" rel=\"noopener\">AB 1775\u003c/a>\u003c/strong>and \u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB834\" target=\"_blank\" rel=\"noopener\">SB 834\u003c/a>: No offshore drilling\u003c/strong>\u003c/p>\n\u003cp>Gov. Brown signed \u003ca href=\"https://www.kqed.org/news/11691228/brown-signs-bills-to-make-new-offshore-drilling-in-california-more-difficult\" target=\"_blank\" rel=\"noopener\">two bills\u003c/a> to stem offshore drilling, in response to the Trump administration’s \u003ca href=\"https://www.kqed.org/science/1919605/offshore-drilling-showdown-in-sacramento-thursday\" target=\"_blank\" rel=\"noopener\">push\u003c/a> to open nearly the entire U.S. coastline to offshore oil leasing in federal waters. The companion bills prevent any new leases for construction of oil or gas infrastructure like pipelines or piers in state waters or tidal lands as of Jan. 1, which would ostensibly prevent any oil from coming ashore.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB1274\" target=\"_blank\" rel=\"noopener\">AB 1274\u003c/a>: Smog check exemption \u003c/strong>\u003c/p>\n\u003cp>Previously, cars six \u003ca href=\"https://www.autoblog.com/2016/04/15/determine-car-model-year-vin/\">model-years\u003c/a> old or newer could forego a smog-check. The new law extends that exemption to cars eight years old or newer. During the last two of those eight years, the smog abatement fee will jump to $25 from $20.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB544\" target=\"_blank\" rel=\"noopener\">AB 544\u003c/a>: HOV stickers for zero-emission cars\u003c/strong>\u003c/p>\n\u003cp>This law \u003ca href=\"https://www.kqed.org/science/1915616/ca-legislature-clean-cars-can-keep-carpool-lane-access\" target=\"_blank\" rel=\"noopener\">extends\u003c/a> the program that allows \u003ca href=\"https://www.arb.ca.gov/msprog/carpool/carpool.htm\" target=\"_blank\" rel=\"noopener noreferrer\">zero-emission cars\u003c/a> to drive in carpool lanes. Here are the new rules:\u003c/p>\n\u003cul>\n\u003cli>Stickers issued before Jan. 1, 2017 expire on Jan. 1, 2019.\u003c/li>\n\u003cli>Stickers issued to new cars after Jan. 1, 2019 are valid for three full years and then until Jan. 1 of their fourth year.\u003c/li>\n\u003cli>Drivers issued stickers in 2017 and 2018 will be able to apply for a new sticker in 2019 that is valid until Jan. 1, 2022.\u003c/li>\n\u003c/ul>\n\u003cp>In addition, drivers that receive the state’s \u003ca href=\"https://cleanvehiclerebate.org/eng\" target=\"_blank\" rel=\"noopener noreferrer\">Clean Vehicle Rebate\u003c/a>, which can be several thousand dollars, won’t be eligible for HOV lane stickers unless their gross annual income falls below $150,000 for a single tax filer, $204,000 for a head of household and $300,000 for joint filers.\u003c/p>\n\u003cp>Here is the California Air Resources Board \u003ca href=\"https://ww2.arb.ca.gov/eligible-carpool-sticker-list\" target=\"_blank\" rel=\"noopener\">list of vehicles\u003c/a>, going back to 1997, that are eligible for carpool stickers.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB606\" target=\"_blank\" rel=\"noopener\">SB 606\u003c/a> and \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB1668\" target=\"_blank\" rel=\"noopener\">AB 1668\u003c/a>: More efficient water use\u003c/strong>\u003c/p>\n\u003cp>These laws don’t go into effect in 2019, but their passage in 2018 was an important part of Gov. Brown’s push to make water conservation “\u003ca href=\"https://www.kqed.org/science/1235760/california-drought-six-years-in-how-will-the-state-keep-saving-water\" target=\"_blank\" rel=\"noopener\">a way of life\u003c/a>.” SB 606 and AB 1668 collectively require the state to establish new efficiency standards for water use by 2022 and mandate that local agencies devise drought and water-shortage plans. The bills also set indoor residential use at 55 gallons per person per day, incrementally reducing that number after Jan. 1, 2025. Basically, this year, you might want to start getting used to using less water and more water- efficient appliances.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB1884\" target=\"_blank\" rel=\"noopener\">AB 1884\u003c/a>: No more plastic straws … unless you really want one\u003c/strong>\u003c/p>\n\u003cp>It was a tough year for plastic straws. \u003ca href=\"https://www.kqed.org/science/1927896/san-francisco-to-consider-outlawing-plastic-straws-stirrers\" target=\"_blank\" rel=\"noopener\">San Francisco banned them, \u003c/a> Starbucks announced a \u003ca href=\"https://www.kqed.org/science/1927062/starbucks-goodbye-plastic-straws\" target=\"_blank\" rel=\"noopener\">phaseout\u003c/a>, and California passed a law removing them from full-service restaurants starting Jan. 1. However, dining establishments can still give you a plastic straw if you ask for one. (This is similar to the new rule that restaurants are not supposed to serve water unless you ask for it.) Businesses that don’t comply will get two warnings and then can be fined $25 per day, up to $300 annually.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB1192\" target=\"_blank\" rel=\"noopener\">SB 1192\u003c/a>: No soda or juice with kid meals\u003c/strong>\u003c/p>\n\u003cp>Restaurants will now have to remove soda and juice from kids’ menus. The default options starting in 2019 will be water with no added sweetners or milk or a dairy-free milk substitute. If kids or their parents want juice or soda, they’ll have to ask. (If you want to go full gadfly, ask for a plastic straw with that soda.) After a warning, restaurant violators can be fined $250, or $500 for a repeat offense.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB1976\" target=\"_blank\" rel=\"noopener\">AB 1976\u003c/a>: Breastfeeding at work\u003c/strong>\u003c/p>\n\u003cp>California already requires employers to provide a reasonable amount of time to breastfeed and a place for lactation that isn’t a toilet stall. AB 1976 now requires that area be outside the bathroom itself. Temporary locations are acceptable, as long as they’re private. Another bill, which would have legislated more specific requirements, was vetoed by Gov. Brown.\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB179\" target=\"_blank\" rel=\"noopener\">SB 179\u003c/a>: Nonbinary gender option on official forms\u003c/strong>\u003c/p>\n\u003cp>The \u003ca href=\"https://www.kqed.org/futureofyou/436110/california-third-gender-nonbinary\" target=\"_blank\" rel=\"noopener\">Gender Recognition Act \u003c/a>was passed in 2017, allowing Caifornians to change the gender on their birth certificates to “\u003ca href=\"https://www.kqed.org/futureofyou/335790/boy-girl-both-neither-a-new-generation-overthrows-gender\" target=\"_blank\" rel=\"noopener\">nonbinary\u003c/a>” instead of male or female. Now the rest of the law goes into effect. Starting Jan. 1, individuals can choose the nonbinary gender designation on \u003ca href=\"https://www.dmv.ca.gov/portal/dmv/detail/dl/gender_id\" target=\"_blank\" rel=\"noopener\">driver’s licenses or state IDs\u003c/a>. People wanting to change their gender on those forms will also no longer have to provide a doctor’s authorization. The law, of course, does not apply to federal forms, such as passports, or documents issued by other states. (For more on the law, check out the Transgender Law Center \u003ca href=\"https://transgenderlawcenter.org/resources/id/ca-sb179\" target=\"_blank\" rel=\"noopener\">fact sheet\u003c/a>.)\u003c/p>\n\u003cp>\u003cstrong>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB1448\" target=\"_blank\" rel=\"noopener\">SB 1448\u003c/a>: Informing patients about physician misconduct\u003c/strong>\u003c/p>\n\u003cp>After a number of \u003ca href=\"https://www.kqed.org/stateofhealth/209413/nationwide-doctors-who-sexually-abuse-their-patients-continue-to-practice\" target=\"_blank\" rel=\"noopener\">instances\u003c/a> in which doctors were allowed to continue practicing following sexual assault or misconduct, a movement ensued to arm the public with information about which physicians have been found culpable. Previously, patients could search an online database to see if their doctors were on probation, but that put the onus on the public. SB 1448 requires doctors to actively inform their patients if they’ve been disciplined by the regulatory board for the following: sexual misconduct involving a patient, drug abuse, criminal convictions involving harm to a patient, and inappropriate prescribing that resulted in patient harm. In July, the list of medical professionals required to proactively inform the public will expand to include surgeons, osteopaths, naturopathic doctors, chiropractors, podiatrists and acupuncturists.\u003c/p>\n\u003cp>\u003cstrong>Also of interest …\u003c/strong>\u003c/p>\n\u003cp>We note: A \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB1138\" target=\"_blank\" rel=\"noopener\">law\u003c/a> requiring vegan meals to be offered in prisons and hospitals; \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB1017\" target=\"_blank\" rel=\"noopener\">one\u003c/a> phasing out drift gill-net fishing, which unintentionally snares marine mammals; and \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180AB2998\" target=\"_blank\" rel=\"noopener\">another\u003c/a> that phases out certain flame retardants by 2020.\u003c/p>\n\u003cp>\u003cem>Jon Brooks contributed to this report.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"marketplace": {
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
"airtime": "MON-FRI 4pm-4:30pm, MON-WED 6:30pm-7pm",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
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"politicalbreakdown": {
"id": "politicalbreakdown",
"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
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"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
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"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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"reveal": {
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"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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},
"science-friday": {
"id": "science-friday",
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"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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"snap-judgment": {
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"title": "Snap Judgment",
"tagline": "Real stories with killer beats",
"info": "The Snap Judgment radio show and podcast mixes real stories with killer beats to produce cinematic, dramatic radio. Snap's musical brand of storytelling dares listeners to see the world through the eyes of another. This is storytelling... with a BEAT!! Snap first aired on public radio stations nationwide in July 2010. Today, Snap Judgment airs on over 450 public radio stations and is brought to the airwaves by KQED & PRX.",
"airtime": "SAT 1pm-2pm, 9pm-10pm",
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},
"soldout": {
"id": "soldout",
"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
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