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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The California Department of Public Health \u003ca href=\"http://www.cdph.ca.gov/Pages/NR15-053.aspx\" target=\"_blank\">issued a warning\u003c/a> Monday, particularly to pregnant women, about the prevalence and danger of whooping cough, and the need to increase the vaccination rate against the disease.\u003c/p>\n\u003cp>Whooping cough, also called pertussis, can be deadly for infants and is responsible for one infant death already this year, according to Karen Smith, director of the state Public Health department.\u003c/p>\n\u003cp>Smith said, so far this year, there have been 126 infant hospitalizations due to whooping cough, along with the death of one baby -- and they're preventable, she said.\u003c/p>\n\u003cp>\"Right now, it's estimated that fewer than half of all pregnant women in California are vaccinated against whooping cough,\" Smith said. \"We need to increase that number to help improve the health of our children and of our communities.\"\u003c/p>\n\u003cp>Pregnant women need to \u003ca href=\"http://www.cdc.gov/pertussis/pregnant/mom/get-vaccinated.html\" target=\"_blank\">receive the whooping cough vaccination \u003c/a>in the last trimester of each pregnancy, Smith said, because the immunity decreases over time. Getting the vaccine is critical to stemming the spread of the illness, she said, which can be particularly dangerous for children under the age of one.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Vaccinated mothers pass protective antibodies to their infants during pregnancy,\" Smith said.\u003c/p>\n\u003cp>The whooping cough vaccine called Tdap is designed to prevent tetanus and diphtheria, as well as pertussis. Whooping cough causes a severe, persistent cough, sometimes strong enough to make infants vomit.\u003c/p>\n\u003cp>In 2014, the state declared a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2014/06/27/whooping-cough-epidemic-continues-1100-new-cases-in-last-two-weeks/\" target=\"_blank\">whooping cough epidemic\u003c/a> and reported the highest rate of the disease since the 1950s, Smith said.\u003c/p>\n\u003cp>The higher incidence of whooping cough in California, along with last year's measles outbreak that originated at Disneyland, led to legislation signed last month by Gov. Jerry Brown that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/06/29/bill-ending-vaccine-exemptions-passes-california-senate-moves-to-governors-desk/\" target=\"_blank\">eliminated the religious and \"personal belief\" exemptions\u003c/a> for childhood immunizations.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>That law goes into effect July 1, 2016.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Sharing Your Fitness Tracker Data? 'Pace' Yourself",
"title": "Sharing Your Fitness Tracker Data? 'Pace' Yourself",
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"content": "\u003cp>\u003cem>Ernesto Ramirez is a program director at \u003ca href=\"http://quantifiedself.com/aboutqs-labs/\">Quantified Self Labs\u003c/a> and a PhD candidate in a Joint Doctoral Program in Public Health at San Diego State University and the University of California, San Diego.\u003c/em>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Recently, I laced up my running shoes, connected my bluetooth headphones, turned on my Spotify playlist, and hit “Go Running” on my Runkeeper mobile app. About an hour later, the app notified me that I had run six miles at a decent pace of around eight minutes per mile.\u003c/span>\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-18577\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/1-BtZdcexFcasFSVVHZsZg8g.png\" alt=\"1-BtZdcexFcasFSVVHZsZg8g\" width=\"637\" height=\"267\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/1-BtZdcexFcasFSVVHZsZg8g.png 637w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/1-BtZdcexFcasFSVVHZsZg8g-400x168.png 400w\" sizes=\"(max-width: 637px) 100vw, 637px\">\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Founded in 2008, Runkeeper is designed to assist individuals who want to track their activities with precision, whether that is walking, running, hiking, or cycling. If you’re moving outdoors, Runkeeper and similar mobile apps, such as Strava or MapMyRun, use your smartphone’s GPS to pinpoint exactly where you are and how fast you’re moving. With all that data, you can train for your next marathon, discover new routes, and now, thanks to efforts by New York University researchers, take part in advancing public health.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">This month, Dr. Rumi Chunara and her colleagues at NYU launched a study called \u003ca href=\"https://keeping-pace.chunaralab.com/\">Keeping Pace\u003c/a>, which is supported by the Robert Wood Johnson Foundation. Over the next few months they will enroll participants who are willing to share their geo-located exercise data from Runkeeper. Because Runkeeper keeps a log of not only what you did, but where you did it, researchers hope to use the large amount of aggregated data to better understand physical activity patterns in communities around the United States.\u003c/span>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">[Disclosure: QS Labs also has funding from the Robert Wood Johnson Foundation.]\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“Typically, this type of research takes a long time and includes long, arduous surveys or giving out GPS devices to participants,” said Dr. Chunara. “But with this type of data from apps people already use, we will be able to understand how the environment and exercise are related over more rapid and longer time periods.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">By analyzing the data, the research team hopes to understand differences in exercise choice between commuting and recreational activities, variation in activities among neighborhoods, and where people spend their time while being active.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Participants who enroll in Keeping Pace will be asked to complete a short demographic survey and then connect their Runkeeper account so researchers can access the type of activities they do and the GPS-based map associated with the activity.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>\u003cspan class=\"s1\">The Genesis for Keeping Pace\u003c/span>\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">A few years ago, Dr. Rumi Chunara was at a meeting hosted by the \u003ca href=\"http://www.hhs.gov/\">U.S. Department of Health and Human Services \u003c/a>in Washington D.C.. She was invited to present and speak with colleagues about the growing importance of citizen science and crowdsourced data. There she met Jason Bobe, executive director of \u003ca href=\"http://personalgenomes.org/\">PersonalGenomes.org\u003c/a>, a project that hosts publicly-available health and genetic data.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Bobe and Chunara chatted about some of their common interests in creating new models for research participation. This year, when it came to build out the infrastructure for the Keeping Pace study, Chunara decided to get back in touch with Bobe and his colleagues, who were now developing a project called \u003ca href=\"http://openhumans.org/\">OpenHumans.org\u003c/a>.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Open Humans represents a new way of thinking about research studies, participants, and the data being transferred between the two. The mission is to make health-related data available for researchers and scientists to mine for discoveries. Bobe has previously described it as “\u003ca href=\"http://www.reuters.com/article/2015/03/24/us-health-openhumans-idUSKBN0MK0CR20150324\">like open-sourcing your body\u003c/a>.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The two teams, Open Humans and Dr. Chunara’s lab at NYU, worked together to develop an easy method for individuals to let researchers access their Runkeeper data, and also maintain control over where and how that data flowed. It sounds like a lot of work, but it takes no more than five minutes for a participant to complete.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>\u003cspan class=\"s1\">An Explosion of Health Data\u003c/span>\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">It’s an exciting time for public health researchers. Thanks to the proliferation of sensors, wearables and smartphones, we are generating a vast amount of data about our lives. Meanwhile, the federal government is setting aside millions in funding for projects like the \u003ca href=\"http://www.nih.gov/precisionmedicine/\">Precision Medicine Initiative\u003c/a>, which are aimed at deriving insights from all this health and genetic data. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">But what about the individuals who create that valuable data? People, like myself, who strap on their phones when they go out for a run or log onto a website to report their flu symptoms? What do they have a right to in regards to their data? This is the question many researchers and scientific institutions are still grappling with. But some have already taken a stand.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Dr. Chunara and her colleagues chose to work with Open Humans because they shared the same perspective — that the individual should ultimately be in control of their data.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The researchers are approaching the study with a different approach in mind. But as with any study, recruitment is a challenge. Dr. Chunara and her colleagues hope to enroll a thousand individuals by the end of summer. But it remains to be seen whether people really want to “open source” their personal data and engage in this new type of research. \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Today, Keeping Pace is the first study to use Open Humans for data access and management for a research study. If successful, researchers may not only learn about exercise and the environment, but also about how studies that place an emphasis on participants’ data access and control may engage the public in new ways.\u003c/span>\u003c/p>\n\u003csection class=\" section--body\">\n\u003cdiv class=\"section-content\">\n\u003cdiv class=\"section-inner layoutSingleColumn\">\n\u003cp class=\"graf--p graf--last\">\u003cem>\u003cstrong class=\"markup--strong markup--p-strong\">Keeping Pace is currently enrolling participants. If you’re a Runkeeper user and want to contribute your data to research, \u003c/strong>\u003ca class=\"markup--anchor markup--p-anchor\" href=\"https://keeping-pace.chunaralab.com/\" rel=\"nofollow\">\u003cstrong class=\"markup--strong markup--p-strong\">please visit the study website\u003c/strong>\u003c/a>\u003cstrong class=\"markup--strong markup--p-strong\"> to learn more.\u003c/strong>\u003c/em>\u003c/p>\n\u003c/div>\n\u003c/div>\n\u003c/section>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Ernesto Ramirez is a program director at \u003ca href=\"http://quantifiedself.com/aboutqs-labs/\">Quantified Self Labs\u003c/a> and a PhD candidate in a Joint Doctoral Program in Public Health at San Diego State University and the University of California, San Diego.\u003c/em>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Recently, I laced up my running shoes, connected my bluetooth headphones, turned on my Spotify playlist, and hit “Go Running” on my Runkeeper mobile app. About an hour later, the app notified me that I had run six miles at a decent pace of around eight minutes per mile.\u003c/span>\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-18577\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/1-BtZdcexFcasFSVVHZsZg8g.png\" alt=\"1-BtZdcexFcasFSVVHZsZg8g\" width=\"637\" height=\"267\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/1-BtZdcexFcasFSVVHZsZg8g.png 637w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/1-BtZdcexFcasFSVVHZsZg8g-400x168.png 400w\" sizes=\"(max-width: 637px) 100vw, 637px\">\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Founded in 2008, Runkeeper is designed to assist individuals who want to track their activities with precision, whether that is walking, running, hiking, or cycling. If you’re moving outdoors, Runkeeper and similar mobile apps, such as Strava or MapMyRun, use your smartphone’s GPS to pinpoint exactly where you are and how fast you’re moving. With all that data, you can train for your next marathon, discover new routes, and now, thanks to efforts by New York University researchers, take part in advancing public health.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">This month, Dr. Rumi Chunara and her colleagues at NYU launched a study called \u003ca href=\"https://keeping-pace.chunaralab.com/\">Keeping Pace\u003c/a>, which is supported by the Robert Wood Johnson Foundation. Over the next few months they will enroll participants who are willing to share their geo-located exercise data from Runkeeper. Because Runkeeper keeps a log of not only what you did, but where you did it, researchers hope to use the large amount of aggregated data to better understand physical activity patterns in communities around the United States.\u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">[Disclosure: QS Labs also has funding from the Robert Wood Johnson Foundation.]\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“Typically, this type of research takes a long time and includes long, arduous surveys or giving out GPS devices to participants,” said Dr. Chunara. “But with this type of data from apps people already use, we will be able to understand how the environment and exercise are related over more rapid and longer time periods.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">By analyzing the data, the research team hopes to understand differences in exercise choice between commuting and recreational activities, variation in activities among neighborhoods, and where people spend their time while being active.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Participants who enroll in Keeping Pace will be asked to complete a short demographic survey and then connect their Runkeeper account so researchers can access the type of activities they do and the GPS-based map associated with the activity.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>\u003cspan class=\"s1\">The Genesis for Keeping Pace\u003c/span>\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">A few years ago, Dr. Rumi Chunara was at a meeting hosted by the \u003ca href=\"http://www.hhs.gov/\">U.S. Department of Health and Human Services \u003c/a>in Washington D.C.. She was invited to present and speak with colleagues about the growing importance of citizen science and crowdsourced data. There she met Jason Bobe, executive director of \u003ca href=\"http://personalgenomes.org/\">PersonalGenomes.org\u003c/a>, a project that hosts publicly-available health and genetic data.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Bobe and Chunara chatted about some of their common interests in creating new models for research participation. This year, when it came to build out the infrastructure for the Keeping Pace study, Chunara decided to get back in touch with Bobe and his colleagues, who were now developing a project called \u003ca href=\"http://openhumans.org/\">OpenHumans.org\u003c/a>.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Open Humans represents a new way of thinking about research studies, participants, and the data being transferred between the two. The mission is to make health-related data available for researchers and scientists to mine for discoveries. Bobe has previously described it as “\u003ca href=\"http://www.reuters.com/article/2015/03/24/us-health-openhumans-idUSKBN0MK0CR20150324\">like open-sourcing your body\u003c/a>.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The two teams, Open Humans and Dr. Chunara’s lab at NYU, worked together to develop an easy method for individuals to let researchers access their Runkeeper data, and also maintain control over where and how that data flowed. It sounds like a lot of work, but it takes no more than five minutes for a participant to complete.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>\u003cspan class=\"s1\">An Explosion of Health Data\u003c/span>\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">It’s an exciting time for public health researchers. Thanks to the proliferation of sensors, wearables and smartphones, we are generating a vast amount of data about our lives. Meanwhile, the federal government is setting aside millions in funding for projects like the \u003ca href=\"http://www.nih.gov/precisionmedicine/\">Precision Medicine Initiative\u003c/a>, which are aimed at deriving insights from all this health and genetic data. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">But what about the individuals who create that valuable data? People, like myself, who strap on their phones when they go out for a run or log onto a website to report their flu symptoms? What do they have a right to in regards to their data? This is the question many researchers and scientific institutions are still grappling with. But some have already taken a stand.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Dr. Chunara and her colleagues chose to work with Open Humans because they shared the same perspective — that the individual should ultimately be in control of their data.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The researchers are approaching the study with a different approach in mind. But as with any study, recruitment is a challenge. Dr. Chunara and her colleagues hope to enroll a thousand individuals by the end of summer. But it remains to be seen whether people really want to “open source” their personal data and engage in this new type of research. \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Today, Keeping Pace is the first study to use Open Humans for data access and management for a research study. If successful, researchers may not only learn about exercise and the environment, but also about how studies that place an emphasis on participants’ data access and control may engage the public in new ways.\u003c/span>\u003c/p>\n\u003csection class=\" section--body\">\n\u003cdiv class=\"section-content\">\n\u003cdiv class=\"section-inner layoutSingleColumn\">\n\u003cp class=\"graf--p graf--last\">\u003cem>\u003cstrong class=\"markup--strong markup--p-strong\">Keeping Pace is currently enrolling participants. If you’re a Runkeeper user and want to contribute your data to research, \u003c/strong>\u003ca class=\"markup--anchor markup--p-anchor\" href=\"https://keeping-pace.chunaralab.com/\" rel=\"nofollow\">\u003cstrong class=\"markup--strong markup--p-strong\">please visit the study website\u003c/strong>\u003c/a>\u003cstrong class=\"markup--strong markup--p-strong\"> to learn more.\u003c/strong>\u003c/em>\u003c/p>\n\u003c/div>\n\u003c/div>\n\u003c/section>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Millions of Americans Use Medical Devices That May Be Vulnerable to Hacking",
"title": "Millions of Americans Use Medical Devices That May Be Vulnerable to Hacking",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>\u003cstrong>Listen to the story:\u003c/strong>\u003cbr>\nhttp://www.kqed.org/.stream/anon/radio/science/2015/08/20150803ScienceMedicaldeviceshacking.mp3\u003cbr>\nYou have passwords for your smart phone and laptop, but what about your pacemaker or insulin pump?\u003c/p>\n\u003cp>Last Friday, the federal \u003ca href=\"http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm456815.htm\">Food and Drug Administration recommended\u003c/a> that all hospitals in California and across the country stop using a medical device that it says is vulnerable to cyber attacks.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Someone will find a reason to change a counter on an insulin pump or take over a defibrillator just because they can.'\u003ccite>Jamie Court,\u003cbr>\nConsumer Watchdog president\u003c/cite>\u003c/aside>\n\u003cp>The device is an infusion pump that delivers medications or nutrients to patients. A hacker who accessed it could change the drug dosage to give a patient not enough -- or a lethal amount.\u003c/p>\n\u003cp>California security expert Billy Rios says he identified the problem \u003ca href=\"http://xs-sniper.com/blog/\" target=\"_blank\">more than a year ago\u003c/a> and notified the FDA and the Department of Homeland Security.\u003c/p>\n\u003cp>\"Some of these pumps are really dangerous,\" says Rios, who founded digital security company Laconicly. \"If we ever gain access to a hospital network and we know of a vulnerability affecting a particular device, what that really means is we can go from one location and touch one hundred different devices all at once.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>These pumps are not the only medical devices vulnerable to hacking. More than 10 million Americans rely on devices like pacemakers and defibrillators.\u003c/p>\n\u003cp>https://youtu.be/MmQZIRJPfLM\u003c/p>\n\u003cp>\u003cspan style=\"font-size: medium\">(Cyber security expert Billy Rios remotely hacks into Hospira’s Symbiq infusion pump, which the FDA has encouraged all medical centers to stop using .)\u003c/span>\u003c/p>\n\u003cp>If you are a fan of the Showtime television series \u003ca href=\"https://vimeo.com/63176830\">Homeland\u003c/a>, you may remember an episode where assassins killed the vice president by hacking into his pacemaker and disabling it.\u003c/p>\n\u003cp>This episode wasn’t just Hollywood making up stuff. Former Vice President Dick Cheney was so \u003ca href=\"http://abcnews.go.com/US/vice-president-dick-cheney-feared-pacemaker-hacking/story?id=20621434\">afraid of a cyber attack on his own pacemaker\u003c/a> that he had the wireless feature on it disabled.\u003c/p>\n\u003cp>As technology has become more connected, so have medical devices. While some, like pacemakers, can only send information, others, can send and receive data.\u003c/p>\n\u003cp>And that leaves some patients vulnerable to a hacker trying to harm them or use their device as a portal to access medical data.\u003c/p>\n\u003cp>\"All the tools that are required to do software debugging, to get software off of chips and basically to do hardware hacking,\" Rios says, \"it’s become available to just any person.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">'My biggest fear is that somebody will take out a large number of devices across an institution.'\u003ccite>Kevin McDonald,\u003cbr>\nClinical Information Security Director\u003cbr>\nMayo Clinic\u003c/cite>\u003c/aside>\n\u003cp>As a benign or “white hat” hacker, Rios does research in his Half Moon Bay garage to help the Department of Homeland Security.\u003c/p>\n\u003cp>He proved he could remotely administer a lethal dose of drugs through a patient’s insulin pump. He has also hacked pre-programmed passwords from hundreds of devices. He and his colleague were able to figure out the passwords after acquiring embedded software and technical manuals from several vendors.\u003c/p>\n\u003cp>\"We knew what those 300 passwords were,\" Rios says. \"We could go to any device we wanted to and we had a set of usernames and passwords that would work against all these devices, and so that was pretty alarming.\"\u003c/p>\n\u003cp>The Food and Drug Administration, which regulates the sale of medical devices, has been issuing formal guidelines on the issue.\u003c/p>\n\u003cp>Suzanne Schwartz is the FDA’s Director of Emergency Preparedness. Last year, she helped publish \u003ca href=\"http://www.fda.gov/ucm/groups/fdagov-public/@fdagov-meddev-gen/documents/document/ucm356190.pdf\">new recommendations\u003c/a> for how medical device makers should take cyber-security attacks into account.\u003c/p>\n\u003cfigure id=\"attachment_19957\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Implantable-medical-devices_graphic_WHITE.jpg\">\u003cimg class=\"size-medium wp-image-19957\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Implantable-medical-devices_graphic_WHITE-800x567.jpg\" alt=\"Many there are many implantable medical devices on the market that have vulnerabilities, in fact, the Food and Drug Administration has received approximately 56,000 reports of adverse events associated with the use of infusion pumps, including numerous injuries and deaths. \" width=\"800\" height=\"567\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/Implantable-medical-devices_graphic_WHITE-800x567.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Implantable-medical-devices_graphic_WHITE-400x283.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Implantable-medical-devices_graphic_WHITE-1180x836.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Implantable-medical-devices_graphic_WHITE-960x680.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Implantable-medical-devices_graphic_WHITE.jpg 1493w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">There are many implantable medical devices on the market that have vulnerabilities, in fact, the Food and Drug Administration has received approximately 56,000 reports of adverse events associated with the use of infusion pumps, including numerous injuries and deaths. \u003ccite>(Massachusetts Institute of Technology)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"That is something, yes, that we continuously monitor and it’s something important that we want to hear about,\" Schwartz says, \"whether it’s directly from the healthcare organizations or from the medical device manufacturers.\"\u003c/p>\n\u003cp>But Consumer Watchdog president Jamie Court says the FDA’s guidelines for medical devices fall short. He says what's needed is a law -- not recommendations -- requiring medical manufacturers and hospitals to upgrade systems to prevent cyber attacks.\u003c/p>\n\u003cp>\"The reality is if they don’t someone is going to die,\" Court says. \"Because it’s not safe. Someone will find a reason to change a counter on an insulin pump or take over a defibrillator just because they can.\"\u003c/p>\n\u003cp>Without legally binding rules, medical device security is left in the hands of hospitals and device makers. And they are required to report device malfunctions only if patients are injured or they die.\u003c/p>\n\u003cp>Medtronic, the nation's largest medical device manufacturer, has not reported any incidents so far.\u003c/p>\n\u003cp>The company declined to be interviewed and sent KQED a statement saying it aims to manufacture products that are as safe and secure as possible.\u003c/p>\n\u003cfigure id=\"attachment_19938\" class=\"wp-caption alignleft\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Kevin-McDonald_Mayo-Clinic_photo.jpg\">\u003cimg class=\"size-medium wp-image-19938\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Kevin-McDonald_Mayo-Clinic_photo-800x600.jpg\" alt=\"Clinical Information Security Director Kevin McDonald (left) at Mayo Clinic in Minnesota leads a team checking medical devices for software vulnerabilities that could cause a device to be infected with malware or exploited by hackers.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/Kevin-McDonald_Mayo-Clinic_photo-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Kevin-McDonald_Mayo-Clinic_photo-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Kevin-McDonald_Mayo-Clinic_photo-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Kevin-McDonald_Mayo-Clinic_photo-1920x1440.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Kevin-McDonald_Mayo-Clinic_photo-960x720.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Clinical Information Security Director Kevin McDonald (left) at Mayo Clinic in Minnesota leads a team checking medical devices for software vulnerabilities that could cause a device to be infected with malware or exploited by hackers. \u003ccite>(Mayo Clinic)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But Mayo Clinic cyber security expert Kevin McDonald says, while they haven't been catastrophic, some incidents have already occurred.\u003c/p>\n\u003cp>\"Back in 2010,\" he says, \"there was a heart catheterization lab out on the East Coast, that, because of some malware viruses, was put out of business for about three days. So they had to divert their patients to other places.\"\u003c/p>\n\u003cp>McDonald leads a team that’s trying to prevent harmful medical incidents.\u003c/p>\n\u003cp>\"My biggest fear,\" he says, \"is that somebody will take out a large number of devices across an institution.\"\u003c/p>\n\u003cp>To increase patient safety, the Mayo Clinic brought in researchers to analyze some of the devices it uses. It then reported vulnerabilities to the manufacturers.\u003c/p>\n\u003cp>But cyber security expert Rios says no matter what precautions one takes, medical devices are imperfect and will always need monitoring.\u003c/p>\n\u003cp>\"At the end of the day, at the core of it, it's really just a computer,\" he says. \"It's a processor and it's software that someone wrote. And so we can't treat those devices as if they're magical devices; they're not magical devices.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>While last year the FDA issued guidelines for the manufacture of these devices, this year the agency is expected to \u003ca href=\"http://blogs.fda.gov/fdavoice/index.php/2015/02/moving-toward-a-national-medical-device-postmarket-surveillance-system/\">release additional guidelines\u003c/a> for how companies should update the devices’ software after they’re on the market.\u003c/p>\n\n",
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"excerpt": "The Food and Drug Administration last Friday advised U.S. medical facilities to stop using a pump that has cyber security flaws.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Listen to the story:\u003c/strong>\u003cbr>\nhttp://www.kqed.org/.stream/anon/radio/science/2015/08/20150803ScienceMedicaldeviceshacking.mp3\u003cbr>\nYou have passwords for your smart phone and laptop, but what about your pacemaker or insulin pump?\u003c/p>\n\u003cp>Last Friday, the federal \u003ca href=\"http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm456815.htm\">Food and Drug Administration recommended\u003c/a> that all hospitals in California and across the country stop using a medical device that it says is vulnerable to cyber attacks.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Someone will find a reason to change a counter on an insulin pump or take over a defibrillator just because they can.'\u003ccite>Jamie Court,\u003cbr>\nConsumer Watchdog president\u003c/cite>\u003c/aside>\n\u003cp>The device is an infusion pump that delivers medications or nutrients to patients. A hacker who accessed it could change the drug dosage to give a patient not enough -- or a lethal amount.\u003c/p>\n\u003cp>California security expert Billy Rios says he identified the problem \u003ca href=\"http://xs-sniper.com/blog/\" target=\"_blank\">more than a year ago\u003c/a> and notified the FDA and the Department of Homeland Security.\u003c/p>\n\u003cp>\"Some of these pumps are really dangerous,\" says Rios, who founded digital security company Laconicly. \"If we ever gain access to a hospital network and we know of a vulnerability affecting a particular device, what that really means is we can go from one location and touch one hundred different devices all at once.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>These pumps are not the only medical devices vulnerable to hacking. More than 10 million Americans rely on devices like pacemakers and defibrillators.\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/MmQZIRJPfLM'\n title='//www.youtube.com/embed/MmQZIRJPfLM'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>\u003cspan style=\"font-size: medium\">(Cyber security expert Billy Rios remotely hacks into Hospira’s Symbiq infusion pump, which the FDA has encouraged all medical centers to stop using .)\u003c/span>\u003c/p>\n\u003cp>If you are a fan of the Showtime television series \u003ca href=\"https://vimeo.com/63176830\">Homeland\u003c/a>, you may remember an episode where assassins killed the vice president by hacking into his pacemaker and disabling it.\u003c/p>\n\u003cp>This episode wasn’t just Hollywood making up stuff. Former Vice President Dick Cheney was so \u003ca href=\"http://abcnews.go.com/US/vice-president-dick-cheney-feared-pacemaker-hacking/story?id=20621434\">afraid of a cyber attack on his own pacemaker\u003c/a> that he had the wireless feature on it disabled.\u003c/p>\n\u003cp>As technology has become more connected, so have medical devices. While some, like pacemakers, can only send information, others, can send and receive data.\u003c/p>\n\u003cp>And that leaves some patients vulnerable to a hacker trying to harm them or use their device as a portal to access medical data.\u003c/p>\n\u003cp>\"All the tools that are required to do software debugging, to get software off of chips and basically to do hardware hacking,\" Rios says, \"it’s become available to just any person.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">'My biggest fear is that somebody will take out a large number of devices across an institution.'\u003ccite>Kevin McDonald,\u003cbr>\nClinical Information Security Director\u003cbr>\nMayo Clinic\u003c/cite>\u003c/aside>\n\u003cp>As a benign or “white hat” hacker, Rios does research in his Half Moon Bay garage to help the Department of Homeland Security.\u003c/p>\n\u003cp>He proved he could remotely administer a lethal dose of drugs through a patient’s insulin pump. He has also hacked pre-programmed passwords from hundreds of devices. He and his colleague were able to figure out the passwords after acquiring embedded software and technical manuals from several vendors.\u003c/p>\n\u003cp>\"We knew what those 300 passwords were,\" Rios says. \"We could go to any device we wanted to and we had a set of usernames and passwords that would work against all these devices, and so that was pretty alarming.\"\u003c/p>\n\u003cp>The Food and Drug Administration, which regulates the sale of medical devices, has been issuing formal guidelines on the issue.\u003c/p>\n\u003cp>Suzanne Schwartz is the FDA’s Director of Emergency Preparedness. Last year, she helped publish \u003ca href=\"http://www.fda.gov/ucm/groups/fdagov-public/@fdagov-meddev-gen/documents/document/ucm356190.pdf\">new recommendations\u003c/a> for how medical device makers should take cyber-security attacks into account.\u003c/p>\n\u003cfigure id=\"attachment_19957\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Implantable-medical-devices_graphic_WHITE.jpg\">\u003cimg class=\"size-medium wp-image-19957\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Implantable-medical-devices_graphic_WHITE-800x567.jpg\" alt=\"Many there are many implantable medical devices on the market that have vulnerabilities, in fact, the Food and Drug Administration has received approximately 56,000 reports of adverse events associated with the use of infusion pumps, including numerous injuries and deaths. \" width=\"800\" height=\"567\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/Implantable-medical-devices_graphic_WHITE-800x567.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Implantable-medical-devices_graphic_WHITE-400x283.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Implantable-medical-devices_graphic_WHITE-1180x836.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Implantable-medical-devices_graphic_WHITE-960x680.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Implantable-medical-devices_graphic_WHITE.jpg 1493w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">There are many implantable medical devices on the market that have vulnerabilities, in fact, the Food and Drug Administration has received approximately 56,000 reports of adverse events associated with the use of infusion pumps, including numerous injuries and deaths. \u003ccite>(Massachusetts Institute of Technology)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"That is something, yes, that we continuously monitor and it’s something important that we want to hear about,\" Schwartz says, \"whether it’s directly from the healthcare organizations or from the medical device manufacturers.\"\u003c/p>\n\u003cp>But Consumer Watchdog president Jamie Court says the FDA’s guidelines for medical devices fall short. He says what's needed is a law -- not recommendations -- requiring medical manufacturers and hospitals to upgrade systems to prevent cyber attacks.\u003c/p>\n\u003cp>\"The reality is if they don’t someone is going to die,\" Court says. \"Because it’s not safe. Someone will find a reason to change a counter on an insulin pump or take over a defibrillator just because they can.\"\u003c/p>\n\u003cp>Without legally binding rules, medical device security is left in the hands of hospitals and device makers. And they are required to report device malfunctions only if patients are injured or they die.\u003c/p>\n\u003cp>Medtronic, the nation's largest medical device manufacturer, has not reported any incidents so far.\u003c/p>\n\u003cp>The company declined to be interviewed and sent KQED a statement saying it aims to manufacture products that are as safe and secure as possible.\u003c/p>\n\u003cfigure id=\"attachment_19938\" class=\"wp-caption alignleft\" style=\"max-width: 800px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Kevin-McDonald_Mayo-Clinic_photo.jpg\">\u003cimg class=\"size-medium wp-image-19938\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Kevin-McDonald_Mayo-Clinic_photo-800x600.jpg\" alt=\"Clinical Information Security Director Kevin McDonald (left) at Mayo Clinic in Minnesota leads a team checking medical devices for software vulnerabilities that could cause a device to be infected with malware or exploited by hackers.\" width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/Kevin-McDonald_Mayo-Clinic_photo-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Kevin-McDonald_Mayo-Clinic_photo-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Kevin-McDonald_Mayo-Clinic_photo-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Kevin-McDonald_Mayo-Clinic_photo-1920x1440.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Kevin-McDonald_Mayo-Clinic_photo-960x720.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Clinical Information Security Director Kevin McDonald (left) at Mayo Clinic in Minnesota leads a team checking medical devices for software vulnerabilities that could cause a device to be infected with malware or exploited by hackers. \u003ccite>(Mayo Clinic)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But Mayo Clinic cyber security expert Kevin McDonald says, while they haven't been catastrophic, some incidents have already occurred.\u003c/p>\n\u003cp>\"Back in 2010,\" he says, \"there was a heart catheterization lab out on the East Coast, that, because of some malware viruses, was put out of business for about three days. So they had to divert their patients to other places.\"\u003c/p>\n\u003cp>McDonald leads a team that’s trying to prevent harmful medical incidents.\u003c/p>\n\u003cp>\"My biggest fear,\" he says, \"is that somebody will take out a large number of devices across an institution.\"\u003c/p>\n\u003cp>To increase patient safety, the Mayo Clinic brought in researchers to analyze some of the devices it uses. It then reported vulnerabilities to the manufacturers.\u003c/p>\n\u003cp>But cyber security expert Rios says no matter what precautions one takes, medical devices are imperfect and will always need monitoring.\u003c/p>\n\u003cp>\"At the end of the day, at the core of it, it's really just a computer,\" he says. \"It's a processor and it's software that someone wrote. And so we can't treat those devices as if they're magical devices; they're not magical devices.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>While last year the FDA issued guidelines for the manufacture of these devices, this year the agency is expected to \u003ca href=\"http://blogs.fda.gov/fdavoice/index.php/2015/02/moving-toward-a-national-medical-device-postmarket-surveillance-system/\">release additional guidelines\u003c/a> for how companies should update the devices’ software after they’re on the market.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Veteran UCSF Scientist Looks Back on Key Discovery That Helped Save Preemies' Lives",
"title": "Veteran UCSF Scientist Looks Back on Key Discovery That Helped Save Preemies' Lives",
"headTitle": "State of Health | KQED News",
"content": "\u003cp>In 1953, Dr. John Clements realized something fundamental about the way the lung functions — an insight that would ultimately save the lives of millions of premature babies.\u003c/p>\n\u003cp>The story begins in 1950, when the U.S. Army sent Clements, a newly graduated physician, to the medical division of what was then called the Army Chemical Center in Edgewood, Md. Clements was interested in doing research in biochemistry. His commanding officer was of a different mind.\u003c/p>\n\u003cp>\" 'We don't need any biochemists,' \" Clements recalls the officer saying. \" 'You're going to be a physiologist.' And I became a physiologist because the Army said so.\"\u003c/p>\n\u003cp>At the time, the Army was worried about the Soviet Union using chemical weapons.\u003c/p>\n\u003cp>\"My assignment was to find out how nerve gases worked on the lungs,\" says Clements. So he set out to learn all he could about human lungs.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Lungs are made up of thin, pliable sacs called alveoli. You can think of them as tiny, somewhat permeable balloons. Oxygen enters the bloodstream though the outer membranes of these sacs.\u003c/p>\n\u003cp>When the sacs inflate, there's more surface area for oxygen to cross into the blood.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/alveoli-5174afd0613caa985beba806758415caeaccc0ef.jpg\">\u003cimg class=\"aligncenter wp-image-56247 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/alveoli-5174afd0613caa985beba806758415caeaccc0ef-e1438625823518.jpg\" alt=\"The tiny sacs in the lungs, called alveoli, move oxygen into the blood and carbon dioxide out.\" width=\"1920\" height=\"1440\">\u003c/a>\u003c/p>\n\u003cp>But how much surface area is there in the normal lung? This wasn't an easy question to answer. Researchers who had looked at lung tissue through the microscope said the surface area was huge — maybe the size of a football field if you spread it all out.\u003c/p>\n\u003cp>But physiologists who estimated the energy that's used to inflate the sacs came up with a much, much smaller area.\u003c/p>\n\u003cp>\"That huge discrepancy between two supposedly correct methods bothered me,\" Clements says.\u003c/p>\n\u003cp>In 1953, he suggested \u003ca href=\"http://www.fasebj.org/content/18/13/1624e.full\">an explanation\u003c/a> for the discrepancy. Maybe there was a substance in the lung that made the alveoli easier to inflate and keep inflated. A few years later, Clements and others found it — a slippery substance known as a surfactant that reduces surface tension in the alveolar membranes. Soon scientists showed that a lack of surfactant is involved in human lung disease.\u003c/p>\n\u003cp>\"At that point the research, to use the trite term, exploded,\" Clements says.\u003c/p>\n\u003cp>Clements was doing basic research, not trying to cure a disease. But his work did contribute to a cure. In 1959, a researcher named \u003ca href=\"http://www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography_17.html\">Dr. Mary Ellen Avery,\u003c/a> who was then at Harvard Medical School, showed that the lungs of premature babies can't make that surfactant. In those days, many children born at less than 37 weeks' gestation would die from something called \u003ca href=\"http://www.nlm.nih.gov/medlineplus/ency/article/001563.htm\">respiratory distress syndrome\u003c/a>, or RDS.\u003c/p>\n\u003cp>The FDA has since approved \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm294984.htm\">five synthetic surfactants\u003c/a> to prevent respiratory distress syndrome in premature babies. Surfaxin, approved in 2012, is the latest to hit the market. (The first, \u003ca href=\"https://www.pharmamedtechbi.com/publications/the-pink-sheet/52/032/burroughs-wellcomes-exosurf-is-approved\">Exosurf, \u003c/a>is no longer sold.)\u003c/p>\n\u003cp>\"It took 40 years — from the initial discovery in the early '50s to the first approval of the FDA in the 1990s,\" says Dr. Sam Hawgood, a neonatologist who once worked in Clements' lab and is now chancellor at the University of California, San Francisco.\u003c/p>\n\u003cp>\"All of us would like to compress that timeline,\" Hawgood says. \"But if you think that we had no idea that this substance even existed or was needed in the '50s, to an actual drug four decades later — it's pretty remarkable.\"\u003c/p>\n\u003cp>What's also remarkable is John Clements himself. Today he has a lab at UCSF. At 92, he still heads in every day and is proud of what his work has meant for treating premature infants with respiratory distress syndrome.\u003c/p>\n\u003cp>\"When we began this work back in the 1950s, the mortality from RDS was above 90 percent,\" he says. \"Today, that mortality is 5 percent or less.\"\u003c/p>\n\u003cp>I asked Clements why he still works — surely he's achieved enough to rest on his laurels. He says there's always the chance that a new day will bring a new scientific insight.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The thrill of that is the best thing there is. At my age, I'd put it even higher than sex,\" says Clements with a laugh. Then his tone is more serious. \"It's a big, big thrill when you think you've made a discovery — found an idea — that no one else has had,\" he says. \"That's as good as it gets.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=How+A+Scientist%27s+Slick+Discovery+Helped+Save+Preemies%27+Lives&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In 1953, Dr. John Clements realized something fundamental about the way the lung functions — an insight that would ultimately save the lives of millions of premature babies.\u003c/p>\n\u003cp>The story begins in 1950, when the U.S. Army sent Clements, a newly graduated physician, to the medical division of what was then called the Army Chemical Center in Edgewood, Md. Clements was interested in doing research in biochemistry. His commanding officer was of a different mind.\u003c/p>\n\u003cp>\" 'We don't need any biochemists,' \" Clements recalls the officer saying. \" 'You're going to be a physiologist.' And I became a physiologist because the Army said so.\"\u003c/p>\n\u003cp>At the time, the Army was worried about the Soviet Union using chemical weapons.\u003c/p>\n\u003cp>\"My assignment was to find out how nerve gases worked on the lungs,\" says Clements. So he set out to learn all he could about human lungs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Lungs are made up of thin, pliable sacs called alveoli. You can think of them as tiny, somewhat permeable balloons. Oxygen enters the bloodstream though the outer membranes of these sacs.\u003c/p>\n\u003cp>When the sacs inflate, there's more surface area for oxygen to cross into the blood.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/alveoli-5174afd0613caa985beba806758415caeaccc0ef.jpg\">\u003cimg class=\"aligncenter wp-image-56247 size-full\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/08/alveoli-5174afd0613caa985beba806758415caeaccc0ef-e1438625823518.jpg\" alt=\"The tiny sacs in the lungs, called alveoli, move oxygen into the blood and carbon dioxide out.\" width=\"1920\" height=\"1440\">\u003c/a>\u003c/p>\n\u003cp>But how much surface area is there in the normal lung? This wasn't an easy question to answer. Researchers who had looked at lung tissue through the microscope said the surface area was huge — maybe the size of a football field if you spread it all out.\u003c/p>\n\u003cp>But physiologists who estimated the energy that's used to inflate the sacs came up with a much, much smaller area.\u003c/p>\n\u003cp>\"That huge discrepancy between two supposedly correct methods bothered me,\" Clements says.\u003c/p>\n\u003cp>In 1953, he suggested \u003ca href=\"http://www.fasebj.org/content/18/13/1624e.full\">an explanation\u003c/a> for the discrepancy. Maybe there was a substance in the lung that made the alveoli easier to inflate and keep inflated. A few years later, Clements and others found it — a slippery substance known as a surfactant that reduces surface tension in the alveolar membranes. Soon scientists showed that a lack of surfactant is involved in human lung disease.\u003c/p>\n\u003cp>\"At that point the research, to use the trite term, exploded,\" Clements says.\u003c/p>\n\u003cp>Clements was doing basic research, not trying to cure a disease. But his work did contribute to a cure. In 1959, a researcher named \u003ca href=\"http://www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography_17.html\">Dr. Mary Ellen Avery,\u003c/a> who was then at Harvard Medical School, showed that the lungs of premature babies can't make that surfactant. In those days, many children born at less than 37 weeks' gestation would die from something called \u003ca href=\"http://www.nlm.nih.gov/medlineplus/ency/article/001563.htm\">respiratory distress syndrome\u003c/a>, or RDS.\u003c/p>\n\u003cp>The FDA has since approved \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm294984.htm\">five synthetic surfactants\u003c/a> to prevent respiratory distress syndrome in premature babies. Surfaxin, approved in 2012, is the latest to hit the market. (The first, \u003ca href=\"https://www.pharmamedtechbi.com/publications/the-pink-sheet/52/032/burroughs-wellcomes-exosurf-is-approved\">Exosurf, \u003c/a>is no longer sold.)\u003c/p>\n\u003cp>\"It took 40 years — from the initial discovery in the early '50s to the first approval of the FDA in the 1990s,\" says Dr. Sam Hawgood, a neonatologist who once worked in Clements' lab and is now chancellor at the University of California, San Francisco.\u003c/p>\n\u003cp>\"All of us would like to compress that timeline,\" Hawgood says. \"But if you think that we had no idea that this substance even existed or was needed in the '50s, to an actual drug four decades later — it's pretty remarkable.\"\u003c/p>\n\u003cp>What's also remarkable is John Clements himself. Today he has a lab at UCSF. At 92, he still heads in every day and is proud of what his work has meant for treating premature infants with respiratory distress syndrome.\u003c/p>\n\u003cp>\"When we began this work back in the 1950s, the mortality from RDS was above 90 percent,\" he says. \"Today, that mortality is 5 percent or less.\"\u003c/p>\n\u003cp>I asked Clements why he still works — surely he's achieved enough to rest on his laurels. He says there's always the chance that a new day will bring a new scientific insight.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The thrill of that is the best thing there is. At my age, I'd put it even higher than sex,\" says Clements with a laugh. Then his tone is more serious. \"It's a big, big thrill when you think you've made a discovery — found an idea — that no one else has had,\" he says. \"That's as good as it gets.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=How+A+Scientist%27s+Slick+Discovery+Helped+Save+Preemies%27+Lives&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New Ebola Vaccine Has '100 Percent' Effectiveness In Early Results",
"title": "New Ebola Vaccine Has '100 Percent' Effectiveness In Early Results",
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"content": "\u003cp>In a development that could change the way the deadly Ebola disease is fought, researchers have announced promising results of a new vaccine's trial in Guinea, one of several countries affected by a historic outbreak in West Africa.\u003c/p>\n\u003cp>\"The estimated vaccine efficacy was 100 percent,\" a team of researchers say.\u003c/p>\n\u003cp>The trial was called \u003cem>Ebola ça Suffit\u003c/em> — French for \"Ebola that's enough.\" Funded by the World Health Organization and other groups, it started in April and ended on July 20, relying on 7,651 participants who consented to be part of the trial. The more than 20 researchers who took part published their findings \u003ca href=\"http://www.thelancet.com/pb/assets/raw/Lancet/pdfs/S0140673615611175.pdf\">in The Lancet medical journal\u003c/a> on Friday.\u003c/p>\n\u003cp>\"The current data basically tells us that the vaccine works to protect people against Ebola,\" says Dr. Bertrand Draguez, medical director of Médecins Sans Frontières, \u003ca href=\"http://www.msf.org/article/ebola-getting-closer-ebola-vaccine\">which took part in the research\u003c/a> along with WHO and authorities in Guinea.\u003c/p>\n\u003cp>Draguez and other experts are heartened by the new results — but they also warn that as testing expands, the effectiveness rate of the vaccine will likely fall below 100 percent. The trial used the \"ring vaccination\" method, in which all suspected contacts receive treatment. No placebos were administered.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Even if the sample size is quite small and more research and analysis is needed,\" Draguez says, \"the enormity of the public health emergency should lead us to continue using this vaccine right now to protect those who might get exposed to the disease: contacts of infected patients and front-line workers.\"\u003c/p>\n\u003cp>The trial vaccine, formally called rVSV-ZEBOV but more commonly known as VSV-EBOV, was supplied by the pharmaceutical firm Merck Sharp & Dohme. The drug was initially developed by Canada's Public Health Agency and was tested \u003ca href=\"http://jid.oxfordjournals.org/content/204/suppl_3/S1066.full\">as early as 2011\u003c/a>.\u003c/p>\n\u003cp>To conduct the Guinea trial, researchers used newly confirmed Ebola cases to identify clusters of people with whom the patients had contact. On a random basis, those clusters then received the vaccine either immediately or after a 21-day delay.\u003c/p>\n\u003cp>\"In the immediate vaccination group, there were no cases of Ebola virus disease with symptom onset at least 10 days after randomization,\" the researchers say, \"whereas in the delayed vaccination group there were 16 cases of Ebola virus disease from seven clusters, showing a vaccine efficacy of 100 percent.\"\u003c/p>\n\u003cp>Researchers say that for both groups — those who got the vaccine immediately and those who received it after a delay — no new Ebola cases were diagnosed starting at six days after vaccination.\u003c/p>\n\u003cp>The randomization phase of the trial was stopped this week, WHO says, \"to allow for all people at risk to receive the vaccine immediately.\" It will also now include younger people than the adults involved in the trial.\u003c/p>\n\u003cp>The first person to receive the trial vaccine in Guinea was Mohamed Soumah, 27. \u003ca href=\"http://www.who.int/features/2015/guinea-ebola-vaccine/en/\">He tells WHO\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\"It wasn't easy. People in the village said that the injection was to kill me. I was afraid. I was the first one to be injected, the very first, here in my village on 23 March 2015. I've been monitored for 3 months and I've had no problems. The last follow-up, 84 days after the vaccination, was all clear.\"\u003c/p>\u003c/blockquote>\n\u003cp>The vaccine is administered via a shot to the upper arm. The researchers who ran the trial say their results suggest a single injection is highly effective, and that protection against Ebola can be established quickly. They're also still analyzing possible adverse reactions to the drug.\u003c/p>\n\u003cp>The interim findings on the Guinea trial are the latest to bolster the belief that VSV-EBOV could be the drug Ebola-fighters have been waiting for. Earlier this year, it showed positive results in clinical trials at the Walter Reed Army Institute of Research and the National Institute of Allergy and Infectious Diseases.\u003c/p>\n\u003cp>\u003ca href=\"http://wrair-www.army.mil/Documents/NEJM%20Press%20Release%20Ebola%20Vaccine%20Trial%201%20Apr%2015.pdf\">A Walter Reed release\u003c/a> about that study explained how the drug is derived:\u003c/p>\n\u003cblockquote>\u003cp>\"VSV-EBOV is based in part on a genetically engineered version of vesicular stomatitis virus, which primarily affects rodents, cattle, swine and horses. Human VSV infections are rare and mild. In the VSV-EBOV investigational vaccine, the gene for the outer protein of VSV replaces the same gene segment of the Zaire Ebola virus species.\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>Researchers in the Guinea trial say the number of new clusters of potential patients is falling, because the rate of new diagnoses in the country has dropped. The next immediate step, they say, is to continue the trial and vaccinate more people. Last Friday, Guinea's government and medical ethics groups approved that plan.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=New+Ebola+Vaccine+Has+%27100+Percent%27+Effectiveness+In+Early+Results&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In a development that could change the way the deadly Ebola disease is fought, researchers have announced promising results of a new vaccine's trial in Guinea, one of several countries affected by a historic outbreak in West Africa.\u003c/p>\n\u003cp>\"The estimated vaccine efficacy was 100 percent,\" a team of researchers say.\u003c/p>\n\u003cp>The trial was called \u003cem>Ebola ça Suffit\u003c/em> — French for \"Ebola that's enough.\" Funded by the World Health Organization and other groups, it started in April and ended on July 20, relying on 7,651 participants who consented to be part of the trial. The more than 20 researchers who took part published their findings \u003ca href=\"http://www.thelancet.com/pb/assets/raw/Lancet/pdfs/S0140673615611175.pdf\">in The Lancet medical journal\u003c/a> on Friday.\u003c/p>\n\u003cp>\"The current data basically tells us that the vaccine works to protect people against Ebola,\" says Dr. Bertrand Draguez, medical director of Médecins Sans Frontières, \u003ca href=\"http://www.msf.org/article/ebola-getting-closer-ebola-vaccine\">which took part in the research\u003c/a> along with WHO and authorities in Guinea.\u003c/p>\n\u003cp>Draguez and other experts are heartened by the new results — but they also warn that as testing expands, the effectiveness rate of the vaccine will likely fall below 100 percent. The trial used the \"ring vaccination\" method, in which all suspected contacts receive treatment. No placebos were administered.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Even if the sample size is quite small and more research and analysis is needed,\" Draguez says, \"the enormity of the public health emergency should lead us to continue using this vaccine right now to protect those who might get exposed to the disease: contacts of infected patients and front-line workers.\"\u003c/p>\n\u003cp>The trial vaccine, formally called rVSV-ZEBOV but more commonly known as VSV-EBOV, was supplied by the pharmaceutical firm Merck Sharp & Dohme. The drug was initially developed by Canada's Public Health Agency and was tested \u003ca href=\"http://jid.oxfordjournals.org/content/204/suppl_3/S1066.full\">as early as 2011\u003c/a>.\u003c/p>\n\u003cp>To conduct the Guinea trial, researchers used newly confirmed Ebola cases to identify clusters of people with whom the patients had contact. On a random basis, those clusters then received the vaccine either immediately or after a 21-day delay.\u003c/p>\n\u003cp>\"In the immediate vaccination group, there were no cases of Ebola virus disease with symptom onset at least 10 days after randomization,\" the researchers say, \"whereas in the delayed vaccination group there were 16 cases of Ebola virus disease from seven clusters, showing a vaccine efficacy of 100 percent.\"\u003c/p>\n\u003cp>Researchers say that for both groups — those who got the vaccine immediately and those who received it after a delay — no new Ebola cases were diagnosed starting at six days after vaccination.\u003c/p>\n\u003cp>The randomization phase of the trial was stopped this week, WHO says, \"to allow for all people at risk to receive the vaccine immediately.\" It will also now include younger people than the adults involved in the trial.\u003c/p>\n\u003cp>The first person to receive the trial vaccine in Guinea was Mohamed Soumah, 27. \u003ca href=\"http://www.who.int/features/2015/guinea-ebola-vaccine/en/\">He tells WHO\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\"It wasn't easy. People in the village said that the injection was to kill me. I was afraid. I was the first one to be injected, the very first, here in my village on 23 March 2015. I've been monitored for 3 months and I've had no problems. The last follow-up, 84 days after the vaccination, was all clear.\"\u003c/p>\u003c/blockquote>\n\u003cp>The vaccine is administered via a shot to the upper arm. The researchers who ran the trial say their results suggest a single injection is highly effective, and that protection against Ebola can be established quickly. They're also still analyzing possible adverse reactions to the drug.\u003c/p>\n\u003cp>The interim findings on the Guinea trial are the latest to bolster the belief that VSV-EBOV could be the drug Ebola-fighters have been waiting for. Earlier this year, it showed positive results in clinical trials at the Walter Reed Army Institute of Research and the National Institute of Allergy and Infectious Diseases.\u003c/p>\n\u003cp>\u003ca href=\"http://wrair-www.army.mil/Documents/NEJM%20Press%20Release%20Ebola%20Vaccine%20Trial%201%20Apr%2015.pdf\">A Walter Reed release\u003c/a> about that study explained how the drug is derived:\u003c/p>\n\u003cblockquote>\u003cp>\"VSV-EBOV is based in part on a genetically engineered version of vesicular stomatitis virus, which primarily affects rodents, cattle, swine and horses. Human VSV infections are rare and mild. In the VSV-EBOV investigational vaccine, the gene for the outer protein of VSV replaces the same gene segment of the Zaire Ebola virus species.\"\u003c/p>\u003c/blockquote>\n\u003cp>\u003c/p>\n\u003cp>Researchers in the Guinea trial say the number of new clusters of potential patients is falling, because the rate of new diagnoses in the country has dropped. The next immediate step, they say, is to continue the trial and vaccinate more people. Last Friday, Guinea's government and medical ethics groups approved that plan.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=New+Ebola+Vaccine+Has+%27100+Percent%27+Effectiveness+In+Early+Results&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Inside Dr. Eric Topol's 'Modern Black Bag'",
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"content": "\u003cp>\u003cstrong>Listen to the talk:\u003c/strong>\u003cbr>\nhttp://www.kqed.org/.stream/anon/radio/science/2015/07/Topoltalk.mp3\u003c/p>\n\u003cp>In the not-so-distant past, it was the fashion for doctors to carry black bags filled with stethoscopes, blood pressure cuffs and other gadgets.\u003c/p>\n\u003cp>Eric Topol, a cardiologist and chief academic officer at Scripps Health is one of the few doctors whose black bag isn't gathering dust. But Topol's black bag is no relic of the past: It contains an assortment of the latest wearable devices and gizmos. He describes it as \"exponentially more powerful\" than an equivalent bag from a century ago.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">I met with Topol at a KQED event in San Francisco hosted by \u003ca href=\"https://rockhealth.com/\">\u003cspan class=\"s2\">Rock Health\u003c/span>\u003c/a>, an early-stage venture firm that invests in digital health. Topol is a cardiologist and geneticist who has written several books about how technology — and the smartphone, in particular — is changing medicine.\u003c/span>\u003c/p>\n\u003cp>Within minutes, Topol granted me a peek inside his black bag and described its contents: A heart health monitor from \u003ca href=\"alivecor.com\">AliveCor\u003c/a> that attaches to an iPhone; a miniature scanning device called the \u003ca href=\"https://www.scanadu.com/scout/\">Scanadu Scout\u003c/a> that measures body temperature and blood pressure in a matter of seconds, a coin-shaped sensor that tracks blood sugar levels, and an early-stage prototype of a wristwatch that monitors blood pressure.\u003c/p>\n\u003cfigure id=\"attachment_18646\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-18646\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/topol-2-800x600.jpg\" alt='Dr. Eric Topol shows me his \"modern black bag\" ' width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-1400x1050.jpg 1400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-960x720.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Eric Topol opens up his\"modern black bag\" \u003ccite>(Christina Farr / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Topol is no ordinary doctor. \u003ca href=\"http://www.nytimes.com/2015/02/15/books/review/the-patient-will-see-you-now-by-eric-topol.html?_r=0\">The New York Times described him\u003c/a> as a \"digital geek\" with an \"enthusiasm for all things wireless [that] would make any Wired subscriber proud.\" While many of his physician colleagues are skeptical about all this new medical technology, he is already recommending that his patients use some of the new tools to monitor their vitals between visits. In Topol's view, that's the basis for a new kind of dialogue between doctor and patient: One where you and I can take a far more active role.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Here are some of the highlights from our talk. Note: The conversation was recorded for broadcast and will air on KQED on September 23rd at 8pm PT.\u003c/p>\n\u003cp>\u003cstrong>On The Hype and Promise of Digital Health \u003c/strong>\u003c/p>\n\u003cp>Five years ago, few people saw potential in digital health. But in 2014, \u003ca href=\"http://rockhealth.com/2015/01/digital-health-funding-tops-4-1b-2014-year-review/\">investment in the space topped $4.1 billion\u003c/a> as technology entered health care in a big way.\u003c/p>\n\u003cp>Topol was one of the earliest physicians to publicly praise the new medical technology, and try it out in his own practice. One of the key benefits, he says, is the ability to keep an eye on patients once they've left the hospital. Patients with cardiac issues, for instance, can pickup an \u003ca href=\"alivecor.com\">Alivecor\u003c/a> mobile electrocardiogram, which fits onto a smartphone, and regularly check their heart function for signs of distress.\u003c/p>\n\u003cfigure id=\"attachment_18953\" class=\"wp-caption alignright\" style=\"max-width: 348px\">\u003cimg class=\" wp-image-18953\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/topol-1-450x600.jpg\" alt=\"Eric Topol at the Rock Health offices in San Francisco \" width=\"348\" height=\"464\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-450x600.jpg 450w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-400x533.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-885x1180.jpg 885w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-1920x2560.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-1180x1573.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-960x1280.jpg 960w\" sizes=\"(max-width: 348px) 100vw, 348px\">\u003cfigcaption class=\"wp-caption-text\">Eric Topol at the Rock Health offices in San Francisco \u003ccite>(Christina Farr / KQED )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Throughout our conversation, Topol shared stories of patients who were able to avoid a deadly outcome by using a mobile medical tool. \u003ca href=\"http://medcitynews.com/2015/07/topol-apple-watch-helps-colleagues-patient-self-diagnose-heart-condition/\">One of his patients \u003c/a>came into his office and requested to be fit with a pacemaker. This patient said he had been feeling dizzy with a fluctuating heart rate, which he was monitoring with his Apple Watch. After performing a Google search of these symptoms, the patient guessed that it might be sick sinus syndrome That diagnosis proved to be accurate.\u003c/p>\n\u003cp>That's all well and good, but it's still early days for mobile health. What are the potential drawbacks of using these tools?\u003c/p>\n\u003cp>For one thing, not every digital health company takes patient privacy all that seriously. Unlike Apple, many companies make money by selling your data to third parties, including pharmaceutical companies, advertisers and marketers.\u003c/p>\n\u003cp>Moreover, many of the new systems that store your data are not secure. Topol recently shared a graphic on Twitter showing that a patient in the U.S. is five times more likely to have their medical record hacked than to access it at all. (In July, just a few months after he shared that stat, hackers broke into UCLA and accessed computers with medical records of 4.5 million people.)\u003c/p>\n\u003cp>https://twitter.com/EricTopol/status/617325499094708224\u003c/p>\n\u003cp>One of the limitations of his latest book, \"The Patient Will See You Now,\" is that it doesn't grapple with the issue of whether some patients will misinterpret the data and diagnose themselves with all manner of ills. Topol does concede that mobile health isn't for everyone -- he refers to those who are addicted to Google searching symptoms as \"anxious and wired\" and \"cyber-chondriacs.\" But he thinks that \"most people will do well,\" and use these tools in moderation.\u003c/p>\n\u003cp>\u003cb>On Medical Paternalism\u003c/b>\u003c/p>\n\u003cp>Topol has observed that many doctors today maintain the view that patients shouldn't have much of a voice. \u003ca href=\"http://www.goodhousekeeping.com/health/wellness/news/a31841/doctors-not-telling-patients-alzheimers/\">In the 1960s, many doctors wouldn't tell their patients they had cancer\u003c/a>, fearing they would get too distressed. It wasn't until the 1980s that the AMA and other groups included the notion of \u003ca href=\"http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion808.page?\">\"informed consent\"\u003c/a> in their code of ethics.\u003c/p>\n\u003cp>https://twitter.com/rvaughnmd/status/440225195131826176\u003c/p>\n\u003cp>In 2012, three medical institutions agreed to conduct an experimen\u003ca href=\"http://www.healthcareitnews.com/news/opennotes-not-software-package-movement\">t called \"Open Notes,\" \u003c/a>which involved doctors sharing their notes with patients. According to Topol, some physicians feared that patients would be horrified to see \"obese\" scrawled in their notes, or they might misinterpret medical jargon like \"SOB.\" But the experiment proved to be a success. Despite these positive results, more recent surveys show that many doctors are still reluctant to share their notes with patients.\u003c/p>\n\u003cp>\u003cstrong>On That Time He Gave Stephen Colbert an Ear Exam\u003c/strong>\u003c/p>\n\u003cp>Many doctors across the country are still tentative about digital health. But Topol is one of its most avid and earliest supporters. In 2013, he showed off the armory of mobile medical devices in his black bag on the Colbert Show. On live television, he examined Stephen Colbert's heart and \u003ca href=\"http://medcitynews.com/2013/03/eric-topol-gives-stephen-colbert-ear-exam-heart-attack-ringtones-and-other-colbert-highlights/\">performed an ear exam \u003c/a>using a mobile otoscope from CellScope.\u003c/p>\n\u003cp>\"The best part was using a handheld device to examine his [Colbert's] heart -- he had to bare his chest on TV. I told Colbert he had an aortic aneurysm to have some fun. Unfortunately, much of that was edited out,\" Topol said.\u003c/p>\n\u003cp>[youtube https://www.youtube.com/watch?v=-4iZQYlygno]\u003c/p>\n\u003cp>\u003cstrong>On the Reign of the Quitbits \u003c/strong>\u003c/p>\n\u003cp>The market is flooded with devices that serve the \"worried well,\" meaning those who are perfectly healthy but are constantly unnerved about getting sick. This set might rush to adopt new devices, such as the Fitbit (which Topol refers to as a \"Quitbit\"), \u003ca href=\"http://www.fool.com/investing/general/2015/06/24/1-red-flag-that-fitbit-inc-investors-cant-ignore.aspx\">but they don't use them for long\u003c/a>. Topol hopes that Silicon Valley will divert its attention away from building tools for the worried well and instead focus on \"devices that are giving clinically relevant information.\"\u003c/p>\n\u003cp>But there are barriers to entry for those who are developing true medical devices. These entrepreneurs will need to gain clearance from the U.S. Food and Drug Administration. This process can take months, and sometimes years.\u003c/p>\n\u003cp>\u003cstrong>On His Bad Luck on Flights\u003c/strong>\u003c/p>\n\u003cp>\"If you see me getting on your flight, reconsider. I seem to have some bad luck in this regard,\" Topol said. He's only slightly kidding. On three occasions in recent years, he's made an emergency diagnosis in the air. Fortunately, his black bag was on hand.\u003c/p>\n\u003cp>In one case, he used an Alivecor to make a \"very quick diagnosis\" that a patient was having a heart attack. The plane made an emergency landing. In his book, 'The Patient Will See You Now,' he recalls another emergency situation where he checked a patient's ECG in the air, as well as performing a cardiac ultrasound and taking their blood pressure -- and concluded that the patient was fine. He writes that in the future, a doctor's intervention wouldn't be required: \"All that was needed were the tools to collect the data.\" This might be taking it a bit far. I would argue that mobile health will improve the doctor-patient relationship, but it isn't going to replace the doctor anytime.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>https://twitter.com/EricTopol/status/600848164267110400\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In the not-so-distant past, it was the fashion for doctors to carry black bags filled with stethoscopes, blood pressure cuffs and other gadgets.\u003c/p>\n\u003cp>Eric Topol, a cardiologist and chief academic officer at Scripps Health is one of the few doctors whose black bag isn't gathering dust. But Topol's black bag is no relic of the past: It contains an assortment of the latest wearable devices and gizmos. He describes it as \"exponentially more powerful\" than an equivalent bag from a century ago.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">I met with Topol at a KQED event in San Francisco hosted by \u003ca href=\"https://rockhealth.com/\">\u003cspan class=\"s2\">Rock Health\u003c/span>\u003c/a>, an early-stage venture firm that invests in digital health. Topol is a cardiologist and geneticist who has written several books about how technology — and the smartphone, in particular — is changing medicine.\u003c/span>\u003c/p>\n\u003cp>Within minutes, Topol granted me a peek inside his black bag and described its contents: A heart health monitor from \u003ca href=\"alivecor.com\">AliveCor\u003c/a> that attaches to an iPhone; a miniature scanning device called the \u003ca href=\"https://www.scanadu.com/scout/\">Scanadu Scout\u003c/a> that measures body temperature and blood pressure in a matter of seconds, a coin-shaped sensor that tracks blood sugar levels, and an early-stage prototype of a wristwatch that monitors blood pressure.\u003c/p>\n\u003cfigure id=\"attachment_18646\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-18646\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/topol-2-800x600.jpg\" alt='Dr. Eric Topol shows me his \"modern black bag\" ' width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-1400x1050.jpg 1400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-960x720.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Eric Topol opens up his\"modern black bag\" \u003ccite>(Christina Farr / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Topol is no ordinary doctor. \u003ca href=\"http://www.nytimes.com/2015/02/15/books/review/the-patient-will-see-you-now-by-eric-topol.html?_r=0\">The New York Times described him\u003c/a> as a \"digital geek\" with an \"enthusiasm for all things wireless [that] would make any Wired subscriber proud.\" While many of his physician colleagues are skeptical about all this new medical technology, he is already recommending that his patients use some of the new tools to monitor their vitals between visits. In Topol's view, that's the basis for a new kind of dialogue between doctor and patient: One where you and I can take a far more active role.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Here are some of the highlights from our talk. Note: The conversation was recorded for broadcast and will air on KQED on September 23rd at 8pm PT.\u003c/p>\n\u003cp>\u003cstrong>On The Hype and Promise of Digital Health \u003c/strong>\u003c/p>\n\u003cp>Five years ago, few people saw potential in digital health. But in 2014, \u003ca href=\"http://rockhealth.com/2015/01/digital-health-funding-tops-4-1b-2014-year-review/\">investment in the space topped $4.1 billion\u003c/a> as technology entered health care in a big way.\u003c/p>\n\u003cp>Topol was one of the earliest physicians to publicly praise the new medical technology, and try it out in his own practice. One of the key benefits, he says, is the ability to keep an eye on patients once they've left the hospital. Patients with cardiac issues, for instance, can pickup an \u003ca href=\"alivecor.com\">Alivecor\u003c/a> mobile electrocardiogram, which fits onto a smartphone, and regularly check their heart function for signs of distress.\u003c/p>\n\u003cfigure id=\"attachment_18953\" class=\"wp-caption alignright\" style=\"max-width: 348px\">\u003cimg class=\" wp-image-18953\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/topol-1-450x600.jpg\" alt=\"Eric Topol at the Rock Health offices in San Francisco \" width=\"348\" height=\"464\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-450x600.jpg 450w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-400x533.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-885x1180.jpg 885w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-1920x2560.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-1180x1573.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-960x1280.jpg 960w\" sizes=\"(max-width: 348px) 100vw, 348px\">\u003cfigcaption class=\"wp-caption-text\">Eric Topol at the Rock Health offices in San Francisco \u003ccite>(Christina Farr / KQED )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Throughout our conversation, Topol shared stories of patients who were able to avoid a deadly outcome by using a mobile medical tool. \u003ca href=\"http://medcitynews.com/2015/07/topol-apple-watch-helps-colleagues-patient-self-diagnose-heart-condition/\">One of his patients \u003c/a>came into his office and requested to be fit with a pacemaker. This patient said he had been feeling dizzy with a fluctuating heart rate, which he was monitoring with his Apple Watch. After performing a Google search of these symptoms, the patient guessed that it might be sick sinus syndrome That diagnosis proved to be accurate.\u003c/p>\n\u003cp>That's all well and good, but it's still early days for mobile health. What are the potential drawbacks of using these tools?\u003c/p>\n\u003cp>For one thing, not every digital health company takes patient privacy all that seriously. Unlike Apple, many companies make money by selling your data to third parties, including pharmaceutical companies, advertisers and marketers.\u003c/p>\n\u003cp>Moreover, many of the new systems that store your data are not secure. Topol recently shared a graphic on Twitter showing that a patient in the U.S. is five times more likely to have their medical record hacked than to access it at all. (In July, just a few months after he shared that stat, hackers broke into UCLA and accessed computers with medical records of 4.5 million people.)\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>One of the limitations of his latest book, \"The Patient Will See You Now,\" is that it doesn't grapple with the issue of whether some patients will misinterpret the data and diagnose themselves with all manner of ills. Topol does concede that mobile health isn't for everyone -- he refers to those who are addicted to Google searching symptoms as \"anxious and wired\" and \"cyber-chondriacs.\" But he thinks that \"most people will do well,\" and use these tools in moderation.\u003c/p>\n\u003cp>\u003cb>On Medical Paternalism\u003c/b>\u003c/p>\n\u003cp>Topol has observed that many doctors today maintain the view that patients shouldn't have much of a voice. \u003ca href=\"http://www.goodhousekeeping.com/health/wellness/news/a31841/doctors-not-telling-patients-alzheimers/\">In the 1960s, many doctors wouldn't tell their patients they had cancer\u003c/a>, fearing they would get too distressed. It wasn't until the 1980s that the AMA and other groups included the notion of \u003ca href=\"http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion808.page?\">\"informed consent\"\u003c/a> in their code of ethics.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>In 2012, three medical institutions agreed to conduct an experimen\u003ca href=\"http://www.healthcareitnews.com/news/opennotes-not-software-package-movement\">t called \"Open Notes,\" \u003c/a>which involved doctors sharing their notes with patients. According to Topol, some physicians feared that patients would be horrified to see \"obese\" scrawled in their notes, or they might misinterpret medical jargon like \"SOB.\" But the experiment proved to be a success. Despite these positive results, more recent surveys show that many doctors are still reluctant to share their notes with patients.\u003c/p>\n\u003cp>\u003cstrong>On That Time He Gave Stephen Colbert an Ear Exam\u003c/strong>\u003c/p>\n\u003cp>Many doctors across the country are still tentative about digital health. But Topol is one of its most avid and earliest supporters. In 2013, he showed off the armory of mobile medical devices in his black bag on the Colbert Show. On live television, he examined Stephen Colbert's heart and \u003ca href=\"http://medcitynews.com/2013/03/eric-topol-gives-stephen-colbert-ear-exam-heart-attack-ringtones-and-other-colbert-highlights/\">performed an ear exam \u003c/a>using a mobile otoscope from CellScope.\u003c/p>\n\u003cp>\"The best part was using a handheld device to examine his [Colbert's] heart -- he had to bare his chest on TV. I told Colbert he had an aortic aneurysm to have some fun. Unfortunately, much of that was edited out,\" Topol said.\u003c/p>\n\u003cp>\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/-4iZQYlygno'\n title='//www.youtube.com/embed/-4iZQYlygno'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>On the Reign of the Quitbits \u003c/strong>\u003c/p>\n\u003cp>The market is flooded with devices that serve the \"worried well,\" meaning those who are perfectly healthy but are constantly unnerved about getting sick. This set might rush to adopt new devices, such as the Fitbit (which Topol refers to as a \"Quitbit\"), \u003ca href=\"http://www.fool.com/investing/general/2015/06/24/1-red-flag-that-fitbit-inc-investors-cant-ignore.aspx\">but they don't use them for long\u003c/a>. Topol hopes that Silicon Valley will divert its attention away from building tools for the worried well and instead focus on \"devices that are giving clinically relevant information.\"\u003c/p>\n\u003cp>But there are barriers to entry for those who are developing true medical devices. These entrepreneurs will need to gain clearance from the U.S. Food and Drug Administration. This process can take months, and sometimes years.\u003c/p>\n\u003cp>\u003cstrong>On His Bad Luck on Flights\u003c/strong>\u003c/p>\n\u003cp>\"If you see me getting on your flight, reconsider. I seem to have some bad luck in this regard,\" Topol said. He's only slightly kidding. On three occasions in recent years, he's made an emergency diagnosis in the air. Fortunately, his black bag was on hand.\u003c/p>\n\u003cp>In one case, he used an Alivecor to make a \"very quick diagnosis\" that a patient was having a heart attack. The plane made an emergency landing. In his book, 'The Patient Will See You Now,' he recalls another emergency situation where he checked a patient's ECG in the air, as well as performing a cardiac ultrasound and taking their blood pressure -- and concluded that the patient was fine. He writes that in the future, a doctor's intervention wouldn't be required: \"All that was needed were the tools to collect the data.\" This might be taking it a bit far. I would argue that mobile health will improve the doctor-patient relationship, but it isn't going to replace the doctor anytime.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Close Listening: How Sound Reveals the Invisible",
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"content": "\u003cp>\u003cstrong>Listen to the story:\u003c/strong>\u003cbr>\nhttp://pd.npr.org/anon.npr-mp3/npr/me/2015/07/20150730_me_close_listening_how_sound_reveals_the_invisible.mp3\u003c/p>\n\u003cp>\u003cem>Over the years, scientists have mostly interpreted the world through what they can see. But in the last few decades, a culture of listening has blossomed, especially among biologists who seek to understand how animals communicate. This week \u003c/em>Morning Edition\u003cem> embarks on a weekly summer series called \u003c/em>Close Listening: Decoding Nature Through Sound\u003cem>. We begin with an innovation that transformed medicine by searching sounds for clues to illness and health.\u003c/em>\u003c/p>\n\u003cp>Microscopes illuminate the invisibly tiny; telescopes reveal the heavens. But sound? Scientists didn't really see it as all that important, until an amazing invention came along that opened new worlds: the stethoscope.\u003c/p>\n\u003cp>\"I think the first time one can see this kind of 'listening culture,' is with the development of the stethoscope at the beginning of the 19th century in Paris,\" says \u003ca href=\"http://sts.cornell.edu/people/tjp2.cfm\">Trevor Pinch\u003c/a>, a Cornell University sociologist.\u003c/p>\n\u003cp>\"You couldn't see inside a body back then,\" Pinch says, \"unless of course it was dead, which was a bit late for anyone except a pathologist.\" But a stethoscope told a living story — of circulating blood, or the seesawing of lungs.\u003c/p>\n\u003cfigure id=\"attachment_19364\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-19364\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/early-stethoscopes_custom-4017714c2df9ca6e45eaaafa8f4ec57e20f92c5f-s800-c85-800x321.jpg\" alt=\"Early stethoscopes from the 1874 book Clinical Lectures on the Principles and Practices of Medicine. Later, binaural stethoscopes were developed that allowed the listener to hear the sound with both ears.\" width=\"800\" height=\"321\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/early-stethoscopes_custom-4017714c2df9ca6e45eaaafa8f4ec57e20f92c5f-s800-c85.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/early-stethoscopes_custom-4017714c2df9ca6e45eaaafa8f4ec57e20f92c5f-s800-c85-400x161.jpg 400w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Early stethoscopes from the 1874 book Clinical Lectures on the Principles and Practices of Medicine. Later, binaural stethoscopes were developed that allowed the listener to hear the sound with both ears. \u003ccite>(Internet Archive Book Imaging/Flickr)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"It was one of the first ways of getting a diagnosis on a patient independent of their own version of what was happening,\" says Pinch. \"In fact, it's become so important that the emblem of the physician is often the stethoscope around the neck — that's how you tell who the doc is.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>We asked one of those doctors to help us hear the way he hears. \u003ca href=\"http://ithacamed.com/?page_id=33\">Dr. Adam Law\u003c/a>, an endocrinologist and primary care physician in Ithaca, N.Y., was teaching a medical student how to use a stethoscope to diagnose a heart problem in one of his patients, and we brought along recording equipment so we could listen in. Law's student is Nick Maston, in his third year at Weill Cornell Medical College.\u003c/p>\n\u003cp>Law ushered the patient into the examining room, and turned to his student. \"Nick, why don't you examine this patient's cardiovascular system?\" We'd already plugged our recorder into the electronic stethoscope, but Law and Maston both warned us — interpreting sounds from inside a body is not for amateurs.\u003c/p>\n\u003cp>\"As a student,\" said Maston, \"it's hard to learn ... you have to listen to thousands of hearts to find that out.\"\u003c/p>\n\u003cp>Maston placed the bell of the instrument on the patient's neck — right on the carotid artery – and we all heard this:\u003c/p>\n\u003cp>\u003ciframe src=\"http://www.npr.org/player/embed/425395825/427431862\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>It's the sound of the heart pumping blood through its aortic valve and out into the pulsing carotid artery. Then Maston moved the bell to the patient's side, placing it just under the man's armpit. A slightly different sound came through:\u003c/p>\n\u003cp>\u003ciframe src=\"http://www.npr.org/player/embed/425395825/427431942\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Law turned to his student: \"Hear the difference in quality?\" Maston didn't hesitate: \"Yeah; very loud second heart sound.\"\u003c/p>\n\u003cp>Law's patient has a heart murmur — a malfunction of the heart valves that control blood flow. Textbooks say you can hear a murmur's \"swishing\" sound. But if you didn't hear it, don't feel bad — we journalists couldn't make out any swishing sound, either.\u003c/p>\n\u003cp>Nick apparently can. \"So do you want me to talk about what I heard?\" he asked us. \"It sounded like a mitral murmur; but I heard it best where I expect to hear an aortic murmur. So ... this is a situation where Dr. Law is going to have to jump in and rescue me.\"\u003c/p>\n\u003cp>Law confirmed that Nick had it right. The patient's heart has a little bit of both types of murmur, he said, from the mitral and aortic valves.\u003c/p>\n\u003cp>We amateurs didn't hear it because we simply didn't know what to listen for. Think of the sound as if it were the audio version of a fossil bone or relic lying in the dirt; a seasoned archaeologist can pick those out more readily than other people because the pros have a sort of \"search image\" in their brain.\u003c/p>\n\u003cp>\"The musical note of the heart is actually complicated,\" Law said. \"It has harmonics; it has overtones. And that gives the sound — and the murmurs — in the heart a certain quality,\" he explained. \"One has to tune one's ears.\"\u003c/p>\n\u003cp>So how do you tune your ears? \"Pattern recognition is the key,\" Pinch told us later.\u003c/p>\n\u003cp>Some patterns, like the start of Beethoven's Fifth Symphony, are easy.\u003c/p>\n\u003cp>Easily recognized. But it gets harder as the sounds get more complex. Two \u003ca href=\"http://neotropical.birds.cornell.edu/portal/species/identification?p_p_spp=533196\">moustached wrens\u003c/a> singing a duet start as two seemingly random singers. Then they suddenly synchronize their songs, and a pattern emerges:\u003c/p>\n\u003cp>\u003ciframe src=\"http://www.npr.org/player/embed/425395825/427431801\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Pinch has made a career of studying how scientists listen. He notes that listening has certain advantages over vision. \"The visual field is kind of in front of us — like a kind of screen,\" he says, while sound is \"all around.\"\u003c/p>\n\u003cp>If seeing is like being in an art gallery, hearing is more being in a swimming pool – where we're swimming all the time. At night, we'll wake up to a baby's cry, or to the sound of danger — a predator, perhaps. Such sounds trigger an \u003ca href=\"http://www.npr.org/sections/health-shots/2015/07/16/423493616/screaming-for-science-the-secrets-of-crying-babies-and-car-alarms\">ancient alarm system\u003c/a> buried deep within our species' brains. Listening, says Pinch, especially at night \"has probably been evolutionarily very, very important.\"\u003c/p>\n\u003cp>The problem of using sound to understand physical phenomena — from the weather to animal behavior, to the fact that an engine needs oil — is that sound is ephemeral. It's in one ear and out the other.\u003c/p>\n\u003cp>That is, until, as Pinch points out, people invented a way to nail down sound. \"I think the development of the phonograph, in particular, around 1880 ... really does change how we think about sound,\" Pinch says. \"Because, for the first time ever, sound is really transportable ... you can store it in a medium.\"\u003c/p>\n\u003cp>Once people could capture sound, and really listen, Pinch says, that \u003ca href=\"http://www.npr.org/series/93588962/wild-sounds\">opened up a universe\u003c/a> of new possibilities.\u003c/p>\n\u003chr>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ca href=\"http://www.birds.cornell.edu/Page.aspx?pid=1735&id=164\">Bill McQuay\u003c/a>\u003cem> is an audio producer at the \u003c/em>\u003ca href=\"http://www.birds.cornell.edu/Page.aspx?pid=1478\">Cornell Lab of Ornithology\u003c/a>\u003cem>.\u003cbr>\n\u003c/em>He's on Twitter: @mcquay_bill\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Close+Listening%3A+How+Sound+Reveals+The+Invisible&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Listen to the story:\u003c/strong>\u003cbr>\nhttp://pd.npr.org/anon.npr-mp3/npr/me/2015/07/20150730_me_close_listening_how_sound_reveals_the_invisible.mp3\u003c/p>\n\u003cp>\u003cem>Over the years, scientists have mostly interpreted the world through what they can see. But in the last few decades, a culture of listening has blossomed, especially among biologists who seek to understand how animals communicate. This week \u003c/em>Morning Edition\u003cem> embarks on a weekly summer series called \u003c/em>Close Listening: Decoding Nature Through Sound\u003cem>. We begin with an innovation that transformed medicine by searching sounds for clues to illness and health.\u003c/em>\u003c/p>\n\u003cp>Microscopes illuminate the invisibly tiny; telescopes reveal the heavens. But sound? Scientists didn't really see it as all that important, until an amazing invention came along that opened new worlds: the stethoscope.\u003c/p>\n\u003cp>\"I think the first time one can see this kind of 'listening culture,' is with the development of the stethoscope at the beginning of the 19th century in Paris,\" says \u003ca href=\"http://sts.cornell.edu/people/tjp2.cfm\">Trevor Pinch\u003c/a>, a Cornell University sociologist.\u003c/p>\n\u003cp>\"You couldn't see inside a body back then,\" Pinch says, \"unless of course it was dead, which was a bit late for anyone except a pathologist.\" But a stethoscope told a living story — of circulating blood, or the seesawing of lungs.\u003c/p>\n\u003cfigure id=\"attachment_19364\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-19364\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/early-stethoscopes_custom-4017714c2df9ca6e45eaaafa8f4ec57e20f92c5f-s800-c85-800x321.jpg\" alt=\"Early stethoscopes from the 1874 book Clinical Lectures on the Principles and Practices of Medicine. Later, binaural stethoscopes were developed that allowed the listener to hear the sound with both ears.\" width=\"800\" height=\"321\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/early-stethoscopes_custom-4017714c2df9ca6e45eaaafa8f4ec57e20f92c5f-s800-c85.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/early-stethoscopes_custom-4017714c2df9ca6e45eaaafa8f4ec57e20f92c5f-s800-c85-400x161.jpg 400w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Early stethoscopes from the 1874 book Clinical Lectures on the Principles and Practices of Medicine. Later, binaural stethoscopes were developed that allowed the listener to hear the sound with both ears. \u003ccite>(Internet Archive Book Imaging/Flickr)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"It was one of the first ways of getting a diagnosis on a patient independent of their own version of what was happening,\" says Pinch. \"In fact, it's become so important that the emblem of the physician is often the stethoscope around the neck — that's how you tell who the doc is.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>We asked one of those doctors to help us hear the way he hears. \u003ca href=\"http://ithacamed.com/?page_id=33\">Dr. Adam Law\u003c/a>, an endocrinologist and primary care physician in Ithaca, N.Y., was teaching a medical student how to use a stethoscope to diagnose a heart problem in one of his patients, and we brought along recording equipment so we could listen in. Law's student is Nick Maston, in his third year at Weill Cornell Medical College.\u003c/p>\n\u003cp>Law ushered the patient into the examining room, and turned to his student. \"Nick, why don't you examine this patient's cardiovascular system?\" We'd already plugged our recorder into the electronic stethoscope, but Law and Maston both warned us — interpreting sounds from inside a body is not for amateurs.\u003c/p>\n\u003cp>\"As a student,\" said Maston, \"it's hard to learn ... you have to listen to thousands of hearts to find that out.\"\u003c/p>\n\u003cp>Maston placed the bell of the instrument on the patient's neck — right on the carotid artery – and we all heard this:\u003c/p>\n\u003cp>\u003ciframe src=\"http://www.npr.org/player/embed/425395825/427431862\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>It's the sound of the heart pumping blood through its aortic valve and out into the pulsing carotid artery. Then Maston moved the bell to the patient's side, placing it just under the man's armpit. A slightly different sound came through:\u003c/p>\n\u003cp>\u003ciframe src=\"http://www.npr.org/player/embed/425395825/427431942\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Law turned to his student: \"Hear the difference in quality?\" Maston didn't hesitate: \"Yeah; very loud second heart sound.\"\u003c/p>\n\u003cp>Law's patient has a heart murmur — a malfunction of the heart valves that control blood flow. Textbooks say you can hear a murmur's \"swishing\" sound. But if you didn't hear it, don't feel bad — we journalists couldn't make out any swishing sound, either.\u003c/p>\n\u003cp>Nick apparently can. \"So do you want me to talk about what I heard?\" he asked us. \"It sounded like a mitral murmur; but I heard it best where I expect to hear an aortic murmur. So ... this is a situation where Dr. Law is going to have to jump in and rescue me.\"\u003c/p>\n\u003cp>Law confirmed that Nick had it right. The patient's heart has a little bit of both types of murmur, he said, from the mitral and aortic valves.\u003c/p>\n\u003cp>We amateurs didn't hear it because we simply didn't know what to listen for. Think of the sound as if it were the audio version of a fossil bone or relic lying in the dirt; a seasoned archaeologist can pick those out more readily than other people because the pros have a sort of \"search image\" in their brain.\u003c/p>\n\u003cp>\"The musical note of the heart is actually complicated,\" Law said. \"It has harmonics; it has overtones. And that gives the sound — and the murmurs — in the heart a certain quality,\" he explained. \"One has to tune one's ears.\"\u003c/p>\n\u003cp>So how do you tune your ears? \"Pattern recognition is the key,\" Pinch told us later.\u003c/p>\n\u003cp>Some patterns, like the start of Beethoven's Fifth Symphony, are easy.\u003c/p>\n\u003cp>Easily recognized. But it gets harder as the sounds get more complex. Two \u003ca href=\"http://neotropical.birds.cornell.edu/portal/species/identification?p_p_spp=533196\">moustached wrens\u003c/a> singing a duet start as two seemingly random singers. Then they suddenly synchronize their songs, and a pattern emerges:\u003c/p>\n\u003cp>\u003ciframe src=\"http://www.npr.org/player/embed/425395825/427431801\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>Pinch has made a career of studying how scientists listen. He notes that listening has certain advantages over vision. \"The visual field is kind of in front of us — like a kind of screen,\" he says, while sound is \"all around.\"\u003c/p>\n\u003cp>If seeing is like being in an art gallery, hearing is more being in a swimming pool – where we're swimming all the time. At night, we'll wake up to a baby's cry, or to the sound of danger — a predator, perhaps. Such sounds trigger an \u003ca href=\"http://www.npr.org/sections/health-shots/2015/07/16/423493616/screaming-for-science-the-secrets-of-crying-babies-and-car-alarms\">ancient alarm system\u003c/a> buried deep within our species' brains. Listening, says Pinch, especially at night \"has probably been evolutionarily very, very important.\"\u003c/p>\n\u003cp>The problem of using sound to understand physical phenomena — from the weather to animal behavior, to the fact that an engine needs oil — is that sound is ephemeral. It's in one ear and out the other.\u003c/p>\n\u003cp>That is, until, as Pinch points out, people invented a way to nail down sound. \"I think the development of the phonograph, in particular, around 1880 ... really does change how we think about sound,\" Pinch says. \"Because, for the first time ever, sound is really transportable ... you can store it in a medium.\"\u003c/p>\n\u003cp>Once people could capture sound, and really listen, Pinch says, that \u003ca href=\"http://www.npr.org/series/93588962/wild-sounds\">opened up a universe\u003c/a> of new possibilities.\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://www.birds.cornell.edu/Page.aspx?pid=1735&id=164\">Bill McQuay\u003c/a>\u003cem> is an audio producer at the \u003c/em>\u003ca href=\"http://www.birds.cornell.edu/Page.aspx?pid=1478\">Cornell Lab of Ornithology\u003c/a>\u003cem>.\u003cbr>\n\u003c/em>He's on Twitter: @mcquay_bill\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Close+Listening%3A+How+Sound+Reveals+The+Invisible&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Your Smartphone as Dermatologist: Fast, Cheap...and Often Wrong",
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"content": "\u003cp>We are often told that the best protection against melanoma skin cancer is staying out of the sun. But the other defense is detection. Spotted early, melanoma is easily treated. Found too late and it's potentially fatal.\u003c/p>\n\u003cp>This year, \u003ca href=\"http://www.cancer.org/cancer/skincancer-melanoma/detailedguide/melanoma-skin-cancer-key-statistics\">some seventy-three thousand\u003c/a> Americans will be diagnosed with melanoma. The disease kills almost ten thousand of these people.\u003c/p>\n\u003cp>That's why doctors recommend that patients undergo frequent skin checks, especially for those who are prone to developing worrisome moles. Bryce Zaffarano, a 23 year-old physical therapy student in Denver, is one of these people. His first encounter with melanoma was when he was just 16-years-old, when he noticed a dark spot on his chest.\u003c/p>\n\u003cp>“It was concerning,” he says, “but I was like, okay, I’m destined,” — both his mother and uncle had been diagnosed with melanomas, and Zaffarano, like them, had spent most of his childhood in the sun.\u003c/p>\n\u003cfigure id=\"attachment_18234\" class=\"wp-caption alignright\" style=\"max-width: 399px\">\u003cimg class=\" wp-image-18234\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/bryce-750x600.jpg\" alt=\"ryce Zaffarano, a high-risk melanoma patient, still enjoys outdoor activities, like triathlons.\" width=\"399\" height=\"319\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/bryce-750x600.jpg 750w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/bryce-400x320.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/bryce-960x768.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/bryce.jpg 1000w\" sizes=\"(max-width: 399px) 100vw, 399px\">\u003cfigcaption class=\"wp-caption-text\">Bryce Zaffarano, a high-risk melanoma patient, still enjoys outdoor activities like triathlons. \u003ccite>(Jorts Photography/Craig Ricke)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The doctors removed his mole right away, catching it early enough. Now, Zaffarano visits the dermatologist every three months for an all-over body check, an appointment he has kept faithfully for the past seven years. He’s already had one more scare he was glad the doctors spotted right away: another melanoma, this time on his lower back.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But those who don't have an existing relationship with a dermatologist may face challenges booking an appointment. The average wait-time for a dermatologist across the country is over four weeks, up from just three weeks in 2009. \u003ca href=\"http://www.merritthawkins.com/uploadedFiles/MerrittHawkings/Surveys/mha2014waitsurvPDF.pdf\">In some cities, like Boston, the average wait is three months. \u003c/a>\u003c/p>\n\u003cp>Now, some companies are trying to capitalize on impatient patients, offering a fast-paced alternative to old-fashioned doctors: smartphones. Why wait months for an hour-long dermatologist appointment, if an app can do the job?\u003c/p>\n\u003cp>\u003cstrong>Missing the Obvious \u003c/strong>\u003c/p>\n\u003cp>There are 39 mobile applications for Apple and Android platforms currently on the market that claim to diagnose or screen for melanoma using images of moles you take with your phone. Some use automated analysis of the photos, similar to popular apps like LeafSnap or MealSnap that use computer vision to identify plant species or food calories. Others claim photos are analyzed by licensed dermatologists.\u003c/p>\n\u003cp>Snapping photos of concerning spots and getting instant feedback may sound convenient but doctors warn about over-reliance on these apps. Laura Ferris, a dermatologist at the University of Pittsburgh, said she had heard of these dermatologist-impersonating apps, but didn’t think many people were actually using them -- until patients starting asking questions.\u003c/p>\n\u003cp>Ferris and two of her students decided to see if the apps worked. They tested four of the most popular apps on the market for accuracy using 188 images of skin lesions, of which 60 were melanomas, and asked the apps to diagnose them as benign or malignant. The results were troubling: three out of four of the apps misclassified 30 percent or more of melanomas as benign. The fourth app, which relied on a dermatologist analyzing the photos, was more accurate, but it cost $5 per lesion evaluated.\u003c/p>\n\u003cp>These photos were “very obvious melanomas,” Ferris says, but the team found that the computer couldn't recognize them.\u003c/p>\n\u003cp>Ferris says the inaccuracy of these apps is especially dangerous for people who feel they can’t afford the time and money to visit to the dermatologist. An incorrect diagnosis via an app would be dangerous for patients who need to get in to the doctor quickly.\u003c/p>\n\u003cp>In more recent years, other studies have questioned the legitimacy of mobile dermatology apps. A review \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/bjd.13665/full\">published last month in the British Journal of Dermatology\u003c/a> found that melanoma detection apps have potential but are largely inaccurate. The majority not been vetted by dermatologists, and make false promises.\u003c/p>\n\u003cp>“No tool is perfect [and] no drug is perfect. But people need to be able to make informed decisions,” Ferris says. “[These apps] need to have data to backup the claims that they’re making.” Right now, there's no watchdog organization that can prove to both doctors and patients that this data is accurate.\u003c/p>\n\u003cp>\u003cb>Wanted: A Mobile Health Watchdog \u003c/b>\u003c/p>\n\u003cp>This lack of clinical evidence is not unique to the so-called melanoma-detection apps. \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3875901/\">A 2013 paper in the Journal of Medical Internet Research\u003c/a> found that of the approximately 295 cancer-focused (prevention, education, or diagnostic) apps on the market, very few had been evaluated by medical professionals. Likewise, a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22646729\">2012 paper on colorectal smartphone apps\u003c/a> found that nearly all the available apps lacked scientific or medical input.\u003c/p>\n\u003cp>The problem is that many health apps don’t have any more restrictions than dating or gaming apps. The FDA only regulates mobile apps that attach to a medical device, or that transform a mobile phone into a medical device.\u003c/p>\n\u003cp>The Federal Trade Commission has taken a more active role than the FDA in policing melanoma-finding smartphone apps. \u003ca href=\"https://www.ftc.gov/system/files/documents/cases/complaint.pdf\">In February of this year, it challenged two companies,\u003c/a> MelApp and Mole Detective, for making false advertising that they could diagnose melanoma accurately. The claim with MelApp was just settled in April, and and the company was fined over $17,000.\u003c/p>\n\u003cp>\u003ca href=\"http://www.reuters.com/article/2014/06/10/mobilephone-healthcare-idUSL1N0OG2JO20140610\">For now, it's largely up to consumers\u003c/a> to decide whether an app developer can be trusted. Ferris warns that it's not enough to give these apps a stamp of approval just because they appear in the App Store.\u003c/p>\n\u003cp>\u003cstrong>A Tool for the Future?\u003c/strong>\u003c/p>\n\u003cp>The skeptical reception from dermatologists and researchers like Ferris doesn’t seem to have deterred app developers.\u003c/p>\n\u003caside class=\"pullquote alignright\">“[These apps] have to have data to backup the claims that they’re making.\"\u003cbr>\n\u003ccite>Laura Ferris, a dermatologist at the University of Pittsburgh\u003c/cite>\u003c/aside>\n\u003cp>Professor Xiaojing Yuan, who studies computer vision in the engineering department at the University of Houston, is in the process of commercializing a fully-automated smartphone tool she’s developed to detect melanoma.\u003c/p>\n\u003cp>Yuan stresses that the app is a screening tool that informs patients whether or not they should worry about a mole -- and isn't intended to replace a doctor. “Diagnosis is a strong word,” she says.\u003c/p>\n\u003cp>But the tool is intended to help patients decide whether or not to visit the dermatologist, which is exactly the decision Ferris is worried about.\u003c/p>\n\u003cp>Yuan admits there are several challenges to using computer vision technology to screen for skin conditions: Melanomas can vary a lot, and the difference between healthy skin and cancerous tissue can be hard even for dermatologists to determine. Moreover, Yuan has to contend with the relative poor quality of smartphone photos as compared to those taken in a doctor’s office.\u003c/p>\n\u003cp>Challenges aside, Yuan claims her tool performs much better than those currently on the market — but she would never recommend that it replace dermatologists altogether. Not yet, at least.\u003c/p>\n\u003cp>\u003cstrong>Establishing a Connection\u003c/strong>\u003c/p>\n\u003cp>And although she’s skeptical of many of the apps she’s tested, Ferris is still excited about the potential of using technology in her practice.\u003c/p>\n\u003cp>She’s especially interested in the emerging field of \"telemedicine\" companies that use smartphones to connect dermatologists to patients in remote areas. Some of the other doctors in her practice are currently testing out telemedicine products.\u003c/p>\n\u003cp>What's most important for Ferris is establishing a real connection between a human doctor and patient -- both in the diagnosis and in the follow-up. This rings true for Zaffarano.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“When there have been problems, they [dermatologists] have taken immediate action,” he said. It’s inconvenient to spend 45 minutes naked in the doctor’s office every three months, but he’s too skeptical of these smartphone apps to trust them with his life.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>We are often told that the best protection against melanoma skin cancer is staying out of the sun. But the other defense is detection. Spotted early, melanoma is easily treated. Found too late and it's potentially fatal.\u003c/p>\n\u003cp>This year, \u003ca href=\"http://www.cancer.org/cancer/skincancer-melanoma/detailedguide/melanoma-skin-cancer-key-statistics\">some seventy-three thousand\u003c/a> Americans will be diagnosed with melanoma. The disease kills almost ten thousand of these people.\u003c/p>\n\u003cp>That's why doctors recommend that patients undergo frequent skin checks, especially for those who are prone to developing worrisome moles. Bryce Zaffarano, a 23 year-old physical therapy student in Denver, is one of these people. His first encounter with melanoma was when he was just 16-years-old, when he noticed a dark spot on his chest.\u003c/p>\n\u003cp>“It was concerning,” he says, “but I was like, okay, I’m destined,” — both his mother and uncle had been diagnosed with melanomas, and Zaffarano, like them, had spent most of his childhood in the sun.\u003c/p>\n\u003cfigure id=\"attachment_18234\" class=\"wp-caption alignright\" style=\"max-width: 399px\">\u003cimg class=\" wp-image-18234\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/bryce-750x600.jpg\" alt=\"ryce Zaffarano, a high-risk melanoma patient, still enjoys outdoor activities, like triathlons.\" width=\"399\" height=\"319\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/bryce-750x600.jpg 750w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/bryce-400x320.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/bryce-960x768.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/bryce.jpg 1000w\" sizes=\"(max-width: 399px) 100vw, 399px\">\u003cfigcaption class=\"wp-caption-text\">Bryce Zaffarano, a high-risk melanoma patient, still enjoys outdoor activities like triathlons. \u003ccite>(Jorts Photography/Craig Ricke)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The doctors removed his mole right away, catching it early enough. Now, Zaffarano visits the dermatologist every three months for an all-over body check, an appointment he has kept faithfully for the past seven years. He’s already had one more scare he was glad the doctors spotted right away: another melanoma, this time on his lower back.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But those who don't have an existing relationship with a dermatologist may face challenges booking an appointment. The average wait-time for a dermatologist across the country is over four weeks, up from just three weeks in 2009. \u003ca href=\"http://www.merritthawkins.com/uploadedFiles/MerrittHawkings/Surveys/mha2014waitsurvPDF.pdf\">In some cities, like Boston, the average wait is three months. \u003c/a>\u003c/p>\n\u003cp>Now, some companies are trying to capitalize on impatient patients, offering a fast-paced alternative to old-fashioned doctors: smartphones. Why wait months for an hour-long dermatologist appointment, if an app can do the job?\u003c/p>\n\u003cp>\u003cstrong>Missing the Obvious \u003c/strong>\u003c/p>\n\u003cp>There are 39 mobile applications for Apple and Android platforms currently on the market that claim to diagnose or screen for melanoma using images of moles you take with your phone. Some use automated analysis of the photos, similar to popular apps like LeafSnap or MealSnap that use computer vision to identify plant species or food calories. Others claim photos are analyzed by licensed dermatologists.\u003c/p>\n\u003cp>Snapping photos of concerning spots and getting instant feedback may sound convenient but doctors warn about over-reliance on these apps. Laura Ferris, a dermatologist at the University of Pittsburgh, said she had heard of these dermatologist-impersonating apps, but didn’t think many people were actually using them -- until patients starting asking questions.\u003c/p>\n\u003cp>Ferris and two of her students decided to see if the apps worked. They tested four of the most popular apps on the market for accuracy using 188 images of skin lesions, of which 60 were melanomas, and asked the apps to diagnose them as benign or malignant. The results were troubling: three out of four of the apps misclassified 30 percent or more of melanomas as benign. The fourth app, which relied on a dermatologist analyzing the photos, was more accurate, but it cost $5 per lesion evaluated.\u003c/p>\n\u003cp>These photos were “very obvious melanomas,” Ferris says, but the team found that the computer couldn't recognize them.\u003c/p>\n\u003cp>Ferris says the inaccuracy of these apps is especially dangerous for people who feel they can’t afford the time and money to visit to the dermatologist. An incorrect diagnosis via an app would be dangerous for patients who need to get in to the doctor quickly.\u003c/p>\n\u003cp>In more recent years, other studies have questioned the legitimacy of mobile dermatology apps. A review \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/bjd.13665/full\">published last month in the British Journal of Dermatology\u003c/a> found that melanoma detection apps have potential but are largely inaccurate. The majority not been vetted by dermatologists, and make false promises.\u003c/p>\n\u003cp>“No tool is perfect [and] no drug is perfect. But people need to be able to make informed decisions,” Ferris says. “[These apps] need to have data to backup the claims that they’re making.” Right now, there's no watchdog organization that can prove to both doctors and patients that this data is accurate.\u003c/p>\n\u003cp>\u003cb>Wanted: A Mobile Health Watchdog \u003c/b>\u003c/p>\n\u003cp>This lack of clinical evidence is not unique to the so-called melanoma-detection apps. \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3875901/\">A 2013 paper in the Journal of Medical Internet Research\u003c/a> found that of the approximately 295 cancer-focused (prevention, education, or diagnostic) apps on the market, very few had been evaluated by medical professionals. Likewise, a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22646729\">2012 paper on colorectal smartphone apps\u003c/a> found that nearly all the available apps lacked scientific or medical input.\u003c/p>\n\u003cp>The problem is that many health apps don’t have any more restrictions than dating or gaming apps. The FDA only regulates mobile apps that attach to a medical device, or that transform a mobile phone into a medical device.\u003c/p>\n\u003cp>The Federal Trade Commission has taken a more active role than the FDA in policing melanoma-finding smartphone apps. \u003ca href=\"https://www.ftc.gov/system/files/documents/cases/complaint.pdf\">In February of this year, it challenged two companies,\u003c/a> MelApp and Mole Detective, for making false advertising that they could diagnose melanoma accurately. The claim with MelApp was just settled in April, and and the company was fined over $17,000.\u003c/p>\n\u003cp>\u003ca href=\"http://www.reuters.com/article/2014/06/10/mobilephone-healthcare-idUSL1N0OG2JO20140610\">For now, it's largely up to consumers\u003c/a> to decide whether an app developer can be trusted. Ferris warns that it's not enough to give these apps a stamp of approval just because they appear in the App Store.\u003c/p>\n\u003cp>\u003cstrong>A Tool for the Future?\u003c/strong>\u003c/p>\n\u003cp>The skeptical reception from dermatologists and researchers like Ferris doesn’t seem to have deterred app developers.\u003c/p>\n\u003caside class=\"pullquote alignright\">“[These apps] have to have data to backup the claims that they’re making.\"\u003cbr>\n\u003ccite>Laura Ferris, a dermatologist at the University of Pittsburgh\u003c/cite>\u003c/aside>\n\u003cp>Professor Xiaojing Yuan, who studies computer vision in the engineering department at the University of Houston, is in the process of commercializing a fully-automated smartphone tool she’s developed to detect melanoma.\u003c/p>\n\u003cp>Yuan stresses that the app is a screening tool that informs patients whether or not they should worry about a mole -- and isn't intended to replace a doctor. “Diagnosis is a strong word,” she says.\u003c/p>\n\u003cp>But the tool is intended to help patients decide whether or not to visit the dermatologist, which is exactly the decision Ferris is worried about.\u003c/p>\n\u003cp>Yuan admits there are several challenges to using computer vision technology to screen for skin conditions: Melanomas can vary a lot, and the difference between healthy skin and cancerous tissue can be hard even for dermatologists to determine. Moreover, Yuan has to contend with the relative poor quality of smartphone photos as compared to those taken in a doctor’s office.\u003c/p>\n\u003cp>Challenges aside, Yuan claims her tool performs much better than those currently on the market — but she would never recommend that it replace dermatologists altogether. Not yet, at least.\u003c/p>\n\u003cp>\u003cstrong>Establishing a Connection\u003c/strong>\u003c/p>\n\u003cp>And although she’s skeptical of many of the apps she’s tested, Ferris is still excited about the potential of using technology in her practice.\u003c/p>\n\u003cp>She’s especially interested in the emerging field of \"telemedicine\" companies that use smartphones to connect dermatologists to patients in remote areas. Some of the other doctors in her practice are currently testing out telemedicine products.\u003c/p>\n\u003cp>What's most important for Ferris is establishing a real connection between a human doctor and patient -- both in the diagnosis and in the follow-up. This rings true for Zaffarano.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“When there have been problems, they [dermatologists] have taken immediate action,” he said. It’s inconvenient to spend 45 minutes naked in the doctor’s office every three months, but he’s too skeptical of these smartphone apps to trust them with his life.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "A Scientist Deploys Light and Sound to Reveal the Brain",
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"content": "\u003cp>Lihong Wang creates the sort of medical technology you'd expect to find on the starship Enterprise.\u003c/p>\n\u003cp>Wang, a professor of biomedical engineering at Washington University in St. Louis, has already helped develop instruments that can detect individual cancer cells in the bloodstream and oxygen consumption deep within the body. He has also created a camera that shoots at 100 billion frames a second, fast enough to freeze an object traveling at the speed of light.\u003c/p>\n\u003cp>\"It's really about turning some of these ideas that we thought were science fiction into fact,\" says \u003ca href=\"http://www.nibib.nih.gov/about-nibib/staff/richard-conroy\">Richard Conroy\u003c/a>, who directs the Division of Applied Science & Technology at the National Institute of Biomedical Imaging and Bioengineering.\u003c/p>\n\u003cp>Wang's ultimate goal is to use a combination of light and sound to solve the mysteries of the human brain. The brain is a \"magical black box we still don't understand,\" he says.\u003c/p>\n\u003cp>Wang describes himself as a toolmaker. And when President Obama unveiled his \u003ca href=\"http://www.npr.org/sections/health-shots/2013/04/02/176060875/obama-s-brain-map-plan-a-most-audacious-project\">BRAIN initiative\u003c/a> a couple of years ago to accelerate efforts to understand how we think and learn and remember, Wang realized that brain researchers really needed a tool he'd been working on for years.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"We want to conquer the brain,\" \u003ca href=\"http://bme.wustl.edu/people/Pages/faculty-bio.aspx?faculty=19\">Wang\u003c/a> says. \"But even for a mouse brain, which is only a few millimeters thick, we really don't have a technique that allows us to see throughout the whole brain.\"\u003c/p>\n\u003cp>Current brain-imaging techniques such as functional MRI or PET scans all have drawbacks. They're slow, or not sharp enough, or they can only see things near the surface.\u003c/p>\n\u003cp>So Wang has been developing another approach, one he believes will be fast enough to monitor brain activity in real time and sharp enough to reveal an individual brain cell.\u003c/p>\n\u003cp>Wang's initial idea was to use light. There was a problem, though — one that's obvious if you hold your hand up to a light bulb. When light enters the body, it starts bouncing around.\u003c/p>\n\u003cfigure id=\"attachment_18556\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-18556\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/laser-1_custom-fc17ee201db1c2ba9294b981d9ef20d7556924d7-s800-c85-800x533.jpg\" alt=\"A nanosecond pulsed laser beam starts the photoacoustic imaging process.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/laser-1_custom-fc17ee201db1c2ba9294b981d9ef20d7556924d7-s800-c85.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/laser-1_custom-fc17ee201db1c2ba9294b981d9ef20d7556924d7-s800-c85-400x267.jpg 400w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A nanosecond pulsed laser beam starts the photoacoustic imaging process. \u003ccite>(Geoff Story/Courtesy of Washington University in St. Louis)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"This is why we can't even see our own bone in the hands,\" Wang says. \"Because light, after, like, a millimeter, it becomes hopeless to get a very good sharp image.\"\u003c/p>\n\u003cp>Wang thought he had a solution. It involved sound. Sound waves don't bounce around much in the body, which is why an ultrasound can show a growing fetus.\u003c/p>\n\u003cp>But ultrasound images are blurry, sometimes so blurry it's hard to tell a boy from a girl. So Wang began experimenting with a technique that blends the speed and precision of light with the penetrating ability of sound. It's called photoacoustic imaging.\u003c/p>\n\u003cp>\"We're combining the strengths of two forms of energy, light and sound, in a single form of imaging,\" Wang says.\u003c/p>\n\u003cp>In the past few years, photoacoustic imaging has become a very big deal in the scientific world. And so has Wang.\u003c/p>\n\u003cp>Last year, he published more than 50 scientific papers. So far his research has attracted nearly $50 million in grant funding. And Caltech was impressed enough to lure him away from Washington University. His lab will be moved from St. Louis to Pasadena over the next year.\u003c/p>\n\u003cp>In the meantime, Wang seems to be everywhere, delivering speeches, leading meetings and sitting on scientific advisory boards. \"It's really nonstop, right? You have to sleep, but then, other than that, you try to work all the time,\" he says.\u003c/p>\n\u003cp>Wang has so many projects going that his lab now has teams working on four different floors of one research building at Washington University.\u003c/p>\n\u003cp>One of those projects is Wang's latest photoacoustic microscope, which occupies much of a metal workbench the size of a pingpong table. Jinyang Liang, a postdoc, shows me how the device turns light into sound and sound into images of a living brain.\u003c/p>\n\u003cp>\"So that big guy, metal box there, is a laser,\" Liang tells me. During an experiment, the laser generates pulses of light that travel through a maze of mirrors and filters before reaching an anesthetized mouse on the other side of the table.\u003c/p>\n\u003cp>Once the pulses of light enter the mouse's skull and brain, they start to bounce around. But enough light energy gets through to cause molecules of brain tissue to vibrate. And those vibrations produce distinctive sound waves.\u003c/p>\n\u003cp>So light goes into the brain, and sounds come out. And just a few months ago, those sounds allowed a lab team to create high-speed, highly detailed, three-dimensional images of a mouse brain at work. \"When I first saw that, I was amazed,\" Liang says.\u003c/p>\n\u003cp>So was Richard Conroy at the National Institute of Biomedical Imaging and Bioengineering. He says he's often amazed by Wang, who has been funded by the institute for more than a decade.\u003c/p>\n\u003cp>\"He's one of these unique people who's able to take technologies and ideas from one field and apply them to a different field,\" Conroy says. \"So, for example, his work trying to target light at individual cells within the body — that's really borrowing ideas from astronomy.\"\u003c/p>\n\u003cp>Photoacoustic imaging can do more than reveal the brain, Conroy says. Wang's lab has helped develop systems that use the technique to show tumors of the breast and skin, and even detect individual cancer cells in the bloodstream.\u003c/p>\n\u003cp>And Conroy says that's just the beginning. \"It's research that really pushes the limits of our understanding of how to image in space and time,\" he says.\u003c/p>\n\u003cp>And that could eventually lead to devices as futuristic as the medical tricorder on the starship Enterprise, Conroy says. \"It would be great to have a device like they had in \u003cem>Star Trek\u003c/em>. You could just lie there, the beam of light would pass over you, it would be able to tell everything that was wrong with you.\"\u003c/p>\n\u003cp>Photoacoustic imaging can't do that yet. It still hasn't been used on a human brain. But Wang says he follows a simple rule in his lab: \"Never say impossible.\"\u003c/p>\n\u003cp>And for Wang, that approach seems to work. A couple of years ago, he got some very special funding from the National Institutes of Health. \"This is a grant that gives you unbridled funds for you to do anything you see fit, essentially,\" he says. \"So we were really emboldened to explore very new directions.\"\u003c/p>\n\u003cp>One of those directions involved a camera. The goal was to build the fastest camera ever — a camera so fast it could take pictures of light itself.\u003c/p>\n\u003cp>Wang picked a small team that included Jinyang Liang, an expert in optics. \"We thought, man, I mean, it sounds crazy, but can we see the propagation of light? Because that's literally the fastest object in the universe,\" Liang says.\u003c/p>\n\u003cp>Wang suggested an approach to achieve this seemingly impossible feat. And about six months later, the team was showing their boss the first movie ever of a pulse of light reflecting off a mirror.\u003c/p>\n\u003cp>\"At the moment, I feel like he is speechless because, you know, no one has ever seen this before,\" Liang says.\u003c/p>\n\u003cp>Wang recalls being awed, but not exactly surprised. \"Science really has no limit, you know,\" he says. \"The minute that you reach one limit, you are trying to break it, trying to reach the next limit.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>And for Wang, that next limit lies somewhere inside the black box that is the human brain.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+Scientist+Deploys+Light+And+Sound+To+Reveal+The+Brain&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/div>\n\n",
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"excerpt": "Try to look inside the brain, and you're not going to get very far. But photoacoustic imaging may be a solution for the shortcomings of conventional imaging. It uses lasers to make the brain sing.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Lihong Wang creates the sort of medical technology you'd expect to find on the starship Enterprise.\u003c/p>\n\u003cp>Wang, a professor of biomedical engineering at Washington University in St. Louis, has already helped develop instruments that can detect individual cancer cells in the bloodstream and oxygen consumption deep within the body. He has also created a camera that shoots at 100 billion frames a second, fast enough to freeze an object traveling at the speed of light.\u003c/p>\n\u003cp>\"It's really about turning some of these ideas that we thought were science fiction into fact,\" says \u003ca href=\"http://www.nibib.nih.gov/about-nibib/staff/richard-conroy\">Richard Conroy\u003c/a>, who directs the Division of Applied Science & Technology at the National Institute of Biomedical Imaging and Bioengineering.\u003c/p>\n\u003cp>Wang's ultimate goal is to use a combination of light and sound to solve the mysteries of the human brain. The brain is a \"magical black box we still don't understand,\" he says.\u003c/p>\n\u003cp>Wang describes himself as a toolmaker. And when President Obama unveiled his \u003ca href=\"http://www.npr.org/sections/health-shots/2013/04/02/176060875/obama-s-brain-map-plan-a-most-audacious-project\">BRAIN initiative\u003c/a> a couple of years ago to accelerate efforts to understand how we think and learn and remember, Wang realized that brain researchers really needed a tool he'd been working on for years.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We want to conquer the brain,\" \u003ca href=\"http://bme.wustl.edu/people/Pages/faculty-bio.aspx?faculty=19\">Wang\u003c/a> says. \"But even for a mouse brain, which is only a few millimeters thick, we really don't have a technique that allows us to see throughout the whole brain.\"\u003c/p>\n\u003cp>Current brain-imaging techniques such as functional MRI or PET scans all have drawbacks. They're slow, or not sharp enough, or they can only see things near the surface.\u003c/p>\n\u003cp>So Wang has been developing another approach, one he believes will be fast enough to monitor brain activity in real time and sharp enough to reveal an individual brain cell.\u003c/p>\n\u003cp>Wang's initial idea was to use light. There was a problem, though — one that's obvious if you hold your hand up to a light bulb. When light enters the body, it starts bouncing around.\u003c/p>\n\u003cfigure id=\"attachment_18556\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-18556\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/laser-1_custom-fc17ee201db1c2ba9294b981d9ef20d7556924d7-s800-c85-800x533.jpg\" alt=\"A nanosecond pulsed laser beam starts the photoacoustic imaging process.\" width=\"800\" height=\"533\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/laser-1_custom-fc17ee201db1c2ba9294b981d9ef20d7556924d7-s800-c85.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/laser-1_custom-fc17ee201db1c2ba9294b981d9ef20d7556924d7-s800-c85-400x267.jpg 400w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A nanosecond pulsed laser beam starts the photoacoustic imaging process. \u003ccite>(Geoff Story/Courtesy of Washington University in St. Louis)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"This is why we can't even see our own bone in the hands,\" Wang says. \"Because light, after, like, a millimeter, it becomes hopeless to get a very good sharp image.\"\u003c/p>\n\u003cp>Wang thought he had a solution. It involved sound. Sound waves don't bounce around much in the body, which is why an ultrasound can show a growing fetus.\u003c/p>\n\u003cp>But ultrasound images are blurry, sometimes so blurry it's hard to tell a boy from a girl. So Wang began experimenting with a technique that blends the speed and precision of light with the penetrating ability of sound. It's called photoacoustic imaging.\u003c/p>\n\u003cp>\"We're combining the strengths of two forms of energy, light and sound, in a single form of imaging,\" Wang says.\u003c/p>\n\u003cp>In the past few years, photoacoustic imaging has become a very big deal in the scientific world. And so has Wang.\u003c/p>\n\u003cp>Last year, he published more than 50 scientific papers. So far his research has attracted nearly $50 million in grant funding. And Caltech was impressed enough to lure him away from Washington University. His lab will be moved from St. Louis to Pasadena over the next year.\u003c/p>\n\u003cp>In the meantime, Wang seems to be everywhere, delivering speeches, leading meetings and sitting on scientific advisory boards. \"It's really nonstop, right? You have to sleep, but then, other than that, you try to work all the time,\" he says.\u003c/p>\n\u003cp>Wang has so many projects going that his lab now has teams working on four different floors of one research building at Washington University.\u003c/p>\n\u003cp>One of those projects is Wang's latest photoacoustic microscope, which occupies much of a metal workbench the size of a pingpong table. Jinyang Liang, a postdoc, shows me how the device turns light into sound and sound into images of a living brain.\u003c/p>\n\u003cp>\"So that big guy, metal box there, is a laser,\" Liang tells me. During an experiment, the laser generates pulses of light that travel through a maze of mirrors and filters before reaching an anesthetized mouse on the other side of the table.\u003c/p>\n\u003cp>Once the pulses of light enter the mouse's skull and brain, they start to bounce around. But enough light energy gets through to cause molecules of brain tissue to vibrate. And those vibrations produce distinctive sound waves.\u003c/p>\n\u003cp>So light goes into the brain, and sounds come out. And just a few months ago, those sounds allowed a lab team to create high-speed, highly detailed, three-dimensional images of a mouse brain at work. \"When I first saw that, I was amazed,\" Liang says.\u003c/p>\n\u003cp>So was Richard Conroy at the National Institute of Biomedical Imaging and Bioengineering. He says he's often amazed by Wang, who has been funded by the institute for more than a decade.\u003c/p>\n\u003cp>\"He's one of these unique people who's able to take technologies and ideas from one field and apply them to a different field,\" Conroy says. \"So, for example, his work trying to target light at individual cells within the body — that's really borrowing ideas from astronomy.\"\u003c/p>\n\u003cp>Photoacoustic imaging can do more than reveal the brain, Conroy says. Wang's lab has helped develop systems that use the technique to show tumors of the breast and skin, and even detect individual cancer cells in the bloodstream.\u003c/p>\n\u003cp>And Conroy says that's just the beginning. \"It's research that really pushes the limits of our understanding of how to image in space and time,\" he says.\u003c/p>\n\u003cp>And that could eventually lead to devices as futuristic as the medical tricorder on the starship Enterprise, Conroy says. \"It would be great to have a device like they had in \u003cem>Star Trek\u003c/em>. You could just lie there, the beam of light would pass over you, it would be able to tell everything that was wrong with you.\"\u003c/p>\n\u003cp>Photoacoustic imaging can't do that yet. It still hasn't been used on a human brain. But Wang says he follows a simple rule in his lab: \"Never say impossible.\"\u003c/p>\n\u003cp>And for Wang, that approach seems to work. A couple of years ago, he got some very special funding from the National Institutes of Health. \"This is a grant that gives you unbridled funds for you to do anything you see fit, essentially,\" he says. \"So we were really emboldened to explore very new directions.\"\u003c/p>\n\u003cp>One of those directions involved a camera. The goal was to build the fastest camera ever — a camera so fast it could take pictures of light itself.\u003c/p>\n\u003cp>Wang picked a small team that included Jinyang Liang, an expert in optics. \"We thought, man, I mean, it sounds crazy, but can we see the propagation of light? Because that's literally the fastest object in the universe,\" Liang says.\u003c/p>\n\u003cp>Wang suggested an approach to achieve this seemingly impossible feat. And about six months later, the team was showing their boss the first movie ever of a pulse of light reflecting off a mirror.\u003c/p>\n\u003cp>\"At the moment, I feel like he is speechless because, you know, no one has ever seen this before,\" Liang says.\u003c/p>\n\u003cp>Wang recalls being awed, but not exactly surprised. \"Science really has no limit, you know,\" he says. \"The minute that you reach one limit, you are trying to break it, trying to reach the next limit.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>And for Wang, that next limit lies somewhere inside the black box that is the human brain.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+Scientist+Deploys+Light+And+Sound+To+Reveal+The+Brain&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Doctors around the world who want to be at the forefront of medicine have many more tools today than they had 20 years ago. Technology and research have come a long way, and primary care is a testing ground for innovative models that embrace these advancements.\u003c/p>\n\u003cp>While many doctors still practice medicine in an analog world, others are grabbing hold of digital tools to empower their patients and improve human health. These avant-garde clinicians are challenging the assumptions of their predecessors, and bringing medicine into the 21st century.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"We are moving toward a world where it is not your doctor's job to 'fix' you.\"\u003ccite>Dr. Robin Berzin, Parsley Health\u003c/cite>\u003c/aside>\n\u003cp>During the early 1990s, before the Web, mobile, sensor and consumer genomics revolutions made today’s era of digital health advancements possible, “sick care” was at its zenith. For decades, much of the focus of healthcare has emphasized the reactive treatment of acute ailments instead of the proactive focus on wellness. Communication between patients and their providers at this time didn’t have the connected devices and smart tools available today.\u003c/p>\n\u003cp>Moreover, the process of care delivery (especially in the West) is based on a fragmented system of providers who often don’t collaborate or have access to data to give them an integrated understanding of each patient’s whole-health continuum.\u003c/p>\n\u003cfigure id=\"attachment_17006\" class=\"wp-caption alignleft\" style=\"max-width: 399px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Patient-using-MedTep-platform.jpg\">\u003cimg class=\" wp-image-17006\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Patient-using-MedTep-platform-800x600.jpg\" alt=\"Patients can use the MedTep engagement platform in Spanish and English.\" width=\"399\" height=\"299\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/Patient-using-MedTep-platform-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Patient-using-MedTep-platform-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Patient-using-MedTep-platform-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Patient-using-MedTep-platform-1400x1050.jpg 1400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Patient-using-MedTep-platform-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Patient-using-MedTep-platform.jpg 1920w\" sizes=\"(max-width: 399px) 100vw, 399px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Patients can use the MedTep engagement platform in Spanish and English. \u003ccite>(MedTep)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In recent years, research on genomics, the microbiome, brain science and the immune system has changed our understanding of human biology. The quantified-self movement taught us how minute changes in diet or daily activity over time can have lasting impacts—both on gross biology (such as liver or cardiac health) and also on more subtle predictors of health (such as immune health and microbiome activity). And new communications platforms are making it possible to connect the dots, not only between patient and clinician, but also between all those involved in the process of providing care.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Today, many doctors are rethinking this fragmented approach to caring for their patients by combining advanced technology and diagnostic platforms, an integrated philosophy and a holistic approach that focuses much more on lifestyle development. Most significantly, the patient is a key player in driving the process. Dr. Robin Berzin, founder of \u003ca href=\"http://parsleyhealth.co/\">Parsley Health\u003c/a>, is one of these pioneering practitioners.\u003c/p>\n\u003cp>“We are moving toward a world where it is not your doctor’s job to ‘fix’ you,” Berzin said. “Instead, doctors and patients are coming together to generate health rather than treat illness.”\u003c/p>\n\u003cfigure id=\"attachment_17007\" class=\"wp-caption alignright\" style=\"max-width: 461px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/image1.jpg\">\u003cimg class=\" wp-image-17007\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/image1-800x450.jpg\" alt=\"Unity Stoakes interviews Dr. Douglas Wood, Medical Director of the Mayo Clinic Center for Innovation, about the future of healthcare.\" width=\"461\" height=\"259\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/image1-800x450.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/image1-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/image1-960x541.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/image1.jpg 1023w\" sizes=\"(max-width: 461px) 100vw, 461px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Unity Stoakes interviews Dr. Douglas Wood, Medical Director of the Mayo Clinic Center for Innovation, about the future of healthcare. \u003ccite>(StartUp Health)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>At \u003ca href=\"http://www.startuphealth.com/\">StartUp Health\u003c/a>, a global network fostering innovation in digital health, I’ve had the opportunity to meet hundreds of bright minds like Dr. Berzin, who are thinking differently about the practice of medicine. I have identified five practices clinicians should be pursuing to keep pace with today’s innovations, and that patients should be demanding from their doctors:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Digital Integration\u003c/strong>\u003c/li>\n\u003cp>Today, streams of data are swirling around us. There’s data streaming from your FitBit or Apple Watch, there are notes from your recent doctor’s visit, and there are past medical records. But too few doctors are integrating this data and helping you access it. Forward-thinking doctors are not only making it simpler for you to get your data but also interacting with patients through online “platforms,” or patient portals. These shouldn’t be complicated electronic health records; the best platforms are as intuitive as your mobile banking app. They allow patients to track their medical records and communicate with their doctor through secure email or chat. Keeping all this information in one place helps patients take control over their data and, more importantly, spot important personal health trends.\u003c/p>\n\u003cli>\u003cstrong>Analyzing More Data, Not Less\u003c/strong>\u003c/li>\n\u003cp>Unfortunately, many doctors still shun the idea that more data is better—often for logical reasons like the rate of false-positives, the cost of diagnostics or their lack of knowledge about how the data could be useful. These providers may be wary of genetic testing, for example, because the information may cause unnecessary stress. They may be cautious about quantifying the microbiome because the analytics systems have not been perfected. But costs are coming down rapidly for new types of diagnostics, and analytics are quickly becoming elegant enough to weed out the false alarms and spot patterns in the chaos. Many people find that knowing about a genetic marker or a certain biometric pattern can help them better understand their health.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Functional Medicine \u003c/strong>\u003c/li>\n\u003cp>The concept of “functional medicine” is something Dr. Berzin is executing with her health services at Parsley Health. It’s the simple idea that doctors should be focused on disease prevention rather than triaging patients after they have already become ill. This concept is not just a grassroots movement. Cleveland Clinic, one of the nation’s largest healthcare and research centers, recently founded a \u003ca href=\"http://my.clevelandclinic.org/services/center-for-functional-medicine\">Center for Functional Medicine\u003c/a>. And \u003ca href=\"https://www.functionalmedicine.org/files/library/evidence.pdf\">Research shows\u003c/a> people live longer, healthier lives when they integrate meditation, exercise and proper diet—not just take medications. The best practitioners are treating you holistically, as your doctor and your life coach, helping you achieve all health goals, whether they're traditionally “medical,” or fall under the purview of emotional and lifestyle support.\u003c/p>\n\u003cli>\u003cstrong>Care Anywhere\u003c/strong>\u003c/li>\n\u003cp>Most of your health happens outside the hospital, as you’re living life. Tragically, a patient’s first experience with the healthcare system is usually after it’s too late—after a stroke, hypoglycemic attack or late-stage cancer, for example. “We need to shift the focus of care out of the hospital and into the community,” Dr. Berzin says. A savvy doctor should be able to bring care into your home, instead of making you trek to a hospital or clinic. Sometimes, they can do this via telemedicine solutions like video conferencing. Harkening back to the mid-19th century, a new brand of doctors is out making house calls. A company called \u003ca href=\"https://www.medicast.com/\">Medicast\u003c/a> is helping doctors and hospitals coordinate the logistics of house visits. Companies like \u003ca href=\"http://carepredict.com/\">CarePredict\u003c/a> and \u003ca href=\"http://www.mylively.com/\">Lively\u003c/a> are developing devices that can track patients’ health in the home. \u003cem>(Disclaimer: Medicast and CarePredict are StartUp Health portfolio companies.)\u003c/em>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Team-Based Care\u003c/strong>\u003c/li>\n\u003cp>Your doctor shouldn’t be the only person directly involved in your care. Instead, you could have an entire team of experts, including patient advocates, nurses, wellness coaches, chiropractors, acupuncturists, nutritionist, lifestyle coaches and financial advisors. Instead of bombarding you with advice separately, this team comes together to craft a care plan that’s specifically suited to you. Most importantly YOU should be the key member of the team. Team-based care is not a new concept. In fact, the World Health Organization and the Institutes of Medicine both emphasize team-based care \u003ca href=\"http://www.ihi.org/communities/blogs/_layouts/ihi/community/blog/itemview.aspx?List=0f316db6-7f8a-430f-a63a-ed7602d1366a&ID=29\">in their recommendations for primary care doctors\u003c/a>. Yet realistically speaking, the practical execution of team-based care at scale is only recently becoming possible, as a result of new digital solutions, and data and communications platforms connecting everyone involved.\n\u003c/p>\u003c/ul>\n\u003cp>\u003cem>Unity Stoakes is cofounder and president of StartUp Health, a health innovation company with more than 100 digital health and wellness companies in its portfolio. Learn more at \u003ca href=\"http://www.startuphealth.com/\">www.startuphealth.com\u003c/a> or @startuphealth.\u003c/em>\u003c/p>\n\u003c/ul>\u003c/ul>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Doctors around the world who want to be at the forefront of medicine have many more tools today than they had 20 years ago. Technology and research have come a long way, and primary care is a testing ground for innovative models that embrace these advancements.\u003c/p>\n\u003cp>While many doctors still practice medicine in an analog world, others are grabbing hold of digital tools to empower their patients and improve human health. These avant-garde clinicians are challenging the assumptions of their predecessors, and bringing medicine into the 21st century.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"We are moving toward a world where it is not your doctor's job to 'fix' you.\"\u003ccite>Dr. Robin Berzin, Parsley Health\u003c/cite>\u003c/aside>\n\u003cp>During the early 1990s, before the Web, mobile, sensor and consumer genomics revolutions made today’s era of digital health advancements possible, “sick care” was at its zenith. For decades, much of the focus of healthcare has emphasized the reactive treatment of acute ailments instead of the proactive focus on wellness. Communication between patients and their providers at this time didn’t have the connected devices and smart tools available today.\u003c/p>\n\u003cp>Moreover, the process of care delivery (especially in the West) is based on a fragmented system of providers who often don’t collaborate or have access to data to give them an integrated understanding of each patient’s whole-health continuum.\u003c/p>\n\u003cfigure id=\"attachment_17006\" class=\"wp-caption alignleft\" style=\"max-width: 399px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Patient-using-MedTep-platform.jpg\">\u003cimg class=\" wp-image-17006\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Patient-using-MedTep-platform-800x600.jpg\" alt=\"Patients can use the MedTep engagement platform in Spanish and English.\" width=\"399\" height=\"299\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/Patient-using-MedTep-platform-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Patient-using-MedTep-platform-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Patient-using-MedTep-platform-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Patient-using-MedTep-platform-1400x1050.jpg 1400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Patient-using-MedTep-platform-960x720.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Patient-using-MedTep-platform.jpg 1920w\" sizes=\"(max-width: 399px) 100vw, 399px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Patients can use the MedTep engagement platform in Spanish and English. \u003ccite>(MedTep)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In recent years, research on genomics, the microbiome, brain science and the immune system has changed our understanding of human biology. The quantified-self movement taught us how minute changes in diet or daily activity over time can have lasting impacts—both on gross biology (such as liver or cardiac health) and also on more subtle predictors of health (such as immune health and microbiome activity). And new communications platforms are making it possible to connect the dots, not only between patient and clinician, but also between all those involved in the process of providing care.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Today, many doctors are rethinking this fragmented approach to caring for their patients by combining advanced technology and diagnostic platforms, an integrated philosophy and a holistic approach that focuses much more on lifestyle development. Most significantly, the patient is a key player in driving the process. Dr. Robin Berzin, founder of \u003ca href=\"http://parsleyhealth.co/\">Parsley Health\u003c/a>, is one of these pioneering practitioners.\u003c/p>\n\u003cp>“We are moving toward a world where it is not your doctor’s job to ‘fix’ you,” Berzin said. “Instead, doctors and patients are coming together to generate health rather than treat illness.”\u003c/p>\n\u003cfigure id=\"attachment_17007\" class=\"wp-caption alignright\" style=\"max-width: 461px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/image1.jpg\">\u003cimg class=\" wp-image-17007\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/image1-800x450.jpg\" alt=\"Unity Stoakes interviews Dr. Douglas Wood, Medical Director of the Mayo Clinic Center for Innovation, about the future of healthcare.\" width=\"461\" height=\"259\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/image1-800x450.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/image1-400x225.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/image1-960x541.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/image1.jpg 1023w\" sizes=\"(max-width: 461px) 100vw, 461px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Unity Stoakes interviews Dr. Douglas Wood, Medical Director of the Mayo Clinic Center for Innovation, about the future of healthcare. \u003ccite>(StartUp Health)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>At \u003ca href=\"http://www.startuphealth.com/\">StartUp Health\u003c/a>, a global network fostering innovation in digital health, I’ve had the opportunity to meet hundreds of bright minds like Dr. Berzin, who are thinking differently about the practice of medicine. I have identified five practices clinicians should be pursuing to keep pace with today’s innovations, and that patients should be demanding from their doctors:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Digital Integration\u003c/strong>\u003c/li>\n\u003cp>Today, streams of data are swirling around us. There’s data streaming from your FitBit or Apple Watch, there are notes from your recent doctor’s visit, and there are past medical records. But too few doctors are integrating this data and helping you access it. Forward-thinking doctors are not only making it simpler for you to get your data but also interacting with patients through online “platforms,” or patient portals. These shouldn’t be complicated electronic health records; the best platforms are as intuitive as your mobile banking app. They allow patients to track their medical records and communicate with their doctor through secure email or chat. Keeping all this information in one place helps patients take control over their data and, more importantly, spot important personal health trends.\u003c/p>\n\u003cli>\u003cstrong>Analyzing More Data, Not Less\u003c/strong>\u003c/li>\n\u003cp>Unfortunately, many doctors still shun the idea that more data is better—often for logical reasons like the rate of false-positives, the cost of diagnostics or their lack of knowledge about how the data could be useful. These providers may be wary of genetic testing, for example, because the information may cause unnecessary stress. They may be cautious about quantifying the microbiome because the analytics systems have not been perfected. But costs are coming down rapidly for new types of diagnostics, and analytics are quickly becoming elegant enough to weed out the false alarms and spot patterns in the chaos. Many people find that knowing about a genetic marker or a certain biometric pattern can help them better understand their health.\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Functional Medicine \u003c/strong>\u003c/li>\n\u003cp>The concept of “functional medicine” is something Dr. Berzin is executing with her health services at Parsley Health. It’s the simple idea that doctors should be focused on disease prevention rather than triaging patients after they have already become ill. This concept is not just a grassroots movement. Cleveland Clinic, one of the nation’s largest healthcare and research centers, recently founded a \u003ca href=\"http://my.clevelandclinic.org/services/center-for-functional-medicine\">Center for Functional Medicine\u003c/a>. And \u003ca href=\"https://www.functionalmedicine.org/files/library/evidence.pdf\">Research shows\u003c/a> people live longer, healthier lives when they integrate meditation, exercise and proper diet—not just take medications. The best practitioners are treating you holistically, as your doctor and your life coach, helping you achieve all health goals, whether they're traditionally “medical,” or fall under the purview of emotional and lifestyle support.\u003c/p>\n\u003cli>\u003cstrong>Care Anywhere\u003c/strong>\u003c/li>\n\u003cp>Most of your health happens outside the hospital, as you’re living life. Tragically, a patient’s first experience with the healthcare system is usually after it’s too late—after a stroke, hypoglycemic attack or late-stage cancer, for example. “We need to shift the focus of care out of the hospital and into the community,” Dr. Berzin says. A savvy doctor should be able to bring care into your home, instead of making you trek to a hospital or clinic. Sometimes, they can do this via telemedicine solutions like video conferencing. Harkening back to the mid-19th century, a new brand of doctors is out making house calls. A company called \u003ca href=\"https://www.medicast.com/\">Medicast\u003c/a> is helping doctors and hospitals coordinate the logistics of house visits. Companies like \u003ca href=\"http://carepredict.com/\">CarePredict\u003c/a> and \u003ca href=\"http://www.mylively.com/\">Lively\u003c/a> are developing devices that can track patients’ health in the home. \u003cem>(Disclaimer: Medicast and CarePredict are StartUp Health portfolio companies.)\u003c/em>\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>Team-Based Care\u003c/strong>\u003c/li>\n\u003cp>Your doctor shouldn’t be the only person directly involved in your care. Instead, you could have an entire team of experts, including patient advocates, nurses, wellness coaches, chiropractors, acupuncturists, nutritionist, lifestyle coaches and financial advisors. Instead of bombarding you with advice separately, this team comes together to craft a care plan that’s specifically suited to you. Most importantly YOU should be the key member of the team. Team-based care is not a new concept. In fact, the World Health Organization and the Institutes of Medicine both emphasize team-based care \u003ca href=\"http://www.ihi.org/communities/blogs/_layouts/ihi/community/blog/itemview.aspx?List=0f316db6-7f8a-430f-a63a-ed7602d1366a&ID=29\">in their recommendations for primary care doctors\u003c/a>. Yet realistically speaking, the practical execution of team-based care at scale is only recently becoming possible, as a result of new digital solutions, and data and communications platforms connecting everyone involved.\n\u003c/p>\u003c/ul>\n\u003cp>\u003cem>Unity Stoakes is cofounder and president of StartUp Health, a health innovation company with more than 100 digital health and wellness companies in its portfolio. Learn more at \u003ca href=\"http://www.startuphealth.com/\">www.startuphealth.com\u003c/a> or @startuphealth.\u003c/em>\u003c/p>\n\u003c/ul>\u003c/ul>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>There’s new evidence suggesting that women’s brains are especially vulnerable to Alzheimer’s disease and other problems with memory and thinking.\u003c/p>\n\u003cp>Women with mild cognitive impairment, which can lead to Alzheimer’s, tend to decline faster than men, researchers \u003ca href=\"https://www.alz.org/aaic/releases_2015/Tues8amET.asp\">reported\u003c/a> this week at the Alzheimer’s Association International Conference in Washington, D.C.\u003c/p>\n\u003cp>Another study showed that women’s brains tend to contain more amyloid, the substance that forms sticky plaques in Alzheimer’s. And a third study found that women who have surgery with general anesthesia are more likely than men to develop long-term problems with thinking and memory.\u003c/p>\n\u003cp>The studies help explain why women make up two-thirds of all Americans with Alzheimer’s. And the results challenge the notion that more women have Alzheimer’s simply because they tend to outlive men, says \u003ca href=\"http://profiles.ucsf.edu/kristine.yaffe\">Kristine Yaffe\u003c/a> of the University of California, San Francisco.\u003c/p>\n\u003cp>“There’s something else going on in terms of the biology [or] the environment for women,” Yaffe says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The research on women with mild cognitive impairment was part of a large ongoing study called the \u003ca href=\"http://www.adni-info.org/\">Alzheimer’s Disease Neuroimaging Initiative\u003c/a>. Researchers studied up to eight years of records on about 400 men and women in that study who had mild cognitive impairment, a condition that often leads to Alzheimer’s.\u003c/p>\n\u003cp>“We found that women decline at almost twice the rate of men and we also found that women have faster acceleration of decline over time,” says Katherine Amy Lin, part of a team at Duke University Medical Center. So many women who had subtle memory problems at the beginning of the study period had major deficits by the end.\u003c/p>\n\u003cp>Another study presented at the Alzheimer’s meeting used PET scanning to measure levels of amyloid in about 1,000 people, including many with cognitive impairment or Alzheimer’s disease. Amyloid is the substance that forms sticky plaques in the brains of Alzheimer’s patients.\u003c/p>\n\u003cp>There was a clear difference between men and women, regardless of their age, says \u003ca href=\"http://profiles.ucsf.edu/michael.weiner\">Michael Weiner\u003c/a> of UCSF, the study’s senior author. “Overall, women had more amyloid in their brain than men,” he says, which suggests they are at higher risk of developing Alzheimer’s.\u003c/p>\n\u003cp>What’s still not clear, though, is why women’s brain cells are more vulnerable than men’s to Alzheimer’s and other memory problems, Weiner says.\u003c/p>\n\u003cp>One possible explanation is that every cell in a woman’s body carries two X chromosomes, instead of an X and a Y, Weiner says. “But there are other differences,” he says, such as hormones, lifestyle, childbearing, diet, and exercise.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If scientists can figure out the mechanism that causes more Alzheimer’s disease in women, Weiner says, they might be able to develop treatments that halt the process.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Women%27s+Brains+Appear+More+Vulnerable+To+Alzheimer%27s+Than+Men%27s&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>There’s new evidence suggesting that women’s brains are especially vulnerable to Alzheimer’s disease and other problems with memory and thinking.\u003c/p>\n\u003cp>Women with mild cognitive impairment, which can lead to Alzheimer’s, tend to decline faster than men, researchers \u003ca href=\"https://www.alz.org/aaic/releases_2015/Tues8amET.asp\">reported\u003c/a> this week at the Alzheimer’s Association International Conference in Washington, D.C.\u003c/p>\n\u003cp>Another study showed that women’s brains tend to contain more amyloid, the substance that forms sticky plaques in Alzheimer’s. And a third study found that women who have surgery with general anesthesia are more likely than men to develop long-term problems with thinking and memory.\u003c/p>\n\u003cp>The studies help explain why women make up two-thirds of all Americans with Alzheimer’s. And the results challenge the notion that more women have Alzheimer’s simply because they tend to outlive men, says \u003ca href=\"http://profiles.ucsf.edu/kristine.yaffe\">Kristine Yaffe\u003c/a> of the University of California, San Francisco.\u003c/p>\n\u003cp>“There’s something else going on in terms of the biology [or] the environment for women,” Yaffe says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The research on women with mild cognitive impairment was part of a large ongoing study called the \u003ca href=\"http://www.adni-info.org/\">Alzheimer’s Disease Neuroimaging Initiative\u003c/a>. Researchers studied up to eight years of records on about 400 men and women in that study who had mild cognitive impairment, a condition that often leads to Alzheimer’s.\u003c/p>\n\u003cp>“We found that women decline at almost twice the rate of men and we also found that women have faster acceleration of decline over time,” says Katherine Amy Lin, part of a team at Duke University Medical Center. So many women who had subtle memory problems at the beginning of the study period had major deficits by the end.\u003c/p>\n\u003cp>Another study presented at the Alzheimer’s meeting used PET scanning to measure levels of amyloid in about 1,000 people, including many with cognitive impairment or Alzheimer’s disease. Amyloid is the substance that forms sticky plaques in the brains of Alzheimer’s patients.\u003c/p>\n\u003cp>There was a clear difference between men and women, regardless of their age, says \u003ca href=\"http://profiles.ucsf.edu/michael.weiner\">Michael Weiner\u003c/a> of UCSF, the study’s senior author. “Overall, women had more amyloid in their brain than men,” he says, which suggests they are at higher risk of developing Alzheimer’s.\u003c/p>\n\u003cp>What’s still not clear, though, is why women’s brain cells are more vulnerable than men’s to Alzheimer’s and other memory problems, Weiner says.\u003c/p>\n\u003cp>One possible explanation is that every cell in a woman’s body carries two X chromosomes, instead of an X and a Y, Weiner says. “But there are other differences,” he says, such as hormones, lifestyle, childbearing, diet, and exercise.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>If scientists can figure out the mechanism that causes more Alzheimer’s disease in women, Weiner says, they might be able to develop treatments that halt the process.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg decoding=\"async\" src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Women%27s+Brains+Appear+More+Vulnerable+To+Alzheimer%27s+Than+Men%27s&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "For Kids With Tourette's, Online Training Could Help",
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"content": "\u003cp>If you've ever had hiccups in a quiet room, you know how embarrassing and completely uncontrollable they can feel. What if, instead of the hiccups, your body jerked involuntarily or you blurted out words without meaning to? That's a rough idea of what living with \u003ca href=\"http://www.ninds.nih.gov/disorders/tourette/detail_tourette.htm\">Tourette syndrome\u003c/a> can be like.\u003c/p>\n\u003cp>Designers of a new computer program called \u003ca href=\"http://www.tichelper.com/\">TicHelper\u003c/a> hope that they will be able to help children recognize and control these impulses themselves.\u003c/p>\n\u003cp>People with Tourette's perform repetitive movements or vocalizations called \u003ca href=\"http://www.cdc.gov/ncbddd/tourette/facts.html\">tics\u003c/a>. A simple tic might be something like head jerking, eye blinking, or throat clearing, and a complex tic might involve patterns of movement or saying multiple words or phrases.\u003c/p>\n\u003cp>We don't know exactly what causes Tourette's, says \u003ca href=\"http://bit.ly/1TOnGlR\">Douglas Woods\u003c/a>, a psychologist at Texas A&M University. Woods, who is also co-chair of the \u003ca href=\"http://tourette.org/\">Tourette Association of America\u003c/a> Medical Advisory Board, is one of the minds behind TicHelper.\u003c/p>\n\u003cp>Tourette's affects more boys than girls, and symptoms usually start between ages 3-7.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Sometimes kids will grow out of [Tourette's],\" Woods says. But if the wait-and-see approach isn't working, and the tics are interfering with daily life, there are a few treatment options.\u003c/p>\n\u003cp>One option is medication. Woods says there are a few different antipsychotic drugs that are used to manage Tourette syndrome, but they have side effects and don't always work. An alternative to pharmaceutical treatment is behavioral therapy.\u003c/p>\n\u003cp>A form of behavioral therapy called \u003ca href=\"http://www.tsa-usa.org/Medical/CBIT.html\">comprehensive behavioral intervention for tics\u003c/a>, or CBIT for short, is commonly used. CBIT training teaches people with Tourette's to recognize the onset of a tic and to perform a different behavior when they feel one coming on.\u003c/p>\n\u003cp>\"The idea is that when someone has a tic, they tend to have an urge,\" says clinical psychologist \u003ca href=\"http://health.usf.edu/medicine/pediatrics/profile.html?person_id=62245\">Eric Storch\u003c/a>, a professor at the University of South Florida and Clinical Director of Pediatrics at Rogers Memorial Hospital in Tampa. \"It's like when you're about to yawn. You know just before it happens that a yawn's coming. [CBIT] teaches a person to be aware.\"\u003c/p>\n\u003cp>And it gives them the tools to manage tics. Storch describes a patient whose tic was rubbing two fingers together, to the point of rubbing off skin. With CBIT, the boy was able to recognize the onset of a tic and instead unobtrusively press down on his kneecap until the urge went away.\u003c/p>\n\u003cp>A typical CBIT training program involves eight sessions with a therapist, spread over 10 weeks. Results, Woods says, can be maintained up to six months.\u003c/p>\n\u003cp>Both psychologists say that CBIT is at least as effective as medical treatments. The problem is that it requires specially trained therapists — and there aren't that many of them. Which is where TicHelper comes in.\u003c/p>\n\u003cp>\"It's essentially a self-help, self-guided program that leads the patient through a CBIT treatment,\" Woods says. He and his colleagues received funding from the National Institute of Mental Health to develop TicHelper, which is now being tested. So far, the results look promising. \"The kids that go through it, enjoy it,\" Woods says. They're able to do the skills,\"\u003c/p>\n\u003cp>The program has four main sections: tic education, reducing tic triggers, tic awareness and tic blocking. Videos featuring a friendly actress guide patients thorough each section. The program personalizes treatment based on feedback from the patient. Woods says the testing will help the designers modify and improve it based on user feedback. Though TicHelper isn't available yet, interested patients or doctors can sign up to receive updates on its progress.\u003c/p>\n\u003cp>The website currently lists the cost of an 8-week program through TicHelper at $150, but Woods says that the price isn't set.\u003c/p>\n\u003cp>Storch, who is unaffiliated with TicHelper, is enthusiastic about the idea of at-home treatment for tics. \"I really think it's an exciting development that has a lot of practicality,\" he says. \"We know what behavioral treatments work well for tics, but the dissemination is really terrible.\"\u003c/p>\n\u003cp>Storch says the biggest advantage of TicHelper will be its accessibility. CBIT, he says, works well and is incredibly safe compared with pharmaceuticals. TicHelper would maximize the benefits of CBIT by making it more inexpensive and easier to get to than therapy.\u003c/p>\n\u003cp>Which is not to say that Storch or Woods would recommend TicHelper as the only form of tic management. Both psychologists suggest that this program might work best as part of a management plan. One option, Woods says, might be to start treatment with TicHelper at first diagnosis and proceed to more intensive care if in-home treatment isn't working.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Storch thinks that ideally the patient would work with the program, but touch base periodically with an experienced therapist or health care provider to check progress. But, he says, \"we don't have enough providers.\" And some treatment, he says, is better than no treatment at all.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=For+Kids+With+Tourette%27s%2C+At-Home+Training+Could+Help&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you've ever had hiccups in a quiet room, you know how embarrassing and completely uncontrollable they can feel. What if, instead of the hiccups, your body jerked involuntarily or you blurted out words without meaning to? That's a rough idea of what living with \u003ca href=\"http://www.ninds.nih.gov/disorders/tourette/detail_tourette.htm\">Tourette syndrome\u003c/a> can be like.\u003c/p>\n\u003cp>Designers of a new computer program called \u003ca href=\"http://www.tichelper.com/\">TicHelper\u003c/a> hope that they will be able to help children recognize and control these impulses themselves.\u003c/p>\n\u003cp>People with Tourette's perform repetitive movements or vocalizations called \u003ca href=\"http://www.cdc.gov/ncbddd/tourette/facts.html\">tics\u003c/a>. A simple tic might be something like head jerking, eye blinking, or throat clearing, and a complex tic might involve patterns of movement or saying multiple words or phrases.\u003c/p>\n\u003cp>We don't know exactly what causes Tourette's, says \u003ca href=\"http://bit.ly/1TOnGlR\">Douglas Woods\u003c/a>, a psychologist at Texas A&M University. Woods, who is also co-chair of the \u003ca href=\"http://tourette.org/\">Tourette Association of America\u003c/a> Medical Advisory Board, is one of the minds behind TicHelper.\u003c/p>\n\u003cp>Tourette's affects more boys than girls, and symptoms usually start between ages 3-7.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Sometimes kids will grow out of [Tourette's],\" Woods says. But if the wait-and-see approach isn't working, and the tics are interfering with daily life, there are a few treatment options.\u003c/p>\n\u003cp>One option is medication. Woods says there are a few different antipsychotic drugs that are used to manage Tourette syndrome, but they have side effects and don't always work. An alternative to pharmaceutical treatment is behavioral therapy.\u003c/p>\n\u003cp>A form of behavioral therapy called \u003ca href=\"http://www.tsa-usa.org/Medical/CBIT.html\">comprehensive behavioral intervention for tics\u003c/a>, or CBIT for short, is commonly used. CBIT training teaches people with Tourette's to recognize the onset of a tic and to perform a different behavior when they feel one coming on.\u003c/p>\n\u003cp>\"The idea is that when someone has a tic, they tend to have an urge,\" says clinical psychologist \u003ca href=\"http://health.usf.edu/medicine/pediatrics/profile.html?person_id=62245\">Eric Storch\u003c/a>, a professor at the University of South Florida and Clinical Director of Pediatrics at Rogers Memorial Hospital in Tampa. \"It's like when you're about to yawn. You know just before it happens that a yawn's coming. [CBIT] teaches a person to be aware.\"\u003c/p>\n\u003cp>And it gives them the tools to manage tics. Storch describes a patient whose tic was rubbing two fingers together, to the point of rubbing off skin. With CBIT, the boy was able to recognize the onset of a tic and instead unobtrusively press down on his kneecap until the urge went away.\u003c/p>\n\u003cp>A typical CBIT training program involves eight sessions with a therapist, spread over 10 weeks. Results, Woods says, can be maintained up to six months.\u003c/p>\n\u003cp>Both psychologists say that CBIT is at least as effective as medical treatments. The problem is that it requires specially trained therapists — and there aren't that many of them. Which is where TicHelper comes in.\u003c/p>\n\u003cp>\"It's essentially a self-help, self-guided program that leads the patient through a CBIT treatment,\" Woods says. He and his colleagues received funding from the National Institute of Mental Health to develop TicHelper, which is now being tested. So far, the results look promising. \"The kids that go through it, enjoy it,\" Woods says. They're able to do the skills,\"\u003c/p>\n\u003cp>The program has four main sections: tic education, reducing tic triggers, tic awareness and tic blocking. Videos featuring a friendly actress guide patients thorough each section. The program personalizes treatment based on feedback from the patient. Woods says the testing will help the designers modify and improve it based on user feedback. Though TicHelper isn't available yet, interested patients or doctors can sign up to receive updates on its progress.\u003c/p>\n\u003cp>The website currently lists the cost of an 8-week program through TicHelper at $150, but Woods says that the price isn't set.\u003c/p>\n\u003cp>Storch, who is unaffiliated with TicHelper, is enthusiastic about the idea of at-home treatment for tics. \"I really think it's an exciting development that has a lot of practicality,\" he says. \"We know what behavioral treatments work well for tics, but the dissemination is really terrible.\"\u003c/p>\n\u003cp>Storch says the biggest advantage of TicHelper will be its accessibility. CBIT, he says, works well and is incredibly safe compared with pharmaceuticals. TicHelper would maximize the benefits of CBIT by making it more inexpensive and easier to get to than therapy.\u003c/p>\n\u003cp>Which is not to say that Storch or Woods would recommend TicHelper as the only form of tic management. Both psychologists suggest that this program might work best as part of a management plan. One option, Woods says, might be to start treatment with TicHelper at first diagnosis and proceed to more intensive care if in-home treatment isn't working.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Storch thinks that ideally the patient would work with the program, but touch base periodically with an experienced therapist or health care provider to check progress. But, he says, \"we don't have enough providers.\" And some treatment, he says, is better than no treatment at all.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=For+Kids+With+Tourette%27s%2C+At-Home+Training+Could+Help&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>",
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"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": "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.",
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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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"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.",
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"possible": {
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"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.",
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"pri-the-world": {
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"radiolab": {
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"reveal": {
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},
"rightnowish": {
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"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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"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.",
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"soldout": {
"id": "soldout",
"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
"info": "Sold Out: Rethinking Housing in America",
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