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"title": "Monkey Viruses: Predicting Pandemics With Strawberry Jam",
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"content": "\u003cp>In Africa or Asia, monkeys thrive in urban settings. They roam freely in villages and temples. They raid the local food sources, rummage through garbage, and scrounge for any goodies tourists may be keeping in their bags. And in all this activity, they can pass their germs to humans, raising serious health concerns.\u003c/p>\n\u003cp>Tierra Smiley Evans, a graduate student at the University of California, Davis, is implementing a new technique to address viral sharing between humans and primates. She works for a project called \u003ca href=\"http://www.vetmed.ucdavis.edu/ohi/predict/\">PREDICT\u003c/a> that aims to prevent diseases that travel from animals to people. Using only nylon rope and strawberry jam, she has figured out a way to get monkeys to happily offer their spit to be screened for contagious viruses.\u003c/p>\n\u003cp>“This is the first time that saliva has been able to be collected non-invasively from wild primates for virus detection,” Smiley says. “This opens up a lot of doors for sampling primate populations that it has not been feasible to sample in the past.”\u003c/p>\n\u003cfigure id=\"attachment_99788\" class=\"wp-caption alignright\" style=\"max-width: 367px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/journal.pntd_.0003813.g003.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-99788\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/journal.pntd_.0003813.g003.png\" alt=\"Red-tailed guenon in Bwindi Impenetrable Forest, Uganda. (T. Smiley Evans/UC Davis)\" width=\"367\" height=\"550\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Red-tailed guenon in Bwindi Impenetrable Forest, Uganda. \u003ccite>( T. Smiley Evans/U.C. Davis)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Smiley tried a similar technique for the first time in 2007, with captive mountain gorillas in Rwanda. But she couldn’t test the technique with wild gorillas because of strict laws against distributing man-made devices (like ropes) to endangered primate species.\u003c/p>\n\u003cp>“I could see then, however, that it could have very useful applications with other types of primates,” she says, “in particular those that are living in close proximity to humans and are already behaviorally accustomed to foraging among garbage and other human materials.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Older methods of collecting samples from monkeys are not very efficient and require anesthetization. Techniques such as drawing blood or using oral swabs put both the monkeys and the handlers at bodily risk. To complicate matters, the monkeys’ innate intelligence enables them to evade capture when threatened. For a long time now, there has been a need for a better way to safely screen these animals for the harmful pathogens they may carry.\u003c/p>\n\u003cp>\u003cstrong>How Do Viruses Get From Monkeys to Humans?\u003c/strong>\u003c/p>\n\u003cp>Between 1940 and 2004, \u003ca href=\"http://www.vetmed.ucdavis.edu/ohi/local_resources/pdfs/chapters/3_predict_introduction.pdf\">greater than 70 percent\u003c/a> of emerging zoonotic diseases in humans originated in wild animals. And, over time, the incidence of emerging infectious diseases caused by wildlife pathogens has increased.\u003c/p>\n\u003cfigure id=\"attachment_103186\" class=\"wp-caption alignleft\" style=\"max-width: 364px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/Rhesus-macaque.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-103186\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/Rhesus-macaque.png\" alt=\"Rhesus macaque in Kathmandu Nepal's Thapatali temple complex. (T. Smiley Evans/UC Davis)\" width=\"364\" height=\"518\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Rhesus-macaque.png 983w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Rhesus-macaque-400x569.png 400w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Rhesus-macaque-800x1138.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Rhesus-macaque-960x1365.png 960w\" sizes=\"(max-width: 364px) 100vw, 364px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rhesus macaques in Kathmandu, Nepal’s Thapathali temple complex. \u003ccite>( T. Smiley Evans/U.C. Davis)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Some pathogens, such as \u003ca href=\"http://www.cdc.gov/herpesbvirus/\">herpes B\u003c/a>, are ubiquitous among certain species of primates and can be contracted by humans through direct contact with saliva–most commonly, through a monkey bite. But a virus can only be passed to humans if the monkey is actively shedding a contagion in their oral cavity. To put it simply, someone bit by a monkey infected with herpes B would not contract the virus if it wasn’t present in the monkey’s mouth during the transgression.\u003c/p>\n\u003cp>Other viruses, like \u003ca href=\"http://www.cdc.gov/yellowfever/transmission/\">yellow fever\u003c/a>, can be passed indirectly among human and non-human primates through mosquito bites.\u003c/p>\n\u003cp>The new, non-invasive technique for screening wild primates is now being established as part of a global plan to keep pandemic diseases at bay. Last year, \u003ca href=\"http://www.usaid.gov/\">The United States Agency for International Development\u003c/a> awarded \u003ca href=\"http://news.ucdavis.edu/search/news_detail.lasso?id=11096\">100 million dollars\u003c/a> to initiate this next stage of the PREDICT project, led by the U.C. Davis \u003ca href=\"http://globalhealth.ucdavis.edu/initiatives/one_health.html\">One Health Institute\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>It All Starts in the Lab\u003c/strong>\u003c/p>\n\u003cp>At the \u003ca href=\"http://www.cnprc.ucdavis.edu\">California National Primate Research Center\u003c/a>, captive-bred rhesus macaques were given various lengths of jam-covered rope. Many of the ropes were equipped with retrieval strings to make them easier to collect after the monkeys were done chewing on them. After recovering the ropes, the \u003ca href=\"http://www.ncbi.nlm.nih.gov/probe/docs/techpcr/\">saliva could be tested\u003c/a> for primate DNA and RNA viruses.\u003c/p>\n\u003cfigure id=\"attachment_102571\" class=\"wp-caption alignright\" style=\"max-width: 409px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/Chewing-rope.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-102571\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/Chewing-rope.png\" alt=\"Researchers tried three different rope materials. Left: nylon oral swab rope, middle: cotton rope, right: nylon rope. Nylon rope works best because RNA viruses degrade very quickly in the environment and cotton does not hold on to them long enough to be sampled. (N. Walker/UC Davis)\" width=\"409\" height=\"274\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Chewing-rope.png 983w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Chewing-rope-400x268.png 400w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Chewing-rope-800x536.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Chewing-rope-960x644.png 960w\" sizes=\"(max-width: 409px) 100vw, 409px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Researchers tried three different rope materials. Left: nylon oral swab rope, middle: cotton rope, right: nylon rope. Nylon rope works best because RNA viruses degrade very quickly in the environment and cotton does not hold on to them long enough to be sampled. \u003ccite>(N. Walker/U.C. Davis)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We tried different kinds of ropes for a couple reasons,” Smiley says. “One was to see if, at first, monkeys had a preference, like for some reason the texture was different, or there was something about it that they didn’t like. Just to see if one was logistically easier to use versus another.”\u003c/p>\n\u003cp>It turns out monkeys do have some preferences.\u003c/p>\n\u003cp>“The length of the rope made a huge difference in captivity,” Smiley says, “which was really interesting because these monkeys at the primate center, they were born there, they’ve never been in the wild, they’ve never encountered anything looking like a snake. But all of the really long ropes, they were really scared of and they didn’t want anything to do with it.”\u003c/p>\n\u003cp>The theory is that monkeys have an ingrained, evolutionary fear of anything resembling a snake.\u003c/p>\n\u003cfigure id=\"attachment_104484\" class=\"wp-caption alignleft\" style=\"max-width: 363px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/bananarope.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-104484\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/bananarope.png\" alt=\"Nylon rope disguised inside a banana for the baboons in Queen Elizabeth National Park, Uganda. (O.R. Okello/UC Davis)\" width=\"363\" height=\"243\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/bananarope.png 983w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/bananarope-400x267.png 400w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/bananarope-800x535.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/bananarope-960x642.png 960w\" sizes=\"(max-width: 363px) 100vw, 363px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Nylon rope disguised inside a banana for the baboons in Queen Elizabeth National Park, Uganda. (O.R. Okello/UC Davis) \u003ccite>(O.R. Okello/U.C. Davis)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>And why strawberry jam?\u003c/p>\n\u003cp>The answer is simple. Because it is affordable, easy to get anywhere in the world, and the monkeys can’t seem to get enough of it.\u003c/p>\n\u003cp>\u003cstrong>Bringing the Rope to the Wild\u003c/strong>\u003c/p>\n\u003cp>With successful results at the primate center, the PREDICT team can now use the same techniques on the free-ranging olive baboons, red-tailed guenons, rhesus macaques, and l’hoest monkeys that populate the villages of Uganda and sacred temples of Nepal.\u003c/p>\n\u003cfigure id=\"attachment_104486\" class=\"wp-caption alignright\" style=\"max-width: 385px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/baboon.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-104486\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/baboon.png\" alt=\"Olive baboon in Queen Elizabeth National Park, Uganda chewing on nylon rope disguised inside a banana. (T. Smiley Evans/UC Davis)\" width=\"385\" height=\"576\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/baboon.png 977w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/baboon-400x599.png 400w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/baboon-800x1198.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/baboon-960x1438.png 960w\" sizes=\"(max-width: 385px) 100vw, 385px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Olive baboon in Queen Elizabeth National Park, Uganda chewing on nylon rope disguised inside a banana. \u003ccite>( T. Smiley Evans/U.C. Davis)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“All species accepted the ropes with fruit jam applied as an attractant except baboons,” Smiley says in her \u003ca href=\"http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003813\">recent study\u003c/a>. “The rope had to be completely disguised inside a banana in order for them to chew on it.”\u003c/p>\n\u003cp>Baboons are also wary of the retrieval strings. Team members have to collect the actual chewed rope, which presents a whole new obstacle in making this method commonplace.\u003c/p>\n\u003cp>“It is important to be able to sample more groups of primates that may be challenging to collect samples from. But on the other hand,” Smiley says, “we want to make sure it’s done very discreetly and that there is no way you attract more human-primate interaction.”\u003c/p>\n\u003cp>Smiley’s methods keep evolving. She is currently working on a non-invasive sampling technique which involves gathering chewed plants to test for primate viruses.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“This is an even more non-invasive method,” she says, “because it can be used with endangered species in which ropes can’t be used.”\u003c/p>\n\n",
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"excerpt": "A sweet new technique used on primates shows promise in predicting viral outbreaks. ",
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"title": "Monkey Viruses: Predicting Pandemics With Strawberry Jam | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In Africa or Asia, monkeys thrive in urban settings. They roam freely in villages and temples. They raid the local food sources, rummage through garbage, and scrounge for any goodies tourists may be keeping in their bags. And in all this activity, they can pass their germs to humans, raising serious health concerns.\u003c/p>\n\u003cp>Tierra Smiley Evans, a graduate student at the University of California, Davis, is implementing a new technique to address viral sharing between humans and primates. She works for a project called \u003ca href=\"http://www.vetmed.ucdavis.edu/ohi/predict/\">PREDICT\u003c/a> that aims to prevent diseases that travel from animals to people. Using only nylon rope and strawberry jam, she has figured out a way to get monkeys to happily offer their spit to be screened for contagious viruses.\u003c/p>\n\u003cp>“This is the first time that saliva has been able to be collected non-invasively from wild primates for virus detection,” Smiley says. “This opens up a lot of doors for sampling primate populations that it has not been feasible to sample in the past.”\u003c/p>\n\u003cfigure id=\"attachment_99788\" class=\"wp-caption alignright\" style=\"max-width: 367px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/journal.pntd_.0003813.g003.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-99788\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/journal.pntd_.0003813.g003.png\" alt=\"Red-tailed guenon in Bwindi Impenetrable Forest, Uganda. (T. Smiley Evans/UC Davis)\" width=\"367\" height=\"550\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Red-tailed guenon in Bwindi Impenetrable Forest, Uganda. \u003ccite>( T. Smiley Evans/U.C. Davis)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Smiley tried a similar technique for the first time in 2007, with captive mountain gorillas in Rwanda. But she couldn’t test the technique with wild gorillas because of strict laws against distributing man-made devices (like ropes) to endangered primate species.\u003c/p>\n\u003cp>“I could see then, however, that it could have very useful applications with other types of primates,” she says, “in particular those that are living in close proximity to humans and are already behaviorally accustomed to foraging among garbage and other human materials.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Older methods of collecting samples from monkeys are not very efficient and require anesthetization. Techniques such as drawing blood or using oral swabs put both the monkeys and the handlers at bodily risk. To complicate matters, the monkeys’ innate intelligence enables them to evade capture when threatened. For a long time now, there has been a need for a better way to safely screen these animals for the harmful pathogens they may carry.\u003c/p>\n\u003cp>\u003cstrong>How Do Viruses Get From Monkeys to Humans?\u003c/strong>\u003c/p>\n\u003cp>Between 1940 and 2004, \u003ca href=\"http://www.vetmed.ucdavis.edu/ohi/local_resources/pdfs/chapters/3_predict_introduction.pdf\">greater than 70 percent\u003c/a> of emerging zoonotic diseases in humans originated in wild animals. And, over time, the incidence of emerging infectious diseases caused by wildlife pathogens has increased.\u003c/p>\n\u003cfigure id=\"attachment_103186\" class=\"wp-caption alignleft\" style=\"max-width: 364px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/Rhesus-macaque.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-103186\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/Rhesus-macaque.png\" alt=\"Rhesus macaque in Kathmandu Nepal's Thapatali temple complex. (T. Smiley Evans/UC Davis)\" width=\"364\" height=\"518\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Rhesus-macaque.png 983w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Rhesus-macaque-400x569.png 400w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Rhesus-macaque-800x1138.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Rhesus-macaque-960x1365.png 960w\" sizes=\"(max-width: 364px) 100vw, 364px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rhesus macaques in Kathmandu, Nepal’s Thapathali temple complex. \u003ccite>( T. Smiley Evans/U.C. Davis)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Some pathogens, such as \u003ca href=\"http://www.cdc.gov/herpesbvirus/\">herpes B\u003c/a>, are ubiquitous among certain species of primates and can be contracted by humans through direct contact with saliva–most commonly, through a monkey bite. But a virus can only be passed to humans if the monkey is actively shedding a contagion in their oral cavity. To put it simply, someone bit by a monkey infected with herpes B would not contract the virus if it wasn’t present in the monkey’s mouth during the transgression.\u003c/p>\n\u003cp>Other viruses, like \u003ca href=\"http://www.cdc.gov/yellowfever/transmission/\">yellow fever\u003c/a>, can be passed indirectly among human and non-human primates through mosquito bites.\u003c/p>\n\u003cp>The new, non-invasive technique for screening wild primates is now being established as part of a global plan to keep pandemic diseases at bay. Last year, \u003ca href=\"http://www.usaid.gov/\">The United States Agency for International Development\u003c/a> awarded \u003ca href=\"http://news.ucdavis.edu/search/news_detail.lasso?id=11096\">100 million dollars\u003c/a> to initiate this next stage of the PREDICT project, led by the U.C. Davis \u003ca href=\"http://globalhealth.ucdavis.edu/initiatives/one_health.html\">One Health Institute\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>It All Starts in the Lab\u003c/strong>\u003c/p>\n\u003cp>At the \u003ca href=\"http://www.cnprc.ucdavis.edu\">California National Primate Research Center\u003c/a>, captive-bred rhesus macaques were given various lengths of jam-covered rope. Many of the ropes were equipped with retrieval strings to make them easier to collect after the monkeys were done chewing on them. After recovering the ropes, the \u003ca href=\"http://www.ncbi.nlm.nih.gov/probe/docs/techpcr/\">saliva could be tested\u003c/a> for primate DNA and RNA viruses.\u003c/p>\n\u003cfigure id=\"attachment_102571\" class=\"wp-caption alignright\" style=\"max-width: 409px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/Chewing-rope.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-102571\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/Chewing-rope.png\" alt=\"Researchers tried three different rope materials. Left: nylon oral swab rope, middle: cotton rope, right: nylon rope. Nylon rope works best because RNA viruses degrade very quickly in the environment and cotton does not hold on to them long enough to be sampled. (N. Walker/UC Davis)\" width=\"409\" height=\"274\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Chewing-rope.png 983w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Chewing-rope-400x268.png 400w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Chewing-rope-800x536.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Chewing-rope-960x644.png 960w\" sizes=\"(max-width: 409px) 100vw, 409px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Researchers tried three different rope materials. Left: nylon oral swab rope, middle: cotton rope, right: nylon rope. Nylon rope works best because RNA viruses degrade very quickly in the environment and cotton does not hold on to them long enough to be sampled. \u003ccite>(N. Walker/U.C. Davis)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“We tried different kinds of ropes for a couple reasons,” Smiley says. “One was to see if, at first, monkeys had a preference, like for some reason the texture was different, or there was something about it that they didn’t like. Just to see if one was logistically easier to use versus another.”\u003c/p>\n\u003cp>It turns out monkeys do have some preferences.\u003c/p>\n\u003cp>“The length of the rope made a huge difference in captivity,” Smiley says, “which was really interesting because these monkeys at the primate center, they were born there, they’ve never been in the wild, they’ve never encountered anything looking like a snake. But all of the really long ropes, they were really scared of and they didn’t want anything to do with it.”\u003c/p>\n\u003cp>The theory is that monkeys have an ingrained, evolutionary fear of anything resembling a snake.\u003c/p>\n\u003cfigure id=\"attachment_104484\" class=\"wp-caption alignleft\" style=\"max-width: 363px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/bananarope.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-104484\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/bananarope.png\" alt=\"Nylon rope disguised inside a banana for the baboons in Queen Elizabeth National Park, Uganda. (O.R. Okello/UC Davis)\" width=\"363\" height=\"243\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/bananarope.png 983w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/bananarope-400x267.png 400w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/bananarope-800x535.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/bananarope-960x642.png 960w\" sizes=\"(max-width: 363px) 100vw, 363px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Nylon rope disguised inside a banana for the baboons in Queen Elizabeth National Park, Uganda. (O.R. Okello/UC Davis) \u003ccite>(O.R. Okello/U.C. Davis)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>And why strawberry jam?\u003c/p>\n\u003cp>The answer is simple. Because it is affordable, easy to get anywhere in the world, and the monkeys can’t seem to get enough of it.\u003c/p>\n\u003cp>\u003cstrong>Bringing the Rope to the Wild\u003c/strong>\u003c/p>\n\u003cp>With successful results at the primate center, the PREDICT team can now use the same techniques on the free-ranging olive baboons, red-tailed guenons, rhesus macaques, and l’hoest monkeys that populate the villages of Uganda and sacred temples of Nepal.\u003c/p>\n\u003cfigure id=\"attachment_104486\" class=\"wp-caption alignright\" style=\"max-width: 385px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/baboon.png\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-104486\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/baboon.png\" alt=\"Olive baboon in Queen Elizabeth National Park, Uganda chewing on nylon rope disguised inside a banana. (T. Smiley Evans/UC Davis)\" width=\"385\" height=\"576\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/baboon.png 977w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/baboon-400x599.png 400w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/baboon-800x1198.png 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/baboon-960x1438.png 960w\" sizes=\"(max-width: 385px) 100vw, 385px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Olive baboon in Queen Elizabeth National Park, Uganda chewing on nylon rope disguised inside a banana. \u003ccite>( T. Smiley Evans/U.C. Davis)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“All species accepted the ropes with fruit jam applied as an attractant except baboons,” Smiley says in her \u003ca href=\"http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003813\">recent study\u003c/a>. “The rope had to be completely disguised inside a banana in order for them to chew on it.”\u003c/p>\n\u003cp>Baboons are also wary of the retrieval strings. Team members have to collect the actual chewed rope, which presents a whole new obstacle in making this method commonplace.\u003c/p>\n\u003cp>“It is important to be able to sample more groups of primates that may be challenging to collect samples from. But on the other hand,” Smiley says, “we want to make sure it’s done very discreetly and that there is no way you attract more human-primate interaction.”\u003c/p>\n\u003cp>Smiley’s methods keep evolving. She is currently working on a non-invasive sampling technique which involves gathering chewed plants to test for primate viruses.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Steve Blank: The \"Lean Startup\" Movement has Finally Reached Health Care",
"title": "Steve Blank: The \"Lean Startup\" Movement has Finally Reached Health Care",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Silicon Valley entrepreneur Steve Blank is addicted to starting companies. So far, he's founded or worked at eight startups that run the gamut from video games to supercomputers.\u003c/p>\n\u003cp>Until recently, there was only one sector that he wouldn't touch: Health care. Blank said he did not see a way to apply his entrepreneurial methods to medicine, a sector that he viewed as slow to innovate.\u003c/p>\n\u003cp>Blank's ideas about startups and entrepreneurship are known around the world. Along with his former student from UC Berkeley Eric Ries, Blank is a leading proponent of the \"Lean Startup\" movement, which directs new companies to allocate their resources as sparingly as possible -- a challenging feat for many health care companies. \u003c/p>\n\u003cp>Blank has shared this approach with thousands of would-be entrepreneurs at top universities like Stanford, New York University, University of California, San Francisco and Imperial College London.\u003c/p>\n\u003cp>He teaches students to take a customer-centric approach by interviewing people about their needs, developing a basic prototype, testing it in the market, and then returning to the drawing board. Rinse and repeat. \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In the wake of the Affordable Care Act and other health reforms, Blank has now changed his tune about health care. He now envisions a way for clinicians, doctors and researchers to bring new medical technologies to market using lean startup methods. This interview has been condensed and edited for brevity.\u003c/p>\n\u003cp>\u003cstrong>What was your turning point in thinking that your approach was relevant for health care?\u003c/strong>\u003c/p>\n\u003cp>I wrote in several books that the lean startup methods would work everywhere -- except for Life Sciences. As I saw it, there was this notion among scientists that there's no need to leave the building until the product works for everyone and everything. But I got a call from UCSF a few years ago. They said, 'Steve, we need you to put on a class. Whether it's digital health or therapeutics -- all of our students could benefit from a customer development process.' I decided to give it a shot.\u003c/p>\n\u003cp>\u003cb>How did you decide to structure the class?\u003c/b>\u003c/p>\n\u003cp>We had about 70 teams apply for about 20 spots. These student 'principal investigators,' who are typically researchers or surgeons, took the class and they picked a grad student and an industry mentor. We ended up splitting the class up into four categories: digital health, therapeutics, diagnostics and medical devices. We talked about everything from making improvements to existing products to innovations that had never existed before. The class itself was a prototype of sorts.\u003c/p>\n\u003cp>\u003cstrong>What did you learn along the way? \u003c/strong>\u003c/p>\n\u003cp>By week four, I realized two things: Clinicians and researchers are actually better at lean startups than almost any other field. In medicine, you know what you don't know. No one believes that they've got everything figured out. I also learned that not only will it work, but the National Institutes of Health might be interested. The NIH came back and decided they wanted to run a version of the class inside their own organization. We were running 25 teams through the NIH six months later.\u003c/p>\n\u003cp>Today, some 40 universities are teaching a version of our program. And both the National Science Foundation and NIH have a training program for educators.\u003c/p>\n\u003cp>\u003cstrong>Did any of the students go on to start successful companies?\u003c/strong>\u003c/p>\n\u003cp>Yes, about half of the UCSF teams did go on to start companies. They also already had some small amount of funding at the start of class. The big challenge was to teach them that although they had money for idea X, perhaps idea X wasn't where they would end up. Some of the teams totally changed their core product by the end -- all based on the customer feedback they had gathered.\u003c/p>\n\u003cp>\u003cstrong>But who is the customer? Is it the organization that foots the bill or the patient? Or is it the doctor, who prescribes or recommends the product? \u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">\"It's clear that we're at an intersection of multiple crises in health care: electronic health record challenges, inflated costs, the price of getting a drug to market, the FDA bottleneck... But entrepreneurs need to see every crisis as an opportunity.\"\u003ccite>Steve Blank, father of the \"lean startup\" movement, serial entrepreneur and academic\u003c/cite>\u003c/aside>\n\u003cp>That's the challenge of turning the science into a company. In some cases, it's not clear whether the customer is the grandma that's going to put this product in her hip, the doctor, the hospital, or the insurance provider. The entrepreneur needs to consider all of these customers and think about regulation and reimbursement options too. They also need to check intellectual property or hire someone to do so.\u003c/p>\n\u003cp>\u003cstrong>Did many of your teams find that although they developed a useful product, it simply couldn't be commercialized?\u003c/strong>\u003c/p>\n\u003cp>Yes. And some learned that no one really wants the product. Or that there are barriers they didn't understand. In some cases, they learned that it would require 10 times more money to commercialize than expected. Almost 100 percent of the teams realized they needed to 'pivot' at least once, which means a substantive change to one or more business model assumptions.\u003c/p>\n\u003cp>\u003cstrong>Did you recommend to some of the clinicians and researchers in the class that they hire a technical or business person to lead the company? \u003c/strong>\u003c/p>\n\u003cp>One of the biggest mistakes that entrepreneurs make (and venture capitalists) is to only keep on the founding CEO for a year or two. I think the founder's vision and passion drives these things at an unparalleled speed and urgency.\u003c/p>\n\u003cp>\u003cstrong>What are some of the biggest lessons that you teach students in the class? \u003c/strong>\u003c/p>\n\u003cp>Some of the founding CEOs learn through the class how to communicate the complex science. What I tell them on day one is that the difference between the introvert and extrovert is whether they're looking at their shoes or my shoes. But either way, they figure out how to describe their projects in effective ways within three days. We teach them how to communicate to insurance companies, patients, regulators -- and not just to their peers.\u003c/p>\n\u003cp>\u003cstrong>You've learned a lot about health care through the class. What were your major takeaways? \u003c/strong>\u003c/p>\n\u003cp>Outside of life sciences, finding\u003ca href=\"https://en.wikipedia.org/wiki/Product/market_fit\"> product / market fit\u003c/a> is the number one thing you do. In the life sciences, that’s important but understanding if you have the freedom to operate [from an intellectual property standpoint] and who’s going to pay for it is equally important.\u003c/p>\n\u003cp>On a big picture level, it's clear that we're at an intersection of multiple crises in health care: electronic health record challenges, inflated costs, the price of getting a drug to market, the FDA bottleneck... But entrepreneurs need to see every crisis as an opportunity. Entrepreneurship is not a job; it's a calling.\u003c/p>\n\u003cp>\u003cstrong>You experienced the dotcom bubble and burst in the 1990s, having arrived to Silicon Valley in the late 70s. And now, the more recent wave of fervor for technology. What's changed?\u003c/strong>\u003c/p>\n\u003cp>In the 90s, no one made money until there was a liquidity event [like an acquisition or initial public offering]. Nowadays, most of the liquidity is in later-stage funds putting money in at exorbitant prices. These companies are worth something but not at that price -- and it inflates everything underneath it.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Venture capitalists are so desperate for deals they are allowing their entrepreneurs to do things that aren't necessarily the right thing. In my opinion, until social media, what venture capitalists invested in and what was good for the country was fairly aligned. What we did with social media is we took all the things people use to do face to face and now mediate that by a computer. That giant sucking sound is Facebook dragging money away from where money used to go: Green energy, education, health. Fortunately, that's starting to change.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Silicon Valley entrepreneur Steve Blank is addicted to starting companies. So far, he's founded or worked at eight startups that run the gamut from video games to supercomputers.\u003c/p>\n\u003cp>Until recently, there was only one sector that he wouldn't touch: Health care. Blank said he did not see a way to apply his entrepreneurial methods to medicine, a sector that he viewed as slow to innovate.\u003c/p>\n\u003cp>Blank's ideas about startups and entrepreneurship are known around the world. Along with his former student from UC Berkeley Eric Ries, Blank is a leading proponent of the \"Lean Startup\" movement, which directs new companies to allocate their resources as sparingly as possible -- a challenging feat for many health care companies. \u003c/p>\n\u003cp>Blank has shared this approach with thousands of would-be entrepreneurs at top universities like Stanford, New York University, University of California, San Francisco and Imperial College London.\u003c/p>\n\u003cp>He teaches students to take a customer-centric approach by interviewing people about their needs, developing a basic prototype, testing it in the market, and then returning to the drawing board. Rinse and repeat. \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In the wake of the Affordable Care Act and other health reforms, Blank has now changed his tune about health care. He now envisions a way for clinicians, doctors and researchers to bring new medical technologies to market using lean startup methods. This interview has been condensed and edited for brevity.\u003c/p>\n\u003cp>\u003cstrong>What was your turning point in thinking that your approach was relevant for health care?\u003c/strong>\u003c/p>\n\u003cp>I wrote in several books that the lean startup methods would work everywhere -- except for Life Sciences. As I saw it, there was this notion among scientists that there's no need to leave the building until the product works for everyone and everything. But I got a call from UCSF a few years ago. They said, 'Steve, we need you to put on a class. Whether it's digital health or therapeutics -- all of our students could benefit from a customer development process.' I decided to give it a shot.\u003c/p>\n\u003cp>\u003cb>How did you decide to structure the class?\u003c/b>\u003c/p>\n\u003cp>We had about 70 teams apply for about 20 spots. These student 'principal investigators,' who are typically researchers or surgeons, took the class and they picked a grad student and an industry mentor. We ended up splitting the class up into four categories: digital health, therapeutics, diagnostics and medical devices. We talked about everything from making improvements to existing products to innovations that had never existed before. The class itself was a prototype of sorts.\u003c/p>\n\u003cp>\u003cstrong>What did you learn along the way? \u003c/strong>\u003c/p>\n\u003cp>By week four, I realized two things: Clinicians and researchers are actually better at lean startups than almost any other field. In medicine, you know what you don't know. No one believes that they've got everything figured out. I also learned that not only will it work, but the National Institutes of Health might be interested. The NIH came back and decided they wanted to run a version of the class inside their own organization. We were running 25 teams through the NIH six months later.\u003c/p>\n\u003cp>Today, some 40 universities are teaching a version of our program. And both the National Science Foundation and NIH have a training program for educators.\u003c/p>\n\u003cp>\u003cstrong>Did any of the students go on to start successful companies?\u003c/strong>\u003c/p>\n\u003cp>Yes, about half of the UCSF teams did go on to start companies. They also already had some small amount of funding at the start of class. The big challenge was to teach them that although they had money for idea X, perhaps idea X wasn't where they would end up. Some of the teams totally changed their core product by the end -- all based on the customer feedback they had gathered.\u003c/p>\n\u003cp>\u003cstrong>But who is the customer? Is it the organization that foots the bill or the patient? Or is it the doctor, who prescribes or recommends the product? \u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">\"It's clear that we're at an intersection of multiple crises in health care: electronic health record challenges, inflated costs, the price of getting a drug to market, the FDA bottleneck... But entrepreneurs need to see every crisis as an opportunity.\"\u003ccite>Steve Blank, father of the \"lean startup\" movement, serial entrepreneur and academic\u003c/cite>\u003c/aside>\n\u003cp>That's the challenge of turning the science into a company. In some cases, it's not clear whether the customer is the grandma that's going to put this product in her hip, the doctor, the hospital, or the insurance provider. The entrepreneur needs to consider all of these customers and think about regulation and reimbursement options too. They also need to check intellectual property or hire someone to do so.\u003c/p>\n\u003cp>\u003cstrong>Did many of your teams find that although they developed a useful product, it simply couldn't be commercialized?\u003c/strong>\u003c/p>\n\u003cp>Yes. And some learned that no one really wants the product. Or that there are barriers they didn't understand. In some cases, they learned that it would require 10 times more money to commercialize than expected. Almost 100 percent of the teams realized they needed to 'pivot' at least once, which means a substantive change to one or more business model assumptions.\u003c/p>\n\u003cp>\u003cstrong>Did you recommend to some of the clinicians and researchers in the class that they hire a technical or business person to lead the company? \u003c/strong>\u003c/p>\n\u003cp>One of the biggest mistakes that entrepreneurs make (and venture capitalists) is to only keep on the founding CEO for a year or two. I think the founder's vision and passion drives these things at an unparalleled speed and urgency.\u003c/p>\n\u003cp>\u003cstrong>What are some of the biggest lessons that you teach students in the class? \u003c/strong>\u003c/p>\n\u003cp>Some of the founding CEOs learn through the class how to communicate the complex science. What I tell them on day one is that the difference between the introvert and extrovert is whether they're looking at their shoes or my shoes. But either way, they figure out how to describe their projects in effective ways within three days. We teach them how to communicate to insurance companies, patients, regulators -- and not just to their peers.\u003c/p>\n\u003cp>\u003cstrong>You've learned a lot about health care through the class. What were your major takeaways? \u003c/strong>\u003c/p>\n\u003cp>Outside of life sciences, finding\u003ca href=\"https://en.wikipedia.org/wiki/Product/market_fit\"> product / market fit\u003c/a> is the number one thing you do. In the life sciences, that’s important but understanding if you have the freedom to operate [from an intellectual property standpoint] and who’s going to pay for it is equally important.\u003c/p>\n\u003cp>On a big picture level, it's clear that we're at an intersection of multiple crises in health care: electronic health record challenges, inflated costs, the price of getting a drug to market, the FDA bottleneck... But entrepreneurs need to see every crisis as an opportunity. Entrepreneurship is not a job; it's a calling.\u003c/p>\n\u003cp>\u003cstrong>You experienced the dotcom bubble and burst in the 1990s, having arrived to Silicon Valley in the late 70s. And now, the more recent wave of fervor for technology. What's changed?\u003c/strong>\u003c/p>\n\u003cp>In the 90s, no one made money until there was a liquidity event [like an acquisition or initial public offering]. Nowadays, most of the liquidity is in later-stage funds putting money in at exorbitant prices. These companies are worth something but not at that price -- and it inflates everything underneath it.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Venture capitalists are so desperate for deals they are allowing their entrepreneurs to do things that aren't necessarily the right thing. In my opinion, until social media, what venture capitalists invested in and what was good for the country was fairly aligned. What we did with social media is we took all the things people use to do face to face and now mediate that by a computer. That giant sucking sound is Facebook dragging money away from where money used to go: Green energy, education, health. Fortunately, that's starting to change.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>We’ve long known that getting active outdoors can reduce stress, improve mental health, and help us get fit or lose weight. Recently, several studies completed or underway are looking for definitive evidence of the benefits of spending time in nature.\u003c/p>\n\u003cp>In a \u003ca href=\"http://www.psmag.com/health-and-behavior/take-a-walk-in-nature\">study by Stanford University\u003c/a> published in \u003ca href=\"http://www.pnas.org/\">Proceedings of the National Academy of Sciences\u003c/a>, a research team worked with 38 healthy adults. They assessed each person for one sign of depression — rumination over negative events — then divided them into two groups.\u003c/p>\n\u003cfigure id=\"attachment_120529\" class=\"wp-caption alignleft\" style=\"max-width: 334px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/Parks-Prescript-CrabCove052014-Razani.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-120529\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/Parks-Prescript-CrabCove052014-Razani-1440x1587.jpg\" alt=\"Exploring outdoors brings benefits to children and adults. (Nooshin Razani)\" width=\"334\" height=\"368\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Parks-Prescript-CrabCove052014-Razani-1440x1587.jpg 1440w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Parks-Prescript-CrabCove052014-Razani-400x441.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Parks-Prescript-CrabCove052014-Razani-800x882.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Parks-Prescript-CrabCove052014-Razani-1400x1543.jpg 1400w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Parks-Prescript-CrabCove052014-Razani-1180x1300.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Parks-Prescript-CrabCove052014-Razani-960x1058.jpg 960w\" sizes=\"(max-width: 334px) 100vw, 334px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Exploring outdoors brings benefits to children and adults. (Dr. Nooshin Razani)\u003c/figcaption>\u003c/figure>\n\u003cp>One group was sent for a 90-minute walk in the hills west of campus while the other group walked along busy El Camino Real with six lanes of traffic. After their walk, the team assessed them again for rumination.\u003c/p>\n\u003cp>The group that walked along El Camino Real had no change in their score, while the nature-walk group slightly improved their score. The change wasn’t large, but “supports the view that natural environments may confer psychological benefits to humans,” the team wrote. Planning for nature near the city is important, as the number of people living in urban areas grows.\u003c/p>\n\u003cp>We seem to know instinctively that it’s good to get outdoors, yet it’s difficult for many of us to work into our everyday lives. A \u003ca href=\"http://www.nrpa.org/uploadedFiles/nrpa.org/About_NRPA/Press_Room/Press_Releases/Park%20and%20Recreation%20Month%20Press%20Release_Final%20with%20Infographic.pdf\">2014 study \u003c/a>from the National Recreation and Parks Association surveyed adults and found that 28 percent do not spend time outdoors each day. The 47 percent who do are outside for 30 minutes or less.\u003c/p>\n\u003cfigure id=\"attachment_120623\" class=\"wp-caption alignright\" style=\"max-width: 844px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/IMG_6318-1.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-120623\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/IMG_6318-1.jpg\" alt=\"Giving children a chance to run and play outdoors each day is vital to their growth, development and health. (Courtesy of Dr. Nooshin Razani)\" width=\"844\" height=\"483\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/IMG_6318-1.jpg 844w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/IMG_6318-1-400x229.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/IMG_6318-1-800x458.jpg 800w\" sizes=\"(max-width: 844px) 100vw, 844px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Giving children a chance to run and play outdoors each day is vital to their growth, development and health. (Dr. Nooshin Razani)\u003c/figcaption>\u003c/figure>\n\u003cp>Movements like \u003ca href=\"http://instituteatgoldengate.org/regional\">Healthy Parks, Healthy People: (HPHP) Bay Area \u003c/a>and \u003ca href=\"http://www.nrpa.org/Grants-and-Partners/Recreation-and-Health/Park-Prescriptions/\">Parks Prescriptions\u003c/a> are addressing this need. The \u003ca href=\"http://www.ebparks.org/\">East Bay Regional Parks District\u003c/a> has been partnering with \u003ca href=\"http://www.childrenshospitaloakland.org/main/home.aspx\">UCSF Benioff Children’s Hospital Oakland\u003c/a> for more than a year to bring families from their clinic out to parks. More than 200 patients and their families have benefited from this partnership, funded by a Regional Parks Foundation grant. \u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Dr. Nooshin Razani, one of the UCSF Benioff pediatricians at the forefront of the Parks Prescriptions and Healthy Parks Healthy People: Bay Area programs, \u003ca href=\"http://instituteatgoldengate.org/blog/children-and-resilience-healing-by-being-together-in-nature\">wrote a blog post\u003c/a> \u003cspan style=\"line-height: 1.5\"> giving a snapshot of what a day in the park is like for participating families.\u003c/span>\u003c/p>\n\u003cp>At the other end of the age spectrum, \u003ca href=\"http://www.sciencedaily.com/releases/2015/07/150709180208.htm\">a study\u003c/a> from the University of Minnesota and a team from Vancouver, British Columbia showed the importance of access to natural spaces for healthy aging in seniors. The study, published in \u003ca href=\"http://www.sciencedaily.com/\">Science Daily\u003c/a> earlier this month, found access to spaces with still or running water are particularly helpful.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>We have a wealth of wonderful natural spaces around the Bay Area, so take some time each day to get out and enjoy it!\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>We’ve long known that getting active outdoors can reduce stress, improve mental health, and help us get fit or lose weight. Recently, several studies completed or underway are looking for definitive evidence of the benefits of spending time in nature.\u003c/p>\n\u003cp>In a \u003ca href=\"http://www.psmag.com/health-and-behavior/take-a-walk-in-nature\">study by Stanford University\u003c/a> published in \u003ca href=\"http://www.pnas.org/\">Proceedings of the National Academy of Sciences\u003c/a>, a research team worked with 38 healthy adults. They assessed each person for one sign of depression — rumination over negative events — then divided them into two groups.\u003c/p>\n\u003cfigure id=\"attachment_120529\" class=\"wp-caption alignleft\" style=\"max-width: 334px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/Parks-Prescript-CrabCove052014-Razani.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-120529\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/Parks-Prescript-CrabCove052014-Razani-1440x1587.jpg\" alt=\"Exploring outdoors brings benefits to children and adults. (Nooshin Razani)\" width=\"334\" height=\"368\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Parks-Prescript-CrabCove052014-Razani-1440x1587.jpg 1440w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Parks-Prescript-CrabCove052014-Razani-400x441.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Parks-Prescript-CrabCove052014-Razani-800x882.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Parks-Prescript-CrabCove052014-Razani-1400x1543.jpg 1400w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Parks-Prescript-CrabCove052014-Razani-1180x1300.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/Parks-Prescript-CrabCove052014-Razani-960x1058.jpg 960w\" sizes=\"(max-width: 334px) 100vw, 334px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Exploring outdoors brings benefits to children and adults. (Dr. Nooshin Razani)\u003c/figcaption>\u003c/figure>\n\u003cp>One group was sent for a 90-minute walk in the hills west of campus while the other group walked along busy El Camino Real with six lanes of traffic. After their walk, the team assessed them again for rumination.\u003c/p>\n\u003cp>The group that walked along El Camino Real had no change in their score, while the nature-walk group slightly improved their score. The change wasn’t large, but “supports the view that natural environments may confer psychological benefits to humans,” the team wrote. Planning for nature near the city is important, as the number of people living in urban areas grows.\u003c/p>\n\u003cp>We seem to know instinctively that it’s good to get outdoors, yet it’s difficult for many of us to work into our everyday lives. A \u003ca href=\"http://www.nrpa.org/uploadedFiles/nrpa.org/About_NRPA/Press_Room/Press_Releases/Park%20and%20Recreation%20Month%20Press%20Release_Final%20with%20Infographic.pdf\">2014 study \u003c/a>from the National Recreation and Parks Association surveyed adults and found that 28 percent do not spend time outdoors each day. The 47 percent who do are outside for 30 minutes or less.\u003c/p>\n\u003cfigure id=\"attachment_120623\" class=\"wp-caption alignright\" style=\"max-width: 844px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/IMG_6318-1.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-120623\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/IMG_6318-1.jpg\" alt=\"Giving children a chance to run and play outdoors each day is vital to their growth, development and health. (Courtesy of Dr. Nooshin Razani)\" width=\"844\" height=\"483\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/IMG_6318-1.jpg 844w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/IMG_6318-1-400x229.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/IMG_6318-1-800x458.jpg 800w\" sizes=\"(max-width: 844px) 100vw, 844px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Giving children a chance to run and play outdoors each day is vital to their growth, development and health. (Dr. Nooshin Razani)\u003c/figcaption>\u003c/figure>\n\u003cp>Movements like \u003ca href=\"http://instituteatgoldengate.org/regional\">Healthy Parks, Healthy People: (HPHP) Bay Area \u003c/a>and \u003ca href=\"http://www.nrpa.org/Grants-and-Partners/Recreation-and-Health/Park-Prescriptions/\">Parks Prescriptions\u003c/a> are addressing this need. The \u003ca href=\"http://www.ebparks.org/\">East Bay Regional Parks District\u003c/a> has been partnering with \u003ca href=\"http://www.childrenshospitaloakland.org/main/home.aspx\">UCSF Benioff Children’s Hospital Oakland\u003c/a> for more than a year to bring families from their clinic out to parks. More than 200 patients and their families have benefited from this partnership, funded by a Regional Parks Foundation grant. \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Dr. Nooshin Razani, one of the UCSF Benioff pediatricians at the forefront of the Parks Prescriptions and Healthy Parks Healthy People: Bay Area programs, \u003ca href=\"http://instituteatgoldengate.org/blog/children-and-resilience-healing-by-being-together-in-nature\">wrote a blog post\u003c/a> \u003cspan style=\"line-height: 1.5\"> giving a snapshot of what a day in the park is like for participating families.\u003c/span>\u003c/p>\n\u003cp>At the other end of the age spectrum, \u003ca href=\"http://www.sciencedaily.com/releases/2015/07/150709180208.htm\">a study\u003c/a> from the University of Minnesota and a team from Vancouver, British Columbia showed the importance of access to natural spaces for healthy aging in seniors. The study, published in \u003ca href=\"http://www.sciencedaily.com/\">Science Daily\u003c/a> earlier this month, found access to spaces with still or running water are particularly helpful.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>We have a wealth of wonderful natural spaces around the Bay Area, so take some time each day to get out and enjoy it!\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Even as a young child, Amanda Angelotti dreamed about becoming a doctor. Five years after graduating from college, she enrolled in the University of California, San Francisco medical school.\u003c/p>\n\u003cp>But by her third year, Angelotti couldn't shake the feeling that something was missing. During a routine shift at the hospital, making rounds with her fellow students, Angelotti said her thoughts kept drifting.\u003c/p>\n\u003cp>\"I was supposed to be focused on the patient's vital signs and presenting a summary, but I was consumed with thoughts about how to improve the process of rounds,\" she said. Most striking was the patient's absence from the discussion. \"I kept asking myself, 'how could we change things to involve the patient more?'\"\u003c/p>\n\u003cp>Just a stone's throw from UCSF Medical Center, a small group of entrepreneurs at \u003ca href=\"http://rockhealth.com\">Rock Health, \u003c/a>a new accelerator program (and now a venture firm), were thinking about how to shake up the health care process with technology. These startups were developing new wearable devices and mobile apps to help patients take more control of their own health.\u003c/p>\n\u003cfigure id=\"attachment_12284\" class=\"wp-caption alignright\" style=\"max-width: 407px\">\u003cimg class=\" wp-image-12284\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/JV0A7413-800x533.jpg\" alt=\"Amanda Angelotti and Connie Chen developed a passion for digital health while at medical school \" width=\"407\" height=\"272\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/JV0A7413-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/JV0A7413-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/JV0A7413-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/JV0A7413-960x640.jpg 960w\" sizes=\"(max-width: 407px) 100vw, 407px\">\u003cfigcaption class=\"wp-caption-text\">Amanda Angelotti and Connie Chen developed a passion for digital health during medical school \u003ccite>(Josh Cassidy, KQED )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The timing was right to bring new ideas to the sector. By 2012, hospitals around the country were rapidly moving away from paper-based medical records to electronic systems, a first step to moving health care into the digital age.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Angelotti graduated the following year, but she did not apply for any residency programs at U.S. hospitals. Instead, she applied to work at Rock Health as a researcher and writer before joining the new medical review site \u003ca href=\"http://www.iodine.com/\">Iodine\u003c/a>, one of an exploding number of digital health startups in San Francisco.\u003c/p>\n\u003cp>By the end of that year, Rock Health projected that digital health funding had exceeded $1.9 billion, a 39 percent jump from the prior year.\u003c/p>\n\u003cp>\u003cstrong>The Rising Tide of Doctors Turning to Entrepreneurship\u003c/strong>\u003c/p>\n\u003cp>Angelotti is far from alone in making the leap from medical school to digital health.\u003c/p>\n\u003cp>Students from around the Bay Area and the country are increasingly dropping out of residency programs and instead going into careers in high-tech start-ups.\u003c/p>\n\u003cp>“We’ve seen that many of these Bay Area-based medical students are drawn to startup opportunities — it used to be biotech, and now it’s more often digital health,” said Jeff Tangney, CEO of Doximity, a physician-network that generates data for the \u003ca href=\"http://health.usnews.com/health-news/blogs/second-opinion/2014/01/10/doximity-begins-surveying-physicians-for-us-news-best-hospitals\">U.S. News Best Hospitals rankings\u003c/a>.\u003c/p>\n\u003cp>Tangney said many of the top digital health companies are more than willing to hire new grads straight out of medical school, who lack years of clinical experience.\u003c/p>\n\u003cp>Dropout doctors are well-positioned, he added, for a career in digital health as they have an insider’s view of the industry — and ideas about how to fix it.\u003c/p>\n\u003cp> \u003c/p>\n\u003cfigure id=\"attachment_13015\" class=\"wp-caption alignright\" style=\"max-width: 437px\">\u003cimg class=\" wp-image-13015\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/sean-duffy-800x533.jpg\" alt=\"Harvard Medical School dropout Sean Duffy addressing a group from Kaiser Permanente\" width=\"437\" height=\"291\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/sean-duffy-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/sean-duffy-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/sean-duffy-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/sean-duffy-960x640.jpg 960w\" sizes=\"(max-width: 437px) 100vw, 437px\">\u003cfigcaption class=\"wp-caption-text\">Harvard Medical School dropout Sean Duffy addressing a group from Kaiser Permanente \u003ccite>(Omada Health )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As Sean Duffy, the CEO of Omada Health and a Harvard medical school dropout put it: \"I wanted to understand what's in the trenches, so I could redefine the trenches.\" Omada Health offers an online program to help people change their behavior and avoid the onset of diabetes.\u003c/p>\n\u003cp>Duffy is part of a private Facebook group called \"dropout doctors,\" which includes some of the biggest names in digital health. It functions as a support group, of sorts, and meets every few months for dinner or drinks. Some members, like Angelotti, said they find solace in the group as it can be difficult and lonely to opt out of clinical medicine and follow a different path.\u003c/p>\n\u003cp>The membership includes Angelotti, who now works at primary care chain One Medical; Duffy, CEO of Omada Health\u003ca href=\"https://omadahealth.com/\">;\u003c/a> Connie Chen, the cofounder of Vida Health; Shaundra Eichstadt, medical director at \u003ca href=\"https://www.grandrounds.com/\">Grand Rounds\u003c/a>; Abhas Gupta, a health-focused venture capitalist with the firm \u003ca href=\"http://www.mdv.com/\">Mohr Davidow\u003c/a>; Molly Maloof, a medical advisor to \u003ca href=\"https://doctorbase.com/\">DoctorBase;\u003c/a> and Rebecca Coelius, the director of health at \u003ca href=\"https://www.codeforamerica.org/\">Code for America\u003c/a>.\u003c/p>\n\u003cp>\u003cb>'I Never Thought I Would Leave Medicine' \u003c/b>\u003c/p>\n\u003cp>Experts say it's both 'push and pull' effect that is motivating young doctors to seek out opportunities with the growing intersection of technology and health care, rather than pursue brick and mortar medicine.\u003c/p>\n\u003cp>Many of the students at the top Bay Area medical schools, Stanford and UCSF, are exposed to entrepreneurial thinking during the course of their education, which can be a major draw.\u003c/p>\n\u003cp>\"I never thought I would leave medicine,\" said Eichstadt, who now works at Grand Rounds Health, a San Francisco-based startup that helps patients access second opinions from top medical experts online. \"But there's such a rich opportunity at companies here.\"\u003c/p>\n\u003cfigure id=\"attachment_13016\" class=\"wp-caption alignright\" style=\"max-width: 410px\">\u003cimg class=\" wp-image-13016\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/SE-photo-800x565.jpg\" alt=\"Dr. Shaundra Eichstadt made the transition from medicine to digital health. \" width=\"410\" height=\"289\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/SE-photo-800x565.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/SE-photo-400x282.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/SE-photo-1180x833.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/SE-photo-960x678.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/SE-photo.jpg 2048w\" sizes=\"(max-width: 410px) 100vw, 410px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Shaundra Eichstadt made the transition from medicine to digital health. \u003ccite>(Shaundra Eichstadt )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Eichstadt graduated from Stanford and pursued several years of residency, specializing in plastic and reconstructive surgery.\u003c/p>\n\u003cp>\"I realized that the system isn't designed for doctors to make the real change you would like to for the patient,\" she said. Eichstadt said she believed that she could make a bigger impact elsewhere.\u003c/p>\n\u003cp>Many of the dropout docs expressed a desire to improve the doctor-patient experience. In interviews with \u003cem>KQED,\u003c/em> several said they spent very little time administering care during medical school, and they felt that patients were too often kept out of the loop.\u003c/p>\n\u003cp>A recent study found that doctors-in-training spend\u003ca href=\"http://well.blogs.nytimes.com/2013/05/30/for-new-doctors-8-minutes-per-patient/\"> an average of just eight minutes\u003c/a> with each patient. This is a drastic decrease from previous generations and is linked to more record-keeping requirements and restricted on-duty hours.\u003c/p>\n\u003cp>Connie Chen still practices medicine a half-day each week. But shortly after medical school, Chen co-founded an app called \u003ca href=\"https://www.vida.com\">Vida\u003c/a>, which connects people with chronic diseases to virtual health coaches, like nutritionists and nurses.\u003c/p>\n\u003cp>Chen said she learned very little about nutrition at medical school. But digital health opened up opportunities for Chen to educate herself about wellness, so she can help patients stay healthy.\u003c/p>\n\u003caside class=\"pullquote alignright\">“Tech culture is very appealing when juxtaposed against the hierarchy and myriad hoops to be jumped through in clinical medicine.\"\u003ccite>Rebecca Coelius, Director of Health at Code for America\u003c/cite>\u003c/aside>\n\u003cp>\"Traditional health care is really oriented to make the life of the provider easier,\" she said. \"Your patients cycle in and out of the hospital, and very often, no one makes enough of an effort to communicate with them.\"\u003c/p>\n\u003cp>\u003cstrong>Lack of Opportunities \u003c/strong>\u003c/p>\n\u003cp>Other dropout docs said they felt pushed out of medicine, due to the lack of career opportunities or earning potential. Family practitioners, who serve at the front lines of health care, \u003ca href=\"http://healthland.time.com/2012/04/27/doctors-salaries-who-earns-the-most-and-the-least/\">are paid the least\u003c/a>.\u003c/p>\n\u003cp>Recent studies have also shown rising levels of \u003ca href=\"http://khn.org/news/doctor-burnout/\">discontent among primary care doctors\u003c/a>. Nearly half of 7,200 doctors who responded to a Mayo Clinic survey in 2012 said they felt a lack of enthusiasm about medicine or cynicism about it. A decade ago, one quarter of doctors reported feeling burnt out.\u003c/p>\n\u003cp>\"I loved working with patients but I looked around me and realized that I didn't want the jobs of anybody who had 'succeeded' as a clinician,\" said Rebecca Coelius, who graduated with an MD from UCSF.\u003c/p>\n\u003cp>Coelius now advises a number of health-tech startups, including Doximity and previously worked for \u003ca href=\"http://healthloop.com/\">HealthLoop\u003c/a>, which was founded by another entrepreneurial MD, Dr. Jordan Shlain. She's also worked for the government as a medical innovation officer.\u003c/p>\n\u003cp>\"Tech culture is very appealing when juxtaposed against the hierarchy and myriad hoops to be jumped through in clinical medicine,\" she explained.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Correction: An earlier version of this article contained data from Doximity on the percentage of Stanford and UCSF medical students applying to residency programs. Doximity says it failed to factor in medical school graduates who pursue further post-graduate studies and that the Stanford information it provided was inaccurate. Stanford officials say Stanford has a 95 percent rate of medical students pursuing residency after graduation.\u003c/em>\u003c/p>\n\n",
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"excerpt": "KQED reports on the growing trend of Bay Area-based doctors making the leap from traditional medicine to digital health. These \"dropout doctors\" say they can make a bigger impact by transforming health care from the outside in, rather than the inside out. ",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Even as a young child, Amanda Angelotti dreamed about becoming a doctor. Five years after graduating from college, she enrolled in the University of California, San Francisco medical school.\u003c/p>\n\u003cp>But by her third year, Angelotti couldn't shake the feeling that something was missing. During a routine shift at the hospital, making rounds with her fellow students, Angelotti said her thoughts kept drifting.\u003c/p>\n\u003cp>\"I was supposed to be focused on the patient's vital signs and presenting a summary, but I was consumed with thoughts about how to improve the process of rounds,\" she said. Most striking was the patient's absence from the discussion. \"I kept asking myself, 'how could we change things to involve the patient more?'\"\u003c/p>\n\u003cp>Just a stone's throw from UCSF Medical Center, a small group of entrepreneurs at \u003ca href=\"http://rockhealth.com\">Rock Health, \u003c/a>a new accelerator program (and now a venture firm), were thinking about how to shake up the health care process with technology. These startups were developing new wearable devices and mobile apps to help patients take more control of their own health.\u003c/p>\n\u003cfigure id=\"attachment_12284\" class=\"wp-caption alignright\" style=\"max-width: 407px\">\u003cimg class=\" wp-image-12284\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/JV0A7413-800x533.jpg\" alt=\"Amanda Angelotti and Connie Chen developed a passion for digital health while at medical school \" width=\"407\" height=\"272\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/JV0A7413-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/JV0A7413-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/JV0A7413-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/JV0A7413-960x640.jpg 960w\" sizes=\"(max-width: 407px) 100vw, 407px\">\u003cfigcaption class=\"wp-caption-text\">Amanda Angelotti and Connie Chen developed a passion for digital health during medical school \u003ccite>(Josh Cassidy, KQED )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The timing was right to bring new ideas to the sector. By 2012, hospitals around the country were rapidly moving away from paper-based medical records to electronic systems, a first step to moving health care into the digital age.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Angelotti graduated the following year, but she did not apply for any residency programs at U.S. hospitals. Instead, she applied to work at Rock Health as a researcher and writer before joining the new medical review site \u003ca href=\"http://www.iodine.com/\">Iodine\u003c/a>, one of an exploding number of digital health startups in San Francisco.\u003c/p>\n\u003cp>By the end of that year, Rock Health projected that digital health funding had exceeded $1.9 billion, a 39 percent jump from the prior year.\u003c/p>\n\u003cp>\u003cstrong>The Rising Tide of Doctors Turning to Entrepreneurship\u003c/strong>\u003c/p>\n\u003cp>Angelotti is far from alone in making the leap from medical school to digital health.\u003c/p>\n\u003cp>Students from around the Bay Area and the country are increasingly dropping out of residency programs and instead going into careers in high-tech start-ups.\u003c/p>\n\u003cp>“We’ve seen that many of these Bay Area-based medical students are drawn to startup opportunities — it used to be biotech, and now it’s more often digital health,” said Jeff Tangney, CEO of Doximity, a physician-network that generates data for the \u003ca href=\"http://health.usnews.com/health-news/blogs/second-opinion/2014/01/10/doximity-begins-surveying-physicians-for-us-news-best-hospitals\">U.S. News Best Hospitals rankings\u003c/a>.\u003c/p>\n\u003cp>Tangney said many of the top digital health companies are more than willing to hire new grads straight out of medical school, who lack years of clinical experience.\u003c/p>\n\u003cp>Dropout doctors are well-positioned, he added, for a career in digital health as they have an insider’s view of the industry — and ideas about how to fix it.\u003c/p>\n\u003cp> \u003c/p>\n\u003cfigure id=\"attachment_13015\" class=\"wp-caption alignright\" style=\"max-width: 437px\">\u003cimg class=\" wp-image-13015\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/sean-duffy-800x533.jpg\" alt=\"Harvard Medical School dropout Sean Duffy addressing a group from Kaiser Permanente\" width=\"437\" height=\"291\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/sean-duffy-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/sean-duffy-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/sean-duffy-1180x787.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/sean-duffy-960x640.jpg 960w\" sizes=\"(max-width: 437px) 100vw, 437px\">\u003cfigcaption class=\"wp-caption-text\">Harvard Medical School dropout Sean Duffy addressing a group from Kaiser Permanente \u003ccite>(Omada Health )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As Sean Duffy, the CEO of Omada Health and a Harvard medical school dropout put it: \"I wanted to understand what's in the trenches, so I could redefine the trenches.\" Omada Health offers an online program to help people change their behavior and avoid the onset of diabetes.\u003c/p>\n\u003cp>Duffy is part of a private Facebook group called \"dropout doctors,\" which includes some of the biggest names in digital health. It functions as a support group, of sorts, and meets every few months for dinner or drinks. Some members, like Angelotti, said they find solace in the group as it can be difficult and lonely to opt out of clinical medicine and follow a different path.\u003c/p>\n\u003cp>The membership includes Angelotti, who now works at primary care chain One Medical; Duffy, CEO of Omada Health\u003ca href=\"https://omadahealth.com/\">;\u003c/a> Connie Chen, the cofounder of Vida Health; Shaundra Eichstadt, medical director at \u003ca href=\"https://www.grandrounds.com/\">Grand Rounds\u003c/a>; Abhas Gupta, a health-focused venture capitalist with the firm \u003ca href=\"http://www.mdv.com/\">Mohr Davidow\u003c/a>; Molly Maloof, a medical advisor to \u003ca href=\"https://doctorbase.com/\">DoctorBase;\u003c/a> and Rebecca Coelius, the director of health at \u003ca href=\"https://www.codeforamerica.org/\">Code for America\u003c/a>.\u003c/p>\n\u003cp>\u003cb>'I Never Thought I Would Leave Medicine' \u003c/b>\u003c/p>\n\u003cp>Experts say it's both 'push and pull' effect that is motivating young doctors to seek out opportunities with the growing intersection of technology and health care, rather than pursue brick and mortar medicine.\u003c/p>\n\u003cp>Many of the students at the top Bay Area medical schools, Stanford and UCSF, are exposed to entrepreneurial thinking during the course of their education, which can be a major draw.\u003c/p>\n\u003cp>\"I never thought I would leave medicine,\" said Eichstadt, who now works at Grand Rounds Health, a San Francisco-based startup that helps patients access second opinions from top medical experts online. \"But there's such a rich opportunity at companies here.\"\u003c/p>\n\u003cfigure id=\"attachment_13016\" class=\"wp-caption alignright\" style=\"max-width: 410px\">\u003cimg class=\" wp-image-13016\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/SE-photo-800x565.jpg\" alt=\"Dr. Shaundra Eichstadt made the transition from medicine to digital health. \" width=\"410\" height=\"289\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/SE-photo-800x565.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/SE-photo-400x282.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/SE-photo-1180x833.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/SE-photo-960x678.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/SE-photo.jpg 2048w\" sizes=\"(max-width: 410px) 100vw, 410px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Shaundra Eichstadt made the transition from medicine to digital health. \u003ccite>(Shaundra Eichstadt )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Eichstadt graduated from Stanford and pursued several years of residency, specializing in plastic and reconstructive surgery.\u003c/p>\n\u003cp>\"I realized that the system isn't designed for doctors to make the real change you would like to for the patient,\" she said. Eichstadt said she believed that she could make a bigger impact elsewhere.\u003c/p>\n\u003cp>Many of the dropout docs expressed a desire to improve the doctor-patient experience. In interviews with \u003cem>KQED,\u003c/em> several said they spent very little time administering care during medical school, and they felt that patients were too often kept out of the loop.\u003c/p>\n\u003cp>A recent study found that doctors-in-training spend\u003ca href=\"http://well.blogs.nytimes.com/2013/05/30/for-new-doctors-8-minutes-per-patient/\"> an average of just eight minutes\u003c/a> with each patient. This is a drastic decrease from previous generations and is linked to more record-keeping requirements and restricted on-duty hours.\u003c/p>\n\u003cp>Connie Chen still practices medicine a half-day each week. But shortly after medical school, Chen co-founded an app called \u003ca href=\"https://www.vida.com\">Vida\u003c/a>, which connects people with chronic diseases to virtual health coaches, like nutritionists and nurses.\u003c/p>\n\u003cp>Chen said she learned very little about nutrition at medical school. But digital health opened up opportunities for Chen to educate herself about wellness, so she can help patients stay healthy.\u003c/p>\n\u003caside class=\"pullquote alignright\">“Tech culture is very appealing when juxtaposed against the hierarchy and myriad hoops to be jumped through in clinical medicine.\"\u003ccite>Rebecca Coelius, Director of Health at Code for America\u003c/cite>\u003c/aside>\n\u003cp>\"Traditional health care is really oriented to make the life of the provider easier,\" she said. \"Your patients cycle in and out of the hospital, and very often, no one makes enough of an effort to communicate with them.\"\u003c/p>\n\u003cp>\u003cstrong>Lack of Opportunities \u003c/strong>\u003c/p>\n\u003cp>Other dropout docs said they felt pushed out of medicine, due to the lack of career opportunities or earning potential. Family practitioners, who serve at the front lines of health care, \u003ca href=\"http://healthland.time.com/2012/04/27/doctors-salaries-who-earns-the-most-and-the-least/\">are paid the least\u003c/a>.\u003c/p>\n\u003cp>Recent studies have also shown rising levels of \u003ca href=\"http://khn.org/news/doctor-burnout/\">discontent among primary care doctors\u003c/a>. Nearly half of 7,200 doctors who responded to a Mayo Clinic survey in 2012 said they felt a lack of enthusiasm about medicine or cynicism about it. A decade ago, one quarter of doctors reported feeling burnt out.\u003c/p>\n\u003cp>\"I loved working with patients but I looked around me and realized that I didn't want the jobs of anybody who had 'succeeded' as a clinician,\" said Rebecca Coelius, who graduated with an MD from UCSF.\u003c/p>\n\u003cp>Coelius now advises a number of health-tech startups, including Doximity and previously worked for \u003ca href=\"http://healthloop.com/\">HealthLoop\u003c/a>, which was founded by another entrepreneurial MD, Dr. Jordan Shlain. She's also worked for the government as a medical innovation officer.\u003c/p>\n\u003cp>\"Tech culture is very appealing when juxtaposed against the hierarchy and myriad hoops to be jumped through in clinical medicine,\" she explained.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Correction: An earlier version of this article contained data from Doximity on the percentage of Stanford and UCSF medical students applying to residency programs. Doximity says it failed to factor in medical school graduates who pursue further post-graduate studies and that the Stanford information it provided was inaccurate. Stanford officials say Stanford has a 95 percent rate of medical students pursuing residency after graduation.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>In need of a knee replacement, prostate resection or gall bladder removal? Now, you can search the \u003ca href=\"https://projects.propublica.org/surgeons/\">Surgeon Scorecard\u003c/a>, a new app from the nonprofit newsroom \u003ca href=\"https://www.propublica.org/\">ProPublica\u003c/a>, that lists the complication rates of surgeons across the United States.\u003c/p>\n\u003cp>ProPublica found half of all hospitals in America have uneven performances among their surgical staff: They have some surgeons with low complication rates and some with high rates. Therefore, it may not be enough for patients to select a well-respected academic hospital and simply hope for the best.\u003c/p>\n\u003cp>At first glance, the app is an impressive feat of data journalism, a three-year project. It includes just shy of 17,000 surgeons, and pulls data from more than 63,000 Medicare patients who were readmitted with complications between 2009 and 2013. The database also includes roughly 3,400 deaths during that period.\u003c/p>\n\u003cfigure id=\"attachment_13677\" class=\"wp-caption aligncenter\" style=\"max-width: 1090px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.05.15-PM.png\">\u003cimg class=\"size-full wp-image-13677\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.05.15-PM.png\" alt=\"Surgeons at St Mary's Medical Center in San Francisco ranked by complication rate.\" width=\"1090\" height=\"577\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.05.15-PM.png 1090w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.05.15-PM-400x212.png 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.05.15-PM-800x423.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.05.15-PM-960x508.png 960w\" sizes=\"(max-width: 1090px) 100vw, 1090px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Surgeons at St Mary's Medical Center in San Francisco ranked by complication rate. \u003ccite>(Screen Shot from ProPublica)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The ProPublica team of Marshall Allen, Olga Pierce and Sisi Wei told KQED they crunched an expansive data set from the federal Centers for Medicare and Medicaid Services, which administers the programs. Then they cross-referenced that data with a number of other sources. CMS agreed to provide this data to ProPublica, with strict limits on sharing the raw data to protect patient privacy.\u003c/p>\n\u003cp>The app includes information about some limitations of the data and about \u003ca href=\"https://www.propublica.org/article/surgeon-level-risk-short-methodology\">the methodology \u003c/a>used to calculate surgical complication rates. The authors stress that they took a conservative approach -- no rate is reported if the surgeon performed that procedure fewer than 20 times, for instance.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"We wouldn't have been able to come up with our methods alone,\" Pierce said. \"We were helped a lot by people who advised us on the best way to use the data.\" The help included a panel of medical experts.\u003c/p>\n\u003cp>\u003cstrong>How Should You Use the App? \u003c/strong>\u003c/p>\n\u003cp>Pierce and Wei say the app is already proving popular with patients, but they declined to disclose how many are using it. They expect that, like other health-transparency tools, it will gain traffic over time.\u003c/p>\n\u003cp>The first thing the ProPublica team wants you to know is the app is \u003cem>not \u003c/em>designed as a be-all and end-all solution. The team recommends patients and their family members use the app as a starting point when researching to find the right surgeon. Some patients may have a gut instinct about a physician, and all patients benefit from asking deeper questions before committing to a procedure.\u003c/p>\n\u003cp>The team said they hope the Surgeon Scorecard will prompt patients and surgeons to have a frank conversation about potential complications. Wei recommends patients ask their surgeon how many procedures they've performed and whether they know their own complication rate.\u003c/p>\n\u003cp>But don't try to catch your surgeon in a lie by comparing your surgeon's response to the scorecard. The Surgeon Scorecard is by no means definitive and includes some gaping holes. CMS barred ProPublica from reporting the exact number of complications if it's between one and ten. The app also doesn't include hospital stays paid for by private insurance or other government programs, like Medicaid.\u003c/p>\n\u003cp>Patient advocates stressed to KQED that the Surgeon Scorecard is just one data point to combine with many others, including transparency tools, online community forums and more. For example, Regina Holliday, a medical advocate from Grantsville, Maryland, suggests patients find out what kind of rehabilitation services are provided after a knee or hip replacement.\u003c/p>\n\u003cfigure id=\"attachment_13692\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-13692\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.30.04-PM-800x359.png\" alt=\"A search of knee replacement performance at hospitals within 25 miles of San Francisco\" width=\"800\" height=\"359\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.30.04-PM-800x359.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.30.04-PM-400x179.png 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.30.04-PM-960x431.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.30.04-PM.png 1157w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A search of knee replacement performance at hospitals within 25 miles of San Francisco.\u003c/figcaption>\u003c/figure>\n\u003cp>Patients should also do some digging about whether it's worth getting the procedure at all, particularly if they've heard from only one doctor. And, as Holliday points out, the data don't touch on whether the procedure was successful from the point of view of former patients.\u003c/p>\n\u003cp>\u003cstrong>Is it Fair to Surgeons?\u003c/strong>\u003c/p>\n\u003cp>The scorecard has gotten positive and negative reviews from the medical community. Some physicians vehemently believe it's not useful to report a surgeon's history of complication rates at all -- and that \u003ca href=\"https://medium.com/@justinmclachlan/propublica-s-surgeonscorecard-should-be-retracted-361055589f5a\">the scorecard should be retracted\u003c/a>.\u003c/p>\n\u003cp>Meanwhile, one anonymous physician raved about the Surgeon Scorecard to\u003ca href=\"http://histalk2.com/\"> a health care blog\u003c/a>, arguing it would set them apart from less talented rivals who were reaping in cash.\u003c/p>\n\u003cp>Others take a more nuanced view.\u003c/p>\n\u003cp>Dr. Bob Wachter, Professor and Interim Chairman of the Department of Medicine at the University of California, San Francisco, said measuring quality is an imperfect science. He does acknowledge, though, that it is useful for patients.\u003c/p>\n\u003cp>In an interview, Dr. Wachter raised a number of concerns about how surgeons are portrayed in the app:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>It's not always the surgeon's fault\u003c/strong>: The outcome of a procedure may have less to do with the surgeon and more to do with the hospital system in which they work (which includes the pharmacists, nurses and hospital leadership.) Moreover, a bad outcome may be a result of a patient failing to take their medication due to a lack of support or a psychiatric condition.\u003c/li>\n\u003cli>\u003cstrong>Some surgeons take on risky cases\u003c/strong>: The data may be skewed against surgeons who take on tricky cases, which are more likely to lead to bad outcomes. It requires a lot of data about a particular case to make sense of the ultimate outcome.\u003c/li>\n\u003cli>\u003cstrong>Some surgeons work at hospitals that care for the very sick and the very poor: \u003c/strong>Some hospitals are regularly referred patients that no others will take. Some patients may also lack social services after they've been discharged, and are more likely to be readmitted.\u003c/li>\n\u003cli>\u003cstrong>Some surgeons have a conservative practice style:\u003c/strong> They may readmit patients more regularly just to monitor them. Although, it may be possible to screen for this by checking the length of the hospital stay.\u003c/li>\n\u003c/ul>\n\u003cp>The team at ProPublica did acknowledge these points and said they took pains to mitigate them in the following ways:\u003c/p>\n\u003cul>\n\u003cli>They did not list complications when they spotted patients who \"looked unusual in some way.\" They also scanned patient records for evidence of comorbidities, like obesity and diabetes -- and did not include these patients in the database.\u003c/li>\n\u003cli>They factored the \"hospital effect\" into the model, meaning that if a hospital is known to release patients without thorough discharge instructions, it may not be the surgeon's fault.\u003c/li>\n\u003cli>They examined the number of days when a patient was readmitted. If the bulk of those stays were three days or longer, that suggested a deeper complication, rather than a conservative approach.\u003c/li>\n\u003cli>They factored into their model the socio-economic status of patients, using \u003ca href=\"http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/InpatientRehabFacPPS/SSIData.html\">SSI data\u003c/a>. There are still be some gaps in this data, however, like the patient's mental state.\u003c/li>\n\u003c/ul>\n\u003cp>The reporters approached the project with the philosophy that surgeons' actions have a major effect on patient outcomes -- and therefore the good and bad actors should be called out. They reference the American College of Surgeons' statement of principles, saying surgeons are responsible for a patient’s entire course of care.\u003c/p>\n\u003cp>\"I will say that surgeons may not be directly responsible, but they do have a lot of power to address these things,\" Pierce said.\u003c/p>\n\u003cp>\u003cstrong>Other Limitations and Concerns\u003c/strong>\u003c/p>\n\u003cp>The most notable hole in ProPublica's data is that they only include Medicare patients. Another important limitation is their reliance on procedure codes. There is a great deal of variation in how hospitals code, \u003ca href=\"http://medicaleconomics.modernmedicine.com/medical-economics/content/tags/centers-medicare-and-medicaid-services/medicare-billing-problems-codi?page=full\">including some that even coded the wrong surgery. \u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_13693\" class=\"wp-caption alignright\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/propublica2.jpg\">\u003cimg class=\"size-full wp-image-13693\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/propublica2.jpg\" alt=\"The reporting team at ProPublica's headquarters in New York City. \" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/propublica2.jpg 640w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/propublica2-400x300.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The reporting team at ProPublica's headquarters in New York City. \u003ccite>(ProPublica )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As Wachter points out, another limitation is that some complications do not lead to readmission or death, and therefore may not be included in the Surgeon Scorecard.\u003c/p>\n\u003cp>Another widely-held concern among doctors and patient advocates is that some physicians may view the Surgeon Scorecard as a benchmark -- if it continues to be popular -- and will opt against taking on tricky cases.\u003c/p>\n\u003cp>\"It's possible that surgeons get frustrated and don't want to stick their neck out in the future,\" said Julia Hallisy, a San Francisco-based patient advocate.\u003c/p>\n\u003cp>\u003cstrong>Next Steps\u003c/strong>\u003c/p>\n\u003cp>Limitations aside, it's important to note that a project like this one would not have been possible a decade ago when hospitals across the country were still relying on paper records. With health systems slowly digitizing, such transparency projects that include thousands, if not millions, of data-sets are now feasible.\u003c/p>\n\u003cp>ProPublica is currently negotiating with states to release similar data, which would include all payers. Currently, it's difficult to follow a specific patient across hospital visits when they have different insurers.\u003c/p>\n\u003cp>In coming months, the team plans to update the data-set with more recent complication rates, and make changes based on the initial feedback and concerns. They're eager to hear from you.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Have you used the Surgeon Scorecard? Got any concerns to share? Contact the team on Twitter using the hashtag #surgeonscorecard.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In need of a knee replacement, prostate resection or gall bladder removal? Now, you can search the \u003ca href=\"https://projects.propublica.org/surgeons/\">Surgeon Scorecard\u003c/a>, a new app from the nonprofit newsroom \u003ca href=\"https://www.propublica.org/\">ProPublica\u003c/a>, that lists the complication rates of surgeons across the United States.\u003c/p>\n\u003cp>ProPublica found half of all hospitals in America have uneven performances among their surgical staff: They have some surgeons with low complication rates and some with high rates. Therefore, it may not be enough for patients to select a well-respected academic hospital and simply hope for the best.\u003c/p>\n\u003cp>At first glance, the app is an impressive feat of data journalism, a three-year project. It includes just shy of 17,000 surgeons, and pulls data from more than 63,000 Medicare patients who were readmitted with complications between 2009 and 2013. The database also includes roughly 3,400 deaths during that period.\u003c/p>\n\u003cfigure id=\"attachment_13677\" class=\"wp-caption aligncenter\" style=\"max-width: 1090px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.05.15-PM.png\">\u003cimg class=\"size-full wp-image-13677\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.05.15-PM.png\" alt=\"Surgeons at St Mary's Medical Center in San Francisco ranked by complication rate.\" width=\"1090\" height=\"577\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.05.15-PM.png 1090w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.05.15-PM-400x212.png 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.05.15-PM-800x423.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.05.15-PM-960x508.png 960w\" sizes=\"(max-width: 1090px) 100vw, 1090px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Surgeons at St Mary's Medical Center in San Francisco ranked by complication rate. \u003ccite>(Screen Shot from ProPublica)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The ProPublica team of Marshall Allen, Olga Pierce and Sisi Wei told KQED they crunched an expansive data set from the federal Centers for Medicare and Medicaid Services, which administers the programs. Then they cross-referenced that data with a number of other sources. CMS agreed to provide this data to ProPublica, with strict limits on sharing the raw data to protect patient privacy.\u003c/p>\n\u003cp>The app includes information about some limitations of the data and about \u003ca href=\"https://www.propublica.org/article/surgeon-level-risk-short-methodology\">the methodology \u003c/a>used to calculate surgical complication rates. The authors stress that they took a conservative approach -- no rate is reported if the surgeon performed that procedure fewer than 20 times, for instance.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We wouldn't have been able to come up with our methods alone,\" Pierce said. \"We were helped a lot by people who advised us on the best way to use the data.\" The help included a panel of medical experts.\u003c/p>\n\u003cp>\u003cstrong>How Should You Use the App? \u003c/strong>\u003c/p>\n\u003cp>Pierce and Wei say the app is already proving popular with patients, but they declined to disclose how many are using it. They expect that, like other health-transparency tools, it will gain traffic over time.\u003c/p>\n\u003cp>The first thing the ProPublica team wants you to know is the app is \u003cem>not \u003c/em>designed as a be-all and end-all solution. The team recommends patients and their family members use the app as a starting point when researching to find the right surgeon. Some patients may have a gut instinct about a physician, and all patients benefit from asking deeper questions before committing to a procedure.\u003c/p>\n\u003cp>The team said they hope the Surgeon Scorecard will prompt patients and surgeons to have a frank conversation about potential complications. Wei recommends patients ask their surgeon how many procedures they've performed and whether they know their own complication rate.\u003c/p>\n\u003cp>But don't try to catch your surgeon in a lie by comparing your surgeon's response to the scorecard. The Surgeon Scorecard is by no means definitive and includes some gaping holes. CMS barred ProPublica from reporting the exact number of complications if it's between one and ten. The app also doesn't include hospital stays paid for by private insurance or other government programs, like Medicaid.\u003c/p>\n\u003cp>Patient advocates stressed to KQED that the Surgeon Scorecard is just one data point to combine with many others, including transparency tools, online community forums and more. For example, Regina Holliday, a medical advocate from Grantsville, Maryland, suggests patients find out what kind of rehabilitation services are provided after a knee or hip replacement.\u003c/p>\n\u003cfigure id=\"attachment_13692\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-13692\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.30.04-PM-800x359.png\" alt=\"A search of knee replacement performance at hospitals within 25 miles of San Francisco\" width=\"800\" height=\"359\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.30.04-PM-800x359.png 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.30.04-PM-400x179.png 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.30.04-PM-960x431.png 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Screen-Shot-2015-07-15-at-1.30.04-PM.png 1157w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">A search of knee replacement performance at hospitals within 25 miles of San Francisco.\u003c/figcaption>\u003c/figure>\n\u003cp>Patients should also do some digging about whether it's worth getting the procedure at all, particularly if they've heard from only one doctor. And, as Holliday points out, the data don't touch on whether the procedure was successful from the point of view of former patients.\u003c/p>\n\u003cp>\u003cstrong>Is it Fair to Surgeons?\u003c/strong>\u003c/p>\n\u003cp>The scorecard has gotten positive and negative reviews from the medical community. Some physicians vehemently believe it's not useful to report a surgeon's history of complication rates at all -- and that \u003ca href=\"https://medium.com/@justinmclachlan/propublica-s-surgeonscorecard-should-be-retracted-361055589f5a\">the scorecard should be retracted\u003c/a>.\u003c/p>\n\u003cp>Meanwhile, one anonymous physician raved about the Surgeon Scorecard to\u003ca href=\"http://histalk2.com/\"> a health care blog\u003c/a>, arguing it would set them apart from less talented rivals who were reaping in cash.\u003c/p>\n\u003cp>Others take a more nuanced view.\u003c/p>\n\u003cp>Dr. Bob Wachter, Professor and Interim Chairman of the Department of Medicine at the University of California, San Francisco, said measuring quality is an imperfect science. He does acknowledge, though, that it is useful for patients.\u003c/p>\n\u003cp>In an interview, Dr. Wachter raised a number of concerns about how surgeons are portrayed in the app:\u003c/p>\n\u003cul>\n\u003cli>\u003cstrong>It's not always the surgeon's fault\u003c/strong>: The outcome of a procedure may have less to do with the surgeon and more to do with the hospital system in which they work (which includes the pharmacists, nurses and hospital leadership.) Moreover, a bad outcome may be a result of a patient failing to take their medication due to a lack of support or a psychiatric condition.\u003c/li>\n\u003cli>\u003cstrong>Some surgeons take on risky cases\u003c/strong>: The data may be skewed against surgeons who take on tricky cases, which are more likely to lead to bad outcomes. It requires a lot of data about a particular case to make sense of the ultimate outcome.\u003c/li>\n\u003cli>\u003cstrong>Some surgeons work at hospitals that care for the very sick and the very poor: \u003c/strong>Some hospitals are regularly referred patients that no others will take. Some patients may also lack social services after they've been discharged, and are more likely to be readmitted.\u003c/li>\n\u003cli>\u003cstrong>Some surgeons have a conservative practice style:\u003c/strong> They may readmit patients more regularly just to monitor them. Although, it may be possible to screen for this by checking the length of the hospital stay.\u003c/li>\n\u003c/ul>\n\u003cp>The team at ProPublica did acknowledge these points and said they took pains to mitigate them in the following ways:\u003c/p>\n\u003cul>\n\u003cli>They did not list complications when they spotted patients who \"looked unusual in some way.\" They also scanned patient records for evidence of comorbidities, like obesity and diabetes -- and did not include these patients in the database.\u003c/li>\n\u003cli>They factored the \"hospital effect\" into the model, meaning that if a hospital is known to release patients without thorough discharge instructions, it may not be the surgeon's fault.\u003c/li>\n\u003cli>They examined the number of days when a patient was readmitted. If the bulk of those stays were three days or longer, that suggested a deeper complication, rather than a conservative approach.\u003c/li>\n\u003cli>They factored into their model the socio-economic status of patients, using \u003ca href=\"http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/InpatientRehabFacPPS/SSIData.html\">SSI data\u003c/a>. There are still be some gaps in this data, however, like the patient's mental state.\u003c/li>\n\u003c/ul>\n\u003cp>The reporters approached the project with the philosophy that surgeons' actions have a major effect on patient outcomes -- and therefore the good and bad actors should be called out. They reference the American College of Surgeons' statement of principles, saying surgeons are responsible for a patient’s entire course of care.\u003c/p>\n\u003cp>\"I will say that surgeons may not be directly responsible, but they do have a lot of power to address these things,\" Pierce said.\u003c/p>\n\u003cp>\u003cstrong>Other Limitations and Concerns\u003c/strong>\u003c/p>\n\u003cp>The most notable hole in ProPublica's data is that they only include Medicare patients. Another important limitation is their reliance on procedure codes. There is a great deal of variation in how hospitals code, \u003ca href=\"http://medicaleconomics.modernmedicine.com/medical-economics/content/tags/centers-medicare-and-medicaid-services/medicare-billing-problems-codi?page=full\">including some that even coded the wrong surgery. \u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_13693\" class=\"wp-caption alignright\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/propublica2.jpg\">\u003cimg class=\"size-full wp-image-13693\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/propublica2.jpg\" alt=\"The reporting team at ProPublica's headquarters in New York City. \" width=\"640\" height=\"480\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/propublica2.jpg 640w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/propublica2-400x300.jpg 400w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The reporting team at ProPublica's headquarters in New York City. \u003ccite>(ProPublica )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As Wachter points out, another limitation is that some complications do not lead to readmission or death, and therefore may not be included in the Surgeon Scorecard.\u003c/p>\n\u003cp>Another widely-held concern among doctors and patient advocates is that some physicians may view the Surgeon Scorecard as a benchmark -- if it continues to be popular -- and will opt against taking on tricky cases.\u003c/p>\n\u003cp>\"It's possible that surgeons get frustrated and don't want to stick their neck out in the future,\" said Julia Hallisy, a San Francisco-based patient advocate.\u003c/p>\n\u003cp>\u003cstrong>Next Steps\u003c/strong>\u003c/p>\n\u003cp>Limitations aside, it's important to note that a project like this one would not have been possible a decade ago when hospitals across the country were still relying on paper records. With health systems slowly digitizing, such transparency projects that include thousands, if not millions, of data-sets are now feasible.\u003c/p>\n\u003cp>ProPublica is currently negotiating with states to release similar data, which would include all payers. Currently, it's difficult to follow a specific patient across hospital visits when they have different insurers.\u003c/p>\n\u003cp>In coming months, the team plans to update the data-set with more recent complication rates, and make changes based on the initial feedback and concerns. They're eager to hear from you.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Have you used the Surgeon Scorecard? Got any concerns to share? Contact the team on Twitter using the hashtag #surgeonscorecard.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Bay Area scientists have developed a new method to test drugs that are likely to be dangerous for pregnant women and cause heart defects in the fetus.\u003c/p>\n\u003cp>Researchers from UC Berkeley and the Gladstone Institutes, an affiliate of the University of California, San Francisco, grew beating heart tissue from stem cells -- essentially a mini human heart chamber in a dish. Stem cells have the potential to become any type of cell in the human body.\u003c/p>\n\u003cp>The researchers intend to use the system to screen medications intended for pregnant women to detect whether they will likely do any harm to the fetus. Among the most commonly-reported birth defects involve the heart.\u003c/p>\n\u003cp>Birth defects affect three percent of babies born in the United States every year, according to the Centers for Disease Control and Prevention. Birth defects are one of the most common causes of infant deaths.\u003c/p>\n\u003cp>[Watch the video below for a demo.]\u003c/p>\n\u003cp>In 2014, scientists in the UK developed a \u003ca href=\"http://www.theguardian.com/science/2014/feb/02/stem-cell-research-heart-disease-long-qt\">similar model\u003c/a> to convert skin cells into beating heart cells in a petri dish. Previously, doctors would have needed to surgically remove heart tissue from patients to test new treatments, which is invasive and not practical.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It's still early days for the technology, but the Gladstone Institutes' Dr. Bruce Conklin said the researchers have already tested whether the system could detect any problems with the drug Thalidomide. Thalidomide was prescribed widely in the 1960s for morning sickness but was later withdrawn for causing thousands of birth defects.\u003c/p>\n\u003cp>The system proved effective in this early experiment. Normal doses of the drug led to myriad problems, such as lower heart beat rate, compared with heart tissue that had not been exposed to the drug.\u003c/p>\n\u003cp>\"Thalidomide was tested in animals,\" said Dr. Conklin, whose research specializes in human genetics that lead to cardiovascular diseases. \"If they had a human model system in the 1960s, they could have caught it.\"\u003c/p>\n\u003cp>Since the Thalidomide disaster, Dr. Conklin said it has been very difficult for pharmaceutical companies to get drugs approved for pregnant women. \"They are so cautious,\" he said. But artificially grown, in vitro, miniature organs -- known as \"organoids\" -- could prove effective as a means to test drugs for potential birth defects.\u003c/p>\n\u003cp>The researchers say that this technology may replace animal models. Today, researchers will dissect animals at different stages of development to study how organs form. But one of the many drawbacks to testing on animals is that a mouse or pig may respond differently to a drug than a human subject.\u003c/p>\n\u003cp>In the future, the researchers say the technology can be adapted to other human organs. Dr. Conklin said he expects that a similar model will benefit cancer patients, who experience cardiac issues as a side effect of medication.\u003c/p>\n\u003cp>The results of their research were published this week in the science journal \u003cem>Nature Communications\u003c/em>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[youtube https://www.youtube.com/watch?v=18-qE1s-Kys]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Bay Area scientists have developed a new method to test drugs that are likely to be dangerous for pregnant women and cause heart defects in the fetus.\u003c/p>\n\u003cp>Researchers from UC Berkeley and the Gladstone Institutes, an affiliate of the University of California, San Francisco, grew beating heart tissue from stem cells -- essentially a mini human heart chamber in a dish. Stem cells have the potential to become any type of cell in the human body.\u003c/p>\n\u003cp>The researchers intend to use the system to screen medications intended for pregnant women to detect whether they will likely do any harm to the fetus. Among the most commonly-reported birth defects involve the heart.\u003c/p>\n\u003cp>Birth defects affect three percent of babies born in the United States every year, according to the Centers for Disease Control and Prevention. Birth defects are one of the most common causes of infant deaths.\u003c/p>\n\u003cp>[Watch the video below for a demo.]\u003c/p>\n\u003cp>In 2014, scientists in the UK developed a \u003ca href=\"http://www.theguardian.com/science/2014/feb/02/stem-cell-research-heart-disease-long-qt\">similar model\u003c/a> to convert skin cells into beating heart cells in a petri dish. Previously, doctors would have needed to surgically remove heart tissue from patients to test new treatments, which is invasive and not practical.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It's still early days for the technology, but the Gladstone Institutes' Dr. Bruce Conklin said the researchers have already tested whether the system could detect any problems with the drug Thalidomide. Thalidomide was prescribed widely in the 1960s for morning sickness but was later withdrawn for causing thousands of birth defects.\u003c/p>\n\u003cp>The system proved effective in this early experiment. Normal doses of the drug led to myriad problems, such as lower heart beat rate, compared with heart tissue that had not been exposed to the drug.\u003c/p>\n\u003cp>\"Thalidomide was tested in animals,\" said Dr. Conklin, whose research specializes in human genetics that lead to cardiovascular diseases. \"If they had a human model system in the 1960s, they could have caught it.\"\u003c/p>\n\u003cp>Since the Thalidomide disaster, Dr. Conklin said it has been very difficult for pharmaceutical companies to get drugs approved for pregnant women. \"They are so cautious,\" he said. But artificially grown, in vitro, miniature organs -- known as \"organoids\" -- could prove effective as a means to test drugs for potential birth defects.\u003c/p>\n\u003cp>The researchers say that this technology may replace animal models. Today, researchers will dissect animals at different stages of development to study how organs form. But one of the many drawbacks to testing on animals is that a mouse or pig may respond differently to a drug than a human subject.\u003c/p>\n\u003cp>In the future, the researchers say the technology can be adapted to other human organs. Dr. Conklin said he expects that a similar model will benefit cancer patients, who experience cardiac issues as a side effect of medication.\u003c/p>\n\u003cp>The results of their research were published this week in the science journal \u003cem>Nature Communications\u003c/em>.\u003c/p>\n\u003cp>\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/18-qE1s-Kys'\n title='//www.youtube.com/embed/18-qE1s-Kys'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Ginger.io Harnesses Big Data to Help Women Fight Perinatal Depression",
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"content": "\u003cp>A new baby usually ushers in a period of sleeplessness and joy in roughly equal measure, but sometimes pregnancy and birth also usher in a period of anxiety and depression.\u003c/p>\n\u003cp>An academic study of 10,000 mothers in Pittsburgh, the \u003ca href=\"http://archpsyc.jamanetwork.com/article.aspx?articleid=1666651\">largest study on this topic to date\u003c/a>, found 14 percent of them suffered from postpartum depression in the year after birth. For some women, the struggle actually starts to emerge while they are pregnant.\u003c/p>\n\u003cp>Prenatal and postnatal depression are \u003ca href=\"http://www.webmd.com/depression/features/postpartum\">two elements in a “constellation”\u003c/a> of mood disorders that affect women during the perinatal period, which spans through pregnancy and up to a year after. Estimates for perinatal mood disorders vary because it is widely underreported -- \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684038/#bib3\">more than half of cases go undetected and undiagnosed\u003c/a>. This is much more serious than the “baby blues,” which is a result of normal hormonal changes and can affect \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684038/\">80 percent of women\u003c/a> in the days immediately following childbirth.\u003c/p>\n\u003caside class=\"pullquote alignright\">“These women continue to suffer, most in silence and bewilderment, about the pathology of their condition, a condition which is treatable and possibly even preventable.”\u003ccite>Sara Thurgood, Daniel Avery\u003cbr>\nand Lloyda Williamson\u003cbr>\nAmerican Journal of Clinical Medicine\u003c/cite>\u003c/aside>\n\u003cp>In fact, one study found mental health conditions tied with urinary tract infections as \u003ca href=\"http://www.cdc.gov/reproductivehealth/Depression/PDFs/Mental_Health_Women_Repo_Age.pdf\">one of the top three\u003c/a> types of maternal complications during pregnancy. Another study found postpartum depression is the \u003ca href=\"http://www.aapsus.org/articles/11.pdf\">most common complication\u003c/a> of childbirth. And yet, a compilation of studies indicate that just \u003ca href=\"http://www.readcube.com/articles/10.1111%2Fj.1523-536X.2006.00130.x?r3_referer=wol&tracking_action=preview_click&show_checkout=1&purchase_referrer=onlinelibrary.wiley.com&purchase_site_license=LICENSE_DENIED_NO_CUSTOMER\">15 percent of women\u003c/a> with perinatal mood disorders receive treatment.\u003c/p>\n\u003cp>Why do so few women get the help and support they need? The overwhelming reason is fear of being stigmatized as an “unhappy” or “bad” mother.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“They may minimize their symptoms or attribute them to feeling overwhelmed by the demands of a new baby, lack of sleep, or difficult infant temperament,” \u003ca href=\"http://www.aapsus.org/articles/11.pdf\">write Sara Thurgood, Daniel Avery and Lloyda Williamson\u003c/a>, in the \u003ca href=\"http://www.aapsus.org/journals\">American Journal of Clinical Medicine\u003c/a>. “These women continue to suffer, most in silence and bewilderment, about the pathology of their condition, a condition which is treatable and possibly even preventable.”\u003c/p>\n\u003cp>\u003cstrong>Maybe Help Could Be, Literally, At Hand\u003c/strong>\u003c/p>\n\u003cp>San Francisco-based \u003ca href=\"https://ginger.io/\">Ginger.io\u003c/a> is a mobile startup seeking to help women by connecting them with medical support when they need it. The perinatal depression app is intended to help users and health care providers identify the difference between normal mood fluctuations and anxieties, and times when intervention and/or treatment is needed.\u003c/p>\n\u003cp>The app collects sensor data and self-reported information for factors such as how much you move around, eat, sleep and talk with people. Then it creates a map of your behavior patterns. When it notices significant changes that indicate perinatal depression or anxiety, the app notifies your care provider who can then reach out with support. In addition, Ginger.io makes it easy for women who are pregnant or recently had a baby to create a log of their behavior and emotions, so they have tangible data to share with during doctor visits.\u003c/p>\n\u003cp>The company emerged out of the MIT Media Lab in 2010 with the broad goal of using smartphones to improve mental health care. It has since formed partnerships with more than 30 institutions across the country, including eight of the top academic medical centers in the U.S..\u003c/p>\n\u003cp>Ginger.io’s perinatal depression program is currently being piloted with three major health systems -- Novant Health in North Carolina, the University of Pennsylvania and a California system the company hasn’t named.\u003c/p>\n\u003cp>\u003cstrong>Identifying Perinatal Depression\u003c/strong>\u003c/p>\n\u003cp>“So often things fall through the cracks,” said Naomi Kincler, Ginger.io’s Head of Customer Success who helped implement the program at Novant. “Even in pregnancy, when you are coming in regularly for visits, a lot that can still happen in between, and the usual visit with a doctor is no more than 15 minutes.”\u003c/p>\n\u003cfigure id=\"attachment_13081\" class=\"wp-caption alignright\" style=\"max-width: 504px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/cdc-chart.jpg\">\u003cimg class=\" wp-image-13081\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/cdc-chart.jpg\" alt=\"Source: Centers for Disease Control and Prevention\" width=\"504\" height=\"203\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/cdc-chart.jpg 728w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/cdc-chart-400x162.jpg 400w\" sizes=\"(max-width: 504px) 100vw, 504px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Source: Centers for Disease Control and Prevention\u003c/figcaption>\u003c/figure>\n\u003cp>Kincler shared the story of a patient with a history of depression, who stopped taking her antidepressant for fear it would harm the baby. Ginger.io triggered an alert to her doctor, noting elevated symptoms of depression. Kincler says when the doctor reached out, the woman said she had no idea it would be so hard and she was done being pregnant.\u003c/p>\n\u003cp>Kincler said the doctor believed the woman was at risk for self-harm, and recommended she restart her antidepressants. But the following week, Ginger.io sent another alert. A triage nurse followed up and found the woman had not restarted her meds. The doctor then followed up again to reinforce the safety of taking the medication, and the woman was able to resume treatment and manage her symptoms.\u003c/p>\n\u003cp>“This story highlights the fact that visits alone don't always provide the best venue to have those discussions with the patients,” Kincler said. “The real power behind our tool is the ability to dig deep into issues, track improvement, and connect dots between visits.”\u003c/p>\n\u003cp>Nurse Birdie Gunyon Meyer backs that up.\u003c/p>\n\u003cp>“Many, many of our care providers are not asking women how they are doing emotionally,” said Meyer, coordinator of the Perinatal Mood Disorders Program at Indiana University Health, and the former President of Postpartum Support International. “They are so busy and only have so much time to see each patient. Most of our OB care providers’ offices still do not screen because it is time-consuming, and so women just don’t know where to go or who to call.”\u003c/p>\n\u003cp>However, Meyer is skeptical that an app would be able to bridge this communication gap.\u003c/p>\n\u003cp>“Care providers are very busy, and so while the app might provide great, useful information, I wonder if they would actually use it?” she said. “And many women may still be reluctant to tell the truth because they do not want to look bad to their OB/GYN. If the care provider usually doesn’t ask how they are doing, they may not feel safe saying anything. Even if they do, its important to make sure women are connected with proper social support, not just medication.”\u003c/p>\n\u003cp>\u003cstrong>In-App Intimacy \u003c/strong>\u003c/p>\n\u003cp>The mental health of pregnant women and new moms is an extremely sensitive issue. Meyer said many women may feel uncomfortable sharing this kind of information with an app. What if the data fell into the wrong hands? Could this information be used in an unwarranted way, for example, to alert Child Protective Services, or to advertise pharmaceuticals?\u003c/p>\n\u003cp>Kincler said Ginger.io treats patient data like a medical record, encrypting it and sharing it only with care providers. Users can also ask Ginger.io to delete their data.\u003c/p>\n\u003cp>Being pregnant and having a newborn can be stressful. Feeling depressed or anxious can be stressful. Keeping secrets can be stressful. With perinatal mood disorders, all three of these stresses can coalesce into one, unbearable burden.\u003c/p>\n\u003cp>Meyer says a key part of alleviating this burden is sharing one simple message: You are not alone. You are not to blame. With help, you will be well.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>It comes down to communication: If the app helps women express their experiences honestly, and if care providers respond quickly and effectively -- two big “ifs” -- then the app could be a tool to help get more women with perinatal mood disorders diagnosed and helped.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A new baby usually ushers in a period of sleeplessness and joy in roughly equal measure, but sometimes pregnancy and birth also usher in a period of anxiety and depression.\u003c/p>\n\u003cp>An academic study of 10,000 mothers in Pittsburgh, the \u003ca href=\"http://archpsyc.jamanetwork.com/article.aspx?articleid=1666651\">largest study on this topic to date\u003c/a>, found 14 percent of them suffered from postpartum depression in the year after birth. For some women, the struggle actually starts to emerge while they are pregnant.\u003c/p>\n\u003cp>Prenatal and postnatal depression are \u003ca href=\"http://www.webmd.com/depression/features/postpartum\">two elements in a “constellation”\u003c/a> of mood disorders that affect women during the perinatal period, which spans through pregnancy and up to a year after. Estimates for perinatal mood disorders vary because it is widely underreported -- \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684038/#bib3\">more than half of cases go undetected and undiagnosed\u003c/a>. This is much more serious than the “baby blues,” which is a result of normal hormonal changes and can affect \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684038/\">80 percent of women\u003c/a> in the days immediately following childbirth.\u003c/p>\n\u003caside class=\"pullquote alignright\">“These women continue to suffer, most in silence and bewilderment, about the pathology of their condition, a condition which is treatable and possibly even preventable.”\u003ccite>Sara Thurgood, Daniel Avery\u003cbr>\nand Lloyda Williamson\u003cbr>\nAmerican Journal of Clinical Medicine\u003c/cite>\u003c/aside>\n\u003cp>In fact, one study found mental health conditions tied with urinary tract infections as \u003ca href=\"http://www.cdc.gov/reproductivehealth/Depression/PDFs/Mental_Health_Women_Repo_Age.pdf\">one of the top three\u003c/a> types of maternal complications during pregnancy. Another study found postpartum depression is the \u003ca href=\"http://www.aapsus.org/articles/11.pdf\">most common complication\u003c/a> of childbirth. And yet, a compilation of studies indicate that just \u003ca href=\"http://www.readcube.com/articles/10.1111%2Fj.1523-536X.2006.00130.x?r3_referer=wol&tracking_action=preview_click&show_checkout=1&purchase_referrer=onlinelibrary.wiley.com&purchase_site_license=LICENSE_DENIED_NO_CUSTOMER\">15 percent of women\u003c/a> with perinatal mood disorders receive treatment.\u003c/p>\n\u003cp>Why do so few women get the help and support they need? The overwhelming reason is fear of being stigmatized as an “unhappy” or “bad” mother.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“They may minimize their symptoms or attribute them to feeling overwhelmed by the demands of a new baby, lack of sleep, or difficult infant temperament,” \u003ca href=\"http://www.aapsus.org/articles/11.pdf\">write Sara Thurgood, Daniel Avery and Lloyda Williamson\u003c/a>, in the \u003ca href=\"http://www.aapsus.org/journals\">American Journal of Clinical Medicine\u003c/a>. “These women continue to suffer, most in silence and bewilderment, about the pathology of their condition, a condition which is treatable and possibly even preventable.”\u003c/p>\n\u003cp>\u003cstrong>Maybe Help Could Be, Literally, At Hand\u003c/strong>\u003c/p>\n\u003cp>San Francisco-based \u003ca href=\"https://ginger.io/\">Ginger.io\u003c/a> is a mobile startup seeking to help women by connecting them with medical support when they need it. The perinatal depression app is intended to help users and health care providers identify the difference between normal mood fluctuations and anxieties, and times when intervention and/or treatment is needed.\u003c/p>\n\u003cp>The app collects sensor data and self-reported information for factors such as how much you move around, eat, sleep and talk with people. Then it creates a map of your behavior patterns. When it notices significant changes that indicate perinatal depression or anxiety, the app notifies your care provider who can then reach out with support. In addition, Ginger.io makes it easy for women who are pregnant or recently had a baby to create a log of their behavior and emotions, so they have tangible data to share with during doctor visits.\u003c/p>\n\u003cp>The company emerged out of the MIT Media Lab in 2010 with the broad goal of using smartphones to improve mental health care. It has since formed partnerships with more than 30 institutions across the country, including eight of the top academic medical centers in the U.S..\u003c/p>\n\u003cp>Ginger.io’s perinatal depression program is currently being piloted with three major health systems -- Novant Health in North Carolina, the University of Pennsylvania and a California system the company hasn’t named.\u003c/p>\n\u003cp>\u003cstrong>Identifying Perinatal Depression\u003c/strong>\u003c/p>\n\u003cp>“So often things fall through the cracks,” said Naomi Kincler, Ginger.io’s Head of Customer Success who helped implement the program at Novant. “Even in pregnancy, when you are coming in regularly for visits, a lot that can still happen in between, and the usual visit with a doctor is no more than 15 minutes.”\u003c/p>\n\u003cfigure id=\"attachment_13081\" class=\"wp-caption alignright\" style=\"max-width: 504px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/cdc-chart.jpg\">\u003cimg class=\" wp-image-13081\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/cdc-chart.jpg\" alt=\"Source: Centers for Disease Control and Prevention\" width=\"504\" height=\"203\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/cdc-chart.jpg 728w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/cdc-chart-400x162.jpg 400w\" sizes=\"(max-width: 504px) 100vw, 504px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Source: Centers for Disease Control and Prevention\u003c/figcaption>\u003c/figure>\n\u003cp>Kincler shared the story of a patient with a history of depression, who stopped taking her antidepressant for fear it would harm the baby. Ginger.io triggered an alert to her doctor, noting elevated symptoms of depression. Kincler says when the doctor reached out, the woman said she had no idea it would be so hard and she was done being pregnant.\u003c/p>\n\u003cp>Kincler said the doctor believed the woman was at risk for self-harm, and recommended she restart her antidepressants. But the following week, Ginger.io sent another alert. A triage nurse followed up and found the woman had not restarted her meds. The doctor then followed up again to reinforce the safety of taking the medication, and the woman was able to resume treatment and manage her symptoms.\u003c/p>\n\u003cp>“This story highlights the fact that visits alone don't always provide the best venue to have those discussions with the patients,” Kincler said. “The real power behind our tool is the ability to dig deep into issues, track improvement, and connect dots between visits.”\u003c/p>\n\u003cp>Nurse Birdie Gunyon Meyer backs that up.\u003c/p>\n\u003cp>“Many, many of our care providers are not asking women how they are doing emotionally,” said Meyer, coordinator of the Perinatal Mood Disorders Program at Indiana University Health, and the former President of Postpartum Support International. “They are so busy and only have so much time to see each patient. Most of our OB care providers’ offices still do not screen because it is time-consuming, and so women just don’t know where to go or who to call.”\u003c/p>\n\u003cp>However, Meyer is skeptical that an app would be able to bridge this communication gap.\u003c/p>\n\u003cp>“Care providers are very busy, and so while the app might provide great, useful information, I wonder if they would actually use it?” she said. “And many women may still be reluctant to tell the truth because they do not want to look bad to their OB/GYN. If the care provider usually doesn’t ask how they are doing, they may not feel safe saying anything. Even if they do, its important to make sure women are connected with proper social support, not just medication.”\u003c/p>\n\u003cp>\u003cstrong>In-App Intimacy \u003c/strong>\u003c/p>\n\u003cp>The mental health of pregnant women and new moms is an extremely sensitive issue. Meyer said many women may feel uncomfortable sharing this kind of information with an app. What if the data fell into the wrong hands? Could this information be used in an unwarranted way, for example, to alert Child Protective Services, or to advertise pharmaceuticals?\u003c/p>\n\u003cp>Kincler said Ginger.io treats patient data like a medical record, encrypting it and sharing it only with care providers. Users can also ask Ginger.io to delete their data.\u003c/p>\n\u003cp>Being pregnant and having a newborn can be stressful. Feeling depressed or anxious can be stressful. Keeping secrets can be stressful. With perinatal mood disorders, all three of these stresses can coalesce into one, unbearable burden.\u003c/p>\n\u003cp>Meyer says a key part of alleviating this burden is sharing one simple message: You are not alone. You are not to blame. With help, you will be well.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "65 Startups That are Treating the Human Body (graphic)",
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"content": "\u003cp>The health sector is opening its doors to innovation in the wake of the Affordable Care Act and other reforms.\u003c/p>\n\u003cp>In buzzing technology hubs like San Francisco and New York, thousands of entrepreneurs are developing new medical devices, lab tests, drugs and software to improve how patients are treated today.\u003c/p>\n\u003cp>Many of these startups are focused on the systems level, meaning they are helping hospitals improve patient experience and/or cut costs. Others are developing new therapies for a specific disease, like diabetes or cancer.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cbinsights.com/\">CB Insights\u003c/a>, a research firm, put together a list of 65 U.S. based health startups that are focused on the latter: Treating the human body. Their research is by no means exhaustive, but I found it to be a useful reference.\u003c/p>\n\u003cp>According to CB Insights, healthcare and life sciences companies \u003ca href=\"https://www.cbinsights.com/blog/healthcare-venture-capital-report-2014/\">raised more than $8B from VC firms in 2014.\u003c/a> While the digital health space is particularly trendy (it's our focus at \u003cem>\u003ca href=\"http://The%20Bay%20Area%20is%20home%20to%20about%20a%20third%20of%20these%20companies,%20which%20fall%20into%20the%20biotech%20category.\">Future of You\u003c/a>)\u003c/em>, many of these startups fall into the biotech category, which is also currently experiencing a surge -- some are even calling it a \u003ca href=\"http://www.forbes.com/sites/panosmourdoukoutas/2015/03/15/is-the-biotechnology-bubble-turning-into-mania/\">\"mania.\"\u003c/a>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Some of the startups that made the list are well-known, such as Theranos, \u003ca href=\"http://www.wired.com/2014/02/elizabeth-holmes-theranos/\">which claims to have invented\u003c/a> a way to run 30 lab tests on a single drop of blood or Neuropace, which is developing an implantable medical device to treat epilepsy. Others are more secretive or under-the-radar as their products may have some unique intellectual property or still be under development.\u003c/p>\n\u003cp>A spokesperson from CB Insights said they developed this list through a combination of \u003ca href=\"https://www.cbinsights.com/blog/private-company-financing-data-sources-cruncher/\">search technology\u003c/a> and manual input. The infographic (above) is restricted to U.S. based private companies with venture capital funding.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Please reach out to me at cfarr@kqed.org if your startup isn't featured in the CB Insights' infographic, but should be considered. \u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The health sector is opening its doors to innovation in the wake of the Affordable Care Act and other reforms.\u003c/p>\n\u003cp>In buzzing technology hubs like San Francisco and New York, thousands of entrepreneurs are developing new medical devices, lab tests, drugs and software to improve how patients are treated today.\u003c/p>\n\u003cp>Many of these startups are focused on the systems level, meaning they are helping hospitals improve patient experience and/or cut costs. Others are developing new therapies for a specific disease, like diabetes or cancer.\u003c/p>\n\u003cp>\u003ca href=\"https://www.cbinsights.com/\">CB Insights\u003c/a>, a research firm, put together a list of 65 U.S. based health startups that are focused on the latter: Treating the human body. Their research is by no means exhaustive, but I found it to be a useful reference.\u003c/p>\n\u003cp>According to CB Insights, healthcare and life sciences companies \u003ca href=\"https://www.cbinsights.com/blog/healthcare-venture-capital-report-2014/\">raised more than $8B from VC firms in 2014.\u003c/a> While the digital health space is particularly trendy (it's our focus at \u003cem>\u003ca href=\"http://The%20Bay%20Area%20is%20home%20to%20about%20a%20third%20of%20these%20companies,%20which%20fall%20into%20the%20biotech%20category.\">Future of You\u003c/a>)\u003c/em>, many of these startups fall into the biotech category, which is also currently experiencing a surge -- some are even calling it a \u003ca href=\"http://www.forbes.com/sites/panosmourdoukoutas/2015/03/15/is-the-biotechnology-bubble-turning-into-mania/\">\"mania.\"\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Some of the startups that made the list are well-known, such as Theranos, \u003ca href=\"http://www.wired.com/2014/02/elizabeth-holmes-theranos/\">which claims to have invented\u003c/a> a way to run 30 lab tests on a single drop of blood or Neuropace, which is developing an implantable medical device to treat epilepsy. Others are more secretive or under-the-radar as their products may have some unique intellectual property or still be under development.\u003c/p>\n\u003cp>A spokesperson from CB Insights said they developed this list through a combination of \u003ca href=\"https://www.cbinsights.com/blog/private-company-financing-data-sources-cruncher/\">search technology\u003c/a> and manual input. The infographic (above) is restricted to U.S. based private companies with venture capital funding.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Please reach out to me at cfarr@kqed.org if your startup isn't featured in the CB Insights' infographic, but should be considered. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Researchers have taken another step toward reversing deafness using gene therapy.\u003c/p>\n\u003cp>The latest success involves mice with an inherited form of deafness, a team \u003ca href=\"http://stm.sciencemag.org/lookup/doi/10.1126/scitranslmed.aab1996\">reports\u003c/a> Wednesday in the journal \u003cem>Science Translational Medicine\u003c/em>. And a similar approach is already being tried in people with hearing loss caused by damage to cells in the inner ear.\u003c/p>\n\u003cp>\"I'd say we are very close\" to having gene therapies that can restore hearing loss from a wide range of causes, says \u003ca href=\"https://www.uni-goettingen.de/en/58009.html\">Dr. Tobias Moser\u003c/a>, a professor of auditory neuroscience at the University of Göttingen in Germany. Moser wrote an \u003ca href=\"http://stm.sciencemag.org/lookup/doi/10.1126/scitranslmed.aac7545\">article\u003c/a> accompanying the mouse study.\u003c/p>\n\u003cp>The new study is the result of an effort to help children with hearing loss caused by genetic defects, says co-author \u003ca href=\"http://www.childrenshospital.org/researchers/jeffrey-holt\">Jeffrey Holt\u003c/a>, a researcher at Harvard and Boston Children's Hospital whose work is supported by the \u003ca href=\"http://www.fondation-bertarelli.org/\">Bertarelli Foundation\u003c/a>. In the U.S. alone, thousands of children are born each year with inherited hearing loss.\u003c/p>\n\u003cp>But gene therapies could eventually allow many of them to hear, Holt says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"A baby who is born deaf could have their genome sequenced,\" he says. \"If we identify the specific gene that's causing the deafness then you could tailor a precision treatment, hopefully restoring function.\"\u003c/p>\n\u003cp>Holt and his team, including lead author \u003ca href=\"https://sites.google.com/site/holtgeleoclab/people\">Charles Askew\u003c/a>, have been studying genes that affect hearing. And they've focused on a gene called TMC1.\u003c/p>\n\u003cp>Normally this gene allows cells in the inner ear to convert sounds into electrical signals that are sent to the brain, Holt says. But when the gene is mutated, he says, this doesn't happen.\u003c/p>\n\u003cp>\"Once we realized we had this deafness gene we began thinking about how we might be able to restore function in these patients with genetic hearing loss,\" Holt says.\u003c/p>\n\u003cp>Their idea was to use gene therapy to replace mutated TMC1 genes with genes that functioned correctly. And when the team tried this in mice, \"the deaf mice began to jump\" when they heard a loud sound.\u003c/p>\n\u003cp>Electrical signals in the brain confirmed that the mice were no longer deaf. But the treatment didn't fully restore hearing, and still needs some tweaks, Holt says.\u003c/p>\n\u003cp>\"It would be premature to say this is ready for the clinic,\" Holt says. \"But I am optimistic that in the not too distant future some of this really could make a difference in people's lives.\"\u003c/p>\n\u003cp>The big question now is not whether gene therapy for inherited deafness will work, but whether there will be enough money to pay for it, says Moser. That's because there are dozens of different genetic mutations that can affect hearing and each one may need its own customized treatment, he says.\u003c/p>\n\u003cp>\"If you think how much it will cost to really go through all the clinical trials until you actually have [Food and Drug Administration] approval, this will I fear really limit the chances to put this into practice,\" he says.\u003c/p>\n\u003cp>On the other hand, countries including the U.S. have already proved willing to spend a lot to restore hearing, says \u003ca href=\"http://www.kumc.edu/school-of-medicine/otolaryngology/faculty-and-staff/faculty/hinrich-staecker.html\">Hinrich Staecker\u003c/a>, an otolaryngologist and researcher at the University of Kansas Medical Center. \"People consider it a very effective use of funds to put two cochlear implants in a child,\" he says. \"So you're looking at an intervention to make a child hear again at a cost of $120,000 or so.\u003c/p>\n\u003cp>Staecker is one of the scientists conducting the first \u003ca href=\"http://www.genvec.com/product-pipeline/cgf-166-hearing-loss\">study\u003c/a> attempting to use gene therapy to restore hearing in people. It's funded by the drug company Novartis and involves adults who have lost most of their hearing because of damage to hair cells, the receptors in the inner ear that detect sound. The most common reasons for this damage are toxic medications and exposure to very loud sounds.\u003c/p>\n\u003cp>The therapy is designed to deliver a gene to the inner ear that generates new hair cells. That approach worked in animals, but it's too soon to say whether it will also work in people, Staecker says.\u003c/p>\n\u003cp>The good news so far is that the treatment hasn't caused any health problems, Staecker says. That's been a major concern ever since a \u003ca href=\"http://www.npr.org/templates/story/story.php?storyId=1064682\">teenager died\u003c/a> in an early experiment using gene therapy\u003c/p>\n\u003cp>\"We have not had any safety issues with the trial,\" Staecker says. \"So I think the whole idea of using gene therapy for hearing loss is probably something that we will be able to do.\"\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=Genetic+Tweaks+Are+Restoring+Hearing+In+Animals%2C+Raising+Hopes+For+People&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/div>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Researchers have taken another step toward reversing deafness using gene therapy.\u003c/p>\n\u003cp>The latest success involves mice with an inherited form of deafness, a team \u003ca href=\"http://stm.sciencemag.org/lookup/doi/10.1126/scitranslmed.aab1996\">reports\u003c/a> Wednesday in the journal \u003cem>Science Translational Medicine\u003c/em>. And a similar approach is already being tried in people with hearing loss caused by damage to cells in the inner ear.\u003c/p>\n\u003cp>\"I'd say we are very close\" to having gene therapies that can restore hearing loss from a wide range of causes, says \u003ca href=\"https://www.uni-goettingen.de/en/58009.html\">Dr. Tobias Moser\u003c/a>, a professor of auditory neuroscience at the University of Göttingen in Germany. Moser wrote an \u003ca href=\"http://stm.sciencemag.org/lookup/doi/10.1126/scitranslmed.aac7545\">article\u003c/a> accompanying the mouse study.\u003c/p>\n\u003cp>The new study is the result of an effort to help children with hearing loss caused by genetic defects, says co-author \u003ca href=\"http://www.childrenshospital.org/researchers/jeffrey-holt\">Jeffrey Holt\u003c/a>, a researcher at Harvard and Boston Children's Hospital whose work is supported by the \u003ca href=\"http://www.fondation-bertarelli.org/\">Bertarelli Foundation\u003c/a>. In the U.S. alone, thousands of children are born each year with inherited hearing loss.\u003c/p>\n\u003cp>But gene therapies could eventually allow many of them to hear, Holt says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"A baby who is born deaf could have their genome sequenced,\" he says. \"If we identify the specific gene that's causing the deafness then you could tailor a precision treatment, hopefully restoring function.\"\u003c/p>\n\u003cp>Holt and his team, including lead author \u003ca href=\"https://sites.google.com/site/holtgeleoclab/people\">Charles Askew\u003c/a>, have been studying genes that affect hearing. And they've focused on a gene called TMC1.\u003c/p>\n\u003cp>Normally this gene allows cells in the inner ear to convert sounds into electrical signals that are sent to the brain, Holt says. But when the gene is mutated, he says, this doesn't happen.\u003c/p>\n\u003cp>\"Once we realized we had this deafness gene we began thinking about how we might be able to restore function in these patients with genetic hearing loss,\" Holt says.\u003c/p>\n\u003cp>Their idea was to use gene therapy to replace mutated TMC1 genes with genes that functioned correctly. And when the team tried this in mice, \"the deaf mice began to jump\" when they heard a loud sound.\u003c/p>\n\u003cp>Electrical signals in the brain confirmed that the mice were no longer deaf. But the treatment didn't fully restore hearing, and still needs some tweaks, Holt says.\u003c/p>\n\u003cp>\"It would be premature to say this is ready for the clinic,\" Holt says. \"But I am optimistic that in the not too distant future some of this really could make a difference in people's lives.\"\u003c/p>\n\u003cp>The big question now is not whether gene therapy for inherited deafness will work, but whether there will be enough money to pay for it, says Moser. That's because there are dozens of different genetic mutations that can affect hearing and each one may need its own customized treatment, he says.\u003c/p>\n\u003cp>\"If you think how much it will cost to really go through all the clinical trials until you actually have [Food and Drug Administration] approval, this will I fear really limit the chances to put this into practice,\" he says.\u003c/p>\n\u003cp>On the other hand, countries including the U.S. have already proved willing to spend a lot to restore hearing, says \u003ca href=\"http://www.kumc.edu/school-of-medicine/otolaryngology/faculty-and-staff/faculty/hinrich-staecker.html\">Hinrich Staecker\u003c/a>, an otolaryngologist and researcher at the University of Kansas Medical Center. \"People consider it a very effective use of funds to put two cochlear implants in a child,\" he says. \"So you're looking at an intervention to make a child hear again at a cost of $120,000 or so.\u003c/p>\n\u003cp>Staecker is one of the scientists conducting the first \u003ca href=\"http://www.genvec.com/product-pipeline/cgf-166-hearing-loss\">study\u003c/a> attempting to use gene therapy to restore hearing in people. It's funded by the drug company Novartis and involves adults who have lost most of their hearing because of damage to hair cells, the receptors in the inner ear that detect sound. The most common reasons for this damage are toxic medications and exposure to very loud sounds.\u003c/p>\n\u003cp>The therapy is designed to deliver a gene to the inner ear that generates new hair cells. That approach worked in animals, but it's too soon to say whether it will also work in people, Staecker says.\u003c/p>\n\u003cp>The good news so far is that the treatment hasn't caused any health problems, Staecker says. That's been a major concern ever since a \u003ca href=\"http://www.npr.org/templates/story/story.php?storyId=1064682\">teenager died\u003c/a> in an early experiment using gene therapy\u003c/p>\n\u003cp>\"We have not had any safety issues with the trial,\" Staecker says. \"So I think the whole idea of using gene therapy for hearing loss is probably something that we will be able to do.\"\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=Genetic+Tweaks+Are+Restoring+Hearing+In+Animals%2C+Raising+Hopes+For+People&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/div>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>",
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"slug": "dining-out-sit-down-restaurants-not-necessarily-healthier-than-fast-food",
"title": "Dining Out? Sit-Down Restaurants Not Necessarily Healthier Than Fast Food",
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"content": "\u003cp>The Bay Area loves its food scene. On average, we eat \u003ca href=\"http://ww2.kqed.org/bayareabites/2013/09/24/2014-san-francisco-zagat-guide-surveys-restaurants-residents-eating-preferences/\" target=\"_blank\" rel=\"noopener\">4.2 meals per week\u003c/a> on the town, and San Francisco has \u003ca href=\"http://insidescoopsf.sfgate.com/blog/2012/08/01/report-san-francisco-has-the-highest-density-of-restaurants-in-america-by-far/\" target=\"_blank\" rel=\"noopener\">more restaurants per household\u003c/a> than any other U.S. city.\u003c/p>\n\u003cp>But when Americans go out to eat, they consume more calories, salt, cholesterol and fat than when they prepare their meals at home, according to \u003ca href=\"http://www.nature.com/ejcn/journal/vaop/ncurrent/abs/ejcn2015104a.html\" target=\"_blank\" rel=\"noopener\">a report\u003c/a> published last week in the \u003ca href=\"http://www.nature.com/ejcn/index.html\">European Journal of Clinical Nutrition\u003c/a>.\u003c/p>\n\u003cp>And full-service restaurants are not necessarily better than fast-food joints. In fact, \u003ca href=\"http://www.kch.illinois.edu/Faculty/Bios/An.aspx\">Ruopeng An\u003c/a>, the report’s author, found that patrons of sit-down restaurants actually consumed \u003cem>more\u003c/em> cholesterol and salt than those who ate fast food.\u003c/p>\n\u003cfigure id=\"attachment_89433\" class=\"wp-caption alignleft\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/unnamed.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-89433\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/unnamed-400x598.jpg\" alt=\"Brunch is one of the most popular meals in San Francisco restaurants, but longer meal times and large portions may encourage diners to over eat.\" width=\"400\" height=\"598\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/unnamed-400x598.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/unnamed.jpg 513w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Brunch is one of the most popular meals in San Francisco restaurants, but longer meal times and large portions may encourage diners to over eat. \u003ccite>(Sarah Lappe)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It’s likely that people consider full-service restaurants to be healthier,” says An, a scientist at University of Illinois, “so they may be less likely to make informed decisions there.”\u003c/p>\n\u003cp>In some ways, the food consumed at restaurants was healthier: restaurant meals contained more beneficial nutrients than fast food, like vitamins, potassium and omega-3 fatty acids.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But these benefits may be undermined by the drawback that people dining at \u003cem>any \u003c/em>establishment consumed about 10% more calories and salt than those eating at home.\u003c/p>\n\u003cp>Going out is usually a social activity that takes a long time. An thinks this may be one factor that encourages overeating at restaurants.\u003c/p>\n\u003cp>The new report is based on data collected between 2003 and 2010 through the federally-funded \u003ca href=\"http://www.cdc.gov/nchs/nhanes/about_nhanes.htm\">National Health and Nutrition Examination Survey\u003c/a>, a project of the \u003ca href=\"http://www.cdc.gov/\">Centers for Disease Control and Prevention\u003c/a>.\u003c/p>\n\u003cp>Approximately 18,000 American adults were asked to recall everything they ate during two separate 24-hour windows, including where they got the food and where they ate it. An then compared how much the same individuals ate when they were at home, versus at a restaurant.\u003c/p>\n\u003cfigure id=\"attachment_89432\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/RS14614_IMG_0554.JPG-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-89432\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/RS14614_IMG_0554.JPG-qut-400x267.jpg\" alt=\"Enjoying good food and company may be benefits of eating out that were not considered in this study. \" width=\"400\" height=\"267\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/RS14614_IMG_0554.JPG-qut-400x267.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/RS14614_IMG_0554.JPG-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/RS14614_IMG_0554.JPG-qut-1440x960.jpg 1440w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/RS14614_IMG_0554.JPG-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/RS14614_IMG_0554.JPG-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/RS14614_IMG_0554.JPG-qut.jpg 1920w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Enjoying good food and company may be benefits of eating out that were not considered in this study. \u003ccite>(Vickie Ly/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But dining out may be healthy in ways that were not considered in the study. \u003ca href=\"http://www.lindabacon.org/\">Linda Bacon\u003c/a>, a Bay Area-based nutrition researcher and the author of the books “Body Respect” and “Health at Every Size,” says enjoying the food and company matters.\u003c/p>\n\u003cp>“You can’t just reduce food to nutrients,” she says. “We have to take into account a much bigger picture than what people are eating if we really want to understand the effect that food is having on them.”\u003c/p>\n\u003cp>Bacon also cautions against using surveys to draw broad conclusions about health and diet, because people are notoriously inaccurate at self-reporting what they eat.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I would encourage people to move away from this fear-based idea of thinking that certain ways of eating are good and others are bad,” she says. “You should end up eating well because you want to and it helps you feel better. That’s much more sustainable.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Bay Area loves its food scene. On average, we eat \u003ca href=\"http://ww2.kqed.org/bayareabites/2013/09/24/2014-san-francisco-zagat-guide-surveys-restaurants-residents-eating-preferences/\" target=\"_blank\" rel=\"noopener\">4.2 meals per week\u003c/a> on the town, and San Francisco has \u003ca href=\"http://insidescoopsf.sfgate.com/blog/2012/08/01/report-san-francisco-has-the-highest-density-of-restaurants-in-america-by-far/\" target=\"_blank\" rel=\"noopener\">more restaurants per household\u003c/a> than any other U.S. city.\u003c/p>\n\u003cp>But when Americans go out to eat, they consume more calories, salt, cholesterol and fat than when they prepare their meals at home, according to \u003ca href=\"http://www.nature.com/ejcn/journal/vaop/ncurrent/abs/ejcn2015104a.html\" target=\"_blank\" rel=\"noopener\">a report\u003c/a> published last week in the \u003ca href=\"http://www.nature.com/ejcn/index.html\">European Journal of Clinical Nutrition\u003c/a>.\u003c/p>\n\u003cp>And full-service restaurants are not necessarily better than fast-food joints. In fact, \u003ca href=\"http://www.kch.illinois.edu/Faculty/Bios/An.aspx\">Ruopeng An\u003c/a>, the report’s author, found that patrons of sit-down restaurants actually consumed \u003cem>more\u003c/em> cholesterol and salt than those who ate fast food.\u003c/p>\n\u003cfigure id=\"attachment_89433\" class=\"wp-caption alignleft\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/unnamed.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-89433\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/unnamed-400x598.jpg\" alt=\"Brunch is one of the most popular meals in San Francisco restaurants, but longer meal times and large portions may encourage diners to over eat.\" width=\"400\" height=\"598\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/unnamed-400x598.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/unnamed.jpg 513w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Brunch is one of the most popular meals in San Francisco restaurants, but longer meal times and large portions may encourage diners to over eat. \u003ccite>(Sarah Lappe)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“It’s likely that people consider full-service restaurants to be healthier,” says An, a scientist at University of Illinois, “so they may be less likely to make informed decisions there.”\u003c/p>\n\u003cp>In some ways, the food consumed at restaurants was healthier: restaurant meals contained more beneficial nutrients than fast food, like vitamins, potassium and omega-3 fatty acids.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But these benefits may be undermined by the drawback that people dining at \u003cem>any \u003c/em>establishment consumed about 10% more calories and salt than those eating at home.\u003c/p>\n\u003cp>Going out is usually a social activity that takes a long time. An thinks this may be one factor that encourages overeating at restaurants.\u003c/p>\n\u003cp>The new report is based on data collected between 2003 and 2010 through the federally-funded \u003ca href=\"http://www.cdc.gov/nchs/nhanes/about_nhanes.htm\">National Health and Nutrition Examination Survey\u003c/a>, a project of the \u003ca href=\"http://www.cdc.gov/\">Centers for Disease Control and Prevention\u003c/a>.\u003c/p>\n\u003cp>Approximately 18,000 American adults were asked to recall everything they ate during two separate 24-hour windows, including where they got the food and where they ate it. An then compared how much the same individuals ate when they were at home, versus at a restaurant.\u003c/p>\n\u003cfigure id=\"attachment_89432\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/RS14614_IMG_0554.JPG-qut.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-89432\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2015/07/RS14614_IMG_0554.JPG-qut-400x267.jpg\" alt=\"Enjoying good food and company may be benefits of eating out that were not considered in this study. \" width=\"400\" height=\"267\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/RS14614_IMG_0554.JPG-qut-400x267.jpg 400w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/RS14614_IMG_0554.JPG-qut-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/RS14614_IMG_0554.JPG-qut-1440x960.jpg 1440w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/RS14614_IMG_0554.JPG-qut-1180x787.jpg 1180w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/RS14614_IMG_0554.JPG-qut-960x640.jpg 960w, https://cdn.kqed.org/wp-content/uploads/sites/35/2015/07/RS14614_IMG_0554.JPG-qut.jpg 1920w\" sizes=\"(max-width: 400px) 100vw, 400px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Enjoying good food and company may be benefits of eating out that were not considered in this study. \u003ccite>(Vickie Ly/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But dining out may be healthy in ways that were not considered in the study. \u003ca href=\"http://www.lindabacon.org/\">Linda Bacon\u003c/a>, a Bay Area-based nutrition researcher and the author of the books “Body Respect” and “Health at Every Size,” says enjoying the food and company matters.\u003c/p>\n\u003cp>“You can’t just reduce food to nutrients,” she says. “We have to take into account a much bigger picture than what people are eating if we really want to understand the effect that food is having on them.”\u003c/p>\n\u003cp>Bacon also cautions against using surveys to draw broad conclusions about health and diet, because people are notoriously inaccurate at self-reporting what they eat.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“I would encourage people to move away from this fear-based idea of thinking that certain ways of eating are good and others are bad,” she says. “You should end up eating well because you want to and it helps you feel better. That’s much more sustainable.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Kuwait Makes DNA Testing Mandatory For Everyone",
"title": "Kuwait Makes DNA Testing Mandatory For Everyone",
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"content": "\u003cp>In response to a \u003ca href=\"http://www.nytimes.com/2015/06/27/world/middleeast/terror-attacks-france-tunisia-kuwait.html?_r=0\">recent ISIS terrorist attack\u003c/a>, the Kuwaiti parliament \u003ca href=\"http://news.kuwaittimes.net/mps-approve-dna-testing-for-citizens-expats-assembly-passes-kd-7-billion-deficit-budget/\">passed a law\u003c/a>, last week, requiring every Kuwaiti citizen and foreign resident to have their DNA tested and the results added to a new database. And the government is serious about people submitting their DNA.\u003c/p>\n\u003cp>Anyone who refuses can face a year in jail and/or a hefty fine. It is even worse if you try to submit someone else’s DNA as your own. Then you can end up in jail for up to seven years!\u003c/p>\n\u003cp>People’s first reaction to this is probably to wince at the loss of privacy. But in some ways, this isn’t all that different than other governments’ responses to terrorist attacks. For example, London is blanketed in cameras because of IRA attacks and the U.S. passed the privacy-sucking Patriot Act in response to 9/11. Both resulted in increased security at the cost of decreased privacy.\u003c/p>\n\u003cp>So the big question is whether a DNA database more comprehensive \u003ca href=\"http://hstlj.org/articles/concerns-associated-with-expanding-dna-databases/\">than that of California or the U.K.\u003c/a> is really as bad as it sounds. That of course depends on what the government does with the information. And perhaps, not surprisingly, what they do with the original DNA samples.\u003c/p>\n\u003cp>\u003cstrong>The Good\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_11515\" class=\"wp-caption alignright\" style=\"max-width: 365px\">\u003cimg class=\" wp-image-11515\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/800px-FBI_Evidence_Response_Team-800x533.jpg\" alt=\"DNA from a crime scene is much less useful if the person's DNA isn't already in a database.\" width=\"365\" height=\"243\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/800px-FBI_Evidence_Response_Team.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/800px-FBI_Evidence_Response_Team-400x267.jpg 400w\" sizes=\"(max-width: 365px) 100vw, 365px\">\u003cfigcaption class=\"wp-caption-text\">DNA from a crime scene is much less useful if the person's DNA isn't already in a database. \u003ccite>(Wikimedia Commons)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As anyone who watches a police drama on TV knows, DNA evidence can be worthless if a “perp’s” DNA isn’t already on file. A DNA database covering every citizen would obviously go a long way towards solving that problem. The Kuwaiti government could quickly identify Kuwaitis or foreign residents involved in a terrorist attack without any other evidence.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>So a big DNA database like this makes it much more likely to catch a criminal or a terrorist. If this prevents another horrific terrorist attack, it just may be worth the loss of privacy.\u003c/p>\n\u003cp>\u003cstrong>The Bad\u003c/strong>\u003c/p>\n\u003cp>Of course there are good reasons people are uncomfortable with this sort of database. DNA can be much more than an identifier. If scientists look more deeply, they can tell a lot from a person’s DNA.\u003c/p>\n\u003cp>To try to allay these fears, the government could just take a brief look at the DNA, collect only the data they need to use it as an identifier, and then destroy the DNA sample. If they were to do this, in many ways it wouldn’t be that different from a fingerprint or a social security number. They would gain no information about health status, national origin, or other traits that could be gleaned from a deeper read.\u003c/p>\n\u003caside class=\"pullquote alignright\">“The big question is whether a DNA database more comprehensive \u003ca href=\"http://hstlj.org/articles/concerns-associated-with-expanding-dna-databases/\">than that of California or the U.K.\u003c/a> is really as bad as it sounds\"\u003c/aside>\n\u003cp>But even if this were all they were to do, DNA is still more than a social security number. For example, you can trace relationships within families using these DNA results. This means it would be pretty easy for the government to identify the estimated \u003ca href=\"http://ww2.kqed.org/science/2013/11/25/new-dna-studies-debunk-misconceptions-about-paternal-relationships/\">0.5 to 1 percent of men who are raising someone else’s children\u003c/a>.\u003c/p>\n\u003cp>This information could create some very uncomfortable or even dangerous situations. The government would have to be very careful about what it does with such data. Heck, they might even be able to tell who the real father is from the database making things even stickier.\u003c/p>\n\u003cp>Another way DNA is different is that a fingerprint or a social security number can’t be traced back to your children. The same is not true for DNA. Even if this is all the DNA testing the government does, in 20 years they might be able to identify the children of the people tested, as was done in a murder case \u003ca href=\"http://usatoday30.usatoday.com/news/nation/2005-06-07-dna-cover_x.htm\">back in 2003 in England\u003c/a>. (Well, actually that was a nephew but the same sorts of rules apply.)\u003c/p>\n\u003cp>So even if the government looks at just the \u003ca href=\"https://en.wikipedia.org/wiki/Combined_DNA_Index_System\">few markers the FBI looks at\u003c/a> and then destroys the DNA samples, there can still be unintended consequences. Even this bit of DNA contains more information than just identification. And of course the consequences could be much more dire if they hold on to the DNA samples or probe it more deeply.\u003c/p>\n\u003cp>\u003cstrong>And The Ugly\u003c/strong>\u003c/p>\n\u003cp>Abuse is always possible for any database but it can be particularly bad with DNA. Authorities could discriminate based on health status, national origin, etc. They could blackmail people with any untoward information they find. They could use the DNA to round up people and/or their relatives who participate in unsanctioned activities. And probably lots of other things I haven’t thought of.\u003c/p>\n\u003cp>So a DNA database of every person living in a country has some huge potential downsides and some big potential upsides. Like any other database, its danger depends on what the government does with the data it collects and how well it protects it.\u003c/p>\n\u003cp>For example, one could imagine that the NSA could use those phone call records they collect to blackmail a man having an affair or tell who is calling a doctor more often than their insurance company might think. This information could be potentially as damaging as any DNA information.\u003c/p>\n\u003cp>But one of the key differences between DNA and phone records is the permanence of DNA. It will be with you for your whole life and even your children’s lives.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>“Fun” facts: The FBI database contains over \u003c/em>\u003ca href=\"https://www.fbi.gov/about-us/lab/biometric-analysis/codis/ndis-statistics\">\u003cem>11 million\u003c/em>\u003c/a>\u003cem> offender DNA profiles, the U.K. over \u003c/em>\u003ca href=\"https://en.wikipedia.org/wiki/Combined_DNA_Index_System\">\u003cem>6 million\u003c/em>\u003c/a>\u003cem>, and the Kuwait DNA database will have a bit more than \u003c/em>\u003ca href=\"http://gizmodo.com/kuwait-just-made-dna-tests-mandatory-for-all-residents-1715512034\">\u003cem>4 million\u003c/em>\u003c/a>\u003cem>. Because of Prop 69, as of the end of 2014, the California database had \u003c/em>\u003ca href=\"http://oag.ca.gov/sites/all/files/agweb/pdfs/bfs/quarterlyrpt-4q-2014.pdf?\">\u003cem>over 2 million\u003c/em>\u003c/a>\u003cem> DNA profiles. \u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In response to a \u003ca href=\"http://www.nytimes.com/2015/06/27/world/middleeast/terror-attacks-france-tunisia-kuwait.html?_r=0\">recent ISIS terrorist attack\u003c/a>, the Kuwaiti parliament \u003ca href=\"http://news.kuwaittimes.net/mps-approve-dna-testing-for-citizens-expats-assembly-passes-kd-7-billion-deficit-budget/\">passed a law\u003c/a>, last week, requiring every Kuwaiti citizen and foreign resident to have their DNA tested and the results added to a new database. And the government is serious about people submitting their DNA.\u003c/p>\n\u003cp>Anyone who refuses can face a year in jail and/or a hefty fine. It is even worse if you try to submit someone else’s DNA as your own. Then you can end up in jail for up to seven years!\u003c/p>\n\u003cp>People’s first reaction to this is probably to wince at the loss of privacy. But in some ways, this isn’t all that different than other governments’ responses to terrorist attacks. For example, London is blanketed in cameras because of IRA attacks and the U.S. passed the privacy-sucking Patriot Act in response to 9/11. Both resulted in increased security at the cost of decreased privacy.\u003c/p>\n\u003cp>So the big question is whether a DNA database more comprehensive \u003ca href=\"http://hstlj.org/articles/concerns-associated-with-expanding-dna-databases/\">than that of California or the U.K.\u003c/a> is really as bad as it sounds. That of course depends on what the government does with the information. And perhaps, not surprisingly, what they do with the original DNA samples.\u003c/p>\n\u003cp>\u003cstrong>The Good\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_11515\" class=\"wp-caption alignright\" style=\"max-width: 365px\">\u003cimg class=\" wp-image-11515\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/800px-FBI_Evidence_Response_Team-800x533.jpg\" alt=\"DNA from a crime scene is much less useful if the person's DNA isn't already in a database.\" width=\"365\" height=\"243\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/800px-FBI_Evidence_Response_Team.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/800px-FBI_Evidence_Response_Team-400x267.jpg 400w\" sizes=\"(max-width: 365px) 100vw, 365px\">\u003cfigcaption class=\"wp-caption-text\">DNA from a crime scene is much less useful if the person's DNA isn't already in a database. \u003ccite>(Wikimedia Commons)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As anyone who watches a police drama on TV knows, DNA evidence can be worthless if a “perp’s” DNA isn’t already on file. A DNA database covering every citizen would obviously go a long way towards solving that problem. The Kuwaiti government could quickly identify Kuwaitis or foreign residents involved in a terrorist attack without any other evidence.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So a big DNA database like this makes it much more likely to catch a criminal or a terrorist. If this prevents another horrific terrorist attack, it just may be worth the loss of privacy.\u003c/p>\n\u003cp>\u003cstrong>The Bad\u003c/strong>\u003c/p>\n\u003cp>Of course there are good reasons people are uncomfortable with this sort of database. DNA can be much more than an identifier. If scientists look more deeply, they can tell a lot from a person’s DNA.\u003c/p>\n\u003cp>To try to allay these fears, the government could just take a brief look at the DNA, collect only the data they need to use it as an identifier, and then destroy the DNA sample. If they were to do this, in many ways it wouldn’t be that different from a fingerprint or a social security number. They would gain no information about health status, national origin, or other traits that could be gleaned from a deeper read.\u003c/p>\n\u003caside class=\"pullquote alignright\">“The big question is whether a DNA database more comprehensive \u003ca href=\"http://hstlj.org/articles/concerns-associated-with-expanding-dna-databases/\">than that of California or the U.K.\u003c/a> is really as bad as it sounds\"\u003c/aside>\n\u003cp>But even if this were all they were to do, DNA is still more than a social security number. For example, you can trace relationships within families using these DNA results. This means it would be pretty easy for the government to identify the estimated \u003ca href=\"http://ww2.kqed.org/science/2013/11/25/new-dna-studies-debunk-misconceptions-about-paternal-relationships/\">0.5 to 1 percent of men who are raising someone else’s children\u003c/a>.\u003c/p>\n\u003cp>This information could create some very uncomfortable or even dangerous situations. The government would have to be very careful about what it does with such data. Heck, they might even be able to tell who the real father is from the database making things even stickier.\u003c/p>\n\u003cp>Another way DNA is different is that a fingerprint or a social security number can’t be traced back to your children. The same is not true for DNA. Even if this is all the DNA testing the government does, in 20 years they might be able to identify the children of the people tested, as was done in a murder case \u003ca href=\"http://usatoday30.usatoday.com/news/nation/2005-06-07-dna-cover_x.htm\">back in 2003 in England\u003c/a>. (Well, actually that was a nephew but the same sorts of rules apply.)\u003c/p>\n\u003cp>So even if the government looks at just the \u003ca href=\"https://en.wikipedia.org/wiki/Combined_DNA_Index_System\">few markers the FBI looks at\u003c/a> and then destroys the DNA samples, there can still be unintended consequences. Even this bit of DNA contains more information than just identification. And of course the consequences could be much more dire if they hold on to the DNA samples or probe it more deeply.\u003c/p>\n\u003cp>\u003cstrong>And The Ugly\u003c/strong>\u003c/p>\n\u003cp>Abuse is always possible for any database but it can be particularly bad with DNA. Authorities could discriminate based on health status, national origin, etc. They could blackmail people with any untoward information they find. They could use the DNA to round up people and/or their relatives who participate in unsanctioned activities. And probably lots of other things I haven’t thought of.\u003c/p>\n\u003cp>So a DNA database of every person living in a country has some huge potential downsides and some big potential upsides. Like any other database, its danger depends on what the government does with the data it collects and how well it protects it.\u003c/p>\n\u003cp>For example, one could imagine that the NSA could use those phone call records they collect to blackmail a man having an affair or tell who is calling a doctor more often than their insurance company might think. This information could be potentially as damaging as any DNA information.\u003c/p>\n\u003cp>But one of the key differences between DNA and phone records is the permanence of DNA. It will be with you for your whole life and even your children’s lives.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>“Fun” facts: The FBI database contains over \u003c/em>\u003ca href=\"https://www.fbi.gov/about-us/lab/biometric-analysis/codis/ndis-statistics\">\u003cem>11 million\u003c/em>\u003c/a>\u003cem> offender DNA profiles, the U.K. over \u003c/em>\u003ca href=\"https://en.wikipedia.org/wiki/Combined_DNA_Index_System\">\u003cem>6 million\u003c/em>\u003c/a>\u003cem>, and the Kuwait DNA database will have a bit more than \u003c/em>\u003ca href=\"http://gizmodo.com/kuwait-just-made-dna-tests-mandatory-for-all-residents-1715512034\">\u003cem>4 million\u003c/em>\u003c/a>\u003cem>. Because of Prop 69, as of the end of 2014, the California database had \u003c/em>\u003ca href=\"http://oag.ca.gov/sites/all/files/agweb/pdfs/bfs/quarterlyrpt-4q-2014.pdf?\">\u003cem>over 2 million\u003c/em>\u003c/a>\u003cem> DNA profiles. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Forget Winning 'Jeopardy,' IBM's Watson Aimed at Transforming Health Care",
"title": "Forget Winning 'Jeopardy,' IBM's Watson Aimed at Transforming Health Care",
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"content": "\u003cp>IBM has bigger plans for its Watson supercomputer than \u003ca href=\"http://www.nytimes.com/2011/02/17/science/17jeopardy-watson.html?pagewanted=all\">destroying its human competition on Jeopardy\u003c/a>.\u003c/p>\n\u003cp>In 2011, with its well-publicized Jeopardy win, IBM showed off Watson's ability to ingest a vast amount of information, and to answer sophisticated questions posed by humans. Since then, the company has been working behind-the-scenes to push Watson into the nation's largest industry sector: Health care.\u003c/p>\n\u003cp>The applications for health care are wide-ranging and diverse. Oncologists at top hospitals are experimenting with using Watson to pull up relevant clinical trials and medical research while treating cancer patients. Other health institutions are analyzing a vast pool of patient data from various sources -- and directing resources to those who are most likely to get sick. The company recently announced a \u003ca href=\"http://identify%20subtle%20signals%20of%20disease%20progression\">partnership with drugstore chain CVS\u003c/a> to reason through 70 million people's health records and identify the subtle signals of disease progression.\u003c/p>\n\u003cp>In June, we broke the news about IBM's latest health care collaboration. The company is working with a nonprofit called \u003ca href=\"http://www.hiccup.co/\">Way to Wellville,\u003c/a> which is on a mission to transform a community’s health status in five places across the country, in just five years.\u003c/p>\n\u003cp>Improving health outcomes for thousands of people is one of Watson's most ambitious projects yet. \u003cem>KQED\u003c/em> spoke with IBM executives and data scientists to determine if Watson is up for the task.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>From Jeopardy to Public Health \u003c/strong>\u003c/p>\n\u003cp>A few years ago, IBM's Steve Gold had a fateful encounter with Esther Dyson, a prominent technology and health investor who has backed startups like \u003ca href=\"23andme.com\">23andMe\u003c/a>.\u003c/p>\n\u003cp>\"She [Dyson] had a noble thought. I got to thinking about how we could help,\" said Gold, who works on the Watson team as a chief marketing officer.\u003c/p>\n\u003cp>That noble thought involved using technology to improve community health. Dyson and the team behind the Way to Wellville project, as it would later be known, opted to work with five communities across the U.S.: Lake County, California; Spartanburg, South Carolina; Niagara Falls, New York; Clatsop County, Oregon; and Greater Muskegon, Michigan.\u003c/p>\n\u003cp>Many of these communities are \"high poverty hotspots,\" meaning they have high concentrations of residents under the poverty line. Across the board, these communities struggle with keeping their citizens healthy and managing ever-rising health care costs.\u003c/p>\n\u003cp>[\u003ca href=\"http://ww2.kqed.org/futureofyou/2015/07/06/can-a-startup-transform-health-care-in-californias-lake-county/\">Related: Can a Startup Transform Health Care in California's Lake County?\u003c/a>]\u003c/p>\n\u003cfigure id=\"attachment_11146\" class=\"wp-caption alignright\" style=\"max-width: 349px\">\u003cimg class=\" wp-image-11146\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Unknown-1-750x600.jpeg\" alt=\"Toshio Mii, IBM Watson's director of partnerships, addresses the citizens of Lake County \" width=\"349\" height=\"279\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/Unknown-1-750x600.jpeg 750w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Unknown-1-400x320.jpeg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Unknown-1-1180x944.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Unknown-1-960x768.jpeg 960w\" sizes=\"(max-width: 349px) 100vw, 349px\">\u003cfigcaption class=\"wp-caption-text\">Toshio Mii, IBM Watson's director of partnerships, addresses the citizens of Lake County \u003ccite>(Nathan DeHart)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The IBM Watson team formally agreed to join up with Dyson in January of 2015. At that time, major research and teaching hospitals like \u003ca href=\"http://www.mdanderson.org/newsroom/news-releases/2013/ibm-watson-to-power-moon-shots-.html\">MD Anderson in Texas and the Mayo Clinic were in the midst of trials \u003c/a>with Watson to gauge its value for doctors.\u003c/p>\n\u003cp>Health experts say that the industry desperately needs user-friendly tools to parse through a massive amount of data, which is often scattered among many different systems. \"The problem of how to make health data meaningful is a very large one,\" said Ash Damle, a data scientist and the chief executive of Lumiata, a company that specializes in analyzing health data.\u003c/p>\n\u003cp>Hospitals and health clinics store a vast amount of data from doctors' notes, patient medical records, research papers and academic journals. It's a virtually impossible task for the human brain to search through this data and dig up the most relevant information for a patient -- but a computing system like Watson may be able to do it.\u003c/p>\n\u003cp>In addition, IBM spent many years pumping Watson full of medical knowledge. By 2013, Watson had analyzed 605,000 pieces of medical evidence, two million pages of text, 25,000 training cases and had the assist of 14,700 clinician hours fine-tuning its decision accuracy,\" Forbes \u003ca href=\"http://www.forbes.com/sites/bruceupbin/2013/02/08/ibms-watson-gets-its-first-piece-of-business-in-healthcare/\" target=\"_blank\">reported.\u003c/a> Much of this data is \"unstructured,\" meaning it is text or video-based and can't be easily stored in a database like Microsoft Excel.\u003c/p>\n\u003cp>\u003cstrong>The Best AI for the Task?\u003c/strong>\u003c/p>\n\u003cp>Still, machine learning experts say that they aren't yet convinced that Watson is the best option for all health providers -- particularly those who lack ample resources.\u003c/p>\n\u003cp>According to Damle, the Lumiata CEO, health organizations need to invest in training for their employees to use Watson for the long-haul, as this kind of technology gets smarter over time. For those who can't afford IBM's consulting fees, this may prove to be an ongoing challenge.\u003c/p>\n\u003cp>Moreover, many Silicon Valley startups are building more affordable \"open source\" alternatives. Data scientists can view the computer code under the hood, and tweak it if necessary.\u003c/p>\n\u003cp>\"IBM is taking a different tack: A more business-focused, closed approach,\" said Anthony Goldbloom, chief executive of Kaggle, a company that hosts data prediction competitions and works with hundreds of data scientists. Goldbloom added Watson's Jeopardy win was an \"unbelievable achievement\" but it's not yet clear whether Watson is the easiest-to-use \"general-purpose\" tool for health care applications.\u003c/p>\n\u003cp>Others take a more skeptical view.\u003c/p>\n\u003cp>\"The IBM approach is to claim to solve every problem and scramble to write custom code where their core capabilities are lacking,\" said Matt Ocko, a venture capitalist at \u003ca href=\"http://dcvc.com/\">Data Collective\u003c/a>, who specializes in data science and machine learning.\u003c/p>\n\u003cp>\"But there may be a lot of startups with better machine learning technology, which take a more specialized approach, ready to solve problems where IBM is behind,\" he said.\u003c/p>\n\u003cp>\u003cstrong>First Steps \u003c/strong>\u003c/p>\n\u003cp>IBM has agreed to work with the Way to Wellville team for five years, lending both its technology and talent.\u003c/p>\n\u003cp>IBM's Gold sees potential for the team to experiment with the new digital health technologies during this period. Watson will ingest data from the latest wearable devices, such as the Fitbit, the iPhone or the Apple Watch, so the community can monitor individuals' exercise levels.\u003c/p>\n\u003cp>\"You could imagine putting a wearable device on a fifth-grader to track their movement,\" said Gold. \"You'd need a good way to merge all this data into the cloud and draw some meaningful conclusions -- and that's where Watson can help.\"\u003c/p>\n\u003cp>IBM's partnerships director Toshio Mii recently flew to Spartanburg, South Carolina to meet with community health officials. Spartanburg is focusing its energies on combating childhood obesity.\u003c/p>\n\u003cp>It's still early days for the project, but Mii said the IBM Watson team is brimming with ideas. He has high hopes for wearable-technology and is currently evaluating trackers from companies that focus on kids, like \u003ca href=\"https://www.sqord.com/\">Sqord\u003c/a>. The community will pay for and distribute the trackers, Mii said.\u003c/p>\n\u003cp>According to Mii, Spartanburg is also exploring ways to improve the quality and nutritional value of school meals, as well as the access to green spaces.\u003c/p>\n\u003cp>Finally, the community will use messaging tools to help uninsured families in Spartanburg access information about improving health and tackling obesity. The community will also use this technology to remind patients to keep their doctors' appointments.\u003c/p>\n\u003cp>If any of these projects prove successful, IBM will help gather up some of the data and present it to policymakers and community health researchers.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"The goal is to replicate some of these projects elsewhere,\" said Mii. \"We want the positive results to proliferate.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>IBM has bigger plans for its Watson supercomputer than \u003ca href=\"http://www.nytimes.com/2011/02/17/science/17jeopardy-watson.html?pagewanted=all\">destroying its human competition on Jeopardy\u003c/a>.\u003c/p>\n\u003cp>In 2011, with its well-publicized Jeopardy win, IBM showed off Watson's ability to ingest a vast amount of information, and to answer sophisticated questions posed by humans. Since then, the company has been working behind-the-scenes to push Watson into the nation's largest industry sector: Health care.\u003c/p>\n\u003cp>The applications for health care are wide-ranging and diverse. Oncologists at top hospitals are experimenting with using Watson to pull up relevant clinical trials and medical research while treating cancer patients. Other health institutions are analyzing a vast pool of patient data from various sources -- and directing resources to those who are most likely to get sick. The company recently announced a \u003ca href=\"http://identify%20subtle%20signals%20of%20disease%20progression\">partnership with drugstore chain CVS\u003c/a> to reason through 70 million people's health records and identify the subtle signals of disease progression.\u003c/p>\n\u003cp>In June, we broke the news about IBM's latest health care collaboration. The company is working with a nonprofit called \u003ca href=\"http://www.hiccup.co/\">Way to Wellville,\u003c/a> which is on a mission to transform a community’s health status in five places across the country, in just five years.\u003c/p>\n\u003cp>Improving health outcomes for thousands of people is one of Watson's most ambitious projects yet. \u003cem>KQED\u003c/em> spoke with IBM executives and data scientists to determine if Watson is up for the task.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>From Jeopardy to Public Health \u003c/strong>\u003c/p>\n\u003cp>A few years ago, IBM's Steve Gold had a fateful encounter with Esther Dyson, a prominent technology and health investor who has backed startups like \u003ca href=\"23andme.com\">23andMe\u003c/a>.\u003c/p>\n\u003cp>\"She [Dyson] had a noble thought. I got to thinking about how we could help,\" said Gold, who works on the Watson team as a chief marketing officer.\u003c/p>\n\u003cp>That noble thought involved using technology to improve community health. Dyson and the team behind the Way to Wellville project, as it would later be known, opted to work with five communities across the U.S.: Lake County, California; Spartanburg, South Carolina; Niagara Falls, New York; Clatsop County, Oregon; and Greater Muskegon, Michigan.\u003c/p>\n\u003cp>Many of these communities are \"high poverty hotspots,\" meaning they have high concentrations of residents under the poverty line. Across the board, these communities struggle with keeping their citizens healthy and managing ever-rising health care costs.\u003c/p>\n\u003cp>[\u003ca href=\"http://ww2.kqed.org/futureofyou/2015/07/06/can-a-startup-transform-health-care-in-californias-lake-county/\">Related: Can a Startup Transform Health Care in California's Lake County?\u003c/a>]\u003c/p>\n\u003cfigure id=\"attachment_11146\" class=\"wp-caption alignright\" style=\"max-width: 349px\">\u003cimg class=\" wp-image-11146\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/Unknown-1-750x600.jpeg\" alt=\"Toshio Mii, IBM Watson's director of partnerships, addresses the citizens of Lake County \" width=\"349\" height=\"279\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/Unknown-1-750x600.jpeg 750w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Unknown-1-400x320.jpeg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Unknown-1-1180x944.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/Unknown-1-960x768.jpeg 960w\" sizes=\"(max-width: 349px) 100vw, 349px\">\u003cfigcaption class=\"wp-caption-text\">Toshio Mii, IBM Watson's director of partnerships, addresses the citizens of Lake County \u003ccite>(Nathan DeHart)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The IBM Watson team formally agreed to join up with Dyson in January of 2015. At that time, major research and teaching hospitals like \u003ca href=\"http://www.mdanderson.org/newsroom/news-releases/2013/ibm-watson-to-power-moon-shots-.html\">MD Anderson in Texas and the Mayo Clinic were in the midst of trials \u003c/a>with Watson to gauge its value for doctors.\u003c/p>\n\u003cp>Health experts say that the industry desperately needs user-friendly tools to parse through a massive amount of data, which is often scattered among many different systems. \"The problem of how to make health data meaningful is a very large one,\" said Ash Damle, a data scientist and the chief executive of Lumiata, a company that specializes in analyzing health data.\u003c/p>\n\u003cp>Hospitals and health clinics store a vast amount of data from doctors' notes, patient medical records, research papers and academic journals. It's a virtually impossible task for the human brain to search through this data and dig up the most relevant information for a patient -- but a computing system like Watson may be able to do it.\u003c/p>\n\u003cp>In addition, IBM spent many years pumping Watson full of medical knowledge. By 2013, Watson had analyzed 605,000 pieces of medical evidence, two million pages of text, 25,000 training cases and had the assist of 14,700 clinician hours fine-tuning its decision accuracy,\" Forbes \u003ca href=\"http://www.forbes.com/sites/bruceupbin/2013/02/08/ibms-watson-gets-its-first-piece-of-business-in-healthcare/\" target=\"_blank\">reported.\u003c/a> Much of this data is \"unstructured,\" meaning it is text or video-based and can't be easily stored in a database like Microsoft Excel.\u003c/p>\n\u003cp>\u003cstrong>The Best AI for the Task?\u003c/strong>\u003c/p>\n\u003cp>Still, machine learning experts say that they aren't yet convinced that Watson is the best option for all health providers -- particularly those who lack ample resources.\u003c/p>\n\u003cp>According to Damle, the Lumiata CEO, health organizations need to invest in training for their employees to use Watson for the long-haul, as this kind of technology gets smarter over time. For those who can't afford IBM's consulting fees, this may prove to be an ongoing challenge.\u003c/p>\n\u003cp>Moreover, many Silicon Valley startups are building more affordable \"open source\" alternatives. Data scientists can view the computer code under the hood, and tweak it if necessary.\u003c/p>\n\u003cp>\"IBM is taking a different tack: A more business-focused, closed approach,\" said Anthony Goldbloom, chief executive of Kaggle, a company that hosts data prediction competitions and works with hundreds of data scientists. Goldbloom added Watson's Jeopardy win was an \"unbelievable achievement\" but it's not yet clear whether Watson is the easiest-to-use \"general-purpose\" tool for health care applications.\u003c/p>\n\u003cp>Others take a more skeptical view.\u003c/p>\n\u003cp>\"The IBM approach is to claim to solve every problem and scramble to write custom code where their core capabilities are lacking,\" said Matt Ocko, a venture capitalist at \u003ca href=\"http://dcvc.com/\">Data Collective\u003c/a>, who specializes in data science and machine learning.\u003c/p>\n\u003cp>\"But there may be a lot of startups with better machine learning technology, which take a more specialized approach, ready to solve problems where IBM is behind,\" he said.\u003c/p>\n\u003cp>\u003cstrong>First Steps \u003c/strong>\u003c/p>\n\u003cp>IBM has agreed to work with the Way to Wellville team for five years, lending both its technology and talent.\u003c/p>\n\u003cp>IBM's Gold sees potential for the team to experiment with the new digital health technologies during this period. Watson will ingest data from the latest wearable devices, such as the Fitbit, the iPhone or the Apple Watch, so the community can monitor individuals' exercise levels.\u003c/p>\n\u003cp>\"You could imagine putting a wearable device on a fifth-grader to track their movement,\" said Gold. \"You'd need a good way to merge all this data into the cloud and draw some meaningful conclusions -- and that's where Watson can help.\"\u003c/p>\n\u003cp>IBM's partnerships director Toshio Mii recently flew to Spartanburg, South Carolina to meet with community health officials. Spartanburg is focusing its energies on combating childhood obesity.\u003c/p>\n\u003cp>It's still early days for the project, but Mii said the IBM Watson team is brimming with ideas. He has high hopes for wearable-technology and is currently evaluating trackers from companies that focus on kids, like \u003ca href=\"https://www.sqord.com/\">Sqord\u003c/a>. The community will pay for and distribute the trackers, Mii said.\u003c/p>\n\u003cp>According to Mii, Spartanburg is also exploring ways to improve the quality and nutritional value of school meals, as well as the access to green spaces.\u003c/p>\n\u003cp>Finally, the community will use messaging tools to help uninsured families in Spartanburg access information about improving health and tackling obesity. The community will also use this technology to remind patients to keep their doctors' appointments.\u003c/p>\n\u003cp>If any of these projects prove successful, IBM will help gather up some of the data and present it to policymakers and community health researchers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"soldout": {
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"title": "SOLD OUT: Rethinking Housing in America",
"tagline": "A new future for housing",
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