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"disqusTitle": "Key Drivers of the Rise in Double Mastectomies: Anxiety and MRIs",
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"content": "\u003cfigure id=\"attachment_19209\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/86541005.jpg\">\u003cimg class=\"size-large wp-image-19209\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/86541005-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp style=\"color: #111111\">\u003cstrong>By Nancy Shute\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2014/05/21/314586804/anxiety-and-mris-may-be-driving-the-rise-in-double-mastectomies\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp style=\"color: #111111\">The number of women getting double mastectomies after a breast cancer diagnosis has been rising in the past 10 years, even though most of them don't face a higher risk of getting cancer in the other breast.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\u003cspan style=\"color: #111111\">More than two-thirds of the women who had the double mastectomy had no risk factors that would make it more likely that they would get breast cancer again.\u003c/span>\u003c/aside>\n\u003cp style=\"color: #111111\">That has cancer doctors troubled, because for those women having the other breast removed doesn't reduce their risk of getting breast cancer again or increase their odds of survival. And they don't know why women are making this choice.\u003c/p>\n\u003cp style=\"color: #111111\">Worry about the cancer coming back is one of the biggest reasons, according to a study of women in California and Michigan that tried to figure out which women decided on a double mastectomy, and why.\u003c/p>\n\u003cp style=\"color: #111111\">Women who had a breast MRI were more likely to decide on a double mastectomy, even if the scan didn't show more cancer.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp style=\"color: #111111\">\"Usually there's something on the image that can't be fully explained,\" says \u003ca style=\"font-style: inherit;color: #4774cc\" href=\"http://www.med.umich.edu/cansort/bio_hawley.html\">Sarah Hawley\u003c/a>, an associate professor at the University of Michigan and lead author of the \u003ca style=\"font-style: inherit;color: #4774cc\" href=\"http://archsurg.jamanetwork.com/article.aspx?articleid=1873911\">study\u003c/a>, which was published Wednesday in\u003cem> JAMA Surgery\u003c/em>. \"The thing that shows up on the MRI may well be nothing, but it's really difficult to know that you saw something unusual and then not worry about it.\"\u003c/p>\n\u003cp style=\"color: #111111\">Hawley and her colleagues looked at 1,447 women who were diagnosed with breast cancer in one breast from 2005 to 2007 or from 2009 to 2010. In all, 19 percent of the women seriously considered having a double mastectomy, and almost 8 percent of them decided to have that surgery.\u003c/p>\n\u003cp style=\"color: #111111\">More than two-thirds of the women who had the double mastectomy — 69 percent — had no genetic or family risk factors that would make it more likely that they would get breast cancer again.\u003c/p>\n\u003cp style=\"color: #111111\">Women with more education were more likely to choose double mastectomy, the study found, as were women who had had genetic testing, even if the results came back showing they had no increased risk.\u003c/p>\n\u003cp style=\"color: #111111\">That surprised Hawley; she thought women who got good news on a genetic test would be less likely to then have a prophylactic mastectomy. She doesn't know if simply having a genetic test is enough to get women thinking seriously about double mastectomy, or if they're making the decision before they get the results back.\u003c/p>\n\u003cp style=\"color: #111111\">Hawley studies how patients make decisions about cancer treatment and says this study raises a big question: Are women not understanding the risk information that doctors communicate, or do they understand and decide to go ahead with the surgery anyway?\u003c/p>\n\u003cp style=\"color: #111111\">\"I think the answer is both are going on,\" Hawley says. \"Women are hearing the message but not completely understanding. Risk information is difficult to convey and understand, especially when you're getting a cancer diagnosis. And even when women understand, they are choosing to go ahead.\"\u003c/p>\n\u003cp style=\"color: #111111\">Most women won't lower their risk of cancer by getting a double mastectomy because their risk of getting breast cancer again was already very low. And removing the noncancerous breast doesn't affect the survival rate from the existing cancer.\u003c/p>\n\u003cp style=\"color: #111111\">For women who don't have a family history of breast cancer or the BRCA genetic mutations, other cancer treatments, including lumpectomy and single mastectomy, can improve a woman's chances just as much as double mastectomy, Hawley says.\u003c/p>\n\u003cp style=\"color: #111111\">\"Not feeling like double mastectomy is the only thing you can do to 'do everything possible' would be a good thing to get out there,\" she adds. \"it seems like there's pressure to consider it now, and if you don't do it you're not doing everything possible.\"\u003c/p>\n\u003cp style=\"color: #111111\">Hawley is testing a decision tool aimed to help women weigh their choices for breast cancer treatment and hopes that it will help reduce the anxiety that comes with a cancer diagnosis and the difficult decisions that follow.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"FnFrgdHm3CmxNVXNNmsSOH7vmlTadUe4\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19209\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/86541005.jpg\">\u003cimg class=\"size-large wp-image-19209\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/86541005-640x426.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp style=\"color: #111111\">\u003cstrong>By Nancy Shute\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2014/05/21/314586804/anxiety-and-mris-may-be-driving-the-rise-in-double-mastectomies\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp style=\"color: #111111\">The number of women getting double mastectomies after a breast cancer diagnosis has been rising in the past 10 years, even though most of them don't face a higher risk of getting cancer in the other breast.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\u003cspan style=\"color: #111111\">More than two-thirds of the women who had the double mastectomy had no risk factors that would make it more likely that they would get breast cancer again.\u003c/span>\u003c/aside>\n\u003cp style=\"color: #111111\">That has cancer doctors troubled, because for those women having the other breast removed doesn't reduce their risk of getting breast cancer again or increase their odds of survival. And they don't know why women are making this choice.\u003c/p>\n\u003cp style=\"color: #111111\">Worry about the cancer coming back is one of the biggest reasons, according to a study of women in California and Michigan that tried to figure out which women decided on a double mastectomy, and why.\u003c/p>\n\u003cp style=\"color: #111111\">Women who had a breast MRI were more likely to decide on a double mastectomy, even if the scan didn't show more cancer.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp style=\"color: #111111\">\"Usually there's something on the image that can't be fully explained,\" says \u003ca style=\"font-style: inherit;color: #4774cc\" href=\"http://www.med.umich.edu/cansort/bio_hawley.html\">Sarah Hawley\u003c/a>, an associate professor at the University of Michigan and lead author of the \u003ca style=\"font-style: inherit;color: #4774cc\" href=\"http://archsurg.jamanetwork.com/article.aspx?articleid=1873911\">study\u003c/a>, which was published Wednesday in\u003cem> JAMA Surgery\u003c/em>. \"The thing that shows up on the MRI may well be nothing, but it's really difficult to know that you saw something unusual and then not worry about it.\"\u003c/p>\n\u003cp style=\"color: #111111\">Hawley and her colleagues looked at 1,447 women who were diagnosed with breast cancer in one breast from 2005 to 2007 or from 2009 to 2010. In all, 19 percent of the women seriously considered having a double mastectomy, and almost 8 percent of them decided to have that surgery.\u003c/p>\n\u003cp style=\"color: #111111\">More than two-thirds of the women who had the double mastectomy — 69 percent — had no genetic or family risk factors that would make it more likely that they would get breast cancer again.\u003c/p>\n\u003cp style=\"color: #111111\">Women with more education were more likely to choose double mastectomy, the study found, as were women who had had genetic testing, even if the results came back showing they had no increased risk.\u003c/p>\n\u003cp style=\"color: #111111\">That surprised Hawley; she thought women who got good news on a genetic test would be less likely to then have a prophylactic mastectomy. She doesn't know if simply having a genetic test is enough to get women thinking seriously about double mastectomy, or if they're making the decision before they get the results back.\u003c/p>\n\u003cp style=\"color: #111111\">Hawley studies how patients make decisions about cancer treatment and says this study raises a big question: Are women not understanding the risk information that doctors communicate, or do they understand and decide to go ahead with the surgery anyway?\u003c/p>\n\u003cp style=\"color: #111111\">\"I think the answer is both are going on,\" Hawley says. \"Women are hearing the message but not completely understanding. Risk information is difficult to convey and understand, especially when you're getting a cancer diagnosis. And even when women understand, they are choosing to go ahead.\"\u003c/p>\n\u003cp style=\"color: #111111\">Most women won't lower their risk of cancer by getting a double mastectomy because their risk of getting breast cancer again was already very low. And removing the noncancerous breast doesn't affect the survival rate from the existing cancer.\u003c/p>\n\u003cp style=\"color: #111111\">For women who don't have a family history of breast cancer or the BRCA genetic mutations, other cancer treatments, including lumpectomy and single mastectomy, can improve a woman's chances just as much as double mastectomy, Hawley says.\u003c/p>\n\u003cp style=\"color: #111111\">\"Not feeling like double mastectomy is the only thing you can do to 'do everything possible' would be a good thing to get out there,\" she adds. \"it seems like there's pressure to consider it now, and if you don't do it you're not doing everything possible.\"\u003c/p>\n\u003cp style=\"color: #111111\">Hawley is testing a decision tool aimed to help women weigh their choices for breast cancer treatment and hopes that it will help reduce the anxiety that comes with a cancer diagnosis and the difficult decisions that follow.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"FnFrgdHm3CmxNVXNNmsSOH7vmlTadUe4\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Study: Steps to Save Lives in a Flu Pandemic",
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"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_19193\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/165785682.jpg\">\u003cimg class=\"size-large wp-image-19193\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/165785682-640x368.jpg\" alt=\"A nurse introduces the front desk for the negative pressure isolation rooms section, which will be used to treat potential H7N9 avian influenza patients, at a Taipei hospital on April 6, 2013, just after the H7N9 virus emerged on China's mainland. (Sam Yeh/AFP/Getty Images)\" width=\"640\" height=\"368\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A nurse introduces the front desk for the negative pressure isolation rooms section, which will be used to treat potential H7N9 avian influenza patients, at a Taipei hospital on April 6, 2013, just after the H7N9 virus emerged on China's mainland. (Sam Yeh/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Brian Lau\u003c/strong>\u003c/p>\n\u003cp>In a new analysis, Stanford researchers, in collaboration with others across the country, suggest changes policy makers could address now to save thousands of lives and billions of dollars in the event of a pandemic, such as the one the world saw in 2009 when H1N1 swept around the world.\u003c/p>\n\u003cp>A new bird flu strain -- H7N9 -- emerged in March, 2013, World Health Organization \u003ca href=\"http://wwwnc.cdc.gov/travel/notices/watch/avian-flu-h7n9-china\" target=\"_blank\">report\u003c/a> 400 deaths since last April, most of them in Asia.\u003c/p>\n\u003cp>Researchers used data from the 2009 pandemic and the virus characteristics of the H7N9 bird flu in a model to estimate the health and economic consequences. They studied the effect of both vaccination programs and public health initiatives, using different time points during the first 12 months of a simulated severe pandemic in a densely populated metropolitan area.\u003c/p>\n\u003cp>In 2009, a vaccine was developed and became available 9 months into the pandemic. Researchers found that a shorter time to vaccination -- 6 months instead of 9 -- would avert nearly 6,000 deaths and save $1.9 billion in treatment costs. The study was published in the \u003ca href=\"http://annals.org/article.aspx?articleID=1872847\" target=\"_blank\">Annals of Internal Medicine\u003c/a> this week.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Influenza is a virus that changes its structure frequently. These subtle changes allow the virus to evade the human immune system and result in repetitive flu outbreaks. This is why each year we have to get a new flu shot.\u003c/p>\n\u003cp>Occasionally, the flu virus undergoes a major shift in its structure, allowing a strain that normally infects only animals to make the jump to humans. These major changes make the virus so unique that our immune systems cannot recognize and fight the virus -- meaning higher rates of infection and potentially causing a large regional or global pandemic.\u003c/p>\n\u003cp>The backbone of the U.S. Centers of Disease Control and Prevention’s response to an influenza pandemic is to develop and distribute an appropriate vaccine. Currently, flu vaccines are egg-based and require months for manufacturers to optimize growth conditions and produce vaccines.\u003c/p>\n\u003cp>\u003cspan>“Best-case scenario: egg-based vaccine delivery is completed in 5 months”, said Dr. Nayer Khazeni, lead author and assistant professor of medicine at the Stanford University School of Medicine. Moving toward new technologies \"can decrease this time by 2-3 months.\" \u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Public Health Measures Can Save Lives in Pandemic\u003c/strong>\u003c/p>\n\u003cp>Still, regardless of the method of vaccine development, there will be a delay from the time a virus appears to delivery of a vaccine. During this time period, public health officials can limit the spread of the virus, the researchers said, possibly through school and childcare closures or even voluntary isolation. But, isolating the population until vaccines are delivered may not be practical or safe. The economic fallout alone could be detrimental.\u003c/p>\n\u003cp>The study found that a 33 percent decrease in contacts with infected individuals would save as many lives and reduce cost similar to vaccinating the population at 4 months into a pandemic. This could result in saving over 11,400 deaths and about $3.8 billion in health care costs compared to vaccinating at 9 months as in the 2009 flu pandemic.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cspan class=\"Apple-style-span\" style=\"font-style: inherit;color: #000000\">Brian Lau is a freelance writer and an orthopedic surgery resident at UCSF medical center. Follow him \u003ca style=\"font-weight: bold;color: #114999\" href=\"https://twitter.com/blauMD\" target=\"_blank\">on Twitter\u003c/a>. \u003c/span>\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19193\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/165785682.jpg\">\u003cimg class=\"size-large wp-image-19193\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/165785682-640x368.jpg\" alt=\"A nurse introduces the front desk for the negative pressure isolation rooms section, which will be used to treat potential H7N9 avian influenza patients, at a Taipei hospital on April 6, 2013, just after the H7N9 virus emerged on China's mainland. (Sam Yeh/AFP/Getty Images)\" width=\"640\" height=\"368\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A nurse introduces the front desk for the negative pressure isolation rooms section, which will be used to treat potential H7N9 avian influenza patients, at a Taipei hospital on April 6, 2013, just after the H7N9 virus emerged on China's mainland. (Sam Yeh/AFP/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Brian Lau\u003c/strong>\u003c/p>\n\u003cp>In a new analysis, Stanford researchers, in collaboration with others across the country, suggest changes policy makers could address now to save thousands of lives and billions of dollars in the event of a pandemic, such as the one the world saw in 2009 when H1N1 swept around the world.\u003c/p>\n\u003cp>A new bird flu strain -- H7N9 -- emerged in March, 2013, World Health Organization \u003ca href=\"http://wwwnc.cdc.gov/travel/notices/watch/avian-flu-h7n9-china\" target=\"_blank\">report\u003c/a> 400 deaths since last April, most of them in Asia.\u003c/p>\n\u003cp>Researchers used data from the 2009 pandemic and the virus characteristics of the H7N9 bird flu in a model to estimate the health and economic consequences. They studied the effect of both vaccination programs and public health initiatives, using different time points during the first 12 months of a simulated severe pandemic in a densely populated metropolitan area.\u003c/p>\n\u003cp>In 2009, a vaccine was developed and became available 9 months into the pandemic. Researchers found that a shorter time to vaccination -- 6 months instead of 9 -- would avert nearly 6,000 deaths and save $1.9 billion in treatment costs. The study was published in the \u003ca href=\"http://annals.org/article.aspx?articleID=1872847\" target=\"_blank\">Annals of Internal Medicine\u003c/a> this week.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Influenza is a virus that changes its structure frequently. These subtle changes allow the virus to evade the human immune system and result in repetitive flu outbreaks. This is why each year we have to get a new flu shot.\u003c/p>\n\u003cp>Occasionally, the flu virus undergoes a major shift in its structure, allowing a strain that normally infects only animals to make the jump to humans. These major changes make the virus so unique that our immune systems cannot recognize and fight the virus -- meaning higher rates of infection and potentially causing a large regional or global pandemic.\u003c/p>\n\u003cp>The backbone of the U.S. Centers of Disease Control and Prevention’s response to an influenza pandemic is to develop and distribute an appropriate vaccine. Currently, flu vaccines are egg-based and require months for manufacturers to optimize growth conditions and produce vaccines.\u003c/p>\n\u003cp>\u003cspan>“Best-case scenario: egg-based vaccine delivery is completed in 5 months”, said Dr. Nayer Khazeni, lead author and assistant professor of medicine at the Stanford University School of Medicine. Moving toward new technologies \"can decrease this time by 2-3 months.\" \u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Public Health Measures Can Save Lives in Pandemic\u003c/strong>\u003c/p>\n\u003cp>Still, regardless of the method of vaccine development, there will be a delay from the time a virus appears to delivery of a vaccine. During this time period, public health officials can limit the spread of the virus, the researchers said, possibly through school and childcare closures or even voluntary isolation. But, isolating the population until vaccines are delivered may not be practical or safe. The economic fallout alone could be detrimental.\u003c/p>\n\u003cp>The study found that a 33 percent decrease in contacts with infected individuals would save as many lives and reduce cost similar to vaccinating the population at 4 months into a pandemic. This could result in saving over 11,400 deaths and about $3.8 billion in health care costs compared to vaccinating at 9 months as in the 2009 flu pandemic.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cspan class=\"Apple-style-span\" style=\"font-style: inherit;color: #000000\">Brian Lau is a freelance writer and an orthopedic surgery resident at UCSF medical center. Follow him \u003ca style=\"font-weight: bold;color: #114999\" href=\"https://twitter.com/blauMD\" target=\"_blank\">on Twitter\u003c/a>. \u003c/span>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_19079\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/paul-w-locke/3849016443/in/photolist-6S8dut-9LRutM-8YmHem-aqg2sC-2ywFK8-dN2e9b-7GBePg-aDSwEo-csMBNC-9hE4j9-9wpRd5-c13yB3-deUPez-8nBLgJ-cfnnEJ-8kzYzM-7Mq3bq-dY7ZM-aowdxy-aaxMY2-au3E95-3dYZDg-aoxi41-7MoDtw-38GR1K-sGdyV-ayHQqr-NPBY2-co2oo5-4Q2oj6-cDEo3G-8GhAtS-3eic6B-bCdCg3-9uFCg3-6HStro-24erFm-atZDXa-7Uoh4A-egGgUo-9cqkMP-atZVS2-aE8cc9-2kFZqA-atZF1T-dd77vL-3GrytX-avLrhK-ftbWhj-9Latke\">\u003cimg class=\"size-large wp-image-19079\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/3849016443_b0c6b90277_b-640x426.jpg\" alt=\"Emotional symptoms such as frustration, and sleep difficulty can start more than a week after the initial injury and may be a sign of more serious concussion. (Paul-W/Flickr) \" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">While headaches and fatigue are the most common concussion symptoms, nearly one in five patients may also suffer emotional symptoms. (Paul-W/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Brian Lau\u003c/strong>\u003c/p>\n\u003cp>That big hit your child took on the football field was over a week ago. He says his headaches are gone -- but he’s just not himself. He can’t sleep and he just snapped back at you when you asked him how he was doing. You wonder if this is just normal teenager behavior or a sign of the concussion.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Frustration, irritability, and sleep difficulty a week or more after injury may signal a more serious concussion.\u003c/aside>\n\u003cp>Concussions are diagnosed by physical symptoms like headaches, dizziness, difficulty thinking clearly, or fatigue after a head injury. But those physical symptoms may evolve into emotional symptoms during the days and weeks after an injury according to \u003ca href=\"http://pediatrics.aappublications.org/content/early/2014/05/07/peds.2014-0158.abstract\" target=\"_blank\">a study \u003c/a>published Monday in the journal \u003cem>Pediatrics\u003c/em>.\u003c/p>\n\u003cp>Yes, headaches and fatigue were the most common symptoms immediately following a concussion, according to researchers at Harvard Medical School. But emotional symptoms such as frustration, irritability, restlessness, and sleep difficulty were seen in up to 17 percent of patients a week or more after injury and may be a marker of a more serious concussion.\u003c!--more-->\u003c/p>\n\u003cp>The study followed 235 patients, ages 11-22 years old, at their initial visit to the emergency department for a concussion and then for 12 weeks following their concussion.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“For individuals who have a prolonged recovery [greater than 14 days], emotional or behavioral symptoms tend to occur later and may reflect different pathophysiology,” said Dr. Christopher Giza in an email. He's a pediatric neurologist at UCLA's David Geffen School of Medicine.\u003c/p>\n\u003cp>Dr. Michael Collins, a neuropsychologist and executive director of the University of Pittsburgh Sports Medicine Concussion Program, also believes that concussions with emotional symptoms may represent a unique subset of patients who have concussion. In particular, he believes that this kind of concussion is the result of injury to the nervous system that assists in balance and coordination. the vestibular system.\u003c/p>\n\u003cp>Dr. Collins says that some of the research suggests that there are unusual processes in the system the helps with balance and coordination -- what doctors call the vestibular system -- \"that may provoke emotional changes following concussions.\" He said that preliminary research suggests that rehabilitation for the vestibular system may help people recover from these unusual symptoms.\u003c/p>\n\u003cp>This \"vestibular rehabilitation\" involves graduated exercises focused on coordination and balance. Although vestibular rehabilitation is promising, more research must be done. Today, the mainstay treatment for concussions remains a short period -- days to weeks -- of \"cognitive rest,\" in effect resting the brain.\u003c/p>\n\u003cp>This kind of rest involves often involves time away from school or work, and other social activities. Although shown to be beneficial, kids must be closely monitored as the components of cognitive rest may also contribute to the development of emotional symptoms later on in recovery.\u003c/p>\n\u003cp>“Cognitive rest is an important component of recovery,\" said Dr. Matthew Eisenberg lead researcher in the study. He's an emergency medicine physician at Boston Children’s Hospital. \"Much like an athlete would avoid jumping on a sprained ankle, there does seem to be a period after which the cost-benefit ratio changes. It is difficult to say when this switch occurs.”\u003c/p>\n\u003cp>The difficulty that many patients with concussions suffer is that unlike ankle injuries there is no cast or crutches to remind others of the injury, which can provoke pressure to return to “normal” in the classroom and athletic field. This social pressure may also contribute to emotional symptoms that develop during recovery.\u003c/p>\n\u003cp>Parents, coaches, and others taking care of patients should have patience during their child’s recovery and keep in mind that all concussions are different and requires close monitoring immediately after the injury, as well as later during recovery.\u003c/p>\n\u003cp>“The biggest takeaway is that while your child may be showing some signs of improvement from the physical symptoms of concussion, it is important to watch out for the late-arriving emotional symptoms,” said Dr. Eisenberg, “The child who is isolating him/herself, exhibiting personality changes, altered sleep behavior, or depressed mood may be experiencing very severe post-concussive symptoms even as his or her headache have resolved.”\u003c/p>\n\u003cp>\u003cem>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">Brian Lau is a freelance writer and an orthopedic surgery resident at UCSF medical center. Follow him \u003ca href=\"https://twitter.com/blauMD\" target=\"_blank\">on Twitter\u003c/a>. \u003c/span>\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"98QLXKoIsFuO0vSQit7GAMy5ZUuvSEsM\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19079\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/paul-w-locke/3849016443/in/photolist-6S8dut-9LRutM-8YmHem-aqg2sC-2ywFK8-dN2e9b-7GBePg-aDSwEo-csMBNC-9hE4j9-9wpRd5-c13yB3-deUPez-8nBLgJ-cfnnEJ-8kzYzM-7Mq3bq-dY7ZM-aowdxy-aaxMY2-au3E95-3dYZDg-aoxi41-7MoDtw-38GR1K-sGdyV-ayHQqr-NPBY2-co2oo5-4Q2oj6-cDEo3G-8GhAtS-3eic6B-bCdCg3-9uFCg3-6HStro-24erFm-atZDXa-7Uoh4A-egGgUo-9cqkMP-atZVS2-aE8cc9-2kFZqA-atZF1T-dd77vL-3GrytX-avLrhK-ftbWhj-9Latke\">\u003cimg class=\"size-large wp-image-19079\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/3849016443_b0c6b90277_b-640x426.jpg\" alt=\"Emotional symptoms such as frustration, and sleep difficulty can start more than a week after the initial injury and may be a sign of more serious concussion. (Paul-W/Flickr) \" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">While headaches and fatigue are the most common concussion symptoms, nearly one in five patients may also suffer emotional symptoms. (Paul-W/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Brian Lau\u003c/strong>\u003c/p>\n\u003cp>That big hit your child took on the football field was over a week ago. He says his headaches are gone -- but he’s just not himself. He can’t sleep and he just snapped back at you when you asked him how he was doing. You wonder if this is just normal teenager behavior or a sign of the concussion.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Frustration, irritability, and sleep difficulty a week or more after injury may signal a more serious concussion.\u003c/aside>\n\u003cp>Concussions are diagnosed by physical symptoms like headaches, dizziness, difficulty thinking clearly, or fatigue after a head injury. But those physical symptoms may evolve into emotional symptoms during the days and weeks after an injury according to \u003ca href=\"http://pediatrics.aappublications.org/content/early/2014/05/07/peds.2014-0158.abstract\" target=\"_blank\">a study \u003c/a>published Monday in the journal \u003cem>Pediatrics\u003c/em>.\u003c/p>\n\u003cp>Yes, headaches and fatigue were the most common symptoms immediately following a concussion, according to researchers at Harvard Medical School. But emotional symptoms such as frustration, irritability, restlessness, and sleep difficulty were seen in up to 17 percent of patients a week or more after injury and may be a marker of a more serious concussion.\u003c!--more-->\u003c/p>\n\u003cp>The study followed 235 patients, ages 11-22 years old, at their initial visit to the emergency department for a concussion and then for 12 weeks following their concussion.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“For individuals who have a prolonged recovery [greater than 14 days], emotional or behavioral symptoms tend to occur later and may reflect different pathophysiology,” said Dr. Christopher Giza in an email. He's a pediatric neurologist at UCLA's David Geffen School of Medicine.\u003c/p>\n\u003cp>Dr. Michael Collins, a neuropsychologist and executive director of the University of Pittsburgh Sports Medicine Concussion Program, also believes that concussions with emotional symptoms may represent a unique subset of patients who have concussion. In particular, he believes that this kind of concussion is the result of injury to the nervous system that assists in balance and coordination. the vestibular system.\u003c/p>\n\u003cp>Dr. Collins says that some of the research suggests that there are unusual processes in the system the helps with balance and coordination -- what doctors call the vestibular system -- \"that may provoke emotional changes following concussions.\" He said that preliminary research suggests that rehabilitation for the vestibular system may help people recover from these unusual symptoms.\u003c/p>\n\u003cp>This \"vestibular rehabilitation\" involves graduated exercises focused on coordination and balance. Although vestibular rehabilitation is promising, more research must be done. Today, the mainstay treatment for concussions remains a short period -- days to weeks -- of \"cognitive rest,\" in effect resting the brain.\u003c/p>\n\u003cp>This kind of rest involves often involves time away from school or work, and other social activities. Although shown to be beneficial, kids must be closely monitored as the components of cognitive rest may also contribute to the development of emotional symptoms later on in recovery.\u003c/p>\n\u003cp>“Cognitive rest is an important component of recovery,\" said Dr. Matthew Eisenberg lead researcher in the study. He's an emergency medicine physician at Boston Children’s Hospital. \"Much like an athlete would avoid jumping on a sprained ankle, there does seem to be a period after which the cost-benefit ratio changes. It is difficult to say when this switch occurs.”\u003c/p>\n\u003cp>The difficulty that many patients with concussions suffer is that unlike ankle injuries there is no cast or crutches to remind others of the injury, which can provoke pressure to return to “normal” in the classroom and athletic field. This social pressure may also contribute to emotional symptoms that develop during recovery.\u003c/p>\n\u003cp>Parents, coaches, and others taking care of patients should have patience during their child’s recovery and keep in mind that all concussions are different and requires close monitoring immediately after the injury, as well as later during recovery.\u003c/p>\n\u003cp>“The biggest takeaway is that while your child may be showing some signs of improvement from the physical symptoms of concussion, it is important to watch out for the late-arriving emotional symptoms,” said Dr. Eisenberg, “The child who is isolating him/herself, exhibiting personality changes, altered sleep behavior, or depressed mood may be experiencing very severe post-concussive symptoms even as his or her headache have resolved.”\u003c/p>\n\u003cp>\u003cem>\u003cspan class=\"Apple-style-span\" style=\"color: #000000\">Brian Lau is a freelance writer and an orthopedic surgery resident at UCSF medical center. Follow him \u003ca href=\"https://twitter.com/blauMD\" target=\"_blank\">on Twitter\u003c/a>. \u003c/span>\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"98QLXKoIsFuO0vSQit7GAMy5ZUuvSEsM\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>\u003cstrong> \u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_19084\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/FatRats-e1400005363707.jpg\">\u003cimg class=\"size-large wp-image-19084\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/FatRats-640x428.jpg\" alt=\"UCLA psychology professor Aaron Blaisdell studied what happened to rats when they were fed a junk food diet. (Photo/Chris Richard)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">UCLA psychology professor Aaron Blaisdell studied what happened to rats when they were fed a junk food diet. (Photo/Chris Richard)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Chris Richard\u003c/strong>\u003c/p>\n\u003cp>A new UCLA psychology study has found evidence that being overweight may make people tired and then become more sedentary, not the other way around.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The rats on the junk food diet rested nearly twice as long as the lean rats. \u003c/aside>\n\u003cp> Researchers got the proof from testing rats, whose physiology is similar to that of human beings.\u003c/p>\n\u003cp>A team led by psychology professor Aaron Blaisdell of \u003ca href=\"http://www.bri.ucla.edu/\">UCLA's Brain Research Institute\u003c/a> put one group of 16 rats on the standard lab diet, largely ground corn, wheat, soybean and fish meal. A second group got a highly processed and refined diet, with casein as the main protein source, soybean oil, sugar and a little starch: a rat’s version of junk food.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It may be no surprise that after three months, the junk food eaters got fat.\u003c!--more-->\u003c/p>\n\u003cp>But what did strike the researchers is that as the rats gained weight, they lost energy. And they didn’t regain their verve when they started getting healthier food.\u003c/p>\n\u003cp>The study started with a long period of differentiating the animals’ diets and monitoring their weight. After six months, Blaisdell’s team started setting giving them tasks to perform.\u003c/p>\n\u003cp>Each rat was placed in a box with a lever that opened a little compartment. At first, the animals had to learn to press the lever to open the compartment and get a drink of sugar water, Blaisdell said. When all the rats had mastered that trick, the researchers made it harder, requiring three presses to open the compartment. Next, researchers demanded progressively more: three presses for the first treat, six for the second, nine for the third and so on.\u003c/p>\n\u003cp>“At a certain point, you’re going to say, ‘It isn’t worth it. I give up.’ And the question was, when would the rats give up?” Blaisdell said.\u003c/p>\n\u003cp>Even though all the rats had had their rations cut and were demonstrably hungry when the half-hour long testing sessions began, the fat animals showed little heart for getting the compartment open. The rats on the junk food diet rested nearly twice as long as the lean rats\u003cstrong> before r\u003c/strong>esuming their attempts to get at the sugar water, Blaisdell said.\u003c/p>\n\u003cp>An Australian study had noted that when rats lived on the kinds of foods typically served in cafeterias, the parts of their brains that control appetite degraded, but they started to recover when the animals got healthier food over a period of nine days.\u003c/p>\n\u003cp>Blaisdell thought the something similar would happen with his test subjects when he switched their diets around. But it didn’t.\u003c/p>\n\u003cp>Even on the healthier diets, the fat rats continued to have trouble sticking to their tasks, and they didn’t lose weight. Likewise, placing the lean rats on the junk food diet for nine days didn't increase their weight noticeably or impair their determination to get at the sugar treats.\u003c/p>\n\u003cp>This suggests that a long-running junk food diet causes the most physical and mental harm, not just the occasional binge, Blaisdell said. And the findings suggest that diet-induced obesity is a cause, not an effect, of lethargy.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"8DIq8xzgzJUQuXz3BqsiZOrMfoyqqqA3\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It may be no surprise that after three months, the junk food eaters got fat.\u003c!--more-->\u003c/p>\n\u003cp>But what did strike the researchers is that as the rats gained weight, they lost energy. And they didn’t regain their verve when they started getting healthier food.\u003c/p>\n\u003cp>The study started with a long period of differentiating the animals’ diets and monitoring their weight. After six months, Blaisdell’s team started setting giving them tasks to perform.\u003c/p>\n\u003cp>Each rat was placed in a box with a lever that opened a little compartment. At first, the animals had to learn to press the lever to open the compartment and get a drink of sugar water, Blaisdell said. When all the rats had mastered that trick, the researchers made it harder, requiring three presses to open the compartment. Next, researchers demanded progressively more: three presses for the first treat, six for the second, nine for the third and so on.\u003c/p>\n\u003cp>“At a certain point, you’re going to say, ‘It isn’t worth it. I give up.’ And the question was, when would the rats give up?” Blaisdell said.\u003c/p>\n\u003cp>Even though all the rats had had their rations cut and were demonstrably hungry when the half-hour long testing sessions began, the fat animals showed little heart for getting the compartment open. The rats on the junk food diet rested nearly twice as long as the lean rats\u003cstrong> before r\u003c/strong>esuming their attempts to get at the sugar water, Blaisdell said.\u003c/p>\n\u003cp>An Australian study had noted that when rats lived on the kinds of foods typically served in cafeterias, the parts of their brains that control appetite degraded, but they started to recover when the animals got healthier food over a period of nine days.\u003c/p>\n\u003cp>Blaisdell thought the something similar would happen with his test subjects when he switched their diets around. But it didn’t.\u003c/p>\n\u003cp>Even on the healthier diets, the fat rats continued to have trouble sticking to their tasks, and they didn’t lose weight. Likewise, placing the lean rats on the junk food diet for nine days didn't increase their weight noticeably or impair their determination to get at the sugar treats.\u003c/p>\n\u003cp>This suggests that a long-running junk food diet causes the most physical and mental harm, not just the occasional binge, Blaisdell said. And the findings suggest that diet-induced obesity is a cause, not an effect, of lethargy.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"8DIq8xzgzJUQuXz3BqsiZOrMfoyqqqA3\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "An Unusual Stanford Art Exhibit Draws Upon Disease for Inspiration",
"headTitle": "An Unusual Stanford Art Exhibit Draws Upon Disease for Inspiration | KQED",
"content": "\u003cfigure id=\"attachment_17243\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/3_D_image_three_hands_in_row.jpg\" rel=\"attachment wp-att-17243\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-17243\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/3_D_image_three_hands_in_row.jpg\" alt=\"Three views of Rodin's hand\" width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">From left to right: A computer scan of Rodin’s sculpture “Left Hand of Eustache de St. Pierre.” Inner anatomy. Exterior scan and inner anatomy combined for an augmented reality view. (Sarah Hegmann/Stanford School of Medicine)\u003c/figcaption>\u003c/figure>\n\u003cp>Art often idealizes the human body, sidelining messy reality. Imagine entering a museum only to recognize on display a disease or disability that you’ve struggled with.\u003c/p>\n\u003cp>This experience is now available to sufferers of \u003ca title=\"NIH - Apert Syndrome\" href=\"http://ghr.nlm.nih.gov/condition/apert-syndrome\">Apert syndrome\u003c/a>, \u003ca title=\"NIH - Dupuytren's contracture\" href=\"http://www.nlm.nih.gov/medlineplus/ency/article/001233.htm\">Dupuytren’s contracture\u003c/a> and a variety of other maladies at “Inside Rodin’s Hands: Art, Technology, and Surgery.” This unusual exhibit, running April 9 – August 3 at Stanford’s \u003ca title=\"Cantor Arts Center\" href=\"https://museum.stanford.edu/index.html\">Cantor Arts Center\u003c/a>, is a collaboration between one of the world’s largest Rodin collections and preeminent medical schools.\u003c/p>\n\u003cp>\u003cb>Intentional or incidental?\u003c/b>\u003c/p>\n\u003cp>Auguste Rodin was famous for departing from traditional mythological figures to create more realistic forms. He may well have been inspired by human injuries and imperfections; for example, his sculpture “Large Clenched Left Hand\u003ci>” \u003c/i>appears to have Charcot-Marie-Tooth—a genetic disorder that damages the nervous system, killing muscle tissue and deforming extremities.\u003c/p>\n\u003cfigure id=\"attachment_17251\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/rodin-hands-combined-040714.jpg\" rel=\"attachment wp-att-17251\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-17251 size-full\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/rodin-hands-combined-040714.jpg\" alt=\"CMT hand and Sculpture that looks like it\" width=\"300\" height=\"251\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Left: hand deformity caused by Charcot-Marie-Tooth disease. Right: Large Clenched Left Hand by August Rodin.\u003c/figcaption>\u003c/figure>\n\u003cp>“It’s striking for somebody like me who sees people with CMT quite often, and quite often the older people have that distinctive hand posture. It’s remarkable to see it cast in bronze,” says Rick Alber, a San Francisco resident who became involved with the \u003ca title=\"CMTA - SF Peninsula/South Bay Support Group\" href=\"http://www.cmtausa.org/index.php?option=com_community&view=groups&task=viewgroup&groupid=29&Itemid=15\">local CMT support group\u003c/a> when his daughter was diagnosed with the disease.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ci>“\u003c/i>Large Clenched Left Hand\u003ci>” \u003c/i>may or may not be actually modeled on the hand of someone with CMT. \u003ca title=\"James Chang - Stanford\" href=\"https://med.stanford.edu/profiles/james-chang\">Dr. James Chang\u003c/a>, the Stanford hand surgeon whose thought experiments inspired the exhibit, points out that the diagnoses are “pure conjecture.”\u003c/p>\n\u003cp>But it’s worth noting that Jean-Martin Charcot, one of the three doctors who first identified CMT, was in Rodin’s social circle. According to Bernard Barryte, curator of the Cantor’s Rodin collection, “Given their association, it is possible that Rodin saw a victim of [CMT] in connection with Charcot. However, it is just as likely that Rodin independently saw someone with this disease, found the configuration of the hand fascinating and expressive and modeled it.”\u003c/p>\n\u003cp>\u003cb>Busted Nerves and Their Consequences\u003c/b>\u003c/p>\n\u003cp>CMT causes the nerves farthest from the brain and spine to deteriorate, first in the feet and legs and later in the hands. The nerves lose their ability to transmit signals and activate muscles, and as anyone who’s worn a cast knows, unused muscles atrophy. In CMT, this creates deformities such as the claw shape recognizable in Rodin’s sculpture. Over time, says Alber, “Your hands and feet become tingly, numb, and weakened. The bottoms of your feet get cuts and blisters and things you can’t feel.”\u003c/p>\n\u003cfigure id=\"attachment_17258\" class=\"wp-caption alignleft\" style=\"max-width: 210px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/anatomy_drawing_L.32.4.2013_Plate6-210x162.jpg\" rel=\"attachment wp-att-17258\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-17258 size-medium\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/anatomy_drawing_L.32.4.2013_Plate6-210x162.jpg\" alt=\"Plate 6 from Engravings of the Bones, Muscles, and Tendons\" width=\"210\" height=\"162\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lots of muscles mean lots of things can go wrong. Plate 6 from John Bell’s Engravings of the Bones, Muscles, and Tendons (London, 1810), on display at the “Inside Rodin’s Hands” exhibit.\u003c/figcaption>\u003c/figure>\n\u003cp>Symptoms of CMT aren’t usually obvious until adulthood, and like all genetic diseases it tends to run in families. But one of CMT’s hallmarks is unpredictability, in part because it can be caused by many different genetic mutations. Says Alber, “One person might be a bit clumsy. Another person is in a wheelchair at age 12.” His daughter didn’t inherent a diseased gene from either parent—her body invented it from scratch with what’s called a \u003ci>de novo\u003c/i> mutation. And although she was diagnosed in early childhood, the disease’s progression has so far been slow. Now 23, she works at a Jamba Juice in San Francisco.\u003c/p>\n\u003cp>CMT can’t be cured like an infectious disease, because every cell in the body has the same mutated gene. One real but distant possibility is \u003ca title=\"Nature - Charcot-Marie-Tooth Gene Therapy\" href=\"http://www.nature.com/mt/journal/v22/n3/full/mt2013250a.html\">gene therapy\u003c/a>, in which functional copies of the affected gene could be delivered directly to the damaged nerves and muscles. In theory, the body could then use these genes to build the missing proteins and repair the damage. Meanwhile, treatment options are limited: physical therapy, orthopedic braces, sometimes surgery.\u003c/p>\n\u003cp>\u003cstrong>Bronze Patients\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_17263\" class=\"wp-caption alignright\" style=\"max-width: 216px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/exhibit-216x162.jpg\" rel=\"attachment wp-att-17263\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-17263\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/exhibit-216x162.jpg\" alt=\"Rodin's hand sculptures with iPads \" width=\"216\" height=\"162\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rodin’s hand sculptures with iPads offering views of their inner anatomy. (Danna Staaf/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>For years, Rodin’s art has been aiding Stanford doctors and medical students to think in three dimensions as they learn to identify and treat the underlying medical conditions. The sculptures inspired Dr. Chang to create an undergraduate class titled “Surgical Anatomy of the Hand: From Rodin to Reconstruction” in which students diagnose a sculpture and develop a treatment plan. Samuel Cohen Tanugi, who took Dr. Chang’s class in 2010, described “Large Clenched Left Hand” as a result of damage to two nerves in particular, the ulnar nerve and the median nerve. He wrote, “Reconstruction would require complex nerve and tendon transfers to rebalance the hand into a more normal posture.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Dr. Chang will give a free public lecture about the exhibit on May 29th at 6:30 p.m. in the Cantor auditorium. Admission to the \u003ca title=\"Stanford - Rodin's Hands\" href=\"https://museum.stanford.edu/news_room/Rodins-hands.html\">exhibit\u003c/a> itself, as to the rest of the Cantor Center and sculpture garden, is also free.\u003c/p>\n\n",
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"excerpt": "Imagine entering an art museum, only to recognize a disease you've struggled with. A variety of maladies are featured in the exhibit “Inside Rodin’s Hands: Art, Technology, and Surgery at Stanford’s Cantor Arts Center.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_17243\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/3_D_image_three_hands_in_row.jpg\" rel=\"attachment wp-att-17243\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-17243\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/3_D_image_three_hands_in_row.jpg\" alt=\"Three views of Rodin's hand\" width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">From left to right: A computer scan of Rodin’s sculpture “Left Hand of Eustache de St. Pierre.” Inner anatomy. Exterior scan and inner anatomy combined for an augmented reality view. (Sarah Hegmann/Stanford School of Medicine)\u003c/figcaption>\u003c/figure>\n\u003cp>Art often idealizes the human body, sidelining messy reality. Imagine entering a museum only to recognize on display a disease or disability that you’ve struggled with.\u003c/p>\n\u003cp>This experience is now available to sufferers of \u003ca title=\"NIH - Apert Syndrome\" href=\"http://ghr.nlm.nih.gov/condition/apert-syndrome\">Apert syndrome\u003c/a>, \u003ca title=\"NIH - Dupuytren's contracture\" href=\"http://www.nlm.nih.gov/medlineplus/ency/article/001233.htm\">Dupuytren’s contracture\u003c/a> and a variety of other maladies at “Inside Rodin’s Hands: Art, Technology, and Surgery.” This unusual exhibit, running April 9 – August 3 at Stanford’s \u003ca title=\"Cantor Arts Center\" href=\"https://museum.stanford.edu/index.html\">Cantor Arts Center\u003c/a>, is a collaboration between one of the world’s largest Rodin collections and preeminent medical schools.\u003c/p>\n\u003cp>\u003cb>Intentional or incidental?\u003c/b>\u003c/p>\n\u003cp>Auguste Rodin was famous for departing from traditional mythological figures to create more realistic forms. He may well have been inspired by human injuries and imperfections; for example, his sculpture “Large Clenched Left Hand\u003ci>” \u003c/i>appears to have Charcot-Marie-Tooth—a genetic disorder that damages the nervous system, killing muscle tissue and deforming extremities.\u003c/p>\n\u003cfigure id=\"attachment_17251\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/rodin-hands-combined-040714.jpg\" rel=\"attachment wp-att-17251\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-17251 size-full\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/rodin-hands-combined-040714.jpg\" alt=\"CMT hand and Sculpture that looks like it\" width=\"300\" height=\"251\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Left: hand deformity caused by Charcot-Marie-Tooth disease. Right: Large Clenched Left Hand by August Rodin.\u003c/figcaption>\u003c/figure>\n\u003cp>“It’s striking for somebody like me who sees people with CMT quite often, and quite often the older people have that distinctive hand posture. It’s remarkable to see it cast in bronze,” says Rick Alber, a San Francisco resident who became involved with the \u003ca title=\"CMTA - SF Peninsula/South Bay Support Group\" href=\"http://www.cmtausa.org/index.php?option=com_community&view=groups&task=viewgroup&groupid=29&Itemid=15\">local CMT support group\u003c/a> when his daughter was diagnosed with the disease.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ci>“\u003c/i>Large Clenched Left Hand\u003ci>” \u003c/i>may or may not be actually modeled on the hand of someone with CMT. \u003ca title=\"James Chang - Stanford\" href=\"https://med.stanford.edu/profiles/james-chang\">Dr. James Chang\u003c/a>, the Stanford hand surgeon whose thought experiments inspired the exhibit, points out that the diagnoses are “pure conjecture.”\u003c/p>\n\u003cp>But it’s worth noting that Jean-Martin Charcot, one of the three doctors who first identified CMT, was in Rodin’s social circle. According to Bernard Barryte, curator of the Cantor’s Rodin collection, “Given their association, it is possible that Rodin saw a victim of [CMT] in connection with Charcot. However, it is just as likely that Rodin independently saw someone with this disease, found the configuration of the hand fascinating and expressive and modeled it.”\u003c/p>\n\u003cp>\u003cb>Busted Nerves and Their Consequences\u003c/b>\u003c/p>\n\u003cp>CMT causes the nerves farthest from the brain and spine to deteriorate, first in the feet and legs and later in the hands. The nerves lose their ability to transmit signals and activate muscles, and as anyone who’s worn a cast knows, unused muscles atrophy. In CMT, this creates deformities such as the claw shape recognizable in Rodin’s sculpture. Over time, says Alber, “Your hands and feet become tingly, numb, and weakened. The bottoms of your feet get cuts and blisters and things you can’t feel.”\u003c/p>\n\u003cfigure id=\"attachment_17258\" class=\"wp-caption alignleft\" style=\"max-width: 210px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/anatomy_drawing_L.32.4.2013_Plate6-210x162.jpg\" rel=\"attachment wp-att-17258\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-17258 size-medium\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/anatomy_drawing_L.32.4.2013_Plate6-210x162.jpg\" alt=\"Plate 6 from Engravings of the Bones, Muscles, and Tendons\" width=\"210\" height=\"162\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Lots of muscles mean lots of things can go wrong. Plate 6 from John Bell’s Engravings of the Bones, Muscles, and Tendons (London, 1810), on display at the “Inside Rodin’s Hands” exhibit.\u003c/figcaption>\u003c/figure>\n\u003cp>Symptoms of CMT aren’t usually obvious until adulthood, and like all genetic diseases it tends to run in families. But one of CMT’s hallmarks is unpredictability, in part because it can be caused by many different genetic mutations. Says Alber, “One person might be a bit clumsy. Another person is in a wheelchair at age 12.” His daughter didn’t inherent a diseased gene from either parent—her body invented it from scratch with what’s called a \u003ci>de novo\u003c/i> mutation. And although she was diagnosed in early childhood, the disease’s progression has so far been slow. Now 23, she works at a Jamba Juice in San Francisco.\u003c/p>\n\u003cp>CMT can’t be cured like an infectious disease, because every cell in the body has the same mutated gene. One real but distant possibility is \u003ca title=\"Nature - Charcot-Marie-Tooth Gene Therapy\" href=\"http://www.nature.com/mt/journal/v22/n3/full/mt2013250a.html\">gene therapy\u003c/a>, in which functional copies of the affected gene could be delivered directly to the damaged nerves and muscles. In theory, the body could then use these genes to build the missing proteins and repair the damage. Meanwhile, treatment options are limited: physical therapy, orthopedic braces, sometimes surgery.\u003c/p>\n\u003cp>\u003cstrong>Bronze Patients\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_17263\" class=\"wp-caption alignright\" style=\"max-width: 216px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/exhibit-216x162.jpg\" rel=\"attachment wp-att-17263\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-17263\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/exhibit-216x162.jpg\" alt=\"Rodin's hand sculptures with iPads \" width=\"216\" height=\"162\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rodin’s hand sculptures with iPads offering views of their inner anatomy. (Danna Staaf/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>For years, Rodin’s art has been aiding Stanford doctors and medical students to think in three dimensions as they learn to identify and treat the underlying medical conditions. The sculptures inspired Dr. Chang to create an undergraduate class titled “Surgical Anatomy of the Hand: From Rodin to Reconstruction” in which students diagnose a sculpture and develop a treatment plan. Samuel Cohen Tanugi, who took Dr. Chang’s class in 2010, described “Large Clenched Left Hand” as a result of damage to two nerves in particular, the ulnar nerve and the median nerve. He wrote, “Reconstruction would require complex nerve and tendon transfers to rebalance the hand into a more normal posture.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Dr. Chang will give a free public lecture about the exhibit on May 29th at 6:30 p.m. in the Cantor auditorium. Admission to the \u003ca title=\"Stanford - Rodin's Hands\" href=\"https://museum.stanford.edu/news_room/Rodins-hands.html\">exhibit\u003c/a> itself, as to the rest of the Cantor Center and sculpture garden, is also free.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Study: Heavy Bleeding Very Common As Women Approach Menopause",
"title": "Study: Heavy Bleeding Very Common As Women Approach Menopause",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_19022\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/178092818.jpg\">\u003cimg class=\"size-large wp-image-19022\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/178092818-640x433.jpg\" alt=\"So common that it will help doctors determine when bleeding is normal, when interveetinon is necessary. (Getty Images)\" width=\"640\" height=\"433\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The researchers hope their findings will help doctors and patients understand what \"normal\" bleeding is during perimenopause. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong> By Jennifer Huber\u003c/strong>\u003c/p>\n\u003cp>I could hear the fear and panic in my friend’s voice over the phone. She was having her period, but bleeding so heavily that she was debating whether to go to the emergency room. Yet she wasn't sure. She wondered if she might be over-reacting, if her experience was simply what happened as a woman approached menopause.\u003c/p>\n\u003caside class=\"pullquote alignleft\">More than three-fourths of women in the study reported periods lasting at least 10 days.\u003c/aside>\n\u003cp>As women get older, their periods can begin to change. This perimenopausal time typically starts when a woman is in her 40s and lasts about four years. (The average age of menopause, when periods stop, is 51.) For some women, the transition means unpredictable, prolonged or heavy bleeding, and that can be frightening. Now new research shows that these changes may be quite normal.\u003c/p>\n\u003cp>In \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.12768/abstract%20\" target=\"_blank\">the study\u003c/a>, researchers from across the country, including UC Davis and UCLA, reviewed data from 1,320 women ages 42-52 who kept detailed records of their menstrual cycles over time. The researchers found that instances of heavy or prolonged bleeding were very common.\u003c!--more-->\u003c/p>\n\u003cp>Researchers found the following rates reported at least three times during the 10-year study period:\u003c/p>\n\u003cul>\n\u003cli>78 percent of women: periods lasted at least 10 days\u003c/li>\n\u003cli>67 percent: spotting lasted six or more days\u003c/li>\n\u003cli>35 percent: heavy bleeding lasted three or more days\u003c/li>\n\u003c/ul>\n\u003cp>The report was recently published in \u003cem>BJOG: An International Journal of Obstetrics and Gynaeocology.\u003c/em>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"These data confirm that two types of bleeding, longer menses with more days of spotting and heavier menses, occur in most women during the (transition to menopause),\" the authors noted.\u003c/p>\n\u003cp>The researchers used data from the \u003ca href=\"http://www.swanstudy.org/about.asp\" target=\"_blank\">Study of Women’s Health Across the Nation\u003c/a> (SWAN), a study of middle-aged women living in the U.S.\u003c/p>\n\u003cp>The participating women completed daily menstrual calendars and provided information monthly on hormone therapy, gynecological procedures, smoking and physical activity.\u003c/p>\n\u003cp>\u003cstrong>First Major Multi-Racial Study of Its Kind\u003c/strong>\u003c/p>\n\u003cp>This was the first long-term study to include a large population of women of multiple races: African-American, Japanese, Chinese and white. More than half the women in the study were not white. Previous studies were short and mostly limited to white women.\u003c/p>\n\u003cp>Very few differences were seen between races. African-American women were less likely to bleed for 10 or more days or to spot for six or more days compared to white women. And Japanese women were less likely to have three or more days of heavy bleeding compared to white women.\u003c/p>\n\u003cp>The researchers hope that their study will help guide both clinicians and patients, by defining “normal” bleeding patterns for women during midlife.\u003c/p>\n\u003cp>“Women need more descriptive information about the bleeding changes they can expect,” said author and University of Michigan professor Sioban Harlow in \u003ca href=\"http://ns.umich.edu/new/releases/22121-prolonged-and-heavy-bleeding-during-menopause-is-common%20\" target=\"_blank\">a statement\u003c/a>. “We need clear guidance to help women understand what changes in bleeding patterns do and do not require medical attention.”\u003c/p>\n\u003cp>The study was funded by the National Institutes of Health and other federal government health agencies.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"HvsaE1friuAlqV5hibJLYCWI5Kne58E1\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_19022\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/178092818.jpg\">\u003cimg class=\"size-large wp-image-19022\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/05/178092818-640x433.jpg\" alt=\"So common that it will help doctors determine when bleeding is normal, when interveetinon is necessary. (Getty Images)\" width=\"640\" height=\"433\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The researchers hope their findings will help doctors and patients understand what \"normal\" bleeding is during perimenopause. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong> By Jennifer Huber\u003c/strong>\u003c/p>\n\u003cp>I could hear the fear and panic in my friend’s voice over the phone. She was having her period, but bleeding so heavily that she was debating whether to go to the emergency room. Yet she wasn't sure. She wondered if she might be over-reacting, if her experience was simply what happened as a woman approached menopause.\u003c/p>\n\u003caside class=\"pullquote alignleft\">More than three-fourths of women in the study reported periods lasting at least 10 days.\u003c/aside>\n\u003cp>As women get older, their periods can begin to change. This perimenopausal time typically starts when a woman is in her 40s and lasts about four years. (The average age of menopause, when periods stop, is 51.) For some women, the transition means unpredictable, prolonged or heavy bleeding, and that can be frightening. Now new research shows that these changes may be quite normal.\u003c/p>\n\u003cp>In \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.12768/abstract%20\" target=\"_blank\">the study\u003c/a>, researchers from across the country, including UC Davis and UCLA, reviewed data from 1,320 women ages 42-52 who kept detailed records of their menstrual cycles over time. The researchers found that instances of heavy or prolonged bleeding were very common.\u003c!--more-->\u003c/p>\n\u003cp>Researchers found the following rates reported at least three times during the 10-year study period:\u003c/p>\n\u003cul>\n\u003cli>78 percent of women: periods lasted at least 10 days\u003c/li>\n\u003cli>67 percent: spotting lasted six or more days\u003c/li>\n\u003cli>35 percent: heavy bleeding lasted three or more days\u003c/li>\n\u003c/ul>\n\u003cp>The report was recently published in \u003cem>BJOG: An International Journal of Obstetrics and Gynaeocology.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"These data confirm that two types of bleeding, longer menses with more days of spotting and heavier menses, occur in most women during the (transition to menopause),\" the authors noted.\u003c/p>\n\u003cp>The researchers used data from the \u003ca href=\"http://www.swanstudy.org/about.asp\" target=\"_blank\">Study of Women’s Health Across the Nation\u003c/a> (SWAN), a study of middle-aged women living in the U.S.\u003c/p>\n\u003cp>The participating women completed daily menstrual calendars and provided information monthly on hormone therapy, gynecological procedures, smoking and physical activity.\u003c/p>\n\u003cp>\u003cstrong>First Major Multi-Racial Study of Its Kind\u003c/strong>\u003c/p>\n\u003cp>This was the first long-term study to include a large population of women of multiple races: African-American, Japanese, Chinese and white. More than half the women in the study were not white. Previous studies were short and mostly limited to white women.\u003c/p>\n\u003cp>Very few differences were seen between races. African-American women were less likely to bleed for 10 or more days or to spot for six or more days compared to white women. And Japanese women were less likely to have three or more days of heavy bleeding compared to white women.\u003c/p>\n\u003cp>The researchers hope that their study will help guide both clinicians and patients, by defining “normal” bleeding patterns for women during midlife.\u003c/p>\n\u003cp>“Women need more descriptive information about the bleeding changes they can expect,” said author and University of Michigan professor Sioban Harlow in \u003ca href=\"http://ns.umich.edu/new/releases/22121-prolonged-and-heavy-bleeding-during-menopause-is-common%20\" target=\"_blank\">a statement\u003c/a>. “We need clear guidance to help women understand what changes in bleeding patterns do and do not require medical attention.”\u003c/p>\n\u003cp>The study was funded by the National Institutes of Health and other federal government health agencies.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"HvsaE1friuAlqV5hibJLYCWI5Kne58E1\"]\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cdiv class=\"audio-wrap\">\n\u003ch2>Listen:\u003c/h2>\n\u003cp>http://www.kqed.org/.stream/anon/radio/science/2014/05/20140505science.mp3\u003c/p>\n\u003c/div>\n\u003cfigure id=\"attachment_17201\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-17201\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/DNA-2.jpg\" alt=\"A magnified strand of DNA. (Credit: Tomasz Wyszomirski)\" width=\"640\" height=\"360\">\u003cfigcaption class=\"wp-caption-text\">A magnified strand of DNA. (Tomasz Wyszomirski)\u003c/figcaption>\u003c/figure>\n\u003cp>Consumers who want to find out about their genetic health risks without going to the doctor and paying a hefty price may have to wait. For a while, personal genetic tests were becoming more affordable and informative. But the industry took a blow last year when the government cracked down on Mountain View company \u003ca href=\"https://www.23andme.com/\">23andMe\u003c/a>.\u003c/p>\n\u003cp>That was the last consumer gene testing company still offering health information after two years of federal efforts to regulate the industry. Unlike other companies, many of which folded or sold, 23andMe is working with regulators to come back to the consumer genetic health market.\u003c/p>\n\u003cp>\u003cstrong>A Passion for Consumer Genetics\u003c/strong>\u003c/p>\n\u003cp>On a recent Thursday evening at the \u003ca href=\"http://www.calacademy.org/\">California Academy of Sciences\u003c/a> in San Francisco, the star of the show was not the giant T-Rex skeleton in the lobby but a small-framed, energetic Silicon Valley entrepreneur speaking about personal genetics.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘One of the main things people think about when they think of their genetic information, is that they want the health interpretation.’\u003c/aside>\n\u003cp>“I want to ask this audience, how many people have ever had a genetic test?” said \u003ca href=\"https://www.23andme.com/about/board/\">Anne Wojcicki\u003c/a>, CEO of 23andMe.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Of about 150 people in the audience, some 30 people raised their hands.\u003c/p>\n\u003cp>“So my goal is in the next ten years that every single one of you would raise your hand,” Wojcicki said.\u003c/p>\n\u003cp>Wojcicki said since 2007, more than half a million customers have sent in a saliva sample and gotten information that included their risks for developing cardiac disease and breast cancer, as well genetic traits such as how fast they metabolize caffeine. But last November the FDA ordered 23andMe to stop sales of its $99 tests.\u003c/p>\n\u003cp>\u003cstrong>FDA to 23andMe: Stop Selling Gene Tests\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://www.fda.gov/newsevents/testimony/ucm219925.htm\">The FDA said\u003c/a>, in a very public letter, that the company’s test kit was a medical device that needed to be regulated and that 23andMe failed to prove it was interpreting health results accurately.\u003c/p>\n\u003cfigure id=\"attachment_17192\" class=\"wp-caption alignleft\" style=\"max-width: 252px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-17192\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/Wojcicki-216x162.jpg\" alt=\"23andMe CEO Anne Wojcicki, speaking at the annual SXSW festival in Austin, Texas in March 2014. (Jenny Oh/KQED)\" width=\"252\" height=\"189\">\u003cfigcaption class=\"wp-caption-text\">23andMe CEO Anne Wojcicki, speaking at the annual SXSW festival in Austin, Texas in March 2014. (Jenny Oh/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Wojcicki said the ruling has hit her company hard. “As a result, we have had to stop offering our healthcare service, and it’s had a significant impact because it’s one of the main things people think about when they think of their genetic information, is that they want the health interpretation.”\u003c/p>\n\u003cp>So now, 23andMe is working with the FDA in an effort to once again be able to offer health information. Meanwhile, the company can still provide ancestry information, which is already a crowded field.\u003c/p>\n\u003cp>Hank Greely directs the \u003ca href=\"https://www.law.stanford.edu/organizations/programs-and-centers/center-for-law-and-the-biosciences\">Center for Law and the Biosciences\u003c/a> at Stanford. He said dwindling sales will impact the company’s efforts to build a sizable research database—and that’s important to its business strategy.\u003c/p>\n\u003cp>“For those customers who agree to it by signing a somewhat opaque consent form,” Greely said, “they can sell that information to pharma and bio, but without lots of new customers coming in that service becomes less attractive to pharma and biotech.”\u003c/p>\n\u003cp>Some have criticized 23andme for considering selling anonymized data. But Wojcicki is unapologetic.\u003c/p>\n\u003cp>“23andMe partners with those companies because those are the people who are making therapies,” she said. “And if we want to get better therapies for breast cancer, and you want to get better therapies for asthma and migraines and all kinds of the other conditions that impact our lives, we have to work with pharma companies.”\u003cbr>\n\u003cstrong>\u003cbr>\nBig Data May Lead to Medical Breakthroughs\u003c/strong>\u003c/p>\n\u003cp>And here’s where consumer genetics isn’t just about the consumer. All that genetic information, or big data, can be used to run studies in search of medical breakthroughs. That means any company that wants to stay at the forefront has to keep up with the changing science.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘We know that the world has been quite focused on getting the so-called thousand-dollar genome.’\u003c/aside>\n\u003cp>In your human genome you have an entire set of 23 human chromosomes, made up of, among other things, DNA building blocks called base pairs. The human genome is composed of 3 billion base pairs.\u003c/p>\n\u003cp>Right now consumer gene tests take tiny snips of less than a million base pairs to look at one person’s unique genetic blueprint. Each of these unique variations is called a snp (yep, pronounced “snip”), for “single nucleotide polymorphism.”\u003c/p>\n\u003cp>\u003cstrong>The Future Lies in Sequencing the Whole Genome\u003c/strong>\u003c/p>\n\u003cp>But a snp is just a fraction of the entire genome. Scientists say the key to the future of genetics lies in sequencing the whole genome.\u003c/p>\n\u003cp>“We know that the world has been quite focused on getting the so-called thousand-dollar genome,” said Vance Vanier, vice president of reproductive and genetic health at San Diego-based \u003ca href=\"http://www.illumina.com/\">Illumina\u003c/a>. The company has just unveiled a system it claims can sequence a human genome for $1,000. That’s a big drop from the nearly $3 billion dollar price tag to sequence the first genome in 2003.\u003c/p>\n\u003cp>“I think the story of the next five years is to see that affordability spread more and more to broader segments of society and to clinical laboratories specifically,” said Vanier, who was CEO of an early consumer gene testing company called Navigenics.\u003c/p>\n\u003cp>And while he believes genetic testing will continue to be done primarily through medical professionals, he said he still sees a place for consumer gene tests. After all, Vanier said, there was a time home pregnancy tests had to be done in a doctor’s office. Now people can even buy over-the-counter HIV tests.\u003c/p>\n\u003cp>“I think the pattern you see,” Vanier said, “is as information gets better understood and as there are more social safeguards around it to protect from a misuse of it, then there is increasing comfort of how it can evolve into the consumer market.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>And so the debate continues between those that believe accessing your DNA has become a basic right and those who believe gene tests are better left to a doctor.\u003cbr>\n\u003cem>\u003cbr>\nSince this story published, 23andMe officials confirm they \u003ca href=\"http://www.reuters.com/article/2014/05/06/23andme-genetictesting-idUSL2N0NS0Y820140506?feedType=RSS\">are considering selling their gene tests in markets outside the U.S.\u003c/a> after facing hurdles with the FDA.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/div>\n\u003cfigure id=\"attachment_17201\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-17201\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/DNA-2.jpg\" alt=\"A magnified strand of DNA. (Credit: Tomasz Wyszomirski)\" width=\"640\" height=\"360\">\u003cfigcaption class=\"wp-caption-text\">A magnified strand of DNA. (Tomasz Wyszomirski)\u003c/figcaption>\u003c/figure>\n\u003cp>Consumers who want to find out about their genetic health risks without going to the doctor and paying a hefty price may have to wait. For a while, personal genetic tests were becoming more affordable and informative. But the industry took a blow last year when the government cracked down on Mountain View company \u003ca href=\"https://www.23andme.com/\">23andMe\u003c/a>.\u003c/p>\n\u003cp>That was the last consumer gene testing company still offering health information after two years of federal efforts to regulate the industry. Unlike other companies, many of which folded or sold, 23andMe is working with regulators to come back to the consumer genetic health market.\u003c/p>\n\u003cp>\u003cstrong>A Passion for Consumer Genetics\u003c/strong>\u003c/p>\n\u003cp>On a recent Thursday evening at the \u003ca href=\"http://www.calacademy.org/\">California Academy of Sciences\u003c/a> in San Francisco, the star of the show was not the giant T-Rex skeleton in the lobby but a small-framed, energetic Silicon Valley entrepreneur speaking about personal genetics.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘One of the main things people think about when they think of their genetic information, is that they want the health interpretation.’\u003c/aside>\n\u003cp>“I want to ask this audience, how many people have ever had a genetic test?” said \u003ca href=\"https://www.23andme.com/about/board/\">Anne Wojcicki\u003c/a>, CEO of 23andMe.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Of about 150 people in the audience, some 30 people raised their hands.\u003c/p>\n\u003cp>“So my goal is in the next ten years that every single one of you would raise your hand,” Wojcicki said.\u003c/p>\n\u003cp>Wojcicki said since 2007, more than half a million customers have sent in a saliva sample and gotten information that included their risks for developing cardiac disease and breast cancer, as well genetic traits such as how fast they metabolize caffeine. But last November the FDA ordered 23andMe to stop sales of its $99 tests.\u003c/p>\n\u003cp>\u003cstrong>FDA to 23andMe: Stop Selling Gene Tests\u003c/strong>\u003c/p>\n\u003cp>\u003ca href=\"http://www.fda.gov/newsevents/testimony/ucm219925.htm\">The FDA said\u003c/a>, in a very public letter, that the company’s test kit was a medical device that needed to be regulated and that 23andMe failed to prove it was interpreting health results accurately.\u003c/p>\n\u003cfigure id=\"attachment_17192\" class=\"wp-caption alignleft\" style=\"max-width: 252px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-17192\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/05/Wojcicki-216x162.jpg\" alt=\"23andMe CEO Anne Wojcicki, speaking at the annual SXSW festival in Austin, Texas in March 2014. (Jenny Oh/KQED)\" width=\"252\" height=\"189\">\u003cfigcaption class=\"wp-caption-text\">23andMe CEO Anne Wojcicki, speaking at the annual SXSW festival in Austin, Texas in March 2014. (Jenny Oh/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Wojcicki said the ruling has hit her company hard. “As a result, we have had to stop offering our healthcare service, and it’s had a significant impact because it’s one of the main things people think about when they think of their genetic information, is that they want the health interpretation.”\u003c/p>\n\u003cp>So now, 23andMe is working with the FDA in an effort to once again be able to offer health information. Meanwhile, the company can still provide ancestry information, which is already a crowded field.\u003c/p>\n\u003cp>Hank Greely directs the \u003ca href=\"https://www.law.stanford.edu/organizations/programs-and-centers/center-for-law-and-the-biosciences\">Center for Law and the Biosciences\u003c/a> at Stanford. He said dwindling sales will impact the company’s efforts to build a sizable research database—and that’s important to its business strategy.\u003c/p>\n\u003cp>“For those customers who agree to it by signing a somewhat opaque consent form,” Greely said, “they can sell that information to pharma and bio, but without lots of new customers coming in that service becomes less attractive to pharma and biotech.”\u003c/p>\n\u003cp>Some have criticized 23andme for considering selling anonymized data. But Wojcicki is unapologetic.\u003c/p>\n\u003cp>“23andMe partners with those companies because those are the people who are making therapies,” she said. “And if we want to get better therapies for breast cancer, and you want to get better therapies for asthma and migraines and all kinds of the other conditions that impact our lives, we have to work with pharma companies.”\u003cbr>\n\u003cstrong>\u003cbr>\nBig Data May Lead to Medical Breakthroughs\u003c/strong>\u003c/p>\n\u003cp>And here’s where consumer genetics isn’t just about the consumer. All that genetic information, or big data, can be used to run studies in search of medical breakthroughs. That means any company that wants to stay at the forefront has to keep up with the changing science.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘We know that the world has been quite focused on getting the so-called thousand-dollar genome.’\u003c/aside>\n\u003cp>In your human genome you have an entire set of 23 human chromosomes, made up of, among other things, DNA building blocks called base pairs. The human genome is composed of 3 billion base pairs.\u003c/p>\n\u003cp>Right now consumer gene tests take tiny snips of less than a million base pairs to look at one person’s unique genetic blueprint. Each of these unique variations is called a snp (yep, pronounced “snip”), for “single nucleotide polymorphism.”\u003c/p>\n\u003cp>\u003cstrong>The Future Lies in Sequencing the Whole Genome\u003c/strong>\u003c/p>\n\u003cp>But a snp is just a fraction of the entire genome. Scientists say the key to the future of genetics lies in sequencing the whole genome.\u003c/p>\n\u003cp>“We know that the world has been quite focused on getting the so-called thousand-dollar genome,” said Vance Vanier, vice president of reproductive and genetic health at San Diego-based \u003ca href=\"http://www.illumina.com/\">Illumina\u003c/a>. The company has just unveiled a system it claims can sequence a human genome for $1,000. That’s a big drop from the nearly $3 billion dollar price tag to sequence the first genome in 2003.\u003c/p>\n\u003cp>“I think the story of the next five years is to see that affordability spread more and more to broader segments of society and to clinical laboratories specifically,” said Vanier, who was CEO of an early consumer gene testing company called Navigenics.\u003c/p>\n\u003cp>And while he believes genetic testing will continue to be done primarily through medical professionals, he said he still sees a place for consumer gene tests. 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"content": "\u003cfigure id=\"attachment_18948\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/hongiiv/3129766406/in/photolist-5LySvL-5weVaD-4tHu8p-5LyQXU-5LyQDm-5LuCbn-5LuAcv-5LuC58-5wjffw-5LyPSC-hKsNWb-6Fg42Y-4bG9Qy-9tLWy1-5wjfcw-5LyQds-5LuBmK-5LuBDr-5weV7r-5LuB7Z-5LuBPc-5PbrNx-5LyR5A-4tHu98-5LyQQw-4tHu7T-5PfFv7-5weV8g-5LuAi6-5wjfdy-5LuBui-4fYr81-5HDkKA-8mM5aA-5nLnEy-9yFvui-4nQTup-2wGsW7-4nVtjy-4T1jMh-iEassb-4pdB6y-4oDoyx-CS7Rc-4m61oD-4Yqs7k-czsfKw-d6MJns-5kDcJH-4mzerB\">\u003cimg class=\"size-large wp-image-18948\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/3129766406_3f62c12d6a_o-640x426.jpg\" alt=\"The FDA's recent enforcement action against genetic testing firm 23andme rattled health-tech executives. (Hong Chang Bum/Flickr)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The FDA's recent enforcement action against genetic testing firm 23andme rattled health-tech executives. (Hong Chang Bum/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Christina Farr\u003c/strong>\u003c/p>\n\u003cp>Health care entrepreneurs are a different breed than most entrepreneurs. Rather than hunkering down to build a cool product, they need to think about regulation and red tape -- right from the start.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Ignoring the FDA and pushing ahead with a product is not a viable option. \u003c/aside>\n\u003cp>As boring as it may sound, health-tech founders need to develop a relationship with the U.S. Food and Drug Administration (FDA). This process might drag on for some time, as this authority has the unenviable job of overseeing an explosion of \u003ca href=\"http://mobihealthnews.com/28361/rock-health-1-97b-invested-in-digital-health-startups-in-2013/\" target=\"_blank\">new medical technology\u003c/a>, whether it’s a new electronic health record or a device that turns your smartphone into an ear scope.\u003c/p>\n\u003cp>As the recent \u003ca href=\"http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2013/ucm376296.htm\" target=\"_blank\">enforcement action\u003c/a> against genetic testing firm 23andMe demonstrated, ignoring the FDA and pushing ahead with a product is \u003ca href=\"http://venturebeat.com/2014/03/12/23andme-ceo-we-need-to-return-to-delivering-health-information/\" target=\"_blank\">not a viable option\u003c/a>.\u003c/p>\n\u003cp>In recent years, Silicon Valley's entrepreneurs have become increasingly critical, attacking the agency's antiquated processes in a string of interviews and \u003ca href=\"http://www.usatoday.com/story/opinion/2014/02/15/fischer-king-health-information-technology/5464693/\" target=\"_blank\">op-eds\u003c/a>.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“There is this perceived myth that the FDA will change its mind on a dime,” said Ellie Cachette, an entrepreneur and health advocate who has served on a number of committee boards for the National Institutes of Health.\u003c/p>\n\u003cp>The crux of the problem is a mismatch of priorities.\u003c/p>\n\u003cp>The FDA's chief mandate is to \u003ca href=\"http://www.fda.gov/aboutfda/transparency/basics/ucm194877.htm\" target=\"_blank\">protect public health\u003c/a>, but some (perhaps many) entrepreneurs fear that it’s under-resourced, overwhelmed, and a roadblock to life-saving innovation. Life sciences-focused venture capitalists say the FDA is prone to delays and abrupt policy changes, making health care a precarious bet.\u003c/p>\n\u003cp>“The first cause of death for our startups is a lack of capital, and if investors aren’t confident that they can scale the FDA hurdles, they simply won’t invest,” said Kyra Davis, a program manager at the Entrepreneurship Center at UCSF, who works closely with budding health-tech entrepreneurs.\u003c/p>\n\u003cp>Life sciences startups are in a particularly tough spot, with investment in a downward spiral. (Note: The picture looked a bit rosier in the first quarter of 2014, in part due to a few successful \u003ca href=\"http://medcitynews.com/2014/04/biotech-attracts-1b-in-venture-capital-funding-medical-device-deal-size-trends-higher/\" target=\"_blank\">recent biotech IPOs\u003c/a>.)\u003c/p>\n\u003cp>Whether it’s justified or not, the FDA is often cited by health investors as the reason for this decline.\u003c/p>\n\u003cp>“We have been pushing the FDA on how difficult it is to get products approved,” said Michael Carusi, a general partner at \u003ca href=\"http://www.atvcapital.com/\">ATV Capital\u003c/a>, in an interview for a series I wrote in April, 2013 for \u003cem>VentureBeat\u003c/em> on Silicon Valley’s perceptions of the FDA.\u003c/p>\n\u003cp>\u003ca href=\"http://venturebeat.com/2013/04/30/stifled-by-regulation-entrepreneurs-take-life-saving-devices-overseas/\">For that article,\u003c/a> the FDA responded that it is doing its best with entrepreneurs and VCs to “develop smart regulation that balance patient safety and innovation.”\u003c/p>\n\u003cp>\u003cstrong>Tension Between Protecting Public Health and Regulating Innovation\u003c/strong>\u003c/p>\n\u003cp>The FDA’s crack down on 23andMe last November prompted health entrepreneurs to quake in their boots and angry Internet commentators to rail against \"Big Government.\" In February, Senators Angus King (I-Maine) and Deb Fischer (R-Nebraska) \u003ca href=\"http://venturebeat.com/2014/02/26/new-digital-health-bill-proposes-to-undermine-the-fda-draws-mixed-reactions/\" target=\"_blank\">proposed a bill \u003c/a>in Congress to prevent the agency from regulating “low risk” health IT altogether.\u003c/p>\n\u003cp>But the FDA has stepped up in one important regard. After demurring for several months, it released its \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm369431.htm\" target=\"_blank\">final guidance\u003c/a> on how it plans to regulate the explosion in mobile medical technology, a particularly trendy space. Most mobile medical apps do not require federal regulation, the FDA found, so developers and investors could breathe a bit easier.\u003c/p>\n\u003cp>According to John Wilson, a health policy expert and advisor to the \u003ca href=\"http://www.newmeaccelerator.com/\" target=\"_blank\">NewMe startup accelerator\u003c/a>, the FDA is doing its job and doesn’t deserve the bad rep.\u003c/p>\n\u003cp>“Entrepreneurs have a tendency to over-promise and under-deliver. But in health care, people’s lives are at stake,” he explained.\u003c/p>\n\u003cp>“When the company doesn’t work out, the FDA is often blamed. Startups are looking for a fall guy.\"\u003c/p>\n\u003cp>While Wilson believes in a “checks and balancing” body like the FDA, he does admit that the agency has plenty of work to do.\u003c/p>\n\u003cp>It’s a boom time for technology, and some of it is genuinely breaking new ground. It will take some time to determine whether this new tech is potentially harmful, and how it should be classified. For instance, it’s a matter of ongoing debate among geneticists and lawyers whether 23andMe should have been treated as a medical device. This field of consumer genetic reporting is nascent, making it a particularly problematic area for the FDA.\u003c/p>\n\u003cp>Meanwhile, Silicon Valley expects to move quickly -- and doesn’t respond well to hesitation and delays.\u003c/p>\n\u003cp>“The pendulum swings with the FDA -- or at least it has in my 25 years,” added Joe Kiani, chief executive of California-based Masimo Corp., a medical technology company that was founded in 1989 and went public in 2007.\u003c/p>\n\u003cp>“Sometimes, the agency can be very difficult, and other times it’s easy and formulaic. Right now, it’s one of those difficult periods.”\u003c/p>\n\u003cp>\u003cstrong>\"Don't View the FDA As This Scary Thing\"\u003c/strong>\u003c/p>\n\u003cp>Even those who are sympathetic to the FDA would admit that the regulatory processes are no small matter.\u003c/p>\n\u003cp>Amy Sheng, founder of a company that develops a low-risk medical device, estimates that it required \"hundreds of thousands of dollars\" and a “truck-load” of paperwork to implement a full quality system.\u003c/p>\n\u003cp>Sheng hired several consultants to navigate legislation, as well as a few key employees. She advises health-tech entrepreneurs to raise significant funding at the outset -- and bring the right set of legal and quality assurance experts on board.\u003c/p>\n\u003cp>\"I've been speaking the medical device language my whole career, so I don't view the FDA as this scary thing,\" said Sheng. \"Just keep in mind that the agency's mission is to protect patients and make sure your product is safe and accurate.\"\u003c/p>\n\u003cp>Meanwhile, Malay Gandhi, chief strategy officer at digital health accelerator \u003ca href=\"http://rockhealth.com/\">Rock Health\u003c/a>, would advise entrepreneurs to take a deep breath and relax. He has a far more optimistic view about regulatory processes, and doesn’t believe that the FDA is \"out to get” health entrepreneurs.\u003c/p>\n\u003cp>“There is some level of fear but the process is well defined and you can get through it,” he said. “There are countless numbers of people who have done it already.”\u003c/p>\n\u003cp>According to Gandhi, the entrepreneurs in Rock Health will often approach the FDA for clarification and typically receive a response within a few weeks. In the past few years, none of the founders were publicly admonished in a similar manner to 23andMe.\u003c/p>\n\u003cp>“At the end of the day, there aren’t that many health companies that are anything like 23andMe,” he added.\u003c/p>\n\u003cp>For those who don’t have the requisite funding, another good option is to take the business overseas.\u003c/p>\n\u003cp>Kiani often advises newcomers to launch their products in Europe first, where regulation is far more predictable. It can take years (and those hundreds of thousands of dollars) for U.S.-based entrepreneurs to gain approval from the FDA -- and in that time, many founders will find success in international markets.\u003c/p>\n\u003cp>“China and Japan and Brazil have their own regulatory difficulties, Japan is a predictable process, but Europe is probably best,” said Kiani. “It’s the fastest way to market.”\u003c/p>\n\u003cp>Ultimately, the experts stress that the FDA is unlikely to pay attention unless something is seriously wrong. Pass the regulatory checks, file the paperwork, do the research, and avoid making overblown statements in marketing to patients.\u003c/p>\n\u003cp>For health entrepreneurs, getting in the FDA’s good graces is money and time well-spent, Walter de Brouwer, founder of Scanadu, a hand-held medical device, told \u003cem>Fast Company.\u003c/em> Despite the efforts of politicians like Senators King and Fisher, the agency is not going anywhere anytime soon, so de Brouwer advises getting in its good graces.\u003c/p>\n\u003cp>“Trying to do something medical and avoiding the FDA, that is a lost battle. It’s like asking the Vatican to become atheist.”\u003c/p>\n\u003cp>\u003cem style=\"color: #1f1f1f\">Christina Farr is a San Francisco-based journalist covering health technology. She previously wrote for Venture Beat, The Bay Citizen and SFGate.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"CNmeBBlBPPwQslZMYMxjOTuOuvmvqRlu\"]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18948\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://www.flickr.com/photos/hongiiv/3129766406/in/photolist-5LySvL-5weVaD-4tHu8p-5LyQXU-5LyQDm-5LuCbn-5LuAcv-5LuC58-5wjffw-5LyPSC-hKsNWb-6Fg42Y-4bG9Qy-9tLWy1-5wjfcw-5LyQds-5LuBmK-5LuBDr-5weV7r-5LuB7Z-5LuBPc-5PbrNx-5LyR5A-4tHu98-5LyQQw-4tHu7T-5PfFv7-5weV8g-5LuAi6-5wjfdy-5LuBui-4fYr81-5HDkKA-8mM5aA-5nLnEy-9yFvui-4nQTup-2wGsW7-4nVtjy-4T1jMh-iEassb-4pdB6y-4oDoyx-CS7Rc-4m61oD-4Yqs7k-czsfKw-d6MJns-5kDcJH-4mzerB\">\u003cimg class=\"size-large wp-image-18948\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/3129766406_3f62c12d6a_o-640x426.jpg\" alt=\"The FDA's recent enforcement action against genetic testing firm 23andme rattled health-tech executives. (Hong Chang Bum/Flickr)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The FDA's recent enforcement action against genetic testing firm 23andme rattled health-tech executives. (Hong Chang Bum/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Christina Farr\u003c/strong>\u003c/p>\n\u003cp>Health care entrepreneurs are a different breed than most entrepreneurs. Rather than hunkering down to build a cool product, they need to think about regulation and red tape -- right from the start.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Ignoring the FDA and pushing ahead with a product is not a viable option. \u003c/aside>\n\u003cp>As boring as it may sound, health-tech founders need to develop a relationship with the U.S. Food and Drug Administration (FDA). This process might drag on for some time, as this authority has the unenviable job of overseeing an explosion of \u003ca href=\"http://mobihealthnews.com/28361/rock-health-1-97b-invested-in-digital-health-startups-in-2013/\" target=\"_blank\">new medical technology\u003c/a>, whether it’s a new electronic health record or a device that turns your smartphone into an ear scope.\u003c/p>\n\u003cp>As the recent \u003ca href=\"http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2013/ucm376296.htm\" target=\"_blank\">enforcement action\u003c/a> against genetic testing firm 23andMe demonstrated, ignoring the FDA and pushing ahead with a product is \u003ca href=\"http://venturebeat.com/2014/03/12/23andme-ceo-we-need-to-return-to-delivering-health-information/\" target=\"_blank\">not a viable option\u003c/a>.\u003c/p>\n\u003cp>In recent years, Silicon Valley's entrepreneurs have become increasingly critical, attacking the agency's antiquated processes in a string of interviews and \u003ca href=\"http://www.usatoday.com/story/opinion/2014/02/15/fischer-king-health-information-technology/5464693/\" target=\"_blank\">op-eds\u003c/a>.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“There is this perceived myth that the FDA will change its mind on a dime,” said Ellie Cachette, an entrepreneur and health advocate who has served on a number of committee boards for the National Institutes of Health.\u003c/p>\n\u003cp>The crux of the problem is a mismatch of priorities.\u003c/p>\n\u003cp>The FDA's chief mandate is to \u003ca href=\"http://www.fda.gov/aboutfda/transparency/basics/ucm194877.htm\" target=\"_blank\">protect public health\u003c/a>, but some (perhaps many) entrepreneurs fear that it’s under-resourced, overwhelmed, and a roadblock to life-saving innovation. Life sciences-focused venture capitalists say the FDA is prone to delays and abrupt policy changes, making health care a precarious bet.\u003c/p>\n\u003cp>“The first cause of death for our startups is a lack of capital, and if investors aren’t confident that they can scale the FDA hurdles, they simply won’t invest,” said Kyra Davis, a program manager at the Entrepreneurship Center at UCSF, who works closely with budding health-tech entrepreneurs.\u003c/p>\n\u003cp>Life sciences startups are in a particularly tough spot, with investment in a downward spiral. (Note: The picture looked a bit rosier in the first quarter of 2014, in part due to a few successful \u003ca href=\"http://medcitynews.com/2014/04/biotech-attracts-1b-in-venture-capital-funding-medical-device-deal-size-trends-higher/\" target=\"_blank\">recent biotech IPOs\u003c/a>.)\u003c/p>\n\u003cp>Whether it’s justified or not, the FDA is often cited by health investors as the reason for this decline.\u003c/p>\n\u003cp>“We have been pushing the FDA on how difficult it is to get products approved,” said Michael Carusi, a general partner at \u003ca href=\"http://www.atvcapital.com/\">ATV Capital\u003c/a>, in an interview for a series I wrote in April, 2013 for \u003cem>VentureBeat\u003c/em> on Silicon Valley’s perceptions of the FDA.\u003c/p>\n\u003cp>\u003ca href=\"http://venturebeat.com/2013/04/30/stifled-by-regulation-entrepreneurs-take-life-saving-devices-overseas/\">For that article,\u003c/a> the FDA responded that it is doing its best with entrepreneurs and VCs to “develop smart regulation that balance patient safety and innovation.”\u003c/p>\n\u003cp>\u003cstrong>Tension Between Protecting Public Health and Regulating Innovation\u003c/strong>\u003c/p>\n\u003cp>The FDA’s crack down on 23andMe last November prompted health entrepreneurs to quake in their boots and angry Internet commentators to rail against \"Big Government.\" In February, Senators Angus King (I-Maine) and Deb Fischer (R-Nebraska) \u003ca href=\"http://venturebeat.com/2014/02/26/new-digital-health-bill-proposes-to-undermine-the-fda-draws-mixed-reactions/\" target=\"_blank\">proposed a bill \u003c/a>in Congress to prevent the agency from regulating “low risk” health IT altogether.\u003c/p>\n\u003cp>But the FDA has stepped up in one important regard. After demurring for several months, it released its \u003ca href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm369431.htm\" target=\"_blank\">final guidance\u003c/a> on how it plans to regulate the explosion in mobile medical technology, a particularly trendy space. Most mobile medical apps do not require federal regulation, the FDA found, so developers and investors could breathe a bit easier.\u003c/p>\n\u003cp>According to John Wilson, a health policy expert and advisor to the \u003ca href=\"http://www.newmeaccelerator.com/\" target=\"_blank\">NewMe startup accelerator\u003c/a>, the FDA is doing its job and doesn’t deserve the bad rep.\u003c/p>\n\u003cp>“Entrepreneurs have a tendency to over-promise and under-deliver. But in health care, people’s lives are at stake,” he explained.\u003c/p>\n\u003cp>“When the company doesn’t work out, the FDA is often blamed. Startups are looking for a fall guy.\"\u003c/p>\n\u003cp>While Wilson believes in a “checks and balancing” body like the FDA, he does admit that the agency has plenty of work to do.\u003c/p>\n\u003cp>It’s a boom time for technology, and some of it is genuinely breaking new ground. It will take some time to determine whether this new tech is potentially harmful, and how it should be classified. For instance, it’s a matter of ongoing debate among geneticists and lawyers whether 23andMe should have been treated as a medical device. This field of consumer genetic reporting is nascent, making it a particularly problematic area for the FDA.\u003c/p>\n\u003cp>Meanwhile, Silicon Valley expects to move quickly -- and doesn’t respond well to hesitation and delays.\u003c/p>\n\u003cp>“The pendulum swings with the FDA -- or at least it has in my 25 years,” added Joe Kiani, chief executive of California-based Masimo Corp., a medical technology company that was founded in 1989 and went public in 2007.\u003c/p>\n\u003cp>“Sometimes, the agency can be very difficult, and other times it’s easy and formulaic. Right now, it’s one of those difficult periods.”\u003c/p>\n\u003cp>\u003cstrong>\"Don't View the FDA As This Scary Thing\"\u003c/strong>\u003c/p>\n\u003cp>Even those who are sympathetic to the FDA would admit that the regulatory processes are no small matter.\u003c/p>\n\u003cp>Amy Sheng, founder of a company that develops a low-risk medical device, estimates that it required \"hundreds of thousands of dollars\" and a “truck-load” of paperwork to implement a full quality system.\u003c/p>\n\u003cp>Sheng hired several consultants to navigate legislation, as well as a few key employees. She advises health-tech entrepreneurs to raise significant funding at the outset -- and bring the right set of legal and quality assurance experts on board.\u003c/p>\n\u003cp>\"I've been speaking the medical device language my whole career, so I don't view the FDA as this scary thing,\" said Sheng. \"Just keep in mind that the agency's mission is to protect patients and make sure your product is safe and accurate.\"\u003c/p>\n\u003cp>Meanwhile, Malay Gandhi, chief strategy officer at digital health accelerator \u003ca href=\"http://rockhealth.com/\">Rock Health\u003c/a>, would advise entrepreneurs to take a deep breath and relax. He has a far more optimistic view about regulatory processes, and doesn’t believe that the FDA is \"out to get” health entrepreneurs.\u003c/p>\n\u003cp>“There is some level of fear but the process is well defined and you can get through it,” he said. “There are countless numbers of people who have done it already.”\u003c/p>\n\u003cp>According to Gandhi, the entrepreneurs in Rock Health will often approach the FDA for clarification and typically receive a response within a few weeks. In the past few years, none of the founders were publicly admonished in a similar manner to 23andMe.\u003c/p>\n\u003cp>“At the end of the day, there aren’t that many health companies that are anything like 23andMe,” he added.\u003c/p>\n\u003cp>For those who don’t have the requisite funding, another good option is to take the business overseas.\u003c/p>\n\u003cp>Kiani often advises newcomers to launch their products in Europe first, where regulation is far more predictable. It can take years (and those hundreds of thousands of dollars) for U.S.-based entrepreneurs to gain approval from the FDA -- and in that time, many founders will find success in international markets.\u003c/p>\n\u003cp>“China and Japan and Brazil have their own regulatory difficulties, Japan is a predictable process, but Europe is probably best,” said Kiani. “It’s the fastest way to market.”\u003c/p>\n\u003cp>Ultimately, the experts stress that the FDA is unlikely to pay attention unless something is seriously wrong. Pass the regulatory checks, file the paperwork, do the research, and avoid making overblown statements in marketing to patients.\u003c/p>\n\u003cp>For health entrepreneurs, getting in the FDA’s good graces is money and time well-spent, Walter de Brouwer, founder of Scanadu, a hand-held medical device, told \u003cem>Fast Company.\u003c/em> Despite the efforts of politicians like Senators King and Fisher, the agency is not going anywhere anytime soon, so de Brouwer advises getting in its good graces.\u003c/p>\n\u003cp>“Trying to do something medical and avoiding the FDA, that is a lost battle. It’s like asking the Vatican to become atheist.”\u003c/p>\n\u003cp>\u003cem style=\"color: #1f1f1f\">Christina Farr is a San Francisco-based journalist covering health technology. She previously wrote for Venture Beat, The Bay Citizen and SFGate.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "California Legislature To Consider Antibiotic Ban in Animals",
"title": "California Legislature To Consider Antibiotic Ban in Animals",
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"content": "\u003cfigure id=\"attachment_18838\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/ab1437edit.jpg\">\u003cimg class=\"size-large wp-image-18838 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/ab1437edit-640x557.jpg\" alt=\"Stanford University Infectious Disease Specialist David Relman with Assemblyman Kevin Mullin looking on (Jeff Walters/Assembly Democratic Caucus).\" width=\"640\" height=\"557\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Stanford University Infectious Disease Specialist David Relman with Assemblyman Kevin Mullin looking on (Jeff Walters/Assembly Democratic Caucus).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Joe Rubin\u003c/strong>\u003c/p>\n\u003cp>A new bill in the California Legislature could give California the distinction of going where the federal government hasn’t — more strictly regulating the way that livestock are given antibiotics.\u003c/p>\n\u003cp>But freshman state Assemblyman Kevin Mullin (D-South San Francisco), who is introducing state Assembly Bill 1437, says getting it through the agricultural committee is a bit of long shot.\u003c/p>\n\u003cp>More than 70 percent of all antibiotics in the U.S. are given to animals, often to healthy livestock. Until very recently drug companies marketed the growth-promoting benefits of antibiotics. And many meat producers, keen for additional profits and assured by pharmaceutical companies that the practice was safe for people and animals, would routinely add antibiotics to feed.\u003c/p>\n\u003cp>In December, the Food and Drug Administration, after years of debate on the issue, asked drug companies to voluntarily stop marketing the growth-promoting benefits of antibiotics out of concerns for public health. The companies are largely complying. But critics like the Natural Resources Defense Council and New York Times food writer \u003ca href=\"http://www.nytimes.com/2013/12/18/opinion/bittman-the-fdas-not-really-such-good-news.html?pagewanted=all&_r=0\" target=\"_blank\">Mark Bittman\u003c/a> have criticized the FDA’s approach as lax and unlikely to lead to any real change.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!--more-->There is reason critics are skeptical about how much change is actually happening. The European Union took a similar step banning the use of antibiotics for animal growth promotion back in 2006. A \u003ca href=\"http://www.wageningenur.nl/en/Research-Results/Projects-and-programmes/MARAN-Antibiotic-usage/Trends-in-use-per-species/Antibiotic-usage-in-broilers.htm\" target=\"_blank\">study\u003c/a> of antibiotic use in the Netherlands found that usage actually went up in chickens in the ensuing years. It seems as if chicken ranches and feed lots continued to use antimicrobials at the same rate, but for disease prevention instead of overtly for growth promotion. It wasn’t until 2009 that rates began to tumble when bans on most of those prophylactic uses of antibiotics started to take effect.\u003c/p>\n\u003cp>Like a similar bill that U.S. Sen. Dianne Feinstein (D-Calif.) has been floating for several years, Mullin’s bill seeks to mirror those tougher European standards.\u003c/p>\n\u003cp>On Tuesday, Dr. David Relman, an infectious disease specialist from Stanford University, spoke at a Sacramento press conference in favor of AB 1437. He said he is treating more and more patients who have contracted so-called superbugs. He recalled one case last year that haunts him, a woman with an infection in her bloodstream that was resistant to every known antibiotic. He couldn’t save her.\u003c/p>\n\u003cp>When asked if the prolific use of antibiotics in livestock were really partly to blame for her death, Relman said, “To that particular woman, we can't say. But to many, many woman and men like her, we would have to say the burden of evidence says yes.”\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/146153547&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\u003cp>That burden of evidence includes some studies that are showing more conclusive evidence of resistant pathogens in animals jumping to people. A recent Johns Hopkins School of Medicine \u003ca href=\"http://www.nature.com/news/pig-manure-fertilizer-linked-to-human-mrsa-infections-1.13752\" target=\"_blank\">examination\u003c/a> found that residents living near a pig farm in Pennsylvania were more likely to become infected with methicillin-resistant Staphylococcus aureus (MRSA) bacteria.\u003c/p>\n\u003cp>The real worry is the unknown. As Relman described it, antimicrobial resistance is a bit like climate change. Every bit of antibiotic overuse can add up to a bigger problem.\u003c/p>\n\u003cp>But Bill Mattos, president of the California Poultry Association, says the health concerns over the use of antibiotics in livestock are being overblown.\u003c/p>\n\u003cp>“Most of the problem comes from doctors overmedicating their patients,\" Mattos said. \"That’s where the problem is because everybody wants antibiotics when they get sick.\"\u003c/p>\n\u003cp>Mattos said he is confident that AB 1437 won’t survive its committee hearing next week because the bill doesn’t have enough supporters. The Poultry Association is backing a competing and more modest bill in the State Senate authored by Jerry Hill (D-San Mateo). Hill’s bill essentially makes the recent FDA’s recommendations mandatory, rather than voluntary in California.\u003c/p>\n\u003cp>Mattos said every year California produces 300 million chickens. Those chickens employ and feed a lot of people.\u003c/p>\n\u003cp>“If you want an antibiotic free product, you can buy it. It says it on the label. Ten to 15 percent of people are looking for antibiotic free, 80 percent don’t care,” Mattos said.\u003c/p>\n\u003cp>On Tuesday, in his assembly office, Mullin — who represents cities in San Mateo County just south of San Francisco — was sounding like a man about to possibly lose a battle.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“There is no question that in this building, we are in an uphill fight to get this public health issue heard and to have action taken on the bill,\" Mullin said. \"But we remain optimistic and hopeful that as the general public becomes more aware of these concerns, that that will change the political calculus at the state capital.”\u003c/p>\n\n",
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"excerpt": "California legislator wants to ban regular use of antibiotics on feed lots over public health concerns.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_18838\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/ab1437edit.jpg\">\u003cimg class=\"size-large wp-image-18838 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/ab1437edit-640x557.jpg\" alt=\"Stanford University Infectious Disease Specialist David Relman with Assemblyman Kevin Mullin looking on (Jeff Walters/Assembly Democratic Caucus).\" width=\"640\" height=\"557\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Stanford University Infectious Disease Specialist David Relman with Assemblyman Kevin Mullin looking on (Jeff Walters/Assembly Democratic Caucus).\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Joe Rubin\u003c/strong>\u003c/p>\n\u003cp>A new bill in the California Legislature could give California the distinction of going where the federal government hasn’t — more strictly regulating the way that livestock are given antibiotics.\u003c/p>\n\u003cp>But freshman state Assemblyman Kevin Mullin (D-South San Francisco), who is introducing state Assembly Bill 1437, says getting it through the agricultural committee is a bit of long shot.\u003c/p>\n\u003cp>More than 70 percent of all antibiotics in the U.S. are given to animals, often to healthy livestock. Until very recently drug companies marketed the growth-promoting benefits of antibiotics. And many meat producers, keen for additional profits and assured by pharmaceutical companies that the practice was safe for people and animals, would routinely add antibiotics to feed.\u003c/p>\n\u003cp>In December, the Food and Drug Administration, after years of debate on the issue, asked drug companies to voluntarily stop marketing the growth-promoting benefits of antibiotics out of concerns for public health. The companies are largely complying. But critics like the Natural Resources Defense Council and New York Times food writer \u003ca href=\"http://www.nytimes.com/2013/12/18/opinion/bittman-the-fdas-not-really-such-good-news.html?pagewanted=all&_r=0\" target=\"_blank\">Mark Bittman\u003c/a> have criticized the FDA’s approach as lax and unlikely to lead to any real change.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->There is reason critics are skeptical about how much change is actually happening. The European Union took a similar step banning the use of antibiotics for animal growth promotion back in 2006. A \u003ca href=\"http://www.wageningenur.nl/en/Research-Results/Projects-and-programmes/MARAN-Antibiotic-usage/Trends-in-use-per-species/Antibiotic-usage-in-broilers.htm\" target=\"_blank\">study\u003c/a> of antibiotic use in the Netherlands found that usage actually went up in chickens in the ensuing years. It seems as if chicken ranches and feed lots continued to use antimicrobials at the same rate, but for disease prevention instead of overtly for growth promotion. It wasn’t until 2009 that rates began to tumble when bans on most of those prophylactic uses of antibiotics started to take effect.\u003c/p>\n\u003cp>Like a similar bill that U.S. Sen. Dianne Feinstein (D-Calif.) has been floating for several years, Mullin’s bill seeks to mirror those tougher European standards.\u003c/p>\n\u003cp>On Tuesday, Dr. David Relman, an infectious disease specialist from Stanford University, spoke at a Sacramento press conference in favor of AB 1437. He said he is treating more and more patients who have contracted so-called superbugs. He recalled one case last year that haunts him, a woman with an infection in her bloodstream that was resistant to every known antibiotic. He couldn’t save her.\u003c/p>\n\u003cp>When asked if the prolific use of antibiotics in livestock were really partly to blame for her death, Relman said, “To that particular woman, we can't say. But to many, many woman and men like her, we would have to say the burden of evidence says yes.”\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/146153547&color=ff5500&auto_play=false&hide_related=false&show_artwork=true\" frameborder=\"no\" scrolling=\"no\" width=\"100%\" height=\"166\">\u003c/iframe>\u003c/p>\n\u003cp>That burden of evidence includes some studies that are showing more conclusive evidence of resistant pathogens in animals jumping to people. A recent Johns Hopkins School of Medicine \u003ca href=\"http://www.nature.com/news/pig-manure-fertilizer-linked-to-human-mrsa-infections-1.13752\" target=\"_blank\">examination\u003c/a> found that residents living near a pig farm in Pennsylvania were more likely to become infected with methicillin-resistant Staphylococcus aureus (MRSA) bacteria.\u003c/p>\n\u003cp>The real worry is the unknown. As Relman described it, antimicrobial resistance is a bit like climate change. Every bit of antibiotic overuse can add up to a bigger problem.\u003c/p>\n\u003cp>But Bill Mattos, president of the California Poultry Association, says the health concerns over the use of antibiotics in livestock are being overblown.\u003c/p>\n\u003cp>“Most of the problem comes from doctors overmedicating their patients,\" Mattos said. \"That’s where the problem is because everybody wants antibiotics when they get sick.\"\u003c/p>\n\u003cp>Mattos said he is confident that AB 1437 won’t survive its committee hearing next week because the bill doesn’t have enough supporters. The Poultry Association is backing a competing and more modest bill in the State Senate authored by Jerry Hill (D-San Mateo). Hill’s bill essentially makes the recent FDA’s recommendations mandatory, rather than voluntary in California.\u003c/p>\n\u003cp>Mattos said every year California produces 300 million chickens. Those chickens employ and feed a lot of people.\u003c/p>\n\u003cp>“If you want an antibiotic free product, you can buy it. It says it on the label. Ten to 15 percent of people are looking for antibiotic free, 80 percent don’t care,” Mattos said.\u003c/p>\n\u003cp>On Tuesday, in his assembly office, Mullin — who represents cities in San Mateo County just south of San Francisco — was sounding like a man about to possibly lose a battle.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“There is no question that in this building, we are in an uphill fight to get this public health issue heard and to have action taken on the bill,\" Mullin said. \"But we remain optimistic and hopeful that as the general public becomes more aware of these concerns, that that will change the political calculus at the state capital.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Scientists Have Engineered a Version of Bird Flu That Can Spread Between Mammals",
"headTitle": "Scientists Have Engineered a Version of Bird Flu That Can Spread Between Mammals | KQED",
"content": "\u003cfigure id=\"attachment_16622\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/ChickenMarket.jpg\" rel=\"attachment wp-att-16622\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-16622\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/ChickenMarket.jpg\" alt=\"Right now you can only get bird flu in places like this chicken market. Five small changes in the bird flu's genetic material can change that so you can catch it from another person. (Wikimedia Commons/M M (Padmanaba01))\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Right now you can only get bird flu in places like this chicken market. Five small changes in the bird flu’s genetic material can change that so you can catch it from another person. (Wikimedia Commons/\u003ca href=\"http://commons.wikimedia.org/wiki/File:Chicken_market_in_Xining,_Qinghai_province,_China.jpg\" class=\"nofancybox\">M M Padmanaba01\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>Back in 2003, four people got sick and died from the\u003ca href=\"http://en.wikipedia.org/wiki/Global_spread_of_H5N1#Human_and_bird_cases\"> H5N1 strain of bird flu\u003c/a> in China. And that wasn’t the last time either. Every few years, new cases reappear and around \u003ca href=\"http://www.who.int/mediacentre/factsheets/avian_influenza/en/\">60% of the infected people die\u003c/a>.\u003c/p>\n\u003cp>Meanwhile, even when it isn’t infecting people, the bird flu continues to percolate in all sorts of domestic and wild birds, spreading and evolving. Millions of birds have died from the disease and millions more have been slaughtered, with the \u003ca href=\"http://www.japantimes.co.jp/news/2014/04/14/national/112000-chickens-culled-at-kumamoto-farms-in-bid-to-curb-bird-flu-outbreak/#.U01y1vldVIF\">latest outbreak being in Japan\u003c/a> where they’ve just killed 112,000 chickens.\u003c/p>\n\u003cp>Ever since it first appeared, scientists have worried that the bird flu would turn into a \u003ca href=\"http://en.wikipedia.org/wiki/Pandemic\">pandemic \u003c/a>similar to the Spanish Flu that killed somewhere between 50 and 100 million people at the end of World War I. For now, the fact that it only spreads from birds to people has kept this deadly disease in check. But as a\u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24725402\"> new study\u003c/a> in the leading journal \u003ca href=\"http://www.cell.com/\">Cell \u003c/a>shows, this protection may not last forever.\u003c/p>\n\u003cp>In this study, the authors find that it takes just five small changes in the virus’ genetic material to make it able to spread from one ferret to another. While the changes may not be the same ones to make a virus able to spread between people, odds are that a similarly small set of changes will be all that is required.\u003c/p>\n\u003cfigure id=\"attachment_16625\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/Ferrets.jpg\" rel=\"attachment wp-att-16625\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-16625\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/Ferrets.jpg\" alt=\"Scientists have engineered a bird flu that passes between ferrets. It was a bit too easy to do. (Wikimedia Commons/Viki)\" width=\"300\" height=\"253\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Scientists have engineered a bird flu that passes between ferrets. It was a bit too easy to do. (Wikimedia Commons/\u003ca href=\"http://commons.wikimedia.org/wiki/File:Fretts_301004_selbstfotografiert,_GNU-FDL.jpg\" class=\"nofancybox\">Viki\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>A search of all the viruses sequenced to date showed that a few of the necessary mutations are already out there in the wild. This means that while the odds are low that one virus would get all five changes, they are not zero. One day, a virus may appear in nature with all five changes.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Luckily for us (and the ferrets), when this virus does mutate so it can spread from ferret to ferret, it becomes much less deadly. Doses that easily wiped out a ferret now have little or no effect. This is pretty common in the viral world—there is a tradeoff between deadliness and the ability to spread.\u003c/p>\n\u003cp>Of course, there is no guarantee that the virus will be less deadly if it mutates to spread from person to person. And it may not have to be to still kill a lot of people.\u003c/p>\n\u003cp>As I said, right now the virus is killing around 60% of the people it infects. The Spanish flu only needed to kill 10% of the people it infected to wipe out somewhere between 3 and 6% of the world’s population. So even if a version of the bird flu evolved to both spread between people and be six times less deadly, it could still be devastating.\u003c/p>\n\u003cp>Research like this is critical for monitoring the virus out in the wild. By identifying the changes that can cause the virus to be able to spread from person to person, we can keep a close watch on things and quarantine people if a virus ever does stumble on the right set of mutations. But research like this is also \u003ca href=\"http://www.npr.org/blogs/health/2013/02/22/172582712/to-keep-deadly-bird-flu-in-the-lab-feds-set-rules-for-scientists\">controversial\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Escaped and Engineered Viruses\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_16628\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/Lab.jpg\" rel=\"attachment wp-att-16628\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-16628\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/Lab.jpg\" alt=\"We could be in trouble if these viruses escaped the lab. Luckily there are lots of safeguards to keep this from happening. (Wikimedia Commons/Zuzanna K. Filutowska)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">We could be in trouble if these viruses escaped the lab. Luckily there are lots of safeguards to keep this from happening. (Wikimedia Commons/\u003ca href=\"http://commons.wikimedia.org/wiki/File:Laboratorium-biologia-molekularna.jpg\" class=\"nofancybox\">Zuzanna K. Filutowska\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>A big worry with this type of research is that a virus might escape the lab and spread out into the wild. There are a huge number of safeguards in place to keep the virus from escaping but nothing is 100%. There is a small chance it could get out. (It is important to note that there has not been a single smallpox outbreak despite almost 40 years of research.)\u003c/p>\n\u003cp>The second concern is that the wrong sorts of people may be able to use this freely available information to make an artificial virus to use as a weapon. This isn’t very likely either but is definitely possible. The researchers created a virus that could spread between ferrets on a machine in a lab which means other people might be able to do this as well. This capability has really only become feasible in the last few years.\u003c/p>\n\u003cp>It is important to keep in mind that the viruses that have been made so far may pose little risk to people or even ferrets. But if they did get out, it might only be a matter of time before they build up the mutations they need to spread between people and then we may be in real trouble. These escaped or engineered viruses would have a head start which makes them more likely to stumble on the set of mutations that makes them lethal and highly infectious.\u003c/p>\n\u003cp>The government decided back in 2012 that this sort of research was OK if done with the right safeguards in place. They argued that the benefits of being able to nip a pandemic in the bud outweighed the risk of the research causing a pandemic on its own. So far this has turned out to be true.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://www.youtube.com/watch?v=90oP2ez8l4k\">Lengthy discussion on the controversy of this research (YouTube) \u003c/a>\u003c/p>\n\n",
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"excerpt": "Scientists were able to engineer a version of the bird flu that can spread between mammals, the first step towards turning this virus into a pandemic. This research is controversial as it has created something that is potentially dangerous.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16622\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/ChickenMarket.jpg\" rel=\"attachment wp-att-16622\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-16622\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/ChickenMarket.jpg\" alt=\"Right now you can only get bird flu in places like this chicken market. Five small changes in the bird flu's genetic material can change that so you can catch it from another person. (Wikimedia Commons/M M (Padmanaba01))\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Right now you can only get bird flu in places like this chicken market. Five small changes in the bird flu’s genetic material can change that so you can catch it from another person. (Wikimedia Commons/\u003ca href=\"http://commons.wikimedia.org/wiki/File:Chicken_market_in_Xining,_Qinghai_province,_China.jpg\" class=\"nofancybox\">M M Padmanaba01\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>Back in 2003, four people got sick and died from the\u003ca href=\"http://en.wikipedia.org/wiki/Global_spread_of_H5N1#Human_and_bird_cases\"> H5N1 strain of bird flu\u003c/a> in China. And that wasn’t the last time either. Every few years, new cases reappear and around \u003ca href=\"http://www.who.int/mediacentre/factsheets/avian_influenza/en/\">60% of the infected people die\u003c/a>.\u003c/p>\n\u003cp>Meanwhile, even when it isn’t infecting people, the bird flu continues to percolate in all sorts of domestic and wild birds, spreading and evolving. Millions of birds have died from the disease and millions more have been slaughtered, with the \u003ca href=\"http://www.japantimes.co.jp/news/2014/04/14/national/112000-chickens-culled-at-kumamoto-farms-in-bid-to-curb-bird-flu-outbreak/#.U01y1vldVIF\">latest outbreak being in Japan\u003c/a> where they’ve just killed 112,000 chickens.\u003c/p>\n\u003cp>Ever since it first appeared, scientists have worried that the bird flu would turn into a \u003ca href=\"http://en.wikipedia.org/wiki/Pandemic\">pandemic \u003c/a>similar to the Spanish Flu that killed somewhere between 50 and 100 million people at the end of World War I. For now, the fact that it only spreads from birds to people has kept this deadly disease in check. But as a\u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/24725402\"> new study\u003c/a> in the leading journal \u003ca href=\"http://www.cell.com/\">Cell \u003c/a>shows, this protection may not last forever.\u003c/p>\n\u003cp>In this study, the authors find that it takes just five small changes in the virus’ genetic material to make it able to spread from one ferret to another. While the changes may not be the same ones to make a virus able to spread between people, odds are that a similarly small set of changes will be all that is required.\u003c/p>\n\u003cfigure id=\"attachment_16625\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/Ferrets.jpg\" rel=\"attachment wp-att-16625\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-16625\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/Ferrets.jpg\" alt=\"Scientists have engineered a bird flu that passes between ferrets. It was a bit too easy to do. (Wikimedia Commons/Viki)\" width=\"300\" height=\"253\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Scientists have engineered a bird flu that passes between ferrets. It was a bit too easy to do. (Wikimedia Commons/\u003ca href=\"http://commons.wikimedia.org/wiki/File:Fretts_301004_selbstfotografiert,_GNU-FDL.jpg\" class=\"nofancybox\">Viki\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>A search of all the viruses sequenced to date showed that a few of the necessary mutations are already out there in the wild. This means that while the odds are low that one virus would get all five changes, they are not zero. One day, a virus may appear in nature with all five changes.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Luckily for us (and the ferrets), when this virus does mutate so it can spread from ferret to ferret, it becomes much less deadly. Doses that easily wiped out a ferret now have little or no effect. This is pretty common in the viral world—there is a tradeoff between deadliness and the ability to spread.\u003c/p>\n\u003cp>Of course, there is no guarantee that the virus will be less deadly if it mutates to spread from person to person. And it may not have to be to still kill a lot of people.\u003c/p>\n\u003cp>As I said, right now the virus is killing around 60% of the people it infects. The Spanish flu only needed to kill 10% of the people it infected to wipe out somewhere between 3 and 6% of the world’s population. So even if a version of the bird flu evolved to both spread between people and be six times less deadly, it could still be devastating.\u003c/p>\n\u003cp>Research like this is critical for monitoring the virus out in the wild. By identifying the changes that can cause the virus to be able to spread from person to person, we can keep a close watch on things and quarantine people if a virus ever does stumble on the right set of mutations. But research like this is also \u003ca href=\"http://www.npr.org/blogs/health/2013/02/22/172582712/to-keep-deadly-bird-flu-in-the-lab-feds-set-rules-for-scientists\">controversial\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Escaped and Engineered Viruses\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_16628\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/Lab.jpg\" rel=\"attachment wp-att-16628\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-16628\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/Lab.jpg\" alt=\"We could be in trouble if these viruses escaped the lab. Luckily there are lots of safeguards to keep this from happening. (Wikimedia Commons/Zuzanna K. Filutowska)\" width=\"300\" height=\"225\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">We could be in trouble if these viruses escaped the lab. Luckily there are lots of safeguards to keep this from happening. (Wikimedia Commons/\u003ca href=\"http://commons.wikimedia.org/wiki/File:Laboratorium-biologia-molekularna.jpg\" class=\"nofancybox\">Zuzanna K. Filutowska\u003c/a>)\u003c/figcaption>\u003c/figure>\n\u003cp>A big worry with this type of research is that a virus might escape the lab and spread out into the wild. There are a huge number of safeguards in place to keep the virus from escaping but nothing is 100%. There is a small chance it could get out. (It is important to note that there has not been a single smallpox outbreak despite almost 40 years of research.)\u003c/p>\n\u003cp>The second concern is that the wrong sorts of people may be able to use this freely available information to make an artificial virus to use as a weapon. This isn’t very likely either but is definitely possible. The researchers created a virus that could spread between ferrets on a machine in a lab which means other people might be able to do this as well. This capability has really only become feasible in the last few years.\u003c/p>\n\u003cp>It is important to keep in mind that the viruses that have been made so far may pose little risk to people or even ferrets. But if they did get out, it might only be a matter of time before they build up the mutations they need to spread between people and then we may be in real trouble. These escaped or engineered viruses would have a head start which makes them more likely to stumble on the set of mutations that makes them lethal and highly infectious.\u003c/p>\n\u003cp>The government decided back in 2012 that this sort of research was OK if done with the right safeguards in place. They argued that the benefits of being able to nip a pandemic in the bud outweighed the risk of the research causing a pandemic on its own. So far this has turned out to be true.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://www.youtube.com/watch?v=90oP2ez8l4k\">Lengthy discussion on the controversy of this research (YouTube) \u003c/a>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"headTitle": "Health Trackers May Be the Rage, But How Useful Are They? | KQED",
"content": "\u003cp>\u003cstrong>By Christina Farr\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_16542\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-16542\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/07_wearing_necklace.jpg\" alt=\"The Shine wearable. (Misfit Wearables)\" width=\"640\" height=\"360\">\u003cfigcaption class=\"wp-caption-text\">The Shine is an activity monitor, sleep tracker and watch. (Misfit Wearables)\u003c/figcaption>\u003c/figure>\n\u003cp>For months, technology entrepreneur Will Imholte was hell-bent on finding the best personal activity tracker.\u003c/p>\n\u003cp>Rather than browsing reviews, he decided to test the \u003ca href=\"https://jawbone.com/up\">Jawbone UP\u003c/a>, \u003ca href=\"http://www.fitbit.com/\">Fitbit Flex\u003c/a>, \u003ca href=\"http://www.nike.com/us/en_us/c/nikeplus-fuelband\">Nike FuelBand SE\u003c/a> and a litany of others to track his calorie count and weight.\u003c/p>\n\u003cp>But all these devices failed to sustain his interest for more than a week. Despite his best efforts, Imholte gave up on the burgeoning wearable trend. He found that a smartphone and a time-keeping Swiss watch were more than sufficient for his purposes.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘Trust me, I wanted to like wearables, but I stopped using them after a few months.’\u003c/aside>\n\u003cp>“I’m a nerd that can’t get enough of the latest gadgets,” said Imholte, the founder of Prime, a startup that helps patients access their personal medical records.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Trust me, I wanted to like wearables, but I stopped using them after a few months,” he said. “I’m not training for a marathon or anything, so I didn’t really see much need for them in my life.”\u003c/p>\n\u003cp>Wearables are currently the darling of Silicon Valley and the majority of them, right now, are health devices, or have some wellness application. The new consumer electronics tools are allowing people to become their own researchers, trainers and medical advisers by monitoring such things as sleep, activity, heart rate and stress levels.\u003c/p>\n\u003cp>But no one has quite nailed the technology just yet. Amid all the hype, it’s easy to forget that this technology is still in its infancy. For now, most of the devices on the market are glorified pedometers with a high price tag and short battery life.\u003c/p>\n\u003cp>The current slew of wrist bands, like the $99.95 Fitbit Flex or $299 \u003ca href=\"http://www.samsung.com/global/microsite/galaxynote3-gear/\">Samsung Galaxy Gear\u003c/a> smartwatch, are the first generation, with more sophisticated models still under development. Most devices today are adept at collecting data, but they fail to provide consumers with valuable health-related insights.\u003c/p>\n\u003cp>For Imholte, the data piqued his interest — he said it was intriguing to learn that he walked 1,000 steps on Monday — but only temporarily. Ultimately, he was disheartened by the lack of practical advice about how he could improve his health and fitness, without significantly altering his lifestyle.\u003c/p>\n\u003cp>\u003cstrong>Skyrocketing Expectations\u003c/strong>\u003c/p>\n\u003cp>For all their limitations, technology investors have gone gaga for wearable devices. Investors poured $570 million into the space in 2013 alone, according to research firm CB Insights. On Kickstarter, a team asked for $100,000 to build a new smartwatch called \u003ca href=\"https://getpebble.com/\">Pebble\u003c/a>, and were stunned when backers invested over $10.2 million.\u003c/p>\n\u003cp>Wearable devices are nothing new. For years, athletes have used basic activity trackers to help them train for competitions. But, unlike today, those devices did not connect with your smartphone and thousands of health-related apps. The current wearables craze was fueled, in part, by members of the “\u003ca href=\"http://quantifiedself.com/\">Quantified Self\u003c/a>” movement, who strive for self-understanding by collecting data about themselves. In cities across the U.S., some 30,000 quantified selfers regularly meet up to trade tips and tricks about the latest health-tracking tech.\u003c/p>\n\u003cp>But this year, wearables will no longer be the domain of athletes, fitness junkies and early adopters. Market research firm Canalys predicts that in 2014 companies will ship some 17 million wearable bands.\u003c/p>\n\u003cp>“Having a computer on your wrist will become increasingly common,” said Canalys analyst Daniel Matte, in a statement.\u003cbr>\n\u003cstrong>\u003cbr>\nMeet the Woman With 27 Fitness Trackers\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_16557\" class=\"wp-caption alignright\" style=\"max-width: 266px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-16557 \" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/wearablesdevcon-768x1024.jpg\" alt=\"Rachel Kalmar models her activity trackers at the DevCon Wearables Conference. (Credit: DevCon Wearables Conference)\" width=\"266\" height=\"354\">\u003cfigcaption class=\"wp-caption-text\">Rachel Kalmar models her activity trackers at the DevCon Wearables Conference. (Credit: DevCon Wearables Conference)\u003c/figcaption>\u003c/figure>\n\u003cp>To prepare for a stroll in San Francisco, Rachel Kalmar straps over two-dozen gadgets to her wrist and forearms.\u003c/p>\n\u003cp>When I first met Kalmar, she was wearing 22 clip-on activity trackers, including the Pebble, Fitbit Flex, \u003ca href=\"http://www.bodymedia.com/\">Bodymedia\u003c/a> and (my personal favorite) an antique pedometer from 1877. Now she has 27 trackers for both Android and iOS monitoring her every waking move.\u003c/p>\n\u003cp>Kalmar isn’t a member of the cult of the quantified self, obsessed with tracking her bodily metrics. For Kalmar, it’s all in pursuit of research. For her day job, she’s a data scientist at\u003ca href=\"http://www.misfitwearables.com/\"> Misfit Wearable\u003c/a>s, maker of the Shine, futuristic jewelry that is popular with young women. The Shine acts as an activity monitor, sleep tracker and watch all in one. It can be worn as a necklace or on a clasp.\u003c/p>\n\u003cp>Kalmar’s been wearing them every day for months, but she hasn’t derived ample benefit from these trackers — and doesn’t expect that you will either.\u003c/p>\n\u003cp>“I thought it would be a week-long project, but then it started getting more and more complicated,” she said.\u003c/p>\n\u003cp>Like Kalmar, Misfit chief executive Sonny Vu is one of the most vocal critiques of the wearables trend. He frequently speaks at conferences and describes these devices as “not that wearable — yet.”\u003c/p>\n\u003cp>The key challenge Kalmar’s unearthed is that the devices don’t speak to each other. When it comes to the human body, data about your steps, heart rate, sleep cycle and glucose levels don’t mean much in isolation.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘I think of wearables today like the first cell phone cameras, which sucked.’\u003c/aside>\n\u003cp>“What we want is our devices to interact with other devices,” said Kalmer. “Interoperability is key.”\u003c/p>\n\u003cp>But that’s not an easy prospect for the still-nascent wearables trend.\u003c/p>\n\u003cp>“I mean, Christ, we can’t even all agree on how to treat time zones in our data and databases,” Kalmar quipped.\u003c/p>\n\u003cp>\u003cstrong>What’s Next for Wearables?\u003c/strong>\u003c/p>\n\u003cp>Kalmar hasn’t given up on wearables altogether — far from it. For now, she hopes that the Shine and other devices will inspire people to be more active. And she expects that the field will figure out how to make them more useful.\u003c/p>\n\u003cp>“I think of wearables today like the first cell phone cameras, which sucked,” she said.\u003c/p>\n\u003cp>In an interview from Misfit’s Vietnam offices, Kalmar offered several predictions for the future of wearables: The devices will eventually allow us to interact with other objects in our lives. (Imagine turning off your thermostat or unlocking your front door with a few taps of a smart watch.) Wearables will also increasingly be used to monitor patients with chronic health conditions. And they won’t be mostly bands; health-related smart glasses, sports bras and shoes are among the next generation of wearable sensors.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘Mobile technology has seen its day. Wearables might be what’s next.’\u003c/aside>\n\u003cp>Another key to longevity, for wearable computers, will be to keep the attention of Silicon Valley’s technology behemoths.\u003c/p>\n\u003cp>Google has just released its futuristic eyeglasses called “Glass” to the public after a trial with developers, and Apple is rumored to be secretly developing a smartwatch, the “iWatch.”\u003c/p>\n\u003cp>“I’m excited about what Apple is going to do next,” said Tommy Leep, an investor at San Francisco’s Rothenberg Ventures.\u003c/p>\n\u003cp>Unlike many of his counterparts, he has not invested in a wearable. But he is keeping a close eye on the space, as he believes that wearable tech is one of less than a handful of emerging platforms that have the potential to be the next big thing.\u003c/p>\n\u003cp>“Wearables in and of themselves aren’t hugely exciting right now,” he said. Leep said he hasn’t personally seen many gadgets that are a significant step beyond the iPhone, the smart computer already in millions of pockets.\u003c/p>\n\u003cp>“That said, many of us believe that mobile technology has seen its day. Wearables might be what’s next.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Christina Farr is a San Francisco journalist covering health technology. She previously wrote for \u003c/em>Venture Beat, The Bay Citizen\u003cem> and \u003c/em>SFGate\u003cem>. \u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Christina Farr\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_16542\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-16542\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/07_wearing_necklace.jpg\" alt=\"The Shine wearable. (Misfit Wearables)\" width=\"640\" height=\"360\">\u003cfigcaption class=\"wp-caption-text\">The Shine is an activity monitor, sleep tracker and watch. (Misfit Wearables)\u003c/figcaption>\u003c/figure>\n\u003cp>For months, technology entrepreneur Will Imholte was hell-bent on finding the best personal activity tracker.\u003c/p>\n\u003cp>Rather than browsing reviews, he decided to test the \u003ca href=\"https://jawbone.com/up\">Jawbone UP\u003c/a>, \u003ca href=\"http://www.fitbit.com/\">Fitbit Flex\u003c/a>, \u003ca href=\"http://www.nike.com/us/en_us/c/nikeplus-fuelband\">Nike FuelBand SE\u003c/a> and a litany of others to track his calorie count and weight.\u003c/p>\n\u003cp>But all these devices failed to sustain his interest for more than a week. Despite his best efforts, Imholte gave up on the burgeoning wearable trend. He found that a smartphone and a time-keeping Swiss watch were more than sufficient for his purposes.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘Trust me, I wanted to like wearables, but I stopped using them after a few months.’\u003c/aside>\n\u003cp>“I’m a nerd that can’t get enough of the latest gadgets,” said Imholte, the founder of Prime, a startup that helps patients access their personal medical records.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Trust me, I wanted to like wearables, but I stopped using them after a few months,” he said. “I’m not training for a marathon or anything, so I didn’t really see much need for them in my life.”\u003c/p>\n\u003cp>Wearables are currently the darling of Silicon Valley and the majority of them, right now, are health devices, or have some wellness application. The new consumer electronics tools are allowing people to become their own researchers, trainers and medical advisers by monitoring such things as sleep, activity, heart rate and stress levels.\u003c/p>\n\u003cp>But no one has quite nailed the technology just yet. Amid all the hype, it’s easy to forget that this technology is still in its infancy. For now, most of the devices on the market are glorified pedometers with a high price tag and short battery life.\u003c/p>\n\u003cp>The current slew of wrist bands, like the $99.95 Fitbit Flex or $299 \u003ca href=\"http://www.samsung.com/global/microsite/galaxynote3-gear/\">Samsung Galaxy Gear\u003c/a> smartwatch, are the first generation, with more sophisticated models still under development. Most devices today are adept at collecting data, but they fail to provide consumers with valuable health-related insights.\u003c/p>\n\u003cp>For Imholte, the data piqued his interest — he said it was intriguing to learn that he walked 1,000 steps on Monday — but only temporarily. Ultimately, he was disheartened by the lack of practical advice about how he could improve his health and fitness, without significantly altering his lifestyle.\u003c/p>\n\u003cp>\u003cstrong>Skyrocketing Expectations\u003c/strong>\u003c/p>\n\u003cp>For all their limitations, technology investors have gone gaga for wearable devices. Investors poured $570 million into the space in 2013 alone, according to research firm CB Insights. On Kickstarter, a team asked for $100,000 to build a new smartwatch called \u003ca href=\"https://getpebble.com/\">Pebble\u003c/a>, and were stunned when backers invested over $10.2 million.\u003c/p>\n\u003cp>Wearable devices are nothing new. For years, athletes have used basic activity trackers to help them train for competitions. But, unlike today, those devices did not connect with your smartphone and thousands of health-related apps. The current wearables craze was fueled, in part, by members of the “\u003ca href=\"http://quantifiedself.com/\">Quantified Self\u003c/a>” movement, who strive for self-understanding by collecting data about themselves. In cities across the U.S., some 30,000 quantified selfers regularly meet up to trade tips and tricks about the latest health-tracking tech.\u003c/p>\n\u003cp>But this year, wearables will no longer be the domain of athletes, fitness junkies and early adopters. Market research firm Canalys predicts that in 2014 companies will ship some 17 million wearable bands.\u003c/p>\n\u003cp>“Having a computer on your wrist will become increasingly common,” said Canalys analyst Daniel Matte, in a statement.\u003cbr>\n\u003cstrong>\u003cbr>\nMeet the Woman With 27 Fitness Trackers\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_16557\" class=\"wp-caption alignright\" style=\"max-width: 266px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-16557 \" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/wearablesdevcon-768x1024.jpg\" alt=\"Rachel Kalmar models her activity trackers at the DevCon Wearables Conference. (Credit: DevCon Wearables Conference)\" width=\"266\" height=\"354\">\u003cfigcaption class=\"wp-caption-text\">Rachel Kalmar models her activity trackers at the DevCon Wearables Conference. (Credit: DevCon Wearables Conference)\u003c/figcaption>\u003c/figure>\n\u003cp>To prepare for a stroll in San Francisco, Rachel Kalmar straps over two-dozen gadgets to her wrist and forearms.\u003c/p>\n\u003cp>When I first met Kalmar, she was wearing 22 clip-on activity trackers, including the Pebble, Fitbit Flex, \u003ca href=\"http://www.bodymedia.com/\">Bodymedia\u003c/a> and (my personal favorite) an antique pedometer from 1877. Now she has 27 trackers for both Android and iOS monitoring her every waking move.\u003c/p>\n\u003cp>Kalmar isn’t a member of the cult of the quantified self, obsessed with tracking her bodily metrics. For Kalmar, it’s all in pursuit of research. For her day job, she’s a data scientist at\u003ca href=\"http://www.misfitwearables.com/\"> Misfit Wearable\u003c/a>s, maker of the Shine, futuristic jewelry that is popular with young women. The Shine acts as an activity monitor, sleep tracker and watch all in one. It can be worn as a necklace or on a clasp.\u003c/p>\n\u003cp>Kalmar’s been wearing them every day for months, but she hasn’t derived ample benefit from these trackers — and doesn’t expect that you will either.\u003c/p>\n\u003cp>“I thought it would be a week-long project, but then it started getting more and more complicated,” she said.\u003c/p>\n\u003cp>Like Kalmar, Misfit chief executive Sonny Vu is one of the most vocal critiques of the wearables trend. He frequently speaks at conferences and describes these devices as “not that wearable — yet.”\u003c/p>\n\u003cp>The key challenge Kalmar’s unearthed is that the devices don’t speak to each other. When it comes to the human body, data about your steps, heart rate, sleep cycle and glucose levels don’t mean much in isolation.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘I think of wearables today like the first cell phone cameras, which sucked.’\u003c/aside>\n\u003cp>“What we want is our devices to interact with other devices,” said Kalmer. “Interoperability is key.”\u003c/p>\n\u003cp>But that’s not an easy prospect for the still-nascent wearables trend.\u003c/p>\n\u003cp>“I mean, Christ, we can’t even all agree on how to treat time zones in our data and databases,” Kalmar quipped.\u003c/p>\n\u003cp>\u003cstrong>What’s Next for Wearables?\u003c/strong>\u003c/p>\n\u003cp>Kalmar hasn’t given up on wearables altogether — far from it. For now, she hopes that the Shine and other devices will inspire people to be more active. And she expects that the field will figure out how to make them more useful.\u003c/p>\n\u003cp>“I think of wearables today like the first cell phone cameras, which sucked,” she said.\u003c/p>\n\u003cp>In an interview from Misfit’s Vietnam offices, Kalmar offered several predictions for the future of wearables: The devices will eventually allow us to interact with other objects in our lives. (Imagine turning off your thermostat or unlocking your front door with a few taps of a smart watch.) Wearables will also increasingly be used to monitor patients with chronic health conditions. And they won’t be mostly bands; health-related smart glasses, sports bras and shoes are among the next generation of wearable sensors.\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘Mobile technology has seen its day. Wearables might be what’s next.’\u003c/aside>\n\u003cp>Another key to longevity, for wearable computers, will be to keep the attention of Silicon Valley’s technology behemoths.\u003c/p>\n\u003cp>Google has just released its futuristic eyeglasses called “Glass” to the public after a trial with developers, and Apple is rumored to be secretly developing a smartwatch, the “iWatch.”\u003c/p>\n\u003cp>“I’m excited about what Apple is going to do next,” said Tommy Leep, an investor at San Francisco’s Rothenberg Ventures.\u003c/p>\n\u003cp>Unlike many of his counterparts, he has not invested in a wearable. But he is keeping a close eye on the space, as he believes that wearable tech is one of less than a handful of emerging platforms that have the potential to be the next big thing.\u003c/p>\n\u003cp>“Wearables in and of themselves aren’t hugely exciting right now,” he said. Leep said he hasn’t personally seen many gadgets that are a significant step beyond the iPhone, the smart computer already in millions of pockets.\u003c/p>\n\u003cp>“That said, many of us believe that mobile technology has seen its day. Wearables might be what’s next.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Christina Farr is a San Francisco journalist covering health technology. She previously wrote for \u003c/em>Venture Beat, The Bay Citizen\u003cem> and \u003c/em>SFGate\u003cem>. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"title": "Chevron Tries Again With Richmond Refinery Revamp",
"headTitle": "Chevron Tries Again With Richmond Refinery Revamp | KQED",
"content": "\u003cdiv class=\"audio-wrap\">\n\u003ch2>Listen:\u003c/h2>\n\u003cp>http://www.kqed.org/.stream/anon/radio/science/2014/04/20140414science.mp3\u003c/p>\n\u003c/div>\n\u003cp>The rust-red painted tanks of Chevron’s Richmond refinery are a familiar sight for drivers in the East Bay. The facility, sprawling across about four and a half miles at the foot of the Richmond-San Rafael Bridge, is the biggest refinery in Northern California.\u003c/p>\n\u003cp>It was built in 1902. Picture those \u003ca href=\"http://libraryphoto.cr.usgs.gov/cgi-bin/show_picture.cgi?ID=ID.%20Degenkolb,%20H.%2013\">black and white photos\u003c/a> of Victorian ladies after the 1906 earthquake. The refinery was already here, chugging along.\u003c/p>\n\u003cp>“There was pretty much nothing else here. It just looked like an open plain,” said Chevron’s Brian Hubinger.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"http://projects1.kqed.org/imageslider/chevronsliders.html\" frameborder=\"0\" scrolling=\"no\" width=\"640\" height=\"530\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Today, according to the company, one out of every five cars on the road in the Bay Area is driving with gas from here, and two-thirds of the jet fuel used at Bay Area airports starts here.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Now Chevron is looking to launch a \u003ca href=\"http://chevronmodernization.com/\">billion-dollar construction project\u003c/a> at the refinery. It’s a slimmed down version of a project that environmentalists stopped with a lawsuit a few years ago.\u003c/p>\n\u003cp>After that legal battle and a \u003ca href=\"http://ww2.kqed.org/news/2013/04/21/how-the-chevron-richmond-fire-happened-feds-release-blow-by-blow-animation-of-accident/\">fire at the refinery\u003c/a> in 2012, Chevron is trying to win back the community’s trust not only with a new environmental impact report on the project, but also with a \u003ca href=\"http://richmondstandard.com/\">company-published local news website\u003c/a> and billboards celebrating the city of Richmond, and TV ads supporting the proposed project.\u003c/p>\n\u003cfigure id=\"attachment_16467\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-16467\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/chevrontanks.jpg\" alt=\"A view of the Chevron refinery from its wharf, where ships deliver crude oil. (Josh Cassidy/KQED)\" width=\"640\" height=\"360\">\u003cfigcaption class=\"wp-caption-text\">A view of the refinery from its wharf, where ships deliver crude oil. (Josh Cassidy/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Hubinger, the technical advisor for what Chevron’s calling its modernization project took me on a tour of the facility. (Critics of the project are more apt to call it an “expansion.”) We drove to the end of the wharf where tankers full of oil from the Middle East and Alaska unload, and then back into the heart of the refinery, past right-angled tangles of pipeline.\u003c/p>\n\u003cp>We parked near what looked like a brown barn on stilts: Chevron’s half-built hydrogen plant. That’s how much the company was able to construct before a state court judge \u003ca href=\"http://www.mercurynews.com/breaking-news/ci_14963441\">stopped the project\u003c/a> in 2010. This plant would produce more hydrogen, more efficiently, than the existing one does.\u003c/p>\n\u003cp>Chevron wants the upgrade — and other changes it’s proposing — because hydrogen helps clean the sulfur out of crude oil. And the company wants to refine crude that has more sulfur in it.\u003c/p>\n\u003cfigure id=\"attachment_16478\" class=\"wp-caption alignright\" style=\"max-width: 346px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-16478 \" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/RS9520_Chevron032714-JoshC-5195-scr-e1397259831604.jpg\" alt=\"The partially-built hydrogen plant. (Josh Cassidy/KQED)\" width=\"346\" height=\"230\">\u003cfigcaption class=\"wp-caption-text\">The partially-built hydrogen plant, the “barn on stilts.” (Josh Cassidy/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>“It provides flexibility to the refinery to remain competitive in the future,” Hubinger said.\u003c/p>\n\u003cp>Chevron won’t say exactly where that oil would be coming from, but the refinery can only receive crude via ship. So this is not about using trains to bring in oil from \u003ca href=\"http://ww2.kqed.org/science/audio/valero-rail-project-fuels-tar-sands-speculation-in-bay-area/\">Canada’s tar sands\u003c/a> or \u003ca href=\"http://ww2.kqed.org/science/audio/bay-area-residents-resist-crude-by-rail-as-accidents-rise/\">North Dakota’s Bakken formation\u003c/a>, the company says. Instead, the project would allow Chevron to process crude from declining oil fields, which are often higher in sulfur.\u003c/p>\n\u003cp>Here’s another case where, like “modernization” versus “expansion,” the language drives a point of view: Opponents call the crude that’s higher in sulfur “dirty.” In the oil industry, they call it “sour.”\u003c/p>\n\u003cp>There’s no debating, though, that sulfur is an impurity in crude oil, and that processing higher sulfur crude will affect emissions at the refinery.\u003c/p>\n\u003cp>“Whatever Chevron says, we have to look at the truth and not accept their word for it,” said Andrés Soto, an organizer with \u003ca href=\"http://www.cbecal.org/\">Communities for a Better Environment\u003c/a> (CBE).\u003c/p>\n\u003cp>CBE, with other partner organizations, was the group that won the lawsuit to stop the earlier project. CBE argued, and a state judge agreed, that Chevron hadn’t provided enough information about how the project would affect air pollution.\u003c/p>\n\u003cfigure id=\"attachment_16483\" class=\"wp-caption alignright\" style=\"max-width: 342px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-16483 \" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/RS9531_Chevron032714-JoshC-5225-scr-e1397261318631.jpg\" alt=\"Andrés Soto is the Richmond organizer with Communities for a Better Environment. (Josh Cassidy/KQED)\" width=\"342\" height=\"229\">\u003cfigcaption class=\"wp-caption-text\">Andrés Soto in Atchison Village, a neighborhood near Chevron’s Richmond refinery. (Josh Cassidy/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>“Chevron refused to disclose the crude slate quality that they would process as a result of this project,” Soto said. “If they were going to expand their hydrogen production, that was because they were going to be processing dirtier crude.”\u003c/p>\n\u003cp>Unlike Chevron’s last attempt at the project, this time its environmental impact report does provide details on the amount of air pollution that will be created. And it describes how Chevron will try to offset that pollution.\u003c/p>\n\u003cp>“Our commitments for no net increase are: no net increase in criteria air pollutants, no net increase in health risk and no net increase in greenhouse gas,” said Nicole Barber, a spokeswoman for Chevron. (Criteria air pollutants are particulates that the Environmental Protection Agency regulates for human and environmental health, such as lead, carbon monoxide and nitrogen oxides.)\u003c/p>\n\u003cp>Greenhouse gas emissions could go up by 15 percent or more if this project happens, but, Barber said, Chevron would offset that by buying carbon credits, giving money to greenhouse gas reduction programs in Richmond and making changes on-site like using LED lighting and reusing water. That’s on the climate change side.\u003c/p>\n\u003caside class=\"left\">The \u003ca href=\"http://chevronmodernization.com/project-documents/\">draft environmental impact report\u003c/a>, including appendices, is thousands of pages long. If you want to learn more about the emissions from the project, here are some places to start.\n\u003cul>\n\u003cli>\u003ca href=\"http://chevronmodernization.com/wp-content/uploads/2014/03/4.8_Greenhouse-Gases.pdf\">Greenhouse gases\u003c/a>: Page 36 shows a table with baseline emissions and potential changes.\u003c/li>\n\u003cli>\u003ca href=\"http://chevronmodernization.com/wp-content/uploads/2014/03/4.3_Air-Quality.pdf\">Air quality\u003c/a>: Page 85 shows a table listing baseline criteria air pollutant emissions and potential changes. Page 96 shows the same for toxic air contaminants.\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>In terms of emissions that could make people sick — toxic air contaminants and criteria air pollutants – Barber said Chevron will offset those, too. The company’s proposals include installing new burners that lower nitrogen oxide emissions and replacing three tanker ships with newer ships that have more efficient engines.\u003c/p>\n\u003cp>That’s all according to the environmental impact report. The Bay Area Air Quality Management District, which regulates emissions, and CBE have both said they’re still examining the report, and have no comment yet on whether the details Chevron provides are thorough and sufficient.\u003c/p>\n\u003cp>“We know they are claiming there will be no net increase in emissions,” said Soto. “And that sounds great. Except that the current level of emissions are already killing us. We have disproportionately high rates of cancers, asthma, other autoimmune diseases.”\u003c/p>\n\u003cp>Richmond is \u003ca href=\"http://www.environmentalhealthnews.org/ehs/news/2012/pollution-poverty-and-people-of-color-richmond-day-1\">an industrial area\u003c/a>. There are other refineries, shipping, trucking and factories. And year in and year out, Chevron’s refinery is one of the biggest polluters in the Bay Area.\u003c/p>\n\u003cfigure id=\"attachment_16496\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-16496\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/9516scr_be7b8f9f55a4074-e1397264375694.jpg\" alt=\"Pipes inside the refinery. (Josh Cassidy/KQED)\" width=\"640\" height=\"427\">\u003cfigcaption class=\"wp-caption-text\">Pipes inside the refinery. (Josh Cassidy/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Soto said the 2012 fire at the refinery is an extreme example of the health risks a refinery poses. The fire released a dark plume of smoke into the sky and sent more than 10,000 people to the hospital complaining of breathing problems\u003c/p>\n\u003cp>“That was an episodic exposure,” he said. “But then there’s the persistent and prolonged every day exposure that also happens.”\u003c/p>\n\u003cp>Richmond mayor Gayle McLaughlin said she wants the project and the 1,000 construction jobs it’s expected to create, but she also wants to make sure it’s safe. And she sees it as a chance to push Chevron for lower emissions.\u003c/p>\n\u003cp>“How often do we have an opportunity to determine whether or not to permit a $1 billion expansion project from a large refinery?” she said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>The draft environmental impact report is open for public comment until May second. The planning commission could vote on it as soon as this summer. There’s a public hearing on the project this week on \u003ca href=\"http://chevronmodernization.com/meetings/\">Thursday night\u003c/a>.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/div>\n\u003cp>The rust-red painted tanks of Chevron’s Richmond refinery are a familiar sight for drivers in the East Bay. The facility, sprawling across about four and a half miles at the foot of the Richmond-San Rafael Bridge, is the biggest refinery in Northern California.\u003c/p>\n\u003cp>It was built in 1902. Picture those \u003ca href=\"http://libraryphoto.cr.usgs.gov/cgi-bin/show_picture.cgi?ID=ID.%20Degenkolb,%20H.%2013\">black and white photos\u003c/a> of Victorian ladies after the 1906 earthquake. The refinery was already here, chugging along.\u003c/p>\n\u003cp>“There was pretty much nothing else here. It just looked like an open plain,” said Chevron’s Brian Hubinger.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"http://projects1.kqed.org/imageslider/chevronsliders.html\" frameborder=\"0\" scrolling=\"no\" width=\"640\" height=\"530\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Today, according to the company, one out of every five cars on the road in the Bay Area is driving with gas from here, and two-thirds of the jet fuel used at Bay Area airports starts here.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Now Chevron is looking to launch a \u003ca href=\"http://chevronmodernization.com/\">billion-dollar construction project\u003c/a> at the refinery. It’s a slimmed down version of a project that environmentalists stopped with a lawsuit a few years ago.\u003c/p>\n\u003cp>After that legal battle and a \u003ca href=\"http://ww2.kqed.org/news/2013/04/21/how-the-chevron-richmond-fire-happened-feds-release-blow-by-blow-animation-of-accident/\">fire at the refinery\u003c/a> in 2012, Chevron is trying to win back the community’s trust not only with a new environmental impact report on the project, but also with a \u003ca href=\"http://richmondstandard.com/\">company-published local news website\u003c/a> and billboards celebrating the city of Richmond, and TV ads supporting the proposed project.\u003c/p>\n\u003cfigure id=\"attachment_16467\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-16467\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/chevrontanks.jpg\" alt=\"A view of the Chevron refinery from its wharf, where ships deliver crude oil. (Josh Cassidy/KQED)\" width=\"640\" height=\"360\">\u003cfigcaption class=\"wp-caption-text\">A view of the refinery from its wharf, where ships deliver crude oil. (Josh Cassidy/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Hubinger, the technical advisor for what Chevron’s calling its modernization project took me on a tour of the facility. (Critics of the project are more apt to call it an “expansion.”) We drove to the end of the wharf where tankers full of oil from the Middle East and Alaska unload, and then back into the heart of the refinery, past right-angled tangles of pipeline.\u003c/p>\n\u003cp>We parked near what looked like a brown barn on stilts: Chevron’s half-built hydrogen plant. That’s how much the company was able to construct before a state court judge \u003ca href=\"http://www.mercurynews.com/breaking-news/ci_14963441\">stopped the project\u003c/a> in 2010. This plant would produce more hydrogen, more efficiently, than the existing one does.\u003c/p>\n\u003cp>Chevron wants the upgrade — and other changes it’s proposing — because hydrogen helps clean the sulfur out of crude oil. And the company wants to refine crude that has more sulfur in it.\u003c/p>\n\u003cfigure id=\"attachment_16478\" class=\"wp-caption alignright\" style=\"max-width: 346px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-16478 \" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/RS9520_Chevron032714-JoshC-5195-scr-e1397259831604.jpg\" alt=\"The partially-built hydrogen plant. (Josh Cassidy/KQED)\" width=\"346\" height=\"230\">\u003cfigcaption class=\"wp-caption-text\">The partially-built hydrogen plant, the “barn on stilts.” (Josh Cassidy/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>“It provides flexibility to the refinery to remain competitive in the future,” Hubinger said.\u003c/p>\n\u003cp>Chevron won’t say exactly where that oil would be coming from, but the refinery can only receive crude via ship. So this is not about using trains to bring in oil from \u003ca href=\"http://ww2.kqed.org/science/audio/valero-rail-project-fuels-tar-sands-speculation-in-bay-area/\">Canada’s tar sands\u003c/a> or \u003ca href=\"http://ww2.kqed.org/science/audio/bay-area-residents-resist-crude-by-rail-as-accidents-rise/\">North Dakota’s Bakken formation\u003c/a>, the company says. Instead, the project would allow Chevron to process crude from declining oil fields, which are often higher in sulfur.\u003c/p>\n\u003cp>Here’s another case where, like “modernization” versus “expansion,” the language drives a point of view: Opponents call the crude that’s higher in sulfur “dirty.” In the oil industry, they call it “sour.”\u003c/p>\n\u003cp>There’s no debating, though, that sulfur is an impurity in crude oil, and that processing higher sulfur crude will affect emissions at the refinery.\u003c/p>\n\u003cp>“Whatever Chevron says, we have to look at the truth and not accept their word for it,” said Andrés Soto, an organizer with \u003ca href=\"http://www.cbecal.org/\">Communities for a Better Environment\u003c/a> (CBE).\u003c/p>\n\u003cp>CBE, with other partner organizations, was the group that won the lawsuit to stop the earlier project. CBE argued, and a state judge agreed, that Chevron hadn’t provided enough information about how the project would affect air pollution.\u003c/p>\n\u003cfigure id=\"attachment_16483\" class=\"wp-caption alignright\" style=\"max-width: 342px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\" wp-image-16483 \" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/RS9531_Chevron032714-JoshC-5225-scr-e1397261318631.jpg\" alt=\"Andrés Soto is the Richmond organizer with Communities for a Better Environment. (Josh Cassidy/KQED)\" width=\"342\" height=\"229\">\u003cfigcaption class=\"wp-caption-text\">Andrés Soto in Atchison Village, a neighborhood near Chevron’s Richmond refinery. (Josh Cassidy/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>“Chevron refused to disclose the crude slate quality that they would process as a result of this project,” Soto said. “If they were going to expand their hydrogen production, that was because they were going to be processing dirtier crude.”\u003c/p>\n\u003cp>Unlike Chevron’s last attempt at the project, this time its environmental impact report does provide details on the amount of air pollution that will be created. And it describes how Chevron will try to offset that pollution.\u003c/p>\n\u003cp>“Our commitments for no net increase are: no net increase in criteria air pollutants, no net increase in health risk and no net increase in greenhouse gas,” said Nicole Barber, a spokeswoman for Chevron. (Criteria air pollutants are particulates that the Environmental Protection Agency regulates for human and environmental health, such as lead, carbon monoxide and nitrogen oxides.)\u003c/p>\n\u003cp>Greenhouse gas emissions could go up by 15 percent or more if this project happens, but, Barber said, Chevron would offset that by buying carbon credits, giving money to greenhouse gas reduction programs in Richmond and making changes on-site like using LED lighting and reusing water. That’s on the climate change side.\u003c/p>\n\u003caside class=\"left\">The \u003ca href=\"http://chevronmodernization.com/project-documents/\">draft environmental impact report\u003c/a>, including appendices, is thousands of pages long. If you want to learn more about the emissions from the project, here are some places to start.\n\u003cul>\n\u003cli>\u003ca href=\"http://chevronmodernization.com/wp-content/uploads/2014/03/4.8_Greenhouse-Gases.pdf\">Greenhouse gases\u003c/a>: Page 36 shows a table with baseline emissions and potential changes.\u003c/li>\n\u003cli>\u003ca href=\"http://chevronmodernization.com/wp-content/uploads/2014/03/4.3_Air-Quality.pdf\">Air quality\u003c/a>: Page 85 shows a table listing baseline criteria air pollutant emissions and potential changes. Page 96 shows the same for toxic air contaminants.\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>In terms of emissions that could make people sick — toxic air contaminants and criteria air pollutants – Barber said Chevron will offset those, too. The company’s proposals include installing new burners that lower nitrogen oxide emissions and replacing three tanker ships with newer ships that have more efficient engines.\u003c/p>\n\u003cp>That’s all according to the environmental impact report. The Bay Area Air Quality Management District, which regulates emissions, and CBE have both said they’re still examining the report, and have no comment yet on whether the details Chevron provides are thorough and sufficient.\u003c/p>\n\u003cp>“We know they are claiming there will be no net increase in emissions,” said Soto. “And that sounds great. Except that the current level of emissions are already killing us. We have disproportionately high rates of cancers, asthma, other autoimmune diseases.”\u003c/p>\n\u003cp>Richmond is \u003ca href=\"http://www.environmentalhealthnews.org/ehs/news/2012/pollution-poverty-and-people-of-color-richmond-day-1\">an industrial area\u003c/a>. There are other refineries, shipping, trucking and factories. And year in and year out, Chevron’s refinery is one of the biggest polluters in the Bay Area.\u003c/p>\n\u003cfigure id=\"attachment_16496\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-16496\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2014/04/9516scr_be7b8f9f55a4074-e1397264375694.jpg\" alt=\"Pipes inside the refinery. (Josh Cassidy/KQED)\" width=\"640\" height=\"427\">\u003cfigcaption class=\"wp-caption-text\">Pipes inside the refinery. (Josh Cassidy/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Soto said the 2012 fire at the refinery is an extreme example of the health risks a refinery poses. The fire released a dark plume of smoke into the sky and sent more than 10,000 people to the hospital complaining of breathing problems\u003c/p>\n\u003cp>“That was an episodic exposure,” he said. “But then there’s the persistent and prolonged every day exposure that also happens.”\u003c/p>\n\u003cp>Richmond mayor Gayle McLaughlin said she wants the project and the 1,000 construction jobs it’s expected to create, but she also wants to make sure it’s safe. And she sees it as a chance to push Chevron for lower emissions.\u003c/p>\n\u003cp>“How often do we have an opportunity to determine whether or not to permit a $1 billion expansion project from a large refinery?” she said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The draft environmental impact report is open for public comment until May second. The planning commission could vote on it as soon as this summer. There’s a public hearing on the project this week on \u003ca href=\"http://chevronmodernization.com/meetings/\">Thursday night\u003c/a>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"tagline": "Where conversation and cultura meet",
"info": "What kind of no sabo word is Hyphenación? For us, it’s about living within a hyphenation. Like being a third-gen Mexican-American from the Texas border now living that Bay Area Chicano life. Like Xorje! Each week we bring together a couple of hyphenated Latinos to talk all about personal life choices: family, careers, relationships, belonging … everything is on the table. ",
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"info": "The Political Mind of Jerry Brown brings listeners the wisdom of the former Governor, Mayor, and presidential candidate. Scott Shafer interviewed Brown for more than 40 hours, covering the former governor's life and half-century in the political game – and Brown has some lessons he'd like to share. ",
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"marketplace": {
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"info": "Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. Updated Monday through Friday at about 3:30 p.m. PT.",
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"info": "The MindShift podcast explores the innovations in education that are shaping how kids learn. Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>",
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"order": 12
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"info": "For decades, the process for how police police themselves has been inconsistent – if not opaque. In some states, like California, these proceedings were completely hidden. After a new police transparency law unsealed scores of internal affairs files, our reporters set out to examine these cases and the shadow world of police discipline. On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"planet-money": {
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"info": "The economy explained. Imagine you could call up a friend and say, Meet me at the bar and tell me what's going on with the economy. Now imagine that's actually a fun evening.",
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"politicalbreakdown": {
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"title": "Political Breakdown",
"tagline": "Politics from a personal perspective",
"info": "Political Breakdown is a new series that explores the political intersection of California and the nation. Each week hosts Scott Shafer and Marisa Lagos are joined with a new special guest to unpack politics -- with personality — and offer an insider’s glimpse at how politics happens.",
"airtime": "THU 6:30pm-7pm",
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"possible": {
"id": "possible",
"title": "Possible",
"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
"airtime": "SUN 2pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg",
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"pri-the-world": {
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"title": "PRI's The World: Latest Edition",
"info": "Each weekday, host Marco Werman and his team of producers bring you the world's most interesting stories in an hour of radio that reminds us just how small our planet really is.",
"airtime": "MON-FRI 2pm-3pm",
"imageSrc": "https://cdn.kqed.org/wp-content/uploads/2024/04/The-World-Podcast-Tile-360x360-1.jpg",
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},
"radiolab": {
"id": "radiolab",
"title": "Radiolab",
"info": "A two-time Peabody Award-winner, Radiolab is an investigation told through sounds and stories, and centered around one big idea. In the Radiolab world, information sounds like music and science and culture collide. Hosted by Jad Abumrad and Robert Krulwich, the show is designed for listeners who demand skepticism, but appreciate wonder. WNYC Studios is the producer of other leading podcasts including Freakonomics Radio, Death, Sex & Money, On the Media and many more.",
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},
"reveal": {
"id": "reveal",
"title": "Reveal",
"info": "Created by The Center for Investigative Reporting and PRX, Reveal is public radios first one-hour weekly radio show and podcast dedicated to investigative reporting. Credible, fact based and without a partisan agenda, Reveal combines the power and artistry of driveway moment storytelling with data-rich reporting on critically important issues. The result is stories that inform and inspire, arming our listeners with information to right injustices, hold the powerful accountable and improve lives.Reveal is hosted by Al Letson and showcases the award-winning work of CIR and newsrooms large and small across the nation. In a radio and podcast market crowded with choices, Reveal focuses on important and often surprising stories that illuminate the world for our listeners.",
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"officialWebsiteLink": "https://www.revealnews.org/episodes/",
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},
"rightnowish": {
"id": "rightnowish",
"title": "Rightnowish",
"tagline": "Art is where you find it",
"info": "Rightnowish digs into life in the Bay Area right now… ish. Journalist Pendarvis Harshaw takes us to galleries painted on the sides of liquor stores in West Oakland. We'll dance in warehouses in the Bayview, make smoothies with kids in South Berkeley, and listen to classical music in a 1984 Cutlass Supreme in Richmond. Every week, Pen talks to movers and shakers about how the Bay Area shapes what they create, and how they shape the place we call home.",
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"source": "kqed",
"order": 16
},
"link": "/podcasts/rightnowish",
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},
"science-friday": {
"id": "science-friday",
"title": "Science Friday",
"info": "Science Friday is a weekly science talk show, broadcast live over public radio stations nationwide. Each week, the show focuses on science topics that are in the news and tries to bring an educated, balanced discussion to bear on the scientific issues at hand. Panels of expert guests join host Ira Flatow, a veteran science journalist, to discuss science and to take questions from listeners during the call-in portion of the program.",
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},
"snap-judgment": {
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