Massachussetts public health department receives 100000 grant to subsidize cost of tick
May 9 2018A recent report from the Centers for Disease Control and Prevention (CDC) that warns of a recent surge of tick-borne disease incidence in the United States was no surprise to Massachusetts State Public Health Veterinarian Dr. Catherine Brown and microbiology professor Stephen Rich, director of the Laboratory of Medical Zoology (LMZ) at the University of Massachusetts Amherst.For years, they have used data from the LMZ’s tick-testing service, TickReport, to track the incidence and spread of Lyme disease and the introduction of new bacterial and viral tick-borne illnesses such as the Borrelia miyamotoi and Powassan virus in the state. What did come as a pleasant surprise this month, however, is a new $100,000 grant from the state’s public health department, using CDC funding, to subsidize the cost of tick testing for Massachusetts residents through a contract with the LMZ.As Rich explains, the $100,000 subsidy will allow the LMZ to provide tick testing for just $15 for Massachusetts residents for a limited time, and a limited portion of that funding will be devoted to testing for Powassan virus. The funds will be used up quickly, he predicts. “We anticipate that this program will be over by early to mid-July, the subsidy is really going to go fast.”Brown says of the new grant and statewide project, “Public health benefits from the data obtained from tick testing and from the educational outreach associated with using the TickReport service. We rely on this tick testing to identify any new tick-borne illnesses and to understand the prevalence of the current tick-borne diseases. We are pleased that this funding will be used to support the LMZ’s activities.”Rich says, “It is extremely welcome to see that tick-borne illness has definitely moved up the CDC’s list of priorities. It’s also great that state and federal agencies are recognizing the relevance of our crowd-sourced passive surveillance. Not only will this make TickReport more accessible and affordable, it is also a recognition by the CDC of the value of tick testing as part of a comprehensive approach to tick-borne disease threats.”A major goal is to encourage more TickReport participation from residents in under-represented places in Massachusetts, he adds. “So we’re hoping to get word out to western Massachusetts towns in particular about this limited-time offer. The funds will be used to reduce the cost to residents, but once the money is expended, normal prices will apply.”Specifically, $50,000 of the grant funds will be used to cover the full cost of Powassan virus testing for all Massachusetts residents on the first 1,000 TickReport orders submitted, while the other $50,000 will be used to offset the cost of TickReport standard DNA testing for residents in towns that do not currently have a partnership arrangement with the LMZ or public health department, Rich adds. The aim is to enhance the coverage of surveillance that TickReport offers.Related StoriesPlant foods may transmit antibiotic-resistant superbugs to humansLong-acting contraceptives do not increase risk of HIV, concludes new studyMosquito surveillance in Madagascar reveals new insight into malaria transmissionAs a result of years of statewide surveillance through LMZ tick testing, the microbiologist points out, public health officials have a much better picture of the tick-borne disease situation in Massachusetts. For example, data from Cape Cod show a high tick bite incidence over many months in Barnstable County. Also, the pathogen Anaplasma is not seen much in Franklin County in the western part of the state, but is often observed in Barnstable. Across the state, mid-November is one a the peak periods for ticks submitted, much later than many people expect.TickReport, which has tested ticks from all 50 states, confirms receipt of ticks by email and guarantees confidential test results within three business days. Test results used for passive surveillance of disease-causing microbes by town or across the state, for example, is kept strictly anonymous.Rich says the volume of ticks tested has risen steadily since LMZ began testing in 2006 to about 14,000 in 2017, and with the new federal/state subsidy he anticipates that number to reach 18,000 to 20,000 this year.”But it may shoot up much higher,” he adds. “In 2014 when we had the last big state subsidy, the volume of tick tests shot up by three or four fold in participating towns. The good news is that increased volume will help us to reduce our fees in the same way as the 2014 increase did. In 2014 the cost of the basic first tier test was $140, and because of the volume savings, that is now $50.”The LMZ is entirely non-profit, the director point out, and any surplus funds are turned into support for educational materials, a tick hotline, research on ticks and tick-borne disease, and a soon-to-be-released mobile app. The mobile app will allow people from anywhere in the United States to send a good-quality photo to the lab for identification at no charge. “This is to help people who can’t afford a test,” Rich says. “They can at least get accurate information on the species.” The app is called “TickReport” and will be freely available wherever phone apps are sold.At present, the LMZ offers 23 different tick tests in three tiers: a standard $50 DNA package which tests the most common bacterial and protozoan pathogens, a $100 DNA+RNA package which adds viruses, and a $200 comprehensive package that extends testing to very rare pathogens like Bartonella.Source: http://www.umass.edu/newsoffice/article/state-public-health-department-umass
Source:https://www.qmul.ac.uk/media/news/2018/se/scientists-develop-material-that-could-regenerate-dental-enamel-.html Jun 1 2018Researchers at Queen Mary University of London have developed a new way to grow mineralized materials which could regenerate hard tissues such as dental enamel and bone.Enamel, located on the outer part of our teeth, is the hardest tissue in the body and enables our teeth to function for a large part of our lifetime despite biting forces, exposure to acidic foods and drinks and extreme temperatures. This remarkable performance results from its highly organized structure.However, unlike other tissues of the body, enamel cannot regenerate once it is lost, which can lead to pain and tooth loss. These problems affect more than 50 per cent of the world’s population and so finding ways to recreate enamel has long been a major need in dentistry.Related StoriesScientists discover hundreds of protein-pairs through coevolution studyStudy: Megakaryocytes play an important role in cell migrationAMSBIO offers new, best-in-class CAR-T cell range for research and immunotherapyThe study, published in Nature Communications, shows that this new approach can create materials with remarkable precision and order that look and behave like dental enamel.The materials could be used for a wide variety of dental complications such as the prevention and treatment of tooth decay or tooth sensitivity – also known as dentin hypersensitivity.Dr Sherif Elsharkawy, a dentist and first author of the study from Queen Mary’s School of Engineering and Materials Science, said: “This is exciting because the simplicity and versatility of the mineralization platform opens up opportunities to treat and regenerate dental tissues. For example, we could develop acid resistant bandages that can infiltrate, mineralize, and shield exposed dentinal tubules of human teeth for the treatment of dentin hypersensitivity.”The mechanism that has been developed is based on a specific protein material that is able to trigger and guide the growth of apatite nanocrystals at multiple scales – similarly to how these crystals grow when dental enamel develops in our body. This structural organization is critical for the outstanding physical properties exhibited by natural dental enamel.Lead author Professor Alvaro Mata, from Queen Mary’s School of Engineering and Materials Science, said: “A major goal in materials science is to learn from nature to develop useful materials based on the precise control of molecular building-blocks. The key discovery has been the possibility to exploit disordered proteins to control and guide the process of mineralization at multiple scales. Through this, we have developed a technique to easily grow synthetic materials that emulate such hierarchically organized architecture over large areas and with the capacity to tune their properties.”Enabling control of the mineralization process opens the possibility to create materials with properties that mimic different hard tissues beyond enamel such as bone and dentin. As such, the work has the potential to be used in a variety of applications in regenerative medicine. In addition, the study also provides insights into the role of protein disorder in human physiology and pathology.
Jul 13 2018BIDMC Research Briefs showcase groundbreaking scientific advances that are transforming medical care.A major goal of hospitals is to prevent unplanned readmissions of patients after they are discharged. A new study reveals that the preventability of readmissions changes over time: readmissions within the first week after discharge are often preventable by the hospital, whereas readmissions later are often related to patients’ difficultly accessing outpatient clinics.”Patients discharged from a hospital are usually recovering from a serious medical condition as well as managing other chronic medical conditions, and they often encounter new logistical challenges adapting to this recovery period,” said Kelly Graham, MD, MPH, Director of Ambulatory Residency Training at BIDMC and an Instructor in Medicine at Harvard Medical School. “Hospitals and outpatient clinics must work together more seamlessly to ensure that patients are equipped to manage these challenges at home.”For their study, published in the Annals of Internal Medicine, Graham and her colleagues examined information on 822 general medicine patients readmitted to 10 academic medical centers in the United States. Overall, 36.2% of early readmissions versus 23.0% of late readmissions were deemed preventable. Hospitals were identified as better locations for preventing early readmissions, whereas outpatient clinics and home were better for preventing late readmissions.Premature discharge and problems with physician decision-making related to diagnosis and management during the initial hospitalization were likely causes of readmissions in the early period. More likely to be amenable to interventions outside the hospital, later readmissions were most often caused by factors over which the hospital has less direct control, such as monitoring and managing of symptoms after discharge by primary care clinicians, as well as end-of-life issues.Related StoriesBordeaux University Hospital uses 3D printing to improve kidney tumor removal surgeryDanbury Hospital launches ‘Healing Hugs’ for its most vulnerable patientsAn active brain and body associated with reduced risk of dementiaTaken together, the findings suggest that readmissions in the week after discharge are more preventable and more likely to be caused by factors over which the hospital has direct control than those later in the 30-day window. In the current US system, however, unplanned readmissions within the 30 days after hospital discharge are considered uniformly preventable by hospitals, and thus hospitals are punished with financial penalties for these events.”Our findings suggest that the 30 days following hospital discharge are not the same with regard to what influences outcomes for sick patients, and that the current model over-simplifies this high-risk time,” said Graham. “One potential unintended consequence of this is that outpatient environments have not been involved in efforts to manage this high-risk timeframe, which results in poorly coordinated care and worse outcomes for our patients.”Graham noted that interventions to improve outcomes after hospital discharge should engage the ambulatory care system, with attention to improving access to primary care. “We should also be careful not to put too much focus on reducing length of stay in the hospital, which may be a driver of premature discharge and early readmissions,” she said. Source:https://www.bidmc.org/about-bidmc/news/2018/06/hospitals-may-take-too-much-of-the-blame-for-unplanned-readmissions
Source:https://www.ehu.eus/en/-/medicion-de-la-exposicion-a-radiofrecuencias Aug 23 2018According to a study by the UPV/EHU-University of the Basque Country, personal exposure can be assessed through spot measurementsA study has quantified emissions coming from radio frequency sources, and by means of personal and spot measurements has analyzed which levels of exposure children find themselves in. The international journal Environment International has just published the results of this work conducted by a research group at the UPV/EHU-University of the Basque Country and the Biodonostia Institute, in collaboration with international organizations.The use of radio frequency sources is very widespread, whether it is in mobile phones, Wi-Fi, Bluetooth, phone antennas, radio and TV, etc., and there is a huge amount of information to find out whether these emissions fall or do not fall within the recommended levels. However, information about the exposure to which individuals, and children, in particular, are subject remains scant, and among experts on the subject there are opposing views about the effect these sources could have on children. In any case, “the levels to which children are exposed need to be properly analyzed to be able to conduct epidemiological studies, and for this it is essential to optimize the methodology”, pointed out Mara Gallastegi-Bilbao. She is the author of the work, she wrote up her PhD thesis at the UPV/EHU and is currently working at the Biodonostia Institute.That is why this work had a triple aim: firstly, by means of spot and personal measurements, to study exposure of 8-year-old children to radio frequencies; secondly, to identify the locations and sources that have the greatest repercussions on the overall calculation of exposure; and finally, to examine whether the assessments obtained through spot measurements could replace personal measurements.To be able to compare the two methodologies, personal and spot measurements were made during the course of the work. “In recent years, personal measurements have been on the increase. Measurements of this type offer personal information, since the people participating carry an exposure measuring device around with them. Such measurements constitute a major effort in terms of money and time,” said Gallastegi. The researcher went on to add that “there are certain disadvantages, because the fact of carrying the device around does not allow the measurements to be made properly. Exposure is reduced because of the shielding effect of the body itself, so the values obtained are not totally reliable”. Apart from that, “the behavior of the participants varies because they are somehow aware that they are being analyzed,” said the researcher. In any case, “we conducted personal measurements among a small sample of 50 children over a three-day period”, she added.Related StoriesDaily intake for phosphates in infants, children can exceed health guidance valuesPositive family relationships can buffer children from poor asthma outcomesNew therapeutic food boosts key growth-promoting gut microbes in malnourished children”The spot measurements, by contrast, were conducted in environments in which children spend much of their daily lives, in other words, at home, in schools and parks. Bearing in mind the level of exposure in these locations and the time spent in them, the TWA (time-weighted average) values were calculated,” said the author of the work. Weighted averages are ones that apply a different weight to the values. “A study was made of 104 children through a measuring device that provides an analysis of each source separately. Measurements of this type do not call for so much effort in terms of time and are not affected by the shielding effect,” she added.According to Gallastegi, “it is the first time that the two methodologies have been compared, in other words, besides carrying out spot measurements in the locations where children spend most of their time, a set of personal measurements was also made on a smaller sample”.”Despite the fact that the absolute values obtained by one methodology and the other do not coincide, no differences were observed when it comes to classifying the child population into one level or another in terms of exposure to sources of radio frequency,” said Gallastegi. “For the epidemiological studies we were not that interested in knowing the exact value of the exposure, but in knowing whether children are exposed to low, moderate or high levels of exposure, since inadequate classifications could lead to incorrect interpretations,” added the researcher. Therefore, “the measurements of the exposure based on spot measurements could be useful and appropriate for classifying children into low, moderate or high levels of exposure, as long as they are studied in environments in which they spend most of their daily lives, and bearing in mind that the child population studied do not yet use mobile phones on a regular basis,” concluded Mara Gallastegi-Bilbao.
Source:https://www.escardio.org/ Reviewed by Alina Shrourou, B.Sc. (Editor)Aug 28 2018An Irish survey of 200 men and women examines awareness, understanding, and use of food labels in preventing lifestyle-related disease in a primary care setting. Participants responded to a questionnaire devised by the lead author. The study identifies gaps in consumers’ use and interpretation of food labels, especially among men and people at risk of cardiovascular disease. The authors conclude that greater awareness of food labels and label improvements are needed.Many consumers have difficulty using and understanding food labels, especially men and people at risk for heart disease, according to research presented at ESC Congress 2018 today.Diet is considered a modifiable risk factor for heart disease prevention. 2 In Ireland, as in many other nations, food labels provide nutritional information to help consumers make informed food choices. But this observational study identifies gaps in adults’ use of food labels.”People find food labels confusing and don’t know what to look for,” said Ms Claire Duffy, a clinical nurse specialist in general practice, MSc preventive cardiology, in Ballina, Ireland, and the study’s lead author. “They still have difficulty understanding and interpreting food labels.”The study involved 200 men and women, ages 18 to 85, attending a primary care practice. Ms Duffy devised a brief questionnaire administered during a one-month period in 2017. Participants supplied demographic data and answered questions about risk factors for cardiovascular disease as well as use and understanding of food labels.Seventy-five percent were female; 40% self-reported being overweight or obese.Significantly more women than men (65% versus 37%) always or often read food labels, the study found. Just 5% of females said they never look at food labels, compared with more than a third (35%) of males.Having a risk factor for cardiovascular disease (CVD) did not necessarily translate into greater use of food labels. Notably, 40% of participants with CVD said they do not read food labels. Among CVD patients that do read labels, two-thirds (67%) read about fats, but only a third (33%) read about saturated fats, fiber, and salt.Related StoriesNew research links “broken heart syndrome” to cancerRepurposing a heart drug could increase survival rate of children with ependymomaImplanted device uses microcurrent to exercise heart muscle in cardiomyopathy patientsAmong participants who had a family member with diabetes, 56% read the sugar and 60% read the salt content of foods.The study also reveals an important gap in label usage among people with elevated blood cholesterol.”You would think people with high cholesterol would check the saturated fat content on food labels, but that did not always happen,” Ms Duffy said.When asked to gauge whether a sample food product had low, medium, or high levels of fat, sugar, fibre, and sodium based on its nutrition label, participants had difficulty making sense of the information. Only 20% knew the product had a medium level of fat, and just 14% correctly identified its low-sugar content.By contrast, most participants successfully deciphered a “traffic light” food label, where green, amber, and red colors are used to signify levels of fat, saturated fat, sugar, and salt.One survey participant remarked that she knew more about the contents of her facial cream than the nutritional elements of the foods she purchases.Said Ms Duffy: “Food labels need to be improved, especially for illiterate groups and those with color and vision deficiency.”She added that the study findings highlight the need for enhanced public education. This ought to begin with efforts across all educational settings to teach children and their parents about food labels, healthy eating, and nutrition. This should continue in adulthood with education provided through primary care, community settings, and media outlets. Perhaps supermarkets and Internet sites could establish dedicated “healthy food” sections with foods where people could easily find items low in sugar, salt, and fat, and high in fiber, Ms Duffy suggested.
“Having a way of remotely measuring the electric fields on the ground … would be very useful,” says lightning physicist Joseph Dwyer of the University of New Hampshire in Durham, who was not involved with the research. To improve our predictions of where lightning will strike, Dwyer says, scientists first need to understand the basics of how it happens. With this method, he says, “eventually we may be able to … catch lightning initiation in action,” which could help unravel the mystery behind its formation.Scientists have come up with a few possible explanations for how lightning gets going, and the new technique could eventually discern between the options. One is that chunks of ice and water in a storm concentrate the fields, creating small regions that are strong enough to spark. Another controversial idea is that cosmic rays themselves might initiate lightning, thanks to the charged particles they leave in their wake. But there’s no convincing evidence for either option. The new method could finally settle the question, Schellart says.The technique is still in its early stages, with just a handful of showers characterized so far, so the results aren’t reshaping scientists’ ideas about thunderstorms yet. But with more data and an improved analysis, it could be a powerful tool. Still, Dwyer says, this is the first time the technique has been demonstrated, “so they certainly deserve a boatload of credit for this.” Email Despite Benjamin Franklin’s best efforts with a kite and a key, the phenomenon of lightning remains a scientific enigma. Now, researchers have developed a new tool that could help them solve some of lightning’s mysteries. By using cosmic rays, space-traveling particles that constantly rain down on our atmosphere, scientists report they can peek inside thunderstorms and measure their electric fields, helping them pinpoint the conditions that cause storms’ electrical outbursts. The advance could help researchers predict more precisely when and where lightning is most likely to strike and get people out of harm’s way in time.Lightning is so poorly understood in part because measuring electric fields inside thunderstorms is challenging. Scientists have made measurements by sending balloons or small rockets into the clouds, but such probes can alter the electrical environment, potentially obscuring the natural activity they’re trying to measure. But such measurements fail to explain lightning’s origin, as they have yet to find fields strong enough to initiate lightning. It could be that the high field regions are very localized, or it could mean another factor is necessary to set off the light show.Cosmic rays could help researchers solve that puzzle. When cosmic rays smash into molecules in our atmosphere, the collisions create showers of subatomic particles, including electrons, positrons, and other electrically charged particles. As these particles travel toward the ground, their trajectories are bent by Earth’s magnetic field, causing them to emit radio waves. Scientists watched those patterns of radio waves with the LOFAR radio telescope in the Netherlands and compared their observations to a computer model simulating the radio wave patterns produced by cosmic ray showers. The model was able to reproduce most of the showers the researchers recorded, but things got wonky when the weather took a turn for the worse. 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Researchers have used cosmic rays to calculate the electric fields inside of thunderstorms. Sign up for our daily newsletter Get more great content like this delivered right to you! Country Click to view the privacy policy. Required fields are indicated by an asterisk (*) “Sometimes [the shower] looks strange, and the times when it looked strange coincide with times when there are thunderstorms present,” says Pim Schellart, an astronomer at Radboud University in Nijmegen, the Netherlands, and the first author of the new study. When a shower passed through a thunderstorm, Schellart and his colleagues found an atypical pattern of radio waves, due to strong electric fields in the storm that wrench charged particles around and change the radio waves’ polarization, or the orientation of their electromagnetic wiggles.By adding electric fields to their model, the scientists were able to calculate what kinds of fields had to be present in the skies above to reproduce the patterns they saw on the ground. For a shower that the scientists studied in detail, they found that the storm was composed of two layers: one between 3 and 8 kilometers above the ground, with an electric field of 50,000 volts per meter, and another, weaker field below that, which pushed particles in the opposite direction of the upper field. Although these results can’t yet explain how lightning sparks, the measurement marks the first time a storm has been probed with cosmic rays—the first step in refining a technique that could improve scientists’ understanding of storms, the team will report in an upcoming paper in Physical Review Letters.
iStock.com/florin1961 Email Sign up for our daily newsletter Get more great content like this delivered right to you! Country The new guidance should quell fears about Plan S’s restrictiveness, he said. Earlier this month, an open letter, now signed by about 1400 researchers, slammed Plan S’s crackdown on “high quality” hybrid journals published by scientific societies, such as the American Chemical Society, saying it would block access to their “valuable and rigorous peer-review system.” The guidance now leaves room for hybrid journals, as long as they sign “transformative agreements” by the end of 2021, pledging to shift to full OA within 3 years.The architects also addressed the plan’s commitment that funders would pick up the bill for reasonable article-processing charges (APCs), the fees that some journals charge authors to have their papers published OA. The letter’s authors saw it as undue focus on, and a financial gift to, for-profit OA publications. But John-Arne Røttingen, chief executive of The Research Council of Norway in Oslo, who co-led the task force that developed the implementation guidance, denies this: “Plan S is not about one particular business model,” he said. “We are neutral and want a plurality of actors,” including fee-free OA journals.Linguist Gareth O’Neill, president of the Brussels-based European Council of Doctoral Candidates and Junior Researchers, sees the implementation guidance as a positive step: “They have listened to the research community and taken concerns on board. What you see now is moving towards a compromise.”But structural biologist Lynn Kamerlin, who wrote the open letter, says the guidance still limits researchers’ freedom to publish their work. “It’s a step in right direction,” she says, but “I’m afraid [it gives researchers] a false illusion of choice. … This is something that funders and publishers should negotiate rather than putting researchers in the crosshairs,” adds Kamerlin, who works at Uppsala University in Sweden.Røttingen said the funders will commission an analysis to find out which disciplines need more OA outlets, and then offer financial incentives to create new journals or flip existing ones to OA. Another study will focus on APCs, which Plan S pledges to standardize and cap.The guidance document, approved unanimously last week by the 16 funding bodies that have signed on to Plan S, does not say exactly how compliance will be monitored. Røttingen said sanctions will likely mean funding agencies don’t complete payment of research grants for scientists who don’t comply.The note gives funders some leeway with the implementation timeline. Starting 1 January 2020, the rules could apply to existing grants, to newly awarded grants, or “at the very least,” to new calls for research proposals.Anyone who wants to provide feedback on the implementation guidelines can do so online until 1 February 2019. Click to view the privacy policy. 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By Tania RabesandratanaNov. 26, 2018 , 7:01 PM Plan S, the contentious plan that a group of European science funders hopes will end scholarly journals’ paywalls, has fleshed out its rules—and softened its tone a bit. In seven pages of implementation guidance released today, the funders explain how their grantees can abide by Plan S rules come 2020, when it goes into effect. But some critics say the document—which is up for public discussion for the next 2 months—remains too restrictive.The guidance outlines three ways researchers can comply with Plan S, which is backed by national funding agencies of countries including the United Kingdom, France, and Austria, as well as private funders including the Bill & Melinda Gates Foundation. They can publish in an open-access (OA) journal or platform. They can also publish in a subscription journal provided they also make a final, peer-reviewed version or accepted manuscript immediately available in an OA repository. Finally, contrary to earlier indications, grantees will be permitted to publish in hybrid journals, which charge subscriptions but also offer an OA option, but only if the journal has committed to flip to a fully OA model.The guidance aims to explain practicalities and “sets things straight,” said Robert-Jan Smits, the European Commission’s OA envoy and one of the creators of Plan S, at a news briefing in London today. Referring to the often-acrimonious debate that has emerged since Plan S was released on 4 September, he admitted to a “lack of clear communication” from his side. Libraries often pay the article-processing charges of some open-access journals. European funders detail their open-access plan
Read more… It’s highly unusual to give an industry group, or anyone who funds scientific work, a chance to influence the outcome of research, according to scientists.”Certainly his ties to industry and comfort with allowing them to influence the science is concerning given he is heading a process where we know there will be heavy industry pressure to influence it,” said Gretchen Goldman, research director for the Center for Science and Democracy at the Union of Concerned Scientists, which is headquartered in Cambridge, Massachusetts.The arrangement is unusual in the scientific community because it stands to discredit a researcher’s work, even if the group that provided funding makes innocuous changes, other researchers said. In this case, the access that Cox gave to API doesn’t seem to have dramatically altered the conclusions of his study. Instead, a small change here and there could have made it a friendlier vehicle for the industry’s message, Goldman said.It “implies that the messaging matters,” she said. EPA science adviser allowed industry group to edit journal article Sign up for our daily newsletter Get more great content like this delivered right to you! Country Smog envelops Salt Lake City. Neither in effect nor in actual fact did they interfere with, shape, or direct my findings or the conduct of my research in any way. Originally published by E&E News When the U.S.Environmental Protection Agency (EPA) begins a major review of air pollution standards this week, a researcher who has received funding from an industry group opposed to the rules will be leading the agency’s panel.Tony Cox, who was named chairman of the Clean Air Scientific Advisory Committee by former EPA Administrator Scott Pruitt, accepted funding from the American Petroleum Institute (API) to help finance his research into particulate matter pollution. He also allowed the Washington, D.C.-based lobbying group to proofread and copy edit his findings before they were published, according to his own acknowledgements. By Scott Waldman, E&E NewsDec. 10, 2018 , 9:55 AM Click to view the privacy policy. Required fields are indicated by an asterisk (*) Cox, who was nominated for his position by the U.S. Chamber of Commerce, has been critical of EPA air pollution regulations and has said that research showing the connection between air pollution and serious human health consequences is overblown. He sent E&E News a study that happened to contain copy edits, which he said were made by reviewers. It’s unclear which changes were made by API, and Cox denies that the fossil fuel lobbying group offered meaningful edits.Cox is a statistician who is now tasked with overseeing the advisory committee’s review of particulate matter pollution standards. It’s supposed to make a key health determination that could affect millions of Americans: chiefly whether the level of air pollution they are breathing is hurting them.The Clean Air Scientific Advisory Committee is meeting Wednesday and Thursday to review EPA’s science assessment for particulate matter. It’s part of the legal requirement under the Clean Air Act that EPA review scientific information related to the national ambient air quality standards for six pollutants. They are: particulate matter, ground-level ozone, carbon monoxide, nitrogen dioxide, lead and sulfur dioxide.Cox states in his study that API provided input before it was published last year.”This paper benefited from close proof-reading and copy-editing suggestions from API, but these reviews and suggestions were provided for the author’s consideration without constraints that any of them be incorporated,” he wrote in the study, which was published in the journal Critical Reviews in Toxicology.API, which lobbies the government on behalf of fossil fuel companies, has a history of fighting regulations on air pollution, sometimes by pointing to the scientific conclusions of studies that it funded.Before Pruitt resigned amid a flurry of ethics investigations earlier this year, EPA replaced academic researchers on its science advisory boards with researchers supported by industry groups. Pruitt declared that scientists who received EPA grants had conflicts of interest, while those who are paid by polluting industries deserved a louder voice. That’s when he named Cox to lead the Clean Air Scientific Advisory Committee.Under acting Administrator Andrew Wheeler, EPA has gone even further to sideline scientists, particularly around air pollution. It recently disbanded a separate panel of scientists, who are supposed to review particulate matter pollution, and canceled plans for another panel that was to review ozone.Meanwhile, the Trump administration has remade the panel led by Cox. It now includes an academic and several state regulators who have downplayed the effects of air pollution.Cox’s 2017 study, which examines the causal relationship between air pollution and human health, was published in Critical Reviews in Toxicology. The journal has a reputation for publishing industry-funded work that’s sometimes used to argue against government regulations.Cox’s research questions previous studies that have connected serious human health problems to air pollution. It fits with the approach that Cox has taken when testifying to Congress: He emphasizes uncertainties, including in 2015, when he told lawmakers that health benefits of reducing ozone exposure were “unwarranted and exaggerated.” Ravell Call/The Deseret News/AP Country * Afghanistan Aland Islands Albania Algeria Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia, Plurinational State of Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, the Democratic Republic of the Cook Islands Costa Rica Cote d’Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People’s Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People’s Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, the former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Martinique Mauritania Mauritius Mayotte Mexico Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Norway Oman Pakistan Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Qatar Reunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela, Bolivarian Republic of Vietnam Virgin Islands, British Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Tony Cox, Clean Air Scientific Advisory Committee Chris Frey, North Carolina State University It’s a perfect storm. So many things have been changed all at once, and every one of them weakens the process, and collectively it just creates a tremendously weak process that borders on being a total sham. Cox denied that API influenced his work and said the organization did not suggest any substantive changes. The fossil fuel group offered “some minor copy editing suggestions on punctuation and my use of ‘relation’ vs. ‘relationship,'” Cox said.”Neither in effect nor in actual fact did they interfere with, shape, or direct my findings or the conduct of my research in any way,” Cox said in an email to E&E News. “My research was complete before I drafted the paper, and nothing of substance changed thereafter except in response to journal reviewer comments and my own re-reading for clarity. My research is and always have been my own, and I do not accept outside interference.”Cox has a history of attacking established research on the health risks of air pollution, using his own statistical model to crunch data associated with particulate matter, or PM2.5.In one study, he said there was “no evidence that reductions in PM2.5 concentrations cause reductions in mortality rates.” In addition to API, he has received funding from the American Chemistry Council and Philip Morris International Inc., the tobacco company.There’s a large body of science that connects serious health ailments to air pollution. Ozone and fine particle air pollution are particularly dangerous to vulnerable groups of people, including children, the elderly, people with asthma and outdoor workers.The World Health Organization published research earlier this year that found nine out of 10 people globally breathe polluted air and that air pollution kills 7 million people annually. It’s one of the leading causes of death. Vehicle emissions are a leading cause of air pollution worldwide.John Bachmann, EPA’s director for science policy on air quality during President George W. Bush’s administration, said it’s “crazy” that EPA is barring researchers who received agency grants from sitting on advisory panels. They are often some of the best researchers, he said.That change means the panel overseen by Cox is reviewing air pollution standards without the help of a single epidemiologist. Altogether, the altered panels once included at least seven epidemiologists; they’re all gone, Bachmann said.He added that current members of the Clean Air Scientific Advisory Committee are qualified, but their capabilities, expertise and perspectives are greatly limited compared with those who once served on a specialized panel to review particulate matter. Pruitt disbanded it.”It’s a huge loss to claim you can review a document that has hundreds and hundreds of pages on epidemiology by people who don’t do it, don’t do the research in it and the one guy who has done some of it has a point of view that is not mainstream,” Bachmann said, referring to Cox.Cox’s 2017 study is a “review paper that focuses on epidemiological literature and application of epidemiological methods to case studies by someone who is not an epidemiologist,” said Christopher Frey, a former chairman of the Clean Air Scientific Advisory Committee and a professor of environmental engineering at North Carolina State University in Raleigh.In the past, it was rare to appoint a chair who had not previously served on the panel, Frey said. The Clean Air Act requires reviews by the advisory panel to be thorough and to rely on the latest science. He said industry researchers, going back to tobacco industry efforts to discredit the health effects of smoking, are largely focused on uncertainty rather than the risks. Frey said EPA, when it funded some of his research, did not seek to edit his work beforehand.”In a regulatory purpose, you really want all the members of the committee to be perceived as impartial and free of conflict of interest, and I don’t think as a group this committee earns that perception.”Frey, who served as chairman of the committee from 2012 to 2015 and was first appointed in 2008 under Bush, said the current board is derived of stakeholders with a vested interest.The panel lost prominence in other ways too. In the past, there were dozens of people reviewing air pollution research for three years. Now, it’s seven people doing the review in one year.”It’s a perfect storm,” Frey said. “So many things have been changed all at once, and every one of them weakens the process, and collectively it just creates a tremendously weak process that borders on being a total sham.”Reprinted from Climatewire with permission from E&E News. Copyright 2018. E&E provides essential news for energy and environment professionals at www.eenews.net. Email
ShareTweetSharePinSaint Lucia jazz guitarist Ronald ‘Boo’ Hinkson performing at the 2019 Jazz ‘n Creole FestivalOrganizers of Jazz ‘n Creole 2019 are rating the event a success.Senior Cultural Officer and Coordinator of the event, Earlson Matthew told in an interview that the fringe and main events were well received.“Jazz ‘n 2019 was a success on many fronts. The fringe events leading up to the main show set the tone. There was also a sharp increase in economic activity in the Portsmouth area with many hotels and apartments being booked for the weekend and many other businesses benefiting from the influx of people,” Matthew said. “Upon further analysis of statistics, we will have a clearer picture as to visitor arrivals to Dominica.”He continued, “The main event was well received, with the audience calling for encores from many of the primary acts. The supporting acts were also very impressive, with Convent High School (CHS) UMOJA stealing the show. We would like to thank the general public for their unwavering support.”Matthew recognized, however, that there are some aspects of the event that can be improved. “With any event, even those being staged annually for decades, there are things that can be improved upon. Jazz ‘n Creole is no exception. The approach was to improve on things that were seen as issues in previous years, for example the number of food vendors, lighting of the venue, signage, shuttles, among others,” he pointed out.Matthew added, “The actual name of the event steers the artist selection process so it’s easy to understand how this year’s artists fit into the event. The goal is not to replicate the WCMF brand at a different venue, but rather to develop a unique package that starts with jazz and creole music but extends to the actual ambiance of the venue, the fashion, socialization and the family aspect.”Matthew said he has seen the growth of Jazz ‘n Creole over the years and hopes that this growth can continue with the support of the private and public sectors and the general public.
September 12, 2018 Challengers enter into Holbrook’s political race Holbrook Mayor Bobby Tyler and Councilman CJ Wischmann will each be facing a contender for their seats in the November election. Former city councilman Phil Cobb has submitted paperwork for the position of mayor andSubscribe or log in to read the rest of this content. Bottom Ad
Still no decision on city manager February 20, 2019 By Linda Kor HOLBROOK — After spending nearly an hour and a half in executive session, the Holbrook City Council reconvened into regular meeting and tabled their decision regarding a selection of a citySubscribe or log in to read the rest of this content. Bottom Ad
Robert Lighthizer, the U.S. trade representative, enters the Senate Finance Committee hearing to examine President Donald Trump’s trade policy agenda on Capitol Hill in Washington, June 18, 2019. (Gabriella Demczuk/The New York Times)Written by Jeanna Smialek, Jim Tankersley and Jack Ewing Advertising Weakness in China, driven in part by fallout from the trade war, has spread to Germany, Australia and other nations, raising supply chain costs, chilling exports and worrying political and economic leaders.On Tuesday, Mario Draghi, the president of the European Central Bank, said the bank was prepared to inject more stimulus into the eurozone economy to combat the economic slowdown.The effects of Trump’s trade war have been particularly hard on Germany, Europe’s largest economy, which has been bracing for a decision about whether the United States will impose tariffs on auto imports. Trade anxiety has led to a decline in business sentiment and spending: Overall German industrial production contracted sharply in April, falling 1.9% on the month versus the 0.5% analysts expected.“The risks that have been prominent throughout the past year, in particular geopolitical factors, the rising threat of protectionism and vulnerabilities in emerging markets, have not dissipated,” Draghi said in a speech Tuesday. “The prolongation of risks has weighed on exports and in particular on manufacturing.” US House rejects Saudi weapons sales; Trump to veto Karnataka trust vote today: Speaker’s call on resignations, says SC, but gives rebel MLAs a shield After Masood Azhar blacklisting, more isolation for Pakistan US House votes to set aside impeachment resolution against Trump More Explained “The biggest self-inflicted risk to growth today would be trade going south,” said Jamie Dimon, chief executive at JPMorgan Chase. Trump lashed out at Draghi by name on Twitter, accusing him of trying to weaken Europe’s currency to get a leg up in global trade by making its goods cheaper to buy overseas.“Mario Draghi just announced more stimulus could come, which immediately dropped the Euro against the Dollar, making it unfairly easier for them to compete against the USA,” Trump wrote on Twitter. “They have been getting away with this for years, along with China and others.”The president’s aggressive approach to trading partners comes as developed and developing nations are already pulling back on the rapid globalization that dominated two decades of economic policymaking. Global flows of foreign direct investment fell by 13% last year, to their lowest level since the financial crisis, the United Nations Conference on Trade and Development reported last week.It was the third consecutive annual decline, which officials blamed on multinational corporations bringing cash back to the United States after Trump’s 2017 tax overhaul. Officials warned that trade tensions posed a “downward risk” for a rebound in investment growth this year. Taking stock of monsoon rain Trump has made steady use of tariffs to punish trading partners like China, Europe, Canada and Mexico that he says have destroyed American jobs by flooding the United States with cheap products and erecting unfair economic barriers at home. The president and his top officials insist that the trade war is lifting the U.S. economy and that any slowdown in global growth is not related to the administration’s trade policies.Treasury Secretary Steven Mnuchin said in an interview this month that he did not “think in any way that the slowdowns you’re seeing in parts of the world are a result of trade tensions at the moment.” He noted that growth in Asia and Europe had been tapering off before trade talks between the United States and China broke down in early May.Trump has repeatedly cited China’s slowdown as proof that his trade war is working, telling reporters last week that the United States has “picked up $14 trillion in net worth of the United States.”“And China has gone down probably by $20 trillion,” he continued. “There’s a tremendous gap.”But a slowdown in the world’s second-largest economy — one that’s deeply enmeshed in global trade networks — affects other economies.“China is the biggest trading nation in the world,” said Jacob Funk Kirkegaard, a senior fellow at the Peterson Institute for International Economics in Washington. “The idea that you could slow down the global growth engine and not affect other countries is just not credible.”Multinational companies are already shifting supply chains and delaying capital spending in response to Trump’s tariffs on Chinese goods and foreign metals.Tom Linebarger, chairman and chief executive of diesel engine manufacturer Cummins, said last week that his company had lost business for part of its operation in China as a result of the trade war. The Indiana company is changing its sourcing practices to minimize exposure to China, and Linebarger said its costs from tariffs now exceeded the benefits from the corporate tax cuts Trump signed in 2017.“The tariffs that are in place now, and which may be in place for some time, are a significant burden on U.S. businesses and farms,” Linebarger said.Data increasingly suggest trade tensions are weighing on economic confidence, globally and in the United States.A Federal Reserve Bank of New York manufacturing survey registered its worst drop ever on Monday, which many economists blamed on Trump’s threats this month to impose tariffs on Mexican imports as punishment for failing to curb unauthorized immigration. While those tariffs were averted, the chance that Trump could make a similar move against another trading partner has caught the attention of global companies and foreign leaders.The trade war is having “a much bigger impact” on business hiring and investment in the United States than most analysts think, Deutsche Bank wrote in a research note on Monday. Several measures of policy uncertainty, compiled by economists Scott R. Baker of Northwestern University, Nicholas Bloom of Stanford University and Steven J. Davis of the University of Chicago, have spiked with the increased tensions.On Tuesday, Trump said on Twitter that he had spoken by phone to President Xi Jinping of China and that the two leaders would have an “extended” meeting next week at the Group of 20 summit in Japan. Those comments could help calm global trade fears, which had risen after the United States accused China of breaking a trade deal last month and Trump raised tariffs on $200 billion worth of Chinese goods as punishment.But no agreement is guaranteed, and Trump has threatened to impose tariffs on an additional $300 billion of Chinese goods if Xi does not agree to the original deal. The president has already placed import taxes on $250 billion worth of products from China and has hit trading partners with steel and aluminum tariffs and threatened tariffs on foreign autos from Europe and Japan.The World Bank cut its forecast for global growth by 0.3 percentage points for this year in response to unexpected weakness in trade and manufacturing across advanced and developing economies. Global trade growth has slowed to its lowest rate since the 2008 financial crisis as exports from Europe and Japan have plummeted, particularly to China.The bank noted that heightened policy uncertainty, including trade tensions, had been accompanied by slowing global investment and weakening confidence. It warned in a report this month that risks to its outlook were “firmly on the downside, in part reflecting the possibility of destabilizing policy developments, including a further escalation of trade tensions between major economies.”International Monetary Fund economists estimate that if Trump follows through on his threat to broaden the Chinese trade spat, tariffs added this year alone will subtract 0.3% off global gross domestic product in 2020, with an additional 0.2% drag coming from tariffs the administration put in place last year.Manufacturing, which is especially vulnerable to trade, is slowing across advanced economies even as service industries hold up. Factory gauges have dipped lower across Europe and are wavering in Japan. In the United States, the Institute for Supply Management’s factory index dropped to its lowest reading of Trump’s presidency in May.Trade policies aren’t the only culprit behind slowing production. A continuing, structural slowdown in Chinese growth and tensions from Britain’s attempted exit from the European Union are among other factors.China posted its weakest economic growth in 28 years in 2018, a pullback analysts blame partly on structural reforms and long-running trends and partly on the trade spat. Analysts at Moody’s Investors Service expect a further slowdown in 2019, to 6.2% from 6.6%, amid continued trade uncertainty.Europe, where the IMF estimates 70% of exports are links in global supply chains, is particularly sensitive to trade disputes. And Germany highlights how the trade war between the United States and China can spill over.The nation’s car industry is the backbone of its economy and is dependent on China for growth. As trade tensions exacerbate China’s economic weakening, manufacturers in Germany pay the price.Volkswagen, the world’s largest carmaker, said last week that sales in China fell 7% from January through May, to about 1.2 million vehicles. Largely because of China, Volkswagen’s global sales fell 5% during the same period.“We are experiencing the biggest decline in the world auto market in 20 years,” Ferdinand Dudenhöffer, a professor at the University of Duisburg-Essen, said in a report. If Trump follows through on threats to impose further tariffs on China, Dudenhöffer said, “there is danger of a global auto crisis.”Germany’s central bank has slashed its forecast for growth this year to 0.6% from 1.6%. That bleak change was “mainly due to the downturn in industry, where lackluster export growth is taking a toll.”“The fear factor, the uncertainty, is denting willingness to spend, willingness to invest,’’ said Carsten Brzeski, chief economist for Germany and Austria at ING in Frankfurt. “It’s therefore undermining growth in the eurozone.”And in Australia, where an almost 28-year-old expansion is looking less secure and the central bank recently cut rates for the first time since 2016, economic officials are watching trade wars warily. Ther governor of the Reserve Bank of Australia, Philip Lowe, called international trade disputes “the main downside risk” in a recent news conference.If coming trade negotiations don’t end in a resolution, the United States and its companies could also pay a price, leaders of the Business Roundtable, a corporate lobbying group in Washington, warned last week. Virat Kohli won’t have a say in choosing new coach Post Comment(s)
In the wake of a call for retractions of dozens of papers from a high-profile Harvard University heart stem cell research lab, federal officials today announced they are pausing a clinical trial based on research in this field. The National Heart, Lung, and Blood Institute (NHLBI) in Bethesda, Maryland, explained in a statement today that the pending retractions “have raised concerns about the scientific foundations of this trial.”The treatment has seemed safe in the 90 patients studied so far, said David Goff, director of NHLBI’s Division of Cardiovascular Sciences. Many labs contributed to the basic research supporting the study, called CONCERT-HF, he said, not just the Harvard group. However, NHLBI is pausing the trial to review it because “it’s the prudent thing to do,” he said.Lab studies by cardiologist Piero Anversa of Harvard Medical School and Brigham and Women’s Hospital in Boston have suggested a certain type of stem cell in the heart called a c-kit+ cell could regenerate heart muscle in mice. If true, the cells could form the basis of a treatment for patients with heart failure. But several labs have reported they could not replicate some of Anversa’s studies. In 2014, Harvard and Brigham and Women’s revealed they had begun a scientific misconduct investigation of Anversa’s work. (Anversa, who lost a lawsuit claiming the investigation was mishandled, no longer works at Harvard.) Click to view the privacy policy. Required fields are indicated by an asterisk (*) SPL/Science Source Country * Afghanistan Aland Islands Albania Algeria Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia, Plurinational State of Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, the Democratic Republic of the Cook Islands Costa Rica Cote d’Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People’s Republic of Korea, Republic of Kuwait Kyrgyzstan Lao People’s Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macao Macedonia, the former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Martinique Mauritania Mauritius Mayotte Mexico Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Norway Oman Pakistan Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Qatar Reunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela, Bolivarian Republic of Vietnam Virgin Islands, British Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe The now-paused clinical trial has explored using stem cells to repair damage to the heart. Sign up for our daily newsletter Get more great content like this delivered right to you! Country
Email By Jocelyn KaiserOct. 29, 2018 , 1:25 PM Federal officials pause trial testing stem cells for heart disease The CONCERT-HF trial for patients with chronic heart failure began to enroll 144 patients 3 years ago and was to end about a year from now. The patients are receiving one of four possible treatments: c-kit+ cells derived from a patients’ own heart tissue, a combination of c-kit+ cells and mesenchymal stem cells from the patient’s bone marrow, mesenchymal stem cells alone, or a placebo. The trial has recruited 125 of a planned 144 participants, Goff said. Of them, 117 have had blood stem cells and heart tissue collected and 90 have received treatment. No safety issues related to the treatment have arisen, although one patient died after a heart biopsy, The Washington Post reported.Goff said when the CONCERT-HF trial was approved, reviewers were aware of concerns about Anversa’s work. But eight other labs had published 11 studies supporting the c-kit+ cell treatment. “The scientific basis really relies on this independent body of work,” he said. But further concerns arose this month, when Harvard and Brigham and Women’s recommended that 31 papers from the Anversa lab be retracted because they included falsified or fabricated data. (At least one journal has already begun to retract papers.) That prompted NHLBI to convene the Data and Safety Monitoring Board that oversees the CONCERT-HF trial. It recommended last Thursday that the trial pause for a review.NHLBI has now paused the trial and asked for Harvard’s list of 31 papers to ensure that the trial is scientifically sound “out of an abundance of caution,” Goff said.He could not say how long review will take, but assured it will be done “in an expeditious manner,” particularly because patients have donated tissue and are awaiting treatment. About half of patients with chronic heart failure die within 5 years, he noted.One longtime critic of Anversa’s work suggested that questions about how c-kit+ cells might repair heart tissue in mice suggest the CONCERT-HF trial never should have started. “The problem is that if you don’t know how something works, then you don’t really have a road map of what to address to make it better,” says Deepak Srivastava, a pediatric cardiologist and president of the Gladstone Institutes in San Francisco, California.But other researchers think the trial should be completed because other basic work supports the approach. “There’s plenty of reason to believe that there’s still promise,” says cardiologist Christopher Granger of Duke University in Durham, North Carolina, who is experienced in clinical trials.And cardiologist Roberto Bolli of the University of Louisville in Kentucky, a longtime Anversa collaborator and co–principal investigator of the CONCERT-HF trial, says that although Anversa’s contention that c-kit+ cells engraft in the heart and differentiate into cardiac cells has “been debunked,” other work supports the idea that these cells help by secreting so-called paracrine factors that promote heart tissue growth. “The controversy [over Anversa’s work] does not really change the validity of using c-kit cells,” Bolli says.Another trial, based in Florida, planned to begin to treat infants born with a certain heart defect with c-kit+ cells this month; the status of the trial was unclear at press time.Goff said NHLBI continues to support basic research on c-kit+ cells and heart disease—it now funds 14 preclinical grants, he said.With reporting by Jennifer Couzin-Frankel. *Update, 30 October, 2:30 p.m.: The number of preclinical grants supported by NHLBI has been updated.
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Country By Munyaradzi MakoniMar. 18, 2019 , 3:00 PM “Wellcome was notified of the Kenyan Court of Appeal judgment by the Kenya Medical Research Institute (KEMRI), [which] is the party involved in this case,” a spokesperson for the Wellcome Trust wrote in a statement sent to Science. “We note the outcome and respect the judgment made by the Court of Appeal.” “We fully respect the judgment and authority of the courts in Kenya,” a spokesperson for the University of Oxford adds.But, Gwer says, “The partnership and other global institutions are hell-bent on maintaining the status quo even if it is an unfair state of affairs.” “Many scientists lack insight on the lopsided relationships they are in with northern organizations,” he adds. “They are content with minimal professional acknowledgment and reward.”Although the three organizations may feel vindicated by the judgment, it does not solve a key problem of this type of international collaboration, says Carel IJsselmuiden, executive director of the Council on Health Research for Development in Geneva, Switzerland. The situation in which a team working on the same or similar health problems has two or more funders or employers, and as a result has greatly different remuneration and career advancement opportunities, is inherently unfair and problematic, he says. “While this may not be a legal problem that is resolvable by a court, it is a continuing moral problem that faces all joint development projects between high-income country institutions and partners in Africa,” IJsselmuiden says.All six researchers have left KEMRI; Gwer is now executive director at Afya Research Africa, a Nairobi-based organization that promotes sustainable health care solutions in Kenya. He is one of only two plaintiffs who have completed their Ph.D.s. 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Required fields are indicated by an asterisk (*) Carel IJsselmuiden, Council on Health Research for Development Email Appeals court dismisses charges of institutional racism at U.K.-Kenyan research partnership The six plaintiffs filed suit in 2011, alleging that African workers in the partnership were paid less, received fewer grants, and were less often appointed at senior scientific positions than their white, European counterparts. Their lawsuit described the situation as “modern-day slavery.” KEMRI emphatically denied the allegations, but a judge sided with the six in 2014. “The systemic discrimination and violation of the fundamental rights has had significant detrimental effect on the researchers,” the judge said. “They have not only lost a chance to renew their employment contracts and connected scholarships to complete their studies, but have lost significant research outcomes as a result of the discriminative practices.”Now, the appeals court says the judge “erred and misdirected himself” by not considering the facts and documents put forward by KEMRI, which it says, “resulted in patent misjustice.” About the plaintiffs’ claims of racism, the court added: “We are not persuaded by the arguments in submissions made on their behalf, which stand out more for their markedly intemperate tone and colorful phraseology than for the accuracy.” The compensations awarded in 2014 were “baffling,” according to the new ruling. (It’s not clear why it took the Court of Appeal more than 4 years to rule on the case.)Samson Gwer, one of the plaintiffs, calls the judgment “weird and fundamentally flawed.” But, he says, “This ruling did not in any way negate the fact that we had won in the first round and demonstrated the ills of the relationship that KEMRI had with the Wellcome Trust and other global entities. … The differences in outcomes on the basis of racial differences are stark and this cannot be wished away.”KEMRI did not respond to requests for comment, but KEMRI Director General Yeri Kombe welcomed the verdict in a comment published by The Daily Nation, a Kenyan newspaper. “We have since learnt valuable lessons and we have continued to strengthen our administrative systems to ensure that we deliver our core mandates in search of better health for humanity,” he was quoted as saying. While this may not be a legal problem that is resolvable by a court, it is a continuing moral problem that faces all joint development projects between high-income country institutions and partners in Africa. An appeals court in Kenya has dismissed charges of institutional racism at a U.K.-Kenyan research partnership. The Court of Appeal in Nairobi overturned a 2014 verdict by a lower court that found that six Kenyan academics working for the Kenya Medical Research Institute (KEMRI)–Wellcome Trust Research Programme, had faced “systemic discrimination” in their careers. The scientists haven’t proved their claims, according to the appeals court, which also struck down 5 million Kenyan shilling (about $50,000 at the current exchange rate) in compensation that the lower court had awarded to each of the plaintiffs.The verdict was handed down on 8 February but has not been widely reported.The research program is a partnership between KEMRI in Nairobi, the University of Oxford in the United Kingdom, and the Wellcome Trust, a U.K. charity, which provides the bulk of the funding. Headquartered in Kilifi, on Kenya’s coast, it now has more than 100 scientists and more than 700 support staff.
*ECT News Network editor’s note – July 13, 2017: Our original published version of this story indicated that Microsoft’s plan to provide broadband access for at least 2 million consumers would cost between US$8 billion and $12 billion. However, that amount does not accurately reflect Microsoft’s investment in the overall rural broadband plan, according to company rep Lindsey Lombardi. “The total capital and initial operating cost to eliminate the rural broadband gap falls into a range of $8 to $12 billion,” Microsoft President Brad Smith said. However, Microsoft has not attached a dollar amount to its own spending on the initiative it announced. Microsoft issued a white paper on the rural broadband gap and how best to approach it, based on research from Boston Consulting Group.Eighty percent of rural areas would benefit from the white spaces spectrum for populations of 2 to 200 people per square mile, according to the paper. Satellite coverage would work best for smaller communities, while fixed wireless would best serve more densely populated areas.Microsoft will work with a group of investment partners through its Rural Airband Initiative to have 12 different projects up and running over the next 12 months in 12 different states, Smith said. The company will make initial investments in capital costs and then work with local operators on a revenue-share plan to recoup investments.Microsoft also has partnered with the National 4-H Council to train people on the latest technology. Deployment of the broadband initiative will improve Internet access for students in local schools, provide telemedicine in rural hospitals, and offer access to greater opportunities to employ precision farming, which uses sensors to estimate the specific needs for water and other resources. It also will aid small businesses and individual consumers.The effort is meant to be a catalyst for a larger industry-wide plan that could expand broadband to the nation’s rural population at a cost of between US$8 billion and $12 billion over a five-year period. Such a plan would cost 80 percent less than the cost of fiber alone and 50 percent less than using fixed wireless technology like 4G, the company said.Microsoft has not specified a cost attached to its own 12-state plan, but said it planned to reach out to additional partners and that the public sector would need to play a role for expanded broadband coverage with federal and state infrastructure investment.FCC Chairman Ajit Pai was in South Boston, Virginia, on Monday, learning more about Microsoft’s efforts to provide broadband service to thousands of students in rural parts of the state.”The FCC is committed to bridging the digital divide and ensuring that all Americans can enjoy the opportunities provided by high-speed Internet access,” said Tina Pelkey, the FCC’s new press secretary. “We will continue to work in partnership with industry, state and local governments, and the nonprofit community to achieve that goal.”Public Knowledge has urged the FCC to make greater use of TV white spaces by managing the public airwaves.”Although the technology has been deployed in some rural communities for high-tech precision farming and some wireless ISPs, the cost of equipment has discouraged widespread adoption,” said Harold Feld, senior vice president of Public Knowledge.The group has urged the FCC to make the technology more affordable, but resistance from the National Association of Broadcasters has stymied that effort, he told TechNewsWorld. Microsoft President Brad Smith outlined the plan at a high-powered luncheon in Washington, D.C., which was sponsored by the Media Institute.Thirty-four million Americans still lack access to broadband, he pointed out, and although 23 million still live in rural areas, progress for broadband penetration in the country has plateaued.”This it not just about watching YouTube videos on tablets, as enjoyable as that may be,” Smith told attendees at the luncheon. It’s about education. It’s about healthcare. It’s about agriculture and growing a small business. It is a vital part of modern day life.” Microsoft on Monday unveiled an ambitious plan that would use technology found in the television white space spectrum to develop affordable broadband Internet access for at least 2 million consumers. [*Editor’s Note – July 13, 2017]The aim is to bridge the technology gap between urban and rural American communities.The spectrum is a currently unused portion in the 600 Mhz frequency range designated for UHF television bands, which allows wireless signals to travel over hills and through buildings and trees into rural areas.Microsoft has deployed 20 such projects in 17 countries around the world, including Columbia, Kenya and Jamaica, providing access to a total of 185,000 people. Promise and Pitfalls
The plan is a positive step, noted Shirley Bloomfield, president of NTCA, the Rural Broadband Association.However, “even the most cutting-edge technology is going to need lots of fiber backhaul to make a compelling broadband product,” she told TechNewsWorld.White space spectrum technology is promising, but it’s very expensive unless you get enough users or participating organizations to make it cost-effective, observed broadband technology consultant Craig Settles.”Microsoft is to white space what Google is to fiber,” he told TechNewsWorld. “Both companies have the money and the market credibility to drive adoption, or at least experimentation with technologies.In order for the plan to work and make money, Microsoft needs to be able to reach critical mass within a certain time frame. Google has run into that problem with deployment of Google Fiber.Every once in a while, Microsoft — whose operating system for desktop computers has dominated the industry for years — takes on an initiative that is beyond its comfort zone, said independent telecom analyst Jeff Kagan.”The future of Microsoft’s business lies in several different areas,” he told TechNewsWorld. “They obviously see this as something that’s important to their business. It plays towards what Microsoft will be tomorrow.” Business Case David Jones is a freelance writer based in Essex County, New Jersey. He has written for Reuters, Bloomberg, Crain’s New York Business and The New York Times.
Reviewed by Alina Shrourou, B.Sc. (Editor)Oct 9 2018According to the United States Department of Justice, “sextortion” is labeled as the most important and fastest-growing cyberthreat to children, with more minor victims per offender than all other child sexual exploitation offenses. Sextortion is the threatened dissemination of explicit, intimate, or embarrassing images of a sexual nature without consent. It is usually for the purpose of getting more images, sexual acts, money or something else.Sextortion in children catapulted into the spotlight in 2012 with the suicide of 15-year-old Amanda Todd from British Columbia. After years of online stalking, public humiliation, and cyberbullying associated with sextortion, she took her own life. Despite increased public interest in sextortion, there have been no studies to empirically examine this behavior among adolescents.Researchers from Florida Atlantic University and the University of Wisconsin-Eau Claire have filled this gap with a study that explored sextortion prevalence behaviors among a nationally-representative sample of 5,568 middle and high school students in the U.S. between the ages of 12 to 17 years.Results from the study, just published in the journal Sexual Abuse, reveals that 5 percent of these youth had been the target of sextortion, and 3 percent admitted that they had done it to others. While these percentages do not seem high, they constitute a meaningful proportion when extrapolated to a U.S. population of teens. Males were significantly more likely than females to have participated in sextortion both as a victim and as an offender.”Our finding that males are more likely to be a victim of sextortion was somewhat surprising given that most attention has focused on female victims,” said Sameer Hinduja, Ph.D., co-author, a professor in FAU’s School of Criminology and Criminal Justice within the College for Design and Social Inquiry, and co-director of the Cyberbullying Research Center. “We also found a connection between offending and victimization, with those involved in one role being more likely to also be involved in the other.”Other findings showed that adolescents who identified as non-heterosexual were more than twice as likely to be the victim of sextortion. This finding is consistent with other forms of online abuse, including cyberbullying and electronic dating violence, which research has shown is more common among those who do not identify as heterosexual. The researchers found no differences by race and age, although 15 year olds were generally more likely to be involved compared with other groups.The study also found that most sextortion experiences occurred within the context of an existing friendship (romantic or otherwise). It was relatively rare that the person targeted by someone was not well known to the target.Related StoriesRevolutionary gene replacement surgery restores vision in patients with retinal degenerationRepurposing a heart drug could increase survival rate of children with ependymomaNew research links “broken heart syndrome” to cancerVictims of sextortion were harmed in a variety of ways, including being stalked or harassed (9.7 percent of males and 23.5 percent of females), being contacted repeatedly online or by phone (42.9 percent of males and 40.9 percent of females), or having a fake online profile created about them (11.2 percent of males and 8.7 percent of females).Most notably, 24.8 percent of males and 26.1 percent of females who were sextorted said the offender posted the sexual image of them online, while 25.5 percent of male victims and 29.6 percent of female victims said the offender sent the sexual image of them to someone else without their permission.”In short, threats that were made were ultimately carried out in some way, and some of these instances may indeed be more accurately characterized as ‘revenge porn,’ another behavior involving the unauthorized distribution of explicit images,” said Hinduja. “Revenge porn is less colloquially known as ‘non-consensual pornography.’ However, the primary difference between revenge porn tends to be public while sextortion is usually private, unless threats are ultimately carried out.”Few victims of sextortion reported the experience to parents or other adult authorities, although significantly more females informed their parents than did males. In addition, very few sextortion victims reported it to the site or app where the situation occurred.”Besides a general distrust or lack of faith in adults, adolescents also fear retaliation, struggle with shame, wish to keep sextortion a secret, attempt to minimize the incident, and don’t know where to turn to or who they can count on to truly come through for them,” said Hinduja.Hinduja and Justin W. Patchin, Ph.D., co-author, a professor at the University of Wisconsin-Eau Claire and co-director of the Cyberbullying Research Center, advise youth to continue to be cautious when it comes to how much trust they can extend to others. They also suggest that parents and other adults who work with teens should cultivate them in a healthy dose of skepticism about the sharing of personal, sexual content – to anyone in their circle because the research makes clear that sextortion rarely involves strangers.”Youth may fall prey to victimization more readily than adults because of the naiveté that stems from a simple lack of experience in the ways of life and love,” said Hinduja. Source:http://www.fau.edu/
Reviewed by Alina Shrourou, B.Sc. (Editor)Jan 17 2019A new anti-inflammatory compound developed at the University of California, Davis, acts as a “surge protector” to suppress inflammation and reduce cancer growth, at least in mouse models of cancer. The work is published this week in the Proceedings of the National Academy of Sciences.”We are excited about this research and its potential,” said Bruce Hammock, a distinguished professor in the UC Davis Department of Entomology and Nematology, and the Comprehensive Cancer Center.During chemotherapy, dying cancer cells can trigger inflammation and an influx of more cancerous cells.”To prevent tumor recurrence after therapy, it will be critical to neutralize the inherent tumor-promoting activity of therapy-generated debris,” said first author Allison Gartung of Harvard Medical School and Beth Israel Deaconess Medical Center. “Our results indicate that a dual COX-2/sEH inhibitor may offer a novel alternative to protect the body from a debris-mediated inflammatory response.”Related StoriesAdding immunotherapy after initial treatment improves survival in metastatic NSCLC patientsResearchers use AI to develop early gastric cancer endoscopic diagnosis systemTrends in colonoscopy rates not aligned with increase in early onset colorectal cancerGartung said the study confirmed that ovarian cancer cells killed by chemotherapy induce surrounding immune cells called macrophages to release a surge of factors that create an optimal environment for tumors to survive and grow.Combines two anti-inflammatory drugsThe team treated the mice with PTUPB, a dual lipid pathway inhibitor discovered several years ago in Hammock’s lab at UC Davis. It combines two anti-inflammatory drugs — a COX-2 inhibitor and a soluble epoxidehydrolase, or sEH, inhibitor — into a single molecule with the aim of reducing tumor angiogenesis and metastasis.In earlier work, PTUPB blocked breast and lung tumors in mice. The drug is being clinically evaluated for its therapeutic properties in other diseases, Hammock said.American Cancer Society statistics show that ovarian cancer ranks fifth in cancer deaths among women. Every year, more than 14,000 die from the disease.”We are exploring all options to translate PTUPB to cancer patients especially in combination with current cancer therapies such as chemotherapy, radiation, immunotherapy or surgery, which either directly or indirectly may generate tumor cell debris,” said senior author Dipak Panigrahy of Harvard Medical School. “Our next step is to investigate whether our findings are consistent with clinical studies involving human cancer.”Hammock’s lab has been researching the sEH inhibitor for 50 years. Hammock and Sarjeet Gill, now distinguished professor at UC Riverside, discovered the molecule as graduate students at UC Berkeley. A series of papers from Hammock’s lab has shown that the soluble epoxidehydrolase inhibitors can block tumor growth and metastasis when used with omega-3 fatty acids or COX inhibitors. Source:https://www.ucdavis.edu/news/anti-inflammatory-compound-protects-against-cancer-growth-and-recurrence
Source:https://www.inria.fr/en/centre/nancy/news/using-algorithms-to-adjust-doses-of-medication Reviewed by James Ives, M.Psych. (Editor)Feb 4 2019Finding the right dose of medication by trial and error can be a painful experience for patients who are already suffering because of their disease. Artificial intelligence can greatly accelerate this process thanks to a new algorithm created by Adrien Coulet, lecturer at the Université de Lorraine and researcher in a joint Inria and Loria team, in collaboration with researchers from Stanford University. By analyzing patients’ digital data, this innovative tool can predict in advance whether patients will need a lower dose of medication thus reducing the suffering caused by side effects. This result was published in Nature Scientific Reports.Using artificial intelligence as a tool to help prescribe treatmentUsing electronic patients’ data from Stanford University Hospital, the team of researchers was able to identify those who required a lower dose than the standard one for certain drugs, even before treatment started. They used an automatic learning method called “Random Forest Classifier”; this algorithm combines the results of decision trees based on slightly different subsets of data.The method was already known, so the innovative side of this project lies in the preparation and selection of the data used. Scientists compiled information from very different sources (analysis results, notes, prescriptions, etc.) on groups of patients who needed to have their dosage of drugs changed or not. Patients’ data from Stanford University Hospitals has been computerized for years so the algorithm had multiple data on the highly variable responses of patients to their treatments. This computerization of the health system allowed the algorithm to learn and then predict whether patients who had never taken the drugs in question at the time would need a lower dosage.Refined predictions about complex drugsRelated StoriesArtificial intelligence can help accurately predict acute kidney injury in burn patientsAI-enabled device detects if targeted chemotherapy is workingResearchers use artificial intelligence to predict molecular classification of colorectal cancerAdrien Coulet and his collaborators were particularly interested in drugs that interact with the family of the P450 enzymes. Malfunctions of this enzyme family are linked to adverse reactions to several types of medications, including some anti-cancer drugs. These adverse reactions can be limited when the dosage of the anti-cancer drugs prescribed as part of a chemotherapy are adjusted to each individual patient according to his or her needs.Traditionally these dosages are very difficult to adjust because the activity of the P450 family of enzymes is highly dependent on the individual characteristics of the patients. Thus the effects felt by patients taking these drugs, whether positive or negative, can vary greatly depending on their genes, their personal history or their way of life. The precision and completeness of the algorithm have made it possible to take this multitude of possibilities into account to apply it to new patients and make accurate predictions.Researchers now wish to adapt this technology to the data and the scientific, social and legal environment of French hospitals. The computerization of the health system can provide valuable support to health personnel and avoid unnecessary inconvenience and suffering for patients.
We’ve developed a needle shaped sensor with different electrodes and have shown we can detect one sepsis biomarker in almost real time, at the clinically relevant levels.”Damion Corrigan, Study Author Co-author David Alcorn says he believes the innovative technology could have global implications and that being able to prescribe the right antibiotic at the right time for patients with sepsis is extraordinary. By Sally Robertson, B.Sc.Feb 21 2019Reviewed by Kate Anderton, B.Sc. (Editor)Researchers have developed an innovative test that can quickly diagnose sepsis and potentially save thousands of lives. Kateryna Kon | ShutterstockPreliminary testing of the device has shown it can generate results in minutes, while the hospital tests that are currently used can take up to 72 to hours.According to the UK Sepsis Trust, approximately 52,000 individuals in the UK die as a result of sepsis every year. The condition develops when substances produced by the immune system to fight infection cause inflammation that affects the entire body. If sepsis is not quickly treated, a person can suffer multiple organ failure and die.Diagnosing sepsis can be a complex process involving a blood test and measurements of heart rate, temperature, and breathing. However, in cases of sepsis, timing is key and for each hour that antibiotic treatment is delayed, the likelihood of death increases. The reliance on a combination of lab techniques and clinical judgment can mean diagnosis takes as long as 72 hours.As recently described in the journal Biosensors and Bioelectronics, researchers at the University of Strathclyde and University of Leeds have developed a simple, sensitive biosensor device that can detect a biomarker of sepsis called interleukin 6 (IL-6).So far, testing of the new device has shown that it can detect increased IL-6 levels in just two-and-a-half minutes.The small size of the device makes it ideal not just for initial, point-of-care, testing but also for inserting into the blood vessels of sepsis patients so that they can be continuously monitored. Source:Russell, C., et al. 2019. Development of a needle-shaped microelectrode for electrochemical detection of the sepsis biomarker interleukin-6 (IL-6) in real time. Biosensors and Bioelectronics. Finding the correct drug not only targets care for that patient, but will cut down on needless antibiotics and the reduced chance of antibiotic resistance. I can definitely see this having a clear use in hospitals, not only in this country, but all round the world.”David Alcorn, Co-author
Reviewed by James Ives, M.Psych. (Editor)Apr 30 2019It was dusk as Oakley Yoder and the other summer camp kids hiked back to their tents at Illinois’ Jackson Falls last July. As the group approached a mound of boulders blocking the path, Oakley, then 9, didn’t see the lurking snake — until it bit a toe on her right foot.”I was really scared,” Oakley said. “I thought that I could either get paralyzed or could actually die.”Her camp counselors suspected it was a copperhead and knew they needed to get her medical attention as soon as they could. They had to keep her as calm and motionless as possible — the venom could circulate more quickly if her heart raced from activity or fear.One counselor gave her a piggyback ride to a van. Others distracted her with Taylor Swift songs and candy as the van sped from their location in a beautiful but remote part of the Shawnee National Forest toward help.First responders met them and recommended Oakley be taken by air ambulance to a hospital.The helicopter flight transported Oakley 80 miles from a school parking lot just outside the forest to St. Vincent Evansville hospital in Indiana, where she received four vials of antivenin and was then transferred to Riley Hospital for Children in Indianapolis for observation.Her parents, Josh Perry and Shelli Yoder, were already in bed that night when they got the call about what had happened to Oakley. They jumped in the car and arrived at Riley about two hours before their daughter. Once she made it, doctors closely observed her condition, her toe still oozing and bruised. By lunchtime, Perry said, physicians reassured the parents that Oakley would be OK.“It was a major comfort for me to realize, OK, we’re getting the best care possible,” said Perry, who is a health care ethics professor at the business school at Indiana University Bloomington. Less than 24 hours after the bite, Oakley left the hospital with her grateful parents.Then the bills came.Oakley Yoder shows her now-deformed toe after a snake bit her at an Illinois summer camp in July 2018. These are the same shoes she wore when bitten.(Chris Bergin for KHN)Patient: Oakley Yoder, now 10, of Bloomington, Ind. Insured through Indiana University Bloomington, where her father and mother work as faculty.Total Bill: $142,938, including $67,957 for four vials of antivenin. ($55,577.64 was charged for air ambulance transport.) The balance included a ground ambulance charge and additional hospital and physician charges, according to the family’s insurer, IU Health Plans.Service Providers: St. Vincent Evansville hospital, part of Ascension, a nonprofit Catholic health system. Riley Hospital for Children, part of Indiana University Health, a nonprofit health system. Air Evac Lifeteam, an air ambulance provider.Medical Service: The essential part of Oakley’s treatment involved giving her four vials of snake antivenin called CroFab.What Gives: When bitten by a venomous snake, there is no time to waste. If left untreated, a venomous bite can cause tissue damage, hemorrhaging and respiratory arrest. Children tend to experience more severe effects because of their relatively small size.CroFab has dominated the U.S. market for snake antivenin since its approval in 2000. When Oakley was bitten, it was the only drug available to treat venomous bites from pit vipers. (Oakley probably was bitten by a copperhead snake, a type of pit viper, the camp directors told her parents.)In short, the drugmaker, London-based BTG Plc, essentially had a monopoly.The average list price for CroFab is $3,198 per vial, according to the health care information tech company Connecture. Manufacturing costs, product improvements and research all factor into the drug’s price, said Chris Sampson, spokesman for BTG.A Mexican version of snake antivenin can cost roughly $200. But it couldn’t be sold in the U.S. (More about that in a moment.)Dr. Leslie Boyer, founding director of the VIPER Institute, a venom research center at the University of Arizona, acknowledges that some of the price in the U.S. can be attributed to strict Food and Drug Administration requirements for testing and monitoring.But more than that, she added: “It’s a profitable drug, and everyone wants a piece of it.”She should know: Funded by government grants and at times working with colleagues over the border in Mexico, her group was instrumental in developing CroFab.Antivenins were first developed more than a century ago. Although CroFab is safer and purer than antivenins of the past, the process — while labor-intensive — remains fundamentally the same. Snakes, spiders and other creatures are milked for their venom, then a small amount of the toxin is injected into animals like horses or sheep. They then make antibodies without falling ill, and the protective molecules are extracted from their blood and processed to make antivenin.Despite the longtime use of antivenins, CroFab and other such products remain a lucrative prospect for manufacturers. Who wouldn’t pay top dollar for an antivenin when their child has been bitten by a venomous snake?What patients pay for CroFab can widely vary. Treatment may require a few vials or dozens of them — it depends on factors like the size of the patient, the potency of venom in the bite and how quickly the patient is treated. The more antivenin needed, the higher the cost.But hospitals also jack up the price, even though some of these facilities purchase the drug at a discount, said Dr. Merrit Quarum, chief executive officer of WellRithms, a health care cost containment company.In Oakley’s case, St. Vincent Evansville hospital charged $16,989.25 for each unit of CroFab, according to the facility’s bill. That’s more than five times as high as the average list price.Related StoriesRevolutionary gene replacement surgery restores vision in patients with retinal degenerationRepurposing a heart drug could increase survival rate of children with ependymomaNew network for children and youth with special health care needs seeks to improve systems of careWellRithms analyzed Oakley’s bill from St. Vincent Evansville at Kaiser Health News’ request and found providers generally accept $16,159.70 for all four vials of the drug.In a statement, St. Vincent Evansville noted that the family was not responsible for that full tab and instead was expected to pay less than $3,500. But the facility appears to have since lowered its price for CroFab. According to its price list — posted online to satisfy a recent federal requirement — the drug now costs $5,096.76 per vial.And the snake antivenin market now has another drug competing for patients: Anavip. The Mexican product — launched in October — has a list price of $1,220 a vial in the U.S, a fraction of what Latin Americans pay for it, according to Rare Disease Therapeutics, which distributes the drug in the U.S.Anavip’s arrival was stalled by a lawsuit filed by BTG in 2013 that claimed the drug infringed on its patent.The drug’s true effect on the market remains unclear. CroFab and Anavip are not entirely interchangeable. (The FDA hasn’t approved Anavip for copperhead bites, for instance.) And, as part of the legal settlement, Anavip makers must pay royalties to BTG until the CroFab patent expires in 2028.Yoder’s father, Josh Perry, teaches a class on the ethics of health care finance at Indiana University, yet he said the cost of Oakley’s care shocked him.(Chris Bergin for KHN)Resolution: The insurer, IU Health Plans, negotiated down the antivenin and air ambulance charges and ended up paying $44,092.87 and $55,543.20, respectively. After adjustments to additional bills, IU Health Plans paid a total of $107,863.33. Oakley’s family did not pay a dime out of pocket for her emergency care, but such high outlays contribute to rising premiums.Secondary insurance offered through the summer camp covered $7,286.34 in additional costs that otherwise would have come out of Perry and Yoder’s pockets for their deductible and coinsurance. The policy covers up to $25,000 in damages.Oakley’s foot is healed, but her toe bends slightly downward and is sensitive to pressure. She intends to return to the same camp this summer.Perry teaches a course on the ethics of the health care industry, and yet he said the cost of Oakley’s care shocked him. But he is aware of how rarely a patient ends up paying nothing for health care. “I know that in this country, in this system,” he said, “that is a miracle.”Takeaway: Hospitals and insurers can negotiate; snakes don’t. If you’ve been bitten by a snake, “take care of your injury,” said Boyer. Don’t wait while you worry about the cost.When you get a bill, compare what the facility charged against other health care providers’ prices using their public charge lists online. Cost estimation tools like Fair Health Consumer or Healthcare Bluebook allow you to see how your bill compares with the average.Momentum is growing for government action on drug prices. In states and in Congress, various proposals have been floated, which include: allowing Medicare to negotiate drug prices, tying the U.S. price of expensive drugs to the average price in other developed countries and allowing the government to inject competition into the market when there is none — such as by speeding generic drug approvals or allowing imports.Consumers should keep an eye on these proposals as they move through the political process.NPR produced and edited the interview with Kaiser Health News’ Elisabeth Rosenthal for broadcast. Jake Harper of WFYI in Indianapolis provided audio reporting.Bill of the Month is a crowdsourced investigation by Kaiser Health News and NPR that dissects and explains medical bills. Do you have an interesting medical bill you want to share with us? Tell us about it! This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.