Science Policy For All

Because science policy affects everyone.

Science Policy Around the Web – June 15, 2018

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By: Morgan Biggs

 

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source: Shaury Nash via Flickr (CC BY-SA 2.0)

DNA Sequencing

Rapid genome sequencing could revolutionize health care for acutely ill babies

Genetic disorders and congenital anomalies are a leading cause of morbidity and mortality in infants. Of the 14% of newborns admitted to neonatal intensive care units, those with genetic disorders are often hospitalized for a greater period of time. Maverick Coltrin, like many other newborns, suffered from an undiagnosed genetic condition. Despite receiving multiple tests and medications, Maverick’s uncontrollable seizures could not be diagnosed by doctors.

However, after his parents were given the opportunity to participate in a study that would analyze both Maverick and his parents’ DNA with a rapid whole genome sequencer, doctors were able to properly diagnose Maverick’s condition in less than two days. They discovered that the newborn suffered from Pyridoxine-Dependent Epilepsy, a form of epilepsy that could be easily treated with vitamin B6 supplements.

Similar trials using rapid whole genome sequencing (rWGS) are being conducted to determine its’ effectiveness compared to standard genetic tests. Results from a study conducted by Stephen Kingsmore, founder of the Rady Genomic Institute, revealed that rapid sequencing offered accurate diagnoses for 18 of 42 infants with suspected genetic disorders, while standard genetic tests identified a disease in only four cases. In addition to providing doctors and families with a faster and more precise diagnosis, rapid whole genome sequencing is more cost-effective. Using the rapid diagnosis method from rWGS resulted in hospital savings of $800,000 for six cases in the Rady Study. Furthermore, the cost of performing the test for all 42 families totaled $675,000, illustrating the economic feasibility of rWGS. Rapid whole genome sequencing technology could greatly benefit families by significantly decreasing hospitalization time and expense.

The implementation of rWGS technology in hospitals has additional value to doctors, as more research opportunities and hypotheses can be generated from the analysis of the collected genome data. In order for physicians and researchers to receive the greatest benefit, they would need to identify which patients could receive the most value from the rapid whole genome sequencing test. As the level of effectiveness varies from different patients, sometimes the less expensive test will suit some patients just as well as the rWGS.

Rapid whole genome sequencing is a healthcare innovation that could drastically improve the health outcomes of acutely ill infants and significantly decrease the cost of care.

(Sarah Elizabeth Richard, The Washington Post)

Epidemiology

An outspoken epidemiologist become U.S. science envoy

Michael Osterholm, director of the Center for Infectious Disease Research and Policy (CIDRAP), has recently been selected to serve as one of five 2018 U.S. Science Envoys. Other 2018 U.S. Envoys include renowned engineers and administrators such as James Schauer, the director of the Wisconsin State Laboratory of Hygiene, and Charles Frank Bolden Jr., the former Administrator of the National Aeronautics and Space Administration.

Since its launch in 2009, the Science Envoy program has significantly enhanced relationships and improved collaboration with other countries to address issues in science and technology, as well as develop cutting edge innovations. These scientists will use their influence and expertise to better aid and develop solutions to various health and technology challenges in priority countries.

Osterholm’s qualifications as the new Science Envoy for Health Security combine expertise in infectious disease epidemiology, as well as leadership in the research, prevention, and control of infectious disease. In this position, Osterholm will focus on combating biological threats by collaborating with priority countries on infectious disease preparedness and antimicrobial stewardship. Through CIDRAP’s Antimicrobial Stewardship Project, information and educational resources will be offered to better educate communities on the appropriate use of antimicrobials, reducing microbial resistance, and decreasing the spread of multi-drug-resistant organisms.

(Jon Cohen, Science Magazine)

 

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June 15, 2018 at 3:36 pm

Science Policy Around the Web – June 11, 2018

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By: Roger Mullins, Ph.D.

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Gender Equality

Minister looks for signs of gender bias in federal science departments

After previously acting to alleviate the gender gap among university researchers, Canada’s minister of science is now taking active measures to do the same with gender inequity in the federal government. Of note is her evidence-based approach to addressing this problem.

The present course of these actions is currently at the information-gathering stage. An earlier 2017 survey by the Professional Institute of the Public Service of Canada (PIPSC) revealed a troubling under-representation of women in science, with a key note of concern being the “diminishing proportion of women to men” in higher level positions. Based on this prior information, Duncan has requisitioned surveys from science-based departments in the federal government to collect more comprehensive and useful demographic data about their staff. This data will then be used to inform any impending policy changes.

Duncan has fought for diversity in research for decades and firmly espouses the idea that “diversity and research excellence go hand in hand.” This is by no means empty rhetoric, as an overly homogeneous or male-dominated field will suffer from limitations in their perspectives on topics that involve gender, which are more common than assumed. For example, she notes deficiencies in the design of early airbags, artificial heart valves, and voice recognition software, which were originally calibrated with male users and recipients in mind. There is no apparent benefit from “halving the potential field of innovation.” Aside from the obvious issues of fairness, researchers may provide better service to society if they actively seek to maintain a diverse set of colleagues and employees.

The results of her actions here will go a long way toward informing actions taken in other countries to alleviate gender bias in their respective science communities. When the information is made available, it will also be interesting to see how other nations science departments compare in their efforts to promote diversity and gender equity.

(Emily Chung, CBC News)

International Research

Here’s how China is challenging the U.S. and European brain initiatives

The ongoing development of the China Brain Project is a major feature of China’s new focus on neuroscience and brain research, as delineated by their government’s latest 5-year plan. Of interest to other leading nations is how their approach to neuroscience will challenge and inform their own research, as well as the impact it will have on national standing in the sciences. The latest step, and perhaps an unexpected one, has been the rapid launch of the Shanghai Research Center for Brain Science and Brain-Inspired Intelligence.

By their own account, the preparation for the national CBP center “was taking a long time,” which spurred Shanghai and Beijing to take the initiative to launch their own center. In line with the latest 5-year plan, the CBP is primarily focused on neural mechanisms underlying cognition, translational studies of neurological diseases, and artificial intelligence. The scientists heading the Shanghai & Beijing center are however also interested in brain changes at the mesoscopic (brain cell circuitry) connectome level and how education affects neural development. China faces the same brain health challenges as other countries with an aging population and many see advances in neuroscience as a means to alleviate the burden to public health systems and caregivers.

The U.S. and European Commission both have their own brain and neuroscience related initiatives and research focus, and the world will be watching and waiting to see how they compare and how researchers integrate their findings. Following at the heels of a large influx of national focus and investment in the sciences, China has also taken steps to attract scientists from across the globe for their research laboratories. This is itself not without complications. While not insurmountable, foreign researchers report feeling constricted by language difficulties and state-limited access to online resources. This step to acquire outside researchers places China in direct competition with other nations in the search for crucial scientific minds.

Time will tell how an emerging major player will affect the science policy of other leading scientific nations, but the well-defined topical focus, high priority, generous funding, and open recruitment of overseas talent all suggest that we will be seeing a great deal of brain research from China in the future.

(Dennis Normile, Science)

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June 12, 2018 at 10:30 pm

Science Policy Around the Web – June 8, 2018

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By: Sarah L. Hawes, PhD

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Treatment Guidelines

Good News for Women With Breast Cancer: Many Don’t Need Chemo

Completion of a large, international clinical study headed by Dr. Joseph A. Sparano of Montefiore Medical Center in New York spells out excellent news for early-stage breast cancer patients. These patients are typically asked to endure both chemo and endocrine therapies after tumor removal. Endocrine therapy to block the hormone estrogen results in side effects similar to menopause and can increase risk of uterine cancer. Notoriously toxic chemo therapy can damage heart and nervous tissue, compromise patient immune systems, and increase risk of leukemia.

Since 2004, genetic test such as Oncotype DX Breast Cancer Assay have provided a small number of women confidence that chemotherapy is not needed to treat their cancer. Following surgical removal of small, non-metastasized breast tumors, tissue is genetically tested to determine whether chemotherapy is advisable as a next step. A very low Oncotype DX tumor score (≤10) indicates cancer with a low risk of recurring, so that chemotherapy is not needed. A very high tumor score of (≥25) indicates a more persistent cancer, and the need for chemotherapy to suppress its recurrence. But most breast cancers return an intermediate tumor score – falling between 10 and 25.

Not knowing what else to do, physicians treating patients with intermediate scores have dutifully followed the 2000 National Cancer Institute recommendation that all pre-metastasis breast cancer patients receive chemo therapy to avoid recurrence and metastasis. Now, Dr. Sparano’s study indicates that many do not need it.

The study, called TAILORx, will be published in The New England Journal of Medicine. It began in 2006 and – with funding from the US and Canadian governments, philanthropic groups, and the company which makes Oncotype DX – followed over 9,000 breast cancer patients aged 18 to 75 for a median duration of seven years. Seventy percent of these women had intermediate tumor scores. With their informed consent, participating women were assigned at random to receive either endocrine therapy alone, or else in combination with chemotherapy.

Over the course of the study, the rates of survival and clearance of cancer were no different between these two groups. This means that for a majority of patients whose cancer is detected at an early stage, toxic chemo therapy provides no added benefit and can be safely avoided. The study results also clarified that, for women younger than 50 (median age at diagnosis is 62 in the US), chemotherapy is still advisable if tumor scores are above 16.

Coauthor Dr. Ingrid A. Mayer from Vanderbilt expressed excitement, noting that with these research findings “we can spare thousands and thousands of women from getting toxic treatment that really wouldn’t benefit them. This is very powerful. It really changes the standard of care.”

(Denise Grady, New York Times)

Basic Science

Scientists race to reveal how surging wildfire smoke is affecting climate and health

A record 2017 wildfire season inflicted serious health and economic challenges throughout the western United States. Over two million acres burned in California and Montana alone, flooding the closest towns with smoke carrying nearly 20 times the acceptable limit of particulate matter set by the Environmental Protection Agency for weeks on end.

The frequency of wildfires is projected to increase, yet a fundamental understanding of their billowing byproduct – smoke – is lacking. Thankfully the next two years will see over $30 million in spending by two cooperative research programs investigating the chemistry, physics, and environmental and public health implications of wildfire smoke. One research campaign is being funded and run by the National Science Foundation (NSF); the other is a joint endeavor by the National Aeronautics and Space Administration (NASA) and the National Oceanic and Atmospheric Administration (NOAA).

“This is definitely the largest fire experiment that has ever happened,” says Carsten Warneke of NOAA’s Earth System Research Laboratory in Boulder, Colorado. Old data on wildfire smoke lacks detail, being largely garnished by satellite observation of established fires. The new research will gather data at all atmospheric levels, using satellites as well as aircraft to fly through and sample smoke plumes and employing researchers on the ground to test low-lying smoke. Sampling will begin in the first 24 hours to monitor fast dynamics of smoke chemistry as it passes through different atmosphere levels and interacts with clouds, potentially seeding ice crystals and impacting weather. In addition to wildfires, researchers will study the smoke released by controlled burns for farming and forestry.

The goal of these large scale research campaigns, Warneke says, is “to do the whole picture at one time and understand how the whole thing plays together.” Newly generated data will enable scientists to predict the rates and types of pollutants released based on the composition of land burned – including density of vegetation or man-made structures – and what that means for climate, weather, and human health.

(Warren Cornwall, Science Magazine)

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June 8, 2018 at 6:03 pm

Science Policy Around the Web – June 6, 2018

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By: Leopold Kong, PhD

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Research funding

China increasingly challenges American dominance of science

Earlier this year, China’s science minister announced that China’s total spending on research and development in 2017 was estimated to be US$279 billion, which is up 70.9% since 2012 and represents 2.1% GDP. In comparison, the United States devoted 2.8% GDP to research and development that same year.  In terms of scientific research, the United States spends half a trillion dollars, more than any other country, but China has pulled into second place and is on track to surpass the U.S. by the end of this year, according to the National Science Board.  In fact, China surpassed the US in terms of scientific publications in 2016. According to Pastor-Pareja, a geneticist who gave up Yale for Bejing, there are now 30 fly genetics laboratories in Beijing, more than in either Boston or San Francisco. Furthermore, China has 202 of the world’s 500 most powerful supercomputers, 60 more than the U.S., and the largest radio telescope ever built, a US$180 million dish used to hunt for black holes.

The increased investment in science has enabled Chinese scientists to make more cutting edge discoveries.  For example, last year, biologists in China were the first to clone a monkey, which may speed medical research. Chinese physicists developed the proof of concept for a quantum communications system that is theoretically instant and secure. Much of this growth is driven by aggressive recruiting programs such as the Thousand Talents, which targets Chinese citizens who have studied science in the United States or elsewhere, driving a “reverse brain drain”.  The program has recruited more than 7,000 scientists, who are given a US$160,000 signing bonus and guaranteed research funding for many years.  Foreign-born scientists may get additional perks such as subsidies for housing, meals, relocation and additional bonuses.

Despite the massive growth in science, Chinese research faces challenges in quality control.  For example, last year, 107 scientific papers involving over 400 Chinese authors were retracted in a major publication fraud.  In fact since 2012, China has retracted more scientific papers because of faked peer-reviews than all other countries and territories put together, according to Retraction Watch.  In 2013, Science had exposed a thriving academic black market in China involving corrupt scientists and editors operating in plain view.  Poor quality Chinese research may be exacerbated by lack of stringent regulatory systems. “In America, if you purposely falsify data, then your career in academia is over.  But in China, the cost of cheating is very low. They won’t fire you. You might not get promoted immediately, but once people forget, then you might have a chance to move up”, said Zhang Lei, a professor of applied physics at Xi’an Jiaotong University in an interview with the New York Times.  Still, China has much to offer as collaborators according to experts. Denis Simon, executive chancellor of Duke Kunshan University noted, “The Chinese, for the first time, really have something to offer us. It is vitally in the U.S. interest to plug in.”

(Ben Guarino, Emily Rauhala and William Wan, The Washington Post)

Privacy

Took an ancestry DNA test? You might be a ‘genetic informant’ unleashing secrets about your relatives

Last Friday, police revealed parts of the arrest warrant for Joseph DeAngelo, the 72 year old former police officer accused of being the Golden State Killer who committed at least 12 murders, more than 50 rapes and over 100 burglaries from 1974 to 1986. Until recently, DeAngelo had eluded capture until DNA from a genealogical website was found to match the DNA found at one of the killer’s crime scenes. The lead from the website belonged to a distant relative of the suspect which helped lead the authorities to focus their investigation on DeAngelo.  Supplemented with other evidence, such as saliva collected from the suspect’s garbage can for a more direct DNA match, the authorities arrested DeAngelo in April of this year.

The DNA match was found on GEDmatch, a Florida- based website that pools raw genetic profiles, which now number more than a million genomes.  In at least eight states, authorities can search law enforcement databases for possible genetic matches.  Genetic family searching has been used numerous times in the past.  For example, in 2003, Craig Harman was identified as the individual who threw a brick through a windshield of a passing vehicle that caused the driver to suffer a fatal heart attack via a DNA match to Harman’s brother. In 2011, the serial killer Lonnie Franklin, charged on 10 counts of murder, was identified through DNA of Franklin’s son.

While genomics searching may provide valuable leads, some critics say it infringes on privacy. “When you put your information into a database voluntarily, and law enforcement has access to it, you may be unwittingly exposing your relatives — some you know, some you don’t know — to scrutiny by law enforcement. Even though they may have done nothing wrong,” said Andrea Roth, assistant professor of law at UC Berkeley Boalt School of Law and an expert on of forensic science in criminal trials.  Genomics searching failed in 2014 when Micheal Usry, a New Orleans filmmaker was falsely accused of murder using evidence from AncestryDNA after authorities asked for access to the data through a court order. “…even though it is easy to think of this technology as something that is used just to track down serial killers,” says Roth, “If we allow the government to use it with no accountability or no further safeguards, then all of our genetic information might be at risk for being used for things we don’t want it to be used for.”

(Ashley May, USA Today)

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June 5, 2018 at 10:00 pm

Science Policy Around the Web – May 29, 2018

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By: Cindo O. Nicholson, Ph.D.

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Biohacking

As D.I.Y. gene editing gains popularity, ‘Someone is going to get hurt’

The tools to delve into gene editing and engineering as a hobby has become more accessible to the public. This can be attributed to the necessary equipment becoming cheaper and the widely-shared expertise in molecular biology techniques like polymerase chain reactions (PCR), DNA restriction mapping, and the new craze CRISPR-Cas9 gene editing. All of this has resulted in the growth of a Biohacking community, i.e. a community of citizen scientists with a shared interest in do-it-yourself genetic engineering projects.

Though members of the Biohacking community share the belief that there should be open-access to genetic engineering technology, there are those that believe that there is the potential for something catastrophic to occur. The biggest fear is that someone will develop and unleash a fast-spreading, rapidly-mutating, and lethal biological agent. The knowledge to make an infectious virus starting with DNA fragments that are pasted together have been published by the open-access journal PLOS One. However, it should be noted that the same knowledge could be used to engineer life-saving vaccines from synthesized DNA fragments instead of extracting and passaging infectious agents from infected tissue. Nevertheless, the question becomes how are U.S. authorities regulating the use of gene-editing technologies by individuals that are not federally funded?

There are currently multiple agencies responsible for regulating various types of research, and would be responsible for mandating the ethical use of gene-editing technologies by labs funded by their grants. However, not all scientific endeavors rely on government funding. In 2013 there was a public crowdfunding campaign through Kickstarter that raised almost half a million dollars for the engineering of a glowing plant. There have been instances of the F.B.I. reaching out to some “whitehat” biohacking labs and many of these biohacking labs have guidelines that must be adhered to by members or risk being kicked out. However, once kicked out an individual is still free to continue their activities on their own and in secret. With no real way to keep track of the unregulated use of synthetic biology, the U.S. and the world is vulnerable to those who would nefariously use these technologies.

(Emily Baumgaertner, The New York Times)

Food Science

As  lab grown meat advances the US calls for regulation

The regulation of lab-grown meat (also known as “clean meat”) is getting serious consideration by the U.S. House of Representatives. A draft spending bill from the House appropriations panel includes a statement instructing the U.S. Department of Agriculture (USDA) to issue rules on the manufacturing and labeling of lab-grown meats. Lab-grown meat is made from cells taken from live animals like poultry or cattle that is grown into muscle tissue that can be pressed into burger patties or breaded to make nuggets. Advocates of lab-grown meat state that among its benefits are sparing the lives of animals, and its environmental friendliness since lab-grown meat does not generate greenhouse gases like methane and requires less land.

The impending arrival of these lab-grown meat on the market brings to the fore a few questions such as what actually counts as meat, and is it the responsibility of the USDA or is it the FDAs (Food & Drug Administration’s) for regulating these products. Lab-grown meats are made from the cells of animals and as such are more similar to the cell-based products already regulated by the FDA. In fact, inspecting the cell culture facilities where lab-grown meat is made would lie in the realm of expertise of FDA inspectors. By contrast, USDA inspectors are more familiar with inspecting animal slaughter houses.

Some argue that the proposal for the USDA to regulate cellular agriculture is premature because of insufficient knowledge on the strengths and weaknesses of this method of food production. Others believe that using a spending bill to mandate agencies to come up with new regulations is wrong, especially without input from the small businesses that will be regulated.

This debate about who should, and how to regulate the marketing of lab-grown meats is another example of regulation lagging behind innovation. Why is this frequently the case? The first lab grown beef patty to be taste-tested was in 2013, which means there was at least 5 years to preemptively brainstorm how to regulate, decide which federal agency is best suited to issue rules, and come up with language necessary for a proposal.

(Kelly Servick, Science Magazine News)

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May 29, 2018 at 11:11 am

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Science Policy Around the Web – May 22, 2018

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By: Patrice J. Persad, PhD

Species Conservation

Massive Eradication Effort Ends Rodents’ Reign Of Terror On Forbidding Isle

In an era when biotechnologies, such as gene drives and in-vitro fertilization, pulsate as pending alternate strategies for species conservation, two seemingly outdated tactics emerge victoriously: man power and canine power. Because of collaborations, for almost ten years, between the South Georgia Heritage Trust (SGHT) and Friends of South Georgia Island, the South Georgia pipit, a native avian species, regained habitat from plaguing invaders—rodents, predators of both chicks and adult birds. After scaling approximately 1,500 miles (area of 400 square meters) of the South Atlantic island’s icy, merciless terrain, “a blessing incognito,” conservation project human members and three dogs, expert ”rodent sniffers,” confirmed the region to be absent of rats and mice. This is giving the South Georgia pipit something to merrily sing about.

How exactly did the 200-year dynasty of the rodent collapse on South Georgia Island? With helicopters furnished by the Friends of South Georgia Island, an American-headquartered organization, pilots circulated poison targeted to the invasive species. Geographical barriers also trapped the whiskery mammals; Goliath-sized glaciers stalled rodents from scurrying to and populating other places on the island. Project members two years later then positioned low-tech chewy apparatuses smothered with tantalizing bait—sticky substances like vegetable oil and sweet peanut butter. These served as checks to record any remaining rodents; any captured teeth impressions signaled rodent infestation. The trinity of dogs, Will, Ahu, and Wai, roamed with their handlers and sniffed amongst the other native wildlife—elephant seals, penguins, and fur seals—while on their quest to determine the deadly invaders’ survival. Fortunately, the rats were history, and this event marked the conservation efforts as successes.

Where one chapter ends, another starts. This characterizes the neverending book of conservation. To permanently keep rodents off the island, the SGHT prudently enforces safeguards. Travellers to South Georgia face examination of their persons and belongings. International governmental officials transfer these individuals to land on miniature vessels from major sea vessels. This is to permit ease of keeping eyes (and canine noses) on any vagabond rats and mice since the vessel area to hide decreases.

As human beings (and dogs) work to restore South Georgia pipits’—and other seabirds’—home into their wings, hope awashes and renews the wildlife conservation front. Given that the triumphant primary actors, the SGHT and Friends of the South Georgia Island, are non-profit organizations, this shows that federal agencies or other government institutes may not be the only ones to fly to species’ rescue. With funding, proper planning, perseverance, and global cooperation [in this case, various networks spanning the United Kingdom (primarily Scotland, the SGHT’s location), the United States, New Zealand, and South Georgia], the inconceivable transforms to the imminent. As Professor Mike Richardson of SGHT envisions, the win over the rodents in South Georgia will inspire others—yes, even “mere” citizens—to take a stand in protecting both native species and their habitats across the hemisphere.

(Colin Dwyer, National Public Radio)

Environment

Air pollution inequality widens between rich and poor nations

Injustice again accompanies the impoverished throughout the world. According to the World Health Organization (WHO), poor air quality (more air pollutants) equals poor health, with the highest percentage (45%) of pollution-linked deaths (total worldwide: 7 million) corresponding to chronic obstructive pulmonary disease. 25% of these deaths corresponded to stroke, the second global leading cause of death. An interactive map of related air pollution annual mean measurements [micrograms of particulate matter (less than 2.5 micrometers in diameter) per cubic meter—PM2.5] highlights Southeast Asian, African, and Middle Eastern lower-income regions with the greatest numbers (PM2.5 > 70 micrograms per cubic meter). Individual cities with monstrous PM10 peaks (micrograms of particulate matter less than 10 micrometers in diameter per cubic meter) include Delhi (292), Cairo (284), Dhaka (104), and Mumbai (104). North America, specifically the United States and Canada, on the other hand, overall inhaled better air quality (PM2.5 < 10 micrograms per cubic meter).

When comparing rich areas to poor areas, what accounts for the disparate distributions of air pollution? In economically struggling communities, dwellers can only purchase cheap means of creating fire or generating heat for cooking and other everyday uses: coal, wood, or kerosene. Governmental policy setting standards and restrictions on PM10 and PM2.5 levels impacts air quality, too, such as the United States’ long-standing Clean Air Act and China’s recent air pollution regulations. However, despite high-income countries’ regulations and air quality management, these dominions, too, are not immune to miasma; well-to-do cities, such as Manchester and London, fail to fall under the WHO recommended PM2.5 threshold (10 micrograms per cubic meter). Thus, existing acts must be evaluated for shortcomings and amended, if not rewritten, for improvements. Jenny Bates, a Friends of the Earth member, suggests championing more research. Studies on air pollution levels during periods/intervals and effects of certain practices on these levels pave the trail for effective policy measures. Research will also uncover pollutant levels in countries—mainly those in Africa—currently missing these data.

(Jonathan Watts, The Guardian)

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May 22, 2018 at 8:02 pm

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Science Policy Around the Web – May 18, 2018

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By: Patrick Wright, Ph.D

Suicide Prevention

Gaps Remain in U.S. State Policies on Suicide Prevention Training

Suicide is the 10th leading cause of death in the United States, with 45,000 people dying by suicide in 2016 according to the Centers for Disease Control and Prevention. Despite this, there is not a universal requirement or standard of suicide prevention training across states, especially among healthcare professionals, according to a recent study in the American Journal of Public Health (AJPH) that aimed to assess the effectiveness of national guidelines by the U.S. Surgeon General and National Action Alliance for Suicide Prevention released in 2012. Given the proximity and dynamic at the healthcare professional-patient interface, clinicians and mental health experts are in a unique, critical position to explicitly tackle suicide in at-risk individuals. As of October 2017, all 50 states had a suicide prevention plan, but only 10 states—California, Indiana, Kentucky, Nevada, New Hampshire, Pennsylvania, Tennessee, Utah, Washington, and West Virginia—require healthcare professionals to complete suicide prevention training and intervene with appropriate intervention. Policies in seven states only encourage training, but do not require it. Even the duration and frequency of training varies extensively.

Jane Pearson, chair of the National Health Suicide Research Consortium, stated “When there’s someone in crisis you have to gather information very quickly and if you’re not asking the exact right questions you can miss someone’s intentions. The most pressing goal is to increase the person’s will to live so it’s greater than their will to die and buy time to get past the crisis, so they have a chance to work on problem solving.” Earlier work has shown that a majority of people who attempt suicide have seen a healthcare professional in the weeks and months prior to their suicide attempt, emphasizing the significance of potential opportunity in these healthcare professional-patient interactions.

The 2012 National Strategy for Suicide Prevention created by the Office of the U.S. Surgeon General and the National Action Alliance for Suicide Prevention outlined four strategic directions, including creating “supportive environments that will promote the general health of the population and reduce the risk for suicidal behaviors and related problems”, developing and implementing clinical and community-based preventive programs, providing treatment and care for high-risk patients, and surveying and evaluating suicide and its prevention nationwide.

Washington was the first state to mandate suicide assessment, treatment, and management training for healthcare providers, through the Matt Adler Suicide Assessment, Treatment, and Management Act of 2012 (House Bill 2366), with the state defining suicide assessment, treatment, and management training as one “of at least six hours in length that is listed on the Best Practices Registry of the American Foundation for Suicide Prevention and the Suicide Prevention Resource Center including, but not limited to: Applied suicide intervention skills training; assessment and management of suicide risk; recognizing and responding to suicide risk; or question, persuade, respond, and treat.”

The AJPH study poses that ensuring that suicide prevention training is disseminated universally among health care professionals is not limited only to legislation; accrediting bodies (e.g. American Psychological Association) share this burden in guaranteeing that graduates are prepared to identify and aid patients who may be at risk for suicide. The study concludes, “Better equipping health care professionals to assess and provide care to patients at risk for suicide may contribute to a meaningful decline in the rate of suicide across the nation, and it is the responsibility of policymakers, health care professionals, and citizens to advocate change.”

(Cheryl Platzman Weinstock, Reuters)

Animal Welfare

Animal Tests Surge Under New U.S. Chemical Safety Law

The Frank R. Lautenberg Chemical Safety for the 21st Century Act of 2016 (H.R. 2576) amended the 1976 Toxic Substances Control Act (TSCA) (S. 3149), the primary chemicals management law in the United States, to require the Environmental Protection Agency (EPA) to “minimize, to the extent practicable, the use of vertebrate animals in testing chemicals” and states “Any person who voluntarily develops information under TSCA must first attempt to develop the information by an alternative or nonanimal test method or testing strategy before conducting new animal testing.” It required the EPA to explicitly develop a strategic plan to promote the development and implementation of alternative test methods that do not require the use of animals. However, despite the goals of the Lautenberg Chemical Safety Act, there has reportedly been a recent increase in the number of animal tests and requested or required by the EPA.

In March 2018, the EPA released a draft of its strategic plan for public comment of their proposed long-term strategy for increasing the use of animal research alternatives, including computer modeling, biochemistry, and cell culture approaches. In response, People for the Ethical Treatment of Animals (PETA) and the Physicians Committee for Responsible Medicine (PCRM) quantified the number of EPA, TSCA-related animal tests and animals used over the last three years. They found that the number of animal tests requested or required by the EPA increased substantially last year, with the total number of tests and animals involved in testing jumping more than an order magnitude, from approximately 6500 across 37 rests required or requested to over 75000 animals across 331 tests. They issued a response letter, stating “The dramatic increase we have documented indicates that EPA is failing to balance its responsibilities to determine whether chemicals present unreasonable risks with its Congressional mandate to reduce and replace the use of vertebrate animals in chemical testing.”

Unfortunately, the underlying cause for this trend is not known. It is possible that the Lautenberg Chemical Safety Act’s stricter requirements on a larger range of chemicals compared to the original TSCA may be driving additional testing and subsequent data collection in order to comply. Moreover, Kristie Sullivan, PCRM’s vice president of research policy, said that EPA staff may need more training and funding of animal research-alternatives and “to stay abreast of new developments in toxicology, so that they can quickly incorporate new methods and kinds of data into their decision-making process.”

In contrast, implementation may be slow due to the EPA’s need to adequately pursue alternatives while adapting to the new law. Daniel Rosenberg, an attorney with the Natural Resources Defense Council, emphasized the importance of taking whatever time is necessary to validate alternative testing strategies: “We need to ensure that the alternative testing methods that are implemented are able to actually identify toxicity, exposure and potential adverse effects of chemicals.”

The comment period on EPA’s draft strategy for reducing animal tests closed earlier this month, with the agency required to release its final plan by the end of June 2018.

(Vanessa Zainzinger, Science)

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May 22, 2018 at 7:31 pm