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Science Policy Around the Web – May 5, 2015

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By: Amy L. Kullas, Ph.D.

Global Health

Antibiotic Resistance: Combating Deadly ‘Superbugs’ Weak In Most Countries, World Health Organization Report Says

According the the World Health Organization (WHO)’s recent report, most countries are still failing to address the serious issue of antibiotic misuse, and are ill-prepared for the resulting increase in drug resistant microbes, allowing previously-treatable diseases to become killers. This statement was delivered approximately a year after the organization released its first global report on antibiotic resistance, which should have sounded an emergency alarm to the world, but essentially went unheard or ignored. At that time, Charles Penn, WHO coordinator on antimicrobial resistance, had this warning for reporters: “We will lose the ability to treat a range of serious conditions such as blood stream infections, pneumonia, tuberculosis, malaria, and HIV, and the benefits of advance medical treatment, such as cancer chemotherapy and major surgery will also become much riskier and may well be lost.”

For the current report, a only dismal 34 of the 133 countries that even responded to the WHO survey, currently have comprehensive national plans to combat resistance to antibiotics and other antimicrobial medicines. Counterfeit and low-quality drugs plague many regions of the globe, “resulting in sub-optimal dosing.” Additionally, many countries do not have standard treatment guidelines, which may allow the overuse and over-consumption of drugs. As a result, the WHO has drafted a Global Action Plan for addressing antimicrobial resistance and plans to ask all 193 member states to approve the plan at the next World Health Assembly, being held in Geneva, Switzerland later this month. By approving the plan, the countries will agree to develop their own national plans over the next two years and hopefully try to stem the tide of antimicrobial resistance. (Elizabeth Whitman, International Business Times)

Climate change policy

Analysis: In boosting climate goals, California daring others to follow

Californian governor, Jerry Brown, took action for climate change policy by issuing an executive order on April 29th requiring the state to reduce greenhouse gas emissions by 40% of the 1990 level by 2030. This level is consistent with scientifically established levels needed in the United States to limit global warming below 2oC, the threshold implicated for “major climate disruptions,” such as rising sea levels, changes in the ocean currents or extensive droughts. Governor Brown stated, “With this order, California sets a very high bar for itself and other states and nations, but it’s one that must be reached-for this generation and generations to come.” Californians usage of renewable resources, such as LED lighting and electric and hydrogen fuel cell cars, will have to leap from the current “25% to at least 50%” while halving their oil consumption. Further, Dan Kammen, an energy professor at the University of California-Berkeley, has estimated “$27 billion of venture capital and other financing has flowed into California clean technology companies since 2006” and almost 460,000 payroll positions have been generated in the past year. California’s effort will be successful on a global level only if other states and nations make set similar goals for themselves. (Marianne Lavelle, ScienceInsider; Adrienne Alvord, The Equation)

Gender equality in science

‘Sexist’ peer review causes storm online

Controversy has erupted after comments made by a reviewer for the journal PLOS ONE about a manuscript submitted by two female researchers were made public last week on Twitter. The reviewer felt that “one or two male biologists” co-authors would improve the manuscript written by the two female researchers to verify that data were interpreted appropriately and to “serve as a possible (fact)check.” The anonymous peer reviewer further stated that men have “better health and stamina” which may contribute to why men publish in higher impact journals and more successful in the highest jobs in science.

Dr. Fiona Ingleby, a postdoctoral fellow in evolution, behavior, and environment at the University of Sussex in the United Kingdom, tweeted sections of the letter that she and her co-author, Dr. Megan Head, received after rejection of their manuscript. The manuscript highlights the progression of Ph.D. graduates in the life sciences to postdoctoral positions and “found that men finished their PhDs with more other-author papers than women, but no difference in number of first-author publications.” According to Dr. Ingleby, “the reviewer acknowledged that they had looked up our websites prior to reading the manuscript” suggesting that the reviewer may not have been an unbiased referee.

As a result, PLOS ONE has requested the editor involved in the situation to step down from the editorial board and removed the anonymous reviewer from the database. Furthermore, the journal “sincerely apologize(s) for the distress the report caused the authors, and …completely oppose(s) the sentiments it expressed.” This incident highlights that while women in science have made significant strides towards gender-equality, more still needs to be accomplished. (Holly Else, Times Higher Education; Rachel Bernstein, ScienceInsider)

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May 5, 2015 at 9:00 am

Science Policy Around the Web – May 1, 2015

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By: Rebecca A. Meseroll, Ph.D.

photo credit: Colours via pixabay

Consumer Safety Regulations

Senators seeks increased FDA oversight for personal care products and cosmetics

Despite the ubiquity of personal care products and cosmetics, federal regulations of these goods have not changed significantly since the Food, Drug, and Cosmetic Act was passed into law in 1938. A bill introduced by Senators Dianne Feinstein (D- California) and Susan Collins (R- Maine) would give new regulatory oversight of personal care products to the Food and Drug Administration (FDA). Under the current regulations, cosmetics manufacturers are not required to divulge adverse health effects of their products reported to them by consumers and the FDA can only request that manufacturers voluntarily disclose this information to the public. If the bill becomes a law, companies would be required to report serious adverse health effects of products, such as death, disfigurement, and hospitalization, to the FDA within 15 days of notification by the consumer. Less severe health effects would need to be reported annually. Furthermore, the bill would require FDA’s yearly evaluation of at least five personal care product ingredients to determine whether the ingredients are safe, to what concentration they are safe, and whether they should have consumer warnings. Some of the proposed ingredients on the list for the first round of evaluations are propylparaben, a preservative in many products including shampoos and lotions, an estrogen-mimicking compound which can act as an endocrine system disruptor, and lead acetate, an additive in hair dyes. In addition to its bipartisan sponsorship, the bill has broad support of several large associations and companies representing the personal care industry, as well as consumer protection groups. (Rachel Abrams, The New York Times)

Federal Research Funding

A call for a doubling of the NIH budget

Health care costs are on the rise, while federal funds for biomedical research have stagnated for more than a decade. Taxpayers already spend upward of a trillion dollars annually on Medicare and Medicaid, but perhaps these costs could be reduced, if cures or preventative measures could be identified for some of the more financially demanding illnesses. Given these observations, former Speaker of the House Newt Gingrich argued last week, in an op-ed published in the New York Times, that Congress should plan double the budget of the National Institutes of Health (NIH), as they previously did between 1998 and 2003. In this article, which he directs particularly toward fiscal conservatives like himself, Gingrich selects Alzheimer’s as a representative disease and describes in detail the skyrocketing financial burdens and human suffering the disease will inflict on the American public if better preventions or cures are not discovered. He contends that there is a great deal of possibility for breakthroughs in treatments and cures for Alzheimer’s and many other diseases, and that increasing NIH funding would be a step in the right direction toward achieving those breakthroughs. Recent discussions in the Senate indicate there is bipartisan support for increasing NIH funding above current levels, although how close it will come to Gingrich’s proposed doubling remains to be seen. There is also history to consider, since the previous NIH budget doubling (and subsequent abrupt end of funds) has lead to some of the problems in federal biomedical research today, such as low grant funding rates and an overabundance of young researchers struggling to get their first grant to even attempt the “breakthroughs” touted by Gringrich. A long-term commitment to sustained funding increases to the NIH could be the best of both worlds. (Newt Gingrich, The New York Times; Peter Sullivan, The Hill)

Lab Animal Rights

Court orders hearing in lab chimpanzee rights case

New York Supreme Court Justice Barbara Jaffe ordered Stony Brook University to appear in court on May 27, 2015 to respond to a petition by the animal rights group, the Nonhuman Rights Project (NhRP), that two evolution research chimpanzees, Hercules and Leo, are being unlawfully detained. NhRP initially filed three lawsuits in 2013 contending that chimps are too cognitively advanced to be kept captive lawfully, and ought to be moved from the lab to a chimpanzee sanctuary. NhRP’s legal strategy has been to petition the courts with a writ of habeas corpus, which is traditionally used to challenge human imprisonment. Prior to the current court order, which was issued in appeals, the lawsuits have been struck down, as the courts stated that the writ of habeas corpus does not apply to the chimps because they are not legal persons. Even the current court order has been amended to strike the writ of habeas corpus, indicating that the court has not granted personhood to the chimps. The upcoming hearing will determine whether Hercules and Leo are being unlawfully detained, and ScienceInsider reports that NhRP has plans to continue to petition for the release of other animals on the basis of personhood, regardless of the outcome of this case. (David Grimm, ScienceInsider)

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May 1, 2015 at 9:00 am

Science Policy Around the Web – April 28, 2015

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By: Sylvina Raver, Ph.D.

Biotechnology and Bioethics

Scientists edit the genome in human embryos for the first time

Scientists now have access to technologies that allow them to edit DNA sequences in human tissue with relative ease. As has been discussed in detail previously, the safety and ethical considerations of permanently altering the human genome are considerable. Genetic modifications, however well intentioned, may be unsafe and result in unintended consequences in the embryo. And because these alterations can be passed on to subsequent generations of people, the far-reaching effects are substantial as well. In light of the many concerns raised by these technological advances, the scientific community has been nearly unanimous in calling for a temporary moratorium on genetic engineering in human embryos until the technical, safety, and bioethical concerns can be more fully understood. However, not all scientists are adhering to this temporary ban. This week a team of researchers at Sun Yat-sen University in Guangzhou, China published a report in the online journal Protein & Cell describing how they were able to successfully modify the genetic code in human embryos. The scientists, led by Dr. Junjiu Huang, performed experiments in non-viable human embryos using the CRISPR-Cas9 technology to modify a gene called HBB, mutations of which can lead to the fatal blood disorder beta-thalassemia. The scientists found that the rate of successful editing was quite low; only 28 of the 86 very early embryos studied demonstrated successful repair of the HBB gene. In addition to the relatively low efficacy of this technique, the paper also reported that embryos contained multiple unintended changes to their DNA. The authors state that their results highlight the need to improve the fidelity and efficacy of the CRISPR-Cas9 platform if it is to be applied in clinical settings in the future. Despite these qualifications, responses to the report by the international scientific community have been swift and mostly critical. Many scientists and watchdog groups argue that these experiments underscore the need for a moratorium on germline gene modification. However, other prominent voices in the bioethical and stem cell communities praise the value of basic research aimed at improving genetic engineering methods. A wave of similar research reports may be on the horizon as multiple Chinese research teams are rumored to be conducting ongoing experiments to edit the genome of human embryos. (David Cyranoski & Sara Reardon, Nature; Rob Stein, NPR; Jocelyn Kaiser & Dennis Normile, ScienceInsider)

Public Health

Contraceptive implants could decrease the rate of unplanned teenage pregnancies in the US

The rate of unplanned pregnancies in the United States is nearly 50%, and since 2001 the US made no substantial progress toward reduce this number. In teenage women between the ages of 15-19, the rate of unintended pregnancy is nearly seven times higher than in countries like Switzerland or the Netherlands. Many of these pregnancies could be averted through more widespread use of highly effective forms of birth control, including hormonal implants (miniature plastic rods inserted under the skin) or intrauterine devices (IUDs). The failure rate for these forms of contraception is only about 0.2%, which is remarkably lower than those for more commonly used methods like the pill (9%) or condoms (18%). Furthermore, because implants and IUDs are inserted and then remain stable for multiple years, they remove the need for women to remember to take a daily pill, or to rely on her partner to use a condom. Long-term contraception essentially changes the default, so that instead of actively preventing pregnancy, women can instead consciously decide when to conceive. Yet despite these clear advantages, only 7% of American teenage women use implants or IUDs, compared to nearly 40% of women in China. A primary reason for the limited use may be lack of information. A recent survey by the National Campaign to Prevent Teen and Unplanned Pregnancy found that nearly 77% of American women knew “little to nothing” about implantable birth control. Misconceptions about the safety and efficacy of these devices are also prevalent, possibly due to a lingering collective memory of a defective IUD that caused infections in some women and was removed from the market in the 1970’s. However, a lack of adequate information concerning implants does not lie solely with patients. Despite guidelines that require medical providers to recommend implants and IUDs as the “first-line” method of birth control for teenagers, many practitioners are not trained to insert these devices or worry that they are not suitable for teenagers. Medical providers, including pediatricians, who many teenagers first approach for birth control, must be reminded of the benefits of recommending IUDs and implants, and must be trained to properly insert and remove these devices. Increased promotion of IUDs and implants by public health agencies is also warranted. States that have increased the prevalence of these devices have seen both their birth rates and abortion rates fall dramatically among teens, particularly those in lower socioeconomic brackets. (The Economist)

Natural Disasters

Major earthquake devastates Nepal, may herald more Himalayan tremors

A 7.8 magnitude earthquake struck late in the morning of Saturday April 25, 2015 and has devastated a large portion of central Nepal, including the capital city of Kathmandu and the mountaineering destination of Mount Everest. At least 3,800 people are dead in what may prove to be one of the most deadly natural disasters to strike the Himalayas in years. Sadly, an earthquake of this magnitude was not unexpected, as the tectonic plates underneath Nepal have been close to the breaking point for centuries. The same geological forces that cause the Himalayan Mountains to reach such towering heights cause this region to be one of the most seismically active in the world. While seismic events are not unexpected in Nepal, the socioeconomic situations of many Nepalese citizens, combined with a rapid rate of urbanization, contribute to the devastation wrought by the April 25th quake. Much of the older infrastructure in villages and cities like Kathmandu has not been upgraded to withstand earthquakes. And as the country becomes more urbanized, new construction that lacks structural reinforcement often occurs hastily in dense and impoverished neighborhoods. Earthquake recovery, rather than prevention, will likely dominate Nepal for the foreseeable future. While the April 25 quake released much of the strain accumulating within the faults in the region, many experts feel that this earthquake was not sufficient to relieve all of the building pressure, and predict more than 30 aftershocks greater than magnitude 5 in the coming weeks. (Matt Schiavenza, The Atlantic; Alexandra Witze, Nature; Priyanka Pulla, ScienceInsider)

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April 28, 2015 at 9:00 am

Science Policy Around the Web – April 24, 2015

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By: Danielle Friend, PhD

photo credit: DSC03602.JPG via photopin (license)

Genetic-based Drug Discovery

23andMe will invent drugs using customer data

As of March 2015, 23andMe will no longer simply be known for direct-to-consumer genetic tests. 23andMe has now made progress toward their long-term goal of influencing drug discovery. 23andMe claims to have collected DNA from approximately 850,000 consumers through marketing of their $99 kit, and the company plans to use this genetic information to identify new drug targets. Additionally, 23andMe reports that approximately 80% of the consumers that purchase the kits have agreed to allow 23andMe to use their genetic information for this research. To help lead these discovery efforts, 23andMe recently hired Richard Scheller, who formerly lead research and development at Genetech, as the chief scientific director and head of operations. In addition to these in-house efforts, 23andMe has also recently formed partnerships with pharmaceutical companies, including both Pfizer and Genetech who plan to use the genetic information to develop drugs for diseases like Parkinson’s disease. Although the partnerships with companies like Pfizer and Genetech are clearly defined to help identify drug targets for particular diseases, 23andMe plans to organize their in-house research as a broad sweep through their databases without a particular disease in mind. However, 23andMe has mentioned that they have a particular interest in metabolic and immune system disorders, eye disease, and cancer. (Mathew Harper, Forbes; Ron Winslow, Wall Street Journal)

Transparency in Clinical Trial Data

World Health Organization calls for increased transparency in clinical trials

In mid-April, the World Health Organization (WHO) released a statement recommending that findings from all clinical trials be made public regardless of the results of the study. Dr. Marie-Paule Kieny, the assistant director-general for health systems and innovation with the WHO, stated that the goals of this new mandate are to “…promote the sharing of scientific knowledge in order to advance public health.” Additionally, Dr. Kieny also stated that, “failure to publicly disclose trial results engenders misinformation, leading to skewed priorities for both [research and development] and public health interventions,” and that “it creates indirect costs for public and private entities, including patients themselves, who pay for sub-optimal or harmful treatments.” Several factors may come between completed research and the publication of results. However, unpublished results (even if negative) can lead to the perception that treatments are more or less effective than they are. The WHO mandate requires that results from clinical studies be submitted to peer-reviewed journals within 1 year after the completion of data collection, and that the work should be published within 24 months in an open access journal. The WHO also asks that “key outcomes” — limited details of the study including the number of participants, main findings, and adverse events — be made available online within a year of study completion. Although these new requirements are a step in the right direction for clinical trial transparency, it remains unclear just how the WHO plans to enforce these recommendations. (Chris Whoolston, Nature Research Highlights; Martin Enserink, Science Insider; The World Health Organization)

Ebola Clinical Trials

Lack of patients hampers Ebola drug and vaccine testing

As attention on the Ebola outbreak in Africa has increased, more resources and medical assistance have been provided. Although the number of Ebola cases has significantly decreased due to these interventions, an unexpected troubling scenario has developed: Ebola vaccine clinical trials are now having trouble testing the efficacy of their vaccines due to the lack patient populations. In fact, one company has altogether halted their trial. Chimerix, a company running a trial for their antiviral drug, brincidofovir, has decided to end the trial altogether due to a lack of patients. In fact, the World Health Organization’s weekly report from April 19 states that new cases of Ebola are now down to a total of 33. Because of the dramatic decrease in Ebola cases, the public health community faces ethical issues regarding whether more promising drugs should be prioritized and given preferential access to patients and geographical regions. (Andrew Pollack, The New York Times; Richard Harris, National Public Radio; The World Health Organization; Kai Kupferschmidt, Science)

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April 24, 2015 at 9:00 am

Science Policy Around the Web – April 17, 2015

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By: Cheryl Jacobs Smith, Ph.D.

photo credit: MJ/TR (´・ω・) via photo pin cc

Genomics in Medicine

Personalizing Cancer Treatment With Genetic Tests Can Be Tricky

Since the New Year, President Obama, backed by National Institutes of Health Director, Dr. Francis Collins, has rejuvenated an initiative to use the human genome to make more informed medical decisions in health care. Since the completed endeavor to sequence the human genome was published in 2001, scientists and physicians have used this information to better understand the underlying complexities of human behavior, health, and disease. As a consequence, many areas in medicine use human genetic information as a diagnostic to guide treatment regimens.

More and more oncologists, or cancer doctors, are relying on genetic tests of a patients’ tumor to help guide cancer treatment. However, given the complexity of our genome coupled with our limited understanding of the millions of A, T, C, and G’s encoding our genetic information, oftentimes much of the information generated from genetic tests can be ambiguous. Researchers writing in Science Translational Medicine say there is a way to make these tests more meaningful.

One of the main issues with genetic testing of tumors is that they harbor mutations and it is unclear which mutation is the key to killing the cancer cell, thus, making a therapeutic decision difficult. In this regard, the researchers suggest not only conducting genetic tests on the cancer of the patient, but also conducting genetic tests on healthy, normal tissue of the patient. In this way, physicians and researchers can detect cancer-specific mutations as these mutations would only be present in the cancer, but not the normal, healthy tissue.

This is not to say that current genetic tests conducted on cancer are not trustworthy. They, indeed, are quite reliable at identifying mutations that are clearly linked to certain cancers. This group asserts that in those cases where this approach does not work, that additional sequencing of the normal, healthy tissue as a means of comparison may help improve the diagnostic quality of those tumors that produce ambiguous results. The future of cancer diagnostics is a booming, changing, field and much is to remain to be seen in regards to consistency of tactic used. (Richard Harris, NPR)

Federal Research Funding

Controversy awaits as House Republicans roll out long-awaited bill to revamp U.S. research policy

The America Creating Opportunities to Meaningfully Promote Excellence in Technology, Education, and Science Act of 2007, or America COMPETES Act, was signed by President Bush in 2007 and it became law on August 9, 2007. The COMPETES Act sets funding targets for select physical science agencies: the National Science Foundation (NSF), the National Institute of Standards and Technology (NIST), and two offices with the Department of Energy (DOE): the Office of Science, and the Advanced Research Projects Agency-Energy, or ARPA-E.

Authored by the panel’s chair, Representative Lamar Smith (R–TX), there are provisions to the reauthorization act that scientists are likely to find interesting.

  • NSF spending: The bill would authorize $126 million less than President Obama requested but $253 more than NSF’s current budget. It relocates NSF’s budget to the natural sciences and engineering at the expense of the geosciences and the social and behavioral sciences. To add injury to insult, additional cuts from the geosciences and the social and behavioral sciences are expected.
  • DOE R&D: At least in 2016, the bill funds most Office of Science programs but the budget remains flat in 2017. Cuts will occur in the more applied renewable energy programs and new energy technologies. Interestingly, funding will boost in the areas on fossil and nuclear energy.
  • Peer review: Since Smith became chair in 2013, this has been a major area of debate regarding how NSF reviews the 50,000 or so requests for funding it receives from scientists every year. Apparently Smith and the NSF Director, France Córdova, have agreed upon legislation that will not “[…]alter[ing] the Foundation’s intellectual merit or broader impacts criteria for evaluating grant applications.”
  • NSF’s portfolio: This section of the bill gives NSF the responsibility “to evaluate scientific research programs undertaken by [other] agencies of the federal government.” This language apparently wants NSF to judge other research agencies about how they are facilitating their research programs. This is quite an awkward and broad demand. It still remains to be seen how this will play out.
  • Large new facilities: This section of the bill tries to rein in “wasteful spending” by requiring the NSF to correct any problems identified by an independent audit on a project’s expected cost before starting construction. However, the bill also restricts spending from contingency funds “[…] to those occurrences that are foreseeable with certainty … and supported by verifiable cost data.” This is interesting language given the need of a contingency fund is to fund unexpected occurrences.
  • Administrative burden: This part of the bill supports reducing administrative oversight in the form of government oversight and regulations. The bill argues that administrative costs are high and costly and these monies could be used to fund research. Instead, the bill will have the White House science advisor convene an inter-agency panel.
  • NIST: The bill increases NIST’s budget; however, falls short of President Obama’s request.

The good news is that the COMPETES bill has finally been reauthorized. However, controversy awaits as to the effectiveness of the reauthorized bill. (Jeffrey Mervis and David Malakoff, ScienceInsider)

Climate Policy

Climate change: Embed the social sciences in climate policy

The Intergovernmental Panel on Climate Change (IPCC) needs to broaden its perspective by adding more social scientists. The organization is akin to a moth to a flame— focusing attention on a well-lit pool of the brightest climate science. But the insights that matter are not readily viewed and are far from the bright light of the debate. The IPCC has involved only a narrow slice of social-sciences disciplines: economics. The other social sciences were mostly absent. Bringing the broader social sciences into the IPCC may prove challenging, but it is achievable if they adapt a strategy that reflects how the fields are organized and which policy-relevant questions these disciplines know well. The IPCC has proved to be important. But presently, it is too narrow and must not monopolize climate assessment. In the future, reforming the organization will benefit the conversation surrounding climate change greatly and move contentious work into other forums. (David Victor, Nature)

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April 17, 2015 at 9:00 am

Science Policy Around the Web – April 14, 2015

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By: Elisavet Serti, Ph.D.

Ebola and Public Health

After Ebola devastation, a measles outbreak threatens West Africa

A second health crisis, after the most widespread Ebola epidemic in history, is threatening thousands of people in West Africa. The Ebola crisis has devastated public health systems and, as a result, has slowed down measles immunizations, a viral lethal disease that could affect the region even worse than Ebola. Even before Ebola hit, only an estimated 62% to 79% of children were vaccinated against measles in Liberia, Guinea, and Sierra in 2012 and 2013, according to the Demographic and Health Surveys — and that was with only one dose of the vaccine. Because the virus is so exquisitely transmissible, 95% of the population must be protected with two doses of vaccine to stop measles. “The secondary effects of Ebola are likely to be as bad as or worse than the direct effects,” says epidemiologist Justin Lessler of Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, who with his collaborators warned about a potential post-Ebola measles outbreak.

The symptoms of measles generally appear about seven to 14 days after a person is infected and include fever, runny nose, cough, red eyes, and sore throat, followed by a rash that spreads over the body. The measles virus is highly contagious and spreads through the air through coughing and sneezing. Common measles complications include ear infections and diarrhea but some people may suffer from severe complications, such as pneumonia and encephalitis that could be lethal. In the United States, as many as one out of every 20 children with measles gets pneumonia, the most common cause of death from measles in young children. Encephalitis is less common (1 out every 1000 children), which can leave the child deaf, or with intellectual disability. Measles is characterized as one of the most contagious viruses on Earth — five to 10 times more infectious than Ebola — and is among the first diseases to erupt in the wake of a disaster. In humanitarian crises in poor countries, it can kill up to 20% of those infected; usually those weakened by malnutrition and vitamin A deficiency.

Dr. Lessler and his collaborators estimated in a new study that a regional post-Ebola measles epidemic would strike roughly twice as many people as a pre-Ebola epidemic; an estimated 227,000 of infections compared with 127,000, and cause 2000 to 16,000 additional deaths. At the high end, the death toll could exceed the nearly 10,000 people killed by Ebola to date. However, nearly all of those deaths could be avoided by effective mass vaccination campaigns. That is why Liberia, with help from Centers for Disease Control and other international partners, is trying to launch a measles campaign as early as May that will target all children between 9 months and 5 years of age. Sierra Leone and Guinea are still affected by the Ebola disease so planning for measles vaccination is not considered a priority for the time being. (Leslie Roberts, Science)

Federal Biomedical Research

National Cancer Institute Director steps down

Harold E. Varmus, the Nobel Prize winner cancer biologist who has led the the National Cancer Institute (NCI) at the National Institutes of Health for nearly five years, stepped down from his post on March 31st. Dr. Varmus was co-recipient of the 1989 Nobel Prize for Physiology or Medicine for research into the cellular origins of cancer while conducting research at the University of California, San Francisco, where he joined the faculty in 1971. He was director of the entire NIH under President Bill Clinton from 1993 to 1999. Dr. Collins, the current NIH director, praised Dr. Varmus as being gifted with “unparalleled expertise.”

In his farewell letter to NCI staff, Dr. Varmus stressed the advances in oncology that NCI researchers led during his time as the NCI director in spite of the congressionally imposed budget cuts and budget sequestration that his institute and the entire NIH have had to endure in recent years. He wrote that his years at NCI “have not been easy ones for managing this large enterprise” and that “we have endured losses in real as well as adjusted dollars, survived the threats and reality of government shutdowns and have not yet recovered all the funds that sequestration has taken away.” He noted a range of scientific breakthroughs that have stemmed in part from NCI investments in recent years, from more widespread use of the HPV vaccine to greater acceptance of imaging tests in heavy smokers to pinpoint lung cancer, based on an NCI trial.

Dr. Varmus plans to return to New York and will head a laboratory in the Meyer Cancer Center at Weill-Cornell Medical College and also work with the New York Genome Center. Dr. Douglas Lowy, currently deputy director of the NCI and a researcher whose work led to development of the HPV vaccine to prevent cervical cancer, will become acting director April 1. (Thomas M Burton, Wall Street Journal)

Emergency Medicine Response

Having a companion is associated with faster treatment of stroke victims

The human element is much more significant in emergency medicine than initially believed by researchers. Dr. Gal Ifergane, a neurologist at Soroka University Medical Centre in southern Israel recently published in Medicine a striking story about the positive impact that relatives and friends have in the care and treatment of stroke victims when they accompany them to the ER. The most common stroke involves a clot blocking blood vessels in the brain, which causes almost immediate brain cell death because of the absence of oxygen transport. Thrombolytic therapy is very effective and uses drugs to dissolve the clot and restore the flow of blood. If started within a couple of hours of a stroke occurring, it can limit brain damage and reduce long-term disability. Time is a matter of life and death for these patients. Another key step is using a computed tomography (CT) scanner to ensure that there has been no bleeding in the brain, in which case thrombolytic drugs would cause excessive bleeding and would probably be lethal for the patient. In order to reduce the time to CT scan and correct treatment, paramedics have been trained to recognize strokes and warn hospitals in advance so that the medical team prepares accordingly.

Evidence for the significance of the human element in this case of emergency medicine came from 15 months of observation at Soroka Medical Center, where the ER staff recorded the number of companions escorting each stroke sufferer (over 700 in all) and monitored their progress. The results of this study showed that stroke victims arriving with someone were more than twice as likely to be correctly diagnosed by the triage nurse, and had their CT scans performed earlier. Patients eligible for thrombolytic medication also received treatment much faster if accompanied; although the patient sample was too small for the researchers to be sure it was because they had relatives or friends bringing them into the ER. The differences between the two groups cannot go unnoticed; patients with one companion had CT scans an average of 15 minutes sooner than those unaccompanied. A second companion reduced this time wait 20 minutes more; however, three or more companions did not confer any additional benefit. Dr. Ifergane believes that this is probably a combination of focusing the attention of clinical staff on their loved ones, and providing basic care when they initially arrive at the hospital. (The Economist)

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Written by sciencepolicyforall

April 14, 2015 at 11:36 am

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