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Science Policy Around the Web – April 12, 2019

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By: Saurav Seshadri, PhD

Photo by Elijah Hiett on Unsplash

With Vertex, NHS back at the pricing table, CF advocates ratchet up the pressure

petition demanding coverage of the cystic fibrosis (CF) drug Orkambi in the UK has now garnered over 100,000 signatures, and must therefore be considered by Parliament for debate.  The milestone is the latest development in the struggle between Orkambi maker Vertex Pharmaceuticals and the British government, which began soon after Orkambi was approved in 2015.  The main point of contention is the price of the drug.  The UK’s National Institute for Health and Care Excellence (NICE) has refused to recommend Orkambi at Vertex’s asking price of £104,000 ($136,000) per patient per year, but Vertex has rejected the UK’s offer of £500 million for 5 years’ access, leaving both parties at an impasse.

The UK is not the first country to clash with Vertex over pricing. Several health agencies have refused to pay for Orkambi on the grounds that it is only marginally effective; some now face lawsuits, as programs like Medicaid are required to provide available drugs for qualifying patients.  While Orkambi is not as effective as Vertex’s first drug Kalydeco, it can be prescribed to more patients (up to 50% of those with CF).  Life expectancy for patients with CF is less than 40 years, and many patients are children, so even small improvements can be life-changing.  However, as with the multiple sclerosis drug Ocrevus, NICE seems unlikely to relent; on the contrary, UK Health Minister Matt Hancock recently accused Vertex of ‘hold[ing] the NHS to ransom’ and ‘profiteering’.  

For its part, Vertex is unlikely to compromise on the price of its best-selling drug, which brought in $1.26 billion in 2018.  CEO Jeffrey Leiden insists that this revenue is critical to the company’s continued investment in CF research.  Ironically, this stance may be pushing the UK closer to a measure that would jeopardize all future medical R&D efforts: invoking ‘Crown’ use, which allows the government to sell a patent without the consent of its owner. While the idea has gained support among some British lawmakers, and has been used in the past (to make Pfizer-owned antibiotic tetracycline available in the 1960s), it would face legal challenges that could render it ineffective.  But with public pressure mounting, especially after Vertex recently admitted to destroying almost 8,000 packs of Orkambi amid the standoff, inaction may not be an option for much longer.

(Eric Sagonowsky, FiercePharma)


Why some low-income neighborhoods are better than others

A recent study, published in PNAS, builds upon a body of evidence that while race can influence upward mobility (with white children having a 4-fold higher chance of moving from the lowest to highest income brackets than their black peers), environmental factors also play a major role.  Previous work demonstrated that the neighborhood in which a child grows up has a large effect on their future success, with better outcomes for children raised in low-poverty neighborhoods, regardless of race.  However, black children are significantly less likely to live in such neighborhoods.  To combat racial inequality, it is critical to understand which aspects of poverty impact long-term socioeconomic progress. 

The new study is based on the Opportunity Atlas, and pulls together data from tax returns, Census surveys, police reports, prison admission records, and blood tests conducted by the health department. The data tracks a cohort of children born in 1978-1983 (age 31-37 in 2014), living in 754 Census tracts in Chicago.  The authors report that even after controlling for other variables, a large proportion of the racial disparity observed in adults can be explained by three factors: violence, incarceration, and lead exposure during adolescence.  Since these factors were highly correlated with each other, the authors combined them into a single ‘neighborhood harshness/toxicity’ factor; this variable proved to be a much stronger predictor of income, incarceration, and teen pregnancy than more traditional factors, such as poverty or college education rates.   

That these elements impair social mobility is perhaps not surprising, as exposure to both violence in the community and high levels of lead have both been linked to cognitive impairment. But the magnitude of the effect is striking: for example, according to their model, toxicity exposure could account for 60% of the difference in incarceration rates between black and white men in their sample, and a 10% increase in teen births among black women.  While the authors acknowledge they cannot establish causality, they conclude that ‘Chicago’s residential segregation is disproportionately exposing its black children to neighborhoods that are hazardous to their development’.  Recently elected mayor Lori Lightfoot ran on a platform that includes stopping violence, expanding affordable housing, and ‘investing in our neighborhoods’.  Insight into the mechanisms that perpetuate inequality can only enhance these policies’ power to improve the trajectories of vulnerable kids.      

(Sujata Gupta, Science News


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April 12, 2019 at 5:21 pm

The worst humanitarian crisis in the world: war, disease outbreaks and famine in Yemen

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By: Silvia Preite, Ph.D.

Source: Wikimedia

War and natural emergencies in low and middle-income countries often result in the weakening of health systems and relaxation of disease surveillance and prevention, leading to increased risk of infectious disease outbreaks. The over four-year civil war in Yemen continues today and, according to the United Nations (UN), has resulted in the worst on-going humanitarian crisis in the world. Hunger and the spread of communicable diseases affects the vast majority of the Yemeni population.

Overview of the ongoing war in Yemen

Before the start of the conflict in 2015, Yemen was already the poorest country in the Middle East, with debilitated health care systems and poor infrastructures. In March 2015, the Houthi movement took over the government in Sana’a (the capital). In response, a Saudi Arabia and United Arab Emirates-led coalition (supported by several other nations including the United States, the United Kingdom and France) started a military intervention in Yemen, with the intention of restoring the Yemeni government. Overall, this conflict resulted in devastation of agriculture, services, and industry in Yemen. Moreover, in more than four years of air strikes, over 50% of Yemeni hospitals, clinics, water treatment plants and sewage have been continuously bombed. The situation is further worsened by restrictions on food and medicines and limited access to fuel, leaving many essential facilities non-functional, including water sanitation centers. These conditions have led to extreme famine and spreading of diseases, including massive cholera outbreaks among the population. 

Cholera outbreaks

Cholera is a bacterial disease leading to severe diarrhea and dehydration, usually caused by the consumption of contaminated water or food. World-wide, an estimated 2.9 million cases and 95,000 deaths occur each year. It has been estimated that cholera has affected more than 1 million people in Yemen, with more than 2000 deaths, becoming the worst cholera outbreak in the world. According to Médecins sans Frontières (MSF) (known in English as Doctors Without Border) and Physicians for Human Rights, hospitals, mobile clinics, ambulances, and cholera treatment centers continue to be bombed, despite the fact that they have been marked as medical centers and the GPS coordinates have been communicated to the Saudi coalition. In addition to cholera, as a consequence of dropping immunization rates, more than 3000 cases of measles have been reported. Cholera and measles can be prevented by vaccinations and proper health infrastructure. Global eradication efforts have been adopted over the years to eliminate these infections, making the spreading of these diseases in Yemen a significant setback. 

Humanitarian violations

The Fourth Geneva Convention concerns the protection of civilians during conflicts, and has been ratified by 196 states, including parties involved and supporting the war in Yemen. The air strikes on medical centers violate the principles of medical neutrality established by the convention that protects hospitals and health care workers from being attacked. Within the standards of this international law, there is also the right of free mobility of medical personnel within a conflict zone. In contrast, during the civil war in Yemen restrictions have been applied by all involved parties on the activity of medical staff, delivery of health care equipment, essential medicines and vaccines. 

Latest UN report on the Yemen crisis

According to the UN, an estimated 24.1 million people (80% of the total population) need assistance and protection in Yemen, and of those, 14.3 million are in acute need (need help to survive). More than 3 million people are currently internally displaced (IDP), living in desperate conditions in Yemen or elsewhere in the region. It is estimated that 20.1 million people need food assistance, 19.7 million people need basic health care services, and 17.8 million people lack potable water, sanitation and hygiene (WASH). 

Children

An estimated 7.4 million children are in need of humanitarian assistance. Severe children’s rights violations are taking place in Yemen, affecting more than 4000 children and including the risk of being armed and recruited in the war for the boys and child marriage for girls. An estimate of 2 million children are deprived of an education, with around 2,000 schools made unusable by air strikes or occupied by IDPs or armed groups. Upwards of 85.000 children under the age of 5 may have died from severe hunger or other diseases. Overall, according to the UN, at least one child dies every ten minutes in Yemen because of diseases that could be normally prevented, hunger and respiratory infections. 

Urgent need for plans and resolutions

Both famine and disease outbreaks are threatening the Yemeni population and their survival currently relies only on international aid. In February 2019, the United Nations and the Governments of Sweden and Switzerland converged in Geneva to face and discuss the “High-Level Pledging Event for the Humanitarian Crisis in Yemen”. The aim of this meeting was to request international support to alleviate the suffering of the Yemeni people, and they requested $4 billion to provide life-saving assistance. Up to now, 6.3% of the requested budget has been funded; it is encouraging to note that last year UN was able to raise almost 100% of what was initially requested through multiple world-wide donations. 

Along with new funding, the OCHA (UN Office for the Coordination of Humanitarian Affairs), argues that urgent action is needed to prevent any exacerbation of the crisis. The most urgent action to resolve this unprecedented, man-made, medical and humanitarian emergency should come from all the parties involved to end the war and allow the re-establishment of food imports and adequate health services.

As the world barely watches, with only intermittent attention given by the international media, the conflicts and emergency remain. Non-profit and humanitarian organizations (UNICEFMSFWFPSave the Children) have greatly aided the Yemeni population, despite challenging operational environments and the import and circulation restrictions. Moreover, when millions of people, including children, die from hunger and preventable diseases every day, the ethical responsibility of this disaster becomes global and concerns all of us. 

Global implications and future perspectives 

The on-going conflict in Yemen, illustrates how the support of research into innovative global-health solutions is highly needed. When the traditional healthcare system has collapsed and human rights are suspended, we need technologies which further support the victims of war-torn countries to achieve basic sanitary and health standards, beside disease monitoring and vaccination strategies.

We live in an increasingly interconnected world where outbreaks of neglected or re-emerging infectious diseases know no boundaries. Therefore, the consequences of conflicts and disasters in low-middle income countries pose a significant global threat and may affect even stable healthcare systems. Proper evaluation of the causes and consequences of infection outbreaks during the Yemeni conflict is therefore critical for two reasons: devise new strategies to more effectively control and prevent the spread in war-torn areas, and proactively encourage and support countries in regions of conflict to take the necessary measures to minimize the risk of similar humanitarian disasters in the future.

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April 11, 2019 at 4:29 pm

Science Policy Around the Web – April 9, 2019

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By: Mohor Sengupta Ph.D.

Image by Sasin Tipchai from Pixabay

Culture of Secrecy Shields Hospitals With Outbreaks of Drug-Resistant Infections

Large hospital settings are thriving spots for drug-resistant infectious organisms. Two recent cases are glaring examples of the problem. A recent report detailed a mysterious and newly discovered germ that was detected in a Brooklyn hospital last year. Doctors identified the culprit to be a fungus, Candida auris, that infects people with compromised immune system. Sooner than a blink in medical timeline, the fungus spread to Venezuela, Spain, South Africa, India and Pakistan. 

The man with the original infection at the Brooklyn hospital died, but the strain ofCandida auris lived on. It was detected in everything he had used and on all items in his hospital room. Recently the fungus showed up in Illinois and New Jersey. 

In January this year, CDC sent out an alert about another disease involving a type of the bacteriumPseudomonasaeruginosa, which is resistant to every known antibiotic. It was discovered at a Tijuana hospital. Multiple patients who had received weight-loss surgery, an invasive procedure, became infected. Several Americans that had traveled to Mexico to get this surgery contracted the indomitable P.aeruginosa infection.

Although the CDC regularly alerts Americans about lapses in medical care elsewhere, it often keeps incidents relating to deadly infections in American hospitals under wraps from public knowledge. 

For example, Klebsiella pneumoniae carbapenemase (KPC)-producing isolates are bacteria of the family Enterobacteriaceae that are resistant to the chemical carbapenem. This strain was first isolated in 2016 from clinical cultures in a small community hospital in rural Kentucky. However, it was not until 2018 that CDC reported the discovery, and the name of the Kentucky hospital has still not been released.

The CDC has claimed in the past that confidentiality is necessary to encourage hospitals to disclose infectious outbreaks to the CDC. Health officials agree that alerting the public about contained infections affecting only a small subgroup of people will create unnecessary panic in the larger population that might not be suitable hosts for the infection in the first place.  

However, that argument fails to contest instances where people died because hospitals did not come clean about an ongoing superbug infection. 11 people died from a contaminated medical scopein Virginia Mason Medical Center in Seattle between 2012 and 2014. 

Measures to pass Federaland state legislaturesin favor of promoting public knowledge about hospital infections have stalled on more than one occasion. 

It is important that drug-resistant infections in the hospital setting are made known to the public. It should be left to their discretion whether they should sign up for the hospital’s services. This knowledge is a fundamental right of the people and denying this knowledge to avoid fear, confusion and panic must be reconsidered.  

(By Andrew Jacobs and Matt Richtel, New York Times)


‘Monkey, Rat and Pig DNA’: How Misinformation Is Driving the Measles Outbreak Among Ultra-Orthodox Jews

“It is our belief that there is no greater threat to public health than vaccines,” says a page tucked inside the “The Vaccine Safety Handbook”, a parenting magazine. 

Over the fall months last year, men visiting New York from the middle east and Europebrought back measles with them, which efficiently spread into communities of orthodox Jewish people, mostly in un-vaccinated children. 

Rockland county is an example of an area of recent intense measles outbreak. Only 72.9 percent of people in the county between the ages of 1 and 18 are vaccinated. This number is far lower than the vaccinated percentage in general population. 

“The Vaccine Safety Handbook” gives spurious information to readers about vaccine manufacture process. “Vaccines contain monkey, rat and pig DNA as well as cow-serum blood, all of which are forbidden for consumption according to kosher dietary law,” Moishe Kahan, a contributing editor for Peach magazine, said in an email.

Resistance from ultra-orthodox communities have led to massive spread of measles in these neighborhoods, prompting Mayor Bill de Blasio to declare the outbreak a public health emergency needing mandatory vaccination, earlier Tuesday. The vaccine is given in two doses in children, at ages 1 and 5. It is 97 percent effective. 

Officials at the CDC said it “continues to be seriously concerned about the accelerating numbers of measles cases being confirmed nationally.” 

The measles virus is an RNA virus of the genus Morbillivirus. It exists as body fluid droplets released into the air from an infected person and can survive for two hours outside a host. 90 percent of unvaccinated people in its proximity will contract the disease.

Health officials have been consistently urging orthodox families to get their children vaccinated, but thanks to magazines such as “The Vaccine Safety Handbook”, their efforts are somewhat thwarted. Added to that, orthodox families tend to have many children, and it becomes difficult to keep a track of everyone’s vaccination schedules. Participation of infected children in social gatherings and attendance in schools have led to the spread of the infection in children and adults. Being an insular community, the measles outbreak has been largely confined to districts inhabited by the community.

 (Tyler Pager, New York Times)


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April 9, 2019 at 9:15 pm

Science Policy Around the Web – April 5, 2019

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By: Janani Prabhakar Ph.D.

Image by Cally Lawson from Pixabay 

Have you herd? It turns out cows have feelings, too.

The idea that nonhuman animals have feelings seems not only far-fetched, but a tad bit Disneyesque. We are used to anthropomorphizing nonhuman animals in movies and television, but the idea that a cow can feel emotions seems unbelievable. Part of this is because the concept of feeling rests on specific behavioral indices. Humans express feelings through facial expressions, through sound, and through language. We can infer others’ emotions by watching people’s actions and what they tell us. How can we possibly gain these kinds of insights from animals? How can we infer a nonhuman animal’s mental states?

With the rise of behaviorism came a focus on concepts of thoughts, feelings, and consciousness. The notion that these concepts are difficult to probe using standard empirical methods in nonhuman animals, behavioral scientists thought less of animals for several decades. Industrialization caused a further rift between humans and nonhuman animals such that the plight and treatment of nonhuman animals did not factor into the everyday ethos of behavioral science. This has since changed. 

Professor Frans de Waal, a primatologist from Emory University, has argued that nonhuman animals do indeed show emotions and in fact, they show emotions in similar ways to humans. The challenge is to determine what emotion they are conveying, when, and why. As Alexandra Horowitz, a canine cognition psychologist, points out, we cannot measure nonhuman animal emotion using the same methods we use to study human emotions. It would be too presumptuous to assume direct overlaps. Instead, she emphasizes that scientists must let the animal show us what the emotion is. This paradigm shift toward understanding how animals show emotion (and not if they do at all) has already had policy impact. Many countries have increased restrictions on using animals for research, with some outright banning use of primates in behavioral science. Restrictions on factory farms may be coming not too long from now.

Beyond policy, independent farms and rescues have heard cry of these notions. VINE Sanctuary, a farm animal rescue mission in Vermont, has taken on this perspective in creating an open, free space for farm animals of different species to roam and mingle. This represents a “radically different way of life for domesticated animals.” According to Pattrice Jones, the goal of this mission is to liberate, in a sense, animals who have been tortured or held in captivity, allowing them to live in a safe space where their emotional well-being and their individual rights can be maintained. That is something we can all get on board with.

(Eoin O’Carroll, Christian Science Monitor


Copenhagen Wants to Show How Cities Can Fight Climate Change

By 2025, Copenhagen hopes to transition from an industrial town to a net carbon neutral city. To achieve this, it will have to generate more renewable energy than dirty energy that it consumes. If Copenhagen achieves this, it will be a big achievement and will set a great example for cities worldwide. If cities can change toward using less dirty energy, then our negative impact on greenhouse gas emissions will substantially drop. Copenhagen is a great test case for the extreme measures that this will require: it is a city with a small population that is rich and who care about climate change. 

Copenhagen has already made great strides toward this goal. It has cut its emissions by 42 percent since 2005. To go even further, it has to change the way people commute and their heating choices, and how the city deals with trash. To really make effective strides, the city needs the support of the national government. However, the national government, led by a center-right party, has been reluctant to impose restrictions on gas-fueled vehicles, which is the largest contributor to the country’s carbon footprint. Contrary to efforts to reduce greenhouse gas emissions, the national government has lowered car-registration taxes, allowing more individuals to own cars. So, as many in Copenhagen would like to see a reduction in their carbon footprint, this footprint is increased with greater personal mobility through car ownership. This is a problem that is faced by many nations trying to reduce their emissions. 

Despite these hurdles, Copenhagen has implemented several key initiatives to help toward their goals. They have several bike lanes on busy city routes. Some of these lanes are three lanes wide, owing to how widely they are used. A new metro line connects more residents, allowing them to take the metro over driving their own cars. Garbage is beginning to be burned in a high-tech incinerator that contributes to heating sources for buildings. Furthermore, natural winds that are common in Copenhagen has made wind energy a viable renewable source. 

However, progress sometimes has a negative side to it as well. For example, the city’s power plants have begun to use wood pellets rather than coal. However, burning wood causes emissions, especially if the trees that were cut cannot be replaced by new trees. The new garbage facility comes with a year-round ski slope as well as a slew of trucks that must bring garbage to its furnaces daily. This also has a carbon footprint, but it may be outweighed by what it can give back in terms of heat to the city. The other part to all this is motivating behavioral change. So far, the city’s residents have utilized the bike paths to a large extent and this is good for the city’s goals. Generalizing this to other cities requires similar paradigm shifts in individual’s behaviors and the city residents to all be equally cognizant of how their choices impact climate change. When people are concerned, as are the residents of Copenhagen, it can help swing policy. Copenhagen, as such, is a perfect test case for this paradigm shift.

(Somini Sengupta, New York Times


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April 5, 2019 at 5:45 pm

Science Policy Around the Web – April 2, 2019

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By: Patrice J. Persad Ph.D.

Image by Jason Gillman from Pixabay

Worrisome nonstick chemicals are common in U.S. drinking water, federal study suggests

What lurks in our drinking water—and all its effects on organismal health—may be more of a mystery than what resides in the deep recesses of our oceans. In a recent investigation conducted by the United States Geological Survey and the Environmental Protection Agency (EPA), manmade per- and polyfluroalkyl substances (PFAS) tainted drinking water samples were analyzed. PFAS, which put the “proof” in water-proof items, are substances of concern, or, more aptly, contaminants of emerging concern (CECs), given their potential carcinogenicity and permanence in ecosystems. Perfluorooctane acid (PFOA), a PFAS discontinued in production domestically, was at a concentration over 70 nanograms per liter (ng/l) in a sample. A trio of other PFAS surpassed this concentration level, as well. A standard level issued by federal agencies has yet to transpire. However, the Centers for Control of Disease(CDC) attests that the existing cut-off of 70 ng/l is unacceptable in that it is not sufficiently low, or conservative, with respect to human health. 

The Environmental Working Group(EWG) suspects that over 100 million individuals in the U.S. drink water with PFAS. Citizens currently advocate for authorities to test drinking water samples and disclose PFAS concentrations. Without setting standards, accountability for future detriments to health is up in the air. Only through discussion with the public, policy makers, the research community, and parties formerly or currently producing PFAS can we set safeguards to protect our water supply plus well-being. 

(Natasha Gilbert, Science)


To Protect Imperiled Salmon, Fish Advocates Want To Shoot Some Gulls

In recreating the fundamental question “Who stole the cookies from the cookie jar?”, nature’s version spins off as “Who stole the juvenile salmon from Miller Island?” In this spiraling whodunit mystery, an unexpected avian culprit surfaces: the gull. According to avian predation coordinator Blaine Parker, surveys revealed that a fifth of imperiled salmon were whisked away by gulls near channels flowing out of dams. Gulls also spirited away these juvenile fish from other avian predators, such as Caspian terns. Parker maintains that not every gull is a perpetrator of decreasing the species’ numbers; gulls can assist with the population control of other birds who feast on the juveniles. Therefore, he supports killing the individual gulls disturbing juvenile salmon booms—lethal management.

Although there has been precedent of sacrificing avian species for the security of juvenile salmon, several entities denounce lethal management of wayward gulls affecting the young fish’s survival rates. The Audubon Society of Portlandpoint out that the Army Corps. of Engineers’ modifications to dams for warding away gulls, or other airborne predators, are slipshod and ineffective, if not inexistent. The U.S. Army Corps., despite this criticism, avows that killing specific gulls is only a final resort. From Parker and these organizations’ opposing viewpoints, a new mystery migrates to the surface. Will killing avian predators populating dams and waterways have a significant impact on the endangered salmons’ survival? Research collaboration on ecological impacts may be a way to tell or reassess the futures of both juvenile salmon and gulls. 

(Courtney Flatt, Northwest Public Broadcasting/National Public Radio



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April 3, 2019 at 10:32 am

Science Policy Around the Web – March 26, 2019

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By: Neetu M. Gulati Ph.D.

Image by Dimitris Vetsikas from Pixabay

Sunscreen ban aimed at protecting coral reefs spark debate – among scientists

Corals around the world have begun “bleaching,” turning white and expelling the algae that live within them. After a 2015 study found that oxybenzone can harm corals, environmentalists have worked to bar the sale of sunscreens containing the chemical. Last year, Hawaii was the first US state to ban sale of sunscreens containing oxybenzone, as well as another harmful chemical octinoxate, which are found in up to 75% of sunscreens on the US market. The ban will go into effect in 2021. Florida and California are considering similar laws. However, while some are fighting to limit the use of these toxic chemicals, others say the major issue is not sunscreen – it’s climate change.

Evidence indicates that harmful chemicals and warming oceans due to climate change are both damaging corals and leading to bleaching. Scientists agree that the major contributing factor is climate change and the chemicals play a lesser role. Nevertheless, they disagree about what should be done. C. Mark Eakin, an oceanographer and the coordinator for NOAA’s Coral Reef Watch program, commented “if we don’t deal with climate change, it won’t matter what we do about sunscreens.” Furthermore, some people believe there is not enough clear evidence explaining how damaging these chemicals can be. While many scientists share this viewpoint, others think that every step towards saving the corals matters. Some lawmakers agree with this philosophy; Teri Johnston, the mayor of Key West, Florida, said of banning the harmful chemicals, “if it’s something we can do to minimize damage to reefs, it’s one small step we’re going to take.” The city of Key West banned the sale of sunscreens containing oxybenzone and octinoxate last month, an act that will go into effect in 2021.

Damage to coral reefs is a complicated issue, with multiple stressors likely to be involved: not only climate change and sunscreens, but also pollution and other harmful chemicals. While many are worried about protecting the reefs, there is also concern as to how these bans will affect human health. In response to the Hawaii ban, the Skin Cancer Foundation put out a statement which said, “by removing access to a significant number of products, this ban will give people another excuse to skip sun protection, putting them at greater risk for skin cancer.” 

One possible solution is to expand the number of ingredients permitted in sunscreen, to allow for other protective chemicals that are less harmful to the environment. The FDA has not expanded its list of approved ingredients in approximately 20 years. Comparatively, Europe allows for more chemicals, hopeful that any one single chemical will have a less harmful environmental impact when more diversity of ingredients is allowed. Towards this end, the FDA recently proposed new regulationsto improve American sunscreens.

(Rebecca Beitsch, Washington Post

In a first, U.S. private sector employs nearly as many Ph.D.s as schools do 

The career landscape for burgeoning PhDs has changed drastically in the last 20 years; while the number of PhDs awarded has increased, especially in the fields of life and health sciences, the proportion of PhDs employed in tenured and tenure-track positions has declined. This is in contrast to what some current faculty members, who may assume that tenure track positions are the standard path for PhDs, and other career paths are “alternative.” According to the Survey of Doctorate Recipients from the US National Science Foundation (NSF), in 2017, for the first time, private sector employment of PhDs (42%) is nearly equivalent to employment by educational institutions (43%). This is in stark contrast to 1997, when educational institutions employed 11% more PhDs than the private sector. While the survey takes into consideration all PhDs under the age of 76 who are employed full-time in the US, it is expected that newer PhDs are less likely to secure tenure-track positions. 

As career trajectories change, some universities are using new information about PhD outcomes to improve programming for current graduate and prospective students. According to the Coalition for Next Generation Life Science, ten academic institutions have released data onlineabout the career outcomes of their PhD graduates, with more institutions planning to release similar data by the end of next year. The data indicates the traditional model of training, which treats graduate school like an apprenticeship to becoming faculty, is outdated. Other skills that transfer beyond educational institutions, may be necessary to successfully train the next generation of PhDs. 

(Katie Langin, Science)



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March 26, 2019 at 5:00 pm

Science Policy Around the Web – March 22, 2019

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By: Caroline Duncombe.

Image by 1388843 from Pixabay

FDA Approves First Drug for Postpartum Depression

In the USA, about 400,000 women develop post-partum depression (PPD) each year. Up until Tuesday, there was no FDA approved pharmaceutical treatment designed specifically for PPD. In attempts to alleviate PPD episodes, doctors previously prescribed drugs designed for general depression, such as selective serotonin-reuptake inhibitors (SSRIs). Such drugs were not specifically designed for PPD which involves distinct mechanisms of action that are directly related to pregnancy and childbirth. SSRIs often take months to achieve remission or adequate response, if ever. Such deficiencies are supposedly addressed by the new drug, brexanolone, marketed at Zulresso, which was designed specifically to address post-partum depression and acheives rapid onset of response alleviation.

Although brexanolone is the first FDA approved treatment for PPD, the long infusion period, the high cost of the treatment, and lacking evidence on the effectiveness of this treatment demonstrate the long road ahead before PPD treatment is ubiquitous and operational. The Brexanolone treatment is not simple: it involves a continuous intravenous (IV) infusion over the course of 60 hours. Due to the risk of the treatment, patients will be required to stay within an in-patient unit of a hospital for those 2.5 days. Considering that the treatment alone cost $34,000 for a full course, the additional cost of in-patient care would make this treatment inaccessible for many who demonstrate severe PPD. Some insurance providers may decide to cover the treatment cost, but for those who do not have insurance or are denied coverage this treatment will be inaccessible.

Additionally, the FDA approval application was largely informed by a flawed phase III clinical trial funded by Sage Pharmaceuticals, the producer of Zulresso. The trial only included 246 participants, which is a relatively small sample size for a phase III trial. A large sample size is important to providing a conclusive clinical trial result on drug side-effects. This is crucial because if a severe side effect is found within 1 in every 1000 participants (or 1 in 10,000, etc) that level of risk would most likely not be detected within a trial only enrolling 246 participants. Additionally, this specific trial compared participants to a placebo, and not existing treatment standards of anti-depressants like SSRIs. The trail also only assessed the women volunteers over a 30-day follow-up period post infusion, which means that the lasting effects beyond the first month of Brexanolone are still unknown.

Further research on Brexanolone will be necessary to definitively assess its impact of reducing PPD. At this moment Sage Therapeutics is also implementing a phase III trialon a PPD treatment drug that is structurally similar to Bexanolone but is capable of being administered via a pill. If successful, such a drug could make treatment for post-partum depression more accessible to all. 

(Pam Belluck, New York Times)



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March 22, 2019 at 5:24 pm