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Science Policy Around the Web – February 21, 2017

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By: Rachel Smallwood, PhD


Should We Treat Obesity Like a Contagious Disease?

Researchers are modeling obesity from a public health perspective as a contagious disease. There are many factors associated with obesity, including genetics, low levels of physical activity, and high caloric intake. An earlier study examined the effects of different social factors on an individual’s risk of being obese; it found that people with obese friends and family were at an increased risk for obesity, and this trend was influenced by how close the relationships were.

In this model of the prevalence of obesity, the researchers included a factor to represent obesity as a “social contagion”, reflecting those previous findings and indicating a potential increased risk and increased prevalence due to transmission from one person to another. This mechanism is assumed to be related to people adopting the behaviors of those close to them; notably, activity levels and type and quantity of food consumed. The model predicts obesity rates in populations with terms associated with the genetic contribution to obesity, the mother’s non-genetic contribution to her offspring, and the prevalence of obesity. Essentially, the more obese individuals there are in a society, the more likely it is for someone to know and interact with an obese person.

The models indicate that obesity prevalence plateaus around 35-40% without an intervention. The model is still fairly primitive, but the researchers hope that in future it could provide insight into the effects of potential interventions. For example, is it better to target an intervention to individuals who are already obese, or should the reach of the intervention be more broad and target the population as a whole? When the models reach a level of complexity comparable to the existing factors for obesity, they can be a powerful tool in preventing and addressing the epidemic. (Kelly Servick, Science Magazine)


Brain Scans Spot Early Signs of Autism in High-Risk Babies

A study recently published in Nature showed that alterations in brain development in children who go on to be diagnosed with autism precede behavioral symptoms. High-risk infants’ brains were scanned with MRI at 6, 12, and 24 months. It was determined that the infants who were subsequently diagnosed with autism had a faster rate of brain volume growth between 12 and 24 months. Additionally, between 6 and 12 months, these infants had a faster rate of growth in the surface area of folds on the brain, called the cortical surface.

Taking these findings, the research team used a machine learning approach called a deep-learning neural network to make a model to predict whether an infant would be diagnosed with autism based on their MRIs from 6 and 12 months. This model was tested in a larger set of infants, and the model correctly predicted 30 out of 37 infants who went on to be diagnosed (true positives), and it incorrectly predicted that 4 infants would be diagnosed with autism out of the 142 who were not later diagnosed (false positives). These results are much more robust than behavior-based predictions from this same age range.

More work needs to be done to replicate the results in a larger sample. Additionally, all of the participants were high-risk infants, meaning they had a sibling who was diagnosed with autism, so the results are not necessarily generalizable to the rest of the population. Further studies need to be done in the general population to determine if these same patterns are observable, but that would require an even larger sample due to the lower risk. However, the early detection of symptoms and prediction of diagnosis are potentially valuable tools, especially considering another recent publication showed that early intervention in children with autism affects the severity of symptoms years down the road. (Ewen Callaway, Nature News)

Science Funding

Ebola Funding Surge Hides Falling Investment in Other Neglected Diseases

Funding totals from 2015 reveal a trending decrease in funding for neglected diseases, excluding Ebola and other viral hemorrhagic fevers. Neglected diseases are diseases that primarily affect developing companies, thus providing little incentive for private research and development by commercial entities; the other diseases include malaria, tuberculosis, and HIV/AIDS. Given the recent surge of funding for Ebola research, the analysis firm, Policy Cures Research, decided to separate it from the other neglected diseases in its analysis to observe funding patterns independent from the epidemic that dominated the news and international concerns. Funding was tracked from private, public, and philanthropic sources.

The funding for Ebola research has primarily gone to development of a vaccine, and over a third of the funds were provided by industry. For the other diseases, the decline in overall funding is mostly represented by a decline in funding from public entities, primarily comprised of the governments of large, developed countries. Those countries accounted for 97% of the research funding for neglected diseases in 2015, so any significant change in that funding category would affect the overall funding amounts. However, there was also a slight decline in philanthropic funding. When including Ebola with the others, funding of neglected diseases was actually at its highest in the past ten years. It is not known whether money was funneled from the other diseases to Ebola research, or if this decline is indicative of less research spending in general. (Erin Ross, Nature News)

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February 21, 2017 at 10:03 am

Science Policy Around the Web – October 28, 2016

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By: Emily Petrus, PhD

Source: Flickr, under Creative Commons

Technology and Health

Can You Please Pass the iPad?

As digital media screens have become more prevalent, doctors have warned parents of its negative impact on developing minds. In 1999, screen time was first addressed, with doctors mandating that no screen time was recommended for children under age 2.   The argument goes that children need parents present in real-time to interact with to develop the ability to read social cues and engage on a personal level.

Now the American Academy of Pediatrics (AAP) has dictated that one hour per day of high-quality educational screen time may be allowed for children between 2 and 5 years of age. For children 18 months to 2 years, some screen time is ok as long as a parent is actively engaged and watching with the child. This is especially relieving for parents of children who have relatives far away who use Skype or FaceTime to communicate. Although this is technically screen time, it does benefit children with those important social interactions and reading facial and vocal cues.

Overall the goal of the AAP is to ensure that media is used in a mindful way, not to replace social interactions but to enhance family discussions and provide supplementary education material for older age groups. They also recommend media-free family time to ensure children develop a healthy relationship with technology. Jenny Radesky, MD, FAAP and lead author for the statement said, “What’s most important is that parents be their child’s media mentor. That means teaching them how to use it as a tool to create, connect and learn.” In relation to screen time rules, it seems the amount of parent involvement and moderation are the keys to success. (AAP)

Mental Health Research

New Director of National Institutes of Mental Health (NIMH)

NIMH has a tall order to fill: bridge the gap from the breakneck speed of basic neuroscience research advances to bring solid and reliable treatments to the clinic. Last month NIMH welcomed a new director, Dr. Joshua Gordon, to take the helm and direct the institute toward a balance between these two priorities. After 19 years as a faculty member at Columbia University, Gordon hopes to bring his experience as both a clinician and a researcher to achieve this delicate result.

NIMH’s strategic plan for research was laid out in September, with four priorities highlighted to combat mental illness. These include describing mechanisms of complex behaviors, at the molecular, cellular, circuit and genetic levels. Second, characterizing mental illness trajectories to determine best intervention procedures and time points, which would include detecting biomarkers and understanding how behavior reflects neuropathology. Third, NIMH strives to marry tried and true existing treatments with new therapies which can be implemented in community settings, thus bringing help to patients. Finally, NIMH funded research must improve public health, with better clinician education about new treatments, and new service delivery models that can be implemented to reach more patients suffering from mental illness.

These are all monumental tasks but Gordon seems up for the challenge. In a recent Q&A session by Meredith Wadman of Science Magazine, he was asked about the op-ed pieces in the Washington Post and the New York Times by NIMH clinical psychiatrists where they accused previous director Thomas Insel of putting too much priority on basic research and letting clinical neuroscience fall by the wayside. Gordon replied by saying, “I think my first priority is good science. Where there are opportunities in psychiatry for short-term effects, we are going to try to take advantage of them. Absolutely. We’d be mad not to. We know so little about the brain, we have so few truly novel treatments in the pipeline that I’m all ears.” (NIH News Release)


Autism early intervention – help the parents, help their children

The plight of the working parent has become an important and almost bipartisan issue this election season. Politicians are proposing policies that will help families with paid family leave and some help with childcare costs, however there is a growing segment of people who desperately need even more help. Raising a child with autism is increasingly common, currently 1% of children and young people in the US are on the spectrum.

The cost of having an autistic child can be tremendous, with extra health care expenses, special equipment, classes and educational requirements. Often one parent must leave the workforce to care for their child as they require extensive and specialized care. Early interventions such as classes and therapy are thought to be effective for lessening the symptoms of autism, but until now the trials have been small and have had short end points. This week The Lancet published an article demonstrating that interventions aimed at educating parents of autistic children had long-term (up to 6 years) benefits. 152 children aged 2-4 years old were recruited to the study, with half given interventions that included therapy, monthly support and a parent-mediated 20-30 minute daily session of planned activities. The children who received this extra support reported lower levels of severe autism and had better teacher and parent assessed behaviors. However, the study did not find significant reductions in anxiety or depression or a language benefit.

This study demonstrates that providing education and resources for parents of autistic children are a worthwhile endeavor. Government resources are often aimed at providing services for the child, which are equally important. Parents armed with the proper educational tools can become personalized therapists for their children, which could reduce societal costs and improve outcomes. (Heidi Ledford, Nature)

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October 28, 2016 at 10:50 am

Science Policy Around the Web – April 1, 2016

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By: Ian McWilliams, Ph.D.

photo credit: Matti Mattila via photopin cc

Federal Research Funding

House budget plan would rearrange and restrict federal research portfolio

Since the financial crisis of 2008, much attention has been given to the state of the economy. With recent optimism about the health of the economy, the president’s new budget plan for 2017, increases the NIH budget in FY 2016, and initiates new research spending for the Cancer moonshot. However, not all agencies are benefiting from the proposed budget. A report filed recently by the U.S. House of Representatives’ budget committee could curtail research spending for the National Science Foundation (NSF), the Department of Energy (DOE), and could lead to reshuffling sections of the Department of Commerce (DOC) into other agencies. Current DOE budget speculation is that there will be a decrease in funding for “several high-risk projects” that should be picked up in the private sector. While NSF biology, computing and information science, and math and physical sciences research directorates are to receive “stable funding”, the omission of specific plans for engineering, geoscience, and the social and behavioral sciences is ominous. It is unclear how the reorganization of the DOC will contribute to decreases in discretionary spending. The DOC is responsible for the research portfolios of the National Oceanic and Atmospheric Administration (NOAA), the National Institute of Standards and Technology (NIST), and the Census Bureau. (Jeffrey Mervis, ScienceInsider)

Science in the Public Eye

Controversial anti-vaccination documentary pulled from Tribeca Film Festival

In 2010, The Lancet retracted a highly controversial paper by Andrew Wakefield which proposed to link the Measles, Mumps, and Rubella (MMR) vaccine to autism. Since the original publication in 1998, this paper has been a cornerstone for the anti-vaccination movement, even after the paper has been discredited and retracted. Recently, Wakefield himself has directed and co-written a documentary titled “Vaxxed: from cover-up to catastrophe,” which claims that the CDC falsified and omitted crucial data linking vaccines to autism. This divisive film was to be screened at the Tribeca film festival , but was pulled, likely due to the backlash over screening the film. The original plan, put forth by Tribeca co-founder Robert De Niro, was to give an “opportunity for a conversation around the issue,” but he later decided after consultation that “we do not believe it contributes to or furthers the discussion I had hoped for.” In response, Wakefield and Del Bigtree, a producer for the film, released a statement that “We will be pressing forward and sharing our plans in the very near future.” With both sides pointing fingers, this argument will likely continue for some time to come. (Jason Ukman, StatNews)

Medical Devices and Testing

Study of Theranos Medical Tests Finds Irregular Results

The first peer-reviewed results of finger prick blood tests offered by Theranos have been published this week and bring more questions about the accuracy of its tests. Theranos, the medical start-up that provides direct-to-consumer blood tests, has come under increased scrutiny after an independent study found irregular results from tests offered by the company. The study, published in the Journal of Clinical Investigation, compared results from 22 different tests offered by Theranos to conventional blood test results from two national diagnostic laboratories, Quest Diagnostics and LabCorp.

Theranos has received much attention for their claims to offer blood tests that require small amounts of blood as a low-cost alternative to conventional laboratory testing. The company offers over two hundred different tests that require only a finger prick compared to vials of blood needed for conventional tests. Elizabeth Holmes, CEO of Theranos, touts the convenience and consumer experience of Theranos’s tests. However, the company has been reluctant to release data regarding their tests and has been mired in controversy after a Wall Street Journal article questioned the accuracy of the results of these tests. Furthermore, Theranos’ Newark, California laboratory has been cited by The Centers for Medicare and Medicaid Services for problems that “pose immediate jeopardy to patient health and safety.”

The current study used 60 healthy, adult volunteers who were tested at separate laboratories on the same day and found more measures outside of their normal range for Theranos’s finger prick blood tests when compared to measures from conventional blood tests. Results from Theranos were out of range for 12.2 percent of measurements compared to 7.5 and 8.3 percent for Quest Diagnostics and LabCorp, respectively. Although variability was seen in results from all three labs, Eric Schadt, one of the authors of the study, said that “Theranos was outside of range in ways that would impact clinical decision-making.”

Theranos’ laboratory directors responded to the study by sending a letter the journal calling the study “flawed and inaccurate.” They claim that a large blood draw from a vein could affect the results from a finger prick test and that the study authors did not attempt to determine which measurements were correct. (Andrew Pollack, New York Times)

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April 1, 2016 at 9:00 am

California governor signs strict vaccination requirements into law

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By: Amy Kullas, PhD

photo credit: Vaccinate Your Child via photopin

On June 29 of this year, the California Senate passed SB277, one of the nation’s strictest vaccination laws. The very next day, California’s governor, Edmund Brown, Jr., signed the bill into law. SB277 transforms California – previously one of the most liberal states in terms of vaccination requirements – into one of the strictest. This bill makes California the third state (after Mississippi and West Virginia) to eliminate religious and other personal exemptions for vaccination. Under the bill, unvaccinated children without a medical exemption would have to study at home or in organized, private home-schooling groups rather than attend public school. Beginning January 1, 2016, schools will begin verifying that children entering kindergarten or advancing to seventh grade for the upcoming school year are vaccinated. On and after July 1, 2016, in order to attend public or private schools, students will need to have received vaccines for: diphtheria, Haemophilus influenza type b (Hib meningitis), measles, mumps, pertussis (whooping cough), poliomyelitis, rubella (German measles), tetanus, hepatitis B and varicella (chickenpox).

Infectious diseases are not new and have been killing since the dawn of mankind. However, in the 18th century, a revolutionary scientific innovation was identified: vaccination. Edward Jenner is accepted as the ‘grandfather’ of the modern vaccine. After hearing stories of how dairymaids were seemingly naturally protected from smallpox after having suffered from cowpox, he hypothesized that cowpox could be used as a deliberate mechanism of protection. In May of 1796, Jenner located a dairymaid, who had fresh lesions on her hands and arms and inoculated a young boy with material drawn from one of her pustules. The boy reportedly developed mild symptoms, but after about 10 days felt much better. That July, Jenner inoculated that same boy again, this time with pustules from a fresh smallpox lesion. After no disease development, Jenner concluded that the boy was protected from smallpox based on his earlier exposure to cowpox. This groundbreaking discovery of transmitted protection was the start the concept of immunization.

The controversy around eliminating the “personal belief exemption” was ignited in California after a measles outbreak started in at Disneyland last December and quickly spread to seven states and internationally into Canada and Mexico. Though the outbreak sickened approximately 150 people in the United States, fortunately no deaths were reported. The majority of the individuals infected by the measles outbreak were either unvaccinated (71 or 45%) or their vaccination status was unknown (60 or 38%). Only 28 people or a dismal 18% had reported receiving the measles vaccine! Further, of the U.S. residents who caught measles and were unvaccinated, 29 (43%) gave philosophical or religious objections to vaccination while 27 (40%) were ineligible because they were too young to receive the full course of vaccines, or they had a medical condition that prevented vaccination. Amidst the measles outbreak, Californian senators, Barbara Boxer and Dianne Feinstein wrote to state health officials, saying that “while a small number of children cannot be vaccinated due to an underlying medical condition, we believe there should be no such thing as a philosophical or personal belief exemption, since everyone uses public spaces…. As we have learned in the past month, parents who refuse to vaccinate their children not only put their own family at risk, but they also endanger other families who choose to vaccinate.”

Dr. Annie Sparrow, Deputy Director Human Rights and Assistant Professor of Global Health at Icahn School of Medicine at Mount Sinai in New York, highlighted another important consequence of infectious diseases making a global comeback: “measles, long forgotten, is ‘back’ in the United States and far too few doctors know how to recognize it.” Alarmingly, if people go to their doctor or to the hospital when they’re feeling sick and a diagnosis at that early stage is missed, the number of people potentially exposed to the disease could increase exponentially. Many early symptoms of diseases often present themselves in similarly with fever, rash, or both, making a diagnosis difficult. Doctors may also no longer consider some of the formerly common childhood diseases, since they have been generally accepted as eradicated due to vaccine development, and this unintentional oversight could have grave public health consequences.

Vaccination is an extremely effective strategy for preventing infectious diseases. However, this strategy is only successful when the vast majority of individuals are immunized against a particular pathogen in order to offer some protection to individuals who are not medically able to receive the vaccine. When a high percentage of the population is vaccinated, it becomes more difficult for the infectious diseases to spread because there are so few people who could potentially be infected in a concept called community immunity or herd immunity. The people who are unable to get vaccinated for medical reasons include infants, pregnant women, and immunocompromised individuals. But for those individuals who are healthy enough to get vaccines, but choose not to, why don’t they vaccinate?

The misguided “anti-vaccination movement” began with a paper published by Andrew Wakefield in The Lancet in 1998. The impact of this now-retracted paper still ripples through the scientific community and beyond, to within the general public in the United States. In the paper, the authors alleged that eight children (out of a very small sample size of 12) developed autism and bowel disease shortly after receiving the measles, mumps and rubella (MMR) vaccine. However, the MMR vaccine had been widely used since 1968, which begs the question of why would it take 30 years for this ‘association’ to be made? After numerous researchers continually failed to replicate Dr. Wakefield’s results, the scientific community uncovered that it was a fraudulent study. However, it still took over 10 years for the retraction to be published. Wakefield has since lost his medical license and in 2010 wrote a book disputing the charges against him. He has been described as the “father of anti-vaccine movement.” Because Dr. Wakefield’s fraudulent conclusions continue to be perpetuated by some, the medical community, scientists, and lawmakers must take a united stance to correct the damage done by one paper.

By signing SB277, the Californian government has mandated vaccinations for all school-aged children regardless of their parents’ personal or religious beliefs. Kudos to California, West Virginia, and Mississippi for passing such strict vaccination laws! My hope is that the other 47 states and the District of Columbia will follow suit for the good of us all.

Written by sciencepolicyforall

July 8, 2015 at 9:00 am

Science Policy Around the Web – June 6, 2014

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By: Kaitlyn Morabito

photo credit: phalinn via photopin cc

photo credit: phalinn via photopin cc

Our weekly linkpost, bringing you interesting and informative links on science policy issues buzzing about the internet.

Google Glass Enters the Operating Room –  Doctors at hospitals around the country are embracing Google Glass as a means to enhance surgery and training.  This technology allows doctors to project patient records and x-rays without having to look across the room.  Additionally, Google Glass can be used to videocast live or record surgeries for consultations with other specialists or train doctors in foreign countries.  It can also be used by emergency response crews to consult with doctors in the field.  Since Google Glass is hands free, it doesn’t pose a contamination threat.  Before Google Glass will be an operating room staples many concerns will need to be address.  This includes protecting patient privacy and preventing the dangers of multitasking and “tunnel vision” by operating doctors.  (Anahad O’Connor)

Unusual Microbe Engineered to Convert Grass to Gas – U.S. researchers have genetically modified bacteria, Caldicellulosiruptor bescii, originally found in the hot springs of Yellowstone National Park, to break down simple sugars into ethanol.  The goal of this research is to decrease the production and environmental cost of ethanol, which is currently manufactured from corn requiring a lot of energy and money.  Using Caldi, ethanol can be derived from cellulosic biomass such as plant leaves and stems including switch grass which can be grown anywhere.  The researcher seek to increase efficiency by 20% to make it viable and cheaper alternative.  (Robert F. Service)

Children with Autism have Elevated Levels of Steroid Hormones in the Womb – In a retrospective study, scientists in Cambridge and Denmark measured hormone levels in amniotic fluid samples from 128 males known to have autism.  These samples were from around 15-16 weeks of pregnancy, a known critical time period for early brain development.  Scientist found higher levels of all steroid hormones compared to normal controls.  This builds on previous knowledge that autistic traits are associated with higher levels of prenatal testosterone.  These finding may begin to explain why the autism rate is higher in males than in females.  Although an important step in finding in understanding autism, these findings cannot function as a prenatal screening test since there was overlap between the groups.  (Science Daily)

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June 6, 2014 at 12:26 pm