Category: Health

Middle Class Wants to Be Free to Choose Skinnier Health Insurance

(p. B4) For Linda Dearman, the House vote last week to repeal the Affordable Care Act was a welcome relief.
Ms. Dearman, of Bartlett, Ill., voted for President Trump largely because of his contempt for the federal health law. She and her husband, a partner in an engineering firm, buy their own insurance, but late last year they dropped their $1,100-a-month policy and switched to a bare-bones plan that does not meet the law’s requirements. They are counting that the law will be repealed before they owe a penalty.
“Now it looks like it will be, and we’re thrilled about that,” Ms. Dearman, 54, said. “We are so glad to feel represented for a change.”
. . .
In interviews over the last few days, people who support repealing the Affordable Care Act pointed to their long-simmering resentment of its mandate that most Americans have health insurance or pay a tax penalty. Many also said that they could no longer afford the comprehensive coverage available on the individual market, and that they were eager to once again be allowed to choose skinnier policies without a penalty.
“Now I will no longer be expected to pay twice what I should for a product I don’t need and be treated like a criminal with a fine if I refuse,” said Edward Belanger, 55, a self-employed business appraiser in Dallas. He is an independent who usually votes Republican but last year chose Gary Johnson, the Libertarian candidate, over Mr. Trump.
Like the Dearmans, Mr. Belanger canceled a plan that complies with the Affordable Care Act and bought a short-term policy that does not meet the law’s standards, paying $580 a month for his family of four compared with the nearly $1,200 a month he paid last year. Policies like theirs usually have high deductibles and primarily offer catastrophic coverage for major injuries.

For the full story, see:
ABBY GOODNOUGH. “Feeling Hurt By Health Law, and Eager to See G.O.P. Repeal It.” The New York Times (Tues., May 16, 2017): A12.
(Note: ellipsis added.)
(Note: the online version of the story has the date May 12, 2017, and has the title “Why Some Can’t Wait for a Repeal of Obamacare.”)

“Death Has Never Made Any Sense to Me”

(p. 10) . . . , Kinsley is intent on being wryly realistic about coping with illness and the terminal prospects ahead. He makes fun of a fellow boomer, Larry Ellison, the C.E.O. of Oracle, who has spent millions in a quest for eternal life, and who was quoted as saying, “Death has never made any sense to me.” Kinsley quips: “Actually the question is not whether death makes sense to Larry Ellison but whether Larry Ellison makes sense to death. And I’m afraid he does.”

For the full review, see:
PHILLIP LOPATE. “Senior Moments’.” The New York Times Book Review (Sun., APRIL 24, 2016): 10.
(Note: ellipsis added.)
(Note: the online version of the review has the date APRIL 18, 2016, and has the title “Michael Kinsley’s ‘Old Age: A Beginner’s Guide’.”)

The book under review, is:
Kinsley, Michael. Old Age: A Beginner’s Guide. New York: Tim Duggan Books, 2016.

Justified Species Extinction

(p. A1) The death toll from diseases carried by mosquitoes is so huge that scientists are working on a radical idea. Why not eradicate them?
Mosquitoes kill more humans than any other animal and were linked to roughly 500,000 deaths in 2015, mostly from malaria. For more than a century, humans have used bed nets, screens and insecticides as weapons, but mosquitoes keep coming back. They are now carrying viruses like Zika and dengue to new parts of the world.
Powerful new gene-editing technologies could allow scientists to program mosquito populations to gradually shrink and die off. Some efforts have gained enough momentum that the possibility of mosquito-species eradication seems tantalizingly real.
“I think it is our moral duty to eliminate this mosquito,” entomologist Zach Adelman says about Aedes aegypti, a species carried afar over centuries by ships from sub-Saharan Africa.
. . .
(p. A8) Purposely engineering a species into extinction–or just diminishing it–is fraught with quandaries. Scientists must weigh the potential impact of removing a species on the environment and food chain. It will take years of more research, testing and regulatory scrutiny before most genetically altered mosquitoes can be released into the wild. And the strategy might not work.
Wiping a species off the face of the earth is “an unfortunate thing to have to do,” says Gregory Kaebnick, a research scholar at the Hastings Center, a bioethics research institute in Garrison, N.Y.
He says humans shouldn’t force a species into extinction to meet their own preferences. “We ought to try not to do it,” says Mr. Kaebnick. One justification, he says, would be to avert a serious public-health threat.

For the full story, see:
BETSY MCKAY. “A World with No Mosquitoes.” The Wall Street Journal (Sat., Sept. 3, 2016): A1 & A8.
(Note: ellipsis added.)
(Note: the online version of the story has the date Sept. 2, 2016, and has the title “Mosquitoes Are Deadly, So Why Not Kill Them All?”)

Tinkerers Build Their Own Pancreases, While Waiting for 100,000 Page Submission to FDA

(p. B1) Third-grader Andrew Calabrese carries his backpack everywhere he goes at his San Diego-area school. His backpack isn’t just filled with books, it is carrying his robotic pancreas.
The device, long considered the Holy Grail of Type 1 diabetes technology, wasn’t constructed by a medical-device company. It hasn’t been approved by regulators.
It was put together by his father.
Jason Calabrese, a software engineer, followed instructions that had been shared online to hack an old insulin pump so it could automatically dose the hormone in response to his son’s blood-sugar levels. Mr. Calabrese got the approval of Andrew’s doctor for his son to take the home-built device to school.
The Calabreses aren’t alone. More than 50 people have soldered, tinkered and written software to make such devices for themselves or their children. The systems–known in the industry as artificial pancreases or closed loop systems–have been studied for decades, but improvements to sensor technology for real-time glucose monitoring have made them possible.
The Food and Drug Administration has made approving such devices a priority and several companies are working on them. But the yearslong process of commercial development and regulatory approval is longer than many patients want, and some are technologically savvy enough to do it on their own.
. . .
(p. B2) “Biology isn’t quite as easy as controlling the temperature in a room,” said Francine Kaufman, chief medical officer for Medtronic’s diabetes division. She sees do-it-yourself efforts as a sign of the interest in the technology, but distinct from the process of getting a commercial device to market. Dr. Kaufman estimates Medtronic’s submission to the FDA will exceed 100,000 pages and hopes that the device will be approved in 2017.
The home-built project that the Calabreses followed, known as OpenAPS, was started by Dana Lewis, a 27-year-old with Type 1 diabetes in Seattle. Ms. Lewis began using the system in December 2014 as a sort of self-experiment. After months of tweeting about it, she attracted others who wanted what she had.
. . .
The FDA declined to comment on the project but said the agency is working with manufacturers to approve a device.
Sarah Howard became interested after she met Ms. Lewis last year. “My first question was: Was it legal?” said the 49-year-old, who has Type 1 diabetes, as does one of her two sons. “I didn’t want to do anything illegal.”
​After ​her husband ​built​ the system for her and her son, she said the main benefit is starting each day with her blood sugar in range and not having to wake in the night to check her son’s glucose levels.

For the full story, see:
Kate Linebaugh. “Tech-Savvy Families Build Robotic Pancreas; Companies work on developing diabetes device, but approval process is too long for many patients.” The Wall Street Journal (Mon., May 9, 2016): B1-B2.
(Note: ellipses added.)
(Note: the online version of the story has the Tech-Savvy Families Use Home-Built Diabetes Device; Companies work on artificial pancreas, but approval process is too long for many patients.”)

Starzl Persisted in Trying “Impossible” Liver Transplants

(p. D8) In 1967, Dr. Starzl led a surgical team at the University of Colorado in a procedure that many in the medical community had dismissed as impractical, if not impossible. Although kidneys had been transplanted successfully since the 1950s, all previous attempts to replace a liver had resulted in the death of the patient.
Indeed, Dr. Starzl’s first four attempts at liver transplantation, in 1963, had failed when the patients experienced complications from the use of blood-clotting agents, which in some cases caused lethal clots to form in the lungs.
After a self-imposed moratorium that lasted three years, Dr. Starzl and his colleagues tried again. They first considered inserting a second liver, to function beneath the impaired one, as a possible route to avoiding the heavy bleeding caused by organ removal. But promising results obtained from liver surgeries on dogs could not be replicated in human patients, and that avenue was abandoned.
The team then operated on a 19-month-old girl and replaced her cancerous liver. The transplanted liver functioned without ill effects for more than a year, before the infant died of other causes. In the next year, as surgical techniques were improved, this pathbreaking success was repeated in six children and, ultimately, in adults.
Dr. Starzl later described those early liver transplants as both a “test of endurance” and “a curious exercise in brutality.” It involved, he explained, “brutality as you’re taking the liver out, then sophistication as you put it back in and hook up all of these little bile ducts and other structures.”
“Each one,” he said, “is a thread on which the whole enterprise hangs.”
. . .
With Dr. John Fung, a surgeon and immunologist, and others, Dr. Starzl evaluated FK-506, also known as tacrolimus. They published their findings in the British medical journal The Lancet in 1989.
Their investigation was not without risk; other scientists showed that tacrolimus had proved toxic when tested in dogs, and they doubted that it could be safe for humans. But the unexpected result was a medical breakthrough for patients and lavish headlines for the University of Pittsburgh, which Dr. Starzl helped fashion into an international center for training transplant specialists.
. . .
A former colleague from Pittsburgh, Dr. Byers Shaw Jr., praised Dr. Starzl’s “indomitable spirit” and said that FK-506, eventually approved in 1994 by the F.D.A., was a shining example of tenacity in a career spent “challenging the conventional thinking.”
Dr. Shaw, who is now the chairman of the department of surgery at the University of Nebraska, observed Dr. Starzl in the operating room in the 1980s, when a patient appeared to be dying during surgery. Dr. Starzl, he recalled, showed “persistence when everything else looked hopeless.”
“It affected everybody in the room,” Dr. Shaw said, “as if a fear of failure was driving all of those around him.”

For the full obituary, see:
JEREMY PEARCE. “Thomas E. Starzl, Pioneering Liver Surgeon, Dies at 90.” The New York Times (Mon., MARCH 6, 2017): D8.
(Note: ellipses added.)
(Note: the online version of the obituary has the date MARCH 5, 2017, and has the title “Dr. Thomas E. Starzl, Pioneering Liver Surgeon, Dies at 90.”)

Bud Shaw paints a vivid picture of Starzl in parts of:
Shaw, Bud. Last Night in the OR: A Transplant Surgeon’s Odyssey. New York: Plume, 2015.

Resveratrol Slows Alzheimer’s

(p. D1) A recent human study that suggested resveratrol could slow the progression of Alzheimer’s used a daily dose equivalent to the amount in about 1,000 bottles of red wine, says Scott Turner, director of the Memory Disorders Program at Georgetown University Medical Center, who led the study. Such high doses can lead to side effects such as nausea, vomiting and diarrhea.
Such side effects have caused past efforts to tap the health benefits of resveratrol to founder. GlaxoSmithKline PLC shelved a project to develop a resveratrol-based pill in 2010 after some clinical-trial patients developed kidney problems. The company, which had hoped to develop the drug as a treatment for a type of blood cancer, concluded that while resveratrol didn’t directly cause those problems, its side effects led to dehydration, which could exacerbate underlying kidney issues.
Now, scientists hope to overcome that problem by increasing the potency of resveratrol at more moderate doses. Researchers at the University of New South Wales, near Sydney, suspect the substance is more effective when accompanied by other ingredients found in red wine, which somehow promote its activity. They are developing a pill that combines puri-(p. D4)fied resveratrol with other compounds in wine in an effort to mimic the drink’s naturally-occurring synergies.
. . .
At the University of New South Wales, researchers have combined resveratrol with two other components of red wine: antioxidants and chelating agents, which have separately been shown also to have health benefits.
. . .
The researchers recently tried the combination in a small trial involving 50 people and found it increased the activity of a substance called NAD+ that plays a key role in maintaining healthy cells.

For the full story, see:
DENISE ROLAND. “Scientists Try to Put Red Wine in a Pill.” The Wall Street Journal (Tues., Aug. 2, 2016): D1 & D4.
(Note: ellipses added.)
(Note: the online version of the story has the date Aug. 1, 2016, and has the title “Scientists Get Closer to Harnessing the Health Benefits of Red Wine.”)

A recent article co-authored by Turner, related to the research summarized above, is:
Moussa, Charbel, Michaeline Hebron, Huang Xu, Jaeil Ahn, Robert A. Rissman, Paul S. Aisen, R. Scott Turner, Xu Huang, and R. Scott Turner. “Resveratrol Regulates Neuro-Inflammation and Induces Adaptive Immunity in Alzheimer’s Disease.” Journal of Neuroinflammation 14 (Jan. 3, 2017): 1-10.

Workers in Open Offices Are Less Able to Focus and Take More Sick Days

(p. R7) Noisy, open-floor plans have become a staple of office life. But after years of employee complaints, companies are trying to quiet the backlash.
Many studies show how open-plan office spaces can have negative effects on employees and productivity. As a result, companies are adding soundproof rooms, creating quiet zones and rearranging floor plans to appeal to employees eager to escape disruptions at their desk.
Companies are “not providing sufficient variety in spaces,” says David Lehrer, a researcher at the Center for the Built Environment at the University of California, Berkeley. Mr. Lehrer studies the impact of office designs on employees, and lack of “speech privacy” is currently a significant problem, he says. Employees in open-plan offices are less likely to be satisfied with their offices than employees in a traditional office layout, Mr. Lehrer adds.
. . .
Companies with open offices, . . . , soon encountered the downsides. For one thing, workers took increased sick days–a 2014 Swedish study of more than 1,800 workers found open-plan workers were twice as likely to take sick days as workers in traditional offices. The reason, the researchers hypothesized: the spread of germs and increased environmental stress of working in an open space. Workers also complained of an inability to focus and were generally less content with their work environment, the study said.
Now, companies are again “realizing people actually have to be productive,” says Ned Fennie, partner at San Francisco-based architecture firm Fennie + Mehl.

For the full story, see:
ALINA DIZIK. “Open Offices Lose Some of Their Openness; Companies look for ways to add privacy and quiet areas without reverting to the traditional design.” The Wall Street Journal (Mon., Oct. 3, 2016): R7.
(Note: ellipses added.)
(Note: the online version of the story has the date Oct. 2, 2016, and has the title “Open Offices Are Losing Some of Their Openness; Companies look for ways to add privacy and quiet areas without reverting to the traditional office design.”)

The 2014 Swedish study mentioned above, is:
Bodin Danielsson, Christina, Holendro Singh Chungkham, Cornelia Wulff, and Hugo Westerlund. “Office Design’s Impact on Sick Leave Rates.” Ergonomics 57, no. 2 (Feb. 2014): 139-47.

“Warfare Among Prehistoric Hunter-Gatherers”

(p. A7) The scene was a lagoon on the shore of Lake Turkana in Kenya. The time about 10,000 years ago. One group of hunter-gatherers attacked and slaughtered another, leaving the dead with crushed skulls, embedded arrow or spear points, and other devastating wounds.
The dead, said the scientists who reported the discovery Wednesday [January 20, 2016] in the journal Nature, seem to have been scattered in no apparent order, and eventually covered and preserved by sediment from the lake. Of 12 relatively complete skeletons, 10 showed unmistakable signs of violent death, the scientists said. Partial remains of at least 15 other people were found at the site and are thought to have died in the same attack.
The bones at the lake, in northern Kenya, tell a tale of ferocity. One man was hit twice in the head by arrows or small spears and in the knee by a club. A woman, pregnant with a 6- to 9-month-old fetus, was killed by a blow to the head, the fetal skeleton preserved in her abdomen. The position of her hands and feet suggest that she may have been tied up before she was killed.
Violence has always been part of human behavior, but the origins of war are hotly debated. Some experts see it as deeply rooted in evolution, pointing to violent confrontations among groups of chimpanzees as clues to an ancestral predilection. Others emphasize the influence of complex and hierarchical human societies, and agricultural surpluses to be raided.
. . .
Marta Mirazon Lahr and Robert A. Foley, of Cambridge University and the Turkana Basin Institute in Nairobi, Kenya, and a team of other scientists, concluded in Nature that the find represented warfare among prehistoric hunter-gatherers.
Luke A. Glowacki, a postdoctoral researcher in human evolutionary biology at Harvard University not involved with the discovery, agreed. “There’s no other find like it,” he said.
With Richard Wrangham, a professor of biological anthropology at Harvard, Dr. Glowacki has traced the evolutionary roots of human warfare in chimpanzee behavior. And, he said, this find “shows warfare occurred before the invention of agriculture.”

For the full story, see:
JAMES GORMAN. “Prehistoric Massacre Hints at War Among Hunter-Gatherers.” The New York Times (Thurs., JAN. 21, 2016): A7.
(Note: ellipsis, and bracketed date, added.)
(Note: the online version of the story has the date JAN. 20, 2016, and has the title “Prehistoric Massacre Hints at War Among Hunter-Gatherers.”)

The Nature article mentioned above, is:
Lahr, M. Mirazón, F. Rivera, R. K. Power, A. Mounier, B. Copsey, F. Crivellaro, J. E. Edung, J. M. Maillo Fernandez, C. Kiarie, J. Lawrence, A. Leakey, E. Mbua, H. Miller, A. Muigai, D. M. Mukhongo, A. Van Baelen, R. Wood, J. L. Schwenninger, R. Grün, H. Achyuthan, A. Wilshaw, and R. A. Foley. “Inter-Group Violence among Early Holocene Hunter-Gatherers of West Turkana, Kenya.” Nature 529, no. 7586 (Jan. 21, 2016): 394-98.

Two Die from Listeria in Artisanal Cheese

(p. A19) Two people have died following an outbreak of listeria linked to a popular artisanal raw milk cheese made in upstate New York, the authorities said this week.
The deaths occurred in Vermont and Connecticut, local officials said. Four other people in New York and Florida reported feeling sick after eating Ouleout, the artisanal cheese, which is produced by Vulto Creamery in Walton, N.Y.
. . .
Ouleout has been celebrated across the United States as much for its unusual back story as for its flavor: It was created by Jos Vulto, a Dutch artist linked to the Museum of Modern Art, who started making cheese in his apartment and aging it under a sidewalk in Brooklyn.
. . .
Mr. Vulto came to the United States from the Netherlands in 1990, according to several media outlets specializing in cheese. He spent two years as an artist-in-residence at P.S. 1 in Queens, a contemporary art institution affiliated with the Museum of Modern Art in New York. He specialized in crafting abstract installations made of metal.
His specialty involved “wrapping empty buildings in cloth and building contained fires of sawdust and hay inside,” according to Culture Cheese Mag. When the building started to emit smoke, the cloth absorbed an imprint of the building. Mr. Vulto called the technique “rooking,” a play on the Dutch word for smoke.
In 2008, Mr. Vulto switched to cheese making, reportedly inspired by the stink caused by a carton of soured milk in his refrigerator. He began creating rudimentary cheese in his apartment, and gradually mastered the art by making and remaking new batches and studying techniques.

For the full story, see:
KIMIKO de FREYTAS-TAMURA. “Two People Die after Eating Raw Milk Cheese.” The New York Times (Sat., MARCH 11, 2017): A19.
(Note: ellipses added.)
(Note: the online version of the story has the date MARCH 10, 2017, and has the title “Two People Die after Eating Raw Milk Cheese Made in New York State.” The last sentence in the next-to-last paragraph quoted above, appears in the online, but not in the print, version of the article.)

“Thank You, Industrialization” (Thank YOU, Hans Rosling)

The TED talk embedded above, is one of my favorites. I sometimes show an abbreviated version to my Economics of Technology seminar.

(p. B8) Hans Rosling, a Swedish doctor who transformed himself into a pop-star statistician by converting dry numbers into dynamic graphics that challenged preconceptions about global health and gloomy prospects for population growth, died on Tuesday in Uppsala, Sweden. He was 68.

The cause was pancreatic cancer, according to Gapminder, a foundation he established to generate and disseminate demystified data using images.
. . .
Brandishing his bubble chart graphics during TED (Technology, Entertainment and Design) Talks, Dr. Rosling often capsulized the macroeconomics of energy and the environment in a favorite anecdote about the day a washing machine was delivered to his family’s cold-water flat.
“My mother explained the magic with this machine the very, very first day,” he recalled. “She said: ‘Now Hans, we have loaded the laundry. The machine will make the work. And now we can go to the library.’ Because this is the magic: You load the laundry, and what do you get out of the machine? You get books out of the machines, children’s books. And Mother got time to read to me.”
“Thank you, industrialization,” Dr. Rosling said. “Thank you, steel mill. And thank you, chemical processing industry that gave us time to read books.”

For the full obituary, see:
SAM ROBERTS. “Hans Rosling, Swedish Doctor, Teacher and Pop-Star Statistician, Dies at 68.” The New York Times (Fri., FEB. 10, 2017): B8.
(Note: ellipses added.)
(Note: the online version of the obituary has the date FEB. 9, 2017, and has the title “Hans Rosling, Swedish Doctor and Pop-Star Statistician, Dies at 68.”)

Fitness Can Improve Even After Age 100

(p. D4) At the age of 105, the French amateur cyclist and world-record holder Robert Marchand is more aerobically fit than most 50-year-olds — and appears to be getting even fitter as he ages, according to a revelatory new study of his physiology.
The study, which appeared in December in The Journal of Applied Physiology, may help to rewrite scientific expectations of how our bodies age and what is possible for any of us athletically, no matter how old we are.
. . .
Conventional wisdom in exercise science suggests that it is very difficult to significantly add to aerobic fitness after middle age. In general, VO2 max, a measure of how well our bodies can use oxygen and the most widely accepted scientific indicator of fitness, begins to decline after about age 50, even if we frequently exercise.
But Dr. Billat had found that if older athletes exercised intensely, they could increase their VO2 max. She had never tested this method on a centenarian, however.
. . .
These data strongly suggest that “we can improve VO2 max and performance at every age,” Dr. Billat says.

For the full story, see:
GRETCHEN REYNOLDS. “Phys Ed; Lessons from a 105-Year-Old.” The New York Times (Tues., FEB. 14, 2017): D4.
(Note: ellipses added.)
(Note: the online version of the article has the date FEB. 8, 2017, and has the title “Phys Ed; Lessons on Aging Well, From a 105-Year-Old Cyclist.”)

The academic article mentioned in the passages quoted above, is:
Billat, Véronique, Gilles Dhonneur, Laurence Mille-Hamard, Laurence Le Moyec, Iman Momken, Thierry Launay, Jean Pierre Koralsztein, and Sophie Besse. “Case Studies in Physiology: Maximal Oxygen Consumption and Performance in a Centenarian Cyclist.” Journal of Applied Physiology 122 (2017): 430-34.