Monthly Archives: March 2015

New sign-up under health care law gets lukewarm reception

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WASHINGTON (AP) - Several million people hit with new federal fines for going without health insurance are getting a second chance to sign up, and that could ease the sting of rising penalties for being uninsured.

But after the enrollment window reopened Sunday, its unclear how many know about the time-limited opportunity, let alone are taking advantage of it.

Fines payable to the IRS are the stick behind the offer of taxpayer-subsidized private insurance under President Barack Obamas health care law. Virtually everyone in the country is now required to have coverage through an employer or a government program, or by buying individual policies.

This is the first year fines are being collected from uninsured people the government deems able to afford coverage. Tax preparation company H&R; Block says the penalty averages about $170 among its affected customers. It usually is deducted from a persons tax refund.

Those penalized are mainly the kind of people the law was intended to help: low- and middle-income workers who do not have coverage on the job or are self-employed. Roughly 4 million people are expected to pay fines, according to congressional estimates. Many more will qualify for exemptions.

Travel agent Charles Baxter of Phoenix said his tax refund was reduced by $247 for being uninsured in 2014. He had not heard about the second chance to sign up for 2015 coverage.

Baxter says he will take another look now, but is not sure whether he will opt to buy insurance. Much of his income goes to help take care of his mother, who has health problems.

I may have to see if any of the health care costs have changed, to where I might be able to squeeze it in, he said. But so far, its not looking like it.

Baxter supports the overall goals of the health law, but says the government should also look at someones expenses - not just income - before assessing the fine.

Penalties for being uninsured are going up this year, to a minimum of $325 for the full 12 months. Thats a significant increase from the $95 minimum in 2014.

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New sign-up under health care law gets lukewarm reception

House, Senate health-care funding disagreement shapes budget talks

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TALLAHASSEE | A disagreement between the Florida House and Senate over health-care funding and Medicaid expansion could foreshadow a budget showdown that leaves hospitals and health clinics vulnerable.

The Senate is including in its budget a plan to use federal Medicaid expansion dollars to provide health coverage to roughly 1 million poor Floridians. The conservative House has blocked similar proposals for the past two years.

However, the House does hope to include about $2 billion in its budget to continue the Low-Income Pool, or LIP, a separate Medicaid program that is set to expire in June. State and federal officials are in discussion about how to keep LIP money flowing for another year or longer, but nothing has been agreed upon.

UF Health Jacksonville, a hospital perpetually on shaky financial ground, receives nearly $95 million from the program each year in addition to $26 million directly from the city budget that would also be in jeopardy if LIP goes away because of the lost incentive of a federal match. It and other safety net hospitals around the state are main beneficiaries of the program.

The Florida Senate has said the uncertainty around LIP makes it even more important to fight for Medicaid expansion and the roughly $50 billion in federal dollars that would come with it over the next decade.

These are Florida dollars; they dont come out of the ground in Washington, D.C., they come out of our pockets in the state of Florida, and we deserve to have them back here, Sen. Bill Galvano, R-Bradenton, said Tuesday when the Health Policy Committee unanimously approved the Medicaid expansion plan. And I assure you and I assure the Florida House that this will be the cornerstone of our 15-16 budget.

While the business and health-care industries are in support of the Senates health care proposal, conservative organizations like Americans for Prosperity and the James Madison Institute are opposed. These groups have singled out the simultaneous debate about LIP as reason why the federal government cant be trusted to keep its long-term promise to shoulder the majority of the costs of Medicaid expansion.

The U.S. Department of Health and Human Services has said that LIP cannot continue in its current form, causing some conservatives to interpret it is a veiled threat that the program would be allowed to expire and leave safety net hospitals that depend on the money in a lurch.

Our concern is anytime you take $50 billion from the federal government, youre asking for trouble, and we see that illustratively with the LIP funding, JMI President and chief executive Bob McClure said during the committee meeting.

Because of time constraints, the public comment period was abbreviated, and McClure wasnt able to read his entire prepared remarks. That statement gives even more insight to the connections he makes between the LIP extension and Medicaid expansion debates.

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House, Senate health-care funding disagreement shapes budget talks

Research calls for new policies to support women veterans' health care needs

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Special issue of Medical Care presents findings from VA's women's health researchers

March 16, 2015 - As more women veterans seek health care in the Veterans Administration (VA) system, effective approaches are needed to ensure that their unique needs are recognized and met. A special April supplement to Medical Care collects new studies from an ongoing research initiative to inform health care policy for women veterans. The journal is published by Wolters Kluwer.

"The goal of this supplement is to disseminate new research findings related to the planning, organization, financing, provision, evaluation and improvement of health services and/or outcomes for women veterans and women actively serving in the military," according to an introductory editorial. Guest Editors for the special issue were drawn from the VA Women's Health Research Network, led by Lori A. Bastian, MD, MPH, of the VA Connecticut Healthcare System, West Haven. The supplement was sponsored by the VA Health Services Research & Development (HSR&D) Service in the Office of Research and Development.

Research to Guide Policy on Health Care for Women Veterans

The number of women veterans receiving care in the VA system has more than doubled, making it essential to understand and introduce system-wide policies to meet their health care needs. The 21 studies in the special issue provide new data to guide policy in areas identified by the VA HSR&D Service's Women's Health Research agenda, including:

A final section on using research evidence to transform women veterans' health and health care identifies "top priority recommendations" for providing gender-sensitive care in each area of comprehensive women's health care. These recommendations can help to guide quality improvement efforts, but will require "multi-level engagement of a broad array of key stakeholders."

In an editorial, David Atkins, MD, MPH, and Linda Lipson, MA, of the HSR&D Service highlight important issues for further research in the wake of the 2014 Veterans Choice Act, which broadens veterans' access to health care services. Kristin Mattocks, PhD, of VA Central Western Massachusetts, Leeds, discusses the policy challenges of coordinating care for women veterans using dual health care systems--both inside and outside the VA.

Elizabeth M. Yano, PhD, MSPH, of the VA Greater Los Angeles HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy reports on the Women's Health Collaborative Research to Advance Transformation and Excellence (CREATE)--a new "partnered research initiative" seeking to accelerate the implementation of comprehensive care for women veterans. The guest editors conclude, "Researchers should continue to engage in effective partnerships with clinical and administrative leaders within the VA to ensure that research is fully capable of informing improvements in clinical care and advancing evidence-based policy," the editors conclude.

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Click here to read the Women Veteran's Health and Health Care supplement.

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Research calls for new policies to support women veterans' health care needs

AACC Cautions FDA Against Over-Regulating the Genetic Testing Technology Vital to Precision Medicine

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Newswise WASHINGTON Today AACC sent formal comments to the Food and Drug Administration (FDA) on the agencys proposed regulation of next-generation sequencing tests. AACC appreciates FDAs efforts to seek input from the healthcare community before developing new policy in this area, but is concerned that FDA regulation of next-generation sequencing could impede the advancement of precision medicine.

Precision medicine uses a persons unique biological makeup, including genetics, to determine which treatments that person would respond to best. Genetic tests hold the potential to predict an individuals risk of developing numerous different conditions throughout life. Having this knowledge could lead one to take a more proactive approach to his or her health, particularly with respect to chronic diseases such as cardiovascular disease and diabetes that could be prevented with basic lifestyle changes. Next-generation sequencing will enhance the application of precision medicine by making genetic testing more readily available.

After reviewing FDAs preliminary discussion paper on the topic, Optimizing FDAs Regulatory Oversight of Next-Generation Sequencing Diagnostic Tests, AACC recommends that oversight of next-generation sequencing remain under the Clinical Laboratory Improvement Amendments (CLIA) like other laboratory developed tests. CLIA-regulated laboratories conducting next-generation sequencing testing are experienced in developing, verifying, and performing clinical tests. AACC believes that CLIA-recognized accrediting bodies and professional societies should continue to take the lead in providing oversight and guidance for next-generation sequencing testing in the absence of specific, identified problems with this approach.

AACC agrees with the FDA that next-generation sequencing tests offer great opportunities for advancing laboratory medicine and improving patient care, and we commend the agencys efforts to initiate a dialogue among the various organizations and professionals involved in next-generation sequencing and those affected by such testing, said AACC President Dr. David D. Koch. We believe, however, that the current oversight mechanisms in place for next-generation sequencing are sufficient for dealing with the particular challenges this technology presents and that further FDA involvement at this time might hinder the advancement of this field.

Read AACCs comment letter here.

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About AACC Dedicated to achieving better health through laboratory medicine, AACC brings together more than 50,000 clinical laboratory professionals, physicians, research scientists, and business leaders from around the world focused on clinical chemistry, molecular diagnostics, mass spectrometry, translational medicine, lab management, and other areas of breaking laboratory science. Since 1948, AACC has worked to advance the common interests of the field, providing programs that advance scientific collaboration, knowledge, expertise, and innovation. For more information, visit http://www.aacc.org.

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AACC Cautions FDA Against Over-Regulating the Genetic Testing Technology Vital to Precision Medicine

Genetic discovery provides clues to how TB may evade the immune system

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The largest genetic study of tuberculosis (TB) susceptibility to date has led to a potentially important new insight into how the pathogen manages to evade the immune system. Published today in the journal Nature Genetics, the study advances understanding of the biological mechanisms involved in TB, which may open up new avenues to design efficient vaccines for its prevention.

TB, caused by infection with the pathogen Mycobacterium tuberculosis, is a major global public health problem. According to the World Health Organization, in 2013 nine million people fell ill with TB and 1.5 million died from the disease. Over 95% of TB deaths occur in low- and middle-income countries. About one-third of the world's population has latent TB - in other words, they carry the infection but show no symptoms; only around one in ten of infected individuals develop active TB.

Evidence suggests that an individual's DNA affects their susceptibility to TB, both in terms of becoming infected and whether the disease progresses from latent to active TB. In order to identify genes that predispose people to TB, an international team of researchers carried out a genome-wide association study (GWAS), comparing the genomes of 5,500 TB patients against those of 5,600 healthy controls. In total, the researchers analysed 7.6 million genetic variants.

The team found that variants of the gene ASAP1 on chromosome 8 affect individuals' susceptibility to TB. The gene encodes a protein carrying the same name and is highly expressed - in other words, larger amounts of the protein are found - in a particular type of immune cells known as dendritic cells that play a key role in kick-starting the body's immune response to incoming pathogens.

The researchers showed that infection with M. tuberculosis leads to the reduction of ASAP1 expression in dendritic cells - but people who have a particular genetic variant in the ASAP1 gene associated with greater susceptibility to TB show stronger reduction of ASAP1 expression after infection than people who have a protective variant of this gene.

The researchers found that reducing levels of the ASAP1 protein affects the ability of dendritic cells to move, which explains the mechanism of the previously-known slow migration of dendritic cells infected with M. tuberculosis and may help the pathogen to evade the immune system, leading to TB.

"Our study provides a new insight into biological mechanisms of TB," says Dr Sergey Nejentsev, Wellcome Trust Senior Research Fellow from the Department of Medicine at the University of Cambridge, who led the research. "TB is a major global health problem and the threat of drug-resistance means that we urgently need to develop new ways of fighting back. In future, it may be possible to target immune pathways that involve ASAP1 to design efficient vaccines for TB prevention."

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The study was supported by the Wellcome Trust, EU Framework Programme 7, European Research Council, the Royal Society and the NIHR Cambridge Biomedical Research Centre.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

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Genetics: No Evidence of Role in Racial Mortality Gap

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Newswise There is still no evidence of genetic difference between blacks and whites to account for the health disparities in cardiovascular disease (CVD), according to a new study by McGill University researchers. Published in the American Journal of Epidemiology, the researchers suggest that after a decade of genetic studies, factors such as lifestyle, education and socio-economics - not genetics - are more promising avenues to understanding racial health disparities.

The researchers focused on cardiovascular disease, the largest contributor to the racial mortality gap, and conducted a systematic review for articles published over a seven year period in which genetic data from African and European populations were available. The team found no explanation for racial disease disparities amongst any of the hundreds of genetic variants reported.

After nearly a decade of genome-wide association studies (GWAS), no assessment had yet been made of their contribution toward an explanation of the most prominent racial health disparities observed at the population level, says Jay Kaufman, of the Department of Epidemiology, Biostatistics & Occupational Health in the Faculty of Medicine.

Kaufman and colleagues assessed the reported associations from published genomic studies, The fact that our results show so little stable evidence of genetic explanations for racial disparities in CVD could be attributed to a general failure of GWAS to explain observed disease phenotypes, adds Kaufman.

Despite the enormous social investment in genomic studies, we have not advanced our understanding into disparities in the most common cause of morbidity and mortality between races, says Kaufman, Given this outcome, more research and investment is needed to examine the effects of social and environmental inequalities, such as exposure to unhealthy food and psychosocial stressors. It is possible that the answer may lie in some kind of interaction between genetic factors and these environmental and behavioural differences, but based on current technology, the detection of such interactions is even more challenging.

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This study was supported by the Canada Research Chairs Program.

The Contribution of Genomic Research to Explaining Racial Disparities in Cardiovascular Disease Jay S. Kaufman, Lena Dolman, Dinela Rishani and Richard S. Cooper, American Journal of Epidemiology DOI:10.1093/aje/kwu319

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Genetics: No Evidence of Role in Racial Mortality Gap

Jailbreaking yeast could amp up wine's health benefits, reduce morning-after headaches

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University of Illinois College of Agricultural, Consumer and Environmental Sciences

URBANA - University of Illinois scientists have engineered a "jailbreaking" yeast that could greatly increase the health benefits of wine while reducing the toxic byproducts that cause your morning-after headache.

"Fermented foods--such as beer, wine, and bread--are made with polyploid strains of yeast, which means they contain multiple copies of genes in the genome. Until now, it's been very difficult to do genetic engineering in polyploid strains because if you altered a gene in one copy of the genome, an unaltered copy would correct the one that had been changed," said Yong-Su Jin, a U of I associate professor of microbial genomics and principal investigator in the Energy Biosciences Institute.

Recently scientists have developed a "genome knife" that cuts across multiple copies of a target gene in the genome very precisely--until all copies are cut. Jin's group has now used this enzyme, RNA-guided Cas9 nuclease, to do precise metabolic engineering of polyploid Saccharomyces cerevisiae strains that have been widely used in the wine, beer, and fermentation industries.

The possibilities for improved nutritive value in foods are staggering, he said. "Wine, for instance, contains the healthful component resveratrol. With engineered yeast, we could increase the amount of resveratrol in a variety of wine by 10 times or more. But we could also add metabolic pathways to introduce bioactive compounds from other foods, such as ginseng, into the wine yeast. Or we could put resveratrol-producing pathways into yeast strains used for beer, kefir, cheese, kimchee, or pickles--any food that uses yeast fermentation in its production."

Another benefit is that winemakers can clone the enzyme to enhance malolactic fermentation, a secondary fermentation process that makes wine smooth. Improper malolactic fermentation generates the toxic byproducts that may cause hangover symptoms, he said.

Jin stressed the genome knife's importance as a tool that allows genetic engineers to make these extremely precise mutations.

"Scientists need to create designed mutations to determine the function of specific genes," he explained. "Say we have a yeast that produces a wine with great flavor and we want to know why. We delete one gene, then another, until the distinctive flavor is gone, and we know we've isolated the gene responsible for that characteristic."

The new technology also makes genetically modified organisms less objectionable, he said. "In the past, scientists have had to use antibiotic markers to indicate the spot of genetic alteration in an organism, and many persons objected to their use in foods because of the danger of developing antibiotic resistance. With the genome knife, we can cut the genome very precisely and efficiently so we don't have to use antibiotic markers to confirm a genetic event."

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Jailbreaking yeast could amp up wine's health benefits, reduce morning-after headaches

Gene Therapy Gastrointestinal Insight: Trends and Challenges Analysed in Research Report – Video

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Gene Therapy Gastrointestinal Insight: Trends and Challenges Analysed in Research Report
Gene Therapy Gastrointestinal Insight: Pipeline Assessment, Technology Trend, and Competitive Landscape provides the information across the gene therapy value chain covering gene therapy ...

By: James Jacob

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Gene Therapy Gastrointestinal Insight: Trends and Challenges Analysed in Research Report - Video

ACGT Surpasses $25 Million Funding Milestone with Two New Grants

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Stamford, CT (PRWEB) March 16, 2015

Alliance for Cancer Gene Therapy (ACGT) the nations only nonprofit dedicated exclusively to cell and gene therapies for cancer has achieved a major milestone, surpassing $25 million donated to innovative and breakthrough cancer research. ACGT was founded by Barbara Netter and her late husband, Edward, in 2001 with the goal of transforming cancer into a manageable, treatable disease.

Pushing the foundation across the $25 million threshold are a pair of three-year, $250,000 grants to two esteemed scientists: Meenakshi Hegde, MD, of Texas Childrens Cancer Center at Baylor College of Medicine in Houston, TX, and Christopher Jewell, PhD, at University of Maryland, College Park. Dr. Hegdes work will focus on immunotherapy, specifically adoptive cellular therapy for melanoma. Dr. Jewells research is centered on harnessing intra-lymph node gene therapy to promote tumor immunity. The grantees will develop genetically-modified T cells and cancer vaccines with the potential to stop cancer in its tracks.

Drs. Hegde and Jewell are two outstanding scientists in the vanguard of treating and defeating cancer, said Barbara Netter, ACGTs President. Their work offers tremendous hope to those battling cancer, and also to their loved ones.

ACGT grants are awarded to promising researchers whose work dovetails with the foundations mission: Leveraging cell and gene therapies to supplant the more harrowing cancer treatments like radiation, chemotherapy and surgery. ACGTs $25 million in grants have funded watershed research and trials such as those that activate patients own immune systems to battle cancer cells. These trials have saved the lives of cancer patients otherwise believed to be beyond treatment.

The two most recent grants continue ACGTs mission of equipping innovative scientists with the tools and support to revolutionize the fight against cancer. ACGT grants range from $250,000 to $1 million, and reward both young, promising researchers and their more established colleagues. Past recipients include such pre-eminent scientists as University of Pennsylvanias Dr. Carl June and Memorial Sloan-Ketterings Dr. Michel Sadelain; this past summer, the Food and Drug Administration (FDA) granted breakthrough status to immunotherapy treatments for leukemia developed by each of these scientists for which ACGT provided early funding.

About Alliance for Cancer Gene Therapy (ACGT) Established in 2001, ACGT (http://www.acgtfoundation.org) is the nations only not-for-profit dedicated exclusively to cell and gene therapy treatments for all types of cancer. One-hundred percent of contributions go directly to research. ACGT has funded 46 grants in the U.S. and Canada since its founding in 2001 by Barbara Netter, President, and her late husband, Edward, to conduct and accelerate critically needed innovative research. Since its inception, ACGT has awarded 31 grants to Young Investigators and 15 grants to Clinical Investigators, totaling more than $25 million in funding. ACGT is located at 96 Cummings Point Road, Stamford, CT 06902.

ACGT on Facebook: http://www.facebook.com/ACGTfoundation ACGT on Twitter: http://www.twitter.com/ACGTfoundation ACGT on YouTube: http://www.youtube.com/user/ACGTfoundation

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ACGT Surpasses $25 Million Funding Milestone with Two New Grants

London Books Roundup: March 2015

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16 March 2015 | Books & Poetry | By: M@

Our regular guide to the latest books about the capital.

Chunky books about architecture arent exactly in short supply, but heres one that punches above its own considerable weight. It does so by taking account of how buildings affect the peopleliving in and around them, and vice-versa. The book is organised by area, with inner London sliced into 30 or so chapters (Clerkenwell, Bankside, etc.). Each covers around a dozen important buildings and other architectural spaces.

Rather than simply characterise the fabric of a building, author Paul Knox delves a bit deeper to recall its history, and even its prehistory. For example, the brutalist former Home Office on Petty France stands on the site of the equally derided Queen Annes Mansions, a continuation of overbearing, Orwellian architecture.With a supremely generous picturebudget (525 colour photos!) and a deftly written text, this is both a first-rate guide to the citys bricks and stones, but also a visual social history of a perplexing city.

From Merrell. Author website.

And now for something completely different. Alice Stevenson is a professionalillustrator, but shes also a keen walker, and an urban walker at that. Her book offers vignettes from 32 urban strolls, nearly all of them north of the river. Her compassmight need oiling, but her experiences flow from the pages with ease and grace. From a melancholy sojourn round the slopes of Hampstead to the antique futurism of the Barbican and its attendant Pedway system, we find that a good walk can conjure all moods and mindsets.

For Alice, as for anyone, London can be a wonderland or a torment, but there is always more to explore.The book is decorated throughout with the authors own semi-abstract illustrations, making this an attractive gift book or inspiring manual of perambulation for anyone who spends too many hours indoors.

From September Publishing. Author website. Authors twitter @AliceStevo.

A tricky one to review, seeing as it pretty much does what it says on the front. This photo-heavy guide to western Europes tallest habitable building takes you through all its evolutions, from design, to construction, to a set of panoramas from the observation decks. Along the way, theres an interview with architect Irvine Sellar, a floor-by-floor guide to whats in the Shard, a history of the area and information on key buildings you can peer down on from the top. Curiously, theres no specific mention of Aqua Shard, Oblix and Hutong, the three restaurants that most make the Shard worth visiting, although the Shangri-La hotel is briefly name-checked. The book isattractive, well illustrated and, best of all, balances on its end like a miniature Shard. It isan official guide, though,so dont expect any other kind of balance, but an account that glows like the Shards illuminated peak.

From Thames & Hudson.

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London Books Roundup: March 2015