Liberty woman tells of ‘terrifying’ break-in – Warren Tribune Chronicle

LIBERTY A woman threw items from her curio shelf at intruders who wrapped her teen daughters hands in duct tape and claimed they were police serving a warrant around 1 a.m. Friday when they broke into their home with assault rifles, she said.

Jacquelyn Cylar, 43, said she was sleeping upstairs in her 36 Euclid Blvd. home when she heard a loud bang and sat up to get out of bed.

A man came up with long gun with a flashlight on it, pointing at me and yelling for me to get up, this is police and we have a search warrant, he said. I tussled with him and he hit me with the gun and got me downstairs. That was when I saw my daughter duct taped, lying face down on the floor, Cylar said.

Police found spent shell casings and two bullet holes through a bedroom window after they arrived, according to the report. A side door to the home was busted in, Cylar said.

There were two to four men in the home, Cylar said, and said she believes they thought only she and her daughter were home when they decided to break in. There were three other juveniles related to Cylar in the home at the time.

Cylars son and nephew ran from the house through a window to get help, Cylar said.

She said she doesnt know what the men were looking for or if they took anything.

The men fled when Cylar started throwing vases and other items at them from her curio cabinet.

I just grabbed anything I could. I think they panicked in the chaos. It didnt work like they thought it would when they first came in, Cylar said.

Cylar and her daughter both called 911.

Youre very, very brave. Hang in there, OK? a Trumbull County 911 Center dispatcher told a girl, 14, on the recorded call.

The girl was crying as she answered questions. No one required medical attention after the incident, according to the police report.

Liberty police Chief Richard Tisone said the investigation is at a standstill until the juveniles that were in the home come down to the station to be interviewed.

Although the victims gave officers statements at the scene, there were some inconsistencies, Tisone said.

Of course we all have different things to say to them, we were all in different rooms and saw and heard different things, Cylar said.

When police were at the house, the father of two of the witnesses arrived and became hostile with officers, the Liberty police report states.

Cylar said the man just wanted the kids to get some rest after the incident, and that they gave statements to the first officers to arrive, and gave a written account.

They were traumatized and it was late, we werent being uncooperative, we cooperated, Cylar said. She said she expected police to call her or stop in later Friday, but hadnt heard from them in the early afternoon.

Tisone said it is procedural to remove witnesses from the chaos of a crime scene to be interviewed individually. And until that happens, the investigation is at a standstill, even with allegations men claiming to be police officers broke into a home.

The fact that we werent able to speak more to the victims is concerning. We werent given access to the victims, so we dont know what happened, what to look for, Tisone said. And the evidence at the crime scene didnt coincide to the statements they gave earlier. But we welcome their cooperation at any point. They can set a time to come anytime.

Cylar said she doesnt understand why the police dont think they are cooperating.

We gave them descriptions of the vehicles, we told them what happened. We want to see these guys caught and convicted, Cylar said.

Police collected duct tape from the girls arms, a roll of duct tape in the living room and a black pipe from the backyard.

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VIENNA Police here are investigating the disappearance of several U.S. flags from a bridge on King Graves Road ...

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NILES The mayors fiscal recovery plan received its second reading Friday by Niles City Council, with five ...

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Liberty woman tells of 'terrifying' break-in - Warren Tribune Chronicle

North Liberty Council votes to end intercity bus service – The Gazette: Eastern Iowa Breaking News and Headlines

Jul 14, 2017 at 5:53 pm | Print View

NORTH LIBERTY The intercity bus service in North Liberty will end less than a year after it began.

The North Liberty City Council voted unanimously Tuesday to end the service Sept. 1, citing to its expense and a lack of ridership.

The program was averaging about 12 riders per month, assuming they took round trips, and cost about $4,010 per month in the first eight months of the program.

Averaged out, each time a rider got on the bus, it cost the city $215.50, city planner Dean Wheatley said.

Theres not much usage of this service. Thats everybodys concern, said council member Chris Hoffman, adding the council wants to find a different, more cost-effective way to provide a transit service.

Hoffman said that previously a transit advisory committee helped the council by developing recommendations for bus services, such as one that goes from North Liberty to Iowa City. He said the city will rely again on the committee for solutions and ask if there are ways to work with surrounding entities such as Coralville, Iowa City and Johnson County on the issue.

We could all benefit from a more inclusive transit system, Hoffman said.

The council budgeted $50,000 and rented a Johnson County SEATS bus last year when it first approved the program. The bus only ran from about 10:30 a.m. to 1:30 p.m. and made four trips around its route per day, Wheatley said.

North Liberty residents, however, still can be served by the Johnson County SEATS paratransit program, which helps to transport senior citizens and people with disabilities to locations such as a doctors office or grocery store.

More information about the SEATS program can be found on its website, johnson-county.com.

l Comments: (319) 339-3172; maddy.arnold@thegazette.com

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North Liberty Council votes to end intercity bus service - The Gazette: Eastern Iowa Breaking News and Headlines

Reason releases hilarious parody video ‘Game of Thrones: Libertarian Edition’ – TheBlaze.com

With season seven of the smash HBO show Game of Thrones debuting on Sunday, Reason has released another hilarious video putting a libertarian spin on the fantasy epic.

ReasonsAustin Bragg, Meredith Bragg, Andrew Heaton, and Remy Munasifihave made libertarian versions of Star Trek and Star Wars in the past. Star Trek: Libertarian Edition won a Southern California Journalism Award forBest Humor/Satire Writingof 2016.

Now Heaton and the Braggs are back. The video features Heaton and Austin Bragg playing numerous roles. Heaton plays theHand of the King attempting to convince the small council that small government and non-interventionism is the key to a more prosperous Westoros.

Heaton and Austin Bragg also play two members of the Nights Watch trying to figure out why their ancestors built a giant wall to keep out the free folk, people who marry whoever they want, live however they please, and elect leaders instead of being under the rule of someone they never approved of.

Also, watch as Heaton attempts to remember what the sayings are for House Republican and House Democrat while attending lessons with Maester Luwin, and learn that the Libertarian sigil is a porcupine humping a pile of money.

Reason releases humorous videos regularly. Some havemockedSaturday Night Live for itsHillary Clinton Hallelujah musical number, and CNN for its biased reporting.

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Reason releases hilarious parody video 'Game of Thrones: Libertarian Edition' - TheBlaze.com

Russia’s global anti-libertarian crusade – Hot Air

Nonetheless, pro-Russian (or at least anti-anti-Russian) arguments have become fairly common not just among conservatives but among a contingent of libertarians, such as former Rep. Ron Paul and Antiwar.com Editorial Director Justin Raimondo. The new Republican affection for Russia is largely a matter of political polarization: Since Putin is the Democrats boogeyman du jour, he cant be all bad. But quite a few conservatives also genuinely see Putins Russia as a Christian ally against Islam, a perspective recently endorsed by Ann Coulter in a March column trollishly titled Lets Make Russia Our Sister Country.

That view manages to ignore not only Russias coziness with Iran but the fact that one of Putins staunchest domestic allies, Chechen leader Ramzan Kadyrov, runs a de facto sharia state within the Russian Federation. This spring, Kadyrov was in the news for throwing gay men in prison camps and threatening a fatwa on Russian journalists who exposed the persecution.

Meanwhile, Ron Paulstyle libertarians are inclined to see Russia as a check on U.S. foreign adventurism and Russia hawks as hardcore proponents of the American imperial leviathan. Unfortunately, there is a small contingent who fall victim to the fallacy that the enemy of the enemy is my friend, and if the Kremlin is the enemy of my enemy, then it must be my friend, Palmer says.

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Russia's global anti-libertarian crusade - Hot Air

In Case You Missed It: Augustus Invictus, Education, Rwanda – Being Libertarian


Being Libertarian
In Case You Missed It: Augustus Invictus, Education, Rwanda
Being Libertarian
Invictus went on to cite a number of reasons why he left, including baseless attacks by fellow libertarians. Over the course of his campaign he was called a devil worshiper, a genocidal maniac, a fascist neo-Nazi hate monger, a white supremacist, and ...

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In Case You Missed It: Augustus Invictus, Education, Rwanda - Being Libertarian

St. Paul bartender will brave hypothermia, bears on around-Apostle Islands swim – TwinCities.com-Pioneer Press

A 36-year-old St Paul man is about to embark on a never-before-done swimming adventure in the chilled waters of Lake Superior and its off-shore archipelago of the Apostle Islands.

Daniel OKane, who lives in the citys Highland Park neighborhood with his wife and cats and works as a bartender at Fitzgeralds, was planning Saturday to set off on a nearly monthlong journey that will feature him swimming to each of the 22 islands, which lie off Wisconsins Lake Superior shoreline near the town of Bayfield.

Everything is just about ready, he said in a telephone interview Friday. Two days of sunshine will make it almost safe in the water. Couple of bear issues on a few islands, and the wind hopefully will change to make it so I can have the wind at my back during some early stretches.

Others have swum from island to island before, but heres OKanes distinction: Its the first self-supported, people-powered circum-tour of the Apostle Islands, he said in a phone interview Friday.

His route pinballing between the islands will not be entirely submerged in the waters, which ranged between 45 and 54 degrees Friday. I cant swim in anything colder than 48 or Ill get hypothermia too fast, he said.

Hell swim, in a wetsuit, from one island to another and then get out of the water as soon as I can. Nearby, his partner, attorney Paul Voge of Duluth, will paddle a kayak filled with their supplies and towing a paddleboard. The paddleboard is essentially a life raft for OKane should he need it.

Then, depending on the island, OKane will bicycle, hike or, most often, stand-up paddleboard along the shore of the island until they reach the a point close to another island. Then hell swim to that island.

As such, OKane is expecting to swim only 48.75 miles, while Voge will paddle 100. In all, OKane expects to paddleboard 20 to 30 miles, hike 10 to 20 miles and bike for 30 miles on the route. He expects it will take 24 to 28 days.

The trip required a special blessing from the National Park Service. Much of the islands are within the Apostle Islands National Lakeshore, which is administered by the agency. The parks regulations dont allow people to stay for more than two weeks, so OKane and Voge received special permits for the endeavor.

If we dont make it out after 30 days, we have to call for a water taxi, he said.

OKane said he decided to do the trip after he completed a swimming race from Bayfield to Madeleine Island, the largest of the Apostles.

There was a woman there greeting us who handed me a Popsicle stick and said Welcome to Madeleine Island. It was this really cool feeling that washed over me that everyone with a pioneering spirit can reach anywhere they want under their own power, he said.

OKane has a satellite-connected device to update his family on his whereabouts and an Instagram account, but there will be no practical way for the public to follow his adventure.

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St. Paul bartender will brave hypothermia, bears on around-Apostle Islands swim - TwinCities.com-Pioneer Press

Two former aides indicted over release of Virgin Islands delegate sex tape – The Hill

Two former aides to Virgin Islands Del. Stacey Plaskett (D) have been indicted on federal charges over the unauthorized leak of Plaskett's sex tape last year.

According to a Justice Department press release, former general counsel Juan McCullum and schedulerDorene Browne-Louis were indicted Thursday in Washington, D.C.

McCullum worked for Plaskett fromApril 2015 until June 2016 in herlegislative office in Washington, D.C. According to the statement, Browne-Louis worked in the same office from January 2015 until April 2016.

According to the press release,McCullum offered in March 2016 to take Plaskett'smalfunctioning iPhone to a local Apple store for service. The device contained lewd photos shared between Plaskett and her husband, which McCullum later distributed online using a fake Facebook account.

McCullum was charged with two counts of cyber stalking, while Browne-Louis was indicted on one count of obstructing justice. Prosecutors said Browne-Louis deleted text messages from McCullum from her phone and made false statements to investigators.

Prosecutors added that McCullum sent many of the leaked pictures and videos to Browne-Louis in emails and text messages, the latter of which she attempted to delete.

Plaskett commented on the leaks when they occurred last July, blasting the hackers for using her marriage to "besmirchme politically.

The theft and distribution of these personal images via the internet marks a new low in Virgin Islands politics. I am shocked and deeply saddened that someone would stoop to such a level as to invade my marriage and the love of my family in an attempt to besmirch me politically, Plaskett said last July.

Private photographs shared between my husband and me, as well as a private playful video of our family, including one of our children, were illegally obtained and disseminated via the internet. To say my family and I are greatly upset would be a tremendous understatement," sheadded.

"As a mother, I am outraged that one of my children was exploited in such a way. The theft and dissemination of these images via the internet is a shockingly disgusting invasion of my familys and my privacy not to mention criminal acts in violation of both territorial and federal law."

According to the Justice Department, cyber stalking carries a maximum of five years in prison, while obstruction of justice charges carry a much higher maximum sentence of 20 years.

Browne-Louis made her first court appearance today according to the release, and plead not guilty. McCullum's first appearance in court has not yet been scheduled.

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Two former aides indicted over release of Virgin Islands delegate sex tape - The Hill

Nuclear weapons and climate change: A double whammy for the Marshall Islands – Bulletin of the Atomic Scientists


Bulletin of the Atomic Scientists
Nuclear weapons and climate change: A double whammy for the Marshall Islands
Bulletin of the Atomic Scientists
On May 30, an unarmed intercontinental ballistic missile launched from the Kwajalein Atoll military base in the Republic of the Marshall Islands collided with an interceptor launched from California's Vandenberg Air Force Base. Planned for years, the ...

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Nuclear weapons and climate change: A double whammy for the Marshall Islands - Bulletin of the Atomic Scientists

Australia’s Cocos Islands: too perfect to be true – South China Morning Post

In late 2016, a new edition of 101 Best Australian Beaches featured 300 metres of palm-fringed sand on an uninhabited speck in the Cocos (Keeling) Islands as its top choice.

As near to perfect as a beach can be, enthused one of the guides authors, who claimed to have visited each of the other 11,760 beaches in Australia before making an announcement that attracted all the media attention no doubt intended. Few Australians had even heard of Direction Island before, let alone visited it.

The Cocos two atolls and 27 coral islands are a four-hour flight northwest over the Indian Ocean from Perth. The view to the left just before landing is of a necklace of low-lying strips of coral that surround a limpid lagoon tousled-palm desert islands too perfect to be true.

A single pretty beach is far from the only reason to visit, not least because so few other people do the same the islands receive fewer than 2,000 leisure travellers a year. Imagine the Maldives without the millions. In fact, imagine the Maldives but without anyone else on the beach at all.

The good, bad and ugly sides of the Maldives

The airport runway dominates West Island and about 150 residents live loosely clustered around this source of supplies. Tourist information, the post office, assorted accommodation, modest restaurants, a supermarket, tour operators and the Cocos Club the hub of the islands social life are all here. The easy-going affability thats typical of Australia is amplified by having a population so small, everyones on first-name terms. From rental car to guest room, no one bothers to lock anything.

The main traffic along the islands 12km single main road is of red crabs and wild chickens that scatter into thick plantations of coconut palms if a vehicle approaches. There are plenty of pocket-sized beaches to visit and a modern jetty for ferries to Home Island, the only other one with a permanent population. A retired wooden ferry has become the Big Barge Arts Centre, displaying and selling items made by imaginatively recycling faded beach-found flotsam.

Solomon Islands bloody history makes Pacific archipelago a must-see for war buffs

Bays facing the waves of the Indian Ocean are lined with unsupervised surfboards while those facing the placid lagoon offer bathwater-warm waters in every shade of turquoise. These beaches are restless, alive with red hermit crabs in every size from fingernail to fist, parading prettily in their white shell homes, their tracks texturing the sand in a herringbone pattern. An old jetty provides a viewing point for small reef sharks, a variety of fish, and turtles, of which the lagoon boasts an estimated 30,000.

A sleek modern catamaran ferry skims regularly across the lagoon to Home Island, locals in its air-conditioned interior and three or four visitors exposed on the upper deck, drawn by the brilliance of the colours and views of the Morse code of palm-topped islands on the horizon, all dots and dashes.

Home Island is occupied by about 600 Cocos Malays, descendants of labourers originally brought in to cultivate the coconuts and prepare copra for export. Here, theres a mosque and a museum, invitations to try Malay curries and to see local crafts being made, and to discover some of the islands history.

Top eight Asian beaches

The uninhabited islands were spotted by one Captain Keeling, in 1609, but following their accidental acquisition for the British crown in 1857, when they were mistaken for islands nearer Burma, Queen Victoria granted the Clunies-Ross family control in perpetuity. Several generations of relatively benevolent feudalism failed to survive the collapse of the copra industry, and the Australian government bought out the last Clunies-Ross in 1978, before the islanders chose in 1984 to join Australia.

The message quickly carved in planking and left to mark the original British claim is on display at two-storey Oceania House, completed in 1897 and once home to the Clunies-Ross family. Its shining white ceramic exterior is curiously constructed from the same sort of Victorian brick originally used to line the platforms of Londons Tube, but its pleasing interior is of dark local hardwoods and stuffed with antiques. It now offers accommodation, with several quaint bedrooms up a spiral staircase.

Motorbike heaven: Sri Lankas laid-back and friendly southern coast

The Pulu Cocos Museum, in a shed near the Home Island jetty, displays Malay cultural items such as wayang puppets, tools used in fishing and the copra industry and locally made shallow-keeled jukong boats, built for collecting coconuts from around the lagoon. Theres also a history of Australias first naval battle, between light cruisers HMAS Sydney and Germany's SMS Emden (a frequent visitor to Hong Kong), sunk off North Keeling Island in 1914.

On Thursdays and Saturdays, the ferry continues to Direction Island and the newly minted Cossies Beach.

Charles Darwin wrote about the islands beauty in his The Voyage of the Beagle(1839), but described a white calcareous beach, the radiation from which under this sultry climate was very oppressive.

SMS Emden: Hong Kongs favourite foe

He should have got his trunks on. Today, the perfect curve of narrow, talcum-like sand is shaded by palms that hide a few tables for picnics. Should pure relaxation pall, theres the option of a brisk swim across the rip, where ocean waters pour through a narrow gap to the lagoon, to be carried by the current past a cliff of coral, thick with fish of tropical brilliance. Timing the tide is important.

Back on West Island, the main social event of the week is the welcoming Scroungers Golf, on Thursday afternoons, not to be missed even by those whove never hit a ball in anger. This is played on the only course in the world bisected by an airport runway, using whats described as Ambrose (group golf) rules with Cocos variations the main ones being that no one pays much attention to the rules and that to have an ice bag full of beer dangling from your golf cart is more or less compulsory.

Any hangover can be slept off on a beach the next day. No ones likely to disturb you.

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Australia's Cocos Islands: too perfect to be true - South China Morning Post

The hotel that offers guests their own plane to explore the Greek islands – Telegraph.co.uk

In this world there are some things only seagulls understand. One of them is Milos. For most of us, its a mountainous crumb of golden limestone, rising up out of the Aegean.

Sprout wings, however, and a glorious, secret landscape appears. You can now see fjords and blowholes, and the coves become a luminous peacock-blue. In the wind-sculpted cliffs, there are arches and organ-pipes, and the valleys turn turquoise as they find the sea and tumble off into the deep. Then a monastery appears, way out on a knob of rock. Now that, you say, is proper prayer.

Ill never forget being a bird or, rather, my ride in a Cessna 182-F. The pilot, Kostas, seemed to know every bay, and wed whirr along at 35 beaches an hour. Sometimes hed swoop down on his favourite places: a Roman amphitheatre perhaps, a Venetian fort or an island of goats. Occasionally, the rock itself would open up, and sulphur mines would appear, like giant staircases descending into the Earth. At the far end of the island we circled a magnificent egg-shaped headland, mounted with a tiny sprig of rust.

An anti-aircraft gun, said Kostas, left by the Germans.

Flying around the Cyclades isnt just about birds-eye views. People have been sailing from crumb-to-crumb for more than 8,000 years, and even Pliny mentions the sulphur.

In the 1850s, an entire French fleet filed into Milos harbour as they hopped their way to Crimea. These inter-island leaps are still fun, of course, but ships can take time, and the ferries keep curious hours.

The other option is to fly. Even this can be a heart-sinking thought for those weary of queues and lounges. Thats why Aria Hotels has devised a new service, to get their guests around. For the price of a scheduled flight, you go whenever you want. They just ring up Kostas, and the Cessna appears. Its your own little airline, at your beck and call. The Uber of the gods, I suggested.

Kostas smiled although I now realise that G-IART isnt simply a taxi. Built in 1963, every bit of her is loved, and shes a little jewel of engineering. Amid all that retro and chrome, it sometimes felt as if we were flying along in a Wurlitzer (except that all the windows were filled with islands). Even her buzz sounded well-machined: more mosquito whine than cackle of birds. In just 50 minutes she can hop the Aegean and be back in Athens.

I spent the night on Milos before flying on. Naturally, this being a tale of air and propellers, I stayed in a windmill. Its old walls were so thick there was only space for three cosy rooms.

Every window looked out to sea, and the front-door key weighed almost a pound. But the miller would have been puzzled by the transformation of his attic, and the arrival of flat screens and Egyptian cotton. Only at breakfast did real life intrude, when the goats appeared like a river of bells.

That morning, I took a walk through the landscape Id known from above. Milos can be not only enchanting but also surprisingly sheer. After the fort and a field full of cats, I arrived in Plaka, where the churchyard falls hundreds of feet on to the plains below.

My own little hill was called Trypiti, or The Hollows, and was honeycombed with tombs. In 1820, a ploughman had slithered into one of these holes, only to emerge with the Venus de Milo. Although shes now in the Louvre, it was up here that shed perfected those curves.

On the way to the airstrip, I stopped for a swim at Firopotamos. My taxi-driver chatted about the old silver mines, and the annual dynamite-throwing competition. But Firopotamos, he said, is the softest place in the world, and the people live in caves. This made more sense down in the inlet, surrounded by silence and by fishing lofts deeply embedded in the rock.

Id have happily paddled around all day if my plane hadnt had a passenger to catch. Id arranged with Kostas to leave after lunch. Like Icaruss father, we never flew too high. At 2,500ft, our planet looks satisfyingly spherical and yet you can still peer down on peoples lives.

We began with Kimolos, which produces the worlds cimolite, and has 80 churches for 600 souls. Then we were over open water, trilling past Folegandros, and little silvery Sikinos. I was just thinking how idyllic it all looked when a great black disc appeared on the horizon: Santorini.

No wonder the ancients called it Devils Island. Close-up, the caldera was prettier but no less forbidding. The whole of central London would fit inside its submerged crater, and the remnants of its rim are marbled in pinks and oranges, and rise the height of The Shard.

Circling around it, I suddenly felt as though I understood what had happened. After millions of years spent blasting Greece with dust and pumice, in about 1628BC, the great volcano had imploded. The ensuing tsunami would wipe out much of Crete, bringing Minoan civilisation to an abrupt end.

The radio crackled, and we had permission to enter the crater. This is how a fly must feel as it buzzes through our world. Amid the dizzying perspectives I spotted a cruise ship the size of a nit, and Nea Kameni, a new volcano, nosing up from the depths.

Then we were soaring over the rim, and down the islands outer slopes. Even here, Santorini can look magnificently post-apocalyptic. Everythings layered in ash; there are no rivers or ponds; the farms look like forts, and it all ends in a band of black sand and wild surf.

I spent the rest of the week picking my way through this fantastical scenery. Although arc-shaped Santorini is only the size of Guernsey, much of it is vertical. I dont think I ever lost that feeling of being airborne.

It helped that my exquisite little hyposkapha or cave-house was built right on the lip of the caldera, with a drop of more than 970ft into the sea below. It was a view full of drama and shipping (in 2007, one of the liners had sunk, leaving nothing but a ring of buoys). I even caught one last glimpse of Kostas, as he flew along the cliffs and out of the crater.

Everyone lives in caves up here, in varying states of boutique-ification. Mine had a Jacuzzi but others had swimming pools and gardens dangling over the void.

Some of my neighbours were Japanese, and Id often see them, wandering around in their wedding dresses. There were also a few troglodytic locals.

My landlord told me that many had fled after the 1956 earthquake but now The Crisis was driving them home. Life is miserable in Athens, he shrugged, but not here. Our economy is different.

From my cave, I set out in all directions. To the north, the cliff path led all the way round the rim, five miles to Oia. Along the way, I met lizards, hawks, a greengrocer with a handcart, and a man selling coffee from his moped. Oia, meanwhile, has risen from its rubble, and is now a spectacle of plate-glass and colours. You can even walk home in a pair of new Jimmy Choos.

Walking in the other direction, I came to Fira. Exuberant and terraced, it was like a theatre perched on the rim.

Every day, the towns donkeys would haul an audience into place, up 587 steps from the cruise ships below. Everything was sold with a flourish. Santorini, ran one ad, The island in the bowels of the Earth.

On my last morning, I boarded a catamaran and sailed around the crater. From down here, Fira looked minute. It was a day of colours: green sand, white stacks, scarlet cliffs, and gorgeous submarine blues. At one point, we clambered over some charred black lava, which had only emerged from the sea in 1866.

The water here was orange and fizzy, and it was like swimming around in mulled Lucozade. I asked the skipper if hed been born here, in this fabulous newly-minted world. No, he said, Santorini had no maternity hospital then. I was born on the ferry.

I was sorry to be tearing myself away, and would regret not calling Kostas. Instead, I took the hydrofoil, 4 hours back to Piraeus. As we pulled out of the crater, I took one last look at Nea Kameni, now the most active vent in the south Aegean. I remember thinking how utterly awesome it had looked from the air, and how harmless it looked from the sea. After that, I was shown to my seat, and saw nothing at all but the reel-to-reel repertoire of Mr Bean.

John Gimlette travelled as a guest of Aria Hotels (0030 210 8996056; ariahotels.gr). Its Fly Me to Aria service (ariahotels.gr/en/pages/fly_me_to_aria) allows guests to travel by air between Arias hotels or villas, wherever there is an airport. The Cessna used can accommodate three passengers, and prices are broadly equivalent to those of scheduled flights (rates supplied on request). The ferry from Piraeus to Milos costs 39 per person, and a hydrofoil from Santorini back to Piraeus costs 76 per person (directferries.co.uk)

Aera Milos, Milos: This old stone windmill has been stylishly restored by the Aria Hotels group, with polished concrete floors and designer furnishings. Although there is no kitchen, there are plenty of local restaurants (from 160 (140) per night for two people).

Caipirinha Residence, Santorini: With a balcony on the lip of the caldera, this is the kind of place you could spend all week, just gawping. The traditional one-bedroom residence has been given a new lease of life by the Aria group, and has an interior spa and an outdoor whirlpool spa, both heated, among its facilities (from 450 per night for two people).

A half-day catamaran trip around the caldera in Santorini costs around 155, including drinks, snorkelling equipment and dinner. The site of Akrotiri, the city destroyed by the volcano circa 1628BC, is reached by bus from Fira (2); entrance costs 12. Akrotiris treasures are displayed at Firas Museum of Prehistoric Thera (entry 6). Boat trips to the volcano in the centre of the crater, Nea Kameni, cost 20, or around 150 for a day-trip by catamaran. Its another 2 to enter the national park.

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The hotel that offers guests their own plane to explore the Greek islands - Telegraph.co.uk

Scientists Push Back Against Booming Genetic Pseudoscience Market – Gizmodo

The premise behind Yes or No Genomics is simple: Genetic disease is typically caused by a variation in at least one of the many thousands of genes in the human genome, so knowing whether your DNA code contains variants could suggest whether your health is at risk. And for just $199, the scientists at Yes or No Genomics can use special technology to determine that.

Except Yes or No Genomics isnt a real company. Its satire.

The mind behind this parody is Stanford geneticist Stephen Montgomery, who hopes the website he launched this week will highlight the extreme absurdity of many of the scientific consumer genetic tests now on the market. Fork over $199 to Yes or No Genomics, and you will find out, inevitably, that you do have genetic variants, because everyone does. And that specialized optical instrument used to determine this? A kaleidoscope.

Montgomery is one of a growing number of scientists pushing back against wild claims in the consumer genetics market, which is flush with tests promising to plumb the secrets of our DNA for answers to everything from what kind of wine well enjoy to what diseases were at risk of developing. These tests vary wildly in levels of absurdity. One test that recently earned eye-rolls promises to improve a childs soccer abilities with a personalized, genetics-based training regimen. In case its not clear, there is still no way to decode from DNA the perfect plan to turn your 7-year-old into a soccer star.

Clearly, there is a whole world of companies that are trying to take advantage of people, Montgomery told Gizmodo. Sports, health advice, nutrition...companies are coming out saying, We can look at your DNA and tell you what you should be doing. Really, though, were still trying to understand the basics of genetic architecture. We need to help people avoid getting caught in these genetic traps.

In the wake of that ridiculous Soccer Genomics test, Montgomerys parody site went viral among those who closely follow genetics developments on the web. And he isnt the only researcher who has realized that combatting psuedoscience in the annals of academic journals isnt enough.

For years, Daniel MacArthur, a geneticist at the Broad Institute, ran a blog dedicated in part to exposing bad science in the realm of genetics. Like many scientists, he now uses Twitter to call attention to bogus tests. Other reliable Twitter crusaders include UCLA geneticist Leonid Kruglyak, health policy expert Timothy Caufield, and CalTech computational biologist Lior Pachter. For every new pseudoscientific DNA test, it seems more voices join the chorus.

Its a pretty exciting time to be in genetics. Theres a lot happening, MacArthur told Gizmodo. But that also makes it really easy for people who dont know anything about genetics to enter the consumer market.

Plenty of the tests out there, MacArthur said, are relatively harmless. Finding out which wine youre genetically likely to enjoy probably isnt going to hurt much more than your wallet. But thats not always the case. MacArthur pointed to a simple genetic test that claimed it could detect autism, which he and his colleagues spoke out about after finding out the test had a patent in the works.

We were very confidant that the variants they were testing for had no relationship to autism, he said.

Genetics comes with this veneer of respectability and the public automatically thinks anything with the word genetics is trustworthy and scientific, he continued. It just isnt possible that there is a useful predictive test for soccer. For academics its easy to see that. But who is responsible for going out there and pushing back? Thats less clear.

In 2008, an European Journal of Human Geneticsarticleargued for better regulatory control of direct-to-consumer genetic testing, pointing out that many of these tests run the risk of being little better than horoscopes.

In rare cases, the Food and Drug Administration has stepped in. In 2013, it cracked down on 23andMe, ordering the company to cease providing analyses of peoples risk factors for disease until the tests accuracy could be validated. After gaining FDA approval, the company now provides assessments and risk factors on a small fraction of 254 diseases and conditions it once scanned for.

But the FDA has steered away from policing smaller, fringe companies like, say, those offering advice on your skin, diet, fitness and what super power you are most likely to possess. Some companies the FDA likely does not even have authority to police, since not all of them can be considered medical interventions.

Its kind of distressing to see [the FDA] go after 23andMe rather than companies that are lower profile, but doing science that is flatly incorrect, said MacArthur. What I would love to see would be an organization like the Federal Trade Commission really step in and take much more responsibility. Historically that just really hasnt happened.

Another thing MacArthur would like to see is companies list the scientific data underlying their claims. If consumers could easily see, for example, that the recommendation to drink apple juice from the company DNA Lifestyle Coach stemmed from a study of just 68 non-smoking men, they might more readily deduce how valid such a recommendation is.

Inspired by satirists like Stephen Colbert, Montgomery is interested in how effective parody might be as a tool to combat bad science. Ive gotten a lot of good reaction to the website, he said. I want to see how far can we take this as a joke.

But more than anything, he wants consumers to be wary of the ever-growing number salesmen peddling genetic snake oil.

We want people to understand which tests are actually useful, he said. People should be empowered in how they use this data.

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Scientists Push Back Against Booming Genetic Pseudoscience Market - Gizmodo

People in the News: Kri Stefnsson, Arthur Beaudet, and Mary Thistle – GenomeWeb

People in the News: Kri Stefnsson, Arthur Beaudet, and Mary Thistle
GenomeWeb
The American Society of Human Genetics has named Kri Stefnsson the winner of this year's William Allan Award, a prize established in 1961 that recognizes a scientist for "substantial and far-reaching scientific contributions to human genetics ...

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People in the News: Kri Stefnsson, Arthur Beaudet, and Mary Thistle - GenomeWeb

Pence touts GOP health care bill to skeptical governors – CNN

Pence is essentially President Donald Trump's envoy to a skeptical group of governors -- including Republicans Brian Sandoval of Nevada and Charlie Baker of Massachusetts -- who are against the Senate bill, citing its damage to the Medicaid expansion included in the Affordable Care Act.

"I understand and appreciate, as the President does, the concerns that many of you have as we talk about Medicaid in the future going forward. Our administration's paid very close attention to this issue," Pence told about 30 governors gathered Friday for the National Governors Association's summer meeting in Rhode Island.

"Let me be clear: President Trump and I believe the Senate health care bill strengthens and secures Medicaid for the neediest in our society, and this bill puts this vital American program on a path to long-term sustainability," he said, without noting that the bill also cuts Medicaid spending from current projections.

"Our administration wants you to innovate," Pence said. "Now is the time to usher in a new era of state-based innovation."

The vice president touted the Republican health care bill's option to block grant Medicaid to the states, and increased funding for combating opioid abuse in the revamped Senate bill.

Pence launched into the topic of health care with a broad -- and tepidly received -- attack on Obamacare.

"President Donald Trump is going to lead this Congress to rescue the American people from the collapsing policies of Obamacare," Pence said.

"As a former governor myself, I know just how important health care is to each and every one of you as you lead your state," he said. "The simple truth, though, is that Obamacare is imploding all across America, and working families and small businesses are paying the price every day."

Virginia Gov. Terry McAuliffe, the NGA chairman, got in a dig at Pence while introducing the vice president, noting that he had expanded Medicaid while governor of Indiana.

Pence did so through a version of the program that includes conservative tweaks designed by now-Centers for Medicare and Medicaid Services Administrator Seema Verma, who has been working with senators in support of the GOP bill.

"He showed true backbone in Indiana when he expanded Medicaid for his citizens," McAuliffe said.

It was a clear shot at the Trump administration's health care push: Federal funding for that Medicaid expansion would be eliminated if Trump and Pence are successful.

Pence thanked McAuliffe for "that warm introduction."

Then he seized on that jab, noting that he and Verma crafted a plan locally but ran into bureaucratic roadblocks getting former President Barack Obama's administration to sign off on a waiver for the program.

He said governors wouldn't encounter such obstacles with the Trump administration, promising governors more flexibility to implement their own visions.

"And we're going to fight to make that a reality in Washington, D.C. President Trump is dedicated to getting the federal government out of your way," Pence said.

Pence's most important sales job was aimed at one person: Nevada Republican Gov. Brian Sandoval.

Dean Heller, the state's Republican senator, has closely tied his vote on health care to Sandoval's stance. And Sandoval has been sharply critical of the bill, warning that it would knock 210,000 Nevadans off of Medicaid.

Pence met individually on Friday with Sandoval and four other Republican governors, including Arizona's Doug Ducey, Tennessee's Bill Haslam, Wisconsin's Scott Walker and Arkansas' Asa Hutchinson.

HHS Secretary Tom Price and Verma were on hand for the meetings, which came after his afternoon speech.

A source familiar with the Sandoval discussion described it as a "good discussion" and "productive," though it's not clear Pence swayed Sandoval.

On Thursday night, Sandoval sounded unwilling to back any GOP effort that would withdraw funding for Obamacare's Medicaid expansion.

"I'm greatly concerned and very protective of the expansion population," Sandoval told CNN. "They are living healthier and happier lives as a result of their receiving coverage, and for them to lose that at this point would be very hurtful for them. And it's about people -- this is about people. And 210,000 people in my state."

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Pence touts GOP health care bill to skeptical governors - CNN

Our Turn: Protecting patients must be the first goal of health care legislation – Concord Monitor

The New Hampshire Hospital Association, New Hampshire Medical Society and AARP New Hampshire have joined in opposition to the Better Care Reconciliation Act currently under consideration in the U.S. Senate.

Our three organizations oppose the BCRA because it would erode health protections for millions of Americans and expose them to increased costs and health risks. We believe that any health care legislation should have the goal of protecting patients first.

We are concerned that the BCRA would reduce funding for Medicare by cutting nearly $59 billion over 10 years from the Hospital Insurance trust fund, which would hasten Medicares insolvency and diminish the programs ability to pay for services in the future. This would affect hospitals, doctors and consumers by reducing revenue and making it more difficult to provide services to Medicare patients. To put a sharper point on the issue, New Hampshire hospitals are projected to receive approximately $1.5 billion less in Medicare reimbursements over the next decade, reductions that were enacted as part of the Affordable Care Act to help pay for the coverage expansions that have occurred. To maintain those spending reductions while millions of people lose health insurance coverage is simply not feasible.

The BCRA threatens protection for people with employer-sponsored health coverage by weakening consumer protections that ban insurance companies from capping how much they will cover annually or over a persons lifetime leaving people vulnerable to costs that could be financially catastrophic for them.

In addition, the bill cuts more than $700 billion from Medicaid by creating a capped financing structure in the Medicaid program. This could lead to cuts in provider payments, program eligibility, covered services or all three, ultimately harming some of our nations most vulnerable citizens and dramatically impacting providers ability to serve patients and communities who depend on them every day. It has been estimated that this would result in over $1.4 billion in reduced federal spending on Medicaid in New Hampshire over the next decade. Where would New Hampshire turn to find the resources necessary to care for our most vulnerable citizens?

According to the CBO, the BCRA will leave 22 million more people uninsured, including more than 118,000 Granite State residents who were able to secure vital health coverage through the Affordable Care Act, making it more difficult for our most vulnerable to receive the services they need to stay in their homes. Without health coverage for, and therefore access to, critical health services, patients will seek care in emergency rooms, ultimately raising uncompensated care costs for hospitals throughout New Hampshire and increasing cost-shifting to New Hampshire businesses.

We believe that the Better Care Reconciliation Act needs to be viewed through the eyes of patients and the caregivers who take care of them, and should make protecting health care coverage for our most vulnerable citizens a higher priority. We remain opposed to the BCRA and urge the Senate to start over and create a new version of legislation that protects coverage for those who have it and provides coverage for those who need it most.

We appreciate the efforts of both of our senators to protect access to affordable health care for all Granite Staters, and we urge them to continue to work toward bipartisan solutions that will cover more people, not less, and reduce health care costs, including insurance premiums and the high cost of prescription drugs.

(Todd C. Fahey is state director of AARP New Hampshire. Stephen Ahnen is President of the New Hampshire Hospital Association. James Potter is executive vice president of the New Hampshire Medical Society.)

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Our Turn: Protecting patients must be the first goal of health care legislation - Concord Monitor

How Bad Is US Health Care? Among High-Income Nations, It’s the Worst, Study says – Newsweek

As Republicans struggle to agree on a replacement forthe Affordable Care Act, the Commonwealth Fund has rated the U.S.health care system as the worst among the 11 developed nations it analyzed as part of an evaluation conducted every three years. The think tank also rated the U.S. health care system as the worst-performing of the nations analyzed when the last evaluation was released in 2014.

Related: John McCain says Senate health care bill is going to fail

The Commonwealth Fund focused on care process, access, administrative efficiency, equity and health care outcomes, studying 72 indicators within those fields. The 11 countries analyzed were Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdomand the United States. In addition to rankinglast or close to last inaccess, administrative efficiency, equity and health care outcomes, the U.S. was found to spend the most money on health care.

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The U.S. rated especially poor in equality of coverage. The report found that 44 percent of low-income Americans have trouble gaining access tocoveragecompared with 26 percent of high-income Americans. The numbers forthe U.K. are 7 percent and 4 percent, respectively. Not unrelated, the U.K.s National Health Servicewas deemed the best health care system, just as it was in 2014.In contrast to the U.S., over the last decade the U.K. saw a larger decline in mortality amenable to health care than the other countries studied, the report reads.

Though the U.S. did rank fifth in care process, which includesprevention, safe care, coordinationand patient engagement, its overall score was easily the worst of the 11 nations.

The U.S. ranks last in health care among the 11 nations evaluated by the Commonwealth Fund. Commonwealth Fund

Particularly distressing when considering the last-place ranking is how much more America spends on health care relative to other nations.

The U.S. leads in health care spending. Commonwealth Fund

The U.S. health care system was the lowest performing. Commonwealth Fund

The U.S. is the only high-income nation to lack universal health care. As the report notes, this has effects that go beyond just access issues. Administrative efficiency, for example, lags because of the time wasted sorting out billing and insurance claims.

Though there is plenty of room for the U.S. to improve, the Commonwealth Fund concludes that for the countrys health care system to compete with those of other high-income nations, a drastic change in course may be necessary.

To gain more than incremental improvement,..the U.S. may need to pursue different approaches to organizing and financing the delivery system,the report reads. These could include strengthening primary care, supporting organizations that excel at care coordination and moving away from fee-for-service payment to other types of purchasing that create incentives to better coordinate care. These steps should ensure early diagnosis and treatment, improve the affordability of care, and ultimately improve the health of all Americans.

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How Bad Is US Health Care? Among High-Income Nations, It's the Worst, Study says - Newsweek

Hawaii a case study in how government can make basic healthcare a nightmare – The Hill (blog)

With politicians debating the future of the federal Affordable Care Act, it may be helpful to take a step back and consider the role of government in health care generally.

Weve become accustomed to hearing about the benefits of heavy government involvement in health care on the national scale. But theres also a benefit to looking at much smaller examples, such as the system of government-run hospitals in Hawaii.

Long in a state of financial and managerial crisis, the state-owned hospitals were intended to serve low-income residents and people in the rural areas throughout the islands, but all of the good intentions in the world were unable to transform Hawaiis government hospital system into a shining example for other states. Instead, it became a cautionary tale.

Maui residents told horror stories about finding no beds available while in the middle of a medical emergency. There were complaints about out-of-date equipment, management issues, overcrowding, a lack of basic supplies, mold, and simply the overall conditions at the hospital.

But when a new acute-care facility was proposed in 2006 to help alleviate some of the problems, the Hawaii State Health Planning and Development Agency blocked the opening of the new hospital, bowing to claims that competition from a new hospital would force Maui Memorial to close.

Then there was the cost of operating the hospital. By 2014, Maui Memorial was operating at a $43 million loss annually. A significant portion of those expenses was due to the states extremely friendly position with organized labor. State employees working for Maui hospital generally made twice as much in fringe benefits as comparable private sector employees. At the same time, those generous compensation and pension plans burdened the state with billions in unfunded liabilities, and the hospital system was one of the first sectors to show the strain.

Fed up with the situation, Maui residents banded together to support the creation of a partnership between the state and Kaiser Permanente Hawaii, a statewide private organization that has 50,000 members and a half-dozen medical facilities of its own on Maui.

No one could deny that Maui Memorial was not meeting the needs of the island, but a political fight still loomed. The state employees union, determined to secure all of the costly benefits it had accrued (and which some claimed helped doom the hospital in the first place), fought the transition in the state legislature and the courts.

Determined to secure union benefits for all hospital employees after the transition, the union lobbied the legislature and succeeded, during a special session called expressly for that purpose.

That package, however, later was dropped after the state Employee Retirement System sued the union, alleging the deal threatened the tax status of the state employee pension fund, and the IRS rendered a concurring opinion letter. In the meantime, the ownership transition was delayed, and Maui residents continued to put up with insufficient facilities while the political disputes went on.

Now, about a year after originally scheduled, Kaiser Permanente has taken control of the medical facilities on Maui formerly owned by the state, and residents are hopeful that the days of substandard care are finished.

So far, the news coming from Maui has been good. Kaiser announced the hiring of new specialists, and promised that fewer patients will be referred to Honolulu for care.

Large-scale hiring suggests that the management and paperwork issues are a thing of the past. Policymakers are optimistic that the public-private partnership model may be able to save not only the state hospital system but other overstressed government services as well.

This is good news, and promising for the future, but its important to remember that it took a crisis to push Hawaii policymakers into trying it.

For years despite the best intentions of its administrators the government-run hospital failed to meet even the most basic needs of the community. It was expensive; it was inadequate; and while no one complained about the dedication of the doctors and nurses, it had problems at the management and operations levels.

In short, the problems came not from the people, but from the top. And its well-meaning bureaucratic administrators simply lacked the capability, or proper incentives, to manage it as efficiently and effectively as entrepreneurial private managers could.

It may be tempting to believe that government can provide the blueprint for a better national health care system. But in reality, when government tries to manage delivery and access to medical care, the results are anything but healthy.

Kelii Akina, Ph.D. is the president and CEO of the Grassroot Institute of Hawaii (@GrassrootHawaii), a public policy think tank dedicated to the principles of individual liberty, free markets and limited, accountable government.

The views expressed by contributors are their own and are not the views of The Hill.

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Hawaii a case study in how government can make basic healthcare a nightmare - The Hill (blog)

Some consistency in all the GOP health-care plans – Washington Post

We have watched one Republican health-care plan after another the original House plan, the Meadows-MacArthur amended plan, the original Senate plan and now the Cruz-amended plan. There are some constants:

As to the last:

The July Kaiser Health Tracking Poll finds that most Americans (61 percent) continue to hold unfavorable views of the plan to repeal and replace the Affordable Care Act (ACA), including over four in ten (44 percent) who say they have very unfavorable view. The share of the public with negative views of the law has increased slightly in the past month, from 55 percent to 61 percent. Views of the Republican plan to repeal and replace the ACA continue to vary widely by party and a large intensity gap remains, with Democrats being nearly three times as likely to hold a very unfavorable view as Republicans are to hold a very favorable view (71 percent versus 25 percent, respectively).

Nearly two-thirds of the public opposes (65 percent) major reductions in federal funding for Medicaid as part of a plan to repeal and replace the ACA, and most continue to oppose these reductions even after hearing arguments in support of them. About half of Republicans and those who approve of President Trump support major reductions in federal funding for Medicaid. . . .As seen in previous months, more of the public views the ACA favorably than the plan to replace the 2010 health care law (50 percent compared to 28 percent).

Voters are telling Congress and the White House what they want. The majority of the public (71 percent) would rather see Republicans in Congress work with Democrats to make improvements to the ACA but not repeal the law, compared to one-fourth (23 percent) who say they would rather Republicans continue working on their own plan to repeal and replace the ACA. Although a majority of self-identified Republicans do not want bipartisan health care, Trump supporters are divided with similar shares saying Republicans in Congress should continue working on their own plan (47 percent) as saying they want them to work with Democrats on improving the ACA (46 percent).

In short, the longer the GOP debates health care, the less appealing its plan becomes. In this regard, Senate Majority Leader Mitch McConnell (R-Ky.) had it initially right set a quick deadline and take a vote so the GOP can move on to other things. Leaving the plan out there does not help its chances. Alas, McConnell caved to right-wing and White House pressure and now will keep working on health care through mid-August. The danger here is threefold: More debate will intensify opposition; the GOP will be less prepared to shift gears to deal with issues like the budget and debt limit in September; and the rest of the GOPs legislative agenda will become less and less viable. On this one, McConnell should have stuck to his original game plan.

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Some consistency in all the GOP health-care plans - Washington Post

In autism, genes drive early eye gaze abnormalities | Washington … – Washington University School of Medicine in St. Louis

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Twin study reveals strong genetic influences on how infants visually explore social world

Using eye-tracking technology, researchers at Washington University School of Medicine in St. Louis and Emory University School of Medicine in Atlanta have found compelling evidence that genetics plays a major role in how children look at the world and whether they have a preference for gazing at peoples eyes and faces or at objects. The discovery adds new detail to understanding the causes of autism spectrum disorder. Studying twins, the researchers found that where babies focus their eyes is under stringent genetic control.

New research has uncovered compelling evidence that genetics plays a major role in how children look at the world and whether they have a preference for gazing at peoples eyes and faces or at objects.

The discovery by researchers at Washington University School of Medicine in St. Louis and Emory University School of Medicine in Atlanta adds new detail to understanding the causes of autism spectrum disorder. The results show that the moment-to-moment movements of childrens eyes as they seek visual information about their environment are abnormal in autism and under stringent genetic control in all children.

The study is published online July 12 in the journal Nature.

Now that we know that social visual orientation is heavily influenced by genetic factors, we have a new way to trace the direct effects of genetic factors on early social development, and to design interventions to ensure that children at risk for autism acquire the social environmental inputs they need to grow and develop normally, said lead author John N. Constantino, MD, the Blanche F. Ittleson Professor of Psychiatry and Pediatrics at Washington University. These new findings demonstrate a specific mechanism by which genes can modify a childs life experience. Two children in the same room, for example, can have completely different social experiences if one carries an inherited tendency to focus on objects while the other looks at faces, and these differences can play out repeatedly as the brain develops early in childhood.

The researchers studied 338 toddlers ages 18 to 24 months using eye-tracking technology, developed at Emory, allowing them to trace young childrens visual orientation to faces, eyes or objects as the children watched videos featuring people talking and interacting.

The children, who were part of the Missouri Family Registry, a database of twins that is maintained at Washington University School of Medicine, included 41 pairs of identical twins such twins share 100 percent of their DNA and 42 sets of fraternal twins who share only about 50 percent of their DNA. In addition, the researchers studied 84 unrelated children and 88 children diagnosed with autism spectrum disorder.

Constantino, with fellow investigators Warren R. Jones, PhD, and Ami Klin, PhD, of Emory University School of Medicine, evaluated the eye-tracking data. Each twin was tested independently, at different times, without the other twin present.

How much one identical twin looked at another persons eyes or face was almost perfectly matched by his or her co-twin. But in fraternal twins, eye movements in one twin accounted for less than 10 percent of the variation in the eye movements of his or her co-twin. Identical twins also were more likely to move their eyes at the same moments in time, in the same directions, toward the same locations and the same content, mirroring one anothers behavior to within as little as 17 milliseconds. Taken together, the data indicate a strong influence of genetics on visual behavior.

The moment-to-moment match in the timing and direction of gaze shifts for identical twins was stunning and inferred a very precise level of genetic control, said Constantino, who directs the William Greenleaf Eliot Division of Child and Adolescent Psychiatry at Washington University. We have spent years studying the transmission of inherited susceptibility to autism in families, and it now appears that by tracking eye movements in infancy, we can identify a key factor linked to genetic risk for the disorder that is present long before we can make a clinical diagnosis of autism.

The effects persisted as the children grew. When the twins were tested again about a year later, the same effects were found: Identical twins remained almost perfectly matched in where they looked, but fraternal twins became even more different than they were when initially evaluated.

Autism spectrum disorder is a lifelong condition that affects about 1 in 68 children in the United States. It is known to be caused by genetic factors, and earlier work by the Emory University team had shown that babies who look progressively less at peoples eyes, beginning as early as 2-6 months of age, have an elevated risk for autism. Meanwhile, Constantino and others in the group have studied how subtle behaviors and symptoms that characterize autism aggregate in the close relatives of individuals with autism, as a way to identity inherited susceptibilities that run in families and contribute to autism risk.

Studies like this one break new ground in our understanding of autism spectrum disorder: Establishing a direct connection between the behavioral symptoms of autism and underlying genetic factors is a critical step on the path to new treatments, said Lisa Gilotty, PhD, chief of the Research Program on Autism Spectrum Disorders at the National Institute of Mental Health, which provided support for the study in tandem with the Eunice Kennedy Shriver Institute of Child Health and Human Development.

Those new treatments could include interventions that motivate very young children to focus their gazes more on faces and less on objects.

Testing infants to see how they are allocating visual attention represents a new opportunity to evaluate the effects of early interventions to specifically target social disengagement, as a way to prevent the most challenging disabilities associated with autism, said senior author Warren R. Jones, PhD, director of autism research at the Marcus Autism Center at Emory. Such interventions might be appropriate for infants showing early signs of risk or those who have been born into families in which autism has affected close relatives. In addition, learning why some infants who tend to not look at eyes and faces develop without social disability is another priority.

The small percentage of healthy children who tended to avoid looking at eyes and faces may provide researchers with insight on how to successfully compensate for those tendencies and therefore inform the development of higher-impact interventions that will produce the best possible outcomes for infants with inherited susceptibility to autism.

In addition to Constantino, the research team at Washington Universityincluded Anne L. Glowinski, MD, a professor of child psychiatry and associate director of child and adolescent psychiatry;Natasha Marrus, MD, PhD, an assistant professor of child psychiatry; and Stefanie F. Kennon-McGill, PhD, a postdoctoral research associate in psychiatry.

As identical twins watched videos, they almost always looked for the same things at the same times and in the same places. Where gazes fell is marked by the plus signs. Fraternal twins didnt match as well as identical twins, indicating that genes control where children look.

Constantino JN, Kennon-McGill S, Weichselbaum C, Marrus N, Haider A, Glowinski AL, Gillespie S, Klaiman C, Klin A, Jones W. Infant viewing of social scenes is under genetic control and is atypical in autism. Nature. Published online July 12, 2017.

This work was supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Mental Health of the National Institutes of Health (NIH), grant numbers HD068479 and U54 HD087011 (to Constantino and the Intellectual and Developmental Disabilities Research Center at Washington University) and MH100029 (to Jones and Klin at Emory). Other support was provided by the Missouri Family Register, a joint program of Washington University and the Missouri Department of Health and Senior Services.

Washington University School of Medicines 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Childrens hospitals. The School of Medicine is one of the leading medical research, teaching and patient-care institutions in the nation, currently ranked seventh in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Childrens hospitals, the School of Medicine is linked to BJC HealthCare.

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In autism, genes drive early eye gaze abnormalities | Washington ... - Washington University School of Medicine in St. Louis

Counseling can help you decide whether to get genetic testing – Lexington Herald Leader


Lexington Herald Leader
Counseling can help you decide whether to get genetic testing
Lexington Herald Leader
Genetic counselors are specially trained in cancer genetics and help provide information, resources and support that are needed for decision making about testing. A counselor will collect a detailed personal medical and family health history to ...

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Counseling can help you decide whether to get genetic testing - Lexington Herald Leader

Medicine For Another Day – HuffPost

A new era in medicine does not come along very often.We had one, perhaps, in 1854 when John Snow effectively invented the practical applications of epidemiology by removing the handle from Londons Broad Street water pump.We had one about 50 years prior when Edward Jenner discovered the prevention of smallpox with vaccination.We had one when the value to public health of basic sanitation was first sorted out; we had one when micronutrients were discovered to cure and prevent various deficiency syndromes; and we had one when Alexander Fleming and a bit of serendipity combined to discover penicillin, and usher in the antibiotic age.

And we had one yesterday- 7/13/17- at least according to the New York Times, which used just that language to report the provisional approval by a FDA panel of a breakthrough therapy for leukemia involving genetic engineering.The approval is provisional because the recommendations of FDA expert panels, unanimously in favor of the new drug called tisagenlecleucel (good luck!) in this case, require formal action by the agency.Such action, however, rarely departs from panel recommendations, and certainly not in the case of a unanimous decision.

The treatments efficacy was not in question; it clearly works, and has saved the lives of mostly children who would almost certainly have died of their leukemia otherwise.It is, however, capable of various and severe toxicities along the way to a potential cure.Of 68 young people treated with tisagenlecleucel for lymphoblastic leukemia in a study run by Novartis, 52 appear to have been cured by the drug; the other 11 died.

The panel was obligated to address concerns about such rather serious dangers of the treatment, but the conclusion was perhaps a foregone conclusion just the same.Just as the dangers of operating on a brain may be justified by the greater dangers of a tumor or hemorrhage inside the skull, so, too the dangers of tisagenlecleucel are justified- in my view as well as that of the FDA panel- by the greater dangers of the inadequately treated disease.Absent this breakthrough, the 52 young people who had failed other treatments- some of whom attended the FDA meeting with their families- would almost certainly all be dead by now.It is a new era for us all as each of them wakes to a new day- with the opportunity to live through it.

The new therapy is perhaps the epitome of personalized medicine.It extracts a variety of white blood cells called T cells from an individual patient, and engineers a genetic adjustment so that these T cells can recognize the patients own malignant B cells as foreign- and attack them.The immune system is in effect reprogrammed to seek out and destroy the leukemia cells.

Along the way, as in any war, there is considerable potential for collateral damage to the innocent cells and tissues in the area- namely, the patients blood and body- and the severe toxicities of the treatment derive from that.But for those who make it through those battles, as over 82% did in the Novartis study, there appears to be an opportunity for that most elusive of words in cancer treatments: a cure.The reprogrammed T cells can seek out and destroy every last rogue cell.The only reason for any reticence about use of the word cure is that one would like to know the outcome of this treatment over a span of years, decades, and then lifetimes- and since its new, we will all have to wait for that.

But we neednt wait for this new era in medicine; it has arrived.And while tisagenlecleucel is its standard-bearer, it wont be alone for long.This same approach can be, and will be, applied to other diseases, perhaps not just cancers, but certainly other varieties of those.

Predictably, the costs involved in extracting one persons cells, reprogramming them with genetic engineering techniques, and infusing them back into that one person- are potentially quite staggering.The amped-up T cells work only for their owner; there is no scalability.How ironic, and opportune, that this stunning but costly advance should arrive even as the basic mechanisms of health care coverage roil our Congress, and our society.

Now is just the time for every parent and grandparent, whatever their political leanings, to ask: would they want access to this product of human ingenuity if ever their beloved child faced all but certain death without it?Would they want access regardless of their ability to pay?Would they want that child forever after subject to potential uninsurability because of that pre-existing condition?

There are all sorts of ways to reduce the costs and improve the outcomes of our so-called health care system quite massively; denying a desperate 6-year-old life-saving access to the progress born of humanitys relentless resourcefulness- should not figure among them.

Those better ways include universal access, and universal coverage for essential, and preventive care.Those better ways include a fundamental shift from just disease care, to a genuine focus on health care, with lifestyle as the preferred medicine.Those better ways include confronting the hypocrisies of a culture that laments diseases in children, but propagates them for profit.

My particular field- lifestyle medicine- is in the vanguard of all such efforts, with attendant benefits for the planet, too, that no other branch of medicine tends even to mention.I am proud and inspired to be involved in so timely and propitious an effort.

I do note, however, the one potential liability to which my camp is prone.The extreme enthusiasm for lifestyle as medicine that prevails among the aware can at times translate into a relative, at least apparent disparagement of other, more conventional varieties of medicine.Such tendencies are perhaps exacerbated at this juncture in our cultural history when everything seems to be supremely dichotomous and polarized: left or right; nature or science; defend or impeach.

The reality is that while lifestyle can often be the very best of medicine, there are times when some other medicine emphatically is.Most of us have experience with that; I certainly do.We are not obligated to choose.

Lets use lifestyle to promote health and prevent disease as only it can; and lets use it as we can to treat and reverse disease, too.But then lets celebrate the stunning scientific advances that empower us to treat those who get sick anyway- as some inevitably will.

We may think of lifestyle and health like a ship at sea; we may benefit greatly from masterful application of ship and sail, but we will never be masters of wind and wave.Bad things, in other words, can happen to people who do everything right, and well- just as gales can cause the best of ships and crews to founder.

When that happens, the rest of us muster the resources for a rescue mission to save all who can be saved.Medicine- more than one kind of medicine- should be used to do the same.

I applaud the insights and toil, inspiration and perspiration that brought us tisagenlecleucel and that will bring us related advances.I call upon us as a society to do whats necessary to honor this endowment of the human mind- and ensure it is never denied to a child in peril.

Its a new era in medicine.But more importantly, its just another day that 52 young people will live to see.

Senior Medical Advisor, Verywell.com

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