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SCHMIDT: Political magic: The politics of Penn & Teller – Seguin Gazette-Enterprise

Posted on June 23, 2017 by Danzig

Last September, I discussed South Park for the first time, and how it has taught libertarianism since its debut in 1997. At one point, I discussed how ReasonTV listed it as one of the 5 Best Libertarian TV Shows Ever. When briefly explaining this, I mentioned another show: Showtimes Penn & Teller: Bull****. This particular show, which aired from 2003-2010, starred the famous magician duo, Penn and Teller, and while they present the topic of each episode, they remain in their regular performance fashion where Penn does all the discussion and Teller stays in his mime persona while performing several magic tricks and gags in the background.

Even though in several episodes where they debunk things like detoxing, the apocalypse, and the link between childhood vaccinations and autism, there are other episodes where they discuss social and political issues, and within the episodes, Penn is not afraid to reveal his strong Libertarian views on the issues discussed. When I became a Libertarian four years ago, it was Penn and Tellers show that Zachary, my friend who introduced me to Libertarianism, pointed me to, and after I watched each episode that he suggested, we would discuss it. The episodes I remember that we discussed the most and which covered very strong Libertarian viewpoints where the episodes based on the War on Drugs, the death penalty, and taxes (which included an interview with Former Congressman Ron Paul). Several other episodes that I watched were based on the War on Porn, gun control, video games, and family values.

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Student Complains After Prof Assigns Libertarian Reading Material – legal Insurrection (blog)

Posted on June 23, 2017 by Danzig

ideological garbage

The professor assigned reading from the Cato Institute. What a crime.

The College Fix reported:

Student tries to get professor in trouble for assigning her libertarian reading

University of St. Francis student Jennifer Martin tweeted Wednesday that her professor (an adjunct, it turns out) gave her an assigned reading on national health care systems from the Cato Institute, a libertarian think tank that is widely respected in D.C. for the quality of its research and thought-provoking events (one such event covered here last fall).

Cato also got tens of millions in funding over the years from Charles and David Koch, the billionaire brothers who are active in Republican politics, and it was co-founded by Charles four decades ago.

This was enough for Martin to declare that her professor had committed an academic sin, and she would get this person in trouble for giving her ideological garbage from a conservative propaganda machine to read. (Never mind the Kochs sued Cato for control of a board seat five years ago, and the settlement protected Catos independence.)

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Student Complains After Prof Assigns Libertarian Reading Material - legal Insurrection (blog)

A new generation of senior housing is making ‘elderly islands’ obsolete – Los Angeles Times

Posted on June 23, 2017 by Danzig

Recently retired, Pam Watkins wanted a new lifestyle.

The former school principal saw her Dana Point neighborhood turning over, increasingly populated with young families busy with kids or work. She wanted more people her own age to play with, but didnt want to live in a grave-yardish retirement community.

So last year, Watkins and her husband moved into a $770,000 house just down the road in Rancho Mission Viejo, a new, large, master-planned community with neighborhoods for seniors as well as those of all ages.

There are community spaces for everyone, but also a seniors-only clubhouse with lounge, fitness center and a resort-style saltwater pool and spa.

We like seeing kids, the 63-year-old said. I dont necessary want them in my pool jumping on me.

Developers are increasingly building such multi-generational communities, lured by the massive baby boomer population aging into retirement. In doing so, theyre targeting people 55 and older, such as Watkins, who want to live near but not too close to families and kids.

Like senior developments around Palm Springs, the communities are built for active adults who get around just fine and might even still be working.

In Southern California, builders were selling homes in 28 active-adult neighborhoods at the end of the first quarter, compared with 15 two years earlier, according to research firm Metrostudy.

More than a third of those were in multi-generational developments, compared with just 20% in 2015.

The investments mirror a larger senior housing boom, as companies provide the demographic with a range of housing tailored to their needs from those who require no help to those who need a significant amount.

In 2015, developers across the country started 37,000 age-restricted homes, a category that includes many assisted-living facilities that provide help with healthcare, transportation and meals, according to the latest analysis of census data from the National Assn. of Home Builders.

Thats down from the previous two years but up sharply from 17,000 in 2009 when the Census Bureau first collected the data and the recession had decimated the housing industry.

Housing experts said they expect age-restricted housing to grow further, given the nations demographics. By 2024, households age 55 and older will make up 44.5% of the U.S. population, compared with 42.8% this year, according to the National Assn. of Home Builders.

Developers are particularly bullish on multi-generational communities, which provide senior-only neighborhoods in an otherwise family-oriented master plan.

A relatively new way to provide senior housing, they are often located in metropolitan areas rather than far-flung resort towns, said Andrew Carle, founding director of the Program in Senior Housing Administration at George Mason University.

Historically, most 55-and-older communities have been elderly islands, on a golf course or on top the mountain somewhere, Carle said. Even in large metropolitan areas, senior apartment buildings or communities such as Laguna Woods Village (formerly Leisure World) tend to be segregated from the surrounding area, he said.

When you place older adults in younger settings, they age slower, but put them all together, they all age faster, Carle said. Its not healthy to separate yourself.

Aware of the latest housing trends, developers try to limit separation while providing some seclusion. In addition to community spaces for all ages, layout is taken into account.

At Rancho Mission Viejo, the 55-and-older neighborhoods in the village of Esencia have a single point of entry, but no gates.

The mini-neighborhoods consist of only around 50 to 150 homes and are connected by a system of trails to adjacent all-age neighborhoods, which have proved popular with young families.

Watkins said that means when her grandchildren visit, they arrive excited, ready to play with children nearby. She can also have a cocktail at a seniors-only pool, or meet people her own age at Taco Tuesday or Wine-Down Wednesday.

Its the best of both worlds, she said.

Christian K. Lee / Los Angeles Times

A multi-generational housing development under construction in Temescal Valley.

A multi-generational housing development under construction in Temescal Valley. (Christian K. Lee / Los Angeles Times)

Developers who typically get entitlements and then sell lots to individual home-builders are eager to provide such experiences, because they fulfill an unmet need and diversify the buying pool.

Instead of finding 1,000 potential homeowners who want to live in a community open to all ages, they can find 500 such buyers and 500 older individuals looking to live with people their own age.

With many young couples struggling to afford a down payment, some developers see a benefit in creating homes restricted to those 55 and older, especially because that cohort is growing.

The problem with the millennials is they dont have [much] money, said Steve Cameron, president of Foremost Companies, which is developing the multi-generational Terramor community in Temescal Valley, just outside Corona in western Riverside County.

Sales at the $100-million-plus project kicked off in April.

When completed, it is expected to have around 400 homes for all ages and 1,000 for households where at least one person is 55 years or older. At the moment, only the age-55-plus homes are for sale and start in the mid-$400,000s, around what typical new homes are fetching in the area.

Rancho Mission Viejo is even larger. About 6,000 of the eventual 14,000 homes will be reserved for people at least 55 years old. Prices for the senior homes start in the $600,000s. The all-age homes sell from the low $400,000s for a townhome to more than $1 million for a large single-family house.

The Irvine Co. is also developing its first senior neighborhood as part of the larger all-age Cypress Village community. Sales of the 243 homes are expected to start by the end of the year.

Though the projects are geared toward active adults, the toll of aging must be taken into account.

At Terramor, street signs will have larger than normal lettering and the senior clubhouse will have no steps, but instead graceful ramps leading people from clubhouse to pool, Cameron said.

The idea? Make it easier for seniors to get around, without making the design tweaks noticeable.

The same idea applies to the age-55-plus homes, which are single story and often have wide doorways and few to no steps. There are also shower stalls, meaning residents dont have to step over a tub to get into the shower.

Companies that build such houses say business is good.

Irvines CalAtlantic, for example, said its building 55-and-older homes in 10 states this year, including at multi-generational communities in San Diego and Santa Clarita, as well as at Rancho Mission Viejo, Terramor and the new Irvine Co. project.

We continue to expand that market segment, said Elliot Mann, the companys Southern California president. That says a lot about how well they have been working for us.

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A new generation of senior housing is making 'elderly islands' obsolete - Los Angeles Times

Why the Cook Islands are the best South Pacific bargain – The Seattle Times

Posted on June 23, 2017 by Danzig

With subsidized airfare, friendly people and the freshest fish youll ever eat, this is, as they say, Hawaii like it was 50 years ago.

RAROTONGA, Cook Islands So hows your day going? asked the post-office lady as I bought some colorful Cook Islands postage stamps.

Funny thing was, the way she asked I had a feeling that she would have lent an ear were I interested in sharing the details of my day, which by the way had gone splendidly. I was in the Cook Islands, after all.

When you ask a Cook Islander what one reaction visitors have when visiting here, they invariably answer the people are so friendly. Of course, the Cooks have the sun and sand and aqua waters youve always associated with the South Pacific, as do Tahiti and Fiji. But there are several ways the Cooks stand out from those other destinations.

First, its the cheapest to reach by air. Air New Zealand flies here every Saturday, a 9- or 10-hour nonstop flight from Los Angeles, and frequently offers airfares around $899 round-trip, or even less with their occasional $400-off coupon codes, which bring the price down to $499-$598 round-trip (the country subsidizes the flights; airfare to other South Pacific hot spots are usually $1,200 round-trip or more).

Second, the main island, Rarotonga, with its large lagoon, is a continuous land mass. Whereas your resort on Fiji or Tahiti might be isolated on its own island, the ones here are all on the same island so you can easily explore different resorts, restaurants and attractions. The small airport is just a few minutes from most resorts.

There are no high-rises, no chain stores, no McDonalds, not even a stop light. This is, as they say, Hawaii like it was 50 years ago.

When to visit: November to April is rainy season, so resort prices are lower, and November to March is cyclone season, although the country hasnt had a serious storm in several years. July to October is whale season during which cavorting whales and their offspring are visible from the shore.

Things to do:

Take a sunset cocktail cruise on the lagoon. Several resorts offer these.

Visit the Whale and Wildlife Centre and Cafe.

Take a Tik-E electric tuk-tuk tour with Karl Jackson, a New Zealander expat. Anything you ever wanted to know about the Cooks will be revealed.

Attend a Sunday church service, where women sport elaborate Polynesian head dresses and the choirs are uplifting.

Cuisine: There are more than 50 cafes and restaurants on Rarotonga, operated both by the native-born and New Zealand expats. Fish and other seafood are the thing to have here. You eat what was caught that day.

Reserve dinner at Tupunas Restaurant for fresh coconut crab.

Getting around: Many resorts offer shuttle service, and you can rent cars and mopeds (drive on the left). A public bus circles Rarotonga every 30 minutes and costs NZD $5 per ride, or $16 for an all-day pass.

Shopping: Stores close around 4 p.m. Monday to Friday and noon on Saturday. Everything is closed on Sunday. Jewelry designed from highly polished shells, carved by local artisans, make a beautiful gift.

Excursions: A 50-minute flight to Aitutaki, the other major island in the Cooks, is a popular option, where all resorts are beachfront.

Etiquette: Dont be surprised if youre greeted with a kiss on the cheek instead of a handshake. These people really are friendly!

Interesting fact: The country will likely be the first to run on 100 percent renewable energy. The plan is that it will happen by 2020, although the prime minister assured me it will be sooner.

More information:cookislands.travel

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Why the Cook Islands are the best South Pacific bargain - The Seattle Times

A tale of two (traffic) islands: Remove on Beach Road, add on South Benson? – Fairfield Citizen

Posted on June 23, 2017 by Danzig

Photo: Genevieve Reilly / Hearst Connecticut Media

A group of teens walks down South Benson Road, headed to Jennings Beach. Some residents of the area would like to see a center traffic island installed to slow down motorists. Fairfield,Ct. 6/21/17

The Police Commission has turned down a request from some residents to remove the island on Beach Road, and install a crosswalk at Judson and East Paulding. Fairfield,CT. 6/21/17

A tale of two (traffic) islands: Remove on Beach Road, add on South Benson?

FAIRFIELD Islands are a hot topic for some local residents, but they arent talking about the tropical ones, where one might book a vacation getaway.

These islands are traffic islands, surrounded by asphalt. One group of beach area residents were hoping to get the island on Beach Road removed, while a block over, residents want an island installed on South Benson Road.

For both groups, safety pedestrian and vehicular was cited as the reason.

The Police Commission has denied the Beach Road request but is waiting on more information on South Benson Road.

Both roads lead to the beach and are considered main arteries, marked with double, yellow center lines and with sidewalks on both sides.

Gateway to Jennings

Ive been here five years, said South Benson resident Sara Ferrizz. I have two small children. South Benson is a very, densely-populated residential area and a thoroughfare to Jennings Beach.

Ferrizz said people are speeding down the road and habitually ignore the stop sign at the Riverside Drive intersection. The last four years, there have been three accidents.

According to Lt. Robert Kalamaras, a speed survey conducted by the department showed the average speed for northbound traffic is 29 mph, while the average speed of vehicles traveling toward the beach is 28 mph. The posted speed limit is 25 mph.

But Deputy Chief Chris Lyddy said while those numbers are accurate, they dont always paint a full picture. For example, he said, during the survey, 157 cars were traveling between 45 to 49 mph.

The average driver is traveling safely, Lyddy said, but added there are some outlier speeds, coupled with the only access to Jennings Beach, a very popular beach in town, especially with families.

South Benson resident Joe Garin said he moved his family to the neighborhood eight years ago. One of the things that attracted me and my family to Fairfield was Jennings Beach. It was a family-oriented area.

Now, Garin, who at times choked back tears while pleading the case for a traffic island, said its all changed.

Now, its the most congested beach, he said. Because of the speeding cars, Garin added, he cant let his children play in the front yard.

Since Superstorm Sandy hit in the fall of 2012, Jennings Beach had taken on some of the beach goers who typically used Penfield Beach. The Penfield Pavilion just reopened this season, meaning there are once again permanent restrooms and a permanent snack bar. The parking lot at Penfield is once again open as well.

Jennings not only has the largest expanse of beach, it also has the largest parking lot. Across the parking lot from the beach is the popular Sandcastle Playground.

While the Parks and Recreation Department does not have counts of the total number of cars coming to the beach, it does keep track of the number of daily parking permits sold. In 2013, Jennings hit a high of 12,595 daily passes. That number in 2014 was 5,617, and in 2015, 6,550 daily passes were sold. For last year, the number was 6,767.

Im scared. I have three very young children, Garin said. Speeding folks, loud mufflers, accidents Im scared for my kids safety.

I want my kids to walk to Jennings, walk to the sandcastle, walk to Sherman, he said. I think the island is a great idea. This is a major issue. Put yourselves in our shoes.

Police Commissioner Arthur Hersh is adamant against the installation of a traffic island. Lets forget the money aspect, I dont think its big enough to take an island. I believe it will do more harm than good, he said.

William Hurley, an engineer with the town, said the road is wide enough to construct a 5-foot-wide, 15-foot-long center island, though that would mean on-street parking would be eliminated.

I would suggest we do a pseudo island with cones or some other material, Hurley said, so everyone could see what the island would look like, and to allow the Fire Department to conduct tests to ensure there is enough room for emergency vehicles.

Public Works Superintendent Scott Bartlett said traffic islands also interfere with snow removal and cause more icing on the road. The cost to install an island on South Benson is about $1,000, Bartlett said, but that does not include labor costs.

Hersh said hes seen firsthand the reason why the crowds at town beaches are growing.

People are coming in from out of town, he said, with carloads dropped off and cars parked at the Bobs Shopping Center on the Post Road. So you have a big increase of traffic on the weekend, Hersh said. Thats where its coming from. Its not from our community, its out-of-towners coming, and I saw it firsthand.

Ferrizz also placed the blame on non-town residents.

It is the out-of-towners, Ferrizz said. Its also the Fairfield (Universtiy) college students. Its people who live in the neighborhood. Ive seen everybody do it. When they go by, it feels like were on the highway. We see havoc on the street everyday.

Any vehicle without a parking sticker is charged $25 to park at Jennings and Penfield beaches on weekdays, and $50 on weekends and holidays. There are no restrictions on anyone walking, or riding a bike, to any of the towns shoreline beaches.

On Tuesday, during the first week of summer vacation for Fairfields public schools, traffic on South Benson was not overwhelming. While there was a relatively steady stream of cars, there were long stretches with no traffic at all.

According to traffic counts from the Police Department, from June 6-8, 2014, there were 1,673 vehicles traveling north on South Benson, and 2,015 traveling southbound on the street.

From June 8-14, 2017, a seven-day period, traffic counts showed 2,181 vehicles northbound and 2,049 southbound.

School zone safety

A block over, on Beach Road, some neighbors were hoping to see the center island near the entrance to the Old Burying Ground removed.

Representative Town Meeting member Jill Vergara, D-7, who lives on the Old Post Road, spearheaded the request for the islands removal, in order to have a crosswalk installed at Judson Road, near the driveway into Sherman School. There is a crosswalk about a block south on Fern Street, that comes with a crossing guard during the school year.

Even if we teach our kids not to cross (at Judson), when they get in the fourth or fifth grade, its hard for kids to come out of school and not go home the most direct route, Vergara said.

But, because of poor sight lines, a crosswalk could not be installed unless the island is removed.

Its nearly impossible to see theres a street or a school there, said Vergara. When I first moved in, I had no idea there was a school there. I know its a really extreme measure, but we have to try and do something.

Ive been on the commission for over nine years, Hersh said. Weve been out to this intersection on two different occasions. If we decide to take out the island, wed have to remove very large, mature trees. And its going to become a drag strip. Youre going to have one straight away.

Turney Road resident Sarah Nuland said shes live here since 2005 and questioned why Beach Road, without an island, would be any different than Rowland or Penfield roads, which she said are straight, and flat, and go right to the beach.

Its a pedestrian paradise in the beach area, Nuland said. Thats why we moved here.

Sherman School Principal Eileen Roxbee also urged the commission to take some action.

That is a blind corner, she said. My big concern, obviously, is for the safety of the children. At least a stop sign at the Fairfield Museum would slow down traffic.

There is a stop sign northbound on Beach at Sunnieholme Drive, across from the entrance to the Fairfield Museum and History Center, but no stop sign southbound. The island itself creates a curve in the road southbound.

Beach Road resident Ken Murphy does not want to see the island removed.

The current curving design around the island works to slow down fast moving cars, Murphy said. Eliminating the island would create a drag strip, with cars screeching to a stop at Judson.

Murphy said the island, with majestic trees, is part of the unique character and beauty of Fairfield and should be protected. It is the only road in this area with this feature, he said. It would be a flagrant misuse of town funds at this time.

He did say, however, he would support a stop sign at the museum driveway, mores signs, and tree and bush trimming to improve sight lines.

To get rid of the Beach Road island would be more costly than adding one a block over on South Benson, Bartlett said, carrying a price tag of about $50,00, which includes removing the island, two oak trees, three cherry trees, 7.412-square-feet of grass, and paving the road.

He said the tree warden would also have to approve the tree removal.

During the school year, parents waiting to pick up or drop off students, line up along Beach Road, waiting to turn into the school driveway. The commission voiced its support of a plan to carve out a pick-up and drop-off lane into school property on Fern Street. Currently the school buses use Fern Street to drop off students.

Hurley said the town did traffic counts at the museum driveway last year. There are pros and cons, he said. It does slow down traffic for about 200 feet, then they speed up. Its not always a cure-all. Were looking at different options.

The commission also agreed to install some school zone signs southbound and improve the existing northbound markings.

Im ecstatic with the school zone sign on Beach Road, Vergara said, but added that signs are likely needed throughout the neighborhoods all around the school. Sherman is surrounded by residential areas. We have kids coming from all four corners of the school. I dont think approving one sign on Beach Road helps everyone.

greilly@ctpost.com; @GreillyPost

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A tale of two (traffic) islands: Remove on Beach Road, add on South Benson? - Fairfield Citizen

US exiting climate pact may doom some small islands – The Recorder

Posted on June 23, 2017 by Danzig

WASHINGTON To small island nations where the land juts just above the rising seas, the U.S. pulling out of the Paris global warming pact makes the future seem as fragile and built on hope as a sand castle.

Top scientists say it was already likely that Earths temperatures and the worlds seas will keep rising to a point where some island states may not survive through the next 100 years. That likelihood increases, they say, if the United States doesnt follow through on promised cuts in heat-trapping carbon dioxide emissions.

If we really push into action, we can save some (small islands) but we may not be able save all of them, said Hans-Otto Poertner, a German scientist who chairs the climate impacts study group for the United Nations Intergovernmental Panel on Climate Change. The chances are even less with the U.S. pulling out of the climate agreement in Paris.

While calling Trumps announcement deeply disappointing, Marshall Islands President Hilda Heine told The Associated Press I cannot give up on my people and my country and my culture. Its very important for us to be optimistic.

Heine and other island leaders are putting their hope in strong pollution curbs by China, other nations, individual American states and cities, as well as improved technology. While visiting Europe, she said its all the more important that Europe takes the lead on climate change.

Palaus environment minister F. Umiich Sengebau said he has no choice but to hope.

Right now some of the islands have disappeared, he said. And so if we continue this trend our very existence as small islands could very well disappear in many instances.

Small islands are the most vulnerable parts of the world, said scientist Jim Skea of the Imperial College in London, who chairs another UN climate panel. Exceeding 1.5 degrees really makes the vulnerability threat for them more acute. Its kind of existential.

US exiting climate pact may doom some small islands - The Recorder

Settling of the Americas: Searching for pieces of the puzzle – Genetic Literacy Project

Posted on June 23, 2017 by Danzig

Beneath the Bering Sea lies potential. There archeologists and paleoanthropologists suspect there is evidence that could explain genetic diversity in modern populations and solve the mysteries of ancient human migration patterns piecing the two pieces of the puzzle together.

But for now, we must find the clues that lie along the edges. University of Alaska researchers have published genetic analysis of two such clues: an infant and pre-term fetus discovered in the Upward Sun River region of Alaska. Although they were buried in the same grave, the neonates were not maternally related. They had differing mitochondrial DNA haplotypes. Those haplotypes are used to identify maternally related humans because the DNA in the mitochondria of our cells are only passed down from our mothers from the mitochondria of her egg cell. Maternal haplotypes help geneticists identify a lineage of people.

Despite the age of the remains, over 11,000 years, geneticists were able to recover DNA, then copy it enough times to read the signature. Mitochondrial DNA is easier to tease out of the bone because there are hundreds of copies in each cell, rather than just one copy of nuclear genetic material.

While the find unearthed a new mystery: why these infants were buried together, it also begs the question of how two such un-related infants ended up in the same group of people at the same time. Carl Zimmer at the New York Times explained:

The researchers can only speculate how an infant and a fetus from different mothers ended up in the same grave. They might have had the same father, or they might have belonged to different families who suffered terrible losses at the same time. But the significance of the DNA found at Upward Sun River extends far beyond the story of two children. It sheds light on how people first moved into the Americas.

The nature of the Bering crossing is at heart: was the land form a highway, or an RV park? The archaeologists and geneticists who studied the babies think the fact that they are genetically unrelated is evidence to bolster the Beringian Standstill Hypothesis. Instead of a constant movement of people from Siberia into North America, the standstill hypothesis suggests that ancient humans moved into the area about 25,000 years ago and then stayed there for about 10,000 years. That would be enough time to build up significant genetic diversity in the populations living on the tundra as people moved, bred and moved again. That diversity was carried Eastward when the glaciers blocking the path into North America receded when the last ice age ended.

The standstill hypothesis is one way to explain genetic diversity patterns. Other scientists have suggested humans came over in one or three waves with possible additional migrations from Aleutian islands and parts of Europe (although that theory, the Soultrean Hypothesis, is falling out of favor based on evidence). Those theories could also explain genetic diversity. But, scientists think the mitochondrial DNA of the Upward Sun River children best supports the Standstill hypothesis. And, with most of Beringia covered in sea water, its likely to be a long time before we find better evidence.

The finding is also rich because of its clues into the culture of the people at that time and place, writes Yereth Rosen at Arctic Newswire:

The Upward Sun River site was a natural place for human habitation, he said. It was perched on the edge of ecosystems that provided different resources a floodplain where salmon could be caught and uplands where game animals roamed. It is possible that the Paleoindians had a more nuanced, more sophisticated use of the landscape, and a varied diet similar to a more modern traditional subsistence diet for people of the region, Ben Potter of University of Alaska Fairbanks said.

Meredith Knight is a frequent contributor to the human genetics section for Genetic Literacy Project and a freelance science and health writer in Austin, Texas. Follow her@meremereknight.

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Settling of the Americas: Searching for pieces of the puzzle - Genetic Literacy Project

Gene editing reverses Huntington’s in mouse model – ScienceBlog.com (blog)

Posted on June 23, 2017 by Danzig

Disrupting a problematic gene in brain cells can reverse Huntingtons disease pathology and motor symptoms in a mouse model of the inherited neurological disorder, Emory scientists report.

The researchers used CRISPR/Cas9 gene editing, delivered by a viral vector, to snip part of a gene producing toxic protein aggregates in the brains of 9-month old mice. Weeks later, where the vector was applied, aggregated proteins had almost disappeared. In addition, the motor abilities of the mice had improved, although not to the level of control mice.

The results were published June 19, 2017 inJournal of Clinical Investigation.

The findings open up an avenue for treating Huntingtons as well as other inherited neurodegenerative diseases, although more testing of safety and long-term effects is needed, says senior author Xiao-Jiang Li, MD, PhD, distinguished professor of human genetics at Emory University School of Medicine.

Huntingtons disease is caused by a gene encoding a toxic protein (mutant huntingtin or mHTT) that causes brain cells to die. Symptoms commonly appear in mid-life and include uncontrolled movements, balance problems, mood swings and cognitive decline.

Touted widely for its potential, CRISPR/Cas9 gene editing has not been used to treat any neurodegenerative disease in humans. Several concerns need to be addressed before its use, such as effective delivery and the safety of tinkering with DNA in brain cells. A similar approach, but using a different technology (zinc finger nucleases), was reported for Huntingtons disease in 2012.

The mice used in this study have a human mutant huntingtin gene replacing one of the mouse huntingtin genes. In these mice, motor problems and aggregated mutant huntingtin can be observed around the age of 9 months.

When planning gene editing, the scientists selected guide sequences that targeted both the normal copy and the disease-driving copy of the huntingtin gene. This non-allele specific approach would not need to be customized to the patients genome, unlike other gene editing proposals for Huntingtons disease.

The Emory researchers have previously shown that mice older than four months do not need the huntingtin gene to stay healthy, suggesting that treatment strategies that aim to shut off both copies of the gene in adult humans could be safe.Clinical studies have begun of such treatments, which probably will require continuous administration of the gene-silencing drug. In contrast, a gene editing treatment could be more durable, if it hits enough cells.

To get CRISPR/Cas9-guided enzymes into brain cells, the researchers harnessed a widely used gene therapy vehicle based on AAV (adeno-associated virus). The scientists injected viral vectors carrying CRISPR/Cas9 into the striatum region of the brains of Huntingtons disease model mice at the age of 9 months. The striatum is a region of the brain that controls body movement and motor function.

This led to a dramatic decrease in aggregated mutant huntingtin in the striatum three weeks later. The study reveals the capacity of brain cells to heal themselves if the genetic source of the toxic proteins is removed, the scientists say.

In comparison with control Huntingtons mice, CRISPR/Cas9-injected mice showed significant improvements on tests of motor control, balance and grip strength, although they did not recover to the point where they performed as well as control mice.

Addressing genetic safety concerns, the researchers showed that in brain cells, frameshift mutations triggered by CRISPR/Cas9 occurred predominantly within the huntingtin gene and not in other potential off-target genes.However, the long-term effects and safety of injecting AAV in the brain to express CRISPR/Cas9 remain to be rigorously tested before applying this approach to patients, Li says.

The co-first authors of the paper are postdoctoral fellows Su Yang, PhD at Emory University and Renbao Chang, PhD at Institute of Genetics and Developmental Biology, Chinese Academy of Sciences.

Emory co-authors include Zhaohui Qin, PhD, associate professor of biostatistics, Peng Jin, PhD, professor of human genetics, and Shihua Li. MD, professor of human genetics. Xiao-Jiang Li also is affiliated with the Guangdong-Hongkong-Macau Institute of CNS Regeneration, Jinan University.

The research was supported by the National Institute of Neurological Disorders and Stroke (NS036232, NS101701, NS095279) and the National Natural Science Foundation of China (grant 91332206).

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Gene editing reverses Huntington's in mouse model - ScienceBlog.com (blog)

Senate health care bill: 4 key Republicans come out against …

Posted on June 23, 2017 by Danzig

Key Republican senators came out against the Senate Republican health care plan on Thursday, and their opposition is enough to defeat the package before a vote.

Sens. Rand Paul, R-Ky., Ted Cruz, R-Texas, Mike Lee, R-Utah, and Ron Johnson, R-Wis., said they would not vote on the Senate Republican plan in its current form.

"Currently, for a variety of reasons, we are not ready to vote for this bill, but we are open to negotiation and obtaining more information before it is brought to the floor," the statement said. "There are provisions in this draft that represent an improvement to our current health care system but it does not appear this draft, as written, will accomplish the most important promise that we made to Americans: to repeal ObamaCare and lower their health care costs."

Paul told reporters on Capitol Hill Thursday that if members who support the bill know they don't have the votes needed, discussion would begin earlier.

"I didn't run on ObamaCare lite," Paul said. "I think we can do better than this --my hope is not to defeat the bill, but to make the bill better."

Reuters (Sen. Rand Paul, R-K.Y., in Washington, D.C. on March 7, 2017)

Paul added: "Now the discussions begin -- I think it could take longer than a week."

Cruz acknowledged that he had not yet had "the opportunity" to fully review the bill in its entirity, but said "there are components that give me encouragement and there are also components that are a cause for deep concern."

Sen. Mike Lee (R-UT) speaks at a rally for nominee Neil Gorsuch outside the Supreme Court in Washington, D.C., U.S. March 29, 2017. REUTERS/Aaron P. Bernstein - RTX339ZH

I have been clear from day one that I want to get to yes, Cruz told reporters on Capitol Hill Thursday. Nobody has fought harder against ObamaCare in the Senate than I have, but we have to actually have legislation that fixes the underlying problem.

Cruz said the current draft doesnt do nearly enough, and would be a disaster politically. Cruz said that key components to get everyone to yes are lowering premiums, and giving the states flexibility.

AP (Senate Majority Leader Mitch McConnell, R-K.Y., on Capitol Hill Dec. 12, 2016)

Senate Republicans released a 142-page draft of their version of a "repeal and replace" health care plan on Thursday titled, Better Care Reconciliation Act of 2017, which eliminates a majority of ObamaCare provisions, already drawing backlash from Senate Democrats, and even some congressional Republicans.

U.S. Sen. Ted Cruz, R-Texas, pauses as he delivers a speech to 2014 Red State Gathering attendees, Friday, Aug. 8, 2014, in Fort Worth, Texas. Possible presidential candidate Cruz predicts Republicans will retake the Senate this year and that "2016 will be even better." (AP Photo/Tony Gutierrez) (AP)

The bill could go to a vote as early as next week, after the Congressional Budget Office reviews and gives a score to the new plan, but McConnell did not announce a specific timeline for consideration. The Congressional Budget Office expects to have a score for the draft early next week.

Senate Majority Leader Mitch McConnell, R-Ky., who rolled out the legislation, needs 50 votes to pass the bill to the House, with Vice President Mike Pence serving as the tie-breaking vote. But without the support of Paul, Cruz, Lee, and Johnson, passage of the bill in its current form will be nearly impossible, unless Republicans can manage to draw two Democratic votes, which is highly unlikely.

The bill repeals key components of ObamaCare, and manages to maintain some "crucial" conservative items congressional Republicans were looking for, like a cut to Planned Parenthood funding.

GOP SENATORS UNVEIL OBAMACARE OVERHAUL

But despite the early GOP-opposition, Sen. Chuck Grassley, R-Iowa, said hes glad the process is moving forward.

The Senate discussion draft is available for everyone to review, Grassley said. There will be a full debate before the Senate, with the ability for senators of both parties to offer amendments.

But Democrats, as expected, are slamming the billand most are hanging on comments made by President Trump earlier this week, suggesting the House bill, called the American Health Care Act, was mean.

The President said the Senate bill needs heart, the President says the House bill was mean, Senate Minority Leader Chuck Schumer, D-N.Y., said on the Senate floor Thursday after the bill was rolled out. The Senate version is meanerthe House bill is a wolf, but this bill is a wolf with sharper teeth -- its a wolf in sheeps clothing.

At the White House, the president remained consistent in his comment from earlier in the week, and said he hoped to get something done with heart.

Wed love to have some Democratic support, but theyre obstructionist, Trump said. Hopefully well get something done and itll be something with heart and very meaningful.

Sen. Bernie Sanders, I-Vt., said the bill is even worse than expected and called it by far the most harmful piece of legislation I have seen in my lifetime.

Our job now is to rally millions of Americans against this disastrous bill to make sure it does not pass the Senate, Sanders said.

Despite Sanders, and other Democrats criticisms, Sen. Lamar Alexander, R-Tenn., said the bill makes no change in current law when it comes to protecting people with pre-existing conditions.

McConnell said on the Senate floor Thursday that Democrats made it clear early on that they did not want to work with us, but Sen. Ron Wyden, D-Ore., said he had never been asked.

It is not just a fiction, it is a gross fiction, Wyden said.

Still, many members have yet to read the 142-page legislation in its entirety, with some Republicans hesitant to forecast votes, prior to reading the bill in full.

WHAT'S IN THE SENATE PROPOSAL: KEY PROVISIONS OF BETTER CARE RECONCILIATION ACT OF 2017

I dont know, Sen. Luther Strange, R-Ala., told Fox News. Weve got a lot of work to do.

Sen. Susan Collins, R-Maine, already has a number of concerns, according to her spokesperson, and plans to read the bill in full.

She has a number of concerns and will be particularly interested in examining the forthcoming CBO analysis on the impact on insurance coverage, the effect on insurance premiums, and the changes in the Medicaid program, Collins spokeswoman Annie Clark said.

On the other side of the Capitol, House Speaker Paul Ryan, R-Wis., said he had been briefed on the legislation, and is not going to opine the Senates process.

I know how hard this process is from personal experience -- Last thing I want is to be disrespectful of the process ahead of them, Ryan said. We made a promise to repeal and replace -- eager for them to pass it but not going to opine on the details as they go along.

Rep. Tom MacArthur, R-N.J., who authored a key amendment to the Houses plan, seemed satisfied with the Senates draft proposal.

I am glad to see the Senate further improve the AHCA and put us one step closer, MacArthur said.

McConnell said that when legislation comes to the floor, it will present Senate Democrats another opportunity to do whats right for the American people.

Fox News' Chad Pergram, Mike Emanuel contributed to this report.

Brooke Singman is a Reporter for Fox News. Follow her on Twitter at @brookefoxnews.

Senate GOP unveils health care plan after weeks of secrecy …

Posted on June 23, 2017 by Danzig

Senate Republicansunveiled a "discussion draft" of the bill Thursday of their plan to repeal and replace Obamacare that would end the health care law's penalties for people who don't buy insurance, cut back an expansion of Medicaid, but would keep protections for people with pre-existing conditions, compared to the House-passed bill.

Here's the full text of the "discussion draft" of the bill.

The 142-page measure would provide tax credits, based on income, age and geography, which would make more money available to lower income recipients to help them buy insurance. This differs from the House bill, which tied its tax credits to age. Obamacare taxes would be repealed under the bill. The Senate bill would provide for expanded tax-free Health Savings Accounts, and it would also eliminate federal funding for Planned Parenthood.

Medicaid would be phased out under the bill beginning in 2021, with gradual reductions until 2024 in the amount of federal Obamacare funds that have financed the entitlement program's expansion. The Senate bill would also slash funding to Medicaid from what Republicans call "gimmicks that drive up federal costs." President Trump repeatedly promised during the 2016 presidential campaign that he would not cut Medicaid, Medicare or Social Security.

Senate Majority Mitch McConnell, R-Kentucky, aims to hold a vote on the legislation before lawmakers leave at the end of next week for the week-long July 4 recess.

"Obamacare isn't working. By nearly any measure, it has failed, and no amount of 11th-hour, reality-denying or buck-passing by Democrats is going to change the fact that more Americans are going to get hurt unless we do something," he said on the floor after the bill was posted. "Republicans believe we have a responsibility to act, and we are."

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Senate Republican leaders say they will release a draft of their health care bill Thursday, as lawmakers from both parties complain about being c...

Senate Minority Leader Chuck Schumer, D-New York, noted that the president had asked for a bill with more "heart" than the House bill, but this bill, Schumer said, is "every bit as bad" as the House version and maybe "meaner." "The way this bill cuts health care is heartless," he said on the floor.

"This bill will result in higher costs, less care and millions of Americans will lose their health insurance, particularly through Medicaid," Schumer added.

Republicans need a simple majority to pass it, rather than a supermajority since they're using the budget reconciliation process. They may still have to rely on Vice President Mike Pence to cast a tie-breaking vote. The Senate currently has 52 Republicans and 48 Democrats. That means if all Democrats vote against the bill, only three no votes from Republicans can torpedo it. Even if Republicans are successful in getting it through the upper chamber, they would then still need to reconcile it with version passed by the House in early May, reach a bicameral agreement with House Republicans, and hold votes in the House and Senate on that version again.

A cost estimate of the bill from the nonpartisan Congressional Budget Office (CBO) is expected to be released by early next week. White House staff met with Senate Republican staffers Wednesday night on Capitol Hill to review the bill.

On Thursday morning, the Senate Republican Conference sat through a closed-door briefing for an hour and a half to learn about the bill's substance. Many inside the meeting didn't actually see the text even though it was posted online.

"You've seen the text?" Moderate Sen. Lisa Murkowski, R-Alaska, asked a reporter. "Well, you've seen it before we've seen it."

Sen. John McCain, R-Arizona, called it a "good proposal overall," but that there's "a lot to absorb."

Senators who emerged from the meeting didn't appear entirely confident it would pass next week.

"I think we have a long way to go before we know the answer to that question, Sen. Tim Scott, R-South Carolina, said when asked if it could pass next week, adding that the draft version could be modified before a vote happens. "I'm open to moving forward on the legislation. We have a lot of time now -- seven days -- to figure out what parts we like about it, what parts we plan to keep. This is only a draft legislation. We're going to make a lot of changes over the next seven days.

Several senators are already expressing concerns about the proposal.

"At first glance, I have serious concerns about the bill's impact on the Nevadans who depend on Medicaid. I will read it, share it with Governor Sandoval, and continue to listen to Nevadans to determine the bill's impact on our state," said Sen. Dean Heller, R-Nevada, in a statement. Heller is up for re-election next year and is considered by Democrats to be one of the most vulnerable Republicans.

Sen. Rand Paul, R-Kentucky, didn't appear to be a fan of the bill.

"Conservatives have always been for repealing Obamacare, and my concern is that this doesn't repeal Obamacare," Paul told reporters. "What I've seen so far is that it keeps 10 out of 12 regulations, it continues the Obamacare subsidies, and I think ultimately will not bring down premiums, because instead of trying to fix the death spiral of Obamacare, it simply subsidizes it with taxpayer money to insurance companies. So for those reasons, it looks a lot like Obamacare instead of a repeal of Obamacare."

Sen. Bill Cassidy, R-Louisiana, said he's happy that the bill makes an effort to lower premiums "immediately," but he said he wants to ensure that as Medicaid is scaled back, "We don't lose the the ability for lower-income folks to be able to afford insurance."

Sen. Lindsey Graham, R-South Carolina, said in a statement that he needs to carefully review the text first, but "would prefer to address health care reform in a bipartisan manner," accusing Democrats of being unwilling to negotiate with Republicans.

The House bill, which narrowly passed in a 217-213 vote on May 4, would significantly reduce the funding for Obamacare subsidies, revamp tax credits so that they're tied to a person's age, freeze the Medicaid expansion in 2020 and allow states to seek waivers from a rule that requires states to offer essential benefits in their plans and a provision that prevents insurers from charging people with pre-existing conditions more money compared to healthy people. Instead of Obamacare's insurance mandate, the House Republican bill would incentivize people to have continuous coverage. Should coverage be interrupted for more than 63 days, insurers would be able to charge a 30 percent penalty over the original premium for one year.

The CBO didn't release its cost estimate on the House bill until May 24, which projected that 23 million more people would be without health insurance over the next decade under the bill.

The Senate's version was supposedly crafted by a working group consisting of 13 Republican men -- and no women -- but one of the group's participants, Sen. Mike Lee, R-Utah, said even he had been left in the dark. Lee said the measure was "apparently being written by a small handful of staffers for members of the Republican leadership in the Senate."

Other Senate Republicans voiced frustration that the process had been too secretive and out of the public eye. Senate Republicans don't intend to hold any committee hearings on the bill, despite their commitment to so-called "regular order."

Nearly three-quarters of Americans said Senate Republicans should discuss their health care plans publicly, according to a CBS News poll released Tuesday. A quarter of the public, by contrast, said it should be developed in private. It also found 57 percent said Obamacare needs some changes, 28 percent said it should be repealed entirely and 12 percent said it should be kept in place.

CBS News' Nancy Cordes and Alan He contributed to this report.

Senate GOP unveils health care plan after weeks of secrecy ...

What Americans really want from health care reform is impossible – New York Post

Posted on June 23, 2017 by Danzig

It is an old joke among health-policy wonks that what the American people really want from health care reform is unlimited care, from the doctor of their choice, with no wait, free of charge.

For Republicans, trying to square this circle has led to panic, paralysis, and half-baked policy proposals such as the Obamacare-replacement bill. For Democrats, it has led from simple disasters such as Obamacare itself to a position somewhere between fantasy and delusion.

The latest effort to fix health care with fairy dust comes from California, whose Senate voted to establish a statewide single-payer system. As ambitious as the California legislation is, encompassing everything from routine checkups to dental and nursing-home care, its authors havent yet figured out how it will be paid for. The plan includes no copays, premiums, or deductibles. Perhaps thats because the legislatures own estimates suggest it would cost at least $400 billion, more than the states entire present-day budget.

In fairness, legislators hope to recoup about half that amount from the federal government and the elimination of existing state and local health programs. But even so, the plan would necessitate a $200 billion tax hike. One suggestion being bandied about is a 15 percent state payroll tax. Ouch.

The cost of Californias plan is right in line with that of other recent single-payer proposals. For example, last fall, Colorado voters rejected a proposal to establish a single-payer system in that state that was projected to cost more than $64 billion per year by 2028. Voters apparently took note of the fact that, even after figuring in savings from existing programs, possible federal funding, and a new 10 percent payroll tax, the plan would have still run a $12 billion deficit within ten years.

Similarly, last year Vermont was forced to abandon its efforts to set up a single-payer system after it couldnt find a way to pay for the plans nearly $4 trillion price tag. The state had considered a number of financing mechanisms, including an 11.5 percent payroll tax and an income-tax hike (disguised as a premium) to 9.5 percent.

On the national level, who could forget Bernie Sanderss proposed Medicare for All system, which would have cost $13.8 trillion over its first decade of operation? Bernie would have paid for his plan by increasing the top U.S. income-tax rate to an astounding 52 percent, raising everyone elses income taxes by 2.2 percentage points, and raising payroll taxes by 6.2 points.

Of course, it is no surprise that Medicare for All would be so expensive, since our current Medicare program is running $58 trillion in the red going forward. It turns out that free health care isnt really free at all.

How, though, could a single-payer system possibly cost so much? Arent we constantly told that other countries spend far less than we do on health care?

It is true that the U.S. spends nearly a third more on health care than the second-highest-spending developed country (Sweden), both in per capita dollars and as a percentage of GDP. But that reduction in spending can come with a price of its own: The most effective way to hold down health-care costs is to limit the availability of care. Some other developed countries ration care directly. Some spend less on facilities, technology, or physician incomes, leading to long waits for care.

Such trade-offs are not inherently bad, and not all health care is of equal value, though that would seem to be a determination most appropriately made by patients rather than the government. But the fact remains that no health care system anywhere in the world provides everyone with unlimited care.

Moreover, foreign health-care systems rely heavily on the U.S. system to drive medical innovation and technology. Theres a reason why more than half of all new drugs are patented in the United States, and why 80 percent of non-pharmaceutical medical breakthroughs, from transplants to MRIs, were introduced first here. If the U.S. were to reduce its investment in such innovation in order to bring costs into line with international norms, would other countries pick up the slack, or would the next revolutionary cancer drug simply never be developed? In the end, there is still no free lunch.

American single-payer advocates simply ignore these trade-offs. They know that their fellow citizens instinctively resist rationing imposed from outside, so they promise unlimited care for all, which is about as realistic as promising personal unicorns for all.

In the process, they also ignore the fact that many of the systems they admire are neither single-payer nor free to patients. Above and beyond the exorbitant taxes that must almost always be levied to fund their single-payer schemes, many of these countries impose other costs on patients. There are frequently co-payments, deductibles, and other cost-sharing requirements. In fact, in countries such as Australia, Germany, Japan, the Netherlands, and Switzerland, consumers cover a greater portion of health-care spending out-of-pocket than do Americans. But American single-payer proposals eliminate most or all such cost-sharing.

Adopting a single-payer system would crush the American economy, lowering wages, destroying jobs, and throwing millions into poverty. The Tax Foundation, for instance, estimated that Sanderss plan would have reduced the U.S. GDP by 9.5 percent and after-tax income for all Americans by an average of 12.8 percent in the long run. That is, simply put, not going to happen. So Americans are likely to end up with a lot less health care and than they have been promised.

Santa Claus will always be more popular than the Grinch. But the health-care debate needs a bit more Grinch and a lot less Santa Claus. Americans cannot have unlimited care, from the doctor of their choice, with no wait, for free. The politician that tells them as much will not be popular. But he or she may save them from something that will much more likely resemble a nightmare than a utopian dream.

Michael Tanner is a senior fellow at the Cato Institute and the author of Going for Broke: Deficits, Debt, and the Entitlement Crisis. You can follow him on his blog, TannerOnPolicy.com. This piece first appeared in the National Review.

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What Americans really want from health care reform is impossible - New York Post

Trump and health care: Promises made, promises broken – MSNBC

Posted on June 23, 2017 by Danzig

MSNBC

Trump and health care: Promises made, promises broken
MSNBC
That's hopelessly bonkers on a wide variety of fronts, but it's especially striking when it comes to health care. The president promised the American public, We're going to have insurance for everybody. Everybody's going to be taken care of. He ...

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Trump and health care: Promises made, promises broken - MSNBC

Medicaid Restructuring Under the American Health Care Act and Children with Special Health Care Needs – Kaiser Family Foundation

Posted on June 23, 2017 by Danzig

Medicaid and CHIP cover 44% of children with special health care needs, providing access to a broad range of medical and long-term care services that enable many to live at home with their families and making coverage affordable. This brief includes state-level data on the share of children with special health care needs covered by Medicaid and describes Medicaids role for these nearly five million children to help inform the debate about the American Health Care Acts (AHCA) reduction of federal Medicaid funding under a per capita cap or block grant.

Nearly of all children with special health care needs live in low or middle income families, below 400% of the federal poverty level (FPL). About one in five are below 100% FPL (<$20,420/year for a family of three in 2017), and another one in five are between 100-199% of poverty.

Medicaid/CHIP children with special health care needs have significantly greater health needs compared to those with private insurance alone, with children covered by both Medicaid/CHIP and private insurance having the greatest needs. Medicaid/CHIP children with special health care needs are nearly two and one-half times as likely (24%), and those with both Medicaid/CHIP and private insurance are three times as likely (30%), to have four or more chronic conditions, compared to those with private insurance alone (10%). Medicaid/CHIP children are more than one and one-half times as likely (58%), and those with both Medicaid/CHIP and private insurance are nearly twice as likely (63%), to have four or more functional difficulties compared to those with private insurance (33%). Medicaid/CHIP cover 60% of the 2.9 million children with special health care needs whose health conditions consistently and often greatly affect their daily activities, with Medicaid/CHIP as the sole source of coverage for nearly half of these children.

Medicaid/CHIP children with special health care needs have access to care on par with those with private insurance alone. For example, Medicaid/CHIP children (92% for both those with and without private insurance) are about equally as likely to have had a preventive care visit in the last year compared to those with private insurance alone (91%). Medicaid/CHIP children are significantly more likely than those with private insurance to report that their coverage is adequate to meet their needs (69% vs 64%).

Medicaid/CHIP children with special health care needs are significantly more likely to report that their coverage is affordable compared to those with private insurance alone. Medicaid/CHIP children are more than five times less likely (6%), and those with Medicaid/CHIP and private insurance are half as likely (16%), to incur out-of-pocket costs of $1,000 or more, compared to those with private insurance alone (32%). Medicaid/CHIP is a safety net, covering 59% of the 2.7 million children with special health care needs whose families have had to reduce their work hours or stop working altogether due to their childs health status, and serving as the sole source of coverage for nearly half of these children.

Medicaid children with special health care needs may be particularly affected by changes in the AHCA, including the shift to per capita capped federal financing. Per enrollee spending for Medicaid children who use long-term care services is over 12 times higher ($37,084) compared to those who do not ($2,836), due to these childrens greater health needs and reliance on Medicaid for expensive but necessary services that are generally unavailable through private insurance and too costly to afford out-of-pocket. Many Medicaid coverage pathways for children with disabilities, and some community-based long-term care services provided through waivers, are offered at state option, making them subject to potential cuts as states adjust to substantial federal funding reductions under a per capita cap.

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Medicaid Restructuring Under the American Health Care Act and Children with Special Health Care Needs - Kaiser Family Foundation

AARP warns senators against supporting GOP healthcare bill – Washington Examiner

Posted on June 23, 2017 by Danzig

AARP doesn't want any senator to support the Republican healthcare proposal introduced on Thursday.

The organization dedicated to lobbying for older Americans over 50 years old took issue not only with some of the cuts the legislation would make but also the circumstances in which it was devised.

"This new Senate bill was crafted in secrecy behind closed doors without a single hearing or open debateand it shows," AARP Executive Vice President Nancy LeaMond said in a statement. The Senate bill would hit millions of Americans with higher costs and result in less coverage for them. AARP is adamantly opposed to the Age Tax, which would allow insurance companies to charge older Americans five times more for coverage than everyone else while reducing tax credits that help make insurance more affordable."

The group also complained that the bill would make cuts to Medicare and Medicaid.

"AARP is also deeply concerned that the Senate bill cuts Medicaid funding that would strip health coverage from millions of low-income and vulnerable Americans who depend on the coverage, including 17 million poor seniors and children and adults with disabilities. The proposed Medicaid cuts would leave millions, including our most vulnerable seniors, at risk of losing the care they need and erode seniors' ability to live in their homes and communities," LeaMond said. "The Senate bill also cuts funding for Medicare which weakens the programs ability to pay benefits and leaves the door wide open to benefit cuts and Medicare vouchers. AARP has long opposed proposals that cut benefits or weaken Medicare."

The bill introduced Thursday follows the passage of the healthcare reform bill passed by the House, which aims to partially repeal and replace Obamacare care, the signature healthcare law of former President Barack Obama. AARP says that like it did with all the members of the House, it will hold all 100 senators "accountable" for their votes on this "harmful" bill.

"Our members care deeply about their health care and have told us repeatedly that they want to know where their elected officials stand. We strongly urge the Senate to reject this bill," LeaMond concluded.

50 GOP votes are needed to pass the bill under the process of reconciliation, with a tie-breaker vote from Vice President Mike Pence. Already four of 52 Republicans, Sens. Ted Cruz of Texas, Ron Johnson of Wisconsin, Mike Lee of Utah and Rand Paul of Kentucky, have said they are "not ready" to support the bill in its current form. It is expected that all Democrats will oppose its passage. President Trump chimed in on Twitter on Thursday to say he supports the Senate bill.

AARP warns senators against supporting GOP healthcare bill - Washington Examiner

Democrats Calling the GOP Health Care Bill Mean Are Impotent and Pathetic – Slate Magazine (blog)

Posted on June 23, 2017 by Danzig

Chuck Schumer speaks during a press conference on the Senate health care bill on June 22, 2017.

AFP/Getty Images

Last week, behind closed doors, Donald Trump apparently called the House health care bill mean. Unlike pretty much everything else the president has done since taking office, this description played to great popular acclaim. The word was like a wisp of a song that got caught in the countrys heada tune by Taylor Swift, perhaps: Why did the Grand Old Party have to be so mean?

On Thursday, Senate minority leader Chuck Schumer upped the rhetorical ante, critiquing the Senates Better Care Reconciliation Act by dramatically scribbling an -er on a piece of poster board.

Also on Thursday, Barack Obama wrote a Facebook post decrying the fundamental meanness at the core of this legislation, noting the act would snatch coverage away from 23 million Americans.

While we wait for the bill to pass and plunge whole swathes of the nation into crisis, lets muse for a moment on this childlike descriptor. Mean. It contains the requisite letters to compose the word men, which is great if youre racking your brain for epithets for a law that identifies womanhood as a costly preexisting condition. It rhymes with green, which is the color of the dollars that insurance and drug companies will bathe in as old people, pregnant people, and people with mental health issues lose their access to affordable health services. Mean also carries the slightly archaic connotation of miserliness or selfishness, and of shoddiness, too. I dont need to belabor the salience of those qualities as we watch a measure scotch-taped together out of the cruel fragments of Scrooge McDucks id work its way through the House of Representatives.

When Trump used the word mean, it seemed at once inadequate and innocenta plaintive plea from the mouth of a babe. The presidents moral imagination is a Chinese violin with only two strings: nice and mean. The House bill plucked the second one.

When Schumer used the comparative meaner, it seemed full of foolishness. The Democrats were so absorbed in and amused by their lame performance of outrage that they turned genuine moral indignation into kindergarten-grade insult comedy. That bill was mean. This bill is mean-ER. Weve got your votes, amirite?

Obamas meanness, however, felt just right, drawing attention to Republicans small-mindedness as well as their cruelty. The effect was similar to Hillary Clintons reclaiming of nasty. Sometimes it takes an adult to reveal a six-year-olds unintentional eloquence.

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Democrats Calling the GOP Health Care Bill Mean Are Impotent and Pathetic - Slate Magazine (blog)

With the health care system threatened, Obama speaks up – MSNBC

Posted on June 23, 2017 by Danzig

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With the health care system threatened, Obama speaks up
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Less than two weeks after leaving office, this led Obama to issue a statement responding to the Trump White House's proposed Muslim ban. This afternoon, with the American health care system in peril, the former president spoke up again, this time via ...

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With the health care system threatened, Obama speaks up - MSNBC

Researchers use long-read genome sequencing for first time in a patient – Stanford Medical Center Report

Posted on June 23, 2017 by Danzig

This allows us to illuminate dark corners of the genome like never before, Ashley said. Technology is such a powerful force in medicine. Its mind-blowing that we are able to routinely sequence patients genomes when just a few years ago this was unthinkable.

The study was conducted in collaboration with Pacific Biosciences, a biotechnology company in Menlo Park, California, that has pioneered a type of long-read sequencing. Lead authorship of the paper is shared by Jason Merker, MD, PhD, assistant professor of pathology and co-director of the Stanford Clinical Genomics Service, and Aaron Wenger, PhD, of Pacific Biosciences.

The type of long-read sequencing developed by the research teams collaborators at the company can continuously spool long threads of DNA for letter-by-letter analysis, limiting the number of cuts needed.

This is exciting, said Ashley, because instead of having 100-base-pair words, you now have 7,000- to 8,000-letter words.

Thanks to technological advances and increased efficiency, the cost of long-read sequencing has been falling dramatically. Ashley estimated the current cost of the sequencing used for this study at between $5,000 and $6,000 per genome.

Though the cost of short-read sequencing is now below $1,000, according to Ashley, parts of the genome not accessible when cutting DNA into small fragments. Throughout the genome, series of repeated letters, such as GGCGGCGGC, can stretch for hundreds of base pairs. With only 100-letter words, it is impossible to know how long these stretches are, and the length can critically determine someones predisposition to disease.

Additionally, some portions of the human genome are redundant, meaning there are multiple places a 100-base pair segment could potentially fit in, said Ashley. This makes it impossible to know where to place those segments when reassembling the genome. With longer words, that happens much less often.

Given these issues, 5 percent of the genome cannot be uniquely mapped, the researchers wrote. And any deletions or insertions longer than about 50 letters are too long to detect.

For patients with undiagnosed conditions, short-read sequencing can help doctors provide a diagnosis in about one-third of cases, said Ashley. But Ramons case was not one of those.

The technique initially used to analyze Ramons genes failed to identify a mutation in the gene responsible for Carney complex, though Ashley said co-author Tam Sneddon, DPhil, a clinical data scientist at Stanford Health Care who browsed through the database of Ramons sequenced genome by hand, did notice something looked wrong. Ultimately, the long-read sequencing of Ramons genome identified a deletion of about 2,200 base-pairs and confirmed that a diagnosis of Carney complex was indeed correct.

This work is an example of Stanford Medicines focus on precision health, the goal of which is to anticipate and prevent disease in the healthy and precisely diagnose and treat disease in the ill.

Carney complex arises from mutations in the PRKAR1A gene, and is characterized by increased risk for several tumor types, particularly in the heart and hormone-producing glands, such as ovaries, testes, adrenal glands, pituitary gland and thyroid. According to the National Institutes of Health, fewer than 750 individuals with this condition have been identified.

The most common symptom is benign heart tumors, or myxomas. Open heart surgery is required to remove cardiac myxomas; by the time Ramon was 18 years old, hed had three such surgeries. He is under consideration for a heart transplant, and having the correct diagnosis for his condition was important for the transplant team. Beyond the typical screening for a transplant, Ashley said the team needed to ensure there werent other health issues that could be exacerbated by immune suppressants, which heart transplant patients must take to avoid rejection of the donated organ.

Though it helps his medical team to have a confirmed diagnosis of Carney complex, Ramon has found it disheartening to face the fact that he cannot escape his condition. I was pretty sad, he said. It took me a while to come to terms with the fact that Ill have this until the day I die.

He tries not to dwell on it, though. Live one day at a time, he said. The bad days are temporary storms, and theyll pass.

His story is quite incredible, said Ashley, who said it was a privilege to be working on Ramons team. To have such a burden on such young shoulders, and to decide whether or not he wants a transplant, requires incredible courage.

Because he couldnt wait any longer for a transplant, Ramon recently underwent his fourth surgery to remove three tumors in his heart. Joseph Woo, MD, professor and chair of cardiothoracic surgery, performed the operation at Stanford Hospital. It is exceedingly rare to have tumors in the heart, said Ashley. It was a particularly heroic operation. Though Ramon is still under consideration for a transplant, the need is less urgent now.

Im in good hands, Ramon said of the Stanford team. Im glad to be here.

Ashley said he and many other doctors believe that long-read technology is part of the future of genomics.

Now we get to see how to do it better, said Ashley. If we can get the cost of long-read sequencing down to where its accessible for everyone, I think it will be very useful.

Other Stanford co-authors of the study are genetic counselor Megan Grove; former graduate student Zach Zappala, PhD; postdoctoral scholar Laure Fresard, PhD; senior research engineer Daryl Waggott, MSc; Sowmi Utiramerur, MS, director of bioinformatics for Stanfords Clinical Genomics Service; research assistant Yanli Hou, PhD; research scientist Kevin Smith, PhD; Stephen Montgomery, PhD, assistant professor of pathology and of genetics; Matthew Wheeler, MD, PhD, clinical assistant professor of cardiovascular medicine; Jillian Buchan, PhD, clinical assistant professor of pathology; and James Ford, MD, professor of medicine and of genetics.

Ashley is a member of Stanford Bio-X, the Stanford Cardiovascular Institute and the Stanford Child Health Research Institute. He is also the founding director of the Stanford Center for Inherited Cardiovascular Disease, the co-director of the Stanford Clinical Genomics Service and the steering committee co-chair for the National Institutes of Health Undiagnosed Diseases Network.

Pacific Biosciences paid for the sequencing.

Stanfords Department of Pathology and the Stanford Cancer Institute also supported the work.

Heart Disease: A Price Humans Pay for Fertility? – Sioux City Journal

Posted on June 23, 2017 by Danzig

THURSDAY, June 22, 2017 (HealthDay News) -- Certain genes linked to heart disease may also improve your chances of having children, a new study suggests.

Australian researchers said the findings seem to offer a potential explanation for why evolution has allowed these genes to persist for centuries.

While lifestyle is clearly important in heart disease risk, scientists have found many genes also influence those odds.

"Genes play a very important role in coronary artery disease risk across an individual's lifetime," said study author Sean Byars, a research fellow at the University of Melbourne. In fact, it's estimated that genes account for about 50 percent of the risk.

The rest, he said, is due to other factors, including habits like smoking and eating a poor diet.

Heart disease is a major killer worldwide, and it has long plagued humanity. Scientists have found evidence of clogged arteries in Egyptian mummies, Byars and his colleagues pointed out.

The researchers said that raises a fundamental question: Why haven't the genes that promote heart disease been weeded out by natural selection?

Natural selection is the process by which organisms -- including humans -- evolve to have better survival odds.

The new study suggests one answer: Byars' team found that a few dozen genes tied to heart disease might also contribute to people's "reproductive success."

Since heart disease usually strikes later in life, after people have had their kids, it would be a reasonable trade-off for better fertility -- at least in terms of survival of the species.

The findings, published online recently in the journal PLOS Genetics, do not have any immediate implications for managing heart disease or fertility, Byars said.

"This study is more about potentially helping to provide a fundamental understanding of why [heart disease] is so prevalent in modern humans," he explained.

Byars did, however, point to a big-picture issue: The findings may sound a cautionary note about "gene-editing" -- a technology scientists are studying with the hope of correcting genetic flaws that cause disease.

"One potential concern a study like this raises," Byars said, "is that in an era of gene-editing, we need to be very careful about unintended consequences of modifying our genomes -- due to shared functions of these genes that are not always obvious."

For the study, the researchers used two large databases with a wealth of genetic information, along with data from a long-running health study of U.S. adults.

The investigators first focused on 76 genes that are linked to heart disease -- the kind caused by clogged arteries. From there, the researchers found that 40 genes were also tied to at least one aspect of reproductive "fitness."

Some were related to the number of children people had, while others were tied to a woman's age at her first and last menstrual period. There were 19 to 29 genes, the researchers said, that were tied to "traits" that can directly sway male or female fertility.

Heart disease is, of course, a complex condition that involves many different factors. Even if Mother Nature insists that humans carry heart-disease genes, there is still plenty that people can do about it, according to Dr. Robert Rosenson.

Rosenson, a cardiologist at Mount Sinai Health System in New York City, pointed to the example of familial hypercholesterolemia (FH).

FH is an inherited disorder caused by a single genetic defect, and it leads to very high "bad" cholesterol levels and a substantial risk of premature heart disease.

But even with those genetic cards stacked against them, Rosenson said, people with FH can prevent or delay heart complications -- by taking cholesterol medication, exercising regularly, not smoking and eating a healthy diet.

"Even if you have a disease-causing genetic trait, lifestyle absolutely makes a difference," Rosenson said.

Most genes tied to heart disease do not have such a dramatic effect -- a large number, he noted, have a "minor" impact on heart disease risk.

But studying the genetics of heart disease will hopefully lead to better treatments, Rosenson said.

Genes, he explained, may help explain why one person responds well to a cholesterol-lowering statin, while someone else "gains weight and develops diabetes," for example.

"Someone might develop a drug side effect simply because they've inherited a trait that interferes with a drug-elimination pathway," Rosenson said.

The hope for the future, he said, is to use genetic information to help predict which treatments will likely benefit an individual patient.

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Heart Disease: A Price Humans Pay for Fertility? - Sioux City Journal

Patient-inspired research uncovers new link to rare disorder | Baylor … – Baylor College of Medicine News (press release)

Posted on June 23, 2017 by Danzig

Meeting a young patient with Zellweger syndrome, a rare, life-threatening genetic disease, started a scientific investigation that culminated with an unexpected discovery. The condition, also known as peroxisomal biogenesis disorder, had been linked only to lipid or fat metabolism. Now, as a team of scientists from several institutions, including Baylor College of Medicine, reveals in PLoS Genetics, the condition also affects sugar metabolism. The discovery of this connection in animal models can potentially lead to treatments that might improve the condition.

Meeting this patient at Texas Childrens Hospital inspired me to begin a research investigation to learn more about this disorder, said first and corresponding author Dr. Michael Wangler, assistant professor of molecular and human genetics at Baylor College of Medicine. The family of the patient found out about this research and offered to help. They started Zellfest, a fundraising event in San Antonio, Texas, that has partially supported our investigation. This led us to study this disorder in the fruit fly model in collaboration with the research team led by Dr. Hugo Bellen, professor of molecular and human genetics and investigator at the Howard Hughes Medical Institute at Baylor College of Medicine.

Peroxisomal biogenesis disorder results from defects in the genes that form the peroxisomes, essential micro-machines inside the cell that are involved in breaking down and producing certain lipids. When peroxisomes do not form, people develop a wide range of conditions that may include poor muscle tone, seizures, hearing and vision loss, poor feeding, skeletal abnormalities, as well as life-threatening problems in organs such as the liver, heart and kidney. There is no cure or treatment, other than palliative care.

Its been well established that several lipid pathways are altered in this disease; these are known peroxisomal functions, but there has been very little focus on other parts of metabolism. Everybody was thinking this was mainly a lipid disorder, Wangler said.

The researchers genetically engineered the laboratory fly, Drosophila, to lack two of the genes that are needed to make peroxisomes, PEX2 and PEX16, and then analyzed the flies metabolism.

We began a collaboration with Dr. James McNew, professor in biosciences at Rice University, who had started looking at flies using a metabolomics approach, Wangler said. Metabolomics is like taking a snapshot of all the metabolism of an organism by measuring hundreds of small molecules all at once, rather than focusing on one molecule at a time. We analyzed lipids, small carbohydrates, amino acids, cholesterol and small lipids. This approach gave us a general view of the metabolism of the organism.

The scientists found that the flies lacking the peroxisome genes had many of the problems observed in patients. The scientists learned, for instance, that these flies had short lives and locomotor problems. Their thorough analysis suggests that flies without PEX genes represent an animal model in which to further investigate the human condition.

In addition, we were surprised to discover that these flies were very sensitive to low-sugar diet, Wangler said. They cannot tolerate a low-sugar diet as well as normal flies; without sugar, flies without peroxisomes appear to be starving.

The researchers also applied a metabolomics approach to mice genetically engineered to lack a mouse PEX gene. As they had found in the flies, mice without peroxisomes also had alterations in the metabolism of sugars.

Our understanding is that the enzymes that break down sugars are not directly connected to peroxisomes, Wangler said. We are continuing our investigations and hope they will lead us to better understand how sugar metabolism is linked to peroxisomal biogenesis disorders.

Peroxisomes also play a role in common diseases such as Alzheimers and cancer, Wangler said. Studying this rare disease can help us understand peroxisomes better, and, in turn, that knowledge will help clarify the role of peroxisomes in Alzheimers and other disorders. Rare diseases can help understand issues that also contribute to more common diseases.

Other authors that contributed to this work include Yu-Hsin Chao, Vafa Bayat, Nikolaos Giagtzoglou, Abhijit Babaji Shinde, Nagireddy Putluri, Cristian Coarfa, Taraka Donti, Brett H. Graham, Joseph E. Faust, Ann Moser, Marco Sardiello and Myriam Baes. The authors are affiliated with one of more of the following institutions: Baylor College of Medicine, Texas Childrens Hospital, KU Leuven, Rice University and the Howard Hughes Medical Institute.

This work was supported by the Clayton Murphy Peroxisomal Disorders Research Fund at Baylor College of Medicine, National Institutes of Health K08 (NS076547) award to Michael Wangler, a grant by the Simmons Family Foundation to foster collaborative efforts between Rice University and Texas Childrens Hospital, awarded to Michael Wangler, Hugo Bellen and James McNew, as well as the support of Hugo Bellen, a Howard Hughes Medical Investigator.

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Patient-inspired research uncovers new link to rare disorder | Baylor ... - Baylor College of Medicine News (press release)

Rady Children’s ambitious genomics expansion to start in Orange County – The San Diego Union-Tribune

Posted on June 23, 2017 by Danzig

Soon, couriers will drive infant blood samples 90 miles south down Interstate 5 from Orange County to San Diego for high-speed genetic sequencing and analysis at the Rady Childrens Institute for Genomic Medicine.

The organization, which recently built its own hot rod genetics lab that can do full DNA work-ups in days instead of weeks, announced this week that it has made a pact with Childrens Hospital of Orange County, offering quick-turnaround service for infants in that facilitys intensive care units who need the speed.

Though most young patients dont need results in days, a break-neck pace can benefit those with unexplained, life-threatening and progressive symptoms which force physicians to make treatment decisions very quickly.

In these situations, doctors sometimes must choose one therapy or another without enough time to fully understand what, exactly, is causing deadly medical problems ranging from seizures to cardiac arrest.

Genetic analysis can spot DNA mutations and help doctors make more informed choices about which procedures are most likely to work and also allow them to test for multiple possible genetic diseases with a single test rather than several, putting less strain on babies already struggling to survive after birth.

Rady began using its own sequencing machines from the San Diego-based company Illumina, stationed in an office building just across the street from the hospital, last year for the time-sensitive minority of patients who have immediate genetic information needs.

Out of the gate, rapid analysis clarified a set of confusing symptoms and ended up canceling a surgery for a newborn because the procedure turned out to be unnecessary, hospitals officials said.

The Rady Childrens institute said this week that it has now sequenced 100 patients enrolled in its research studies. Forty percent have received a genomic diagnosis of their disease while 80 percent have had some sort of change in their plan of care as a result of undergoing sequencing.

About one in 20 is a life saved, and wed like to save as many as we can, said Dr. Stephen Kingsmore, director of the institute.

CHOC is just the start, he added. He expects to help 10 childrens hospitals across the nation start offering high-speed sequencing to their patients by the end of June 2018. And Kingsmore hopes to go far beyond that initial goal.

Ideally, he said in a previous interview, every hospital should have access to rapid sequencing and analysis. Though a request for a $100 million MacArthur Grant that would have jump started that larger ambition did not come through, plans are still underway to move forward as quickly as possible with another hospital in the Midwest expected to announce a collaboration this week or next.

Cost is one of the biggest obstacles for pediatric sequencing which must include the patient, both parents and sometimes siblings. Only by comparing a childs genetic sequence to their parents can new mutations be spotted quickly. A full analysis can cost $20,000 per family in rapid-turnaround situations.

Most families dont have that kind of cash on hand, and it can take weeks or months to convince health insurance companies to cover the expense, a time lag that is too long when a babys condition is deteriorating rapidly.

Rady is able to temporarily circumvent this limitation by getting seed funding from the South Dakota-based Sanford Health Foundation, Kingsmore said. Hospitals will still seek reimbursement from patients health insurance companies whenever they can, but Sanfords contribution allows work to begin immediately rather than waiting for insurance approval.

For this to be sustainable and nationwide, we will need to convince insurers to reimburse, Kingsmore said, adding that he expects Rady to begin receiving samples from CHOC next week.

paul.sisson@sduniontribune.com

(619) 293-1850

Twitter: @paulsisson

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Rady Children's ambitious genomics expansion to start in Orange County - The San Diego Union-Tribune

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