Sisode health care
Dr Rajan patil.
By: drrajan patil
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Health-Care Job Growth Has Been Bright. Heres the Cloud.
One of the most consequential unknowns in health care is whether the slow growth in spending over recent years will pick up as the economy recovers. Data suggest that in 2014 growth in health-care spendingaccelerated,rising 5% compared with 3.6% growth in 2013.
The largest cost driver in health care is labor, which representsthree-quarters of ambulatoryand two-thirds of in-patient costs. Patterns in health-care employment and wages may offer insight into future patterns in health-care spending.
Growth in health-care jobs has been constant over the past 25 years: from about 8.2 million in 1990 to 14.8 million in 2014. Even the Great Recession did not stop growth in health-care employment. In the 21stcentury, health care has created about as many jobs as the entire non-health-care economy. Between 1990 and 2013, health care became the dominant source of employment in 35 states. Wages have also grown faster in health care than in most other sectors of the economy in recent years.
But the health-care sector cannot continue to add well-paying jobs without eventually passing on those costs. Its something of a mystery to economists why this hasnt occurred in recent years. One possibility is that other, non-labor expenses decreased dramatically, partially buffering the impact of rising labor costs. This has occurred with spending on pharmaceuticals, which has fallen in recent years. But drugs account for only about 10% of total U.S. health spending and are not enough on their own to explain the magnitude of the overall spending slowdown. In addition, drug costs are rising again because of powerful, and expensive, specialty pharmaceuticals: They were up13.1% in 2014. With both labor and pharma costs rising, national health expenditures are likely to rise as well.
Growth in health-care employment has helped to ease the pain of the Great Recession. Eventually, however, something has to give, and that is likely be the pocketbooks of those who pay for care.
David Blumenthal, who was the national coordinator for health information technology from 2009 to 2011, is president of the Commonwealth Fund, a private foundation that researches health and social policy issues. He is on Twitter: @DavidBlumenthal. David Squires is senior researcher to the president at the Commonwealth Fund.
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Florida House, Senate clash over health care spending
TALLAHASSEE The Florida House and Senate rolled out vastly different health care spending plans Thursday, putting the two chambers on a collision course over the state's $77 billion budget.
The dueling health care proposals are $5 billion apart more than the entire budget for the state of Vermont.
The Senate version includes $2.8 billion in federal money to pay for expanded health care coverage, something the House adamantly opposes. It also includes a $2.2 billion program known as the Low Income Pool (or LIP) that helps hospitals treat uninsured, under-insured and Medicaid patients.
Reaching consensus on the two issues will be difficult and could require an extended or special legislative session. For now, leaders in both chambers are holding firm.
"Those are the Senate's priorities," Senate Health and Human Services Appropriations Subcommittee Chairman Ren Garca, R-Hialeah, said Thursday.
The stakes are high. The final budget could expand coverage to nearly 1 million poor Floridians or result in dramatic cuts to safety-net hospitals across the state.
Building the health care budget is more complicated than usual this year because the LIP program is set to end on June 30. The federal government has said it may be willing to approve a replacement program, but no deal has been reached.
There's also the issue of Medicaid expansion, a provision of the federal Affordable Care Act, also known as Obamacare.
For the past two years, House Republicans have rejected billions of federal dollars to extend health care coverage to the poor. The Senate is hoping to tap into the money this year, saying it would help hospitals pay for uncompensated care if LIP disappears.
The Senate's proposed $35.2 billion health care budget includes $2.2 billion in LIP money. It also includes a LIP replacement program that would distribute the money to all hospitals based on the services they provide, rather than targeting a few select hospitals.
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Sick scams: $3.3B recouped from health-care fraud
Officials highlighted a number of initiatives that have helped both prevent health-care fraud and recoup federal money. Those steps included increased funding to expand the Medicare Fraud Strike Force to nine geographic territories.
Authorities said efforts by the strike force and other initiatives led the Justice Department to open 924 new criminal health-care fraud probes in fiscal 2014. Federal prosecutors actually filed criminal charges in nearly 500 cases, involving more than 800 defendants, and 734 defendants were convicted of health-care-related fraud that year.
Read MoreThe kids aren't all right: 3.3M may lose insurance
Officials also noted how the Affordable Care Act requires the Centers for Medicare and Medicaid Services to use new screening requirements to revalidate all 1.5 million Medicare suppliers and providers.
"As a result of this and other proactive initiatives, CMS has deactivated 470,000 enrollments and revoked nearly 28,000 enrollments to prevent certain providers from re-enrolling and billing the Medicare program," officials said. "Both of these actions immediately stop billing."
CMS also continued a temporary moratorium on the enrollment of new home health and ambulance service providers in six metropolitan areas considered "hot spots" for health fraud: Miami, Chicago, Dallas, Houston, Detroit and Philadelphia.
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Taking the pulse of Obamas health care law at age 5
WASHINGTON With more than 50 congressional repeal votes, a near-death Supreme Court experience and a botched marketplace debut to its credit, the Affordable Care Act has had a tortured five-year existence as the Republican Partys legislative enemy No. 1.
And since President Barack Obama signed the health care measure into law on March 23, 2010, its troubled legislative history isnt close to being fully written.
Yet another Supreme Court case threatens to topple one of the laws main pillars, theres bipartisan support in Congress to eliminate the tax on medical devices one of the laws primary funding mechanisms and a slight majority of Americans still have negative views of the sprawling legislation.
But despite the political head winds, experts say Obamas legacy-defining law is quietly accomplishing the goals it was created to achieve.
The nations uninsured rate has plummeted as more Americans enroll in Medicaid or in federal and state marketplace coverage.
The laws consumer protections and insurance-benefit requirements have improved the quality of coverage for millions of people who get health insurance outside the workplace.
Premiums for marketplace health insurance have largely been reasonable and have increased only moderately thus far. Long-term cost estimates for providing coverage under the law have been falling.
Early Congressional Budget Office projections showed the law would trim the federal budget deficit by $124 billion from 2010 to 2019, while its repeal would increase the deficit by more than $100 billion from 2013 to 2022. The CBO cant update the laws projected impact on the deficit because of forecasting difficulties.
While its too soon to declare a summary judgment on the law, its early success usually would quiet most naysayers.
Most of the dire predictions made by the critics of the ACA have not come to pass, said Drew Altman, president and CEO of the Kaiser Family Foundation.
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$3.3B recouped from health-care fraud
Officials highlighted a number of initiatives that have helped both prevent health-care fraud and recoup federal money. Those steps included increased funding to expand the Medicare Fraud Strike Force to nine geographic territories.
Authorities said efforts by the strike force and other initiatives led the Justice Department to open 924 new criminal health-care fraud probes in fiscal 2014. Federal prosecutors actually filed criminal charges in nearly 500 cases, involving more than 800 defendants, and 734 defendants were convicted of health-care-related fraud that year.
Read MoreThe kids aren't all right: 3.3M may lose insurance
Officials also noted how the Affordable Care Act requires the Centers for Medicare and Medicaid Services to use new screening requirements to revalidate all 1.5 million Medicare suppliers and providers.
"As a result of this and other proactive initiatives, CMS has deactivated 470,000 enrollments and revoked nearly 28,000 enrollments to prevent certain providers from re-enrolling and billing the Medicare program," officials said. "Both of these actions immediately stop billing."
CMS also continued a temporary moratorium on the enrollment of new home health and ambulance service providers in six metropolitan areas considered "hot spots" for health fraud: Miami, Chicago, Dallas, Houston, Detroit and Philadelphia.
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Health Care Sector Update for 03/20/2015: CELG,PRTA,THRX
Top Health Care Stocks
JNJ +0.70%
PZE +0.29%
MRK +0.06%
ABT +0.55%
AMGN +0.50%
Health care stocks were notching strong gains Friday with the NYSE Health Care Sector Index climbing more than 0.9% and shares of health care companies in the S&P 500 also rising almost 0.9% as a group.
In company news, Celgene ( CELG ) shares climbed to an all-time high Friday after the drugmaker reported that patients with plaque psoriasis maintained improved symptoms over the long term.
The company said improvements in the severity of preexisting nail, scalp and palmoplantar psoriasis achieved at week 16 were maintained in Otezla responders through week 52. Long-term safety profile for up to 104 weeks in ESTEEM 1 was consistent with previously reported data from Otezla clinical trial programs, with no new safety signals and no clinically meaningful changes in laboratory values.
CELG was up 1.5% at $127.26 each in late trade, earlier topping out at a new all-time high of $129.06 a share.
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Health Care Sector Update for 03/20/2015: BIIB,PRTA,THRX
Top Health Care Stocks
JNJ +0.76%
PZE +0.54%
MRK +0.33%
ABT +0.60%
AMGN +0.43%
Health care stocks were notching strong gains Friday with the NYSE Health Care Sector Index climbing more than 0.9% and shares of health care companies in the S&P 500 also rising almost 0.9% as a group.
In company news, Biogen Idec ( BIIB ) jumped to an all-time high Friday morning after interim results from Phase Ib testing of its aducanumab drug candidate indicated the experimental drug treatment reduced amyloid plaque in the brains of patients with prodromal or mild Alzheimer's disease.
Statistically significant declines of amyloid plaque were seen in both the 3 milligrams and the 10 milligrams per kilogram study arms, the company said, adding the drug also demonstrated an acceptable safety profile and positive results on radiologic and clinical measurements.
"This is the first time an investigational drug for Alzheimer's disease has demonstrated a statistically significant reduction on amyloid plaque as well as a statistically significant slowing of clinical impairment in patients with prodromal or mild disease," said Dr. Alfred Sandrock, chief medical officer at BIIB. "Based on these results, we are advancing the aducanumab clinical program to Phase 3 with plans to initiate enrollment later this year."
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The Race to Build a Search Engine for Your DNA
Photo: Andrew Brookes/Corbis
In 2005, next-generation sequencing began to change the field of genetics research. Obtaining a persons entire genome became fast and relatively cheap. Databases of genetic information were growing by the terabyte, and doctors and researchers were in desperate need of a way to efficiently sift through the information for the cause of a particular disorder or for clues to how patients might respond to treatment.
Companies have sprung up over the past five years that are vying to produce the first DNA search engine. All of them have different tacticssome even have their own proprietary databases of genetic informationbut most are working to link enough genetic databases so that users can quickly identify a huge variety of mutations. Most companies also craft search algorithms to supplement the genetic information with relevant biomedical literature. But as in the days of the early Web, before Google reigned supreme, a single company has yet to emerge as the clear winner.
Making a functional search engine is a classic big-data problem, says Michael Gonzalez, the vice president of bioinformatics at one such company, ViaGenetics, which was expected to relaunch its platform in March. Before doctors or researchers can use the data, genomic data must be organized so that humans can read and search it. The first step toward that is to put it in a standard form called the variant call format, or VCF. As raw data, a persons complete sequenced genome would take up about 100 gigabytes, so a database that adds the genomes of even 10 patients per day would quickly get out of hand. But VCF files are more compact, requiring only a few hundred megabytes per genome, which helps researchers find the specific variants they want to search in a fraction of the time. Unlike a fully sequenced genome, VCF files point only to where a persons genetic data deviates from the standardthe genome originally compiled by the Human Genome Project in 2001.
With VCF, sifting the genomes themselves for pinpoint mutations isnt the challenge for search engine companies. Most of these companies are allocating their resources toward efforts to seamlessly compile supplementary information about a specific mutation from other databases across the Web, such as the biomedical research archive PubMed or various troves of electronic medical records. Many of these tools have finely tuned algorithms that prioritize the results by credibility or relevance. You want to be able to pull together the information known about a mutation in that position [of the genome] and quickly make an assessment, says David Mittelman, the chief scientific officer for Tute Genomics, based in Provo, Utah, another company designing a genetic-search engine.
In an effort to expand the information that can be attached to a genome under examination, ViaGenetics, based in Miami Beach, Fla., is making its newly updated platform useful for researchers who want to collaborate across institutions. With ViaGenetics tools, researchers can make their data available to other users, so other people can come across these projects, request access, and form a collaboration, Gonzalez says. It helps people connect the dots between different researchers and institutions. This is especially helpful for smaller labs that may not have very extensive genome databases or for researchers from different universities working to decode the same mutation.
Although the genomic-search industry is now focused on serving scientists, that might not always be the case. Mittelman envisions that Tute Genomics could eventually serve consumers directly. People are already demanding information about their genomes just to understand themselves better, Mittelman says, but most companies dont yet consider the average person to be their primary customer. In order to make that shift, the tool will have to be even more intuitive and user-friendly. Fire-hosing someone with data thats not easy to interpret, or using terminology thats not standardized, has the potential to confuse people, he says. Privacy is also a major concern for the average user; the information that Tute users upload isnt stored permanently, Mittelman says, but users will need extra reassurance if the platform becomes available to the lay public.
And a further evolution of the industry is in the offing. Both ViaGenetics and Tute are hoping to be able to run the entire process in-housefrom the initial DNA sequencing to the presentation of final searchable results to users. The market for analyzing and interpreting genomic data is very fragmented, like the computer industry in the 1990s, where you had to go to separate providers to buy a video card or a motherboard and then try to put it together, Mittelman says. Soon this field will consolidate, as the computer industry did.
This article originally appeared in print as A Google for DNA.
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Letting go of the (genetic) apron strings
Researchers explore the shift from maternal genes to the embryo's genes during development
A new study from Princeton University sheds light on the handing over of genetic control from mother to offspring early in development. Learning how organisms manage this transition could help researchers understand larger questions about how embryos regulate cell division and differentiation into new types of cells.
The study, published in the March 12 issue of the journal Cell, provides new insight into the mechanism for this genetic hand-off, which happens within hours of fertilization, when the newly fertilized egg is called a zygote.
"At the beginning, everything the embryo needs to survive is provided by mom, but eventually that stuff runs out, and the embryo needs to start making its own proteins and cellular machinery," said Princeton postdoctoral researcher in the Department of Molecular Biology and first author Shelby Blythe. "We wanted to find out what controls that transition."
Blythe conducted the study with senior author Eric Wieschaus, Princeton's Squibb Professor in Molecular Biology, Professor of Molecular Biology and the Lewis-Sigler Institute for Integrative Genomics, a Howard Hughes Medical Institute investigator, and a Nobel laureate in physiology or medicine.
Researchers have known that in most animals, a newly fertilized egg cell divides rapidly, producing exact copies of itself using gene products supplied by the mother. After a short while, this rapid cell division pauses, and when it restarts, the embryonic DNA takes control and the cells divide much more slowly, differentiating into new cell types that are needed for the body's organs and systems.
To find out what controls this maternal to zygotic transition, also called the midblastula transition (MBT), Blythe conducted experiments in the fruit fly Drosophila melanogaster, which has long served as a model for development in higher organisms including humans.
These experiments revealed that the slower cell division is a consequence of an upswing in DNA errors after the embryo's genes take over. Cell division slows down because the cell's DNA-copying machinery has to stop and wait until the damage is repaired.
Blythe found that it wasn't the overall amount of embryonic DNA that caused this increase in errors. Instead, his experiments indicated that the high error rate was due to molecules that bind to DNA to activate the reading, or "transcription," of the genes. These molecules stick to the DNA strands at thousands of sites and prevent the DNA copying machinery from working properly.
To discover this link between DNA errors and slower cell replication, Blythe used genetic techniques to create Drosophila embryos that were unable to repair DNA damage and typically died shortly after beginning to use their own genes. He then blocked the molecules that initiate the process of transcription of the zygotic genes, and found that the embryos survived, indicating that these molecules that bind to the DNA strands, called transcription factors, were triggering the DNA damage. He also discovered that a protein involved in responding to DNA damage, called Replication Protein A (RPA), appeared near the locations where DNA transcription was being initiated. "This provided evidence that the process of awakening the embryo's genome is deleterious for DNA replication," he said.
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Planet Bizzaro Ep Seventeen Genetic Gas – Video
Planet Bizzaro Ep Seventeen Genetic Gas
Zoomer and his pals find out Zargon has plagued their food supply with genetically engineered bugs, so Zoomer uses his own genetic engineering to create a super fruit that ends up creating...
By: Evil Zargon
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International Centre for Genetic Engineering and Biotechnology – Video
International Centre for Genetic Engineering and Biotechnology
ICGEB: A brief overview and introduction by Mauro Giacca, Director-General, and Researchers in Trieste, Italy.
By: ICGEB
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Scientists urge caution in using new CRISPR technology to treat human genetic disease
BERKELEY
A group of 18 scientists and ethicists today warned that a revolutionary new tool to cut and splice DNA should be used cautiously when attempting to fix human genetic disease, and strongly discouraged any attempts at making changes to the human genome that could be passed on to offspring.
Among the authors of this warning is Jennifer Doudna, the co-inventor of the technology, called CRISPR-Cas9, which is driving a new interest in gene therapy, or genome engineering. She and colleagues co-authored a perspective piece that appears in the March 20 issue of Science, based on discussions at a meeting that took place in Napa on Jan. 24. The same issue ofSciencefeatures a collection of recent research papers, commentary and news articles on CRISPR and its implications.
Given the speed with which the genome engineering field is evolving, our group concluded that there is an urgent need for open discussion of the merits and risks of human genome modification by a broad cohort of scientists, clinicians, social scientists, the general public and relevant public entities and interest groups, the authors wrote.
Doudna, director of UC Berkeleys Innovative Genomics Initiative, was joined by five current and two former UC Berkeley scientists, plus David Baltimore, a Nobel laureate and president emeritus of the California Institute of Technology, Stanford Nobelist Paul Berg and eminent scientists from UC San Francisco, Stanford, Harvard and the universities of Wisconsin and Utah. Several of these scientists are currently involved in gene therapy to cure inherited diseases.
Such warnings have been issued numerous times since the dawn of genetic engineering in 1975, but until now the technology to actually fix genetic defects was hard to use.
However, this limitation has been upended recently by the rapid development and widespread adoption of a simple, inexpensive and remarkably effective genome engineering method known as CRISPR-Cas9, the scientists wrote. The simplicity of the CRISPR-Cas9 system enables any researcher with knowledge of molecular biology to modify genomes, making feasible many experiments that were previously difficult or impossible to conduct.
Correcting genetic defects
Scientists today are changing DNA sequences to correct genetic defects in animals as well as cultured tissues generated from stem cells, strategies that could eventually be used to treat human disease. The technology can also be used to engineer animals with genetic diseases mimicking human disease, which could lead to new insights into previously enigmatic disorders.
The CRISPR-Cas9 tool is still being refined to ensure that genetic changes are precisely targeted, Doudna said. Nevertheless, the authors met to initiate an informed discussion of the uses of genome engineering technology, and to identify proactively those areas where current action is essential to prepare for future developments. We recommend taking immediate steps toward ensuring that the application of genome engineering technology is performed safely and ethically.
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Scientists urge caution in using new CRISPR technology to treat human genetic disease
Scientists Urge Temporary Moratorium On Human Genome Edits
A new technology called CRISPR could allow scientists to alter the human genetic code for generations. That's causing some leading biologists and bioethicists to sound an alarm. They're calling for a worldwide moratorium on any attempts to alter the code, at least until there's been time for far more research and discussion.
It's not new that scientists can manipulate human DNA genetic engineering, or gene editing, has been around for decades. But it's been hard, slow and very expensive. And only highly skilled geneticists could do it.
Recently that's changed. Scientists have developed new techniques that have sped up the process and, at the same time, made it a lot cheaper to make very precise changes in DNA.
There are a couple of different techniques, but the one most often talked about is CRISPR, which stands for clustered regularly interspaced short palindromic repeats. My colleague Joe Palca described the technique for Shots readers last June.
Why scientists are nervous
On the one hand, scientists are excited about these techniques because they may let them do good things, such as discovering important principles about biology. It might even lead to cures for diseases.
The big worry is that CRISPR and other techniques will be used to perform germline genetic modification.
Basically, that means making genetic changes in a human egg, sperm or embryo.
Those kinds of changes would be passed down for generations. And that's something that's always been considered taboo in science.
One major reason that it's considered off limits, ethically, is that the technology is still so new that scientists really don't know how well it works.
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Engineering humans: Utah professor joins group urging caution
While it holds promise for eradicating genetic diseases, the technology also has big implications for the human genome: A person whose DNA is edited would pass the altered genes on to his or her future children.
There's also a fear the technology could be used in unethical ways, such as "engineering" a baby to look a certain way, or to be athletic or intelligent.
"One of the concerns is that some people may want to use the technology to make trivial or cosmetic changes, rather than using it to prevent devastating diseases," said Carroll, distinguished professor of biochemistry at the University of Utah School of Medicine.
The paper Carroll co-signed is expected to amplify discussion in the scientific community, which last week heard from another group of researchers who recommend that the new technology never be used on human embryos.
Changing the genome could have unpredictable effects on future humans, and that's unacceptable, the group says.
Instead, that group, led by Edward Lanphier, chief executive of the biotechnology company Sangamo Biosciences, suggests research focus on somatic, or non-reproductive cells.
CRISPR-Cas9, was developed in the lab of Jennifer Doudna, the University of California-Berkeley scientist who organized the Napa meeting.
Hundreds of papers in the past two years have proven the usefulness of the new tool in research involving mammals.
"The applications to humans are potentially just around the corner," Carroll said.
CRISPR-Cas9 allows more subtle, precise changes in DNA than was possible with technologies used in genetically modified organisms (GMOs), he added. Such genetic engineering typically involves introducing new genes into an organism.
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Engineering humans: Utah professor joins group urging caution
Lumber Liquidators Scandal with Dr Mitch Gaynor on Fox Business – Video
Lumber Liquidators Scandal with Dr Mitch Gaynor on Fox Business
Subscribe to the GeneChanger YouTube: http://goo.gl/jOPcep Dr Mitch Gaynor, Medical Oncologist at Cornell Medical Center Author of "Gene Therapy Plan" on Fox Business. The Gene Therapy...
By: Mitchell Gaynor M.D.
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Explaining gene therapy for wet AMD – Video
Explaining gene therapy for wet AMD
Shows how wet macular degeneration destructs vision, how secretion gene therapy works and how people can benefit.
By: Elizabeth Rakoczy
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The Alpha Clinic for Cell Therapy and Innovation | City of Hope – Video
The Alpha Clinic for Cell Therapy and Innovation | City of Hope
A new grant to City of Hope from the California Institute for Regenerative Medicine (CIRM) will make it possible for novel stem cell based therapies developed here at City of Hope to...
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The Alpha Clinic for Cell Therapy and Innovation | City of Hope - Video
Scientists Call for a Summit on Gene-Edited Babies
Nobel Prize winners raise alarm over genetic engineering of humans.
A group of senior American scientists and ethics experts is calling for debate on the gene-engineering of humans, warning that technology able to change the DNA of future generations is now imminent.
In policy recommendations published today in the journal Science, eighteen researchers, including two Nobel Prize winners, say scientists should accept a self-imposed moratorium on any attempt to create genetically altered children until the safety and medical reasons for such a step can be better understood.
The concern is over a rapidly advancing gene-editing technology, called CRISPR-Cas9, which is giving scientists the ability to easily alter the genome of living cells and animals (see Genome Surgery). The same technology could let scientists correct DNA letters in a human embryo or egg cell, for instance to create children free of certain disease-causing genes, or perhaps with improved genetics.
What we are trying to do is to alert people to the fact that this is now easy, says David Baltimore, a Nobel Prize winner and former president of Caltech, and an author of the letter. We cant use the cover we did previously, which is that it was so difficult that no one was going to do it.
Many countries already ban germ line engineeringor changing genes in a way that would be heritable from one generation to the nextonethical or safety grounds. Others, like the U.S., have strict regulations that would delay the creation of gene-edited children for years, if not decades. But some countries have weak rules, or none at all, and Baltimore said a reason scientists were speaking publicly now was to keep people from doing anything crazy.
The advent of CRISPR is raising social questions of a kind not confronted since the 1970s, when the ability to change DNA in microrganisms was first developed. In a now famous meeting in 1975, in Asilomar, California, researchers agreed to avoid certain kinds of experiments that were then deemed dangerous. Baltimore, who was one of the organizers of the Asilomar meeting, says the scientists behind the letter want to offer similar guidance for gene-engineered babies.
The prospect of genetically modified humans is surprisingly close at hand. A year ago, Chinese researchers created monkeys whose DNA was edited using CRISPR (see 10 Breakthrough Technologies 2014: Genome Editing).
Since then,several teams of researchers in China, the U.S., and the U.K. have begun using CRISPR to change the DNA of human embryos, eggs, and sperm cells, with an eye toward applying the technology at in vitro fertility (IVF) clinics. That laboratory research was described by MIT Technology Review earlier this month (see Engineering the Perfect Baby).
Last week, in Nature, representatives of an industry group, the Alliance for Regenerative Medicine, recommended a wider moratorium that would also include a cessation of such laboratory studies, which it termed dangerous and ethically unacceptable (see Industry Body Calls for Gene-Editing Moratorium).
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