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Morning Rounds Shraddha Chakradhar

Judge places hold on N.Y. county's controversial emergency measles order

A New York state judge issued a preliminary injunction late last week on a controversial order in Rockland County that banned unvaccinated children from enclosed public places. Judge Rolf Thorsen ruled in favor of several dozen parents in the county who brought a lawsuit last week challenging the ban, which was intended to curb the spread of measles. The ban went into effect nearly two weeks ago as part of a 30-day state of emergency declaration, but the judge said such emergency orders cannot exceed five days. He also said that the 167 measles cases among the county’s 330,000 people since October doesn’t constitute an "epidemic" that warrants such a declaration, and that unvaccinated children could return to schools and other public spaces. 

CDC investigating E. coli outbreak in five states 

The CDC is investigating an E. coli outbreak that has sickened 72 people in five states. The majority of the cases have been reported in Kentucky, in addition to Tennessee, Georgia, Ohio, and Virginia. Eight people have also been hospitalized in connection to the outbreak, which has been traced to a strain of E. coli that produces Shiga toxin. Symptoms usually include severe stomach cramps, diarrhea, and vomiting. The CDC hasn’t yet identified a specific food item, grocery store, or restaurant chain as the source of the bacteria and is not yet recommending that people avoid any particular food or food source. 

Here are this year’s STAT Madness winners

Susan Shore (right) of the University of Michigan with a postdoctoral fellow in her lab. (BRYAN MCCULLOUGH/MICHIGAN MEDICINE/UNIVERSITY OF MICHIGAN)

The winners of the third annual STAT Madness — our tournament-style search for the most innovative research in science and medicine — were announced this morning. Here’s a look at the two winners:

  • People’s choice: With 65% of the final round’s votes, Susan Shore and others from the University of Michigan led this year’s winning research: a potential treatment for the phantom noises that plague people with tinnitus. More here.  

  • Editors’ pick: Our choice this year was research from Shawn Liu, Rudolf Jaenisch, and others at the Whitehead Institute in Cambridge, Mass., that used CRISPR-Cas9 to edit the gene silencers — and not the genome itself — in fragile X syndrome. Read more about their work here.

Inside STAT: Five pharmacy ‘middlemen’ head to Capitol Hill’s hot seat — some have an easier defense than others

They’ve been called “middlemen” who indulge in “dishonest double dealing.” They also have been decried for working under “a veil of secrecy.” They are pharmacy benefit managers, who aim to help insurance companies negotiate lower drug prices, and this week, five of the industry's top executives will head to Capitol Hill for a pair of back-to-back hearings Tuesday and Wednesday. The executives will hail from CVS Health, Cigna, UnitedHealthcare subsidiary OptumRx, Prime Therapeutics, and Humana, but whether their appearances will manage to assuage some of the criticisms they have faced — or whether they succumb to tough questions — remains to be seen. STAT’s Nicholas Florko has more on what you can expect here

Lab Chat: How thirst activates widespread neurons in the brain

Basic biological drives, such as thirst and hunger, motivate a lot of our behavior, but scientists are still trying to understand how these instincts manifest in the brain. In a new study published in Science, researchers looked at roughly 24,000 neurons across 34 brain regions in mice, and found that contrary to previous expectations, there weren’t specific thirst-sensing neurons limited to specific regions of the brain. Here’s what study author Dr. Karl Deisseroth of Stanford University told me about the work: 

What did you find — and what was surprising? 

Even for simple motivational drives states, most of the brain, and most of the corresponding neurons, become involved. This appears to be important, for example, in determining what the brain does with new sensory input.  

What are the next steps? 

We’d like to understand how this brain-wide state is created from actions of just a few cells, why the state needs to be so widespread, and which state features are essential to which behavioral contingencies — perhaps adjudicating conflicts among competing drives.

More antibiotics prescribed through telemedicine than in-person doctor visits

Children who have telemedicine visits with their physicians are more likely to be prescribed antibiotics than children who see doctors in person, according to a new study. Looking at more than half a million telemedicine, urgent care, and primary care physician visits using insurance claims data between 2015-2016, researchers found that 52% of children who had telemedicine visits for a nonchronic respiratory illness were likely to be prescribed antibiotics, compared to 42% of those who visited with urgent care physicians and 31% who visited their PCPs. Those who met with physicians virtually were also less likely to be prescribed antibiotics based on clinical guidelines than in-person visitors.

What to read around the web today

  • Opinion: Taking care of Charlie helped one California town nearly halve hospital use. STAT
  • In a poor Kenyan community, cheap antibiotics fuel deadly drug-resistant infections. The New York Times
  • NHS patients have cancer scans cancelled after supplier problems. The Guardian
  • What cancer takes away. The New Yorker
  • Our organ donation system is unfair. The solution might be too. FiveThirtyEight

Thanks for reading! More tomorrow,

Shraddha

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Monday, April 8, 2019

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