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Wednesday, January 11, 2017

Morning Rounds by Megan Thielking

Happy Wednesday, everyone! I'm here with the day's big stories in health and medicine. 

National Cancer Institute launches drug access effort

The National Cancer Institute this morning announced a new program that aims to help scientists get new drugs quickly to test in clinical trials. The program, called the NCI Formulary, launches as a collaboration between the NCI and six drug companies, including Eli Lilly, Genentech, and Bristol-Myers Squibb. The NCI will work as a middleman between those companies and researchers, who currently have to work out their own deals with drug makers to access new drugs.  The office hopes to add more companies going forward.

Your rundown on Robert Kennedy and vaccines

Speculation is flying about what vaccine skeptic Robert F. Kennedy might do if he does, in fact, chair a panel on vaccine safety and scientific integrity in the Trump administration. Kennedy announced yesterday he'd head up the panel, but hours later, a spokesperson for the president-elect said no decisions had been made. It's unclear how much power the panel would have if it does get off the ground. Recommendations about which vaccines children should get, and when, are developed by a different advisory group of scientists housed within the CDC. That's not the same panel Robert F. Kennedy will run. For more on what the new administration can and can't do with vaccines, read this. And for background on Kennedy's stance on vaccines, read this. We've also got a hard look at the science of vaccines from Helen Branswell here.

Lab Chat: A kid's toy inspires a cheap diagnostic tool

 (prakash lab / Stanford university)

Tie together some twine, a sheet of paper, and a little bit of plastic and pull — you've got a toy whirligig. Or  human-powered blood centrifuge. Scientists have created the new "paperfuge" — which costs about 20 cents to make — to separate blood plasma from red cells in just a minute and a half. They're currently working on clinical validation studies; so far, it's just a proof of concept prototype. Here's what bioengineer Manu Prakash told me about the work, published in Nature Biomedical Engineering

What inspired the idea behind the paperfuge?

Every single lab or diagnostic facility uses centrifuge. Our constraint was to make something that was purely human-powered but that could meet the standard used in diagnostics. We wanted to make it extremely low cost and affordable. And for it to work in areas where there's no electricity, in developing countries, we wanted them to be human-powered. As a team we looked thorough many many toys. We started with yo-yos, we moved to tops, and eventually we stumbled upon a toy called a whirligig.

What went into making it?

We realized that nobody actually understood the mathematics and the physics behind the toy, which can't move fast enough. But when you understand the parameters, you can adjust them and achieve all the way up to 125,000 revolutions per minute. So you can actually pull out malaria parasites, African sleeping sickness, and all kinds of other different parasites from blood. 

Leading cancer centers push for more HPV vaccinations

Cancer experts and public health authorities have had only middling success getting parents and pediatricians to embrace human papillomavirus, or HPV, vaccines. But this morning, the country’s 69 leading cancer centers endorsed recent federal guidelines which say that giving 11-to-14-year olds two shots at least six months apart provides the same protection against HPV-caused cancers as the original three shots. (The vaccine is more effective in pre-teens, so people 15 to 26 still need three doses.)

An added bonus: moving the goal posts automatically increases the completion rate among the six in 10 girls and five in 10 boys who get at least one HPV shot. With 40,000 new cases of HPV-associated cancers in the US each year, the cancer centers urged “parents and health care providers to increase vaccination rates so our nation’s children do not grow up to become cancer patients.”

How kidney failure tumbled among Native Americans

Native Americans have the highest diabetes risk of any racial group in the US — but there is some good news. Up until 1996, Native Americans were nearly five times more likely than white individuals to have kidney failure from diabetes, which can be caused by high blood sugar, high blood pressure, and other conditions. But the rate of diabetes-related kidney failure fell 54 percent between 1996 and 2013. That’s thanks in part to population-wide efforts by the Indian Health Service such as boosting use of medicines that can protect the kidneys, increasing kidney testing in Medicare patients over 65 with diabetes, and improving access to transportation for health care services.

“A public health problem such as diabetes requires years of sustained effort and intervention,” said Mary L. Smith, deputy director of the IHS. The CDC and the IHS have teamed up to release a new Vital Signs report on how those approaches can serve as a model for other populations to consider — read the report here.

The doctors who are happiest at work

If you’re happy and you know it, you’re probably a dermatologist. A new survey of 14,000 physicians from Medscape this morning finds that 43 percent of dermatologists say they’re either happy or extremely happy at work. Ophthalmologists weren’t far behind, at 42 percent. At the bottom of the list: Rheumatologists and nephrologists, just 24 percent of whom said they were happy at work.

A program to make kids' menus healthier failed to do so

Restaurants participating in a nationwide push to make their kids' menus healthier haven't improved them any more than restaurants not participating in the program. The effort, run by the National Restaurant Association, launched back in 2011. But a new analysis run by Harvard finds there wasn't any significant improvement in the calorie, saturated fat, or sodium counts for the children's menu choices at participating or nonparticipating restaurants. Another key finding: 80 percent of drink options for kids are still sugary beverages. I keep track of negative results in this newsletter — if you see one, send it my way at newsletter@statnews.com. 

What to read around the web today

More reads from STAT

Thanks for reading! More tomorrow,

Megan

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