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Morning Rounds Shraddha Chakradhar

Second debate night brings more talk of health insurance 

Last night’s Democratic primary debate included more heated discussion of all things health care. And while “Medicare for All” was once again a main topic, candidates went back and forth on whether the future of health care ought to involve private insurance companies or whether only a public option was the way to go. When talking about his proposed plan, former Vice President Joe Biden brought up controlling drug prices and the future of drugs as being biologics and “no longer chemicals.” He also iterated his view that insurance executives ought to be jailed “for the nine billion opioids they sell out there.”

Another noteworthy moment: Washington Gov. Jay Inslee mentioned mental health, an issue that hasn’t received much attention in the campaign so far. “It is time to give people adequate mental health care in this country,” he said.   

More drama in the CRISPR patent fight

If you enjoy mudslinging, you’ll love the latest incarnation of the CRISPR patent battle between the Broad Institute and the University of California. In legal documents filed this week, UC accuses the Broad’s CRISPR biologist Feng Zhang of essentially stealing UC’s work, presenting “incomplete, cherry-picked data” in patent documents, and intentionally omitting information “that shows his claims of successful DNA [editing] to be false.” The patent case that began in late June will decide whether 10 CRISPR patent applications submitted by UC and its partners claim the same invention — use of CRISPR to edit the genomes of eukaryotes — as a dozen key CRISPR patents already awarded to the Broad. If UC can show the Broad’s patents are based on lies and science fraud, it could get them invalidated, clearing the path for its own applications to finally be granted.

U.S. infant mortality rates may be leveling off 

The infant mortality rate has stayed roughly the same since 2013, according to new CDC data. More than 22,300 infants died in the U.S. in 2017, when the mortality rate was roughly six deaths per 1,000 births. Here’s more: 

  • Maternal age: The infant mortality rate was highest for those born to women under the age of 20, a rate nearly 90% higher than for babies born to women aged 30-34. 

  • Race and ethnicity: Infants born to black women had the highest mortality rate, at almost 11 deaths per 1,000 births. The mortality rate was the lowest — at less than four per 1,000 — for Asian women. 

  • Cause of death: The leading cause of death among infants in 2017 was congenital malformations, followed by disorders due to low birth weight, maternal complications, SIDS, and accidental injuries.

Inside STAT: The unsung rotifer is helping us untangle the biology of aging


A young female rotifer. (KRISTIN GRIBBLE/MARINE BIOLOGICAL LABORATORY)

We're familiar with the usual lineup of model organisms: mice, rats, roundworms, and fruit flies. And as well as they have served for research, one scientist is on a mission to preach the gospel of the rotifer, a common tiny aquatic organism. To Kristin Gribble, these creatures and their genetic makeup, lifespan, and largely asexual nature make them a good candidate to study aging. Rotifers have also evolved to withstand a host of conditions, from boiling temperatures to a lack of water altogether. And as much as Gribble wants people to embrace rotifers, “I do have to spend a portion of my talk every time explaining what the heck a rotifer is,” says Gribble, who's based at Marine Biological Laboratory on Cape Cod. STAT's Eric Boodman has more here

Q&A: Researcher calls for a ‘contraception revolution’

Talk of mitigating climate change usually involves mentions of reducing fossil fuel and plastic use. A less discussed approach? Population control. In a new perspective piece in NEJM, Boston University reproductive health researcher Deborah Anderson tackles that controversial proposal by calling for “a contraception revolution”: an investment in new and better methods. I spoke with her to learn more.

Why did you feel the need to raise this issue? 

About half of all pregnancies are unplanned, which is just a staggering number to me. We need more contraceptives out there so that women — and men — have more choices and contraception has more impact so we can bring the population down. 

What would be a better contraceptive? 

We need more user-friendly, non-prescription methods for women. And the other big — huge — gap is male contraception.

Read the rest of our interview here.

How racism influences where medical students say they want to practice

A survey of nearly 4,000 medical students from 49 schools finds that racism — both implicit and explicit — seems to influence the students’ decision on whether to practice in communities of color or underserved communities. Medical students were surveyed as first-years and then again in their third or fourth year of school. Researchers found that students who had more negative racial attitudes or who went to school with many minority students tended to have less of an intention to practice in communities with minority populations. Students who were enrolled in schools with curricula that focused on improving the health of minorities and students who interacted more with black faculty and students were more likely to want to serve in underrepresented communities. The findings underscore the need to better understand racism in medical education, the authors write. 

What to read around the web today

  • Everything you need to know about importing drugs from Canada. STAT
  • Why the placental microbiome should be a cautionary tale. The Atlantic
  • The deep emotional ties between depression and autism. Spectrum
  • Health insurers walk delicate line against Democrats’ health proposals. The Wall Street Journal
  • From diagnostics to autopsy to burial, stillbirths are alarmingly expensive in America. Vox

Thanks for reading! More tomorrow,

Shraddha

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Thursday, August 1, 2019

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