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Wednesday, May 30, 2018

Morning Rounds by Megan Thielking

Good morning, Morning Rounds readers! Reporter Andrew Joseph here filling in for Megan for the day.

One quick note: For over a year, STAT's multimedia team has been tracking researchers and surgeons on their quest to create a better prosthetic leg, traveling from Boston to California to the Cayman Islands to follow the story. We're releasing a trailer for the new documentary today at 2 p.m., so be sure to check it out at statnews.com.

Now, to the news:

A crowded treatment landscape in the Ebola outbreak

As tragic as they are, Ebola outbreaks present an opportunity: the chance to use and test therapies and vaccines. The current outbreak in the Democratic Republic of the Congo is the latest example, with one vaccine deployed and some players gunning to get their therapeutics studied in a head-to-head clinical trial. But as STAT’s Helen Branswell explains, the jockeying has led to a chaotic and politically charged process. One of the therapeutics, for example, has only just entered a Phase 1 human trial to determine if it’s safe. Complicating the situation further: The two communities that are at the heart of the epidemic have limited health resources, which could make it extremely difficult to offer some of the therapies.

Today: Opioid events on pain management, border security

A House homeland security subcommittee is holding a hearing on the opioid epidemic and border security this morning in Phoenix. Among the people testifying: Arizona Gov. Doug Ducey; federal officials from Customs and Border Protection and the DEA; and state health and law enforcement officials. You can watch the hearing here.

Also today, federal officials from HHS, FDA, and other agencies are convening the first meeting of an inter-agency task force that may devise new pain management best practices. The task force, which was created out of a 2016 law focused on the addiction crisis, comes as experts grapple with how to ensure patients get the medication they need to control pain without being too lax in prescribing patterns, which helped fuel the opioid epidemic.

And lastly, President Trump is slated early this afternoon to sign the hard-fought "right-to-try" measure passed by Congress earlier this month. Here's some background on the soon-to-be law.
 

Inside STAT: Heredity and our body's other genomes

Are you my mother's mitochondrial dna? (Eros Dervishi FOR STAT)

Heredity cannot always be explained by the DNA that makes up our chromosomes. In a new piece, STAT contributor Carl Zimmer investigates how the DNA contained in the trillions of bacterial cells on and inside us affects human health, aiding in our immune responses and helping newborns break down milk into vital vitamins. He also explains how the genes in our mitochondria, the result of a bacterial invasion into our ancestors’ cells 1.8 billion years ago, can go awry, introducing mutations that cause hereditary diseases. Read more here. The piece is an excerpt from “She Has Her Mother’s Laugh,” Carl’s new book all about heredity. It’s out now.

Sponsor content by STAT Events

An exclusive STAT documentary takes an intimate look at friends who fell prey to opioids

The opioid crisis has reached epidemic levels. STAT’s multimedia team goes inside the tight-knit community of Somerville, Mass., to retrace the lives of a group of friends through the families they left behind and the friends who barely made it out alive. STAT will feature this documentary in New York City on June 13th, followed by an open conversation with STAT editorial, members of the documentary cast, and NYU faculty and former Rikers Island Chief of Addiction Medicine, Dr. Lipi Roy, MD, MPH. Register now and reserve your seat (space is limited).

Federal report highlights prenatal care discrepancies

More than three-quarters of pregnant women start prenatal care in the first trimester, while 4.6 percent of women start it in the third trimester and 1.6 percent of women get no care, according to a federal report of 2016 data. The CDC report details differences based on age of the mother (women in their 30s were more likely to get care in their first trimester) and race (about half of Native Hawaiian and Pacific Islander women got first-trimester care versus 80 percent for white women). It also highlighted geographic discrepancies — Southern states typically had lower rates of prenatal care access in the first trimester — and a split by payer source, with women on Medicaid or who paid for their own care more likely to start prenatal care late or have no care than women with private insurance. 

Stricter laws tied to fewer alcohol-linked crash deaths

In states with looser alcohol policies, fatal crashes are more likely to be alcohol-related than in other parts of the country, according to a new study in JAMA Internal Medicine. For the study, researchers at Boston Medical Center examined the cases of more than 500,000 adults killed in crashes in the U.S. from 2000 to 2015, of which almost 180,000 were alcohol-related. They compared those to the restrictiveness of 29 alcohol policies on the state level, which were scored on a scale. The researchers found that a 10 percentage point increase in the strictness of a state’s rules correlated to a 10 percent decrease in the chances that a fatal crash was tied to alcohol. The study was only an associative study — it could not show that the stricter laws caused the decrease in alcohol-related deaths in some states — but the authors said that tightening alcohol policies could reduce these traffic deaths.

The bowel ballet: How rhythmic firing of neurons leads to waste passage

Scientists have gleaned some insights into how nerve cells in the gut, erm, “propel content along the bowel," they write in a new paper. With the help of a special imaging system, the researchers were able to see that neurons in the intestines of mice perform a coordinated choreography to pass waste along the last portion of the GI tract. The neurons pulse simultaneously and rhythmically, in turn causing muscle cells to contract at the same tempo and escorting what needs to get out toward the exit. So anyone who says they don't have rhythm clearly doesn't know what's happening in their bowels.

What to read around the web today

  • Origins of an epidemic: Purdue Pharma knew its opioids were widely abused. New York Times
  • Opinion: DNA donors must demand stronger protection for genetic privacy. STAT
  • Study estimates thousands died in Puerto Rico due to Hurricane Maria. Washington Post
  • The Addyi female libido pill has fewer restrictions in Canada. Is the U.S. next? STAT Plus
  • 'Reprogrammed' stem cells approved to mend human heart for the first time. Nature

Thanks for reading! Megan will be back tomorrow,

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