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Morning Rounds

Hello! This is STAT reporter Eric Boodman, filling in for Megan for the rest of the week.

FDA goes after e-cig manufacturers and retailers

The FDA is cracking down on the makers and sellers of e-cigarettes, announcing yesterday that manufacturers had 60 days to show they can keep the devices away from minors. They agency also issued warning letters and fines to 1,300 retailers for illegally selling vapes to kids. “We see clear signs that youth use of electronic cigarettes has reached an epidemic proportion,” said FDA Commissioner Scott Gottlieb in a statement. He threatened to take flavored vaping products off the market if companies like Juul can’t prevent minors from using them. The American Medical Association commended the FDA's action, but urged “more stringent policies to help keep all harmful tobacco products, including e-cigarettes, out of the hands of our nation’s youth.”

Planned Parenthood chooses Baltimore health commissioner as next president

Dr. Leana Wen has been named Planned Parenthood’s next president — the first physician to take the role in nearly five decades. Wen is currently the health commissioner for the city of Baltimore, where she helped reduce overdose deaths by issuing a blanket prescription for naloxone, started a program to give glasses to kids for free, and helped bring down maternal mortality rates. She also took on the federal government when it tried to remove funding for the department’s teen pregnancy prevention program. She begins her new position on Nov. 12.

Seven U.S. states have adult obesity rates of 35 percent or higher

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Map of adult obesity rates by state (Centers for Disease Control and Prevention)

As recently as 2012, not a single state had an adult obesity rate above 35 percent. In 2017 data just released by the CDC, seven states do: Alabama, Arkansas, Iowa, Louisiana, Mississippi, Oklahoma, and West Virginia. Here's a closer look at the numbers:

  • In every state, at least 1 in 5 adults is obese. Only Colorado, Washington, D.C., and Hawaii had rates below 25 percent.
  • The adult obesity rate was at 36 percent for those without a high school degree; 32 percent for those who’d finished high school; 32 percent for those with some college-level education; and 23 percent for college graduates.
  • For black adults, the obesity rate was 39 percent, compared with 32 percent for Hispanics and 29 percent for whites.

Inside STATStudy cracks open the secrets of the cancer-causing BRCA1 gene

For 22 years, the genetic testing company Myriad Genetics has refused to make public its database of variants in the BRCA1 gene that would allow patients to know which mutations might put them at higher risk for breast and ovarian cancer. “But now,” STAT’s Sharon Begley writes, “a blitzkrieg of biology has hacked the secret cache of life-and-death data.” Researchers at the University of Washington have deliberately caused these mutations and tracked how cells in lab dishes respond, determining which genetic misspellings can cause disease and which are benign. Read more here.

Lab Chat: Our gut bugs produce electricity

For decades, biologists have known that some bacteria can produce electricity. Now scientists have shown that these currents are emitted by more kinds of microbes than previously thought. Here's what Daniel Portnoy and Sam Light of University of California, Berkeley, told me about the research, published in Nature.
 
What’s new here?

This process, extracellular electron transfer, was known in bacteria that grow in nutrient-poor environments, where they were able to use it for respiration. We discovered that this bug listeria also has EET, but uses a different mechanism. It decorates its surface with flavin, and it transfers electrons from the inside of bacteria, through the flavin molecule, and then to another electron receptor, which can be iron, or an electrode. Also, we identified nine genes that are responsible for this, and many, many other bacteria have these genes — like hundreds of them.
 
Why is this process important?

Listeria is being developed as a live vaccine for cancer. We’re wondering if this contributes to its interaction with the host immune system. It could make it a better vaccine. There are also some bio-electrochemical applications for this. Bacteria can be used to break down organic matter and harvest the energy from it, and this process is used to transfer it to an electrode, which generates electricity.

New coalition working to decrease diagnostic errors

Every year, 12 million adults are affected by diagnostic errors in outpatient settings, and those kinds of mistakes contribute to an estimated 80,000 deaths in American hospitals. Now, over 40 health care and patient advocacy organizations have come together to work on possible solutions. The Coalition to Improve Diagnosis has pinpointed a few reasons why these errors might be occurring: information can slip through the cracks when patients are passed off between facilities, doctors, and departments; providers don’t always hear about diagnoses they made that turned out to be incorrect; and doctors can’t necessarily take a full history if they’re rushing from one appointment to the next.

Only half of European clinical trials follow reporting requirements

With the exception of some Phase 1 studies, any team conducting a clinical trial in the European Union is required to post its results within a year of completion. But a new study from researchers at Oxford found that this rule was only upheld in only half of the 7,274 trials that had results due. Those with a commercial sponsor involved or conducted by groups that run a lot of clinical trials were more likely to have followed the regulation. The researchers hope that pointing out lapses among European research groups will help improve compliance. In 2015, a STAT investigation showed a similar problem in the U.S., and in the next few years, there was a jump in the number of trials being properly reported on ClinicalTrials.gov.

What to read around the web today

  • The new Apple Watch, with FDA’s blessing, comes with an EKG app. STAT
  • Thousands of scientists publish a paper every five days. Nature
  • Many 'recovery houses' won't let residents use medicine to quit opioids. NPR
  • More than 4,300 Arkansas residents lose Medicaid under work requirements. Washington Post
  • Biotech unicorn Moderna prepares for sector’s biggest-ever IPO. STAT Plus

Thanks for reading! More tomorrow,

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Thursday, September 13, 2018

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