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Thursday, May 3, 2018

Morning Rounds by Megan Thielking

Good morning, everyone! Welcome to Morning Rounds. 

The fight over Title X funding is escalating

Three leading reproductive rights groups are suing the Trump administration over its guidance on the federal Title X program, which helps pay for family planning and reproductive health services nationwide. Here’s your rundown:

  • The background: Back in February, HHS released new Title X grant guidance, which stressed “natural family planning” strategies to prevent pregnancy without contraceptives and promoting the “benefits of delaying sex or returning to a sexually risk-free status."
  • The case: The lawsuits — one filed by Planned Parenthood and another filed by the ACLU and the National Family Planning & Reproductive Health Association — say the policy will divert funds from clinics that also provide preventive health services, including STD and cancer screenings.
  • On a related note: This week, some GOP lawmakers and anti-abortion groups sent letters asking the Trump administration to prohibit Title X funds from going to providers such as Planned Parenthood that perform abortions or refer patients for abortions.

The government's new push to accelerate microbiome research

Nearly two dozen federal agencies are joining forces to spur new research on microbiomes of people, plants, and other organisms that are home to the tiny communities of microbes. An interagency working group that includes the NIH, FDA, and EPA just released a five-year plan to bolster the study of microbiomes, which are thought to play a critical role in health. On the to-do list: support collaborative research; develop platforms that make it easier to share and access to microbiome data; and expand the number of people studying microbiomes through academic opportunities and citizen science projects.

Lab Chat: How livers rebuild their damaged plumbing

a mouse liver that has regenerated its own bile ducts. (cincinnati children's)

New research highlights how liver cells regenerate missing or damaged plumbing by becoming a new cell type. Here’s what Stacey Huppert of Cincinnati Children’s told me about the work, published in Nature.

What did you discover about how livers repair themselves?

We wanted to understand whether the bile ducts, or the plumbing of the liver, could be rebuilt from other cell types. We generated a model that lacked the plumbing system inside the liver. And, to our surprise, the animal rebuilt the plumbing system with the help of hepatocytes. They were not only able to do their jobs, but they were also able to become a different cell type, cholangiocytes.

How can that finding be used? 

We now know that there’s one molecular pathway that’s important in building the bile ducts, but that there’s another pathway, at least in these adult cells, that can compensate if that one doesn't work. That gives us another target to go after. That could potentially be with a genetic therapy or hepatocyte transplantation.

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Inside STAT: Francis Collins talks CRISPR and his missed calling

STAT's Meghana Keshavan caught up with NIH Director Francis Collins yesterday at a conference in Los Angeles and picked his brain about gene-editing, science policy, and his childhood career goals. Here are a few snippets from their conversation, which you can read here

  • The technology he's most excited about: gene-editing to cure rare disease. "CRISPR-Cas9 has made it possible not just to dream about such protocols, but actually design them."
  • His childhood job aspirations: "When I was 7, I wanted to be a truck driver. When I was 13, I wanted to be a musician. When I was 14, I got introduced to science."
  • The puzzle he's surprised we haven't solved: electronic health records. "I thought by now [those] would be interoperable and portable, so patients would have easy access to their own records."

Bath products for eczema don't ease symptoms

Bath products used to treat eczema in kids don’t make much of a difference, according to new research. Doctors often recommend emollient bath products for the skin condition in addition to emollient creams, which put a protective barrier over the skin, lock in moisture, and have been shown to ease eczema symptoms. But in a randomized trial on 482 kids with eczema receiving the standard treatment, there wasn’t any difference in symptoms between kids who also used bath additives and those who didn’t after a year. 

I keep tabs on negative trial results in this newsletter. If you see one, send it my way at newsletter@statnews.com.

Mobility in home health care patients is improving nationwide

The Commonwealth Fund just released its annual state health scorecard — and it points to big-picture improvements in nursing home and home health care. The percentage of home health patients who saw improvements in walking and moving around rose in every state. And in 48 states and D.C., the potentially harmful use of antipsychotic drugs in nursing home patients has declined. The report’s authors say that likely reflects state-level work to curb inappropriate antipsychotic drug use and improve dementia care.

What to read around the web today

  • The opioid that made a fortune for its manufacturer — and its prescribers. New York Times Magazine
  • Scientists are studying former fighters and victims of violence in Colombia. Nature
  • Maine becomes the latest state to adopt a law seeking transparency on drug pricing. STAT Plus
  • NYC mayor's delay on supervised injection study infuriates advocates. Politico
  • The secrets of neurons emerge in Nobel-winning scientists’ ink and pencil drawings. STAT

Thanks for reading! More tomorrow,

Megan

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