One-Third of Americans Don’t Know Obamacare and Affordable Care Act Are the Same

❝ A sizable minority of Americans don’t understand that Obamacare is just another name for the Affordable Care Act.

This finding, from a poll by Morning Consult, illustrates the extent of public confusion over a health law that President Trump and Republicans in Congress hope to repeal.

❝ In the survey, 35 percent of respondents said either they thought Obamacare and the Affordable Care Act were different policies (17 percent) or didn’t know if they were the same or different (18 percent). This confusion was more pronounced among people 18 to 29 and those who earn less than $50,000 — two groups that could be significantly affected by repeal…

When respondents were asked what would happen if Obamacare were repealed, even more people were stumped. Approximately 45 percent did not know that the A.C.A. would be repealed. Twelve percent of Americans said the A.C.A. would not be repealed, and 32 percent said they didn’t know.

The ever-present question: Are Americans stupid or just plain ignorant?

Our politicians, the Congressional clown show, the so-called president occupying the White House – with a few exceptions, none of these really care what the answer is. Their only concern is how to make political hay from a field sown in superstition and grandpa’s advice that was out-of-date a half-century ago.

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Clinical trials tend to be positive when Docs get industry dollar$

When study investigators have financial relationships with pharmaceutical companies, clinical trial results are more likely to turn up positive…

In a review of 190 papers on randomized controlled trials, taking money from industry was significantly associated with favorable trial results in a fully adjusted model…Salomeh Keyhani, MD, of the University of California San Francisco, and colleagues reported online…

Their findings suggest bias in the evidence base, Keyhani said. Practicing clinicians “should be concerned enough to employ healthy skepticism while reviewing the results of any one trial,” she told MedPage Today.

❝ The paper makes the distinction between a study being funded by a drug company, and investigators who have financial relationships with those companies.

Researchers with financial relationships can influence the study results in less obvious ways, such as study design and analytic approach, but Keyhani noted that the current research is a “cross-sectional study so any interpretation of the findings should be made with caution.”…

Gasp! Who’da thunk it.

RTFA for methodology – and more.

The death rate gap widens between urban and rural America


Sometimes you actually get what you voted for

❝ If you live in a city or a suburb, chances are you’ve seen the health of people around you improve over time — fewer deaths from cardiovascular disease, better cancer treatments, and fewer premature deaths.

But if you’re one of the 46 million Americans who live in a rural area, odds are you’ve watched the health of your neighbors stagnate and worsen.

❝ New data from the Centers for Disease Control and Prevention shows that rates of the five leading causes of death — heart disease, cancer, unintentional injuries, chronic lower respiratory disease, and stroke — are higher among rural Americans. In other words, mortality rates in rural areas for these preventable deaths, which were going down, are now plateauing and even increasing…

❝ …More than income, more than the frequency with which you exercise, the simple fact of where you live can have a huge impact on your health…

…the most pronounced rural-urban gaps are deaths from unintentional injuries — like suicide or drug overdose — and deaths from chronic lower respiratory disease…

❝ …According to the CDC, part of it is that people in rural areas often don’t have access to health care facilities that can quickly treat severe trauma. The opioid epidemic is also overwhelmingly concentrated in rural pockets of the US, as are the related overdose deaths.

But it’s not just deaths from unintentional injuries that disproportionately affect rural Americans. Rural Americans are also far more likely to die from CLRD, which encompasses a wide range of lung diseases from occupational lung diseases to pulmonary hypertension. The CDC believes this discrepancy is largely due to cigarette smoking being far more prevalent among adults living in rural counties…

❝ Additionally, a higher percentage of rural Americans are in poorer health. Generally speaking, rural Americans report higher incidences of preventable conditions like obesity, diabetes, cancer, and injury. They also face higher uninsured rates in addition to fewer health services.

Yes, these folks represent one of the significant communities that voted for Trumponomics, Republican plans to repeal Obamacare, just about any government program predicated on mandating better healthcare and preventive medicine.

The operative question remains – stupid or ignorant? You might throw in gullible if you look at folks who rely on “good enough for Grandpa”.

GMO cows resistant to tuberculosis — first step to antibiotic-free cattle

❝ Precise gene editing, the stuff of science fiction, has been a reality since 2015. That was when CRISPR-Cas9 came in full force to the scientific field after decades of research. The technology allows scientists to go in and essentially snip and tuck genes from one organism to another to enhance them in some way, and it’s already been done with pigs, fish, mice, and mosquitos, as well as human embryos.

❝ …Scientists from the Northwest A&F University in Shaanxi, China demonstrated they have made healthy baby cows that have been modified to be more resilient against bovine tuberculosis — with no adverse side effects.

…Yong Zhang, a bioinformaticist and the lead author of the paper…and his team meticulously combed through the cow genome and found a place where they thought they may be able to insert another copy of a gene called NRAMP1, which occurs naturally in cows. This gene has been associated with being able to resist infection from bovine TB; by adding a second copy, the researchers thought they could vamp up this resistance.

They used CRISPR-Cas9 technology to insert the extra copy of NRAMP1 into 11 young cow embryos before inserting them back into cows to gestate as usual. After the healthy calves were born, the researchers exposed them to bovine TB. The cattle, who didn’t appear to have any other health consequences as a result of being modified, didn’t get sick, and their immune systems seemed less bothered by the bacteria than cows that hadn’t been altered.

❝ …In North America, farmers don’t give antibiotics to cows with this infection. Instead, they are slaughtered, Reynold Bergen, the science director of the Canadian Cattlemen’s Association, said in an email. This is because bovine TB spreads really quickly, and often when one cow is diagnosed, the whole herd has to be killed to prevent further infection of people or other animals, and it’s difficult to detect early on.

But if cows don’t get sick to begin with, farmers wouldn’t lose their herds. Additionally, the authors think that similar methods could be used to give cows and other livestock genetic resistance to other bacterial infections, which means that they would not need to take antibiotics, which contributes to the growing problem of infections that are resistant to the treatments we have available for them.

Bravo! Not only a successful result; but, the sort of practical goal which improves health for a couple of species – including us. Sometimes, working towards less medication is realized to be a positive end.

In opioid withdrawal – and no help in sight

A patient receives prescription opioids after an accident — and no support from his physicians as he weans himself off.

❝ No one will be surprised to hear that I was angry. Angry at myself, angry at my doctors, angry at the medical community. Just — angry. I had been hit by a van and undergone five surgeries, yet the worst part of the experience was my month in withdrawal hell. How could it be that my doctor’s best tapering advice led to that experience? And how could it be that not one of my more than ten doctors could help?

Sad, but, true. A tale worth reading. Worth understanding what happens in a nation where healthcare is considered privilege rather than right. How priorities are – and aren’t – established.

Thanks, Danny Blanchflower

Human-Pig chimera is a step towards replacement organs


Human cells (green) differentiated into endoderm progenitors (red)

Every day, 22 people in America die while waiting for an organ transplant. But when scientists can grow replacement livers or kidneys or pancreases inside of animal hosts, medicine’s organ shortage may end. That’s the hope anyway—and this week there’s more reason to hope than ever that it might become reality.

❝ The key to producing human organs in other animals is the chimera, a mixture of cells from more than one species growing together as a single animal. For decades, researchers have struggled to coax Petri dishes of stem cells into functional, three-dimensional tissues and organs, hampered by technical challenges and political stonewalling. Now, two milestone papers have taken two big steps toward solving the chimeric riddle. Will you be ordering up a homo-porcine gallbladder on Amazon this time next year? No. No, definitely not. But researchers have done two things they’ve never done before: 1. Combine two large, distantly-related species into one embryo. And 2. Use organs from one species grown in another to actually treat disease…

❝ With other advances, scientists are hoping to do away with artificial insulin altogether. About 30 million Americans have diabetes; more than 3 million of them rely on artificial insulin to stay alive. Chimeras could potentially help those patients make their own insulin—and Hiromitsu Nakauchi, a stem-cell biologist at the University of Tokyo and Stanford, showed you can do just that in a paper published yesterday in Nature. At least, you can in rats. His team used genetic tweaks to prevent rats from making their own pancreases. Then they injected mouse stem cells (complete with all the necessary pancreas-making genes) into the developing pancreas-less rat embryos. The rats grew normally. The only thing different was their pancreases were made almost entirely of mouse cells.

Then they went a step further. From those rat-mouse chimeras, Nakauchi’s team took out tiny clusters of pancreatic cells that make insulin (called islets) and transplanted them into diabetic mice. The islets settled in and made enough insulin to keep the host mice’s blood glucose levels in a normal range for more than a year. In layman’s terms? The mice were cured. It’s the first time a chimera-created organ has ever treated a medical condition.

❝ …Scientists will have to improve human stem cells’ colonization of their animal hosts. The Salk team’s next hurdle is trying to embed one human cell in 1,000, or even 100 pig cells. “That’s when we can start thinking about practical applications,” says Wu. But that’s also when ethical questions start to become more urgent.

More urgent, that is, for people who consider religious ideology more important than keeping someone alive. Folks more concerned with the creation of new species or sub-species and the uses thereof – instead of reducing numbers in the thousands and more of individuals who have to die – are socially, criminally out of touch with human needs.

A woman died from a superbug that beat all 26 antibiotics available in the United States


A culture of Klebsiella pneumoniaeLarry Mulvehill/Getty

❝ If you had any doubts about the “nightmare” and “catastrophic threat” of antimicrobial resistance, take a look at this new field report from the Centers for Disease Control and Prevention.

Nevada public health officials tell the story of a Washoe County resident who appeared at a Reno hospital in August 2016 with sepsis. Doctors found out that she was infected with a type of carbapenem-resistant enterobacteriaceae, or CRE, superbug called Klebsiella pneumoniae and quickly put her in isolation. Tests showed that the bacterium, which spread throughout her body, was resistant to 26 different antibiotics — or every antibiotic available in the US.

In early September, the woman, who was in her 70s, developed septic shock and died.

❝ What makes this case particularly alarming is that the infection probably didn’t originate in the US. The woman had spent significant amounts of time in India, and while there, was hospitalized on several occasions over two years for a femur fracture and later, bone infections.

India has a major superbug issue, particularly in its hospitals. The authors of the report suggest the patient may have picked up her infection while in hospital there…

❝ This is a frightening story of a deadly bacterium doctors couldn’t control — and the real limits of our antibiotic arsenal. But it’s also a reminder of how tricky the superbug problem will be to solve without a lot of international collaboration.

RTFA, especially if you think the GOUSA can solve all its own problems alone. Mobility, communications, ease of travel compared to what was available a half-century ago, all mean little to someone who thinks the world begins and ends at their county line.

The rest of us have to be concerned with staying alive.

Koch Bros new campaign wants to convince Black folks that dirty fuel is good for them

Fueling U.S. Forward, a public relations operation funded by the Koch brothers, is trying to spread the message that Black people benefit the most from cheap fossil fuels, according to a story in The New York Times. Clean energy, they say, is a threat.

Last month, the group sponsored a toy drive and gospel concert in Richmond, Virginia. The event included a panel discussion on how the holidays were only possible thanks to oil and gas.

What went unsaid, of course, was that people of color are far more likely to be harmed by the fossil fuel industry than helped. They’re more at risk from climate change and pollution and more likely to suffer health problems tied to burning fossil fuels.

Asthma is more common among Black people than white people, partially because they’re more likely to live near coal-fired power plants and other fossil-fuel infrastructure. That’s not exactly because they want those plants in their neighborhoods; it’s because they have less power to fight them.

And on and on. Black communities, Black neighborhoods, can always be certain to receive the “benefits” of walk-in jobs from polluting industries. Same as it ever was.

Researchers find more new invasive tropical mosquitoes in Florida

❝ Two more tropical disease-carrying mosquitoes have been found on the U.S. mainland for the first time, caught in traps near Florida’s Everglades.

The scientists involved say this could raise the risk of mosquito-borne viruses reaching people and birds, but health officials say it’s too early to sound an alarm.

Think they’d keep their jobs if they raised an alarm with a thug like Scott as governor?

❝ The new arrivals from Latin America and the Caribbean — Culex panocossa and Aedeomyia squamipennis — were trapped in October in rural areas bordering Everglades National Park by University of Florida…entomologist Nathan Burkett-Cadena and…researcher Erik Blosser…

❝ In the traps, they discovered that native species were crowded out by thousands of Culex panocossa mosquitoes and hundreds of Aedeomyia squamipennis mosquitoes.

Both species can be found on a few Caribbean islands as well as from Mexico into South America. They lay their eggs on water lettuce — invasive weeds that float in the canals, drainage ditches and other waterways crisscrossing Florida neighborhoods.

“‘Hundreds’ is substantial, particularly when you get a hundred from a single trap. This is not a single specimen that blew in from a storm — this is a reproducing species,” Burkett-Cadena said.

❝ About 15 invasive mosquitoes now live in Florida, including nine that have arrived in the last decade. One, Aedes aegypti, is blamed for spreading the Zika virus, along with dengue fever and chikungunya.

The new arrivals are another sign that climate change, along with increased tourism and global trade, has made Florida more hospitable to exotic species, Burkett-Cadena said.

Populistus teabagocrap isn’t an exotic species in any of the Old Confederate states. Top it off with a governor from the latest generation of neo-con Republican and you won’t find any attention paid to potential disasters which reflect climate change. Rick Scott made a career from profiteering from the sick and poor. Then, he turned to politics and didn’t change a beat in his anti-science bongo solos.

A history of living conditions on Earth in 5 charts

world-pop-vs-poverty

A recent survey asked “All things considered, do you think the world is getting better or worse, or neither getting better nor worse?”. In Sweden 10% thought things are getting better, in the US they were only 6%, and in Germany only 4%. Very few people think that the world is getting better.

What is the evidence that we need to consider when answering this question? The question is about how the world has changed and so we must take a historical perspective. And the question is about the world as a whole and the answer must therefore consider everybody. The answer must consider the history of global living conditions – a history of everyone.

Cynic that I am – even as an optimist – I tend to have a low opinion of my fellow Americans’ commitment to lifetime learning, understanding the world around us. This study makes it clear I should extend that analysis to our species worldwide. 🙂

Actually, things are better than that. But, I can’t resist grumbling – especially on a cold, snowy weekend moving into the mud phase.

RTFA. It serves as the debut for OUR WORLD IN DATA website. Which looks really interesting and useful.

Thanks, Barry Ritholtz