Wednesday, May 30, 2018

How Dangerous Are Cigarettes?



Source: Mirror.co.uk



By now there are probably few people who are not aware of the dangerous aspects (health dangers) of smoking cigarettes.  The adverse health impact of smoking cigarettes is very visible in our society today.  People are dying of lung cancer due to smoking.  Additionally, the tobacco industry lost a landmark case in the late '90's' for covering up the fact that nicotine is addictive and the industry was aware of that fact.  Currently, the movement is now shifting toward 'vaping'.  I wrote a blog post about the potential hazards of vaping which can be found here.  For this blog post, I thought that I would talk a little about cigarettes and the dangers behind them.



Cigarette Production Is Dangerous




Recently, I stumbled upon a video created by the U.S. Food and Drug Regulatory Agency regarding the dangers of cigarettes (3 minutes in length):






Let's take a step back and review the crucial steps outlined in the video above:


1) Plant

2) Harvesting/Processing

3) Combustion


Below, each of the above steps are slightly elaborated on for the purpose of clarity for the reader:



1) Plant Stage:



As indicated in the video, plants have natural 'pesticides' defense mechanisms to keep bugs and invaders away.  Just so happens that the pesticide commonly found in tobacco plant is the addictive component in cigarettes -- Nicotine.  In the late 90's, a huge lawsuit ensued around the tobacco companies disregard for evidence that was in their hands regarding the 'addictive nature' of nicotine.  One of the largest legal battles gave the largest monetary settlement which cost the tobacco companies hundreds of millions of dollars.


On top of the addictive nature of the chemical  nicotine, plants also have a wide range of chemicals stored in their arsenal to carry out day to day operations.  In addition to the arsenal of compounds needed for daily operation, plants also uptake chemicals found in the soil.  Which means that toxic metals like arsenic or lead (not to mention cadmium) could potentially be incorporated into the cigarette's composition solely based on growth location.  Additionally



For instance, what if a tobacco field was next to a chemical plant?  Any chemicals which made their way into the air and further into the soil could potentially end up in the cigarette that you hold in your hand.  These are just the chemicals which make their way into your cigarette by being in the soil in which the tobacco plant is grown in.  Rarely do people consider chemicals leaching (entering) into a plant if diffusing from a far off chemical or industrial plant.  Location matters.



2) Harvesting/Processing Stage:


The next stage after the planting the tobacco plant and allowing them to grow is the 'harvesting/processing' stage.  The plant is taken from the ground and exposed to the 'curing process' during which 'tobacco specific nitrosoamines' are formed.  Termed 'TSNA's' by the Food and Drug Administration (FDA), these compounds are known carcinogens which cause cancer in both the lungs and esophagus.  The tobacco plant is dried out during the curing process and treated with specific chemicals to prepare the plant for processing into a cigarette.



During the 'processing stage' of the production of cigarettes, at different stages chemicals are added to the tobacco plant to mask undesirable features in a cigarette such as harshness or odors along with undesirable tastes.  These chemicals or sugars can eventually become acid aldehydes which are known carcinogens.  Other chemicals may be added during the processing stage to enhance other qualities of the cigarette which contribute to the desirability of the final product which resides in the consumer's hand.  The point is that during the harvesting/processing stage, the tobacco is exposed to a large number of chemicals which was previously unknown to any reader of this article.  One large assumption is that all harmful chemicals are produced in the combustion process -- which is far from true.



3) Combustion Stage:



In the combustion stage, the cigarette has been formed into the familiar product sold in packages shown in the introductory photo above.  The process of burning the cigarette is defined as a 'combustion' process explained beautifully by the Government of Canada below:



Combustion is referred to as a chemical reaction.
Here is an example of a chemical reaction: a nail getting rusty (the metal oxidizes in the presence of oxygen).
Matter is changed by combustion.
Combustion modifies the order and organization of atoms in chemicals.
Order and organization
Just in the same way building blocks can be put together, taken apart and re-assembled to form a new construction, atoms can be put together, taken apart and re-assembled to form new chemicals.
In combustion, oxygen from the air and intense heat cause the atoms of the chemicals naturally present in the tobacco plant to reorganize into new chemicals.
The example shown here demonstrates this modification using building blocks as an analogy.
When a cigarette burns, the chemicals in the tobacco are changed into new chemicals!
Many of these new chemicals are toxic.



To understand the chemistry behind a combustion reaction, here is an image taken from the University of Indiana -- with a quick but concise lesson on combustion reactions shown below:








As shown in the image above, the combustion reaction is portrayed in the first reaction line with a pile of wood reacting with "Oxygen (O2)" producing black smoke and heat.  These are not conventional symbols (or chemical language), the reaction is represented in the basic sense -- visually.  Here is the combustion reaction of paper shown below:




Source: byjus.com



In the reaction above, methane reacts with 2 moles of oxygen to produce carbon dioxide along with 2 moles of water.  For more about moles, visit previous blog posts.   Or consult the wikipedia page for Avogadro's Number by clicking here.  The point is that during the combustion reaction, atoms rearrange themselves.  In the product phase, there is extra energy given off as 'heat'.  Below is a spectrum of different thermal (heat driven) processes: distillation, pyrolysis, and combustion.  On the x-axis is temperature.




Source: Bat-Science



By clicking on the 'Source link' below the image, the enlarged (larger) image will appear.  The point of the picture above is to show that if different amounts of heat is applied to the same tobacco (chemical), then different products will be given off.  This is a very important concept to grasp when thinking in terms of energy and chemistry reactions.



Depending on the source (different measures), the combustion of cigarette smoke produces a range of chemical products.  But wait, above, in the simple combustion reaction the products were: Carbon dioxide, Water, and Smoke along with Heat?  Yes, that smoke contains harmful (toxic) chemicals.  Here is an infographic produced by 'Compound Chemistry' detailing a multitude of compounds contained in cigarette smoke:







Again, by clicking on "Compound Chemistry" in the 'Source' - below the picture, a larger (the original) image will appear in a webpage.  The number of compounds (chemicals) found in cigarette smoke are limited by the ability to measure the exact composition of chemicals.  Additionally, combustion produces partial decomposition products too.  As technology improves, the ability to measure a more precise composition of chemicals will emerge over time.



Conclusion...




Chemistry is pervasive throughout the world.  Molecules are made up of atoms of space.  The atoms are connected with bonds which are made up of shared electrons.  These forces (bonds) can be broken with sufficient energy (i.e. heat) such as in the combustion reaction.  Upon which other molecules are formed.  Why do I stress this obvious aspect of chemistry?



The reason is that during the process of growing tobacco to the process of combustion involves the making and breaking of chemical bonds which results in various chemicals.  The take home message in the post above is that more chemicals exist which are harmful in cigarettes than are advertised or reported by the tobacco industry.  In the future, I will talk more about vaping and the parameters which contribute to the dangerous chemicals which are produced in the process of enjoying vaporizing 'juice'.







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Sunday, May 27, 2018

Thoughts: What Does National Institute of Health Director Francis Collins get asked in front of Congress?

Source: C-SPAN



Regardless of each opinion held by every person existing in the great nation of the United States, each of us could learn a great deal by watching a hearing held by Congress on any given topic.  The topics are very diverse and surprising when a person decides to look into the variety.  I would even go onto say, there is a tremendous amount of content to mull over when making choices for constituents across every district of the United States.  Our elected politicians have an enormous amount of material to consider for a given topic.  Of course, that is the purpose of hiring aides (in Washington D.C.).



With that being said, what do the people who are asked to testify in front of congress say?  What type of questions are asked of them by congressional leaders?  At the end of the blog post, I will include other posts with links to other congressional testimonies.  Since I am focused mainly on science and the environment, I thought that highlighting the recent testimony of Dr. Francis Collins, the Director of the National Institutes of Health would be appropriate for the present post.  Below are the introductory remarks with a couple of short videos.



NIH Director's Opening Remarks




At the beginning of a congressional testimony, the major players get a chance to give an opening statement or submit opening remarks to be entered for the record.  Below are Dr. Francis Collins opening remarks:



  
Good morning, Chairman Blunt, Ranking Member Murray, and distinguished Members of the Subcommittee.  I am Francis S. Collins, M.D., Ph.D., and I have served as the Director of the National Institutes of Health (NIH) since 2009.  It is an honor to appear before you today.
Before I discuss NIH’s diverse investments in biomedical research and some of the exciting scientific opportunities on the horizon, I want to thank this Subcommittee for your sustained commitment to NIH to ensure that our nation remains the global leader in biomedical research and advances in human health.
I want to personally express gratitude to this Subcommittee and its leadership for its support in crafting and passing the FY 2018 Consolidated Appropriations Bill.  The FY 2018 Omnibus provides an incredible increase of $3 billion for NIH, including funding for opioid- and pain-related research, Alzheimer’s disease, antimicrobial resistance, and development of a universal influenza vaccine.  NIH has immediately set to work to invest those additional resources into groundbreaking research.
As the nation’s premier biomedical research agency, NIH’s mission is to seek fundamental knowledge about the nature and behavior of living systems and to apply that knowledge to enhance human health, lengthen life, and reduce illness and disability.  As some of you have witnessed first-hand on your visits to NIH, our leadership and employees carry out our mission with passion and commitment.  This extends equally to the hundreds of thousands of individuals whose research and training we support, located in every State of this great country, and where 81 percent of our budget is distributed.
The FY 2019 Budget provides $34.8 billion for NIH to fund the highest priority scientific discoveries while also maintaining fiscal stewardship of Federal resources.  This Budget will consolidate research functions across the Department, optimize available grant dollars to fund research, invest in NIH’s buildings and facilities, and support NIH priority areas including combatting the opioid epidemic, advancing Precision Medicine, and investing in translational research.
The FY 2019 Budget consolidates HHS research programs into three new institutes within the NIH.  The Budget provides $380 million for the activities of the Agency for Healthcare Research and Quality (AHRQ), consolidated into the National Institute for Research on Safety and Quality.  The National Institute for Occupational Safety and Health (NIOSH), including the Energy Employees Occupational Illness Program (EEOCIPA), currently administered by the Centers for Disease Control and Prevention, and the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), currently administered by the Administration for Community Living, are also proposed for consolidation into the NIH.
America’s continuing leadership in conducting biomedical research requires infrastructure and facilities that are safe, compliant with all laws and regulations, and conducive to cutting edge research and research support.  NIH owns 281 facilities, including a research hospital, laboratories, and offices.  NIH’s Backlog of Maintenance and Repair exceeds $1.8 billion.  NIH is currently working with the National Academies of Sciences, Engineering and Medicine to identify NIH facilities and infrastructure most in need of repair.  We look forward to providing that report to the Committee as soon as it is final.
The FY 2019 Budget makes much needed investments in NIH’s facilities.  The Budget proposes $200 million to support multiple biomedical research infrastructure priorities.  The FY 2019 Budget will allow NIH to continue to repair and upgrade deteriorated infrastructure.  In a recent analysis requested by this Committee, the condition of NIH laboratories ranks near the lowest in the federal government due to the high likelihood of floods, power outages, and mechanical failures.  Items on the backlog list include: install steam and chilled water distribution systems; conduct structural repairs to older buildings; upgrade plumbing systems; repair elevators; upgrade heating, ventilating, and air conditioning systems; replace deteriorated electrical systems, and more.  In addition, due to the age and use of NIH facilities, NIH must invest funds in removing contaminants and hazardous waste before construction or capital repairs can begin in most of its buildings.  The Budget will allow NIH to track what contaminants are being cleared from each of our buildings, which will ultimately help NIH do a better job of anticipating the cost and time required to begin new projects in existing buildings.
Truly exciting, world class science is taking place.  I would like to provide just a few examples of the depth and breadth of the amazing research the FY 2019 Budget supports across the Institutes and Centers of NIH.
Over the past 15 years, communities across our Nation have been devastated by increasing prescription and illicit opioid misuse, addiction, and overdose.  This Committee made a historic investment of $500 million in our work in FY 2018, and the FY 2019 Budget builds on that with an investment of $850 million to support a range of activities to advance research on pain and addiction.  NIH has and will continue to support cutting-edge research on pain, opioid misuse, addiction, and overdose.  Drug addiction is a complex neurological condition, driven by many biological, environmental, social, and developmental factors.  Continued research will be key to understanding the crisis and informing future efforts.  Pain is an equally complex condition affecting millions of Americans.  NIH will: explore new formulations for overdose reversal medications capable of combatting powerful synthetic opioids; search for new options for treating addiction and maintaining sobriety; continue to research how best to treat babies born in withdrawal through our ACT NOW trial; develop biomarkers to objectively measure pain; build a clinical trial network for pain research; and attempt to find non-addictive and non-pharmacological approaches to chronic pain.  Thanks to your support, all hands are on deck at NIH for this public health crisis.
Another exciting area of continued investment in FY 2019, building on this Committee’s long-standing support, is Precision Medicine.  On May 6th, NIH officially launched the national roll-out of the All of Us Research Program.  This program will partner with one million or more people across the United States to provide the most diverse biomedical data resource of its kind and gain unprecedented insights into the biological, environmental and behavioral influences of disease.  The FY 2019 Budget, including resources from the 21st Century Cures Act, supports the ramp up of the program. After pilot testing system and forming partnerships with community organizations across the country, national enrollment is about to begin.  All of Us will not focus on only one specific disease.  Rather, it will be a national data resource to inform many research studies on a wide variety of health conditions. The data provided by one million participants will provide opportunities for researchers—including academics and citizen scientists—who want to understand how and why different people experience certain diseases and conditions while others do not, and why many people respond differently to treatments and prevention methods that will help accelerate medical breakthroughs.
NIH is the largest funder of basic biomedical research in the United States, providing a critical research foundation for both the public and private sector.  Building on that solid foundation of basic research, NIH also supports translational research that turns observations in the laboratory, clinic, and community into interventions that improve the health of individuals and the public, whether those interventions be diagnostics, therapeutics, medical procedures, or behavioral changes.  For example, Congress created the Cures Acceleration Network (CAN) at the National Center for Advancing Translational Sciences (NCATS) to advance the development of high-need cures and to reduce significant barriers between research discovery and clinical trials.  For example, CAN currently supports NCATS’ Tissue Chip for Drug Screening program, which was designed to revolutionize the process for predicting drug safety.  Researchers developing miniaturized platforms that could support miniature models of living organs — such as the lung, liver, and heart — that could be integrated into connected organ systems.  New Tissue Chip initiatives were funded in FY 2017 and this support will continue into FY 2019.  CAN uses flexible research awards using the special authorization called other transaction authority to attract non-traditional government partners, and to expand, modify, and, if needed, discontinue activities to meet program needs.  The FY 2019 Budget will allow NCATS, through CAN, to continue to invest in high-risk, high reward initiatives designed to address significant scientific and technical challenges that hinder translational research. 
One of my personal priorities is developing the next generation of talented biomedical researchers.  Last year, I shared with the Committee NIH’s plans to build on our support for early-stage investigators through a new initiative known as the Next Generation Researchers Initiative.  The FY 2019 Budget includes a dedicated fund of $100 million in the Office of the Director to incentivize additional Institute and Center support for these researchers.  NIH remains committed to the development, support, and retention of our next generation of investigators. 
We have never witnessed a time of greater promise for advances in medicine than right now.  Your support has been critical, and will continue to be.  Thank you again for inviting NIH to testify today. We look forward to answering your questions.




There is a lot to cover since there is a tremendous amount of research done.  Imagine trying to report on all of the new discoveries which have been accomplished over the year which are funded by the government.  Especially given the wide diversity of funding initiatives.  The information gained during the process of research and discovery are wide ranging and some times uncertain in understanding.  New drug targets could be discovered while the technology to bring to market the medicine might not be available yet. 



Additionally, new companies could be emerging looking to invest and take a new drug to market.  The future is exciting yet unknown and Dr. Francis Collins has to stand up before congress to report and justify the funding -- while always looking to increase the annual budget.  The task must seem monumental given the scope and wide range of projects not to mention the needs of the NIH.


Short Videos of Questions




Now that you have seen the opening statement, a couple of videos might be appropriate.  The first video is of the opening remarks from the committee chair - Senator Roy Blunt.  He gives a good overview of the current state of funding and initiatives that have been considered over the past few years in around 6 minutes of speech:





Wow!  That is pretty impressive.  Dr. Collins mentions that the 'ROI' -- 'Return On Investment' from spending money for research at the National Institutes of Health is $8.38 for every $1 spent (over a five year period).  Remember, the money invested goes to research medical disease at the basic science stage along with grants which help pharmaceutical companies bring a drug to market to treat a disease (when success is shown).



For those concerned citizens who worry about spending needless money on projects which 'seem' to produce nothing, I would argue that every project pursued yields fruits of knowledge.  Whether that yield be as small as the realization of the need for newer technology or the realization that the existing projects will really have to be broken up into many smaller components with each a separate funding cut.  Meaning that there is no money which is wasted in research.  I understand that there are scientists who will disagree with me.  That is not to say that money could be better spent from grants coming out of the National Institutes of health.  What always strikes me as amazing is the wide range of projects (under various sub-agencies throughout the NIH) that are undertaken by scientists throughout our nation.



Senator Roy Blunt mentions the newly launched initiative of the National Institutes of Health guided toward precision medicine called "All of Us."  I just wrote a short blog post with a video embedded in the post to give a reader an introduction into the ground breaking initiative toward understanding unique traits among individuals rather than large populations.



The next video shows Senator Jerry Moran questioning







Dr. Richard Hodes, Director of the National Institute on Aging, spoke briefly about identifying various biomarkers of disease.  Recently, I wrote a short blog post with a video on the mission of the National Institute on Aging (NIA) -- which is worth checking out if you are unfamiliar with the NIA and research conducted within the facility and outside (funded by the agency).



For those who are interested in listening/viewing the entire hearing, here is the link to the Senate Appropriations web page with the embedded video of testimony.



Conclusion...




Congress has a difficult job in front of them when dealing with spending issues on behalf of the entire United States of America.  Each geographical region has different spending needs which require different amounts of funding from the government on an annual basis.  What is not different or unique is that each geographical region is filled with human beings.  Each of us eventually will need hospital services within our lifetime.  Each of us will eventually need a medication which was funded by the National Institutes of Health.  And eventually, each of us will realize that money spent on medical research is important.



Just ask a person with a rare disease for which there is no treatment available.  What would you say to that person from a spending perspective?  Although, just because money is thrown at a project (research problem) does not guarantee positive results.  Unfortunately, the answer may be beyond the reach of our current research capabilities or understanding.  If we do not continue to promote research and discovery across a wide range of fields, then we will never know our limits of understanding.  Research is not an area from which we (as a nation) should be trying to save money.  If anything, an annual increase should be without question.  This statement is backed by a great return on investment as stated above by Dr. Francis Collins.






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Thursday, May 24, 2018

Update: EPA Throws Journalists Out Of PFAS Conference - Why?


Source: EPA



The week began with an update (a blog post) regarding the decision of the Environmental Protection Agency to hold 'a conference' to explore the dangers of PerFluoroOctanoic Acid (PFOA) and PerFluoroOctaneSulfonic Acide (PFOS).  This conference was in response to the breaking news last week that the White House was suppressing a health report by the Department of Health and Human Services (HHS) which was about to be released regarding the safety of the chemicals above.  The levels of the PerFluoroAlkyl compounds which were found in various geographical areas were disturbing as uncovered by Politico news.  Below is the disturbing update regarding the conference at the EPA -- which began with quite a hiccup to say the least -- or was it a hiccup?



Day 1 of PFAS Conference at EPA




As I just stated, the two day conference which was held at the EPA started roughly to say the least.  According to early reports by 'Politico Energy' the following disturbing event occurred at the beginning of the conference:



MAKE SOME ROOM — PFAS SUMMIT ENTERS DAY 2: It's the second and final day of EPA's summit on dangerous chemicals cropping up in drinking water supplies around the country. Deputy Administrator Andrew Wheeler will deliver opening remarks, but the rest of today's agenda is pretty vague, mostly listing "open discussions" among the state regulators, federal officials and other participants.
EPA Administrator Scott Pruitt announced Tuesday that he would take the first step toward regulating PFOA and PFOS. Today's proceedings will be closed to the press, an agency spokesman tells ME. EPA initially tried to bar reporters from most of Tuesday's proceedings, before reversing itself a few hours later, but the outcry over that move overshadowed much of the event (more on that below).
'NOBODY EVER ASKED US': Ahead of today's meeting, Pro's Annie Snider and Emily Holden confirmed that a controversial — and still unreleased — HHS chemical safety assessment will find that the contaminants can be dangerous at much lower exposures than EPA has previously said were safe. "Nobody ever asked us to change the numbers," Patrick Breysse, the head of the Agency for Toxic Substances and Disease Registry within HHS, told POLITICO. Breysse, who worked on the study, said the agencies involved were "getting close to finalizing it in January," but paused its release to come up with a better communications strategy to describe its findings. At the time, as POLITICO reported last week, a White House official worried of a "public relations nightmare" if the study were made public and asked EPA to intervene. While speaking on a panel at EPA's summit Tuesday, Breysse said the minimum risk levels reported last week for PFOA, PFOS and two other similar chemicals will remain the same when the assessment is released "soon."
Following up: Republican Sen. Shelley Moore Capito told reporters she is "not totally pleased" with EPA's response to the blocked release of a health study on a nationwide water-contamination crisis and would be following up with agency later this week after a national summit on the issue. "I think the health study that HHS put forward needs to be released," she said. "I want to have the full information and I want to find out what kind of levels are acceptable and then remediate the problems." And does she think Pruitt can adequately respond to her concerns? "Time will tell, honestly," she said.
— Separately, Sen. Tom Udall demanded to know why EPA tried to bar reporters from Tuesday's session — a decision that was eventually reversed a few hours later. Udall sent a letter to Administrator Scott Pruitt to express concern over EPA's "disturbing treatment" of journalists. "This intimidation of journalists seeking to cover a federal official presiding over important policy-making is un-American and unacceptable," Udall wrote, calling on Pruitt to apologize to reporters.
But EPA spokesman Jahan Wilcox defended the agency in a statement, noting an Associated Press reporter who had been physically removed from EPA headquarters, "showed up" after being told ahead of time the event was at capacity. "When we were made aware of the incident, we displaced stakeholders to the overflow room who flew to Washington for this meeting so that every member of the press could have a seat," he said.



Which was after the evening reporting by news agencies which resulted in a tweet by Senator Tom Udall shown below:






Here is the 6 and 1/2 minute video below from CNN:





Wow.  Read more about the event (barring of news) from two additional news sources -- Politico and Reason Blog.  According to reporting on the website 'Reason' the conference was proposed based on chemical levels reported earlier by Politico as shown below:



The Summit is being held on the heels of the revelation in Politico that the EPA is apparently suppressing a new report on the safety of PFAS from the Agency for Toxic Substances and Disease Registry. That report suggested that the EPA's safe level of exposure at 70 parts per trillion is about six times too high. Most of the concerns about exposure to PFAS are based on a large number of epidemiological studies that detect fairly subtle health effects. Subtle, however, does not mean no effects.


Wow.  That was only on the first day of the conference.



Day 2 of PFAS Conference at EPA




After the press being thrown out of the EPA hosted conference on the first day, the EPA took a few heavy hits from congressional leaders and the press -- and rightfully so.  One would think that the possibility of throwing the press out of the conference on the second day would be not possible.  But, leave it to the Pruitt Administration to have the gull to attempt the ejection of the free press from the conference again as reported by Politico:



EPA staff Wednesday morning barred POLITICO and reporters from at least two other publications from entering a national summit on toxic chemicals, a day after a partial media blackout at the same event brought criticism from congressional Democrats and a pledge by the White House to investigate the incident.
The agency on Tuesday had allowed a select group of reporters to cover the first hour of the summit's introductory remarks, including comments by Administrator Scott Pruitt, but then escorted press out. EPA reversed its decision to ban media after news coverage of the policy and reports from the Associated Press that one of its journalists was forcibly ejected from the building by a security guard. Reporters were invited back for Tuesday afternoon.
But on Wednesday, the agency again said no reporters would be allowed to attend.
The event, where attendees are discussing whether and how to regulate a class of chemicals linked to immune disorders and certain cancers, included federal and state officials, health groups and industry interests on Tuesday. On Wednesday, it is limited to the agencies that handle chemical oversight and state regulators, according to an EPA statement.



This was such an outrageous action that Politico's Editor even made a statement on behalf of the press about the restriction of access to the conference:



"The summit was focused on an important public health crisis that has affected drinking water supplies across the country, and chemicals that are present in the bloodstreams of nearly all Americans," she said. "We believe it is important that the news media have access to the entirety of this discussion to keep the public informed with fact-driven, accountability coverage of this important issue — we would much rather be writing about the agency's efforts to address this health problem than about reporters being excluded."



Even more congressional leaders took to their twitter accounts.  Senator Tom Carper of the Environmental and Public Works Committee posted on twitter:



"I can’t believe I have to say this two days in a row, but @EPA works for the American people," Carper wrote. "Unfortunately, it’s clear that this EPA is more concerned with protecting the EPA chemical summit from the public than it is with protecting the public from harmful chemicals."



I am really amazed at the obvious lack of understanding of the current Administration that the government works for the people of the United States.  Their actions are funded by tax-payer money.  The actions of the EPA over the last couple of days have called on the Society of Environmental Journalists to take action and send a letter to EPA Administrator Scott Pruitt which is shown below:



May 23, 2018
Scott Pruitt, Administrator
U.S. Environmental Protection Agency
Mail Code: 1101A
William Jefferson Clinton Building
1200 Pennsylvania Avenue, N. W.
Washington, DC 20460
via e-mail: Pruitt.scott@Epa.gov
Dear Administrator Pruitt:
The Society of Environmental Journalists strenuously objects to the Environmental Protection Agency’s selective barring of news reporters from your “National Leadership Summit” on per and polyfluoroalkyl substances (PFAS) in drinking water, and to the EPA physically forcing an Associated Press reporter from the premises.
It beggars understanding that the EPA would prevent any reporters from covering a topic of such intense nationwide interest and concern. But these are just the latest additions to your pattern of antagonism toward the press, and disregard for the public’s right to know what EPA is or is not doing to protect their health and the environment.
This meeting, organized well in advance to gather input on a critical public health policy initiative, as a matter of course should have admitted news reporters in order to inform the public about what occurred. But as recently as a couple weeks ago, your staff was informing reporters that there would be no room for the press at this invitation-only event, because there was not enough space in the room selected for it.
This is patently ridiculous. Surely, larger rooms were available at the EPA headquarters or in a nearby federal building or hotel.
Evidently your staff relented at some point on May 22 and agreed to admit reporters for some news organizations. But not all: The Associated Press, CNN and E&E News, all highly respected news outlets serving enormous national audiences, were turned away at the door.
A female AP reporter has recounted that when, in response to being barred, she asked to speak with a public affairs staffer, guards instead laid hands on her and removed her from the building by force. This is completely unacceptable.
The livestream of the May 22 event provided by EPA - which has been offered as some sort of alternative to on-the-scene coverage - turned out to be highly selective as well, with most of the summit’s morning session held without being broadcast online.
Finally, though you allowed press coverage the afternoon of the summit’s first day, your agency once again excluded at least some reporters on the session’s second day, May 23.
While informing the public via news media is just good policy, holding the meeting open to the public is also legally required under the Federal Advisory Committee Act (5 USC § 1-16) and the Government in the Sunshine Act (5 U.S.C. §552b). According to your own agency’s press release, the summit included representatives from more than 40 states, tribes and territories, 20 federal agencies, congressional staff, industry groups and non-governmental organizations, and the agency intends to use information from the summit to help it develop a management plan. There is no justification for secrecy here.
On behalf of SEJ’s 1,400 members and all other journalists covering the EPA, we urge you to:
• Repudiate this hostile approach to dealing with the press and public.
• Consistently open up important meetings, announcements and events to the public and press.
• Never discriminate against a news outlet based on the content or editorial slant of its coverage.
• Make arrangements to accommodate rather than restrict access by the press and public — and to answer their questions.
• Withdraw your objections to the publication by the Agency for Toxic Substances and Disease Registry of a draft assessment of water contamination by these chemicals. According to news reports, that study is still being withheld from the public.
Your failure to release this report, along with the difficulties inflicted on reporters trying to cover the summit, inhibit public understanding of how the EPA is regulating water quality and constitutes an abuse of the free press and the public’s right to know. We emphatically urge you to end these practices immediately.


The behavior described (the actions of the EPA officials toward the press) are unprofessional and violate unwritten rules and regulations within the government.  Since when does any EPA official have the right to handle another personal in a physical capacity.  The EPA official could be brought up on charges of assault.  At the very least, the EPA official should have called a security official.  But the above removal of a person in the press are just another reminder that this administration believes that they exist outside or above the law -- which is very unfortunate.



Conclusion...




I would hope that after the unfortunate events, the nation can move on and learn from the events of the past.  The current Administration at the EPA needs a strict reminder from congress regarding the behavior toward the public.  Each public official should remember that ultimately the tax-payer is deciding their course in the future.  Based on the actions over the last few days, the EPA seems to have been taken over and funded exclusively by the Private sector.



The blatant disregard for the public should make any citizen sick to their stomach.  After all, the fall-out of the decisions being discussed and made result in resources which we need for every day living.  No person should have to drink or be exposed to contaminated water just because the federal regulating agency (i.e. EPA) is unwilling to do their job.  Further more, disease needs not be spread due to a lack enforcement on government, state, and local facilities.




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Monday, May 21, 2018

Update: Congress asks Federal Agencies about Dangerous Chemicals -- PFOA and PFOS


Source: SlidePlayer



Last week, I wrote a blog about an emerging controversy surrounding a report about the two dangerous chemicals -- PerfluoroOctanoic Acid (PFOA) and PerfluoroOctaneSulfonic Acid (PFOS) which has been suppressed by the Administration.  As a result of learning about that report and the suppression by the Trump Administration, Congress informed by the Department of Defense (DOD) and the Environmental Protection Agency (EPA) that an explanation is needed about this critical issue.  Why is this critical?  Do you like turning the tap on to get 'clean' drinking water? If the answer is yes, then the emerging information will be of critical importance to you.



This morning, emails which were obtained through the Freedom Of Information Act by the Environmental Defense Fund (EDF) shows the initial problems with the emerging issue.  The following introduction to the information obtained by the EDF was emailed out this morning by 'Politico Energy' - shown below:



PRUITT'S CHEMICALS PROBLEM GETS BIGGER: Several major chemical companies have told federal regulators they planned to have hundreds of pounds of hot-button chemicals dumped daily into rivers that an environmental group warns could be used as drinking water sources. The Environmental Defense Fund obtained documents showing that chemicals companies estimated that paper mills making pizza boxes and other food packaging would be discharging as much as 225 pounds of the chemicals into nearby waterways each day. Companies such as Chemours and Daikin America submitted those estimates to the Food and Drug Administration to support applications to sell chemicals related to PFOA, which is linked with thyroid disease and certain cancers, for use in food packaging. The FDA has approved applications from six companies in recent years and the dumping could now be taking place at paper mills across the country.
But here's the catch: EDF says discharges of the PFOA-related chemicals are likely unregulated, and there is no public information about which plants are using these chemicals and which waterways they're being discharged into. That means that drinking water utilities that draw their water just downstream might not know to treat for the contaminants, and state regulators wouldn't know to set limits for the chemicals in the permits they issue the mills. EDF estimates that in many major waterways with pulp mills along them, like the Cape Fear River in North Carolina, those discharges would put concentrations of the chemicals well above EPA's health advisory level for PFOA. "If you're not told that these chemicals are used in the facility, you don't know to set a limit, you don't know to do testing," said Tom Neltner, EDF's chemicals policy director.
The revelations come as EPA Administrator Scott Pruitt faces fierce questions from lawmakers on his top lieutenant's efforts to block a health study produced by HHS that was poised to find that PFAS chemicals can pose a danger at lower levels than EPA has previously said were safe. On Friday, three Republicans, including a member of House GOP leadership and a key ally of President Donald Trump, joined with 10 Democrats to demand that Pruitt release the study and explain the brouhaha. A planned leadership summit on PFAS chemicals kicks off Tuesday at EPA's headquarters.




The information obtained by the EDF tells a different story than just suppressing a 'report about dangerous chemicals.'   Dumping cancer causing chemicals into potential water sources should set off 'red alarms' at the EPA.  Just look at the response so far -- not much concern after receiving e-mails about dumping large amounts (high concentrations) of dangerous chemicals into water sources. 



The other disturbing news contained in the excerpt has to do with 'who is in charge?' of the water sources.  As noted in the excerpt above, the EPA did nothing in response to the information obtained/sent by the corporations regarding the discharging of high concentrations of chemicals into water sources.  In the event that is the case, who can local water districts turn to in order to ensure that the water coming into a source is safe.



Luckily, congress is reaching out and asking questions on our behalf.  Don't be afraid to reach out to your local politician (elected senator) and express concern for this issue.  Providing safe access to water should be each politician's top priority as a public health issue.  Each of us deserve safe drinking water.  As I find more information out regarding this issue, I will keep providing more updates on the important matter.



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Friday, May 18, 2018

Congress Asks Defense Department and Environmental Protection Agency about Dangerous Chemicals


Source: Wikipedia


Over the last few decades, a war has been ongoing between environmental justice advocate groups and industry groups regarding chemical safety in society.  I say society for the simple reason that the implications of such work propagate through every avenue of our lives.  From the safety of the chemicals used in the products which we purchase along with the different points in the supply chain.  The obvious disregard for the environment is the cost for a profit for industry shareholders.  Less regulation is great for profit.  At least that is what the message is from the top (White House) down (to society).  A recent example of this has emerged and is in need of attention within the government.  This has caused some uneasiness from politicians in congress.



White House Obstructs Disseminating Science




Last Monday, began (for me) opening my email and finding the following excerpt from 'Politico Energy' shown below:



WHITE HOUSE INTERVENED IN CHEMICAL ASSESSMENT: The White House sought to block a draft Health and Human Services assessment related to the release of toxic chemicals, calling on political staffers at EPA to look into the issue after the administration concluded the report’s findings would cause a “public relations nightmare,” new emails obtained by the Union of Concerned Scientists show. Pro’s Annie Snider reports on the internal EPA emails that show the unreleased assessment concluded that the chemicals, known as PFOA and PFOS, pose a danger to human health at far lower contamination levels than EPA previously said was safe. The study, if finalized, could increase the cost of cleanups at sites like military bases and chemical manufacturing plants, as the chemicals have long been used in products like Teflon and firefighting foam, and could force communities across the country to pour money into cleaning up their tainted water supplies.
What the emails say: On Jan. 30, James Herz, a political appointee who oversees environmental issues at the White House Office of Management and Budget, forwarded an email from another White House aide about the forthcoming HHS assessment to EPA’s top financial officer. “The public, media, and Congressional reaction to these numbers is going to be huge,” that forwarded email, whose author is not identified, reads. “The impact to EPA and DoD is going to be extremely painful. We (DoD and EPA) cannot seem to get ATSDR to realize the potential public relations nightmare this is going to be.” EPA’s chief of staff, Ryan Jackson, confirmed to Annie that he spoke with his counterpart at HHS, as well as with the head of the agency producing the report, arguing it is important that the government speak with a single voice on the topic. More than three months later, the draft assessment remains unpublished. HHS' Agency for Toxic Substances and Disease Registry says it has no scheduled date to release it for public comment. Read more here.
Related doc: Sens. Debbie Stabenow and Gary Peters sent this letter to Defense Secretary Jim Mattis last week, raising concerns with the DoD’s response to water contaminated from per- and polyfluoroalkyl substances at and around defense installations across Michigan. “Communities in Michigan are not at fault for the release of these harmful contaminants, and it is imperative that the Department do whatever is necessary to address the public health and environmental risks associated with exposure to these chemicals,” they write.


Two chemical members of the PerFluoroAlkyl class of chemicals which are discussed in the excerpt above are shown below:



1) PerFluoroOctanoic Acid (PFOA):







2) PerFluoroOctaneSulfonic Acid (PFOS)







For the purpose of the present post which is to call your attention to the intent of the Administration to bury the dangers uncovered in the report, I will be brief of the chemistry of the class of chemicals shown above.  The class of chemicals which encompasses both types of molecules are called PerFluorinated Alkyl substances.  I will write a post in the near future discussing more in depth of the danger posed by the class of chemicals.



The present take home message regarding the danger of these compounds is due to their resilient properties.  Chemicals with these properties are heavily resistant to water, oil, and grease.  For this reason alone, the chemicals are widely used in food packaging and cookware.  Also, the chemicals are widely found in clothes, furniture, and as fire retardants.  The properties of these chemicals make them very difficult to break down in biological species which cause bioaccumulation as a result.  Further progression of the accumulation can cause certain diseases.



More can be read about these chemicals on the Environmental Protection Agencies website -- located here.  The fact that the chemicals are harmful is not under debate.  Although, the exact concentration might be debatable by certain organizations.  Which makes the present report useful in adding information to the debate.  As pointed out below, the report was funded by the tax-payer (you and I), therefore, we should be able to see the contents of the report.  Congress has reacted appropriately (at least a couple of members of congress have acted) to steer the report into the public eyes as shown below.



Congressional Action Is Necessary




We would hope that our elected politicians have our best interest in mind when it comes to the discussion of chemical safety.  After all, chemical safety impacts all of us -- although, in some cases, not equally.  On a larger scale, we all are equally impacted (city, state), therefore, congress should instruct the appropriate agencies to turn over the results of the report -- regardless of the findings.



First, on Monday, the concern of the two senators from Michigan (Senator Stabenow and Senator Peters) was sent in letter form to the Department of Defense and is shown below:



The Honorable James Mattis
Secretary of Defense
1000 Defense Pentagon
Washington, D.C. 22202

Dear Secretary Mattis:

We write to express our concerns with the Department of Defense’s response to addressing groundwater and surface water contaminated by per- and polyfluoroalkyl substances (PFAS) at and around defense installations across Michigan.  Expedited action is needed to address these contaminants that pose a threat to human health and the environment.
PFAS are chemicals used in firefighting foams at military bases around the country with impacts to human health that are not well understood. Studies have associated PFAS exposure to cancer, as well as thyroid, kidney, reproductive, and heart issues.  In the Fiscal Year 2018 Consolidated Appropriations Act, Congress included $310 million for environmental remediation at Base Realignment and Closure bases, $54 million above from the previous fiscal year.  The bill report specifies that this additional funding should be used to address PFAS contaminated sites.  In addition, the Army Guard base maintenance account also received $40 million more than the previous fiscal year’s level, which can be used for investigating and remediating PFAS contamination.
In 2016, the U.S. Environmental Protection Agency (EPA) established new lifetime health advisories for two types of PFAS – perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS) – to assist federal, state, tribal and local officials with protecting public health when these chemicals are present in the drinking water.  In addition, the State of Michigan’s cleanup criteria for groundwater protective of drinking water was established on January 10, 2018.  Furthermore, the State of Michigan has Water Quality Standards that apply to both surface waters and to groundwater venting to surface waters. Michigan regulations specify that water quality standards shall be met in all waters of the state, and that these standards sufficiently protect both human and aquatic health.
PFOA and PFOS have been discovered in and around multiple active and decommissioned military installations across Michigan, including: Wurtsmith; Camp Grayling; KI Sawyer; Selfridge; Alpena Combat Readiness Training Center; Escanaba Defense Fuel Supply Point; Battle Creek; Grand Ledge; and Kincheloe.  The State of Michigan has estimated that it will cost upwards of $335 million to investigate and address initial remediation actions at sites near the bases at which the contamination originated.
It is imperative that the Department of Defense comply with Michigan’s water quality standards and cleanup criteria and stop the movement of contamination from military installations into groundwater and surface waters.  While we appreciate the challenges of addressing emerging contaminants such as PFAS, as well as the costs the military faces in addressing environmental contamination at bases throughout the United States, we are concerned about the pace at which the Department is proceeding to address contamination across Michigan.  In addition, it has come to our attention that the Department may be considering changing its policy on compliance with individual state drinking and surface water standards for some contaminants, including PFAS.  We would have great concern if in fact the Department or any of the individual branches were considering this action.  Communities in Michigan are not at fault for the release of these harmful contaminants, and it is imperative that the Department do whatever is necessary to address the public health and environmental risks associated with exposure to these chemicals.
We look forward to receiving your response on the Department’s near- and long-term plans to address these public health and environmental problems in Michigan.   In addition, we would also ask that you provide additional clarity on whether the Department is considering changing its policy on compliance with state drinking and surface water standards for PFOA and PFOS.
Thank you for your consideration of these requests.




If any improvement on chemical safety can occur on the military side the outcome to the environment overall would be enormous.  Why?  The military employs large corporations through government contracts worth billions of dollars per year.  Typically, these contracts are about technology which requires large industrial space to construct along with large amounts of chemical waste.



Although, the department of defense can only do a certain amount of regulating corporations which carry out large contracts for the military.  The largest regulatory agency in this regard is the Environmental Protection Agency which possesses the power to regulate the practices of these corporations.  Any destructive practices can be regulated by the EPA and should be.



Of course, at any given point in time, the EPA has a director which is promoting the agenda of the White House.  Even though this is not supposed to be the case.  Congress recently reminded the EPA in the form of a letter that chemical safety is paramount as shown below:



Administrator Pruitt,
I'm writing today to request that you immediately cease your efforts to suppress a report prepared by the Agency for Toxic Substances and Disease Registry (ATSDR) regarding the health effects of perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA).  This report should be immediately released to the taxpayers who funded the study and rely on its results to maintain their health. 
My constituents in New York's Hudson Valley are directly affected by the findings of this report, as PFOS was discovered in significant quantities in the water supply of the City of Newburgh in my district.  In 2016, it was discovered that runoff from Stewart Air National Guard Base contaminated the groundwater that eventually flowed into the municipal water supply. 
Since the contamination was detected, the State of New York offered free blood testing to affected residents.  The testing found that PFOS levels in the blood of Newburgh residents are higher than the national average.  I was successful in passing legislation into law to require the Centers for Disease Control and Prevention (CDC) to conduct a five-year study into the long-term health effects of PFOS exposure.  But as that study is conducted, my constituents and I have great interest in the results of the ATSDR report. 
The people I represent are understandably concerned about their health since the contamination was detected.  Given that this report can shed light on the health impacts of exposure to PFOS, it must be released immediately.  In addition to being the right thing to do, it is your legal responsibility to release this report to the American people.  I look forward to a prompt reply. 
Sincerely, 
Senator Sean Patrick Maloney 



The two letters above serve as appropriate forms of action by congressional appointees to a serious situation.  Our health is at risk.  Cover ups are not appropriate.  Just because the results are not what the public might like does not give the government the authority to keep them hidden.



Conclusion...




Chemical safety has got to be elevated in importance.   Especially, given the state of technological development and our ability to deal with chemical threats and chemical design.  Instead of covering up reports, the reports should be made public to initiate a discussion on producing a solution.   A few legislators and leaders in the chemical industry worry that the results might be distorted.  So what.  Scientific results are what they are.  Release them immediately.



With that being said, coming up with alternative chemicals or solutions should be where the conversation is headed.  Aside from stemming the current environmental and health impact of the damage currently done along with decades of use of these chemicals.  Where we go from here will define what we learned from the past.  Hopefully, the direction will be toward a more sustainable and environmentally friendlier solution.  Otherwise, the planet is in big trouble in the future.




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Tuesday, May 15, 2018

Parameters: What is the 'mission' of the National Institute for Aging?




All of us will age whether we like it or not.  What can we do if anything to prevent the process of aging?  Or more appropriately, what can be done to slow down the process of aging?  Below is a brief post with a video that highlights work being conducted (research and development) to better understand the process of aging in human beings.



The government has an initiative specifically looking at the process of aging.  The initiative is actually research which is performed at the National Institute of Aging.  Most people are unaware that the government has such a facility solely devoted to the process of aging.  Here is a video below taken from an article from the National Institute of Aging website introducing the mission:






Click here to access the web page on which the video above is hosted on.  Additionally, at the bottom of the article, there are social media links which I have posted below on this page:



1) What is the National Institute on Aging? Learn about the leader in federal research on aging, as well as Alzheimer’s and dementia. https://youtu.be/qMm5renQibo

2) What major advances have we seen in aging & Alzheimer’s research? Find out in this video about the National Institute on Aging at NIH, leading the federal government for research on aging and Alzheimer’s. https://youtu.be/qMm5renQibo

3) Watch this video to learn about research advances supported and conducted by the National Institute on Aging at NIH. https://youtu.be/qMm5renQibo

4) Understanding how we age and what we can do to be as healthy as possible as we grow older is important. Find out in this video how the National Institute on Aging is educating and training the next generation of scientists in aging and dementia research. https://youtu.be/qMm5renQibo

5) The National Institute on Aging at NIH leads the federal effort to study Alzheimer’s disease and related dementias. Watch this video to learn how research is uncovering effective ways to treat and prevent these disorders. https://youtu.be/qMm5renQibo





Conclusion... 


In the event that the public is unaware that the government does perform research on aging along with a whole host of other areas of medicine.  My last post was on the initiative -- "All of Us" -- which is the largest clinical study aimed at understanding the variability between different populations along with between genders.  All of these initiatives along with other basic research funding initiatives (outside of government -- academia, private sector, etc.) make the vast amount of research results cover a wide range of aspects of life.  Stay tuned for more results and highlights to come.





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Friday, May 11, 2018

"All Of Us" - The Best Medical Knowledge Update Effort - Please Join!





How does the medical community collect medical knowledge?  Through research efforts at University hospitals?  Through research efforts at private medical facilities?  Do these different entities share information freely among one another?  The answer to the last question is "no" unfortunately.  Although, groundbreaking results are shared through publishing in medical journals which disseminate the knowledge to the world at large.  What am I getting at?



There is a lack of 'collective information' on the present state of 'medicine' -- which might sound rather strange at first pass to the reader (you).  If a person stops to think about how information is gathered to advance science (in general) then the problem might just present itself in a better light with regard to the lack of dissemination of knowledge within the medical community.  Even reading that there is a lack of knowledge in the medical community might raise alarm in readers minds -- which is good -- considering the proposed change by the National Institutes of Health.  First, lets look at drug discovery briefly.


How are drugs discovered?




As I wrote about in a previous post, the process of drug discovery begins at the university stage. Basic research begins at the university with funding provided by the National Science Foundation along with the National Institutes of Health -- two large government funding agencies.  Of course, there are a whole host of other possible funding sources, but the top two are undoubtedly the NSF and the NIH.  During this research and discovery period, scientists are looking for basic targets that are associated with diseases or other biological functions.



If a discovery is made, then that target -- site on a protein or other biological surface might be passed onto the biotech or chemical industry to develop drugs (pharmaceutical) or chemicals (pesticides -- chemical industry) -- to name a couple of routes.  The take home message is that research done at this stage is purely discovery and not necessarily money driven.  Unlike the research which is conducted in industry settings which must yield profits or be discontinued.



The cost of such research in industry is large.  Why?  Because, as I stated in a previous blog -- the total cost of bringing a drug to market (i.e. pharmacy shelf) is around 20 billion dollars -- yes, "$20,000,000,000.00"-- which is very expensive.  The development of a drug target into an actual treatment is costly from a research standpoint.  Not to mention, the legal paperwork, the marketing, and other regulatory paperwork that is involved in the process.  Even with assistance from government funding agencies like the NIH and the NSF, the cost of bringing a drug to the pharmacy counter is costly.



As a result of this cost, information (data) regarding the drug trials (clinical trials) is secretive and held by the drug manufacturer.  Even though the drug was ultimately produced with money from the tax-payers, the information is proprietary.  Most drug companies tend to keep such information very close and secretive.  This results in the information on patient variability or patient participation that is kept secret and not for government or public researchers to access.  Such information would be extremely beneficial to public researchers and should be made public for mining or searching.



Overall, patient information in research settings and medical practice settings are kept secret from the world.  The results/information is very important and should be available since the information shows the differences in patient variability.  Differences in treatment and differences in outcomes.  What if that information was made available to incorporate into public research?  How much better off would the medical community be?


Personalized Medicine



There is a tremendous amount of variation that is present throughout the human population.  Each of us have similarities but many differences too.  The practice of medicine has relied on the sharing of information throughout the world.  A great deal of that sharing has been either through participation at conferences or through the dissemination of knowledge/results in medical/science journals which publish research results.  Additionally, a small amount of advances have been carried by the media.  The media could do a large amount more but unfortunately, research results do not always attract viewer attention compared to salacious scandals involving politicians and corporations.



What if we paid more attention to the results of medicine?


How can the public get involved in the effort to do so?


Especially, given the lack of understanding in participation?



After all, patients hear about clinical trials which are underway through their respective physicians or by learning about the possibility of participation via the internet.  Of course, that takes a tremendous amount of effort (not really) on each human part.  The main obstacle toward achieving greater solutions in medicine is sharing medical files.



At present, each of us go to the doctor to be examined and treated for an ailment (problem).  A medical file (medical folder) is created at the doctor's office with the medical history and the medical issue along with the recommended treatment (as prescribed by the physician) him/herself.  That medical information is not 'shared' with researchers around the world.  Which is a large issue.  Why? The motivation for change can be stated as the following:


Imagine all of the medical files that are kept at all of the different doctors offices around the world which are not being shared.  In order to share them, each patient needs to sign a 'release form' to whichever physician or agency he/she would like to share their medical history with.  This means that there is a tremendous (huge, enormous) amount of medical history about the citizens of the world that is kept 'private' and not accessible to the research community.  That information could be extremely useful to understand the different types (of variability) of diseases which exist in the human population.  Until that medical history is shared, then medicine will rely on the few cases which are shared (which is very little compared to the human population).



What if the ability to share each of our personal medical information was possible?  What if the government had access to a million medical files?  Imagine the amount of information that could be obtained?  The opportunity just arose with the unveiling of the initiative called "All of Us" by the National Institutes of Health.  Here is the mission statement (brief) on the webpage linked:



The All of Us Research Program is a historic effort to gather data from one million or more people living in the United States to accelerate research and improve health. By taking into account individual differences in lifestyle, environment, and biology, researchers will uncover paths toward delivering precision medicine.



Below is a video which serves to motivate the reason why the "All Of Us" project is important:






See?  A testimonial video is shown below of the personal impact that 'personalized medicine' has had on a silicon valley investor - Eric Dishman:





Here is another description from Indian University shown below:





Imagine if researchers had the enormous amount of medical files that are reported to be possible by the "All of Us" initiative by the National Institutes of Health?  All of the patient information which displays the variability (differences) between 1 million patients.  Plus, the similarities in disease type and treatment would be known too.  Which would help researchers understand to a greater extent what works and what does not for a given disease (or type of disease).  Everyone wins when we understand the differences between various citizens walking the Earth.



Conclusion...



The photo at the beginning of the blog post shows two horizontal lines indicating two different paths of treatment.  In the first path (the top) is a single pill which is given to four different patients.  There is a large red 'X' indicating that precision medicine does not aim to continue to give 'one treatment' to everyone and expect a 'good outcome.'  Whereas in the second (lower) horizontal treatment path, the same 'pill' is shown to be blocked en route to the patient by a strand of DNA.  Further, the original path is split into four different treatment paths for four different patients.   This indicates that the treatment which was previously thought to treat four different people is insufficient.  Upon accessing greater knowledge regarding variability in the patient population, the one treatment path turns into four different treatment paths for four different people.  As indicated a patient might get the same pill, whereas, another might get half of the same pill.  Yet another (a third) patient might get a totally different treatment.  We do not know without understanding the differences which exist between us.


Are you convinced yet?


What can you do to participate?


Sign up to share your medical history and participate in the well-being of the world by upgrading the medical community's knowledge by shedding light on the exact differences between patient populations (gender, race, ethnicity, etc.).  By understanding the differences among us, we arrive more quickly at more precise and effective treatments for each of us.



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